Get Application Form (form 4223) - Ohio Epa - Epa Ohio
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How to fill out the Application Form (Form 4223) - Ohio EPA online
This guide provides a comprehensive overview of how to accurately complete the Application Form (Form 4223) for the Ohio Environmental Protection Agency. Following this step-by-step process will help ensure that all necessary information is correctly submitted for your permit application.
Follow the steps to successfully complete the application form.
- Press the ‘Get Form’ button to access the application form and open it in the editing tool.
- Identify the permit action you are applying for by selecting one of the options: New, Renewal, or Modification. If you are applying for a renewal, please provide the current permit number.
- Fill in the waste water source by selecting either Proposed or Existing.
- Provide your Company Name and the Contact Name along with their Title.
- Complete the Mailing Address section, including City, State, and Zip Code.
- Fill in the Billing Address if it is different from the Mailing Address and include the Contact Person and their Title.
- Enter the Facility Name and its Address, providing the Latitude and Longitude coordinates.
- Include the Facility Contact Name, Title, Telephone Number, and FAX number.
- Indicate the Publicly Owned Treatment Works (POTW) receiving the wastewater discharge.
- Describe the products manufactured, services performed, and materials used at the facility.
- State the number of production days per week and the number of employees per shift, specifying the number of shifts per day and hours for each shift.
- Provide a description of the wastewater treatment system in place at the facility.
- Describe the discharge location, specifying the manufacturing process and flow rates (average and maximum), whether the discharge is continuous or batch, and the frequency of batch discharge.
- Answer if residuals or sludges are generated during the process and provide details if applicable.
- If applying for a new permit or modification, confirm if a Permit to Install was obtained and provide the PTI number if available.
- For modification requests, detail the modifications being requested and attach additional sheets if necessary.
- Indicate if the facility is regulated by other environmental permits and list them if applicable.
- Review all completed information for accuracy.
- At the final step, you can save any changes, download, print, or share the completed form as needed.
Complete your Application Form (Form 4223) online to ensure timely processing of your permit.
Related links form
To report a spill in Ohio, contact the Ohio EPA’s emergency response team immediately. Provide them with essential details such as the location, type of material spilled, and any potential impact on the environment. Quick reporting can help mitigate the effects of the spill on both health and ecology. For formal documentation, consider using the Application Form (Form 4223) - Ohio EPA - Epa Ohio to submit your report.