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Home My WebLink About05-286 Resolution No. 05-286 RESOLUTION AUTHORIZING AND RATIFYING THE EXECUTION OF IEPA APPLICATION FOR INTERIM AUTHORIZATION FOR CLEAN CONSTRUCTION OR DEMOLITION DEBRIS FILL OPERATIONS FOR THE CITY'S SPORTS COMPLEX PROPERTY BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ELGIN,ILLINOIS,that it hereby authorizes and ratifies the execution of the IEPA Application for Interim Authorization for Clean Construction or Demolition Debris Fill Operations by Olufemi Folarin,City Manager,for the City's Sports Complex Property (also known as Facility Name: Prairie Materials Sales Yard 93), a copy of which is attached hereto and made a part hereof by reference. s/Ed Schock Ed Schock, Mayor Presented: September 28, 2005 Adopted: September 28, 2005 Omnibus Vote: Yeas: 6 Nays: 0 Attest: s/Dolonna Mecum Dolonna Mecum, City Clerk Illinois Environmental File room o?908050 y Site# pR9l,�p5D5? 03I -CCDD0D3-1 Protection Agency ROD R.BLAGOJEVICH,GOVERNOR Application for Interim Authorization for Clean Construction or Demolition Debris Fill Operations (LPC-PA24) This form must be used to apply for interim authorization for clean construction or demolition debris fill operations pursuant to Section 22.51 of the Illinois Environmental Protection Act. Interim authorization is required only for sites where clean construction or demolition debris is being used as fill in a current or former quarry,mine,or other excavation. This application is not required for clean construction or demolition debris recycling sites,active mining operations,or permitted landfills unless clean construction or demolition debris is being used as fill at the site in a current or former quarry,mine,or other excavation. One original and two(2)photocopies of all forms must be submitted to: Illinois EPA Mail Code#33 1021 N.Grand Ave.East,P.O.Box 19276 Springfield,IL,62794-9276 Please type or print legibly. Required fields are indicated with '. Forms that do not have the necessary information in the required fields will be considered incomplete and will be rejected, which may result in the denial of interim authorization. L SITE IDENTIFICATION (Describe the location of the excavation site being filled) Facility Name:*Prairie Material Sales Yard 93 Office Phone#,if available: Physical Site Location(Street,Road):*9N 684 Route 31 South City: * Elgin State: IL Zip Code: * 60123 County:* Kane Township:* Latitude and Longitude of approximate center of site to five decimal places(e.g.,90.12345N 40.67890W): Longitude: 1 r CE T E D Latitude: AUG V IEPA Site#s(if assigned): BOL: AG 1 7 2005 BOW: IEPA-BOL BOA: PERMIT SECTION IL OWNER/OPERATOR INFORMATION (Site owner is the owner of the property on which the clean construction or demolition debris fill operation is located,site operator is the owner of the clean construction or demolition debris fill operation. If the site owner or site operator is not a sole proprietorship,or government entity,please complete and return form LPC-PA24A as part of this application.) SITE OWNER SITE OPERATOR Name: * City of Elgin Name: * Prairie Material Sales,Inc. Address: * 150 Dexter Ct. Address: *7601 West 79th Street City: *Elgin State: *IL Zip: * 10120 City: * Bridgeview State: * lL Zip: *60455 Contact Name: *Cogley William Contact Name: * Furlong Robert Last Name First Name Last Name First Name Phone#: *(847)931-5659 Phone#: * (708)594-3146 Email: cogley_w @cityofelgin.org Email: b_fniong®prairiegroup.com 1 • IIL TYPES OF CLEAN CONSTRUCTION OR DEMOLITION DEBRIS ACCEPTED FOR FILL (*Mark all types that are accepted for fill. At least one field must be checked.) Uncontaminated concrete without protruding rebar fl Stone IN Brick j Reclaimed asphalt pavement Rock Fi Uncontaminated soil ❑ Other:(Specify) IV. AMOUNT OF CLEAN CONSTRUCTION OR DEMOLITION DEBRIS ACCEPTED *Estimated annual fill(yd3/year): Check only one: El Less than 10,000 Q 10,000 to 50,000 ❑50,000 to 100,000 ❑100,000 to 150,000 0 Greater than 150,000 Estimated average daily volume(yd3/day):*5,000 Approximate bulk density of material(tons/yd3):* 1.5 Comments: V. CONFLICT OF INTEREST DISCLOSURE * Pursuant to Section 22.52 of the Illinois Environmental Protection Act,certain individuals are prohibited from having a direct financial interest in or receiving a personal financial benefit from(1)any waste disposal operation or any clean construction or demolition debris fill operation that requires a permit or interim authorization under the Illinois Environmental Protection Act,or (2)any corporate entity related to any such waste-disposal operation or clean construction or demolition debris fill operation. This prohibition does not apply to the ownership of publicly traded stock. On or after August 18,2005,other than the ownership of publicly traded stock,will any of the persons listed below have a direct financial interest in or receive a personal financial benefit from(1)the clean construction or demolition debris fill operation for which interim authorization is sought,including but not limited to a direct financial interest in or a personal financial benefit from the site owner or site operator,or(2)any corporate entity related to the clean construction or demolition debris fill operation, including but not limited to any corporate entity related to the site owner or site operator? (a) the Governor of the State of Illinois; (b) the Attorney General of the State of Illinois; (c) the Director of the Illinois Environmental Protection Agency; (d) the Chairman of the Illinois Pollution Control Board; (e) a Member of the Illinois Pollution Control Board; (f) the staff of any person listed in items(a)through(e)who makes a regulatory or licensing decision that directly applies to any waste-disposal operation or any clean construction or demolition debris fill operation; (g) the relative'of any person listed in items(a)through(f) Yes 0 No If the answer to the above question is"yes,"please complete and submit form LPC-PA24B as a part of this application. For purposes of this application,the term"relative"means father,mother,son,daughter,brother,sister,uncle,aunt,husband, wife,father-in-law,mother-in-law,brother-in-law,or sister-in-law. 2 VI. COMPLIANCE WITH SECTION 39(i-5)OF THE ACT* Pursuant to Section 39(i-5)of the Environmental Protection Act,for any clean construction or demolition debris fill operation in which any ownership interest was transferred between January 1,2005 and July 19,2005,the Illinois EPA must conduct an evaluation of the operation if any previous activities at the site or facility may have cause or allowed contamination at the site. The Illinois EPA may deny an interim authorization if previous activities at the site may have caused or allowed contamination at the site,unless such contamination is authorized under a permit issued by the Agency. Was any ownership interest in the clean construction or demolition debris fill operation,including but not limited to any ownership interest in a current or former owner or operator,transferred between January 1,2005 and July 19,2005? EYes 0 No If the answer to the above question is"yes,"please complete and submit form LPC-PA24C as a part of this application. VII. SIGNATURES* (Original signatures required. Signature stamps or applications transmitted electronically or facsimile are not acceptable.) All applications must be signed by the site owner and site operator or duly authorized representatives of the site owner and site operator. The following persons are considered duly authorized representatives of the following site owners or site operators: 1. For a corporation-A principal executive officer of at least the level of vice-president; 2. For a partnership-A general partner; 3. For a sole proprietorship-The sole proprietor; 4. For a government entity-Either a principal executive officer or a ranking elected official;or 5. Another person authorized by one of the persons listed in items 1 through 4 above to sign this application on behalf of the site owner or site operator. Written proof of such authorization must be submitted with this application. CERTIFICATION STATEMENT To the best of my knowledge and belief,no waste or construction or demolition debris other than clean construction or demolition debris has been or will be disposed of or used as fill material at the site for which this application is submitted. I certify under penalty of law that the information submitted,including but not limited to all attachments and other information,is, to the best of my knowledge and belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,including the possibility of fine and imprisonment for knowing violations.Furthermore,I certify that I am either the site owner or site operator or a duly authorized representative of the site owner or site operator and am authorized to sign this form. Site Owner Signature: 1110141111111,111ta— - Date: ^ \o&" Q S First Name: Olufemi ast Name: olarin Title: City Manager (this line may be typed) Notary: Subscribed and sworn before me this/� day of"1�f, Notary Signature:Lt/V4/1-4' `x;14 1" Notary Seal: My commission expires on: "OFFICIAL SEAL" MARY GIFFORT Notary Public,State of Illlnols My Commission Expires 6/13/08 ��.�.��•�.�.�.�:,.�.,��.�; 3 • Site Operator Signature: r 7.,,,,v IDate: - First Name: Robert Last Name: Furlong 4 ltle: G.M.-Manager-Ag Division (this line may be typed) Notary: Subscribed and swoi, before me this 4 day of ( c900 Notary Signatur ..r<. yLg Notary Seal: : Pueuc SANDRA B. f 4 I. ruxvas. COMMISSr 41 F%J'R+ > /IF : My commission expires on: 6' a/ 67 •••al•All information submitted as part of the Application is available to the public except when specifically designated by the Applicant to be treated confidentially as a trade secret or secret process in accordance with Section 7(a)of the Illinois Environmental Protection Act,applicable Rules and Regulations of the Illinois Pollution Control Board and applicable Illinois EPA rules and guidelines. / • ■ �' "OFFICIAL SEAL" : , SANDRA BIAKNEY „4:,. COMMISSION EXPIRES 06/21 •' : • • 4 CERTIFICATE OF AUTHORITY PRAIRIE MATERIAL SALES, INC. an Illinois corporation The undersigned officer of Prairie Material Sales, Inc . , an Illinois corporation, do hereby certify that at a meeting of the Board of Directors of the Corporation held on August 1, 2005, at which all directors were present, the following resolution was unanimously adopted: RESOVLED, that the following individual, namely: Robert Furlong General Manager - Aggregates Division of Prairie Material Sales, Inc . acting singly and without the authority of any other party, is authorized to execute and deliver authorizations, applications or other materials pertaining to applications for Interim Authorization for Clean Construction Demolition Debris Fill Operations to be submitted to Illinois Environmental Protection Agency on behalf of Prairie Material Sales, Inc . , an Illinois corporation and is authorized to execute and deliver such other related documents and to take such other action deemed appropriate to carry out the transactions contemplated thereby. This Certificate of Authority is directed to and may be relied upon by third parties doing business with Prairie Material Sales, Inc. IN WITNESS WHEREOF, the undersigned officer of Prairie Material Sales, Inc . have executed this Certificate as of August 1, 2005 . Prairie Material Sales, Inc . , an Illinois corporation I r- By: 11. • Pau Enger, Treasurer Illinois Environmental Protection Agency ROD R BLAGOJEVICH,GOVERNOR ATTACHMENT A to LPC-24 Site Owner and Site Operator Disclosure(LPC-PA24A) This form must be submitted as a part of the application for interim authorization if the site owner or site operator listed at Section II of form LPC-PA24 is not a sole proprietorship or a government entity. Please type or print legibly. L SITE IDENTIFICATION (Describe the location of the excavation site being filled) Facility name: Prairie Materials Sales Yard 93 Office phone#,if available: Physical Site Location(Street,Road): 9N 684 Route 31 South City: Elgin State: IL Zip Code: 60177 County: Kane Township: Elgin IL SITE OWNER/SITE OPERATOR INFORMATION Each site owner that is not a sole proprietorship or a government entity must provide the following information in sufficient detail to provide the hierarchy of individuals and business entities that,through direct or indirect means,have an ownership interest in the property on which the clean construction or demolition debris operation is located. Each site operator that is not a sole proprietorship or a government entity must provide the following information in sufficient detail to provide the hierarchy of individuals and business entities that,through direct or indirect means,have an ownership interest in the clean construction or demolition debris fill operation. For the purposes of this form,an ownership interest includes,but is not limited to,a deed;a common or preferred stock certificate;a lien on the property on which the clean construction or demolition debris operation is located;a right(including,but not limited to,any mining or mineral right);a warrant;an option;a bill of sale;a contract;and an interest in a proprietorship,a partnership,joint venture,or other business entity. a. Direct Ownership. The information provided below must identify the following information concerning the direct ownership of the site or the clean construction or demolition debris fill operation: 1) For site owners,the name,address,phone number,and ownership interest of each individual or business entity with an ownership interest in the property on which the clean construction or demolition debris operation is located. If the site owner is a publicly traded entity,the identification of ownership must be provided as required in(c)below. 2) For site operators,the name,address,phone number,and ownership interest of each individual or business entity with an ownership interest in the clean construction or demolition debris fill operation. If the site operator is a publicly traded entity, identification of ownership must be provided as required in(c)below. 3) For each trust holding an ownership interest in the property or the clean construction or demolition debris fill operation,and for each voting trust,the name,address,phone number,and ownership interest of the trustee of the trust. b. Intermediary Entities and Ultimate Ownership. To the extent that a site or a clean construction or demolition debris operation is owned through intermediary business entities,the information provided below must identify,in hierarchical fashion,all intermediary entities and their owners,and provide similar information on all parent business entities. Ultimate ownership must RECEIVED AUG 1 7 2005 • be traced back to each individual with a direct or indirect ownership interest in intermediary entities and ultimate parent entities, except that if an intermediary entity or ultimate parent entity is a publicly traded entity identification of ownership must be provided as required in(c)below. c. Ownership of Publicly Traded Entities. If a business entity is a publicly traded entity,the following information must be provided: 1) The name and percentage ownership interest of each individual or business entity with ownership of more than five percent of the voting shares of the entity,to the extent such information is known or contained in 13D or 13G Securities and Exchange Commission filings. 2) Any trust with ownership of more than five percent of the voting shares of the entity,to the extent such information is known or contained in 13D or 13G Securities and Exchange Commission filings. Attach additional sheets if necessary. A. Name: SEE ATTACHED SHEETS FOR II b. Phone: Address: City: State: _Zip: Ownership Interest: Name of Entity in Which Interest is Held: Relationship of Entity to Site Owner or Site Operator B. Name: Phone: Address: City: State: _ Zip: Ownership Interest: Name of Entity in Which Interest is Held: Relationship of Entity to Site Owner or Site Operator C. Name: Phone: Address: City: State: _. Zip: Ownership Interest: Name of Entity in Which Interest is Held: Relationship of Entity to Site Owner or Site Operator D. Name: Phone: Address: City: State: _ Zip: Ownership Interest: Name of Entity in Which Interest is Held: Relationship of Entity to Site Owner or Site Operator E. Name: Phone: Address: City: State: — Zip: Ownership Interest: Name of Entity in Which Interest is Held: Relationship of Entity to Site Owner or Site Operator Information for Attachment A Ultimate Ownership: Prairie Material Sales, Inc Oremus Family Trusts 7601 W. 79th Street Bridgeview, IL 60455 708-458-0400 J. Alan Oremus Dorothy A. Oremus Co-Trustees 7601 W. 79th Street Bridgeview, IL 60455 708-458-0400 Each Individual with a direct or indirect ownership interest All Beneficiaries of The Oremus Family Trusts Jordan Hanson James T. Oremus Justin Hanson John C. Oremus Kimberly Hanson Joseph Oremus Taylor Hanson Michael J. Oremus Alexandra Oremus Robert J. Oremus Austin Oremus Sara Oremus Dorothy A. Oremus Abbey Oremus Gary R. Oremus Chloe Oremus J. Alan Oremus Evan Oremus J. R. Oremus Sheri Oremus Smith For Further Information Contact: Robert M. Furlong General Manager—Aggregates Division 7601 W. 79th Street Bridgeview, IL 60455 408-594-3146