United States
          Environmental Protection
          Agency
Office of Water
Enforcement and Permits
Washington, DC 20460
EPA Form 3510-2D
August 1990
           Permits Division
&EPA    Application Form 2D —

          New Sources and
          New Dischargers:

          Application for Permit to
          Discharge Process
          Waste water

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EAPERWORK REDUCTION ACT NOTICE: The public reporting and
recordkeeping burden for this collection of information is
estimated to average 32 hours as an average response for some
minor facilities, to 46 hours as an average per response for some
major facilities , with a weighted average for major and minor of
33.2 hours per response.  This estimate includes the time needed
to review instructions; develop, acquire, install, and utilize
technology and systems for the purposes of collecting,
validating, and verifying information, processing and maintaining
information, and disclosing and providing information; adjust the
existing ways to comply with any previously applicable
instructions and requirements; train personnel to respond to a
collection of information; search existing data sources; complete
and review the collection of information; and transmit or
otherwise disclose the information.  As specified in 5 CFR
1320.5(b)(2), an Agency may not conduct or sponsor, and a person
is not required to respond to a collection of information unless
it displays a currently valid OMB control number.

Send comments regarding the burden estimate or any other aspect
of this collection of information, including suggestions for
reducing the burden, to Chief, OPPE Regulatory Information
Division, U.S. Environmental Protection Agency (2136), 401 M St.,
S.W., Washington, DC 20460; and to the Office of Information and
Regulatory Affairs, Office of Management and Budget, 725 17th
St., N.W., Washington, DC 20503, Attention: Desk Officer for EPA.
Include the OMB control number in any correspondence.  Do not
send the completed application form to these addresses.
     EPA Form 3510-2D (Rev. 8-90)

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                                     Form 2D
Form 2D must be completed in conjunction with EPA
Form 3510-1 (Form 1).
This form must be completed  by all  applicants who
checked "yes" to Item II-D in Application Form 1. How-
ever, facilities which discharge only nonprocess was-
tewater that is not regulated by an effluent limitations
guideline or new source performance standard may use
EPA Form 3510-2E (Form 2E). Educational, medical, and
commercial chemical laboratories should use this form
or EPA Form 3510-2C (Form 2C). To further determine if
you are a new source or a new discharger, see §122.2
and §122.29. This form should not be used for dis-
charges of stormwater runoff.
Public Availability of Submitted Information
You may not  claim as confidential  any information
required by this form or Form 1, whether the information
is reported on the forms or in an attachment. Section
402(j) of the CWA requires that all permit applications
shall be available to the public. This  information will
therefore be made available to the public upon request.
You may claim as confidential any information you sub-
mit to EPA which goes beyond that required bythisform
and Form 1. Confidentiality claims for effluent data must
be denied. If you do not assert a claim of confidentiality
at the time of submitting the information, EPA may make
the information public without further  notice. Claims of
confidentiality will be handled in accordance with EPA's
business confidentiality regulations in 40 CFR Part 2.
Completeness
Your application will not be considered complete unless
you answer every question on this form and on Form 1
(except as instructed below). If an item does not apply to
you, enter "NA" (for "not applicable") to show that you
considered the question.
Followup Requirements
Although you are  now required to submit estimated
data on this form (Form 2D), please note that no rater
than  two years after you begin discharging from the
proposed facility, you must complete and submit Items
V and VI of  NPDES  application Form 2C  (EPA Form
3510-2C).  How-ever, you need not complete those
portions of Item  V requiring  tests which you have
already  performed under the discharge  monitoring
requirements of your NPDES  permit. In addition,  the
permitting authority may waive requirements of Items
V-A and VI if the permittee makes the demonstrations
required  under  40 CFR  §122.22(g)(7)(i)(B)  and
 122.21(gX9).
 Definitions
All significant terms used in these instructions and in
 the form are defined in the glossary found in the General
 Instructions which accompany Form 1.

 EPA Form 3510-2D (Rev. 8-90)
Instructions
     Item I
     You may use the map you provided for Item XI of Form 1
     to determine the latitude and longitude (to the nearest
     15 seconds) of each of your outfalls and the name of the
     receiving water. You should name all waters to which
     discharge is made and which  flow  into  significant
     receiving waters. For example, if the discharge is made
     to a ditch which flows into an unnamed tributary which
     in turn flows into a named river, you should provide the
     name or description (if no name is available) of the ditch,
     the tributary, and the river.
     Item II
     This item requires your best estimate of the date on
     which your facility or new outfall will begin to discharge.
     Itemlll-A
     List all outfalls, their source (operations contributing to
     the flow), and estimate an average flow  from  each
     source. Briefly describe the planned treatment for these
     wastewaters prior to discharge. Also describe the ulti-
     mate disposal of any solid or liquid wastes  not dis-
     charged. You should describe the treatment in either a
     narrative form or list the proper code for the treatment
     unit from a list provided in Table  2D-1.
     Item III-B
     An example of an acceptable  line drawing  appears in
     Figure 2D-1 to these instructions. The line  drawing
     should show the route taken by water in your proposed
     facility from intake to discharge. Show  all  sources of
     wastewater, including process and production  areas,
     sanitary flows, cooling water, and  storm water runoff.
     You may group similar operations into  a  single unit,
      labeled to correspond to the more detailed listing in Item
      III-A. The water balance should show estimates of antic-
      ipated average flows. Show  all significant losses of
      water to production, atmosphere,  and discharge. You
      should use your best estimates.
      Itemlll-C
      Fill in every  applicable  column in this  item  for each
      source of intermittent or seasonal discharge. Base your
      answers on your best estimate. A discharge is intermit-
      tent if it occurs with interruptions during the operating
      hours of the facility. Discharges caused by routine main-
      tenance shutdowns, process changes, or other similar
      activities are not considered to  be intermittent. A dis-
      charge is seasonal if it occurs only during certain parts
      of the year. The reported flow rate is the highest daily
      value and should be measured in gallons per day. Maxi-
      mum total volume means  the total volume of any one
      discharge within 24 hours and is measured in units
      such as gallons.

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Item IV
"Production" in this question refers  to those goods
which the proposed facility will produce, not to "waste-
water" production. This information is only necessary
where production-based  new source  performance
standards (NSPS) or effluent guidelines apply to your
facility. Your estimated production figures should be
based on a realistic projection of actual daily production
level (not design capacity) for each of the first three
operating years of the facility. This estimate must be a
long-term-average estimate (e.g., average production
on an annual basis). If production will vary depending on
long-term shifts in operating schedule or capacity, the
applicant may report alternate production estimates and
the basis for the alternate estimates.
If known, report quantities in the units  of measurement
used in the  applicable NSPS or effluent guideline. For
example, if the applicable NSPS is expressed as "grams
of pollutant discharged per kilogram of unit production,"
then report maximum "Quantity Per Day" in kilograms.
If you do not know whether any NSPS or effluent guide-
line applies to your facility, report quantities in any unit
of measurement known to you. If an effluent guideline
or NSPS specifies a method for estimating production,
that method must be followed.
There is no need to conduct new studies to obtain these
figures; only data already on hand are  required. You are
not required to indicate how the reported information
was calculated.
Items V-A, B, and C
These items require you to estimate and report data on
the pollutants  expected to be discharged from each of
your outfalls. Where there is more than one outfall, you
 should submit a separate Item V for each outfall. For Part
 C only a list is  required. Sampling and analysis are not
 required at this time. If, however, data from such ana-
 lyses are available, then those data should be reported.
 Each part of this item addresses a. different set of pollu-
 tants or parameters and  must be completed in accor-
 dance with the specific instructions  for that part. The
 following are the general and specific instructions for
 Items V-A through V-C.
 Item V  — General Instructions
 Each part of this item requires you to provide an esti-
 mated maximum daily and average daily value for each
 pollutant or parameter listed (see Table 2D-2), according
 to the specific  instructions below. The source of the data
 is also required.
 For Parts  A through C, base  your  determination  of
 whether a  pollutant will be present in your discharge on
 your knowledge of the proposed facility's raw materials.
  EPA Form 3510-2D (Rev. 8-90)
maintenance chemicals, intermediate and final  prod-
ucts, byproducts, and any analyses of your effluent or of
any similar effluent. You may also provide the determi-
nation and the estimates based on available in-house or
contractor's  engineering reports or any other  studies
performed on the proposed facility (see Item VI of the
form). If you  expect a pollutant to be present solely as a
result of its presence in your intake water, please state
this information on the form.
Please note  that no later than 2 years after you  begin
discharging  from the proposed facility, you must com-
plete and submit Items V and VI of NPDES application
Form 2C (followup data).
Reporting Intake Data. You are not required to report
pollutants or parameters present in intake water unless
you wish to demonstrate your eligibilty for a "net" efflu-
ent limitation for these pollutants or parameters, that is,
an effluent limitation adjusted to provide allowance for
the pollutants or parameters present in  your intake
water. If you wish  to obtain  credits for pollutants or
parameters  present in your intake water, please insert a
separate sheet, with a short statement of why you
believe you  are eligible (see §122.45 (g», under Item VII
(Other Information). You will  then  be contacted by the
permitting authority for further instructions
All estimated pollutant or parameter  levels must  be
reported as  concentration and as total mass, except for
discharge flow, temperature,  and pH. Total mass is the
total weight of pollutants or parameters discharged over
a day.
Use the following abbreviations for units:
       Concentration                 Mass
ppm ... .parts per million     Ibs	pounds
 mg/1. .-. .milligrams per liter  ton	tons (English tons)
 ppb	parts per billion     mg	milligrams
 Ug/1 .. .micrograms per liter g	grams
 kg	kilograms          T	Tonnes (metric tons)
 Source
 In providing the estimates, use the codes in the following table
 to indicate the source of such information in column 4 of.Parts
 V — A and — B.
                        Code
 Engineering  study 	1
 Actual data from pilot plants	1
 Estimates from other engineering studies	2
 Data from other similar plants 	3
 Best professional estimates	4
 Others	'....' specify on the form
  Item V-A
  Estimates of data on pollutants or parameters in Group A must
  be reported  by all applicants for all outfallsr including  outfalls
                                                      1-2

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containing only noncontact cooling water or nonprocess
wastewater.
To request a waiver from reporting any of these pollu-
tants or parameters, the applicant must submit to the
permitting authority a written request specifying which
pollutants or parameters should be waived and the rea-
sons for requesting such a waiver. This request should
be submitted to the permitting authority before or with
the permit  application. The permitting  authority may
waive the requirements for information about these pol-
lutants or parameters if he or she determines that less
stringent reporting requirements are adequate to sup-
port issuance of the permit. No extensive documenta-
tion will normally be needed, but the applicant should
contact the permitting authority if she or he wishes to
receive instructions  on  what his or  her  particular
request should contain.
Item V-B
Estimates of data on  pollutants  in Group B must  be
reported by all applicants for all outfalls, including out-
falls containing only noncontact cooling water or non-
process wastewater.You are merely required to report
estimates for those pollutants which you know or have
reason to believe will be discharged or which are limited
directly by an effluent limitations guideline (or NSPS) or
indirectly through promulgated limitations on an indica-
tor pollutant. Ths priority pollutants in Group  B  are
divided into the following three sections:
1)  Metal toxic pollutants, total cyanide, and total
    phenols
2)  2,3,7,8-Tetrachlorodibenzo-P-Dioxin (TCDD) (CAS
    #1764-016)
3)  Organic Toxic Pollutants (Gas Chromatography/-
    Mass Spectrometry Fractions)
    a) Volatile compounds
    b) 'Acid compounds
    c)  Base/neutral compounds
    d)  Pesticides
For RoJIutants listed in Sections 1  and 3, you must report
estimates as instructed above.
 For Section 2, you are required to report that TCDD may
 be dischargedxif you will use or manufacture one of the
 following compounds, or if you know or have reason to
 believe that TCDD is or may be present  in an  effluent:
 A.  2,4,5-trichlorophenoxy acetic acid (2,4,5-T) (CAS #
     93-765);
 B.  2-(2,4,5-trichlorophenoxy) propanoic acid (Silvex,
     2,4, 5TP) (CAS # 93-72-I);
 C.  2-(2,4,5-trichlorophenoxy) ethyl 2,2-
     dichloropropionate (Erbon) (CAS # 136-25-4);
 D.  0,0-dimethyl 0-(2,4,5-trichlorophenyl) phosphoro-
     thioate (Ronnel) (CAS # 299-84-3);

 EPA tform 3510-2D (Rev. 8-90)
    E.  2,4,5-trichlorophenol (TCP)(CAS # 95-95-4); or
    F.  Hexachlorophene (HCP) (CAS # 70-30-4).
    Small Business Exemption
    If you are a "small business," you are exempt from the
    reporting requirement for Item V-B (section 3). You may
    qualify as a "small business" if you fit one of the fol-
    low-ing definitions:
    1)  Your expected gross sales will total less than
       $100,000 per year for the next three years, or
    2)  in the case of coal mines, your average production
       will be less than 100,000 tons of coal per year.
    If you are a "small business," you may submit projected
    sales or production figures to qualify for this exemption.
    The sales or production figures you submit must be for
    the facility which is the source of the discharge. The data
    should not be limited only to production or sales for the
    process or processes which contribute to the discharge,
    unless those are the only processes at your facility. For
    sales data, where intracorporate transfers of goods and
    services are involved, the transfer price per unit should
    approximate market prices for those goods and services
    as closely as possible. If necessary, you may index your
    sales figures to the second quarter of 1980 to demon-
    strate your eligibility  for a small business exemption.
    This may be done by  using the gross national product
    price deflator (second quarter of 1980 = 100), an index
    available in "National Income and Product Accounts of
    the United States" (Department of Commerce, Bureau
    of Economic Analysis).
    The small business exemption applies to the GC/MS
    fractions (Section 3) of  Item V-B only. Even if you are
    eligible for a small business exemption; you are still
    required to provide information on metals, cyanide, total
    phenols, and dioxin in Item V-B, as well as all of Items
    V-A and C.
     ItemV-C
     List any pollutants in Table 2D-3 that you believe will be
     present in  any outfalls and briefly  explain why you
     believe they will be present. No  estimate of the pollu-
     tant's quantity  is required, unless you already h.ave
     quantitative  data.
     Note:'The discharge of pollutants listed in Table 2D-4
     may subject you to the additional requirements of sec-
     tion 311 of the  CWA (Oil and Hazardous Substance
     Liability). These requirements are  not  administered
     through the NPDES program. However, if you wish an
     exemption under 40 CFR 117.12(a)(2) from these require-
     ments, attach additional sheets of paper to this form
     providing the following information:
     A.  The substance and the amount of each substance
        which may be discharged;
1-3

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 B. The origin and source of the discharge of the
7-  substance;
 C. The treatment which is to be provided for the dis-
    charge by:
    1.  An onsite treatment system separate from any
        treatment system which will treat your normal
        discharge,
    2.  A treatment system designed to treat your nor-
        mal discharge and which is additionally capable
        of treating the amount of the substance identi-
        fied under paragraph 1 above, or
    3.  Any combination of the above.
 An exemption from the section 311 reporting require-
 ments pursuant to 40 CFR Part 117 for pollutants on
 Table 2D does not exempt you from the section 402
 reporting requirements pursuant  to 40 CFR Part 122
 (Item V-C) for pollutants listed on Table 2D-3.
 For further information on exclusions from Section 311,
 see 40 CFR Section 117.12(a)(2) and (c), or contact your
  EPA Regional off ice (Table 1 in the Form 1 instructions).
  Item VI-A
  If an engineering study was conducted, check the box
  labeled "report available." If no study was done, check
  the box labeled "no report."
  Item VI-B
  Report the name and location of any existing plant(s)
  which (to the best of your knowledge) resembles your
  planned operation with respect to items produced, pro-
  duction process, wastewater constituents,  or waste-
  water treatment.  No studies need  be conducted to
  respond to this item. Only data which are already availa-
  ble need be submitted.
  This information will be used to inform the permit writer
  of appropriate treatment methods and their associated
  permit conditions and limits.
  Item VII
  A space is provided for additional information which you
  believe would be useful in setting permit limits, such as
  additional sampling. Any response is optional.
  Item VIII
  The Clean Water Act provides for severe penalties for
  submitting false information on this application form.
  Section 309(c)(2) of the Clean Water Act provides that
   "Any person who knowingly makes any false statement,
   representation, or certification in any application, . . .
   shall upon conviction, be punished by a fine of no more
   than $10,000 or by imprisonment for not more than six
   months, or both."
40 CFR Part 122.22 Requires the Certification To Be
Signed as Follows:
A.  For a corporation: by a responsible corporate officer.
    A responsible corporate officer means (i) a presi-
    dent, secretary, treasurer, or vice-president of the
    corporation in charge of a  principal business func-
    tion, or any other person who performs similar pol-
    icy or decision-making functions for the corporation,
    or (ii) the manager of one  or more manufacturing,
    production or operating facilities  employing more
    than 250 persons or having gross annual sales or
    expenditures exceeding $25,000,000 (in second-
    quarter 1980 dollars), if 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; or
 C.  For a municipality. State,  Federal, or other public
    agency: by either a principal  executive officer or
    ranking elected official. For purposes of this section,
    a principal executive officer of a Federal agency
    includes (i) the chief executive officer of the agency,
    or (ii) a senior executive officer having responsibility
    for the overall operations  of a principal geographic
    unit of the agency (e.g.. Regional Administrators of
    EPA).
   EPA Form 3510-20 (Rev. 8-90)
                                                       1-4

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                   PHYSICAL TREATMENT PROCESSES
1—A	Ammonia Stripping
1—B	Dialysis
1—C	Diatomaceous Earth Filtration
1—D...
1—E ...
1—F ....
1—G...
1—H ...
1—1....
1—J ...
1—K	Gas-Phase Separation
1—L	Grinding (Comminutors)
.Distillation
. Electrodialysis
.Evaporation
. Flocculation
.Flotation
.Foam Fractionation
.Freezing
1—M 	Grit Removal
1 —N	Microstraining
1—0	Mixing
1 —P	Moving Bed Filters
1 —Q	Multimedia Filtration
1—R	Rapid Sand Filtration
1 —S	Reverse Osmosis (Hyperfiltration)
1—T	Screening
1—U	Sedimentation (Settling)
1—V	Slow Sand Filtration
1—W	Solvent Extraction
1—X	.Sorption
                   CHEMICAL TREATMENT PROCESSES
2—B
2—C
2—D
2—E
2—F
.Carbon Adsorption
.Chemical Oxidation
.Chemical Precipitation
.Coagulation
. Dechlorination
.Disinfection (Chlorine)
2—G	Disinfection (Ozone)
2—H	Disinfection (Other)
2—I	.Electrochemical Treatment
2—J	Ion Exchange
2—K	Neutralization
2—L	Reduction
                  BIOLOGICAL TREATMENT PROCESSES
3—A
3—B
3—C
3-D
.Activated Sludge
.Aerated Lagoons
.Anaerobic Treatment
. Nitrification-Denitrification
3—E
3—F
3—G
3—H
. Preaeration
.Spray Irrigation/Land Application
.Stabilization Ponds
.Trickling Filtration
                               OTHER PROCESSES
4—A	Discharge to Surface Water
4—B	Ocean Discharge Through Outfall
                                       4—C
                                       4—D
          .Reuse/Recycle of Treated Effluent
          .Underground Injection
          SLUDGE TREATMENT AND DISPOSAL PROCESSES
5—A	Aerobic Digestion
5—B	Anaerobic Digestion
5—C	Belt Filtration
5—D	Centrifugation
5—E
5—F
5—G
5—H
5—I.
5—J
5—K
5—L
 .Chemical Conditioning
 .Chlorine Treatment
 .Composting
 .Drying Beds
 .Elutriation  v
 .Flotation Thickening
 .Freezing
 .Gravity Thickening
5—M	Heat Drying
5—N	Heat Treatment
5—0	Incineration
5—P	 Land Application
5—Q	Landfill
5—R	Pressure Filtration
5—S	Pyrolysis
5—T	Sludge Lagoons
5—U	Vacuum Filtration
5—V	Vibration
5—W	Wet Oxidation
                                         Table 2D-1
 EPA Form 3510-20 (Rev. 8-90)

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                                         GROUP A
Biochemical Oxygen Demand (BOD)
Chemical Oxygen Demand (GOD)
Total Organic Carbon (TOG)
Total Suspended Solids (TSS)
Flow
Bromide
Total Residual Chlorine
Color
Fecal Coliform
Fluoride
Nitrate-Nitrite (as N)
Oil and Grease
Phosphorus (as P) Total
Radioactivity
  (1) Alpha, Total
  (2) Beta, Total
  (3) Radium, Total
  (4) Radium 226, Total
Section  1

Antimony, Total
Beryllium, Total
Chromium, Total
Lead, Total
Nickel, Total
Silver, Total
Zinc, Total
Phenols, Total

Section  2
Ammonia (as N)
Temperature (winter)
Temperature (summer)
pH
                                         GROUPS
Sulfate (as S04)
Sulfide (as S)
Sulfite (as S03)
Surfactants
Aluminum, Total
Barium, Total
Boron, Total
Cobalt, Total
Iron, Total
Magnesium, Total
Molybdenum, Total
Manganese, Total
Tin, Total
Titanium, Total
Arsenic, Total
Cadmium, Total
Copper, Total
Mercury, Total
Selenium, Total
Thallium, Total
Cyanide, Total
2,3,7,8,Tetrachlorodibenzo-P-Dioxin

Section 3

GC/MS FRACTION* — VOLATILE COMPOUNDS
Acrolein
Benzene
Carbon Tetrachloride
Chlorodibramomethane
2-Chloroethylvinyl Ethe/
Dichlorobomomethane
1,2-Dichloroethane
1,2-Dichloropropane
Ethylbenzene
Methyl Chloride
1,1,2,2-Tetrachloroethane
Toluene
1,1,1-Trichloroethane
Trichloroethylene
 Vinyl Chloride
 Acrylonitirle
 Bromoform
 Chlorobenzene
 Chloroethane
 Chloroform
 1,1-Dichloroethane
 1,1 -Dichloroethane
 1,3-Dichloropropylene
 Methyl Bromide
 Methylene chloroethane
 Tetrachloroethylene
 1,2-Trans-Dichloroethylene
 1,1,2-Trichloroethane ~
                                            Table 2D-2
 EPA Form 3510-2D (Rev. 8-90)

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GS/MS FRACTION — ACID COMPOUNDS
2-Chlorophenol
2,4-Dimethylphenol
2,4-Dinitro-phenol
4-Nitrophenol
Pentachlorophenol
2,4,6-Trichlorophenol

GC/MS FRACTION —  BASE/NEUTRAL COMPOUNDS
2,4-Dichlorophenol
4,6-Dinitro-O-Cresol
2-Nitrophenol
P-Chloro-M-Cresol
Phenol
Acenaphthene
Anthracene
Benzo (a) Anthracene
3,5-Benzofluoranthene
Benzo (k) Fluoranthene
Bis (2-Chloroethyl) Ether Bis
Bis (2-Ethylhexyl) Phthalate
Butyl Benzyl Phthalate
4-Chlorophenyl Phenyl Ether
Dibenzo (a, h) Anthracene
1,3-DichHorobenzene
3,3-Dichlorobenzidine
Dimethyl Phthalate
2,4-Dinitrotoluene
Di-N-Octyl Phthalate
Fluoranthene
Hexachlorobenzene
Hexachlorocyelopentadiene
Indeno (1,2,3-cd) Pyrene
Naphthalene
N-Nitro-sodimethylamine
N-Nitro-sodiphenylamine
Pyrene
Acenaphtylene
Benzidine
Benzo (a) Pyrene
Benzo (ghi) Perylene
Bis (2 Chloroethoxy) Methane
(2-Chloroisopropyl) Ether
4-Bromophenyl Phenyl Ether
2-Chloronaphthalene
Chrysene
1,2-Dichlorobenzene
1,4-Dichlorobenzene
Diethyl Phthalate
Di-N-Butyl Phthalate
2,6-Dinitrotoluene
1,2, Diphenylhydrazine (as Azobenzen)
Fluorene
Hexachlorobutadiene
Hexachloroethane
Isophorone
Nitrobenzene
N-Nitrosodi-N-Propylamine
Phenanthrene
1,2,4-Trichlorobenzene
 GC/MS  FRACTION — PESTICIDES
 Aldrin
 Alpha-BHC
 Beta-BHC
 4,4' DDT
 4,4'-DDD
 Alpha-EndosuJfan
 Endosulfan Sulfate
 Endrin Aldehyde
 Heptachlor Epoxide
 PCB-1254
 .PCB-1232
 PCB-1260
 Toxaphene

 •fractions defined in 40 CFR Part 136
 Gamma-BHC
 Delta-BHC
 Chlordane
 4,4' DDE
 Dieldrin
 Beta-Endosulfan
 Endrin
 Heptachlor
 PCB-1242
 PCB-1221
 PCB-1248
 PCB-1016
                                           Table 2D-2
 EPA Form 3510-20  (8-90)

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        TOXIC POLLUTANTS AND HAZARDOUS SUBSTANCES
    REQUIRED TO BE  IDENTIFIED  BY APPLICANTS IF EXPECTED
                                  TO BE PRESENT
TOXIC POLLUTANT

Asbestos

HAZARDOUS SUBSTANCES

Aceltaldehyde
Allyl alcohol
Ally! chloride
Amyl acetate
Aniline
Benzonitrile
Benzyl chloride
Butyl acetate
Butylamine
Captan
Carbaryl
Carbofuran
Carbon disulfide
Chlorpyrifos
Coumpahos
Cresol
Crotonaldehyde
Cyclohexane
2,4-D (2,4-Dichlorophinoxyacetic acid)
Diazinon
Dicamba
Dichlobenil
Dichlone
2,2 Dichloropropionic acid
Dichlorvos
Diethyl amine
Dimethyl amine
Dintrobenzene
• Diquat
 Disulfoton
 Diuron
 Epichlordhydrin
 Ethion
 Ethylene diamine
 Formaldehyde
 Furfural
 Guthion
 Isoprene
 Isopropanolamine dodecylbenzenesulfonate
 Kelthane
 Kepone
 Malathion
 Mercaptodimethur
 Methoxychlor
HAZARDOUS SUBSTANCES

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
2,4,5-T (2,4,5-Trichlorophenoxyacetic acid)
IDE (Tetrochlorodiphenyl ethane)
2,4,5-TP [2-(2,4,5-Trichlorophenoxy) propanic acid]
Trichlorofon
Triethanolamine dodecylbenzenesulfonate
Triethylamine
Uranium
Vanadium
Vinyl acetate
Xylene
Xylenol
Zirconium
  EPA Form 3510-2D (Rev. 8-90)
                                            TABLE 2D-3

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                                HAZARDOUS  SUBSTANCES
Acetaldehyde
Acetic acid
Acetic anhydride
Acetone cyanohydrin
Acetyl bromide
Acetyl chloride
Acrolein
Acrylonitrile
Adipic acid
Aldrin
Allyl alcohol
Alyll chloride
Aluminum sulfate
Ammmonia
Ammonium acetate
Ammonium benzoate
Ammonium bicarbonate
Ammonium bichromate
Ammonium bifluoride
Ammonium bisulfite
Ammonium carbamate
Ammonium carbonate
Ammonium chloride
Ammonium chromate
Ammonium citrate
Ammonium flouroborate
Ammonium fluoride
Ammonium hydroxide
Ammonium oxalate
Ammonium silicofluoride
Ammonium sulfamate
Ammonium sulfide
Ammonium sulfite
Ammonium tartrate
Ammonium thiocyanate
Ammonium thiosulfate
Amyl acetate
Aniline
Antimony pentachloride
Antimony potassium tartrate
Antimony tribromide
Antimony trichloride
Antimony trifluoride
Antimony trioxide
Arsenic disulfide
Arsenic trichloride
Arsenic trioxide
Arsenic trisulfide
 Barium cyanide
 Benzene
 Benzoic acid
 Benzonitrite
 Benzoyl chloride
 Benzyl chloride
 Beryllium chloride
 Beryllium fluoride
 Beryllium nitrate
 Butylacetate
 n-Butylphthalate
 Butylamine
 Butyric acid
 Cadmium acetate
 Cadmium bromide
 Cadmium chloride
 Calcium arsenate
 Calcium arsenite
 Calcium carbide
 Calcium chromate
 Calcium cyanide
 Calcium dodecylbenzenesulfonate
 Calcium hypochlorite
 Captan
 Carbaryl
 Carbofuran
 Carbon disulfide
 Carbon tetrachloride
 Chlordane
 Chlorine
 Chlorobenzene
 Chloroform
 Chloropyrifos
 Chlorosulfonic acid
 Chromic acetate
 Chromic acid
 Chromic sulfate
 Chromous chloride
 Cobaltous bromide
 Cobaltous formate
 Cobaltous sulfamate
 Coumaphos
 Cresol
 Crotonaldehyde
 Cupric acetate
 Cupric acetoarsenite
 Cupric chloride
 Cupric nitrate
 Cupric oxalate
 Cupric sulfate
 Cupric sulfate ammoniated
 Cupric tartrate
 Cyanogen chloride
• Cyclohexane
 2,4-D acid
  (2,4-Dichlorophenoxyacetic acid)
 2,4-D esters
  (2,4-Dichlorophenoxyacetic acid
  esters)
 DDT
 Diazinon
 Dicamba
 Dichlobenil
 Dichlone
 Dichlorobenzene
 Dichloropropane
 Dichloropropene
 Dichloropropene-Dichloropropane
   mix
 2.2-Dichloropropionic acid
Dichlorvos
Dieldrin
Diethylamine
Dimethylamine
Dinitrobenzene
Dinitrophenol
Dinitrotoluene
Diquat
Disulfoton
Diuron
Dodecylbenzesulfonic acid
Endosulfan
Endrin
Epichlorohydrin
Ethion
Ethylbenzene
Ethylenediamine
Ethylene dibromide
Ethylene dichloride
Ethylene diaminetetracetic
 acid (EDTA)
Ferric ammonium citrate
Ferric ammonium exalate
Ferric chloride
Ferric fluoride
Ferric nitrate
Ferric sulfate
Ferrous chloride
Ferrous sulfate
Formaldehyde
Formic acid
Fumaric acid
Furfural
Guthion
Heptachlor
Hexachlorocyclopentadiene
Hydrochloric acid
Hydrofluoric acid
'Hydrogen cyanide
Hydrogen sulfide
Isoprene
Isopropanolamine
 dodecylbenzenesulfonate
Kelthane
Kepone
Lead acetate
Lead arsenate
Lead chloride
Lead fluoborate
Lead fluorite
Lead iodide
Lead nitrate
Lead stearate
Lead sulfate
Lead sulfide
Lead thiocyanate
Lindane
 Lithium chromate
 Malathion
 EPA  Form 3510-2D (8-90)
                                                TABLE 2D-4

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                       HAZARDOUS SUBSTANCES (Continued)
Maleic acid
Maleic anhydride
Mercaptodimethur
Mercuric cyanide
Mercuric nitrate
Mercuric sulfate
Mercuric thiocyanate
Mercurous nitrate
Methoxychlor
Methyl mercaptan
Methyl methacrylate
Methyl parathion
Mevinphos
Mexacarbate
Monoethylamine
Monomethylamine
Naled
Naphthalene
Naphthenic acid
Nickel ammonium sulfate
Nickel chloride
Nickel hydroxide
Nickel nitrate
Nickel sulfate
Nitric acid
Nitrobenezene
Nitrogen dioxide
Nitrophenil
Nitrotoluene
Paraformaldehyde
Parathion
Pentachlorophenol
Phenol
Phosoene
Phosphoric acid
Phosphorus
Phosphorus oxychloride
Phosphorus pentasulfide
Phosphorus trichloride
Polychlorinated biphenyls (PCB)
Potassium arsenate
Potassium arsenite
Potassium bichromate
Potassium cyanide
Potassium hydroxide
Potassium permanganate
Propargite
Prop'ionic acid
Propionic anhydride
Propylene oxide
Pyrethrins
Quinoline
Resorcinol
Selenium oxide
Silver nitrate
Sodium
Sodium arsenate
Sodium arsenite
Sodium bichromate
EPA Form 3510-20 (Rev. 8-90)
Sodium bifluoride
Sodium bisulfite
Sodium chromate
Sodium cyanide
Sodium dodecylbenzenesulfonate
Sodium fluoride
Sodium hydrosulfide
Sodium hydroxide
Sodium hypochlorite
Sodium methylate
Sodium nitrate
Sodium phospate (dibasic)
Sodium phosphate (tribasic)
Sodium selenite
Strontium chromate
Strychnine
Styrene
Sulfuric acid
Sulfur monochloride
2,4,5-T acid
 (2,4,5-Trichlorophenoxy
 acetic acid)
2,4,5-Tamines
 (2,4,5-Trichlorophenoxy
 acetic acid amines)
2,4,5-T esters
 (2,4,5-Trichlorophenoxy
 acetic acid esters)
2,4,5-T salts
 (2,4,5-Trichlorophenoxy acetic
 acid salts)
2,4,5-TPacid
 (2,4,5-Trichlorophenoxy
 propanoic acid)
2,4,5-TP acid esters
 (2,4,5-Trichlorophenoxy
 propanoic acid esters)
TDE (Tetrachlorpdiphenyl ethane)
Tetraethyl lead
Tetraethyl pyrophosphate
Thallium sulfate
Toluene
Toxaphene
Trichlorofon
Trichloroethylene
Trichlorophenol
Triethanolamine
 dodecylbenzenesulfonate
Triethylamine
Trimethylamine
Uranyl acetate
Uranyl nitrate
Vanadium pentoxide
Vanadyl sulfate
Vinyl acetate
Vinylidene chloride
Xylene
Xylenol
Zinc acetate

             Table 2D-4
Zinc ammonium chloride
Zinc borate
Zinc bromide
Zinc carbonate
Zinc chloride
Zinc cyanide
Zinc fluoride
Zinc formate
Zinc hydrosulfite
Zinc nitrate
Zinc phenolsulfonate
Zinc phosphide
Zinc silicofluoride
Zinc sulfate
Zirconium nitrate
Zirconium potassium fluoride
Zirconium sulfate
Zirconium tetrachloride

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                                                LINE DRAWING
      RAW
     BLUE RIVER

         1 90.000 GPD

45.000 GPD
                                            45,000 GPO
                                                           MUNICIPAL
                                                         WATER SUPPLY
1 30,000 GPO
                 BLUE RIVER
10,000 GPD
COOLING WATER
AERIALS
000 GPD
D WASTE
00 GPD
TORMWAT
FIBER
PREPARATION
i
15,000
GPD

DYE
40,000 GPD
GRIT
SEPARATOR
ER

36,000 GPD
-
ING

40.000 C
NEUTRAL-
IZATION
TANK
1
20,000 10.000
GPD WASHING GPD^ pRYINfl

PD '
LOSS WASTE
^ 1 „ TREATMENT ^ j
6.000 GPD PLANT* 2
34.000 GPD 1 OUTFALL 002
f 50,000 GPD
WASTE
TREATMENT
PLANT * 1

OUTFALL 001
    MAX: 20,000 GPD
                                                                     SCHEMATIC OF WATER FLOW
                                                                     BROWN MILLS. INC.
                                                                     CITY. COUNTY. STATE
                                                                                                    TO ATMOSPHERE
                                                                                                       5,000 GPD
                                                                                            TO PRODUCT
                                                                                               5.000 GPD
EPA Form 3510-20 (Rev. 8-90)
                                                 Figure 2D-1

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                                                                 Form Approved. OMB No. 2040-0086. Approval expires 8-31-98.
3lease type or print en the unshaded areas only
                                    EPA ID Number (copy from Item 1 of Form 1)
  2D
  NPDES
                         New Sources and New Dischargers
          Application for  Permit to Discharge Process Wastewater
 Outfall Location
   For each outfalt, list the latitude and longitude, and the name of the receiving water.
 Outfall Number

     (list)
   Latitude
Deg  Min
Sec
       Longitude
Deg  Min   Sec
                            Receiving Water (name)
II. Discharge Date (When do you expect to begin discharging?)
III. Flows. Sources of Pollution, and Treatment Technologies
A.   For each outfall, provide a description of (1} All operations contributing wastewater to the effluent, including
     process wastewater, sanitary wastewater, cooling water, and stormwater runoff; (2) The average flow contrib-
     uted by each operation; and (3) The treatment received by the wastewater. Continue on additional sheets
     if necessary.
     Outfall
     Number
      1. Operations Contributing Flow
                Uisti
                              2. Average Flow
                               (include units)
                                                      3. Treatment
                                           (Description or List Codes from Table 2D-1J
  EPA Form 3510-20 (Rev. 8-90)
                                                                                   Page 1 of 5

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B. Attach a line drawing showing the water flow through the facility. Indicate sources of intake water,
operations contributing wjstewater to the effluent, and treatment units labeled to correspond to the more
1 detailed descriptions in Item III-A. 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 pictorial description of the nature and amount of any sources of water and
any collection or treatment measures.
C. Except for storm runoff, leaks, or spills, will any of the discharges described in item III-A be intermittent or
seasonal?
CJ Yes (complete the following table) LJ No (go to item IVJ
Outfall
Number

IV. Production " IJj^HII


1^^
1 . Freq
a. Days
Per Week
{specify
average)
••••
uency
b. Months
Per Year
f specify
average)
mm^
2. Flow
a. Maximum
Daily Flow
Rate
fin mgd)
mmmm
b. Maximum .
Total Volume
(specify
with units)
!••••
c. Duration
(in days)
••Bl
If there is an applicable production-based effluent guideline or NSPS. for each outfall list the estimated level of production (projection of
actual production level, not design), expressed in the terms and units used in the applicable effluent guideline or NSPS, for each of the
first 3 years of operation. If production is likely to vary, you may also submit alternative estimates (attach a separate sheet).
a. Quantity
Year Per Day



b. Units of
Measure



c. Operation. Product. Material, etc (specify/



EPA Form 3510-20 (Rev. 8-90)
Page 2 of 5
CONTINUE ON NEXT PAGE

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CONTINUED FROM THE FRONT 1
V. Effluent Characteristics ^^^^^^^H
A, and B: These items require you to
be discharged from each of your out
be completed in accordance with tl
separate page. Attach additional sh
EPA ID Number (copy from Item 1 of Form 1) Outfall Number 1
report estimated amounts (both concentration and mass) of the pollutants to
alls. Each part of this item addresses a different set of pollutants and should
le specific instructions for that part. Data for each outfall s,hould be on a
eets of paper if necessary. ,
General Instructions (See table 2D-2 for Pollutants)
Each part of this item requests you to provide an estimated daily maximum and average for certain pollutants and
the source of information. Data for all pollutants in Group A, for all outfalls, must be submitted unless waived by
the permitting authority. For all outfalls, data for pollutants in Group B should be reported only for pollutants
which you believe will be present or are limited directly by an effluent limitations guideline or NSPS or indirectly
through limitations on an indicator pollutant.
1. Pollutant











. .










2. Maximum
Daily
Value
(include units)






















3. Average
Daily
Value
(include units)




.





•











4. Source (see instructions)






















EPA Form 3510-20 (Rev. 8-90)
Page 3 of 5
CONTINUE ON REVERSE

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CONTINUED FROM THE FRONT
EPA ID Number (copy from Item 1 of Form 1)
Cl   Use the space below to list any of the pollutants listed in Table 2D-3 of the instructions which you know or have
     reason to believe will be discharged from any outfall. For every pollutant you list, briefly describe the reasons you
     believe it will be present.
 . Pollutant
2. Reason for Discharge
VI. Engineering Report on Wastewater Treatment
A.   If there is any technical evaluation concerning your wastewater treatment, including engineering reports or pilot plant studies, check the
     appropriate box below.

  	    I—I Report Available          LJ No Report
     Provide the name and location of any existing plant(s) which, to the best of your knowledge, resembles this
     production facility with respect to production processes, wastewater constituents, or wastewater treatments.
  Name
                                       Location
 EPA Form 3510-20 (Rev. 8-90)
              Page 4 of 5
CONTINUE ON NEXT PAGE

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It. Other Information (Optional!
   Use the space below to expand upon any of the above questions or to bring to the attention of the reviewer any
   other information you feel should be considered in establishing permit limitations for the proposed facility.
   Attach additional sheets if necessary.
   / 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 ard
   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, andcomplete. I am awarethatthere are significant penalties for submitting
   false information, including the possibility of fine and imprisonment for knowing violations.
A. Name and Official Title (type or print)
B. Phone No.
C. Signature
D. Date Signed
EPA Form 3510-2D (Rev. 8-90)
             Page 5 of 5.

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