Form MO780-1882 "Closure and Post-closure Cost Worksheet" - Missouri

What Is Form MO780-1882?

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

Form Details:

  • Released on January 1, 2012;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • 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 MO780-1882 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

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Download Form MO780-1882 "Closure and Post-closure Cost Worksheet" - Missouri

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MISSOURI DEPARTMENT OF NATURAL RESOURCES
SOLID WASTE MANAGEMENT PROGRAM
CLOSURE AND POST-CLOSURE COST WORKSHEET
THIS WORKSHEET IS ONLY REQUIRED FOR THOSE FACILITIES THAT ACCEPT WASTE AFTER JAN. 1, 2004. OTHERS MAY USE THE WORKSHEET IF THEY CHOOSE.
DATE
NAME OF FACILITY
PERMIT NUMBER
TOTAL PERMITTED ACREAGE
TOTAL ACREAGE WITH WASTE IN PLACE
TOTAL ACREAGE WITH OFFICIAL CLOSURE APPROVAL
(INCLUDING UNDEVELOPED AREAS)
(INCLUDING OFFICIALLY CLOSED AREAS)
SUBTITLE D
NON-SUBTITLE D
SUBTITLE D
NON-SUBTITLE D
SUBTITLE D
NON-SUBTITLE D
1.
How many acres is this financial assurance instrument intended for?
acres for closure
acres for post-closure
2.
Description of area (cell number, etc.)
3.
What is the approved final cover system design?
Subtitle D: one foot of compacted clay overlain with a geomembrane, a drainage layer and two feet of vegetative soil.
Standard soil cover: two feet of compacted clay overlain with one foot of vegetative soil.
(If your facility has both subtitle D and non-subtitle D areas, separate worksheets are advisable for these areas to avoid confusion.)
4.
Has an easement been granted to the Missouri Department of Natural Resources for access to and use of the borrow material for cap construction?
Yes
No
5.
What is the average round-trip distance from the landfill (or phase) to the borrow area? Round trip distance should be to the nearest ½ mile if less than five miles. If more
than five miles, round trip distance should be to the nearest mile. If the department does not have an easement to the borrow area, the round trip haul distance is assumed
to be 10 miles.
miles
6.
What is the approximate volume of soil remaining in the borrow area?
Clay (cubic yards)
Vegetative soil (cubic yards)
7.
What is the approved gas control system design?
Active extraction system
Passive venting system
No gas control system
If you have an active extraction system, check the appropriate box.
a. Required to control gas migration
b. Required under NSPS
c. Required by other agency (city, county, etc.)
d. Specified only by design engineer
If you check box “d”, is any part of the active gas system constructed at this time?
Yes
No
If yes, provide a general description of the portion(s) of the system installed.
Note: Owners of Subtitle D facilities must provide a closure financial assurance instrument for either an active extraction system or a passive venting system. You must provide a closure FAI for an
active system only when you are: 1) Required to install the system by the department to control off-site gas migration, or 2) Required to install the system under the Federal New Source Performance
Standards, or NSPS, or 3) Required to install the system by another regulatory agency (city, county, etc.).
If you own a Subtitle D facility and meet any of the conditions, complete Form A. If you own a Subtitle D facility and do not meet any of these conditions, you are only required to provide a closure
FAI for a passive venting system. Complete Form B if you own a non-Subtitle D facility (with a soil cap), you are not required to provide a closure FAI for a gas control system at all unless you also
meet at least one of the above conditions. If you have installed any portion of an active gas control system, you must provide post-closure maintenance funds for the portion of the system
constructed. Do this by checking the appropriate box on the post-closure cost worksheet and adding that amount to the total.
MO 780-1882 (01-12)
Page 1 of 4
MISSOURI DEPARTMENT OF NATURAL RESOURCES
SOLID WASTE MANAGEMENT PROGRAM
CLOSURE AND POST-CLOSURE COST WORKSHEET
THIS WORKSHEET IS ONLY REQUIRED FOR THOSE FACILITIES THAT ACCEPT WASTE AFTER JAN. 1, 2004. OTHERS MAY USE THE WORKSHEET IF THEY CHOOSE.
DATE
NAME OF FACILITY
PERMIT NUMBER
TOTAL PERMITTED ACREAGE
TOTAL ACREAGE WITH WASTE IN PLACE
TOTAL ACREAGE WITH OFFICIAL CLOSURE APPROVAL
(INCLUDING UNDEVELOPED AREAS)
(INCLUDING OFFICIALLY CLOSED AREAS)
SUBTITLE D
NON-SUBTITLE D
SUBTITLE D
NON-SUBTITLE D
SUBTITLE D
NON-SUBTITLE D
1.
How many acres is this financial assurance instrument intended for?
acres for closure
acres for post-closure
2.
Description of area (cell number, etc.)
3.
What is the approved final cover system design?
Subtitle D: one foot of compacted clay overlain with a geomembrane, a drainage layer and two feet of vegetative soil.
Standard soil cover: two feet of compacted clay overlain with one foot of vegetative soil.
(If your facility has both subtitle D and non-subtitle D areas, separate worksheets are advisable for these areas to avoid confusion.)
4.
Has an easement been granted to the Missouri Department of Natural Resources for access to and use of the borrow material for cap construction?
Yes
No
5.
What is the average round-trip distance from the landfill (or phase) to the borrow area? Round trip distance should be to the nearest ½ mile if less than five miles. If more
than five miles, round trip distance should be to the nearest mile. If the department does not have an easement to the borrow area, the round trip haul distance is assumed
to be 10 miles.
miles
6.
What is the approximate volume of soil remaining in the borrow area?
Clay (cubic yards)
Vegetative soil (cubic yards)
7.
What is the approved gas control system design?
Active extraction system
Passive venting system
No gas control system
If you have an active extraction system, check the appropriate box.
a. Required to control gas migration
b. Required under NSPS
c. Required by other agency (city, county, etc.)
d. Specified only by design engineer
If you check box “d”, is any part of the active gas system constructed at this time?
Yes
No
If yes, provide a general description of the portion(s) of the system installed.
Note: Owners of Subtitle D facilities must provide a closure financial assurance instrument for either an active extraction system or a passive venting system. You must provide a closure FAI for an
active system only when you are: 1) Required to install the system by the department to control off-site gas migration, or 2) Required to install the system under the Federal New Source Performance
Standards, or NSPS, or 3) Required to install the system by another regulatory agency (city, county, etc.).
If you own a Subtitle D facility and meet any of the conditions, complete Form A. If you own a Subtitle D facility and do not meet any of these conditions, you are only required to provide a closure
FAI for a passive venting system. Complete Form B if you own a non-Subtitle D facility (with a soil cap), you are not required to provide a closure FAI for a gas control system at all unless you also
meet at least one of the above conditions. If you have installed any portion of an active gas control system, you must provide post-closure maintenance funds for the portion of the system
constructed. Do this by checking the appropriate box on the post-closure cost worksheet and adding that amount to the total.
MO 780-1882 (01-12)
Page 1 of 4
8.
How many ground water monitoring wells do you have?
wells
9.
List the primary and secondary wastewater treatment plants used for leachate disposal, and the cost of disposal.
(Primary plant)
$
per gallon
(Secondary Plant)
$
per gallon.
Check if the facility discharges directly to a wastewater treatment plant.
10. What is the estimated post-closure leachate generation rate and how was it derived?
(gal/acre/day)
HELP model
Other (please explain.)
OFFICIALLY CLOSED AREAS
11. If any areas of the landfill have been officially closed, list the following information.
Area
consisting of
acres received official closure
,
years post-closure.
Area
consisting of
acres received official closure
,
years post-closure.
Area
consisting of
acres received official closure
,
years post-closure.
Area
consisting of
acres received official closure
,
years post-closure.
Area
consisting of
acres received official closure
,
years post-closure.
MO 780-1882 (01-12)
Page 2 of 4
CLOSURE COSTS
Final Cover System
Subtitle D (Composite cover)
acres x $
per acre =
$
(From Table One)
Non – Subtitle D (soil cover)
acres x $
per acre =
$
(From Table One)
Gas Control System
Active extraction system (Complete Form A and write the amount in the right column.)
$
Passive gas venting system (Complete Form B and write the amount in the right column.)
$
Note: Owners are not required to provide an FAI for an active gas system unless required to install the system for one of the reasons listed under section 7 of this worksheet.
However, owners of Subtitle D landfills are required to provide an FAI for a passive gas system if they do not provide one for an active system.
Other Critical Design Features
Include total cost for construction of other critical design features. Attach separate sheet(s) for cost calculations.
$
Total Closure Cost (sum of all lines) (2004 Dollars)
$
* Inflation Update
Adjust amount from 2004 dollars to present value.
Total closure cost 2004 dollars $
x current Implicit Price Deflator * /*Please contact the Solid Waste Management Program, 573-526-5401, for the current IPD
$
MO 780-1882 (01-12)
Page 3 of 4
POST-CLOSURE COSTS
Inseparable Annual Costs
Annual landfill inspection and reporting
$
1,000
Gas monitoring and reporting
$
4,450
Annual groundwater sampling and analysis cost.
wells x 2,000 = $
Annual groundwater monitoring system maintenance and statistics cost.
$
13,700
Leachate system maintenance
$3,100
$
(Check if applicable and write this amount in the space provided.)
Leachate testing
$2,250
$
(Check if applicable and write this amount in the space provided.)
Active gas extraction system maintenance and utilities
$17,600
$
(Check if applicable and write this amount in the space provided.)
Passive gas system maintenance
$1,600
$
(Check if applicable and write this amount in the space provided.)
Separable Annual Costs
Cap repair and maintenance
acres x
=
$
(From Table One)
Leachate treatment (check if applicable)
acres x
x (Cost per gallon)
=
$
(Gal/Acre/Year)
Leachate hauling (check if applicable)
acres x
x $0.05 =
$
(Gal/Acre/Year)
Annual Costs for Other Critical Design Features
Include total annual cost for maintenance of other critical design features. Attach separate sheet(s) for cost calculations.
$
Total Annual Post- Closure Cost (2004 Dollars)
Adjust for Inflation
Adjust Amount for 2004 dollars to present value
Annual closure cost 2004 Dollars
$
x current Implicit Price Deflator*/* Please contact the Solid Waste Management Program, 573-526-5401, for the current IPD = $
Sum of all annual post – closure costs
$
(Reduction. On the sixth anniversary of receiving official closure, a facility can reduce the post-closure FAI by one year’s worth of fund.)
Total Post-Closure Cost
Annual post-closure costs x 30 years
$
MO 780-1882 (01-12)
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