Attachment 5 

DMR records 
· FaciHi)-;Nfi/ii( - ·- -- -· aca/ion) -- ··-----· ... , ........... ~ .... l"r' I lVi'<i\L l'ULLU 1 Ai'\ I 1.)1:'-' "I IA:t<J[ ELI!\-11"1\:ATJON SYSTEM (NPDESJ 

··-·- ----··--- -·-- ----DtSCltKRGl: Ml fORiNG REPORT (DMR) . 

NAJ\1E: Municipal Authority of the Borough of 

Belle Vernon 

ADDRESS: PO Box !8l. 10 ?\1ain Street 

Beile Vernon. PA 15012 

FACILITY: Belle Vemon-~orth Belle Vernon \VPCP 

LOCATIO~: Belle Vernon Borough, fayene County 

Parameter (3 Card Only) 

(32-37) (46-53) 

(2- 16) , ___ , (17-19 , . .. . ) 

PA0092355 I I 001 

PEM•ITT NUM.BER I I DISCHARGE NUMBER 

MONITORING PERIOD 

FROM .YEAR I MO I DAY I TO I YEAR I MO I DAY 

U)t[ I 7 I I I I 

~"''~ I 7 l -; ( (20-21) (22-23) \24-25) (26-27) (28-29) (30-31) 

QUANTITY OR LOADI:\G (4 Card Only) Ql'ALITI" OR COl'CE:-\TR.4. TIO;\ (54-61) (38-45) (46-53) (54-61) 

I 

J 

J 

Sample 

AVERAGE MAXIMUM UNITS MrNIMUM AVERAGE MAXIMUM 

,z.l:5 ' yz.) • Measurement Penmt * • Flow Requirement MONITOR AND REPORT MGD Sample * * • Measurement 7 . /J I 'f' . 3 

Permit • ~ & CBOD-5 Day Reau

Sample irement 104..3 !56.4 LB/DY • 25 38 Measurement 

~f. i f ~ z.. 3 * 2..") Pc:rmlr <t.3 Suspended Solids Requirement 125.0 187.7 LBIOY • 30 45 t-ecaJ Collform Sample Measurement 

May 1 * • • z. eo {000 to Sep 30 Perrott 

200 Oct lO_o_o_ 1 to Apr 30 Reauirement .. • .. Sample • 2000 10000 Measurement • • Permit ({? ' '-1 • 6.0 

~H Requirement • * .. 6.0 . Sample 9.0 Measurement .. * • ().5 .. Permtt Total Residual Chlorine 

Re<~uirement * • • .. 0 .5 Sample * Measurement .. • • Penn it * • 

Requirement • • * * • NAMEfnTU: PRlNCIPAL EXECUID'E I CERTIFY UNDER PENALTY OF LAW * TllAT I HAVE PERSONALLY EXAMINED AND AM FAMILIAR. OFFICER WITH THE INFORMATION SUBMITTED HEREIN AND BASED ON MY INQUIRY OF THOSE !NDIYJDUALS IMMEDIATELY RESPONSIBLE FOR OBTA!Nil\'G THE INFORMATION. l BEI.IEVE TilE SUBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. I AM AWARE TiiAT 

Thi~ DM

0.5 mgd

Dischar

.E>:pan.s

treating 

1'\0TE: R

UNITS 

• 

MG/L 

MGIL 

#/IOOML 

S.U. 

MGIL 

* 

TELEPHON

Gv~ 

~~ c, t~s· 

C. J-r.ry>,o7 lliER.EAR:E SIGNIFICANT PENALTIES FOR SUBMrrTING FALSE INFORMATION. INCl-UDING iHE 

/t...;;... 'j J..~- g 

POSSIBILITY OF FINE AND IMPR.JSONMENT SEE 18 U.S.C. §1001 AND 33 U.S.C. §1319. TYPE OR PRlNT (Penalties under these statutes may 

includes fines up to SIO,OOO and or maximum rsJGNATUR! OF PPJJOC!P A.L EXECUTIVE AREA 

imprisonment ()fberw~ 6rn_on ths8JI~ars) COMMENT AND EXPLANATION OF ANY VIOLATIONS OFFICER OR AUTHO.R..IZED AGEI>.'T CODE NUM

(Reference all attachments here) 

EPA FORM 3320-1 (Rev 9- 88) Previous edition maybe used. {REPLACES EPA FORM T-40 WHICH MAY NOT BE USED) 

NOTE: YOUR PERMIT WILL EXPIRE ON NC;\/ 3 Q 2008 . PLEASE SUBMIT YOUR RENEWAL APPLICATION BY JUN - 
DI!ICHARGl! MOmTOIUNG REPO]!.T S1li -~~ENT~SEW A.GE SLUDGt REFORt 

Instructions: 

. 

· ij * · · · · 

· 

· mP.letemont}flyandsubmitwitheachDMR. Attach additional _ f . · Permittee: MIL 

0-,t

:/BkL L~ IJ

-· ----1:)- r· ----··-- ---........ - ... - ...... , .............. _...,.,. __ ..., ... ' ......... _ • .., l" ... ~ .. ~ ··---S: /J/1- (J~ 9"

performBllcc. Report orily sludge which has been removed from Munlclpallty:· fj£( t

1~ 

digesters and other solids which have been permanently removed County: _E_A-t-/h 7T

from the treatment process. ·Do not include sludge from ·other 0 . f . ,. - plarits which is prr;>cessed.at your facility. 

·I 

3. In the disposal site section, report all sludge leaving your For sludge that is incinerated: facility for disposal. If another plant processes and disposes Pre-incineration weight= 

of your sludge, just provide the name of that plant. If you 

:. ,_} dispose of sludge from other: plants, Post-incineration weight - 

include their tonnage in the 

disposal site section and provide the!r names and individual dry - tonnage on the back of this fonn. 4. If no sludge was removed, note on fonn. 

, . SLUDGE PRODUCTION INFORMATION (prior to incineration) 

' HAULED AS LIQUID 

SLUDGE HAUhED ~-D~V{ ATERE

(Conversion (Tons of 

. ;(Gallons) X (%Solids) X Factor) ... Dry Toils :;Q,Qwatered Sludge) X (%Solids) 

: 

----

.. 

Name: 

Pennlt No.: 

Dry Tons Disposed: 

Type: (check one) 

Landfill 

Agr. Ut1l.izatwn ' 

Other (specify) 

County: 

(SSR-1 3/21/91) 

. 0000417 OJ 

I 

l 

I 

I fr..~ 

j . 

I 

I 

, 

() ---· 

DISPOSAL SITE INFORMA.TION: ·List all sites, even if not used this month 

Stte 1 

Site 2 

'f 

... 

. I ... :. 

Signature 

Stte 3 

... 

-Su#--t/~/>Jb~ 

Title 

: 

1!-; 

Date 
. - -- -·. ... ~- ·- .. ·-- - ----............. ... 

----Facility-Nom;' ·Torrc.,-artlnio'J'llrrl)!---------

i -

~AJ\·fE: 

--

-· l'vlunicipa.l Authority of the Borough of 

Belle Vernon 

ADDRESS: PO Box 181 , I 0 Main Street 

Belle Vernon. PA 15012 

"'" IVJ'i"'-L P.JLLU I ''l" I LJL'' rtAKVt I:.LII\1lNAllUN :-:. y::, II:.M (NPDES) 

----DISCHARGE M TORING·REPORT-(DMR-)- --

(,.2-16 -- - ~. ) (] 7-19) 

PA0092355 J l 001 I 

PER.MIT NUMBER I I DISCHARGE NUMBER 

MON!TORfNG PERIOD i FACILITY: Belle Vernon-North Belle Vernon Vv1'CP 

LOCATION: Belle Vernon Borough, Fayette County 

FROM YEAR I MO I DAY I TO I YEAR I MO I DAY I 

~"!? I t(} I I I I ;_., £ I l' I !> ( - -- (20-2 1) ·- - · (22-23) (24-25) (26-27) (28-29,1 (30-31) Parameter (3 Card Only) Ql'Al\'Tln' OR LOADING (4 Card Only) QUALITY OR (Ol'iCE~TRA TIO'i (32-37) (46-53) (54-61) (38-45) (46-53) (54-61) AVERAGE MAXIMUM liNITS MINIMUM AVERAGE !1.1AXIMUM Sample ~r. Measurement ' l.." ~ . 5Lf * + Permit * Flow Requirement MONITOR AND REPORT MGD * • Sample * Measurement I '1 • 2.- !> I . 1.. * ? 13 Perrmt CBOD-5 Day Requirement 104.3 156.4 LB/DY * 25 38 Sample 7-t . ) - 9 

3 . 7 31 3 'J Measurement * Permn SuSPended Solids Reouirernent. 125.0 187.7 LB/DY * 30 45 

This DM

0.5 mg

Discha

Expans

treating 

~OTE: R

UNITS 

* 

MGJL 

MGIL 

Fecal Colitonn Sample 

• * * 3cJZ'1''- s-Pc,_,, 

Measurement May I to Sep 30 Permn 200 1000 

Oct lto~30 Requirement • • * • 2000 10000 #/IOOML 

Sample 

Measurement • • '1.7 • 'f, 7 

Penn1t 

2_H Re_guirement * • .. 6.0 .. Sample 9.0 S.U. 

Measurement .. • * ...-- () ~ Permit • 

Total Res.idual Chlorine Re{luirernenl * * * • 0.5 * MGIL Sample 

Measurement * * • * • t'emut 

Requirement * • * • * • . NAMf./TilLE PRINCIPAL EXECUTIVE I CER.11FY UNDER P£NAL. 

TY OF LAW iliA T I HAVE PERSONALLY EXAMINED AND AM FAMILIAR OFFJCER WITH TiiE TELEPHO

INFORMATION SUBMITTED HEREIN .AND BASED ON MY INQUIRY OF lliOSE 

INDMDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING THE INFORMATION. I BELIEVE 

(; V l c L t-,lf§ 1 

TilE SlJBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. I AM AWARE iliAT 

A~ (_2 r~ THEltE ARE SIGNIFICANT PENAl. TIES FORSUBMmJNG FAlSE INFORMATION. INCLUDING THE ?l--1-"i'--$-1

POSSIBILITY OF FINE AND !MPRJSONMENT SEE 18 U.S.C. §1001 .AND 33 U.S.C. §!319. 

TYPEORP T (Penalties under these statutes may includ~ fines up to S l 0,000 and or maximum 

~-OF PR!NCfPAL EXECLTTIVE AREA 

COMMENT 

impnS()Ditlent of between 6 months and 5 years) _ _ -- ___ _ OmCER OR A_{JT)iORJZED AGENT CODE NUM

AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) 

EPA FORM 3320-1 (Rev 9 - 88) Previous edition maybe used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED) 

NOTE: YOUR PERMIT WILL EXPIRE ON NCl\f 3 0 2008 -------· PLEASE SUBMIT YOUR RENEWAL APPLICATION BY JUN - 
· 2. .~Hons: ---cpmplete montl).ly and submit with each D.MR. Attach additional sheets and comments as needed for completeness and clarity. Sludge production information will be used to evaluate plant perfonna.nce. Report orily sludge wJlich has been removed from digesters end other solids wbjch have been permanently removed from the treatment process. 'Do not include sludge from other 

DISCHARGE MONITORING REPOF:.T 

. 

S"41F ... 

ij 

__ ,.

· 

,~

• · :·. Rt-{TALSEW A.GE · SLUDGlt REPORT "

.. 

. 

~ :_ 

W . 

Permittee: MIL W-,t,Jt

Plant: 

::S..tLL~ '/::.

. ~ 

NPDES: 

~ "tJ 3 

plants which is processed. at your facility. . 3. In the disposal site section, report all sludge leaving your facility for disposal. If another plant processes and disposes f vour sludR:e. just orovide the name of that olant. If 

. -- - -- - --

- - -

- - - -

. HAULED AS LIQUID Sl:UDOE 

(ConversiOn 

. :coa11ons) X (%Solids) X Factor) .. Dry Toils 76.111 

. 0000417 tJ , <:>-F 

' 

-""""' .. -tJ.::r.K 

tj Mwl1cipeUty: .6..( t. 

· County: E~1Tp_ 

For sludge that is incinerated: 

Pre-incineration weight= 

Post-incineration weight.. - 

' jl 

-

RMA TION (prior to incineration) 

- 

HAULED AS DEWA . t<.t<:nu 

(Tons of 

:~watered Sludge) X 

(%Solids) X 

c .... 

''" 

"l""''.f"''\.1 

DISPOSAL SITE INFORMATION: List all sites, even lfnot used this month SltC 1 

Name: Site2 

PennitNo.: 

Dry Tons Disposed: . Type: {check one) 

· r:-anamr 

Agr. Utilization ••• . . Other TspeCI!Y) . County: ' . . 

(SSR-1 3/21191) 

Sigilarure 

81te 3 

... 

-.:S'u.,o;~"-/~.Nt:>~ Title 

: 

;/-(frO 

Date 
Facility 

;'J:.KJ.VI!l 

Na,li. 

1.1:.1:. NAM.J::: ADDRESS (lnclude NATIONAL POLLUTANT D! LARGE ELIMINATION SYSTEM (NPDES) ocation) DISCHARGE MG •. tTORING REPORT (DMR) 

NAME: Municip~J Authority of the Borough of (2-16) (17-19) Belle Vemon PA0092355 ADDRESS I I 001 : PO Box 181, 10 Main Street PERMIT NUMBER I Belle l DISCHARGE NUMBER Vernon, PA 15012 MONITORING PERlOD FACILITY: Belle Vernon-North Belle Vernon WPCP 

LOCATION: Belle Vernon Borough, Fayette County 

FROM YEAR I 

:ttJo o I 

MO I DAY I TO 

II I I I 

- (20-21) (22-23) (24-25) 

Parameter (3 Card Only) QUANTITY OR LOADING (4 Card Only) (32-37) (46--53) (54-61) (38-45) AVERAGE MAXIMUM UNITS MINIMUM Sample 

'30'1 Measurement . L(tJ/ • Permn Flow Requirement MONITOR AND REPORT MGD Sample * Measurement jrL3 z_ g.'( • Permtt CBOD-5Day ReQuirement 1043 I 56.4 LB/DY • Sample Measurement t, '(. 5 ? '(. 1 • Permit Suspended Solids ReQuirement 125.0 187.7 LB/DY Fecal C'oliform Sample * 

• • • Measurement May I to Sep 30 Permit Oct 1 to Apr 30 ReQuirement • • • .. Sample Measurement • • ~.7. Pc:rm.it pH Requirement. "' • • 6.0 :sample Measurement • • • Pcmut Total Residual Chlorine ReQuirement • * * • :sample Measurement • • * l'ennit 

ReQuirement 

NAMffrm..E 

• • • • 

OFFICER 

PRINCIPAL EXECUTIVE J CERTIFY UNDER PE;":ALTY OF LAW TiiAT I HAVE PERSONAL I. Y EXAMINED AND AM FAMILIAR 

WITil THE INFORMATION SUBMmED HEREIN AND BASED ON MY INQIJIRY OF lliOSE ll'iDIVIDUALS IMMEDlHELY RESPONSIBLE FOR OBTA!NrNG lliE INFORMATION. I BELIEVE 

THE SUBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT 

I YEAR I MO I DAY I uu t! I 1/ 1 .J6 

. ~ --· (26-27) . - --· (28-29) ·-- .. (30-31) 

QUALllY OR CONCENTRATION 

(46-53) (54-61) 

AVERAGE MAXIMUM 

* * 

* * 

i If 

25 38 

L") 31 

30 45 

'fZ 77 /7 01)0 

200 1000 

2000 10000 

• {;, r 

.. 9.0 

()' 'I • 

0.5 • 

• • 

• • 

This D

0.5 mg

Discha

Expans

treating 

NOTE: 

UNITS 

• 

MGIL 

MGIL 

i!/IOOML 

S.U . 

MGIL 

• 

TELEPHO

{;;v~. f:rvrr' 

A~c.t 

lliEREARE SIGNIFICANT PENALTIES FOR SUBMmTNG FALSE INFORMATION. !NCLlJ'DING lliE 

7 '-£!- "i' t- r ~ 

POSSlBli.ITY OF FINE A.'ID IMPRISONMENT SEE 18 U.S.C. §100) AND 33 U.S.C, §1319. r 

EORPRINT (Penalties under these statutes may includes 

---

--

fines up to S 10,000 and or maximum SIGNATURE OF l"'ui-'CIP AL EXECUTIVE AREA 

imprisonment of between 6 monllls and 5 ye3l'S) 

--- - - _9FFICER OltAU_T!IQg.IlED AG~ CODE NUM

COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference ------ -

all attachments here) 

During the month of November 2008, 183,330 gallons of gas-weel water was treated. 

EPA FORM 3320-1 (Rev 9- 88) Previous edition maybe used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED) 

NOTE: YOUR PERMIT WILL EXPIRE ON N'' -. ' -:: Q 2008 . PLEASE SUBMIT YOUR RENEWAL APPLICATION BY JUN - 
I 

t 

i 

2. 

DISCHARGE MONITORING REPOR't: AGE SLUOGE REI'OR'J' 

mont])ly and submft with each DMR. Mach additional ' ·: l .' · . Pennttt.e: Mk v.{!_., 

sheets and as needed for and clarity. j . Plant: A.LL/e 

Sludge prt>duction lnfof!llatlon will be used to evaluate plant NPDES: - tJCJ 

perfonnance. Report orily sludge has been removed from 1$. Munlolpallty: · e( t

digesters and other solids hav.e been permanently removed '·· County: 7T

from the treatment process. Do not 1I1Clude sludge from ·other ,. 

plants which is processed. at your facility. . ; . 

In the disposal site section, report all sludge leaving your ' :1 

facility for disposal. If another plant processes and disposes ) ·.. · 

of your sludge, just provide the name of that plant. If you : 

dispose of sludge from other: plants, include their tonnage in the r : disposal site section and provide their names and individual dry 

tonnage on the back of this fonn. 

If no sludge was removed, note on fonn. 

3. 

4. 

For sludge that is incinerated: 

Pre-incineration weight"" 

Post-incineration weight "' 

-

. 

---- -------

-

- ---- - -- --

- -- ---- --- - "" . 

.i<' '1 AS LIQUID SLUDGE HAtJLBD AS DEW ATERE

(Convers10n (Tons oT 

. ;(Gallons) X (%Solids) X Factor) - Dry Tons Sludge) X (%Solids) 

3.,- d 0 2.. { 

' 

-

. 

-

Name: 

Permit}lo.: Dry Tons Dlsposed: 

Type: (check one) 

Landfill 

Ag:r. Utlbzation I ' Other (specify) 

County: 

(SSR-1 3/21191) 

.0000417 0 · s I 

f 

I 

I h . 

I. 

.. 

.. 

CJ • 3 i ---· 

DISPOSAL SITE INFORMATION: List all sites, even if not used thls month 

Site 1 

. 

Sigilature 

·-· 

Site 2 

(.. 

. ,:d ! 

S1te 3 

Title' 

(-(

Date 
.-u~'!lt 11:.1:. I':A.!Vll. Al.Jl.)R..ESS (lnci~<de NAllONAL POLLUTANT 

Facii;~l ; Nal}u ;calion) IJI ARGE EUMT\:,':!1~1~ SYSTEM (~PDES) DISCHARGE MOr,tTORI!'\G REPORT (D:\1R) 

NAME: Municipal Authority of the Borough of 

Belle Vernon 

ADDRESS: PO Box 181. 10 Main Street 

(2-16) 

PA0092355 

PERMIT NUMBER 

(17-19) I I 001 

Belle Vernon, PA 15012 I I DISCHARGE NUMBER 

FACILITY MONITORJNG PERIOD 

:. Belle Vernon-North Belle Vernon \VPCP LOCATION: Belle Vernon Borou!lh. Faverte Count'\· FR0\1 YE.I\R I MO I z...::,. z I ii.. I DAY I TO I I 

(20-21) (22-23) (24-25)' Parameter 

(32-37) (3 Card Only) QUANTITY OR LOADL~G (4 Card Only) (46--53) (54-61) (38-45) 

Sample 

AVERAGE MAXIMUM UNITS MINIMUM 

Measurement : 7&2. 2. :r Permit • Flow Requirement MONITOR AND REPORT MGD Sample * 

Meas~ent il·7 i7.\<> Pem11t • CBOD· 5Dav ReQuirement 104.3 156.4 LB/DY Sample * ll7_:; Measurement sio.5 -- PerrnJi • Sus_ll_ended Solids 

R_~:guirement 125.0 187.7 LB/DY * Fecal COliform Sample 

• 

Measurement • May I to Sep 30 • Penmt Oct J to Apr 30 Requirement • • .. Sample * Measurement • • 6,. L Pemnt oH Requi11m1ent • Sample * * 6.0 Measurement • * . Perm1t Total Residual Chlorine Requirement 

~ample 

• • • • 

Measurement • • Pennjt • Requirement NAME/TITLE PRINCIPAL EXECUTIVE • • • • OFFICER 1 CERTIFY UNDER PENALlY OF LAW THATI HAVE PERSONALLY EXAMINED AND AM FAMILIAR WlTH TilE INFORMATION SUBMITICD HEREIN AND BASED ON MY INQUIRY OF 7HOSE INOMOUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING 1H£ INFORMATION. I BELIEVE ll1E SUBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. I AM AWARE TliAT 

I YL\R I MO I DAY I z od' I i L I J/ 

(26-27) -- -- (28-29) (30-31) 

Ql'ALIH OR CONCE~TRATIO!'\ 

{46-53) (54-61) 

AVERAGE MAXIMUM 

• * 

• • 

'L .3 

25 38 

32- S.3 

30 45 

s-z..~ 

20_\)_ '~" 2000 lo ~o 

• 

y 

.. 9.0 

a.5 .. 

0.5 .. 

• • 

• • 

This DM

0.5 mgd

Dischar

Expansi

treating 

NOTE: R

liNITS 

• 

MGIL 

MGIL 

#/IOOML 

s.u. 

MGIL 

• 

TELEPHON

0v~ 

{_.~'!t=r~ 

~ 

c~~( . 

THERE ARE SIGNIFICANT PENALTIES FOR SUSMJ1TING FAI.5E INFORMATION. INCLUDING l1iE 

?L '(- ') t-(f /;

TYPEORP (Penalties POSSIBIUTY Of FINE AND IMPRJSONMENT SEE 18 U.S.C. §100] AND 33 U.S.C. §1~~ under these statutes may includes fines up to S 10,000 and or maxim l->Kl'_!"AT0R.E OF P~CIP AL EXECUTIVE AREA 

_imprisonment ofberwe~ 6 months and 5 years) OFFICER OR AUTHOR.JZED AGENT CODE NUM.B

- - -- COMl\1E?\tT AND EXPLANATION OF ANY VJOLATJONS (Reference all attachments here) 

During the month of December 2008, 212,520 gallons of gas well water was treated. 

EPA FORM 3320-1 (Rev 9- 88) Previous edition maybe used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED) NOTE: YOUR PERMIT WILL 

EXPIRE ON NIJV 3 0 2008 PLEASE SUBMJT YOUR RENEWAL APPLICATION BY JUN - 

--

-

-
t 

i! 

I 

r 

i 

DISCHARGE MONITORING REPORT,. 

Instructions: 

. . 1. CpmP.lete montl)J.y and submit with each DMR. Attach additional 

2. 

sheets and comments as needed for completeness and clarity. Sludge production information will be used to evaluate plant performance. Report orily sludge which has been removed from digesters and other solids whlch have been permanently removed from the treatment process. ·oo not include sludge from ·other plants which is processed. at your facility. . 3. In the disposal site section, report all sludge leaving your facility for disposal. If another plant processes and disposes of your sludge, just provide the name of that plant. If you dispose ofsludge from othe~ plants, include their tonnage ln the disposal site section and provide their names and individual dry tonnage on the back of this form. 4. If no sludge was removed, note on form. ~ ;!;}. 

;I 

A~SEWAGESLUDGtREFORr 

. SLUDGE PRODUCTION INFORJ.\1A.TION HAULED AS J..IQUID SI;UDQE (prior to incineration) HAULED AS DEWATE

. ;(Gallons) X (%Solids) X 

: 

~ .. 

Name: 

Penntt No.: 

Dry Tons Disposed: Type: (check one) 

Landfill 

Agr. Uhhzation . 

Other ' (specifY) County: 

(SSR-1 3/2lt91) 

(Convemon (Tons of Factor) ... Dry Toils 

.~watered Sludge) X (%Solids) • 0000417 q 

I 

I 

I 

I .,, 

I .. 

I 

c:-

Site 

DIS.POSAL SITE rNFOFJvf.A TION: List all sites, even if not used this month 1 

I 

, I 

IP/Y"I

~~

/~ 

Site 2 

~ 

. . 

<; ::l Signature ' -, . .,. j ~~~ 

. . 

j , .• 

Stte 3 

~ 

--Su#--i./~Afb~ Title 

; -

Dat
I 

I 

'"lL .. 

~J)L.~F~.~

·- :)·· .. :uJ ... -

_:.:.•:'nr;.: 

·: ,·_.-.~---~£ !i..!r~icirZ:.~ 

~~i!:-:;ri~ c-ft:·1t Bo:·(-rwz;, of B=~:-: '.:::-~-~--·:·. 

.!.TJ:JR:~~: f->i , i 3r:,_ li;i. 1:.~~ \~~::: S::-e~: d~ L:.: \:e;;:(ifL .~. i50!:2 

: ~.( ~L~'TY: S=i·t ::::.: >~'or:.~. S·.: ::::~·Jo!~ ~.\· !:.cp .. . !,;!' .... ~- ~: .. ·.· .. - .::. ~~ ... 4:. •. ?·:.: ;.:· .. ! ...... . 

?~rar;·r;~er 

I 

I 13 Ct.rri 0~~-! 132-C:7) (46--).c) 

I .'. \ ." >'P ~r;~ .. ...... -~ ···:< ~.!. ! '<'i!.L 1. :~J J:.: :· !.J! :' !<.C:J!: EL!:-.:;'</1TJ(·::·, SYS'IE!'- 1 t~,] '!Ji:.:'~ DlSC'HARGL \10:-.• 01{!\C. RCPORT W:'\m, (2-1 f:·.: ( 1 ;. j ~! P.~J!C!923~~ fjfl] ?EJ-:J.·lJT \:-:_-~\~BEP u; SCH.-;.P.G!: ~..:1 '\·!}:·.~ ~: \10:"\JTC,?.J\G PERi(JD ;:;:•):. : I ":'E..·'..f'( \!(..; I D.j.·y I T(J 1 YE.~.?. t \~ f~j i [.: _.::_·.,- 2.. (} f!1 ( I (C" 7 I .J I ;.,;;_1.].: i t:.:-:.:' QL;,.:·\TITi OR LO.-i.Df\"G 

!54-(>l) 

_.:.:.-..:.. . · .: . ::.-:- , ~-;:~ .: _, .; ! 

QL>,.LITY (JR CO:'\CfSTkATIO:"'o 

Firrv-. 

Permit--, I 

Reouiremem MO}IlTOR A:'\:0 REPORT 1 MGD * 

CBOD- 5 D;;v 

Suspended S o lids 

Fecal Collfonn 

May I to Sep 30 

Oct I to~30 

pH 

Total Residual Chlorine 

!:,ampl e I Measurement 2. Y · (:, 

Pi.lll~~ 

Requir~mcn\ ~;,n·:j)le J\·1e2.surcn1er~t 

Jle;mit 

Requirement 

Sample 

Measurement 

Permit 

Requirement 

Sample 

Measurement 

Permit 

Requirement 

Sample 

Measurement 

Pc:mu! 

Rectuirernenl 

--sample 

Measurement 

Pemut 

104.3 

II g. 2-

]25.0 

• 

.. 

* 

• 

* 

* 

" 

I 

I 

Requirement I "' 1 

s '(. 5" 1~6A LB.'DY 

/77. L 

187.7 LBIDY 

* 

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NAME/TITLE PRINCIPAL EXECl.iTIVE J I CERTIFY UNDER PENALTY OF LAW TIIA T I HA \'E PERSONALlY EX.~ MINED AND AM FAMILIAl!. 

OFFlCER 

s 

25 

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30 

2<!7 

200" 

2000 

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WITH THE INFORMATION SUBMITTED Hl>REIN AND BASED ON MY INQUIRY OF TilOSE 

JNDMDvALS IMMWIATfLY RESPONSIBLE FOR OBTAINrNG iHE INFORMATION. 1 BE\.tE\'E 

THE SUBMJTIED !NFOR.MATION IS TilUE, ACClTRATE AND COMPLETE I AM AWARE TliAT 

"!HERE ARE SIGNli'ICAl'-'T PENALTIES FOR SUB~11TTTNG FALSE INFOR.J\V,TION !NCLL'DJNG iHE 

POSSrBILln' OF FINE AND IMPRJSONMENT SEE 18 U.S.C. §1001 AND 33 ll.S.C. §1319. .. 7 Z.'f~1 J..f-,f 

tYPE OR PRINT (Penalties under these statutes may includes fines up to SJO,OOO and or maximum 

imprisonment of between 6 months and 5_years) 

COMMENT AND EXPLA'NATJON OF ANY VIOLATIONS (Reference all attachments here) 

During the month of January 2009, 193,200 gallons of gaswell water was treated. 

AREA 

CODE 

EPA FORM 3320-1 (Rev 9 - 88) Previous edition maybe used. (REPLACES EPA FORM T~40 WHICH MAY NOT BE USED) 

NUM

NOTE: YOUR PERMIT WILL EXPIRE ON W'\f 3 0 2008 PLEASE SUBMIT YOUR RENEWAL APPLICATION BY JUN - 

----------------
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Ccrr;.'Jl!:te. !nO:i:~~..J) · s.,;-~d s:Jbrnit v:ith each Di·r·:!?\..J } .. .t~ch addit~or t! 

she~ts an.d comffient: e.s ne::~;d for completer~e:.s 

~-:d. clarity. S!udg;: produ~tiOZ'! L-. .fcmm.tion will be used to evalu:.te planr 

r~:-forrne..<ce. Rep on only sludge 

which has been removed fro::J digesters and other solids which heve been pe~E .. t1emly remo·/e.d 

t on ~!: t tr :e~

t:nen r p:-cc;ss. ·oc not inc!udf; ~~~:.g= fro:7: c::_~t~ 

plarm whi~h is proces:.ed 

e' ;our faciiiiy. L'l the di~posal site section, report 

all sludge leavi.t"lg 

your facility for disposal. If another ple.nt processes and disposes of your sludge, jlb'i 

pro

vide the name of that plent. If you dispose of sludge from 

other. plants, include their tonnage in the disposal site section and provide their names and individual dry tonnage on the back of this form. 

If no siudgs was removed, note on form. 

HAULED AS LIQ

UID SLUDGE 

(Convemon 

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For sludge that is incbemed: 

P re-mcrneratton . ' . we1g ' h 

t = 

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R~uLEDASD

WATERE

. :coallons) X (%Solids) X Factor) = Dry Tons ~watered Sludge) X (%Solids) X 

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Name: 

Pennit No.: 

Dry Tons Disposed: 

Type: (check on

e) 

Landfill 

Agr. Utilization . 

Other ' {specify) . . 

County: 

(SSR·l 3121191) 

.0000417 ct 

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DISPOSAL SITE INFORMATION: List all sites, even if not used this month S1te 1 Site 2 

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Title 

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BELLE VERNON SEWAGE TREATMENT PLANT 

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?~-~-;- t; I ~ r· O~ c (J-:. ' Ql'A\'TITY OR LOADI:'\'G 1 , -1 ~~-;~ i~. , I · - ---... ,,. _. J Q l.-'I.LIT\ OH (O:>iCJ::>iTR.-HiCJ:, I ~32-.3'7 I !46--53) I (54-6 j) 146-~Si 154-6] i 

,.;\'ERAGE \1.A_'<J\~1_ M l l"\'TTS I \W~l'. l':,·; I .A.\-'EP_.l..GE 

M,!..)'J:,1l'!, 1 

Sarnple 

JX~ea=a

1ren:e.in I '-/7/ '7d/ • I " I • Permit I I f}C.~\\ I R;Quiremem MONITOR Al\:1) REPORT MGD ::;, ., Sample "' 7.z/v I (I. $ 2-

M ! J ci!Surement < I CBC!D - 5 Da-. I Pe!mn I Reauiremem ](l.'l_3 156.4 LB!DY . 25 38 i J .:·unp:::: ' ! I !\ 1~a; remcr.t •n . i- ~I, I I I i/ 1:5 I 

Suspended Solids Pcnnu Reau irement 125.0 I 187.7 LB/DY ~ Fecal Cohl 30 ~ orm Sample Measurement .. .. 

May * l to Sep 30 Perm1t 

Oc 200 JO_U_O t I tc> Apr 30 Re'luiremcnt • • • .. - 2000 JOOOO Sample Measureme .. (o-7 7-'t nt .. • Permit pH __ I Reauirement " .. * 6.0 * 9.0 ·-- Sample Measurement .. • .. o-3 .. 

Permn Total Residual Chlorme I Reoujrement ~ .. • * 0.5 

S * ample 

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OFFICER 

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WJTII THE INFORMATION SUBMITTED HEREIN AND BASED ON MY I!<QU!RY OF THOSE 

INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING THE INFORMATION . l BELIEVE 

THE SUBMmED INFORMATION IS TRUE, ACCURATE AND COMPLETE. J AM AWARE THAT 

THERE ARE SIGNIFICANT PENALTIES FOR SUBMmrNG FA!..SE INFORAt~TION. ri'CLI.lDING iHE 

POSSIBILITY OF FJ~E Al'-ID IMPRISONMENT SEE 18 U.S.C. § 1001 AND 33 U.S .C. §1319. ~ 71-'t~/l-1-

TYPE OR PRINT (Penalties under these statutes may includes fines up to SIO.OOO and or maxim 

imprisonment of berween 6 months and 5 years) 

COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) 

During the month of Feb, 2009 193,200 Gallons of Gas Well water was treated. 

AREA 

CODE 

EPA FORM 3320-1 (Rev 9- 88) Previous edition maybe used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED) 

NUM

NOTE: YOUR PERMIT WILL EXPIRE ON 

--------

Nr.'\f 3 

--Q ------ 2008 PLEASE SUBMIT YOUR RENEWAL APPLICATION BY JUN - 
D lS,::E ... -4..·P.C~ E. ~.; ·i· (.t NIT· C. ::J.t<(i B~2Pf)! i: ; ~~r .. rf' .. 

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Complete mon:l}ly e.:u1 !?Ubr:~.it \Vith each Dkvf? ..... A.ttach addit~or.al she!ts and com:r:.ent~ as n;ed~

:i for 

offip

te;

ess ?..!-:d cle:ity. Sludge pro,h.<ction inform~don w:U o~ used tv evaluate pla..!t p;.;forrna.oJ.ce. Report only s!udge which he.s been removed from digesters and other solids which b;.ve beer, pe:na...'iently removed 

ton~~!~ 

~~E:tr.-:r .. : 

:C·C~!!' De r. c··. j;e::·

=-t .. .!~;c 

fr~:-::1 

c::-~t!" plants which is processed at your facility, in the disposal site section, report all siudge leaving your facility 

for disposal. If anoth

er plant processes end disposes 

ofy0ut sludge, just provide the name of that plent. If you dispose of sludge from other plents, include their tonnege in the disposal site section and provide their names and individual dry tonne.ge on t1e back ofthLs form. 

If no shldge we.s removed, note on fonn. 

:JfL ~·:~-n:·:.I: s.::;-;;•.: AGI: $L!JDGE :;:::'P. rcrr~ 

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P~m:ittee : .h.lk 

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Plent: Ai..LL/::. I)I

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1'-I'"PDES: - Cit>,. ., 

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11 

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Municipe.li')': 6,( ~ 

County: ~/£ 1T

For siudge that is incinerated; 

Pre·L11cineration weight= 

Post-incineration weight"' 

SLUDGE PRODUCTION INFORMATION (prior to inci..·m~ticn) 

. :(Gallons) X 

' 

Name: 

Penmt No.: 

Dry Tons Disposed: 

Type; (check one) 

Landfill 

Agr, 

Utiliz

ation 

Other (gpectfy) 

County: 

(SSR-1 3/21/91) 

HAULED AS LIQUID 

SLUDGE HAULED AS DBWA1'BRED 

(%Solids) X 

<Tr'I'T' A T 

' 

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' 

(Conversion (T

o

ns of Factor) ... Dry Tons ~w

atered Sludge) X (o/o Solids) .0000417 Cq 

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DISPOSAL SITE INFORMATION: List all sites, even if not used this month Site 1 S1te 2 

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. ;P/Y]

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Signature · -- . . j ~~ 

1t~3 ~ --Sut'h-1(./~Nb~ 

Title' 

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Date