Request For Permission To Use Toxic Materials For Aquatic Life Management Purposes Form - Maryland Department Of The Environment
Download a blank fillable Request For Permission To Use Toxic Materials For Aquatic Life Management Purposes Form - Maryland Department Of The Environment in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Request For Permission To Use Toxic Materials For Aquatic Life Management Purposes Form - Maryland Department Of The Environment with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2MARYLAND DEPARTMENT OF THE ENVIRONMENT
1800 Washington Boulevard • Baltimore MD 21230
410-537-3000 • 1-800-633-6101 •
When Completed, Mail to: *
Maryland Department of the Environment
REQUEST FOR PERMISSION TO USE
Industrial and General Permits Division
TOXIC SUBSTANCES FOR AQUATIC
1800 Washington Boulevard, Suite 455
LIFE MANAGEMENT PURPOSES
Baltimore, Maryland 21230-1708
(under authority of Environment Article §9-314(b)(4),
Or Email to:
Annotated Code of Maryland, and COMAR 26.08.03.02)
jonathan.rice@maryland.gov
*Except for requests to control Phragmites sp. with Glyphosate,
which should be submitted directly to:
Toxic Materials Permit (TMP)
Maryland Department of Natural Resources
Project Number:
Attn: Roland Limpert, Environmental Review Unit
Tawes State Office Bldg.,
____________________________
580 Taylor Avenue, B-3
Annapolis, Maryland 21401
A.
PERSON REQUESTING PERMIT
E. PROPOSED BEST MANAGEMENT
NAME:
PRACTICES AND IMPACT MINIMIZATION
STREET:
MEASURES
CITY:
STATE:
ZIP:
Markers to delineate application area
DAYTIME PHONE:
Pond drawdown
EMAIL: ___________________________________
Prevention of pond discharge following application -
specify duration: __________________________
B. PROJECT PURPOSE
Application at slack tide
Maintenance of surface flow conveyance
Time-of-year restrictions – specify:
Right-of-way maintenance
_______________________________
Mosquito control
Survey of species listed by the State as endangered,
Wildlife management – specify:
threatened, or in need of conservation
_______________________________________
Mechanical harvesting of nuisance species where
Aesthetic improvements
feasible
Fisheries management – specify:
Use of nontoxic dyes for algae and submerged
_______________________________________
aquatic plant control when feasible
Other – specify: __________________________
Removal of dead fish resulting from the application
C. TARGETED SPECIES TYPE
Other – specify: ___________________________
Submerged aquatic vegetation - specify:
_______________________________________
F. PHRAGMITES SP. CONTROL with
Algae
GLYPHOSATE
Emergent vegetation – specify:
Management plan ** - (Briefly specify on the bottom
_______________________________________
of this sheet or an attachment the schedule and
Phragmites sp. (See Section F. for Permit conditions)
proposed elements of the plan, which may include
Mosquitoes
controlled burns, changes in hydrology, follow-up
treatments, re-vegetation with preferred species.)
Finfish – specify: _________________________
Other – specify: __________________________
Review conducted for species listed by the State as
being endangered, threatened, or in need of
D. SUPERVISOR OF APPLICATION:
conservation **
NAME: ____________________________________
COMPANY: ________________________________
**The Department of Natural Resources (DNR) must
TITLE: ____________________________________
approve the plan prior to issuance. The species review
ADDRESS: _________________________________
(shaded block) must be completed by DNR. Upon
___________________________________________
completion of their review, DNR will forward their
PHONE: ___________________________________
response and the application to MDE to complete the
EMAIL: ___________________________________
TMP process
1
2
Form Number: MDE/WMA/PER.015
of
Revision Date: September 17, 2014
TTY Users 1-800-735-2258
Recycled Paper
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 8508 Request For Waiver From Filing Information Returns Electronically - Department Of The Treasury
Legal
Form 8003 - Request For Additional Information From Tax-exempt Organizations - Department Of The Treasury
Legal
Form 8003 - Request For Additional Information From Tax-exempt Organizations - Department Of The Treasury - Internal Revenue Service
Financial
Data Transfer Request For Other Agency Accounts Program Form - Oregon Department Of Revenue
Financial
Form 14095 - Department Of The Treasury - Internal Revenue Service The Health Coverage Tax Credit (hctc) Reimbursement Request Form
Business
Related Categories
Parent category: Legal