| - ‘~a ILLINOIS ENVIRONMENTAL PROTECTION AGENCY
- # Technical Cut (12,926.90)
- Author: Kevin Mably Personal Phone: (217) 785-1235
- Document Required By: ASAP Letterhead Phone: (217) 782-6762
- Attachment AAccounting Deductions
- Document # Page #0007A 62
- Number Information
- 1) LPC# 1898115003--Washington
- Okawville/Kruep-Rocky’s 66 DaLee Oil Co.
- Rt. 177 West
- LUST Incident # 923466
- $7.43 Total Accounting Deductions$ 12,926.90 Total Technical Deductions
- $ 12,934.33 Total Deductions
- So,n~
- ~o22.O5
- /792~~?
- Fax: (618) 735-2907
- E-Mail: unitedscience@unitedscience.com
- UNDERGROUND STORAGE TANK FUND
- OWNER OR OPERATOR BILLING CERTIFICATION
- Illinois Environmental Protection Agency
- Request for TaxpayerIdentification Number and Certification
- 923464
- PRIVATE INSURANCE AFFIDAVIT
- 217/782-6762
- 923466
- 923465
- ,C°32
- TOTAL PAYMENT REQUESTED
- UNDERGROUND STORAGE TANK PROGRAM
- SUBCONTRACTORS
- (1039
- Illinois Environmental Protection Agency
- PAYMENT ITEM TOTAL PAYMENT REQUESTED
- 6,529.19
- TOTAL PAYMENT REQUESTED
- Woodlawn, IL 62898Phone: (618) 735-2411
- Fax: (618) 735-2907
- INVOICE
- Equipment Charges $ 3965.00
- Stock Item Charges $ 38.60
- Field Purchases $ 808.34
- Woodlawn, IL 62898 o04o
- Illinois Environmental Protection Agency
- UNDERGROUND STORAGE TANK PROGRAM
- REQUEST FOR PAYMENT OF liST CORRECTIVE ACTION COSTS
- UND~ROROUND STORAGE TANK PROGRAM
- Illinois Environmental Protection Agency
- EmployeeTypeofWork Performed
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEET
- EQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
- BILLING SUMMARY
- Balance Brought Forward
- YOUR ENERGY USE
- BULLETIN BOARD
- ELECTRIC SERVICE
- PAYMENT ITEM TOTAL PAYMENT REQUESTED
- Woodlawn, IL 62898Phone: (618) 735-2411 Fax: (618) 735-2907
- Stock Item Charges $ 0.00
- Field Purchases $ 549.27
- Illinois Environmental Protection Agency
- UNDERGROUNDSTORAGE TANK PROGRAM
- REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
- 65.00 65.00
- Illinois Environmental Protection Agency
- Employee Type of Work Performed
- SUN MON TUES WED THURS FRI SATTOTAL HOURS
- Illinois Environmental Protection Agency
- THURS FRI SAT TOTAL HOURS
- Emplayee Type of Work Performed
- Incident No:923466
- UNDERGROUND STORAGE TANK PROGRAM
- FIELD PURCHASES
- $ 5.98496.40
- YOUR ENERGY USE
- BULLETIN BOARD
- ELECTRIC SERVICE
- Illinois Environmental Protection Agency
- PAYMENT ITEM
- TOTAL PAYMENT REQUESTED
- INVOICE
- Illinois Environmental Protection Agency
- TI-fURS
- TOTAL HOURS
- Illinois Environmental Protection Agency
- Incident No:923466UNDERGROUND STORAGE TANK PROGRAM
- TOTAL AMOUNT DUE TO ILLINOIS POWER after 07-23-02
- IllinoisEnvironmental Protection Agency
- PAYMENT ITEM
- TOTAL PAYMENT REQUESTED
- TOTAL PAYMENT REQUESTED
- INVOICE
-
- Illinois Environmental Protection Agency
- Illinois Environmental Protection Agency
- illinois Environmental Protection Agency
- Employee Type of Work Performed at ot at ot st ot at ot at ot at ot at ot at ot
-
- Equipment Used Time Used *Unit Rate Total Cost
- ROCKY’S GROUNDWATER 1.00 MONTH 3750.00 3,750.0?
- WEEKLY WORK SHEETEQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
-
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- Illinois Environmental Protection Agency
- FIELD PURCHASES
- TOTAL AMOUNT DUE TO ILLINOIS POWERTOTAL AMOUNT DUE TO ILLINOIS POWER
- BY:~____
-
- Illinois Environmental Protection Agency
- PAYMENT ITEM
- INVOICE
- Illinois Environmental Protection Agency
- 28.50
- MON TUES WED THURS FRI SAT TOTAL HOURS
- Illinois Environmental Protection Agency
- Illinois Environmental Protection Agency
- Illinois Environmental Protection Agency
- Protection Agency
- SUN MON TUES WED TI-IURS FRI SAT TOTAL HOURS
- Illinois Environmental Protection Agency
- Equipment Used Time Used *jJ~j~ Rate Total Cost
- ROCKY’S GROUNDWATER 1.00 MONTH 3750.00 3,750.0(
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- Date:
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- Illinois Environmental Protection Agency
- FIELD PURCHASES
- BILLING SUMMARY
- 923466
- ILLINOIS POWER
- $495.60
- Previous Balance os~.~~1; $Payment Posted 04-16-02 ~Balance Brought Forward $
- PAYMENT ITEM TOTAL PAYMENT REQUESTED
- United Science Industries, Inc.
- INVOICE
- Personnel Charges $ 2,747.50
- Stock Item Charges $ 0.00
- Field Purchases $ 1,813.69
- Illinois Environmental Protection Agency
- Total Personnel 2747.50(
- Illinois Environmental Protection Agency
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
- Illinois Environmental Protection Agency
- SUN MON TIJES WED THURS FRI SAT TOTAL HOURS
-
- Equipment Used Time Used *Unit Rate Total Cost
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORKSHEETEQUIPMENT
- UNDERGROUND STORAGETANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
- EQUIPMENT
- FIELD PURCHASES
- TOTAL AMOUNT DUE TO ILLINOISTOTAL AMOUNT DUE TO ILLINOIS
- AVERAGES FORPERIOD
- 01-27
- INVOICE
- ATTN: Bill Parr
- Field Purchases $ 839.42
- 21.00 95.00
- Total Personnel 35.25~ I
- Illinois Environmental Protection Agency
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
-
- SUN MON TIJES WED THURS FRI SAT TOTAL HOURS
- Illinois Environmental Protection Agency
- Illinois Environmental Protection Agency
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
- EQUIPMENT
- Equipment Used Time Used *unit Rate Total Cost
- UNDERGROUND STORAGE TANK PROGRAM
-
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEET
- EQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEET
- EQUIPMENT
- FIELD PURCHASES
- 749.48
- $89.94.839.42
- BILLING SUMMARY
- Account Number:
- Previous Balance 02-Payment Posted 02-2Balance Brought Forward $
- AVERAGES FORBILLING PERIOD
- BULLETIN BOARD
- *BWNGRNG nssAUTOss 3-DIGIT 628*01B7676130817476*
- UNITED SCIENCE INDUSTRIES 79P0 BOX 360
- WOODLAWN XL 62898-0360
- P.O. Box 2522
- Decatur, Xl 62525-2522
- 654.48
- 654.48664.30
- ILLINOIS POWER
- ELECTRIC SERVICE
- 9913788566
- 24.000 kw
- PAYMENT ITEM TOTAL PAYMENT REQUESTED
- TOTAL PAYMENT REQUESTED
- Illinois Environmental Protection Agency
- Total Personnel
- 2893.00’
- 162.50
-
- Illinois Environmental Protection AgencyUNDERGROUND STORAGE TANK PROGRAM
- FRI SAT TOTAL HOURS
- Employee Type of Work Performed
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
- Equipment Used Time Used *Unit Rate Total Cost
- REMEDIATION UTILITY VEHICLE 1.00 DAY 60.00 60.01
- ROCKY’S GROUNDWATER 1.00 MONTH 3750.00 3,750.01
- UNOERGROUNO STORAGE TANK PROGRAM
- WEEKLY WORK SHEET
- EQUIPMENT
- WEEKLY WORK SHEETEQUIPMENT
-
- WEEKLY WORK SHEETEQUIPMENT
- FIELD PURCHASES
- Subcontract of FieldPurchase Cost
- 100.00
- YOUR ENERGY USE
- BULLETIN BOARD
- WOODLAWN XL 62898-0360
- 509.78
- ITEM TOTAL PAYMENT REQUESTED
- TOTAL PAYMENT REQUESTED
- INVOICE
- Personnel Charges $ 4250.00
- Equipment Charges $ 3,840.00
- Illinois Environmental Protection Agency
- Illinois,Environmental Protection Agency
- Employee Type of Work Performed st ot st ot et ot st ot st ot et ot st ot st ot
- UNDERGROUND STORAGE TANK PROGRAM
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
- Illinois Environmental Protection Agency
- Illinois Environmental Protection Agency
- UNDERGROUND STORAGE TANK PROGRAM
-
- Illinois Environmental Protection Agency
- Illinois Environmental Protection Agency
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEET
- EQUIPMENT
- WEEKLY WORK SHEETEQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- Illinois Environmental Protection Agency
- FIELD PURCHASES
- -BILLING SUMMARY
- Total Current ChargesPrevious Balance 12-04-01
- AVERAGES FORBILLING PERIOD
- Illinois Environmental Protection Agency
- PAYMENT ITEM TOTAL PAYMENT REQUESTED
- United Science Industries, Inc.
- Equipment Charges $ 3,860.00
- Stock Item Charges $ 20.00
- Field Purchases $ 422.23
- uue V
- Illinois Environmental Protection Agency
- Illinois Envkonmental Protection Agency
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
- Illinois Environmental Protection Agency
- Illinois Environmental Protection Agency
- SUN MON TUES WED THURS FRI SAT TOTAL HOURS
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- UNDERGROUND STORAGE TANK PROGRAM
- WEEKLY WORK SHEETEQUIPMENT
- WEEKLY WORK SHEETEQUIPMENT
- Illinois Environmental Protection Agency
- STOCK ITEMS
- FIELD PURCHASES
- 62271BY:
- ELECTRIC SERVICE
- ~19~O
|
BEFORE
THE
POLLUTION
CONTROL BOARD
OF
THE
STATE OF ILLINOIS
WED
CLERK’S
OPFJCE
IJALEE
OIL
COMPANY,
V.
Petitioner,
ILLINOIS ENVIRONMENTAL
PROTECTION AGENCY,
Respondent.
)
)
)
PCBNo. 03-150
)
(USTAppeal)
)
)
NOTICE
JUL
182003
STATE OF ILLINOIS
Pollution
Control Board
Dorothy M. Gunu, Clerk
Illinois Pollution ControlBoard
James R.
Thompson Center
100 West Randolph Street
Suite
11-500
Chicago, IL 60601
Carol Sudman,
Hearing Officer
Illinois Pollution Control Board
600 South Second Street
Suite 402
Curtis W. Martin
Shaw & Martin, P.C.
123
South Tenth Street
Suite 302
P.O.
Box
1789
Mt. Vernon, IL 62864
Chicago, IL
62704
PLEASE
TAKE
NOTICE that
I have
today
filed
with
the
office
ofthe
Clerk of the
Pollution
Control Board a MOTION FOR LEAVE
TO
FILE
INSTANTER THE ADMINISTRATWE RECORD
and ADMINISTRATIVE RECORD, copies ofwhich
are
herewith served upon you.
Respectfully submitted,
ILLINOIS ENVIRONMENTAL PROTECTION AGENCY,
Respondent
Special Assistant Attorney General
Division ofLegal counsel
1021 North Grand Avenue, East
P.O.
Box
19276
Springfield, Illinois 62794-9276
217/782-5544
217/782-9143 (TDD)
Dated: July
17, 2003
Assistant Counsel
‘~a
ILLINOIS
ENVIRONMENTAL
PROTECTION AGENCY
1021
NORTH
GRAND AVENUE EAST,
P.O.
Box
19276,
SPRINGFIELD,
ILLINOIS
62794-9276
JAMES
R.
THOMPSON
CENTER,
100
WEST
RANDOLPH,
Surrt
11-300,
CHICAGO,
IL
60601
ROD
R.
BLAGOSEVICH,
GOVERNOR
RENEE
CIPRIANO,
DIRECTOR
217/782-6762
-
CERTIFIED MAIL
FEB
0
5
7~~3
Dalee Oil Company
Attention:
Ronald Kruep
201
Hanover Street
Okawville, IL
62271
Re:
LPC #1898115003
--Washington County
Okawville/Kruep-Rocky’s
66
(Dalee Oil
Co.)
Route
177
West
LUST Incident #923466
LUST FISCAL FILE
Dear
Mr.
Kruep:
The Agency has completed the review of the request for reimbursement of corrective action
costs
from the Illinois Underground Storage Tank Fund
for
the above-referenced facility.
The invoices
reviewed covered the period from November
1,
2001
to August 3-1. 2002.
The amount requested
was
$75,555.27.
The deductible amount for this claim
is
$ 15.000.00.
which
was previously deducted
from
the
Invoice Voucher dated January
3.
1997.
Listed
in Attachment
A are the costs
which ar~not
being reimbursed from this request
and
the reasons these costs are
not
beinu reimbursed.
On October
18,
2002,
the
Agency received your complete request for payment for this
claim.
As
a result of the Agency’s review
of
this
claim,
a
voucher
for $62,620.94 will
be prepared for
submission
to
the
Comptroller’s Office for payment
as
funds
become available
based upon
the
date the Agency received your complete request for payment of this claim.
Subsequent claims
that have heenlare submitted
will
be processed
based
upon
tile
date complete subsequent
billings
requests
are received by
the Agency.
This constitutes
the Agency’s
final action
\Vith regard
to
tlie
above
invoices,
An
undergrulllld
storage tank owner or operator may appeal
this
linal
decision
to the
Illinois
PollulitlIl (onirol
Board
(Board)
pursuant to
Section
22.
1
8b(g)
und
Section 40
ui’ the
Act
by
Ii 1mg a petition
br
a
hearing within
35
days after
the
date of issuance othc
final
decision.
However,
the 35-day
period
may be
extended
for
a period
oftinie
not to
exceed 90
days
by
written
notice from
the
owner or operator
and the
Illinois EPA within
the
initial
35—day appeal period.
lfthe~wneror
ROcKC,
4aQz
Nqrtb Main Street, Rockiord,
IL 61103— (815)987-7760
•
Ots
PEAINIS—951
I
W. Harrison
SI
Des
Plaines,
IL
60016— (1547t
244-4000
a
~
-
595 South Sole,
Elgin,
IL
60123
—
(847) 608-31 31
•
Peoria
—
5415
N
University SI, Peoria,
IL 6614
—
(309) 693-5461
BLREAL!
if
Lai~o
-
Pa
RIA
—
7620
N
UnIverliIy
St.,
Peoria,
IL
61614
—
(309) 693-5462
•
CH,xu~puN
—
2125 Soulh
First
Street, Char,ipaigi
(
12)71
2711-5800
Srei.’,c,
inn
—
4500
S. Sixth
SIred
Rd.,
Springfletd,
IL
62706
—
(21
7)
7(16-6092
•
COLLJNSV,lu
—
2009 MaO
SIred,
Co((insvi))u,
IL
(‘2
1
,
46-5
120
—
2
309 W
Main
St.,
Suite
116,
Marion.
IL
62959
—(618) 993-7200
PtINI
Ii)
IN
RICYLLFD
P
-‘ire
Page
2
operator wishes
to receive a
90-day extension,
a written request
that includes
a statement of the
date the final decision was received, along with a copy
of this decision, must be
sent to
the
Illinois EPA as soon as possible.
For information regarding the filing of an
appeal,
please contact:
Dorothy Gunn,
Clerk
Illinois Pollution
Control
Board
State of Illinois Center
100
West Randolph,
Suite
11-500
Chicago, Illinois 60601
312/814-3620
For information regarding the filing
of an extension, please contact:
-
-
-.
Illinois
Environmental Protection
Agency
Division of Legal
Counsel
1021
North Grand Avenue East
Springfield,
Illinois
62794-9276
217/782-5544
If you
have
any
questions, please contact
Kevin
Mably of my staff
or
Brian Batter of Harry
Chappel’s staff at 217/782-6762.
Doug~tE.Oakley, Manager
LUST Claims
Unit
Planning
& Reporting
Section
Bureau of Land
DEO:KM:jk\033386.doc
Attachment
cc:
United Science
Industries
bce:
Division File
LCU
File
Kevin Mably
Brian Bauer
0002
Attachment A
Accounting Deductions
Re:
LPC #1898115003
--Washington County
Okawville/Kruep-Rocky’s
66 (Dalee Oil
Co.)
Route
177 West
LUST Incident #923466
LUST FISCAL FILE
Item #
Description of Deductions
$7.43,
deduction in costs that the owner/operator failed to demonstrate were
reasonable (Section 22.18b(d)(4)(C) ofthe Environmental
Protection Act),
United Science Industries-Invoice #18-9188
Late charge and handling-IL
Power
$7.43 Total Accounting Deductions
$12,926.90 Total Teclmical Deductions
$12,934.33
Total
Deductions
DEO:KM:jk\033386.doc
0003
-
OLD PROGRAM PAYMENT
SUMMARY
Reviewer:
Kevin Mably
Incident: #
923466
Initial
Review Date:
1/16/03
Queue:
10/18/02
Billing
Period:
11/1/01
to
8/31/02
Site
Name:
OkawvillefKruep-Rock~s
66 DaLee Oil Co.
PM:
Hale
Amount Requested:
$75,555.27
SUB TOTAL:
-
$75,555.27
Less:
STANDARD
DEDUCTIBLE:
(Met
1-3-97 Voucher)
Less:
DEDUCTIONS:
-
18
(7.43)
#
Technical Cut
(12,926.90)
SUMMARY
DATE:
ORIGINAL
Q-DATE:
Total
Amount
Due:
$62,620.94
Payee:
FYI
Facility:
Address:
Address:
City:
_______________________________
City:
County:
-
County:
TO:
Word
Processing
Center
-
#1
Div
-
Sec
-
LCU
Mail Code
-
#24
Author:
Kevin Mably
Personal Phone:
(217) 785-1235
Document Required
By:
ASAP
Letterhead Phone:
(217) 782-6762
Circle Choices:
Letterhead
Plain Paper
Envelope
Mailing
Label
Attachment A
Accounting Deductions
Document #
Page #
0007A
62
Variable
-
Number
Information
1)
LPC#
1898115003--Washington
Okawville/Kruep-Rocky’s
66 DaLee
Oil
Co.
Rt.
177 West
LUST Incident #
923466
LUST /
FISCAL
PILE
2)
#18
7.43
United Science Industries-Invoice #
18-9188
Late charge
and
handling-IL Power
$7.43
Total Accounting Deductions
$ 12,926.90
Total Technical Deductions
$ 12,934.33
Total Deductions
000s
-,
OLD PROGRAM
(Section 731)
TO:
Doug Oakley
Initial Review Date:
1/16/03
FROM:
Kevin Mably
Project Manager: Hale
Sent to Tech:
LPC
II &
County:
1898115003--Washington
Site City & Name:
Okawville/Kruep-Rocky’s
66 DaLee Oil Co.
Site Address:
Rt.
177 West
LUST Incident #
923466
LUST / FISCAL FILE
The above referencedfacility’s consultants/contractors submission regarding invoices and billings has been reviewed.
The consultant/contractor in
this billing package
is:
United Science Industries
-
Queue:
10/18/02
IEMA:
12/4/92
OSFM:
Revised
Q:
________________
Tank Pull:
_______________
Planned:
Not Planned:
Eligible Tanks:
-
The Billing Period for this claim bovers:
11/1/01
to
8/31/02
The Amount Requested in this billing package is:
$75,555.27
The Deductible Applied to this billing package is:
(Met 1-3-97 Voucher)
MANDATORY DOCUMENTS:
X
1.
Owner / Operator Billing Certification
2.
Professional Engineer’s Certification
3.
Proof ofPayment of Deductible Amount
X
4.
Minority
I
Women’s Business Enterprise Form
X
5.
Federal Taxpayer Identification Number Form.
X
6.
Private Insurance Coverage Forms.
The
costs have been deemed reasonable based upon established standards, practices and procedures with the
following exceptions:
#18
$7.43
United Science
Industries
$7.43
Total Deductions
(Sent to Tech. 1-16-03)
This review does not take into consideration thefollowing issues:
1)
The legitimacy or
validity
ofthe site rem
ediation
activities;
2)
Whether or notplans for corrective action were submitted or approved by the Agency pursuant to
Sefli~z
8b(d)(4)(E) and
22.1 Sb(d)(4) (F) of theEnvironmental ProtectionAct;
3) Ifthere are
any reports, technical data, or infèhWa
in support ofthis
claim.
QUEUE
DATE TRACKING
SHEET
LUST CLAIMS
UNIT
INCIDENT!
QUEUEDATE
)O-)SHp~
12ODAYDATE_______
SITE NAME
__________________________________________
OWNER/OPERATOR
__________________________________
REQUESTED AMOUNT
.fl
t7
‘351
9’7
TITLE 16 CODE
________________________________
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r
~
e;~
~
OOIt
Attachment A
Technical Deductions
Re:
LPC #1898115003
--
Washington County
Okaville
I
Rocky’s 66 (DaLee Oil Co.)
Route
177 West
LUST Incident No.
923466
LUST FISCAL FILE
Item #
Description of Deductions
1.
$12,926.90, deduction in costs that the owner/operator failed to
demonstrate were
reasonable (Section 22.18b(d)(4)(C) of the Environmental Protection Act).
2.
The Illinois
EPA has reviewed the lease agreement for equipment being used at the
above-referenced site and has determined that
a maximum of 16 month(s) of additional
lease payments at a rate of
$2,457.31
would be eligible
for
reimbursement.
-
Any
requests for reimbursement of lease fees beyond 36 month(s) will not be eligible for
reimbursement.
The illinois EPA considers these costs unreasonable (Section
22.18b(d)(4)(C) of the Environmental Protection Act).
BPB\
0(97
P.O.
Box 360
6295
East Illinois Highway
15
Woodlawn,
Illinois
62898-0360
October 16, 2002
Dear Mr. Bauer:
I
UNITED
SCIENCE
INDUSTRIES
W”
Phone:
(618J 735-2411
Fax: (618)
735-2907
E-Mail:
unitedscience@unitedscience.com
Mr. Brian Bauer
Illinois Environmental Protection Agency
L.U.S.T.
Reimbursement Section
#24
1021
North Grand Avenue East
-
P.O. Box
19276
Springfield,
IL
62794-9276
U.S.!.
Project No.
1894176
RE:
LUST
Reimbursement Package
—
Kruep-Rockv’s 66.
Washington County,
Incident
Number
923466.
Site
Number
189811503:
November
1.
2001
through
September
30.
2002.
Please
find
enclosed
three
reimbursement
packages
with
eng)neering
certifications,
owner/operator
billing
certification,
insurance
forms,
taxpayer
identification
forms,
personnel/equipment
breakdown
and
the
IEPA
letters
showing
the
deductible
determination and
approval ofthe work for the above referenced site.
**PI~e
find
2
previous
disallowed
packages
included
with
the
$75,555.27
claim
request.
Please re-review
for further reimbursement
as
per your request.
Should you have
any questions, please
do
not hesitate
to
call
our office
at (618)
735-2411.
UNiTED SCIENCE INDUSTRIES,
NC.
ía
RECEiVED
OCT
18
2002
iEPA/b
OL
nptst
Sincerely,
ü~
~a4oã
Project Coordinator
Enclosures
Cc: Lisa Watson
Illinois
Environmental Protection Agency
923466
UNDERGROUND STORAGE TANK FUND
OWNER OR
OPERATOR
BILLING CERTIFICATION
I, Ronatd Kruep,
the
Owner,
Operator, or duly authorized
representative thereof,
of Kruep-Rocky’s
66
Leaking
Underground
Storage Tank site,
do herby
certify
under
penalty
of law, that the bills and the supporting documentation attached
hereto for
the sum of
of $75,555.27 work
performed
at said Leaking Underground Storage Tank
site for the
period
November
1.
2001 through September
30. 2002 further
certify that
this billing and
aU attachments
thereto were prepared under my dfrection or supervision in accordance with a system designed to assure
that qualified personnel properly gathered and evaluated the information submitted therein.
I affirm that
the information
is, to the best of my knowledge and
belief,
true,
accurate
and complete and the costs for
rernediating
said
Leaking Underground
Storage Tank site are correct and reasonable.
Such affirmation
is
made under penalty of perjury
as defined
in Section 32.2 of the Criminal Code of
1961,
III.
Rev.
Stat.
1991,
ch.
38,
par. 32.2.
I am aware that there
are significant penalties
for submitting false information,
including the possibility of fine and imprisonment for knowingly committing v~oIations.
923466
Owner
—~
/
-
~‘P4cJ.~\~
This agency is
authorized
to request this informatEon under the Illinois
EnvFronmental
Protection
Act,
415
ILCS 5/I et seq
(formedy
Ill
Rev.
Stat
Chill
1/2,
1001
et
seq.).
Disojosure of this informadon
s
required.
FaUure toproperly
comp~ete
hs
loon n ts en3rety
may
resut
in the da~av
or
denial
ot any
paymeni
reiuested hereunder
This form
has been
approved
by the Forms Management Centsr.
IL
532
2099
LPC
463
Rev.
Mar-93
REeF WED
-
OCT
is
2002
REP~
/bOL
0019
6
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
PROFESSIONAL ENGINEER CERTIFICATION FORM
I
(USE WHERE WORK PLAN APPROVED BY (EPA)
923466
The work associated with the attached
claim(s) for Payment of Corrective Action
Costs was per-
formed
in
accordance with
a work plan approved by the illinois EPA.
I
certify under penalties
of law,
based on my inquiry of the person or persons who
gathered the information
or managed the systems for
gathering the information, that the information submitted
s, to the best of my
know!edge
and belief, true
accurate,
arid compete.
I am aware that there are sign~ficantpenalties for submitting false information,
inokiding the possibility of fine
and frnprisonment for
Irnowing violations.
KtwrL-Rockv’s66
This cerUficafion applies to work conducted,
as represented by the
from
11/01/2001
through
08/31/2002
attached
claim(s),
•,,i.tflh,,.
Ill,,,
F.
:4o43o.t.~
S
:
REGISTERED
•
:
PROFESSIONA
ENGINEER
*
OF
•.
¾
t
,t•~
C
“Sian spit’”
Note:
Original
signature
and
seal
required.
IL 532
1889
LPC
368
Rev. Mar-93
I ~1rs
agency Is
autriorizod to request
ui’s
ritormallon unaer me
ilNnois Envrranmental
Protect,on ACt, 4th
LUS b/I et seq.
(formerly
1$
Nev.
Stat
Uti
111
112,
1UUI
81
Seq.l.
UiseIosure 0! tIlls
flTo’matiOn
9 required.
-alIure
to properly oomplote Ellis
Form
n ~S
ent~rety
may result
ri
the
delay
or denial
01 any payment
Tequesleo nereun~er.
nis torn, nas
been
approvea
oy me !-orms Management center.
OCT
182002
PM9M9L
P.E.
SEAL
Name:
IL.
Reg. #
Date:
e
(Please Print)
&~(
ç~3icnature)
(n~.-O
1t0*3O
‘°/~8/Q2
P.E.
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Illinois
Environmental
Protection Agency
923466
The
IEPA is required to report State and
Federal funds paid to Women’s Business Enterprises
(WBE)
and
to
Minority
Business
Enterprises
(MBE).
Therefore, please
provide the required information for all
Prime Consultants/Contractors and Subcontractors
used to perform the work for this billing:
Name of LUST site:
Kruep
-
Rocky’s 66
The worK forthis
billing was performed from:
1110112001
Incident
No.:
To
923466
09/30/2002
Prime Consukants and/or Contractors:
Billing Subtotal
$
Subcontractors:
73,66O~27
I
I
~
~
~
~
~•)
,
‘(f
.3~
••i~
~
.
1
~-)
1
+
+
+
+
+
+
+
4-
his ton,,
(si~,1
..
~uuced
ifspace is not sufficient to include all
Subcontractors
used on
this billing.
This agency
s
auft~onzed
to
request
thEs nfomiaton under the
!lllno~sEnvfronniental Protection
Act,
415
ILCS
5/1
et
seq. (formerly
Ill
Rev.
Stat Ch iii
1/2,1001
et seq.).
Disclosure
of ft,is
information
s
requfred.
Failure
to
properly
complete this
form
In
to
entirsty may
result In the
delay or denia!
of any payment
requested
hereutider,
This
(tm
Ms beer, approved by the
Forms Mtrta~ement
Conter,
PP2I
FIRM’S
NAME,
ADDRESS, AND
TELEPHONE NO.
IS THIS
FIRM
A WBE/MBE?
IF YES,
WHAT
IS THEIR
STATE
OF ILLINOIS
VENDOR NUMBER?
AMOUNT PAID
OR
DUE
THIS
BILLING
United Science
Industries, Inc.
P.O.
Box 360
Woodlawn,
IL
62898
No
.
$
73~66O.27
Environmental Science
Corp.
No
$
100.00
Environmental Science Corp.
No
$
1,695.00
Environmental $cience Corp.
No
$
100.00
1)??
4
/
$$
a WBE,
place
the term WBE in
the
space
provided.
If the
fIrm
s a
MBE,
rn MBE
in
the
space provided.
If the firm
is
neither a WBE
nor MBE,
lid
NO
in
the space provided.
75,555.27
IL
532
2167
LPC
481
Mar-93
Federal Taxpayer identification Number and
Legal Status
Disclosure Certification
Requirements
923466
in order to
comply with requirements mandated by Interna! Revenue SeMce Rutes and Regulations, the tank owner/operator
must complete the section entitled TAXPAYER IDENTIHCATION NUMBER AND
LEGAL STATUS DISCLOSURE
CERTIF)CATION below.
Enter your taxpayer identification
number (TIN)
in
the appropriate space.
For individuals
and sole proprietors,
this
is your
social
security number.
For other entities, it is your employer identification number.
Federal Employer Identification
Numbers
(FEINJs) must
not be used for so’e proprietorships.
If you
do not have a
TIN,
apply forone imrnediat&y.
To apply, get Form SS-5, Appflcation for a Social Security Number Card
(for individuals) from your local office of the
Social Security administration,
or Form SS-4, Appucation for Employer
Identification Number (for businesses
and
all other
eritlUes), from your )ocal Internal Revenue
Service office.
To complete the certification
if
you do not have TIN, fill out the certification indicating that
a TIN
has been applied for, sign
and
date the form,
and return
it to
this Agency.
As
soon as you receive
your TIN,
(IV out another such form including your TIN,
sign
and date the form,
and send it to this Agency.
If you fail to furnish your correct TiN to this Agency, you
are subjectto
an
IRS penalty of $50.00 for each such failure unless
your failure is due
to reasonable cause and
not to wiUful neglect.
WiLLFULLY FALSWYING CERTIF~CAT~ONS
OR AFFIRMATIONS MAY SUBJECT YOU TO CRtMINAL PENALTIES
INCLUDING
FINES AND/OR IMPRISONMENT.
Please return the completed form to the Bureau of Land,
Remedial
Projects, Accounting
&
Procurement Unit1
P.O.
Box 19276,
Springfield,
IL
62794-9276.
TAXPAYER IDENTIFICATION
t~tUMSERAND LEGAL STATUS DISCLOSURE
CERTIFiCATION.
Under penafties of perjury,
I
certify that the
FEIN or Social Security Number indicated below is my correct Federal Taxpayer
dentification Number.
I
am
doing business as
a (please check one):
DaLee
Oil Companv-Okawville
Name of
Firm (Please Print or
Type)
Real Estate Agent
Not-for-Profit Corp.
Medical & Health
Care
Services
Provider Corp.
Note:
Original
Signature
Required.
this agency is
authorized
(0 request
(his
nforrnatiDn
under the
Pl!ino~sEnvironmenIa~Prôteot~onAct,
415
ILCS 5/1 et seq.
(formerly ill
Rev.
Stat
Ch
111
1/2.
1001 e
‘
sure of
h~s
information
s
requfred.
Failure
to
properly
complete
this
form
ri
its
entirety
may
resu!(
in
he deray
or
denial of
any
payment requested
hereunder.
This form
has
been approve
anagemerit
Center.
IL
532 1687
LPC 367
Rev. Mar-93
______
Individual
_____
Partnership
)‘(
Corporation
______
Trust or Estate
37~C5i
_____
Sole Proprietorship
______
Governmental Entity
_____
Tax Exempt Organization
(IRC 501(a)
Taxpayer Identification Number
4a?7-cs--t
/1,
Date
Request
for Taxpayer
Identification
Number
and
Certification
NetTle
(See
Speciñc
Instruc0ons
on page
24
\
I
(3,2/”
C1-n’~u
ausiness nan*
if
diueent
from above. IStt
Spcviric
In,truc6ons øa
page
24
ChSCk
.pp~i,pñ.ts
bc~
)InaMduauSoIe
prupfiewc
~orpnti~n
0
P.ri,w
0
DEfIer I
AaQress
(rRmter, ~n.t
—
apt
suite
no,j
Requnw’z name
inc iflu
(cpcion.Q
.!
2-o4
,‘
pcva,ç,.
a.
~
..
.~ 2iP cod
~
4i--*
.
I
Tapayer
Identification
Number
(TINt.
..
List
a~:ou~
nUmbedsj hca ~pCUsfl
Enir
your
TIN
Wi
th~
appropflatt
box. For
______________________
‘J~ç~e~id~
fwter:~
(SSN). Hdvávsr,
for
a t!Side1!~
a~efl,
sale
.
______
-
prnjdatuctr
disregarded
entity.
Len
the P?L.
_____
j,stnsctions
on pagc
2.
Fat cOw
enUdes. It
Is
your
____
emp1oy&
~trIc81ion
~nber
(EIN~.
W
~w
do
net
or
flaw a
number.
see
How to get
a
TIN
on
page
2.
~~IS7lIEI-~~Ceniflcationli
-
£lnp~oytr
identiflcnion
numba
-.
1.
The
nombgr:sbowl1~ofl$tIi5
termS
my correct.
pt~sUS!c8JionrA3mbec
‘(cc
I
era w~dng
for a number to be issued
to me).
emd
a
lam
not
iisbjiã(L
ii&dpcsftnifolafrig.betause:(a)
lam
exeinpi
from
b3ckup withho!dThg.
Or
(b)
I
have
not
Deennctil~ed-by
the
lntgrnal
Revenue Sen4ce
(iRS)
that
I am sthbject
to
badkup
.~ithol5ing
as ~ rcsuic of a Iaikrc
to topaz
aN inenst
or
dividends, o
bt) the
IRS has
nodfiS
me
that
am no longer
sut~4eato b~acupwinding.
—~
3.
1am aU.S.perSOrI (inchid ing
•
tJ.s:.’res~dentauenJ~—
Certilication
kntructiuns.
You
must
cross
out
kern
2
above
if you
have
been
notified
by the
IRS
that
)vu are
cuTenuy
subject to
backup
withholding because
you
have
(ailed to
report
aH
interest
and
dividends
on
your
tax
return.
For
real estate
transactions.
ke.n
2 does
not apply.
Ear m0a989e
interest
paid.
acquisWon
or abenaonmenc of
secureø properly,
cancellation or debt.
tonrriLwtions
to
an
Individuel
retfrg.n.nt
arrangement
(IRAJ.
end
ges~øafly.payments ouw
than busiest
and dividends, you ar~no
regufre4
to sign
the
CaliflcatJat
biu you
must
pnMde
your cna
TIN.
(S
ucdons on
Sign
s~n
Here
us.
ptrso~~
____
Purpose of Form
A
peson who is
required to
flue
~
Certain
pa me~ to you
must
withhold
and
pay
Co the
IRS
31
of
sud,
ps)werlc5 under
cer*ain
re9.Jm wftti
the
IRS
muSt
gel Your
COTeC*
conditions.
This S
caaed
backup wiflthoIding.
tazpayet identThcflicfl nwnbec (TIN)
tO
mpoa.
tcr
Payments that
may
be
wt~1eato
D&wp
exanp~e.incoryn paC tc
you;-(eaI ts(att
,
--
t!~~!9IdW~
include
interat.
aividends broker
transactions. mott9age Wrest
~
and
baiter nt
i~ai~~&ii~iz.
TtIt,
acq’isitiOfl
o
abandonment
of secu,ed
groptfly.
rayiftits
nonemp4Oyte
pay. trid
ctnsln
cancellation
at
debt
cc contributions you tnaøa
‘~
afltt1~ftrfisbirtgboaropnton.-Real
to an
IRA.
.....
.
—.
.
--estate
tfOnSaCtOflS are
nOL
SI*CL
to
backup
_._
Penalties
Use
Farm
W.9
only if
yOU
StE
a U.S.
~P~I~sOfl
Withholding.
Failn to Junish TIN. If
~tu
faIl 10 (uiiish yott
(iflcIudin9
a residcln
allert
Cc’
g~yoUr cO~~ct
if
you gin
the requestac
your correct
TIN.
contct uN to a
requeger, you at sth~ett
W a
TIN Ia the
pEisOl~
telueStiflg~
iUu!~
14R
*StW)~...rnakethe
pope
ei~ficfl~ns~sn4flpcn
aSl
-
~
~
~
anc,
when appliceble, to:
~‘
~
CSX2bIS
ThCreSt
and ~eM5
0(1 3IOLS
~
taflin ~s
mu
to
iüsor~b4e~au~a
end
“a
In
1. CtniVy the
TIN
you
&e
giving is correct
jar
-----retail.
paymerflsyou
receWs will •no~
tie
~
nognt
you
are
waking for
a
numt’e,
to
be
issued).
CO
Dackup
withholding.
Payments
you
receive
wW
be subject to becki~,
wfthholding if:
2.
You do
mt
ceitfy
yaw
TIN
wren requied
(seQ
me
Pan III
insrfucriDns
on
page
?
for
-details), or
if
you
are
a
Foreign person.
use
the
apprcpfiate
Forni
W4.
See Pit.
~
the
Ftquest?c that
yøu
-
For~9n
Corporations.
&‘rnithe~
art
incoaec(
TIN.
C~vU
penalty foR
falseIntormaijon wth respect
to
withholdin9. Ii you
make
m
fNs~
statement
~.._wtthnasenac3sbIQ,bai LV$SJ!!~*Ii!’
‘~
baclciç wiU~ho1dhQ.
you
are sut~ect
W
a
$500
Cat.
No. 10231X
Frm
W-9
iRsy.
12-2O~)
~O23
Farm
jR~v.
December 2WO)
b.p.nN
dn
T.nny
inc~R.wrue
~!
Give form to the
rcquesta~
Do not
send to
the
IRS.
Notet
K tht .ccasw ~
In
jflae
(flail
Doe flame,
see
me
chart on
page
2
for gj,hielines
on
whose nurnbe
roenre&
~FT141I
FcrUSPayeesEscmptFSm
Backup W*talding ISa the
instructions on
page
2.)
S.
You do
notcel~to the reqta~*c
that you.
are not
sitjtct
to baawp wthhowing urtdec 4
aboQe
~or
r.pcnable
Intscesz
and
digloend
stcowt
opened Site
1383 on(y~.
Cenahi payees and paymet
we exempt
tram
baclcup withholding.
Sea
the
Part
It
instuctions
slid
the separate
Insttuctiotis
(or
the
Requesterci Pmni
W4.
2. Cv~t~fy
you
sit
noc
subjea to backup
3.
C)airr e’emplion from backup v4thholthng ~
reqoeteic
or
you
nI
U.S. nenpt
payee.
i. You
do not tun~sh
your
TIN to
me
Note:
It
a
EtQLJeSt&
ghtSFMJ
(01177
O(P)e’
then
form
W-9 to request
yoti’
IN,
yOu
IflOSt
use
the
cequeS(CKS ftm~
Ilk
is swbstPflJai/y semi/ar
to
Fc’~,,W~9.
4. The
IRS
ISIs you rbn
you
are
subject to
backup
withholding
beCausG
you
oid
n~t~
a~Iyour i~.enst
and th~eidends
On
your
tn
reutn
(for
reponabk
ntnst
and
vid&dz
cnty). or
Crirninai penalty for falsifying kdocnwAian.
wiaftt~,
(e$Ilying
cqcttcations of VVInTWtIOflS
mrj
SLI
Ct ~OU
to
ctiminat pftn&It
ind~ing
fines and/cr
imp.lsor.mwfl.
Misust at
tINs~
t( the tequeSW aisdoses or
uses
tiNs In
violation of FeaGral
iaw,
the
reque4ter
may be sut~ectto civil
and
o*T*m
penaldes.
98261
UNDERGROUN)
STORAGE
TANK
PROGRAM
Private Insurance
Coverage
Questionnaire and Affidavit
923466
This form must be completed
in full
by all owners/operators or their authorized
representatives,
that have a
claim
for payment from
the State of Illinois
Leaking Underground Storage Tank
(LUST) program, for the
labor, materials.
overhead and profit costs related to
the study and/or remediation of
a LUST
site.
Name
and Address of the LUST site:
DaLee Oil Company.
Rt.
177
West. Okawvilie. IL
62271
2.
Name of insurance company providing coverage for this
LUST site:
tALES
3.
Amount
of coverage provided:
$..NL&
4.
Have you or your firm filed
a claim against your insurance company for this
LUST site?
YES
(NO)
4a.
If yes, how much and when?
$
N/A
Date:
N/A
4b.
If
no, exp’ain why,
$ N/A
Have you or your firm
received payment for
a claim against your insurance company for this LUST site?
YES
(P40)
If yes,
Date:
bow much and when?
NIA
$
N/A
5b.
If
no, explain why,
$ N/A
6.
Arc
you going to
file
a claim against your insurance
policy?
6a,
If yes, how much and when?
$ N/A
Date:
NLA
—
-
YES
(NO)
6b.
If no, explain
why,
$ N/A
nfornlalion
s
required.
Fa~ure
to properly
comp’ete this
form
n its
entErety
may resurt
in
ho
delay or deniat
of any
payment
requested
hereunder.
ThÉs
form has
been approved by
the Forms
Management Center.
1L5321817
LPC
324
Rev. Mar-93
923464
PRIVATE
INSURANCE AFFIDAVIT
I,
Ronald Krueo.
a duly authorized representative of the
DaLee
Oil Company
hereby certify that
the DaLee
Oil Company.
does not have
private
insurance coverage for all
or
part
of costs retated to claim
payment
of study
arid\or remediation
costs for work performed
at the
DaLee Oil
Comnany,
located at
Rt. 177 West. Okawvil$e. IL
62271
(Job
site address)
Ronald Kruep
a duly authorized representative of
the
DaLee Oil Company verify that as of this
date
the
above information
is accurate and complete.
Furthermore,
I also agree to reimburse the
Illinois
EPA
fo
any overpayment made by my private
insurance company in
excess of the deductible amount for each
site
s ig
Date:______________________________
Subscribed
and sworn to before me this
day of
_________
2002.
c~4A&~
~
(Uo-z4~
(Notary Public)
My commission expires
~
/
(p
20
0(0
OFFICIAL
SEAL
Note:
original signatures and Notary Public seal required.
iFS
agency is
aunorrzec
0 reque&
1)18
inTOfma~,OflUfloer
ne Illinois tnvilonmencai
i-ioieC(iotl
#~CI,410
iu.,b b/I O~
seq. flolmeny
II
I-tot
b’at t~n
111
lIZ.
1uU~e~
~q.j.
thsciosure bi
mIs
inlormm4on
is
requtreo,
Failure
0
properiy compiece
In’s rorrn
Fl
flS
eflhirely may resthl
nine
aeiayOr aerilal or any
pay,nenc
requeslea nereunoer.
TIES
,orm
nas
Deen appro~ea
Dy ~nO
I-oTlts TQlanagemem
L.enieT.
IL
532 2008
LPC 419
Rev.
Mar-93
0025
//7Y/4~
&
~‘/.
~ufr’.
/
I
~,
ILLINOIS
ENVIRONMENTAL
PROTECTION
AGENCY
c~pç~
1021
NORTH
GRAND AVENUE
EAST,
P.O.
Box
19276,
SPRINGFIELD, ILLINOIS
62794-9276
-
THOMAS
V.
SKINNER, DIRECTOR
217/782-6762
OtT26~W
•
~OPy
Kruep--Roclcys 66
Atm:
Ron
Kruep
201 Hanover
Okawville, Illinois
62271
Re:
LPC #1898 115003
--Washington County
Okawville/KiIlions
66
203
Elm Street
LUST Incident #923466
LUST FISCAL FILE
Dear Mr. Kruep:
The Agency has completed the review ofthe request for reimbursement of corrective action costs
from the Illinois Underground Storage Tank Fund for the above-referenced facility.
The invoices
reviewed covered the period from May
1, 2000 to May 31, 2000.
The amount requested was
$45,292.13.
The deductible amount for this
claim
is
$15,000.00,
which was previously deducted from the
Invoice Voucher dated January 3,
1997.
On July
11,
2000, the Agency received your complete request for payment for this
claim.
As
a
result
of
the Agency’s review of this claim, a voucher for $45,29213
will be
prepared for
submission to
the Comptrollers Office for payment if funds become available based upon
the
date the Agency received your complete request for payment of this
claim.
Subsequent claims
that have been/are submitted will
be processed based upon the date complete subsequent
billings
requests
are received by the Agency.
This constitutes the Agency’s final action with regard to
the above invoices.
An underground
storage tank owner or operator may appeal this decision to the I~Iinois
Pollution Control Board
(Board) pursuant to
Section 22.lBb(g)
and Section 40 of the Illinois Environmental Protection
Act.
An owner or operator who seeks to
appeal
the Agency decision shall file a petition for a
hearing before the Board within 35
calendar days of the date of mailing of the
Agency’s final
decision (35 Iii.
Adm.
Code
105. 102(a)(2)).
GEORGE
H.
RYAN.
GoVERNOR
PgINTED Or1
RECYCLED
PAPER
923466
Page 2
For information regarding the filing of an appeal,
please contact:
Dorothy Guirn, Clerk
Illinois Pollution
Control Board
State of Illinois
Center
100 West Randolph, Suite
11-500
Chicago, Illinois 60601
312/814-3620
For information
re,garding the filing of an extension, please contact:
Illinois Environmental Protection
Agency
Division of
Legal Counsel
1021 North
Grand Avenue East
Springfield,
Illinois
62794-9276
217/782-5544
If you have any questions, please contact Barbara Settecase of my staff at 217/782-6762.
Since
y,
DcxugMs B.
Oakley, Manager
LUST Claims Unit
Planning & Reporting
Section
Bureau of Land
DEO:BS:mls\0067 1O.doc
cc:
United Science Industries
0027
November
4,
1994
Ronald
J.
Kruep
DaLee Oil Company, Inc.
201
Hanovec St.
Okawvifle, IL
62271
In
Re:
Facility No. 6-006141
EMA
Incident
No. 92-3466
Killion’s
66
Itt.
177
Okawville, WASHINGTON CO., IL
•
9?L3466
Office
of
the
Illinois
State
!ire
Marshal
FAX
.
CERTIFIED
MAIL
-
RECEIPT REQUESTED
#Z
207
509
389
217-782-1062
Divisions
ARSON
INVESTIGATION
211-782-6855
BOILER
and
PRESSURE
VESSEL
SAFETY
211-782-2696
FIRE
PREVENTION
217-755-4714
MANAGEMENT
SERVICES
217-7824889
INFIRS
211-785-1016
PERSONNEL
•
•
217-785-1009
PERSONNEL
STANDARDS
and
EDUCATION
21fl82-4542
PETROLEUM
and
CHEMICAL
SAFEW
217-785-5878
PUBLIC INFORMATION
21T785432~
Dear
Mr. Knep:
The Reimbursement
Eligibility
and
Deductible AppLication, received ott
10-17-94 for the above
referenced
occurrence has been reviewed.
The following detenn(nations have been made based upon
this review.
It
has been determinedthat you
are eligible to seek payment ofcosts in excess of$15,000.
The
costs
must
be in responseto the
occurrence referenced above and associated with the following tanks:
Eligible
Tanks
TaXIJC#I
-6,700
gallongasoline
Tank #2
-
4,000
gallon
gasoline
Tank #3
-
4,000 gallon gasoline
Tank #7
-
(,000 gallon
gasoline
You
must contact the
Illinois
Environmental
Protection Agency to receive
a packet of Agency billing
forms for submitting your request for
payment.
An owner or operator
is eligible
to access the
Underground Storage Tank Fund
if
the eligibility
iequirements are satisfied:
I.
Neither the owner nor the
operator is the
United
States Government;
2.
The tank does not contain
fuel which
is
exempt from
the
Motor
Fuel Tax Law;
ICJE
~:ev3!-sn;1DH:~
•
5~r~nc;~-~c
Ulinc’s
62723~4;5~
0029
General
Office
211-785-0969
923466
3.
The costs were incurred as a result ofa confirmed release of
any of the followingsubstances:
“Fuel”, as defined in Section
1.10
ofthe Motor Fuel
Tax Law
Aviation fuel
Heating oil
Kerosene
•
Used
oB,
which
has been
refmed
from
crude oil used in a motor vehkle,
as defmed
in Section
1.3
of
the Motor Fuel Tax Law.
4.
The owner or operatorregistered
the tank
and paid all
fees
in accordance*ith the
statutory
and regulatory requirements ofthe
Gasoline Storage Act
5.
The owner or operatornotified the
Illinois
Emergency Management Agency of a confirmed
release,
the costs were
incurred
after
the
notification
and
the costs were a result ofa release
of
a substance listed in this Section.
Costs ofcorrective action or indemnification incurred
before providing that notification shalt not be eligible
for
payment
6.
The costs have not already been paid to the owner or operatorunder a private
insurance
•
policy,
other
written
agreement, or court order.
7.
The costs
were associated with “corective action”.
This
constitutes
the final decisionas
it relates to your eligibility and deductibility.
We reserve the
right to
change the deductible determination should additional
information
that
would change the
determination become availabte.
An underground
storage tank
owner or operatormay appeal
the
decisionto the Illinois
Pollution Control Board (Board),
pursuant to Section
57.9
(c)
(2).
An owner
oroperator who seeksto
appeal the decision shall file a
petition for a hearingbefore the Board within
35
days ofthe
date of mailing of the final decision
(35
ruinois Administrative
Co4e
105.102(a) (2)).
For
information regarding
the
filing ofan
appeal,
please contact:
Dorothy Quart, Clerk
•
Illinois
Pollution
Control
Board
State of Illinois
Center
100 West Randolph, Suite
11-500
Chicago,
Illinois
60601
(312)814-3620
The following tanks
are
also listedfor this site:
Tank
#4
4,000 gallon gasoline
Tank ~6
-
2,000 gallon
kerosene
0029
923468
Your application
indicates that there
has not been a release from these tanks.
You
may
be eligible
to
seek payment ofcon~ective
action
costs associated with these tanks if it is determined that there has
been a
release from one ormore ofthese
tanks.
Once
it
is determined that there has been a release
from one or
more ofthSe tanks you may submit
a separate application for an eligibility
determination to seek corrective action costs associated with this/these tanks.
ifyou
have
any
questions
regarding the eligibility or deductibility determinations, pleasecontact
our
Office at
(217)785-1020
or
(217)785-5878
between 2:00
-
4:00 p.m.
Sincerely,
Director
Division ofPetroleum
and Chemical Safety
JIM:bdc
cc:
EPA
Facility File
Rn’)
James
1.
McCaslin
923466
ILLINOIS
ENVIRONMENTAL
PROTECTION
AGENCY
1021
NORTH GRAND
AVENUE
EAST,
P.O. Box
19276,
SPRINGFIELD,
ILLINOIS
62794-9276
RENEE
CJPRJANO,
DIRECTOR
217/782-6762
JUL
24
21197
Dalee Oil Company
Ronald
Kruep
201
Hanover Street
Okaville, Illinois 62271
Re:
LPC #189811503-- Washington
County
Okaville / Rocky’s 66
(Dalee Oil
Company)
Route
177
LUST Incident No. 923466
LUST Technical
File
Dear Mr.
Kruep:
The Illinois Environmental Protection Agency (Illinois EPA)
has reviewed the reimbursement
package submitted for the above-referenced
LUST incident.
In order for the Agency
to continue
its review the following information is needed:
I.
A copy ofthe lease between the owner or operator arid the lesser associated
with the
remediation system.
If there is no
written
lease, a notarized copy
of
the terms to the oral
lease signed by the owner or operator
and the lesser must be
submitted.
In addition, an
explanation must be provided as to how the lease may be terminated prior to, or extended
beyond, the terms
of
the lease agreement.
2.
The expected life of the remediation system and the disposition ofall components ofthe
remediation system once the remediation system reaches the end ofthe remediation
project.
In addition, a reasonable salvage value ofthe remediation system must be
provided.
GEORGE
H.
RYAN, GovERNoR
Page
2
The above information should be submitted within 60 days ofthe date ofthis letter to:
Illinois Environmental Protection Agency
Bureau of Land
-
#24
LUST Section
1021
North Grand Avenue East
Post Office Box
19276
Springfield, Illinois 62794-9276
923465
Please submit
all
corre~pondencein duplicate and include the
“Re:”
block at the beginning ofthis
letter.
If you have
any
questions orneed further assistance, please contact
Brian
Bauerat 217/782-3335.
Sincerely
(
Harry
A. Chappel, P.R
Unit Manager
Leaking Underground Storage Tank Section
Division ofReniediation Management
Bureau of Land
HAC:BPB
cc:
United Science Industries
Division File
,C°32
923466
House
Bill 4471
is now Public Act 92-0554
Governor George Ryan signed House
Bill
4471
into law as Public Act
92-0554
on June
24, 2002.
Public Act
92-0554
amends the Environmental Protection Act Sections
57.1,
57.2, 57.5, 57.6,
57.7, 57.8, 57.10,
and
57.13
and adds Section 57.14A.
The Act includes
some significant changes
to the handling of
underground
storage tank releases.
Owieis
or operators who report a release on orafter June 24, 2002 will no longer be able to
perform Site Classification, pursuant to
35
111. Adm. Code
732.307 and 35
111. Ada
Code
732.312,
and
must now perform Site Investigation.
However,
if
a release
was
reported
prior to June 24, 2002, owners or operators may elect to
perform
Site Investigation.
Public Act 92-0554 also raised the
maximum amount
that may be reimbursed from the
Underground Storage Tank Fund.
The Illinois EPA will request that the Illinois Pollution
Control Board change the Illinois
Administrative Code to reflect Public Act 92-0554.
This change is expected to
occur in 2003.
Public Act
92-0554
may be viewed at:
http://www.Iegis.state.jLus/publicacts/pubact92/acts/92-0554.html
The effective date ofPublic Act
92-0554
was June
24,
2002.
For additional it~formation,please
call
the illinois EPA,
Leaking Underground Storage
Tank Section at (217)
782-6762.
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE
TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Summary Sheet for All Charges
in this Billing Package
923466
The owner/operator or their representative shall complete this
form and place
tin the front of the billing
package.
All charges in this
billing package shall
be summarized on
this
form.
PAYMENT ITEM
PERSONNEL
EQUIPMENT
MATERIALS
& EXPENDABLES
(In Stock Items)
MATERIALS
& EXPENDABLES
(Field
Purchases)
SUBCONTRACTORS
TOTAL PAYMENT REQUESTED
$
0.00
0.00
$
0.00
$
$
1,895.00
$
1,895.00
/
IL
532
2168
LPC
482
Mar-93
this
Agency is
guthorized
to request
h~sn(orrnat~oriunder
he llriflo~s
EnvFronmental Protocijon
Act
415
ILCS
5/I
et
seq. (formedy
IN
Rev.
Stat Ch
111112.
1001 et seq).
Disclosure offliEs in~crn,ations
required.
Fajlurø to properly complete Eh~sform
n Is
entirety may result
in the delay or
denial of any
payment
requested
hereunder.
This
form
has
been
approved
by the Forms Mar~gement
Center.
0034
?
Illinois
Environmental
Protection Agency
UNDERGROUND
STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF liST CORRECTIVE ACTION COSTS
923466
SUBCONTRACTORS
Billing
Period
Job Name:
Krup-Rocky’s 66
05/01/2002
Contractor:
United
Science Industries,
Inc.
07/31/2002
Subcontractors Name
Work Description
Subcontract Amount
Environmental Science
Corp
Sample Analysis
$100.00
Environmental
Science
Corp
Sample Analysis
$1 ,695.OO
Environmental
Science
Corp
Sampie Analy&s
$100.00
*
Note:
Copies
of
invoices or billings must be attached.
Subtotal
$1,895.00
Some
subcontractor invoices
and billings
may
require
**
HandUng Charge
________________________________
further
time and material itemization,
Tota’
Subcontract Cost
$1,895.00
Handllng
charges
are
eligible
for
payment
only if
they are equa(
to
or less
than the followingamounts:
Subcontract
or Field
Eligible Handling Charges
Purchase Cost
as a Percentage of Cost
~1-$5,OOO
$12
$5,001
-$15,000
$600
+10
of amt.
over $5,000
$15,001
-
$50000
!$1,6OO+&/~of arrt. over
~5OUO
$50,001
-
$100,000
~$4,4UO+5
of
anit,
civec
$50000
sioo,ooi
-
151
000,000
$6,900+2
of arnt.
over ~1QO,OUO
This
agency is
authodred to request this
nfQccnat~on
under the l~ino~s
Ecwkonmental Protection
Act. 415
IICS
5/1
at
seq
(formerly III
Rev. Stat
Ch
111
1/2.
1001
et seq.).
Dsclosuro
of
his nformatior,
is
required.
Fairure
to
proper!y complete
this form
n
ts
entirety may
result
in
the delay
or denial of any payment
requested
hereunder,
This
form
has been approved
bythe
Forms Management Cer~tec.
IL
532
1823
LPC
330
Rev.
Mar-93
~35
~2346B
‘.1
L
4r~
12065
t~ebanon Rd.
Mt.
Juliet,
TN
37122
(615)
758-5858
ENviRONMENTAt~©~9PVI
1-8OO-167~S859
Fax
(615)
758-5659
SCIENCE
CoR~
Tax
I.D. 62-0814289
Invoice No.
163849
~t.
1970
Invoice Date 14-JUL-02
Bill
To:
Rflpqtted
Th~
Duane Doty
folly Morgan
lcruep-Rockys do
USI
Ptoj~t
*S,et
P.O. Box 360
1894176
Woodlawn,
ha
62898
1O-tJNSOO2
U~SCIR-1894176
P~zrch*s~Dtdet
~Ii~Imb~
terttls
Net 30
Arrio~z~t
~e
$
100.00
Sample
Numbers:
L82824-O1
08—JUL-02
Sample
IDs:
EFFLUENT
R5
kust
Urtit
~tide
~.st~liat
Kruep-Rockys
1
GW
8921 BTEX
1
GW
Oil
& Grease
Total
$
55.00
$
45.00
$
55.00
$
45.00
$
100.00
Accounts Beyond Terms
Please
Return
One
Copy
with
Payment
(Visa/MC/pNEC
Accepted)
Are Subject to
1 1/2
Monthly Service Charge
Page
1
07/15/02
tl:24
HPRRIS_D
AcoL
Date
01/17/02
In
the
absence
of
a
contract
Or
written
agreenieiit
to
the
contrary,
the
ESC
Standard
Terms
and
Conditions
accompanying
this
communication
represeaL
the
entire
agreement
between
ESC
and
the
addressee.
0fl3~
I.,
Qfl’~
I
~
‘~:~
‘J
12065
Lebanon
Rd.
Mt.
Juliet,
TN
37122
(615)
158-5858
1-800-767-5859
Fax
(615)
758-58S9
Tax
I.D.
62-0814289
Eat.
1970
Account~ Beyond
Terms
Are
Subject
~o
1
1/2
Monthly Service Charge
Please
Return
One
Copy
with
Paynent
Page
1
(VisatMC/NIEC
Accepted~
07/12/02
14~O5 H~RRIS~
Acct
Date
01/14/02
In
the
absence
of
a
contract
or
written
agreement
to
the
contrary,
the
ESC
Standard
Terms
coimnurlication
represent
the
entire
agreement
between
ESC
and
the
addressee.
and
Conditioos
acco
003
5anying
this
4—
ioi’/
ENVIRONMENTAL
KE
~-~-
SCIENCE
CORP.
CDVI
Mn
-
BY
Invoice
No.
163667
Invoice
Date
11-JUL-02
Bill
To:
Duane
Doty
Kruep-Rockys
C/a
liSt
P.O.
Box
360
Woodlawn,
IL
62898
1O-tJN$002
~p~tttd
to~
Pvrchase
Order
~tumb~t
Holly
Morgan
Pr~ett
Thamber
mats
1894176
Net 30
Site
IP#~
M~o~mt
~
Ub~SCIR-1894V16
$
1695
00
Sa~p1e
Nuatbers:
L8232G-O1
L82316-02,
L823i6-03.
L82316-04,
L8231.6-O5,
L82316-06,
L82316’-O7.
L82316-O8.
L82316-09,
L82316-lO.
£82316-it.
L82316-13,
L82316~.13,
L82316-14,
b82316-15,
t~8231G-lG~L82316-17,
LB23iC-18.
L82316.-19,
1j82316—20,
L823t6-21,
L82316—22,
L823.6-23,
Z82316.24,
L82316-25,
L82316-2G,
L82316—21,
L82316-28,
L82316—29,__L82316-30
‘1,..: .:c~~3~j
28..JTJN—02
Sample
lOs,
MW-i,
lV~4-2,
MW-3,
MW-6,
MW-7,
MW-S.
Mw-s.
MW
10,
MW-t2,
MW-13,
MW-14,
MW-iS,
MW-ic,
MW-ti,
RS’l-l,
EtW-2,
9W-a,
RW-4,
RW-S,
RW-E~
RW-7,
RW-8.
9,
RW-1O,
RW-11,
Rtt-12,
RW-13,
RW-14,
RW-15,
EFFLUENT
RS
Qty
Matrix
Rust
Unit
?c1~ce
~a~ous~t
Kruep-Rockys
30
GW
8921 BTEX
1
‘3W
Oil
&
Grease
Total
$
55.00
$
45.00
$
1650.00
$
45.00
$
169S.OQ~
/
923466
12065
Lebanon
Rd.
Mt.
Juliet,
TN
37122
*1~’
ENVIRONMENTAL
(615)
758—5858
1—800-761—5859
SCIENCE
CORP
Fax
(615)
758-5859
Tax
ID.
62-0814289
Invoice
No.
158953
Est.
1910
Invoice Date 23-MAY-02
Bill
To:
.
Duane
~oty
Kruep-Roc)cys
do
USI
P.O.
Box
360
Woodlawn,
IL
62898
1O-UNSOO2
Iteportea
to~
Purchase
Drd~r
1~umber
Duane
floty
~toj~ct
I~t~ite~
terMs
1894176
Net
30
Site
ZD#
Amoi~ntDu~
TJNSCIR-1894176
$
100.
00
Sample
Nut~thers:
L77900-O1
tS-MAY-02
Sample
LOs:
EFFLUENT
RB
Oty
Matrix
~escription
i~usr
I/ni
Price
Amount
Kruep—Rockys
1
GW
8921 BTEX
1
GW
Oil
& Grease
Total
$
55.00
$
45.00
$
55.00
$
45.00
$
100.00
Account~
Beyond
Terms
please
Return
One
Copy
with
Payment
(Visa/MC/N’IEC
Accepted)
Are Subject ~o
1 2/2
Monthly Service Charge
Page
1
05/23/02
1613
RP,RRISfl
Acct
Date
05/25/02
(1039
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Summary
Sheet forAl) Charges
in this Billing Package
Incident No: 923466
The owner/operator or their representative
shall complete this
form
and
place
it in the front of the billing
package.
All
charges
in
this billing package shall be
summarized
on
this form.
PAYMENT ITEM
TOTAL PAYMENT REQUESTED
,—
38
60
808.34
‘V
0.00
6,529.19
This Agency is authorized to request this
n(ocmatton under
the
lUnois Env
n
e
I
rotection Act, 415
ILCS 5/I
et seq.
(formedy
III Rev, Stat
Ch
111
1/2,
IDOl
et seq.)
Discios
hi
I
mation
is required.
Failure to properly complete this form
in
its
entirety
may
resuft in
the
de!ay or
en
ny payment
requested h&eunder.
This
form
has been approved
by the
Forms Management Center.
$
1,697.25
3,985.00
$
PERSONNEL
EQUIPMENT
MATERIALS & EXPENDABLES
(In Stack Reins)
MATERIALS & EXPENDABLES
(Field Purchases)
SUBCONTRACTORS
TOTAL PAYMENT REQUESTED
IL 532 2165
LPC 482
Mar-93
United Science
Industries, Inc.
6295
E
Illinois Hwy 15
Woodlawn, IL 62898
Phone: (618) 735-2411
DaLee Oil Company
206
North
Hanover
Okawville
ATTN:
Ronald Kruep
Fax: (618) 735-2907
IL
62271
Back to top
INVOICE
S
Task:
Corrective action
activities; Effluent sampling; Monthly groundwater treatment system
and SVE
rental;
Operation
and maintenance; Project management;
Quarterly
report;
Sampling; Monthly
discharge
monitor
report
Reference:
Kruep
-
Rocky’s 66
Work Period:
08/0112002
to
09/30/2002
Personnel
Charges
$
1~697.25
Equipment Charges
$
3965.00
Stock Item Charges
$
38.60
Field Purchases
$
808.34
Subcontractor Charges
$
0.00
(Subcontractor
& Field Expenses pending rece’~,t
by US!
are not included
on this invoice and am subject
to
future billing.)
-
~
NetDue This Invoice
$
6~52919
Payment Terms:
Category 31DM
Customer P.O.
Number:
Please make checks payable
to:
United Science
Industries,
Inc.
6295 E Illinois
Hwy
15
Woodlawn, IL 62898
o
04
o
0
10002
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF
liST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage
instructions,
see
reverse.
BILliNG
PERIOD
Incident No:923466
Job
Name:
Kruep
-
Rocky’s 66
from:
08/01/2002
Contractor:
Unfted Science Industries, Inc.
to:
09130/2002
T1MS
Agency
s authorized to request this intormat~on
under the
IIIino~sEnvironmental
Protection
Act, 415
ILCS 5/I
et seq.
(fbrmerly
II Rev. Stat Ch Iii
1/2,
1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in
its entirety
may
result in tile delay
or denial ofany payment
requested hereunder.
This form
has been approved by the
Forms Management Center.
IL 532
1818
LPC
325
Rev. Mar-93
25.501
o041
Employee
Work Classification
ShOT
*j~~
Total
Echols,
J.
.a61
PROJECT COORDINATOR
•.-~
0.25
.-
5000
12,50
Morgan
PROJECT MANAGER
..j
8.25
95.00
783.75
Shawn
-II
ENVIRONMENTAL TECHNICIAN
7.00
‘
53.00
371.00
Weatherford
3,7’
SENIOR ENVIRONMENTAL TECH
10.00
530.00
*
Use
Time
and
Materials
Rate
Totaf Personnel
1697.25
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of liST Corrective Action
Costs
Incident
No:
923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kwep
-
Rock~s
66
Billing Period:
from:
09/01/20
to:
09/07/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
at
in
at
in
at
in
at
in
at
Employee
Type
of Work Performed
st
at
st
at
St
ot
st
at
st
at
st
at
st
ot
st
at
Weatherfard
SENIOR ENVIRONMENTAL
11.30
14.00
11.00
11.30
2.50
0.50
3.00
6~’
IL
532 1822
Total Hours
3.00
LPC
329
Rev. Mar-93
This Agency is authorized to requestthis information under the
Illinois Environmental
Protection Act, 415
ILCS 5/i
et seq.
(formerly Ill Rev. Stat Chili
1(2,1001 et seq.)
Disclosure ofthis information is required,
Failure to properly complete
this form
in
its
entirety may
result
in
the
delay or denial of any payment
Page:
1
requested
hereunder.
This
form
has been approved by the
Forms Management Center.
0.
0
S
0
0
Request
for Payment of liST Corrective Action Costs
Incident Na:923466
For usage instructions,
see
reverse
,
Illinois Environmental
Protection Agency
UND~ROROUND
STORAGE TANK PROGRAM
WEEKLY WORKSHEET
Personnel
Jab:
Kruep
-
Rocky’s 66
Billing Period:
from:
09/08/20
to:
09/14/2002
Contractor:
United Science
Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
at
in
at
in
at
in
at
in
at
Employee
Type of Work
Performed
st
at
st
at
st
at
st
ot
st
at
st
at
st
at
st
ot
Morgan
PROJECT MANAGER
11.30
12.00
08,00
08.30
12.15
12.30
12.30
14.30
0.50
0.50
0.25
2.00
3.25
‘~
Morgan
.
PROJECT MANAGER
13.00
14.30
1.50_v
Morgan
PROJECT MANAGER
15.00
1&30
V
.
1.50
1.50
IL532 1822
LPC 329
Rev. Mar-93
Total
Hours
This Agency is authorized to request this information under the
Illinois Environmental
Protection Act, 415
ILCS 5/I
et
seq.
(formerly
Ill Rev. Stat Ch
1111/2,
1001
et
seq.)
Disclosure
of this information is required.
Failure to properly complete this ¶01mm its
entirety may
result in
the delay
or
denial of
any payment
Page:
1
requested hereunder.
This form
has been
approved by the
Forms Management center.
6.25~
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective
Action Costs
Incident
No: 923466
For
usage /nstructions,
see reverse
WEEKLY
WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
09/15/20
to:
09/21/2002
Contractor:
—
el
Science
Industdes,
Inc.
.
—
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
ot
in
at
in
at
in
at
in
at
in
at
Employee
Type of Work Performed
st
at
st
at
st
ot
st
ot
st
at
st
at
st
at
st
at
Shawn
ENVIRONMENTAL TECHNICIAN
07.00
14.00
/
7.00
7.00
“
Weatherford
SENIOR ENVIRONMENTAL
07.00
14.00
.
7.00
7.00
IL532
1822
Total
Hours
14.00
LPC
329
Rev. Mar-93
This Agency
is authorized
to request this
information under the Illinois
Environmental Protection Act,
415
ILCS
5/let seq.
(formerly III Rev. Stat Chill
1/2,1001
et seq.)
Disclosure
of
this
information
is
required,
Failure to properlycomplete this form in its entirety may result In the
delay or denial of any payment
Page:
1
requested hereunder.
This form has been approved by the Forms Management Center.
0~
0
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action
Costs
Far
usage
/nstructions,
see reverse
WEEKLY WORKSHEET
Personnel
Incident No:
923466
This Agency is authorized to request
this information
under the Illinois
Environmental Protection Act. 415
ILCS 511
et seq.
(formerly III Rev. Stat Chili
1/2,
1001
et
seq.)
Disclosure
of
this
Information is required.
Failure to properly complete this form
in its entirety
may result in the
delay or denial of any payment
requested hereunder.
This
form
has been approved bythe
Forms Management center.
Job:
Krtiep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
Billing Period:
from:
09/22/20
to:
09/26/2002
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
•in
at
in
at
in
at
in
ot
in
at
in
at
Employee
Type
of
Work Performed
at
at
st
at
st
at
st
at
at
at
at
at
at
at
st
at
Echols,
J.
PROJECT COORDINATOR
10.30
10.45
0.25
0.25
~“~‘
Morgan
PROJECT MANAGER
13.30
14.00
16.45
17.30
0.50
0.75
1.25
IL
532 1822
LPC
329
Rev. Mar-93
0
0
..~
rjr
Page:
1
TotaiHours
I
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Job:
KrtJep
-
Rocky’s
66
Request for Payment of UST Corrective Action Costs
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Incident
Na:
923466
Billing
Period:
from:
09/29/20
to:
09/30/2002
Contractor:
United Science Industries, Inc.
This Agency is authorized to request this information
under the Illinois Environmental
Protection Act, 415
lLCS
5/1 et
seq.
(formerly Ill Rev, Stat
Ch 1111/2,
1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in its
entirety may result in the
delay
or denial of any payment
requested hereunder.
This form
has been approved by the
Forms Management center.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
.
in
at
in
at
in
at
in
at
in
at
in
at
in
at
Employee
Type of Work Performed
st
at
at
at
at
at
at
at
at
at
st
at
at
at
at
at
Morgan
PROJECT MANAGER
16.45
17.30
.
0.75
0.75
“
Page:
1
IL 532 1822’
LPC
329
Rev. Mar-93
0
0
a)
Total Hours
I
-
.
O.7SJ
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT
OF
UST CORRECTIVE ACTION COSTS
For usage instructions,
see
reverse.
EQUIPMENT
Bilfing
Period
From:
08/01/2002
To:
09/30/2002
IL
532
1819
LPC
326
Rev. Mar-93
This
Agency
is authorized
to request
this
information under the
Illinois Environmental
Protection
Act, 41
ILCS 511
et seq. (forn~erleyIll Rev. Stat ChIll
1/2,
1001
et
seq.)
Oisc4osure of this
information
is requ
Failure to properly complete this form
in its
entirety
may
result in
the delay
or denial of any payment
requested
hereunder.
This
form has
been
approved
by the
Forms Management Center.
0047
_____
Illinois
Environmental Protection Agency
Note:
Include
cost
of operator
in the unit rates.
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Sdence
Industries, Inc.
Incident
No:923466
ENV.
UTILITY VEHICLE
Equipment Used
Time Used
*unit Rate
Total Cost
ROCKY’S
GROUNDWATER
1.00 MONTH
3750.00
3,750,0(
1.
50
DAY
*
Use
Time and Materials Rates
ELECTRONIC WATER LEVEL
INDICAT
2.00 DAY_—
20.00
40.0(
PHOTOIONIZATION
DETECTOR
#1
1.00 DAY
105.00
105.0C
60.00
Total
Equipment Cost
3,985.Ocl
•
flhinois Environmental Protection Agency
Thts Agency is authorized to request this information under the Illinois
Environmental Protection
Act. 415
rLcs
5/1
et
seq.
(formerly Ill Rev.
Stat Ch 1111/2,
1001
et
seq.)
Disclosure of this
information
is required.
Failure to properly complete this
form
in
its
entirety may
result
in
the delay or
denial of any payment
requested
hereunder.
This form has
been
approved by The Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rock/s 66
Contractor:
United
Science Industries, Inc.
LEO
UIPMENT
ENV.
UTILITY VEHICLE
Billing Period:
from:09/0112002
to:
09/07/2002
I
TOTAL
4jlrs. or Days
O.5~OAY
f
Contractors Authorized Representative:
Date:
Date:
SUN
0.00
I
THURS
FRI
SAT
MON
TUES
0.00
0.50DM’
)
WED
-F
0.00
0.00
0.00
IL
532
1540
*..__
nfl
-
-
This
Agency is authorized
to request this
information under the
Illinois
Environmental Protection Act, 415
•
Illinois
Environmental
Protection
Agency
ILCS 5/let
seq.
(formerly
III
Rev.
Stat
Ch 1111/2,
1001
et
seq.)
Disclosure oflhis
information
is required.
Failure to property complete this
form
in its
entirety may
result
in the delay or denial of any payment
requested hereunder.
This form
has
been approved by the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
Rocky’s 66
Contractor:
United
Science
Industries, Inc.
Billing
Period:
frorn:09fl5(2002
to:
09/21(2002
EQUI PMENT
ENV.
UTILITY VEHICLE
ELECTRONIC WATER LEVEL INDICAT
PHOTOIONIZATION DETECTOR #1
C
C
‘(p
Contractors Authorized Representative:
IL 532
1540
Date:
Date:
0.00
0.00
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL
Hrs.or
Days
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
I.000AY
0.00
0.00
0,00
2.00 DAY
0.00
0.00
1.00
DAY
1
.0GOAY~
2.OIDAY/
0.00
1.OIOAY/
Illinois Environmental Protection
Agency
This Agency is authorized to
equest
this information under the
Illinois Environmental Protection
Act, 445
ILcS 5/1
et seq.
(formerly
Ill
Rev, Stat
ch 1111/2, 1001
et seq.)
Disclosure of
this
information is required.
Failure to
properly complete this form
in its entirety may
result
in
the delay
or denial ofany payment
requested hereunder.
This form has been
approved by the
Forms Management center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science
Industries,
Inc.
0
Billing
Period: Ircm:09/29/2002
to:
09/30/2002
Contractors Authorized
Representative:
IL 532
1540
Date:
Date:
ROCKY’S GROUNDWATER TREATMENT
I
TOTAL
EQUIPMENT
j
SUN
j
MON
TUES
WED
THURS
FRI
SAT
jI-trs.orbays
0.00
j
1.OOMONTHj
0.00
0.00
I
0.00
~
0.00
1.0~ON~1~
•
•—_
nn
‘
Illinois
Environmental
Protection Agency
UNDERGROUND STORAGE TANK
PROGRAM
REQUEST FOR PAYMENT OF liST CORRECTIVE ACTION COSTS
STOCK ITEMS
Incident No:
923466
For Usage instructions,
see
reverse.
BILLING
PERIOD
Job Name: Kruep
-
Rocky’s
66
from:
08/01/2002
Contractor: United Science Industries, Inc.
to:
09/30/2002
Stock
Items
.
Quantity
Price/Item
Total Cost/Item
LATEX GLOVES
14.00
0.40 / PAIR
5.60
DEDICATED POLl BAILER
2.00
16.50 / EACH
33.00
Total Stock Items
38.60
,
~
.
This Agency
is authorized
to request this
information under the
Illinois Environmental Protection Act,
415
IL
5Q2
I
a3
1
LCS
Sn
et
seq.
(formerly Ill
Rev. Stat Oh
1111/2, 1001
et seq.)
Disclosure of this information is requirec
LPC
328
Rev.
Mar-93
Failure to properly complete this
form
in its
entirety may
result
in
the delay or denial of any payment
requested
hereunder.
This
form
has been approved by the Forms Management
center.
005t
,
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
Incident No:
923466
FIELD PURCHASES
Billing Period
Job Name:
Kruep
-
Rocky’s
66
From:
0
/0
/2
0
Contractor:
United Science Industries, Inc.
To:
09/30/2002
Field Purchases
~t~y
Price/Item
Total Costs/Item
GWT
ELectricity
1.00
721.73 / EACH
721.73
Note:
Copies of invoices orbillings must be altached.
Subtotal
721
.73
Some
subcontractor
invoices and
billings
may
require
further
time arid material itemization.
**
Handling
Charge
$86.61
Total Subcontract Cost
808.34
Handling Charges are eligible for payment only ifthey are equal to or less
than the followingamounts:
Subcontract of
Field
Eligible Handling Charges
Purchase
Cost
as
a Percentage of Cost
$1 -$5,000
$12
$5,001
-
$15,000
$600+10
of
amt. over $5,000
$15,001
-$50,000
$1,600+8
of amt.
over $15,000
$50,001 -$100,000
$4,400+5
of amt.
over $50,000
$100,000 -$1,000,000
$6$00+2
of
anit. over
$100,000
This
Agency is
authorized to request this information under the
Illinois Environmental
Protection Act, 415
ILCS
511
et seq.
(formerly
Ill
Rev. Stat Oh 1111(2,
1001
et seq.)
Disclosure
of
this information is required.
IL
532
1823
Failure to properly complete this form
in
its
entirety may
result
in the
delay
or denial of any payment
LPC
330
Rev.
Mar-93
requested
hereunder.
This
form
has
been
approved by the Forms Management center.
0053
-
BILLING
SUMMARY
Account
Number:
6761308174
If
you
have
any
questions
about
your
bill,
please
call
1-800’363-6505.
Please
nail
general
correspondence
to
our
Company
headquarters
Illinois
Power
Pa
a~511
Decatur,
XL
62525
SEP
132002
BY:
Previous
Balance
08-02-02
Delayed
Payment
Charge
08-21-02
Payment Posted
08-29-02
Balance
Brought Forward
$
$
496.40
7.45
-496.40
$
7.45
by
09-19-02
after
09-19-02
729.16
740.
12
Back to top
YOUR
ENERGY
USE
BULLETIN
BOARD
LAST
—
actual
YEAR
9O(O~
554
Illinois Power offers convenient, safe electronic payment
options.
Please call our 24 Hour Customer Service Center at
1-800-755-5000
or visit our web site at www.illinoispower.com
for more information.
73
Fold
and
tear
on
~erforat5on
at
dotted
iinej
ILLINOIS
POWER
#BWNGRNG *~AUT0*+?
3-DIGIT 628
#01376761308174761*
UNITED
SCIENCE
INDUSTRIES
79
P0
BOX
360
WOODLAWN
IL.
62898-0360
I II.~
EII,IIIII,II)IIIIIIIII
~
~
P.M.
Box
2522
Decatur,
Ii
62525-2522
1 04
FR2
0053
Return
this
portion
with
your
payment
ILLINOIS POWER
Part
of the Dysicy Perfornance Team
UNITED SCIENCE INDUSTRIES
203
W
ELM
ST
R
OKAWVILLE
IL
62271
/
Commercial
Electric Service
Total
Current
Charges
S
721.73
—
721.73
TOTAL AMOUNT DUE TO ILLINOIS POWER
TOTAL AMOUNT
DUE
TO
ILLINOIS
POWER
ELECTRIC/kwh
-usage tast
13 months
AVERAGES
FOR
BILLING
PERIOD
S
$
I
es..
5.521
~1M~HiH
THIS
YEAR
TEMPERATURE
79
78
ELEC/kwh per
Day
cost per Day
costperkwh
309
$20.88
$~t~7
108
$13.81
$0.13
Oot.Lr
*e,cunte
tistd
on
pretax
ft~ut’tx.
S
0
N
0
J
F
M
AM
.1
J
A
$
AVG
estimated
-
current month
-
current month
last year
AMOUNT PAID:
DUE DATE:
DUE NOW:
AFTER DUE DATE:
September
19,
~uu2
$729.18
$740.12
YES!
I
want
to
be
a Warm Neighbor.
Sign
me
up
for a monthly
donation
of:
$1.00
$2.00
Other
ACCOUNT
1*:
6761308174
BILL DATE:
Sentember
05.
2002
0
2
0S2302
U
000000740124
00000072t11&?
67L1308174
‘1
-,
.
ILLINOIS POWER
P.,t.fth. Pv~i@vPivfon,unc.
T.am
—
ACCOUNT.NUMBER:
6761308174
UNITED
SCIENCE
INDUSTRIES
PAGE
2
—
ELECTRIC
SERVICE
METER~:
Dial
Remove
Meter Reading, 08/05/02
(Actual)
25314
40484373
Previous Meter Reading.
08/01/02
(Actual)
24412
Amount of
Electricity
Used in
4
Days
kwh
902
Maximum Demand
.
11.000
kw
METER#:
Current
Meter
Reading.
09/03/02
(Actual)
9295
83018692
Dial Install Meter
Reading. 08/05/02
(Actual)
.
.
0
Amount
of
Electricity
Used
in
29 Days
kwh
9296
Maximum Demand
18.684
kw
Total
Usage
Ending
09/03/02
10,198
ftwh
Billing
Demand
Ending
09/03/02
18.684
kw
On
09-03
Distribution
Capacity
Ending
09/03/02
24.500
kw
On
02-04
Rate
11
Cost of Electricity
Used
for 33
Days
Ending
09/03/02
Account
Charge
-
Below
2.4
kv
-
I
Phase
$
45.75
Distribution
Capacity
Charge
24.500
kw
x
$
1.750000
$
42.88
Summer
Energy Charge
3.737
kwh
x
$
0.092990
$
347.50
6,461
kwh x
$ 0.035990
$
232.53
Transformation
Charge
24.500
kw
x
$ 0.750000
$
18.38
Instrument
Funding Charge
10.198
kwh
x
$ 0.007600
$
77.50
Instrument
Funding Charge
Credit
10.198
kwh
x
$
0.007600-
$
-77.50
Decommissioning
Expense
Adjustment
10.198
kwh
x
$
0.000190
$
1.94
SERVICE
BILLING
SUBTOTAL
$
688.98
Electricity Excise
Tax
2,000
kwh
x
$003300
$
6.60
8.198
kwh
x
5.003190
$
26.15
TOTAL
COST FOR
ELECTRIC SERVICE
$
721.73
0054
E3
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE
TANK
PROGRAM
Request for Payment of
UST
Corrective Action
Costs
Summary
Sheet for All Charges
in this Billing Package
Incident No: 923466
The owner/operator or their representative shall complete this form
and place it in the front of the billing
package.
All charges in this billing
package shall be summarized on this form.
PAYMENT ITEM
TOTAL PAYMENT REQUESTED
PERSONNEL
$
1,314.75
EQUIPMENT
MATERIALS
&
EXPENDABLES
(In Stock Items)
MATERIALS
& EXPENDABLES
(Field Purchases)
SUBCONTRACTORS
0.00
549.27
a-
0.00
I
5, 674.02
This
Agency is authodzed to request thLs
information under
the
Illinois Environmental Protection
Act.
415
ILcs
5/1
et
seq
(formerly
II Rev. Stat
Ch
lii
1/2,
1001
et seq.)
isciosure of-this information is required.
Palure to properly complete this form
in
its
entirety
may
result
in
Al
enial
ofany payment
requested hereunder,
This
form
has been approved by the Forms
Man
t center.
3,810.00
a-
$
TOTAL PAYMENT REQUESTED
IL 532
2168
LPC 482
Mar-93
United Science Industries,
Inc.
6295
E
Illinois
Hwy
15
Woodlawn,
IL
62898
Phone:
(618) 735-2411
Fax: (618) 735-2907
DaLee
OH
Company
206 North Hanover
Okawville
IL
62271
ATTN:
Ronald Kruep
INVOICE
‘Si
UNITED
SCIENCE
INDUSTRIES
Task:
Corrective action activities;
Effluent sampling;
Monthly groundwater treatment unit and SVE
rental;
Operation and
maintenance; Project management; Monthly discharge monitor report
Reference:
Kruep
-
Rocky’s
66
Work Period:
07/01/2002
to
08/31/2002
Personnel
Charges
$
1314.75
Equipment Charges
.
$
3,810.00
Stock Item Charges
$
0.00
Field Purchases
$
549.27
Subcontractor Charges
.
$
0.00
(Subcontractor
& F/e/d Expenses pend/ng
i~e
ce/pt by US!
are
not included
on (li/s invoice and
are subject
to
future billing.)
~
Payment Terms:
Category 3/DM
Customer
P.O. Number:
Please make checks payable to:
United Science
Industries,
Inc.
6295 F Illinois Hwy
15
Woodlawn,
IL 62898
0056
Illinois
Environmental Protection Agency
UNDERGROUND
STORAGE TANK PROGRAM
REQUEST FOR PAYMENT
OF
UST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For
Usage instructions) see reverse.
BILLING PERIOD
Incident No:
923466
Job Name:
Kruep
-
Rocky’s
66
Contractor:
United Science Industries,
Inc.
from:
07/01/2002
to:
08/31/2002
*
Use
Time and Materials Rate
Total Personnel
17.25
1314.75!
—
This Agency
is authorized to request lhis information under the
Illinois
Environmental
Protection Act, 415
Lcs
5/1
et seq.
(formerly Ill Rev.
Stat
Ch 1111/2, lOOt et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in
its
entirety may
result in
the delay
or
denial of any payment
requested hereunder.
This
form has been approved
by the
Forms
Managementcenter.
IL 532
1818
LPC
325
Rev. Mar-93
Pr’5~7
Employee
I
Work Classification
ST/OT
*Rate
Total
Morgan
~s3~
~,
3~
PROJECT
MANAGER
-
—
95.00
878.75
Morgan,
R.
~_.6
~
Weatherford
ASSISTANT PROJ MANAGER
SENIOR ENVIRONMENTAL TECH
1.00
65.00
65.00
7.00
53.00
371.00
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective
Action
Costs
Incident
No: 923466
For
usage instructions, see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Bifling Period:
from:
08/04/20
to:
08/10/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
TI-fURS
FRI
SAT
TOTAL HOURS
in
ot
in
at
in
ot
in
at
in
at
in
at
in
at
Employee
Type of Work Performed
st
at
st
at
st
at
st
at
st
ot
st
at
st
at
st
at
Morgan
PROJECT MANAGER
13.00
0.25
13.15
16.15
0.75
17.00
1.00
—
Weatherfard
SENIOR
ENVIRONMENTAL
11.30
15.00
3.50
3.50
~
L 532 1822
Total Hours
4.50j
LPC
329
Rev. Mar-93
This Agency
is authorized to request this information under the
Illinois Environmental Protection
Act, 415
ILCS
5/let
seq.
(formerly Ill Rev, Stat Chill
1/2,
1001 et seq.)
Oisclosure of this Inlbrmation is required.
Failure to property complele this lorrn
in
its entirely may
result in the delay
or denial
ofany
payment
Page:
1
requested hereunder.
This
form
has beep approved by the
Forms ManagemeiltCenter.
-)
,
cJt
~,
Illinois Environmental
Protection Agency
____
UNDERGROUND
STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
For usage
instructions,
see reverse
WEEKLY
WORKSHEET
Personnel
Incident
No:
923466
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
08/11/20
to:
08/17/2002
Contractor
United Science Industries, Inc.
Employee
Type of Work Performed
Morgan
PROJECT MANAGER
IL
532
1822
LPC 329
Rev. Mar-93
VT
Ca
This
Agency
is authorized
to request this
information under the
Illinois
Environmental
Protection Act,
415
ILcs
5/1
et
seq.
(formerly Ill
Rev. Stat
ch
1111/2,
1001 et seq.)
Disclosure of this information is required.
Failure to property complete this form
in
its entirety
may
result in the detay or denial of any payment
requested hereunder.
This
form
has been
approved by the
Forms Management center.
Page:
1
Total
Hours
I
Illinois
Environmental
Protection Agency
____
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST
CorrectiveAction
Costs
Incident No: 923466
For usage instructions,
see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
08~’18/20
to:
08,’24,’2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
ot
in
at
in
at
in
at
in
ot
Employee
Type of Work
Performed
st
—
ot
st
at
st
at
st
ot
st
at
st
ot
st
at
st
at
Morgan
PROJECT MANAGER
14.00
16.00
11.00
12.00
2.00
1.00
3.00
.—“
Morgan,
R.
ASSISTANT PROJ MANAGER
15.45
16.15
0.50
0.50
—
Weatherford
SENIOR ENVIRONMENTAL
11.00
14.30
3.50
3.50
IL 532
1822
Total
Hours
7.OOj
LPC
329
Rev.
Mar-93
This Agency is authorized to request this information under the Illinois
Environmental Protection Act,
415
1LCS
5/1
et seq.
(formerly Ill Rev. Stat Ch 1111/2, 1001
at seq.)
Disclosure of this information is required,
Failure to property complete this form
in
its
entirety
may
result
in
the delay
or denial of any payment
Page:
1
requested hereunder.
This
form has
been approved by the Forms
Management Center.
C
C
a~
0~
Illinois
Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST
Corrective Action
Costs
Incident
No:
923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing
Period:
from:
08/25(20
to:
08/31/2002
Contractor
United Science Industries,
Inc.
SUN
~iiEi
WED
THURS
FRI
SAT
TOTAL HOURS
Emplayee
Type of Work Performed
in
st
ot
at
in
st
at
at
in
st
at
at
in
st
at
at
in
st
ot
at
in
st
at
at
at
at
Morgan
~—
PROJECT
MANAGER
13.30
14.00
10.30
12.00
0.50
1.50
2.00
Morgan,
R.
ASSISTANT PROJ MANAGER
08.00
08.30
0.50
0.50
IL 532 1822
Total Hours
LPC
329
Rev. Mar-93
This Agency is authorized lo request this information under the Illinois Environmental
Protection
Act,
415
1LCS 5/1
et
seq.
(formerly
iii
Rev. Stat
Ch 1111/2, 1001
et seq.)
Disclosure of this information is required.
Failure to property complete this form in its entirety may
result in the
delay or denial of any payment
Page:
1
requested hereunder.
This
form
has been approved by the
Forms Management center.
C
C
..sa)
_____
Illinois
Environmental
Protection Agency
Incident No:923466
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR
PAYMENT OF UST CORRECTIVE ACTION COSTS
For usage instructions,
see
reverse.
EQUIPMENT
Note:
Include cost of operator/n the unit rates.
I
Billing Period
Job Name:
Kruep
-
Rocky’s 66
From:
07/01/2002
Contractor:
United Science Industries,
Inc.
LT0:
08/31/2002
Equipment
Used
Time
Used
Unit Rate
Total Cost
ROCKY’S GROUNDWATER
1.00 MONTH
3750.00
3,750.0(
ENV.
UTILITY VEHICLE
1.00 DAY
60.00
60.0(
*
Use
Time
and Materials Rates
Total Equipment Cost
L
This
Agency
is authorized
to
request this
information under the Illinois Environmental Protection Act,
415
LOS
5/let
seq.
(formerley Ill Rev. Slatphi 111/2,1001
et seq.)
Oisclosure ofthis
information is requir
I L
532
1 8
1 9
Failure to properly complete this form
in its
entirety
may
result
in
the
delay or denial of any payment
LPC
326
Rev.
Mar-93
requested hereunder.
This
form has been approved by the Forms Management Center.
a
4
This Agency is authorized to request this
information under the Illinois
Environmental
Protection Act. 415
r7~
Illinois
Environmental
Protection
Agency
ILC$ 5/1 etseq
(tormerly Ill Rev. Statctt
111
1(2.1001
etseq) Oisdosureotthis intormationis
required.
Failure to properiy complete this form
in
its
ent$rety may
result
in
ihe delay
or
denial of any payment
requesled
hereunder
This
form
has
been approved by
the
Forms Management cenler.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rockys 66
Contractor:
United Science Industries. Inc.
j~QU
PM
~TlLITV
VEHICLE
C
C
0,
to:
08/10/2002
Contractors Authorized Representative:
Date:
Date:
0.00
+
SUN
THURS
j
FRI
SAT
MON
TUES
0.500AYJ
0.00
WED
Billing
Period:
from:
08/04/2002
0.00
f
0,00
0.00
0.00
I UI
Mrs. orOays
0.5cOAY
IL 532
1540
I
PC
248
Rev.
Mar-93
-
-
.
.
This Agent)’ is authorized
to
request this information under the
Illinois Environmental
Protection Act. 415
Illinois
Environmental
Protection Agency
l~
541 etseg
(formerly
Ill
Rev. Statch
111
1(2,1001 etseq.)
Oisctosureofthislnformatton isrequired.
Failure
to properly complete this form
in its entirety
may
result in the delay
or denial ofany payment
requested hereunder
Trus
form
has been approved
by
the
Forms Management center
UNDERGROUND STORAGE TANK PROGRAM
Incident
No:
923466
WEEKLY WORK SHEET
EQUIPMENT
Job:
Kruep
-
Rocky’s
66
Contractor:
United Science industries, Inc.
Billing
Period:
from:
08/18/2002
to:
08/24/2002
EQUIPMENT
I
~NV.
UTILIfl VEHICLE
SUN
MON
I
~
TUES
j
WED
THURS
0.00
I
~
FRI
I
SAT
I
IUIAL
~Hrs.orDays
0.5WAY
1
0.00
0.00
0.00
0.00
0.00
C
o
0)
Contractors Authorized
Representative:
Date:
_______________________________________
Date:
IL 532
1540
LPC 248
Rev. Mar-93
-
-
-
-
This Agency is authorized to request this information under the Illinois Environmental
Protection
Act. 415
Illinois Environmental
Protection Agency
ILCS 5/1
etseq. (formerly Ill Rev.
StatCh 111 1/2.1001
et seq.)
Oisclosureofthis information is required.
~,
Failure
to properly complete
this form in its entirety may
result in the
delay or denial of any payment
requested hereunder.
Th~s
term
has been approved by the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
Incident
No:
923466
WEEKLY WORK SHEET
EQUIPMENT
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
Billing
Period:
from:
08/2512002
to:
08/31/2002
SUN
MON
TUES
WED
ThURS
FRI
SAT
Mrs. or Days
1
ROCKY’S
GROUNDWATER TREATMENT
~I__0,00
0.00
0.00
-
0.00
0.00
0.00
1.OOMONTH
1.0~v1ONTH
C
C
0)
C)’
I
Contractors Authorized
Representative:
Date:
IL 532
1540
Date:
LPC
248
Rev.
Mar-93
Illinois Environmental Protection Agency
FIELD PURCHASES
~niingrerioo
From:
07/01/2002
To:
08/31/2002
Subcontract of Field
Purchase Cost
$1
-
$5,000
$5,001
-$15,000
$15,001 -$50,000
$50,001 -$100,000
$100,000 -$1,000,000
IL
532
1823
LPC 330 Rev.
Mar-93
Eligible
Handling
Charges
as
a
Percentage of Cost
$12
$600+10
of amt.
over
$5,000
$1,600+8
ofamt. over $15,000
$4,400+5
ofwilt, over $50,000
$6,900+2
of amt. over $100,000
This Agency is authorized to request this information under the
Illinois Environmental
Protection
Act, 415
LOS
5/ 1
et
seq.
(formerly ill Rev. Stat Oh 1111/2,
1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in its
entirety
may
result in the
delay
or denial of any payment
requested hereunder.
This
form
has been approved by the
Forms Management Center.
0086
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
F
Incident No:
923466
Field Purchases
j
Quantity
1.00
Price/item
Total Costs/Item
GWT Electricity
490.42 / EACH
490.42
*
Note:
Copies of
invoices or
billings must be attached,
Some subcontractor invoices and billings may require
further time and material itemization.
Subtotal
~.
Handling Charge
Total Subcontract Cost
Handling Charges are eligible forpayment only if they are equal to or less
than the following amounts:
490.42
$58.85
549.27
S.-
Previous Balance
07-08-02
Delayed
Payment Charge
07-25-02
Payment Posted
07-31-02
Balance
Brought Forward
ILLINOIS POWER
Partof
oh. pretoy
Performance team
UNITED
SCIENCE
INDUSTRIES
203
W
ELM
ST
R
OKAWVILLE
IL
62278y:
398.46
5.98
-398-46
$
5.98
496.40
503.85
YOUR
ENERGY
USE
ELECTRIC/kwh
-
usage
last 13 months
AVERAGES FOR
___________
___________
BILLING
PERIOD
BULLETIN
BOARD
-
actual
-
estimated
-
current month
-
current month
last
year
c-f
Illinois Power
offers convenient,
safe electronic payment
options.
Please call our 24 Hour Customer
Service
Center
at
1-800-755-5000
or visit our web site
at www.illinoispower.com
for
more information.
Fold and tear on perforation
at dotted line
ILLINOIS
POWER
~8WNGRNG *s**AUTOs* 3-DIGIT 628
801B76761308174761t
UNITED
SCIENCE
INDUSTRIES
79
P0
BOX
360
WOODLAWN
XL
62898-0360
I III..
lilt11
..l.I11, iI~.l~II
1111111
~
~
P.O.
Box 2522
Decatur,
I.
62525-2522
1
04
FR2
Return this portflrflq&lyour payment
BILLING
SUMMARY
Account
Number’:
676l3O8l7~
If
you
have
any
questions
about your
bill, please
call
l-8OO-36368O~.
Please mail general
correspondence
to our
Company headquarters:
Illinois Power
PD Box 511
Decatur,
IL
62525
Commercial Electric Service
Total Current
Charges
I~1Zr’rfl...
I
~
V
AUG
-
92002
$
$
S
$
490.42
$
490.42
TOTAL AMOUNT DUE
TO
ILLINOIS
POWER
by
08-19-02
TOTAL
AMOUNT
DUE
TO
ILLINOIS
POWER
after 08-19-02
$
S
Th/s
YEAR
~lliR
A
SO
N
D
J
FM
AM
J
J
AAVG
ft
LAST
YE/iA
TEMPERATURE
81
81
ELEO/kwh per Day
243
329
costperDay
$17.38
$22.22
costperkwh
$0.07
$0.07
Ocilar
amounts
based
or~pretao
fleuras.
(~@//74
AMOUNT
PAID:
DUE
DATE:
August
19,
2002
DUE NOW:
$496.40
AFTER DUE DATE:
$503.35
YES!
I want to be
a Warm Neighbor.
Sign me up for
a monthly
donation of:
$1.00
fl-Do
Other
ACCOUNT *:
6761308174
fILL DATE:
August
05.
2002
0
2
082102
0
000000503851
000000496403
6761308174
1
ELECTRIC
SERVICE
923466
PAGE
2
—
METER~
Current
Meter Reading,
08/01/02
(Actual)
40484373
Previous Meter Reading,
07/05/02
(Actual)
Amount of
Electricity Used
In
27
Days
Maximum
Demand
Billing
Demand
Ending 08/01/02
Distribution
Capacity Ending
08/01/02
Rate
11
Cost of Electricity
Used for 27
Days Ending
08/01/02
Account Charge
-
Below 2.4
kv
-
I
Phase
Distribution
Capacity Charge
Summer Energy
Charge
Transformation
Charge
Instrument
Funding
Charge
Instrument
Funding
Charge Credit
Decommissioning
Expense Adjustment
SERVICE
BILLING
SUBTOTAL
Electricity Excise Tax
TOTAL
COST
FOR
ELECTRIC SERVICE
2,000
kwh
x
$003300
4548
kwh
x
$003190
ACCOUNT
NUt~BER:
6761308174
UNITED
SCIENCE
Ph
ILLINOIS POWER
P.m
of the Ovarcy Performance
Team
INDUSTRIES
24412
17864
kwh
8548
11.000
kw
11.000
kw
On 08-Cl
24.500
kw
On 02-04
$
45.75
24.500
kw
x
$
1,750000
$
42.88
2,200
kwh
x
$
0.092990
$
204.58
4:348
kwh
x $ 0.035990
$
156.48
24.500
kw
x $ 0.750000
$
18.38
6,548
kwh
x $ 0.007600
$
49.76
6.548
kwh
x
$
0.007600-
$
-49.76
6,548
kwh
x
$
0.000190
$
1.24
$
469.31
S
6.60
5
14.51
$
490.42
pp6s
Illinois
Environmental
Protection Agency
UNDERGROUND STORAGE TANK
PROGRAM
Request for Payment of UST corrective
Action
costs
Summary
Sheet
for All
Charges
in this Billing
Package
Incident No:923466
The owner/operator or their representative shall complete this form and place it in the front of the billing
package.
All charges in this
billing package shall
be summarized on this
form.
PAYMENT ITEM
PERSONNEL
$
TOTAL PAYMENT REQUESTED
2,765.75
/
EQUIPMENT
MATERIALS &
EXPENDABLES
(In
Stock Items)
MATERIALS
&
EXPENDABLES
(Field
Purchases)
SUBCONTRACTORS
TOTAL
PAYMENT REQUESTED
IL 532 2168
446.28
0.00
7,082.03
This Agency is authorized to request this
information under
the
Illinois
Environmental
Protection Act, 415
ILCS
5/
1
et
seq.
(formerly III Rev. Stat Ch 1111/2,
1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form in its entirety may resu
e
I
or denial ofany payment
requested hereunder. This form has
been approved by the
ment Center.
3,870.00
0.00
$
LPC 482
Mar-93
United Science Industries,
Inc.
6295
E
Illinois
Hwy
15
~
Woodlawn,
IL
62898
(iu~iua~iuUwi&u~ixii~
Phone:
(618) 735-2411
Fax: (618) 735-2907
INVOICE
DaLee Oil
Company
206
North Hanover
Okawville
IL
62271
ATTN:
Bill Parr
Task:
Corrective action activities;
Effluent sampling; Monthly groundwater treatment systems and SVE
rentals; Operation and
maintenance; Project management; Monthly discharge
monitoring report
Reference:
Kruep
-
Rocky’s
66
Work Period:
06/01/2002
to
07/31/2002
Personnel Charges
$
2,765.75
Equipment Charges
$
3,870.00
Stock Item Charges
$
0.00
Field Purchases
$
446.28
Subcontractor Charges
$
0.00
(Subcontractor & Field Expenses pending receipt by US/
are not included
on
this invoice and
are
subject
to
future billing.)
Payment Terms:
Category
31DM
Customer P.O. Number:
Please make checks payable to:
United science Industries, Inc.
6295
E
Illinois
Hwy
15
Woodlawn,
IL 62598
00 7 0
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR PAYMENT OF
UST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage instructions,
see reverse.
BILLING PERIOD
Incident
No:
923466
Job Name:
Kruep
-
Rocky’s
66
Contractor:
United Science Industries,
Inc.
from:
06/01/2002
to:
07/31/2002
Total Personnel
$
‘
34.75
This Agency is authorized to request this information under the
Illinois Environmental Protection Act, 415
tLcs
5/1
et seq.
(formerly
Ill Rev.
Stat Ch
111
1/2,
1001
et seq.)
Disclosure of this information is required.
Failure to property complete this form in its entiretymay result in the delay or denial ofany payment
requested hereunder. This form has been approvedby the Forms Management Center.
Employee
Work Classification
ST/OT
*Rate
Total
Johnson, M.
‘$0,
PROJECT MANAGER
.
t
0.50
95.06
47.50
1’
Morgan,
H.
PROJECT MANAGER
~-
21.00
95.00
1995.00
).15,
~
Q.5~
3.95
Morgan,
R.
1~~p
/..1~,
ASSISTANT PROJ MANAGER
115
—
6~.O0
113.75
,
Weatherford
f~g
‘~•?
SENIOR ENVIRONMENTAL TECH
53.00
609.50
~‘
*
Use
Time and Materials Rate
2765.75(
IL 532
1818
LPC 325
Rev. Mar-93
Illinois
Environmental
Protection Agency
____
UNDERGROUND STORAGE TANK PROGRAM
Request
for
Payment of UST Corrective Action
Costs
Incident No:923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
07/07/20
to:
07/13/2002
Contractor:
United Science Industries,
Inc.
S
in
UN
at
MON
TUES
in
at
in
at
W
in
ED
at
TI-fURS
in
at
‘FR
in
I
ot
SA
in
I
at
TOTAL HOURS
‘
Employee
Type of Work Performed
st
ot
st
at
st
ot
st
at
st
at
st
at
st
at
st
ot
Morgan,
H.
PROJECT MANAGER
16.30
0.50
ITOO
0930
0.75
1015
—
—
1.25
.—
“
Morgan,
H.
PROJECT MANAGER
16.00
16.30
0.50
0.50
Morgan,
R.
ASSISTANT PROJ MANAGER
~
16.15
0,25
16.30
09.00
025
09.15
0.50
Weatherfard
SENIOR
ENVIRONMENTAL
—
07.00
14.00
07.00
05.00
—
-~
IL 532 1622
Totat Hours
l0.25j
LPC 329
Rev. Mar-93
This Agency
is
authorized to request this information under the
Illinois Environmental
Protection Act. 415
ILCS
5/I
et seq. (formerly Ill Rev. Stat Cri 1111/2, 1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this form in its entirety may result in the delay or denial ofanypayment
Page:
1
requested
hereunder, This form has been approved bytheForms Management center.
so
0
-~a
ta
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment
of
UST Corrective Action Costs
Incident No
923466
For usage instructions, see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
07~’14/20
to:
07/20/2002
Contractor
United Science Industries, Inc.
SUN
MON
TUES
WED
TI-fURS
FRI
SAT
TOTAL HOURS
in
at
it-i
at
in
at
in
ot
in
at
in
at
in
at
Employee
Type
of
Work Performed
st
at
st
at
st
at
st
at
st
at
st
at
st
at
st
at
Johnson,
M.
PROJECT MANAGER
10.30
11.00
0.50
0.50
Morgan,
H.
PROJECT MANAGER
09.15
09.30
11.15
11.45
05.00
09.45
10.00
10,30
0,25
0.50
1,75
0.50
SOC
•
Morgan,
H.
PROJECT
MANAGER
14.15
17.15
.
3.00
3_ca
.._-
Morgan,
H.
PROJECT MANAGER
10.00
12.00
2.00
2.00
.—
Morgan,
H.
PROJECT MANAGER
12.15
14.15
2.00
~00
—
Morgan,
H.
PROJECT
MANAGER
15.00
17.15
.
2.25
2.25
“
Morgan,
R.
ASSISTANT PROJ
MANAGER
10.45
11.00
10.30
10.45
p
a
0.25
0.25
0.50
—~
Marga~.
ASSISTANTPROJ MANAGER
14.00
1430
,.~—
0.50
0.50
Morgan,
R.
ASSISTANT PROJ
MANAGER
13.00
13.15
,/7
0.25
0.25
IL 532 1822
Totat
Hours
fl4.aoj ~
LPC 329
Rev Mar-93
mis
Agency is authorized to request this information under the Illinois Environmental Protection Act. 415
lLcS
511
et seq. (formerly
iii Rev. Stat ~h111
1/2, 1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this form in its entirety may result in the delayer denial of any payment
Page: 2
requested hereunder
This form has been approved by the Forms Management center
0
0
-4..
Co
(A)
C)
C))
Illinois
Environmental
Protection Agency
____
.
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Incident
No:923466
For
usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
07/21/20
to:
07/27/2002
Contractor:
United
Science Industries,
Inc.
SUN
MON
TUES
WED
TI-fURS
FRI
SAT
TOTAL HOURS
in
at
in
at
it-i
ot
in
at
in
at
in
at
in
at
.
Employee
Type of Work
Performed
at
at
at
at
at
ot
.
st
at
at
at
at
at
st
at
at
at
Morgan,
H.
PROJECT MANAGER
1015
1030 15A5
1615
1615
1715 nOD
i2MO
.
0,25
0.50
1.00
1.00
2.75
Weatherfard
SENIOR ENVIRONMENTAL
07.00
10.30
—
3.5O~
IL 532
1822
Total
Hours
6.25j
LPC 329
Rev. Mar-93
This Agency is authorized to request this information under the Illinois Environmental Protection Act, 415
ILCS
5/1 et seq. (formerly Ill Rev. Stat
ct~
1111/2,
1001
et
seq.)
Disclosure ofthis
information
is required.
Failure to properly complete this foam in its entirety may result in the delay or denial ofany payment
Page:
1
requested hereunder.
This form hasbeen approvedby theFonts Management Center.
0
0
-4
P-fl
Illinois Environmental Protection
Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action
Costs
Incident
No: 923466
For usage
instructions,
see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
.
‘Billing
Period:
from:
07/28/20
to:
07/31/2002
Contractor:
United Science IndustrIes, Inc.
I
SUN
MON
TI.ffiS
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
at
in
at
in
at
in
at
in
at
Employee
Type of Work Performed
at
at
at
at
at
at
at
ot
at
at
at
at
at
ot
at
at
Morgan,
H.
PROJECT
MANAGER
18.15
18.45
10.15
10.30
10.00
12.00
0.50
0.25
2.00
2.75
t’
Morgan, H.
PROJECT MANAGER
t&~s
I&45
1.00
1.00
IL 532
1822
Total
Hours
LPC 329
Rev. Mar-93
This Agency is authorized to request this information under the Illinois Environmental Protection Act. 415
ILCS
5/1
et seq. (formerly
Ill
Rev,
stat cii
1111/2,
1001 etseq,) Disclosure of this information is required.
Failure to properly complete this font in
its entirety
may
result in the delay or denialofany payment
Page: 1
requested hereunder.
This font has been approved bythe Forms Management center.
0
t~
-1
a)
Illinois Environmental Protection Agency
Incident No:923466
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF
UST CORRECTIVE ACTION COSTS
For usage
instructions,
see
reverse.
EQUIPMENT
Billing
Period
From:
06/01/2002
To:
07/31/2002
387o.oq
—
IL
532
1819
LPC 326 Rev. Mar-93
This
Agency is
authorized to request
this information under the
Illinois
Environmental Protection
Act,
4l~
ILCS
5/I
et seq.
(formerley
Ill
Rev. Stat
Ch
111112,
1001
et seq.)
Disclosure ofthis
information is requi
Failure to properly complete this form in
its entirety may result in the delay or denialofanypayment
requested hereunder.
This form has been approved by the Forms Management Center.
fl97
Note:
Include
cost ofoperator in the unit
rates.
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries,
Inc.
*
Use
Time and Materials Rates
Equipment Used
Time Used
*(jffl~
Rate
Total
Cost
ROCKY’S GROUNDWATER
1.00 MONTHJ
3750.00
3,750.0(
ENV.
UTILITY VEHICLE
2.00 DAY
60.00
120.OC
Total
EquipmentCost
This Agency is authorized to request this inloifflation under the Illinois
Environmental Protection Act. 415
~
Illinois
Environmental
Protection
Agency
ct.cs sit etseq. (formetly III Rev. Statch
111
112.1001 etseq.) Oisdosureofthis Inlormationisrequired.
Failure to properly complete this form in its entirety may result in the delay or denial ofany payment
requested hereunder. This form has been approved bythe Forms Management center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries,
Inc.
BilUng Period:
from:
07107/2002
to:
07/13/2002
Contractors Authorized
Representative:
Date:
Date:
ENV:UTILITY VEFIICLE
0.00
TU ES
~1
I .000AY
I
IQIAL
I
EQUIPMENT
j
SUN
MON
THURS
FRI
SAT
Hrs.orDays
WED
0.00
+
0.00
1
0.00
1_
2T?°.
0.00
1.OcOAV
0
.4
IL
532 1540
LPC
248
Rev.
Mar-93
Illinois
Environmental Protection
Agency
This Agencyis authorized to request this information under the Illinois Environmental Protection Act, 415
lLcs Sn
et seq.
(formerly
II Rev,
stat
cti
111
1/2,
1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in its entirety may result in the delay or denial of any payment
requested hereunder.
This form has been approved by the Forms Management center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rocky’s
66
BUhing
Period:
from:07/21/2002
Contractors Authorized Representative:
IL
532 1540
LPC 248
Rev.
Mar-93
Contractor:
United
Science Industries, Inc.
ENV.
UTILITY
VEHIcLE
0.00
I
IQIAL
EQUIPMENT
SUN
MON
TUES
WED
THURS
FRI
j
SAT
H~orOays
1 00DM’
0.00
to:
07/27/2002
0.00
j
0.00
j
0.00
0.00
I.000AY
0
•0
(0
Date:
Date:
This
Agency is authorized
to request this
information under the Illinois
Environmental
Protection Act. 415
Illinois
Environmental
Protection
Agency
.
~
5/1 et
seq.
(formerly Ill Rev. Stat Ch
111
1/2,
1001
et
seq.)
Disclosure of this information
is required.
Failure to properly complete this
form in
its entirety may
result in the delay or denial
or any payment
requested hereunder
This form has been approved bythe Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rock~s66
Contractor:
United Science Industries,
nc.
0
C
0’
Billing
Period:
from:07/28/2002
to:
07/31/2002
Contractors Authorized Representative:
IL 532
1540
Date:
Date:
I
ROCKY’SGROUNDWATER TREATMENT
1
MON
0.00
TUES
0.00
+
I
IOIAL
I
EQUIPMENT
SUN
THURS
I
FRI
SAT
Hrs.oroays
WED
1~
0.00
1.00 MONTH
0.00
0.00
0.00
1.0~ONTH
LPC 248
Rev. Mar-93
•
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION
COSTS
Incident No:923466
FIELD PURCHASES
billing
~erioa
Job Name:
Kruep
-
Rocky’s 66
.
From:
06/01/2002
Contractor:
United Science industries,
Inc.
To:
07/31/2002
Field Purchases
Quantity
Price/Item
Total Costs/item
GWT
electricity
1.00
398.46 / E
395.46
‘Note:
Copies
of invoices or billings must be
attached.
Subtotal
398.46
Some subcontractor in voices and
billings may
require
.
further time
and matealal itemization.
Handhng
Charge
$47.82
Total Subcontract Cost
446.28
Handling
Charges
are
eligible forpayment only if they are equal to or less
than the following amounts:
Subcontract of Field
Eligible Handling Charges
Purchase Cost
as
a Percentage of Cost
$1-$5,000
$12
-
$5,001
-$15,000
$600+I0
of arnt.
over $5,000
$15,001 -$50,000
$1600+8
of amt. over $15,000
$50,001
-$100,000
$4,400+5
of antt. over $50,000
$100,000
-
$1,000,000
$6900÷2
of amt. over $100,000
ThisAgency is authorized torequest this information under the Illinois Environmental Protection Act, 415
1
~
ILCS
5/let
seq. (formerly
ill
Rev.
Stat Ch 1111/2,
1001
et
seq.)
Disclosure of this information is required.
IL.
.JOL
I OZ.O
Failure
to property complete
this form in its entirety
may result in
the delay ordenialofany payment
LPC 330
Rev.
Mar-93
requested
hereunder.
This form has been approved bythe Forms Management center.
0081
BILLING
SUMMARY
Accouht
Number:
6761308174
ILLINOIS POWER
Partof
the Ov.~Ecy
perforn,ance Team
UNITED
SCIENCE
INDUSTRIES
203
W
ELM
ST
R
OKAWVI LLE
IL
62271
923466
If
you
have
any
questions
Commercial Electric Service
about
your
bill,
please
Total Current Charges
call
l-800—3636805.
\‘
Please
mail,
general
Previous Balance
06-05-02
correspondence
to
our_
Company
headquarters:
~NI
Illinois
Power
PG
Box
Eli
Decatur,
IL
62525
YOUR
ENERGY
USE
Thank you for your prompt paymentsC
We appreciate
customers like
you.
Illinois Power offer~
convenient,
safe electronic
payment
options.
Please
call
our 24
Hour’
Customer
Service
Center
l-B00-755-5000
or
visit
our web site at
www.illinoispower.
for more information.
Fold
and
tea
tn
perforMion
at
dotted
.line
ffBWNGRNG
****AUTO~Et3-DIGIT
628
4t01S7676l30817476~
UNITED
SCIENCE
INDUSTRIES
79
PG
BOX
360
WOODLAWN
IL
62898-0360
.1.
l..l
I~IIIII
‘..lI.,Il
,.ll ,.11I
P.O.
Box
2522
Decatur,
Ii
62525-2322
0082
1
04
FR2
Return
this
portion
with
your
payment
a
Payment Posted
06-24-02
__________
Balance Brought
Forward
S
TOTALAMOUNT
DUE
TO
ILLINOIS
POWER by 07-23-02
TOTAL AMOUNT DUE
TO
ILLINOIS
POWER after 07-23-02
$
398.46
$
.473.66
-473.66
S
398.46
.00
$
398.46
S
404.44
ELECTRIC/kwh
-
usage last 13 months
AVERAGES
FOR
THIS
LAST
BILLING
PERIOD
YEAR
YEAR
7054
hII~+fI
TEMPERATURE
78
74
ELEC/kwh
Oer
Day
136
201
Cost per
Day
$12.41
$17.49
costperkwh
$0.09
$0.09
0,11
smountr
band
pr.tax
J
A
S
0
N
0
.3
F
M
A
M
3
.3
AVG
Ut,
-
actual
a
~-
estimated
-
current month
-
current month
last year
cit/ttV/
7~
BULLETIN
BOARD
~~ite~
at
corn
AMOUNT
PAID:!
t
DUE
DATE:
‘-1(~
I
donation
of:
July
23,
2002
DUE
NOW:
$398.46
AFTER
DUE
DATE:
$404.44
ILLINOIS
POWER
YES!
I want
to be a Warm Neighbor.
Sign me up for
a monthly
$1.00
$2.00
Other
ACCOUNT
$t:
BILL_DATE:
6761308174
July
09.
2002
0
2
072502
0
000000404446
000000398460
6761308174
1
ILUNOIS POWER
Part o~
00
Proton Pontorinanca 1nm
F
.r1~
;•~~t
~
terlir
923466
,~~‘
•
rT~~
it
1Ct~
rj::..
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Od,)
F!e~
rb’
l’,ci’e
‘t’ticipu~
ta’
L’tt~
.
•
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-
:~.j
~
“R~cF
)cJ
~
It!
!tn~.i~\L’
—~•
•~
.
e
0083
ACCOUNT
NUMBER:
6761308174
ILliNOIS POWER
Partof
the Pywacy Performance lean,
UNITED
SCIENCE
INDUSTRIES
923466
-
PAGE
2
—
ELECTRIC
SERVICE
Current Meter
Readi
Previous
Meter
Read
Amount oI Electricity
Maximum
Demand
ng,
07/05/02
(Actual)
ing,
06/04/02
(Actual)
Used
In
31
Days
Billing
Demand Ending
07/05/02
Distribution
Capacity Ending 07/05/02
24.500
kw
2.200
kwh
2,012
kwh
24.500
kw
x
$
$
$
$
$
$
$
17864
13652
kwh
4212
On
07-05
On
02-04
45,75
42.88
204.58
72.41
18.38
32.01
-32.01
384.80
METER#:
40484373
Rate
11
kw
kw
11.000
kw
11,000
24.500
-
x
$
1.750000
x
$
0.092990
x
$
0.035990
$
0.750000
4,212 kwh
x
$
0.007600
4,212
kwh
x
$
0,007600-
4.212
kwh
x $ 0.0001 90
Cost of Electricity
Used for
31
Days
Ending
07/05/02
Account Charge
-
Below
2.4 kv
-
1
Phase
Distribution
Capacity Charge
Summer Energy Charge
Transformation
Charge
Instrument
Funding
Charge
Instrument
Funding
Charge Credit
Decommissioning
Expense Adjustment
SERVICE BILLING
SUBTOTAL
Electricity Excise
Tax
TOTAL COST
FOR
ELECTRIC
SERVICE
2,000
kwh
x
$003300
2,212
kwh
x
$003190
$
$
6.60
$
7.06
$
398.46
00-84
S
923466
ILLINOIS POWER
Pan
of
the
Drecor Perkrmence
learn
0055
S
f-f
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE
TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Summary Sheet for All Charges in
this Billing Package
Incident No: 923466
The
ownerfoperator or their representative shall complete this form and place it
in the front of the billing
-
package.
All charges in this
billing package shall be summarized on
this form.
PAYMENT ITEM
MATERIALS
&
EXPENDABLES
(In Stock Items)
MATERIALS &
EXPENDABLES
(Field Purchases)
SUBCONTRACTORS
TOTAL PAYMENT REQUESTED
IL 532 2168
LPC 482
Mar-93
TOTAL PAYMENT REQUESTED
3,
3,970.00
,/‘•~
0.00
530.50
7
0.00
8,414.50
-PERSONNEL
EQUIPMENT
V
$
$
This
Agency is authorized
to request this information under
the Illinois Environmental Protection Act, 415
lLcs
511
et seq.
(formerly
II
Rev. Stat
ch
1111/2,
1001
else
of this information is required
Fatlure to properly complete This
form in
its
entirety may
result i
denial of any payment
requested hereunder
This
form
has been approved by the
Forms Managethent center
United Science Industries, Inc.
6295
E
Illinois Hwy 15
Woodlawn, IL 62898
Phone: (618) 735-2411
Fax: (618) 735-2907
INVOICE
DaLee Oil Company
206
North Hanover
Okawville
IL
62271
ATTN:
Bill
Parr
f~
Task:
Corrective
action
activities; Effluent sampling; Monthly groundwater treatment
system and SVE rental;
Operation and
maintenance; Project management;
Monthly
discharge monitor report Quarterly
sampling
Reference:
Kruep
-
Rocky’s 66
Work Period:
03/01/2002
to
06/30/2002
Personnel Charges
$
3,914.00
Equipment Charges
$
3,970.00
Stock
Item Charges
.
$
0.00
Field Purchases
-
$
530.50
Subcontractor Charges
$
0.00
(Subcontractor & Field Expenses pending receipt by US? are
not included
on this invoice arid
are
subject
to
future billing.)
NetDe°hi~In
pice
SO4~6
Payment Terms:
Category 3/DM
Customer P.O. Number:
united Science Industries, Inc.
6295
E
Illinois
Hwy
15
Woodlawn, IL 62898
0087
Please make checks payable to:
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage instructions,
see
reverse.
BILLING PERIOD
Incident P1a:923466
.Job Name:
Kruep
-
Rocky’s
66
Contractor:
united Science Industries,
Inc.
from:
03/01/2002
to:
06/30/2002
*
Use
Time
and Materials Rate
Total Personnel
61 .001
3914.00j~
This
Agency is authortzed to request this
nformation under
the
Illinois
Environmental
Protection
Act,
415
ftcs
s/i
at seq.
(formerly Ill F~ev.Stat
ct~
111
1/2,
1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in
its
entirety may
result
in
the
delay or
denial ot any payment
requested hereunder
This
form
has been approved by the
Forms Management center.
IL 532
1816
LPC
325
Rev.
Mar-93
-
0085
Employee
Work Classification
ST/OT
*Rate
I
Total
Johnson,
M.
PROJECT MANAGER
—
—
1.00
95.00
95.00
1,
Morgan,
H.
/
~
5.jg,
i
PROJECT MANAGER
-
12.50
95.00
1187.50
Morgan, ft
1.15,_7.75,
Shawn
~I
Weathertord
c,
Weatherford
5
ASSISTANT
PROJ MANAGER
e
9.50
65.50
617.50
ENVIRONMENTAL TECHNICIAN
SENIOR ENVIRON. TECH OT
SENIOR ENVIRONMENTAL TECH
B.OOf
5&O0
5300
-‘
53.00
~
1a.oof
424.00
212.00
954.00
Vearwood
~.,
ENVIRONMENTAL TECHNICIAN
8.00
53.00
424.00
.
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action
Costs
Incident
No
923466
For usage instructions)
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
06/02/20
to:
06/08/2002
Contractor:
United Science
Industries, Inc.
.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL
HOURS
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Employee
Type of Work Performed
at
ot
st
ot
at
ot
at
ot
at
ot
at
ot
at
ot
at
ot
Morgan,
H.
PROJECT MANAGER
14.00
14.15
11.00
11.30
09.30
11.30
15.30
16.00
0.25
0.50
2.00
0.50
3.25
~—
Morgan,
H.
PROJECT MANAGER
14.30
14.45
0.25
0.25
Morgan,
H.
PROJECT
MANAGER
16.00
16.30
16.15
16.30
.
Morgan,
H.
PROJECT
MANAGER
0.25
0.25
—•‘~
Morgan,
R.
ASSISTANT
PROJ
MANAGER
13.45
14.45
08.30
08.45
1.00
0.25
1.25
,~
Morgan,
R.
ASSISTANT PROJ
MANAGER
08.45
09.00
:
0.25
~‘
Morgan,
S.
ASSISTANT
PROJ
MANAGER
~
—
15.15
0.25
15.30
0.25
p
IL 532 4~2
LPC 3~Rev.
‘
—
Total Hours
6.00~
Mar-93
This Agency is authorized to request this Information under the Illinois Environmental
Protection Act, 415
lLcs
5/1
et
seq.
(formerly lii
Rev. Stat Ch 1111/2.
1001
et seq.)
Disclosure ofthis
information is required.
Failure
to properly complete this
form
in
its entirety
may
result in
the
delay or
denial of any payment
Page:
/
requested hereunder.
This
form
has been approved by the
Forms Management Center.
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST
Corrective Action
Costs
Incident
No:923466
For usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
06~’09~’20
to:
06/15/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
.TUES
WED
THURS
FRI
SAT
TOTAL HOURS
—
In
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Ifl
.øt
Employee
Type of Work Performed
st
ot
at
ot
at
ot
at
ot
at
ot
at
ot
at
ot
at
ot
Morgan,
H.
PROJECT MANAGER
.
12.15
~
12.45
12.30
13.00
09.00
09.30
j
1.50
Weatherford
SENIORENVIRONMENTAL
12.00
13.30
07.00
15.00
1.50
8,00
9.50
—~
Yearwood
ENVIRONMENTAL TECHNICIAN
07.00
15.00
~.
8.00
8.00
IL 532 1822
Total Hours
19.OOf
LPC 329
Rev. Mar-93
This Agency is authorized to request this information under the
Illinois
Environmental
Protection
Act, 415
lWS
5/1
et seq.
(formerly
Ill Rev.
Stat
Ch 111112, 1001
et seq.)
Disclosure ofthis information Is
required.
Failure to properly complete this form
in its
entirety
may
result in
the delay
or denial of any payment
Page:
1
requested
hereunder.
This
form
has
been approved by the Forms Management center.
p
Co
a
Illinois
Environmental
Protection Agency
UNDERGROUND STORAGE TANK
PROGRAM
Request for Payment of UST
Corrective Action
Costs
Incident
No: 923466
For
usage
/nstrucfions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing
Period:
from:
06/16(20
to:
06/22/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
.
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Employee
Type of Work
Performed
at
ot
at
ot
at
ot
at
ot
at
ot
at
ot
at
ot
at
ot
Johnson,
M.
PROJECT MANAGER
10.30
11.30
1.00
1.00
“
Morgan,
H.
PROJECT MANAGER
08.45
09.45
07.30
08.30
1.00
1.00
2.00
‘~
Morgan,
H.
PROJECT MANAGER
09.00
10.00
,,
1.00
1.00
—
Morgan,
H.
PROJECT MANAGER
12.30
14.15
,,..
1.75
1.75
Morgan,
H.
PROJECT MANAGER
11.00
0.50
11.30
0.50
Weatherford
SENIOR ENVIRONMENTAL
11.30
16.00
—
IL 532
1822
Total Hours
10~75J
LPC 329
Rev. Mar-93
This
Agency is authorized to request this information underthe Illinois Environmental Protection
Act, 415
O
ILcS
5/1
et seq. (formerly
Ill
Rev. Stat
Ch
111
1/2,
1001
et
seq.)
Disclosure
of this information is required.
Failure to property complete this form
in its
entirety may result in
the
delay or
denial
of any payment
o
Page:
1
requested hereunder.
This form has
been approved by the Forms Management Center.
co
illinois Environmental
Protection Agency
UNbERGROUND STORAGE TANK PROGRAM
Request
for Payment of UST
Corrective Action
Costs
Incident
No:
923466
For usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing
Period:
from:
06/23/20
to:
06/29/2002
Contractor:
United Science Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL
HOURS
in
at
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Employee
Type of Work Performed
at
ot
at
ot
st
ot
at
ot
at
ot
at
ot
at
ot
at
ot
Morgan,
H.
PROJECTMANAGER
‘
—
—
08.30
09.15
—
09.30
10.00
—
07.15
07.30
—
-~
-~
.
1.50
Morgan,
R.
ASSISTANT PROJ MANAGER
09,15
09.30
07.00
14.30
Shawn
ENVIRONMENTALTECHNICIAN
0.25
7.50
07.00
15M0
7.75
,_.—
.
8.00
8.00
—
Weatherford
SENIOR ENVIRON. TECH 01
10.30
14.30
r
4.00
4.00
,—
Weatherford
SENIOR
ENVIRONMENTAL
—
—.—--
—
—
—
—
14.30
—
15.30
—
—
07.30
10.30
—
—
—
—
—
1.00
3.00
4.00
IL5321822
TotalHours
25.25j
LPC 329
Rev, Mar-93
This
Agency is authorized to request this information under the
Illinois Environmental
Protection
Act, 415
ILca
5)1 et seq.
(formerly Ill Rev. Stat
Ch
1111/2, 1001
etseq.)
Disclosure of this information Is
required.
Failure to property complete this form
in its entirety
may
result
in
the delay
or denial
of anypayment
Poge:
/
requested
hereunder,
This
form
has been approved
bythe
Forms
Management
Center.
0
0
Co
“I,
Illinois
Environmental
Protection Agency
Incident No:923466
UNDERGROUND STORAGE TANK
PROGRAM
REQUEST FOR
PAYMENT OF
UST CORRECTIVE ACTION
COSTS
For usage instructions,
see
reverse.
EQUIPMENT
Note:
Include cost
of
operator in the unit rates.
Job
Name:
Kiuep
-
Rocky’s
66
Contractor:
United Science Industries,
Inc.
From:
To:
Billing Period
03/01/2002
06130/2002
Equipment Used
Time Used
*Unit Rate
Total Cost
ROCKY’S GROUNDWATER
1.00 MONTH
3750.00
3,750.0?
ENV.
UTILITY
VEHICLE
300 DAY
60.00
180.0(
ELECTRONIC WATER LEVEL INDICAT
2.00 DAY
20.00
40CC
*
Use
Time and Materials Rates
Total Equipment Cost
3,97O.cK~
—
IL
532
1819
LPC
326
Rev.
Mar-93
This
Agency is authorized to request this information under the
Illinois
Environmental Protection
Act!
41
ILCS 5/I
at
seq.
(forniertey
lit Rev. Stat
Ch 1111/2,
tOOl at seq.)
Disclosure of this information is requi.
Failure to property complete this form
n hs entirety
may
result
in
the
delay
or denial of any payment
requested
hereunder.
This form
has
been approved by the Forms Management center.
0093
This
Agency
is authorized to requestthis
iniormalion under the Illinois
Environmental
Protection Act,
415
Illinois
Environmental
Protection
Agency
IL~SS/1etseq.(Iormerlyllt Rev. StatChill
1/2,1001 etseq.)
Disclosureofthisinformaticnisrequired.
Failure to properly complete this form
in
its
entirety may
result in
the delay or denial of any payment
c--i
Contractor:
United Science Industries, inc.
Billing Period:
from:
06/09/2002
to:
06/15/2002
Contractors Authorized Representative:
IL
532 1540
Date:
Date:
Job:
Kruep
-
Rocky’s 66
requested
hereunder.
This
form has
been approved by the
Forms Management center.
UNDERGROUND STORAGE TANK PROGRAM
InCident
No:
923466
WEEKLY WORK SHEET
EQUIPMENT
MON
0.00
+
TUES
0.00
-F
EQUIPMENT
SUN
THURS
FRI
SAT
WED
-f
1.00 DAY
0-00
+
0.00
0.00
F
0.00
lOt
F-irs.
or Days
1.OcOAY
ENV.
UTILITY VEHICLE
0
0
Co
I
I
Dr
~AR
Pc~, !tAor_Q’~
-
This
Agency is authorized
to request
this
information under the Illinois
Environmental
Protection
Act,
415
Illinois
Environmental
Protection
Agency
ILCS 5/let
seq.
(formerly III Rev. StatCh
111
1/2,
1001
et
seq.)
Discjosureofthis information is required,
Failure to properly complete this
form in
its
entirety may
result
in
the delay or denial of
any payment
requested
hereunder.
This form
has
been
approved by the Forms Management center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Fcruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
UI
PMENT
ENV. UTILITYVEHICLE
0
0
Co
01
Contractors Authorized
Representative:
Date:
Date:
SUN
MON
0.00
‘F
THURS
FRI
j
SAT
TUES
0.00
I’
WED
0.00
I-
Billing Period:
from:
06/16/2002
to:
06/22/2002
0.00
1-
1.00 DAY
0.00
0.00
I
I’JISL
~j-lrs. or Days
1.OWAY
I
IL 532
1540
I
Pr, 74R
Rev Mer-93
Illinois Environmental Protection Agency
Job:
Kruep
-
Rockys 66
This Agency is authorized to request~his
intormalion
under the Illinois
Environmental Proteclion Act 415
It_CS
5/1
et seq. (formerly
Ill
Rev. Stét Chili
1/2
1001
et seq.)
Disclosure
of
this information
is required.
Failure to properly complete this form In its entirely may
result in
the
delay or denial of any
payment
requested hereunder.
This form
has been approved by the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Contractor:
United Science Industries, Inc.
0
0
Co
a)
Billing
Period:
from:
06/23/2002
Contractors Authorized
Representative:
IL 532
1540
to:
06/29/2002
Date:
Date:
LPC 248 Rev. Mar-93
This Agency
is authorized to requeslfllsinformation under the Illinois
Environmental
Protection Act, 415
itS
sf1
et
seq.
(formerly Ill Rev. StatCh
1111(2, 1001
et
seq.)
Disclosure of this
information
is required.
Failure to properly complete this forn’f in. Its entirety may
result in
the delay or denial of any payment
Illinois
Environmental
Protection
Agency
requested
hereunder.
This
form
has
been
approved by the Forms Management Center.
UNDERGROUND STORAGE TANKPROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
0
0
Co
a,
Billing
Period:
from:
06/30/2002
Contractors Authorized
Representative:
IL
532
1540
I
PC 74R
Rev.
Mar-93
Date:
Date:
I
ROCKY’S GROUNDWATER TREATMENT
1.00 MONTH
0.00
EQUIPMENT
I
SUN
I
MON
THURS
FRI
I
SAT
F-Irs.
VIAL
or Days
TU ES
1-
WED
0.00
f
DM0
-f
to:
06/30/2002
0.00
0-00
0.00
I.0~ONT~
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION
COSTS
Incident
No:
923466
FIELD
PURCHASES
bIlhng Period
Job Name:
Kruep
-
Rocky’s 66
From:
03/0112002
Contractor:
United Science Industries,
Inc.
To:
06/30/2002
Field Purchases
Quantity
Price/Item
Total Costs/Item
Utilities
1.00
473.66
I
EACH
473.56
Note:
Cop/es of invoices or billings must be
attached.
Subtotal
473.66
Some
subcontractor invoices and
billings may require
furthertime
and material itemization.
**
Handling Charge
$56.84
Total Subcontract Cost
530.50
Handling Charges are eligible forpayment only if theyare equalto orless
than the following amounts:
Subcontract of Field
Eligible Handling Charges
Purchase Cost
as
a
Percentage of Cost
$1
-$5,000
$12
$5,001
-$15,000
$600+10
of amt.
over $5,000
$15,001
-$50,000
$1
600+8
of
amt.
over $15,000
$50,001
-$100,000
$4,400+5
of amt.
over
$50,000
$100,000 -$1,000,000
$6,900+2
of arm.
over $100,000
This
Agency is
auihorized io requesi
this
information under ihe
illinois Environmental
Protection
Act. 415
S32
182~
it_CS
5/let
seq.
(lormerly Iii Rev,
stal Chill
1/2,1001
et seq.)
Disclosure of Ihis information is required.
IL
I
U
Failure to properiy complete this form in
its entirety
may result in
the
delay or
denial of any payment
LPC 330
Rev, Mar-93
requested hereunder.
This form
has been approved by the Fcrms Management Center.
0098
B~LUN6—SUMMARY
Account
Number:
6761308174
If
you have any questions
about your bill, please
call
1-800-363-6805.
Please mail general
correspondence ko our
Company headquarters:
Illinois Power
P0 Box 511
Commercial Electric Service
Total
Current Charges
Previous Balance
05-02-02
Payment
Posted
05-17-02
Balance
Brought Forward
TOTAL
AMOUNT DUE
TO
ILLINOIS
POWER
TOTAL AMOUNT DUE TO
ILLINOIS POWER
$
$
488.28
-488.28
$
.00
by
06-20-02
after
06-20-02
Decatur,
IL
62525
YOUR
ENERGY
USE
ELECTRIC/kwh
.
usage last 13months
1t,Stl
iant
J
J
A
S
0
N
0
.1
F
M
A
IA
J
AVG
/1?
-
actual
-
estimated
current
month
-
current month
last
year
/U~7~
I,
BULLETIN
BOARD
Illinois
Power
offers
options.
Please
call
1—800-755—5000
or vjsj
-j
for
more
information.
convenient,
safe
electronic
payment
our 24 Hour Customer Service Center at
t
our web site at www.illinojspower.com
ILLINOIS
POWER
~MOUNT
PAID:
)UE DATE:
IUE
NOW:
FIER
DUE
DATE:
1
June
20,
2002
$473.66
$480.76
1
YES!
I.
want
to
be
a
Warm
Neighbor.
Sign
me
up
for
a
monthly
~J
donation
of:
$1.00
$2.00
_________________________________
Other
_________________________________
ACCOUNT *:
6761308174
~EILL
DATE:
June
06.
2002
*BWNGRNG
~***AUT0u
3-DIGIT
628
*0 1E76761308 1747 6*
UNITED
SCIENCE
INDUSTRIES
79
P0
SOX
360
WOODLAWN
IL
62898-0360
P.O.
Box 2522
Decatur,
I.
62525-2522
1
04
FR2
I
~
IIIIIIIIIIIIIIIIIIIIIIIIIIIIII
Return
this
portion
payment
i~cr”c:’~~
/r-~.
I
t...._d.,_.~
~
—
JUN
-
7
2002
BY:~____
ILLINOIS POWER
Part oftht
Oy.nov Ptrfot,nanc.
rein
UNITED
SCIENCE
INDUSTRIES
203
W
ELM
ST
R
0KAWVILLE
IL
62271
923466
473.66
$
473.”
473.66
480.76
$
$
AVERAGES
FOR
BILLING
PERIOD
TM/s
YEAR
LAST
YEAR
TEMPERATURE
65
68
ELECRCWh per Day
188
340
CostperDay
$13.75
$19.64
Cestperlcwh
$0.07
$0.06
Dollar
amounts
based
on
pretax
flaurea.
a
v~’
‘a’
Thank you for your prompt payments.
We appreciate customers
like
you.
0
2
062402
3
000000480765
300330473666
6761308174
1
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE
TANK PROGRAM
Request for Payment of UST Corrective
Action Costs
Summary
Sheet for All Charges
in this Billing
Package
Incident
No:
923466
The owner/operator or their representative shall complete this form
and place it in the front of the billing
package.
All charges in
this billing package shall be summarized on
this
form,
PAYMENT ITEM
PERSONNEL
EQUIPMENT
MATERIALS
& EXPENDABLES
(In Stock Items)
MATERIALS &
EXPENDABLES
(Field Purchases)
SUBCONTRACTORS
TOTAL
PAYMENT REQUESTED
3,975.00
0.00
546.87
0. 00
,~
6,561.87
This Agency is authorized to request this information under the
liii
n
ental Protection Act, 415
LOSS/let
seq. (tonnerly Ill Rev. Stat Chill
1/2.
1001
et seq.)
‘
c
his intormalion
is
reqthred.
Failure to properly complete
this form
in
its
entirety
may ~esutt
in
the delay
or denial of any payment
requested hereunder,
This
form
has
been approved
by the
Forms Management Center,
$
$
TOTAL PAYMENT REQUESTED
IL 532 2168
LPC 482
Mar-93
United Science Industries, Inc.
6295
E
Illinois Hwy
15
Woodlawn,
IL 62898
Phone: (618) 735-2411
Fax:
(618) 735-2907
INVOICE
Okawville
IL
62271
DaLee Oil Company
206 North
Hanover
Task:
Corrective
action
activities;
Effluent sampling; Monthly ground water treatment
system and
SVE
rental,
Operation and
maintenance;
Project management; Quarterly report;
Monthly discharge monitoring
report
ATTN:
Bill Parr
Reference:
Kruep
-
Rocky’s
66
Work Period:
03/01/2002
to
05/31/2002
Personnel Charges
$
2,040.00
Equipment Charges
$ 3,975.00
Stock Item Charges
$
0.00
Field Purchases
$
546.87
Subcontractor Charges
$
0.00
(Subcontractor & Field Expenses pending receipt by
USI
are
not
included
on this invoice and
are
subject
to
future billing.)
s~
a”~r
~-#
,
Mt~l*1rM
?~_bie
~VJ~ce
,
$
6~56’I27
Payment Terms:
Category
3/OM
Customer
P.O. Number:
Please make checks payable to:
United Science Industries, Inc.
6295 E Illinois Hwy 15
Woodlawn,
IL 62896
a
UNITED
SCIENCE INDUSTKIES
0101
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR PAYMENT OF
UST CORRECTIVE ACTION COSTS
PERSONNEL
SUMMARY SHEET
For Usage instructions, see reverse.
BILLING PERIOD
Incident
No:
923466
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
from:
03/01/2002
to:
05/31/2002
28.50
This~gency
is authorized to request this information under the Illinois
Environmental
Protection Act, 415
tLcS
5/1
et seq.
(formerly
It Rev. Stat
Ch
111
1/2.
1001 et seq.)
Disclosure of this intormation is required.
Failure to property complete this form
in
its
entirety may
result
in
the delay or
denial of any payment
requested
hereunder.
This
form
has been approved
by the
Forms Management
Center.
IL532 1818
LPC
325
Rev. Mar-93
0102
Employee
Work Classification
ST/OT
*Rate
Total
Morgan,
H.
PROJECT MANAGER
1225
95.00
1163.75
1~_7.75.
;.)$,
,‘5o,.~5,
Morgan,
R.
-
ASSISTANT PROJ MANAGER
t25
6~00
53.00
81.25
Weathe~ord
1,
ca,,
SENIOR ENVIRONMENTALTECH
15M0
795.00
*
Use Time and Materials
Rate
r
Total Personnel
2040.0O_-
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment ofUST Corrective Action Costs
Incident No
923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kcuep
-
Rocky’s
66
BiDing Period:
from:
04/28/20
to:
05/04/2002
Contractor:
United Science Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
j
st
ot
Employee
Type of Work Performed
st
ot
st
ot
st
ot
st
at
st
at
et
at
st
at
Morgan,
H.
PROJECT MANAGER
10.15
10.45
09.00
09.30
“
0.50
0.50
1.00
Morgan,
H.
PROJECT MANAGER
10.30
~O
too
too
IL
532 1822
Total Hours
2.001
LPC 329
Rev. Mar-93
This
Agencyi~
authorized to request this information
under the Illinois Environmental
Protection Act, 415
ILcS
5/1
et seq.
(formerly
ill
Rev.
Stat Ch 1111/2, 1001
et seq.)
Disclosure of this information is required.
Failure
to properly complete this
form
in
its
entirety
may
result in
the
delay or
denial
of
any payment
Page: 1
requested hereunder.
This
form has
been approved by the Forms Management Center.
C
I-
0
Ca)
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of
UST
Corrective Action
Costs
incident
No:923466
For
usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
05/05/20
to:
05/11/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Employee
Type of Work Performed
st
at
st
at
st
at
st
ot
st
ot
st
ot
st
ot
st
ot
Morgan,
H.
PROJECT MANAGER
07.45
15.30
.
7.75
,,
Weatherford
SENIOR ENVIRONMENTAL
07.00
16.00
9.00~
IL 532
1822
Total
Hours
16.75~
LPC 329
Rev. Mar-93
This
Agency is authorized to request ths information under the
Illinois Environmental
Protection
Act, 41t
ILCS
5/1
et
seq.
(formerly
Ill Rev. Stat
Ch 1111/2,
1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this
form
in
its entirety
may
result in the
delay or denial of any payment
Page:
1
requested
hereunder.
This
form
has been approved by the Forms Management Center.
0
—
0
*.
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST
Corrective Action Costs
Incident
No
923466
For usage
instructions,
seereverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing
Period:
from:
05/12/20
to:
05/18/2002
Contractor:
United Science
Industries, Inc.
SUN
MON
TOES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
in
ot
in
at
in
ot
in
ot
in
ot
Employee
Type of Work Performed
st
ot
st
ot
st
ot
st
ot
st
ot
st
ot
st
ot
st
at
Morgan,
H.
—
PROJECT MANAGER
14.00
14.15
11.00
12.00
Morgan,
R.
ASSISTANT PROJ
MANAGER
0.25
too
13.45
14.00
1.25
—
.
0.25
0.25
Weatherford
SENIOR ENVIRONMENTAL
07.00
12.30
14.00
14.30
6.00
IL 532 1822
Total
Hours
7.501
LPC 329
Rev. Mar-93
This
Agency is authorized to request this information under the Illinois Environmental
Protection
Act, 415
ucs
5/i
el seq.
(formerly Ill Rev.
Stat Chili
1/2.1001
et seq.)
Disclosure of this information is required.
FaiLure to
properly complete this form in Ks entirety
may
result in the
delay or
denial of any payment
Page: /
requested hereunder.
This form has
been approved by the
Forms Management center.
C
,~
0
(~)1
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action
Costs
Incident
No: 923466
For
usage instructions, see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
05~’19/20
to:
05i’25/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
....—
in
ot
in
at
in
at
in
at
in
at
in
at
in
at
Employee
Type
of Work Performed
st
at
st
at
st
at
st
at
st
at
st
at
st
at
st
at
Morgan,
H.
PROJECT MANAGER
13.45
14.15
0.50
0.50
IL 532 1822
Total
Hours
0.50~
LPC 329
Rev, Mar-93
This Agency is authorized to requestihis
information under the
Illinois Environmenlal Protection
Act, 415
105 5/1 et
seq.
(formerly Ill Rev. Stat
Oh 1111/2, 1001
et seq.)
Disclosure of this information Is required.
Failure to
property complete this form in its entirety may result in the
delay or
denial of any payment
Page:
1
requested
hereunder. This form has
been approved by the Forms Management Center.
0
C)
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE
TANK
PROGRAM
Request for Payment of UST Corrective
Action Costs
Incident
No
923466
For usage instructions, see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
05/26/20
to:
05/31/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
TI-IURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
ot
in
ot
in
ot
in
at
in
at
Employee
Type
of Work Performed
st
ot
st
ot
st
of
st
ot
st
ot
st
ot
st
ot
st
at
Morgan,
H.
PROJECT MANAGER
10.45
11.00
08.30
09.00
0.25
0.50
0.75
Morgan, R.
ASSISTANT PROJ MANAGER
1O.15
11.15
‘
1.00
1.00 ~
IL
532
1822
Total Hours
1.75j
LPC 329
Rev. Mar-93
This
Agency
is
authorized to
request this information under the
Illinois Environmental
Protection Act,
415
ILcS 5/i et
seq. (formerly
Ill Rev. Stat
Oh
1111/2, 1001 et seq.)
Disclosure of this’inforrnation
is
required.
Failure to properly complete this form in its entirety may result in the delay or denialofany paynienl
Page:
1
requested
hereunder,
This
form
has been approved by the Forms Management center.
0
J-
0
-4
Illinois
Environmental
Protection Agency
Incident No:923466
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR
PAYMENT OF
UST CORRECTIVE ACTION
COSTS
For usage instructions,
see
reverse.
EQUIPMENT
Note.
Include cost of operator in the unit rates.
BilUng
Period
Job Name:
Kriiep
-
Rocky’s 66
From:
03/01/2002
Contractor:
United
Science
Industries, Inc.
To:
05/31/2002
Equipment Used
Time Used
*jJ~j~
Rate
Total Cost
ROCKY’S GROUNDWATER
1.00 MONTH
3750.00
3,750.0(
ENV.
UTILITY VEHICLE
2.00 DAY
60.00
120.0(
PHOTOIONIZATION
DETECTOR #1
1.00 DAY
105.00
—
105.OC
Total
Equipment Cost
3975TO~
*
Use
Time and Materials
Rates
________________
This
Agency is authorized to request this
information under the
Illinois
Environmental
Protection
Act, 415
LCS
5/1 ét
seq.
(formerley
Ill Rev. Stat Oh 1111/2. 1001 et seq.)
Disclosure of this information
is requir
IL
532 1819
Failure to properly complete this form in its entirety may result in the delay or denial of any payment
LPC
326
Rev.
Mar-93
requested hereunder.
This form has been approved bythe Forms Management center.
010$
This Agency is authorized
to request this
information under
the Illinois
Environmental
Protection Act,
415
Illinois
Environmental
Protection
Agency
LOS
5/let
seq.
(formerly Ill Rev. StatCh
111
1/2,1001
et
seq.)
Disclosureofthis information
is required.
Failure to properly complete this
form
in its
entirety may
result
in
the delay or
denial of
any payment
requested hereunder.
This
form
has been
approved by the Forms Management center.
UNDERGROUND STORAGE TANK
PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
0
0
CD
Bifling Period:
from:
05/05/2002
Contractors Authorized Representative:
to:
05/11)2002
Date:
Date:
IL 532
1540
LPC 248
Rev.
Mar-93
This Agency is authorized
to request this information under
the illinois Environmental
Protection Act,
415
Illinois
Environmental
Protection
Agency
ILCS Sn
et seq.
(formerly ill Rev.
StatCh
111
1(2,
1001
et
seq.)
Disclosure ofthis information
is required.
@
Failure to properly complete
This form
in its
entirety may
result
in the delay or
denial of any payment
requested
hereunder.
This
form
has been
approved by the Forms Management Center.
UNDERGROUND STORAGE TANK
PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rockys 66
Contractor:
United Science Industries, Inc.
Billing
Period:
from:
05/1212002
to:
05/18/2002
Contractors Authorized
Representative:
IL 532 1540
Date:
Date:
0.00
t
0.00
EQUIPMENT
SUN
MON
TUES
THURS
FRI
SAT
WED
0.00
+
+
1.00 DAY
0.00
0.00
ENV.
UTILITY VEHICLE
C
0
0.00
I
tOtAL
Hrs.
orDays
1.0WAY
I
LPC 248 Rev. Mar-93
This
Agency
is authorized
to request
this
inlormation under the Illinois
Environmental
Protection Act,
415
tICS
5(1
et seq.
(formerly
III Rev. Stat Chill
1/2.
1001
et seq.)
Disclosure
of
this information is required.
Failure to propedy complete this
form
in its entirety may result
in the delay or denial of any payment
Iltinois
Environmental
Protection
Agency
requested
hereunder.
This
form
has
been
approved by the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rockys 66
Contractor:
United Science Industries, Inc.
ROCKY’SGROUNDWATER TREATMENT
C
-4
Date:
Date:
Billing
Period:
from:
05/26/2002
to:
05/31/2002
0.00
1.OOMONTHI
0.00
MON
0.00
101AL
EQUIPMENT
j
SUN
THURS
FRI
SAT
Hrs.orDays
TU ES
0.00
I-
WED
0.00
f
0.00
+
1
.O~ONThH
Contractors Authorized
Representative
IL 532 1540
LPC 248
Rev.
Mar-93
Illinois
Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
Incident
No:
923466
FIELD PURCHASES
bluing
Period
Job
Name:
Kruep
-
Rocky’s 66
From’
03/01/2002
Contractor:
United Science
Industries, Inc.
To:
05/31/2002
Field Purchases
.
Quantity
Price/Item
Total Costs/Item
GWt
Electricity
1.00
488,28 / EACH
488.28
*
Note:
Copies of
invoices or billings must be
attached.
Subtotal
488.28
Some
subcontractor invoices and billings may
require
furthertime and material itemization.
**
Handling
Charge
$58.59
Total Subcontract Cost
546.87
Handling Charges are eligible forpayment only if they are equalto orless
than the
following amounts:
Subcontract of Field
Eligible Handling Charges
Purchase Cost
as
a
Percentage of Cost
$1 -$5,000
512
$5,001 -$15,000
$600+10°Joof arM, over $5,000
$15,001 -$50,000
$1 ,600i-8
of arM. over $15,000
$50,001
-$100,000
54,400+5
of amt. over $50,000
$100,000-Si 000,000
56,900÷2 ofamt. over $100,000
This
Agency
is authorized to request this information under the Illinois Environmental Protection Act, 415
‘L
532
823
tLcS
5/1 et seq. (formerly
ill Rev. StatCh 1111/2, 1001 el seq.) Disclosure ofihis information is required.
I
I
Failure
to properly
complete this form in
its entirety may result in the delay or denial ofany payment
LPC
330
Rev.
Mar-93
requested hereunder,
This form has been approved bythe Forms Management center.
0112
I’
BILLING
SUMMARY
Acco~.t—44umber:
67 6T3
08174
If you have any questions
about your bill,
please
call 1—800-363-6805.
Please mail general
correspondence
to
our
Company
headquarters:
Illinois
Power
P0
Box
513.
Decatur, IL
6252S
YOUR
ENERGY
USE
ELECTRIC/kwh
-
usage last 13 months
10,f45
1
i11~T
M
.1
J A
SON V
.1
FM AMAVO
AVERAGES
FOR
THIS
LAST
BILLING
PERIOD
YEAR
YEAR
TEMPERATURE
60
64
ELEC/kwt,
per Day
228
339
Costperflay
$16.10
$18.77
Costperkwh
*0.07
*0.06
Dollar
amounts
band
on
pr.tax
(S~uras,
923466
S
488.28
$
488.28
219.37
-219.37
488.28
495.60
.00
$
$
-
actual
-
estimated
-
current month
•
-
current month
last
year
)KQ
Vi
BULLETIN
BOARD
(k-?O~Y
sY35~
Thank
you for your prompt payments.
We appreciate customers like
you.
Illinois Power
offers convenient,
safe
electronic payment
options.
Please
call
our
24
Hour
Customer
Service
Center
at
1-800-755-5000
or
visit
our web site at www.illinoispower.com
for more information.
L&
Field
rapd
‘,tear
~on
iert*rsjion ~M ~dok*edline
~
~
~
:1:_i
ILLINOIS
POWER
AMOUNT
PAID:t
~V~Sb~S”
DUE DATE:
DUE
NOW:
AFTER
DUE
DATE:
flay
17,
2002
$488.28
$495.60
ACCOUNT
*:
6761308174
BILL
DATE:
May
OS.
2002
P.O.
Box
2522
Decatur,
I).
62525-
2522
1
04
F’R2
111111111
Ill
1111111
PhIl)
III
III
11)11111
‘‘U
III
Ill
I
Ill
111111111
Return
this portion with your payment
ILLINOIS POWER
Pad Mthe
DYN,cyPefo,manc.
rum
UNITED SCIENCE INDUSTRIES
203
W ELM ST
R
IL
62271
OKAWVILLE
•
‘t~?’_~
‘a—-
Commercial
Electric Service
M4~
~
Total Current Charges
Previous
Balance
os~.~~1;
$
Payment Posted
04-16-02
~
Balance Brought Forward
$
TOTAL AMOUNT DUE
TO
ILLINOIS
POWER
by
05-1
7-02
TOTAL AMOUNT DUE
TO
ILLINOIS
POWER
after 05-17-02
‘11
1
YES!
I
want to be a Warm Neighbor.
Sign me up for a monthly
I
donation
of:
*BWNGRNG
*~flAUTO~*
3-DIGIT
628
*0 127676 1308 17476*
UNITED SCIENCE INDUSTRIES
79
P0 BOX 360
WOODLAWN
IL
62898-0360
0
2
052102
0
000000495604
000000488280
6761306174
1
Illinois Environmental
Protection Agency
Incident No: 923466
UNDERGROUND STORAGE
TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Summary Sheet for All
Charges
in
this Billing Package
The owner/operator or their representative
shaD complete this form and place
it in the front- of the biDing
package.
All charges
in this
billing package shalt be summarized on
this
form.
PAYMENT ITEM
TOTAL PAYMENT REQUESTED
PERSONNEL
-
$
2,74L50
~‘
-
EQUIPMENT
3,840.00
,r
MATERIALS & EXPENOABLES
(In Stock Items)
0.00
MATERIALS&EXPENDABLES
1,813.69
(Field Purchases)
SUBCONTRACTORS
0.00
/
TOTAL
PAYMENT REQUESTED
$
8,401.19
This Agency is authorized to request this information under the l~inoisEnvironmental Protection Act, 415
-
ILCS
5/1 et
seq.
(formerly
lii Rev. StatOh 1111/2, 1001 et seq.)
Disclosure of this information is required.
Failure
to properly complete this
form in its entirety may result in
a
or
enial of any payment
IL 532
2168
requested
hereunder.
This form
has been approved bythe
Form
a
tCenter.
LPC 482
Mar-93
United Science Industries, Inc.
6295
E
Illinois
Hwy
15
Woodlawn1 IL 62898
Phone:
(618) 735-2411
Fax: (6181 735-2907
INVOICE
DaLee Oil Company
206
North
Hanover
Okawville
IL
62271
ATTN:
Bill Parr
Task:
Corrective action activities;
Effluent sampling; Quarterly
unit and
SVE rental;
Operation and maintenance
Reference:
Kruep
-
Rocky’s 66
Work Period:
03/01/2002
to
04/30/2002
Personnel Charges
$
2,747.50
Equipment Charges
-
$
3,840.00
Stock Item Charges
$
0.00
Field Purchases
$
1,813.69
Subcontractor
Charges
$
0.00
(Subcontractor &Field Expensespending receipt by US! are not included
on thisinvoice
and
are subject to future
billing.)
IJF;tJ~!B~1~~’
Payment Terms:
Category 31DM
Customer
P.O. Number:
Please make checks payable to:
United Science Industries, Inc.
6295E Illinois Hwy
15
Woodlawn, IL 62898
0115
IJNITE.D
SCIENCE
INDUSTKIES
sampling; Monthly ground water treatment
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR
PAYMENT OF UST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage instructions,
see reverse.
BILLING PERIOD
Incident No:
923466
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science
Industries, Inc.
from:
03/01/2002
to:
04/30/2002
Total
Personnel
2747.50(
This Agency is authorized
to request this information under
the
IllInois Environmental Protection
Act, 415
ILcs 5/1
et seq.
(formerly Ill Rev. Stat Oh 111112, 1001
et seq.)
Disclosure of this information is required.
Failure to property complete this form
in its entirety
may
result
in
the delay or
denial of any payment
requested hereunder.
This form has been approved
by the
Forms Management Center.
IL 532
1818
LPC
325
Rev.
Mar-93
OUR
Employee
Work Classification
ST/OT
Rate
Total
‘
95.00
95.00..-
Johnson
PROJECT MANAGER
1.00
-
Morgan,
H.
A.57~~5’7~,
.50,
:~0J~TMA~~R
95.00
1662.50
Morgan,
R.
~~?f
‘15~
-
ASSISTANT PROJ
MANAGER
3.00
65.00
195.00
Weathe~ord
q.~,
SENIOR
ENVIRO
TECH
4.501
53.00
238.50’’
-
-t
Weathedord
3~5,
55,
)“5,
SENIOR ENVIRONMENTALTECH
10.50
53.00
556.50’
*
Use Time and Materials
Rate
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective
Action Costs
IncEdent No923466
Far
usage
instructions,
see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Bifling Period:
from:
03/31/20
to:
04/06/2002
Contractor:
United Science
Industdes,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
Th
Th
in
ot
Th
Employee
Type of Work Performed
st
at
st
at
st
at
st
at
st
at
st
at
St
at
St
at
Morgan,
H.
PROJECT
MANAGER
14.15
14,45
11.30
1145
0915
10.15
0.50
0.25
100
1.75
-“
Morgan,
H.
PROJECT MANAGER
1615
17.00
,~—
0.75
0.75
Morgan, Ft
ASSISTANTPROJ MANAGER
16.45
17.00
Weatherford
SENIORENVIROTECH
11.30
15.30
07.30
08.00
4.50
IL 532
1822
Total Hours
7.25~
LPC
329
Rev. Mar-93
This Agency is authorized to request this information underthe Illinois Environmental
Protection Act, 415
ILCS
5/1
et
seq.
(formerly Ill Rev. Stat ChIll
1/2,
1001 et seq.)
Disclosure
of
this information is
required.
Failure to property
complete this
form in its entirety may result in the
delay or
denial of any payment
Page;
1
requested hereunder.
This form
has been approved by the
Forms Management center.
C
~.a
—
.4
.
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action
Costs
Incident No:923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
04/07/20
to:
04/13/2002
Contractor:
United Science Industries,
Inc.
-
SUN
MON
TUES
WED
TI-IURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
in
at
in
at
in
at
in
ot
in
ot
Employee
Type
of Work Performed
st
at
st
at
st
at
st
at
st
at
st
at
st
at
st
at
Johnson
PROJECT
MANAGER
.
13.30
14.30
1~
Morgan,
H.
PROJECT
MANAGER
09.30
10.30
10.30
11.00
11.15
12.15
14.00
1600
10.30
1115
1.00
0.50
1.00
2.00
0.75
5.25
,r
.
Morgan,
H.
PROJECT MANAGER
13.30
15.30
zoo
2.00
Morgan,
R.
ASSISTANT
PROJ MANAGER
—
11.15
12.00
11.30
1230
1.75
-“
Weatherford
SENIOR ENVIRONMENTAL
12.00
15.30
.
3.50
3.50
.
IL 532 1822
Total Hours
13.50j
LPC 329
Rev. Mar-93
This Agency
is
authorized to requestthis information under the
Illinois Environmental
Protection
Act, 415
lLCS
5/let
seq.
(formerly Ill Rev.
Stat chill
1/2,1001
Ct seq.)
Disclosure
of this information is required.
Failure to properly complete this form in its entirety may result in the
delay or
denial of any payment
Page;
1
requested hereunder.
This form has
been approved by the
Forms Management center.
C
:‘
I-
c~
Illinois Environmental Protection Agency
____
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST
Corrective Action Costs
Incident No:
923466
For
usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
04/14/20
to:
04/20/2002
Contractor:
United Science
Industries, Inc.
SUN
MON
TIJES
WED
THURS
FRI
SAT
TOTAL
HOURS
in
ot
in
at
in
at
in
at
in
ot
in
at
in
at
Employee
Type
of Work Performed
st
ot
st
ot
st
ot
st
ot
st
at
st
at
st
at
st
at
Morgan,
H.
PROJECT MANAGER
12.15
12.45
07.00
12.45
0.50
5.75
—
6.25
r~”
Morgan,
H.
PROJECT MANAGER
14.30
15.30
1.00
tOo
‘—
Weatherford
SENIOR
ENVIRONMENTAL
—
07.30
13.00
5.50
5.50
IL 532 1822
Total Hours
12.75~
LPC 329
Rev. Mar-93
This Agency is authorized to request this information under the
Illinois Environmental
Protection Act,
415
lLcs
5/I et seq. (formerly
Ill
Rev. Stat
Cli
111112. 1001
et seq.)
Disclosure ofthis information Is required.
Failure to properly complele
this form in
its
entirety
may
result in
the
delay or denial ofany payment
Page;
1
requested hereunder.
This form
has been approved
Dy the
Forms Management center.
a
~-‘
—
CD
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action
Costs
Incident No:923466
For usage
instructions,
see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
~
Billing Period:
from:
04/21/20
to:
04/27/2002
Contractor:
United Science Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
at
in
at
in
at
in
at
in
at
Employee
Type of
Work Performed
st
ot
st
at
st
at
at
at
st
at
at
at
at
at
st
at
Morgan,
H.
PROJECT MANAGER
10.30
11.00
.
.
0.50
0.50
Morgan,
R.
ASSISTANT PROJMANAGER
12.45
13.15
08.30
O9~OO
0.50
0.50
1.00
,_.‘~
Weatherford
SENIOR ENVIRONMENTAL
13.00
14.30
IL 532 1822
Total Hours
3.00~
LPC 329
Rev. Mar-93
This
Agency is authorized to request this information under the
Illinois Environmental
Protection
Act, 415
lI_CS
5/1
et seq.
(formerly ill
Rev. Stat
Ch 1111/2, 1001 et seq.)
Disclosure
of this information is
required.
Failure to property complete this form
in
its
entirety may
result in the
delay or denial of any payment
Page;
1
requested
hereunder.
This
form has
been approved bythe Forms
Management center.
C
I’
C’),
0
Illinois Environmental
Protection Agency
Incident
No:923466
UNDERGROUND STORAGE TANK
PROGRAM
REQUEST FOR
PAYMENT OF
UST CORRECTIVE ACTION COSTS
For usage instructions,
see reverse.
EQUIPMENT
Note:
Include cost of operator in the unit rates,
Billing Period
Job Name:
Kruep
-
Rocky’s 66
From:
03/01/2002
Contractor:
United Science
Industries,
Inc.
To:
04/30/2002
Equipment
Used
Time Used
*Unit Rate
Total Cost
ROCKY’S
GROUNDWATER
1.00
MONTH
3750.00
3,750.0
ENV.
UTILITY
VEHICLE
1.50
DAY
60.00
90.0
*
Use Time and Materials Rates
Total
Equipment
Cost
3~840.0~
~
This Agency is authorized
to request this Information under the
Illinois Environmental
Protection Act. 415
ILCS
5/I
et seq. (formerley
Ill
Rev.
Stat
Oh III
1/2,
1001
et seq.)
Disclosure of this information is requir
IL
532 1819
Failure
to properly complete this form in Itsentirety may
result
in the delay or
denial of any payment
LPC
326
Rev. Mar-93
requested hereunder.
This
form
has been approved by the
Forms Management
Center.
0121
This Agency
is authorized
to request
this
information under the
Illinois
Environmental
Protecdon Act,
415
lI_cS
5/1
et seq.
(formerly Ill Rev. Stat Gb
1111/2,
1001
et seq.)
Disclosure orthis
information
is required.
Failure to property complete this
form in
its entirety may
result
in the delay or
denial of any payment
Illinois
Environmental
Protection
Agency
requested hereunder.
This
form
has been approved
by the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORKSHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
0
I.
to
Contractors Authorized Representative:
IL 532
1540
Date:
Date:
ENV. UTILITYVEhICLE
0.00
1
~QUIPMENT
SUN
L
MON
j
TUES
j
WED
TI-1URS
FRI
SAT
0.00
0.00
Billing Period:
from:
03/3112002
to:
04/06/2002
0.50
DAY
0.00
0.00
0.00
IU
I
Firs, orDays
0.&DAY
LPC 248
Rev.
Mar-93
-
.
-
This Agency is authorized to request
this
information under
the Illinois
Environmental Protection Mt. 415
~
Illinois
Environmental
ProtectIon
Agency
ILcS 5/let seq. ~formefly
III Rev. Stat Ch 1111/2,1001
et
seq.)
Disclosure otthis information
is required.
Failure to properly complete this form
in
its
entirety may
result in the delay or denial of
any payment
______
requested hereunder,
This
form
has been approved by the Forms Management Center.
UNDERGROUND STORAGE
TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
0
Billing
Period:
from:
04/14/2002
to:
04/20/2002
Contractors Authorized
Representative:
IL
532
1540
Date:
Date:
ENV.
UTILITY VEHICLE
MON
0.00
f
I
JOIAL
EQUIPMENT
I
SUN
THURS
I
FRI
I
SAT
~Hrs.orDays
TU ES
0.00
1-
WED
0,00
1’
0.00
+
1.00DAY
1
0.00
0,00
1 .O&JAY
LPC 248
Rev.
Mar-93
This
Agency is authorized to request
this
information under
the Illinois
Environmental Protection Act, 415
lLcs
5/1 et seq.
(formerly
III
Rev. Stat Ch 1111/2,
1001
et seq.)
Disclosure of this
information is required.
Failure to property ~mplete
this form
in its
entirety may result in the delay or denial of any payment
Illinois
Environmental
Protection
Agency
requested
hereunder.
This
form
has
been approved by the Forms Management center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
C
Date:
Date:
ROCKY’S GROUNDWATER TREATMENT
0.00
MON
1’
EQUIPMENT
j
SUN
THURS
FRI
SAT
TUES
0.00
‘F
1.00MONTH
WED
Billing Period:
from:
04/28/2002
to:
04/30/2002
0.00
+
0.00
0.00
Firs.
0.00
+
I LI I AL
or Days
—
1 .0ct~10NTH
Contractors Authorized Representative:
IL 532
1540
LPC
248
Rev. Mar-93
tilinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION
COSTS
Incident No:
923466
FIELD PURCHASES
~mfling
Feriod
Job Name:
Kruep
-
Rocky’s 66
From:
03/01/2002
Contractor:
United Science
Industries, Inc.
To:
04/30/2002
Field
Purchases
Quanti~
Price/Item
Total Costs/Item
GWT Electricity
1.00
219.37 /
EACH
219.37
Sample Analysis
1.00
1300.00/
EACH
1300.00
Sample Analysis
1.00
100.00 /
EACH
100.00
*
Note:
Copies of invo/ces or
billings
must be
attached.
Subtotal
1619.37
Somesubcontractorinvoices and billingsmay
require
further time and material itemization.
•~
Handling
Charge
$194.32
Total Subcontract Cost
1813.69
Handling Charges are eligible forpayment only if they
are
equal to orless
than the followingamounts:
Subcontract of Field
Eligible Handling Charges
Purchase Cost
as a Percentage of Cost
$1
-$5,000
$12
$5,001 -$15,000
$600+10ofamt.over$5,000
$15,001
-
$50,000
$1
600+8
of amt.
over $15,000
$50,001
-$100,000
$4,400+5
of amt.
over
$50,000
$100,000-$1,000,000
$6,900÷2
of
amt. over $100,000
This Agency is authorized
to request this information under the
Illinois Environmental
Protection
Act.
415
IL
532
~823
tiCS
5)1
et seq.
(Formerly lit Rev. Stat Ch
1111/2, 1001
et seq.)
Disclosure of this information is required.
I
Failure to property complete this form in its entirety may result in the delay
or denial of any payment
LPC
330
Rev.
Mar-93
reqwested hereunder.
This
form
has been approved
by
the
Forms Management Center.
0125
BiLLING
SUMMARY
Account
Number:
6761308176
If
you
have
any
questions
about
your bill,
please
call
18003636$O5.
Please
mail
general
~
correspondence
to
our
.~
company
headquarters:
•Illinois Power
P0
Box
$11
Commercial Electric
Service
Total Current Charges
Previous Balance
03-06-02
Payment Posted
03-21-02
Balance
Brought
Forward
TOTAL AMOUNT
DUE
TO
ILLINOIS
TOTAL AMOUNT DUE
TO
ILLINOIS
$
219.37
—~C_
$
654.48
-654.48
YOUR
ENERGY
USE
TEMPERATURE
45
43
ELEc/kwti
per
Day
60
169
Costper
Day
$7.64
$12.98
Coslperkwh
$0.13
$0.08
Ooll.r
•,nounts
band
on
pr•tax
f1~ur.s.
BULLETIN
BOARD
Thank
you
for
your
prompt
payments.
We
appreciate
customers
like
you.
Illinois
Power
offers
convenient,
safe
electronic
payment
options.
Please
call our
24 Hour Customer
Service Center at
1-800-755-5000
or
visit
our
web
site
at
www.illinoispower.com
for more information.
AMOUNT
PAID:I
~
f~/9’37
DUE
DATE:
April
19,
2002
DUE
NOW:
fl19.37
AFTER
DUE
DATE:
$222.66
ILLINOIS
POWER
*BWNGRNG
UTOu
ALL
FOR
AADC
630
*0137676130817476*
UNITED
SCIENCE
INDUSTRIES
79
P0
BOX
360
WOODLAWN
IL
62898-0360
P.M.
Box
2522
Decatur,
I.
62525-2522
Return
this
portion
with
your
paynant
‘a’C-~~.d
,rJ~
APR
—
81001
ILLINOIS POWER
uNrTEn~et~rTumittRIEs
9234 66
IL
62271
203
W
ELM
ST
R
OKAWVILLE
P9jbyO~lS.O2
after 04-19-02
Decatur,
IL.
62325
.00
$
$
7,230
ELECTRIC/kwh
-
usage
last
13
months
219.37
222.66
AVERAGES
FOR
PERIOD
3,615
1W
THIS
YEAR
0
LAST
YEAR
AM
.J
.1
AS
0
N
0
.J
FM
•
-
actual
-
estimated
-
current
month
--
*
current
month
last
year
h
__
-
-
t
/~
‘~
ACCOUNT *:
6761308174
BILL
DATE:
Aeril
05.
2002
IJIllICIE!
IIId~I~
~
~II,1!i1~,1II11tt1
I
11,1111
01—26
1
04
0
2
042302
0
000000222668
000000219372
6761308174
1
ACCOUNT
NUMBER:
6761308174
ILLINOIS POWER
UNITED SCIENCE
923466
PAGE
2
—
ELECTRIC
SERVICE
METER#:
Current Meter
Reading. 04/03/02
(Actual)
40484373
Previous
Meter Reading,
03/06/02
(Actual)
Amount of Electricity Used
In
28
Days
Maximum
Demand
Billing
Demand Ending 04/03/02
Distribution
Capacity Ending
04/03/02
Cost of
Electricity
Used for 28
Days
Ending
04/03/02
Account
Charge
-
Below
2.4
1w
-
I
Phase
Distribution Capacity Charge
Winter Energy Charge
Transformation
Charge
Instrument
Funding
Charge
Instrument Funding
Charge
Credit
Decommissioning
Expense Adjustment
SERVICE
BILLING SUBTOTAL
Electricity
Excise
Tax
TOTAL COST
FOR
ELECTRIC
SERVICE
24.500 1w
x
$
1.750000
1,685
kwh
x
$
0.063190
24.500
lcw
x
$
0.750000
1,685
kwh
x
$ 0.008700
1,685
kwh x $
0.008700-
1,885
kwh
x
$
0,000190
1,685 kwh
x
$003300
Rate
11
822
99137
kwh
1685
19.000
1w
-
19,000
24.500
1w
1w
$
$
$
$
$
$
$
On 04-03
On 02-04
45.75
42.88
106.48
18.38
14.66
-14.66
.32
213.61
$
$
5.56
$
219.37
01-27
12065
Lebanon
Rd.
Mt.
Juliet,
TN
37122
(615)
158-5858
1—800—761—5859
Fax
(615)
758-5859
Tax
I.D.
62-0814289
Accounts
BeyQn9
Terms
Are
S1n,~jec
Monttt~
Se ~U~Jti~rge
Please
Return
One
Copy witi,
Payment
Page
1
(Visa/MC/AMEC
Accepted)
04/04/02
16:51
HARRIS
0
Acct
Date
04/06/02
0128
-
it-I
?~ENCE
CORP.
~~~tr’czn
,rr\
•
‘.—‘._..g_..•
APH
11
2O~2
If”
fl~
fV7y’7
Ithoice No.
153972
Invoice Date 03-APR-02
Eat.
1970
Q22466
~.1
-,;,
-I
Bill
to:
Mr.
Duane
Dot
•
1
United
Science
Industries
N,_,
6295
East
Illinois
Highway
15
Woodlawn, IL 62898
lO-UNSOOI
Rflp4t~4’t*t
P~u~c)w~e
O~s~
~4mt~
Mr.
Duane
Doty
1474?
•Prc~~at
Ru~eç
•
Tens
1894176
Net 180
‘site I~
.
Am*un~
~ue
UNSCIMO-1894176
$
1300.00
Sample
Numbers:
•
L?2421—0i,
t~7242l-02,
L72421—03,
L72421-04,
1j72421-OS,
L72421-06,
L72421—07,
L72421—08,
1,72421-09,
L72421—10,
L’72421-i1,
L72421-12,
L12421-13,
1,72421—14,
L’72421—15,
1,72421-16,
1,72421-17,
1,72421-18,
1,72421-19,
L72421-20,
L72421-21,
1,72421—22,
1,72421—23,__1,72421.24,_1,72421-25,__L72421-26
••:•::.~fl:e~ted:::•~:•:•:•::
1T1XtOY~
r
sample
It’s:
MW-i,
MW-2,
MW-3,
MW-?,
MW-8,
MW-9,
MW-iD,
MW
12,
MW-13.
MW-14,
MW-is,
MW-16,
MW-17,
RW-2,
RW-3,
RW-4,
RW-S,
RW-6,
RW-7,
RW-8,
RW-9,
RW-10,
RW-
12,
RW-13,
RW-14,
RW-i5
ES
•
~ty
Mat~xit
besetlpflbn
•
Uait
Price
Kruep
-
Rockys
26
GW
8021 ETEX
$
50.00
Total
/~.$b73
?as’2-(f
Amount
$
1300.00
$
1300.00
‘I
4/
CORP.
V
12065
Lebanon
Rd.
Mt.
Juliet,
TtX
37122
(615
758—5058
1-800-767-5859
Fax
(615)
758-5859
Tax
I.D.
62-0814289
Set.
1970
Accounts
BeycSnd/Texms
Are,SjectjJ~j~
1-2
Mont-tfly
Serflt~
tCiarge
Please
Return
One
Copy
with
Payment
Page
1
(Visa/MC/AEIEC
Accepted)
04/16/02
15:47
HARRIS
0
Acct
Date
04/18/02
0129
RONMENTAL
SCIENCE
~1
/fl4’7~
/t/77/
APR
192002
Invoice No.
155147
Invoice
Date
15-APR-02
923 466
&
nill
To:
BY~
‘
Mr. Duane Doty
“
United Science Industries
6295
East
Illinois
Righway
15
Woodlawn,
II.
62898
l0-UNSOO1
~êp~r~adt~m
~ha~e
&~dWr
Number
Mr.
Duane Doty
14771
Project
~(uther
1e~tna
1894176
Net
180
$it~
XDW
JOPZ~
~Ue
UNSCIMO-1894176
$
100.00
Sample
Numbers:
L73619-0l
03-APR-02
Sample IDs:
EFFLUENT
•
•
RS
~ty
Mattix
,
4”
batriptl~tt
Pis~
Kruep
-
Rockys
tInt Qtiee
Mtt,nt
1
OW
8Q~J. BTEX
•
1
OW
Oil
&
Grease
$
55.00
S
45.00
$
~
55.00
45.00
Total
$
100.00
/tQ~7~
st
¼1-/5
/
-1:’
Illinois
Environmental
Protection Agency
Incident
No:923466
UNDERGROUND STORAGE TANK PROGRAM
Request
for Payment of UST Corrective Action
Costs
Summary
Sheet for All Charges in this Billing Package
The owner/operator or their representative shall complete this form and
place it
in the front of the billing
package.
All charges in this biuing package shall be summarized
an
this form.
PAYMENT ITEM
•
TOTAL
PAYMENT REQUESTED
PERSONNEL
$
-
2,753.25
EQUIPMENT
3,995.00
MATERIALS
& EXPENDABLES
(In
Stock Items)
0.00
MATERIALS&EXPENDABLES
839.42
i”’
(Field Purchases)
SUBCONTRACTORS
.
0.00
TOTAL PAYMENT REQUESTED
$
7,587.67
This
Agency is authorized to request this information under the Illinois Environmental
Protection
Act, 415
LOS
511
et
seq.
(torrnerly Ill Rev,
Stat
Oh 1111/2,
1001
et seq.)
Dis
information is required.
Failure to properly complete this form
in its
entirety
may result in the d
r
of any payment
IL532 2168
requested hereunder,
This
form has been
approved
by the
Forms Management canter.
LPC 482
Mar-93
United Science Industries,
Inc.
6295
E
Illinois
Hwy 15
Woodlawn, IL 62898
Phone: (618)
735-2411
Fax: (618) 735-2907
INVOICE
DaLee Oil Company
206
North
Hanover
Okawville
IL
62271
ATTN:
Bill
Parr
Task:
Corrective action
activities; Project management;
Effluent sampling; Monthly ground water treatment
unit and
SVE rental,
operation and maintenance
Reference:
Kruep
-
Rocky’s 66
Work Period:
02/01/2002
to
03/31/2002
Personnel Charges
•
$
2,753,25
Equipment Charges
$
3,995.00
Stock
Item Charges
$
0.00
Field
Purchases
$
839.42
Subcontractor Charges
$
0.00
(Subcontractor & Field Expenses pending receipt by
US! are
not included
on
this invoice
and
are
subject
to
future bitting.)
it.~,H
Payment Terms: Category
3/DM
Customer
P.O. Number:
Please makechecks payable to:
fl’31
UNITED
SCIENCE
)NDUSTKIES
United Science Industries, Inc.
6295 E Illinois
Hwy
16
Woodlawn, IL 62898
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR PAYMENT
OF
UST CORRECTIVE
ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage
instructions,
see reverse.
BILLING
PERIOD
Incident No:
923466
Job
Name:
Kruep
-
Rocky’s 66
Morgan,
H.
PROJECT MANAGER
L5,
~,
IC),
4.75,
~
*
Use
Time and Materials Rate
from:
02/01/2002
21.00
95.00
Total Personnel
35.25~
I
This Agency is authorized to request this information under the Illinois Environmental
Protection Act. 415
tICS
5/1
et seq.
(tormerty Ill Rev. Stat
Oh
1111/2, 1001
et seq.)
Disclosure of this information is required.
Failure to properly
complete this
form
in its
entirety may
result
in
the delay
or
denial of any payment
requested hereunder.
This
form
has been approved by the
Forms Management Center.
IL 532
1818
LPC
325
Rev.
Mar-93
0132
Contractor:
United Science Industries, Inc.
to:
03/31(2002
Employee
Work Classification
ST/OT
Rate
Total
1
1995.00
Morgan,
R.
at6
ASSISTANT PROJ
MANAGER
—
0.25
65.00
16.25
Weatherford
5~
cg~
SENIOR
ENVIRO TECH
—
14.00
53.00
742.00
2753.25
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Incident
No:923466
For
usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
03/03/20
to:
03/09/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
at
in
at
in
ot
in
ot
in
at
in
at
Employee
Type of Work Performed
st
at
at
at
at
at
at
at
at
at
at
at
at
at
at
at
Morgan,
H.
PROJECT MANAGER
0830
09.30
1.00
1.00
-r
Morgan,
H.
PROJECT
MANAGER
12.15
12,45
.
0.50
0.50
“
Weatherford
SENIOR ENVIRO
TECH
08.30
14.00
IIIIIIFEIIIIIIIIIIIJ
sso~fl
IL 532 1822
Total
Hours
7.OOj
1
LPC 329
Rev. Mar-93
This Agency is authorized to request this information under the Illinois Environmental
Protection
Act, 415
ILCS 5/1
et seq. (formerly Ill Rev. Stat Ch
11
1/2, 1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this form in
its
entirety may
result in
the
delay
or denial of any payment
Page:
1
requested hereunder,
This form
has been approved
by the
Forms Management center.
a
—
.c’~
ca
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Incident
No:
923466
For usage ir~structions,
see reverse
-
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
BiDing
Period:
from:
03/10/20
to:
03/16/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TIJES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
ot
in
ot
in
at
in
at
in
at
in
at
Employee
Type of Work Performed
st
ot
at
ot
at
at
st
ot
at
ot
st
at
st
at
at
at
Morgan,
H.
PROJECT MANAGER
07.00
10.00
3.00
.
3.00
Morgan, ft
ASSISTANT PROJ
MANAGER
10.15
10.30
0.25
0.25
IL 532 1822
Total
Hours
3.253
LPC 329
Rev. Mar-93
This
Agency is authorized to request
this
information under the
Illinois Environmental
Protection
P~cl,415
ILCS 5/1
et
seq. (formerly
Ill
Rev.
SlatCh 1111/2, 1001
et
seq.)
Disclosure of this information
is required.
Failure to properly complete this
form in
its
entirety may
result in
the
delay or
denial
ofany payment
Page:
1
requested
hereunder.
This
form
has been approved by the
Forms Management Center,
a
~s
CA~
l~.
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request
for Payment of
UST
Corrective Action
Costs
Incident
No’ 923466
For usage insfrucfions,
see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing
Period:
from:
03/17/20
to:
03/23/2002
Contractor
United Science Industries,
Inc.
.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
inf
at
in
in
Employee
Type of Work Performed
at
at
at
at
at
at
at
at
at
at
at
ot
at
at
at
at
Morgan,
H.
PROJECT MANAGER
—
06.30
9.50
16.00
0T30
0.50
0&0O
10,00
“
Weatherford
SENIOR ENVIROTECH
08.00
16.00
~______
8.00
IL 532 1822
Total Hours
18.00~
LPC 329
Rev. Mar-93
This Agency is authorized to request this
information under the
Illinois Environmental
Protection
Act, 415
lLcS
5/1
et
seq.
(formerly
III Rev. Stat
Ch 1111/2, 1001
et seq.)
Disclosure of this
information is required.
Failure to properly complete this form
in
its
entirety may result
in
the delay
or denial ot any payment
Page:
1
requested hereunder.
This
form
has
been approved by the
Forms Management Center.
a
..
(a)
-
Ca
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Incident
No:
923466
For usage insfructions,
see reverse
WEEKLY WORKSHEET
Personnel
Jab:
Kruep
-
Rocky’s
66
Billing
Period:
from:
03/24/20
to:
03/30/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
ot
in
at
in
at
in
at
in
at
in
at
Employee
Type of Work Performed
at
at
at
at
at
at
at
at
at
at
at
at
at
at
at
at
Morgan,
H.
PROJECT MANAGER
07.00
09.00
13.00
15.00
2.00
2.00
4.00
‘
Morgan,
H.
PROJECT MANAGER
11.00
11.45
—
~75
Morgan,
H.
PROJECT MANAGER
15.00
16.45
1.75
Weatherfard
SENIOR ENVIRO TECH
08.00
08.30
0.50
0.50
“
IL
532
1822
Total Hours
7.001
LPC 329
Rev. Mar-93
‘mis
Agency is
authorized to request this information underthe Illinois Environmental
Protection
Act, 415
ILCS
5/1
et seq.
(formerly lii
Rev.
atat cri
111
1/2, 1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in its entirety may result in the
delay or denial of any payment
Page:
1
requested hereunder.
This
form
has been approved
by the
Forms Management Center.
C
—
C4)
~)
_____
Illinois
Environmental
Protection Agency
Incident
No:923466
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR
PAYMENT OF
UST
CORRECTIVE ACTION
COSTS
Forusage instructions, see reverse.
Note: Include cost of operator in the unit rates.
Job
Name:
KrlJep
-
Rocky’s 66
Contractor:
United Science Industries,
Inc.
PHOTOJONIZATION DETECTOR
#1
*
Use
Time
andMaterials Rates
EQUIPMENT
IL
532
1819
LPC
326
Rev.
Mar-93
This
Agency is
authorized
to
request this information under
the
Illinois Environmental
Protection
Act.
415
LCS
5/1
~t
seq.
(fornierley
ti
Rev. Stat Oh
1111/2, 1001
et seq.)
Disotosure of this information is requir
Failure to property complete this form
in
its
entirety may result
in
the
delay or
denial of any payment
requested hereunder.
This form has been approved
by
the Forms Management Center,
p137
Billing Period
From:
02/01(2002
To:
03/31/2002
Equipment Used
Time Used
*unit Rate
Total Cost
ENV, UTILITY
VEHICLE
2.00
DAY
60.00
120th
ROCKYS GR.WATER TREATMENT
SYS
1.00 MONTH
3750.00
3,750th
ELECTRONIC WATER LEVEL INDICAT
1.00
DAY
20.00
20.01
1.00 DAY
r
105.00
105.01
Total Equipment
Cost
3995.09
-_—
a
Illinois Environmental
Protection Agency
this Agency is authorized to request this information under the
Illinois Environmental
Protection Act, 415
lieS 5/1
et
seq.
(formerly itt
Rev.
Stat Oh 111 1/2, 1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in its entirety
may result in
the delay
or
denial of any paymern
requested hereunder.
Tbis form has been approved by the Forms Management Center.
UNDERGROUND STORAGE TANK
PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science tndustries, Inc.
C
S
Co
Billing Period:
from:
03/03/2002
Contractors Authorized
Representative:
to:
03/09/2002
Date:
Date:
IL
532
1540
LPC 248
Rev. Mar-93
Illinois Environmental Protection Agency
This Agency is authorized to request this information under the tltinois Environmental
Protection
Act. 415
LOS
5/1
et seq.
(formerly Ill
Rev.
StatCh
1111/2,
1001
et seq.)
Disclosure of
this information is required.
Failure to properly complete this form
in its
entirety
may
result in
the
delay or
denial of any payment
requested hereunder.
This form has been approved bytheForms Management center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK
SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rocky’s66
Contractor:
United Science Industries, Inc.
Billing Period:
from:
03/17/2002
IEQUIPMENT
ENV. UTILITYVEHICLE
L~ECTRONIC
WATER LEVEL INDICAT
o.oo
C
CA)
CD
Contractors Authorized Representative:
IL 532 1540
LPC 248
Rev. Mar-93
to:
03/23/2002
Date:
Date:
Illinois Environmental Protection Agency
This Agency is authorized to request
this
information under the
Illinois Environmental
Prcteclion Act. 415
II..CS 5/1
at seq.
(formerly Ill Rev,
Stat Ch
111
1(2,
1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in Its entirety may
result in the delay
or denial ofany
payment
requested hereunder.
This
form has
been approved by the
Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science industries,
nc.
0
-a
a
0
Billing
Period:
from:
03/24/2002
to:
03/30/2002
Contractors Authorized
Representative:
Date:
Date:
ROCKY’S ORWATERTREATMENT SYS
SUN
MON
0.00
TUES
0.00
~QUIPMENT
THURS
FRI
j
SAT
Firs. ~rD’a~
f
0,00
WED
+
000
+
0.00
I
1.o0MONTH~
0.00
I
1,0~ONTH1
IL 532 1540
LPC 248
Rev. Mar-93
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF LiST CORRECTIVE ACTION COSTS
FIELD PURCHASES
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science
Industries, Inc.
Field Purchases
GWT
Electricity
Sample Analysis
*
Note:
Copies
of
invoices
or
billings
must be
attached.
Some subcontractor invoices and billings may require
furthertime and material itemization.
**
Handling
Charge
Total Subcontract Cost
Handling Charges are eligible forpayment only if they are equal to orless
than the following amounts:
Subcontract of Field
Purchase Cost
$1
-
$5,000
$5,001 -$15,000
$15,001
-
$50,000
$50,001 -$100,000
$100,000 -$1,000,000
IL
532
1823
LPC
330
Rev.
Mar-93
Incident No:
923466
atlung
Period
From:
02/U 1/2002
To:
03/31/2002
Eligible Handling Charges
as
a
Percentage of cost
$1 2
$600+10
of amt.
over $5,000
$1,600+8
ofamf. over $15,000
$4,400+5
of
amt. over $50,000
$6,900+2
of anit. over $100,000
This
Agency is authorized to request this information under the
Illinois
Environmental
Protection Act, 415
LOS
5/1
et seq.
(formerly III Rev. Stat Oh
111112,
1001 et seq.)
Disclosure of this information is required.
Failure to properly
complete this form
in
its
entirety
may
result
in
the delay or
denial of any payment
requested hereunder
This form
has been approved
by the
Forms Management Center,
~J41
Total
Costslltem
Subtotal
654.48
..O0
—
749.48
$89.94.
839.42
BILLING
SUMMARY
Account
Number:
6761fl8i4
it
you
hav,
any
questions
about
your bill,
please
call
1-800-363-6805,
Please
mail
general
correspondence
to
our
Company
headquarters:
Illinois
Power
PG
Box
511
Decatur,
IL
62525
YOUR ENERGY
USE
ELECTRIC/kwh
-
usage last 13 months
10.845
Ii
ilkil
T
.~:iCr:~.
MAR I ~
BY;
‘-$~
~k1yv
~
11
ILLINOIS POWER
UNITED~TL~~t?’tYTh~JflRIES
203
W
ELM
ST
OKAWVILLE
Commercial
Electric Service
Total Current Charges
Previous
Balance
02-
Payment
Posted
02-2
Balance
Brought Forward
$
TOTALAMOUNT DUE
TO
ILLINOIS
POWER
by 03-21-02
TOTAL AMOUNT
DUE
TO
ILLINOIS
POWER
after
03-21-02
AVERAGES
FOR
BILLING
PERIOD
THIS
YEAR
LAST
YEAR
TEMPERATURE
37
37
ELECFKwft per
Day
353
234
CostperDay
*20.68
$16.46
Costpefkwh
$0.06
$0.07
Octiur
~fl,Q~ts
bind
on
pritax
flier.,.
$
S
509.76
-509.76
.00
654.48
/79
c/i7&’
-
actual
B
estimated
-
current
month
—
current
month
last
year
IAFJDNOSAJJMAMAVG
BULLETIN
BOARD
C
Thank you for your prompt payments. We
appreciate
customers
like
you.
Illinois Power offers convenient,
safe electronic payment
options.
Please call
our 24 Hour Customer Service Center at
1—600-755—5000
or visit our web site
at
www.illinoispower.com
for more information.
c.~C
AMOUNT PAID:
L.
DUE DATE:
DUE
NOW:
AFTER
DUE
DATE:
March
21,
2002
$654.48
$664.30
ACCOUNT
*:
6761308174
BILL
DATES
March
07.
2002
*BWNGRNG
nssAUTOss
3-DIGIT
628
*01B7676130817476*
UNITED
SCIENCE
INDUSTRIES
79
P0
BOX
360
WOODLAWN
XL
62898-0360
I~
,I,II..I
‘1,1 ~I
I
1111111
~lI~
~II
~Il,,.,~I
.0
P.O.
Box
2522
Decatur,
Xl
62525-2522
Return this
portion
with~
your
peycent
~T42
1
04
R
XL
622
S
654.48
$
$
654.48
664.30
Back to top
ILLINOIS
POWER
0
2
032502
0
0000006~4309
000000654467
676130S174
I
ACCOUNT
NUMBER:
6761308174
ILLINOIS POWER
UNITED
SCIENCE
xl
t~1~
t~t”°~”
(~l
1’
‘•)
i8
flfl
udc’~oo
PAGE
2
—
ELECTRIC
SERVICE
Current
Meter Reading,
03/06/02
(Actual)
Previous
Meter
ReadIng, 02/04/02
(Actual)
Amount of Electricity
Used
In
30 Days
Maximum
Demand
METER#:
40484373
Rate
11
99137
88566
kwh
10581
Billing
Demand
Ending
03/06/02
Distribution Capacity Ending 03/06/02
Cost of Electricity Used for 30 Days
Ending 03/06/02
Account
Charge
-
Below 2.4
kv
-
I
Phase
Distribution
Capacity Charge
Winter Energy Charge
Transformation
Charge
instrument
Funding Charge
Instrument Funding
Charge
Credit
Decommissioning
Expense
Adjustment
SERVICE BILLING
SUBTOTAL
Electricity Excise Tax
TOTAL
COST
FOR
ELECTRIC
SERVICE
24.000
kw
24.000
kw
24.500
kw
$
24.500
kw x
$
1.750000
$
5,280
kwh x
$ 0.063190
$
kwh
x
$
0.033490
$
24.500
kw
x
$
0.750000
$
10,581
kwh
x
$ 0.008700
$
10,581
kwh
x
$ 0,008700-
$
10,581
kwh
x
$
0.000220
5
—
$
5,301
On
03-06
On
02-04
45.75
42.88
333.64
177.53
18.38
92.05
-92.05
2.33
620.51
2,000 kwh
x $003300
8,581
kwh
x
$003190
$
$
8.60
27.37
$
654.48
Q
()i
(fl
~~466
Mt.
Juliet, TN 37122
)NVIRONMENTAL
/t9
c//~
12065
Lebanon
Rd.
(615)
758—5858
1-800-767—5859
SCIENCE
CORP.
~a
Fax
(615)
758-5859
~j~ir’;.~.
¶\
ir~m,
Tax ID.
62-0814289
Invoice No.
152172
Est.
1970
MARZ7ZOOZ
Invoice Date 19-MAR-02
Bill To:
~
Mr.
Duane
Doty
•
,___
~
United
Science
Industries
6295
East
Illinois
Highway 15
l4oodlawn
IL
62898
lO-UNSOO1
tOl
a~~1**~
O4~t4erttnb~
Mr.
Duane
Doty
14709
Pto~ct W*1*~*r
t~r~
1894176
Net 190
Sttt
£I~
7~stw~t
~oe
UNSCIMO-1894176
$
95 .00
Saiip 1
e
Nuri~bers
L70787-01
07-MAR-02
Sample
IDs:
EFFLUENT
ES
aty
KaSix
teserIptatn
limit
fl,iee
Meoui~t
Kruep
-
Rockys
1
GW
8921
BTEX
1
GW
Oil
& Grease by 9070
Total
(fSo7~
.rSo”iy
$
50.00
$
45.00
S
50.00
$
45.00
$
95.00
Accounts Beyo d
r
Are S~i~ect
Please
Return One Copy with
Payment
YJisa/MCJAMEC
Accepted)
Montlt~rSerá4Lrge
Page
1
03/19102
12:12
H~RIS_D
Acct
Date
03/21/02
p144
Illinois Environmental Protection Agency
C:,
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Summary Sheet forAll
Charges in this Billing Package
Incident
P4o:923466
The
owner/operatoror their representative shall complete this
form and place
it
in the front of the billing
package.
Al! charges
in this billing package shall be summarized on
this
form.
PAYMENT ITEM
TOTAL PAYMENT REQUESTED
0_Go
7
7,490.95
This Agency is authorized to requestthis information under the Illinois Environrnentat
Protection Act. 415
ILCS 5/I
et seq.
(formerly lit Rev, stat Ch
1111/2. 1001
et seq.)
Discios
t
rmation is required.
Failure to properly complete this form
in its
entirety
may
result
in
the
dela
r
e
any payment
requested
hereunder.
This
form
has been
approved by the
Forms Management center.
St
$
2,893.00
3,915.00
,‘
0.00
682.
95
/
$
PERSONNEL
EQUIPMENT
MATERIALS & EXPENOABLES
(in
Stock items)
MATERIALS & EXPENDABLES
(Field Purchases)
SUBCONTRACTORS
TOTAL PAYMENT REQUESTED
IL 532 2168
LPC 482
Mar-93
United Science Industries, Inc.
6295
E
Illinois
Hwy
15
Woodlawn, IL 62898
Phone: (618) 735-2411
Fax:
(618) 735-2907
Please make checks
payable to:
United Science Industries, Inc.
6295
~ Illinois
Hwy
15
Woodlawn, IL
62898
ku~inn.tr.i*i~~uawi.iu~wuslj
‘S1
tNVOICE
0146
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR PAYMENT
OF UST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage instructions, see reverse.
BILLING PERIOD
Incident No:
923466
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science industries,
Inc.
from:
01/01/2002
to:
02128/2002
~‘
3~7’5
~.5,-).7~i
Morgan, R.
•,.4,
.50,
,5P~
*
Use Time
and Materials Rate
ASSISTANT
PROJ
MANAGER
Total Personnel
—
2.50
35.
ooj
65.00
2893.00’
This Agency
is authorized to request this information under the
Illinois
Environmental
Protection Act, 415
ILCS
5/1
et seq.
(formerly
Ill Rev. Stat
Ch 1111/2,
1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in its
entirety
may result in the
delay or
denial of any payment
requested hereunder.
This
form
has
been approved by the
Forms Management center,
IL 532 1818
LPC
325
Rev.
Mar-93
Morgan,
H.
Employee
Work Classification
STIOT
*Rate
Total
Johnson
~
I,
PROJECT MANAGER
—
2.00
95.OQ
—
190.00
PROJECT
MANAGER
—
22.00
2090.00
r
Weatherford
SENIOR
ENVIRO
TECH
—
8.50
53.00
450.50
“I~l
162.50
p147
Utinois Environmental Protection
Agency
UNDERGROUND
STORAGE TANK PROGRAM
Requestfor Payment of UST Corrective Action Costs
Incident
No: 923466
For usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s66
BilUng
Period:
from:
01/27/20
to:
02/0212002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL
HOURS
in
ot
in
ot
in
at
in
ot
in
ot
in
ot
in
at
Employee
Type of Work Performed
st
at
at
at
at
ot
at
at
at
at
st
at
at
at
at
ot
Johnson
PROJECTMANAGER
09.00
10.00
1.00
Morgan,
H.
PROJECT MANAGER
15.00
17.00
2.00
2.00
IL 532
1822
Total Hours
3.00~
LPC 329
Rev. Mar-93
This Agency is authorized to request this information under the
Illinois Environmental
Protection Act, 415
ILCS 5(1 et seq.
(formerly
III Rev. Stat Ch Ill
1(2,
1001 et seq.)
Disclosure of this information is required.
Failure to properly
complete this form
in its
entirety may result in the
delay or denial of any payment
Page: /
requested hereunder,
This
form has
been approved by the
Forms Management Center.
0
~a
~.
~
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST
Corrective Action Costs
Incident No: 923466
For
usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s66
Billing Period:
from:
02/03/20
to:
02/09/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
ot
in
ot
in
at
in
ot
in
at
in
ot
Employee
Type of Work Performed
at
at
at
ot
at
ot
at
at
at
at
st
at
~F
at
at
Morgan,
R:
ASSISTANT PROJ
MANAGER
08.00
09.30
.
1.50
1.50
Weatherford
SENIOR
ENVIRO TECH
06.30
11.00
4.50
4.50
IL532 1822
.
‘
Total Hours
6.001
LPC 329
Rev. Mar-93
This
Agency is authorized to requestttiis information under the Illinois Environmental Protection Act, 415
LOS
5/1
et seq. (formerly
Ill Rev. Stat Cli 111 1/2, 1001 et seq.)
Disclosure of this information is required.
Failure
to
properly complete this form
in
its
entirety may
result in the
delay or denial of any payment
Page: 1
requested
hereunder.
This
form
has been approved by the
Forms Management center.
0
..-
~
Co
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST
Corrective Action Costs
Incident Na:
923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s66
Billing
Period:
from:
02/10/20
to:
02/16/2002.
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
Employee
Type of Work Performed
in
at
ot
at
in
at
at
in
at
at
at
ot
in
at
at
at
in
at
at
at
in
at
at
at
in
st
at
at
at
at
Morgan,
H.
PROJECT MANAGER
15.00
15.15
14.45
16.15
13.00
14.00
0.25
2.75
,,,,-
Morgan,
H.
PROJECT
MANAGER
16.00
17.00
.
—
—
—
1.00
Morgan,
R.
ASSISTANT PROJ
MANAGER
13.30
14.00
0.50
IL 532 1822
Total
Hours
4.25~
LPC
329
Rev. Mar-93
This
Agency
is
authorized
to
request
this
information
under the Illinois
Environmental
Protection Act,
415
ILcS
5/1
et seq. (formerly
Ill Rev. Stal Oh 1111/2, 1001 et seq.)
Disclosure ofthis information is required.
Failure to properly complete this form
in its
entirety may
result in
the delay
or denial of any payment
Page:
1
requested hereunder.
This
form has
been approved by the
Forms Management center.
0
h-a
VT
0
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment
of
UST
Corrective Action
Costs
Incident
No:923466
Forusage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
02/17/20
to:
02/23/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
at
in
at
in
at
in
at
in
at
Employee
Type of Work Performed
st
at
at
at
st
at
at
at
at
at
at
at
at
at
at
ot
Morgan,
H.
PROJECT MANAGER
07.30
15.00
14.00
15.00
.
7.50
1.00
8.50
r’’
Weatherford
SENIOR
ENVIRO TECH
07.30
11.30
4.00
4.00
IL
532 1822
Total Hours
12.501
LPC
329
Rev. Mar-93
mis Agency is authorized to request this information
under the
Illinois Environmental
Protection
Act, 415
ILCS 5/1
et
seq.
(formerly Ill Rev. Stat Ch 1111/2, 1001
et seq.)
Disclosure of this information is required.
Failure
to properly complete this form
in
its entirety
may
result
in
the
delay or denial ofany payment
Page:
1
requested hereunder.
This
form
has been approved by the Forms Management center.
~‘
~
—
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
Incident
No- 923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
02/24/20
to:
02/28/2002
Contractor:
United Science Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
at
in
at
in
ot
in
at
in
at
in
at
Employee
Type of Work Performed
at
at
at
at
at
at
at
at
at
at
at
at
at
ot
at
at
Johnson
PROJECT MANAGER
15.30
16.30
Morgan,
H.
PROJECT MANAGER
1030
1,75
1215
1120
0.50
1100
1145
1.00
1&45
0&00
1.50
0930
—
1.00
4.75
1—
“
Morgan,
H.
PROJECT
MANAGER
16.30
17.15
0.75
0.75
Morgan,
H.
PROJECT MANAGER
16.15
2.25
18.30
2.25
..-
‘
Morgan,
ft
ASSISTANT PROJ MANAGER
15,30
16.00
0.50~_
IL 532 1822
Total Hours
f
9.25j
LPC 329
Rev. Mar-93
This Agency is authorized to request this information under the
Illinois Environmental
Protection Act, 415
lLcS
5/1
et
seq.
(formerly Ill Rev. Stat Ch 1111/2,
1001 et seq.)
Disclosure of this information is required.
Failure
to properly complete this form
in its
entirety
may
result in the delay
or denial of any payment
Page:
1
requested hereunder.
This
form has
been approved
by
the
Forms Management center.
0
‘-a
V1
t~
•,
_____
Illinois Environmental
Protection Agency
Incident
Nc:923466
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR
PAYMENT OF UST
CORRECTIVE ACTION COSTS
For usage instructions,
see
reverse.
EQUIPMENT
Note:
Include cost of operatorin the unit mtes.
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science
Industries, Inc.
PHOTOIONIZATION DETECTOR #4
*
Use
Time and Materials Rates
From:
To:
Billing
Period
01/01/2002
02/28/2002
1.00 DAY
J
105.00
Total
Equipment Cost
3915.0t”~
IL 532 1819
LPC
326
Rev. Mar-93
This
Agency is authorized
to request this information under the
Illinois Environmental
Protection
Act, 41
ILCS
5/1
et seq.
(formerley Ill Rev. Stat Ch 1111/2. 1001
et seq.)
Disclosure of this information is requi
Failure to
properly
complete this farm in
its entirety
may result
in
the delay
or denial of any
payment
requested hereunder,
This
farm
has been approved by the
Forms Management Center.
0153
Equipment Used
Time Used
*Unit Rate
Total Cost
REMEDIATION
UTILITY VEHICLE
1.00 DAY
60.00
60.01
ROCKY’S GROUNDWATER
1.00 MONTH
3750.00
3,750.01
105Cc
Illinois
Environmental Protection Agency
This Agency is authorized to requestA~~intormation
under the Illinois Environmental
Protection Act, 415
ILCS 5(1 at seq.
(formerly III Rev. St$h
111
1(2,
1001 et seq.)
Disclosure of this information is required.
Failure
to
properly complete this (orm’ifi its
entirety
may
result in
the
delay
or denial of any payment
requested
hereunder.
This
form hes
been approved by the
Forms Management center.
UNOERGROUNO
STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
UnitedScience Industries. Inc.
EQU
PMENT
REMEDIATIONUTILITY VEHICLE
I
PHOTOIONIZATION DETECTOR
#4
‘-a
cm
4
Billing
Period:
from: 02103/2002
Contractors Authorized
Representative:
IL
532 1540
LPC 248
Rev.
Mar-93
to:
02/09/2002
Date:
Date:
This
Agency
is authorized to request~3~ntormation
under the
Illinois Environmental
Protection
Act, 415
Illinois
Environmental
Protection Agency
ILCS 5/I
etseg.
(formerly Ill Rev.
stifáh
111 1/2,1001
etseq.)
Oisclosureofthis Information isrequired.
Failure
to properly complete this form
Mft~
entirety
may result in the
delay or denial of any payment
requested hereunder.
This
form
has b~eiapproved by the
Forms Management Center.
C-
UNDERGROUND STORAGE TANK PROGRAM
Incident
No:
923466
WEEKLY WORK SHEET
EQUIPMENT
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
Billing
Peñod:
from:
02/17/2002
to:
02/23/2002
EQUIPMENT
SUN
MON
TUES
WED
THURS
FRI
SAT
Firs,
or Days
REMEDIATION UTILEFY VEHICLE
0.00
0.00
0,00
0.50
DAY
0.00
0.00
0.00
0.ScDAY
C
C/I
ca
Contractors Authorized Representative:
_______________________________________
Date:
IL
532
1540
Date:
I PC
24R
RevS Mar-93
Illinois
Environmental
Protection Agency
This
Agency
is authorized to request
éF~lsinformation under the
Illinois Environmental
Protection Act, 415
lLcs
5/I
at
seq.
(formerly III Rev. Stat Chill
l/Z,
1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form In its entirety rriay result In the delay or denialof any payment
requested hereunder.
This
form
has been approved by the Forms
Management
center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
Job:
Kruep
-
Rocky’s 66
Contractor:
United
Science
Industries,
Inc.
C
01
0)
Date:
Date:
ROCKY’S
GROUNDWATER TREATMENT
SUN
+
MON
0.00
-F
EQUIPMENT
THURS
j
FRI
SAT
Firs. orDays
TUES
•0.00
WED
0.00
‘f
Billing
Period:
from:
02/24/2002
to:
02/28/2002
0.00
‘f
1.00MONTH
0.00
I
0.00
I
1.OtlvlONTH
Contractors Authorized Representative:
IL
532 1540
LPC 248
Rev.
Mar-93
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF liST CORRECTIVE ACTION COSTS
Incident
No:923466
FIELD
PURCHASES
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science
Industries, Inc.
Field Purchases
GWT
Electricity
Sample Analysis
*
Note:
Copies
of
invoices or
billings
must be
attached.
Some
subcontractor in voices and billings may require
furthertime
and material itemization.
Subcontract of Field
Purchase Cost
$1
-
$5,000
$5,001 -$15,000
$15,001 -$50,000
$50,001 -$100,000
$100,000-$1,000,000
IL
532
1823
LPC
330
Rev.
Mar-93
**
Handling Charge
Total Subcontract Cost
100.00
609.76
682.95
Eligible Handling Charges
as
a Percentage of Cost
$12
$600+l0
of amt.
over $5,000
$1
600+8
of arM.
over $15,000
$4,400+5
of amt.
over $50,000
$6,900+2
of
arnt.
over $100,000
This Agency is authorized to request this information under the Illinois
Environmental
Protection Act,
415
)Lcs
5/1
et seq.
(formeily
II
Rev,
stat
cii
1111)2,
1001
et seq.)
Disclosure
of this information is required.
Failure to properly complete this form
in its
entirety
may
result
in
the
delay
or denial of any payment
requested
hereunder.
This
form
has been approved by the
Forms Management center,
0157
Illinois
Environmental Protection Agency
IJtwng Period
From:
01/01/2002
To:
02/28/2002
Total Costs/Item
509.78
Subtotal
Handling Charges are eligible for payment only/f they are equal to or less
than the following amounts:
$73.17
BILLiNG
SUMMARY
‘Account
Number:
6761308174
If
you
hay,
any
questions
about
your
bill,
please
cell
1-800-563-6805.
fl
Pleas, mail
general
“correspandenc.
to
our
Coapany
headquart.rs:
Illinois Power
P0
Box
511
Decatur,
XL
62525
YOUR
ENERGY
USE
BY:
commercIal Electric
Service
Total Current
Charges
Previous
Balance
01-08.02
Payment Posted
01-22-02
Balance
Brought
Forward
TOTAL AMOUNT DUE
by 02-19-02
TOTAL
AMOUNT
DUE
after
02-19-02
ELECTRXCFkWh
-
usage last
13
months
w,B45
7,220
3,815
IUThiII
F
M
A
M
J
.1
A
S
0
N
0
.1
F
AVG
BULLETIN
BOARD
1~1-
AVERAGES
FOR
EXLLING
PERIOD
THIS
YEAR
LAST
YEAR
TEMPERATURE
39
52
ELECIIcMi per Day
235
193.
Cost per Day
$17.45
$15.31
Costperkwh
$0.07
$0.08
Dellir
.i,ourit,
b...d
on
pr.t.x
flgur.s.
—
actual
-
estimated
current
month
*
-
current
month
last
year
Just imagine, bills that practically pay themselves.
Illinois
Power now offers you automatic bill payment convenience using
your Master Card,
Visa or Discover card.
To set up an automatic
payment plan,
contact
the Illinois Power 24-hour Customer
Contact Center at 1—800—755-5000.
Illinois Power offers convenient, safe electronic payment
options.
Please call our 24
Hour Customer Service Center at
1-800-755-5000
or visit
our web site
at www.illinoispower.com
for more information.
ILLINOIS
POWER
AMOUNT
PAID:
DUE
DATE:
DUE
NOW:
AFTER
DUE
DATE:
•$ ~iF?
I
February
19,
2002
i4509.78
$517.43
ACCOUNT
*:
6763.308174
BILL nATE:
Pebruarv 0~.2002
*BWNGRNG
KKuAUTO~3-DIGIT
628
*0 137676 130817476*
UNITED
SCIENCE
INDUSTRIES
79
P0
BOX
360
WOODLAWN
XL
62898-0360
I
~
~l
illi
~I,l~I
~
~I
I,~
iii
~
Illislit
‘in
nih
P.O.
Box
2522
Decatur,
I.
62525-2522
1 04 FR2
Return this portion with your payment
FEB
—
67002
•
~.,iLLINoISPOwER
uNITEnMr!wb11~tRIES
923466
203
W
ELM
ST
R
OKAWVILLE
IL
62271
$
509.78
$
$
373.12
-373.12
$
.00
$
S
509.78
509.78
517.43
fl
P
t1?’PtflP
fl
flflflflflflCfltflfl
~
L~L1
~flfl1
lu
ACCOUNT tWMBER:
6761308174
tEl
•
ILLINOIS
POWER
UNITED
SCIENCE
I&M~Jt1’I~tfft~””
mm
923466
PAGE
2
—
ELECTRIC
SERVICE
METER#:
Curtent
Meter Reading,
02/04/02
(Actual)
40484373
Previous Meter
Reading,
01107/02
(Actual)
Amount of Electricity Used
In 28
Days
Maximum
Demand
88556
81985
kwh
6571
Billing
Demand Ending
02/04/02
Distribution
Capacity Ending
02/04/02
Rate
11
Cost of Electricity
Used for
28
Days
Ending 02/04/02
Account Charge
.
Below 2.4
Icy
-
1
Phase
Distribution
Capacity Charge
Winter Energy
Charge
Transformation
Charge
Instrument Funding
Charge
Instrument Funding
Charge Credit
Decommissioning Expense Adjustment
SERVICE
BILLING
SUBTOTAL
Electricity
Excise Tax
TOTAL COST
FOR ELECTRIC
SERVICE
24.500
kw x $
1.750000
5,390
kwh x $0063190
1,161
kwh
x
$
0.033490
24.600 Iv~
x $
0.750000
6,571
kwh
x
$
0.008700
6,571
kwh x
$ 0.008700-
6,571
kwh
x
$
0.000220
2,000
kwh
x $003300
4,571
kwh
x $003190
24.500
kw
24.500
24.500
kw
kw
$
$
$
$
$
I,
$
$
$
On
02-04
On 02-04
45.75
42.88
340.59
39.55
18.36
57.17
-57.17
1.45
4ss.so
$
0.00
$
14.58
$
509.78
O-15g
923486
ENVIRONMENTAL
SCIENCE
Cop.e.
/fl4//7(o
fo
12065
Lebanon Rd.
Mt.
Juliet,
TN
37122
(615)
758—5858
1-800-767—5859
Fax
(615)
758-5859
Tax
ID. 62-0814289
FEb
157097
Invoice No.
148999
Invoice Date 13-FEB-02
Bill
To:
Mr.
Duane
Doty
~
United
Science Industries
6295
East Illinois flighway 15
Woodlawn,
XL
62898
lO-UNSOO1
*S~)4tI~fl
t’UJ?~11á*~
4ij~4~
~1A4~ftb~
Mr.
Duane Dot1
14625
1~r~j~t
i~1i~ber
•
•
IS
1694l~6
Net 180
Site
IP4t
~M~uAtPu~
UNSCIMO-1894176
$
100.00
Sample Numbers:
L67543-01
•~~:~:i
05F5B02
Sample IDe:
EWT
55
aty
Matrix
~eSCr&pt&ofl
•
limit
~P@a
.
z.motj~at
Kruep
-
Rockys
1
GW
8921 BTEX
1
GW
Oil
&
Grease
by
9070
Total
/.~“
32973
•c,
$
55.00
S
45.00
$
55.00
~
•
45.00
$
100.00
w—
I
—
Account~BeyoI~.dTerms
Are
SJala9ect
t.D lia,(2
Mont~J&-Se r~~it~UCt~iaoge
Please
Return
One
Copy
with
Payment
Page
1
(Visa/MC/AMEC Accepted)
02/14/02
11t41
HA~RISO
Acct Date
02/16/02
ens0
Set. 1970
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request
for Payment of
UST
Corrective
Action Costs
Summary Sheet for
All
Charges in
this
Billing
Package
Incident
No:
923466
The owner/operator or their representative shall
complete this
form
and place it in the front of the billing
package.
All charges in this
billing package shall be summarized on
this
form.
PAYMENT
ITEM
TOTAL
PAYMENT REQUESTED
PERSONNEL
EQUIPMENT
MATERIALS
& EXPENOABLES
(In Stock Items)
MATERIALS
& EXPENDABLES
(Field Purchases)
SUBCONTRACTORS
TOTAL PAYMENT REQUESTED
$
$
4,250.00
3,840.00
,/~
0.00
2,195.87/
0.00
/
10,285.87/
This
Agency is authorized to request this information under the
lii
‘s
n
-
0
ental Protection Act. 415
LOS
5/I
et seq.
~formeriy
lit Rev.
Stat
Ch 1111/2,
IDOl
et
seq.)
ic
this information is required•
Failure to properly complete
this form in its entiretymay result in the deia
0
nial of any payment
requested
hereunder,
This formhas been approved by
the Forms Management Center,
IL 532 2168
1.20 482
Mar-93
United Science Industries, Inc.
6295 E
Illinois Hwy 15
Woodlawn,
IL 62898
iuwnaVlii~Sai~ini*ninSJ
Phone:
(618)
735-2411
Fax:
(618) 735-2907
INVOICE
DaLee Oil Company
206 North Hanover
Okawville
IL
62271
ATTN:
Bill
Parr
Reference:
Kruep
-
Rocky’s 66
J
Work
Period:
08/0112001
to
0113112002
Personnel Charges
$
4250.00
Equipment
Charges
$
3,840.00
Stock Item Charges
$
0.00
Field Purchases
$
2,195.87
Subcontractor Charges
$
0.00
(Subconfracfor & Field EKpenses pending receipt by US/ are not included
on
fhis invoice and
are subject
to
future billing.)
a
Payment Terms:
Category 3/DM
Customer
P.O.
Number:
Please make
checks payable to:
united
Science
Industries,
Inc.
6295
E Illinois
Hwy
15
Woodlawn,
IL 62898
Task:
Corrective Action Activities; Quarterly Sampling;
Groundwater
&
Effluent Sampling; Monthly
-
Groundwater Treatment Unit
& SVE Rental; Operation & Maintenance; Prepare LUST Paperwork
Illinois
Environmental Protection Agency
UNDERGROUND
STORAGE TANK
PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage
instructions, see reverse.
BILLING PERIOD
Incident
No:923466
Job Name:
Kruep
-
Rocky’s 66
from:
08/01/2001
Contractor:
United Science Industries, Inc.
to:
01/31/2002
*
Use Time and Materials
Rate
Total Personnel
49.ooj
This Agency is authorized to request this information under the Illinois Environmental Protection Act, 415
ILOS 5/1 et seq. (formerly
Ill Rev. Stat Oh 1111/2, 1001 et seq.)
Disclosure of this information is required.
Failure to properly complete this Form in its entiretymay result in the delay or denial of any payment
requested hereunder.
This form has been approvedby the Forms Management Center.
IL 532
1818
LPC 325
Rev. Mar-93
0162/1
Employee
Work Classification
ShOT
*Rate
Total
Johnson
PROJECTMANAGER
.-‘
-
12.75
95M~
1211.25
I
Kelly
‘5
PROF ENG
I
GEOLOGIST
1.50
—_
115.00
172.50
7-
Morgan
I
2..?5,
PROJECTMANAGER
-,
17.oof
ds.oo
1615.00
Morgan,
H.
-.a~,5° f~,
Morgan, R.
PROJECT MANAGER
ASSISTANT PROJMANAGER
6.25
9’~.00
593.75
1.25
~c(oo
81.25
/
Overturt
(I
ASSISTANT PROJ MANAGER
f
1.00
6g00
65.00
7-
Richards,
J.
7~
Weathertord
i2/5~_3~
ASSISTANT PROJ MANAGER
SENIOR ENVIRO
TECH
1.75
/5.00
113.75
~.O0
397.50
4250.00
Illinois,Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment
of
UST
Corrective
Action Costs
Incident No
923466
For usage instructions,
see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
front
12/30/20
to:
01/05/2002
Contractor:
United Science
Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Employee
Type of Work Performed
st
ot
st
ot
et
ot
st
ot
st
ot
et
ot
st
ot
st
ot
Morgan
PROJECT
MANAGER
—
—
15.30
1830
—
1.00
1.00
Total
Hours
i.ooj
This
Agency is authorlted to request this information under the Illinois Environmental Protection Act,415
LoS
5/1
et seq.
(formerly
III Rev, StatOh 1111/2, 1001 et seq.) Disclosure ofthis information is required.
Failure
to properly complete this form in its entirety may result in the
delay or
denial ofany payment
requested hereunder. This form hasbeen approved
by
the
Forms Management center.
IL 532 1822
LPC 329
Rev. Mar-93
Page:
1
C
—
0)
Co
,
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Job:
Kruep
-
Rocky’s 66
Request for Payment of
UST
Corrective Action
Costs
For usage
instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Incident
No:
923466
Billing Period: from:
01/06/20
to:
01/12/2002
Contractor
United Science Industries, Inc.
This Agency is authorized to request this Information under the Illinois Environmental Protection ACt, 415
LOS
511
et
seq. (formerly Ill Rev. StatOh 111112, 1001 et seq.)
Disclosure of this information is required.
Failure
to
property complete this form
in its entiretymay result in the delay or denial ofany payment
requested hereunder.
This
form
has been approved by
the
Forms Management
center.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Employee
.
Type
of
Work Performed
st
ot
st
ot
st
ot
st
ot
st
ot
st
ot
st
ot
st
ot
Johnson
PROJECTMANAGER
13.00
17.00
11.15
12.30
4.00
1.25
5.25
Morgan
PROJECT MANAGER
10.30
iLls
0.75
1330
3.50
1T00
~30
10.00
aso
4.75
Morgan
PROJECT
MANAGER
10.00
12.00
2.00~
Morgan
PROJECT MANAGER
14.00
15.00
T~
Morgan, H.
PROJECT MANAGER
16.15
16.30
0.25
0.25
~_—
Richards, J,
ASSISTANT PROJ MANAGER
—
14.00
15.45
1.75
1.75
Weatherford
SENIOR
ENVIRO TECH
08.00
12.00
07.30
08.00
—
1L532
2
LPC
3
Rev. Mar-93
Total Hours
19.50j
Page:
1
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of
LiST
Corrective Action
Costs
Incident
No:923466
For
usage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s66
Billing Period:
from:
01/13/20
to:
01/19/2002
Contractor:
United Science Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
in
ot
in
ot
in
ot
in
ot
in
ot
in
ot
Employee
Type of Work Performed
at
ot
st
ot
st
ot
st
ot
st
ot
st
at
st
ot
st
ot
Johnson
PROJECT
MANAGER
09.00
13.30
07.45
09.15
4.50
1.50
6.00
Morgan
PROJECT
MANAGER
10.30
12.00
14.15
15.15
08.00
09.00
1.50
1.00
1.00
3.50
~.-‘
Morgan
.
PROJECT MANAGER
16.15
015
17.00
0.75
Morgan
PROJECT MANAGER
oaoo
1.00
10.00
.
-
-
-
-
1.00
~-
Morgan,
H.
PROJECT MANAGER
16.30
17.00
-
a~
°~°
K
Overturf
ASSISTANT PROJ MANAGER
16.00
17.00
1.00
-~‘
IL 532 1822
Total Hours
12.75~
LPC3~ Rev. Mar-93
This Agency is authorized to request this information under the Illinois Environmental Proleclion Act, 415
ILCS 5/I
et
seq. (formerly
Ill Rev. StatCh 111 1/2, 1001 et seq.)
Disclosure of this information is required.
3’)
Failure to properly complete this
form in its entirety may result in the delay
or denial ofany payment
cat
.
Page:
1
requested hereunder.
This form has been approved bythe Forms Management center.
Illinois
Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment
of
UST
Corrective Action
Costs
Incident No’ 923466
For
usage
instructions,
see reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
BilUng Period:
from:
01/20/20
to:
01/26/2002
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
in
ot
in
ot
in
at
in
at
Employee
Type of Work Performed
at
at
st
ot
st
ot
st
ot
st
at
st
at
st
at
st
at
Johnson
PROJECT MANAGER
14.00
14.30
0.50
Kelly
PROF ENG
/ GEOLOGIST
12.30
~
14.00
.
1.50
Morgan
PROJECTMANAGER
11.30
12.30
16.00
18.00
.
1.00
2.00
3.00
,..—
Weatherford
SENIOR
ENVIRO TECH
10.30
13.30
—
.
3.00
3.00
IL
532
1822
Total
Hours
1
8.00~
LPC 329
Rev. Mar-93
This
Agency
is authorized to request
this
information
under the
Illinois
Environmental Protection Act, 415
ILcS
5/1
et
seq. (formerly
Ill
Rev.
Stat
Oh 1111/2,
1001
et
seq.)
Disclosure of this information is required.
Failure
to
properly complete this
form
iii its
entirety may result in the
delay or denial of any payment
Page:
1
requested hereunder,
This
form
has been approved by the Forms
Management center.
0
*-‘
a)
0)
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request
for Payment of
UST
Corrective Action
Costs
Incident Mo: 923466
Forusage instructions,
see
reverse
WEEKLY WORKSHEET
Personnel
Job:
Kruep
-
Rocky’s
66
Billing Period:
from:
01/27/20
to:
01/31/2002
Contractor:
United Science Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
,
TOTAL HOURS
in
ot
in
ot
in
ot
in
ot
in
at
in
at
in
ot
Employee
Type of Work Performed
at
at
st
at
st
ot
at
ot
st
at
st
at
st
at
st
at
Johnson
PROJECT MANAGER
13.00
14.00
1.00
1.00
Morgan,
H.
PROJECT MANAGER
13,00
15.00
17.00
17.30
11.00
12.00
2.00
0.50
1.00
3.50
7
Morgan, H.
PROJECT MANAGER
16.00
17.00
1.00
/
Morgan,
H.
PROJECT
MANAGER
—
17.00
18.00
1.00
/
Morgan, ft
ASSISTANT
PROJ MANAGER
15.00
15.45
‘
10.45
11.00
~a
y~
Morgan, Ft
ASSISTANT PROJ MANAGER
16.00
16.15
-,
0.25
0.25
IL
532 1822
Total Hours
7.75j
LPC 329
Rev. Mar-93
This Agen~
is authortzed to
requestThis information under the
Illinois Environmental Protection Act 415
O
ILOS 5(1
et seq.
(forrnerty
Ill Rev.
Stat Oh 111112, lOCI
et
seq.
Disclosure of this information is required.
Failure to property complete this form in
its
entirety
may
result in die delay
or denial
of any payment
Page:
1
requested
hereunder,
This form has
been
approved
bythe
Forms Management
Center.
-1
‘
Illinois Environmental
Protection Agency
Incident No:923466
UNDERGROUND STORAGE TANK PROGRAM
REQUEST
FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
For usage instructions,
see
reverse.
EQUIPMENT
Note:
Include cost of operator/n
the
un/t rates.
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries, Inc.
Rifling Period
From:
08/01/2001
To:
01/3112002
IL
532 1819
LPC
326
Rev. Mar-93
This
Agency is authorired
to request this information under the
Illinois
Environmental Protec~on
Act, 415
ILCS 5/1
et seq. (forme~ey
Ill
Rev,
Stat Ch 1111/2, 1001 et seq.)
Disclosure ofthis informatLon is requir
Failure to
properly complete this form
in its
entirety
may result
in
the
delay
or denial ofany payment
requested
hereunder.
This
form has
been
approved
by
the
Forms Management center,
olse
Equipment Used
Time Used
Unit Rate
Total Cost
UTILITY
VEHICLE
1.00 DAY
60.00
60.0(
UTILITY VEHICLE #53
0.50 Day
60.00
30.0C
ROCKY’S GROUNDWATER
1.00 MONTH
3750.00
3,750.0(
*
Use
Time and Materials Rates
Total Equipment Cost
3840.09
0~~
Illinois
Environmental
Protection Agency
This Agency is
authorized to request this information
under the
Illinois Environmental
Protection Act, 415
ILCS
5/1 et seq. (formerly
II Rev. StatCh 1111/2, 1001 et seq.) Disclosure of this information is required.
Failure to
properly
complete
this
form
in
its
entirety
may
result in the
delay or
denial ofany
payment
requested
hereunder.
This
form has tieen approved
by
the
Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Inddent No:
923466
Job:
Kruep
-
Rocky’s 65
Contractor:
United Science Industries,
Inc.
0
0)
Co
BiIHng Period:
from:o1/o6/2002
to:
01/12/2002
Contractors
Authorized Representative:
Date:
Date:
UTILITYVEHICLE
#53
0.00
I
IQIAL
EQUIPMENT
SUN
MON
TUES
WED
THURS
FRI
SAT
jHrs.orDays
0.00
I
0.500ay
0.00
0.00
I
0.00
I
0.00
0.5~ay
CL 532 1540
LPC 248
Rev.
Mar-93
-
-
-
This
Agency is authorized
to request this information under the
Illinois Environmental
Protection
Act, 415
Illinois Environmental
Protection Agency
tLCS 5/1
etseq. (formerly III Rev. Stat ChIll
112,1001
etseq.)
Disclosure ofthis information is required,
& £3
Failure
to
properly
complete this form
in
its entirety
may
result in the
delay
or denial of any payment
________
requested
hereunder.
This
form has been approved
by
the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
Incident No:
923466
WEEKLY WORK SHEET
EQUIPMENT
Job:
Kruep
-
Rocky’s 56
Contractor:
United Science
Industries,
Inc.
Billing Period:
from: 01/20/2002
to:
01/26/2002
jEQUIPMENT
SUN
MON
TUES
WED
THURS
FRI
SAT
Hrs.
or Days
UTILITY
VEHICLE
0.00
0.00
0.00
0.00
0.00
0.50DM
0.00
0.5cDAY
0
I.
-l
0
Contractors Authorized Representative:
_______________________________________
Date:
__________________________________________
Date:
IL 532 1540
LPC 248 Rev. Mar-93
This
Agency is authorized to request
this
information under the Illinois
Environmental
Protecuon Act.
415
ILcS
5/1 et
seq.
(formeity Ill Rev. Stat CM
1111/2,
1001
et seq.)
Disclosure
of this
information is required.
Illinois
Environmental
Protection
Agency
Failure to property complete this
form in
its enbrety may
result
in the delay or
denial of any payment
requested hereundet
This
form
has been approved by the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident No:
923466
Job:
Krtiep
-
Rocky’s 66
Contractor:
United Science Industries,
Inc.
C
-4
Billing Period:
from:01F27/2002
to:
01/31/2002
Contractors Authorized Representative:
Date:
Date:
IL 532 1540
LPC 248
Rev.
Mar-93
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
Incident
No:923466
FIELD PURCHASES
~IlIlngPeriod
Job Name:
Kruep
-
Rocky’s 66
From:
08(01(2001
Contractor:
United
Science
Industries, Inc.
To:
01/31/2002
Field Purchases
Quantity
Price/Item
Total Costs/Item
GWT
Electricity
1.00
375.60/ EACH
375.60
Sample Analysis
1.00
1485.00/
EACH
1485.00
Sample Analysis
1.00
100.00/ EACH
100.00
“Note:
Copies of invoices or billings must be
attached.
Subtotal
1960.60
Some subcontractorinvoicesand billings may require
furthertime and material itemization.
**
HandlIng Charge
$235.27
Total Subcontract Cost
2195.87
Handling Charges are eligible
for
payment only if they are equal
to or/ass
than the following
amounts:
Subcontract of Field
Eligible Handling Charges
Purchase Cost
as
a Percentage of
Cost
$1-$5,000
$12
$5,001
-$15,000
$600+10
of amt.
over $5,000
$15,001
-$50,000
$1,600÷8
of amt.
over $15,000
$50,001
-$100,000
$4,400÷5
of
STU.
over
$50,000
$100000 -$1,000,000
$6,900+2
of amt. over $100,000
This
Agency is authorized to request this information under the
Illinois Environmental
Protection
Act, 415
,L
532
823
ILCS
5/1
et
seq.
(formerly Ill Rev. Stat Ch 1111/2,
1001
et
seq.)
Disclosure of this
information
is required.
I
Failure
to property
complete
this
form in
its entirety
may
result
in
the
delay
or denial of any
payment
LPC
330
Rev.
Mar-93
requested hereunde.
This
form has been approved by the
Forms Management center.
Q172
ILLINOISPOWER
J~QL(j7(n
-BILLING
SUMMARY
Account
Num~3er:
676 130fl74
n
C.)
JAN
117QQ?
Partoith.
DVNlCYPerlorm.nce
lean,
UNITED
SCIENCE
INDUSTRIES
203
W
ELM
ST
R
OKAWVILLE
II
62271
(
V
j,I(
923466
Total Current Charges
Previous Balance
12-04-01
Delayed
Payment
Charge
12-21-01
Payment Posted
12-27-01
Balance Brought Forward
TOtAL AMOUNT DUE
by
01-23-02
P0
Box
511
TOTAL AMOUNT DUE
after
01-23-02
Decaur,
IL
62525
YOUR
ENERGY
USE
ELECTRIC/kwh
-
usage
last
13
months
10,645
1,230
3.615
0
ithfl1~d
.1
F
M
A
M
J
.J
A
S
C
N
U
J
AVG
$
-
actual
$
373.12
378.72
estimated
current month
*
-
current
month
last
year
BULLETIN
BOARD
(E-
All
non-residential
customers
are eligible for delivery
services.
K-i?
schools,
religious
facilities,
grain
drying
or
handling
facilities
may
be
eligible
for
an
optional
electric
rate.
Optional
rates
may
or
may
not
result
in
lower
bills.
To
view
detailed
information
on
non-residential
rate
options,
including
delivery
services,
visit
our
web
site
at
www.illinoispower.com.
Or
contact
our
Business Center at
1-800-363-6805.
8761CO
tt
Vø1~
an4 tear~
oys pet’torat~oita*
d*f
ted
tine
ILLINOIS
POWER
AMOUNT PAID:
DUE
DATE:
DUE NOW:
AFTER DUE DATE:
315”
60
I
January 23,
2002
$373.12
$378.72
ACCOUNT
*:
6761308174
BILL
DATE:
January
09.
2002
*BWNGRNG
*MflAUTOXX
3-DIGIT
628
*0137676130817476*
UNITED
SCIENCE
INDUSTRIES
79
P0
BOX
360
WOODLAWN
XL
62898-0360
P.O.
Box
2522
Decatur,
Xl
62525-2522
—
104FR2
l.l1.’IIl.Il.
11,111.1.11
III..
.iil.
~
~.II..I1.
,..
.1.11
Return
this
PoØzln7wSth
your
payment
If
you
have
any
ciuestions
Commercial
Electric
Service
about
your
bill,
please
call
1-800-363-6805.
Please
mail
general
correspondence
to
our
Company
headquarters:
Illinois
Power
$
375.60
$
276.99
$
4.15
t
-283.62
$
375.60
i
-2.48
AVERAGES
FOR
BILLING
PERIOD
TillS
YEAR
LAST
YEAR
TEMPERATURE
36
19
ELEc/lcwtt per Day
125
158
CostperDay
cost
per
kwh
$10.64
$10.19
$0.09
$0.06
Dollar
amounts
band
on
pretax
flguras.
0
2
012502
0
0000003?~72? 0O00O037B12l~
671.,I.RflM1?’4
1,
923463
ILLINOIS
POWER
~.flcftMDywaw.Prfam,.r,ciTnm
ACCOUNT
NUMBER:
6761308174
ELECTRIC
SERVICE
METER~:
Current Meter Reading, 01/07/02
(Actual)
40484373
Previous Meter Reading, 12/04/01
(Actual)
Amount of Electricity
Used
in
34 Days
Maximum
Demand
Billing
Demand Ending
01/07/02
Distribution Capacity Ending
01/07/02
UNITED
SCIENCE
INDUSTRIES
23.500
kw
3,850 kwh
392
kwh
23.500
kw
x
4,242
kwh
$
$
$
$
$
$
$
$
45.75
41.13
243.28
13.13
17.63
36.91
-36.91
.93
361.85
6.60
7.15
375.50
$
$
$
S
PAGE
2
8 1985
77743
Rate
11
kwh
4242
17.500
kw
17.500
kw
On
01-07
23.500
kw
On
03-02
Cost of Electricity Used for 34
Days
Ending 01/07/02
Account Charge
Below
2.4
1w
- I
Phase
DistribuUon
Capacity Charge
x
$
1.750000
Winter Energy Charge
x
$
0.063190
x
$
0.033490
Transformation Charge
$ 0.750000
Instrument
Funding
Charge
x
$
0.008700.
Instrument
Funding
Charge
Credit
4,242
kwh
x $
0.008700-
Decommissioning Expense Adjustment
4,242
kwh
x
$
0.000220
_______________________
SERVICE BILLING SUBTOTAL
Electricity
Excise
Tax
2,000
kwh
x
$003300
2,242
kwh
x $003190
___________________
TOTAL COST
FOR
ELECTRIC SERVICE
p
0174
9°
66
L,
L
12065
Lebanon
Rd.
Mt.
Juliet,
TN 37122
•~ThCIRONMENTAL
/
8T~/7(~
(G15)
758—5858
1-800-767-5859
.SCIENcE
CORP.
.
~o
Fax
(615)
758-5859
Tax ID.
62-0814289
JAN
147902
Invoice No.
145323
Est.
1970
Invoice Date 03-JAN-02
Bill
To:
Mr.
Duane
Doty
~
United
Science
Industries
r’.
6295
East
Illinois
Highway 15
Woodlawn,
IL 62898
99-0145001
~oport~8ib~
Purchfle
Order ~uvthfl
Mr.
Duane
Doty
1449’S
ProjSt
Nuii~er
tents
1894176
Net 180
Site ID#
IWPUX*tI
ate
tJWSCIMO-1894176
$
1485,00
Sample Numbers:
L63717-0l, L63717-02.
L63717-03,
L63717-04,
L63717-05,
L637l7-06,
L637i7-07,
t63717-08,
L63717—09,
L63717-iO,
L63717-ll,
L63717.’12,
L63717-13,
L63717-14,
L63717-15, L63717-16,
L63717—17,
L63717.18, L63717-19,
L63717-20,
L63717-21,
L63717’.22, L63717—23,
L63717-24,
L63717-25,
L63717-26,
L63717-27
21—DEC-01
Sample Ins:
MW-?,
MW-B,
MW-9,
MW-b,
MW-12,
MW-13,
l’114-14,
MW
15,
MW-16,
RW-12,
RW-13,
RW-14,
RW-l5,
MW-i,
MW-2,
MW-3,
MW-6,
MW-17,
RW-2,
RW-3,
RW-4,
nW-S.
RW-
6,
RW-7,
RW-8,
RW-9,
RW-lo
R5
.
Oty
M~ttik
Description
1~ask
Unit
?rioe
A~tount
Kruep
-
Rockys
/
27
GW
8021 ETEX
Total
tJ~s-oZ3
y~q~~~1/
$
55.00
.
$
1485.00
$
1485.00
Account
S
Be,d~rms
Please
Return
One
Copy
with
Payment
(Visa/MC/ANEC Ac~epted)
Are Su~~ct
/~Q°
Monthly Ser
‘
atgi
Page
1
01/04/02
14:47
Aect Date
01/06/02
0175
923466
12065
Lebanon
Rd.
Mt. Juliet,
TN 37122
NVIRONMENTAL
I*~
V/i’~
(615)
758-5858
~ScIENcE
CORP~
~
/~S~V
Fax
(615)
758-5859
1—800—767-5859
Tax
ID.
62-0814289
JAN ~?Z0OZ
Invoice No.
146165
Est. 1970
Invoice
Date
15-JAN-02
~Bibb
To:
‘
~
Mr.
Duane
Doty
~
United Science Industries
6295
East
Illinois
Highway 15
Woodlawn,
IL
62898
99-UNSOOl
tt-
Pt~cAasebrd~tNynbet
Mr.
Duane
Doty
14528
Prolest Number
,
mats
1894176
Net 180
site
xrn~
,
Antotmt
true
UNSCIMO-1894176
$
100.00
Sample Numbers:
L64282-0l
...
:~1é~té4..
.
08—JAN-02
p’
Sample
IDa:
EFFLUENT
KS
Qty
Matrix
Description
Rust
Unit Price
Mtcuftt
Kruep
-
Rocky(
1
GW
8921 ETEX
1
GW
Oil & Grease
.
/J-5~j73
Total
~4((
$
55.00
$
45.00
S
55.00
$
45.00
/
$
100.00
Account~~
Please Return One Copy with Payment
(Visa/MC/N4EC Accepted)
Are Su4~-ectt
Month~,t~ervti.
a~
.
Page
1
01/16/02
12:16
HARRISD
Rcct Date
01/18/02
0176
Illinois
Environmental Protection Agency
Incident
No:
923466
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of
UST
Corrective Action Costs
Summary Sheet for All
Charges
in this
Billing Package
The owner/operator or their representative shall
complete this
form and place it in the front of the
billing
package.
All charges
in this
billing package shall be summarized on this
form.
PAYMENT ITEM
TOTAL PAYMENT REQUESTED
PERSONNEL
$
1,330.75
EQUIPMENT
3,860.00
MATERIALS &
EXPENDABLES
(In
Stock Items)
20.00
q
-10
MATERIALS &
EXPENDABLES
*2frr2-3
(Field Purchases)
SUBCONTRACTORS
0.00
TOTAL PAYMENT REQUESTED
$
5r63’2-r
5c.a6.
5$
This
Agency
is authorized to request this information under the
Illinois Envfronmental Protection
Act, 415
ILCS 5/I
etseq. (formerly
lit
Rev,
stat
ChIll
1/2,
1001
et
seq.)
Disclosure
oft
‘s
0
atlon
is
required.
Faiture to properly complete this form
in
its
entirely may
result in the
delay
o
I
payment
IL 532 2168
requested
hereunder.
This
form has
been
approved by the Forms Managem
t
er.
LPC 482
Mar-93
United Science Industries, Inc.
6295
E
Illinois
Hwy
15
Woodlawn,
IL 62898
Phone:
(618) 735-2411
Fax:
(618) 735-2907
INVOICE
DaLee Oil Company
206 North Hanover
Okawville
IL
62271
AUN:
Bill
Parr
Task:
Monthly Operation
& Maintenance;
Quarterly Sampling
Reference:
Kruep
-
Rocky’s
66
Work
Period:
11/01/2001
to
12/31/2001
Personnel
Charges
$
1,330.75
Equipment
Charges
$
3,860.00
Stock Item Charges
$
20.00
Field
Purchases
$
422.23
Subcontractor Charges
.
$
0.00
(Subconfracfor
&
Field Expenses pending receipt by US!
are not included
on
this
in voice and are
subject
to
future billing.)
uue
V
Payment Terms:
Category
3/DM
Customer P.O. Number:
Please
make checks
payable to:
United Science Industries,
Inc.
6295 E
Illinois Hwy 15
_a_
Gtoar~a,
E4ctW&T
0178’
Woodlawn, IL 62898
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR
PAYMENT OF
UST CORRECTIVE ACTION COSTS
PERSONNEL SUMMARY SHEET
For Usage instructions, see reverse.
BILLING PERIOD
Incident No: 923466
Job Name:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries,
Inc.
from:
11/01/2001
to:
12/31/2001
*
Use Time and Materials Rate
Total
Personnel
1330.75(’~
This
Agency
is authorized
to
request this
information
under the
Illinois
Environmental
Protection
Act,
415
lLcS
5/I
et seq.
(formerly III Rev, Stat
ch
Ill
1/2,
1001
et
seq.)
Disclosure of this
information is required.
Failure
to properly
complete
this
form
in
its
entirety
may
resurt in
the delay
ordenial of any payment
requested hereunder.
This form has been approved
by
the Forms
Management center.
IL 532
1818
LPC
325
Rev. Mar-93
Employee
Work Classification
ST/OT
*Rate
Total
Echols
~o,
PROJECT COORDINATOR
0.50
50.00
25.00
Kroeger
7.5/
ENVIRONMENTAL TECHNICIAN
/
7.50
53.00
397.50
Probst
1~,
PROJECT MANAGER
0.751
.-
95.00
H~21
~95.OO
6.50
,-‘~‘53.o0
71.25
Richards
PROJECT MANAGER
95.00
Weatherford
&‘s)
SENIOR
ENVIRO TECH
344.50
-.
Weatherford
75,
SENIOR
ENVIRO
TECH
OT
I’~~’
7.50
V 53.00
397.50
I
23.75
017.9
Illinois Envkonmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of UST Corrective Action Costs
incident No:
923466
For
usage instructions, see reverse
C
WEEKLY WORKSHEET
Personnel
C-
Job:
Kruep
-
Rockys 66
Billing Period:
from:
12/02/20
to:
12/08/2001
Contractor:
United Science
Industries, Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
at
i~
at
in
ot
in
at
in
at
in
at
in
ot
Employee
Type of Work Performed
at
at
st
ot
at
at
at
ot
at
at
at
at
at
at
at
at
Richards
PROJECT MANAGER
•
14.00
0.50
14.30
———————————-—.—-—--—-——-—-
0.50
—
Richards
PROJECT MANAGER
15.30
16.00
0.50
“
Weatherford
SENIOR
ENVIRO TECH
07.00
13.00
07.00
07,30
I_______
IL 532 1622
LPC 329
Rev. Mar-93
.
6.00
0.50
6.50
.,/
Total Hours
7.5ö1
This Agency is authoriaed to request this information under the Itinois Environmental Protection Act, 415
ILCS 5/1
et seq.
(fomerly
II Rev,
Stat
Gb
1111/2, 1001
el
seq.)
Disclosure of this information is required.
Failure to properly complete
this
form
in
its
entirely
may
result in
the delay
or
denial of any payment
Page:
1
requested
hereunder.
This
bryn has been approved
by the Forms Management Center.
Illinois
Environmental
Protection Agency
____
UNDERGROUND STORAGE TANK PROGRAM
Request for Payment of liST Corrective Action Costs
Incident No
923466
For usage instructions,
see
reverse
WEEKLY WORKSHEET
C
Personnel
Job:
Kruep
-
Rocky’s 66
Billing Period:
from:
12109120
to:
12/15/2001
Contractor:
United Science
Industries, Inc.
SUN
MON
TUES
WED
‘
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
ot
in
at
in
at
in
ot
in
at
in
ot
Employee
Type of Work Performed
at
at
at
ot
at
at
st
at
at
at
at
at
at
at
at
ot
Echols
PROJECT COORDINATOR
10.00
10,30
0.50
0.50
,,.,.—
Prabst
PROJECT MANAGER
13,00
13.45
0.75
0.75
IL 532
1822
Total Hours
j
1.251
LPC 329
Rev. Mar-93
This
Agency is authorized to request this information under the
Illinois
Environmental
Protection
Act, 415
ILGS
5/I
et seq.
(formerly
Ill Rev.
Stat
Ch
111
1/2,
1001 et seq.)
Disclosure of this information is required.
Failure
to properly complete this form
in its entire~g
may
result in
the delay
or denial of any payment
Page:
1
requested
hereunder.
This
form
has
been approved by the
Forms Management Center,
Illinois
Environmental Protection Agency
UNDERGROUND STORAGE TANK
PROGRAM
Request for Payment of
UST
Corrective Action Costs
Incident Na:
923466
For usage instructions, see
reverse
CU
WEEKLY WORKSHEET
Personnel
C
Job:
Kruep-Rocky’s66
Billing Period:
from:
12/16/20
to:
12/22/2001
Contractor:
United Science Industries,
Inc.
SUN
MON
TUES
WED
THURS
FRI
SAT
TOTAL HOURS
in
ot
in
at
in
at
in
ot
in
at
in
at
in
at
Employee
Type of Work Performed
st
at
st
at
st
ot
st
at
at
at
at
at
at
at
at
.
at
Kroeger
ENVIRONMENTAL TECHNICIAN
07.30
7.50
15.00
7.50
~—“
Weatherford
SENIOR
ENVIRO TECH
OT
07.30
15.00
7,50
7.50
IL 532 1822
Total Hours
LPC
329
Rev.
Mar—93
This
Agency is authorized to request this information under
the
Illinois
Environmental
Protection Act,
415
ILGS
5/1
et seq.
(formerly
Ill
Rev, Stat
Ch
1111/2, 1001
et
seq.)
Disclosure of
this information
is
required.
Failure
to
properly complete this
form
in its
entirety
may result
in
the
delay or denial of any payment
Page:
1
requested hereunder.
This
form
has been approved
by the
Forms Management center
I
UNDERGROUND STORAGE
TANK PROGRAM
REQUEST FOR
PAYMENT OF
UST CORRECTIVE
ACTION COSTS
For usage instnjctions,
see reverse.
EQUIPMENT
Note:
Include
cost
of operator in the
unit rates.
Job
Name:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries,
Inc.
ELECTRONIC WATER LEVEL INDICAT
*
Use Time and Materials
Rates
20.Oc(
Total Equipment Cost
f
3860.Og
IL
532
1819
LPC
326
Rev.
Mar-93
This
Agency is authorized to requestthis information under the Illinois
Environmental
Protection
Act, 415
ILcS
511 et seq.
(formerley
lit Rev. Stat
Oh lii
1/2,
1001
et seq.)
Disclosure of this information is requir
Failure to properly complete this form
in its
entirety
may
result
in
the delay
or
denial of any payment
requested hereunder.
This
form
has been approved by the
Forms Management center.
0181
•
Illinois
Environmental Protection Agency
Incident No:923466
Billing Period
From:
11/01/2001
To:
12/31/2001
Equipment Used
Time Used
*Unjt Rate
Total
Cost
UTILITY VEHICLE #53
1.50 DAY
60.00
90.0C
ROCKY’S
GROUNDWATER
1.00 MONTH
3750.00
3,750.0(~
1. 00
DAY
20.00
Illinois Environmental
Protection Agency
This Agency is authorized
to request this information under the
Illinois Environmental
Protection
Act, 415
ILCS 5/1
et seq.
(formerly Ill Rev. Stat Ch 1111/2, 1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this form
in
its
entirety
may
result
in
the delay or
denial of any payment
requested hereunder.
This
torm
has been approved by the
Forms Management Center,
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Incident
No:
923466
S
Job:
Kruep
-
Rocky’s 56
Contractors Authorized
Representative:
Date:
Billing Period:
from:
12/02/2001
IL 532 1540
Date:
Contractor:
United
Science
Industries,
Inc.
UTILITY VEHICLE #53
0.00
MON
0.00
EQUIPMENT
SUN
TUES
WED
TI-4URS
FRI
SAT
0.00
0.50
DAY
to:
12/08/2001
0.00
0.00
0.00
I
IL)If\L.
1Hrs. or Days
0.5cOAY
C
a
LPC 248
Rev.
Mar-93
Illinois Environmental
Protection Agency
This Agency is authorized to request this information under the
Illinois Environmental
Protection
Act, 415
lLcS
5/1
et seq.
(formerly Ill Rev. Stat Oh 1111/2,
1001
et seq.)
Disclosure of this information is required.
Failure to properly complete this lorm in
its
entirety may
result in
the
delay
or denial of any payment
requested hereunder.
This
form
has been approved by the
Forms Management center.
UNDERGROUND STORAGE TANK PROGRAM
WEEKLY WORK SHEET
EQUIPMENT
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science Industries,
inc.
Th
(I’
Billing Period:
from:
12/16/2001
Contractors Authorized
Representative:
IL 532
1540
Incident
No:
923466
to:
12/22/2001
Date:
Date:
LPC 248
Rev.
Mar-93
-
This Agency is authorized to request this information under
the
Illinois Environmental
Protection Act 415
~
Illinois
Environmental Protection Agency
ILCS 5/let seq.
(formerly Ill Rev, Stat Chill
1/2,
1001
et seq.)
Disclosure of this information
is required.
Failure to properly complete this form
in
its
enWety
may
result in
the
delay or denial of any payment
requested hereunder.
This
form has been approved by the Forms Management Center.
UNDERGROUND STORAGE TANK PROGRAM
incident No:
923466
WEEKLY WORK SHEET
EQUIPMENT
Job:
Kruep
-
Rocky’s 66
Contractor:
United Science
Industries,
Inc.
Billing
Period:
from:
12/23/2001
to:
12/29/2001
$EQUIPMENT
SUN
MON
TUES
WED
THURS
FRI
SAT
Firs.
‘~a~
~
ROCKY’S GROUNDWATER TREATMENT
0.00
0.00
0.00
0.00
0.00
1.OOMONTH
0.00
1.0ct~iONTH
C
a)
Contractors Authorized
Representative:
Date:
____________________________________
Date:
IL 532 1540
LPC 248
Rev.
Mar-93
Illinois Environmental
Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
STOCK ITEMS
For Usage instructions,
see
reverse.
BILLING PERIOD
Incident No:
923466
Job Name:
Kruep
-
Rocky’s 66
from:
11/01/2001
IL
532
1831
LPC
328
Rev.
Mar-93
This Agency is authorized to request this Information
under the
Illinois
Environmental Protection
Act. 415
LOS
5/1
et seq.
(formerly lii Rev. Stat
Ch 1111/2, 1001
et seq.)
Disclosure ofthis information
is requirec
Failure to properly complete this form
in
its
entirety
may result in
the
delay
or denial of any payment
requested hereunder.
This form
has
been approved by
the
Forms Management center.
Contractor
United Science Industries, Inc.
to:
12/31/2001
j
I
Stock
Items
Quantity
Price/Item
Total Cost/Item
1
20.00
DEDICATEDPOLYBAILER
1.00
20.00/EACH
Total Stock
Items
0187
Illinois Environmental Protection Agency
UNDERGROUND STORAGE TANK PROGRAM
REQUEST FOR PAYMENT OF UST CORRECTIVE ACTION COSTS
Incident No:
923466
FIELD PURCHASES
bIlling l-’enod
Job Name:
Kruep
-
Rocky’s 66
From:
/
/2
1
Contractor:
United Science Industries,
Inc.
To:
12/31/2001
Field
Purchases
Quantity
Price/Item
Total Costs/Item
GWT
Electricity
1.00
276.99 / EACH
~~3jt?6.09
Sample Analysis
.
1.00
100,00 /
EACH
100.00
*
Note:
Copies of invoices or billings must be
attached.
Subtotal
~
7
6
3~
3~7&4t
Some subcontractor
invoices
and billings may require
-
a
furthertime and mateflal itemization.
**
Handling Charge
-,
.-~.
q
‘.1
$4~t4
Total Subcontract Cost
s~
~jSO
..422,fl
Handling Charges are eligible forpayment only if they are equal to orless
than the following amounts:
‘7.
Subcontract of Field
Eligible Handling Charges
Purchase
Cost
as
a Percentage of Cost
$1
-$5,000
$12
$5,001 -$15,000
$600+10
ofamt.over$5,000
$15,001
-$50,000
$1eoo+8
of amt.
over$15000
$50,001 -$100,000
$4,400+5
of amt.
over $50,000
$100,000 -$1,000,000
$6,900-f2
of amt.
over $100,000
This Agency is authorized to request this information under the Illinois
Environmental
Protection
Act, 415
(LcS
5/I
et seq. (formerly
Ill Rev. Stat Oh 1111/2, 1001
et seq.)
Disclosure of this information is required.
IL OOL
Oh’)
Failure
to property complete this form
in
its entirety
may
result in the
delay
or denial of any payment
LPC
330
Rev.
Mar-93
requested hereunder.
This
form
has been approved by the
Forms Management center.
nisa
Account
Number’:
6761308174
N~
If you have any questions
about
your bill, please
call
1-800-363-6805.
‘l’lease mail general
correspondence to our
Company headquarters:
Illinois Power
P0 Box 511
Decatur,
IL
62S25
BY:
_—
Commercial Electric Service
Total
Current Charges
Previous
Balance
10-31-01
Delayed
Payment Charge
11-19-01
Payment Posted
11-26-01
Balance
Brought Forward
TOTAL AMOUNT
DUE
by 12-19-01
TOTAL AMOUNT
DUE after
12-19-01
YOUR
ENERGY
USE
ELECTRIC/kwh
-
usage last 13 months
0
J
F
MA
M
J
J
A SO
N
BULLETIN
BOARD
-
actual
-
esi:imated
-
current month
current
month
last year
L.~
ILLINOIS
POWER
AMOUNT PAID:
I
I
Decem~.9~_a0-0-L)
AFTER DUE DATE:
~281.14
*BWNGRNG
~AUTO~
3-DIGIT 628
*0157676130817476*
UNITED SCIENCE INDUSTRIES
79
P0 BOX 360
WOODLAWN
IL
62898-0360
11111111
liii.,
1111111
I
111111
IIIIII~III
•
111.11 ullillIuul 111111
P.O. Box 2522
Decatur,
Ii
62525-2322
104
FR2
0F89
Return
this
portion
with
your
payment
BILLING
SUMMARY
~~~.tVED
I..
f
ILLINOIS P0WER
Part of
the
DYNEGY
Performance
Team
UNITED
SCIENCE
203
W
ELM
ST
R
OKAWVILLE
IL
r~E(~--~
vi~
INDUSTRIES
CEC~62001
62271BY:
$
$
$
$
270.36
$
27O~
441.77
6.63
$
276.99
$
281.14
AVERAGES FOR
BILLING PERIOD
THIS
YEAR
LAST
YEAR
TEMPERATURE
51
0
ELEC/kwhper Day
73
0
CostperDay
$7.71
$0.00
Costoerkwh
$0.11
$0.00
•
-
Dollar emounts based
on pretax figures.
Zeros indicate non—use
or insufficient data.
OAVG
~
~
(g~q(7~
Illinois
Power
Gift
Certificates:
Easy to give,
great
to get!
Send them to friends and relatives for birthdays and holidays,
or to help someone you care about
at any time
of
the year.
Gift
certificates can be ordered by calling 1-877-770-4438
or
purchased online
at
www.illinoispower.com.
Illinois Power offers convenient,
safe electronic payment
options.
Please call our 24 Hour Customer Service Center
at
1-800-755-5000
or visit our web site at www.illinoispower.com
for more information.
iFGld~ah&feae~.:ort
pe~foi-a.tidrt.at~dó.t*edE-1in~
DUE DATE:
DUE NOW:
ACCOUNT
#:
6761308174
BILL DATE:
December
05,
2001
0
2
:L22l0~
0 000000251146 000000276993 6761305174
1
ACCOUNT NUMBER:
6761308174
ILLINOIS POWER
Partof
the
DYNEGY
Performance Team
UNITED SCIENCE INDUSTRIES
923466
PAGE
2
ELECTRIC
SERVICE
METER#:
Current Meter Reading,
12/04/01
(Actual)
40484373
Previous
Meter Reading,
10/31/01
(Actual)
-
Amount of Electricity
Used
In
34
Days
kwh
Maximum
Demand
17.500
kw
Billing
Demand
Ending
12/04/01
Distribution
Capacity Ending
12/04/01
$
$
$
$
$
$
$
$
$
$
$
45.75
41.13
157.15
17.63
18.90
-18.90
.55
262.21
6.60
1.55
270.36
Rate
11
77743
75256
2487
On
12-04
On
03-02
kw
kw
17.500
23.500
23.500 kw x
$
1.750000
2,487
kwh x
$
0.063190
23.500
kw x
$
0.750000
2,487
kwh x $ 0.007600
2,487
kwh x
$
0.007600-
2,487
kwh x
$
0.000220
2,000
kwh x $.003300
487 kwh
x $.003190
Cost of Electricity
Used for 34
Days
Ending
12/04/01
Account
Charge
-
Below
2.4
kv
-
I
Phase
Distribution
Capacity Charge
Winter Energy Charge
Transformation Charge
Instrument Funding
Charge
Instrument
Funding Charge
Credit
Decommissioning
Expense
Adjustment
SERVICE
BILLING SUBTOTAL
Electricity Excise
Tax
TOTAL COST FOR
ELECTRIC SERVICE
~19~O
923466
--
II~,
•
~
g-ç~
L//
7ç~~
12065 Lebanon
Rd.
Mt. Juliet,
TN 37122
(615)
758-5858
ENvIRONMENTAL
1-800-767-5859
•
~-~~CIENCE
CORP.
.
Fax
(615)
758-5859
Tax I.D. 62-0814289
•
Invoice No.
143748
Est.
1970
•
•
Invoice Date 17-DEC-01
Bill
To
Mr.
Duane
Doty
United
Science
Industries
6295 East Illinois Highway
15
~
Woodlawn,
IL 62898
99-UNSOO1
Reported
To
Purchase
Order
Number
Mr.
Duane
Doty
Proj
eot
1~umber
14450
‘j.~
1894176
Net 180
•
UNSCIMO-1894176
-
$
100.00
Sample
Numbers:
L62019-01
•.
•
—
05-DEC-01
Sample IDs:
EFFLUENT
R5
Qty
Matrix
::.
.
Description
.
~.
.
..
Ru2
~Uni.t
Price.
Amount
Kruep
-
Rockys
1
GW
8021 BTEX
.
1
•GW
Oil & Grease
~_6~
~
-~
(~co?3
Total
~(04b1(
$
55.00
$
45.00
-
$
55.00
$
45.00.
$
100.00
Accounts
Beyond
~kms
Please
Return
One
Copy
with
Payment
(Visa/MC/AMEC
Accepted)
Are
Subj’~~to~1
~
Monthly
~
arge
•
Page
1
12/18/01
11:46
HARRIS_D
Acct
Date
12/20/01
(1192