NC0039586_Permit Rating Worksheet_19940510

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NPDES Permit Rating Work Sheet D Regular Addition
f tn
. Discretionary Addition
llwn/� " ' Score change, Lint no
status change
NPDES No.:
AID v", 7/ / 3 Gam/ , D Deletion
Facility Name:
Q
City: illl_II I L. I �i_I—I_I_I_I_I_I_I—I_I_I_I_I I_I_I_I
Receiviing Water II `y i�I I�I_Iitk-I—I_I_I—I_I—I_I_I_I_I_I_I_I—I_I—I_I_I_I
Reach 'Number. I_I_I_I_I—I_I_I_I—I_I_I
Is this facility a steam electric power plant (SIC=4911) Is this permit for a municipal separate storm sewer
with one or more of the following characteristics? serving a population greater than 100,0007
1. Power output 500 MW or greater (not using a coding pond/lake)
2. A rmxlear power plant ❑ YES; score is 700 (stop here)
�3. {Cooling water discharge greater than 25% of the receiving stream's 7Q10 flow rate ❑ NO (continue)
l� YES; score is 600 (stop here) ❑ NO (continue) _
FACTOR 1: Toxic Pollutant -Potential
PCS SiIC Code: 1_I 1_I_I
Primary SIC Code: I—I_I—I_I
Section A Wastewater Flow Only Considered
Section B Wastevvater and Stream Flow Considered
Other SIC Codes:
Wastewater Type
Code
Points
Wastewater Type Percent of Instream Code
Industrial Subcategory Code: I_I_I_I
(Code 000 if no subcategory) .
(See Instructions) Wastewater Concen-
Determine the Toxicity potentia/ from Appendix A. Be sure to use the TOTAL toxicity potential column and check one)
Type 1: Flow < 5 MGD
Toxicity Group Code Points
Toxicity Group
Code
Points
Tokrdty Group Code
Points
❑ No process
❑ 3.
3
15
❑ 7. 7
35
Haste streams 0 0
❑ 4•
4
20
❑ 8. 8
40
❑ 1. ' 1 5
❑ 5•
5
25
❑ 9. 9
45
Cl 2_ 2 10
❑ 6•
6
30
Elio. 10
50
FACTOR 2: Flow/Stream Flow Volume
(Corrvlofe ollharsacBon A orSocilon e; chock only ono)
Section A Wastewater Flow Only Considered
Section B Wastevvater and Stream Flow Considered
Wastewater Type
Code
Points
Wastewater Type Percent of Instream Code
Points
(See Instructions)
(See Instructions) Wastewater Concen-
Type 1: Flow < 5 MGD
❑
11
0
tration at Receiving
Flow 5 to 10 MGD
❑
12
10
Stream Low Flow
Flow >10 to 50 MGD
❑
13
20
Flow > 50 MGD
❑
14
30
TYPE I/III: < 10% ❑ 41
0
Type 11: Flow <1 MGD
❑
21
10
a 1096 to <50% ❑ 42
10
Flow 1 to 5 MGD
❑
22
20
Flow >5 to 10 MGD
❑
23
30
2 5096 O 43
20
Flow >10 MGD
❑
24
50
❑
_
Type If: < 1096 51
0
Type III: Flow <1 MGD
❑
31
0
❑ S2
Flow 1 to 5 MGD
O
32
10
210% to <50%
20
Flow >5 to 10 MGD
❑
33
20
❑ 53
30
Flow >10 MGD
❑
34
30
2 50%
i
Code Checked from -5ection A or 6- !
1 F
....
2.
(Points Factor i
Tota. nt
I I
:.:
+
..
-- x

f�
NPDES
FACTOR 3: Conventional Pollutants
(only when limited by the permit)
A. Oxygen Demanding Pollutant:=(check one) ❑ BOD
Permit Limits: (check one)
S. Total Suspended Solids (TSS)
Permit Omits: (check one)
IMM
Rating Work Meet,&
G
NPDES No.: IC-) I
,
❑ COD ❑ Other:
Code Points
<10 lbs/day 1 0
10 to 1000 lbs/day 2 5
>1600 to 3000 Ibs/day 3 15
>3 00 lbs/day 4 20
':Code Checked: I
Pants Scored: I—I_I
C. Nitrogen Pollutant: (check one) ❑ Ammonia ❑Other:
� itrogen fquiwltnt Code Points
FACTOR 4: Public Health lmpGct
Is there a public drinking water supply located wi In SO miles downstream of the effluent discharge (this Includes any body of
water to which the receiving water Is a tributary) A public drinking water supply may Include /nflitratlon galleries, or other
methods of conveyance that ultimately get water orn the above referenced supply.
❑ YES (If yes, check toxicity potential number below)
❑ NO (If no, go to Factor 5)
Determine the human health toxicity potential from�Appendix A. Use the same SIC code and subcategory reference as in Factor 1. (Be
sure to use the human health toxicity group colum — check one below)
Toxicity Group
Code
Code
Points
❑
<1001bs/day
1
0
❑
1 to 1000 Ibs/day
2
5
❑
10
> 000 to 5000 Ibs/day
3
15
❑
>5000lbs/day
4
20
❑ 8. 8 20
❑ 1.
1
_- Code .Checked- !_I
5.
5
5
Points Scored: I—L_I
C. Nitrogen Pollutant: (check one) ❑ Ammonia ❑Other:
� itrogen fquiwltnt Code Points
FACTOR 4: Public Health lmpGct
Is there a public drinking water supply located wi In SO miles downstream of the effluent discharge (this Includes any body of
water to which the receiving water Is a tributary) A public drinking water supply may Include /nflitratlon galleries, or other
methods of conveyance that ultimately get water orn the above referenced supply.
❑ YES (If yes, check toxicity potential number below)
❑ NO (If no, go to Factor 5)
Determine the human health toxicity potential from�Appendix A. Use the same SIC code and subcategory reference as in Factor 1. (Be
sure to use the human health toxicity group colum — check one below)
Toxicity Group
Code
Points
oxidty Group
Code
Points
Toxicity Group Code Points
❑ No process
3.
3
0
❑ 7. 7 15
waste streams
0
0
4.
4
0
❑ 8. 8 20
❑ 1.
1
0
5.
5
5
❑ 9. 9 25
❑ 2.
2
0
❑ 6.
6
10
❑ 10. 10 30
.:
Code Fkl nber Checked: t -1_I
ToW Points Factor 4I I I
1' 2

a.
r
NPDES Permit Rating Work SheewQ-
FACTOR &-Water`Cuality Factors NPDES No.: 16 613 Ic7�i?
A. Is (or will) one or more of the effluent discharge limits based on water quality factors of the receiving stream (rather than
technology-based federal effluent guidelines, or technology-based state effluent guidelines), or has a wasteload allocation
been assigned to the d1schar9e7
Code Points
❑ Yes 1 10
❑ No 2 0
B. Is the receiving water in compliance with applicable water quality standards for pollutants that are water quality limited in
the per7nit7
Code Points
❑ Yes 1 0
❑ No 2 5
C. Does the effluent discharged from this facility exhibit the reasonable potential to violate water quality standards due to whole
effluent toxicity?
Code Points
❑ Yes 1 10
❑ No 2 0
Code Number Checked.: Ai- I - 8 i_i E E 1 • ,;
:Points tractor 5.. A t I I :.+ B J_E + CII 1 K 1 SOTAL
FACTOR 6: Proximity to Near Coastal Waters
A. Base Score: Enter flow code here (from Factor 2): I I_I
Check appropriate facility HPRI Code (from PCS):
HPRI N
Code
HPRI Score
❑ 1
1
20
O 2
2
0
0 3
3
30
❑ 4
4
0
❑ 5
5
20
HPRI code checked: I_I
Enter the multiplication factor that corresponds
to the flow code: I I 1
Flow Code Multiplication Factor
11, 31, or 41
0.00
12, 32, or 42
0.05
13, 33, or 43
0.10
14 or 34
0.15
21 or 51
0.10
22 or 52
0.30
23 or 53
0.60
24
1.00
Base Score: (HPRI Score) x (Multiplication Factor) _ (TOTAL POINTS)
B. Additional Points — NEP Program C. Additional Points — Great Lakes Area of Concern
For a facility that has an HPRI code of 3, does the facility For a facility that has an HPRI code of S, does the facility
discharge to one of the estuaries enrolled In the National discharge any of the pollutants of concern Into one of the
Estuary Protection (NEP) program (see instructions) or Great Lakes' 31 areas of concern (see Instructions)
the Chesapeake Bay?
Code Points Code Points
❑ Yes 1 10 D Yes 1 10
❑ No 2 0 ❑ No 2 0
.....'Code Number Checked:
` A l I B IJ C
V....: I
Potnts factor 6: A I_I (.+ . B l_I_J -C-
3 _ + tr 3
L

NPDES
SCORE SUMMARY/
Rating Work Sheet ,kL, .. :
NPDES No.: I-L101SlI I I� 1_I_I
Factor Description Total Points
1 Toxic Pollutant Potential
2 Flow/Streamflow Volume
3 Conventional Pollutants
4 Public Health Impacts
S Water Quality Factors
6 Proximity to Near Coastal Waers
TOTAL. (Factors 1 through 6)
S1. Is the total score equal to or greater than 80? ❑ es (Facility is a major) ❑ No
S2. If the answer to the above question is no, would you lik this facility to be discretionary major?
❑ No - —
❑ Yes (Add 500 points to the above score and For 'de reason below:
Reason:
NEW SCORE:
OLD SCORE:
4
p��1E6Q.
Phone Number
Date
1