1 **Example Form –**  **Biosolids Annual**  **Report EPA Regulations**  **– 503.18, 503.28, 503.48**  **Example Data Entry Form** [ **Note:** Users will also be able to batch this data into this form via a spreadsheet or CSV file. ] NPDES Number <system generated> Start Date of Reporting Period (YYYY

- MM
- DD) End Date of Reporting Period (YYYY

- MM
- DD) NPDES Data Group Number 4 <system generated>

**I. BIOSOLIDS FACILITY**  **AND ANALYTICAL METHODS INFORMATION**  **Biosolids Management Facility Type:** Note: This field will be auto

- populated from data supplied by the authorized NPDES program. These programs receive these data on individual NPDES forms or Notices of Intent (NOIs) for coverage under a general NPDES permit. This form will also expand so t ha t users can add this data if not already submitted to the state. Biosolids Management Facility Type : The unique code/description that identifies whether the facility was issued a permit as a biosolids generator, processor, or end user (e.g., land application site, surface disposal site, incinerator). For the Biosolids Annual Report this data element is also the unique code/description that identifies an off

- site facility or location receives biosolids or s ewage sludge from this facility
.2

**Biosol ids or Sewage Sludge Treatment Processes**  **Treatment Process Code (pick list)**  **Treatment Process Name (system generated)**

Biosolids or Sewage Sludge Treatment Processes : This data element identifies the biosolids or sewage sludge treatment process or processes at the facility. For example, this may indicate whether primary, secondary, and tertiary treatment is being used, a nd the type of the biosolids or sewage sludge treatment process or processes used, including drying processes. **Biosolids or Sewage Sludge Analytical Methods**  **Analytical Method Code (pick list)**  **Analytical Method Name (system generated)**

Biosolids or Sewage Sludge Analytical Methods : The unique code(s)/description(s) that identify the analytic methods used by the facil ity to analyze for enteric viruses, fecal coliforms, helminth ova, Salmonella sp ., and other regulated parameters. EPA requires facilities to monitor for the certain parameters, which are listed in Tables 1, 2, 3, and 4 at 40 CFR 503. 13 and Tables 1 an d 2 at 503.233

**II. BIOSOLIDS OR SEWAGE SLUDGE MANAGEMENT**  **Biosolids or**  **Sewage Sludge Unique**  **Identifier (system**  **generated) Biosolids** 

**or Sewage Sludge**  **Form Biosolids or** 

**Se wage Sludge**  **Management Practice**  **Annual Whole**

**Biosolids or Sewage Sludge**  **Application Rate Biosolids or Sewage** 

**Sludge Pathogen Class (e.g., Class A,**  **Class B) Biosolids or** 

**Sewage Sludge Vector Attraction**  **Reduction Options Biosolids or** 

**Sewage Sludge**  **Land Application Option**  **Biosolids or**

**Sewage Sludge Volume Amount**  **( dry metric tons)** 
* * * **Note:** The unique identifiers in the ‘ Biosolids or Sewage Sludge Unique Identifier’ column are system generated and are used by the form to link data across different tables. Biosolids or Sewage Sludge Form : This data element describes the nature of each biosolids and sewage sludge material generated by the facility in terms of whether the material is a biosolid or sewage sludge and whether the material is ultimately conveyed off

- site in bulk or in bags. The facility will separately report t he form for each biosolids or sewage sludge management practice or practices used by the facility. Biosolids or Sewage Sludge Management Practice : This data element will identify the type of biosolids or sewage sludge management practice or practices (e.g ., land application, surface disposal, incineration) for each different form of biosolids and sewage sludge generated by the facility. This data element will also identify the management practices used by surface disposal site owners/operators (see 40 CFR 503.24). Annual Whole Biosolids or Sewage Sludge Application Rate : This data element identifies the annual whole biosolids or sewage sludge application rate for biosolids or sewage sludge sold or given away in bags or containers (see 40 CFR 503.13). The facility will separately report the application rate for each biosolids or sewage sludge management practice used by the facility and by ea ch bi osolids or sewage sludge form. Biosolids or Sewage Sludge Pathogen Class : This data element will identify the p athogen class or classes (e.g., Class A, Class B) for biosolids or sewage sludge generated by the facility. The facility will separately report the pathogen class for each biosoli ds or sewage sludge management practice used by the facility and by each bios olids or sewage sludge form
.4

Biosolids or Sewage Sludge Vector Attraction Reduction Options : This data element will identify the land application and surface disposal vector attraction reduction options used by the facility. The facility will separately r eport the vector attraction reduction options for each biosolids or sewage sludge management practice used by the facility and by each biosolids or sewage sludge form as well as by each biosolids or sewage sludge pathogen class. Biosolids or Sewage Sludg e Land Application Option : This data element will identify the land application option or options used by the facility (e.g., EQ, PC, CPLR, APLR). The facility will separately report the land application option for each biosolids o r sewage sludge managemen t practice used by the facility and by each biosolids or sewage sludge form as well as by each biosolids or sewage sludge pathogen class and each vector attraction reduction option. Biosolids or Sewage Sludge Volume Amount : This is the amount (in dry metric tons) of biosolids or sewage sludge generated by the facility. This identification will be made for each biosolids or sewage sludge management practice used by the facility and b y each biosolids or sewage sludge form as we ll as by each biosolids or sewage sludge pathogen class, by each vector attraction reduction option, and by each land application option..5

**III. BIOSOLIDS OR SEWAGE SLUDGE MONITORING**  **Biosolids or Sewage Sludge Unique Identifier**  **(system generated) Biosolids or Sewage Sludge**  **Monitored Parameter Biosolids or Sewage Sludge**  **Monitored Parameter Concentration Biosolids or Sewage Sludge**  **Monitored Parameter Units** ***** ***** ***** **Note:** The unique identifiers in the ‘Biosolids or Sewage Sludge Unique Identifier’ column are auto - populate from the entries in the ‘Biosolids or Sewage Sludge Management’ table
. Biosolids or Sewage Sludge Monitored Parameter : This is the biosolids or sewage sludge parameter that is monitored by the facility. If there is more than one class, then the facility will separately report each monitored parameter for each biosolids or sewa ge sludge management practice used by the facility and by each biosolids or sew age sludge form. EPA requires facilities to monitor for the certain parameters, which are listed in Tables 1, 2, 3, and 4 at 40 CFR 503. 13 and Tables 1 and 2 at 503.23. Biosolids or Sewage Sludge Monitored Parameter Concentration : This is the concentration value of the Biosolids or Sewage Sludge Monitored Parameter. Biosolids or Sewage Sludge s Monitored Parameter Units : This is the measurement unit (e.g., mg/kg) associated with the Biosolids or Sewage Sludge Monitored Parameter Concentration.6 

### Standard Signature Block and Certification Statement for CWA Reporting (in compliance with CFR Parts 3, 122.22, 127, and 503). **IV. BIOSOLIDS OR SEWAGE SLUDGE LOADING AT OFF**  **- SITE LANDS**  **Biosolids or Sewage Sludge Receiving Site Name**  **Biosolids or Sewage Sludge Measured Cumulative Pollutant Loading Amount**  ( **kg per hectare) Biosolids or Sewage Sludge Measured Annual**  **Pollutant Loadin g Amount (kg per hectare)**  ***** ***** ***** **Note:** The list of sites receiving biosolids or sewage sludge will be auto
- populated from data supplied by the authorized NPDES program. These programs receive these data on individual NPDES forms or Notices of Intent (NOIs) for coverage under a general NPDES permit. Each site receiving sewage sludge or biosolids will have a unique FRS identifier . This form will also expand so that users can add new sites that receive sewage sludge or biosolids . Users will need to enter the following data for these new facilities: Facility Site Name , Facility Site Address, Facility Site City, Facility Site State, Facility Site Zip Code , Facility Site Longitude , and Facility Site Latitude
. Biosolids or Sewage Sludge Measured Cumulative Pollutant Loading Amount : This is the measured cumulative amount of a pol lutant (in kg per hectare) that has been applied to each off

- site area of land as specified in the regulations at 40 CFR 503 during the entire life of the application site. The list of pollutants to be measured is at 40 CFR 503.13, Table 2. When the measured cumulative pollutant loading amount exceeds the Cumulative Pollutant Loading Rate (CPLR) limit for any pollutant, as identified at 40 CF R 503.13, Table 2, no additional bulk biosolids subject to CPLR limits may be applied to the site. Biosolids or Sewa ge Sludge Measured Annual Pollutant Loading Amount : This is the measured amount of a pollutant (in kg per hectare) that has been applied to each off

- site area of land as specified in the regulations at 40 CFR 503 in the preceding 365

- day period. This valu e is compared against the Annual Pollutant Loading Rate (see 40 CFR 503.13, Table 4) to determine compliance for each Biosolids or Sewage Sludge Receiving Site for each preceding 365

- day period.

SUBMIT REPORT