Form 616-GC3T 2025

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  1. Click ‘Get Form’ to open Form 616-GC3T in the editor.
  2. Begin by selecting the type of authorization requested in Section A. Choose from New, Renewal, or Modification.
  3. In Section B, enter the name of your facility. Follow this with the facility contact details in Section C, including name, title, phone number, and email address.
  4. Complete Section D with the facility's mailing address. Ensure you provide accurate street address, city, state, and zip code.
  5. For Section E, specify the facility location details including street identifier and legal description.
  6. Fill out operator information in Section F. Include operator name, contact details, status (public/private), and address.
  7. Indicate if the facility is located on Indian land in Section G by selecting Yes or No.
  8. Attach required maps as specified in Section H to illustrate facility layout and water sources.
  9. Continue filling out subsequent sections regarding business nature, water supply sources, chemical inventory, and waste disposal methods as outlined in the form.

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2020 4.8 Satisfied (145 Votes)
2010 4.1 Satisfied (56 Votes)
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