HomeMy WebLinkAbout20022844.tiff % ; n c o Fu kev sVr-4
DEPARTMENT OF PLANNING SERVICES
1555 N. 17th Avenue, Greeley, CO 80631
/'-% Phone(970)353-6100, Ext. 3540, Fax(970)304-6498
USE BY SPECIAL REVIEW APPLICATION Vida Yi/O/
Application Fee Paid t I(oo — Receipt# 'g-1 Date .514 Jcr..-
Recording Fee Paid Receipt# Date
Application Reviewed by: (Go
TO BE COMPLETED BY APPLICANT: (Please print or type, except for necessary signature)
LEGAL DESCRIPTION OFS9POEOCIA ZREVIEW PERMIT AREA:0012 2 digiF+umber-fo found on Tax I.D.T
PARCEL NUMBER: 08
Information or obtained at the Assessor's Office.
Section /f ,T 6 N, R 64 W-Total Acreage 80 Zone District 4 Overlay Zone E-i
airport overlay
Property Address(if available) 97549 Wet d County Road Si
Proposed Use Portable restroom business
SURFACE FEE(PROPERTY OWNERS)OF AREA PROPOSED FOR THE SPECIAL REVIEW
PERMIT
Name: Raymond Lahr t. fl hki1J c)I n Address:. 32549 Weld County Road 51
City/State/ZipGreeley, Co.8063Home Telephone:970-356-489Beeusiness Telephone 970-346-0479
Name: Dorthula tohr Address: 32549 Weld County Road 51
City/State/ZipGreeley, Co.8063Home Telephone:970-356-489Business Telephone 970-346-0479
APPLICANT OR AUTHORIZED AGENT(if different than above)
Name:
Address: City/State/Zip:
Home Telephone: Business Telephone:
DEPARTMENT OF PLANNING SERVICES USE ONLY
Case#
Floodplain: ❑ Yes o No Geologic Hazard: o Yes O No
I hereby state that all statements and plans submitted with the application are true and correct to the best
of my knowledge. j1
2
Rev: 14-01 Siighare:: Owner or Aut =• Ai
�� / d on nt
1
2002-2844
n
FOR COMMERCIAL SITES, PLEASE FILL OUT THE FOLLOWING INFORMATION
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BUSINESS EMERGENCY INFORMATION:
Business Name: Country Johns Phone: 970-346-0479
Address: PO Box 27, Gill. Colorado 80624
Business Owner: Lohr Inc. Phone: 970-346-0479
Home Address: 32549 Weld County Road 51 City: Greeley
List three persons in the order to be called in the event of an emergency:
NAME TITLE ADDRESS PHONE
Raymond lohr owner 32549 Weld County Road 51 970-356-4896
Rodney Lohr owner 36616 Wcld County Road 55 970 4;4 207G
Mike Lohr owncr 30350 Skid Ca.,.ty R.1 dGGC 970-353 7730
Business Hours: 7 am-4 pm Days:Mon-Fri
Type of Alarm* one 13urglar Holdup Fire Silent Audible
Name and address of alarm company:
Location of Safe: None
It******+ear*e***f**** wwm,**er***t»f nit********eert+*»*eIeeIe*ti:*a*f*fv******:ferewf*ertif�++v*+
MISCELLANEOUS INFORMATION: Shed
Number of entry/exit doors In this building: 4 Location(s):2 south garage doors, 1 east
garage dppr, .walk—in deer en Pact
Is alcohol stored in building? no Location(s):
Are drugs stored in building? no Locatlon(s):
Are weapons stored in building? no Location(s):
The following programs are offered as a public service of the Weld County Sheriffs Office. Please indicate the programs
of interest.
Physical security check Crime Prevention Presentation
UTILITY SHUT OFF LOCATIONS:
Main electrical: 1st utility pole east of residential house
Gas shut off: Profane tank west of south entrance to residential house
Exterior water shutoff: Northwest of mailboX 6 feet
Interior water shutoff: none in shed
A
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I. The property will be used for storage of portable toilets,service trucks,trailers and supplies. Sec. 23-3-
20-W allows for the disposal of domestic sludge,however no waste will be disposed of on this farm. All
supplies are biodegradable. See Material Safety Data Sheets(MSDS). The trailers will be used to deliver
portable toilets. The service trucks are for pumping and servicing the toilets on the sites. There is one
shed on the property,at this time, that will be used to garage the trucks and supplies. The portable toilets
will be stored to the south west of the shed. There will also be a temporary office building on the
property. We will put in a bay to wash the service trucks and toilets,with a vat to collect the dirty water.
The water will be pumped from the vat and taken to City of Greeley Waste Treatment plant along with all
other sewage that is pumped. We will build a new metal building,when it is feasible,east and south of
the existing shed. It will house service trucks,supplies and an office in the future. The temporary office
will be sold when it is no longer needed. There will also be fence to screen our business from our
neighbors view.
2. We started this business to supplement our farm income and to supply a much needed service to
farmers and others. According to sec 22-2-20-b3,we have a role in the Colorado farm and food system.
We furnish portable toilets to farmers and others,which are required by the state, counties,and cities and
OSHA. Then we service them in a timely manner. The waste generated is taken to the City of Greeley
Waste Treatment plant,for which we have a permit(sec attached),where it is dumped and processed.
/''N Then it is hauled by trucks to farms in the surrounding area and spread on the farm ground as fertilizer.
Sec 22-2-20-C also states that every dollar we spend to increase agriculture production or a service to
agriculture production,,creates a chain of purchase,that benefit's the county immensely. Our cropland
will still be farmed. There will be no change to that aspect. It will also provide an open space area that
will be pleasing to wildlife,the neighbors, and us. The natural systems and natural process of fanning
will not be jeopardized by this business. See sec 22-2-20-e,f. Sec 22-2-60-A-1 &2 of goals and policies
is being adhered to by the continual fanning of the land. Sec 22-2-60-B-1 &2 allow commercial uses
which are directly related to agricultural zoning. Agricultural businesses are defined as those which are
related to ranching,livestock production,farming and agricultural uses. We fall within this range
3. We live on a farm which will continue to be used as a farm. No fannable land will be used for the
storage of our portable toilets or trucks. This business is related to farming in that we do considerable
business with area farmers. They employ migrant workers in their fields to plant,weed, irrigate and
harvest their crops which are then sent to stores for us to buy. These same workers need portable toilets
for their convenience,which the farmers are required to provide. The same also applies to construction
worker and special events. Our service is needed. We pump and service these toilets,then the waste is
taken to the City of Greeley Waste Treatment plant where it is dumped and reclaimed as sludge to be
spread on farm ground in the area. This completes a circle recycling project.
Our buildings and the land used for this business are part of our farmyard. Any human waste will be
deposited at the City of Greeley Waste Treatment plant. The trash will be put in a dumpster and hauled
away. The intent of sec 23-3-10 indicates that we are in the agriculture zone because we fans. The
portable restroom business is compatible with fanning as stated above and provides a much needed service
to farmers and others. Sec 23-1-40 purpose and intent is to provide a unified regulatory system for land
use in this county. #7 says the present and future inhabitants of the county will be benefited through
fostering the county's agricultural,business and mining and other economic bases.
4. Agricultural first and then residential. This is a farm and we are supplementing our income with this
eeN
business venture. We extend our service to farmers and others who are required to have restroom
facilities for their hired help. There are farmers in the area who hire migrant help during the summer to
plant,weed, irrigate and harvest their crops. Portable restrooms arc a must for these workers. We
service them twice a week, in most cases. This is a required service by OSHA for these farmers to provide
for their help. The main use of ground in a five mile radius to us is for agricultural purposes. We also
supply portable restrooms to construction sites and for special events which are required to have facilities
for their employees and attendees at these functions. We are storing portable restroom,supplies,and
service trucks only on this property.
The Agricultural Zone District is intended to provide areas for the conduct of agricultural activities
and activities related to agriculture and agricultural production without the interference of other
Incompatible land USES. Sec 23-3-10.
5. A There will be 5-10 people using this site. Customers will not come to this site.
B There will be 4-10 employees using this site. There will be office help and service truck drivers. It
is hard to tell where the future will lead.
C The hours of operation will be from 5 a.m. to 7 p.m.,Monday thru Saturday. Occasionally earlier
or later due to special events. And occasionally on Sunday.
D In the future,when feasible, there will be a metal building built, (30'x 100')that will house our
service trucks and supplies and an office on the north end. We will also have a temporary mobile office,
for now. We will also build privacy fences and a bay to wash the trucks and portable restrooms in the
shed already on the property. This bay will have a vat to catch all residue,which will then be pumped
into the service truck and dumped at the Greeley Water Treatment plant See attached contract with the
City of Greeley for this right. There will also be three(more as needed) 1500 gal tanks to store
magnesium Chloride solution used to keep the water in the toilets from freezing in the winter.
E Corrals will remain in use until expansion is needed. Seven horses at the max will be in the corral.
Cattle on field pasture will come to the corrals to water. The cattle will stay in the corral when blizzard
conditions exist,for their safety and also to be able to feed them.
/ns\ F Employee pickups and cars will access this site during the week. There will also be two-three
service pickups daily Monday through Friday. These pickups are one ton pickups. An occasional larger
truck will be delivering supplies. Three-four times a year a semi-truck may enter the yard.
G Galeton Fire Department will provide fire protection.
H North Weld County Water District and a well. We also have irrigation water from#2 ditch.
I The home on the property is not within the use by special review area. A sewage system will not be
nrncsary at this time. Them will be a portable restroom dedicated for the mobile office. It will be
pumped weekly.
J Supplies and portable restrooms will be stored on the property.
6. We will be using privacy fencing on the east,west,and south. See attached use by special review
maps. There will also be some on the north,east of the shed already there. (Drought conditions make
this the most feasible thing to do at this time)
Also,these same fences can be used for windbreaks for cattle,later.
7. The sheds on the property will be used for crop and machinery storage. The privacy fences will be
windbreaks for cattle in severe weather. Very little change will be necessary to reuse these facilities on
the farm,because they will only be for storage of supplies and portable restrooms.
8. The storm water flows to the west of the yard and out into the west field. Drainage will not be altered
through this proposal and will continue to function as in the past.
9. Privacy fencing will be install after approval and will take six months. New metal building will not
be constructed till future,as feasible.
10.Dumpsters will be provided for trash. All waste pumped from portable restrooms will be dumped at
the City of Greeley Waste Treatment plant. In the future,a tank trailer might be placed on the property
to receive the waste. This would be a matter of economics.
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APPENDIX B
WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Public Works Department Date: S' ' (5? el
1111 H Street,P.O.Box 758, Greeley,CO 80632
Phone: (970)356-4000,Ext.3750 Fax: (970)304-6497
1. Applicant Name Raymond Lohr & Dorthula Lohr Phone 970-356-4896
Address 32549 Weld County Road 51 City Greeley State co Zip 80631
2. Address or location of access 32549 Weld County Road 51
Section skne':t sec 19Township 6N Range 64
Subdivision Block Lot
Weld County Road # 51 Side of Roadyest Distance from nearest intersection '5 mi t e
3. Is there an existing access to the property? Yes_X. No_ #of accesses 1
4. Proposed Use:
4 Permanent RI ResidentialAgricultural O Industrial
❑ Temporary O Subdivision Ea Commercial ❑ Other
5. Site Sketch nr
Ag Res agJ0&G 9t
Legend for Access Description:
y
AG = Agricultural �v ..
•
RES = Residential 1''i ..
O&G= Oil&Gas
D.R. = Ditch Road
D
-i.,, ,,r--
OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
r ❑ Installation authorized O Information Insufficient
Reviewed By: Tide:
0
Identify Results n !—m Page 1 of 1
Parcel Valuation
(Account*: R1200786 Parcel#: 080119000012
Owners Name &Address: Property Address:
LOHR DORTHULA L & RAYMOND W Street: 32549 51 CR
32549 COUNTY RD 51 City: WELD
GREELEY, CO 80631
Business/Complex:
Legal Description
9664 S2NE4 19 6 64 (1R2D) %32549 WCR 51% SITUS: 32549 51 CR WELD 00000
Land Value $20,685 Land Assessed Value $6,000
Impr. Value $75,113 Impr. Assessed Value $7,280
Total Value $95,798 Total Assessed Value $13,280
Total Taxes: $1,087.98 Amount Due: $0.00
Tax Area: Bordering County:
Township Range Section Quart. Sec. Subdivison Name Block# Lot*
06 - 64 - 19 - 0 - -
Acres: 2
Sq. Ft: 0
Sale Price Sale Date Deed Type Reception #
$0
http://maps.merrick.com/W ebsite/Weld/setSgl.asp?cmd=QUERY&DET=Parcel&pin'O80 1 1 900001 2&ac... 07/22/2002
07/30/2002 10:16 7708888835 SUPREME CHEMICALS PAGE 03
MATERIAL SAFETY DATA SHEET
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ORIGINAL KRUD KUTTER
HAZARD RATINGS
NFPA HMIS DATA
ORIGINAL KRUD KUTTER HEALTH \ 1 «IWIMAL
10 WORT
FIRE 0 2NMODERATE
Sala
REACTIVITY 0 aaxnREME
SECTION I
MANUFACTURED BY: SUPREME CHEMICALS OF GEORGIA.INC.
ADDRESS: 000 SUN VALLEY DRIVE,e 7
ROSWELL.OEOIWIA!0070
EMERGENCY PHONE NUMBER: (S00)2144124 CHaEMTEL for EMERGENCY ONLY
PHONE NUMBER FOR INFORMATION: (770)010.7111
DATE REVISED: June 21,2000
NAME OF PREPARER: CLIFFORD M.CANTRELL
SECTION I HAZARDOUS INGREOIENTSONPORMATION
INGREDIENT CM NO. OSHA ACpH OTHER %OR S
PEL-TWA TLV-TWA Sta. RHO K
2-SUTOXYETHANOL 111.70,2 2a PPM 26 PPM N PPM CS
ETNANOl,2JAMIND 141-434 ltn of 2none Ongr a <N
POTASSIUM HYDROxrE 1310+64 2 PPM 2 PETS_ (PPM <2
NOTE: AN IT UNDER Skit INDICATES THAT OSHA REQUIRES Skid PROTECTION TO PREVENT OR REDUCE EXPOSURE
TO THIS PIGMENT.ETHANOL,!AMNO and 2a1r1OXYETIMNOL ARE SARA TRLE M.SECTION 311 SUBSTANCES
WHICH MAY BE SUBJECT TO REPORTING BY MANUFACTURING SECTOR USERS.
EPA HAZARD CATEGORIES
ACUTE HEALTH-CHRONIC HEALTH
P"1 SECTION M-PMYSICALJCHSEMICAL CHARACTERISTICS
Boning Point: 212°F Specific Gravity(H2O.1) 1.01 -1.02
Vapor Pressure(mm Hg) 17 Melting Pant < 30°F
Vapor Density(Aira1) 3.2 Evaporation Rate(Water=1) < 1
Solubility in Water: Complete
Appearance and odor: Clear liquid with mild odor.
SECTION IV-FIRE AND EXPLOSION HAZARD DATA
Flesh Point(Method Used): Nona Finneala Lints:LELJ UEL:,(((A
Extinguishing Mee Careen dioxide,dry canal,alcohol loon war lag
Special Fire Fighting Prot:inns: FIREFIGHTERS SHOULD WEAR SELF-CONTAINED BREATHING APPARATUS AND
PULL PROTECTIVE CLOTHING WREN FIGHTING FINES INVOLVING THIS PRODUCT.
Unusual Fife end Explosion Hasa: Nene to awn.
SECTION V-REACTNrTY DATA
stow: Staple
UewwWth 1y(MelerYY LOS'S): Ds a a in ail ASS or adadex web.
Mama=Dee°wpaN w a 54,,J,,, Had wed amino diwMt
Hardee?Myan adww N7 Net Oar
Page 1 o13
07/30/2002 10:16 7708888835 SUPREME O-EMICALS PAGE 04
MATERIAL SAFETY DATA SHEET
ORIGINAL KRUD KUTTER
SECTION VI-HEALTH HAZARD DATA
RoR$s) et Entry: SMrlMbnt Y Skh?J l- tugnNliTill_ Elva YRS
Health It.aros(Acute aid airenk) None known.
� ingredients PM sled.
INCMueopsphst Inpedi.rbnot Nhd.
OSHA RegalehdT Ingredients nnol
Signs and Swinton,of Ewan
INHALATION: irritate of respiratory system with possible difficulty M breathing.
INGESTION: SI M.s,mts may aide gastric diskws,diems and vaulting.
Skid CONTACT: Postai*klllrllte.C4naistsd WslarIM Ray be Owned tnagb skin.
EYE CONTACT: kreiUorr and b..nM,eneslon with poabte earned flee.
Madkal Collation Genoa Aggravated NI Expoaae. Unknown
Emergency and FOR Aid Procedures:
INGESTION: OM 1-1 proses of water.Do not adminlehr fluids to Mn unconscious prism Do not Wow va iting.
GET MEDICAL ATTENTION NMEDIATELY.
INHALATION: Remora victim to bush Mt. If breelking don not return to aonnn.GET MEDICAL ATTENTION.
EYE CONTACT: krerwdately flush iFsa in deer nmMhg wider he at Mani Snubs eating upper and lower Ids
prkdMMy.R koLd.-.raus ad prsst%GET MEDICAL ATTENTION.
SIGN CONTACT: Flush Ain aAn dais wring enter test Nast IS min des. I brltaoA meats and paalMs.GET MEDICAL
ATTENTION.
SECTION VI-PRECAUTIONS FOR SAFE HINDUISM AND USE
Steps to Be Tan M CdN MaterW Is Retessed a Spank
SMALL SPILLS: Flush to sanitary ensef-
LARGE SPILLS: Dike to avoid spreading.Transfer to aei.bNe containers for disposal at en approved haxrdare waste We. Rinse
pill area Wilt want.Report any miss to ground or surface waters
Yeast.Disposal Maw Consign wastes to Feeding,Satt and locally wormed hazardous wash diponi fly for netsdatlon.
Preceudans to Bs Taken in►andlrg end Sbrag: Do not heaven Follow MI label Inkvdhoos. Keep container closed when non m use.
Other er his o n MEP TMS eNDmi ALL oanaklere betan depoeirg boo smeary wade far tat
ICALS OUT OF REACH OF CHILDREN
Container Ofepo.st: Triple Owe and punch=
SECTION VIII-Control Means
Rapfiory Protean Weeny Type): For two In enclosed areas.when spraying or when concentration lo air exceeds Willis(see
SECTION n.is wanton apgr.•.a COLON or bete respirator.
Ventilation: GENERAL EXHAUST AS REQUIRED TO MAINTAIN CONCENTRATION BELOW PEL
Protective Mon Reber a eropent.
Eye Protection: CMedral goggle facaelnaided skis using ay eln.ndeJ.
Heise
e Clothing a Equipment As'squired be reduce a prevail skin contact.Wash mrnadnsN clothing before reuse.
WertiHyy.n k Walk= Wait product Mendegree end skin. UM good boua_MepM5 preellaIL
SECTION IX-Addreml Manrllan
ENVIRONMENTAL
IMOosoIADAELm: ITIONNRADABLE.
WASTE DISPOSAL METHODS: DISPOSE OF N AN AUTHORIZED WASTE FACILITY N ACCORDANCE WITH LOCAL.
STATE AND FEDERAL IIEWMT10NS.
ADDITIONAL INFORMATION
EMPTY CONTAINER HAMEL *:WARMNGI EMPTIED CONTAINER RETAINS PRODUCT RESIDUE.OESEWE ALL PRECAUTIONS
EVEN AFTER CONTANM IS EMPTIED. IEEP EMPTY CONTAINER CLOSED TIGHTLY.
Page 2of3
07/30/2002 10:16 7708888835 SUPREME CHEMICALS PAGE 05
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MATERIAL SAFETY DATA SHEET
ORIGINAL KRUD KUTTER
SARA WILE IS REFORMS A ININLE IlMS
SECTION 302-EXTREMELY HATJSlbOU.sunSTANCES REPORTING
PAT NAT REQUIRED
SECTION 314-COMMUNITY
HAZARDOUS RELEASES REPORTING REPORTING RHOS®FOR INVENTORY ABOII!TPn
SECTION$11•R-T4C INVENTORY
E N RIGHORY TO R7gW'GTaQ REPORTRNG Same FOR INVENT RY ABOVE TP4
SECTION NI-IMIS IONS DATA REPORTING MAYBE D�
SECTION f1f-ESNISRXNO ANtS R6JFAtE MANUFACTURED SECTOR USERS
CaRCLA SAME AS SECTION* 4
REFERENCES
•
TOXIC SUBSTANCE 00NTIRX.ACT UST MICA►.IIORmCITS LSNIED.
PERMISSIBLE EXPOSURE ACES:
REGISTRY OF TOXIC EFFECTS OF CI EMCAL SUBSTANCES
WILE s COOS OF FEDERAL REGULATIONS
NATIONS.TOXICO600Y PROGRAM MI'►1 REPORT ON CARCI NOOENS
INTERISTIONAL AGENCY FOR RESEARCH ON CANCER$MC)MONOGRAPHS
REGULATORY STANDARDS:
DOT TOLE 43 CODE OF FEDERAL REGULATIONS 172111
SARA TIRE■
NUCLEAR REGULATORY AGENCY
THIS OOCRNIENT COMPLIES MIRK OGIN FORM 174 AS names UNDER 21P CPR 1t0.1TSS.
•
TIN FFORYATTON CONTAINED HERON In bNe.edb be sae rw r net wrraMW blow. Uses re advised to seem In
Moss of mod Owl Wo anwagert— SeWMned NSWcekmdroumwnena ,m. Vendor iron b kr
Yn}rybw�rA..ut r. arpaSMNWFcad WIN obWR�roSIYNwMFM�+r'»
Mm.debt St. FldwU.ae,.idorwawa we netraESEFIae5iryal o by entertal vie of WS tralatelSYenIt
neeenebU a4gF matador's an Marl
•
•
Peg.3 of 3
fTh n
tit U.S. Department of Labor
May be used to comply with Occupational Safety and Health Administration
OSHA's Hazard Communication Standard, (Non-Mandatory Form)
29 CFR 1910.1200. Standard must be Form Approved
consulted for specific requirements. OMB No. 1218-0072
IDENTITY(As Used On Label and List Note: Blank spaces are not permitted. If any Item is not applicable,or no
Information is available,the space must be marked to Indicate that.
Section I
Manufacturer's Name Emergency Telephone Number
Satellite Industries, Inc. 1-800424-9300
Address(Number,Street,City,State,and Zip) _ Telephone Number forinfornatlo& -- ---
2530 Xenium Lane North 763-553-1900
Date Prepared
Plymouth,MN 55441 April 27, 1998
Signature of Preparer(Optional)
Section 11-Hazardous Ingredients/Identity Information
Other Limits
Hazardous Comoonents(Specific Chemical Identit'c Common Name(s)) OSHA PFI ACGIH TLV Recommended %(optional)
This product contains the following ingredients:
Preservative(proprietary),Benzalkonium Chloride,
Glutaraldehyde,Dldecyldimethylammontum Chloride,
P" detergent,fragrance,dye and inert ingredient.
This mixture contains no known carcinogens.
Section III-Physical/Chemical Characteristics
Boiling Point Specific Gravity(H2O=1)
Mixture 212'F At 72'F(2Y C) 1.1
. Vapor Pressure (mm Hg.) Melting Point
Mixture Unknown Mixture N/A
Vapor Density(AIR= 1) Evaporation Rate
Mixture Unknown (Butyl Acetate=1) Unknown
Solubility in Water Corn*ely Appearance and Odor Blue liquid/pleasant fragrance
Section IV-Fire and Explosion Hazard Data
Flash Point(Method Used) Flammable Limits LEL UEL
158°F(70°C) (PMCC) Unknown N/A N/A
Extinguishing Media
Dry chemical,foam,CO2.water sprayer or fog. Cool container exposed to flame with water.
Special Fire Fighting Procedures
Wear OSHANIOSHA approved self-contained breathing apparatus and protective clothing.
Unusual Fire and Explosion Hazards
erN Product may produce a floating fire. Material Is not nyrophoric,does not react with water,not oxygen donor. Material is shock stable.
WORKER SAFETY INFORMATION OSHA 174 Sept.1985
PLEASE KEEP THIS MSDS ON FILE
Customer Service
t.w....d.. In.
Section V-Reactivity Data
Stability Unstable Conditions to Avoid
Excessive heat(1400 F,600 C),strong oxidizing agents(bleach).
Stable X
Incompatibility(Materials to Avoid) Strong oxidizing agents,excessive heat.
Hazardous Decomposition or By-products Burning can produce carbon monoxide,carbon dioxide,oxides of sulfur,and Irritating
organic products.
Hazardous May Occur Conditions to Avoid
Polymerization N/A
Will Not Occur
X
Section VI -Health Hazard Data
Route(s)of Entry: Inhalation? Skin? Ingestion?
X X X
Health Hazards(Acute and Chronic) Eye irritant Prolonged exposure may result in dermatitis or allergenic dermatitis, Prolonged
breathing of mist may cause chest discomfort or coughing. Ingestion may cause lathery,nausea,vomiting,and diarrhea.
Carcinogenicity NIP? IARC Monographs? OSHA Regulated?
Non carcinogenic
Signs and Symptoms of Exposure May cause dryness of skin with prolonged exposure. Vapors may cause initation of nose and throat,
and prolonged breathing may cause chest discomfort or coughing.
Medical Conditions Generally Aggravated by Exposure
Respiratory diseases,pre-existing skin disorders and allergies
Emergency and First Aid Procedures
If accidentally sprayed into the eyes,flush eyes thoroughly with water. If It-ration develops or persists,contact a physician. If swallowed,contact a
-physician. If medical help is not available,give water to drink In case of skin contact,wash thoroughly with water.
Section VII-Precautions for Safe Handling and Use
Steps To Be Taken In Case Material Is Released or Spilled
Absorb with an inert material,sweep up and dispose of properly. Small amounts(less than 1 gallon)may be washed directly into sewage drain.
Waste Disposal Method
Wash down drain with large amounts of water.
Precautions To Be Taken In Handling and Storing
Store between 320 F and 1200 F(00 C and 490 C). Avoid Ngi temperatures above 1400 F(600 C).
Other Precautions
None
Section VIII-Control Measures
Respiratory Protection (Specify Type)
Ventilation Local Exhaust Special
Preferable None
Mechanical(General) Other
Acceptable None
Protective Gloves Wear water proof gloves(latex,PVQ,rubber Eye Protection
or neoprene)to prevent skin contact. Safety goggles preferred
Other Protective Clothing or Equipment Wear complete clothing to minimize skin contact.
Work/Hygienic Practices Wash hands after using.
MSD-SPSP.doc
i•,
•
•
U.S. Department of Labor
�. May be used to comply with Occupational Safety and Health Administration
OSHA's Hazard Communication Standard, (Non-Mandatory Form)
29 CFR 1910.1200.Standard must be Form Approved
consulted for specific requirements. OMB No. 1218-0072
IDENTITY(As s n Label and List) Note: Blank spaces are not permitted. If any Item is not applicable,or no
information is available,the space must be marked to indicate that.
Section I
Manufacturer's Name - Emergency Telephone Number
Satellite Industries, Inc. 1-800-424-9300
Address(Number,Street,City,State,and Zip) Telephone Number for Information
2530 Xenium Lane North (763)-553-1900
__
--- . _ IIate Prepared-.
Plymouth, MN 55441 November 20,2000
Signature of Preparer(Optional)
Section II-Hazardous Ingredients/Identity Information
Other Limits —
Hazardous Components(Specific Chemical Identity: Comrr on Name(s)) OSHA PEL ACGIH TLV Recommended %(optional)
The identity of the Individual components of this mixture Is
proprietary information and is regarded
as a bade secret This mixture contains no known carcinogens.
Section III -Physical/Chemical Characteristics
Boiling Point Specific Gravity(H2O=1) 1.01
Mixture Unknown At 720 F(220 C)
Vapor Pressure(mm Hg.) Melting Point
Mixture Unknown Mixture N/A
Vapor Density(AIR=1) Evaporation Rate
Mixture Unknown (Butyl Acetate=1) Mixture Unknown
Solubility in Water ComPlesly Appearance and Odor Light blue/green with
spice fragrance
Section IV-Fire and Explosion Hazard Data
Flash Point(Method Used) Flammable Limits LEL UEL
>2000 F(930 C)(PMCC) Unknown N/A NM
Extinguishing Media
Dry chemical,CO2,foam. Cool container exposed to flame with water.
Special Fire Fighting Procedures
Wear OSHAINIOSH approved self-contained breathing apparatus and protective clothing.
Unusual Fire and Explosion Hazards
Product may produce a floating fire. Material is not pyroph3ric,does not react with water not oxygen donor. Material is shock stable.
OSHA 174 Sept. 1985
Pr`
WORKER SAFETY INFORMATION
PLEASE KEEP THIS MSDS ON FILE
Customer Service
Satellite Industries, Inc.
1-800-883-1123/ 1-800.328-3372
• r'eN,
faN
Section V-Reactivity Data
Stability Unstable f Conditions to Avoid
Excessive heat(140'F,60' ),strong oxidizing agents.
Stable X
Incompatibility(Materials to Avoid) Strong alkali caustic soda.
Hazardous Decomposition or By-products Ma form some oxides of carbon.
Hazardous May Occur Conditions to void
Polymerization N/A
Will Not Occur
X
Section VI-Health Hazard Data _
Route(s)of Entry: Inhalation? Skin? Ingestion?
X X X
Health Hazards(Acute and Chronic) Eye Irritant. Prolonged exposure may result In dermatitis or allergenic dermatitis. Prolonged
breathing of mist may cause chest discomfort or coughing. I gestlon may cause lethargy,nausea,vomiting,and diarrhea.
Carcinogenicity NTP? V1RC Monographs? OSHA Regulated?
Not known Not known No
Signs and Symptoms of Exposure It may cause I ion. In high concentration,it may cause eye irritation/posible skin IMtatlon upon
prolonged or repeated contact. Vapors may cause Imitation nose and throat,and prolonged breathing may cause chest discomfort or coughing.
Medical Conditions Generally Aggravated by posure
Respiratory diseases,pre-existing skin disorders and allergie .
Emergency and First Aid Procedures In case of g y ye contact,immediately rinse with water for 15 minutes. If swallowed,do not induce
vomiting,do not give anything to drink and call physician im lately.
Section VII -Precautions for Safe Handling a Use
Steps to be Taken in Case Material is Releas or Spilled Small spill: Use absorbent and use bleach to remove dye.
Large spill: Contain spill and either reclaim or use absorbent and use bleach to remove dye.
Waste Disposal Method
Dispose of in compliance with all federal,state and local and regulations.
-- Precautions to-be Taken-in Handling-and-Sto ng- --_ --. _._ — --- - ----
Store in cool,dry place.
Other Precautions
KEEP OUT OF REACH OF CHILDREN
Section VIII -Control Measures
Respiratory Protection (Specify Type) OSHA approved respirators recommended.
Ventilation Local Exhaust Special
Recommended WA
Mechanical(General) Other
Acceptable WA
Protective Gloves Eye Protection
Solvent resistant rubber or plastic Safety goggles preferred.
Other Protective Clothing or Equipment
r' Solvent resistant apron or overall is recommended. Wear complete clothing to minimize skin contact.
Work/Hygienic Practices
Wash hands after using.
MSDS-STF-TDS.doc
5/EJVH'ROTECH/
SERWCES,INC
SECTION I: MATERIAL IDENTIFICATION
Trade Name: F •
Chemical Name: Magnesium Chlo-ide Solution
Manufacturer: IMC Salt
Address: 765 North 10500 West
Ogden, UT 8440'
Telephone: (801) 731-3100
Date Prepared: December 2, 199
Date Updated: October 9, 2001
SECTION II: HAZARDOUS INGREDIENTS/IDENTITY INFORMATION
None
SECTION III: PHYSICAL/CHEMICAL CHARACTERISTICS
Boiling Point: 2257
Vapor Pressure: NA
Vapor Density: NA
Solubility in Water: 100%
Specific Gravity: 1.24 to 1.34
Melting Point: NA
Evaporation Rate: I
Odor/Appearance: Liquid colorless to yellow
SECTION IV: FIRE AND EXPLOSION HAZARD DATA
Flash Point: NA (Nonflammable)
Flammable Limits: STP in Air LEL: NA UEL: NA
Extinguishing Media:NA (Non-flammable)
Special Fire Fighting Procedures:None
Unusual Fire and Explosion Hazards:Ncne
SECTION V: REACTIVITY DATA
Stability: Stable
Incompatibility: None
Hazardous Decomposition or Byproducts: None
Hazardous Polymerization: Will Not Occur
Conditions to Avoid: None
FreezGard®Zero with Shield (Cont'd) Page 2
SECTION VI: HEALTH HAZARD DATA
Routes of Entry: Ingestion, Eye Contact, Skin Contact and Inhalation
Effects of Overexposure: Ingestion—Large doses would cause GI irritation
Emergency and First Aid Procedures:F'lush with water
SECTION VII: PRECAUTION FOR SAFE HANDLING AND USE
Steps th water.
p to is Taken in MetCashod:
material is Rele Solu3le n water. Neutral oror Spilled:Flush sslightly basic solution occurs
Waste Disposal Method:
Precautions to be Taken in Handling and Storage: No special requirements
Other Precautions: Normal standard practice for good hygiene
SECTION VIE: CONTROL MEASURES
Respiratory Protection: None Ventilation: Local exhaust: NA
Mechanical(general):NA
Special (Other): NA
Protective Gloves: NA
Eye Protection: Glasses with splas h shields
Other Protective Equipment or Precautions: NA
The information contained in this Material Saety Data Sheet is, to the best of our knowledge, accurate and reliable.
No warranty of any kind is either expressed o.implied
This information should be provided to all indtviduals handling this product. Federal,state, and local regulations
should be followed when handling this product.
I
CITY OF GREELEY •
HAULED WASTEWATER PERMIT
NO. LHW-010
TABLE OF CONTENTS
AUTHORIZATION TO DISCHARGE
SECTION A - GENERAL CONDITIONS
1
SECTION B - DESCRIPTION OF OUTFALL
4
SECTION C - SPECIFIC CONDITIONS
4
SUBSECTION 1 - Effluent Limitations
4
SUBSECTION 2 - Prohibited Wastes
4
SUBSECTION 3 - Monitoring Facilities
4
SUBSECTION 4 - Compliance Schedule Requirements
5
SUBSECTION 5 - Sampling and Analysis Requirements
6
SUBSECTION 6 - Reporting Requirements
6 - 8
EPA PRIORITY POLLUTANTS
9 - 11
WASTE DISPOSAL MANIFEST (Form I-a. )
12
WPCF MAP
13
I-b Self Monitoring Compliance Report Form
14
res
INDUSTRIAL WASTE PERMIT CONDITIONS FOR COUNTRY JOHNs
A. GENERAL CONDITIONS
1 . Discharge Violation
All discharges authorized herein shall be consistent with the
terms and conditions of this permit . The discharge of any
pollutant more frequently than, or at a level in excess of,
that identified and authorized by this permit shall constitute
a violation of the terms and conditions of this permit . Such
a violation may result in the imposition of administrative
penalties of up to $1000 per day per violation, civil and/or
criminal penalties as provided for in the City of Greeley
Code, Federal Water Pollution Control Act, and/or General
Pretreatment Regulations .
2 . Permit Modification, Suspension, Revocation
This permit may be modified, suspended or revoked in whole or
in part during its term for cause including the following:
a) Violation of any term or condition of this permit;
b) obtaining a permit by misrepresentation or failure to
disclose fully all relevant facts in either the permit or
any required report;
,0°-` c) promulgation of a more stringent pretreatment standard by
State or Federal agencies having jurisdiction over
receiving waters;
d) changes in the processes used by the permittee or changes
in the discharge volume or character;
e) changes in design or capability of the receiving sewage
treatment plant .
3 . Right of Entry
The permittee shall allow the City' s Water and Sewer Director
or his duly authorized representative bearing proper
credentials and identification:
a) To enter all properties for the purpose of inspection,
observation, measurement, and sampling and testing to
determine compliance with the provisions of this chapter;
and
b) to examine and copy any and all records required to be
maintained by industrial users for the purpose of
determining compliance with Pretreatment Standards and
Regulations.
The Director or his representative shall have no
authority to inquire into any industrial processes beyond
that point having a bearing on the kind and source of
discharge to the sewers or waterways or facilities for
waste treatment .
4 . Non-Compliance Notification
In the event the permittee is unable to comply with any of the
conditions of this permit, the permittee shall provide the
Director with the following information in writing within five
(5) days after commencement of such occurrence :
a) Cause of non-compliance;
b) anticipated time the condition of non-compliance is
expected to continue, or if such condition has been
corrected, the duration of the period of non-compliance;
c) steps taken by the permittee to reduce and eliminate the
non-complying discharge; and
d) steps to be taken by the permittee to prevent recurrence
of the condition of non-compliance.
The City reserves all rights and remedies that it has under or
by reason of any statutory law, ordinance, or common law to
cure any breach of this agreement or to enforce any penalty
for the breach thereof.
5 . Adverse Impact
The permittee shall take all reasonable steps to minimize any
adverse impact to the public treatment resulting from non-
compliance with any effluent limitation specified in this
permit, including such accelerated or additional monitoring as
necessary to determine the nature and impact of the non-
complying discharge . The permittee shall immediately notify
City Authorities of slug discharges or spills that may enter
the public sewer, or any other significant changes in
operations, wastewater characteristics and constituents .
6 . Facilities
The permittee shall at all times maintain in good working
order and operate as efficiently as possible all treatment or
control facilities or systems installed or used by the
permittee to achieve compliance with the terms and conditions
of this permit .
7 . Removed Substances
Solids, sludges, filter backwash, or other pollutants removed
in the course of treatment or control of wastewaters shall be
disposed of in manner such as to prevent any pollutant from
such materials from entering the City' s sewerage system.
8 . Transfer of Ownership or Control
Wastewater discharge permits may be transferred to a new owner
or operator only if the permittee gives at least 30 days
notice to the Wastewater Treatment Division Manager, and the
Wastewater Treatment Division Manager approves the wastewater
tws` discharge permit transfer. The notice to the Wastewater
Treatment Division Manager must include a written
certification by the new owner or operator which states that
Pas "Th
the new owner and/or operator has no immediate intent the
change the Facilities operation or processes; Identifies the
specific date on which the transfer is to occur; and
acknowledges full responsibility for complying with the
existing wastewater discharge permit .
9 . Property Rights
The issuance of this permit does not convey any property
rights in either real or personal property, or any exclusive
privileges, nor does it authorize any injury to private
property of any invasion of personal rights, nor any
infringement of Federal, State or local laws or regulations.
10 . Severability
The provisions of this permit are severable, and if any
provision of this permit, or the application of any provision
of this permit to any circumstance, is held invalid, the
application of such provision to other circumstances, and the
remainder of this permit, shall not be affected thereby.
11 . Reapplication
If the permittee desires to continue to discharge after the
expiration of this permit, it shall reapply on the application
forms then in use at least sixty (60) days before this permit
expires . Under no circumstances shall the permittee continue
to discharge after the expiration of the permit .
12 . Records Retention
All reports and records required pursuant to 40 CFR 403 . 8 and
4 s a be retained or a mi i m of 3 years, and shall
make all reports available for copying and inspection. This
retention period shall be extended during the course of any
unresolved litigation regarding the records in question.
13 . Right to Refusal
In the event that the permittee discharges hauled wastewater
which causes or contributes to upset, inhibition or pass-
through with the City wastewater treatment system or
surcharges the public sewer, or creates a hazardous or
nuisance condition in the sewer, then the City shall have the
right to refuse the hauled wastewater discharge at any point
during the discharge.
r1
14 . Treatment Fees
The cost for treatment of hauled portable toilet waste shall
be $0 . 065 per gallon. The assessed volume of_ discharge shall
be to en tom e weight obtained from the Greeley wastewater
treatment plant scale. If the scale is not operable a weight
may e no her certifie sca a au er may a so
use the maximum tank volume regardless of the actual volume
dischargeniftrile wastewater LreaLment scale is
q�erab� e _. Amended 1/23/2002
15 . Dedicated Tank
The permittee shall use dedicated tanks for hauling portable
toilet waste . The dedicated tanks must be numbered and
reported on the hauling manifest .
B. DESCRIPTION OF OUTFALLS
Outfall Description
01 The discharge of portable toilet wastes
from Country Johns portable toilet
business. The point of discharge is the
Greeley WPCF South plant hauled liquid
waste disposal pit. The pit is identified
on the attached map (page 12) .
C. SPECIFIC CONDITIONS
1 . Wastewater discharged into the sanitary sewer system shall not
have an average concentration (proportional to flow) greater
than that listed for the substances below.
Outfall 01
Parameters Maximum For Any One Day
Flow 1500 gpd
2 . The following wastes are prohibited and shall not be discharged
into the City' s sanitary sewer system:
a. THE PRIORITY POLLUTANTS THAT HAVE NO LOCALLY DEVELOPED
LIMITATIONS, LISTED IN SECTION C. 8, AND REFERENCED IN 307
(a) OF THE CLEAN WATER ACT OF 1977 . IF PRIORITY
POLLUTANTS ARE DETERMINED TO BE PRESENT, THE PERMITTEE
SHALL TAKE STEPS TO ELIMINATE THOSE POLLUTANTS FROM THE
ter-. WASTESTREAM UNLESS THOSE CONCENTRATIONS CAN BE
DEMONSTRATED, TO THE CITY' S SATISFACTION, AS NON-
SIGNIFICANT.
'r" NON-SIGNIFICANT CONCENTRATIONS ARE THOSE, WHICH WILL NOT
INTERFERE WITH TREATMENT OF CITY WASTEWATERS, WILL NOT
PASS THROUGH TO THE RECEIVING STREAM, OR WILL NOT INHIBIT
THE RECYCLING VALUE OF TREATED SLUDGE.
b. WASTES OR WATERS DESCRIBED IN SECTION 14 .12 .250 OF THE
SEWER USE ORDINANCE.
3 . The permittee shall install and maintain on its own premises
monitoring facilities described as follows :
a. NOT REQUIRED AT THIS TIME.
4 . The permittee shall install and maintain necessary wastewater
treatment as required to comply with this permit and all Federal
Categorical Pretreatment Standards and subject to the following
conditions :
a. NOT REQUIRED AT THIS TIME.
5 . The industry named above shall follow the City Self-Monitoring
Policy Guidelines, and shall sample and analyze its wastewaters
for the following pollutants under the following schedule :
a. SELF-MONITORING POLICY GUIDELINES
* The designated schedule of monitoring stated in 5.c
shall be adhered to. The disregarding of this
schedule constitutes a violation of the Sewer Use
Ordinance (Section 14.12 .460) , which is a
misdemeanor and upon conviction shall be punishable
by a fine of not more than one thousand dollars, or
confinement in the county jail for not more than
ninety days, or by both fine and confinement.
Permit revocation may also be a result.
* The dates of actual monitoring sample collection are
determined by the Control Authority. The permittee
shall be notified of the date of commencement of
sampling at least five days prior.
* The Control Authority will be performing unscheduled
sampling at times other than concurrent with the
self-monitoring periods.
* The Control Authority shall reserve the right of
approval of any laboratory used by the III for self-
monitoring analyses.
•
* All sampling procedures, collection, preservation
!� and analysis shall be performed in accordance with
the latest edition of Guidelines Establishing Test
Procedures For The Analysis of Pollutants; CFR 40
part 136.
* A chain of custody form shall be signed by both
parties before an IV releases any sample to a
contract laboratory.
* The results of self-monitoring laboratory and
analysis may be verified by periodic split sampling
with the WPCF laboratory. •
* The permittee shall record their self-monitoring
results on the appropriate recording sheet. The
reporting sheets will be supplied by the Control
Authority.
* All reports shall be submitted to the City of
Greeley Industrial Pretreatment Program Coordinator.
* The Industrial Pretreatment Program may consider a
self-monitoring report INVALID if any of the
previously listed policy guidelines are not
followed.
b. DEFINITIONS
1. A "GRAB" SAMPLE, IS A SINGLE DIP AND TAKE
SAMPLE COLLECTED AT A REPRESENTATIVE POINT IN
THE DISCHARGE STREAM.
2 . GODS = BIOCHEMICAL OXYGEN DEMAND
TSS = TOTAL SUSPENDED SOLIDS
GPD = GALLONS PER DAY
MG/L = MILLIGRAMS PER LITER
STD UNITS = STANDARD UNITS
TRC = TOTAL RESIDUAL CHLORINE
c. SELF-MONITORING REQUIREMENTS
n
Outfall 01
Parameters Frequency Type
Flow each load max. tank volume measurement
BOD mg/1 2 load/year grab
TSS mg/1 2 load/year grab
g 2 load/year grab
P Chromi.um,Total 2 load/year grab
Cadmium, Total 2 load/year grab
Copper, Total 2 load/year grab
Nickel, Total 2 load/year grab
Mercury, Total 2 load/year grab
Zinc, Total 2 load/year grab
Silver, Total 2 load/year grab
Lead, Total 2 load/year grab
RESULTS SHALL BE EXPRESSED IN (MG/L) MILLIGRAMS PER LITER
EXCEPT FOR pH WHICH SHALL BE EXPRESSED IN STANDARD UNITS.
d. REPRESENTATIVE SAMPLING
SAMPLES AND MEASUREMENTS TAKEN AS REQUIRED SHALL BE
REPRESENTATIVE OF THE VOLUME AND NATURE OF THE MONITORED
DISCHARGE. MONITORING POINTS SHALL NOT BE CHANGED
WITHOUT APPROVAL BY THE CONTROL AUTHORITY.
6 . The permittee shall provide compliance, discharge, and other
technical reports according to the following schedule and
conditions :
Self-Monitoring Reports
a. WASTE DISPOSAL MANIFEST:
THE PERMITTEE SHALL COMPLETE AND SUBMIT THE WASTE
DISPOSAL FORM I. (a) AND CHECK IN WITH THE OPERATOR ON
DUTY AT THE WPCF DEWATERING BUILDING PRIOR TO DISCHARGE.
b. SELF-MONITORING REPORT
THE MONITORING RESULTS REQUIRED IN SECTION B.5 (c) SHALL
BE SUBMITTED TO THE OFFICE OF THE CONTROL AUTHORITY ON OR
BEFORE 30 DAYS AFTER THE END OF THE MONITORING EVENT.
THE SELF-MONITORING COMPLIANCE REPORT FORM I.b. SHALL BE
/^ SIGNED AND ATTACHED TO THE MONITORING RESULTS.
F
c . NON-COMPLYING DISCHARGES
IN THE EVENT OF A NON-COMPLYING DISCHARGE DURING THE
MONITORING PERIOD, MONITORING RESULTS OF THE VIOLATING
DISCHARGE SHALL BE REPORTED BY TELEPHONE OR LETTER TO THE
CONTROL AUTHORITY WITHIN 24 HOURS OF BECOMING AWARE OF
THE VIOLATION. THE PERMITTEE SHALL ALSO REPEAT THE
SAMPLING AND ANALYSIS AND SUBMIT THE RESULTS OF THE
REPEAT ANALYSIS WITHIN 30 DAYS AFTER BECOMING AWARE OF
THE VIOLATION. A STATEMENT OUTLINING THE SPECIFIC
ACTIONS OR PRETREATMENT NECESSARY TO BRING THE DISCHARGE
TO COMPLIANCE WITH THE PERMIT STANDARDS SHALL BE
REPORTED. THE REPORT SHALL BE SIGNED AND MAILED TO THE
OFFICE OF THE WATER QUALITY SUPERVISOR WITHIN 5 DAYS OF
THE DETECTED VIOLATION.
d. NOTIFICATION OF CHANGED DISCHARGE
THE PERMITTEE SHALL PROMPTLY NOTIFY THE CONTROL AUTHORITY
IN ADVANCE OF ANY SUBSTANTIAL CHANGE IN THE VOLUME OR
CHARACTER OF POLLUTANTS IN THEIR DISCHARGE INCLUDING THE
LISTED OR CHARACTERISTIC HAZARDOUS WASTES WHICH WERE
REPORTED UNDER SECTION 14.12 .341.C OF THE ORDINANCE.
eTh
8 . EPA PRIORITY POLLUTANTS:
1. acenaphthene
2 . acrolein
3 . acrylonitrile
4 . benzene
5 . benzidine
6. carbon tetrachloride
(tetrachloromethane)
7 . chlorobenzene
8 . 1, 2 , 4-trichlorobenzene
9. Hexachlorobenzene
10. 1, 2-dichloroethane
11 . 1, 1, 1-trichloroethane
12 . hexachloroethane
13 . 1, 1-dichloroethane
14 . 1, 1,2-trichloroethane
15 . 1, 1, 2 , 2-tetrachloroethane
16 . chloroethane
17 . bis (2-chloroethyl) ether
18 . 2-chloroethyl vinyl ether
(mixed)
19 . 2-chloronaphthalene
20 . 4-bromophenyl phenyl ether
21 . bis (2-chloroisopropyl) ether
22 . bis (2-chloroethoxy) methane
23 . methylene chloride
(dichloromethane)
24 . methyle chloride
(chloromethane)
25 . methyl bromide
26 . bromoform (tribromomethane)
27 . dichlorobromomethane)
28 . chlorodibromomethane
29 . hexachlorobutadiene
30 . hexachlorocyclopentadiene
31 . isophorone
32 . naphthalene
33 . nitrobenzene
34 . 2-nitrophenol
35. 4-nitrophenol
36. 2 , 4-dinitrophenol
37 . 4 , 6-dinitro-o-cresol
38 . 2, 4, 6-trichlorophenol
39 . parachlorometacresol
40 . chloroform (trichloromethane)
41 . 2-chlorophenol
42 . 1, 2-dichlorobenzene
43 . 1, 3-dichlorobenzene
44 . 1, 4-dichlorobenzene
45. 3 , 3 ' -dichlorobenzidine
46 . 1, 1-dichloroethylene
47 . 1, 2-trans-dichloroethylene
48 . 2, 4-dichlorophenol
49 . 1, 2-dichloropropane
50 . 1 , 3-dichioropropylene
51 . 2 , 4-dimethylphenol
n "--"k.
52 . 2 , 4-dinitrotoluene
e \ 53 . 2, 6-dinitrotoluene
54 . 1, 2-diphenylhydrazine
55. ethylbenzene
56 . fluoranthene
57 . 4-chlorophenyl phenyl ether
58 . toluene
59. trichloroethylene
60 . vinyl chloride
(chloroethylene)
61 . aldrin
62 . dieldrin
63 . chlordane' (tech. mixture &
metabolites)
64 . 4, 4 ' -DDT
65. 4 , 4 ' -DDE (p,p' -DDX)
66 . 4,4 ' -DDD(p,p' -TDE)
67. alpha-endosulfan
68 . beta-endosulfan
69 . endosulfan sulfate
70 . endrin
71 . endrin aldehyde
72 . heptachlor
73 . heptachlor epoxide
74 . alpha-BHC
75 . beta-BHC
76 . gamma-BHC (lindane)
('` 77 . delta-BHC
78 . N-nitrosodimethlyamine
79 . N-nitrosodiphenylamine
80 . N-nitrosodi-n-propylamine
81 . pentachlorophenol
82 . phenol (4APP method)
83 . bis (2-ethylhexyl) Phthalate
84 . butyl benzyl phthalate
85 . di-n-butyl phthalate
86 . di-n-octyl phthalate
87 . diethyl phthalate
88 . dimethyl phthalate
89 . benzo (a) anthracene
(1, 2-benzanthracene)
90 . benzo (a) pyrene (3 , 4-
benzopyrene)
91 . 3 ,4-benzofluoranthene
92 . benzo (k) fluoranthane
(11, 12-benzofluoranthene)
93 . chrysene
94 . acenaphthylene
95 . anthracene
96 . benzo (ghi) perylene
(1, 12-benzoperylene)
97 . fluorene
98 . phenanthrene
r' 99 . dibenzo (a.h) anthracene
100 . indeno (1, 2 , 3-cd) pyrene
101 . pyrene
n
102 . tetrachloroethylene
103 . PCB-1242 (Aroclor 1242)
104 . PCB-1254 (Aroclor 1254)
105 . PCB-1221 (Aroclor 1221)
106 . PCB-1232 (Aroclor 1232)
107 . PCB-1248 (Aroclor 1248)
108 . PCB-1260 (Aroclor 1260)
109 . PCB-1016 (Aroclor 1016)
110 . Toxaphene
111 . Antimony (total)
112 . Arsenic (total)
113 . Asbestos (fibrous
114 . Beryllium (total)
115 . Cadmium (total)
116 . Chromium (total)
117 . Copper (total)
118 . Cyanide (total)
119 . Lead (total)
120 . Mercury (total)
121 . Nickel (total)
122 . Selenium (total)
123 . Silver (total)
124 . Thallium (total)
125 . Zinc (total)
126 . 2, 3 , 7, 8-tetrachlorodibenzo
p-dioxin (TCDD)
r
•
n r"1
I-a. Self-Monitoring Compliance Report The Greeley Municipal Code
(Section 14 . 12 .250) requires that all industrial users subject to Sewer
Use Permit conditions submit a self-monitoring report .
COUNTRY JOHNS. subject to LHW-010 monitored the regulated pollutants
appearing in its Sewer Use Permit on
date(s) of sampling
All sampling, collection, preservation, and analysis of samples were
performed in accordance with the latest edition of Guidelines
Establishing Test Procedures For The Analysis of Pollutants; CFR 40 Part
136 .
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 who manage the system, or those 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 knowing
( "•' violations.
Official Signature
*If unable to certify continuous compliance, please proceed to section
I-b.
re"\
I-b. Non-Compliance Report
The Greeley Municipal Code (Section 14 . 12 .280 (e) ) provides that the
Control Authority can require the maintaining and submitting of
technical reports and plant records relating to wastewater discharges.
If Sewer Use Permit conditions are violated, a report stating which
conditions were violated and what additional operating and maintenance
and/or pretreatment actions are necessary to eliminate the violation by
the permittee .
COUNTRY JOHNS subject to LHW 010, violated
the following permit condition standards on Date of Violation
Pollutant Concentration Permit Standard
1.
2 .
3 .
with an average and maximum daily flow of gpd, and gpd,
respectively.
COUNTRY JOHNS will perform the following
adjustments to operations, and/or maintenance and housekeeping
activities,
and/or pretreatment in order to eliminate the cause of any violation(s) :
Action(s) Taken Date of Completion
1.
2 .
3 .
I certify, to the best of my knowledge, COUNTRY JOHNS
will conform to this schedule of compliance.
Official Signature
Hello