Laserfiche WebLink
CITY OF DECATUR—UST OWNER/OPERATOR <br /> HIGHWAY AUTHORITY AGREEMENT <br /> INITIAL INFORMATION FORM <br /> FOR LEAKING UNDERGROUND <br /> STORAGE TANK SITES <br /> OVERVIEW <br /> T'he purpose of this document is to notify the City of Decatur(City) <br /> of the extent of hydrocarbon impact within soil and/or groundwater and to provide <br /> the necessary initial information needed to enter into a highway authority agreement, <br /> pursuant to 35 IAC 742.1020. <br /> Applicant Information <br /> UST Owner: Maple Investments,LLC Owner(if different): <br /> Address: P.O. Box 122 Address: <br /> Cedar Rapids,IA 52406 <br /> Telephone No: (319) 396-2222 <br /> Fax No: <br /> Name and Title of Person Authorized to Sign for Owner: Steve Dummermuth, Jr. <br /> Name and Title of Person Authorized to Sign for Owner(if different): <br /> Apnlicant's Attorney Environmental Consultant <br /> Name: Name: Environmental Management, Inc. <br /> Address: Address: 1154 North Bradfordton Road, Springfield, IL 6271 l <br /> Telephone No: Telephone No: (217) 726-9468 <br /> Propertv Adjacent to the Ri�ht-of-Wav <br /> Address: 1303 North Main Street,Decatur, IL 62526 <br /> Ri�ht-of-Way�,$) re�uirin�Hi�hwav A�reement <br /> (Check one or both) <br /> Highway Number(s): X Soil Impact X Groundwater Impact <br /> Street Name(if any): Grand Avenue in Right-of Way in Right-of-Way <br /> Re�ulatorv Information <br /> IEMA Incident Number: 930779 & 951957 <br /> IEPA Project Manager: Carol Hawbaker <br /> (Check one) <br /> IEPA Status: _Conditional Approval X Approval Pending <br /> _Other <br />