GENERAL INSTRUCTIONS
Please complete the attached form and return it by _____________________________ to the following address:
If you have any questions, please contact the following person(s):
SPECIFIC INSTRUCTIONS
Item
1.
A.-H.
Provide all requested information about the facility producing the discharge of wastewaters.
Item 2. A.
-8. Provide a listing of all primary raw materials and chemicals used in the facility's operations. Avoid use
of trade names of chemicals. If trade names are u
sed, provide information regarding the active ingredients.
C.
Self-explanatory
D.
List each regulated process, t
he production rate (i.e., 10,000 lbs. of (product name)/year), the category and
subpart of the applicable Categorical Pretreatment Standard as well as the SIC code for each process.
Item 3. A. Provide the total plant flow rate (average and maximum) to the sanitary sewer in gallons per day (gpd). If
accurate flow measurements are unavailable, provide the best estimate.
B.
Provide a breakdown of the sources of the total plant flow to the sanitary sewer including regulated and
nonregulated flows, sanitary wastewater, cooling water, etc. Also indicate the flow rate (gpcl) and the type of
discharge (batch, continuous or none).
C.
In order to provide the reviewing agency a complete understanding of the facility's processes, location of
pretreatment facilities and sampling points, the discharger is required to submit a schematic of each process
and a schematic of wastewater flows. Flow rates may be estimated. Refer to Figures 1 and 2 for example
schematics. Be sure to indicate on the flow or process schematic where samples are taken.
D.
Self-explanatory
Item 4. A. The facility
must
sample, analyze and report the concentration of all regulated pollutants for the regu
lated processes. If the flow of the wastestream being sampled
if less than or equal to
250,000
gallons per day, at
least three samples within a two-week period m us t be collected and analyzed. If the flow is greater than
250,000 gallons per day, at least six samples must be collected and analyzed within a two week period. [In any
case, all samples must be representative of normal operations and be of sufficient number to allow
comparison with the applicable Categorical Pretreatment Standard. Samples should be collected immediately
after the regulated process (after treatment, if applicable) before being combined with other wastestreams.
Type of sample (i.e., gr ab, composite), sample location, number of samples and methods of analysis should be
adequately described. If analytical data is provided for more than one sampling point, identify the location of
all sampl ing points in the schematic diagram required in question 3.C above.
B.
If the facility is unable to sample the wastewater from the regulated processes before being mixed with
other wastewater flows, the facility may sample the total plant flow and calculate an equivalent concentration
limit using the combined wastestream formula. These results may be shown in Part 48. Figure 3 provides
information on the use of the combined wastestream formula.
Item 5, 6, 7, 8 and 9 - Self-explanatory
Item 10. This report must be signed by an authorized representative, which may include a principal executive officer
of at least the level of vice president;
a general partner or proprietor; or
a duly auth
orized representative
that is responsible for the overall operation of the facility.
49-238-791
INDUSTRIAL USER BASELINE MONITORING REPORT
Dept. of Industrial Monitoring
7472 Cochran Road, College Park, GA 30349
404-612-0212-office
404-612-2931-fax
ngozi.daramola@fultoncountyga.gov
INDUSTRIAL USER BASELINE MONITORING REPORT
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