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12. Chemical treatment: Will any flocculants (settling agents or chemical additives) be Deed to treat water prior to discharge? <br />No ~ Yes If YES, list here, and include the Material Safety Data Shce[ (MSDS): <br />Chemical Name • Manufacturer Purpose In Which Waste Stream? <br />* If the chemical formula is tmlmown or confidential, provide the manufacturcr's name, contact person, address and phone number ar a copy of <br />the manufacturer's brochure, product label information or materials handling data shcet for each product used. Please list the major constituents <br />or active ingredient(s), if known. <br />13. Are the receiving waters, indicated in item 5, a ditch or storm sewer? <br />o No v Yes <br />If YFS, submit documentation that the owner of the ditch or storm sewer allows this discharge. No certification will be processed unless <br />docwnertation of approval is received s~?`` ~x~ t ~ ~ r l) ~ 1( <br />Note: A discharge permit does not allow a discharge into a ditch or municipal storm sewer system without the approval of the owner/apem[or of <br />that system. Please provide documentation of approval from the ditch company or owner of the storm sewer for all new discharges. <br />14. Flow measurement: What method of flow measurement will be used for each discharge point (e.g., v-notch weu, pump capacity, parshall flume, <br />etc.)? .-. <br />6 <br />