Laserfiche WebLink
Attachment D D-2 <br /> Reissued Waste Discharge Requirements General Order No. R5-2013-0122 <br /> Existing Milk Cow Dairies <br /> Method used to determine amount of manure: <br /> Enter the amount of process wastewater hauled in gallons and the method used to determine the <br /> amount. <br /> Process Wastewater: Gallons <br /> Method used to determine volume of process wastewater: <br /> Written Agreement: <br /> Does the Operator have a written agreement (in compliance with Land Application Specification <br /> E.3 of Reissued Waste Discharge Requirements General Order No. R5-2013-0122) with any <br /> party that receives process wastewater from the Operator for its own use? (please check one) <br /> Yes No <br /> If the answer is no, the Operator agrees to have such a written agreement with any such party <br /> for any process wastewater transferred after 31 December 2007 to such party. <br /> (Operator shall provide initials here to acknowledge this requirement). <br /> Certification: <br /> I declare under the penalty of law that I personally examined and am familiar with the information <br /> submitted in this document, and that based on my inquiry of those individuals immediately responsible for <br /> obtaining the information, I believe that the information is true, accurate, and complete. I am aware that <br /> there are significant penalties for submitting false information, including the possibility of a fine and <br /> imprisonment for knowing violations. <br /> Operator's Signature: Date: <br /> Hauler's Signature: Date: <br />