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11.. Site-specific eonditioas: • • <br />a) Does this facility have bulk storage of diesel fuel, gasoline, solvenu, fertilver, <br />or other hazardous materials on site? ~ 0 No ^ Yes <br />b) Is [his operation located within one mile of a landfill, or any mute or mill railings? 0 No ^ Yes <br />c) Does the dewatering area have or possibly have groundwater contamination, such as <br />Plumes from leaking underground storage tanks, e[c.7 ^X No ^ yes <br />IF YES for any of these, please show location of the landfill, tailings or possible groundwater contamination on the (option map in item g or in <br />the general sketch in item 10. Please explain the loption, ez[ent of conratnination, and possible effect on the discharges from this facility. <br />12. Chemlpl treatment: Will any fiocculants (settling agents or chemical additives) be used [o treat water prior to discharge? <br />^X No ^ Yes If YFS, list here, and include the Material Safety Data Sheet (MSDS): <br />Chemical Name ~ Mawfactutrs Purpose In Whirl Waste Stream? <br />If Ne chemipl formula is tmkaown or confidential, provide the manufacturer's name, cotrtatt person, address and phone number or a copy <br />of the manufacturer's brochure, product Zabel information or materials handling data sheet for each product rued. Please list the major <br />constituents or active ingredient(s), if known. <br />13. Are the receiving waters, indicated in item S, a ditch or smrm sewer? <br />^ No ^X Yes <br />If YES, submit documentation that the owner of the dimh or smrm sewer allows this discharge. No certification will be processed unless <br />documearatioo of approval is received. <br />Nate: A discharge permit dots not allow a discharge into a ditch or mtmicipal storm sewer system without the approval of the owner/operator 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 >z~+~ro+~ent: What method of flow measurement will be rued for each discharge point (e.g., v-notch wev, primp capacity, parshall <br />flume, etc.)T <br />To be determined; at minimum a v-notch weir will be used prior m entry inm [!te drainage pipe <br />