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Page 4 of 5 <br /> <br />C. Will the project involve a land application system for treatment of wastewater? <br />  Yes  No - If yes, describe <br /> <br /> Has an application for a non-discharge permit been submitted to the NC <br />Department of Environmental Management or Orange County Department of <br />Environmental Health?  Yes  No <br />D. Is a septic tank system proposed which has a design capacity of more than <br />3,000 gallons per day? <br /> Yes  No - If yes, describe <br /> <br />E. Does the activity involve sludge disposal?  Yes  No <br /> If yes, where is the source of the sludge? <br /> <br /> Describe where and how the sludge is being disposed <br /> <br /> <br /> Has a NPDES permit from the NC Division of Environmental Quality been issued? <br /> Yes  No <br />F. Water Usage <br /> Estimated number of employees: x 25 gallons per day (gpd) = ______ gpd <br /> Estimated water use for climate control = gpd <br /> Process Water <br /> % Consumed <br /> % Discharged to septic system <br /> % Discharged to surface (including storm sewers) - Describe: <br /> <br /> % Evaporated <br /> % Reclaimed/reused <br /> % Other <br />= 100% <br /> Water used for cooling, heating, etc., in association with production or manufacturing <br /> % Reused <br /> % Consumed <br /> % Discharged - Describe: <br />= 100% <br /> gpd Total Water Usage <br /> Describe source of water: <br /> <br />50