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United States
Environmental Protection Agency
Office of Water
Washington, D.C.
EPA Form 3510-1
Revised March 2019
Water Permits Division
aEPA Application Form 1
General Information
NPDES Permitting Program
Note: All applicants to the National Pollutant Discharge Elimination System (NPDES) permits
program, with the exception of publicly owned treatment works and other treatment works treating
domestic sewage, must complete Form 1. Additionally, all applicants must complete one or more of the
following forms: 2B, 2C, 2D, 2E, or 2F. To determine the specific forms you must complete, consult the
"General Instructions" for this form.
Paperwork Reduction Act Notice
The U.S. Environmental Protection Agency estimates the average burden to collect information
and complete Form 1 to be 2.9 hours for new applicants and 0.9 hours for applicants renewing
existing permits. This estimate includes time to review instructions, search existing data sources,
gather and maintain the needed data, and complete and review the collection of information.
New respondents must also prepare a topographic map. Send comments about the burden
estimate or any other aspect of this collection of information to the Chief, Information Policy
Branch (PM-223), U.S. Environmental Protection Agency, 1200 Pennsylvania Avenue, NW,
Washington, DC 20460, and to the Office of Information and Regulatory Affairs, Office of
Management and Budget, 725 17th Street, NW, Washington, DC 20503, marked "Attention:
Desk Officer for EPA."
DESCRIPTION OF NPDES PERMIT APPLICATION FORMS
CONTENTS OF FORM 1 PACKAGE
The application forms for individual National Pollutant Discharge
Elimination System (NPDES) permits include the following:
Form 1—General Information (included in this package).
Form 2—Forms Based on Facility or Activity Type (not included
in this package):
2A. New and Existing Publicly Owned Treatment Works
2B. Concentrated Animal Feeding Operations and
Concentrated Aquatic Animal Production Facilities
2C. Existing Manufacturing, Commercial, Mining, and
Silvicultural Operations
2D. New Manufacturing, Commercial, Mining, and Silvicultural
Operations That Have Not Yet Commenced Discharge of
Process Wastewater
2E. Manufacturing, Commercial, Mining, and Silvicultural
Facilities Which Discharge Only Nonprocess Wastewater
2F. Stormwater Discharges Associated with Industrial Activity
2S. New and Existing Treatment Works Treating Domestic
Sewage
Form 1—General Instructions
Form 1—Line-by-Line Instructions
Form 1—Activities That Do Not Require Permits
Form 1—Glossary
Form 1—Application
FORM 1—GENERAL INSTRUCTIONS
Who Must Apply for an NPDES Permit?
With the exceptions described in "Form 1—Activities That Do Not
Require Permits," the federal Clean Water Act (33 U.S.C. 1251 et
seq.) prohibits any person from discharging pollutants into waters
of the United States without first having been issued a permit
under the NPDES program.
Who Must Complete Form 1?
All applicants, other than publicly owned treatment works
(POTWs) and treatment works treating domestic sewage
(TWTDS), must submit Form 1. If you operate one of the
following facilities, you must submit Form 1: concentrated animal
feeding operations and aquatic animal production facilities;
manufacturing, commercial, mining, and silvicultural operations;
or other industrial facilities.
At the state level, either the U.S. Environmental Protection
Agency (EPA) or an approved state agency administers the
NPDES permit program. If you are located in a jurisdiction in
which an EPA regional office administers the NPDES permit
program, you should use Form 1 and all other applicable forms
described in these instructions. If you are located in a jurisdiction
where a state administers the NPDES permit program, contact
the state to determine the forms you should complete. States
often develop their own application forms rather than use the
federal forms. See http://www.epa.gov/npdes/npdes-state-
program-information for a list of states that have approved
NPDES permit programs and those that do not.
Exhibit 1-1 (see end of this section) provides contact information
for each of EPA's 10 regional offices. Since the exhibit's content is
subject to change, consult EPA's website for the latest information:
http://www.epa.gov/aboutepa#regional.
Upon your request, and based on information supplied by you,
EPA or the authorized NPDES state will determine whether you
are required to obtain a permit for a particular facility or activity.
Be sure to contact EPA or your state if you have a question.
Form 1 collects general information only. You must also complete
a more detailed application based on your proposed discharge
activity, as follows:
• If your facility is a concentrated animal feeding operation
or a concentrated aquatic animal production facility, you
must also complete Form 2B.
• If your facility is an existing manufacturing, commercial,
mining, or silvicultural facility that currently discharges
process wastewater, you must also complete Form 2C.
• If your facility is a new manufacturing, commercial, mining,
or silvicultural facility that has yet to commence discharge of
process wastewater, you must also complete Form 2D.
• If your facility is a new or existing facility (including
manufacturing, commercial, mining, and silvicultural
facilities) that discharges only nonprocess wastewater,
you must also complete Form 2E.
• If your facility is a new or existing facility whose discharge
is composed entirely of stormwater associated with industrial
activity —excluding discharges from construction activity
under 122.26(b)(14)(x) or (b)(15)—you must also complete
Form 2F. If the discharge is composed of stormwater and
non-stormwater, you must complete Form 2F and you must
also complete Forms 2C, 2D, and/or 2E, as appropriate. See
Form 2F's instructions for further details.
1-1
FORM 1—GENERAL INSTRUCTIONS CONTINUED
Where to File Your Completed Form
• If you are in a jurisdiction with an approved state NPDES
permit program, file according to the instructions on the state
forms.
• If you are in a jurisdiction where EPA is the NPDES
permitting authority (i.e., the state is not an NPDES-
authorized state), mail the completed application forms to the
EPA regional office that covers the state in which your facility
is located (see Exhibit 1-1).
When to File Your Completed Form
Because of statutory and regulatory requirements, the deadlines
for filing applications vary according to your facility or activity type
and the type of permit you need. The various permit application
deadlines are listed in Exhibit 1-2 at the end of this section.
Fees
EPA does not require applicants to pay a fee for applying for
NPDES permits. However, states that administer the NPDES
permit program may charge fees. Consult with state officials for
further information.
Public Availability of Submitted Information
EPA will make information from NPDES permit application forms
available to the public for inspection and copying upon request.
You may not claim any information on Form 1 (or related
attachments) as confidential.
You may make a claim of confidentiality for any information that
you submit to EPA that goes beyond the information required by
Form 1. If you do not assert a claim of confidentiality at the time
you submit your information to the NPDES permitting authority,
EPA may make the information available to the public without
further notice to you. EPA will handle claims of confidentiality in
accordance with the Agency's business confidentiality regulations
at Part 2 of Title 4 of the Code of Federal Regulations (CFR).
Completion of Forms
Print or type in the specified areas only. If you do not have enough
space on the form to answer a question, you may continue on
additional sheets, as necessary, using a format consistent with the
form.
The NPDES permitting authority could consider your application
incomplete if you do not provide an answer (or indicate "NA" for
"not applicable") for all questions on Form 1 and the applicable
Form 2.
Provide your EPA Identification Number from the Facility Registry
Service, NPDES permit number, and facility name at the top of
each page of Form 1 and any attachments. If your facility is new
(i.e., not yet constructed), write or type "New Facility" in the space
provided for the EPA Identification Number and NPDES number.
If you do not know your EPA Identification Number, contact your
NPDES permitting authority. See Exhibit 1-1 for contact
information.
Do not leave any response areas blank unless the form directs
you to skip them. If the form directs you to respond to an item that
does not apply to your facility or activity, enter "NA" for "not
applicable" to show that you considered the item and determined
a response was not necessary for your facility.
The NPDES permitting authority will consider your application
complete when it and any supplementary material are received
and completed according to the authority's satisfaction. The
NPDES permitting authority will judge the completeness of any
application independently of the status of any other permit
application or permit for the same facility or activity.
1-2
FORM 1—GENERAL INSTRUCTIONS CONTINUED
Exhibit 1-1. Addresses of EPA Regional Contacts and Covered States
REGION 1
U.S. Environmental Protection Agency, Region 1
5 Post Office Square, Suite 100, Boston, MA 02109-3912
Phone: (617) 918-1111; toll free: (888) 372-7341
Fax: (617) 918-0101
Website: http://www.epa.gov/aboutepa/epa-region-1-new-england
REGION 6
U.S. Environmental Protection Agency, Region 6
1445 Ross Avenue, Suite 1200, Dallas, TX 75202-2733
Phone: (214) 665-2200; toll free: (800) 887-6063
Fax: (214) 665-7113
Website: http://www.epa.gov/aboutepa/epa-region-6-south-central
Covered states: Connecticut, Maine, Massachusetts, New Hampshire, Rhode
Island, and Vermont
Covered states: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas
REGION 2
U.S. Environmental Protection Agency, Region 2
290 Broadway, New York, NY 10007-1866
Phone: (212) 637-3000; toll free: (877) 251-4575
Fax: (212) 637-3526
Website: http://www.epa.gov/aboutepalepa-region-2
REGION 7
U.S. Environmental Protection Agency, Region 7
11201 Renner Boulevard, Lenexa, KS 66219
Phone: (913) 551-7003; toll free: (800) 223-0425
Website: http://www.epa.gov/aboutepa/epa-region-7-midwest
Covered states: Iowa, Kansas, Missouri, and Nebraska
Covered states: New Jersey, New York, Virgin Islands, and Puerto Rico
REGION 3
U.S. Environmental Protection Agency, Region 3
1650 Arch Street, Philadelphia, PA 19103-2029
Phone: (215) 814-5000; toll free: (800) 438-2474
Fax: (215) 814-5103
Website: http://www.epa.gov/aboutepa/epa-region-3-mid-atlantic
REGION 8
U.S. Environmental Protection Agency, Region 8
1595 Wynkoop Street, Denver, CO 80202-1129
Phone: (303) 312-6312; toll free: (800) 227-8917
Fax: (303) 312-6339
Website: http://www.epa.gov/aboutepa/epa-region-8-mountains-and-plains
Covered states: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia,
and West Virginia
Covered states: Colorado, Montana, North Dakota, South Dakota, Utah, and
Wyoming
REGION 4
U.S. Environmental Protection Agency, Region 4
Sam Nunn Atlanta Federal Center
61 Forsyth Street, SW, Atlanta, GA 30303-8960
Phone: (404) 562-9900; toll free: (800) 241-1754
Fax: (404) 562-8174
Website: http://www.epa.gov/aboutepa/about-epa-region-4-southeast
REGION 9
U.S. Environmental Protection Agency, Region 9
75 Hawthorne Street, San Francisco, CA 94105
Phone: (415) 947-8000; toll free: (866) EPA -WEST
Fax: (415) 947-3553
Website: http://www.epa.gov/aboutepa/epa-region-9-pacific-southwest
Covered states: Arizona, Califomia, Hawaii, Nevada, Guam, American Samoa,
and Trust Territories
Covered states: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina,
South Carolina, and Tennessee
REGION 5
U.S. Environmental Protection Agency, Region 5
77 West Jackson Boulevard, Chicago, IL 60604-3507
Phone: (312) 353-2000; toll free: (800) 621-8431
Fax: (312) 353-4135
Website: http://www.epa.gov/aboutepa/epa-region-5
REGION 10
U.S. Environmental Protection Agency, Region 10
1200 Sixth Avenue, Suite 900, Seattle, WA 98101
Phone: (206) 553-1200; toll free: (800) 424-4372
Fax: (206) 553-2955
Website: http://www.epa.gov/aboutepa/epa-region-10-pacific-northwest
Covered states: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin
Covered states: Alaska, Idaho, Oregon, and Washington
Exhibit 1-2. Filing Dates for NPDES Permit Applications
Permit Application
When to File
2A
180 days before your present NPDES permit expires or, if you are a
new discharger, 180 days before the date on which the discharge is
to commence unless the NPDES permitting authority has granted
permission for a later date.
2B
180 days before your present NPDES permit expires or 180 days
prior to startup if you are a new facility.
2C
180 days before your present NPDES permit expires.
2D
180 days prior to startup.
2E
180 days before your present NPDES permit expires, or 180 days
prior to startup if you are a new facility.
2F
Construction: 90 days prior to date construction is to commence.
Nonconstruction: 180 days before your present NPDES permit
expires or 180 days prior to startup if you are a new facility.
2S
180 days before your present NPDES permit expires or 180 days
prior to startup if you are a new facility.
1-3
FORM 1—LINE-BY-LINE INSTRUCTIONS
Section 1. Activities Requiring an NPDES Permit
Item 1.1. Review the questions in Item 1.1 to determine if you are
required to submit Form 1. Be sure to check the Form 1—
Glossary for the legal definitions of any key terms.
If you answer "Yes" to a question in Item 1.1, then you do not
need to complete Form 1, but you must comply with the
application requirements specified.
Item 1.2. Respond to the questions in Items 1.2.1 to 1.2.5. If you
answer "Yes" to any question, you must complete Form 1 and the
Form 2 application specified. See Exhibit 1-2 for filing deadlines.
If you answer "No" to every question in Items 1.1 and 1.2, then
you do not need an NPDES permit, and you do not need to
complete and return any of the NPDES application forms.
Section 2. Name, Mailing Address, and Location
Item 2.1. Enter the facility's official or legal name. Do not use a
colloquial name.
Item 2.2. Provide your EPA Identification Number from the
Facility Registry Service if you have an existing facility. If you do
not know your EPA Identification Number, contact your NPDES
permitting authority. If your facility is new (i.e., not yet
constructed), write or type "New Facility."
Item 2.3. Give the name (first and last), title, work telephone
number, and email address of the person who is thoroughly
familiar with the operation of the facility and with the facts
reported in this application. The NPDES permitting authority will
contact the person listed if they have questions on the material
submitted.
Item 2.4. Give the complete mailing address of the office to which
the NPDES permitting authority should send correspondence.
This often is not the address used to designate the location of the
facility or activity.
Item 2.5. Give the address or location of the facility identified
under Item 2.1. If the facility lacks a street name or route number,
give the most accurate, alternative geographic information (e.g.,
section number or quarter section number from county records or
"at intersection of Routes 425 and 22"). Also provide the county
name, county code (if known), city or town, state, and zip code.
For concentrated aquatic animal production facilities, provide the
address or location of the production area (i.e., the location where
the animals are contained, grown, or held).
Section 3. SIC and NAICS Codes
Items 3.1 and 3.2. List, in descending order of significance, up to
four 4-digit standard industrial classification (SIC) codes and
North American Industrial Classification System (NAICS) codes
that best describe your facility in terms of the principal products or
services it produces or provides. If the SIC or NAICS codes do
not adequately describe your facility's products or services, you
have the option to provide additional descriptive information.
You can find SIC code numbers and descriptions in the
1987 Standard Industrial Classification Manual, prepared by the
Executive Office of the President, Office of Management and
Budget. This document is available from the Government Printing
Office, Washington, D.C. An online version of the manual is also
available courtesy of the Occupational Safety and Health
Administration at http://www.osha.gov/pls/imis/sic manual.html.
You can find NAICS code numbers and descriptions in the North
American Industrial Classification System Manual prepared by the
Executive Office of the President, Office of Management and
Budget. This document is available from the National Technical
Information Service (NTIS) in Alexandria, Virginia. It is also
available online at http://www.census.gov/eos/www/naics/.
Use the latest edition of the manuals. If you have any questions
about the appropriate SIC or NAICS codes for your facility,
contact your NPDES permitting authority.
Section 4. Operator Information
Item 4.1. Give the legal name of the person, firm, public
organization, or other entity that operates the facility described in
this application. This may or may not be the same as the facility's
name. The operator of the facility is the legal entity that controls
the facility's operation rather than the plant or site manager. Do
not use a colloquial name.
Item 4.2. Indicate whether the entity listed in response to Item 4.1
also owns the facility by marking the appropriate box.
Item 4.3. Indicate the ownership status of the operator of the
facility by marking the appropriate box. If the facility is a federal
facility (i.e., owned by the U.S. government), check the box for
"Public —federal." If the facility is owned by a state government,
check the box for "Public —state." If the facility is owned by a
county government, municipal (e.g., city or town) government,
tribal government, school district, water district, or other local
government entity, check the box for "Other public" and specify
the type of government entity. If the facility is owned by a
corporation or other private entity, check the box for "Private." If
the facility has mixed ownership (e.g., public/private) or is not
owned by an entity of the types previously listed, check the box
for "Other" and specify the type of entity.
Items 4.4 to 4.6. Enter the telephone number, address, and email
address of the operator identified in Item 4.1.
Section 5. Indian Land
Item 5.1. Indicate whether the facility is located on Indian Land.
Section 6. Existing Environmental Permits
Item 6.1. Check the appropriate boxes and provide the permit
numbers for all relevant federal, state, and local environmental
permits or construction approvals received or applied for under
any of the programs listed below. If you have more than one
currently effective permit under a particular permit program for
your facility, list the additional permit numbers on the application
form or on a separate sheet of paper.
1-4
FORM 1—LINE-BY-LINE INSTRUCTIONS CONTINUED
• Hazardous waste management program under the Resource
Conservation and Recovery Act (RCRA).
• Underground Injection Control (UIC) program under the Safe
Drinking Water Act (SDWA).
• NPDES program under the Clean Water Act (CWA).
• Prevention of Significant Deterioration (PSD) program under
the Clean Air Act (CAA).
• Nonattainment program under the CAA.
• National Emission Standards for Hazardous Pollutants
(NESHAPs) preconstruction approval under the CAA.
• Ocean dumping permits under the Marine Protection
Research and Sanctuaries Act (MPRSA).
• Dredge or fill permits under Section 404 of the CWA.
• Other federal, state, or local environmental permits.
Section 7. Map
Unless the facility is a concentrated animal feeding operation,
provide a topographic map(s) of the area extending at least one
mile beyond the property boundaries of the facility that clearly
shows the following:
• The legal boundaries of the facility.
• The location and serial number of each of your existing and
proposed intake and discharge structures.
• All hazardous waste management, storage, and disposal
facilities.
• Each well where you inject fluids underground.
• All wells, springs, surface water bodies, and drinking water
wells that are in the public record or otherwise known to you
and that are located in the map area.
If the facility has associated water intakes, discharge structures,
hazardous waste disposal sites, or injection wells and these items
are located more than one mile from the facility, include them on
the map if possible. If you cannot, attach additional sheets
describing the location of the structures, disposal site(s), or well(s)
and identify the U.S. Geological Survey (USGS) or other map
corresponding to the location(s).
On each map, include the map scale, a meridian arrow showing
north, and latitude and longitude to the nearest second. Latitude
and longitude coordinates may be obtained in a variety of ways,
including use of hand held devices (e.g., a GPS enabled
smartphone), internet mapping tools (e.g.,
https://mynasadata.larc.nasa.gov/latitudelongitude-finder/),
geographic information systems (e.g., ArcView), or paper maps
from trusted sources (e.g., USGS).
On all maps of rivers, show the direction of the current. In tidal
waters, show the directions of ebb and flow tides.
You may develop your map by going to USGS's National Map
website at http://nationalmap.gov/. (For a map from this site, use
the traditional 7.5-minute quadrangle format. If none is available,
use a USGS 15-minute series map.) You may also use a plat or
other appropriate map. Briefly describe land uses in the map area
(e.g., residential, commercial). An example of an acceptable
location map is shown as Exhibit 1-3 at the end of these
instructions. Note: Exhibit 1-3 is provided for illustration only; it
does not show an actual facility.
If the facility is a concentrated animal feeding operation, you are
not required to provide the topographic map required by this
section of Form 1. Instead, you are required to provide a
topographic map as specified in Section 4 of Form 2B.
Item 7.1. Note that you have completed your topographic map
and attached it to the application.
Section 8. Nature of Business
Briefly describe the nature of your business (e.g., products
produced or services provided). See Examples 1 and 2.
Example 1
Facilities Subject to 40 CFR 426, Subparts F and G
Industry A is an auto tempered and auto laminated glass
manufacturing facility subject to effluent limitation guidelines
(ELGs) for the "Automotive Glass Tempering" and "Automotive
Glass Laminating" subcategories of the "Glass Manufacturing"
point source category at 40 CFR 426, subparts F and G. At the
facility, glass is cut and then passed through a series of
processes that grind and polish the edges, bend the glass, and
then temper the glass to produce side and back windows for
automobiles. Tempering involves heating the glass near the
melting point, then rapidly cooling it to increase its mechanical
and thermal endurance. The facility also produces automobile
windshields and undertakes processes that laminate a plastic
sheet between two layers of glass and that prepare the glass for
lamination (e.g., cutting, bending, and washing).
Example 2
Facility Not Subject to ELGs
Industry B undertakes batch -type resin manufacturing operations.
It has aboveground storage tanks for raw materials and finished
goods, resin loading operations, and warehouses for 55-gallon
drums of finished product. Industry B manufactures alkyd,
saturated and unsaturated polyester resins in batches using
reactor vessels and mix tanks. Most of the feedstock liquids are
pumped from storage tanks to the kettles and mixers via a closed
piping system. Additional feedstocks are added manually as
solids from bags and sacks via manways, which are located on
top of the kettles. The resin is then chemically reacted in the
kettles. After the reaction step finishes, the resin is transferred
from the kettles to the mix tanks, where solvents are added to
thin it. The primary byproduct of the reaction is water vapor
containing condensed soluble organics. The byproduct flows to
an isolation tank where the vapors are directed to an onsite
thermal oxidizer. The finished resin is then pumped through one
of three types of filtration systems into finished goods storage
tanks, 55-gallon drums, 350-gallon intermediate bulk container
totes, or directly into tanker trucks. A typical batch takes about 30
hours to complete.
1-5
FORM 1—LINE-BY-LINE INSTRUCTIONS CONTINUED
Section 9. Cooling Water Intake Structures
Item 9.1. Indicate whether the facility uses cooling water. If yes,
continue to Item 9.2. If no, skip to Item 10.1.
Item 9.2. Identify the source of the cooling water. For example,
indicate whether the cooling water is from a surface water,
groundwater well, public water system, or treated effluent that
would otherwise be discharged to a water of the U.S.
If the facility uses a cooling water intake structure as described in
40 CFR 125, Subparts I and J, the facility may have additional
application requirements under 40 CFR 122.21(r). Note that the
information required by 40 CFR 122.21(r) is not requested as part
of Form 1. Contact your NPDES permitting authority to determine
the specifics of what you should provide and when.
Section 10. Variance Requests
An applicant (other than a POTW) may request a variance from
otherwise applicable effluent limitations under certain conditions
described at 40 CFR 122.21(m).
Item 10.1. If known at the time of application, check all of the
authorized variances that you plan to request or renew. Note that
you are not being asked to submit any other information at this
time. Contact your NPDES permitting authority to determine the
specifics of what you should provide and when. The ability to
request a variance is not limited to the time of application, and an
applicant may request a variance consistent with statutory and
regulatory requirements.
Section 11. Checklist and Certification
Item 11.1. Review the checklist provided. In Column 1, mark the
sections of Form 1 that you have completed and are submitting
with your application. In Column 2, indicate for each section
whether you are submitting attachments.
Item 11.2. The Clean Water Act provides for severe penalties for
submitting false information on this application form. CWA Section
309(c)(2) provides that, "Any person who knowingly makes any
false statement, representation, or certification in any application,
...shall upon conviction, be punished by a fine of no more than
$10,000 or by imprisonment for not more than six months, or
both."
FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS
APPLICATION TO BE SIGNED AS FOLLOWS:
A. For a corporation, by a responsible corporate officer. For the
purpose of this section, a responsible corporate officer
means: (1) a president, secretary, treasurer, or vice-president
of the corporation in charge of a principal business function,
or any other person who performs similar policy- or decision -
making functions for the corporation, or (2) the manager of
one or more manufacturing, production, or operating facilities,
provided the manager is authorized to make management
decisions which govern the operation of the regulated facility
including having the explicit or implicit duty of making major
capital investment recommendations, and initiating and
directing other comprehensive measures to assure long term
environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary
systems are established or actions taken to gather complete
and accurate information for permit application requirements;
and where authority to sign documents has been assigned or
delegated to the manager in accordance with corporate
procedures.
B. For a partnership or sole proprietorship, by a general partner
or the proprietor, respectively.
C. For a municipality, state, federal, or other public facility, by
either a principal executive officer or ranking elected official.
For purposes of this section, a principal executive officer of a
federal agency includes: (1) The chief executive officer of the
agency, or (2) a senior executive officer having responsibility
for the overall operations of a principal geographic unit of the
agency (e.g., Regional Administrators of EPA).
1-6
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1-7
FORM 1—ACTIVITIES THAT DO NOT REQUIRE PERMITS
You are not required to obtain an NPDES permit if your discharge
is in one of the following categories, as provided by the CWA and
NPDES regulations at 40 CFR 122 to 125. (However, under CWA
Sections 510 and 312, some discharges exempted from the
federal NPDES requirements may still be regulated by a state
permitting authority.)
• Any discharge of sewage from vessels and any effluent from
properly functioning marine engines, laundry, shower, and
galley sink wastes, or any other discharge incidental to the
normal operation of a vessel, including vessels of the Armed
Forces within the meaning of section 312 of the CWA and
recreational vessels within the meaning of section 502(25) of
the CWA. None of these exclusions apply to rubbish, trash,
garbage, or other such materials discharged overboard; nor
to other discharges when the vessel is operating in a
capacity other than as a means of transportation such as
when used as an energy or mining facility, a storage facility
or a seafood processing facility, or when secured to a
storage facility or a seafood processing facility, or when
secured to the bed of the ocean, contiguous zone or waters
of the United States for the purpose of mineral or oil
exploration or development.
• Discharges of dredged or fill material into waters of the
United States that are regulated under CWA Section 404.
• The introduction of sewage, industrial wastes, or other
pollutants into publicly owned treatment works by indirect
dischargers. Plans or agreements to switch to this method of
disposal in the future do not relieve dischargers of the
obligation to have and comply with permits until all
discharges of pollutants to waters of the United States are
eliminated. (See also 40 CFR 122.47(b).) This exclusion
does not apply to the introduction of pollutants to privately
owned treatment works or to other discharges through pipes,
sewers, or other conveyances owned by a state, municipality,
or other party not leading to treatment works.
• Any discharge in compliance with the instructions of an On -
Scene Coordinator pursuant to 40 CFR 300 (The National Oil
and Hazardous Substances Pollution Contingency Plan) or
33 CFR 153.10(e) (Pollution by Oil and Hazardous
Substances).
• Any introduction of pollutants from non point -source
agricultural and silvicultural activities, including stormwater
runoff from orchards, cultivated crops, pastures, range lands,
and forest lands, but not discharges from concentrated
animal feeding operations as defined in 40 CFR 122.23,
discharges from concentrated aquatic animal production
facilities as defined in 40 CFR 122.23, discharges from
concentrated aquatic animal production facilities as defined
in 40 CFR 122.24, discharges to aquaculture projects as
defined in 40 CFR 122.25, and discharges from silvicultural
point sources as defined in 40 CFR 122.27. Note: Per 40
CFR 122.26(b)(14)(ii), facilities classified within SIC 24,
Industry Group 241, that are rock crushing, gravel washing,
log sorting, or log storage facilities operated in connection
with silvicultural activities defined in 40 CFR 122.27(b)(2)—(3)
and Industry Groups 242 through 249; 26 (except 265 and
267), 28 (except 283), 29, 311, 32 (except 323), 33, 3441,
and 373 (not included are all other types of silviculture
facilities) are considered stormwater discharges associated
with industrial activity, and are required to obtain an NPDES
permit.
• Return flows from irrigated agriculture.
• Discharges into a privately owned treatment works, except as
the NPDES permitting authority may otherwise require under
40 CFR 122.44(m).
• Discharges from a water transfer. "Water transfer" means an
activity that conveys or connects waters of the United States
without subjecting the transferred water to intervening
industrial, municipal, or commercial use. This exclusion does
not apply to pollutants introduced by the water transfer
activity itself to the water being transferred.
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FORM 1—GLOSSARY
Note: This glossary includes terms used in the various NPDES application forms, including Form 1. The definitions are from the NPDES
regulations at 40 CFR 122.2 unless otherwise specified. If you have any questions concerning the meaning of any of these terms, contact
your NPDES permitting authority.
ANIMAL FEEDING OPERATION (defined at § 122.23) means a lot or facility (other than an aquatic animal production facility) where the
following conditions are met;
• Animals (other than aquatic animals) have been, are, or will be stabled or confined and fed or maintained for a total of 45 days or
more in any 12-month period; and
• Crops, vegetation, forage growth, or post -harvest residues are not sustained in the normal growing season over any portion of the lot
or facility.
APPLICATION means the EPA standard national forms for applying for a permit, including any additions, revisions, or modifications to the
forms; or forms approved by EPA for use in approved states, including any approved modifications or revisions.
APPROVED PROGRAM or APPROVED STATE means a State or interstate program which has been approved or authorized by EPA
under part 123.
AQUACULTURE PROJECT (defined at § 122.25) means a defined managed water area which uses discharges of pollutants into that
designated area for the maintenance or production of harvestable freshwater, estuarine, or marine plants or animals. DESIGNATED
PROJECT AREA means the portions of the waters of the United States within which the permittee or permit applicant plans to confine the
cultivated species, using a method or plan or operation (including, but not limited to, physical confinement) which, on the basis of reliable
scientific evidence, is expected to ensure that specific individual organisms comprising an aquaculture crop will enjoy increased growth
attributable to the discharge of pollutants, and be harvested within a defined geographic area.
AVERAGE MONTHLY DISCHARGE LIMITATION means the highest allowable average of daily discharges over a calendar month,
calculated as the sum of all daily discharges measured during that month divided by the number of daily discharges measured during that
month.
AVERAGE WEEKLY DISCHARGE LIMITATION means the highest allowable average of daily discharges over a calendar week,
calculated as the sum of all daily discharges measured during a calendar week divided by the number of daily discharges measured during
that week.
BEST MANAGEMENT PRACTICES (BMPs) means schedules of activities, prohibitions of practices, maintenance procedures, and other
management practices to prevent or reduce the pollution of waters of the United States. BMPs include treatment requirements, operation
procedures, and practices to control plant site runoff, spillage or leaks, sludge or waste disposal, or drainage from raw material storage.
BIOSOLIDS (see sewage sludge).
BYPASS (defined at § 122.41(m)) means the intentional diversion of waste streams from any portion of a treatment facility.
COMBINED SEWER OVERFLOW (CSO) means a discharge from a combined sewer system (CSS) at a point prior to the Publicly Owned
Treatment Works (POTW) Treatment Plant (defined at § 403.3(r)).
COMBINED SEWER SYSTEM (CSS) means a wastewater collection system owned by a State or municipality (as defined by section
502(4) of the CWA) which conveys sanitary wastewaters (domestic, commercial and industrial wastewaters) and storm water through a
single -pipe system to a Publicly Owned Treatment Works (POTW) Treatment Plant (as defined at § 403.3(r)).
CONCENTRATED ANIMAL FEEDING OPERATION (defined at § 122.23) means an animal feeding operation that is defined as a Large
CAFO or as a Medium CAFO by the terms of (A) or (B) below, or that is designated as a CAFO in accordance with 40 CFR 122.23(c). Two
or more AFOs under common ownership are considered to be a single AFO for the purposes of determining the number of animals at an
operation, if they adjoin each other or if they use a common area or system for the disposal of wastes.
A. LARGE CONCENTRATED ANIMAL FEEDING OPERATION (LARGE CAFO) means an AFO that stables or confines as many as or
more than the numbers of animals specified in any of the following categories:
1. 700 mature dairy cows, whether milked or dry;
2. 1,000 veal calves;
3. 1,000 cattle other than mature dairy cows or veal calves. Cattle includes but is not limited to heifers, steers, bulls and cow/calf
pairs;
4. 2,500 swine each weighing 55 pounds or more;
5. 10,000 swine each weighing less than 55 pounds;
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FORM 1—GLOSSARY CONTINUED
6. 500 horses;
7. 10,000 sheep or Iambs;
8. 55,000 turkeys;
9. 30,000 laying hens or broilers, if the AFO uses a liquid manure handling system;
10. 125,000 chickens (other than laying hens), if the AFO uses other than a liquid manure handling system;
11. 82,000 laying hens, if the AFO uses other than a liquid manure handling system;
12. 30,000 ducks (if the AFO uses other than a liquid manure handling system); or
13. 5,000 ducks (if the AFO uses a liquid manure handling system).
B. MEDIUM CONCENTRATED ANIMAL FEEDING OPERATION (MEDIUM CAFO) means any AFO with the type and number of
animals that fall within any of the ranges listed below and which has been defined or designated as a CAFO. An AFO is defined as a
Medium CAFO if:
1. The type and number of animals that it stables and confines falls within any of the following ranges:
a. 200 to 699 mature dairy cows, whether milked or dry;
b. 300 to 999 veal calves;
c. 300 to 999 cattle other than mature dairy cows or veal calves. Cattle includes but is not limited to heifers, steers, bulls and
cow/calf pairs;
d. 750 to 2,499 swine each weighing 55 pounds or more;
e. 3,000 to 9,999 swine each weighing less than 55 pounds;
f. 150 to 499 horses;
g. 3,000 to 9,999 sheep or Iambs;
h. 16,500 to 54,999 turkeys;
i. 9,000 to 29,999 laying hens or broilers, if the AFO uses a liquid manure handling system;
j. 37,500 to 124,999 chickens (other than laying hens), if the AFO uses other than a liquid manure handling system;
k. 25,000 to 81,999 laying hens, if the AFO uses other than a liquid manure handling system;
I. 10,000 to 29,999 ducks (if the AFO uses other than a liquid manure handling system); ore
m. 1,500 to 4,999 ducks (if the AFO uses a liquid manure handling system); and
2. Either one of the following conditions are met:
a. Pollutants are discharged into waters of the United States through a man-made ditch, flushing system, or other similar man-
made device; or
b. Pollutants are discharged directly into waters of the United States which originate outside of and pass over, across, or
through the facility or otherwise come into direct contact with animals confined in the operation.
CONCENTRATED AQUATIC ANIMAL PRODUCTION FACILITY (defined at § 122.24) means a hatchery, fish farm, or other facility which
contains, grows, or holds aquatic animals in either of the following categories, or which the Director designates as such on a case -by -case
basis:
A. Cold water fish species or other cold water aquatic animals including, but not limited to, the Salmonidae family of fish (e.g., trout and
salmon) in ponds, raceways, or other similar structures which discharge at least 30 days per year but does not include:
1. Facilities which produce less than 9,090 harvest weight kilograms (approximately 20,000 pounds) of aquatic animals per year;
and
2. Facilities which feed less than 2,272 kilograms (approximately 5,000 pounds) of food during the calendar month of maximum
feeding.
B. Warm water fish species or other warm water aquatic animals including, but not limited to, the Ameiuridae, Cetrarchiclae, and
Cyprinidae families of fish (e.g., respectively, catfish, sunfish, and minnows) in ponds, raceways, or other similar structures which
discharge at least 30 days per year, but does not include;
1. Closed ponds which discharge only during periods of excess runoff; or
2. Facilities which produce less than 45,454 harvest weight kilograms (approximately 100,000 pounds) of aquatic animals per year.
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FORM 1—GLOSSARY CONTINUED
CWA means the Clean Water Act (formerly referred to as the Federal Water Pollution Control Act or Federal Water Pollution Control Act
Amendments of 1972) Public Law 92-500, as amended by Public Law 95-217, Public Law 95-576, Public Law 96-483 and Public Law
97-117, 33 U.S.C. 1251 et seq.
CWA AND REGULATIONS means the Clean Water Act (CWA) and applicable regulations promulgated thereunder. In the case of an
approved State program, it includes State program requirements.
DAILY DISCHARGE means the "discharge of a pollutant" measured during a calendar day or any 24-hour period that reasonably
represents the calendar day for purposes of sampling. For pollutants with limitations expressed in units of mass, the "daily discharge" is
calculated as the total mass of the pollutant discharged over the day. For pollutants with limitations expressed in other units of
measurement, the "daily discharge" is calculated as the average measurement of the pollutant over the day.
DIRECT DISCHARGE means the "discharge of a pollutant."
DIRECTOR means the Regional Administrator or the State Director, as the context requires, or an authorized representative. When there
is no "approved State program," and there is an EPA administered program, "Director" means the Regional Administrator. When there is
an approved State program, "Director" normally means the State Director. In some circumstances, however, EPA retains the authority to
take certain actions even when there is an approved State program. (For example, when EPA has issued an NPDES permit prior to the
approval of a State program, EPA may retain jurisdiction over that permit after program approval, see § 123.1.) In such cases, the term
"Director" means the Regional Administrator and not the State Director.
DISCHARGE (OF A POLLUTANT) means:
• Any addition of any pollutant or combination of pollutants to waters of the United States from any point source; or
• Any addition of any pollutant or combination of pollutants to the waters of the contiguous zone or the ocean from any point source
other than a vessel or other floating craft which is being used as a means of transportation.
This definition includes discharges into waters of the United States from: surface runoff which is collected or channelled by man;
discharges through pipes, sewers, or other conveyances owned by a State, municipality, or other person which do not lead to a treatment
works; and discharges through pipes, sewers, or other conveyances, leading into privately owned treatment works. This term does not
include an addition of pollutants by any "indirect discharger".
DISCHARGE MONITORING REPORT means the EPA uniform national form, including any subsequent additions, revisions, or
modifications for the reporting of self -monitoring results by permittees. DMRs must be used by "approved States" as well as by EPA. EPA
will supply DMRs to any approved State upon request. The EPA national forms may be modified to substitute the state agency name,
address, logo, and other similar information, as appropriate, in place of EPA's.
DRAFT PERMIT means a document prepared under § 124.6 indicating the Director's tentative decision to issue or deny, modify, revoke
and reissue, terminate, or reissue a "permit." A notice of intent to terminate a permit, and a notice of intent to deny a permit, as discussed
in § 124.5, are types of "draft permits." A denial of a request for modification, revocation and reissuance, or termination, as discussed in
§ 124.5, is not a "draft permit." A "proposed permit" is not a "draft permit."
EFFLUENT LIMITATION means any restriction imposed by the Director on quantities, discharge rates, and concentrations of "pollutants"
which are "discharged" from "point sources" into "waters of the United States," the waters of the "contiguous zone," or the ocean.
EFFLUENT LIMITATIONS GUIDELINES means a regulation published by the Administrator under section 304(b) of the CWA to adopt or
revise "effluent limitations."
ENVIRONMENTAL PROTECTION AGENCY (EPA) means the United States Environmental Protection Agency.
FACILITY or ACTIVITY means any NPDES "point source" or any other facility or activity (including land or appurtenances thereto) that is
subject to regulation under the NPDES program.
GENERAL PERMIT means an NPDES "permit" issued under § 122.28 authorizing a category of discharges under the CWA within a
geographical area.
HAZARDOUS SUBSTANCE means any substance designated under 40 CFR part 116 pursuant to section 311 of the CWA.
INDIAN COUNTRY (or INDAN LANDS) means:
• All land within the limits of any Indian reservation under the jurisdiction of the United States Government, notwithstanding the
issuance of any patent, and, including rights -of -way running through the reservation;
• All dependent Indian communities with the borders of the United States whether within the originally or subsequently acquired territory
thereof, and whether within or without the limits of a state; and
• All Indian allotments, the Indian titles to which have not been extinguished, including rights -of -way running through the same.
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FORM 1—GLOSSARY CONTINUED
INDIAN TRIBE means any Indian Tribe, band, group, or community recognized by the Secretary of the Interior and exercising
governmental authority over a Federal Indian reservation.
INDIRECT DISCHARGE means a nondomestic discharger introducing "pollutants" to a "publicly owned treatment works."
LARGE MUNICIPAL SEPARATE STORM SEWER SYSTEM (defined at § 122.26(b)(4)) means all municipal separate storm sewers that
are either:
(i) Located in an incorporated place with a population of 250,000 or more as determined by the 1990 Decennial Census by the Bureau of
the Census (Appendix F of 40 CFR 122); or
(ii) Located in the counties listed in appendix H of 40 CFR 122, except municipal separate storm sewers that are located in the
incorporated places, townships or towns within such counties; or
(iii) Owned or operated by a municipality other than those described in paragraphs (i) or (ii) and that are designated by the Director as part
of the large or medium municipal separate storm sewer system due to the interrelationship between the discharges of the designated
storm sewer and the discharges from municipal separate storm sewers described under paragraphs (i) or (ii). In making this determination
the Director may consider the following factors:
(A) Physical interconnections between the municipal separate storm sewers;
(B) The location of discharges from the designated municipal separate storm sewer relative to discharges from municipal separate storm
sewers described in paragraph (i);
(C) The quantity and nature of pollutants discharged to waters of the United States;
(D) The nature of the receiving waters; and
(E) Other relevant factors; or
(iv) The Director may, upon petition, designate as a large municipal separate storm sewer system, municipal separate storm sewers
located within the boundaries of a region defined by a storm water management regional authority based on a jurisdictional, watershed, or
other appropriate basis that includes one or more of the systems described in paragraphs (i), (ii), (iii).
LOG SORTING AND LOG STORAGE FACILITIES (defined at § 122.27) means facilities whose discharges result from the holding of
unprocessed wood, for example, logs or roundwood with bark or after removal of bark held in self-contained bodies of water (mill ponds or
log ponds) or stored on land where water is applied intentionally on the logs (wet decking). (See 40 CFR 429, subpart I, including the
effluent limitations guidelines.)
MAJOR FACILITY means any NPDES "facility or activity" classified as such by the Regional Administrator, or, in the case of "approved
State programs," the Regional Administrator in conjunction with the State Director.
MAXIMUM DAILY DISCHARGE LIMITATION means the highest allowable "daily discharge."
MEDIUM MUNICIPAL SEPARATE STORM SEWER SYSTEM (defined at § 122.26(b)(7)) means all municipal separate storm sewers that
are either:
(i) Located in an incorporated place with a population of 100,000 or more but less than 250,000, as determined by the 1990 Decennial
Census by the Bureau of the Census (appendix G of 40 CFR 122); or
(ii) Located in the counties listed in appendix I of 40 CFR 122, except municipal separate storm sewers that are located in the incorporated
places, townships or towns within such counties; or
(iii) Owned or operated by a municipality other than those described in paragraph (i) or (ii) and that are designated by the Director as part
of the large or medium municipal separate storm sewer system due to the interrelationship between the discharges of the designated
storm sewer and the discharges from municipal separate storm sewers described under paragraph (i) or (ii). In making this determination
the Director may consider the following factors:
(A) Physical interconnections between the municipal separate storm sewers;
(B) The location of discharges from the designated municipal separate storm sewer relative to discharges from municipal separate storm
sewers described in paragraph (i);
(C) The quantity and nature of pollutants discharged to waters of the United States;
(D) The nature of the receiving waters; or
(E) Other relevant factors; or
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FORM 1—GLOSSARY CONTINUED
(iv) The Director may, upon petition, designate as a medium municipal separate storm sewer system, municipal separate storm sewers
located within the boundaries of a region defined by a storm water management regional authority based on a jurisdictional, watershed, or
other appropriate basis that includes one or more of the systems described in paragraphs (i), (ii), (iii) of this section.
MUNICIPALITY means a city, town, borough, county, parish, district, association, or other public body created by or under State law and
having jurisdiction over disposal of sewage, industrial wastes, or other wastes, or an Indian tribe or an authorized Indian tribal organization,
or a designated and approved management agency under section 208 of the CWA.
MUNICIPAL SEPARATE STORM SEWER (defined at § 122.26(b)(8)) means a conveyance or system of conveyances (including roads
with drainage systems, municipal streets, catch basins, curbs, gutters, ditches, man-made channels, or storm drains):
• Owned or operated by a State, city, town, borough, county, parish, district, association, or other public body (created by or pursuant to
State law) having jurisdiction over disposal of sewage, industrial wastes, stormwater, or other wastes, including special districts under
State law such as a sewer district, flood control district or drainage district, or similar entity, or an Indian tribe or an authorized Indian
tribal organization, or a designated and approved management agency under section 208 of the CWA that discharges to waters of the
United States.
• Designed or used for collecting or conveying stormwater.
• Which is not a combined sewer; and
• Which is not part of a POTW as defined at 40 CFR 122.2.
MUNICIPAL SLUDGE (see sewage sludge)
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) means the national program for issuing, modifying, revoking
and reissuing, terminating, monitoring and enforcing permits, and imposing and enforcing pretreatment requirements, under sections 307,
402, 318, and 405 of the CWA. The term includes an "approved program."
NEW DISCHARGER means any building, structure, facility, or installation:
• From which there is or may be a "discharge of pollutants;"
• That did not commence the "discharge of pollutants" at a particular "site" prior to August 13, 1979;
• Which is not a "new source;" and
• Which has never received a finally effective NPDES permit for discharges at that "site."
This definition includes an "indirect discharger" which commences discharging into "waters of the United States" after August 13, 1979. It
also means any existing mobile point source (other than an offshore or coastal oil and gas exploratory drilling rig or a coastal oil and gas
developmental drilling rig) such as a seafood processing rig, seafood processing vessel, or aggregate plant, that begins discharging at a
"site" for which it does not have a permit; and any offshore or coastal mobile oil and gas exploratory drilling rig or coastal mobile oil and gas
developmental drilling rig that commences the discharge of pollutants after August 13, 1979, at a "site" under EPA's permitting jurisdiction
for which it is not covered by an individual or general permit and which is located in an area determined by the Regional Administrator in
the issuance of a final permit to be an area of biological concern. In determining whether an area is an area of biological concern, the
Regional Administrator shall consider the factors specified in 40 CFR 125.122(a)(1) through (10).
An offshore or coastal mobile exploratory drilling rig or coastal mobile developmental drilling rig will be considered a "new discharger" only
for the duration of its discharge in an area of biological concern.
NEW SOURCE means any building, structure, facility, or installation from which there is or may be a "discharge of pollutants," the
construction of which commenced:
• After promulgation of standards of performance under section 306 of the CWA which are applicable to such source, or
• After proposal of standards of performance in accordance with section 306 of the CWA which are applicable to such source, but only
if the standards are promulgated in accordance with section 306 within 120 days of their proposal.
OWNER OR OPERATOR means the owner or operator of any "facility or activity" subject to regulation under the NPDES program.
PERMIT means an authorization, license, or equivalent control document issued by EPA or an "approved State" to implement the
requirements of this part and parts 123 and 124. "Permit" includes an NPDES "general permit" (§ 122.28). Permit does not include any
permit which has not yet been the subject of final agency action, such as a "draft permit" or a "proposed permit."
PESTICIDE DISCHARGES TO WATERS OF THE UNITED STATES FROM PESTICIDE APPLICATION means the application of
biological pesticides, and the application of chemical pesticides that leave a residue, from point sources to waters of the United States. In
the context of this definition of pesticide discharges to waters of the United States from pesticide application, this does not include
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FORM 1—GLOSSARY CONTINUED
agricultural storm water discharges and return flows from irrigated agriculture, which are excluded by law (33 U.S.C. 1342(1); 33 U.S.C.
1362(14)).
PESTICIDE RESIDUE for the purpose of determining whether a NPDES permit is needed for discharges to waters of the United States
from pesticide application, means that portion of a pesticide application that is discharged from a point source to waters of the United
States and no longer provides pesticidal benefits. It also includes any degradates of the pesticide.
POINT SOURCE means any discernible, confined, and discrete conveyance, including but not limited to, any pipe, ditch, channel, tunnel,
conduit, well, discrete fissure, container, rolling stock, concentrated animal feeding operation, landfill leachate collection system, vessel or
other floating craft from which pollutants are or may be discharged. This term does not include return flows from irrigated agriculture or
agricultural stormwater runoff. (See § 122.3).
POLLUTANT means dredged spoil, solid waste, incinerator residue, filter backwash, sewage, garbage, sewage sludge, munitions,
chemical wastes, biological materials, radioactive materials (except those regulated under the Atomic Energy Act of 1954, as amended (42
U.S.C. 2011 et seq.)), heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal, and agricultural waste
discharged into water. It does not mean:
• Sewage from vessels; or
• Water, gas, or other material which is injected into a well to facilitate production of oil or gas, or water derived in association with oil
and gas production and disposed of in a well, if the well used either to facilitate production or for disposal purposes is approved by
authority of the State in which the well is located, and if the State determines that the injection or disposal will not result in the
degradation of ground or surface water resources. Note: Radioactive materials covered by the Atomic Energy Act are those
encompassed in its definition of source, byproduct, or special nuclear materials. Examples of materials not covered include radium
and accelerator -produced isotopes. See Train v. Colorado Public Interest Research Group, Inc., 426 U.S. 1 (1976).
PRIMARY INDUSTRY CATEGORY means any industry category listed in the NRDC settlement agreement (Natural Resources Defense
Council et al. v. Train, 8 E.R.C. 2120 (D.D.C. 1976), modified 12 E.R.C. 1833 (D.D.C. 1979)); also listed in appendix A of part 122.
PRIVATELY OWNED TREATMENT WORKS means any device or system which is (1) used to treat wastes from any facility whose
operator is not the operator of the treatment works and (2) not a "POTW."
PROCESS WASTEWATER means any water which, during manufacturing or processing, comes into direct contact with or results from the
production or use of any raw material, intermediate product, finished product, byproduct, or waste product.
PROPOSED PERMIT means a state NPDES "permit" prepared after the close of the public comment period (and, when applicable, any
public hearing and administrative appeals) which is sent to EPA for review before final issuance by the State. A "proposed permit" is not a
"draft permit."
PUBLICLY OWNED TREATMENT WORKS or POTW (defined at § 403.3) means a treatment works as defined by CWA Section 212,
which is owned by a state or municipality (as defined by CWA Section 502(4)). This definition includes any devices or systems used in the
storage, treatment, recycling, and reclamation) of municipal sewage or industrial wastes of a liquid nature. This definition also includes
sewers, pipes, and other conveyances only if they convey wastewater to a POTW. The term also means the municipality as defined in
CWA Section 502(4), which has jurisdiction over the indirect discharges to and the discharges from such a treatment works.
REGIONAL ADMINISTRATOR means the Regional Administrator of the appropriate Regional Office of the Environmental Protection
Agency or the authorized representative of the Regional Administrator.
ROCK CRUSHING AND GRAVEL WASHING FACILITIES (defined at § 122.27) means facilities which process crushed and broken
stone, gravel, and riprap (See 40 CFR 436, subpart B, including the effluent limitations guidelines).
SCHEDULE OF COMPLIANCE means a schedule of remedial measures included in a "permit", including an enforceable sequence of
interim requirements (for example, actions, operations, or milestone events) leading to compliance with the CWA and regulations.
SECONDARY INDUSTRY CATEGORY means any industry category which is not a primary industry category.
SEWAGE FROM VESSELS means human body wastes and the wastes from toilets and other receptacles intended to receive or retain
body wastes that are discharged from vessels and regulated under section 312 of the CWA, except that with respect to commercial
vessels on the Great Lakes this term includes graywater. For the purposes of this definition, "graywater" means galley, bath, and shower
water.
SEWAGE SLUDGE means any solid, semi -solid, or liquid residue removed during the treatment of municipal waste water or domestic
sewage. Sewage sludge includes, but is not limited to, solids removed during primary, secondary, or advanced waste water treatment,
scum, septage, portable toilet pumpings, type III marine sanitation device pumpings (33 CFR 159), and sewage sludge products. Sewage
sludge does not include grit or screenings, or ash generated during the incineration of sewage sludge.
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FORM 1—GLOSSARY CONTINUED
SILVICULTURAL POINT SOURCE (defined at § 122.27) means any discernible, confined, and discrete conveyance related to rock
crushing, gravel washing, log sorting, or log storage facilities which are operated in connection with silvicultural activities and from which
pollutants are discharged into waters of the United States. This term does not include non -point source silvicultural activities such as
nursery operations, site preparation, reforestation and subsequent cultural treatment, thinning, prescribed burning, pest and fire control,
harvesting operations, surface drainage, or road construction and maintenance from which there is natural runoff. However, some of these
activities (such as stream crossing for roads) may involve point source discharges of dredged or fill material which may require a CWA
Section 404 permit (see 33 CFR 209.120 and part 233).
SITE means the land or water area where any "facility or activity" is physically located or conducted, including adjacent land used in
connection with the facility or activity.
SLUDGE -ONLY FACILITY means any "treatment works treating domestic sewage" whose methods of sewage sludge use or disposal are
subject to regulations promulgated pursuant to section 405(d) of the CWA and is required to obtain a permit under § 122.1(b)(2).
STANDARDS FOR SEWAGE SLUDGE USE OR DISPOSAL means the regulations promulgated pursuant to section 405(d) of the CWA
which govern minimum requirements for sludge quality, management practices, and monitoring and reporting applicable to sewage sludge
or the use or disposal of sewage sludge by any person.
STATE means any of the 50 States, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Virgin Islands, American
Samoa, the Commonwealth of the Northern Mariana Islands, the Trust Territory of the Pacific Islands, or an Indian Tribe as defined in
these regulations which meets the requirements of § 123.31 of this chapter.
STATE DIRECTOR means the chief administrative officer of any State or interstate agency operating an "approved program," or the
delegated representative of the State Director. If responsibility is divided among two or more State or interstate agencies, "State Director"
means the chief administrative officer of the State or interstate agency authorized to perform the particular procedure or function to which
reference is made.
STORMWATER (or STORM WATER) (defined at § 122.26(b)(13)) means stormwater runoff, snow melt runoff, and surface runoff and
drainage.
STORMWATER DISCHARGE ASSOCIATED WITH INDUSTRIAL ACTIVITY (defined at § 122.26(b)(14)) means the discharge from any
conveyance that is used for collecting and conveying stormwater and that is directly related to manufacturing, processing or raw materials
storage areas at an industrial plant. The term does not include discharges from facilities or activities excluded from the NPDES program
under this part 122. For the categories of industries identified in this section, the term includes, but is not limited to, stormwater discharges
from industrial plant yards; immediate access roads and rail lines used or traveled by carriers of raw materials, manufactured products,
waste material, or by-products used or created by the facility; material handling sites; refuse sites; sites used for the application or disposal
of process waste waters (as defined at 40 CFR 401); sites used for the storage and maintenance of material handling equipment; sites
used for residual treatment, storage, or disposal; shipping and receiving areas; manufacturing buildings; storage areas (including tank
farms) for raw materials, and intermediate and final products; and areas where industrial activity has taken place in the past and significant
materials remain and are exposed to stormwater. For the purposes of this paragraph, material handling activities include storage, loading
and unloading, transportation, or conveyance of any raw material, intermediate product, final product, by-product or waste product. The
term excludes areas located on plant lands separate from the plant's industrial activities, such as office buildings and accompanying
parking lots as long as the drainage from the excluded areas is not mixed with stormwater drained from the above described areas.
Industrial facilities (including industrial facilities that are federally, State, or municipally owned or operated that meet the description of the
facilities listed in paragraphs 1 through 14 below) include those facilities designated under the provisions of 40 CFR 122.26(a)(1)(v). The
following categories of facilities are considered to be engaging in "industrial activity" for purposes of 40 CFR 122.26(b)(14):
1 Facilities subject to stormwater effluent limitations guidelines, new source performance standards, or toxic pollutant effluent standards
under 40 CFR Subchapter N (except facilities with toxic pollutant effluent standards which are exempted under paragraph 11 below);
2. Facilities classified as Standard Industrial Classification 24, Industry Group 241 that are rock crushing, gravel washing, log sorting, or
log storage facilities operated in connection with silvicultural activities defined in 40 CFR 122.27(b)(2)—(3) and Industry Groups 242
through 249; 26 (except 265 and 267), 28 (except 283), 29, 311, 32 (except 323), 33, 3441, 373; (not included are all other types of
silvicultural facilities);
3. Facilities classified as Standard Industrial Classifications 10 through 14 (mineral industry) including active or inactive mining
operations (except for areas of coal mining operations no longer meeting the definition of a reclamation area under 40 CFR 434.11(1)
because the performance bond issued to the facility by the appropriate SMCRA authority has been released, or except for areas of
non —coal mining operations which have been released from applicable State or Federal reclamation requirements after
December 17, 1990) and oil and gas exploration, production, processing, or treatment operations, or transmission facilities that
discharge stormwater contaminated by contact with or that has come into contact with, any overburden, raw material, intermediate
products, finished products, byproducts or waste products located on the site of such operations; (inactive mining operations are
mining sites that are not being actively mined, but which have an identifiable owner/operator; inactive mining sites do not include sites
1-15
FORM 1-GLOSSARY CONTINUED
where mining claims are being maintained prior to disturbances associated with the extraction, beneficiation, or processing of mined
materials, nor sites where minimal activities are undertaken for the sole purpose of maintaining a mining claim);
4. Hazardous waste treatment, storage, or disposal facilities, including those that are operating under interim status or a permit under
subtitle C of RCRA;
5. Landfills, land application sites, and open dumps that receive or have received any industrial wastes (waste that is received from any
of the facilities described under this subsection) including those that are subject to regulation under subtitle D of RCRA;
6. Facilities involved in the recycling of materials, including metal scrapyards, battery reclaimers, salvage yards, and automobile
junkyards, including but limited to those classified as Standard Industrial Classification 5015 and 5093;
7. Steam electric power generating facilities, including coal handling sites;
8. Transportation facilities classified as Standard Industrial Classifications 40, 41, 42 (except 4221-25), 43, 44, 45, and 5171 which have
vehicle maintenance shops, equipment cleaning operations, or airport deicing operations. Only those portions of the facility that are
either involved in vehicle maintenance (including vehicle rehabilitation, mechanical repairs, painting, fueling, and lubrication),
equipment cleaning operations, airport deicing operations, or which are otherwise identified under paragraphs 1-7 or 9-11 are
associated with industrial activity;
9. Treatment works treating domestic sewage or any other sewage sludge or wastewater treatment device or system, used in the
storage treatment, recycling, and reclamation of municipal or domestic sewage, including land dedicated to the disposal of sewage
sludge that are located within the confines of the facility, with a design flow of 1.0 mgd or more, or required to have an approved
pretreatment program under 40 CFR 403. Not included are farm lands, domestic gardens or lands used for sludge management
where sludge is beneficially reused and which are not physically located in the confines of the facility, or areas that are in compliance
with section 405 of the CWA;
10. Construction activity including clearing, grading and excavation, except operations that result in the disturbance of less than five acres
of total land area. Construction activity also includes the disturbance of less than five acres of total land area that is a part of a larger
common plan of development or sale if the larger common plan will ultimately disturb five acres or more;
11. Facilities under Standard Industrial Classifications 20, 21, 22, 23, 2434, 25, 265, 267, 27, 283, 285, 30, 31 (except 311), 323, 34
(except 3441), 35, 36, 37 (except 373), 38, 39, and 4221-25.
TOXIC POLLUTANT means any pollutant listed as toxic under section 307(a)(1) or, in the case of "sludge use or disposal practices," any
pollutant identified in regulations implementing section 405(d) of the CWA.
TREATMENT WORKS TREATING DOMESTIC SEWAGE (TWTDS) means a POTW or any other sewage sludge or waste water
treatment devices or systems, regardless of ownership (including federal facilities), used in the storage, treatment, recycling, and
reclamation of municipal or domestic sewage, including land dedicated for the disposal of sewage sludge. This definition does not include
septic tanks or similar devices. For purposes of this definition, "domestic sewage" includes waste and waste water from humans or
household operations that are discharged to or otherwise enter a treatment works. In States where there is no approved State sludge
management program under section 405(f) of the CWA, the Regional Administrator may designate any person subject to the standards for
sewage sludge use and disposal in 40 CFR 503 as a "treatment works treating domestic sewage," where he or she finds that there is a
potential for adverse effects on public health and the environment from poor sludge quality or poor sludge handling, use or disposal
practices, or where he or she finds that such designation is necessary to ensure that such person is in compliance with 40 CFR 503.
UPSET (defined at § 122.41(n)) means an exceptional incident in which there is unintentional and temporary noncompliance with
technology based permit effluent limitations because of factors beyond the reasonable control of the permittee. An upset does not include
noncompliance to the extent caused by operational error, improperly designed treatment facilities, inadequate treatment facilities, lack of
preventive maintenance, or careless or improper operation.
VARIANCE means any mechanism or provision under section 301 or 316 of the CWA or under 40 CFR 125, or in the applicable "effluent
limitations guidelines" which allows modification to or waiver of the generally applicable effluent limitation requirements or time deadlines of
the CWA. This includes provisions which allow the establishment of alternative limitations based on fundamentally different factors or on
sections 301(c), 301(g), 301(h), 301(i), or 316(a) of the CWA.
WATERS OF THE UNITED STATES as defined at § 122.2.
WHOLE EFFLUENT TOXICITY (WET) means the aggregate toxic effect of an effluent measured directly by a toxicity test.
1-16
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
Form
1
NPDES
V%EPA
U.S. Environmental Protection Agency
Application for NPDES Permit to Discharge Wastewater
GENERAL INFORMATION
co
Activities Requiring an NPDES Permit o
0
1. ACTIVITIES
1.1
REQUIRING AN NPDES PERMIT (40 CFR 122.21(f) and (f)(1))
Applicants Not Required to Submit Form 1
1.1.1
Is the facility a new or existing publicly
treatment works?
If yes, STOP. Do NOT complete
Form 1. Complete Form 2A.
owned
1 1 2
Is the facility a new
treating domestic
If yes, STOP. Do NOT
complete Form 1.
Form 2S.
or existing treatment works
sewage?
✓ No
✓ No
Complete
1.2
Applicants Required to Submit Form 1
1.2.1
Is the facility a concentrated animal
operation or a concentrated aquatic
production facility?
Yes 4 Complete Form 1
and Form 2B.
feeding
animal
1.2.2
Is the facility an existing
commercial, mining,
currently discharging
Yes 4 Complete
1 and
manufacturing,
or silvicultural facility that is
process wastewater?
✓ No
Form ✓ No
Form 2C.
1.2.3
Is the facility a
mining, or silvicultural
commenced to
new manufacturing, commercial,
facility that has not yet
discharge?
Complete Form 1 No
and Form 2D.
1.2.4
Is the facility a new
commercial, mining,
discharges only nonprocess
❑ Yes 4 Complete
1 and
or existing manufacturing,
or silvicultural facility that
wastewater?
✓ Yes 4
Form i No
Form 2E.
1.2.5
Is the facility a new or existing facility
discharge is composed entirely of stormwater
associated with industrial activity
discharge is composed of both stormwater
non-stormwater?
Yes 4 Complete Form 1
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x) or
b 15 .
whose
or whose
and
✓ No
Name, Mailing Address, and Location
2. NAME,
MAILING ADDRESS, AND LOCATION (40 CFR 122.21(f)(2))
Facility Name
2.1
Surf City Water Treatment Plant
2.2
EPA Identification Number
110012842843
2.3
Facility Contact
Name (first and last)
David Price
Title
Director of Utilities
Phone number
(910) 329-1055
Email address
dprice@surfcitync.gov
2.4
Facility Mailing Address
Street or P.O. box
P.O. 2475
City or town
Surf City
State
NC
ZIP code
28445
EPA Form 3510-1 (revised 3-19)
Page 1
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
m m Name, Mailing Address,
Operator Information o SIC and NAILS Codes and Location Continued
0 0
2.5
Facility Location
Street, route number, or other specific identifier
102 H2o PI,.
County name
Pender
County code (if known)
071
City or town
Surf City
State
NC
ZIP code
28445
3. SIC
AND NAICS CODES (40 CFR 122.21(f)(3))
3.1
SIC Code(s)
Description (optional)
4941
Water Supply
3.2
NAICS Code(s)
Description (optional)
221310
Water Supply and Irrigation Systems
4. OPERATOR
INFORMATION (40 CFR
122.21(f)(4))
4.1
Name of Operator
Zachary C. Butler
4.2
Is the name
❑ Yes
you listed in Item 4.1 also the owner?
' No
4.3
Operator Status
❑ Public —federal
' Public —state ❑ Other public (specify)
❑ Private ❑ Other (specify)
Phone Number of Operator
4.4
(910) 329-1055
Indian m Operator Information
Land -I Continued
0
4.5
Operator Address
Street or P.O. Box
P.O. Box 2475
City or town
Surf City
State
NC
ZIP code
28445
Email address of operator
zbutler@surfcitync.gov
5. INDIAN
LAND (40 CFR 122.21(f)(5))
5.1
Is the facility
❑ Yes
located on Indian Land?
' No
EPA Form 3510-1 (revised 3-19)
Page 2
EPA Identification Number
110012842843
NPDES Permit Number Facility Name
Surf City Water Treatment Plant
SECTION 6. EXISTING ENVIRONMENTAL PERMITS (40 CFR 122.21(f)(6))
Form Approved 03/05/19
OMB No. 2040-0004
6.1 Existing Environmental Permits (check all that apply and print or type the corresponding permit number for each)
❑ NPDES (discharges to surface ❑ RCRA (hazardous wastes) ❑ UIC (underground injection of
water) fluids)
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
❑ Ocean dumping (MPRSA)
SECTION 7. MAP (40 CFR 122.21(f)(7))
o
❑ Dredge or fill (CWA Section 404)
❑ Other (specify)
Drinking Water PWSID #04-71-
7.1 Have you attached a topographic map containing all required information to this application? (See instructions for
specific requirements.)
❑ Yes ❑ No ❑ CAFO—Not Applicable (See requirements in Form 2B.)
SECTION 8. NATURE OF BUSINESS (40 CFR 122.21(f)(8))
Nature of Business
8.1 Describe the nature of your business.
The facility is a drinking water treatment plant. Groundwater is withdrawn from the Castle Hayne aquifer. It is
treated for drinking using aeration, oxidation with NaMn04 and NaOCI, manganese greensand filtration, cation
exchange softening, chloramination, and corrosion control. The brine process wastewater produced is proposed to
be discharged following dechlorination.
SECTION 9. COOLING WATER INTAKE STRUCTURES (40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
❑ Yes ❑s No 4 SKIP to Item 10.1.
9.2 Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122.21(r). Consult with your
NPDES permitting authority to determine what specific information needs to be submitted and when.)
SECTION 10. VARIANCE REQUESTS (40 CFR 122.21(f)(10))
Variance Requests
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)? (Check all that
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors (CWA ❑ Water quality related effluent limitations (CWA Section
Section 301(n)) 302(b)(2))
❑ Non -conventional pollutants (CWA ❑ Thermal discharges (CWA Section 316(a))
Section 301(c) and (g))
❑✓ Not applicable
EPA Form 3510-1 (revised 3-19) Page 3
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
SECTION 11. CHECKLIST AND CERTIFICATION STATEMENT (40 CFR 122.22(a) and (d))
Checklist and Certification Statement
11.1
In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1
Column 2
✓
Section 1: Activities Requiring an NPDES Permit
❑ w/ attachments
✓
Section 2: Name, Mailing Address, and Location
❑ wl attachments
✓
Section 3: SIC Codes
❑ wl attachments
✓
Section 4: Operator Information
❑ w/ attachments
1
Section 5: Indian Land
❑ w/ attachments
✓
Section 6: Existing Environmental Permits
❑ w/ attachments
1
Section 7: Map✓
w/ topographic
map ❑ w/ additional attachments
1
Section 8: Nature of Business
❑ wl attachments
1
Section 9: Cooling Water Intake Structures
❑ w/ attachments
✓
Section 10: Variance Requests
❑ wl attachments
✓ Section 11: Checklist and Certification Statement
❑ wl attachments
11.2
Certification Statement
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 submitted 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 (print or type first and last name)
David Price
Official title
Director of Utilities
Signature
eci/ii,...,,,.
Date signed
EPA Form 3510-1 (revised 3-19)
Page 4
Print All Pages
Print Form Only
r.EPA
United States
Environmental Protection Agency
Office of Water
Washington, D.C.
EPA Form 3510-2D
Revised March 2019
Water Permits Division
Application Form 2D
New Manufacturing,
Commercial, Mining, and
Silvicultural Operations That
Have Not Yet Commenced
Discharge of Process
Wastewater
NPDES Permitting Program
Note: Complete this form and Form 1 if your facility is a new manufacturing, commercial, mining, or
silvicultural facility that has yet to commence discharge of process wastewater.
Paperwork Reduction Act Notice
The U.S. Environmental Protection Agency estimates the average burden to complete Form 2D to
average 31.5 hours for some minor facilities and 45.5 hours for some major facilities, with a weighted
average for major and minor facilities of 32.7 hours per response. This estimate includes time for
reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and
completing and reviewing the collection of information. Send comments about the burden estimate or
any other aspect of this collection of information to the Chief, Information Policy Branch (PM-223),
U.S. Environmental Protection Agency, 1200 Pennsylvania Avenue, NW, Washington, DC 20460, and
to the Office of Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street,
NW, Washington, DC 20503, marked "Attention: Desk Officer for EPA."
FORM 2D—INSTRUCTIONS
General Instructions
Who Must Complete Form 2D?
You must complete Form 2D if you answered "Yes" to Item 1.2.3 on
Form 1—that is, if you are a new manufacturing, commercial,
mining, or silvicultural facility that has yet to commence discharge
of process wastewater.
Where to File Your Completed Forms?
Submit your completed application package (Forms 1 and 2D) to
your National Pollutant Discharge Elimination System (NPDES)
permitting authority. Consult Exhibit 1-1 of Form 1's "General
Instructions" to identify your NPDES permitting authority.
Public Availability of Submitted Information
The U.S. Environmental Protection Agency (EPA) will make
information from NPDES permit application forms available to the
public for inspection and copying upon request. You may not claim
any information on Form 2D (or related attachments) as
confidential.
You may make a claim of confidentiality for any information that you
submit to EPA that goes beyond the information required by Form
2D. Note that NPDES permitting authorities will deny claims for
treating any effluent data (estimated or actual) as confidential. If
you do not assert a claim of confidentiality at the time you submit
your information to the NPDES permitting authority, EPA may make
the information available to the public without further notice to you.
EPA will handle claims of confidentiality in accordance with the
Agency's business confidentiality regulations at Part 2 of Title 40 of
the Code of Federal Regulations (CFR).
Completion of Forms
Print or type in the specified areas only. If you do not have enough
space on the form to answer a question, you may continue on
additional sheets, as necessary, using a format consistent with the
form.
Provide your EPA Identification Number from the Facility Registry
Service and facility name at the top of each page of Form 2D and
any attachments. If you do not know your EPA Identification
Number, contact your NPDES permitting authority. See Exhibit 1-1
of Form 1's "General Instructions" for contact information.
Additionally, for Tables A through E, provide the applicable outfall
number at the top of each page.
Do not leave any response areas blank unless the form directs you
to skip them. If the form directs you to respond to an item that does
not apply to your facility or activity, enter "NA" for "not applicable" to
show that you considered the item and determined a response was
not necessary for your facility.
The NPDES permitting authority will consider your application
complete when it and any supplementary material are received and
completed according to the authority's satisfaction. The NPDES
permitting authority will judge the completeness of any application
independently of the status of any other permit application or permit
for the same facility or activity.
Follow-up Requirements
Form 2D requires that you submit estimated data on your
effluent. Note that no later than 24 months after you commence
discharging from the proposed facility, you must complete and
submit Section 7 of NPDES Application Form 2C [see
requirements at 40 CFR 122.21(g)(7)]. However, you need not
complete those portions of Section 7 that require tests you have
already performed under the discharge monitoring requirements
of your NPDES permit.
Definitions
The legal definitions of all key terms used in these instructions
and Form 2D are in the "Glossary" at the end of the "General
Instructions" in Form 1.
Line -by -Line Instructions
Section 1. Expected Outfall Location
Item 1.1. Identify each of the facility's outfall structures by
number. For each outfall, specify the latitude and longitude to the
nearest 15 seconds and name of the receiving water. The
application form provides reporting space for three outfalls. If
your facility has more than this number, attach additional sheets
as necessary. The location of each outfall (i.e., where the
coordinates are collected) shall be the point where the discharge
is released into a water of the United States. Latitude and
longitude coordinates may be obtained in a variety of ways,
including use of hand held devices (e.g., a GPS enabled
smartphone), internet mapping tools (e.g.,
https://mynasadata.larc.nasa.gov/latitudelongitude-finder/),
geographic information systems (e.g., ArcView), or paper maps
from trusted sources (e.g., U.S. Geological Survey or USGS).
For further guidance, refer to
http://www.epa.qov/geospatial/latitudelongitude-data-standard.
Section 2. Expected Discharge Date
Item 2.1. Report the expected date the facility will commence
discharging (month, day, and year).
Section 3. Average Flows and Treatment
Item 3.1. For each outfall, report the operations expected to
contribute wastewater to the effluent and an estimated average
flow from each. Briefly describe the planned wastewater
treatment for each operation or list the applicable treatment
code(s) from Exhibit 2D-1, located at the end of these
instructions. Finally, for each operation, note the ultimate
disposal of any solid or liquid wastes not expected to be
discharged.
Section 4. Line Drawing
Item 4.1. Attach a line drawing showing the expected water flow
through your facility, from intake to discharge. Indicate the
sources of intake water (e.g., city, well, stream, other); all
sources of wastewater contributing to the effluent, including
process and production areas, sanitary flows, cooling water, and
stormwater runoff; and labeled treatment units. You may group
similar operations into a single unit.
2D-1
FORM 2D—INSTRUCTIONS CONTINUED
Construct a water balance on the line drawing by showing average
flows (specify units) between intakes, operations, treatment units,
and outfalls. Show all significant losses of water to products, the
atmosphere, and discharge. You should use your best estimate. If
you cannot determine a water balance for your activities (such as
mining activities), provide a pictorial description of the nature and
amount of any sources of water and any collection and treatment
measures. An example of an acceptable line drawing is provided in
Exhibit 2D-2 at the end of these instructions.
Section 5. Intermittent or Seasonal Flows
Item 5.1. Specify whether any of the expected discharges
described in Sections 1 and 3 will be intermittent or seasonal. If
yes, continue to Item 5.2. If no, skip to Section 6.
Item 5.2. List applicable outfalls that will have intermittent or
seasonal flows. For each, indicate the operations that will contribute
to the flow. For each operation, indicate the average days per week
and average months per year the discharge will occur, the
maximum daily flow rate, the maximum total volume, and the
duration of the discharge in days. The estimated flow rate and
volume should not include stormwater runoff, spillage, or leaks. A
discharge is intermittent if it occurs with interruptions during the
operating hours of the facility. Discharges caused by routine
maintenance shutdowns, process changes, or other similar
activities are not considered to be intermittent. A discharge is
seasonal if it occurs only during certain parts of the year. The
frequency is the average recurrence rate of the discharge (in days
per week and months per year). The duration is the average value
of the time duration during which the discharge occurs (in days).
The maximum daily flow rate is the highest daily value and should
be reported in million gallons per day (mgd). Maximum total volume
means the total volume of any one discharge within 24 hours and is
measured in units such as gallons.
Section 6. Production
Item 6.1. Indicate whether any effluent limitation guidelines (ELGs)
promulgated under Section 304 of the Clean Water Act (CWA)
apply to your facility. All ELGs promulgated by EPA appear in the
Federal Register and are published annually in 40 CFR
Subchapter N. An ELG applies if you have any operations
contributing process wastewater in any subcategory covered by
New Source Performance Standards (NSPS). If you are unsure
whether you are covered by a promulgated ELG, consult your
NPDES permitting authority (see Exhibit 1-1 of Form 1's "General
Instructions"). You must check "Yes" if an applicable ELG has been
promulgated, even if the ELG is being contested in court. If you
believe that a promulgated ELG has been remanded for
reconsideration by a court and does not apply to your operations,
you may answer "No" to item 6.1 and skip to Section 7.
Item 6.2. Complete Item 6.2 by indicating the applicable ELG
category, ELG subcategory, and corresponding regulatory citation.
See the example below.
Applicable ELGs
6.2
ELG Category
ELG
Subcategory
Regulatory
Citation
Pulp, Paper,
and
Paperboard
Point Source
Category
Secondary
Fiber Non-
Deink
Subcategory
40 CFR 430,
Subpart J
Item 6.3. Indicate whether the limitations in the applicable ELGs
are expressed in terms of production (or other measure of
operation). An ELG is expressed in terms of production (or
another measure of operation) if the limitation is expressed as
mass of pollutant per operational parameter (e.g., "pounds of
biological oxygen demand per cubic foot of logs from which bark
is removed," or "pounds of total suspended solids per megawatt
hour of electrical energy consumed by smelting furnace."). An
example of an ELG not expressed in terms of a measure of
operation is one that limits the concentration of pollutants. If you
answer "No" to this item, skip to Section 7.
Item 6.4. For each applicable outfall to which an applicable
production -based ELG applies, list the estimated level of
production (projection of actual production level, not design), for
each of the first three years of operation. The estimated
production level must be a long-term average estimate (e.g.,
average production on an annual basis). If production will vary
depending on long-term shifts in operating schedule or capacity,
you may report alternative production estimates, but you must
provide the basis for such alternatives. If known, report
quantities in units of measurements used in the applicable ELG.
If an ELG specifies a method for estimating production, you must
follow that method.
Section 7. Effluent Characteristics and Tables A through E
General Information. Section 7 requires you to report estimated
flow data for the parameters and pollutants listed in Tables A
through E, located at the end of Form 2D. You are not required
to conduct actual sampling and analysis at this time. If, however,
data from such analyses are available, you must report those
data. Note that no later than 24 months after you begin
discharging from the proposed facility, you must complete and
submit quantitative data for the pollutants and parameters in
Tables A through E. However, you need not report results for
tests you have already performed and reported under the
discharge monitoring requirements of your NPDES permit.
Complete a set of tables (Tables A through E) for each outfall at
your facility. Be sure to note the EPA Identification Number,
facility name, and outfall number at the top of each table page
and any associated attachments.
Tables A through D require you to report estimated effluent data,
with some exceptions, as discussed further below. Base your
estimates on available in-house or contractors' engineering
reports or any other studies performed on the proposed facility.
Table E requires you to report quantitative data for the pollutants
listed, but only if it is already available.
Several tables require you to provide estimates for pollutants you
believe will be present in your discharge or will be limited directly
by an ELG or indirectly through promulgated limitations on an
2D-2
FORM 2D—INSTRUCTIONS CONTINUED
indicator pollutant. Base your determination of whether a
pollutant will be present in your discharge on your knowledge of
the proposed facility's raw materials, maintenance chemicals,
intermediate and final products, byproducts, and any analyses of
any pollutant (you are required to report it).
For those pollutants you believe will be present in the discharge,
you are to provide the maximum daily and average daily
concentration and total mass and the source of the information.
Use the following codes to report your source information:
Data Source
Code
Engineering report
1
Actual data from pilot plants
1
Estimates from other engineering
reports
2
Data from other similar plants
3
Best professional estimates
4
Others
5 and specify on
the table
You may report some or all of your estimates (or actual data
when available) by attaching separate sheets of paper instead
of completing Tables A through E for each of your outfalls, so
long as the sheets contain all of the required information and
are similar in format to Tables A through E.
Reporting of Intake Data
If you expect a pollutant to be present solely because of its
presence in your intake water, you must mark "Yes" under the
"Intake Water" column of Tables A through D. If you wish to
obtain -credits for pollutants or parameters present in your
intake water, insert a separate sheet with a short statement of
why you believe you are eligible (see 40 CFR 122.45(g)).
Reporting of Effluent Data
Report all estimated pollutant or parameter levels as
concentration and as total mass, with the exception of discharge
flow, temperature, and pH.
Use the following abbreviations in the columns requiring "units"
in Tables A through E.
Concentration
Mass
ppm = parts per million
mg/L = milligrams per liter
ppb = parts per billion
pg/L = micrograms per liter
MPN = most probable number
per 100 milliliters
Ibs = pounds
ton = tons (English tons)
mg = milligrams
g = grams
kg = kilograms
T = tonnes (metric tons)
Conventional and Non -Conventional Parameters
Item 7.1 and Table A. All applicants are required to complete
Table A for each outfall, including outfalls discharging only
noncontact cooling water or nonprocess water unless a waiver
has been received or requested from the NPDES permitting
authority. For each parameter listed on Table A, indicate
whether a waiver has been requested. If you have requested a
waiver for all pollutants for a given outfall, check the box indicating
this at the top of Table A.
To request a waiver, submit a written request to the NPDES
permitting authority in advance or with the permit application. The
written request should specify the parameters that should be waived
and for what outfall(s) and why. The NPDES permitting authority
may waive Table A requirements upon a determination that less
stringent reporting requirements are adequate to support issuance
of an NPDES permit. Attach a copy of any waiver approval notice(s)
received, if applicable, to this application.
Answer Item 7.1 by indicating if you are requesting a waiver for any
of your outfalls. If yes, continue to Item 7.2. Otherwise, complete
Table A by estimating your maximum daily and average daily
discharge. Provide the source(s) of your information. Also on
Table A, indicate whether you believe each of the parameters will
be present in the facility's intake water. See "Reporting of Intake
Data" above for further information. Skip to Item 7.3.
Item 7.2. Indicate the outfalls for which you have requested a
waiver.
Item 7.3. Indicate if you have provided estimates or actual data for
all Table A parameters for each of your outfalls for which a waiver
has not been requested and attach the results to your application
package.
Certain Conventional and Non -Conventional Pollutants
Items 7.4 through 7.6 and Table B. Complete one table for each
outfall, including outfalls discharging only noncontact cooling water
or nonprocess wastewater. Check the box at the top of Table B if
you believe all pollutants listed will be absent in the discharge. If so,
you do not need to complete Table B for the noted outfall. (You still
need to complete Items 7.4 through 7.6.) Otherwise, for each
pollutant listed in Table B, indicate whether you expect it will be
present or absent in the discharge or whether the pollutant is limited
directly by an ELG or indirectly through promulgated limitations or
an indicator pollutant. (For example, total suspended solids is used
as an indicator to control the discharge of iron and aluminum.) Next,
provide an estimated maximum daily and average daily value,
including the source of the information. If you have quantitative data
available, report it. Also on Table B, indicate whether you believe
the listed pollutants will be present in the facility's intake water. See
"Reporting of Intake Data" above for further information. Answer
"Yes" to Items 7.4 through 7.6 once you have completed the above
tasks.
Toxic Metals, Total Cyanide, and Total Phenols
Items 7.7 and 7.8 and Table C. Complete one table for each
outfall, including outfalls discharging only noncontact cooling water
or nonprocess wastewater. Check the box at the top of Table C if
you believe all pollutants listed will be absent in the discharge. If so,
you do not need to complete Table C for the noted outfall (unless
you have quantitative data available). You still need to respond to
Items 7.7 and 7.8, however. Otherwise, indicate whether you
believe each pollutant on Table C will be present or absent in your
discharge for each applicable outfall. For those pollutants you
2D-3
FORM 2D—INSTRUCTIONS CONTINUED
believe will be present, provide an estimated maximum daily and
average daily value and source of the information. (Provide
quantitative data if you have them available.) Also, on Table C,
indicate whether you believe the pollutant is or will be present in
your facility's intake water. See "Reporting of Intake Data" above
for more information. Answer "Yes" to Items 7.7 and 7.8 when
you have completed the above tasks.
Organic Toxic Pollutants
(Gas Chromatography/Mass Spectrometry or GC/MS
Fractions)
Item 7.9. Applicants are exempt from the reporting requirements
associated with Table D if they expect to have gross sales of
less than $100,000 per year for the next three years; also
exempt are coal mines with expected average production of less
than 100,000 tons of coal per year. If you believe you meet one
of these criteria, answer "Yes" to Item 7.9, check the small
business box at the top of Table D, and attach projected sales or
production figures. Skip to Item 7.12.
The sales or production figures must be for the facility that will
be the source of the discharge. The data should not be limited
only to production or sales for the process or processes that will
contribute to the discharge, unless those are the only processes
at the facility.
For sales data, where intra-corporate transfers of goods and
services will be involved, the transfer price per unit should
approximate market process for those goods and services as
closely as possible. If necessary, you may index your sales
figures to the second quarter of 1980 to demonstrate your
eligibility for a small business exemption. You may accomplish
this by using the gross national product price deflator (second
quarter of 1980 = 100). This index is available online from the
U.S. Department of Commerce, Bureau of Economic Analysis at
http://bea.gov/national/pdf/SNTables.pdf.
Item 7.10 and 7.11 and Table D. Complete one table for each
outfall, including outfalls discharging only noncontact cooling
water or nonprocess wastewater. Check the box at the top of
Table D if you believe all pollutants listed will be absent in the
discharge from the outfall. If so, you do not need to complete
Table D for the noted outfall (unless you have quantitative data
available). Otherwise, for each pollutant listed, indicate whether
you believe it will be present or absent in the discharge. For
those you believe will be present, provide an estimated
maximum daily and average daily value and the source of the
information. Also, on Table D, indicate whether you believe the
pollutant is or will be present in your facility's intake water. See
"Reporting of Intake Data" above for further information. Finally,
answer "Yes" to Items 7.10 and 7.11 when you have completed
the above tasks.
2,3,7,8-Tetrachlorodibenzo-p-Dioxin (TCDD)
Item 7.12. Answer whether the facility uses or manufactures one
or more of the 2,3,7,8-TCDD congeners listed below or if you
know or have reason to believe that TCDD is or may be present
in effluent from any of your outfalls:
• 2,4,5-trichlorophenoxy acetic acid (2,4,5-T) (CAS # 93-765).
• 2-(2,4,5-trichlorophenoxy) propanoic acid (Silvex, 2,4,5-TP)
(CAS # 93-72-1).
• 2-(2,4,5-trichlorophenoxy) ethyl 2,2-dichloropropionate (Erbon)
(CAS # 136-25-4).
• 0,0-dimethyl 0-(2,4,5-trichlorophenyl) phosphorothioate
(Ronnel) (CAS # 299-84-3).
• 2,4,5-trichlorophenol (TCP) (CAS # 95-95-4).
• Hexachlorophene (HCP) (CAS # 70-30-4).
Certain Hazardous Substances and Asbestos
Table E. Complete Table E for each outfall. Check the box at the
top of Table E if you believe all pollutants listed will be absent in the
discharge. Otherwise, for each pollutant listed in Table E, indicate
whether you believe it will be present or absent in the discharge. If
you have quantitative estimates available for any of the pollutants
listed, provide the maximum daily and average daily average value
and the source of the information. Also, on Table E, if you believe
the pollutant is or will be present in your facility's intake water, state
so in the "Reason Pollutant Believed Present in Discharge" column.
Item 7.13. Indicate whether, for each of your outfalls, you have
indicated whether you know or have reason to believe that any
pollutants listed in Table E are discharged.
Item 7.14. Indicate whether, for each of your outfalls, you have
completed and attached Table E to the application describing the
reasons the applicable pollutants are expected to be discharged
and providing quantitative data if available.
Under 40 CFR 117.12(a)(2), certain discharges of hazardous substances
(listed in Exhibit 2D-3 at the end of these instructions) may be exempted from
the requirements of Section 311 of the CWA, which establishes reporting
requirements, civil penalties, and liability for cleanup costs for spills of oil and
hazardous substances. A discharge of a particular substance can be exempted
if the origin, source, and amount of the discharged substances are identified in
the NPDES permit application or in the permit, if the permit contains a
requirement for treatment of the discharge, and if the treatment is in place.
Exemptions are allowed from the requirements of CWA Section 311.
Applications for exemptions must set forth the following information:
1. The substance and the amount of each substance that may be discharged.
2. The origin and source of the discharge of the substance.
3. The treatment to be provided for the discharge by:
a. An onsite treatment system separate from any treatment system
treating your normal discharge;
b. A treatment system designed to treat your normal discharge and that is
additionally capable of treating the amount of the substance identified
under paragraph 1 above; or
c. Any combination of the above.
See 40 CFR 117.12(a)(2) and (c) or contact your NPDES permitting authority
for further information on exclusions from CWA Section 311.
Intake Credits
Item 7.15. Answer whether you are seeking to obtain credits for any
of the pollutants or parameters listed in Section 7 (Tables A through
E) in your intake water for any of the facility's outfalls.
2D-4
FORM 2D—INSTRUCTIONS CONTINUED
Section 8. Engineering Report
Item 8.1. Indicate if any technical evaluations have been
conducted of your wastewater treatment, including engineering
reports or pilot plant studies. If yes, continue to Item 8.2. If no,
skip to Item 8.3.
Item 8.2. Attach the technical evaluation(s) you considered when
responding to Item 8.1 and any related documentation, then
answer "Yes" to Item 8.2. The NPDES permit writer will use this
information to determine appropriate treatment methods and
associated permit conditions and limits.
Item 8.3. Answer "Yes" if you are aware of any existing plant(s)
that resemble your production processes, wastewater
constituents, or wastewater treatment. If you are unaware of such
plants, answer "No" and skip to Section 9.
Item 8.4. Provide the name and location of any existing plant(s)
that resemble(s) your production facility. You do not need to
conduct any studies to respond to this item.
Section 9. Other Information
Item 9.1. Indicate whether you have attached to the application
any optional information that you would like considered as part of
the application review process. These should be items beyond
those you have already noted as being included in the package.
Skip to Section 10 if you do not have further information to
provide.
Item 9.2. List the additional materials attached and note why you
think the NPDES permitting authority should consider them when
reviewing your application and developing your permit.
Section 10. Checklist and Certification Statement
Item 10.1. Review the checklist provided. In column 1, mark the
sections of Form 2D that you have completed and are submitting
with your application. For each section, indicate in column 2
whether you are submitting attachments.
Item 10.2. The CWA provides for severe penalties for submitting
false information on this application form. Section 309(c)(2) of the
CWA provides that "Any person who knowingly makes any false
statement, representation, or certification in any application,
...shall upon conviction, be punished by a fine of no more than
$10,000 or by imprisonment for not more than six months or both."
FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS
APPLICATION TO BE SIGNED AS FOLLOWS:
A. For a corporation, by a responsible corporate officer. For the
purpose of this section, a responsible corporate officer
means: (1) a president, secretary, treasurer, or vice-president
of the corporation in charge of a principal business function,
or any other person who performs similar policy- or decision -
making functions for the corporation, or (2) the manager of
one or more manufacturing, production, or operating facilities,
provided the manager is authorized to make management
decisions which govern the operation of the regulated facility
including having the explicit or implicit duty of making major
capital investment recommendations, and initiating and
directing other comprehensive measures to assure long term
environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary
systems are established or actions taken to gather complete
and accurate information for permit application requirements;
and where authority to sign documents has been assigned or
delegated to the manager in accordance with corporate
procedures.
B For a partnership or sole proprietorship, by a general partner
or the proprietor, respectively.
C. For a municipality, state, federal, or other public facility, by
either a principal executive officer or ranking elected official.
For purposes of this section, a principal executive officer of a
federal agency includes: (1) The chief executive officer of the
agency, or (2) a senior executive officer having responsibility
for the overall operations of a principal geographic unit of the
agency (e.g., Regional Administrators of EPA).
END
Submit your completed Form 1, Form 2D, and
all associated attachments
(and any other required NPDES application forms)
to your NPDES permitting authority.
2D-5
1—A
1—B
1—C
1—D
1—E
1—F
1—G
1—H
1-1
1—J
1—K
1—L
2—A
2—B
2—C
2—D
2—E
2—F
3—A
3—B
3—C
3—D
Exhibit 2D-1. Codes for Treatment Units and Disposal of Wastes Not Discharged
Ammonia stripping
Dialysis
Diatomaceous earth filtration
Distillation
Electrodialysis
Evaporation
Flocculation
Flotation
Foam fractionation
Freezing
Gas -phase separation
Grinding (comminutors)
PHYSICAL TREATMENT PROCESSES
1—M
1—N
1-0
1—P
1—Q
1—R
1—S
1—T
1—U
1—V
1—W
1—X
Grit removal
Microstraining
Mixing
Moving bed filters
Multimedia filtration
Rapid sand filtration
Reverse osmosis (hyperfiltration)
Screening
Sedimentation (settling)
Slow sand filtration
Solvent extraction
Sorption
2. CHEMICAL TREATMENT PROCESSES
Carbon adsorption 2—G Disinfection (ozone)
Chemical oxidation
Chemical precipitation
Coagulation
Dechlorination
Disinfection (chlorine)
Activated sludge
Aerated lagoons
Anaerobic treatment
Nitrification—denitrification
2—H
2-1
2—J
2—K
2—L
Disinfection (other)
Electrochemical treatment
Ion exchange
Neutralization
Reduction
3. BIOLOGICAL TREATMENT PROCESSES
3—E Pre -aeration
3—F Spray irrigation/land application
3—G Stabilization ponds
3—H Trickling filtration
4—A Discharge to surface water
4—B Ocean discharge through outfall
4. OTHER PROCESSES
4—C Reuse/recycle of treated effluent
4—D Underground injection
5. SLUDGE TREATMENT AND DISPOSAL PROCESSES
5—A Aerobic digestion
5—B Anaerobic digestion
5—C Belt filtration
5—D Centrifugation
5—E Chemical conditioning
5—F Chlorine treatment
5—G Composting
5—H Drying beds
5-1 Elutriation
5—J Flotation thickening
5—K Freezing
5—L Gravity thickening
5—M Heat drying
5—N Heat treatment
5-0 Incineration
5—P Land application
5—Q Landfill
5—R Pressure filtration
5—S Pyrolysis
5—T Sludge lagoons
5—U Vacuum filtration
5—V Vibration
5—W Wet oxidation
2D-6
Exhibit 2D-2. Example Line Drawing
Blue River
190,000 GPD
45,000 GPD 145,000 GPD
Raw Materials
10,000 GPD
Solid Waste
1
4,000 GPD
Fiber
Preparation
15,000
GPD
40,000 GPD
Grit
Separator
Stormwater
36,000 GPD
Dyeing
20,000
Municipal
Water Supply
30,000 GPD
GPD
40,000 GPD
Washing
Neutralization Loss
Tank
8,000 GPD
34,000 GPD
Max: 20,000 GPD
Waste
Treatment
Plant #1
40,060
GPD
10,000
GPD
Blue River
10,000 GPD
Cooling Water
Drying
5,000 GPD
10,000
GPD
Waste
Treatment
Plant #2
Outrall 0D1
70,000 GPD + Stormwa er
Outrail 002
50,000 GPD
To Atmosphere
To Product
5,000 GPD
Schematic of Water Flow
Brown Mills, Inc_
City, County, State
2D-7
1. Acetaldehyde
2. Acetic acid
3. Acetic anhydride
4. Acetone cyanohydrin
5. Acetyl bromide
6. Acetyl chloride
7. Acrolein
8. Acrylonitrile
9. Adipic acid
10. Aldrin
11. Ally! alcohol
12. Allyl chloride
13. Aluminum sulfate
14. Ammonia
15. Ammonium acetate
16. Ammonium benzoate
17. Ammonium bicarbonate
18. Ammonium bichromate
19. Ammonium bifluoride
20. Ammonium bisulfite
21. Ammonium carbamate
22. Ammonium carbonate
23. Ammonium chloride
24. Ammonium chromate
25. Ammonium citrate
26. Ammonium fluoroborate
27. Ammonium fluoride
28. Ammonium hydroxide
29. Ammonium oxalate
30. Ammonium silicofluoride
31. Ammonium sulfamate
32. Ammonium sulfide
33. Ammonium sulfite
34. Ammonium tartrate
35. Ammonium thiocyanate
36. Ammonium thiosulfate
37. Amyl acetate
38. Aniline
39. Antimony pentachloricle
40. Antimony potassium tartrate
41. Antimony tribromide
42. Antimony trichloride
43. Antimony trifluoride
44. Antimony trioxide
45. Arsenic disulfide
46. Arsenic pentoxide
47. Arsenic trichloride
48. Arsenic trioxide
49. Arsenic trisulfide
50. Barium cyanide
51. Benzene
52. Benzoic acid
53. Benzonitrile
54. Benzoyl chloride
55. Benzyl chloride
56. Beryllium chloride
57. Beryllium fluoride
58. Beryllium nitrate
59. Butylacetate
60. n-butylphthalate
61. Butylamine
62. Butyric acid
63. Cadmium acetate
64. Cadmium bromide
65. Cadmium chloride
66. Calcium arsenate
67. Calcium arsenite
68. Calcium carbide
69. Calcium chromate
70. Calcium cyanide
71. Calcium dodecylbenzenesulfonate
72. Calcium hypochlorite
Exhibit 2D-3. Hazardous Substances
73. Captan
74. Carbaryl
75. Carbofuran
76. Carbon disulfide
77. Carbon tetrachloride
78. Chlordane
79. Chlorine
80. Chlorobenzene
81. Chloroform
82. Chloropyrifos
83. Chlorosulfonic acid
84. Chromic acetate
85. Chromic acid
86. Chromic sulfate
87. Chromous chloride
88. Cobaltous bromide
89. Cobaltous formate
90. Cobaltous sulfamate
91. Coumaphos
92. Cresol
93. Crotonaldehyde
94. Cupric acetate
95. Cupric acetoarsenite
96. Cupric chloride
97. Cupric nitrate
98. Cupric oxalate
99. Cupric sulfate
100. Cupric sulfate ammoniated
101. Cupric tartrate
102. Cyanogen chloride
103. Cyclohexane
104. 2,4-D acid (2,4-dichlorophenoxyacetic acid)
105. 2,4-D esters (2,4-dichlorophenoxyacetic acid esters)
106. DDT
107. Diazinon
108. Dicamba
109. Dichlobenil
110. Dichlone
111. Dichlorobenzene
112. Dichloropropane
113. Dichloropropene
114. Dichloropropene-dichloproropane mix
115. 2,2-dichloropropionic acid
116. Dichlorvos
117. Dieldrin
118. Diethylamine
119. Dimethylamine
120. Dinitrobenzene
121. Dinitrophenol
122. Dinitrotoluene
123. Diquat
124. Disulfoton
125. Diuron
126. Dodecylbenzesulfonic acid
127. Endosulfan
128. Endrin
129. Epichlorohydrin
130. Ethion
131. Ethylbenzene
132. Ethylenediamine
133. Ethylene dibromide
134. Ethylene dichloride
135. Ethylene diaminetetracetic acid (EDTA)
136. Ferric ammonium citrate
137. Ferric ammonium oxalate
138. Ferric chloride
139. Ferric fluoride
140. Ferric nitrate
141. Ferric sulfate
142. Ferrous ammonium sulfate
143. Ferrous chloride
144. Ferrous sulfate
145. Formaldehyde
146. Formic acid
147. Fumaric acid
148. Furfural
149. Guthion
150. Heptachlor
151. Hexachlorocyclopentadiene
152. Hydrochloric acid
153. Hydrofluoric acid
154. Hydrogen cyanide
155. Hydrogen sulfide
156. Isoprene
157. Isopropanolamine dodecylbenzenesulfonate
158. Kelthane
159. Kepone
160. Lead acetate
161. Lead arsenate
162. Lead chloride
163. Lead fluoborate
164. Lead fluorite
165. Lead iodide
166. Lead nitrate
167. Lead stearate
168. Lead sulfate
169. Lead sulfide
170. Lead thiocyanate
171. Lindane
172. Lithium chromate
173. Malathion
174. Maleic acid
175. Maleic anhydride
176. Mercaptodimethur
177. Mercuric cyanide
178. Mercuric nitrate
179. Mercuric sulfate
180. Mercuric thiocyanate
181. Mercurous nitrate
182. Methoxychlor
183. Methyl mercaptan
184. Methyl methacrylate
185. Methyl parathion
186. Mevinphos
187. Mexacarbate
188. Monoethylamine
189. Monomethylamine
190. Naled
191. Naphthalene
192. Naphthenic acid
193. Nickel ammonium sulfate
194. Nickel chloride
195. Nickel hydroxide
196. Nickel nitrate
197. Nickel sulfate
198. Nitric acid
199. Nitrobenzene
200. Nitrogen dioxide
201. Nitrophenol
202. Nitrotoluene
203. Paraformaldehyde
204. Parathion
205. Pentachlorophenol
206. Phenol
207. Phosgene
208. Phosphoric acid
209. Phosphorus
210. Phosphorus oxychloride
211. Phosphorus pentasulfide
212. Phosphorus trichloride
213. Polychlorinated biphenyls (PCB)
214. Potassium arsenate
215. Potassium arsenite
2D-8
216. Potassium bichromate
217. Potassium chromate
218. Potassium cyanide
219. Potassium hydroxide
220. Potassium permanganate
221. Propargite
222. Propionic acid
223. Propionic anhydride
224. Propylene oxide
225. Pyrethrins
226. Quinoline
227. Resorcinol
228. Selenium oxide
229. Silver nitrate
230. Sodium
231. Sodium arsenate
232. Sodium arsenite
233. Sodium bichromate
234. Sodium bifluoride
235. Sodium bisulfite
236. Sodium chromate
237. Sodium cyanide
238. Sodium dodecylbenzenesulfonate
239. Sodium fluoride
240. Sodium hydrosulfide
241. Sodium hydroxide
242. Sodium hypochlorite
243. Sodium methylate
244. Sodium nitrite
Exhibit 2D-3. Hazardous Substances
245. Sodium phosphate (dibasic)
246. Sodium phosphate (tribasic)
247. Sodium selenite
248. Strontium chromate
249. Strychnine
250. Styrene
251. Sulfuric acid
252. Sulfur monochloride
253. 2,4,5-T acid (2,4,5-trichlorophenoxyacetic acid)
254. 2,4,5-T amines (2,4,5-trichlorophenoxy acetic acid
amines)
255. 2,4,5-T esters (2,4,5-trichlorophenoxy acetic acid
esters)
256. 2,4,5-T salts (2,4,5-trichlorophenoxy acetic acid
salts)
257. 2,4,5-TP acid (2,4,5-trichlorophenoxy propanoic
acid)
258. 2,4,5-TP acid esters (2,4,5-trichlorophenoxy
propanoic acid esters)
259. TDE (tetrachlorodiphenyl ethane)
260. Tetraethyl lead
261. Tetraethyl pyrophosphate
262. Thallium sulfate
263. Toluene
264. Toxaphene
265. Trichlorofon
266. Trichloroethylene
267. Trichlorophenol
268. Triethanolamine dodecylbenzenesulfonate
269. Triethylamine
270. Trimethylamine
271. Uranyl acetate
272. Uranyl nitrate
273. Vanadium penoxide
274. Vanadyl sulfate
275. Vinyl acetate
276. Vinylidene chloride
277. Xylene
278. Xylenol
279. Zinc acetate
280. Zinc ammonium chloride
281. Zinc borate
282. Zinc bromide
283. Zinc carbonate
284. Zinc chloride
285. Zinc cyanide
286. Zinc fluoride
287. Zinc formate
288. Zinc hydrosulfite
289. Zinc nitrate
290. Zinc phenolsulfonate
291. Zinc phosphide
292. Zinc silicofluoride
293. Zinc sulfate
294. Zirconium nitrate
295. Zirconium potassium fluoride
296. Zirconium sulfate
297. Zirconium tetrachloride
2D-9
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EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
Form
2D
NPDES
.EP
U.S. Environmental Protection Agency
Application for NPDES Permit to Discharge Wastewater
NEW MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURAL OPERATIONS
THAT HAVE NOT YET COMMENCED DISCHARGE OF PROCESS WASTEWATER
SECTION 1. EXPECTED OUTFALL LOCATION (40 CFR 122.21(k)(1))
1.1
Outfall Location
Provide information on each of the facility's outfalls in the table below.
Outfall
Number
Receiving Water
Name
Latitude
Longitude
001
Topsail Sound (18-87-10)
34° 25' 51" N
77° 32' 58" W
SECTION 2. EXPECTED DISCHARGE DATE (40 CFR 122.21(k)(2))
2.1
Month
Day
Year
January
1
2022
SECTION 3. AVERAGE FLOWS AND TREATMENT (40 CFR 122.21(k)(3)(i))
3.1
Average Flows and Treatment
For each outfall identified under Item 1.1, provide average flow and treatment information. Add additional sheets as
necessary.
**Outfall Number** 001
Operations Contributing to Flow
Operation
Existing Cation Exchange Softening Brine Process Wastewater at rate of 180
GPM fnr S SR hnurc r r clay = n n71 MGr) (when WTP is at frill nrnduetinn of
Average Flow
0.071 mgd
mgd
mgd
mgd
Treatment Units
Description
(include size, flow rate through each treatment unit,
retention time, etc.)
Code from
Exhibit 2D-1
mgd
Final Disposal of Solid or Liquid
Wastes Other Than by Discharge
Existing Brine Waste Storage Basin with effective
vnluma of 33 coo aallnnc
Proposed Pump Station (180 GPM duplex)
Proposed In -Line Dechlorination
2-E
Proposed Flow Meter (in line)
Proposed Sample Tap
EPA Form 3510-2D (Revised 3-19) Page 1
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
Average Flows and Treatment Continued
3.1
Cont.
**Outfall Number**
001
Operations Contributing
to Flow
Operation
Average Flow
mgd
mgd
mgd
mgd
mgd
Treatment Units
Description
(include size, flow rate through each treatment unit,
retention time, etc.)
Code from
Exhibit 2D-1
Final Disposal of Solid or Liquid
Wastes Other Than by Discharge
Proposed Force Main and Diffuser
4-A
To Diffuser/Outfall 001 (see line
diaaraml
**Outfall Number**
Operations Contributing
to Flow
Operation
Average Flow
mgd
mgd
mgd
mgd
mgd
Treatment Units
Description
(include size, flow rate through each treatment unit,
retention time, etc.)
Code from
Exhibit 2D-1
Final Disposal of Solid or Liquid
Wastes Other Than by Discharge
EPA Form 3510-2D (Revised 3-19)
Page 2
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
SECTION
4. LINE
4.1
DRAWING (40 CFR
122.21(k)(3)(ii))
application
that shows the water flow through your facility with a water
See Exhibit 2D-2 at end of instructions for example.)
No
ah
�_ 3
J o
Have you
balance?
attached a line drawing to this
(See instructions for drawing requirements.
Yes
0
■
co co
m m
o Intermittent or Seasonal Flows o
0
5. INTERMITTENT
5.1
Except for
or seasonal?
OR SEASONAL FLOWS (40
stormwater runoff, leaks, or spills,
Yes
CFR 122.21(k)(3)(iii))
are
any expected discharges described in Sections 1 and 3 intermittent
No 4 SKIP to Section 6.
MI
■
5.2
6. PRODUCTION
6.1
Provide information on intermittent or seasonal flows for each applicable outfall. Attach additional pages, if
necessary.
Outfall
Number
Operations
(list)
Frequency
Rate and Volume
Duration
Average
Days/Week
Average
Months/Year
Maximum Daily
Discharge
Maximum Total
Volume
001
Softening
Rrina W ista
7 days/week
12 months/year
0.2592 mgd
71,064 gallons
0.2742 days
days/week
months/year
mgd
gallons
days
days/week
months/year
mgd
gallons
days
Outfall
Number
Operations
(list)
Frequency
Rate and Volume
Duration
Average
Days/Week
Average
Months/Year
Maximum Daily
Discharge
Maximum Total
Volume
days/week
months/year
mgd
gallons
days
days/week
months/year
mgd
gallons
days
days/week
months/year
mgd
gallons
days
Outfall
Number
Operations
(list)
Frequency
Rate and Volume
Duration
Average
Days/Week
Average
MonthslYear
Maximum Daily
Discharge
Maximum Total
Volume
Do any effluent
❑ Yes
days/week
months/year
mgd
gallons
days
days/week
months/year
mgd
gallons
days
(40 CFR 122.21(k)(4))
limitation
days/week
guidelines
(ELGs)
months/year
promulgated
mgd
by EPA under CWA Section
No —I SKIP to Section
gallons
304 apply to your
7.
days
facility?
Production
i
6.2
Provide the following information on applicable ELGs.
ELG Category
ELG Subcategory
Regulatory Citation
EPA Form 3510-2D (Revised 3-19)
Page 3
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
Production Continued
6.3
Are the limitations in the applicable ELGs expressed in terms of production (or other measure of operation)?
❑ Yes ❑ No 4 SKIP to Section 7.
6.4
Provide an expected measure of average daily production expressed in terms and units of applicable ELGs.
Expected Actual Average Daily Production for First Three Years
Outfall
Number
Year
Operation, Product, or Material
Quantity per Day
(note basis if applicable)
Unit of Measure
Year 1
Year2
Year 3
Year 1
Year2
Year 3
Year1
Year2
Year3
co
Effluent Characteristics o
—I
7. EFFLUENT CHARACTERISTICS (40 CFR 122.21(k)(5))
See the instructions to determine the parameters and pollutants you are
complete. Note that not all applicants need to complete each table.
required to monitor and, in turn,
the tables you must
Table A. Conventional and Non -Conventional Parameters
7.1
Are you requesting
of your outfalls?
a waiver from your NPDES permitting
authority
for one or more of the Table A parameters for any
No 4 SKIP to Item 7.3.
• Yes
13
7.2
If yes, indicate the applicable outfalls below. Attach waiver request and other required information to the application.
Outfall number Outfall number Outfall number
7.3
Have you
waiver has
have provided estimates or actual data
not been requested and attached the
for all Table A
results to this
parameters for each of your outfalls for which a
application package?
No; a waiver has been requested from my
NPDES permitting authority for all parameters at
all outfalls.
0 Yes
•
Table B. Certain Conventional and Non -Conventional Pollutants
7.4
Have you
applicable
checked "Believed Present" for all pollutants listed in Table B that are limited directly or indirectly by an
ELG?
Yes ❑ No
✓
7.5
Have you
checked "Believed Present" or "Believed Absent" for all remaining pollutants listed in Table B?
Yes ❑ No
✓
7.6
Have you
in your discharge?
provided estimated data for those Table B pollutants for which you have indicated are "Believed Present"
Yes ❑ No
✓
EPA Form 3510-2D (Revised 3-19)
Page 4
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
cn
Engineering Report o Effluent Characteristics Continued
0
Table C. Toxic Metals, Total Cyanide, and Total Phenols
7.7
Have you indicated
for all outfalls?
whether pollutants are "Believed Present" or `Believed Absent" for all pollutants listed on Table C
❑ No
✓ Yes
7.8
Have you completed
including the source
Table C by providing estimated data for pollutants you indicated are "Believed Present,"
of the information, for each applicable outfall?
❑ No
✓ Yes
Table D. Organic Toxic Pollutants (GC/MS Fractions)
7.9
Do you qualify for
Yes 4
a small business exemption under
Note that you qualify at the top
Table D, then SKIP to Item 7.12.
the criteria specified in the Instructions?
of•
p No
7.10
Have you indicated
for all outfalls?
whether pollutants are "Believed Present" or "Believed Absent" for all pollutants listed on Table D
❑ No
✓ Yes
7.11
Have you completed
including the source
Table D by providing estimated data for pollutants you indicated are "Believed Present,"
of the information, for each applicable outfall?
❑ No
✓ Yes
2,3,7,8-Tetrachlorodibenzo-p-Dioxin (TCDD)
7.12
Does the facility use or manufacture one or more
know or have reason to believe that TCDD is or
❑ Yes
of the 2,3,7,8-TCDD congeners listed
may be present in effluent from any
in the Instructions, or do you
of your outfalls?
✓ No
Table E. Certain Hazardous Substances and Asbestos
7.13
Have you indicated
for all outfalls?
whether pollutants are "Believed Present" or "Believed Absent" for all pollutants listed in Table E
❑ No
✓ Yes
7.14
Have you completed
quantitative data for
Table E by reporting the reason the pollutants are expected to be present and available
pollutants you indicated are "Believed Present" for each applicable outfall?
❑ No
✓ Yes
Intake Credits, Tables A through E
7.15
Are you applying for net credits for the presence
outfalls?
❑ Yes 4 Consult with your NPDES permitting
authority.
of any of the pollutants on Tables
A through E for any of your
✓ No
8. ENGINEERING
REPORT
(40 CFR 122.21(k)(6))
technical evaluations of your wastewater treatment, including engineering reports or pilot plant
❑ No 4 SKIP to Item 8.3.
8.1
Do you have any
studies?
✓ Yes
8.2
Have you provided
the technical evaluation and all related documents to this application package?
❑ No
✓ Yes
8.3
Are you aware of any existing plant(s) that resemble
treatment at your facility?
❑ Yes
production processes, wastewater
constituents, or wastewater
Section 9.
✓ No 4 SKIP to
EPA Form 3510-2D (Revised 3-19)
Page 5
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
m Engineering Report
Other Information 0 Continued
0
8.4
Provide the name and location of the similar plants.
Name of Similar Plants
Location of Similar Plants
9. OTHER
INFORMATION (40 CFR 122.21(k)(7))
9.1
Have you attached
(i.e., material beyond
any optional information that you would like considered as part of the application review process
that which you have already noted in the application as being attached)?
❑ No 4 SKIP to Section 10.
✓ Yes
9.2
List the additional items and briefly note why you have included them.
1 GMA Mixing Model Evaluation for a Proposed Process WW Discharge
2. Highfill Engineering Report including Engineering Alternatives Analysis
3. Record Drawing - Design Criteria
4. Well #3 & 5 Water Quality Tests
5. WTP Brine Waste Batch Water Quality Test
SECTION
10. CHECKLIST
AND CERTIFICATION STATEMENT (40 CFR 122.22(a) and (d))
Checklist and Certification Statement
10.1
In Column 1 below, mark the sections of Form 2D that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to complete all sections or tables, or provide attachments.
Column 1
Column 2
Section
1: Expected Outfall
w/ attachments (e.g., responses for additional outfalls)
✓
•
Location
Section
2: Expected
Date
w/ attachments
✓
•
Discharge
Section
3: Average Flows
wl attachments
✓
•
and Treatment
4: Line Drawing
w/ line
w/ additional attachments
✓ Section
0
drawing 0
Section
5: Intermittent or
Flows
w/ attachments
✓
•
Seasonal
6: Production
w/ attachments
✓ Section
•
Section
7: Effluent
w/ Table
request
approval
Table
Table
w/ other
attachments
A waiver
Table A
Table C
Table E
0
or 0
0
B 0
✓
Characteristics
4
D 0
■
Section
8: Engineering
w/ technical evaluations and related attachments
✓
p
Report
9: Other Information
w/ optional information
✓ Section
■
Section
10: Checklist and
Statement
■
w/ attachments
✓
Certification
EPA Form 3510-2D (Revised 3-19)
Page 6
EPA Identification Number
110012842843
NPDES Permit Number
Facility Name
Surf City Water Treatment Plant
Form Approved 03/05/19
OMB No. 2040-0004
10.2
a.' E
a)
al
c
a
c.) a
a
a) _
V a
-aV
a
ca
a>
V
Certification Statement
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 submitted 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 (print or type first and last name)
David Price
Official title
Director of Utilities
Date signed
7/9 7/a
EPA Form 3510-2D (Revised 3-19) Page 7
This page intentionally left blank.
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE A. CONVENTIONAL AND
NON CONVENTIONAL
PARAMETER ESTIMATES
(40 CFR 122.21(k)(5)(i))1
Pollutant
Waiver
Requested
(if applicable)
Units
Effluent Data
Intake Water
Maximum Daily
Discharge
(required)
Average Daily
Discharge
(if available)
Source of Information
(use codes in instructions)
Believed Present?
(check only one response per
parameter)
❑
Check here if you have applied to your NPDES authority for a waiver for all of the pollutants listed on this table for the noted outfall.
1'
Biochemical oxygen
demand (BOD5)
❑
Concentration
❑ Yes
✓ No
Mass
2
Chemical oxygen demand
(COD)
❑
Concentration
Yes❑No
✓
Mass
3
Total organic carbon
(TOC)
❑
Concentration
mg/L
7.4
6.9
5 - Wells #3 & # TNew Well Series ectc
❑ No
Yes
Mass
4
Total suspended solids
(TSS)
❑
Concentration
mg/L
10.3
5 Brine Waste Batch WQTests
❑Yes
✓ No
Mass
5.
Ammonia (as N)
❑
Concentration
mg/L
<0.2
5 - Brine Waste Batch WQ Tests
❑ No
✓ Yes
Mass
6.
Flow
❑
Rate
mgd
0.071
❑ No
✓ Yes
7.
Temperature (winter)
❑
°C
°C
16.1
5 - Brine Waste Batch WQTests
❑ No
✓ Yes
Temperature (summer)
❑
°C
°C
18.5
5 - Well #3 New Well Series WQ
TPctc
8
pH (minimum)
❑
Standard units
s.u.
7.15
5 - Well #3 New Well Series WQ
TPctc
❑ No
✓ Yes
pH (maximum)
❑
Standard units
s.u.
7.77
5 - Brine Waste Batch WQ Tests
1 Samplina shall be conducted accordina to sufficiently sensitive test procedures (i.e.. methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2D (Revised 3-19)
Page 1
This page intentionally left blank.
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE B. CERTAIN CONVENTIONAL
Pollutant
AND NON CONVENTIONAL
Presence or Absence
(check one)
POLLUTANTS (40 CFR 122.21(k)(5)(ii))1
Estimated Data for Pollutants Expected to be Present or Limited by an ELG
(Provide both concentration and mass estimates for each pollutant.)
Believed
Present
Believed
Absent
Effluent
Intake Water
Units
Maximum Daily
Discharge
(required)
Average Daily
Discharge
(if available)
Source of Information
(use codes in instructions)
Believed Present?
(check only one
response per item)
Check (✓) here if you believe all pollutants listed to be absent from the discharge. You need not complete Table B for the noted outfall unless you have quantitative data available.
•
1
Bromide
(24959-67-9)
Concentration
µg/L
<1
0•
✓ Yes ❑ No
Mass
2
Chlorine, total
residual
Concentration
mg/L
0.11
-Brine Waste Batch WQ
Tests
0•
✓
❑ Yes No
Mass
3.
Color
Concentration
units
19
17
5 - Wells #3 & #5 New Well
Series WQTests
■
0
✓ Yes ❑ No
Mass
4.
Fecal coliform
Concentration
5 - Wells #3 & #5 New Well
Series WQTests
■
0
❑ Yes ✓ No
Mass
5'
Fluoride
(16984 48 8)
Concentration
mg/L
1.0
0.47
5 - Wells #3 & #5 New Well
Series WQTests and Brine
Waste Batch WQ Tests
0
■
✓ Yes ❑ No
Mass
6.
Nitrate -nitrite
Concentration
mg/L
0.20
0.18
5 - Brine Waste Batch WQ
Tests and Well #3 New Well
Series WQTests
0
■
✓ Yes ❑ No
Mass
7
Nitrogen, total
organic (as N)
Concentration
mg/L
0.7
5 - Brine Waste Batch WQ
Tests
0
•
✓ Yes ❑ No
Mass
8.
Oil and grease
Concentration
■
0
❑ Yes ✓ No
Mass
9'
Phosphorus (as P),
total 14 0
( )
Concentration
mg/L
0.29
5 - Brine Waste Batch WQ
Tests
151
�
•7723
❑ Yes ✓ No
Mass
10.
Sulfate (as SO4)
(14808 79 8 )
Concentration
mg/L
<2
0
5 - Wells #3 & #5 New Well
Series WQTests
•
•
❑ Yes ✓ No
Mass
11.
Sulfide (as S)
Concentration
mg/L
<0.01
5 - Well #5 New Well Series
WQ Tests
•
IN
❑ Yes ✓ No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 3
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
Outfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE B. CERTAIN CONVENTIONAL
Pollutant
AND NON CONVENTIONAL
Presence or Absence
(check one)
POLLUTANTS (40 CFR 122.21(k)(5)(ii))1
Estimated Data for Pollutants Expected to be Present or Limited by an ELG
(Provide both concentration and mass estimates for each pollutant.)
Believed
Present
Believed
Absent
Effluent
Intake Water
Units
Maximum Daily
Discharge
(required)
Average Daily
Discharge
(if available)
Source of Information
(use codes in instructions)
Believed Present?
(check only one
response per item)
- 12.
Sulfite (as SO3)
(14265-45-3)
Concentration
■
0
❑ Yes ✓ No
Mass
13.
Surfactants
Concentration
■
0
❑ Yes ✓ No
Mass
14.
Aluminum, total
(7429-90-5)
Concentration
❑ Yes ✓ No
Mass
15.
Barium, total
(7440-39-3)
Concentration
mg/L
0.011
0
5 - Wells #3 & #5 New Well
Series WQ Tests
0
•
✓ Yes ❑ No
Mass
- 16.
Boron, total
(7440-42-8)
Concentration
•
0
❑ Yes ' No
Mass
17.
Cobalt, total
7440-48-4
( )
Concentration
•
0
❑ Yes ✓ No
Mass
18.
Iron, total
(7439 89 6)
Concentration
mg/L
1.60
5 - Brine Waste Batch WQ
Tests
0
•
✓ Yes ❑ No
Mass
'
19.
Magnesium, total
7439 95 4
( )
Concentration
mg/L
160
5 - Engineer's Calc. for
Concentrate
151
•
✓ Yes ❑ No
Mass
20.
Molybdenum, total
(7439-98-7)
Concentration
■
0
❑ Yes ✓ No
Mass
21.
Manganese, total
(7439 96 5 )
Concentration
mg/L
0.386
5 - Brine Waste Batch WQ
Tests
IN
•
✓ Yes ❑ No
Mass
- 22.■
Tin,total
(7440-31-5)
Concentration
0
❑ Yes ✓ No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 4
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
Outfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE B. CERTAIN CONVENTIONAL
Pollutant
AND NON CONVENTIONAL
Presence or Absence
(check one)
POLLUTANTS (40 CFR 122.21(k)(5)(ii))1
Estimated Data for Pollutants Expected to be Present or Limited by an ELG
(Provide both concentration and mass estimates for each pollutant.)
Believed
Present
Believed
Absent
Effluent
Intake Water
Units
Maximum Daily
Discharge
(required)
Average Daily
Discharge
(if available)
Source of Information
(use codes in instructions)
Believed Present?
(check only one
response per item)
23.
Titanium, total
(7440-32-6)
Concentration
No
■
MI
❑ Yes
Mass
24.
Radioactivity
24.1
Alpha, total
Concentration
pCi/L
<3.0
0
5 - Wells #3 & #5 New Well
Series WQTests
No
■
0
❑ Yes '1
Mass
24.2
Beta, total
Concentration
pCi/L
<4.0
0
5 - Wells #3 & #5 New Well
Series WQTests
No
•
0
Yes
Mass
24.3.
Radium, total
Concentration
pCi/L
<1.0
0
5 - Wells #3 & #5 New Well
Series WQTests
No
■
0
❑ Yes
Mass
24.4
Radium 226, total
Concentration
pci/L
<1.0
0
5 - Wells #3 & #5 New Well
Series WQTests
No
•
0
❑Yes
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2D (Revised 3-19)
Page 5
This page intentionally left blank.
EPA Identification
110012842843
TABLE C. TOXIC METALS,
Number
TOTAL CYANIDE,
Presence or Absence
(check one)
AND TOTAL
Facility Name
Surf City Water Treatment Plant
PHENOLS (40 CFR 122.21(k)(5)(ii
Estimated
(Provide
0utfall Number
001
)(A))1
Data for Pollutants Expected to be Present in Discharge
both concentration and mass estimates for each pollutant.)
Form Approved 03/05/19
OMB No. 2040-0004
Pollutant
Effluent
Intake Water
(CAS Number, if available)
Believed
Present
Believed
AbsentDaily
Units
Maximum
Discharge
(required)
Average
Daily
Discharge
(if available)
Source of Information
(Use codes in Instructions.)
Believed Present?
(Check only one
response per pollutant.)
•
Check (✓) here if you believe all pollutants listed to be absent from the discharge. You need not complete Table C for the noted outfall unless you have quantitative data
available.
1.
Antimony, Total
(7440-36-0)
0
Concentration
me/L
<0.003
5 - Wells #3 & #5 New•
Well Series WQTests
❑ Yes
✓
No
Mass
2.
Arsenic, Total
(7440-38-2)
Concentration
me/L
<0.005
5 - Wells #3 & #5 New
Well Series WQTests
❑Yes
✓
No
Mass
3.
Beryllium, Total
(7440-41-7)
0
Concentration
me/L
<0 002
5 - Wells #3 & #5 New•
Well Series WQTests
❑ Yes
✓
No
Mass
4.
Cadmium, Total
(7440-43-9)
Concentration
me/L
<0.001
5 - Wells #3 & #5 New
Well Series WQTests
❑Yes
✓
No
Mass
5.
Chromium, Total
(7440-47-3)
•
EAme/L
Concentration
<0.020
5 - Wells #3 & #5 New
Well Series WQTests
❑Yes
✓
No
Mass
6.
Copper, Total
(7440-50-8)
Concentration
me/L
0.004
5 - Brine Waste Batch
WQ Tests
❑Yes
✓
No
Mass
7.
Lead, Total
(7439-92-1)
0•Concentration
me/L
0.006
<0.001
5 - Brine Waste Batch
WQ Tests and Wells #3
✓
Yes
❑
No
Mass
8.
Mercury, Total
(7439-97-6)
•
0
Concentration
me/L
<0 0002
5 - Wells #3 & #5 New
Well Series WQTests
❑ Yes
✓
No
Mass
9.
Nickel, Total
(7440-02-0)
•
MIme/L
Concentration
<0.005
5 - Wells #3 & #5 New
Well Series WQTests
❑Yes
✓
No
Mass
10.
Selenium, Total
(7782-49-2)
Concentration
me/L
<0.005
5 - Wells #3 & #5 New
Well Series WQTests
❑Yes
✓
No
Mass
11.
Silver, Total
(7440-22-4)
•
0
Concentration
me/L
<0.005
5 - Wells #3 & #5 New
Well Series WQTests
❑ Yes
✓
No
Mass
12.
Thallium, Total
(7440-28-0)
0
Concentration
me/L
<0.001
5 - Wells #3 & #5 New•
Well Series WQTests
❑ Yes
✓
No
Mass
13.
Zinc, Total
(7440-66-6)
0
•Concentration
me/L
0.037
5 - Wells #3 & #5 New
Well Series WQ Tests and
✓
Yes
❑
No
Mass
14.
Cyanide, Total
(57-12-5)
Concentration
me/L
<0.04
5 - Wells #3 & #5 New
Well Series WQTests
❑Yes
✓
No
Mass
15.
Phenols, Total
•
0
Concentration
❑ Yes
✓
No
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See Instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2D (Revised 3-19)
Page 7
This page intentionally left blank.
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Units
Effluent
Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
Check here if all pollutants listed in Table D are expected to be absent from your facility's discharge.
4
Check here if the facility believes it is exempt from Table D reporting requirements because it is a qualified small business. See the instructions for exemption criteria and for a list
of materials you must attach to the application.
•
Note: f you check either of the above boxes, you do not need to complete Table D for the noted outfall unless you have quantitative data available.
1. Organic Toxic Pollutants (GC/MS Fraction —Volatile Compounds)
1.1
Acrolein
(107-02-8)
Concentration
•
0
❑ Yes ' No
Mass
1.2
Acrylonitrile
(107-13-1)
Concentration
•
0
❑ Yes ' No
Mass
1.3
Benzene
(71-43-2)
Concentration
•
0
❑ Yes ✓ No
Mass
1.4
Bromoform
(75-25-2)
Concentration
pg/L
<0.5
5 - Well #3 New Well
Series DBP Formation
n..... t-.I r..-+ . ..-;....
0
•
❑ Yes ' No
Mass
1.5
Carbon tetrachloride
(56-23-5)
Concentration
•
SI
❑ Yes ' No
Mass
1.6
Chlorobenzene
(108-90-7)
Concentration
•
0
❑ Yes ' No
Mass
1.7
Chlorodibromomethane
(124-48-1)
Concentration
pg/L
<0.5
5 - Well #3 New Well
Series DBP Formation
n..a..... a:..l r....a ..........
IN
•
❑ Yes ' No
Mass
1.8
Chloroethane
(75-00-3)
Concentration
0
❑ Yes ' No
Mass
1.9
2-chloroethylvinyl ether
(110-75-8)
Concentration
•
0
❑ Yes ' No
Mass
1.10
Chloroform (67-66-3)
Concentration
pg/L
348
5 - Well #3 New Well
Series DBP Formation
❑ Yes ' No
Mass
1.11
Dichlorobromomethane
(75 27 4)
Concentration
pg/L
25.2
5 - Well #3 New Well
Series DBP Formation
❑ Yes ' No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 9
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Units
Effluent
Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
1.12
1,1-dichloroethane
(75-34-3)
Concentration
■
0
❑ Yes ' No
Mass
1.13
1,2-dichloroethane
(107-06-2)
Concentration
■
0
❑ Yes ' No
Mass
1.14
1,1-dichloroethylene
(75-35-4)
Concentration
■
0
❑ Yes ' No
Mass
1.15
1,2-dichloropropane
(78-87-5)
Concentration
•
0
❑ Yes ' No
Mass
1.16
1,3-dichloropropylene
(542-75-6)
Concentration
•
0
❑ Yes ' No
Mass
1.17
Ethylbenzene
(100-41-4)
Concentration
•
0
❑ Yes ' No
Mass
1.18
Methyl bromide
(74-83-9)
Concentration
•
MI
❑ Yes ' No
Mass
1.19
Methyl chloride
(74-87-3)
Concentration
❑ Yes ' No
Mass
1.20
Methylene chloride
(75-09-2)
Concentration
•
151
❑ Yes ' No
Mass
1.21
1,1,2,2-tetrachloroethane
(79-34-5)
Concentration
•
0
❑ Yes ' No
Mass
1.22
Tetrachloroethylene
(127-18-4)
Concentration
•
0
❑ Yes ' No
Mass
1.23
Toluene
(108-88-3)
Concentration
•
0
❑ Yes ' No
Mass
1.24
1,2-trans-dichloroethylene
(156-60-5)
Concentration
•
15i1
❑ Yes ' No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 10
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Effluent
Intake Water
Units
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
1.25
1,1,1-trichloroethane
(71-55-6)
•
0
Concentration
Mass
❑ Yes
'
No
1.26
1,1,2-trichloroethane
(79-00-5)
0
Concentration
Mass
❑ Yes
'
No
1.27
Trichloroethylene
(79-01-6)
•
0
Concentration
'
Mass
❑ Yes
No
1.28
Vinyl chloride
(75-01-4)
•
SI
Concentration
Mass
❑ Yes
'
No
2. Organic Toxic Pollutants (GC/MS Fraction —Acid
Compounds)
2.1
2-chlorophenol
(95-57-8)
IN
SI
Concentration
❑ Yes
'
No
Mass
2.2
2,4-dichlorophenol
(120-83-2)
•
0
Concentration
❑ Yes
'
No
Mass
2.3
2,4-dimethylphenol
(105-67-9)
•
0
Concentration
❑ Yes
'
No
Mass
2.4
4,6-dinitro-o-cresol
(534-52-1)
0
Concentration
❑ Yes
'
No
Mass
2.5
2,4-dinitrophenol
(51-28-5)
•
0
Concentration
❑ Yes
'
No
Mass
2.6
2-nitrophenol
(88-75-5)
•
El
Concentration
❑ Yes
'
No
Mass
2.7
4-nitrophenol
(100-02-7)
•
El
Concentration
❑ Yes
'
No
Mass
2.8
p-chloro-m-cresol
(59-50-7)
•
0
Concentration
❑ Yes
'
No
Mass
2.9
Pentachlorophenol
(87-86-5)
•
0
Concentration
❑ Yes
'
No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 11
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Units
Effluent
Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
2.10
Phenol
(108-95-2)
Concentration
•
0
❑ Yes ' No
Mass
2.11
2,4,6-trichlorophenol
(88-05-2)
Concentration
•
0
❑ Yes ' No
Mass
3. Organic Toxic Pollutants (GC/MS Fraction —Base /Neutral Compounds)
3.1
Acenaphthene
(83-32-9)
Concentration
■
❑ Yes ✓ No
Mass
3.2
Acenaphthylene
(208-96-8)
Concentration
•
0
❑ Yes ' No
Mass
3.3
Anthracene
(120-12-7)
Concentration
•
0
❑ Yes ' No
Mass
3.4
Benzidine
(92-87-5)
Concentration
•
0
❑ Yes ' No
Mass
3.5
Benzo (a) anthracene
(56-55-3)
Concentration
•
0
❑ Yes ' No
Mass
3.6
Benzo (a) pyrene
(50-32-8)
Concentration
0
❑ Yes ' No
Mass
3.7
3,4-benzofluoranthene
(205-99-2)
Concentration
❑ Yes ' No
Mass
3.8
Benzo (ghi) perylene
(191-24-2)
Concentration
•
51
❑ Yes ' No
Mass
3.9
Benzo (k) fluoranthene
(207-08-9)
Concentration
•
El
❑ Yes ' No
Mass
3.10
Bis (2-chloroethoxy) methane
(111-91-1)
Concentration
•
0
❑ Yes ' No
Mass
3.11
Bis (2-chloroethyl) ether
(111-44-4)
Concentration
•
0
❑ Yes ' No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 12
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Units
Effluent
Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
3.12
Bis (2-chloroisopropyl) ether
(102-80-1)
Concentration
•
0
❑ Yes ' No
Mass
3.13
Bis (2-ethylhexyl) phthalate
(117-81-7)
Concentration
0
❑ Yes ' No
Mass
3.14
4-bromophenyl phenyl ether
(101-55-3)
Concentration
•
0
❑ Yes ' No
Mass
3.15
Butyl benzyl phthalate
(85-68-7)
Concentration
•
0
❑ Yes ' No
Mass
3.16
2-chloronaphthalene
(91-58-7)
Concentration
•
II
❑ Yes ' No
Mass
3.17
4-chlorophenyl phenyl ether
(7005-72-3)
Concentration
•
0
❑ Yes ' No
Mass
3.18
Chrysene
(218-01-9)
Concentration
•
0
❑ Yes ' No
Mass
3.19
Dibenzo (a,h) anthracene
(53-70-3)
Concentration
❑ Yes ' No
Mass
3.20
1,2-dichlorobenzene
(95-50-1)
Concentration
•
0
❑ Yes ' No
Mass
3.21
1,3-dichlorobenzene
(541-73-1)
Concentration
•
0
❑ Yes ' No
Mass
3.22
1,4-dichlorobenzene
(106-46-7)
Concentration
•
0
❑ Yes ' No
Mass
3.23
3,3-dichlorobenzidine
(91-94-1)
Concentration
•
0
❑ Yes ' No
Mass
3.24
Diethyl phthalate
(84-66-2)
Concentration
•
0
❑ Yes ' No
Mass
3.25
Dimethyl phthalate
(131-11-3)
Concentration
0
❑ Yes ' No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 13
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Units
Effluent
Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
3.26
Di-n-butyl phthalate
(84-74-2)
Concentration
•
0
❑ Yes ' No
Mass
3.27
2,4-dinitrotoluene
(121-14-2)
Concentration
0
❑ Yes ' No
Mass
3.28
2,6-dinitrotoluene
(606-20-2)
Concentration
•
0
❑ Yes ' No
Mass
3.29
Di-n-octyl phthalate
(117-84-0)
Concentration
•
0
❑ Yes ' No
Mass
3.30
1,2-diphenylhydrazine
(as azobenzene) (122-66-7)
Concentration
•
0
❑ Yes ' No
Mass
3.31
Fluoranthene
(206-44-0)
Concentration
•
MI
❑ Yes ' No
Mass
3.32
Fluorene
(86-73-7)
Concentration
•
0
❑ Yes ' No
Mass
3.33
Hexachlorobenzene
(118-74-1)
Concentration
0
❑ Yes ' No
Mass
3.34
Hexachlorobutadiene
(87-68-3)
Concentration
•
0
❑ Yes ' No
Mass
3.35
Hexachlorocyclopentadiene
(77-47-4)
Concentration
❑ Yes ' No
Mass
3.36
Hexachloroethane
(67-72-1)
Concentration
•
0
❑ Yes ' No
Mass
3.37.
Indeno (1,2,3-cd) pyrene
(193-39-5)
Concentration
•
0
❑ Yes ' No
Mass
3.38
lsophorone
(78-59-1)
Concentration
•
0
❑ Yes ' No
Mass
3.39
Naphthalene
(91-20-3)
Concentration
•
0
❑ Yes ' No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 14
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Pollutant
(CAS Number, if available)
Believed
Present
Believed
Absent
Effluent
Intake Water
Units
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
3.40
Nitrobenzene
(98-95-3)
•
0
Concentration
Mass
❑ Yes
'
No
3.41
N-nitrosodimethylamine
(62-75-9)
0
Concentration
Mass
❑ Yes
'
No
3.42
N-nitrosodi-n-propylamine
(621-64-7)
•
0
Concentration
Mass
❑ Yes
'
No
3.43
N-nitrosodiphenylamine
(86-30-6)
•
151
Concentration
Mass
❑ Yes
'
No
3.44
Phenanthrene
(85-01-8)
•
GI
Concentration
Mass
❑ Yes
'
No
3.45
Pyrene
(129-00-0)
•
0
Concentration
Mass
❑ Yes
'
No
3.46
1,2,4-trichlorobenzene
(120-82-1)
•
0
Concentration
Mass
❑ Yes
'
No
4. Organic Toxic Pollutants (GC/MS Fraction —Pesticides)
4.1.
Aldrin
(309-00-2)
0
Concentration
❑ Yes
'
No
Mass
4.2
a-BHC
(319-84-6)
•
0
Concentration
❑ Yes
'
No
Mass
4.3
R-BHC
(319-85-7)
•
151
Concentration
❑ Yes
'
No
Mass
4.4
y-BHC
(58-89-9)
•
151
Concentration
❑ Yes
'
No
Mass
4.5
b-BHC
(319-86-8)
•
151
Concentration
❑ Yes
'
No
Mass
4.6
Chlordane
(57-74-9)
•
151
Concentration
❑ Yes
'
No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 15
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Units
Effluent
Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
4.7
4,4'-DDT
(50-29-3)
Concentration
•
0
❑ Yes ' No
Mass
4.8
4,4'-DDE
(72-55-9)
Concentration
0
❑ Yes ' No
Mass
4.9
4,4'-DDD
(72-54-8)
Concentration
•
0
❑ Yes ' No
Mass
4.10
Dieldrin
(60-57-1)
Concentration
•
13
❑ Yes ' No
Mass
4.11
a-endosulfan
(115-29-7)
Concentration
■
MI
❑ Yes ' No
Mass
4.12
R-endosulfan
(115-29-7)
Concentration
■
0
❑ Yes ' No
Mass
4.13
Endosulfan sulfate
(1031-07-8)
Concentration
■
IS
❑ Yes ' No
Mass
4.14
Endrin
(72-20-8)
Concentration
■
0
❑ Yes ' No
Mass
4.15
Endrin aldehyde
(7421-93-4)
Concentration
■
0
❑ Yes ' No
Mass
EPA Form 3510-2D (Revised 3-19)
Page 16
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
0utfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass Spectrometry or GC/MS Fractions) (40 CFR 122.21(k)(5)(iii)(B))1
Pollutant
(CAS Number, if available)
Presence or Absence
(check one)
Estimated Data for Pollutants Expected to Be Present in Discharge
(provide both concentration and mass estimates for each pollutant)
Believed
Present
Believed
Absent
Units
Effluent
Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
Information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
4.16
Heptachlor
(76-44-8)
Concentration
•
0
❑ Yes I No
Mass
4.17
Heptachlor epoxide
(1024-57-3)
Concentration
0
❑ Yes ' No
Mass
4.18
PCB-1242
(53469-21-9)
Concentration
•
MI
❑ Yes J No
Mass
4.19
PCB-1254
(11097-69-1)
Concentration
•
SI
❑ Yes J No
Mass
4.20
PCB-1221
(11104-28-2)
Concentration
•
El
❑ Yes I No
Mass
4.21
PCB-1232
(11141-16-5)
Concentration
•
0
❑ Yes I No
Mass
4.22
PCB-1248
(12672-29-6)
Concentration
•
0
❑ Yes I No
Mass
4.23
PCB-1260
(11096-82-5)
Concentration
0
❑ Yes ' No
Mass
4.24
PCB-1016
(12674-11-2)
Concentration
❑ Yes ' No
Mass
4.25
Toxaphene
(8001-35-2)
Concentration
❑ Yes ' No
Mass
1 Sampling shall be conducted according to sufficiently sensit've test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2D (Revised 3-19)
Page 17
This page intentionally left blank.
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
Outfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE
E. CERTAIN HAZARDOUS SUBSTANCES
Pollutant
AND ASBESTOS (40 CFR 122.21(k)(5)(v))1
Presence or Absence
(check one)
Reason Pollutant Believed Present in Discharge
Available Quantitative Data
(specify units)
Believed
Present
Believed
Absent
Check (✓) here if you believe all pollutants listed to be absent from the discharge. You need not complete Table E for the noted outfall unless you have quantitative data available.
✓
1.
Asbestos
❑
✓
2.
Acetaldehyde
❑
✓
3.
Ally' alcohol
❑
✓
4.
Allyl chloride
❑
✓
5.
Amyl acetate
❑
✓
6.
Aniline
❑
✓
7.
Benzonitrile
❑
✓
8.
Benzyl chloride
❑
✓
9.
Butyl acetate
❑
✓
10.
Butylamine
❑
✓
11.
Captan
❑
✓
12.
Carbaryl
❑
✓
13.
Carbofuran
❑
✓
14.
Carbon disulfide
❑
✓
15.
Chlorpyrifos
❑
✓
16.
Coumaphos
❑
✓
17.
Cresol
❑
✓
18.
Crotonaldehyde
❑
✓
EPA Form 3510-2D (Revised 3-19)
Page 19
TABLE
EPA Identification Number
110012842843
E. CERTAIN HAZARDOUS SUBSTANCES
Pollutant
Facility Name
Surf City Water Treatment
AND ASBESTOS (40 CFR 122.21(k)(5)(v))1
Presence or Absence
(check one)
Plant
Reason
Outfall Number
001
Pollutant Believed Present in Discharge
Form Approved 03/05/19
OMB No. 2040-0004
Available Quantitative Data
(specify units)
Believed
Present
Believed
Absent
19.
Cyclohexane
❑
✓
20.
2,4-D (2,4-dichlorophenoxyacetic acid)
❑
✓
21.
Diazinon
❑
✓
22.
Dicamba
❑
✓
23.
Dichlobenil
❑
✓
24.
Dichlone
❑
✓
25.
2,2-dichloropropionic acid
❑
✓
26.
Dichlorvos
❑
✓
27.
Diethyl amine
❑
✓
28.
Dimethyl amine
❑
✓
29.
Dintrobenzene
❑
✓
30.
Diquat
❑
✓
31.
Disulfoton
❑
✓
32.
Diuron
❑
✓
33.
Epichlorohydrin
❑
✓
34.
Ethion
❑
✓
35.
Ethylene diamine
❑
✓
36.
Ethylene dibromide
❑
✓
37.
Formaldehyde
❑
✓
EPA Form 3510-2D (Revised 3-19)
Page 20
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
Ouffall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE
E. CERTAIN HAZARDOUS SUBSTANCES
Pollutant
AND ASBESTOS (40 CFR 122.21(k)(5)(v))1
Presence or Absence
(check one)
Reason Pollutant Believed Present in Discharge
Available Quantitative Data
(specify units)
Believed
Present
Believed
Absent
38.
Furfural
❑
✓
39.
Guthion
❑
✓
40.
Isoprene
❑
✓
41.
Isopropanolamine
❑
✓
42.
Kelthane
❑
✓
43.
Kepone
❑
✓
44.
Malathion
❑
✓
45.
Mercaptodimethur
❑
✓
46.
Methoxychlor
❑
✓
47.
Methyl mercaptan
❑
✓
48.
Methyl methacrylate
❑
✓
49.
Methyl parathion
Not believed present - pdf glitching and putting check on both
✓
✓
50.
Mevinphos
❑
✓
51.
Mexacarbate
❑
✓
52.
Monoethyl amine
❑
✓
53.
Monomethyl amine
❑
✓
54.
Naled
❑
✓
55.
Naphthenic acid
❑
✓
56.
Nitrotoluene
❑
✓
EPA Form 3510-2D (Revised 3-19)
Page 21
EPA Identification Number
110012842843
TABLE E. CERTAIN HAZARDOUS SUBSTANCES
Pollutant
Facility Name
Surf City Water Treatment
AND ASBESTOS (40 CFR 122.21(k)(5)(v))1
Presence or Absence
(check one)
Plant
Reason
Outfall Number
001
Pollutant Believed Present in Discharge
Form Approved 03/05/19
OMB No. 2040-0004
Available Quantitative Data
(specify units)
Believed
Present
Believed
Absent
57.
Parathion
❑
✓
58.
Phenolsulfonate
❑
✓
59.
Phosgene
❑
✓
60.
Propargite
❑
✓
61.
Propylene oxide
❑
✓
62.
Pyrethrins
❑
✓
63.
Quinoline
❑
✓
64.
Resorcinol
❑
✓
65.
Strontium
❑
✓
66.
Strychnine
❑
✓
67.
Styrene
❑
✓
68.
2,4 5-T (2,4,5-trichlorophenoxyacetic
acid)
❑
✓
69.
TDE (tetrachlorodiphenyl ethane)
❑
✓
70.
2,4,5-TP [2-(2,4,5-trichlorophenoxy)
propanoic acid]
❑
✓
71.
Trichlorofon
❑
✓
72.
Triethanolamine
❑
✓
73.
Triethylamine
❑
✓
74.
Trimethylamine
❑
✓
75.
Uranium
❑
Wells #3 & #5 New Well Series WQTests
0 & <2.0 pCi/L
✓
EPA Form 3510-2D (Revised 3-19)
Page 22
EPA Identification Number
110012842843
Facility Name
Surf City Water Treatment Plant
Ouifall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE
E. CERTAIN HAZARDOUS SUBSTANCES
Pollutant
AND ASBESTOS (40 CFR 122.21(k)(5)(v))1
Presence or Absence
(check one)
Reason Pollutant Believed Present in Discharge
Available Quantitative Data
(specify units)
Believed
Present
Believed
Absent
76.
Vanadium
❑
✓
77.
Vinyl acetate
❑
✓
78.
Xylene
❑
✓
79.
Xylenol
❑
✓
80.
Zirconium
❑st
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
Click to go back to the beginning of Form
EPA Form 3510-2D (Revised 3-19)
Page 23