ADEM Form 14 "Information Needed for 316(B) Determination in Regards to General Npdes Permits" - Alabama

What Is ADEM Form 14?

This is a legal form that was released by the Alabama Department of Environmental Management - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2011;
  • The latest edition provided by the Alabama Department of Environmental Management;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of ADEM Form 14 by clicking the link below or browse more documents and templates provided by the Alabama Department of Environmental Management.

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Download ADEM Form 14 "Information Needed for 316(B) Determination in Regards to General Npdes Permits" - Alabama

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Page 1 of 3 
Information Needed for 316(b) Determination in Regards to General NPDES Permits
Permit Number _________________________________
Permittee Name _________________________________
1. Regarding type of facility and date it began operating:
a.
Is this a new offshore oil and gas facility which began operation after June
16, 2006?
Yes [
]
No [
]
(If yes, Phase III rules (40 CFR Part 125.130) may apply.)
b.
Is this a new facility, other than offshore oil and gas, which began operation
after January 17, 2002?
Yes [
]
No [
]
(If yes, Phase I rules (40 CFR Part 125.80) may apply.)
c.
Is this an existing power plant which began operation prior to September 7,
2004?
Yes [
]
No [
]
(If yes, Phase II rules (40 CFR Part 125.90) may apply.)
2. Do you have a surface water intake?
Yes [
]
No [
]
(If “No,” go to question 3. If “Yes,” go to question 5. If more than one intake,
provide information for each intake separately.)
3. Does the provider of your source water operate a surface water intake?
Yes [
]
No [
]
(If “Yes,” provide name and location of provider, including the latitude and
longitude of the intake, and provide responses to questions 4 through 7. If “No,”
stop.)
Provider Name ___________________________________
Location of provide ________________________________
Latitude and longitude of the intake
___________________________
____________________________
4. Is the provider a public water system (defined as a system which provides water to the
public for human consumption or which provides only treated water, not raw water, to the
industry with the NPDES permit)?
Yes [
]
No [
]
(If “Yes,” stop. If “No,” provide responses to questions 5 through 7.)
ADEM Form 014 01/11
 
 
Page 1 of 3 
Information Needed for 316(b) Determination in Regards to General NPDES Permits
Permit Number _________________________________
Permittee Name _________________________________
1. Regarding type of facility and date it began operating:
a.
Is this a new offshore oil and gas facility which began operation after June
16, 2006?
Yes [
]
No [
]
(If yes, Phase III rules (40 CFR Part 125.130) may apply.)
b.
Is this a new facility, other than offshore oil and gas, which began operation
after January 17, 2002?
Yes [
]
No [
]
(If yes, Phase I rules (40 CFR Part 125.80) may apply.)
c.
Is this an existing power plant which began operation prior to September 7,
2004?
Yes [
]
No [
]
(If yes, Phase II rules (40 CFR Part 125.90) may apply.)
2. Do you have a surface water intake?
Yes [
]
No [
]
(If “No,” go to question 3. If “Yes,” go to question 5. If more than one intake,
provide information for each intake separately.)
3. Does the provider of your source water operate a surface water intake?
Yes [
]
No [
]
(If “Yes,” provide name and location of provider, including the latitude and
longitude of the intake, and provide responses to questions 4 through 7. If “No,”
stop.)
Provider Name ___________________________________
Location of provide ________________________________
Latitude and longitude of the intake
___________________________
____________________________
4. Is the provider a public water system (defined as a system which provides water to the
public for human consumption or which provides only treated water, not raw water, to the
industry with the NPDES permit)?
Yes [
]
No [
]
(If “Yes,” stop. If “No,” provide responses to questions 5 through 7.)
ADEM Form 014 01/11
 
 
Page 2 of 3 
Information Needed for 316(b) Determination (continued)
Permit Number _________________________________
Permittee Name _________________________________
5. Is any water withdrawn from the source water used for cooling?
(If “No,” stop. If “Yes,” continue.)
2
6. Approximately what percentage
of water withdrawn is used exclusively for cooling
water?
___________%
2
The percentage must be based on average monthly measurements.
7. Is treated process effluent used as part or all of the cooling water?
Yes [
]
No [
]
(If “Yes,” stop. If “No,” continue.)
8. Is the cooling water used in a once-through or closed cycle cooling system?
Yes [
]
No [
]
9. When was the intake installed?
(Please provide dates for all major construction/installation of intake components
including screens.)
10. What is the location and configuration of the intake pipe in the source water? (e.g.,
source water name, onshore/offshore, at what depth, location in relation to bottom, etc.).
Include a diagram of the intake.
11. What is the maximum design intake volume? (maximum pumping capacity in gallons per
day)
___________________________ gallons/day
12. What is the average intake volume? (average intake pump rate in gallons per day
average in any 30-day period)
___________________________ gallons/day
ADEM Form 014 01/11
 
 
Page 3 of 3 
Information Needed for 316(b) Determination (continued)
Permit Number _________________________________
Permittee Name _________________________________
13. How is the intake operated? (e.g., continuously, intermittently, batch)
14. What is the mesh size of the screen on your intake?
15. What is the intake screen flow-through area?
16. What is the through screen design intake flow velocity?
17. What is the mechanism for cleaning the screen? (e.g., does it rotate for cleaning?)
18. Do you have any additional fish detraction technology on your intake?
19. Have there been any studies to determine the impact of the intake on aquatic organisms?
(If so, please provide.)
20. Attach a site map showing the location of the water intake in relation to the facility,
shoreline, water depth, etc.
"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
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."
____
____________________________________
____________
Signature
Date
____
_____________________________________
Printed Name
_________________________________________
Title
ADEM Form 014 01/11
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