3510-2F NPDES Application Form 2F

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United States
Environmental Protection Agency

Office of Water
Washington, D.C.

OMB No. 2040-0004
Expires MM/DD/YYYY

Water Permits Division

Application Form 2F
Stormwater Discharges
Associated with Industrial
Activity
NPDES Permitting Program

Note: Complete this form and Form 1 if you are a new or existing facility whose discharge is composed
entirely of stormwater associated with industrial activity, excluding discharges from construction
activity under 40 CFR 122.26(b)(14)(x) or (b)(15). If your discharge is composed of stormwater and
non-stormwater, you must complete Forms 1 and 2F, and you must complete Form 2C, 2D, or 2E, as
appropriate. See the “Instructions” inside for further details.

Paperwork Reduction Act Notice
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C.
3501 et seq. (OMB Control No. 2040-0004). Responses to this collection of information are mandatory
(40 CFR 122.21 and 40 CFR 122.26). An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control
number. The public reporting and recordkeeping burden for this collection of information is estimated to
be 2.7 hours per response. Send comments on the Agency’s need for this information, the accuracy of
the provided burden estimates and any suggested methods for minimizing respondent burden to the
Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200
Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any
correspondence. Do not send the completed form to this address.

FORM 2F—INSTRUCTIONS
Public Availability of Submitted Information

General Instructions
Who Must Complete Form 2F?

The U.S. Environmental Protection Agency (EPA) will make
information from NPDES permit application forms available to
the public for inspection and copying upon request. You may not
claim any information on Form 2F (or related attachments) as
confidential.

You must complete Form 2F if you answered “Yes” to Item 1.2.5
on Form 1—that is, you are a new or existing facility and your
discharge is composed entirely of stormwater associated with
industrial activity (excluding discharges from construction
activity under 40 CFR 122.26(b)(14)(x) or (b)(15)) or composed
of stormwater and non-stormwater and are seeking coverage
under an individual National Pollutant Discharge Elimination
System (NPDES) permit. Note that applicants in the latter
category must also complete Forms 2C, 2D, or 2E, as
applicable. See inset below.

You may make a claim of confidentiality for any information that
you submit to EPA that goes beyond the information required by
Form 2F. Note that NPDES permitting authorities will deny
claims for treating any effluent data (estimated or actual) as
confidential. If you do not assert a claim of confidentiality at the
time you submit your information to the NPDES permitting
authority, EPA may make the information available to the public
without further notice to you. EPA will handle claims of
confidentiality in accordance with its business confidentiality
regulations in Part 2 of Title 40 of the Code of Federal
Regulations (CFR).

Notes
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•

•

Form 2F must be completed by any operator of a
facility that discharges stormwater associated with
industrial activity or the operator of any
stormwater discharger that EPA is evaluating for
designation as a significant contributor of
pollutants to waters of the United States, or as
contributing to a violation of a water quality
standard.
For discharges composed entirely of stormwater,
the operator must complete Form 2F in
conjunction with Form 1.
For discharges of stormwater combined with
process wastewater, the operator must complete
and submit Form 2F, Form 1, and Form 2C.
Process wastewater is water that comes into
direct contact with or results from the production
or use of any raw material, intermediate product,
finished product, byproduct, waste product, or
wastewater.
For discharges of stormwater combined with
nonprocess wastewater, the operator must
complete Form 2F, Form 1, and Form 2E.
Nonprocess wastewater includes noncontact
cooling water and sanitary wastes that are not
regulated by effluent guidelines, except
discharges by educational, medical, or
commercial chemical laboratories.
For new discharges of stormwater associated with
industrial activity that will be combined with other
new non-stormwater discharges, the operator
must submit Form 2F, Form 1, and Form 2D.

Completion of Forms
Print or type in the specified areas only. If you do not have
enough space on the form to answer a question, you may
continue on additional sheets, as necessary, using a format
consistent with the form.
Do not leave any response areas blank unless the form directs
you to skip them. If the form directs you to respond to an item
that does not apply to your facility or activity, enter “NA” for “not
applicable” to show that you considered the item and
determined a response was not necessary for your facility.
The NPDES permitting authority will consider your application
complete when it and any supplementary material are received
and completed according to the authority’s satisfaction. The
NPDES permitting authority will judge the completeness of any
application independently of the status of any other permit
application or permit for the same facility or activity.
Definitions
The legal definitions of all key terms used in these instructions
and Form 2F are in the “Glossary” at the end of the “General
Instructions” in Form 1.
Line-by-Line Instructions
EPA Identification Number, NPDES Permit Number, Facility
Name, and Outfall Number
Provide your EPA Identification Number from the Facility
Registry Service, NPDES permit number, and facility name at
the top of each page of Form 2F and any attachments. If your
facility is new (i.e., not yet constructed), write or type “New
Facility” in the space provided for the EPA Identification Number
an NPDES permit number. If you do not know your EPA
Identification Number, contact your NPDES permitting authority.
See Exhibit 1–1 of Form 1’s “General Instructions” for contact
information. Additionally, for Tables A through D, provide the
applicable outfall number at the top of each page.

Where to File Your Completed Form
Submit your completed application package (Forms 1 and 2F
plus any other applicable forms) to your NPDES permitting
authority. Consult Exhibit 1–1 of Form 1’s “General Instructions”
to identify your NPDES permitting authority.

2F-1

FORM 2F—INSTRUCTIONS (CONTINUED)
Section 1. Outfall Location
Item 1.1. Identify each of the facility’s outfalls by number. For
each outfall, specify the latitude and longitude to the nearest 15
seconds or equivalent decimal degrees (e.g., 38.893829, 77.029289) and name of the receiving water. Latitude and
longitude coordinates may be obtained in a variety of ways,
including use of hand held devices (e.g., a GPS enabled
smartphone), internet mapping tools, geographic information
systems (e.g., ArcView), or paper maps from trusted sources
(e.g., U.S. Geological Survey or USGS). The location of each
outfall (i.e., where the coordinates are collected) shall be the
location where collected and concentrated stormwater flows are
discharged from the facility such that the first receiving water
body into which the discharge flows, either directly or through a
separate storm sewer system, is a water of the United States. If
you need further guidance in responding to Item 1.1, refer to
http://www.epa.gov/geospatial/latitudelongitude-data-standard.

an outline of drainage areas served by the outfall(s) covered in
the application. The site map must include the following
information:
• Each of its drainage and discharge structures.
• The drainage area of each stormwater outfall.
• Paved areas and buildings within the drainage area of each
stormwater outfall; each past or present area used for
outdoor storage or disposal of significant materials; each
existing structural control measure to reduce pollutants in
stormwater runoff; materials loading and access areas; and
areas where pesticides, herbicides, soil conditioners, and
fertilizers are applied.
Each hazardous waste treatment, storage, or disposal
facility (including each area not required to have a
Resource Conservation and Recovery Act permit and is
used for accumulating hazardous waste for less than 90
days under 40 CFR 262.34).
• Each well where fluids from the facility are injected
underground.
• Springs and other surface water bodies that receive
stormwater discharges from the facility.
When you have completed and attached your site map to Form
2F, answer “Yes” to Item 3.1.
•

Note: In EPA’s stormwater permits, “outfalls” are referred to as
“discharge points.”
Note that space has been provided on the form for six outfalls. If
you have more than this number, type your information on a
separate sheet of paper in a format similar to that of the form.
Make sure you note the EPA Identification Number, NPDES
permit number, and facility name at the top of the page and
indicate the specific item of the form to which you are
responding—Item 1.1 in this case. In other sections of the form,
you will be asked to provide information by outfall number
(Sections 2, 4, 5, and 7).

Section 4. Pollutant Sources
Item 4.1. List all outfalls discharging stormwater. Provide an
estimate of the impervious surface area drained by the outfall.
Specify units of measure. (Impervious surfaces are surfaces
where stormwater runs off at rates significantly higher than
background rates—e.g., predevelopment levels. They include
paved areas, building roofs, parking lots, and roadways.)

Section 2. Improvements
Item 2.1. Indicate if you are required by any federal, state, or
local authority to meet an implementation schedule for
constructing, upgrading, or operating wastewater treatment
equipment or practices or any other environmental programs
that could affect the discharges described in this application.
The requirements include, but are not limited to, permit
conditions, administrative enforcement orders, enforcement
compliance schedule letters, stipulations, court orders, and
grant or loan conditions. If yes, continue to Item 2.2. If no, skip
to Section 3.

Provide an estimate of the total surface area (impervious and
pervious areas) drained by each outfall (within a mile radius of
the facility). You may use the site map developed under Item 3.1
to estimate the total area drained by each outfall. For areas
under 5 acres, consult your NPDES permitting authority to
determine whether the area should be reported to the nearest
tenth of an acre or nearest quarter of an acre.
Item 4.2. Provide a narrative description of the following:

Item 2.2. Briefly identify and describe each applicable project
(e.g., consent decree, enforcement order, or permit condition).
For each condition, specify the affected outfall number(s), the
source(s) of the discharge, the required final compliance date,
and the projected final compliance date.

•

•

Item 2.3. OPTIONAL ITEM. Indicate if you have attached any
sheets describing any additional water pollution control
programs (or other environmental projects that could affect your
discharges) that you may now have underway or planned. If you
attach additional sheets, indicate in the attachment whether
each program is actually underway or is planned, and indicate
your actual or planned schedule for construction. Be sure to
note your EPA Identification Number, NPDES permit number,
and facility name at the top of any attached pages.

•

•
•

Significant materials that in three years prior to the
submittal of this application have been treated, stored, or
disposed of in a manner to allow exposure to stormwater.
Method of treatment, storage, or disposal of such
materials.
Materials management practices employed, in the three
years prior to the submittal of this application, to minimize
contact by these materials with stormwater runoff.
Materials loading and access areas.
The location, manner, and frequency in which pesticides,
herbicides, soil conditioners, and fertilizers are applied.

You should identify your significant materials by chemical name,
form (e.g., powder, liquid), and type of container or treatment
unit. Indicate any materials treated, stored, or disposed of
together. The term “significant materials” includes, but is not

Section 3. Site Drainage Map
Item 3.1 Attach a site drainage map showing the topography of
the facility. If a topographic map is unavailable, you may provide
2F-2

FORM 2F—INSTRUCTIONS (CONTINUED)
limited to: raw materials; fuels; materials such as solvents,
detergents, and plastic pellets; finished materials such as
metallic products; raw materials used in food processing or
production; hazardous substances designated under Section
101(14) of the Comprehensive Environmental Response,
Compensation, and Liability Act; any chemical the facility is
required to report pursuant to Section 313 of Title III of the
Superfund Amendments and Reauthorization Act; and fertilizers;
pesticides; and waste products such as ashes, slag, and sludge
that have the potential to be released with stormwater
discharges.
Item 4.3. For each outfall, list the location and type of existing
structural and non-structural control measure(s) to reduce
pollutants in stormwater runoff. Structural controls include
structures that enclose materials handling or storage areas;
structures that cover materials; and berms, dikes, or diversion
ditches around manufacturing, production, storage, or treatment
units and retention ponds. Spill prevention plans, employee
training, visual inspections, preventive maintenance, and
housekeeping measures are examples of non-structural
controls.

parameters and pollutants listed in Exhibits 2F–2, 2F–3, and
2F–4 (at the end of the instructions). The instructions for
completing Tables A through D are table-specific, as are the
criteria for determining who should complete them.
Important note: Read the “General Instructions for Reporting,
Sampling, and Analysis” below before completing Items 7.2 to
7.17.
Item 7.2 and Table A. All applicants must complete Table A. If
the discharge is an existing discharge and your discharge is
composed exclusively of stormwater (i.e., no process or
nonprocess wastewater) then you only need to provide
monitoring data for oil and grease, total phosphorus, total
Kjeldahl nitrogen, and total nitrogen. Indicate “NA” for “not
applicable” in the columns for all other parameters. Answer
“Yes” to Item 7.2 once you have completed this task.
Item 7.3 and Table B. Indicate whether the facility is subject to
an effluent limitations guideline (ELG) (see 40 CFR Subchapter
N to determine which pollutants are limited in ELGs) or if the
facility is subject to effluent limitations in an NPDES permit for
its process wastewater or stormwater (if the facility is operating
under an existing NPDES permit). If yes, continue to Item 7.4. If
no, skip to Item 7.5.

Describe the treatment, including the schedule and type of
maintenance activities performed, and the ultimate disposal of
any solid or fluid wastes other than by discharge. For each
structural control identified, indicate the type of treatment the
stormwater receives using the codes in Exhibit 2F–1, at the end
of the instructions. For each non-structural control identified,
indicate “Not Applicable” in the “Codes from Exhibit 2F–1”
column.

Note: Stormwater discharges from certain industrial sources or
activities have specific ELGs for which they must comply. These
stormwater-specific ELGs include:
Regulated Discharge
Discharges resulting from spraydown or
intentional wetting of logs at wet deck storage
areas
Runoff from phosphate fertilizer manufacturing
facilities that comes into contact with any raw
materials, finished product, byproducts, or
waste products (SIC 2874)
Runoff from asphalt emulsion facilities

Section 5. Non-Stormwater Discharges
Item 5.1. Provide a certification that all outfalls that should
contain stormwater discharges associated with industrial activity
have been tested or evaluated for the presence of nonstormwater discharges. Tests for such non-stormwater
discharges can include smoke tests, fluorometric dye tests,
analysis of accurate schematics, and others.

Runoff from material storage piles at cement
manufacturing facilities
Mine dewatering discharges at crushed stone,
construction sand and gravel, or industrial sand
mining facilities
Runoff from hazardous waste and nonhazardous waste landfills

Item 5.2. Include a description of the method used, the date of
any testing, and the onsite drainage points that were directly
observed during a test used to support the certification in Item
5.1. All non-stormwater discharges must be identified in a Form
2C, 2D, or 2E. See “Who Must Complete Form 2F?” above for
more information.
Section 6. Significant Leaks or Spills
Item 6.1. Describe any significant leaks or spills of toxic or
hazardous pollutants at the facility within the three years prior to
the submittal of this application. Include the approximate date
and location of the spill or leak and the type and amount of
material released.

Runoff from coal storage piles at steam electric
generating facilities
Runoff containing urea from airfield pavement
deicing at existing and new primary airports
with 1,000 or more annual non-propeller
aircraft departures

Section 7. Discharge Information
Item 7.1. Answer whether you are a new source or new
discharge. Contact your NPDES permitting authority to
determine if you are a new source or new discharge.

40 CFR Section
Part 429,
Subpart I
Part 418,
Subpart A
Part 443,
Subpart A
Part 411,
Subpart C
Part 436,
Subparts B, C,
and D
Part 445,
Subparts A and
B
Part 423
Part 449

Item 7.4. In Table B, list all pollutants that are limited in an ELG
to which the facility is subject and all pollutants listed in the
facility's NPDES permit for its process wastewater (if the facility
is operating under an existing NPDES permit) and provide
quantitative data for each pollutant (provide actual data for
existing dischargers and estimated data for new sources and
new dischargers). If a pollutant in Exhibits 2F–2 or 2F–3 is

Tables A, B, C, and D
Items 7.2 to 7.17. These items require you to collect and report
data in Tables A through D, at the end of Form 2F, for the
2F-3

FORM 2F—INSTRUCTIONS (CONTINUED)
Item 7.10. Indicate whether you expect any of the pollutants
from Exhibit 2F–3 to be discharged in concentrations of 10 parts
per billion (ppb) or greater. If yes, continue to Item 7.11. If no,
skip to Item 7.12.

indirectly limited by an ELG through an indicator (e.g., use of
total suspended solids as an indicator to control the discharge of
iron and aluminum), you must provide data for the pollutant in
Table B. Complete one table for each outfall. Answer “Yes” to
Item 7.4 once you have completed this task.

Item 7.11. Provide quantitative data in Table C for those
pollutants in Exhibit 2F–3 that you expect to be discharged in
concentrations of 10 ppb or greater (provide actual data for
existing dischargers and estimated data for new sources and
new dischargers). Answer “Yes” to Item 7.11 once you have
completed this task.

Item 7.5 and Table C. Table C requires you to address the
pollutants in Exhibits 2F–2, 2F–3, and 2F–4 for each outfall.
Pollutants in each of these exhibits are addressed differently.
Indicate whether you know or have reason to believe any
pollutants in Exhibit 2F–2 are present in the discharge. If yes,
continue to Item 7.6. If no, skip to Item 7.7.

Item 7.12. Indicate whether you expect acrolein, acrylonitrile,
2,4-dinitrophenol, or 2-methyl-4,6-dinitrophenol to be discharged
in concentrations of 100 ppb or greater. If yes, continue to Item
7.13. If no, skip to Item 7.14.

Item 7.6. For each outfall, list all pollutants in Exhibit 2F–2 that
you know or have reason to believe are present in the discharge
in Table C (except pollutants previously listed in Table B that are
limited directly or indirectly by an ELG) and either report
quantitative data or briefly describe the reasons the pollutant is
expected to be discharged. Answer “Yes” to Item 7.6 once you
have completed this task.

Item 7.13. Provide quantitative data in Table C for the pollutants
identified in Item 7.12 that you expect to be discharged in
concentrations of 100 ppb or greater (provide actual data for
existing dischargers and estimated data for new sources and
new dischargers). Answer “Yes” to Item 7.13 once you have
completed this task.

Item 7.7. This item asks if you qualify as a “small business.” If
so, you are exempt from the reporting requirements for the
organic toxic pollutants listed in Exhibit 2F–3.

Item 7.14. For any pollutants you expect to be present in the
discharge at concentrations less than 10 ppb (or less than
100 ppb for the above four pollutants), either submit quantitative
data or briefly describe the reasons the pollutant is expected to
be discharged in Table C. Answer “Yes” to Item 7.14 once you
have completed this task.

You can qualify as a small business in two ways: (1) if your
facility is a coal mine and if your probable total annual
production is less than 100,000 tons per year, you may submit
past production data or estimated future production (such as a
schedule of estimated total production under 30 CFR 795.14(c))
instead of conducting analyses for the organic toxic pollutants;
(2) if your facility is not a coal mine and if your gross total annual
sales for the most recent three years average less than
$100,000 per year (in second quarter 1980 dollars), you may
submit sales data for those years instead of conducting
analyses for the organic toxic pollutants. The production or sales
data must be for the facility that is the source of the discharge.
The data should not be limited to production or sales for the
process or processes that contribute to the discharge, unless
those are the only processes at your facility. For sales data, in
situations involving intra-corporate transfer of goods and
services, the transfer price per unit should approximate market
prices for those goods and services as closely as possible.
Sales figures for years after 1980 should be indexed to the
second quarter of 1980 by using the gross national product price
deflator (second quarter of 1980 = 100). This index is available
online from the U.S. Department of Commerce, Bureau of
Economic Analysis, at
https://apps.bea.gov/national/pdf/SNTables.pdf.

Item 7.15. Indicate whether you know or have reason to believe
any pollutants in Exhibit 2F–4 are present in the discharge. If
yes, continue to Item 7.16. If no, skip to Item 7.17.
Item 7.16. For each outfall, list any pollutant in Exhibit 2F–4 that
you know or believe to be present in the discharge in Table C
and explain why you believe it to be present. No analysis is
required, but if you have analytical data, you must report it.
Answer “Yes” to Item 7.16 once you have completed this task.
Note: Under 40 CFR 117.12(a)(2), certain discharges of hazardous
substances (listed in Exhibit 2F–5) may be exempted from the
requirements of CWA Section 311, which establishes reporting
requirements, civil penalties, and liability for cleanup costs for spills
of oil and hazardous substances. A discharge of a particular
substance can be exempted if the origin, source, and amount of the
discharged substances are identified in the NPDES permit
application or in the permit, if the permit contains a requirement for
treatment of the discharge, and if the treatment is in place. If you
would like to apply for an exemption from the requirements of CWA
Section 311, attach additional sheets of paper to your application,
setting forth the following information:

If you qualify as a small business according to the criteria
above, answer “Yes” to Item 7.7 and skip to Item 7.18.
Otherwise, answer “No” and continue to Item 7.8.

1. The substance and the amount of each substance that might be
discharged.
2. The origin and source of the discharge of the substance.
3. The treatment to be provided for the discharge by:
a. An onsite treatment system separate from any treatment
system treating your normal discharge;
b. A treatment system designed to treat your normal discharge
and that is additionally capable of treating the amount of the
substance identified under paragraph 1 above; or

Item 7.8. Indicate whether you know or have reason to believe
any pollutants in Exhibit 2F–3 are present in the discharge. If
yes, continue to Item 7.9. If no, skip to Item 7.10.
Item 7.9. For each outfall, list all pollutants in Exhibit 2F–3 that
you know or have reason to believe are present in the discharge
in Table C (except pollutants previously listed in Table B).
Answer “Yes” to Item 7.9 once you have completed this task.
2F-4

FORM 2F—INSTRUCTIONS (CONTINUED)
Item 9.2. Provide the name, address, phone number, and
pollutants analyzed by the laboratory or consulting firm(s) in the
spaces provided.

c. Any combination of the above.
See 40 CFR 117.12(a)(2) and (c) or contact your NPDES permitting
authority for further information on exclusions from CWA
Section 311.

Section 10. Checklist and Certification Statement
Item 10.1. Review the checklist provided on the application. In
Column 1, mark the sections of Form 2F that you have
completed and are submitting with your application. For each
section in Column 2, indicate whether you are submitting
attachments.

Item 7.17 and Table D. Provide data for the storm event(s) that
resulted in the maximum daily discharges for the flow weighted
composite sample in Table D. If sampling is conducted during
more than one storm event, you only need to report the
information requested in Table D for the storm event(s) that
resulted in any maximum pollutant concentration reported in
Tables A through C.

Item 10.2. The Clean Water Act (CWA) provides for severe
penalties for submitting false information on this application
form. Section 309(c)(2) of the CWA provides that, “Any person
who knowingly makes any false material statement,
representation, or certification in any application, …shall upon
conviction be punished by a fine of not more than $10,000 or by
imprisonment for not more than six months or both.”

Provide flow measurements or estimates of the flow rate, as well
as the total amount of discharge for the storm event(s) sampled,
the method of flow measurement, or estimation. Provide the
data and duration of the storm event(s) sampled, rainfall
measurements, or estimates of the storm event that generated
the sampled runoff and the duration between the storm event
sampled and the end of the previous measurable (greater than
0.1 inch rainfall) storm event. Answer “Yes” to Item 7.17 once
you have completed this task.
Used or Manufactured Toxics
Item 7.18. Review Exhibits 2F–2 through 2F–4 and determine if
you currently use or manufacture any of the pollutants listed as
intermediate or final products or byproducts. If so, answer “Yes.”
You should also answer “Yes” if you know or have reason to
believe that 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD) is
discharged or if you use or manufacture 2,4,5-trichlorphenoxy
acetic acid (2,4,5-T); 2-(2,4,5-trichlorophenoxy) propanoic acid
(Silvex, 2,4,5-TP); 2-(2,4,5-trichlorophenoxy) ethyl, 2,2dichloropropionate (Erbon); 0,0-dimethyl 0-(2,4,5-trichlorphenyl)
phosphorothioate (Ronnel); 2,4,5-trichlorophenol (TCP); or
hexachlorophene (HCP). If your answer to Item 7.18 is “No,”
skip to Section 8.

FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS
APPLICATION TO BE SIGNED AS FOLLOWS:
A.

For a corporation, by a responsible corporate officer. For
the purpose of this section, a responsible corporate officer
means: (1) a president, secretary, treasurer, or vicepresident of the corporation in charge of a principal
business function, or any other person who performs
similar policy- or decision-making functions for the
corporation, or (2) the manager of one or more
manufacturing, production, or operating facilities, provided
the manager is authorized to make management decisions
which govern the operation of the regulated facility
including having the explicit or implicit duty of making major
capital investment recommendations, and initiating and
directing other comprehensive measures to assure long
term environmental compliance with environmental laws
and regulations; the manager can ensure that the
necessary systems are established or actions taken to
gather complete and accurate information for permit
application requirements; and where authority to sign
documents has been assigned or delegated to the
manager in accordance with corporate procedures.
B. For a partnership or sole proprietorship, by a general
partner or the proprietor, respectively.
C. For a municipality, state, federal, or other public facility, by
either a principal executive officer or ranking elected
official. For purposes of this section, a principal executive
officer of a federal agency includes: (1) the chief executive
officer of the agency or (2) a senior executive officer having
responsibility for the overall operations of a principal
geographic unit of the agency (e.g., Regional
Administrators of EPA).
END

Item 7.19. List all of the toxic pollutants identified under Item
7.18, including TCDD. Note that the NPDES permitting authority
may waive or modify the requirement if you demonstrate that it
would be unduly burdensome to identify each toxic pollutant and
the NPDES permitting authority has adequate information to
issue your permit. You may not claim any information submitted
in response to Item 7.18 as confidential; however, you do not
have to distinguish between use or production of the pollutants
or list the amounts.
Section 8. Biological Toxicity Testing Data
Item 8.1. Answer whether you know of or have reason to
believe that biological toxicity testing has been conducted of
your wastewater treatment, including engineering reports or pilot
plant studies. If no, skip to Section 9. Otherwise, continue.

Submit your completed Form 1, Form 2F, and
all associated attachments
(and any other required NPDES application forms)
to your NPDES permitting authority.

Item 8.2. List any tests of which you are aware and their
purposes.
Section 9. Contract Analysis Information
Item 9.1. Indicate if any of the analyses performed in Section 7
were performed by a contract laboratory or consulting firm. If no,
skip to Section 10. If yes, continue to Item 9.2.
2F-5

FORM 2F—INSTRUCTIONS (CONTINUED)
General Instructions for Reporting, Sampling, and Analysis
Important note: Read these instructions before completing
Tables A through C and Section 7 of Form 2F.

Base your determination that a pollutant is/will be present in your
discharge on your knowledge of the facility’s raw materials,
material management practices, maintenance chemicals, history
of spills and releases, intermediate and final products and
byproducts, and any previous analyses known to you of your
effluent or similar effluent.

General Items
Complete the applicable tables for each outfall at your facility. Be
sure to note the EPA Identification Number, NPDES permit
number, facility name, and applicable outfall number at the top of
each table page and any associated attachments.

Sampling

You may report some or all of the required data by attaching
separate sheets of paper instead of completing Tables A through
C for each of your outfalls so long as the sheets contain all of the
required information and are similar in format to Tables A through
C. For example, you may be able to print a report in a compatible
format from the data system used in your gas chromatography/
mass spectrometry (GC/MS) analysis completed under Table B.
If you are an existing discharger, you are required to report actual
quantitative data. See “Use of Historical Data” below for use of
historical data. If you are a new source or discharge, you may
supply estimated data along with the source of each estimate. If
you have quantitative data available, however, you must provide
it. Base estimates on available in-house or contractor engineering
reports or any other studies performed on the proposed facility.
Use the following codes to report your source information in the
“Source of Information” column:
Data Source
Engineering reports
Actual data from pilot plants
Estimates from other engineering
reports
Data from other similar plants
Best professional estimates

Code
1
1
2

3
4
5 and specify on
Others
the table
No later than 24 months after your facility commences to
discharge, you must complete and submit sampling and analysis
data for the pollutants and parameters in Tables A through C.
However, you need not report results for tests you have already
performed and reported under the discharge monitoring
requirements of your NPDES permit.
Table A requires you to report at least one analysis for each
pollutant listed. Tables B and C require you to report analytical
data in two ways. For some pollutants addressed in Tables B and
C, if you know or have reason to know that the pollutant is
present in your discharge, you may be required to list the
pollutant and test (sample and analyze) and report the levels of
the pollutants in your discharge. For all other pollutants
addressed in Tables B and C, you must list the pollutant if you
know or have reason to know that it is present in the discharge;
you must also either report quantitative data for the pollutant or
briefly describe the reasons it is expected to be discharged. (See
Items 7.2 through 7.17 of the instructions for completing Tables A
through C.)

The collection of the samples for the reported analyses should be
supervised by a person experienced in performing sampling of
industrial wastewater or stormwater discharges. You may contact
your NPDES permitting authority for detailed guidance on
sampling techniques and for answers to specific questions. See
Exhibit 1–1 of Form 1 for contact information. Any specific
requirements in the analytical methods—for example, sample
containers, sample preservation, holding times, and the collection
of duplicate samples—must be followed.
The time when you sample should be representative of your
normal operation to the extent feasible, with all processes that
contribute wastewater in normal operation, and with your
treatment system operating properly with no system upsets.
Collect samples from the center of the flow channel, where
turbulence is at a maximum, at a site specified in your present
NPDES permit or at any site adequate for the collection of a
representative sample.
Grab samples must be taken in the first 30 minutes of discharge
(or as soon thereafter as practicable) for pH, temperature,
cyanide, total phenols, residual chlorine, oil and grease, fecal
coliform (including E. coli) and enterococci (previously known as
fecal streptococcus at 40 CFR 122.26(d)(2)(iii)(A)(3)), and volatile
organic compounds. You are not required to analyze a flowweighted composite for these parameters.
For all other pollutants, both a grab sample collected during the
first 30 minutes (or as soon thereafter as practicable) of the
discharge and a flow-weighted composite sample must be
analyzed. However, a minimum of one grab sample may be taken
for effluents from holding ponds or other impoundments with a
retention period of greater than 24 hours.
All samples must be collected from the discharge resulting from a
storm event that is greater than 0.1 inches and at least 72 hours
from the previously measurable (greater than 0.1 inch rainfall)
storm event. Where feasible, the variance in the duration of the
event and the total rainfall of the event should not exceed 50
percent from the average or median rainfall event in that area.
A grab sample must be taken during the first 30 minutes of the
discharge (or as soon thereafter as practicable), and a flowweighted composite must be taken for the entire event or for the
first three hours of the event.
Grab and composite samples are defined as follows:
Grab sample: An individual sample of at least 100 milliliters
collected during the first 30 minutes (or as soon thereafter as
practicable) of the discharge. This sample is to be analyzed
separately from the composite sample.

2F-6

FORM 2F—INSTRUCTIONS (CONTINUED)
General Instructions for Reporting, Sampling, and Analysis Continued
Flow-weighted composite sample: A flow-weighted composite
sample may be taken with a continuous sampler that proportions
the amount of sample collected with the flow rate or as a
combination of a minimum of three sample aliquots taken in each
hour of discharge for the entire event or for the first three hours of
the event, with each aliquot being at least 100 milliliters and
collected with a minimum period of 15 minutes between aliquot
collections. The composite must be flow proportional; the time
interval between either each aliquot or the volume of each aliquot
must be proportional to either the stream (effluent) flow at the
time of sampling or the total stream (effluent) flow since the
collection of the previous aliquot. Aliquots may be collected
manually or automatically. Where GC/MS volatile organic
analysis is required, aliquots must be combined in the laboratory
immediately before analysis. Only one analysis for the composite
sample is required.
Use of Historical Data
Existing data may be used, if available, in lieu of sampling
conducted solely for the purposes of this application, provided
they are representative of the present discharge and were
collected within 3 years of the application due date. If you sample
for a listed pollutant on a monthly or more frequent basis,
summarize the data collected within one year of the application
for the pollutant(s) at issue.
Among the factors that would cause the data to be
unrepresentative are significant changes in production level;
changes in raw materials, processes, or final products; and
changes in stormwater treatment. The NPDES permitting
authority may request additional information, including current
quantitative data, if they determine it to be necessary to assess
your discharges. The NPDES permitting authority may allow or
establish appropriate site-specific sampling procedures or
requirements including sampling locations, the season in which
the sampling takes place, the minimum duration between the
previous measurable storm event and the storm event sampled,
the minimum or maximum level of precipitation required for an
appropriate storm event, the form of precipitation sampled (snow
melt or rainfall), protocols for collecting samples under 40 CFR
136, and additional time for submitting data on a case-by-case
basis.
Reporting
Report sampling results for all pollutants in Tables A through C
as concentration and mass, with the exception of flow,
temperature, pH, color, and fecal coliform organisms.
Flow, temperature, pH, color, and fecal coliform organisms must
be reported as million gallons per day (mgd), degrees Celsius
(°C), standard units, color units, and most probable number per
100 milliliters (MPN/100 mL), respectively. Use the following
abbreviations in the columns requiring “units” in Tables A
through C.

Concentration
ppm = parts per million
mg/L = milligrams per liter
ppb = parts per billion
µg/L = micrograms per liter
MPN = most probable number
per 100 milliliters

Mass
lbs. = pounds
ton = tons (English
tons)
mg = milligrams
g = grams
kg = kilograms
T = tonnes (metric
tons)

All reporting of values for metals must be in terms of “total
recoverable metal” unless:
•

An applicable, promulgated ELG specifies the limitation for
the metal in dissolved, valent, or total form;

•

All approved analytical methods for the metal inherently
measure only its dissolved form (e.g., hexavalent chromium);
or

•

The NPDES permitting authority has determined that in
establishing case-by-case limitations it is necessary to
express the limitations of the metal in dissolved, valent, or
total form to carry out the provisions of the CWA.

If you measure only one grab sample and one flow-weighted
composite sample for a given outfall, complete only the “Maximum
Daily Discharge” columns in the tables and enter “1” in the
“Number of Storm Events Sampled” column. The NPDES
permitting authority may require you to conduct additional
analyses to further characterize your discharges.
If you measure more than one value for a grab sample or a flowweighted composite sample for a given outfall and those values
are representative of your discharge, you must report them. You
must describe your method of testing and analysis.
The “Average Daily Discharge” column in Tables A to C is not
compulsory but should be filled out if data are available. To
complete the “Average Daily Discharge” column, determine the
average of all values within the last year and report the
concentration and mass. Report the total number of storm events
sampled under the “Number of Storm Events Sampled” column.
Substantially Identical Outfalls
If you have two or more substantially identical outfalls, you may
request permission from your NPDES permitting authority to
sample and analyze only one outfall and submit the results of the
analysis for all substantially identical outfalls. If your request is
granted, submit the following information on a separate sheet
attached to the application form: the identity of the outfall you did
test and an explanation of how it is substantially identical to the
outfall(s) that you did not test.

2F-7

FORM 2F—INSTRUCTIONS (CONTINUED)
General Instructions for Reporting, Sampling, and Analysis Continued
Analysis
Except as specified below, all required quantitative data shall be
collected in accordance with sufficiently sensitive analytical
methods approved under 40 CFR 136 or required under 40 CFR
Chapter I, Subchapter N or O. A method is “sufficiently sensitive”
when:
•

The method minimum level (ML) is at or below the level of
the applicable water quality criterion for the measured
pollutant or pollutant parameter.

•

The method ML is above the water quality criterion, but the
amount of the pollutant or pollutant parameter in the facility’s
discharge is high enough that the method detects and
quantifies the level of the pollutant or pollutant parameter in
the discharge.

•

The method has the lowest ML of the analytical methods
approved under 40 CFR 136 or required under 40 CFR
Chapter I, Subchapter N or O, for the measured pollutant or
pollutant parameter.

Consistent with 40 CFR 136, you may provide matrix- or samplespecific MLs rather than the published levels. Further, where you
can demonstrate that, despite a good faith effort to use a method
that would otherwise meet the definition of “sufficiently sensitive,”
the analytical results are not consistent with the quality assurance
(QA)/quality control (QC) specifications for that method, then the
NPDES permitting authority may determine that the method is not
performing adequately and the NPDES permitting authority should
select a different method from the remaining EPA-approved
methods that is sufficiently sensitive consistent with 40 CFR
122.21(e)(3)(i). Where no other EPA-approved methods exist, you
must select a method consistent with 40 CFR 122.21(e)(3)(ii).
When there is no analytical method that has been approved under
40 CFR 136; required under 40 CFR Chapter I, Subchapter N or
O; or otherwise required by the NPDES permitting authority, you
may use any suitable method but shall provide a description of the
method. When selecting a suitable method, you may consider
other factors such as a method’s precision, accuracy, or
resolution.

2F-8

FORM 2F—INSTRUCTIONS (CONTINUED)
Exhibit 2F–1. Codes for Treatment Units and Disposal of Wastes Not Discharged
1.
1–A ............... Ammonia stripping
1–B ............... Dialysis
1–C ............... Diatomaceous earth filtration
1–D ............... Distillation
1–E ............... Electrodialysis
1–F................ Evaporation
1–G ............... Flocculation
1–H ............... Flotation
1–I ................. Foam fractionation
1–J ................ Freezing
1–K ............... Gas-phase separation
1–L ................ Grinding (comminutors)
2.
2–A ............... Carbon adsorption
2–B ............... Chemical oxidation
2–C ............... Chemical precipitation
2–D ............... Coagulation
2–E ............... Dechlorination
2–F................ Disinfection (chlorine)
3.
3–A ............... Activated sludge
3–B ............... Aerated lagoons
3–C ............... Anaerobic treatment
3–D ............... Nitrification–denitrification

PHYSICAL TREATMENT PROCESSES
1–M ...............Grit removal
1–N ................Microstraining
1–O................Mixing
1–P ................Moving bed filters
1–Q................Multimedia filtration
1–R ................Rapid sand filtration
1–S ................Reverse osmosis (hyperfiltration)
1–T ................Screening
1–U ................Sedimentation (settling)
1–V ................Slow sand filtration
1–W ...............Solvent extraction
1–X ................Sorption
CHEMICAL TREATMENT PROCESSES
2–G................Disinfection (ozone)
2–H ................Disinfection (other)
2–I .................Electrochemical treatment
2–J.................Ion exchange
2–K ................Neutralization
2–L ................Reduction
BIOLOGICAL TREATMENT PROCESSES
3–E ................Pre-aeration
3–F ................Spray irrigation/land application
3–G................Stabilization ponds
3–H ................Trickling filtration

4. WASTEWATER DISPOSAL PROCESSES
4–A ............... Discharge to surface water
4–C................Reuse/recycle of treated effluent
4–D................Underground injection
4–B ............... Ocean discharge through outfall
5. SLUDGE TREATMENT AND DISPOSAL PROCESSES
5–A ............... Aerobic digestion
5–M ...............Heat drying
5–B ............... Anaerobic digestion
5–N................Heat treatment
5–C ............... Belt filtration
5–O................Incineration
5–D ............... Centrifugation
5–P................Land application
5–E ............... Chemical conditioning
5–Q................Landfill
5–F................ Chlorine treatment
5–R................Pressure filtration
5–G ............... Composting
5–S................Pyrolysis
5–H ............... Drying beds
5–T ................Sludge lagoons
5–I................. Elutriation
5–U................Vacuum filtration
5–J ................ Flotation thickening
5–V................Vibration
5–K ............... Freezing
5–W ...............Wet oxidation
5–L................ Gravity thickening

2F-9

FORM 2F—INSTRUCTIONS (CONTINUED)
Exhibit 2F–2. Conventional and Nonconventional Pollutants (40 CFR 122.21, Appendix D, Table IV)

Bromide
Chlorine, total residual
Color
Fecal coliform
Fluoride
Nitrate-nitrite
Nitrogen, total organic (as N)
Oil and grease
Phosphorus (as P), total
Radioactivity (as alpha, total; beta, total; radium, total; and radium 226, total)
Sulfate (as SO4)
Sulfide (as S)
Sulfite (as SO3)
Surfactants
Aluminum, total
Barium, total
Boron, total
Cobalt, total
Iron, total
Magnesium, total
Molybdenum, total
Manganese, total
Tin, total
Titanium, total

2F-10

FORM 2F—INSTRUCTIONS (CONTINUED)
Exhibit 2F–3. Toxic Pollutants (40 CFR 122.21, Appendix D, Tables II and III)
Toxic Pollutants and Total Phenol
Antimony, total
Arsenic, total
Beryllium, total
Cadmium, total
Chromium, total

Copper, total
Lead, total
Mercury, total
Nickel, total
Selenium, total

Silver, total
Thallium, total
Zinc, total
Cyanide, total
Phenols, total

GC/MS Fraction—Volatile Compounds
Acrolein
Acrylonitrile
Benzene
Bromoform
Carbon tetrachloride
Chlorobenzene
Chlorodibromomethane
Chloroethane
2-Chloroethylvinyl ether
Chloroform

Dichlorobromomethane
1,1-dichloroethane
1,2-dichloroethane
1,1-dichloroethylene
1,2-dichloropropane
1,3-dichloropropylene
Ethylbenzene
Methyl bromide
Methyl chloride
Methylene chloride

1,1,2,2-tetrachloroethane
Tetrachloroethylene
Toluene
1,2-trans-dichloroethylene
1,1,1-trichloroethane
1,1,2-trichloroethane
Trichloroethylene
Vinyl chloride

GC/MS Fraction—Acid Compounds
2-chlorophenol
2,4-dichlorophenol
2,4-dimethylphenol
4,6-dinitro-o-cresol

2,4-dinitrophenol
2-nitrophenol
4-nitrophenol
P-chloro-m-cresol

Pentachlorophenol
Phenol
2,4,6-trichlorophenol

GC/MS Fraction—Base/Neutral Compounds
Acenaphthene
Acenaphthylene
Anthracene
Benzidine
Benzo (a) anthracene
Benzo (a) pyrene
3,4-benzofluoranthene
Benzo (ghi) perylene
Benzo (k) fluoranthene
Bis (2-chloroethoxy) methane
Bis (2-chloroethyl) ether
Bis (2-chloroisopropyl) ether
Bis (2-ethylhexyl) phthalate
4-bromophenyl phenyl ether
Butyl benzyl phthalate
2-chloronaphthalene

4-chlorophenyl phenyl ether
Chrysene
Dibenzo (a,h) anthracene
1,2-dichlorobenzene
1,3-dichlorobenzene
1,4-dichlorobenzene
3,3-dichlorobenzidine
Diethyl phthalate
Dimethyl phthalate
Di-n-butyl phthalate
2,4-dinitrotoluene
2,6-dinitrotoluene
Di-n-octyl phthalate
1,2-diphenylhydrazine (as azobenzene)
Fluoranthene
Fluorene

Hexachlorobenzene
Hexachlorobutadiene
Hexachlorocyclopentadiene
Hexachloroethane
Indeno (1,2,3-cd) pyrene
Isophorone
Naphthalene
Nitrobenzene
N-nitrosodimethylamine
N-nitrosodi-n-propylamine
N-nitrosodiphenylamine
Phenanthrene
Pyrene
1,2,4-trichlorobenzene

GC/MS Fraction—Pesticides
Aldrin
α-BHC
β-BHC
γ-BHC
δ-BHC
Chlordane
4,4’-DDT
4,4’-DDE
4,4’-DDD

Dieldrin
α-endosulfan
β-endosulfan
Endosulfan sulfate
Endrin
Endrin aldehyde
Heptachlor
Heptachlor epoxide
PCB-1242

PCB-1254
PCB-1221
PCB-1232
PCB-1248
PCB-1260
PCB-1016
Toxaphene

2F-11

FORM 2F—INSTRUCTIONS (CONTINUED)
Exhibit 2F–4. Certain Hazardous Substances and Asbestos (40 CFR 122.21, Appendix D, Table V)
Toxic Pollutant
Asbestos
Hazardous Substances
Acetaldehyde
Allyl alcohol
Allyl chloride
Amyl acetate
Aniline
Benzonitrile
Benzyl chloride
Butyl acetate
Butylamine
Captan
Carbaryl
Carbofuran
Carbon disulfide

Dintrobenzene
Diquat
Disulfoton
Diuron
Epichlorohydrin
Ethion
Ethylene diamine
Ethylene dibromide
Formaldehyde
Furfural
Guthion
Isoprene
Isopropanolamine

Chlorpyrifos

Kelthane

Coumaphos

Kepone

Cresol

Malathion

Crotonaldehyde
Cyclohexane
2,4-D (2,4-dichlorophenoxyacetic acid)
Diazinon
Dicamba
Dichlobenil
Dichlone
2,2-dichloropropionic acid
Dichlorvos
Diethyl amine
Dimethyl amine

Mercaptodimethur
Methoxychlor
Methyl mercaptan
Methyl methacrylate
Methyl parathion
Mevinphos
Mexacarbate
Monoethyl amine
Monomethyl amine
Naled

Naphthenic acid
Nitrotoluene
Parathion
Phenolsulfonate
Phosgene
Propargite
Propylene oxide
Pyrethrins
Quinoline
Resorcinol
Strontium
Strychnine
Styrene
2,4,5-T (2,4,5-trichlorophenoxyacetic
acid)
TDE (tetrachlorodiphenyl ethane)
2,4,5-TP [2-(2,4,5-trichlorophenoxy)
propanoic acid]
Trichlorofon
Triethanolamine
Triethylamine
Trimethylamine
Uranium
Vanadium
Vinyl acetate
Xylene
Xylenol
Zirconium

2F-12

FORM 2F—INSTRUCTIONS (CONTINUED)
Exhibit 2F–5. 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 (dichlorodiphenyltrichloroethane)
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. EDTA (ethylene diaminetetracetic acid)
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

2F-13

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. PCBs (polychlorinated biphenyls)
214. Potassium arsenate
215. Potassium arsenite

FORM 2F—INSTRUCTIONS (CONTINUED)
Exhibit 2F–5. Hazardous Substances (Continued)
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

2F-14

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

EPA Identification Number

NPDES Permit Number

Facility Name

OMB No. 2040-0004
Expires MM/DD/YYYY

U.S Environmental Protection Agency
Application for NPDES Permit to Discharge Wastewater

Form
2F
NPDES

STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY

Longitude

Outfall Location

SECTION 1. OUTFALL LOCATION (40 CFR 122.21(G)(1))
1.1
Provide information on each of the facility’s outfalls in the table below
Outfall
Receiving Water Name
Latitude
Number

SECTION 2. IMPROVEMENTS (40 CFR 122.21(G)(6))
2.1
Are you presently required by any federal, state, or local authority to meet an implementation schedule for
constructing, upgrading, or operating wastewater treatment equipment or practices or any other environmental
programs that could affect the discharges described in this application?


2.2



Yes

No  SKIP to Section 3.

Briefly identify each applicable project in the table below.
Affected Outfalls
(list outfall numbers)

Source(s) of Discharge

Final Compliance
Dates
Required

Projected

Improvements

Brief Identification and
Description of Project

2.3

Have you attached sheets describing any additional water pollution control programs (or other environmental
projects that may affect your discharges) that you now have underway or planned? (optional item)


EPA Form 3510-2F

Yes



No
Page 1

EPA Identification Number

NPDES Permit Number

Facility Name

OMB No. 2040-0004
Expires MM/DD/YYYY

Site
Drainage
Map

SECTION 3. SITE DRAINAGE MAP (40 CFR 122.26(C)(1)(I)(A))
3.1
Have you attached a site drainage map containing all required information to this application? (See instructions for
specific guidance.)



Yes

SECTION 4. POLLUTANT SOURCES (40 CFR 122.26(C)(1)(I)(B))
4.1
Provide information on the facility’s pollutant sources in the table below.
Outfall
Number

Impervious Surface Area

(within a mile radius of the facility)
specify units

Total Surface Area Drained

(within a mile radius of the facility)
specify units

specify units

specify units

specify units

specify units

specify units

specify units

specify units

specify units

specify units

specify units

Provide a narrative description of the facility’s significant material in the space below. (See instructions for content
requirements.)

4.3

Provide the location and a description of existing structural and non-structural control measures to reduce pollutants
in stormwater runoff. (See instructions for specific guidance.)

Pollutant Sources

4.2

Stormwater Treatment

Outfall
Number

Control Measures and Treatment

Codes
from
Exhibit
2F–1
(list)

EPA Form 3510-2F

Page 2

EPA Identification Number

NPDES Permit Number

Facility Name

OMB No. 2040-0004
Expires MM/DD/YYYY

SECTION 5. NON-STORMWATER DISCHARGES (40 CFR 122.26(C)(1)(I)(C))
5.1
Provide the following certification. (See instructions to determine the appropriate person to sign the application.)
I certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the
presence of non-stormwater discharges. Moreover, I certify that the outfalls identified as having non-stormwater
discharges are described in either an accompanying NPDES Form 2C, 2D, or 2E application.
Name (print or type first and last name)
Official title

Non-Stormwater Discharges

Signature

5.2

Date signed

Provide the testing information requested in the table below.
Outfall
Number

Description of Testing Method Used

Date(s) of Testing

Onsite Drainage Points
Directly Observed
During Test

Significant Leaks or Spills

SECTION 6. SIGNIFICANT LEAKS OR SPILLS (40 CFR 122.26(C)(1)(I)(D))
6.1
Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years.

Discharge Information

SECTION 7. DISCHARGE INFORMATION (40 CFR 122.26(C)(1)(I)(E))
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must
complete. Not all applicants need to complete each table.
7.1
Is this a new source or new discharge?
 See instructions regarding submission of
 See instructions regarding submission of
 Yes
 No
estimated data.
actual data.
Tables A, B, C, and D
7.2
Have you completed Table A for each outfall?

EPA Form 3510-2F



Yes

Page 3

EPA Identification Number

7.3

Discharge Information Continued

No

Yes



No  SKIP to Item 7.10.

Yes

Yes



No  SKIP to Item 7.12.

Yes

Yes



No  SKIP to Item 7.14.

Yes

Yes

Do you know or have reason to believe any pollutants in Exhibit 2F–4 are present in the discharge?


EPA Form 3510-2F



Have you provided quantitative data or an explanation in Table C for pollutants you expect to be present in the
discharge at concentrations less than 10 ppb (or less than 100 ppb for the pollutants identified in Item 7.12)?


7.15

Yes SKIP to Item 7.18.

Have you provided quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be
discharged in concentrations of 100 ppb or greater?


7.14

Yes

Do you expect acrolein, acrylonitrile, 2,4-dinitrophenol, or 2-methyl-4,6-dinitrophenol to be discharged in
concentrations of 100 ppb or greater?


7.13

No  SKIP to Item 7.7.

Have you provided quantitative data in Table C for those pollutants in Exhibit 2F–3 that you expect to be discharged
in concentrations of 10 ppb or greater?


7.12



Do you expect any of the pollutants in Exhibit 2F–3 to be discharged in concentrations of 10 ppb or greater?


7.11

Yes

Have you listed all pollutants in Exhibit 2F–3 that you know or have reason to believe are present in the discharge in
Table C?


7.10

Yes

Do you know or have reason to believe any pollutants in Exhibit 2F–3 are present in the discharge?


7.9

No  SKIP to Item 7.5.

Do you qualify for a small business exemption under the criteria specified in the Instructions?


7.8



Have you listed all pollutants in Exhibit 2F–2 that you know or have reason to believe are present in the discharge
and provided quantitative data or an explanation for those pollutants in Table C?


7.7

Yes

Do you know or have reason to believe any pollutants in Exhibit 2F–2 are present in the discharge?


7.6

OMB No. 2040-0004
Expires MM/DD/YYYY

Have you completed Table B by providing quantitative data for those pollutants that are (1) limited either directly or
indirectly in an ELG and/or (2) subject to effluent limitations in an NPDES permit for the facility’s process
wastewater?


7.5

Facility Name

Is the facility subject to an effluent limitation guideline (ELG) or effluent limitations in an NPDES permit for its
process wastewater?


7.4

NPDES Permit Number

Yes



No  SKIP to Item 7.17.
Page 4

EPA Identification Number

7.16

Discharge Information Continued

Facility Name

OMB No. 2040-0004
Expires MM/DD/YYYY

Have you listed pollutants in Exhibit 2F–4 that you know or believe to be present in the discharge and provided an
explanation in Table C?


7.17

NPDES Permit Number

Yes

Have you provided information for the storm event(s) sampled in Table D?



Yes

Used or Manufactured Toxics
7.18 Is any pollutant listed on Exhibits 2F–2 through 2F–4 a substance or a component of a substance used or
manufactured as an intermediate or final product or byproduct?


7.19



Yes

No  SKIP to Section 8.

List the pollutants below, including TCDD if applicable. Attach additional sheets, if necessary.
1.

4.

7.

2.

5.

8.

3.

6.

9.

Biological Toxicity Testing Data

SECTION 8. BIOLOGICAL TOXICITY TESTING DATA (40 CFR 122.21(G)(11))
8.1
Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made
on any of your discharges or on a receiving water in relation to your discharge within the last three years?


8.2



Yes

Identify the tests and their purposes below.
Test(s)

Purpose of Test(s)

No  SKIP to Section 9.

Submitted to NPDES
Permitting Authority?



Yes



No



Yes



No



Yes



No

Date Submitted

SECTION 9. CONTRACT ANALYSIS INFORMATION (40 CFR 122.21(G)(12))
9.1 Were any of the analyses reported in Section 7 (in Tables A through C) performed by a contract laboratory or
consulting firm?

Contract Analysis Information


9.2



Yes

No  SKIP to Section 10.

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

EPA Form 3510-2F

Page 5

EPA Identification Number

NPDES Permit Number

Facility Name

OMB No. 2040-0004
Expires MM/DD/YYYY

SECTION 10. CHECKLIST AND CERTIFICATION STATEMENT (40 CFR 122.22(A) AND (D))
10.1 In Column 1 below, mark the sections of Form 2F 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 complete all sections or provide attachments.

Checklist and Certification Statement

Column 1

10.2

Column 2



Section 1



w/ attachments (e.g., responses for additional outfalls)



Section 2



w/ attachments



Section 3



w/ site drainage map



Section 4



w/ attachments



Section 5



w/ attachments




Section 6



w/ attachments

Section 7



Table A



w/ small business exemption request



Table B



w/ analytical results as an attachment



Table C



Table D



Section 8



w/ attachments



Section 9



w/ attachments (e.g., responses for additional contact laboratories or firms)



Section 10

Provide the following certification. (See instructions to determine the appropriate person to sign the application.)
Certification Statement
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.

EPA Form 3510-2F

Name (print or type first and last name)

Official title

Signature

Date signed

Page 6

EPA Identification Number

NPDES Permit Number

Facility Name

Outfall Number

OMB No. 2040-0004
Expires MM/DD/YYYY

TABLE A. CONVENTIONAL AND NON-CONVENTIONAL PARAMETERS (40 CFR 122.26(C)(1)(I)(E)(3))1
You must provide the results of at least one analysis for every pollutant in this table. Complete one table for each outfall. See instructions for additional details and requirements.
Maximum Daily Discharge
Average Daily Discharge
Source of
(specify units)
(specify units)
Information
Number of Storm
Pollutant or Parameter
Grab Sample Taken
Grab Sample Taken
(new source/new
Events Sampled
Flow-Weighted
Flow-Weighted
During First
30 Minutes

1.

Oil and grease

2.

Biochemical oxygen demand (BOD5)

3.

Chemical oxygen demand (COD)

4.

Total suspended solids (TSS)

5.

Total phosphorus

6.

Total Kjeldahl nitrogen (TKN)

7.

Total nitrogen (as N)

8.

Composite

During First
30 Minutes

Composite

dischargers only; use
codes in instructions)

pH (minimum)
pH (maximum)

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 under 40 CFR Chapter I, Subchapter N or O. See instructions and 40 CFR 122.21(e)(3).

EPA Form 3510-2F

Page 7

This page intentionally left blank.

EPA Identification Number

NPDES Permit Number

Facility Name

Outfall Number

OMB No. 2040-0004
Expires MM/DD/YYYY

TABLE B. CERTAIN CONVENTIONAL AND NON-CONVENTIONAL POLLUTANTS (40 CFR 122.26(C)(1)(I)(E)(4) AND 40 CFR 122.21(G)(7)(VI)(A))1
List each pollutant that is limited in an effluent limitation guideline (ELG) that the facility is subject to or any pollutant listed in the facility’s NPDES permit for its process wastewater (if the
facility is operating under an existing NPDES permit). Complete one table for each outfall. See the instructions for additional details and requirements.
Maximum Daily Discharge
Pollutant and CAS Number
(if available)

(specify units)

Grab Sample Taken
During First
30 Minutes

Flow-Weighted
Composite

Average Daily Discharge
(specify units)

Grab Sample Taken
During First
30 Minutes

Flow-Weighted
Composite

Number of Storm
Events Sampled

Source of
Information

(new source/new
dischargers only; use
codes in instructions)

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 under 40 CFR Chapter I, Subchapter N or O. See instructions and 40 CFR 122.21(e)(3).

EPA Form 3510-2F

Page 9

This page intentionally left blank.

EPA Identification Number

NPDES Permit Number

Facility Name

Outfall Number

OMB No. 2040-0004
Expires MM/DD/YYYY

TABLE C. TOXIC POLLUTANTS, CERTAIN HAZARDOUS SUBSTANCES, AND ASBESTOS (40 CFR 122.26(C)(1)(I)(E)(4) AND 40 CFR 122.21(G)(7)(VI)(B) AND (VII))1
List each pollutant shown in Exhibits 2F–2, 2F–3, and 2F–4 that you know or have reason to believe is present. Complete one table for each outfall. See the instructions for additional
details and requirements.
Maximum Daily Discharge
Average Daily Discharge
Source of
(specify units)
(specify units)
Information
Number
of
Storm
Pollutant and CAS Number
Grab Sample Taken
Grab Sample Taken
(new source/new
(if available)
Flow-Weighted
Flow-Weighted
Events Sampled
During First
During First
30 Minutes

Composite

30 Minutes

Composite

dischargers only; use
codes in instructions)

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 under 40 CFR Chapter I, Subchapter N or O. See instructions and 40 CFR 122.21(e)(3).
1

EPA Form 3510-2F

Page 11

This page intentionally left blank.

EPA Identification Number

NPDES Permit Number

Facility name

Outfall Number

OMB No. 2040-0004
Expires MM/DD/YYYY

TABLE D. STORM EVENT INFORMATION (40 CFR 122.26(C)(1)(I)(E)(6))
Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow-weighted composite sample.
Date of Storm Event

Duration of Storm Event
(in hours)

Total Rainfall During
Storm Event
(in inches)

Number of Hours Between
Beginning of Storm Measured and
End of Previous Measurable Rain
Event

Maximum Flow Rate
During Rain Event
(in gpm or specify units)

Total Flow from Rain Event
(in gallons or specify units)

Provide a description of the method of flow measurement or estimate.

Click to go back to the beginning of Form
EPA Form 3510-2F

Page 13