Form 2-P "Application for a State Operating Pretreatment Permit" - Mississippi

What Is Form 2-P?

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:

  • 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 printable version of Form 2-P by clicking the link below or browse more documents and templates provided by the Mississippi Department of Environmental Quality.

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Download Form 2-P "Application for a State Operating Pretreatment Permit" - Mississippi

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FORM 2-P
For Agency Use
Application Number
Date Received
STATE OF MISSISSIPPI
OFFICE OF POLLUTION CONTROL
P. O. BOX 2261
JACKSON, MISSISSIPPI 39225-2261
APPLICATION FOR A STATE OPERATING PRETREATMENT PERMIT
(Please print or type)
1. Name of Applicant:
2. Mailing Address of Applicant:
Number & Street (P. O. Box):
City:
State:
Zip:
Telephone Number:
3. Applicant's Authorized Agent:
Name and Title:
Number & Street (P. O. Box):
City:
State:
Zip:
Telephone Number:
4. Facilities Location:
Number & Street (P. O. Box):
City:
County:
Latitude (Deg., Min., Sec.):
Longitude (Deg., Min., Sec.):
5. Nature of Business:
6. Location Map: (Provide as an attachment to this application)
7. SIC CODES (4-digit, in order of priority)
Page 1
FORM 2-P
For Agency Use
Application Number
Date Received
STATE OF MISSISSIPPI
OFFICE OF POLLUTION CONTROL
P. O. BOX 2261
JACKSON, MISSISSIPPI 39225-2261
APPLICATION FOR A STATE OPERATING PRETREATMENT PERMIT
(Please print or type)
1. Name of Applicant:
2. Mailing Address of Applicant:
Number & Street (P. O. Box):
City:
State:
Zip:
Telephone Number:
3. Applicant's Authorized Agent:
Name and Title:
Number & Street (P. O. Box):
City:
State:
Zip:
Telephone Number:
4. Facilities Location:
Number & Street (P. O. Box):
City:
County:
Latitude (Deg., Min., Sec.):
Longitude (Deg., Min., Sec.):
5. Nature of Business:
6. Location Map: (Provide as an attachment to this application)
7. SIC CODES (4-digit, in order of priority)
Page 1
A. FIRST
B. SECOND
C. THIRD
D. FOURTH
8. Name of POTW Receiving
Wastewater:
Number & Street (P. O. Box):
City:
County:
9. Discharge Type and Occurrence:
A. Type of Discharge:
Continuous; If Continuous
Gallons Per Day,
Batch
B. Discharge Occurrence:
Days per Week
C. Discharge Occurrence:
January
February
March
April
May
June
July
August
September
October
November
December
10. If Batch: A.
Thousand Gallons per Discharge
B.
Hours per Day
C.
Discharge Occurrence per Day
11. Maximum Period of Flow: From
to
Month
Month
Page 2
12. Facility Water Use:
Estimate average volume in thousand gallons per day for the following types of water usage at this facility.
Non-contact Cooling:
Boiler Feed:
Process (Including Contact Cooling):
Sanitary:
Other:
Total:
13. List all Facility Discharges:
Other water losses (surface water, product consumption, evaporation). Indicate volume in thousand gallons.
14. Give narrative description of process(es) producing discharge, or in case of no discharge, that generates wastewater.
15. List raw materials used:
Page 3
16. PRODUCTION
A.
Does an effluent guideline limitation promulgated by EPA under Section 304 of the Clean Water Act apply to your Facility?
~ Yes (complete Item 16-B)
~ No (Go to 17)
B.
Are the limitations in the applicable effluent guidelines expressed in terms of production (or other measure of operation)?
~ Yes (complete Item 16-C)
~ No (Go to 17)
C.
If you answered "yes" to Item 16-B, list the quantity which represents an actual measurement of your level of production,
expressed in the terms and units used in the applicable effluent guideline, and indicate the affected outfalls.
1. AVERAGE DAILY PRODUCTION
2. AFFECTED
OUTFALLS
(list
outfall
numbers)
a. QUANTITY
B. UNITS OF
c. OPERATION, PRODUCT,
PER DAY
MEASURE
MATERIAL, ETC.
(specify)
Page 4
17. Effluent Characteristics:
A.
You must provide the results of at least one analysis for every pollutant in this table. Complete one table for each outfall to the city sewer. If your facility does not have a
discharge indicate so and disregard.
1.
4. INTAKE
(optional)
2. EFFLUENT
3. UNITS (specify I
POLLUTANT
blank)
a. MAXIMUM
b. MAXIMUM 30 DAY
c. LONG TERM
d. No.
a. LONG TERM
b. N0. OF
DAILY
VALUE
AVRG. VALUE
OF ANAL-
AVERAGE
ANALYSES
VALUE
(if available)
(if available)
YSES
VALUE
(1)
(2)
(1)
(2)
(1)
(2)
a. CONCENT-
b.
(1)
(2)
CONCENT-
CONCENT-
MASS
CONCENT-
MASS
RATION
MASS
CONCENT
MASS
MASS
RATION
RATION
RATION
-RATION
a.
Biochemical
Oxygen Demand
(BOD)
b. Chemical
Oxygen Demand
(COD)
c. Total
Suspended
Solids (TSS)
d. Ammonia (as
N)
e. Flow
VALUE
VALUE
VALUE
VALUE
f. Temperature
VALUE
VALUE
VALUE
C
VALUE
(winter)
g. Temperature
VALUE
VALUE
VALUE
C
VALUE
(summer)
h. pH
MIN
MAX
MIN
MAX
STANDARD UNITS
Page 5
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