EPA FORM 3510-6 (Revised 09-2008) Page 6 of 7
question then you have a 30 day waiting period before you are authorized to
discharge. If you select “no” to this question and you post your SWPPP on the
Internet and provide EPA the URL in E.2, then you have a 30 day waiting period
before you are authorized to discharge. If you select “no” to this question, but do
not post your SWPPP on the Internet and therefore do not answer E.2, then you
have a 60 day waiting period before you are authorized to discharge.
3.a-e. Enter the street address, including city, state, zip code, county or similar
government subdivision of the actual physical location of the facility. Do not use
a P.O. Box.
3.f-g. Provide the facility latitude and longitude in one of three formats: (1) degrees,
minutes, seconds; (2) degrees, minutes, decimal; or(3) degrees decimal. You
can obtain your facility’s latitude and longitude though Global Positioning
System (GPS) receivers, U.S. Geological Survey (USGS) quadrangle or
topographic maps, and EPA’s web-based siting-tools, among other methods.
Refer to www.epa.gov/npdes/stormwater/msgp
for guidance on the use of these
methods. For consistency, EPA requests you take measurements from the
location of your facility’s stormwater outfall. Outfalls are locations where the
stormwater exits the facility, including pipes, ditches, swales, and other
structures that transport stormwater. If there is more than one outfall present,
measure at the primary outfall (i.e., the outfall with the largest volume of
stormwater discharge associated with industrial activity).
3.h. Identify the data source that you used to determine the facility latitude and
longitude. If you did not use a USGS quadrangle or topographic map, the EPA
website, or GPS receivers, then select “Other” and write the method used on
the line provided. If you used a USGS quadrangle or topographic map, write the
map scale on the line provided. Scale should be identified on the map.
4. Enter the estimated area of industrial activity at your site exposed to
stormwater, in acres.
5. Indicate if the facility is considered a “federal facility” - Federal facilities include
any buildings, installations, structures, land, public works, equipment, aircraft,
vessels, and other vehicles and property, owned or leased by the federal
government.
6. Indicate whether the facility is located in Indian Country, and, if so, provide the
name of the reservation, if applicable.
Section D. Discharge Information
1. Indicate whether stormwater from your site will be discharged into a municipal
separate storm sewer system (MS4). An MS4 is a conveyance or system of
conveyances, including roads with drainage systems, municipal streets, catch
basins, storm drains, curbs and gutters, ditches and man-made channels,
owned or operated by a state, city, town, borough, county, parish, district,
association or other public body, used to collect or convey stormwater. If you
check “Yes” then identify the name of the MS4 operator on the line provided. If
you are uncertain of the MS4 operator, contact your local government for that
information. MS4s are different than combined sewers, which are designed to
convey both stormwater and sanitary wastewater. Discharges to combined
sewers do not require an NPDES permit but may be subject to other CWA
requirements (contact the combined sewer operator for more information).
2. Enter information regarding your discharge. If additional space is needed fill out
Attachment
1.
2a. Indicate
in column “a” of the table the name(s) of the receiving water(s) into
which stormwater from your facility will discharge. Also provide in parentheses
the name of the impaired water (and segment, if applicable) into which your
stormwater is discharged. If you identified more than on receiving water for your
facility, indicate the first receiving water and complete question 2b and 2.b.1-3 (if
applicable), before entering the next receiving water. The EPA’s Water Locator
Tool can help you identify the closest receiving water to your facility
(
www.epa.gov/npdes/msgp
). Your receiving water may be a lake, stream, river,
ocean, wetland or other waterbody, and may or may not be located adjacent to
your facility. Your stormwater may discharge directly to the receiving water or
indirectly via a storm sewer system, an open drain or ditch, or other conveyance
structure. Do NOT list a man-made conveyance, such as a storm sewer system,
as your receiving water. Indicate the first receiving water your stormwater
discharge enters. For example, if your discharge enters a storm sewer system,
that empties into Trout Creek, which flows into Pine River, your receiving water is
Trout Creek, because it is the first waterbody your discharge will reach. Similarly,
a discharge into a ditch that feeds Spring Creek should be identified as “Spring
Creek” since the ditch is a manmade conveyance. If you discharge into a
municipal separate storm sewer system (MS4), you must identify the waterbody
into which that portion of the storm sewer discharges. That information should be
readily available from the operator of the MS4.
2b. Indicate in column “b” of the table whether you discharge directly to an impaired
water (lake, stream segment, estuary, etc), listed as “impaired” under section
303(d) of the Clean Water Act. Each state water quality agency maintains a list of
waters that are impaired. Most state agencies publish these lists online. The
EPA’s Water Locator Tool may also help you identify if the nearest receiving
water is impaired (www.epa.gov/npdes/msgp
). If you discharge into a stream
segment that is upstream of a listed impaired water but which is not itself on the
State’s impaired waters list, answer “no” to this question. In this case,
requirements in the MSGP for discharges into impaired waters do not apply to
you, unless notified otherwise by EPA.
Answer the following three questions only if you answered “Yes” to D 2.b:
2b1. Provide the pollutant(s) listed as causing the impairment in the water identified
in D.2.b.1 above. Enter each pollutant individually on a separate row in the
table.
2b2. Out of the pollutant(s) that you identified in D.2.b.1 above, indicate which
pollutants you believe will be present in your discharge. If you do not expect the
pollutant(s) to be in your discharge, then select “no.”
2b3.Indicate the pollutant(s) that have a Total Maximum Daily Load (TMDL) for the
impaired stream segment that you identified in D.2.b.2 above. Check with your
state water quality agency for lists of waters with approved or established
TMDLs. See www.epa.gov/npdes/msgp
for more information.
3. Water Quality Standards
3a.If you selected “no” in C.2 indicating that stormwater discharges from your facility
have not been previously covered under an NPDES permit, then you are
considered a new discharger and must answer this question; otherwise you are
considered an existing discharger and may skip this question. State water
quality agencies are responsible for setting water quality standards for waters
within the state’s boundaries. Check EPA’s website (www.epa.gov/npdes/msgp
)
to determine if the water(s) that you discharge into are designated as a “Tier 2
(or Tier 2.5) water” (See Appendix A of the MSGP 2008 for definitions of “Tier 2
water” and “Tier 2.5 water”). If you discharge into these waters, EPA may impose
additional permit conditions to ensure that you do not violate the State’s
antidegradation policy.
3.b Idenitfy whether your receiving water is designated as a Tier 3 waterbody. Go to
www.epa.gov/npdes/msgp
for a list of Tier 3 waterbodies. Note that new
discharges into designated Tier 3 waters are not eligible for coverage under the
MSGP 2008.
4. Federal Effluent Limitation Guidelines and Sector-Specific Requirements
4.a-b. Depending on your industrial activities, your facility may be subject to effluent
limitation guidelines which include additional effluent limits and monitoring
requirements for your facility. Please review these requirements, described in
Part 2.1.3 of the MSGP, and check any appropriate boxes on the NOI form.
4.c. For Sector S facilities (Air Transportation), indicate whether you anticipate that
the entire airport facility will use more than 100,000 gallons of glycol-based
deicing/anti-icing chemicals and/or 100 tons or more of urea on an average
annual basis. If so, additional effluent limits and monitoring conditions apply to
your discharge (see Part 8 Sector S of the MSGP 2008).
5. List the four-digit Standard Industrial Classification (SIC) code and/or two
character activity code that best describes the primary industrial activities
performed by your facility under which you are required to obtain permit
coverage. Your primary industrial activity includes any activities performed on-
site which are (1) identified by the facility’s one SIC code for which the facility is
primarily engaged; and (2) included in the narrative descriptions of 40 CFR
122.26(b)(14)(i), (iv), (v), or (vii), and (ix). See Appendix D of the MSGP for a
complete list of SIC codes and activities codes.
6. If your site has co-located industrial activities that are not identified as your
primary industrial activity, identify the sector and subsector codes that describe
these other industrial activities. For a complete list of sector and subsector
codes, see Appendix D of the MSGP.
7.a-b Indicate whether your facility is currently inactive and unstaffed. If so then
indicate whether your facility will be inactive and unstaffed for the entire permit
term, or if not, specify the specific length of time in units of days, weeks, months,
or years (e.g. 3 months) that you expect the facility to be inactive and unstaffed.
Section E. Facility Contact Information and SWPPP Location
1.a-c. Identify the name, telephone number, and email address of the person who
will serve as a contact for EPA on issues related to stormwater management at
your facility. This person should be able to answer questions related to
stormwater discharges, the SWPPP, and other issues related to stormwater
permit coverage, or have immediate access to individuals with that knowledge.
This person does not have to be the facility operator, but should have intimate
knowledge of stormwater management activities at the facility.
2. If you are making your Stormwater Pollution Prevention Plan publicly available
on a website provide the appropriate Internet URL address. (Please note that by
posting your SWPPP on the web, you may qualify for a shortened authorization
waiting period. See Table 1-2 of the MSGP for more information.)
Section F. Endangered Species Protection
1. Based on the instruction provided in Appendix E of the MSGP 2008, indicate
which permit criterion (A,B,C,D,E, or F) listed in Part 1.1.4.5 you are using to
satisfy your eligibility obligations for protection of endangered and threatened
species, and designated critical habitat.