APPLICATION FORM FOR DISCHARGE PERMIT

EPD: FORM 99-01a (Rev.08/21/02) Republic of the Philippines Department of Environment and Natural Resources LAGUNA LAKE DEVELOPMENT AUTHORITY Rizal Provincial Capitol Compound Pasig City INSTRUCTION: Fill in all appropriate white spaces. Mark all appropriate boxes with an "X" BOX A: General Information Name of Establishment/Plant Plant Address No. & Street Name City or Municipality Type of Industry Name of PCO Tel. No. & Cel.No. Legal Classification Ownership Terms New Renewal

DSK SPRING CO., INC.

National Hi-way Calamba Manufacturing William L. Realis 049-545-5528/5443
Proprietorship Private Corp. % X Multi-National

x Expiry Date May 18, 2005 x x Application No.: x x TIN: 004-465-293 x x Est. Code: x Year Est. x Barangay Makiling x
X

Province

Laguna September 06, 2004

Accreditation Date Fax No.:

049-545-5429
Others: Specify

Private

100

Foreign

Government

BOX B: Employment and Operation Information Total employment (number of workers) in the factory: Production Time: No. of hours/day Production

30
No. of mos./year

Non-Production

23

No. of days/mo.

22

12

BOX C: Sources of Water Supply and Wastewater Generation Sources of Water Supply MWSS (please attach water bills) Local Water District (please attach water bills) Deep Well Surface water (lake, river, creek, etc.) Others
Monthly ave. vol. (m3) daily ave. vol. (m3)

Generating Process Process Wastewater Washing/Cleaning of Process Eqpt. Cooling Domestic Recycled/Reuse
Others (drinking water, gardening, evaporation, leaks, products components, etc.)

Estimated Flow (m3/day) ------------700m3 1m3 700m3 1m3 zero

----------52m3 -----------

----------2m3 ----------

Total Water Consumption

Total Volume of Discharge Wastewater

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

Total Floor Area (m2) Total Area for Dining Units BOX E: Product Information

X X

No. of Bedrooms

No. of Guests/year

No. of Restaurants/Dining Units

X
Product 3 ------------------Batch Continous Batch

Product 1 Product Name** Annual Production Capacity Actual Production in the previous year Type of Process BOX F: Water Pollution Information Outlet Number Location & Description of the Outlet Leaf Spring 3,600 tons 730 tons
Batch X

Product 2 ------------------------Batch Continous

Product 4 ------------------Continous

X X

Continous

Name of the Receiving Body if NOT Discharging Directly in the Lake Canals Septic tanks Cooling tower basin Total

Estimated Average BOD Conc. (mg/L)

Estimated Average Rate of Discharge (m3/day)

Estimated Average BOD Load (kg/day)

1 2 3

Lavatories Toilets Cooling water

1m3

700 m3 (Recyced) ZERO DISCHARGED

BOX G: Flow Meter Information Flow meter is installed at: Influent Effluent Parshall Flume Both Total Plant Effluent Rectangular weir Triangle weir None x

Type of flow meter and method used at (effluent side):

Venturi meter

Direct Reading If others, please specify device and/or method:

Area Velocity Method

None

BOX H: Information on the Wastewater Treatment System Wastewater treatment system existing? Yes No Pesos x Date primary system installed : Month Year x If YES, what is the capacity m3/day

Value of capital investment in the wastewater treatment plant. Is there a primary treatment system? Yes No

If Yes, what is the composition of the physical treatment system? Screening Equalization Grit Removal Oil-Water separation (Flotation) x Sedimentation (Primary Settling) If others, specify

Is there a chemical treatment?

Yes

No

Date chemical treatment installed: Month

Year

If Yes, what is the composition of the chemical treatment system? Adsorption Disinfection Flocculation/coagulation Yes No x pH Adjustment Date installed : Month Anaerobic Digestion If others, specify If others, specify Year Oxidation/Stabilization (Pond)

Is there a secondary treatment system? Activated Sludge Trickling Filtration

Single Batch Reaction Rotating Biological Contact

BOX I : Vicinity Map (the map should show relative location of the establishment with respect to existing structures, landmarks, rivers, the lake and other water bodies, etc., use scale to fit into the frame below)

SEE ATTACHED

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), slaugthering/preserving meat (ton LWK, electroplating (m2)). I hereby certify that the above information are true and correct to the best of my knowledge. ________________, ________. WILLIAM REALIS Name and Signature of the Pollution Control Officer Done this ___________________ day of

DR. GEORGE C. LIM Chief Executive Officer (Name, Signature and Position)

SUBSCRIBED AND SWORN to before me a Notary Public, This _____ day of _________________, affiant exhibiting to me his/her Community Tax Receipt No. 21835567, issued at Manila, on January 18, 2005

NOTARY PUBLIC