(5)
Submit, on separate paper, the proposed amendments/revisions for each document identified pursuant to (4) above, based on the
below listed instructions, {Note: The revisions may be presented in the form of replacernent pages ready for substitution into the last
approved plan of record, each page being clearly marked to show the date of revision. in the event there is no last approved plan of
record for any of the following, you must prepare and submit a full plan, including the proposed modification(s}, in accordance with
the applicable cited Rules.)
Facility desion plans must be prepared in accordance with Env-Sw 1103.05.
|| | Facility operating plans must be prepared in accordance with Env-Sw 1105.11.
| Ed | Facility closure plans must be prepared in accordance with Env-Sw 1106.04.
LJ | Financial assurance plans must be prepared as specified in Env-Sw 1400 and must include all related draft financial
assurance documents required fo effect the proposed modification.
(8)
In order for DES to approve the propased modification, the agency must be able to conclude from the information provided in this
application that the proposed modification meets all applicable requirements of the Rules. Therefore, for any aspect of the proposed
modification where it may not be self-evident that the proposed change meets all applicable requirements of the Rules, you should
explicitly provide such information. Provide your response below and/or use separate paper as necessary. (Check box if response
is atlached on separate paper [ J}
Project wilt restore landfill cover to pre-disturbance conditions.
SECTION IV. SCHEDULE
Provide a proposed schedule for implementing the modification. Use separate paper if necessary. (Check box if response is
attached on separate paper [_})
Drilling of micrapiles to commence January 7, 2018. Expected project duration is 45 to 60 days, with site restoration 100% complete on
or about April 1, 2078.
SECTION V. STATEMENT OF NEED
Pravide a statement of need describing why the proposed change Is necessary or desirable. Use separate paper if necessary.
{Check box if response is attached on separate paper Ex)
See cover jetter, Underpinning is necessary to restore the structural integrity of the building and mifigate settlement.
SECTION VI. IMPACT EVALUATION
On separate paper, identify all impacts, both positive and adverse, which the proposed madification will have, including each of the
below listed considerations.
(1)
(2)
(3)
{4}
{5)
The effect the modification will have on facility function, capacity, life expectancy, service type and service area.
The effect the modification will have on the environment, public health and safety.
The effect the modification wilt have on the state's ability to achieve the goals and objectives specified in RSA 149-M:2, namely
achieving a 40% minimum weight reduction in the solid waste stream on a per capita basis by the year 2000 and avoiding the
disposal of recyclable materials in a lined landfill with a leachate collection system.
The effect the modification will have on establishing and maintaining integrated waste management systems consistent with the
hierarchy of waste management methods in RSA 149-M:3 [the methods, in descending order of preference as specified in RSA 149-
M:3, are: source reduction; recycling and reusing; composting; waste-to-energy technologies (including incineration), incineration
without resource recovery; and landfilling].
Consistency with the state solid waste management plan and the applicable district plan, pursuant to RSA 149-M:72,[(b). If
necessary, contact the P&DRS at (603) 271-2925 for plan Information.
SECTION VI. PUBLIC BENEFIT DEMONSTRATION
Provide a “demonstration of public benefit’ based on the below fisted instructions. Check which one of the listed instructions
applies to your particular application.
LJ
For a type I-A modification of a standard permit, provide a “demonstration of public benefit” in accardance with RSA 149-M:114
and in conformance with the provisions of Env-Sw 1005.05. Prepare and submit the demonstration on separate paper,
L
For a type I-A modification of an emergency permit or a research and development permit, or a permit-by-notification, there
is a presumption of public benefit, provided that the proposed modification meets all requirements of the Rules. Therefore, you may
skip this section and go to Section Vill.
es
For a type I-B modification, there is a presumption of public benefit, provided that the proposed modification meets all
requirernents of the Rules. Therefore, you may skip this section and go to Section Vill.
Page 2 of 4 Application Form for Type § Permit Modification Rev, 10/09
