Application For Non-Residential Sewer Connection
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Document Overview
This is a Sewer Connection Request Form issued by The Borough of Hollidaysburg, PA. It is designed for non-residential facilities seeking to connect to the municipal sewer system. The form requires detailed information about the applicant, water usage, and industrial processes to ensure compliance with local pretreatment standards.
Key Information & Requirements
Applicant Information (Section I)
- Submission: The completed form must be mailed to the Hollidaysburg Pretreatment Coordinator at 401 Blair Street, Hollidaysburg, PA 16648.
- Required Details: Applicants must provide:
- Company Name and Facility Address.
- Contact information for the Responsible Official (Name and Phone).
- Number of employees at the facility.
- A description of business activities conducted at the site.
Water Usage (Section II)
- Sources: Applicants must identify water sources (Private well, Surface Water, or Water Utility).
- Volume Estimates: Estimated average daily usage for both water intake and wastewater discharge (in gallons per day) must be listed.
- Discrepancies: If water usage and wastewater discharge do not balance, an explanation is required.
Process and Waste Information (Section III)
- Waste Description: A narrative description of manufacturing or service activities that produce process waste (excluding restroom/cafeteria waste) is required.
- Disposal Methods: The method of disposal for identified process wastes (e.g., sewer, landfill) must be indicated.
- Chemical Additives: Any liquid, chemical, or solid substances added to water during use must be identified.
- Specific Substances: The form asks specifically about the use of:
- Industrial Solvents: If yes, details on type, usage rate (gal/month), storage location, and destination of spent solvent are required.
- Dyes, Paints, or Inks: If yes, details on type, usage rate (gal/month), storage location, and destination of waste material are required.
Certification (Section IV)
- Legal Statement: The applicant must certify that they have examined the information and believe it to be true, accurate, and complete based on inquiry of responsible individuals.
- Signatures: The form requires a signature, date, and an official seal (if applicable).