Supplemental Permit Questionnaire
This form must be completed for NPDES Industrial Activity for any facilities that manufacture or process any of the following products or activities:
Timber Products; Paper and Allied Products; Chemical and Allied Products; Asphalt Paving, Roofing Materials and Lubricants; Glass Clay, Cement, Concrete and Gypsum Products; Primary Metals; Metal Mining (Ore Mining and Dressing); Coal Mines and Coal Mining Related Facilities; Oil and Gas Extraction and Refining; Mineral Mining and Dressing; Hazardous Waste Treatment, Storage, or Disposal Facilities; Landfills and Land Application Sites; Automobile Salvage Yards; Scrap Recycling Facilities; Steam Electric Generating Facilities; Water Transportation; Ship and Boat Building or Repairing Yards; Air Transportation; Treatment Works, Sewerage 1.0 MGD, Land Dedicated for Disposal; Food and Kindred Products; Textile Mills, Apparel, and Other Fabric Product Manufacturing, Leather and Leather Products; Furniture and Fixtures; Printing and Publishing; Rubber, Miscellaneous Plastic Products, and Miscellaneous Manufacturing Industries; Transportation Equipment, Industrial or Commercial Machinery; Electronic, Electrical, Photographic, and Optical Goods; Food Service Establishment; Commercial Facility with a Cafeteria; Non-Domestic Categorical Industry as defined by 40 CFR Parts 405-471; Groundwater Reclamation/Remediation Project; Photographic or X-Ray Equipment Installed; Discharges of Wastewaters other than Domestic or Boiler Blow-Downs; Wastewater flows greater than 25,000 gallons per day.
Supplemental Permit Application Form