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EPA ID Number (copy hom Item 1 of Form 1) <br />Form Approved. OMB No. 204P008(i <br />Approval axplrea 5-31 A2 <br />VII. Dischar a Information Continued from e 3 of Form 2 <br />Pert A- Vou must provide the resuhs Of at~baet one anafyels for every pollulaM In thla lobo. Compote one table for each oudall. See <br />Instructions for additional details. <br /> <br />Pollutant Maximum Values <br />(nclude units) Average Value <br />Qnduds units) rLrmbar <br />of <br />and <br />CAS Number <br /> <br />(l available) Grab Sample <br />Taken Dunng <br />Frt 20 <br />Minutes <br />Flow-weighted <br /> <br />Composite Grab Sample <br />Taken During <br />Fret 20 <br />Minutes <br />Flow~veigftted <br /> <br />Composite Storm <br />C-vents <br /> <br />Sampled ' <br /> <br /> <br />Sources of Pollubnts <br />al end Grasso N/A <br />Biological Oxygen <br />Demand GODS <br />Chemlcel Oxygen <br />Demand COD <br />Total Suspended <br />Solids SS <br />Total <br />Nitro en <br />Total <br />Phos horns <br />pH Minimum Maximum Minimum Maximum <br />Part B - List each pollutant that is limited In en effluent guideline which the facility is subject to or any pollutant listed in the facility's NPDES <br />permit for its process wastewater (f the facility is operating under an existing NPDES permit). Complete one bole for each oudall. See <br /> <br />Pollutant Maximum Values <br />Qnclude units) Average Valusa <br />(nclude uniOC) Number <br />of <br />and <br />CAS Number <br /> <br />(l available) Grab Sample <br />Taken Dunng <br />Frst 20 <br />Minutes <br />Floc weighted <br /> <br />Composite Grab Sample <br />Taken Durng <br />Fret 20 <br />Minutes <br />Flow-weighted <br /> <br />Composite Storm <br />Events <br /> <br />Sampled <br /> <br /> <br />ources of Pollutants <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />EPA Form 3510-2F (Rev. 1-g2) Paga VI41 Continue an Reverse <br />