Wisconsin Administrative Code › Department of Natural Resources › NR 600-699 - Environmental Protection - Hazardous Waste Management › Chapter NR 667 - Standards For Owners And Operators Of Hazardous Waste Facilities Operating Under A Standardized License › Subchapter H - Financial Requirements › Section NR 667.0151 - Wording of the Instruments

Current through June 24, 2024
(1) The chief
				  financial officer of an owner or operator of a facility with a standardized
				  license who uses a financial test to demonstrate financial assurance for that
				  facility shall complete a letter as specified in s.
				  NR
				  667.0143(6). The letter shall 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 subch. H of
					 ch. NR 667, Wis. Adm. Code. 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 Investors Services" 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 $10 million, 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 & 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 you did not answer Yes to either of these two
					 questions, you cannot use the financial test and need not complete this letter.
					 Instead, you shall notify the department for the facility that you intend to
					 establish alternate financial assurance as specified in s.
					 NR
					 667.0143. The owner or operator shall send this notice
					 by certified mail within 90 days following the close of the owner or operator's
					 fiscal year for which the year-end financial data show that the owner or
					 operator no longer meets the requirements of this section. The owner or
					 operator shall also provide alternative financial assurance within 120 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 your firm. You
					 may add additional lines and leave blank entries that do not apply to your
					 situation.]
State
Closure
Long-Term Care
Corrective Action
Hazardous Waste Facility Name and ID
________________________________________
______
$______
$______
$______
_________________________
Hazardous Waste Third Party Liability Municipal
								  Waste Facilities
_________________________
_________________________
_____
$______
$______
$______
Petroleum Underground Storage Tanks
_________________________
_____
$______
PCB Storage Facility Name
_________________________
_____
$______
Any financial assurance required under, or as part of an
					 action undertaken under, the Comprehensive Environmental Response, Compensation
					 and Liability Act.
Site name
____________________________________________________________
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
[You must be able to answer Yes to both of 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 s. NR 667.0151 as such rules were
					 constituted on the date shown immediately below.
[Signature] _________________________
[Name] ____________________________
[Title] _____________________________
[Date] ____________________________
[After completion, send a signed copy of the form to the
					 department. In addition, send a signed copy to every authority who (1) requires
					 a demonstration through a financial test for each of the other obligations in
					 the letter that are assured through a financial test, or (2) 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 license who uses a financial test
				  to demonstrate financial assurance only for third party liability for that (or
				  other standardized license) facility or facilities shall complete a letter as
				  specified in s.
				  NR
				  667.0147(6). The letter shall 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
					 [insert "subchapter H of 40 CFR part 267" or the citation to the corresponding
					 state regulation]. This firm qualifies for the financial test on the basis of
					 having tangible net worth of at least $10 million 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 $10,000,000 greater than Line 7? ___Yes
					 ___No
Is Line 6 at least equal to Line 7? ___Yes ___No
[You must be able to answer Yes to both of 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 s. NR 667.0151 as such rules were
					 constituted on the date shown immediately below.
[Signature] _________________________
[Name] ____________________________
[Title] _____________________________
[Date] _____________________________
[After completion, send a signed copy of the form to the
					 department.]