Get Chemical Additives Notification Form - Pennsylvania Department Of ... - Files Dep State Pa

The Chemical Additives Notification Form is essential for notifying the Pennsylvania Department of Environmental Protection about the introduction of new or increased chemical additives. This guide provides clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to retrieve the form and open it for editing.
2. Begin by entering the Permittee Name and Permit Number. This identifies your facility and the relevant permit.
3. Next, provide the Facility Name, Municipality, and County to specify the location of the chemical additive usage.
4. Input the Trade Name of the Chemical Additive and the Manufacturer Name, which clarifies the specific additive being notified.
5. Clearly state the Intended Uses of the chemical additive, outlining how it will be utilized within the project.
6. Specify the Locations of Use, providing details on where the chemical additive will be applied.
7. Indicate the Frequency of Use, explaining how often the additive will be applied.
8. Describe the Method of Introduction, detailing how the additive will be introduced into the system.
9. Document the Treatment Following Introduction to describe the procedures that take place after the chemical is added.
10. Fill in the Discharge Point (Outfall No.) for accurate tracking of where the discharge will occur.
11. Report the Design Flow of Discharge in million gallons per day (MGD) to assess the volume of effluent.
12. Provide the Receiving Stream Name, identifying where the discharge flow will be directed.
13. Input the Q7-10 Flow of Stream in cubic feet per second (cfs) from relevant resources or calculations.
14. Calculate and enter the Calculated Water Quality-Based Effluent Limit (WQBEL) in mg/L, ensuring compliance with water quality standards.
15. Determine the Maximum Usage Rate for the chemical additive and attach necessary calculations to support your submission.
16. Answer whether Other Chemical Additives Will Be Introduced at the Same Time, selecting either 'YES' or 'NO'.
17. Finally, review the certification section, provide your Name/Title, contact Phone number, Date of submission, and Signature of either the Principal Executive Officer or Authorized Agent. Ensure all information is accurate.

Complete your Chemical Additives Notification Form online today to ensure compliance with Pennsylvania regulations.