NCS000538_HISTORICAL WITH APPLICATION_20100628

STORMWATER DIVISION CODING SHEET
PERMIT NO.
h 1. � DOD � -3
1�
DOC TYPE
❑FINAL PERMIT
❑ MONITORING INFO
APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ 2p(o Dfo26
YYYYMMDD

.A'"4iA'
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Mr. Torld Blair, GM,
Roll -Tech, LLC
243 Performance Drive SE'
Hickory, North Carolina 28602 .
Dear Mr. Blair:
Coleen H. Sullins
Director
June 28, 2010
Subject: Draft NPDES Stormwater Permit
Permit No. NCS000538
Roll -Tech, LLC
Catawba County
Dee Freeman
Secretary
Enclosed with this letter is a copy of the draft stormwater permit for your facility in response to your
request for coverage under an individual NPDES stormwater permit received June 9, 2010. Please review
the draft carefully to ensure thorough understanding of the conditions.and requirements it contains.
Please note that analytical monitoring is required under this permit for parameters including BOD, COD,
TSS, pH, Zinc, and Lead at an initial frequency of quarterly, then semi-annually for the remainder of the
permit. Analytical results submitted with your application showed highly polluted levels of BOD and COD
at all outfall locations as well as greater than expected variability in pH, particularly at the NE outfall. It is
recommended that these discharges be expeditiously investigated to locate and correct cause of the
observed results.
Please submit any comments to my attention no later than thirty (30) days following your receipt of the
draft. Comments should be sent to my attention at the address listed at the bottom this letter. If no
adverse comments are received from the public or Roll -Tech, this permit will likely be issued within two
months.
If you have any questions or comments concerning this draft permit, feel free to contact me at (919) 807-
6365 or [e-mail].
Sincerely,
trysen
Environmental Engineer
Stortr,tvater Permitting Unit
cc: Mooresville Regional Office, Wes Bell
Central Piles .
Stormwater Permitting Unit
Wetlands and Stormwater Branch One 1
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 NorthCar011na
Location: 512 N. Salisbury S!. Raleigh, North Carolina 27604 l�
���ur� r
Phone: 91 M07.63001 FAX: 91 M07.64941 Customer Service:1-877-623-6748
Inlemet: www.ncwaterquality,org
An Equal Opportunity 1 Affirmative Aeon Employer

AfJ1;AV
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H, Sullins Dee Freeman
Governor Director Secretary
June 17, 2010
Individual NPDES Stormwater Permit Renewal Transmittal Cover`
.Page ..... -,
Mooresville Regional Office, Wes Bell
Subject: NPDES Stormwater Permit No. NCS000538 JUN' 2 j 2010
Roll -Tech, LLC.
Hickory, NC (Catawba County)
Attachment Description
Staff Report
Draft Permit
Renewal Application
Wes,
Please review, sign and return the staff report if acceptable to you and MRO for this draft permit.
Call me if you'd like to discuss 919-807-6365. Thanks.
Return to Cory Larsen at the Central Office by July 20, 2010 if possible.
Cory Larsen
io' Division of Water Quality
' Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Wetlands and Stormwaler Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 .
Phone: [phone] FAX [phone] Customer Service: 1-877.623.6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
None
rthCarolina
Natura!!Y

•'NCS060538
A';
CCD NR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
STAFF REVIEW AND EVALUATION
NPDES Stormwater Permit
Facility Name:
[Loll -Tech, LLC
NPDES Permit Number:
NCS000538
Facility Location:
243 Performance Drive SE, Hickory, NC (Catawba Co), See Figure I
Type of Activity:
Tire/wheel Mfg.
SIC Code (if applicable):
3011.: Tires and Inner Tube Mfg (primary)
3089: Plastic Products Mfg (secondary)
Receiving Streams:
Miller Branch.
River Basin:
Catawba River Basin, Sub -basin 03-08-35
Stream Classification:
C
Proposed Permit Requirements:
See attached draft permit.
Monitoring Data:
See Table 1
Response Requested by (Date):
July 20, 2010
Central Office Staff Contact:
Return to Cory Larsen, [phone]; [e-mail]
Special Issues:
Issue
Rating Scale: i(easy) to
10(hard)
Com liance histor
N/A
Benchmark exceedance
N/A
Location (TMDL, T&E species,
etc)
3
Other Challenges:
7
• Withdrawing NCG
application and
requesting
NCS
Difficult Rating:
(10)/40
Description of Onsite Activities:
• Rol! -'tech manufactures solid rubber tired wheels. Tires are compression melded. from
crumb rubber (ground truck tires) and hubs are injection molded from post -consumer
plastics.
Pagel of 8

NCS000538 l' 1
Documents Reviewed:
• EPA TRI Data & MSGP
• 2008 303(d) List
• NC TMDLs
• Catawba Basinwide.Plan (BWP)
• NC Natural heritage Program for T&E
History:
• Applied for NCG05: 12/10/20()9
• Site Visit Performed by Wes Bell of MRO: 01/13/2010
• Application for NCS Permit Submitted: 06/09/2010
Page 2 of 8

NCS000538
NCS000538
Map Scale 1:20,000
ROLL -TECH, LLC
Lati tude: 340 43' 10" N
Longitude, 810 16' 51" W
County : Catawba
Receiving Streams: Hiller Branch
Stream Class: C
Sub -basin. 03-08-35 (Catawba River Basin)
Figure 1: Location Map of Facility
=I
Facility Location
Page 3 of 8

NCS000538
Central Office Review Summary:
1. Owner's Other Permits:
• N/A
2. General Observations:
• Relatively small facility with approximately 40% impervious area;
• Three (3) identified SDOs.
3. Impairment:
o None.
4. Threatened and End angered-Lwithin _ 2 miles):
o No aquatic species returned in search.
3. Location:
o The facility is located near downtown Hickory in an industrial park area.
6. Industrial Changes Since Previous Permit:
o N/A - New permit.
7, Analytical Monitoring -Notes:
o Five parameters were analyzed at three (3) SDO locations (NE and NW corners of plant,
loading dock) and reported on EPA Form 2F: TSS, pH, BOD, COD, and Zn;
o Exceedances of benchm.a..rk values for.all parameters were observed, except for TSS;
o BOD and COD benchmark exceedances were unexpectedly high in comparison tO TSS results.
Further investigation will be necessary to identify source;
o pFl was highly variable considering proximity of sample locations;
o See Table 1 for full summary.
8. Qualitative Monitoring Notes:
o N/A - New permit.
Page 4 of 8

NCS000538
Table 1: Analytical Monitoring
Sample
Date
Total Flow
(MGD)
Precip.
(in)
Duration
(hours)
TSS
COD
BOD5
Zn
IRH
Benchmark:
100 mgIL
Benchmark:
120 mg/L
Benchmark:
30 mg(L
Benchmark:
0.067 mg/L
Benchmark:
6-9 Su
NW
5/171201 011.;
„'; s —1
0-5
1 0-5
1 5
8.25 1
NE
5117120101�;�-.T-',,�
5,�; 1 0.5
1 0.5 1 17 N
DOCK
5/17/2010[,,---'-' ' -
1 0.5
0.5 5 7.74
Over Current Benchmark
Data Not Collected
ND = not detected
NA = not applicable
Page 5 of 8

NCS0005:38
Revised Permit Recommendations: Analytical Monitoring:
1. Proposed strategy: Initial frequency set to quarterly based on elevated analytical results to help
encourage more rapid investigation of pollutant sources and solutions to bring results back within
benchmark concentrations. Semi-annual frequency will be scheduled to begin Year 3 once discharges
normalize following SPPP and/or Tier response actions (if any).
a. Adding parameters:
i. BOD — high levels of BOD/CUD observed in analytical results;
ii. COD — high levels of BOD/COD observed in analytical results;
iii. TSS — standard addition. Will help in locating source of BUD/COD;
iv. pH — standard addition plus one benchmark exceedance observed with initial results;
v. Zinc — 2008 MSGP recommendation. Crumb rubber contains high concentrations of
zinc (see literature in file);
vi. Lead — Crumb rubber contains a significant amount of lead (see literature in file). May
be useful to monitor in conjunction with zinc for monitoring purposes.
2. New individual permit template utilized that includes the Tiered monitoring system, analytical and
qualitative monitoring required during representative storm events, and annual summary DMR due
to RO in March of every year
3. Qualitative monitoring required regardless of representative outfall status. Qualitative monitoring
to be performed at same: schedule as analytical monitoring.
Discussion with Permittee: `Todd Blair, General Manager, 2010, Todd Blair [,[e-mail]]
Informed facility that it was not eligible for NCG05 permit due to their industrial activities and
SIC codes in December 2009.
o See correspondence in file.
Wes Bell visited in January 2010 to confirm that permit coverage was required or qualify for No
Exposure.
o See emails in file.
• Assisted applicant with directions for competing required forms for individual permit coverage
and provided minimum set of pollutant parameters to analyze for in April 2010.
Page 6 of 8

NCS0005 78
Recommendations: Based on the documents reviewed and RO site visit, the application information
submitted on June 9, 2010 is deemed sufficient to issue an individual Stormwater Permit.
Prepared by (Signature)
Stormwater Permitting Unit Supervisor �
Date 6 ! / & / o
Date "141,fe 16 2,010
for Bradley Bennett
Concurrence by Regional Office �t�t/.r�— ter_/`' ' Date WZ,9
Water Quality Supervisor Date CA - 11b
Regional Office Staff Comments
r SSNeel ei`ir1 i i '40,d[>f P Gloci f�/ T; CCL
Ot P� �/ Y1 c�� r �'I� �' i�C,� �` S e
e. fk) 4e n I �5 �C d 'P7 G� `
° Page 7of8

NCS000538
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE STORMWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE EL}IMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute'143-2153, other lawful
standards and regulations promulgated and adopted by the,North Carolina Environmental
Management Commission, and the Federal Water Pollution oCntrol Act, as amended,
ROLL; TECHt LLC
is hereby authorized*to discliarge,sorm twater from a facility located at
Ao11-Tech, LLC
e formance Drive SE
Hickory, NC
Catawba County
to receiving waters designated as Miller Branch, a class C stream in the Catawba River Basin, in
accordance with the discharge limitations, monitoring requirements, and other conditions set
forth in Parts I, II, III, IV, V and VI hereof.
Note: Draft Permit Dates are Approximate
This permit shall become effective [September 1, 2010].
This permit and the authorization to discharge shall expire at midnight on [August 31, 2015].
Signed this day [August 31, 2010].
for Coleen H. Sullins Director
Division of Water Quality
By the Authority of the Environmental Management Commission

Permit No. NCS000538
PART
Section A:
Section B:
Section C:
PART II
Section A:
Section B:
Section C:
Section D:
PART III
Section A:
Section B:
TABLE OF CONTENTS
INTRODUCTION
Individual Permit Coverage
Permitted Activities
Location Map
MONITORING, CONTROLS, AND LIMITA
DISCHARGES
Stormwater Pollution Prevention Plante
Analytical Monitoring Requir mnts�
Qualitative Monitoring Re irU s
FOR PERMITTED
On -Site Vehicle iMain a�r1cMonitoring Requirements
STANDARD CONDITIONS FOR NPDES STORMWATER INDIVIDUAL
PERMITS
Compliance and Liability
1. Compliance Schedule
2. Duty to Comply
3. Duty to Mitigate
4. Civil and Criminal Liability
5. Oil and Hazardous Substance Liability
6. Property Rights
7. Severability
8. Duty to Provide Information
9. Penalties for Tampering
10. Penalties for Falsification of Reports
General Conditions
1. Individual Permit Expiration
2. Transfers
3. Signatory Requirements
1

Permit No. NCS000538
4. Individual Permit Modification, Revocation and Reissuance, or
Termination
5. Permit Actions
Section C: Operation and Maintenance of Pollution Controls
1. Proper Operation and Maintenance
2. Need to Halt or Reduce Not a Defense
3. Bypassing of Stormwater Control Facilities
Section D: Monitoring and Records
1.
Representative Sampling
2.
Recording Results
3.
Flow Measurements
4.
Test Procedures
5.
Representative Outfall
6.
Records Retention
7.
Inspect�ionwand�Ept
;1 A
Section E: Reporting
Requirements_
I .
Discharge Monitoring Reports
2.
S6ittingtReports
3.
AvaiW50ity of Reports
4.
Nan-Stormwater Discharges
5.
Planned Changes
6.
Anticipated Noncompliance
7.
Spills
8.
Bypass
9.
Twenty-four Hour Reporting
10.
Other Noncompliance
11.
Other Information
PART IV LIMITATIONS REOPENER
PART V ADMINISTERING AND COMPLIANCE MONITORING FEE
REQUIREMENTS
PART VI DEFINITIONS
T

Permit No. NCS000538
PART I INTRODUCTION
SECTION A: INDIVIDUAL PERMIT COVERAGE
During the period beginning on the effective date of the permit and lasting until expiration, the
permittee is authorized to discharge stormwater associated with industrial activity. Such
discharges shall be controlled, limited and monitored as specified in this permit.
If industrial materials and activities are not exposed to precipitation or runoff as described in 40
CFR § I22.26(g), the facility may qualify for a No Exposure Exclusion from NPDES stormwater
discharge permit requirements. Any owner or operator wishing:ko' obtain a No Exposure
Certification must submit a No Exposure Certification NOI form to the Division; must receive
approval by the Division; must maintain no exposure conditions unless authorized to discharge
under a valid NPDES stormwater permit; and must reapply for the`No Exposure Exclusion once
every five (5) years.
SECTION B: PERMITTED ACTIVITIES
Until this permit expires or is modified or revoked, the permittee is authorized to discharge
stormwater to the surface waters of North Carolina or separate storm sewer system that has been
adequately treated and managed in accordance with the terms and conditions of this individual
permit. All stormwater discharges shall•bein accordance with the conditions of this permit.
Any other point source discharge_tsurface waters of the state is prohibited unless it is an
allowable non-stormwater discharge or is covered by another permit, authorization, or approval.
The stormwater discharges allowed by this individual permit shall not cause or contribute to
violations of Water Quality Standards.
This permit does not relieve the permittee from responsibility for compliance with any other
applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or decree.
Part I Page 1 of 2

SECTION C: LOCATION MAP
Permit No. NCS000538
NCS000538
ti
Allap Scale 1.-20,000
; rI
� Roll -Tech, LLCyc'`
Ilk
may. ` r , i ``� �!`.•,�'����J 1
pop
IF yx
A.
F - �
ROLL -TECH, LLC
Latitude: 340 43' 40" N
LongiUide: 810 1651" W
County; Catawba
Receiving Streams: Miler Branch
Stream Class: C
Sub -basin: 03-08-35 (Catawba River Basin)
Facility Location
Part I Page 2 of 2

Permit No. NCS000538
PART II MONITORING, CONTROLS, AND LIMITATIONS FOR
PERMITTED DISCHARGES
SECTION A: STORMWATER POLLUTION PREVENTION PLAN
The Permittee shall develop a Stormwater Pollution Prevention Plan, herein after referred to as
the Plan. This Plan shall be considered public information in accordance with Part III, Standard
Conditions, Section E, Paragraph 3 of this individual permit. The Plan shall include, at a
minimum, the following items:
1. Site Plan. The site plan shall provide a description of the physical facility and the
potential pollutant sources which may be expected to cone butc to contamination of
stormwater discharges. The site plan shall contain the,following:
{�-� \��
(a) A general location map (USGS quadr� gle,map or appropriately drafted
equivalent map), showing the facility_s location in relation to transportation routes
and surface waters, the name of the receivingewater(s) to which the stormwater
w-
outfall(s) discharges, or if the discharge is to a municipal separate storm sewer
system, the name of the municipality and the ultimate receiving waters, and
accurate latitude and longitude of the point(s) of discharge. The general location
map (or altematively,the•sitd map) shall identify whether each receiving water is
impaired (on the stat'' 3a3(d)-,list of impaired waters) or is located in a
watershed for whicli a TMDL has been established, and what the parameter(s)
of concern are.!/"
(b) A narrative dbsciiptibn of storage practices, loading and unloading activities,
outdoor process areas, dust or particulate generating or control processes, and
waste disposal practices. A narrative description of the potential pollutants which
could be expected to be present in the stormwater discharge from each outfall.
(c) A site map drawn to scale (including a distance legend) showing: the site property
boundary, the stormwater discharge outfalls, all on -site and adjacent surface
waters and wetlands, industrial activity areas (including storage of materials,
disposal areas, process areas, loading and unloading areas, and haul roads), site
topography, all drainage features and structures, drainage areas for each outfall,
direction of flow in each drainage area, industrial activities occurring in each
drainage area, buildings, existing BMPs, and impervious surfaces. The site map
must indicate the percentage of each drainage area that is impervious.
(d) A list of significant spills or leaks of pollutants that have occurred at the facility
during the three (3) previous years and any corrective actions taken to mitigate
spill impacts.
(e) Certification that the stormwater outfalls have been evaluated for the presence of
non-stormwater discharges. The certification statement will be signed in
accordance with the requirements found in Part III, Standard Conditions, Section
Part II Page 1 of 10

Permit No. NCS000538
B, Paragraph 5. The permittee shall re -certify annually that the stormwater
outfalls have been evaluated for the presence of non-stormwater discharges.
2. .Stormwater Management Plan. The stormwater management plan shall contain a
narrative description of the materials management practices employed which control or
minimize the exposure of significant materials to stormwater, including structural and
nonstructural measures. The stormwater management plan, at a minimum, shall
incorporate the following:
(a) Feasibility Study. A review of the technical and economic feasibility of changing
the methods of operations and/or storage practices to eliminate or reduce exposure
of materials and processes to stormwater. Wherever practical, the permittee shall
prevent exposure of all storage areas, materiall'.1handling operations, and
manufacturing or fueling operations. In areas where elimination of exposure is
not practical, the stormwater management plan shalhdocument the feasibility of
diverting the stormwater runoff away from,areas of potential contamination.
(b) Secondary Containment Requirements and Records. Secondary containment is
required for: bulk storage of ligdidmatenals; storage in any amount of Section
313 of Title III of the Superfund Amend a is and Reauthorization Act (SARA)
water priority chemicals; and/torage,iffany amount of hazardous substances, in
order to prevent leaks and :spills from contaminating stormwater runoff. A table
or summary of alhucli.ta��nk wand stored materials and their associated secondary
containment areas,shall be•maintained. If the secondary containment devices are
connected to stormwater conveyance systems, the connection shall be controlled
by manually activated valves or other similar devices (which shall be secured
closed with a(locking;mechanism), and any stormwater that accumulates in the
containment area -shall be at a minimum visually observed for color, foam, outfall
staining, visible sheens and dry weather flow, prior to release of the accumulated
stormwater. Accumulated stormwater shall be released if found to be
uncontaminated by any material. Records documenting the individual making the
observation, the description of the accumulated stormwater, and the date and time
of the release shall be kept for a period of five years.
(c) BMP Summary. A listing of site structural and non-structural Best Management
Practices (BMP) shall be provided. The installation and implementation of BMPs
shall be based on the assessment of the potential for sources to contribute
significant quantities of pollutants to stormwater discharges and data collected
through monitoring of stormwater discharges. The BMP Summary shall include a
written record of the specific rationale for installation and implementation of the
selected site BMPs. The BMP Summary shall be reviewed and updated annually.
Spill Prevention and Response Plan. The Spill Prevention and Response Plan (SPRP)
shall incorporate an assessment of potential pollutant sources based on a materials
inventory of the facility. Facility personnel (or the team) responsible for implementing the
SPRP shall be identified in a written list incorporated into the SPRP and signed and dated
by each individual acknowledging their responsibilities for the plan. A responsible
Part II Page 2 of 10

Permit No. NCS000538
person shall be on -site at all times during facility operations that have the potential to
contaminate stormwater runoff through spills or exposure of materials associated with the
facility operations. The SPRP must be site stormwater specific. Therefore, an oil Spill
Prevention Control and Countermeasure plan (SPCC) may be a component of the SPRP,
but may not be sufficient to completely address the stormwater aspects of the SPRP. The
common elements of the SPCC with the SPRP may be incorporated by reference into the
SPRP.
4. Preventative Maintenance and Good Housekeeping Program. A preventative
maintenance and good housekeeping program shall be developed. The program shall list
all stormwater control systems, stormwater discharge outfalls, all on -site and adjacent
surface waters and wetlands, industrial activity areas (including material storage areas,
material handling areas, disposal areas, process areas loading and unloading areas, and
haul roads), all drainage features and structures andexisting structural BMPs. The
program shall establish schedules of inspections, maintenance and housekeeping
activities of stormwater control systems, as well as facility -equipment, facility areas, and
facility systems that present a potential for stormwater "exposure or stormwater pollution.
Inspection of material handling areas and regular cleaning schedules of these areas shall
be incorporated into the program. Timelcompliance with the established schedules for
inspections, maintenance, and housekeeping shall"be recorded in writing and maintained
in the SPPP.
5. Employee Training. Training programs, s ,hall be developed and training provided at a.
minimum on an annual b asis-f6r, facility personnel with responsibilities for: spill response
and cleanup, preventative maimenance activities, and for any of the facility's operations
that have the potential to contaminate stormwater runoff. Facility personnel (or team)
responsible for implementing the training shall be identified, and their annual training
shall be documented by -the signature of each employee trained.
6. Responsible Party. The Stormwater Pollution Prevention Plan shall identify a specific
position(s) responsible for the overall coordination, development, implementation, and
revision to the Plan. Responsibilities for all components of the Plan shall be documented
and position assignments provided.
7. Plan Amendment. The permittee shall amend the Plan whenever there is a change in
design, construction, operation, or maintenance which has a significant effect on the
potential for the discharge of pollutants to surface waters. All aspects of the
Stormwater Pollution Prevention Plan shall be reviewed and updated on an annual
basis. The annual update shall include an updated list of significant spills or leaks of
pollutants for the previous three years, or the notation that no spills have occurred. The
annual update shall include written re -certification that the stormwater outfalls have been
evaluated for the presence of non-stormwater discharges. Each annual update shall
include a documented re-evaluation of the effectiveness of the BMPs listed in the BMP
Summary of the Stormwater Management Plan.
The Director may notify the permittee when the Plan does not meet one or more of the
minimum requirements of the permit. Within 30 days of such notice, the permittee shall
Part II Page 3 of I O

Permit No. NCS000538
submit a time schedule to the Director for modifying the Plan to meet minimum
requirements. The permittee shall provide certification in writing (in accordance with
Part.I1I, Standard Conditions, Section B, Paragraph 5) to the Director that the changes
have been made.
8. Facility Inspections. Inspections of the facility and all stormwater systems shall occur as
part of the Preventative Maintenance and Good Housekeeping Program at a minimum on
a semi-annual schedule, once during the first half of the year (January to June), and once
during the second half (July to December), with at least 60 days separating inspection
dates (unless performed more frequently than semi-annually). These facility inspections
are different from, and in addition to, the stormwater discharge characteristic monitoring
required in Part II B and C of this permit.
9. Implementation. The permittee shall implement the 1?1anImplementation of the Plan
shall include documentation of all monitoring;; -measurements inspections, maintenance
activities, and training provided to employees ncluding the tog of the sampling data and
of actions taken to implement BMPs associated with,the industrial activities, including
vehicle maintenance activities. Such documentation shall be kept on -site for a period of
five years and made available to the Director/a>he;Director's authorized representative
immediately upon request. ,
Part I1 Page 4 of 10

Permit No. NCS000538
SECTION B: ANALYTICAL MONITORING REQUIREMENTS
Analytical monitoring of stormwater discharges shall be performed as specified in Table 1. All
analytical monitoring shall be performed during a representative storm event. The required
monitoring will result in a minimum of 14 analyticaI samplings being conducted over the term of
the permit at each stormwater discharge outfall (SDO).
A representative storm event is a storm event that measures greater than 0.1 inches of rainfall. The time
between this storm event and the previous storm event measuring greater than 0.1 inches must be at least
72 hours. A single storm event may have a period of no precipitation of up to 10 hours. For example, if
it rains but stops before producing any collectable discharge, a sample may be collected if the next rain
producing a discharge begins within 10 hours.
%�
Table 1. Analytical MonitoringRe uirements"i
Discharge
Characteristics
Units
Measurement
Fre uenc l
Sample
TypC2
Sample
Location3
Total Suspended Solids
m L
Quarterly, semi annual
Grab
SDO
Chemical Oxygen Demand
m L
/,Quarterly, seir►i-annual
Grab
SDO
Biochemical Oxygen Demand
m L. ;
/Quarterly, semi-annual
Grab
SDO
Zinc, Total Recoverable
f m
Quarterly, semi-annual
Grab
SDO
Lead, Total Recoverable
-- \ ,�
t Quarterly, semi-annual
Grab
SDO
H
Tstandard
` Quarterly, semi-annual
Grab
SDO
Total Rainfal14
inchJes
Quarterly, semi-annual
ain Gauge
I -
Footnotes:
I Measurement Frequency: Four times per year during a representative storm event for Year I and Year 2, then twice per
year for the remainder of the permit according to the schedule in Table 2.
2 Grab samples shall be collected within the first 30 minutes of discharge.
3 Sample Location: Samples shall be collected at each stormwater discharge outfall (SDO) unless representative outfall
status has been granted.
4 For each sampled representative storm event the total precipitation must be recorded. An on -site rain gauge or local rain
gauge reading must be recorded.
The permittee shall complete the minimum ten analytical samplings in accordance with the
schedule specified below in Table 2. A minimum of 30 days must separate sample dates
unless monthly monitoring has been instituted under a Tier Two response.
Part I1 Page 5 of 10

Permit No. NCS000538
Table 2. Monitoring Schedule
Monitoring period"'
Sample Number
-, ""Starf ,
End
Year 1 = Period 1
1
September 1, 2010
November 30, 2010
Year 1 — Period 2
2
December 1, 2010
February 28, 2011
Year 1 — Period 3
3
March 1, 2011
May 31, 2011
Year 1 — Period 4
4
June 1, 2011
August 31, 2011
Year 2 — Period 1
5
September 1, 2011
November 30, 2011
Year 2 — Period 2
6
December 1, 2011
February 29, 2012
Year 2 — Period 3
7
March 1, 2012
May 31, 2012
Year 2 -- Period 4
8
June 1, 2012
August 31, 2012
Year 3 — Period 1
9
September 1, 2012
February 28, 2013
Year 3 — Period 2
10
March 1, 26113
August 31, 2013
Year 4 — Period 1
11
Sepfemberl 2013
February 28, 2014
Year 4 — Period 2
12
1VMarchtil , 2014--,
August 31, 2014
Year 5 — Period 1
13
Sel0mber14_2014
February 28, 2015
Year 5 — Period 2
14
/f March 11 2015
August 31, 2015
Footnotes: ���
1 Maintain semi-annual monitoring during permit r ewalrprocess. If at the expiration of the Individual
Permit, the permittee has submitted an appjicationlforrenewal of coverage before the submittal deadline,
J
the permittee will be considered for renewed coverage. The applicant must continue semi-annual
monitoring until the renewed per nit`is issued
2 If no discharge occurs during the:sampling period, the permittee must submit a monitoring report indicating
"No Flow" within 30 days of;the endof the six-month sampling period.
The permittee shall report the alytical results from each sample within the monitoring period. The
permittee shall compare monitoring results to the benchmark values in Table 3. The benchmark
values in Table 3 are not permit limits but should be used as guidelines for the permittee's
Stormwater Pollution Prevention Plan (SPPP). Exceedences of benchmark values require the
permittee to increase monitoring, increase management actions, increase record keeping, and/or
install stormwater Best Management Practices (BMPs) in a tiered program. See below the
descriptions of Tier One and Tier Two.
Table 3. Benchmark Values for Analytical Monitoring
Discharge Characteristics
Units
Benchmark
Total Suspended Solids
mg/L
100
Chemical Oxygen Demand
mg/L
120
Biochemical Oxygen Demand
mg/L
30
Zinc, Total Recoverable
mg/L-
0.067
Lead, Total Recoverable
mg/L
0.03
pH
standard
6-9
Part 11 Page 6 of 10

Permit No. NCS000538
Tier One
If: The first valid sampling results are above a benchmark value, or outside of the benchmark range, for any
parameter at any outfall;
Then: The permittee shall:
1. Conduct a stormwater management inspection of the facility within two weeks of receiving
sampling results.
2. Identify and evaluate possible causes of the benchmark value exceedencc.
3. Identify potential and select the specific: source controls, operational controls, or physical
improvements to reduce concentrations of the parameters of concern, or to bring concentrations
within the benchmark range.
4. Implement the selected actions within two months of the inspection.
5. Record each instance of a Tier One response in the Skormwater.Pollution Prevention Plan. Include
the date and value of the benchmark exceedence, the_ nspecttan date, the personnel conducting the
inspection, the selected actions, and the date the selected.actions were implemented.
Tier Two
If: During the term of this permit, the first valid sampling results from two consecutive monitoring periods
are above the benchmark values, or outside of thid benchmark range, for any specific parameter at a
specific discharge outfall;
Then: The permittee shall:<\
�--f
1. Repeat all the required actions, outlined, above in Tier One.
P
2. Immediately institute monthly monitoring of r all parameters at every outfall where a sampling result
exceeded the benchmark alue for two consecutive samples. Monthly (analytical and qualitative)
monitoring shall continue until three consecutive sample results are below the benchmark values or
. ' within the benchmark range.
3. If no discharge occurs during the sampling period, the permittee is required to submit a monthly
monitoring report indicating "No Flow" to comply with reporting requirements.
4. Maintain a record of the Tier Two response in the Stormwater Pollution Prevention Plan.
During the term of this permit, if the valid sampling results required for the permit monitoring periods
exceed the benchmark value, or are outside the benchmark range, for any specific parameter at any specific
outfall on four occasions, the permittee shall notify the DWQ Regional Office Supervisor in writing within
30 days of receipt of the fourth analytical results. DWQ may but is not limited to:
• require that the permittee revise, increase, or decrease the monitoring frequency for the remainder
of the permit;
• require the permittee to install structural stormwater controls;
• require the permittee to implement other stormwater control measures
• require the pertittee to perform upstream and downstream analytical monitoring ; or
• require that the permittee implement site modifications to qualify for the No Exposure Exclusion.
Part II Page 7 of 10

Permit No. NCS000538
SECTION C: QUALITATIVE MONITORING REQUIREMENTS
Qualitative monitoring requires a visual inspection of each stormwater outfall regardless of
representative outfall status and shall be performed as specified in Table 4, during the analytical
monitoring event. Qualitative monitoring is for the purpose of evaluating the effectiveness of the
Stormwater Pollution Prevention Plan (SPPP) and assessing new sources of stormwater pollution.
In the event an atypical condition is noted at a stormwater discharge outfall, the permittee shall
document the suspected cause of the condition and any actions taken in response to the
discovery. This documentation will be maintained with the SPPP.
Table 4. Qualitative Monitoring Requirements %l
Discharge Characteristics.
'
Tr.equencyt
T Monitoring
Locatibn2 '
Color
Quarterly, semi=at nual
SDO
Odor
Quarterly,,s
SDO
Clarity
uarterlys_mi'zannuual
SDO
Floating Solids
uartel ;!semi annual
SDO
Suspended Solids
uarterlt`,,smi-annual
SDO
Foam N,�
"Quarterl , semi-annual
SDO
Oil Sheen
_' uarterl , semi-annual
SDO
Erosion or deposition at the outfall
M
/, uarterl , semi-annual
SDO
Other obvious indicators ''--
of stormwater pollution
Quarterly, semi-annual
SDO
Footnotes:
1 Measurement Frequency: To be performed concurrently and on the same schedule as analytical monitoring. See
Table 2 for schedule of monitoring periods through the end of this permitting cycle.
2 Monitoring Location: Qualitative monitoring shall be performed at each stormwater discharge outfall (SDO)
regardless of representative outfall status.
SECTION D: ON -SITE VEHICLE MAINTENANCE MONITORING REQUIREMENTS
Facilities which have any vehiclermaintenance activity occurring on -site which uses more than 55
gallons of new motor oil per month when averaged over the calendar year shall perform
analytical monitoring as specified below in Table 5. This monitoring shall be performed at all
stormwater discharge outfalls which discharge stormwater runoff from vehicle maintenance areas
and in accordance with the schedule presented in Table 2 (Section B). All analytical monitoring
shall be performed during a representative storm event.
Part II Page 8 of 10

Permit No. NCS000538
Table 5. Analytical Monitoring Requirements for On -Site Vehicle Maintenance
Discharge Characteristics
Units
Measurement
-Fre uenc 1
Sample
Type2
Sample
Location3
H
standard
semi-annual
Grab
SDO
Non -Polar O&G / TPH
EPA Method 1664 SGT-HEM
mg/L
semi-annual
Grab
SDO
Total Suspended Solids
mg/L
semi-annual
Grab
SDO
Total Rainfa114
inches
semi-annual
Rain gauge
New Motor Oil Usage
I gallons/month
semi-annual
Estimate
-
Footnotes:
I Measurement Frequency: Twice per year during a representative storm -event, for each year until either another
permit is issued for this facility or until this permit is revoked or rescinded..%at the end of this permitting cycle
the permittee has submitted the appropriate paperwork for a renew 1 permit,before the submittal deadline, the
permittee will be considered for a renewal application. The applicant must continue semi-annual,monitoring until
the renewed permit is issued. See Table 2 for schedule of mgnitonng periods through the end of this permitting
cycle.
2 �'� .r.
If the stormwater runoff is controlled by a stormwater detention,pond a grab sample of the discharge from the
pond shall be collected within the first 30 minutes.of dischargef rom the pond.
3 �f /r
Sample Location: Samples shall be collected at each stormwater discharge outfall (SDO) that discharges
n r�lr t-.
stormwater runoff from area(s) where'.vehicle�rnaintenance activities occur.
4 For each sampled representative storm event the total precipitation must be recorded. An on -site or local rain
gauge reading must be recorded.'
Monitoring results shall be compared, o the benchmark values in Table 6. The benchmark
values in Table 6 are not permit lif its but should be used as guidelines for the permittee's
Stormwater Pollution Prevention Plan (SPPP). Exceedences of benchmark values require the
permittee to increase monitoring, increase management actions, increase record keeping, and/or
install stormwater Best Management Practices (BMPs), as provided in Part II Section B.
Table 6.
Benchmark Values for Vehicle Maintenance Analytical Monitoring
Discharge Characteristics
Units
Benchmark
pH
standard
6-9
Non -Polar O&G / TPH
[EPA Method 1664 (SGT-HEM)]
mg/L
15
Total Suspended Solids
mg/L
100
Part 11 Page 9 of 10

Permit No. NCS000538
PART III STANDARD CONDITIONS FOR NPDES STORMWATER INDIVIDUAL PERMITS
SECTION A: COMPLIANCE AND LIABILITY
Compliance Schedule
The permittee shall comply with Limitations and Controls specified for stormwater discharges in
accordance with the following schedule:
Existing Facilities already operating but applying for permit coverage for the first time: The Stormwater
Pollution Prevention Plan shall be developed and implemented within 12 months of the effective date of the
initial permit and updated thereafter on an annual basis. Secondary containment, as specified in Part II,
Section A, Paragraph 2(b) of this permit, shall be accomplished within 12 months of the effective date of
the initial permit issuance.
New Facilities applying for coverage for the first time an' d existi g,facilities previously permitted and
applying for renewal under this permit: The Stormwater Pollution Prevention Plan shall be developed and
implemented prior to the beginning of discharges from the operation of the industrial activity and be
updated thereafter on an annual basis. Secondary containment, as specified in Part II, Section A, Paragraph
2(b) of this permit shall be accomplished prior to,th�e-beginning,of discharges from the operation of the
industrial activity.
Duty to Comply
The permittee must comply with all'conditions _of this individual permit. Any permit noncompliance
constitutes a violation of the Clean Water Act and is grounds for enforcement action; for permit
termination, revocation and reissuance, or modification; or denial of a permit upon renewal application.
a. The permittee shall comply�with standards or prohibitions established under section 307(a) of the
Clean Water Act for toxin pollutants within the time provided in the regulations that establish these
standards or prohibitions, even if the permit has not yet been modified to incorporate the
requirement.
b. The Clean Water Act provides that any person who violates a permit condition is subject to a civil
penalty not to exceed $25,000 per day for each violation. Any person who negligently violates any
permit condition is subject to criminal penalties of $2,500 to 25,000 per day of violation, or
imprisonment for not more than 1 year, or both. Any person who knowingly violates permit
conditions is subject to criminal penalties of $5,000 to $50,000 per day of violation, or
imprisonment for not more than 3 years, or both. Also, any person who violates a permit condition
may be assessed an administrative penalty not to exceed $10,000 per violation with the maximum
amount not to exceed $125,000. [Ref: Section 309 of the Federal Act 33 USC 1319 and 40 CFR
122.41(a). ]
C. Under state law, a daily civil penalty of not more than ten thousand dollars ($10,000) per violation
may be assessed against any person who violates or fails to act in accordance with the terms,
conditions, or requirements of a permit. [Ref: NC General Statutes 143-215.6A].
d. Any person may be assessed an administrative penalty by the Director for violating section 301,
302, 306, 307, 308, 318 or 405 of the Act, or any permit condition or limitation implementing any
of such sections in a permit issued under section 402 of the Act. Administrative penalties for Class
I violations are not to exceed $10,000 per violation, with the maximum amount of any Class I
penalty assessed not to exceed $25,000. Penalties for Class II violations are not to exceed
Part III Page I of 8

Permit No. NCS000538
$10,000 per day for each day during which the violation continues, with the maximum amount of
any Class lI penalty not to exceed $125,000.
Duty- to Mitigate
The permittee shall take all reasonable steps to minimize or prevent any discharge in violation of this
individual permit which has a reasonable likelihood of adversely affecting human health or the environment.
4. Civil and Criminal Liability
Except as provided in Part III, Section C of this permit regarding bypassing of stormwater control facilities,
nothing in this individual permit shall be construed to relieve the permittee from any responsibilities,
liabilities, or penalties for noncompliance pursuant to NCGS 143-215.3, 143-215.6A, 143-215.6B, 143-
215.6C or Section 309 of the Federal Act, 33 USC 1319. Furthermore, the permittee is responsible for
consequential damages, such as fish kills, even though the responsibility for effective compliance may be
temporarily suspended. '\ n
5. Oil and Hazardous Substance Liability
Nothing in this individual permit shall be construed to -preclude the institution of any legal action or relieve
the permittee from any responsibilities, liabilities; or'penaltieslto which the permittee is or may be subject to
under NCGS 143-215.75 et seq. or Section 31 I�pf th/e;Federal Act, 33 USC 1321.
6. Property Rights r/
The issuance of this individual it does not convey any property rights in either real or personal
or an exclusive rivile es nor does'it authorize an in to private roe or an invasion of
property, Y P g �, ..ram. Y jm'Y p property rtY Y
personal rights, nor any infringement of Federal, State or local laws or regulations.
7. Severability
The provisions of this individual permit are severable, and if any provision of this individual permit, or the
application of any provision of this individual permit to any circumstances, is held invalid, the application
of such provision to other circumstances, and the remainder of this individual permit, shall not be affected
thereby.
8. Duty to Provide Information
The permittee shall furnish to the Director, within a reasonable time, any information which the Director
may request to determine whether cause exists for modifying, revoking and reissuing, or terminating the
permit issued pursuant to this individual permit or to determine compliance with this individual permit. The
permittee shall also furnish to the Director upon request, copies of records required to be kept by this
individual permit.
Penalties for Tampering
The Clean Water Act provides that any person who falsifies, tampers with, or knowingly renders inaccurate,
any monitoring device or method required to be maintained under this individual permit shall, upon
conviction, be punished by a fine of not more than $10,000 per violation, or by imprisonment for not more
than two years per violation, or by both. If a conviction of a person is for a violation committed after a first
conviction of such person under this paragraph, punishment is a fine of not more that $20,000 per day of
violation, or by imprisonment of not more than 4 years, or both.
Part III Page 2 of 8

Permit No. NCS000538
I0. Penalties for Falsification of Reports
The Clean Water Act provides that any person who knowingly makes any false statement, representation, or
certification in any record or other document submitted or required to be maintained under this individual
permit, including monitoring reports or reports of compliance or noncompliance shall, upon conviction, be
punished by a fine of not more than $10,000 per violation, or by imprisonment for not more than two years
per violation, or by both.
SECTION B: GENERAL CONDITIONS
1. Individual Permit Expiration
The permittee is not authorized to discharge after the expiration dateIn order to receive automatic
authorization to discharge beyond the expiration date, the pernuthe 'e shall submit forms and fees as are
required by the agency authorized to issue permits no later7thani 80'days prior to the expiration date. Any
permittee that has not requested renewal at least 180 days prior to expiration, or any permittee that does not
have a permit after the expiration and has not requested >> newal at least-l'80 days prior to expiration, will be
subjected to enforcement procedures as provided in NCGS § P43-215.3b and 33 USC 1251 et. seq.
Transfers
This permit is not transferable to any personqzcepf after'notice to and approval by the Director. The
Director may require modification or revochtiontand�rei suance of the permit to change the name and
incorporate such other requirements as may be necessary under the Clean Water Act. The Permittee is
required to notify the Divisionjn tvrsting In)_the event the permitted facility is sold or closed.
3. Signatory Requirements
All applications, reports, or•infrm tion submitted to the Director shall be signed and certified.
a. All applications to-liemc o ered under this individual permit shall be signed as follows:
(1) In the case of a corporation: by a principal executive officer of at least the level of vice-
president, or his duly authorized representative, if such representative is responsible for
the overall operation of the facility from which the discharge described in the permit
application form originates;
(2) In the case of a partnership or limited partnership: by a general partner;
(3) In the case of a sole proprietorship: by the proprietor;
(4) In the case of a municipal, state, or other public entity: by a principal executive officer,
ranking elected official, or other duly authorized employee.
b. All reports required by the individual permit and other information requested by the Director shall
be signed by a person described above or by a duly authorized representative of that person. A
person is a duly authorized representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having responsibility for the
overall operation of the regulated facility or activity, such as the position of plant
manager, operator of a well or well field, superintendent, a position of equivalent
Part III Page 3 of 8

Permit No. NCS000538
4.
responsibility, or an individual or position having overall responsibility for environmental
matters for the company. (A duly authorized representative may, thus be either a named
individual or any individual occupying a named position.); and
(3) The written authorization is submitted to the Director.
C. Any person signing a document under paragraphs a. or b. of this section shall make the following
certification:
"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 the
information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalti6s for submitting false information,
including the possibility of fines and imprisonment for•kribwing violations."
The issuance of this individual permit does not prohibii,the Director from reopening and modifying the
individual permit, revoking and reissuing the individual p`ermit,,or terminating the individual permit as
allowed by the laws, rules, and regulations contained%in'Title 40, Code of Federal Regulations, Parts 122
and 123; Title 15A of the North Carolina Administiative'Code, Subchapter 2H .0100; and North Carolina
General Statute 143-215.1 et al.
X.
Permit Actions <� (�
The permit may be modified„fevokedlan&reissued, or terminated for cause. The notification of planned
changes or anticipated noncompliance;does not stay any individual permit condition.
SECTION C: OPERATION AND -MAINTENANCE OF POLLUTION CONTROLS
Proper Operation and Maintenance
The permittee shall at all times properly operate and maintain all facilities and systems of treatment and
control (and related appurtenances) which are installed or used by the permittee to achieve compliance with
the conditions of this individual permit. Proper operation and maintenance also includes adequate
laboratory controls and appropriate quality assurance procedures. This provision requires the operation of
back-up or auxiliary facilities or similar systems which are installed by a permittee only when the operation
is necessary to achieve compliance with the conditions of this individual permit.
2.' Need to Halt or Reduce Not a Defense
It shall not be a defense for a permittee in an enforcement action that it would have been necessary to halt or
reduce the permitted activity in order to maintain compliance with the condition of this individual permit.
Bypassing of Stormwater Control Facilities
Bypass is prohibited and the Director may take enforcement action against a permittee for bypass unless:
a. Bypass was unavoidable to prevent loss of life, personal injury or severe property damage; and
Part III Page 4 of 8

Permit No. NCS000538
There were no feasible alternatives to the bypass, such as the use of auxiliary control facilities,
retention of stormwater or maintenance during normal periods of equipment downtime or dry
weather. This condition is not satisfied if adequate backup controls should have been installed in
the exercise of reasonable engineering judgment to prevent a bypass which occurred during normal
periods of equipment downtime or preventive maintenance; and
C. The perminee submitted notices as required under, Part III, Section E of this permit.
If the Director determines that it will meet the three conditions listed above, the Director may approve an
anticipated bypass after considering its adverse effects.
SECTION D: MONITORING AND RECORDS
►F]
iU
4.
Representative Sampling
Samples collected and measurements taken, as required herein, s all tie'characteristic of the volume and
nature of the permitted discharge. Analytical samplinguailbe performed during a representative storm
event. Samples shall be taken on a day and time that is, characteristic of the discharge. All samples shall be
taken before the discharge joins or is diluted by any otlier waste stream, body of water, or substance.
Monitoring points as specified in this permit shall,,not.b changed without notification to and approval of
the Director.
Recording Results
For each measurement, sampl ,inspection 0—r maintenance activity performed or collected pursuant to the
requirements of this individual perm t; the pa ittee shall record the following information:
a. The date, exact place, and time`�of sampling, measurements, inspection or maintenance activity;
b. The individual(s)`,wkho-pe'rformed the sampling, measurements, inspection or maintenance activity;
C. The date(s) analyses were performed;
d. The individual(s) who performed the analyses;
e. The analytical techniques or methods used; and
f. The results of such analyses.
Flow Measurements
Where required, appropriate flow measurement devices and methods consistent with accepted scientific
practices shall be selected and used to ensure the accuracy and reliability of measurements of the volume of
monitored discharges.
Test Procedures
Test procedures for the analysis of pollutants shall conform to the EMC regulations published pursuant to
NCGS 143-215.63 et. seq, the Water and Air Quality Reporting Acts, and to regulations published pursuant
to Section 304(g), 33 USC 1314, of the Federal Water Pollution Control Act, as Amended, and Regulation
40 CFR 136.
Part III Page 5 of 8

Permit No. NCS000538
To meet the intent of the monitoring required by this individual permit, all test procedures must produce
minimum detection and reporting levels and all data generated must be reported down to the minimum
detection or lower reporting level of the procedure.
Representative_Outfall
If a facility has multiple discharge locations with substantially identical stormwater discharges that are
required to be sampled, the permittee may petition the Director for representative outfall status. If it is
established that the stormwater discharges are substantially identical and the permittee is granted
representative outfall status, then sampling requirements may be performed at a reduced number of outfalls.
Records Retention
Visual monitoring shall be documented and records maintained at the facility along with the Stormwater
Pollution Prevention Plan. Copies of analytical monitoring resufts.shall also be maintained on -site. The
permittee shall retain records of all monitoring information; including all calibration and maintenance
records and all original strip chart recordings for continuous momtbringrinsfrumentation, and copies of all
reports required by this individual permit for a period of itleast 5 years -from the date of the sample,
measurement, report or application. This period may be extended by request of the Director at any time.
7. Inspection and Entry
The permittee shall allow the Director, or an authorized Representative (including an authorized contractor
fl
acting as a representative of the Director),jor in the,ca�e of a facility which discharges through a municipal
separate storm sewer system, an;authorizedkrepresentative of a municipal operator or the separate storm
sewer system receiving the discharge uponthe,presentation of credentials and other documents as may be
required by law, to;
a. Enter upon the permitte % ses where a regulated facility or activity is located or conducted,
or where records must be kept under the conditions of this individual permit;
b. Have access to and-cop"y, at reasonable times, any records that must be kept under the conditions of
this individual permit;
Inspect at reasonable times any facilities, equipment (including monitoring and control equipment),
practices, or operations regulated or required under this individual permit; and'
d. Sample or monitor at reasonable times, for the purposes of assuring individual permit compliance
or as otherwise authorized by the Clean Water Act, any substances or parameters at any location.
SECTION E: REPORTING REQUIREMENTS
Discharge Monitoring Reports
Samples analyzed in accordance with the terms of this permit shall be submitted to the Division on
Discharge Monitoring Report forms provided by the Director. Submittals shall be delivered to the Division
no later than 30 days from the date the facility receives the sampling results from the laboratory.
The permittee shall submit an Annual Summary Data Monitoring Report to the appropriate DWQ Regional
Office in February of each year. The submittal shall be on forms supplied by the Division.
Part III Page 6 of 8

Permit No. NCS000538
2.
3.
5.
When no discharge has occurred from the facility during the report period, the permittec is required to
submit a discharge monitoring report, within 30 days of the end of the six-month sampling period, giving all
required information and indicating "NO FLOW" as per NCAC T15A 02B .0506.
The permittee shall record the required qualitative monitoring observations on the SDO Qualitative
Monitoring Report form provided by the Division, and shall retain the completed forms on site. Visual
monitoring results should not be submitted to the Division, except upon DWQ's specific requirement to do
SO.
Submitting Reports
Two signed copies of Discharge Monitoring Reports (DMRs) shall be submitted to:
Central Files
Division of Water Quality
1617 Mail Service Center�-
Raleigh, North Carolina�27699-161.7. �-
In addition, a separate signed Annual Summary DMR
Office (RO) by March I of each year.
Addresses for each RO and the counties
on site. Visual monitoring
specifically requested by I
Availability of Reports
be submitted to the local DWQ Regional
:O can be found here:
he permittee shall retain the completed originals
to the Regional Offices or Central Files unless
Except for data determined`to be confidential under NCGS 143-215.3(a)(2) or Section 308 of the Federal
Act, 33 USC 1318, all reports prepared in accordance with the terms shall be available for public inspection
at the offices of the Division of -Water Quality. As required by the Act, analytical data shall not be
considered confidential. Knowingly making any false statement on any such report may result in the
imposition of criminal penalties as provided for in NCGS 143-215.613 or in Section 309 of the Federal Act.
Non-Stormwater Discharges
If the storm event monitored in accordance with this Individual Permit coincides with a non-stormwater
discharge, the permittee shall separately monitor all parameters as required under the non-stormwater
discharge permit and provide this information with the stormwater discharge monitoring report.
Planned Changes
The permitter shall give notice to the Director as soon as possible of any planned changes at the permitted
facility which could significantly alter the nature or quantity of pollutants discharged. This notification
requirement includes pollutants which are not specifically listed in the Individual Permit or subject to
notification requirements under 40 CFR Part 122.42 (a).
Anticipated Noncompliance
The permittee shall give notice to the Director as soon as possible of any planned changes at the permitted
facility which may result in noncompliance with the Individual Permit requirements.
Part III Page 7 of 8

Permit No. NCS000538
10,
Sills
The permittee shall report to the local DWQ Regional Office, within 24 hours, all significant spills as
defined in Part VI of this permit. Additionally, the permittee shall report spills including: any oil spill of 25
gallons or more, any spill regardless of amount that causes a sheen on surface waters, any oil spill
regardless of amount occurring within 100 feet of surface waters, and any oil spill less than 25 gallons that
cannot be cleaned up within 24 hours.
Bypass
a. Anticipated bypass. If the permittee knows in advance of the need for a bypass, it shall submit
prior notice, if possible at least ten days before the date of the bypass; including an evaluation of
the anticipated quality and affect of the bypass.
b. Unanticipated bypass. The permittee shall submit notice within 24 hours of becoming aware of an
unanticipated bypass.
Twenty-four Hour Reporting
The permittee shall report to the central office or the
may endanger health or the environment. Any inforr
the time the permittee became aware of the circumm
within 5 days of the time the permittee becomes/wa
The written submission shall contain a description of
noncompliance, including exackn dates and timeAaiud
anticipated time compliance s expected't continue;
prevent reoccurrence of the noncompliance
regional office any noncompliance which
3e provided orally within 24 hours from
tten submission shall also be provided
`e bf the circumstances.
,,the noncompliance, and its causes; the period of
'if the noncompliance has not been corrected, the
and steps taken or planned to reduce, eliminate, and
The Director may waive the°written repNrt on a case -by -case basis if the oral report has been received
within 24 hours. 7e
Other Noncompliance
The permittee shall report all instances of noncompliance not reported under 24 hour reporting at the time
monitoring reports are submitted.
Other Information
Where the permittee becomes aware that it failed to submit any relevant facts in a Notice of Intent to be
covered under this Individual Permit or in any report to the Director, it shall promptly submit such facts or
information.
Part III Page 8 of 8

NCS000538
PART IV LIMITATIONS REOPENER
This individual permit shall be modified or alternatively, revoked and reissued, to comply with any applicable
effluent guideline or water quality standard issued or approved under provisions of the Clean Water Act, if the
effluent guideline or water quality standard so issued or approved:
Contains different conditions or is otherwise more stringent than any effluent limitation in the individual
permit; or
b. Controls any pollutant not limited in the individual permit.
The individual permit as modified or reissued under this paragraph'.shall;also contain,any other requirements in the
Act then applicable. ff
PART V ADMINISTERING AND COMPLIANCE MONITORING FEE
REQUIREMENTS
The permittee must pay the administering and compliance inonitbring fee within 30 (thirty) days after being billed by
the Division. Failure to pay the fee in,tiinely manner in accordance with 15A NCAC 2H .0105(b)(4) may cause this
Division to initiate action to revoke thedridividual Permit.
µ,me
ART' DEFINITIONS
1. Act
See Clean Water Act.
2. Allowable Non-Stormwater Discharges
This permit regulates stormwater discharges. Non-stormwater discharges which shall be allowed in the
stormwater conveyance system are:
(a) All other discharges that are authorized by a non-stormwater NPDES permit.
(b) Uncontaminated groundwater, foundation drains, air -conditioner condensate without added
chemicals, springs, discharges of uncontaminated potable water, waterline and fire hydrant
flushings, water from footing drains, flows from riparian habitats and wetlands.
(c) Discharges resulting from fire -fighting or fire -fighting training.
3. Best Management Practices (BMPs)
Measures or practices used to reduce the amount of pollution entering surface waters. BMPs may take the
form of a process, activity, or physical structure. More information on BMPs can be found at:
http: //c fpub. epa, gov/npdcs/stormwater/menuofbmps/index. c fm.
4. Bypass
A bypass is the known diversion of stormwater from any portion of a stormwater control facility including
the collection system, which is not a designed or established operating mode for the facility.
Bulk Storage of Liquid Products
Liquid raw materials, manufactured products, waste materials or by-products with a single above ground
storage container having a capacity of greater than 660 gallons or with multiple above ground storage
containers located in close proximity to each other having a total combined storage capacity of greater than
1,320 gallons.
Parts IV, V and VI Page 1 of 4

Permit No. NCS000538
6. Certificate of Coverage
The Certificate of Coverage (COC) is the cover sheet which accompanies the Individual Permit upon
issuance and lists the facility name, location, receiving stream, river basin, effective date of coverage under
the permit and is signed by the Director.
8.
IN
Clean Water Act
The Federal Water Pollution Control Act, also known as the Clean Water Act (CWA), as amended, 33 USC
1251, et. seq.
Division or DWO
The Division of Water Quality, Department of Environment and Natural Resources.
Director
The Director of the Division of Water Quality, the permit
EMC
The North Carolina Environmental Management
Grab Sample
An individual sample collected instantaneously.
qualitatively) must be taken within the first 30 r.
12. Hazardous Substance
Any substance designated under 40 CFR Pat
13. Landfill
A disposal facility or part of a disposal"facili
treatment facility, a surface impoundme ai
a surface storage facility. �/ J
14.
11.6�
t
will be analyzed (quantitatively or
to Section 311 of the Clean Water Act,
eivhere waste is placed in or on land and which is not a land
injection well, a hazardous waste long-term storage facility or
A stormwater collection system" Within an incorporated area of local self-government such as a city or town.
15. No Exposure
A condition of no exposure means that all industrial materials and activities are protected by a storm
resistant shelter or acceptable storage containers to prevent exposure to rain, snow, snowmelt, or runoff.
Industrial materials or activities include, but are not limited to, material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products.
DWQ may grant a No Exposure Exclusion from NPDES Stormwater Permitting requirements only if a
facility complies with the terms and conditions described in 40 CFR § 122.26(g)
16. Notice of Intent
The state application form which, when submitted to the Division, officially indicates the facility's notice of
intent to seek coverage under an Individual Permit.
17. Permittee
The owner or operator issued a certificate of coverage pursuant to this Individual Permit.
18. Point Source Discharge of Stormwater
Any discernible, confined and discrete conveyance including, but not specifically limited to, any pipe, ditch,
channel, tunnel, conduit, well, or discrete fissure from which stormwater is or may be discharged to waters
of the state.
Part VI Page 2 of 4 Pages

Permit No. NCS000538
19. Representative Storm Event
A storm event that measures greater than 0.1 inches of rainfall. The time between this storm event and the previous
storm event measuring greater than 0.1 inches must be at least 72 hours. A single storm event may have a period of
no precipitation of up to 10 hours. For example, if it rains but stops before producing any collectable discharge, a
sample may be collected if the next rain producing a discharge begins within 10 hours.
20. Representative Outfall Status
When it is established that the discharge of stormwater runoff from a single outfall is representative of the
discharges at multiple outfalls, the DWQ may grant representative outfall status. Representative outfall
status allows the permittee to perform analytical monitoring at a reduced number of outfalls.
2 L Secondary Containment
Spill containment for the contents of the single largest tank within the containment structure plus sufficient
freeboard to allow for the 25-year, 24-hour storm event.
22. Section 313 Water Priority Chemical
A chemical or chemical category which: . s�
a. Is listed in 40 CFR 372.65 pursuant to Section 313,of Title III -of the Superfund Amendments and
Reauthorization Act (SARA) of 1986, also tit Iled•the Emergency Planning and Community Right -
to -Know Act of 1986;
23,
b. Is present at or above threshold levels
requirements; and
C. Meets at least one of the following, n
(1) Is listed in appendix D o640
III (certain instals, cyanides,
hazardous si
(2) Is listed as a
CFR 116.4;'
(3) Is a pollutan
to SARA title III, Section 313 reporting
122 on Table 11(organic priority pollutants), Table
,ls) or Table IV (certain toxic pollutants and
pursuant to section 311(b)(2)(A) of the CWA at 40
A has published acute or chronic water quality criteria.
Means substantial physical•danraage to property, damage to the control facilities which causes them to
become inoperable, or substantial and permanent loss of natural resources which can reasonably be
expected to occur in the absence of a bypass. Severe property damage does not mean economic loss caused
by delays in production.
24. Significant Materials
Includes, but is not limited to: raw materials; fuels; materials such as solvents, detergents, and plastic
pellets; finished materials such as metallic products; raw materials used in food processing or production;
hazardous substances designated under section 101(14) of CERCLA; any chemical the facility is required to
report pursuant to section 313 of Title III of SARA; fertilizers; pesticides; and waste products such as ashes,
slag and sludge that have the potential to be released with stormwater discharges.
25. Significant Spills
Includes, but is not limited to: releases of oil or hazardous substances in excess of reportable quantities
under section 311 of the Clean Water Act (Ref: 40 CFR 110.10 and CFR 117.21) or section 102 of
CERCLA (Ref: 40 CFR 302.4).
26. Stormwater Discharge Outfall (SDO)
The point of departure of stormwater from a discernible, confined, or discrete conveyance, including but not
limited to, storm sewer pipes, drainage ditches, channels, spillways, or channelized collection areas, from
which stormwater flows directly or indirectly into waters of the State of North Carolina.
Part VI Page 3 of 4 Pages

M
Permit No. NCS000538
27. Stormwater Runoff
The flow of water which results from precipitation and which occurs immediately following rainfall or as a
result of snowmelt.
28. Stormwater Associated with Industrial Activi
The discharge from any point source which is used for collecting and conveying stormwater and which is
directly related to manufacturing, processing or raw material storage areas at an industrial site. Facilities
considered to be engaged in "industrial activities" include those activities defined in 40 CFR 122.26(b)(14).
The term does not include discharges from facilities or activities excluded from the NPDBS program.
29. Stormwater Pollution Prevention Plan
A comprehensive site -specific plan which details measures and practices to reduce stormwater pollution and
is based on an evaluation of the pollution potential of the site.
30. Total Maximum Daily Load (TMDL) /f
TMDLs are written plans for attaining and maintaining water q alitystandards, in all seasons, for a specific
water body and pollutant. (A list of approved TMDLs for the -state of North -Carolina can be found at
http://h2o.enr.state.ne.us/tmdl/) y
31. Toxic Pollutant
Any pollutant listed as toxic under Section 307(a)(I)°of the, Clean Water Act.
32. Vehicle Maintenance Activity �� ,
Vehicle rehabilitation, mechanical repairs, pamtmg,.fuelmg, lubrication, vehicle cleaning operations, or
airport deicing operations.t�
33. Visible Sedimentation
Solid particulate matter, both.mineral�4 nd"orgamc, that has been or is being transported by water, air,
gravity, or ice from its sitee,,f origin wwkiich can be seen with the unaided eye.
34. 25- ear 24 hour storm event`--�
The maximum 24-hour precipitation event expected to be equaled or exceeded, on the average, once in 25
years.
Part VI Page 4 of 4 Pages

N
,�- 4,NCS000538
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
STAFF REVIEW AND EVALUATION
NPDES Stormwater Permit
Facility Name:
NPDES Permit Number
Facility Location:
Type of Activity:
SIC Code (if applicable)
Receiving Streams:
River Basin:
Stream Classification:
Proposed Permit Requirements:
Monitoring Data:
Response Requested by (Date):
Central Office Staff Contact:
Special Issues:
Roll -Tech, LLC
NCS000538
Dee Freeman
Secretary
243 Performance Drive SE, Hickory, NC (Catawba Co), See Figure 1
Tire/wheel Mfg.
3011: Tires and Inner Tube Mfg (primary)
3089: Plastic Products Mfg (secondary)
Miller Branch
Catawba River Basin, Sub -basin 03-08-35
C
See attached draft permit.
See Table 1
July 20, 2010
Return to Cory Larsen, [phone]; [e-mail]
Issue
Rating Scale:1(easy) to
-10(hard)
Com Rance history
N/A
Benchmark exceedance
N/A
Location (TMDL, T&E species, etc)
3
Other Challenges:
7
• Withdrawing NCG
application and requesting
NCS
Difficulty Rating:
(10)/40
Description of Onsite Activities:
[Ul-Tech manufactures solid rubber tired wheels. Tires are compression molded from
crumb rubber (ground truck tires) and hubs are injection melded from post-consurner
plastics.
Page 1 of 8

1. NCS000538
Documents Reviewed:
• EPA TRI Data & MSGP
• 2008 303(d) List
• NC TMDLs
• Catawba Basinwide Plan (BWP)
• NC Natural Heritage Program for T&E
History:
• Applied for NCG05: 12/10/2009
• Site Visit Performed by Wes Bell of MRO: 01/13/2010
• Application for NCS Permit Submitted: 06/09/2010
Page 2 of 8

,r NCS000538
V-1, "Ili, �64L 44
vKt
Roll -Tech, LLCEk
�'rCy 5 ��j' �' ��^ A�4/j \Y!, ,,Y4 GIAt I 1 �.-� d� S� � � •'• f 1 !t'�.
+i l ' ` ~�,, r J[j/J .1- 1�..�f �'•/ J ,..� 14 yf ri •� .., ,.,"
� t� .- Y( � .rf:.iil �,� {ti!'t �>' . ;�",,;,j . r'" F�•S•f�.k .� .�" �;� �:= .'�'i, : �-;;
3 i4 "'-�'+�•.�... rl ,1 /l �:1..—_\V�/' �1. ;.i. �: \•, ti~L�J��r 1 �, �i\- � }
({fJ,;� f 1�, �,, �t�I/`/t`; ��- `r /•/ )�°'� ♦y � yjI ������ r� i= /`/"J`` �a-I��i
` `�"I".� r f ! I`Y -ii' it i' ^f • . `�,� �'� 1✓- l- y� nt�y"��.?�."'�A Q ��,. L / � e f�
•� �'l 1 I / ,q I S (s ' I 4 i { ��}} _»'d•Y mil. - ., J� .ice'.. i t
NCS000538
hl�
Map Scale i,24,44Q
ROLL -TECH, LLC
Lab tude : 340 43' 40" 1N
Longitude: 810 16' 51" W
County: Catawba
Receiving Streams: Mller Branch
Stream Class: C
Sub -basin: 03-08-35 (Cata�vba River Basin)
Figure 1: Location Map of Facility
Page 3 of 8
,:+�i��•,rYa�:rri fi►��. �1
Facility 1-6cation

r"
NCS000538
Central Office Review Summary:
1. Owner's Other Permits:
• N/A
2. General Observations:
• Relatively small facility with approximately 40%.> impervious area;
• Three (3) identified SDOs.
3. Impairment:
o None.
4. Threatened and Endangered (within 2 miles):
o No aquatic species returned in search.
5. Location:
o The facility is located near downtown Hickory in an industrial park area.
6. Industrial Changes Since Previous Permit:
o N/A - New permit.
7. Analytical Monitoring Notes: ,
o Five parameters were analyzed at three (3) SDO locations (NE and NW corners of plant,
leading dock) and reported on EPA Form 2F: TSS, pH, BOD, COD, and Zn;
o Exceedances of benchmark values for ail parameters were observed, except for TSS;
o BOD and COD benchmark exceedances were unexpectedly high in comparison to TSS results.
Further investigation will be necessary to identify source;
o pH was highly variable considering proximity of sample locations;
o See Table 1 for full summary.
8. Oualitative Monitoring Notes;
o N/A - New permit.
Page 4 of 8

NCS000538
Table 1: Analytical Monitoring
Sample
Date
Total Row
(MGD)
Precip.
(in)
Duration
(hours)
TSS
COD
BOD5
Zn
pH
Benchmark:
100 mglL
Benue:
120 rrg/L
Benchmark
30 mgfL
Benchmark.
Q067 rrg/L
Benchmark:
6-9 su
NW
5/17/20101
1 0.5 1
0.5
1 5
8.25
NE
5/17=101
1 0.5
1 0.5
1 17
DOCK
5117/20101
1 0.5
1 0.5
1 5 7.74
"119 Over Current Benchmark
Data Not Collected
ND = not detected
NA = not applicable
Page 5 of 8

f
NCS000538
Revised Permit Recommendations: Analytical Monitoring:
Proposed strategy: initial frequency set to quarterly based on elevated analytical results to help
encourage more rapid investigation of pollutant sources and solutions to bring results back within
benchmark concentrations. Semi-annual frequency will be scheduled to begin Year 3 once discharges
normalize following SPPP and/or Tier response actions (if any).
Adding parameters:
i. BOD - high levels of BOD/COD observed in analytical results;
ii. COD - high levels of BOD/COD observed in analytical results;
iii, TSS - standard addition. Will help in locating source of BUD/COD;
iv. p.H - standard addition plus one benchmark exceedance observed with initial results;
v. Zinc - 2008 MSGP recommendation. Crumb rubber contains high concentrations of
zinc (see literature in file);
vi. Lead - Crumb rubber contains a significant amount of lead (see literature .in .file). May
be useful to monitor in conjunction with zinc for monitoring purposes.
2. New individual permit template utilized that includes the Tiered monitoring system, analytical and
qualitative monitoring required during representative storm events, and annual summary DMR due
to RO in March of every year
3. Qualitative monitoring required regardless of representative outfall status. Qualitative monitoring
to be performed at same schedule as analytical monitoring.
Discussion with Permittee: Todd Blair, General Manager, 2010, Todd Blair [[e-mail]]
Informed facility that it was not eligible for NCG05 permit due to their industrial activities and
SIC codes in December 2009.
o See correspondence in file.
Wes Bell visited in January 2010 to confirm that permit coverage was required or qualify for No
Exposure.
o See emails in file.
• Assisted applicant with directions for competing required forms for individual permit coverage
and provided minimum set of pollutant parameters to analyze for in April 2010.
Page 6 of 8

., NCS000538
Recommendations: Based on the documents reviewed and RO site visit, the application information
submitted on June 9, 2010 is deemed sufficient to issue an Individual Stormwater Permit.
4f—�Prepared by (Signature) Date
Stormwater Permitting Unit Supervisor Date 16_ lazy
for Bradley Bennett /'
or
Concurrence by Regional Office W-�rX"a
Date �f a
Water Quality Supervisor �}� � Date 2 L /b
Regional Office Staff Comments
i fig S s� r►m,`� 5ha �,.l�l r'nGl ti de -f-he. 61 nr,
ke ✓; s e
k-t C 0 M f'?\ Y h d 16A0 5,1 0
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1 S S k A n c ,e O-T �"h 4` 5 -� { rn � �" Gv ,` �I'1 Ci. � � 5 � ►'
0r? tA r�tf' e ►'N P n �'y A. n o� ►` � �d n S
Page 7 of 8

Please pnn1, or type in the unshaded areas only
(fill—in areas are spaced for elite type, i.e., f2charactersanch).
A/4000 s'j 8 'fy �, '� L-a (s e in
Form Approved. OMB No. 2040-0086.------------
FORK}
"" u.S, ENVIRONMENTAL PROTECTION AGENCY.'
I, EPA I.D, NUMBER
GENERAL_ INFORMATION
D'
„EPA Consolidated Perrnits Program
GENERAL
(Read the "General tnatrurtionr"
before atarrinp.)
z
s
GENERAL INSTRUCTIONS
If a preprinted, label has teen provided, affix
1. EPA I.D. NUMBER
\
it in the designated space. Review the inform-,,
ation carefully; if any .of it is incorrect, Cross
LIE. FACILITY NAME\ ` \
\ \
through it and enter the correct data in the,
appropriate fill —`in area below. Also, if any of
the data is (the
FACILl7Y �` �' \
preprinted absent area to the.
label.
V \'
left of the space lists the information
MAILING ADDRESS�\� PLEASE PLACE -LABEL IN
THIS SPACE that should appear),' please provide it in tfie"
fill—in..
�\
proper erea(s), -below, if the label is
\
\ complete and correct, you need not complete..
Items I, Ill, V, end. V1 (except Vl-8 which
��
\
must be completed .regardless). Complete, all 'i
A
Vf FCILITY
items if no label has provided, Refer to.,
LOCATION \
the instructions for detailed . item descrip-
tions and for the legal authorizations under
which this data is collected.
II, POLLUTANT CHARACTERISTICS'
INSTRUCTIONS: Complete A through J to determine whether you need to
submit any permit application forms to the EPA.Af you.tinswer "yes" to any
questions, you must -submit this farm and the supplementsi form listed in. the parenthesis following the'question. Mark "X" in the box in the third column
if the supplemental form is attached, If you answer "no".to each question, you
need not stil6rn t'any of -these forms You,may tmswer•'•'no":if your activity.;yx
is excluded from permit requirements; see Section C of the instructions. See also, Section 1) of the instructions for definitions`of botd-faced terms.
SPECIFIC QUL•STrONS ;:
-
Me
■anM
err wc..eo
-SPECIFIC'OUESTIONS
ray
M
rya
FOAM �.
wrr wc,+e"
A. Is this facility it publicly owned treatment. works
B. Does or-witl'this facility (eltherexisting orproposvinfl ;
which results in a discharge to waters of the U.S.?
}�
include it concentrated animal feeding operation for
(FORM 2A1
aquatic animal production facility which results in,a
discharge to waters of the U.S.? (FORM 23)
,
, ,,
Is this a lacihwhich currently results in discharges
X
Isty this a propose facility other than t ose describe
to waters of the'U,S. other than those described in
•'In A or 8 above! which will result in'discharge to
iX
A or 8 aUove? !FORM 2C1
waters of the U.S7 (FORM 2Di
11
F. Do you o7'will-you inject at this facility'industrial:oi'
E, Does or will this fackily treat, store, 0; dispose of
j�
municipal effiuent below the lowermost Stratum con -
hazardous wastes? (FORM 3)
raining, .with iit'':one '.quarter. mile of-the:weil ..byre,,,.
'tr
as
30
undergrou; d,sources of drinking water? (FORM 41::
'31
32
1 33 "
o you or will you inject at t is all Ity any pro uce
water or other fluids which are brought to the surface
H Do you or wilS you Inject at this feclltty'flwds for spo .'
in connection with conventional Dil,or natural as pro.
g P
�/
cial prp.cesse4'sueh':as'�mining of sulfur !iy the.Frukh ,
ductian, inject fluids, for
/\
a�processs solution mining'i of minerars,, in';altu cornbw
used enhanced recovery of.+tlon`of
fossll''fuel or recovery of geothermal anergy7
oil or natural gas, or inject fluids for storage 0f, did
.,..i
�y(FORM ';- . ;r
:`.?
h drocarbons? IFORM 41'
s.
.'ta
a, �'�.-.c:4 '.+-'.-.:•'• . a7r.` _ z'
:.tr
,.
,x»..<�
I. s sh+s acI ity a,propose stat+omry.sourl:ew is rs
is Is. .acllity`a propose 's#attonary sourca;whlch;ls;'
one of the' 28 industrial categories Misted In ,the' in-
NOTE one of the 28 rndustHal categorles listed Ir1'th6
structions and which-will'poterluaily.emlt too -tons
"per
�/
/�
�tnstruCtlons and which'will,potentlaliy,eiitlt 250 tons '
year of; any air pollutant regulated `under -ihp.
pet year of;any,eir�kI!6tant regulated uniier,the;Clea"ny,
Clean Air Act and `rrtey effect or be" located m an'
Air.`ACt andrnay affect or be located to ;
x�d 51�,
attainrnentarea?::fI=ORM'5FvS�,'�" �`.�:� 5.,1r.%,a—
��t.+t'•
�an,,{iattetnment
�� r-'C,w4y'']-,.�.r-f.4/
�'40*'7a17
C�7_
'a4. r�.i.Y�,
Ill. NAME OF FACILITY
Z.
IV. FACILITY CONTACT
A.'NAME & TITL„E (Iat t,li((vl
"^'S M"••� -- 'B., PH ONE (ari•u cPdr•'d: rip.'} �'. .
', :-ter±},
o l'1r
a+ ar �a .a n et s•
to ,e
V. FACILITY MAILING ADDRESS
-
..� A. STRECY OR P.O. BOX',
s7
r b r iw. p ►1 (�e� y r s
B, CITY oR,rawN
.� ... �@�I! L'
C:STATE o. xIP CODE I
4 a r t
nr L Z 6 6
Vl, FACILITY LOCATION
A. STREET, ROUTIt NO. OR OTHER SPECIFIC IDENTIFIER
5 Z t{ e- r �D Y lu. a h I. t Y S
R- WATER Q' AILITY
gr
RMUEMA
B. COUNTY NAME
'Vk0MV
.�
iA
- x
l!� 1
.a -
-OR
ttr aw ./11 � {1,
2O I
C. CITY TOWN - "-�' -
F. CO C ✓�I, IO x t
'' Y '0,15TA're •! E z1P CooEfit 1 41 III
1 LIB
`6L>
L."
`>+s
6��
Al Eft Qt ` ' IR
EPA Form 3510.1 (8.90)

IV I I, SIC CODES N-digit, in order of priority!
. ..' A. FIRST ' ' .. -B. SCCONO :ra�_, 4d.•1f�.>
7 3 t
(speciJi'1
`FI ve,S 4- /&_Ktr ! 1.. (� l�if' 7 D 8 �!
(specifl•J
a.//t LJ kD dul-iJ
C. THIRD
'%j D. FOURTH - •+14.`:,�i§1
I1SPr­Jl /
I Ispeclrrl
VIER. OPERATOR INFORMATION
A. NAME
S. Is the -name listed In
c
Ito n V I I I -A also -,the
owner'..
YES NO
66 r2'r
C, ST&ATUS OF OPERATOR (Enter the 1ppropr aw lcttc'r is ro the mrs�rer bax-: if,'-U rhrr", SpeCirl'.)
D. PHONE (arCa Code & r10,)
F = F DERAIL
S -STATE
M = PUBLIC (ocher than federal or sic
O - OTHER {spcclfyi
P=PRIVATE
as
IVG�iL+
e
n - r+
rr zl
xx u
'
E. STREET OR P.O. 901C
i -i lei
3 r rr
n r �. Iti G� t? r s E
r
F.'C ITY OR TOWN
-` G,5TAT
H.:Z1P`CO6e'
IX.'INDIAN LAND
` .} Is the,f=0ity located on;lndian
g � L �t7 r ` NCB (/a � DZ O YEs ,N0.
y)))
is :'af. ax
X. EXISTING ENVIRONMENTAL PERMITS i T
A. NPDEs (Discharges to Surface Water) D. PSo (,tir b:rnissions from Proposed Sources)
9 fJ
xu ,. 9 P s
l ��
s. ufC (Underground Injection of,P7uids) E. OTHER (specilj'J
i�.�r�.•t
`c T i- (specify) -
�- C. R C R A (Ha SardOtlS WaS feS) <-., E. OTHER lSPCCirp) - - r,­$y_I
., .. l
—,—r--, - - - (specify)
,s ,•
IL MA'!
Attach to this'application a'topographic map ¢t the area exter!ng tout leas"t aria"ritile beyond propertylboundenet.
s The map must shorn
..the outline:of:ahe faculty the _location of eachfof its existing and proposed -intake and discharge,structures each of Its hazardouswa3t
treatment, storage or dlspose� faclitties and 'each well where' it Injects ftutd;'underground <inGude�all springs Aver; and other suFfaci
, d g„� er it E
Ovate rbodles In the map area.'See Instructlons,forlpreclse requlrerrsents F �, y? y l A; PTRI iti�^�`;ly>
XIL:NATURE OF=BUSINESS (provide.a brief deseriptipn
IA.t�.o +nit 4-kl k4s 0,11 �1>~ u i;
XIII. CERTIFICATION (see instructio0
! certify under penalty of law that 1 have personally.examined and am familiar with t4inf4orma-tion submitted in'this application and alis `
attachments and that,''based on my inquiry of those persons immediately responsible 'for obtaining"the information contained in they;
application, ! believe that the information is true, accurate and cothplete.' 1 am aware that there are significant penalties'for submitting A, j
false information, including the possibility of fine and imprisonment.
6. SIGNATURE C. DATE SIGNED
A. NAME & OFFICIAL YITLE.ftl'pPOr print) '
vglzZl1v
COMMENTS FOR,OFFICIAL USE ONLY k
rid '+'i-�r l.YirF.. C
�.'
EPA Forin 3510.1 (8-90)

Please print or type in the unehadetl areas only EPA ID Number (copy from item f of Form 7)
via Form Approved.
OMB Na 2040-0086.
Approval expires 8-31.98:
Form
2F
NpDES
United States Environmental Proteetion.Ageney
. Washington, DC M460
Application for Permit To Discharge Stormwater
EPA Discharges Associated with Industrial Activity
Paperwork Reduction Act Notice
Public reporting burden for this application is estimated to average 28,6 hours per application, including time for reviewing instructions.
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing lire collection of information. Send
comments regarding the burden estimate, any other aspect of this collection of information, or suggestions for Improving this farm, including
suggestions which may increase or reduce this burden to: Chief, Information Policy Branch, PM-223, U:S. Environmental Protection Agency,
401 M St., SW. Washington, DC 20460. or Director, Office of Information and Regulatory Affairs, Office of Management and Budget.
Washington. DC 20503.
1. •Outfall Location
For each outfall. list the latitude and lontlintude of its location to the nearest 15 seconis end the name of Ahe raceivingLwater,
A. Outfali Number
list
6. Latitude
172r79
C. Lon ituda
r71
D, Receiving Water
name)
W
Alf
�12SL'
8[
I1.Improvements
A. Are you now required by any Federal. State, or local authority to meet any implementation schedule for the construction, upgrading or
operation of wastewater treatment equipment or practices or any other environmental programs which may affect the discharges
described in this application? This includes, but is not limited to, permit conditions, administrative or enforcement orders. enforcement
compiiance schedule letters, siipulwions court orders. and grant or loan conditions.
1. Identification of Conditions.
A teements. Etc.
2. Affected Outfalis
3. Brief Descri lion of Project
4. Final
Com fiance Date
number
source of discharge
a. fog.
b, ►o',
S. You may attach additional sheets describing any additional water pollution (or other environmental projects which may affect your
discharges) you now have under way or which you plan. Indicate whether each program is now under way or planned, and indicate yow
actual or planned schedules for construction,
Ill. Site Drains a Ma
Attach a site map showing topography (or Indicating the ovVine of drainage areas served by the oudall(s) covered in the application if a
topographic map is unavailable) depicting the facility including: each of its intake and discharge structures; the drainage area of each storm
water outfall; paved areas and buildings within the drainage area- of each storm water outtall, each known past or present areas used for
outdoor storage or disposal of significant materials, each existing structural control measure to reduce pollutants in storm water runoff,
materials loading and access areas, areas where pesticides, herbicides, soil conditioners and fertilizers are applied; each of its hazardous'
waste treatment, storage or disposal units (including each area not rirquired to have a RCRA permit which is used for accumulating hazardous
waste under 40 CFR 262:34); each well where fluids from the facility are injected underground; springs, and other surface water bodies which
receive storm.water discharges from the facility.
EPA Form 3510.2F (11-00) Page t of 3 Continue on Page 2

Contfnued from the Font
W—NarraiNg Description of Pollutant Snuress
A. For each outfall, provide an estimate of the area pnclude units) of impervious surfaces (including paved areas and building roofs) drained
to the outlall, and an estimate of the total surface area drained by the outtall.
Ou"III
Number
Area of Impervious Surface
(provide u4AJ
Total Area Drained
Mlovide Units
Ouflatl
Number
Area of Impervious Surface
1provide unifs)
Total Area Drained
Innnyide unitst
�
s•� = ��2
� 5a1� �2
�
R� = �K � Z
zsr< �'�
wat
B. Provide a narrative description of significant materials that are currently or in the past three years have been treated, stored or disposed in
a manner to allow exposure to storm water; method of treatment, storage, or disposal: past and present materials management practices
employed. in the last three years. to minimize contact by these materials with storm water runoff; matariale loading and access areas; and
the local on. manner. and frequency in which pesticides. herbicides, soil conditioners, and fertilizers are applied.
ert,w� r,&, (g V" +IIV4- �)f'4Lt J V is 5" 1;, b ifs on 0L r
tyk"
C For each rvrfai1 pr:vioe the location and a description of existing structural and nonstructural control measures to reduce pollutants in
storm water runo": and a gesuiptian of the treatment the storm water receives, inclumn the schedule and type of maintenance for control
n r
WWI
List Codes from
Nurnber
Tr@atmenjT
3�ys 14.p� Glprc.J -] 671A�
1 �
c�rff
P'D �
V. NV nstormwater Dlschar es
A I certify under penalty of law that the ou all(s) covered by this application have been tested or evaluated for the presence of
nonstormwater discharges. and that all nonstormwater discharges from these outtall(s) are identified in either an accompanying Form 2C
r Form 29 applicalil2nf toe ougall.
Name and Official Title (type or prinrl
Signature
Date Signed
dd
E. Provide a descr'.p:ion of 1he method used, the date of any testing. and the ite drainage points that were directly observed during a test.
3rd 'e'SNIX-tJ can d:-I t.J �,� PAO' 4 Arlpt fo1 S v9 d
VI. Significant LeAks or sliiiiii
Provide existing information regarding the history of significant leaks or Wile at toxic or hazardous pollutants at the facility in the last three
years, including the approximate date and location of the spill or leak, and the type and amount of material released.
NONE
EPA Form 3510.2F (11-00) Page 2 of 3 continue on vage a

EPA IG Number (copy from Item 1 of Form r)
Continued from Pon* 2
A.B.C. & D: See instructlona before proceeding, Complete one set of tables for each outfall. Annotate the outfali number in the space prodded.
Tables VII•A. VANE and Vil-C are Included on separate sheets numbered VII-i and VII-2.
E. Potential discharges not covered by analysis - Is any pollutant listed in Table 2F•2 a substance or a component of a substance which you
currently use or manufacture as an intermediate or final product or byproduct?
Yes P..St all such pollufams below) NO (o to Section Vll!
Vill. Biological Toxicity Talling Data
Yes .:r st res-,'ts belcaf•
No ( o to Sec 5o.rt IX)
Yes
[21'No (go to Sevion X)
A. Name
B. Address
C, Area Coded Phone No ! D. Pollutants Ana!jaecl
X. Certificafl
A Name & Oft=aal Title (type or print)
i DC0
B Area Code and Phone No
431- YrIS-'
C. Signature
D. Date Si ned
EPA Form 3510.2F (11-9o) Page 3 of 3

EPA ID Number (copy from Item r of Form 1 ) — OMB Na2o4o-00BB.
} Approval ei�lres 1t-31-98. .
0
Part A- You must provide the results of at least one analysis for every pollutant in this table. Complete one table for each outtatt, See
instructions for additional details.
Maximum Values
Average Values
Number
aoslutan!
(include units)
(include units)
of
Grab Sample
Grab Sample
. and
Storm
CAS Number
Taken During
First 30
plow -weighted
Taken During
First 30
Flow -weighted
Events
!if availame)
Minutes
Composite
Minutes
Composite
Sampled
Sources of Pollutants
Ci! and Grease
5,oiogical Oxygen
Demand BODSI
Cnemicai Oxygen
/r1
Demand (COD)
Total Suspended
Solids (TSS)
Total Kieldahl
Nitro en
Nitrate plus
Nil-ite Nitrogen
Ota•
�H f"., ^ r st hlar-r^um Minimum Maximum
Pert v • its: each pc:•utam ;rat is :im+tec in an effluent guoelrne wnich the tecaity is suolect to or any ovwiant us;ea ir, the facility s NPDES
permit for its process wastewater {if the facility is operating under an exrsling NPDES permits. Complete one table lot each outfeJi,
ge h i. r '• r aggiliQnal
Maximum va'.ues I Average Values } Number
Poliaeeir-Clude uni;ei (include units) of
a-C Grab Sample Grab Sample I Storm
.: Taker. During i Taken During
Fi st �C Flow -weighted I Past 30 Flow -weighted Events
b"notes. Ccmposite Minutes Composite (Sampled Sources of Pollutants
EPA Form 3510-2F (11.90)
��Sir�i/l�tllt �
0
an

Part C - List each pollutant shown in Tables 2F-2, 2F-3, and 2F4 that you know or have reason to believe is present, See the instructions for
additional details and requirements. Complete one tags for each outfall,
Pollutant
and
CAS Number
(ilavailable)
Maximum Values
(lnelude unks)
Average Values
(include units)
Number
of
Storm
Events
Sampled
Sources of Pollutants
Grab Sample
Take f 30 9
Minutes
Flow -weighted
Composite
Grab Sample
Ta Fr51 30
Minutes
Flow -weighted
I Composite
I r
i ! i
I
a
I
!
if
-
i
I
Part D - Provide data for the storm @VentsI
which resulted in the'maximum values for the flow weighted com osits sample.
t.
Date of
Storm
Event
2.
Duration
of Storm
(in minutes
3•
Total rainfall
during storm event
in inches
,,
Number of hours between
beginning of storm mass-
tired and end of previous
measurable rain event
5.
Maximum floe rate
during rain event
(gallons/minute or
s units
8.
Total flow from
rain event
(gallons or
MPGOV units)
7.
Season
sample was
taken
B.
Form of
Precipitation
(rainfaA,
snowrrtelt
JV
9. Provide a description of the method of flow measurement or estimate.
EPA Form 3510.2f (11.90)
PageVll-2

Print Parcel Map Page 1 of 1
Real
cA�,�wsa coin Tv, NcEstate
Search
Parcel summar F Printed Map Scale 1 inch = 820ft
Parcel ID: 372206371611 11 Parcel Address: 243 PERFORMANCE DR SE, HICKORY
Owner: SHUFORD
Address: PO BOX 2228
City: HICKORY
DEVELOPMENT INC
Owner2: Address2: State/Zip: NC, 28603-2228
Building(s) Value: $62,100 Land Value: $315,000 Total Value: $377,100
DISCLAIMER; This map/report product was prepared from the Catawba County, NC Geospatlal Information Services, Catawba County
has made substantiai efforts to ensure the accuracy of location and labeling Information contained on this map or data on this report.
Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the
user. The County or Catawba, Its employees, agents, and personnel, disclaim, and shall not be held liable for any and all damages, loss
or liability, whether direct, indirect or consequential which arises or may arise from this map/report product or the use thereof by any
person or entity.
http://www.gis.catawba.nc.us/website/Parcel/printMap.asp?pinc=372206371611 &paddr=2... 4/26/2010

Client : Roil Tech
243 Performance Drive SE
Hickory, NC 28602
Attention• Mr. Todd Blair
Date Received:
18-May-10
Report Date:
03-Jun-10
Sample Date:
17-May-10
ItRL h:
EARL-2010-0360
Lah Sample ID:
LSID-2010-02178
Client Sample 1D:
NW
Parameter
TSS
ptl
Reported By:
Result MQL
5 1
8,25 HT 0.01
W Analysis
Analysis
Unit Method Time
Date Analyst
mg/l SM 19 2540D 16:21
5/24/2010 KCJ
su SM 19th 4500 13:10.
5/18/2010 KCJ
S. I son, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page l of 12

Client:
Roll Tech
243 Performance Drive SE
Hickory, NC 28602
Attention:
Mr. Todd Blair
Date Received:
18-May-10
Report Date:
03-Jun-10
Sample Date:
17-May-10
BR I, th
BRL-2010-0360
Lab Sample ID:
LSID-2010-02179
Client Sample ID:
NW
Parameter
Result MQL
BOD-5 day
- 236.7 2
Unit Method
mg/1 EPA 405.1
Analysis Analysis
Time Date Analyst
5/24/2010 WtrQlty
Reported By:
S. J nson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 2 of 12

Client : Roll Tech
243 Performance Drive SE
Hickory, NC 28602
Attention• Mr. Todd Blair
Date Received:
18-May-I0
Report Date:
03-Jun-10
Sample Date:
17-May-10 .
Bill, #:
BRL-2010-0360
Lab Sample ID:
LSID-2010-02180
Client Sample ID:
NW
Parameter
Result MQL
�
7_11 ---��
_.
0.234 0.001
Reported By:
Unit Method
mg/I EPA 200.7
S. J. nson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 3 of 12
Analysis Analysis
Time Date Analyst
14:35 5/20/2010 KCJ

Client: Roll Tech
243 Performance Drive SE
Hickory, NC 28602
Attention• Mr. Todd Blair
Date Received:
18-May-10
Report Date:
03-Jun-10
Sample Date:
17-May-10
BRL ti:
BRIE 2010-0360
Lab Sample ID:
LSID-2010-02181
Client Sample ID:
NW
Parameter
Result MQL
_ - ----
COD - -�. _ --- - --
- -
170 20
Unit Method
mg/l SM 5220D
Analysis Analysis
Time Date Analyst
5/25/2010 WtrQlty
Reported By: eSVn
_, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 4 of 12

Client :
Roll Tech
243 Performance Drive SC
Hickory, NC 28602
Attention:
Mr, Todd Blair
Date Received:
18-May-10
Report Datc:
03-Jun-10
Sample Datc:
17-May-i0
BRL #:
BRL-2010-0360
Lab Sample ID:
LSID-2010-02182
Client Sample ID:
NE-
J�
Analysis
Analysis
Parameter
Result
MQL Unit Method
Time
Date Analyst
-
- _—' 17
1 mgll SM 19 2540D
16:22
5/24/2010 KCJ
I SS
PI -I
5.90 HT
0.01 su SM l9th 4500
13:12
5/18/2010 KCJ
Reported By:---
S. I son, D.R. Wessinger
* Concentrations are
below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 5 of 12

Client: Roll Tech
243 Performance Drive SE
Hickory, NC 28602
Attention: Mr. Todd Blair
Date Received:
18-May-10
Report Date:
03-.1un-10
Sample Date:
17-May-10
BRL H:
BRL-2010-0360
Lab Sample ID:
LSiD-2010-02183
Client Sample ID:
NE
Parameter Result MQL
13OD-5 day 285.0 2
Reported By:
Unit Method
mg/i EPA 405.1
S. . hnson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 6 of 12
Analysis Analysis
Time Date Analyst
5/24/2010 WtrQlty

Client:
Attention:
Roll Tech
243 Performance ,Drive SE
Hickory, NC 28602
Mr. Todd Blair
Date Received:
18-May-10
Report Date:
03-Jun-10
Sample Date:
17-May-10
BRL 4:
BRL-2010-0360
Lab Sample ID:
LSID-2010-02184
Client Sample ID:
NE
Parameter
%n
Reported By:
Result MQL
0.133 0.001
Analysis Analysis
Unit Method Time Date
mg/1 EPA 200.7 11:41 6/3/2010
S. J. nson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 7 of 12
Analyst
KCJ

Client :
Roll Tech
243 Performance Drive SC
1-lickory, NC 28602
Attention:
Mr. "Todd Blair
Date Received:
18-May-10
Report Date:
03-Jun-10
Sample Date:
17-May-10
BRL H:
BRL-20 10-03 60
Lab Sample ID:
LSID-2010-02185
Client Sample ID:
NE _-_ ___�__ �— -•._.
Analysis Analysis
Parameler
Result MQL Unit_ Method Time Date Analyst
2210 20 mg/l SM 5220D 5/25/2010 WtrQlty
COD
Reported By:
S. J Anson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 8 of 12

Client :
Roll Tech
243 Performance Drive SE
Hickory, NC 28602
Attention:
Mr. Todd Blair
Date Received:
18-May-10
Report Date:
03-Jun-10
Sample Date:
17-May-10 .
B111, ti:
BRL-2010-0360
Lab Sample ID:
LSID-201 0-02 186
Client Sample 11):
Dock
Analysis Analysis
Parameter Result MQL Unit Method Time Date Analyst
1"SS 5 I mg/l SM 19 2540D 16:23 5/24/2010 KCJ
PH 7.74 HT 0,01 Su SM 19th 4500 13:14. 5/18/2010 KCJ
. Reported By:
S. I J on, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 9 of 12

Client : Roll Tech
243 Performance Drive SE
Hickory, NC 28602
Attention: Mr. Todd Blair
Date Received: 18-May-10
Report Date: 03-.tun-10
Sample Date: 17-May-10
BRL 4: BRL-2010-0360
Lab Sample I1): LSID-2010-02187
Client Sample ID: Dock
_ Analysis Analysis
Parameter Result MQL Unit Method Time Date Analyst
E30D-5 day- - — `-----351.7 2 mg/l EPA 405.1 5/24/2010 WtrQlty
4
Reported By: _ __ __ _ ---
S. J. J� son, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 10 of 12

Client :
Roll Tech
243 Performance Drive SE
Hickory, NC 28602
Attention:
Mr. Todd Blair
Date Received:
18-May-I0
Report Date:
03-Jun-10
Sample Date:
17-May-10
Bill, 4:
BRL-2010-0360
Lab Sample ID:
LSID-2010-02188
Client Sample ID:
Dock
Parameter
%n
Result MQL
0.074 0.001
Analysis Analysis
Unit Method Time Date Analyst
mgll EPA 200.7 11:55 6/3/2010 KCJ
Reported By:
S.J. nson, D.R. Wessinger
J.
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page l 1 of 12

Client :
Attention:
Roll Tech.
243 Performance Drive SF
Hickory, NC 28602
Mr. Todd Blair
Date Received:
18-May-10
Report Date:
03-Jun-10
Sample Date:
17-May-10
B12L #:
BRL-2010-0360
Lab Sample ID:
LSID-2010-02189
Client Sample -ID:
Dock
Parameter
COD
Reported By:
Result MQL
140 20
Unit Method
mg/l SM 5220D
S. J. son, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 12 of 12
Analysis Analysis
Time Date Analyst
5/25/2010 WtrQlty

Data Qualifiers
The following is a list of data qualifiers used on Blue Ridge Labs' Reports. Any of the
qualifiers may make the data unacceptable for state reporting. Data qualifiers are
found in the results column and their definitions are as follows:
* The concentration found is below our minimum concentration value which is
reported in the MQL column.
*** The concentration reported is an estimated value. The result is above our
highest standard.
HT The sample was received out of hold time.
IC The sample was received in an improper container.
NC The sample was received without proper cooling.
NP The sample was received without proper preservatives.
IC The sample was received in an improper container.
HS The VOC container was received with headspace present.
NR The sample was riot run due to lab error.
UC Unable to confirm analysis due to insufficient sample being submtted.
D Sample was diluted due to physical problems with the sample..
J Value is an estimate from a library search using the nearest internal standard.

.•, — -- , i .1— w yr r nn 01v, VC 0UJUULJJ
r uui
WATER QUALITY LAB & OPERATIONS, INC.
P.O. BOX 1107
BANNER -ELK, NC•,28604-------.-.......---.....,..__—...---__ ..�_,..�... - -...._
[phone]
CLIENT: BLUE RIDGE LABS LOGIN TIME;
ADDRESS: P,O. BOX 2940 SAMPLER:
CITY: LENOIR RECEIVED DATE:
STATE: NO ZIP 28645 REPORTED DATE: 25-May-10
IDA.
.W
-
COD
1709
170
20
MOIL
25-Ma -10
PI
COD
2000
430
20
MG/L
26-M -10
PI
COD
2002
690
20
MOIL
25-Ma -10
PI
COD
2116
010
20
MGIL
26-MA -10
Pl
COD
2181
170
20
M(3IL
25-Ma -10
PI
COD
2186
210
20
MG/L
28-Ma -1p
PI
COD
2189
140
20
MOIL
125-May-101
PI
COD
2260
100
20
MGIL
1.25-May-101
PI
REPORTED BY: NO CERTIFIED LAB # 544
PAUL ISENHOUR,'SUPERVISOR
'
4
•
I
E
-1
Eli

WATER QUALITY LAB & OPERATIONS, INC.
P.O. BOX 1167
BANNER ELK, NC 28604
[phone]
CLIENT: BLUE RIDGE LABS LOGIN TIME:
ADDRESS; P.O. BOX 2940 SAMPLER:
CITY: LENOIR RECEIVED BATE:
STATE: NC ZIP 28646 REPORTED DATE: 25-May-10
ID#:
MAW
SOD 6 DAY
2179
230,7
2.00
M41L
24-Ma -10
PI
130D 6 DAY
2183
285.0
2.00
MAIL
24-Me -10
PI
BOD 6 DAY
2187
351.7.
2.00
FMG/L
24-Ma -10
1 PI
REPORTED BY: NO CERTIFIED LAB # 644
R�
PAUL ISENHOUR, SUPERVISOR

NPDS Reporting
Report To:
Groundwater
T dd T�la:w
M 3 r�erf-.,a�.� u �j r ,SE
�] ti.,k.n2 , NC ZSL4?Z
4-1,GIA'ho Q- vs1LL.k _.J Field
Blue Ridge Labs, Inc.
fix, PIM , 0
P.O. Sox 2940 M &I
Lenoir. AC 28645 l �/
Telephone [phone] Fax [phone]
Chain of Custody
t Ok YO
Sanitary Landfill . Hazardous Waste Industrial or QC Non State Reporting
UST/Trust Fund Reporting
Bill To:
Project Name:
PO Number:
° Preservatives Lab Check
Sample ID
Sample
Type
Date
Time
Time &
Temp
HR:MM �C
Resid Chlor
Field Check
Yes No
Field
Decldorination
Yes No
pH
Resid
Chlor
P or A
Temp
°C
Sampler
Initials
Analysis Requested
NW tx�)
Dock �K4'
elinqui D te: Time:
s�
Date: Time:
S %G
Rev. 12/23/2009
Upon submission of samples, client agrees that invoices are due at the time work is completed. Open accounts are due 20 days following invoice date. A finance charge of 1.5% per month will be imposed on all pastiue accounts.
When relinquishing samples to Blue Ridge Labs (BRL), buyer authorizes BRL to perform only the analysis indicated above and also agrees to pay collection and attorneys fees if the account becomes delinquent. Blue Ridge Labs
reserves the right to deny documentation for any work where payment has not been made, in effect rendering that data unsupported for re--ktory purposes. BRL cannot guarantee that any work submitted will be accepted by any
regulatory authority, therefore it is the client's responsibility to request on this form appropriate tests. NC DENR Ccrtifed Lab 9275

Larsen, Cory
From: Bell, Wes
Sant: Wednesday, January 20, 2010 4:12 PM
To: Larsen, Cory
Subject; RE: SW Permit Designation - Roll -Tech, Catawba County
They could do "No Exposure" route but it would take quite a bit of effort (and probably money too). I did not get an
indication from them as to which route they will go....
M
Wes Bell - Wes.Bell ncdenr. ov
North Carolina Dept. of Environment & Natural Resources
Div. of Water Quality
610 E. Center Ave., Suite 301
Mooresville, NC 28115
Ph:704.663.1699 Fax:[phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties. .
From: Larsen, Cory
Sent: Wednesday, January 20, 2010 9:30 AM
To: Bell, Wes
Cc: Krebs, Rob
Subject: RE: SW Permit Designation - Roll -Tech, Catawba County
Thanks Wes. I've been out of the office until today. Did you get an indication of whether they going to go ahead and
submit forms for an individual permit like I requested or try to achieve no exposure?
Cory
From: Bell, Wes
Sent: Wednesday, January 13, 2010 4:39 PM
To: Larsen, Cory
Cc: Krebs, Rob
Subject: SW Permit Designation - Roll -Tech, Catawba County
Cory, I visited the Roll -Tech facility today and they will need to apply for a SW Permit. They do have exposure (from the
tire material) and will have, to do some site adjustments before they consider going the NO Exposure route. I have
informed Todd Blair, General Manager, of his options (SW Permit or No Exposure Certification following the removal of
exposures- if performed)., Let me know if there's anything else.
WB
Wes Bell - [e-mail]
North Carolina Dept. of Environment &.Natural Resources
Div. of Water Quality
610 E. Center Ave., Suite 301
Mooresville, NC 28115
Ph:704.663.1699 Fax:[phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.

The Charlotte Observer Publishing Co.
Charlotte, NC
North Carolina ) ss Affidavit of Publication
Mecklenburg County)
THE CHARLOTTE OBSERVER
--------------------------------------------------+------------------------
DINA SPRINKLE
NCDENR/DWQ/POINT SOURCE BRANCH
1617 MAIL SERVICE CENTER
RALEIGH NC 27699
REFERENCE: 30063432
6483355 ncs000538
Before the undersigned, a Notary Public of said
County and State, duly authorized to administer l
oaths affirmations, etc., personally appeared,
being duly sworn or affirmed according to law, l
doth depose and say that he/she is a
representative of The Charlotte Observer l
Publishing Company, a corporation organized and l
doing business under the laws of the State of l
Delaware, and publishing a newspaper known as The l
Charlotte Observer in the city of Charlotte, l
County of Mecklenburg, and State of North Carolinal
and that as such he/she is familiar with the l
books, records, files, and business of said
Corporation and by reference to the files of said
publication, the attached advertisement was l
inserted. The following is correctly copied from
the books and files of the aforesaid Corporation l
and Publication. I
PUBLISHED ON: 07/10
NC5000530 A W..r,rhit(17iti-
NC OIYISION OF WATER OUAU Y-INTENT TO ISSUE A
). f 'STORMWATER DISCHARGE PERMIT .
Public gcomment or'objection to the draft permit is invited. Submit
wrisentcommente to-oWO'aVthe(addrassybelow..All oommams
received prior to Augus1 14. 2014.w111 be corwldered'in'the finial
determination fpgardkng permit issuance and perms proir i ns.
'Appticntlon; Roll-Tach,,LLC' has,appifed tor''an NPDES permit to
discharge stormwater from an Industrial facility located in Hickory,
Catawba County, NC. The facilitydischargea to Miller Branch.
Copley o1 the tlraft pemdt,number NC5000538; are available at
http://portal. ncdonr. orgtweblwq)wsisu(currant-nDtices!'Additlonal
permit documents are avellable.f-or;the reproduchon cost at;
OWO Stormvwefai Permitting Z.,
.3
512 N. swiseufy.simet (location, tip 21WOL:
1017 Mall Service Center Small)'"""-
Ra19Igh;NC'Y7699-t6iT"'Mi".'A110J
OWO Contsct: CoryLarsen-. Lr>#Wi).
(919)f l�e.i?sl ll
+w;yu
LP$463355= . If
i
I
I
I
AD SPACE: 50 LINE l
FILED ON: 07/15/10 l
------ ---- --- ---------- + --
NAME: TITLE:
DATE: 5 Zulu
In Testimony Whereof 1 have hereunto set my hand and affixed my seal, the
day and year aforesaid.
My Commission Expires May 17, 2011
Notar .�-fkal�oamission Expires: _/_/_

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coieen H. Sullins
Governor Director
December 17, 2009
Mr. Patrice Bertrand, President/CEO
Roll -Tech, LLC
243 Performance Drive SE
Hickory, North Carolina 28602
Subject: Request for Additional Information
Roll -Tech Facility
Catawba County
Dear Mr, Bertrand:
Dee Freeman
Secretary
The Division of Water Quality's Stormwater Permitting Unit is currently reviewing your application for coverage under NPDES
General Permit NCG050000 received on December 10, 2009. A preliminary review of the application and subsequent email
correspondence has determined that the primary industrial activities performed by the Roil -Tech facility exclude it from
coverage under NCG050000, As noted on the Notice of Intentand text of the general permit, activities described by SIC 301
Tires and Inner Tubes are specifically excluded from coverage under this general permit. As such, an NPDES individual permit
will be required for the facility. The following information is needed to apply for coverage under -an individual permit:
EPA Form 1 (attached and located electronically on our website at:
http://h2o.enr.state.nc.us/su/documents/EPAform_1 August1990,pdf).
EPA Form 2F (attached and located electronically on our website at:
bttla:1lh2o.enr.state.nc.us/suldocuments/EPAform 2f lanuary1992.1)df)
Permit application fee of $860.00 made payable to NCDENR.
The requested information should be received by this Office prior to January 29, 2010. If you need additional time to submit
the information, please send your request for a time extension to the Division at the address and fax number at the bottom of
this letter. The request must indicate the date by which you expect to submit the required information.
If you have any quE-dons concerning this matter feel free to contact me at [phone] or [e-mail].
Sincerely,
Cory Larsen
Environmental Engineer
cc: Mooresville Regional Office
Stormwater Permitting Unit Files
Attachments
Wettands and Stormwater Branch One
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 North Carol i li a
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1.877-623.6748 ;Vatu ally
Internet: www.ncwaterQuality.org

Larsen, Cory
From: pbertrand [pbertrand@rolltechmet]
Sent, Wednesday, December 16, 2009 8 36 AM
To; Larsen, Cory
Cc: TBlalrCrolltech net
Subject: RE: Rcll-Tech Notice of Intent for NCG05M
Dear Sir,
Our primary activity is Rubber manufacturing. We used scrap rubber from recycled car tires and
make a new solid rubber tires for material handling wheels. We manufacture plastic rims to assemble
with tires as part a secondary process,
Hoping I answered your question?
Best regards,
Patrice Bertrand
From: Larsen, Cory [mailto:[e-mail]]
Sent: Tuesday, December 15, 2009 4:09 PM
To: [e-mail]
Subject: Roll -Tech Notice of Intent for NCG050000
Dear Mr. Bertrand,
I'm processing an application for the Roll -Tech facility received by DWQ on December 1, 2009 for coverage under NPDES
stormwater permit NCG05000. The application lists two SIC codes: 3011 and 3089. Which one is the primary SIC code?
In other words, is most of Roll-Tech's business generated from activities associated with 3011—Tires and Inner Tubes OR
from 3089 — Plastics Products? This is needed to evaluate whether or not this particular permit is appropriate. Please
let me know at your earliest convenience.
Thank you.
Cory Larsen
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
E-mail correspondence to and from this addre may b subject to the North Carolina Public Records Law and may be
disclosed to third parties. W?_0
p2[11 f 0-1 -- � ��V-�. Alt otu ,

Expired Permits
10/24/2007
W10500068
M L Norwood
Norwood, M. L. - SFR
Minor
EXPIRED
08/02/88
07/15/93
evan-kane
Orange.
Raleigh
W10500069
Karl Mrozek
Mrozek, Karl & Marilyn - SFR
Minor
EXPIRED
03/29189
03/15/94
evan.kane
Durham -
Raleigh
W10500132
Seven Properties BDM, LLC
Southern States BDM, LLC
Minor
EXPIRED
09/15/05
09/01/07
michael.ranck
Wake '
Raleigh
W10500135
Gentex Printing c/o Crown Carriers
Former Gentex Printing
Minor
EXPIRED
09/27/05
10/01/07
peter pozzo -
Nash
Raleigh
W10500141
M M Fowler Inc
Fanner SP Station No. 24184
Minor
EXPIRED
04111ft
10/01/07
michael.ranck
Durham-
Raleigh
W10500142
Mid Atlantic Warehouse And Storage
Former Benetton Facility
Minor
EXPIRED
06/01/06
10/01/07
michael.ranck
Nash
Raleigh
WI0600001
Michael Batenburg
Batenburg, Michael - SFR
Minor
EXPIRED
06/20/97
06/30/02
evan.kane
Moore
Fayetteville
WL0600602
McGirt Store
McGirt Store
Minor
EXPIRED
06/06196
06/01/01
evan.kane '
Robeson
Fayetteville
W L0600003
Fort Bragg Simons Airfield
Fort Bragg Simons Airfield
Minor
EXPIRED
10123196
10/31/01
evan.kane
Cumberland
Fayetteville
W 10600004
Pape Air Force Base
Pope Air Force Base
Minor
EXPIRED
10121/98
10/31/03
evan.kane
Cumberland
Fayetteville
W10600005
Alamac American Knit LLC - Lumberton Plant
Alamac American Knit LLC - Lumberton Plan
Minor
EXPIRED
04105/00
03G1105
evan.kane
Robeson
Fayetteville
W10600006
Segro
Segro-Colonial Abrasive Produc
Minor
EXPIRED
0210WII
01/31/04
evan.kane
Moore
Fayetteville
W10600010
Abbott Laboratories
Abbott Laboratories -Scotland
Minor
EXPIRED
07/16/01
07/31/03
evan.kane
Scotland
Fayettevii
W10600016
Gulf Oil Co Ser Station
Gulf Oil Co. Ser. Station
Minor
EXPIRED
11/09/84
11/09/89
evan.kane
Cumberland
Fayetteville
Vi/10600030
US ArmylFort Bragg
Fort Bragg Military Reservation
Minor
EXPIRED
05/20/05
03/27107
evan.kane
Cumberland
Fayetteville
W I0700003
Eugene W Pate
Pate, Jr., Dr. Eugene W. - SFR
Minor
EXPIRED
08/01/95
08/31/00
evan.kane
Lenoir
Washington
WI0700004
Robert C Nielson
Nielson, Robert C. - SFR
Minor
EXPIRED
08/06/90
08/06/95
evan.kane
Lenoir
Washington
W10700005
David Taylor
Taylor, David - SFR
Minor
EXPIRED
0a106190
08/06/95
evan.kane
Lenoir -
Washington
W10700009
Donald B Parrott
Parrott, Donald B. - SFR
Minor
EXPIRED
03/10/92
03/10/97
evan.kane
Lenoir'
Washington
W10700010
Allyn Preston
Preston, Allyn -SFR
Minor
EXPIRED
06/12/92
06/12/97
evan.kane
Craven'
Washington
W10700011
H A Robinson
Robinson, H. A. - SFR
Minor
EXPIRED
03/11/91
03/11/96
evan-kane
Beaufort
Washington
W10700014
Jones, William T. -SFR
Minor
EXPIRED
06/30/92
06130/97
evan-kane - '
Dare
Washington
W10700015
Tom Harp
Harp, Tom - SFR
Minor
EXPIRED
08103M8
08/31/03
evan.kane R
Hertford
Washington
WI0700016
Harold Seaman
Seaman, Harald -SFR
Minor
EXP[RED
02/10/94
03/01/99
evan.kane
Dare,
Washington
W10700017
E I DuPont de Nemours and Company
E.I. Dupont Nemours Co.
Minor
EXPIRED
02121/94
02/28199
evan.kane
Lenoir.
Washington
W10700021
Zbigniew Kabala
Kabala,Zbigniew -SFR
Mirror
EXPIRED
08/12197
08/31102
evan.kane
Greene -
Washington
W10700022
Dare County Bombing Range
Dare County Bombing Range
Minor
EXPIRED
05120/98
05KI1103
evan.kane
Dare
Washington
W10700023
United States Coast Guard
USCG
Minor
EXPIRED
05/12/00
05131M3
evan.kane
Pasquotank
Washington
WI0700024
United States Coast Guard
USCG
Minor
EXPIRED
02/26/99
06130l00
evan.kane
Pasquotank
Washington
W10700025
Dupont Co - Kinston
Dupont Co. - Kinston
Minor
EXPIRED
03/23/99
04/15/04
evan.kane
Lenoir
Washington
W10700026
United States Coast Guard
USCG
Minor
EXPIRED
05/01/00
05/31/03
evan.kane
Pasquotank
Washington
W10700028
Alamac Knit Fabrics
Alamac Knit Fabrics
Minor
EXPIRED
08110M
08/3t/00
evan.kane
Martin
Washington
WI0700029
Duke University
Duke University
Minor
EXPIRED
M19100
08Y31/05
evan-kane
Greene
Washington
W10700033
United States Coast Guard
USCG
Minor
EXPIRED
05/01/01
04MM6
evankane
Pasquotank
Washington
W1070DO36
United States Coast Guard
USCG
Minor
EXPIRED
02/28/02
03131/07
evan.kane
Pasquotank
Washington
W10700047
Robert W Barber
Barter, Robert W. - SFR
Minor
EXPIRED
06/06/80
04/15185
evan.kane
Beaufort
Washington
WI0700048
John H Culley
Culley, John H. - SFR
Minor
EXPIRED
09123/85
12/31/90
evan.kane - •
Craven
Washington
W10700084
SMG Real Estate Holding Company, LLC
former White Packing Company site
Minor
EXPIRED
03M6105
0313t/07
thomas.slusser
Martin
Washington
W107OW85
Seymour Johnson AFS Ss09
Seymour Johnson AFB
Minor
EXPIRED
08/17/05
08/01/07
michael,rarrck
Wayne
Washington
W10700090
Seymour Johnson AFBSs09
Seymour Johnson AFB
Minor
EXPIRED
04/17/06
09/01/07
michael.ranck -
Wayne
Washington
Wt0800002
Barden- NCSU: Jennifer Site
Borden- NCSU: Jennifer Site
Minor
EXPIRED
08/31/93
68131/98
evan.kane
Brunswick
Wilmington
WIG800003
Barden- NCSU: Arvida Site
Borden- NCSU: Arvida Site
Minor
EXP1REp
03102/94
63 331199
evan.kane
Pender
-
Wilmington
Peppertree Resorts LTD
Peppertree Resorts, LTD.
-Minor
Minor
EXPIRED
08117/94
05/01/96
evan.kane
Carteret
Wilmington

NCDENR
IM �.IN� 11U\PTIM�E�Y�f M
rHYwoNMrvr .NA IiQUUY.....TNlG�
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCGO50000
FOR AGENCY USE ONLY
Date Rectived
Year
:North
Da
Certificate of Covers
e
Check #
Amount
Pcmai Avsiined to
_;
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCGO50000:
STORMWATER DISCHARGES associated with activities classified as:
SIC' 23
Apparel and Other Finished Products Made from Fabrics and Similar Materials
SIC 265
Paperboard Containers and Boxes
SIC' 267
Converted Paper and Paperboard Products
;
SIC 27
Printing, Publishing and Allied Industries
I CD
SIC' 30
Rubber and Miscellaneous Products (except as specified below)
C�=
SIC+ 31
Leather and Leather Products (except as specified below)
tJ LWM
SIC 39
Miscellaneous Manufacturing Industries
VSIC"
NIA
Like activities deemed by DWO to be similar in the process and/or the exposu ram„'
materials, products, -by-products, or waste materials
i`9
The following activities are specifically excluded from coverage under this General Permit:
SIC 301 Tires and Inner Tubes
SIC' 311 Leather Tanning and Finishing
" Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondgoggll be mailed
Name gerfralld
Street Address!_ ��g01
City III aKa 04
Telephone No. SLS 431- q515
E-mail Address o b e-r f irn ntl &
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
State lVG ZIP Code XSG 0'2-
Fax: RIA _ ±�1 -qHSo
1+ i L kotr„ _ State Ur, - ZIP Code 9 Ql� m ;;t-
$ x %- . 14 31 - y 1 5 Fax: !R 2,�3 - b
3) Physical Location Information:
Please provide a narrative description of how to get to thA facility (use street names, state
distance and direction from a roadway intersection). i--:N n IN i EAi Ire c-o uc CharLh
%1 1 5 —1 1 � . L l . %,� -- L —1 . 1 n . . i 1. L 1 _
(A copy of a county map or USES quad sheet with facility clearly located on the map is required with this
Page 1 of 4
14
numbers, and
pui ICI�'t-i,� vyt i�
SWU-220-07140E Last Revised 7/14108

Y I.S
� •;Z r � t'1� rIL. - .. 1� l .'' f.!'�t'. V 1,
•� .':r Sri � ..
_ �.''...- .Il' y.. 'j. _.M 'l lyl,I1 _..'.lT. -. �....��'rl:i' .r r>t•wi •c ..+•- ' i
Jr ).41a '

NCG050000 N.O.I.
4) Latitude 3,5' �5 ' 39 " Longitude n 43 ' 4bz (degrees, minutes, seconds)
6) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin 49
Existing `r rC, *,4 j�.Kt, `� otz — kIiX4.("
6) Standard Industrial Classifl ion:
Provide the 4 digit Standar Industrial lassification Code (SIC Code) that describes the primary industrial
activity at this f _ G j S�rt,t
3 08� • Ckt.L � s� th' I1
SIC Cod :� LL _L E I�
7) Provide a rative description of the types of Industrial activities and products manufactured at
this facility: Jbi2yau�,A��u�rc _Sp� �uf��nr�� hire ubeelS C.r1ct~_c,!ftjir,-i1Aa c_
-I ;tee 5 _ _ _
8) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? X
9) Receiving waters.
What is the name of the body or bodies of water (creek f steam, river, lake, etc.) that th facility stormwater
discharges end up in? Li,. C C-0-ay, C it- U - (d `sl Cf An�/Fd
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer). 6U,4
10) Does this facility have any other NPDES permits?
0 No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
I$1 No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
1 2) Does this facillty employ any best management practices for stormwater control?
(I No
❑ Yes
If yes, please briefly describe:
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
X1 Yes
If yes, when was it implemented?
14) Are vehicle maintenance activities occurring at this facility?
0 No ❑ Yes
Page 2 of 4
SWU-2M071406 Last Revised 7/14/08

._. , ,,� , _.,. , ��,,. _. � r
._ .�i �

NCG050000 N.O.I.
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
CQ No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg
hazardous waste?
1ANo ❑ Yes
or more of hazardous waste generated per month) of
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor: _
Vendor address:
16) Certification:
North Carolina General Statute 143-215.6 b (1) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is%tr c-omplete�, and accurate.
Printed Na a of Person Signing: L +Cc cc ijCrt l fZA h[_ o
Title:.._..._._ / "" e a c k /mac"a
a— lie J-;o
(Signature of Applicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR.
Page 3 of 4
SWU-220-071408 Last Revised 7/14/08

Catawba County, North Carolina
This map product was prepared from the Catawba County, NC, Geographic information System.
N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information
contained on this map. Catawba Countypromotes and recommends the independent verification ofany
data contained on this map product by the user. The County of Catawba, its employees, agents and
personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect
or consequential which arises or may arise from this map product or the use thereof by arty person or entity. Legend
1 inch = 151 feet
/ THIS 1S NOT A LEGAL DOCUMENT
Selected Parcel Number: 3722-06-37-1611
Prepared for:
Thursday, September 10, 2009 12:38 PM
"/ / / 11i11 \ \ \ \ \

Print Map Page 1 of 1
Real
@&O Estate
Search
Plat Book 38 Page 133
DISCLAIMER, This map/report product was prepared from the Catawba County, NC Geospatlal Information Services. Catawba
County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this
report. Catawba County promotes and recommends the independent verification of any data contained on this map/report product by
the user. The County of Catawba, Its employees, agents, and personnel, disclaim, and shall not be held liable for any and all damages,
loss or liability, whether direct, Indirect or consequential which arises or may arise from this map/report product or the use thereof by
any person or entity.
http://www.gis.catawba.nc.us/website/Parcel/printMap2.asp?key=38&key2 =133&typ=PB 9/10/2009

+� 1
STATE OF NORTH CAROLINA HIC:KO TY QUADRANGLE
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RALEIGH, NORTH CAROLINA 7.5 MINUTE�PERIES (TOPOGRAPHIC)4755 IV SE
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