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United States Office of Water EPA Form 3510-2F Environmental Protection Agency Washington, D.C. Revised March 2019 Water Permits Division U.S. EPA logo Application Form 2F Stormwater Discharges Associated with Industrial Activity NPDES Permitting Program Note: Complete this form and Form 1 if you are a new or existing facility whose discharge is composed entirely of stormwater associated with industrial activity, excluding discharges from construction activity under 40 CFR 122.26(b)(14)(x) or (b)(15). If your discharge is composed of stormwater and non-stormwater, you must complete Forms 1 and 2F, and you must complete Form 2C, 2D, or 2E, as appropriate. See the “Instructions” inside for further details. Print All Pages Print Form Only Paperwork Reduction Act Notice The U.S. Environmental Protection Agency estimates the average burden to collect and complete Form 2F to be 28.1 hours. The estimate includes time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and reviewing the collection of information. Send comments about the burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Chief, Information Policy Branch (PM-223), U.S. Environmental Protection Agency, 1200 Pennsylvania Avenue, NW, Washington, DC 20460, and to the Office of Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street, NW, Washington, DC 20503, marked “Attention: Desk Officer for EPA.” FORM 2F—INSTRUCTIONS General Instructions Who Must Complete Form 2F? You must complete Form 2F if you answered “Yes” to Item 1.2.5 on Form 1—that is, you are a new or existing facility and your discharge is composed entirely of stormwater associated with industrial activity (excluding discharges from construction activity under 40 CFR 122.26(b)(14)(x) or (b)(15)) or composed of stormwater and non-stormwater and are seeking coverage under an individual National Pollutant Discharge Elimination System (NPDES) permit. Note that applicants in the latter category must also complete Forms 2C, 2D, or 2E, as applicable. See inset below. Notes • Form 2F must be completed by any operator of a facility that discharges stormwater associated with industrial activity or the operator of any stormwater discharger that EPA is evaluating for designation as a significant contributor of pollutants to waters of the United States, or as contributing to a violation of a water quality standard. • For discharges composed entirely of stormwater, the operator must complete Form 2F in conjunction with Form 1. • For discharges of stormwater combined with process wastewater, the operator must complete and submit Form 2F, Form 1, and Form 2C. Process wastewater is water that comes into direct contact with or results from the production or use of any raw material, intermediate product, finished product, byproduct, waste product, or wastewater. • For discharges of stormwater combined with nonprocess wastewater, the operator must complete Form 2F, Form 1, and Form 2E. Nonprocess wastewater includes noncontact cooling water and sanitary wastes that are not regulated by effluent guidelines, except discharges by educational, medical, or commercial chemical laboratories. • For new discharges of stormwater associated with industrial activity that will be combined with other new non-stormwater discharges, the operator must submit Form 2F, Form 1, and Form 2D. Where to File Your Completed Form Submit your completed application package (Forms 1 and 2F plus any other applicable forms) to your NPDES permitting authority. Consult Exhibit 1–1 of Form 1’s “General Instructions” to identify your NPDES permitting authority. Public Availability of Submitted Information The U.S. Environmental Protection Agency (EPA) will make information from NPDES permit application forms available to the public for inspection and copying upon request. You may not claim any information on Form 2F (or related attachments) as confidential. You may make a claim of confidentiality for any information that you submit to EPA that goes beyond the information required by Form 2F. Note that NPDES permitting authorities will deny claims for treating any effluent data (estimated or actual) as confidential. If you do not assert a claim of confidentiality at the time you submit your information to the NPDES permitting authority, EPA may make the information available to the public without further notice to you. EPA will handle claims of confidentiality in accordance with the Agency’s business confidentiality regulations in Part 2 of Title 40 of the Code of Federal Regulations (CFR). Completion of Forms Print or type in the specified areas only. If you do not have enough space on the form to answer a question, you may continue on additional sheets, as necessary, using a format consistent with the form. Provide your EPA Identification Number from the Facility Registry Service, NPDES permit number, and facility name at the top of each page of Form 2F and any attachments. If your facility is new (i.e., not yet constructed), write or type “New Facility” in the space provided for the EPA Identification Number an NPDES permit number. If you do not know your EPA Identification Number, contact your NPDES permitting authority. See Exhibit 1–1 of Form 1’s “General Instructions” for contact information. Additionally, for Tables A through D, provide the applicable outfall number at the top of each page. Do not leave any response areas blank unless the form directs you to skip them. If the form directs you to respond to an item that does not apply to your facility or activity, enter “NA” for “not applicable” to show that you considered the item and determined a response was not necessary for your facility. The NPDES permitting authority will consider your application complete when it and any supplementary material are received and completed according to the authority’s satisfaction. The NPDES permitting authority will judge the completeness of any application independently of the status of any other permit application or permit for the same facility or activity. Definitions The legal definitions of all key terms used in these instructions and Form 2F are in the “Glossary” at the end of the “General Instructions” in Form 1. 2F-1 FORM 2F—INSTRUCTIONS CONTINUED Line-by-Line Instructions Section 1. Outfall Location Item 1.1. Identify each of the facility’s outfalls by number. For each outfall, specify the latitude and longitude to the nearest 15 seconds and name of the receiving water. Latitude and longitude coordinates may be obtained in a variety of ways, including use of hand held devices (e.g., a GPS enabled smartphone), internet mapping tools (e.g., https://mynasadata.larc.nasa.gov/latitudelongitude-finder/), geographic information systems (e.g., ArcView), or paper maps from trusted sources (e.g., U.S. Geological Survey or USGS). The location of each outfall (i.e., where the coordinates are collected) shall be the location where collected and concentrated stormwater flows are discharged from the facility such that the first receiving water body into which the discharge flows, either directly or through a separate storm sewer system, is a water of the United States. If you need further guidance in responding to Item 1.1, refer to http://www.epa.gov/geospatial/latitudelongitude-data-standard. Note: In EPA’s stormwater permits, “outfalls” are referred to as “discharge points.” Note that space has been provided on the form for six outfalls. If you have more than this number, type your information on a separate sheet of paper in a format similar to that of the form. Make sure you note the EPA Identification Number, NPDES permit number, and facility name at the top of the page and indicate the specific item of the form to which you are responding—Item 1.1 in this case. In other sections of the form, you will be asked to provide information by outfall number (Sections 2, 4, 5, and 7). Section 2. Improvements Item 2.1. Indicate if you are required by any federal, state, or local authority to meet an implementation schedule for constructing, upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could affect the discharges described in this application. The requirements include, but are not limited to, permit conditions, administrative enforcement orders, enforcement compliance schedule letters, stipulations, court orders, and grant or loan conditions. If yes, continue to Item 2.2. If no, skip to Section 3. Item 2.2. Briefly identify and describe each applicable project (e.g., consent decree, enforcement order, or permit condition). For each condition, specify the affected outfall number(s), the source(s) of the discharge, the required final compliance date, and the projected final compliance date. Item 2.3. OPTIONAL ITEM. Indicate if you have attached any sheets describing any additional water pollution control programs (or other environmental projects that could affect your discharges) that you may now have underway or planned. If you attach additional sheets, indicate in the attachment whether each program is actually underway or is planned, and indicate your actual or planned schedule for construction. Be sure to note your EPA Identification Number, NPDES permit number, and facility name at the top of any attached pages. Section 3. Site Drainage Map Item 3.1 Attach a site drainage map showing the topography of the facility. If a topographic map is unavailable, you may provide an outline of drainage areas served by the outfall(s) covered in the application. The site map must include the following information: • Each of its drainage and discharge structures. • The drainage area of each stormwater outfall. • Paved areas and buildings within the drainage area of each stormwater outfall; each past or present area used for outdoor storage or disposal of significant materials; each existing structural control measure to reduce pollutants in stormwater runoff; materials loading and access areas; and areas where pesticides, herbicides, soil conditioners, and fertilizers are applied. • Each hazardous waste treatment, storage, or disposal facility (including each area not required to have a Resource Conservation and Recovery Act permit and is used for accumulating hazardous waste for less than 90 days under 40 CFR 262.34). • Each well where fluids from the facility are injected underground. • Springs and other surface water bodies that receive stormwater discharges from the facility. When you have completed and attached your site map to Form 2F, answer “Yes” to Item 3.1. Section 4. Pollutant Sources Item 4.1. List all outfalls discharging stormwater. Provide an estimate of the impervious surface area drained by the outfall. Specify units of measure. (Impervious surfaces are surfaces where stormwater runs off at rates significantly higher than background rates—e.g., predevelopment levels. They include paved areas, building roofs, parking lots, and roadways.) Provide an estimate of the total surface area (impervious and pervious areas) drained by each outfall (within a mile radius of the facility). You may use the site map developed under Item 3.1 to estimate the total area drained by each outfall. For areas under 5 acres, consult your NPDES permitting authority to determine whether the area should be reported to the nearest tenth of an acre or nearest quarter of an acre. Item 4.2. Provide a narrative description of the following: • Significant materials that in three years prior to the submittal of this application have been treated, stored, or disposed of in a manner to allow exposure to stormwater. • Method of treatment, storage, or disposal of such materials. • Materials management practices employed, in the three years prior to the submittal of this application, to minimize contact by these materials with stormwater runoff. • Materials loading and access areas. • The location, manner, and frequency in which pesticides, herbicides, soil conditioners, and fertilizers are applied. You should identify your significant materials by chemical name, 2F-2 FORM 2F—INSTRUCTIONS CONTINUED form (e.g., powder, liquid, etc.), and type of container or treatment unit. Indicate any materials treated, stored, or disposed of together. The term “significant materials” includes, but is not limited to: raw materials; fuels; materials such as solvents, detergents, and plastic pellets; finished materials such as metallic products; raw materials used in food processing or production; hazardous substances designated under Section 101(14) of the Comprehensive Environmental Response, Compensation, and Liability Act; any chemical the facility is required to report pursuant to Section 313 of Title III of the Superfund Amendments and Reauthorization Act; and fertilizers; pesticides; and waste products such as ashes, slag, and sludge that have the potential to be released with stormwater discharges. Item 4.3. For each outfall, list the location and type of existing structural and non-structural control measure(s) to reduce pollutants in stormwater runoff. Structural controls include structures that enclose materials handling or storage areas; structures that cover materials; and berms, dikes, or diversion ditches around manufacturing, production, storage, or treatment units and retention ponds. Spill prevention plans, employee training, visual inspections, preventive maintenance, and housekeeping measures are examples of non-structural controls. Describe the treatment, including the schedule and type of maintenance activities performed, and the ultimate disposal of any solid or fluid wastes other than by discharge. For each structural control identified, indicate the type of treatment the stormwater receives using the codes in Exhibit 2F–1, at the end of the instructions. For each non-structural control identified, indicate “Not Applicable” in the “Codes from Exhibit 2F–1” column. Section 5. Non-Stormwater Discharges Item 5.1. Provide a certification that all outfalls that should contain stormwater discharges associated with industrial activity have been tested or evaluated for the presence of non-stormwater discharges. Tests for such non-stormwater discharges can include smoke tests, fluorometric dye tests, analysis of accurate schematics, and others. Item 5.2. Include a description of the method used, the date of any testing, and the onsite drainage points that were directly observed during a test used to support the certification in Item 5.1. All non­ stormwater discharges must be identified in a Form 2C, 2D, or 2E. See “Who Must Complete Form 2F?” above for more information. Section 6. Significant Leaks or Spills Item 6.1. Describe any significant leaks or spills of toxic or hazardous pollutants at the facility within the three years prior to the submittal of this application. Include the approximate date and location of the spill or leak and the type and amount of material released. Section 7. Discharge Information Item 7.1. Answer whether you are a new source or new discharge. Contact your NPDES permitting authority to determine if you are a new source or new discharge. Tables A, B, C, and D Items 7.2 to 7.17. These items require you to collect and report data in Tables A through D, at the end of Form 2F, for the parameters and pollutants listed in Exhibits 2F–2, 2F–3, and 2F–4 (at the end of the instructions). The instructions for completing Tables A through D are table-specific, as are the criteria for determining who should complete them. Important note: Read the “General Instructions for Reporting, Sampling, and Analysis” below before completing Items 7.2 to 7.17. Item 7.2 and Table A. All applicants must complete Table A. If the discharge is an existing discharge and your discharge is composed exclusively of stormwater (i.e., no process or nonprocess wastewater) then you only need to provide monitoring data for oil and grease, total phosphorus, total Kjeldahl nitrogen, and total nitrogen. Indicate “NA” for “not applicable” in the columns for all other parameters. Answer “Yes” to Item 7.2 once you have completed this task. Item 7.3 and Table B. Indicate whether the facility is subject to an effluent limitations guideline (ELG) (see 40 CFR Subchapter N to determine which pollutants are limited in ELGs) or if the facility is subject to effluent limitations in an NPDES permit for its process wastewater or stormwater (if the facility is operating under an existing NPDES permit). If yes, continue to Item 7.4. If no, skip to Item 7.5. Note: Stormwater discharges from certain industrial sources or activities have specific ELGs for which they must comply. These stormwater-specific ELGs include: Regulated Discharge 40 CFR Section Discharges resulting from spraydown or intentional wetting of logs at wet deck storage areas Part 429, Subpart I Runoff from phosphate fertilizer manufacturing facilities that comes into contact with any raw materials, finished product, byproducts or waste products (SIC 2874) Part 418, Subpart A Runoff from asphalt emulsion facilities Part 443, Subpart A Runoff from material storage piles at cement manufacturing facilities Part 411, Subpart C Mine dewatering discharges at crushed stone, construction sand and gravel, or industrial sand mining facilities Part 436, Subparts B, C, and D Runoff from hazardous waste and non-hazardous waste landfills Part 445, Subparts A and B Runoff from coal storage piles at steam electric generating facilities Part 423 Runoff containing urea from airfield pavement deicing at existing and new primary airports with 1,000 or more annual non-propeller aircraft departures Part 449 Item 7.4. In Table B, list all pollutants that are limited in an ELG to which the facility is subject and all pollutants listed in the facility's NPDES permit for its process wastewater (if the facility is operating under an existing NPDES permit) and provide quantitative data for each pollutant (provide actual data for existing dischargers and estimated data for new sources and new dischargers). If a pollutant in Exhibits 2F–2 or 2F–3 is indirectly limited by an ELG through an indicator (e.g., use of total suspended solids as an indicator to control the discharge of iron and aluminum), you must provide data for the pollutant in Table B. Complete one table for each outfall. Answer “Yes” to Item 7.4 once you have completed this task. 2F-3 FORM 2F—INSTRUCTIONS CONTINUED Item 7.5 and Table C. Table C requires you to address the pollutants in Exhibits 2F–2, 2F–3, and 2F–4 for each outfall. Pollutants in each of these exhibits are addressed differently. Indicate whether you know or have reason to believe any pollutants in Exhibit 2F–2 are present in the discharge. If yes, continue to Item 7.6. If no, skip to Item 7.7. Item 7.6. For each outfall, list all pollutants in Exhibit 2F–2 that you know or have reason to believe are present in the discharge in Table C (except pollutants previously listed in Table B that are limited directly or indirectly by an ELG) and either report quantitative data or briefly describe the reasons the pollutant is expected to be discharged. Answer “Yes” to Item 7.6 once you have completed this task. Item 7.7. This item asks if you qualify as a “small business.” If so, you are exempt from the reporting requirements for the organic toxic pollutants listed in Exhibit 2F–3. You can qualify as a small business in two ways: (1) If your facility is a coal mine and if your probable total annual production is less than 100,000 tons per year, you may submit past production data or estimated future production (such as a schedule of estimated total production under 30 CFR 795.14(c)) instead of conducting analyses for the organic toxic pollutants; (2) If your facility is not a coal mine and if your gross total annual sales for the most recent three years average less than $100,000 per year (in second quarter 1980 dollars), you may submit sales data for those years instead of conducting analyses for the organic toxic pollutants. The production or sales data must be for the facility that is the source of the discharge. The data should not be limited to production or sales for the process or processes that contribute to the discharge, unless those are the only processes at your facility. For sales data, in situations involving intra-corporate transfer of goods and services, the transfer price per unit should approximate market prices for those goods and services as closely as possible. Sales figures for years after 1980 should be indexed to the second quarter of 1980 by using the gross national product price deflator (second quarter of 1980 = 100). This index is available online from the U.S. Department of Commerce, Bureau of Economic Analysis at http://www.bea.gov/national/pdf/SNTables.pdf. If you qualify as a small business according to the criteria above, answer “Yes” to Item 7.7 and skip to Item 7.18. Otherwise, answer “No” and continue to Item 7.8. Item 7.8. Indicate whether you know or have reason to believe any pollutants in Exhibit 2F–3 are present in the discharge. If yes, continue to Item 7.9. If no, skip to Item 7.10. Item 7.9. For each outfall, list all pollutants in Exhibit 2F–3 that you know or have reason to believe are present in the discharge in Table C (except pollutants previously listed in Table B). Answer “Yes” to Item 7.9 once you have completed this task. Item 7.10. Indicate whether you expect any of the pollutants from Exhibit 2F–3 to be discharged in concentrations of 10 parts per billion (ppb) or greater. If yes, continue to Item 7.11. If no, skip to Item 7.12. Item 7.11. Provide quantitative data in Table C for those pollutants in Exhibit 2F–3 that you expect to be discharged in concentrations of 10 ppb or greater (provide actual data for existing dischargers and estimated data for new sources and new dischargers). Answer “Yes” to Item 7.11 once you have completed this task. Item 7.12. Indicate whether you expect acrolein, acrylonitrile, 2,4­ dinitrophenol, or 2-methyl-4,6-dinitrophenol to be discharged in concentrations of 100 ppb or greater. If yes, continue to Item 7.13. If no, skip to Item 7.14. Item 7.13. Provide quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be discharged in concentrations of 100 ppb or greater (provide actual data for existing dischargers and estimated data for new sources and new dischargers). Answer “Yes” to Item 7.13 once you have completed this task. Item 7.14. For any pollutants you expect to be present in the discharge at concentrations less than 10 ppb (or less than 100 ppb for the above four pollutants), either submit quantitative data or briefly describe the reasons the pollutant is expected to be discharged in Table C. Answer “Yes” to Item 7.14 once you have completed this task. Item 7.15. Indicate whether you know or have reason to believe any pollutants in Exhibit 2F–4 are present in the discharge. If yes, continue to Item 7.16. If no, skip to Item 7.17. Item 7.16. For each outfall, list any pollutant in Exhibit 2F–4 that you know or believe to be present in the discharge in Table C and explain why you believe it to be present. No analysis is required, but if you have analytical data, you must report it. Answer “Yes” to Item 7.16 once you have completed this task. Item 7.17 and Table D. Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow weighted composite sample in Table D. If sampling is conducted during more than one storm event, you only need to report the information Note: Under 40 CFR 117.12(a)(2), certain discharges of hazardous substances (listed in Exhibit 2F-5) may be exempted from the requirements of CWA Section 311, which establishes reporting requirements, civil penalties, and liability for cleanup costs for spills of oil and hazardous substances. A discharge of a particular substance can be exempted if the origin, source, and amount of the discharged substances are identified in the NPDES permit application or in the permit, if the permit contains a requirement for treatment of the discharge, and if the treatment is in place. If you would like to apply for an exemption from the requirements of CWA Section 311, attach additional sheets of paper to your application, setting forth the following information: 1. The substance and the amount of each substance that might be discharged. 2. The origin and source of the discharge of the substance. 3. The treatment to be provided for the discharge by: a. An onsite treatment system separate from any treatment system treating your normal discharge; b. A treatment system designed to treat your normal discharge and that is additionally capable of treating the amount of the substance identified under paragraph 1 above; or c. Any combination of the above. See 40 CFR 117.12(a)(2) and (c) or contact your NPDES permitting authority for further information on exclusions from CWA Section 311. 2F-4 FORM 2F—INSTRUCTIONS CONTINUED requested on Table D for the storm event(s) that resulted in any maximum pollutant concentration reported on Tables A through C. Provide flow measurements or estimates of the flow rate, as well as the total amount of discharge for the storm event(s) sampled, the method of flow measurement, or estimation. Provide the data and duration of the storm event(s) sampled, rainfall measurements, or estimates of the storm event that generated the sampled runoff and the duration between the storm event sampled and the end of the previous measurable (greater than 0.1 inch rainfall) storm event. Answer “Yes” to Item 7.17 once you have completed this task. Used or Manufactured Toxics Item 7.18. Review Exhibits 2F–2 through 2F–4 and determine if you currently use or manufacture any of the pollutants listed as intermediate or final products or byproducts. If so, answer “Yes.” You should also answer “Yes” if you know or have reason to believe that 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD) is discharged or if you use or manufacture 2,4,5-trichlorphenoxy acetic acid (2,4,5-T); 2-(2,4,5-trichlorophenoxy) propanoic acid (Silvex, 2,4,5-TP); 2-(2,4,5-trichlorophenoxy) ethyl, 2,2­ dichloropropionate (Erbon); 0,0-dimethyl 0-(2,4,5-trichlorphenyl) phosphorothioate (Ronnel); 2,4,5-trichlorophenol (TCP); or hexachlorophene (HCP). If your answer to Item 7.18 is “No,” skip to Section 8. Item 7.19. List all of the toxic pollutants identified under Item 7.18, including TCDD. Note that the NPDES permitting authority may waive or modify the requirement if you demonstrate that it would be unduly burdensome to identify each toxic pollutant and the NPDES permitting authority has adequate information to issue your permit. You may not claim any information submitted in response to Item 7.18 as confidential; however, you do not have to distinguish between use or production of the pollutants or list the amounts. Section 8. Biological Toxicity Testing Data Item 8.1. Answer whether you know of or have reason to believe that biological toxicity testing has been conducted of your wastewater treatment, including engineering reports or pilot plant studies. If no, skip to Section 9. Otherwise, continue. Item 8.2. List any tests of which you are aware and their purposes. Section 9. Contract Analysis Information Item 9.1. Indicate if any of the analyses performed in Section 7 were performed by a contract laboratory or consulting firm. If no, skip to Section 10. If yes, continue to Item 9.2. Item 9.2. Provide the name, address, phone number, and pollutants analyzed by the laboratory or consulting firm(s) in the spaces provided. Section 10. Checklist and Certification Statement Item 10.1. Review the checklist provided on the application. In Column 1, mark the sections of Form 2F that you have completed and are submitting with your application. For each section in Column 2, indicate whether you are submitting attachments. Item 10.2. The Clean Water Act (CWA) provides for severe penalties for submitting false information on this application form. Section 309(c)(2) of the CWA provides that, “Any person who knowingly makes any false material statement, representation, or certification in any application, …shall upon conviction be punished by a fine of not more than $10,000 or by imprisonment for not more than six months or both.” FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS APPLICATION TO BE SIGNED AS FOLLOWS: A. For a corporation, by a responsible corporate officer. For the purpose of this section, a responsible corporate officer means: (1) a president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function, or any other person who performs similar policy- or decision-making functions for the corporation, or (2) the manager of one or more manufacturing, production, or operating facilities, provided the manager is authorized to make management decisions which govern the operation of the regulated facility including having the explicit or implicit duty of making major capital investment recommendations, and initiating and directing other comprehensive measures to assure long term environmental compliance with environmental laws and regulations; the manager can ensure that the necessary systems are established or actions taken to gather complete and accurate information for permit application requirements; and where authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures. B. For a partnership or sole proprietorship, by a general partner or the proprietor, respectively. C. For a municipality, state, federal, or other public facility, by either a principal executive officer or ranking elected official. For purposes of this section, a principal executive officer of a federal agency includes: (1) The chief executive officer of the agency, or (2) a senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency (e.g., Regional Administrators of EPA). END Submit your completed Form 1, Form 2F, and all associated attachments (and any other required NPDES application forms) to your NPDES permitting authority. 2F-5 General Instructions for Reporting, Sampling, and Analysis Important note: Read these instructions before completing Tables A through C and Section 7 of Form 2F. General Items Complete the applicable tables for each outfall at your facility. Be sure to note the EPA Identification Number, NPDES permit number, facility name, and applicable outfall number at the top of each table page and any associated attachments. You may report some or all of the required data by attaching separate sheets of paper instead of completing Tables A through C for each of your outfalls so long as the sheets contain all of the required information and are similar in format to Tables A through C. For example, you may be able to print a report in a compatible format from the data system used in your gas chromatography/ mass spectrometry (GC/MS) analysis completed under Table B. If you are an existing discharger, you are required to report actual quantitative data. See “Use of Historic Data” below for use of historic data. If you are a new source or discharge, you may supply estimated data along with the source of each estimate. If you have quantitative data available, however, you must provide it. Base estimates on available, in-house or contractor engineering reports, or any other studies performed on the proposed facility. Use the following codes to report your source information in the “Source of Information” column: Data Source Code Engineering reports 1 Actual data from pilot plants 1 Estimates from other engineering reports 2 Data from other similar plants 3 Best professional estimates 4 Others 5 and specify on the table No later than 24 months after your facility commences to discharge, you must complete and submit sampling and analysis data for the pollutants and parameters in Tables A through C. However, you need not report results for tests you have already performed and reported under the discharge monitoring requirements of your NPDES permit. Table A requires you to report at least one analysis for each pollutant listed. Tables B and C require you to report analytical data in two ways. For some pollutants addressed in Tables B and C, if you know or have reason to know that the pollutant is present in your discharge, you may be required to list the pollutant and test (sample and analyze) and report the levels of the pollutants in your discharge. For all other pollutants addressed in Tables B and C, you must list the pollutant if you know or have reason to know that the pollutant is present in the discharge, and either report quantitative data for the pollutant or briefly describe the reasons the pollutant is expected to be discharged. (See Items 7.2 through 7.17 of the instructions for completing Tables A through C.). Base your determination that a pollutant is/will be present in your discharge on your knowledge of the facility’s raw materials, material management practices, maintenance chemicals, history of spills and releases, intermediate and final products and byproducts, and any previous analyses known to you of your effluent or similar effluent. Sampling The collection of the samples for the reported analyses should be supervised by a person experienced in performing sampling of industrial wastewater or stormwater discharges. You may contact your NPDES permitting authority for detailed guidance on sampling techniques and for answers to specific questions. See Exhibit 1–1 of Form 1 for contact information. Any specific requirements in the analytical methods—for example, sample containers, sample preservation, holding times, and the collection of duplicate samples—must be followed. The time when you sample should be representative of your normal operation, to the extent feasible, with all processes that contribute wastewater in normal operation, and with your treatment system operating properly with no system upsets. Collect samples from the center of the flow channel, where turbulence is at a maximum, at a site specified in your present NPDES permit, or at any site adequate for the collection of a representative sample. Grab samples must be taken in the first 30 minutes of discharge (or as soon thereafter as practicable) for pH, temperature, cyanide, total phenols, residual chlorine, oil and grease, fecal coliform (including E. coli) and enterococci (previously known as fecal streptococcus at 40 CFR 122.26(d)(2)(iii)(A)(3)), and volatile organic compounds. You are not required to analyze a flow-weighted composite for these parameters. For all other pollutants, both a grab sample collected during the first 30 minutes (or as soon thereafter as practicable) of the discharge and a flow-weighted composite sample must be analyzed. However, a minimum of one grab sample may be taken for effluents from holding ponds or other impoundments with a retention period of greater than 24 hours. All samples must be collected from the discharge resulting from a storm event that is greater than 0.1 inches and at least 72 hours from the previously measurable (greater than 0.1 inch rainfall) storm event. Where feasible, the variance in the duration of the event and the total rainfall of the event should not exceed 50 percent from the average or median rainfall event in that area. A grab sample must be taken during the first 30 minutes of the discharge (or as soon thereafter as practicable), and a flow- weighted composite must be taken for the entire event or for the first three hours of the event. Grab and composite samples are defined as follows: Grab sample: An individual sample of at least 100 milliliters collected during the first 30 minutes (or as soon thereafter as practicable) of the discharge. This sample is to be analyzed separately from the composite sample. Flow-weighted composite sample: A flow-weighted composite sample may be taken with a continuous sampler that proportions the amount of sample collected with the flow rate or as a combination of a minimum of three sample aliquots taken in each hour of discharge 2F-6 General Instructions for Reporting, Sampling, and Analysis Continued for the entire event or for the first three hours of the event, with each aliquot being at least 100 milliliters and collected with a minimum period of 15 minutes between aliquot collections. The composite must be flow proportional; the time interval between either each aliquot or the volume of each aliquot must be proportional to either the stream (effluent) flow at the time of sampling or the total stream (effluent) flow since the collection of the previous aliquot. Aliquots may be collected manually or automatically. Where GC/MS volatile organic analysis is required, aliquots must be combined in the laboratory immediately before analysis. Only one analysis for the composite sample is required. Use of Historical Data Existing data may be used, if available, in lieu of sampling conducted solely for the purposes of this application, provided it is representative of the present discharge and was collected within 3 years of the application due date. If you sample for a listed pollutant on a monthly or more frequent basis, summarize the data collected within one year of the application for the pollutant(s) at issue. Among the factors that would cause the data to be unrepresentative are significant changes in production level; changes in raw materials, processes, or final products; and changes in stormwater treatment. The NPDES permitting authority may request additional information, including current quantitative data, if they determine it to be necessary to assess your discharges. The NPDES permitting authority may allow or establish appropriate site-specific sampling procedures or requirements including sampling locations, the season in which the sampling takes place, the minimum duration between the previous measurable storm event and the storm event sampled, the minimum or maximum level of precipitation required for an appropriate storm event, the form of precipitation sampled (snow melt or rainfall), protocols for collecting samples under 40 CFR 136, and additional time for submitting data on a case-by-case basis. Reporting Report sampling results for all pollutants in Tables A through C as concentration and mass, with the exception of flow, temperature, pH, color, and fecal coliform organisms. Flow, temperature, pH, color, and fecal coliform organisms must be reported as million gallons per day (mgd), degrees Celsius (°C), standard units, color units, and most probable number per 100 milliliters (MPN/100 mL), respectively. Use the following abbreviations in the columns requiring “units” in Tables A through C. Concentration Mass ppm = parts per million lbs = pounds mg/L = milligrams per liter ton = tons (English tons) ppb = parts per billion mg = milligrams µg/L = micrograms per liter g = grams MPN = most probable number per kg = kilograms 100 milliliters T = tonnes (metric tons) All reporting of values for metals must be in terms of “total recoverable metal” unless: • An applicable, promulgated ELG specifies the limitation for the metal in dissolved, valent, or total form; • All approved analytical methods for the metal inherently measure only its dissolved form (e.g., hexavalent chromium); or • The NPDES permitting authority has determined that in establishing case-by-case limitations it is necessary to express the limitations of the metal in dissolved, valent, or total form to carry out the provisions of the CWA. If you measure only one grab sample and one flow-weighted composite sample for a given outfall, complete only the “Maximum Daily Discharge” columns in the tables and enter “1” in the “Number of Storm Events Sampled” column. The NPDES permitting authority may require you to conduct additional analyses to further characterize your discharges. If you measure more than one value for a grab sample or a flow- weighted composite sample for a given outfall and those values are representative of your discharge, you must report them. You must describe your method of testing and analysis. The “Average Daily Discharge” column on Tables A to C is not compulsory but should be filled out if data are available. To complete the “Average Daily Discharge” column, determine the average of all values within the last year and report the concentration and mass. Report the total number of storm events sampled under the “Number of Storm Events Sampled” column. Substantially Identical Outfalls If you have two or more substantially identical outfalls, you may request permission from your NPDES permitting authority to sample and analyze only one outfall and submit the results of the analysis for all substantially identical outfalls. If your request is granted, submit the following information on a separate sheet attached to the application form: the identity of the outfall you did test and an explanation of how it is substantially identical to the outfall(s) that you did not test. Analysis Except as specified below, all required quantitative data shall be collected in accordance with sufficiently sensitive analytical methods approved under 40 CFR 136 or required under 40 CFR chapter I, subchapter N or O. A method is “sufficiently sensitive” when: • The method minimum level (ML) is at or below the level of the applicable water quality criterion for the measured pollutant or pollutant parameter. • The method ML is above the water quality criterion, but the amount of the pollutant or pollutant parameter in the facility’s discharge is high enough that the method detects and quantifies the level of the pollutant or pollutant parameter in the discharge. 2F-7 General Instructions for Reporting, Sampling, and Analysis Continued • The method has the lowest ML of the analytical methods approved under 40 CFR 136 or required under 40 CFR chapter I, subchapter N or O, for the measured pollutant or pollutant parameter. Consistent with 40 CFR 136, you may provide matrix- or sample- specific MLs rather than the published levels. Further, where you can demonstrate that, despite a good faith effort to use a method that would otherwise meet the definition of “sufficiently sensitive,” the analytical results are not consistent with the quality assurance (QA)/quality control (QC) specifications for that method, then the NPDES permitting authority may determine that the method is not performing adequately and the NPDES permitting authority should select a different method from the remaining EPA-approved methods that is sufficiently sensitive consistent with 40 CFR 122.21(e)(3)(i). Where no other EPA-approved methods exist, you must select a method consistent with 40 CFR 122.21(e)(3)(ii). When there is no analytical method that has been approved under 40 CFR 136; required under 40 CFR chapter I, subchapter N or O, and is not otherwise required by the NPDES permitting authority, you may use any suitable method but shall provide a description of the method. When selecting a suitable method, other factors such as a method’s precision, accuracy, or resolution, may be considered when assessing the performance of the method. 2F-8 Exhibit 2F–1. Codes for Treatment Units and Disposal of Wastes Not Discharged 1. PHYSICAL TREATMENT PROCESSES 1–A.................Ammonia stripping 1–M................Grit removal 1–B.................Dialysis 1–N................Microstraining 1–C ................Diatomaceous earth filtration 1–O................Mixing 1–D ................Distillation 1–P ................Moving bed filters 1–E.................Electrodialysis 1–Q................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 1–L.................Grinding (comminutors) 1–X ................ Sorption 2. 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 3. 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 4. WASTEWATER DISPOSAL PROCESSES 4–A.................Discharge to surface Water 4–C................Reuse/recycle of treated effluent 4–B.................Ocean discharge through outfall 4–D................Underground injection 5. 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–O................Incineration 5–D ................Centrifugation 5–P ................Land application 5–E.................Chemical conditioning 5–Q................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 2F-9 Exhibit 2F–2. Conventional and Nonconventional Pollutants (40 CFR 122.21, Appendix D, Table IV) Bromide Chlorine, total residual Color Fecal coliform Fluoride Nitrate-nitrite Nitrogen, total organic (as N) Oil and grease Phosphorus (as P), total Radioactivity (as alpha, total; beta, total; radium, total; and radium 226, total) Sulfate (as SO4) Sulfide (as S) Sulfite (as SO3) Surfactants Aluminum, total Barium, total Boron, total Cobalt, total Iron, total Magnesium, total Molybdenum, total Manganese, total Tin, total Titanium, total 2F-10 Exhibit 2F–3. Toxic Pollutants (40 CFR 122.21, Appendix D, Tables II and III) Antimony, total Arsenic, total Beryllium, total Cadmium, total Chromium, total Acrolein Acrylonitrile Benzene Bromoform Carbon tetrachloride Chlorobenzene Chlorodibromomethane Chloroethane 2-Chloroethylvinyl ether Chloroform 2-chlorophenol 2,4-dichlorophenol 2,4-dimethylphenol 4,6-dinitro-o-cresol Acenaphthene Acenaphthylene Anthracene Benzidine Benzo (a) anthracene Benzo (a) pyrene 3,4-benzofluoranthene Benzo (ghi) perylene Benzo (k) fluoranthene Bis (2-chloroethoxy) methane Bis (2-chloroethyl) ether Bis (2-chloroisopropyl) ether Bis (2-ethylhexyl) phthalate 4-bromophenyl phenyl ether Butyl benzyl phthalate 2-chloronaphthalene Aldrin α-BHC β-BHC γ-BHC δ-BHC Chlordane 4,4’-DDT 4,4’-DDE 4,4’-DDD Toxic Pollutants and Total Phenol Copper, total Lead, total Mercury, total Nickel, total Selenium, total GC/MS Fraction—Volatile Compounds Dichlorobromomethane 1,1-dichloroethane 1,2-dichloroethane 1,1-dichloroethylene 1,2-dichloropropane 1,3-dichloropropylene Ethylbenzene Methyl bromide Methyl chloride Methylene chloride GC/MS Fraction—Acid Compounds 2,4-dinitrophenol 2-nitrophenol 4-nitrophenol P-chloro-m-cresol GC/MS Fraction—Base/Neutral Compounds 4-chlorophenyl phenyl ether Chrysene Dibenzo (a,h) anthracene 1,2-dichlorobenzene 1,3-dichlorobenzene 1,4-dichlorobenzene 3,3-dichlorobenzidine Diethyl phthalate Dimethyl phthalate Di-n-butyl phthalate 2,4-dinitrotoluene 2,6-dinitrotoluene Di-n-octyl phthalate 1,2-diphenylhydrazine (as azobenzene) Fluoranthene Fluorene GC/MS Fraction—Pesticides Dieldrin α-endosulfan β-endosulfan Endosulfan sulfate Endrin Endrin aldehyde Heptachlor Heptachlor epoxide PCB-1242 Silver, total Thallium, total Zinc, total Cyanide, total Phenols, total 1,1,2,2-tetrachloroethane Tetrachloroethylene Toluene 1,2-trans-dichloroethylene 1,1,1-trichloroethane 1,1,2-trichloroethane Trichloroethylene Vinyl chloride Pentachlorophenol Phenol 2,4,6-trichlorophenol Hexachlorobenzene Hexachlorobutadiene Hexachlorocyclopentadiene Hexachloroethane Indeno (1,2,3-cd) pyrene Isophorone Naphthalene Nitrobenzene N-nitrosodimethylamine N-nitrosodi-n-propylamine N-nitrosodiphenylamine Phenanthrene Pyrene 1,2,4-trichlorobenzene PCB-1254 PCB-1221 PCB-1232 PCB-1248 PCB-1260 PCB-1016 Toxaphene 2F-11 Exhibit 2F–4. Certain Hazardous Substances and Asbestos (40 CFR 122.21, Appendix D, Table V) Asbestos Acetaldehyde Allyl alcohol Allyl chloride Amyl acetate Aniline Benzonitrile Benzyl chloride Butyl acetate Butylamine Captan Carbaryl Carbofuran Carbon disulfide Chlorpyrifos Coumaphos Cresol Crotonaldehyde Cyclohexane 2,4-D (2,4-dichlorophenoxyacetic acid) Diazinon Dicamba Dichlobenil Dichlone 2,2-dichloropropionic acid Dichlorvos Diethyl amine Dimethyl amine Toxic Pollutant Hazardous Substances Dintrobenzene Diquat Disulfoton Diuron Epichlorohydrin Ethion Ethylene diamine Ethylene dibromide Formaldehyde Furfural Guthion Isoprene Isopropanolamine Kelthane Kepone Malathion Mercaptodimethur Methoxychlor Methyl mercaptan Methyl methacrylate Methyl parathion Mevinphos Mexacarbate Monoethyl amine Monomethyl amine Naled Naphthenic acid Nitrotoluene Parathion Phenolsulfonate Phosgene Propargite Propylene oxide Pyrethrins Quinoline Resorcinol Strontium Strychnine Styrene 2,4,5-T (2,4,5-trichlorophenoxyacetic acid) TDE (tetrachlorodiphenyl ethane) 2,4,5-TP [2-(2,4,5-trichlorophenoxy) propanoic acid] Trichlorofon Triethanolamine Triethylamine Trimethylamine Uranium Vanadium Vinyl acetate Xylene Xylenol Zirconium 2F-12 Exhibit 2F–5. Hazardous Substances 1. Acetaldehyde 2. Acetic acid 3. Acetic anhydride 4. Acetone cyanohydrin 5. Acetyl bromide 6. Acetyl chloride 7. Acrolein 8. Acrylonitrile 9. Adipic acid 10. Aldrin 11. Allyl alcohol 12. Allyl chloride 13. Aluminum sulfate 14. Ammonia 15. Ammonium acetate 16. Ammonium benzoate 17. Ammonium bicarbonate 18. Ammonium bichromate 19. Ammonium bifluoride 20. Ammonium bisulfite 21. Ammonium carbamate 22. Ammonium carbonate 23. Ammonium chloride 24. Ammonium chromate 25. Ammonium citrate 26. Ammonium fluoroborate 27. Ammonium fluoride 28. Ammonium hydroxide 29. Ammonium oxalate 30. Ammonium silicofluoride 31. Ammonium sulfamate 32. Ammonium sulfide 33. Ammonium sulfite 34. Ammonium tartrate 35. Ammonium thiocyanate 36. Ammonium thiosulfate 37. Amyl acetate 38. Aniline 39. Antimony pentachloricle 40. Antimony potassium tartrate 41. Antimony tribromide 42. Antimony trichloride 43. Antimony trifluoride 44. Antimony trioxide 45. Arsenic disulfide 46. Arsenic pentoxide 47. Arsenic trichloride 48. Arsenic trioxide 49. Arsenic trisulfide 50. Barium cyanide 51. Benzene 52. Benzoic acid 53. Benzonitrile 54. Benzoyl chloride 55. Benzyl chloride 56. Beryllium chloride 57. Beryllium fluoride 58. Beryllium nitrate 59. Butylacetate 60. n-butylphthalate 61. Butylamine 62. Butyric acid 63. Cadmium acetate 64. Cadmium bromide 65. Cadmium chloride 66. Calcium arsenate 67. Calcium arsenite 68. Calcium carbide 69. Calcium chromate 70. Calcium cyanide 71. Calcium dodecylbenzenesulfonate 72. Calcium hypochlorite 73. Captan 74. Carbaryl 75. Carbofuran 76. Carbon disulfide 77. Carbon tetrachloride 78. Chlordane 79. Chlorine 80. Chlorobenzene 81. Chloroform 82. Chloropyrifos 83. Chlorosulfonic acid 84. Chromic acetate 85. Chromic acid 86. Chromic sulfate 87. Chromous chloride 88. Cobaltous bromide 89. Cobaltous formate 90. Cobaltous sulfamate 91. Coumaphos 92. Cresol 93. Crotonaldehyde 94. Cupric acetate 95. Cupric acetoarsenite 96. Cupric chloride 97. Cupric nitrate 98. Cupric oxalate 99. Cupric sulfate 100. Cupric sulfate ammoniated 101. Cupric tartrate 102. Cyanogen chloride 103. Cyclohexane 104. 2,4-D acid (2,4-dichlorophenoxyacetic acid) 105. 2,4-D esters (2,4-dichlorophenoxyacetic acid esters) 106. DDT 107. Diazinon 108. Dicamba 109. Dichlobenil 110. Dichlone 111. Dichlorobenzene 112. Dichloropropane 113. Dichloropropene 114. Dichloropropene-dichloproropane mix 115. 2,2-dichloropropionic acid 116. Dichlorvos 117. Dieldrin 118. Diethylamine 119. Dimethylamine 120. Dinitrobenzene 121. Dinitrophenol 122. Dinitrotoluene 123. Diquat 124. Disulfoton 125. Diuron 126. Dodecylbenzesulfonic acid 127. Endosulfan 128. Endrin 129. Epichlorohydrin 130. Ethion 131. Ethylbenzene 132. Ethylenediamine 133. Ethylene dibromide 134. Ethylene dichloride 135. Ethylene diaminetetracetic acid (EDTA) 136. Ferric ammonium citrate 137. Ferric ammonium oxalate 138. Ferric chloride 139. Ferric fluoride 140. Ferric nitrate 141. Ferric sulfate 142. Ferrous ammonium sulfate 143. Ferrous chloride 2F-13 144. Ferrous sulfate 145. Formaldehyde 146. Formic acid 147. Fumaric acid 148. Furfural 149. Guthion 150. Heptachlor 151. Hexachlorocyclopentadiene 152. Hydrochloric acid 153. Hydrofluoric acid 154. Hydrogen cyanide 155. Hydrogen sulfide 156. Isoprene 157. Isopropanolamine dodecylbenzenesulfonate 158. Kelthane 159. Kepone 160. Lead acetate 161. Lead arsenate 162. Lead chloride 163. Lead fluoborate 164. Lead fluorite 165. Lead iodide 166. Lead nitrate 167. Lead stearate 168. Lead sulfate 169. Lead sulfide 170. Lead thiocyanate 171. Lindane 172. Lithium chromate 173. Malathion 174. Maleic acid 175. Maleic anhydride 176. Mercaptodimethur 177. Mercuric cyanide 178. Mercuric nitrate 179. Mercuric sulfate 180. Mercuric thiocyanate 181. Mercurous nitrate 182. Methoxychlor 183. Methyl mercaptan 184. Methyl methacrylate 185. Methyl parathion 186. Mevinphos 187. Mexacarbate 188. Monoethylamine 189. Monomethylamine 190. Naled 191. Naphthalene 192. Naphthenic acid 193. Nickel ammonium sulfate 194. Nickel chloride 195. Nickel hydroxide 196. Nickel nitrate 197. Nickel sulfate 198. Nitric acid 199. Nitrobenzene 200. Nitrogen dioxide 201. Nitrophenol 202. Nitrotoluene 203. Paraformaldehyde 204. Parathion 205. Pentachlorophenol 206. Phenol 207. Phosgene 208. Phosphoric acid 209. Phosphorus 210. Phosphorus oxychloride 211. Phosphorus pentasulfide 212. Phosphorus trichloride 213. Polychlorinated biphenyls (PCB) 214. Potassium arsenate 215. Potassium arsenite Exhibit 2F–5. Hazardous Substances 216. Potassium bichromate 217. Potassium chromate 218. Potassium cyanide 219. Potassium hydroxide 220. Potassium permanganate 221. Propargite 222. Propionic acid 223. Propionic anhydride 224. Propylene oxide 225. Pyrethrins 226. Quinoline 227. Resorcinol 228. Selenium oxide 229. Silver nitrate 230. Sodium 231. Sodium arsenate 232. Sodium arsenite 233. Sodium bichromate 234. Sodium bifluoride 235. Sodium bisulfite 236. Sodium chromate 237. Sodium cyanide 238. Sodium dodecylbenzenesulfonate 239. Sodium fluoride 240. Sodium hydrosulfide 241. Sodium hydroxide 242. Sodium hypochlorite 243. Sodium methylate 244. Sodium nitrite 245. Sodium phosphate (dibasic) 246. Sodium phosphate (tribasic) 247. Sodium selenite 248. Strontium chromate 249. Strychnine 250. Styrene 251. Sulfuric acid 252. Sulfur monochloride 253. 2,4,5-T acid (2,4,5-trichlorophenoxyacetic acid) 254. 2,4,5-T amines (2,4,5-trichlorophenoxy acetic acid amines) 255. 2,4,5-T esters (2,4,5-trichlorophenoxy acetic acid esters) 256. 2,4,5-T salts (2,4,5-trichlorophenoxy acetic acid salts) 257. 2,4,5-TP acid (2,4,5-trichlorophenoxy propanoic acid) 258. 2,4,5-TP acid esters (2,4,5-trichlorophenoxy propanoic acid esters) 259. TDE (tetrachlorodiphenyl ethane) 260. Tetraethyl lead 261. Tetraethyl pyrophosphate 262. Thallium sulfate 263. Toluene 264. Toxaphene 265. Trichlorofon 266. Trichloroethylene 267. Trichlorophenol 268. Triethanolamine dodecylbenzenesulfonate 269. Triethylamine 270. Trimethylamine 271. Uranyl acetate 272. Uranyl nitrate 273. Vanadium penoxide 274. Vanadyl sulfate 275. Vinyl acetate 276. Vinylidene chloride 277. Xylene 278. Xylenol 279. Zinc acetate 280. Zinc ammonium chloride 281. Zinc borate 282. Zinc bromide 283. Zinc carbonate 284. Zinc chloride 285. Zinc cyanide 286. Zinc fluoride 287. Zinc formate 288. Zinc hydrosulfite 289. Zinc nitrate 290. Zinc phenolsulfonate 291. Zinc phosphide 292. Zinc silicofluoride 293. Zinc sulfate 294. Zirconium nitrate 295. Zirconium potassium fluoride 296. Zirconium sulfate 297. Zirconium tetrachloride 2F-14 ’ EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 Form 2F NPDES U.S Environmental Protection Agency Application for NPDES Permit to Discharge Wastewater STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY SECTION 1. OUTFALL LOCATION (40 CFR 122.21(g)(1)) Outfall Location 1.1 Provide information on each of the facility’s outfalls in the table below Outfall Number Receiving Water Name Latitude Longitude ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” ° ’ ” SECTION 2. IMPROVEMENTS (40 CFR 122.21(g)(6)) Improvements 2.1 Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing, upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could affect the discharges described in this application? □ Yes □ No • SKIP to Section 3. 2.2 Briefly identify each applicable project in the table below. Brief Identification and Description of Project Affected Outfalls (list outfall numbers) Source(s) of Discharge Final Compliance Dates Required Projected 2.3 Have you attached sheets describing any additional water pollution control programs (or other environmental projects that may affect your discharges) that you now have underway or planned? (Optional Item) □ Yes □ No EPA Form 3510-2F (Revised 3-19) EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 SECTION 3. SITE DRAINAGE MAP (40 CFR 122.26(c)(1)(i)(A)) Site Drainage Map 3.1 Have you attached a site drainage map containing all required information to this application? (See instructions for specific guidance.) □ Yes □ No SECTION 4. POLLUTANT SOURCES (40 CFR 122.26(c)(1)(i)(B)) Pollutant Sources 4.1 Provide information on the facility’s pollutant sources in the table below. Outfall Number Impervious Surface Area (within a mile radius of the facility) Total Surface Area Drained (within a mile radius of the facility) specify units specify units specify units specify units specify units specify units specify units specify units specify units specify units specify units specify units 4.2 Provide a narrative description of the facility’s significant material in the space below. (See instructions for content requirements.) 4.3 Provide the location and a description of existing structural and non-structural control measures to reduce pollutants in stormwater runoff. (See instructions for specific guidance.) Stormwater Treatment Outfall Number Control Measures and Treatment Codes from Exhibit 2F–1 (list) EPA Form 3510-2F (Revised 3-19) EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 SECTION 5. NON STORMWATER DISCHARGES (40 CFR 122.26(c)(1)(i)(C)) Non-Stormwater Discharges 5.1 I certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the presence of non-stormwater discharges. Moreover, I certify that the outfalls identified as having non-stormwater discharges are described in either an accompanying NPDES Form 2C, 2D, or 2E application. Name (print or type first and last name) Official title Signature Date signed 5.2 Provide the testing information requested in the table below. Outfall Number Description of Testing Method Used Date(s) of Testing Onsite Drainage Points Directly Observed During Test SECTION 6. SIGNIFICANT LEAKS OR SPILLS (40 CFR 122.26(c)(1)(i)(D)) Significant Leaks or Spills 6.1 Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years. SECTION 7. DISCHARGE INFORMATION (40 CFR 122.26(c)(1)(i)(E)) Discharge Information See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must complete. Not all applicants need to complete each table. 7.1 Is this a new source or new discharge? Yes • See instructions regarding submission of No • See instructions regarding submission of □ □ estimated data. actual data. Tables A, B, C, and D 7.2 Have you completed Table A for each outfall? □ Yes □ No EPA Form 3510-2F (Revised 3-19) EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 Discharge Information Continued 7.3 Is the facility subject to an effluent limitation guideline (ELG) or effluent limitations in an NPDES permit for its process wastewater? □ Yes □ No • SKIP to Item 7.5. 7.4 Have you completed Table B by providing quantitative data for those pollutants that are (1) limited either directly or indirectly in an ELG and/or (2) subject to effluent limitations in an NPDES permit for the facility’s process wastewater? □ Yes □ No 7.5 Do you know or have reason to believe any pollutants in Exhibit 2F–2 are present in the discharge? □ Yes □ No • SKIP to Item 7.7. 7.6 Have you listed all pollutants in Exhibit 2F–2 that you know or have reason to believe are present in the discharge and provided quantitative data or an explanation for those pollutants in Table C? □ Yes □ No 7.7 Do you qualify for a small business exemption under the criteria specified in the Instructions? □ Yes SKIP to Item 7.18. □ No 7.8 Do you know or have reason to believe any pollutants in Exhibit 2F–3 are present in the discharge? □ Yes □ No • SKIP to Item 7.10. 7.9 Have you listed all pollutants in Exhibit 2F–3 that you know or have reason to believe are present in the discharge in Table C? □ Yes □ No 7.10 Do you expect any of the pollutants in Exhibit 2F–3 to be discharged in concentrations of 10 ppb or greater? □ Yes □ No • SKIP to Item 7.12. 7.11 Have you provided quantitative data in Table C for those pollutants in Exhibit 2F–3 that you expect to be discharged in concentrations of 10 ppb or greater? □ Yes □ No 7.12 Do you expect acrolein, acrylonitrile, 2,4-dinitrophenol, or 2-methyl-4,6-dinitrophenol to be discharged in concentrations of 100 ppb or greater? □ Yes □ No • SKIP to Item 7.14. 7.13 Have you provided quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be discharged in concentrations of 100 ppb or greater? □ Yes □ No 7.14 Have you provided quantitative data or an explanation in Table C for pollutants you expect to be present in the discharge at concentrations less than 10 ppb (or less than 100 ppb for the pollutants identified in Item 7.12)? □ Yes □ No 7.15 Do you know or have reason to believe any pollutants in Exhibit 2F–4 are present in the discharge? □ Yes □ No • SKIP to Item 7.17. 7.16 Have you listed pollutants in Exhibit 2F–4 that you know or believe to be present in the discharge and provided an explanation in Table C? □ Yes □ No 7.17 Have you provided information for the storm event(s) sampled in Table D? □ Yes □ No EPA Form 3510-2F (Revised 3-19) EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 Discharge Information Continued Used or Manufactured Toxics 7.18 Is any pollutant listed on Exhibits 2F–2 through 2F–4 a substance or a component of a substance used or manufactured as an intermediate or final product or byproduct? □ Yes □ No • SKIP to Section 8. 7.19 List the pollutants below, including TCDD if applicable. 1. 4. 7. 2. 5. 8. 3. 6. 9. SECTION 8. BIOLOGICAL TOXICITY TESTING DATA (40 CFR 122.21(g)(11)) Biological Toxicity Testing Data 8.1 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 three years? □ Yes □ No • SKIP to Section 9. 8.2 Identify the tests and their purposes below. Test(s) Purpose of Test(s) Submitted to NPDES Permitting Authority? Date Submitted □ Yes □ No □ Yes □ No □ Yes □ No SECTION 9. CONTRACT ANALYSIS INFORMATION (40 CFR 122.21(g)(12)) Contract Analysis Information 9.1 Were any of the analyses reported in Section 7 (on Tables A through C) performed by a contract laboratory or consulting firm? □ Yes □ No • SKIP to Section 10. 9.2 Provide information for each contract laboratory or consulting firm below. Laboratory Number 1 Laboratory Number 2 Laboratory Number 3 Name of laboratory/firm Laboratory address Phone number Pollutant(s) analyzed EPA Form 3510-2F (Revised 3-19) EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 SECTION 10. CHECKLIST AND CERTIFICATION STATEMENT (40 CFR 122.22(a) and (d)) Checklist and Certification Statement 10.1 In Column 1 below, mark the sections of Form 2F that you have completed and are submitting with your application. For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not all applicants are required to complete all sections or provide attachments. Column 1 Column 2 □ Section 1 □ w/ attachments (e.g., responses for additional outfalls) □ Section 2 □ w/ attachments □ Section 3 □ w/ site drainage map □ Section 4 □ w/ attachments □ Section 5 □ w/ attachments □ Section 6 □ w/ attachments □ Section 7 □ Table A □ w/ small business exemption request □ Table B □ w/ analytical results as an attachment □ Table C □ Table D □ Section 8 □ w/attachments □ Section 9 □ w/attachments (e.g., responses for additional contact laboratories or firms) □ Section 10 □ 10.2 Certification Statement I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name (print or type first and last name) Official title Signature Date signed EPA Form 3510-2F (Revised 3-19) EPA Identification Number NPDES Permit Number - Facility Name Outfall Number Form Approved 03/05/19 OMB No. 2040-0004 Pollutant or Parameter TABLE A. CONVENTIONAL AND NON CONVENTIONAL PARAMETERS (40 CFR 122.26(c)(1)(i)(E)(3))1 You must provide the results of at least one analysis for every pollutant in this table. Complete one table for each outfal Maximum Daily Discharge (specify units) l . See instructions for addit Average Daily Discharge (specify units) ional detail s and requirements. Number of Storm Events Sampled Source of Information (new source/new dischargers only; use codes in i nstructions) Grab Sample Taken During First 30 Minutes Flow-Weighted Composite Grab Sample Taken During First 30 Minutes Flow-Weighted Composite 1. Oil and grease 2. Biochemi cal oxygen demand (BOD5) 3. Chemical oxygen demand (COD) 4. Total suspended solids (TSS) 5. Total phosphorus 6. Total Kj eldahl nitrogen (TKN) 7. Total nitrogen (as N) 8. pH (mini mum) pH (maxi mum) EPA Form 3510-2F (Revised 3-19) 1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I, subchapter N or O. See instructions and 40 CFR 122.21(e)(3). This page intentionally left blank. - EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 OMB No. 2040-0004 TABLE B. CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vi)(A))1 List each pollutant that is limited in an effluent limitation guideline (ELG) that the facility is subject to or any pollutant listed in the facility’s NPDES permit for its process wastewater (if the facility is operating under an existing NPDES permit). Complete one table for each outfall. See the instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (specify units) (specify units) Information Number of Storm Pollutant and CAS Number (if available) Grab Sample Taken Grab Sample Taken (new source/new Flow-Weighted Flow-Weighted Events Sampled During First During First dischargers only; use Composite Composite codes in instructions) 30 Minutes 30 Minutes 1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I, subchapter N or O. See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2F (Revised 3-19) This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19 OMB No. 2040-0004 TABLE C. TOXIC POLLUTANTS, CERTAIN HAZARDOUS SUBSTANCES, AND ASBESTOS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vi)(B) and (vii))1 List each pollutant shown in Exhibits 2F–2, 2F–3, and 2F–4 that you know or have reason to believe is present. Complete one table for each outfall. See the instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (specify units) (specify units) Information Number of Storm Grab Sample Taken Grab Sample Taken Pollutant and CAS Number (if available) (new source/new Flow-Weighted Flow-Weighted Events Sampled During First During First dischargers only; use Composite Composite codes in instructions) 30 Minutes 30 Minutes 1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I, subchapter N or O. See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2F (Revised 3-19) This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility name Outfall TABLE D. STORM EVENT INFORMATION (40 CFR 122.26(c)(1)(i)(E)(6)) Number Form Approved 03/05/19 OMB No. 2040-0004 Provide data for the storm event(s) that resulted in the max imum daily discharges for the flow-weighted composite sample. Number of Hours Between Total Rainfall During Duration of Storm Event Beginning of Storm Measured and Date of Storm Event Storm Event (in hours) End of Previous Measurable Rain (in inches) Event Maximum Flow Rate Total Flow from Rain Event During Rain Event (in gallons or specify units) (in gpm or specify un its) Provide a descripti on of the method of flow measurement or estimate. EPA Form 3510-2F (Revised 3-19) Click to go back to the beginning of Form