Illinois Administrative Code
Title 35 - ENVIRONMENTAL PROTECTION
Part 811 - STANDARDS FOR NEW SOLID WASTE LANDFILLS
Subpart G - FINANCIAL ASSURANCE
Appendix A - Financial Assurance Forms
ILLUSTRATION G - Owner's or Operator's Bond Without Surety

OWNER'S OR OPERATOR'S BOND WITHOUT SURETY

Date bond executed: ______________________________________________________

Effective date: ___________________________________________________________

Owner or Operator: _______________________________________________________

Owner's or Operator's address: ______________________________________________

Site: __________________________________________________________________

Site address: ___________________________________________________________

Penal Sum $ ______________________________

The owner or operator promises to pay the penal sum to the Illinois Environmental Protection Agency unless the owner or operator provides closure and post-closure care or corrective action for the site in accordance with the closure and post-closure care or corrective action plans for the site.

Owner or Operator _______________________________________________________

Signature ______________________________________________________________

Typed Name ____________________________________________________________

Title ___________________________________________________________________

Date: _______________________

Corporate seal