North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-24 - Hazardous Waste Management › Chapter 33-24-05 - Standards for Treatment, Storage, and Disposal Facilities and for the Management of Specific Hazardous Wastes and Specific Types of Hazardous Waste Management Facilities › STANDARDS FOR FACILITIES OPERATING UNDER A STANDARDIZED PERMIT › Section 33-24-05-1071 - Wording of the instruments

Current through Supplement No. 393, July, 2024
1. The chief
				  financial officer of an owner or operator of a facility with a standardized
				  permit who uses a financial test to demonstrate financial assurance for that
				  facility must complete a letter as specified in subsection 6 of section
				  33-24-05-1063. The letter must be worded as follows, except that instructions
				  in brackets are to be replaced with the relevant information and the brackets
				  deleted:
I am the chief financial officer of [name and address of
					 firm]. This letter is in support of this firm's use of the financial test to
					 demonstrate financial assurance for closure costs, as specified in sections
					 33-24-05-1060 through 33-24-05-1079. This firm qualifies for the financial test
					 on the basis of having [insert "a current rating for its senior unsecured debt
					 of AAA, AA, A, or BBB as issued by Standard and Poor's or Aaa, Aa, A or Baa as
					 issued by Moody's" or "a ratio of less than 1.50 comparing total liabilities to
					 net worth" or "a ratio of greater than 0.10 comparing the sum of net income
					 plus depreciation, depletion and amortization, minus ten million dollars, to
					 total liabilities"].
This firm [insert "is required" or "is not required"] to
					 file a Form 10K with the Securities and Exchange Commission (SEC) for the
					 latest fiscal year.
The fiscal year of this firm ends on [month, day]. The
					 figures for the following items marked with an asterisk are derived from this
					 firm's independently audited, year-end financial statements for the latest
					 completed fiscal year, ended [date].
[If this firm qualifies on the basis of its bond rating
					 fill in the requested information: "This firm has a rating of its senior
					 unsecured debt of" [insert the bond rating] "from" [insert "Standard and
					 Poor's" or "Moody's"].
[Complete Line 1. Total Liabilities below and then skip the
					 remaining questions in the next section and resume completing the form at the
					 section entitled Obligations Covered by a Financial Test or Corporate
					 Guarantee.]
[If this firm qualifies for the financial test on the basis
					 of its ratio of liabilities to net worth, or sum of income, depreciation,
					 depletion, and amortization to net worth, please complete the following
					 section.]
*1.
Total Liabilities
$
*2.
Net Worth
$
*3.
Net Income
$
*4.
Depreciation
$
*5.
Depletion (if applicable)
$
*6.
Amortization
$
*7.
Sum of Lines 3, 4, 5, and 6
$
[If the above figures are taken directly from the most
					 recent audited financial statements for this firm insert "The above figures are
					 taken directly from the most recent audited financial statements for this
					 firm". If they are not, insert "The following items are not taken directly from
					 the firms most recent audited financial statements" [insert the numbers of the
					 items and attach an explanation of how they were derived].
[Complete the following calculations]
8.
Line 1. ÷ Line 2. =
$
9.
Line 7. ÷ Line 1. =
$
Is Line 8. less than 1.5?
Yes
No
Is Line 9. greater than 0.10?
Yes
No
[If the owner or operator did not answer Yes to either of
					 these two questions, the owner or operator cannot use the financial test and
					 need not complete this letter. Instead, the owner or operator must notify the
					 department that the owner or operator intends to establish alternate financial
					 assurance as specified in section 33-24-05-1063. The owner or operator must
					 send this notice by certified mail within ninety days following the close of
					 the owner's or operator's fiscal year for which the yearend financial data show
					 that the owner or operator no longer meets the requirements of this section.
					 The owner or operator must also provide alternative financial assurance within
					 one hundred twenty days after the end of such fiscal year].
Obligations Covered by a Financial Test or Corporate
					 Guarantee
[On the following lines list all obligations that are
					 covered by a financial test or a corporate guarantee extended by the owner's or
					 operator's firm. The owner or operator may add additional lines and leave blank
					 entries that do not apply to the owner's or operator's situation.]
Hazardous Waste Facility Name and
								ID
State
Closure
Post-Closure
Corrective Action
$
$
$
$
$
$
Hazardous Waste Third Party Liability
$
Municipal Waste Facilities
State
Closure
Post-Closure
Corrective Action
$
$
$
$
$
$
Underground Injection Control
State
Plugging Action
$
Petroleum Underground Storage Tanks
$
PCB Storage Facility Name and ID
State
Closure
$
Any financial assurance required under, or as part of an
					 action undertaken under, the Comprehensive Environmental Response,
					 Compensation, and Liability Act:
Site Name
State
Amount
$
Any other environmental obligations that are assured
								through a financial test:
Name
Amount
$
*10. Total of all amounts $
*11. Line 10. + $10,000,000 = $
*12. Total Assets $
*13. Intangible Assets $
*14. Tangible Assets (Line 12. - Line 13.) $
*15. Tangible Net Worth (Line 14. - Line 1.) $
*16. Assets in the United States $
Is Line 15. greater than Line 11?
Yes
No
Is Line 16. no less than Line 10?
Yes
No
[The owner or operator must be able to answer Yes to both
					 these questions to use the financial test for this facility.]
I hereby certify that the wording of this letter is
					 identical to the wording specified in section 33-24-05-1071 as such rules were
					 constituted on the date shown immediately below.
[Signature]
[Name]
[Title]
[Date]
[After completion, a signed copy of the form must be sent
					 to the department. In addition, a signed copy must be sent to every authority
					 who requires a demonstration through a financial test for each of the other
					 obligations in the letter that are assured through a financial test, or accepts
					 a guarantee for an obligation listed in this letter.]
2. The chief financial officer of an owner or
				  operator of a facility with a standardized permit who use a financial test to
				  demonstrate financial assurance only for third party liability for that (or
				  other standardized permit) facility or facilities must complete a letter as
				  specified in subsection 6 of section 33-24-05-1067. The letter must be worded
				  as follows, except that instructions in brackets are to be replaced with the
				  relevant information and the brackets deleted:
I am the chief financial officer of [name and address of
					 firm]. This letter is in support of this firm's use of the financial test to
					 demonstrate financial assurance for third party liability, as specified in
					 sections 33-24-05-1060 through 33-24-05-1079. This firm qualifies for the
					 financial test on the basis of having tangible net worth of at least ten
					 million dollars more than the amount of liability coverage and assets in the
					 United States of at least the amount of liability coverage.
This firm [insert "is required" or "is not required"] to
					 file a Form 10K with the Securities and Exchange Commission (SEC) for the
					 latest fiscal year.
The fiscal year of this firm ends on [month, day]. The
					 figures for the following items marked with an asterisk are derived from this
					 firm's independently audited, year-end financial statements for the latest
					 completed fiscal year, ended [date].
[Please complete the following section.]
*1.
Total Assets
$
*2.
Intangible Assets
$
* *3.
Tangible Assets (Line 1. - Line 2.)
$
*4.
Total Liabilities
$ $
5.
Tangible Net Worth (Line 3. - Line 4.)
$ $
*6.
Assets in the United States
$
7.
Amount of liability coverage
$
Is Line 5. at least $10 million greater than Line
								7?
Yes
No
Is Line 6. at least equal to Line 7?
Yes
No
[The owner or operator must be able to answer Yes to both
					 these questions to use the financial test for this facility.]
I hereby certify that the wording of this letter is
					 identical to the wording specified in section 33-24-05-1071 as such rules were
					 constituted on the date shown immediately below.
[Signature]
[Name]
[Title]
[Date]
[After completion, a signed copy of the form must be sent
					 to the department.]
General Authority:
NDCC
						23-20.3-03
Law Implemented:
NDCC
						23-20.3-03,
						23-20.3-04,
						23-20.3-05