Free [PFP#1222199219] - Indiana

INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT MUNICIPAL SOLID WASTE LANDFILL CLOSURE PLAN

CLOSURE PLAN FORM SWF-3
SF 50390 (7-01)

To begin: Please read the instruction manual before beginning. This form shall be used to submit closure plans for municipal solid waste landfills (MSWLFs) both individually and with permit applications. Closure plans, either individually or with permit applications, along with support documentation, should be submitted to: Solid Waste Permits Section Office of Land Quality (N1154) Indiana Department of Environmental Management 100 North Senate Avenue, P. O. Box 6015 Indianapolis, Indiana 46206-6015

MUNICIPAL SOLID WASTE LANDFILL CLOSURE PLAN
(329 IAC 10-22)

I. GENERAL INFORMATION A. Facility Name: B. Facility Location: C. Facility County: D. Facility Solid Waste Permit No. (if existing permitted facility) E. Total Fill Acreage

II. CLOSURE ACTIVITIES-GENERAL DESCRIPTION Provide a description of the steps that will be used to partially close, if applicable, and finally close the facility. See instructions for items that should be included

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 2 of 29)

II. CLOSURE ACTIVITIES-GENERAL DESCRIPTION-Continued (Photocopy additional pages as necessary)

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page III.

of

(MSWLF Closure Form Page 3 of 29)

FINAL COVER DESCRIPTION - Provide a detailed description of the final cover (see instructions). Attach additional sheets as necessary.

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 4 of 29)

IV. LABOR, MATERIALS AND TESTING - Provide a listing of items necessary to close the facility (see instructions). For items that will vary depending upon the number of acres to be closed, the quantities should be indicated on a per acre basis. Include items for both the closure activities and final cover noted above. Use additional sheets as needed. A. Item B. Quantity (use applicable unit as appropriate) C. Units (use unit as appropriate)

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page V. EXPECTED YEAR OF CLOSURE AND CLOSURE SCHEDULE A. Expected Year of Closure B. Total Time Required to Close Facility

of

(MSWLF Closure Form Page 5 of 29)

C. Time Required for Completion of Intervening Closure Activities - Provide a description of intervening closure activities and the time required; see instructions.

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page VI. ESTIMATE OF MAXIMUM INVENTORY OF WASTE

of

(MSWLF Closure Form Page 6 of 29)

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page VII.

of

(MSWLF Closure Form Page 7 of 29)

ESTIMATE OF COST PER ACRE FOR FINAL COVER & VEGETATION - Please see instructions; attach additional sheets as necessary.

A. COVER MATERIAL AVAILABILITY, & ACQUISITION, PLACEMENT AND COMPACTION COSTS FOR AREAS CLOSING WITH A COMPOSITE BOTTOM LINER AND A LEACHATE COLLECTION SYSTEM-329 IAC 10-22-6(b) 1. Percent of Final Cover Material Available from Areas That Are Controlled, and Will be Controlled Through Post-Closure, by the Owner, Operator or Permittee. a. Methane Gas Venting Layer Material (12 inches) 1) % of material 2) Describe location of sources (include distance from facility)

b. Soil Barrier Layer Material (lower 12 inches-structural fill) 1) % of material 2) Describe location of sources (include distance from facility)

c. Soil Barrier Layer Material (upper 12 inches-earthen material) 1) % of material 2) Describe location of sources (include distance from facility)

d. Geomembrane layer

not applicable-delivered to site

e. Drainage Layer Material (12 inches) 1) % of material 2) Describe location of sources
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page (include distance from facility)

of

(MSWLF Closure Form Page 8 of 29)

f.

Top Protective Soil Layer Material (18 inches; 30 inches if geosynthetic drainage layer used) 1) % of material 2) Describe location of sources (include distance from facility)

g. Vegetative Layer (topsoil) (6 inches) 1) % of material 2) Describe location of sources (include distance from facility)

2. Cost Per Acre for Acquisition, Placement & Compaction of Final Cover Layers a. Methane Gas Venting Layer Material (12 inches) 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) 1,613 yd3

e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Spreading a) Placement/spreading cost ($/yd3) b) Placement and spreading costs ($/acre) line 1.a * line 2.a 3) Testing and QA/QC a) Tests for grain size and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b 4) TOTAL COST, METHANE GAS VENTING LAYER ($/acre) Line 1.e + line 2.b + line 3.c b. Soil Barrier Layer Material and Structural Fill (24 inches) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Compaction a) Placement/spreading cost ($/yd3) b) Compaction unit cost ($/yd3)

of

(MSWLF Closure Form Page 9 of 29)

3,227 yd3

c) Placement and compaction costs ($/acre) line 1.a * (line 2.a + line 2.b)

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page 3) Testing and QA/QC a) Tests for grain size, Atterberg limits and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Density and moisture content testing (if planned) ($/acre) d) Testing cost ($/acre) Line 3.a + line 3.b + line 3.c 4) TOTAL COST, SOIL BARRIER LAYER AND STRUCTURAL FILL ($/acre) Line 1.e + line 2.c + line 3.d c. Geomembrame Liner 1) Acquisition a) Quantity of material needed per acre (yd2) b) Purchase unit cost ($/yd2) c) Delivery unit cost ($/yd2) (if applicable) d) Acquisition cost ($/acre) Line 1.a * (line 1.b + line 1.c) 2) Placement a) Placement unit cost ($/yd2) (if applicable and not included in purchasing unit cost) b) Placement costs ($/acre) Line 1.a * line 2.a 3) Testing and QA/QC a) Fingerprinting, destructive (shear, and peel tests) & non-destructive seam test) ($/acre) b) Other testing ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b (if applicable)

of

(MSWLF Closure Form Page 10 of 29)

4,840 yd2

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page 4) TOTAL COST, GEOMEMBRANE LINER ($/acre) Line 1.d + line 2.b + line 3.c d. Drainage Layer Material (12 inches) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Spreading a) Placement/spreading cost ($/yd3) b) Placement and spreading costs ($/acre) line 1.a * line 2.a 3) Testing and QA/QC a) Tests for grain size and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b 4) TOTAL COST, DRAINAGE LAYER MATERIAL ($/acre) Line 1.e + line 2.b + line 3.c

of

(MSWLF Closure Form Page 11 of 29)

1,613 yd3

e. Top Protective Soil Layer Material (18 inches; 30 inches if geosynthetic drainage layer used) Per Acre If drainage layer constructed of soil, the top protective soil layer must be at least 18 inches thick (2420 yd3/ac); if drainage layer constructed with geosynthetics, the top protective soil layer must be at least 30 inches thick (4033 yd3/ac).

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Spreading a) Placement/spreading cost ($/yd3) b) Placement and spreading costs ($/acre) line 1.a * line 2.a 3) Testing and QA/QC a) Tests for grain size ($/acre) b) Survey control for cover thickness ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b 4) TOTAL COST, TOP PROTECTIVE SOIL LAYER ($/acre) Line 1.e + line 2.b + line 3.c f. Vegetative Layer (topsoil) Material (6 inches) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) 2,420 yd3-18 in. layer 4,033 yd3-30 in. layer

of

(MSWLF Closure Form Page 12 of 29)

807 yd3

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 13 of 29)

e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement a) Spreading unit cost ($/yd3) b) Placement costs ($/acre) line 1.a * line 2.a 3) TOTAL COST, VEGETATIVE SOIL LAYER ($/acre) Line 1.e + line 2.b g. TOTAL COST PER ACRE FOR ACQUISITION, PLACEMENT & COMPACTION OF FINAL COVER LAYERS Line a.4 + line b.4 + line c.4 + line d.4 + line e.4 + line f..3 B. AVAILABILITY, & ACQUISITION, PLACEMENT AND COMPACTION COSTS FOR AREAS

CLOSING WITH A SOIL BOTTOM LINER AND A LEACHATE COLLECTION SYSTEM WITH SLOPES EQUAL TO OR LESS THAN 15%-329 IAC 10-22-7(b)(1)
1. Percent of Final Cover Material Available from Areas That Are Controlled, and Will be Controlled Through Post-Closure, by the Owner, Operator or Permittee. a. Soil Barrier Layer Material (24 inches; k #1 x 10-7 cm/sec) 1) % of material 2) Describe location of sources (include distance from facility)

b. Vegetative Layer (topsoil) 1) % of material

2) Describe location of sources (include distance from facility)

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 14 of 29)

2. Cost Per Acre for Acquisition, Placement & Compaction of Final Cover Layers a. Soil Barrier Layer Material (24 inches; k #1 x 10-7 cm/sec) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Compaction a) Placement/spreading cost ($/yd3) b) Compaction unit cost ($/yd3) c) Placement and compaction costs ($/acre) line 1.a * (line 2.a + line 2.b) 3) Testing and QA/QC a) Tests for grain size, Atterberg limits and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Density testing ($/acre) d) Testing cost ($/acre) Line 3.a + line 3.b + line 3.c 4) TOTAL COST, SOIL BARRIER LAYER ($/acre) Line 1.e + line 2.c + line 3.d b. Vegetative Layer (topsoil) Material (6 inches) 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3)
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

3,227 yd3

807 yd3

Page (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement a) Spreading unit cost ($/yd3) b) Placement costs ($/acre) line 1.a * line 2.a

of

(MSWLF Closure Form Page 15 of 29)

3) TOTAL COST, VEGETATIVE LAYER (topsoil)($/acre) Line 1.e + line 2.b c. TOTAL COST PER ACRE FOR ACQUISITION, PLACEMENT & COMPACTION OF FINAL COVER LAYERS Line a.4 + line b.3 C. AVAILABILITY, & ACQUISITION, PLACEMENT AND COMPACTION COSTS FOR AREAS

CLOSING WITH A SOIL BOTTOM LINER AND A LEACHATE COLLECTION SYSTEM WITH SLOPES GREATER THAN 15%-329 IAC 10-22-7(b)(2)
1. Percent of Final Cover Material Available from Areas That Are Controlled, and Will be Controlled Through Post-Closure, by the Owner, Operator or Permittee. a. Soil Barrier Layer Material (24 inches-thickness may be more per approved plan; k #1 x 10-6 cm/sec) 1) % of material 2) Describe location of sources (include distance from facility)

b. Vegetative Layer (topsoil) 1) % of material 2) Describe location of sources (include distance from facility)
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 16 of 29)

2. Cost Per Acre for Acquisition, Placement & Compaction of Final Cover Layers a. Soil Barrier Layer Material (24 inches; k #1 x 10-6 cm/sec) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Compaction a) Placement/spreading cost ($/yd3) b) Compaction unit cost ($/yd3) c) Placement and compaction costs ($/acre) line 1.a * (line 2.a + line 2.b) 3) Testing and QA/QC a) Tests for grain size, Atterberg limits and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Density testing ($/acre) 3,227 yd3

d) Testing cost ($/acre) Line 3.a + line 3.b + line 3.c 4) TOTAL COST, SOIL BARRIER LAYER ($/acre) Line 1.e + line 2.c + line 3.d b. Vegetative Layer (topsoil) Material (6 inches) Per Acre

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement a) Spreading unit cost ($/yd3) b) Placement costs ($/acre) line 1.a * line 2.a 3) TOTAL COST, VEGETATIVE LAYER (topsoil)($/acre) Line 1.e + line 2.b c. TOTAL COST PER ACRE FOR ACQUISITION, PLACEMENT & COMPACTION OF FINAL COVER LAYERS Line a.4 + line b.3 807 yd3

of

(MSWLF Closure Form Page 17 of 29)

D. COVER MATERIAL AVAILABILITY, & ACQUISITION, PLACEMENT AND COMPACTION COSTS FOR AREAS CLOSING WITHOUT A COMPOSITE OR SOIL BOTTOM LINER OR A LEACHATE COLLECTION SYSTEM, CLOSING AFTER JANUARY 1, 1998, WITH SLOPES EQUAL TO OR LESS THAN 15%-329 IAC 10-22-7(c)(1) 1. Percent of Final Cover Material Available from Areas That Are Controlled, and Will be Controlled Through Post-Closure, by the Owner, Operator or Permittee. a. Methane Gas Venting Layer Material (12 inches) 1) % of material 2) Describe location of sources (include distance from facility)

b. Soil Barrier Layer Material (lower 12 inches-structural fill)
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page 1) % of material 2) Describe location of sources (include distance from facility)

of

(MSWLF Closure Form Page 18 of 29)

c. Soil Barrier Layer Material (upper 12 inches-earthen material) 1) % of material 2) Describe location of sources (include distance from facility)

d. Geomembrane layer

not applicable-delivered to site

e. Drainage Layer Material (12 inches) 1) % of material 2) Describe location of sources (include distance from facility)

f.

Top Protective Soil Layer Material (18 inches; 30 inches if geosynthetic drainage layer used) 1) % of material

2) Describe location of sources (include distance from facility)

g. Vegetative Layer (topsoil) (6 inches) 1) % of material
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page 2) Describe location of sources (include distance from facility)

of

(MSWLF Closure Form Page 19 of 29)

2. Cost Per Acre for Acquisition, Placement & Compaction of Final Cover Layers a. Methane Gas Venting Layer Material (12 inches) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Spreading a) Placement/spreading cost ($/yd3) b) Placement and compaction costs ($/acre) line 1.a * line 2.a 1,613 yd3

3) Testing and QA/QC a) Tests for grain size and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b 4) TOTAL COST, METHANE GAS VENTING LAYER ($/acre) Line 1.e + line 2.b + line 3.c
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 20 of 29)

b. Soil Barrier Layer Material and Structural Fill (24 inches) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Compaction a) Placement/spreading cost ($/yd3) b) Compaction unit cost ($/yd3) c) Placement and compaction costs ($/acre) line 1.a * (line 2.a + line 2.b) 3) Testing and QA/QC a) Tests for grain size, Atterberg limits and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Density and moisture content testing ($/acre) d) Testing cost ($/acre) Line 3.a + line 3.b + line 3.c 4) TOTAL COST, SOIL BARRIER LAYER AND STRUCTURAL FILL ($/acre) Line 1.e + line 2.c + line 3.d c. Geomembrame Liner Per Acre 1) Acquisition a) Quantity of material needed per acre (yd2)

3,227 yd3

4,840 yd2

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page b) Purchase unit cost ($/yd2) c) Delivery unit cost ($/yd2) (if applicable) d) Acquisition cost ($/acre) Line 1.a * (line 1.b + line 1.c) 2) Placement a) Placement unit cost ($/yd2) (if applicable and not included in purchasing unit cost) b) Placement costs ($/acre) Line 1.a * line 2.a 3) Testing and QA/QC a) Fingerprinting, destructive (shear, and peel tests) & non-destructive seam tests) ($/acre) b) Other testing ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b (if applicable) 4) TOTAL COST, GEOMEMBRANE LINER ($/acre) Line 1.d + line 2.b + line 3.c d. Drainage Layer Material (12 inches) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3)

of

(MSWLF Closure Form Page 21 of 29)

1,613 yd3

b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Spreading

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page a) Placement/spreading cost ($/yd3) b) Placement and spreading costs ($/acre) line 1.a * line 2.a 3) Testing and QA/QC a) Tests for grain size limits and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b 4) TOTAL COST, DRAINAGE LAYER MATERIAL ($/acre) Line 1.e + line 2.b + line 3.c

of

(MSWLF Closure Form Page 22 of 29)

e. Top Protective Soil Layer Material (18 inches; 30 inches if geosynthetic drainage layer used) If drainage layer constructed of soil, the top protective soil layer must be at least 18 inches thick (2420 yd3/ac); if drainage layer constructed with geosynthetics, the top protective soil layer must be at least 30 inches thick (4033 yd3/ac). 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Spreading a) Placement/spreading cost ($/yd3) b) Placement and spreading costs ($/acre) line 1.a * line 2.a 3) Testing and QA/QC a) Tests for grain size ($/acre) b) Survey control for cover thickness
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

2,420 yd3-18 in. layer 4,033 yd3-30 in. layer

Page ($/acre) c) Testing cost ($/acre) Line 3.a + line 3.b 4) TOTAL COST, TOP PROTECTIVE SOIL LAYER ($/acre) Line 1.e + line 2.b + line 3.c f. Vegetative Layer (topsoil) Material (6 inches) 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement a) Spreading unit cost ($/yd3) b) Placement costs ($/acre) line 1.a * line 2.a

of

(MSWLF Closure Form Page 23 of 29)

807 yd3

3) TOTAL COST, VEGETATIVE LAYER ($/acre) Line 1.e + line 2.b g. TOTAL COST PER ACRE FOR ACQUISITION, PLACEMENT & COMPACTION OF FINAL COVER LAYERS Line a.4 + line b.4 + line c.4 + line d.4 + line e.4 + line f..3 E. AVAILABILITY, & ACQUISITION, PLACEMENT AND COMPACTION COSTS FOR AREAS CLOSING WITHOUT A COMPOSITE OR SOIL BOTTOM LINER OR A LEACHATE COLLECTION SYSTEM, CLOSING AFTER JANUARY 1, 1998, WITH SLOPES GREATER THAN 15%-329 IAC 10-22-7(c)(2) 1. Percent of Final Cover Material Available from Areas That Are Controlled, and Will be Controlled Through Post-Closure, by the Owner, Operator or Permittee. a. Soil Barrier Layer Material (24 inches-thickness may be more per approved plan; k #1 x 10-6 cm/sec)
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page 1) % of material 2) Describe location of sources (include distance from facility)

of

(MSWLF Closure Form Page 24 of 29)

b. Vegetative Layer (topsoil) 1) % of material 2) Describe location of sources (include distance from facility)

2. Cost Per Acre for Acquisition, Placement & Compaction of Final Cover Layers a. Soil Barrier Layer Material (24 inches; k #1 x 10-6 cm/sec) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement and Compaction a) Placement/spreading cost ($/yd3) b) Compaction unit cost ($/yd3) c) Placement and compaction costs ($/acre) line 1.a * (line 2.a + line 2.b) 3) Testing and QA/QC 3,227 yd3

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page a) Tests for grain size, Atterberg limits and hydraulic conductivity ($/acre) b) Survey control for cover thickness ($/acre) c) Density testing( $/acre) d) Testing cost ($/acre) Line 3.a + line 3.b + line 3.c 4) TOTAL COST, SOIL BARRIER LAYER ($/acre) Line 1.e + line 2.c + line 3.d b. Vegetative Layer (topsoil) Material (6 inches) Per Acre 1) Acquisition a) Quantity of material needed per acre (yd3) b) Excavation unit cost ($/yd3) (if obtained on-site) c) Purchase unit cost ($/yd3) (if obtained off-site) d) Delivery unit cost ($/yd3) (if obtained off-site) e) Acquisition cost ($/acre) Line 1.a * line 1.b (on-site) or Line 1.a * (line 1.c + line 1.d) (off-site) 2) Placement a) Spreading unit cost ($/yd3) b) Placement costs ($/acre) line 1.a * line 2.a 3) TOTAL COST, VEGETATIVE LAYER (topsoil)($/acre) Line 1.e + line 2.b c. TOTAL COST PER ACRE FOR ACQUISITION, PLACEMENT & COMPACTION OF FINAL COVER LAYERS Line a.4 + line b.3 F. COST PER ACRE TO ESTABLISH VEGETATION (ALL AREAS) 1. Vegetation a. Seeding unit cost ($/acre) b. Fertilization unit cost ($/acre) 807 yd3

of

(MSWLF Closure Form Page 25 of 29)

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 26 of 29)

c. Mulching unit cost ($/acre) d. TOTAL VEGETATION ESTABLISHMENT COSTS ($/acre) Line 1.a + line 1.b + line 1.c G. COST PER ACRE TO CERTIFY CLOSURE (ALL AREAS) 1. Registered Professional Engineer (PE) a. Initial review of closure plan (hrs) b. Total number of inspections c. Inspection time required (hrs/visit) d. Total inspection time (hrs) Line 1.b * line 1.c e. Prepare final documentation of construction of cover (hrs) f. Total engineer time (hrs) Line 1.a + line 1.d + line 1.e

g. Professional engineer unit labor cost ($/hr) h. Professional engineer cost ($) Line 1.f * line 1.g i. Area of site permitted for filling (acres) TOTAL CLOSURE CERTIFICATION COSTS ($/acre) Line 1.h ÷ line 1.i

H. OTHER COSTS PER ACRE FOR FINAL COVER AND CERTIFICATION (ALL AREAS) 1. Other Costs ($/acre) (describe on lines below)

TOTAL, OTHER COSTS PER ACRE ($/acre)

I. SUBTOTAL, PER ACRE FINAL COVER AND CERTIFICATION COSTS For closure over areas with composite bottom liner system, enter amount no less than $75,000 For closure over areas without composite bottom liner system, enter amount no less than $20,000
Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 27 of 29)

Total, Section A.2 + Total, Section B.2, + Total, Section C.2 + Total, Section D.2 + Total, Section E.2 + Total, Section F + Total, Section G + Total, Section H VIII. OTHER CLOSURE COSTS - Please give on a total facility basis rather than a per acre basis A. Notation on Property Deed B. Other Costs - include here costs for such items as drainage features, gas vents, etc. 1. Activity Cost

C. TOTAL, OTHER CLOSURE COSTS Line A + line B IX. TOTAL CLOSURE COST [Item I.E (total fill acreage) * item VII.I (per acre final cover and certification costs)] + item VIII.C (other closure costs) X. CONTINGENCY COST Line IX * (0.10) XI. TOTAL CLOSURE COST ESTIMATE (including contingency cost) Line IX + line X

XII. FINAL CLOSURE COST PER ACRE Line XI ÷ line I.E (total fill acreage) XIII. CONSTRUCTION QUALITY ASSURANCE/QUALITY CONTROL PLAN Attach at the end of this closure plan form a construction quality assurance/quality control plan detailing the quality assurance/quality control steps that will be taken during construction and installation of the final cover system. XIV. Optional - INFORMATION REQUIRED FOR FACILITIES INCREMENTALLY FUNDING FINANCIAL ASSURANCE - enter "na" on the first line of the table if you are not incrementally funding using one of these options

A. Maximum Areas of Waste Deposition and Closure Costs - provide in the table below the listed information for each remaining year of the facility's life
Maximum Area of Waste Deposition (cumulative acres at end of each year Closure Cost w/o Partial Closure ($) Area Partially Closed (cumulative acres at start of each year) Incremental Closure Cost Estimate ($)

Year

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page

of

(MSWLF Closure Form Page 28 of 29)

Attach additional sheets if your facility's expected remaining lifetime is more than 20 years B. Map of Areas of Waste Deposition - Attach copy of facility's final contour map marked to show the maximum areas of waste deposition for each succeeding year of the remaining life of the facility. XV. LARGEST CLOSED AREA ESTIMATE - Provide an estimate of the largest area of the MSWLF unit ever requiring a final cover at any time during the unit's proposed active life.

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99

Page XVI.

of

(MSWLF Closure Form Page 29 of 29)

Optional - ESTIMATE OF YEARLY MAINTENANCE COSTS FOR A DIKE OR DIKES REQUIRED FOR CONSTRUCTION IN FLOOD PLAIN - provide in the table below estimates for the yearly maintenance costs for any dikes you will build if you are constructing your facility in a flood plain. Enter "na" on the first line if not applicable Year Costs ($) Year Costs ($)

Attach additional sheets if your facility's expected remaining lifetime is more than 20 years

XVII. SIGNATORY CERTIFICATION "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the persons who managed the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. I further certify that I am authorized to submit this information."

Signature:

Date:

Name: Address:

Telephone No.:

Professional Engineer Registration No.

Although this closure plan form is being provided to aid you in preparing your closure plan in accordance with the new rules, this form is subject to review and revision. Please consult the actual rule language. 8/99