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EFTA01221076

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FORM I GENERAL U.S. ENVIRONMENTAL PROTECTION AGENCY I. EPA I.D. NUMBER PA GENERAL INFORMATION s VA C %AO E Consolidated Permits Program "General F D (Read the Instructions" before starting.) 1 2 13 14 IS LABEL ITEMS GENERAL INSTRUCTIONS I. EPA I.D. NUMBER If a preprnted label has been provided. affix it in the designated space. Review the informabon carefully: if any of it is incorrect. cross through it and enter the II. FACILITY NAME correct dat ny a in the appropriate fill.in area below. Also. if a of the prepnmed dala is absent (the area to the left of the label space lists the III. FACILITY MAILING ADDRESS PLEASE PLACE LABEL IN THIS SPACE nbrmation that should appear). please provide it in the proper fil in areals) below. If the label is complete and Carted you need not complete Items I. III, V. and Vftexcect VI-8 which must be N. FACILITY LOCATION II. POLLUTANT CHARACTERISTICS INSTRUCTIONS: Complete A through this tom and the supplemental from listed each question. you need not submit any of the instructions for definitions of bold-faced J to determine whether you need to submit any permit applicabon forms to the EPA. I in the parenthesis following the question. Mark 'X' in the box in the third column if the of these forms. You may answer 'no' if your activity is excluded from permit requirements: terms. completed regardless). Complete all items dno completed haS been proved. Refer to the instructions for detated item descriptions and for the legal authorization under which this data is collected. you answer yes' to any questions. you must Subait supplemental form is attached. If you answer 'no" to see Section C of the instructions. See also. Section D MARK 'X' MARK "X SPECIFIC QUESTIONS YES NO FORM ATTACHED SPECIFIC QUESTIONS YES NO FORM ATTACHED A. Is this facility a publicly owned treatment works which results in a discharge to waters of the U.S.? (FORM 2A) B. Does or will this facility

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