The applicant shall provide the following information on or with the applicant portion of the discharge request form:

1. (a) The name, street address, and mailing address of the indirect discharger;
2. (b) The name, position, and daytime telephone number of a responsible individual at the indirect discharger, such as a plant manager, plant engineer, president, or vice president of the company, who has been authorized by the indirect discharger to certify the permit application as specified in Env-Wq 305.14(b);
3. (c) The North American Industry Classification System (NAICS) code of the indirect discharger and, if available, the SIC code(s);
4. (d) Whether the indirect discharger is subject to national categorical standards, and if so, which standards;
5. (e) Information on the proposed flow, including the estimated average, minimum, maximum and total daily flow for domestic discharges and each process discharge and the time and duration of those discharges;
6. (f) A schematic of the proposed pretreatment process;
7. (g) The name, company, and license number of the chemical, civil, sanitary, or environmental professional engineer (PE) authorized to work in New Hampshire under RSA 310-A who prepared the treatment system plans and specifications, if plans and specifications are being submitted for review;
8. (h) If applicable, plans, specifications, and operation and maintenance procedures for new or modified treatment facilities at the indirect discharger, stamped by the PE identified pursuant to (g), above;
9. (i) A schematic diagram showing the production process, including the origin of each waste stream;

10. (j) A list of pollutants expected to be present in the discharge and the anticipated quantity of each, based on:

    1. (1) Analyses of the waste stream(s) to be discharged, in which case test results shall be submitted with the discharge permit request; or
    2. (2) Knowledge of the process that produces the wastewater;
11. (k) If pretreatment is proposed, whether as a BMP or control technique or technology, performance results of the pretreatment as determined by testing or by the manufacturer;
12. (l) Information on the toxicity and treatability of the pollutants proposed to be discharged, as available from manufacturer’s testing, safety, and data publications;
13. (m) A map showing the location within the municipality of the indirect discharger with respect to the POTW;
14. (n) A listing of all chemicals used at the indirect discharger that will be or could be discharged, such as production chemicals, degreasers, and cleaning solvents;
15. (o) A description and location diagram of all sampling locations at the indirect discharger;

16. (p) A brief narrative describing those measures taken or planned to reduce water usage and implement pollution prevention techniques, if any, such as:

    1. (1) Flow restrictors;
    2. (2) Countercurrent rinses;
    3. (3) Recycling of non-contact cooling water;
    4. (4) Chemical substitutions; and
    5. (5) Pollutant source reduction; and
17. (q) A list of all environmental permits held by or for the indirect discharger.

Source. (See Revision Note at part heading for Env-Wq 305) #10381, eff 8-1-13; ss by #13241, eff 7-24-21