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Groundwater VOC and Fuel General Permit ORDER NO.R2-2012-0012 <br /> NPDES NO.CAG912002 <br /> Table B-5. Dischar e location information <br /> Dischar e Point Location Dischar e Point Latitude Dischar e Point Lon itude Receivin Water <br /> Storm Drain Location Not applicable(complete the <br /> where dischar e enters: ° ' " ° ' " row below <br /> Location where discharge <br /> enters receiving water <br /> either directly ar via storm ° ' " ° ' °° <br /> drain s stem: <br /> Table B-6. List of pollutants (For new and existing discharges. For existing discharges, complete <br /> one table for influent and one for effluent <br /> Monitoring data since effective Pollutant 1 Pollutant 2 Pollutant 3 Add Columns and/or tables as needed(ail <br /> date of the initial discharge detected pollutants with effluent limitations <br /> and all triggered pollutants exceeding the <br /> authorization letter,or estimated triggers shall be listed in this table) <br /> from groundwater monitoring <br /> data for new dischar es <br /> Number of Samples <br /> Maximum Concentration <br /> Average Concentration(average of <br /> detected ollutants onl <br /> Number of times the effluent <br /> limitation was exceeded <br /> Median Concentration <br /> Minimum Concentration <br /> Number of Non-Detects <br /> Lowest Reporting Limit <br /> Highest Reporting Limit <br /> Number of Samples with Lowest <br /> Re ortin Limit <br /> Most recent sample Date,Method <br /> Number <br /> Note:The Regional Water Board may modify this form at any time to reflect any new fees and other needed improvements <br /> as applicable. <br /> Attachment B—NOI Application Forn1 and Instructions B-4 <br />