Form LA-1 "Application for a Permit to Operate a Land Application Facility Which Will Land Apply Municipal Wastewater Sludges Only" - Mississippi

What Is Form LA-1?

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

Form Details:

  • Released on April 16, 1999;
  • The latest edition provided by the Mississippi 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 Form LA-1 by clicking the link below or browse more documents and templates provided by the Mississippi Department of Environmental Quality.

ADVERTISEMENT
ADVERTISEMENT

Download Form LA-1 "Application for a Permit to Operate a Land Application Facility Which Will Land Apply Municipal Wastewater Sludges Only" - Mississippi

Download PDF

Fill PDF online

Rate (4.6 / 5) 9 votes
MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY
OFFICE OF POLLUTION CONTROL
SOLID WASTE AND MINING BRANCH
PERMIT APPLICATION INFORMATION FOR LAND APPLICATION
FACILITIES WHICH WILL LAND APPLY MUNICIPAL
WASTEWATER SLUDGES ONLY
According to the Mississippi State Nonhazardous Waste Management Regulations, a permit is
required to operate a land application facility. The completion of a permit application is required
for permitting all new or expanded land application facilities. To apply for a land application
permit, complete the attached permit application form and include all maps, engineering
drawings and other required information and then submit it in a report format in a three-ring
binder. Application shall be submitted in triplicate. Information/documentation pertaining to the
permit application, but not part of the discussion (e.g., letters, calculations, reports, etc.) should
be contained as appendices at the end of the appropriate part/section. All pages should list the
date the submittal was prepared, the revision number, and page number. For example:
PREPARED:
2-29-1999
REVISION NO.: 0
PAGE:
1-1
Applications should be sent to the following appropriate address:
BY MAIL
BY DELIVERY
Mississippi Department of
Mississippi Department of
Environmental Quality
Environmental Quality
Office of Pollution Control
Office of Pollution Control
Nonhazardous Waste Branch
Nonhazardous Waste Branch
P.O. Box 2261
515_East_Amite_Street
Jackson, MS 39289-2261
Jackson, MS 39204
After a permit is issued for operating a land application facility, the permitted facility must be
operated in accordance with all the applicable state regulations and requirements. Also, the
operation of the permitted facility needs to be conducted in compliance with the standards for
disposal of sewage sludge by land application as provided in the EPA final sludge regulations 40
CFR Part 503, a copy of which is also enclosed in this application information package.
The Office of Pollution Control (OPC) reserves the right to ask for additional information as
determined necessary. Questions regarding land application facilities should be directed to the
Nonhazardous Waste Branch Permitting Section at the telephone number (601) 961-5171.
MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY
OFFICE OF POLLUTION CONTROL
SOLID WASTE AND MINING BRANCH
PERMIT APPLICATION INFORMATION FOR LAND APPLICATION
FACILITIES WHICH WILL LAND APPLY MUNICIPAL
WASTEWATER SLUDGES ONLY
According to the Mississippi State Nonhazardous Waste Management Regulations, a permit is
required to operate a land application facility. The completion of a permit application is required
for permitting all new or expanded land application facilities. To apply for a land application
permit, complete the attached permit application form and include all maps, engineering
drawings and other required information and then submit it in a report format in a three-ring
binder. Application shall be submitted in triplicate. Information/documentation pertaining to the
permit application, but not part of the discussion (e.g., letters, calculations, reports, etc.) should
be contained as appendices at the end of the appropriate part/section. All pages should list the
date the submittal was prepared, the revision number, and page number. For example:
PREPARED:
2-29-1999
REVISION NO.: 0
PAGE:
1-1
Applications should be sent to the following appropriate address:
BY MAIL
BY DELIVERY
Mississippi Department of
Mississippi Department of
Environmental Quality
Environmental Quality
Office of Pollution Control
Office of Pollution Control
Nonhazardous Waste Branch
Nonhazardous Waste Branch
P.O. Box 2261
515_East_Amite_Street
Jackson, MS 39289-2261
Jackson, MS 39204
After a permit is issued for operating a land application facility, the permitted facility must be
operated in accordance with all the applicable state regulations and requirements. Also, the
operation of the permitted facility needs to be conducted in compliance with the standards for
disposal of sewage sludge by land application as provided in the EPA final sludge regulations 40
CFR Part 503, a copy of which is also enclosed in this application information package.
The Office of Pollution Control (OPC) reserves the right to ask for additional information as
determined necessary. Questions regarding land application facilities should be directed to the
Nonhazardous Waste Branch Permitting Section at the telephone number (601) 961-5171.
Form LA-1
04-16-1999
MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY
OFFICE OF POLLUTION CONTROL
SOLID WASTE AND MINING BRANCH
P.O. BOX 2261
JACKSON, MISSISSIPPI 39225-2261
APPLICATION FOR A PERMIT TO OPERATE A LAND APPLICATION FACILITY
WHICH WILL LAND APPLY MUNICIPAL WASTEWATER SLUDGES ONLY
Part 1 General Data
1.
Name of facility:
2.
Name, address and telephone number of applicant:
(Name)
(Street address, P.O. Box, etc.)
(City)
(State)
(Zip)
Telephone number:
3.
Name, address, and telephone number of contract operator (if not applicable, so
indicate):
(Name)
(Street address, P.O. Box, etc.)
(City)
(State)
(Zip)
Telephone number:
2
4.
Name, address, and telephone number of the landowner (if same as applicant, so
indicate):
(Name)
(Street address, P.O. Box, etc.)
(City)
(State)
(Zip)
Telephone number:
5.
Attach a complete copy of the land deed, certified by the county clerk.
6.
When the applicant intends to lease rather than own the land on which the site is located,
a notarized statement signed by the owner of the land which acknowledges and concurs
in the use of this property as a land application facility shall be attached to this
application. (See Attachment A for form).
7.
If the applicant or the contract operator (for commercial facilities only) is not a public
agency, disclosure information must be included with the application, as required by
Section 17-17-501 et seq., Mississippi Code of 1972. The disclosure statement must be
submitted on forms supplied by the Department.
Part 2 Property Information and Maps
8.
The proposed facility will be located in
County.
9.
The total property consists of
acres and lies in the following topographic
sections:
Section
Township
Range
10.
The actual area for land application (excluding buffer zones and other unused areas)
consists of
acres.
3
11.
Attach a United States Geological Survey (USGS) topographic quadrangle map of the
area showing the following:
a.
the property boundaries of the site;
b.
the approximate land application area within the property boundary; and
c.
the location of active/inactive hydrocarbon wells and water wells present within the
land application area.
The map may be a high quality photocopy.
12.
Is the property line buffer distance designated on the map less than 200 feet on any side?
yes
no
If yes, attach documentation of compliance with Section III.T., of the State of Mississippi
Nonhazardous Waste Management Regulations.
13.
Is the proposed application area within 300 feet from any inhabited building?
yes
no
If yes, attach documentation of compliance with Section VIII.D., of the State of
Mississippi Nonhazardous Waste Management regulations.
14.
Attach a property owners map indicating the immediately adjacent landowners to the site
and a list of the complete names and addresses of the landowners.
Part 3 Local Government Regulation/Solid Waste Management Plans
15.
Attach a letter from the appropriate County or City official confirming that the siting of
the proposed facility will be in conformance with all local laws, regulations and
ordinances, or that no such laws, regulations, or ordinances are applicable.
16.
The proposed facility must be consistent with the approved local solid waste management
plan, as submitted to the Department by the local solid waste management authority.
Attach a copy of the page(s) of the plan which recognizes the operation of this facility. If
the local solid waste management plan has not yet been approved for land application
sites, no submittal is necessary. The Department should be contacted prior to addressing
this item.
4
Part 4 Demonstration of Need
Section 17-17-229, Mississippi Code Annotated, requires each permit application to
contain a demonstration of need which shall include the items in italics below. This may
be achieved by answering questions in items 17 - 19 below.
17.
Verification that the facility for which the permit is sought meets the twenty year capacity
needs identified in the county or regional nonhazardous solid waste management plan
which shall take into account the quantities of municipal solid waste generated and the
design capacities of existing facilities
.
If the proposed facility is included in and consistent with the local solid waste
management plan, then the facility meets the twenty year capacity needs. Is the proposed
facility included in and consistent with the local solid waste management plan?
yes
no. If not, provide explanation on an attached sheet.
18.
Demonstration that the host jurisdiction and the jurisdiction generating the solid waste
destined for the applicant
s facility are actively involved in, and have a strategy for
=
meeting the statewide waste minimization goal.
Certification that the proposed service area of the facility is consistent with a local solid
waste management plan.
Every approved local solid waste management plan has an approved waste minimization
strategy included in the plan. If the jurisdiction (excluding out-of-state jurisdictions)
generating the solid waste destined for the facility (the proposed service area) has an
approved local solid waste management plan, the first requirement above is met. The
service area for the proposed facility must be consistent with the service area as specified
in the approved local solid waste management plan for this facility. List below the
service area of the facility (by city, county and/or state):
19.
The extent to which the proposed facility is needed to replace other facilities.
Many of the state=s landfills were forced to close in 1993 and 1994 due to the Subtitle D
regulations. Disposal at the remaining landfills became more expensive and in most
cases, involved a long haul out of county. As a result, it has become economically and
environmentally advantageous to find alternate or supplemental disposal/management
methods for solid waste and rubbish waste. Is this situation representative for your
proposed facility?
yes
no. If not, provide on an attached sheet a description of
the extent to which the proposed facility is needed to replace other facilities.
5