VII. BIOLOGICAL TOXICITY TESTING DATA 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 3 years? YES (identify the test(s) and describe their purposes below) NO (go to Item VIII) VIII. CONTRACT ANALYSIS INFORMATION Were any of the analyses reported in Item V performed by a contract laboratory or consulting firm? YES (list the name, address, and telephone number of, and pollutants analyzed by, each such laboratory or firm below) NO (go to Section IX)) A. NAME B. ADDRESS C. TELEPHONE (area code & no.) D. POLLUTANTS ANALYZED (list)
CONTINUED FROM THE FRONT 1. POLLUTANT AND CAS NO. (if available) 2. MARK “X” 3. EFFLUENT 4. UNITS 5. INTAKE (optional) a. TESTING REQUIRED b. BELIEVED PRESENT c. BELIEVED ABSENT a. MAXIMUM DAILY VALUE b. MAXIMUM 30 DAY VALUE (if available) c. LONG TERM AVRG. VALUE (if available) d. NO. OF a. CONCEN- TRATION b. MASS a. LONG TERM AVERAGE VALUE b. NO. OF ANALYSES (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS GC/MS FRACTION – VOLATILE COMPOUNDS 1V. Accrolein (107-02-8) 2V. Acrylonitrile (107-13-1) 3V. Benzene (71-43-2) 4V. Bis (Chloro- methyl) Ether (542-88-1) 5V. Bromoform (75-25-2) 6V. Carbon Tetrachloride (56-23-5) 7V. Chlorobenzene (108-90-7) 8V. Chlorodi- bromomethane (124-48-1) 9V. Chloroethane (75-00-3) 10V. 2-Chloro- Ethylvinyl Ether (110-75-8) 11V. Chloroform (67-66-3) 12V. Dichloro- bromomethane (75-27-4) 13V. Dichloro- difluoromethane (75-71-8) 14V. 1,1-Dichloro- Ethane (75-34-3) 15V. 1,2-Dichloro- ethane (107-06-2) 16V. 1,1-Dichloro- Ethylene (75-35-4) 17V. 1,2-Dichloro- Propane (78-87-5) 18V. 1,3-Dichloro- Propylene (542-75-6) 19V. Ethylbenzene (100-41-4) 20V. Methyl Bromide (74-83-9) 21V. Methyl Chloride (74-87-3)
CONTINUED FROM THE 1. POLLUTANT AND CAS NO. (if available) 2. MARK “X” 3. EFFLUENT 4. UNITS 5. INTAKE (optional) a. TESTING REQUIRED b. BELIEVED PRESENT c. BELIEVED ABSENT a. MAXIMUM DAILY VALUE b. MAXIMUM 30 DAY VALUE (if available) c. LONG TERM AVRG. VALUE (if available) d. NO. OF a. CONCEN- TRATION b. MASS a. LONG TERM AVERAGE VALUE b. NO. OF ANALYSES (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS GC/MS FRACTION – BASE/NEUTRAL COMPOUNDS (continued) 43B. N-Nitro- sodiphenylamine (86-30-6) 44B. Phenanthrene (85-01-8) 45B. Pyrene (129-00-0) 46B. 1,2,4-Trichloro- Benzene (120-82-1) GC/MS FRACTION – PESTICIDES 1P. Aldrin (309-00-2) 2P. α-BHC (319-84-6) 3P. β-BHC (319-85-7) 4P. -BHC (58-89-9) 5P. -BHC (319-86-8) 6P. Chlordane (57-74-9) 7P. 4,4’-DDT (50-29-3) 8P. 4,4’-DDE (72-55-9) 9P. 4,4’-DDD (72-54-8) 10P. Dieldrin (60-57-1) 11P. α-Enosulfan (115-29-7) 12P. β-Endosulfan (115-29-7) 13P. Endosulfan Sulfate (1031-07-8) 14P. Endrin (72-20-8) 15P. Endrin Aldehyde (7421-93-4) 16P. Heptachlor (76-44-8)
CONTINUED FROM PAGE 12 EPA I.D. NUMBER (copy from Item 1 of Form 1) OUTFALL NUMBER 1. POLLUTANT AND CAS NO. (if available) 2. MARK “X” 3. EFFLUENT 4. UNITS 5. INTAKE (optional) a. TESTING REQUIRED b. BELIEVED PRESENT c. BELIEVED ABSENT a. MAXIMUM DAILY VALUE b. MAXIMUM 30 DAY (if available) c. LONG TERM AVRG. (if available) d. NO. OF a. CONCEN- TRATION b. MASS a. LONG TERM AVERAGE VALUE b. NO. OF ANALYSES (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS (1) CONCENTRATION (2) MASS GC/MS FRACTION – PESTICIDES (continued) 17P. Heptachlor Epoxide (1024-57-3) 18P. PCB-1242 (53469-21-9) 19P. PCB-1254 (11097-69-1) 20P. PCB-1221 (11104-28-2) 21P. PCB-1232 (11141-16-5) 22P. PCB-1248 (12672-29-6) 23P. PCB-1260 (11096-82-5) 24P. PCB-1016 (12674-11-2) 25P. Toxaphene (8001-35-2)