Pretreatment Forms

These are the various forms used by Environmental Services to apply for a Wastewater Discharge Permit, permit renewal and annual reporting requirements.

Type

Name

Description

Accidental Spill Prevention Plan and Slug Control Plan

The ASPP/SCP is a guidelines document that can be used by industry to complete the requirement to submit and ASPP/SCP to the City of Salem. The ASPP/SCP is required for spill prevention and protection of the POTW.

Authorized Representative and Total Toxic Organics Statement

The Authorized Representative and TTO Certification Statement must be submitted by applicable permitted industries, twice per year, usually with the Biannual Compliance Report on June 1 and December 1.

Biannual Compliance Report Requirements

Biannual Compliance Reports must be submitted by appropriate permitted industries by June 1 and December 1 of each year. The Biannual Compliance Report outline the production activiites or compliance issues over the past 6 months.

City of Salem pH Enforcement Policy

This document outlines the enforcement response to be used for wastewater discharges outside of the required discharge range.

Determining Permit Duration Status

This document shows the guidelines used to determine the duration of an industry permit. Permit duration is based on the industries compliance history for the past year or the life of the current permit.

Final Compliance Report

The Final Compliance Report(FCR) must be submitted within 90 days of the startup of a new permitted industry. It documents their compliance status during the startup process.

Industrial Sewer Charges and Permit Fees

Current sewer charges and permit fees

Pretreatment Grant Application

Water Conservation Pretreatment Grant Application form used to apply for a grant from the City of Salem for conserving water usage.

Pretreatment Manual

The Pretreatment Manual outlines the Pretreatment Program used in the City of Salem as mandated by State and Federal Regulations.

Septic Haulers Discharge Application

This application must be submitted to Environmental Services to request a Septic Haulers Discharge Permit with the City of Salem.

Septic Haulers Discharge Permit Blank

This is the document used as a discharge permit for authorized septic haulers

Total Toxic Organics List Part 433

This is a list of the applicable Total Toxic Organic parameters for the Metal Finishing Industry.

Total Toxic Organics List Part 469

This is a list of the applicable Total Toxic Organic parameters for the Electronics Industry.

Toxic Organics Manangement Plan Guidelines For Non TTO Users

TOMP guidelines used to submit a TOMP for an industry that does NOT uses listed TTO's.

Toxic Organics Manangement Plan Guidelines For TTO Users

TOMP guidelines used to submit a TOMP for an industry that uses listed TTO's.

TTO Certification Statement

The TTO Certification Statement must be submitted by applicable permitted industries, twice per year, usually with the Biannual Compliance Report on June 1 and December 1.

Wastewater Discharge Permit Application

This application must be submitted to Environmental Services 90 days prior to discharge, to request a Wastewater Discharge Permit with the City of Salem.

Wastewater Permit Blank Form

This document is a sample of a Wastewater Discharge Permit as issued by the City of Salem.

Wastewater Permit Renewal Application

This renewal application must be submitted to Environmental Services 90 days prior to the expiration date, to request a Wastewater Discharge Permit renewal with the City of Salem.

Wastewater Permit Zero Discharge Application

This application is for a regulated industrial user that does not discharge process wastewater but is under a control mechanism.