Sewer Discharge Application
Applicant Name
E-mail address
Phone number
What building will the discharge occur in?
*
Select or enter value
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What room will the discharge occur in?
*
Briefly describe the waste being generated
*
Describe the process generating the waste
*
How much waste will be discharged per batch?
*
How often will discharges occur?
*
Enter the first constituent of the waste
*
Enter the percentage of the first constituent in the total mixture
*
%
Enter the second constituent of the waste
Enter the percentage of the second constituent in the total mixture
%
Enter the third constituent of the waste
Enter the percentage of the third constituent in the total mixture
%
Enter the fourth constituent of the waste
Enter the percentage of the fourth constituent in the total mixture
%
Enter the fifth constituent of the waste
Enter the percentage of the fifth constituent in the total mixture
%
Enter any additional constituents and their percentage in the total waste
Does the waste contain
Solids
Biological Materials
Radioactive Materials
Dyes
If the waste contains any solids, biological materials, radioactive materials, or dyes, describe those contents and their quantity here
Does the waste contain any of the following metals:
Arsenic
Cadmium
Chromium
Copper
Lead
Mercury
Molybdenum
Nickel
Selenium
Silver
Zinc
If the waste contains any of the metals listed above, describe the contents and quantity here
What is the anticipated temperature of the discharge?
*
What is the anticipated pH of the discharge?
*
What is the anticipated Biological Oxygen Demand (BOD) of the discharge?
*
What is the primary hazard of the discharge?
*
Corrosive
Flammable
Toxic
Other
If you noted the hazard as "Other," describe the hazard here
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