FORM 1 GENERAL U.S. ENVIRONMENTAL PROTECTION AGENCY I. EPA IM. NUMBER GENERAL INFORMATION s VA C %it EPA Consolidated Permits Program "General F VI 0040525 D (Read the Instructions" before starting.) t 2 13 14 IS LABEL ITEMS GENERAL INSTRUCTIONS I. EPA.. NUMBER If a prepriited label has been prowled. affix it in the designated space. Review the information carefully: if any of it a incorrect. cross through it and enter the II. FACILITY NAME correct data in the appropriate fill.in area below. Also. if any of the prepnmed data a absent the area to the left of the label space lists the III. FACILITY MAILING ADDRESS PLEASE PLACE LABEL IN THIS SPACE eiformation that should appear), please provide it in the proper fill-in areals) below. If the label is complete and Correa you need not complete hems I. III, V. and Vhexcept VI-8 which must be IV. FACILITY LOCATION II. POLLUTANT CHARACTERISTICS INSTRUCTIONS: Complete A through this form 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 reed to submit any permit application forms to the EPA. I in the parenthesis following the question. Mark 'X' in the box in the third column if the of these toms. You may answer 'no' if your activity i$ excluded from permit requirements: terms. completed regardless). Complete all items i no label has been proved. Refer to the instructions for detaled item descriptions and for the legal authorization under which this data is collected. you answer yes' to any questions, you midst submit supplemental form is attached. If you answer 'no" to see Section C of the instructions. See also. Section D 1C' MARK FORM MARK 1C SPECIFIC QUESTIONS YES NO ATTACHED SPECIFIC QUESTIONS YES NO FORAI ATTACHED A. Is this facility a publicly owned treatment works which results in a discharge to waters of the U.S.? (FORM 2A) K Fr B. Does or will this f