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United States Environmental Protection Agency Office of Water Washington, D.C. EPA Form 3510-2B

Revised <INSERT DATE>



### Water Permits Division 

# Application Form 2B

Concentrated Animal Feeding Operations and Concentrated Aquatic Animal Production

Facilities

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 fo r 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 your facility is a new or existing concentrated animal feeding operation or concentrated aquati c animal production facility.

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### Paperwork Reduction Act Notice

The U.S. Environmental Protection Agency (EPA) esti mates the average burden for concentrated animal feeding operation (CAFO) respondent s to collect information and complete Form 2B to be 9.5 hours (9 hours to complete and submit the applicati on and 0.5 hours to complete and submit a nutrient management plan). EPA estimates the average bu rden for concentrated aquatic animal production (CAAP) respondents to collect information and comp lete Form 2B to be 6 hours. These estimates include time for reviewing instructions, searching ex isting data sources, gathering and maintaining the needed data, and completing and reviewing the colle ction of information. Send comments regarding the burden estimates or any other aspect of this collec tion of information to the Chief, Information Policy Branch (PM-223), U.S. Environmental Prot ection Agency, 1200 Pennsylvania Avenue, NW, Washington, DC 20460 and to the Office of Informati on and Regulatory Affairs, Office of Management and Budget, 725 17 th 

### Street, NW, Washington, DC 20503, marked “Attention: Desk Officer for EPA.”2B-1 

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FORM 2B—INSTRUCTIONS

General Instructions

Who Must Complete Form 2B?

Applicants who answered “yes” to Item 1.2.1 on Form 1 are required to complete Form 2B. This means that you are either a concentrated animal feeding operation (CAFO) or a concentrated aquatic animal production (CAAP) facility.

Where to File Your Completed Form

Submit your completed application package (Forms 1 and 2B) to your National Pollutant Discharge Elimination System (NPDES) permitting authority. Consult Exhibit 1

– 1 of the “General Instructions” of Form 1 to determine your NPDES permitting authority.

Public Availability of Submitted Information

The U.S. Environmental Protection Agency (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 2B (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 2B. Note that NPDES authorities will deny claims for treating any effluent data as confidential. If you do not assert a claim of confidentiality at the time you submit your information to the NPDES permitting authority, EPA may make the information available to the public without further notice to you. EPA will handle claims of confidentiality in accordance with the Agency’s business confidentiality regulations at 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, usi ng a format consistent with the

form.

Provide your EPA Identification Nu mber from the Federal Registry Service, NPDES Permit Number, and facility name at the top of each page of Form 2B 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.

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 w ill 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 te rms used in these Instructions and Form 2B are in the “Glossary,” which follows the “General

Instructions” in Form 1.

Line-By-Line Instructions

Section 1. General Information

Item 1.1. Mark whether your facility/bu siness type is a CAFO or a CAAP facility.

 If your facility/business type is a CAFO, you must complete Sections 1 through 6 and Section 8 of Form 2B.

 If your facility/business type is a CAAP, you must complete
Sections 1, 7, and 8 of Form 2B.

Item 1.2. Indicate whether your fac ility is an existing or proposed facility. Mark “proposed” if your fa cility is presently not in operation or is expanding to meet the definition of a CAFO in accordance with the regulations at 40 CFR 122.23.

Section 2. CAFO Owner/Oper ator Contact Information

Provide the name, complete mailing address, telephone number, and electronic mail (email) address (if available) of the owner/operator of the facility/business.

Section 3. CAFO Location and Contact Information

Item 3.1. Provide the legal name and location (complete mailing address) of the facility. Also indicate who the NPDES permitting authority should contact regarding the application, including a telephone number and email address (if available).

Item 3.2. Provide the latitude and longitude to the nearest second of the entrance to the production area (i.e., the part of the animal feeding operation that includes the animal confinement area, the manure storage area, the raw materials storage area, and the waste containment areas). Provide the associated collection method information, including 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) the 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) the horizontal reference datum (i.e., the coordinate reference system) to which your coordinates relate.

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., U.S. Geological Survey or USGS) to identify

coordinates. The online services r equire 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:2B-2 

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FORM 2B—INSTRUCTIONS CONTINUED

1. North American Datum of 1927 (NAD27): This datum was based on the ground survey in Europe and North America in the

19

th

century. NAD27 was the standard for many years because the 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 3.2, refer to http://www.epa.gov/geospatial/latitudelongitude-data-standard

.

Item 3.3. If the facility uses a contract grower, provide the name and complete mailing address of the integrator.

Section 4. CAFO Topographic Map

Item 4.1. Provide a topographic map of the geographic area in which the facility is located, showing the specific location of the production area(s). You are not r equired to provide the topographic map required by Section 7 of Form 1.

On each map, include the map scale, a meridian arrow showing north, and latitude and longitude to the nearest second.

On all maps of rivers, show the direction of the current. In tidal
waters, show the directions of ebb and flow tides.

You may develop your map by going to the United States Geological Survey’s (USGS’s) National Map website at http://nationalmap.gov/. Use the traditional 7.5-minute quadrangle format. If none is available, you may use a USGS 15 minute series map. You may also use a plat or other appropriate map. Briefly describe land uses in the map area (e.g., residential, commercial, etc.).

Section 5. CAFO Characteristics

Supply all information in Section 5 if you checked “Existing Facility” in response to Item 1.2.

Item 5.1. Provide the maximum number of each type of animal in open confinement or housed under roof (either partially or totally) that are held at your facility for a total of 45 days or more in any 12- month period. Provide the total number of animals confined at the facility.

Item 5.2. Identify the applicable types of containment and storage for manure, litter, and process wastewater at the facility and indicate the capacity of storage in days and gallons or tons. Item 5.3. Indicate the total number of acres that are drained and collected in the containment and storage structure(s).

Item 5.4 . Specify the tons of manure or litter and the gallons of process wastewater generated at the facility on an annual basis.

Item 5.5. Indicate whether the manure, litter, and/or process wastewater is land applied. If “yes”, continue to Item 5.6. If “no”, skip to Item 5.8.

Item 5.6. Indicate the number of acres of land under the control of the applicant that are available for application of the manure, litter, or process wastewater.

Item 5.7. Check any of the identified best management practices that are being implemented at the facility to control runoff and protect water quality.

Item 5.8. Indicate if the manure, litter, and/or process wastewater is transferred to any other persons. If “yes”, continue to Item 5.9. If “no”, skip to Item 5.10.

Item 5.9. Specify the tons of manure or litter or the gallons of process wastewater transferred annually to other people.

Item 5.10. Describe any alternative uses of manure, litter, or process wastewater, if any (e.g., composting, pelletizing, energy generation, etc.).

Section 6. CAFO Nutrient Management Plans

Item 6.1. Indicate if you have submitted a nutrient management plan that satisfies the requirements at 40 CFR 122.42(e) and, if applicable, the requirements at 40 CFR 412.4(c).

Item 6.2. If you have not yet submitted a nutrient management plan, provide an explanation for why not.

Item 6.3. Indicate if a nutrient management plan is being implemented at the CAFO. If not land applying, describe the alternative uses of the manure, litter, and wastewater (e.g., composting, pelletizing, energy generation, etc.).

Item 6.4. Indicate the date of the last review or revision of the nutrient management plan.

Note: A permit application is not complete until a nutrient management plan is submitted to the NPDES permitting authority.

Section 7. CAAP Facility Characteristics

Item 7.1. Indicate if the CAAP facility is located on land. If the CAAP facility is located in water (e.g., a net pen or submerged cage system), check “no” and skip to Item 7.3. If “yes”, continue to Item

7.2.

Item 7.2. Outfalls should be numbered to correspond with the map and receiving waters submitted in Section 7 of Form 1.

Values given for flow should be representative of your normal operation. The maximum daily flow is the maximum measured flow occurring over a calendar day. The maximum average monthly flow is the average of measured daily fl ow over the calendar month of highest flow.2B-3 

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FORM 2B—INSTRUCTIONS CONTINUED

Item 7.3. Indicate the number of ponds, raceways, net pens, submerged cages, or similar structures at your facility that result in discharges to waters of the United States. Describe each type and provide the name of the associated receiving water and intake

water source.

Item 7.4. List the species of fish or aquatic animals held and fed at your facility. Distinguish between those that are cold water versus warm water species. The names of fish species should be proper, common, or scientific names as given in special Publication No. 6 of the American Fisheries Society, “A List of Common and Scientific

Names of Fishes from the United States and Canada.”

For each species, provide the total harvestable weight in pounds (lbs.) for a typical calendar year. Also indicate the maximum weight present at any one time at your facility.

Item 7.5. Indicate the maximum monthly pounds of food given at your facility. Also indicate the month given. The amounts should be representative of your normal operations.

Section 8. Certification Statement

The Clean Water Act provides for severe penalties for submitting false information on this application form. CWA Section 309(c)(2) provides that, “Any person who knowingly makes any false statement, representation, or certification in any application, ...shall upon conviction, be punished by a fine of no 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-p resident of the corporation in charge of a principal business function, or any other person who performs similar policy- or decision-making functions for the corporation, or (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 including having the explicit or implicit duty of making major capital investment recommendations, and initiating and directing other comprehensive measures to assure long term environmental compliance with environmental laws and regulations; the manager can ensure that the necessary systems are established or actions taken to gather complete and accurate information for permit application requirements; and where authority to sign documents has been assigned or delegated to the manager in accordance wi th corporate procedures.

B. For partnership or sole proprie torship, by a general partner or the proprietor, respectively.

C. For a municipality, State, Federal, or other public facility, By either a principal executive office r or ranking elected official. For purposes of this section, a principal executive officer of a Federal agency includes: (i) The chief executive officer of the agency, or (ii) a senior executiv e officer having responsibility for the overall operations of a principal geographic unit of the agency (e.g., Regional Administrators of EPA).

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2B

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

CONCENTRATED ANIMAL F EEDING OPERATIONS and

CONCENTRATED AQUATIC ANIMAL PRODUCTION FACILITIES
SECTION 1. GENERAL INFORMATION (40 CFR 122.21(I)(1))GeneralInformation 1.1 Indicate the facility/business type. (Check only one response.) 

##  CAFO  Complete Sections 1 through 6 and Section 8.



##  CAAP  Complete Sections 1, 7, and 8.

1.2 Indicate the operational status of the facility. (Check one.)


##  Existing Facility 

##  Proposed Facility

SECTION 2. CAFO OWNER/OPERATOR CONTACT INFORMATION (40 CFR 122.21(i)(1)(i))CAFO Owner/OperatorContact Information 2.1 Owner/Operator Contact Name (first and last) Title

Phone Number Email Address

2.2 Owner/Operator Mailing Address

Street or P.O. Box

City or Town State Zip Code

SECTION 3. CAFO LOCATION AND CONTACT IN FORMATION (40 CFR 122.21(i)(1)(ii and iii))CAFO Location and Contact Information 3.1 CAFO Location and Contact

Name

Address (Street, Route Number, or other Specific Identifier) County

City or Town State Zip Code

Facility Contact Name Phone Number Email Address

3.2 Latitude/Longitude of Entrance to Production Area (See Instructions.)

Latitude Longitude
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)EPA Form 3510-2B (revised <INSERT DATE>) Page 2 EPA Identification Number NPDES Permit Number Facility Name Form Approved

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– Not for ImplementationCAFO Location and ContactInformation Continued 3.3 Integrator Name and Address

Name

Street Address

City or Town State Zip Code

SECTION 4. CAFO TOPOGRAPHIC MAP (40 CFR 122.21(i)(1)(iv))CAFOTopographicMap 4.1 Have you attached a topographic map containing all required in formation to this application? (See Instructions for specific requirements.)



##  Yes  SKIP to Section 5. 

##  No

SECTION 5. CAFO CHARACTERISTIC S (40 CFR 122.21(i)(1)(v-ix))CAFO Characteristics 5.1 Provide information on the type and number of animals in the table below.

Animal Type Number in Open

Confinement Number

Housed

Under Roof Animal Type Number in Open

Confinement Number

Housed

Under Roof 

##  Mature Dairy

Cows 

##  Sheep or

Lambs 

##  Dairy Heifers 

##  Chickens (broilers) 

##  Veal Calves 

##  Chickens (layers) 

##  Cattle (not dairy or veal calves) 

##  Ducks



##  Swine (55 lbs. or more) 

##  Other (specify)



##  Swine (under 55 lbs.) 

##  Other (specify)



##  Horses 

##  Other (specify)



##  Turkeys Total Animals

5.2 Indicate the type of containment and storage, total number of days, and total capacity for manure, litter, and process wastewater storage in the table below.

Type of Containment and Storage Total Number of Days Total Capacity (specify gallons or tons) Type of

Containment and Storage Total Number of Days Total Capacity (specify gallons or tons)


##  Anaerobic Lagoon 

##  Belowground Storage Tanks



##  Evaporation 

##  Roofed Storage Shed



##  Aboveground Storage Tanks 

##  Concrete Pad



##  Storage Pond 

##  Impervious

Soil Pad



##  Underfloor Pit 

##  Other (specify)

5.3 Indicate the total number of acres drained and collected in the containment and storage structure(s) reported under

Item 5.2.

____________ acresEPA Form 3510-2B (revised <INSERT DATE>) Page 3 EPA Identification Number NPDES Permit Number Facility Name Form A pproved

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– Not for ImplementationCAFO Characteristics Continued Manure, Litter, and/or Process Wastewater Production and Use
5.4 How many tons of manure or litter and gallons of process wastewater are generated annually at the CAFO?

Manure tons

Litter tons

Process Wastewater gallons

5.5 Is manure, litter, and/or process wastew ater generated at the CAFO land applied?



##  Yes 

##  No  SKIP to Item 5.8.

5.6 How many acres of land under the control of the applicant ar e available for applying the CAFO’s manure, litter, or process wastewater?

______________ acres

5.7 Check all land application best management practices that apply. 

##  Buffers 

##  Infiltration field


##  Setbacks 

##  Grass filter


##  Conservation tillage 

##  Terrace


##  Constructed wetlands 

##  Other (specify)

5.8 Is manure, litter, and/or process wast ewater transferred to any other persons?



##  Yes 

##  No  SKIP to Item 5.10.

5.9 How many tons of manure or litter and gallons of process wastewater, produced by the CAFO, are transferred annually to other people?

Manure tons

Litter tons

Process Wastewater gallons

5.10 Describe alternative use(s) of manure, litter, or process wastewater, if any.

SECTION 6. CAFO NUTRIENT MANAGEME NT PLANS (40 CFR 122.21(i)(1)(x))CAFO Nutrient Management Plans 6.1 Has the applicant attached a nutrient management plan that satisfies the requirements at 40 CFR 122.42(e) and, if applicable, the requirements at 40 CFR 412.4(c)? Note: A permit application is not complete until a nutrient management plan is submitted to the NPDES permitting authority. 

##  Yes  SKIP to Item 6.3. 

##  No

6.2 Explain why a nutrient management plan is not attached to the application.

6.3 Is a nutrient management plan being implemented at the CAFO? 

##  Yes 

##  No

6.4 What was the date of the last review or revision of the nutrient management plan? Date_________________________________EPA Form 3510-2B (revised <INSERT DATE>) Page 4 EPA Identification Number NPDES Permit Number Facility Name Form A pproved

OMB No. <INSERT NO.> Form Expires <INSERT DATE>



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– Not for Implementation SECTION 7. CAAP FACILITY CHARACTERISTICS (40 CFR 122.21(i)(2))CAAP Facility Characteristics 7.1 Is the CAAP facility located on land? 

##  Yes 

##  No  SKIP to Item 7.3.

7.2 Provide the maximum daily and maximum aver age monthly discharge at CAAP by outfall.

Outfall

Number Discharge
Maximum Daily Discharge Maximum Average Monthly Discharge

gpd gpd

gpd gpd

gpd gpd

7.3 Indicate the type and number of discharge structures at the CAAP. Provide a brief description of each structure. Also note the name of the receiving water and the source of the intake water for each structure.

Structure Type Number of Each Description Receiving Water

Name Source of Intake

Water

Ponds

Raceways

Net Pens Not Applicable

Submerged

Cages Not Applicable

Similar

Structures

(specify)

7.4 List the cold water and/or warm water aquatic species raised/produced in the table below. For each species listed, indicate the total yearly and maximum harvestable weight (in pounds).
Cold Water Species Warm Water Species

Species Harvestable Weight Species Harvestable Weight
Total Yearly Maximum Total Yearly Maximum

lbs. lbs. lbs. lbs.

lbs. lbs. lbs. lbs.

lbs. lbs. lbs. lbs.

lbs. lbs. lbs. lbs.

7.5 Indicate the calendar month of maximum feeding and the total mass of food fed (in pounds) during that month.

Month of Maximum Feeding Total Mass of Food Fed

lbs.EPA Form 3510-2B (revised <INSERT DATE>) Page 5 EPA Identification Number NPDES Permit Number Facility Name Form A pproved

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– Not for Implementation SECTION 8. CERTIFICATION STATEMENT (40 CFR 122.22(a))Certification Statement I certify under penalty of law that this document and all atta chments were prepared under my direction or supervision in accordance with a system designed to assure that qualified per sonnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the syst em, 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 info rmation, including the possibility of fine and imprisonment for knowing violations. Name (first and last) Official Title

Signature Date Signed