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HomeMy WebLinkAboutDWQ-2024-006035EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 Does your facility currently have an effective NPDES permit or have you been directed by your NPDES permitting authority to submit a full Form 2S permit application? Yes Complete Part 2 of application package (begins p. 7). No Complete Part 1 of application package (below). Complete this part only if you are a “sludge-only” facility (i.e., a facility that does not currently have, and is not applying for, an NPDES permit for a direct discharge to a surface body of water). . 1.1 Facility name Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address Location address (street, route number, or other specific identifier) Same as mailing address City or town State ZIP code 1.2 Public—federal Public—state Other public (specify)___________________ Private Other (specify) _________ 2.1 Is applicant different from entity listed under Item 1.1 above? Yes No SKIP to Item 2.3 (Part 1, Section 2). 2.2 Applicant name Applicant address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address 2.3 Is the applicant the facility’s owner, operator, or both? (Check only one response.) Owner Operator Both 2.4 To which entity should the NPDES permitting authority send correspondence? (Check only one response.) Facility and applicantFacilityApplicant(they are one and the same) . 3.1 Provide the total dry metric tons per the latest 365-day period of sewage sludge generated, treated, used, and disposed of: Amount generated at the facility Amount treated at the facility Amount used (i.e., received from off site) at the facility Amount disposed of at the facility EPA Form 3510-2S (Revised 3-19) Page 1 UTL025585 Bayview Landfill Bayview Landfill 1997 E 3500 N Layton UT 84040 Jared Maughan Landfill Manager (801) 822-6328 jmaughan@northernutahera.org 10800 S State Rd 68 Inter Local Agency 0 0 0 0 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 . 4.1 Using the table below or a separate attachment, provide existing sewage sludge monitoring data for the pollutants for which limits in sewage sludge have been established in 40 CFR 503 for your facility’s expected use or disposal practices. If available, base data on three or more samples taken at least one month apart and no more than 4.5 years old. Check here if you have provided a separate attachment with this information. (mg/kg dry weight) Arsenic Cadmium Chromium Copper Lead Mercury Molybdenum Nickel Selenium Zinc Other (specify) ___________________ Other (specify) ___________________ Other (specify) ___________________ Other (specify) ___________________ Other (specify) ___________________ Other (specify) ___________________ Other (specify) ___________________ Other (specify) ___________________ Other (specify) ___________________ EPA Form 3510-2S (Revised 3-19) Page 2 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 . 5.1 For each sewage sludge use or disposal practice, indicate the amount of sewage sludge used or disposed of, the applicable pathogen class and reduction alternative, and the applicable vector attraction reduction option. Attach additional pages, as necessary. (check one) (dry metric tons) Land application of bulk sewage Land application of biosolids (bulk) Land application of biosolids (bags) Surface disposal in a landfill Other surface disposal Incineration Not applicable Class A, Alternative 1 Class A, Alternative 2 Class A, Alternative 3 Class A, Alternative 4 Class A, Alternative 5 Class A, Alternative 6 Class B, Alternative 1 Class B, Alternative 2 Class B, Alternative 3 Class B, Alternative 4 Domestic septage, pH adjustment Not applicable Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8 Option 9 Option 10 Option 11 5.2 For each of the use and disposal practices specified in Item 5.1, identify the treatment process(es) used at your facility to reduce pathogens in sewage sludge or reduce the vector attraction properties of sewage sludge. (Check all that apply.) Preliminary operations (e.g., sludge Thickening (concentration) grinding and degritting) Stabilization Anaerobic digestion Composting Conditioning Disinfection (e.g., beta ray irradiation, Dewatering (e.g., centrifugation, sludge drying gamma ray irradiation, pasteurization) beds, sludge lagoons) Heat drying Thermal reduction Methane or biogas capture and recovery Other (specify) _____________________________ . 6.1 Does the sewage sludge from your facility meet the ceiling concentrations in Table 1 of 40 CFR 503.13, the pollutant concentrations in Table 3 of 40 CFR 503.13, Class A pathogen reduction requirements at 40 CFR 503.32(a), and one of the vector attraction reduction requirements at 40 CFR 503.33(b)(1)–(8)? Yes SKIP to Part 1, Section 8 (Certification). No 6.2 Is sewage sludge from your facility provided to another facility for treatment, distribution, use, or disposal? Yes No SKIP to Part 1, Section 7. 6.3 Receiving facility name Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address 6.4 Which activities does the receiving facility provide? (Check all that apply.) Treatment or blending Sale or give-away in bag or other container Land application Surface disposal Incineration Other (describe) Composting EPA Form 3510-2S (Revised 3-19) Page 3 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 . Provide the following information for each site on which sewage sludge from this facility is used or disposed of. Check here if you have provided separate attachments with this information. 7.1 Site name or number Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address Location address (street, route number, or other specific identifier) Same as mailing address City or town State ZIP code County County code Not available 7.2 Site type (check all that apply) Agricultural Lawn or home garden Forest Surface disposal Public contact Incineration Reclamation Municipal solid waste landfill Other (describe) . 8.1 In Column 1 below, mark the sections of Form 2S, Part 1, that you have completed and are submitting with your application. For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not all applicants are required to provide attachments. Section 1: Facility Information w/ attachments Section 2: Applicant Information w/ attachments Section 3: Sewage Sludge Amount w/ attachments Section 4: Pollutant Concentrations w/ attachments Section 5: Treatment Provided at Your Facility w/ attachments Section 6: Sewage Sludge Sent to Other Facilities w/ attachments Section 7: Use and Disposal Sites w/ attachments Section 8: Checklist and Certification Statement EPA Form 3510-2S (Revised 3-19) Page 4 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 8.2 I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name (print or type first and last name) Official title Phone number Signature Date signed EPA Form 3510-2S (Revised 3-19) Page 5 UTL025585 Bayview Landfill Jared Maughan Landfill Manager (801) 822-6328 08/20/2024 This page intentionally left blank. EPA Form 3510-2S (Revised 3-19) Page 6 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 Complete this part if you have an effective NPDES permit or have been directed by the NPDES permitting authority to submit a full permit application. In other words, complete this part if your facility has, or is applying for, an NPDES permit. Part 2 is divided into five sections. Section 1 pertains to all applicants. The applicability of Sections 2 to 5 depends on your facility’s sewage sludge use or disposal practices. See the instructions to determine which sections you are required to complete. . All Part 2 applicants must complete this section. 1.1 Facility name Mailing address (street or P.O. box) City or town State ZIP code Phone number Contact name (first and last) Title Email address Location address (street, route number, or other specific identifier) Same as mailing address City or town State ZIP code 1.2 Is this facility a Class I sludge management facility? Yes No 1.3 million gallons per day (mgd) 1.4 1.5 Public—federal Public—state Other public (specify) ____________ Private Other (specify) ____________ 1.6 Is applicant different from entity listed under Item 1.1 above? Yes No SKIP to Item 1.8 (Part 2, Section 1). 1.7 Applicant name Applicant mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address 1.8 Is the applicant the facility’s owner, operator, or both? (Check only one response.) Operator Owner Both 1.9 To which entity should the NPDES permitting authority send correspondence? (Check only one response.) Facility and applicantFacilityApplicant(they are one and the same) EPA Form 3510-2S (Revised 3-19) Page 7 UTL025585 Bayview Landfill Bayview Landfill 1997 E 3500 N Layton UT 84040 (801) 822-6328 Jared Maughan Landfill Manager jmaughan@northernutahera.org 10800 S State Rd 68 Elberta UT 84626 0 0 Norther Utah Enviornmental Resource Agency EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 1.10 Facility’s NPDES permit number Check here if you do not have an NPDES permit but are otherwise required to submit Part 2 of Form 2S. 1.11 Indicate all other federal, state, and local permits or construction approvals received or applied for that regulate this facility’s sewage sludge management practices below. RCRA (hazardous wastes) _________________________ Nonattainment program (CAA) _________________________ NESHAPs (CAA) _________________________ PSD (air emissions) _________________________ Dredge or fill (CWA Section 404) _________________________ Other (specify) _________________________ _________________________ Ocean dumping (MPRSA) _________________________ UIC (underground injection of fluids) _________________________ 1.12 Does any generation, treatment, storage, application to land, or disposal of sewage sludge from this facility occur in Indian Country? No SKIP to Item 1.14 (Part 2, Section 1) Yes below. 1.13 Provide a description of the generation, treatment, storage, land application, or disposal of sewage sludge that occurs. 1.14 Have you attached a topographic map containing all required information to this application? (See instructions for specific requirements.) Yes No 1.15 Have you attached a line drawing and/or a narrative description that identifies all sewage sludge practices that will be employed during the term of the permit containing all the required information to this application? (See instructions for specific requirements.) Yes No 1.16 Do contractors have any operational or maintenance responsibilities related to sewage sludge generation, treatment, use, or disposal at the facility? No SKIP to Item 1.18 (Part 2, Section 1) Yes below. 1.17 Provide the following information for each contractor. Check here if you have attached additional sheets to the application package. Contractor company name Mailing address (street or P.O. box) City, state, and ZIP code Contact name (first and last) Telephone number Email address EPA Form 3510-2S (Revised 3-19) Page 8 UTL025585 Bayview Landfill UTL025585 EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 1.17 cont. Responsibilities of contractor Using the table below or a separate attachment, provide sewage sludge monitoring data for the pollutants for which limits in sewage sludge have been established in 40 CFR 503 for this facility’s expected use or disposal practices. All data must be based on three or more samples taken at least one month apart and must be no more than 4.5 years old. Check here if you have attached additional sheets to the application package. 1.18 (mg/kg dry weight) Arsenic Cadmium Chromium Copper Lead Mercury Molybdenum Nickel Selenium Zinc 1.19 In Column 1 below, mark the sections of Form 2S, Part 2, that you have completed and are submitting with your application. For each section, specify in Column 2 any attachments that you are enclosing. Note that not all applicants are required to complete all sections or provide attachments. See Exhibit 2S–2 in the Instructions. Section 1 (General Information) w/ attachments Section 2 (Generation of Sewage Sludge or Preparation of a Material Derived from Sewage Sludge) w/ attachments Section 3 (Land Application of Bulk Sewage Sludge) w/ attachments Section 4 (Surface Disposal) w/ attachments Section 5 (Incineration) w/ attachments 1.20 I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name (print or type first and last name) Official title Signature Date signed Telephone number Upon the request of the NPDES permitting authority, you must submit any other information the authority deems necessary to assess sewage sludge use or disposal practices at your facility and identify appropriate permitting requirements. EPA Form 3510-2S (Revised 3-19) Page 9 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 . 2.1 Does your facility generate sewage sludge or derive a material from sewage sludge? Yes No SKIP to Part 2, Section 3. 2.2 Total dry metric tons per 365-day period generated at your facility: 2.3 Does your facility receive sewage sludge from another facility for treatment use or disposal? Yes No SKIP to Item 2.7 (Part 2, Section 2) below. 2.4 Indicate the total number of facilities from which you receive sewage sludge for treatment, use, or disposal: Provide the following information for each of the facilities from which you receive sewage sludge. Check here if you have attached additional sheets to the application package. 2.5 Name of facility Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address Location address (street, route number, or other specific identifier) Same as mailing address City or town State ZIP code County County code Not available 2.6 Indicate the amount of sewage sludge received, the applicable pathogen class and reduction alternative, and the applicable vector reduction option provided at the offsite facility. (dry metric tons) Not applicable Class A, Alternative 1 Class A, Alternative 2 Class A, Alternative 3 Class A, Alternative 4 Class A, Alternative 5 Class A, Alternative 6 Class B, Alternative 1 Class B, Alternative 2 Class B, Alternative 3 Class B, Alternative 4 Domestic septage, pH adjustment Not applicable Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8 Option 9 Option 10 Option 11 2.7 Identify the treatment process(es) that are known to occur at the offsite facility, including blending activities and treatment to reduce pathogens or vector attraction properties. (Check all that apply.) Preliminary operations (e.g., sludge grinding and Thickening (concentration) degritting) Stabilization Anaerobic digestion Composting Conditioning Disinfection (e.g., beta ray irradiation, gamma ray Dewatering (e.g., centrifugation, sludge drying irradiation, pasteurization) beds, sludge lagoons) Heat drying Thermal reduction Methane or biogas capture and recovery Other (specify) ___________________________ EPA Form 3510-2S (Revised 3-19) Page 10 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 2.8 For each sewage sludge use or disposal practice, indicate the applicable pathogen class and reduction alternative and the applicable vector attraction reduction option provided at your facility. Attach additional pages, as necessary. (check one) Land application of bulk sewage Land application of biosolids (bulk) Land application of biosolids (bags) Surface disposal in a landfill Other surface disposal Incineration Not applicable Class A, Alternative 1 Class A, Alternative 2 Class A, Alternative 3 Class A, Alternative 4 Class A, Alternative 5 Class A, Alternative 6 Class B, Alternative 1 Class B, Alternative 2 Class B, Alternative 3 Class B, Alternative 4 Domestic septage, pH adjustment Not applicable Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8 Option 9 Option 10 Option 11 2.9 Identify the treatment process(es) used at your facility to reduce pathogens in sewage sludge or reduce the vector attraction properties of sewage sludge? (Check all that apply.) Preliminary operations (e.g., sludge grinding and Thickening (concentration) degritting) Stabilization Anaerobic digestion Composting Conditioning Disinfection (e.g., beta ray irradiation, gamma ray Dewatering (e.g., centrifugation, sludge drying irradiation, pasteurization) beds, sludge lagoons) Heat drying Thermal reduction Methane or biogas capture and recovery 2.10 Describe any other sewage sludge treatment or blending activities not identified in Items 2.8 and 2.9 (Part 2, Section 2) above. Check here if you have attached the description to the application package. 2.11 Does the sewage sludge from your facility meet the ceiling concentrations in Table 1 of 40 CFR 503.13, the pollutant concentrations in Table 3 of 40 CFR 503.13, Class A pathogen reduction requirements at 40 CFR 503.32(a), and one of the vector attraction reduction requirements at 40 CFR 503.33(b)(1)–(8) and is it land applied? No SKIP to Item 2.14 (Part 2, Section 2) Yes below. 2.12 Total dry metric tons per 365-day period of sewage sludge subject to this subsection that is applied to the land: 2.13 Is sewage sludge subject to this subsection placed in bags or other containers for sale or give-away for application to the land? Yes No Check here once you have completed Items 2.11 to 2.13, then SKIP to Item 2.32 (Part 2, Section 2) below. EPA Form 3510-2S (Revised 3-19) Page 11 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 2.14 Do you place sewage sludge in a bag or other container for sale or give-away for land application? No SKIP to Item 2.17 (Part 2, Section 2) Yes below. 2.15 Total dry metric tons per 365-day period of sewage sludge placed in a bag or other container at your facility for sale or give-away for application to the land: 2.16 Attach a copy of all labels or notices that accompany the sewage sludge being sold or given away in a bag or other container for application to the land. Check here to indicate that you have attached all labels or notices to this application package. Check here once you have completed Items 2.14 to 2.16, then SKIP to Part 2, Section 2, Item 2.32. 2.17 Does another facility provide treatment or blending of your facility’s sewage sludge? (This question does not pertain to dewatered sludge sent directly to a land application or surface disposal site.) No SKIP to Item 2.32 (Part 2, Section 2) Yes below. 2.18 Indicate the total number of facilities that provide treatment or blending of your facility’s sewage sludge. Provide the information in Items 2.19 to 2.26 (Part 2, Section 2) below for each facility. Check here if you have attached additional sheets to the application package. 2.19 Name of receiving facility Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address Location address (street, route number, or other specific identifier) Same as mailing address City or town State ZIP code 2.20 Total dry metric tons per 365-day period of sewage sludge provided to receiving facility: 2.21 Does the receiving facility provide additional treatment to reduce pathogens in sewage sludge from your facility or reduce the vector attraction properties of sewage sludge from your facility? No SKIP to Item 2.24 (Part 2, Section 2) Yes below. 2.22 Indicate the pathogen class and reduction alternative and the vector attraction reduction option met for the sewage sludge at the receiving facility. Not applicable Class A, Alternative 1 Class A, Alternative 2 Class A, Alternative 3 Class A, Alternative 4 Class A, Alternative 5 Class A, Alternative 6 Class B, Alternative 1 Class B, Alternative 2 Class B, Alternative 3 Class B, Alternative 4 Domestic septage, pH adjustment Not applicable Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8 Option 9 Option 10 Option 11 EPA Form 3510-2S (Revised 3-19) Page 12 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 2.23 Which treatment process(es) are used at the receiving facility to reduce pathogens in sewage sludge or reduce the vector attraction properties of sewage sludge from your facility? (Check all that apply.) Preliminary operations (e.g., sludge grinding and Thickening (concentration) degritting) Stabilization Anaerobic digestion Composting Conditioning Disinfection (e.g., beta ray irradiation, gamma ray Dewatering (e.g., centrifugation, sludge drying irradiation, pasteurization) beds, sludge lagoons) Heat drying Thermal reduction Methane or biogas capture and recovery Other (specify) ____________________________ 2.24 Attach a copy of any information you provide the receiving facility to comply with the “notice and necessary information” requirement of 40 CFR 503.12(g). Check here to indicate that you have attached material. 2.25 Does the receiving facility place sewage sludge from your facility in a bag or other container for sale or give-away for application to the land? No SKIP to Item 2.32 (Part 2, Section 2) Yes below. 2.26 Attach a copy of all labels or notices that accompany the product being sold or given away. Check here to indicate that you have attached material. Check here once you have completed Items 2.17 to 2.26 (Part 2, Section 2), then SKIP to Item 2.32 (Part 2, Section 2) below. 2.27 Is sewage sludge from your facility applied to the land? Yes No SKIP to Item 2.32 (Part 2, Section 2) below. 2.28 Total dry metric tons per 365-day period of sewage sludge applied to all land application sites: 2.29 Did you identify all land application sites in Part 2, Section 3 of this application? No Submit a copy of the land application plan Yes with your application. 2.30 Are any land application sites located in states other than the state where you generate sewage sludge or derive a material from sewage sludge? No SKIP to Item 2.32 (Part 2, Section 2) Yes below. 2.31 Describe how you notify the NPDES permitting authority for the states where the land application sites are located. Attach a copy of the notification. Check here if you have attached the explanation to the application package. Check here if you have attached the notification to the application package. 2.32 Is sewage sludge from your facility placed on a surface disposal site? No SKIP to Item 2.39 (Part 2, Section 2) Yes below. 2.33 Total dry metric tons of sewage sludge from your facility placed on all surface disposal sites per 365-day period: 2.34 Do you own or operate all surface disposal sites to which you send sewage sludge for disposal? Yes SKIP to Item 2.39 (Part 2, Section 2) No below. 2.35 Indicate the total number of surface disposal sites to which you send your sewage sludge. (Provide the information in Items 2.36 to 2.38 of Part 2, Section 2, for each facility.) Check here if you have attached additional sheets to the application package. EPA Form 3510-2S (Revised 3-19) Page 13 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 2.36 Site name or number of surface disposal site you do not own or operate Mailing address (street or P.O. box) City or Town State ZIP Code Contact Name (first and last) Title Phone Number Email Address 2.37 Site Contact (Check all that apply.) Owner Operator 2.38 Total dry metric tons of sewage sludge from your facility placed on this surface disposal site per 365-day period: 2.39 Is sewage sludge from your facility fired in a sewage sludge incinerator? No SKIP to Item 2.46 (Part 2, Section 2) Yes below. 2.40 Total dry metric tons of sewage sludge from your facility fired in all sewage sludge incinerators per 365-day period: 2.41 Do you own or operate all sewage sludge incinerators in which sewage sludge from your facility is fired? Yes SKIP to Item 2.46 (Part 2, Section 2) No below. 2.42 Indicate the total number of sewage sludge incinerators used that you do not own or operate. (Provide the information in Items 2.43 to 2.45 directly below for each facility.) Check here if you have attached additional sheets to the application package. 2.43 Incinerator name or number Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address Location address (street, route number, or other specific identifier) Same as mailing address City or town State ZIP code 2.44 Contact (check all that apply) Incinerator owner Incinerator operator 2.45 Total dry metric tons of sewage sludge from your facility fired in this sewage sludge incinerator per 365-day period: 2.46 Is sewage sludge from your facility placed on a municipal solid waste landfill? Yes No SKIP to Part 2, Section 3. 2.47 Indicate the total number of municipal solid waste landfills used. (Provide the information in Items 2.48 to 2.52 directly below for each facility.) Check here if you have attached additional sheets to the application package. EPA Form 3510-2S (Revised 3-19) Page 14 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 2.48 Name of landfill Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address Location address (street, route number, or other specific identifier) Same as mailing address County County code Not available City or town State ZIP code 2.49 Total dry metric tons of sewage sludge from your facility placed in this municipal solid waste landfill per 365-day period: 2.50 List the numbers of all other federal, state, and local permits that regulate the operation of this municipal solid waste landfill. 2.51 Attach to the application information to determine whether the sewage sludge meets applicable requirements for disposal of sewage sludge in a municipal solid waste landfill (e.g., results of paint filter liquids test and TCLP test). Check here to indicate you have attached the requested information. 2.52 Does the municipal solid waste landfill comply with applicable criteria set forth in 40 CFR 258? Yes No EPA Form 3510-2S (Revised 3-19) Page 15 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 3.1 Does your facility apply sewage sludge to land? Yes No SKIP to Part 2, Section 4. 3.2 Do any of the following conditions apply? The sewage sludge meets the ceiling concentrations in Table 1 of 40 CFR 503.12, the pollutant concentrations in Table 3 of 40 CFR 503.13, Class A pathogen reduction requirements at 40 CFR 503.32(a), and one of the vector attraction reduction requirements at 40 CFR 503.33(b)(1)–(8); The sewage sludge is sold or given away in a bag or other container for application to the land; or You provide the sewage sludge to another facility for treatment or blending. Yes SKIP to Part 2, Section 4. No 3.3 Complete Section 3 for every site on which the sewage sludge is applied. Check here if you have attached sheets to the application package for one or more land application sites. 3.4 Site name or number Location address (street, route number, or other specific identifier) Same as mailing address County County code Not available City or town State ZIP code (see instructions) USGS map Field survey Other (specify) ______________ 3.5 Provide a topographic map (or other appropriate map if a topographic map is unavailable) that shows the site location. Check here to indicate you have attached a topographic map for this site. 3.6 Are you the owner of this land application site? Yes SKIP to Item 3.8 (Part 2, Section 3) below. No 3.7 Owner name Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address 3.8 Are you the person who applies, or who is responsible for application of, sewage sludge to this land application site? Yes SKIP to Item 3.10 (Part 2, Section 3) below. No 3.9 Applier’s name Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address EPA Form 3510-2S (Revised 3-19) Page 16 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 3.10 Type of land application: Agricultural land Forest Reclamation site Public contact site Other (describe) 3.11 What type of crop or other vegetation is grown on this site? 3.12 What is the nitrogen requirement for this crop or vegetation? 3.13 Are the vector attraction reduction requirements at 40 CFR 503.33(b)(9) and (b)(10) met when sewage sludge is applied to the land application site? No SKIP to Item 3.16 (Part 2, Section 3) Yes below. 3.14 Indicate which vector attraction reduction option is met. (Check only one response.) Option 9 (injection below land surface) Option 10 (incorporation into soil within 6 hours) 3.15 Describe any treatment processes used at the land application site to reduce vector attraction properties of sewage sludge. Check here if you have attached your description to the application package. 3.16 Is the sewage sludge applied to this site since July 20, 1993, subject to the cumulative pollutant loading rates (CPLRs) in 40 CFR 503.13(b)(2)? Yes No SKIP to Part 2, Section 4. 3.17 Have you contacted the NPDES permitting authority in the state where the bulk sewage sludge subject to CPLRs will be applied to ascertain whether bulk sewage sludge subject to CPLRs has been applied to this site on or since July 20, 1993? No Sewage sludge subject to CPLRs may Yes not be applied to this site. SKIP to Part 2, Section 4. 3.18 Provide the following information about your NPDES permitting authority: NPDES permitting authority name Contact person Telephone number Email address 3.19 Based on your inquiry, has bulk sewage sludge subject to CPLRs been applied to this site since July 20, 1993? Yes No SKIP to Part 2, Section 4. 3.20 Provide the following information for every facility other than yours that is sending, or has sent, bulk sewage sludge subject to CPLRs to this site since July 20, 1993. If more than one such facility sends sewage sludge to this site, attach additional pages as necessary. Check here to indicate that additional pages are attached. Facility name Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address EPA Form 3510-2S (Revised 3-19) Page 17 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 4.1 Do you own or operate a surface disposal site? Yes No SKIP to Part 2, Section 5. 4.2 Complete all items in Section 4 for each active sewage sludge unit that you own or operate. Check here to indicate that you have attached material to the application package for one or more active sewage sludge units. 4.3 Unit name or number Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address Location address (street, route number, or other specific identifier) Same as mailing address County County code Not available City or town State ZIP code (see instructions) USGS map Field survey Other (specify) ______________ 4.4 Provide a topographic map (or other appropriate map if a topographic map is unavailable) that shows the site location. Check here to indicate that you have completed and attached a topographic map. 4.5 Total dry metric tons of sewage sludge placed on the active sewage sludge unit per 365-day period: 4.6 Total dry metric tons of sewage sludge placed on the active sewage sludge unit over the life of the unit: 4.7 Does the active sewage sludge unit have a liner with a maximum permeability of 1 × 10-7 centimeters per second (cm/sec)? No SKIP to Item 4.9 (Part 2, Section Yes 4) below. 4.8 Describe the liner. Check here to indicate that you have attached a description to the application package. 4.9 Does the active sewage sludge unit have a leachate collection system? No SKIP to Item 4.11 (Part 2, Section Yes 4) below. 4.10 Describe the leachate collection system and the method used for leachate disposal and provide the numbers of any federal, state, or local permit(s) for leachate disposal. Check here to indicate that you have attached the description to the application package. EPA Form 3510-2S (Revised 3-19) Page 18 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 4.11 Is the boundary of the active sewage sludge unit less than 150 meters from the property line of the surface disposal site? No SKIP to Item 4.13 (Part 2, Yes Section 4) below. 4.12 Provide the actual distance in meters: meters 4.13 Remaining capacity of active sewage sludge unit in dry metric tons: dry metric tons 4.14 Anticipated closure date for active sewage sludge unit, if known (MM/DD/YYYY): 4.15 Attach a copy of any closure plan that has been developed for this active sewage sludge unit. Check here to indicate that you have attached a copy of the closure plan to the application package. 4.16 Is sewage sludge sent to this active sewage sludge unit from any facilities other than your facility? No SKIP to Item 4.21 (Part 2, Section Yes 4) below. 4.17 Indicate the total number of facilities (other than your facility) that send sewage sludge to this active sewage sludge unit. (Complete Items 4.18 to 4.20 directly below for each such facility.) Check here to indicate that you have attached responses for each facility to the application package. 4.18 Facility name Mailing address (street or P.O. box) City or town State ZIP code Contact name (first and last) Title Phone number Email address 4.19 Indicate the pathogen class and reduction alternative and the vector attraction reduction option met for the sewage sludge before leaving the other facility. Not applicable Class A, Alternative 1 Class A, Alternative 2 Class A, Alternative 3 Class A, Alternative 4 Class A, Alternative 5 Class A, Alternative 6 Class B, Alternative 1 Class B, Alternative 2 Class B, Alternative 3 Class B, Alternative 4 Domestic septage, pH adjustment Not applicable Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8 Option 9 Option 10 Option 11 4.20 Which treatment process(es) are used at the other facility to reduce pathogens in sewage sludge or reduce the vector attraction properties of sewage sludge before leaving the other facility? (Check all that apply.) Preliminary operations (e.g., sludge grinding and degritting) Thickening (concentration) Stabilization Anaerobic digestion Composting Conditioning Disinfection (e.g., beta ray irradiation, gamma ray Dewatering (e.g., centrifugation, sludge irradiation, pasteurization) drying beds, sludge lagoons) Heat drying Thermal reduction Methane or biogas capture and recovery Other (specify) _____________________ EPA Form 3510-2S (Revised 3-19) Page 19 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 4.21 Which vector attraction reduction option, if any, is met when sewage sludge is placed on this active sewage sludge unit? Option 11 (Covering active sewage Option 9 (Injection below and surface) sludge unit daily) Option 10 (Incorporation into soil within 6 hours) None 4.22 Describe any treatment processes used at the active sewage sludge unit to reduce vector attraction properties of sewage sludge. Check here if you have attached your description to the application package. 4.23 Is groundwater monitoring currently conducted at this active sewage sludge unit, or are groundwater monitoring data otherwise available for this active sewage sludge unit? No SKIP to Item 4.26 (Part 2, Yes Section 4) below. 4.24 Provide a copy of available groundwater monitoring data. Check here to indicate you have attached the monitoring data. 4.25 Describe the well locations, the approximate depth to groundwater, and the groundwater monitoring procedures used to obtain these data. Check here if you have attached your description to the application package. 4.26 Has a groundwater monitoring program been prepared for this active sewage sludge unit? No SKIP to Item 4.28 (Part 2, Yes Section 4) below. 4.27 Submit a copy of the groundwater monitoring program with this permit application. Check here to indicate you have attached the monitoring program. 4.28 Have you obtained a certification from a qualified groundwater scientist that the aquifer below the active sewage sludge unit has not been contaminated? No SKIP to Item 4.30 (Part 2, Yes Section 4) below. 4.29 Submit a copy of the certification with this permit application. Check here to indicate you have attached the certification to the application package. 4.30 Are you seeking site-specific pollutant limits for the sewage sludge placed on the active sewage sludge unit? Yes No SKIP to Part 2, Section 5. 4.31 Submit information to support the request for site-specific pollutant limits with this application. Check here to indicate you have attached the requested information. EPA Form 3510-2S (Revised 3-19) Page 20 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 5.1 Do you fire sewage sludge in a sewage sludge incinerator? Yes No SKIP to END. 5.2 Indicate the total number of incinerators used at your facility. (Complete the remainder of Section 5 for each such incinerator.) Check here to indicate that you have attached information for one or more incinerators. 5.3 Incinerator name or number Location address (street, route number, or other specific identifier) County County code Not available City or town State ZIP code (see instructions) USGS map Field survey Other (specify) ______________ 5.4 Dry metric tons per 365-day period of sewage sludge fired in the sewage sludge incinerator: 5.5 Submit information, test data, and a description of measures taken that demonstrate whether the sewage sludge incinerated is beryllium-containing waste and will continue to remain as such. Check here to indicate that you have attached this material to the application package. 5.6 Is the sewage sludge fired in this incinerator “beryllium-containing waste” as defined at 40 CFR 61.31? Yes No SKIP to Item 5.8 (Part 2, Section 5) below. 5.7 Submit with this application a complete report of the latest beryllium emission rate testing and documentation of ongoing incinerator operating parameters indicating that the NESHAP emission rate limit for beryllium has been and will continue to be met. Check here to indicate that you have attached this information. 5.8 Is compliance with the mercury NESHAP being demonstrated via stack testing? Yes No SKIP to Item 5.11 (Part 2, Section 5) below. 5.9 Submit a complete report of stack testing and documentation of ongoing incinerator operating parameters indicating that the incinerator has met and will continue to meet the mercury NESHAP emission rate limit. Check here to indicate that you have attached this information. 5.10 Provide copies of mercury emission rate tests for the two most recent years in which testing was conducted. Check here to indicate that you have attached this information. 5.11 Do you demonstrate compliance with the mercury NESHAP by sewage sludge sampling? No SKIP to Item 5.13 (Part 2, Section 5) Yes below. 5.12 Submit a complete report of sewage sludge sampling and documentation of ongoing incinerator operating parameters indicating that the incinerator has met and will continue to meet the mercury NESHAP emission rate limit. Check here to indicate that you have attached this information. EPA Form 3510-2S (Revised 3-19) Page 21 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 5.13 Dispersion factor in micrograms/cubic meter per gram/second: 5.14 Name and type of dispersion model: 5.15 Submit a copy of the modeling results and supporting documentation. Check here to indicate that you have attached this information. 5.16 Provide the control efficiency, in hundredths, for each of the pollutants listed below. Arsenic Cadmium Chromium Lead Nickel 5.17 Attach a copy of the results or performance testing and supporting documentation (including testing dates). Check here to indicate that you have attached this information. 5.18 Provide the risk-specific concentration (RSC) used for chromium in micrograms per cubic meter: 5.19 Was the RSC determined via Table 2 in 40 CFR 503.43? Yes No SKIP to Item 5.21 (Part 2, Section 5) below. 5.20 Identify the type of incinerator used as the basis. Fluidized bed with wet scrubber Other types with wet scrubber Fluidized bed with wet scrubber and wet Other types with wet scrubber and wet electrostatic electrostatic precipitator precipitator 5.21 Was the RSC determined via Table 6 in 40 CFR 503.43 (site-specific determination)? No SKIP to Item 5.23 (Part 2, Section 5) Yes below. 5.22 Provide the decimal fraction of hexavalent chromium concentration to total chromium concentration in stack exit gas: 5.23 Attach the results of incinerator stack tests for hexavalent and total chromium concentrations, including the date(s) of any test(s), with this application. Check here to indicate that you have attached this information. Not applicable 5.24 Do you monitor total hydrocarbons (THC) in the exit gas of the sewage sludge incinerator? Yes No 5.25 Do you monitor carbon monoxide (CO) in the exit gas of the sewage sludge incinerator? Yes No 5.26 Indicate the type of sewage sludge incinerator. 5.27 Incinerator stack height in meters: 5.28 Indicate whether the value submitted in Item 5.27 is (check only one response): Actual stack height Creditable stack height EPA Form 3510-2S (Revised 3-19) Page 22 UTL025585 Bayview Landfill EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 OMB No. 2040-0004 5.29 Maximum performance test combustion temperature: 5.30 Performance test sewage sludge feed rate, in dry metric tons/day 5.31 Indicate whether value submitted in Item 5.30 is (check only one response): Average use Maximum design 5.32 Attach supporting documents describing how the feed rate was calculated. Check here to indicate that you have attached this information. 5.33 Submit information documenting the performance test operating parameters for the air pollution control device(s) used for this sewage sludge incinerator. Check here to indicate that you have attached this information. 5.34 List the equipment in place to monitor the listed parameters. Total hydrocarbons or carbon monoxide Percent oxygen Percent moisture Combustion temperature Other (describe) 5.35 List all air pollution control equipment used with this sewage sludge incinerator. Check here if you have attached the list to the application package for the noted incinerator. EPA Form 3510-2S (Revised 3-19) Page 23 UTL025585 Bayview Landfill