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Form 2c - Application For Permit To Discharge Wastewater - Existing Manufacturing, Commrecial, Mining And Silviculture Operarions - Idaho Department Of Environmental Quality Page 11

Please print or type in the unshaded areas only.

I.D. NUMBER (copy from Item 1 of Form 1)

FORM

IDAHO DEPARTMENT OF ENVIRONMENTAL QUALITY

APPLICATION FOR PERMIT TO DISCHARGE WASTEWATER

EXISTING MANUFACTURING, COMMERCIAL, MINING AND SILVICULTURE OPERATIONS

IPDES

I. OUTFALL LOCATION

For each outfall, list the latitude and longitude of its location to the nearest 15 seconds and the name of the receiving water.

A. OUTFALL NUMBER

B. LATITUDE

C. LONGITUDE

(list)

D. RECEIVING WATER (name)

1. DEG.

2. MIN.

3. SEC.

1. DEG.

2. MIN.

3. SEC.

II. FLOWS, SOURCES OF POLLUTION, AND TREATMENT TECHNOLOGIES

A. Attach a line drawing showing the water flow through the facility. Indicate sources of intake water, operations contributing wastewater to the effluent, and treatment units

labeled to correspond to the more detailed descriptions in Item B. Construct a water balance on the line drawing by showing average flows between intakes, operations,

treatment units, and outfalls. If a water balance cannot be determined (e.g., for certain mining activities), provide a pictorial description of the nature and amount of any

sources of water and any collection or treatment measures.

B. For each outfall, provide a description of: (1) All operations contributing wastewater to the effluent, including process wastewater, sanitary wastewater, cooling water,

and storm water runoff; (2) The average flow contributed by each operation; and (3) The treatment received by the wastewater. Continue on additional sheets if

necessary.

2. OPERATION(S) CONTRIBUTING FLOW

3. TREATMENT

1. OUT-

FALL

b. AVERAGE FLOW

b. LIST CODES FROM

NO. (list)

a. OPERATION (list)

(include units)

a. DESCRIPTION

TABLE 2C-1