"Industrial Wastewater Hauler Permit" - Massachusetts

Industrial Wastewater Hauler Permit is a legal document that was released by the Massachusetts Department of Environmental Protection - a government authority operating within Massachusetts.

Form Details:

  • Released on June 1, 2017;
  • The latest edition currently provided by the Massachusetts Department of Environmental Protection;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Environmental Protection.

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Download "Industrial Wastewater Hauler Permit" - Massachusetts

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Commonwealth of Massachusetts
City/Town of
Industrial Wastewater Hauler Permit
MassDEP has provided this form for use by local Boards of Health if they choose to do so.
Board of Health or Approving Authority
Approves this application to haul industrial wastewater and the content of industrial wastewater
holding tanks. This permit expires on the date set forth below. All transport must be in accordance
with 314 CMR 18.12 and applicable local regulations. A copy of this permit shall be kept in every
vehicle in which the permittee carries industrial wastewater over the roads of the Commonwealth.
Permit Number
Permit Expiration Date (close of year issued)
Approved by
Date
Signature
iwhaulerpermit.doc • 06/17
Page 1 of 1
Commonwealth of Massachusetts
City/Town of
Industrial Wastewater Hauler Permit
MassDEP has provided this form for use by local Boards of Health if they choose to do so.
Board of Health or Approving Authority
Approves this application to haul industrial wastewater and the content of industrial wastewater
holding tanks. This permit expires on the date set forth below. All transport must be in accordance
with 314 CMR 18.12 and applicable local regulations. A copy of this permit shall be kept in every
vehicle in which the permittee carries industrial wastewater over the roads of the Commonwealth.
Permit Number
Permit Expiration Date (close of year issued)
Approved by
Date
Signature
iwhaulerpermit.doc • 06/17
Page 1 of 1