NC0000361_Permit Rating Worksheet_20040330

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NPDES
Permit Rating Work Sheet
❑ Regular Addition
/ ❑ Discretionary Addition
D b
0 Score change,but no status change
NPDES No.: 1/11/6W1010
J_J J_J ❑ Deletion
Mliky NilMame:
rl A/ C 0I?.IP - 1 5 C-I\I t v1v Lit-110 u _ 1[ _ a1t1 MIT z IP b IA INI'J` .
City:
SI2I_IUC-I11 19 It NI El I I I 1 I _ I I I
Receiving Water:
/11010 "I 1,- i o IEI P-I-1- VI El's 1 1 1 I I 1 1 11 I 1 1
Reach Number:
I [ I111 1 1 1 1 1 1 I
Is this facility a steam electric power plant(SIC=4911) Is this permit for a municipal separate storm
with one or more of the following characteristics? sewer serving a population greater than 100,000?
1.Power output 500 MW or greater(not using a cooling pond/lake)
2.A nuclear power plant ❑Yes:score is 700(stop here)
3.Cooling water discharge greater than 25%of the receiving stream's 7Q10 flow rate J$No(continue)
❑Yes;score is 600(stop here) JNo(continue)
FACTOR 1: Toxic Pollutant Potential
PCS SIC Code: J_J_JJ_J Primary SIC Code: II iii J J
Other SIC Codes: 0.1_2_116.1 J--J_J_J_J J-1—J---J—J LJ_1.._1_1
Industrial Subcategory Code: 1J2021_-_{ (Code 000 if no subcategory)
Determine the Toxicity potential from Appendix A. Be sure to use the TOTAL toxicity potential column and check one
Toxicity Group Code Points Toxicity Group Code Points Toxicity Group Code Points
❑No process ❑3. 3 15 ❑7. 7 35
waste streams 0 0 ❑4. 4 20 ❑8. 8 40
ISI I. I El 5. 5 25 ❑9. 9 45
02. 2 10 06. 6 30 010. 10 50
FACTOR 2: Flow/Stream Flow Volume (Complete either Section A or Section B;check only one)
Section A-Wastewater Flow Only Considered Section B- Wastewater and Stream Flow Considered
Wastewater Type Code Points Wastewater Type Percent of Instream Code Points
(See Instructions) (See Instructions) Wastewater Concen-
Type l: Flow<5 MGD ❑ I I 0 tration at Receiving
Flow 5 to 10 MGD 0 12 10 Stream Low Flow
Flow>10 to 50 MGD❑ 13 20
Flow>50 MGD 0 14 30 Type VIII: <10% ❑ 41 0
>1 o%to<50% ❑ 42 10
Type II: Flow<I MGD El 21 10 >_50% ❑ 43 20
Flow 1 to 5 MGD ❑ 22 20
Flow>5 to 10 MCD ❑ 23 30 Type II: < 10% ❑ 51 0
Flow>10 MGD ❑ 24 50 > 10%to<50% 1g 52 ta.
>_50% ❑ 53 30
Type III: Flow<I MGD 0 31 0
Flow I to 5 MGD ❑ 32 10
Flow>5 to 10 MGD ❑ 33 20
Flow>10 MGD ❑ 34 30
Code Checked from Section A or B: 11
x� Total Points Factor 2 2dot

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NPDES Permit Rating Work Sheet
FACTOR 3: Conventional Pollutants NPDES NO.: I J e 1 0I 0I OI vl 316 I/I
(only when limited by the permit) N/A la
A.Oxygen Demanding Pollutant:(check one) 0 BOD 0 COD 0 Other: /�V /I '
Code Points
Permit Limits:(check one) ❑ <100 lbs/day 1 0
9 I00 to 1000 lbs/day 2 5
9 >1000 to 3000 lbs/day 3 15
❑ >30001hs/day 4 20
B. Total Suspended Solids(TSS)
Code Points
Permit Limits: (check one) 0 <100 lbs/day 1 0
Igl 100 to 1000 lbs/day 2 5
❑ >1000 to 5000 lbs/day 3 15
❑ >5000 lbs/day 4 20
-,,,,;c:
C.Nitrogen pollutant:(check one) ❑Ammonia ['Other: N/t
Nitrogen Equivalent Code Points
Permit Limits:(check one) ❑ <300 lbs/day 1 0
❑ 300 to 1000 lbs/day 2 5
❑ >l000 to 3000 lbs/day 3 15
❑ >3000 lbs/day 4 20
t„.:,:i-'t - „r t&z� ' r : . . .. .. .,
FACTOR 4: Public Health Impact
Is there a public drinking water supply located within 50 miles downstream of the effluent discharge(this includes any body of water
to which the receiving water is a tributary)? A public drinking water supply may include infiltration galleries,or other methods of
conveyance that ultimately get water from the above referenced supply.
IRYes(If yes,check toxicity potential number below)
No(If no,go to Factor 5)
Determine the human health toxicity potential from Appendix A. Use the same SIC code and subcategory reference as a Factor I
(Be sure to use the human health toxicity group column—check one below)
Toxicity Group Code Points Toxicity Group Code Points Toxicity Group Code Points
❑No process ❑3. 3 0 ❑7. 7 15
waste streams 0 0 ❑4. 4 0 ❑8. 8 20
]II. 1 A El 5- 5 5 9. 9 25
02. 2 0 1:1 6. 6 10 010 10 30
Code Number Checked: 10111
Total Points Factor 4: 1 1© 1

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NPDES Permit Rating Work Sheet
FACTOR 5: Water Quality Factors NPDES No.: vlcWI 01 00 01316 14
A. Is(or will)one or more of the effluent discharge limits based on water quality factors of the receiving stream(rather than
technology—based federal effluent guidelines,or technology—based state effluent guidelines),or has a waste load
allocation been assigned to the discharge?
Code Points
NI Yes 1 (0
❑No 2 0
B. Is the receiving water in compliance with applicable water quality standards for pollutants that are water quality limited in
the permit?
Code Points�
Yes 1 `GJ
No 2 5
C. Does the effluent discharged from this facility exhibit the reasonable potential to violate water quality standards due to
whole effluent toxicity?
Codeants
rfYes 1 1
❑No 2 0
gt ,- s 6 • _
,4.
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FACTOR 6: Proximity to Near Coastal Waters
A.Base Score:Enter flow code here(from Factor 2): 15121 Enter the multiplication factor that corresponds
to the flow code: LI_i
Check appropriate facility HPRI Code(from PCS):
HPRI# Code HPRI Score Flow Code Multiplication Factor
❑ 1 1 20 1 1,31,or 41 0.00
❑ 2 2 0 12,32,or 42 0.05
3 3 30 13,33,or 43 0.10
4 4 0 14 or 34 0.15
5 5 20 21 or 51 0.10
22 or 52 0.30
�(�t 23 or 53 0.60
HPRI code checked:111-1 24 1.00
Base Score: (HPRI Score) 0 x(Multiplication Factor) 0. = 0) (TOTAL POINTS)
B.Additional Points—NEP Program C.Additional Points—Great Lakes Area of Concern
For a facility that has an HPRI code of 3,does the facility For a facility that has an HPRI code of 5,does the facility
discharge to one of the estuaries enrolled in the National discharge any of the pollutants of concern into one of the
Estuary Protection(NEP)program(see Instructions)or Great Lakes 31 areas of concern(see Instructions)
the Chesapeake Bay?
Code Points Code Points
WYes I 10 ❑Yes I 10
No 2 0 t21 No 2 0
Code Number Checked: A it B 121 C LZE
Points factor 6: A 1121 + 13 � V1_01 + C ( � �� _ — Q) TOTAL

1
1 Toxic Pollutant Potential
2 Flow/Streamflow Volume
3. Conventional Pollutants
4 Public Health Impacts
5 Water Quality Factors 23
6 Proximity to Near Coastal Waters
TOTAL(Factors 1 through 6) 50
51.Is the total score equal to or greater than 80? 0 Yes(Facility is a major) WO No
52.If the answer to the above question is no,would you like this facility to be discretionary major?
,(No
❑Yes(Add 500 points to the above score and provide reason below):
Reason:
NEW SCORE:49_
OLD SCORE:
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Permit Reviewer's Name
(54.03 50 83 CS '1
Phone number
03/30/ 09
Date