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Home My WebLink About185032 04/28/2010 f CITY OF CARMEL, INDIANA VENDOR: 00352715 Page 1 of 1 0 ONE CIVIC SQUARE SESCO GROUP CHECK AMOUNT: $1,683.25 CARMEL, INDIANA 46032 1426 w29TH Sr INDIANAPOLIS IN 46208 CHECK NUMBER: 185032 CHECK DATE: 412812010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460827 2010 -191 1,683.25 AMOCO STATION SITE 3 S 0 Air- Earth- Emerything In Bo-- tw4-- SESCO Group 1426 W. 29th Street Indianapolis, IN 46208 317- 347 -9590 City of Carmel Invoice number 2010 -191 Carmel Redevelopment Commission Date 03116/2010 Carmel City Hall One Civic Square Attn: Sherry Mielke, Staff Rede Carmel, IN 46032 Project: 3308 CRC -BP Amoco Site SESCO EIN 35- 2080452 Invoice Summary Budget Prior Total Current Description Amount Billed Billed Billed 12 ORC -A INJECTION REMEDIATION 11,966.00 11,252.96 11,252.96 0.00 13 GW MONITORING (7 QUARTERS) 53,151.00 30,131.53 31,679.78 1,548.25 14 WASTE DISPOSAL 5,805.00 1,306.15 1,306.15 0.00 15 -CAPI REPORT 2,955.00 2,259.25 2,259.25 0.00 IDEM RESPONSE LETTER 1,870.00 1,870.41 1,870.41 0.00 SUPPLEMENTAL PROJECT MANAGEMENT 0.00 2,088.75 2,223.75 135.00 Total 75,747.00 48,909.05 50,592.30 1,683.25 City of Carmel Invoice number: 2010 -191 Invoice date: 0311612010 Page 1 of 6 City of Carmel Invoice number 2010 -191 Date 03116/2010 Project: 3308 CRC -BP Amoco Site 13 GW Monitoring (7 Quarters) Professional Fees Billed Hours Rate Amount 12/10/2009 Project Manager Russell Schlukebir Oversight of waste characterization, transport and disposal 1.00 90.00 90.00 Waste disposal arrangements for purge water 12/17/2009 Senior Project Manager Russell Schlukebir Review report 0.50 110.00 55.00 Review 4th Qtr 2009 CAPR Staff Manager Kristen S. Gehlbach Technical document preparation 1.00 75.00 75.00 Project Manager Russell Schlukebir Finalize report 1.00 90.00 90.00 Revise 4th Qtr 2009 CAPR. Publishing request form 12/1812009 Staff Manager Nathan Hyde Deliver 1 Pick up work product 1.00 75.00 75.00 Trip to 1DEM Project Manager Russell Schlukebir Finalize report 0.50 90.00 45.00 4th Qtr 2009 CAPR IDEM Submittal 12/21/2009 Project Manager Russell Schlukebir Communicate with client 125 90.00 112.50 Prepare Letter of Transmittal for sending 4th qtr CAPR to Property owner. Director of Operations Joseph L. Gordon Management Oversight 0.25 110.00 27.50 Discuss report with Russ 12/30/2009 Project Manager Russell Schlukebir Coordinate dept, client or subcontractor work 0.25 90.00 22.50 Review Approve Laboratory Invoice 01/08/2010 Project Manager Russell Schlukebir Review vendor agreement 1 invoice 0.50 90.00 45.00 Review Approve NE Waste Disposal Invoice Reimbursables Billed Date Units Amount City of Carmel Invoice number: 2010 -191 Invoice date: 0311612010 Page 2 of 8 City of Carmel Invoice number 2010 -191 Date 03116/2010 Protect: 3306 CRC -BP Amoco Site (Continued) 13 GW Monitoring (7 Quarters) Reimbursables Billed Date Units Amount Maps 12/18/2009 28.00 56.00 photocopies- B &W 8.5X11 01/01/2010 25.00 3.75 CD's 12/18/2009 1.00 10.00 photocopies Color 8.5 X11 01/01/2010 236.00 59.00 Vendors Cost Billed Un A mount M u l t ip lier A m o u n t ENVision Laboratories, Inc Lab Fees 1.00 440.00 1.15 506.00 National Environmental Waste Disposal 1.00 240.00 1.15 276.00 Task subtotal 1,548.25 total 1,548.25 Supplemental Project Management Professional Fees Billed Hours Rate Amount 01/07/2010 Project Manager Russell Schlukebir RBC Plume Stability 0.50 90.00 45.00 Discuss/Assign MtBE Trend Analysis with CBrown 01/0812010 Project Manager Russell Schlukebir RBC Plume Stability 1.00 90.00 90.00 Discuss closure options with RThompson GLosonsky Task subtotal 135.00 total 135.00 Invoice total 1,683.25 City of Carmel Invoice number: 2010 -191 Invoice date: 03/16/2010 Page 3 of 8 City of Carmel Invoice number 2010 -191 Date 03/16/2010 Project: 3308 CRC -BP Amoco Site Invoice Supporting Detail 3308 CRC -BP Amoco Site Phase: 12 -ORC -A Injection Remediation Phase Summary Contract Billed Remaining Labor 11,966.00 5,906.25 49 6,059,75 51 Expense 13903 139.03 Consultant 5, 5,207.68 Total 11,966.00 11,252.96 94 713.04 6 Phase: 13 GW Monitoring (7 Quarters) Date Units Rate Amount Labor Senior Project Manager Russell Schlukebir Review report 12/17/2009 0.50 110.00 55.00 Subtotal 0.50 55.00 Staff Manager Kristen S. Gehlbach Technical document preparation 12/17/2009 1.00 75.00 75.00 Subtotal 1.00 75.00 Nathan Hyde Deliver/ Pick up work product 12/18/2009 1.00 75.00 75.00 Subtotal 1.00 75.00 Project Manager Russell Schlukebir Finalize report 12/17/2009 1.00 90.00 90.00 Finalize report 12/18/2009 0.50 90.00 45,00 Communicate with client 12/2112009 1.25 90.00 112.50 Coordinate dept, client or subcontractor work 12/30/2009 0.25 90.00 22.50 Review vendor agreement/ invoice 01/08/2010 0.50 90.00 45.00 Oversight of waste characterization, transport 12/1012009 1.00 90.00 90.00 and disposal Subtotal 4.50 405.00 Director of Operations Joseph L. Gordon Management Oversight 12/21/2009 0.25 110.00 27.50 Subtotal 0.25 27.50 Labor Total 7.25 637.50 Expense In -House Expense Maps 12/16/2009 28.00 2.00 56,00 photocopies- B &W 8.5X11 01/01/2010 25.00 0.15 3,75 CD's 12/18/2009 1.00 10.00 10.00 photocopies Color 8.5 X11 01/01/2010 236.00 0.25 59.00 Subtotal 290.00 128.75 Expense Total 290.00 128.75 City of Carmel Invoice number: 2010 -191 Invoice date: 0311612010 Page 4 of 8 City of Carmel Invoice number 2010 -191 Date 03/16/2010 Project: 3308 CRC -BP Amoco Site 3308 CRC -BP Amoco Site Phase: 13 GW Monitoring (7 Quarters) Date Units Rate Amount Consultant ENVision Laboratories, Inc Lab Fees 12117/2009 1.00 508.00 506.00 Subtotal 1.00 506.00 National Environmental Waste Disposal 12112/2009 1.00 276.00 276.00 Subtotal 1.00 276.00 Consultant Total 2.00 782.00 Phase Summary Contract Billed Remaining Labor 53,151.00 17,528.75 33 35,622.25 67 Expense 4,342.10 4,342.10 Consultant 9,808.93 9,808.93 Total 53,151.00 31,679.78 60 21,471.22 40 Phase: 14 Waste Disposal Phase Summary Contract Billed Re Labor 5,805.00 471.25 8 5,333.75 92 Expense Consultant 8 34.90 834.90 Total 5,805.00 1,306.15 23 4,498.85 77 Phase: 15 -CAPI Report Phase Summary Contra Billed Remaining Labor 2,955.00 2,218.25 75 738.75 25 Expense 43.00 -43.00 Consultant Total 2,955.00 2,259.25 76 69535 24 Phase: IDEM Response Letter Phase Summary C Bill Remai Labor 1,870.00 1,527.50 82 342.50 18 Expense 342.91 342.91 Consultant Total 1,870.00 1,870.41 100 -0.41 0 Phase: Supplemental Project Management Date Units Rate Amount Labor Project Manager Russell Schlukebir RBC Plume Stability 01/07/2010 0.50 90.00 45.00 City of Carmel Invoice number: 2010 -191 Invoice date: 03/16/2010 Page 5 of 8 City of Carmel Invoice number 2010 -191 Date 03/16/2010 Project: 3308 CRC -BP Amoco Site 3308 CRC -BP Amoco Site Phase: Supplemental Project Management Date Units Rate Amount Labor Project Manager Russell Schlukebir RBC Plume Stability 01108/2010 1.00 90.00 90.00 Subtotal 1.50 135.00 Labor Total 1.50 135.00 Phase Summary Contract Billed Remaining Labor 2,223.75 2,223.75 Expense Consultant Total 0.00 2,223.75 0 2,223.75 0 Invoice Summary C ontract Bill Remaining Labor 75,747.00 29,873.75 39 45,873.25 61 Expense 0.00 4,867.04 0 4,867.04 0 Consultant 0.00 15,851.51 0 15,851.51 0 Total 75,747.00 50,592.30 67 25,154.70 33 City of Carmel Invoice number: 2010 -191 Invoice date. 0311612010 Page 6 of 8 t City of Carmel Invoice number 2010 -191 Date 03/16/2010 Project: 3308 CRC -BP Amoco Site Joseph L. Gordon Timesheet date: 1212712009 Project Task Activity Employee Type Mon -21 Tue -22 Wed -23 Thu -24 Fri -25 111-26 9un -21 Total CRC -BP Amoco Site 13 GW Monitoring (7 Quarters) Management Director of Operations 0,25 0.25 Oversight 3308 Direct Total D.25 0.00 0.00 0.00 0.00 0.00 0.00 0.25 Regular total 0.25 0.00 0.00 0.00 0.00 0.00 0.00 0.25 esheet Total D.25 0.00 0.00 O.DO D.00 0.00 0.00 Tim 0.25 Kristen S. Gehlbach Timesheet date: 12/2012009 Project Task Activity Employee Type Mon -14 Tue -16 Wed -16 Thu -17 Fri -16 Sat -19 Sun -20 Total CRC -BP Amoco Site 13 GW Monitoring (7 Quarters) Technical document Staff Manager 1.00 1.00 preparation 3305 Direct Total 0.00 0.00 0.00 1.00 0.00 0.00 0.00 1.00 Regular total 0.00 0,00 O,DO 1.00 0.00 0.00 0.60 1.00 Timesheet Total 0.00 O.OP 0.00 1.00 0.00 0.00 0.00 1.00 Nathan Hyde Timesheet date: 12!2012009 Project Task Activity Employee Type Mon -14 Tue -15 Wed -16 Thu -17 Fri -0B Sat -19 sun -20 Total CRC -BP Amoco Site 13 GW Monitoring (7 Quarters) Deliver f Pick up work Staff Manager 1.00 1.00 product 3308 Direct Total 0.00 0.00 0.00 0.00 1 1.00 0100 0100 1A0 Regulartotal 0.00 0.00 0.00 0.00 1.00 0.00 0.00 1.00 Timesheet Total 0.00 O.DO 1 0.00 0.00 1.00 0.00 D.00 1.00 Russell Schlukebir Timesheet date: 0111012010 Project Task Activity Employee Type Mon -04 Tue-05 Wed-06 Thu -07 Fri -06 Sat -09 Sun -10 Total CRC -BP Amoco Site Supplemental Project RBC Plume Stability Project Manager 0.50 1.00 1.50 Management 3308 CRC -BP Amow Site 13 GW Monitoring (7 Quarters) Review vendor Project Manager 0.50 0.50 agreement I invoice 3308 Direct Total 0.00 0.00 0,00 0.50 1.50 0.00 0.00 2.00 Regular total O.DO O.DO 0.60 0.60 1.50 0.00 0.00 2.00 0 Timesheet Total 0.00 .00 0.00 0.60 1.50 0.00 0,00 2.00 City of Carmel Invoice number: 2010 -191 Invoice date: 03/1612010 Page 7 of 8 t City of Carmei Invoice number 2010 -191 Date 03/16/2010 Project: 3308 CRC -BP Amoco Site Russell Schlukehir Timesheet date: 0110312010 Project Task Activity Employee Type Mon -28 Tue -29 Wed-30 Thu-31 Fri -01 Sat -02 Sun -03 Twat CRC -BP Amoco Site 13 GW Monitoring (7 Quarters) Coordinate dept, client Project Manager 0.25 or subcontractor work 015 3308 Direct Total 0.00 0.00 0.25 0.00 0.00 0.00 0.00 0.25 Regular total 0.00 0.00 1 0,25 0.00 0100 0.00 0.00 0.25 Trmesheet Total D.00 0.00 0.25 0.00 7 0,00 0.00 0.25 Timesheet date: 1212712009 Project Task Activity Pno�ject ployee Type Mon -21 Tue -22 Wed -23 Thu -24 Fri -25 Sat -2fi Sun -27 Total CAmoco Site 13 GW Monitoring (7 Quarters Communicate with Ma nager 125 client 1'25 3 Direct Total 1.25 O.DO 0.00 0.00 0.00 0.00 0.00 1.25 Regular total 1.25 0.00 0.00 0.00 0.00 0.00 0.00 1.25 Timesheet Total 1.25 O.DO 0.00 0.00 0.00 0.00 0,00 1.25 Timesheet date: 1212012009 Project Task Activity Employee Type Mon -14 Tue -18 Wed -16 Thu47 Fri -18 Sat -19 Sun -20 Total CRC -BP Amoco Site 13- GW Monitoring (7 Quarters) Review report Senior Project Manager 0.50 0.50 3308 CRC -BP Amoco Site 13 GW Monitoring (7 Quarters) Pinalize report Project Manager 1.00 0.50 1.50 3308 Direct Total D.aD 0.00 0.00 140 0.50 0.00 0.00 2.00 Regular total 0.00 0.00 0.00 1.50 0.60 0.00 O.DO 2.00 Timesheet Tote 0.00 0.00 0.00 1.50 0.60 O.OD 0.00 2.00 Tlmesheet date: 1211312009 [CRC-BP oject Task Activity Employee Type Mon -07 Tue -08 Wed -09 Thu -10 Fri -11 Sat -12 Sun -13 Total Amoco Site 13 G W Monitoring (7 Quarters) Oversight of waste Project Manager 1.00 1.00 charactedzatron, transport and disposal 8 Direct Total 0.00 0.00 0.00 1.00 0.00 0.00 0.00 1.00 Regulartotal 0.00 0.00 0.00 1.00 0.00 0.00 0.00 1A0 Timesheet Total 0.00 0.00 0.00 1.00 0.00 0.00 0.00 1,00 City of Carmel Invoice number: 2010 -191 Invoice date: 03116/2010 Page B of B Publishing Request Form Project Name: F'rojectfl ask Requested BY: PkASS Date Requested: 12 1 D Total of Publications: j,, Deadline: 11 .1 Pile Palh: 7WM4 &aMe- C.W AZY, j Forlrtat PDF: Yes NO v 7zotJ Ac1'ztr f 9 are �F expandable 2- Pocket h��. p}� Color Black/White Staple Binder Clip a Ring Binder Alvider labs Plastic Crnoln CD a Delt4e Folder Folder Recipient: Notes: pj 7 Address: Expandable 2 Packet Color i3iacktYYftite Staple Binder Clip 3 -Rings Binder Divider Tabs Plastic Comb CD x pellYery Folder Folder Recipient: Lffnd.. Notes: Address: fk F&ZM x a rY Expandable 2- Pocket s Olok 3 Color £ilacic/White Staple Binder Clip 3 -Ring Binder Divider Tabs Plastic Comb CD Detivery�'a ?;�y Folder Folder r cisent: Notes: dress: pt1� Color Black/While Staple Binder Clip 3 -Ring Bindw Divider Tabs Plastic Comb able 2 Pocket CD 5Z.Detive z kk P Folder Folder R [Recipient: J�. Notes: A� Address: Number of Maps ate if color or b1w): 11" x 17" 18" x 24" 24" x 36" 36" >r4 Total CD's M J �I UservEveryoi�afFomrs�Publfshing Request roan S E S C 0 0 k 0 u P Environmental Invesfiga.tion Rernediation Corrective .actor,. Progress Report 4 th Qer 2009 City of Carmel /Carmel Redevelopment Commission ormer BP Station #20210 11:0 South Rangeline ][load Carmel, Indiana IDEM Facility ID #1122 ID ELI Incident #1989 -11 -672 and #2006 -01 -102 SESCO Project. ##3308 7'ssued December.. 18, 2009 Prepared. for: Mr. Kay Ifekoya Indiana D epartiinet -it of Environmental Management Office of La_ad. Quality ELI' 5'ection 100 N. Senate Avenue Indianapcilis, IN 46206 -6015 Prepared by: Jay Novotny DER 1w (I J y OR Staff Project Manager r:4VAJOt ENJT L MANAGEME. T SESCO Group December 2009 Accounting Copier Technical Copier Map Printer Carryover Carryover Carryover from from from Map Printing previous Prints previous 8 112 X Map Total color Totai b/w Project Task of Copie previous s month(s) (color) Copies month(s) less month(s) 11 11 X 17 Plotter copies to be copies to (less than 20) than 20 less than billed be billed Prints (color) 20 Co Dies 3101 4 150 104 150 108 3156 2 55 5 55 7 3175 3 148 38 146 41 3235 63 21 63 21 3239 1 123 132 123 133 3251 1 281 273 281 274 3262 18 68 110 6 1 3308 4 236 21 236 25 3312 38 59 161 4 9 3327 3 163 53 163 56 3337 13 117 235 117 248 3351 2 13 8 13 10 3381 4 58 151 58 155 3390 26 20 0 46 3408 11 12 2 9 13 21 417 1 125 320 125 321 3459 154 22 154 22 3465 25 124 119 124 144 3480 3 44 0 47 3518 3 80 182 1 80 185 3523 1 161 40 1 161 41 3526 8 100 73 100 81 3527 2 55 85 55 87 3528 73 25 1 73 25 3529 27 77 87 1 77 114 3533 2 117 68 1 117 68 3544 8 21 66, 21 74 3557 6 50 19 50 25 3560 4 266 294 266 298 3573 11 132 185 132 196 3580 7 143 16 143 23 3586 4 239 68 239 72 3590 1289 705 1289 705 3616 17 7 44 7 61 3637 1 26 22 26 23 3638 7 6 7 6 14 3647 24 2465 404 2465 428 ENVision Laboratories, Inc. I 1439 Sadlier Circle West Drive Indianapolis, IN 46239 Date Invoice Tel: (317)351 -8632 12/17/2009 13702 Fax: (3.17)351 -8639 Bill To SESCO Group 1426 W. 29th St. Indianapolis, IN 46208 DE C Attu: Russ Schiukebir C Terms Net 30 Description Qty Rate Amount SESCO Group Project: Former BP Carmel, IN 8260 BTEX/MTr3E 6 30.00 130.00 Iron 2 10.00 20.00 Dissolved Ferrous Iron 2 25.00 50,00 Sulf '1� tii J Nitr l Zt✓ I® 2 25.00 50.00 Nitrate 2 25.00 50.00 ]Nitrite 2 25.00 50.00 Level TV 10% 40.00 40.00 PO Project: Task: Approved By: Comments: ENVison Project. Number 2009 -2563 Total 1 $440.00 UNVlsion Pm) w.o �G, Page of CHAIN OF CUSTOD RECORD ENVision Laboratories, Inc, 1 1439 Sadlier Circle West Drive Indianapolis, IN 46239 Phone; (317) 351 -8632 J Fax: (317) 351 -8639 Client: SE, Co Invoice Address: REQUESTED PARAMETERS �fr�ct Report Project Name: 7 sarnp[e n P `I 7 I ]3� Address: l` 1 rM N c Cooler Temp: °C Sam plesonIce? No Re Report To: Lab Contact: 'Sanmples Intact? es No P I u55 Sch I klc�b;. Custody 5ea1 Yes o EW1sl0n Provided battles: Ye No Phone; 1 .3l 17 9 0 Sampled by: M'- I� a`y Zv ;t, VOC vials free of head space. Yes .No N/A a pH checked? .Yes',No N/A Fax: P,0. Number: a 3 3 D Please ind/rafe number of Qe§redTAT: (Pleaseorde I QA/QC Req uired: (cirdeifap Ilcable) �7 containersperpreservativebe %w 1 -2 days 3 6 days Std (7 bus. da s Level III evel IV I ENVision Sample ID Sample ID CblI... Coil Cbmp (C) Matrix Q o x.. v crab C) c Dade; -Time no r 1 OW- `7 lift �aq I;Zr; GV,1 I i Qi,J ilfi` /a1 I,Zo( 6 w Z-Z 2�2 ks I I a Comfnents: F,l� �'�is�oi ✓e "10-N L '6 6w -pare 4z TPF-M P-�5C 9D(fLs. Relinquished by Date Time eceiued by: Dalte TimiS fi lofo'i O:d� L If a c) i W, 0 h National Environmental Invoice P. O. Box 33637 Indianapolis, Indiana 46203 Date Invoice 317 7 91 -2200 I2/12n009 8568 r JA Bill To Ship To scsco Group 110 S RANGELINE ROAD Ice Gordon CARM:EL IN 1426 W. 29th Street Indianapolis, IN 46208 P.O. Number Terms Rep Ship Via F.O.B. Project 09-977 Net 30 12/12/2009 Quantity Item Code Description Price Each Amount 1 001ST Box Track 180.00 180.00 1 001LW Liquid Waste WATER 60,00 60.00 Pd 4 Project: Task: Approved By: comments: ENT JW1 2014 Plc= ren it: to above address. To $240.00 NO"AZARDOUS 1. Generator ID Number 2 Page 1 of 3. Emergency Response Phone 14. Waste Tracking Number WASTE MANIFEST 1 800 -424- -9300 09 -977 5. Generator s Name and Maifag Address Generaton s Site Address (B diflerend than mailing address) i• Former BP #3308 C/o SESM 14 -26 West 29th Street 110 South Range Line RD y'4 317- 347 -8590 7ndianpolis, IN 46208 Carawel, IN 46032 Gonerates Phone: B Transporter 1 Company Name US. EPA iD Number National F- vvirormmntal, Inc. IlNROW118372 n 7. Transporter 2 Company Name U.S. EPA 10 Nurnbat S Designated Facifriyr Name and Re Address U.S. EPA ID Number Caldwell Landfill 11380 N. 300 E Morristown., h'4 46 ?61 s Phone: 765- 763 -6258 s. waste 10. Comainera 1 t" Total 12. Unll Shipping Name and Description No. Type Quatmdy WINot Nw PORK a o Petroleu n Contaminated "water P a W Z Z c d. P 13, Special Handflrg truuue8one and Additional 1nto"abon 1. Verificatiatl i1mber 291792 14. GENERATOR'S CF.R nFICATIGR I certify the mateaals described above on this manifest are not subject to federaE reptfetim for reporting proper disposal of Hazardous Waste. Genova>nr'gMr&sP&tetfMAWName f Signature Month Day. Year ._.r 15. International Shipments import to U.S F->4od from U.S. Port of erdry/e:ar 1 Transporter Si re for experts Date krp�n. US M1 16. Transporter Admo%vledgnenl of Roceipt ol Materials cc Trani I Printed Name i Signature Month Day Year d A{�i.is l�SatlTtl 7 LGr�z 0.� /2C+ Transporter Pdmedffyped Name Signature Month Day Year 17. Discrepancy y s 17a. Discrepancy Endicalion Space? Quin Type Resfdus ❑Partial Rejection Fuif Rejection ManBest Reierenoe Number. 170. Alternate Facifdy (or Generator) U.S. EPA ID Number U FeaTiVs Ptwne: Ck 170. Signature of Alternate Fedray (or Generator) Month Day Year z r 1 i 18. Designated Facd nor or Operator: Cen7Cmation aF receipt M materr� covered by the mardfe� pt as ed in Item 17e �Y Print Month Da Y� e df� %Z 1^tid 169-BLS-CS 111979 (Rev. BK16) DESIGNATED FACILITY TO GENERATOR 20'd M CGS SeMces lam PO 8" 212 2920 B US 62 Morrtstom, I N 45161 ON -HA R.[ OUS WASM VERMCATION JV077CE �mrwa..s P65- T83$2�d' 9- $1�0-453.35'F3 Fax 785463.9174 Generator Information go be completed by the Generator suttm t6ed to Gds$ p rior to ltlitlal disposal,) Gen tw' Plame: Former SP NT108 Mailing Address. 1428 {+rest 29' Street County: Madon Contact Marne: Russell Schlukebir City: Indlonapotis State: IN Contact Phone: 317 ZIP. 46208 Contact Faic 317.347.81 Ete r8rsentative, Consultant, or Third Party Information Company Name: National Environmer t L Inc. Wiling Address: 24134 Ntath Ritter Avenue County: Marion Co*ct Madame Mathes City: Indiana 4S s tate: IN Contact Phone: 317-791-2204 2' 46218 Contact Fax 317 791.2210 Location of Waste Street Address: 11 p South Ra elflre Raad City: .1.2001 StI• IN Zip: 46032 Waste tr[f mwtton Name of Waste: Petroleum Coa%ninated Water Eat annual amount of waste Cydm 'Tons: Gallons: Drub: 1 Is the above waste material a result of a one time project cleanup? v0 Description of process generaft the waste: Site Invtrstt tion and Cleanue at UST Site Verification Is this verification notice a result of a significant raw material change or a process change? No Was this waste preftusly perrnirtted or verified? No Generator Notification (If a� of the following apply, !please indicate wtth ap es) The above waste is a: (Indicate by drding) Water Is this waste a hamrdoms waste that Is defined by USEPA and/or state regulation? No Does the Waste contain regulated radioat:dive material? No Does the waste &mtsin regulated concentratlarts of Polychlorinated Biphenyls (PCB's)? No Om the toasts generate fugitive dus14 Na Is the waste trot or capable of generating heat? No Is the waste a regulated Asbestos- containing material? No Have the chameterisilos of this waste changed since a waste determination was performed? No By signing this waste notification sheet, I hereby attest the above Inforrnetfon on this waste nothicatkm Is true and accurate, I hereby acknowledge that documenteffon dud supports the *asle determination YAII be made avaAabie upon request to the landfill and IDEM. Gen. Signature: vgl Title: Project M;s Wr Name (Print). Russ chiukebir Co. Name: Ss= roup Date: 11' Landfill Vedficaation Wa De nation: Veri3�tton Nuthber: t Approval Signature: gate: I f A 09 Irmnspartbr Information (to tea ellod out a leeindporterl Company Name: National Enviranmantal, Ins. Drivers Signature: Mailing Address: 2400 N RISer, Indianapolis, IN 46218 I7atEt; 2- 2 2 C DlBpas6[ seta Irt[otTnatlorr (to Bn tuted out by rn8 OMM o Site Narrre: CGS Servim Inc. IDEM Facility ID V. 73-01 Address: PO Box 21 MWbtawi IN 49n i o e (Weight}: Authorized Slgnaturef Date; 12 v on•� AYrJ7TC1 i TOY 03 �AYT CM-117 hu7C cmn mod-a C9.!.GL Frin7- F.V, --"()P Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee ,S e 1 Purchase Order No. Vy 2 f Terms hdi�ihQ�o�ls �ZQ r� Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) �_y� 2t�10 G UV J�LD r, �72u�U erS r MO n 3;fe 3. Total 5 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance. with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF -I, 44Jt,S N 4162 09 I, 95=)5 ON ACCOUNT OF APPROPRIATION FOR Joy Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s) or l 4q(0 227 3,2, bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Dlrector of to eveloprn Title Cost distribution ledger classification if claim paid motor vehicle highway fund