Form MO780-1635 (S) "Section 4 - Sludge Hauling" - Missouri

What Is Form MO780-1635 (S)?

This is a legal form that was released by the Missouri Department of Natural Resources - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2004;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MO780-1635 (S) by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

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Download Form MO780-1635 (S) "Section 4 - Sludge Hauling" - Missouri

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MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM, WATER POLLUTION BRANCH
FORM S – SECTION 4. SLUDGE HAULING
PERMIT NO.:
REPORTING PERIOD: CALENDAR YEAR
FACILITY NAME
Complete this section if the sludge generator or contract hauler transports sludge to another wastewater treatment
facility or slugde disposal facility. Applicable sludge requirements are listed under Part III Standard Conditions.
Show the applicable NPDES permit number (MO-) under 4.14 and 4.24. If disposal is at a landfill, surface disposal
facility, or sludge disposal lagoon, the solid waste disposal permit number (SW) must also be given.
If the facility has a design population equivalent (P.E.) of 150 or less, treat the sludge generated as septage and
consequently, no testing is required. See WQ 422 guide, Land Application of Septage, for further guidance.
4.10
Person Responsible for Hauling Sludge to Disposal Facility
4.11
HAULER NAME
4.12
CONTACT PERSON
4.13
CONTACT ADDRESS
4.14
PHONE
PERMIT NO:
SW
MO-
4.20
Person Responsible for Final Sludge Disposal
4.21
FACILITY NAME
4.22
CONTACT PERSON
4.23
CONTACT ADDRESS
4.24
PHONE
PERMIT NO:
SW
MO-
4.25
SLUDGE DISPOSAL METHOD
4.26
LEGAL
¼,
¼,
SEC
,
T
,
R
,
COUNTY
MO 780-1635 (6-04)
MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM, WATER POLLUTION BRANCH
FORM S – SECTION 4. SLUDGE HAULING
PERMIT NO.:
REPORTING PERIOD: CALENDAR YEAR
FACILITY NAME
Complete this section if the sludge generator or contract hauler transports sludge to another wastewater treatment
facility or slugde disposal facility. Applicable sludge requirements are listed under Part III Standard Conditions.
Show the applicable NPDES permit number (MO-) under 4.14 and 4.24. If disposal is at a landfill, surface disposal
facility, or sludge disposal lagoon, the solid waste disposal permit number (SW) must also be given.
If the facility has a design population equivalent (P.E.) of 150 or less, treat the sludge generated as septage and
consequently, no testing is required. See WQ 422 guide, Land Application of Septage, for further guidance.
4.10
Person Responsible for Hauling Sludge to Disposal Facility
4.11
HAULER NAME
4.12
CONTACT PERSON
4.13
CONTACT ADDRESS
4.14
PHONE
PERMIT NO:
SW
MO-
4.20
Person Responsible for Final Sludge Disposal
4.21
FACILITY NAME
4.22
CONTACT PERSON
4.23
CONTACT ADDRESS
4.24
PHONE
PERMIT NO:
SW
MO-
4.25
SLUDGE DISPOSAL METHOD
4.26
LEGAL
¼,
¼,
SEC
,
T
,
R
,
COUNTY
MO 780-1635 (6-04)
4.30
Sludge Removal from Treatment Facility
4.31
CAPACITY OF SLUDGE HOLDING STRUCTURES
DAYS OF STORAGE
Sludge storage provided:
gallons.
AVERAGE PERCENT SOLIDS OF SLUDGE
No sludge storage is provided
4.32
Sludge hauled for disposal during the report period.
DRY TONS
CUBIC FEET
GALLONS
4.33
Number of dry tons or gallons hauled each month from the wastewater treatment facility.
JAN.
FEB.
MAR.
APR.
MAY
JUNE
JULY
AUG.
SEPT.
OCT.
NOV.
DEC.
If sludge hauled was more than the sludge holding capacity, attach explanation.
4.40
Sludge Monitoring (Per Subsection J of Part III Standard Conditions)
4.41 If the receiving facility is permitted facility, then it is responsible for testing and submitting section 2.
4.42 If the receiving facility is not a permitted facility, then the generator is responsible for testing and completing section 2.
4.50
Sludge Disposal Requirements
4.51
If the disposal facility listed under 4.20 does not have a sludge disposal permit, the wastewater treatment facility or sludge generator shall
submit detailed information on sludge disposal:
Attach completed Section 3 of From S, if sludge is land applied.
Attach sheets providing the information listed under section K of Part III Special Conditions, if sludge is not land
applied.
4.52
Are alternate limits or exceptions listed in the Special Conditions section of the wastewater treatment facility permit or sludge generator
permit?
YES
NO
If yes, attach explanation sheet.
MO 780-1635 (6-04)
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