OF THE STATE

OF ILLINOIS

ROYER OIL (SORENTO

GARAGE),

)

)

Petitioner,

)

)

V.

)

PCB

05-16

)

(UST Appeal)

)

ILLINOIS ENVIRONMENTAL

PROTECTION AGENCY,

)

)

Respondent.

)

NOTICE

OF FILING

John Kim

Special Assistant Attorney General

Illinois Environmental Protection Agency

1021 North Grand Avenue East

P.O.

Box 19276

Springfield, Illinois 62794-9276

Carolyn S. Hesse

Barnes

& Thornburg LLP

One North Wacker Drive

Suite 4400

Chicago, Illinois 60606

(312)

357-1313

243400v

1

Carol Sudman

Hearing Officer

Illinois Pollution Control Board

1021

North Grand Avenue East

P.O.Box

19274

Springfield, Illinois

62794-9274

RECEIVED

CLERK’S OFFICE

OCT

2

8

2004

STATE OF ILLINOIS

Pollution Control Board

TO:

PLEASE TAKE

NOTICE

that on

October 28,

2004,

filed with the Clerk ofthe Illinois

Pollution

Control

Board

of the

State

of Illinois

an

original,

executed

copy of a

Petition

for

Review of Illinois Environmental Protection Agency Decision.

Dated:

October 28, 2004

Respectfully submitted,

Royer Oil (Sorento Garage)

By~

~

Ori~’of

Its Atto~ieys

This

filing submitted

on recycled

paper as defined

in

35

III.

Adm. Code

101.202

---

RECEIVED

CLERK’S OFFICE

OCT

2 82004

CERTIFICATE OF SERVICE

STATE

OF ILLINOIS

POII~tj~~

Control Board

I,

on

oath

state

that

I

have

served

the

attached

Petition

for

Review

of

Illinois

Environmental Protection Agency Decision. by placing a copy

in an envelope addressed to:

John Kim

Special

Assistant Attorney General

Illinois Environmental Protection Agency

1021

North Grand Avenue

East

P.O. Box

19276

Springfield, Illinois

62794-9276

from

One North

Wacker Drive,

Suite

this

28th

Day of October, 2004.

Carol Sudman

Hearing Officer

Illinois Pollution Control Board

1021

North Grand Avenue East

P.O. Box

19274

Springfield, Illinois

62794-9274

This

filing

submitted on recycled paper as defined

in 35

Ill. Adm. Code

101.202

2

4400,

Chicago, Illinois,

before the hour of 5:00

p.m.,

on

~

~

Carolyn S. H~se

---

~ECE~VED

CLERK’S OFFICE

BEFORE THE POLLUTION CONTROL BOARD

OCT

282004

OF THE STATE OF ILLINOIS

STATE OF

ILLINOIS

ROYER OIL (SORENTO GARAGE),

)

Pollution

Control Board

)

Petitioner,

)

)

v.

)

PCBO5-16

)

(UST Appeal)

ILLINOIS ENVIRONMENTAL

)

PROTECTION AGENCY,

)

)

Respondent.

)

PETITION FOR REVIEW OF ILLINOIS ENVIRONMENTAL

•

PROTECTION AGENCY DECISIONS

Royer

Oil

Company,

by

its

attorney,

Carolyn S.

Hesse of Barnes

&

Thornburg,

pursuant

to

the

Illinois

Environmental

Protection Act,

415

ILCS

5/1

et. seq.

(the “Act”) and

35

Illinois

Administrative

Code

Section

105.400

et.

seq.,

hereby appeals

certain decisions

by

the

Illinois

Environmental

Protection Agency (the “Agency”).

1.

Royer

Oil

Company

(“Royer”

or

“Petitioner”)

is

the

owner

of property

referred

to

as

Sorento

Garage

located

on

Main

Street

in

Sorento,

Bond

•

County,

Illinois.

The

site

was

a

gasoline

service

station

that

had

underground

storage tanks (UST5)

on the property, which

stored gasoline

and diesel fuel.

2.

LUST

Incident

Number

20000692

was

obtained

following

a

site

investigation.

LPC #0050305009-Bond County has also been assigned.

3.

On May 13, 2004, Petitioner sent to the Agency a High Priority Corrective

Action Plan

Budget Amendment

(the “Budget

Amendment”)

to

perform

corrective action at the Station.

(See

Exhibit 1.)

The Agency received this

document

on May

14,

2004.

The Budget included

signed certifications to

This

filing submitted

on

recycled paper as defined

in 35

III.

Adm.

Code

101.2021

---

the

effect

that

the

submitted

Budget

complied

with

the

Environmental

Protection

Act

and

a

revised

budget

certification was

sent

to

IEPA

on

June 2, 2004.

(See

Exhibit 2)

4.

On June 24,

2004,

the Agency sent a letter to

Petitioner rejecting the High

Priority Corrective Action Plan Budget Amendment

(See

Exhibit 3.)

The

letter stated as follows:

The Budget Amendment

is rejected for the reasons(s)

listed below

~(Section

57.7(c)(4)

of the Act

and

35

Ill.

Adm.

Code

732.405(c)

and 732.503(b)).

*

*

*

The

Illinois

EPA previously notified

the

owner or operator of its

final action.

Further,

in accordance with 57.7(c)(4) of the Act and

35

Ill.

Adm.

Code 732.503(f), the Illinois EPA’s action to reject or

require

modification of the plan or budget, or the rejection of any

plan or budget

by

operation of law,

was

subject to

appeal

to

the

Illinois

Pollution

Control

Board

within

35

days

after the

Illinois

EPA’s final action.

The

letter

then

goes

on

to

state

that

Petitioner

has

the

right

to

appeal this decision to the Illinois Pollution

Control Board.

5.

The

Agency’s

letter

provides

no

additional

information

regarding

why

JEPA disapproved the Budget Amendment.

6.

Petitioner is appealing the Agency’s decision letter dated June 24, 2004.

7.

The

parties

timely

filed

a joint

notice

to

extend

the

35-day

period

for

Carter to file this appeal.

(See

Exhibit 4.)

8.

By

Order

dated

August

5,

2004,

the

Illinois

Pollution

Control

Board

extended the appeal period to

October 28, 2004.

(See

Exhibit

5.)

9.

•

Petitioner’s

submittal

dated May

13,

2004

to

the Illinois

EPA included a

•

detailed budget.

This

filing

submitted

on recycled paper

as

defined

in

35 III. Adm.

Code

101.2021

2

---

10.

The letter from Petitioner’s

consultant to the Agency dated May

13,

2004

that forwards the Budget Amendment states that:

The

approved

costs

have

been

reassessed

and

found

to

be

insufficient to complete the work required as described below.

(See

Exhibit

1)

11.

Section 732.405(e) provides as follows:

e)

If, following approval of any groundwater monitoring plan,

corrective action

plan or associated

budget plan, an

owner

or

operator

determines

that

revised

procedures

or

cost

estimates

are

necessary

in

order

to

comply

with

the

minimum

required

activities

for

the

site,

the

owner

or

•

operator

shall

submit,

as

applicable,

an

amended

groundwater

monitoring

plan,

corrective

action

plan

or

associated

budget

plan

for

review

by

the

Agency.

The

Agency

shall

review

and

approve,

reject

or

require

modifications

of the

amended

plan

in

accordance with

the

procedures contained in

Subpart E ofthis Part.

12.

Petitioner’s

Budget

Amendment

provides

costs

that

are

necessary

to

comply with the Act.

13.

Under the terms of Section

732.405(e),

the Agency

is

required

to

review

the

Budget Amendment

in

accordance with

the

procedures

contained

in

Subpart E

of part

732.

Illindis

EPA has

failed

to

perform the

detailed

review required by

Subpart E,

Section 732.505.

14.

Petitioner has determined that revised cost estimates are necessary in

order

to

comply

with the minimum required

activities for the

site

and

that

the

costs

IEPA previously approved

are not

adequate

to

allow

Petitioner

to

comply

with

the

Act

or to

perform the

work

described

in

the

approved

CAP.

This

filing submitted on

recycled paper as defined

in

35 Ill.

Adm.

Code

101.2021

3

---

15.

Petitioner’s

costs

to

perform

the

work

as

set

forth

in

the

Budget

Amendment are reasonable

costs.

WHEREFORE, Royer Oil

(Sorento

Garage) respectfully requests that the Board enter an

order that will provide that it be reimbursed from the UST Fund for its submitted costs and for its

attorneys’ fees

and costs in bringing this appeal.

Respectfully submitted,

Royer Oil (Sorento Garage)

By:

~

Oi~’

ofIts Attorn~ys

Carolyn S. Hesse, Esq.

Barnes

& Thornburg LLP

One North Wacker Drive

Suite 4400

Chicago, Illinois 60606

(312) 357-1313

243347v1

This

filing

submitted

on recycled

paper as defined

in 35 III. Adm.

Code

101.2021

---

•

C’V~I~1

Corn p any

•

701 W.South

Grand

Avenue

Environmental Consulting

•

Services

Phone:

Fax:

(217) 522-8001

(217)522-8009

!

•

May 13,

2004

Mr. Steve Jones, Project 1\’Ianager

LUST Section, B1ireau of Land

Illinois Environmental Protection Agency

1021

North

Grand Avenue East

Springfield, Illinois 62794-927 6

RE:

LPC #0050305009—Bond

County

Sorento/Royer

Oil Company (Sorento

Garage)

Main Street

LUST

Incident Number: 00-0692

LUST Technical Reports—Corrective

Action Plan Amendment

Dear Mr.

Jones:

This budget amendment is being submitted in response to the Agency’s letter

datedNovember

22,

2002.

The

approved costs have been reassessed and been found to be insufficient to

complete the work required as described below.

Since the

deductions were not made to a level of

detail which indicates

either hours or rates that were deducted, the budget amendment includes a

complete estimate of the required costs and subtracts out the previously approved amounts on the

B-i page.

Following our review of the deductions and the

associated budget, adjustments have been made.

Specifically, sand backfill, disposal charges and construction foreman costs have been modified.

It has been determined that the remaining requested amount will be necessary in order to

complete the approved work in accordance with the regulations.

Ifyou have any questions or require additional information, please do not hesitate to contact

Vince

E.

Smith,

P.E.

or me

at (217) 522-8001.

Sincer

y

~

~owe,P.G.

Senior Environmental Geologist

Enclosure

xc:

Mr.

Stephen Royer,

Royer Oil Company, Inc.

Mr.

Gary Wall,

Sorento

Garage Property Owner

Mr.

William T. Sinnott,

CW3M Company, Inc.

Ms. Carrie

L. DeVore,

CW3M Company, Inc.

D:\CW3M Projects\Royer Garage\CAP\3

cLdoc

A

EXHIBIT

701

W.

South

Grand

Avenue

400

W.

Jackson

Suite

C

Springfield, IL

62704

Marion,

IL

62959

(217) 522-8001

(618) 997-2238

---

Illinois Environmental Protectiod Agency

Owner/Operator

and

Professional

Engineer Budget Certification Form for

Leaking Underground

Storage Tanks

Sites

In accordance

with 415

ILCS

5/57,

if

an owner or operator

intends to seek

payment from

the UST Fund,

an

owner or operator must submit to the Agency, for the Agency’s

approval or modification, a budget

which

includes an accounting of all

costs associated with the implementation of the

investigative,

monitoring and/or corrective

bction plans.

I hereby certify that

I

intend to seek payment from the UST Fund for performing Corrective

Action

_____________________________________activities

at

Sorento

Garage

LUST site.

I

further certi~’that the costs

set forth

in

this budget are necessary activities and are reasonable and

accurate to the best of my knowledge and belief.

I also certify that the

costs included in this budget are

not for corrective action in excess of the minimum

requirements of 415 ILCS 5/57 and no

costs

are

included

in this budget which are not described

in the corrective action plan.

I further certify that costs

ineligible for payment from the Fund pursuant to 35 Illinois Administrative

Code Section

732.606 are

not included

in the budget proposal or amendment.

Such

ineligible costs

include but

are

not limited

to:

Costs

associated with ineligible tanks.

Costs associated with site restoration (e.g.,

pump

islands, canopies).

Costs associated with utility replacement (e.g., sewers,

electrical, telephone,

etc.).

Costs

incurred prior to IEMA notification.

Costs associated with planned tank pulls.

Legal de~fensecosts.

Costs incurred prior to July 28,

1989.

Costs

associated with installation of new USTs or the

repair of existing USTs.

Subscribed and sworn to before

me the

___________

day of

(Budget Proposals andBudget Amendments must be notarized when

(Notary

Public)

Seal:

The Agency

is

authorized to

require this

information under 415

ILCS

5/I.

Disclosure

of this

information

-

is required.

Failure

to

do

so may

result

in the delay or denial of any budget

or payment requested

hereunder.

This form

has been approved

by

theForms

Management Center.

IL

532

2273

LPC

499

Rev.

Mar-94

B

B

:j

k\97

1405 S .WPD

Owner/Operator:

~tephen

L. Royer, Royer

Oil

Signature:

Subscribed

amr’d sworn tdbm

(Budget Prop dsals and

Title:

Owner

Date:

P.E.:

~

P.E.

Signature:~~

---

BUDGET

AND

BILLING

FORM

FOR

LEAKING

UNDERGROUND

STORAGE

TANK SITES

-

A.

SITE INFORMATION

Site Name: Royer Oil

Company

-

Sorento

Garage

•

Site Address:

Corner of

Center and Main Street

City:

Sorento

Zip:

62914

County:

Bond

EPA

Generator No.:

0050305009

TEMA Incident No.:

00-0692

IEMA

Notification

Date:

4/18/00

Date

this

Form was Prepared:

May 13, 2004

This

form is being

submitted

as a:

__________Budget Proposal (Revised)

x

BudgetAmendment

(Budget Amendments must include only the co~

over the previous budget.)

-

Amendment Number:

2

_________Biliing

Package for

costs incurred pursuant to

35

Illinois Administrati

Code (IAC), Part 732 (“New

program”).

This

form is

being submitted for the

Site Activities indicated below

(che~kone):

•

Early

Action

__________

Site Classification

Low

Priority Corrective Action

X

High

Priority

Corrective Action

__________

Other (indicate activities)

____________________________________________________

DO NOT SUBMIT “NEW PROGRAM” COSTS AND

“OLD PROGRAM”

COSTS AT THE SAME TIME,

ON

THE SAME FORMS.

A-i

IL 532-2263

-

-

LFC

494

Rev.

11/97

This form must be submitted in duplicate.

---

IEMA No.

00-0692

Ifeligible for reimbursement where should

reimbursement checks be sent?

Please note that only

owners or operators

of USTs may be eligible for reimbursement.

Therefore, payment

can only be made

to

an owner

or operator.

Pay

to the order of:

Stephen L. Royer

Send in care of:

-

CW3M Company, Inc.

Address:

P.O. Box 571

-

-

City:

Carlinville

State:

Illinois

Zip:

62626

Number of Petroleum

USTs in Illinois presently owned

or operated

by the owner or operator;

any subsi

parent or joint stock company of the owner or operator, and any company owned by any parent,

subsidi

joint stock company

of the owner or

operator:

-

Fewer than 101:

X

101 or more:

Number of USTs at the

sit’

3

(Number of TJSTs includesUSTs presently at the site and USTs

that have been removed.)

Number

of incidents

reported to IEMA

1

Incident

Numbers assigned

to the site due to releases from 1.

00-0692

Please list

all tanks which have ever been located at the site and

are presently located at the site:

Product Stored

Size

Did UST

Type of

(gallons)

have a release?

Incident No.

Release

Gasoline

300

Yes

No

00-0692

tank

Gasoline

300

Yes

No

00-0692

tank

Gasoline

550

Yes

No

00-0692

Line leaks, overfills

__________________

Yes

No

_________

___________________

-

Yes

No

________

__________________

__________________

Yes

No

________

__________________

__________________

Yes

No

________

__________________

__________________

Yes

No

________

___________________

•

Yes

No

•

_____________________

Yes

•

No

_____________________

•

A-2

-

This form must be submitted in duplicate.

---

•

IBMA No.

99-2274

B.

PROPOSED BUDGET SUMMARY AND BUDGET TOTAL

REQUIRED

PREVIOUSLY

TOTAL

AMOUNT

APPROVED

REQUESTED

1.

Investigation Costs:

$

13,725.00

$

13,671.00

$

54.00

2.

Analysis

Costs:

$

16,265.00

$

16,265.00

$

3.

Personnel

Costs:

$

194,512.50

$

142,971,46

$

51,541.04

4.

Equipment

Costs:

$

1,328.00’

$

1,228.00

$

100.00

5.

Field

Purchases and Other Costs:

$

369,801.16

$

220,686.23

$

149,114.93

6.

Handling

Charges:

$

12,698.43

$

12,952.09

$

(253.66)

TOTAL PROPOSED BUDGET

=

$

200,556.31

B-l

This form must be

submitted in duplicate.

---

Other Costs

•

Number of

Units

Unit Cost

Total Cost

see attached “Other” sheet

2.

Professional

Services (eg., P.E., geologist)

-

These costs

must be

Listed in Section

I, the Persomel

section

of the forms.

E-Tl.

IEMA No.

00-0692

E.

INVESTIGATION COSTS

Method

I

_________

Method II

•

Method III

Not Applicable

X

Drilling Costs

-

This includes the costs for drilling labor, drill rig usage, and other drilling equipment.

Borings which are to be completed

as monitoring wells should

be

listed here.

Costs associated with

disiiosal of cuttings should not be included here.

An indication

must be made as to why each boring is

being conducted (I.e..

classification, monitoring wells, migration pathways).

14

borings

to

15

feet

•

210

feet to be bored for

investigation/monitorin

___________

borings

to

8

feet

___________

f~et

to be bored for

investigation

5

borings

to

10

feet

=

50

feet to be bored for

investigation

___________

borings

to

50

feet

=

feet to be bored for

classification

__________

borings

to

15

feet

=

‘

feet to be bored for

investigation/migrator~

Total Feet to be Bored:

260

•

•

Borings:

260

feet

x

$

20

per foot

‘$

5,200.00

(or)

Hours

•

x

$

__________

per hour

=

$

_____________________

__________

borings

thiough

__________

ft of bedrock

=

________Ft

bedrock

to be bored

__________

borings

through

__________

ft of bedrock

=

________Ft

bedrock to be bored

Total Feet bedrock

to be Bored:

_______________________

Borings:

__________

Ft bedrock x

$

___________

per ft bedrock

$

____________

(or)

Hours

x

$_________

per Hour

=

$

__________________

4

#

of

Mobilizations

@

$

260

per mobilization

$

1,040.00

This form must be submitted In duplicate.

---

IEMA No.

00-0692

3.

Monitoring Well Installation Materials

-

Costs listed must be costs associated

with well casing,

•

well screens, filter pack, annular seal, surface seal, well covers, etc.

List the items below in a time and

materials format.

Material

Number

of

Units

Unit Cost

Total Cost

15-foot monitoring wells

10-foot,

2” PVC screen

14

$

55.00

$

770.00

5-foot,

2” PVC riser pipe

14

$

25.00

$

350.00

Misc. PVC connectors, 0-rings,

etc.

14

$

25.00

$

350.00

2” bottom caps

14

$

20.00

$

280.00

2” Expandable

locking caps

14

$

30.00

$

420.00

•

Flush mount manway

14

$

105.00

$

1,470.00

Sand filter pack

(3

bags per well)

-

42

$

12.00

$

504.00

Bentonite

chips (annular seal’~

.

14

$

30.00

$

420.00

Concrete (surface seal)

14

$

19.00

$

266.00

Monitor well installation time

14

$

105.00

$

1,470.00

15-foot monitoring well with 10-foot well

screen,

PVC riser, flush mount manway,

filter

pack,_annular_seal,_and_surface_seal

Total

$

6,300.00

Disposal

Costs

-

This includes

the

costs for disposing of boring cuttings and any water generated

WhilE

performing borings or installatin

wells.

Disposal

of Cuttings:

9

drums

x

$

65

per drum

=

$

585.00

Disposal

of Water:

300

gallons

x

$

2

per gallon

=

$

600.00

Transportation Costs:

$

0.00

Describe how the water/soil

will be disposed:_____________________________________________________

TOTAL INVESTIGATION

COSTS

$13,725.00

E-2

4.

This form most be submitted in duplicate.

---

TEMA No.

00-0692

F.

ANALYSIS COSTS

INVESTIGATION & CAP DEVELOPMENT

1.

Physical Soil Analysis

-

This must only include

analiisis

costs for classification of soil types at

the

_____

Moisture Content samples

x

$

$

5.00

per sample

=

$

Soil Classification samples

x

$

_______________

per sample

=

$

Indicate method to be performed:

______________________________

_____

Soil Particle Size samples

x

$

•

$

135.00

per sample

=

$

______________

____

Ex-situ Hydraulic Conductivity/Permeability

samples

x

$

$

900.00

per sample

=

$

_______________

Indicate method to be performed:

_____________________________

____Rock

Hydraulic Conductivity/Permeability

samples

x

$

___________

persample$

Natural

Organic

Carbon Fraction

(foc) samples

x

$

•

per sample=

$

Indicate the ASTM or SW-846 method

to be performed:

___________________

______________________

samples

x

$

______________

per sample

=

$

0

___________________

samplesx

$

•

per sample

$

0

•

samples

x

$

_____________

per sample

= $

0

______________________

samples

x

$

______________

per sample

= $

0

•

samples

x

$

______________

per sample

= $

•

0

2.

Soil Analysis

Costs

-

This must be for laboratory

anali/sis

only.

17

BTEX

samples

x

$

75.00

per sample

=

$

1,275.00

_____PNA samples

x

$

•

175.00

per sample

=

$

-

17

Total Lead samples

x

•

5

20.00

per sample

=

$

340.00

F-i

0

0

0

0

0

0

This form must be submitted in duplicate

---

_____

pH Samples x

10.00

per sample

= $

-

_____

Paint Filter samples

x

$

per sample

=

$

-

17

TCLP © samples

x

85.00

per sample

=

$

1,445.00

_____

Flash Point samples

x

$

per

sample

= $

-

_____

Lab and/or Field Bank samples x

$

per sample

= $

-

LUST Appendix

B

samples x

$

900.00

per sample

= $

-

1

Waste Char,

samples

x

$

400.00

per sample

=

$

400.00

TACO Parameters

samples

x

$

‘

100.00

per sample

=

$

-

__________________________

samples x

$

______________

per sample

=

$

-

__________________________ samples x

$

______________

per sample

=

$

-

3.

Groundwater

Analysis

Costs

-

This must be for laboratory

analysis

only.

14

BTEX

samples x

$

75.00

per sample

=

$

1,050.00

_____PNA

samples x

175.00

per sample

=

$

-

14 Total Leadsamples

x

$

20.00

per sample

“~$

280.00

_____pH

Samples x

$_____________

per sample

=

$

0

_____Lab

and/or Field Blank samples x

$

per sample

= $

-

•

Flash Point samples

x

$

per sample

=

$

0

•

1

Waste Charactertzatioi

samples x

$

375.00

Per sample

=

$

375.00

___________________________

samples x

$

•

Per sample

= $

-

•

samples x

$

_______________

Per sample

=

$

-

___________________________

samples

x

$

_______________

Per sample

=

$

-

___________________________

samples

x

$

_______________

Per sample

=

$

-

___________________________

samples

x

$

_______________

Per sample

= $

-

TOTAL ANALYSIS

COSTS

$

5,165.00

F-2

This form must be submitted in duplicate.

---

IEMA No.

00-0692

G.

PERSONNEL

INVESTIGATION

ALl personnel costs

that are not included elsewhere in the budget/billing

form must be listed here.

Cos

be

Listed per task,

not personnel type..

The following are some examples of tasks:

Drafting, data collecti

plan, report,

or budget preparation fa CAP

&

(i.e., site classification work plan, 45 day report, or

hi

priority

corrective action budget),

sampling,

field oversite

I CAP Dev.i

(i.e.,

drilling/well installatioi

corrective action, or early action)of maintenance

Sorento G~.The above list is not inclusive

of all

possible tasks.

Environmental Engineer

29.75

hours

x

$

105.00

per hour

=

$

3,123.75

(Title)

Task to be performed for the above hours:

site mv.

(drilling, sampling, surveying, off-site access)

Senior Env. Engineer

0

hours

x

$

115.00

per hour

=

$

(Title)

Task to be performed for the abovehours:

site mv.

(drilling, sampling,

surveying, off-site access)

Senior Env. Geologist

23.25

hours

x

$

92.00

per hour

=

$

2,139.00

(Title)

Task to be performed for the above hours:

site mv.

(drilling, sampling,

surveying, off-site access)

General Project Manager

3

hours

x

$

100.00

per hour

=

$

300.00

(Title)

Task to be performed for the above hours:

site inv. (drilling, sampling, surveying, off-site access)

Env. Project Geologist

49.25

hours

x

$

81.00

per hour

=

$

3,989.25

(Title)

Task to be performed for the

above hours:

site inv,

(drilling, sampling,

surveying, off-site access)

Env, Project Scientist

29.5

hours

x

$

81.00

per hour

=

$

2,389.50

(Title)

Task to be performed for the above hours:

site inv.

(drilling, sampling, surveying, off-site access)

Engineering Technican

9.25

hours

x

$

55.00

per hour

=

$

508.75

(Title)

Task to be performed for the

above hours:

site inv.

(drilling, sampling,

surveying, off-site access)

Laborer

0

hours

x

$

40.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

site inv.

(drilling,

sampling,

surveying, off-site access)

G-l

This form must

be submitted in duplicate.

---

IEMA No.

00-0692

G.

PERSONNEL

INVESTIGATION

All personnel costs

that are not included elsewhere in the budget/billing

form must be

listed here.

Cos

be listed per task, not personnel type.

The following are some examples of tasks: Drafting, data coLlectit

plan, report,

or budget preparation fo CAP &

(i.e., site classification work plan, 45 day report,

or hi~

priority

corrective action budget), sampling,

field oversite

I CAP Dev.~l (i.e., drilling/well installation

corrective action, or early action)of maintenance Sorento G~.The above list

is not inclusive

of all

possible tasks.

Technical Editor

0

hours

x

$

55.00

per hour

=

$

•

-

(Title)

Task to be performed for the above hours:

site inv.

(drilling, sampling, surveying, off-site access)

Draftsman

8.25

hours

x

$

65.00

per hour

‘

$

536.25

(Title)

Task to be performed for the

above hours:

site inv. (drilling, sampling, surveying, off-site access)

Technical Coordinator

0

hours

x

$

65.00

per hour

=

$

-

(Title)

Task to be performed for the

above hours:

site inv. (drilling, sampling, surveying, off-site access)

Administrative Assistant

11.5

hours

x

$

45.00

per hour

=

$

517.50

(Title)

Task to be performed for the above hours:

site inv.

(dril Lii g, sampling, surveying, off-site access)

Office Manager

3

hours

x

$

40.00

per hour

=

$

120.00

(Title)

Task to be performed for the above hours:

site inv. (drilling, sampling, surveying, off-site access)

Principal

0

hours

x

$

130.00

per hour

=

$

-

(Title)

Task to be performed.for the above hours:

site inv.

(drilir~g,sampling, surveying, off-site access)

Field Supervisor/Coordinator

0

hours

x

$

110.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

site inv.

(drilling, sampling, surveying, off-site’ access)

Wastewater Trtmt. Operator

0

hours x

$

100.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

site inv.

(drilling,

sampling, surveying, off-site access)

•

G-ia

This form must be submitted

in duplicate.

---

•

•

IBMA No.

00-0692

•

G.

PERSONNEL

CAP DEVELOPMENT

All personnel costs that are not included elsewhere in the budget/billing

form must be listed here.

Co~

be listed per task,

not personnel type.

The following are some examples of tasks: Drafting, data collect

plan, report,

or budget preparation

fo CAP &

(i.e.,

site classification work plan, 45 day report,

or hi

•

priority

corrective action budget), sampling, field oversite

I CAP Dev.~ (i.e., drilling/well

installatioj

corrective action, or early action)of maintenance Sorento G~.The above list is not inclusive

of all

•

possible tasks.

Environmental Engineer

22.75

hours

x

$

105.00

per hour

=

$

2,388.75

(Title)

Task to

be performed for the above hours:

Site Assessment Report and

CAP Development

Senior Fnv. Engineer

•

2

hours

x

$

115.00

per hour

=

$

230.00

(Title)

Task to be performed for the above hours:

Site Assessment Report and CAP Development

Senior Env. Geologist

11.25

hours x

$

92.00

per hour

=

$

1,035.00

(Title)

Task to be performed for the above hours:

Site Assessment Report and CAP Development

General Project Manager

8.5

hours x

$

100.00

per hour

=

$

850.00

(Title)

Task to be performed for the above hours:

Site Assessment Report and CAP Development

Env. Project Geologist

65.5

hours x

$

81.00

per hour

=

$

5,305.50

(Title)

Task to be performed for the above hours:

Site Assessment Report andCAP Development

Env. ProjectScientist

0

hours x

$

81.00

per hour

=

$

-

•

(Title)

Task

to be performed for the above hours:

Site Assessment Report and CAP Development

EngineeringTechnican

0

hours x

$

55.00

per

hour

=

$

-

(Title)

Task to be performed for the above hours:

Site Assessment Report

and CAP Development

Laborer

0

hours x

$

40.00

perhour

=

$

-

(Title)

•

Task to

be

performed for the above hours:

Site Assessment Report

and CAP Development

G-1b

This form must be

submitted in

duplicate.

---

Technical Editor

(Title)

Task to be performed for the above hours:

Draftsman

7.5

(Title)

Task to be performed for the

above hours:

Technical Coordinator

(Title)

Task to be performed forthe

above hours:

Administrative Assistant

10.75

1.

ItiC)

Task to be performed

for the above hours:

Office Manager

(Title)

Task to be performed for the

above hours:

Principal

(Title)

Task to be performed forthe

above hours:

Field Supervisor/Coordinator

(Title)

Task to be performed for the

above hours:

Wastewater Trtmt. Operator

(Title)

Task to be performed for the above hours:

(Title)

Task to be performed for the above hours:

IEMA No.

00-0692

5

hours

x

$

55.00

per hour

=

$

275.00

Site Assessment Report and ‘CAP Development

hours x

$

65.00

per hour

=

$

487.50

Site Assessment R~portand CAP Development

0

hours

x

$

65.00

per hour

=

$

-

Site Assessment Report and CAP Development

hours x

$

45.00

per hour

=

$

483.75

Site Assessment Report and CAP Development

hoursx

$

40.00

perhour

=

$

120.00

Site Assessment Report

and CAP Development

0

hoursx

$

130.00

per hour

=

$

-

Site Assessment Report and CAP Development

0

hours

x

$

110.00

per hour

=

$

-

Site Assessment Report and CAP Development

0

hours x

$

100.00

per

hour

=

$

-

Site Assessment Report and CAP Development

hours

x

per hour

=

$

-

TOTAL PERSONNEL COSTS:

$

24,799.50

G-2

This form must be submitted in duplicate.

---

IEMA No.

00-0692

H.

EQUIPMENT

COSTS

INVESTIGATION

& CAP DEVELOPMENT

All equipment used must be listed below in

a

time

and

materials

format.

Handling

charges

should

not

added

here;

use

Section

J.

Equipment

Own

or

Rent

Time

Used

Units

Unit

Rate

Total

Cost/Item

PID Rental

.

rent

4.00

/day

$

125.00

$

500.00

Water

Level Indicator

rent

8.00

/day

$

21.00

$

168.00

Survey Equipment Rental

rent

4.00

/clay

$

65.00

$

260.00

Measuring WheelRental

rent

5.00

/day

S

15.00

$

75.00

Slug Rental

rent

0.00

/day

$

36.00

$

-

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

0

0

0

Total

Page H-i

$

1,003.00

H-i

This form must be submitted in duplicate

---

IEMA No.

00-0692

I.

FIELD PURCHASES AND OTHER COSTS

INVESTIGATION

& CAP DEVELOPMENT

All equipment used must be listed below in a time and materials

format.

Handling charges shouldnot

I

added here; use Section

~.

Purchases

Quantity

Item

Price/Item Total Cost

Handling

Charges

0

/each

$

1.25

$

-

yes

0 /each

$

600.00

$

-

yes

0

/each

$

1.00

$

-

yes

0 /each

$

4.00

$

-

yes

14

/each

$

12.00

$

168.00

yes

1

/each

$

6.00

$

6.00

yes

‘Copies

1

/each

$

15.00

$

15.00

yes

34

/each

$

10.00

$

340.00

yes

$

64.96

yes

9

/each

$

50.00

$

450.00

yes

$

-

$

-

$

-

$

-

.

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

-

$

-

S

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

r

L

I—1

Subtotal Page

1-1

$

1,043.96

This form must be submitted in

duplicate

---

IEMAl~00-0692

INVESTIGATION

& CAP DEVELOPMENT

Other Costs

-

A listing

and description

of all other costs which will be/were

incurred and

are not specificall~y

listed on this form should be attached.

The listing should include a cost breakdown in a time and materials

format.

Other

Costs

No.

Rate

Cost

Copies

•

2518

$

0.10

$

251.80

Mileagefor CW3M trips

1200.00

$

0.37

$

444.00

Per Diem

0.00

$

36.00.

$

-

Total Other

$

695.80

*Nlileage

8

trips at

150

miles/trip

4 trips for

drilling, 4

for surveying

and sampling

TOTAL OTHERCOSTS

=

$

1,739.76

1-2

jsubt

Total (Pages

I-i

otal Page 1-2

and 1-2)

$

$

695.80

1,739.76

*

P

This form must be submitted

in duplicate

---

IEMA No.

00-0692

J.

HANDLING

CHARGES

INVESTIGATION & CAP DEVELOPMENT

Handling

charges are eligible for payment on subcontractor billings and/or

field purchases

only if they

equal to or less than

the amounts determined by the following table:

Subcontractor or Field

Purchase

Cost

$-i-$5,o’oo

$5,001

-

$15,000

$15,001

-

$50,000

$50,001

-

$100,000

$100,001

-

$1,000,000

Eligible Handling Charges as a

Percentage

of Cost

12

$600

+

10

of amt. Over $5,000

$1,600

+

8

of amt. Over $15,000

$4,400

+

5

of amt. Over $50,000

$6,900

+

2

of amt. Over $100,000

A.

Subcontractor

Charges

Subcontractor

Section

where cost

is

listed

SubcontractAmount

Drilling

Costs

E-1

$

6,240.00

Monitoring

Well Installation

E-2

$

6,300.00

Disposal

of Cuttings

E-2

•

$

585.00

Disposal of Water

E-2

$

600.00

Transportation

•

E-2

$

-

Laboratory Analysis

F-2

$

5,165.00

J-1

Subtotal J-1 Subtota

S

18,890.00

This form must be submitted

in duplicate

H

---

IEMANo.

00-0692

INVESTIGATION

& CAP DEVELOPMENT

Isubtotal

Page 1-2:

$

1,043.96

Subtotal of Pages J-1 and J-2

$

19,933.96

Handling

Charge

*:

See Handling Charge Total

*

Use chartat

top

ofPage J-i

to calculate the allowable

handling

charge.

Copies of invoices for subcontractor costs

and

receiptsfor field purchases

are reqinre&foT billing

su1omiSSiOflS

J-2

B.

Field Purchase

Field Purchase

Field Purchase

Amount

Color Copies

$

-

Carbon Filter Purchase

$

-

Manifests

$

-

Truck

Liner

$

-

Bailers

‘

‘

$

168.00

Film

$

•

6.00

Photo Development& Copies

.

$

15.00

Encore Samplers

$

340.00

Postage

$

64.96

Drums

$

450.00

This form must be submitted in duplicate

---

IEMA No.

00-0692

HIGH PRIORITY CORRECTIVE ACTION

Corrective

Action

at

High Priority Sites

may involve both soil and groundwater

remediation.

Below

provide

a summary

of costs

for

the remediation type(s)

chosen

and attach the appropriate

sections of

the

budget/billing

forms

to support

the

summary

of

costs.

A.

Preparation

of the Corrective Action Plan.

-

1.

Investigation Costs:

$

13,725.00

2.

Analysis Costs:

$

5,165.00

3.

Personnel Costs:

$

24,799.50

4. Equipment Costs:

$

1,003.00

5.

Field Purchases

and Other Costs:

$

1,739.76

6. Handling Charges:

See Handling Charge Total

B.

________Months

of O&Mx

__________

per month

=

$

•

-

(includes utilities, maintenance and expendable items)

C.

Excavation and Disposal

1.

Analysis Costs:

$

4,180.00

2.

Personnel Costs:

$

77,760.00

3.

Equipment Cosis:

$

-

4,

Field Purchases and Other Costs:

$235,952.50

5.

Handling Charges:

See Handling Charge Total

Of the above costs, please provide

a break

down of the costs associated with excavation,

transportation, and disposal as

requestd below:

Excavation

4,102.59

cubic yards X

$

13.45

per cu yd

$

55,200.00

Transport:

4,102.59

cubic yards X

$

11.28

per cu yd

=

$

46,280.00

Disposal:

4,102.59

cubic yards

X

$

31.05

per cu yd

=

$127,385.50

•

L-l

1.

2.

3.

4.

5.

Groundwater Remediation

Analysis

Costs:

•

$

3,420.00

Personnel

Costs:

$

-

Equipment

Costs:

$

268.00

Field Purchases and Other Costs:

$

-

Handling Charges:

See Handing

Charge Total

Of the

above costs, please provide

a break

down of the costs associated with operation and

maintenance (O&M). if applicable, as requested below.

This form must be submitted in duplicate

---

IEMA No.

00-0692

D.

Alternative Technology,

Type

1.

Investigation Costs:

2.

Analysis

Costs:

3.’

Personnel Costs:

4.

Equipment

Costs:

5.

Field Purchases and Other Costs:

6.

Handling

Charges:

Bioremediation Treatability Study

S

-

$

3,500.00

5

4,675.00

8

57.00

$

201.20

$

444.14

Of the above costs, please provide a break

down of the following costs

as requested below if

applicable:

Excavation:

Transport:

___________

Disposal:

________

cubic yards

X

$

cubic yards

X

$

cubic yards

X $

_________per cu yd

=

___________

per cu yd

=

____________

per cu yd

=

Operation

and Maintenance (O&M):

_________Months

of O&M

x

$

E.

Backfill

Costs

_____________

per month

=

$

1.

Personnel Costs:

$

69,750.00

2.

Equipment Costs:

$

-

3.

Field Purchases and Other Costs:

$

124,881.71

4.

Handling

Charges:

See Handling Charge Total

Of the above costs, please provide a break down of the following costs

as requested below if

applicable:

Type

of Backfill:

Sand Backfill

3897.46

cubic yards

X

_____________

__________

__________

$

8.10

per cu yd

=

$31,569.45

Type of Backfill:

Aggregate Backfffl

205.13

cubic yards

X

$

18.98

per cu yd

=

$

3,894.26

Type of Backfill:

Septic Gravel

Backfill

_________

cubic yards

X

_____________per

cu yd

=

$

-

Type of Backfill:

Concrete

for Trailer Pad

__________

cubic yards X

______________

per cu yd

=

$

-

L-2

This form must be submitted in duplicate

H

---

IEMA No.

00-0692

F.

ANALYSIS

COSTS

‘

GW REMEDIATION

1.

Physical Soil Analysis

-

This must only include

anczlvsi’s

costs for classification of soil types at the

Moisture Content samples

x

$

_______________

per sample

=

$

_______________

Soil

Classification

samples

x

$

______________

per sample

=

$

Indicate method

to be performed:

______________________________

Soil Particle Size samples

x

$

•

per sample

=

$

_____Ex-situ

Hydraulic Conductivity/Permeability samples

x

$

____________

per sample

$

____________

Indicate method to be performed:

______________________________

_____RockHydraulic Conductivity/Permeabilitysamples

x

$ ____________persample

$

____________

Natural Organic Carbon

Fraction (foc) samples

x

$ ______________per

sample

=

$

Indicate the ASTM or SW-846 method

to be performed:

___________________

____________________________

_________________

0

____________________________

_________________

0

___________________________

________________

0

___________________________

________________

0

__________

______

0

2.

Soil Analysis

Costs

-

This must

be for laboratory

analysis

only.

_____

BTEX

samples

x

$

_____________

per sample

=

$

•

0

_____

PNA samples

x

$

______________

per sample

=

$

0

_____LUST Pollutants

samples

x

$

per sample

=

$

0

F-l(2)

0

0

0

0

0

0

samples

x

$

______________

per sample

=

$

samples

x

$

______________

per sample

= $

samples

x

$

______________

per sample

= $

samples

x

$

______________

per sample

= $

samples

x

$

______________

per sample

=

$

This form must be submitted in duplicate

---

~

_____

pH Samples

x

$

per sample

=

$‘

0

_____

Paint Filter samples x

$

per sample

=

$

0

_____TCLP @ samples

x

$_____________

per sample

=

$

0

_____

Flash Point samples

x

$

per sample

=

$

0

_____Lab and/or Field Bank samples

x

$

per sample

=

$

0

___________________________

samples x

$

_______________

per sample

= $

•

0

___________________________

samples x

$

_______________

per sample

= $

0

___________________________

samples x

$

_______________

per sample

= $

0

_________________________

samples x

$

______________

per sample

= $

0

•

samples x

$

______________

per sample

= $

0

3.

Groundwater

Analysis

Costs

-

This must be for

laboratory

analysis

only.

•

36 BTEX samples x

$

75.00

per sample

=

8

2,700.00

0 PNA

samples x

$

175.00

per sample

=

$

-

_____LUST Pollutants

samples x

$

per sample

$

0

_____

pH Samples

x

$_____________

per sample

= $

0

_____

Lab and/or

Field Blank samples

x

$

per sample

=

$

0

_____

Flash Point samples

x

$

per sample

= $

0

36 Total Lead

samples x

$

20.00

Per sample

=

$

720.00

_________________________

samples

x

$

______________

Per sample

=

$

-

___________________________

samples

x

$

_______________

Per sample

=

$

-

___________________________

~amp1es x

$

_______________

Per sample

=

$

-

___________________________

samples x

$

_______________

Per sample

= $

0

___________________________

samples

x

$

_______________

Per sample

= $

0

TOTAL

ANALYSIS

COSTS

~3,420.00

F-2 (2)

This form must be submitted

in duplicate.

---

I

IEMA No.

00-0692

G.

PERSONNEL

QUARTERLY GW MONITORING

All personnel costs that are not included elsewhere in the budget/billing

form must be listed here.

Cos

be listed per task, not personnel type.

The following are some examples of tasks: Drafting, data collecti

plan, report,

or budget preparation

fo GW Rem.

(i.e., site classification work plan, 45 day report,

or

I

pribrity corrective action budget),

sampling,

field oversite for

__________

(i.e., drilling/well installatio

corrective action, or

earlyaction),

of maintenance

Sorento G~.The above list is not inclusive

of all

possible tasks.

Environmental Engineer

32

hours x

$

105.00

per hour

=

$

3,360.00

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly M

Senior

Env. Engineer

0

hours

x

$

115.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly M

Senior

Env. Geologist

4

hours x

$

92.00

per hour

=

$

368.00

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly M

General Project Manager

0

hours x

$

100.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Drilling/MW Install,

Post-Remediation QuarterlyM

Env. Project Geologist

32

hours x

$

81.00

per hour

=

$

2,592.00

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remed.iation Quarterly M

Env. Project Scientist

0

hours x

$

81.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly M

Engineering Technican

.

0

hours x

$

55.00

per houx

=

$

-

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly M

Laborer

0

hours

x

$

40.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly M

G-ld(2)

.

This form must be submitted in duplicate.

---

I

IEMA

No.

00-0692

•

G.

PERSONNEL

QUARTERLY

GW

MONITORING

All personnel

costs

that

are not included elsewhere in the budget/billing

form must be listed here.

Costs must

be

listed per task, notpersonnel

type.

The following are

some examples of tasks: Drafting, data collection,

plan,

report,

or

budget

preparation for

GW

Rem.

(i.e.,

site classification

work plan,

45

day report, or high

priority corrective action budget),

sampling,

field oversite for

_____________

(i.e., drilling/well

installation,

corrective action, or early action), of maintenance of

Sorento

Ga

.

The above list is not inclusive

of all

possible tasks.

Technical

Editor

0

hours

x

8

55.00

per hour

=

8

-

(Title)

Task to be performed for the above

hours:

Drilling/MW

Install, Post-Remediation Quarterly M

Draftsman

0

hours x

$

65.00

per

hour

=

8

-

(Title)

Task to be performed for

the above hours:

Drilling/MW

Install, Post-Remediation Quarterly

M

Technical

Coordinator

0

hours x

$

65.00

per hour

=

$

-

(Title)

Task to be performedfor the above hours:

Drilling/MW

Install, Post-Remediation Quarterly NI

Administrative

Assistant

2

hours

x

S

45.00

per hour

=

$

90.00

(Title)

Task to be performedfor

the

above hours:

Drilling/MW Install, Post-Remediation Quarterly M

Office Manager

0

hours x

$

40.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly M

Principal

0

hours

x

$

130.00

per hour

=

$

-

(Title)

Task to be performed for the

above hours:

Drilling/MW Install, Post-Remediation Quarterly M

Field Supervisor/Coordinator

0

hours

x

$

110.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Drilling/MW Install, Post-Remediation Quarterly lvi

Wastewater

Ti-t’mt.

Operator

0

hours

x

$

100.00

per hour

=

$

-

(Title)

Task to be performed for the

above hours:

Drilling/MW

Install, Post-Remediation QuarterlyM

G-le(2)

This form

must

be submitted

in duplicate.

---

IEMA No.

00-0692

G.

PERSONNEL

QUARTERLY GW REPORTING

All personr~el

costs that are not included elsewhere in the budget/billing

form must be listed here.

Cos

be listed per

task, not personnel type. The following

are some examples of tasks: Drafting, data collecti

plan, report,

or

budget preparation

fo Quart. Rept

(i.e., site classification work plan, 45 day report,

or

I

priority

corrective action budget), sampling, field oversite for___________

(i.e., drilling/well installatia

corrective action, or early action),

of maintenance

Sorento G~.The above list is

not inclusive

of all

possible tasks.

Environmental Engineer

20

hours

x

$

105.00

per hour

=

$

2,100.00

(Title)

Task to be performed for the above hours:

Protect/Data Management, Quarterly Reporting

Senior

Env. Engineer

8

hours

x

$

115.00

per hour

=

$

920.00

(Title)

Task to be performed for the above hours:

Project/Data Management, Quarterly Reporting

Senior Env. Geologist

0

hours

x

$

92.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Project/Data Ivlanagement, Quarterly

Reporting

General Project Manager

4

hours

x

$

100.00

per hour

=

$

400.00

(Title)

Task to be performed for the

above hours:

Project/Data Management, Quarterly Reporting

Env. ProjectGeologist

0

hours

x

$

81.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Prolect/Data Management, Quarterly Reporting

Env. Project Scientist

.

0

hours

x

$

81.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Project/Data Management, Quarterly Reporting

Engineering Technican

0

hours

x

$

55.00

per hour

=

$

-.

-

(Title)

Task to be performed for the above hours:

Project/Data Management, Quarterly Reporting

Laborer

,

0

hours

x

$

40.00

per hour

=

$

-

(Title)

Task to be performed

for the above hours:

Project/Data Management, Quarterly Reporting

G-lh(2)

This form must be submitted in duplicate.

---

IEMA No.

00-0692

Technical Editor

0

hours

x

$

55.00

per hour

=

$

$

-

(Title)

Task to be performed for

the

above

hours:

Project/Data

Management,

Quarterly

Reporting

Draftsman

10

hours

x

$

65.00

per hour

=

$

$

650.00

(Title)

Task to be performed for the above hours:

.

Project/Data Management,

Quarterly Reporting

Technical Coordinator

0

hours

x

$

65.00

per hour

=

$

$

-

(Title)

Task to be performed for the above hours:

Project/Data Management, Quarterly Reporting

Administrative

Assistant

20

hours x

5

45.00

per hour

=

$

$

900.00

~11t1e)

Task to be performed for the above hours:

Project/Data Management, QuarterlyReporting

Office Manager

0

hours

x

$

40.00

per hour

=

$

$

-

(Title)

Task to be performed for

the

above hours:

Project/Data Management,

Quarterly Reporting

Principal

0

hours

x

$

130.00

per hour

=

$

$

-

(Title)

Task to be performed for the

above hours:

Project/Data Management, Quarterly Reporting

Field Supervisor/Coordinator

0

hours

x

$

110.00

per hour

=

$

$

-

(Title)

Task to be performed for the above hours:

Project/Data Management, Quarterly Reporting~

Wastewater

Trtmt. Operator

0

hours

x

$

100.00

per hour

=

$

$

-

(Title)

Task to be performed

for the above hours:

Project/Data Management, Quarterly Reporting

hours

x

_________

per hour

=

$

$

-

(Title)

Task to be performed foi~the above hours:

__________________

TOTAL PERSONNEL COSTS:

$

11,380.00

G-2(2)

This form must be submitted in duplicate.

---

IEMA No.

00-0692

H.

EQUIPMENT COSTS

GW REMEDIATION

All equipment used must be listed below in a time and materials

format.

Handling

charges should not

added here; use Section

J.

Equipment

Own or

Rent

Time

Used

Units

Unit Rate

Total

Cost/Item

Groundwater

Treatment

Unit (includes t’raile Rent

0

/mnth

$

2,070.00

$

-

surge

tank,

oil/water

separator,

shallow tray

0

air stripper,

vent pipes, air compressor/blower

0

holding

tank,

effluent pump, particulate filter,

0

initial set carbon filters, sampling tank,

-

0

autodialer, lights, exhaust fans and climate

0

control)

0

PID Rental

Rent

1.0 /day

$

125.00

$

125.00

Survey Equipment Rental

Rent

1.0

/day

$

65.00

$

65.00

Water

Level Indicator

Rent

3.0

/day

$

21.00

$

63.00

Measuring

WheelRental

•

Rent

1.0

/day

$

15.00

$

15.00

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

I

0

T

H-1(2)

Total Page

H.-1

$

268.00

This form must be submitted

in duplicate

---

IEMA No.

00-0692

I.

FIELD

PURCHASES AND OTHER COSTS

GW MONITORING

-

All equipment used must be listed below in a time and materials format.

Handling

charges should not

be

added here; use Section

J.

Field Purchases

Quantity

Item

Price/Item

Total Cost

Handling

Charges

Color Copies

0 /each

$

1.25

$

-

yes

Carbon-Filter Purchase

0

/each

$

600.00

$

-

yes

Manifests

0

/each

$

1.00

$

-

yes

Truck Liner

-

0

/each

$

4.00

$

-

yes

Bailers

54

/each

$

12.00

$

648.00

yes

Film

1

leach

$

6.00

$

6.00

yes

Photo Development

& Copies

1 /each

$

15.00

5

15.O0~yes

Injection Point Installation

0.0

/each

$

500.00

$

-

yes

Postage

-

5

40.00

yes

Drums

0

/each

$

50.00

$

-

yes

Permit Fees

0

/each

$

100.00

$

-

yes

Subcontractors

Sand Backfffl

0.00 /ton

$

5.00

$

-

yes

Aggregate Backfill

0.00 /ton

$

11.25

$

-

yes

Septic Gravel Backfill

0.00 /ton

$

7.75

$

-

yes

Concrete

0.00 Icy.

$

61.00

$

-

yes

Disposal Charge

0.00 /ton

$

20.00

$

-

yes

Trackhoe

0.00

/hour

$

145.00

$

-

yes

Backhoe

0.00

/hour

$

95.00

5

-

yes

Trucking Charge (10 c.y.)

0.00

/hour

$

65.00

$

-

yes

End Loader

0.00 /hour

$

95.00

$

-

yes

Trucking Charge

(15 c.y.)

•

0.00

/hour

$

85.00

$

-

yes

Baker Tank

0.00

/month

$

1,200.00

$

-

yes

Electrician

0.00

/hour

$

40.00

$

-

yes

Electrician Mileage

0.00

/mile

$

0.37

$

-

yes

Plumber/Inspector

0.00

/hour

$

45.00

$

-

yes

Plumber Mileage

0.00

/mile

$

0.37

$

-

yes

Carbon Filter Disposal

0 /each

$

1,000.00

$

-

yes

Electricity

•

0

/mo.

$

200.00

$

-

-

yes

Sewer Disposal

Charge

-‘

0

/gal.

0.001

$

-

yes

Recovery Sump Installation

0

/each

$

2,500.00

$

-

yes

Recovery Sump Closure

0

/each

$

1,200.00

$

-

yes

Monitoring Well Closure

0

/each

$

350.00

$

-

yes

Telephone Line Installation

0

/each

$

150.00

$

-

yes

Telephone Line (autodialer)

0

/month

$

30.00

$

-

yes

Recovery Well Installation

0

/each

$

800.00

$

-

yes

Recovery Well Closure

0

/each

$

400.00

$

-

yes

Drilling (15 ft. wells)

105

/ft.

$

20.00

$

2,100.00

yes

MW Installation

(replacement)

7

/each

$

450.00

$

3,150.00

yes

Drill Rig Mobilization

1

/each

$

260.00

$

260.00

yes

$

r

1-1

(2)

Subtotal Page

1-1

$

6,219.00

This form must be submitted

in duplicate

---

IEMA 00-0692

I

GW MONITORING

Other Costs

-

A listing and

description of

all- other costs which wifi be/were incurred

and are not specifically

listed on this form should be attached.

The listing

should include a costbreakdown in a

time and materials

format.

-

Other

Costs

No.

Rate

Cost

Copies

550.0

5

0.10

/each

$

55.00

Mileage for C.W3M trips

1380.0

$

0.37

/each

$

510.60

Per Diem

‘

0.0

$

36.00

/day

$

-

GWTUMobi.lizationtoSit

0.0

$

350.00

/each

$

-

Maintenance Cost

•

0.0

$

50.00

/month

$

-

Total

Other

$

565.60

*Number of Trips

3 trips each at

150

miles/trip

for Environmental Engineer

(1 forMW replacement, 2 for Quarterly Monitoring)

3

tips

each

at

310

miles/trip

-

for Environmental Project G~oiogist

(1 for

MW replacement,

2 for Quarterly Monitorii~g)

TOTAL OTHER

COSTS

=

$

565.60

Total (Pages

1-1 and 1-2)

$

6,784.60

1-2

(2)

*

This form must be submitted in

duplicate

---

IEMA No.

00-0692

J.

HANDLING

CHARGES

QUARTERLY REPORTING/BIO-TRENCH

Handling charges are eligible for payment on subcontractor

billings

and/or field purchases

only if they

equal to or less

than the

amounts

determined by

the following table:

Subcontractor

or Field

Purchase Cost

$1

-

$5,000

$5,001

-

$15,000

$15,001

-

$50,000

$50,001

-

$100,000

$100,001

-

$1,000,000

Eligible Handling

Charges as

a

Percentage of Cost

12

$600

+

10

of amt. Over $5,000

$1,600

+

8

of amt. Over $15,000

$4,400

+

5

of amt. Over $50,000

$6,900

+

2

of amt. Over $100,000

A.

Subcontractor Charges

Subcontractor

Section where cost

is listed

Subcontract Amount

Laboratory Analysis

F-2(2)

$

3,420.00

Sand Backfill

1-1(2)

$

-

Aggregate Backfill

1-1(2)

$

-

Septic Gravel Backfill

1-1(2)

$

-

Concrete

1-1(2)

$

-

Disposal Charge

1-1(2)

$

-

Trackhoe

1-1(2)

$

-

Backhoe

1-1(2)

$

-

Trucking Charge

(10

c.y.)

.

1-1(2)

$

-

End Loader

1-1(2)

$

-

Trucking Charge (15

c.y.)

1-1(2)

$

-

Baker Tank

1-1(2)

-

$

-

Electrician

1-1(2)

$

-

Electrician Mileage

1-1(2)

$

-

Plumber/Inspector

1-1(2)

$

-

Plumber Mileage

-

1-1(2)

$

-

Carbon Filter Disposal

•

1-1(2)

$

-

Electricity

1-1(2)

$

Sewer Disposal Charge

1-1(2)

$

-

Recovery Sump Installation

1-1(2)

$

-

Recovery Sump Closure

1-1(2)

$

-

Monitoring Well Closure

1-1(2)

$

-

Telephone Line Installation

1-1(2)

$

-

Telephone Line (autodialer)

•

1-1(2)

$

-

Recovery Well Installation

1-1(2)

$

-

Recovery Well Closure

•

1-1(2)

$

-

Telephone Line

(autodialer)

1-1(2)

$

-

Drilling (15 ft. wells)

1-1(2)

$

2,100.00

MW Installation

(replacement)

1-1(2)

$

3,150.00

Drill Rig Mobilization

1-1(2)

$

260.00

Injection Point Installation

1-1(2)

$

-

j-1(2)

Subtotal 1-1 Subtotal:

$

8,930.00

This form must

be submitted

in duplicate

---

IEMA No.

00-0692

QUARTERLY REPORTING

/

BIO’-TRENCH

Subtotal Page 1-2:

$

709.00

Subtotal of Pages J-1 and 1-2:

$

9,639.00

Handling Charge’

See Handling Charge Total

*

Use

chart at

top

ofPage J-1 to calculate the allowable handling charge.

Copies of invoices for subconmict~rcosts and receipts for field purchases are required for billing submissions

J-2(2)

B.

Field Purchase

•

Field Purchase

Field Purchase Amount

Color Copies

-

-

$

-

Carbon Filter Purchase

$

-

Manifests

-

Truck Liner

$

-

Bailers

$

648.00

Film

$

6.00

Photo Development & Copies

-

$

15.00

Postage

$

40.00

Drums

-

•

$

-

Permit Fees

$

-

This form must be submitted

in duplicate

---

IEMA No.

00-0692

F.

ANALYSIS COSTS

EXCAVATION

AND

DISPOSAL

1.

Physical Soil Analysis

-

This

must

only include

analysis

costs for

classification

of

soil types at the

Moisture Content samples

x

$

______________

per sample

=

$

______________

Soil Classification samples

x

$

______________

per

sample

=

$

Indicate method to be performed:

______________________________

_____

Soil Particle Size samples

x

$

______________

per sample

=

$

______________

____

Ex-situ Hydraulic Conductivity/Permeability

samples

x

$

•

per sample

$

___________

Indicate method

to be performed:

-

_____________________________

____

Rock Hydraulic Conductivity/Permeability samples

x

$

___________

per

sample

$

Natural Organic CarbonFraction (foc) swnples

x

$

______________

per sample

=

$

Indicate the ASTM or SW-846 method

to be performed:

__________________

_______________________

samples x

$

______________

per sample

= $

0

________________________ samples x

$

-

per sample

=

$

0

_______________________

samples x $

______________

per sample

= $

0

________________________ samples x

$

_______________

per sample

=

$

0

•

samples x

$

_______________

per

sample

=

$

0

2.

Soil Analysis

Costs

-

This

must be for laboratory

analysis

only.

21

BTEX samples

x

$

75.00

per sample

=

$

1,575.00

0 PNA samples

x

$

175.00

per sample

=

$

-

_____LUST Pollutants samples

x

$

per sample

=

$

-

-

-

F-l(3)

This form must be submitted

in

duplicate

0

0

-

0

0

0

0

I

---

_____pHSamples x

$

per sample

= $

0

_____

Paint

Filtersamples

x

$

per sample

= $

0

21 TCLP © samples x

85.00

per sample

= $

1,785.00

_____

Flash Point samples x$

per sample

= $

0

_____

Lab and/or Field Bank samples

x

$

-

per sample

=

$

-

1 Waste Characterizatior

samples x

$

400.00

per sample

=

$

400.00

____________________

samples x

$

______________

per sample

= $

-

_________________________ samples x

$

______________

per sample

=

$

-

_________________________ samples x

$

______________

per sample

=

$

-

________________________

samples x

$

_____________

per sample

= $

-

3.

Groundwater Analysis

Costs

-

This must be for laboratory

analysis

only.

_____BTFX samples x

$

-

per sample

=

$

-

-

_____PNA samples x

$______________

per sample

= $

-

____LUST

Pollutants

samples x

$

per sample

‘$

0

_____

pH Samples

x

$

per sample

= $

0

_____Lab and/or FieldBlank samples x

$

per sample

=

$

______________

•

Flash Point samples

x

$

per sample

= $

0

-

_________________________

samples

x

$

______________

Per sample

=

$

0

_________________________

samples

x

$

______________

Per sample

=

$

0

samples

x

$

Per sample

= $

0

_________________________

samples

x

$

______________

Per sample

=

$

0

_________________________

samples

x

$

Per sample

= $

0

_________________________

samples

x

$

______________

Per sample

= $

0

TOTAL ANALYSIS

COSTS

4,180.00

F-2(3)

This form thust

be submitted in duplic-ate.

---

IEMA No.

00-0692

G.

PERSONNEL

EXCAVATION AND DISPOSAL

All personnel costs that are not included elsewhere in the budget/billing

form

must

be listed here.

Cos

be listed per task, not personnel type.

The following are some examples of tasks: Drafting, data collectic

plan, report, or budget preparation fa Excavation

(i.e., site classification work plan, 45 day report, or

I

priority

corrective

action budget), sampling, field oversite for

__________

(i.e., drilling/well installatia

corrective action, or early action),

of maintenance

i

Sorento G~.The above list is not inclusive

of all

possible tasks.

-

Environmental Engineer

288.00

hours

x

$

105.00

per hour

=

$

30,240.00

(Title)

Task to be performed for the above hours:

Excavation activities

Senior Env.

Engineer

-

hoursx

$

115.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Excavation activities

Senior

Env.

Geologist

-

hours

x

$

92.00

per hour

=

$

-

(Title)

Task to be performed for the

above hours:

Excavation activities

General Project Manager

-

hours

x

$

100.00

per hour

=

$

-

(Title)

-

Task to be performed for the above

hours:

Excavation activities

Env. Project Geologist

-

hours x

$

81.00

per hour

=

$

-

(Title)

-

Task to be performed for the above hours:

Excavation activities

Env. Project Scientist

-

hours

x

$

81.00

per hour

=

$

-

(Title)

-

Task to be performed for the above hours:

Excavation activities

Engineering Technican

288.00

hours x

$

55.00

per hour

=

$

15,840.00

(Title)

Task to be performed for the above hours:

Excavation activities

Laborer

-

hours x

$

40.00

per hour

=

$

(Title)-

Task to be performed for the above hours:

Excavation activities

G-1(3)

This form must be submitted in duplicate.

---

TOTAL PERSONNEL

COSTS:

$

77,760. 00-

-

G-2(3)

-

This form must be submi~tedin duplicate.

Technical

Editor

(Title)

Task to be performed for the above hours:

Draftsman

•

-

.

(Title)

Task to be performed-for the above hours:

Technical Coordinator

(Title)

Task to be performed

for the

above hours:

Administrative

Assistant

(1. ILIC)

Task to be performed for the

above hours:

Office Manager

(Title)

Task

to be performed

for the above hours:

Principal

(Title)

Task to be

performed for the above hours:

Field Supervisor/Coordinator

(Title)

Task to be performed for the above hours:

Wastewater Trtmt. Operator

(Title)

Task to be performed for the above hours:

Construction

Foreman

•

•

(Title)

IEMA No.

00-0692

0.00

hours

x

$

55.00

per hour

=

$

-

Excavation activities

0.00

hours

x

$

65.00

per hour

=

$

Excavation activities

0.00

hours

x

$

65.00

per hour

=

$

-

Excavation activities

0.00

hours

x

$

45.00

per hour

=

$

-

Excavation activities

0.00

hours

x

$

40.00

per hour

=

$

-

Excavation activities

0.00

hours

x

$

130.00

per hour

=

$

Excavation activities

288.00 hours x

$

110.00

per

hour

=

$

31,680.00

Excavation activities

0.00

hours x

$

100.00

per

hour

=

$

Excavation activities

0.00

hours x

$

65.00

per hour

Task to beperformed for the above

hours:

---

IEMA

No.

00-0692

•

H.

EQUIPMENT

COSTS

EXCAVATION AND DISPOSAL

-

All

equipment

used must be

listed below in

a time and materials format.

Handling

charges should not

added here; use Section

J.

H-1(3)

This form must be ~ubmitted

in duplicate

Total Page H-i

$

Equipment

Own or

Rent

fime Usec

Units

-

Unit Rate

Total

Cost/Item

$

•

0

0

0

0

0

0

•

0

0

0

0

0

.

0

0

0

•

0

0

0

-____

0

0

-

0

0

0

0

0

0

0

0

-

0

0

0

.

0

-

0

0

0

-

0

-

0

0

•

0

---

IEMA No.

00-0692

FIELD

PURCHASES AND OTHER

COSTS

EXCAVATION AND DISPOSAL

All

equipment

used must be listed below in a time and materials format.

Handling charges -should not be

added here; use Section

J.

-

Field Purchases

Quantity

Item

Price/Item

Total Cost

Handling

Charges

Color Copies

0

/each

$

1.25

$

-

yes

Carbon Filter Purchase

0

/each

$

600.00

$

-

yes

Manifests

-

530

/each

$

1.00

$

530.00

yes

Truck Liner

-

530 /each

$

4.00

$

2,120.00

yes

Bailers

0 /each

$

12.00

$

-

yes

Film

1 /each

$

6.00

$

6.00

yes

Photo Development & Copies

1 /each

$

15.00

$

15.00

yes

Encore Samplers

42 /each

$

•

10.00

$

420.00

yes

Postage

•

$

-

yes

Drums

0

/each

$

5000

$

-

yes

•

$

Subcontractors

$

-

UST Removal

0

/gallon

$

1.00

$

-

yes

Building

Demolition

•

0.00

L.S.

$

8,000.00

$

-

yes

Asbestos Inspection

0.00

/each

$

900.00

$

-

yes

Sand Backfill

-

0

/ton

$

5.00

$

-

yes

Aggregate Backfill

0 /ton

$

11.25

$

-

yes

Septic Gravel Backfill

0

/ton

$

7.75

$

•

-

yes

Concrete

0

/c.y.

$

61.00

$

•

-

yes

Disposal Charge

•

-

6,369.28

/ton

$

20.00

$127,385.50

yes

Trackhoe

230.00

/hour

$

145.00

$

33,350.00

yes

Backhoe

•

230.00

/hour

$

95.00

$

21,850.00

yes

Trucking Charge

(10 c.y.)

712.00

/hour

$

65.00

$

46,280.00

yes

End Loader

0

/hour

$

95.00

$

-

yes

Trucking Charge

(15 c.y.)

0

/hour

$

85.00

$

•

-

yes

Baker

Tank

0 /month

$

1,200.00

$

-

yes

Electrician

0

/hour

$

40.00

$

-

yes

Electrician Mileage

0

/mile

$

0.37

$

-

yes

Plumber/Inspector

0

/hour

$

45.00

$

-

yes

Plumber Mileage

0

/mile

$

0.37

$

-

yes

$

-

$

$

$

•

$

$

•

$

.

$

-

-

$

1-1

(3)

Subtotal Page I-I

$

231,956.50

This form must be submitted

in duplicate

---

IRMA

00-0692

-

EXCAVATION AND DISPOSAL

Other Costs

-

A

listing

and description

of all

other

costs

which wifi be/were incurred

and are not specifically

listed

on

this form should be attached.

The listing

should include

a cost breakdown in a time and materials

format.

Other

Costs

No.

Rate

Cost

Copies

•

-

0

$

0.10

/each

$

-

Mileage for CW3M trips

10800

$

0.37

/each

•

$

3,996.00

Per Diem

•

0

$

36.00-

/day

$

-

•

$•

-

$

Total Other

$

3,996.00

*Number ofTrips

48 trips at

24

trips at

150

miles

per trip for field crew

150 miles per trip for Environmental

Engineer

Total

(Pages

1-1 and 1-2)

1-2

(3)

I 5

235,952.50

I

I

*

TOTAL OTHER COSTS

=

$

3,996.00

This form must be

submitted in duplicate

---

IEMA

No.

00-0692

J.

-

HANDLING CHARGES

EXCAVATION AND DISPOSAL

Handling charges are eligible

for payment

on subcontractor billings and/or

field purchases

only if they

equal

to

or

less

than the amounts determined by the following table:

Subcontractor

or Field

Purchase Cost

$1

-

$5,000

$5,001

-

$15,000

$15,001

-

$50,000

$50,001

-

$100,000

$100,001

-

$1,000,000

Eligible Handling Charges

as a

Percentage of Cost

12

$600

±

10

of amt. Over$5,000

$1,600

+

8

of amt. Over

$15,000

$4,400

+

5

of amt. Over $50,000

$6,900

+

2

of

amt.

Over $100,000

J-1(3)

$233,045.50

A.

Subcontractor

Charges

Subcontractor

Section

where cost

is listed

SubcontractAmount

Laboratory Analysis

F-2(3)

$

4,180.00

UST Removal

1-1(3)

$

-

Building Demolition

-

1-1(3)

•

$

-

-

Asbestos Inspection

1-1(3)

-

$

-

Sand Backfill

1-1(3)

$

-

Aggregate Backfill

1-1(3)

•

$

-

Septic Gravel Backfffl

1-1(3)

$

-

Concrete

-

1-1(3)

$

-

Disposal

Charge

1-1(3)

$127,385

50

Trackhoe

1-1(3)

$

33,350.00

Backhoe

-

-

•

1-1(3)

$

21,850.00

Trucking Charge

(10 c.y.)

1-1(3)

$

46,280.00

End Loader

1-1(3)

5

-

Trucking Charge

(15 c.y.)

1-1(3)

$

-

Baker Tank

1-1(3)

-

$

-

-

Electrician

1-1(3)

$

-

-

Electrician Mileage

1-1(3)

$

-

Plumber/Inspector

1-1(3)

$

-

Plumber Mileage

1-1(3)

$

-

-

Subtotal

T-1 Subtotal:

This form must be submitted in

duplicate

---

B.

Field Purchase

EXCAVATION AND DISPOSAL

IEMA No.

00-0692

Subtotal Page 1-2:

$

3,091.00

L~ubtotalof Pages

J-1

andj-2:

$236,136.50

Handling Charge

See Handling

Charge Total

*

Use chartat top

of Page J-1

to

calculate the allowable handling

charge.

Copies of invoices for subconmictor

costs and receipts

for field purchases are required for billing submissions

J-2(3)

-

Field Purchase

Field Purchase Amount

Color Copies

$

-

Carbon Filter Purchase

$

-

Manifests

$

530.00

Truck Liner

-

$

2,120.00

Bailers

-

$

-

Film

$

6.00

Photo

Development & Copies

-

$

15.00

•

$

420.00

Postage

$

-

Drums

•

S

-

This form must

be submitted in duplicate

---

•

IEMA

No.

00-0692

G.

PERSONNEL

BACKFILL

All personnel costs that are not included elsewhere in

the budget/billing

form

must

be

listed here. Cos

be

Listed per task, not personnel type.

The following are some examples

oftasks: Drafting, data

collecti

plan, report, or budget preparation

fo Backfill

(i.e., site

classification work plan,

45 day report, or

I

priority

corrective

action

bud-get), sampling, field

oversite

for

__________

(i.e.,

drilling/well installatia

corrective action, or early action),

of maintenance

Sorento G~.The

above list

is

not inclusive of

all

possible tasks.

Environmental

Engineer

225.00

hours

x

$

105.00

per hour

=

$

23,625.00

(Title)

-

Task to be performed for the above hours:

Backfill activities

Senior Env. Engineer-

0.00

hours

x

$

115.00

per

hour

=

$

-

-

(Title)

-

Task

to be performed

for the above hours:

Backfffl activities

Senior Env. Geologist

0.00

hours

x

$

92.00

per hour

=

$

-

(Title)

Task to be performed for the above hours:

Backfill activities

General Project Manager

-

0.00

hours

x

$

100.00

per hour

=

$

(Title)

Task to be performed for the above hours:

Backfill activities

Env. Project Geologist

0.00

hours

x

$

81.00

per hour

=

$

-

(Title)

-

Task to be performed

for the above hours:

Backfill activities

Env. Project Scientist

.

0.00

hours

x

$

81.00

per hour

=

$

(Title)

Task to be performed for the above hours:

-

Backfill activities

-

Engineering Technican

225.00

hours x

$

55.00

per hour

=

$

12,375.00

(Title)

Task to be performed

for the above hours:

Backfill activities

Laborer

225.00

hours

x

$

40.00

per hour

=

$

9,000.00

(Title)

Task to be performed for the above hours:

Backfill activities

-

-

~

G-1(4)

This

form must be submitted in duplicate.

---

IEMA

No.

00-0692

Technical Editor

0.00

hours

x

$

55.00

per hour

=

$

_____________

(Title)

Task to be performed for the

above hours:

Backfill activities

Draftsman

0.00

hours

x

$

65.00

per hour

=

$

-

-

(Title)

-

Task to be performed

for the

above

hours:

Backfill activities

-

-

Technical Coordinator

0.00

hours

x

$

65.00

per hour

=

$

(Title)

Task to be performed for the

above hours:

Backfill activities

Administrative Assistant

0.00

hours

x

$

45.00

per

hour

=

$

I

1UC)

Task to be performed for the above hours:

Backfill activities

Office Manager

-

0.00 hours x

$

40.00

per hour

-=

$

-

(Title)

Task to be performed for the

above hours:

Backfill activities

Principal

0.00

hours

x

$

130.00

per hour

=

$

-

-

(Title)

Task to be performed

for the

above hours:

-

Backfill activities

Field Supervisor/Coordinator

225.00

hours

x

$

110.00

per hour

=

$

24,750.00

(Title)

‘

-

Task to be performed

for the

above hours:

Backfill activities

-

Wastewater Trtmt

Operator

0.00

hours

x

$

100.00

per hour

=

$

(Title)

-

-

Task to be performed

for the above hours:

Backfill activities

Construction Foreman

0.00

hours

x

$

65.00

per hour

=

$

(Title)

Task to be performed

for the

above hours:

TOTAL PERSONNEL COSTS:

$

69,750.00

G-2(4)

This form must be submitted

in duplicate.

---

IEMA No.

00-0692

H.

EQUIPMENT

COSTS

BACKFILL

-

All equipment used must be listed below in a time and materials format.

Handling charges should not

added here; use Sectionj.

1

Own

or

1

Equipment

J

Rent

Time Use

Units

Unit Rate

Total

Cost/Item

-

-

0

0

0

0

0

0

0

0

0

0

0

0

0

-__________________

0

0

0

0

0

0

0

0

0

-

0

0

0

0

0

0

0

0

0

0

0

0

Q

0

0

.

0

0

-

Total Page H-I.

$

H-1(4)

This form must be submitted

in duplicate

---

-

-

—

IEMA

No.

00-0692

I.

--

FIELD PURCHASES

AND OTHER COSTS

BACKFILL

All equipment used must be listed below in a time and materials format.

Handling charges should not be

added here; use Section

J.

-

Field Purchases

Quantity

Item

Price/Item

Total Cost

Handling

Charges

Color Copies

0

/each

$

1.25

$

-

yes

Carbon Filter Purchase

0

/each

$

600.00

$

-

yes

Manifests

0

/each

$

1.00

$

-

yes

Truck Liner

0

/each

$

4.00

$

-

yes

Bailers

0

/each

$

12.00

$

-

yes

Film

-

0

/each

$

6.00

$

-

yes

Photo Development & Copies

0

/each

$

15.00

$

-

yes

$

-

yes

Postage

-

$

-

yes

Drums

-

0

/~ach

$

50.00

$

-

-

yes

$

Subcontractors

$

-

Sand Backfill

6,313.89 /ton

$

5.00

$

31,569.45

yes

Aggregate Backfill

346.16 /ton

$

11.25

$

3,894.26

yes

Septic Gravel Backfill

0.00 /ton

$

7.75

$

-

yes

Concrete

0.00

/c.y.

$

61.00

$

-

-

yes

Disposal Charge

0.00

/ton

$

20.00

$

-

yes

-

Trackhoe

0.00

/hour

$

145.00

$

-

yes

Backhoe

240.00 /hour

$

95.00

$

22,800.00

yes

Trucking Charge (10 c.y.)

960.00

/hour

5

65.00

$

62,400.00

yes

End Loader

0.00 /hour

$

95.00

$

-

yes

Trucking Charge

(15

c.y.)

0.00

/hour

$

85.00

$

-

yes

Baker Tank

-

0.00

/month

$

1,200.00

$

-

yes

Electrician

-

0.00 /hour

$

40.00

$

-

yes

Electrician Mileage

0.00

/mile

$

0.37

$

-

yes

Plumber/Inspector

-

0.00

/hour

$

45.00

$

-

yes

Plumber Mileage

0.00

/mile

$

0.37

$

-

yes

Drill Rig Mobilization

0 /each

$

260.00

$

-

yes

Replacement MW Install. 25ft

0

/each

$

550.00

$

-

yes

$

$

$

$

-

$

$

$

-

-

$

-

$

Subtotal Page 1-1

5

120,663.71

-I-I.

(4)

This form must be submitted in duplicate

---

IEMA 00-0692

-

BACKFILL

Other Costs

-

A

listing and description

of all other costs

which will be/were

incurred and are not specifically

listed on

this form should be

attached.

The listing should include

a cost breakdown in a

time

and materials

format.

Other Costs

-

No.

Rate

Cost

Copies

0.00

5

0.10

/each

$

-

Mileage for CW3M

trips

11,400.00

$

0.37

/each

$

4,218.00

Per Diem

-

-

0.00

$

36.00

/day

$

-

$

$

Total Other

$

4,218.00

*Number of Trips

57 trips at

150

miles per

trip for field crew

19 trips at

150

miles per trip for Environmental Engineer

-

-

TOTAL

OTHER COSTS

=

$

$

4,218.00

ITotal (Pages I-i

and 1-2)

I

S

124,881.71

1

1-2 (4)

This form must be submitted

in

duplicate

---

IEMA

No.

00-0692

J.

HANDLING CHARGES

BACKFILL

Handling charges are eligible

for

payment

on subcontractor

billings and/or field purchases

only if they

equal to

or less

than the amounts

determined by

the following table:

Subcontractor

or Field

Purchase

Cost

$1

-

$5,000

$5,001

-

$15,000

$15,001

-

$50,000

$50,001

-

$100,000

$100,001

-

$1,000,000

Eligible Handling Charges as a

Percentage of Cost

12

$600

+

10

of amt.

Over $5,000

$1,600

+

8

of amt. Over $15,000

$4,400

±

5

of

amt.

Over $50,000

$6,900

+

2

of

amt.

Over $100,000

A.

Subcontractor

Charges

-

Subcontractor

Section where cost

is listed

-

-

Subcontract Amount

Sand

Backfill

1-1(4)

$

31,569.45

Aggregate Backfill

1-1(4)

$

3,894.26

Septic Gravel

Backfill

-

1-1(4)

$

-

Concrete

1-1(4)

$

-

Disposal Charge

-

1-1(4)

$

-

Trackhoe

1-1(4)

-

$

-

Backhoe

1-1(4)

$

22,800.00

Trucking Charge

(10 c.y.)

1-1(4)

-

$

62,400.00

End Loader

1-1(4)

$

-

Trucking Charge

(15 c.y.)

1-1(4)

$

-

Baker Tank

1-1(4)

$

-

Electrician

1-1(4)

$

-

Electrician Mileage

1-1(4)

$

-

-

Plumber/ Inspector

1-1(4)

$

-

Plumber Mileage

1-1(4)

$

-

Drill Rig Mobilization

1-1(4)

-

$

-

ReplacementMW

Install. 2Sft

1-1(4)

$

-

J-1(4)

Subtotal J-1 Subtotal:

$120,663.71

This form must be submitted in duplicate

---

00-0692

Subtotal Page 1-2:

$

Subtotal of Pages J-1

and 1-2:

$

120,663.71

Handling

Charge

See Handling

Charge Totai

*

Use chart at top

of Page J-1

to calculate

the allowable handling charge.

Copies of invoices

for subcontractor costs and receipts for field purchases are required for billing submissions

J-2(4)

B.

Field Purchase

BACKFILL

Carbon Filter Purchase

IEMANo.

Manifests

-

Field Purchase

Field Purchase

Amount

Truck Liner

Color Copies

$

-

Ballers

-

-

Film

-

$

Photo Development & Copies

-

Postage

$

Drums

$

$

$

$

$

$

$

This form must be submitted in duplicate

---

IEMA

No.

00-0692

G.

PERSONNEL

REIMBURSEMENT PREPARATION

All

personnel

costs

that

are not included elsewhere in the budget/billing

form

must

be listed here.

Costs mas

be listed per task, not personnel type.

The following are some examples of tasks: Drafting, data collection,

plan, report,

or budget preparation for

Reimb~

(i.e., site classification work plan, 45 day report,

or high

priority corrective action budget), sampling,

field oversite for

___________

(i.e.,

drilling/well installation,

corrective action, or early action),

of maintenance

Sorento G~.The above list is not inclusive

of all

possible tasks.

Environmental Engineer

4.25

hours

x

$

105.00

per hour

=

$