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    Discharge Permit (New) Evaluation Form

    Uploaded by

    rhyzeupjun25

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    © All Rights Reserved
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    Discharge Permit (New) Evaluation Form

    Uploaded by

    rhyzeupjun25
    17 views1 page

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    17 views1 page

    Discharge Permit (New) Evaluation Form

    Uploaded by

    rhyzeupjun25

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    LAGUNA LAKE DEVELOPMENT AUTHORITY

    DISCHARGE PERMIT (New) EVALUATION FORM


    Company Name: _______________________________________________
    Project Name: _________________________________________________
    Address: ______________________________________________________
    A. Application Form
     completely filled out  notarized
     acceptable water balance  LC/LE attached
     with signature of PCO/Rep.  certification/proof of start of operation
     with signature of CEO  schedule of discharge (if by-batch)
    B. Water Bills/Reading
     in the name of the applicant/owner of the building
    Source of water is from the supplier/water provider
     water bills/reading for the last three months
    Source of water is from groundwater/deepwells
     water permit or water application from NWRB
    Source of water is from surface water
     water permit or water application from LLDA
    C. Water Treatment Facility/Septic Tank/ OWS/Grease Trap Lay-out
     with complete specification of the treatment process
     duly signed and sealed by a licensed civil/sanitary engineer
    D. Engineer’s Report or Technical Report
     project description, area and location
     declaration of product capacity stating the quantity or volume and the
    generic name (s) of the product(s) if applicable
    With wastewater discharge
     nature and characteristic of applicant’s waste including its chemical
    composition
     total daily volume of discharge of raw waste
     treatment process and estimated treatment efficiency
     total daily volume of discharge of finally treated waste or effluent
     with attached results of laboratory analysis
     signed by preparer
    No wastewater discharge (Zero discharge) / With storage of used oil,
    chemicals, or hazardous waste
     nature and characteristic of waste including its chemical composition
     nature of zero discharge scheme
    o recycle/re-use
    o haul by service provider/treated
    o containment/loss by evaporation

    Other Remarks:_________________________________________________

    Evaluated by:_________________________ Date: ____________________


    Name & Signature

    Checked by:_________________________ Date: ____________________


    Name & Signature

    LLDA-CPD-Form 13 Issue Date: August 2022 Issue No.: 04

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