DEQ Form 2M2 "Application for Permit to Discharge Municipal/Domestic Wastewater" - Oklahoma

What Is DEQ Form 2M2?

This is a legal form that was released by the Oklahoma Department of Environmental Quality - a government authority operating within Oklahoma. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on July 1, 2013;
  • The latest edition provided by the Oklahoma Department of Environmental Quality;
  • 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 DEQ Form 2M2 by clicking the link below or browse more documents and templates provided by the Oklahoma Department of Environmental Quality.

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Download DEQ Form 2M2 "Application for Permit to Discharge Municipal/Domestic Wastewater" - Oklahoma

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OKLAHOMA DEPARTMENT OF ENVIRONMENTAL QUALITY
APPLICATION FOR PERMIT TO DISCHARGE MUNICIPAL/DOMESTIC WASTEWATER
UNDER THE OKLAHOMA POLLUTANT DISCHARGE ELIMINATION SYSTEM (OPDES)
Application for Permit to Discharge Municipal/Domestic Wastewater
FORM 2M2 (Minor)
Application/Permit Number OK00 _____________ Facility ID No. __________
Date Received: ___________________________________________________
FOR DEQ
SIC Code: _______________________________________________________
USE ONLY
If a proposed facility, give estimated date of completion: _________________
DEQ PERMIT ENGINEER: ____________________________________________
DO NOT attempt to complete this application without reading the instructions!
SECTION I
1. Legal name of applicant: _______________________________________________________________
2. Mailing address of applicant:
Street Address or P.O. Box ________________________________________________________________
City ______________________ County ____________________ State _____ Zip Code ______________
Telephone ________________________________________ Fax ________________________________
E-mail Address _________________________________________________________________________
3. Name and address of facility:
Facility Name __________________________________________________________________________
Street Address _________________________________________________________________________
City ________________________ County _______________________ State _____ Zip Code _________
Telephone ____________________________________ Fax _____________________________________
E-mail Address _________________________________________________________________________
4. Location of discharging facility (e.g., NE ¼ , SW ¼ , SE ¼ , Section 1, Township 2 North, Range 3 West):
Legal Description of Facility Location ______, ______, ______, Section _____, Township _____, Range ______
Latitude: _______________ N Longitude: _______________ W
5. Type of Ownership:
Public
Private
Federal
State
DEQ Form 2M2 - Minor Discharge
July 2013 -
Page 1
OKLAHOMA DEPARTMENT OF ENVIRONMENTAL QUALITY
APPLICATION FOR PERMIT TO DISCHARGE MUNICIPAL/DOMESTIC WASTEWATER
UNDER THE OKLAHOMA POLLUTANT DISCHARGE ELIMINATION SYSTEM (OPDES)
Application for Permit to Discharge Municipal/Domestic Wastewater
FORM 2M2 (Minor)
Application/Permit Number OK00 _____________ Facility ID No. __________
Date Received: ___________________________________________________
FOR DEQ
SIC Code: _______________________________________________________
USE ONLY
If a proposed facility, give estimated date of completion: _________________
DEQ PERMIT ENGINEER: ____________________________________________
DO NOT attempt to complete this application without reading the instructions!
SECTION I
1. Legal name of applicant: _______________________________________________________________
2. Mailing address of applicant:
Street Address or P.O. Box ________________________________________________________________
City ______________________ County ____________________ State _____ Zip Code ______________
Telephone ________________________________________ Fax ________________________________
E-mail Address _________________________________________________________________________
3. Name and address of facility:
Facility Name __________________________________________________________________________
Street Address _________________________________________________________________________
City ________________________ County _______________________ State _____ Zip Code _________
Telephone ____________________________________ Fax _____________________________________
E-mail Address _________________________________________________________________________
4. Location of discharging facility (e.g., NE ¼ , SW ¼ , SE ¼ , Section 1, Township 2 North, Range 3 West):
Legal Description of Facility Location ______, ______, ______, Section _____, Township _____, Range ______
Latitude: _______________ N Longitude: _______________ W
5. Type of Ownership:
Public
Private
Federal
State
DEQ Form 2M2 - Minor Discharge
July 2013 -
Page 1
6. Contact Person:
Name and Title _________________________________________________________________________
Address _______________________________________________ City ___________________________
County _______________________ State ______ Zip Code _________ Telephone __________________
Fax ___________________________________ Cell Phone ______________________________________
E-mail Address _________________________________________________________________________
7. Type of discharge:
A. Wastewater from lagoon system
B. Wastewater from mechanical plant
C. Other (specify) ___________________________________________________________________
8. Type of treatment:
A. Lagoon system with total retention by evaporation (Does not require this form, it requires Form 530E)
B. Lagoon system with effluent used for land application only (Does not require this form, it requires
Form 627-WRP)
C. Lagoon system with effluent discharge to receiving water
D. Lagoon system with effluent discharge and water reuse (Also fill out Section III of application)
E. Mechanical Plant with effluent discharge: (please describe briefly the type of treatment plant)
________________________________________________________________________________
F. Mechanical Plant with discharge and water reuse: (please describe briefly the type
of treatment plant and fill out Section III of application)
___________________________________________________________________________________
9. Is chlorine or any other halogen used at this facility?
Yes
No
If yes, is dechlorination or dehalogenation used at this facility? (See instructions)
Yes
No
Is an ultraviolet (UV) system used at this facility?
Yes
No
10. Design flow of facility in million gallons per day (mgd) _____________________________________
DEQ Form 2M2 - Minor Discharge
Page 2
July 2013 -
11. Discharge point number
Total volume presently discharged
(List all outfalls)
million gallons per day (mgd)
001
______________________________
002 (if applicable)
______________________________
003 (if applicable)
______________________________
12. Legal description(s) of all discharge point(s):
Outfall 001:
Name of receiving water(s): _____________________________________________________________
Discharge is (check one): Continuous
Batch
Intermittent
Seasonal
Latitude: _______________ N
Longitude: _______________ W
Legal Description of discharge point _______, _______, _______, Section ______, Township _____, Range _______
Outfall 002 (if applicable):
Name of receiving water(s): _____________________________________________________________
Discharge is (check one): Continuous
Batch
Intermittent
Seasonal
Latitude: _______________ N
Longitude: _______________ W
Legal Description of discharge point _______, _______, _______, Section ______, Township _____, Range _______
Outfall 003 (if applicable):
Name of receiving water(s): ______________________________________________________________
Discharge is (check one): Continuous
Batch
Intermittent
Seasonal
Latitude: _______________ N
Longitude: _______________ W
Legal Description of discharge point _______, _______, _______, Section ______, Township _____, Range _______
13. During periods of heavy rain, is the increased flow:
Bypassed to the receiving stream with no treatment
Given partial treatment and discharged
Given complete treatment and discharged
Stored for later treatment
DEQ Form 2M2 - Minor Discharge
July 2013 -
Page 3
14. Biosolids/Sludge generated by this facility:
A. Current biosolids/sludge treatment process. (Please state if sludge is self-contained in the lagoon system,
otherwise explain the treatment process)
______________________________________________________________________________________
______________________________________________________________________________________
B. Amount of biosolids/sludge produced (dry metric tons/year) ___________________________________
1. Land application of biosolids
Sludge management plan, if any: _______________________________________________________
Sludge management permit number ______________________ approved by the Oklahoma Department
of Environmental Quality or the Oklahoma State Department of Health on _________________________
Location(s) of current land application site(s) (legal description to the nearest 10 acres).
Site 1: ______, ______, _____, Section ______, Township _____, Range _______, County __________
Site 2: ______, ______, ______, Section ______, Township _____, Range _____, County ________________
(if applicable)
Site 3: ______, ______, ______, Section ______, Township _____, Range _____, County ________________
(if applicable)
2. Landfilled sludge
Sludge disposition plan, if any: _________________________________________________________
Sludge disposition permit number (if applicable) _____________________ approved by the Department
of Environmental Quality or the Oklahoma State Department of Health on _____________________
Name of Landfill _____________________________________________________________________
Landfill’s permit number ______________________________________________________________
Yes
No
15. Does this facility receive industrial wastewater?
If "Yes", Submit Section II of this form (attached) for each significant industrial
facility discharging to the sewer system, including wastewater from water treatment plant.
Are industrial discharge(s) to the system(s) controlled by
Ordinance
Pretreatment Program
Yes
No
16. Does this facility supply reclaimed water?
If "Yes", Submit Section III of this form (attached) for each user of reclaimed water.
DEQ Form 2M2 - Minor Discharge
Page 4
July 2013 -
17. Landowner Notification
(THIS SECTION MUST BE COMPLETED PRIOR TO SUBMISSION OF THE APPLICATION –
THE APPLICATION WILL AUTOMATICALLY BE CONSIDERED INCOMPLETE IF IT IS NOT COMPLETED):
Is any part of the land on which the facility is located (including treatment units, discharge
conveyances, stormwater holding basins, and/or flow equalization basins) owned by a person or
entity other than the applicant?
No
Yes – the applicant or applicant’s certifying official must ensure that such landowner(s) have
been notified of the applicant’s intent to obtain an OPDES permit and initial the box to the
right indicating that such notification has been made.
*NOTE: Please mail completed landowner notification affidavit form to DEQ (see instructions)
18. List other information which should be brought to the attention of the Department of
Environmental Quality (DEQ) in regard to the issuance of a discharge permit for the facility.
DEQ Form 2M2 - Minor Discharge
July 2013 -
Page 5
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