ENVIRONMENTAL PERMITS CHECKLIST

Developed by Minnesota Rural Water Association for use by
communities in the management of wellhead protection areas.
(Compiled from materials furnished by the state of Michigan, Minnesota Environmental
Quality Board and Ramsey County Soil & Water Conservation District,)

The intention of this checklist is to identify facilities that must comply with federal, state, county or other local environmental permit requirements. This form must be submitted along with your site plan. This checklist is not a permit application form. Facilities are responsible for obtaining information and permit applications from appropriate permitting agencies. Compliance with state and local regulations may be required for site plan approval and/or permit issuance.

Date:_________________________________________________________________________

Business Name: ________________________________________________________________

Mailing Address: ______________________________________________________________

Facility Address: ______________________________________________________________

Telephone/Fax: ________________________________________________________________

Facility Owner: _______________________________________________________________

Facility Operator or Manager: ___________________________________________________

Type of Facility: _______________________________________________________________ 

Please circle the proper Yes or No response for the regulations which you think may apply to your facility.

1. Y N Will the project or facility discharge any type of wastewater to a sanitary sewer, storm sewer, drain, lake, stream, wetland, or other surface water body?

Contact: Metropolitan Waste Control Commission, your local watershed management organization, Minnesota Department of Natural Resources and/or local county or city planning/zoning, environmental, public works or public health office. 
 

2. Y N Will the project or facility involve the discharge of liquids, sludges, wastewater and/or wastewater residuals into or onto the land surface?

Contact: Minnesota Pollution Control Agency, your local watershed management organization, Minnesota Department of Natural Resources and/or your local planning/zoning, environmental or public health office.

3. Y N Will the project or facility store or use hazardous substances? Depending on the type of substance, secondary containment and/or material storage, a permit may be required.

Contact: Your city or county planning/zoning department, Minnesota Pollution Control Agency, Minnesota Emergency Response Commission, local fire department and/or Minnesota Department of Agriculture (for bulk pesticide storage).

 
4. Y N Will the project or facility use above or underground storage tanks or other containers for hazardous substance storage? Tanks with holding capacities greater than 1,100 gallons must be registered with and conform to the requirements of the State of Minnesota. Smaller tanks, depending on their contents, may also require registration.

Contact: Minnesota Pollution Control Agency, or local fire department.

5. Y N Do hazardous substance tank locations, storage and preparation areas meet the isolation distance requirements outlined in the Minnesota Water Well Code?

Contact: Minnesota Department Health: Well Management Unit.

6. Y N Will the project or facility involve the generation, transport, on-site treatment, storage or disposal of hazardous waste? If yes, a county hazardous waste permit is required.

Contact: Your local county planning/zoning, solid waste, environmental or public health office.

7. Y N Will the project or facility involve the burning, landfilling, transferring, or processing of any types of solid non-hazardous wastes on site?

Contact: Local county planning/zoning, solid waste, environmental or public health office.

8. Y N Will the project or facility involve the installation, construction, reconstruction, relocation or alteration of any process equipment (including air pollution control equipment) which has the potential to emit air contaminants?

Contact: Minnesota Pollution Control Agency: Air Quality Division.

9. Y N Will the project or facility involve any man-made change in the natural cover or topography of the land, including cut and fill activities which may contribute to soil erosion and/or sedimentation?

Contact: Your local city or county engineering department, local watershed management organization, or County Soil & Water Conservation District.

10. Y N Does the project involve any work (dredging, filling, construction) proposed in a river, stream, creek, ditch, wetland or floodplain?

Contact: Your local city or county engineering department, local watershed management organization, Corps of Engineers or County Soil & Water Conservation District.

11. Y N Will an on-site wastewater treatment system or on-site sewage treatment system be installed?

Contact: Local city or county planning/zoning, environmental or public health office.

12. Y N Will septage be stored or disposed of on-site?

Contact: Local city or county planning/zoning, environmental or public health office.

13. Y N Is this facility (or any facility under your ownership) currently involved in any compliance issues or discussions with the Minnesota Pollution Control Agency or other federal, state or local agency?

If YES, please describe briefly the compliance issue.

 
14. Y N Is this site currently contaminated or has it been a site of past contamination?

If YES, please briefly describe the incident and its current clean-up status.

PLEASE RETURN COMPLETED CHECKLIST AND SUPPORTING INFORMATION
TO LOCAL WELLHEAD PROTECTION OR PERMITTING OFFICE.