Ill. Admin. Code tit. 35, § 391.APPENDIX I
1. Climate Conditions:
2. Buffer Area Requirements
3. Soil and Geologic Conditions:
4. Interim Storage and Application Restrictions:
b. Off-site interim storage of dried sludge in excess of 2 months is not allowed.
________________________________________
I hereby agree to adhere to the above conditions.
All blanks other than the above sign-off shall be filled in by the sludge generator.
| 1. | Date: | ||||||||||||||||||||
| 2. | Name of User: | ||||||||||||||||||||
| 3. | Address of User: | ||||||||||||||||||||
| 4. | Phone Number of User: | ||||||||||||||||||||
| 5. | Location Where Sludge is to be Used: | ||||||||||||||||||||
| 6. | Size of Area Where Sludge is to be Used: | ||||||||||||||||||||
| 7. | Proximity of Site to closest: | (a) Stream or other body of water | |||||||||||||||||||
| (b) Dwelling | (c) Well | ||||||||||||||||||||
| (d) Other Water Supply, (describe) | |||||||||||||||||||||
| 8. | Amount of Sludge Obtained: | ||||||||||||||||||||
| (Specify units) | |||||||||||||||||||||
| 9. | Describe Use(s) of Sludge (e.g., Farmland or Agricultural, Garden, Yard, Reclamation of Nutrient Deficient Land, Other): | ||||||||||||||||||||
| 10. | Manner in Which Sludge is to be Applied (e.g., Spread by Truck or dry applicator, by Hand, Worked into the Soil by Plowing, Rototilling, Surface Application, Splash Plate, Knife injection, other): | ||||||||||||||||||||
| 11. | Will Sludge be Stockpiled Before Application: | Yes | No | (Circle One) | |||||||||||||||||
| 12. | Estimated Length of Time Sludge is to be Stockpiled: | ||||||||||||||||||||
| 13. | Type and expected yield of crops to be grown on sludge conditioned land: | ||||||||||||||||||||
| 14. | The soil pH of the land that I am applying sludge is: | ||||||||||||||||||||
| 15. | Limitations from Site Characteristics: | ||||||||||||||||||||
| 16. | Has sludge been applied to land within last 5 years? | Yes | No | (Circle One) | |||||||||||||||||
| Name of Generator | |||||||||||||||||||||
| Amount Applied | |||||||||||||||||||||
| Years Applied | |||||||||||||||||||||
SPECIFIC REQUIREMENTS FOR THE USE OF
WATER TREATMENT PLANT SLUDGE
The sludge that you are obtaining contains the following:
| Calcium Carbonate Equivalent | % | |||||||||||||
| pH | ||||||||||||||
| Barium (Ba) | lbs. per dry ton | |||||||||||||
| Cadmium (Cd) | lbs. per dry ton | |||||||||||||
| Copper (Cu) | lbs. per dry ton | |||||||||||||
| Lead (Pb) | lbs. per dry ton | |||||||||||||
| Nickel (Ni) | lbs. per dry ton | |||||||||||||
| Selenium (Se) | lbs. per dry ton | |||||||||||||
| Zinc (Zn) | lbs. per dry ton | |||||||||||||
To maximize the benefits of conditioning soils with sludge and minimizing possible adverse effects on the environment, it is required that the following provisions be adhered to: