DEP7021B Form - SW - Application for a Special Waste ...



ENERGY AND ENVIRONMENT CABINET

DEPARTMENT FOR ENVIRONMENTAL PROTECTION

DIVISION OF WASTE MANAGEMENT

200 FAIR OAKS LANE, SECOND FLOOR

FRANKFORT, KY 40601

TELEPHONE NUMBER 502-564-6716

|Application for a Special Waste |

|Landfarming Facility Permit |

|Form DEP 7021B (5/13) |

Statutes and regulations may be viewed online at the following website address:

Solid waste application forms are available at the following website address:

GENERAL INSTRUCTIONS

1. APPLICABILITY - Use of this application - This form is an application for a landfarming permit to allow the Cabinet to determine if the proposed project is consistent with solid waste management area requirements and to review the potential effects on human health and the environment.

2. ASSISTANCE – Questions regarding this application form should be directed in writing to the Division of Waste Management at the address listed above or by calling (502) 564-6716.

3. SUBMISSION – Submit the original and two (2) copies of the completed application to the Division of Waste Management at the address listed above. If an item cannot be answered, leave it blank. If an item does not appear to be applicable to your application, write “N/A” for not applicable.

4. FILING FEES – Applicants must submit a filing fee at the time of application submittal in accordance with 401 KAR 45:250, Section 2.

5. LAWS AND REGULATIONS – Applicants are expected to understand and comply with all laws and regulations applicable to the facility.

To assist you in the submittal of a complete and accurate application, the DWM has identified the most common errors found during the review process. These errors are listed below for your convenience.

1. Failure to provide the appropriate fee.

2. Failure to complete all parts of the application.

3. Failure to comply with public notice requirements.

4. Failure to properly sign and notarize the application.

Warning! Due to the potential for identity theft, do not provide social security numbers to the DWM as part of this application. If this information is required during the normal course of review of the application, a cabinet representative will contact the appropriate individual to acquire this information in a secure format.

SPECIAL WASTE LANDFARMING FACILITY

PERMIT APPLICATION

Table of Contents

Page

A. General Information      

B. Ownership and Past Performance      

C. Waste Information      

D. Sludge Application Information      

E. Geologic Information      

F. Surface Water, Groundwater, and Corrective Action      

G. Permit Preparation Information      

H. Public Notice      

I. Certification      

Attachments

Attachments Page Number

1. Landfarming lease guidelines      

2. Property deed(s) or landfarming lease(s)      

3. Site(s) location (if needed)      

4. Financial assurance statement      

5. Past Performance Information (DEP 7094J)      

6. Application methods narrative (if needed)      

7. Waste storage provisions narrative (if needed)      

8 Two year application schedule and cropping plan      

9. Subplot boundaries narrative (if needed)      

10. Worksheet for calculating application rates      

11. Enlarged topographic map      

12. A. Narrative soil description(s)      

B. Narrative geologic description(s)      

C-1. Soil properties form      

C-2. Soil properties form      

13. Soil Analysis      

14. Narrative sampling procedures      

15. Fertilizer recommendations      

16. Groundwater quality assurance plan      

17. Run-on/Run-off control narrative      

18. A. Surface Water Monitoring Plan Narrative      

B. Surface Water Monitoring Plan Fact Sheet      

19. A. Groundwater Monitoring Plan      

B. Groundwater Monitoring Plan Fact Sheet      

20. Public Notice      

General Information

1. New Landfarm (If you check this item, skip items 2 and 3.)

Modification of existing landfarm (If you check this item, complete items 2 and 3.)

2. Agency Interest #:       3. Permit #:     -      

4. Fee Submitted: $      .  

5. Method of Payment:

Check Money Order

Cashier’s Check Exempt (Publicly Owned Facility)

Other – Explain:      

6. Check or Money Order #:      

Applicant Information

7. Permittee Name:      

(This refers to the corporation, LLC, business, person, government agency, etc., that owns or operates the facility.)

8. Permittee Mailing Address:      

9. City:       10. State:    11. Zip Code:      

12. Contact Person:       13. Title:      

14. E-Mail Address:      

15. Phone #: (     )     -      16. Cell #: (     )     -      17. Fax #: (     )     -     

Facility Information

18. Facility Name:       19. County:      

20. Facility Location:      

(Provide the street or physical location. Do not use P. O. Box #’s, etc.)

21. City:       22. Zip Code:      

23. Facility Contact:       24. Title:      

25. E-Mail Address:      

26. Phone #: (     )     -      27. Fax #: (     )     -      28. Cell #: (     )     -     

Preparer Information

(Complete items 29 – 35 if the following information concerning the person preparing this

application is different from the contact persons named in items 12 and 23.)

29. Preparer’s Name:       30. Company:      

31. Mailing Address:       32. City:      

33. State:    34. Zip Code:       35. E-mail Address:      

36. Phone #: (     )     -      37. Fax #: (     )     -      38. Cell #: (     )     -     

39. Applicant legal status: Government

Private

40. Do you now hold, or have you held, any other permit or approval to dispose of solid waste from the Division, including a landfarming permit, registered permit-by-rule, sludge giveaway, or permit modification to landfill? If so, state type, permit number if applicable, and date permit or approval was granted. If you have been granted approval to landfill your sludge, also indicate the landfill name and permit number.

If not applicable, check here.

|Type |Permit Number |Date of Approval |Landfill Name |Landfill Permit Number |

| |(if applicable) | |(if applicable) |(if applicable) |

|    |    |    |    |    |

|    |    |    |    |    |

|    |    |    |    |    |

|    |    |    |    |    |

|    |    |    |    |    |

|    |    |    |    |    |

|    |    |    |    |    |

41. Provide a copy of the property deed(s), or landfarming lease(s) if the applicant is not the property owner. Refer to the “Landfarming Lease” instructions in Attachment 1. The lease must conform to the “Landfarm Lease” in the back of application. Label as Attachment 2.

42. Describe the location of the proposed landfarming site(s), official mailing address and directions to the sites using highways and roads. Label as Attachment 3.

43. Provide a statement of financial assurance in accordance with 401 KAR 45:080. Label as Attachment 4.

Ownership and Past Performance Information

44. Indicate, by checking the appropriate blank, the legal organizational structure of the applicant.

Proprietorship

Partnership - General Limited

Corporation

Joint venture

Governmental agency - City County State Federal

Other – Describe:      

45. If the owner is a corporation, is it registered with the Kentucky Secretary of State?

Yes No

46. For the applicant and each person meeting the definition of key personnel, provide a Past Performance Information form as required by KRS 224.40-330(1) and (3). The Cabinet has developed form DEP 7094J for submittal of this information. Complete this form and submit it as Attachment 5.

Form DEP 7094J is available at the Division of Waste Management’s website

Waste Composition Information

(Repeat items 47 through 57 for each source)

47. Waste Source (Generator):      

48. Mailing Address:      

49. City:       50. State:    51. Zip Code:      

52. Phone #: (     )     -     

53. Facility Contact:      

54. Solid Waste Classification: Type A Type B

55. Daily design capacity of the plant (gallons per day)

Less than 1,000,000

1,000,000 -10,000,000

More than 10,000,000

56. Describe the Process to Significantly Reduce Pathogens, specified in 401 KAR 45:100 Section 11 that will be used under this permit:      

57. Total estimated quantity of waste to be disposed per year:

(Choose One)

      TONS or       GALLONS

Sludge Application Information

58. Method of Application:

Subsurface Injection

Surface Application without Incorporation

Surface Application with Incorporation

59. Provide, as Attachment 6, a narrative description of the application method, equipment, and transportation method from the point of waste production to the proposed site. The application method must address the rate and manner of discharge from the truck. The transportation method must state the estimated distance and predicted routes for hauling the sludge. Also describe the distance and route for transporting the sludge.

60. Provide, as Attachment 7, a narrative of waste storage provisions or alternate disposal methods to be used during adverse weather conditions or breakdowns of equipment. Address storage capacities and locations of structures including tanks.

61. Provide, as Attachment 8, the anticipated cropping program for each subplot and the schedule of waste application for each subplot for a period of two (2) years, and calculate an application rate for each crop grown. Complete the two year cropping plan provided in the back of this document as part of Attachment 8.

62. Provide the name, address, telephone number and certification number of the Kentucky certified landfarming operator(s) of the proposed landfarming site:

|Name |Address |Telephone Number |Certification Number |

|    |    |    |    |

|    |    |    |    |

|    |    |    |    |

|    |    |    |    |

63. Provide, as Attachment 9, a description of how the subplot boundaries shall be marked to ensure their identification during the life of the permit.

64. Determine the application rate for each crop/subplot, using the forms provided, labeled as Attachment 10. Use the average of the sludge analysis submitted in the Notice of Intent to Apply for completing the formulas.

Geologic Site Information

65. Provide, as Attachment 11, an enlargement of a current United States Geological Survey topographic map. The enlarged map shall have a minimum scale of one (1) inch equals four hundred (400) feet and the contour interval as published. This map shall contain the following:

(a) The property lines and boundaries of the proposed site.

(b) Proposed land application unit and subplots, numbered sequentially, within the land application boundary;

(c) Access and proposed or existing roads;

(d) Streams, areas of standing water such as lakes, ponds, or marshes, and sinkholes within 1,000 feet of the proposed site boundary;

(e) All existing manmade features within 1,000 feet of the proposed site boundary including structures, public roads, utilities, and water wells;

(f) The boundaries of one hundred (100) year floodplain if applicable;

(g) The delineation of existing site surface water drainage, and existing and proposed run-off/run-on structures;

(h) Steepest slope of each sub-plot (numerical value) on the proposed landfarming site;

(i) Boundaries of any and all buffer zones with the distance marked;

(j) Proposed surface and groundwater monitoring locations; and

(k) Map legend showing all symbols used, total site acreage, and quadrangle name.

66. Provide, as Attachment 12, a narrative soil and geologic description of the proposed site. Include:

(a) A physical description of the soils in the uppermost five (5) feet. Soils information may be obtained from a current USDA Soil Conservation Service Soil Survey or a field investigation.

(b) The surface and subsurface geology including depth to bedrock, depth to seasonal high groundwater table, karst formations, and names and descriptions of geologic formations.

(c) Complete Attachments 12C-1 and 12C-2, entitled “Soil Properties”.

67. Provide a copy of a current soil analysis from each proposed subplot. Parameters must include: pH (both water and buffer), total phosphorus, total potassium, cadmium, copper, lead, nickel, zinc, cation exchange capacity (CEC) and polychlorinated biphenyls (PCBs). Label as Attachment 13. The soils analysis for pH must be recent (within 6 months) and from each subplot. The sample must be a composite of at least three (3) plugs per acre and represent a subplot of no more than 20 acres. The applicant may choose another sampling plan, in writing, from the USDA Soil Conservation Service or county extension agent.

68. Describe procedure and equipment used to collect soil, samples. Label as Attachment 14.

69. Provide, as Attachment 15, written fertilizer recommendations from the county agricultural extension agent for crop nitrogen, phosphorus, potassium, and lime requirements.

70. Submit a groundwater quality assurance plan as Attachment l6. The plan shall include:

a. A Groundwater Quality Assurance Plan. The Plan must include a narrative description of geology/hydrology of the area based on a survey of existing information and a reconnaissance of the site. This should include a description of geologic units, noting any potential water bearing units, any confining units, structural dip, and potential groundwater flow direction based on topography and dip.

b. A description of the surface and subsurface geology of the site; and

c. A description of the hydrologic characteristics of the site.

Note: Applicants with Type A sludge shall also submit a groundwater monitoring plan as Attachment 19, to include location and specification of wells, monitoring parameters, and monitoring schedules in accordance with 401 KAR 45:160.

71. Describe how surface precipitation runoff/run-on shall be controlled to minimize the possibility of applied solid waste contaminating nearby surface water or adjacent land areas. Label as Attachment 17.

Surface Water, Groundwater, and Corrective Action

72. Provide, as Attachment 18A, a Surface Water Monitoring Plan as required by 401 KAR 45:160. At a minimum, the plan must include:

a. The proposed locations of the monitoring points shown on the site plans.

b. A written description of how the monitoring point locations ensure that the sampling will characterize the quality of water unaffected by the landfarming facility, as well as determining if the water leaving the landfarming facility as surface drainage is contaminated with leachate.

c. A description of sampling protocol and analytical parameters.

d. A monitoring schedule and list of analytical parameters.

e. A sample form for reporting results of the analyses to the Division.

f. Documentation that the applicant currently holds or has applied for a KPDES permit for all structures to be used to control storm water runoff and all point source discharges.

g. Complete Attachment 18B regarding the location of monitoring points.

73. Submit, as Attachment 19A, a Groundwater Monitoring Plan that meets the requirements of 401 KAR 45:110 and 401 KAR 45:160. At a minimum, the plan must provide the following information:

a. A list and description of the specific aquifer(s) proposed for monitoring

b. The number, location, and depth of proposed monitoring points. Show the location of the point on the site plan.

c. Provide a brief discussion of the groundwater quality that currently exists based on the Groundwater Quality Characterization required in 401 KAR 45:160.

d. Provide a Groundwater Sampling and Analysis Plan which describes the procedures and techniques designed to accurately measure groundwater quality upgradient and downgradient of the waste disposal area. Include a discussion regarding the chain of custody as well as field and lab quality assurance and quality control.

e. Provide a monitoring schedule and list of analytical parameters in accordance with 401 KAR 45:160, Section 8.

f. Provide monitoring well construction specifications which meet the requirements of 401 KAR 45:160, Section 3.

g. Is the proposed special waste disposal site located in karst terrain? Yes No If “Yes”, the Groundwater Monitoring Plan must include dye trace studies to determine the nature and extent of the karst drainage beneath the site and proposed monitoring locations.

h. Provide a completed Attachment 19B concerning proposed well locations and depth.

Public Notice

74. Public notices shall be required for Type A landfarming facilities and may be required for Type B facilities in accordance with 401 KAR 45:100, Sections 2 and 3. A draft notice is found in Attachment 20. Complete the public notice form; however, only those applicants notified by the Cabinet may publish the notice.

Certification

75. Pursuant to 401 KAR 45:030, Section 10, a person with signature authority such as a sole proprietor, owner, partner, corporate officer, plant manager, LLC member, mayor, county judge-executive, or other authorized official must sign this certification statement.

NOTE: Consultants may not sign the following certification statement.

“I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for such violations.”

Name of Person Signing (type or print):      

Title of Person Signing:      

Date:    -    -     

Signature per 401 KAR 45:030_________________________________________________

Subscribed and sworn to before me this ______ day of ________________, Year 20____

Notary Public Signature: ___________________________________________________

State of _____ County of ________________ My commission expires: ______________

ATTACHMENT 1

Landfarming Lease

The following items must be addressed in the landfarming lease:

1. A statement that the area of land covered under the lease will receive treated municipal sewage.

2. A brief description of the site location and a map showing the boundaries of the proposed application zones.

3. The following restrictions pursuant to 401 KAR 45:100:

a. Tobacco show not be raised or harvested on land where wastewater treatment plant sludge has been applied within one (1) year.

b. Dairy cattle (cows and heifers) or any lactating animals may not graze for six (6) months after the application of wastewater treatment plant sludge. Other livestock may not graze for three (3) months after application of wastewater treatment plant sludge.

c. Leafy vegetables and root crops for direction human consumption shall not be harvested within twelve (12) months of wastewater treatment plant sludge application. Other crops (i.e., corn, wheat, or grain crops) for direct human consumption shall not be harvested within two (2) months of wastewater treatment plant sludge application.

d. The general public shall not be allowed on land where sludge has been applied for a period of twelve (12) months.

e. If soil monitoring indicates cumulative concentrations of contaminants greater than that allowed by regulation, a notice shall be recorded in the deed stating that the land has received concentrations exceeding permitted levels and that food chain crops shall not be grown due to possible health hazards.

f. A farm cropping plan is required for each subplot where sludge is to be applied. The farmer must notify the permit holder of any cropping change and the permit holder must in turn notify the Division. The landowner agrees to harvest crops as indicated in the application and/or any permit modifications.

4. A two year right of reentry following closure of the landfarming site to allow the lessor or representative of the Division to conduct any observations, tests, or monitoring which may be needed.

5. Language that addresses the terms established between the landowner and the lessor for termination of the lease agreement.

ATTACHMENT 8

Two year application schedule and cropping plan

|Year |Months |Subplot # |Acres |Sludge |Method of application |Crop |

| | | | |gallon/acre dry | | |

| | | | |tons/acre | | |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

|     |      |    |      |      |      |      |

ATTACHMENT 10

Worksheet for calculating application rates

Subplot:     Crop:      

For column B below, use the average of last year’s sludge analyses or the two (2) most recent analyses used for classification of sludge as Type A or B.

|A. Parameter |B. Dry Weight, ppm |C. |D. Percent |

|1. Total Kjeldahl Nitrogen (TKN) |      |÷ 10,000 = |     % (D1) |

|2. Ammonium Nitrogen (NH4N) |      |÷ 10,000 = |     % (D2) |

|3. Nitrate Nitrogen (NO3N) |      |÷ 10,000 = |     % (D3) |

|4. Total Phosphorus |      |÷ 10,000 = |     % (D4) |

|5. Total Potassium |      |÷ 10,000 = |     % (D5) |

1. Percent Available Organic Nitrogen

|% TKN (D1) | | %NH4N (D2) | | %NO3N (D3) | |% Available Organic Nitrogen |

|     |- |     |- |     |= |     % |

2. Available Nitrogen in Waste

a)Incorporation:

|%NH4N (D2) x 20 | |%NO3N (D3) x 20 | |% Available N x 4 | | lbs available N/ton |

|     |+ |     |+ |     |= |      |

b) Surface Application:

|%NH4N (D2) x 10 | |%NO3N (D3) x 20 | |% Available N x 4 | | lbs available N/ton |

|     |+ |     |+ |     |= |      |

3. Residual Nitrogen (Calculate using Residual N worksheet):     

4. Annual Application Rate:

|Crop N requirement | | Residual N | |lbs Available N/ton | |Dry tons per acre |

|      |- |      |÷ |      |= |      |

a)

|Cd limit per regulation | |mg/kg Cd in biosolids x | |Dry tons per acre |

| | |0.002 | | |

|0.44 lbs of CD/acre |÷ |      |= |      |

b)

Annual application rate (Lower of either a or b above):       (D6)

5. Conversion Formula: Dry Tons to Gallons

|dry tons per acre (D6) | |percent solids /100 | |wet tons per acre |

|      |÷ |     |= |      |

a)

|wet tons per acre | | | | | |gallons per acre |

|      |x |2,000 lb/ton |÷ |8.34 lbs/gallon |= |      |

b)

6. Additional Phosphorus and Potassium needed:

a) Phosphorus (P2O5) in waste:

|dry tons per acre (D6) | |% P in waste x 45.8 | |lbs P2O5 per acre added from sludge |

|      |x |      |= |      |

b) Additional P2O5 fertilizer needed:

|total P2O5 needed per acre | |lbs P2O5 per acre added from | |additional lbs P2O5 needed |

| | |sludge | | |

|      |- |      |= |      |

(A negative answer for this formula means no additional phosphorus fertilizer is needed.)

c) Potassium (K2O) in waste:

|dry tons per acre (D6) | |% K in waste x 24 | |lbs K2O per acre added from sludge |

|      |x |      |= |      |

b) Additional K2O fertilizer needed:

|total K2O needed per acre | |lbs K2O per acre added from | |additional lbs K2O needed |

| | |sludge | | |

|      |- |      |= |      |

(A negative answer for this formula means no additional potassium fertilizer is needed.)

Nitrogen required – (lbs available N/Ton x maximum tons of waste to be applied per acre) = lbs of additional fertilizer nitrogen per acre. Additional nitrogen may be needed if the annual application rate is limited by cadmium.

7. Maximum Amount of Waste Allowable per Acre:

Obtain maximum amount of Pb, Cd, Cu, Ni, and Zn allowed from the following table. If sludge has been previously applied, calculate the remaining lifetime limits by subtracting the total amount of each metal previously applied from the maximum allowed.

|Maximum Amount of Metals Cation Exchange Capacity |

|(meq/100g) |

|Parameter |0-5 |5-15 |15+ |

|Lead |500 lbs/ac. |1000 lbs/ac. |2000 lbs/ac. |

|Cadmium |4.46 lbs/ac. |8.92 lbs/ac. |17.84 lbs/ac. |

|Copper |125 lbs/ac. |250 lbs/ac. |500 lbs/ac. |

|Nickel |50 lbs/ac. |100 lbs/ac. |200 lbs/ac. |

|Zinc |250 lbs/ac. |500 lbs/ac. |1000 lbs/ac. |

|Amount Cd allowable per acre | |Dry mg/kg of Cd in biosolids x | |Tons of waste per acre |

| | |0.002 | | |

|      |÷ |      |= |      |

|Amount Cu allowable per acre | |Dry mg/kg of Cu in biosolids x | |Tons of waste per acre |

| | |0.002 | | |

|      |÷ |      |= |      |

|Amount Pb allowable per acre | |Dry mg/kg of Pb in biosolids x | |Tons of waste per acre |

| | |0.002 | | |

|      |÷ |      |= |      |

|Amount Ni allowable per acre | |Dry mg/kg of Ni in biosolids x | |Tons of waste per acre |

| | |0.002 | | |

|      |÷ |      |= |      |

|Amount Zn allowable per acre | |Dry mg/kg of Zn in biosolids x | |Tons of waste per acre |

| | |0.002 | | |

|      |÷ |      |= |      |

8. Number of years that waste can be applied:

|Lowest amount in tons of waste per acre from | |Tons waste applied per acre per | |Life of facility in number of|

|above | |year | |years |

|      |÷ |      |= |      |

RESIDUAL NITROGEN WORKSHEET

Calculations should be completed for each sub-plot which has received sludge

|Years since last |Organic nitrogen content of sludge |

|application | |

| |2.0 |2.5 |3.0 |3.5 |4.0 |4.6 |

| |Lbs N released per ton of sludge added |

|1 |1.0 |1.2 |1.4 |1.7 |1.9 |2.2 |

|2 |0.9 |1.2 |1.4 |1.6 |1.8 |2.1 |

|3 |0.9 |1.1 |1.3 |1.5 |1.7 |2.0 |

One year ago:

|Lbs N released per ton of sludge added | |Tons sludge applied | |Residual N (one year) |

|      |x |      |= |      (RN1) |

Two years* ago:

|Lbs N released per ton of sludge added | |Tons sludge applied | |Residual N (two years) |

|      |x |      |= |      (RN2) |

Three years* ago:

|Lbs N released per ton of sludge added | |Tons sludge applied | |Residual N (three years) |

|      |x |      |= |      (RN3) |

Total residual nitrogen:

Sum of RN1+RN2+RN3 =      

*NOTE: To calculate residual nitrogen for years 2 and 3, if necessary, you must find the organic nitrogen content of the sludge from each year. Refer to your previous annual review.

ATTACHMENT 12C-1

Soil Properties Form

|Soil Properties within 60” of |Series 1 |Series 2 |Series 3 |

|surface | | | |

|Soil series |      |      |      |

|USDA map symbol |      |      |      |

|Covers approximate % of whole area|     |     |     |

|Erodibility potential |      |      |      |

|Drainage class |      |      |      |

|Depth to bedrock in inches |     |     |     |

|Depth to seasonal high water table|     |     |     |

|in inches | | | |

ATTACHMENT 12C-2

Soil Properties

The source of this information is the narrative geologic description of the site

|PROFILE INFORMATION |SERIES 1 |SERIES 2 |SERIES 3 |

|Horizon number |1 |2 |3 |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

ATTACHMENT 19B

GROUNDWATER MONITORING WELL FACE SHEET

LOCATION AND DEPTH

Provide the information requested in the chart below:

|Monitoring station ID |Latitude in decimal |Longitude in decimal |Station type (well or |Aquifer |Elevation of spring or |Depth |Depth of water |

| |degrees |degrees |spring) | |top of well casing (ft) | | |

|      |      |      |      |      |      |      |      |

|      |      |      |      |      |      |      |      |

|      |      |      |      |      |      |      |      |

|      |      |      |      |      |      |      |      |

|      |      |      |      |      |      |      |      |

|      |      |      |      |      |      |      |      |

ATTACHEMENT 20

PUBLIC NOTICE

Pursuant to application number:      

The Energy and Environment Cabinet, Division of Waste Management, Solid Waste Branch has received a special waste landfarming facility permit application from

      for the following facility:

(name of applicant)

     

(name of facility)

     

(street address)

      ,       ,      

(city, state, zip code)

This application, if approved, would allow the construction of the landfarming facility to accept the following types of waste and the following activities:

     

The proposed facility may be accessed from       by travelling

(nearest town or city)

     

(directions to facility)

Additional information regarding this application may be obtained from

     

(contact person)

     

(mailing address)

      ,       ,       or by telephone at      

(city, state, zip code)

The permit application is being processed at the following location:

Division of Waste Management

Solid Waste Branch

200 Fair Oaks Ln, 2nd Floor

Frankfort, Kentucky 40601

Within 30 days of the publication of this notice, any person who wishes to comment on the application may submit written comments, and, if desired, request from the Cabinet a public meeting. Please refer to Application No.       and Agency Interest No.       on all correspondence. Publication of this notice is pursuant to 401 KAR 45:050.

-----------------------

DWM OFFICAL USE ONLY

AI#: ____________ Application #: ________________________

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