Wastewater Systems Effluent Regulations (SOR/2012-139)

[Name and address of owner or operator]

in respect of [name and address of wastewater system]

• (a) is (are) authorized as of [the date of issuance referred to in subsection 26(2) of the Wastewater Systems Effluent Regulations] to deposit effluent that contains the deleterious substances set out below until [expiry date]Footnote ^* from [identify final discharge point and, in the case of a fictional consolidated wastewater system referred to in section 4 of those Regulations, identify the final discharge point for each of the original wastewater systems] .

  Deleterious Substance	Average Concentration over the Calendar Year, Quarter or Month	Maximum Concentration over the Calendar Year, Quarter or Month
  CBOD matter	mg/L of carbonaceous biochemical oxygen demand	not applicable
  suspended solids (SS)	mg/L	not applicable
  un-ionized ammonia (NH3)	not applicable	mg/L, as nitrogen (N) at 15°C ± 1°C

• (b) is (are) authorized as of [the date of issuance referred to in subsection 26(2) of the Wastewater Systems Effluent Regulations] to deposit effluent whose average concentration of total residual chlorine does not exceed 0.02 mg/L until [expiry date]Footnote ^* from [identify final discharge point and, in the case of a fictional consolidated wastewater system, identify the final discharge point for each of the original wastewater systems] if chlorine, or one of its compounds, was used in the treatment of wastewater in the wastewater system.

  IMPORTANT: Please refer to sections 28 and 29 of the Wastewater Systems Effluent Regulations for the conditions and compliance requirements related to the authorization. Please also take note that this authorization may be revoked under section 32 of the Wastewater Systems Effluent Regulations.

  • Return to footnote ^*This authorization may expire under subsection 33(1) of the Wastewater Systems Effluent Regulations on a date earlier than the date indicated above as the expiry date.

  Authorization Officer:
  [Signature] [Name] [Title]	Date: