The Ohio EPA 4309 form, officially titled "Supplement to Form A – B1 Division of Environmental & Financial Assistance Permit-to-Install/Plan Approval Application Sanitary Sewers," is a detailed document required by the State of Ohio Environmental Protection Agency's Division of Surface Water. It comprehensively outlines the specifics of proposed sanitary sewer projects, including project descriptions, pipe specifications, design flow, and more to ensure environmental compliance and protect water quality. This form serves as a critical step for any entity looking to install or modify sanitary sewer infrastructure within Ohio, highlighting the importance of thorough planning and environmental stewardship.
In the realm of environmental responsibility and infrastructure development within Ohio, the Ohio EPA 4309 Form plays a crucial role. This document, formally known as the Supplement to Form A – B1, is integral to the Permit-to-Install/Plan Approval Application process for sanitary sewers, outlining a comprehensive framework for applicants to follow. Its sections span from detailed project descriptions, including the location, size, potential future extensions, and any included pump stations, to specific pipe specifications such as type, material, and bedding requirements. Importantly, it delves into design flow rates, detailing expected flows at both startup and design completion, alongside considerations for the receiving wastewater treatment facility’s capacity. The form ensures thoroughness by addressing sewer design parameters, potential impacts on water bodies, and manhole construction specifics. Safeguarding water supplies is also a priority, requiring information on any proximities to potable water sources and protective measures. Additionally, it specifies requirements for installation and testing procedures, underscoring the importance of rigorous inspection and adherence to standards to prevent issues post-construction. Moreover, the documentation encompasses sewer use ordinances, stressing the prohibition of non-sanitary connections, and mandates for the submission of detailed plans and technical specifications. By capturing a wide array of considerations—from environmental protection to technical engineering requirements—the Ohio EPA 4309 Form embodies a critical step in ensuring the responsible expansion and maintenance of the state’s sanitary sewer infrastructure.
State of Ohio Environmental Protection Agency
Division of Surface Water
Supplement to Form A – B1
Division of Environmental & Financial Assistance
Permit-to-Install/Plan Approval Application
Sanitary Sewers
FOR AGENCY USE ONLY
Application Number:
Date Received: /
/
Applicant:
Facility Owner:
Ultimate owner (if different):
Application/Plans Prepared by:
Project Name:
1. Project Description
a. Describe the location, size and current development of the area to be served. List street address, township, county, and include longitude and latitude coordinates in describing location.
b. What is the possibility that future sanitary sewer extensions will connect to the sanitary sewers which are the subject of this application?
c. Are there any pump stations included as part of this sewer construction? (If Yes, fill out attachment to Form B1)
d. Indicate type(s) of sewers proposed (check all that apply):
Conventional gravity
Small diameter gravity (w/septic tanks)
Vacuum
Siphon
Yes
No
Pressure (GP or STEP)
Force main (must include pump station)
2. Pipe Specifications
Please identify each type (as indicated in 1d above) and size of pipe included in this project.
Type
Pipe
Material *
Joint*
Bedding**
Minimum
Size
Material
Specification
Classification
Slope
Length
Maximum
Manhole
Spacing
*List ASTM, AWWA, or ANSI specification number. For any specification that does not appear on Ohio EPA’s pipe specification list, the applicant shall submit the standard for approval with the Permit-to-Install.
** 100 percent to pass ¾-1.0 inch sieve. ASTM C-12 (A, B, C), D-2321 (IA, IB, II, III), or other. Ohio EPA Approvable Pipe Specification List: http://www.epa.ohio.gov/dsw/pti/PipeSpecs.aspx
EPA 4309 (rev. 9/09)
Form B1
Page 1 of 4
3. Design Flow in Proposed Sewer
Identify flows expected at start-up (for example, currently existing flows plus design flow for this project) and the flows expected at design (for example, start-up flows plus flows from future phases of development) at terminus of proposed sewer.
Average Daily Flow
Peak Hourly Flow
Start-Up Flows (based on immediate area served)
MGD
Design Flows (based on planned area served)
Hydraulic Capacity of Sewer
Assumptions used to calculate above flows: (check all that apply)
Start-Up
Design
Residential Population at:
gal/home*
homes
gal/cap/day
people
Non-Residential Flows (for example commercial, industrial, etc.):
Computer Flow Modeling Results (attach explanation and data)
*120 gallon/bedroom in accordance w/ OAC 3745-42-05 unless additional information is submitted
4. Receiving Wastewater Treatment Facility
a. What treatment facility will be receiving flow from these sewers?
Present treatment facility average daily flow
MGD (based on
/20
(month/year) ADF)*
Proposed treatment facility average daily flow (based on present average daily flow plus all connections currently under construction or being designed)
Design average daily flow of the treatment facility
b.Does the treatment facility have adequate capacity to treat anticipated flows from existing sewers plus the proposed sewers based on the sewer's design capacity?
If No, on a separate sheet, please describe the steps being taken to ensure that the treatment facility has adequate capacity. Include specific work items and schedules as appropriate.
MGD design year)
Yes No
c. Is there intent to expand the treatment facility to treat additional flows?
*Note: Flow data to be no older than one calendar year from date of PTI submission
5. Sewer Design
a. Are the sewers deep enough to serve all adjacent basements?
(refer to GLUMRB, Recommended Standards for Wastewater Facilities, 2004, Section 33.2)
If No, please explain how the basements will be served:
b. Are sewers at a sufficient depth to prevent freezing? (GLUMRB Section 33.2)
If No, please explain how freezing will be prevented:
c. Where small sewers join larger ones, have the inverts of the larger sewers been lowered sufficiently to maintain the same energy gradient? (GLUMRB Section 33.6)
d. Have provisions been made to protect sewers against displacement by erosion and impact at velocities over 15 fps? (GLUMRB Section 33.45)
e. Are sewers with slopes greater than 20 percent secured with concrete anchors (or equal), spaced as required? (GLUMRB Section 33.46)
f. Are there any overflows or bypasses upstream of the point of connection that may be impacted by the flows from the new sewer?
g. Are there any sanitary overflows or bypasses or combined sewer overflows downstream of the point of connection?
* (If Yes to f. or g., on a separate sheet provide a description of the exact location of any overflows or bypasses)
Yes* No
N/A
h. Is the force main designed to withstand water hammer pressures and associated cyclic reversal of stresses that are expected with the cycling of wastewater pump stations?
(GLUMRB Section 49.4)
If No, please explain:
Page 2 of 4
6. Stream Protection
a. Are there any stream crossings? (If Yes, fill out the stream evaluation addendum)
Yes*
If Yes,
1.
How many crossings are made? (GLUMRB Section 36.14)
Number of crossings:
2.
Are the crossings perpendicular to the stream? (GLUMRB Section 36.14)
3.
Are crossings to be made at previously disturbed areas?
4.
Is the streambed substrate composed primarily of solid rock, sand and gravel, or silt?
Rock
Sand/gravel
Silt
5.
In areas of steep slope or unstable soils, are the sewers located on more level, terraced areas?
6.
Are the sewers at a sufficient depth to protect the sewer line? (GLUMRB Section 36.11)
b. Do any sewers run parallel to any streams?
Is there any woody vegetation along the stream banks?
Are the sewers and construction easements located outside of the vegetated areas?
*If the response to either a. or b. is Yes, please provide the specific measures in the detail plans and specifications that will be used to ensure that damage to the stream corridor is minimized to the greatest extent possible and that the stream corridor is restored to original condition.
7. Manhole Design
a. Manhole type (precast cast-in-place, etc.):
b. Material specification (ASTM):
c. Joint specification (ASTM):
d. Are watertight frames and covers used wherever manhole tops may be flooded by street runoff or high water?
If No, explain*:
e. Are manholes provided at the upstream end of each line? (GLUMRB Section 34.1)
f. Are manholes provided at all changes in size, grade, and alignment? (GLUMRB Section 34.1)
g. Are manholes provided at all sewer intersections? (GLUMRB Section 34.1)
h. Are drop manholes provided where the entrance sewer invert is 24 inches or more above the manhole invert?
i. Are inlet/outlet pipes connected with gasketed flexible watertight connections? (GLUMRB Section 34.6)
* Attach any additional sheets necessary for explanations.
8. Protection of Water Supplies
a. Are there any physical connections between the sewer and a public or private potable water supply system (including all appurtenances)?
b. Are any existing public waterworks units (for example public supply wells, water treatment facilities, storage facilities) within 200 feet of the proposed sewer or any private wells within
50 feet of the proposed sewer?
If Yes, specify the plan sheets on which the sources are shown:
If Yes, will sewers be encased or constructed of watertight pipe?
Encased
Watertight
c. Are the sewers at least 10 feet horizontally separated from water lines? (GLUMRB Section 38.31)
If No, please specify the plan sheets where these conditions are not met & describe the measures taken to ensure protection of the water system:
d. When crossing water mains, are the sewers at least 18 inches below water lines?
If No, please specify the plan sheets on which these conditions are not met and describe the measures taken to ensure protection of the water system:
Page 3 of 4
9. Installation and Testing
a. Installation Inspector:
Name:Firm:
Street Address:
City:State:
b. What type of sewer leakage test will be used? (GLUMRB 33.9)
Page numbers in specifications for testing requirements of gravity and pressure sewers:
c. Is flexible pipe deflection testing specified? (GLUMRB 33.85)
Page numbers in specifications for testing requirements of flexible pipe:
d. What type of manhole testing will be used? (GLUMRB Section 34.7)
Page numbers in specifications for testing requirements of manholes:
Phone: ( )
-
Zip:
Hydrostatic
Air
10. Sewer Use Ordinance
A statement that "Roof drains, foundation drains, and other clean water connections to the sanitary sewer system are prohibited" must be shown on the plans. Copies of the ordinances or regulations providing for the enforcement of this requirement must be on file with Ohio EPA.
a. An ordinance/regulation to this effect was adopted on:
/ /
(date).
b. Enforcement of this ordinance/regulation is the responsibility of:
Name:
Title:
c. It is the opinion of the engineer submitting these plans that adequate enforcement
of this ordinance/regulation is being properly carried out.
Unknown
11. Authorities
a. Plans for the proposed installation of a county, village, or municipal sewer that is tributary to a sewage treatment plant with another political entity must be accompanied by written consent of both entities.
Is a written inter-municipal agreement attached? If No, state what form of consent is provided:
12. Submittals:
This application must include the following unless otherwise directed by Ohio EPA:
Four copies of the detail plans including profile and plan views of all sewers (shown on the same sheet), existing (as applicable) and proposed pump station facilities, incorporating all of the details outlined in Section 20.1, 20.2 and 20.3 of Recommended Standards for Wastewater Facilities.
Two copies of complete technical specifications.
Two copies of the Application including Form A, pertinent B & C form(s), and antidegradation addendum (if applicable)
13. The foregoing data is a true statement of facts pertaining to this proposed sanitary sewer installation.
Date:
Signed:
P.E.
Plans prepared by:
Page 4 of 4
Filling out the Ohio EPA Form 4309 B1 involves providing detailed information about the sanitary sewers project for which a permit-to-install or plan approval is being sought. This form is used to review the project's specifications, including descriptions, designs, and the protective measures taken to prevent environmental harm. Following the steps outlined below will help ensure that all necessary details are accurately recorded, facilitating a smoother review process by the Ohio Environmental Protection Agency.
After completing and reviewing the form for accuracy, submit it along with all required documentation and specifications to the Ohio EPA for review. Properly completing Form 4309 B1 is crucial for obtaining the necessary approvals for your sanitary sewer project. Ensure all information is clear, correct, and comprehensive to avoid delays in the process.
What information is required for the project description in the Ohio EPA 4309 form?
The project description section of the Ohio EPA 4309 form requires detailed information about the location, size, and current development of the area to be served by the proposed sanitary sewer system. Applicants must provide the street address, township, county, and the longitude and latitude coordinates to describe the location accurately. Furthermore, the form asks whether future sanitary sewer extensions are expected to connect to the proposed construction, if any pump stations are included, and the types of sewers proposed (e.g., conventional gravity, pressure, force main, etc.). This comprehensive description ensures the agency can accurately assess the project's scope and potential impact on the environment and local infrastructure.
How are pipe specifications detailed in the form?
In the Ohio EPA 4309 form, applicants are required to list each type and size of pipe included in their project. This includes specifying the pipe material, joint, bedding classification, minimum slope, pipe length, and maximum manhole spacing, adhering to specific standards, such as ASTM, AWWA, or ANSI specification numbers. This detailed information allows for the evaluation of the project's compliance with Ohio EPA’s standards and practices, ensuring the reliability and environmental safety of the proposed sewer installation. It’s vital that any specifications not appearing on the Ohio EPA’s approvable pipe specification list be submitted for approval with the Permit-to-Install.
What does the section on design flow in the proposed sewer entail?
The design flow section of the form requires applicants to identify both the expected flows at startup and at design capacity at the terminus of the proposed sewer. Applicants must provide average daily flow and peak hourly flow in millions of gallons per day (MGD) for start-up flows and design flows, along with the hydraulic capacity of the sewer. Assumptions used for these calculations, such as residential population and non-residential flows, are indicated, ensuring that planned sewer systems are adequately designed to handle anticipated waste volumes, reducing the risk of overflows and environmental contamination.
How is the protection of water supplies addressed in the form?
The Ohio EPA 4309 form includes critical questions regarding the protection of water supplies in proximity to the proposed sewer installation. Applicants must disclose any physical connections between the sewer and any public or private potable water supply systems, including all appurtenances, and detail any public waterworks units or private wells within specific proximity to the proposed sewer. Additionally, the form requires information on the horizontal and vertical separation between sewers and water lines, ensuring that the planned sewer system does not compromise water quality. If conditions do not meet the requirements, applicants must specify the measures taken to protect the water system, highlighting the importance of preventing contamination of potable water sources.
When filling out the Ohio EPA 4309 form for sanitary sewer installation or plan approval, common mistakes can delay the processing and approval of your application. Familiarizing yourself with these errors can help ensure a smoother application process.
Not accurately describing the project area, including failing to provide specific location details such as longitude and latitude coordinates, street address, township, and county. This description is crucial for the EPA to visualize and understand the project's scope and location.
Omitting details about the possibility of future sanitary sewer extensions. Including potential extensions in your plan can demonstrate foresight and comprehensive planning, making the application stronger.
Incorrectly specifying pipe types, materials, and bedding specifications. It's essential to refer to the Ohio EPA's approvable pipe specification list to ensure your materials meet the required standards.
Neglecting to detail the anticipated flows at startup and design alongside the hydraulic capacity of the sewer. Accurate flow rates are crucial for designing a system that sufficiently meets current and future demands.
Failing to confirm that the receiving wastewater treatment facility has adequate capacity to handle the proposed sewer's flow. This oversight can lead to significant operational problems in the future.
Overlooking stream protection measures. If your project involves stream crossings or running parallel to streams, it's imperative to outline specific measures that will be taken to minimize environmental impact.
Incorrect or incomplete manhole design information, including types, material specifications, and positioning. Manholes play a critical role in maintaining and servicing the sewer system, so precise details are necessary.
Not including ordinances or regulations regarding roof drains, foundation drains, and other connections to the sanitary sewer system can be a critical mistake. These documents are necessary to ensure compliance with local and state regulations.
Lack of clarity on installation and testing procedures, including the type of sewer leakage test and manhole testing. Detailed testing protocols ensure the system's integrity and operational efficacy.
Failing to attach or properly refer to relevant agreements or contracts when the project involves multiple political entities. Collaboration and consent among all parties involved are crucial for project approval and implementation.
Addressing these common mistakes before submitting the Ohio EPA 4309 form can significantly streamline the review process and increase the likelihood of your project's approval.
When dealing with the Ohio EPA Form 4309 for sanitary sewers, professionals often need to include several other important documents to ensure a comprehensive application. These documents support the application's details, comply with regulatory requirements, and facilitate a streamlined review process by providing a clear and complete overview of the project.
In conclusion, each of these documents plays a critical role in supplementing the Ohio EPA Form 4309 application. They provide the necessary details and assurances to regulatory agencies that the proposed sanitary sewer project is well-planned, environmentally responsible, and compliant with all regulations. Ensuring that these documents are complete and accurately reflect the proposed project will aid in a smoother and more efficient review process.
The National Pollutant Discharge Elimination System (NPDES) application is closely related to the Ohio EPA 4309 form. Both are essential for managing water quality impacts associated with sanitary sewers and other discharges. The NPDES application, much like the 4309 form, requires detailed information about the discharge, including its source, composition, and anticipated impact on local water bodies. This ensures that environmental standards are met and that the discharge does not harm aquatic ecosystems or water quality.
Construction Stormwater Permit applications share similarities with the Ohio EPA 4309 form in terms of their focus on protecting water quality during and after construction projects. These applications require detailed plans showing how runoff and potential pollutants will be managed to prevent contamination of nearby streams, lakes, or wetlands. This parallels the 4309 form's emphasis on detailing the environmental impact of sanitary sewer projects and measures for mitigating potential harm to water resources.
The Safe Drinking Water Act (SDWA) Permit application is another document resembling the Ohio EPA 4309 form. Both ensure public health and environmental protection concerning water sources. The SDWA application focuses on the safety of drinking water through standards for water treatment plants and water sources, similar to how the 4309 form emphasizes ensuring that sanitary sewer systems do not adversely affect water quality.
Air Quality Permit applications, while focusing on a different environmental medium, share the goal of preventing environmental harm with the Ohio EPA 4309 form. These applications require detailed descriptions of emissions sources, control technologies, and impacts assessments to demonstrate compliance with air quality standards, paralleling the thorough analysis required of sanitary sewers' impacts on water quality in the 4309 form.
Hazardous Waste Management permits, akin to the Ohio EPA 4309 form, are crucial for protecting environmental quality and public health. Applicants must detail the types of waste, handling procedures, and disposal methods to prevent contamination of land and water, reflecting the 4309 form's focus on mitigating potential water quality impacts from sanitary sewer projects.
Wetlands Impact Permits bear a resemblance to the Ohio EPA 4309 form through their emphasis on protecting water resources. Projects impacting wetlands require a meticulous review of potential effects and mitigation strategies, similar to the scrutiny applied to sanitary sewer projects in the 4309 form to ensure they do not harm aquatic ecosystems or water quality.
Water Withdrawal Permits, while not directly related to waste disposal, share the Ohio EPA 4309 form's concern for water resource management. These permits assess the sustainability and environmental impact of withdrawing large water volumes, ensuring that such activities do not adversely affect water bodies, akin to how sanitary sewer systems are evaluated to prevent harm to water quality.
Solid Waste Facility Permits align with the Ohio EPA 4309 form in their role in environmental protection. Both types of permits require comprehensive review processes to ensure that waste management practices do not pose risks to the environment, with a particular emphasis on preventing contamination of water resources in the case of the 4309 form.
Industrial Stormwater Permits, similar to the Ohio EPA 4309 form, are designed to protect water quality from the impacts of industrial activities. Applicants must outline measures to control runoff and prevent pollutants from reaching water bodies, paralleling the 4309 form's focus on ensuring that sanitary sewers do not contaminate streams, lakes, or other aquatic ecosystems.
Underground Injection Control (UIC) Permits, while primarily aimed at regulating the underground injection of fluids, share the Ohio EPA 4309 form's concern for preventing water contamination. Both permit processes involve rigorous evaluation of how the proposed activities could affect water quality, ensuring protective measures are in place to prevent environmental harm.
When filling out the Ohio EPA 4309 form, there are several important dos and don'ts to keep in mind to ensure your application is complete and accurate. Here are five recommendations for each to guide you through the process:
Things You Should Do:
Things You Shouldn't Do:
When it comes to the Ohio EPA 4309 Form, a comprehensive document used for Permit-to-Install/Plan Approval Application Sanitary Sewers, there are a variety of misconceptions that can lead to confusion or errors in completion. Here’s a look at some common misconceptions and the truths behind them:
It’s only for large construction projects. Many assume that this form is exclusively for large-scale construction projects. However, it applies to a range of projects, including small developments, that involve the installation or modification of sanitary sewers.
The form is too complex for non-professionals. While the form is detailed, it's designed to be filled out by or with the guidance of professionals such as engineers or project planners. These experts can navigate the form's requirements effectively.
All sections must be completed by the applicant. This is not entirely the case. Certain parts of the form are explicitly designated "FOR AGENCY USE ONLY" which indicates they are to be filled out by the EPA personnel reviewing the application.
Future sanitary sewer extensions don’t need to be considered. Quite the contrary, one section asks specifically about the possibility of future extensions, emphasizing the need for foresight in planning.
No technical specifications are required with the submission. The form requires detailed technical specifications for the pipes and other materials used in the project, ensuring that everything meets the state’s standards.
If the information doesn’t precisely fit the form’s fields, it can be skipped. Not correct. The form allows for attachments and additional sheets for explanations, ensuring that all relevant details can be accurately conveyed.
Submission via email or online is acceptable. At this time, the form and accompanying documentation often need to be submitted in hard copy, although it’s always best to check with the Ohio EPA for the most current submission guidelines.
Manhole details may be generalized. Specific details about manhole design, spacing, and construction are required. This includes type, material specifications, and whether they are designed to prevent water infiltration.
Environmental and stream protection measures are optional. The form requires detailed responses regarding how the project will avoid or minimize impact on streams and other natural resources, demonstrating the EPA's emphasis on environmental protection.
No follow-up is required after submission. Typically, applicants will need to be available for questions or clarifications from the Ohio EPA as the review process goes forward. Additionally, post-approval, there may be inspections or compliance checks.
Correctly understanding and completing the Ohio EPA 4309 Form is crucial for any project involving the installation or modification of sanitary sewers. Clearing up these misconceptions ensures a smoother application process and helps projects adhere to environmental guidelines more effectively.
Filing and managing the Ohio EPA 4309 form, integral to the Permit-to-Install/Plan Approval Application for sanitary sewers, requires a meticulous understanding of its sections, compliance standards, and specificity to ensure accurate submission. Here are five key takeaways to help navigate the process:
Properly completing the Ohio EPA 4309 form demands a holistic approach to project planning, an adherence to prescribed environmental standards, and a proactive stance on future growth and sustainability. This process not only facilitates regulatory compliance but also promotes the health and well-being of Ohio's communities and natural resources.
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