## l. 

# • DANGEROUS WASTE COMPLIANCE CHECKLIST/QUESTIONNAIRE CHAPTER 173-303 WAC



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## * * * 

## * * * * * 

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# •

• Part 6: Closure This part of the checklist/questionnaire is applicable to all dangerous waste management facilities operating under interim status. Dangerous waste facilities may include containers. tanks. surface impoundments. waste piles. thermal treatment. chemical. physical and biological treatment. land treatment. incinerators. and landfills. The abbreviation "0/0" is used frequently throughout this checklist/questionnaire and stands for the words "owner and/or operator." The questions in the checklist have been written in a manner such that they can be answered either "Yes" or "No. " However. the answers to some questions may require additional explanation. The space provided for comments at the end of each section may be used for explanations. If a question does not apply to a particular facility. simply write "NA" (not applicable) next to the question.

r-CLOSURE PLAN CHECKLIST
6.1. GENERAL FACILITYINFORMATION 

# o

Facility Name: Inspectors Name: EPA/State I.D.: #



## ------- Date:
Checkthe type(s) ofunit operations that the 

### % manages athis facility (refer to 6.3 for Unit Specific Requirements):
Page No.

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o

o

o

o

o

o

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o Containers • • Tanks. . • • Surface Impoundments Piles•••••• LandTreatment • Landfills. '•• Inci.nerators • Thermal Treatment. Chemical, physical andbiological treatment. • • •• ••••••



### - 2 - 13 14 15 16 

### 17 18 19 

### 20
21 " «-



# ()

# • 6.2. GENERAL CLOSURE REQUIREMENTS 1• WRITTEN PLAN A. Is there a WRITTEN CLOSURE PLAN kept at the facility? (40 CFR 261.112(a)) 

### B. Does the closure plan cover all areas and facilities that were AC.TIVE as of 11/19/80? C. Does the closure plan include general information about the facility which would'be helpful in reviewing the plan, including (Note: regulations do not presently require the inclusion of the following information. However, inclusion of this information will aid in the review of the plan.): YES NO



# •

• a. b. c. 

### d. e. f. g. 

### h. i. j. k. 1. m. n. o. p. q. Comments: facility size(s) facility type(s) 'descriptions of all on-site equipment topography waste characterization soil type description of, surrounding land use surrounding population size of facility (acres) volume of impoundment type(s) of treatment/processing description of liner leachate collection system gas collection system dredging procedures/schedules, etc. incinerator specifications other (specify )

- 3 -2. MAXIMUM EXTENT OFOPERATION (40 CFR265.112(a)(1)) YES NO 

# c
A. Does the plan identify the MAXIMUM EXTENT OF OPERATIONwhich will be unclosed during the life of the facility? B. Is the MAXIMUM EXTENT OFOPERATION estimate exceeded by current operations? C. Does the MAXIMUM EXTENT OFOPERATION estimate include:

a. b.
c. d.

e. the maximum area of landfill or land treatment ever"containing wastes? inactive areas open because of operating problems or contingencies? maximum area of land ever used for land spreading? " the most extensive treatment requjred for land spreading? the maximum area used for storage? Explain each "NO" answer. Comments: 

# ()

3. PARTIAL CLOSURE (40 CFR265.112(a» A. Does the plan identify the steps for PARTIAL CLOSURE, at any time during the intended operating life, of

) surface impoundments? landfills? tanks? other (specify:

_ a. 

### h. c. d. IFNO PARTIAL CLOSURE PLAN,WRITEN/AAND SKIP TO SECTION 5. B. Does the PARTIAL CLOSURE Plan identify
a. 

### h. c. "d. e. the size of areas partially closed procedures for partial closure? maintenance program? frequency ofpartial closures? source of covermaterials? 

# o

- 4 -

# • C. Does the plan for PARTIAL CLOSURE demonstrate the adequacy of the cap, etc. to meet the closure requirements? OR Are these areas or activities otherwise included in the extent of operations of the closure plan? (Note: IfPARTIAL CLOSURE operations would not satisfy closure requirements, the planmust indicate how and when those requirements will be met.)

Does the PARTIAL CLOSURP PLAN describe maintenance activities for partially· closed areas, including: YES NO



## --"



# • a. b. c. 

### d. e. f. g. h. i. visual inspections? groundwatermonitoring? maintaining cover? maintaining diversion structures? controlling erosion? maintaining vegetation? security reauirements? leachate collection? gas collection? D. Does the CLOSURE PLAN describe maintenance frequencies for partially closed areas, including:
a. visual inspections? b. groundwatermonitoring? c. maintaining the cover? d. ID2intaining diversion structures? e. controlling erosion f. maintaining vegetation? g. security requirements? h. leachate collection? i. gas collection? c-



# • F. Is there a SCHEDULE FOR PARTIAL CLOSURE? If "NO" SKIP TO SECTION 5. Note: the regulations do not require that plans contain schedules for partial closure, only for final closure•

- 5 -G. If a schedule is included, does the SCHEDULE FORPARTIAL CLOSURE include:
a. date(s) ofpartial closure(s)? b. total time required for each partial closure? c•.time required for key steps-- 

### YES NO

----). i. ii. iii.

iv.

v. vi. vii. viii. waste removal? waste stabilization? waste treatment? waste disposal? placement of cover? vegetation? decontamination? other (specify: Comments:

MAXIMUM INVENTORY (40 CFR 265.112(a)(2» 

### 4. A. Is there an estimate of the MAXIMUM INVENTORY ofwastes in storage or treatment at any time during the life of the facility? (No.tet write NA for those cases where there is no storage or treatment prior to disposal.) 

# o

B. Does the MAXIMUM INVENTORY estimate include the maximumamount ofon-site wastes?
a. requiring pre-treatment? b. requiring treatment? c. requiring disposal? C. Does the MAXIMUM INVENTORY estimate include the maximumamount of on-site:
a. b.
c. d. e. f. g. wastes in surface impoundments? wastes in partially-closednondisposal surface impoundments? wastes in tanks? wastes in piles? wastes in drainage pits? wastes in containers? standing liquids?

- 6 - 

# o

# • C. Does the MAXIMUM INVENTORY estimate include the maximumamount of on-site: (continued) h. sludge? i. contaminated soil from land treatment fields? j. contaminated soil from around tanks, containers, piles? k. contaminated soil from around tanks, containers, piles? 1. process residues? m. decontamination residues? YES NO

D. Does the plan discuss the type(s) of TESTINGAND CRITERIAto be used to determine: Note: the rpgulations do not require closure plans to include information on waste testing and criteria. Write "NAil for situations where soil contamination, decontamination residues, or process residues are not relevant. 

# • a. b.

c. whether soil is contaminated? whether decontamination residues are hazardous? whether process residues are hazardous? 

### E. Are INCOMPATIBLEWASTES identified and provisions described for keeping them separate during closure (Note: write "NA"only if there are no incompatible wastes beingmanaged at the facility.) Comments:

5. FINAL CLOSURE A. Does the plan clearly identify the STEPS TO CLOSE 

# • a. b • at any point during the intended operating life? (40 CFR 265.112(a» at the end of the intended operating life? (40 CFR 265.112(a»

- 7 -B.Do the STEPS TOCLOSE in the plan include:
a. removal ofwastes? (40 CFR265.113(a» b. treatment ofwastes? (40 CFR265.113(a» c. waste disposal? (40 CFR265.113(a» d. waste containment? e. cover? (40 CFR265.310(b» f. decontamination of equipment and structures? (40 CFR265.112(a)(3» g. groundwater monitoring? h. closure certification? (40 CFR265.115) i. maintenance of leachate program? j. maintenance of gas collection program? k. security requirements? C. With respect to the REMOVAL, TREATMENT, OR DISPOSAL ofwaste, does the plan identify:
a. the source and type ofmaterials and equipment needed? b. the amount of labor required? c. the capacity, number, and location of trenches or cells needed? d. the ar.ea required for landspreading?
D. Does the plan describe the DECONTAMINATION (40 CFR265.112(a)(3); 265.114) of facility equipment and structures, including: YES NO 

# c

o

a.
b. c. a list of equipment, containers, and structures requiring disposal or decontamination? decontamination procedures? method of treatment or disposal of residues? testing program? E. With respect to MONITORING, does**_~e** closure plan describe:
a. details of the groundwater monitoring program during closure? b. soil testing and monitoring? c. maintenance ofmonitoring equipment during closure? d. other (specify:



### - 8 - 

# ()

# • F • With respect to CERTIFICATION of closure (40 CFR 265.115), does the closure plan describe scheduled or estimated number of inspections? YES NO

G. If a system for COLLECTING.LEACHATE is present, does the closure plan:
a. describe leachate removal, treatment, and disposal during closure? b. identify the approximate volume of leachate collected? c. provide for maintenance of the leachate collection systemduring closure? H. Ifa GAS COLLECTION SYSTEM is required during operation, does the closure plan?

If SECURITY (ex: fencing) is required, does the closure plan:
a. describe the maintenance of security equipment during the closure period? b.describe the installation ofappropriate equipment at closure? c. state the dimensions of the fence and the area to be enclosed? ) 

# • 1. a. b.

c. describe procedures for collecting gas during closure? describe monitoring samples and analysis during closure? describe maintenance of gas collection system during closure?

Comments:

6. FINAL CLOSURE: SCHEDULE A. Does the plan identify the YEARwhen final closure is expected to occur? (40 CFR 265.112(a)(4)) 

# • o What is the expected year of closure?



### - 9 -

### B. Is there a SCHEDULE for final closure activities? (40 CFR 265.112(a)(4» IF "NO" SKIPTO COMMENTS SECTION. YES NO 

# c

C. Does the SCHEDULE for final closure include (Note: regulations require the closure schedules to include, at a minimum, both the total time required to**clo~e** the facility as well as the time required for intervening activities.):
a. date closure is expected to begin? (40 CFR 265.112(a)(I» b. total time required to close? c. the time for intervening closure activities? (40 CFR 265.112(a)(4» d. time required for key steps: i. waste inventory treatment? (40 CFR 265.112(a)(4» ii. waste inventory disposal? (40 CFR 265.112(a)(4» iii. removal ofwaste inventory and residues? iv. decontamination of facility equipment and structures? v. installation ofcontainment and diversion structures? vi. placement of final cover? (40CFR265.112(a}(4» vii. plantingvegetation? viii.closure certification? ix. other (specify:
D. Does the SCHEDULE for final closure: 

# c

1'..,

a.

b.

Comments: encompass.more than 90 days for treatment. removal. or disposal ofhazardouR wastes after receipt of final volULr ofwastes? (40 CFR 265.113(a» encompass more than 180 days for completionof closure plan activities afterreceipt of final volume ofwastes? (40 CFR 265.113(b»

- 10 - 

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# • 7. GENERAL CLOSURE COST ESTIMATE A. Is there awritten closure cost estimate? YES NO



### B. What is the amount of the closure cost estimate?
. $--- C. Is there documentation supporting the cost estimate?
a. work-ups? b. contractorbids? c. operating history? d. other D. Has the cost estimate been adjustedby the 9% inflation factor? 

### (40 CFR 

### 265.142(b»


# •

• E.

F. Does the cost estimate cover all the activities in the closure plan including costs of labor? Does the closure cost estimate cover all required closure activities? 

### (40 CFR

### 265.142(a» If "NO"specify in comments below: Comments:

- 11 -

### 6.3 UNIT SPECIFICREQUIREMENTS This section addresses requirements which are specific to individual TSD units. In an effort to simplify the checklist. the requirements in this sectionhave been organized into unit specific modules. This enables the inspector to select only those requirements which are specific to the**~articular** facility under investigation. Please note that with respect to surface impoundments, waste piles and land treatment units. if if % either cannot or elects not to remove all waste residues, contaminated soils. structures, and equipment. he must close the facility and performpost-closure care in accordance with the closure and post-closure requirements that apply to landfills. 

# c



# c

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# •

•

• 1. 

### CONTAINERS A. Does the closure plan describe the following:
a. the procedure for removing hazardous waste containers from the facility; b. inspection ofwaste containers for leaks; c. the procedure for transferring dangerous wastes from leaking containers to non-leaking containers; B. Rave provisions beenmade for the decontamination ofequipment and structures? C. Does the plan describe the testing programneeded tojudge the success of the decontamination efforts? D. Does the testing program include:
a. samplingmethods b. testing parameters c. analytical procedures Comments:

- 13 - 

### YES NO

(-2. TANKS (40 CFR 265.197) 

### YES NO 

# c

A.



### B.

C.

D. Does the closure plan describe procedures for removing hazardous wastes from the tank? Does the plan describe procedures for decontaminating the tank, discharge control equipment, and discharge confinement structures? Have criteriabeen established to determine the effectiveness of the decontamination process? Have test procedures been included to determine the effectivenss of the decontaminationprocedures? E. Does the testing procedure include:

Comments: a. b. c. samplingmethods testing parameters analytical procedures



# o

# '. 

# • 3. SURFACE IMPOUNDMENTS (40 CFR 265.228) A. Uponclosure, does the 

### % plan to remove the impoundment:'
a. standing liquids b. waste andwaste residue c.underlying and surrounding contaminated soil B. Does the closure planprovide a detailed plan for the removal of:
a. all hazardous wastes b. the containment system (ifapplicable) ,**c~** contaminated scil C. Does the closure plan describe a testing program to determine if the site is clean? 

### YES NO



# •

• D. Does the closure plan provide an estimate of each quantity ofmaterial to be removed from the site? Comments:

- 15 - ,**~:.."**.

.,

;,

### 4. WASTEPILES (40·CFR 265.258(a» A. Does the closure plan provide R detailed plan for the removal of:
a. all hazardous wastes b. the contaminated system (ifapplicable) c. contaminated soil B. Does the closure plan describe the procedures to be used to decontaminate equipment and structures? 

### YES NO 

# c

C.

D.

Comments: Have criteria been establiRhed to judge the effectiveness of the decontamination procedures? Does the closure plan describe a testing program to determine ifthe site is clean? 

# c

o

# •

• 5. LAND TREATMENT (40 CFR 265.280) A. Does the closure plan address the following objectives and explain howtheywill be achieved?
a. control ofmigration of hazardous wastes and constituents into groundwater. b. control of the release of contaminated run-off into surface water. c. control of the release of airborne particulate contaminants causedby wind erosion. d. protection of rood chain crops. B. Does the closureplan include at least a nnrrative statement indicating that the following factors were considered in addressing the closure objectives?
a. type and amount ofwaste. b. mobility and rate ofmigration c. site location,**topography~** and surrounding landuse. d. climate, including precipitation. e. characteristics of the cover, includingmaterial, final surface contour, thickness, porosity, permeability, slope, vegetation•. f. geological and soil profiles and surface and subsurface hydrology. g. unsaturated zone monitoring. h. type, concentration, and depth ofhazardous constituentmigration as compared to background concentrations. YES NO



# • Comments:

- 17 -6. LANDDISPOSAL (40 CFR 265.310) A. Does the closure plan address'the following objectives and explain. how they will be achieved?
a. control ofpollution migration from the facility via groundwater, surface water, and air. b. control of surface water infiltration, including prevention ofpooling. c. prevention oferosion. 

### YES NO 

# c

B.

Comments: Does the closure plan include at least a narrative statement indicating that the following factors were considered in addressing the closure objectives?
a. type and amount ofwaste b. mobility and rate ofmigration c. site'location, topography, and surrounding land d. climate, including amount. frequency and pHofprecipitation e. characteristics of the cover. includingmaterial type. final surface contour, thickness, porosity, permeability, slope. and type ofvegetation' f. geologic characteristics, soil profiles, and surface and subsurface hydrology g. unsaturated zonemonitoring h. type. concentration. and depth ofhazardous constituentmigration as compared to background concentrations 

# c

()

# • 7. 

### INCINERATORS (40 CFR265.351) A. Does the closure plan address the removal of:
a. all wastes b. ash c. scrubberwaters d. scrubber sludges B. Areprocedures for decontaminating the incinerator, ash collection equipment, and emissioncontrol equipment. described orreferenced in the closure plan? C. Does the closure**p~an** address the disposal ofall contaminated equipment, residues. solvents. and contaminated cleaning agents? 

### YES NO

D. Has the plan included criteria to be used to judge the success of the decontamination efforts? 

# • E. Does the closure plan describe a testing program to determine if the standards ofdecontaminationhas been met?



# • Comments:

- 19-8. THERMALTREATMENT (40 CFR 265.381) 

### YES NO 

# c

A.
B.

C.

Comments: Does the closure plan address the disposal.ofall wastes and residues? Does the closure plan describe the procedure for decontamination of the thermal treatment equipment and surrounding structures?· Does the closure plan describe a testing program to determine ifthe standard ofdecontaminationhas been met?

r

# o

# • 9. 

### CHEMICAL, PHYSICALAND BIOLOGICALTREATMENT (40 CFR265.404) YES NO

A.
B.

C. Does the closure plan address the disposal ofall wastes and residues? Does the closure plandescribe the procedures for decontamination of the thermal treatment equipment and surrounding structures? Does the closure plandescribe a testing program to determine ifthe standard ofdecontaminationhas beenmet?



# •

• Counnents:



### - 21 - c-

### 6.4 VERIFICATIONOFCLOSURECOST ESTIMATES Sections 1-7 deal with the verification ofcost estimates for various tasks performed during the closure of a dangerous wastemanagement facility. However, some of the informationrequested in the following sections maynot be applicable to a particular facility. Ifan item does not apply. mark 

### "NA" (not applicable) on the line located to the left of that item. If the requested information is applicable.**~imply** place a " " on the line and enter the**e~timated** figure on the line located to the right ofthe item. On the otherhand, ifthe requested information is applicable and yet the facility has not provided an estimate for the particular item. enter "NP" (not provided) on the line in the right column. Be sure that all estimates entered below are assigned the appropriate units (i.e., dollars, cubic meters, years. etc.). 

# c



# c

o

# • 1. TREAMENT, DISPOSAL ORREMOVAL OF INVENTORY 

### (40 CFR265.112(a)(2)) Applicable/NA 

### A. On-Site 

## * a. Amount of inventory and residues to be disposed on-site (yd3) i. from cost estimate ii. from closure plan iii. fromvisual inspection b. Unit cost for on-site treatment or disposal ($/yd3) i. from cost estimate
c. Totul cost ofon-site treatment disposal ($) i. from cost estimate Amount/NP

B. Off-Site 

# • a.

b. Amount of inventory and residues to be disposed off-site (yd3) i. from cost estimate ii. from closure plan iii. fromvisual inspection Unit cost for off-site treatment or disposal ($/yd3) i. from cost estimate



# • c. Total cost for off-site disposal excluding transportation i. from cost estimate d. Unit cost for transport of inventory ($/yd3/mile) i. from cost estimate



## *Residues here refer to residues existing at initiationof closure.



### - 23 -Applicable/NA

e. Transport distance (miles) i. from cost estimate ii. by mapreference Amount/NP

# C

Comments: f. Cost of transport ($) i. from cost estimate g. Cost ofoff-site treatment or disposal including transport ($) i. from cost estimate ii. inspector calculation C. Total cost ofTreating, Disposing or Removing Inventory ($)
a. From cost estimate


# -----------------------10



# ()

# • Applicab1e/NA 2. DECONTAMINATION A. Soil Excavation (40 CFR 265.280(c)(1))
a. Volume of soil to be removed (yd3) i. from cost estimate ii. from closure plan iii. inspector's estimate b. Unit cost for soil excavation ($/yd3) i. from cost estimate
c. Total cost ofcontaminated soil excavation ($) i. from cost estimate B. Wastewater'Remova1 Amount/NP

a. Volume ofwastewater to be removed (yd3) 

# • b. i. from cost estimate ii. from closure plan iii. inspector's estimate Unit cost for wastewater removal ($/yd3) i. from cost estimate .-.'-.i-Jo1"'"

(..



# • c. Total cost ofwastewater removal ($) i. from cost estimate C. On-Site Treatment orDisposal of Contaminated Soil, Wastewater and Residues Generated During Decontamination
a. Volume of soil, wastewater and residues to be treated/disposed on-site (yd3) i. from cost estimate ii. from closure plan iii. inspector's estimate

- 25 -Applicable/NA b. Unit cost for treatment/disposal ($/yd3) i. from cost estimate
c. Cost ofon-site treatment/disposal ($) i. from cost estimate D. Off-Site Treatment orDisposal of Contaminated Soil, Wastewater and Residues Generated During Decontamination
a. Volume of soil, wastewaterand residues to be treated/disposal ·off-site (yd3) i. from cost estimate ii. from closure plan iii. fromvisual inspection Amount/NP

# c

b.

c. Unit cost for off-site
. treatment/disposal ($/yd3) i. from cost estimate Cost ofoff-site treatment/ disposal ($) excluding transportation i. from cost estimate 

# --'0

d. Unit cost for transport ($/yd3/mile) i. from cost estimate
e. Transport**di~LJnce** (miles) i. from cost estimate ii. by mapreference f. Cost of transport ($) i. from cost estimate g. Total cost ofoff-site treatment or disposal including transport ($) i. from cost**e~timate** 

# ()

-----

# '. 

# • Applicable/NA 

### E. Equipment Decontamination (40 CFR 265.112(a)(3»
a. Amount ofequipment to be decontaminated (tons) i. from cost estimate ii. from closure plan iii. inspector's estimate b. Unit cost for equipment decontamination ($/ton) i. from cost estimate
c. Cost ofequipment decontamination ($) i. from cost estimate Amount/NP



# •

• Comments: F. Total Cost ofDecontamination ($)
a. From cost estimate

- 27 -Applicable/NA 3. CERTIFICATION Amount/NP

# C

Applicable/NA 

### A. Professional Engineer Hours (hrs) (40 CFR265.115)
a. from cost estimate b. from closure plan c. inspector's estimate Amount/NP

Comments: B. Unit**Cos~** for Professional Engineer ($/hr.)
a. from cost estimate C. Total Certification·Cost ($)
a. from cost estimate



# --------------------------I(j

*Loadedwith costs for support personnel. 

# ()

# • Applicable/NA 

### 4. VERIFICATION OF COST ESTIMATE FORCOVER 

## ** A. CoverMaterial (40 CFR 265.112(a)(4);

265.280(c)(2))
a. Area to be covered (yd2) i. from cost estimate ii. from closure plan iii. fromvisual inspection b. Depth of covermaterial (yd) i. from cost estimate ii. from closure plan iii. inspector's estimate
c. Volume ofmaterial to be obtained on-site (yd3) Amount/NP



# • d.

e. i. from cost estimate ii. from closure plan iii. inspector's estimate Volume ofmaterial to be obtained off-site (yd3) i. from cost estimate ii. from closure plan iii. inspector's estimate Unit cost ofexcavating material on-site ($/yd3) i. from cost estimate



# • f. Unit cost ofpurchasing material off-site ($/yd3) i. from cost estimate g. Unit cost of transporting material ($/yds/mile) i. from cost estimate ii. by mapreference



## **Include materials to be used for cover, for example gravel or clay, except for top-soil•



### - 29 -Applicab1e/NA h. Transport distance (miles) 1. from cost estimate ii. by mapreference i. Transport cost ($) i. from cost estimate j. Total cost of acquiring material ($) i. from cost estimate k. Unit cost of spreading and compacting material ($/yd3) i. from cost**~stimate** 1. Cost of spreading and compacting material ($) Amount/NP

# C

m. i. from cost estimate Total cost of acquiring and placingmaterial ($) i. from cost estimate 

# o

r
B. Top-Soil
a. Area to be covered (yd3) i. from cost estimate ii. from closure plan iii. inspector's estimate b. Depth of top-soil. allowing for appropriate**gra~ing** (yd) i. from cost estimate ji. from closure plan iii. inspector's estimate
c. Volume of top-soil to be obtained on-site (yd3) i. from cost estimate ii. from closure plan iii. inspector's estimate r:-



# o

# • Applicable/NA d. Volume of top-soil obtained off-site (yd3) i. from cost estimate ii. from closure plan iii. inspector's estimate Amount/NP

e. Unit cost ofexcavating top-soil on site ($/yd3) i. from cost estimate f. Unit cost ofpurchasing top-soil off-site ($/yd3) i. fromcost estimate g.**Uni~** cost of transporting top-soil off-site ($/yd3) i. from cost estimate h. Transport distance (miles) 

# • i . i. from cost estimate ii. by mapreference Transport cost ($) i. from cost estimate



# • j. Total cost of acquiring top-soil ($) i. from cost estimate k. Unit cost of spreading and compacting**top-~oil** ($/yd3) i. from cost estimate 1. Cost of spreading and compacting top-soil ($) i. from cost estimate
m. Total cost ofacquiring and placing top-soil**(~)** i. from cost estimate

- 31 -Applicable/NA 

## c. Synthetic Liner and BufferMaterial
a. Area to be covered (yd2) i. from cost estimate ii. from closure plan iii. visual estimate


## * b. Depth of sand buffer (yd) i. from cost estimate ii. from closure plan iii. inspector's estimate
c. Volume of sand to be obtained on-site (yd3) i. from cost estimate il. from closure plan iii. inspector's estimate d. Volume of sand to be obtained off-site (yd3) i. from cost estimate ii. from closure plan iii. inspector's estimate
e. Unit cost ofexcavating sand on-site ($/yd3) i. from cost estimate f. Unit cost ofpurchasing sand off-site ($/yd3) i. from cost estimate g. Unit cost of**tr~nsporting·** sand ($/yd3/mile) i. from cost estimate h. Transport distance (miles) 1. from cost estimate ii. by map reference Amount/NP

# C



# --0

*Includes othermaterials (other than clay and top-soil) whichmay be used alongwith the snythe'tLc liner. 

# (\

# • Applicable/NA i. Total cost ofacquiring sand ($) i. from cost estimate Amount/NP

j. Unit cost of spreading and compacting sand ($/yd3) i. from cost estimate k. Cost of spreading and compacting sand ($) i. from cost estimate 1. Total cost ofacquiring and placing sand ($) i. from cost estimate
m. Unit cost of acquiring and installing synthetic liner ($) 

# • n.

o. i. from cost estimate Cost of acquiring and installing synthetic liner ($) i. from cost estimate Unit cost of acquiring and installing synthetic liner and buffermaterials ($/yd2) i. from cost estimate



# • p. Total cost of acquiring and installing synthetic liner andbuffermaterials ($) i. from cost estimate D. Total Cover Cost
a. Unit cost ofcover ($/yd2) i. from cost estimate b. Total cost ofcover ($) i. from cost estimate

- 33 -

### Applicable/NA Comments: Amount/NP

# 0



# o



# o

# • Applicable/NA 5 • REVEGETATION (40 CFR 265.280(c)(2)(ii» A. Area inNeed

## atrevegetation (yd2)
a. Fromcost estimate b. Fromclosure plan c. Fromvisual inspection Amount/NP

B. Unit Cost for Acquiring and Placing Seed, Fertilizer, etc. ($/yd2)
a. Fromcost estimate C. Total Cost ofAcquiring and Placing Seed, Fertilizer, etc. ($)
a. Fromcost estimate 6. OTHER (from cost estimate) ($) (specify) $---- 

# •

• 7 • (specify) TOTAL CLOSURE COSTS ($) A. Fromcost estimate

- 35 - $----