NC0049867_Application_20181001

ROY COOPER NORTH CAROUNA
Governor Frtrlronmenfai Qudity
NIICHAEL S_ REGAN
secretmv
LINDA CULPEPPER
Inrerfm Director
October 01, 2018
Danny Gabriel, Mayor
Town of Cleveland
PO Box 429
Cleveland, NC 27013
Subject: Permit Renewal
Application No. NCO049867
Cleveland WWTP
Rowan County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 1, 2018 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 15OB-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•lldeq nc oov/permits-regulationslpermit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely, 1
�/1piYl a 78
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-161.7
919-807-6300

Town of Cleveland
302 East Main Street
P.O. Box 429
Cleveland, NC 27013
{704}278-4777
September 26, 2018
NC DEQ/DWQ / Point Source Branch
Attention: NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: NPDES Permit Renewal Application
Town of Cleveland
NCO049867
RECENEDIDEWDWR
OCT 01 2019
Water Resources
Permitting Section
By this letter the Town of Cleveland is requesting renewal of the Town of Cleveland's
WWTP NPDES Permit number NC0049867. The EPA Form 2A is enclosed.
There have not been any modifications or additions to the WWTP since the last permit
was issued. The sludge generated by the WWTP is disposed of by either land application
or incineration.
If you need any additional information, please call the Town office at 704-278-4777.
Sincer ,
Danny Gabriel
Mayor
Enc of i5i"VlC14 /13-( COpiE-5

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
FORM
2A NPDES . FORM `2A. APPLICATION OVERVIEW
NPDES
APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. Somepalicants must also complete the Supplemental
Application Information packet , The fo owing items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow Z 0.1 mgd. All treatment'RJ!Va?WMG"
greater than or equal to 0.1 million gallons per day must complete questions B.1 through 13.6.
C. Certification. All applicants must complete Part C (Certification). OCT 1 2��8
Water Resources
SUPPLEMENTAL APPLICATION INFORMATION: Permitting Section
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
C. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
Re
RIVER BASIN:
Pee4 16
100iof levejcc 'A .-NO, octom-7
n e- U) a-
q n
BASIC APPLICATION INFORMATION
PART A. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet.
A.I. Facility Information.
Facility Name -ToLin � Cte\fej"1d W W T-P
bm( 4a
Mailing Address
6 a r-\ 6 N(2, a q® 13
Contact PersonC-_7a&J'e'/
Title Cr
Telephone Number 75 "r4I /
(652 57 ,\ (-A(yP k U (-cf -1
Facility Address 1 1
\ifrJ1x1,3, ry C_ Q70-5
(not P.O. Box)
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name is aj_�
Mailing Address
Contact Person Cw!f'r q Pawn e-
_T'D afn le r K
Title
Telephone Number ( a L S� —4- ! 77
Is the applicant the owner or operator (or both) of the treatment works?
owner ❑ operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
facility ❑ applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -issued permits).
�j I
NPDES +Qi04q a to PSD
UIC Other
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
Total population served
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 2 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
`Tow
n 0+ C12ve(o na- t\1 C oa4qg 67 :P,eh e-w a,I qqakN.14C Tec
A.S. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes X No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes 0 No
-A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12'^ month of "this year" occurring no more than three months prior to this application submittal.
a. Design flow rate ©• A,7D mgd �' �?
�1(e
1
@64O #VU4 q&140 Two Years Ago Last Year
This Year
dailyflow OO /0 5S
• /CR4-!
h. Annual average • rate
R8
'03I 9
C. Maximum daily flow rate 1
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply. Also estimate the percent
contribution (by miles) of each.
;, Separate sanitary sewer r/ ll1
1 le-5 'r O D %
❑ Combined storm and sanitary sewer
%
A.B. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
I. Discharges of treated effluent
ii. Discharges of untreated or partially treated effluent
III. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
V. Other
b. Does the treatment works discharge effluent to basins, ponds, or other surface Impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes
If yes, provide the following for each surface impoundment:
Location:
Annual average daily volume discharge to surface Impoundment(s)
Is discharge ❑ continuous or ❑ Intermittent?
C. Does the treatment works land -apply treated wastewater?
If yes, provide the following for each land application site:
d.
Location:
Number of acres:
Annual average daily volume applied to site:
Is land application ❑ continuous or Intermittent?
Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
A No
0 Yes
mgd
❑ Yes
mgd
❑ No
No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER: -- II,q PER T ACTION REQUESTED: RIVER BASIN:
/J CA 00 %4p
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transporteJ to the other treatment works
(e.g., tank truck, pipe).
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number ( )
For each treatment works that receives this discharge, provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number ( )
If known, provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works Into the receiving facility. mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.S. through A.8.d above (e.g., underground percolation, well injection): Yes No
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) if applicable):
srccc—f.k AM M0
Annual daily volume disposed by this method: _
Is disposal through this method ❑ continuous
or jj, intermittent?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PEL;eZCN UESTED: RIVER BASIN:
A)GOOtk$iG 7 f t, ca, 4e
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.a, complete questions A.9 through A.12 once for each outfall (including bypass points) through
which effluent Is discharged. Do not include Information on combined sewer overflows In this section. If you answered "No" to question
A.8.a, go to Part B. "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number 00 1
b. Location 1 own c& �((:!.ielo-t1d C�! ©(3
(City or town, if applicable) (Zip Code)
ko wan NC -
(County) 0/g/ If D ! �� (State)
1,35 8S jg
(Latitude) (Longitude)
C. Distance from shore (if applicable) ft
d. Depth below surface (if applicable) ft
e. Average daily flow rate /mgd
f. Does this outfall have either an intermittent or a periodic discharge? ❑ Yes No (go to A.9.g.)
If yes, provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge:
Months in which discharge occurs:
g. Is outfall equipped with a diffuser?
A.10. Description of Receiving Waters.
14
a. Name of receiving water 1 In 1 If U t 1 C Ln
b. Name of watershed (if known)
United States Soil Conservation Service 14-digit watershed code (if known): N 110
C. Name of State Management/River Basin (if known): !�
United States Geological Survey 8-digit hydrologic cataloging unit code (if known): gj
d. Critical low flow of receiving stream (if applicable)
acute cfs chronic cfs
e. Total hardness of receiving stream at critical low flow (if applicable): mg/I of CaCO3
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER:``�
PERMIT;10,N REQUESTED:
RIVER BASIN:
A.11. Description of Treatment
a. What level of treatment are provided? Check ail that apply.
Primary Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
Design BOD5 removal or Design CBOD5 removal `� o D� %
T g�� %
Design SS removal
Design P removal %
Design N removal %
Other %
C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
If disinfection is by chlorination is dechlorination used for this outfall? Yes ❑ No
Does the treatment plant have post aeration? ❑ Yes ❑ No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent Is
discharged. Do not include Information on combined sewer overflows In this section. All Information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA1QC requirements of
40 CFR Part 136 and other appropriate QAIQC requirements for standard methods for anaiytes not addressed by 40 CFR Part 136. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number. M f
MAXIMUM DAILY VALUE
AVERAGE DAILY VALUE
PARAMETER
Value
Units
Value
Units
Number of Samples
pH (Minimum)
. o 3
S.U.
Sit
pH (Maximum)
S.U.
Flow Rate
Q •
t�,.v
,
rny
Temperature (Winter)
C
!� Pg
0 C
Temperature (Summer)
C-
C
*.For pH please report a minimum
and a maximum daily value
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
MLIMDL
Number of
Cone.
Units
Cone.
Units
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
J}
BIOCHEMICAL OXYGEN BOD5 m • �1 6
fim
DEMAND (Report one) CBODS --r •-r» r-" �•r �"" �'� ��~
FECAL COLIFORM
60 10m
(� dn
TOTAL SUSPENDED SOLIDS (TSS)
rn A1
S4Cb.11
END OF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
IS/
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 6 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT CTION REQUESTED: RIVER BASIN:
AX D00�1� I P&
BASIC APPLICATION INFORMATION
PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR
EQUAL TO 0.1.MGD (100,000 gallons per day).
All applicants with a design flow rate z 0.1 mgd must answer questions B.1 through 8.6. All others go to Part C (Certification).
B.I. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
gpd
Briefly explain a steps underw y or planne to minimize inflow nd infiltration.
Wwr S�41VLD
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within % mile of the property boundaries of the treatment
works, and 2) listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g.,
chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
B.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (r la ed to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? ❑ Yes No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary).
Name:
Mailing Address:
Telephone Number:
Responsibilities of Contractor:
B.S. Scheduled improvements and Schedules of Implementation. Provide Information on any uncompleted implementation schedule or
uncompleted plans for Improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
a. List the outfall number (assigned In�question A.9) for each outfall that is covered by this implementation schedule. -
NI n E- I1
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes ❑ No 1.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 7 of 22

FACILITY NAME AND PERMIT NUMBER:
PER ;ACTION REQUESTED:
RIVER BASIN:
Aez—
Ott
A"Adz).
C. If the answer to B.5.b is "Yes," briefly describe, including new maximum daily inflow rate (if applicable).
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as
applicable. For improvements planned independently of local, State, or Federal agencies, Indicate planned or actual completion dates, as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYYY MM/DD/YYYY
- Begin Construction 1 1 1 1
- End Construction 1 I 1 1
- Begin Discharge 1 1 1 I
- Attain Operational Level 1 1 1 1
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the Indicated
effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not Include Information
on combine sewer overflows In this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA1QC requirements of 40 CFR Part 136 and other appropriate
QA1QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
Outfall Number: 001
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
MLlMDL
Number of
Conc.
Units
Conc.
Units
Samples
CONVENTIONAL AND NON CONVENTIONAL
COMPOUNDS
Q
AMMONIA (as N)
•
f
1M
Ern 45 wi
RES DUTAL, TRC)AL
411
(A I
a •
1
P1� �D�
1•
DISSOLVED OXYGEN
•O
• Oth
oj1
'L% rJ-oa
.Q
TOTAL KJELDAHL
NITROGEN (TKN)
p�•
/� v
1 Q
ft)456onI
ee !
NITRATE PLUS NITRITE
NITROGEN
•
rn4566 NO
x
V
OIL and GREASEW-1
U
3.
j 4 �V
.� A
PHOSPHORUS (Total)
•
• 5
1A .
�Q A
Q.
TOTAL DISSOLVED SOLIDS
f1crild
3
(TDS)
OTHER
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22,
Page 6 of 22

FACILITY NAME AND PERMIT NUMBER:
PER ACTION REQ ESTED:
RIVER BASIN:
At on
�eneW
i-��•i([.J
BASIC APPLICATION INFORMATION
PART C. CERTIFICATION
All applicants must complete the Certification Section. Refer to Instructions to determine who Is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application Is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
Basic Application Information packet Supplemental Application Information packet:
Part D (Expanded Effluent Testing Data)
Part E (Toxicity Testing: Blomonitoring Data)
Part F (industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G (Combined Sewer Systems)
ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION.
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my Inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of tine and imprisonment
for knowing violations.
�t
Name and official title rl 0. br
a
Signature
G �J
Telephone number
Date signed
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22

M
FACILITY NAME AND PERMIT NUMBER:
PERMIT CTION REQU STED:
f 10A.
RIVER BASIN:
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged. Do not include information on combined sewer overflows In this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and
other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old. �—
Outfall number: (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MLIMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
ANTIMONY
•
j�D
I�
`
a
3
el.4 a�o� .1
Ctt3
ARSENIC
BERYLLIUM
! 8
r
ap
,A
"I�
3
am?
o-to
CADMIUM
..28
���f �*7
1V
CHROMIUM
Ni.
�• 3
K�i/�•
'3
'�
CWCPA
WFT
�•
COPPER
�.
a
�"'
L
MA =1
s ` O
LEAD
�,.
N�
J
VW4
fW
Is a m `
3.l
MERCURY
•�
K�/�
O.�
•
A�7 1
• (. D
NICKEL
�1
u�
f-9A a
Q
SELENIUM
ere
� L
Y
(fG
400�
.3
` A �7
4• A
SILVER
`i1
�
I L.
Q01
for" O�► I
`'
THALLIUM
ui�•.
`��L
3
ad ?
tD
zlNc
IlaIG
os�i
uRIL
3
A �• 7
CYANIDE
�
P.4 NW-4•00*
TOTAL PHENOMPOUNDSOLIC
�
L1
•O
•
AW
6-F. I
•
HARDNESS (as CaCO3)
Ato�j
iinformation
Ii, •
L/_L
ift
1 3
C 1 tri
Use this space (or a separate sheet) to provide on other metals requested by the permit winter
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 10 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Il nft &-')
Outfall number: 061 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Cone.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
VOLATILE ORGANIC COMPOUNDS
ACROLEIN
/ 0
I�
! L
fib
141q,D41,
-t
%) D
3
�f
f PA (,% '
44.
ACRYLONITRILE
lG
ap
- !%L
ND
6A 6Ai
3,5
BENZENE
5,0
" j�
�D
o
-1/�/
a D
4 0a
5. zm Pof
BROMOFORM
qj
k j L
.'�'IlAq
1471
Ul /L
1
3
9r17' a
o iv1
CARBON
.L
5 t 0
fA,p
"t L
N�
+ v iwk
Nb
�
04
VA
D�TETRACHLORIDE
CHLOROBENZENE
�r0
Will
oD
t
11 1b
13Q
WA &;
�Q
METHANE IBROMO-O
- /da
ll I
`
(f4
i
3
/,�,
iffy'
CHLOROETHANE
2-CHLOROETHYLVINYL
ETHER
lO�
5
�(C� f L
LA/,
��
`` f �
N�
r�?
1�
c 1
� •
!(C�
�l/
jJ �
3
,
f 9A CQ
81]/j_
TAT
A
CHLOROFORM
,�
����
��
` L
`
04 (A
6j)
DICHLOROBROMO-
METHANE
f0 �
I
V
�A
1
I. �! n7 04h,
v)p
n/A (eA4
il'r
A ,'
1,1-DICHLOROETHANE L
_
1,2-DICHLOROETHANE
'`L
'
OW
0
I
DICHLORO-
ETHYLENE
�AqL
L
Q �
Wqh,
r
4T 4
5-D "l.
1,1-DICHLORO-
ETHYLENE
�D
R"//�� 1 L
O
Y
Wi
N
3
y�1,2-DICHLOROPROPANE
mi- oA4
5. o
1,3-DICHLORO-
PROPYLENE
ETHYLBENZENE
L,
��G
�� J
AIM
3
`/
6A4 �Q v�7
METHYL BROMIDE
tat'
u� f�
a,�
�, .�
� I�
. �y p
-
3
p/�- �a
.,0 Uti
METHYL CHLORIDE
f I�
4q�,
N
j
���} ._&A
?�j 0
METHYLENE CHLORIDE
/b,-0
ltq it
L)b
---
74
1141L.
0p
3
9PA kA
CHLO OETHANE A
f 3
TETRCHLO
ETHYLENE RO-
•�
! L'
1V'�
o en
✓
a*4 tw
� v
TOLUENE
4!510
All"
A. is
I
UA ieA4
�
I.
L
L
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 11 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
Wen wa/
RIVER BASIN: ja r��A�
Outfall number: D 6 + (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MLIMDL
Cone.
Units
Mass
Units
Cone.
Units
Mass
Units
Number
of
Samples
TRICHLOROETHANE
A66
Q
, 0�
Q,
`
Do /07
TRICHLOROETHANE
��o�
u
#
JV
u f
ex 4d4
• 1
TRICHLOROETHYLENE o45Daalt
em o4
r
VINYL CHLORIDE
� D
• DIV
1.��
��i f
4%
3
CiI
®• 3dt
Use this space (or a separate sheet) to provide information on other Iblatile organic compounds requested by the permit writer
ACID -EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
2-CHLOROPHENOL
1010
4IG
a•!
-`7l�
,019
�
�OAf /T M5
laa
'0
2,4-DIMETHYLPHENOL
l b
A
`
�'(�a�
/�
Dig/
/�/
Is
t..
Ole,
4I �
1%
a O�'
jI�3
� •
J-1 * 0
2
S
3
Al2,4-DICHLOROPHENOL
a Al ��
Q�
v.o ���►
�Q 141
4,6-DINITRO-0-CRESOL
2,4-DINITROPHENOL
qtGo006
(�
�a
�`
Y
3
/�
G��
6W
2-NITROPHENOL
ID'a
WCQ ft„
10M;to
�
A�
"`440
t & A
p
3
�QA' �a
Sao
4-NITROPHENOL
dD�
�`
�
'a
9f r1
A
PENTACHLOROPHENOL
��
64 J`
•�
1) `
$S4
'A L
•�
ILI
a
3
�jr/l
J�DW
PHENOL 44060
4416
Oro
4fb
11
41&
.moot
i.p-4. wr,2,4.6-
TRICHLOROPHENOL 410,0
L
too
�
,w
kqL0
4600dL
W-:3
Ga44
lovio 44/1 P
Use this space (or a separate sheet) to provide information on other acid -extractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
op
�D(a
/D
ACENAPHTHYLENE
`aV
jt*lto •Oro
Axa
1&01*1
ANTHRACENE
0 4
1"140 top
D
w4`
'604a
+ -b
'o-o uO
A
�•O
C
1�.7
hq
�
.
�/I
"'+�
ljJBENZ[DINE
Di 1
��
W
10,/ 441
BENZO(A)ANTHRACENE
'�
f a�
A
(�
RBENZO(A)PYRENE
00,C%i�
A
AS !
ICr
•
IJ
3
4
W)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 22

D PE MIT NUMBER:
FACILITY NAM7a;
l(��/��%
Ax oQ q I '^i t
PER ACTION REQUESTED:
�D gyp,, t
i. GW Q
RIVER BASINPe,
!�Ve
�/
Outfall number:yt (Complete once for each outfall discharging effluent to waters of the Ated States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
METHOD
MLIMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
FLUORANTHENE
l��
�+
�/1
�v"�
•
G
�,
n
J44�
�
/".3
BENZO(GHI)PERYLENE
•
FLUORANTHENE *.
IW
Rik 4
4 dO
05
`
•G�
L
BISME HAKE OROETHOXY)
METHANE
�i
��
`
� �
�
,*,
-#1D
+A
v''�.
t�A f.1ll�'
/f
` III
BIS HLOROETHYL)-
E H(ER
.
G
'm�
i�
^
&AA
BIS (2-CHLOROISO-
PROPYL) ETHER
;3
G'
�CC1D
3
�/ ��`V
�•`r
PHTHALATE HEXYL)
♦ A
u `
�l
.�f+
���
G nf� /� '%5
/, /
PHENYL ETHERYL
/VeWJ
BUTYL BENZYL
�
O
3
�(
W5
i 0 aqlzPHTHALATEMO
NAPHTHALENE �
NA H THAL
td�
u� `
�/y�
'�1��
�
�
�`
A
W,Q# /_o
(fir (/
�J1 Gt �G
(�
4-CHLORPHENYL
PHENYL ETHER j.
O
777 Lvzoo
, of
/0 4 �,- �
CHRYSENE
•
�:r
��%
�.
�a
�,D
(411.
J6
DI-N-BUTYL PHTHALATE
•0
11w/.
�(
G
��
u L
DI-N-OCTYL PHTHALATE
DIBENZO(A,H)
ANHRACENE A
%
.� `
(
1 o
!Q
(
S
/�
�'j' 6�K
*/L
1,2-DICHLOROBENZENE
��
���
I
/
!�
1,3-DICHLOROBENZENk
O,
� jj�
-�I
��
IG
.0
/4
� QG
1,4-DICHLOROBENZENE
a
D`
�L
owl
1
LTG
V
Ow
��
'�
BENZ DI{NERO-
'Z�,g
GCAR
/p
3
1i'4/
DIETHYL PHTHALATE
T
`
.o'
G
��a
01A
3
DIMETHYL PHTHALATE
AD
G
.001
.5
'Ni `
0
3
L
2,4-DINITROTOLUENE
��•�
Aqk
A/4090,
I r
3
<<
O G
`
`4(,
2,6-DINITROTOLUENE
-nit,
`vaa
fL3
`�
G
1,2-DIPHENYL-
HYDRAZINE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 13 of 22

FACILITY NAME AND PER IT NUMBER:
X ?'
PERMI CTION REQUESTED:
RIVER BASIN•
ee Ac
die te ,tJ
Riga
�;�
Outfall number: (Complete once for each outfail discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
METHOD
MLIMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
FLUORANTHENE
4
G
.
j
'" �
,
'
�
10.D
FLUORENE`
1000
D
HEXACHLOROBENZENE 01
10
HEXACHLORO-
BUTADIENE
�'
�� G
D+
`� :+
L 46
4 ���O
�+D� �
PENTADIENE HEXACHLOROCYCLO-
G
OI
D
ftal
6 �
�O 1
3
HEXACHLOROETHANE
00
'`"� / _
V
�O !
�z
� L
o
`a
Y
3
em &R5
• o
INDENO(1,2,3-CD)
PYRENE
ISOPHORONE
p.l7
K�
I
/iU
G�
ALf
Q
� �P�
AO kY
NAPHTHALENE
•]�
�� G
+ QI
GAL
=
D
3
NITROBENZENE
,^ T
/ _
,4I
D
0
"'1 L:'4fQ
OtD
'3
bP*. 60
/0..
PROPYLAM NIE
t o
D�
:11i�
�f�
•
I D 1
3
V l �7�
�� ti
$�
METHYLAM NN-NITROSODIE
TT�`19
�•V
• ;'01
dof
Q
•I
• �a"
•
(�/ NCR/
Alai
�N
N-NITROSO NI-�
PHENYLAM E �'
�i
/
• (
o
rr
777 �r
PHENANTHRENE
��•p
`
•�!
!v
PYRENE 4
to•�
u �"
sDI
3 i
•
lo
-3
WR 05
INDlb
1,2,4-
TRICHLOROBENZENE
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use this space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer
END OF PART D.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 14 of 22

FACILITY NAME AND PERMIT NUMBER:
PER T ACTION REQUESTED:
RIVER BASIN:
p�Jejao
01v* Jt�Coo ��tv�
�n�e�[
ll� e✓
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403); or 3)iPOTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at feast annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include
information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC.requirements of 40 CFR Part 136 and other appropriate QA/QC
requirements for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealedtoxlcity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested in question EA for previously submitted information. If EPA me ods were no used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomonitodng data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.I. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. n
a[^J t
chronic ❑ acute-�-,,.b
E.2. Individual Test Data. Complete the following chart for each whole effluent toxi test conducted in the last four and one-half Years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number. Test number: Test number.
a. Test information.
Test Species & test method number
Age at Initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
Grab
d. Indicate where the sample was taken In relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
c 1a,�i�jx'& T'W 6
PERMIT ION REQU
` `t __
RIVER BASIN: PaESTED:
* &a.,
8 i�
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
Flow -through
h. Source of dilution water. If laboratory water, specify type: if receiving water, specify source.
Laboratory water
Receiving water
I. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100%
effluent
%
%
%
LCso
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7650-22. Page 16 of 22

FACILITY NA E AND PERMIT NUMBER:
C-' J��GODt $�
PER ACTION REQUESTED:
r� ubor
RIVER BASIN:
Pee
rye a
Chronic:
NOEC
%
%
%
IC25
%
%
%
Control percent survival
%
%
%
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes 0 No If yes, describe:
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: I I (MM/DD/YYYY)
Summary of results: (see instructions) J ,oar
leg" OM kg
t
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT CTI0 REQUESTED: RIVER BASIN:
/ D
N � 7 e� W
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRAICERCLA WASTES
All treatment works receiving discharges from significant Industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
VYes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs.
b. Number of CIUs.
A
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: �OLI fV1ler -Trucks_
PCs
Mailing Address: gO)C 39 r
Ole-4elar\d WO, a 7®r3
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Il �si;n
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s):
Raw material(sp
Ire-Ir
i
0 LLM eeJ b 1 cs in+5 01 y e rx+5 aC1 h 5i ves_)
F.S. Flow Rate. fe+role- G- m "Prod U ) co t e m hf6 fS
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
gpd (_ continuous or Intermittent)
b. Non -process wastewater Sow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
gpd (_ continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ❑ Yes ❑ No
b. Categorical pretreatment standards, Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
T `UESTED:
94
PERMIT A ION REQ
� iC f�Q
RIVER BASIN:
(41
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or con buted to any problems (e.g..
upsets, interference) at the treatment works in the past three years?
❑ Yes )(No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes )k No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remedlation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) 1�( No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
Yes ❑ No
If yes, describe the tre tment (provide info_ tion bout removal efficiency):% 62#44
VAL, cb
b. Is the discharge (or will the discharge be) continuous or intermittent?
continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER;
n1�'vc� `M/
PERMIT ACTION REQUESTED:
r-�,eneujal
RIVER BASIN:
�d�l�,�, PPSbP
SUPPLEMENTAL APPLICATION INFORMATION
ON
PART G. COMBINED SEWER SYSTEMS
If the treatment works has a combined sewer system, complete Part G.
G.I. System Map. Provide a map indicating the following: (may be Included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs (e.g., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
C. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in GA or on a separate drawing, of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines, both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
C. Locations of in -line and off-line storage structures.
d. Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFALLS:
Complete questions G.3 through G.6 once for each CSO discharge point.
G.3. Description of Outfall.
a. Outfall number
b. Location
(City or town, if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
C. Distance from shore (if applicable) ff•
d. Depth below surface (if applicable) ft•
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
G.4. CSO Events.
a. Give the number of CSO events in the last year.
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 20 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
e tj eux- V�, Ayi -Pe e
C. Give the average volume per CSO event.
million gallons (❑ actual or ❑ approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.5. Description of Receiving Waters.
a. Name of receiving water:
b. Name of watershed/river/stream system:
United State Soil Conservation Service 14-digit watershed code (if known):
C. Name of State Management/River Basin:
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
G.6. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO (e.g., permanent or intermittent beach closings, permanent or
Intermittent shell fish bed closings, fish kills, fish advisories, other recreational loss, or violation of any applicable State water quality standard).
END OF PART G.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7650-6 8 7550-22.
Page 21 of 22

FIGURE
TOWN OF CLEVELAND WWTP
Final Eff. &
2 Flow Measurement
To Streaaa
Bar ° uent
To Sludge
Disposal kv

J.+
FACILITY NAME AND PERMIT NUMBER:
Y
PERMIT ACTION REQUESTED: RIVER BASIN:
FORM
2A s"r,
NPDES'"
APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts Armand C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. -Some applicants must also complete the Supplemental
Application Information packet. The follow ni g items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must pomplete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow z 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions B.1 through 6.6. RECEIVEDIDENR/DWR
C. Certification. All applicants must complete Part C (Certification). OCT 0 120
SUPPLEMENTAL APPLICATION INFORMATION: Water Resources
Permitting Section
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRAICERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes -must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
C. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
ALL APPL'I,CANITS-NtU CdMPLsETE.PART>C.(CERTIFICATION):'
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Pagel of 22

Vr
FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
Re-i �
RIVER BASIN:
a
n CE _�C 0- br7
10 eve( cu\.
ew oc.
i
BASIC APPLICATIOLN 400.R* NIATI'OIV
PART A. BASIiC`4010LICAfi10K rNFORMA'16W.001R.ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet.
A.1. Facility Information.
`-�� ( / / , W `+ ��
Facility Name 1 OLO YA � C[e\fej"1(4w -P
PQ bo)( 4-a I
Mailing Address
Contact Person i
Title
Telephone Number (` A z2 -4 ! 717
57 ! i1 i— Cckck CA U cd--) Rao d
Facility Address i
(not P.O. Box)
A.2. Applicant (information. If the applicant from the above, provide the following:
is�isssdifferent
Applicant Name J
Mailing Address
Contact Person Pa t4n e
�� urn C1 r K.
Title :e
Telephone Number U a q j —A/1 77
Is the applicant the owner or operator (or both) of the treatment works?
owner ❑ operator
Indicate wI11h��-ether correspondence regarding this permit should be directed to the facility or the applicant.
facility ❑ applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -issued permits).
tt°�� a ca r/ PSD
NPDES K ()(04 L
.
UIC Other
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
C_°lGy elw�
18wr\ If CVye- 9a I f%, I o a a E&
Total population served la1 -+ 1 �
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 2 of 22

• FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
-- � C O©4g9 67 W a'1 Ctakt r• S fie- lec
Tfw , A �l G�f G�G�n� � C.f'1 C
A.S. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes X No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes Pf No
A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12t" month of *this year" occurring no more than three months prior to this application submittal.
91
A AID
a. Design flow rate mgd
. 640 f#V4.k-jTwo Years Arro Last Year
This Year
b. Annual average daily flow rate it /ODIC w /0 59
• •ca'a
new a '13 s34
.3I
C. Maximum daily rate .
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply.
Also estimate the percent
contribution (by miles) of each.
j Separate sanitary sewer /11
/
f ! t°s - / mn %
❑ Combined storm and sanitary sewer
%
A.8. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
I. Discharges of treated effluent
H. Discharges of untreated or partially treated effluent
III. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
i
V. Other i
b. Does the treatment works discharge effluent to basins, ponds, or other surface impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes
If yes, provide the following for each surface Impoundment:
Location:
Annual average dairy volume discharge to surface impoundment(s)
Is discharge ❑ continuous or ❑ intermittent?
C. Does the treatment works land -apply treated wastewater?
If yes, provide the following for each land application site:
d
Location:
Number of acres:
Annual average daily volume applied to site:
Is land application ❑ continuous or intermittent?
Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
A No
Yes
mgd
❑ Yes
mgd
❑ No
No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER: PER T ;;REQUESTED: RIVER BASIN:
vo18�? ��� i
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transporteJ to the other treatment works
(e.g., tank truck, pipe).
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number ( l
For each treatment works that receives this discharge, provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number ( )
If known, provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility. mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
In A.B. through A.B.d above (e.g.. underground percolation, well Injection): Yes Po
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) if applicable):
AM A)U) ffO4-0-
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or intermittent?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PERMI ACTION REQUESTED: RIVER BASIN:
AG00(kt f �nrewa.I Ask
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.a, complete questions A.9 through A.12 once for each outfall (including bypass points) through
which effluent is discharged. Do not include information on combined sewer overflows in this section. If you answered "No" to question
A.8.a, go to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number 00
b. Location lown nf- C -e—iej o-n d --
(City or town, if applicable) (Zip Code)
& W an KC
(County) (State)
5 . $ 0 ,�. i 39 i1)
(Latitude) (Longitude)
C. Distance from shore (if applicable) �� ft
d. Depth below surface (if applicable) tt
e. Average daily flow rate O `44 mgd
f. Does this outfall have either an intermittent or a periodic discharge? ❑ Yes No (go to A.9.g.)
If yes, provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge:
Months in which discharge occurs:
g. Is outfaii equipped with a diffuser?
A.10. Description of Receiving Waters.
a. Name of receiving water ti C�rP k
b. Name of watershed (If known) - rjig
United States Soil Conservation Service 14-digit watershed code (if known):
C. Name of State Management/River Basin (if known): 19
United States Geological Survey 8-digit hydrologic cataloging unit code (if known): 119
d. Critical low flow of receiving stream (if applicable)
acute cis chronic cfs
e. Total hardness of receiving stream at critical low flow (if applicable): mg/I of CaCO3
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER:
t� /w
PERMIT TIO,Np�R,E�QUESTED:
PERM
RIVER BASIN: P
A
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
9 Primary Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
c Design BOD5 removal or Design CBOD5 removal %
Design SS
removal
Design P removal %
Design N removal %
Other %
C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
If disinfection is by chlorination is dechlorination used for this outfall? Yes ❑ No
i
--- Does the treatment plant have post aeration? i ❑ Yes ❑ No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is
discharged. Do not include Information on combined sewer overflows in this section. All Information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA10C requirements of
40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number cot
MAXIMUM DAILY'VALUE'
AVERAGE DAILY -.VALUE
PARAMETER
Value
Units
Value
Units
Number of Samples
pH (Minimum)
. Q 3
s.u,
pH (Maximum)
S.U.
C
u.
Flow Rate
Q.
m 6�
a
rnG-D
Temperature Winter)
C
.�
Temperature (Summer)
C
I
* For pH please report a minimum and a maximum daily value
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
POLLUTANT
DISCHARGE
ANALYTICAL
METHOD
MUMDL
Cone.
Unit$
Cone.
Units
Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BOD5 jn i D�
BIOCHEMICAL OXYGEN
DEMAND (Repoli one) moo.-- �.-�--- -
CBODS ---•' --r.. .�— -r..
FECAL COLIFORM
AM
6001n
1d
At Aw j
TOTAL SUSPENDED SOLIDS (TSS)
MCAl
S a54-61
G
.:END ObF P:ART=A:
REFER TO THE. APPLICATION- OVERVIEW (PAGE 1) TO- `DETERMINE 'WHICH OTHER PARTS
OF FORMA 2AYOU MUST COMPLETE
nl
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 6 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT CTION REQUESTED: RIVER BASIN:
f wiewP'& .6.e.
BASIC APPLICATION INFORMATION
PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR
EQUAL TO 0.1.MGD (100,000 gallons per day).
All applicants with a design flow rate z 0.1 mgd must answer questions B.1 through B.S. All others go to Part C (Certification).
B.I. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
gpd
Briefly explain apJ steps underwpy or planned to minimize inflowpnd infiltration.
♦ . A
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is Injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within % mile of the property boundaries of the treatment
works, and 2) listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g..
chlorination and dechlorination). The water balance must show daily average flov) rates at Influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
B.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (rqilaled to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? ❑ Yes No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary).
Name: -
Mailing Address:
Telephone Number. f
Responsibilities of Contractor.
B.S. Scheduled Improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
a. List the outfall number (assigned in,question A.9) for each outfall that is covered by this implementation schedule.
No in 61
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes ❑ No •
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 7 of 22

FACILITY NAME AND PERMIT NUMBER:
PER ;ACTION REQUESTED:
RIVER BASIN:
Pico
C. If the answer to B.5.b is `Yes," briefly describe, including new maximum daily inflow rate (if applicable).
i
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as
applicable. For Improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MMIDD/YYYY MM/DD/YYYY
- Begin Construction 1 1 1 I
- End Construction I I I I
- Begin Discharge I I 1 I
- Attain Operational Level 1 1 1 1
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated
effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not include information
on combine sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QAIQC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
i
Outfall Number. 001
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
ML,lMDL
Number of
Conc.
Units
Conc.
Units
Samples
CONVENTIONAL AND NON CONVENTIONAL
COMPOUNDS �l
AMMONIA (as N)
, m j cI� 45 tan +<<
CHLORINE
RES DUAL, T C) (TOTAL
ell
{A 1
Q` . O�
t( (
a
;5M `7�00�
�•
DISSOLVED OXYGEN
.O
OS©C�
.Q
TOTALHL
NITROGEN (TKNITROGEN
1347
lQ
0)454DI44&B
+ c2tv b
NITRATE PLUS NITRITE66
NITROGEN
N013MI5F
x
V
OIL and GREASE
3.
*7l `fRev
.D
PHOSPHORUS (Total)
5
Q�
fl•
jL DISSOLVED SOLIDS
TOTAL
4W' 0C. _ ` if
ry
OTHER
Nb OfPART B.
REFER T`b THE APPLICATION OVERVIEW (PAGE,.1.) TO.ETERMIWE:V�IHCH OTHER -PARTS
- -OF FOR�U`I2A;YOU MUST'C�t�fPLE7E .
EPA Form 3510.2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 8 of 22

FACILITY NAME AND PERMIT NUMBER:
PER ACTION REQ ESTED:
RIVER BASIN:Pee
J�C oa �
gene OR
BASIC APPLICATION:INFORMATION !
PART C. CERTIFICATION
All applicants must complete the Certification Section. Refer to instructions to determine who Is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
Basic Application Information packet.. Supplemental Application Information packet:
Part D (Expanded Effluent Testing Data)
Part E (Toxicity Testing: Biomonitoring Data)
Part F (Industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G (Combined Sewer Systems)
ALL APPLICANTS•MUST COMPLETE•TH.E�.FOLL-QWING•CERTIFICATtON. ..
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment
for knowing violations.
Name and official title
Signature
�J �%
Telephone number s a 17 I / -
Date signed
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENRI DWO
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT CTION REQU STED:
RIVER BASIN:
'All
effxm IV
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
i
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or It has .(or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged. Do not include information on combined sewer overflows in this section. All Information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and
other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number: rv-,N 1 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Cone.
Units
Mass
Units
Cone.
Units
Mass
Units
Number
of
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
ANTIMONY
•
`
j'p
1�
�
a
3
A a*. ` A
.?
6t `�
ARSENIC
`
3���
BERYLLIUM
)
*14
jjD
9
��
•�
'
�r am?
p•10
CADMIUM
!e�
�`+
• v
'
3
&N aml
1.0
CHROMIUM
�. 4�.
�
�
�� 3
3
��4 ace.?
1• 4
COPPERIda
I 4-[*VL
.04
3
t x =1
s+ o
LEAD
MERCURY
•� D
k�lL
fV+�
Q•
'L"
3
�W i
• ���
NICKEL
n/
u�V
♦�' f
Gr►QA,a=1Q-9ti
SELENIUM
Do
✓
ip A a=1
�Ps
SILVER
f5z
"i.
tab
4410oo1
d
3
o0i9 �a !
g
THALLIUM
�A
ual �
. S
-Ag.6
'OIL
`M
PC%
.3
?
to'
ZINC
j5414Ir•
-al
&
I u k
e D
%3
40A
clrrr W. *7
CYANIDE
j
.Q
;1
3
PA Y0.
•�
TOTAL PHENOLIC/
COMPOUNDS 4
(�
' _ `j`
n
�f•�
.D�`
l
•
AW
+�
a
�� `1
,
HARDNESS (as CaCO3)IL
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 10 of 22

.
FACILITY NAME AND PERMIT NUMBER:
PERMIT / CTION REQUESTED:
RIVER BASIN: jp
Pee A0
Outfall number: o6 / (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE GAILY DISCHARGE
ANALYTICAL
METHOD
M�DL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
VOLATILE ORGANIC COMPOUNDS
ACROLEIN
ficao
I L
aD141M
y�-
d-1'
44.
ACRYLONITRILE
IV
kqIIV
O4q,5w1b,
Ny
6A GA
3,5Afi
BENZENE
jlftqj,�_
5,D
"1J
F S% o
4jj00,
60A
BROMOFORM
CARBON
TETRACHLORIDE
6,0
Vi q ,
.
NDNA04
04
CHLOROBENZENE
�fC)
reko,
w
44IL
131>
-3CHLOROD
`+rQ�
♦O
ME HANEIBROMO-
6.4 • fra
-11 &*1-
CHLOROETHANE
f/1
�C��'�
��
���f•�
•
tA
3
ETHER ROETHYLVINYL
ETHER
5
�'7
�"f�l►
��
L
`
u�`L
`
��
6� y_ 4
fQd�
5ID A
CHLOROFORM
.j
"f L
A)b
` gq
4 tA4
6j)DICHLORO
METHANE BROMO-
� �
` L
uA
/.
>
teA 4
A !�
1,1-DICHLOROETHANE
1,2-DICHLOROETHANE�
L
5i(7 II
ETHY ENE DICHLORO-
+�
u(B 1�
L
�T
1oh
l` f
13
G M /_A
U L
1,1-DICHLORO-
ETHYLENE
1,2-DICHLOROPROPANE
���
��!!J
444,
O
`
�l
" ` yL
`, ('�
N •D
- (eA4
�
J+ oyA
1,3-DICHLORO-
PROPYLENE
ETHYLBENZENE
��
10
METHYL BROMIDE
lot-0
'i f L
��
'�
{
! •
3
6PA. 4,
6.0 wi
METHYL CHLORIDE
tW1,0
i
j 1
D
METHYLENE CHLORIDE
1IDi-0
I(R L
1,
3
9PA kA
CHLORO HANE A6D
'`..
-
93
�P,+6.1
�jauti
ETHYLENE
�
r1
�
�
6PA 4.%V
604)
TOLUENE
�`Ji�
v,L
Kits
0
EfA 'eA4
i
,V
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 11 of 22

FACILITY NAME AND PERMIT NUMBER:
�1 00
PERMIT ACTION REQUESTED:
�j
!i �/1 �k3ii
RIVER BASIN: ��j�
�1 e 4j
Outfall number (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MUMDL
Cone.
Units
Mass
Units
Cone.
Units
Mass
Units
Number
of
Samples
TRICHLOROETHANE
�
(Q
, �j400.0
TRICHLOROETHANE
450D
1k.
,&r6
Wt
l g
u
•
�
0 •
TRICHLOROETHYLENE
�✓��
MI e
05
*
' 511W
,S
SPA �?,x4
01 1
VINYL CHLORIDE -PIR0
)s
000
of
•�I,
3
Ci/ a 414 1&,.3A
Use this space (or a separate sheet) to provide Information on other olatile organic compounds requested by the permit writer
ACID -EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
2-CHLOROPHENOL
�d�0
!G
Q ro
•
*I�
. o IS
.3
�jJ'�T 6
vz
2,4-DICHLOROPHENOL
016.0.
/�j
'`I✓
�f?
Nt3
!QQ
VTR �p
&0
2,4-DIMETHYLPHENOL
IDOD
"�'�i��I
,ND
j..
m
ILIA
3
Q�
.0 04
4,6-DIN ITRO-O-CRESO L
2,4-DINITROPHENOL
,cu
A
i4I Lo
m
L
,.'�
G ar 4 ?
00
2-NITROPHENOL 4
(6.�k
j�
D!a
+�
Agoi
L'dt
O
V
�11v
4-NITROPHENOL
�
�
/�
D ►
��
'•��
N
.3
PENTACHLOROPHENOL
1D
IWI/i,
��
$�q
"� G
ILI p
3'
�I
J�DWgo
PHENOL
_" `fG
4ofo
A
�e�
��
t�o�
!v
�
WA- �
ID40 1*16
2.4.6- N
TRICHLOROPHE OL
j ��
WV&
,,.�o/�
tNvA
, J�
n
,�V4
Wto
i
D
�
G� � Y
Use this space (or a separate sheet) to provide information on other acid
-extractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
01D
W%ko
001b
Ite��
'"I
to
400
r�j�
"'� ,U
316
L
AW W6
1DiO u
ACENAPHTHYLENE
A.106V
IVAIj,to
0�
��
"YL
s�
A
'3
W6
`64i*A
ANTHRACENE
ID t�
"hG`�
"'�(�
�Q
* Ib3
BENZIDINE A,
oo
MIL,
/fit
*10:
p�
`
/j/
�i 1�wl
` a
44'
iwo
BENZO(A)ANTHRACENE�I`
6�
jjam�,,
'`r�`�/
3
f•0
BENZO(A)PYRENE
��
�(�
4010
40
* 1
L% (000axvIJ
,/
ItA4 4oW
04 u~
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 22

FACILITY NAM NO PE MIT NUMBER:
ktVo O �T 7
PER ACTION REQUESTED:
�• i 4WK
RIVER BASIN:
Outfall number.yy (Complete once for each outfall discharging effluent to waters of the Aied States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
METHOD
MLIMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
3,4 BENZO-
FLUORANTHENE
jj
��.,J
L+
�2
'005�
• �
��
G
,
jJ
n
�
60425
BENZO(GHI)PERYLENE
FLUORANTHENE
lV
`lli
6wI
(
I
u
sOa�
L
+' ��
%0,0
BIS OROETHOXY)
METHANEBIS
ETHER HLOROETHYL)-
toa
�`,I
j
BIS (2-CHLOROISO-
PROPYL) ETHER
f�
r, ,�j
,A
CD
�" 4 &RS'
10
BIS PHTHALATE
4141
GI
.�i
L/��
pn AQ�+
z` /l
PHENYL ETHER L J/10
W, - -
�W!
, I
.
L
4 '
I�
p�
6A+ �6
`' "
BUTYL
PHTHALATE Alox
4
4f
'
3
tPR «5
`40 IL-
NAPH ALENE
1
3
w
M.4 6, a5
/V 14G
P ENY LET ER L �.
�j
`
�p�
��
3
4PA
CHRYSENE
• V
r�f
, %
�7
"`� G
via.
DI-N-BUTYL PHTHALATE
Ds 7►/`
V
v
•�
1/G
��
f
x lei (,
v
DI-N-OCTYL PHTHALATE
l
1
DIBENZO(A,H)
ANTHRACENE A1,2-DICHLOROBENZENEIVA4
L
IT
16-7!�
.M'
e
,001
`
G
I,/J
��
tok
1,3-DICHLOROBENZENk
of
-"!
+od
1
L
1,4-DICHLOROBENZENE 4
Z96'6
�IG
4too`
(
-D
` G
, oza
BENZ D NE RO- A
7%.
,QD r
Goaaa
*65
3
l
o lk
DIETHYL PHTHALATE
T
DIMETHYL PHTHALATE
`Djo440
�y `
a
1
D u L
2,4-DINITROTOLUENE
�O�'�
/,
a
O
2,6-DINITROTOLUENE
V
V
1,2-DIPHENYL-
HYDRAZINE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 13 of 22

FACILITY NAME AND PER IT NUMBER:
� Co ?'
PERMI CTION REQUESTED:
RIVER BASIN•
ee Ale,
,(JCS
�i a_Maw
Outfall number: (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
POLLUTANT
Cone. Units Mass Units
Number
Cone. Units Mass Units of
Samples
METHOD
MUMDL
FLUORANTHENE
G�
`
L
f/i
AL
!o•D
FLUORENE
`�
~� `
SODA
�,�
.3�j�/`a'
HEXACHLOROBENZENE
�!
T(J
�QC
�p
3
�jv/7-
W� ~!
HEXACHLORO-
BUTADIENE
Kf
G
oI
�� �•
�i
a �rZ
%/
l
3
(�Q, /
tP# 17
fv�
HEXACHLOROCYCLO-
PENTADIENE
/0r0
G
0/
D
_�
lD
6 I�
HEXACHLOROETHANE
L
�O !
PL.�
'{JL7
(�
• 0aa
4*/Y
3
fi7
INDENO(1,2,3-CD)
PYRENE
ISOPHORONE
•�
u�{
'
AL
if
I
Q
✓
�`(�` /-1 W5
•"�O k
NAPHTHALENE
]�
L
Q I
G
D
(.��Q
U4
AV
NITROBENZENE
sV
'^�
�G
��I
Q
0
L
&L
3
,(�/� /
`jr41Q0
//�(
!ff u�
N-NITROSODI-N-
PROPYLAMINE
wwyL
`I
/A
J1J
40 40
Q
�!%
3
N-NITROSODI-/
METHYLAMINE ,4
��(�
((r
iV
c•�`
N-NITROSODI-
4 l
rL
�r�`
•,
PHENYLAMINE
PHENANTHRENE
�0 00
(r
��!
Ip
3
�j I
-"•(t+
•��
n
�Y
3
n/�
U.4 k25
l�
PYRENE
��
u �..
o
V
V
3
nn
�R 057
I/-
JAV!v
1,2,4-
TRICHLOROBENZENE
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
L
I
t
Use this space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer
EN1� OF PART D.
REFER TO THE•APPLICATION OVERVIEW- (PAGE 1) TO DETERMINE WHICH -OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 755d-22. Page 14 of 22

FACILITY NAME AND PERMIT NUMBER:
PER T ACTION REQUESTED:
RIVER BASIN:
�ee
�11�e
tee
SUPPLEMENTAL>APPLICATION, INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403); or 3YPOTWs required by the permitting authority to gUbmit data for these parameters.
• At a minimum, these results must Include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed atjeast annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include
information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC.requirements of 40 CFR Part 136 and other appropriate QA/QC
requirements for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide an f information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted. j .
• If you have already submitted -any of the information requested in Part E, you nbed not submit it again. Rather, provide the information
requested in question EA for previously submitted Information. If EPA me ods were not use , report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no blomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.I. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years. n
chronic ❑ acutej�� tl�1Z11%`
E.2. Individual Test Data. Complete the following chart for each whole effluent toxi test conducted In the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number. Test number: Test number.
a. Test information.
Test Species & test method number
Age at initiation of test
Outfall number
Dates sample collected
Date test started
I
Duration
!
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
C� A)� ��ft6
1a
PERMIT ION REQUESTED:
�� �*k,4
RIVER BASIN:
Pa
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
L I
f. For each test, include whether the test was Intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
i
Flow -through
'
h. Source of dilution water. If laboratory water, specify type: if receiving water, specify source.
Laboratory water
Receiving water
i. Type of dilution water. If salt water, specify anaturalm or type of artificial sea salts or brine used.
Fresh water
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100%
effluent
%
%
ova
LC5o
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22

FACILITY NA E AND PERMIT NUMBER:
/) I - qq
ACTION REQUESTED:
P7-e
RIVER BASIN:
Pee
. X=
n1ewct
Chronic:
NOEC
%
%
%
IC25
%
%
%
Control percent survival
%
%
%
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes 0 No If yes, describe:
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MM/DD/YYYY)
Summary of results: (see instructions)
tog
END..OP 'PART`E.
REFER TO -'.THE :APPLICATION. -OVERVIEW: (PAGE t) TO DETERMINE WHICH OTHER PARTS
OF *FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT CTIeO REQUESTED: RIVER BASIN: %�
1 �/
�6 .,� ! � ,dam
/UG � 7 ��I�PWa
SUPPLEMENTAL APPLICATION INFORMATION
PART F. INDUSTRIAL'.USER; biSCHARGES`A110:.RCRAICERCLA-WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
V Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs.
b. Number of CIUs.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than One SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: %oLi ty "ruck.�
Mailing Address: Po 04DX 39 1
clJe,l 0J,xa KO, oZ 7O 1.3
F.4. Industrial Processes. Describe all the Industrial processes that affect or contribute to the SIU's discharge.
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s): 4,oa1( C QcA i�u(- r
Raw material(s): Q i r) LL M b 1 C. 5 1n++55 F4. y f 1 51 fesd
F.6. Flow Rate.
'o(e (J-m ��'od c,L 5 C® c� i Elm 1'cct IS
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system In gallons per
day (gpd) and whether the discharge is continuous or intermittent.
gpd ( X , continuous or intermittent)
t
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or Intermittent.
gpd (_ continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ❑ Yes ❑ No
b. Categorical pretreatment standards ), Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT AR ON REQUESTED:
RIVER BASIN:
too
F.8. Problems at the Treatment Works Attributed to Waste_ Discharge by the SIU. Has the SIU caused or con buted to any problems (e.g..
upsets, interference) at the treatment works in the past three years?
❑ Yes P(No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has It in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes YL No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
Yes ❑ No ,
If yes, describe the tre tment (provide Info tion bout the removal effcielcy):
wae,IV L2#
b. Is the discharge (or will the discharge be) continuous or intermittent?
continuous ❑ Intermittent If intermittent, describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION -OVERVIEW- (:PAGE 1)• TO DETERMINE WHICH -OTHER .PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
'i✓����'� J ('enewal 46Pee -be �
SUPPLEMENTAL APPLICATION INFORMATION
PART G. COMBINED` SEINER SYSTEMS
If the treatment works has a combined sewer system, complete Part G.
G.I. System Map. Provide a map Indicating the following: (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs (e.b., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
C. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in G.1 or on a separate drawing, of the combined sewer collection system that
includes the following Information.
a. Location of major sewer trunk lines, both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
C. Locations of in -line and off-line storage structures.
d. Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFALLS:
Complete questions G.3 through G.6 once for each CSO discharge_ point.
G.3. Description of Outfall.
a. Outfall number
b. Location
(City or town, if applicable)
(County)
(Zip Code)
(State)
(Latitude) ' (Longitude)
C. Distance from shore (if applicable) g•
d. Depth below surface (if applicable) ff
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
G.4. CSO Events.
a. Give the number of CSO events in the last year.
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 20 of 22

FIGURE
TOWN OF CLEVELAND WWTP
r1 Bar
ueat
� Flow � �a
S linerRA
4s
Oxidation Ditch #1 ;,.--!S
(0.09 MG) w
I
Final Eff. &
Q2 Flow Measurement
To Stream -- — Clarifier # 1 WAS_
10.019 MG)
Digester
i`
Chlorine �__---- ..._----- _RAs..�_..._
Contact
i
Clarifier # 2 WAS M
10.0476 G) To Sludge
- Ss Disposal 6
3b
Oxidation Ditch #2
(0.18MG) _�

- __ r` �`\ �' ��� ! 1/ -� �� �. �'�� J \ � � � �,�� , 1" � � �� -�� �' ;/.i - I: �- ,•1 h��` � = ram- t�' -_-�_ ��� f \� �♦ -
aaa � !i �I � \` e� _ __ �\°`i `-� _; I�) - / , - ��;lf i —!f �' 'i `_'-'_' = _ —. / // • t"' _ --: ��b� l \ � / �� •,. j-^ �`+- J�(
•l- 1.EqUSn �t ,- .rr���`{Il i'-'- i"� ice.. - a', -',
. _ L}.1 - _. ✓,ri �- � - ti �. 1973,�-���(I( ��1`�� - ;i) "WASTEWATER
IiG
TREATMENT FACELMES
/ _ 1 _�' rag' Q1b _=) :;�^�`\�Vi �l ✓f- _: _�� _I�� 1i4 \`0�� }� -
- , � __ �_ - — ,- _ � � � - � . %• ✓f �_ �� - -�� .I - .�,: � - - �-� - � ��:_----u:._ _�, /ems i �r -��. � �f :�'
r �- '.��'_ -V f{/%��7/n\- -Jl .•�� BM 735 _ �, oi,�!/ ./4� _ 8 V �1/_ - - /• - /- tT�- - ���!'-4::=Taos"- __1`l .i�� �!:�`� ( �1r- __
F,y11
\ _ 2557 % — — --'A(0'
CLEVELAH ! _ ;:-j SAUSBURY s ICE AREA -
-. �- t/ - _ .- �• ry— :� / \. 16e '�`�o if - -- y = ]__: / � ;.� _
'jam' - I.�11_ - n u i/•- e _ .=.�• u - -i i 3u7� - -'I �. -i„ - `�'�-_ j� j ��` - f, Yt��� i/ 'f�P - -a• .fit' ��.`•,'- -
®M:i �- .• -- g - v':- 1Y I _ �'�.�i
� ��";� ;:�.f, -\._; _ -_ d •� :"�' .'f, - �' �� Vim_ - _- �' - ,".,'-� _ ,"-!•� - / �.L J C;`,-\\
-- l �� -5� ".asi- - ,�;��.: e-•--� , ; �1 " I Lri T('u*`.61� - --'- - _ _ - \J k E731 - - V) _�.��� t.
EIGHT fUER a _ _ ,_- 7Hs t_ 1 ;_ ___ ; _ ; . �o : -t M7
-- =�� _ � � i _.��. -� V. -' = �� it " 1 - �-- `_�_.t `''.�:�-tE t _ - _ -- � _ �n � 1 _( � �_ � %•�-_ � _ ,_ -_ - � `n � + l_
_ _ -^�_( FF :/�_ � i.ti .�. —1 '1: ° ay ;�� � _� � ;gl i :% I -_ -. ��� •/ 7�'J - - /_ C ; �� _ Q_r `� t� %. _ -,L _ I/ � o •--. / �
ire- � - 1 - �r � - -�� -.T _ _ � ��i' -� _ ' '� - j!�' ' �_ _ � ate• '
-razes _tu
C:ZEVELAND SERVICE AREA
_ - �'_ 't�-:�•_- - 1 ��% - - -rrP_ � - t - 1 ./E � � -'fir- \./ar _ ` ; r' _ •. /:✓J � t=�--�_ �e � � Tom• e > . - �A - - `•'-„
739,
726
�s, - - _J %:' � \ �- . � n - - '-�--��' - s�T ns- � -�6 � •.JJV 'd � ' l.Y'I +�: r : . -ram : \ � _$, r � - (ii - - • t� ?s� " \ Sf : -�: �•�
- - — — - 1 - -� .'- .�" "�\- i _' ' •,tip �- - - l`` -' _ -� � ~ _ .- - `'.' - tS _ � _ . --, fl � i \ _ l - ) �' H r t � (f/i/
- � �` — •-7 .' _ _ � - _ - - _ —' -- 4.� _ _ --- __ � 1 - _- _ `-_ -- � � t � --- - _ ) vim+' � - \ .� 1 \ - , �� _
.fit=- ��-/ :�� -F�_ ' ��• gt -J \\l� ,�8�/�� -���, .
- -.-`:' - `,`\�.. -- �,, -_ Boo -:_�, _ � — ��•- �- `�--.,'-•;,!- �--=1.,-� ;�:� = _�//•-=` 'PP __r� L 1\ -,n� Gy,�✓� �� .'lVi -
/ . •i _ 'J :. 1547
\`\\ � '' _�r'�-'- �-' /� - - ' J - _-_Certr-; Cam` --'-�r- � �-�/ ;: -'� �� �- . .` �j��-� _� • 1 ��� J � i'„`" ! 1�$ -`` � i � � ';(! �_ �-

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED:
FORM
2A
NPDES
APPLICATION OVERVIEW
RIVER BASIN:
\16-c.kl h
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. Somepallcants must also complete the Supplemental
Application Information packet. The follo Iw ng items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow z 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions 13.1 through B.6.
C. Certification. All applicants must complete Part C (Certification).
i
SUPPLEMENTAL APPLICATION INFORMATION: i
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percentormore of the average dry weather hydraulic or organic
capacity of the treatment plant; or
C. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
ALL APPLICANTS.MUST= COMPLE`fE PART -C -(CERTIFICATION)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
Renewa_'t
RIVER BASIN:
Pee��
u1'n of c(evetar4 oaf W 7
akin
BASIC APPLICATIO.W.INF.ORmATION,:
PART A. BASIC AP`PLICAT ON INFORMATION FOR ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet.
A.I. Facility Information.
[ / , l
Facili Name l+tj YZ C[e\iej6_A1dWT�
Pp Box " 7 a I
Mailing Address -
( -vaa_ra NC' CP `7013
Contact Person nu C-7&iyj-e,1
Title A i (-
Telephone Number
d
0-cp e aLA Cc!) Road
Facility Address .� ! i�c� _F-.
e f a.j'15t, ► V 1 Q l ©l -5
(not P.O. Box) 1,
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant NameMailing
Address
Address
Contact Person Pa
0 Lon -e r
Title
Telephone Number �UTt oZ L b —L ! / 7
Is the applicant the owner or operator (or both) of the treatment works?
owner ❑ operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
[� facility ❑ applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -issued permits).
��
NPDES � 04q S t,, r� PSD
UIC Other
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and. if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
I low t* 0le e- nI1 i a e&
Total population served ell
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 2 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
-FOW n V-� CleU. :P, G
le"7-
A.S. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes X No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes X No
-A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12"' month of 'this year' occurring no more than three months prior to this application submittal.
?h�
a. Design flow rate A AI W mgd
=Ae
7 �1
6+)tjW" i[oj"Z Two Years Ago
Last Year This Year
Annual dal flow ,0
. /0 55 0 lvt4-
average rate
w. � h+
2
9
Maximum daily flow rate e � 3
• &4 • JI
c.
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant.
Check all that apply. Also estimate the percent
contribution (by miles) of each.
r'%
/i} r J es " - / To- %
Separate sanitary sewer
/
❑ Combined storm and sanitary sewer
%
A.B. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
I. Discharges of treated effluent
ii. Discharges of untreated or partially treated effluent
Ili. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
V. Other
b. Does the treatment works discharge effluent to basins, ponds, or other surface Impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes
If yes, provide the following for each surface impoundment:
Location:
i
Annual average daily volume discharge to surface Impoundment(s)
Is discharge ❑ continuous or ❑ intermittent?
C. Does the treatment works land -apply treated wastewater?
If yes, provide the following for each land application site:
d.
Location:
Number of acres:
Annual average daily volume applied to site:
Is land application ❑ continuous or intermittent?
Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
A No
0 Yes
mgd
❑ Yes
mgd
❑ No
No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER: PER T ACTION REQUESTED: RIVER BASIN: f ��
' Ncoo 4ri �� � w P
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transporte to the other treatment works
(e.g., tank truck, pipe).
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
i
Contact Person
Title '
Telephone Number )
For each treatment works that receives this discharge, provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number ( ) If known, provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility. mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.B. through A.8.d above (e.g., underground percolation, well Injection): 41 Yes K No
If yes, provide the following for each disposal method:
Description of method (including location and size of site(s) if applicable):
kidam/1 , J Akoo W-n4ik)
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous
or, intermittent?
EPA Form 3510-2A (Rev.1-99). Replaces EPA forms 7550-6 & 7550-�2.
Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PERMI ACTION REQUESTED: RIVER BASIN:
�n►e .I ACC
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.a, complete questions A.9 through A.12 once for each outfall (including bypass points) through
which effluent is discharged. Do not include information on combined sewer overflows in this section. If you answered "No" to question
A.8.a, go to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number d© 1
b. Location lown of
(City or town, if applicable) (Zip Code)
(County)
(Latitude)
C. Distance from shore (if applicable)
d. Depth below surface (if applicable)
e. Average daily flow rate
f. Does this outfall have either an intermittent or a periodic discharge?
If yes, provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge:
Months In which discharge occurs:
g. Is outfall equipped with a diffuser?
A.10. Description of Receiving Waters.
`�� (State)
` 06'
(Longitude)
d ft.
00 / mgd
❑ Yes 9k No (go to A.9.g.)
a. Name of receiving water -7-h I ed C -LiP _K
i
b. Name of watershed (if known) --
United States Soil Conservation Service 14-digit watershed code (if known): N
C. Name of State Management/River Basin (if known): N / 9
United States Geological Survey 84git hydrologic cataloging unit code (if known):
d. Critical low flow of receiving stream (if applicable)
acute cfs
e. Total hardness of receiving stream at critical low flow (if applicable):
chronic
cis
mg/l of CaCO3
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMITION REQUESTED:
RIVER BASIN:
I - C
&
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
9 Primary Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
Design BOD5 removal or Design CBOD5 removal !E&
Design SS OZ � � %
removal
Design P removal %
Design N removal %
i
Other r %
C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
Cik lm-oi n e a 615
If disinfection is by chlorination is dechlorination used for this outfall? Yes ❑ No
Does the treatment plant have post aeration? ❑ Yes ❑ No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is
discharged. Do not Include information on combined sewer overflows In this section. All information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QAIQC requirements of
40 CFR Part 136 and other appropriate QAIQC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number.
MAXIMUM -DAILY VALUE
AVERAGE DAILY VALUE
PARAMETER
Value
Units
Value
Units
Number of Samples
pH (Minimum)
. Q 3
S.U.
pH (Maximum)
SM.
coil,
�-•n
Flow Rate
Q.
in G-
,Mtsy
M
Temperature (Winter)
m
Temperature (Summer)
and a maximum daily value
• For pH please report a minimum
MAXIMUM DAILY
AVERAGE DAILY DISCHARGE
POLLUTANT
DISCHARGE
ANALYTICAL
METHOD
MLlMDL
Conc.
Units
Conc.
Units
Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BOD5 rn 1 5 MqtnDo
BIOCHEMICAL OXYGEN .
DEMAND (Report one) Ul
FECAL COLIFORM
60,wini
afit hwj
TOTAL SUSPENDED SOLIDS (TSS)
l
S.?.LJ
ENDOF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO .DETERMINE WHICH OTHER PARTS
OF FORM2A YOU. MUST COMPLETE
In/
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 6 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT CTION REQUESTED: RIVER BASIN:
AX V002
BASIC APPLICATION INFORMATION
PART B. ADDITIONAL APPLICATION"INFORMATION FOR APPLICANTS WITH A DESIGN FLOW GREATER THAN OR
EQUAL TO 0.1.MGD (100,000.gallons per day).
All applicants with a design flow rate Z 0.1 mgd must answer questions B.1 through B.6. All others go to Part C (Certification).
B.I. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
gpd
Briefly explain a steps unde y or planne to minimize inflow, nd infiltration. `
IF dMadda t11iD
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within % mile of the property boundaries of the treatment
works, and 2) fisted in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
f. If the treatment works receives waste that is classed as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g.,
chlorination and dechlodnation). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
B.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (r la ed to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? ❑ Yes No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary). `
Name: '
Mailing Address:
Telephone Number.
Responsibilities of Contractor -
B.S. Scheduled improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different Implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
a. List the outfall number (assigned � in�question A.9) for each outfall that is covered by this implementation schedule.
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes ❑ No
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. 1 Page 7 of 22

FACILITY NAME AND PERMIT NUMBER:
PER ;ACTION REQUESTED:
RIVER BASIN:
Aewew
' NNv000S�q
Aft
i -v
C. If the answer to B.5.b is "Yes,' briefly describe, including new maximum daily inflow rate (if applicable).
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below, as
applicable. For improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dates, as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYYY MM/DD/YYYY
- Begin Construction I 1 I 1
- End Construction I I 1 1
- Begin Discharge 1 I I I
- Attain Operational Level I I I !
e. Have appropriate permits/clearances concerning other FederalfState requirements been obtained? ❑ Yes ❑ No
Describe briefly:
B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated
effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not include Information
on combine sewer overflows In this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QAlQC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
Outfall Number: 001
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
POLLUTANT
METHOD
MLJMDL
Number of
Conc.
Units
Conc.
Units
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
O
AMMONIA (as N)
jN
RES DUTAL, TRC)AL
ell
'
`
1 f J
'450C
�• �}
DISSOLVED OXYGEN
.O
• O
fhA
445-
Da
TOTAL KJELDAHL
1367
Al Q
SM456014 4&8NITRATE
(Q 1
NITROGEN (TKN)
a,
43
+
NITROGENLUS NITRITE
.66il
x
OIL and GREASE
+3�A4
em u4 Pie>r
.� %i�►
PHOSPHORUS (Total)
5
�D
Q.AWIL
TOTAL DISSOLVED SOLIDS
Cj1
(TDS)
`
�JV
OTHER
- -:- END OF PART:B,
REFER` TO THE. APPLICATION QVERVIEW :(PAGE .1,).TO.DETERMINE. WH�CW OTHER -PARTS
OFFORJ�A A Y4U. MUST`COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 8 of 22

FACILITY NAME AND PERMIT NUMBER:
PER ACTION REQ ESTED:
RIVER BASIN:Pee
oa
AX`
gene
BASIC APPLICATION,,:INFORMATfON� =
PART C.. CERTIFf CATION , .
All applicants must complete the Certification Section. Refer to Instructions to determine who Is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained In the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certificagon statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this a pllcation is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
Basic Application Information packet. Supplemental Application Information packet:
Part D (Expanded Effluent Testing Data)
Part E (Toxicity Testing: Biomonitoring Data)
}� Part F (Industrial User Discharges and RCRA/CERCLA Wastes)
T❑`
Part G (Combined Sewer Systems)
ALL APPLICANTSMUST-COMPLETE•THE:FOLLOWING-CER-TIFICATION.' .
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my Inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment
for knowing violations.
Name and official title
a
Signature
G `]
Telephone number /!/ ,7 / --
Date signed
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements. {
SEND COMPLETED FORMS TO:
NCDENR/ DWO
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER: r,I
' V ��`�T
PERMIT CTI.ON REQU STED:
�a•
RIVER BASIN: r��
r v1G�J
SUPPLEMENTAL APPLICATION! INFORMATION .
PART D. EXPANDED EFFLUENT TESTING DATA
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has -(or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged. Do not include Information on combined sewer overflows in this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and
other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate In the blank rows provided below
any data you may have on pollutants not specifically listed In this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number: 1 (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MUMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS.
ANTIMONY
•
`
+gyp`
N
a
3
uA
ARSENIC
/
�!s
�
iAS.
�
3
�A w.1
�•
BERYLLIUM Ic1.41
'i14
jjD
3
bA4 J^46?
Q-10
CADMIUM 40
to 11"60
• as
'
3
610.4 J2 M `
1.0
CHROMIUM
I-
'�i��+
.4103
Y�
�!r�
3
& am?
1 •
COPPER
/
- 7L.►
aA =1
s le
LEAD
N�
�O�
/�• o�i�r�
�.I
MERCURY
.1 ID
MIL.
V
• I`�
NICKEL
a
uV
•
%6
*3
VA. a?
�=01
SELENIUM
A,L.
i/L
00
3
.4 .7
Cook 7
SILVER
fit
!.
qqh-
ffl
d
3
! `�
THALLIUM
g%/,-
a 1 n
15
�l
.&A1
*1
3zM
►?
10
zlNc�G
,OS'I
ugly►
, 0
3
e9A' off• 7
CYANIDE
.ON.7L,,,AOI
"
f0
.oat
U;
TOTAL PHENOLIC
-
I0
10'd
3
0A jCOMPOUNDS
03
HARDNESS (as CaCO3)JL
J6 `
I/_L1"09
O
C
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 10 of 22

FACILITY NAME AND PERMIT NUMBER:
le Cleo Lui T�(,7
PERMIT ACTION REQUESTED:
�eWa1.
RIVER BASIN: Pee I
Outfall number: o6 r (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MLIMDL
Cone.
Units
Mass
Units
Cone.
Units
Mass
Units
Number
of
Samples
VOLATILE ORGANIC COMPOUNDS
ACROLEIN
/j��
1`
lab
OL
jD416
3
tf,(,a�
44
4
ACRYLONITRILE14
60
141G
Vr 4 (IA
15
BENZENE
jj'
Ijr
.�
41LO,
NY
DA
BROMOFORM
I
kj L
149eq
'W L
141
3
94CARBON
V r
TETRACHLORIDE .41610
1N IL
OD
1$9
k
ab
o4
510q,416
CHLOROBENZENE
�i0
(ri
4�-qj
In/,C,
v)
�V
CHLORODIBROMO-
METHANE
Ml,
a��
W ,
l�
.010 (
%q
3
6.4
.I(�
ss�i
CHLOROETHANE
1r74
4/,'
lma-
tA
5
6A
ROETHYLVINYL
ETHER
��/;I��%
a
,r y�`✓���
CHLOROFORM
A
f
job
4.
Sq
��p-3
4
64DwdL,
DICHLOROME HANE BROMO-
� sr
`
I).D
1.0 041.,
4?A4
1,1-DICHLOROETHANE
G
!��
��j�
141 L
ID3
1,2-DICHLOROETHANE
4 I �►
�
''
� l D
�y�i�
VA
p*1
3
4 ��'i(�
I
ETHY ENEDICHLORO-4
�,V
u(,rl�
��
L
-1V
�4�1L.
��
ya�/j w4
'
6'hf`
"l
1,1-DICHLORO-
ETHYLENE
1,2-DICHLOROPROPANE
Vl��i
O
`
L
� - (eA4
�.0
1,3-DICHLORO-
PROPYLENE
ETHYLBENZENE 1
�✓
-"�
j
'�
`c�`/'
METHYL BROMIDE
10c'0
��YI
3
tpa4
�r.0 144
METHYL CHLORIDE
V`?
"o'ir�
.• f Y/
,v
1
p
�� -
10 D
METHYLENE CHLORIDE
11q 140
-it L
P
3
�i
1Or4011
1,1 LO TETRA-
CHLOROETHANE
.v
W4! J..
�V'1<
-
,� !
4q
ETHYLENE RO-
.O
f"I10
11
lotsfqb
L
f,, A &t
60
TOLUENE
4 4e10
og11,
Nb
P
3
`fA iedA4.
r
v
�0
t
21.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22.
Page 11 of 22

FACILITY NAME AND PERMIT NUMBER:
y�e Div 0�
PERMIT ACTION REQUESTED:
WenaP�a
RIVER BASIN: ��A
�1 eG4i/Z�
Outfall number t)o (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
MLIMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
TRICHLOROETHANE
1!j
Oa l,�
TRICHLOROETHANE
�� �
s
� �
��t&.9111
u C
-
.3
�
, /
TRICHLOROETHYLENE
5��
I �
'440jQC
6PA ��4
r 15
VINYL CHLORIDE
" +0
.41
D jD
0104
66011
3
V4 494
®, 3�
-1 -information
Use this space (or a separate sheet) to provide on other olatile organic compounds requested by the permit writer
I
t
L
ACID -EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
jd,0
{ iL
/� /�
� �
{�(�
� �'�
#A,2-CHLOROPHENOL
.�
SPA- 6oV
Awh
0� "7,
2,4-DICHLOROPHENOL
lbb
`.
DAD
.I
'��
.Of?
11
✓
&i�r: (go
�.V�L
2,4-DIMETHYLPHENOL
A
WI,
1%1
AIA
3
toil
4,6-DINITRO-0-CRESOL
2,4-DINITROPHENOL
(�
/�
�a
441 V
M
�D
3
/n� r
G�R (�7
2-NITROPHENOL
I�+a
�k�L
��
Y
I�r{/r
�'
�O't
O
'✓
�T/7' �p
J�v 1
4-NITROPHENOL
�
�
'/�
D A
��
�•��
445
3
6PA �
siv
PENTACHLOROPHENOL
�lD
J6
`
1-9
M G
.�
p
3
�j 6
�*V 4 14
PHENOL
D
o�
p�•�
WL
�
4
3
<</�D
TRICHLOROPHENOL
IOC
`
twM
D
to
G tv
+✓
3
44
Use this space (or a separate sheet) to provide information on other acid -extractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
0�
� •D��
jj
�
*Ib.3
n
�ji��' (a
IV,Q 4
ACENAPHTHYLENE
`aV
Aho .oto
04
_ 14
4.ow
1b
3
&;6
16,0 64A
ANTHRACENEID
40`
`
�i`
$0
`''
�QPJ
�•� u�!
BENZIDINE
MIL0 10bZa
/
a
&-�
�l/1
BENZO(A)ANTHRACENE
'�
O�
i
`�/IDA
Co K
�D+D
BENZO(A)PYRENE
��i
l.I .�Qt(��
+�
3
!ems
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 22

FACILITY NAM NO PE MIT NUMBER:
kt oogg9G7
PER ACTION REQUESTED:
+'!t 2JwA
RIVER BASINPee 'WV
Outfall number. V t (Complete once for each outfall discharging effluent to waters of the Ated States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
POLLUTANT
ANALYTICAL
METHOD
MLIMDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
3.4 BENZO-
FLUORANTHENE
��,3
/m/
�+
046/
rD
•
&A44;6
3
BENZO(GHI)PERYLENE
FLUORANTHENE .4
" `ho a
4 il0j
I •
D5
u "�L
AX
SIS
METHANE OROETHOXY)44/0
SIS
ETHER HLOROETHYL)-
/►, hh
G
�L
^
�AA
/42
BIS (2-C) ETHER O-I'%&zVe
ETHER
�V
s
•
��
V#4PROPYL
I �
PIHTHALATELHEXYL)
/ • !
`/
�I
�1��
'��
JJ
t A T ,76
t/
l e
4-BROMOPHENYL
PHENYL ETHER
�
�v
/
L
M/
�W!
.
�.
. �
(�•
1J
6P,4 / L�
W��/
/ b
( `
BUTYL YL PHTHALATE
Ib.?S
�/ '
1G
.t
•
' oa
Q
ORO-HALENE
NAPHTHALENE
TTk"r
3
V1 VI
rVi G
4-CHLORPHENYL
PHENYL ETHER
A
�
G�
��1D
3
CHRYSENE
•D
RI `
801
0
L
DI-N-BUTYL PHTHALATE
Di��
,eY1(
�M
a1/G
DI-N-OCTYL PHTHALATE
1
ANTHRACENE A
�k
�.24
L'
��
�
/�' �.7
� 4#�L
aW
•�1
�
e�
1,2-QICHLOROBENZENE
�
L
�
�
�
iA6
it
1,3-DICHLOROBENZENk
oI
-"! /4,��
d4wla3
'(*to•0��
�{
1,4-DICHLOROBENZENE
a
V%
I
1
-D
-3
3,3-DICHLORO-
BENZIDINE A
D
�( �
`
L
'�p�,
n
/Q
3
DIETHYL PHTHALATE
A
T
IDS
G
���
`
L
tO�a
046
1
DIMETHYL PHTHALATE
�,�
L
�1A
u i`ow
v
.3
1
D u L
2,4-DINITROTOLUENE
1440
ft.
4
u4 fL
It 0
Yu L
10
`
.3JAGI
2,6-DINITROTOLUENE
L
`�
IC
.0042
fL3
4t
L
1,2-DIPHENYL-
HYDRAZINE
-
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550.6 & 7550-22. Page 13 of 22

FACILITY NAME AND PER IT NUMBER:
PERMI CTION REQUESTED:
RIVER BASIN•
ee
Outfall number. (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
AVERAGE DAILY DISCHARGE
ANALYTICAL
Cone.
Units
Mass
Units
Cone.
Units
Mass
Units
Number
of
Samples
POLLUTANT
METHOD
MUMDL
FLUORANTHENE
k
.'11
G
•
,�
3
ep„
!o•D
FLUORENE
tV
�� •�
ii
Q
I+
~� `
���►�
3
fj0!'t' i�t
f(+t S
HEXACHLOROBENZENE
1
O
.
(��
- 7 (r
sow
oft
n
K/,/
HEXACHLORO-
BUTADIENE
u f /
G
/
��+
/.
��/ �•
L
iZl
//
3
s ��}}
G►�I7'
u
�.*
HEXACHLOROCYCLO-
PENTADIENE
1
�� V
G
/
Qi
D
L
,.,..�9 Oaz
lD3
�
HEXACHLOROETHANE
, 00,;
INDENO(1,2,3-CD)
PYRENE
,
ISOPHORONE
,�•(�
��,
. 1
Ali
/
G
tZ
Q
^
�v{l7"4J5
D k
NAPHTHALENE
0
iV
D
�P# 6o
/a a
NITROBENZENE
'^�
A0
Sol
0
0
� L
*�
to
3
&PA- P5
/V' u�
PROP AMIN N-
PROPYLAMINE
a•V
`
D `
� !
�l`
•
O
3
6h4a5
`�'
/i Z�g
`V
METHYLAMINE �
�
`r 01
4f,�
N-NITROSODI-k/4A.
PHENYLAMINE
• �
�
J
3
A
3
rr
PHENANTHRENE 40
10.0
f A
ko
. xQ
MA 425
A-0witle
PYRENE
e'D
" 1-
01
D 1+
.��
lAd-
WVYf,
�+'
•
Y
�7 40.v
��!
1,2,4-
TRICHLOROBENZENE
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use this space (or a separate sheet) to provide Information on other pollutants (e.g., pesticides) requested by the permit writer
-END'OF'PART D.
REFER TO THE APPLICATION OVERVIEW (PAGE 1') TO DETERMINE WHICH -OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 14 of 22

FACILITY NAME AND PERMIT NUMBER:
PER T ACTION REQUESTED:
RIVER BASIN:
�,ee
�sCao�R�t�'7
fA e WJ
lee
. SUPPLEMENTAL=APPLICATION� INFORMATION
PART E. TOXICITY TESTING DATA '
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403); or 3)►POTWs required by the permitting authority to Submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at Jeast annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include
Information on combined sewer overflows In this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC.requirements of 40 CFR Part 136 and other appropriate QA/QC
requirements for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted -any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested in question EA for previously submitted Information. If EPA me ods were not used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no blomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted In the past four and one-half years.
chronic ❑ acute ��.�•,�,.�Q.�\\\
E.2. Individual Test Data. Complete the following chart for each whole effluent toxi test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number. Test number. Test number.
a. Test information. !
Test Species & test method number
Age at initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all tl�at apply for each.
Before disinfection
After disinfection
After dechlorination
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
�a �40QY,
PERMIT TION REQUESTED:
l �i�
RIVER BASIN:
84 P&, �
Test number: i Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
f. For each test, Include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
Flow -through
h. Source of dilution water. If laboratory water, specify type: if receiving water, specify source.
Laboratory water
Receiving water
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100%
effluent
LC5o
95% C.I.
%
%
%
Control percent survival
%
%
%
Other (describe)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22

FACILITY NA E AND PERMIT NUMBER:
Clrv�
PER ACTION REQUESTED:
�evewati.WW
RIVER BASIN:
Pee
Chronic: I
NOEC
%
%
%
IC25
%
%
%
Control percent survival
%
%
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes 0 No If yes, describe:
I -
EA. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MM/DD/YYYY)
Summary of results: (see instructions) %��%
A4 le5kWf
I V
Il
ENO.OF PART E.
REFER TQ .THE;APPLICATION=OVER ' IEW:�(PAGE 1�) TO DETERMINE WHICH OTHER PARTS
OF'FORM 2A YOU -MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT CTION REQUESTED: RIVER BASIN:
! D
IV t)o 7 �n�Wa,dv
��
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRAICERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCI_A, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ot, an approved pretreatment program?
V Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs.
b. Number of CIUs.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following Information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary. �r
Name: �al t~y1 le f l �—�`uC 5
Mailing Address: Po Box 39
Ne-4et caNa a 7M r3
F.4. Industrial Processes. Describe all the Industrial processes that affect or contribute to the SIU's discharge.
i
I T ; 5k i-n Ci
11
F.S. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s):
Raw material(s):
re-r
J 1
Q. I' Lun eet b c5 1, ©I ��S - h gfes-)
F.6. Flow Rate. f e ' o le c- rnk Q
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
gpd (_ continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
gpd (_ continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ❑ Yes ❑ No
b. Categorical pretreatment standards L Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 18 of 22

FACILIYY NAME AND PERMIT NUMBER:
#7
PERMIT A ION REQUESTED:
4
RIVER BASIN:
F.8. Problems at the Treatment Works Attributed to Waste ,Dischatge by the SIU. Has the SIU caused or con buted to any problems (e.g..
upsets, interference) at the treatment works in the past three years?
❑ Yes P(No if yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes Ilk No (go to F.12)
F.10. Waste transport. Method by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
i
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATIONICORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently (or has it been notified that it will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) 1V No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years). j
i
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
Yes ❑ No
If yes, describe the tre tment (provide info tion bout the removal efficiency):
E
e de Ate" q#al!d4
b. Is the discharge (or will the discharge be) continuous or intermittent?
continuous ❑ Intermittent If intermittent, describe discharge schedule.
_END OF PART 'F�
REFER TO THE A00LICATI0-N -OVERVIEW'(PAGE I) -TO DETERMINE WHICH OTHER .PARTS
OF . FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
�fQ
6 7"1���', i
PERMIT ACTION REQUESTED:
RIVER BASIN:
46All(), Pee -be
SUPPLEMENTAL APPLICATION INFORMATION
PART G. COMBINED SEWER'SYSTEMS
If the treatment works has a combined sewer system, complete Part G.
G.1. System Map. Provide a map indicating the following: (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs (e.g., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
C. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in G.1 or on a separate drawing, of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines, both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
C. Locations of in -line and off-line storage structures.
d. Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFALLS:
Complete questions G.3 through G.6 once for each CSO dis har a point.
G.3. Description of Outfall. '
a. Outfall number
b. Location
(City or town, if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
C. Distance from shoe; (if applicable)
d. Depth below surface (if applicable)
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
G.4. CSO Events.
a. Give the number of CSO events in the last year.
i
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 20 of 22

r,
fA
1r
Z
w
N
0(1)FIGURE
I
a
�,
")0)
w
©
�
°`
L
�
TOWN OF CLEVELAND WWTP
U
� E
'-
Final Eff. &
2 Flow Measurtment
To Stream LEE]
Ba3 Sct�en Puent
d/
Digester
r
To Sludge
Disposal 6

- I •)1.\ - �. '.�1: - '� :J I\t _ �• •h \ ., -�� _ '__�^. '�< ;l _ � � 't\_-'i J, _-fit - rl,. ,\`�\ � 7 ��,�}�,��-J-'/ \ f':��,1 \
�. �:. .//' - \ t � �_�t� ;' _.. �. ��-` _�(' ,. i _ _ .\�� •�: ,ICE. ��71 . ,�_ Ir�o. .� \ i c_r .--n: ____
_ `'8� - }1��� •- stz r ��'•�r- t';'�' .;:1t� -7t. � .- i'- ' --• .- - .� � .-\�� - � - �� � �l� -- :��• '- � �—�. �.� -\ �- _ ���-l•�./ �.'Zy ���;��1f�� �
;t � '-/ �� - i �: \ _ 957' � _ t @jT — m t rat , _ _ _ • ` - �. `,1 J��� � � i
82.
1973 s ^b J \ / l '; f /if %�[I(��`� - - �l1 ; '//� f r� 1� t�! I �L. \\= •_
EUSTNG
_ TREATMENT
F�� -� � ::j / __ _ _.,�;,. �j ,� _ o ,\ ao0 • ✓ ' \\ �!/lj;��/ 1���.-\mil � j �.I.
7 y(. :-- jt {! %�/ - 1. '� :/r /' 1^ \ .'� w • I=
BM 735
y/ - �. � �-_ —�\ ;-��.-,��___ '%h \ J ,, it 3Ra'F ___ ,.._�\ i •-� q3
150
� ! � �(,• �- �� \ �� � - � • O ��.;. � \ ,,'Q� `t'�''IR 1. '�1,' � -- � •\-, � •� \ 1 \ .
f ` 4(o.
a._
_-_ _ry ` iy �• - - ? ' -- ! SALISBURY AREA SERVICE 'EA
IUD I_ :., Fti\j - -
/
.� / 1.- • ,ice' -�;• _ f6d w. 1" �'_� _ 1ri�itCh.Seb •�. - I. tB�-,I'tr�—%:> '>�` �e �[ - 1�'"�-�1.
ian tl7ii) i• lAnd.
1957 BMA .
959
�y '-1 -I +�,'� __ �- .- i u�, HT�B_ I ,'1�"••_ �' _
ter. L� I
FREIGHT
_ _
17.1
_.. =-y^+_ � � �` -,l. -��\\) v - _1111 n - �fl' _.� _•_i-.\. i'fl i •r - - _� � ` Tail: �i: �-__'_ ..f - \, �� '-.i. _ s -
Lj
-' - - - �f32a
- CLEVELAND SERVICE AREA _
1720
�• �a . - _\\ • �. _�� �'-- " 750 'i\ \- - J I - `upy
-
Lu
7261
�����_-�+�� ;;` �,�1' ___ _- _=lam__ �1 — - - .. �.✓'- - _�1\ `_-\` �� -'% _ �i _ l�a� � %�14�7`�'G'.� - -1 .. :\�`\ �`:,'�,�
-��, '�T. - � %� i i�- -- N Jr � �,��-� -off .�i= - - -_- _)�_ '! I 'i�� - $- _. - - �/-.�.•.IV /�/`BM\ �-.� 7i�1-.\• - 7�--� _
�� ,_•\ \ %; / __ � =`:yl, \ � A� !f lr/r;-
` 1537=�'.zj. �J./ , , _ �i, ' - _� •\ Oi J/-1.�

_ -11: _ 1973 ` -) - __ : % - ;. y�^ � � � -' _ "/t � '` � �\ ,. _ - ! � - �� l' -• 1 1 : �, --�f , . ` � � i, - _`\ \{�� '\ _ _ - ` �: �7,:.;t, .
.�'' -- -i{ ... � .\ •/i - Iti' r' /�-r - ;;- - ado 1� _ o i '` \� _ _ ).� °` _ ��,-f/�,' l�; �' � � ;���: .--r• _ --
-`�� _ �,►�� �lI r -�`- I . �'• !'�1^ .\1 �: /� it � t^ ' - � 4 i'\\\ -�- \, l i.:,�� _J +l � ` ! /,' •���J -� »\ -\\ � _l•" � �C < --
i aea - _ �``� .J/�/,• _ -_. _ 0� �\\\� J1�/ / ,��/li -• "; -i 7 _ - _ J� �/' _ _ 1', - � � \ !�` � / �_ \�� � 1 I `)�� 1�"�i�% L'�\ _,`t a:'"` +
- - /� %' ice' / ,i��f q � - -- � _ �' ✓' !_ �-�a.' I f�-. +.
.,; a - - ii - -- � �' :ti`�:: --'"J! /� .•�! i~'r' / _- �-"^ � Mai: ��; -_._ --���. _ �:�'� � , '� ��„�-::-� \��-- `
WASTEWATER
ri/��1`�lf����_ ^-� _- , _ :�� , •. EXISTING
_
TREATiIIIEMT FACiUTiES _ - \;:,; , r, - .:'a.•. �) . - - ` �\�-. �= �� ���'r,,"�_-��t f: ���r-
\)cv
�� 1'I - �� - ��i �'_ I \ _ f�•i. ( ram- 1( i ' �� _C
!' � �., '� � 'iN • �• a \ �`� x7 �\, . 1 111 _ -.j - f - � �_ � \ ..wb+..u�. C3 / i..,
- � - j = Jr / V - _ � .i, l - fi'tr.. '�+✓'- � •I � - _ �-' - _ - �3:��� Ce^'�
-i.} - �('! �a:{(` _ \ :' - !lYt` _ '-• -- i/ _ %/�i�•'I `/ �' 'Q�r ' :ice=�� 1\`:�-.. \ i i! ' \l •� �- n f'
F `� _ _ I' - �,J^a-C(• ��� � �1\\I rl:�\ I• --� - •! •i �• _ _ ` "� -�/ - ,ppp_ ��, �\ .� i - �� I
m 735 _ r-� �I 1Ir: ` '4. 1 Sl Q=� j 1 - �\
� � _ 'i \ _- l t l `� :�_- n' 'sp r, •. �. - -_ i- q • / qL. � ��kO !'-�^J._" .r ,I'. 'i�`.� \ \, ! � • •� ^\- ;
- - ''j - '1 u a� 1957 -- - H� -1 - - -- V C \\�y�'-'\-•{�II' Ia'I�� 'a - .�8'/ r \ \
�. `_ f � -� lY - �� _� �•• 1� \� �-. _ `- I � _.�{\ ,'. _- } (�- _ .I• Jl�'-v., ll•�:i:i — lI' -.� , 4
- _ ,. - ^_r s� ` _ ro \�\,__•� LE V E1 D SALISBURY SERVICE AREA ,
__-
� ..11i! - ram` rm _ / . j,_ _ A Tank 3��� - �'- _ - _ �-•�''•. I, Ll/ i/a' - "\ �'To\'� <` � � �'i ) l \,\-.
Ia.I1.d• - _ - _ -->• I _ ��-• \ _ _ •�� / \I\- `
- ___ -- _ "�(i,�� - ,n .__ :( .. \ - - � �� •- � .. - 0- � 1951- BMI � .. �- _�/?tea '� v � I .` .\_.. f i���=♦
959 \ \�
ir� Lc -Tru CKS -�� . �_ -- - _ - _ O i
v :� a t71
FREIGHTLINER
u .. -`�- �-. 78Z • a;- ��: �/ .f:1 ` B3i `l �. / �_ '�
_- _ - �S �• �` -�� � - �.JI! I: I. _ d _ � �'( - � `` •i f� ._ _ -i.l\ i , ' -750 ;� v,. •.%' �� s - fI T
'_=��-_ \ � -•- -_�, � ,_ - �' ` — -.- _ _ _- ` � _ : p�c3 -�\ .. Yl-�_ , i �' `-\j 1.
r� _ - m :� •s, r' `- _ ' ` _ - CLEVELAND SERVICE AREA �� w
``\\_ l \ ;:�\', J � / •I -��\\ -�\ _ _- � �•' \ / 'I 11 ,;�� ; � { /.-= („3 �'' 17+0 `° '�� �."^. ^�v' d/�- - L • ":' � �` �`�,•i .
�\ -\ _ ,�` __�� P'- - _ 'i5Q 'i 1- - f _ I J \t _ //�, Y( �/• gi74 Q yam_ • �i�4��� \ "�` l '-.�- �/ /r '
1 1 . Bz/ '- _ �. .y_ -- •\111\ -� . - �1� � •• \ _ __' _- � - _ - ---_- — 1 - hi �•I _ ,tJ•: �l 1 \� - I" a �3� S -!f' '- _ � i-l�
713,
in
. 11 I� •\�\ -.-/• \-'_• - - - •; o r.�l t slr�lr :1�. \ aa r, so _ W p _�.�.��- j p -.` \• •\ ! \
7 _ _ _ : Tca 1 - q �t l--^
\, x -,726
5
- 'i. 1 _ �'-c � � . _ � //\� — .-. '/' i .-1 77d i b-• �/ /� -�`-g. . � - \ � \-4 - __ -- �r %�� 1. :- I --
.;�