Ordinance Number 472ORDINANCE NII. 472
INDUSTRIAL WASTE CONTROL
AN ORDINANCE OF THE CITY OF SAN JUAN CAPISTRANO,
CALIFORNIA, ADDING CHAPTER 9 TO TITLE 6 OF THE
SAN JUAN CAPISTRANO MUNICIPAL CODE, PROVIDING
FOR REGULATION OF INDUSTRIAL WASTEWATER DISCHARGES
THE CITY COUNCIL OF THE CITY OF SAN JUAN CAPISTRANO, CALIFORNIA,
DOES HEREBY ORDAIN AS FOLLOWS:
SECTION 1. Addition.
The San Juan Capistrano Municipal Code is hereby
amended by the addition of Chapter 9 to Title 6 to provide for
regulation of Industrial Wastewater Discharges:
Chapter 9, Industrial Wastewater Discharges
Section 6-9.01. Purpose.
The purpose of this Ordinance is to provide for the
maximum beneficial use of the City of San Juan Capistrano
facilities through adequate regulation of sewer use and
industrial wastewater discharges, and to provide procedures for
complying with industrial waste discharge requirements placed
upon City of San Juan Capistrano by state and federal regulatory
agencies.
Section 6-9.02. Definitions.
As used in this Ordinance:
(a) "City" is the City of San Juan Capistrano.
(b) "Department of Public Works" is the City of San
Juan Capistrano Department of Public Works.
(c) "Director" is the Director of the Department of
Public Works.
(d) "SERRA" is the South East Regional Reclamation
Authority.
(e) "Industrial Discharger" means any person, firm,
business or entity discharging non-domestic
wastewater to the sewer system. Industrial
dischargers are divided as follows:
(1) Class 1 Dischargers: Dischargers subject to
federal categorical pretreatment standards.
(2) Class 2 Dischargers: Dischargers of wastes
of a quality or in quantities that may, in
the judgement of the Director of the
Department of Public Works adversely impact
wastewater collection, treatment or disposal
or sludge treatment or disposal.
Qin
1 (3) Class 3 Dischargers: All other dischargers.
(f) "Existing Discharge" is an industrial discharge in
existence prior to the effective date of this
Ordinance.
(g) "Proposed Discharge" is an industrial discharge
planned or proposed to begin discharging
subsequent to the effective date of this
Ordinance.
(h) "Special Effluent Discharge Limitations" shall mean
any effluent limitations imposed on an industrial
discharger which differ from the standard effluent
discharge limitations contained in this Ordinance.
Section 6-9.03. Effective Date of Ordinance.
The provisions of this Ordinance shall become effective
on November 1, 1982.
Section 6-9.04. Industrial Discharge Permits.
(a) The Department of Public Works shall issue
industrial waste discharge permits to all Class 1
and Class 2 dischargers within the service area of
the City. Industrial waste discharge permits issued
by the Department of Public Works shall be valid
for a period not to exceed five years.
(b) Applications for industrial discharge permits
shall be submitted by all existing and proposed
industrial dischargers. Department of Public
Works staff shall notify existing dischargers of
the need to submit a permit application within 60
days of the effective date of this Ordinance.
Department of Public Works staff shall notify
proposed dischargers of the need to submit a
permit application at the time the proposed
discharge comes to the attention of the member
agency. Standard permit application forms
(appended as Exhibit "A" of this Ordinance) shall
be made available to industrial dischargers at the
Department of Public Works office.
(c) Upon receipt of the required permit application
information and fees, the application shall be
processed by the Department of Public Works staff.
Staff shall review the application, determine if a
permit is required and, if so, recommend an
appropriate self-monitoring program. Staff shall
then forward the application to the Director of
the Department of Public Works. Upon approval by
the Director, the signed permit shall be attached
to the application forms. Permit and application
originals shall be maintained by the Department of
Public Works in a file system. Copies shall be
forwarded to the discharger.
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(d) Any application or information submitted by the
discharger to the City may be claimed as
confidential by the discharger. Any such claim
must be asserted at the time of submission by
stamping the words "confidential business
information" on each page containing such
information. If a claim is asserted, the City
will treat the information in accordance with
Chapter 40, Code of Federal Regulations, Part 2.
If no claim is made at the time of submission, the
City may make the information available to the
public.
(e) Where the industrial discharger becomes aware that
relevant facts were omitted or incorrect
information was submitted in the industrial
discharge permit application, the facts or
corrected information shall be promptly submitted
to the Department of Public Works.
(f) Industrial dischargers under permit shall file a
new application with the Department of Public
Works 60 days prior to any of the following:
(1) Expiration of an existing industrial
discharge permit.
(2) Implementation of changes at the industry
which increase the flow beyond that specified
in the industrial discharge permit, cause a
significant change in the nature of the
wastewater, or change the location of the
discharge.
(3) Implementation of any changes at the industry
which may result in non-compliance with any
requirements of this Ordinance.
Section 6-9.05. Discharge Prohibitions.
All discharges of wastewater to the City sewer system
shall comply with the following:
(a) The pH of wastes discharged shall at all times be
within the range of 6.0 to 9.5.
(b) Heat in discharged wastewater shall not cause the
temperature of wastewater entering the headworks
of any wastewater treatment plant to exceed 40° C
(104° F).
(c) Radioactivity in the effluent shall not exceed the
limits specified in Title 17, Chapter 5,
Subchapter 4, Group 3, Article 5, Section 30287,
of the California Administrative Code.
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1 (d) The discharge of wastes to sewer manholes without
the written permission of the Director or
designate is prohibited.
(e) Discharge of the following wastes into the public
sewer system is prohibited:
(1) Any solids or viscous substances of such size
or in such quantity that may cause
obstruction to the flow in the sewer or to be
detrimental to proper wastewater treatment
plant operation.
These objectionable substances may include,
but are not necessarily limited to, asphalt,
dead animals, offal, ashes, sand, mud, straw,
industrial process shavings, metal, glass,
rags, feathers, tar, plastics, wood, whole
blood, bones, hair, coffee grounds, egg
shells, seafood shells, flashings, entrails,
paper dishes, paper cups, milk containers, or
other similar paper products either whole or
ground.
(2) Organic wastes in concentrations that cause
the BOD of wastewater entering the headworks
of any wastewater treatment plant to exceed
500 mg/1.
(3) Any strongly odorous waste or waste which can
create odors in receiving waters or at sewage
collection or treatment facilities.
(4) Any waste containing substances that may
precipitate, solidify or become viscous at
temperatures between 50° F and 100° F.
(5) Any waste capable of passing through the
wastewater treatment works and producing
discoloration of wastewater treatment plant
effluent.
(6) Any water added for purposes of diluting
wastes which would otherwise exceed
applicable maximum concentration limitations.
(7) Any waste which may create a fire or
explosion hazard in the wastewater collection
or treatment system.
(8) Any waste prohibited by federal standards
from being discharged to the sewer system.
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(9) Any—other wastes which may be specifically
prohibited by SERRA or the City.
Section 6-9.06. Effluent Discharge Limitations.
(a) All industrial discharges to the City sewer system
shall comply with the following effluent discharge
limitations unless special permit provisions are
approved by both the Department of Public Works
and SERRA Board of Directors, in accordance with
Section 6-9.06(2).
STANDARD MAXIMUM EFFLUENT CONCENTRATIONS
CONSTITUENT mg/1
Ammonia
500
Arsenic
0.8
Barium
10.0
Boron
2.0
Cadmium
0.2
Chlorinated Hydrocarbons
ND
Chromium, Total
0.4
Chromium, Hexavalent
0.4
Copper
10.0
Cyanide
1.0
Lead
0.4
Mercury
0.015
Nickel
10.0
Oil & Grease of Mineral Origin
200
Phenol
10.0
Selenium
0.1
Silver
0.6
Sulfate
500
Sufide
25
Zinc
10.0
ND: Not Detectable
(b) Special permit provisions for Class 1 or Class 2
industrial dischargers allowing relaxation of the
above listed effluent standards may be approved by
Director only with the concurrence of the SERRA
Board of Directors and then only if the following
is demonstrated by the discharger:
(1) That the discharger cannot, with reasonable
modification to the discharging facility,
meet the Ordinance effluent standards;
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(2) That the requested variance will not
discernibly impact the treatment operation of
any wastewater treatment plant, cause the
plant wastewaters or sludges to violate
applicable requirements or harm plant
facilities or personnel; and,
(3) That the relaxation
violate any federal
requirements.
Section 6-9.07
of requirements will not
pretreatment
Discharge Permit Provisions.
All industrial dischargers shall be subject to the
following requirements.
(a) Industrial discharge permits issued do not
authorize the commission of any act causing injury
to the property of another, nor protect the
discharger from his liabilities under federal,
state, or local laws, nor guarantee the discharger
a capacity right in the sewer system.
(b) A copy of the industrial discharge permit shall be
maintained at the industry so as to be available
at all times to personnel of the industry.
(c) The industrial discharge permit is valid only for
a waste discharge volume stated in the
application, and at a discharge rate not exceeding
the stated maximum discharge rate.
(d) The discharger shall allow staff of the Department
of Public Works, SERRA, or an authorized
representative upon presentation of credentials
to:
(1) Enter upon the discharger's premises where a
regulated discharge is located or where
records must be kept under the conditions of
the industry's discharge permit;
(2) Have access to and copy, at reasonable times,
any records that must be kept under the
conditions of the industry's discharge
permits;
(3) Inspect at reasonable times any facilities,
equipment (including monitoring and control
equipment), practices or operations regulated
or required under the industry's discharge
permit; and,
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(4) Sample or monitor at reasonable times, for
the purposes of assuring compliance with this
Ordinance or any applicable federal
pretreatment standards, any substances or
parameters at any location.
(e) The industrial discharger must comply with all
conditions of this Ordinance. Noncompliance with
any condition of this Ordinance is grounds for (a)
enforcement action, (b) discharge permit revision
or revocation or (c) the denial of a discharge
permit renewal application.
(f) The industrial discharger shall furnish to the
Department of Public Works or SERRA any
information which may be requested to determine
whether cause exists for modifying, revoking or
reissuing a discharge permit. The discharger
shall also upon request furnish to the Department
of Public Works SERRA copies of any records
required by the discharge permit to be kept.
(g) Wastewater discharge permits are issued to a
specific operation. A wastewater discharge permit
shall not be reassigned, transferred or sold to a
new owner, new user, different premises, or a new
or changed operation. In the event of any change
in name, ownership or control of the industry, the
discharger shall notify the Director of such
change. The Department of Public Works may upon
review, require the new owner or operator to
submit a new industrial discharge permit
application.
(h) In the event the discharger is unable to comply
with any of the conditions of the industrial waste
discharge permit due to: (a) breakdown of waste
treatment equipment; (b) accidents caused by human
error or negligence; or (3) other causes such as
acts of nature, the discharger shall notify the
Department of Public Works by telephone, as soon
as he or his agents have knowledge of the
incident, and confirm this notification in writing
within two weeks of the telephone notification.
The written notification shall include pertinent
information explaining reasons for the
noncompliance, and shall indicate what steps were
taken to correct the problem, and the dates
thereof, and what steps are being taken to prevent
the problem from recurring.
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(i) All wastes or sludges which are prohibited from
being discharged into public sewers including, but
not limited to, chemical solutions, acids, caustic
wastes, solvents, oil and grease, screenings,
sludges, and other solids removed from liquid
wastes, etc., shall be held in impervious
containers and disposed of at a legal point of
disposal, and in accordance with the provisions of
Division 7.5 of the California Water Code. For
the purpose of this requirement, a legal point of
disposal is defined as one for which waste
discharge requirements have been prescribed by a
Regional Water Quality Control Board, and which is
in full compliance therewith.
(j) Industrial dischargers identified as generators of
toxic solid wastes shall be notified by Department
of Public Works staff of applicable requirements
promulgated under the Solid Waste Disposal Act, as
amended, and the Resource Conservation and
Recovery Act and shall be referred to the State of
California Department of Health Services.
(k) Industrial dischargers shall comply with
applicable mandatory toxic waste and pretreatment
standards promulgated in accordance with Sections
307 and 308 of the Federal Water Pollution Control
Act, or amendments thereto. Within 180 days of
the date such pretreatment standards are
promulgated, industrial dischargers subject to the
standards shall submit a baseline monitoring
report to the Department of Public Works and to
the U.S. Environmental Protection Agency
detailing, in accordance with Section 403.12,
Chapter 40, Code of Federal Register, as amended,
the industry's compliance status with the
regulations. If the industry is in noncompliance,
the report shall include a time schedule outlining
how the industry will achieve compliance within
the date established for the applicable
pretreatment standards. Progress reports,
monitoring and reports of compliance shall also,
as required by Section 403.12, be submitted by the
discharger at the specified times.
Section 6-9.08. Self-monitoring and Reporting.
All Class 1 and Class 2 dischargers shall be subject to
the following self-monitoring and reporting requirements:
(a) Self-monitoring and reporting requirements for
each applicable discharger shall be determined by
the Director of the Department of Public Works
(permit issuing authority) and included in the
industry's discharge permit. The nature of the
sampling and frequency of analysis and reporting
shall be based on the size and nature --of the
discharge.
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(b) All sampling and analysis of wastewater shall be
performed in accordance with the applicable test
procedures approved by EPA at a laboratory
certified for such testing by EPA or the State
Department of Health Services.
(c) Dischargers subject to self-monitoring
requirements shall establish and maintain a
sampling port or chamber on each discharge line at
a location representative of the discharge to the
sewer. Sampling locations shall be approved by
the Department of Public Works.
(d) Self-monitoring programs shall, at the minimum,
consist of the following:
Class 1 Dischargers:
(1) Semiannual sampling and reporting for all
toxic constituents for which federal
categorical pretreatment standards exist.
Semiannual reports shall be submitted by June
30 and December 31.
(2) Reporting of average and peak discharge flow
rates during the specified reporting period.
(3) Any other sampling or reporting information
so required by the member agencies.
Class 2 Dischargers:
(1) Annual sampling and reporting for all toxic
constituents known to be in the discharge and
for which this Ordinance specifies effluent
limitations. Annual reports shall be
submitted by December 31.
(2) Reporting of average and peak discharge flow
rates during the specified reporting period.
(3) Any other sampling or reporting information
so required by the member agencies.
(e) Self-monitoring reports shall be signed by a duly
authorized representative responsible for the
overall operation of the facility from which the
discharge originates. Each report shall contain
the following declaration:
"I declare under penalty of perjury that the
foregoing is true and correct."
DATE
SIGNATURE
TITLE
MC
127,
(f) Records shall be maintained by industrial
dischargers subject -to -self-monitoring
requirements for a minimum of three years for:
(1) The date, exact place, method and time of
sampling and the names of the person or
persons taking the samples;
(2) The dates the analyses were performed;
(3) Who performed the analyses and the analytical
techniques used; and,
(4) The results of the analyses.
(g) The Department of Public Works staff shall review
all monitoring reports submitted by dischargers
and in a timely manner notify the discharger in
writing of the compliance status of the industry
with applicable effluent discharge standards.
Staff shall maintain a file of all dischargers
required to submit self-monitoring reports. The
file shall include the nature and required
submittal times of the required reports. If a
discharger is delinquent in submitting
self-monitoring information, the Department of
Public Works staff shall notify the delinquent
discharger in writing of the need to immediately
submit the monitoring information. Failure of the
discharger to submit self-monitoring information
after such notification constitutes a violation of
this Ordinance and is grounds for enforcement
action.
Section 6-9.09. Enforcement.
The City and SERRA shall enforce the industrial
regulations contained in this Ordinance in accordance with the
following:
(a) Compliance inspections of discharge permit holders
shall be regularly conducted by the Department of
Public Works staff. Reasonable efforts shall be
made to perform the inspections and conduct random
sampling of discharges semiannually for industries
subject to federal categorical pretreatment
standards and annually for all other industries
subject to self-monitoring programs. The
inspections shall: (1) monitor compliance of
dischargers with federal pretreatment standards
and the pretreatment ordinance prohibitions, (2)
evaluate the site potential for accidental spills
and recommend preventative measures, and (3)
insure that the industrial discharge operation is
in accord with the description of the industry
contained in the industry's discharge permit
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application. Random sampling by the Department of
Public Works shall be performed for wastewater
constituents for which the industry must sample
and analyze as part of a self-monitoring program.
Samples shall be analyzed at a laboratory
certified for such analyses.
(b) During compliance inspections, the Department of
Public Works industrial discharge inspector shall
record inspection observations and the results of
field tests on an inspection report form, noting
any violations. The inspection report form shall
be signed by a representative of the discharge
permitee and a copy of the form given to the
discharger. If analyses of wastewater samples
taking during the inspection reveal a violation of
applicable effluent discharge standards, the
discharger shall be notified in writing of the
violation and a follow-up inspection shall be
conducted.
(c) The Department of Public Works staff shall
investigate instances of noncompliance with
requirements of this Ordinance or federal
pretreatment standards as indicated by compliance
or other inspections, random sampling,
self-monitoring reports, or other surveillance.
Investigations shall be conducted with sufficient
care to produce evidence admissible in enforcement
proceedings or judicial actions.
(d) For violations or threatened violations which
constitute an imminent endangerment to the health
or welfare of persons, to the environment, or
causes interference with the operation of any
treatment plant (which shall be defined as
emergency violations), the Director shall take
immediate and effective measures to halt or
eliminate the violations or threatened violations.
In such cases, the Director may immediately and
without notice revoke on an interim basis the
offending industry's permit subject to a timely
_ decision on permanent revocation by the City as
provided in this Ordinance. If the threatening
discharge is not terminated after permit
revocation, the City legal counsel at the request
of the Director, shall take immediate legal
actions to enjoin the offending industry from
discharging.
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e! (e) For non -emergency discharge violations noted by
inspection or self-monitoring reports, the
Department of Public Works staff shall notify the
offending industry in writing of the violation,
requesting a response in writing from the industry
indicating why the violation occurred and what
corrective measures are being taken to insure that
the violation does not recur. The offending
industry shall respond to the request within 10
days of receipt of the violation notification.
(f) For a recurring violation, the Director may
require the discharger to submit for the
Director's approval a detailed time schedule of
specific actions which the user shall take in
order to prevent or correct such violation. Any
failure to comply with such an approved time
schedule shall constitute a violation of this
Ordinance. For violating dischargers, the City
Council may establish sur -charges on the
continuation of sewer service until such time as
the discharger has complied with the requirements
of this ordinance.
(g) If deemed necessary, the Director may order a
public hearing for the purpose of hearing
testimony on which to base a formal enforcement
action. Such a hearing shall be held by the
Director within 45 days of the date of serving
notice to the offending discharger. Although the
hearing need not be conducted in accordance with
technical rules relating to evidence and
witnesses, testimony taken at the hearing shall be
under oath and recorded stenographically. The
recorded hearing transcript shall be made available
to any member of the public or party to the
hearing at the cost of reproducing the transcript.
(h) After a public hearing, the Director or his
designate may revise discharge permit effluent
requirements, issue temporary effluent discharge
requirements, establish compliance time schedules,
temporarily or permanently revoke discharge
permits, or modify in any way discharge permits of
non -complying industries. Any actions taken by
the Director regarding permit revisions or
modifications shall be consistent with applicable
federal pretreatment standards.
(i) Requests to reestablish service subsequent to the
revocation of a permit and the termination of
sewer service shall be in the form of a new permit
application submitted with the appropriate fee.
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130
(j) In instances of repeated and uncorrected
violations, the Director or City Council shall
direct the City legal counsel to seek conjunctive
relief and or civil penalties against
non -complying industries. Civil penalties of a
sum not to exceed $6,000 for each day on which a
violation occurs may be sought by the City. The
City may also seek preliminary or permanent
injunction or both to restrain the continuance of
any violating discharge. In addition to the
penalties, the City may recover reasonable
attorneys' fees, court costs, court reporters'
fees and other expenses of litigation by
appropriate suit at law against the person or
discharger found to have violated this Ordinance
or any discharge permit issued hereunder.
(k) The names of industries in significant
noncompliance with federal pretreatment standards
shall be annually noticed by the City, in
accordance with EPA requirements specified in 40
CFR 403.8(f)(2)(vii), in the largest daily
newspaper published in the City.
(1) Upon notification by SERRA wastewater treatment
plant personnel or others that an illicit
discharge may be occurring within the City sewer
system, the Department of Public Works staff shall
take steps to locate and terminate the discharge.
(m) The Director shall submit to the SERRA Board of
Directors on a monthly basis a brief report
summarizing the pretreatment violations identified
and corrective measures taken by the City.
(n) The SERRA Board of Directors and its designates
shall have the authority to at any time assume any
enforcement powers established in this Ordinance.
Section 6-9.10
Appeals.
Any permit applicant or discharger affected by any
decisioZ, action or determination made by the Director regarding
implementing or interpreting the provisions of this Ordinance may
file with the Director a written request for reconsideration
within 10 days of any such action by the Director. The Director
shall rule on the request within 10 days of receipt thereof. If
the ruling on the request for reconsideration made by the
Director is unsatisfactory, the person requesting reconsideration
may, within 10 days after receipt of notification of the
Director's ruling, file a written appeal with the Secretary of
the City Council. A fee of $50.00 shall accompany any such
appeal to the City Council. This fee may be refunded if the
appeal is substained in favor of the appellant. The written
appeal shall be heard by the City Council within 45 days from the
date of filing. The City Council shall make a final ruling on
the appeal within 60 days from the date of filing. -
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13 1 Section 6-9.11. Fees and User Charges.
The submission of application fees is required as part
of all applications to the Department of Public Works for
industrial waste discharge permits, as follows:
Class 1 Discharger . . . . . . . $50.00
Class 2 Discharger . . . . . . . $25.00
Adjustments to these fees will be made by Council
resolution.
Section 6-9.12. Severability and Repeal.
If any section, subsection, clause, or phrase of the
Ordinance is for any reason held to be invalid or
unconstitutional, such decision shall not affect the remaining
portions of the Ordinance. This City Council declares that it
would have passed said Ordinance by section, subsection,
sentence, clause, or phrase thereof. All ordinances or parts of
ordinances inconsistent with the provisions of this Ordinance are
hereby repealed.
SECTION 2. Effective Date.
This Ordinance shall take effect and be in force thirty
(30) days after its passage.
SECTION 3. City Clerk's Certification.
The City Clerk shall certify to the adoption of this
Ordinance and cause same to be posted at the duly designated
posting places within the City of San Juan Capistrano within
fifteen (15) days after its passage.
PASSED, APPROVED AND ADOPTED this 5th day of
October , 1982 , by the following vote, to wit:
AYES: Councilmen Friess, Hausdorfer, Bland
Schwartze, and Mayor Buchheim
NOES: None
ABSENT: None
ATTEST:
ITY CLERK
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OWWCE F. BTYC14ffEIM,/MANOR
1 f2 4 1
PERMIT NUMBER
WASTEWATER DISCHARGE PERMIT
Assessor's Parcel No.
CLASS PERMIT
1. Applicant Business. Name
2. Address of premise discharging wastewater:
A. Street
3. Chief Executive Officer
A Name 8. Title
C. Moiling Address M City �. State
4. Person to be c3niocied about this permit:
A. Nome B. Title C Phone
AUTHORIZATION: The above applicant is hereby authorized to discharge wastewater to the
fewer system subject to the applicant's compliance with
and conditions:
and the following terns
S. Payment of the following fees and charges when billed by the District:
o. Permit Fee ,
. . . . . . . S—
►. Other Fees or charges
(. Submittal of sett -monitoring information in accordance with the attached reporting requirements and schedule.
7. The applicant shall report to any changes (permanent or temporary)
• to the premise or
operations that significantly change the quality or volume of the wastewater discharge or deviate from the terms
and conditions under which this Permit is granted.
B. EFFECTIVE DATE: EXPIRATION
Agency Official or Aut.,,d Agent
hIMI: Any pr rsoe aggrJvv,-d by any prnvisian of this prrmit has the right of appeal. Refer to Section t of
-----i ----- EXHIBIT A Page 1 of 8 -
3
PERMIT NUMBER
WASTEWATER DISCHARGE PERMIT
Assessor's Porcel No.
CLASS .PERMIT
a
MONITORING AND REPORTING REQUIREMENTS
The discharger shall submit self-eonitoring and reporting information in accordance with the following requirements
and schedule:
Page 2 of 8
IMR
Wastewater Discharge Permit Application
Part A - General Information
Tris opplicalion must be typewritten. ,
Return the completed application by:
Al. Applicant Business Name -
A2. Address of premise discharging wastewater:
{- A, Street .
A3. Business Address
A. Street
Member Agency Use I
Date Application Received
Assessor's Parcel No.
B. Mailing - "P
City State lip
P<. Chief Executive Officer .
A. Nam B. Till-
C -
ill G Moiling Address D. Gty State •dip
A5. Person to be contacted about this application
A. Name B. title C Phone
A6. Person to be contacted in case of emergency
A. Name B. Title
Day Phone Night Phone
A7. CERTIFICATION: I certify that the information above and on the following Paris is true and correct to the best of my
knowledge.
Return this application by the date indicated above to:
Ypnotvre . Dm
hint Name tilt.
Page 3 of 8
Wastewater uiscnarge vermir tAppticatvuri
Part B—Business Description
Purpose—The Business Description is primarily used to determine substances which may enter
Uifo the wastewater discholge from the Business, Activity. The production quantities are neces- Permit
wry for.State and Federal Reports.
No -
51. Business Activity—ICOmplete a separate Part B for each major business activity occurring on the premise.)
"T
ACTIVITY Sic
(a) Product:
IASr CAIENDAe YEAR pumw w✓ o..+.......
t►IB OF FROOUCTS (91 --4 N--1 A,M Amsunr Un1M
_. unih •.._ M...
(b) Description—Describe the wastewater generating operations. Indicate variations in production and opera-
tions during the year. (Use additional sheets as necessary)
_ (v Substances Proposed to be Discharged --Give common and technical names of any materials discharged or
proposed to be discharged to the sewer. Briefly describe the physical and chemical properties of each sub-
.r,.nre and product_
B2 Discharge Period oa. varmuon or perauon -
(a) Discharge occurs daily: from to Indicate whether the business activity is:
(b) Circle the days of the week that the discharge (' ) Continuous throughout the year, or
actin: 5 M T W T F S ( ) Seasonal --Circle the months of the year
which discharge occurs:
J F M A M J J A S O N D.
B4. Other liquid Wasics—list the type and volume of liquid wastes removed from the premises by means other than
Community srwrrs and dispnsal site.
D_cCIrpliaN _V011u4 1,14 PIMOVID BY I".— and —Id'—) DISPOSAL SITE
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f
Wastewater Discharge Permit Application _
C—Schematic Flow Diagram
PERMIT
Purpose - The Schematic Flow Diagram shows the flow pattern of products through the facility NUMBER
and the various sources of wastewater. This information will enable -
- to.assess the quality. rolume and peak flows of the discharge.
Schematic Flow Diagram—For each major activity in which wastewater is generated, draw a diagram of the flow of
_ moteriols and water from start to completed product, showing all unit processes generating wastewater. Number
Cacti unit process having discharges to the sewer. Use these numbers when showing this unit process in the
building layout in Part D.
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0
Wastewater Discharge Permit Application
Part D—Building Layout
PERMIT
� purpose - The 6utiding layout short the wastewater, generating operations which Contribute Co NUMBER. - --
j each building sewer. This building layout will also enable and the
epp/ieant to select suitable sampling locations for determining and verifying wastewater strength.
Wilding Layout—Draw to scale the location of each building on the premises. Show location of all water meters,*
storm drains, numbered unit processes (from Part Q, sewers and each building sewer. connected to the
sewer. Number each building sewer and show possible or existing sampling locations. --
Wastewater Discharge Permit Application
Part F—Building Sewer Discharge
Purpose—The Building Sewer Discharge information will. iddntifv the variation in flow rate Permit No.
and the type of constituents and characteristics of the discharge for each side sewer. Samplling
Fl. Building Sewer No. ----!From Part D) -
F2. Wostewote'r Flow Rate
PEAK NOUEIY
IAA%, DAIIY
ANNUM DAILY AVG. I
It RAGE AVN) PRC LONSI.Na
AVERAGE DAILY IaAllONS/D4Y)
9allanr/minora
9all.ns/day
90lbna/doy
I nal m_
not maa.
e
RAD
Radioactivity
AL
Aluminum
HC
s•
SE
Fj If Batch Discharge. Indicate:
o: Number of batch discharges- per month
L Time of batch discharges_ er w�U of py a �t Dn1
c. Average quantity per botch- gollons.
d. Flow Rate• gallons/minute_
F4. Wastewater Constituents—Indicate if any of the following constituents, characteristics or substances is or can
be present (X) in your wastewater discharge as a result of your. operations. -
COOL
CONSUME
[ODEky
UENTS 1
CODE
CONSTITUENTS
ALTAlgicides*
FORMA
e
RAD
Radioactivity
AL
Aluminum
HC
s•
SE
SeleniumNH3N
Ammonia
1-
AG
SilverSB
Antimony
FE
NA
SodiumArsenic
PB
SOLV
Solvents'Barium
MG
504=
Sulfate
$E
Beryllium
MN
S=T
Sulfide
B
Boron
HG
Mercury
S03=
Sulfite
7 BR.
Bromide
Mo
Molybdenum
MBAS
Surfactants MBAS
CD
Cadmium
NI
Nickel
TEMP
Temp. Increase 1+)
-CA -
Calcium
01G M
Oil & Grease 1Min. Orig.)
TEMP
Temp. Decrease I—)
CL2
Chlorine
O&G T
Oil & Grease (Tota;)
I I
Titanium
CL.
Chloride
PES TC
Pesticides-
SN
Tin
CR
Chromium
PH
pH Increase 1+1
V
Vanadium
CA
Cobalt
PH
pH Decrease (—)
TVA
Volatile Acids
Cll
Copper
PHENL
Phenols
-ZN
Zinc
CN-
Cyanide
P
Phosphorus
. F-
Fluoride
11 K
Potassium
"Identify the Chemical Compounds or Elements
Cornmentso-:.
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JL 41
PART F lCont'd)
• FS. Wastewater Slrenglh Estimates—Enter the average annual and maximum wnstewolcr strength for this building
for each of the following elements al wastewater strength for the period covered by the permit.
ALIV elrwnrANT nrVIATION FROM THESE VALUES CAN RESULT IN TERMINATION _OF THE PERMIT.
_ UNIt
IIIMINII a1 WA9FWATE4 P4[NLTN
1 AVFEALE 1 1 MAXIMUM
Suspended Solids mg/I Total Chemical Oxygen Demand mg/I Filtered Chem. Oxygen Demond mgJl
Grease mg/
LCL2D
Chlorine Demand (See Instructions) mg/I
eiuehemical OxygenDemand (Five.dayl mg/1
If data from a commercial laboratory was used to determine the values, please give me name urrV ..VV•=�. �•
the laboratory.
F6. Pollution Abatement Practices - - --
. U. Wastewater Pretreatment -Check the type of treatment, if any, given wastewater from this building sewer
before it is discharged to the District sewer:-
O none, ❑ holding tank, Q grease trap, Q oil and. water separator, ❑ grinding, ❑ sedimentation,
PH adjustment, ❑ biological treatment, ❑ screening, Q chlorination, or p other.
Description.
Describe the loading rates, design copodty, physical size, etc of each pretreatment facility checked above.
b. Planning Wastewater Pretreatment Improvements—Describe any changes in treatment or disposal methods
planned or under construction for the wastewater carried by this building sewer.
F7. Stormwaler Area - -
Total Area in square feet exposed to storm water and draining to this building sewer:
square reef.
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