Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

United States 

Environmental Protection Agency 

Office of Water 

Washington, D.C. 

EPA Form 3510-2F 

Revised <INSERT DATE> 

Water Permits Division 

Application Form 2F 

Stormwater Discharges 

Associated with Industrial 

Activity 

NPDES Permitting Program 

NPDES Proposed Application Forms for Public Docket ID No. EPA-HQ-OW-2016-

0145 & Docket ID No. EPA-HQ-OW-2016-0146. 

This document is being distributed for comment purposes only. Comments and 

suggestions regarding this draft document should be submitted through electronic 

comments to http://www.regulations.gov. 

Note: Complete this form and Form 1 if you are a new or existing facility whose discharge is composed 

entirely of stormwater associated with industrial activity, excluding discharges from construction 

activity under 40 CFR 122.26(b)(14)(x) or (b)(15). If your discharge is composed of stormwater and

non-stormwater, you must complete Forms 1 and 2F, and you must complete Form 2C, 2D, or 2E, as 

appropriate. See the “Instructions” inside for further details. 

For Comment Only
Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Paperwork Reduction Act Notice 

The U.S. Environmental Protection Agency estimates the average burden to collect and complete 

Form 2F to be 28.6 hours. The estimate includes time for reviewing instructions, searching existing data 

sources, gathering and maintaining the needed data, and completing and reviewing the collection of 

information. Send comments regarding the burden estimate or any other aspect of this collection of 

information, including suggestions for reducing the burden, to the Chief, Information Policy Branch 

(PM-223), U.S. Environmental Protection Agency, 1200 Pennsylvania Avenue, NW, Washington, DC 

20460 and to the Office of Information and Regulatory Affairs, Office of Management and Budget, 

725 17th Street, NW, Washington, DC 20503, marked “Attention: Desk Officer for EPA.” 

For Comment Only
2F-1 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

FORM 2F—INSTRUCTIONS 

General Instructions 

Who Must Complete Form 2F? 

Applicants who answered “yes” to Item 1.2.3 on Form 1 should 

complete Form 2F. This means that you are a new or existing 

facility and your discharge is composed entirely of stormwater 

associated with industrial activity (excluding discharges from 

construction activity under 40 CFR 122.26(b)(14)(x) or (b)(15)) or

composed of stormwater and non-stormwater and are seeking 

coverage under an individual NPDES permit. Note that applicants 

in the latter category must also complete Form 2C, 2D, or 2E, as 

applicable. See inset below. 

Where to File Your Completed Form 

Submit your completed application package (Forms 1 and 2F plus 

any other applicable forms) to your NPDES permitting authority. 

Consult Exhibit 1–1 of the “General Instructions” section of Form 1 

to identify your NPDES permitting authority. 

Public Availability of Submitted Information 

EPA will make information provided on the various NPDES permit 

application forms available to the public for inspection and copying 

upon request. No information on Form 2F (or related attachments) 

may be claimed as confidential. 

You may make a claim of confidentiality for any information that you 

submit to EPA that goes beyond the information required by Form 

2F. Note that NPDES permitting authorities will deny claims for 

treating any effluent data (estimated or actual) as confidential. If you 

do not assert a claim of confidentiality at the time you submit your 

information to the NPDES permitting authority, EPA may make the 

information available to the public without further notice to you. EPA 

will handle claims of confidentiality in accordance with the Agency’s 

business confidentiality regulations in Part 2 of Title 40 of the Code 

of Federal Regulations (CFR). 

Completion of Forms 

Print or type in the specified areas only. If you do not have enough 

space on the form to answer a question, you may continue on 

additional sheets, as necessary, using a format consistent with the 

form. 

Provide your EPA Identification Number from the Federal Registry 

Service, NPDES Permit Number, and facility name at the top of 

each page of Form 2F and any attachments. If your facility is new 

(i.e., not yet constructed), write or type “New Facility”. If you do not 

know your EPA Identification Number, contact your NPDES 

permitting authority. See Exhibit 1–1 of the “General Instructions” of 

Form 1 for contact information. Additionally, for Tables A through D, 

provide the applicable Outfall Number at the top of each page. 

Do not leave any response areas blank unless the form directs you 

to skip the item. If the form directs you to respond to an item that 

does not apply to your facility or activity, enter “NA” for “not 

applicable” to show that you considered the item and determined a 

response was not necessary for your facility. 

The NPDES permitting authority will consider your application 

complete when it and any supplementary material are received and 

completed according to the authority’s satisfaction. The NPDES 

permitting authority will judge the completeness of any application 

independently of the status of any other permit application or permit 

for the same facility or activity. 

Definitions 

Definitions of all significant terms used in these Instructions and 

Form 2F are in the “Glossary”, which follows the “General 

Instructions” in Form 1. 

Notes 

 Form 2F must be completed by operators of 

facilities who discharge stormwater associated 

with industrial activity or by operators of 

stormwater discharges who EPA is evaluating 

for designation as a significant contributor of 

pollutants to waters of the United States, or as 

contributing to a violation of a water quality 

standard. 

 Operators of discharges that are composed 

entirely of stormwater must complete Form 2F 

in conjunction with Form 1. 

 Operators of discharges of stormwater that is 

combined with process wastewater must 

complete and submit Form 2F, Form 1, and 

Form 2C. Process wastewater is water that 

comes into direct contact with or results from 

the production or use of any raw material, 

intermediate product, finished product, 

byproduct, waste product, or wastewater. 

 Operators of discharges of stormwater that is 

combined with nonprocess wastewater must 

complete Form 2F, Form 1, and Form 2E. 

Nonprocess wastewater includes noncontact 

cooling water and sanitary wastes that are not 

regulated by effluent guidelines, except 

discharges by educational, medical, or 

commercial chemical laboratories. 

 Operators of new discharges of stormwater 

associated with industrial activity that will be 

combined with other non-stormwater new 

discharges must submit Form 2F, Form 1, and 

Form 2D. 

For Comment Only
2F-2 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

FORM 2F—INSTRUCTIONS CONTINUED 

Line-By-Line Instructions 

Section 1. Outfall Location 

Item 1.1. Identify each of the facility’s outfalls by number. For each 

outfall, specify the latitude and longitude, method of collection, and 

name of the receiving water. The location of each outfall (i.e., where 

the coordinates are collected) shall be the location where collected 

and concentrated stormwater flows are discharged from the facility 

such that the first receiving water body into which the discharge 

flows, either directly or through a separate storm sewer system, is a 

water of the United States. In the column marked “Collection 

Method Information”, indicate the following: (a) horizontal collection 

method, which is the type of method/device used to identify the 

coordinates (e.g., global positioning system or GPS device, census 

block centroid, an address, State Plane Coordinate System or 

SPCS, etc.); (b) scale of your source map or photo if applicable 

(e.g., the proportional distance on the ground for one unit of 

measure typically expressed in ratio form such as 1:24,000); and 

(c) horizontal reference datum (i.e., the coordinate reference 

system) to which your coordinates relate. 

Note: In EPA’s stormwater permits, “outfalls” are referred to as 

“discharge points”. 

GPS devices are commonly used to electronically record the 

latitude and longitude coordinates of a property. It is also possible to 

use geographic information systems (e.g., ArcView), online sources 

(e.g., Terra Server or Google Earth), or paper maps from trusted 

sources (e.g., U.S. Geological Survey) to identify coordinates. The 

online services require that you enter a property address, the 

nearest intersection, or zip code. The system then generates the 

coordinates. The horizontal collection method for such sources is 

“Interpolation—Satellite.” You would not report a source map scale 

if you used a GPS device or one of the online systems. For the 

horizontal reference datum, you would report one of the following 

three options: 

1. North American Datum of 1927 (NAD27): This datum was 

based on the ground survey in Europe and North America in 

the 19th century. NAD27 was the standard for many years 

because the U.S. Geological Survey (USGS) published its 

topographic maps in this datum. If you are reporting a location 

using a USGS 7.5-minute map, NAD27 is your default datum. 

2. North American Datum of 1983 (NAD83): NAD83 updated 

NAD27 with current measurements using radio astronomy and 

satellite observations. When the USGS began publishing 

digital data, the NAD83 was used, which provided a more 

accurate representation of the earth’s shape and a more 

accurate depiction of the location of objects on the earth. 

3. World Geodetic System of 1984 (WGS84): This datum was 

developed from the measurements calculated in NAD83. If you 

used a GPS to calculate your latitude/longitude coordinates, 

WGS84 is the default datum. 

If you need further guidance in responding to Item 1.1, refer to 

http://www.epa.gov/geospatial/latitudelongitude-data-standard. 

Note that space has been provided on the form for six outfalls. If 

you have more than this number, type your information on a 

separate sheet of paper in a format similar to that of the form. Make 

sure you note the EPA Identification Number, NPDES Permit 

Number, and facility name at the top of the page and indicate the 

specific Item of the form to which you are responding, which is Item 

1.1 in this instance. Note that in other sections of the form, you will 

be asked to provide information by outfall number (Sections 2, 4, 5, 

and 7). Note that space has been provided on the form for six 

outfalls. If you have more than this number, type your information 

on a separate sheet of paper in a format similar to that of the form. 

Make sure you note the EPA Identification Number, NPDES Permit 

Number, and facility name at the top of the page and indicate the 

specific Item of the form to which you are responding, which is Item 

1.1 in this instance. Note that in other sections of the form, you will 

be asked to provide information by outfall number (Sections 2, 4, 5, 

and 7). 

Section 2. Improvements 

Item 2.1. Indicate if you are required by any federal, state, or local 

authority to meet an implementation schedule for constructing, 

upgrading, or operating wastewater treatment equipment or 

practices or any other environmental programs that could affect the 

discharges described in this application. The requirements include, 

but are not limited to, permit conditions, administrative enforcement 

orders, enforcement compliance schedule letters, stipulations, court 

orders, and grant or loan conditions. If “yes”, continue to Item 2.2. If 

“no,” skip to Section 3. 

Item 2.2. Briefly identify and describe each applicable project (e.g., 

consent decree, enforcement order, or permit condition). For each 

condition, specify the affected outfall number(s), the source(s) of 

the discharge, the required final compliance date, and the projected 

final compliance date. 

Item 2.3. OPTIONAL ITEM. Indicate if you have attached any 

sheets describing any additional water pollution control programs 

(or other environmental projects that could affect your discharges) 

that you may now have underway or planned. If you attach 

additional sheets, indicate in the attachment whether each program 

is actually underway or is planned, and indicate your actual or 

planned schedule for construction. Be sure to note your EPA 

Identification Number, NPDES Permit Number, and facility name at 

the top of any attached pages. 

Section 3. Site Drainage Map 

Item 3.1 Attach a site drainage map showing the topography of the 

facility. If a topographic map is unavailable, you may provide an 

outline of drainage areas served by the outfall(s) covered in the 

application. The site map must include the following information: 

 Each of its drainage and discharge structures; 

 The drainage area of each stormwater outfall; 

 Paved areas and buildings within the drainage area of each 

stormwater outfall; each past or present area used for outdoor 

storage or disposal of significant materials; each existing 

structural control measure to reduce pollutants in stormwater 

runoff; materials loading and access areas; areas where 

For Comment Only
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FORM 2F—INSTRUCTIONS CONTINUED 

pesticides, herbicides, soil conditioners, and fertilizers are 

applied; 

 Each hazardous waste treatment, storage, or disposal facility 

(including each area not required to have a Resource 

Conservation and Recovery Act (RCRA) permit and is used 

foraccumulating hazardous waste for less than 90 days under 

40 CFR 262.34); 

 Each well where fluids from the facility are injected 

underground; and 

 Springs and other surface water bodies that receive 

stormwater discharges from the facility.

When you have completed and attached your site map to Form 2F, 

answer “yes” to Item 3.1. 

Section 4. Pollutant Sources 

Item 4.1. List all outfalls discharging stormwater. Provide an 

estimate of the impervious surface area drained by the outfall. 

Specify units of measure. Impervious surfaces are surfaces where 

stormwater runs off at rates that are significantly higher than 

background rates (e.g., predevelopment levels) and include paved 

areas, building roofs, parking lots, and roadways. 

Provide an estimate of the total surface area (impervious and 

pervious areas) drained by each outfall (within a mile radius of the 

facility). You may use the site map developed under Item 3.1 to 

estimate the total area drained by each outfall. For areas under 

5 acres, consult your NPDES permitting authority to determine 

whether the area should be reported to the nearest tenth of an acre 

or nearest quarter of an acre. 

Item 4.2. Provide a narrative description of the following: 

 Significant materials that in three years prior to the submittal 

of this application have been treated, stored, or disposed in a 

manner to allow exposure to stormwater; 

 Method of treatment, storage, or disposal of such materials; 

 Materials management practices employed, in the three years 

prior to the submittal of this application, to minimize contact by 

these materials with stormwater runoff;

 Materials loading and access areas; and

 The location, manner, and frequency in which pesticides, 

herbicides, soil conditioners, and fertilizers are applied.

You should identify your significant materials by chemical name, 

form (e.g., powder, liquid, etc.), and type of container or treatment 

unit. Indicate any materials treated, stored, or disposed of together. 

The term significant materials includes, but is not limited to: raw 

materials; fuels; materials such as solvents, detergents, and plastic 

pellets; finished materials such as metallic products; raw materials 

used in food processing or production; hazardous substances 

designated under Section 101 (14) of the Comprehensive 

Environmental Response, Compensation, and Liability Act 

(CERCLA); any chemical the facility is required to report pursuant 

to Section 313 of Title III of the Superfund Amendments and 

Reauthorization Act (SARA); and fertilizers; pesticides; and waste 

products such as ashes, slag, and sludge that have the potential to 

be released with stormwater discharges. 

Item 4.3. For each outfall, list the location and type of existing 

structural and non-structural control measure(s) to reduce pollutants 

in stormwater runoff. Structural controls include structures that 

enclose materials handling or storage areas; structures that cover 

materials; and berms, dikes, or diversion ditches around 

manufacturing, production, storage, or treatment units and retention 

ponds. Spill prevention plans, employee training, visual inspections, 

preventive maintenance, and housekeeping measures are 

examples of non-structural controls. 

Describe the treatment, including the schedule and type of 

maintenance activities performed, and the ultimate disposal of any 

solid or fluid wastes other than by discharge. For each structural 

control identified, indicate the type of treatment the stormwater 

receives using the codes in Exhibit 2F-1, located at the end of the 

Instructions. For each non-structural control identified, indicate “Not 

Applicable” in the “Codes from Exhibit 2F-1” column. 

Section 5. Non-Stormwater Discharges 

Item 5.1. Provide a certification that all outfalls that should contain 

stormwater discharges associated with industrial activity have been 

tested or evaluated for the presence of non- stormwater discharges. 

Tests for such non-stormwater discharges can include smoke tests, 

fluorometric dye tests, analysis of accurate schematics, and others. 

Item 5.2. Include a description of the method used, the date of any 

testing, and the onsite drainage points that were directly observed 

during a test used to support the certification in Item 5.1. All nonstormwater discharges must be identified in a Form 2C, 2D, or 2E. 

See the above section on “Who Must Complete Form 2F” for further 

information. 

Section 6. Significant Leaks or Spills 

Item 6.1. Describe any significant leaks or spills of toxic or 

hazardous pollutants at the facility within the three years prior to the 

submittal of this application. Include the approximate date and 

location of the spill or leak and the type and amount of material 

released. 

Section 7. Discharge Information 

Item 7.1. Answer whether you are a new source or new discharge. 

Contact your NPDES permitting authority to determine if you are a 

new source or new discharge. 

Tables A, B, C, and D 

Items 7.2 to 7.17. These items require you to collect and report 

data in Tables A through D, located at the end of Form 2F, for the 

parameters and pollutants listed in Exhibits 2F–2, 2F–3, and 2F–4 

(located at the end of the Instructions). The instructions for 

completing Tables A through D are table-specific in addition to the 

criteria for determining who should complete them. 

IMPORTANT NOTE: Read the “General Instructions for Reporting, 

Sampling, and Analysis” below before completing Items 7.2 to 7.17.

For Comment Only
2F-4 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

FORM 2F—INSTRUCTIONS CONTINUED 

Item 7.2 and Table A. All applicants must complete Table A. If the 

discharge is an existing discharge and your discharge is composed 

exclusively of stormwater (i.e., no process or nonprocess 

wastewater) then you only need to provide monitoring data for oil and 

grease, total phosphorus, total Kjeldahl nitrogen, and total nitrogen. 

Indicate “NA” for “Not Applicable” in the columns for all other 

parameters. Answer “yes” to Item 7.2 once you have completed this 

task. 

Item 7.3 and Table B. Indicate whether the facility is subject to an 

effluent limitations guideline (ELG) (see 40 CFR Subchapter N to 

determine which pollutants are limited in ELGs) or if the facility is 

subject to effluent limitations in an NPDES permit for its process 

wastewater or stormwater (if the facility is operating under an existing 

NPDES permit). If “yes”, continue to Item 7.4. If “no”, skip to Item 7.5. 

Note: Stormwater discharges from certain industrial sources or 

activities have specific ELGs for which they must comply. These 

stormwater-specific ELGs include: 

Regulated Discharge 40 CFR Section

Discharges resulting from spray down or intentional 

wetting of logs at wet deck storage areas 

Part 429, Subpart I

Runoff from phosphate fertilizer manufacturing facilities 

that comes into contact with any raw materials, finished 

product, by-products or waste products (SIC 2874) 

Part 418, Subpart A

Runoff from asphalt emulsion facilities Part 443, Subpart A

Runoff from material storage piles at cement 

manufacturing facilities 

Part 411, Subpart C

Mine dewatering discharges at crushed stone, 

construction sand and gravel, or industrial sand mining 

facilities 

Part 436, Subparts B, 

C, and D 

Runoff from hazardous waste and non-hazardous waste 

landfills 

Part 445, Subparts A 

and B 

Runoff from coal storage piles at steam electric 

generating facilities 

Part 423

Runoff containing urea from airfield pavement deicing at 

existing and new primary airports with 1,000 or more 

annual non-propeller aircraft departures 

Part 449

Item 7.4. In Table B, list all pollutants that are limited in an ELG to 

which the facility is subject and all pollutants listed in the facility's 

NPDES permit for its process wastewater (if the facility is operating 

under an existing NPDES permit) and provide quantitative data for 

each pollutant (provide actual data for existing dischargers and 

estimated data for new sources and new dischargers). If a pollutant 

in Exhibits 2F–2 or 2F–3 is indirectly limited by an ELG through an 

indicator (e.g., use of total suspended solids as an indicator to 

control the discharge of iron and aluminum), you must provide data 

for the pollutant in Table B. Complete one table for each outfall. 

Answer “yes” to Item 7.4 once you have completed this task. 

Item 7.5 and Table C. Table C requires you to address the 

pollutants in Exhibits 2F–2, 2F–3, and 2F–4 for each outfall. 

Pollutants in each of these exhibits are addressed differently. 

Indicate whether you know or have reason to believe any pollutants 

in Exhibit 2F–2 are present in the discharge. If “yes”, continue to Item 

7.6. If “no”, skip to Item 7.7.

Item 7.6. For each outfall, list all pollutants in Exhibit 2F–2 that 

you know or have reason to believe are present in the discharge in 

Table C (except pollutants previously listed in Table B that are 

limited directly or indirectly by an ELG) and either report 

quantitative data or briefly describe the reasons the pollutant is 

expected to be discharged. Answer “yes” to Item 7.6 once you 

have completed this task. 

Item 7.7. This item asks if you qualify as a “small business”. If so, 

you are exempt from the reporting requirements for the organic 

toxic pollutants listed in Exhibit 2F–3. 

You can qualify as a “small business” in two ways: (1) If your 

facility is a coal mine and if your probable total annual production 

is less than 100,000 tons per year, you may submit past 

production data or estimated future production (such as a 

schedule of estimated total production under 30 CFR § 795.14(c))

instead of conducting analyses for the organic toxic pollutants; (2) 

If your facility is not a coal mine and if your gross total annual 

sales for the most recent three years average less than $100,000 

per year (in second quarter 1980 dollars), you may submit sales 

data for those years instead of conducting analyses for the organic 

toxic pollutants. The production or sales data must be for the 

facility that is the source of the discharge. The data should not be 

limited to production or sales for the process or processes that 

contribute to the discharge, unless those are the only processes at 

your facility. For sales data, in situations involving intra-corporate 

transfer of goods and services, the transfer price per unit should 

approximate market prices for those goods and services as 

closely as possible. Sales figures for years after 1980 should be 

indexed to the second quarter of 1980 by using the gross national 

product price deflator (second quarter of 1980=100). This index is 

available online from the U.S. Department of Commerce, Bureau 

of Economic Analysis at 

http://www.bea.gov/national/pdf/SNTables.pdf. 

If you qualify as a small business according to the criteria above, 

answer “yes” to Item 7.7 and skip to Item 7.18. Otherwise, answer 

“no” and continue to Item 7.8. 

Item 7.8. Indicate whether you know or have reason to believe 

any pollutants in Exhibit 2F–3 are present in the discharge. If 

‘yes”, continue to Item 7.9. If “no”, skip to Item 7.10. 

Item 7.9. For each outfall, list all pollutants in Exhibit 2F–3 that 

you know or have reason to believe are present in the discharge in 

Table C (except pollutants previously listed in Table B). Answer 

“yes” to Item 7.9 once you have completed this task. 

Item 7.10. Indicate whether you expect any of the pollutants from 

Exhibit 2F–3 to be discharged in concentrations of 10 parts per 

billion (ppb) or greater? If “yes”, continue to Item 7.11. If “no”, skip 

to Item 7.12. 

Item 7.11. Provide quantitative data in Table C for those pollutants 

in Exhibit 2F–3 that you expect to be discharged in concentrations 

of 10 ppb or greater (provide actual data for existing dischargers 

and estimated data for new sources and new dischargers). 

Answer “yes” to Item 7.11 once you have completed this task.

For Comment Only
2F-5 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

FORM 2F—INSTRUCTIONS CONTINUED 

Item 7.12. Indicate whether you expect acrolein, acrylonitrile, 2,4-

dinitrophenol, or 2-methyl-4,6-dinitrophenol to be discharged in 

concentrations of 100 ppb or greater? If “yes”, continue to Item 

7.13. If “no”, skip to Item 7.14. 

Item 7.13. Provide quantitative data in Table C for the pollutants 

identified in Item 7.12 that you expect to be discharged in 

concentrations of 100 ppb or greater (provide actual data for 

existing dischargers and estimated data for new sources and new 

dischargers). Answer “yes” to Item 7.13 once you have completed 

this task. 

Item 7.14. For any pollutants you expect to be present in the 

discharge at concentrations less than 10 ppb (or less than 100 ppb 

for the above four pollutants), either submit quantitative data or 

briefly describe the reasons the pollutant is expected to be 

discharged in Table C. Answer “yes” to Item 7.14 once you have 

completed this task. 

Item 7.15. Indicate whether you know or have reason to believe 

any pollutants in Exhibit 2F–4 are present in the discharge. If ‘yes”, 

continue to Item 7.16. If “no”, skip to Item 7.17. 

Item 7.16. For each outfall, list any pollutant in Exhibit 2F–4 that 

you know or believe to be present in the discharge in Table C and 

explain why you believe it to be present. No analysis is required, 

but if you have analytical data, you must report it. Answer “yes” to 

Item 7.16 once you have completed this task. 

Item 7.17 and Table D. Provide data for the storm event(s) that 

resulted in the maximum daily discharges for the flow weighted 

composite sample in Table D. If sampling is conducted during more 

than one storm event, you only need to report the information 

requested on Table D for the storm event(s) that resulted in any 

maximum pollutant concentration reported on Tables A through C. 

Provide flow measurements or estimates of the flow rate, and the 

total amount of discharge for the storm event(s) sampled, the 

method of flow measurement, or estimation. Provide the data and 

duration of the storm event(s) sampled, rainfall measurements, or 

estimates of the storm event that generated the sampled runoff and 

the duration between the storm event sampled and the end of the 

previous measurable (greater than 0.1 inch rainfall) storm event. 

Answer “yes” to Item 7.17 once you have completed this task. 

Used or Manufactured Toxics 

Item 7.18. Review Exhibits 2F-2 through 2F-4 and determine if you 

currently use or manufacture any of the pollutants listed as an 

intermediate or final product or byproduct. If so, answer “yes” to 

Item 7.18. You should also answer “yes” if you know or have 

reason to believe that 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD) 

is discharged or if you use or manufacture 2,4,5-trichlorphenoxy 

acetic acid (2,4,5-T); 2-(2,4,5-trichlorophenoxy) propanoic acid 

(Silvex, 2,4,5-TP); 2-(2,4,5-trichlorophenoxy) ethyl, 2,2-

dichloropropionate (Erbon); 0,0-dimethyl 0-(2,4,5-trichlorphenyl) 

phosphorothioate (Ronnel); 2,4,5-trichlorophenol (TCP); or 

hexachlorophene (HCP). If your answer to Item 7.18 is “no,” skip to 

Section 8.

Item 7.19. List all of the toxic pollutants identified under Item 7.18, 

including TCDD. Note that the NPDES permitting authority may 

waive or modify the requirement if you demonstrate that it would be 

unduly burdensome to identify each toxic pollutant and the NPDES 

permitting authority has adequate information to issue your permit. 

You may not claim any information submitted in response to Item 

7.18 as confidential; however, you do not have to distinguish 

between use or production of the pollutants or list the amounts. 

Section 8. Biological Toxicity Testing Data 

Item 8.1. Answer whether you know of or have reason to believe 

that biological toxicity testing has been conducted of your 

wastewater treatment, including engineering reports or pilot plant 

studies. If “no,” skip to Section 9. Otherwise, continue. 

Item 8.2. List any tests of which you are aware and their purposes. 

Section 9. Contract Analysis Information 

Item 9.1. Indicate if any of the analyses performed in Section 7 

were performed by a contract laboratory or consulting firm. If “no,” 

skip to Section 10. If “yes,” continue to Item 9.2. 

Item 9.2. Provide the name, address, phone number, and pollutants 

analyzed by the laboratory or consulting firm(s) in the spaces 

provided. 

Section 10. Checklist and Certification Statement 

Item 10.1. Review the checklist provided on the application. In 

Column 1, mark the sections of Form 2F that you have completed 

and are submitting with your application. For each section in 

Column 2, indicate whether you are submitting attachments. 

Note: Under 40 CFR 117.12(a)(2), certain discharges of 

hazardous substances may be exempted from the requirements 

of CWA Section 311, which establishes reporting requirements, 

civil penalties, and liability for cleanup costs for spills of oil and 

hazardous substances. A discharge of a particular substance 

can be exempted if the origin, source, and amount of the 

discharged substances are identified in the NPDES permit 

application or in the permit, if the permit contains a requirement 

for treatment of the discharge, and if the treatment is in place. If 

you would like to apply for an exemption from the requirements 

of CWA Section 311, attach additional sheets of paper to your 

application, setting forth the following information: 

1. The substance and the amount of each substance that might 

be discharged. 

2. The origin and source of the discharge of the substance. 

3. The treatment to be provided for the discharge by: 

a. An onsite treatment system separate from any treatment 

system treating your normal discharge; 

b. A treatment system designed to treat your normal 

discharge and that is additionally capable of treating the 

amount of the substance identified under paragraph 1 

above; or 

c. Any combination of the above. 

See 40 CFR 117.12(a)(2) and (c) or contact your NPDES 

permitting authority for further information on exclusions from 

CWA Section 311. 

For Comment Only
2F-6 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

FORM 2F—INSTRUCTIONS CONTINUED

Item 10.2. The CWA provides for severe penalties for submitting 

false information on this application form. Section 309(c)(2) of the 

Clean Water Act provides that, “Any person who knowingly makes 

any false material statement, representation, or certification in any 

application, ...shall upon conviction be punished by a fine of not 

more than $10,000 or by imprisonment for not more than six 

months or both.” 

FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS 

APPLICATION TO BE SIGNED AS FOLLOWS: 

A. By a responsible corporate officer. For the purpose of this 

section, a responsible corporate officer means: (i) A president, 

secretary, treasurer, or vice-president of the corporation in 

charge of a principal business function, or any person who 

performs policy- or decision-making functions for the 

corporation, or (ii) 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 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 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: (i) the chief officer of the agency, or 

(ii) 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 

Submit your completed Form 1, Form 2F, and 

all associated attachments 

(and any other required NPDES application forms) 

to your NPDES permitting authority. 

For Comment Only
2F-7 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

General Instructions for Reporting, Sampling, and Analysis

IMPORTANT NOTICE: Read these instructions prior to completing 

Tables A through C and Section 7 of Form 2F. 

General Items

Complete the applicable tables for each outfall at your facility. Be 

sure to note the EPA Identification Number, NPDES Permit 

Number, facility name, and applicable outfall number at the top of 

each table page and any associated attachments. 

You may report some or all of the required data by attaching 

separate sheets of paper instead of completing Tables A through C 

for each of your outfalls so long as the sheets contain all of the 

required information and are similar in format to Tables A through 

C. For example, you may be able to print a report in a compatible 

format from the data system used in your Gas Chromatography/ 

Mass Spectrometry analysis completed under Table B. 

If you are an existing discharger, you are required to report actual

quantitative data. See “Use of Historic Data” below for use of 

historic data. If you are a new source or discharge, you may supply 

estimated data along with the source of each estimate. If you have 

quantitative data available, however, you must provide it. Base 

estimates on available, in-house or contractor engineering reports, 

or any other studies performed on the proposed facility. Use the 

following codes to report your source information in the “Source of 

Information” column: 

Data Source Code

Engineering study 1 

Actual data from pilot plants 1 

Estimates from other engineering 

studies 2 

Data from other similar plants 3 

Best professional estimates 4 

Others 5 and specify on 

the table 

No later than two years after your facility commences to discharge, 

you must complete and submit sampling and analysis data for the 

pollutants and parameters in Tables A through C. However, you 

need not report results for tests you have already performed and 

reported under the discharge monitoring requirements of your 

NPDES permit. 

Table A requires you to report at least one analysis for each 

pollutant listed. Tables B and C require you to report analytical data 

in two ways. For some pollutants addressed in Tables B and C, if 

you know or have reason to know that the pollutant is present in 

your discharge, you may be required to list the pollutant and test 

(sample and analyze) and report the levels of the pollutants in your 

discharge. For all other pollutants addressed in Tables B and C, 

you must list the pollutant if you know or have reason to know that 

the pollutant is present in the discharge, and either report 

quantitative data for the pollutant or briefly describe the reasons 

the pollutant is expected to be discharged. (See Items 7.2 through 

7.17 of the instructions for completing Tables A through C.). Base 

your determination that a pollutant is/will be present in your 

discharge on your knowledge of the facility’s raw materials, 

material management practices, maintenance chemicals, history of 

spills and releases, intermediate and final products and 

byproducts, and any previous analyses known to you of your 

effluent or similar effluent. 

Sampling 

The collection of the samples for the reported analyses should be 

supervised by a person experienced in performing sampling of 

industrial wastewater or stormwater discharges. You may contact 

NPDES permitting authority for detailed guidance on sampling 

techniques and for answers to specific questions. Refer to Exhibit 1–

1 of Form 1 for contact information. Any specific requirements in the 

analytical methods must be followed, including factors related to 

sample containers, sample preservation, holding times, and the 

collection of duplicate samples. 

The time when you sample should be representative of your normal 

operation, to the extent feasible, with all processes that contribute 

wastewater in normal operation, and with your treatment system 

operating properly with no system upsets. Samples should be 

collected from the center of the flow channel, where turbulence is at 

a maximum, at a site specified in your present permit, or at any site 

adequate for the collection of a representative sample. 

Grab samples must be taken in the first 30 minutes of discharge (or 

as soon thereafter as practicable) for pH, temperature, cyanide, total 

phenols, residual chlorine, oil and grease, fecal coliform (including 

E. coli) and Enterococci (previously known as fecal streptococcus at 

40 CFR 122.26(d)(2)(iii)(A)(3)), and volatile organic chemicals. You 

are not required to analyze a flow-weighted composite for these 

parameters. 

For all other pollutants, both a grab sample collected during the first 

30 minutes (or as soon thereafter as practicable) of the discharge 

and a flow-weighted composite sample must be analyzed. However, 

a minimum of one grab sample may be taken for effluents from 

holding ponds or other impoundments with a retention period of 

greater than 24 hours. 

All samples must be collected from the discharge resulting from a 

storm event that is greater than 0.1 inches and at least 72 hours 

from the previously measurable (greater than 0.1 inch rainfall) storm 

event. Where feasible, the variance in the duration of the event and 

the total rainfall of the event should not exceed 50 percent from the 

average or median rainfall event in that area. 

A grab sample must be taken during the first 30 minutes of the 

discharge (or as soon thereafter as practicable), and a flowweighted composite must be taken for the entire event or for the first 

three hours of the event. 

Grab and composite samples are defined as follows: 

Grab sample: An individual sample of at least 100 milliliters 

collected during the first 30 minutes (or as soon thereafter as 

practicable) of the discharge. This sample is to be analyzed 

separately from the composite sample. 

Flow-weighted Composite sample: A flow-weighted composite 

sample may be taken with a continuous sampler that proportions the 

amount of sample collected with the flow rate or as a combination of 

a minimum of three sample aliquots taken in each hour of discharge 

For Comment Only
2F-8 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

General Instructions for Reporting, Sampling, and Analysis Continued 

for the entire event or for the first three hours of the event, with 

each aliquot being at least 100 milliliters and collected with a 

minimum period of 15 minutes between aliquot collections. The 

composite must be flow proportional; the time interval between 

either each aliquot or the volume of each aliquot must be 

proportional to either the stream (effluent) flow at the time of 

sampling or the total stream (effluent) flow since the collection of 

the previous aliquot. Aliquots may be collected manually or 

automatically. Where GC/MS Volatile Organic Analysis (VOA) is 

required, aliquots must be combined in the laboratory immediately 

before analysis. Only one analysis for the composite sample is 

required. 

Use of Historic Data 

Existing data may be used, if available, in lieu of sampling 

conducted solely for the purposes of this application, provided it is 

representative of the present discharge and was collected within 

three years of the application due date. If you sample for a listed 

pollutant on a monthly or more frequent basis, summarize the data 

collected within one year of the application for the pollutant(s) at 

issue. 

Among the factors that would cause the data to be 

unrepresentative are significant changes in production level, 

changes in raw materials, processes, or final products, and 

changes in stormwater treatment. The NPDES permitting authority 

may request additional information, including current quantitative 

data, if they determine it to be necessary to assess your 

discharges. The NPDES permitting authority may allow or 

establish appropriate site-specific sampling procedures or 

requirements including sampling locations, the season in which 

the sampling takes place, the minimum duration between the 

previous measurable storm event and the storm event sampled, 

the minimum or maximum level of precipitation required for an 

appropriate storm event, the form of precipitation sampled (snow 

melt or rainfall), protocols for collecting samples under 40 CFR 

Part 136, and additional time for submitting data on a case-bycase basis. 

Reporting 

Report sampling results for all pollutants in Tables A through C as 

concentration and mass, with the exception of flow, temperature, 

pH, color, and fecal coliform organisms. 

Flow, temperature, pH, color, and fecal coliform organisms must 

be reported as mgd, degrees Celcius (°C), standard units, color 

units, and most probable number per 100 milliliters (MPN/100 mL), 

respectively. Use the following abbreviations in the columns 

requiring “units” in Tables A through C. 

Concentration Mass 

ppm = parts per million lbs = pounds 

mg/L = milligrams per liter ton = Tons (English tons) 

ppb = parts per billion mg = milligrams 

μg/L = micrograms per liter g = grams 

MPN = most probable number kg = kilograms 

per 100 milliliters T = tonnes (metric tons) 

All reporting of values for metals must be in terms of “total 

recoverable metal” unless: 

1. An applicable, promulgated ELG specifies the limitation for the 

metal in dissolved, valent, or total form; 

2. All approved analytical methods for the metal inherently 

measure only its dissolved form (e.g., hexavalent chromium); 

or 

3. The NPDES permitting authority has determined that in 

establishing case-by-case limitations it is necessary to express 

the limitations of the metal in dissolved, valent, or total form to 

carry out the provisions of the C WA. 

If you measure only one grab sample and one flow-weighted 

composite sample for a given outfall, complete only the “Maximum 

Daily Discharge” columns in the tables and insert “1” under the 

“Number of Storm Events Sampled” column. The NPDES permitting 

authority may require you to conduct additional analyses to further 

characterize your discharges. 

If you measure more than one value for a grab sample or a flowweighted composite sample for a given outfall and those values are 

representative of your discharge, you must report them. You must 

describe your method of testing and analysis. You must also 

determine the average of all values within the last year and report 

the concentration and mass under the “Average Daily Discharge” 

columns of the tables and the total number of storm events sampled 

under the “Number of Storm Events Sampled” columns. 

The “Average Daily Discharge” column on Tables A to C is not

compulsory but should be filled out if data are available. 

Substantially Identical Outfalls 

If you have two or more substantially identical outfalls, you may 

request permission from your NPDES permitting authority to sample 

and analyze only one outfall and submit the results of the analysis 

for all substantially identical outfalls. If your request is granted by 

the NPDES permitting authority, submit the following information on 

a separate sheet attached to the application form: the identity of the 

outfall you did test and an explanation of how it is substantially 

identical to the outfall(s) that you did not test. 

Analysis 

Except as specified below, all required quantitative data shall be 

collected in accordance with sufficiently sensitive analytical methods 

approved under 40 CFR part 136 or required under 40 CFR 

chapter I, subchapter N or O. A method is “sufficiently sensitive” 

when: 

(1) The method minimum level (ML) is at or below the level of the 

applicable water quality criterion for the measured pollutant or 

pollutant parameter. 

(2) The method ML is above the water quality criterion, but the 

amount of the pollutant or pollutant parameter in the facility’s 

discharge is high enough that the method detects and quantifies the 

level of the pollutant or pollutant parameter in the discharge. 

(3) The method has the lowest ML of the analytical methods 

approved under 40 CFR part 136 or required under 40 CFR 

For Comment Only
2F-9 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

General Instructions for Reporting, Sampling, and Analysis Continued 

chapter I, subchapter N or O for the measured pollutant or pollutant 

parameter. 

Consistent with 40 CFR part 136, you may provide matrix or 

sample specific MLs rather than the published levels. Further, 

where you can demonstrate that, despite a good faith effort to use 

a method that would otherwise meet the definition of “sufficiently 

sensitive”, the analytical results are not consistent with the quality 

assurance (QA) / quality control (QC) specifications for that 

method, then the NPDES permitting authority may determine that 

the method is not performing adequately and the NPDES 

permitting authority should select a different method from the 

remaining EPA-approved methods that is sufficiently sensitive 

consistent with 40 CFR 122.21(e)(3)(i). Where no other EPAapproved methods exist, you must select a method consistent with 

40 CFR 122.21(e)(3)(ii). 

When there is no analytical method that has been approved under 

40 CFR part 136, required under 40 CFR chapter I, subchapter N or 

O, and is not otherwise required by the NPDES permitting authority, 

you may use any suitable method but shall provide a description of 

the method. When selecting a suitable method, other factors such 

as a method’s precision, accuracy, or resolution, may be considered 

when assessing the performance of the method.

For Comment Only
2F-10 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Exhibit 2F–1. Codes for Treatment Units and Disposal of Wastes Not Discharged 

1. PHYSICAL TREATMENT PROCESSES 

1–A ................. Ammonia Stripping 

1–B ................. Dialysis 

1–C ................ Diatomaceous Earth Filtration 

1–D ................ Distillation 

1–E ................. Electrodialysis 

1–F ................. Evaporation 

1–G ................ Flocculation 

1–H ................ Flotation 

1–I .................. Foam Fractionation 

1–J ................. Freezing 

1–K ................. Gas–Phase Separation 

1–L ................. Grinding (Comminutors) 

1–M ................ Grit Removal 

1–N ................ Microstraining 

1–O ................ Mixing 

1–P ................ Moving Bed Filters 

1–Q ................ Multimedia Filtration 

1–R ................ Rapid Sand Filtration 

1–S ................ Reverse Osmosis (Hyperfiltration) 

1–T ................ Screening 

1–U ................ Sedimentation (Settling) 

1–V ................ Slow Sand Filtration 

1–W ............... Solvent Extraction 

1–X ................ Sorption 

2. CHEMICAL TREATMENT PROCESSES 

2–A ................. Carbon Adsorption 

2–B ................. Chemical Oxidation 

2–C ................ Chemical Precipitation 

2–D ................ Coagulation 

2–E ................. Dechlorination 

2–F ................. Disinfection (Chlorine) 

2–G ................ Disinfection (Ozone) 

2–H ................ Disinfection (Other) 

2–I .................. Electrochemical Treatment 

2–J ................. Ion Exchange 

2–K ................ Neutralization 

2–L ................. Reduction 

3. BIOLOGICAL TREATMENT PROCESSES 

3–A ................. Activated Sludge 

3–B ................. Aerated Lagoons 

3–C ................ Anaerobic Treatment 

3–D ................ Nitrification–Denitrification 

3–E ................ Pre-Aeration 

3–F ................ Spray Irrigation/Land Application 

3–G ................ Stabilization Ponds 

3–H ................ Trickling Filtration 

4. WASTEWATER DISPOSAL PROCESSES 

4–A ................. Discharge to Surface Water 

4–B ................. Ocean Discharge Through Outfall 

4–C ................ Reuse/Recycle of Treated Effluent 

4–D ................ Underground Injection 

5. SLUDGE TREATMENT AND DISPOSAL PROCESSES 

5–A ................. Aerobic Digestion 

5–B ................. Anaerobic Digestion 

5–C ................ Belt Filtration 

5–D ................ Centrifugation 

5–E ................. Chemical Conditioning 

5–F ................. Chlorine Treatment 

5–G ................ Composting 

5–H ................ Drying Beds 

5–I .................. Elutriation 

5–J ................. Flotation Thickening 

5–K ................. Freezing 

5–M ................ Heat Drying 

5–N ................ Heat Treatment 

5–O ................ Incineration 

5–P ................ Land Application 

5–Q ................ Landfill 

5–R ................ Pressure Filtration 

5–S ................ Pyrolysis 

5–T ................ Sludge Lagoons 

5–U ................ Vacuum Filtration 

5–V ................ Vibration 

5–W ............... Wet Oxidation 

5–L ................. Gravity Thickening 

For Comment Only
2F-11 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

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

Bromide 

Chlorine, Total Residual 

Color 

Fecal Coliform 

Fluoride 

Nitrate-Nitrite 

Nitrogen, Total Organic (as N) 

Oil and Grease 

Phosphorus (as P), Total 

Radioactivity ( as Alpha, Total; Beta, Total; Radium, Total; and Radium 226, Total) 

Sulfate (as SO4) 

Sulfide (as S) 

Sulfite (as SO3) 

Surfactants 

Aluminum, Total 

Barium, Total 

Boron, Total 

Cobalt, Total 

Iron, Total 

Magnesium, Total 

Molybdenum, Total 

Manganese, Total 

Tin, Total 

Titanium, Total 

For Comment Only
2F-12 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Exhibit 2F–3. Toxic Pollutants (40 CFR 122.21, Appendix D, Tables II and III)

Toxic Pollutants and Total Phenol 

Antimony, Total Copper, Total Silver, Total 

Arsenic, Total Lead, Total Thallium, Total 

Beryllium, Total Mercury, Total Zinc, Total 

Cadmium, Total Nickel, Total Cyanide, Total 

Chromium, Total Selenium, Total Phenols, Total 

GC/MS Fraction—Volatile Compounds 

Acrolein Dichlorobromomethane 1,1,2,2- Tetrachloroethane 

Acrylonitrile 1,1-Dichloroethane Tetrachloroethylene 

Benzene 1,2-Dichloroethane Toluene 

Bromoform 1,1-Dichloroethylene 1,2-Trans- Dichloroethylene 

Carbon Tetrachloride 1,2-Dichloropropane 1,1,1-Trichloroethane 

Chlorobenzene 1,3-Dichloropropylene 1,1,2-Trichloroethane 

Chlorodibromomethane Ethylbenzene Trichloroethylene 

Chloroethane Methyl Bromide Vinyl Chloride 

2-Chloroethylvinyl Ether Methyl Chloride 

Chloroform Methylene Chloride 

GC/MS Fraction—Acid Compounds 

2-Chlorophenol 2,4-Dinitrophenol Pentachlorophenol 

2,4-Dichlorophenol 2-Nitrophenol Phenol 

2,4-Dimethylphenol 4-Nitrophenol 2,4,6-Trichlorophenol 

4,6-Dinitro-O-Cresol P-Chloro-M-Cresol 

GC/MS Fraction—Base/Neutral Compounds

Acenaphthene 4-Chlorophenyl Phenyl Ether Hexachlorobenzene 

Acenaphtylene Chrysene Hexachlorobutadiene 

Anthracene Dibenzo (a,h) Anthracene Hexachlorocyclopentadiene 

Benzidine 1,2-Dichlorobenzene Hexachloroethane 

Benzo (a) Anthracene 1,3-Dichlorobenzene Indeno (1,2,3-cd) Pyrene 

Benzo (a) Pyrene 1,4-Dichlorobenzene Isophorone 

3,4-Benzofluoranthene 3,3-Dichlorobenzidine Naphthalene 

Benzo (ghi) Perylene Diethyl Phthalate Nitrobenzene 

Benzo (k) Fluoranthene Dimethyl Phthalate N-Nitrosodimethylamine 

Bis (2-Chloroethoxy) Methane Di-N-Butyl Phthalate N-Nitrosodi-N-Propylamine 

Bis (2-Chloroethyl) Ether 2,4-Dinitrotoluene N-Nitrosodiphenylamine 

Bis (2-Chloroisopropyl) Ether 2,6-Dinitrotoluene Phenanthrene 

Bis (2-Ethylhexyl) Phthalate Di-N-Octyl Phthalate Pyrene 

4-Bromophenyl Phenyl Ether 1,2-Diphenylhydrazine (as Azobenzene) 1,2,4-Trichlorobenzene 

Butyl Benzyl Phthalate Fluoranthene 

2-Chloronaphthalene Fluorene 

GC/MS Fraction—Pesticides

Aldrin Dieldrin PCB-1254 

α-BHC α-Enosulfan PCB-1221 

β-BHC β-Endosulfan PCB-1232 

γ-BHC Endosulfan Sulfate PCB-1248 

δ-BHC Endrin PCB-1260 

Chlordane Endrin Aldehyde PCB-1016 

4,4’-DDT Heptachlor Toxaphene 

4,4’-DDE Heptachlor Epoxide 

4,4’-DDD PCB-1242 

For Comment Only
2F-13 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Exhibit 2F–4. Certain Hazardous Substances and Asbestos (40 CFR 122.21, Appendix D, Table V)

Toxic Pollutant 

Asbestos 

Hazardous Substances 

Acetaldehyde Dintrobenzene Napthenic acid 

Allyl alcohol Diquat Nitrotoluene 

Allyl chloride Disulfoton Parathion 

Amyl acetate Diuron Phenolsulfonate 

Aniline Epichlorohydrin Phosgene 

Benzonitrile Ethion Propargite 

Benzyl chloride Ethylene diamine Propylene oxide 

Butyl acetate Ethylene dibromide Pyrethrins 

Butylamine Formaldehyde Quinoline 

Captan Furfural Resorcinol 

Carbaryl Guthion Strontium 

Carbofuran Isoprene Strychnine 

Carbon disulfide Isopropanolamine Styrene 

Chlorpyrifos Kelthane 2,4,5-T (2,4,5-Trichlorophenoxyacetic 

acid) 

Coumaphos Kepone TDE (Tetrachlorodiphenyl ethane) 

Cresol Malathion 2,4,5-TP [2-(2,4,5-Trichlorophenoxy) 

propanoic acid] 

Crotonaldehyde Mercaptodimethur Trichlorofon 

Cyclohexane Methoxychlor Triethanolamine 

2,4-D (2,4-Dichlorophenoxyacetic acid) Methyl mercaptan Triethylamine 

Diazinon Methyl methacrylate Trimethylamine 

Dicamba Methyl parathion Uranium 

Dichlobenil Mevinphos Vanadium 

Dichlone Mexacarbate Vinyl acetate 

2,2-Dichloropropionic acid Monoethyl amine Xylene 

Dichlorvos Monomethyl amine Xylenol 

Diethyl amine Naled Zirconium 

Dimethyl amine 

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> Page 1 

EPA Identification Number NPDES Permit Number Facility Name Form Approved

OMB No. <INSERT NO.> 

Form Expires <INSERT DATE> 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Form 

2F 

NPDES 

U.S Environmental Protection Agency 

Application for NPDES Permit to Discharge Wastewater 

STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY

SECTION 1. OUTFALL LOCATION (40 CFR 122.21(g)(1)) Outfall Location

1.1 Provide information on each of the facility’s outfalls in the table below 

Outfall 

Number Receiving Water Name Degrees Minutes Seconds Degrees Minutes Seconds 

Collection Method Information 

Horizontal Collection Method (Type of 

method/device used to identify the coordinates)

Scale (Proportional distance on the ground for 

one unit of measure) Not Applicable

Horizontal Reference Datum

(Coordinate reference system)

 NAD 27  NAD 83  WGS85  Other (specify)

Outfall 

Number Receiving Water Name Degrees Minutes Seconds Degrees Minutes Seconds 

 

Collection Method Information 

Horizontal Collection Method (Type of 

method/device used to identify the coordinates)

Scale (Proportional distance on the ground for 

one unit of measure) Not Applicable

Horizontal Reference Datum

(Coordinate reference system)

 NAD 27  NAD 83  WGS85  Other (specify)

Outfall 

Number Receiving Water Name Degrees Minutes Seconds Degrees Minutes Seconds 

 

Collection Method Information 

Horizontal Collection Method (Type of 

method/device used to identify the coordinates)

Scale (Proportional distance on the ground for 

one unit of measure) Not Applicable

Horizontal Reference Datum

(Coordinate reference system)

 NAD 27  NAD 83  WGS85  Other (specify)

Outfall 

Number Receiving Water Name Degrees Minutes Seconds Degrees Minutes Seconds 

 

Collection Method Information 

Horizontal Collection Method (Type of 

method/device used to identify the coordinates)

Scale (Proportional distance on the ground for 

one unit of measure) Not Applicable

Horizontal Reference Datum

(Coordinate reference system)

For 

 NAD 27  NAD 83  WGS85  Other (specify)

Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> Page 2 

EPA Identification Number NPDES Permit Number Facility Name Form Approved

OMB No. <INSERT NO.> 

Form Expires <INSERT DATE> 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Outfall Location Continued 

1.1 Outfall 

Number Receiving Water Name cont. Degrees Minutes Seconds Degrees Minutes Seconds 

Collection Method Information 

Horizontal Collection Method (Type of 

method/device used to identify the coordinates)

Scale (Proportional distance on the ground for 

one unit of measure) Not Applicable

Horizontal Reference Datum

(Coordinate reference system)

 NAD 27  NAD 83  WGS85  Other (specify)

Outfall 

Number Receiving Water Name Degrees Minutes Seconds Degrees Minutes Seconds 

 

Collection Method Information 

Horizontal Collection Method (Type of 

method/device used to identify the coordinates)

Scale (Proportional distance on the ground for 

one unit of measure) Not Applicable

Horizontal Reference Datum

(Coordinate reference system)

 NAD 27  NAD 83  WGS85  Other (specify)

SECTION 2. IMPROVEMENTS (40 CFR 122.21(g)(6)) Improvements 

2.1 Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing, 

upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could 

affect the discharges described in this application? 

 Yes  No  SKIP to Section 3. 

2.2 Briefly identify each applicable project in the table below. 

Brief Identification and 

Description of Project 

Affected Outfalls 

(List Outfall Numbers) Source(s) of Discharge 

Final Compliance Dates 

Required Projected 

 

 

 

 

2.3 Have you attached sheets describing any additional water pollution control programs (or other environmental projects 

that may affect your discharges) that you now have underway or planned? (Optional Item) 

 Yes  No 

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> Page 3 

EPA Identification Number NPDES Permit Number Facility Name Form Approved

OMB No. <INSERT NO.> 

Form Expires <INSERT DATE> 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

SECTION 3. SITE DRAINAGE MAP (40 CFR 122.26(c)(1)(i)(A)) Site Drainage Map

3.1 Have you attached a site drainage map containing all required information to this application? (See Instructions for 

specific guidance.) 

 Yes  No 

SECTION 4. POLLUTANT SOURCES (40 CFR 122.26(c)(1)(i)(B)) Pollutant Sources

4.1 Provide information on the facility’s pollutant sources in the table below. 

Outfall 

Number 

Impervious Surface Area 

(within a mile radius of the facility)

Total Surface Area Drained 

(within a mile radius of the facility)

 

specify units specify units

 

specify units specify units

 

specify units specify units

 

specify units specify units

 

specify units specify units

 

specify units specify units

4.2 Narrative Description of Significant Materials. Provide a narrative description of the facility’s significant material in 

the space below. (See Instructions for content requirements.) 

4.3 Provide the location and a description of existing structural and non-structural control measures to reduce pollutants in 

stormwater runoff. (See Instructions for specific guidance.) 

Stormwater Treatment 

Outfall 

Number Control Measures and Treatment 

Codes 

from 

Exhibit 

2F-1 

(list) 

   

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> Page 4 

EPA Identification Number NPDES Permit Number Facility Name Form Approved

OMB No. <INSERT NO.> 

Form Expires <INSERT DATE> 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

SECTION 5. NON-STORMWATER DISCHARGES (40 CFR 122.26(c)(1)(i)(C)) Non-Stormwater Discharges

5.1 I certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the 

presence of non-stormwater discharges. Moreover, I certify that the outfalls identified as having non-stormwater 

discharges are described in either an accompanying NPDES Form 2C, 2D, or 2E application. 

 Name (first and last) Official Title 

 

 Signature Date Signed 

5.2 Provide the testing information requested in the table below. 

Outfall 

Number Description of Testing Method Used Date(s) of Testing 

Onsite Drainage Points 

Directly Observed 

During Test 

SECTION 6. SIGNIFICANT LEAKS OR SPILLS (40 CFR 122.26(c)(1)(i)(D)) Significant Leaks or Spills

6.1 Description of Significant Leaks or Spills. Provide a description of any significant leaks or spills of toxic or 

hazardous pollutants in the last three years. 

 

SECTION 7. DISCHARGE INFORMATION (40 CFR 122.26(c)(1)(i)(E)) Discharge Information 

See the Instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must 

complete. Not all applicants need to complete each table. 

7.1 Is this a new source or new discharge? 

 Yes  See Instructions regarding submission of 

estimated data.  No  See Instructions regarding submission of actual data. 

Tables A, B, C, and D 

7.2 Have you completed Table A for each outfall? 

 Yes  No 

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> Page 5 

EPA Identification Number NPDES Permit Number Facility Name Form Approved

OMB No. <INSERT NO.> 

Form Expires <INSERT DATE> 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Discharge Information Continued

7.3 Is the facility subject to an ELG or effluent limitations in an NPDES permit for its process wastewater? 

 Yes  No  SKIP to Item 7.5. 

7.4 Have you completed Table B by providing quantitative data for those pollutants that are (a) limited either directly or 

indirectly in an ELG and/or (b) subject to effluent limitations in an NPDES permit for the facility’s process wastewater? 

 Yes  No 

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

 Yes  No  SKIP to Item 7.7. 

7.6 Have you listed all pollutants in Exhibit 2F–2 that you know or have reason to believe are present in the discharge and 

provided quantitative data or an explanation for those pollutants in Table C? 

 Yes  No 

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

 Yes SKIP to Item 7.18.  No 

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

 Yes  No  SKIP to Item 7.10. 

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

Table C? 

 Yes  No 

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

 Yes  No  SKIP to Item 7.12. 

7.11 Have you provided quantitative data in Table C for those pollutants in Exhibit 2F–3 that you expect to be discharged in 

concentrations of 10 ppb or greater? 

 Yes  No 

7.12 Do you expect acrolein, acrylonitrile, 2,4-dinitrophenol, or 2-methyl-4,6-dinitrophenol to be discharged in concentrations

of 100 ppb or greater? 

 Yes  No  SKIP to Item 7.14. 

7.13 Have you provided quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be 

discharged in concentrations of 100 ppb or greater? 

 Yes  No 

7.14 Have you provided quantitative data or an explanation in Table C for pollutants you expect to be present in the 

discharge at concentrations less than 10 ppb (or less than 100 ppb for the pollutants identified in Item 7.12)? 

 Yes  No 

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

 Yes  No  SKIP to Item 7.17. 

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

explanation in Table C? 

 Yes  No 

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

 Yes  No 

   

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> Page 6 

EPA Identification Number NPDES Permit Number Facility Name Form Approved

OMB No. <INSERT NO.> 

Form Expires <INSERT DATE> 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

Discharge Information Continued 

Used or Manufactured Toxics 

7.18 Is any pollutant listed on Exhibits 2F–2 through 2F–4 a substance or a component of a substance used or 

manufactured as an intermediate or final product or byproduct? 

 Yes  No  SKIP to Section 8. 

7.19 List the pollutants below, including TCDD if applicable. 

 1. 4. 7. 

 2. 5. 8. 

 3. 6. 9. 

SECTION 8. BIOLOGICAL TOXICITY TESTING DATA (40 CFR 122.21(g)(11)) Biological Toxicity Testing Data 

8.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on 

any of your discharges or on a receiving water in relation to your discharge within the last three years? 

 Yes  No  SKIP to Section 9.

8.2 Identify the tests and their purposes below. 

Test(s) Purpose of Test(s) Submitted to NPDES 

Permitting Authority? Date Submitted 

  Yes  No 

  Yes  No 

  Yes  No 

SECTION 9. CONTRACT ANALYSIS INFORMATION (40 CFR 122.21(g)(12)) Contract Analysis Information 

9.1 Were any of the analyses reported in Section 7 (on Tables A through C) performed by a contract laboratory or 

consulting firm? 

 Yes  No  SKIP to Section 10.

9.2 Provide information for each contract laboratory or consulting firm below. 

Laboratory Number 1 Laboratory Number 2 Laboratory Number 3 

Name of Laboratory/Firm 

Laboratory Address 

Phone Number 

Pollutant(s) Analyzed 

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> Page 7 

EPA Identification Number NPDES Permit Number Facility Name Form Approved

OMB No. <INSERT NO.> 

Form Expires <INSERT DATE> 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

SECTION 10. CHECKLIST AND CERTIFICATION STATEMENT (40 CFR 122.22(a) and (d)) Checklist and Certification Statement 

10.1 In Column 1 below, mark the Form 2F sections you have completed and are submitting with your application. For each 

section, specify in Column 2 the attachments you are enclosing. Note that not all applicants are required to complete all 

sections or attachments.

Column 1 Column 2 

 Section 1  w/attachments (e.g., responses for additional outfalls) 

 Section 2  w/attachments 

 Section 3  w/site drainage map 

 Section 4  w/attachments 

 Section 5  w/attachments 

 Section 6  w/attachments 

 Section 7  Table A  w/small business exemption request 

 Table B  w/analytical results as an attachment 

 Table C  Table D 

 Section 8  w/attachments 

 Section 9  w/attachments (e.g., responses for additional contact laboratories or firms) 

 Section 10 

10.2 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 (first and last) Official Title 

 

Signature Date Signed 

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE> 

EPA Identification Number NPDES Permit Number Facility Name Outfall Number 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

TABLE A. CONVENTIONAL AND NON-CONVENTIONAL PARAMETERS (40 CFR 122.26(c)(1)(i)(E)(3))1

You must provide the results of at least one analysis for every pollutant in this table. Complete one table for each outfall. See Instructions for additional de

Pollutant or Parameter 

Maximum Daily Discharge 

(specify units) 

Average Daily Discharge 

(specify units) Numbe

Events 

Grab Sample Taken 

During First 

30 Minutes 

Flow-weighted 

Composite 

Grab Sample Taken 

During First 

30 Minutes 

Flow-weighted 

Composite 

1. Oil and Grease 2. Biochemical Oxygen Demand (BOD5) 3. Chemical Oxygen demand (COD) 4. Total Suspended Solids (TSS) 5. Total Phosphorus 6. Total Kjeldahl Nitrogen (TKN) 7. Total Nitrogen (as N) 8. 

pH (minimum) 

pH (maximum) 

1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR Part 136 for the analysis of polluta

required under 40 CFR chapter I, subchapter N or O. See Instructions and 40 CFR 122.21(e)(3). 

For Comment Only
Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

This page intentionally left blank.

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE>) 

EPA Identification Number NPDES Permit Number Facility Name Outfall Number 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

TABLE B. CERTAIN CONVENTIONAL AND NON-CONVENTIONAL POLLUTANTS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vi)(A))1List each pollutant that is limited in an ELG that the facility is subject to or any pollutant listed in the facility’s NPDES permit for its process wastewater (if thexisting NPDES permit). Complete one table for each outfall. See the Instructions for additional details and requirements. 

Pollutant and CAS Number (if available) 

Maximum Daily Discharge 

(specify units)

Average Daily Discharge 

(specify units) Numbe

Events 

Grab Sample Taken 

During First 

30 Minutes 

Flow-weighted 

Composite 

Grab Sample Taken 

During First 

30 Minutes 

Flow-weighted 

Composite 

1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR Part 136 for the analysis of polluta

required under 40 CFR chapter I, subchapter N 

For 

or O. See Instructions and 40 CFR 122.21(e)(3).

Comment Only
Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

This page intentionally left blank.

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE>) 

EPA Identification Number NPDES Permit Number Facility Name Outfall Number 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

TABLE C. TOXIC POLLUTANTS, CERTAIN HAZARDOUS SUBSTANCES, AND ASBESTOS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vList each pollutant shown in Exhibits 2F-2, 2F-3, and 2F-4 that you know or have reason to believe is present. Complete one table for each outfall. See the and requirements. 

Pollutant and CAS Number (if available)

Maximum Daily Discharge 

(specify units) 

Average Daily Discharge 

(specify units) Numbe

Events 

Grab Sample Taken 

During First 

30 Minutes

Flow-weighted 

Composite

Grab Sample Taken 

During First 

30 Minutes

Flow-weighted 

Composite

1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR Part 136 for the analysis of polluta

required under 40 CFR chapter I, subchapter N or O. See Instructions and 40 CFR 122.21(e)(3).

For Comment Only
Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

This page intentionally left blank.

For Comment Only
EPA Form 3510-2F (Revised <INSERT DATE>) 

EPA Identification Number NPDES Permit Number Facility name Outfall Number 

Contains Nonbinding Recommendations

Draft Application Forms – Not for Implementation

TABLE D. STORM EVENT INFORMATION (40 CFR 122.26(c)(1)(i)(E)(6)) Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow weighted composite sample. 

Date of Storm Event Duration of Storm Event (in hours) Total Rainfall During Storm Event (in inches) Number of Hours between Beginning of Storm Measured and End of Previous Measurable Rain Event Maximum Flow Rate During Rain Event (in gpm or specify units) 

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

For Comment Only