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HomeMy WebLinkAboutNC0005762_Renewal (Application)_20190708ROY COOPER Governor Mi;CHAEL S. REGAN sec wtary LINDA CULPEPPER Director Kevin Patterson, County Manager Scotland County PO Box 489 Laurinburg, NC 28353 Subject: Permit Renewal Application No. NC0005762 Wagram plant Scotland County Dear Applicant: .NORTH CAROLINA Environmental Quality July 10, 2019 The Water Quality Permitting Section acknowledges the July 8, 2019 receipt of your permit renewal application and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made. Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a timely manner to requests for additional information necessary to allow a complete review of the application and renewal of the permit. Information regarding the status of your renewal application can be found online using the Department of Environmental Quality's Environmental_ Application Tracker at: https://deg.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker If you have any additional questions about the permit, please contact the primary reviewer of the application using the links available within the Application Tracker. '5*4'U k-j Wren Thedford Administrative Assistant Water Quality Permitting Section ec: WQPS Laserfiche File w/application b. .�„- North Carolina Department of Environmental Quality I DiiWDn of water Resource-as ��jj FayetteviCs Fiegonai 4ffce 1 225 Green Street, S7rte 714 1 Fayett=vll_, North C rofna 28301 MM— a10-433-3300 FACILITY NAME AND PERMIT NUMBER: Wagram Industrial WWTP, NC0005762 PERMIT ACTION REQUESTED: RIVER BASIN: Renewal L_umbe, FORM 2A 7PDES FORM 2A APPLICATION OVERVIEW NPDES APPLICATION OVERVIEW Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet and a "Supplemental Application Information" packet. The Basic Application Information packet is divided into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or equal to 0.1 mgd must also complete Part B. Some applicants must also complete the Supplemental Application Information packet. The following items explain which parts of Form 2A you must complete. BASIC APPLICATION INFORMATION: A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works that discharges effluent to surface waters of the United States must also answer questions A.9 through A..12. B. Additional Application Information for Applicants with a Design Flow 2 0.1 mgd. All treklMlArK`; rnifi fl5avNesign flows greater than or equal to 0.1 million gallons per day must complete questions B.1 through B.6. JUL 0 8 2019 C. Certification. All applicants must complete Part C (Certification). Water Quality SUPPLEMENTAL APPLICATION INFORMATION: Permitting Section D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets one or more of the following criteria must complete Part D (Expanded Effluent Testing Data): 1. Has a design flow rate greater than or equal to 1mgd, 2. Is required to have a pretreatment program (or has one in place), or 3. Is otherwise required by the permitting authority to provide the information. E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing Data): 1. Has a design flow rate greater than or equal to 1 mgd, 2. Is required to have a pretreatment program (or has one in place), or 3. Is otherwise required by the permitting authority to submit results of toxicity testing. F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges and RCRA/CERCLA Wastes). SIUs are defined as: 1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and 40 CFR Chapter I, Subchapter N (see instructions); and 2. Any other industrial user that: a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain exclusions); or b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic capacity of the treatment plant; or C. Is designated as an SIU by the control authority. G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer Systems). ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1 of 22 EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 22 FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN: Wagram Industrial WWTP, NC0005762 Renewal Lumber A.11. Description of Treatment a. What level of treatment are provided? Check all that apply. ® Primary [1 Secondary ❑ Advanced ❑ Other. Describe: b. Indicate the following removal rates (as applicable): Design BOD5 removal or Design CBOD5 removal ____ % Design SS removal % Design P removal % Design N removal % Other % C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe: Chlorine If disinfection is by chlorination is dechlorination used for this outfall? ® Yes C_l No Does the treatment plant have post aeration? ® Yes ❑ No A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart. Outfall number: 001 — no discharge since 2014 MAXIMUM DAILY VALUE AVERAGE DAILY VALUE PARAMETER Value Units Value Units Number of Samples pH (Minimum) s.u. pH (Maximum) s.u. Flow Rate Temperature (Winter) Temperature (Summer) ' For pH please report a minimum and a maximum daily value MAXIMUM DAILY AVERAGE DAILY DISCHARGE DISCHARGE ANALYTICAL POLLUTANT METHOD MUMDL Conc. Units Conc. Units Number of Samples CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS BIOCHEMICAL OXYGEN BOD5 DEMAND (Report one) CBOD5 FECAL COLIFORM TOTAL SUSPENDED SOLIDS (TSS) END OF PART A. REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS OF FORM 2A YOU MUST COMPLETE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 6 of 22 FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN: Wagram Industrial WWTP, NC0005762 Renewal Lumber BASIC APPLICATION INFORMATION PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR EQUAL TO 0.1 MGD (100,000 gallons per day). All applicants with a design flow rate 2 0.1 mgd must answer questions B.1 through B.6. All others go to Part C (Certification). B.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration. N_r',_ gpd Briefly explain any steps underway or planned to minimize inflow and infiltration. B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire area.) a. The area surrounding the treatment plant, including all unit processes. b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable. c. Each well where wastewater from the treatment plant is injected underground. d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within'/. mile of the property boundaries of the treatment works, and 2) listed in public record or otherwise known to the applicant. e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed. f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail, or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed. B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g., chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow rates between treatment units. Include a brief narrative description of the diagram. B.4. Operation/Maintenance Performed by Contractor(s). Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works the responsibility of a contractor? 0 Yes ❑ No If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional pages if necessary). Name: Laurinburg Maxton Airport Commission Mailing Address: 16701 Airport Road Maxton NC 28364 Telephone Number: (910) 844-5081 Responsibilities of Contractor: Be uired plant inspection_ visits and DMR submittal B.5. Scheduled improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5 for each. (If none, go to question B.6.) a. List the out -fall number (assigned in question A.9) for each outfall that is covered by this implementation schedule. b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies. ❑ Yes [i No EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 7 of 22 FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN: Wagram Industrial WWTP, NC0005762 Renewal Lumber C. If the answer to B.5.b is "Yes," briefly describe, including new maximum daily inflow rate (if applicable). d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as applicable. For improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as applicable. Indicate dates as accurately as possible. Schedule Actual Completion Implementation Stage MM/DD/YYYY MM/DD/YYYY Begin Construction End Construction Begin Discharge Attain Operational Level e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? ❑ Yes ❑ No Describe briefly: B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY). Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not include information on combine sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be based on at least three pollutant scans and must be no more than four and on -half years old. Outfall Number: 001 — No discharge since 2014 MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE POLLUTANT ANALYTICAL ML/MDL Cone. Units Cone. Units Number of METHOD Samples CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS AMMONIA (as N) CHLORINE (TOTAL RESIDUAL, TRC) DISSOLVED OXYGEN TOTAL KJELDAHL NITROGEN (TKN) NITRATE PLUS NITRITE NITROGEN OIL and GREASE PHOSPHORUS (Total) TOTAL DISSOLVED SOLIDS (TDS) OTHER END OF PART B. REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS OF FORM 2A YOU MUST COMPLETE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 8 of 22 FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN: Wagram Industrial WWTP, NC0005762 Renewal Lumber BASIC APPLICATION INFORMATION PART C. CERTIFICATION All applicants must complete the Certification Section. Refer to instructions to determine who is an officer for the purposes of this certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed Form 2A and have completed all sections that apply to the facility for which this application is submitted. Indicate which parts of Form 2A you have completed and are submitting: L] Basic Application Information packet Supplemental Application Information packet: Part D (Expanded Effluent Testing Data) Part E (Toxicity Testing: Biomonitoring Data) Part F (Industrial User Discharges and RCRA/CERCLA Wastes) Ll Part G (Combined Sewer Systems) ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name and official title Kevin G. Patterson, County Manager Signature Telephone number (910) 277-2406 Date signed ___ Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment works or identify appropriate permitting requirements. SEND COMPLETED FORMS TO: NCDENR/ DWQ Attn: NPDES Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22 FACILITY NAME AND PERMIT NUMBER: Wagram Industrial WWTP, NC0005762 PERMIT ACTION REQUESTED: Renewal RIVER BASIN: Lumber SUPPLEMENTAL APPLICATION INFORMATION PART D. EXPANDED EFFLUENT TESTING DATA Refer to the directions on the cover page to determine whether this section applies to the treatment works. Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which effluent is discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant scans and must be no more than four and one-half years old. Outfall number: 001- No discharge since 2014 (Complete once for each outfall discharging effluent to waters of the United States.) POLLUTANT MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE ANALYTICAL METHOD ML/MDL Conc. Units Mass Units Conc. Units Mass Units Number of Samples METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS. ANTIMONY ARSENIC BERYLLIUM CADMIUM CHROMIUM COPPER LEAD MERCURY NICKEL SELENIUM SILVER THALLIUM ZINC CYANIDE TOTAL PHENOLIC COMPOUNDS HARDNESS (as CaCO3) Use this space (or a separate sheet) to provide information on other metals requested by the permit writer EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 10 of 22 FACILITY NAME AND PERMIT NUMBER: Wagram Industrial WWTP, NC0005762 PERMIT ACTION REQUESTED: Renewal RIVER BASIN: Lumber Outfall number: (Complete once for each outfall discharging effluent to waters of the United States.) POLLUTANT MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE ANALYTICAL METHOD ML/MDL Conc. Units Mass Units Conc. Units Mass Units Number of Samples VOLATILE ORGANIC COMPOUNDS ACROLEIN ACRYLONITRILE BENZENE BROMOFORM CARBON TETRACHLORIDE CHLOROBENZENE CHLORODIBROMO- METHANE CHLOROETHANE 2-CHLOROETHYLVINYL ETHER CHLOROFORM DICHLOROBROMO- METHANE 1,1-DICHLOROETHANE 1,2-DICHLOROETHANE TRANS-I,2-DICHLORO- ETHYLENE 1,1-DICHLORO- ETHYLENE 1,2-DICHLOROPROPANE 1,3-DICHLORO- PROPYLENE ETHYLBENZENE METHYL BROMIDE METHYL CHLORIDE METHYLENE CHLORIDE 1,1,2,2-TETRA- CHLOROETHANE TETRACHLORO- ETHYLENE TOLUENE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 11 of 22 FACILITY NAME AND PERMIT NUMBER: Wagram Industrial WWTP, NC0005762 PERMIT ACTION REQUESTED: Renewal RIVER BASIN: Lumber Outfall number: (Complete once for each outfall discharging effluent to waters of the United States.) POLLUTANT MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE ANALYTICAL METHOD ML/MDL Conc. Units Mass Units Conc. Units Mass Units Number of Samples TRICHLOROETHANE 1,1,2- TRICHLOROETHANE TRICHLOROETHYLENE VINYL CHLORIDE Use this space (or a separate sheet) to provide information on other volatile organic compounds requested by the permit writer ACID -EXTRACTABLE COMPOUNDS P-CHLORO-M-CRESOL 2-CHLOROPHENOL 2,4-DICHLOROPHENOL 2,4-DIMETHYLPHENOL 4,6-DIN ITRO-O-CRESOL 2,4-DINITROPHENOL 2-NITROPHENOL 4-NITROPHENOL PENTACHLOROPHENOL PHENOL 2,4,6- TRICHLOROPHENOL Use this space (or a separate sheet) to provide information on other acid -extractable compounds requested by the permit writer BASE -NEUTRAL COMPOUNDS ACENAPHTHENE ACENAPHTHYLENE ANTHRACENE BENZIDINE BENZO(A)ANTHRACENE BENZO(A)PYRENE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 22 FACILITY NAME AND PERMIT NUMBER: Wagram Industrial WWTP, NC0005762 PERMIT ACTION REQUESTED: Renewal RIVER BASIN: Lumber Outfall number: _ (Complete once for each outfall discharging effluent to waters of the United States.) POLLUTANT MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE ANALYTICAL METHOD ML/MDL Conc. Units Mass Units Conc. Units Mass Units Number of Samples 3,4 BENZO- FLUORANTHENE BENZO(GHI)PERYLENE BENZO(K) FLUORANTHENE BIS (2-CHLOROETHOXY) METHANE BIS (2-CHLOROETHYL)- ETHER BIS (2-CHLOROISO- PROPYL)ETHER BIS (2-ETHYLHEXYL) PHTHALATE 4-BROMOPHENYL PHENYLETHER BUTYL BENZYL PHTHALATE 2-C H LO RO- NAPHTHALENE 4-CHLORPHENYL PHENYLETHER CHRYSENE DI-N-BUTYL PHTHALATE DI-N-OCTYL PHTHALATE DIBENZO(A,H) ANTHRACENE 1,2-DICHLOROBENZENE 1,3-DICHLOROBENZENE 1,4-DICHLOROBENZENE 3,3-DICHLORO- BENZIDINE DIETHYL PHTHALATE DIMETHYL PHTHALATE 2,4-DINITROTOLUENE 2,6-DINITROTOLUENE 1,2-DIPHENYL- HYDRAZINE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 13 of 22 FACILITY NAME AND PERMIT NUMBER: Wagram Industrial WWTP, NC0005762 PERMIT ACTION REQUESTED: Renewal RIVER BASIN: Lumber Outfall number: _ _ (Complete once for each outfall discharging effluent to waters of the United States.) POLLUTANT MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE ANALYTICAL METHOD ML/MDL Conc. Units Mass Units Conc. Units Mass Units Number of Samples FLUORANTHENE FLUORENE HEXACHLOROBENZENE HEXACHLORO- BUTADIENE HEXACHLOROCYCLO- PENTADIENE HEXACHLOROETHANE INDENO(1,2,3-CD) PYRENE ISOPHORONE NAPHTHALENE NITROBENZENE N-NITROSODI-N- PROPYLAMINE N-NITROSODI- METHYLAMINE N-NITROSODI- PHENYLAMINE PHENANTHRENE PYRENE 1,2,4- TRICHLOROBENZENE Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer Use this space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer END OF PART D. REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS OF FORM 2A YOU MUST COMPLETE EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 14 of 22 FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN: Wagram Industrial WWTP, NC0005762 Renewal Lumber SUPPLEMENTAL APPLICATION INFORMATION PART E. TOXICITY TESTING DATA POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters. • At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. • In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a toxicity reduction evaluation, if one was conducted. • If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods. If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E. If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to complete. E.1. Required Tests. Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. 0 — No discharge since 2014 E7 chronic D acute E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one column per test (where each species constitutes a test). Copy this page if more than three tests are being reported. Test number: Test number: Test number: a. Test information. Test Species & test method number Age at initiation of test Outfall number Dates sample collected Date test started Duration b. Give toxicity test methods followed. Manual title Edition number and year of publication Page number(s) c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used. 24-Hour composite Grab d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each. Before disinfection After disinfection After dechlorination EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22 FACILITY NAME AND PERMIT NUMBER: Wagram Industrial WWTP, NC0005762 PERMIT ACTION REQUESTED: Renewal RIVER BASIN: Lumber Test number: Test number: Test number: e. Describe the point in the treatment process at which the sample was collected. Sample was collected: f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both Chronic toxicity Acute toxicity g. Provide the type of test performed. Static Static -renewal Flow -through h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source. Laboratory water Receiving water i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used. Fresh water Salt water j. Give the percentage effluent used for all concentrations in the test series. k. Parameters measured during the test. (State whether parameter meets test method specifications) pH Salinity Temperature Ammonia Dissolved oxygen I. Test Results. Acute: Percent survival in 100% effluent LCm 95% C.I. % % % Control percent survival % % % Other (describe) EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22 FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN: Wagram Industrial WWTP, NC0005762 Renewal Lumber Chronic: NOEC % % % IC25 % % % Control percent survival % % % Other (describe) m. Quality Control/Quality Assurance. Is reference toxicant data available? Was reference toxicant test within acceptable bounds? What date was reference toxicant test run (MM/DD/YYYY)? Other (describe) E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation? ❑ Yes Ll No If yes, describe: EA. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary of the results. Date submitted: _ / / (MM/DD/YYYY) Summary of results: (see instructions) END OF PART E. REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS OF FORM 2A YOU MUST COMPLETE. EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22