Section 811. APPENDIX A Financial Assurance Forms

Section 811.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

(Source: Amended at 35 Ill. Reg. 10842, effective June 22, 2011)