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Indiana Department of Environmental Management

IDEM > Permitting > Water Permits > Wastewater Permits > Industrial Wastewater Permits > Industrial Permit Application Review Checklist Industrial Permit Application Review Checklist

Form 2C

Line drawing showing the flow of water into, through and out of thevarious processes that generate the wastewater.

List of outfalls showing the outfall number, Lat./Long., and receiving stream

List of outfalls showing the outfall number, the operation(s) contributing flow to that outfall, the average flow from that outfall, a description of the treatment applied to the wastewater generated from that outfall with the corresponding code from Table 2c-1 of the application.

List of intermittent or seasonal discharges per outfall which includes:

a. The outfall number

b. A description of the process contributing the wastewater flow

c. The frequency of the flow in days/week and months/year

d. The flow rate long term average and daily maximum

e. The total volume of flow long term average and daily maximum

f. The duration of the discharge in days

The production rate which is applicable to a process which is subject to an effluent guideline that is calculated based on the production rate.

The production rate is expressed in the quantity per day, the units of measurement, the product which is produced, and the affected outfalls.

A listing of treatment facility improvements which are required by any federal, state or local authority.

The improvements are described by: the condition or agreement to be achieved, the affected outfall(s), the source of the discharge by outfall, a brief description of the project, and the required and expected compliance dates.

A list of the pollutants listed in Table 2c-3 of the application which the applicant knows or has reason to believe is discharged or may be discharged through an outfall.

The applicants shall state why the pollutant is believed to be present and/or provide any analytical data which shows the pollutant to be present. (Most applicants don't provide this information)

A list of pollutants listed in Item V-C which is used or manufactured as an intermediate or final product or byproduct. (Most applicants don't provide this information)

A description of any biological toxicity tests which have been performed on any outfall or the receiving stream within the previous three years.

The name, address, phone number and list of pollutants analyzed by a contract lab for the analytical results listed in Item V of the application.

Name, title, phone number, signature and date signed by a responsible corporate officer or other authorized person who is filing the application.

Intake and Effluent Characteristics which include the following information:

a. Effluent analytical results for each pollutant describing the Maximum daily value, the maximum 30 day average, and the long term average including the number of analyses and the units of measure for concentration and mass.

b. Influent analytical results for each pollutant describing the long term averages for concentration and mass along with the number of analyses. (This is most useful when the applicant is applying for NET limits).

The applicant must provide analytical results for all pollutants listed in Part A.

The applicant must provide analytical results for all pollutants listed in Part B which they know or have reason to believe are present or for pollutants which are limited in an applicable effluent guideline.

The applicant must follow the instructions for Part C on page V-3 to determine if they must provide analytical results for the pollutants listed in Part C.

Form 2D

List of outfalls showing the outfall number, Lat./Long., and receiving stream

List of outfalls showing the outfall number, the operation(s) contributing flow to that outfall, the average flow from that outfall, a description of the treatment applied to the wastewater generated from that outfall with the corresponding code from Table 2c-1 of the application.

Line drawing showing the flow of water into, through and out of the various processes that generate the wastewater.

List of intermittent or seasonal discharges per outfall which includes:

a. The outfall number

b. A description of the process contributing the wastewater flow

c. The frequency of the flow in days/week and months/year

d. The flow rate long term average and daily maximum

e. The total volume of flow long term average and daily maximum

f. The duration of the discharge in days

The production rate which is applicable to a process which is subject to an effluent guideline that is calculated based on the production rate.

The production rate is expressed in the quantity per day, the units of measurement, the product which is produced, and the affected outfalls.

The applicant must provide analytical results for all pollutants listed in Group A of Table 2D-2 of the application.

The applicant must provide analytical results for the pollutants listed in Group B of Table 2D-2 which the applicant believes to be present in the discharge and for pollutants which are limited by an applicable effluent guideline.

A list of the pollutants listed in Table 2D-3 of the application which the applicant knows or has reason to believe is discharged or may be discharged through an outfall.

The applicants shall state why the pollutant is believed to be present and/or provide any analytical data which shows the pollutant to be present.

A list of the names and locations of existing facilities which resemble this facility with respect to production processes, wastewater characteristics and treatment.

Other information relative to any previous part of the application which the applicant believes should be brought to the attention of the permit writer.

The name, title, phone number, signature and date signed of the person who is filing the application.

Form 2E

The outfall number, Lat./Long., and receiving stream

The anticipated discharge date for a new discharger.

The type of wastewater and any water treatment additives used.

The applicant must provide analytical results for all pollutants listed in Part IV unless they obtain a waiver from us first.

A description of any intermittent or seasonal discharge.

A description of the wastewater treatment system.

Other information that the applicant believes should be brought to the attention of the permit writer.

The name, title, phone number, signature and date signed of the person who is filing the application.

Additional Information

Water Treatment Additives MSDS including aquatic toxicity information (LC50)

Zebra Mussel Controls