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DP Application Form

The document is an application for a discharge permit submitted by Delightful Treats Inc. in Sogod, Southern Leyte, detailing general information about the owner, permittee, and the type of industry. It includes employment details, water supply sources, wastewater generation, and information about the wastewater treatment system. The application also contains a notarized certification confirming the accuracy of the information provided.
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0% found this document useful (0 votes)
28 views3 pages

DP Application Form

The document is an application for a discharge permit submitted by Delightful Treats Inc. in Sogod, Southern Leyte, detailing general information about the owner, permittee, and the type of industry. It includes employment details, water supply sources, wastewater generation, and information about the wastewater treatment system. The application also contains a notarized certification confirming the accuracy of the information provided.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Page 1 of 3

Republic of the Philippines


Department of Environmental and Natural Resources App No
Environmental Management Bureau 401730
Region VIII

APPLICATION FOR DISCHARGE PERMIT


BOX A: General Information

Type: New
Name of Owner: Johannah Jehan L. Ong
Office Address: Shell Osmeña Street, Zone V (Pob.), Sogod, Southern Leyte

Name of Permittee: Delightful Treats Inc. TIN: 735-137-987-001


PSIC Code: 56 Year Est.: 2024
Plant Address No & Street Name: Shell Osmeña Street Barangay: Zone V (Pob.)
City or Municipality: SOGOD Region: Region VIII
Type of Industry: Restaurants, food chains, bars and other food/beverage services
Name of PCO: Shane H. Pakig Accreditation Date: Dec. 7, 2024
Tel. No. & Cel. No: 09190784560 Fax No:

Legal Classification Private Corp

Ownership forms Private 100.0 % Foreign None % Government None %

BOX B: Employment and Operation Information

Total employment (number of workers) in the factory: Production: 30 Non Production: 3

Production Time: No of hours/day: 12 No of days/mo: 30

No of months/year: 12 No of days with discharge/mo: 30

BOX C: Sources of Water Supply and Wasterwater Generation

Monthly Daily Estimated


Sources of Water Supply ave vol. ave vol. Generating Process Flow
(m3) (m3) (m3/day)

MWSS (please attach water bills) 0.0 0.0 Process Wastewater 6.0

Local Water District (please attach water Washing/Cleaning of Process


105.0 89.0 50.0
bills) Eqpt.

Deep Well 0.0 0.0 Cooling 5.0

Surface water (lake, river, creek, etc.) 0.0 0.0 Domestic 10.0

Others 0.0 0.0 Recycled/Reuse 3.0

Others (drinking water, gardening,


evaporation, leaks, product 15.0
components, etc.)

Total Volume of Discharge


Total Water Consumption 105.0 89.0 89.0
Wastewater

BOX D: Dwelling Units Information (hotels, condominium, restaurants, malls, etc.)

Total Floor Area (m2): 393.62 No of Bedrooms: 0 No of Guests/year: 122640


Page 2 of 3

Total Area for Dining Units: 393.62 No of Restaurants/Dining Units: 1

BOX E: Product Information

Annual Annual
Product Name Production Production in the Type of Process
Capacity previous year

BOX F: Water Pollution Information

Ave. Rate of
Outlet Location and Description of the Name of the Receiving Ave. BOD, Ave. BOD
Discharge,
Number Outlet Body of Water mg/L Load, kg/day
m3/day

Parking area in front of the store -


1 None 0.0 89.0 0.0
Pipes

Total 0.0 89.0 0.0

BOX G: Flow Meter Information

Flow meter is installed at: Influent

Type of flow meter and method used at (effluent side): Not Applicable

BOX H: Information on the Wastewater Treatment System

Wastewater treatment system existing?: Yes ✔ No If YES, what is the capacity: N/A m3/day

Value of capital investent in the wastewater treatment plant: Php None

Is there a primary treatment system?: Yes ✔ No Date primary system installed:

If Yes, what is the composition of the physical treatment system:

Screening Equalization Grit Removal

Oil-Water separation (Floatation) Sedimentation (Primary Setting) If others, please specify:

Is there a chemical treatment?: Yes ✔ No Date primary system installed:

If Yes, what is the composition of the chemical treatment system:

Absorption Disinfection Flocculation/coagulation

pH Adjustment If others, specify: N/A

Is there a secondary treatment


Yes ✔ No Date primary system installed:
system?:

Activated Sludge Single Batch Reaction Anaerobic Digestion Oxidation/Stabilization (Pond)

Tricking Filtration Rotating Biological Contract If others, specify: N/A

Note: **Please use generic name. Not brand names, in metric tons of products except for the following subsectors:
hog raising (heads), carbonated drinks and beers (m3), slaughtering/preserving meat (ton LWK, electroplating (m2)).
Page 3 of 3

NOTARIZED CERTIFICATION

We hereby certify that the above information and attached documents are true and correct to the best of my
knowledge. Done this _________________________ day of ________________________,
__________________.

Name and Signature of the Pollution Control Chief Executive Officer


Officer (Name, Signature and Position)

SUBSCRIBED AND SWORN to before me a Notary Public. This __________ day of ______________________,
affliant exhibiting to me his/her _________________________________________________________________,
issued at ___________________________________________________________________________________
on ______________________________________________________________.

(Notary Public)

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