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National Pollutant Discharge Eliminations System (NPDES) Permit Application Package Form 2D 51957 - Indiana
| National Pollutant Discharge Eliminations System (NPDES) Permit Application Package Form 2D Form. This is a Indiana form and can be used in Water Department Of Enviromental Management Statewide . |
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NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) PERMIT APPLICATION PACKAGE FORM 2D State Form 51957 (10-04) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT APPLICATION FOR PERMIT TO DISCHARGE WASTEWATER NEW SOURCE AND NEW DISCHARGE APPLICATION FOR PERMIT TO DISCHARGE PROCESS WASTEWATER Applicability Application Requirements Water Treatment Additives Information Identification of Potentially Affected Persons (AOPA) Fee Information for NPDES Permit Applications Application for Approval to use Water Treatment Additives Identification of Potentially Affected Persons Form (AOPA) Request For Information Form Owner/Operator Affidavit to Determine the Appropriate NPDES Permittee(s) General Information Form Instructions General Information Form Glossary Industrial NPDES 2C Permit Application Review Checklist Instructions Form 2C Table 2D-1 (Codes for Treatment Units) Table 2D-2 (Pollutant Listing) Table 2D-3 (Toxic Pollutants and Hazardous Substances Required To Be Identified) Table 2D-4 (Hazardous Substances) Figure 2D-1 (Line Drawing) Application Form 2D Page 2 Page 2 Page 3 Page 3 Page 3 Page 5 Page 9 Page 11 Page 12 Page 13 Page 15 Page 18 Page 28 Page 29 Page 36 Page 37 Page 40 Page 41 Page 43 Page 44 American LegalNet, Inc. www.FormsWorkflow.com NPDES PERMIT APPLICATION FORM 2D NEW SOURCE AND NEW DISCHARGE APPLICATION FOR PERMIT TO DISCHARGE PROCESS WASTWATER SUPPLEMENTAL APPLICATION INSTRUCTIONS In order to avoid unnecessary effort, please read all instructions carefully before completing the applications. In addition, you may disregard all reference to the EPA ID number when completing these forms unless an ID number has already been obtained from EPA. APPLICABILITY Form 2D is to completed for proposed new sources or new dischargers of process wastewater. Additionally, a General Information Form must be completed and submitted with Form 2D. Other forms are available for existing facilities of process wastewater (Form 2C) and for proposed new and existing facilities which do not discharge process wastewater (Form 2E). Public Water Supplies with a direct discharge of filter backwash or lime softener wastewater should complete and submit a Public Water Supply Permit Application Package. These application forms may be obtained by calling 317/233-0864. In addition to the above, an "Application for Permit to Discharge Storm Water Associated With Industrial Activity" (Form 2F) may need to be submitted. The facilities covered by this requirement are included in the Federal Regulation 40 CFR 122.26(b)(14). Form 2F must be submitted if the industry is included in the definition and there are point source discharges which are composed entirely of storm water and/or if storm water is combined with either process or non-process wastewater. For further information and to request the 2F form, call 317/233-6725 and ask for the Storm Water Desk. APPLICATION REQUIREMENTS For the purpose of completing this application, this Agency shall consider the following waters to be non-process wastewaters: (1) sanitary wastewater (including restaurant or cafeteria wastes); (2) once through non-contact cooling waters; (3) cooling tower blowdown (except from those industries for which cooling tower blowdown is considered a process wastewater, i.e. steam electric power plants); (4) water from stone, sand, and gravel quarries; and (5) water used solely for intake screen backwash. If the above wastewaters are the sole contributors to a discharge, please complete Form 2E; otherwise complete Form 2D. Special care should be taken by all industries when determining whether a pollutant may be present in a discharge. All water additives used at your facility should be examined with respect to their active ingredients. Specifically, this Agency requests that the information listed on the Application for Approval to Use Water Treatment Additives concerning the usage of any water conditioning or biofouling control agents be submitted as a supplement to your application. If no additives are used, please make a statement to that effect in your transmittal letter. 2 American LegalNet, Inc. www.FormsWorkflow.com A flow diagram must be included in accordance with Form 2D Instructions, Item III-B. In addition, a separate narrative description of your manufacturing or materials processing operation should be included to aid the permit writer in preparing the permit. The manufacturing description may be included as a part of Item 13 of the General Information Form. If EPA effluent limitation guidelines are based on production, it is most important to give the production figures asked for in Item IV of Form 2D. Also include when applicable, the particular EPA effluent limitation guidelines subcategory or subcategories in which the manufacturing operation lies, and the production figures for each subcategory. Except for the Petroleum Refining Category, the production figures are to be representative of actual production rather than a design rate or capacity. WATER TREATMENT ADDITIVES INFORMATION The enclosed form "Application for Approval to use Water Treatment Additives" State Form 50000. Dischargers utilizing water treatment additives in their treatment systems must include the requested information in the Application for Approval to use Water Treatment Additives. This information must also be provided any time that water treatment additives are changed during the term of the NPDES permit. Approval from the IDEM is required prior to the use of any water treatment additive. IDENTIFICATION OF POTENTIALLY AFFECTED PERSONS Please see the enclosed form, "Identification of Potentially Affected Persons". Include with the completed application the attached form to fully identify all persons, by name and mailing address, who may be affected by the issuance of this permit (i.e. the discharge from the facility). These parties may include but not necessarily be limited to adjoining landowners, persons with a proprietary interest, or the first downstream non-adjacent property owner. Also, include the name of any fish and wildlife or conservation groups, downstream marinas, etc., which may be potentially affected, and/or persons who may have expressed concern regarding the discharge. Failure to fully identify a potentially affected person may result in any issued permit being challenged and rendered null and void. UPDATED FEE INFORMATION FOR NPDES PERMIT APPLICATIONS The following revised fees were established, pursuant to IC 13-18-2
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