WI0700012_Application_20070914

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REQUEST FORM SEA 1 8 2007
Date: September 14, 2007
To:
❑ Landon Davidson,.ARO-APS
n Art Barnhardt, FRO-APS
❑ Andrew Pitner, MRO-APS
❑ Jay Zimmerman, RRO-APS
From: Peter Pow, Groundwater Protection Unit
Telephone: [phone]
E-Mail: [e-mail]
Y, ; H ftFGI1::"1AL
® David May, WalZ�'- RE
❑ Charlie Stehman;: WiKO-APS
❑ Sherri Knight, .W8t.QaAPS—
Fax: [phone]
A. Permit Number: WI0700012
B. Owner: PCS Phosphate
C. Facility/Operation: PCS Phosphate
❑ Proposed Existing
D. Application:
1. Permit Type: ❑ Animal 0 Surface Irrigation
❑ Recycle ❑ UE Lagoon
❑ UIC - (5Z) other (specify)
For Residuals: 0 Land App.
❑ 503
❑ Facility ❑ Operation
❑ Reuse ❑ H-R Infiltration
❑ GW Remediation (ND)
❑ D&M
O 503 Exempt
❑ Surface Disposal
❑ Animal
2. Project Type: ❑ New ❑ Major Mod. ❑ Minor Mod. ® Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: /1 I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 30 calendar days, please take the following actions:
® Return a Completed Form APSSRR.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO*.
* Remember that you will be responsible for coordinating site visits, reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above. j
RO-APS Reviewer: Ai, i. t r'1-r'1— Date: c/ T - 0 7
FORM: APSARR 02/06 Page 1 of 1