Instructions for DEQ Form 2M1 "Application for Permit to Discharge Municipal/Domestic Wastewater" - Oklahoma

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Download Instructions for DEQ Form 2M1 "Application for Permit to Discharge Municipal/Domestic Wastewater" - Oklahoma

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Oklahoma Department of Environmental Quality
Water Quality Division | Phone: 405-702-8100
Municipal Permits Section
707 N. Robinson, OKC, OK 73102-6010
P.O. Box 1677, OKC, OK 73101-1677
Instructions for Permit to Discharge Municipal/Domestic Wastewater
Form 2M1 - Major Discharge
PLEASE DETACH THESE INSTRUCTIONS AND RETURN ONLY THE COMPLETED APPLICATION FORM ITSELF.
This form must be completed by all major facilities applying for a permit to discharge under DEQ’s
Municipal OPDES Permit Program.
See instructions for the submittal of applications and the public notice requirements.
OKLAHOMA DEPARTMENT OF ENVIRONMENTAL QUALITY
INSTRUCTIONS - DEQ FORM 2M1 (major)
APPLICATION FOR PERMIT TO DISCHARGE
MUNICIPAL/DOMESTIC WASTEWATER
Form 2M1 must be completed by the owner/responsible official of a major municipal/domestic wastewater
facility that wishes to discharge pollutants to waters of the State of Oklahoma. A major municipal/domestic
wastewater facility is defined as a facility that discharges one million gallons per day (mgd) or greater. Please
read the instructions below while completing Form 2M1 and respond to each item. The Oklahoma Department
of Environmental Quality (DEQ) cannot procees an application until it is complete. If a particular item does
not apply to the facility for which the application is being prepared, or if the correct answer is “NA” (for not
applicable) indicate this on the application. If you have questions about any of the items, please contact DEQ
or your local DEQ office for assistance. DO NOT attempt to complete the application form before reading
these instructions.
NOTE: DO NOT write in box marked “ FOR DEQ USE ONLY”.
SECTION I
1. Give the legal name of the town, city, public entity or name of the person (if privately owned) legally
responsible for operating and maintaining the facility.
2. Give the street address or P.O. Box, city, county, state, zip code, telephone number, fax number, and
e-mail address if applicable of the main office for the applicant in Item 1. This may or may not be the
same as the location of the facility.
DEQ Form 2M1 - Major Discharge
July 2013
- Instructions Page 1
Oklahoma Department of Environmental Quality
Water Quality Division | Phone: 405-702-8100
Municipal Permits Section
707 N. Robinson, OKC, OK 73102-6010
P.O. Box 1677, OKC, OK 73101-1677
Instructions for Permit to Discharge Municipal/Domestic Wastewater
Form 2M1 - Major Discharge
PLEASE DETACH THESE INSTRUCTIONS AND RETURN ONLY THE COMPLETED APPLICATION FORM ITSELF.
This form must be completed by all major facilities applying for a permit to discharge under DEQ’s
Municipal OPDES Permit Program.
See instructions for the submittal of applications and the public notice requirements.
OKLAHOMA DEPARTMENT OF ENVIRONMENTAL QUALITY
INSTRUCTIONS - DEQ FORM 2M1 (major)
APPLICATION FOR PERMIT TO DISCHARGE
MUNICIPAL/DOMESTIC WASTEWATER
Form 2M1 must be completed by the owner/responsible official of a major municipal/domestic wastewater
facility that wishes to discharge pollutants to waters of the State of Oklahoma. A major municipal/domestic
wastewater facility is defined as a facility that discharges one million gallons per day (mgd) or greater. Please
read the instructions below while completing Form 2M1 and respond to each item. The Oklahoma Department
of Environmental Quality (DEQ) cannot procees an application until it is complete. If a particular item does
not apply to the facility for which the application is being prepared, or if the correct answer is “NA” (for not
applicable) indicate this on the application. If you have questions about any of the items, please contact DEQ
or your local DEQ office for assistance. DO NOT attempt to complete the application form before reading
these instructions.
NOTE: DO NOT write in box marked “ FOR DEQ USE ONLY”.
SECTION I
1. Give the legal name of the town, city, public entity or name of the person (if privately owned) legally
responsible for operating and maintaining the facility.
2. Give the street address or P.O. Box, city, county, state, zip code, telephone number, fax number, and
e-mail address if applicable of the main office for the applicant in Item 1. This may or may not be the
same as the location of the facility.
DEQ Form 2M1 - Major Discharge
July 2013
- Instructions Page 1
3. Give the name of the facility, the street address, city, county, state, zip code, telephone number, fax
number, and e-mail address if applicable and if it is different from the address in Items 1 and 2.
4. Give the physical location of the facility – longitude/latitude and legal description to a 10 acre tract,
¼,¼,¼, Section, Township, and Range. Note: This is the location of the treatment plant and it is not
necessarily the same as the point of discharge.
5. Indicate whether this is a Public, Private, Federal or State owned facility.
6. Give the name and title, address, city, county, state, zip code, telephone number, fax number, cell
phone number, and e-mail address of a person who is familiar with the facility and information in the
application and who may be contacted concerning the application.
7. Indicate whether the discharge is wastewater from a lagoon system, mechanical plant or, if other, specify.
8. Below is a list of definitions of the types of treatment listed in Item #8. Check more than one item if needed.
Lagoon systems:
A. Total Retention by Evaporation - Wastewater goes to a lagoon or series of lagoons which have no
outlet or any other way to discharge. Lagoons cannot be classified total retention if they have any
kind of operable outlet structure, even if it is not used. See DEQ Form 530E (Affidavit of No Discharge)
for Total Retention Facilities.
B. Land Application - Wastewater is given preliminary treatment then applied to land (example:
irrigation) in such a manner to insure that no runoff enters surface waters. Submit DEQ
Form 627-WRP for any land application of the wastewater.
C. Discharge to Receiving Water - Wastewater goes to a lagoon or series of lagoons and then to a
receiving water through a designed outlet structure. Check this box even if the outlet structure
is not being used.
Mechanical Treatment Plants - Please name and describe the mechanical treatment process used at your
facility. (Examples: trickling filter, activated sludge, extended air, sequential batch reactor, oxidation ditch)
Other - Please name and explain any process used at your facility other than those listed above.
DEQ Form 2M1 - Major Discharge
July 2013
- Instructions Page 2
9. If the facility uses chlorine or any other halogen, indicate whether the facility dechlorinates or
dehalogenates before discharging to a receiving water. Indicate if ultraviolet (UV) system is used.
If chlorine or any other halogen is used as a disinfecting agent to meet bacteria limits, or for other
purposes, a residual limit of no-measurable value will be included in the permit. Dechlorination
or dehalogenation will be necessary to meet the limit. Please indicate whether dechlorination or
dehalogenation is provided at your facility.
10. Design flow is established when the construction permit is approved by the DEQ. Design Flow: the
quantity of wastewater in million gallons per day (mgd) the facility was designed to treat in one day. List
up to 3 decimal places. Example: 3.120 = three million one hundred twenty thousand gallons per day.
11. Enter the number for each discharge point and the average quantity of treated wastewater discharged
each day from each pipe. Attach additional sheets, if necessary.
12. Name the body of surface water that receives treated wastewater. If the receiving stream does not have a
name, please indicate what named creek or river downstream receives the tributary flow, and fill out as
“tributary of ________________________________ Creek or River. ”
Check the item which indicates the frequency of wastewater discharges.
continuous:
discharging without interruption
batch:
discharging several times during the day (i.e. from a sequential batch reactor facility)
Intermittent:
sporadic discharges during the year
seasonal:
discharging only during certain periods during the year
Give the location of the point of discharge to the receiving water. This may be different than the
location of the facility. When giving the legal description, provide both the latitude, longitude and ¼,
¼, ¼, Section, Township, and Range to a 10 acre tract. Attach additional sheets if necessary to describe
additional outfalls.
13. Indicate whether the higher influent flow caused by heavy rains is diverted and discharged resulting
in a bypass of partially or completely treated wastewater or if it is stored for later treatment (as in a
holding basin).
14. Number 14. A through B of the application concerns the treatment and disposal of biosolids/sludge.
A. Common biosolids/sludge treatment processes are aeration, lime stabilization, heat stabilization etc.
DEQ Form 2M1 - Major Discharge
- Instructions Page 3
July 2013
B 1.
Sludge management plan numbers start with SMP and usually have 7 digit numbers. In giving
the land application sites, provide the legal description ¼, ¼, ¼, Section, Township, Range
and County. Attach additional sheets if facility has more than three (3) sites.
B 2.
The permittee shall be certain that all landfills used for sewage sludge disposal comply with the
state and federal regulations for landfills and solid waste disposal.
15. State if any industries in the community discharge industrial wastewater to the sewer system. If the
answer to this question is yes, submit Section II of the application form for each significant industrial
facility. Identify any industrial facilities that are “Categorical”. Categorical industries are listed at 40 CFR
122 Appendix A - NPDES Primary Industry Categories (See Attachment 1, page 8). Also, submit section III
for wastewater from water treatment plants.
Indicate what type of controls are in place to deal with industrial discharges to the treatment system.
16. State if the facility supplies reclaimed water for any of the category stated in subchapter 27 of OAC
252:656. If the answer to this question is yes, submit Section III of the application form for each user of
the reclaimed water.
17. Maps and Drawings - A schematic of wastewater flow through the facility and a location map of the
facility are required. All sheets should be letter size with margins for filing and binding and on paper
suitable for reproduction. Discharge points should be identified with discharge serial numbers. All
sheets must include the applicant’s name, facility location, and date of drawing.
18. Any information, laboratory analysis, concerning the pollutants in Table 1 should be entered in the table
or results attached to the application.
19. Refer to Attachments 2 and 3 (Pages 9 through 12 of instructions) that are enclosed for your
convenience. Attachment 2 is 40 CFR 122 Appendix D listing all the priority pollutants (Tables II, III,
IV, and V). Attachment 3 lists the approved test methods for analyses of wastewater and associated
minimum quantification levels as required.
20. Tables IV and V of 40 CFR 122, Appendix D are reproduced in attachment 2 (Page 9) of these instructions.
21. The results for any and all analysis of pollutants for the previous three years should be put in a table and
attached to the application.
22. If the answer to this question is yes, Form 100-810: Landowner Notification Form (found at
http://www.deq.state.ok.us/WQDnew/forms/landowner_notification_affidavit.pdf
) must be sent to the
landowner and the applicant’s certifying official must initial the box certifying that this has been done.
DEQ Form 2M1 - Major Discharge
July 2013
- Instructions Page 4
23. All other information regarding the facility having to do with the environmental/operational permits
including maps, process diagrams, or chemical analysis should be included with the permit application.
CERTIFICATION AND PUBLIC NOTICE OF APPLICATION
The information provided in the application will be considered in the evaluation and processing of a
discharge permit for the referenced facility. Be advised that test procedures used in the analyses of influents,
effluents and sludge, must conform to approved EPA methodology or it will not be accepted for the
discharge permit evaluation.
Please note that the application must be signed by the authorized chief elective or executive officer of the
applicant, or by the applicant if an individual. The authorized signature must be notarized. An example of a
common mistake is when a Public Works Authority Chairman signs the application as - John Doe, Mayor. The
Mayor is not the legal official of the PWA, the chairman is, even if the individual holds both positions.
Please read the certification carefully. There are significant penalties for submitting false information on this
application form.
Form 2M1 may be separated from the instruction before mailing.
NOTICE FOR ALL APPLICANTS
Upon filing an application for a new permit, renewal of an existing permit, or major modification of an
existing permit with the Department, the applicant shall publish a notice of the filing in a local newspaper
which contains:
(1)
Date of filing;
(2)
Name and address of the applicant;
(3)
Type of wastewater discharge and permit sought;
(4)
Location, including legal description and street address of facility and discharging point or points;
(5)
Name of receiving water;
(6)
Category of reclaimed water supplied and the legal locations of user sites, if applicable;
(7)
Name, address, and telephone number of contact person for applicant; and
(8)
Locations where application may be reviewed.
SECTION II
INDUSTRIAL WASTEWATER CONTRIBUTION
1. Give the name and title of the contact person, name of facility, address, city, county, state, zip code,
telephone number, fax number, cell phone number, and e-mail address of a person who is familiar with
the industrial facility and information in the application and who may be contacted concerning the
application.
2. All products and by-products for this facility should be listed.
DEQ Form 2M1 - Major Discharge
July 2013
- Instructions Page 5
Oklahoma Department of Environmental Quality Oklahoma Legal Forms United States Legal Forms

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