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1. FACILITY: Self-explanatory. <br /> 11. REASON FOR FILING: <br /> A. New discharge or facility: A discharge or facility that is proposed but does not now exist. <br /> B. Existing discharge or facility: Discharge or facility is currently in operation but does not have waste discharge requirements <br /> or a permit. <br /> C. Increase in quantity of discharge: Discharge quantity increased or is proposed to increase above 25% of the quantity set <br /> forth in the existing requirements;or less if such an increase,in your opinion,might have a significant impact on the quality <br /> of the receiving waters or disposal area. Final determination of whether the reported increase would have a significant effect <br /> will be made by the appropriate agency. <br /> D. Change in character of discharge: A material change in characteristics of the waste from existing discharge requirements is <br /> defined as follows: <br /> a. The addition of a major industrial waste discharge to a discharge of essentially domestic sewage, or the addition of a <br /> new product by an industrial facility resulting in a change in the character of the waste. <br /> b. A change in the type of waste accepted at a disposal facility. <br /> E. Chane; in place or method of disposal: Change from a land disposal to a direct disposal to water;change in the method of <br /> treatment which would significantly alter the waste discharge characteristics;moving the discharge to another drainage area, <br /> to a different water body, or to a disposal area sigiiificantly removed from the original area,causing different water quality <br /> or nuisance effects. <br /> F. Change in design or operation: A significant change in design or operation from that existing when discharge requirements <br /> or other permits were last issued. <br /> G.,H.,and L: Self-explanatory. <br /> Ill. TYPE OF OPERATION: Self-explanatory. <br /> IV. TYPE OF WASTE: <br /> A. Sewage,sewage sludge,and/or septic tank pumpings: Human or animal origin (not industrial). <br /> B. Industrual wastes: Liquid,solid,gaseous or radioactive waste from any producing,manufacturing,or processing operation. <br /> C. Municipal solid wastes: Residential and commercial refuse,garbage and/or rubbish. <br /> D. Hazardous wastes: "Waste or a combination of wastes which because of its quantity,concentration,or physical,chemical,or <br /> infectious characteristics may either: (1) Cause, or significantly contribute to an increase in mortality or an increase if. <br /> serious irreversible,or incapacitating reversible,illness. (2) Pose a substantial present or potential hazard to human health o. <br /> environment when improperly treated,stored,transported,or disposed of,or otherwise managed. <br /> E. Agricultural wastes: Wastes resulting from the production and processing of farm or agricultural products. <br /> F. Animal wastes: Wastes from confined holding or feeding areas. <br /> G. Forest product wastes: Shavings, sawdust, chips, bark,slabs, edgings,wood and other flammable waste material incidental <br /> to thc.processing of wood products. <br /> H. Construction/demolition wastes: Waste building materials, packaging and rubble resulting from construction, remodeling, <br /> repair,and demolition operations on pavements,houses,commercial buildings,and other structures. <br /> 1. Inert materials: Brick, rock, concrete, soil, silt, clay, glass, asphalt, plastics, plasterboard, rubber, and any other inei. <br /> materials. (Does not include wood.) <br /> J., K.,and L.: Self-explanatory. <br /> V. SITE DESIGN CAPACTIY: Self-explanatory. <br /> VI. QUANTITY OF WASTES: <br /> A.,C.,and D.: Self-explanatory. <br /> B. Design flow: Treatment,design flow(not maximum hydraulic capacity) when for sewage treatment. <br /> VII. EXACT LOCATION OF POINT OF DISPOSAL: Map or sketch should be to a scale adequate to show location precisely. Use of <br /> a portion of a U.S.G.S. Quadrangle map is recommended.Map must show proximity of disposal location to populated areas anti <br /> must indicate all wells and drainage courses within 1,000 feet of any disposal point(s). <br /> Vill. SOURCE OF WATER SUPPLY (This is the water that contributes to or transports the waste.): <br /> A. Municipal or utility service: Give name and address of the water purveyor. <br /> B. Individual wells: Those not part of a municipal or utility service. <br /> C. Surface supply: <br /> (1) Name of stream,lake,spring,etc.,if named. <br /> (2) Type of water rights: Check appropriate item. <br /> (3) If a state permit or license has been granted,give identification number. <br /> IX. ENVIRONMENTAL IMPACT REPORT: Self-explanatory. <br />