AQ_F_1700005_20221009_EI_PreForm (4)

List of Contents of this Inventory Package
The list below is a summary of the forms contained in this package.
1. Pre-Submittal Check List(optional tool for your use and benefit as a double check before submittal).
2. Listing of Emission Sources and Control Devices on Permit List(check list to use for organization,review and keeping
track of data previously submitted and in the inventory)
3. Blank Emission Source/Operating Scenario Data Form-make multiple copies to be used to fill in individual Operating
Scenario information
4. Facility Total Emissions Summary Form To use to summarize facility-wide emissions, summed from individual Emission
Source/Operating Scenario Data Forms, for each pollutant.
5. Certification Form for use and signature of Responsible Official must be mailed(postmarked)by inventory due date.
1

NC DEQ, Division of Air Quality
Emission Inventory Pre-Submittal Check List
The following list provides some suggestions for you to use in reviewing your Air Emission Inventory submittal.It is meant
as a reminder of some of the key points to be remembered.It is not meant to be all inclusive or to repeat many important
parts of the instructions.Persons who have questions are reminded to contact their Division of Air Quality regional office.
Verify Action to Check(X)
Has the "Responsible Official'reviewed the information submitted and certified it as correct by means of a
signature in blue ink on the correct Certification Form?
Is your postage sufficient and have you arranged for"return receipt requested?"
Have you included emission estimates for all emission sources/operating scenarios and all pollutants,using the
"best available information?"
Is each form and each supplemental page clearly marked with your Facility ID,Permit Number and other
identification sufficient for each page to be properly replaced in your package if it should become separated?
Did you include emissions for all HAPs and TAPS separately, even if they may be part of VOC or PM-10 totals,
realizing for Title V billing purposes they will NOT be double counted/billed?
Have you shown proper"affiliations"between each emission release point and operating scenario within the
facility?
Are all forms completely filled out and in correct order?
Have you adequately researched and documented the best information to use to estimate your emissions?Have
you considered testing or supporting your industry association in testing programs to develop better emission
factors?
Have you used the proper address so that the submittal goes to the proper DAQ regional office for the county in
which the facility operates?
Did you evaluate whether a General Facility Information Form is required?
Did you provide the certified original of forms with calculation documentation and one additional copy of forms?
Submit packet of completed forms to the appropriate Regional Office as specified in your cover letter.Do NOT send them to
DAQ Central Office.Do NOT Fax.
This check list is provided for your convenience.You are not required to use it or send it to the Division of Air Quality.
Your Division of Air Quality contact is
Dylan Wright
Winston-Salem Regional Office
450 West Hanes Mill Road
Suite 300
Winston-Salem NC 27105
336-776-9800
2

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Listing of Emission Sources and Control Devices on Permit. See instructions
*ES ID on *ES Description *CS Description *CD ID's on Permit
Air Permit
Natural Gas/No.2 Fuel Oil/Used No.2
Fuel Oil/No.4 Fuel Oil/Used No.4 Fuel
ES1 Oil-fired(116 million Btu per hour Bagfilter(10,842 square feet of filter area) CD1
maximum heat input)Double Barrel
Drum Mixer(350 tons per hour
maximum permitted capacity)
ES2.1 Hot Mix Asphalt Storage Silo(200 tons
maximum design capacity)
ES2.2 Hot Mix Asphalt Storage Silo(200 tons
maximum design capacity)
ES2.3 Cold Asphalt Storage Silo(40 ton
capacity)
ES2.4 Hot Mix Asphalt Storage Silo(200 tons
maximum design capacity)
ES2.5 RAP/RAS Handling System
ES3 Truck Loadout Operation
Natural Gas/No.2 Fuel Oil-fired Hot Oil
I-1 Heater(1.6 million Btu per hour
maximum heat input)
I 2 Fuel Oil Storage Tank(1,000 gallons
capacity)
I-3 Recycled Fuel Oil Storage Tank(25,000
gallons capacity)
I-ES6 Liquid Asphalt Storage Tank(30,000
gallons capacity)
I-ES7 Liquid Asphalt Storage Tank(30,000
gallons capacity)
I-ES8 Liquid Asphalt Storage Tank(1,000
gallons capacity)
I-ES9 Electric furnaces used for QA/QC testing
activities
*If blank, no data recorded in DAQ System.
*CD = Control Device.
*CS =Control System.
*ES =Emission Source.
3

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source & Operating Scenario List- See Instructions
*ES Group ID *ES ID *OS ID *OS Description Forms Did Not Operate Not Required to
Completed Report
ES 1 1 Natural Gas Operating Scenario for
ES1
ES2.1,
GRl ES2.2,ES3, 5 Silos and Loadout
ES2.3
I-1 4 Natural Gas Operating Scenario for
I-1
I-ES6 NONE NONE
I-ES7 NONE NONE
1-2 NONE NONE
1-3 NONE NONE
I-ES8 NONE NONE
ES2.4 NONE NONE
ES2.5 NONE NONE
I-ES9 NONE NONE
*Blank, if not part of a group.
*ES =Emission Source
*OS = Operating Scenario
Form Completed=Form printed and completed.
Please return this completed Form with your submittal. Be sure to fill in with or similar mark if the ES or OS did
not operate and/or if it was Not required to report.
4

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) ES 1
or Emission Source Group ID
2. Emission Source Description : Natural Gas/No. 2 Fuel Oil/Used No. 2 Fuel Oil/No. 4 Fuel Oil/Used No. 4
Fuel Oil-fired(116 million Btu per hour maximum heat input) Double
Barrel Drum Mixer(350 tons per hour maximum permitted capa
3. Operating Scenario ID/ OS - I/Natural Gas Operating Scenario for ES
Description:
4. SCC Number/Description: 39000699 /Natural Gas ; General
5. Throughput/units in 2021: / TON/yr
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented 100
to Control Device or Stack):
8. Control Device Information
Order CS-ID CD ID Control Device Description
(as listed in permit)
1 CS-1 CD1 bagfilter(10,842 square feet of filter area)
9. Emission Release Point(ERP) Information: (Sources vented to more than one ERP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (Feet/sec)
Rectangle(L x W) (F) Rate
(in 0.1 feet) (Acfm)
ERP-1 VERTICAL 22 3.83 350 98.37 68000 Mixer Stack
STACK
10. Operating Schedule:(Source/OperatingScenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb + Dec % March-May % June-Aug. oho Sept.-Nov.
2021 2021 2021 IF2021
5

Operating Scenario: OS - 1 Emission Source/Group ID: ES 1
13. Actual Emissions per Pollutant Listed
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission Control
GHG CAS Estimation
Pollutants (see instructions) GHG Pollutants Mthd Cd Efficiency
eo oe
(Tons/Year) (Net after all controls)
(See Instructions)
2021 2014
Emissions- Emission Control
Criteria Pollutant Estimation
(NAAQS) Pollutants Code Criteria Pollutants Method Code Efficiency
(Tons/Year) (Net after all controls)
(See Instructions)
2021 2014
CO CO 7.71
NOx NOx 1.54
TSP TSP 1.96
PM10 PM10 1.36
PM2.5 PM2.5
S02 S02 0.0058
VOC VOC 1.9
Emission
HAP/TAP/Other Pollutants (In CAS Emissions Control
HAP/TAP/Other Estimation Efficiency
Alphabetical Order) (see instructions) Method Code y
(Pounds/Year) (Net after all controls)
(See Instructions)
2021 2014
Antimony Unlisted Compounds -
Specify Compound (Component of SBC-Other 0.021
SBC)
Arsenic Unlisted Compounds -
Specify Compound (Component of ASC-Other 0.066
ASC)
Benzene 71-43-2 46.3
Benzo(a)pyrene (Component of 50-32-8 0.0012
83329/POMTV & 56553/7PAH)
Cadmium Unlisted Compounds -
Specify Compound (Component of CDC-Other 0.049
CDC)
Chromic acid (VI) (Component of 7738-94-5 0.0534
So1CR6 & CRC)
Chromium Unlisted Compounds -
Specify Compound (Component of CRC-Other 0.6
CRC)
Cobalt Unlisted Compounds -
Specify Compound (Component of COC-Other 0.0031
COC)
Ethyl benzene 100-41-4 28.5
Formaldehyde 50-00-0 368
Hexane, n- 110-54-3 109
Hydrogen sulfide 7783-06-4 6.14
Lead Unlisted Compounds -
Specify Compound (Component of PBC-Other 0.074
PBC)
6

Manganese Unlisted Compounds -
Specify Compound (Component of MNC-Other 0.91
MNC)
Mercury Unlisted Compounds -
Specify Compound (Component of HGC-Other 0.029
HGC)
Methyl chloroform 71-55-6 5.69
Naphthalene (Component of
83329/POMTV) 91-20-3 10.7
Nickel Unlisted Compounds NIC-Other 7.47
(Component of NIC - Specify)
Phosphorus Metal, Yellow or 7723-14-0 3.32
White
Polycyclic Organic Matter (Inc
PAH, dioxins, etc. NC & AP 42 POM 22.5
historic)
Selenium Compounds SEC 0.042
Toluene 108-88-3 17.8
Trimethylpentane, 2,2,4- 540-84-1 4.74
Xylene (mixed isomers) 1330-20-7 23.7
7

Operating Scenario: OS - 1 Emission Source/Group ID: ES 1
Comments regarding this Operating Scenario (identify by field or general):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https:Hdeg.nc.gov/about/divisions/air-quality/air-gualily-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned(Postmarked)to the appropriate DAQ regional office by March 02,2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
8

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) Group GR1 Consisting of ES2.1, ES2.2, ES3, ES2.3
or Emission Source Group ID
2. Emission Source Description : Silo and Loadout
3. Operating Scenario ID/ OS - 5/Silos and Loadout
Description:
4. SCC Number/Description: 30500213 /Asphalt Concrete - Storage & Handling ; Storage Silo
5. Throughput/units in 2021: / TON/yr
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented 0
to Control Device or Stack):
8. Control Device Information :None
Order CS-ID CD ID Control Device Description
(as listed in permit)
9. Emission Release Point (ERP) Information: (Sources vented to more than one ERP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft V (Feet/sec)
Rectangle(L x W) (F J Rate
(in 0.1 feet) (Acfm)
ERP-2 FUGITIVE (NO 1 72 Area= 1 Fugitive Emissions
STACK)
10. Operating Schedule:(Source/OperatingScenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
I L Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb + Dec I % March-May I % June-Aug. I % Sept.-Nov.
2021 2021 2021 2024
9

Operating Scenario: OS - 5 Emission Source/Group ID: GRl
13. Actual Emissions per Pollutant Listed
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission Control
GHG CAS Estimation
Pollutants (see instructions) GHG Pollutants Mthd Cd Efficiency
eo oe
(Tons/Year) (Net after all controls)
(See Instructions)
2021 2014
Emissions- Emission Control
Criteria Pollutant Estimation
(NAAQS) Pollutants Code Criteria Pollutants Method Code Efficiency
(Tons/Year) (Net after all controls)
(See Instructions)
2021 2014
CO CO 0.15
NOx NOx
TSP TSP 0.066
PM10 PM10 0.066
PM2.5 PM2.5
S02 S02
VOC VOC 0.96
Emission
HAP/TAP/Other Pollutants (In CAS Emissions Control
HAP/TAP/Other Estimation Efficiency
Alphabetical Order) (see instructions) Method Code y
(Pounds/Year) (Net after all controls)
(See Instructions)
2021 2014
Benzene 71-43-2 0.72
Benzo(a)pyrene (Component of 50-32-8 0.0009
83329/POMTV & 56553/7PAH)
CFC-11 (Trichlorofluoromethane) 75-69-4 0.0064
Carbon disulfide 75-15-0 0.3
Cumene 98-82-8 0.54
Ethyl benzene 100-41-4 1.93
Ethyl chloride (chloroethane) 75-00-3 0.001
Formaldehyde 50-00-0 10.4
Hexane, n- 110-54-3 2.19
Hydrogen sulfide 7783-06-4 0.35
MEK (methyl ethyl ketone, 2- 78-93-3 0.81
butanone)
Methyl bromide (bromomethane) 74-83-9 0.12
Methyl chloride (chloromethane) 74-87-3 0.074
Methylene chloride 75-09-2 0.0039
Naphthalene (Component of
8 91-20-3 1.05
3329/POMTV)
Perchloroethylene 127-18-4 0.038
(tetrachloroethylene)
Phenol 108-95-2 0.48
Styrene 100-42-5 0.11
Toluene 108-88-3 1.93
Trimethylpentane, 2,2,4- 540-84-1 0.013
Xylene (mixed isomers) 1330-20-7 4.91
Xylene, o- 95-47-6 1.22
10

11

Operating Scenario: OS - 5 Emission Source/Group ID: GR1
Comments regarding this Operating Scenario (identify by field or general):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https:Hdeg.nc.gov/about/divisions/air-quality/air-gualily-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned(Postmarked)to the appropriate DAQ regional office by March 02,2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
12

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) I-1
or Emission Source Group ID
2. Emission Source Description : Natural Gas/No. 2 Fuel Oil-fired Hot Oil Heater(1.6 million Btu per hour
maximum heat input)
3. Operating Scenario ID/ OS - 4/Natural Gas Operating Scenario for I-1
Description:
4. SCC Number/Description: 39000699 /Natural Gas ; General
5. Throughput/units in 2021: / TON/yr
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented 0
to Control Device or Stack):
8. Control Device Information :None
Order CS-ID CD ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information: (Sources vented to more than one ERP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (Feet/sec)
Rectangle(L x W) (F) Rate
(in 0.1 feet) (Acfm)
ERP-2 FUGITIVE (NO 1 72 Area= 1 Fugitive Emissions
STACK)
10. Operating Schedule:(Source/OperatingScenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
I L Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb + Dec % March-May % June-Aug. I % Sept.-Nov.
2021 2021 2021 2024
13

Operating Scenario: OS - 4 Emission Source/Group ID: I-1
13. Actual Emissions per Pollutant Listed
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission Control
GHG CAS Estimation
Pollutants (see instructions) GHG Pollutants Mthd Cd Efficiency
eo oe
(Tons/Year) (Net after all controls)
(See Instructions)
2021 2014
Emissions- Emission Control
Criteria Pollutant Estimation
(NAAQS) Pollutants Code Criteria Pollutants Method Code Efficiency
(Tons/Year) (Net after all controls)
(See Instructions)
2021 2014
CO CO 0.23
NOx NOx 0.27
TSP TSP 0.021
PM10 PM10 0.021
PM2.5 PM2.5
S02 S02 0.0016
VOC VOC 0.015
Emission
HAP/TAP/Other Pollutants (In CAS Emissions Control
HAP/TAP/Other Estimation Efficiency
Alphabetical Order) (see instructions) Method Code y
(Pounds/Year) (Net after all controls)
(See Instructions)
2021 2014
Acetaldehyde 75-07-0 0.0001
Acrolein 107-02-8 0.0001
Ammonia (as NH3) 7664-41-7 17.3
Benzene 71-43-2 0.011
Benzo(a)pyrene (Component of
50-32-8 0
83329/POMTV & 56553/7PAH)
Cobalt Unlisted Compounds -
Specify Compound (Component of COC-Other 0.0004
COC)
Formaldehyde 50-00-0 0.41
Hexane, n- 110-54-3 9.72
Lead Unlisted Compounds -
Specify Compound (Component of PBC-Other 0.0027
PBC)
Naphthalene (Component of 91-20-3 0.0033
83329/POMTV)
Selenium Compounds SEC 0.0001
Toluene 108-88-3 0.018
14

15

Operating Scenario: OS -4 Emission Source/Group ID: I-1
Comments regarding this Operating Scenario (identify by field or general):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https:Hdeg.nc.gov/about/divisions/air-quality/air-gualily-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned(Postmarked)to the appropriate DAQ regional office by March 02,2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
16

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) I-3
or Emission Source Group ID
2. Emission Source Description: Recycled Fuel Oil Storage Tank(25,000 gallons capacity)
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
17

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
18

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
19

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) I-ES8
or Emission Source Group ID
2. Emission Source Description: Liquid Asphalt Storage Tank(1,000 gallons capacity)
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
20

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
21

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
22

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) ES2.4
or Emission Source Group ID
2. Emission Source Description: Hot Mix Asphalt Storage Silo (200 tons maximum design capacity)
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
23

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
24

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
25

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) ES2.5
or Emission Source Group ID
2. Emission Source Description: RAP/RAS Handling System
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
26

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
27

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
28

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) I-ES9
or Emission Source Group ID
2. Emission Source Description: Electric furnaces used for QA/QC testing activities
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
29

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
30

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
31

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) I-ES6
or Emission Source Group ID
2. Emission Source Description: Liquid Asphalt Storage Tank(30,000 gallons capacity)
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
32

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
33

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
34

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) I-ES7
or Emission Source Group ID
2. Emission Source Description: Liquid Asphalt Storage Tank(30,000 gallons capacity)
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
35

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
36

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
37

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data(Data here resulted from information entered into the system earlier by you or DAQ staff)
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit) I-2
or Emission Source Group ID
2. Emission Source Description: Fuel Oil Storage Tank(1,000 gallons capacity)
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information:(Sources vented to more than one EPP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule:(Source/Operating Scenario that best characterizes Calendar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start & End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb +Dec I % March-May I % June-Aug. I % Sept.-Nov.
38

13. Actual Emissions per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission
GHG CAS Estimation Control
Pollutants ( ) GHG Pollutants Efficiency Net after
see instructions
(Tons/Year) for year 2021 Method Code all controls)
(See Instructions)
Emissions- Emission Control
Criteria Pollutant Estimation
Criteria Pollutants Efficiency
(NAAQS) Pollutants Code ( ) y Method Code
TOriS/yeaY for year 2021 (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
SO2 SO2
VOC VOC
Emissions Emission Control
HAP/TAP/Other Pollutants CAS HAP/TAP/Other Estimation
(In alphabetical order) (see instructions) Method Code Efficiency (Net aver
(Pounds/Year) for year 2021 all controls)
(See Instructions)
39

Comments regarding this Operating Scenario (identify by field orgeneral):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https://deg.ne.gov/about/divisions/air-quality/air-quality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned (Postmarked)to the appropriate DAQ regional office by March 02, 2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
40

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
Emission Source/Operating Scenario Data
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
1.Emission Source ID (from permit)
or Emission Source Group ID
2. Emission Source Description:
3. Operating Scenario ID/
Description:
4. SCC Description:
5. Throughput/units in 2021: /
(e.g.production or fuel use):
6. Fuel Information %Sulfur %Ash Heat Content
(If fuel is used) /
(Btu/units)
7. Capture Efficiency
(%of Emissions from this Process Vented
to Control Device or Stack):
8. Control Device Information
Order CS-ID Control Devices ID Control Device Description
(as listed in permit)
9. Emission Release Point(ERP) Information: (Sources vented to more than one ERP use additional entry lines):
ERP ID ERP Type Height Diameter Temperature Velocity Volume Flow ERP Description
(in feet) Circle(enter ft (F) (Feet/sec) Rate (Acfm
Rectangle(L x W) )
(in 0.1 feet)
10. Operating Schedule: (Source/Operating Scenario that best characterizes Caleldar Year 2021)
Hours per Day ( ) Days per Week ( ) Weeks per Year ( )
11. Typical Start& End Times For Operating Scenario: Start: End:
12. Seasonal Periods Percent Annual Throughput:
Jan-Feb + Dec % March-May I % June-Aug. I % Sept.-Nov.
41

Emission Source ID:
13. Actual Emissions Per Pollutant Listed for :
Attach calculations and documentation of emission factors or other estimation methods used.
Emissions Emission Control
GHG CAS Estimation
Pollutants (see instructions) GHG Pollutants Efficiency
(Tons/Year) for year 2021 Method Code (Net after all controls)
(See Instructions)
Criteria Emissions- Emission Control
(NAAQS) Pollutant Code Criteria Pollutants Estimation Efficiency
Pollutants (Tons/Year) for year 2021 Method Code (Net after all controls)
(See Instructions)
CO CO
NOx NOx
PM(TSP) PM(TSP)
PM10 PM10
PM2.5 PM2.5
S02 S02
VOC VOC
HAP/TAP/Other Emissions Emission Control
Pollutants CAS HAP/TAP/Other Estimation Efficiency
(see instructions) Method Code y
(In Alphabetical Order) (Pounds/Year) for year 2021 (Net after all controls)
(See Instructions)
42

Emission Source ID:
Comments regarding this Operating Scenario (identify by field or general):
If you do not provide all information your inventory will be deemed incomplete and returned to you
To review detailed instructions or other information, go to web page: https:Hdeg.nc.gov/about/divisions/air-quality/air-guality-
data/emissions-inventories/emission-inventories-tools
Most information on this form is not subject to claims as confidential business information.
The emission inventory must be returned(Postmarked)to the appropriate DAQ regional office by March 02,2023.
If pre-filled information is incorrect,please strike over and replace with correct information.
43

Facility Total CY 2021 Emissions Summary
Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
Record Facility-Wide Totals From all Permitted and Non-Permitted Air Pollutant Emission Sources
GHG Pollutants CAS De Minimus Actual Emissions
(see instructions) Reporting level (Tons/Year)
(Tons) CY 2021 CY2014
Criteria Pollutants De Minimus Actual Emissions
Reporting level (Tons/Year)
(Tons) CY 2021 Reported CY2014
Carbon Monoxide(CO) .5 8.09
Oxides of Nitrogen(NOx) .5 1.81
PM/TSP - Particulate Matter .5 2.047
PM _ 10 .5 1.447
PM - 2.5 .5 -
Sulfur Dioxide(S02) .5 .0074
VOC .5 2.875
Below and following: Enter,in Alphabetical Order,All HAP/TAP/Other Required by Instructions
(Sum Source Emissions From Emission Source/Operating Scenario Forms)
Hazardous Air Pollutants(HAPs) CAS De Minimus Actual Emissions
and/or Toxic Air Pollutants(TAPs) (see instructions) Reporting level (Pounds/Year)
and/or Other Pollutants (Pounds) CY 2021 CY2014
Acetaldehyde 75-07-0 10 .00008
Acrolein 107-02-8 110 .0001
Ammonia(as NH3) 7664-41-7 100 17.3
Antimony&Compounds(total mass,inc elemental SB) SBC 10 .021
Antimony Unlisted Compounds-Specify Compound(Component SBC-Other 10 .021
of SBC)
Arsenic&Compounds(total mass of elemental AS,arsine and all ASC(7778394) .01 .066
inorganic compounds)
Arsenic Unlisted Compounds- Specify Compound(Component of ASC-Other .01 .066
ASC)
Benzene 171-43-2 1 1 47.031
Benzo(a)pyrene(Component of 83329/POMTV&56553/7PAH) 50-32-8 1 1 .00214
44

Beryllium&compounds(Total mass) BEC 1 0
CFC-11 (Trichlorofluoromethane) 75-69-4 100 .0064
Cadmium&compounds(total mass includes elemental metal) CDC 1 .049
Cadmium Unlisted Compounds-Specify Compound(Component CDC-Other 1 .049
of CDC)
Carbon disulfide 75-15-0 10 .3
Chromic acid(VI)(Component of So1CR6&CRC) 7738-94-5 .01 .0534
Chromium(VI)Soluble Chromate Compounds(Component of So1CR6 .01 .0534
CRC)
Chromium-All/Total(includes Chromium(VI)categories,metal CRC 1 .6534
and others)
Chromium Unlisted Compounds-Specify Compound(Component CRC-Other 1 .6
of CRC)
Cobalt&compounds COC 1 .00355
Cobalt Unlisted Compounds-Specify Compound(Component of COC-Other 1 .00355
COC)
Cumene 98-82-8 100 .54
Ethyl benzene 100-41-4 100 30.43
Ethyl chloride(chloroethane) 75-00-3 10 .001
Formaldehyde 50-00-0 10 378.81
Hexane,n- 110-54-3 100 120.91
Hydrogen sulfide 7783-06-4 1 6.49
Lead&compounds PBC 1 .0767
Lead Unlisted Compounds-Specify Compound(Component of PBC-Other 10 .0767
PBC)
MEK(methyl ethyl ketone,2-butanone) 78-93-3 100 .81
Manganese&compounds MNC 10 .91
Manganese Unlisted Compounds- Specify Compound(Component MNC-Other 10 .91
of MNC)
Mercury&Compounds-all total mass includes Hg Vapor HGC .001 .029
Mercury Unlisted Compounds-Specify Compound(Component of HGC-Other .001 .029
HGC)
Methyl bromide(bromomethane) 74-83-9 1 .12
Methyl chloride(chloromethane) 74-87-3 1 .074
Methyl chloroform 71-55-6 100 5.69
Methylene chloride 75-09-2 1 .0039
Naphthalene(Component of 83329/POMTV) 91-20-3 1 11.7533
Nickel&Compounds,sum total mass includes elemental NIC 1 7.47
Nickel Unlisted Compounds(Component of NIC-Specify) NIC-Other 1 7.47
Perchloroethylene(tetrachloroethylene) 127-18-4 100 .038
Phenol 108-95-2 100 .48
Phosphorus Metal,Yellow or White 7723-14-0 1 3.32
Polycyclic Organic Matter(7 PAH Compounds for NIF) 56553/7PAH 1 .00214
Polycyclic Organic Matter(Inc PAH,dioxins,etc.NC&AP 42 POM 1 22.5
historic)
Polycyclic Organic Matter(Specific Compounds from OAQPS for 83329/POMTV 1 11.75544
TV)
Selenium Compounds SEC 10 .04213
Styrene 100-42-5 100 .11
Toluene 108-88-3 100 19.748
Total Reduced Sulfur(TRS as total mass) TRS-MASS 6.49
Trimethylpentane,2,2,4- 540-84-1 100 4.753
Xylene(mixed isomers) 1330-20-7 100 28.61
Xylene,o- 95-47-6 100 1.22
45

Pollutants "specified" to add to Pollutant List:
Pollutant Name CAS
Attach supporting documentation and calculations. Report any quantity above the threshold shown on the pollutant list
on the website https:Hdeq.ne.gov/about/divisions/air-quality/air-quality-data/emissions-inventories/emission-inventories-
tools
(If using a blank form,you do not need to replicate the CY 2014 emissions column except to point out errors)
Information on this form cannot be held confidential
Inventory Prepared By
Telephone Number
Fax Number
Email Address
The 2021 preparer is a Facility employee or consultant
46

Facility Name: Piedmont Asphalt,LLC -Pelham Plant Facility ID : 1700005
1675 Rock Quarry Road Permit : 01902
Pelham,NC 27311 County : Caswell
DAQ Region : Winston-Salem
North Carolina Department of Environmental Quality
Division of Air Quality
Air Pollutant Point Source Emissions Inventory- Calendar Year 2021
These forms must be completed and returned even if the facility did not operate or emissions were zero
The legally defined "Responsible Official" of record for your facility is Douglas Dawson
This person or one that meets the definition below must sign this certification form.
The official submitting the information must certify that he/she complies with the requirements as specified in Title 15A NCAC
2Q .03040)which define the responsible official as the following:
1. For corporations, by principal executive officer of at least the level of vice-president, or his duly authorized representative,
if such representative is responsible for overall operation of the facility from which the emissions described in the permit
application form originates
2. for partnership or limited partnership,by a general partner
3. for a sole proprietorship,by the proprietor
4. for municipal, state federal, or other public entity, by a principal executive officer, ranking elected official, or other duly
authorized employee
CERTIFICATION STATEMENT:
(Important:Legally Responsible Official,read and sign after all submissions are final.)
I certify that I am the responsible official for this facility, as described above, and hereby certify that the information contained in
this air emissions report, including attached calculations and documentation, is true, accurate and complete. (Subject to legal
penalties of up to $25,000 per occurrence and possible imprisonment as outlined in G.S. § 143-215.3(a)(2))
Responsible Official's Signature Below (use blue ink): Date Signed:
Printed Name: Douglas Dawson
Signature:
This form applies to Non Title V facilities. If this facility is classified as Title V,please telephone your regional office
Emission Inventory Contact at once for proper forms and classification.
Email address of Responsible Official: [e-mail]
Information on this Form cannot be held confidential
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