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CALIFORNIA REGIONAL WATER QUALITY CONTROL BOARD <br /> CENTRAL VALLEY REGION <br /> ATTACHMENT A TO <br /> GENERAL ORDER NO. 92-160 <br /> FOR DISCHARGE OF GROUND WATER FROM CLEANUP <br /> OF PETROLEUM FUEL POLLUTION <br /> TO SURFACE WATERS <br /> APPLICATION REQUIREMENTS <br /> An NPDES Application for Permit to Discharge (Forms 1 and 2D) , a Report of Waste <br /> Discharge (Form 200 plus supplemental information) and filing fee must be <br /> submitted for each proposed discharge. The Report of Waste Discharge shall be <br /> prepared by a California Registered Civil Engineer, Registered Geologist, or <br /> Certified Engineering Geologist and shall provide at least the following <br /> information or if a Problem Assessment Report has been approved it may be <br /> submitted. The Report of Waste Discharge shall be signed by a person meeting the <br /> qualifications listed in Reporting Requirements D.6 of Standard Provisions. <br /> Additional data may be requested for specific sites. <br /> A. Wastewater treatment system and characteristics <br /> I. An evaluation of land disposal options, including discharge to a <br /> municipal wastewater collection system, and justification for selecting <br /> a surface water disposal alternative. <br /> 2. Description of event(s) which caused the ground water pollution, <br /> including type and source of the contaminants and date(s) when the <br /> discharge occurred or was discovered. <br /> 3. Narrative and schematic descriptions of the proposed extraction, <br /> treatment, and disposal systems. If the proposed treatment system uses <br /> activated carbon, submit an estimate of the breakthrough time for each <br /> carbon treatment unit. <br /> 4. A map(s) showing the location of the facility, plume, extraction <br /> well(s) , monitoring wells, treatment system, disposal facilities, site <br /> boundaries, and the flow path of the proposed discharge to a major <br /> river or lake. <br /> 5. Any water supply wells, and surface waters within 0.5 miles of the site <br /> shall be identified on the map. <br /> 6. The anticipated average and maximum flows from the treatment system, <br /> and the design flow of the treatment and disposal systems. <br /> 7. An operation plan describing general operations and maintenance <br /> procedures, process controls, monitoring and pumping rates shall be <br /> supplied. <br /> 8. A minimum of one of each of the following analyses of the ground water <br /> which will be treated and discharged: <br /> a. Chlorinated volatile hydrocarbons (EPA Method 601 or 8010) <br />