CENTRALCOAST WATER BOARD WASTE PILE MANAGEMENT FACILITIES PROGRAM (R3-2005-006)
REPORT OF WASTE DISCHARGE APPLICATION INSTRUCTIONS
A. INSTRUCTIONS
The following instructions will provide general direction for completing forms WPM-APP, WPM-1, WPM-2 and WPM-3. Applicants are encouraged to review Waste Discharge Requirements Order No. R3-2005-006 (Waste Pile Waiver) as they complete the forms.
Waste Pile Management Facility Application (WPM-APP)
This form provides information supplemental to the Water Board Form 200 application. It addresses the specific requirements of the Waste Pile Waiver. Please be comprehensive to ensure that additional applications won’t be required.
Section A-This section describes where the material to be stored at the Waste Pile Management Facility (WPMF) originated. The Map ID refers to maps in Section E. Latitude and longitude coordinates are to be provided. The application is intended to cover a single lease or fee property. However, it may cover several contiguous fee or lease properties that are covered by the applicant’s existing Hazardous Materials Business Plan.
Section B-This section describes where the WPMF will be located. Again, the applicant should be comprehensive in the description and describe all WPMF locations, if more than one is planned. This will help ensure that additional applications are not required.
Section C-This section describes the physical properties of the WPMF.
Section D-This section is used to detail the construction plan for the WPMF. Key elements may be found in WPM-APP Sections E&I.
Section E-This section is a checklist for required maps. At least 2 will be required. One will describe the physical properties of the WPMF. The other will be used to describe the location of the WPMF and important features of the surrounding area. USGS maps can be used for this purpose and may be obtained on-line at sites such as
Section F-This section describes actions to be taken to comply with the provisions of the Waste Pile Waiver. This Compliance Plan should incorporate appropriate elements required by the Waste Pile Waiver e.g. training, management practices, reviews of effectiveness, etc.
Section G-This section is only to be filled out in the event that the Water Board Executive Officer requires the installation of monitoring systems or devices.
Section H-This section is only to be filled out in the event that the Water Board Executive Officer requires the installation of monitoring systems or devices.
Section I-This section describes the operation and features of the WPMF. Column 3 is a description of the storage, operation, treatment, processing and maintenance of the material in the WPMF and the WPMF itself. Column 4 is a description of mechanical means to ensure that groundwater is protected. Column 5 describes the material stored in the WPMF. Crude oil impacted soil from spills, tank bottoms and spent sandblasting aggregate are the beneficial use materials allowed. Clean aggregate and fill may also be in the WPMF for mixing in preparation for use. Column 6 is a description of the sampling protocol and screening procedures. Column 6 must be filled out with a description acceptable to the Water Board. Column 8 is the expected period of time the WPMF will operate. In most cases, the WPMF will be operated year round. Column 9 identifies present and future land uses. Present land use should be oilfield, however, other uses may be occurring along with the oilfield operations. Columns 12, 13 and 14 (next page) require the identification of water wells and surface waters within ½ mile downgradient of the WPMF as well as the users and uses of this source of water.
Section J-Any other information that the applicant wants to include in the application to help the Water Board to make their decision on the application should be included here.
Section K-This section is used to describe Management Practices (non-structural and structural) that will be implemented to prevent pollutants from contacting storm water discharges. Examples of Non-structural Management Practices include training, annual reviews for effectiveness, etc. Examples of Structural Management Practices include construction of culverts to redirect flow, installation of rip rap to prevent erosion, etc. Section K also requires a map illustrating structural and non-structural Management Practices (See Section E).
Section L-This section describes strategies to control liquid buildup in the WPMF. In general, liquids are required to be removed when discovered. However, some liquids may be useful in controlling dust or useful in the reuse process (oil).
Section M-This section is a checklist for the attachments that are required as part of this form. They include the requirement to submit evidence that the landowner has been notified regarding the WPMF project, the fee and evidence that permits, if any are required, have been obtained.
Section N-This certification statement must be signed by a company employee of the senior vice-president or general partner level.
Site Inspection and Observation Log (WPM-1)-To be Submitted with Annual Report
This log can be used to fulfill the inspection/observation and logbook requirements found in Attachment 2 (General Monitoring and Reporting Program) to the Waste Pile Waiver. This form is self explanatory in most cases. Please note that there are a minimum of 3 inspections required per year; once during the pre-rainy season, once during the rainy season and once during the post rainy season. There are 2 location types for each inspection; the perimeter of the WPMF and within and around the WPMF. If offsite erosion or a washout is observed, it should be described in Column 10 and Form WPM-2 needs to be completed.
Maintenance and Repair Log (WPM-2)-To be Submitted with Annual Report
This form is to be completed and submitted to the Water Board with the annual report (WPM-3). It should be completed for every situation described in Column 10 on Form WPM-1.
Annual Report Form (WPM-3)-To be Submitted by October 1 Each Year
This form may be used to meet the annual reporting requirements of the Waste Pile Waiver. The reporting year covers July 1-June 30 and the report must be submitted by October 1 each year.
Section A-This section describes the status of WPMF and contains information on the source of the material transported to the WPMF. If any characterization occurred, the analytical should be included in the annual report.
Section B-This section is used to summarize Non-Structural and Structural Management Practices that were implemented before the rainy season.
Section C-This section is used for evaluating the effectiveness of the Management Practices implemented. Changes or improvements can also be entered here.
Section D-This section requires visual stormwater observations and dates. Reference to the Form WPM-1 (included in annual report) should be satisfactory.
Section E-This section is used to describe stabilization and erosion control measures which were implemented. Section B of this form as well as the inclusion of any Form WPM-2’s should be satisfactory.
Section F-Summarize violations (if any) that occurred during the reporting period.
Section G-This section requires a summary of Standard Observations. Form WPM-1 is included in the annual report and will provide necessary details.
Section H-Actions implemented to protect water quality should be described here. Ideally, they should come from Section B of this form.
Section I-Rainfall data is required in this section. A simple reference to an on-line data source will suffice.
Section J-Complete this section only if the Water Board Executive Officer has required you to perform monitoring.
Section K-All data and photos must be submitted in electronic format (Adobe Acrobat) using the Water Board Geotracker program.
Section L-Use this section to describe any recommendations you may have for improving your monitoring and reporting program.
Section M-This section requires you to submit maps that show monitoring locations (if any), physical features of the area of the WPMF, etc. A suitable USGS topographic map for your site can be obtained on line at websites such as
Section N-This section is used to summarize analytical results obtained during the reporting year. Additionally, any relevant monitoring performed that was not specifically part of this program should be included. Analytical results must be included as part of the annual report.
Section O-This section is a checklist for the attachments for the annual report.
Section P-This section must be filled out by the report preparer.
Section Q-This certification statement must be signed by a company employee of the Senior Vice-President or General Partner level.
B. SUBMITTAL CHECKLIST
Complete Form 200 Application / Report of Waste Discharge
(See
Complete supplemental application Form WPM-APP
Attach copy of CEQA document, Environmental Impact Report, or Negative Declaration (see Form 200 Section V)
Attach map(s) (see Form WPM-APP Section E)
Attach notification letter to property owner (see Form WPM-APP Section M)
If other agency permits are required, attach letter from local permitting agency certifying that it has the permitted the proposed project (See Form WPM-APP Section M)
Contact the Central Coast Regional Water Quality Control Board (Water Board) to determine submittal fee. Attach fee to application.
Submit application (Form 200, Form WPM-APP, maps, attachments, and fee) to:
CentralCoast Regional Water Quality Control Board, SLIC Unit
895 Aerovista Place
San Luis Obispo, CA93401
C. APPLICATION COMPLIANCE MATRIX
ROWD Requirement
/ LocationWaiver Condition 8.a / See Form WPM-APP Section A and attached map(s)
Waiver Condition 8.b / See Form WPM-APP Section B
Waiver Condition 8.c.i / See Form WPM-APP Sections B-C and attached map(s)
Waiver Condition 8.c.ii / See Form WPM-APP Section C and attached map(s)
Waiver Condition 8.c.iii / See Form WPM-APP Section C and attached map(s)
Waiver Condition 8.c.iv / See Form WPM-APP Section C and attached map(s)
Waiver Condition 8.d / See Form WPM-APP Sections E and I
Waiver Condition 8.e / See Form WPM-APP Section F
Waiver Condition 8.f / See Form WPM-APP Section G
Waiver Condition 8.g / See Form WPM-APP Section H
Waiver Condition 8.h.i / See Form WPM-APP Section I and attached map(s)
Waiver Condition 8.h.ii / See Form WPM-APP Section I
Waiver Condition 8.h.iii / See Form WPM-APP Section I
Waiver Condition 8.h.iv / See Form WPM-APP Section I
Waiver Condition 8.h.v / See Form WPM-APP Section I
Waiver Condition 8.h.vi / See Form WPM-APP Section E and attached map(s)
Waiver Condition 8.h.vii / See Form WPM-APP Section J
Waiver Condition 8.i.i / See Form WPM-APP Section E and attached map(s)
Waiver Condition 8.i.ii / See Form WPM-APP Section K.2
Waiver Condition 8.i.iii / See Form WPM-APP Section K.3
Waiver Condition 8.j / See Form WPM-APP Section L
Waiver Condition 8.k / See Form WPM-APP Section M
Waiver Condition 8.l / See Form WPM-APP Section M
Waiver Condition 8.m / See Form WPM-APP Section M
Form WPM-INS Rev 0 (02/10/06)Page 1 of 5
CENTRALCOAST WATER BOARD WASTE PILE MANAGEMENT FACILITIES PROGRAM (R3-2005-006)
REPORT OF WASTE DISCHARGE FORM WPM-APP
A. SOURCE MATERIAL
1. Lease or Fee Name / 2. Map ID / 3. Describe Location Where Source Material was Generated / 4. Latitude / 5. Longitude / 6. Lat-Long Datum(e.g. WGS84)
B. FACILITY LOCATION
1. Lease or Fee Name / 2. Map ID / 3. Describe Where WPMF Will Be Located with Reference to Oil Wells or Other Existing Landmarks * / 4. Latitude / 5. Longitude / 6. Lat-Long Datum(e.g. WGS84)
* WPMF = Waste Pile Management Facility
C. SITE PLAN
1. Lease or Fee Name / 2. Map ID / 3. WPMF Size(acres) / 4. Describe WPMF Physical Boundaries (e.g. berms) / 5. Storm Water Run-on and
Run-off Control Devices
D. CONSTRUCTION PLAN
- See Form WPM-APP Sections E & I
E. MAPS
1. Provide maps showing the following information (try to limit maps to a scale of 1:24,000 (7.5’ USGS Quadrangle) or a street map, if more appropriate):Location of all source material
Location, size, shape, and physical boundaries of each WPMF
Location of proposed infrastructure, storage, processing, and treatment at each WPMF
Location of storm water run-on and runoff control devices at each WPMF
Topographic scale map showing each WPMF as well as the location, users and uses of all water wells and surface water bodies (creeks, rivers, lakes, etc.) located within 0.5 miles downgradient of each WPMF
Location of structural and non-structural Management Practices for each WPMF
F. COMPLIANCE PLAN
1. Describe strategy/plan of action to achieve compliance (attach additional pages if necessary):G. MONITORING SYSTEM/DEVICES (Complete Sections G & H only if required by the Water Board Executive Officer, otherwise skip to Section I)
1. Lease or Fee Name / 2. Map ID / 3. Describe Monitoring System/Device / 4. Justification for Monitoring LocationH. MONITORING SYSTEM/DEVICES IMPLEMENTATION PLAN (Complete Sections G & H only if required by the Water Board Executive Officer, otherwise skip to Section I)
1. Describe implementation plan designed specifically for the proposed water quality monitoring program and as required by the General MRP (attach additional pages if necessary):Form WPM-APP Rev 0 (02/23/06)Page 1 of 5
CENTRALCOAST WATER BOARD WASTE PILE MANAGEMENT FACILITIES PROGRAM (R3-2005-006)
REPORT OF WASTE DISCHARGE FORM WPM-APP
I. WASTE PILE MANAGEMENT FACILITY
1. Lease or Fee Name / 2. Map ID / 3. Describe Storage, Operation, Treatment, Processing (Mixing), and Maintenance Activities / 4. Liner Details (e.g. 40 mil plastic, 2’ impermeable soil, adequate thickness of beneficial reuse material, etc.) / 5. Types of Waste Handled(e.g. tank bottoms, petroleum impacted soil from spills and leaks, spent sandblasting aggregate) / 6. Sampling and Analysis Protocol / Screening Procedures / 7. Total Volume of Waste Handling Capacity
(cu yds) / 8. Expected Time Period for WPMF Operation / 9. Present & FutureLand Use for WPMF Location
(If Known)
Minimum of one representative sample from each source or one representative sample per 2,500 cubic yards, whichever is less. Material shall be analyzed for:
- TPH full (EPA Method 8015)
- VOC’s (EPA Method 8260)
- PAH (EPA Method 8270 SIMS)
- PCB (EPA Method 8081)
- Title 22 metals (EPA Method 6020/7471)
- If elevated concentrations are detected, additional analyses may be required
- This list may be modified at the direction of the Executive Officer
Form WPM-APP Rev 0 (02/23/06)Page 1 of 5
CENTRALCOAST WATER BOARD WASTE PILE MANAGEMENT FACILITIES PROGRAM (R3-2005-006)
REPORT OF WASTE DISCHARGE FORM WPM-APP
I. WASTE PILE MANAGEMENT FACILITY (cont.)
10. Lease or Fee Name / 11. Map ID / 12. Identify All Water Wells and Surface Water Within 0.5 Miles Downgradient of WPMF / 13. Describe Users of Water Wells/ Surface Waters / 14. Describe Uses of Water Wells/ Surface WatersJ. OTHER INFORMATION
1. Describe any other information pertinent to protection of water quality or public health and prevention of nuisance (attach additional pages if necessary):K. MANAGEMENT PRACTICES (MP) PLAN
1. Provide map with locations of all proposed structural and non-structural Management Practices for each WPMF:- See attached map.
2. Describe non-structural MPs. These typically include processes, prohibitions, procedures, activity schedules, etc. that prevent pollutants from contacting storm water discharges (attach additional pages if necessary).
3. Describe structural MPs. These generally consist of structural devices that reduce or prevent pollutants in storm water discharges (attach additional pages if necessary).
L. LIQUIDS MANAGEMENT STRATEGY
1. Provide details on how liquid wastes (oily liquids, produced water, and storm water) will be managed including intended disposal methods (attach additional pages if necessary):M. ATTACHMENTS
1. Attach the following:Fee (contact the Central Coast Water Board to determine fee)
Landowner Notification (copy of formal notification letter sent to landowner regarding project)
Permitting Approval (if other agency permits are required, copy of letter from local permitting agency certifying it has permitted the project)
N. CERTIFICATION
“I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the information is true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment.”Print Name: / Title:
Signature: / Date:
Form WPM-APP Rev 0 (02/23/06)Page 1 of 5
CENTRALCOAST WATER BOARD WASTE PILE MANAGEMENT FACILITIES PROGRAM (R3-2005-006)
MONITORING AND REPORTING FORM WPM-1
SITE INSPECTION AND OBSERVATION LOG
1. Company Name: / 3. Inspector’s Name: / 5. Inspection Type and Frequency (Check one):Pre-Rainy Season (At least once before October 1)
During Rainy Season (At least once from October 1 to April 1)
Post Rainy Season (At least once after April 1)
Failed Management Measure / Discharge Reported (Per event)
2. Lease or Fee Property: / 4. Signature:
6. Date/Time
(See Item 5 for required inspection frequencies) / 7. Waste Pile Facility / 8. Waste Pile Facility Perimeter / 9. Within and Around Waste Pile Facility / 10. If off-site erosion or washout (storm water, sedimentation, etc.) is observed, then briefly describe problem below and complete Form WPM-2
8a. No Liquid Entering / 8b. No Liquid Leaving / 8c. Size of Affected Area * / 8d. Flow Rate * / 8e. No Erosion or Sedimen-tation / 8f. No Perimeter Integrity Issues / 9a. No Ponding On or Adjacent to Waste Pile, Treatment, or Processing Area / 9b. No Erosion or Sedimentation in the Immediate Vicinity of a Waste Pile, Treatment, or Processing Area
* If liquid is observed to enter or leave the waste pile facility, then record the affected area size (Item 8c), record flow rate (Item 8d), and attach map of affected area.
Form WPM-1 Rev 0 (02/10/06)Page 1 of 1Submit Form WPM-1 with Annual Report Form WPM-3
CENTRALCOAST WATER BOARD WASTE PILE MANAGEMENT FACILITIES PROGRAM (R3-2005-006)