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'»toi"Ti Or.rn.if <br />Dom storm water (atonn water and anew msK ninoff, aurfaea runoff, and diaeharea rosuk Jng from | <br />pradpitellon) drain off tha aMa7 <br />If yea, provide tbe name of the neareit wat» body (hkt, rfver, stream, vmamed wetland itons. watar fbet dralni ime <br />00 DNo <br />«aC^i,<kJb <br />Non-Storm Wotrr Dr:.chnigc^. rmd Pormtts <br />1. Doaa the alto or teelifty have any other NP0E8/SDS permit (for discharge of waataw iter), a • <br />Haaardoue Waste Oonerator 10 • or any other type of MPCA permit? <br />■If yea, indicate: Typeofpennit Permit or ideotifiwtimaainber <br />□Yea □No <br />I <br />1. Does tha site or teellltydiaeharganoncontaetceenngwaier(a.g. water used in poerargoneratlofi 0X00 BNa <br />and refrigeration, etc.)? <br />If yea, rdwre does noncontact cooling water discharge to7 (check an that apply) <br />G Municipal storm Mwer □ Sanitary sewer n Septic tauk/draJn field □ OUier. indicike where wder diadiargea to <br />(dtteh, detention pend, etc). <br />3. Does the site or fSollltydIaehargeproeaas wastewater (e.g. water ueed In an industrial process-. □Yes pNe <br />food or othsr produel wsahing)? <br />If yes. ^irfiere doai proosM wastewater discharge to7 (cheek al) teat apply) <br />n Muaicipal atonn sewer G Sanitary sewer Q Septic tartk/drain field G Other, indicate' where watar fischasgea to <br />' (ditch, detents. H pond, etc). <br />PiOM"foi Afiplyifig tor «t Pi rmit nr L Apo'j>urf? Cntificjlum <br />1. Deaertee tha primary acttvlty at lha site or facility (whet are die prfne/pel produeta areenttcee). <br />Indicate the Standard loduatrial Oasaificatioo (SIC) code for 1)uU activily <br />(see qppUcatlOH Inspvctlens /or a list of all aetfvities and SICcodei(). <br />Ptimarv: <br />Secoodaiy: <br />2. la tha primary aefivily or SIC code you indicated in questton 0.1. Hated under the Itet <br />of primary activUloa and/or SIC eodta In tha application tnatruedona? <br />(Ifeppheeble) <br />□Uatad <br />□Not Listed <br />If not listed, pctmit ewversgc is not req;uixed for your site. Skill to part H and sip the Owner TOpanter CtitifieaiiaB, <br />iSfCAtnentmeiSnmWmwHme/^famSen <br />I