Biosolids Management Program

Registration

Contact Information:

Organization Name:

Organization Address:

City: State: ZIP: Country:

Organization Phone:

Organization Fax:

Organization website:

Utility Manager's Name:

Utility Manager Title:

Utility Manager Department/Division:

Utility Manager Address:

City: State: ZIP: Country:

Utility Manager Phone:

Utility Manager Email:

Lead BMP Contact's Name:

Lead BMP Contact Title:

Lead BMP Contact Department/Division:

Lead BMP Contact Address:

City: State: ZIP: Country:

Lead BMP Contact Phone:

Lead BMP Contact Fax:

Lead BMP Contact Email:

Application Submitted By:

Submitter Name:

Submitter Email:

Submission Date:

Submitter Signature:
If submitting electronically, please check the e-signature box to confirm authorized submission. By selecting the "E-Signature" checkbox the submitter agrees and confirms that they are an authorized signatory on behalf of the organization or entity provided in the “Contact Information” section of this application.

Please provide information about your Wastewater & Biosolids Management Program:

Number of water resource recovery facilities (wastewater treatment plants):

Population served by these facilities:

Gallons of wastewater treated daily at these facilities: MGD

Dry tons of biosolids produced annually at these facilities:

Solids treatment method(s):

Solids end use/disposition method: