Laserfiche WebLink
11. Site-speafic conditions: • • <br />a) Does [his facility have bulk storage o(diesel fuel, gasoline, solvents, fertilizer, <br />or other hazardous materials on site? ^X No ^ Yes <br />b) Is this operation located within one mile of a landfill, or any mine or mill tailings? ^x No ^ Yes <br />c) Does the dewatering area have or possibly have groundwater contamination, such as <br />Plumes from leaking underground storage tanks, etc.7 ~ No ^ Yes <br />If YES for any of these, please show location of the landfill, tailings or possible groundwater contamination on the location map in item 8 or in <br />the general sketch N item 10. Please explain the location, extent of contamination, and possible effect on the discharges from this facility. <br />l2. Chemical treatment: Will any flocculants (settling agents or chemical additives) be ttsed to treat water prior to discharge? <br />No ^ Yes If YES, list here, and include [he Material Safety Data Sheet (MSDS): <br />Chemical Name + I Manufacturer <br />In Which Waste Stream? <br />' If the chemical formula is tutknown or confidential, provide the manufacturer's name, contact person, address and phone number or a copy <br />of the manufacturer's brochure, product label information or materials handling data sheet for each product used. Please list the major <br />wnstiments or active ingredient(s), if known. <br />13. Are the receiving waters, indicated in item 5, a ditch or storm sewer? <br />^ No ^X Yes <br />If YES, submit documentation that the owner of the ditch or riotm sewer allows this discharge. No certification will be processed unless <br />documentation of approval is received. <br />Note: A discharge permit does not allow a discharge into a ditch or municipal 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 measurement: What method of Flow measurement will be used for each discharge point (e.g., v-notch weir, pump capacity, parshall <br />Flume, etc.)? <br />To be determined; at minimum a v-notch weir will be used prior m entry into the drainage pipe <br />