NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM FORM APPROVED OMB No. 158-R0103 GENERAL INSTRUCTIONS The Federal Water Pollution Control Act, as amended by Public Law 92-500, enacted October 18, 1972, prohibits any person from discharging pollutants into a waterway (e.g., streams, rivers, lakes) from a point source (see definitions below), unless his discharge is authorized by a permit issued either by the U.S. Environmental Protection Agency or by an approved State agency. (See "Proce dures for Filing.") Requirements If you have a discharge or discharges, such as that described in the first paragraph of these instructions, you must complete one of the following forms to apply for a discharge permit. The forms differ by types of discharges as indicated below: Short Form A-Municipal Wastewater Dischargers. Short Form C-Manufacturing Establishments and Mining. If your business or activity involves production of both raw products and ready-for-market products, you may be required to complete two of the above forms. For example, if you produce a raw product, such as milk, and, on the same site, process the raw milk into cheese, you must complete Form B-Agriculture, and Form C-Manufacturing and Mining. If the discharge is from a Federal facility's treatment plant receiving more than 50 percent domestic waste (based on the dry weather flow rate), complete and submit form A. If the discharge is from a sewage treatment process which is not from a municipal, agricultural, or industrial facility (eg., housing subdivision, school), complete and submit form D. ,Procedures for Filing If you have any questions as to whether or not you need a permit under this program, contact your State water pollution control agency or the nearest regional office of the U.S. Environmental Protection Agency. A list of EPA regional offices is given in table 1. Copies of all forms are available at State water pollution control agencies and at all Environmental Protection Agency regional offices. Data submitted on these forms are to be used as a basis for issuing discharge permits. Depending on the adequacy and nature of the data submitted, you may be called upon for additional information before a permit is granted. Complete the appropriate form(s) for your operation, being sure that each item is considered and the required data submitted. Give the answer which most nearly applies to you and your operation. If an item does not apply, please enter, in the appropriate place, "Not Applicable" or "NA" to show that the item was given consideration. Most of the items on the form require the checking of one or more of several possible answers. If the application is to be sent to the Environmental Protection Agency, there is an application fee of $10. This fee, in the form of a check or money order made payable to the Environmental Protection Agency, should be mailed with the original of the application form to the EPA regional office having jurisdiction over the State in which the discharge is located. If the State in which the discharge is located has a federally approved permit program, the application should instead be sent to the State agency administering the program. You will be informed as to the amount of the application fee, if any, and the address to which the application and fee should be sent. Agencies and instrumentalities of Federal, State, or local governments will not be required to pay an application fee to the Environmental Protection Agency. Anyone who applied to the US. Army Corps of Engineers for a discharge permit under the Refuse Act of 1899 need not reapply for a permit for the same discharge, unless it is substantially changed in nature, volume, or frequency; application must also be made for any other discharges not covered by the Refuse Act. Applications for proposed discharges must apply at least 180 days before the date the discharge is due to begin, unless a delay is granted by the approved State agency or by EPA. Signature on Application The person who signs the application form will often be the applicant himself. When another person signs on behalf of the applicant, his title or relationship to the applicant should be shown in the space provided. In all cases, the person signing the form should be authorized to do so by the applicant. An application submitted by a corporation must be signed by a principal executive officer of at least the level of vice president, or his duly authorized representative, if such representative is responsible for the overall operation of the facility from which the discharge(s) described in the form originate. In the case of a partnership or a sole proprietorship, the application must be signed by a general partner or the proprietor, respectively. In the case of a municipal, State, Federal, or other public facility, the application must be signed by EPA Form 7550-7A (7-73) TABLE 1.-Addresses of EPA regional offices and States within their jurisdiction Address and phone Regional Administrator, Region I, Environmental Protection Agency, Agency, 1421 Peachtree St., N.E., Atlanta, Ga. 30309. Atten- Regional Administrator, Region V, Environmental Protection Agency, Regional Administrator, Region VI, Environmental Protection Regional Administrator, Region X, Environmental Protection States Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Virgin Islands, Puerto Rico. Delaware, District of Columbia, Maryland, Pennsylvania, Alabama, Florida, Georgia, Kentucky, Mississippi, North Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin. Arkansas, Louisiana, New Mexico, Oklahoma, Texas. lowe, Kansas, Missouri, Nebraska. Colorado, Montana, North Dakota, South Dakota, Utah, Arizona, California, Hawaii, Nevada, Guam, American Alaska, Idaho, Oregon, Washington. either a principal executive officer, ranking elected official, or other duly authorized employee. Use of Information All information contained in this application will, upon request, be made available to the public for inspection and copying. A separate sheet entitled "Confidential Answers" must be used to set out information which is considered by the applicant to be methods and processes entitled to protection as trade secrets. The information must clearly indicate the item number to which it applies. Confidential treatment can be considered only for that information for which a specific written request of confidentiality has been made on the attached sheet. However, in no event will identification of the contents, volume, and frequency of a discharge be recognized as confidential or privileged information, except in certain cases involving the national security. Definitions 1. A "person" is an individual, partnership, corporation, associa tion, State, municipality, commission, other political subdivision of a State, or any interstate body. 2. The term "pollutant" includes solid waste, incinerator residue, sewage, garbage, sewage sludge, munitions, chemical wastes, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, and industrial, municipal, and agricultural waste discharged into water. 3. A "point source" is any discernible, confined and discrete conveyance including but not limited to a pipe, ditch, channel, tunnel, conduit, well, discrete fissure, container, rolling stock, 2 concentrated animal-feeding operation, or vessel or other floating craft from which pollutants are or may be discharged. 4. A "discharge of pollutant" or a "discharge of pollutants" means any addition of any pollutant to the waters of the United States from any point source; any addition of any pollutant to the waters of the contiguous zone or the ocean from any point source other than a vessel or other floating craft. 5. A "discharge," when used without qualification, includes a "discharge of pollutant" and a "discharge of pollutants" (see above). 6. The term "municipality" means a city, town, borough, county, parish, district, association, or other public body created by or pursuant to State law and having jurisdiction over disposal of sewage, industrial wastes, or other wastes, or an Indian tribe or an authorized Indian tribal organization, or a designated and approved areawide waste treatment management agency. Who Must Apply SPECIFIC INSTRUCTIONS The owner or operator of any facility as described below or any facility, regardless of size, which the Regional Administrator or Director of the State water pollution control agency or interstate agency considers to be a significant pollution problem. Final determination on the need for a permit will be based upon a review of the application and, in many instances, site visits. 1. Animal production facilities. A. A facility that has or may have a discharge, providing a confined area for feeding or holding animals, but not including areas EPA Form 7550-7A (7–73) Since the total exceeds 1,000, a permit, application must be submitted. C. Owners or operators, whether individuals, partnerships, or corporations, with more than one confined animal production facility located on adjacent or nearby properties, where: (1) such facilities utilize a common waste control system or disposal area, and (2) the total number of animals or combination of animals in the individual operations exceeds the above animal limits. 2. Fish and aquatic animal production facilities. A. Facilities such as hatcheries, fish farms, or other facilities which contain, grow, or hold aquatic animals in ponds, raceways or other similar structures for purposes of production and from which there is or will be a discharge for any 30 days or more per year. Closed ponds which discharge less than 30 days per year or only during periods of excess runoff are excluded from these requirements except as provided in 2B and 4 below. In addition, facilities which produce less than 20,000 pounds of aquatic animals per year are excluded from filing an application, except as provided for in 2B and 4 below. B. Any facility which contains, grows, or holds any species of fish or other aquatic animal life nonnative to the United States, from which there is a discharge to a navigable water at any time. The nonnative species of fish are as defined in Special Publication No. 6 of the American Fisheries Society, entitled, "A List of Common and Scientific Names of Fishes from the United States and Canada." (For purposes of this application, carp, brown trout, and goldfish are not considered to be nonnative species.) 3. Irrigation activities. -Discharges of irrigation return flow (such as tailwater, tile drainage, surfaced ground water flow or bypass water), operated by public or private organizations or individuals if: (1) there is a point source of discharge (e.g., a pipe, ditch, or other defined or discrete conveyance, whether natural or artificial) and; (2) the return flow is from land areas of 3,000 or more contiguous acres, or 3,000 noncontiguous acres which use the same drainage system. It is the individual or organization who actually has control of or responsibility for the discharge of irrigation return flow who must apply for the permit. For example, if water is supplied by an organization but returned to navigable waters by an individual who has 3,000 or more acres under irrigation, it is the individual who must apply for a permit. On the other hand, if an irrigation organization supplies and controls thè irrigation return flow discharged from a total of 3,000 or more acres to navigable waters, the organization must apply for a permit; an individual whose acreage is counted in the organization's total, even though the individual's acreage alone may be 3,000 acres or more, need not apply for a permit if the organization, and not the individual, controls the discharge of return flow. 4. General agriculture activities.-Any agricultural operation with any point source discharge, otherwise excluded from mandatory application filing requirements, which the EPA Regional Administrator or State or interstate agency identifies as a significant contributor of pollution. 5. Voluntary filing.-None of the above requirements preclude the voluntary filing of an NPDES application by the owner or operator of an agricultural or silvicultural activity. Instructions for Individual Items Section I-General Item 1. A. Give the name, as it is legally referred to, of the person, firm, public organization, or any other entity which owns or is directly responsible for the facility or activity described in this application. This may or may not be the same name as the facility or activity producing the discharge. Do not use colloquial names as a substitute for the official name. B. Give the complete mailing address of the applicant's main office. This often will not be the same address used to designate the location of the facility or activity. Item 2. Give the name, title, address, and telephone number of a person who is thoroughly familiar with the facts reported on the forms and can be contacted by reviewing offices if necessary. Item 3. The facility is the distinct activity or installation, under the responsibility of the applicant, which produces or may produce one or more point sources of pollution. Name the facility as it is officially or legally referred to in order to distinguish it from similar entities in the same geographical area. Do not use colloquial names as a substitute for the official name. Check the appropriate box in item 3.B to indicate if the facility is publicly or privately owned or both. Check the box in item 3.C if this is a federally owned or operated facility. Give the actual location of the facility in item 3.D. If the area in which the facility is located uses the grid system (i.e., township, section, quarter, range) for specifying location, complete items 3.D.1 (a-f). If the grid system is not used, complete items 3.D.2 (a-c). Item 4. Indicate whether the facility is existing (currently operating) or proposed (to be operating in the future). Item 5. For an existing facility, give the date construction was completed for its current capacity. The expected completion date should be given if the facility is currently under construction or planned. EPA Form 7550-7A (7-73) Item 6. Name the waterway(s) (e.g., stream, river, lake) at the Item 7. Self-explanatory. Item 8. Self-explanatory. Item 9. Directions should use known landmarks and route Item 10. Self-explanatory. Item 11. Check the appropriate box(es) to indicate the one or Section II-Animal confinement and feeding facilities. Item 1. Give the largest number of each type of animal held by Item 2. Give only the area used for the animal confinement or Item 3. Give acres of land that are owned or leased by the Item 4. Indicate in 4.A whether the animals are entirely in the Section III-Fish and other aquatic animal production facilities. Item 3. Self-explanatory. Item 5. Provide the values for the parameters listed in the units Item 6. Give the average number of pounds of food fed per day Section IV-Irrigation activities with point return flows. Item 1. If return flows from the irrigation occur the year Item 2. Give the acreage irrigated by each irrigation method. Item 3. Give the total water diverted (total inflow) by this Item 4. Give the number of separate discrete points at which TABLE 2.-Chemical parameters: standard analytical methods (interim) References Parameter, units, and (code) Method Total suspended (nonfilterable) solids, milligrams Glass fiber filtration 103°-105° C. BOD 5-day, milligrams per liter (00310) Distillation-nesslerization or Modified winkler or probe method. Note.-This table is to be used as a guide in reporting the data concerning each parameter. The first column, Parameter, units, and (code)" 1. "Standard Methods for the Examination of Water and Wastewaters," 13th Edition, 1971, American Public Health Association, New 2. "A.S.T.M. Standards," pt. 23, Water; Atmospheric Analysis; 1972, American Society for Testing and Materials, Philadelphia, Pa. 19103. Copies of the publications are available from the above sources, or for review in the regional offices of the Environmental Protection Agency Data must be reported with an accuracy of at least two significant digits; i.e., values less than 1 must be reported at least to the nearest .01, EPA Form 7550-7A (7–73) 4 GPO 865-719 To be completed by confined animal production facilities, fish farms, hatcheries, and preserves, and irrigation activities meeting size or I certify that I am familiar with the information contained in the application and that to the best of my knowledge and belief such in- Printed name of person signing Signature of applicant Tide Date application signed 18 U.S.C. section 1001 provides that: Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies, |