NOTICE OF REGULAR MEETING ALTUS MUNICIPAL AUTHORITY

NOTICE OF REGULAR MEETING ALTUS MUNICIPAL AUTHORITY

DATE TIME PLACE

MARCH 2, 2021 6:00 PM COUNCIL CHAMBERS 509 S. MAIN STREET

AGENDA

1. Call to Order

2. Roll Call

3. Comments from the Audience

4. Consent Agenda

All matters under the “Consent” are considered by the Trust Authority to be routine and will

be enacted by one motion. Any Trustee may, however, remove an item from consent by

request.

a. Minutes Approval

1. Altus Municipal Authority - Regular Meeting - Feb 2, 2021 6:00 PM

b. Acknowledge Receipt of Claims List

c. Authorize the AMA Board Chairman/Mayor to Sign the Application for a Permit to

Construct from the Oklahoma Department of Environmental Quality for DWSRF Water

Looping Project

5. Consider any item(s) removed from the Consent Agenda if necessary

6. Consideration, Discussion, and Possible Action to (1) Approve Purchase of a John Deere

310SL Backhoe Under Sourcewell National Purchasing Contract #032119-JDC for the Line

Maintenance and Construction Department in an Amount Not to Exceed $107,000 (2)

Declare Surplus a 2008 Caterpillar 416E Backhoe and Authorize Trust Manager to Dispose

of by Sealed Bids

7. Consideration, Discussion, and Possible Action to Hire D&K Fencing of Cache, OK to

Install a New Chain Link Fence and Motor-Operated Cantilever Gate at the Polishing

Lagoons for a Fee of $14,612.35

8. Consideration, Discussion, and Possible Action to Authorize the Mayor to Sign Application

Forms as Needed to Apply for a Permit to Treat and Dispose of Commercial Car Wash

Sludge

ALTUS MUNICIPAL AUTHORITY AGENDA - MARCH 2, 2021 PAGE 2

9. Trust Manager's Reports and Comments

10. Trustees' Comments

11. Chairman's Comments

12. Adjourn

The City of Altus encourages participation from all of its citizens. If participation at any public

meeting is not possible due to a disability, notification to the Mayor’s office at least 48 hours

prior to the scheduled meeting is encouraged to make the necessary accommodations. The City

may waive the 48 hour rule if signing is not the necessary accommodation. Call 481-2202 to

make the necessary arrangements. We will accommodate you anytime and in every way

possible. Just call and let us know your needs.

To be completed by person filing notice:

NAME: Debbie Davis

TITLE: City Clerk

ADDRESS: 509 S. Main

Altus, OK 73521

PHONE: (580) 481-2244

Filed in the office of the City Clerk/Treasurer at ________ a.m./p.m. on ___________________.

Signed:______________________

Clerk/Deputy Clerk

ALTUS MUNICIPAL AUTHORITY

MEETING MINUTES

FEBRUARY 2, 2021

1. Call to Order

The Altus Municipal Authority met in a regular meeting, Tuesday, February 2, 2021 at 6:50

P.M. in the Council Chambers of City Hall. Notice of the meeting was duly filed and posted

in the office of the City Clerk January 29, 2021 at 3:43 P.M.

2. Roll Call Attendee Name Present Absent Late Arrived

Perry Shelton

Dwayne E. Martin

Doyle Jencks

Jon Kidwell

Jack Smiley

John Womack

Robert Garrison

Roberta Brady-Lee

Patricia Blackman

3. Consent Agenda

All matters under the “Consent” are considered by the Trust Authority to be routine and will

be enacted by one motion. Any Trustee may, however, remove an item from consent by

request.

RESULT: APPROVED [UNANIMOUS]

MOTION: John Womack, Trustee

SECOND: Doyle Jencks, Trustee

AYES: Shelton, Martin, Jencks, Kidwell, Smiley, Womack, Garrison, Brady-Lee, Blackman

a. Minutes Approval

1. Altus Municipal Authority - Regular Meeting - Jan 5, 2021 6:00 PM

b. Acknowledge Receipt of Claims List

4. Consider any item(s) removed from the Consent Agenda if necessary

5. Consideration, Discussion and Possible Action to Approve a Contract with Cowan Group

Engineering, LLC of Oklahoma City, OK for Closed Circuit TV Inspection of Sewer Mains

for a Not-To-Exceed Fee of $100,000.00 and Authorize the Mayor to Sign the Contract

City Engineer Johnny Barron presented the item. Trust Manager Gary Jones and Trustee

Kidwell commented.

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ALTUS MUNICIPAL AUTHORITY MINUTES - FEBRUARY 2, 2021 PAGE 2

RESULT: APPROVED [8 TO 1]

MOTION: Doyle Jencks, Trustee

SECOND: Robert Garrison, Trustee

AYES: Shelton, Jencks, Kidwell, Smiley, Womack, Garrison, Brady-Lee, Blackman

NAYS: Dwayne E. Martin

6. Consideration, Discussion, and Possible Action to Authorize the Mayor to Sign an

Application to Modify a Solid Waste Disposal Facility Permit for the Expansion of the Altus

Municipal Landfill

City Engineer Johnny Barron presented the item. Chairman Smiley, Trustee Kidwell, and

City Engineer Johnny Barron commented.


MOTION: Jon Kidwell, Trustee

SECOND: John Womack, Trustee


7. Consideration, Discussion, and Possible Action to Accept the Work Performed by R.B.

Electric, LLC to Install a New 450 KW Generator and Switch Gear at Altus Water Treatment

Plant (Bid No. 20065), Approve Change Order No. 1 in the Amount of $38,000.00 and

Authorize the Mayor to Sign the Letter of Acceptance

City Engineer Johnny Barron presented the item.


MOTION: John Womack, Trustee

SECOND: Roberta Brady-Lee, Trustee


8. TRUST MANAGER'S REPORTS AND COMMENTS

None

9. TRUSTEES' COMMENTS

None

10. CHAIRMAN'S COMMENTS

None

11. ADJOURN

7:01 P.M.

_______________________________ _______________________________

Debbie Davis, Secretary Jack Smiley, Chairman

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Date: March 2, 2021

AGENDA ITEM COMMENTARY

ITEM TITLE: Acknowledge Receipt of Claims List

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Fund Summary

Payment AmountFund

53 - ENTERPRISE FUND (53) 1,370,851.68

54 - WATER TREATMENT PLANT IMP 14,760.00

1,385,611.68Grand Total:

AMA - Claims ListAltus, OK By Fund

Payable Dates 2/1/2021 - 2/19/2021

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AmountDescription (Item)Account NamePayable NumberVendor Name Payment Number

Fund: 53 - ENTERPRISE FUND (53)

Department: 16 - PW - W/S MAINTENANCE

Vendor: 044654 - ALTUS POWER

587.14WATER/SEWER # 16Utilities202102018890ALTUS POWER 22086

Vendor 044654 - ALTUS POWER Total: 587.14

Vendor: 03124 - CINTAS CORP

337.92LAUNDRY SERVICELaundryINV0000174CINTAS CORP 22218

Vendor 03124 - CINTAS CORP Total: 337.92

Vendor: 044184 - FLEET SERVICES

938.37FUEL CREDIT CARD CHARGESGasoline Fuel69743559FLEET SERVICES 0

Vendor 044184 - FLEET SERVICES Total: 938.37

Vendor: 043860 - GARCIA CONCRETE

4,027.95CONCRETEContract Services137GARCIA CONCRETE 22128

2,263.70CONCRETEContract Services138GARCIA CONCRETE 22223

Vendor 043860 - GARCIA CONCRETE Total: 6,291.65

Vendor: 041498 - M & B CONTRACTING, LP

1,150.00EXCAVATOR AND OPERATORContract ServicesEO1127M & B CONTRACTING, LP 22182

1,150.00EXCAVATOR AND OPERATORContract ServicesE01127M & B CONTRACTING, LP 22227

Vendor 041498 - M & B CONTRACTING, LP Total: 2,300.00

Vendor: 16070 - PIONEER SUPPLY

207.001"X3/4" BRSS BUSHINGLine MaintINV8932, INV9739PIONEER SUPPLY 221271,185.806"X30" REPAIR CLAMPLine MaintINV8932, INV9739PIONEER SUPPLY 221272,035.682" BRSS 90 DEG ELLLine MaintINV8932, INV9739PIONEER SUPPLY 22127

582.001" CTS COMP NUT&GLine MaintINV8932, INV9739PIONEER SUPPLY 22127

817.006"X12" REPAIR CLAMPLine MaintINV8932, INV9739PIONEER SUPPLY 22127

303.001" MIPT ADAPTERLine MaintINV8932, INV9739PIONEER SUPPLY 22127

384.003/4" MIPT ADAPTERLine MaintINV8932, INV9739PIONEER SUPPLY 22127

482.00CTS COMP NUT&GASKETLine MaintINV8932, INV9739PIONEER SUPPLY 22127

489.001" CTS COMP N&GLine MaintINV8932, INV9739PIONEER SUPPLY 22127

507.503/4"X2.4" METER BRSSLine MaintINV8932, INV9739PIONEER SUPPLY 22127

575.00CTS CORP NUT&GASKETSLine MaintINV8932, INV9739PIONEER SUPPLY 22127

40.004" PVC X PVC CANTEXLine MaintINV9738PIONEER SUPPLY 22127

290.006"X4" SEWER SADDLELine MaintINV9738PIONEER SUPPLY 22127

804.003/4" CPPR TUBING, FTLine MaintINV9738PIONEER SUPPLY 22127

893.206" SDR SEWER PIPE FTLine MaintINV9738PIONEER SUPPLY 22127

420.00UNI CANTEX STRAPSLine MaintINV9738PIONEER SUPPLY 22127

40.004" CLAY X PVC CANTEXLine MaintINV9738PIONEER SUPPLY 22127

Vendor 16070 - PIONEER SUPPLY Total: 10,055.18

Vendor: 044039 - WESTERN PRAIRIE SERVICES

1,000.00ROAD BOREContract Services202102028892WESTERN PRAIRIE SERVICES 22138

Vendor 044039 - WESTERN PRAIRIE SERVICES Total: 1,000.00

Department 16 - PW - W/S MAINTENANCE Total: 21,510.26

AMA - Claims List Payable Dates: 2/1/2021 - 2/19/20214.b.a

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AMA - Claims List Payable Dates: 2/1/2021 - 2/19/2021

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Department: 18 - PW - AAFB CONTRACT





412.68FUEL CREDIT CARD CHARGESDiesel Fuel69743559FLEET SERVICES 0


Department 18 - PW - AAFB CONTRACT Total: 552.68

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Department: 19 - PW - SANITATION


364.91SANITATION # 19Utilities202102018890ALTUS POWER 22086

Vendor 044654 - ALTUS POWER Total: 364.91






4,490.07FUEL CREDIT CARD CHARGESDiesel Fuel69743559FLEET SERVICES 0

Vendor 044184 - FLEET SERVICES Total: 4,853.74

Vendor: 046145 - JOHN EARLS CONSTRUCTION

1,509.003RD QTR BTPU FY 20-21Contract Services71JOHN EARLS CONSTRUCTION 22120

2,477.003RD QTR BTPU FY 20-21Contract Services72JOHN EARLS CONSTRUCTION 22180

Vendor 046145 - JOHN EARLS CONSTRUCTION Total: 3,986.00


450.00BTPU ROLL OFFSContract ServicesC01800M & B CONTRACTING, LP 22182



Vendor 041498 - M & B CONTRACTING, LP Total: 850.00

Department 19 - PW - SANITATION Total: 10,702.86

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Department: 21 - PW - WATER TREATMENT


26,423.37STEED PUMP STATIONUtilities202102018890ALTUS POWER 22086

Vendor 044654 - ALTUS POWER Total: 26,423.37







Vendor: 046671 - MUNICIPALH2O

4,200.00Annual fee-Risk Management P…Contract Services10451MUNICIPALH2O 22230

Vendor 046671 - MUNICIPALH2O Total: 4,200.00

Vendor: 16130 - PUBLIC SERVICE COMPANY OF OKLAHOMA

6,410.99MT. PARK UTILITESUtilitiesINV0000009PUBLIC SERVICE COMPANY OF … 22188

Vendor 16130 - PUBLIC SERVICE COMPANY OF OKLAHOMA Total: 6,410.99

Department 21 - PW - WATER TREATMENT Total: 37,614.19

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Department: 22 - PW - ELECTRIC

Vendor: 046327 - ALCORTA'S CARWASH

8.00VEHICLE CAR WASHMaint/EquipmentINV0000180ALCORTA'S CARWASH 22213

Vendor 046327 - ALCORTA'S CARWASH Total: 8.00


1,012.37ELECT SUBSTATION # 22Utilities202102018890ALTUS POWER 22086


Vendor: 01495 - ARKANSAS ELECTRIC COOP, INC

5,274.0075 KVA POLE MOUNTTransformers03986168ARKANSAS ELECTRIC COOP, INC 22169

Vendor 01495 - ARKANSAS ELECTRIC COOP, INC Total: 5,274.00

Vendor: 044603 - CHRIS FINLEY MOBILE SERVICE, INC

2,827.00TRUCKS ANNUAL TESTINGContract Services2038CHRIS FINLEY MOBILE SERVICE, … 22108

Vendor 044603 - CHRIS FINLEY MOBILE SERVICE, INC Total: 2,827.00


1,250.34LAUNDRY SERVICELaundryINV0000174CINTAS CORP 22218

Vendor 03124 - CINTAS CORP Total: 1,250.34

Vendor: 04110 - DITCH WITCH OF OKLAHOMA, DBA

52,905.00EXCAVATORHeavy EquipmentE02466DITCH WITCH OF OKLAHOMA, … 22175

Vendor 04110 - DITCH WITCH OF OKLAHOMA, DBA Total: 52,905.00


1,290.44FUEL CREDIT CARD CHARGESGasoline Fuel69743559FLEET SERVICES 0



Vendor: 13372 - LAMAR ENTERPRISES, INC.

8,279.003 PH TRANSFORMERTransformers12871LAMAR ENTERPRISES, INC. 22124

Vendor 13372 - LAMAR ENTERPRISES, INC. Total: 8,279.00


125.00ROLL OFF DUMPBuildings & GroundsCO1839M & B CONTRACTING, LP 22182

Vendor 041498 - M & B CONTRACTING, LP Total: 125.00

Vendor: 15064 - OKLA MUNICIPAL POWER AUTH

1,050,744.40JANUARY 2021 POWER BILLElectric Power PurchasesINV0000175OKLA MUNICIPAL POWER AUTH DFT0000102

Vendor 15064 - OKLA MUNICIPAL POWER AUTH Total: 1,050,744.40

Vendor: 041825 - SPARKLIGHT

59.50INTERNET/CABLECommunicationsINV0000010SPARKLIGHT 22191

Vendor 041825 - SPARKLIGHT Total: 59.50

Vendor: 20037 - TECHLINE, LTD.

940.00EQUIPMENTTools,Equip&Safety Gear1724426-00TECHLINE, LTD. 22192

Vendor 20037 - TECHLINE, LTD. Total: 940.00

Vendor: 044571 - TEXAS ELECTRIC COOP

2,308.96POLELINE SUPPLIESPoleline Supplies202102038914TEXAS ELECTRIC COOP 22137

4,725.00WIRECable Conductors202102038914TEXAS ELECTRIC COOP 22137

989.04BULBSLight Fixtures & Lamps202102038914TEXAS ELECTRIC COOP 22137

633.44POLE LINE HARDWAREPoleline SuppliesINV01053885TEXAS ELECTRIC COOP 22137

18.46POLE LINE HARDWAREPoleline SuppliesINV01057948TEXAS ELECTRIC COOP 22137

1,211.52PRIMARY BELLSPoleline SuppliesINV01067083TEXAS ELECTRIC COOP 22137

7,543.00FBGS TANG X-ARMSPoleline SuppliesINV01067085TEXAS ELECTRIC COOP 22137

Vendor 044571 - TEXAS ELECTRIC COOP Total: 17,429.42

Department 22 - PW - ELECTRIC Total: 1,142,830.29

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Department: 25 - PW - ENTERPRISE SERVICES

Vendor: 041301 - BANK OF OKLAHOMA

56,497.13SERIES 2015 PAYMENTSeries 2015 Note Payment202102038903BANK OF OKLAHOMA 22105

Vendor 041301 - BANK OF OKLAHOMA Total: 56,497.13

Vendor: 047293 - DAN L WIGINGTON

4,500.00LAND APPRAISALSTrust ContingencyINV0000008DAN L WIGINGTON 22174

Vendor 047293 - DAN L WIGINGTON Total: 4,500.00

Department 25 - PW - ENTERPRISE SERVICES Total: 60,997.13

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Department: 26 - PW - WASTEWATER

Vendor: 01008 - ACCURATE ENVIRONMENTAL, LLC

220.00MONTHLY TESTINGLab TestingDA06172ACCURATE ENVIRONMENTAL, L… 22099




Vendor 01008 - ACCURATE ENVIRONMENTAL, LLC Total: 655.00


16.00VEHICLE CAR WASHMaint/Equipment & VehiclesINV0000180ALCORTA'S CARWASH 22213




15,075.03WWTP # 26Utilities202102018890ALTUS POWER 22086


Vendor: 08030 - ALTUS READY MIX, INC.

784.00CONCRETEMaint/Equipment & Vehicles5960ALTUS READY MIX, INC. 22165

Vendor 08030 - ALTUS READY MIX, INC. Total: 784.00




Vendor: 046261 - COVE ENVIROMENTAL, LLC

7,993.00Lab Testing FeesLab Testing27-1-21COVE ENVIROMENTAL, LLC 22109

Vendor 046261 - COVE ENVIROMENTAL, LLC Total: 7,993.00


1,979.21FUEL CREDIT CARD CHARGESGasoline Fuel69743559FLEET SERVICES 0



Vendor: 08087 - HAYNES EQUIPMENT CO., LLC

1,204.08Service Call to look at valve act…Maint/Equipment & Vehicles8124391-INHAYNES EQUIPMENT CO., LLC 22224

1,283.50Service Call to look at Bar ScreenMaint/Equipment & Vehicles8124392-INHAYNES EQUIPMENT CO., LLC 22225

Vendor 08087 - HAYNES EQUIPMENT CO., LLC Total: 2,487.58

Vendor: 041064 - OKLA TURNPIKE AUTHORITY

74.75PIKEPASSTraining & Travel Expenses20210194070OKLA TURNPIKE AUTHORITY 22114

Vendor 041064 - OKLA TURNPIKE AUTHORITY Total: 74.75

Vendor: 046437 - PRAIRIE HILL CONSTRUCTION AND SERVICES LLC

1,600.00TRACKHOE EXCAVATION AND V…Contract Services282615PRAIRIE HILL CONSTRUCTION A… 22232

Vendor 046437 - PRAIRIE HILL CONSTRUCTION AND SERVICES LLC Total: 1,600.00

Vendor: 043166 - REYES ELECTRIC, LLC

3,150.00ELECTRICAL WORKContract Services201017-01REYES ELECTRIC, LLC 22190

200.00CHAIN HOIST REPAIRMaint/Equipment & Vehicles201017-02REYES ELECTRIC, LLC 22190

Vendor 043166 - REYES ELECTRIC, LLC Total: 3,350.00

Vendor: 047454 - TWISTED S CONTAINERS

4,618.00STORAGE CONTAINERMaint/Equipment & Vehicles2422TWISTED S CONTAINERS 22194

Vendor 047454 - TWISTED S CONTAINERS Total: 4,618.00

Vendor: 25000 - WESTERN EQUIPMENT, LLC

8,625.00BOX BLADEEquipment3129605WESTERN EQUIPMENT, LLC 22197

Vendor 25000 - WESTERN EQUIPMENT, LLC Total: 8,625.00

Department 26 - PW - WASTEWATER Total: 48,174.62

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Department: 28 - PW - UTILITY SERVICES







Vendor: 041590 - EXPRESS SERVICES, INC

249.25COLLECTIONS/UTILITIESContract Services24978071EXPRESS SERVICES, INC 22220

Vendor 041590 - EXPRESS SERVICES, INC Total: 249.25




Vendor: 046797 - TECHNICAL PROGRAMMING SERVICES, INC.

3,114.30Prep of Altus Power BillsContract Services108283TECHNICAL PROGRAMMING SE… 22135

1,697.11Prep of Altus Power BillsContract Services108328TECHNICAL PROGRAMMING SE… 22135

1,532.70PREP OF ALTUS POWER BILLSContract Services108433TECHNICAL PROGRAMMING SE… 22236

Vendor 046797 - TECHNICAL PROGRAMMING SERVICES, INC. Total: 6,344.11

Vendor: 23180 - WILMES SUPERSTORE, INC.

271.77Starter wire EyelitMaint/Equipment & Vehicles148472WILMES SUPERSTORE, INC. 22139

Vendor 23180 - WILMES SUPERSTORE, INC. Total: 271.77

Department 28 - PW - UTILITY SERVICES Total: 7,497.65

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Department: 35 - ENGINEERING DEPT

Vendor: 047390 - ASBESTOS HANDLERS, INC

5,500.00Sampling at PoolContract Services7795-21-0202ASBESTOS HANDLERS, INC 22171

Vendor 047390 - ASBESTOS HANDLERS, INC Total: 5,500.00




Vendor: 06150 - FOX, DRESCHLER & BRICKLEY, INC.

6,060.00Survey for Pool ProjectContract Services8516FOX, DRESCHLER & BRICKLEY, I… 22113

Vendor 06150 - FOX, DRESCHLER & BRICKLEY, INC. Total: 6,060.00

Vendor: 046041 - MESHEK & ASSOCIATES, LLC

1,472.66Annual GIS HostingContract Services8003MESHEK & ASSOCIATES, LLC 22183

Vendor 046041 - MESHEK & ASSOCIATES, LLC Total: 1,472.66

Department 35 - ENGINEERING DEPT Total: 13,128.97

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Department: 36 - PW - LANDFILL

Vendor: 044341 - ASAP ENERGY INC.

4,020.00DIESELDiesel Fuel4250414ASAP ENERGY INC. 22101

4,504.50CLEAR DIESELDiesel Fuel4270902ASAP ENERGY INC. 22215

Vendor 044341 - ASAP ENERGY INC. Total: 8,524.50




Vendor: 045333 - DUKE MUNICIPAL AUTHORITY

53.90DUKE WATER USEUtilities202102038912DUKE MUNICIPAL AUTHORITY 22111

Vendor 045333 - DUKE MUNICIPAL AUTHORITY Total: 53.90




Vendor: 12134 - MANGUM OIL & GAS COMPANY, INC.

416.58PROPANEPropane-Landfill140167MANGUM OIL & GAS COMPANY… 22123

Vendor 12134 - MANGUM OIL & GAS COMPANY, INC. Total: 416.58

Vendor: 04052 - WARREN POWER & MACHINERY, INC

18,531.93DOZER REPAIRMaint/DozerWOOO8OO77359WARREN POWER & MACHINERY… 22196

Vendor 04052 - WARREN POWER & MACHINERY, INC Total: 18,531.93

Department 36 - PW - LANDFILL Total: 27,843.03

Fund 53 - ENTERPRISE FUND (53) Total: 1,370,851.68

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Fund: 54 - WATER TREATMENT PLANT IMP

Department: 40 - CAPITAL DEVELOPMENT

Vendor: 041793 - R.B. ELECTRIC

14,760.00RETAINAGE FROM BID 20066-G…Settlement & Projects5585R.B. ELECTRIC 22189

Vendor 041793 - R.B. ELECTRIC Total: 14,760.00

Department 40 - CAPITAL DEVELOPMENT Total: 14,760.00

Fund 54 - WATER TREATMENT PLANT IMP Total: 14,760.00

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% Complete: 57.69%JAN 2021 FY21 FY TD

DEPT NAME ACTUAL BUDGET ACTUALPW- W/S MAINT 67,713.15 573,095.00 425,403.89 74.23%PW- SANITATION 40,718.65 559,476.00 366,435.05 65.50%PW- AAFB RECYCLING 13,252.02 140,796.00 90,107.17 64.00%PW- WATER TRMT 50,667.79 591,952.00 377,831.84 63.83%PW- ELECTRIC 109,753.51 1,361,510.00 788,239.17 57.89%PW- WASTEWATER 31,982.09 445,504.00 285,615.83 64.11%PW- UTILITY SVC 42,059.02 543,653.00 308,548.04 56.75%PW- ENGINEERING 10,684.16 134,587.00 80,687.98 59.95%PW- LANDFILL 29,787.13 255,150.00 176,421.76 69.14%TOTAL PAYROLL: 396,617.52 4,605,723.00 2,899,290.73 62.95%

ENTERPRISE FUNDPAYROLL: BUDGET TO ACTUALMONTH END: JANUARY 2021

**This report includes all wages, taxes, and benefits.**

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DEPARTMENT AMOUNTELECTRIC Total 3,875.79 ENGINEERING Total 41.50 SANITATION Total 9,775.27 UTILITIES Total 109.02 WASTE WTR Total 4,807.09 WATER TRMT Total 3,905.26 WTR/SWR MNTC Total 2,627.33 Grand Total 25,141.26

ALTUS MUNICIPAL AUTHORITYPurchase Cards - 12/29/2020 - 1/27/2021

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DEPARTMENT VENDOR DESCRIPTION AMOUNTELECTRIC LOCKE SUPPLY WE ALTUS PUMP STATION LIGHTING 40.58 ELECTRIC LOCKE SUPPLY WE ALTUS PUMP STATION LIGHTING 54.64 ELECTRIC LOCKE SUPPLY WE ALTUS UPGRADE WASH HOUSE ELECTR 243.07 ELECTRIC LOCKE SUPPLY WE ALTUS EMERGENCY LIGHT RETROFIT 143.13 ELECTRIC LOCKE SUPPLY WE ALTUS RO PLC FUSE 5.95 ELECTRIC LOCKE SUPPLY WE ALTUS REPLACE MOTOR EXHAUST FAN 11.47 ELECTRIC FOX BUILDING SUPPLY AL DEWALT ORGANIZER 29.13 ELECTRIC NAPA OF ALTUS GREASE 72.20 ELECTRIC FOX BUILDING SUPPLY AL SOCKET SET 18.99 ELECTRIC AMSCO STEEL LLC 4 1/2 INCH PIPE 276.00 ELECTRIC HABOR FREIGHT TOOLS304 AUGER EXTENTION 24.99 ELECTRIC FOX BUILDING SUPPLY AL CEMENT MIX 14.20 ELECTRIC FOX BUILDING SUPPLY AL CEMENT MIX 3.55 ELECTRIC FOX BUILDING SUPPLY AL 7.48 ELECTRIC CONSOLIDATED BEARING O HAMMER DRILL 419.26 ELECTRIC AMAZON.COM*ZZ40M6YE3 FR COAT DJ GONZALES 259.99 ELECTRIC ATWOOD 11 ALTUS GREASE FIITINGS AND COUPL 40.76 ELECTRIC TEXAS ELECTRIC COOPERA WORK GLOVES 333.36 ELECTRIC SQ *ARKANSAS ELECTRIC SM WOOD BRACES 172.00 ELECTRIC WARREN HEIM CORPORATIO BUCKET COVERS 306.35 ELECTRIC MOONLIGHT MAINTENANCE TRASH BAGS, SPRAY, BLEACH 69.58 ELECTRIC HI-LINE 7813 VINYL TOOL BOARD W/ HOOKS 275.01 ELECTRIC MANGUM OIL & GAS FILL PROPANE TANKS 59.04 ELECTRIC JACKSON HIRSH INC 9 X 12-10 LAMINATING SHEE 75.74 ELECTRIC CEMBRE INC 18 V LI-ION BATTERIES 455.00 ELECTRIC IN *PRIVETT SALES DESKTOP CALENDERS 50.00 ELECTRIC HI-LINE 7813 TOOL BOARD 414.32 ELECTRIC Total 3,875.79 ENGINEERING SOUTHWEST TECHNOLOGY C PRINTING FEES 12.00 ENGINEERING USPS PO 3902420401 POSTAGE 13.90 ENGINEERING USPS PO 3902420401 CERTIFIED MAIL TO SELVIDG 15.60 ENGINEERING Total 41.50 SANITATION WARREN CAT-PARTS STORE HYD HOSE 68.09 SANITATION PHILLIPS 66 - HUTCHS 1 USER ERROR SEE ATTACHED 10.84 SANITATION ATWOOD 11 ALTUS TRASH BAGS 84.49 SANITATION NAPA OF ALTUS DOZER FILTERS 55.45 SANITATION UNITED SUPERMARKET 3 DRINKING WATER 20.69 SANITATION SOLID WASTE ASSOCIA SWANA MEMBERSHIP 223.00 SANITATION WARREN CAT-PARTS STORE FILTER 56.51 SANITATION WARREN CAT-PARTS STORE SERVICE FILTERS 330.15 SANITATION NAPA OF ALTUS BATTERIES FIRE TRUCK 249.14 SANITATION ATWOOD 11 ALTUS SHOP LIGHTS 76.76 SANITATION FOX BUILDING SUPPLY AL RAKES FOR LITTER 28.98 SANITATION WARREN CAT COMPACTOR SAMPLE 29.00 SANITATION FOX BUILDING SUPPLY AL CLEVIS HOOKS 21.16 SANITATION SOUTHWESTERN EQUIPMENT HYD FILLER CAPS 122.22 SANITATION WAL-MART #0479 STENCILS, ETC. 16.15 SANITATION NAPA OF ALTUS HYD HOSE 212 165.35 SANITATION O'REILLY AUTO PARTS 32 SPRAY PAINT 36.82 SANITATION WASTE SYSTEMS SIDELOADER PARTS 107.66 SANITATION FOX BUILDING SUPPLY AL BLACK PAINT 22.35 SANITATION FOX BUILDING SUPPLY AL PIPE & NUTS 6.34


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DEPARTMENT VENDOR DESCRIPTION AMOUNT


SANITATION WAL-MART #0479 TORCH HEAD & PROPANE 19.02 SANITATION HABOR FREIGHT TOOLS304 PAINTER'S TAPE 5.19 SANITATION HABOR FREIGHT TOOLS304 TRANSFER PUMP 7.99 SANITATION WESTERN EQUIPMENT ALTU ELEC CONNECTORS 203 3.40 SANITATION NAPA OF ALTUS SOLDER BEADS 4.68 SANITATION HABOR FREIGHT TOOLS304 PAINTER'S TAPE 5.19 SANITATION HABOR FREIGHT TOOLS304 RACHET STRAP 218 11.99 SANITATION NAPA OF ALTUS BTTRY, TRMNLS, WIRE 218 145.97 SANITATION FOX BUILDING SUPPLY AL HYDRATED LIME 12.35 SANITATION FOX BUILDING SUPPLY AL LOCK NUTS; CLAMPS--218 4.73 SANITATION J-SYSTEMS GLOVES #9688L 5 DZ 123.00 SANITATION ATWOOD 11 ALTUS BOLTS & WASHERS--218 8.38 SANITATION O'REILLY AUTO PARTS 32 TOGGLE SWITCHES 218 9.98 SANITATION WM SUPERCENTER #479 ELEC CONNECTORS 15.94 SANITATION AMSCO STEEL LLC METAL FOR RACK--218 155.00 SANITATION O'REILLY AUTO PARTS 32 HOSE & CONNECTOR--218 26.01 SANITATION FOX BUILDING SUPPLY AL HOSE CLAMPS 7.12 SANITATION O'REILLY AUTO PARTS 32 30 AMP FUSES 3.99 SANITATION NAPA OF ALTUS FITTINGS/HOSES 218 153.77 SANITATION WM SUPERCENTER #479 WATER 77.60 SANITATION O'REILLY AUTO PARTS 32 EMERY CLOTH 4.22 SANITATION WEBER'S DIESEL SERVICE GASKET & SEAL KITS 205 426.79 SANITATION ALTUS PRINTING CO POLYCART LABELS 396.00 SANITATION AMZN MKTP US*XP0F20OF3 GREASE GUN BRACKET 15.50 SANITATION HABOR FREIGHT TOOLS304 PAINT SHAKER 103.99 SANITATION ATWOOD 11 ALTUS DEF 209.70 SANITATION FOX BUILDING SUPPLY AL SPLIT - NUTS, BOLTS, WASH (79.96%) 38.06 SANITATION FOX BUILDING SUPPLY AL SPLIT - FILTERS (20.04%) 9.54 SANITATION DOLLAR TREE CLEANER, SOAP 9.00 SANITATION O'REILLY AUTO PARTS 32 COPPER LUGS 218 10.98 SANITATION WEBER'S DIESEL SERVICE 206 WIRING REPAIR 137.00 SANITATION ROLL OFFS OF AMERICA ROLLOFF SHIPPING 367.00 SANITATION NAPA OF ALTUS SIDELOADER PARTS 1,385.51 SANITATION FOX BUILDING SUPPLY AL AIR COMPRESSOR FOR BASE 463.99 SANITATION NAPA OF ALTUS ONE TON PARTS 30.52 SANITATION WALGREENS #9670 SCALE OFFICE HEATER 34.99 SANITATION NAPA OF ALTUS ONE TON PARTS 21.31 SANITATION SOLID WASTE ASSOCIA SWANA TRAINING 843.00 SANITATION SOLID WASTE ASSOCIA SWANA MEMBERSHIP 223.00 SANITATION SOLID WASTE ASSOCIA SWANA MEMBERSHIP PER JONN 843.00 SANITATION NAPA OF ALTUS SIDELOADER PARTS 136.72 SANITATION NAPA OF ALTUS AAFB BASE EQUIPMENT 1,388.00 SANITATION TILLCO SUPPLY CO SIDELOADER PARTS 145.00 SANITATION Total 9,775.27 UTILITIES WAL-MART #0479 WATER FOR OFFICE 25.04 UTILITIES IN *PRIVETT SALES OFFICE SUPPLY 83.98 UTILITIES Total 109.02 WASTE WTR AMSCO STEEL LLC WIRE FOR CONCRETE 100.00 WASTE WTR AMAZON.COM*TP6IC83Z3 INTERIOR DOOR HANDLE 601 57.39 WASTE WTR NAPA OF ALTUS JUMP STARTER 12/24VOLT 399.00 WASTE WTR NAPA OF ALTUS BATTERY UNIT 601 93.56 WASTE WTR PIONEER SUPPLY LLC GATE VALVE PVC GASKET NUT 1,069.20

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WASTE WTR FOX BUILDING SUPPLY AL GLOVES 27.96 WASTE WTR LOCKE SUPPLY ALTUS COUPLINGS 37.86 WASTE WTR KIRBYS WRECKER & SERVI FLAT REPAIR 20.00 WASTE WTR THE HOME DEPOT #3914 HOSE CLAMP DRAIN PIPE ELB 160.07 WASTE WTR LOCKE SUPPLY ALTUS COUPLING/CLAMP 39.77 WASTE WTR THE HOME DEPOT #3914 DRAIN PIPE FITTINGS 30.98 WASTE WTR 1@PVC-FLEX-AND-FITTING PVC FITTINGS 78.13 WASTE WTR PVC FITTINGS ONLINE 4" PVC FLANGE 161.19 WASTE WTR 1@PVC-FLEX-AND-FITTING HOSE FITTINGS 25.25 WASTE WTR AMAZON.COM*XS9IO2RJ3 HIP BOOTS 81.12 WASTE WTR AMAZON.COM*ZZ3NS92H3 FITTINGS 73.26 WASTE WTR FOX BUILDING SUPPLY AL STEEL WOOL 4.49 WASTE WTR TEEX RETAIL BENNY CLASS TEXAS CANCELL 440.00 WASTE WTR HABOR FREIGHT TOOLS304 GLOVES SCREWDRIVER HEX 130.92 WASTE WTR USA BLUE BOOK SLUDGE JUDGE TOP AND MIDD 193.67 WASTE WTR OFFICESUPPLY.COM PAPER LABELING TAPE HANDL 162.16 WASTE WTR FOX BUILDING SUPPLY AL PLYWOOD FRAMING 34.36 WASTE WTR FOX BUILDING SUPPLY AL TAPE SCREWS U/KNIFE BROOM 60.12 WASTE WTR AMZN MKTP US*WP0G71RQ3 HEATER/EAST PLANT SHOP 948.27 WASTE WTR USA BLUE BOOK SLUDGE JUDGE VALVE 142.39 WASTE WTR FOX BUILDING SUPPLY AL SCREWS 9.47 WASTE WTR NAPA OF ALTUS FUEL FILTER 8.10 WASTE WTR FOX BUILDING SUPPLY AL HANDLE COUPLING SQUEEGEE 31.26 WASTE WTR FOX BUILDING SUPPLY AL PLYWOOD/FRAMING 61.04 WASTE WTR FOX BUILDING SUPPLY AL BLADE 19.99 WASTE WTR NAPA OF ALTUS FUEL CAP 12.45 WASTE WTR FOX BUILDING SUPPLY AL PLUG TEST SPONGES BRACKET 33.62 WASTE WTR FOX BUILDING SUPPLY AL ROPE 19.99 WASTE WTR WAL-MART #0479 SPLENDA COFFEE 40.05 WASTE WTR Total 4,807.09 WATER TRMT HACH COMPANY LAB SUPPLIES 63.85 WATER TRMT HACH COMPANY LAB SUPPLIES 14.59 WATER TRMT WM SUPERCENTER #479 OFFICE SUPPLIES 77.09 WATER TRMT ROSE STATE COLLEGE WOR TRAINING/SCHOOL 428.00 WATER TRMT ROSE STATE COLLEGE WOR TRAINING/SCHOOL 223.00 WATER TRMT ROSE STATE COLLEGE WOR TRAINING/SCHOOL 428.00 WATER TRMT HACH COMPANY LAB SUPPLIES 266.00 WATER TRMT LOCKE SUPPLY - ALTUS PVC SUPPLIES 6.50 WATER TRMT LOCKE SUPPLY - ALTUS PVC SUPPLIES 1.86 WATER TRMT HACH COMPANY LAB SUPPLIES 606.61 WATER TRMT USA BLUE BOOK LAB SUPPLIES 35.71 WATER TRMT FOX BUILDING SUPPLY AL PVC ADPT,CEMENT PVC 21.31 WATER TRMT LOCKE SUPPLY WE ALTUS HIGH OUTPUT LIGHTING 98.80 WATER TRMT ATWOOD 11 ALTUS CORD REEL,CORD REEL W/OUT 62.97 WATER TRMT ATWOOD 11 ALTUS HOSE CLAMPS,HOSE. 48.19 WATER TRMT WM SUPERCENTER #479 HAND SANI,BLCH WIPES,DISI 104.27 WATER TRMT JANUS SUPPLY CO. BROWN PAPER TOWELS 31.80 WATER TRMT WM SUPERCENTER #479 SURGE STRIPS. 28.78 WATER TRMT ATWOOD 11 ALTUS SAW BLADE SET 27.99 WATER TRMT LOCKE SUPPLY ALTUS BALL VALVE COUPLING 34.48 WATER TRMT GRAINGER REFUND CALENDERS. NVR GOT (34.13) WATER TRMT LOCKE SUPPLY - ALTUS COUPLING SCH 80 7.97

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WATER TRMT LOCKE SUPPLY ALTUS COUPLINGS SCH 80 16.85 WATER TRMT USA BLUE BOOK ROTARY PUMP 96.14 WATER TRMT USA BLUE BOOK CHEMICAL PUMP. 104.48 WATER TRMT ATWOOD 11 ALTUS BARREL PUMP 32.99 WATER TRMT TRACTOR SUPPLY # 1289 STALL MATTS 152.60 WATER TRMT GATEHOUSE LIMIT SWITCHES 27.85 WATER TRMT GATEHOUSE LIMIT SWITCHES 63.18 WATER TRMT GATEHOUSE REFUNDED GOT WRONG SWITCH (27.85) WATER TRMT WAL-MART #0479 DESK CALENDERS 9.94 WATER TRMT ATWOOD 11 ALTUS BATTERY ADAPTER,U BOLT. 157.98 WATER TRMT FOX BUILDING SUPPLY AL CABLETIES PIPE. 13.96 WATER TRMT SQ *SCOTT BROWN PROPANE 70.00 WATER TRMT LOCKE SUPPLY ALTUS PRESSURE TEE SLIP CAP 8.38 WATER TRMT TRACTOR SUPPLY # 1289 STALL MATT 406.93 WATER TRMT LOCKE SUPPLY ALTUS 2 PVC 45 ELL 3.66 WATER TRMT CONSOLIDATED BEARING O CHAIN BREAKER, LINK. 32.53 WATER TRMT FOX BUILDING SUPPLY AL PVC PIPING 25.34 WATER TRMT ADVANTAGE OFFICE PRODU PRINTER PAPER. 37.99 WATER TRMT FOX BUILDING SUPPLY AL MORE PVC PIPING 34.60 WATER TRMT FOX BUILDING SUPPLY AL CLAMP HOSE ADPTR FLAIR 54.07 WATER TRMT Total 3,905.26 WTR/SWR MNTC PIONEER SUPPLY LLC GATE VALVE AND PIPE LUBE 477.05 WTR/SWR MNTC WM SUPERCENTER #479 OFFICE SUPPLIES 55.43 WTR/SWR MNTC AUTOZONE #0524 RATCHET 34.99 WTR/SWR MNTC ATWOOD 11 ALTUS STRAINER, HOSE CLAMPS 17.46 WTR/SWR MNTC KENNYS SIGN GRAPHX LLC ON CALL PLAQUES 10.00 WTR/SWR MNTC LOCKE SUPPLY WE ALTUS SPLICE KIT 5.00 WTR/SWR MNTC ATWOOD 11 ALTUS CHAIN BINDER CABLES HANDL 146.71 WTR/SWR MNTC FOX BUILDING SUPPLY AL RASP, KEYS 61.89 WTR/SWR MNTC LOCKE SUPPLY - ALTUS 6" PVC COUPLING 78.45 WTR/SWR MNTC NAPA OF ALTUS BATTERY 28.39 WTR/SWR MNTC ATWOOD 11 ALTUS GLOVES, MASKS 52.95 WTR/SWR MNTC WESTERN EQUIPMENT ALTU SOCKET, HOSE, PLUG 132.82 WTR/SWR MNTC LOCKE SUPPLY ALTUS PIPE 146.52 WTR/SWR MNTC ATWOOD 11 ALTUS JB WELD, DETERGENT 15.97 WTR/SWR MNTC EREPLACEMENTPARTS.COM CHOKE CONTROL 26.14 WTR/SWR MNTC SUPPLYHOUSE.COM PONY PUMP 108.77 WTR/SWR MNTC AUTOZONE #0524 REFUND FOR DEFECTIVE RATC (34.99) WTR/SWR MNTC FOX BUILDING SUPPLY AL CHISELS, OIL, WIRE 31.14 WTR/SWR MNTC SQ *OKIE INDUSTRIAL SU TURBO NOZZLE 344.89 WTR/SWR MNTC PHILLIPS 66 - HUTCHS 1 FILL UP GAS CAN 10.73 WTR/SWR MNTC USA BLUE BOOK PIPE DESCALERS 752.53 WTR/SWR MNTC AUTOZONE #0524 RATCHETS 69.98 WTR/SWR MNTC ATWOOD 11 ALTUS LIGHTS, BRAKE CLEANER, PA 54.51 WTR/SWR MNTC Total 2,627.33 Grand Total 25,141.26

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Date: March 2, 2021


ITEM TITLE: Authorize the AMA Board Chairman/Mayor to Sign the Application for a

Permit to Construct from the Oklahoma Department of Environmental Quality for DWSRF

Water Looping Project

BACKGROUND: On January 21, 2014, the City Council voted to “begin the process of

implementing Treatment Alternative No. 1 as recommended by Freese & Nichols, which

requires construction of a 12” water line…”

On August 5, 2014, the AMA Board and City Council voted to approve an Agreement for

Engineering Services with SBC Consulting Engineers of Altus, OK for professional design and

construction oversight services for this project to include the 12-inch water main as well as

various water line looping projects.

The project was partially funded by a State Financial Assistance Program Grant for Emergency

Drought Relief for an amount of $575,000 (Grant No. FAP-13-0002-EDR). 60% of grant funds

were applied to construction costs and 40% of the grant were applied to design costs.

The remainder of project costs were funded by a loan through the Drinking Water State

Revolving Fund (DWSRF). This loan, known as DWSRF Loan No. ORF-15-0005-DW has

already coverer $1,084,624.07 of construction costs and $167,000 of engineering costs for the

12-inch water main.

This loan also had an additional $1,204,307.07 available for water line looping projects. SBC

Consulting has completed the design and bid documents and we are ready to apply for a Permit

to Construct from ODEQ. Dead-end lines will be looped together in five separate areas.

Staff respectfully requests that the AMA Board of Trustees authorize the Chairman to sign the

application for the Permit to Construct.

FUNDING: None

EXHIBITS: ODEQ Application for Permit to Construct

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Oklahoma Department of Environmental QualityWater Quality Division | (405) 702-8100707 N. Robinson , OKC, OK 73102-6010

P.O. Box 1677, OKC, OK 73101-1677

ppli a on for Permit to Constru t Water Pollu on Control or Publi Water upply a ili es an or upply Potable Water

Check type(s) of Construc on Propose

Water Wells Waterlines Water Treatment Sanitary Sewer Wastewater Treatment Water Reuse

A. Supply Potable Water: Date: ______________ , 20 ___ ONLY

_____________________________________

______________________________________

______________________________________

________________________________________

_____________________________________

B. Supply Reclaime Water: Date: ______________ , 20 ___ONLY

_______________________________________

________________________________________

______________________________________

________________________________________

_________________________________________

______________________________________

C. Construc on acili es: Date: ______________ , 20 ___

__________________________________________________________________________________________________

______________________________________________________________________________________________

_______________________________ _____________________________________________________________

________________________ ___________________________ _________________________

________________________________________________________________________________________

_____________________________________________________________________________________________________

____/4 _____ /4 _____ /4 _______ ______ ____ _______ ____ ________________________

____/4 _____ /4 _____ /4 _______ ______ ____ _______ ____ ________________________

D. Fee: ________ _______________ / _________________

E. n makin this applica on, the applicant cer es an states the followin : Yes No

4

____________________________________________________________________________________

PRIVATE APPLICANT WITHIN MUNICIPALITY

RECEIVE, TRANSPORT, OR TREAT

____________________________________________________________________________________

X

City of Altus, Oklahoma / Altus Municipal AuthorityFebruary 19 21

1011501580-481-3515 [email protected]

[email protected] 580-512-1597 NAPotable Water Lines

City of Altus, Oklahoma

2 N 20 WIM JacksonSee At tachment I

NA

FAP-13-0002-EDR

NA

NA

X

XX

X

XX

X

X

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F. Fun in Source(s)

_______________________

Applicant Signature or Private Applicant Within MunicipalityNote:

______________

___________________________________________ ___________________________________________

___________________________________________ ___________________________________________

___________________________________________ ___________________________________________

___________________________________________ ___________________________________________

___________________________________________ ___________________________________________

___________________________________________ ___________________________________________ / / / /

___________________________________________ ___________________________________________ / / / /

Receive, Transport, or TreatNote:

________________________________________ ____________________

_____________________________________________________ ____________________________________________________

_____________________________________________________ ____________________________________________________

_____________________________________________________

_____________________________________________________ / /

_____________________________________________________ / /

NOTARY SEAL

NOTARY SEAL

NOTARY SEAL

XXX

X

NA

City of Altus, Oklahoma / Altus Municipal Authority

Jack Smiley

509 South Main Street

Mayor / Chairman

Altus, Oklahoma 73521

--------------------------------------------- ________

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Date: March 2, 2021


ITEM TITLE: Consideration, Discussion, and Possible Action to (1) Approve Purchase of a

John Deere 310SL Backhoe Under Sourcewell National Purchasing Contract #032119-JDC for

the Line Maintenance and Construction Department in an Amount Not to Exceed $107,000 (2)

Declare Surplus a 2008 Caterpillar 416E Backhoe and Authorize Trust Manager to Dispose of by

Sealed Bids

BACKGROUND:

FUNDING: Series 2015 Loan Proceeds

EXHIBITS: (1) Quote from CLBoyd (2) Sourcewell Contract Information

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Salesperson : X ______________ Accepted By : X ______________

Confidential

Quote SummaryPrepared For:CITY OF ALTUS509 S MAIN STALTUS, OK 73521Business: 580-477-1950

Prepared By:STEVE LITTLE

The Clarence L. Boyd Company4220 West Reno

Oklahoma City, OK 73107Phone: 405-942-8000Mobile: 580-585-7427

[email protected]

Pricing provided through the Sourcewell National Purchasing Contract. JD Contract ID#032119-JDC City of Altus member ID#62660

Quote Id: 23723122

Expiration Date: 31 March 2021

Equipment Summary Suggested List Selling Price Qty Extended

JOHN DEERE 310SL BACKHOE LOADER

$ 187,686.80 $ 106,510.00 X 1 = $ 106,510.00

Extended WarrantyExtended Warranty, 310SL, Comprehensive, 2500 Total Hours or 48 Total Months, $200 Deductible

Sub Total $ 106,510.00

Equipment Total $ 106,510.00

Trade In Summary Qty Each Extended

2008 CATERPILLAR 416E - CAT0416EPSHA03466

1 $ 24,000.00 $ 24,000.00

PayOff $ 0.00Total Trade Allowance $ 24,000.00

Trade In Total $ 24,000.00Quote SummaryEquipment Total $ 106,510.00Trade In $ (24,000.00)SubTotal $ 82,510.00

Est. Service Agreement Tax $ 0.00

Total $ 82,510.00Balance Due $ 82,510.00

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Selling Equipment

Quote Id: 23723122 Customer: CITY OF ALTUS

Confidential

JOHN DEERE 310SL BACKHOE LOADERHours:Stock Number:

Suggested List$ 184,592.00Selling Price$ 103,415.20

Code Description Qty Unit Extended0A71T 310SL BACKHOE LOADER 1 $ 124,205.00 $ 124,205.00

Standard Options - Per Unit170C JDLink Ultimate 5 Year Subscription 1 $ 0.00 $ 0.001065 John Deere PowerTech™ EWL 4.5L

(276 Cu. In.) Engine Meets Final Tier 4 and Stage IV Emissions

1 $ 10,028.00 $ 10,028.00

2035 Cab 1 $ 13,243.00 $ 13,243.002401 English Decals with English Operator

and Safety Manuals1 $ 0.00 $ 0.00

3025 2 Wheel Drive Autoshift Transmission 1 $ -8,406.00 $ -8,406.004446 Galaxy 19.5L - 24 in. 12 PR Rear &

12.5/80-18 12PR Front1 $ 66.00 $ 66.00

5285 Pilot Controls, Two Lever, with Pattern Selection

1 $ 2,594.00 $ 2,594.00

5401 Less Coupler - Thumb Ready 1 $ 0.00 $ 0.005656 24" (610 mm) Wide, Heavy-Duty, 7.5

Cu. Ft. (0.21 Cu. M.) Capacity Bucket1 $ 1,370.00 $ 1,370.00

6020 Extendible Dipperstick 1 $ 8,365.00 $ 8,365.006230 Auxiliary Hydraulic with One & Two

Way Flow (Hammer & Thumb/Swinger)1 $ 4,582.00 $ 4,582.00

7080 Three-Function Loader Hydraulics, Single Lever

1 $ 3,268.00 $ 3,268.00

7685 Wide Multipurpose Bucket 1 $ 7,593.00 $ 7,593.008475 1000 Lb. (454 kg) Front Counterweight 1 $ 1,374.00 $ 1,374.008685 Dual Maintenance Free Batteries With

Disconnect and Jump Post1 $ 544.00 $ 544.00

9060 Front View Mirror 1 $ 82.00 $ 82.009115 Auto Ride Control 1 $ 2,335.00 $ 2,335.009230 37 Inch Hydraulic Backhoe Thumb - 4

Tine1 $ 5,697.00 $ 5,697.00

9917 Radio, Bosch Basic Package 1 $ 873.00 $ 873.009919 Sun Visor 1 $ 95.00 $ 95.009965 Seat, Cloth Air-Suspension 1 $ 503.00 $ 503.00

Standard Options Total $ 54,206.00Dealer Attachments

AT448428 Hand Held Hydraulics 1 $ 464.00 $ 464.00AT448429 Auxilary Hydraulic Selective Flow

Control Kit1 $ 1,259.00 $ 1,259.00

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Selling Equipment

Quote Id: 23723122 Customer: CITY OF ALTUS

Confidential

AT437340 BKH Pin-on Bucket 18 In. (457 mm) Heavy-Duty 5.1 Cu. Ft. (0.14 Cu. M.)

1 $ 1,358.00 $ 1,358.00

Dealer Attachments Total $ 3,081.00Value Added Services

Extended Warranty 1 $ 3,094.80 $ 3,094.80Value Added Services Total $ 3,094.80

Other ChargesFreight 1 $ 2,300.00 $ 2,300.00Setup 1 $ 800.00 $ 800.00Other Charges Total $ 3,100.00

Suggested Price $ 187,686.80Customer Discounts

Customer Discounts Total $ -81,176.80 $ -81,176.80Total Selling Price $ 106,510.00

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Confidential

Extended Warranty Proposal PowerGard™ Protection PlanConstructionDate : February 24, 2021Machine/Use Information Plan Description Price

Manufacturer JOHN DEERE Plan Type: Extended Warranty Deductible: $ 200

Equipment Type Construction Coverage: Comprehensive Quoted Price $ 3,094.80

Model 310SL Total Months: 48

Country US Total Hours: 2500 Date Quoted February 23, 2021

MFWD/Tracks N

Scraper Use Extended Warranty is available only through authorized John Deere Dealers for John Deere Products,and may be purchased at any time before the product's Standard Warranty,or Extended Warranty expires.

Customer Name - Please Print

Customer Signature

Extended Warranty Proposal Prepared for: I have been offered this extended warranty and

I ACCEPT the Extended Warranty✔

I DECLINE the Extended Warranty

If declined, I fully understand that any equipment listed above is not covered for customer expenses due to component failures beyond the original basic warranty period provided by John Deere.

This is not a contract. For specific Extended Warranty coverage terms and conditions, please refer to the actual Extended Warranty contract for more information and the terms, conditions and limitations of the agreement.

Note :

What Extended Warranty is :The Extended Warranty Program is for the reimbursement on parts and labor for covered components that fail due to faulty material or original workmanship that occur beyond the John Deere Basic Warranty coverage period. The agreement is between Deere & Company and the owners of select John Deere Construction and Forestry equipment, who purchase the Extended Warranty Plans for the desired coverage as indicated in this proposal.

What Extended Warranty is not :Extended Warranty is not insurance. It also does not cover routine maintainance or high wear items,or insurance-related risks/perils such as collision, overturn, vandalism, wind, fire, hail, etc. It does not cover loss of income during or after an equipment failure. See the actual product-specific Extended Warranty agreement for a complete listing of covered components, and limitations and conditions under the program.

Features/Benefits:Extended Warranty includes the following features and benefits under the program :Pays for parts and labor costs incurred on failed covered components (less any applicable deductibles),Does not require pre-approval before repairs are made by the authorized John Deere dealership,Payments are reimbursed directly to the dealership with no prepayment required by the contract holder.

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Date: March 2, 2021


ITEM TITLE: Consideration, Discussion, and Possible Action to Hire D&K Fencing of

Cache, OK to Install a New Chain Link Fence and Motor-Operated Cantilever Gate at the

Polishing Lagoons for a Fee of $14,612.35

BACKGROUND: As part of an ongoing effort to increase security at our sewer plants, we have

been installing new gates. In 2018, a new gate was installed at the SW plant by BestBuilt

Fencing of Lawton, OK. In, 2020, a new gate was installed at the SE plant by D&K Fencing of

Cache, OK.

Both of these gates are motor-operated cantilever gates that can be triggered with remote devices

or by entering a code on the key pad.

Staff would like to install a new gate for the polishing lagoons west of the SW plant. This

property is not currently fenced and there is no gate on the entrance road.

Price quotes were requested for a new 20-foot wide gate with 50 feet of chain link fence on

either side. The following fencing contractors were asked for a price quote.

• D&K Fencing

• BestBuilt Fencing

• Collins Fencing

• Big Bob’s Fencing

Two quotes were received as follows:

Contractor Address Price Quote

BestBuilt Fencing P.O. Box 2172

Lawton, OK

$11,038.60

D&K Fencing 316 Wildflower Cir

Cache, OK

$14,612.35

When BestBuilt Fencing installed the gate at the SW Plant, there were quality problems. They

did not pull the fence fabric tight and they did not install bracing on the gate which was sagging.

They were not initially responsive to fixing the sag in the gate but they put in square tube steel

for bracing instead of round steel and it looks tacky. Finally, the gate still sagged and dragged on

the ground a bit and we asked for that to be adjusted and they didn’t come back. Our operators

purchased and installed an additional roller to fix the sag. Staff does not want to hire them again.

D&K Fencing installed the same fence and gate at the SE plant and did a much better job. Even

though their price is higher, staff recommends hiring D&K Fencing using Capital Improvement

funds.

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FUNDING: 21-5-26-5400.100 Capital Improvement

EXHIBITS: Price Quote from D&K Fencing

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Date: March 2, 2021


ITEM TITLE: Consideration, Discussion, and Possible Action to Authorize the Mayor to Sign

Application Forms as Needed to Apply for a Permit to Treat and Dispose of Commercial Car

Wash Sludge

BACKGROUND: The Great American Car Wash has been dumping sludge from grit chambers

at the Altus SW WWTP. This sludge has a slot of mud and treatment plant operators wanted to

discontinue allowing the sludge in the sewer lagoon.

It was decided to construct a drying bed on City property close to the landfill where the sludge

could be dumped and allowed to dry by evaporation. Then the solids, could be removed and

placed in the landfill.

Staff feels this approach is least costly and less burdensome on City operations.

ODEQ, however, requires this to be permitted and has order that we complete and submit an

OPDES Application to Discharge and/or Treat or Dispose of Industrial Wastewater or Sludge.

The application has two separate forms as follows:

Form 1 - General Information

Form 2S1 – Surface Impoundments and Underground Tank Systems

Both forms need to be signed by “the principal executive officer of the entity or the ranking

elected official.”

FUNDING: N/A

EXHIBITS: Application Form 1 and Form 2S1

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Return to:

Oklahoma Department of

Environmental Quality

Water Quality Division 707 N. Robinson

P.O. Box 1677

Oklahoma City, OK 73101-1677

Revised August 2019

Industrial Permits Section

Oklahoma DEQ Application for Permit to Discharge and/or Treat or Dispose of Industrial Wastewater or Sludge

Form 1 - General Information

PLEASE DETACH THESE INSTRUCTIONS AND RETURN ONLY THE

COMPLETED APPLICATION FORMS THEMSELVES.

This form must be completed by all persons applying for a permit under DEQ’s

Industrial OPDES Permit Program. Form 2C, 2D, 2SI, and/or 2L must also be

filled out (see Item B of the Form 1 Line-by-Line Instructions to determine

which specific forms you will need).

See Form 1, Attachment 1 for instructions for the submittal of applications

and the public notice requirements.

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Form 1 Instructions (Rev. 8/2019) Page 1 of 14

DESCRIPTION OF INDUSTRIAL FORM 1 PACKAGE

PERMIT APPLICATION FORMS TABLE OF CONTENTS

The Industrial Permit Application Forms are:

Form 1 - General Information (included in this package);

Form 2 - Industrial Pollutant Discharge and/or Wastewater Treatment:

2C. Discharge: Existing Manufacturing, Commercial and Mining

Operations (not included in this package),

2D. Discharge: New Manufacturing, Commercial and Mining

Operations (not included in this package), and

2SI. Surface Impoundments (Pits, Ponds, Lagoons, etc.), Subsurface Tank Systems, Land Application of Sludge or Wastewater, and/or

Other Treatment/Disposal Methods (not included in this package).

2L. Land Application of Sludge or Wastewater (not included in this

package)

606-008. Categorical or Significant Industrial User in a Non-

Pretreatment Municipality to Discharge Industrial Waste to the Publicly Owned Treatment Works (POTW)

Section A. General Instructions

Section B. Instructions for Form 1

Section C. Activities Which Do Not Require Regular Discharge Permits

Section D. Glossary

Form 1

SECTION A - GENERAL INSTRUCTIONS

Who Must Apply

These application forms must be filled out by anyone applying for a new

industrial discharge permit, industrial wastewater treatment permit and/or

permit for land application of industrial sludge or wastewater, or for a

renewal or major modification of an existing such permit from the Oklahoma

Department of Environmental Quality (DEQ), with the exception of facilities

listed in Section C of these instructions.

A discharge permit must be obtained prior to commencing any discharge of a

pollutant into waters of the State, from any facility, source or activity subject to

the jurisdiction of DEQ (as outlined below). When a facility or activity is owned by one person but operated by another person, it is the operator’s duty to obtain a

permit.

The Oklahoma Pollutant Discharge Elimination System Act, 27A O.S. §2-6-201

et seq. (the OPDES Act) provides that it shall be unlawful to discharge any

pollutant to waters of the State or elsewhere without first obtaining a permit from the Executive Director of DEQ. DEQ has jurisdiction over point source and

nonpoint discharges to waters of the State including:

A. All point source discharges of pollutants and stormwater to waters of

the State which originate from municipal, industrial, commercial,

mining, transportation and utilities, construction, trade, real estate and finance, services, public administration, manufacturing and all other

sources, facilities and activities, except as provided in 27A O.S. §1-3-

101, subsections D and E; B. All nonpoint source discharges and pollution of waters of the State,

except as provided in 27A O.S. §1-3-101, subsections D, E, and F;

C. Surface water and groundwater quality and protection and water quality certifications;

E. Discharges of pollutants and stormwater, surface impoundment and

land application of wastes and sludge from: 1. Commercial manufacturers of fertilizers, grain and feed

products, and chemicals, and over manufacturing of food and

kindred products, tobacco, paper, lumber, wood, textile mill and

other agricultural products;

2. Dairy waste and wastewater associated with milk production

facilities, but not including discharges to waters of the United States from concentrated animal feeding operations at such

facilities;

3. Slaughterhouses, but not including feedlots at such facilities; 4. Animal aquaculture and fish hatcheries;

F. Stormwater discharges required by EPA NPDES regulations to obtain

a permit for facilities which store grain, feed, seed, fertilizer, and agricultural chemicals;

G. Deleterious substances from Corporation Commission regulated

facilities and activities which enter point source discharges of pollutants or stormwater from a facility or activity regulated by DEQ;

H. Point source discharges of pollutants to waters of the United States

during site remediation of underground storage tanks;

I. Point source discharges of pollutants to waters of the United States

during site remediation of aboveground storage tanks used in

connection with the retail sale of flammable liquids into fuel tanks; J. Discharge or release of deleterious substances or solid or hazardous

waste or other pollutants from rolling stock and rail facilities;

K. Point and nonpoint source discharges of pollutants and stormwater to waters of the State from:

1. Refineries, petrochemical manufacturing plants and natural gas

liquid extraction plants; 2. Manufacturing of oil and gas related equipment and products;

3. Bulk terminals, aboveground and underground storage tanks not

subject to the jurisdiction of the Corporation Commission; 4. Other facilities, activities and sources not subject to the

jurisdiction of the Corporation Commission or Department of

Agriculture as specified in 27A O.S. §1-3-101, subsections D and E;

L. Environmental regulation of any entity or activity, and the prevention,

control and abatement of any pollution, not subject to the specific statutory authority of another state environmental agency.

In addition, it shall be unlawful for any person to carry on any of the following activities with regard to industrial wastewater or sludge without first securing a

permit from DEQ:

A. The construction, installation, operation, and closure of any industrial

surface impoundment or treatment system, or the use of any existing

unpermitted surface impoundment or treatment system that is within the jurisdiction of DEQ and which is proposed to be used for the

containment or treatment of industrial wastewater or sludge;

B. The construction, installation, or operation of any industrial or commercial facility subject to the permitting authority of DEQ, the

operation of which would cause an increase in the discharge of waste

into the waters of the State or would otherwise alter the physical, chemical, or biological properties of any waters of the State in any

manner not already lawfully authorized; or

C. The construction or use of any new outfall for the discharge of any

industrial waste or pollutant into the waters of the State.

If you have any questions about whether you need a permit or if you need information as to whether a particular permit program is administered by DEQ or

another agency, or if you need to obtain application forms, contact DEQ at the

address and phone number listed below under Where to File.

Upon your request, and based upon information supplied by you, DEQ will

determine whether you are required to obtain a permit for a particular facility. Be sure to contact DEQ if you have a question, because state and federal laws provide

that you may be heavily penalized if you do not apply for a permit when a permit

is required.

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What Forms to Fill Out

Form 1 of the Industrial Permit Application Forms collects general information applying to all facilities. You must fill out Form 1. In addition, you must fill

out one or more of the supplementary forms (Forms 2C, 2D, 2SI, 2L, and

606-008), as appropriate to the activities at your facility. Item B of Form 1 will guide you to the appropriate supplementary forms.

You should note that there are certain exclusions to the permit requirements listed above. The exclusions are described in detail in Section C of the instructions. If

your activities are excluded from permit requirements then you do not need to

complete Form 1 or any of the Forms 2. Depending on the nature of your activity, however, you may have to complete some other application form.

In addition to issuing regular individual permits, DEQ also issues several types of general permits. These general permits are located at

http://www.deq.state.ok.us/wqdnew/genpermits.html. If you have questions

about whether these types of permits are applicable to your activity or if you need to obtain application forms, contact DEQ.

Where to File

Completed applications must be filed with DEQ’s central office at the following

address:

Water Quality Division

Oklahoma Department of Environmental Quality 707 N. Robinson

P.O. Box 1677

Oklahoma City, OK 73101-1677 (405) 702-8100

See Form 1, Attachment 1 for guidance with the number of applications submitted and placement of application for public review.

When to File

An application for a new or modified permit should be submitted at least 180 days

before the date on which the discharge or other activity requiring a permit (e.g., construction of a surface impoundment, installation of a treatment system, etc.) is

to commence.

An application for renewal of an existing permit shall be submitted at least 180

days before the existing permit expires.

Different submittal dates may be required under the terms of applicable general

permits.

The filing of an application itself shall not be construed as authority to carry on

such activity. Activities being carried on without a permit are unlawful and shall be subject to applicable enforcement provisions and penalties contained in the

Environmental Quality Code. Unauthorized activities must cease until a proper

permit or other written authorization is obtained from DEQ. State and federal regulations provide that you may not begin construction of any industrial surface

impoundment or treatment system; any industrial or commercial facility, the

operation of which would cause an increase in the discharge of waste into the waters of the State; or any new outfall for the discharge of industrial waste or

pollutants into the waters of the State; without first securing a permit under the

applicable program. Please note that if you are required to obtain a permit before beginning construction, as described above, you may need to submit your permit

application well in advance of the applicable deadlines listed above.

Fees

Application fees are non-refundable and are due when an application is filed with DEQ. Annual fees shall be paid upon receipt of an invoice from DEQ. Payments

for annual fees received by DEQ shall be applied for each fiscal year (July 1st –

June 30th). Failure to pay an annual fee may result in suspension or termination of the permit. Fees are described in OAC 252:606 and OAC 252:616.

Availability of Information to Public

Information contained in these application forms will, upon request, be made

available to the public for inspection and copying. This includes any information submitted on the forms themselves and any attachments used to supply

information required by the forms. You may, however, request confidential

treatment for certain supplemental information you may be asked to provide

during the drafting of the permit. Such requests shall be handled in accordance

with the Oklahoma Open Records Act.

Completion of Forms

Unless otherwise specified in instructions to the forms, each item in each form must be answered. To indicate that each item has been considered, enter “NA,”

for not applicable, if a particular item does not fit the circumstances or

characteristics of your facility or activity.

If you have previously submitted information to DEQ, to another state agency or

to EPA which answers a question, you may either repeat the information in the space provided or attach a copy of the previous submission. Some items in the

form require narrative explanation. If more space is needed to answer a question,

attach a separate sheet entitled “Additional Information.”

Public Notice Requirement

Upon filing a Tier II or Tier III application for a permit (including an application

for a permit renewal), you must publish notice of the filing in a newspaper local

to the area of the facility site. Proof of publication should be filed with the Department within twenty (20) days after the application is filed or the application

may be deemed incomplete. Instructions for filing the public notice are given in

Form 1, Attachment 1.

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http://www.deq.state.ok.us/wqdnew/genpermits.html


SECTION B - FORM 1 LINE-BY-LINE INSTRUCTIONS

This form must be completed by all applicants.

Completing This Form

Please type or print in the unshaded areas only. Abbreviate if necessary to stay

within the space allowed for each item. Use one space for breaks between words,

but not for punctuation marks unless they are needed to clarify your response.

Item A

Indicate the permit action requested by marking the appropriate box.

Item B

Answer each question to determine which supplementary forms you need to fill

out. Be sure to check the glossary in Section D of these instructions for the legal definitions of the bold faced words. Check Section C of these instructions to

determine whether your activity is excluded from permit requirements.

If you answer “no” to every question, then you do not need a regular individual

industrial permit, and you do not need to complete and return any of these forms.

However, you may still require one of the other types of permits administered by

DEQ (as outlined under Who Must Apply in Section A). If you have questions

about whether you need one of these permits or if you need to obtain application

forms, contact DEQ.

If you answer “yes” to any question for which a form number is listed, then you

must complete and file the supplementary form. (The applicable form number follows each question and is enclosed in parentheses.)

Item C

Enter the facility’s official or legal name. Do not use a colloquial name.

Item D

Give the name, title, work telephone number, and email address of a person who is thoroughly familiar with the operation of the facility and with the facts reported

in this application and who can be contacted by reviewing offices if necessary.

Item E

Give the complete mailing address of the office where correspondence should be sent. This often is not the address used to designate the location of the facility or

activity.

Item F

Give the address or location of the facility identified in Item C of this form. If the facility lacks a street name or route number, give the most accurate alternative

geographic information. Also give the legal description of the facility’s location to the nearest 10 acres (¼, ¼, ¼, Section, Range, Township). If you do not know

the legal description of location, it should be available from county records of

property deeds, or can be determined from a topographic map. Alternately, if you are filing for permit renewal, you can find the legal description of location in your

previous permit.

Item G-1

Give the full legal name of the person, firm, public organization, or any other

entity which operates the facility described in this application. This may or may

not be the same name as the facility. The operator of the facility is the legal entity

which controls the facility’s operation rather than the plant or site manager. Do not use a colloquial name.

Item G-2

Indicate whether the entity which operates the facility also owns it by marking the

appropriate box.

Item G-3

Enter the appropriate letter to indicate the legal status of the operator of the facility.

Indicate “public” for a facility solely owned by local government(s) such as a city,

town, county, parish, etc.

Items G-4 through G-9

Enter the telephone number, email address, and mailing address, of the operator

identified in Item G-1.

Item H

Indicate whether the facility is located on Indian Lands.

Item I

If the permit applicant does not own all land subject to the permit application, then

fill out DEQ Form 100-810 that is available on the DEQ web page.

Item J

Give the number of each presently effective permit issued to the facility for each

program or, if you have previously filed an application but have not yet received

a permit, give the number of the application, if any. If you have more than one currently effective permit for your facility under a particular permit program, you

may list additional permit numbers on a separate sheet of paper. List any relevant

environmental federal (e.g., permits under Section 404 of the Clean Water Act or

the Surface Mining Control and Reclamation Act), state (e.g., state permits for

new air emission sources in nonattainment areas under Part D of the Clean Air

Act or state permits under Section 404 of the Clean Water Act), or local permits or applications under “other.”

Item K

Provide a plat or topographic map or maps of the area extending at least to one

mile beyond the property boundaries of the facility which clearly show the following:

(1) The legal boundaries of the facility;(2) The location and ID number of each of your existing and proposed

intake and discharge structures;

(3) All hazardous waste management facilities (including surface impoundments and land application sites);

(4) Each monitoring well or well where you inject fluids underground;

and (5) All springs and surface water bodies in the area, plus all drinking water

wells within 1/4 mile of the facility which are identified in the public

record or otherwise known to you.

If an intake or discharge structure, hazardous waste disposal site, or injection well

associated with the facility is located more than one mile from the plant, include it on the map, if possible. If not, attach additional sheets describing the location

of the structure, disposal site, or well, and identify the U.S. Geological Survey (or

other) map corresponding to the location.

On each map, include the map scale, a meridian arrow showing north, and latitude and longitude at the nearest whole second. On all maps of rivers, show the

direction of the current. Use a 7-1/2 minute series map published by the U.S.

Geological Survey, which may be available at a local engineering supply company or can be obtained from the Oklahoma Geological Survey at the address listed

below. If a 7-1/2 minute series map has not been published for your facility site,

then you may use a 15 minute series map published by the U.S. Geological Survey. If neither a 7-1/2 nor 15 minute series map has been published for your

facility site, use a plat map or other appropriate map, including all the requested

information; in this case, briefly describe land uses in the map area (e.g.,

residential, commercial).

You may trace your map from a geological survey chart, or other map meeting the above specifications. If you do, your map should bear a note showing the number

or title of the map or chart it was traced from. Include the names of nearby towns,

water bodies, and other prominent points.

The Oklahoma Geological Survey’s address is:

Oklahoma Geological Survey

100 E. Boyd

Norman, OK 73019 (405) 325-3035

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Item L

List, in descending order of significance, up to four 4-digit standard industrial

classification (SIC) codes and up to four 6-digit North American Industry

Classification System (NAICS) codes which best describe your facility in terms of the principal products or services you produce or provide. Also, specify each

classification in words. These classifications may differ from the codes describing

the operation generating the wastes.

SIC code numbers are descriptions which may be found in the “Standard

Industrial Classification Manual” prepared by the Executive Office of the President, Office of Management and Budget. This document is available online

from the Occupational Safety and Health Administration (OSHA) website at

http://www.osha.gov/pls/imis/sic_manual.html.

NAICS code numbers and descriptions can be found in the “North American

Industrial Classification System Manual” prepared by the Executive Office of the President, Office of Management and Budget. This document is available online

from the National Technical Information Service (NTIS) website at

http://www.census.gov/eos/www/naics/.

If you have any questions concerning the appropriate code(s) for your facility,

contact DEQ.

Item M

Briefly describe the nature of your business (e.g., products produced or services

provided). List all manufacturing or production processes, and industrial

operations. Processes and operations may be described in general terms (for example, “strip mine,” “distillation tower,” “vehicle wash,” or “transfill of tank

trucks”). Do not include office operations.

Also list intermediate and final products produced (if any), and daily quantity

produced. Give the date the facility began operations, the approximate number of

employees at the facility, and the routine hours of operation, including number of shifts.

Item N

Indicate whether your facility uses cooling water, and if so, specify the source of

the cooling water. If the facility uses a cooling water intake structure, you may be

required to submit the additional information described in 40 CFR 122.21(r) with

your permit application. If you have any questions concerning whether or not this

additional information is required, contact DEQ.

Item O

Indicate whether you plan to request and/or renew a variance.

Item P

Enter the appropriate letter(s) to identify all sources of water supply and provide the appropriate description of each source (as indicated in parentheses). List each

source on a separate line. For each source, list the average daily flows received.

If you have more than one source of a given type, indicate this by entering the letter, followed by two digits (e.g., if you obtained your water from three different

wells, the sources would be indicated as G01, G02, and G03).

Item Q

State statutes provide for severe penalties for submitting false information on this

application form.

27A O.S. §2-6-206(G)(4) provides that, “Any person who knowingly makes any

false material statement, representation, or certification in any application, record,

report, plan, or other document filed or required to be maintained under the Oklahoma Pollutant Discharge Elimination System Act... shall upon conviction

be punished by a fine of not more than Ten Thousand Dollars ($10,000.00), or by

imprisonment for not more than two (2) years, or by both.”

All applications must be signed by the applicant. Signatures must be original

signatures; photostatic copies of signatures will not be accepted. Permit applications must be signed as follows:

(A) If the applicant is a private corporation, the application must be signed by:

(i) A president, secretary, treasurer, or vice-president of the

corporation in charge of a principal business function, or any other person who performs similar policy- or decision-making

functions for the corporation; or

(ii) The manager of one or more manufacturing, production, or operating facilities employing more than 250 persons or having

gross annual sales or expenditures exceeding $25 million (in

second-quarter 1980 dollars), if authority to sign documents has been assigned or delegated to the manager in accordance with

corporate procedures.

(B) If the applicant is a partnership, sole proprietorship or individual person, the application must be signed, respectively, by a general

partner, the proprietor or the individual.

(C) If the applicant is a municipality, political subdivision, the state or federal government or other public agency or entity, the application

must be signed by the principal executive officer of the entity or the

ranking elected official.

Any person signing an application form must make the following certification:

I certify under penalty of law that this document and all attachments were

prepared under my direction or supervision in accordance with a system

designed to assure that qualified personnel properly gather and evaluate the

information submitted. Based on my inquiry of the person or persons who

manage the system, or those persons directly responsible for gathering the

information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant

penalties for submitting false information, including the possibility of fine

and imprisonment for knowing violations.

I further certify that the facility to be permitted possesses or shall acquire a right to the use of the property or properties on which discharging facilities,

activities or discharge sources are located and the property on which the

proposed discharge point or points are located, including the access route thereto, and that the facility to be permitted shall maintain such right of use

and access for the duration of the permit term.

SECTION C - ACTIVITIES WHICH DO NOT REQUIRE REGULAR POLLUTANT DISCHARGE PERMITS

You are not required to obtain a regular individual industrial discharge permit

from DEQ if your discharge is in one of the following categories. However, you may be required to secure another type of permit from DEQ or to secure a permit

from another agency.

A. DISCHARGES INTO PUBLICLY OWNED TREATMENT WORKS

(POTW). The introduction of sewage, industrial wastes, or other pollutants

into a POTW does not require a regular industrial discharge permit from DEQ. You must comply with all applicable pretreatment standards

promulgated under Section 307(b) of CWA, which may be included in the

permit issued to the POTW. If you have a plan or an agreement to switch to a POTW in the future, this does not relieve you of the obligation to apply for

and receive an industrial discharge permit until you have stopped discharging

pollutants into waters of the State.

B. DISCHARGES FROM AGRICULTURAL AND SILVICULTURAL

ACTIVITIES. Most discharges from agricultural and silvicultural activities

to waters of the State do not require discharge permits from DEQ. These

include point and nonpoint discharges from agricultural crop production, agricultural services, livestock production, silviculture, feed yards, livestock

markets, forestry, and nurseries, etc. Such activities may, however, be

subject to EPA permitting requirements. The facilities or activities listed below do require discharge permits from DEQ:

1. Commercial manufacturers of fertilizers, grain and feed products and chemicals, food and kindred products, tobacco, paper, lumber, wood,

textile mill and other agricultural products.

2. Dairy waste and wastewater associated with milk production facilities, but not including concentrated feeding operations at such facilities.

3. Slaughterhouses, but not including feedlots at such facilities.

4. Animal aquaculture and fish hatcheries. Discharge from an aquatic animal production facility using only pond culture requires a general

discharge permit from DEQ. Discharge from all other animal

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aquaculture and fish hatcheries requires a regular industrial discharge

permit.

5. Facilities which store grain, feed, seed, fertilizer, and agricultural chemicals that are required by federal NPDES regulations to obtain a

permit for stormwater discharges. Such facilities only fall under DEQ

jurisdiction with respect to such stormwater discharges.

C. DISCHARGES FROM PUBLICLY OWNED TREATMENT WORKS

(POTW). Most POTWs do not require regular industrial discharge permits. However, POTWs which treat only industrial wastes do require regular

industrial discharge permits.

D. OPERATIONS COVERED BY GENERAL DISCHARGE PERMITS.

General discharge permits have been established for certain categories of

operations for which the same general conditions exist. Each type of general permit has its own application form. Please contact the Water Quality

Division directly or visit the Division’s web site at

http://www.deq.state.ok.us/wqdnew/forms.html for the appropriate form.The categories of general permits are:

1. Petroleum Storage and Transfer (PST) Facilities. PST facilities which

are not within the boundaries of refineries, petrochemical

manufacturing plants or natural gas liquid extraction plants are under

the jurisdiction of the Corporation Commission. Thus, PST General

Permits are no longer issued by the DEQ.

2. Groundwater Remediation Projects Associated With Leaking Underground Storage Tanks Containing Hydrocarbons (UST

projects). All other groundwater remediation projects require regular

industrial discharge permits. Request Application Form 606-G83. 3. Hydrostatic Test Projects. Some hydrostatic test projects fall under the

jurisdiction of the Corporation Commission, and thus must be

permitted through EPA rather than DEQ. DEQ has direct jurisdiction over and has a general permit for hydrostatic test projects at the

following facilities and activities: refineries, petrochemical

manufacturing plants, natural gas liquid extraction plants, manufacturing of oil and gas related equipment and products, bulk

terminals, aboveground and underground tanks not subject to

Corporation Commission jurisdiction, and other facilities and activities not subject to Corporation Commission jurisdiction.

Request Application Form G27.

5. Surface Coal Strip Mines. Request Application Form 606-G04.

6. Vehicle Wash Facilities. Request Application Form 606-G75.

7. Concrete Batch Plants. Request Application Form 606-G11.

8. Mobile Concrete Batch Plants. Request Application Form 616-G11MT.

9. Total Retention Class III Industrial Surface Impoundments. Request

Application Form 616-GC3T. 10. Rock, Sand, and Gravel Quarries. Request Application Form 606-

OKG95.

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SECTION D - GLOSSARY

NOTE: This Glossary includes terms used in the instructions and in Forms 1, 2C, 2D, 2SI, 2L, and 606-008. If you have any questions concerning the

meaning of any of these terms, please contact DEQ.

ANIMAL FEEDING OPERATION means a lot or facility (other than an aquatic animal production facility) where the following conditions are met:

A. Animals (other than aquatic animals ) have been, are, or will be stabled or confined and fed or maintained for a total of 45 days or more in any

12 month period; and

B. Crops, vegetation, forage growth, or post-harvest residues are not sustained in the normal growing season over any portion of the lot or

facility.

Two or more animal feeding operations under common ownership are a single animal feeding operation if they adjoin each other or if they use a common area

or system for the disposal of wastes.

Note: In Oklahoma, animal feeding operations are regulated by the Department

of Agriculture, rather than the DEQ. Thus, such facilities do not require permits

from DEQ.

ANIMAL UNIT means a unit of measurement for any animal feeding operation

calculated by adding the following numbers: The number of slaughter and feeder

cattle multiplied by 1.0; Plus the number of mature dairy cattle multiplied by 1.4;

Plus the number of swine weighing over 25 kilograms (approximately 55 pounds) multiplied by 0.4; Plus the number of sheep multiplied by 0.1; Plus the number of

horses multiplied by 2.0.

APPLICATION means the DEQ standard forms for applying for a permit,

including any additions, revisions, or modifications to the forms.

AQUATIC ANIMAL PRODUCTION FACILITY means a hatchery, fish farm,

or other facility which contains, grows or holds aquatic animals in either of the

following categories:

A. Cold water fish species or other cold water aquatic animals including,

but not limited to, the Salmonidae family of fish (e.g., trout and salmon) in ponds, raceways, or other similar structures which

discharge at least 30 days per year; or

B. Warm water fish species or other warm water aquatic animals including, but not limited to the Ameiuridae, Cetrarchidae, and

Cyprinidae families of fish (e.g., respectively, catfish, sunfish, and

minnows) in ponds, raceways, or other similar structures which discharge at least 30 days per year.

AQUIFER means a formation that contains sufficient saturated, permeable material to yield significant quantities of water to wells and springs. This implies

an ability to store and transmit water; unconsolidated sands and gravels are typical

examples.

BEST MANAGEMENT PRACTICES (BMP) means schedules of activities,

prohibitions of practices, maintenance procedures, and other management practices to prevent or reduce the pollution of waters of the State or United States.

BMPs also include treatment requirements, operating procedures, and practices to

control plant site runoff, spillage or leaks, sludge or waste disposal, or drainage from raw material storage.

BIOLOGICAL MONITORING TEST means any test which includes the use of aquatic algal, invertebrate, or vertebrate species to measure acute or chronic

toxicity, and any biological or chemical measure of bioaccumulations.

BOARD means the Environmental Quality Board.

BYPASS means the intentional or unintentional diversion of waste streams from any portion of a treatment, disposal, or collection facility.

CATEGORICAL USER means an industrial discharger that employs or will be employing processes in any of the industrial categories or business activities listed

below (regardless of whether they generate wastewater, waste sludge, or

hazardous wastes). A facility with processes inclusive in these business areas may be covered by Environmental Protection Agency's (EPA) categorical pretreatment

standards.

Aluminum Forming

Asbestos Manufacturing

Battery Manufacturing

Can Making

Canning & preserved Fruits and Vegetables

Canning & preserved Seafood

Carbon Black

Cement Manufacturing

Centralized Waste Treatment

Coal Mining

Coil Coating

Copper Forming

Dairy Products Processing

Electric and Electronic Components

Electroplating

Explosive Manufacturing

Feedlots Specify type

Fertilizer Manufacturing

Ferroalloy Manufacturing

Foundries (Metal Molding and Casting)

Glass Manufacturing

Grain Mills

Gum & Wood Chemicals Manufacturing

Hospital

Ink Formulating

Landfills

Leather Tanning and Finishing

Meat Products

Metal Finishing

Metal Powders

Mineral Mining & Processing

Nonferrous Metals Forming

Nonferrous Metals Manufacturing

Oil & Gas Extraction

Ore Mining and Dressing

Organic Chemicals Manufacturing

Organic Plastics & Synthetic Fibers Mfg.

Paint and Ink Formulating

Paper & Board Mills

Paving and Roofing Manufacturing

Pesticides Manufacturing

Petroleum Refining

Pulp, Paper, and Paperboard Manufacturing

Rubber Manufacturing

Soap and Detergent Manufacturing

Steam Electric Power Generation

Sugar Processing

Textile Mills

Timber Products

Transportation Equipment Cleaning

Inorganic Chemicals

Iron and Steel Manufacturing

CELL means a part of a surface impoundment system that shares a wall or berm

with another impoundment area.

CLEAN WATER ACT means the federal Water Pollution Control Act, 33 U.S.C., Section 1251 et seq., as amended.

COMPLETE APPLICATION means an application which contains all information required by any appropriate form, applicable rules, requested by DEQ

staff, filed with the appropriate DEQ service and that all appropriate fees have

been paid to and received by the DEQ.

COMPLIANCE SCHEDULE means a schedule of time for initiation and

completion of remedial measures set forth in a Department Permit or Order and includes an enforceable sequence of interim requirements (e.g., actions,

operations, or milestone events) leading to compliance with the limitations and

conditions of a pollutant discharge permit.

CONCENTRATED ANIMAL FEEDING OPERATION means an animal

feeding operation which meets the criteria set forth in either (A) or (B) below or which the Director designates as such on a case-by-case basis:

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A. More than the numbers of animals specified in any of the following

categories are confined:

1. 1,000 slaughter or feeder cattle, 2. 700 mature dairy cattle (whether milked or dry cows),

3. 2,500 swine each weighing over 25 kilograms (approximately 55

pounds), 4. 500 horses,

5. 10,000 sheep or lambs,

6. 55,000 turkeys, 7. 100,000 laying hens or broilers (if the facility has a continuous

overflow watering),

8. 30,000 laying hens or broilers (if the facility has a liquid manure handling system),

9. 5,000 ducks, or

10. 1,000 animal units; or B. More than the following numbers and types of animals are confined:

1. 300 slaughter or feeder cattle,

2. 200 mature dairy cattle (whether milked or dry cows),3. 750 swine each weighing over 25 kilograms (approximately 55

pounds),

4. 150 horses,5. 3,000 sheep or lambs,

6. 16,500 turkeys,

7. 30,000 laying hens or broilers (if the facility has continuous

overflow watering),

8. 9,000 laying hens or broilers (if the facility has a liquid manure

handling system),9. 1,500 ducks, or

10. 300 animal units; AND

Either one of the following conditions are met: Pollutants are

discharged into waters of the State through a man-made ditch flushing

system or other similar manmade device (“man-made” means constructed by man and used for the purpose of transporting wastes);

or Pollutants are discharged directly into waters of the State which

originate outside of and pass over, across or through the facility or otherwise come into direct contact with the animals confined in the

operation.

Provided, however, that no animal feeding operation is a concentrated

animal feeding operation as defined above if such animal feeding

operation discharges only in the event of a 25 year, 24 hour storm

event.

Note: In Oklahoma, concentrated animal feeding operations are regulated by the Department of Agriculture, rather than the DEQ. Thus, such facilities do not

require permits from DEQ.

CONCENTRATED AQUATIC ANIMAL PRODUCTION FACILITY means an

aquatic animal production facility which meets the criteria in either (A) or (B) below or which the Director designates as such on a case-by-case basis:

A. Facilities which: 1. Produce more than 9,090 harvest weight kilograms

(approximately 20,000 pounds) of cold water fish species or

other cold water aquatic animals per year; and 2. Feed more than 2,272 kilograms (approximately 5,000 pounds)

of food during the calendar month of maximum feeding.

B. Facilities which produce more than 45,454 harvest weight kilograms(approximately 100,000 pounds) of warm water fish species or other

warm water aquatic animals per year; provided, however, that the

aquatic animals are not held in closed ponds which discharge only during periods of excess runoff.

CONTACT COOLING WATER means water used to reduce temperature which comes into contact with a raw material, intermediate product, waste product other

than heat, or finished product.

CONTAINER means any portable device in which a material is stored,

transported, treated, disposed of, or otherwise handled.

CONTINUOUS DISCHARGE means a discharge which occurs without

interruption throughout the operating hours of the facility, except for infrequent

shutdowns for maintenance, process changes, or other similar activities.

COUNCIL means the Water Quality Management Advisory Council.

CWA means the Clean Water Act.

DEPARTMENT means the Oklahoma Department of Environmental Quality.

DEQ means the Oklahoma Department of Environmental Quality.

DIKE means any embankment or ridge of either natural or manmade materials

used to prevent the movement of liquids, sludges, solids, or other materials.

DIRECT DISCHARGE means the discharge of a pollutant to waters of the State.

DIRECTOR or EXECUTIVE DIRECTOR means the Executive Director of the

Oklahoma Department of Environmental Quality.

DISCHARGE when used without qualification means the discharge of a pollutant.

DISCHARGE OF A POLLUTANT means:

1. Any addition of any pollutant or combination of pollutants to waters of

the United States or to waters of the State from any point source.

2. Includes additions of pollutants into the waters of the State, including waters of the United States from:

a. surface runoff which is collected or channeled by man;

b. discharges through pipes, sewers, or other conveyances owned by a federal agency or division of the federal government, state,

municipality, or other person which do not lead to a treatment

works; and

c. discharges through pipes, sewers, or other conveyances, leading

into privately owned treatment works.

4. Does not include an addition of pollutants by an indirect discharger. 5. Means any release by leaking, pumping, pouring, emitting, emptying,

dumping, escaping, seeping, or leaching of wastes into any waters of

the State or into a location where they may enter waters of the State.

This definition includes additions of pollutants into waters of the United States

from: surface runoff which is collected or channeled by man; discharges through pipes, sewers, or other conveyances owned by a state, municipality, or other

person which do not lead to a treatment works; and discharges through pipes,

sewers, or other conveyances, leading into privately owned treatment works. This term does not include an addition of pollutants by an indirect discharger.

Discharge shall also mean any release by leaking, pumping, pouring, emitting,

emptying, dumping, escaping, seeping, or leaching of pollutants into any waters of the State, into a location where they may enter waters of the State or elsewhere.

DISCHARGE POINT means the point at which pollutants or wastewater or

stormwater enters waters of the State or becomes waters of the State.

DISPOSAL (in the RCRA program) means the discharge, deposit, injection, dumping, spilling, leaking, or placing of any hazardous waste into or on any land

or water so that the hazardous waste or any constituent of it may enter the

environment or be emitted into the air or discharged into any waters, including ground water.

DISPOSAL FACILITY (in the RCRA program) means a facility or part of a

facility at which hazardous waste is intentionally placed into or on land or water,

and at which hazardous waste will remain after closure.

DISPOSAL SYSTEM means a system for disposing of wastewater, including

treatment systems.

DOMESTIC WASTEWATER means and includes but is not limited to

wastewater from drinking fountains, showers, toilets, lavatories, and kitchens.

DRAFT PERMIT means a document prepared under 40 CFR §124.6 or applicable

Department rules indicating the Director’s tentative decision to issue or deny, modify, revoke and reissue, terminate, or reissue a permit. A notice of intent to

terminate a permit and a notice of intent to deny a permit, as discussed in 40 CFR

§124.5 and applicable Department rules, are types of draft permits. A denial of arequest for modification, revocation and reissuance, or termination, as discussed

in 40 CFR §124.5 and corresponding Department rules, is not a draft permit. A

proposed permit is not a draft permit.

EFFLUENT LIMITATION means any restriction imposed by the Executive

Director on quantities, discharge rates, and concentrations of pollutants which are discharged from point sources into waters of the United States, the waters of the

contiguous zone, waters of the State, or the ocean.

EFFLUENT LIMITATIONS GUIDELINES means a regulation published by the

EPA under Section 304(b) of the Clean Water Act to adopt or revise effluent limitations.

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EXISTING SOURCE or EXISTING DISCHARGER (in the NPDES program)

means any source which is not a new source or a new discharger.

FACILITY or ACTIVITY means any OPDES point source or any other facility

or activity (including land or appurtenances thereto) that is subject to regulation under the OPDES program.

FLEXIBLE MEMBRANE LINER means a manufactured liner material composed of plastics, resins or other flexible materials, which is designed and

manufactured to be used to control the seepage or release of waste through the

liner material.

FLOW-THROUGH SURFACE IMPOUNDMENT means an impoundment

designed and constructed with an outfall structure which allows the controlled discharge of wastes or wastewater out of the impoundment.

FLUID means material or substance which flows or moves whether in a semisolid, liquid, sludge, gas, or any other form or state.

FREEBOARD means the distance between the water surface in an impoundment and the top of the lowest part of the surrounding berm.

GENERAL PERMIT means an NPDES permit issued under 40 CFR §122.28

authorizing a category of discharges under the CWA within a geographical area,

or a general permit issued by the Department through rulemaking procedures as

allowed under the Oklahoma Administrative Procedures Act and other applicable state law.

GPD means gallons per day.

GROUNDWATER means waters of the state under the surface of the earth

regardless of the geologic structure in which it is standing or moving outside the cut bank of any definite stream.

HAZARDOUS SUBSTANCE means any of the substances designated under 40 CFR Part 116 pursuant to Section 311 of CWA. (NOTE: These substances are

listed in Table 2c-4 of the instructions to Form 2C.)

HAZARDOUS WASTE has the meaning set forth in the Environmental Quality

Code and rules promulgated by the Board pursuant thereto.

HAZARDOUS WASTE MANAGEMENT FACILITY (HWM facility) means

all contiguous land, structures, appurtenances, and improvements on the land,

used for treating, storing, or disposing of hazardous wastes. A facility may consist of several treatment, storage, or disposal operational units (for example, one or

more landfills, surface impoundments, or combinations of them).

IMPOUNDMENT means Surface Impoundment.

INDIRECT DISCHARGER means a non-domestic discharger introducing

pollutants to a publicly owned treatment works.

INDUSTRIAL WASTEWATER TREATMENT PERMIT shall mean permits

issued by the Department after July 1, 1993, under Section 2-6-501 of Title 27A

of the Oklahoma Statutes, and waste disposal permits issued on or before June 30, 1993, by the Oklahoma Water Resources Board for land application of industrial

waste or surface impoundments or disposal systems for industrial waste or

wastewater.

INDUSTRY means any person, manufacturer, trade, or business who discharges

or retains wastes.

INJECTION WELL means a well into which fluids are being injected.

LAGOON means a surface impoundment.

LAND APPLICATION means the controlled discharge of waste or wastewater or sludge which is not a hazardous waste onto the land surface, as may be allowed

under provisions of Title 27A O.S. §2-1-101 et seq. and OAC 252:616.

LINER means a barrier which is designed, constructed and installed in a surface impoundment and which has appropriate chemical and physical properties to

ensure that such structures do not fail to control the seepage or release of waste

and wastewater from the impoundment.

MGD means millions of gallons per day.

MONITORING WELL means all borings, wells, piezometers, or other means of

retrieving a soil, waste, wastewater, or vapor sample from the subsurface.

MUNICIPALITY means a city, village, town borough, county, parish, district,

association, or other public body created by or under state law and having

jurisdiction over disposal of sewage, industrial wastes, or other wastes, or an Indian tribe or an authorized Indian tribal organization, or a designated and

approved management agency under Section 208 of CWA.

OKLAHOMA POLLUTANT DISCHARGE ELIMINATION SYSTEM

(OPDES) means the EPA approved state program for issuing modifying, revoking

and reissuing, terminating, monitoring, and enforcing permits and imposing and enforcing pretreatment requirements, under Sections 307, 318, 402 and 405 of

CWA. The term includes an approved program.

NEW DISCHARGER (in the OPDES program) means any building, structure,

facility, or installation: (A) From which there is or may be a new or additional

discharge of pollutants at a site at which on October 18, 1972, it had never discharged pollutants; (B) Which has never received a finally effective NPDES or

OPDES permit for discharges at that site; and (C) Which is not a “new source.”

This definition includes an indirect discharger which commences discharging into waters of the United States. It also includes any existing mobile point source, such

as an offshore oil drilling rig, seafood processing vessel, or aggregate plant that

begins discharging at a location for which it does not have an existing permit.

NEW SOURCE (in the OPDES program) means any building, structure, facility

or installation from which there is or may be a discharge of pollutants, the construction of which commenced:

A. After promulgation of standards of performance under Section 306 of CWA which are applicable to such source; or

B. After proposal of standards of performance in accordance with Section

306 of CWA which are applicable to such source, but only if the standards are promulgated in accordance with Section 306 within 120

days of their proposal.

NON-CONTACT COOLING WATER means water used to reduce temperature

which does not come into direct contact with any raw material, intermediate

product, waste product (other than heat), or finished product.

NON-PRETREATMENT MUNICIPALITY means a municipality that does

not contain a pre-treatment facility for industrial waste.

NONPOINT SOURCE means the contamination of the environment with a

pollutant for which a specific path of origin may not be well defined.

NOTICE BY PUBLICATION means, unless otherwise specifically provided,

publication in a daily or weekly newspaper of general circulation in the area(s) affected by proposed or actual activities regulated by the Department.

OAC means the Oklahoma Administrative Code.

OFF-SITE means any site which is not “on-site.” OKLAHOMA’S WATER QUALITY STANDARDS means the rules

promulgated by the Oklahoma Water Resources Board which designate the

beneficial uses for which the various waters of the State shall be maintained and protected, classify waters of the State, prescribe the water quality standards

required to sustain designated uses, and set forth implementation requirements, as

specified in OAC 785:45.

ON-SITE means on the same or geographically contiguous property which may

be divided by public or private right(s)-of-way provided the entrance and exit between the properties is at a cross-roads intersection, and access is by crossing

as opposed to going along, the right(s)-of-way. Non-contiguous properties owned

by the same person, but connected by a right-of-way which the person controls and to which the public does not have access, is also considered on-site property.

OPDES Act means the Oklahoma Pollutant Discharge Elimination System Act, 27A Oklahoma Statutes §2-6-201 et seq.

O.S. means Oklahoma Statutes.

OUTFALL means the point where monitoring can occur or takes place for the

purpose of evaluating compliance with discharge permits issued.

OWNER or OPERATOR means the owner or operator of any facility or activity

subject to regulation under the NPDES or OPDES or other state water permit

program, and shall include but is not limited to the person holding legal or equitable title to property, and the person responsible for the maintenance and

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operation of a treatment or disposal system or site and for keeping records and

providing reports to the Department.

PERMIT means an authorization, license, or equivalent control document issued

by EPA to implement the requirements of 40 CFR Parts 122, 123, 124, and the

license issued by the Executive Director of the Department of Environmental Quality or the authorization issued by the Executive Director of the Department

under a general permit promulgated by the Environmental Quality Board to

implement the requirements of these rules, state law, federal regulations and the Clean Water Act. Permit includes an NPDES general permit, state-issued

individual permits, and authorizations under general permits, as authorized under

the ODPES Act and the Environmental Quality Code. Permit does not include any permit which has not yet been the subject of final agency action, such as a

draft permit or a proposed permit. In the State of Oklahoma, the term permit shall

be equivalent to the term license as defined under the Oklahoma Administrative Procedures Act.

PERSON means any individual, association, partnership, firm, company, public trust, corporation, joint-stock company, trust, estate, municipality, state or federal

agency, other governmental entity, any other legal entity or an agent, employee,

representative, assignee or successor thereof.

PILE means any non-containerized accumulation of solid, non-flowing hazardous

waste that is used for treatment or storage.

POINT SOURCE means any discernible, confined, and discrete conveyance,

including but not limited to any pipe, ditch, channel, tunnel, conduit, well, discrete fissure, container, rolling stock, concentrated animal feeding operation, landfill

leachate system, vessel or other floating craft from which pollutants are or may be

discharged. This term does not include return flows from irrigated agriculture or agricultural stormwater runoff.

POLLUTANT includes but is not limited to dredged spoil, solid waste, incinerator residue, filter backwash, sewage, garbage, sewage sludge, munitions, chemical

wastes, biological materials, radioactive materials, heat, wrecked or discarded

equipment, rock, sand, cellar dirt and industrial, municipal, and agribusiness waste discharged into water.

POLLUTION means the presence in the environment of any substance, contaminant or pollutant, or any other alteration of the physical, chemical or

biological properties of the environment or the release of any liquid, gaseous, or

solid substance into the environment which is or will likely create a nuisance or

render the environment harmful or detrimental or injurious to public health, safety

or welfare, or to domestic, commercial, industrial, agricultural, recreational, or

other legitimate beneficial uses, or to livestock, wild animals, birds, biological communities, fish or other aquatic life, or to property. For purpose of this

definition, environment shall include but is not limited to waters of the state and

release shall include but is not limited to discharge of a pollutant. Pollution shall include such acts or conduct as will or are likely to cause a violation of

Oklahoma’s Water Quality Standards. POTW means publicly owned treatment works.

PREVENTION OF SIGNIFICANT DETERIORATION (PSD) means the national permitting program under 40 CFR 52.21 to prevent emissions of certain

pollutants regulated under the Clean Air Act from significantly deteriorating air

quality in attainment areas.

PRIVATELY OWNED TREATMENT WORKS means any device or system

which is (A) Used to treat wastes from any facility whose operator is not the operator of the treatment works; and (B) Not a POTW.

PROCESS WASTEWATER means any water which, during manufacturing or processing, comes into direct contact with or results from the production or use of

any raw material, intermediate product, finished product, byproduct, or waste

product.

PROPOSED PERMIT means an OPDES permit prepared after the close of the

public comment period (and, when applicable, any public hearing and administrative appeals) before final issuance by the State. A proposed permit is

not a draft permit.

PUBLICLY OWNED TREATMENT WORKS or POTW means any device or

system used in the treatment (including recycling and reclamation) of municipal

sewage or industrial wastes of a liquid nature which is owned by a state or municipality. This definition includes any sewers, pipes, or other conveyances

only if they convey wastewater to a POTW providing treatment.

RCRA means the Solid Waste Disposal Act as amended by the Resource

Conservation and Recovery Act of 1976 (Pub. L. 94-580, as amended by Pub. L.

95-609, 42 U.S.C. Section 6901 et seq.)

RECEIVING WATER means that portion of any waters of the state into which

wastes are discharged.

SDWA means the Safe Drinking Water Act (Pub. L. 95-523, as amended by Pub.

L. 95-1900, 42 U.S.C. Section 300[f] et seq.).

SEWAGE SLUDGE means the solids, residues, and precipitate separated from or

created in sewage by the unit processes of a POTW. “Sewage” as used in this definition means any wastes, including wastes from humans, households,

commercial establishments, industries, and stormwater runoff that are discharged

to or otherwise enter a publicly owned treatment works.

SIC CODE means Standard Industrial Classification code of the Executive Office

of the President of the U.S., Office of Management and Budget.

SIGNIFICANT INDUSTRIAL USER means

A. All industrial uses subject to categorical pretreatment standards,

also known as CATEGORIAL USER

B. Any other industrial user that:

1. discharges 25,000 gallons per day or more of process

wastewater to the POTW (excluding sanitary, non-contact

cooling water, and boiler blow down wastewater) and/or2. contributes process wastewater to the POTW which makes

up 5% or more of the average dry weather hydraulic capacity of

the wastewater treatment plant and/or 3. contributes process wastewater to the POTW which makes

up 5% or more of the organic capacity of the wastewater

treatment plant and/or 4. is designated as such by the POTW on the basis that the

industrial user has a reasonable potential for adversely

affecting the wastewater treatment plant’s operation andsewer system or for violating any pretreatment requirement

and/or

5. discharges pollutants exhibiting significant pass through or interference in the POTW.

SILVICULTURAL POINT SOURCE means any discernible, confined, and

discrete conveyance related to rock crushing, gravel washing, log sorting, or log

storage facilities which are operated in connection with silvicultural activities and

from which pollutants are discharged into waters of the State. This term does not include nonpoint source silvicultural activities such as nursery operations, site

preparation, reforestation and subsequent cultural treatment, thinning, prescribed

burning, pest and fire control, harvesting operations, surface drainage, or road construction and maintenance from which there is natural runoff. However, some

of these activities (such as stream crossing for roads) may involve point source discharges of dredged or fill material which may require a CWA Section 404

permit. “Log sorting and log storage facilities” are facilities whose discharges

result from the holding of unprocessed wood, e.g., logs or roundwood with bark or after removal of bark in self-contained bodies of water (mill ponds or log ponds)

or stored on land where water is applied intentionally on the logs (wet decking).

(See 40 CFR Part 429, Subpart J, and the effluent limitations guidelines for these facilities.)

SLUDGE has the meaning assigned to that term in OAC 252:525.

SOLID WASTE has the meaning assigned to that term in OAC 252:500.

STATE means the State of Oklahoma or any of the other 49 states as the context

requires.

STORAGE (in the RCRA program) means the holding of hazardous waste for a

temporary period at the end of which the hazardous waste is treated, disposed, or

stored elsewhere.

STORMWATER POINT SOURCE means a conveyance or system of

conveyances (including pipes, conduits, ditches, and channels) primarily used for collecting and conveying stormwater runoff.

STORMWATER RUNOFF means water discharged as a result of rain, snow, or other precipitation.

SURFACE IMPOUNDMENT means an excavated soil or lined basin either below or above ground level which is designed, maintained and/or operated to

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store, recycle, treat and/or dispose of industrial wastewater or stormwater, and

shall include but is not limited to natural and man-made topographic depressions,

excavations, basins, diked areas, lagoons, pits, and ponds.

SYSTEM means pipelines or conduits, pumping stations, and force mains, and all

other constructions, devices, appurtenances, and facilities used for collecting or conducting wastewater to a point of storage, treatment, or ultimate disposal.

TANK SYSTEM means any subsurface disposal system which involves the storage and/or treatment of wastewater.

TOTAL RETENTION SURFACE IMPOUNDMENT means an impoundment designed and constructed without an outfall structure.

TOXIC POLLUTANT means any pollutant listed as toxic under Section 307(a)(1) of CWA.

TOXIC WASTE means substances regulated by the Department to protect beneficial uses, human health, or the environment.

TREATMENT means any method, technique, or process used to remove pollutants from wastewater or sludge to the extent that the wastewater or sludge

may be reused, discharged into waters of the State or otherwise disposed and

includes, but is not limited to, the utilization of mechanized works, surface

impoundments and lagoons, aeration, evaporation, digesters, or other devices or

methods.

TREATMENT WORKS means any plant, disposal field, lagoon, dam, pumping

station, incinerator or any other facility used for the purpose of treating or

stabilizing wastes or wastewater.

UNDERGROUND INJECTION means well injection.

UNDERGROUND SOURCE OF DRINKING WATER or USDW means an

aquifer or its portion which is not an exempted aquifer and:

A. Which supplies drinking water for human consumption; or

B. In which the ground water contains fewer than 10,000 mg/l total

dissolved solids.

UNDERGROUND STORAGE SYSTEM means a partially or totally submerged

wastewater or waste containment system or treatment system.

UPSET means an exceptional incident in which there is unintentional and

temporary noncompliance with technology-based permit effluent limitations because of factors beyond the reasonable control of the permittee. An upset does

not include noncompliance to the extent caused by operational error, improperly

designed treatment facilities, inadequate treatment facilities, lack of preventive maintenance, or careless or improper operation.

WASTE means any liquid, gaseous or solid or semi-solid substance, or thermal

component, whether domestic, municipal, commercial, agricultural or industrial

in origin, which may pollute or contaminate, or tend to pollute or contaminate, any air, land or waters of the State and which is within the jurisdiction of the

Department.

WASTE CONTAINMENT SYSTEMS means storage tanks, containers, and

other storage reservoirs, transfer lines, pumps, fittings, overfill prevention devices,

and any associated anticorrosion measures and/or leak prevention/detection systems.

WASTEWATER includes any substance, including sewage, that contains any

discharge from the bodies of human beings or animals, or contaminating chemicals or other waste or pollutants from domestic, municipal, commercial,

agricultural, industrial or manufacturing activities or facilities and which is within

the jurisdiction of the Department.

WASTEWATER PERMIT means a permit issued by the Department which limits

the types and quantities of pollutants or wastes an industry may store, transport,

or dispose of and consists of four categories:

1. Construction and operation of total retention systems;

2. Tanks other than those used solely for domestic waste; 3. Construction and operation of other wastewater treatment systems;

4. Underground or aboveground wastewater or waste containment,

treatment or storage systems, including but not limited to tanks, pipes, and fittings.

WASTEWATER TREATMENT SYSTEM means treatment works and all related pipelines or conduits, pumping stations and force mains, and all other

appurtenances and devices used for collecting, treating, conducting, or

discharging wastewater.

WASTEWATER TREATMENT SYSTEM means treatment works and all

related pipelines or conduits, pumping stations and force mains, and all other appurtenances and devices used for collecting, treating, conducting, or

discharging wastewater.

WATERS OF THE STATE means all streams, lakes, ponds, marshes,

watercourses, waterways, wells, springs, irrigation systems, drainage systems,

storm sewers, and all other bodies or accumulations of water, surface and

underground, natural or artificial, public or private, which are contained within,

flow through, or border upon this state or any portion thereof, and shall include

under all circumstances the waters of the United States which are contained within the boundaries of, flow through or border upon this State or any portion thereof.

WATERS OF THE UNITED STATES means:

A. All waters which are currently used, were used in the past, or may be

susceptible to use in interstate or foreign commerce, including all waters which are subject to the ebb and flow of the tide;

B. All interstate waters, including interstate wetlands;

C. All other waters such as intrastate lakes, river, streams (including intermittent streams), mudflats, sandflats, wetlands, sloughs, prairie

potholes, wet meadows, playa lakes, and natural ponds, the use,

degradation, or destruction of which would or could affect interstate or foreign commerce including any such waters:

1. Which are or could be used by interstate or foreign travelers for

recreational or other purposes,

2. From which fish or shellfish are or could be taken and sold in

interstate or foreign commerce,

3. Which are used or could be used for industrial purposes by industries in interstate commerce;

D. All impoundments of waters otherwise defined as waters of the United

States under this definition; E. Tributaries of waters identified in paragraphs (A) - (D) above;

F. The territorial sea; and G. Wetlands adjacent to waters (other than waters that are themselves

wetlands) identified in paragraphs (A) - (F) of this definition.

Waste treatment systems, including treatment ponds or lagoons designed to

meet requirement of CWA (other than cooling ponds as defined in 40 CFR

Section 423.11(m) which also meet the criteria of this definition) are not waters of the United States. This exclusion applies only to manmade bodies

of water which neither were originally created in waters of the United States

(such as a disposal area in wetlands) nor resulted from the impoundments of waters of the United States.

WELL INJECTION means the subsurface emplacement of fluids through a bored, drilled, or driven well; or through a dug well, where the depth of the dug well is

greater than the largest surface dimension.

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Form 1, Attachment 1

Public Notice and Application Requirements

A public notice is not required for a Tier I permit application. The Oklahoma Uniform Environmental Permitting Act, 27A O.S. §2-

14-301 requires that upon filing a Tier II or Tier III application with the Department, the applicant shall publish notice of the filing as legal notice in one newspaper local to the proposed new site or existing facility. For Tier III applications, the publication shall also include notice of a thirty-day opportunity to request, or give the date, time and place for, a process meeting on the permitting process.

One (1) copy of Tier I applications must be filed with DEQ. One (1) copy of Tier II and Tier III applications must be filed with DEQ and one copy must be placed for public review in the county in which the facility is located. A copy of the application must remain on

file at the location of the public review site until issuance of the related permit.

Use the following table as guidance for determining the public notice and application requirements for the facility. Select the category

appropriate to the facility and follow the public notice and application requirements. If a public notice is necessary, instructions for

completing the public notice are given in the following pages.

Question Yes

No

Tier I,

II, or

III

Public Notice

Requirements Applications

Is the facility applying for a renewal

of an expiring permit for an

industrial, non-discharging

impoundment or tank system?

Tier I None

One (1) copy of the

application must be filed

with the DEQ.


of an expiring permit with minor or

no change for land application of

sludge and/or wastewater?

Is the facility applying for a new or

renewal of an expiring permit for a

Categorical or Significant Industrial

User in a Non-Pretreatment

Municipality to discharge industrial

waste to the POTW?

Is the facility applying for a new

discharge permit or renewal of an

expiring discharge permit for a

minor facility?

Tier II

The applicant must publish notice of the

filing as legal notice in one newspaper local

to the proposed new site or existing facility.

One (1) copy of the


with the DEQ and one

copy must be placed for

public review in the county

in which the facility is

located.


of an expiring discharge permit for a

major facility?


permit for an industrial, non-

discharging impoundment or tank

system?


permit or major modification of an

existing permit for land application

of sludge and/or wastewater?


discharge permit for a major

facility?

Tier III

The applicant must publish notice of the

filing as legal notice in one newspaper local

to the proposed new site or existing facility.

The publication must also include notice of

a thirty-day opportunity to request (or give

the date, time, and place for) a process

meeting on the permitting process.

One (1) copy of the


with the DEQ and one

copy must be placed for

public review in the county

in which the facility is

located.

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Instruction for Completing the Public Notice

for Tier II and Tier III Applications

The Notice Must Contain the Following Information:

(1) Name and address of the applicant;

(2) Name, address, and legal description (i.e., ¼, ¼, ¼, Section, Township, Range, County) of the site,

facility and/or activity;

(3) Purpose of notice;

(4) Type of permit or permit action being sought;

(5) Description of activities to be regulated;

(6) Locations where the application may be reviewed;

(7) Names, addresses, and telephone numbers of contact persons for the DEQ and for the applicant;

(8) Description of public participation opportunities and time period for comment and requests;

(9) Any other information required by DEQ rules; and

(10)Any information the applicant deems relevant.

Templates for the public notice which fulfills the above requirements appears on the following sheets, and

should be used as a guideline in preparing your own notice. Choose the notice appropriate to the facility and

application. Instructions appear in brackets {} and should not be included in the notice to be published. Square

brackets [ ] indicate spaces where information should be inserted.

If you have any other questions concerning public notice requirements or preparation of the public notice,

please contact the Industrial Permits Section at (405) 702-8100.

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{Instructions in brackets should not be included in the Notice to be published.}

{If your application is a Tier II application and uses only Forms 1, 2SI, and/or 2L, use paragraphs one, two, and

three, and seven, eight, and nine below.}

{If your application is a Tier II application and uses Forms 1, 2C, or 2D, and/or 2SI, and/or 2L, use paragraphs

four through nine below.}

OKLAHOMA DEPARTMENT OF ENVIRONMENTAL QUALITY

TIER II NOTICE OF FILING

A Tier II application for a [new/renewal of an] OPDES permit to operate an industrial wastewater treatment

system has been filed with the Department of Environmental Quality (DEQ) by [Company Name], [Street,

Route, or Other Specific Identifier], [City, State].

The applicant requests a permit to treat industrial wastewater by [Impoundment(s), Tank(s), and/or Land

Application] at their [Name of facility/plant/quarry/mine/etc., if different than Company Name] facility, located

in the [Legal Location], Oklahoma, or at [Street Address/General Location].

The wastewater to be treated will consist of [Wastewater Description(s)]. The permit, if issued, would

establish guidelines for the operation of the industrial wastewater treatment system.

A Tier II application for a [new/renewal of an] OPDES permit to discharge industrial wastewater has been

filed with the Department of Environmental Quality (DEQ) by [Company Name], [Street, Route, or Other

Specific Identifier], [City, State].

The applicant requests a permit to discharge wastewater from their [Name of facility/plant/quarry/mine/etc.,

if different than Company Name] facility, located in the [Legal Location], Oklahoma, or at [Street

Address/General Location].

The discharge, which will consist of [Wastewater Description(s)], will be to [Receiving Stream(s)], in the

[Legal Location(s) of Discharge Point(s)], Oklahoma. The permit, if issued, would establish effluent

limitations on the discharge.

The application may be reviewed at [Address where the application has been made available for review].

After reviewing the application the DEQ will prepare either a draft permit or draft denial. At that time, notice

of the prepared draft will be made by the Department and the public will be given the opportunity to review

it, submit written comments, or request a public meeting within thirty days.

For additional information, contact the applicant’s representative, [Facility Contact] at [Facility Contact’s

Phone Number] or [Facility Contact’s Address], or the Industrial Permitting Unit of the Water Quality

Division of the Department’s central office, located at 707 N. Robinson, P.O. Box 1677, Oklahoma City,

OK 73101-1677, (405) 702-8100.

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{If your application is a Tier III application, use the Notice below.}

OKLAHOMA DEPARTMENT OF ENVIRONMENTAL QUALITY

TIER III NOTICE OF FILING

A Tier III application for a new OPDES permit to discharge industrial wastewater has been filed with the

Department of Environmental Quality (DEQ) by [Company Name], [Street, Route, or Other Specific Identifier],

[City, State].

The applicant requests a permit to discharge wastewater from their [Name of facility/plant/quarry/mine/etc.,

if different than Company Name] facility, located in the [Legal Location], Oklahoma, or at [Street

Address/General Location].

The proposed discharge, which will consist of [Wastewater Description(s)], will be to [Receiving Stream(s)],

in the [Legal Location(s) of Discharge Point(s)], Oklahoma. The permit, if issued, would establish effluent

limitations on the proposed discharge.

The application may be reviewed at [Address where the application has been made available for review].

Any person may now request a process meeting on the permitting process through which this application will

go. The request must be in writing and must be made within 30 days after the date of this publication. Address

the request to the DEQ contact listed below. If the DEQ finds that a sufficient degree of public interest in the

application exists, it will hold the requested meeting after advance notice of the meeting’s time, date, and place

has been given.

Regardless of whether a process meeting is held, the DEQ will prepare either a draft permit or draft denial.

At that time, notice of the prepared draft will be made by the Department and the public will be given the

opportunity to review it, submit written comments, or request a public meeting within thirty days.

For additional information, contact the applicant’s representative, [Facility Contact] at [Facility Contact’s

Phone Number] or [Facility Contact’s Address], or the Industrial Permits Section of the Water Quality

Division of the Department’s central office, located at 707 N. Robinson, P.O. Box 1677, Oklahoma City,

OK 73101-1677, (405) 702-8100.

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Form 1 (Rev. 8/2019) Page 1 of 3

FORM

1 GENERAL

OKLAHOMA

DEQ

OPDES APPLICATION TO DISCHARGE AND/OR TREAT OR DISPOSE OF

INDUSTRIAL WASTEWATER OR SLUDGE

GENERAL INFORMATIONA. TYPE OF PERMIT REQUESTED

NEW RENEWAL MODIFICATION CONVERSION FROM

GENERAL PERMIT

B. REGULATED ACTIVITIESINSTRUCTIONS: ALL applicants MUST fill out FORM 1. Complete items 1 through 5 below to determine which additional forms you need to

submit. If you answer “yes” to any questions, you must submit the supplemental form listed after the question in parentheses. If you answer “no” to

every question, you do not need to submit an application. You may answer “no” if your activity is covered by a general permit or is otherwise excluded

from individual permit requirements (see Section C of the instructions). See Section D of the instructions for definitions of bold-faced terms.

SPECIFIC QUESTIONS YES NO

1. Is this an existing facility which currently results in a discharge of industrial wastewater to waters of the State and is not

eligible for an authorization under a general permit? (FORM 2C)

2. Does this facility use or propose to use surface impoundments (pits, ponds or lagoons) and/or tank systems to treat or

dispose of industrial wastewater and/or land apply industrial sludge or wastewater? (FORM 2SI)

3. Is this a proposed facility which will result in a discharge of industrial wastewater to waters of the State? (FORM 2D)

4. Does this facility perform or propose to perform land application of industrial sludge or wastewater (including beneficial

use for soil conditioning, crop or vegetative fertilization, erosion control or dust suppression)? (FORM 2L)

5. Is this a new or existing categorical user or significant industrial user in a non-pretreatment municipality that will or

does discharge industrial wastewater to a public owned treatment works? (FORM 606-008)

C. NAME OF FACILITY

D. FACILITY CONTACT

1. NAME & TITLE

2. PHONE (area code & number) 3. EMAIL ADDRESS

E. FACILITY MAILING ADDRESS

1. STREET OR P.O. BOX

2. CITY OR TOWN 3. STATE 4. ZIP CODE

F. FACILITY LOCATION

1. STREET, ROUTE NO., OR OTHER SPECIFIC IDENTIFIER 2. COUNTY

3. CITY OR TOWN 4. STATE 5. ZIP CODE

6. LEGAL DESCRIPTION (¼, ¼, ¼, Section, Township, Range)

G. OPERATOR INFORMATION

1. NAME 2. Is the operator also the owner?

YES NO

3. STATUS OF OPERATOR (select the appropriate box below; if “Other,” specify)

Federal State Private Public (other than federal or state) Other (specify):

4. OPERATOR PHONE (if different from facility contact) 5. EMAIL ADDRESS (if different from facility contact)

6. STREET OR P.O. BOX

7. CITY OR TOWN 8. STATE 9. ZIP CODE H. Is the facility located on Indian land?

YES NO

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I. DEQ LANDOWNER NOTIFICATION AFFIDAVIT

1. Does applicant own all land subject to the application: YES NO

If yes, proceed to Section J. If no, proceed to Part 2 of this section.

2. Application(s) for which the applicant does not own all the land subject to the application must notify the owner(s) of leases and/or

pipeline right-of-ways that a permit application has been submitted to the DEQ. The basis for this requirement is 27A of the Oklahoma

Statutes, § 2-14-103(9), as described in OAC 252:004-7-13(b). DEQ Form 100-810 shall be used for this purpose and is available on the

DEQ web page.

J. EXISTING ENVIRONMENTAL PERMITS

1. NPDES 2. UIC 3. RCRA 4. PSD

5. OTHER (permit number) (description) 6. OTHER (permit number) (description)

K. MAP

Attach a topographic map (or other map if a topographic map is unavailable) extending one mile beyond the property boundaries. The

map must show the outline of the facility, the location of each of its intake and discharge structures; each of its hazardous waste

treatment, storage, or disposal facilities; each well where fluids are injected underground; and those wells, springs, other surface water

bodies, and drinking water wells listed in public records or otherwise known to the applicant.

L. SIC and NAICS CODES (in order of priority)

SIC CODE NUMBER DESCRIPTION

NAICS CODE NUMBER DESCRIPTION

M. NATURE OF BUSINESS

1. PRODUCTS AND SERVICES

2. PLANT OPERATIONS

a. PROCESS/OPERATION b. PRODUCT c. DAILY QUANTITY (units)

3. Date the facility began operations: 4. Number of employees at this location:

5. Plant normally operates: hours per day, days per week, in shifts.

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N. COOLING WATER INTAKE STRUCTURES

1. Does the facility use cooling water? YES NO

2. If so, specify the source of the cooling water:

Facilities that use or propose to use a cooling water intake structure as defined in 40 CFR 125 Subparts I and J may be required to

submit additional information as described in 40 CFR 122.21(r). Please consult with DEQ to determine if this additional information

is required.

O. VARIANCE REQUESTS

Do you intend to request and/or renew one or more of the variances authorized at 40 CFR 122.21(m)? Check all that apply.

If you do intend to request one or more variances, please consult with DEQ to determine what additional information you may need to

submit with your application.

Fundamentally different factors (CWA Section 301(n))

Non-conventional pollutants (CWA Section 301(c) and (g))

Water quality-related effluent limitations (CWA Section 302(b)(2))

Thermal discharges (CWA Section 316(a))

No variance requested

P. SOURCES OF WATER SUPPLY AND AMOUNT USED

Identify all sources of facility water by entering the appropriate letter(s) in the boxes below and then providing the appropriate

description(s), as indicated in parentheses. List each source on a separate line. If you have more than one source of a given type,

indicate this by entering the letter, followed by two digits (e.g., if your water comes from three wells, the sources would be indicated

as G01, G02, and G03). For each source, estimate of the average daily use. Continue on additional sheets if needed.

G = GROUNDWATER WELL

S = SURFACE WATER

P = PUBLIC WATER SUPPLY

W = WASTEWATER TREATMENT PLANT

O = OTHER

(legal description of well location)

(name of stream, river, lake, etc., and legal description of intake)

(name of entity from which water is obtained)

(name of entity from which water is obtained)

(source of supply, and legal description if applicable)

1. SOURCE 2. DESCRIPTION3. AVG. DAILY USE

(specify units)

Q. CERTIFICATION (see instructions)

I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with

a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the

person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted

is, to the best of my knowledge and true belief, true, accurate, and complete. I am aware that there are significant penalties for submitting

false information, including the possibility of fine and imprisonment for knowing violations.

1. NAME & OFFICIAL TITLE (type or print) 2. SIGNATURE 3. DATE SIGNED

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Return to: Oklahoma Department of

Environmental Quality

Water Quality Division 707 N. Robinson

P.O. Box 1677

Oklahoma City, OK 73101-1677

Revised July 2019

Industrial Permits Section

Oklahoma DEQ Application for Permit to Discharge and/or Treat or Dispose of

Industrial Wastewater or Sludge

Form 616-2SI

Surface Impoundments and

Underground Tank Systems

This form must be completed by all persons applying for a permit to treat or

dispose of industrial wastewater in surface impoundments (pits, ponds, or

lagoons) and/or underground tanks. This form must be completed in addition

to Form 1 and any other applicable forms.

See Form 1, Attachment 1 for instructions for the submittal of applications and

the public notice requirements.

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Form 616-2SI Instructions (Rev 7/2019) Page 1 of 3

INSTRUCTIONS - FORM 2SI OPDES APPLICATION TO TREAT AND/OR DISPOSE OF INDUSTRIAL WASTEWATER OR SLUDGE

SURFACE IMPOUNDMENTS & UNDERGROUND TANK SYSTEMS

This form must be completed by all applicants who check “yes” to Item B-2

in Form 1.

Your application will not be considered complete unless you answer every

question on this form and on any other required forms. If an item does not apply to you, enter “NA” (for not applicable) to show that you considered the question.

Public Availability of Submitted Information

You may not claim as confidential any information required by this form or by

any other required forms, whether the information is reported on the forms or in an attachment. This information will be made available to the public upon request.

Any information you submit to the Oklahoma Department of Environmental Quality (DEQ) which goes beyond that required by this or any other forms you

may claim as confidential, but claims for information which is effluent data will

be denied. If you do not assert a claim of confidentiality at the time of submitting the information, DEQ may make the information public without further notice to

you. Claims of confidentiality will be handled in accordance with the Oklahoma

Public Records Act.

Definitions All significant terms used in these instructions and in Form 2SI are defined in the

glossary found in the General Instructions to Form 1.

Item A

Enter the facility’s official or legal name. Do not use a colloquial name.

Item B Give the name, title, work telephone number, and email address of a person who

is thoroughly familiar with the operation of the facility and with the facts reported

in this application and who can be contacted by reviewing offices if necessary.

Item C

All surface impoundments and/or tanks on your map should be identified by

number (see Item F below for how to determine impoundment numbers).

Your map should meet the specifications outlined under Item J in the General

Instructions to Form 1. Topographic maps may be obtained from the Oklahoma

Geological Survey at the address also listed under that item.

You may use the same map to fulfill the requirements for Item J in Form 1, Item

C in Form 2SI, provided it clearly shows all information required for each item.

Item D

List all chemical compounds and raw materials in containers of 55 gallons or

more, used in plant operations. Describe the purpose for which each chemical is used. Uses may be described in general terms (for example, “cooling tower

pretreatment,” “process feed stock,” “wastewater treatment,” or “stored pending

sale”). Chemicals may be identified by trade name, but in such case a Safety Data Sheet (SDS) for the product should be attached to the application.

Also describe the storage location, indicating whether it is indoors or outdoors, above or below ground. Storage locations may be keyed to locations on the

facility map included for Item J of Form 1, provided all such locations are clearly

labeled on the map. List the number and type of containers (for example, cylinders, bottles, sacks, barrels, or bulk tanks) used to store each chemical; if the

number varies over time, give a daily average. Also list the average and maximum

daily quantity of each chemical stored on site. For bulk storage tanks, maximum capacity may be reported in place of maximum quantity.

Item E

Impoundment numbers should consist of the letter F (for flow-through) or T (for

total retention) followed by two digits. Number separately for flow-through and total retention impoundments. For example, if you have four (4) flow-through

impoundments and two (2) total retention impoundments, they would be

numbered F01, F02, F03, F04, and T01, T02.

Tank numbers should consist of the letter S (for tank system without lateral lines) or Z (for tanks with lateral lines) followed by two digits.

Use the same numbers throughout Form 2SI to identify the impoundments and/or tanks. If you have an existing permit, use the same numbering scheme in the

application as that used in your current permit, where applicable.

List the impoundment numbers of any impoundments that lie within the 100-year

floodplain. If you are not sure whether an impoundment lies within the 100-year

floodplain, you can determine this by reviewing the Flood Insurance Rate Map (FIRM) for your community or county. FIRMs are prepared by the Federal

Emergency Management Agency (FEMA) as part of the National Flood Insurance

Program (NFIP). If your community or county is a member of NFIP, copies of FIRMs should be on file in the offices of your community or county government,

and are also available online at https://msc.fema.gov/portal/home, or at

https://www.owrb.ok.gov/maps/index.php (see Floodplain Zoning & Community Participation map).

Item F-1

The line drawing should show generally the route taken by water in your facility

from intake to discharge or final disposal. Show all operations contributing wastewater, including process and production areas, sanitary flows, cooling water,

and stormwater runoff. You may group similar operations into a single unit,

labeled to correspond to the more detailed listing in Item G-2. The water balance should show average flows. Show all significant losses of water to products,

atmosphere, and discharge. Use actual measurements whenever available;

otherwise use your best estimate.

You may use the same drawing to fulfill the requirements of Item D-1 in Form 2C

or Item D-1 in Form 2D and Item G-1 in Form 2SI, provided the drawing shows both outfalls and surface impoundments.

Item F-2

List all sources of wastewater to each impoundment and/or tank. Operations may

be described in general terms (for example, “dye-making reactor” or “distillation

tower”). You may estimate the flow contributed by each source if no data are

available. For stormwater runoff you may estimate the average flow, but you must

indicate the rainfall event upon which the estimate is based and the method of estimation.

Report the highest and lowest daily values for flow rate in the “Maximum” and “Minimum” columns (columns c-(2) and c-(3)). Report the average of all daily

values measured during days when discharge occurred within the last year in the “Average” column (column c-(1)).

Item F-3

List all wastes and/or pollutants which are or will otherwise be contained in each

surface impoundment and/or tank (e.g., lubricants, additives, bactericides, detergents, softeners) and their sources. Be as specific as possible in identifying

pollutants. Operations may be described in general terms (for example, “dye-

making reactor” or “distillation tower”). Include all waste types which have the potential to be contained in the impoundments due to spills, bypasses, or unit

failures (e.g., raw materials, oils and greases, solvents or product). Also indicate

(with a “Y” or an “N”) whether you possess analytical data on the wastes contained in each impoundment.

Item F-4

List the volume of sludge generated annually in each impoundment and/or tank.

Use actual measurements if available; otherwise use your best estimate. Indicate whether the sludge will be periodically removed or will accumulate in the

impoundment as a site of final disposal. If sludge is to be removed, give the

frequency of removal (e.g., every six months, annually, every two years, etc.) Determine this frequency using historical data if available; otherwise use your best

estimate. Indicate (with a “Y” or an “N”) whether you possess analytical data on

the sludge generated in each impoundment.

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Form 616-2SI Instructions (Rev 7/2019) Page 2 of 2

Item F-5

List the treatment purpose of each impoundment and/or tank (e.g., settling,

aeration, evaporation, or final disposal). If an impoundment is made up of several

cells (as defined in OAC 252:616-1-2) having different treatment purposes, list

each cell on a separate line.

List any chemicals or equipment used for each treatment method. Also list the

treatment operation parameters (inlet concentration, goal concentration, and detention time) for each impoundment. Use averages of actual measurements

whenever possible; otherwise use design values or your best estimate of average

values.

Item G-1

The plans and specifications should show all inlets to and outlets from each

impoundment, as well as each impoundment’s physical dimensions. The plans

should be clearly labeled with the appropriate impoundment number(s). If the impoundment is made up of several cells, all cells should be clearly shown and

labeled according to flow sequence.

Item G-2

You may use the plans and specifications from Item H-1 to determine each

impoundment’s holding capacity and dimensions. If an impoundment is made up

of several cells, list the overall capacity and dimensions of the impoundment on the first line, followed by the capacity and dimensions of each cell (according to

flow sequence) on a separate line.

Item G-3

List the type of liner material to be installed or currently in use for each

impoundment. Use the classifications in OAC 252:616-7-3 thru 7-7 (e.g., native

soil, compacted clay, flexible membrane, etc.) Within each classification, describe the material of construction as completely as possible (for example,

flexible membrane - HDPE, or alternative - fiberglass tank in excavated-soil pit).

Also list the liner thickness in inches. Hydraulic conductivity (permeability) in column d should be expressed in cm/sec for all liner types as proposed or as built,

except that inches/hour may be used for native soil liners, if desired.

List the type(s) of soil (series name(s) and USDA texture(s)) underlying each impoundment. This information can be found in the appropriate Soil Survey for

the county in which the facility is located. Soil Surveys are published by the

United States Department of Agriculture Soil Conservation Service, and are

available online at

https://websoilsurvey.sc.egov.usda.gov/App/WebSoilSurvey.aspx.

Item G-4

In addition to describing the rationale used to select the liner system, indicate whether you possess any engineering reports or analytical data to support your

rationale.

Item H

The plans and specifications should show the location and length of lateral lines

as well as the distance from each tank and lateral line to potable water wells, water

lines, buildings, property lines, streams, lakes, embankments, and cuts. The plans should be clearly labeled with the appropriate impoundment number(s). Note that

you do not need to list subsurface tanks that are used solely for sanitary wastewater

treatment/disposal.

For each tank, list the tank volume and construction material (e.g. concrete,

steel, plastic, fiberglass). If lateral lines are used for disposal, list the length of

lateral lines and the percolation rate of the soil. Briefly describe the rationale used to select the proposed or currently used lateral line system. If wastewater

is disposed of other than by lateral lines (e.g. impoundment, discharge, recycle),

list the other destination.

Item I

List the method and volume of sanitary wastewater disposal used by the facility.

Item J

Briefly describe any other methods of waste disposal used by your facility which have not been previously covered. Examples include disposal wells, tanks,

aboveground and underground storage tanks, and waste hauling. Include

information on the nature and volume of wastes disposed of by each method, and the legal description of the final disposal site. If the wastes are removed from the

facility, provide the name, address, and phone number of the company hauling the waste, and (if appropriate), the name, address, and phone number of the final

disposal site.

Item K

For each surface impoundment and/or tank, list the depth to groundwater, the

hydrologic gradient or direction of groundwater flow, and the legal description of

each well used to determine groundwater information. The hydrologic gradient or groundwater flow direction should be determined using a minimum of three

wells spaced in a triangular pattern. Hydraulic connections to surface water bodies

may also be used to estimate groundwater flow direction. Attach copies of any well logs or hydrologic atlas pages used to determine this information, if available.

You may list multiple impoundments and/or land application sites on the same

line, provided the same well was used to determine the groundwater information for all impoundments and/or sites. If you cannot determine the direction of

groundwater flow, enter “Unknown” in column C to show that you considered the

question.

Well logs may be obtained from OWRB by utilizing the online tool at http://www.owrb.ok.gov/wd/search/search.php. You should consider well logs

for all Sections (or quarter-sections) lying full or in part within a ½-mile radius of

the surface impoundment(s) and/or outside boundary of the land application site(s).

Item L

For each surface impoundment and/or tank, list the total depth and depth of completion of each monitoring well or water well within ½ mile of the

impoundment and/or tank. Also list the elevation of each well as surveyed, the

depth to static water level, the date the static water level was measured, and the legal description of each monitoring well. Do not include monitoring wells that

are used only to monitor USTs. If there are no water wells within one-half (½)

mile of any impoundments and/or land application sites, enter “N/A” in column A.

Item M

State statutes provide for penalties for submitting false information on this application form.

27A O.S. §2-6-206(G)(4) provides that, “Any person who knowingly makes any

false material statement, representation, or certification in any application, record,

report, plan, or other document filed or required to be maintained under the

Oklahoma Pollutant Discharge Elimination System Act... shall upon conviction

be punished by a fine of not more than Ten Thousand Dollars ($10,000.00), or by imprisonment for not more than two (2) years, or by both.”

All applications must be certified as provided on the forms furnished by the

Department, and must be signed by the applicant. Signatures must be original

signatures; photostatic copies of signatures will not be accepted. Permit applications must be signed as follows:

A. If the applicant is a private corporation, the application must be signed

by:

1. a president, secretary, treasurer, or vice-president of the corporation

in charge of a principal business function, or any other person who

performs similar policy- or decision-making functions for the corporation, or

2. the manager of one or more manufacturing, production, or operating

facilities employing more than 250 persons or having gross annual sales or expenditures exceeding $25 million (in second-quarter 1980

dollars), if authority to sign documents has been assigned or delegated

to the manager in accordance with corporate procedures.

B. If the applicant is a partnership, sole proprietorship or individual

person, the application must be signed, respectively, by a general

partner, the proprietor or the individual.

C. If the applicant is a municipality, political subdivision, the State or

Federal government or other public agency or entity, the application

must be signed by the principal executive officer of the entity or the ranking elected official.

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Form 616-2SI (Rev 7/2019) Page 1 of 6

FORM

2SI OPDES

OKLAHOMA

DEQ OPDES APPLICATION TO TREAT AND/OR DISPOSE OF INDUSTRIAL WASTEWATER OR SLUDGE

SURFACE IMPOUNDMENTS & UNDERGROUND TANK SYSTEMS

A. NAME OF FACILITY

B. FACILITY CONTACT

1. Name & Title 2. Phone (area code & number) 3. Email Address

C. MAP

On the map used for Item K of Form 1, add the locations of any of the following items which are or will be present:

surface impoundments, tank systems, storage facilities, containment devices, monitoring wells, and any water wells

within one-half (½) mile of any surface impoundment or tank system.

D. INVENTORY OF CHEMICALS AND RAW MATERIALS

List all chemical compounds and raw materials in containers of 55 gallons or more, used in plant operations and stored

outside a building (e.g., solvents, cleaning compounds, water treatment chemicals). Describe the storage location and the

purpose for which each chemical is used. Continue on additional sheets if needed.

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E. LOCATION

For each industrial surface impoundment and/or tank system, provide the ID number, legal description, and indicate if the

impoundment or tank is located in the 100 year flood plain. If the impoundment(s) or tank(s) have previously been

permitted, use the ID number(s) contained in the previous permit. If the impoundment(s) or tanks(s) have not previously

been permitted, ID numbers should be assigned using the appropriate letter followed by two digits (e.g., if you have three

flow-through impoundments, their ID numbers would be F01, F02, and F03). Each type of impoundment and/or tank

system should be numbered separately (e.g., if you have one flow-through and one total retention impoundment, their ID

numbers would be F01 and T01, rather than F01 and T02). Use the same numbers throughout this form. Continue on

additional sheets if needed.

F = Flow-Through Surface Impoundment

T = Total Retention Surface Impoundment

S = Underground Tank System Without Lateral Lines

Z = Underground Tank System With Lateral Lines

1. ID

No. 2. Legal Description (¼, ¼, ¼, Section, Township, Range) 3. Flood Plain (yes or no)

F. FLOWS, SOURCES OF WASTE, AND TREATMENT

1. Attach a line drawing showing the flow of wastes or wastewaters through the facility unit processes. Indicate sources of

intake water, chemicals, raw materials, and other sources of wastes. Label all unit processes or operations that

contribute wastes or wastewater, including production areas, waste treatment units, and sources of blowdown or

backwash. Indicate disposal pathways of the wastes and wastewaters, including evaporation, recycle, discharge, solid

waste storage, tanks, impoundments, land application, landfill, or other pathways. Provide a water balance (measured

or estimated) on the line drawing that shows average flows between sources, unit processes, and disposal pathways. If

you filled out Form 2C, you may use the same line drawing, provided it shows all required information.

2. For each impoundment and/or tank system, provide a description of: (1) All operations and other sources of pollution

which contribute waste to the impoundment or tank, including but not limited to process wastes, sanitary wastes,

cooling water, and stormwater; and (2) The average, maximum, and minimum flows contributed by each operation or

other source of pollution. Continue on additional sheets if needed.

a. ID

No. b. Operation(s)/Source(s)

c. Daily Flow (specify units)

(1) Average (2) Maximum (3) Minimum

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3. List all wastes which are or will be contained in the surface impoundment(s) and/or tank system(s) (e.g., lubricants,

additives, bactericides, detergents, softeners) and their sources. Include all wastes which have the potential to be

contained in the impoundment(s) or tank(s) due to spills, bypasses, or unit failures (e.g., raw materials, oils and

greases, solvents, or product). Also indicate whether you possess any chemical analysis of the wastes. Continue on

additional sheets if needed.

a. ID

No. b. Waste/Pollutant c. Source d. Data?

4. For each impoundment and/or tank, list the actual or engineering estimate of the volume of sludge generated annually.

Indicate whether the sludge will be periodically removed from the impoundment or tank (give frequency of removal) or

will accumulate in the impoundment or tank as a site of final disposal. Also indicate whether you possess analytical

data on the sludge generated in each impoundment. Continue on separate sheets if necessary.

a. ID

No. b. Frequency Of Removal/Final Disposal Site c. Sludge Analytical Data d. Volume

5. Describe the treatment purpose of each cell, impoundment, or tank (e.g., settling, aeration, evaporation, or final

disposal). List any chemicals and equipment used for each treatment method. Also list the treatment operation

parameters (inlet concentration, goal concentration, and detention time) for each impoundment or tank. Continue on

additional sheets if necessary.

a. ID

No.

b. Treatment

(1) Description

(2) Chemicals/

Equipment

(3) Inlet

Conc.

(units)

(4) Goal

Conc.

(units)

(5) Detention

Time (units)

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G. IMPOUNDMENT INFORMATION

1. For each impoundment, attach plans sufficient to define the following design parameters: (1) Length and width at top

and bottom; (2) Total depth; (3) Designed minimum and maximum freeboard; (4) Interior and exterior side-slopes

(ratio of horizontal to vertical distances); and (5) Inlet and outlet structures.

2. For each impoundment, list the holding capacity in gallons (assuming a minimum freeboard) and the dimensions in

feet. The following abbreviations are used in the table to indicate the various impoundment dimensions.

BW = Bottom Width

BL= Bottom Length

TW= Top Width

TL = Top Length

D = Depth

F = Minimum Freeboard

MF = Maximum Freeboard

IS = Interior Side-Slope Ratio (Horiz:Vert)

ES = Exterior Side-Slope Ratio (Horiz:Vert)

a. ID No. b. Holding Capacity

(gallons)

c. Dimensions (feet)

(1)

BW

(2)

BL

(3)

TW (4) TL (5) D (6) F

(7)

MF

(8) IS

(ratio)

(9) ES

(ratio)

3. In the table below, list the type of liner material (e.g., native soil, compacted clay, flexible membrane, composite,

soil/bentonite, concrete, or alternative) to be installed or currently in use. Definitive information and justification is

required for alternative liner systems. List the thickness (in inches, feet, or miles, as appropriate) and permeability rate

(in inches/hour) or hydraulic conductivity (in centimeters/second), as appropriate, of each liner as proposed or as built.

Also list the type of soil (series name and USDA texture) underlying the impoundment. Continue on additional sheets

if necessary.

a. ID No. b. Liner Type c. Thickness

(inches)

d. Hydraulic Conductivity

(Permeability)

(cm/sec or in/hr, as

appropriate)

e. Soil Type

(1) Series

Name

(2) USDA

Texture

4. Briefly describe the rationale used to select the proposed or currently used liner systems. Include the date of

construction, along with a discussion of the physical and chemical properties of liner materials which are indicative of

the waste/liner compatibility and the liner’s effectiveness as a physical barrier between the waste and groundwater.

References can be made to similar facilities, related research, or trade organization guidelines. Continue on additional

sheets if necessary.

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H. TANK INFORMATION

1. Attach plans that show the locations of lateral lines, water wells, water lines, buildings, property lines, streams, lakes,

embankments, and cuts within 150 feet of tanks.

2. In the table below, list the tank volume (in gallons) and construction material (e.g. concrete, steel, plastic, fiberglass).

If lateral lines are used for disposal, list the length of lateral lines and the percolation rate of the soil. If wastewater is

disposed of other than by lateral lines (e.g. impoundment, discharge, recycle), list the other destination. Continue on

additional sheets if necessary.

a. ID No. b. Tank Volume

(gallons) c. Construction

Material

d. Lateral Lines e. Other

Destination (1) Length

(feet) (2) Percolation Rate

(minutes/inch fall)

3. Briefly describe the rationale used to select the proposed or currently used lateral line system (if applicable).

I. SANITARY WASTEWATER DISPOSAL

In the table below, list the estimated volume of sanitary wastewater and the method of sanitary wastewater disposal.

1. Volume Of Sanitary Wastewater 2. Method Of Sanitary Wastewater Disposal

J. OTHER DISPOSAL METHODS

Briefly describe any other methods of waste disposal used by your facility which have not been previously covered.

Examples include disposal wells, tanks (with or without leach fields), aboveground or underground storage tanks, and

waste hauling. Include information on the nature and volume of wastes disposed of by each of these other methods.

Continue on additional sheets if necessary.

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K. GROUNDWATER INFORMATION

For each surface impoundment and/or land application site, list the depth to groundwater, the direction of groundwater

flow, and the legal description of each well used to determine groundwater information. Continue on additional sheets if

necessary.

1. ID No. 2. Depth to Water

(feet) 3. Direction of Flow 4. Legal Description of Well

L. WELL INFORMATION

1. For each monitoring well or water well within ½ mile of any impoundment and/or tank system, list in the table below

the total depth, depth of completion, elevation, static water level, and legal description of well. Continue on additional

sheets if necessary.

2. For each well, attach the well log or drillers log, if available. If no water wells are found within ½ mile, attach a copy

of the OWRB letter indicating no wells were found in their records search.

a. ID No. b. Total

Depth

c. Depth of

Completion d. Elevation

e. Static

Water Level

f. Legal Description

of Well

M. CERTIFICATION (see instructions)

I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in

accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.

Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering

the information, the information submitted is, to the best of my knowledge and true belief, true, accurate, and complete. I

am aware that there are significant penalties for submitting false information, including the possibility of fine and

imprisonment for knowing violations.

1. Name & Official Title (type or print) 2. Signature 3. Date Signed

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NOTICE OF REGULAR MEETING ALTUS MUNICIPAL AUTHORITY

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Transcript of NOTICE OF REGULAR MEETING ALTUS MUNICIPAL AUTHORITY