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Fill and Sign the North Carolina Residential Lease Agreement Form

Fill and Sign the North Carolina Residential Lease Agreement Form

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INSTRUCTION SHEET FOR THE PERMIT APPLICATION FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE (BIOSOLIDS) IN LOUISIANA (ELECTRONIC VERSION) (READ ENTIRE INSTRUCTIONS CAREFULLY) NOTE: Portions of this Permit Application can be filled out directly from a computer. Embedded “Macros” will allow you to make selections and also activate links to other Sections of the application. However, if you intend to utilize a computer to enter information, the embedded “Macros” must be “enabled”. If you are unable to enter requested information or make selections or if the links do not work, you will have to perform the following: 1. Click “Tools” on your MSWord Toolbar. 2. Click on “Options”. 3. Click on the “Security” Tab. 4. Click on “Macro Security” box (usually at the bottom right of the “Security” window.). 5. Set the security to “Medium”. 6. Close this Document. 7. Reopen this Document and click on “Enable Macros” in the box that pops up when the Document opens on your computer. A. Who Should Apply 1. Any person who compost, treats, or prepares sewage sludge or a material derived from sewage sludge, including but not limited to Publicly Owned Treatment Works, Privately Owned Sanitary Wastewater Treatment Facilities, and Commercial Preparers (includes the dewatering and solidification of sewage sludge); 2. Any person who applies sewage sludge or a material derived from sewage sludge to the land; 3. Any person who prepares sewage sludge, including dewatering and solidification, that is disposed in a Municipal Solid Waste Landfill; 4. The owner/operator of a sewage sludge incinerator; and, 5. The owner/operator of a surface disposal site. B. Where to Submit and Number of Copies If you or your company fits any of the “Who Should Apply” in “A. above, you will need to completely fill out this application and submit one (1) “original” and two (2) ‘copies” to the following address: Louisiana Department of Environmental Quality Office of Environmental Services Water & Waste Permits Division P.O. Box 4313 Baton Rouge, Louisiana 70821-4313 NOTE: If the “original” contains any colored or color-coded maps, schematics, drawings, etc., the two “copies” shall also be provided with the colored or color-coded maps, schematics, drawings, etc. 1 Form_7156_r00 03/21/2006 C. Definitions Beneficial Use - using sewage sludge or a material derived from sewage sludge or domestic septage for the purpose of soil conditioning or crop or vegetative fertilization in a manner that does not pose adverse effects upon human health and the environment or cause any deterioration of land surfaces, soils, surface waters, or groundwater. Commercial Preparer or Land Applier of Sewage Sludge - any person who prepares or land applies sewage sludge or a material derived from sewage sludge for monetary profit or other financial consideration and either the person is not the generator of the sewage sludge or the sewage sludge was obtained from a facility or facilities not owned by or associated with the person. Exceptional Quality - sewage sludge or a material derived from sewage sludge that meets the ceiling concentrations in Table 1 of LAC 33:IX.6903.D, the pollutant concentrations in Table 3 of LAC 33:IX.6903.D, the pathogen requirements in LAC 33:IX.6909.C.1, one of the vector attraction reduction requirements in LAC 33:IX.6909.D.2.a-h, and the concentration of PCBs of less than 10 mg/kg of total solids (dry weight). Grease - a material either liquid or solid, composed primarily of fat, oil, or grease from animal or vegetable sources. The terms fats oils and grease, oil and grease and oil and grease substances shall all be included within this definition. Land Application - the beneficial use of sewage sludge, a material derived from sewage sludge, or domestic septage by either spraying or spreading onto the land surface, injection below the land surface, or incorporation into the soil. Non-exceptional Quality – sewage sludge or a material derived from sewage sludge that lacks one or more of the criteria needed to meet Exceptional Quality. Owner or Operator of a Sewage Sludge Incinerator – the owner or person who fires sewage sludge in an incinerator. Person Who Prepares Sewage Sludge— the person who generates sewage sludge during the treatment of domestic sewage in a treatment works, the person who treats sewage sludge, or the person who derives a material from sewage sludge. Private Land Applier – the person who land applies sewage sludge or a material derived from sewage sludge for private benefit purposes and the land application is not for monetary profit or other financial consideration and either the person did not generate or prepare the sewage sludge or a material derived from sewage sludge or the facility or facilities where the sewage sludge or a material derived from sewage sludge was obtained is not owned by or associated with the private land applier. Privately Owned Sanitary Wastewater Treatment Facility (POSWTF) – a privately owned treatment works that is utilized to treat sanitary wastewater and is not a Publicly Owned Treatment Works (POTW). Publicly Owned Treatment Works (POTW) - a treatment works, as defined by Section 212 of the Clean Water Act, that is owned by a state or municipality [as defined by Section 502(4) of the Clean Water Act]. This includes any devices and systems used in the storage, treatment, recycling, and reclamation of municipal sewage or industrial wastes of a liquid nature. It includes sewers, pipes, and other conveyances only if they convey wastewater to a POTW; and the municipality [as defined by Section 502(4) of the Clean Water Act] that has jurisdiction over the indirect discharges to and the discharges from such a treatment works. Qualified Ground Water Scientist - an individual with a baccalaureate or post-graduate degree in the natural sciences or engineering who has sufficient training and experience in ground-water hydrology, subsurface geology, and/or related fields, as may be demonstrated by state registration, professional certification, or completion of accredited university programs, to make sound professional judgments regarding ground-water monitoring, pollutant fate and transport, and corrective action. Surface Disposal - the use or disposal of sewage sludge that does not meet the criteria of land application as defined in this Subsection. This may include, but is not limited to, ponds, lagoons, sewage sludge only landfills (monofills), or landfarms. To Store, or Storage of Sewage Sludge - the temporary placement of sewage sludge on land. 2 Form_7156_r00 03/21/2006 To Treat, or Treatment of, Sewage Sludge—the preparation of sewage sludge for final use or disposal. This includes, but is not limited to, blending, mixing, composting, thickening, stabilization, and dewatering & solidification of sewage sludge. This does not include storage of sewage sludge. D. Explanation of How to Utilize and Complete the Application I. Information can be entered directly from a computer for parts of this application and other parts will require the attachment of material that may or may not be generated directly off of the computer (i.e. maps, schematics, drawings, soil descriptions, laboratory analysis, etc.). II. The application contains sections that will require you to furnish information in blank spaces, make a selection from a “Drop-down Box” or from a “List”. The application also contains “Yes” or “No” selections, selections that will lead you to another section of the application, and “Tables” to be filled out. Examples follow: Example 1: Information requested by submittal of responses in “blank” spaces Applicant Name: Job or Position Title: Mailing Address: Enter Post Office Box Number or Street Address Enter Name of City Example 2: Selection of your state or province will be through a “Drop-Down” Menu Select State/Province: Alabama - Louisiana You will have to click on the appropriate “State/Province” box Æ Then, click on the appropriate state to make your selection Æ 3 Form_7156_r00 03/21/2006 Example 3: Selection from a list of choices Some list will require you to “Select all that applies”… Type of sewage sludge that will be handled at this facility (Select all that applies): Sludge from POTW or POSWTF Domestic Septage Portable Toilet Waste …and some will limit you to “Select only one” Select from the following choices, the treatment level for Pollutants (Select only one): Tables 1 & 2 of LAC 33:IX.6903.D Tables 1 & 3 of LAC 33:IX.6903.D Tables 1 & 4 of LAC 33:IX.6903.D Example 4: “ Yes or No” Selection boxes - Does the facility meet the following buffer zones in (b).i and (b).ii? i. 1,200 feet from any aircraft’s approach or departure airspace or Air Operations Area as defined in LAC 6901.I; or the distance called for by the U. S. Department of Transportation Federal Aviation Administration’s airport design requirements for a facility that prepare or compost only sewage sludge or blend, mix, or compost sewage sludge and have only woodchips or yard waste (e.g., leaves, lawn clippings, or branches) as feed stock or supplements Yes No ii. 5,000 feet from any airport property boundary (including any aircraft’s approach or departure airspace or Air Operations Area) if the airport does not sell Jet-A fuel and serves only piston-powered aircrafts; or 10,000 feet from any airport property boundary (including any aircraft’s approach or departure airspace or Air Operations Area) if the airport sells Jet-A fuel and serves turbine-powered aircrafts or sells Jet-A fuel and is designed to serve turbine-powered and/or piston-powered aircrafts for a facility that blend, mix, or compost sewage sludge that include food or other municipal solid waste as feed stock or supplements Yes No Example 5: “ Yes or No” Selection boxes with additional questions or a requirement to submit additional material/information (usually as an “APPENDIX”) Is the Facility located 200 feet from a property line? Yes No Æ Provide a copy of the notarized affidavit, of the adjoining landowners and occupants waiving the 200-foot buffer zone that was entered in the mortgage and conveyance records of the parish for the adjoining landowner's property as APPENDIX SITE & OP – WAIVER PLB. 4 Form_7156_r00 03/21/2006 Example 6: Selection and the subsequent requirement to “Double-Click” on a “LINK” to another section of the application in order to continue the application process. There exist two types – One type allows you to chose from a list of options; then instructs you to “Double-Click” on a “LINK”to continue the application process… Publicly Owned Treatment Works Double-Click on SPECIFIC_FACILITY_INFO to continue the application process. Privately Owned Sanitary Wastewater Treatment Facility (Includes Private and Commercial Businesses and Industrial or Petro-Chemical Facilities that treat their sanitary wastewater separate from any process wastewater.) Double-Click on SPECIFIC_FACILITY_INFO to continue the application process. Commercial Preparer of Sewage Sludge (Includes a solidification/dewatering facility) Double-Click on SPECIFIC_FACILITY_INFO to continue the application process. …the other requires you to determine if your facility meets a certain criteria. If so, then you are instructed to “STOP” filling out the section you are presently in and “Double-Click” on a “LINK” to another section of the application in order to continue the application process. STOP If Grease Trap Waste is handled and mixed with sewage sludge at this facility, STOP filling out this section and Double-Click on Æ GREASE_TRAP_WASTE to continue the application process. Example 7: Selection with a NOTE 1 attached to it. This “NOTE” will direct you to a set of instructions that will require you to submit additional information (usually as an “APPENDIX”) and/or direct you to a certain Item within the Section you are presently working in. It is very important that you read and follow the requirements of the “NOTE”. You must submit all the information requested and follow the instructions given by the “NOTE” or your application will be deemed incomplete. Class B – Alternative 3 (See LAC 33:IX.6909.C.2.d) NOTE 1 NOTE 1 If Exceptional Quality - Alternative 6 or Class B - Alternative 3 is selected: (1) Provide a copy of the Environmental Protection Agency’s Pathogen Equivalency Committee Approval as APPENDIX SPECIFIC FACILITY INFO – EPA/PEC (2) Provide a detailed description of the treatment process as APPENDIX SPECIFIC FACILITY INFO – EPA/PEC/BTP (Include maps, diagrams and schematics that are necessary to fully describe the location and flow of the treatment process.) (3) Skip to Item “p.” below to continue the application process. 5 Form_7156_r00 03/21/2006 Example 8: Tables to be filled out. Laboratory analysis will be required on the sewage sludge and any material that will be added, blended, or mixed with the sewage sludge. The results must be reported in a “table” format with any additional information requested in the “table”. Additionally, all sampling and analysis must be performed at a lab that has been approved and certified by the Department of Environmental Quality or your application will be deemed “unacceptable” and “incomplete” (See additional information regarding Laboratory Accreditation in “G. Laboratory Accreditation/Certifications Requirements”, below.). INDICATE THE TYPE OF SEWAGE SLUDGE POLLUTANT CONCENTRATION (mg/kg dry weight) ANALYTICAL METHOD DETECTION LEVEL FOR ANALYSIS ARSENIC CADMIUM CHROMIUM COPPER LEAD MERCURY MOLYBDENUM NICKEL SELENIUM ZINC III. You must furnish all the information requested in each Section until you either are directed to “Jump” to another Section or you get to the “End” of a Section that will be indicated by the following wording Æ END “GENERAL INFORMATION” SECTION . CAUTION: You should be instructed to “Jump” to another Section of the application prior to landing on the wording. If you have not jumped to another Section prior to getting to the above wording, you will need to back track and determine where you need to “jump” to another Section. The “complete” end of the application is achieved when you reach the wording below: END OF PERMIT APPLICATION The above symbols and wording will be on the “Certification and Signatory” page. You and the person who filled out your application (if performed by someone other than yourself) will have to “carefully” and “completely” read the “Certification Statement” and sign and date the application (See I. Signatures below for further information regarding “signatures”.). 6 Form_7156_r00 03/21/2006 E. Proper Labeling & Placement of Appendices Appendices must be tabbed and “properly” labeled with the name indicated in the permit application and sub-tabbed and further labeled with the “sub-name” indicated in the permit application. As an example, the Appendix indicated as “APPENDIX SITE & OP – WAIVER PLB” in the application must be tabbed and first labeled as “APPENDIX SITE & OP”; then, it is to be further labeled and “sub-named” as “WAIVER PLB”. The appendix and all of its requested contents must be placed immediately after the Section for which it is being requested. In this example, “APPENDIX SITE & OP – WAIVER PLB” with its contents must be placed immediately following the Section entitled “SITTING AND OPERATION”. F. Air Quality Permit Application Submittal for the Owners/Operators of a Sewage Sludge Incinerator In addition to submittal of the information requested in this “Sewage Sludge Use or Disposal” permit application, owners/operators of a sewage sludge incinerator must complete and submit with this application, the “Title V Permit Application Form and Emissions Inventory Questions”. The “Title V Permit Application Form and Emissions Inventory Questions” and pertinent information regarding this form can be accessed by clicking on one of the Internet Sites below: Title V Air Quality Permit Forms --> http://www.deq.louisiana.gov/Air.htm then scroll down to and click on “Title V Permit Application Form and Emissions Inventory Questions (zip format)” OR simply click on http://www.deq.louisiana.gov/permits/air/titlev5.zip Form. 7 Form_7156_r00 03/21/2006 in order to access the G. Laboratory Accreditation/Certifications Requirements Laboratory procedures and analyses performed by commercial laboratories shall be conducted in accordance with the requirements set forth under LAC 33:I.Subpart 3, Chapters 49-55. Laboratory data generated by commercial laboratories that are not accredited under LAC 33:I.Subpart 3, Chapters 47-57, will not be accepted by the department. Retesting of analysis will be required by an accredited commercial laboratory. In the case where effluent testing was completed by an unaccredited laboratory, and where retesting is not possible (i.e. data reported on DMRs for prior month's sampling), the data generated will be considered invalid. Regulations on the Environmental Laboratory Accreditation Program and a list of labs that have applied for accreditation are available on the department website located at Æ http://www.deq.louisiana.gov/laboratory/ Questions concerning the program may be directed to: Laboratory Services Division 1209 Leesville Avenue Baton Rouge, LA 70802 Email: mailto:deqlaboratory@LA.GOV Phone: 225.219.9800 FAX: 225.219.9898 H. Map Requirements and where to get them Appropriate maps can be obtained from local government agencies such as DOTD or the Office of Public Works. Maps can also be obtained online at http://map.deq.state.la.us/ or http://www.topozone.com/ . Private map companies can also supply you with these maps. If you cannot locate a map through these sources you can contact the Louisiana Department of Transportation and Development at: 1201 Capitol Access Road Baton Rouge, LA 70802 (225) 379-1107 mailto:maps@dotd.louisiana.gov USDA Natural Resources Conservation Service Soil Survey Maps and Soils Information can be accessed at Æ http://websoilsurvey.nrcs.usda.gov/app/ 8 Form_7156_r00 03/21/2006 I. Signatures The following requirements shall apply to the signatory page in this application: Signatories to permit applications and reports A. B. All permit applications shall be signed as follows: 1. For a corporation - by a responsible corporate officer. For the purpose of this Section responsible corporate officer means: (a) A president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function, or any other person who performs similar policy- or decision-making functions for the corporation, or (b) The manager of one or more manufacturing, production, or operating facilities employing more than 250 persons or having gross annual sales or expenditures exceeding $25 million (in second-quarter 1980 dollars), if authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures. 2. For a partnership or sole proprietorship - by a general partner or the proprietor, respectively; or 3. For a municipality, parish, State, Federal or other public agency - either a principal executive officer or ranking elected official. For the purposes of this Section a principal executive officer of a Federal agency includes: (a) The chief executive officer of the agency, or (b) A senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency (e.g., Regional Administrator of EPA). All reports required by permits, and other information requested by the state administrative authority shall be signed by a person described in A, or by a duly authorized representative of that person. A person is a duly authorized representative only if: 1. The authorization is made in writing by a person described in LAC 33:IX.2503.A. 2. The authorization specifies either an individual or a position having responsibility for the overall operation of the regulated facility or activity, such as a position of plant manager, operator of a well or well field, superintendent, position of equivalent responsibility, or an individual or position having overall responsibility for environmental matters for the company. (A duly authorized representative may thus be either a named individual or any individual occupying a named position); and 3. The written authorization is submitted to the state administrative authority. C. Changes to authorization. If an authorization under B is no longer accurate because a different individual or position has responsibility for the overall operation of the facility, a new authorization satisfying the requirements of LAC 33:IX.2503.B must be submitted to the state administrative authority prior to or together with any reports, information, or applications to be signed by an authorized representative. D. Any person signing any document under A or B shall make the following certification: I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with the system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. 9 Form_7156_r00 03/21/2006 J. Other Submittal Information To prevent any unnecessary delay in the processing of your application, please take a moment and check to be certain that the following items have been addressed and enclosed: 1. ALL questions and requested information have been answered. 2. ALL required maps, drawings, lab analysis, and other reports are enclosed. 3. If your facility is an oxidation pond, aerated lagoon, or a constructed wetland system, a copy of the Louisiana Department of Health and Hospitals approval letter for the plans and specifications of this treatment facility must be supplied. 4. The appropriate person has signed the signatory page. 5. Submittal of two copies and the original (Colored-coded maps, schematics, designs, aerial photographs must be provided for the original and also the two copies) to the following address: STATE OF LOUISIANA DEPARTMENT OF ENVIRONMENTAL QUALITY Office of Environmental Services – Water & Wastes Permits Division Post Office Box 4313 Baton Rouge, LA 70821-4313 PHONE#: (225) 219-3050 ANY APPLICATION THAT DOES NOT CONTAIN ALL OF THE REQUESTED INFORMATION WILL BE CONSIDERED INCOMPLETE. APPLICATION PROCESSING WILL NOT PROCEED UNTIL ALL REQUESTED INFORMATION HAS BEEN SUBMITTED. NOTE: UPON RECEIPT AND SUBSEQUENT REVIEW OF THE APPLICATION BY THE WATER & WASTE PERMITS DIVISION, YOU MAY BE REQUESTED TO FURNISH ADDITIONAL INFORMATION IN ORDER TO COMPLETE THE PROCESSING OF THE PERMIT. K. Where the regulations can be obtained Please be aware that on September 1, 2005 and Emergency Rule was signed and placed into effect that essentially transferred the regulating and permitting of the Use or Disposal of Sewage Sludge from the Solid Waste Regulations (LAC 33:VII) to Chapter 69 of LAC 33:IX. The following Internet sites should get you to the location to access the proper new regulations regarding the use or disposal of sewage sludge: (1) Emergency RuleÆ http://www.deq.louisiana.gov/planning/regs/pdf/OS066E.pdf (2) Water Regulations or LAC 33:IX Æ http://www.deq.louisiana.gov/planning/regs/title33/33v09.doc (Go to Chapter 69) OR http://www.deq.louisiana.gov/planning/regs/title33/33v09.pdf (Go to Chapter 69) You will have to combine the two to get the entire new set of regulations and updates. To Begin Filling Out the Application, Double-Click Here Æ GENERAL_INFORMATION 10 Form_7156_r00 03/21/2006

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