Form MO780-2835 "Multiple Discharger Variance (Mdv) Engineering Field Evaluation Form" - Missouri

What Is Form MO780-2835?

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

Form Details:

  • Released on February 1, 2020;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • 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 MO780-2835 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

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Download Form MO780-2835 "Multiple Discharger Variance (Mdv) Engineering Field Evaluation Form" - Missouri

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MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM
MULTIPLE DISCHARGER VARIANCE (MDV) ENGINEERING FIELD
EVALUATION FORM
An engineering field evaluation will be completed by Department of Natural Resources
NOTE ►
engineers for each MDV applicant to determine if the facility meets the requirements of a
facultative, multi-cell, well-functioning lagoon.
1.
GENERAL INFORMATION
OWNER NAME
PERMIT NUMBER (s)
#MO-
FACILITY NAME
COUNTY
2.
LAGOON BASIC INFORMATION
DESIGN FLOW
ACTUAL FLOW
PEAK FLOW
2.1
Is the discharge continuous throughout the year?
Yes
No
2.2 If the lagoon’s discharge is not continuous throughout the year, explain. What is the frequency and duration of
the discharge?
2.3
Lagoon type:
Aerated
Unaerated
2.4
Number of lagoon cells:
_____________ cells
2.5
Required acreage for wastewater irrigation:
_____________ acres
3.
SLUDGE INFORMATION
3.1
Sludge depth measurements for each cell:
Sludge depth measurements must be provided by the facility
Field Notes:
MO 780-2835 (02-20)
MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM
MULTIPLE DISCHARGER VARIANCE (MDV) ENGINEERING FIELD
EVALUATION FORM
An engineering field evaluation will be completed by Department of Natural Resources
NOTE ►
engineers for each MDV applicant to determine if the facility meets the requirements of a
facultative, multi-cell, well-functioning lagoon.
1.
GENERAL INFORMATION
OWNER NAME
PERMIT NUMBER (s)
#MO-
FACILITY NAME
COUNTY
2.
LAGOON BASIC INFORMATION
DESIGN FLOW
ACTUAL FLOW
PEAK FLOW
2.1
Is the discharge continuous throughout the year?
Yes
No
2.2 If the lagoon’s discharge is not continuous throughout the year, explain. What is the frequency and duration of
the discharge?
2.3
Lagoon type:
Aerated
Unaerated
2.4
Number of lagoon cells:
_____________ cells
2.5
Required acreage for wastewater irrigation:
_____________ acres
3.
SLUDGE INFORMATION
3.1
Sludge depth measurements for each cell:
Sludge depth measurements must be provided by the facility
Field Notes:
MO 780-2835 (02-20)
4.
LAGOON EVALUATION
4.1
Are there industries discharging to the facility?
Yes
No
4.2
Is the vegetation maintained properly?
Yes
No
4.3
Are the berms maintained properly?
Yes
No
4.4
Is the fence maintained properly?
Yes
No
4.5 Note any issues with vegetation, rodent burrowing, erosion, sludge, etc.
4.6 Note the appearance of the effluent such as color, odor, particles, etc.
5.
CONCLUSION
5.1
General overall condition of the lagoon:
Good
Fair
Poor
5.2 Overall Comments:
5.3
Recommendation:
The facility does meet the requirements of the MDV as a “well-functioning” lagoon.
The facility does not meet the requirements of the MDV as a “well-functioning” lagoon.
5.4 Explain the recommendation:
STAFF NAME
DATE OF FIELD EVALUATION
Field Notes:
MO 780-2835 (02-20)
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