C. The required registration statement shall
contain the following information:
1.
Facility name and street address, owner name, mailing address, telephone
number, and email address (if available);
2. Operator or other contact name, mailing
address, telephone number, and email address;
3. The nature of the business;
4. A USGS 7.5 minute topographic map or
equivalent computer generated map showing the facility location extending to at
least one mile beyond the property boundary and the location of the discharge
points;
5. The receiving waters of
the discharge;
6. The outfall
number, latitude and longitude (in decimal degrees (six digits -
ten-thousandths place)), the daily maximum and monthly average process
wastewater flow (millions of gallons per day or gallons per day), duration of
discharges, and frequency of discharge;
7. The type of water treatment (e.g.,
conventional filtration treatment, microfiltration, ultrafiltration,
nanofiltration, reverse osmosis, or a combination of these) and, if applicable,
a description of any treatment type changes since the previous registration
statement was submitted;
8. The
number of any existing VPDES or VPA permit;
9. The Virginia Department of Health Public
Water Supply Identification (PWSID) number;
10. If the existing VPDES permit contains a
groundwater monitoring plan requirement, a copy of the department-approved plan
shall be submitted unless the plan has been previously submitted and approved
and remains unchanged. If a plan has been previously approved, cite the plan
and date of approval;
11.
Information regarding the lining of any settling basins or lagoons, whether
such units are earthen lined, and if so, whether the linings have a
permeability of no greater than 10-6
cm/sec;
12. The results of any
whole effluent toxicity evaluation required by the 2018 potable water treatment
plant general permit regulation,
9VAC25-860-50 A 3, or the current
individual permit, if not previously submitted to the department;
13. A schematic drawing showing the treatment
of the water from raw water intake through finished water distribution.
Indicate clearly where backwash, reject water, clean in place water, and
disinfection chemicals could enter the process wastewater and exit the outfall
to state waters. Also include in schematic where solids from any treatment
process are settled or dried;
14.
Information on chemicals used in the production of drinking water and process
wastewater treatment, to include (i) a description of chemicals, (ii) a
proposed or actual schedule and quantity of chemical usage, (iii) a description
of any chemical or chemical usage changes since the previous registration
statement was submitted, and (iv) a description of which chemicals have no
likelihood of entering the process wastewater;
15. A description of how solids and residue
from any settling basins or lagoons are disposed;
16. Whether the facility will discharge to a
municipal separate storm sewer system (MS4). If yes, the name of the MS4 owner
must be provided. If the owner of the potable water treatment plant is not the
owner of the MS4, the facility owner shall notify the MS4 owner of the
existence of the discharge and include a copy of the notification with the
registration statement. The notification shall include the following
information: the name of the facility, a contact person and contact information
(telephone number and email), the location of the discharge, the nature of the
discharge, and the owner's VPDES general permit number;
17. If a new potable water treatment plant
owner proposes to discharge within five miles upstream of another public water
supply system's intake, the new potable water treatment plant owner shall
notify the public water supply system's owner and include a copy of the
notification with the registration statement; and
18. The following certification:
"I certify under penalty of law that this document and all
attachments were prepared under my direction or supervision in accordance with
a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system or those persons directly responsible for
gathering the information, the information submitted is to the best of my
knowledge and belief true, accurate, and complete. I am aware that there are
significant penalties for submitting false information including the
possibility of fine and imprisonment for knowing violations."