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3. Specify whether owner or operator Ss making appl3ca[ion for the permit. <br />4. Location of Operation <br />Legal description: (Township, Range, 1/4 Section) <br />Street <br />City <br />County Zip Code <br />5. Has there been any change in chemical useage, either type or quantity, <br />or any change in operating conditions at the site or any change which <br />would affect effluent quality? <br />No Go to 6 <br />Yes , Please correct on certification. <br />Submit MS DS sheets for new chemicals. <br />6. Please describe all stormwater discharges which are not currently <br />permitted. This includes drainages from plant yards, roads and rail <br />lines used for bringing materials eo and hauling materials from plant <br />site, material handling sites, refuse sites, sites where wastewaters and <br />disposed sites used for the storage sad maintenance of material handling <br />equipment, sites for residual treatment storage or disposal, shipping <br />sad receiving areas, manufacturing building sad storage areas. The <br />description should define the drainage area and the receiving stream or <br />etormwater sewer system (Sf not owned by permittee) receiving the <br />discharge. A map is prefered. <br />7. Please describe all present and proposed best management practices to be <br />used at the site. Include a map showing the location of eaisting <br />structural controls. <br />fate <br />-4- <br />