NPDES Industrial Permit Information Application Instructions General Information Form {51952}

NPDES INDUSTRIAL PERMIT INFORMATION APPLICATION INSTRUCTIONS GENERAL INFORMATION State Form 51952 (R / 4-12) Approved by State Board of Accounts, 2012 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT (Replaces EPA General Form 1 Instructions) Item 1-Facility Name: Provide the facility's official or legal name as it is to appear on the permit. Item 2-Facility Contact: Give the name, title, and work telephone number of a person who is thoroughly familiar with the operation of the facility and with the facts reported in this application and who can be contacted by the Indiana Department of Environmental Management. Item 3-Certified Operator: Give the name, Address, and Certification information, for the operator of the facility being permitted. Information concerning operator certification should be directed to this office at 317/233-0419. Item 4-Facility Mailing Address: Give the complete mailing address of the office where correspondence should be sent. This often is not the address used to designate the location of the facility or activity. Item 5-Facility Location: Give the address or location of the facility identified in Item 1 of this form. If the facility lacks a street name or route number, give the most accurate alternative geographic information (i.e., section number or quarter section number from county records or at an intersection of Streets or County Roads.) Item 6-Type of Permit Action: Specify the type of application. If the facility has never had an NPDES permit mark new. If it is to renew or modify the existing permit mark accordingly. Item 7-EPA I.D. Number: Give the EPA I.D. number if one has been obtained from the EPA. If an I.D. number has not been obtained from EPA, you may disregard this section. Items 8, 9 and 10-Applicable Permit Applications: Answer each question to determine which form you need to fill out. If you answer yes to any of these questions, you must fill out and submit the appropriate form. Item 11-SIC Code(s): List, in descending order of significance, the four 4-digit standard industrial classification (SIC) codes which best describe your facility in terms of the principal products or services you produce or provide. Also, specify each classification in words. These classifications may differ from the SIC codes describing Page 1 of 15 American LegalNet, Inc. www.FormsWorkFlow.com the operation generating the discharge, air emissions, or hazardous wastes. SIC code numbers are descriptions which may be found in the "Standard Industrial Classification Manual" prepared by the Executive Office of the President, Office of Management and Budget, which is available from the Government Printing Office, Washington, D.C. Use the current edition of the manual. Item 12-Existing Environmental Permits: Give the number of each presently effective permit issued to the facility for each program or, if you have previously filed an application but have not yet received a permit, give the number of the application, if any. Item 13-Nature of Business: Briefly describe the nature of your business (e.g., products produced or services provided). Item 14-Map: Provide a topographic map or maps as explained in the application. Item 15-Signature Block: The General Information Form must be signed by a person legally responsible for the facility. Glossary NOTE: This Glossary includes terms used in the instructions and in Forms 2C, 2D and 2E. Additional terms will be included in the future when other forms are developed to reflect the requirements of other parts of the Consolidated Permits Program. ALIQUOT means a sample of specified volume used to make up a total composite sample. ANIMAL FEEDING OPERATION means a lot or facility (other than an aquatic animal production facility) where the following conditions are met: A. Animals (other than aquatic animals) have been, are, or will be stabled or confined and fed or maintained for a total of 45 days or more in any 12 month period; and B. Crops, vegetation, forage growth, or post-harvest residues are not sustained in the normal growing season over any portion of the lot or facility. Two or more animal feeding operations under common ownership are a single animal feeding operation if they adjoin each other or if they use a common area or system for the disposal of wastes. ANIMAL UNIT means a unit of measurement for any animal feeding operation calculated by adding the following numbers: The number of slaughter and feeder cattle multiplied by 1.0; Plus the number of mature dairy cattle multiplied by 1.4; Plus the number of swine weighing over 25 kilograms (approximately 55 pounds) multiplied by 0.4; Plus the number of sheep multiplied by 0.1; Plus the number of horses multiplied by 2.0. APPLICATION means the EPA standard national forms for applying for a permit, including any additions, revisions, or modifications to the forms; or forms approved by EPA for use in approved States, including any approved modifications or revisions. For RCRA, "application" also means "Application, Part B." APPLICATION, PART A means that part of the Consolidated Permit Application forms which a RCRA permit applicant must complete to qualify for interim status under Section 3005(e) of RCRA and for Page 2 of 15 American LegalNet, Inc. www.FormsWorkFlow.com consideration for a permit. Part A consists of Form 1 (General Information) and Form 3 (Hazardous Waste Application Form). APPLICATION, PART B means that part of the application which a RCRA permit applicant must complete to be issued a permit. (NOTE: EPA is not developing a specific form for Part B of the permit application, but an instruction booklet explaining what information must be supplied is available from the EPA Regional office.) APPROVED PROGRAM or APPROVED STATE means a Sate program which has been approved or authorized by EPA under 40 CFR Part 123. AQUACULTURE PROJECT means a defined managed water area which uses discharges of pollutants into that designated area for the maintenance or production of harvestable freshwater, estuarine, or marine plants or animals. "Designated area" means the portions of the waters of the United States within which the applicant plans to confine the cultivated species, using a method of plan or operation (including, but not limited to, physical confinement) which, on the basis of reliable scientific evidence, is expected to ensure the specific individual organisms comprising an aquaculture crop will enjoy increased growth attributable to the discharge