DERR-2024-005305

Voluntary Cleanup Program Application – January 2022 1
UTAH DEPARTMENT OF ENVIRONMENTAL QUALITY
VOLUNTARY CLEANUP PROGRAM APPLICATION
Complete this application to apply and request assistance, review and oversight from the Utah
Department of Environmental Quality (DEQ), through the Division of Environmental Response
and Remediation (DERR) under the Voluntary Cleanup Program (VCP), pursuant to Title 19,
Chapter 8 of the Utah Code. All applications will be reviewed to determine program eligibility.
Incomplete or inaccurate applications may be rejected pursuant to Utah Code § 19-8-106. Please
call [phone] should you have any questions concerning the completion of this
application.
Property Information:
Site Name
Address
City State Zip Code
Property Size (acres)
Property Tax Identification Number(s)
Legal Description and Site Map are required with the Environmental Assessment
Applicant:
(The Applicant is the person who submits an application to participate in a Voluntary Cleanup Agreement or who enters into a Voluntary Cleanup Agreement
with the Executive Director or the Executive Director’s designee. The term “Applicant,” whether in upper or lower case, includes both the singular and the
plural. Additional Applicants should complete the Additional Applicants Form attached to this application. Applicants are jointly and severally responsible for
payment of DEQ costs for review and oversight.)
Applicant
Contact Person Title________________________________
Address
City State Zip Code
Phone Email Address
Applicant is: ( ) Individual ( ) Business
Is the Applicant currently registered to conduct business in the State of Utah? ☐Y ☐N
Type of Business: ( ) Corporation ( ) LLC ( ) Sole Proprietorship
( ) General Partnership ( ) Limited Partnership
Entity Number and State of Creation*:
*Must include proof of current business registration.
Voluntary Cleanup Program Application – January 2022 2
Current Property Owner, if Different from the Applicant:
Owner(s)
Contact Person Title________________________________
Address
City State Zip Code
Phone Email address
Other Contacts (i.e., Consultants/Attorneys):
Name(s) Title________________________________
Organization
Address
City State Zip Code
Phone Email address
Property Use and Operator Information:
Current Property Use(s):
Proposed Property Use(s):
Previous Property Use(s) and Operator Information:
801-853-8185 [e-mail]
Voluntary Cleanup Program Application – January 2022 3
Involvement with Other Regulatory Programs:
Please describe all prior/current contact with local, state and/or federal regulatory programs or
agencies which relates to the environmental condition of the property. Discuss any orders,
permits, notices of violations, inspections or other oversight activities. Please also indicate if
there have been no contacts with other agencies.
Please provide all state and federal identification numbers related to the property in question,
including any solid waste, Underground Storage Tank, CERCLA (e.g., SEMS), and RCRA (e.g.,
RCRIS) registration numbers which have been assigned. Please also indicate if there are no
assigned numbers.
Eligibility in the VCP- In accordance with Title 19, Chapter 8, any site is eligible for
participation in the VCP except: 1) a treatment, storage, or disposal facility regulated under 42
U.S.C. 6901 et seq; 2) that portion of a site that is on the National Priorities List; and 3) any
portion of a site for which an administrative, state, or federal enforcement action is existing or
pending against the applicant for remediation of contaminants described in the application.
Does the Site meet any of the three exceptions listed above? ☐Y ☐N
If yes, please explain:
Environmental Assessment:
In accordance with Utah Code § 19-8-107(2)(e) and (3), an Environmental Assessment (EA)
must be included with this application and contain:
1. a current legal description of the site;
2. the physical characteristics of the site;
3. the operational history of the site, to the extent the history is known by the Applicant;
Voluntary Cleanup Program Application – January 2022 4
4. information that the Applicant is aware of concerning the nature and extent of any
relevant contamination and/or release at the site and immediately contiguous to the site,
and where the contamination is located; and
5. relevant information Applicant is aware of concerning the potential for human and
environmental exposure to contamination at the site.
Please include all information supporting the EA.
Applicant’s Intended Response Action Objectives:
___ Not known at this time. Applicant wishes to receive guidance from VCP staff.
___ Cleanup to Background.
___ Cleanup to Generic Risk-Based Levels (may require a Site Management Plan and
Environmental Covenant).
___ Cleanup to Site Specific Risk-Based Levels not relying on engineering or institutional
controls (may require a Site Management Plan and Environmental Covenant).
___ Cleanup to Site Specific Risk-Based Levels which rely on engineering or institutional
controls (may require a Site Management Plan and Environmental Covenant).
___ Other (explain)
Intent to Participate:
The Applicant requests oversight by DEQ of investigation and cleanup activities relating to
possible contamination at the property described above and intends to enter in good faith a
written agreement with DEQ to provide oversight under the VCP. This application does not
constitute such an agreement, and neither DEQ nor the Applicant will be bound to proceed with
the voluntary cleanup unless a Voluntary Cleanup Agreement (VCA) is executed. The Applicant
should be aware, that in order for DEQ to issue a Certificate of Completion for an entire site, the
Applicant must provide adequate information to document that the entire site meets the
applicable standards. As an alternative, the Applicant may pursue a Certificate of Completion
for only a portion of the site, as a partial response action area. The DEQ issues only one
Certificate of Completion per site. The VCA will describe the project activities of each party.
The DEQ will not proceed with the project, other than establishing program eligibility, until the
VCA is executed.
With this application, the Applicant does not admit or assume liability for investigation or
cleanup of the site. In addition, the Applicant may terminate the application at any time as
allowed by statute. If the application is rejected, the DEQ will follow the procedures in Utah
Code § 19-8-106.
Voluntary Cleanup Program Application – January 2022 5
Application Fee and Billing Information:
The Applicant must submit with this VCP application an application fee in the amount of
$2,500.00. The DEQ also bills for agency oversight of the work to be conducted under the VCA.
This cost is in addition to the application fee. Both the application fee and DEQ’s hourly rate are
outlined in the Agency’s approved Fee Schedule.
Invoicing for the voluntary cleanup should be directed to the person listed below:
Name(s)__________________________________Title_________________________________
Organization______________________ Phone ( )_______________ Email ________________
Address_______________________________________________________________________
City______________________________ State______________ Zip Code__________________
Submit the Application and Fee:
Electronic:
The application fee may be paid on the DEQ/DERR’s on-line payment portal shopping cart. In
this scenario and in lieu of mailing the VCP Application, the DEQ can accept an electronic
submission. The Applicant may submit the application, supporting documents (PDF preferred)
and a copy of the application fee payment to the VCP Program Manager at: [e-mail].
In Person Delivery, U.S. Mail, etc.:
Please submit the fee and supporting information to:
Attention: Voluntary Cleanup Program
UDEQ/DERR
P.O. Box 144840
Salt Lake City, Utah 84114
Applicant’s Signature:
Correctness of Information, Authorization to Sign and Financial Capability
The undersigned affirms that the information contained in this application is true and accurate to the best of their
knowledge. The undersigned represents that he/she is legally authorized to sign the application. By completing and
signing this application, the undersigned affirms the Applicant's financial capability to assess the site, perform the
cleanup, manage institutional controls and pay all costs, as allowed by statute, for the DEQ’s oversight.
By:__________________________________Name:___________________________________
(signature of authorized representative) (print or type)
Date:________________________________Title:_____________________________________
Company:____________________________Phone: ( )________________________________
Mackenzie Jones
3/1/2024 SVP Investments
Redstone Residential 801-948-8000
Voluntary Cleanup Program Application – January 2022 6
Enclosures:
● Application Fee Receipt ☐Y ☐N
● Environmental Assessment ☐Y ☐N
● Legal Property Description ☐Y ☐N
● Proof of Business Registration ☐Y ☐N
Application Submittal Schedule
NOTE: An application may be submitted during normal DEQ Business Hours, Monday – Friday
8:00 a.m. to 5:00 p.m. Applications received after 5:00 p.m. or on Holidays or weekends will be
processed the next business day.
Previously submitted to UDEQX
X
X
Voluntary Cleanup Program Application – January 2022 7
UTAH DEPARTMENT OF ENVIRONMENTAL QUALITY
VOLUNTARY CLEANUP PROGRAM APPLICATION
Program Application - Additional Applicants Form
Additional Applicant
Contact Person Title________________________________
Address
City State Zip Code
Phone Email Address
Interest in the Property_______________________________________________________
Applicant is: ( ) Individual ( ) Business
Is the Applicant currently registered to conduct business in the State of Utah? ☐Y ☐N
Type of Business: ( ) Corporation ( ) LLC ( ) Sole Proprietorship
( ) General Partnership ( ) Limited Partnership
Entity Number and State of Creation*:
*Must include proof of current business registration
Correctness of Information, Authorization to Sign and Financial Capability
The undersigned affirms that the information contained in this VCP application is true and accurate to the best of
their knowledge. Correspondences and billing will be directed towards the primary Applicant, but all applicants are
jointly responsible for the work conducted, the representations made and the costs incurred under the VCP. By
completing and signing this Additional Applicant Form, the undersigned affirms the Additional Applicant's financial
capability to assess the site, perform the cleanup, manage institutional controls and pay all costs, as allowed by
statute, for the DEQ’s oversight.
By:__________________________________Name:___________________________________
(signature of authorized representative) (print or type)
Date:_______________________________