EFTA01221078

United States Office of EPA Fenn 3510.2C Environments, Protection Enforcement Revised August 1990 Washington. DC 20460 Previous edltons are obsolete Parrn its Division "ve•EPA Application Form 2C - Wastewater Discharge Information Consolidated Permits Program This form must be completed by all persons applying for an EPA permit to discharge wastewater (existing manufacturing, commercial, mining, and silviculture; operations). Printe000 Flecvdo, Pat., EFTA01221078 Paperwork Reduction Act Notice The public reporting burden for this collection of information is estimated to average 33 hours per response. This estimate includes time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information to the Chief, Information Policy Branch (PM-223), US Environmental Protection Agency, 401 M Street, SW, Washington, DC 20460, and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503, marked Attention: Desk Officer for EPA. Proted on Recycled Paper EFTA01221079 INSTRUCTIONS - FORM 2C Applicant for Permit to Discharge to Wastewater EXISTING MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTUREAL OPERATIONS This information must be completed by all applicants who check "yes' daily value for flow rate and total volume in the "Maximum Daily' to Item II-C in Form 1. columns (columns 4-a-2 and 4-b-2). Report the average of all daily Public Availability of Submitted Information values measured during days when discharge occurred within the last year in the "Long Term Average" columns (columns 4-a-1 and 4-b-1). Your application will not be considered complete unless you answer every question on this form and on Form 1. If an item does not apply Item III-A to you, enter "NA" (for not applicable) to show that you considered the An effluent guidelines promulgated by EPA appear in the Federal question. Register and are published annually in 40 CFR Subchapter N. A You may not claim as confidential any information required by this form guideline applies to you if you have an operations contributing process or Form 1, whether the information is reported on the forms or in an wastewater in any subcategory covered by a BPT, BCT, or BAT guideline. If you are unsure whether you are covered by a attachment. This information will be made available to the public upon request. promulgated effluent guideline, check with your EPA Regional office (Table 1in the Form 1instructions). My information you submit to EPA which goes beyond that required Item III-B by this form or Form 1 you may claim as confidential, but claims for information which is effluent data will be denied. If you do not assert a An effluent guideline is expressed in terms of production (or other claim of confidentiality at the time of submitting the information, EPA measure of operation) if the limitation is expressed as mass of may make the information public without further notice to you. Claims pollutant per operational parameter. for example, "pounds of BOD per of confidentiality will be handled in accordance with EPA's business cubic foot of logs from which bark is removed," or "pounds of TSS per confidentiality regulations at 40 CFR Part 2. megawatt hour of electrical energy consumed by smelting furnace.' An example of a guideline not expressed in terms of a measure of Definitions operation is one which limits the concentration of pollutants. All significant terms used in these instructions and in the form are Item III-C defined in the glossary found in the General Instructions which accompany Form 1. This item must be completed only if you checked yes" to Item EPA ID Number The production information requested here is necessary to apply effluent guidelines to your facility and you cannot claim it as Fill in your EPA Identification Number at the top of each page of Form confidential. However. you do not have to indicate how the reported 2C. You may copy this number directly from Item 1 of Form 1. information was calculated. Report quantities in the units of Item 1 measurement used in the applicable effluent guideline. The production figures provided must be based on actual daily production and not on You may use the map you provided for Item XI of Form 1 to determine design capacity or on predictions of future operations. To obtain the latitude and longitude of each of your outfalls and the name of the alternate limits under 40 CFR 122.45(bX2Xii), you must define your receiving water. maximum production capability and demonstrate to the Director that Item II-A your actual production is substantially below maximum production capability and that there is a reasonable potential for an increase The line drawing should show generally the route taken by water in above actual production during the duration of the permit. your facility from intake to discharge. Show all operations contributing wastewater, including process and production areas, sanitary flows, Item N-A cooling water, and stomiwater runoff. You may group similar If you check "yes' to this question, complete all pans of the chart, or operations into a single unit, labeled to correspond to the more detailed attach a copy of any previous submission you have made to EPA listing in Item II-B. The water balance should show average flows. containing same information. Show all significant losses of water to products. atmosphere, and discharge. You should use actual measurements whenever available: Item IV-B otherwise use your best estimate. An example of an acceptable line You are not required to submit a description of future pollution control drawing appears in Figure 2C-1 to these instructions. projects if you do not wish to or if none is planned. Item II-B Item V-A, B, C, and List all sources of wastewater to each outlet!. Operations may be The items require you to collect and report data on the pollutants described in general terms (for example. "dye-making reactor" or discharged for each of your outfalls. Each part of this item addresses "distillation tower). You may estimate the flow contributed by each a different set of pollutants and must be completed in accordance with source if no data are available. For stormwater discharges you may the specific instructions for that part. The following general instructions estimate the average flow. but you must indicate the rainfall event apply to the entire item. upon which the estimate is based and the method of estimation. For each treatment unit, indicate its size. flow rate, and retention time, and General Instructions describe the ultimate disposal of any solid or liquid wastes not Part A requires you to report at least one analysis for each pollutant discharged. Treatment units should be listed in order and you should listed. Part B and C require you to report analytical data in two ways. select the proper code from Table 2C-1 to fill in column 3-B for each For some pollutants, you may be required to mark "X" in the 'Testing treatment unit. Insert "XX' into column 3-B if no code corresponds to a Required' column (column 2-a, Part C), and test (sample and analyze) treatment unit you list. If you are applying for a permit for a privately and report the levels of the pollutants in your discharge whether or not owned treatment works, you must also identify all of your contributors you expect them to be present in your discharge. For all others, you in an attached listing. must mark "X" in either the "Believe Present' column or the 'Believe Absent' column (columns 2-a or 2-b. Part Et and columns 2-b or 2-c. Item II-C Part C) based on your best estimate, and test for those which you A discharge is intermittent unless it occurs without interruption during believe to be present. (See specific instructions on the form and below the operating hours of the facility, except for infrequent shutdowns for for Parts A through D.) Base your determination that a pollutant is maintenance, process changes, or other similar activities. A discharge present in or absent from your discharge on your knowledge of your is seasonal if it occurs only during certain parts of the year. Fill in raw materials, maintenance chemicals, intermediate and final products every applicable column in this item for each source of intermittent or seasonal discharges. Base your answers on actual data whenever available: otherwise, provide your best estimate. Report the highest 2C-1 EFTA01221080 FORM 2C - INSTRUCTIONS (continued) Item V - A, B, C, and D (continued) times, the collection of duplicate samples, etc. The time when you and byproducts, and any previous analyses known to you or your effluent sample should be representative of your normal operation, to the extent feasible, with all processes which contribute wastewater in or similar effluent. (For example. if you manufacture pesticides, you should expect those pesticides to be present in contaminated stormwater normal operation, and with your treatment system operating properly runoff.) If you would expect a pollutant to be present solely as a result of with no system upsets. Samples should be collected from the its presence in your intake water, you must mark 'Believe Present' but you center of the flow channel, where turbulence is at a maximum. at a site specified in your present permit. or at any site adequate for the are not required to analyze for that pollutant. Instead, mark an "X" in the Intake" column. collection of a representative sample. For pH, temperature, cyanide, total phenols, residual chlorine, oil A. Reporting. All levels must be reported as concentration and as total mass. You may report some or all of the required data by and grease, and fecal coliform, grab samples must be used. For all attaching separate sheets of paper instead of filling out pages V-1 to other pollutants 24-hour composite samples must be used. V-9 if the separate sheets contain all the required information in a However, a minimum of one grab sample may be taken for effluents from holding ponds or other impoundments with a retention period of format which is consistent with pages V-1 to V-9 in spacing and In identification of pollutants and columns. (For example. the data greater than 24 hours. For stormwater discharges a minimum of system used in your GC/MS analysis may be able to print data in the one to four grab samples may be taken, depending on the duration proper format.) Use the following abbreviations in the columns of the discharge. One grab must be taken in the first hour (or less) of discharge. with one additional grab (up to a minimum of four) headed "Units" (column 3. Part A, and column 4, Parts B and C). taken in each succeeding hour of discharge for discharges lasting Concentration Mass four or more hours. The Director may waive composite sampling for ppm parts per million lbs pounds any outfall for which you demonstrate that use of an automatic sampler is infeasible and that a minimum of four grab samples will mgA milligrams per liter ton tons (English tons) be representative eof your discharge. ppb parts per billion mg milligrams Grab and composite samples are defined as follows: WI micrograms per liter g grams Grab sample: An individual sample of at least 100 milliliters kg kilograms collected at a randomly-selected time over a period not exceeding 15 minutes. T tonnes (metric tons) Composite sample: A combination of at least 8 sample aliquots All reporting values for metals must be in terms of 'total recoverable of at least 100 milliliters, collected at periodic intervals during metal," unless: the operating hours of a facility over a 24-hour period. The (1) An applicable, promulgated effluent limitation or standard composite must be flow proportional; either the time interval specifies the limitations for the metal in dissolved. valent, or total between each aliquot or the volume of each aliquot must be form: or proportional to either the stream flow at the time of sampling or (2) All approved analytical methods for the metal inherently measure the total stream flow since the collection of the previous aliquot. Aliquots may be collected manually or automatically. For only its dissolved form (e.g., hexavalent chromium); or GC/MS Volatile Organic Analysis (VOA), aliquots must be (3) The permitting authority has determined that in establishing case- combined in the laboratory immediately before analysis. Four by-case limitations it is necessary to express the limitations on the (4) (rather than eight) aliquots or grab samples should be metal in dissolved. valent, or total form to carry out the provisions of collected for VOA. These four samples should be collected the CWA. during actual hours of discharge over a 24-hour period and If you measure only one daily value, complete only the "maximum need not be flow proportioned. Only one analysis is required. Daily Values" columns and insert "1" into the "Number of Analyses' The Agency is currently reviewing sampling requirements in light of column (columns 2-a and 24, Part A, and columns 3-a, 34, Parts recent research on testing methods. Upon completion of its review, Band C). The permitting authority may require you to conduct the Agency plans to propose changes to the sampling requirements. additional analyses to further characterize your discharges. For Data from samples taken in the past may be used , provided that: composite samples, the daily value is the total mass or average concentration found in a composite sample taken over the operating All data requirements are met; hours of the facility during a 24-hour period: for grab samples. the Sampling was done no more than three years before daily value is the arithmetic or flow-weighted total mass or average submission; and concentration found in a series of at least four grab samples taken over the operating hours of the facility during a 24-hour period. All data are representative of the present discharge. If you measure more than one daily value for a pollutant and those Among the factors which would cause the data to be values are representative of your wastestream, you must report them. unrepresentative are significant changes in production level, You must describe your method of testing and data analysis. You changes in raw materials. processes. or final products. and also must determine the average of all values within the last year and changes in wastewater treatment. When the Agency report the concentration and mass under the "Long Term Average promulgates new analytical methods in 40 CFR Part 136, EPA Values" columns (column 24, Part A, and columns 34, Parts B and will provide information as to when you should use the new C). Also, determine the average of all daily values taken during each methods to generate data on your discharges. Of course, the calendar month, and report the highest average under the "Maximum Director may request additional information, including current 30-day Values" columns (column 2-c. Part A, and column 3-b. Parts quantitative data, if she or he determines it to be necessary to B and C). assess your discharges. B. Sampling: The collection of the samples for the reported analyses C. Analysis: You must use test methods promulgated in 40 CFR should be supervised by a person experienced in performing Part 136: however, if none has promulgated for a particular sampling of industrial wastewater. You may contact your EAP or pollutant, you may use any suitable method for measuring the level State permitting authority for detailed guidance on sampling of the pollutant in your discharge provided that you submit a techniques and for answers to specific questions. Any specific description of the method or a reference to a published method. requirements contained in the applicable analytical methods should Your description should include the sample holding time, be followed for sample containers. sample preservation holding preservation techniques, and the quality control measures which you used. If you have two or more substantially identical outlet's, you may request permission from your permitting authority to sample and analyses only one outfall and submit the results of the analysis 2C-2 EFTA01221081 FORM 2C - INSTRUCTIONS (continued) Item V • A, B. C. and D (continued) in Part V-C. For example, the Organic Chemicals Industry has an asterisk in all four fractions; therefore, applicants in this category For other substantially identical outfalls. If your request is granted by the permitting authority, on a separate sheet attached to the must test for all organic toxic pollutants in Part V-C. The inclusion of application form, identify which outfall you did test, and describe why total phenols in Part V-C is not intended to classify total phenols as a toxic pollutant. If you are applying for a permit for a privately the outfalls which you did not test are substantially identical to the owned treatment works, determine your testing requirements on the outfall which you did test. basis of the industry categories of your contributors. When you D. Reporting of Intake Data: You are not required to report data determine which industry category you are in to find your testing under the "Intake" columns unless you wish to demonstrate your requirements, you are not determining your category for any other eligibility for a "net' effluent limitation for one or more pollutants, that purpose and you are not giving up your right to challenge your is, an effluent limitation adjusted by subtracting the average level of inclusion in that category (for example. for deciding whether an the pollutant(s) present in your intake water. NPDES regulations effluent guideline is applicable) before your permit is issued. For all allow net limitations only in certain circumstances. To demonstrate other cases (secondary industries. nonprocess wastewater outfalls your eligibility, under the "Intake" columns report the average of the and non-required GC/MS fractions), you must mark "X" in either the results of analyses on your intake water (if your wafer is treated 'Believed Present column (column 2-b) or the 'Believed Absent' before use, test the water after it is treats), and discuss the column (column 2-c) for each pollutant. For every pollutant you requirements for a net limitation with your permitting authority. know or have reason to believe is present in your discharge in Part V-A concentrations of 10 ppb or greater. you must report quantitative data. For acrolein, acrylonitrile, 2, 4. dinitrophenol, and 2-methyl-4, Part V-A must be completed by all applicants for all outfalls. including 6 dinitrophenol, where you expect these four pollutants to be outfalls containing only noncontact cooling water or storm runoff. discharged in concentrations of 100 ppb or greater, you must report However, at your request, the Director may waive the requirement to quantitative data. For every pollutant expected to be discharged in test for one or more of these pollutants, upon a determination that concentrations less than the thresholds specified above. you must available information is adequate to support issuance of the permit either submit quantitative data or briefly describe the reasons the with less stringent reporting requirements for these pollutants. You pollutant is expected to be discharged. At your request. the Director also may request a waiver for one or more of these pollutants for your of Office of Water Enforcement and Permits may waive the category or subcategory from the Director, Office of Water requirement to test for pollutants for an industrial category or Enforcement and Permits. See discussion in General Instructions to subcategory. Your request must be supported by data Item V for definitions of the columns in Pan A. The 'Long Term representatives of the industrial category or subcategory in question. Average Values' column (column 2-c) and "Maximum 30-Day The data must demonstrate that individual testing for each applicant Values" column (column 2-b) are not compulsory but should be filled is unnecessary. because the facilities in question discharge out if data are available. substantially identical levels of the pollutant. or discharge the Use composite samples for all pollutants in this Part, except use grab pollutant uniformly at sufficiently low levels. If you qualify as a small samples for pH and temperature. See discussion in General business (see below) you are exempt from testing for the organic Instructions to Item V for definitions of the columns in Part A. The toxic pollutants, listed on pages V-4 to V-9 in Part C. For pollutants 'Long Term Average Values" column (column 2-c) and "Maximum in intake water, see discussion in General Instructions to this item. 30-Day Values' column (column 2-b) are not compulsory but should The "Long Term Average Values" column (column 3-c) and be filled out if data are available. 'Maximum 30-Day Values" column (column 3-b) are not compulsory but should be filled out if data are available. You are required to Part V-B mark "Testing Required" for dioxin if you use or manufacture one of Part V-B must be completed by all applicants for all outfalls. including the following compounds: outfalls containing only noncontact cooling water or storm runoff. You must report quantitative date if the pollutant(s) in question is (a) 2,4,54rtchlorophenoxy acetic add, (2,4,5-1): limited in an effluent limitations guideline either directly, or indirectly (b) 2-(2,4,54rtchlorophenoxy) propanoic acid, (Slivex. 2,4.5- but expressly through limitation on an indicator (e.g., use of TSS as TP); an indicator to control the discharge of iron and aluminum). For other (c) 2-(2,4,54richlorophenoxy) ethyl 2,2-dichloropropionate, discharged pollutants you must provide quantitative data or explain (Erbon): their presence in your discharge. EPA will consider requests to the Director of the Office of Water Enforcement and Permits to eliminate 0,0-dimethyl 0-(2,4.5-Vichlorophenyl) phosphorothioate, the requirement to test for pollutants for an industrial category or (Rowel); subcategory. Your request must be supported by data representative (e) 2,4,5-trichlorophenol. (TCP): of the industrial category or subcategory in question. The data must demonstrate that individual testing for each applicant is unnecessary, (0 Hexachlorophene. (HCP). because the facilities in the category or subcategory discharge If you mark "Testing Required" or "Believed Present,' you must substantially identical levels of the pollutant or discharge the pollutant perform a screening analysis for dioxins, using gas chromatography uniformly at sufficiently low levels. Use composite samples for all with an electron capture detector. A TCDD standard for quanlitation pollutants you analyze for in this part, except use grab samples for is not required. Describe the results of this analysis in the space residual chlorine, oil and grease, and fecal midterm. The 'Long Term provided: for example. 'no measurable baseline deflection at the Average Values' column (column 2-c) and "Maximum 30-Day retention time of TCDD" or "a measurable peak within the tolerances Values" column (column 2-b) are not compulsory but should be filled of the retention time of TCDD.' The permitting authority may require out if data are available. you to perform a quantitative analysis if you report a positive result. Part V-C The Effluent Guidelines Division of EPA has collected and analyzed samples from some plants for the pollutants listed in Part C in the Table 2c-2 lists the 34 "primary' industry categories in the left-hand course of its BAT guidelines development program. If your effluents column. For each outfall, if any of your processes which contribute are sampled and analyzed as part of this program in the last three wastewater falls into one of those categories. you must mark 'X' in years, you may use these data to answer Part C provided that the the 'Testing Required" column (column 2-a) and test for (1) all of the permitting authority approves, and provided that no process change toxic metals. cyanide. and total phenols, and (2) the organic toxic or change in raw materials or operating practices has occurred since pollutants contained in Table 2c-2 as applicable to your category, the samples were taken that would make the analyses unless you qualify as a small business (see below). The organic unrepresentative of your current discharge. toxic pollutants are listed by GC/MS fractions on pages V-4 to V-9 2C-3 EFTA01221082 FORM 2C - INSTRUCTIONS (continued ITEM V -A, B, C, and D (continued) Item VII Small Business Exemption: If you qualify as a "small business, Self explanatory. The permitting authority may ask you t provide you are exempt from the reporting requirements for the organic toxic additional details after your application is received. pollutants, listed on pages V-4 to V-9 in Pan C. There are two ways Item IX in which you can qualify as a "small business.' If your facility is a coal mine. and if you probable total annual production is less than The Clean Water Act provides for severe penalties for submitting false 100,000 tons per year. you may submit past production data or information on this application form. estimated future production (such as a schedule of estimated total Section 309(c)(2) of the Clean Water Act provides that 'Any person who production under 30 CFR § 795.14(c)) instead of conducting knowingly makes any false statement representation, or certification in analyses for the organic toxic pollutants. If your facility is not a coal any application, ...shall upon conviction, be punished by a fine of not mine, and if your gross total annual sales for the most recent three more than $10,000 or by imprisonment for not more than six months, or years average less than $100,000 per year (In second quarter 1980 by both." dollars), you may submit sales data for those years instead of conducting analyses for the organic toxic pollutants. The production 40 CFR Part 122.22 requires the certification to be signed as follows: of sales data must be for the facility which is the source of the (A) For a corporation: by a responsible corporate official. For purposes discharge. The data should not be limited to production or sales for of this section. a responsible corporate official means (I) a president, the process or processes which contribute to the discharge. unless secretary, treasurer, or vice-president of the corporation in charge of a those are the only processes at your facility. For sales data in principal business function, or any other person who performs similar situations involving intracorporate transfer of goods and services. the policy- or decision-making functions for the corporation, or (ii) the transfer price per unit should approximate market prices for those manager of one or more manufacturing, production, or operating facilities goods and services as closely as possible. Sales figures for years employing more than 250 persons or having gross annual sales or after 1980 should be indexed to the second quarter of 1980 by using expenditures exceeding $25.000,000 (in second-quarter 1980 dollars), if the gross national product price deflator (second quarter of 1980 = authority to sign documents has been assigned or delegated to the 100). This index is available in National Income and Product manager in accordance with corporate procedures. Accounts of the United States (Department of Commerce. Bureau of Economic Analysis). Note: EPA does not require specific assignments or delegation of authority to responsible corporate officers identified in §122.22(a)(1)(1). Part V-D The Agency will presume that these responsible corporate officers have List any pollutants in Table 2c-3 that you believe to be present and the requisite authority to sign permit applications unless the corporation explain wily you believe them to be present. No analysis is required, has notified the director to the contrary. Corporate procedures goveming but if you have analytical data, you must report IL authority to sign permit applications may provide for assignment or delegation to applicable corporate position under §122.22(a)(1)(ii) rather Note: Under CFR 117.12(a)(2), certain discharges of hazardous than to specific individuals. substances (listed in Table 2c-4 of these instructions) may be exempted from the requirements of Section 311 of CWA, which (8) For a partnership or sate proprietorship: by a general partner establishes reporting requirements, civil penalties and liability for or the proprietor, respectively; or cleanup costs for spills of oil and hazardous substances. A discharge (C) For a municipality, State. Federal. or other public agency: by either of a particular substance may be exempted in the origin, source. and a principal executive officer or ranking elected official. For purposes of amount of the discharged substances are identified in the NPDES this section, a principal executive officer of a Federal Agency includes (i) permit application or in the permit if the permit contains a the chief executive officer of the Agency, or (ii) a senior executive officer requirement for treatment of the discharge, and if the treatment is in having responsibility for the overall operations of a principal geographic place. To apply for an exclusion of the discharge of any hazardous unit of the Agency (e.g.. Regional Administrators of EPA). Applications substance from the requirements of Section 311, attach additional for Group II stormwater dischargers may be signed by a duty authorized sheets of paper to your form. setting for the following information: representative (as defined in 40 CFR 122.22(b)) of the Individuals 1. The substance and the amount of each substance which may identified above. be discharged. 2. The origin and source of the discharge of the substance. 3. The treatment which is to be provided for the discharge by: a. An onsite treatment system separate from any treatment system treating your normal discharge; b. A treatment system designed to treat your normal discharge and which is additionally capable of treating the amount of the substance identified under paragraph 1 above: or c. My combination of the above. See 40 CFR § 117.12(aX2) and (c), published on August 29. 1979. In 44 FR 50766, or contact your Regional Office (Table 1 on Form 1, Instructions), for further information on exclusions from Section 311. Item VI This requirement applies to current use or manufacture of toxic pollutant as an intermediate or final product or byproduct. The Director may waive or modify the requirement if you demonstrate that it would be unduly burdensome to identify each toxic pollutant and the Director has adequate information to issue your permit. You may not claim this information as confidential: however, you do not have to distinguish between use or production of the pollutants or list the amounts. 2C-4 EFTA01221083 CODES FOR TREATMENT UNITS PHYSICAL TREATMENT PROCESSES 1-A Ammonia Stripping 1-M Grit Removal 1-B Dialysis 1-N Microstraining 1-C Diatomaceous Earth Filtration 1-0 Mixing 1-D Distillation 1-P Moving Bed Fitters 1-E Electrodialysis 1.O Multimedia Filtration 1-F Evaporation 1-R Rapid Sand Filtration 1-G Flocculation 1-S Reverse Osmosis (Hyperfiltration) 1-H Flotation 1-T Screening 1-I Foam Fractionation 1-U Sedimentation (Settling) 1-J Freezing 1-V Slow Sand Filtration 1-K Gas-Phase Separation 1-W Solvent Extraction It Grinding (Comminutors 1-X Sorption CHEMICAL TREATMENT PROCESSES 2-A Carbon Adsorption 2-G Disinfection (Ozone) 2-B Chemical Oxidation 2-H Disinfection (Other) 2-C Chemical Precipitation 2-I Electrochemical Treatment 2-D Coagulation 2-J Ion Exchange 2-E Dechlorination 2-K Neutralization 2-F Disinfection (Chlorine) 2-L Reduction BIOLOGICAL TREATMENT PROCESSES 3-A Activated Sludge 3-E Pre-Aeration 3-B Aerated Lagoons 3-F Spray Irrigation/Land Application 3-C Anaerobic Treatment 3-G Stabilization Ponds 3-D Nitrification-Denitrification 3-H Trickling Filtration OTHER PROCESSES 4-A Discharge to Surface Water 4-C Reuse/Recycle of Treated Effluent 4-B Ocean Discharge Through Outfall 4-D Underground Injection SLUDGE TREATMENT AND DISPOSAL PROCESSES 5-A Aerobic Digestion 5-M Heat Drying 5-B Anaerobic Digestion 5-N Heat Treatment 5-C Belt Filtration 5-0 Incineration 5-D Centrifugation 5-P Land Application 5-E Chemical Conditioning 5-0 Landfill 5-F Chlorine Treatment 5-R Pressure Filtration 5-G Composting 5-S Pyrolysis 5-H Drying Beds 5-T Sludge Lagoons 5-I Elutriation 5-U Vacuum Filtration 5-J Flotation Thickening 5-V Vibration 5-K Freezing 5-W Wet Oxidation 5-L Gravity Thickening TABLE 2C-1 EFTA01221084 TESTING REQUIRMENTS FOR ORGANIC TOXIC POLLUTANTS INDUSTRY CATEGORY* i GC/MS FRACTION' INDUSTRY CATEGORY Volatile Acid Base/Neutral Pesticide Adhesives and sealants X X X - Aluminum Forming X X X - Auto and other laundries X X X X Battery manufacturing X - X - Coal mining X X X X Coil coating X X X Copper forming X X X - Electric and electronic compounds X X X X Electroplating X X X Explosives manufacturing X X - Foundries X X X - Gum and wood chemicals X X X X Inorganic chemicals manufacturing X X X - Iron and steel manufacturing X X X - Leather tanning and finishing X X X X Mechanical products manufacturing X X X Nonferrous metals manufacturing X X X X Ore mining X X X X Organic chemicals manufacturing X X X X Pain and ink formulation X X X X Pesticides X X X X Petroleum refining X X X X Pharmaceutical preparations X X X Photographic equipment and supplies X X X X Plastic and synthetic materials manufacturing X X X X Plastic processing X - - - Porcelain enameling X - X X Printing and publishing X X X X Pulp and paperboard mills X X X X Rubber processing X X X - Soap and detergent manufacturing X X X - Steam electric power plants X X X - Textile mills X X X X Timber products processing X X X X *See note at conclusion of 40 CFR Part 122, Appendix D (1983) for explanation of effect of suspensions on testing requirements for primary industry categories. 'The pollutants in each fraction are listed in Item V-C. X = Testing required. - = Testing not required. TABLE 2C-2 EFTA01221085 TOXIC POLLUTANTS AND HAZARDOUS SUBSTANCES REQUIRED TO BE IDENTIFIED BY APPLICANTS IF EXPECTED TO BE PRESENT TOXIC POLLUTANT HAZARDOUS SUBSTANCES Asbestos Methyl mercaptan Methyl methacrylate HAZARDOUS SUBSTANCES Methyl parathion Mevinphos Acetaldehyde Mexacarbate Allyl alcohol Monoethyl amine Allyl chloride Monomethyl amine Amyl acetate Naled Aniline Naphthenic acid Benzonitrile Nitrotoluene Benzyl chloride Parathion Butyl acetate Phenolsufonate Butylamine Phosgene Captan Propargite Carbaryl Propylene oxide Carbofuran Pyrethrins Carbon disulfide Quinoline Chlorpyrifos Resorcinol Coumpahos Strontium Cresol Strychnine Crotonaldehyde 2,4,5-T (2,4,5-Trichlorophenoxyacetic acid) Cyclohexane TOE (Tetrochlorodiphenyl ethane 2,4-D (2,4-Dichlorophinoxyacetic acid) 2,4,5-TP [2-(2,4,5-Trichlorophenoxy) propanic acid) Diazinon Trichlorofon Dicamba Triethanolamine dodecylbenzenesulfonate Dichlobenil Triethylamine Dichlone Uranium 2,2 Dichloropropionic acid Vanadium Dichlorvos Vinyl acetate Diethyl amine Xylene Dimethyl amine Xylenol Dintrobenzene Zirconium Diquat Disulfoton Diuron Epichlorohydrin Ethion Ethylene diamine Formaldehyde Furfural Guthion Isoprene Isopropanolamine Kelthane Kepone Malathion Mercaptodimethur Methoxychlor TABLE 2C-3 EFTA01221086 HAZARDOUS SUBSTANCES Acetaldehyde Butylamine Dichlorvos Acetic acid Butyric acid Dieldrin Acetic anhydride Cadmium acetate Diethylamine Acetone cyanohydrin Cadmium bromide Dimethylamine Acetyl bromide Cadmium chloride Dinitrobenzene Acetyl chloride Calcium arsenate Dinirophenol Acrolein Calcium arsenite Dinitrotoluene Acrylonitrile Calcium carbide Diquat Disulfoton Adipic acid Calcium chromate Diuron Aldrin Calcium cyanide Dodecylbenzesulfonic acid AIlyl alcohol Calcium dodecylbenzenesulfonate Endosulfan Alyll chloride Calcium hypochlorite Endrin Aluminum sulfate Captan Epichlorohydrin Ammonia Carbaryl Ethion Ammonium acetate Carbofuran Ethylbenzene Ammonium benzoate Carbon disulfide Ethylenediamine Ammonium bicarbonate Carbon tetrachloride Ethylene dibromide Ammonium bichromate Chlordane Ethylene dichloride Ammonium bifluoride Chlorine Ethylene diaminetetracetic acid Ammonium bisulfate Chlorobenzene (EDTA) Ammonium carbamte Chloroform Ferric ammonium citrate Ammonium carbonate Chloropyrifos Ferric ammonium exalate Ammonium chloride Chlorosulfonic acid Ferric chloride Ammonium chromate Chromic acetate Ferric fluoride Ammonium citrate Chromic acid Ferric nitrate Ammonium flouroborate Chromic sulfate Ferric sulfate Ammonium fluoride Chromous chloride Ferrous chloride Ammonium hydroxide Cobaltous bromide Ferrous sulfate Ammonium oxalate Cobaltous formate Formaldehyde Ammonium silicofluoride Cobaltous sulfamate Formic acid Ammonium sulfamate Coumaphos Fumaric acid Furfural Ammonium sulfide Cresol Guthion Ammonium silfite Crotonaldehyde Heptachlor Ammonium tartrate Cupric acetate Hexachlorocyclopentadiene Ammonium thiocyanate Cupric acetoarsenite Hydrochloric acid Ammonium thisulfate Cupric chloride Hydrofluoric acid Amyl acetate Cupric nitrate Hydrogen cyanide Aniline Cupric oxalate Hydrogen sulfide Antimony pentachloride Cupric sulfate Isoprene Antimony potassium tartrate Cupric sulfate ammoniated Isopropanolamine Antimony tribromide Cupric tartrate dodecylbenzenesulfonate Antimony trichloride Cyanogen chloride Kelthane Antimony trifluoride Cyclohexane Kepone Antimony trioxide 2,4-D acid (2,4-Dichlorophenoxyacetic Lead acetate Arsenic disulfide acid esters) Lead arsenate Barium cyanide DDT Lead chloride Benzene Diazinon Lead fluoborate Benzoic acid Dicamba Lead fluorite Benzonitrite Dichlobenil Lead iodide Benzoyl chloride Dichlone Lead nitrate Benzyl chloride Dichlorobenzene Lead stearate Beryllium chloride Dichloropropane Lead sulfate Beryllium fluoride Dichloropropene Lead sulfide Lead thiocyanate Beryllium nitrate Dichloropropene-Dichloropropane mix Lindane Butylacetate 2.2-Dichloropropionic acid Lithium chromate n-Butylphthalate Malathion TABLE 2C-4 EFTA01221087 HAZARDOUS STUBSTANCES (Continued) Maleic acid Sodium bifluoride Zinc ammonium chloride Maleic anhydride Sodium bisulfite Zinc borate Mercaptodimethur Sodium chromate Zinc bromide Mercuric cyanide Sodium cyanide Zinc carbonate Mercuric nitrate Sodium dodecylbenzenesulfonate Zinc chloride Mercuric sulfate Sodium fluoride Zinc cyanide Mercuric thiocyanate Sodium hydrosulfide Zinc fluoride Mercurous nitrate Sodium hydroxide Zinc formate Methoxychlor Sodium hypochlorite Zinc hydrosulfite Methyl methacrylate Sodium methylate Zinc nitrate Methyl parathion Sodium nitrate Zinc phenolsulfonate Mevinphos Sodium phospate (dibasic) Zinc phosphide Mexacarbate Sodium phosphate (tribasic) Zinch silicofluoride Monethylamine Sodium selenite Zinc sulfate Monomethylamine Strontium chromate Zirconium nitrate Naled Strychnine Zirconium potassium fluoride Naphthalene Styrene Zirconium sulfate Naphthenic acid Sulfuric acid Zirconium tetrahloride Nickel ammonium sulfate Sulfur monochloride Nickel chloride 2,4,5-T acid (2,4,5-Trichlorophenoxy Nickel hydroxide acetic acid) Nickel nitrate 2,4,5-Tamines (2,4,5-Trichlorophenoxy Nickel sulfate acetic acid amines) Nitric acid 2,4,5-T esters (2,4,5-Trichlorophenoxy Nitrobenezene propanoic acid) Nitrogen dioxide 2,4,5-TP acid esters (2,4,5- Nitrophenil Trichlorophenoxy propanoic acid Nitrotoluene esters) Paraformaldehyde TDE (Tetrachlorodiphenyl ethane) Parathion Tetraethyl lead Pentachlorophenol Tetraethyl pyrophosphate Phenol Thallium sulfate Phosoene Toluene Phosphoric acid Toxaphene Phosphorus Trichlorofon Phosphorus oxychloride Trichloroethylene Phosphorus pentasulfide Trichlorophenol Phosphorus trichloride Triethanolamine Polychlorinated biphenyls (PCB) dodecylbenzenesulfonate Potassium arsenate Triethylamine Potassium arsenite Trimethylamine Potassium bichromate Uranyl acetate Potassium cyanide Uranyl nitrate Potassium hydroxide Vanadium pentoxide Potassium permanganate Vanadyl sulfate Propargite Vinyl acetate Propionic acid Vinylidene chloride Propionic anhydride Xylene Propylene oxide Xylenol Pyrethrins Zinc acetate Quinoline Resorcinol Selenium oxide Silver nitrate Sodium Sodium arsenate Sodium arsenite Sodium bichromate TABLE 2C-4 (continued) EFTA01221088 LINE DRAWING BLUE RIVER MUNICIPAL 90.000 GPO WATER SUPPLY BLUE RIVER 10,000 GPD 45.000 GPD 45.000 GPO 30.000 GPO RAW COOLING WATER 15,000 20.000 10.000 MATERIALS FIBER TO ATMOSPHERE GPO GP() WASHING GPO DYEING DRYING PREPARATION 5,000 GPO 10.000 GPD 10.000 GPD 40.000 GPO 40.000 GPO TO PRODUCT 40.000 GPO 5.000 GPD _at SOLID WASTE NEUTRAL- WASTE GRIT LOSS QATION TREATMENT SEPARATOR TANK PLANT -2 4.000 GPD 6.000 GPD 36.000 GPO 34.000 GPO OUTFALL 002 50.000 GPO WASTE TREATMENT 70 000 GPD • STORMWATER STORMWATER PLANT a 1 OUTFALL 001 MAX 20.000 GPD SCRSIAATIC OF WATER FLOW BROWN AWL LS, INC CITY COUNT' STATE FIGURE 2C-1 EFTA01221089 EPA ID Number (Copy from Item 1 ofForm 1) Form Approved Please type or pent in the unshaded areas only OMB 2040-0086 Approval expires 8-31-98 Form U.S. ENVIRONMENTAL PROTECTION AGENCY 2C a APPLICATION FOR PERMIT TO DISCHARGE WASTEWATER EXISTING MANUFACTURING, COMMERCIAL, MINING AND SILVICULTURAL OPERATIONS NPDES la EPA Consolidated Permits Program I Outfall Location For this outfall, list the latitude and longitude. (degrees, min.xxxx) and name of the receiving water(s) Outfall Latitude Longitude Receiving Water (name) Number (list) SLi Min S_ 1,.Cr II. Flows, Sources of Pollution, and Treatment Technologies A. Attach a line drawing showing the water flow through the facility. Indicate sources of intake water, operations contributing wastewater to the effluent. and treatment units labeled to correspond to the more detailed description In Item B. Construct a water balance on the line drawing by showing average flows between intakes, operations. treatment units. and outfalls. If a water balance cannot be determined (e.g.. for certain mining activities), provide a pictoral description of the nature and amount of any sources of water and any collection or treatment measures. B. For each outfall, provide a description of (1) All operations contributing wastewater to the effluent. including process wastewater. sanitary wastewater, cooling water, and storm water runoff: (2) The average flow contributed by each operation: and (3) The treatment received by the wastewater. Continue on additional sheets if necessary. 1. Ouffall No. 2. Operations Contributing Flow 3. Treatment (list) a. OPERATION (list) b. AVERAGE FLOW a. DESCRIPTION b. LIST CODES FROM TABLE 2C-1 (include units) EPA Form 3510-2C (8-90) Page 1 of 4 CONTINUE ON REVERSE EFTA01221090 CONTINUED FROM THE FRONT C. Except fors am runoff, leaks, or spills, are any of the discharges described in Items II-A or B intermittent or seasonal? ❑ YES (complete the following table) 0 NO to Section III) 3. FREQUENCY 4. FLOW 1. OUTFALL 2. OPERATION(s) a. DAYS b. MONTHS a. FLOW RATE b. TOTAL VOLUME (specify with units C. DUR- NUMBER CONTRIBUTING FLOW PER WEEK PER YEAR (in mgd) ATION (list) (list) (specify (specify 1. LONG TERM 2. MAXIMUM 1. LONG TERM 2. MAMMUM On days) AILY III. PRODUCTION A. Does an effluent guideline limitation promulgated by EPA under Section 304 of the Clean Water Act apply to your facility? IN YES (complete Item 111-8) 0 NO (go to Section IV) B. Are the limitations in the applicable effluent guideline expressed in terms of production (or other measure of operation)? ❑ YES (complete Item Ill-C) 0 NO (qo to Section IV) C. If you answered 'yes' to Item Ill-B, list the quantity which represents an actual measurement of your level of production, expressed in the terms and units used In the applicable effluent guideline, and indicate the affected outfalls. 1. AVERAGE DAILY PRODUCTION 2. AFFECTED OUTFALLS a. OUANTITY PER DAY b. UNITS OF MEASURE c. OPERATION. PRODUCT. MATERIAL. ETC. (list outfall numbers) (specify) IV. IMPROVEMENTS A. Are you now required by any Federal. State. or local authority to meet any implementation schedule for the construction, upgrading, or operation of wastewater treatment equipment or practices or any other environmental programs which may affect the discharges described in this application? This includes, but is not limited to. permit conditions, administrative or enforcement orders, enforcement compliance schedule kitten, stipulations, court orders, and grant or loan conditions 0 YES (complete the following table) ❑ NO (go to Item IV-8) 2. AFFECTED OUTFALLS 4. FINAL 1. IDENTIFICATION OF CONDITION, 3. BRIEF DESCRIPTION OF PROJECT COMPLIANCE DATE AGREEMENT, ETC. a. No b. SOURCE OF DISCHARGE a. REO- b. PRO- UIRED JECTED B. OPTIONAL: You may attach additional sheets describing any additional water pollution control programs (or other environmental projects which may affect your discharges) you now have underway or which you plan. Indicate whether each program is now underway or planned. and indicate your actual or planned schedules for construction. 0 MARK "X- IF DESCRIPTION OF ADDITIONAL CONTROL PROGRAM IS ATTACHED EPA FORM 3510-2C (Rev. 2-85) Page 2 of 4 CONTINUED ON PAGE 3 EFTA01221091 EPA ID Number (Copy from Item I of F0(111 1) CONTINUED FROM PAGE 2 V. INTAKE AND EFFLUENT CHARACTERISTICS A, B. & C: See instructions before proceeding - Complete one set of tables or each outfall - Annotate the outfall number in the space provided. NOTE: Tables V-A. V-B. and V-C are included on separate sheets number V-1 through V-9. D: Use the space below t list any of the pollutants listed in Tables 2c-3 of the instructions, which you know or have reason to believe is discharged or may be discharged from any outfall. For every pollutant you list. briefly describe the reasons you believe it to be present and report any analytical data in your possession. 1. POLLUTANT 2. SOURCE 1. POLLUTANT 2. SOURCE VI. POTENTIAL DISCHARGES NOT COVERED BY ANALYSIS Is any pollutant listed in Item V-C a substance or a component of a sub lance which you currently use or manufacture as an intermediate or final product or byproduct? ❑ YES (list all such pollutants below) ■ NO (go to Item VI-B) EPA FORM 3510-2C (Rev. 8-90) Page 3 of 4 CONTINUED ON REVERSE EFTA01221092 CONTINUED FROM THE FRONT VII. BIOLOGICAL TOXICITY TESTING DATA Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on any of your discharges or on a receiving water in relation to your discharge within the last 3 years? MI YES (identify the test(s) and describe their purpose below) • NO (go to Section VIII) VIII. CONTRACT ANALYSIS INFORMATION Were any of the analyses reported in Item V performed by a contract laboratory or consulting firm? ❑ YES (list the name, address, and telephone number of. and pollutants IMI NO (go to Section IX) anal zed b each such laborer° or firm below C. TELEPHONE D. POLLUTANTS ANALYZED area code & no.) (list) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) IX. 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 submitted is, to the best of my knowledge and belief. true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. A. NAME & OFFICIAL TITLE (type or print) B. PHONE NO. (area code & no.) ( ) C. SIGNATURE D. DATE SIGNED EPA FORM 3510-2C (Rev. 8-90) Page 4 of 4 EFTA01221093 PLEASE PRINT OR TYPE IN THE UNSHADED AREAS ONLY. You may report some or EPAIn NUMBER (copy from item 1ofForm 1) all of this information on separate sheets (use the same format) instead of completing these Daces. SEE INSTRUCTIONS. V. INTAKE AND EFFLUENT CHARACTERISTICS (continued from page 3 of Form 2-C) PART A - You must provide the results of at least one analysis for every po lutant in this table. Complete one table for each outfall. See instructions for additional details. 2. EFFLUENT 3. UNITS 4. INTAKE (optional) a. MAXIMUM DAILY b. MAXIMUM 0 DAY VALUE c. LONG TERM AVRG. VALUE (specify if blank) a. LONG TERM 1. POLLUTANT VALUE Of ereatiat?e) (if av liable) d. NO. OF AVERAGE VALUEb. NO. OF (I) Cl) 0) ANALYSIS a. CONGER. b MASS II) ANALYSES mammal ($) $$$$$ CONCENTRATI I "ASS CONCENTRATI 0) MASS CONCENTRAT In SASS TRATION ON ON ON ON a. Biochemical Oxygen Demand (BOD) b. Chemical Oxygen Demand (COD) c. Total Organic Carbon (TOC) d. Total Suspended Solids (TSS) e. Ammonia (as N) Value Value Value Value f. Flow Value Value Value Value g. Temperature (winter) °C h. Temperature (summer) Value Value Value °C Value Minimum Maximum Minimum Maximum I. pH STANDARD UNITS PART B - Mark 'X" in column 2-a fo each pollutant you know or have reason to believe is present. Mark 'X" in column 2-b for each pollutant you believe to be absent. If you mark column 2a for any pollutant which is limited either directly, or indirectly but expressly in an effluent limitation guideline, you must provide the results of at least one analysis for that pollutant. For other pollutants for which you mark column 2a, you must provide quantitative data or an explanation of their presence in your discharge Complete one table for each outfall. See the instructions for additional details and requirements. 1. POLLUT- 2. MARK 'X' 3. EFFLUENT 4. UNITS 5. INTAKE (opt/one° ANT AND a ". nii. a. MAXIMUM DAILY b. MAXIMUM 0 DAY VALUE c. LONG TERM AVRG. VALUE (Specify if blank) a. LONG TERM Met VALUE 0f magage) (ffavalkible) d. NO. OF b. NO. OF AVERAGE VALUE CAS NO. (If pftils of (I) (II ANALYSIS a. CONCEN. in ANALYSES Butt 0) (21 MASS TRATION b. MASS concifionno. available) ea coNcegRA Wan coticimpAno MIALSS coNc ENTRADO MUM TIM N N a. Bromide O O (24959-67-9) O Ctionne. Total Roadie/ C. Color 0 0 d. Fecal Colifomi e. Fluoride O O (16984-48-8) f. Nitrate- Nitrite (as N) EPA FORM 3510-2C (Rev. 8-90) Page V-1 CONTINUE ON REVERSE EFTA01221094 ITEM V-8 CONTINUED FROM FRONT 1. POLLUT- 2. MARK X 3. EFFLUENT 4. UNITS 5. INTAKE (optional) ANT AND •• BS Lave a BE- Lave a. MAXIMUM DAILY b. maximum 0 DAY VALUE Ar reatiabee) c. LONG TERM AVRG. VALUE (if available) d. NO. OF (specify if blank) a. LONG TERM AVERAGE VALUE b. NO. OF VALUE CAS NO. (if 066 °e µ ANALYSIS a. coNcEN. ANALYSES ar (n cn u) b. MASS (I) available) ENT CONCENTRA alIan CONCBRRAll te MASS CONCENTRATI MIMES CONCENTRATI IN MASS TRATION NON ON on ON g. Nitrogen. Total Organic 0 (es N) h. Oil and Grease El ❑ i. Phosphorus O O Os P), Total (7723-14-0) J. Radioactivity Of Naha. Total 0 0 (2) Bets, II 0 Total (3) Radium. Total O ❑ (4) Radium • O 226. Total k. Sulfate (as SO..) O ❑ (14808-79-8) I. Sulfide (as S) m. Sulfite (es SC/141( 14265-45-3) n. Surfactants o. Aluminum. O Total MI (7429-90-5) p. Barium. Total (7040-39-3) q. Boron. ❑ Total 0 (7440-42-8) r. Cobalt. Total (7440-48-4) s. Iron. Total (7439-89-4) L Magnesium, Total (7439-95-4) u. Mciybdenum. Total (7439.96.7) v. Manganese. Total (749.964) w. Tin. Total ii O (7440-31-5) x. Titanium. Total 0 0 (7440-32-6) EPA FORM 3510-2C (Rev. 8-90) Page V-2 CONTINUE ON PAGE V-3 EFTA01221095 EPA NUMBER (copy from Item 1 ofForm 1) I OUTFALL NUMBER CONTINUED FROM PAGE 3 OF FORM 2-C PART C - If you are a primary industry and this outsell contains process wastewater. refer to Table 2c-2 in the instrucbons to determine which of the GC/MS fractions you must test for. Mark "r in column 2-a for all such GUMS fractions that apply to your industry and for ALL toxic metals. cyanides. and total phenols. If you are not required to mark column 2-a (secondary industnes. nonprocess wastewater °Walls and non-required GC AS fractions). mark 'X" in column 2-b for each pollutant you know or have reason to believe is present. Mark "r NI column 2-c for each pollutant you believe is absent If you mark column 2a for any pollutant. you must provide the results ct at least one analysts for that pollutant. If you mark column 2b for any pollutant. you must provide the results of at least one analysis for that pollutant. If you know or have reason to bekeve it will be discharged in concentrations of 10 ppb or greater. If you mark column 2b for acrolein. acrybnitrile. 2.4 dinitrophenol. or 2-methyl-4. 6 dinitrophenol, you must provide the results of at least one analysis fa each of these pollutants which you know or have reason to believe that you discharge in concentrations of 100 ppb or greater. Otherwise. for polutants for which you mark column 2b. you must ether submit at least one analysis or briefly describe the reasons the pollutant is expected to be discharged. Note that there are 7 pages to this part: please review each carefuly. Complete one table (all 7 pages) for each caudal. See instructions for additional details and requirements. 2. MARK 'Xi 3. EFFLUENT 4. UNITS 5. INTAKE (optional) 1. POLLUT- ANT AND a. TEST- 0. BE. c. BE- a. MAXIMUM DAILY VALUE b. MAXIMUM 30 DAY VALUE e. LONG TERM AVRG. (specify if blank) a. LONG TERM NG RE- UEVED LIEVED Ofavabfe) NO. b. OF VALUE d. AVERAGE CAS NO. (If *WIRED PRE-SENT ABSENT (IIwaitabk) ANALYSI ANALYSE available) NI CONCERT. lo CONCERT. NI CONCENT. S a. b. MASS (I) S RATION II2) MSS RADON IOMASS RATION ii2)MSS CONCEN- comammA I2AVLSS TRATION TON METALS, CYANIDE, AND TOTAL PHENOLS 1m. Anbmony. Taal 0 0 0 (7440-36-0) 2M. Arsenic. Taal 0 0 0 (7440-38.2) 3M. Beryllium, Total 0 (7440-41-71__ 4M. Caciaium. Taal El E U (7440-43.9) 5MalChromium. Tot 0 0 0 (7440-47.3) 6M Copper. Taal 0 0 ❑ (744050.8) 7M leacl. TOW (7439-92-1) 0 0 0 8M Mercury. Trial 0 0 0 7439-97-6 9M Nickel. Taal 0 0 (7440-02.0) 10M Selenium. Taal 0 (7782-49.2) 11M Slyer. Taal 0 0 ❑ (7440-22-4) 1214 Thalkon. Total El E U (7440-28-0) 13M Zinc. Taal 0 0 (7440-6643) 14M Cyanide, Taal 0 0 ❑ (57-12-51 15M Phenols, Taal 0 U U DIOXIN 2.3.2.8-iebb- DESCRIBE RESULTS CIONOINDEN120- O P-CtOnn (1764-01-6) EPA FORM 3510-2C (Rev. 8-90) Page V-3 CONTINUE ON REVERSE EFTA01221096 CONTINUED FROM THE FRONT 1. POLLUT- 2. MARK 'X' 3. EFFLUENT 4. UNITS 5. INTAKE (optional) ANT AND IL TEST 0. BE. C. BE. a. MAXIMUM DAILY b. MAXIMUM 30 DAY VALUE C. LONG TERM AVRG. (specify if blank) a. LONG TERM ING RE- UEVED LIEVED VALUE Of ava.0.0.0.) VALUE d. NO. Of AVERAGE VALUE b. NO. OF CAS NO. (If OLNRED PRESENT ABSENT ("available) ANALYSI ANALYSE available) iii CONCERT. RATION PAW% III CONCERT. RATION PANS, ill 0014CFNT. RATION )211A4.54 $ a. b. MASS (I) CONCENTRA R6 S GOWEN. non TRATION GC/MS - VOLATILE COMPOUNDS W. ANON'. (10 O 02.01 0 0 2V. Atryloriid* (10743-11 0 W. Swam* (71-13.2i 0 0 ❑ 4V Eitt(CI4vo. melvMElun ISO- 88.11 0 W. Betarokrat (75.25.2I 0 0VCato, ToIrochiode• MI 0 0 (562941 W. Chbrobouom (108.93.7i AV Clibm0- Iminnotanc. (124-49-ii 0 0 0 W Chlvefane ((750031 0 10V. 20loo. 00.1Nr9110Nt (110.754) 1W. Ctiatecari 0574431 12V. Dittlao. CI 0 0 biornooffuria ( 75-274) 1W, Mauro. orloaranthere (7S71-91 0 0 0 0th 14V 1.1CICION0- 0 • El (7547.31 I5V. 12.0Ichbio- &An 00700.21 ICV.1.1.01chnio- e 0 0 0 (7535-4) in, I.2000:40- ❑ 04094,14 O in 0 (70874i 18V. 1.3.01chnio- WOW* 042.7,41 19V 4I.4) 000.4I-4) 0 0 El 20V 1401101 13,94e464 (74434) 2W. kInlIbl Chloncb (f4.131 EPA FORM 3510-2C (Rev. 8-90) Page V-4 CONTINUE ON PAGE V-5 EFTA01221097 EPA NUMBER (copy from Item 1 of POMP 1) OUTFALL NUMBER CONTINUED FROM PAGE V-4 1. POLLUT- 2. MARK 'X' 3. EFFLUENT 4. UNITS 5. INTAKE (optional) ANT AND a. TEST- b. BE- c. BE- a. MAXIMUM DAILY b. MAXIMUM 30 DAY VALUE c. LONG TERM AVRG. (specify if blank) a. LONG TERM IND RE- LIEVED UEVED VALUE (Wavagabb) VALUE a.NO. OF AVERAGE VALUE b. NO. OF CAS NO. (If (Navigable) ANALYSI ANALYSE QUIRED PRE- ABSENT I1I OONCENT available) SENT III concar. NATION °ANTS I2)MSS ill CONOENT. ITIIAASS 5 a. b. MASS (I) CONCNTRAm I2) /AATS S RATION . RATION CONCEN- E ON TRATION GC/MS - VOLATILE COMPOUNDS (continued) 22 V. IhItheale ChM& • 0 0 SO9x1 TN I.I.22-1.76- ChlorcenAT OW 344 0 ❑ 0 24V. Tankrioro. 40011.0( 127.18-4) ❑ 0 ❑ 2511 Tals* 006-61-31 0 0 0 MC I.2-kine ITIGIVOITIIIIINIe (I60-004) ❑ 0 ❑ 001070100.1. 6165-61 OS 0 0 0 (7.00-5I Niv Imam- 0 (1901-01 I:l El ❑ 30V. Manua. .140(00Chat* (7S-69-4I 3Ile vireo Cando (M.w.al El El El GCIMS FRACTION -ACID COMPOUNDS IA 2. CAIC400.4001 0 0 0 (9E-SUri TA 2.3.1230113.0. yard El 020-0.2i 3/4 2A-DIMOVell. 1101001 (10647.91 4A 44-0140-0. wed (53 2.4- SA 4.52.11 D 0 0 ❑ rdro- Owed 0 0 GA ($1.26-5I 244110.61.plel (M7541 IA .63(26036631 O O • ocaozn SA P.Cilina- COTICI 0 0 (9)40.7I 96, .." orforactiocol • 0 0 67435 061 PlIenN 00496.2I 0 Mk 2A6.T.I. orforactiocol 0 0 ❑ (63-06.21 EPA FORM 3510-2C (Rev. 8 - 90) Page V-5 CONTINUE ON REVERSE EFTA01221098 CONTINUED FROM THE FRONT 2. MARK 'X' 3. EFFLUENT 4. UNITS 5. INTAKE (optional) 1. POLLUT- ANT AND a. TEST. b BE. C. BE. a. MAXIMUM DAILY b. MAXIMUM 30 DAY c. LONG TERM AVRG. (specify If blank) a. LONG TERM IN RE. UEVED LIEVED VALUE VALUE VALUE d. NO. OF AVERAGE VALUE b. NO. OF CAS NO. (if CURED PRESENT ABSENT Of avatbble) (N available) ANALYSI ANALYSE available) 01 OONCENT. 111 00110012. ill CONCENT. 12)MASS S a. (a S RADON 12) kw RATION 12)14489 RATION CONCENTRAll 12)159 CONCEIT. AMASS ON I TRATION GC/MS FRACTION - BASE/NEUTRAL COMPOUNDS 1 Acephrome 023.3491 0 0 0 28 Acoropre9ta (2004541 no 0 38 AftlirablA0 ❑ (men 0 El 48 NOILI000 024741 0 $B Elor99219) AISMOC410 5045.3 El 0 In 0I3 Sterol.) P0994(504241 0 0 • >8 3.44•920. (Onaffirene 0 53C+8 <9:;:>i 19(41 Per(fene (191.2441 0 0 0 98 bercolkl FluoriniMne ❑ 0 El (2024841 loft Eli (4 Chlacerayl 111.1, 999 011.9141 ill E 0944C109ro- WO lls (111-M-41 0 1212B11(2. Chlorom02(99(11 ❑ ❑ 0 Erwr((10040-1 131 bota.Eress h.q.) alts* (117414, 0 0 • e ia 4-ecomo- fACO0 FIVINI 9.0( 00126-31 15B840 Elanzil ❑ Ontielale 0 0 (11 5Mice Se 014041 0 0 0 lit •Ctiato- Phinyl Phatryi 0 91er(?005424) let Cliwomo (210-0191 let 00(9929(4.1(1 AnT999(no 634041 0 0 0 208 124nbro- 19.929/41 (994411 2112 I.I.Diebbrck Comm 0 (511.7111 ❑ EPA FORM 3510-2C (Rev. 8-90) Page V-6 CONTINUE ON PAGE V-7 EFTA01221099 EPA NUMBER (copy from Item 1 of Form 1) OUTFALL NUMBER CONTINUED FROM PAGE V-6 1. POLLUT- 2. MARK IX' 3. EFFLUENT 4 (fblank) 5. INTAKE (optional) AND a. TEST. b. BE. e. RE a. MAXIMUM DAILY b. MAXIMUM 30 DAY VALUE C. LONG TERM AVRG. a. LONG TERM ING RE. IJEVED LEWD VALUE (wavewabos VALUE A. NO. OF AVERAGE VALUE A. NO. OF CAS NO. (II (ERRED PRESENT ABSENT gI available) ANALYSI ANALYSE available) III CONCENt. RATION I21IMS3 III CONCENT. RATION I2AVISS III WHOOP. RATION l2)MSS 5 a. CONCEN. (I) CC44CENTSUIll l2)PASS $ TRATION b. MASS ON I GC/MS - BASE/NEUTRAL COMPOUNDS (continued) 221 Wawa 004146.71 231 3.3‘Otitto. beware (9144.11 0 0 El 241 Cootril Rapala (84411.2I IM 0 0 251Man,. Prawn).* 031.11-31 261 IN/443AI Ontalsie (61.74.2] 0 0 0 Mk 2.44>Niro. Wax* 0 0 0 (12144.21 281 2.60ININ. mbar* (1191 E4)20.21 2 DiN.OctO PISMO. 0174)1-0) 0 0 El NM I.00ptemil• IVP)IPII.Os Pao Watt.) 0 ❑ 0 I22-504 318. Fborantone (200-MOI 0 0 0 328 Monne OE-737i ❑ 0 ❑ 338 Hon. Olootarimp 118.74.11 ❑ IM 0 341 Hoop elop.tutoSala (87438.3I 0 0 0 368 Hmtaatoo. Otlopomadaaa Or/47m 368 Hon. oinion (67.72.II IM M 0 3T1 lobo, 0.2.3. OR RIPIA.1 (1934X5 0 0 388 luorteetS (784941 301 Ntanalene (91.20Ol 4CO. Intobionao 0 ❑ 0 ❑ ❑ (98-95.3I 0 418. Winn) solvoilrrylonne (62.75.9I 0 0 0 42P ItHeroolIP. Prooilimpo (621.04.7) 0 IM 0 EPA FORM 3510-2C (Rev. 8-90) Page V-7 CONTINUE ON REVERSE EFTA01221100 CONTINUED FROM THE FRONT 1. POLLUT- 2. MARK X 2. EFFLUENT 3. UNITS 4. INTAKE (optional) AND . TEST. 0. BE. C. BE. a. MAXIMUM DAILY VALUE b. MAXIMUM 30 DAY VALUE e. LONG TERM AVRG. (specify it blank) a. LONG TERM ING RE. LIEVED LIEVED Of mai able) VALUE d. NO. OF AVERAGE VALUE b. NO. OF CAS NO. (If OUIRED PRESENT ABSENT (if available) ANALYSIS ANALYSES available) III 00NCENT. PA110f1 12/MSS III COWEN-T. Rana' IZIMSS III CONCENT. aanon 12) 1MSS a. CONCEN. b. MASS (I) 0:44C1N1RA 12/MASS TRAllON TOM GC/MS FRACTION - BASE/NEUTRAL COMPOUNDS (continued) 431 H.1100- 60c1800.0.011414 • (60-304I 0S-014 441. F11411111Ittele CI CI CI 451Pm.* (1294341 CI CI ❑ 461I.Z44.1. cfrioneanwe El El El 02042.1I GC/MS FRACTION - PESTICIDES IP. AM (33.03.21 CI 2P 9404 2 , 44E El El CI 3P Ile% (31943.71 4P. Taft (56494) SP. 84114 El 0 ❑ (3194641 6P Carlin (97449) OP. 4.4'.DOT 0 CI • (641431 ❑ El ❑ 8P. 4.C.DDE masa) CI CI CI BP 4.4, 1)01) (72-5441I 10P. Di611416 CI 0 ❑ (60417.1I CI CI • 11P. an354011 (116.2949 CI 0 ❑ 12P PInt*L0/10, (118287 13P. Endow'', Sul= (1031.074) • CI CI 140 EMM (72.286I 130 Ent141 41,191,0e (7421404) 0 CI ❑ 10P Iltqa.hbe ❑ (76-4141I CI EPA FORM 3510-2C (Rev. 8-90) Page V-13 CONTINUE ON PAGE V-9 EFTA01221101 EPA NUMBER (copy from Item 1 of Form 1) OUTFALL NUMBER CONTINUED FROM PAGE V-6 1. POLLUT- 2. MARK 'X' 3. EFFLUENT 4. UNITS S. INTAKE (optionaa ANT AND a. TEST- b. BE- C. BE- a. MAXIMUM DAILY b. MAXIMUM 30 DAY C. LONG TERM AVRG. VALUE 0. NO. OF (specify if blank) a. LONG TERM b. NO. OF ING RE- LIEVED U EVED VALUE VALUE AVERAGE VALUE CAS NO. (If Of available) ANALYST ANALYSES (MIRED PRE- ABSENT Ilf aval able) available) SENT III CONCERT. III CONCERT. III CONCERT. S a. CONCEN) 0) RATON ii2)INLES RATON 0)MSS PATON 0)MSS CONCENTRA 11) MASS TRARON b. MASS nom GCIMS - PESTICIDES (continued) "P. NRARAIEE &Enda 0024474) 0 0 0 1SP. PCS-I242 0.14(0.21.0) CI ❑ CI ISP. POIAINA 01092401I El 20P. PC8.1221 01101.2fAN SIP. PCIA)212 CI CI CI (11)410041 22P PC8024$ El 02072.2fAN 23P. PCIA)260 CI CI CI 010904241 24P PCSIOIS El 02074.0.2i 2SP. Taa.prano 0 CI CI 0001.3S-2) EPA FORM 3510-2C (Rev. 8-90) Page V-9 EFTA01221102