DEPARTMENT OF ENVIRONMENTAL PROTECTION

Attn: Geraldine Travers

Solid Waste Program, DEP

17 State House Station

Augusta, Maine04333-0017

FOR DEP USE ONLY

ATS ID: _Seq.: _DEP ID: / Received by DEP:
Bureau: SType of Application: S_Activity: A / Fees Paid:
Project Analyst: / Check No.:

APPLICATION TO AMEND A RESIDUAL UTILIZATION SITE

Use this form to request approval to add fields or otherwise amend an existing residual utilization site, pursuant to 38 MRSA, Section 1301 etseq., and Maine's Solid Waste Management Regulations, specifically Chapter 419, Agronomic Utilization of Residuals (effective July 19, 1999).

PLEASE TYPE OR PRINT

License Number of site you are amending: S---

Company Name (Generator):

Applicant's Last Name: / First Name:
Contact Person: / Telephone:
Address Information: Applicant
Name:
Mail Address:
Street Address
Town: State:Zip:
Telephone ( ) Fax: ( ) E-Mail: @
Address Information: Agent/Consultant
Name:
Mail Address:
Street Address
Town: State:Zip:
Telephone ( ) Fax: ( ) E-Mail: @
Address Information: Billing
Name:
Mail Address:
Street Address
Town: State:Zip:
Telephone ( ) Fax: ( ) E-Mail: @
Project Description

Type of Utilization activity (check one) fertilization

amending soil

liming

artificial topsoil placement

other (describe)

Residual type (check one):

Type Code / Type of Residual
(SB) / industrial sludge / papermill sludge / short-paper fiber sludge
(SI) / sewage sludge
(SK) / woodash
(SJ) / bioash / CKD / lime-mud / other ash or liming agent
(SL) / food waste / food by-products / fish by-products
(SM) / Other (Please describe):

Owner of site:Operator of site:

Location of Project (town(s)):

Directions to site:

SIGNATURE OF APPLICANT

By signing this application, the applicant certifies that he or she has: (1) published the public notice form once in a newspaper circulated in the area where the project is located, (2) sent a copy of the public notice form to the owners of property abutting the land upon which the project is located, (3) sent a copy of the public notice form to the chief municipal officer and chair of the municipal planning board of the municipality in which the project is located (4) filed a complete copy of this application in the municipal office of the municipality in which the project is located, (5) reviewed the instructions contained in this application form, and (6) reviewed the appropriate state laws that relate to the proposed project.

I certify under penalty of law that I have personally examined the information submitted in this document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe the information is true, accurate, and complete. I certify that the property owner or lessee of the site authorizes the Department to enter the property that is the subject of this application, at reasonable hours, including buildings, structures or conveyances on the property, to determine the accuracy of any information provided herein. I am aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment.

DATE:NAME:

(Applicant)

TITLE:

(If other than applicant, attach letter of agent authorization.)
INSTRUCTIONS

  1. Applicable rules. Please refer to the following Department regulations to complete this application. Copies of the rules may be obtained from Department Staff and via DEP's Web Page (
  • Department Regulations Chapter 419, Agronomic Utilization of Residuals (effective December 19, 1999) contains the majority of the rules that relate to agronomic utilization.
  • Chapter 400, General Provisions (effective September 6, 1999) contains the definitions and licensing standards that apply to all solid waste activities, including utilization.
  • Chapter 405 Waste Characterization (effective September 6, 1999) contains analytical requirements for utilization. Pay particular attention to section 6 of Chapter 405.
  • Chapter 2, Rules concerning the Processing of Applications (effective August 1, 1994) governs the procedures that must be followed when applications are processed.
  1. Help. If you have any questions that arise at any point during the application or review process, please contact one of the following DEP Utilization Program staff:

Region / Staff / Phone / Fax / e-mail
Augusta / Carla Hopkins / 207-287-8491 / 207-287-7826 /
Augusta / Jim Pollock / 207-592-8343 / 207-287-7826 /
Bangor / Rick Haffner / 207-941-4331 / 207-941-4584 /
Bangor / Roger Johnstone / 207-561-5020 / 207-941-4584 /
Portland / Mike Clark / 207-822-6341 / 207-822-6303 /
Presque Isle / Jay Duncan / 207-760-3165 / 207-764-1507 /
  1. Pre-Application meeting. Applicants proposing to use a new site are encouraged to meet with DEP staff to discuss the proposed project. The meetings can help avoid unnecessary expense and processing delays.
  1. Fill out the application completely. INCOMPLETE APPLICATIONS WILL BE RETURNED, CAUSING UNNECESSARY DELAYS IN THE REVIEW PROCESS. All work to support the proposed utilization activity must be undertaken by individuals whose training, experience and professional certification is appropriate to accomplish the specific tasks with accuracy and technical proficiency. Reports, plans or other materials submitted in support of the application must bear the signature and, if appropriate, the seal of the individual who drafted or supervised the drafting of each document. If a portion of the form is not applicable, note that on the application form.
  1. Publish a “Notice of Intent to File” this application once in a newspaper circulated in the area where the project is located. (A form for this notice is attached to this application.) The notice must appear in the newspaper no more than 30 days before you file the application with the DEP.
  1. Send by certified mail, a copy of the “Notice of Intent to File” to all the owners of property abutting the project. Their names and addresses can be obtained from town tax maps or local public officials. Abutters must receive notice no more than 30 days before you file the application with the DEP. If your project abuts a road or other public or private right-of-way, the person on the opposite side of the right-of-way must be notified.
  1. Send by certified mail, a copy of the “Notice of Intent to File” to the chief municipal officer and to the chairperson of the planning board in the municipality where the project is to be located. If the project is located in an unorganized area, send the notice and application to the appropriate Office of the County Commissioners and the Maine Land Use Regulation Commission, 22 State House Station, Augusta, Maine 04333-0022. The notice must be filed in the appropriate office within 30 days prior to filing with the DEP.
  1. Submit to the Department the application along with all attachments. Please consult with DEP staff to determine how many copies of the completed application form and supporting reports must be submitted to the Department. In general, three copies of site plans, drawings, soil maps, or other data on sheets larger than 8½" x 14" copies must be submitted unless the staff determines that fewer copies are needed. All plans should be folded to size 8½" x 11" unless otherwise indicated by DEP staff. Any part of the application which has been prepared by a P.E., C.G. or C.S.S. must be stamped and signed by that person. Send the complete application to:

Attn: Geraldine Travers, ATS Coordinator

BRWM, DEP

17 SHS

Augusta, ME 04333-0017

  1. Send one complete copy of the application and any amendments that are subsequently submitted to the municipal office of the town within which the project is located. If the project is located in an unorganized area, send the application to the appropriate Office of the County Commissioners and the Maine Land Use Regulation Commission, 22 State House Station, Augusta, Maine 04333-0022. The application must be filed in the municipal office or at the County Commissioners Office and LURC at the time of filing with the DEP.
  1. Keep a copy of the completed application for your files. This copy will be helpful in speeding up communications with the DEP staff if any questions arise during the review of the project.
  1. Upon the approval by the Department of Environmental Protection, a permit will be issued and sent to the applicant. The applicant should read the permit carefully in order to become familiar with any conditions. Failure to comply with the approved plan or conditions of approval may lead to enforcement action or the revocation of a permit.

Required Application Information to amend an

Agronomic Utilization Site

Unless otherwise approved in a program license or a pre-application meeting with the DEP, the utilization site application must include all of the following information. If a program license or the Department exempts submission of an item, note that in this application.

  1. Public Notice. Provide all of the following:
  1. Notification form. Provide a copy of the completed “Notice of Intent to File” (attachment I) and evidence of compliance with the public notice requirements delineated in items 4, 5, and 6 of the instructions, as required in Chapter 419, section 2.F. The form in attachment I is for use in notifying abutting property owners, the municipality in which the project is located, and publishing the notice in the newspapers.
  1. Abutters. A list of the names and addresses of all the owners of property abutting the proposed facility site.
  1. Application Fee. Submit a check for the appropriate application fee made payable to “Treasurer, State of Maine”.
  1. Schedule. Provide all of the following:
  1. Preferred date to start utilization operations:
  2. Anticipated lifetime of site use:
  1. Utilization Program Summary. Provide all of the following::
  1. Attach a summary of the type of residual generated by your facility, how it is treated, and residual monitoring requirements.
  2. Attach analytical results of the residual to be land applied.
  1. Site Utilization Summary. Attach a summary of the acres already licensed for used, the additional acres proposed to be added, types of crops to be grown, method of application, anticipated spreading schedule, proposed application rates in tons of residual per acre of land, sample loading rate calculations (meeting the standards in Chapter 419, Appendix A), any special management considerations for the site based on site characteristics, and a general description of how the residual will be stored and transported.
  1. Title, Right or Interest. Attach information demonstrating that the generator has sufficient title, right or interest in a property proposed for utilization by providing one of the following:
  1. a copy of an agreement between a landowner(s) and a residual generator certifying that the owners in fact own the land and agree to allow the utilization, and if applicable storage, of the residual on the property. The agreement must also include the signature, printed name, and address of the generator and all property owners, the site location, a description of the area authorized for use including acreage, and if available, the map and lot number from municipal tax maps. The landowner must also agree to allow the DEP to enter the property that is the subject of this application, at reasonable hours, including buildings, structures or conveyances on the property, to determine the accuracy of any information provided in the generator's application to DEP for site utilization.
  2. a copy of the deed(s) to the property demonstrating that the generator owns the site;
  3. a copy of a lease or easement demonstrating that the generator has a lease or easement on the property of sufficient duration and terms to permit the proposed utilization activity;
  4. an option agreement to buy or lease the property, demonstrating sufficient rights to title, leasehold, or easement of sufficient duration and terms to permit the utilization activity;
  5. or another demonstration of title, right or interest in the property acceptable to DEP.
  1. Site Maps. Attach clear, legible copies of all of the following maps
  1. Topographical Map. The most recent 7.5 minute US. Geological Survey topographic or equivalent map marking the proposed utilization boundaries for the areas that are being added, and site owner's property boundaries;
  2. Site Sketch. Site sketch(es) of the proposed new utilization area(s) of sufficient quality and scale, and with sufficient features to ensure that the person spreading the residual can determine appropriate utilization boundaries. At a minimum the map must depict the area suitable for utilization, storage locations, buffers and setbacks, features requiring buffers and setbacks, drainage features, and the map scale, orientation, and title.
  3. Tax Map. If available, the appropriate town tax map showing the new area's property boundaries, the new area proposed for utilization, and the names and location of abutters.
  4. Soils Map and Report. A clear copy of the appropriate United States Department of Agriculture (USDA) Natural Resources Conservation Service (NRCS) County medium intensity soil survey map with the new area of the site clearly outlined and a copy of the key to the soil mapping units.
  5. Sand and Gravel Aquifer map. If the proposed new area of the site is within 500 feet of a sand and gravel aquifer, a copy of the most recent Hydrogeologic Data for Significant Sand and Gravel Aquifer map with the proposed utilization site clearly delineated.
  6. Flood Zone Map. If the proposed new area of the site is within 500 feet of a 100 year flood zone, the most recent Federal Emergency Management Agency (FEMA) flood zone map or its equivalent with the proposed utilization site clearly delineated.
  1. Soils Description. For the proposed new area of the site, describe the soil slope, permeability, flooding potential, drainage, depth to bedrock and/or sand or gravel deposits, along with appropriate operational standards to be employed to prevent surface or groundwater contamination, taking into consideration site and residual characteristics.
  1. Soils investigation report. If the Department questions the accuracy of the site soil map, attach a soils investigation report and/or site specific soils map. The report must describe the soil slope, permeability, flooding potential, drainage, depth to bedrock and/or sand or gravel deposits, along with appropriate operational standards to be employed to prevent surface or groundwater contamination taking into consideration site and residual characteristics. Contact the Department before conducting the investigation if you intend to have someone other than a Maine Certified Soil Scientist conduct the soils investigation.
  1. Buffers and Erosion Control. A description of buffer zones at the new portion of the utilization site to be established to meet the standards in sections 3 and 4 of Chapter 419. If the applicant is proposing a reduction in the buffers enumerated in table 419.2, a rationale for the reduction and a site specific soil erosion control plan meeting the standards in section 3.B(2).
  1. Soil Nutrients. Representative soil nutrient analysis for the new area of the site.
  1. Nutrient Need. For residuals used to supply nitrogen, phosphorus, or other nutrients, a demonstration that the site has a need for the nutrient provided by the residual, in addition to other on site nutrients. (Note: Department of Agriculture Regulations, Chapter 565, effective December 15, 1998, requires farms utilizing residuals to have a licensed nutrient management specialist develop a whole farm nutrient management plan by January 1, 2000. While the plan itself need not be submitted to the Department, the information in any existing plan should form the basis for the above determination that additional nutrients are needed on a farm.)
  1. Odor Control Plan. For repeat utilization of putrescible residuals, a site specific odor control plan to prevent nuisance odors at adjacent occupied buildings.
  1. Pathogen and Vector Control. For a type II residual that is treated to a class B pathogen reduction standard: a description of the method of treatment to achieve Class B pathogen reduction; a description of any class B vector attraction reduction method proposed for the site; and a copy of a statement signed by the generator, landowner and the operator of the site that ensures that the applicable site restrictions in Chapter 419, section 4.I will be met.
  1. Storage. Describe where residuals to be used on the site will be stored prior to use. Also answer all of the following questions:
  1. Permanent Storage. Will residuals be stored on the site in a contained (impervious) storage facility? If yes, please provide the license number of the facility. If the facility is not licensed, submit a complete "Residuals Storage Application Form" along with this application. (Note: Until July 19, 2000, you do not need to license a SCS storage pad that was approved for use under Chapter 567. Simply attach the approval letter from the Department to this application.)
  2. Field stacking. Will residuals be field stacked at the site? If yes, has this location already been approved in a prior license?. If no, please submit the following information:

(1)Residual Characteristics. A description of the physical and chemical characteristics of the residual that will be stored and discuss the applicability of the standards in Chapter 419, section 10.C, 10.D and 12.B(4).

(2)Narrative and site sketch. A narrative and site sketch of the storage site features and proposed structures, of sufficient detail to demonstrate compliance with the standards in Chapter 419, section 10, and to ensure that the person stacking the residual can locate the approved storage area. The sketch must include the title, scale and orientation, buffers, slopes, run-on and run-off control features, and leachate management features.

(3)Odor and dust control plan. For putrescible residuals, a site specific odor control plan to treat the residual or locate, design, and operate the site to avoid nuisance odors at off site occupied buildings. For dusty residuals, a site specific dust control plan to treat the residual or locate, design, and operate the site to avoid dust at off site locations.

(4)Operations manual. An operations manual meeting the standards in Chapter 419, section 12.A(1).

(5)Environmental monitoring program. If the Department determines that it is necessary, a monitoring program for ground water, surface water or waste characteristics, as applicable, designed in accordance with the provisions of Chapter 405.

(6)Chapter 400 submissions. The submission requirements of Chapter 400, section 4, subsections B, C, F, G, H, I, J, and L.

  1. Traffic.One of the following:
  1. A certification that the residual will be used as a topsoil replacement;
  2. A certification that the site will be, and has been, utilized one time or less in a five year period;
  3. A certification that the utilization activity at this site results in 16 or fewer vehicle trips per day to the utilization site in addition to other traffic to the site when not utilized; or
  4. the traffic information required by Chapter 400, section 4.D(2).
  1. Sensitive areas. A statement as to whether or not the new portion ot the site is located in, on, over or next to a protected natural resource, a sensitive receptor, and/or the direct watershed to marine waters. If the site is located near one or more of these areas, provide the name of the feature and horizontal distance from nearest site boundary to the feature. (see Chapter 400, section 1 for definitions.)
  1. Protected location. For new portions of sites that are adjacent to protected significant wildlife habitat, fragile mountain areas, or the location of rare, threatened and endangered plant or animal species, letters from the Maine Department of Inland Fisheries and Wildlife, and from the Natural Areas Program of the Department of Conservation that the activity will not unreasonably adversely impact these features.
  1. Flooding. For new utilization activities due to this amendment where the topography will be altered or structures built as part of the utilization activity, the application submissions in Chapter 400, section 4.J(2)(a) and Chapter 400, section 4.M(2).
  1. Natural environment. One of the following:
  1. A certification that the residual replaces a virgin material, such as topsoil or fertilizer, in a construction project;
  2. A certification that the purpose of the utilization project is to reclaim a mined area, close a landfill, or remediate a state designated uncontrolled hazardous substance site;
  3. Both a description of the applicable buffer requirements for utilization and storage in Chapter 419 that will be met at the proposed new area of utilization; and a certification that the new portion of the utilization project is located at least 100 feet from "protected natural resources" and rare, threatened and endangered plant and animal species. (See Chapter 400, section 1 for definitions.) or
  4. The submissions enumerated in Chapter 400, sections 4.E(2) and 4.F(3).
  1. Dioxin. If utilizing residuals with greater than 27 ppt total 2,3,7,8 TCDD equivalents (dry weight), submit a site specific sampling and analytical work plan to monitor soil dioxin concentrations in the new area. The applicant must also submit a copy of a statement signed by the generator, landowner and, if different, the operator of the site, that specifically acknowledges the presence and concentrations of PCDDs and PCDFs in the residual to be spread, and the ability and willingness of the landowner to comply with the standards in Chapter 419, section 4.K(4).
  1. Metals. For residuals subject to the additional standards for heavy metals in section 4.J, a site specific sampling and analytical work plan to monitor soil metal concentrations in the new area; and loading rate calculations demonstrating that applicable annual and cumulative loading rates for metals in tables 419.3, 419.4 or 419.5 will not be exceeded.
  1. Environmental monitoring program. If required by the Department, a waste characterization sampling and analytical work plan and/or a site monitoring plan developed in accordance with Chapter 405. The frequency of sampling must be adequate to represent the residual, soil or other media. (The Department will require a site monitoring plan when it determines in a program or site license that a utilization program poses a potential threat to public health or safety or the environment because of the nature of the residuals utilized and/or the location, design and operation of a utilization site.)
  1. Joint Utilization. When more than one generator are utilizing a residual that requires a site specific license at the same site, a joint utilization agreement, meeting the standards in Chapter 419, section 2.D, unless previously submitted.
  1. Corporation: If the applicant is a corporation, a recent certificate of good-standing from the Secretary of State must be attached.
  1. Variance. If a variance or variances are being requested as part of this application, specify the nature of the variance and the justification for why it should be granted. Refer to Chapter 400, Section13 of the Solid Waste Management Rules for the standards and submissions required in this variance application.

END