HomeMy WebLinkAboutDWQ-2025-004161
Lila Canyon Mine
794 North ‘C’ Canyon Road
P.O. Box 910
East Carbon, UT 84526
Phone: (435) 888-4000
Fax: (435) 888-4002
Via Electronic Mail
May 13, 2025
Utah Division of Water Quality
UPDES Program
195 North 1950 West
Salt Lake City, Utah 84116
Attn: Jeff Studenka
UPDES Permit
Re: Emery County Coal Resources, Inc.
Lila Canyon Mine, UPDES Permit #UT0026018
Renewal of UPDES Permit
Dear Mr. Studenka:
Please find the attached application for an intent to renew of Emery County Coal Resources, Inc.
(“ECCR”), Lila Canyon Mine’s UPDES Permit Number UT0026018.
We appreciate your time and consideration of this application.
If you have any questions, please contact me at 435-650-1850.
Sincerely,
Jesse Candelaria
Environmental Tech.
Lila Canyon Mine
Lila Canyon Mine
794 North ‘C’ Canyon Road
P.O. Box 910
East Carbon, UT 84526
Phone: (435) 888-4000
Fax: (435) 888-4002
Written Waver Request:
Lila Canyon mine is requesting a waver for the requirement of sampling the pollutants
specified in Table A of the attached UPDES Permit renewal application, which are not included
in the current UPDES Permit UTU002618 and are not considered pollutants of concern at the
mining facility. These Pollutants Include:
Biochemical Oxygen Demand (BOD5)
Chemical Oxygen Demand (COD)
Total Organic Carbon (TOC)
Ammonia (N)
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 1 of 23
Part I. General Information (40 CFR 122.21(j)(1) and (9))
Permit Status: Renewal New Permit
UPDES Permit No.: New Permit; UPDES Permit # Not Available
Facility Name:
Facility Location:
City State Zip
Facility Mailing Address:
City State Zip
Facility Contact: Title:
Phone Number: Email Address:
Name of Signatory: Title:
Is the applicant the facility owner, operator or both? (check only one response.)
Owner Operator Both
Indicate below any existing environmental permits. (Check all that apply and type the corresponding permit number for each.)
RCRA (hazardous waste) UIC (underground injection control) PSD (air emissions)
Nonattainment program (CAA) NESHAPs (CAA) Dredge or fill (CWA Section 404)
Other (specify)
Nature of Business CFR (40 CFR 122.21(f)(8))
Describe the nature of your business
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 2 of 23
Part II. Facility Information
Design and Actual Flow Rates
Provide design and actual flow rates in designated spaces. Maximum Design Flow Rate
mgd
Annual Average Flow Rates (Actual)
Five Years Ago Four Years Ago Three Years Ago
mgd mgd mgd
Two Years Ago Last Year Current Year
mgd mgd mgd
Maximum Daily Flow Rates (Actual)
Five Years Ago Four Years Ago Three Years Ago
mgd mgd mgd
Two Years Ago Last Year Current Year
mgd mgd mgd
Describe the treatment for each outfall*
Outfall
Number
Outfall
Number
Outfall
Number
Level of Treatment
Primary Treatment
Unit
Treatment
Unit
Treatment
Unit
Size Size Size
Flow rate Flow rate Flow rate
Retention
time
Retention
time
Retention
time
Other Other Other
Equivalent to secondary Treatment
Unit
Treatment
Unit
Treatment
Unit
Size Size Size
Flow rate Flow rate Flow rate
Retention
time
Retention
time
Retention
time
Other Other Other
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 3 of 23
Part II. Facility Information continued
Describe the treatment for each outfall* continued
Outfall # Outfall # Outfall #
Secondary Treatment
Unit
Treatment
Unit Treatment
Unit
Size Size Size
Flow rate Flow rate Flow rate
Retention
time
Retention
time Retention
time
Other Other Other
Advanced Treatment
Unit Treatment
Unit Treatment
Unit
Size Size Size
Flow rate Flow rate Flow rate
Retention
time Retention
time Retention
time
Other Other Other
Other (specify)
Treatment
Unit Treatment
Unit Treatment
Unit
Size Size Size
Flow rate Flow rate Flow rate
Retention
time Retention
time Retention
time
Other Other Other
* The data can be entered in the section above or an excel spreadsheet. Attached additional sheets if needed.
Production
Outfall Number Operation, Product, or
Material Quantity per Day Unit of Measure
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 4 of 23
Part II. Facility Information continued
BLUEPRINT: Attach a line drawing that shows the water flow through your facility with a water balance.
Line Drawing/Blueprint Attached
MAP: Attach a USGS topographic map or aerial photo extending one mile beyond the property boundaries of
the site, the facility or activity boundaries, any treatment area(s), outfall(s), major drainage patterns, and the
receiving surface waters stated above.
Map Attached
Are improvements to the facility scheduled?
YES If YES, explain below.
NO If NO, Skip to Part III
Briefly list and describe the schedule improvements.
1.
2.
3.
4.
Provide scheduled or actual dates of completion for improvements.
Scheduled or Actual Dates of Completion for Improvements
Scheduled
Improvement
(from above)
Affected Outfalls
(list outfall number)
Begin
Construction
(MM/DD/YYYY)
End
Construction
(MM/DD/YYYY)
Begin Discharge
(MM/DD/YYYY)
Attainment of
Operational
Level
(MM/DD/YYYY)
1.
2.
3.
4.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 5 of 23
Part III. Sampling Information
Provide all parameter sampling data with analytical results, reporting limit and any laboratory flags on an
Excel or similar spreadsheet. An Excel Spreadsheet template may be provided upon request.
Has WET testing been conducted during the last 5 years? YES NO
Indicate the acute and chronic WET tests (PASS or FAIL) results for the past 5 years. If no WET testing for the quarter,
then leave blank (e.g., for semi-annual or annual testing or missed testing events).
Year Outfall No. ________ Outfall No. ________ Outfall No. ________
Acute Chronic Acute Chronic Acute Chronic
Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL
Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
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FAIL
Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL
Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL
Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL
Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL
Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL
Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL
Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL
Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL
Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL
Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL
Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL
Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL
Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL
Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL
Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL Qtr 1 PASS
FAIL
Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL Qtr 2 PASS
FAIL
Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL Qtr 3 PASS
FAIL
Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL Qtr 4 PASS
FAIL
Describe any cause(s) of toxicity:
Were the above WET analysis submitted to Utah DWQ? YES NO
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 6 of 23
Part IV. Compliance Information
Has the facility had and parameter exceedances over the past five years? YES NO
If Yes, provide the below information:
Parameter Exceedance Month/Year Cause
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 7 of 23
Part IV. Compliance Information continued
Facility monitoring data.
Please provide the past five years of all parameters required to be monitored in the UPDES permit. The data can be
entered in the section below or an excel spreadsheet. Attached additional sheets if needed.
Month Year Parameter Min Max Avg MDL/RL*
*MDL/RL is the analysis method detection limit or reporting limit located on the laboratory analysis report.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 8 of 23
Part V. Outfalls and Receiving Water(s)
Provide the latitude and longitude to the nearest second for each dewatering outfall. The specified location should be after
all treatment and before release to the receiving water. Provide the name of the initial receiving water. If the initial
receiving water is unnamed, please also indicate the closed named drainage the receiving water flows into (i.e. unnamed
tributary of City Creek). Attach additional sheets if necessary for more outfalls.
Each outfall to a different receiving water segment is subject to additional application fees and annual fees.
Outfall No. Average daily
flow rate
Latitude Longitude Receiving Surface Waters (Name)
mgd O ‘ “ O ‘ “
mgd O ‘ “ O ‘ “
mgd O ‘ “ O ‘ “
Do any of the outfalls described above have a season or periodic discharges?
YES NO
If so, provide the following information for each applicable outfall.
Outfall No. Outfall No. Outfall No.
Number of times per year
discharges occurs
Average duration of each
discharge (specify units)
Average flow of each discharge mgd mgd mgd
Months in which discharge occurs
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 9 of 23
Part VI. Effluent and Intake Characteristics
Table A.
Conventional and Non-Conventional Pollutants
Are you requesting a waiver for one or more pollutants listed Table A for any of your outfalls?
YES NO
If yes, indicate the applicable outfalls below. Provide a written waiver request and other required
information with the application.
Outfall Number Outfall Number Outfall Number
Have you completed monitoring for all Table A pollutants at each of your outfalls for which a waiver has not
been requested and attached the results to this application?
YES NO; a waiver has been requested for all pollutants at all outfalls
Table B.
Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants
Do any of the facility’s processes that contribute wastewater fall into one or more of the primary industry
categories listed in Appendix A?
YES NO Not applicable
Have you checked “Testing Required” for all toxic metals, cyanide, and total phenols in Section 1 of Table B?
YES NO
List the applicable primary industry categories and check the boxes indicating the required Gas
Chromatography/Mass Spectrometry (GS/MS) Fraction(s) identified in Appendix A.
Primary Industry Category Required Gas Chromatography/Mass Spectrometry
(GS/MS) Fraction(s)
Volatile Acid Base/Neutral Pesticide
Volatile Acid Base/Neutral Pesticide
Volatile Acid Base/Neutral Pesticide
Have you checked “Testing Required” for all required pollutants in Sections 2 through 5 of Table B for each of
the GC/MS fractions?
YES NO
Have you checked “Believe Present” or Believed Absent” for all pollutants listed in Sections 1 through 5 of Table
B where testing is not required?
YES NO
Have you provided (1) quantitative data for those Section 1, Table B, pollutants for which you have indicated
testing is required or (2) quantitative data or other required information for those Section 1, Table B, pollutants
that you have indicated are “Believe Present” in your discharge?
YES NO
Have you provided (1) quantitative data for those Sections 2 through 5, Table B, pollutants for which you have
determined testing is required or (2) quantitative data or an explanation for those Sections 2 through 5, Table B,
pollutants you have indicated are “Believed Present” in your discharge?
YES NO
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 10 of 23
Part VI. Effluent and Intake Characteristics continued
Table C.
Certain Conventional and Non-Conventional Pollutants
Have you indicated whether pollutants are “Believed Present” or “Believed Absent” for all pollutants listed on
Table C for all outfalls?
YES NO
Have you completed Table C by providing (1) quantitative data for those pollutants that are limited either directly
or indirectly in an Effluent Limitation Guidelines and/or (2) quantitative data or an explanation for those
pollutants for which you have indicated “Believe Present”?
YES NO
Table D.
Certain Hazardous Substances and Asbestos
Have you indicated whether pollutants are “Believed Present” or “Believed Absent” for all pollutants listed on
Table D for all outfalls?
YES NO
Have you completed Table D by (1) describing the reasons the applicable pollutants are expected to be
discharged and (2) by providing quantitative data, if available?
YES NO
Table E.
2,3,7,8-Tetrachlorodibenzo-p-Dioxin (2,3,7,8-TCDD)
Does the facility use or manufacture one or more of the 2,3,7,8-TCDD congeners listed below:
2,4,5-trichlorophenoxy acetic acid (2,4,5-T)
2-(2,4,5-trichlorophenoxy) propanoic acid (Silvex, 2,4,5-TP)
2-(2,4,5-trichlorophenoxy) ethyl 2,2-dichloro-propionate (Erbon)
0,0-dimethyl 0-(2,4,5-trichlorophenyl) phosphorothioate (Ronnel)
2,4,5,-trichlorophenol (TCP)
hexachlorophene (HCP).
Or do you know of have reason to believe that TCDD is or may be present in the effluent?
YES, Complete Table E NO, Skip to Part VII
Have you completed Table E by reporting qualitative data for TCDD?
YES NO
Were any of the analyses reported in this section performed by a contract laboratory or consulting firm?
YES NO, Skip to Part VII
Provide information for each contract laboratory or consulting firm below.
Laboratory Number 1 Laboratory Number 2 Laboratory Number 3
Name of laboratory/firm
Laboratory address
Phone Number
Pollutant(s) analyzed
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 11 of 23
Part VII. Used or Manufactured Toxics
Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
an intermediate or final product or byproduct?
YES NO, Skip to Part VIII
List the pollutants below.
1. 4. 7.
2. 5. 8.
3. 6. 9.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 12 of 23
Part VIII. Biosolids Information (If Not Applicable, Skip to Part IX.)
Was the Biosolids Annual Report submitted? YES NO
Attach a Biosolids Management Plan with application
Serve Connections?
Provide the total dry metric tons per the latest 365-day period of sewage sludge generated, treated, used and disposed of:
Practice Dry Metric Tons per 365-day Period
Amount generated at the facility
Amount treated at the facility
Amount used (i.e., received from offsite) at the facility
Amount disposed of at the facility
Treatment Provided at Your Facility
Identify the treatment process(es) used at your facility to reduce pathogens in sewage sludge
Preliminary operations (e.g., sludge grinding and
degritting)
Stabilization
Composting
Disinfection
Heat drying
Methane or biogas capture and recovery
Thickening (concentration)
Anaerobic digestion
Conditioning
Dewatering (e.g. centrifugation, sludge drying beds,
sludge lagoons)
Thermal reduction
Sewage Sludge Disposal Method
Land Application of Bulk Sewage Sludge
Is sewage sludge form your facility applied to the land? YES NO If No, Skip to next section
Total dry metric tons per 365-day period of sewage sludge applied to all land sites:
Surface Disposal
Is sewage sludge from your facility placed on a surface disposal site?
YES NO If No, Skip to next section
Total dry metric tons of sewage sludge from your facility placed on all surface
disposal sites per 365-day period:
Do you own or operate all surface disposal sites to which you send sewage sludge for disposal?
YES NO If No, complete the below information
Surface disposal site you do not operate
Site name
Mailing address
City State Zip
Contact Name Title
Phone Number Email Address
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 13 of 23
Part VIII. Bisolids Information continued
Incineration
Is sewage sludge from your facility fired in a sewage sludge incinerator?
YES NO If No, Skip to next section
Total dry metric tons of sewage sludge from your facility fired in all sewage sludge
incinerators per 365-day period:
Do you own or operate all sewage sludge incinerators in which sewage sludge from facility is fired?
YES NO If No, complete the below information
Incinerator location you do not operate
Site name
Mailing address
City State Zip
Contact Name Title
Phone Number Email Address
Disposal in a Municipal Solid Waste Landfill
Is sewage sludge from your facility placed on a municipal solid waste landfill?
YES NO If No, Skip to next section
Total dry metric tons of sewage sludge from your facility placed in this municipal
solid waste landfill per 365-day period:
Do you own or operate the municipal solid waste landfill in which sewage sludge is disposed?
YES NO If No, complete the below information
Municipal Solid Waste Landfill you do not operate
Site name
Mailing address
City State Zip
Contact Name Title
Phone Number Email Address
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 14 of 23
Part IX. Reuse Information (If Not Applicable, skip to Part X.)
Is wastewater effluent directly applied to land?
YES NO If YES, complete the below information.
Land Application Site and Discharge Data
Location Size Average Daily Volume
Applied How often
acres gpd
Seasonal
Continuous
Intermittent
acres gpd
Seasonal
Continuous
Intermittent
acres gpd
Seasonal
Continuous
Intermittent
Seasonal land application.
Indicate months of seasonal land application
January
February
March
April
May
June
July
August
September
October
November
December
Where is the Reuse water distributed
Residential irrigation
Urban uses
Non-residential landscape irrigation
Golf course irrigation
Toilet flushing
Fire protection
Irrigation of food crops (direct contact with edible part) – spray irrigation
Irrigation of food crops (Non direct contact with edible part) – no spray irrigation
Irrigation
Sod farms
Silviculture
Limited access highway rights of way
Other areas where human access is restrict or unlikely to occur
Irrigation of animal feed crops other than pasture for milking animals
Impoundment of wastewater where direct human contact is not allowed or is unlikely to occur
Cooling water
Soil compaction or duct control in construction areas
Other
Attached an updated Reuse Project Plan
An updated Reuse Project Plan is required during every permit renewal.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 15 of 23
Part X. Antidegradation Review
The objective of antidegradation rules and policies is to protect existing high quality waters and set forth a process
for determining where and how much degradation is allowable for socially and/or economically important reasons.
In accordance with Utah Administrative Code (UAC R317-2-3), an antidegradation review (ADR) is a permit
requirement for any project that will increase the level of pollutants in waters of the state. The rule outlines
requirements for both Level I and Level II ADRs, as well as public comment procedures. This review form is
intended to assist the applicant and Division of Water Quality (DWQ) staff in complying with the rule but is not a
substitute for the complete rule in R317-2-3.5. Additional details can be found in the Utah Antidegradation
Implementation Guidance and relevant sections of the guidance are cited in this review form.
ADRs should be among the first steps of an application for a UPDES permit because the review helps establish
treatment expectations. The level of effort and amount of information required for the ADR depends on the nature
of the project and the characteristics of the receiving water. To avoid unnecessary delays in permit issuance, DWQ
recommends that the process be initiated at least one year prior to the date a final approved permit is required.
DWQ will determine if the project will impair beneficial uses (Level I ADR) using information provided by the
applicant and whether a Level II ADR is required. The applicant is responsible for conducting the Level II ADR.
For the permit to be approved, the Level II ADR must document that all feasible measures have been undertaken to
minimize pollution for socially, environmentally or economically beneficial projects resulting in an increase in
pollution to waters of the state.
For permit requiring a Level II ADR, this antidegradation form must be completed and approved by DWQ before
any UPDES permit can be issued. Typically, the ADR form is completed in an iterative manner in consultation
with DWQ. The applicant should first complete the statement of social, environmental and economic importance
(SEEI) in Section C and determine the parameters of concern (POCs) in Section D. Once the POCs are agreed
upon by DWQ, the alternatives analysis and selection of preferred alternative Section E can be conducted based on
minimizing degradation resulting from discharge of the POCs. Once the applicant and DWQ agree upon the
preferred alternative, the review is considered complete, and the form is submitted to DWQ.
What are the designated uses of the receiving water (R317-2-6)? (check all that apply)
Domestic Water Supply
Recreation
Aquatic Life
Agricultural Water Supply
Great Salt Lake
Antidegradation Category 1, 2 or 3 of receiving water?
(R317-2-3.2, -3.3, and -3.4):
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 16 of 23
Part X. Antidegradation Review continued
Effluent flow reviewed: typically, this should be the maximum daily discharge at the design capacity of the
facility. Exceptions should be noted.
What is the application for? (Check all that apply)
A UPDES permit for a new facility, project, or outfall.
A UPDES permit renewal with an expansion of modification of an existing wastewater treatment
works.
A UPDES permit renewal requiring limits for a pollutant not covered by the previous permit and/or
an increase to existing permit limits.
A UPDES permit renewal with no charges in facility operations.
Section B. Is a Level II ADR required?
This section of the form is intended to help applicants determine if a Level II ADR is required for specific
permitted activities. In addition, the Executive Secretary/Director may require a Level II ADR for an
activity with the potential for major impact on the quality of waters of the state (R317-2-3.5a.1).
B1. The UPDES permit is new or is being renewed and the proposed effluent concentration and
loading limits are higher than the concentration and loading limits in the previous permit and any
previous antidegradation review(s).
YES – (Proceed/Skip to B3 of the Form)
NO – No Level II ADR is required and there is no need to proceed further with the review questions.
Continue to the Certification Statement and Signature page.
B2. Will any pollutants use assimilative capacity of the receiving water, i.e. do the pollutant
concentrations in the effluent exceed those in the receiving waters at critical conditions? For most
pollutants, effluent concentrations that are higher than the ambient concentrations require an
antidegradation review? For a few pollutants such as dissolved oxygen, and antidegradation review is
required if the effluent concentrations are less than the ambient concentrations in the receiving water.
(Section 3.3.3 of Implementation Guidance)
YES – (Proceed to B3 of the Form)
NO – No Level II ADR is required and there is no need to proceed further with the review questions.
Continue to the Certification Statement and Signature page.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 17 of 23
Part X. Antidegradation Review continued
B3. Are water quality impacts of the proposed project temporary and limited (Section 3.3.4 of
Implementation Guidance)? Proposed projects that will have temporary and limited effects on water quality
can be exempted form a Lev le II ADR.
YES – Identify the reason used to justify this determination if B4.1 and proceed to Section G. No Level
II ADR is required.
NO – A Level II ADR is required (Proceed to Section C)
B3.1 Complete this question only if the applicant is requesting a Level II review exclusion for
temporary and limited projects (See R317-2-3.5(b)(3) and R317-2-3.5(b)(4)). For projects requesting a
temporary and limited exclusion please indicate the factor(s) used to justify this determination (check
all that apply and provide details as appropriate) (Section 3.3.4 of Implementation Guidance):
Water quality impacts will be temporary and related exclusively to sediment or turbidity and fish
spawning will not be impaired.
Factors to be considered in determining whether water quality impacts will be temporary and
limited:
a)The length of time during which water quality will be lowered:
b)The perfect change in ambient concentrations of pollutants:
c)Pollutants affected:
d)Likelihood for long-term water quality benefits:
e)Potential for any residual long-term influences on existing
uses:
f)Impairment of fish spawning, survival and development of
aquatic fauna excluding fish removal efforts:
Additional justification, as needed:
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 18 of 23
Part X. Antidegradation Review continued
Level II ADR
Section C, D, E, and F of the form constitute the Level II ADR Review. The applicant must provide as much
detail as necessary for DWQ to perform the antidegradation review. Questions are provided for the
convenience of applicants; however, for more complex permits it may be more effective to provide the
required information in a separate report. Applicants that prefer a separate report should record the report
name here and proceed to Section G of the form.
Option Report Name:
Section C. Is the degradation from the project socially and economically necessary to accommodate
important social or economic development in the area in which the waters are located? The applicant
must provide as much detail as necessary for DWQ to concur that the project is socially and economically
necessary when answering the questions in the section. More information is available in Section 6.2 of the
Implementation Guidance.
C1. Describe the social and economic benefits that would be realized through the proposed project,
including the number and nature of jobs created and anticipated tax revenues.
C2. Describe any environmental benefits to be realized through implementation of the proposed
project.
C3. Describe any social and economic losses that may result from the project, including impacts to
recreation or commercial development.
C4. Summarize any supporting information from the affected communities on preserving assimilative
capacity to support future growth and development.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 19 of 23
Part X. Antidegradation Review continued
C5. Please describe any structures or equipment associated with the project that will be placed within
or adjacent to the receiving water.
C6. Will the discharge potentially impact a drinking water source, e.g., Class 1C waters? Depending
upon the locations of the discharge and its proximity to downstream drinking water diversions,
additional treatment or more stringent effluent limits or additional monitoring, beyond that which may
otherwise be required to meet minimum technology standards or in stream water quality standards,
may be required by the Director in order to adequately protect public health and the environment
(R317-2-3.5 d.).
YES
NO
Section D. Identify and rank (from increasing to decreasing potential threat to designated uses) the
parameters of concern. Parameters of concern are parameters in the effluent at concentrations greater than
ambient concentrations in the receiving water. The applicant is responsible for identifying parameter
concentrations in the effluent and DWQ will provide parameter concentrations for the receiving water. More
information is available in Section 3.3.3 of the Implementation Guidance.
Parameters of Concern:
Rank Pollutant Ambient Concentration Effluent Concentration
1.
2.
3.
4.
5.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 20 of 23
Part X. Antidegradation Review continued
Pollutants Evaluated that are not Considered Parameters of Concern:
Pollutant Ambient Concentration Effluent Concentration Justification
1.
2.
3.
4.
5.
Section E. Alternative Analysis Requirements of Level II Antidegradation Review. Level II ADRs
require the applicant to determine whether there are feasible less-degrading alternatives to the proposed
project. More information is available in Section 5.5 and 5.6 of the Implementation Guidance.
E1. The UPDES permit is being renewed without any changes to flow or concentrations. Alternative
treatment and discharge options including changes to operations and maintenance were considered
and compared to the current processes. NO economically feasible treatment or discharge alternatives
were identified that were not previously considered for any previous antigradation review(s).
YES – (Proceed to Section F)
NO or Does Not Apply (Proceed to E2)
E2. Attach as an appendix to this form a report that describes that following factors for all alternative
treatment options (see 1) a technical descriptions of the treatment process, including construction costs
and continued operation and maintenance expenses, 2) the mass and concentration of discharge
constituents, and 3) a description of the reliability of the system, including the frequency where
recurring operation and maintenance may lead to temporary increases in discharged pollutants. Most
of this information is typically available from a Facility Plan, if available.
Report Name:
E3. Describe the proposed method and cost of the baseline treatment alternative. The baseline
treatment alternative is the minimum treatment required to meet water quality based effluent limits
(WQBEL) as determined by the preliminary or final wasteload analysis (WLC) and any secondary or
categorical effluent limits.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 21 of 23
Part X. Antidegradation Review continued
E4. Were any of the following alternatives feasible and affordable?
Alternative Feasible Reason Not Feasible/Affordable
Pollutant Trading YES NO
Water Recycling/Reuse YES NO
Land Application YES NO
Connection to Other Facilities YES NO
Upgrade to Existing Facility YES NO
Total Containment YES NO
Improved O&M of Existing Systems YES NO
Seasonal or Controlled Discharge YES NO
New Construction YES NO
No Discharge YES NO
E5. From the applicant’s perspective, what is the preferred treatment option?
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Page 22 of 23
Part X. Antidegradation Review continued
E6. Is the preferred option also the least polluting feasible alternative?
YES NO
If No, what were less degrading feasible alternative(s)?
If No, provide a summary of the justification for not selecting the least polluting feasible alternative
and if appropriate, provide a more detailed justification as an attachment.
Section F. Optional Information
F1. Does the applicant want to conduct optional public review(s) in addition to the mandatory public
review? Level II ADRs are public noticed for a thirty day comment period. More information is
available in Section 3.7.1 of the Implementation Guidance.
YES NO
F2. Does the project include an optional mitigation plan to compensate for the proposed water quality
degradation?
YES NO
Report Name:
Division of Water Quality (DWQ) UPDES Program
UPDES Industrial Permit Application
Appendix A. Testing Requirements for Organic Toxic Pollutants Industry Categories*
Industry Category Volatile Gas Chromatography/Mass Spectrometry (GS/MS) Fraction(s)† Pesticide Acid Base/Neutral
1. Adhesives and sealants X X X
2. Aluminum forming X X X
3. Auto and other laundries X X X X
4. Battery manufacturing X X
5. Coal mining
6. Coil coating X X X
7. Copper forming X X X
8. Electric and electronic compounds X X X X 9. Electroplating X X X 10. Explosives manufacturing X X
11. Foundries X X X
12. Gum and wood chemicals (all subparts except D and F) X X
13. Gum and wood chemicals, Subpart D (tall oil rosin) X X X
14. Gum and wood chemicals, Subpart F (rosin-based derivatives) X X X
15. Inorganic chemicals manufacturing X X X
16. Iron and steel manufacturing X X X
17. Leather tanning and finishing X X X
18. Mechanical products manufacturing X X X 19. Nonferrous metals manufacturing X X X X
20. Ore mining, Subpart B (base and precious metals) X
21. Organic chemicals manufacturing X X X X
22. Paint and ink formulation X X X
23. Pesticides X X X X
24. Petroleum refining X
25. Pharmaceutical preparations X X X
26. Photographic equipment and supplies X X X 27. Plastic and synthetic materials manufacturing X X X X
28. Plastic processing X
29. Printing and publishing X X X X 30. Pulp and paperboard mills X X X X
31. Rubber processing X X X
32. Soap and detergent manufacturing X X X
33. Steam electric power plants X X
34. Textile mills (except Subpart C, Greige Mills) X X X 35. Timber products processing X X X X
Key *See note at conclusion of 40 CFR 122, Appendix D (1983) for explanation of effect of suspensions on testing requirements for primary industrycategories† The pollutants in each fraction are listed in Table B X Testing is required
Testing is not required
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
Table A Page 1 of 1
UPDES Permit No. Facility Name Outfall Number
Table A. Conventional and Non-Conventional Pollutants1
Pollutant Waiver Requested (if applicable)
Units (specify)
Effluent Intake (optional)
Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Check here if you have applied to Utah DWQ for a waiver for all of the pollutants listed on this table for the noted outfall.
1. Biochemical oxygen demand (BOD5)
Concentration
Mass
2. Chemical oxygen demand (COD) Concentration
Mass
3. Total organic carbon (TOC) Concentration
Mass
4. Total suspended solids (TSS) Concentration
Mass
5. Ammonia (as N)
Concentration
Mass
6. Flow Rate
7. Temperature (winter) Fahrenheit
Temperature (summer) Fahrenheit
8. pH (minimum) Standard units SU
pH (maximum) Standard units SU
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 1 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one)
Units (specify)
Effluent Intake (optional) Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 1. Toxic Metals, Cyanide, and Total Phenols
1. Antimony, Total (7440-36-0) Concentration
Mass
2. Arsenic, Total (7440-38-0) Concentration
Mass
3. Beryllium, Total (7440-41-7) Concentration
Mass
4. Cadmium, Total (7440-43-9) Concentration
Mass
5. Chromium, Total (7440-47-3) Concentration
Mass
6. Copper, Total (7440-50-8) Concentration
Mass
7. Lead, Total
(7439-92-1) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 2 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one)
Units (specify)
Effluent Intake (optional) Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 1. Toxic Metals, Cyanide, and Total Phenols continued
8. Mercury, Total
(7439-97-6) Concentration
Mass
9. Nickel, Total (7440-02-0) Concentration
Mass
10. Selenium, Total (7782-49-2) Concentration
Mass
11. Silver, Total (7440-22-4) Concentration
Mass
12. Thallium, Total (7440-28-0) Concentration
Mass
13. Zinc, Total (7440-66-6) Concentration
Mass
14. Cyanide, Total (57-12-5) Concentration
Mass
15. Phenols, Total
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 3 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 2. Organic Toxic Pollutants (GC/MS Fraction – Volatile Compounds)
1. Acrolein (107-02-8) Concentration
Mass
2. Acrylontrile (107-13-1) Concentration
Mass
3. Benzene (71-43-2) Concentration
Mass
4. Bromoform (75-25-2) Concentration
Mass
5. Carbon tetrachloride
(56-23-5) Concentration
Mass
6. Chlorobenzene (108-90-7) Concentration
Mass
7. Chlorodibrompmethane (124-48-1) Concentration
Mass
8. Chloroethane (75-00-3)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 4 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 2. Organic Toxic Pollutants (GC/MS Fraction – Volatile Compounds) continued
9. 2-chloroethylvinyl either
(110-75-80) Concentration
Mass
10. Chloroform (67-66-3) Concentration
Mass
11. Dichlorobromomethane (75-27-4) Concentration
Mass
12. 1,1-dichloroethane (75-34-3) Concentration
Mass
13. 1,2-dichloroethane
(78-875) Concentration
Mass
14. 1,1-dichloroethylene (75-35-4) Concentration
Mass
15. 1,2-dichloropropane (78-87-5) Concentration
Mass
16. 1,3-dichloropropylene (542-75-6)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 5 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 2. Organic Toxic Pollutants (GC/MS Fraction – Volatile Compounds) continued
17. Ethylbenzene (100-41-4) Concentration
Mass
18. Methyl bromide (74-83-9) Concentration
Mass
19. Methyl chloride (74-87-3) Concentration
Mass
20. Methylene chloride (75-09-2) Concentration
Mass
21. 1,1,2,2-tetrachloroethane (79-34-5) Concentration
Mass
22. Tetrachloroethlyne (127-18-4) Concentration
Mass
23. Toluene (108-88-3) Concentration
Mass
24.
1,2-trans-
dichloroethylene (156-60-5)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 6 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 2. Organic Toxic Pollutants (GC/MS Fraction – Volatile Compounds) continued
25. 1,1,1-trichloroethane (71-55-6) Concentration
Mass
26. 1,1,2-trichloroethane (79-00-5) Concentration
Mass
27. Trichloroethylene (79-01-6) Concentration
Mass
28. Vinyl chloride (75-01-4) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Continue to Section 3
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 7 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 3. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Acid Compounds)
1. 2-chlorophenol (95-57-8) Concentration
Mass
2. 2,4-dichlorophenol (120-83-2) Concentration
Mass
3. 2,4-dimethylphenol (105-67-9) Concentration
Mass
4. 4,6-dinitro-o-cresol
(534-52-1) Concentration
Mass
5. 2,4-dinitrophenol
(51-28-5) Concentration
Mass
6. 2-nitrophenol (88-75-5) Concentration
Mass
7. 4-nitrophenol (100-02-7) Concentration
Mass
8. p-chloro-m-cresol (59-50-7)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 8 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 3. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Acid Compounds) continued
9. Pentachlorophenol (87-86-5) Concentration
Mass
10. Phenol (108-95-2) Concentration
Mass
11. 2,4,6-trichlorophenol (88-05-2) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Continue to Section 4
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 9 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 4. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Base/Neutral Compounds)
1. Acenaphthene (83-32-9) Concentration
Mass
2. Acenaphthylene (208-96-8) Concentration
Mass
3. Anthracene (120-12-7) Concentration
Mass
4. Benzidine
(92-97-5) Concentration
Mass
5. Benzo (a) anthracene
(56-55-3) Concentration
Mass
6. Benzo (a) pyrene (50-32-8) Concentration
Mass
7. 3,4-benzofluoranthene (205-99-2) Concentration
Mass
8. Benzo (ghi) perylene (191-24-2)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 10 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 4. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Base/Neutral Compounds) continued
9. Benzo (k) fluoranthene (207-08-9) Concentration
Mass
10. Bis (2-chloroethoxy) methane
(111-91-1) Concentration
Mass
11. Bis (2-chloroethyl) ether (111-44-4) Concentration
Mass
12. Bis (2-chloroisopropyl) ether (102-80-1) Concentration
Mass
13. Bis (2-ethylhexyl) phthalate (85-68-7) Concentration
Mass
14. 4-bromophenyl phenyl ether (101-55-3) Concentration
Mass
15. Butyl benzyl phthalate (85-68-7) Concentration
Mass
16. 2-chlorophthalene (91-58-7)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 11 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 4. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Base/Neutral Compounds) continued
17. 4-chlorophenyl phenyl ether (7005-72-3) Concentration
Mass
18. Chrysene (218-01-9) Concentration
Mass
19. Dibenzo (a,h) anthracene (53-70-3) Concentration
Mass
20. 1,2-dichlorobenzene
(95-50-1) Concentration
Mass
21. 1,3-dichlorobenzene
(541-73-1) Concentration
Mass
22. 1,4-dichlorobenzene (106-46-7) Concentration
Mass
23. 3,3-dichlorobenzidine (91-94-1) Concentration
Mass
24. Diethyl phthalate (84-66-2)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 12 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 4. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Base/Neutral Compounds) continued
25. Dimethyl phthalate (131-11-3) Concentration
Mass
26. Di-n-butyl phthalate (84-74-2) Concentration
Mass
27. 2,4-dinotrotoluene (121-14-2) Concentration
Mass
28. 2,6-dinotrotoluene
(121-14-2) Concentration
Mass
29. Di-n-octyl phthalate
(117-84-0) Concentration
Mass
30. 1,2-Diphenylhydrazine (as azobenzene) (122-66-7) Concentration
Mass
31. Fluoranthene (206-44-0) Concentration
Mass
32. Fluorene (86-37-7)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 13 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 4. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Base/Neutral Compounds) continued
33. Hexachlorobenzene (118-74-1) Concentration
Mass
34. Hexachlorobutadiene (87-68-3) Concentration
Mass
35. Hexachlorocyclopentadiene (77-47-4) Concentration
Mass
36. Hexachloroethane
(67-72-1) Concentration
Mass
37. Indeno (1,2,3-cd) pyrene (193-39-5) Concentration
Mass
38. Isophorone (78-59-1) Concentration
Mass
39. Naphthalene (91-20-3) Concentration
Mass
40. Nitrobenzene (98-95-3)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 14 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 4. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Base/Neutral Compounds) continued
41. N-nitrosodimethylamine (62-75-9) Concentration
Mass
42. N-nitrosodi-n-propylamine
(621-64-7) Concentration
Mass
43. N-nitrosodiphenylamine (86-30-6) Concentration
Mass
44. Phenanthrene
(85-01-8) Concentration
Mass
45. Pyrene
(129-00-0) Concentration
Mass
46. 1,2,4-trichlorobenzene (120-82-1) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Continue to Section 5
Division of Water Quality (DWQ)
UPDES Program
UPDES Industrial Permit Application
UPDES Permit No. Facility Name Outfall Number
Table B Page 15 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 5. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Pesticides) continued
1. Aldrin (309-00-2) Concentration
Mass
2. α-BHC (319-84-6) Concentration
Mass
3. β-BHC (319-85-7) Concentration
Mass
4. γ-BHC
(58-89-9) Concentration
Mass
5. δ-BHC
(319-86-8) Concentration
Mass
6. Chlorodane (57-74-9) Concentration
Mass
7. 4,4’-DDT (50-29-3) Concentration
Mass
8. 4,4’-DDE (72-55-9)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
Division of Water Quality (DWQ)
UPDES Program
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Table B Page 16 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 5. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Pesticides) continued
9. 4,4’-DDD (72-54-8) Concentration
Mass
10. Dieldrin (60-57-1) Concentration
Mass
11. α-endosulfan (115-29-7) Concentration
Mass
12. β-endosulfan
(115-29-7) Concentration
Mass
13. Endosulfan sulfate
(1031-07-8) Concentration
Mass
14. Endrin (72-20-8) Concentration
Mass
15. Endrin aldehyde (7421-93-4) Concentration
Mass
16. Heptachlor (76-44-8)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table B Page 17 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 5. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Pesticides) continued
17. Heptachlor epoxide (1024-57-3) Concentration
Mass
18. PCB-1242 (53469-21-9) Concentration
Mass
19. PCB-1254 (11097-69-1) Concentration
Mass
20. PCB-1221
(11104-28-2) Concentration
Mass
21. PCB-1232
(11141-16-5) Concentration
Mass
22. PCB-1248 (12672-29-6) Concentration
Mass
23. PCB-1260 (11096-82-5) Concentration
Mass
24. PCB-1016 (12674-11-2)
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table B Page 18 of 18
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Testing Required
Presence or Absence (check one) Units (specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Section 5. Organic Toxic Pollutants (Gas Chromatography/Mass Spectrometry (GS/MS) Fraction – Pesticides) continued
25. Toxaphene (8001-35-2) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table C Page 1 of 4
Table C. Certain Conventional and Non-Conventional Pollutants 1
Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one)
Units (specify)
Effluent Intake (optional) Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
Check here if you believe all pollutants on Table C to be present in your discharge from the noted outfall. You need not complete the “Presence or Absence” column of Table C for each pollutant.
Check here if you believe all pollutants on Table C to be absent in your discharge from the noted outfall. You need not complete the “Presence or Absence” column of Table C for each pollutant.
1. Bromide (24959-67-9) Concentration
Mass
2. Chlorine, total residual Concentration
Mass
3. Color Concentration
Mass
4. E.coli Concentration
Mass
5. Fluoride (16984-48-8) Concentration
Mass
6. Nitrate Concentration
Mass
7. Nitrite Concentration
Mass
8. Nitrogen, total organic (as N) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table C Page 2 of 4
Table C. Certain Conventional and Non-Conventional Pollutants 1 continued
Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one)
Units
(specify)
Effluent Intake (optional)
Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
9. Oil and Grease Concentration
Mass
10. Phosphorus (as P), total (7723-14-0)
Concentration
Mass
11. Sulfate (as SO4) (14808-798-) Concentration
Mass
12. Sulfide (as S) Concentration
Mass
13. Sulfite (as SO3)
(14265-45-3) Concentration
Mass
14. Surfactants Concentration
Mass
15. Aluminum, total (7429-90-5) Concentration
Mass
16. Barium, total (7440-39-3) Concentration
Mass
17. Boron, total
(7440-42-8) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table C Page 3 of 4
Table C. Certain Conventional and Non-Conventional Pollutants 1 continued
Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one)
Units (specify)
Effluent Intake (optional) Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
18. Cobalt, total
(7440-48-4) Concentration
Mass
19. Iron, total
(7439-89-6) Concentration
Mass
20. Magnesium, total (7439-95-4) Concentration
Mass
21. Molybdenum, total
(7439-95-4) Concentration
Mass
22. Manganese, total
(7439-95-5) Concentration
Mass
23. Tin, total
(7440-31-5) Concentration
Mass
24. Titanium, total
(7440-32-6) Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table C Page 4 of 4
Table C. Certain Conventional and Non-Conventional Pollutants 1 continued
Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one)
Units (specify)
Effluent Intake (optional) Believed Present Believed Absent Maximum Daily Discharge (required)
Maximum Monthly Discharge (if available)
Long-Term Average Daily Discharge (if available)
Number of Analyses Long-Term Average Number of Analyses
25. Radioactivity
Alpha, total Concentration
Mass
Beta, total Concentration
Mass
Radium, total Concentration
Mass
Radium 226, total Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table D Page 1 of 6
Table D. Certain Hazardous Substances and Asbestos 1 Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data (specify units) Believed Present Believed Absent
1. Asbestos
2. Acetaldehyde
3. Allyl alcohol
4. Allyl chloride
5. Amyl acetate
6. Aniline
7. Benzonitrile
8. Benzyl chloride
9. Butyl acetate
10. Butylamine
11. Captan
12. Carbaryl
13. Carbofuran
14. Carbon disulfide
15. Chlorpyrifos
16. Coumaphos
17. Cresol
18. Crotonaldehyde
19. Cyclohexane
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table D Page 2 of 6
Table D. Certain Hazardous Substances and Asbestos 1 continued Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data (specify units) Believed Present Believed Absent
20. 24-D (2,4-dichlorophenoxyacetic acid)
21. Diazinon
22. Dicamba
23. Dichlobenil
24. Dichlone
25. 2,2-dichloropropionic aicd
26. Dichlorvos
27. Diethyl amine
28. Dimethyl amine
29. Dintrobenzene
30. Diquat
31. Disulfoton
32. Diuron
33. Epichlorohydrin
34. Ethion
35. Ethylene diamine
36. Ethylene dibromide
37. Formaldehyde
38. Furfural
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table D Page 3 of 6
Table D. Certain Hazardous Substances and Asbestos 1 continued Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data (specify units) Believed Present Believed Absent
39. Guthion
40. Isoprene
41. Isopropanolamine
42. Kelthane
43. Kepone
44. Malathion
45. Mercaptodimethur
46. Methoxychlor
47. Methyl mercaptan
48. Methyl methacrylate
49. Methyl parathion
50. Mevinphos
51. Mexacarbate
52. Monoethyl amine
53. Monomethyl amine
54. Naled
55. Naphthenic acid
56. Nitrotoluene
57. Parathion
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table D Page 4 of 6
Table D. Certain Hazardous Substances and Asbestos 1 continued Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data (specify units) Believed Present Believed Absent
58. Phenolsulfonate
59. Phosgene
60. Propargite
61. Propylene oxide
62. Pyrethrins
63. Quinoline
64. Resorcinol
65. Strontium
66. Strychnine
67. Styrene
68. 2,4,5-T (2,4,5-trichlorophenoxyacetic acied)
69. TDE (tetrachlorodiphenyl ethane)
70. 2,4,5-TP [2-(2,4,5-triclorophenoxy) propanoic acid]
71. Trichlorofon
72. Triethanolamine
73. Triethylamine
74. Trimethylamine
75. Uranium
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table D Page 5 of 6
Table D. Certain Hazardous Substances and Asbestos 1 continued Pollutant/Parameter (and CAS Number, if available)
Presence or Absence (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data (specify units) Believed Present Believed Absent
76. Vandium
77. Vinyl acetate
78. Xylene
79. Xylenol
80. Zioconium
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required 40 CFR chapter I, subchapter N or O.
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Table D Page 6 of 6
Hazardous Substances
1. Acetaldehyde 2. Acetic acid 3. Acetic anhydride 4. Acetone cyanohydrin 5. Acetyl bromide 6. Acetyl chloride 7. Acrolein 8. Acrylonitrile 9. Adipic acid 10. Aldrin 11. Allyl alcohol 12. Allyl chloride 13. Aluminum sulfate 14. Ammonia 15. Ammonium acetate 16. Ammonium benzoate 17. Ammonium bicarbonate 18. Ammonium bichromate 19. Ammonium bifluoride 20. Ammonium bisulfite 21. Ammonium carbamate 22. Ammonium carbonate 23. Ammonium chloride 24. Ammonium chromate 25. Ammonium citrate 26. Ammonium fluoroborate 27. Ammonium fluoride 28. Ammonium hydroxide 29. Ammonium oxalate 30. Ammonium silicofluoride 31. Ammonium sulfamate 32. Ammonium sulfide 33. Ammonium sulfite 34. Ammonium tartrate 35. Ammonium thiocyanate 36. Ammonium thiosulfate 37. Amyl acetate 38. Aniline 39. Antimony pentachloricle 40. Antimony potassium tartrate 41. Antimony tribromide 42. Antimony trichloride 43. Antimony trifluoride 44. Antimony trioxide 45. Arsenic disulfide 46. Arsenic pentoxide 47. Arsenic trichloride 48. Arsenic trioxide 49. Arsenic trisulfide 50. Barium cyanide 51. Benzene 52. Benzoic acid 53. Benzonitrile
54. Benzoyl chloride 55. Benzyl chloride 56. Beryllium chloride 57. Beryllium fluoride 58. Beryllium nitrate 59. Butylacetate 60. n-butylphthalate 61. Butylamine 62. Butyric acid 63. Cadmium acetate 64. Cadmium bromide 65. Cadmium chloride 66. Calcium arsenate 67. Calcium arsenite 68. Calcium carbide 69. Calcium chromate 70. Calcium cyanide 71. Calcium dodecylbenzenesulfonate 72. Calcium hypochlorite 73. Captan 74. Carbaryl 75. Carbofuran 76. Carbon disulfide 77. Carbon tetrachloride 78. Chlordane 79. Chlorine 80. Chlorobenzene 81. Chloroform 82. Chloropyrifos 83. Chlorosulfonic acid 84. Chromic acetate 85. Chromic acid 86. Chromic sulfate 87. Chromous chloride 88. Cobaltous bromide 89. Cobaltous formate 90. Cobaltous sulfamate 91. Coumaphos 92. Cresol 93. Crotonaldehyde 94. Cupric acetate 95. Cupric acetoarsenite 96. Cupric chloride 97. Cupric nitrate 98. Cupric oxalate 99. Cupric sulfate 100. Cupric sulfate ammoniated 101. Cupric tartrate 102. Cyanogen chloride 103. Cyclohexane 104. 2,4-D acid (2,4-dichlorophenoxyacetic acid)
105. 2,4-D esters (2,4-dichlorophenoxyacetic acid esters) 106. DDT 107. Diazinon 108. Dicamba 109. Dichlobenil 110. Dichlone 111. Dichlorobenzene 112. Dichloropropane 113. Dichloropropene 114. Dichloropropene-dichloproropane mix 115. 2,2-dichloropropionic acid 116. Dichlorvos 117. Dieldrin 118. Diethylamine 119. Dimethylamine 120. Dinitrobenzene 121. Dinitrophenol 122. Dinitrotoluene 123. Diquat 124. Disulfoton 125. Diuron 126. Dodecylbenzesulfonic acid 127. Endosulfan 128. Endrin 129. Epichlorohydrin 130. Ethion 131. Ethylbenzene 132. Ethylenediamine 133. Ethylene dibromide 134. Ethylene dichloride 135. Ethylene diaminetetracetic acid (EDTA) 136. Ferric ammonium citrate 137. Ferric ammonium oxalate 138. Ferric chloride 139. Ferric fluoride 140. Ferric nitrate 141. Ferric sulfate 142. Ferrous ammonium sulfate 143. Ferrous chloride 144. Ferrous sulfate 145. Formaldehyde 146. Formic acid 147. Fumaric acid 148. Furfural 149. Guthion 150. Heptachlor 151. Hexachlorocyclopentadiene 152. Hydrochloric acid 153. Hydrofluoric acid 154. Hydrogen cyanide
155. Hydrogen sulfide 156. Isoprene 157. Isopropanolamine dodecylbenzenesulfonate 158. Kelthane 159. Kepone 160. Lead acetate 161. Lead arsenate 162. Lead chloride 163. Lead fluoborate 164. Lead fluorite 165. Lead iodide 166. Lead nitrate 167. Lead stearate 168. Lead sulfate 169. Lead sulfide 170. Lead thiocyanate 171. Lindane 172. Lithium chromate 173. Malathion 174. Maleic acid 175. Maleic anhydride 176. Mercaptodimethur 177. Mercuric cyanide 178. Mercuric nitrate 179. Mercuric sulfate 180. Mercuric thiocyanate 181. Mercurous nitrate 182. Methoxychlor 183. Methyl mercaptan 184. Methyl methacrylate 185. Methyl parathion 186. Mevinphos 187. Mexacarbate 188. Monoethylamine 189. Monomethylamine 190. Naled 191. Naphthalene 192. Naphthenic acid 193. Nickel ammonium sulfate 194. Nickel chloride 195. Nickel hydroxide 196. Nickel nitrate 197. Nickel sulfate 198. Nitric acid 199. Nitrobenzene 200. Nitrogen dioxide 201. Nitrophenol 202. Nitrotoluene 203. Paraformaldehyde 204. Parathion 205. Pentachlorophenol 206. Phenol
207. Phosgene 208. Phosphoric acid 209. Phosphorus 210. Phosphorus oxychloride 211. Phosphorus pentasulfide 212. Phosphorus trichloride 213. Polychlorinated biphenyls (PCB) 214. Potassium arsenate 215. Potassium arsenite 216. Potassium bichromate 217. Potassium chromate 218. Potassium cyanide 219. Potassium hydroxide 220. Potassium permanganate 221. Propargite 222. Propionic acid 223. Propionic anhydride 224. Propylene oxide 225. Pyrethrins 226. Quinoline 227. Resorcinol 228. Selenium oxide 229. Silver nitrate 230. Sodium 231. Sodium arsenate 232. Sodium arsenite 233. Sodium bichromate 234. Sodium bifluoride 235. Sodium bisulfite 236. Sodium chromate 237. Sodium cyanide 238. Sodium dodecylbenzenesulfonate 239. Sodium fluoride 240. Sodium hydrosulfide 241. Sodium hydroxide 242. Sodium hypochlorite 243. Sodium methylate 244. Sodium nitrite 245. Sodium phosphate (dibasic) 246. Sodium phosphate (tribasic) 247. Sodium selenite 248. Strontium chromate 249. Strychnine 250. Styrene 251. Sulfuric acid 252. Sulfur monochloride 253. 2,4,5-T acid (2,4,5-trichlorophenoxyacetic acid) 254. 2,4,5-T amines (2,4,5-trichlorophenoxy acetic acid amines)
255. 2,4,5-T esters (2,4,5-trichlorophenoxy acetic acid esters) 256. 2,4,5-T salts (2,4,5-trichlorophenoxy acetic acid salts) 257. 2,4,5-TP acid (2,4,5-trichlorophenoxy propanoic acid) 258. 2,4,5-TP acid esters (2,4,5-trichlorophenoxy propanoic acid esters) 259. TDE (tetrachlorodiphenyl ethane) 260. Tetraethyl lead 261. Tetraethyl pyrophosphate 262. Thallium sulfate 263. Toluene 264. Toxaphene 265. Trichlorofon 266. Trichloroethylene 267. Trichlorophenol 268. Triethanolamine dodecylbenzenesulfonate 269. Triethylamine 270. Trimethylamine 271. Uranyl acetate 272. Uranyl nitrate 273. Vanadium penoxide 274. Vanadyl sulfate 275. Vinyl acetate 276. Vinylidene chloride 277. Xylene 278. Xylenol 279. Zinc acetate 280. Zinc ammonium chloride 281. Zinc borate 282. Zinc bromide 283. Zinc carbonate 284. Zinc chloride 285. Zinc cyanide 286. Zinc fluoride 287. Zinc formate 288. Zinc hydrosulfite 289. Zinc nitrate 290. Zinc phenolsulfonate 291. Zinc phosphide 292. Zinc silicofluoride 293. Zinc sulfate 294. Zirconium nitrate 295. Zirconium potassium fluoride 296. Zirconium sulfate 297. Zirconium tetrachloride
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Table E Page 1 of 1
Table E. 2,3,7,8 Tetrachlorodibenzo P Dioxin (2,3,7,8 TCDD) Pollutant
TCDD Congeners Used or Manufactured
Presence or Absence (check one) Results of Screening Procedure Believed Present Believed Absent
1. 2,3,7,8-TCDD