Company Name:
Division Name:
Mailing Address:
Facility Address:
The above industrial/commercial (I/C user) is authorized to discharge industrial wastewater to the Borough of Dauphin in compliance with the rules and regulations governing connection to the sewer system and the acceptance of residential, commercial, and industrial wastes, any applicable provisions of Federal or State law or regulation, and in accordance with discharge point(s), effluent limitations, monitoring requirements, and other conditions set forth herein.
If there is a conflict between the application, its supporting documents and/or amendments and the standard or special conditions, the standard or special conditions shall apply.
Failure to comply with the provisions of the rules and regulations governing connection to the sewer system and the acceptance of residential, commercial, and industrial wastes, or with the provisions of Federal Categorical Pretreatment Standards, any other appropriate legal, State and Federal regulations may result in suspension of this permit and the authorization to discharge granted hereby.
The industrial waste acceptance agreement is an integral part of this permit. This agreement between I/C user and the Borough of Dauphin, a copy of which is attached, is made a part hereof.
This permit shall become effective on
This permit and the authorization to discharge shall expire at midnight on ____________________________.
Permit issued by:
Borough of Dauphin