1. | Date: | __________________________________________________________ | |||||||||||||||||||
2. | Name of User: | ________________________________________________________ | |||||||||||||||||||
3. | Address of User: | ______________________________________________________ | |||||||||||||||||||
4. | Phone Number of User: | ____________________________________________________ | |||||||||||||||||||
5. | Location Where Sludge is to be Used: | _______________________________________ | |||||||||||||||||||
6. | Size of Area Where Sludge is to be Used: | ___________________________________ | |||||||||||||||||||
7. | Proximity of Site to closest: | (a) Stream or other body of water | _________________ | ||||||||||||||||||
(b) Dwelling | ___________________ | (c) Well | __________________ | ||||||||||||||||||
(d) Other Water Supply, (describe) | ___________________________________________ | ||||||||||||||||||||
8. | Amount of Sludge Obtained: (Specify units) | _______________________________________________ | |||||||||||||||||||
9. | Describe Use(s) of Sludge (e.g., Farmland or Agricultural, Garden, Yard, Reclamation of Nutrient Deficient Land, Other): | ||||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
10. | Manner in Which Sludge is to be Applied (e.g., Spread by Truck or dry applicator, by Hand, Worked into the Soil by Plowing, Rototilling, Surface Application, Splash Plate, Knife injection, other): | ||||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
11. | Will Sludge be Stockpiled Before Application: | Yes | No | (Circle One) | |||||||||||||||||
12. | Estimated Length of Time Sludge is to be Stockpiled: | _______________________ | |||||||||||||||||||
13. | Type and expected yield of crops to be grown on sludge conditioned land: | ||||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
14. | The soil pH of the land that I am applying sludge is: | _________________________ | |||||||||||||||||||
15. | Limitations from Site Characteristics: | ___________________________________________ | |||||||||||||||||||
_______________________________________________________________ | |||||||||||||||||||||
16. | Has sludge been applied to land within last 5 years? | Yes | No | (Circle One) | |||||||||||||||||
Name of Generator | ___________________________ | ||||||||||||||||||||
Amount Applied | ___________________________ | ||||||||||||||||||||
Years Applied | _____________________________ |
SPECIFIC REQUIREMENTS FOR THE USE OF
WATER TREATMENT PLANT SLUDGE
The sludge that you are obtaining contains the following:
Calcium Carbonate Equivalent _______ %
pH ________
Barium (Ba) _______ lbs. per dry ton
Cadmium (Cd) _______________ lbs. per dry ton _______________________
Copper (Cu) ______________lbs. per dry ton __________________________
Lead (Pb) ___________lbs. per dry ton
Nickel (Ni) _____________lbs. per dry ton
Selenium (Se) _____________lbs. per dry ton __________________________
Zinc (Zn) ____________lbs. per dry ton
To maximize the benefits of conditioning soils with sludge and minimizing possible adverse effects on the environment, it is required that the following provisions be adhered to:
1. Climate Conditions:
a. Sludge application shall not be permitted on land during precipitation.
b. Sludge application shall not be permitted on land which is saturated or with ponded water.
c. Sludge application should not be permitted upon sites when precipitation is imminent or which have received greater than 1/4 inch rainfall within the 24 hour period preceding the application time.
d. Sludge application shall not be permitted on ice or snow covered ground. Frozen ground which is not ice or snow covered and has a slope of 5% or less may be used for winter spreading providing a 200 feet grassy area or forage crop exists between the sludge applied land and any surface water or water well.
2. Buffer Area Requirements
a. Sludge application by incorporation or injection shall not be done closer than 20 feet from any occupied dwelling or 10 feet from the closest edge of traveled portions of a public road or outside roadway fence lines.
b. Surface application of sludge with no immediate incorporation shall not be done closer than 200 feet from any occupied dwelling or 20 feet from the closest edge of traveled portions of a primary and secondary public roads or 10 feet from the closest edge of lesser utilized public roads or outside roadway fence lines.
c. Sludge shall not be applied in waterways. Application to flood plains having a frequency of return more often than a ten-year frequency shall not be allowed.
3. Soil and Geologic Conditions:
a. Sludge shall not be top applied (no incorporation) to farm land having greater than 5% slope. If the slope does exceed 5% top application can be used providing the annual soil loss, as calculated by the Universal Soil Loss Equation shall not exceed 5 tons/acre.
b. Sludge may be incorporated on lands having slopes up to eight percent, irrespective of soil loss. If the slope exceeds eight percent, incorporation methods may be used providing the annual soil loss does not exceed five tons per acre when applying the Universal Soil Loss Equation.
4. Interim Storage and Application Restrictions:
a. Off-site interim storage of liquid sludge to land application is not allowed.
b. Off-site interim storage of dried sludge in excess of 2 months is not allowed.
________________________________________
I hereby agree to adhere to the above conditions.
All blanks other than the above sign-off shall be filled in by the sludge generator.
Ill. Admin. Code tit. 35, pt. 391, subpt. E, app I