Pulp and Paper Effluent Regulations

[Name and address of owner and operator]

in respect of [name and address of mill or off-site treatment facility]

is/are hereby authorized, as of [date] , until [date] ,

[Check items that apply.]

☐ To combine treated effluent with other effluent before the treated effluent is deposited.

☐ To deposit BOD of the BOD matter and suspended solids in the quantities and during the periods indicated as follows:

MAXIMUM QUANTITIES PER DAILY PERIOD
BOD OF THE MATTER (kg)	SUSPENDED SOLIDS (kg)

NOTE: These parameters are defined in sections 19 to 21 of the Pulp and Paper Effluent Regulations.

IMPORTANT:

Please refer to section 7 of the Pulp and Paper Effluent Regulations for conditions governing the authority to deposit. In addition, please note that this authorization may be amended or withdrawn in accordance with section 18 of those Regulations.

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