DEQ Form 515-020 "Solid Waste Permit Modification Application" - Oklahoma

What Is DEQ Form 515-020?

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

Form Details:

  • Released on July 1, 2016;
  • 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 printable version of DEQ Form 515-020 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 515-020 "Solid Waste Permit Modification Application" - Oklahoma

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APPLICATION TO MODIFY A SOLID WASTE
DISPOSAL FACILITY PERMIT
Date:
County:
Send to:
Solid Waste Permitting Unit
FOR DEQ USE
Waste Management Division
Dept. of Environmental Quality
DEQ Log No.
707 N. Robinson (PO Box 1677)
No. Copies
Oklahoma City, OK 73101-1677
Date Received:
proposes to modify the permit of
(Applicant’s Name)
the
, located at
(Facility Name)
(Exact legal description:
metes & bounds, platted lot, or land survey. Append extra sheets if necessary)
in
County, Oklahoma. We hereby make application for a modification
of existing permit number
as required by the Oklahoma Solid Waste
Management Act and the Rules pursuant thereto.
Remarks & brief description of proposed modification:
Applicant or Authorized Agent:
Preparing Engineer:
Signature
Signature
Typed Name
Typed Name
Address:
Address:
City:
State:
City:
State:
Date signed:
Date signed:
Phone:
Phone:
Facility Address (if any):
DEQ USE ONLY
July 2016
DEQ Form #515-020
APPLICATION TO MODIFY A SOLID WASTE
DISPOSAL FACILITY PERMIT
Date:
County:
Send to:
Solid Waste Permitting Unit
FOR DEQ USE
Waste Management Division
Dept. of Environmental Quality
DEQ Log No.
707 N. Robinson (PO Box 1677)
No. Copies
Oklahoma City, OK 73101-1677
Date Received:
proposes to modify the permit of
(Applicant’s Name)
the
, located at
(Facility Name)
(Exact legal description:
metes & bounds, platted lot, or land survey. Append extra sheets if necessary)
in
County, Oklahoma. We hereby make application for a modification
of existing permit number
as required by the Oklahoma Solid Waste
Management Act and the Rules pursuant thereto.
Remarks & brief description of proposed modification:
Applicant or Authorized Agent:
Preparing Engineer:
Signature
Signature
Typed Name
Typed Name
Address:
Address:
City:
State:
City:
State:
Date signed:
Date signed:
Phone:
Phone:
Facility Address (if any):
DEQ USE ONLY
July 2016
DEQ Form #515-020
1
VERIFICATION
STATE OF OKLAHOMA
)
)
ss
COUNTY OF
)
, of lawful age, being first duly sworn, upon oath
state that I have read the foregoing APPLICATION TO MODIFY A SOLID WASTE
DISPOSAL FACILITY PERMIT, that I am familiar with the matters set forth therein, and that
the same are true to the best of my information and belief.
Applicant
Subscribed and sworn to before me this
day of
, 20
,
by
(Applicant or legal representative).
Notary Public
My commission expires:
1
This Verification is required for a Tier III modification application.
July 2016
DEQ Form #515-020
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