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85-82 ; l . I ~ ~, . . l ~ \ '\ . ' , ~ , " \ , . " ." ~:/ ...... . ,'" . . ; \ " I, " !; .~ . .! ! < ~ .' u ". > ! i. .. ~ .:. . .... ..-; ~ j' '. " . ,. ,'j .~ . " ,t I . ':, ~. ." i l" : ~ .' ;: ~ '. ... , , ' . ~' . ~ .. S "'1 ' 'I' ~. '.,. ~: .' . I. 'I: :,..... . , . , ',' ," '. I ~ . r ~ . .: t Ai' ,". .. '\ ;;'iV:;,~'~ \~/;':~ j':/ ,>' '. ,d~'~ .:.:.' .'J', ." ""," < f ~ > l '.' 'j'l . J . l ~ I , ~.f"' ~ . Gt @ RES 0 L UTI 0 N No, 85 82 A RESOLUTION OF THE CITY OF CLEARWATER, FLORIDA, APPROVING PROCEDURES AND REGULATIONS FOR TRANS- PORTED LIQUID WASTE DISCHARGES AND IMPLEMENTATION THEREOF BY THE WATER POLLUTION CONTROL DIVISION. WHEREAS, it is the intent of the City of Clearwater to provide adequate treatment for all domestic sewage wastes generated within the sanitary sewer service area of Clearwater: and WHEREAS, liquid wastes removed from septic tanks and portable toilets within the sanitary sewer service area are transported to treatment facilities by liquid waste transport or similar trucks; and WHEREAS, present and future operation of the City's Wastewater Treatment Plant is dependent upon controlled discharges from liquid waste transport trucks; and WHEREAS, it is the responsibility of the City of Clearwater to regulate the discharge of wastes from liquid waste transport trucks to ensure that toxic or other prohibited wastes are not discharged into the wastewater treatment facilities of Clearwater; and WHEREAS, the Water Pollution Control Division Superintendent is authorized to regulate the discharge of wastes into the treatment facilities of Clearwater; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF CLEARWATER, FLORIDA, IN SESSION DULY AND REGULARLY ASSEMBLED, AS FOLLOWS: 1. That the Procedures and Regulations for Transported Liquid Waste DischRrges, attached hereto and made a part hereof, is hereby approved, and implementation thereof by the Water Pollution Control Division of the City of Clearwater is hereby directed. 2. This resolution shall become effective immediately upon its passage. PASSED AND ADOPTED this 3rd October . Attest: ': 1985. ~,v2 ~,..!~. ~ . .. Ci t ,Clerk . c' -- u, Res. 85-82 10/3/85 ,; - : :"-~~R{:f~~~~~~.t:.:~::. . ..t.~~>...... ~'__"'l""'-.:.' '.:~ _. ... ~ ~ ---~...":~~ --- -. 1 ~. :~'+~ t. . .: ~ . .' ... c,h, -.:,;',? l"\ ,.."~~ .~~~', I ;.: ::i \ " , . . , " . .1' ,'.. . ~ I ': t . ~ ~,: ','1 .'~;;';~:/,:;: , '. . ~ ~ ,. I \ . i ~.: . . :,1,.: ..;::';' .., 'j< .'\ . \. ..\1. , c. ~ .:- ,; . ",. .~i ' I....; l . "i 1 : ~ i , ~ . ~. " '~ ::, '.',/c., " .,,~...L ; '. .,".1 .,1" .~. .~:\.\~':'~~~.I i. "'.~~ ~ '..' . ~:.. ~ ." ... . ~:. , I ; . . .. ", .... \.: " , . ,. " '.! . ~~ . .1 .'1 Sf;': \),: ,~ '.;, " . 'f d C < 1 . ~L .', .! { c\<\ 7,:, .}. t..... .0, l'~" ~i \, ~, ~r.i- :~~+{l.,:.~,~~ :,\i;, ,~):{~i~\/;.: \.~-\,"...,.,i' ......~'"t ..Iti....~. '1'-;';, 'b:',i. .':~'!'.\II"..'\'. .,;, 'f" '...... ...j.,,--./.'O',/. ~i~:'i:~:':'.}~ \~.~,:~.,~~'.'~ ~:C:I,:~t ,\~" ",['....(\'". >,',t.' I 1i'\~,'!\?:::\:\i,W . '::,'L',. " . .'. '.' I'..c" .~ , . .t. C' .,j 1-;' ,'" ,s~.' . i ~ " . ,.C " , .~:l,.i~",~.';r:~.]';~.~ ."; ...., i) It." CITY OF CLEAR\iATER . WATER POLLUTION CONTROL DIVISION PUBLIC WORKS DEPARTMENT TRANSPORTED LIQOID WASTE DISCHARGES \. PROCEDURES AND REGULATIONS " , d...: ' ",-;' - .,~ .. , .. " . , .' '., . . . ~...... ' ... }~~.~~~~~: :~t~~:, ~~~J~;;..' '~~~... .....1; '.,1:111-.... .,~ "'~~"."""'1''''.J"~,,,:7.<,-...:;;... ..."rJ",~\, ~~~;(,-.,., "'fa> .' . :~~~~l~~~*~~f~f.\~~~~y~~~t:~~;~~? < ~:'-. '.~~~,~;:"/<j~S'~. :~i~'~i~:: } , " "In..I\..&A......,.IA~~.,.~1 _ <c >........ ......___............ ___~.... ..,L..... ~. --.- .~ , '. .t ~ :' .."'.~ 'r'\ '1' , .. , : ~'~ J,l J} '. ,\\. ~ J 'l '< j ~ '",\ ~ ,': ,,!It, \ , l . I f. ,', e ',. e .\ ,'. '1.' ",I " \.. .', " , ;'" \ , " . I, \ ~ ' ) <':~,'::. " " ;. '; ) 'l, : ,: ',' ,~. . .,~.~'~.:~.~ . i" . CITY OF CLEARWATER . .! WATER POLLUTION CONTROL DIVISION ., , ,,\:'~ ~ ~ . .:.:: I" TRANSPORTED LIQUID WASTE DISCHARGES -' ; PROCEDURES AND REGULATIONS . , ,. ;, \ " " ."-}:;\,~.:_"I I I '" TABLE OF CONTENTS \ . . .. , .' '.~ ~ ~ f . . ".,.' .',''':' "' .' I. BACKGROUND . . ~ .. .',~ ",. . I " ~"'" ~ .... II. PURPOSE III. DISCHARGE REQUIREMENTS .: \~. '1 ~' \, A. LET'rER OF AtrrHORI ZATION B. ACCEPTABLE WASTES C. MAN'IFEST D. LOCATION AND TIt'lE E. SERVICE FEE F. SAMPLING AND TESTING G. SPILL REPOR'rING I.:, .. .;;;", :.. ;! . :~ - \_. ...' ., , , .'..' :~.:' ;' ~ ".. ,. ".' '/i.' \ !-:!::' :.;.'" ;1"'; . ~':.:' ".~. ~ " . ~: c 'f '(. f: J'. " A:. '.' IV. EFFECTIVE DATE v. REVIEW ~f:t~~ "~)'.! "'fi"~I,,,'~1 ;;.~ ;:' ;~':.?(3(:;'.:~~ \\ ...:I:l~\.': t,~. ...,.,.,'-.t ,,', .",,1' ~'i'~?~ ,i',!' 1" ..~ 'r:~. ~tt. 5' .~,!~ 1~H.~}~':~'.Pt.'~"..J ~~:~'::{~t (~:1;lil;,t'!I!\1 ..... ' . .~'.~: .~.~~~:; }.'~' .\ '; ~ <.' ". , , . .~<1..t,. '", .:' ..\~; ~:l!:' .~..:! ... \. . .... )' ...~... .' ., . It \, , '}, :. 'I' .' ". ~ '. " ' ; . , " ,', '.. .~, ' .~.' ....... to.; '-. I', ,0 ,0 . ' . . r' ... t '. ' , , ,i , " c, ' , , ' , .... :', <, :. ':,', ';; i" j , , ;,'t... '} ~ " , .. .: ~ . '< I " . ,". i'" .,\' J,: / ", ,L ~ ~ .~. '~', ~ '. '., (' ; ,"j e,", '0 ~"o.' ," ;. ' ", ". " '. ~ ~ ~; .~~.~ . \.o.'~ ,. ... . '" '<, I r:. - , ,,011,. . , .'. ~ L . '., .', " ~,p : c,' - i, , ~..... '. ~ ~ . .. " :~:>I .. . (i) - I. BACKGROUND The City of Clearwater provides sewer services for a large portion of Central'Pinllas County. Some customers within the service area use septic tanks, as collection facilities are unavailable. Other liquid waste generators may not be connected to the sewer system because they have temporary holding facilities or their wastes are prOhibited from disposal into the syst~n. These would include portable toilet and holding tank facilities, or industrial wastes containing to~dc or hazardous materials. Septic tank and other unsewered wastes are provided collection serrices by commercial liquid waste transporters. The City has not, however, allowed disposal of these IItank truckll wastes at any of its Wastewater Treatment Plants. Since the waste sources are unknown, a high potential ,exists that some of the wastes are either toxic, hazardous or otherwise unacceptable fo~ disposal into the system. In fact, past analyses have confirmed that toxic wastes have been dumped into the collection system. and such incidents of illegal dumping in manholes also indicates ,the probability that unacceptable wastes are being handled by liquid waste transporters. Note that City of Clearwater Code Sect. 53.25 states that no septic tank is to be cleaned without having a written permit from the proper authority. The following procedures and regulations have been developed under, authority established in Chapter 53 of the City of clearwater City Co~e of Ordinances to regulate the discharge of waste from liquid waste transporters into Clearwater Wastewater Treatment Facilities. These procedures and regulations are separate and apart from those which may exist to control discharge of these wastes at other treatment plants in Pinellas County. I, " , ., . ~J. If ~' '10;... - ----....- . ' ~ ~. .to i , ..1 ' I', '.. : '. , o , ' -. ." .... ~ ~ ... I: , , : i ~ .' '.' . . ~ .. ~:: l\I~~ ':, :' . '. ~ . : ~ , . ::, , " . . ',. '. " -/, l I',:' : ~ I~. . - ~ . .,' ,.~ ; > . . . ~. .' ':'!"'\\..':: .{\i~: /i ". -\ ': . . . . ,," ':. ~ ~. . ',':,11 ' .. . ,c, ~ ./ . " '", ~ - II. PURPOSE It is the intent of the Water pollution Control Division, City of Clearwater, to provide adequate treatment for all domestic sewage wastes generated within the sanitary sewer service area of Clearwater. Certain domesti'c sewage wastes, including primarily those liquid wastes removed from septic tanks and portable toilets, may be transported to treatment facilities by liquid waste tr~sport or similar trucks. The purpose of these procedures and regulations, under authority established in Cha.pter S3 of the City of Clearwater City Code, is to regulate the discharge of wastes from liquid waste trans- port trucks into the wastewater facilities of Clearwater. Primarily these regulations are established to: -, Ensure that no industrial wastes (Which includes greasetrap wastes) are discharged into Clearwater's wastewater treatment facilities frpm liquid. waste transport trucks. Ensure that no toxic or other prohibited wastes as defined in Section 53.32 are discharged from liquid waste transport trucks. - Provide an acceptable means for adequately treating domestic sewage wastes generated within the sanitary sewer service area of Clearwater and transported in liquid waste transport trucks. Establish location and time where such liquid wastes may be diSCharged. Establish fees to cover expenses associated with the treatment of such wastes. Establish a manifest system which will be required to document the source of all such liquid wastes. Establishing that written authorization to discharge must be obtained from the Water Pollution Control Division by each firm wishing to discharge such wastes from liquid waste transport trucks prior to discharge. Limit the volume of such wastes that may be discharged from anyone truck. Provide for the sampling and testing of liquid wastes from any truck wishing to discharge, for determining the possible p~esence of industrial, toxic or other prohibited wastes. - Provide for the withdrawal of authorization to discharge by the Water Pollution Control Division'if it is determined that records are falsified or if prohibited wastes are discharged, or if any wastes are discharged in any non-approved site. .' " " , 1 . , I .' ;, " f, "' " I. I ~ . I.. . ,: ~ '\ i'''' ~ I r . , ". ' '. .~ " ~ . I cj :.~:. ) : j . +' ~.. t . I . F ,~ . . . .. ~ ". , . ~ : . . , t" " , . . ... - .... '. " .1 : .r.. i';:,;;,. .::' ~\:-'.i'I.J:I~'I'\; 1"':- . .,' . ,toO, 'r.' . ) <Ii- ~ .' i .< ~ I I~'~..,::.":: .":- T ~.: T';.)~..~., . ;. > ., '.: H I . ~;: . '..~' : J , ,. , , ,. ~~'. ", .1', ./ ,. . ,~ . ' .. . . .. I~+ ~. ~ ~ III. OISCHARGE REQUIREMENTS A. Letter of Authorization' A letter of authorization approved by the Superintendent of the Water Pollution Control Division is required for any person or business discharging domestic sewage wastes from liquid waste transport trucks into an approved Wastewater Treatment Facility. The Water Pollution Control Division Superintendent shall appr.ove, deny or approve with special conditions within a period of thirty (30) days all applications for such authorization in accordance with the policies and regulations established herein., Prior to discharging wastes into Clearwater Facilities an application (Exhibit 1) must be submitted to Water pollution Control Oivision. Each application shall include the following information: 1, Name of the applicant. If the applicant is a partnership, corporation or other business, the name of an individual in responsible charge who can serve as primary contact must be provided. 2. Applicant address and phone number, including who should be contacted and appropriate phone number for contact outside of regular business hours. 3. The type, license tag number, and description of each vehicle from which wastes will be discharged by the applicant. Any new or replacement equipment acquired subsequent to the application shall be reported to the Water Pollution Control Division prior to any discharge from this new equipment into Clearwater's Facilities. 4. . Each application must include; 1. A signed statement that the provided information is accurate, 2. Transporters city Occupational License number, 3. Pinellas County Health Dept. License number. Each letter of authorization approved by the City will be effective for a one (1) year peX'iod and may include special conditions as deemed necessary by the City. An application for renewal of authorization shall be submitted at. least thirty (30) days prior to the expiration dat~ of existing authorization by each applicant wishing to continue tb discharge into Clearwater Facilities. Failur~ to submit app~ications in a timely manner may 'result in periods when discharge will not be permitted due to lack of proper authorization. The letter of authorization required by the Water Pollution Control Division'shall be in addition to any'other permits, registrations, or occupational licenses which may be required ~y Federal, State or Local law. 5. Fee: Each application must be accompanied by an annual fee in the amount of $20.00. 'i. d,~ '. . . ~,' " 10.' ' -, .., ~. ~..... .. . I , "{ t'. . .. " 1. I, ,'~ ~. . .' A,:~ j J, ~ . .. ": ". ,., ,; " ~ ". . : ~ . .' ~ . ~' ~ . ~' . " . . ~. . " < . ~ :,i ':. .;\).;L; ,,' t .. ~ : ,~J c ( . "": ; .~, " ~T< . : .:; :" :'c ,~ . c~ ~ "~ . " ~) . . " ~ e Ill. 1l1SCI1l\RGE REQUlRE1-iENTS 1\. Le!:l:.er of 1\ul:.J1oriza!:ion (Con!:.) 1\ny le!:l:.er of au!:horization approved by the City may be w! thdra\'In should l:he tlpplicant fa! 1 to abide by condi Hons regulating discharges as established in these regulat:ions and'Sect.ions 53.22 thru 53.45 of the Clearwater Cil:y Code. 1\u!:horizal:ion to discharge will bewi!:hdrawn for a period of l:wo (2) years for any applicant: whos Falsifies. informal:ion SUbmitted to obtain a letl:er of aUl:hoJ;'izal:ion 1:0 discharge. Falsifies information required for a disoharge manifest (Secl:ion III, C.). Discharges any toxic or ol:her prohibil:ed wasl:es into auy sl:orm sewer, or wastewater faoi111:y (including manJmles) of Clearwater (Section 53.30-53.32) city Code. Discharges any waste into any non-authorized' location. The wil:hdrawal of authorization to discharge shall be in addition to 'any penall:ies for violations of ci I:y Code (Chaeter 53) governing sewers and sewage disposal. B. Acceptable Was!:es: Domesl:ic sewage wastes generated within the sanil:.ary sewer service area of I:he Cil:y of Clearwater are acceptable for discharge inl:o Cil:y Sewer Facilities. The sanitary sewer service area is shown on Exhibi t 2, attached., Generally, dome$l;ic sewage wastes which require transport for disposal will include, sepl:ic tank wastes or portable toilel: wasl:es. Wastes originating outside tIre Clearwater sewer service area are not accepl:able. 1\11 I:.o.xic and other wastes (including grease trap wasl:es) " \'lhich may interfere with or damage wastewater facilities are prohibil:ed (Chapt.er 53 Clearwal:er city Code' . l'lasl:es \.lill be acceptable for discharge into Clearwater Facilil:ies from liquid waste t:ransport t:rucks or ol:her transport vehicles having a maximum capacity of 2,500 gallons. The maximum allowable ?ischarge from a single vehicle shall be 2,000 gallons and/or a maximum ,of (2) l:\'lO residential cus tamers ~rfu~. r The City will not accept tlsplit loads" that is a load from two customers one with~n the City's service area and the other from another service area. 'All vehicles must ha~e sight:. gauges to accural:.ely measure quantities and if more l:.han one customer has been served a separate discharge manifest: shall be present:ed for each, prior 1:.0 discharge. .. ~..... ~ ~~"1i-::f..J.~I~.,.1"":"':"-<;, "~;-~~~~S@W~~}f~(t:.~~:~~~,,!,; ,.". .:',. . ~ ,,'~'. ,......... _....~.. c " \. , 'p... ." \0. ~ _.' ~ ." ~ + l " ,; I..... ,c ',' ~ \ ., . y" " , , . ~, ~ ~ ',.... -.... . " ~ . , . .' ~ : . ~" '/: . . , .. ~ '. ~ "~ : . ~ ' ,'\" ., <,.',!.' . '.' '~ , .., , 'f" ", I ',~ . .~ c ' f , ... ' : .1. ~ ~:~ : ; , : ,~.; :.;;<: r...' .' :\ :~I"" . . .) . ':~;J. ':" <.":!;(~;>": ~ ~'. ":,,,,':, ~;~,:,:. ::::.":+ ,', ;', " ; ". ',':.: ~...i '(::,; I':' .' : \', 'dl ~..--+''' ." d:' l' 'I ~ :( ... .. .. <\,.: I . ; ~ (@ II! . VlSCUl\lH.;E P.ECJUIREHE~l'1!S c. Hanlfes l:~nequlrement: Prior 1:.0 discharge of each load of wastes into City Facilities from a liquid wasl:e transport: truck, a complel:ed and signed manifest, Exhibit 3, musl: be present:ed to I:he wastewal:er plant o?erator in-charge at: the t:ime of t:he discharge. Each liquid waste transport I:ruck shall also carry a copy of the current: letter of aul:horization (Section III, fl..) which shall be pre- sent:ed along wil:h the manifest if requested. The completed manifest shall indicat:e the origin of all wastes cOlltained in the truck l:o be discharged. (trhe date, cusl:.omers name, address served, telephone number, and the type and amount of wastes musl: be idenl:ified on the manifest for each source of waste contained in the truck. The cust:omer shall certify the origin of the wasl:es by signature. The llame of the liquid waste t:rnnsport business, vehicle license tag number, driver name, date, t:ime and drivers signal:ure musl: be prQvided for the manifest:. to be complete. By signing the manifest:, the driver will be cerl:ifyil1g the accuracy of the information provided on thaI: manifest. Discharge will be permitted only when a complel:ed ma'l1ifest: is. provided.. If customer is not available for signature at the time service is rendered the waste transportor will obtain said signature and deliver same to City within 10 days. D. Location c1J1d Times 1\ccepl::.'able transported liquid wastes - shall be dischar'gad at I:he Harshall SI:. Wasl:ewater Treatment Plant, Marshall 51:.. aud. Harbor Orive, between 1:11e hours of 7: 00 1\.M. and 5: 00 P.M., "'onday thru Friday. Discharges may be permitted during other hours and on weekends, however, for securi.t:.y reasons plant personnel musl: be notified in advance and transporter.s will be g1 ven approval and a time for 1:11e discharge ~ . The e,cacl: local:ion of the discharge point within the plant will be specified. l\t no I:.ime will discharge be allowed until operator on duty al: the plant: site has verified the manifest. The operator will over~ee the discharge and I:.ake the required sample for laboral:ory analysis. I tis' unla''Iful to dump, dispose t unload, leak or otherw.ise discharge liquid tvasl:e at any sil:e in clearwater without proper approval of I:he Water Pollul:.ion Control Division Superintendent (Chnpl:er 53, Clearwater City Code). Nhan issued, a lel:l:er of 'authorizal:ion (Section III, A.) constitutes proper approval only for the Harshall St. Waste\'ial:er Treatment Plant location. .~ . '~..... - l ., . ~. ~ - __._ ... -.0- .--,__~... ,~ !" - ~_-----..:._--~~- - .: I:" . .' : '" " ., ' ~ .. < . :'\~;~ ll'J. ' , ':' ". 1': ~. '. " (,' " \ ~ \ , '" ",\ .' '. ' " ""Il '. ,. . ~ .. . , " i.I.;' \,' ; -I ~ "i .\ ~. >... I;...... l IV. EFFECTIVE DATE - - These Regulations shall become effective immediately upon approval by the City CommiDsion. \ '. :\ ~ . .,. '. tl , ~, ':C , 1':''- , J' . ' ~. ; I .- ~~. :cc,' . . \ .... ,. ~., " I.' . ~ V.. REVIEW , " " " , ',,:::.\\;;., ~' The City Manager shall have'the authority to periodically review these regulations ar~d shall make any rule change necessary for the best interest of the C!ty, and may adjust fees where such adjustment is a direct function of actual costs of providing the liquid waste service. <".' ~ ,f , , ~.' " .' ....j... '. , . '. .f: :, . ." ,;; l' ; ~ . " ~ : ~ .; i .~. ;l ~ ',' .. .'c: ...".4 !.~::/,:.; i:':.. . .....,: " '. " \ .,'> ". . "',' '::.'~\Y:'~:::',.: '.~':; " ~ ;':r::/::: .:~,;' :~. t:::';:;:~.l .:. / ..,.':: ~(":'~.:'.:'::;?~ '.. . " ..: " . " T ....., ~ , 'i. " . '.... c. " ". .~ 0j} " CITY OF CLEARWATER PUBLIC WORKS DEPARTMENT WATER POLLUTION CONTROL DIVISION EXHIBIT 1 Application for Liquid Waste Transportors Letter of Authorization Applicant~ Please fill out completely to insure prompt handling - (Print or typet '. Company Name: Address: Zip Name ,and title of person completing application: Title .,.' '.> Telephone office Primary contact person After hours ----------~--------------------------------------------------------------------- City of Clearwater Occupational License number Pinolla9 County Health Department Permit number -------------------------------~------------------------------------------------ List below all vehicles for which discharge authorization is requested: (Vehicle description) Make Tank Capacity License Tag number Year l. 2. 3. ~ ' . 1. s. 6. , . ';', , This is to certify that the above information is correct. I understand that falaification of this information will result in denial of authorization to discharge. ~ ' . { ,;. " , . . 1 (Signed) !2E_Qi.fJ:s~_y~~_Q:gJy.l Application received on Fee received ' Application reviewed by ApPJ:'oved Letter of authorization Applicant Date .' . ~. .' ;;' c . .. . , ~ . I, ~ . ~ ~ '.. '" '., ~ ~'. ! . . Check By Cash ~ '. ~ : I ~"'.' r L~ .",' i',',,: ,I . Disapproved issued on Date . I i ~ '. . I . ,L. '.... >' . {~ , t>/' ;.\{:n;; ~';:\:; ~>:~ :', ::(/:'::" >, . : '.::' ,.:" " i" ~~l 1.' ,:::.r . ....' '1, , , ," ~ .'Vo-..... ,...:, ',(: "...:..~.:,-~.,~,;.:,~~' -- .... - ~- -~.. - IT JOII'''I leUHII .~r,1t . I,C,I,,",II. II . 6 . HIOIIl..lHO 'AfIII et.. '. ."' . " i i !" .. "' '" If ... ~ . II! lilt 1111. ... I . ... ~ I) , ~ 1'1 2 K 0,' . .. 0 ... ;11 0 . Q -- ... i : . AVI. ... ... ,.:; 0 .. "a ~oC lUCHti' 110 IIAHII . .. ~ :< . ... 0 HIIIHW&Y II t II,', III OHII'''''I' " . ,:," " , I" ,. \, ~', . , . 1~ t\)'(\ C i-, 'r ) ~ ~ €i' ~1 " EXHIBIT 2 GULF 0' MEXICO CL 1,foIlW""U ....ell E ~ . ~ ~,. c ;:'" 11 II · !! ! ~ 100'" ... o ! s "' .. n .. It .. . '" .. ,. n ~ c .. ... .. ~ In n :t>' r- m ;t ~ i: P- m en 0 " '~ " ....... ~ , ---.-J...-..-..... .... ., , I 1!' " ... . I, l" , ." ',. . ~. I. ~ ~i . i J .' ., . . ~ } ~, . . r ~ ~ . ~ I \ . , t. . t. < {. {",~':'..,>::; ,. ~ ..' >'.' r,. r " i"/; .':' >>\,i./;,;'f\{ l' I, , , ,I <., t . '-" . ~ ~' "(.,:. ~ ,"}.2' "~?};;"\;f~:i"; . .' .: L~" ::~: ',:i. ? . c." ," ~ . , ~ . / . . '" t c ~ t,. .' > ~ ~ ,.' . 'T' , , . t::lJ\ ~ - I . EXHIBIT 3 I city of Clearwater Florida Public Works Department Water Pollution Control Oivision \ Liquid Wastes Tr~nsporters Discharge Manifest Busines9 Name: Addrossa Zip Vehicle license number ci'ty Permit no. Drivers Name Pinellas Co. Health Dept. no. (Origin of Waste) Customers Name Address Served 'Telephone no. Type of waste Amount of waste in gals. (Verification of Origi~ - This is to certify that the above information is accurate and that the subject liquid wastes are from a residence and not therefore industrial wastes and to my knowledge contain no toxic substt11l1ces. Customers verification must be received within 10 days service date. are of ,0, ! . Date Customers Signature (Verification by Hauler) - I certify that the information contained in this manifest is accurate and I understand that falsification of this information will result in the cancellation of authorization to discharge into City of Clearwater facilities. Drivers Signature Discharge Approval: . On this date this manifest were discharged and time the wastes permitted by at the approved disposal site. Operators Signature .' For Office Use Onlvl Waetes received - Gallons Amount due $ ~,,:~,;~~~[~~?C:J<::'> :~.,.' ~~: