Wastewater Systems Effluent Regulations

[Name and address of owner or operator]

in respect of [name and address of wastewater system]

is (are) authorized, as of [date] , to deposit effluent that contains un-ionized ammonia until [date] from [identify final discharge point] if the concentration of un-ionized ammonia in the water at any point that is 100 m from the point of entry where effluent is deposited in that water via the final discharge point is less than or equal to 0.016 mg/L, expressed as nitrogen (N).

IMPORTANT: Please refer to section 38 of these Regulations for the compliance obligations for this authorization. In addition, please note that this authorization may be revoked under section 42 of the Regulations.