LOCAL AUTHORITY CERTIFICATION LETTER

LOCAL AUTHORITY CERTIFICATION LETTER To: Iowa Department of Natural Resources (DNR) Underground Storage Tank Section Wallace State Office Building Des Moines, IA 50319 Restriction on installation of drinking and non-drinking water wells UST facility location _______________, DNR LUST #______ Re: Dear DNR: The undersigned is authorized to represent the [local or county] private well permitting authority. The permitting authority is the [county or local body] having the authority to regulate the installation of private water wells within the area of concern discussed below through the issuance of permits. [Local or county] ordinance number ______________ restricts the permitting of private water wells as defined in the ordinance when public water is readily available. The ordinance [provides] [or does not grant] discretionary authority to make exceptions to this general prohibition when public water is determined to be readily available. The undersigned has reviewed the site maps and other information provided by ____________________ which depicts the area presently affected by contaminated groundwater (actual plume) and the area which potentially could be contaminated based on modeling (simulated plume) associated with a release of petroleum from the underground storage tank facility located at ____________________________. This area is referred to as the area of concern. The undersigned has made a determination that a public water system is readily available within the meaning of ordinance number _______________ to all properties within the area of concern. The definition of private water wells in the above ordinance is interpreted to include drinking and non-drinking water wells as defined in department rule 567 Iowa Administrative Code 135.2. This letter constitutes a legally non-binding assurance that drinking and non-drinking water wells as defined by the Iowa Department of Natural Resources rule 567 Iowa Administrative Code 135.2 would not likely be permitted in the area of concern due to a determination that public water is available. The permitting authority also maintains an information system which would reasonably assure the DNR Underground Storage Tank Section would be notified if a permit application for a private well is filed and approved within the area of concern. Sincerely, E2-1

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