Bethlehem, PA · Lehigh County
Industrial Wastewater Discharge Permit Application
Industrial facilities use this application to provide Bethlehem with information about wastewater sources, processes, discharges, monitoring, and authorized representatives.
What this form is
The City of Bethlehem Wastewater Treatment Plant uses this application to review requests for an industrial wastewater discharge permit. Facilities provide details about operations, wastewater and solid waste, water use, pollutants, monitoring, and the authorized representative. The form also requests supporting materials, including process flow charts, safety data sheets, and laboratory results, and states that a $250 processing fee must accompany the application.
Who needs it
Businesses with proposed or existing industrial facilities that discharge wastewater provide the information requested in this application.
How to submit it
Return the completed application and a $250 check or money order payable to the City of Bethlehem to Mr. Kenneth Greiser, MIPP/QC Coordinator, City of Bethlehem Wastewater Treatment Plant, 144 Shimersville Road, Bethlehem, PA 18015.
About notarization
This application is signed without a notary; the authorized representative signs and dates the certification, and the form identifies no notarized attachment or related step.
How to submit this form
- 1
Download the Application
Download the Industrial Wastewater Discharge Permit Application PDF.
- 2
Complete the Application
Provide the requested facility, process, water use, wastewater, waste, and monitoring information.
- 3
Gather Supporting Materials
Include applicable process flow charts, safety data sheets or product labels, laboratory reports, and other requested attachments.
- 4
Sign and Submit
Have an authorized representative sign and date the certification, include the stated $250 payment, and mail the application to the Wastewater Treatment Plant address shown.
Frequently asked questions
- What information does the Industrial Wastewater Discharge Permit Application request?
- It requests facility and process details, water use, wastewater characteristics, solid waste information, monitoring data, supporting materials, and an authorized representative’s certification.
- How do I submit the Industrial Wastewater Discharge Permit Application?
- Send the completed application with a $250 check or money order payable to the City of Bethlehem to the Wastewater Treatment Plant at 144 Shimersville Road, Bethlehem, PA 18015.
- Do I need a notary for the Industrial Wastewater Discharge Permit Application?
- No. The application calls for an authorized representative to sign and date its certification; it identifies no notarized attachment or related step.
Need something notarized?
This Industrial Wastewater Discharge Permit Application doesn’t need a notary — but if you have another Bethlehem form that does, a commissioned online notary can help.