3510-2S NPDES Application Form 2S

National Pollutant Discharge Elimination System (NPDES) Program (Renewal)

NPDES Application Form 2S

Consolidated NPDES ICR - Public Sector

OMB: 2040-0004

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2040-0004 can be found here:

2024-11-15 - No material or nonsubstantive change to a currently approved collection

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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 2S

New and Existing Treatment
Works Treating Domestic
Sewage
NPDES Permitting Program

Note: Complete Form 2S if you are a new or existing treatment works treating domestic sewage.

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). 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 2S—INSTRUCTIONS
General Instructions

March 22, 1993. The regulations are often referred to as “the Part
503 rule” or “Part 503.”

Who Must Complete Form 2S?
A person must complete Form 2S to apply for a National
Pollutant Discharge Elimination System (NPDES) permit
covering sewage sludge (biosolids) use or disposal standards if
they own or operate a treatment works treating domestic
sewage (TWTDS). A person is an owner or operator of a
TWTDS if the facility generates, changes the quality of, or
provides final disposition of solids, practices for which are
ultimately subject to Part 503 of Title 40 of the Code of Federal
Regulations (CFR).1

2If all the sewage sludge received by a sewage sludge blender or
composter is of exceptional quality (EQ) per 40 CFR 503, then no
permit will be required for the person who receives or processes
the EQ sludge.
3The NPDES permitting authority may request permit applications
from these facilities when necessary to protect public health and
the environment from reasonably anticipated effects of pollutants
that may be present in sewage sludge.

If you are a POTW and discharge wastewater to surface water,
you must also complete NPDES application Form 2A. If you are
a federally owned or privately owned treatment works and
discharge wastewater to surface water, contact your permitting
authority to determine the appropriate form(s) to submit (see 64
FR 42436).

The TWTDSs that are required to apply for NPDES permits
include the following:
•

•

•
•
•

•

All generators of sewage sludge that is regulated by
40 CFR 503 (i.e., it is applied to the land, placed on a
surface disposal site, fired in a sewage sludge incinerator,
or placed in a municipal solid waste landfill unit).
Industrial facilities that separately treat domestic sewage
and generate sewage sludge that is regulated by 40 CFR
503.

40 CFR 503 defines “sewage sludge” as a solid, semi-solid, or
liquid residue generated during the treatment of domestic
sewage in a treatment works. Sewage sludge includes scum or
solids removed in primary, secondary, or advanced wastewater
treatment processes and any material derived from sewage
sludge (e.g., a blended sewage sludge/fertilizer product) but
does not include grit and screenings or ash generated by the
firing of sewage sludge in an incinerator.

All surface disposal site owners/operators.
All sewage sludge incinerator owners/operators.
Any person (e.g., individual, corporation, or government
entity) who changes the quality of sewage sludge regulated
by 40 CFR 503 (e.g., sewage sludge blenders or
processors).2
Any other person or facility designated by the NPDES
permitting authority as a TWTDS.

40 CFR 503 considers domestic septage as sewage sludge and
sets separate requirements for domestic septage applied to
agricultural land, forests, or reclamation sites. “Domestic
septage” is defined as a liquid or solid material removed from a
septic tank, cesspool, portable toilet, Type III marine sanitation
device, or similar system that receives only domestic sewage.
The 40 CFR 503 definition of domestic septage excludes
grease-trap pumpings and commercial or industrial waste.

TWTDSs and other persons that may be required to apply for an
NPDES permit3 include the following:
•

•
•
•

Sewage sludge land appliers, haulers, persons who store,
or transporters who do not generate or do not change the
quality of the sewage sludge.
Landowners of property on which sewage sludge are
applied.
Domestic septage pumpers/haulers/treaters/appliers.
Sewage sludge packagers/baggers that do not change the
quality of the sewage sludge.

At the state level, either EPA or an approved state agency
administers the NPDES permit program. If you are located in a
jurisdiction in which an EPA regional office administers the
NPDES permit program, you should use Form 2S. If you are
located in a jurisdiction where a state administers the NPDES
permit program, contact the state to determine the forms you
should complete. States often develop their own application
forms rather than use the federal forms. See
http://www.epa.gov/npdes/npdes-state-program-information for
a list of states that have approved NPDES permit programs
and those that do not.

If any of the above TWTDS categories are owned and operated
by different persons/entities, it is the operator’s duty to obtain
the NPDES permit.

Exhibit 2S–1 (see end of this section) provides contact
information for each of EPA’s 10 regional offices. Since the
exhibit’s content is subject to change, consult EPA’s website
for the latest information:
http://www.epa.gov/aboutepa#regional.

Notes
1The U.S. Environmental Protection Agency (EPA) developed
regulations in 1993 as required by the Clean Water Act (CWA)
Amendments of 1987 to protect public health and the
environment from any reasonably anticipated adverse effects of
pollutants that might be present in sewage sludge biosolids. The
regulation, The Standards for the Use or Disposal of Sewage
Sludge (40 CFR 503) was published in the Federal Register on
February 19, 1993 (58 CFR 9248 to 9404) and became effective

Where to File Your Completed Form
•

2S-1

If you are in a jurisdiction with an approved state sewage
sludge NPDES permit program, file according to the
instructions on the state forms.

FORM 2S—INSTRUCTIONS (CONTINUED)
•

If you are in a jurisdiction where EPA is the sewage sludge
NPDES permitting authority (i.e., the state is not a sewagesludge-authorized state), mail the completed application
forms to the EPA regional office that covers the state in
which your facility is located (see Exhibit 2S–1).

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.

•

To determine where to send your completed Form 2S, visit
http://www.epa.gov/biosolids/forms/contact-us-aboutbiosolids.

If you have previously submitted information that answers a
specific question to EPA or an approved state NPDES agency,
you may either repeat the information in the space provided or
attach a copy of the previous submission. Some items in the
form require narrative explanations. If more space is necessary
to answer a question, attach a separate sheet titled “Additional
Information.” Provide your information on this attachment in a
format that is consistent with the form.

When to File Your Completed Form
A TWTDS with a currently effective NPDES permit must submit
a permit application at the time of its next NPDES permit
renewal application (i.e., at least 180 days before your present
NPDES permit expires). Any other TWTDS must submit the
information in Part 1 of Form 2S within one year after publication
of a standard applicable to its sewage sludge or disposal
practice(s). The NPDES permitting authority will determine when
such TWTDS must submit a full permit application. The NPDES
permitting authority may require permit applications from a
TWTDS at any time if it determines that a permit is necessary to
protect public health and the environment from any potential
adverse effects that may occur from toxic pollutants in sewage
sludge. Any TWTDS that commences operations after
promulgation of an applicable “standard for sewage sludge use
or disposal” must submit an application to the NPDES permitting
authority at least 180 days prior to the date proposed for
commencing operations.

Upon request of the NPDES permitting authority, you must
submit any other information necessary to assess sewage
sludge use or disposal practices at your facility or identify
appropriate permitting requirements.
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.
Which Parts of the Form Apply?
Form 2S is presented in a modular format, enabling information
collection to be tailored to your facility’s sewage sludge
generation, treatment, use, or disposal practices. The form
specifies which parts must be filled out for each type of
applicant.

Fees
EPA does not require applicants to pay a fee for applying for
NPDES permits. However, states that administer the NPDES
programs may charge fees. Consult with state officials for
further information.

Part 1 requests a limited amount of information from ‘‘sludgeonly’’ facilities (facilities without a currently effective NPDES
permit) that are not directed by the permitting authority to submit
a full permit application at this time. It is intended to allow the
permitting authority to identify these facilities, track sewage
sludge use and disposal, and establish priorities for permitting.

Public Availability of Submitted Information
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 2S (or related
attachments) as confidential.

Part 2 is for any facility that is submitting a full NPDES permit
application. See Exhibit 2S–2, at the end of these general
instructions, to determine which sections of Part 2 cover your
facility’s sewage sludge use or disposal practices.

You may make a claim of confidentiality for any information that
you submit to EPA that goes beyond the information required by
Form 2S. Note that NPDES authorities will deny claims for
treating any biosolids data 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 at Part 2 of Title 40 of the CFR.
Completion of Forms

Complete the “Preliminary Information” section on page 1 by
indicating whether your facility has an effective NPDES permit
or you have been directed by your NPDES permitting authority
to submit a full Form 2S permit application. If yes, skip Part 1
and complete Part 2 of the application package (see the line-byline instructions for Part 2). If no, complete only Part 1 of the
application package.

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.

The legal definitions of all key terms used in the various NPDES
application forms are included in the “Glossary” at the end of
these instructions.

Definitions

2S-2

FORM 2S—INSTRUCTIONS (CONTINUED)
Exhibit 2S–1. Addresses of EPA Regional Contacts and Covered States
REGION 1
U.S. Environmental Protection Agency, Region 1
5 Post Office Square, Suite 100, Boston, MA 02109-3912
Phone: (617) 918-1111; toll free: (888) 372-7341
Fax: (617) 918-0101
Website: http://www.epa.gov/aboutepa/epa-region-1-new-england
Covered states: Connecticut, Maine, Massachusetts, New Hampshire, Rhode
Island, and Vermont

REGION 6
U.S. Environmental Protection Agency, Region 6
1445 Ross Avenue, Suite 1200, Dallas, TX 75202-2733
Phone: (214) 665-2200; toll free: (800) 887-6063
Fax: (214) 665-7113
Website: http://www.epa.gov/aboutepa/epa-region-6-south-central
Covered states: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas

REGION 2
U.S. Environmental Protection Agency, Region 2
290 Broadway, New York, NY 10007-1866
Phone: (212) 637-3000; toll free: (877) 251-4575
Fax: (212) 637-3526
Website: http://www.epa.gov/aboutepa/epa-region-2
Covered states: New Jersey, New York, Virgin Islands, and Puerto Rico

REGION 7
U.S. Environmental Protection Agency, Region 7
11201 Renner Boulevard, Lenexa, KS 66219
Phone: (913) 551-7003; toll free: (800) 223-0425
Website: http://www.epa.gov/aboutepa/epa-region-7-midwest
Covered states: Iowa, Kansas, Missouri, and Nebraska

REGION 3
U.S. Environmental Protection Agency, Region 3
1650 Arch Street, Philadelphia, PA 19103-2029
Phone: (215) 814-5000; toll free: (800) 438-2474
Fax: (215) 814-5103
Website: http://www.epa.gov/aboutepa/epa-region-3-mid-atlantic
Covered states: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia,
and West Virginia

REGION 8
U.S. Environmental Protection Agency, Region 8
1595 Wynkoop Street, Denver, CO 80202-1129
Phone: (303) 312-6312; toll free: (800) 227-8917
Fax: (303) 312-6339
Website: http://www.epa.gov/aboutepa/epa-region-8-mountains-and-plains
Covered states: Colorado, Montana, North Dakota, South Dakota, Utah, and
Wyoming

REGION 4
U.S. Environmental Protection Agency, Region 4
Sam Nunn Atlanta Federal Center
61 Forsyth Street, SW, Atlanta, GA 30303-8960
Phone: (404) 562-9900; toll free: (800) 241-1754
Fax: (404) 562-8174
Website: http://www.epa.gov/aboutepa/about-epa-region-4-southeast
Covered states: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina,
South Carolina, and Tennessee

REGION 9
U.S. Environmental Protection Agency, Region 9
75 Hawthorne Street, San Francisco, CA 94105
Phone: (415) 947-8000; toll free: (866) EPA-WEST
Fax: (415) 947-3553
Website: http://www.epa.gov/aboutepa/epa-region-9-pacific-southwest
Covered states: Arizona, California, Hawaii, Nevada, Guam, American Samoa,
and Trust Territories

REGION 5
U.S. Environmental Protection Agency, Region 5
77 West Jackson Boulevard, Chicago, IL 60604-3507
Phone: (312) 353-2000; toll free: (800) 621-8431
Fax: (312) 353-4135
Website: http://www.epa.gov/aboutepa/epa-region-5
Covered states: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin

REGION 10
U.S. Environmental Protection Agency, Region 10
1200 Sixth Avenue, Suite 900, Seattle, WA 98101
Phone: (206) 553-1200; toll free: (800) 424-4372
Fax: (206) 553-2955
Website: http://www.epa.gov/aboutepa/epa-region-10-pacific-northwest
Covered states: Alaska, Idaho, Oregon, and Washington

2S-3

FORM 2S—INSTRUCTIONS (CONTINUED)
Exhibit 2S–2. Part 2 Sections to Complete



Generates sewage sludge or derives material from
sewage sludge that is applied to the land in bulk form



Applies bulk sewage sludge to land or generates
sewage sludge that is applied to the land by others



Owns or operates a surface disposal site



Owns or operates a sewage sludge incinerator



INCINERATION

GENERATION OF
SEWAGE SLUDGE OR
PREPARATION OF A
MATERIAL DERIVED
FROM SEWAGE SLUDGE

Generates sewage sludge or derives material from
sewage sludge that:
• Meets ceiling concentrations in Table 1 of 40
CFR 503.13, pollutant concentrations in Table 3
of Section 503.13, Class A pathogen
requirements in Section 503.32, and one of the
eight vector attraction reduction options in 40
CFR 503.33(b)(1)–(8)
• Is sold or given away in bags or other containers
for application to the land (and not already
addressed in Item 2.4)
• Is shipped offsite for treatment or blending
• Is placed on a surface disposal site
• Is fired in an incinerator
• Is sent to a municipal solid waste landfill

Activity(ies) Performed

SURFACE DISPOSAL

GENERAL INFORMATION

LAND APPLICATION OF
BULK SEWAGE SLUDGE

Part 2 Sections to Complete
2
3
4






2S-4

FORM 2S—PART 1 LINE-BY-LINE INSTRUCTIONS
Item 2.4. Specify whether the NPDES permitting authority
should send correspondence to the facility or the applicant.

Part 1—Limited Background Information
Complete Part 1 if your facility is a “sludge-only” facility (i.e., a
facility that does not currently have, and is not applying for, an
NPDES permit for a direct discharge to a surface body of water).

Section 3. Sewage Sludge Amount
Item 3.1. Provide the total dry metric tons of sewage sludge
generated, treated, used (i.e., received from offsite), and
disposed over the last 365-day period.

EPA Identification Number, NPDES Permit Number, and
Facility Name
Provide your EPA Identification Number from the Facility
Registry Service, NPDES permit number, and facility name at
the top of each page of Form 2S 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
and NPDES permit number. If you do not know your EPA
Identification Number, contact your NPDES permitting authority.
See Exhibit 2S–1 for contact information.

Section 4. Pollutant Concentrations
Item 4.1. Provide the most recent sewage sludge monitoring
data available on the quality of the sewage sludge, including for
pollutants for which limits in sewage sludge have been
established in 40 CFR 503 for your facility’s expected use or
disposal practices. Provide the average monthly concentration
in milligrams per kilogram (mg/kg) dry weight, analytical method,
and detection level. If available, base data on three or more
samples taken at least one month apart, no more than 4.5 years
old. If providing the monitoring data in a separate attachment,
check the box to indicate that this information has been attached
to the application package.

Section 1. Facility Information
Item 1.1. Enter the facility’s official or legal name. Do not use a
colloquial name. Provide the mailing address of the facility.
Next, give the name (first and last), title, work telephone
number, and email address of the person who is thoroughly
familiar with the operation of the facility and with the facts
reported in this application.

Section 5. Treatment Provided at Your Facility
Item 5.1. In the “Use or Disposal Practice” column, check the
sewage sludge use or disposal practice used at your facility. In
the following columns, indicate the amount of sewage sludge
used or disposed of, the pathogen class and reduction
alternative, and the vector attraction reduction option associated
with the practice. To determine the applicable pathogen class
and reduction alternative, see 40 CFR 503.32. To determine the
applicable vector attraction reduction option, see 40 CFR
503.33. Vector attraction reduction options 1 through 8 are
typically met at the point where sewage sludge is generated or
where a material is derived from sewage sludge, and options 9
through 11 are typically met at the point of use or disposal.
Complete Item 5.1 for each sewage sludge use or disposal
practice by attaching additional sheets, as necessary.

Include a complete location address for the facility if different
from the mailing address. If the facility or site lacks a street
name or route number, give the most accurate alternative
geographic information (e.g., section number or quarter section
number from county records or “at intersection of Routes 425
and 22”).
Item 1.2. Indicate the legal status of the owner of the facility by
marking the appropriate box. If the facility is a federal facility
(i.e., owned by the U.S. government), check the box for
“Public—federal.” If the facility is owned by a state government,
check the box for “Public—state.” If the facility is owned by a
county government, municipal (e.g., city or town) government,
tribal government, school district, water district, or other local
government entity, check the box for “Other public” and specify
the type of government entity. If the facility is owned by a
corporation or other private entity, check the box for “Private.” If
the facility has mixed ownership (e.g., public/private) or is not
owned by an entity previously listed, check the box for “Other”
and specify the type of entity.

Item 5.2. For each use or disposal practice indicated in Item 5.1,
identify the treatment process(es) used at your facility to reduce
pathogens or vector attraction properties in sewage sludge. If
you check “Other,” specify the treatment process(es) in the
space provided or in a separate attachment.
Section 6. Sewage Sludge Sent to Other Facilities
Item 6.1. Indicate whether the sewage sludge meets ceiling
concentrations in Table 1 of 40 CFR 503.13, pollutant
concentrations in Table 3 of 40 CFR 53.13, Class A pathogen
reduction requirements at 40 CFR 503.32(a), and one of the
vector attraction reduction requirements at 40 CFR
503.33(b)(1)–(8). If yes, skip to Item 8.1 (Part 1, Section 8). If
no, continue to Item 6.2.

Section 2. Applicant Information
Item 2.1. Indicate if the applicant is different from the entity
listed under Item 1.1. If yes, continue to Item 2.2. If no, skip to
Item 2.3 (Part 1, Section 2).
Item 2.2. Enter the applicant’s name and mailing address.
Provide the name (first and last), title, work telephone number,
and email address of the contact person for the applicant.

Item 6.2. Indicate whether sewage sludge from your facility is
provided to another facility for treatment, distribution or disposal.
If yes, continue to Item 6.3. If no, skip to Item 7.1 (Part 1,
Section 7).

Item 2.3. Indicate if the applicant is the facility’s owner, operator,
or both.

2S-5

FORM 2S—PART 1 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
Item 6.3. Enter the name and mailing address of the receiving
facility. Provide the name (first and last), title, work telephone
number, and email address of the contact person for the
receiving facility.

more than $10,000 or by imprisonment for not more than six
months, or both.”
FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS
APPLICATION TO BE SIGNED AS FOLLOWS:

Item 6.4. Indicate the activities provided by the receiving facility.
If you check “Other,” provide a description in the space provided
or in a separate attachment.

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 OF PART 1

Section 7. Use and Disposal Sites
Complete Items 7.1 through 7.2 for each site on which sewage
sludge from the facility is used or disposed of. Check the box to
indicate that this information has been attached to the
application package.
Item 7.1. Specify the site name or number and mailing address.
Provide the name (first and last), title, work telephone number,
and email address of the contact person for the use or disposal
site.
Include a complete location address for the site if different from
the mailing address. If the facility or site lacks a street name or
route number, give the most accurate alternative geographic
information (e.g., section number or quarter section number
from county records or “at intersection of Routes 425 and 22”).
Item 7.2. Identify the type of use or disposal site (e.g.,
agricultural, surface disposal, reclamation, lawn or home
garden, public contact, municipal solid waste landfill, forest,
incineration). If you check “Other,” provide a description in the
space provided or in a separate attachment.
Section 8. Checklist and Certification Statement
Item 8.1. Review the checklist provided. In Column 1, mark the
sections of Form 2S, Part 1, that you have completed and are
submitting with your application. For each section that you have
completed, indicate in Column 2 whether you are submitting
attachments.
Item 8.2. The CWA provides for severe penalties for submitting
false information on this application form. CWA Section
309(c)(2) provides that “Any person who knowingly makes any
false statement, representation, or certification in any
application, …shall upon conviction, be punished by a fine of no

Submit your completed Part 1 of Form 2S
and all associated attachments
to your NPDES permitting authority.

2S-6

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS
tribal government, school district, water district, or other local
government entity, check the box for “Other public” and specify
the type of government entity. If the facility is owned by a
corporation or other private entity, check the box for “Private.” If
the facility has mixed ownership (e.g., public/private) or is not
owned by an entity previously listed, check the box for “Other”
and specify the type of entity.
Applicant Information
Item 1.6. Indicate if the applicant is different from the entity
listed under Item 1.1. If yes, continue to Item 1.7. If no, skip to
Item 1.18 (Part 2, Section 1).

Part 2—Permit Application Information
Complete Part 2 if you have an effective NPDES permit or have
been directed by the NPDES permitting authority to submit a full
permit application. Part 2 is divided into five sections. Section 1
pertains to all applicants. The applicability of Sections 2 to 5
depends on your facility’s sewage sludge use or disposal
practices. See Exhibit 2S–2 at the end of the general
instructions to determine the sections that you are required to
complete.
EPA Identification Number, NPDES Permit Number, and
Facility Name
Provide your EPA Identification Number from the Facility
Registry Service, NPDES permit number, and facility name at
the top of each page of Form 2S 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
and NPDES permit number. If you do not know your EPA
Identification Number, contact your NPDES permitting authority.
See Exhibit 2S–1 for contact information.

Item 1.7. Enter the applicant’s name and mailing address.
Provide the name (first and last), title, work telephone number,
and email address of the contact person for the applicant.
Item 1.8. Indicate if the applicant is the facility’s owner, operator,
or both.
Item 1.9. Specify whether the NPDES permitting authority
should send correspondence to the facility or the applicant.
Permit Information
Item 1.10. Provide the facility’s NPDES permit number or check
the box to indicate that you do not have an NPDES permit
number but are otherwise required to submit Part 2 of Form 2S
by your NPDES permitting authority.

Section 1. General Information
Facility Information
Item 1.1. Enter the facility’s official or legal name. Do not use a
colloquial name. Provide the mailing address of the facility.
Next, give the name (first and last), title, work telephone
number, and email address of the person who is thoroughly
familiar with the operation of the facility and with the facts
reported in this application.

Item 1.11. Indicate all other federal, state, and local permits or
construction approvals received or applied for that regulate the
facility’s sewage sludge management practices. If you check
“Other,” specify the permit or approval in the space provided.
You may list permits or approvals and corresponding permit
numbers in a separate attachment. If so, check the box to
indicate that this information has been attached to the
application package.

Indian Country
Item 1.12. Indicate whether any generation, treatment, storage,
application to land, or disposal of sewage sludge from the facility
occurs in Indian Country. If yes, continue to Item 1.13. If no, skip
to Item 1.14 (Part 2, Section 1).

Item 1.2. Indicate whether the facility is a Class I sludge
management facility.
Item 1.3. Provide the facility design flow rate in million gallons
per day (mgd).

Item 1.13. In the space provided or in a separate attachment,
describe the generation, treatment, storage, land application, or
disposal of sewage sludge that occurs in Indian Country.

Item 1.4. Provide the total population served by the facility.
Enter the best estimate of the actual population served at the
time of application for all areas served by the treatment works
(municipalities and unincorporated service areas). If another
treatment works discharges into this treatment works, provide
on a separate attachment the name of the other treatment works
and the actual population it serves. It is not necessary to list the
communities served by the other treatment works.

Topographic Map
Item 1.14. Provide a topographic map(s) of the area extending
at least 1 mile beyond the property boundaries of the facility that
clearly shows the following:
•
•

Item 1.5. Indicate the ownership status of the owner of the
facility by marking the appropriate box. If the facility is a federal
facility (i.e., owned by the U.S. government), check the box for
“Public—federal.” If the facility is owned by a state government,
check the box for “Public—State.” If the facility is owned by a
county government, municipal (e.g., city or town) government,

•

2S-7

The legal boundaries of the facility.
All sewage sludge management facilities, including onsite
treatment, storage, and disposal sites.
Wells, springs, and other surface water bodies that are
within ¼ mile of the property boundaries and listed in public
records or otherwise known to applicant.

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
Item 1.20. The 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 statement, representation, or certification in any
application, ...shall upon conviction, be punished by a fine of no
more than $10,000 or by imprisonment for not more than six
months or both.”

On the map, include the map scale, a meridian arrow showing
north, and latitude and longitude to the nearest second or
equivalent decimal degrees (e.g., 38.893829, -77.029289).
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).

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

You may develop your map by going to USGS’s National Map
website at http://nationalmap.gov/. (For a map from this site, use
the traditional 7.5-minute quadrangle format. If none is available,
use a USGS 15-minute series map.) You may also use a plat or
other appropriate map.

Note that you have completed your topographic map and
attached it to the application.
Line Drawing
Item 1.15. Provide a line drawing and/or narrative description
that identifies all sewage sludge practices that will be employed
during the permit term, including all units used for collecting,
dewatering, storing, or treating sewage sludge; the
destination(s) of all liquids and solids leaving each such unit;
and all processes used for pathogen reduction and vector
attraction reduction. Answer “Yes” when a line drawing and/or
narrative description containing all required information has
been attached to the application.
Contractor Information
Item 1.16. Indicate whether contractors have any operational or
maintenance responsibilities related to sewage sludge
generation, treatment, use, or disposal at the facility. If yes,
continue to Item 1.17. If no, skip to Item 1.8 (Part 2, Section 1).
Item 1.17. Provide the company name, mailing address, contact
name (first and last), telephone number, and email address for
each contractor and describe the contractor’s responsibilities.
The application form provides reporting space for three
contractors. If your facility has more than three contractors,
attach additional sheets as necessary.
Pollutant Concentrations
Item 1.18. Provide the most recent sewage sludge monitoring
data available on the quality of the sewage sludge, including for
pollutants for which limits in sewage sludge have been
established in 40 CFR 503 for your facility’s expected use or
disposal practices. Provide the average monthly concentration
in milligrams per kilogram (mg/kg) dry weight, analytical method,
and detection level. If available, base data on three or more
samples taken at least one month apart, no more than 4.5 years
old. If providing the monitoring data in a separate attachment,
check the box to indicate that this information has been attached
to the application package.

Section 2. Generation of Sewage Sludge or Preparation of a
Material Derived from Sewage Sludge
Complete this section if you are a ‘‘person who prepares
sewage sludge.’’ This section pertains to any POTW or other
TWTDS that generates sewage sludge, as well as to any facility
that derives a material from sewage sludge (e.g., it composts
sewage sludge or blends sewage sludge with another material).
Simply distributing sewage sludge or placing it in a bag or other
container for sale or give-away for application to the land is not
considered ‘‘deriving a material’’ from sewage sludge (because
it does not change sludge quality), and thus a facility that only
distributes or bags a sewage sludge is not required to provide
the information in this section.

Checklist and Certification Statement
Item 1.19. Review the checklist provided. In Column 1, mark the
sections of Form 2S, Part 2, that you have completed and are
submitting with your application. For each section that you have
completed, indicate in Column 2 whether you are submitting
attachments.

Item 2.1. Answer “Yes” or “No” to indicate if the facility
generates sewage sludge or derives a material from sewage
sludge (e.g., it composts sewage sludge or blends sewage
2S-8

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
sludge with another material). If yes, continue to Item 2.2. If no,
skip to Part 2, Section 3. Note that all POTWs generate sewage
sludge and should check “Yes” regardless of whether the sludge
is removed on a regular basis.

and options 9 through 11 are typically met at the point of use or
disposal. Complete Item 2.8 for each sewage sludge use or
disposal practice by attaching additional sheets, as necessary.
Item 2.9. For each use or disposal practice indicated in Item 2.8,
identify the treatment process(es) used at your facility to reduce
pathogens or vector attraction properties in sewage sludge. If
you check “Other,” specify the treatment process(es) in the
space provided or in a separate attachment.

Amount Generated Onsite
Item 2.2. Provide the total dry metric tons of sewage sludge
generated at the facility over a 365-day period. If sludge is
generated but is not removed (e.g., sludge collecting in a
lagoon), provide an estimate of the amount generated.

Item 2.10. Use the space provided to describe any other
sewage sludge treatment or blending activities not identified in
Items 2.8 and 2.9. Check the box if your description has been
attached to the application package.
Preparation of Sewage Sludge Meeting Ceiling and
Pollutant Concentrations, Class A Pathogen Requirements,
and One of Vector Attraction Reduction Options 1 to 8

Amount Received from Offsite Facility
Item 2.3. Indicate whether the facility receives sewage sludge
from another facility for treatment, use, or disposal. If yes,
continue to Item 2.4. If no, skip to Item 2.8 (Part 2, Section 2).
Item 2.4. Indicate the total number of facilities from which your
facility receives sewage sludge for treatment, use, or disposal.
Item 2.5. Complete Items 2.5 through 2.7 for each facility from
which your facility receives sewage sludge for treatment, use or
disposal. Check the box to indicate that this information has
been attached to the application package.

Item 2.11. Indicate whether the sewage sludge meets the
ceiling concentrations in Table 1 of 40 CFR 503.13, the pollutant
concentrations in Table 3 of 40 CFR 503.12, Class A pathogen
reduction requirements at 40 CFR 503.32(a), and one of the
vector attraction reduction requirements at 40 CFR
503.33(b)(1)–(8) and is land applied. Sewage sludge meeting all
of these criteria is often referred to as “exceptional quality (EQ)”
and is exempt from the general requirements of 40 CFR 503.12
and the management practices of 40 CFR 503.14, and thus
fewer permitting and permit application requirements typically
pertain to facilities generating such sludge. For this reason, if
you check “Yes” for Item 2.11, complete Items 2.12 and 2.13;
then you may skip Items 2.14 through 2.16, Items 2.17 through
2.26, and Items 2.27 through 2.31 unless specifically required to
complete any of them by the permitting authority. If you check
“No,” skip to Item 2.14 (Part 2, Section 2).

Enter the name and mailing address of the facility. Provide the
name (first and last), title, work telephone number, and email
address of the contact person for the facility. Provide a complete
location address for the facility if different from the mailing
address. If the facility or site lacks a street name or route
number, give the most accurate alternative geographic
information (e.g., section number or quarter section number
from county records or “at intersection of Routes 425 and 22”).
Item 2.6. Indicate the amount of sewage sludge received, the
applicable pathogen class and reduction alternative, and the
applicable vector attraction reduction option provided at the
offsite facility. To determine the applicable pathogen class and
reduction alternative, see 40 CFR 503.32. To determine the
applicable vector attraction reduction option, see 40 CFR
503.33. Vector attraction reduction options 1 through 8 are
typically met at the point where sewage sludge is generated or
where a material is derived from sewage sludge, and options 9
through 11 are typically met at the point of use or disposal.

Item 2.12. Provide the total dry metric tons of sewage sludge,
meeting the requirements specified in Item 2.11 that is applied
to land per 365-day period.
Item 2.13. Indicate whether the subject sewage sludge is placed
in a bag or other container and sold or given away for land
application. Check the box indicating completion of Items 2.11
through 2.13 and skip to Item 2.32 (Part 2, Section 2).

Item 2.7. Identify the treatment process(es) that are known to
occur at the offsite facility, including blending activities and
treatment to reduce pathogens or vector attraction properties in
sewage sludge. If you check “Other,” specify the treatment
process(es) in the space provided or in a separate attachment.

Sale or Give-Away in a Bag or Other Container for
Application to the Land
Item 2.14. Indicate whether the subject sewage sludge is placed
in a bag or other container and sold or given away for land
application. If yes, continue to Item 2.15. If no, skip to Item 2.17
(Part 2, Section 2).

Treatment Provided at Your Facility
Item 2.8. In the “Use or Disposal Practice” column, check the
sewage sludge use or disposal practice used at your facility. In
the following columns, indicate the pathogen class and
reduction alternative and the vector attraction reduction option
associated with the practice. To determine the applicable
pathogen class and reduction alternative, see 40 CFR 503.32.
To determine the applicable vector attraction reduction option,
see 40 CFR 503.33. Vector attraction reduction options 1
through 8 are typically met at the point where sewage sludge is
generated or where a material is derived from sewage sludge,

Item 2.15. Provide the dry metric tons of sewage sludge placed
in a bag or other container and sold or given away for land
application per 365-day period.
Item 2.16. When sewage sludge is placed in a bag or other
container for sale or give-away for application to the land, either
a label must be affixed to the bag or other container, or an
information sheet must be provided to the person receiving the
sewage sludge. The information that must be on the label or
2S-9

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
information sheet is listed at 40 CFR 503.14(e). Attach copies of
all labels or notices that accompany sewage sludge being sold
or given away in a bag or other container for land application.
Check the box to indicate that these copies have been attached
to the application package.

box to indicate that this information has been attached to the
application package.
Item 2.25. Indicate whether the receiving facility places sewage
sludge from your facility in a bag or other container to sell or
give away for land application. If yes, continue to Item 2.26. If
no, skip to Item 2.32 (Part 2, Section 2).

Check the box indicating completion of Items 2.14 through 2.16
and skip to Item 2.32 (Part 2, Section 2).

Item 2.26. When sewage sludge is placed in a bag or other
container for sale or give-away for application to the land, either
a label must be affixed to the bag or other container, or an
information sheet must be provided to the person receiving the
sewage sludge. The information that must be on the label or
information sheet is listed at 40 CFR 503.14(e). Attach copies of
all labels or notices that accompany sewage sludge being sold
or given away in a bag or other container for land application.
Check the box to indicate that this information has been
attached to the application package.

Shipment Offsite for Treatment or Blending
Item 2.17. Indicate whether another facility provides treatment
or blending of your facility’s sewage sludge. (This does not
pertain to dewatered sludge sent directly to a land application or
surface disposal site.) If yes, continue to Item 2.18. If no, skip to
Item 2.32 (Part 2, Section 2).
Item 2.18. Indicate the total number of facilities that provide
treatment or blending of your facility’s sewage sludge. Complete
Items 2.19 through 2.26 for each facility that provides treatment
or

Check the box indicating completion of Items 2.17 through 2.26
and skip to Item 2.32 (Part 2, Section 2).

blending of your facility’s sewage sludge. Check the box to
indicate if this information has been attached to the application
package.

Land Application of Bulk Sewage
Item 2.27. Answer “Yes” or “No” to indicate whether sewage
sludge from your facility is applied to the land. If yes, continue to
Item 2.28. If no, skip to Item 2.32 (Part 2, Section 2).

Item 2.19. Enter the name and mailing address of the receiving
facility. Provide the name (first and last), title, work telephone
number, and email address of the contact person for the
receiving facility. Include a complete location address for the
facility if different from the mailing address. If the facility or site
lacks a street name or route number, give the most accurate
alternative geographic information (e.g., section number or
quarter section number from county records or “at intersection of
Routes 425 and 22”).

Item 2.28. Provide the total dry metric tons of sewage sludge
applied to all land application sites per 365-day period.
Item 2.29. Indicate whether all land application sites were
identified in Part 2, Section 3, of this application. If no, submit a
copy of the land application plan with your application package.
Current regulations require you to submit a land application plan
at the time of permit application if you intend to apply sewage
sludge that does not meet the EQ requirements to land
application sites that have not been identified at the time of
permit application. The minimum requirements for this plan are
listed in 40 CFR 122.21(q)(9)(v). The NPDES permitting
authority will work with you to develop additional details of the
land application plan on a case-by-case basis. Such details
could include site selection criteria (site slope, runon and runoff
control, etc.) and site management guidelines (sludge
application rates, access controls, etc.). A land application plan
provides for public notice when it is developed as part of the
permit, and it discusses how the public will be notified about
new sites.

Item 2.20. Provide the dry metric tons of sewage sludge
provided to the receiving facility per 365-day period.
Item 2.21 Indicate whether the receiving facility provides any
additional treatment to reduce pathogens in, or vector attraction
properties of, the sewage sludge from your facility. If yes,
continue to Item 2.22. If no, skip to Item 2.24 (Part 2, Section 2).
Item 2.22. Indicate the pathogen class and reduction alternative
and the vector attraction reduction option met for the sewage
sludge at the receiving facility. To determine the applicable
pathogen class and reduction alternative, see 40 CFR 503.32.
To determine the applicable vector attraction reduction option,
see 40 CFR 503.33. Vector attraction reduction options 1
through 8 are typically met at the point where sewage sludge is
generated or where a material is derived from sewage sludge,
and options 9 through 11 are typically met at the point of use or
disposal.

Item 2.30. Indicate whether there are any land application sites
in states other than the state where you generate sewage
sludge or derive a material from the sewage sludge. If yes,
continue to Item 2.31. If no, skip to Item 2.32 (Part 2, Section 2).
Item 2.31. If any land application sites are in states other than
the state where you generate the bulk sewage sludge or derive
the material from sewage sludge, the notice to the permitting
authority in the states where the land application sites are
located must contain the requirements listed at 40 CFR
503.12(i). In a separate attachment, describe how you notify the
NPDES permitting authority for the states where the land
application sites are located. Check the boxes to indicate if the

Item 2.23. Identify the treatment process(es) used at the
receiving facility to reduce pathogens or vector attraction
properties of sewage sludge from your facility. If you check
“Other,” specify the treatment process(es) in the space provided
or in a separate attachment.
Item 2.24. Attach a copy of any information you provide to the
receiving facility to comply with the “notice and necessary
information” requirement under 40 CFR 503.12(g). Check the
2S-10

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
explanation and/or the notification have been attached to the
application package.

street name or route number, give the most accurate alternative
geographic information (e.g., section number or quarter section
number from county records or “at intersection of Routes 425
and 22”).

Surface Disposal
Item 2.32. Indicate whether sewage sludge from your facility is
placed on a surface disposal site. If yes, continue to Item 2.33. If
no, skip to Item 2.39 (Part 2, Section 2).

Item 2.44. Indicate whether the site contact is the owner and/or
operator of the incinerator.

Item 2.33. Provide the total dry metric tons of sewage sludge
from your facility placed on all surface disposal sites per 365day period.

Item 2.45. Provide the total dry metric tons of sewage sludge
from your facility fired in the sewage sludge incinerator per 365day period.

Item 2.34. Indicate whether you own or operate all surface
disposal sites to which you send sewage sludge for disposal. If
yes, skip to Item 2.39 (Part 2, Section 2). If no, continue to
Item 2.35.

Disposal in a Municipal Solid Waste Landfill
Item 2.46. Indicate whether sewage sludge from your facility is
placed on a municipal solid waste landfill. If yes, continue to
Item 2.47. If no, skip to Part 2, Section 3.

Item 2.35. Provide the total number of surface disposal sites to
which you send sewage sludge. Complete Items 2.36 through
2.38 for each surface disposal site to which you send your
sewage sludge. Check the box to indicate that this information
has been attached to the application package.

Item 2.47. Provide the total number of municipal solid waste
landfills to which you send sewage sludge. Complete Items 2.48
through 2.52 for each landfill used. Check the box to indicate
that this information has been attached to the application
package.

Item 2.36. Enter the site name or number and mailing address
of the surface disposal site you do not own or operate. Provide

Item 2.48. Enter the name and mailing address of the municipal
solid waste landfill. Provide the name (first and last), title, work
telephone number, and email address of the contact person for
the landfill.

the name (first and last), title, work telephone number, and email
address of the contact person for the surface disposal site.

Include a complete location address for the landfill if different
from the mailing address. If the landfill lacks a street name or
route number, give the most accurate alternative geographic
information (e.g., section number or quarter section number
from county records or “at intersection of Routes 425 and 22”).

Item 2.37. Indicate whether the site contact is the owner and/or
operator of the surface disposal site.
Item 2.38. Provide the total dry metric tons of sewage sludge
from your facility placed on the surface disposal site per 365-day
period.

Item 2.49. Provide the total dry metric tons of sewage sludge
from your facility placed in each municipal solid waste landfill
per 365-day period.

Incineration
Item 2.39. Answer “Yes” or “No” to indicate if sewage sludge
from your facility is fired in a sewage sludge incinerator. If yes,
continue to Item 2.40. If no, skip to Item 2.46 (Part 2, Section 2).

Item 2.50. In the space provided or in a separate attachment,
list the number and type of all other federal, state, and local
permits that regulate the operation of this municipal solid waste
landfill.

Item 2.40. Provide the total dry metric tons of sewage sludge
from your facility fired in all sewage sludge incinerators per 365day period.

Item 2.51. Attach information to determine whether the sewage
sludge meets applicable requirements for disposal in a
municipal solid waste landfill (e.g., results of paint filter liquids
test and toxicity characteristic leaching procedure, or TCLP,
test). Check the box to indicate that this information has been
attached to the application package.

Item 2.41. Answer “Yes” or “No” to indicate if you own or
operate all sewage sludge incinerators to which you send
sewage sludge for firing. If yes, skip to Item 2.46. If no, continue
to Item 2.42 (Part 2, Section 2).
Item 2.42. Indicate the total number of sewage sludge
incinerators that you use but do not own or operate. Complete
Items 2.43 through 2.45 for each of these incinerators. Check
the box to indicate that this information has been attached to the
application package.

Item 2.52. Sewage sludge placed on a municipal solid waste
landfill must meet requirements in 40 CFR 258 concerning the
quality of materials placed on a landfill unit. Part 258 specifies
minimum federal criteria for municipal solid waste landfills,
including landfills that accept sewage sludge along with
household waste. In contrast to 40 CFR 503, 40 CFR 258
controls sewage sludge placed in municipal solid waste landfills
through a facility design and management practice approach. In
40 CFR 503, EPA has adopted the 40 CFR 258 criteria as the
appropriate standard for sewage sludge disposed of with
municipal waste. EPA concluded that if sewage sludge is
disposed of in a municipal solid waste landfill complying with 40
CFR 258 criteria, public health and the environment are

Item 2.43. Enter the name or number and mailing address of
each sewage sludge incinerator that you use but do not own or
operate. Provide the name (first and last), title, work telephone
number, and email address of the contact person for the
incinerator.
Include a complete location address for the incinerator if it is
different from the mailing address. If the incinerator lacks a
2S-11

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
protected. Note that the POTW is legally responsible for
knowing whether a municipal solid waste landfill is in
compliance with 40 CFR 258 and may be liable if it sends
sludge to a municipal solid waste landfill that is not in
compliance with 40 CFR 258. Indicate whether the municipal
solid waste landfill complies with applicable criteria set forth in
40 CFR 258.

Provide the latitude and longitude to the nearest second or
equivalent decimal degrees (e.g., 38.893829, -77.029289) for
the site and method of determination. The location of the land
application site (i.e., where the coordinates are collected) shall
be the approximate center of the area where the sewage sludge
is directly released to the environment. 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., USGS). For
further guidance, refer to
http://www.epa.gov/geospatial/latitudelongitude-data-standard.

Section 3. Land Application of Bulk Sewage Sludge
Complete this section if you completed Section 2, Items 2.27
through 2.31. Unless the NPDES permitting authority specifically
requires you to complete this section, you may skip this section
for sewage sludge that is covered in any of the following
portions of this application:

Item 3.5. Check the box to indicate that a topographic map (or
other appropriate map if a topographic map is unavailable)
showing the site location has been attached to the application.
See Item 1.14 (Part 2, Section 1) for guidance on obtaining a
topographic map.
Owner Information
Item 3.6. Indicate whether you are the owner of the land
application site. If yes, skip to Item 3.8 (Part 2, Section 3). If no,
continue to Item 3.7.

Section 2, Items 2.11 through 3.13. Such sewage sludges
are exempt from the general requirements and
management practices of 40 CFR 503 when they are land
applied (unless the permitting authority requires otherwise),
and thus the site information in Section 3 is not required for
permitting.
• Section 2, Items 2.17 through 2.26. Section 3 does not
apply to a generator that sends sewage sludge to another
facility for treatment or for blending, because the 40 CFR
503 requirements addressed by Section 3 will largely be
the responsibility of the receiving facility.
Provide the information in this section for each land application
site that has been identified at the time of permit application. In
cases where the sewage sludge is applied to numerous sites
with similar characteristics, you may combine the information for
several sites under a single response (the name and address of
each site must still be provided, however).
•

Item 3.7. Enter the name and mailing address of the owner of
the land application site. Provide the name (first and last), title,
work telephone number, and email address of the contact
person for the owner.
Applier Information
Item 3.8. Indicate whether you are the person who applies, or is
responsible for application of, sewage sludge to this land
application site. If yes, skip to Item 3.10 (Part 2, Section 3). If
no, continue to Item 3.9.

Item 3.1. Indicate whether your facility applies sewage sludge to
land. If yes, continue to Item 3.2. If no, skip to Part 2, Section 4.

Item 3.9. Enter the name and mailing address of the applier.
Provide the name (first and last), title, work telephone number,
and email address of the contact person for the applier.

Item 3.2. Indicate if any of the following conditions apply:
•

•
•

The sewage sludge meets the ceiling concentrations in
Table 1 of 40 CFR 503.13, the pollutant concentrations in
Table 3 of 40 CFR 503.13, Class A pathogen requirements
at 40 CFR 503.32(a), and one of the vector attraction
reduction requirements at 40 CFR 503.33(b)(1)–(8).
The sewage sludge is sold or given away in a bag or other
container for application to the land.
You provide the sewage sludge to another facility for
treatment or blending.

Site Type
Item 3.10. Identify the type of land application site (e.g.,
agricultural land, forest, reclamation site, public contact site, or
other). If you check “Other,” provide a description in the space
provided or in a separate attachment.
Crop or Other Vegetation Grown Onsite
Item 3.11. In the space provided or in a separate attachment,
describe the type of crop or other vegetation that is grown on
the site. If the crop or vegetation to be grown on the site is not
yet known, or is likely to change in an unforeseeable manner
during the life of the permit, you may so indicate instead of
providing the type of crop or other vegetation.

If yes, skip to Part 2, Section 4. If no, continue to Item 3.3.
Item 3.3. Complete the remainder of Section 3 for each site on
which sewage sludge is applied. Check the box to indicate if this
information has been attached to the application package.

Item 3.12. In the space provided or in a separate attachment,
indicate the nitrogen requirement for the crop or other
vegetation identified in Item 3.11. You can get information on
the nitrogen content of vegetation grown on the site from local
agricultural extension services, a local Farm Advisor’s Office, or
published sources.

Identification of Land Application Site
Item 3.4. Enter the name or number and location address for
the land application site. If the site lacks a street name or route
number, give the most accurate alternative geographic
information (e.g., section number or quarter section number
from county records or “at intersection of Routes 425 and 22”).
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FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
Vector Attraction Reduction
Item 3.13. Indicate whether the vector attraction reduction
requirements at 40 CFR 503.33(b)(9) and (b)(10) are met when
sewage sludge is applied to the land application site. If yes,
continue to Item 3.14. If no, skip to Item 3.16 (Part 2, Section 3).

Information on Active Sewage Sludge Units
Most requirements for surface disposal of sewage sludge under
40 CFR 503 pertain to individual active sewage sludge units at a
surface disposal site. The information required in Items 4.3
through 4.15 may be developed on a unit-by-unit basis or may
be developed for the entire surface disposal site if all units are
sufficiently similar.

Item 3.14. Indicate which vector attraction option (Option 9,
injection below land surface, or Option 10, incorporation into soil
within 6 hours) is met when sewage sludge is applied to the land
application site.

Item 4.3. Enter the name or number and mailing address of the
active sewage sludge unit. Provide the name (first and last),
title, work telephone number, and email address of the contact
person for the active sewage sludge unit.

Item 3.15. In the space provided or in a separate attachment,
describe any treatment processes used at the land application
site to reduce vector attraction properties of sewage sludge.
Check the box to indicate that your description has been
attached to the application package.

Include a complete location address for the unit if different from
the mailing address. If the unit lacks a street name or route
number, give the most accurate alternative geographic
information (e.g., section number or quarter section number
from county records or “at intersection of Routes 425 and 22”).

Cumulative Loadings and Remaining Allotments
Item 3.16. Indicate whether the sewage sludge applied to this
site since July 20, 1993, is subject to the cumulative pollutant
loading rates (CPLRs) at 40 CFR 503.13(b)(2). If yes, continue
to Item 3.17. If no, skip to Part 2, Section 4.

Provide the latitude and longitude to the nearest second or
equivalent decimal degrees (e.g., 38.893829, -77.029289) for
the unit and method of determination. The location of the unit
(i.e., where the coordinates are collected) shall be the
approximate center of the area where the sewage sludge is
directly released to the environment. 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., USGS). For
further guidance, refer to
http://www.epa.gov/geospatial/latitudelongitude-data-standard.

Item 3.17. Indicate whether you have contacted the NPDES
permitting authority in the state where the bulk sewage sludge
subject to CPLRs will be applied, to ascertain whether bulk
sewage sludge subject to CPLRs has been applied to this site
on or since July 20, 1993. If yes, continue to Item 3.18. If no,
because sewage sludge subject to CPLRs may not be applied
to this site, skip to Part 2, Section 4.
Item 3.18. Provide your NPDES permitting authority’s name,
contact person, telephone number, and email address.

Item 4.4. Check the box to indicate that a topographic map (or
other appropriate map if a topographic map is unavailable)

Item 3.19. Indicate, based on your inquiry, whether bulk sewage
sludge subject to CPLRs has been applied to the site since
July 20, 1993. If yes, continue to Item 3.20. If no, skip to Part 2,
Section 4.

showing the site location has been attached to the application.
See Item 1.14 (Part 2, Section 1) for guidance on obtaining a
topographic map.

Item 3.20. Provide the name and mailing address for every
facility other than yours that is sending, or has sent, bulk
sewage sludge subject to CPLRs to this site since July 20,
1993. Give the name (first and last), title, work telephone
number, and email address of the contact person for the facility
that is sending, or has sent, bulk sewage sludge subject to
CPLRs to this site since July 20, 1993.

Item 4.5. Provide the total dry metric tons of sewage sludge
placed on the active sewage sludge unit per 365-day period.
Item 4.6. Provide the total dry metric tons of sewage sludge
placed on the active sewage sludge unit over the life of the unit.
Item 4.7. Indicate whether the active sewage sludge unit has a
liner with a maximum permeability of 10-7 centimeters per
second (cm/sec). If yes, continue to Item 4.8. If no, skip to
Item 4.9 (Part 2, Section 4).

Section 4. Surface Disposal
Complete this section if you own or operate a surface disposal
site and are required to submit a full permit application (i.e., Part
2 of Form 2S) at this time. A sewage sludge surface disposal
site is, by definition, a TWTDS, and the owner/operator of the
site is required to apply for a permit.

Item 4.8. In the space provided or in a separate attachment,
describe the liner. Check the box to indicate that a description
has been attached to the application package.
Item 4.9. Indicate whether the active sewage sludge unit has a
leachate collection system. If yes, continue to Item 4.10. If no,
skip to Item 4.11 (Part 2, Section 4).

Item 4.1. Indicate whether you own or operate a surface
disposal site. If yes, continue to Item 4.2. If no, skip to Part 2,
Section 5.

Item 4.10. In the space provided or in a separate attachment,
describe the leachate collection system and the leachate
disposal method. Also provide the numbers of any federal, state,
or local permit(s) for leachate disposal. Check the box to

Item 4.2. Complete the remainder of Section 4 for each active
sewage sludge unit you own or operate. Check the box to
indicate that this information has been attached to the
application package.
2S-13

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
Item 4.22. In the space provided or in a separate attachment,
describe any treatment processes used at the active sewage
sludge unit to reduce vector attraction properties of sewage
sludge. Check the box to indicate that this description has been
attached to the application package.

indicate that this description has been attached to the
application package.
Item 4.11. Indicate if the boundary of the active sewage sludge
site is less than 150 meters from the property line of the surface
disposal site. If yes, continue to Item 4.12. If no, skip to
Item 4.13 (Part 2, Section 4).

Groundwater Monitoring
Placement of sewage sludge on an active sewage sludge unit
must not contaminate an aquifer. Compliance must be
demonstrated through either (1) the results of a groundwater
monitoring program developed by a qualified groundwater
scientist or (2) certification by a qualified groundwater scientist
that contamination has not occurred. This section solicits
existing groundwater monitoring data and other documentation
to indicate the potential for contamination of an aquifer at the
active sewage sludge unit, as well as the capability of the
owner/operator of the surface disposal site to demonstrate that
contamination has not occurred.

Item 4.12. Provide the distance, in meters, between the active
sewage sludge site boundary and the surface disposal site
property line.
Item 4.13. Provide the remaining capacity of active sewage
sludge in dry metric tons.
Item 4.14. List the anticipated closure date for the active
sewage sludge unit, using the format MM/DD/YYYY, if known.
Item 4.15. Submit a copy of any closure plan that has been
developed for this active sewage sludge unit. Check the box to
indicate that you have attached a copy to the application
package.

Item 4.23. Indicate whether groundwater monitoring is currently
conducted at, or ground monitoring data are otherwise available
for, this active sewage sludge unit. If yes, continue to Item 4.24.
If no, skip to Item 4.26 (Part 2, Section 4).

Sewage Sludge from Other Facilities
Item 4.16. Indicate whether sewage sludge is sent to this active
sewage sludge unit from any facilities other than yours. If yes,
continue to Item 4.17. If no, skip to Item 4.21 (Part 2, Section 4).

Item 4.24. Provide a copy of available groundwater monitoring
data. Check the box to indicate that the data have been
attached to the application package.

Item 4.17. Indicate the total number of facilities, other than
yours, that send sewage sludge to this active sewage sludge
unit. Complete Items 4.18 through 4.20 for each such facility.
Check the box to indicate that this information has been
attached to the application package.

Item 4.25. In the space provided or in a separate attachment,
describe the well locations, the approximate depth to
groundwater, and the groundwater monitoring procedures used
to obtain the data.

Item 4.18. Enter the name and mailing address of the facility
that sends sewage sludge to this active sewage sludge unit.

Check the box to indicate that the descriptions have been
attached to the application package.

Provide the name (first and last), title, work telephone number,
and email address of the contact person for the facility.

Item 4.26. Indicate whether a groundwater monitoring program
has

Item 4.19. Indicate the pathogen class and reduction alternative
and the vector attraction reduction option met for the sewage
sludge before it leaves the other facility. To determine the
applicable pathogen class and reduction alternative, see
40 CFR 503.32. To determine the applicable vector attraction
reduction option, see 40 CFR 503.33. Vector attraction
reduction options 1 through 8 are typically met at the point
where sewage sludge is generated or where a material is
derived from sewage sludge, and options 9 through 11 are
typically met at the point of use or disposal.

been prepared for this active sewage sludge unit. If yes,
continue to Item 4.27. If no, skip to Item 4.28 (Part 2, Section 4).
Item 4.27. Submit a copy of the groundwater monitoring
program that has been developed for this active sewage sludge
unit. Check the box to indicate that this documentation has been
attached to the application package.
Item 4.28. Indicate whether you have obtained certification from
a qualified groundwater scientist that the aquifer below the
active sewage sludge unit has not been contaminated. If yes,
continue to Item 4.29. If no, skip to Item 4.30 (Part 2, Section 4).

Item 4.20. Identify the treatment process(es) used at the other
facility to reduce pathogens or vector attraction properties of
sewage sludge before it leaves that facility. If you check “Other,”
specify the treatment process(es) in the space provided or in a
separate attachment.

Item 4.29. Submit a copy of the certification indicating that the
aquifer below the active sewage sludge unit has not been
contaminated. Check the box to indicate that this certification
has been attached to the application package.

Vector Attraction Reduction
Item 4.21. Indicate which, if any, vector attraction reduction
option (Option 9, injection below land surface; Option 10,
incorporation into soil within 6 hours; Option 11, covering active
sewage sludge unit daily; or none) is met when sewage sludge
is placed on this active sewage sludge unit.

Site-Specific Limits
After August 18, 1993, you are allowed to seek site-specific
pollutant limits only for good cause, and must do so within
180 days of becoming aware that good cause exists. If you
request site-specific pollutant limits with this permit application,
you are required to submit information supporting the request,
2S-14

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
Beryllium NESHAP
The firing of sewage sludge in a sewage sludge incinerator must
not violate the National Emission Standard for Hazardous Air
Pollutants (NESHAP) for beryllium as established in Subpart C
of 40 CFR 61. The beryllium NESHAP only applies, however, to
sewage sludge incinerators firing ‘‘beryllium-containing waste.’’
The beryllium NESHAP is 10 grams of beryllium in the exit gas
over a 24-hour period, unless the incinerator owner/operator has
been approved to meet a 30-day average ambient concentration
limit on beryllium in the vicinity of the sewage sludge incinerator
of 0.01 μg/m3. Complete this section to demonstrate compliance
with the beryllium NESHAP.

including a demonstration that existing values for site
parameters specified by the permitting authority differ from the
values for those parameters used to develop the pollutant limits
in Table 1 of 40 CFR 503.23. You must also submit follow-up
information at the request of the NPDES permitting authority. If
the NPDES permitting authority determines that site-specific
pollutant limits are appropriate, the authority may specify those
limits in the permit as long as the existing concentrations of the
pollutants in the sewage sludge are not exceeded.
Item 4.30. Indicate whether you are seeking site-specific
pollutant limits for the sewage sludge placed on the active
sewage sludge unit. If yes, continue to Item 4.31. If no, skip to
Part 2, Section 5.

Item 5.5. Submit information, test data, and a description of
measures taken that demonstrate whether the sewage sludge
incinerated is beryllium-containing waste and will continue to
remain as such. Check the box to indicate that this material has
been attached to the application package.

Item 4.31. Submit information to support the request for sitespecific pollutant limits. Check the box to indicate that this
information has been attached to the application package.
Section 5. Incineration
Complete this section if you own or operate a sewage sludge
incinerator. A sewage sludge incinerator is, by definition, a
treatment works treating domestic sewage, and the owner/
operator of a sewage sludge incinerator is required to submit a
full permit application.

Item 5.6. Indicate whether the sewage sludge fired in the
incinerator is beryllium-containing waste as defined at 40 CFR
61.31. If yes, continue to Item 5.7. If no, skip to Item 5.8 (Part 2,
Section 5).
Item 5.7. Submit a complete report of the latest beryllium
emission testing and documentation of ongoing incinerator
operating parameters indicating that the NESHAP emission rate
limit for beryllium has been and will continue to be met. Check
the box to indicate that this documentation has been attached to
the application package.

Incinerator Information
Item 5.1. Indicate whether you fire sewage sludge in a sewage
sludge incinerator. If yes, continue to Item 5.2. If no, skip to the
end.
Item 5.2. Indicate the total number of incinerators used at your
facility. Complete the remainder of Section 5 for each
incinerator. Check the box to indicate that you have attached
information for one or more incinerators.

Mercury NESHAP
The firing of sewage sludge in a sewage sludge incinerator must
not violate the NESHAP for mercury as established in Subpart E
of 40 CFR 61. Complete this section to demonstrate compliance
with the mercury NESHAP. Information on stack testing and
sewage sludge sampling can be found at 40 CFR 61.53 and
61.54.

Item 5.3. Enter the incinerator’s name or number. Include a
complete location address for the incinerator. If the incinerator
lacks a street name or route number, give the most accurate
alternative geographic information (e.g., section number or
quarter section number from county records or “at intersection of
Routes 425 and 22”).

Item 5.8. Indicate whether compliance with the mercury
NESHAP is being demonstrated via stack testing. If yes,
continue to Item 5.9. If no, skip to Item 5.11 (Part 2, Section 5).

Provide the latitude and longitude to the nearest second or
equivalent decimal degrees (e.g., 38.893829, -77.029289) for
the incinerator and method of determination. The location of the
incinerator (i.e., where the coordinates are collected) shall be
the approximate center of the area where the sewage sludge is
directly released to the environment. 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., USGS). For
further guidance, refer to
http://www.epa.gov/geospatial/latitudelongitude-data-standard.

Item 5.9. Submit a complete report of stack testing and
documentation of ongoing incinerator operating parameters
indicating that the NESHAP emission rate limit for mercury has
been and will continue to be met. Check the box to indicate that
this documentation has been attached to the application
package.
Item 5.10. Provide copies of mercury emission rate tests for the
two most recent years in which testing was conducted. Check
the box to indicate that this information has been attached to the
application package.
Item 5.11. Indicate whether you demonstrate compliance with
the mercury NESHAP by performing sewage sludge sampling. If
yes, continue to Item 5.12. If no, skip to Item 5.13 (Part 2,
Section 5).

Amount Fired
Item 5.4. Provide the dry metric tons of sewage sludge fired in
the sewage sludge incinerator per 365-day period.

Item 5.12. Submit a complete report of sewage sludge sampling
and documentation of ongoing incinerator operating parameters
2S-15

FORM 2S—PART 2 LINE-BY-LINE INSTRUCTIONS (CONTINUED)
Incinerator Parameters
Item 5.24. Indicate whether you monitor total hydrocarbons
(THC) in the exit gas of the sewage sludge incinerator.

indicating that the incinerator has been meeting and will
continue to meet the NESHAP emission rate limit for mercury.
Check the box to indicate that this documentation has been
attached to the application package.

Item 5.25. Indicate whether you monitor carbon monoxide (CO)
in the exit gas of the sewage sludge incinerator.

Dispersion Factor
Item 5.13. Provide the dispersion factor in micrograms/cubic
meter per gram/second.

Item 5.26. Specify the type of sewage sludge incinerator used.
Item 5.27. Provide the incinerator stack height in meters.

Item 5.14. Specify the name and type of dispersion model.

Item 5.28. Indicate whether the value submitted in Item 5.27 is
the actual stack height or creditable stack height.

Item 5.15 Submit a copy of the modeling results and supporting
documentation. Check the box to indicate that the
documentation has been attached to the application package.

Performance Test Operating Parameters
Item 5.29. Provide the maximum performance test combustion
temperature.

Control Efficiency
Item 5.16. Provide the control efficiency, in hundredths, for
arsenic, cadmium, chromium, lead, and nickel.

Item 5.30. Provide the performance test sewage sludge feed
rate, in dry metric tons/day.

Item 5.17. Submit the results of performance testing and
supporting documentation, including test dates. Check the box
to indicate that this documentation has been attached to the
application package.

Item 5.31. Indicate whether the value submitted in Item 5.30 is
the average use rate or maximum design rate.
Item 5.32. Supply supporting documentation describing how the
feed rate was calculated. Check the box to indicate that this
documentation has been attached to the application package.

Risk-Specific Concentration for Chromium
Item 5.18. Provide the risk-specific concentration (RSC) used
for chromium in micrograms per cubic meter.

Item 5.33. Submit information documenting the performance
test operating parameters for the air pollution control device(s)
used for this sewage sludge incinerator. Check the box to
indicate that this information has been attached to the
application package.

Item 5.19. Indicate whether the RSC was determined using
Table 2 at 40 CFR 503.43. If yes, continue to Item 5.20. If no,
skip to Item 5.21 (Part 2, Section 5).
Item 5.20. Identify the incinerator used as the basis: either
fluidized bed with wet scrubber, other types with wet scrubber,
fluidized bed with wet scrubber and wet electrostatic
precipitator, or other types with wet scrubber and wet
electrostatic precipitator.

Monitoring Equipment
Item 5.34. Use the table provided, or a separate attachment, to
indicate the equipment in place to monitor total hydrocarbons or
carbon monoxide, percent oxygen, percent moisture,
combustion temperature, and any other parameters not listed.

Item 5.21. Indicate whether the RSC was determined using
Table 2 at 40 CFR 503.43 (site-specific determination). If yes,
continue to Item 5.22. If no, skip to Item 5.23 (Part 2, Section 5).

Air Pollution Control Equipment
Item 5.35. List all air pollution control equipment used with this
sewage sludge incinerator. Check the box to indicate that the list
has been attached to the application package.

Item 5.22. Provide the decimal fraction of hexavalent chromium
to total chromium concentration in the stack exit gas.

END OF PART 2

Item 5.23. Submit the results of incinerator stack testing for
hexavalent and total chromium concentrations, including test
dates. Check the box to indicate that these results have been
attached to the application package, or check “Not applicable.”

Submit your completed Part 2 of Form 2S
and all associated attachments
to your NPDES permitting authority.

2S-16

FORM 2S—GLOSSARY
Note: This glossary includes terms used in the various NPDES application forms, including Form 2S. The definitions are from the NPDES
regulations at 40 CFR 122.2 unless otherwise specified. If you have any questions concerning the meaning of any of these terms, contact
your NPDES permitting authority.
ANIMAL FEEDING OPERATION (defined at § 122.23) means a lot or facility (other than an aquatic animal production facility) where the
following conditions are met;
•
•

Animals (other than aquatic animals) have been, are, or will be stabled or confined and fed or maintained for a total of 45 days or
more in any 12-month period; and
Crops, vegetation, forage growth, or post-harvest residues are not sustained in the normal growing season over any portion of the lot
or facility.

APPLICATION means the EPA standard national forms for applying for a permit, including any additions, revisions, or modifications to the
forms; or forms approved by EPA for use in approved states, including any approved modifications or revisions.
APPROVED PROGRAM or APPROVED STATE means a State or interstate program which has been approved or authorized by EPA
under part 123.
AQUACULTURE PROJECT (defined at § 122.25) means a defined managed water area which uses discharges of pollutants into that
designated area for the maintenance or production of harvestable freshwater, estuarine, or marine plants or animals. DESIGNATED
PROJECT AREA means the portions of the waters of the United States within which the permittee or permit applicant plans to confine the
cultivated species, using a method or plan or operation (including, but not limited to, physical confinement) which, on the basis of reliable
scientific evidence, is expected to ensure that specific individual organisms comprising an aquaculture crop will enjoy increased growth
attributable to the discharge of pollutants, and be harvested within a defined geographic area.
AVERAGE MONTHLY DISCHARGE LIMITATION means the highest allowable average of daily discharges over a calendar month,
calculated as the sum of all daily discharges measured during that month divided by the number of daily discharges measured during that
month.
AVERAGE WEEKLY DISCHARGE LIMITATION means the highest allowable average of daily discharges over a calendar week,
calculated as the sum of all daily discharges measured during a calendar week divided by the number of daily discharges measured during
that week.
BEST MANAGEMENT PRACTICES (BMPs) means schedules of activities, prohibitions of practices, maintenance procedures, and other
management practices to prevent or reduce the pollution of waters of the United States. BMPs include treatment requirements, operation
procedures, and practices to control plant site runoff, spillage or leaks, sludge or waste disposal, or drainage from raw material storage.
BIOSOLIDS (see sewage sludge).
BYPASS (defined at § 122.41(m)) means the intentional diversion of waste streams from any portion of a treatment facility.
COMBINED SEWER OVERFLOW (CSO) means a discharge from a combined sewer system (CSS) at a point prior to the Publicly Owned
Treatment Works (POTW) Treatment Plant (defined at § 403.3(r)).
COMBINED SEWER SYSTEM (CSS) means a wastewater collection system owned by a State or municipality (as defined by section
502(4) of the CWA) which conveys sanitary wastewaters (domestic, commercial and industrial wastewaters) and storm water through a
single-pipe system to a Publicly Owned Treatment Works (POTW) Treatment Plant (as defined at § 403.3(r)).
CONCENTRATED ANIMAL FEEDING OPERATION (defined at § 122.23) means an animal feeding operation that is defined as a Large
CAFO or as a Medium CAFO by the terms of (A) or (B) below, or that is designated as a CAFO in accordance with 40 CFR 122.23(c). Two
or more AFOs under common ownership are considered to be a single AFO for the purposes of determining the number of animals at an
operation, if they adjoin each other or if they use a common area or system for the disposal of wastes.
A.

LARGE CONCENTRATED ANIMAL FEEDING OPERATION (LARGE CAFO) means an AFO that stables or confines as many as or
more than the numbers of animals specified in any of the following categories:
1. 700 mature dairy cows, whether milked or dry;
2. 1,000 veal calves;
3. 1,000 cattle other than mature dairy cows or veal calves. Cattle includes but is not limited to heifers, steers, bulls and cow/calf
pairs;
4. 2,500 swine each weighing 55 pounds or more;
5. 10,000 swine each weighing less than 55 pounds;
6. 500 horses;
7. 10,000 sheep or lambs;
2S-17

FORM 2S—GLOSSARY (CONTINUED)
8.
9.
10.
11.
12.
13.
B.

55,000 turkeys;
30,000 laying hens or broilers, if the AFO uses a liquid manure handling system;
125,000 chickens (other than laying hens), if the AFO uses other than a liquid manure handling system;
82,000 laying hens, if the AFO uses other than a liquid manure handling system;
30,000 ducks (if the AFO uses other than a liquid manure handling system); or
5,000 ducks (if the AFO uses a liquid manure handling system).

MEDIUM CONCENTRATED ANIMAL FEEDING OPERATION (MEDIUM CAFO) means any AFO with the type and number of
animals that fall within any of the ranges listed below and which has been defined or designated as a CAFO. An AFO is defined as a
Medium CAFO if:
1.

The type and number of animals that it stables and confines falls within any of the following ranges:
a. 200 to 699 mature dairy cows, whether milked or dry;
b. 300 to 999 veal calves;
c. 300 to 999 cattle other than mature dairy cows or veal calves. Cattle includes but is not limited to heifers, steers, bulls and
cow/calf pairs;
d. 750 to 2,499 swine each weighing 55 pounds or more;
e. 3,000 to 9,999 swine each weighing less than 55 pounds;
f. 150 to 499 horses;
g. 3,000 to 9,999 sheep or lambs;
h. 16,500 to 54,999 turkeys;
i. 9,000 to 29,999 laying hens or broilers, if the AFO uses a liquid manure handling system;
j. 37,500 to 124,999 chickens (other than laying hens), if the AFO uses other than a liquid manure handling system;
k. 25,000 to 81,999 laying hens, if the AFO uses other than a liquid manure handling system;
l. 10,000 to 29,999 ducks (if the AFO uses other than a liquid manure handling system); or
m. 1,500 to 4,999 ducks (if the AFO uses a liquid manure handling system); and
2. Either one of the following conditions are met:
a. Pollutants are discharged into waters of the United States through a man-made ditch, flushing system, or other similar manmade device; or
b. Pollutants are discharged directly into waters of the United States which originate outside of and pass over, across, or
through the facility or otherwise come into direct contact with animals confined in the operation.
CONCENTRATED AQUATIC ANIMAL PRODUCTION FACILITY (defined at § 122.24) means a hatchery, fish farm, or other facility which
contains, grows, or holds aquatic animals in either of the following categories, or which the Director designates as such on a case-by-case
basis:
A.

Cold water fish species or other cold water aquatic animals including, but not limited to, the Salmonidae family of fish (e.g., trout and
salmon) in ponds, raceways, or other similar structures which discharge at least 30 days per year but does not include:
1. Facilities which produce less than 9,090 harvest weight kilograms (approximately 20,000 pounds) of aquatic animals per year;
and
2. Facilities which feed less than 2,272 kilograms (approximately 5,000 pounds) of food during the calendar month of maximum
feeding.

Warm water fish species or other warm water aquatic animals including, but not limited to, the Ameiuridae, Cetrarchiclae, and
Cyprinidae families of fish (e.g., respectively, catfish, sunfish, and minnows) in ponds, raceways, or other similar structures which
discharge at least 30 days per year, but does not include;
1.

Closed ponds which discharge only during periods of excess runoff; or

Facilities which produce less than 45,454 harvest weight kilograms (approximately 100,000 pounds) of aquatic animals per year.

CWA means the Clean Water Act (formerly referred to as the Federal Water Pollution Control Act or Federal Water Pollution Control Act
Amendments of 1972) Public Law 92–500, as amended by Public Law 95–217, Public Law 95–576, Public Law 96–483 and Public Law
97–117, 33 U.S.C. 1251 et seq.
CWA AND REGULATIONS means the Clean Water Act (CWA) and applicable regulations promulgated thereunder. In the case of an
approved State program, it includes State program requirements.
2S-18

FORM 2S—GLOSSARY (CONTINUED)
DAILY DISCHARGE means the “discharge of a pollutant” measured during a calendar day or any 24-hour period that reasonably
represents the calendar day for purposes of sampling. For pollutants with limitations expressed in units of mass, the “daily discharge” is
calculated as the total mass of the pollutant discharged over the day. For pollutants with limitations expressed in other units of
measurement, the “daily discharge” is calculated as the average measurement of the pollutant over the day.
DIRECT DISCHARGE means the “discharge of a pollutant.”
DIRECTOR means the Regional Administrator or the State Director, as the context requires, or an authorized representative. When there
is no “approved State program,” and there is an EPA administered program, “Director” means the Regional Administrator. When there is
an approved State program, “Director” normally means the State Director. In some circumstances, however, EPA retains the authority to
take certain actions even when there is an approved State program. (For example, when EPA has issued an NPDES permit prior to the
approval of a State program, EPA may retain jurisdiction over that permit after program approval, see § 123.1.) In such cases, the term
“Director” means the Regional Administrator and not the State Director.
DISCHARGE (OF A POLLUTANT) means:
•
•

Any addition of any pollutant or combination of pollutants to waters of the United States from any point source; or
Any addition of any pollutant or combination of pollutants to the waters of the contiguous zone or the ocean from any point source
other than a vessel or other floating craft which is being used as a means of transportation.

This definition includes discharges into waters of the United States from: surface runoff which is collected or channelled by man;
discharges through pipes, sewers, or other conveyances owned by a State, municipality, or other person which do not lead to a treatment
works; and discharges through pipes, sewers, or other conveyances, leading into privately owned treatment works. This term does not
include an addition of pollutants by any “indirect discharger.”
DISCHARGE MONITORING REPORT means the EPA uniform national form, including any subsequent additions, revisions, or
modifications for the reporting of self-monitoring results by permittees. DMRs must be used by “approved States” as well as by EPA. EPA
will supply DMRs to any approved State upon request. The EPA national forms may be modified to substitute the state agency name,
address, logo, and other similar information, as appropriate, in place of EPA's.
DRAFT PERMIT means a document prepared under § 124.6 indicating the Director's tentative decision to issue or deny, modify, revoke
and reissue, terminate, or reissue a “permit.” A notice of intent to terminate a permit, and a notice of intent to deny a permit, as discussed
in § 124.5, are types of “draft permits.” A denial of a request for modification, revocation and reissuance, or termination, as discussed in
§ 124.5, is not a “draft permit.” A “proposed permit” is not a “draft permit.”
EFFLUENT LIMITATION means any restriction imposed by the Director on quantities, discharge rates, and concentrations of “pollutants”
which are “discharged” from “point sources” into “waters of the United States,” the waters of the “contiguous zone,” or the ocean.
EFFLUENT LIMITATIONS GUIDELINES means a regulation published by the Administrator under Section 304(b) of the CWA to adopt or
revise “effluent limitations.”
ENVIRONMENTAL PROTECTION AGENCY (EPA) means the United States Environmental Protection Agency.
FACILITY or ACTIVITY means any NPDES “point source” or any other facility or activity (including land or appurtenances thereto) that is
subject to regulation under the NPDES program.
GENERAL PERMIT means an NPDES “permit” issued under § 122.28 authorizing a category of discharges under the CWA within a
geographical area.
HAZARDOUS SUBSTANCE means any substance designated under 40 CFR part 116 pursuant to Section 311 of the CWA.
INDIAN COUNTRY (or INDAN LANDS) means:
•
•
•

All land within the limits of any Indian reservation under the jurisdiction of the United States Government, notwithstanding the
issuance of any patent, and, including rights-of-way running through the reservation;
All dependent Indian communities with the borders of the United States whether within the originally or subsequently acquired territory
thereof, and whether within or without the limits of a state; and
All Indian allotments, the Indian titles to which have not been extinguished, including rights-of-way running through the same.

INDIAN TRIBE means any Indian Tribe, band, group, or community recognized by the Secretary of the Interior and exercising
governmental authority over a Federal Indian reservation.
INDIRECT DISCHARGE means a nondomestic discharger introducing “pollutants” to a “publicly owned treatment works.”

2S-19

FORM 2S—GLOSSARY (CONTINUED)
LARGE MUNICIPAL SEPARATE STORM SEWER SYSTEM (defined at § 122.26(b)(4)) means all municipal separate storm sewers that
are either:
(i) Located in an incorporated place with a population of 250,000 or more as determined by the 1990 Decennial Census by the Bureau of
the Census (Appendix F of 40 CFR 122); or
(ii) Located in the counties listed in appendix H of 40 CFR 122, except municipal separate storm sewers that are located in the
incorporated places, townships or towns within such counties; or
(iii) Owned or operated by a municipality other than those described in paragraphs (i) or (ii) and that are designated by the Director as part
of the large or medium municipal separate storm sewer system due to the interrelationship between the discharges of the designated
storm sewer and the discharges from municipal separate storm sewers described under paragraphs (i) or (ii). In making this determination
the Director may consider the following factors:
(A) Physical interconnections between the municipal separate storm sewers;
(B) The location of discharges from the designated municipal separate storm sewer relative to discharges from municipal separate storm
sewers described in paragraph (i);
(C) The quantity and nature of pollutants discharged to waters of the United States;
(D) The nature of the receiving waters; and
(E) Other relevant factors; or
(iv) The Director may, upon petition, designate as a large municipal separate storm sewer system, municipal separate storm sewers
located within the boundaries of a region defined by a storm water management regional authority based on a jurisdictional, watershed, or
other appropriate basis that includes one or more of the systems described in paragraphs (i), (ii), (iii).
LOG SORTING AND LOG STORAGE FACILITIES (defined at § 122.27) means facilities whose discharges result from the holding of
unprocessed wood, for example, logs or roundwood with bark or after removal of bark held in self-contained bodies of water (mill ponds or
log ponds) or stored on land where water is applied intentionally on the logs (wet decking). (See 40 CFR 429, subpart I, including the
effluent limitations guidelines.)
MAJOR FACILITY means any NPDES “facility or activity” classified as such by the Regional Administrator, or, in the case of “approved
State programs,” the Regional Administrator in conjunction with the State Director.
MAXIMUM DAILY DISCHARGE LIMITATION means the highest allowable “daily discharge.”
MEDIUM MUNICIPAL SEPARATE STORM SEWER SYSTEM (defined at § 122.26(b)(7)) means all municipal separate storm sewers that
are either:
(i) Located in an incorporated place with a population of 100,000 or more but less than 250,000, as determined by the 1990 Decennial
Census by the Bureau of the Census (appendix G of 40 CFR 122); or
(ii) Located in the counties listed in appendix I of 40 CFR 122, except municipal separate storm sewers that are located in the incorporated
places, townships or towns within such counties; or
(iii) Owned or operated by a municipality other than those described in paragraph (i) or (ii) and that are designated by the Director as part
of the large or medium municipal separate storm sewer system due to the interrelationship between the discharges of the designated
storm sewer and the discharges from municipal separate storm sewers described under paragraph (i) or (ii). In making this determination
the Director may consider the following factors:
(A) Physical interconnections between the municipal separate storm sewers;
(B) The location of discharges from the designated municipal separate storm sewer relative to discharges from municipal separate storm
sewers described in paragraph (i);
(C) The quantity and nature of pollutants discharged to waters of the United States;
(D) The nature of the receiving waters; or
(E) Other relevant factors; or
(iv) The Director may, upon petition, designate as a medium municipal separate storm sewer system, municipal separate storm sewers
located within the boundaries of a region defined by a storm water management regional authority based on a jurisdictional, watershed, or
other appropriate basis that includes one or more of the systems described in paragraphs (i), (ii), (iii) of this section.

2S-20

FORM 2S—GLOSSARY (CONTINUED)
MUNICIPALITY means a city, town, borough, county, parish, district, association, or other public body created by or under State law and
having jurisdiction over disposal of sewage, industrial wastes, or other wastes, or an Indian tribe or an authorized Indian tribal organization,
or a designated and approved management agency under Section 208 of the CWA.
MUNICIPAL SEPARATE STORM SEWER (defined at § 122.26(b)(8)) means a conveyance or system of conveyances (including roads
with drainage systems, municipal streets, catch basins, curbs, gutters, ditches, man-made channels, or storm drains):

•

Owned or operated by a State, city, town, borough, county, parish, district, association, or other public body (created by or pursuant to
State law) having jurisdiction over disposal of sewage, industrial wastes, stormwater, or other wastes, including special districts under
State law such as a sewer district, flood control district or drainage district, or similar entity, or an Indian tribe or an authorized Indian
tribal organization, or a designated and approved management agency under Section 208 of the CWA that discharges to waters of
the United States.
Designed or used for collecting or conveying stormwater.

•
•

Which is not a combined sewer; and
Which is not part of a POTW as defined at 40 CFR 122.2.

•

MUNICIPAL SLUDGE (see sewage sludge)
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) means the national program for issuing, modifying, revoking
and reissuing, terminating, monitoring and enforcing permits, and imposing and enforcing pretreatment requirements, under Sections 307,
402, 318, and 405 of the CWA. The term includes an “approved program.”
NEW DISCHARGER means any building, structure, facility, or installation:
•

From which there is or may be a “discharge of pollutants;”

•
•
•

That did not commence the “discharge of pollutants” at a particular “site” prior to August 13, 1979;
Which is not a “new source;” and
Which has never received a finally effective NPDES permit for discharges at that “site.”

This definition includes an “indirect discharger” which commences discharging into “waters of the United States” after August 13, 1979. It
also means any existing mobile point source (other than an offshore or coastal oil and gas exploratory drilling rig or a coastal oil and gas
developmental drilling rig) such as a seafood processing rig, seafood processing vessel, or aggregate plant, that begins discharging at a
“site” for which it does not have a permit; and any offshore or coastal mobile oil and gas exploratory drilling rig or coastal mobile oil and gas
developmental drilling rig that commences the discharge of pollutants after August 13, 1979, at a “site” under EPA’s permitting jurisdiction
for which it is not covered by an individual or general permit and which is located in an area determined by the Regional Administrator in
the issuance of a final permit to be an area of biological concern. In determining whether an area is an area of biological concern, the
Regional Administrator shall consider the factors specified in 40 CFR 125.122(a)(1) through (10).
An offshore or coastal mobile exploratory drilling rig or coastal mobile developmental drilling rig will be considered a “new discharger” only
for the duration of its discharge in an area of biological concern.
NEW SOURCE means any building, structure, facility, or installation from which there is or may be a “discharge of pollutants,” the
construction of which commenced:
•
•

After promulgation of standards of performance under Section 306 of the CWA which are applicable to such source, or
After proposal of standards of performance in accordance with Section 306 of the CWA which are applicable to such source, but only
if the standards are promulgated in accordance with Section 306 within 120 days of their proposal.

OWNER OR OPERATOR means the owner or operator of any “facility or activity” subject to regulation under the NPDES program.
PERMIT means an authorization, license, or equivalent control document issued by EPA or an “approved State” to implement the
requirements of this part and parts 123 and 124. “Permit” includes an NPDES “general permit” (§ 122.28). Permit does not include any
permit which has not yet been the subject of final agency action, such as a “draft permit” or a “proposed permit.”
PESTICIDE DISCHARGES TO WATERS OF THE UNITED STATES FROM PESTICIDE APPLICATION means the application of
biological pesticides, and the application of chemical pesticides that leave a residue, from point sources to waters of the United States. In
the context of this definition of pesticide discharges to waters of the United States from pesticide application, this does not include
agricultural storm water discharges and return flows from irrigated agriculture, which are excluded by law (33 U.S.C. 1342(l); 33 U.S.C.
1362(14)).
PESTICIDE RESIDUE for the purpose of determining whether an NPDES permit is needed for discharges to waters of the United States
from pesticide application, means that portion of a pesticide application that is discharged from a point source to waters of the United
States and no longer provides pesticidal benefits. It also includes any degradates of the pesticide.
2S-21

FORM 2S—GLOSSARY (CONTINUED)
POINT SOURCE means any discernible, confined, and discrete conveyance, including but not limited to, any pipe, ditch, channel, tunnel,
conduit, well, discrete fissure, container, rolling stock, concentrated animal feeding operation, landfill leachate collection system, vessel or
other floating craft from which pollutants are or may be discharged. This term does not include return flows from irrigated agriculture or
agricultural stormwater runoff. (See § 122.3).
POLLUTANT means dredged spoil, solid waste, incinerator residue, filter backwash, sewage, garbage, sewage sludge, munitions,
chemical wastes, biological materials, radioactive materials (except those regulated under the Atomic Energy Act of 1954, as amended (42
U.S.C. 2011 et seq.)), heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal, and agricultural waste
discharged into water. It does not mean:
•
•

Sewage from vessels; or
Water, gas, or other material which is injected into a well to facilitate production of oil or gas, or water derived in association with oil
and gas production and disposed of in a well, if the well used either to facilitate production or for disposal purposes is approved by
authority of the State in which the well is located, and if the State determines that the injection or disposal will not result in the
degradation of ground or surface water resources. Note: Radioactive materials covered by the Atomic Energy Act are those
encompassed in its definition of source, byproduct, or special nuclear materials. Examples of materials not covered include radium
and accelerator-produced isotopes. See Train v. Colorado Public Interest Research Group, Inc., 426 U.S. 1 (1976).

PRIMARY INDUSTRY CATEGORY means any industry category listed in the NRDC settlement agreement (Natural Resources Defense
Council et al. v. Train, 8 E.R.C. 2120 (D.D.C. 1976), modified 12 E.R.C. 1833 (D.D.C. 1979)); also listed in appendix A of part 122.
PRIVATELY OWNED TREATMENT WORKS means any device or system which is (1) used to treat wastes from any facility whose
operator is not the operator of the treatment works and (2) not a “POTW.”
PROCESS WASTEWATER means any water which, during manufacturing or processing, comes into direct contact with or results from the
production or use of any raw material, intermediate product, finished product, byproduct, or waste product.
PROPOSED PERMIT means a state NPDES “permit” prepared after the close of the public comment period (and, when applicable, any
public hearing and administrative appeals) which is sent to EPA for review before final issuance by the State. A “proposed permit” is not a
“draft permit.”
PUBLICLY OWNED TREATMENT WORKS or POTW (defined at § 403.3) means a treatment works as defined by CWA Section 212,
which is owned by a state or municipality (as defined by CWA Section 502(4)). This definition includes any devices or systems used in the
storage, treatment, recycling, and reclamation) of municipal sewage or industrial wastes of a liquid nature. This definition also includes
sewers, pipes, and other conveyances only if they convey wastewater to a POTW. The term also means the municipality as defined in
CWA Section 502(4), which has jurisdiction over the indirect discharges to and the discharges from such a treatment works.
REGIONAL ADMINISTRATOR means the Regional Administrator of the appropriate Regional Office of the Environmental Protection
Agency or the authorized representative of the Regional Administrator.
ROCK CRUSHING AND GRAVEL WASHING FACILITIES (defined at § 122.27) means facilities which process crushed and broken
stone, gravel, and riprap (See 40 CFR 436, subpart B, including the effluent limitations guidelines).
SCHEDULE OF COMPLIANCE means a schedule of remedial measures included in a “permit”, including an enforceable sequence of
interim requirements (for example, actions, operations, or milestone events) leading to compliance with the CWA and regulations.
SECONDARY INDUSTRY CATEGORY means any industry category which is not a primary industry category.
SEWAGE FROM VESSELS means human body wastes and the wastes from toilets and other receptacles intended to receive or retain
body wastes that are discharged from vessels and regulated under Section 312 of the CWA, except that with respect to commercial
vessels on the Great Lakes this term includes graywater. For the purposes of this definition, “graywater” means galley, bath, and shower
water.
SEWAGE SLUDGE means any solid, semi-solid, or liquid residue removed during the treatment of municipal waste water or domestic
sewage. Sewage sludge includes, but is not limited to, solids removed during primary, secondary, or advanced waste water treatment,
scum, septage, portable toilet pumpings, type III marine sanitation device pumpings (33 CFR 159), and sewage sludge products. Sewage
sludge does not include grit or screenings, or ash generated during the incineration of sewage sludge.
SlLVICULTURAL POINT SOURCE (defined at § 122.27) means any discernible, confined, and discrete conveyance related to rock
crushing, gravel washing, log sorting, or log storage facilities which are operated in connection with silvicultural activities and from which
pollutants are discharged into waters of the United States. This term does not include non-point source silvicultural activities such as
nursery operations, site preparation, reforestation and subsequent cultural treatment, thinning, prescribed burning, pest and fire control,
harvesting operations, surface drainage, or road construction and maintenance from which there is natural runoff. However, some of these
activities (such as stream crossing for roads) may involve point source discharges of dredged or fill material which may require a CWA
Section 404 permit (see 33 CFR 209.120 and part 233).
2S-22

FORM 2S—GLOSSARY (CONTINUED)
SITE means the land or water area where any “facility or activity” is physically located or conducted, including adjacent land used in
connection with the facility or activity.
SLUDGE-ONLY FACILITY means any “treatment works treating domestic sewage” whose methods of sewage sludge use or disposal are
subject to regulations promulgated pursuant to Section 405(d) of the CWA and is required to obtain a permit under § 122.1(b)(2).
STANDARDS FOR SEWAGE SLUDGE USE OR DISPOSAL means the regulations promulgated pursuant to Section 405(d) of the CWA
which govern minimum requirements for sludge quality, management practices, and monitoring and reporting applicable to sewage sludge
or the use or disposal of sewage sludge by any person.
STATE means any of the 50 States, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Virgin Islands, American
Samoa, the Commonwealth of the Northern Mariana Islands, the Trust Territory of the Pacific Islands, or an Indian Tribe as defined in
these regulations which meets the requirements of § 123.31 of this chapter.
STATE DIRECTOR means the chief administrative officer of any State or interstate agency operating an “approved program,” or the
delegated representative of the State Director. If responsibility is divided among two or more State or interstate agencies, “State Director”
means the chief administrative officer of the State or interstate agency authorized to perform the particular procedure or function to which
reference is made.
STORMWATER (or STORM WATER) (defined at § 122.26(b)(13)) means stormwater runoff, snow melt runoff, and surface runoff and
drainage.
STORMWATER DISCHARGE ASSOCIATED WITH INDUSTRIAL ACTIVITY (defined at § 122.26(b)(14)) means the discharge from any
conveyance that is used for collecting and conveying stormwater and that is directly related to manufacturing, processing or raw materials
storage areas at an industrial plant. The term does not include discharges from facilities or activities excluded from the NPDES program
under this part 122. For the categories of industries identified in this section, the term includes, but is not limited to, stormwater discharges
from industrial plant yards; immediate access roads and rail lines used or traveled by carriers of raw materials, manufactured products,
waste material, or by-products used or created by the facility; material handling sites; refuse sites; sites used for the application or disposal
of process waste waters (as defined at 40 CFR 401); sites used for the storage and maintenance of material handling equipment; sites
used for residual treatment, storage, or disposal; shipping and receiving areas; manufacturing buildings; storage areas (including tank
farms) for raw materials, and intermediate and final products; and areas where industrial activity has taken place in the past and significant
materials remain and are exposed to stormwater. For the purposes of this paragraph, material handling activities include storage, loading
and unloading, transportation, or conveyance of any raw material, intermediate product, final product, by-product or waste product. The
term excludes areas located on plant lands separate from the plant's industrial activities, such as office buildings and accompanying
parking lots as long as the drainage from the excluded areas is not mixed with stormwater drained from the above described areas.
Industrial facilities (including industrial facilities that are federally, State, or municipally owned or operated that meet the description of the
facilities listed in paragraphs 1 through 14 below) include those facilities designated under the provisions of 40 CFR 122.26(a)(1)(v). The
following categories of facilities are considered to be engaging in “industrial activity” for purposes of 40 CFR 122.26(b)(14):
1.
2.

4.
5.
6.

Facilities subject to stormwater effluent limitations guidelines, new source performance standards, or toxic pollutant effluent standards
under 40 CFR Subchapter N (except facilities with toxic pollutant effluent standards which are exempted under paragraph 11 below);
Facilities classified as Standard Industrial Classification 24, Industry Group 241 that are rock crushing, gravel washing, log sorting, or
log storage facilities operated in connection with silvicultural activities defined in 40 CFR 122.27(b)(2)–(3) and Industry Groups 242
through 249; 26 (except 265 and 267), 28 (except 283), 29, 311, 32 (except 323), 33, 3441, 373; (not included are all other types of
silvicultural facilities);
Facilities classified as Standard Industrial Classifications 10 through 14 (mineral industry) including active or inactive mining
operations (except for areas of coal mining operations no longer meeting the definition of a reclamation area under 40 CFR 434.11(1)
because the performance bond issued to the facility by the appropriate SMCRA authority has been released, or except for areas of
non–coal mining operations which have been released from applicable State or Federal reclamation requirements after
December 17, 1990) and oil and gas exploration, production, processing, or treatment operations, or transmission facilities that
discharge stormwater contaminated by contact with or that has come into contact with, any overburden, raw material, intermediate
products, finished products, byproducts or waste products located on the site of such operations; (inactive mining operations are
mining sites that are not being actively mined, but which have an identifiable owner/operator; inactive mining sites do not include sites
where mining claims are being maintained prior to disturbances associated with the extraction, beneficiation, or processing of mined
materials, nor sites where minimal activities are undertaken for the sole purpose of maintaining a mining claim);
Hazardous waste treatment, storage, or disposal facilities, including those that are operating under interim status or a permit under
subtitle C of RCRA;
Landfills, land application sites, and open dumps that receive or have received any industrial wastes (waste that is received from any
of the facilities described under this subsection) including those that are subject to regulation under subtitle D of RCRA;
Facilities involved in the recycling of materials, including metal scrapyards, battery reclaimers, salvage yards, and automobile
junkyards, including but limited to those classified as Standard Industrial Classification 5015 and 5093;
2S-23

FORM 2S—GLOSSARY (CONTINUED)
7.
8.

Steam electric power generating facilities, including coal handling sites;
Transportation facilities classified as Standard Industrial Classifications 40, 41, 42 (except 4221–25), 43, 44, 45, and 5171 which have
vehicle maintenance shops, equipment cleaning operations, or airport deicing operations. Only those portions of the facility that are
either involved in vehicle maintenance (including vehicle rehabilitation, mechanical repairs, painting, fueling, and lubrication),
equipment cleaning operations, airport deicing operations, or which are otherwise identified under paragraphs 1–7 or 9–11 are
associated with industrial activity;
9. Treatment works treating domestic sewage or any other sewage sludge or wastewater treatment device or system, used in the
storage treatment, recycling, and reclamation of municipal or domestic sewage, including land dedicated to the disposal of sewage
sludge that are located within the confines of the facility, with a design flow of 1.0 mgd or more, or required to have an approved
pretreatment program under 40 CFR 403. Not included are farm lands, domestic gardens or lands used for sludge management
where sludge is beneficially reused and which are not physically located in the confines of the facility, or areas that are in compliance
with Section 405 of the CWA;
10. Construction activity including clearing, grading and excavation, except operations that result in the disturbance of less than five acres
of total land area. Construction activity also includes the disturbance of less than five acres of total land area that is a part of a larger
common plan of development or sale if the larger common plan will ultimately disturb five acres or more;
11. Facilities under Standard Industrial Classifications 20, 21, 22, 23, 2434, 25, 265, 267, 27, 283, 285, 30, 31 (except 311), 323, 34
(except 3441), 35, 36, 37 (except 373), 38, 39, and 4221–25.
TOXIC POLLUTANT means any pollutant listed as toxic under Section 307(a)(1) or, in the case of “sludge use or disposal practices,” any
pollutant identified in regulations implementing Section 405(d) of the CWA.
TREATMENT WORKS TREATING DOMESTIC SEWAGE (TWTDS) means a POTW or any other sewage sludge or waste water
treatment devices or systems, regardless of ownership (including federal facilities), used in the storage, treatment, recycling, and
reclamation of municipal or domestic sewage, including land dedicated for the disposal of sewage sludge. This definition does not include
septic tanks or similar devices. For purposes of this definition, “domestic sewage” includes waste and waste water from humans or
household operations that are discharged to or otherwise enter a treatment works. In States where there is no approved State sludge
management program under Section 405(f) of the CWA, the Regional Administrator may designate any person subject to the standards for
sewage sludge use and disposal in 40 CFR 503 as a “treatment works treating domestic sewage,” where he or she finds that there is a
potential for adverse effects on public health and the environment from poor sludge quality or poor sludge handling, use or disposal
practices, or where he or she finds that such designation is necessary to ensure that such person is in compliance with 40 CFR 503.
UPSET (defined at § 122.41(n)) means an exceptional incident in which there is unintentional and temporary noncompliance with
technology based permit effluent limitations because of factors beyond the reasonable control of the permittee. An upset does not include
noncompliance to the extent caused by operational error, improperly designed treatment facilities, inadequate treatment facilities, lack of
preventive maintenance, or careless or improper operation.
VARIANCE means any mechanism or provision under Section 301 or 316 of the CWA or under 40 CFR 125, or in the applicable “effluent
limitations guidelines” which allows modification to or waiver of the generally applicable effluent limitation requirements or time deadlines of
the CWA. This includes provisions which allow the establishment of alternative limitations based on fundamentally different factors or on
Sections 301(c), 301(g), 301(h), 301(i), or 316(a) of the CWA.
WATERS OF THE UNITED STATES as defined at § 122.2.
WHOLE EFFLUENT TOXICITY (WET) means the aggregate toxic effect of an effluent measured directly by a toxicity test.

2S-24

This page intentionally left blank.

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 for Sewage Sludge Management

Form
2S
NPDES

NEW AND EXISTING TREATMENT WORKS TREATING DOMESTIC SEWAGE
PRELIMINARY INFORMATION
Does your facility currently have an effective NPDES permit or have you been directed by your NPDES permitting authority to submit a
full Form 2S permit application?
 Yes  Complete Part 2 of application package (begins p. 7).
 No  Complete Part 1 of application package (below).
Part 1
LIMITED BACKGROUND INFORMATION (40 CFR 122.21(c)(2)(ii))
Complete this part only if you are a “sludge-only” facility (i.e., a facility that does not currently have, and is not applying for, an NPDES
permit for a direct discharge to a surface body of water).
PART 1, SECTION 1. FACILITY INFORMATION (40 CFR 122.21(C)(2)(II)(A))
Facility name
1.1
Mailing address (street or P.O. box)
Facility Information

City or town
Contact name (first and last)

Title

State

ZIP code

Phone number

Email address

Location address (street, route number, or other specific identifier)
City or town
1.2

 Same as mailing address

State

ZIP code

Ownership Status

 Public—federal
 Private

 Public—state
 Other public (specify)___________________
 Other (specify) _________

PART 1, SECTION 2. APPLICANT INFORMATION (40 CFR 122.21(C)(2)(II)(B))
2.1

Applicant Information

2.2

Is applicant different from entity listed under Item 1.1 above?
 Yes
 No  SKIP to Item 2.3 (Part 1, Section 2).
Applicant name
Applicant address (street or P.O. box)
City or town
Contact name (first and last)

2.3
2.4

Title

State

ZIP code

Phone number

Email address

Is the applicant the facility’s owner, operator, or both? (Check only one response.)
 Owner
 Operator
 Both
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
Facility and applicant
Facility
Applicant



PART 1, SECTION 3. SEWAGE SLUDGE AMOUNT (40 CFR 122.21(C)(2)(II)(D))
Sewage Sludge Amount

3.1



(they are one and the same)

Provide the total dry metric tons per the latest 365-day period of sewage sludge generated, treated, used, and
disposed of:
Dry Metric Tons per
Practice
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

EPA Form 3510-2S

Page 1

EPA Identification Number

NPDES Permit Number

Facility Name

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

PART 1, SECTION 4. POLLUTANT CONCENTRATIONS (40 CFR 122.21(C)(2)(II)(E))
4.1

Using the table below or a separate attachment, provide existing sewage sludge monitoring data for the pollutants
for which limits in sewage sludge have been established in 40 CFR 503 for your facility’s expected use or disposal
practices. If available, base data on three or more samples taken at least one month apart and no more than
4.5 years old.

 Check here if you have provided a separate attachment with this information.
Pollutant
Arsenic

Concentration
(mg/kg dry weight)

Analytical Method

Detection Level
for Analysis

Cadmium
Chromium
Copper
Lead
Pollutant Concentrations

Mercury

EPA Form 3510-2S

Molybdenum
Nickel
Selenium
Zinc
Other (specify)
___________________
Other (specify)
___________________
Other (specify)
___________________
Other (specify)
___________________
Other (specify)
___________________
Other (specify)
___________________
Other (specify)
___________________
Other (specify)
___________________
Other (specify)
___________________

Page 2

EPA Identification Number

NPDES Permit Number

Facility Name

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

Treatment Provided at Your Facility

PART 1, SECTION 5. TREATMENT PROVIDED AT YOUR FACILITY (40 CFR 122.21(C)(2)(II)(C))
5.1
For each sewage sludge use or disposal practice, indicate the amount of sewage sludge used or disposed of, the
applicable pathogen class and reduction alternative, and the applicable vector attraction reduction option. Attach
additional pages, as necessary.
Pathogen Class and
Vector Attraction
Use or Disposal Practice
Amount
(check one)
(dry metric tons)
Reduction Alternative
Reduction Option
 Land application of bulk sewage
 Not applicable
 Not applicable
 Land application of biosolids
 Class A, Alternative 1
 Option 1
(bulk)
 Class A, Alternative 2
 Option 2
 Land application of biosolids
 Class A, Alternative 3
 Option 3
(bags)
 Class A, Alternative 4
 Option 4
 Disposal in a landfill
 Class A, Alternative 5
 Option 5
 Surface disposal
 Class A, Alternative 6
 Option 6
 Incineration
 Class B, Alternative 1
 Option 7
 Class B, Alternative 2
 Option 8
 Class B, Alternative 3
 Option 9
 Class B, Alternative 4
 Option 10
 Domestic septage, pH  Option 11
adjustment
5.2
For each of the use and disposal practices specified in Item 5.1, identify the treatment process(es) used at your
facility to reduce pathogens in sewage sludge or reduce the vector attraction properties of sewage sludge. (Check
all that apply.)
Preliminary operations (e.g., sludge

 Thickening (concentration)
grinding and degritting)
Stabilization

 Anaerobic digestion






Composting
Disinfection (e.g., beta ray irradiation,
gamma ray irradiation, pasteurization)
Heat drying
Methane or biogas capture and recovery








Yes  SKIP to Part 1, Section 8 (Certification).

Conditioning
Dewatering (e.g., centrifugation, sludge drying
beds, sludge lagoons)
Thermal reduction
Other (specify) _____________________________

PART 1, SECTION 6. SEWAGE SLUDGE SENT TO OTHER FACILITIES (40 CFR 122.21(C)(2)(II)(C))
6.1
Does the sewage sludge from your facility meet the ceiling concentrations in Table 1 of 40 CFR 503.13, the
pollutant concentrations in Table 3 of 40 CFR 503.13, Class A pathogen reduction requirements at 40 CFR
503.32(a), and one of the vector attraction reduction requirements at 40 CFR 503.33(b)(1)–(8)?
6.2

Sewage Sludge Sent to Other Facilities

Is sewage sludge from your facility provided to another facility for treatment, distribution, use, or disposal?


6.3




Yes

No  SKIP to Part 1, Section 7.

Receiving facility name
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

6.4

EPA Form 3510-2S

Title

State

ZIP code

Phone number

Email address

Which activities does the receiving facility provide? (Check all that apply.)
Treatment or blending

 Sale or give-away in bag or other container





Land application
Incineration




Surface disposal
Other (describe)

Composting

Page 3

EPA Identification Number

NPDES Permit Number

Facility Name

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

PART 1, SECTION 7. USE AND DISPOSAL SITES (40 CFR 122.21(C)(2)(II)(C))
Provide the following information for each site on which sewage sludge from this facility is used or disposed of.

Check here if you have provided separate attachments with this information.
7.1
Site name or number
Mailing address (street or P.O. box)

Use and Disposal Sites

City or town
Contact name (first and last)

Title

State

ZIP code

Phone number

Email address

Location address (street, route number, or other specific identifier)

7.2

City or town

State

County

County code

 Same as mailing address
ZIP code
 Not available

Site type (check all that apply)





Agricultural
Surface disposal
Reclamation





Lawn or home garden
Public contact
Municipal solid waste landfill





Forest
Incineration
Other (describe)

PART 1, SECTION 8. CHECKLIST AND CERTIFICATION STATEMENT (40 CFR 122.22(A) AND (D))

Checklist and Certification Statement

8.1

EPA Form 3510-2S

In Column 1 below, mark the sections of Form 2S, Part 1, that you have completed and are submitting with your
application. For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting
authority. Note that not all applicants are required to provide attachments.
Column 1
Column 2



Section 1: Facility Information



w/ attachments



Section 2: Applicant Information



w/ attachments



Section 3: Sewage Sludge Amount



w/ attachments



Section 4: Pollutant Concentrations



w/ attachments




Section 5: Treatment Provided at Your Facility



w/ attachments

Section 6: Sewage Sludge Sent to Other
Facilities



w/ attachments



Section 7: Use and Disposal Sites



w/ attachments



Section 8: Checklist and Certification Statement

Page 4

EPA Identification Number

Checklist and Certification Statement
Continued

8.2

NPDES Permit Number

Facility Name

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

Provide the following certification. (See instructions to determine the appropriate person to submit 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.
Name (print or type first and last name)
Official title
Phone number
Signature

Date signed

PART 1 APPLICANTS STOP HERE.
Submit completed application package to your NPDES permitting authority.

EPA Form 3510-2S

Page 5

This page intentionally left blank.

EPA Form 3510-2S

Page 6

EPA Identification Number

NPDES Permit Number

Facility Name

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

PART 2
PERMIT APPLICATION INFORMATION (40 CFR 122.21(q))
Complete this part if you have an effective NPDES permit or have been directed by the NPDES permitting authority to submit a full
permit application. In other words, complete this part if your facility has, or is applying for, an NPDES permit.
Part 2 is divided into five sections. Section 1 pertains to all applicants. The applicability of Sections 2 to 5 depends on your facility’s
sewage sludge use or disposal practices. See the instructions to determine which sections you are required to complete.
PART 2, SECTION 1. GENERAL INFORMATION (40 CFR 122.21(Q)(1–7) AND (Q)(13))
All Part 2 applicants must complete this section.
Facility Information
1.1 Facility name
Mailing address (street or P.O. box)
City or town

State

ZIP code

Contact name (first and last)

Title

Email address

Location address (street, route number, or other specific identifier)
City or town

General Information

1.2
1.3
1.4
1.5

Facility Design Flow Rate
Total Population Served
Ownership Status

 Public—federal
 Private

 Same as mailing address

State

Is this facility a Class I sludge management facility?
 Yes

Phone number

ZIP code



No
million gallons per day (mgd)

 Public—state
 Other public (specify) ____________
 Other (specify) ____________

Applicant Information
1.6 Is applicant different from entity listed under Item 1.1 above?
 Yes
1.7 Applicant name



No  SKIP to Item 1.8 (Part 2, Section 1).

Applicant mailing address (street or P.O. box)
City or town
Contact name (first and last)
1.8
1.9

ZIP code

Phone number

Email address

Is the applicant the facility’s owner, operator, or both? (Check only one response.)



Operator
 Owner
 Both
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
Facility and applicant
Facility
Applicant



EPA Form 3510-2S

Title

State



(they are one and the same)

Page 7

EPA Identification Number

NPDES Permit Number

Facility Name

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

Permit Information
NPDES Permit Number
1.10 Facility’s NPDES permit number
Check here if you do not have an NPDES permit but are otherwise required
 to submit Part 2 of Form 2S.
1.11 Indicate all other federal, state, and local permits or construction approvals received or applied for that regulate this
facility’s sewage sludge management practices below.



Check here if you have provided a separate attachment with this information.

Existing Environment Permits (check all that apply and print or type the corresponding permit number for each)



RCRA (hazardous wastes)



_________________________



PSD (air emissions)

General Information Continued

Ocean dumping (MPRSA)



_________________________



_________________________



Nonattainment program (CAA)



Dredge or fill (CWA Section
404)
_________________________

NESHAPs (CAA)
_________________________



UIC (underground injection of
fluids)
_________________________

Other (specify)
_________________________
_________________________

_________________________
Indian Country
1.12 Does any generation, treatment, storage, application to land, or disposal of sewage sludge from this facility occur in
Indian Country?
 SKIP to Item 1.14 (Part 2, Section 1)
 Yes
 No
below.
1.13 Provide a description of the generation, treatment, storage, land application, or disposal of sewage sludge that
occurs.
Topographic Map
1.14 Have you attached a topographic map containing all required information to this application? (See instructions for
specific requirements.)
 Yes
Line Drawing
1.15 Have you attached a line drawing and/or a narrative description that identifies all sewage sludge practices that will be
employed during the term of the permit containing all the required information to this application? (See instructions for
specific requirements.)



Yes

Contractor Information
1.16 Do contractors have any operational or maintenance responsibilities related to sewage sludge generation, treatment,
use, or disposal at the facility?
No  SKIP to Item 1.18 (Part 2, Section 1)
 Yes
 below.
1.17 Provide the following information for each contractor.
 Check here if you have attached additional sheets to the application package.
Contractor 1

Contractor 2

Contractor 3

Contractor company name
Mailing address (street or
P.O. box)
City, state, and ZIP code
Contact name (first and last)
Telephone number
Email address
EPA Form 3510-2S

Page 8

EPA Identification Number

1.17
cont.

NPDES Permit Number

Responsibilities of contractor

Facility Name

Contractor 1

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

Contractor 2

Contractor 3

Pollutant Concentrations
Using the table below or a separate attachment, provide sewage sludge monitoring data for the pollutants for which limits in
sewage sludge have been established in 40 CFR 503 for this facility’s expected use or disposal practices. All data must be
based on three or more samples taken at least one month apart and must be no more than 4.5 years old.



Check here if you have attached additional sheets to the application package.

General Information Continued

1.18

Pollutant

Average Monthly
Concentration
(mg/kg dry weight)

Analytical Method

Detection Level

Arsenic
Cadmium
Chromium
Copper
Lead
Mercury
Molybdenum
Nickel
Selenium
Zinc
Checklist and Certification Statement
1.19 In Column 1 below, mark the sections of Form 2S, Part 2, that you have completed and are submitting with your
application. For each section, specify in Column 2 any attachments that you are enclosing. Note that not all
applicants are required to complete all sections or provide attachments. See Exhibit 2S–2 in the Instructions.
Column 1
Column 2
 Section 1 (General Information)
 w/ attachments
Section 2 (Generation of Sewage Sludge or Preparation of a Material
 Derived from Sewage Sludge)
 w/ attachments
 Section 3 (Land Application of Bulk Sewage Sludge)
 w/ attachments
Secti
on
4
(Surface
Disposal)

 w/ attachments
1.20



 w/ attachments

Section 5 (Incineration)

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.
Name (print or type first and last name)
Official title
Signature

Date signed

Telephone number
Upon the request of the NPDES permitting authority, you must submit any other information the authority deems necessary to
assess sewage sludge use or disposal practices at your facility and identify appropriate permitting requirements.
EPA Form 3510-2S

Page 9

EPA Identification Number

NPDES Permit Number

Facility Name

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

PART 2, SECTION 2. GENERATION OF SEWAGE SLUDGE OR PREPARATION OF A MATERIAL DERIVED FROM SEWAGE
SLUDGE (40 CFR 122.21(Q)(8) THROUGH (12))
2.1 Does your facility generate sewage sludge or derive a material from sewage sludge?



Yes
 No  SKIP to Part 2, Section 3.
Amount Generated Onsite
2.2 Total dry metric tons per 365-day period generated at your facility:

Generation of Sewage Sludge or Preparation of a Material Derived from Sewage Sludge

Amount Received from Offsite Facility
2.3 Does your facility receive sewage sludge from another facility for treatment use or disposal?
 Yes
 No  SKIP to Item 2.8 (Part 2, Section 2) below.
2.4 Indicate the total number of facilities from which you receive sewage sludge for
treatment, use, or disposal:
Provide the following information for each of the facilities from which you receive sewage sludge.
 Check here if you have attached additional sheets to the application package.
2.5 Name of facility
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

Title

State

ZIP code

Phone number

Email address

Location address (street, route number, or other specific identifier)

2.6

2.7

City or town

State

County

County code

ZIP code
 Not available

Indicate the amount of sewage sludge received, the applicable pathogen class and reduction alternative, and the
applicable vector reduction option provided at the offsite facility.
Pathogen Class and Reduction
Vector Attraction Reduction
Amount
(dry metric tons)
Alternative
Option
 Not applicable
 Not applicable
 Class A, Alternative 1
 Option 1
 Class A, Alternative 2
 Option 2
 Class A, Alternative 3
 Option 3
 Class A, Alternative 4
 Option 4
 Class A, Alternative 5
 Option 5
 Class A, Alternative 6
 Option 6
 Class B, Alternative 1
 Option 7
 Class B, Alternative 2
 Option 8
 Class B, Alternative 3
 Option 9
 Class B, Alternative 4
 Option 10
 Domestic septage, pH adjustment  Option 11
Identify the treatment process(es) that are known to occur at the offsite facility, including blending activities and
treatment to reduce pathogens or vector attraction properties. (Check all that apply.)
Preliminary operations (e.g., sludge grinding and
 degritting)
 Thickening (concentration)






EPA Form 3510-2S

 Same as mailing address

Composting




Disinfection (e.g., beta ray irradiation, gamma ray
irradiation, pasteurization)



Stabilization

Heat drying
Methane or biogas capture and recovery




Anaerobic digestion
Conditioning
Dewatering (e.g., centrifugation, sludge drying
beds, sludge lagoons)
Thermal reduction
Other (specify) ___________________________
Page 10

Generation of Sewage Sludge or Preparation of a Material Derived from Sewage Sludge Continued

EPA Identification Number

NPDES Permit Number

Facility Name

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

Treatment Provided at Your Facility
2.8 For each sewage sludge use or disposal practice, indicate the applicable pathogen class and reduction alternative
and the applicable vector attraction reduction option provided at your facility. Attach additional pages, as necessary.
Use or Disposal Practice
Pathogen Class and Reduction
Vector Attraction Reduction
(check one)
Alternative
Option
 Land application of bulk sewage
 Not applicable
 Not applicable
 Land application of biosolids
 Class A, Alternative 1
 Option 1
(bulk)
 Class A, Alternative 2
 Option 2
 Land application of biosolids
 Class A, Alternative 3
 Option 3
(bags)
 Class A, Alternative 4
 Option 4
 Disposal in a landfill
 Class A, Alternative 5
 Option 5
 Surface disposal
 Class A, Alternative 6
 Option 6
 Incineration
 Class B, Alternative 1
 Option 7
 Class B, Alternative 2
 Option 8
 Class B, Alternative 3
 Option 9
 Class B, Alternative 4
 Option 10
 Domestic septage, pH adjustment  Option 11
2.9 Identify the treatment process(es) used at your facility to reduce pathogens in sewage sludge or reduce the vector
attraction properties of sewage sludge? (Check all that apply.)
operations (e.g., sludge grinding and
 Preliminary
 Thickening (concentration)
degritting)
 Stabilization
 Anaerobic digestion

2.10






Composting
Disinfection (e.g., beta ray irradiation, gamma ray
irradiation, pasteurization)
Heat drying
Methane or biogas capture and recovery





Conditioning
Dewatering (e.g., centrifugation, sludge drying
beds, sludge lagoons)
Thermal reduction

Describe any other sewage sludge treatment or blending activities not identified in Items 2.8 and 2.9 (Part 2, Section
2) above.



Check here if you have attached the description to the application package.

Preparation of Sewage Sludge Meeting Ceiling and Pollutant Concentrations, Class A Pathogen Requirements, and
One of Vector Attraction Reduction Options 1 to 8
2.11 Does the sewage sludge from your facility meet the ceiling concentrations in Table 1 of 40 CFR 503.13, the pollutant
concentrations in Table 3 of 40 CFR 503.13, Class A pathogen reduction requirements at 40 CFR 503.32(a), and one
of the vector attraction reduction requirements at 40 CFR 503.33(b)(1)–(8) and is it land applied?
 Yes
 No  SKIP to Item 2.14 (Part 2, Section 2)
below.
2.12 Total dry metric tons per 365-day period of sewage sludge subject to this
subsection that is applied to the land:
2.13

Is sewage sludge subject to this subsection placed in bags or other containers for sale or give-away for application to
the land?
 No
 Yes

 Check here once you have completed Items 2.11 to 2.13, then  SKIP to Item 2.32 (Part 2, Section 2) below.
EPA Form 3510-2S

Page 11

EPA Identification Number

NPDES Permit Number

Facility Name

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

Sale or Give-Away in a Bag or Other Container for Application to the Land
2.14 Do you place sewage sludge in a bag or other container for sale or give-away for land application?
No  SKIP to Item 2.17 (Part 2, Section 2)
 Yes
 below.
2.15 Total dry metric tons per 365-day period of sewage sludge placed in a bag or
other container at your facility for sale or give-away for application to the land:

Generation of Sewage Sludge or Preparation of a Material Derived from Sewage Sludge Continued

2.16

Attach a copy of all labels or notices that accompany the sewage sludge being sold or given away in a bag or other
container for application to the land.
 Check here to indicate that you have attached all labels or notices to this application package.

 Check here once you have completed Items 2.14 to 2.16, then  SKIP to Part 2, Section 2, Item 2.32.
Shipment Offsite for Treatment or Blending
2.17 Does another facility provide treatment or blending of your facility’s sewage sludge? (This question does not pertain to
dewatered sludge sent directly to a land application or surface disposal site.)
No  SKIP to Item 2.27 (Part 2, Section 2)
 Yes
 below.
Indicate the total number of facilities that provide treatment or blending of your facility’s
2.18 sewage sludge. Provide the information in Items 2.19 to 2.26 (Part 2, Section 2) below
for each facility.
 Check here if you have attached additional sheets to the application package.
2.19 Name of receiving facility
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

Title

State

ZIP code

Phone number

Email address

Location address (street, route number, or other specific identifier)

 Same as mailing address

City or town

ZIP code

State

2.20

Total dry metric tons per 365-day period of sewage sludge provided to receiving
facility:

2.21

Does the receiving facility provide additional treatment to reduce pathogens in sewage sludge from your facility or
reduce the vector attraction properties of sewage sludge from your facility?
 Yes
 No  SKIP to Item 2.24 (Part 2, Section 2) below.

2.22

EPA Form 3510-2S

Indicate the pathogen class and reduction alternative and the vector attraction reduction option met for the sewage
sludge at the receiving facility.
Pathogen Class and Reduction Alternative
Vector Attraction Reduction Option
 Not applicable
 Not applicable
 Class A, Alternative 1
 Option 1
 Class A, Alternative 2
 Option 2
 Class A, Alternative 3
 Option 3
 Class A, Alternative 4
 Option 4
 Class A, Alternative 5
 Option 5
 Class A, Alternative 6
 Option 6
 Class B, Alternative 1
 Option 7
 Class B, Alternative 2
 Option 8
 Class B, Alternative 3
 Option 9
 Class B, Alternative 4
 Option 10
 Domestic septage, pH adjustment
 Option 11

Page 12

EPA Identification Number

Generation of Sewage Sludge or Preparation of a Material Derived from Sewage Sludge Continued

2.23

2.24

2.25

2.26

NPDES Permit Number

Facility Name

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

Which treatment process(es) are used at the receiving facility to reduce pathogens in sewage sludge or reduce the
vector attraction properties of sewage sludge from your facility? (Check all that apply.)
Preliminary operations (e.g., sludge grinding and
 degritting)
 Thickening (concentration)
 Stabilization
 Anaerobic digestion






Composting
Disinfection (e.g., beta ray irradiation, gamma ray
irradiation, pasteurization)
Heat drying
Methane or biogas capture and recovery






Conditioning
Dewatering (e.g., centrifugation, sludge drying
beds, sludge lagoons)
Thermal reduction
Other (specify) ____________________________

Attach a copy of any information you provide the receiving facility to comply with the “notice and necessary
information” requirement of 40 CFR 503.12(g).
 Check here to indicate that you have attached material.
Does the receiving facility place sewage sludge from your facility in a bag or other container for sale or give-away for
application to the land?
 Yes
 No  SKIP to Item 2.32 (Part 2, Section 2) below.
Attach a copy of all labels or notices that accompany the product being sold or given away.
 Check here to indicate that you have attached material.

 Check here once you have completed Items 2.17 to 2.26 (Part 2, Section 2), then  SKIP to Item 2.32 (Part 2, Section 2)
below.
Land Application of Bulk Sewage Sludge
2.27 Is sewage sludge from your facility applied to the land?
✔
Yes

 No  SKIP to Item 2.32 (Part 2, Section 2) below.
2.28 Total dry metric tons per 365-day period of sewage sludge applied to all land
application sites:
2.29
2.30

2.31

Did you identify all land application sites in Part 2, Section 3 of this application?
 Submit a copy of the land application plan
 Yes
 No
with your application.
Are any land application sites located in states other than the state where you generate sewage sludge or derive a
material from sewage sludge?
 Yes
 No  SKIP to Item 2.32 (Part 2, Section 2) below.
Describe how you notify the NPDES permitting authority for the states where the land application sites are located.
Attach a copy of the notification.




Check here if you have attached the explanation to the application package.

Check here if you have attached the notification to the application package.
Surface Disposal
2.32 Is sewage sludge from your facility placed on a surface disposal site?
 Yes
 No  SKIP to Item 2.39 (Part 2, Section 2) below.
2.33 Total dry metric tons of sewage sludge from your facility placed on all surface
disposal sites per 365-day period:
2.34 Do you own or operate all surface disposal sites to which you send sewage sludge for disposal?
Yes  SKIP to Item 2.39 (Part 2, Section 2)
 No
below.
Indicate the total number of surface disposal sites to which you send your sewage
sludge.
(Provide the information in Items 2.36 to 2.38 of Part 2, Section 2, for each facility.)


2.35

 Check here if you have attached additional sheets to the application package.

EPA Form 3510-2S

Page 13

EPA Identification Number

2.36

NPDES Permit Number

Facility Name

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

Site name or number of surface disposal site you do not own or operate
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

Generation of Sewage Sludge or Preparation of a Material Derived from Sewage Sludge Continued

2.37
2.38

Title

Site contact (check all that apply)
 Owner

State

ZIP code

Phone number

Email address



Operator

Total dry metric tons of sewage sludge from your facility placed on this surface
disposal site per 365-day period:
Incineration
2.39 Is sewage sludge from your facility fired in a sewage sludge incinerator?
 Yes
 No  SKIP to Item 2.46 (Part 2, Section 2) below.
2.40 Total dry metric tons of sewage sludge from your facility fired in all sewage
sludge incinerators per 365-day period:
2.41 Do you own or operate all sewage sludge incinerators in which sewage sludge from your facility is fired?
Yes  SKIP to Item 2.46 (Part 2, Section 2)
 below.
 No
2.42 Indicate the total number of sewage sludge incinerators that you use but do not own or
operate. (Provide the information in Items 2.43 to 2.45 directly below for each facility.)

 Check here if you have attached additional sheets to the application package.
2.43

Incinerator name or number
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

2.44
2.45

Title

State

ZIP code

Phone number

Email address

Location address (street, route number, or other specific identifier)

 Same as mailing address

City or town

State

ZIP code

Contact (check all that apply)
 Incinerator owner



Incinerator operator

Total dry metric tons of sewage sludge from your facility fired in this sewage
sludge incinerator per 365-day period:

Disposal in a Municipal Solid Waste Landfill
2.46 Is sewage sludge from your facility placed on a municipal solid waste landfill?
 Yes
 No  SKIP to Part 2, Section 3.
2.47 Indicate the total number of municipal solid waste landfills used. (Provide the
information in Items 2.48 to 2.52 directly below for each facility.)

Generation of Sewage
Sludge or Preparation
of a Material Derived

 Check here if you have attached additional sheets to the application
2.48

EPA Form 3510-2S

package.
Name of landfill

Mailing address (street or P.O. box)
City or town
Contact name (first and last)

Title

State

ZIP code

Phone number

Email address
Page 14

EPA Identification Number

NPDES Permit Number

Facility Name

Location address (street, route number, or other specific identifier)
County

County code

City or town

State

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

 Same as mailing address
 Not available
ZIP code

2.49

Total dry metric tons of sewage sludge from your facility placed in this
municipal solid waste landfill per 365-day period:

2.50

List the numbers of all other federal, state, and local permits that regulate the operation of this municipal solid waste
landfill.
Permit Number
Type of Permit

2.51

Attach information to determine whether the sewage sludge meets applicable requirements for disposal of sewage
sludge in a municipal solid waste landfill (e.g., results of paint filter liquids test and TCLP test).


2.52

Does the municipal solid waste landfill comply with applicable criteria set forth in 40 CFR 258?



EPA Form 3510-2S

Check here to indicate you have attached the requested information.
Yes



Page 15

EPA Identification Number

NPDES Permit Number

Facility Name

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

PART 2, SECTION 3—LAND APPLICATION OF BULK SEWAGE SLUDGE (40 CFR 122.21(Q)(9))
3.1 Does your facility apply sewage sludge to land?
3.2

3.3



Yes

No  SKIP to Part 2, Section 4.

Do any of the following conditions apply?
• The sewage sludge meets the ceiling concentrations in Table 1 of 40 CFR 503.12, the pollutant concentrations in
Table 3 of 40 CFR 503.13, Class A pathogen reduction requirements at 40 CFR 503.32(a), and one of the vector
attraction reduction requirements at 40 CFR 503.33(b)(1)–(8);
• The sewage sludge is sold or given away in a bag or other container for application to the land; or
• You provide the sewage sludge to another facility for treatment or blending.



Yes  SKIP to Part 2, Section 4.
 No
Complete Section 3 for every site on which the sewage sludge is applied.

 Check here if you have attached sheets to the application package for one or more land application sites.
Identification of Land Application Site
3.4 Site name or number
Location address (street, route number, or other specific identifier)

Land Application of Bulk Sewage Sludge

County
City or town

 Same as mailing address

County code

 Not available

State

ZIP code

Latitude/Longitude of Land Application Site (see instructions)
Latitude

Longitude

Method of Determination

 USGS map
3.5

 Field survey

 Other (specify) ______________

Provide a topographic map (or other appropriate map if a topographic map is unavailable) that shows the site location.

 Check here to indicate you have attached a topographic map for this site.
Owner Information
3.6 Are you the owner of this land application site?
3.7



Yes  SKIP to Item 3.8 (Part 2, Section 3) below.
Owner name



Mailing address (street or P.O. box)
City or town
Contact name (first and last)

Title

State

ZIP code

Phone number

Email address

Applier Information
3.8 Are you the person who applies, or who is responsible for application of, sewage sludge to this land application site?
3.9



Yes  SKIP to Item 3.10 (Part 2, Section 3) below.
Applier’s name



Mailing address (street or P.O. box)
City or town
Contact name (first and last)

EPA Form 3510-2S

Title

State

ZIP code

Phone number

Email address

Page 16

EPA Identification Number

NPDES Permit Number

Site Type
3.10 Type of land application:
 Agricultural land




Facility Name




Reclamation site

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

Forest
Public contact site

Other (describe)
Crop or Other Vegetation Grown Onsite
3.11 What type of crop or other vegetation is grown on this site?
3.12

What is the nitrogen requirement for this crop or vegetation?

Land Application of Bulk Sewage Sludge Continued

Vector Attraction Reduction
3.13 Are the vector attraction reduction requirements at 40 CFR 503.33(b)(9) and (b)(10) met when sewage sludge is
applied to the land application site?
No  SKIP to Item 3.16 (Part 2, Section 3)
 Yes
 below.
3.14 Indicate which vector attraction reduction option is met. (Check only one response.)
3.15



Option 9 (injection below land surface)
 Option 10 (incorporation into soil within 6 hours)
Describe any treatment processes used at the land application site to reduce vector attraction properties of sewage
sludge.



Check here if you have attached your description to the application package.

Cumulative Loadings and Remaining Allotments
3.16 Is the sewage sludge applied to this site since July 20, 1993, subject to the cumulative pollutant loading rates
(CPLRs) in 40 CFR 503.13(b)(2)?
 Yes
 No  SKIP to Part 2, Section 4.
3.17 Have you contacted the NPDES permitting authority in the state where the bulk sewage sludge subject to CPLRs will
be applied to ascertain whether bulk sewage sludge subject to CPLRs has been applied to this site on or since
July 20, 1993?
No  Sewage sludge subject to CPLRs may
Yes
not be applied to this site. SKIP to Part 2,


Section 4.
3.18 Provide the following information about your NPDES permitting authority:
NPDES permitting authority name
Contact person
Telephone number
Email address
3.19 Based on your inquiry, has bulk sewage sludge subject to CPLRs been applied to this site since July 20, 1993?
 Yes
 No  SKIP to Part 2, Section 4.
3.20 Provide the following information for every facility other than yours that is sending, or has sent, bulk sewage sludge
subject to CPLRs to this site since July 20, 1993. If more than one such facility sends sewage sludge to this site,
attach additional pages as necessary.



Check here to indicate that additional pages are attached.

Facility name
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

EPA Form 3510-2S

Title

State

ZIP code

Phone number

Email address

Page 17

EPA Identification Number

NPDES Permit Number

Facility Name

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

PART 2, SECTION 4—SURFACE DISPOSAL (40 CFR 122.21(Q)(10))
4.1 Do you own or operate a surface disposal site?
 Yes
 No  SKIP to Part 2, Section 5.
4.2 Complete all items in Section 4 for each active sewage sludge unit that you own or operate.
Check here to indicate that you have attached material to the application package for one or more active
 sewage sludge units.
Information on Active Sewage Sludge Units
4.3 Unit name or number
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

Title

State

ZIP code

Phone number

Email address

Location address (street, route number, or other specific identifier)

 Same as mailing address

County

County code

City or town

State

Surface Disposal

Latitude/Longitude of Active Sewage Sludge Unit (see instructions)
Latitude

 Not available
ZIP code

Longitude

Method of Determination

 USGS map
4.4

4.5
4.6
4.7

4.8

4.9
4.10

EPA Form 3510-2S

 Field survey

 Other (specify) ______________

Provide a topographic map (or other appropriate map if a topographic map is unavailable) that shows the site
location.
 Check here to indicate that you have completed and attached a topographic map.
Total dry metric tons of sewage sludge placed on the active sewage sludge unit
per 365-day period:
Total dry metric tons of sewage sludge placed on the active sewage sludge unit
over the life of the unit:
Does the active sewage sludge unit have a liner with a maximum permeability of 1 × 10-7 centimeters per second
(cm/sec)?
No  SKIP to Item 4.9 (Part 2, Section
 Yes
 4) below.
Describe the liner.
 Check here to indicate that you have attached a description to the application package.

Does the active sewage sludge unit have a leachate collection system?

No  SKIP to Item 4.11 (Part 2, Section
4) below.
Describe the leachate collection system and the method used for leachate disposal and provide the numbers of any
federal, state, or local permit(s) for leachate disposal.



Yes



Check here to indicate that you have attached the description to the application package.

Page 18

EPA Identification Number

4.11

4.12

NPDES Permit Number

Facility Name

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

Is the boundary of the active sewage sludge unit less than 150 meters from the property line of the surface disposal
site?
No  SKIP to Item 4.13 (Part 2,
 Yes
 Section 4) below.
Provide the actual distance in meters:
meters

4.13

Remaining capacity of active sewage sludge unit in dry metric tons:

4.14

Anticipated closure date for active sewage sludge unit, if known (MM/DD/YYYY):

dry metric tons

4.15

Attach a copy of any closure plan that has been developed for this active sewage sludge unit.
 Check here to indicate that you have attached a copy of the closure plan to the application package.
Sewage Sludge from Other Facilities
4.16 Is sewage sludge sent to this active sewage sludge unit from any facilities other than your facility?
No  SKIP to Item 4.21 (Part 2, Section
 Yes
 4) below.
4.17 Indicate the total number of facilities (other than your facility) that send sewage
sludge to this active sewage sludge unit. (Complete Items 4.18 to 4.20 directly
below for each such facility.)

Surface Disposal Continued


4.18

Check here to indicate that you have attached responses for each facility to
the application package.
Facility name
Mailing address (street or P.O. box)
City or town
Contact name (first and last)

4.19

4.20

ZIP code

Phone number

Email address

Indicate the pathogen class and reduction alternative and the vector attraction reduction option met for the sewage
sludge before it leaves the other facility.
Pathogen Class and Reduction Alternative
Vector Attraction Reduction Option
 Not applicable
 Not applicable
 Class A, Alternative 1
 Option 1
 Class A, Alternative 2
 Option 2
 Class A, Alternative 3
 Option 3
 Class A, Alternative 4
 Option 4
 Class A, Alternative 5
 Option 5
 Class A, Alternative 6
 Option 6
 Class B, Alternative 1
 Option 7
 Class B, Alternative 2
 Option 8
 Class B, Alternative 3
 Option 9
 Class B, Alternative 4
 Option 10
 Domestic septage, pH adjustment
 Option 11
Which treatment process(es) are used at the other facility to reduce pathogens in sewage sludge or reduce the vector
attraction properties of sewage sludge before it leaves that facility? (Check all that apply.)
 Preliminary operations (e.g., sludge grinding and degritting)  Thickening (concentration)







EPA Form 3510-2S

Title

State

Stabilization
Composting
Disinfection (e.g., beta ray irradiation, gamma ray
irradiation, pasteurization)
Heat drying
Methane or biogas capture and recovery







Anaerobic digestion
Conditioning
Dewatering (e.g., centrifugation, sludge
drying beds, sludge lagoons)
Thermal reduction
Other (specify) _____________________

Page 19

EPA Identification Number

NPDES Permit Number

Facility Name

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

Vector Attraction Reduction
4.21 Which vector attraction reduction option, if any, is met when sewage sludge is placed on this active sewage sludge
unit?
Option 11 (covering active sewage
 Option 9 (injection below and surface)
 sludge unit daily)
 Option 10 (incorporation into soil within 6 hours)
 None
4.22 Describe any treatment processes used at the active sewage sludge unit to reduce vector attraction properties of
sewage sludge.

Surface Disposal Continued



Check here if you have attached your description to the application package.

Groundwater Monitoring
4.23 Is groundwater monitoring currently conducted at this active sewage sludge unit, or are groundwater monitoring data
otherwise available for this active sewage sludge unit?
No  SKIP to Item 4.26 (Part 2,
 Yes
 Section 4) below.
4.24 Provide a copy of available groundwater monitoring data.


4.25

Describe the well locations, the approximate depth to groundwater, and the groundwater monitoring procedures used
to obtain these data.



4.26
4.27

4.29

Check here if you have attached your description to the application package.

Has a groundwater monitoring program been prepared for this active sewage sludge unit?
No  SKIP to Item 4.28 (Part 2,
 Yes
 Section 4) below.
Submit a copy of the groundwater monitoring program with this permit application.


4.28

Check here to indicate you have attached the monitoring data.

Check here to indicate you have attached the monitoring program.

Have you obtained a certification from a qualified groundwater scientist that the aquifer below the active sewage
sludge unit has not been contaminated?
 SKIP to Item 4.30 (Part 2,
 Yes
 No
Section 4) below.
Submit a copy of the certification with this permit application.



Check here to indicate you have attached the certification to the application package.

Site-Specific Limits
4.30 Are you seeking site-specific pollutant limits for the sewage sludge placed on the active sewage sludge unit?
 No  SKIP to Part 2, Section 5.
 Yes
4.31 Submit information to support the request for site-specific pollutant limits with this application.



EPA Form 3510-2S

Check here to indicate you have attached the requested information.

Page 20

EPA Identification Number

NPDES Permit Number

Facility Name

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

PART 2, SECTION 5—INCINERATION (40 CFR 122.21(Q)(11))
Incinerator Information
5.1 Do you fire sewage sludge in a sewage sludge incinerator?


5.2



Yes

No  SKIP to END.

Indicate the total number of incinerators used at your facility. (Complete the remainder
of Section 5 for each such incinerator.)


5.3

Check here to indicate that you have attached information for one or more
incinerators.
Incinerator name or number
Location address (street, route number, or other specific identifier)
County

County code

 Not available

City or town

State

ZIP code

Latitude/Longitude of Incinerator (see instructions)
Latitude

Longitude

Method of Determination

Incineration

 USGS map

 Field survey

 Other (specify) ______________

Amount Fired
5.4 Dry metric tons per 365-day period of sewage sludge fired in the sewage sludge
incinerator:
Beryllium NESHAP
5.5 Submit information, test data, and a description of measures taken that demonstrate whether the sewage sludge
incinerated is beryllium-containing waste and will continue to remain as such.


5.6

Check here to indicate that you have attached this material to the application package.

Is the sewage sludge fired in this incinerator “beryllium-containing waste” as defined at 40 CFR 61.31?



Yes



No  SKIP to Item 5.8 (Part 2, Section 5) below.

5.7

Submit with this application a complete report of the latest beryllium emission rate testing and documentation of
ongoing incinerator operating parameters indicating that the NESHAP emission rate limit for beryllium has been and
will continue to be met.
 Check here to indicate that you have attached this information.
Mercury NESHAP
5.8 Is compliance with the mercury NESHAP being demonstrated via stack testing?
 No  SKIP to Item 5.11 (Part 2, Section 5) below.
 Yes
5.9

Submit a complete report of stack testing and documentation of ongoing incinerator operating parameters indicating
that the incinerator has met and will continue to meet the mercury NESHAP emission rate limit.


5.10

Provide copies of mercury emission rate tests for the two most recent years in which testing was conducted.


5.11
5.12

Check here to indicate that you have attached this information.

Do you demonstrate compliance with the mercury NESHAP by sewage sludge sampling?
No  SKIP to Item 5.13 (Part 2, Section 5)

 Yes
below.
Submit a complete report of sewage sludge sampling and documentation of ongoing incinerator operating parameters
indicating that the incinerator has met and will continue to meet the mercury NESHAP emission rate limit.


EPA Form 3510-2S

Check here to indicate that you have attached this information.

Page 21

EPA Identification Number

NPDES Permit Number

Facility Name

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

Dispersion Factor
5.13 Dispersion factor in micrograms/cubic meter per gram/second:
5.14

Name and type of dispersion model:

5.15

Submit a copy of the modeling results and supporting documentation.



Check here to indicate that you have attached this information.

Control Efficiency
5.16 Provide the control efficiency, in hundredths, for each of the pollutants listed below.
Pollutant
Control Efficiency, in Hundredths
Arsenic
Cadmium
Chromium
Lead
Nickel
5.17 Attach a copy of the results or performance testing and supporting documentation (including testing dates).

Incineration Continued



Check here to indicate that you have attached this information.

Risk-Specific Concentration for Chromium
5.18 Provide the risk-specific concentration (RSC) used for chromium in
micrograms per cubic meter:
5.19 Was the RSC determined via Table 2 in 40 CFR 503.43?


5.20

Yes



No  SKIP to Item 5.21 (Part 2, Section 5) below.

Identify the type of incinerator used as the basis.



5.21

5.22
5.23

Fluidized bed with wet scrubber
 Other types with wet scrubber
Fluidized bed with wet scrubber and wet
Other types with wet scrubber and wet electrostatic
 precipitator
electrostatic precipitator
Was the RSC determined via Table 6 in 40 CFR 503.43 (site-specific determination)?
No  SKIP to Item 5.23 (Part 2, Section 5)
 Yes
 below.
Provide the decimal fraction of hexavalent chromium concentration to total
chromium concentration in stack exit gas:
Attach the results of incinerator stack tests for hexavalent and total chromium concentrations, including the date(s) of
any test(s), with this application.



Check here to indicate that you have attached this information.



Not applicable

Incinerator Parameters
5.24 Do you monitor total hydrocarbons (THC) in the exit gas of the sewage sludge incinerator?


5.25

Yes



Do you monitor carbon monoxide (CO) in the exit gas of the sewage sludge incinerator?



Yes



5.26

Indicate the type of sewage sludge incinerator.

5.27

Incinerator stack height in meters:

5.28

Indicate whether the value submitted in Item 5.27 is (check only one response):
 Actual stack height
 Creditable stack height

EPA Form 3510-2S

Page 22

EPA Identification Number

NPDES Permit Number

Facility Name

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

Performance Test Operating Parameters
5.29 Maximum performance test combustion temperature:
5.30

Performance test sewage sludge feed rate, in dry metric tons/day

5.31

Indicate whether value submitted in Item 5.30 is (check only one response):


5.32
5.33



Average use

Maximum design

Attach supporting documents describing how the feed rate was calculated.
 Check here to indicate that you have attached this information.
Submit information documenting the performance test operating parameters for the air pollution control device(s)
used for this sewage sludge incinerator.



Check here to indicate that you have attached this information.

Monitoring Equipment
5.34 List the equipment in place to monitor the listed parameters.
Parameter

Equipment in Place for Monitoring

Incineration Continued

Total hydrocarbons or carbon monoxide
Percent oxygen
Percent moisture
Combustion temperature
Other (describe)
Air Pollution Control Equipment
5.35 List all air pollution control equipment used with this sewage sludge incinerator.

 Check here if you have attached the list to the application package for the noted incinerator.

END of PART 2
Submit completed application package to your NPDES permitting authority.
Click to go back to the beginning of Form

EPA Form 3510-2S

Page 23

File Type	application/pdf
File Title	NPDES Permitting Program: New and Existing Treatment Works Treating Domestic Sewage, Application Form 2S
Subject	U.S. Environmental Protection Agency, office of water, National Pollutant Discharge Elimination System, NPDES, NPDES Permitting
Author	USEPA, OW, OWM, WPD, National Program Branch
File Modified	2021-06-30
File Created	2021-06-15