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SOLID WASTE DISPOSAL AREA NOTICE IN

TO WHOM IT MAY CONCERN:

I, a representative of (Printed name of authorized owner/operator) the solid waste management facility located at , (Complete Address of Facility)

City of , County of , State of , hereby give the following notice as required by Nebraska Administrative Code, 132-Integrated Solid

Waste Management Regulations, and Neb. Rev. Stat §76-2,119.

1. I am, and since (month) , (year)______, have been in of the following described lands.

(Legal Description)

2. Since (month) , (year)______, I have disposed of solid waste under the terms of Title 132-Integrated Solid Waste Management Regulations promulgated by the Nebraska Department of Environmental Quality (NDEQ) on/in the above described land.

3. The future use of the above described land is restricted under the terms of Title 132: The post- closure use of the must not disturb the integrity of either the containment system or the facility’s monitoring system, unless the Director of NDEQ determines that the proposed use (a) will not increase the potential threat to human health or the environment, or (b) is necessary to reduce the threat to human health or the environment. Records of operations of the facility are maintained at the Nebraska Department of Environmental Quality, P.O. Box 98922, Lincoln, Nebraska 68509-8922.

4. I have filed a survey plat with the Register of of County and with (County Name) NDEQ showing the location and dimensions of landfill cells and a record of the type, location and quantity of waste disposal within each area of the facility, as well as the location of existence of any monitoring systems.

5. Any and all future purchasers of this land should inform themselves of the requirement of the regulations and type, depth and location of the waste on the property, as well as the existence of any monitoring systems. This notation or instrument shall, in perpetuity, notify any potential purchaser of the above information.

Signature of Authorized Owner/Operator Date

Seal of Notary Public