Fillable Preliminary Application For Wastewater Discharge Permit (City of Bethlehem)

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Preliminary Application For Wastewater Discharge Permit (City of Bethlehem)

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The Preliminary Application For Wastewater Discharge Permit (City of Bethlehem) form is 2 pages long and contains:

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  • 58 check-boxes
  • 31 other fields

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1
City of Bethlehem
Wastewater Treatment Plant Industrial Pretreatment Program
Preliminary Application for Industrial Wastewater Discharge Permit
All non-residential establishments proposing to discharge to the sanitary sewer system
must complete this form. The information submitted will be used to determine the need
to apply for an industrial waste discharge permit. Please return to:
Christian Torres
City of Bethlehem
Wastewater Treatment Plant
144 Shimersville Road
Bethlehem, PA 18015
1. Contact Information
Facility or Business Name
Mailing Address
Facility Location
Contact Person & Title
Telephone Number
Fax Number
Email Address
2. Standard Industrial Classification (SIC) Code(s)
North American Industry Classification System (NAICS) Code(s)
3. Average daily volume (gallons) of wastewater discharged.
Process
Non-contact cooling
Sanitary
Other (describe)
4. Describe each process that produces waste. Include the year in which discharge of each
process began. Attach additional sheets if necessary.
5. List all raw materials, process additives, cleaning materials, byproducts, etc. used or
generated at this facility. Attach additional sheets if necessary.
2
6. Describe any spill prevention and containment measures that are in place both inside and
outside this facility that may prevent any slug discharge releases into the sanitary or
stormwater sewer system. Attach additional sheets if necessary.
7. Describe the location of any sanitary sewer cleanouts, grease interceptors, and private
sanitary sewer manholes at the facility. Attach additional sheets and diagrams if necessary.
8. If any analysis has been performed on the wastewater discharge from the facility, please
attach a copy of the most recent laboratory report to this application.
9. Does this facility perform any operations which could be included in the following industrial
categories? Check all that apply.
☐Airport Deicing 449
☐Leather Tanning and Finishing 425
☐Aluminum Forming 467
☐Meat and Poultry Products 432
☐Asbestos Manufacturing 427
☐Metal Finishing 433
☐Battery Manufacturing 461
☐Metal Molding and Casting 464
☐Canned and Preserved Fruits and Vegetables Processing 407
☐Metal Products and Machinery 438
☐Canned and Preserved Sea Food Processing 408
☐Mineral Mining and Processing 436
☐Carbon Black Manufacturing 458
☐Nonferrous Metals Forming and Metals Powders 471
☐Cement Manufacturing 411
☐Nonferrous Metals Manufacturing 421
☐Centralized Waste Treatment 437
☐Oil and Gas Extraction 435
☐Coal Mining 434
☐Ore Mining and Dressing 440
☐Coil Coating 465
☐Organic Chemicals, Plastics, and Synthetic Fibers 414
☐Concentrated Animal Feeding Operations 412
☐Paint Formulating 446
☐Concentrated Aquatic Animal Production 451
☐Paving and Roofing Materials 443
☐Construction and Development 450
☐Pesticide Chemicals 455
☐Copper Forming 468
☐Petroleum Refining 419
☐Dairy Products Processing 405
☐Pharmaceutical Manufacturing 439
☐Electrical and Electronic Components 469
☐Phosphate Manufacturing 422
☐Electroplating 413
☐Photographic 459
☐Explosives Manufacturing 457
☐Plastics Molding and Forming 463
☐Ferroalloy Manufacturing 424
☐Porcelain Enameling 466
☐Fertilizer Manufacturing 418
☐Pulp, Paper, and Paperboard 430
☐Glass Manufacturing 426
☐Rubber Manufacturing 428
☐Grain Mills 406
☐Soap and Detergent Manufacturing 417
☐Gum and Wood Chemicals Manufacturing 454
☐Steam Electric Power Generating 423
☐Hospital 460
☐Sugar Processing 409
☐Ink Formulating 447
☐Textile Mills 410
☐Inorganic Chemicals Manufacturing 415
☐Timber Products Processing 429
☐Iron and Steel Manufacturing 420
☐Transportation Equipment Cleaning 442
☐Landfills 445
☐Waste Combustors 444
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Preliminary Application For Wastewater Discharge Permit (City of Bethlehem)

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Completed 21 July 2020

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