8. Are any significant (+- 20 %) changes in production that will affect wastewater discharge expected in the next 5 If yes, please describe. Yes No 9. List all current waste haulers. Give name, address, phone numbers, volume and materials hauled off. 10. Attach a copy of laboratory analyses performed in the last year on the wastewater discharge(s) from your facilities. Summarize data on the attached Data Summary Form. 11. Attach sketch or schematic showing sampling points and all connections to the sewer. 12. Complete the Wastewater Pollutants Checklist attached to this Survey. 13. Do you have, or have you ever applied for, been issued, or been denied an permit to discharge to the surface waters or storm sewers of North Carolina? If yes, list all other NPDES permits, permit numbers, dates, and names used to apply for them, or reason denied. If yes: Permit , #, date, applicant name Yes
8. Are any significant (+- 20 %) changes in production that will affect wastewater discharge expected in the next 5 If yes, please describe. Yes No 9. List all current waste haulers. Give name, address, phone numbers, volume and materials hauled off. 10. Attach a copy of laboratory analyses performed in the last year on the wastewater discharge(s) from your facilities. Summarize data on the attached Data Summary Form. 11. Attach sketch or schematic showing sampling points and all connections to the sewer. 12. Complete the Wastewater Pollutants Checklist attached to this Survey. 13. Do you have, or have you ever applied for, been issued, or been denied an permit to discharge to the surface waters or storm sewers of North Carolina? If yes, list all other NPDES permits, permit numbers, dates, and names used to apply for them, or reason denied. If yes: Permit , #, date, applicant name Yes
Industrial%20Wastewater%20Survey%20&%20IUP%20Permit%20Application%20(Long%20Form).docx