Application to Discharge Non-Domestic Waste at the Iona Island Wastewater Treatment Plant Trucked Liquid Waste Facility

Transcription

1 Application to Discharge Non-Domestic Waste at the Iona Island Wastewater Treatment Plant Trucked Liquid Waste Facility Trucked Liquid Waste Form A - Authorization Application

2 This is an application for an Authorization to discharge Non-Domestic liquid Waste at the Iona Island Wastewater Treatment Plant trucked liquid waste facility. User fees are in place for Non-Domestic Wastes and the fees recover the operating expenses of the facility and the cost of treating the waste. The fees are prorated on the basis of 1000 litres (one cubic metre), and are reviewed on an annual basis. For information on the disposal fee, contact Metro Vancouver at You are advised that falsifying information on the application or to an employee of Metro Vancouver may result in rejection of the application and loss of use of the trucked liquid waste facility. Metro Vancouver may also initiate legal action as per the provisions in GVS&DD Sewer Use Bylaw No. 299, Please allow up to five working days for processing of completed applications, longer if a wastewater contaminant profile is requested. GENERAL INSTRUCTIONS Provide all required information. If you do not have an answer for the requested information, indicate so and explain why. Indicate n/a if a section does not apply to your application. Use additional pages, as required. Send the completed application form to the following address: Metro Vancouver Corporate Services Environmental Regulation and Enforcement Division 4330 Kingsway Burnaby, BC V5H 4G8 Telephone: (604) Facsimile: (604) Trucked Liquid Waste Form A - Authorization Application

3 CONTENTS Page SECTION A: Generator Information... 1 SECTION B: Business Activities, Manufacturing Processes or Site History... 1 SECTION C: Liquid Waste Treatment... 2 SECTION D: Liquid Waste Classification and Quality... 2 SECTION E: Hazardous Wastes... 4 SECTION F: Discharge Frequency and Volumes... 4 SECTION G: Carrier Information... 4 SECTION H: Declaration... 5 Trucked Liquid Waste Form A - Authorization Application

4 SECTION A: GENERATOR INFORMATION GENERATOR BUSINESS NAME (Registered Company Name): ADDRESS WHERE THE WASTE WAS GENERATED: Same as business address, or; GENERATOR BUSINESS ADDRESS: (Street) (City/Province) (Postal Code) (Street) (City/Province) (Postal Code) CONTACT PERSON REGARDING THIS APPLICATION: (Name) (Company Name) (Street Address) (City/Province) (Title) (Postal Code) (Telephone) (Fax) SECTION B: BUSINESS ACTIVITIES / PROCESSES / SITE HISTORY Summarize the business activities and/or manufacturing processes carried out that generated the liquid waste. For groundwater remediation sites, summarize the activities that contaminated the site. (use additional pages if necessary) Trucked Liquid Waste Form A - Authorization Application Page 1

5 SECTION C: LIQUID WASTE TREATMENT Describe the works and/or procedures, if any, that have or will be used to treat the liquid waste. (use additional pages, if necessary) SECTION D: LIQUID WASTE CHARACTERIZATION Use the check boxes to indicate whether the liquid waste contains any of the following types of wastes, as defined in Section 2.1 (Page 1) Schedule A of the Bylaw. WASTE TYPE Storm Water Uncontaminated Water Flammable Or Explosive Waste Water Causing Obstruction or Interference Waste Causing Air Pollution High Temperature Creating Waste (>65 C) Radioactive Waste Biomedical Waste Specified Risk Material for Bovine Spongiform Encephalopathy Don t Know Yes No Trucked Liquid Waste Form A - Authorization Application Page 2

6 SECTION D: LIQUID WASTE CHARACTERIZATION CONTINUED Indicate whether the liquid waste been sampled and tested for quality: Yes No Use the following tables to provide a characterization of the liquid waste. When present, please indicate or estimate the concentration of each contaminant before and after treatment. Provide laboratory analytical reports, if available. Please note that additional testing / characterization may be required. PARAMETER Biochemical Oxygen Demand Food Waste Particle Size (in centimeters) Oil And Grease (Hydrocarbons) ph Waste Radioactivity Total Oil And Grease Total Suspended Solids Total Aluminum Total Arsenic Total Boron Total Cadmium Total Chromium Total Cobalt Total Copper Total Iron Total Lead Total Manganese Total Mercury Total Molybdenum Total Nickel Total Selenium Total Silver Total Zinc Ammonia Chemical Oxygen Demand Chlorinated Phenols Conductivity Dissolved Organic Halogen Formaldehyde Styrene Total Cyanide Total Phenols Total Sulphate Total Sulphide Carbon Tetrachloride Tetrachloroethylene Total Benzene/Ethylbenzene/Toluene/Xylenes Total Polychlorinated Biphenyls Total Polynuclear Aromatic Hydrocarbons Trichloroethylene Vinyl Chloride Don t Know Trucked Liquid Waste Form A - Authorization Application Page 3 Yes No Before Treatment (Concentration or Range) After Treatment (Concentration or Range)

7 SECTION E: HAZARDOUS WASTES Indicate whether the liquid waste contains Hazardous Waste, either before or after treatment: Yes No If yes, list the criteria and concentrations in the liquid waste which classify it as Hazardous Waste, and detail the provisions taken to comply with Column 3 of Schedule 1.2 of the provincial Hazardous Waste Regulation. (use additional pages if necessary) SECTION F: DISCHARGE FREQUENCY AND VOLUMES 1. For how long is the TLW Authorization required? one day one week one month one year ongoing other: 2. If the term of the TLW Authorization is not ongoing identify the date(s) for disposal: from: to: day/month/year day/month/year 3. Expected frequency of disposal at the TLW facility during the Authorized term: once only daily weekly monthly annually other: 4. Expected volume of each load: m 3 SECTION G: CARRIER INFORMATION Provide the company name and contact information for the carrier who will be contracted to deliver the liquid waste to the Iona TLW facility. Please note that the carrier must have a current credit account with Metro Vancouver for use of Metro Vancouver TLW facilities. Carrier Company Carrier Contact Name Telephone Trucked Liquid Waste Form A - Authorization Application Page 4

8 SECTION H: DECLARATION An officer of your company or a duly authorized agent must sign this application form. I declare that the information given on this form is correct and accurate to the best of my knowledge. Name (please print) Title.. Signature.. Date If you elect to appoint an agent, please complete the following: I hereby authorize the following representative to deal with all aspects of the subject application. Name (please print) Title Affiliation Telephone Number Trucked Liquid Waste Form A - Authorization Application Page 5