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9. The wastewater must be sampled at least once for the following constituents prior to discharge and <br />subject to the associated limits listed below. Samples must be submitted prior to discharge, <br />to verify discharge limits. Should lab samples indicate higher than allowed discharge limits, a plan of how to <br />bring the discharge within the required limits will be required before issuance of the permit. <br />Analyte <br />Limit <br />As <br />0.5 mg/L <br />Cd <br />0.24 mg/L <br />Cr <br />5.0 mg/L <br />Cu <br />3.0 mg/L <br />Pb <br />1.9 mg/L <br />Hg <br />0.1 mg/L <br />Ni <br />2.83 mg/L <br />Ag <br />0.49 mg/L <br />Zn <br />4.0 mg/L <br />CN- <br />0.65 mg/L <br />Nonpolar FOG <br />200 mg/L <br />C. Additional Pertinent Information: (Attach additional information if necessary) <br />D. Discharge Authorization Conditions <br />1. You must comply with the general use and discharge requirements of the Industrial Pretreatment Ordinance <br />#3070-08 as amended (attached), as well as any applicable Federal and State regulations. <br />2. The City solely reserves the right to modify, suspend, or terminate the authorization at any time, once issued. <br />3. The City may modify the discharge location at any time to an alternate location that best suits the City. <br />Discharge operations shall comply with the City's Noise Ordinance. <br />4. Discharges during rainfall may be prohibited. <br />E. Discharge Authorization Permit Fee <br />1. The total fee for the Discharge Authorization Permit is $500. Payment must be received with application. Make <br />payments only by mail. Make check payable to "City of Everett Utilities". <br />F. Sewer Discharge Rates <br />1. Sewer collection and Industrial Pretreatment fees will be billed monthly, and will include the then current sewer <br />rate (2020 rate of $8.569 per 100 cubic feet) AND the industrial surcharge of $0.19 per thousand gallons of flow. <br />G. Certification of Information <br />I hereby certify that the information supplied in this request is correct and complete to the best of my knowledge. <br />Name (Print): <br />Signature <br />Email: <br />Title: <br />Date: <br />Phone: <br />Send or email completed request to address at the top of this form. For further questions regarding this request, <br />contact Fred Rapelyea at 425-257-8828 (or FRapelyea@)everettwa.govl. Fax: 425-257-8882. <br />Page 2 of 2 <br />