EFTA01221868.pdf

CONTINUED FROM THE FRONT VII. SIC CODES (4-digit, in order of non A. FIRST B. SECOND t N/A (sPecr49 7 N/A (way) 7 7 13 1 IB 17 15 16 19 C. THIRD D. FOURTH c N/A Wear) 77 N/A (2PecifY) is 16 17 15 16 19 VIII. OPERATOR INFORMATION A. NAME B. Is the name listed in Item C Arran McGinnis VIII-A also the owner? 8 ❑ YES 123 NO IS 19 65 C. STATUS OF OPERATOR (Enter the appropriate letter into the answer box; al 'Other, specify.) D. PHONE area code & no.) F= FEDERAL M= PUBLIC (other than federal a state) I p I (specify) c 340 1690 1 1487 S • STATE O = OTHER (specify) lf P • PRIVATE 16 16 IS 19 21 12 ZS E. STREET OR PO BOX 6100 Red Hook Quarters B-3 26 55 F. CITY OR TOWN G. STATE H. ZIP CODE IX. INDIAN LAND c St. Thomas VI 00802 Is the facility loca ed on Indian lands? B 15 16 40 42 42 47 51 ❑ YES 8 NO X. EXISTING ENVIRONMENTAL PERMITS A. NPDES (Discharges to Surface Wafer) D. PSDemir Emissions from Proposed Sources) C 7 I N 9 N 9 P It5 16 57 /A 15 18 17 l 18 30 B. UIC (Underground Injection of Fluids E. OTHER (specify) (Specify) C T I G T s N/A 9 U 9 15 03 17 IS 30 15 18 I? 18 30 C. RCRA (Hazardous Wastes) E. OTHER (specW) (Specify) T I N/A c 9 R 9 15 16 17 18 30 15 18 12 18 30 XI. MAP Attach to this application a topographic map of the area extending to at least one mile beyond properly boundaries. The map must show the outline of the facility, the location of each of its existing and proposed intake and discharge structures, each of its hazardous waste treatment, storage, or disposal facilities, and each well where it injects fluids underground. Include all springs, rivers and other surface water bodies in the map area. See instructions for , recise re. uirements. XII. NATURE OF BUSINESS (provide a brief description) Private Residence, Domestic Use, Irrigation use. XIII. CERTIFICATION (see instructions) I certify under penally oflaw that I have personally examined and am familiar with the information submitted in this application and all attachments and that, based on my inquiry of those persons immediately responsible for obtaining the information contained in the application, I believe that the information is true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibilit of fine and imprisonment. A. NAME & OFFICIAL TITLE (type or print) B. SIGNATURE C. DATE SIGNED - Island Manager COMMENTS FOR OFFICIAL USE ONLY c C is 16 55 EPA FORM 3510.1 (8-90) EFTA01221868  PLEASE PRINT OR TYPE IN THE UNSHADED AREAS ONLY. You may report some or EPA E NUMBER (copy from Item 1of Form I) all of this information on separate sheets (use the same format) instead of completing VI 0040525 these pages. SEE INSTRUCTIONS. V. INTAKE AND EFFLUENT CHARACTERISTICS (continued from page 3 of Form 2-C) PART A - 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 details. 2. EFFLUENT 3. UNITS 4. INTAKE (optional) 1. POLLUTANT a. MAXIMUM DAILY 0. MAXIMUM 30 DAY VALVE e. LONG TERM AVRG. VALUE (specify if blank) a. LONG TERM VALUE oraix(orie) Of ImNitible) d. NO. OF AVERAGE VALUE b. NO. OF iii in in ANALYSIS a. CONCEN. b MASS in ANALYSES coratimun in MASS eateENTRAll (2) MASS nonce/man Ca MASS TRANON eoNcEmitAn MP KASS ON ON ON ON a. Biochemical Oxygen Demand (8OD) N/A b. Chemical Oxygen Demand (COD) N/A C. Total Organic Carbon (TOC) N/A d. Total Suspended Solids (TSS) N/A e. Ammonia (as N) N/A Value Value Value Value f. Flow 30 Day 300 000 9,000,000 6,000,000 Value Value Value Value g. Temperature (winter) Y9c Daily `C 29c 29c h. Temperature (summer) Value Value Value Value 29c 29c 29c Daily .0 Minimum Maximum Minimum Maximum i. pH 30 Day STANDARD UNITS 7.6 7.8 7.6 7.8 PART B - Mark "X' in column 2-a for each pollutant you know or have reason to believe is present. Mark "r in column 2-b for each pollutant you believe to be absent. If you mark column 2a for any pollutant which is limited either directly, or indirectly but expressly in an effluent limitation guideline, you must provide the results of at least one analysis for that pollutant. For other pollutants for which you mat* column 2a, you must provide quantitative data or an explanation of their presence in your discharge. Complete one table for each outfall. See the instructions for additional details and requirements. 1. POLLUT- 2. MARK le 3. EFFLUENT 4. UNITS 5. INTAKE (optional) B. a. MAXIMUM DAILY b MAXIMUM 30 DAY VALUE C. LONG TERM AVRG. VALUE blank) a. LONG TERM ANT AND Livia& M. VALUE Of ava2eON) (specify if (if avagablo) d. NO. OF AVERAGE VALUE b. NO. OF CAS NO. (if D star 0( oi oi ANALYSIS CONGER. b MASS ANALYSES available) err OONCEIMA (2) MASS cat epiattao CI %MSS coNcENTRATIO CZ MASS a.TRAT1ON CONaPaltATION PI .ova: MN N N a. Bromide • s (24959-67-9) a Chrima Total Residual ❑ 02 c. Color 0 ei d. Fecal Coliform 0 r a. Fluoride O (16984-48-8) f. Nitrate- Nitrite (as N) 0 0 EPA FORM 3510-2C (Rev. 8-90) Page V-1 CONTINUE ON REVERSE EFTA01221869