Wastewater Lab Certification Program
Environmental Data Quality Unit
Doc Type: Certification Application
Instructions:
For renewal and initial applications fill out the following form and submit any revisions to your Quality Assurance Manual (QAM) or Standard Operating Procedures (SOPs)along with this application. If you need further assistance, please referto the Application Instructions found at the end of this form. It is recommended that initial applicants read the instructions closely to reduce errors and ensure all documents are submitted for certification. If you have questions, contact Jennifer Thoreson by email at phone number 651-757-2805. / MPCA Use OnlyAgency Interest ID
Date received (mm/dd/yyyy)
Initial Renewal Change request(change of ownership or add/drop method)
Submittal:
We prefer that you submit your application electronically as a MS Word document only, andattach it in an email to Jennifer Thoreson at . Please address the subject line with the name of your facility name and Lab Application(For example: St. Peter Lab Application). If you do not have access to email, you may print the completed application and mail it to: Jennifer Thoreson, Minnesota Pollution Control Agency, 520 Lafayette Road North, St. Paul, MN 55155. You may also print your application and fax it to 651-296-8676.
Permittee information
/ Certification year:Permittee name: / Permit number:
Mailing address:
City: / State: / Zip code:
Phone: / Fax: / Email:
Authorized agent: / Title:
Facility information
Facility name:Street address:
City: / State: / Zip code:
Township: / County:
Lab information
Contact name: / Title::Mailing address:
City: / State: / Zip code:
Phone: / Fax: / Email:
Authorized representative (current or previous owner)
By typing your name below, you certify the information on this application to be true and correct, to the best of your knowledge, and that you are requesting acceptance to the Minnesota Pollution Control Agency’s Laboratory Registration Program.
Owner name: / Title:(This document has been electronically signed.) / Date (mm/dd/yyyy):
Laboratory certification test procedures
(Note: hit tab to move to the next field for automatic calculations to work on Total category number of methods.)
Test category
/Analytes in test category
/Test method
/Number of methods
0. Certification not required
/Specific conductance, micromhos/cm at 25°C (Conductivity)
/Select test method:EPA 120.11 (Rev. 1982)SM 2510 B-2011ASTM D1125-95(99) (A)AOAC 973.40USGS I-2781-85
If other, specify:
Dissolved oxygen
/Select test method:SM 4500-O B-2011SM 4500-O C-2011SM 4500-O D-2011SM 4500-O E-2011SM 4500-O F-2011SM 4500-O G-2011ASTM D888-09 (A)ASTM D888-09 (B)ASTM D888-09 (C)AOAC 973.45BUSGS I-1575-78In-Situ Method 1002-8-2009Hach Method 10360, Rev.1.2, October 2011
If other, specify:
Hydrogen ion (pH)
/Select test method:EPA 150.2 (Dec. 1982)SM 4500-H+B-2011ASTM D1293-99 (A or B)AOAC 973.41USGS I-1586-85USGS I-2587-85Technicon 378-75WA Oct 1976
If other, specify:
Hydrogen ion (pH) - Solids
/Select test method - Solids:EPA SW-846 9045D
If other, specify:
Total residual chlorine
/Select test method:SM 4500-Cl B-2011SM 4500-Cl C-2011SM 4500-Cl D-2011SM 4500-Cl E-2011SM 4500-Cl F-2011SM 4500-Cl G-2011ASTM D1253-08Orion Research Inst Man Electrode Model 97-70.1977
If other, specify:
Temperature
/Select test method:SM 2550 B-2010WaterTemperature-InfluentialFactors,USGS,Bk1,ChD1
If other, specify:
Total Category 0 number of methods:
/ 01. Oxygen utilization
/Biological oxygen demand (BOD5)
/Select test method:SM 5210 B-2011AOAC 973.44American National Standard on Photographic ProcessUSGS I-1578-78In-Situ Method 1003-8-2009Hach Method 10360 Revision 1.2, October 2011
If other, specify:
Carbonaceous biochemical oxygen demand (CBOD5)
/Select test method:SM 5210 B-2011In-Situ Method 1004-8-2009Hach Method 10360 Rev. 1.2, October 2011
If other, specify:
Total Category 1 number of methods:
/ 02. Nitrogen
/Ammonia (as N)
/Select test method:EPA 350.1, Rev. 2.0 (1993)SM 4500-NH3 B-2011SM 4500-NH3 C-2011SM 4500-NH3 D-2011SM 4500-NH3 E-2011SM 4500-NH3 F-2011SM 4500-NH3 G-2011SM 4500-NH3 H-2011ASTM D1426-08 (A)ASTM D1426-08 (B)ASTM D6919-09AOAC 973.49USGS I-3520-85USGS I-4523-85Industrial Method Number 379-75 WE Ammonia
If other, specify:
Ammonia – Solids
/Select test method - Solids:EPA 350.1, Rev. 2.0 (1993)SM 4500-NH3 B-2011SM 4500-NH3 C-2011SM 4500-NH3 D-2011SM 4500-NH3 E-2011SM 4500-NH3 F-2011SM 4500-NH3 G-2011SM 4500-NH3 H-2011ASTM D1426-08 (A)ASTM D1426-08 (B)ASTM D6919-09AOAC 973.49USGS I-3520-85USGS I-4523-85Industrial Method Number 379-75 WE Ammonia
If other, specify:
Kjeldahl Nitrogen-Total, (as N)
/Select test method:EPA 350.1 Rev. 2.0 1993EPA 351.1 (Rev. 1978)EPA 351.2 Rev. 2.0 1993Hach 10242SM 4500-NH3 C-2011SM 4500-NH3 E-2011SM 4500-NH3 D-2011SM 4500-NH3 F-2011SM 4500-NH3 G-2011SM 4500-NH3 H-2011SM 4500-Norg D-2011ASTM D1426-08 (A)ASTM D1426-08 (B)ASTM D3590-02(06) (B)AOAC 973.48USGS I-4551-78USGS I-4515-91NCASI TNTP W10900
If other, specify:
Kjeldahl Nitrogen-Total, (as N) - Solids
/Select test method - Solids:EPA 350.1 Rev. 2.0 1993EPA 351.1 (Rev. 1978)EPA 351.2 Rev. 2.0 1993Hach 10242SM 4500-NH3 C-2011SM 4500-NH3 E-2011SM 4500-NH3 D-2011SM 4500-NH3 F-2011SM 4500-NH3 G-2011SM 4500-NH3 H-2011SM 4500-Norg D-2011ASTM D1426-08 (A)ASTM D1426-08 (B)ASTM D3590-02(06) (B)AOAC 973.48USGS I-4551-78USGS I-4515-91NCASI TNTP W10900
If other, specify:
Nitrate (as N)
/Select test method:AOAC 973.5AOAC 993.30ASTM D4327-03ASTM D6508-00(05)Calculated: Nitrate-nitrite N minus Nitrite N EPA 300.0, Rev 2.1 (1993)EPA 300.1-1, Rev 1.0 (1997)EPA 352.1 (Issued 1971)EPA 419DHach 10206SM 4110 B-2011SM 4110 C-2011SM 4140 B-2011SM 4500-NO3 D-2011Waters Corp D6508, Rev. 2 Dec2000Technicon Auto Analyzer II 379-75 WE 2-19-76American National Standard on Photographic ProcessEasy (1-Reagent) Nitrate Method Rev. 11-12-11
If other, specify:
Nitrate - Solids
/Select test method - Solids:EPA SW-846 9056AEPA SW-846 9210A
If other, specify:
Nitrate-nitrite (as N)
/Select test method:EPA 353.2, Rev. 2.0 (1993)EPA 300.0, Rev. 2.1 (1993)EPA 300.1-1, Rev. 1.0 (1997)SM 4500-NO3 E-2011SM 4500-NO3 F-2011SM 4500-NO3 H-2011SM 4110 B-2011SM 4110 C-2011SM 4140 B-2011Hach 10206ASTM D3867-04 (B)ASTM D3867-04 (A)ASTM D4327-03ASTM D6508-00(05)USGS I-2545-90Easy (1-Reagent) Nitrate Method Rev. 11-12-11AOAC 993.3Waters Corp Method D6508, Rev. 2. Dec2000
If other, specify:
Nitrite (as N)
/Select test method:EPA 353.2, Rev. 2.0 (1993)EPA 300.0, Rev. 2.1 (1993)EPA 300.1-1, Rev. 1.0 (1997)SM 4500-NO2 B-2011SM 4500-NO3 F-2011SM 4500-NO3 E-2011SM 4110 B-2011SM 4110 C-2011SM 4140 B-2011ASTM D3867-04 (A)ASTM D3867-04 (B)ASTM D4327-03ASTM D6508-00(05)Hach Company Method 8507 1979USGS I-4540-85USGS I-4545-85Easy (1-Reagent) Nitrate Method, Rev. 11-12-11Waters Corp Method D6508, Rev. 2 12-2000AOAC 993.3
If other, specify:
Total Category 2 number of methods:
/ 0(Note: hit tab to move to the next field for automatic calculations to work on Total category number of methods.)
Test category
/Analytes in test category
/Test method
/Number of methods
3. Phosphorous
/Total phosphorous
/Select test method:EPA 365.1 Rev. 2.0 (1993)EPA 365.3 (Issued 1978)EPA 365.4 (Issued 1974)EPA 200.7, Rev. 4.4 (1994)SM 4500-P E-2011SM 4500-P F-2011SM 4500-P G-2011SM 4500-P H-2011SM 3120 B-2011ASTM D515-88 (A)ASTM D515-88 (B)AOAC 973.55AOAC 973.56USGS I-4600-85USGS I-4471-97USGS I-4610-91ThermoJarrell Ash Corp Method AES0029 1986 Rev1991NCASI TNTP W10900
If other, specify:
Total phosphorous - Solids
/Select test method - Solids:EPA 365.1 Rev. 2.0 (1993)EPA 365.3 (Issued 1978)EPA 365.4 (Issued 1974)EPA 200.7, Rev. 4.4 (1994)SM 4500-P E-2011SM 4500-P F-2011SM 4500-P G-2011SM 4500-P H-2011SM 3120 B-2011ASTM D515-88 (A)ASTM D515-88 (B)AOAC 973.55AOAC 973.56USGS I-4600-85USGS I-4471-97USGS I-4610-91ThermoJarrell Ash Corp Method AES0029 1986 Rev1991NCASI TNTP W10900
If other, specify:
Orthophosphate as P
/Select test method:EPA 365.1, Rev. 2.0 (1993)EPA 365.3 (Issued 1978)EPA 300.0, Rev. 2.1 (1993)EPA 300.1-1, Rev. 1.0 (1997)SM 4500-P E-2011SM 4500-P F-2011SM 4500-P G-2011SM 4110 B-2011SM 4110 C-2011SM 4140 B-2011ASTM D515-88(A)ASTM D4327-03ASTM D6508-00(05)AOAC 973.55AOAC 973.56AOAC 993.30USGS I-4601-85Waters Corp. D6508, Rev. 2.54 Dec2000
If other, specify:
Total Category 3 number of methods:
/ 04. Physical
/Residue-Total (total solids)
/Select test method:SM 2540 B-2011USGS I-3750-85
If other, specify:
Residue-filterable (total dissolved solids)
/Select test method:SM 2540 C-2011ASTM D5907-03USGS I-1750-85
If other, specify:
Residue-Volatile (volatile solids)
/Select test method:EPA 160.4 (Issued 1971)SM 2540-E-2011USGS I-3753-85
If other, specify:
Residue-non-filterable (total suspended solids)
/Select test method:SM 2540 D-2011ASTM D5907-03USGS I-3765-85
If other, specify:
Oil and grease
/Select test method:EPA 1664 Rev. AEPA 1664 Rev. BSM 5520 B-2011SM 5520 F-2011
If other, specify:
Turbidity
/Select test method:EPA 180.1, Rev. 2.0 (1993)SM 2130 B-2011ASTM D1889-00USGS I-3860-85Mitchell Method M5331 Rev. 1.0, 7-31-2008Mitchell Method M5271 Rev. 1.0, 7-31-2008Orion Method AQ4500 Rev. 5, 3-12-09
If other, specify:
Total, Fixed and Volatile solids in Solid and Semisolid samples
/Select test method:SM 2540 G-2011
If other, specify:
Total Category 4 number of methods:
/ 05. General I
/Acidity, as CaCO3
/Select test method:SM 2310 B-2011ASTM D1067-06USGS I-1020-85
If other, specify:
Alkalinity, as CaCO3
/Select test method:EPA 310.2 (Rev. 1974)SM 2320 B-2011ASTM D1067-06AOAC 973.43USGS I-1030-85USGS I-2030-85
If other, specify:
Color
/Select test method:SM 2120 B-2011NCASI Technical Bulletin 253, 12-1971USGS I-1250-85
If other, specify:
Hardness-total, as CaCO3
/Select test method:EPA 130.1 (Issued 1971)SM 2340 B-2011SM 2340 C-2011ASTM D1126-02(07)AOAC 973.52BUSGS I-1338-85
If other, specify:
Silica-dissolved
/Select test method:EPA 200.5, Rev 4.2 (2003)EPA 200.7, Rev 4.4 (1994)EPA 200.8, Rev 5.4 (1994)SM 4500-SiO2 C-2011SM 4500-SiO2 E-2011SM 4500-SiO2 F-2011SM 3120 B-2011SM 3125 B-2011ASTM D859-05ASTM D5673-05USGS I-1700-85USGS I-2700-85USGS I-4471-97AOAC 993.14
If other, specify:
Sulfite (as SO3)
/Select test method:4500-SO3 2-B-2011
If other, specify:
Surfactants
/Select test method:SM 5540 C-2011ASTM D2330-02
If other, specify:
Total Category 5 number of methods:
/ 0(Note: hit tab to move to the next field for automatic calculations to work on Total category number of methods.)
Test category
/Analytes in test category
/Test method
/Number of methods
6. General II
/Chemical oxygen demand
/Select test method:EPA 410.3 (Rev. 1978)EPA 410.4 Rev. 2.0 (1993)SM 5220 B-2011SM 5220 C-2011SM 5220 D-2011Hach Company Method 8000 Hach Hdbk of Water AnalysASTM D1252-06 (A)ASTM D1252-06 (B)AOAC 973.46USGS I-3560-85USGS I-3561-85American National Standard on Photographic ProcessOIC Chemical Oxygen Demand Method.1978.Oceanograph
If other, specify:
Total phenolic compounds
/Select test method:EPA 420.1 (Rev. 1978)EPA 420.4, Rev. 1.0 (1993)SM 5530 D-2010ASTM D1783-01 (A or B)
If other, specify:
Cyanide-total
/Select test method:EPA 335.4, Rev. 1.0 (1993)SM 4500-CN D-2011SM 4500-CN E-2011SM 4500-CN F-2011ASTM D2036-09(A)ASTM D7284-08Lachat Instruments, QuikChem Method 10-204-00-1-XAmerican National Standard on Photograph ProcessUSGS I-3300-85USGS I-4302-85
If other, specify:
Cyanide-available
/Select test method:SM 4500-CN G-2011ASTM D2036-09(B)ASTM D6888-09OIA-1677-09
If other, specify:
Sulfide
/Select test method:SM 4500-S2 B-2011SM 4500-S2 C-2011SM 4500-S2 D-2011SM 4500-S2 F-2011SM 4500-S2 G-2011ASTM D4658-08USGS I-3840-85
If other, specify:
Sulfate
/Select test method:EPA 375.2, Rev 2.0 (1993)EPA 300.0, Rev 2.1 (1993)EPA 300.1-1, Rev 1.0 (1997)SM4500-SO4 2-C-2011SM4500-SO4 2-D-2011SM4500-SO4 2-E-2011SM4500-SO4 2-F-2011SM4500-SO4 2-G-2011SM 4110 B-2011SM 4110 C-2011SM 4140 B-2011ASTM D516-07ASTM D4327-03ASTM D6508-00(05AOAC 925.54.3AOAC 993.303USGS I-4020-05Waters Corp Method D6508, Rev. 2.54 12-2000
If other, specify:
Chloride
/Select test method:EPA 300.0, Rev 2.1 (1993)EPA 300.1-1, Rev 1.0 (1997)SM 4500-Cl-B-2011SM 4500-Cl-C-2011SM 4500-Cl-D-2011SM 4500-Cl-E-2011SM 4110 B-2011SM 4110 C-2011SM 4140 B-2011ASTM D512-04 (A)ASTM D512-04 (B)ASTM D512-04 (C)ASTM D4327-03ASTM D65-08-00(05)USGS I-1183-85USGS I-1184-85USGS I-1187-85USGS I-2187-85USGS I-2057-90AOAC 993.30AOAC 973.51Waters D6508, Rev. 2 12-2000
If other, specify:
Total Category 6 number of methods:
/ 07. General III
/Total organic carbon
/Select test method:SM 5310 B-2011SM 5310 C-2011ASTM D7573-09ASTM D4839-03AOAC 973.47USGS, Book 5, Ch. A3, 1972 Rev. 1987, p. 14
If other, specify:
Total Category 7 number of methods:
/ 08. Metals
/AluminumAntimonyArsenicBariumBerylliumBoronCadmiumCalciumTotal ChromiumCobaltCopperIronLeadMagnesiumManganese,MolybdenumNickelPotassiumSeleniumSilverSodiumStrontiumThalliumTinVanadiumZinc
/Select test method:EPA 200.5, Rev. 4.2 (2003)EPA 200.7, Rev. 4.4 (1994)EPA 200.8, Rev. 5.4 (1994)EPA 200.9, Rev. 2.2 (1994)SM 3111 B-2011SM 3111 D-2011SM 3111 E-2011SM 3113 B-2010SM 3120 B-2011SM 3125 B-2011ASTM D5673-05ASTM D4190-08USGS I-3051-85USGS I-4471-97AOAC 993.14Thermo Jarrell Ash Corp Method AES0029
If other, specify:
–Metals - Solids
AluminumAntimony ArsenicBariumBerylliumBoronCadmium Calcium Total ChromiumCobaltCopperIronLeadMagnesiumManganese,MolybdenumNickelPotassiumSeleniumSilverSodiumStrontiumThalliumTinVanadiumZinc
/Select test method - Solids:EPA SW-846 6010DEPA SW-846 6020BEPA SW-846 7000BEPA SW-846 7010
If other, specify:
Hexavalent chromium
/Select test method:EPA 218.6, Rev. 3.3 (1994)SM 3111 C-2011SM 3500-Cr B-2011SM 3500-Cr C-2011
If other, specify:
Mercury
/Select test method:EPA 245.1, Rev. 3.0 (1994)EPA 245.2 (Issued 1974)EPA 245.7 Rev. 2.0 (2005)EPA 1631ESM 3112 B-2011ASTM D3223-02(07)AOAC 977.22USGS I-3462-85USGS I-4464-01
If other, specify:
Mercury - Solids
/Select test method - Solids:EPA SW-846 7471B
If other, specify:
Total Category 8 number of methods:
/ 0(Note: hit tab to move to the next field for automatic calculations to work on Total category number of methods.)
Test category
/Analytes in test category
/Test method
/Number of methods
9. Microbiology
/E.coli, number per 100 mL
/Select test method:SM 9223 B-2004SM 9223 B (Colilert)-2004SM 9223 B (Colilert-18)-2004SM 9221 B.1-2006SM 9221 F-2006
If other, specify:
Coliform (fecal) number per 100 mL or number per gram dry weight
/Select test method:Colilert-18EPA/600/8-78/017 P.132 1978EPA/600/8-78/017 P.124 1978SM 9221 C E-2006SM 9222 D-2006USGS B-0050-85
If other, specify:
Coliform (fecal) number per 100 mL or number per gram dry weight - Solids
/Select test method - Solids:EPA/600/8-78/017 P.124 1978EPA/600/8-78/017 P.132 1978EPA 1680EPA 1681SM 9221C E-2006SM 9222 D-2006
If other, specify:
Coliform (total), number per 100 mL
/Select test method:EPA/600/8-78/017 p.108 1978EPA/600/8-78/017 p.111 1978EPA/600/8-78/017 p.114 1978SM 9221 B-2006SM 9222 B-2006USGS B-0025-85 1989
If other, specify:
Total Category 9 number of methods:
/ 010. Organics; Purgeable by Gas Chromatography or Gas Chromatography/ Mass Spectrometry
/Volatile organic compounds
/Select test method:EPA 624.1EPA 1624B
If other, specify:
Total Category 10 number of methods:
/ 011. Organics; Semivolatile by Gas Chromatography/Mass Spectrometry
/Phenolic Compounds (acid-extractables) and base/neutral extractable compounds (excluding pesticides)
/Select test method:EPA 625.11625B
If other, specify:
Total Category 11 number of methods:
/ 012. Organics; Organochlorine Compounds
/Polychlorinated biphenyls
/Select test method:EPA 608.3
If other, specify:
Polychlorinated biphenyls - solids
/Select test method solids:EPA SW-846 8082A
If other, specify:
Organochlorine pesticides
/Select test method:EPA 608.3
If other, specify:
Total Category 12 number of methods:
/ 0(Need to manually add from categories above)Total number of methods:
Additional permit required testing(To add a new row, place cursor in last row of last column and hit tab)
your preferred relay service•Available in alternative formats
p-eao7-01 • 10/4/18Page 1 of 7
Laboratory
/Accrediting body
/Parameter
Ex: ABC Laboratory / MDH / Priority Pollutants and Total Phosphorusyour preferred relay service•Available in alternative formats
p-eao7-01 • 10/4/18Page 1 of 7
Fee calculator
(Note: hit tab to move to the next field for automatic calculations to work on Total fee due.)
Part 1. Application type / Fee / Selection(mark with fee)
Initial / $1,350
Renewal / $900
Change request
Transfer of ownership / $900
Part 1. subtotal / $ 0
Part 2. Test category
0.Certification not required / $0
1.Oxygen utilization / $225
2.Nitrogen / $225
3.Phosphorous / $225
4.Physical / $225
5.General I / $225
6.General II / $450
7.General III / $900
8.Metals / $900
9.Microbiology / $225
10.Organics; Purgeable by gas chromatography or gas chromatography/mass spectrometry / $900
11.Organics; Semivolatile by gas chromatography/mass spectrometry / $900
12.Organics; Organochlorine compounds / $900
Part 2. Subtotal / $ 0
Part 3. Total amount due
Part 1. Subtotal / $ 0
Part 2. Subtotal / $ 0
Total fee due / $ 0
Application instructions
To complete your laboratory certification application, start by opening a copy of the application. We strongly suggest that you save a copy of the application to the computer before completing it, and save changes frequently while you are working. Be sure to save the document in a place where you will be able to find it later.
Certification year
Enter the certification year that is being applied for.(For example: The labs applying in November 2015 for the 2016 certification year would indicate 2016 in the field.)
Authorized representative section
The form must be signed by your authorized representative. This is the person at your facility responsible for submitting Discharge Monitoring Report data.
Laboratory certification test procedures section
If your method is not listed on the form, please be sure that your method is compliant with U.S. Environmental Protection Agency 40 CFR 136.3 and/or 503.8 lists of approved test procedures. If you have approval for a method not listed, please specify this in the “Other” field.
If you are uncertain of the year of approval for the method you are using from Standard Methods, please refer to the Introduction page of the method in Standard Methods to find the year of approval by the Standard Methods Committee.
New test methods can also be added to your certification at any point in the certification cycle.
Additional permit required testing section
Please fill in the name(s) of any laboratories used by your facility for compliance testing.This might include priority pollutants, biosolids, and acute toxicity. It may also include individual testing for ammonia or total phosphorus if not performed by your laboratory.
If you use multiple laboratories, fill in the requested information for the one used most often, and only list the names for labs that that are used occasionally.
Fee calculator section
If your laboratory has never had Minnesota Pollution Control Agency (MPCA) certification, or if MPCA certification has lapsed, select “initial” for the application type.
To complete the “Test category” section, refer to the Laboratory Certification Test Procedures section of the form. Select the box that corresponds to each test category for which your lab does testing. There is only one fee for each test category, regardless of the number of test procedures that are performed.
The form will calculate your estimated total amount due. No fee is due at this time. Invoices will be sent out in the early part of the next certification year.
Supporting documentation
If you are renewing your certification, and have revisions to your QAM or SOPs, please attach them to your application. Please also attach performance testresults if you have not already submitted them.
If you are applying for initial certification or certification for new test methods, please submit the following for each method:
- Standard operating procedure for the method
- Quality assurance manual
- Method detection limit study, if applicable
- Initial demonstration of capability, if applicable
- Passing results from a blind performance test
Submitting your application
After completing the application, save the completed form to your computer.
We prefer that you submit your application electronically as a MS Word document only (Save your file named: application year followed with lab name Lab Application. Example: 2017 St. Peter Lab Renewal Application.doc or docx) by attachment in an email to Jennifer Thoreson . Please address the subject line with the name of your facility name and Lab Application. For example: 2017 St. Peter Lab Application. If you do not have access to email, you may print the completed application and mail it to: Jennifer Thoreson, Minnesota Pollution Control Agency, 520 Lafayette Road North, St. Paul, MN 55155. You may also print your application and fax it to 651-296-8676.
Renewal applications (including forms and Quality Assurance/Quality Control documents) are due by November 30.
Initial applications may be submitted at any time.
your preferred relay service•Available in alternative formats
p-eao7-01 • 10/4/18Page 1 of 7