HomeMy Public PortalAboutEquivalent Concentration Limits RequestRev. 01/29/2013
REQUEST FOR USE OF
EQUIVALENT CONCENTRATION LIMITS
IN LIEU OF MASS LIMITS
Facility Name:
Premise Address:
Regulated process for which equivalent
concentration limits are requested:
40 CFR Part
Subpart
Describe regulated process:
Average daily regulated discharge volume (gal.):
Maximum daily regulated discharge volume (gal.):
Provide a detailed explanation of why the above level of process water is used and/or discharged,
including an explanation for the difference between average and maximum daily discharge
volumes, or any other variability (attach schematics, diagrams, and additional sheets as needed):
Certification: I certify that equivalent concentration limits are not currently being and will not
subsequently be met through the use of dilution or by-pass as a substitute for
treatment.
I further certify under penalty of law that this document and all attachments were
prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system,
or those persons directly responsible for gathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fine and imprisonment for knowing
violations.
Name of Authorized Facility Representative:
Title:
Signature:
Date: