561—10.9(17A,455A) Contents of petition. A petition for waiver shall include the following information when applicable and known to the petitioner:
	10.9(1) The name, address, and telephone number of the entity or person for whom a waiver is requested, and the case number of any related contested case.
	10.9(2) A description and citation of the specific rule from which a waiver is requested.
	10.9(3) The specific waiver requested, including the precise scope and operative period that the waiver will extend.
	10.9(4) The relevant facts that the petitioner believes would justify a waiver. This statement shall include a signed statement from the petitioner attesting to the accuracy of the facts provided in the petition and a statement of reasons that the petitioner believes will justify a waiver.
	10.9(5) A history of any prior contacts between the department and the petitioner for the past five years, including a description of each affected permit held by the petitioner, and any notices of violation, administrative orders, contested case proceedings, and lawsuits involving the department and the petitioner.
	10.9(6) Any information known to the petitioner regarding the department’s treatment of similar cases.
	10.9(7) The name, address, and telephone number of any public agency or political subdivision of the state or federal government which also regulates the activity in question, or which might be affected by the granting of a waiver.
	10.9(8) The name, address, and telephone number of any person or entity that would be adversely affected by the granting of a petition.
	10.9(9) The name, address, and telephone number of any person with knowledge of relevant facts relating to the proposed waiver.
	10.9(10) Signed releases of information authorizing persons with knowledge regarding the request to furnish the department with information relevant to the waiver.
[ARC 5516C, IAB 3/10/21, effective 4/14/21]