Free 51952 - Indiana

NPDES Industrial Permit Information Application Instructions General Information Form
State Form 51952 (10-04)

INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT

(Replaces EPA General Form 1 Instructions) Item 1-Facility Name: Provide the facility's official or legal name as it is to appear on the permit. Item 2-Facility Contact: Give the name, title, and work telephone number of a person who is thoroughly familiar with the operation of the facility and with the facts reported in this application and who can be contacted by the Indiana Department of Environmental Management. Item 3-Certified Operator: Give the name, Address, and Certification information, for the operator of the facility being permitted. Information concerning operator certification should be directed to this office at 317/233-0419. Item 4-Facility Mailing Address: Give the complete mailing address of the office where correspondence should be sent. This often is not the address used to designate the location of the facility or activity. Item 5-Facility Location: Give the address or location of the facility identified in Item 1 of this form. If the facility lacks a street name or route number, give the most accurate alternative geographic information (i.e., section number or quarter section number from county records or at an intersection of Streets or County Roads.) Item 6-Type of Permit Action: Specify the type of application. If the facility has never had an NPDES permit mark new. If it is to renew or modify the existing permit mark accordingly. Item 7-EPA I.D. Number: Give the EPA I.D. number if one has been obtained from the EPA. If an I.D. number has not been obtained from EPA, you may disregard this section. Items 8, 9 and 10-Applicable Permit Applications: Answer each question to determine which form you need to fill out. If you answer yes to any of these questions, you must fill out and submit the appropriate form. Item 11-SIC Code(s): List, in descending order of significance, the four 4-digit standard industrial classification (SIC) codes which best describe your facility in terms of the principal products or services you produce or provide. Also, specify each classification in words. These classifications may differ from the SIC codes describing the operation generating the discharge, air emissions, or hazardous wastes.

SIC code numbers are descriptions which may be found in the "Standard Industrial Classification Manual" prepared by the Executive Office of the President, Office of Management and Budget, which is available from the Government Printing Office, Washington, D.C. Use the current edition of the manual. Item 12-Existing Environmental Permits: Give the number of each presently effective permit issued to the facility for each program or, if you have previously filed an application but have not yet received a permit, give the number of the application, if any. Item 13-Nature of Business: Briefly describe the nature of your business (e.g., products produced or services provided). Item 14-Map: Provide a topographic map or maps as explained in the application. Item 15-Signature Block: The General Information Form must be signed by a person legally responsible for the facility. Glossary NOTE: This Glossary includes terms used in the instructions and in Forms 2C, 2D and 2E. Additional terms will be included in the future when other forms are developed to reflect the requirements of other parts of the Consolidated Permits Program. ALIQUOT means a sample of specified volume used to make up a total composite sample. ANIMAL FEEDING OPERATION means a lot or facility (other than an aquatic animal production facility) where the following conditions are met: A. 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 B. Crops, vegetation, forage growth, or post-harvest residues are not sustained in the normal growing season over any portion of the lot or facility. Two or more animal feeding operations under common ownership are a single animal feeding operation if they adjoin each other or if they use a common area or system for the disposal of wastes. ANIMAL UNIT means a unit of measurement for any animal feeding operation calculated by adding the following numbers: The number of slaughter and feeder cattle multiplied by 1.0; Plus the number of mature dairy cattle multiplied by 1.4; Plus the number of swine weighing over 25 kilograms (approximately 55 pounds) multiplied by 0.4; Plus the number of sheep multiplied by 0.1; Plus the number of horses multiplied by 2.0. 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. For RCRA, "application" also means "Application, Part B." APPLICATION, PART A means that part of the Consolidated Permit Application forms which a RCRA permit applicant must complete to qualify for interim status under Section 3005(e) of RCRA and for consideration for a permit. Part A consists of Form 1 (General Information) and Form 3 (Hazardous Waste Application Form).

APPLICATION, PART B means that part of the application which a RCRA permit applicant must complete to be issued a permit. (NOTE: EPA is not developing a specific form for Part B of the permit application, but an instruction booklet explaining what information must be supplied is available from the EPA Regional office.) APPROVED PROGRAM or APPROVED STATE means a Sate program which has been approved or authorized by EPA under 40 CFR Part 123. AQUACULTURE PROJECT 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 area" means the portions of the waters of the United States within which the applicant plans to confine the cultivated species, using a method of plan or operation (including, but not limited to, physical confinement) which, on the basis of reliable scientific evidence, is expected to ensure the 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. AQUIFER means a geological formation, group of formations, or part of a formation that is capable of yielding a significant amount of water to a well or spring. AREA OF REVIEW means the area surrounding an injection well which is described according to the criteria set forth in 40 CFR Section 146.06. AREA PERMIT means a UIC permit applicable to all or certain wells within a geographic area, rather than to a specified well, under 40 CFR Section 122.37. ATTAINMENT AREA means, for any air pollutant, an area which has been designated under Section 107 of the Clean Air Act as having ambient air quality levels better than any national primary or secondary ambient air quality standard for that pollutant. Standards have been set for sulfur oxides, particulate matter, nitrogen dioxide, carbon monoxide, ozone, lead, and hydrocarbons. For purposes of the Glossary, "attainment area" also refers to "unclassifiable area," which means, for any pollutants, an area designated under Section 107 as unclassifiable with respect to that pollutant due to insufficient information. BEST MANAGEMENT PRACTICES (BMP) means schedule of activities, prohibitions of practices, maintenance procedures, and other management practices to prevent or reduce the pollution of waters of the United States. BMP's 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. BIOLOGICAL MONITORING TEST means any test which includes the use of aquatic algal, invertebrate, or vertebrate species to measure acute or chronic toxicity, and any biological or chemical measure of bioaccumulation. BYPASS means the intentional diversion of wastes from any portion of a treatment facility. CONCENTRATED ANIMAL FEEDING OPERATION means an animal feeding operation which meets the criteria set forth in either (A) or (B) below or which the Director designates as such on a case-by-case basis: A. More than the numbers of animals specified in any of the following categories are confined: 1. 1,000 slaughter or feeder cattle, 2. 700 mature dairy cattle (whether milked or dry cows), 3. 2,500 swine each weighing over 25 kilograms (approximately 55 pounds), 4. 500 horses, 5. 10,000 sheep or lambs,

6. 55,000 turkeys, 7. 100,000 laying hens or broilers (if the facility has a continuous overflow watering), 8. 30,000 laying hens or broilers (if the facility has a liquid manure handling system), 9. 5,000 ducks, or 10. 1,000 animal units; or B. More than the following numbers and types of animals are confined: 1. 300 slaughter or feeder cattle, 2. 200 mature dairy cattle (whether milked or dry cows), 3. 750 swine each weighing over 25 kilograms (approximately 55 pounds), 4. 150 horses, 5. 3,000 sheep or lambs, 6. 16,500 turkeys, 7. 30,000 laying hens or broilers (if the facility has a continuous overflow watering), 8. 9,000 laying hens or broilers (if the facility has a liquid manure handling system), 9. 1,500 ducks, or 10. 300 animal units; AND Either one of the following conditions are met: Pollutants are discharged into the waters of the United States through a manmade ditch, flushing system or other similar manmade device ("manmade" means constructed by man and used for the purpose of transporting waste); or Pollutants are discharged directly into the waters of the United States which originate outside of and pass over, across, or through the facility or otherwise come into direct contact with the animals confined in the operation. Provided, however, that no animal feeding operation is a concentrated animal feeding operation as defined above if such animal feeding operation discharges only in the event of a 25 year, 24 hour storm event. CONCENTRATED AQUATIC ANIMAL PRODUCTION FACILITY 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 Salimonidae 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.

B. Warm water fish species or other warm water aquatic animals including, but not limited to, the Ameiuridae, Cetrarchidae, 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 2. Facilities which produce less than 45,454 harvest weight kilograms (approximately 100,000 pounds) of aquatic animals per year. CONTACT COOLING WATER means water used to reduce temperature which comes into contact with a raw material, intermediate product, waste product other than heat, or finished product. CONTAINER means any portable device in which a material is stored, transported, treated, disposed of, or otherwise handled. CONTIGUOUS ZONE means the entire zone established by the United States under article 24 of the convention of the Territorial Sea and the Contiguous Zone. CWA means the Clean Water Act (formally referred to the Federal Water Pollution Control Act) Pub. L. 92-500, as amended by Pub. L. 95-217 and Pub. L. 95-576, 33 U.S.C. 1251 et seq. DIKE means any embankment or ridge of either natural or manmade materials used to prevent the movement of liquids, sludges, solids, or other materials. DIRECT DISCHARGE means the discharge of a pollutant as defined below. DIRECTOR means the EPA Regional Administrator or the State Director as the context requires. DISCHARGE (OF A POLLUTANT) MEANS: A. Any addition of any pollutant or combination of pollutants to waters of the United States from any point source; or B. 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 channeled by man; Discharges through pipes, sewers or other conveyances owned by a State, municipality, or other person which do not lead to POTW's; 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. DISPOSAL (in the RCRA program) means the discharge, deposit, injection, dumping, spilling, leaking, or placing of any hazardous waste into or on any land or water so that the hazardous waste or any constituent of it may enter the environment or be emitted into the air or discharged into any waters, including ground water. DISPOSAL FACILITY means a facility or part of a facility at which hazardous waste is intentionally placed into or on land or water, and at which hazardous waste will remain after closure. 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 LIMITATION GUIDELINE means a regulation published by the Administrator under Section 304(b) of the Clean Water Act to adopt or revise effluent limitations. ENVIRONMENTAL PROTECTION AGENCY (EPA) means the United States Environmental Protection Agency. EPA IDENTIFICATION NUMBER means the number assigned by EPA to each generator, transporter, and facility. EXEMPTED AQUIFER means an aquifer or its portion that meets the criteria in the definition of USDW, but which has been exempted according to the procedures in 40 CFR Section 122.35(b). EXISTING HWM FACILITY means a Hazardous Waste Management facility which was in operation, or for which construction had commenced, on or before October 21, 1976. Construction had commenced if (A) the owner or operator had obtained all necessary Federal, State, and local preconstruction approvals or permits, and either (B1) a continuous on-site, physical construction program had begun, or (B2) the owner or operator had entered into contractual obligations, which could not be canceled or modified without substantial loss, for construction of the facility to be completed within a reasonable time. (NOTE: This definition reflects the literal language of the statute. However, EPA believes that amendments to RCRA now in conference will shortly be enacted and will change the date for determining when a facility is an "existing facility" to one no earlier than May of 1980; indications are the conferees are considering October 30, 1980. Accordingly, EPA encourages every owner or operator of a facility which was built or under construction as of the promulgation date of the RCRA program regulations to file Part A of its permit application so that it can be quickly processed for interim status when the change in the law takes effect. When those amendments are enacted, EPA will amend this definition.) EXISTING SOURCE or EXISTING DISCHARGER (in the NPDES program) means any source which is not a new source or a new discharger. EXISTING INJECTION WELL means an injection well other than a new injection well. FACILITY means any HWM facility, UIC underground injection well, NPDES point source, PSD stationary source, or any other facility or activity (including land or appurtenances thereto) that is subject to regulation under the RCRA, UIC, NPDES, or PSD programs. FLUID means material or substance which flows or moves whether in a semisolid, liquid, sludge, gas, or any other form or state. GENERATOR means any person by site, whose act or process produces hazardous waste identified or listed in 40 CFR Part 261. GROUNDWATER means water below the land surfaces in a zone of saturation. HAZARDOUS SUBSTANCE means any of the substances designated under 40 CFR Part 116 pursuant to Section 311 of CWA. (NOTE: These substances are listed in Table 2c-4 of the instructions to Form 2C.) HAZARDOUS WASTE means a hazardous waste as defined in 40 CFR Section 261.3 published May 19, 1980. HAZARDOUS WASTE MANAGEMENT FACILITY (HWM facility) means all contiguous land, structures, appurtenances, and improvements on the land, used for treating, storing, or disposing of hazardous wastes. A facility may consist of several treatment, storage, or disposal operational units (for example, one or more landfills, surface impoundments, or combinations of them). IN OPERATION means a facility which is treating, storing, or disposing, of hazardous waste.

INCINERATOR (in the RCRA program) means an enclosed device using controlled flame combustion, the primary purpose of which is to thermally break down hazardous waste. Examples of incinerators are rotary kiln, fluidized bed, and liquid injection incinerators. INDIRECT DISCHARGER means a nondomestic discharger introducing pollutants to a publicly owned treatment works. INJECTION WELL means a well into which fluids are being injected. INTERIM AUTHORIZATION means approval by EPA of a State hazardous waste program which has met the requirements of Section 3006(c) of RCRA and applicable requirements of 40 CFR Part 123, Subparts A, B, and F. LANDFILL means a disposal facility or part of a facility where hazardous waste is placed in or on land and which is not a land treatment facility, a surface impoundment, or an injection well. LAND TREATMENT FACILITY (in the RCRA program) means a facility or part of a facility at which hazardous waste is applied onto or incorporated into the soil surface; such facilities are disposal facilities if the waste will remain after closure. LISTED STATE means a State listed by the Administrator under Section 1422 of SDWA as needing a State UIC program. MGD means millions of gallons per day. MUNICIPALITY means a city, village, 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 CWA. 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, 318, 402, and 405 of CWA. The term includes an approved program. NEW DISCHARGER means any building, structure, facility, or installation: (A) From which there is or may be a new or additional discharge of pollutants at a site at which on October 18, 1972, it had never discharged pollutants; (B) Which has never received a finally effective NPDES permit for discharges at that site; and (C) Which is not a "new source." This definition includes an indirect discharger which commences discharging into the waters of the United States. It also includes any existing mobile point source, such as an offshore oil drilling rig, seafood processing vessel, or aggregate plant that begins discharging at a location for which it does not have an existing permit. NEW HWM FACILITY means any Hazardous Waste Management facility which began operation or for which construction commenced after October 21, 1976. NEW INJECTION WELL means a well which begins injection after a UIC program for the State in which the well is located is approved. NEW SOURCE (in the NPDES program) means any building, structure, facility, or installation, from which there is or may be a discharge of pollutants, the construction of which commenced: A. After promulgation of standards of performance under Section 306 of CWA which are applicable to such source; or

B. After proposal of standards of performance in accordance with Section 306 of 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. NON-CONTACT COOLING WATER means water used to reduce temperature which does not come into direct contact with any raw material, intermediate product, waste product (other than heat), or finished product. OFF-SITE means any site which is not "on-site." ON-SITE means on the same or geographically contiguous property which may be divided by public or private right(s)-of-way, provided the entrance and exit between the properties is at a cross-roads intersection, and access is by crossing as opposed to going along, the right(s)-of-way. Non-contiguous properties owned by the same person, but connected by a right-of-way which the person controls and to which the public does not have access, is also considered on-site property. OPEN BURNING means the combustion of any material without the following characteristics: A. Control of combustion air to maintain adequate temperature for efficient combustion; B. Containment of the combustion-reaction in an enclosed device to provide sufficient residence time and mixing for complete combustion; and C. Control of emission of the gaseous combustion products. (See also "incinerator" and "thermal treatment"). OPERATOR means the person responsible for the overall operation of a facility. OUTFALL means a point source. OWNER means the person who owns a facility or part of a facility. PERMIT means an authorization, license, or equivalent control document issued by EPA or an approved State to implement the requirements of 40 CFR Parts 122, 123, and 124. PHYSICAL CONSTRUCTION (in the RCRA program) means excavation, movement of earth, erection of forms or structures, or similar activity to prepare a HWM facility to accept hazardous waste. PILE means any noncontainerized accumulation of solid, nonflowing hazardous waste that is used for treatment or storage. 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, vessel or other floating craft from which pollutants are or may be discharged. This term does not include return flows from irrigated agriculture. POLLUTANT means dredged spoil, solid waste, incinerator residue, filter backwash, sewage, garbage, sewage sludge, munitions, chemical waste, biological materials, radioactive materials (except those regulated under the Atomic Energy Act of 1954, as amended [42 U.S.C. Section 2011 et. seq.]), heat, wrecked or discarded equipment, rocks, sand, cellar dirt and industrial, municipal, and agriculture waste discharged into water. It does not mean: A. Sewage from vessels; or B. 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].) PREVENTION OF SIGNIFICANT DETERIORATION (PSD) means the national permitting program under 40 CFR 52.21 to prevent emissions of certain pollutants regulated under the Clean Air Act from significantly deteriorating air quality in attainment areas. PRIMARY INDUSTRY CATEGORY means any industry category listed in the NRDC Settlement Agreement (Natural Resources Defense Council v. Train, 8 ERC 2120 [D.D.C. 1976], modified 12 ERC 1833 [D.D.C. 1979]). PRIVATELY OWNED TREATMENT WORKS means any device or system which is: (A) Used to treat wastes from any facility whose operator is not the operator of the treatment works; and (B) 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. PUBLICLY OWNED TREATMENT WORKS or POTW means nay device or system used in the treatment (including recycling and reclamation) of municipal sewage or industrial wastes of a liquid nature which is owned by a State or a municipality. This definition includes any sewers, pipes, or other conveyances only if they convey wastewater to a POTW providing treatment. RENT means use of another's property in return for regular payment. RCRA means the Solid Waste Disposal Act as amended by the Resource Conservation and Recovery Act of 1976 (Pub. L. 94-580, as amended by Pub. L. 95-609, 42 U.S.C. Section 6901 et seq.). ROCK CRUSHING AND GRAVEL WASHING FACILITIES are facilities which process crushed and broken stone, gravel, and riprap (see 40 CFR Part 436, Subpart B, and the effluent limitations guidelines for these facilities). SDWA means the Safe Drinking Water Act (Pub. L. 95-523, as amended by Pub. L. 95-1900, 42 U.S.C. Section 300 [f] et. seq.). 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 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 the solids, residues, and precipitate separated from or created in sewage by the unit processes of a POTW. "Sewage" as used in this definition means any wastes, including wastes from humans, households, commercial establishments, industries, and storm water runoff, that are discharged to or otherwise enter a publicly owned treatment works. SILVICULTURAL POINT SOURCE means any discernable, 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 nonpoint 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 401 permit. "Log sorting and log storage facilities" are facilities whose discharges result from the holding of unprocessed wood, e.g., logs or roundwood with bark or after removal of bark 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 Part 429, Subpart J, and the effluent limitations guidelines for these facilities.) STATE menas any of the 50 States, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands (except in the case of RCRA), and the Commonwealth of the Northern Mariana Islands (except in the case of CWA). STATIONARY SOURCE (in the PSD program) menas any building, structure, facility or installation which emits or may emit any air pollutant regulated under the Clean Air Act. "Building, structure, facility, or installation" menas any grouping of pollutant-emitting activities which are located on one or more contiguous or adjacent properties and which are owned or operated by the same person (or by persons under common control). STORAGE (in the RCRA program) means the holding of hazardous waste for a temporary period at the end of which the hazardous waste is treated, disposed, or stored elsewhere. STORM WATER RUNOFF means water discharged as a result of rain, snow, or other precipitation. SURFACE IMPOUNDMENT or IMPOUNDMENT means a facility or part of a facility which is a natural topographic depression, manmade excavation, or diked area formed primarily of earthen materials (although it may be lined with manmade materials), which is designed to hold an accumulation of liquid wastes or wastes containing free liquids, and which is not an injection well. Examples of surface impoundments are holding, storage, settling, and aeration pits, ponds, and lagoons. TANK (in the RCRA program) means a stationary device, designed to contain an accumulation of hazardous waste which is constructed primarily of non-earthen materials (e.g., wood, concrete, steel, plastic) which provide structural support. THERMAL TREATMENT (in the RCRA program) means the treatment of hazardous wastes in a device which uses elevated temperature as the primary means to change the chemical, physical, or biological character or composition of the hazardous waste. Examples of thermal treatment processes are incineration, molten salt, pyrolysis, calcination, wet air oxidation, and microwave discharge. (See also "incinerator" and "open burning.") TOTALLY ENCLOSED TREATMENT FACILITY (in the RCRA program) means a facility for the treatment of hazardous waste which is directly connected to an industrial production process and which is constructed and operated in a manner which prevents the release of any hazardous waste or constituent thereof into the environment during treatment. An example is a pipe in which waste acid is neutralized. TOXIC POLLUTANT means any pollutant listed as toxic under Section 307 (a)(1) of CWA. TRANSPORTER (in the RCRA program) means a person engaged in the off-site transportation of hazardous waste by air, rail, highway, or water. TREATMENT (in the RCRA program) means any method, technique, or process, including neutralization, designed to change the physical, chemical, or biological character or composition of any hazardous waste so as to neutralize such waste, or so as to recover energy or material resources from the waste, or so as to render such waste nonhazardous, or less hazardous; safer to transport, store, or dispose of; or amenable for recovery, amenable for storage, or reduced in volume. UNDERGROUND INJECTION means well injection. UNDERGROUND SOURCE OF DRINKING WATER or USDW means an aquifer or its portion which is not an exempted aquifer and:

A. Which supplies drinking water for human consumption; or B. In which the groundwater contains fewer than 10,000 mg/l total dissolved solids. UPSET 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 preventative maintenance, or careless or improper operation. WATERS OF THE UNITED STATES means: A. All waters which are currently used, were used in the past, or may be susceptible to use in interstate or foreign commerce, including all waters which are subject to the ebb and flow of the tide; B. All interstate waters, including interstate wetlands; C. All other waters such as intrastate lakes, rivers, streams (including intermittent streams), mudflats, sandflats, wetlands, sloughs, prairie potholes, wet meadows, playa lakes, and natural ponds, the use, degradation, or destruction of which would or could affect interstate or foreign commerce including any such waters: 1. Which are or could be used by interstate or foreign travelers for recreational or other purposes, 2. From which fish or shellfish are or could be taken and sold in interstate and foreign commerce, 3. Which are used or could be used for industrial purposes by industries in interstate commerce; D. All impoundments of water otherwise defined as waters of the United States under this definition; E. Tributaries of waters identified in paragraphs (A) - (D) above; F. The territorial sea; and G. Wetlands adjacent to waters (other than waters that are themselves wetlands) identified in paragraphs (A) - (F) of this definition. Waste treatment systems, including treatment ponds or lagoons designed to meet requirement of CWA (other than cooling ponds as defined in 40 CFR Section 423.11(m) which also meet the requirement of this definition) are not waters of the United States. This exclusion applies only to manmade bodies of water which neither were originally created in waters of the United States (such as a disposal area in wetlands) nor resulted from the impoundments of waters of the United States. WELL INJECTION or UNDERGROUND INJECTION means the subsurface emplacement of fluids through a bored, drilled, or driven well; or through a dug well, where the depth of the dug well is greater than the largest surface dimension. WETLANDS means those areas that are inundated or saturated by surface or groundwater at a frequency and duration sufficient to support, and that under normal circumstances, do support, a prevalence of vegetation typically adapted for life in saturated soil conditions. Wetlands generally include swamps, marshes, bogs, and similar areas.

INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) GENERAL INFORMATION FORM (TO BE SUBMITTED WITH FORMS 2C, 2D AND 2E) (Replaces EPA General Form 1) Revised 10/08/2004 1. Name of Facility: 2. Facility Contact Name: Address: City or Town: Telephone: Work: 3. Certified Operator Name: Certification Number: Address: City or Town: Telephone: Work: 4. Facility Mailing Address Street or P.O. Box: City or Town: 5. Facility Location Street, Route No. or Other Specific Identifier: State: ZIP Code: Home: State: ZIP Code: Classification: Home: State: ZIP Code:

6. Type of Permit Action: New Renewal Modification

7. EPA I.D. Number:

8. Does or will this facility (either existing or proposed) include a concentrated animal feeding operation or aquatic animal production facility which results in a discharge to waters of the state? (Form 2B). Yes No Form Attached

9. Is this a facility which currently results in discharges to waters of the state other than described in 8? (Form 2C-Process Wastewater or Form 2E-Nonprocess Wastewater) Yes No Form Attached

10. Is this a proposed facility (other than described in 8) which will result in a discharge to waters of thestate? (Form 2D) Yes No Form Attached 11. SIC Codes (4-digit, in order of priority) First: Second: Third: Fourth: Specify: Specify: Specify: Specify:

12. Existing Environmental Permits (Identification #) NPDES (Discharge to Surface Waters): UIC (Underground Injection of Fluids): RCRA (Hazardous Wastes): PSD (Air Emissions from Proposed sources): Other: Other: Specify: Specify:

13. Nature of Business (Provide a Brief Description)

14. Map Attach to this application a topographic map of the area extending to at least one mile beyond property boundaries. The map must show the outline of the facility, the location of each of its existing and proposed intake and discharge structures, each of its hazardous waste treatment, storage, or disposal facilities, and each well where it injects fluid underground. Include all springs, rivers and other surface water bodies in the map area. 15. Signature Block: This application must be signed by a person in responsible charge to be valid. This signature attests to the following: "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".

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Return Completed Application and Associated Materials to: Indiana Department of Environmental Management Office of Water Quality NPDES Permits Section 100 North Senate Ave. Indianapolis, Indiana 46204