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Submission of this completed Notice of Intent (NOI) constitutes notice that the entity in Section A intends to be authorized to discharge pollutants to waters
of the United States, from the vessel identified in Section B, under EPA's Vessel General Permit (VGP). Submission of the NOI also constitutes notice that
the party identified in Section A of this form has read, understands, and meets the eligibility conditions of Part 1 of the VGP; agrees to comply with all
applicable terms and conditions of the VGP; and understands that continued authorization under the VGP is contingent on maintaining eligibility for
coverage. In order to be granted coverage, all information required on this form must be completed. Please read and make sure you comply with all permit
requirements.
B. Vessel Information
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NPDES Permit Tracking Number: VPAAD598O
D. Discharge Information
1. All applicable discharges vessel may generate: Anti-fouling hull coatings; Aqueous Film Forming Foams (AFFF); Ballast Water; Bilgewater/Oily Water
Separator Effluent; Boiler/Economizer Blowdown; Controllable Pitch Propeller Hydraulic Fluid and other Oil-to-Sea Interfaces; Deck Washdown and
Runoff; Firemain Systems; Freshwater layup; Graywater; Graywater Mixed with Sewage; Refrigeration and Air Condensate Discharge; Seawater Cooling
Overboard Discharge; Seawater Piping Biofouling Prevention; Underwater Ship Husbandry
2. Does Vessel ever engage in or have capacity to engage in industrial operations? N
2a. If Yes, please provide:
3. Will the vessel be using a ballast water treatment system which discharges residual biocides? N
3b. Are residual biocide concentrations expected to be below those listed in Part 2.2.3.5.1.1.5 of the permit?
3c. List the biocide residuals or derivatives that may be discharged by the ballast water treatment system:
4. Is your vessel required to collect analytical monitoring? N
If so, for which of the discharges must you conduct monitoring:
If Graywater, do you use a treatment system for Graywater?
5. Does the vessel have onboard treatment systems for any waste stream(s) covered by this permit? Y
5a. On board treatment system: Bilgewater
5b. Treatment System Type/Design: SBT 40
5c. Treatment System Manufacturer: TAIKO KIKAI
5d. Treatment System Capacity: 4 cubic meters/hour
Average Treatment System Flow Rate: 3.4 cubic meters/hour
Peak Treatment System Flow Rate: 3.8 cubic meters/hour
5e. Residuals (wastes) generated by this treatment system: Oil and sludge
5f. How are residuals generated by this treatment system disposed? Incineration and landing ashore
5g. Is the system type approved by the US Coast Guard? Y
5h. For ballast water, has the system been determined by the US Coast Guard to be an alternative management system (AMS)?
6. Ballast Water and Invasive Species Management
6a. How often is the ballast tank cleaned and sediment disposed of? Every 2-4 years
6b. How and where do you typically dispose of ballast tank sediment? Dry dock
6c. Does vessel have an existing ballast water management plan? Y
7a. Type of anti-fouling hull coating on the vessel: Copper Based
List specific product(s): Organotin-Free self Polishing Type
7b. When was anti-fouling hull coating last applied? 11/28/2013
Where was anti-fouling coating last applied?
7c. Describe hull husbandry practices, such as frequency of hull cleaning, method used, how niches and propellers are cleaned, etc: Scrubbing, Power
wash
7d. Date Of last hull cleaning: 11/20/2013
7e. Method of last hull cleaning: Scrubbing, Power wash
7f. Location of last hull cleaning:
7g. Date of next scheduled/anticipated hull cleaning:
7h. Anticipated method of next cleaning: High pressure cleaning
7i. Planned location of next cleaning: Dry dock
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 gathered and evaluated the information contained therein. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the information, the information contained is, to the best of my
knowledge and belief, true, accurate, and complete. I have no personal knowledge that the information submitted is other than 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.
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NPDES Permit Tracking Number: VPAAD598O
NOI Preparer (Complete if NOI was prepared by someone other than the certifier)
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