If yes: Permit , #, date, applicant name No 14. Do you have, or have you ever applied for or been issued an Industrial User Pretreatment Permit (IUP) to discharge wastewater to the sewer collection system. If yes, list all other IUP permits, permit numbers, dates, and names used to apply for them. If yes: Permit , #, date, applicant name Yes If yes: Permit , #, date, applicant name No 15. Do you have, or have you ever applied for or been issued any other Environmental Permits (for example; air, RCRA, groundwater, stormwater, general, Non-Discharge, septic tank, etc.). If yes, list all other permits, permit numbers, dates, and names used to apply for them. If yes: Permit type, #, date, applicant name Yes If yes: Permit type, #, date, applicant name No If yes: Permit type, #, date, applicant name 16. Is a Prevention Control and Countermeasure (SPCC) Plan prepared for this facility? Yes No 17. Is a Spill /Slug Control Plan required by the POTW, prepared for this facility? Yes No 18. Do you have any underground storage tanks at your facility? If yes, list contents and volume of each tank. Yes No
If yes: Permit , #, date, applicant name No 14. Do you have, or have you ever applied for or been issued an Industrial User Pretreatment Permit (IUP) to discharge wastewater to the sewer collection system. If yes, list all other IUP permits, permit numbers, dates, and names used to apply for them. If yes: Permit , #, date, applicant name Yes If yes: Permit , #, date, applicant name No 15. Do you have, or have you ever applied for or been issued any other Environmental Permits (for example; air, RCRA, groundwater, stormwater, general, Non-Discharge, septic tank, etc.). If yes, list all other permits, permit numbers, dates, and names used to apply for them. If yes: Permit type, #, date, applicant name Yes If yes: Permit type, #, date, applicant name No If yes: Permit type, #, date, applicant name 16. Is a Prevention Control and Countermeasure (SPCC) Plan prepared for this facility? Yes No 17. Is a Spill /Slug Control Plan required by the POTW, prepared for this facility? Yes No 18. Do you have any underground storage tanks at your facility? If yes, list contents and volume of each tank. Yes No
Industrial%20Wastewater%20Survey%20&%20IUP%20Permit%20Application%20(Long%20Form).docx