Form ECY020-74 "Voluntary Cleanup Program Application Form" - Washington

What Is Form ECY020-74?

This is a legal form that was released by the Washington State Department of Ecology - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2020;
  • The latest edition provided by the Washington State Department of Ecology;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ECY020-74 by clicking the link below or browse more documents and templates provided by the Washington State Department of Ecology.

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Download Form ECY020-74 "Voluntary Cleanup Program Application Form" - Washington

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VCP Application
Standard and Expedited Processes
Washington State Department of Ecology
Toxics Cleanup Program
Check the box
Application Form
of the process
The Department of Ecology (Ecology) may provide informal, site-specific,
you are applying for:
technical consultations to persons conducting independent remedial actions
Standard VCP
at contaminated sites under the
Voluntary Cleanup Program
(VCP).
1
Ecology
Expedited VCP
may provide the consultations under either the
Standard VCP
process or
the
Expedited VCP
process.
Apply to the
Standard VCP process
To apply for the
Standard
VCP
process, you must submit to Ecology all the following:
 this form
VCP application form, completed and signed
VCP agreement
form,
2
signed by applicant
Agency determination
checklist,
3
completed.
To request an opinion on a planned or completed remedial action, you must complete Part 1.F in this
form. Submit with this application one searchable pdf file and one hard copy of each report you want us to
Working with the Voluntary Cleanup Program
review. See our report requirements on our
webpage.
4
Send your completed application to our regional contact listed, based on your site’s county.
1
https://www.ecy.wa.gov/VCP
2
https://fortress.wa.gov/ecy/publications/SummaryPages/ecy070324.html
3
http://ecyapfass/Biblio2/SummaryPages/ECY070620.html
4
https://ecology.wa.gov/Spills-Cleanup/Contamination-cleanup/Voluntary-Cleanup-Program/Working-with-
VCP
VCP Application
Standard and Expedited Processes
Washington State Department of Ecology
Toxics Cleanup Program
Check the box
Application Form
of the process
The Department of Ecology (Ecology) may provide informal, site-specific,
you are applying for:
technical consultations to persons conducting independent remedial actions
Standard VCP
at contaminated sites under the
Voluntary Cleanup Program
(VCP).
1
Ecology
Expedited VCP
may provide the consultations under either the
Standard VCP
process or
the
Expedited VCP
process.
Apply to the
Standard VCP process
To apply for the
Standard
VCP
process, you must submit to Ecology all the following:
 this form
VCP application form, completed and signed
VCP agreement
form,
2
signed by applicant
Agency determination
checklist,
3
completed.
To request an opinion on a planned or completed remedial action, you must complete Part 1.F in this
form. Submit with this application one searchable pdf file and one hard copy of each report you want us to
Working with the Voluntary Cleanup Program
review. See our report requirements on our
webpage.
4
Send your completed application to our regional contact listed, based on your site’s county.
1
https://www.ecy.wa.gov/VCP
2
https://fortress.wa.gov/ecy/publications/SummaryPages/ecy070324.html
3
http://ecyapfass/Biblio2/SummaryPages/ECY070620.html
4
https://ecology.wa.gov/Spills-Cleanup/Contamination-cleanup/Voluntary-Cleanup-Program/Working-with-
VCP
Apply to the
Expedited VCP process
You may apply for the
Expedited VCP
process only during periods specified by Ecology. To see when
Expedited VCP process webpage
Ecology is accepting
Expedited VCP
applications, see the
5
or
subscribe to our
Expedited VCP
email
list.
To apply for the
Expedited VCP
process, you must submit to Ecology all the following:
VCP application form, completed and signed 
this form
Voluntary Cleanup Program Expedited Process
agreement,
signed by applicant
6
Agency determination
checklist, completed
Remedial investigation report or equivalent, meeting the elements of our
remedial investigation
checklist, and other reports you want us to review (one searchable pdf file and one hard copy each)
Electronic environmental data submitted to the
Environmental Information Management
(EIM) system,
7
which provides automatically generated email as confirmation
Project schedule.
Voluntary Cleanup Program (VCP): Guidance for the Expedited VCP Process
See the
8
for additional
information.
To submit your
Expedited VCP
application to Ecology, upload electronic files to Box.com,
9
after creating
your online account:
Sarah Wollwage, Expedited VCP Planner
Toxics Cleanup Program
Department of Ecology
PO Box 47600 Lacey, WA 98504-7600
Do not send your
Expedited VCP
application materials to an Ecology regional office.
You must pay the nonrefundable application fee within seven calendar days of receiving our invoice, or
we may reject your
Expedited VCP
application. After receiving the complete application, we will send the
invoice to the email listed for the project billing contact in Part 1.C of this form. We will not process your
application until we have received payment. Contact Sarah Wollwage at
Sarah Wollwage@ecy.wa.gov
or (360) 407-7141 for additional information.
Part 1 – Administration
1.A
Applicant. The applicant is the person or organization requesting services from Ecology, and is
responsible for paying Ecology’s incurred costs incurred. The agreement explains the applicant’s
authority and duty.
Name of applicant:
What type of entity is the applicant?
A person applicant must serve as the project billing contact. Identify this person and
Person
their contact information in both Parts 1.B and 1.C.
An organization applicant must identify the project manager in Part 1.B and the
Organization
project billing contact in Part 1.C. The organization must employ both persons.
5
https://ecology.wa.gov/Spills-Cleanup/Contamination-cleanup/Voluntary-Cleanup-Program/VCP-Expedited
6
http://ecyapfass/Biblio2/SummaryPages/ECY070633.html
7
https://ecology.wa.gov/Research-Data/Data-resources/Environmental-Information-Management-database/
EIM-submit-data
8
https://fortress.wa.gov/ecy/publications/summarypages/2009053.html
9
https://account.box.com/login
ECY 020-74 (revised June 2020)
Page 2 of 19
Part 1 – Administration
What is the applicant’s involvement at the site? Check all that apply.
property owner
business owner (operator)
agent of property owner
past property owner
mortgage holder
private person / organization
future property owner
consultant
public agency / organization
property lessee
attorney
other – specify:
Expedited VCP
note: The
Expedited VCP
applicant must have an ownership interest in or operate the
facility or have a contractual right to purchase, redevelop, or reuse the facility. Agents for the property
owner, such as a consultant, may not apply for the
Expedited VCP
process.
If not the current property owner, is the applicant authorized to grant property access?
yes
no
1.B
Project manager. We will send the project manager all official correspondence. The project
manager must be either the applicant or employed by the applicant. The project manager may
not be an independent contractor hired by the applicant. Enter the required information.
Name:
Title:
Mailing address:
City:
State:
Zip:
Phone:
Email:
Fax:
1.C
Project billing contact. We will send the project billing contact monthly invoices. The project
billing contact must be either the applicant or employed by the applicant. The project billing
contact may not be an independent contractor hired by the applicant. Enter the required
information.
Name:
Title:
Mailing address:
City:
State:
Zip:
Phone:
Email:
Fax:
1.D
Project consultant.
Is the applicant a consultant?
yes
no
If “yes”, skip to Part 1.E.
If “no”, and the applicant hired a consultant to conduct the independent remedial action, enter the
required information.
Name:
Title:
Organization:
Mailing address:
City:
State:
Zip:
Phone:
Email:
Fax:
Do you want us to contact the project consultant?
yes
no
ECY 020-74 (revised June 2020)
Page 3 of 19
Part 1 – Administration
1.E
Property owner.
Is the applicant the owner of the property where independent remedial action is being conducted?
yes
If “yes”, enter the type of entity and skip to Part 1.F.
no
If “no”, enter below all of the required information.
Name:
Title:
Organization:
Mailing address:
City:
State:
Zip:
Phone:
Email:
Fax:
What type of entity is the property owner? Check one.
private
tribal
federal
state
county
municipal
public school
mixed
other – specify:
1.F
Request for written opinion.
Are you requesting a written opinion at this time?
yes
no
If “yes”, list the report(s) or plan(s) below you are requesting a written opinion for. Note: Your reports
Working with the Voluntary Cleanup Program
must meet the requirements on our
webpage.
10
Attach to this application additional remedial action reports or plans you want us to review. We will
base our opinion on the information in the site file, including information attached to this application.
1.G
Reporting requirements. Comply with the following two reporting requirements when requesting
written opinions on planned or completed remedial actions.
1.G.1 Professional licensing. Documents submitted containing geologic, hydrogeologic, or
engineering work must be stamped by of an appropriately licensed professional, as required by
Chapters 18.220 and 18.43 RCW.
10
https://ecology.wa.gov/Spills-Cleanup/Contamination-cleanup/Voluntary-Cleanup-Program/Working-with-VCP
ECY 020-74 (revised June 2020)
Page 4 of 19
Part 1 – Administration
1.G.2 Data submittal to EIM. You must submit all site environmental sampling and analysis data in an
electronic format that meets our requirements for transfer into our
EIM
system. Refer to our
EIM webpage
for instructions on how to apply for an account and submit your data. Failure to
comply with these requirements may result in unnecessary delays.
For
Expedited VCP
applications only, the study ID and CSV file name must both begin with
“XVC” in the title. Do not use spaces or hyphens in either the study ID or CSV file name.
Have you submitted all the site’s environmental data to EIM?
yes
no
yes
If “yes”, enter the study ID and CSV file name below.
no
If “no”, and data need to be submitted, submit your data to EIM first, and then complete
the required information below.
We will not accept your
Expedited VCP
application unless you have satisfied these requirements.
We will not issue a no further action (NFA) opinion, unless you have satisfied these requirements.
Submitted to EIM? (y/n)
CSV File name
Study ID
yes
Ex: XVCNW9999
Ex: XVCnw9999_June20_results.csv
Study ID:
CSV File name:
Study ID:
CSV File name:
Study ID:
CSV File name:
Study ID:
CSV File name:
Study ID:
CSV File name:
Study ID:
CSV File name:
Study ID:
CSV File name:
Study ID:
CSV File name:
Part 2 – Site description
2.A
Site name. If we have already identified the site, enter the site name we provided. Otherwise,
enter a suggested name for the site. You may also include an alternative name.
Name:
Alternative name:
ECY 020-74 (revised June 2020)
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