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 ------- 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) ------- 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. 1-1 ------- 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 ------- 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 ------- 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 ------- PHYSICAL TREATMENT PROCESSES 1A Ammonia Stripping 1B Dialysis 1C Diatomaceous Earth Filtration 1D... 1E ... 1F .... 1G... 1H ... 11.... 1J ... 1K Gas-Phase Separation 1L Grinding (Comminutors) .Distillation . Electrodialysis .Evaporation . Flocculation .Flotation .Foam Fractionation .Freezing 1M Grit Removal 1 N Microstraining 10 Mixing 1 P Moving Bed Filters 1 Q Multimedia Filtration 1R Rapid Sand Filtration 1 S Reverse Osmosis (Hyperfiltration) 1T Screening 1U Sedimentation (Settling) 1V Slow Sand Filtration 1W Solvent Extraction 1X .Sorption CHEMICAL TREATMENT PROCESSES 2B 2C 2D 2E 2F .Carbon Adsorption .Chemical Oxidation .Chemical Precipitation .Coagulation . Dechlorination .Disinfection (Chlorine) 2G Disinfection (Ozone) 2H Disinfection (Other) 2I .Electrochemical Treatment 2J Ion Exchange 2K Neutralization 2L Reduction BIOLOGICAL TREATMENT PROCESSES 3A 3B 3C 3-D .Activated Sludge .Aerated Lagoons .Anaerobic Treatment . Nitrification-Denitrification 3E 3F 3G 3H . Preaeration .Spray Irrigation/Land Application .Stabilization Ponds .Trickling Filtration OTHER PROCESSES 4A Discharge to Surface Water 4B Ocean Discharge Through Outfall 4C 4D .Reuse/Recycle of Treated Effluent .Underground Injection SLUDGE TREATMENT AND DISPOSAL PROCESSES 5A Aerobic Digestion 5B Anaerobic Digestion 5C Belt Filtration 5D Centrifugation 5E 5F 5G 5H 5I. 5J 5K 5L .Chemical Conditioning .Chlorine Treatment .Composting .Drying Beds .Elutriation v .Flotation Thickening .Freezing .Gravity Thickening 5M Heat Drying 5N Heat Treatment 50 Incineration 5P Land Application 5Q Landfill 5R Pressure Filtration 5S Pyrolysis 5T Sludge Lagoons 5U Vacuum Filtration 5V Vibration 5W Wet Oxidation Table 2D-1 EPA Form 3510-20 (Rev. 8-90) ------- 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) ------- 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) ------- 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 ------- 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 ------- 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 ------- 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 ------- 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 ------- 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 ------- 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 ------- 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. II 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 ------- 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. ------- |