Forms

LPC-PA1 General Application for Permit

LPC-PA1 General Application for Permit Form

Because of the many different types of permit requirements, and the numerous types of facilities being permitted, it is necessary to utilize several different permit forms. Most applications will only require one or two forms be used, however, in some instances, more may be necessary. In all cases, (except for the composting of landscape waste only) it will be necessary to complete the General Application for Permit (LPC-PA1). It is important that this form be filled out with other applications since it readily identifies the type of application, facility and waste. This will insure proper administrative processing. This form also identifies many completeness requirements. This will enable the Illinois EPA to quickly identify whether the application can be processed, or whether the applicant has to submit additional information. Finally, since applicant signature requirements have been included, this will be the only form that is necessary for many supplemental applications. None of the forms below are intended to be used for RCRA, Subtitle C permitting.

Failure to properly complete the forms will result in a rejection for incompleteness and will not preserve your filing rights for decision deadlines. DO NOT INCLUDE APPLICATIONS FOR PRIOR CONDUCT CERTIFICATION, HAULER PERMITS OR FINANCIAL ASSURANCE DOCUMENTS WITH PERMIT REQUESTS FOR WASTE MANAGEMENT FACILITIES.

GENERAL INFORMATION

Read the enclosed instructions carefully to acquire an understanding of permit application requirements. The application form is to be supplemented by plans and reports which are required to describe the development and/or operation of the facility. The information submitted by the applicant must provide the Illinois Environmental Protection Agency with assurance that no violation of the Environmental Protection Act or Regulations adopted thereunder will result as a consequence of the development or operation of the site.

All data and information should be typed or legibly printed in ink.

The letters "NA" may be used if requested information is not applicable. However, for any information requested but not provided, justification demonstrating the reasons for not doing so must be stated.

Submit the original, with original signatures, and two (2) photocopies (or three (3) if applicable*) of all application forms and supporting documentation, including plan sheets and maps, requested in the application to:

Illinois Environmental Protection Agency
Bureau of Land
Permit Section #33
1021 North Grand Avenue East
Post Office Box 19276
Springfield, Illinois 62974-9276

FAILURE TO DO THIS WILL RESULT IN REJECTION OF THE APPLICATION. A complete application submittal will contain an original plus two (2) photocopies (or three (3) if applicable*) for a total of three (or four) sets of the application.

* If the application for permit contains information or proposals which you are requesting approval regarding the hydrogeologic setting, groundwater monitoring, modeling or classification, and/or a groundwater impact assessment, you must submit a third (3rd) copy of the application forms and supporting documentation.

If you have questions regarding the use or completion of this form, please contact the Permit Section at 217/524-3300. Questions regarding a previously submitted application can be directed to the State Permit log clerk. The log clerk can forward your call to the assigned permit reviewer.

Note: Permit applications which are to be hand-delivered to the Bureau of Land, Permit Section must be delivered to the 1021 North Grand Avenue East location between the hours of 8:30 a.m. to 5:00 p.m., Monday through Friday (excluding State Holidays).

INSTRUCTIONS

I. Site Identification

For new facilities located within the boundaries of other existing permitted and/or closed solid waste management facilities, for expansions of existing facilities or for existing facilities renewing the permit, fill in both the facility name and the Illinois EPA site number. For new independent facilities, simply give the name of the facility. The Illinois EPA will assign a site number.

For all facilities, fill in the Physical Site Location (street or road, etc. DO NOT USE POST OFFICE BOX NUMBERS), City, Zip Code (9 digit if available) and County. Illinois EPA must have a 9-digit zip code for the facility to provide a notification letter list.

For existing permitted and/or closed solid waste management facilities, fill in existing permit numbers.

II. Owner/Operator Identification

Fill in:

1. Owner and Operator name, address, city, state, contact person and phone number. Because the Illinois EPA must send all final actions by certified mail, a street address must be provided by the owner and operator.

III. Permit Application Identification

TYPE OF SUBMISSION/REVIEW PERIOD

Your facility will be subject to 35 IAC 807 or 813 depending on the type of facility and type of waste (municipal solid waste, etc., disposal, treatment, etc.). The type of permit requested must be checked correctly. The following describe each.

- New Landfill/180 days (35 IAC Part 813). A landfill not permitted before September 18, 1990.

- Landfill Expansion/180 days (35 IAC Part 813) - Proposing an expansion of an existing landfill.

- Sign. Mod to Operate/90 days (35 IAC Part 813). A request to operate at an 813 new landfill or one which has been permitted pursuant to 35 IAC 814.

- Other Sign. Mod/90 days (35 IAC Part 813). A landfill which has a permit issued pursuant to 35 IAC 813 and which is modifying an aspect of its operation or development.

- Renewal of Landfill/90 days (35 IAC Part 813). Renewal of a permit issued pursuant to 35 IAC 813.

- Developmental/90 days (35 IAC Part 807). A permit for development of a new waste management facility or expansion of an existing facility. These facilities are not landfills. They will include transfer stations, incinerators, storage areas, treatment facility, etc.

- Operation/45 days (35 IAC Part 807). A permit to request approval to begin operation of a waste management facility which has an 807 development permit.

- Supplemental/90 days (35 IAC Part 807). A modification of an existing 807 development permit. This includes changes to an operating permit as well.

- Permit Transfer/90 days (35 IAC Part 807). A request to change the owner or operator of an 807 permit. Note, transferring an 813 permit is an "Other Significant Modification).

- Renewal of Experimental Permit (35 IAC Part 807). Renewal of an experimental permit issued pursuant to 35 IAC 807.

The type of submission must be checked accurately. To ease the log in procedures and to avoid a potential clerical error, this procedure has been established. Please call if you have any questions. INDICATING THE WRONG TYPE SUBMISSION MAY RESULT IN AN INCOMPLETENESS DETERMINATION.

Type Facility

Check the type of facility which is the subject of the application. If more than one activity occurs at the facility, also check each type that has a development or landfill permit issued to it.

Type Waste

Indicate all types of waste which are managed at the facility.

Description of this Permit Request

This should provide sufficient information to generally describe all aspects of the request being made in this specific request, not merely what occurs at the facility.

IV. Completeness Requirements

The following items must be submitted unless they are not required, or have previously been approved. Any items marked "N/A" must be fully explained. For example, a treatment facility may indicate "N/A" for prior conduct certification and explain that certification is not required for treatment facilities. FAILURE TO COMPLETE EACH ITEM WILL RESULT IN REJECTION OF THE APPLICATION.

1. Refer to LPC-PA16 instructions.

2. Applies to new and expanding pollution control facilities.

3. Either a. or b. should be yes.

4. For waste disposal sites only, as defined in 35 Ill. Adm. Code Part 745.102(c). Any other type of application should specify not applicable. If this item is NA, then move on to Item 6.

5. This requirement only applies to disposal facilities located on property held in a land trust. (Refer to Section 22.19(b) of the Act.) Disposal facilities should check Yes or No. Other facilities should check N/A. If Yes is checked, LPC-PA9 must be completed and submitted. Please refer to the LPC-PA9 form and instructions.

6. This applies to any application which includes groundwater monitoring or hydrogeologic information necessary for reviewing the permit request indicated and described in Section III. In addition to the examples listed in LPC-PA1, a third copy of the application and supporting documents must be submitted for any groundwater reports or notifications submitted as a permit application.

V. Signatures

ORIGINAL SIGNATURES REQUIRED. BOTH OWNER AND OPERATOR SIGNATURES ARE TO BE NOTARIZED. SIGNATURE STAMPS OR APPLICATIONS TRANSMITTED ELECTRONICALLY OR BY FACSIMILE ARE NOT ACCEPTABLE.

The landowner, facility operator, notary and engineer signatures must be provided. Identify any preparer or person to contact, should any additional information or clarification be necessary. Provide a printed name for each signature.

In accordance with the Environmental Protection Act, all information submitted as part of the application is available to the public except when specifically designated by the applicant to be treated confidentially as regarding a trade secret process in accordance with Section 7(a) of the Environmental Protection Act.