Og-21a Notice Of Violation (Nov) Abatement Form Page 2
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1
2The Office of Oil and Gas Resource Management has adopted this new form in order to track the
completion of all remedial work related to Notices of Violation and to ensure that all NOV’s are abated
by the Department in a timely manner.
Please contact your local District Office if you require an extension to complete all remedial work.
INSTRUCTIONS:
1)
COMPLETE ALL REQUIRED REMEDIAL WORK.
2)
COMPLETE AND SIGN FORM.
3)
ATTACH ANY SUPPORTING DOCUMENTATION SHOWING THAT THE REMEDIAL
ACTIONS HAVE BEEN COMPLETED. SUPPORTING DOCUMENTATION MAY
INCLUDE, BUT IS NOT LIMITED TO:
A)
BEFORE AND AFTER PHOTOGRAPHS
B)
INVOICES AND/OR RECEIPTS FOR EQUIPMENT, PARTS, SUPPLIES AND/OR
LABOR RELATED TO REMEDIAL WORK
C)
INVOICES AND/OR RECEIPTS FOR REMOVAL OR DISPOSAL OF ANY
CONTAMINATED SOIL OR OTHER MATERIAL
D)
WORK LOGS MEMORIALIZING WORK COMPLETED
4)
SUBMIT FORM AND ATTACHENTS TO LOCAL DISTRICT OFFICE BY MAIL OR
EMAIL.
A)
OFFICE OF OIL AND GAS RESOURCE MANAGEMENT
SPRINGFIELD DISTRICT OFFICE
ONE NATURAL RESOURCES WAY
SPRINGFIELD, IL 62702-1271
217/782-7756
HOLLI.COLE@ILLINOIS.GOV
B)
OFFICE OF OIL AND GAS RESOURCE MANAGEMENT
CENTRALIA DISTRICT OFFICE
800 S. LOCUST STREET
CENTRALIA, IL 62801
618/533-8979
DNR.CENTRALIA@ILLINOIS.GOV
C)
OFFICE OF OIL AND GAS RESOURCE MANAGEMENT
MT. CARMEL DISTRICT OFFICE
2517 W 9TH STREET, SUITE C
MT. CARMEL 62863
618/262-2106
KATHY.WEISS@ILLINOIS.GOV
5)
KEEP A COPY FOR YOUR RECORDS.
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