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CALIFORNIA REAL WATER QUALITY CONTROIROARD <br /> CENTRAL VALLEY REGION <br /> ATTACHNENT A <br /> TO <br /> GENERAL ORDERNO. 5-00-119 <br /> FOR DISCHARGE OF GROUND WATER FROM CLEANUP OF PETROLEUM FUEL <br /> POLLUTION <br /> TO SURFACE WATERS <br /> APPLICATION REQUIREMENTS <br /> An NPDES Application for Permit to Discharge(Forms 1 and 21)), a Report of Waste Discharge (Form <br /> 200 plus supplemental information) and filing fee must be submitted for each proposed discharge. The <br /> Report of Waste Discharge shall be prepared by a California Registered Civil Engineer,Registered <br /> Geologist, or Certified Engineering Geologist and shall provide at least the following information or if a <br /> Problem Assessment Report has been approved it maybe submitted. The Report of Waste Discharge <br /> shall be signed by a person meeting the qualifications listed in Reporting Requirements D.6 of Standard <br /> Provisions. Additional data may be requested for specific sites. <br /> A Wastewater treatment system and_characteristics <br /> 1. An evaluation of land disposal options, including discharge to a municipal-wastewater <br /> collection system, and justification for selecting a surface water disposal alternative. <br /> 2. Description of event(s)which caused the ground water pollution, including type and source <br /> of the contaminants and date(s)when the discharge occurred or was discovered. <br /> 3. Narrative and schematic descriptions of the proposed extraction,treatment, and disposal <br /> systems. If the proposed treatment system uses activated carbon, submit an estimate of the <br /> breakthiough'time for each carbon treatment unit. <br /> 4. A map(s) showing the location of the facility,plume, extraction well(s),monitoring wells, <br /> treatment system, disposal facilities, site boundaries, and the flow path of the proposed <br /> discharge to a major river or lake. <br /> 5. . Any water supply wells, and surface waters within 0.5 miles of the site shallbe identified <br /> on the map. <br /> 6. s from the treatment system, and the design <br /> The anticipated average and maximum flow <br /> flow of the treatment and disposal-systems. <br /> 7. An operation plan describing general operations and maintenance procedures,process <br /> controls,monitoring and pumping rates shall be supplied. <br /> 8. A minimum of one of each of the following analyses of the.ground water which will be <br /> treated and discharged: <br /> a. Chlorinated volatile hydrocarbons_(EPA Method 601 or 8260) <br /> b. Aromatic volatile hydrocarbons (EPA Method 602 or 8020) <br />