AQ_F_1800194_20210617_CMPL_InspRpt

NORTH CAROLINA DIVISION OF Mooresville Regional Office
AIR QUALITY Frye Regional Medical Center
NC Facility ID 1800194
Inspection Report County/FIPS:Catawba/035
Date: 06/17/2021
Facility Data Permit Data
Frye Regional Medical Center Permit 02790/R15
420 North Center Street Issued 12/31/2015
Hickory,NC 28601 Expires 5/31/2022
Lat: 35d 44.2794m Long: 81d 20.2392m Class/Status Small
SIC: 8062/General Medical&Surgical Hospitals Permit Status Active
NAILS: 62211 /General Medical and Surgical Hospitals Current Permit Application(s)None
Contact Data Program Applicability
Facility Contact Authorized Contact Technical Contact SIP
Todd Cook Chris Fensterle Eddie Braswell MACT Part 63: Subpart WWWWW,SubpartZZZZ
Admin.Director,Facility Chief Operating Officer Plant Operations NSPS: Subpart Dc, Subpart IIII
Services [phone] Manager
[phone] [phone]
Compliance Data
Comments:
Inspection Date 06/17/2021
Inspector's Name Donna Cook
Inspector's Signature: De4 a C'ev* XM Operating Status Operating
Compliance Status Compliance-inspection
Action Code FCE
Date of Signature: C611SIMI Inspection Result Compliance
Total Actual emissions in TONS/YEAR:
TSP S02 NOX VOC CO PM10 *HAP
2013 0.2800 0.2500 4.20 0.2700 2.93 0.2800 134.00
2008 0.9000 0.2500 12.87 0.6500 10.22 0.9000 427.43
*Highest HAP Emitted in ounds
Five Year Violation History:None
Date Letter Type Rule Violated Violation Resolution Date
Performed Stack Tests since last FCE:None
Date Test Results Test Method(s) Source(s)Tested

Frye Regional Medical Center
June 17,2021
Page 2
Type Action: X Full Compliance _Partial Compliance _Complaint Other:
Evaluation Evaluation/Reinspection Investigation
Data Tracking: X Date submitted for initial review 06/18/2021 _IBEAM WARNING/OB,NOD,NOV,NRE
X IBEAM Document
X IBEAM Inspection,list date inspected X IBEAM LAT/LONG,Facility Locked
X IBEAM Inspection,list date draft is submitted X IBEAM LAT/LONG,Coordinates checked
X IBEAM Inspection,pollutants/programs checked _IBEAM Complaint
X IBEAM Planning,Next Inspection Date 06/01/2023
Directions: From Mooresville Regional Office to Hickory,travel W. Statesville Avenue;North Broad
Street and the name changes to Statesville Highway(Highway 115 North) and then to Charlotte Highway
(Highway 21 North and Highway 115 North); Interstate 77 North; Exit 51 (Hickory/Winston-Salem)-
Interstate 40 West toward Asheville; off Interstate 40 West take Exit 125 Hickory,turn right off exit ramp
onto Lenoir Rhyne Blvd. SE; 1.3 miles turn left at the stop light onto 1st Ave. SE; 0.4 mile turn right onto
NC 127 N.; 0.4 mile turn left on 3'Ave.NE; 0.1 turn right onto North Center Street; and 0.1 mile on the
right is the hospital. The visitor parking for the hospital is on the left. The street address for the hospital is
420 North Center Street. It is recommended that the facility contact be phoned prior to leaving the office.
The facility contact will meet the inspector in the lobby area of the hospital.
Safety Equipment: Inspector is required to wear hearing protection when the generators and boilers are
operating.A face covering is required to be worn by all visitors at this hospital. I wore a face covering
during the on-site inspection of this hospital.
Safety Issues: No safety issues were observed by me during the inspection. The hospital requires all
visitors to wear face coverings due to the ongoing coronavirus pandemic.
Lat/Long Coordinates: A review of the "Facilities Regulated by Air Quality" on the DAQ web site
indicates the facility's location is accurate and matches the facility's latitude and longitude coordinates
listed in IBEAM.No changes to the latitude and longitude coordinates of this facility are needed in
IBEAM. The latitude and longitude coordinates of this facility are locked in IBEAM.
Email Contacts: The emails for the facility, authorized and technical contacts were verified by Mr. Todd
Cook, administrative director of facility services. I updated the email address for the authorized contact,
Chris Fensterle, in IBEAM.
General Information:
1. The purpose of this site visit was to conduct a routine air quality inspection. Frye Regional Medical
Center is a hospital that utilizes two permitted boilers for food preparation, domestic hot water,
sterilization purposes and heating/humidification of this facility; and two permitted and one exempt
diesel-fired emergency generators for electrical outages. Mr. Todd Cook, administrative director of
facility services,Mr. Eddie Braswell,plant operations manager, and Mr. Jonathan Homan,
maintenance technician, accompanied me during this inspection.

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June 17,2021
Page 3
2. Facility Contact Information:
During the inspection, I verified the facility contact information in IBEAM with Mr. Cook. No
changes to the facility contact information are needed in IBEAM.
3. Compliance history file review:
No problems have been noted in the last five years by DAQ prior to this inspection. The current
compliance status is discussed in the following sections.
4. Observations of permitted air emission sources and control devices:
Emission Emission Source F Control Control System
Source ID Description System ID Description
B 1 (NSPS) natural gas/No. 2 fuel oil-
fired boiler(14.29 million N/A N/A
Btu per hour maximum
heat input)
B2 (NSPS) natural gas/No. 2 fuel oil-
fired boiler(14.29 million N/A N/A
Btu per hour maximum
heat input)
The two boilers(ID Nos. B 1 and B2)are used for food preparation,domestic hot water,
sterilization purposes and heating/humidification at this hospital.Natural gas is the primary fuel
source for each boiler.No. 2 fuel oil is the backup fuel source for each boiler if natural gas is
curtailed to this hospital. Mr. Cook stated that the hospital has a contract for uninterruptable
service from the natural gas supplier.
According to the records provided by this hospital,the amount of natural gas combusted in the
two boilers was 44,259 dekatherms in 2019; 48,150 dekatherms in 2020 and 21,965 dekatherms
from January 1 through May 31,2021.No. 2 fuel oil was not combusted in the two boilers for
curtailment purposes in 2019, 2020 and from January 1 through May 31,2021.
The fuel oil for the two boilers(ID Nos. B 1 and B2) is stored in two underground storage tanks
with capacities of 10,000 and 15,000 gallons, each. The boilers share the two fuel oil storage tanks
with the three diesel-fired generators(ID Nos. EG1, EG4 and I-EG5).
On the plates of the two boilers (ID Nos. B 1 and B2),I observed the following information:
Boiler(ID No. B1 or#1): manufacturer,Cleaver Brooks;model#CB 1200-350-150; serial#
OL096346; date, 1997; input rating, 14,288,100 Btu/hr; and 102.1 gph oil. The boiler stack
exhausts through the roof to the outdoor atmosphere. The stack of the boiler is vertical with a rain
cap.A ladder has to be climbed to observe the stack of the boiler.
Boiler(ID No. B2 or#2): manufacturer,Cleaver Brooks;model#CB 1200-350-150; serial#
OL102674; date,2003; input rating, 14,288,000 Btu/hr; and 102.1 gph oil. The boiler stack
exhausts through the roof to the outdoor atmosphere. The stack of the boiler is vertical with a rain
cap.A ladder has to be climbed to observe the stack of the boiler.

Frye Regional Medical Center
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Page 4
The two boilers are considered an existing area source per NESHAP area boiler GACT Subpart
JJJJJJ(6J), since it commenced construction before June 4,2010. This company chose to avoid
NESHAP Subpart 6J boiler GACT by only burning No. 2 fuel oil during times of curtailment,
emergencies and periodic testing as specified in Specific Condition and Limitation No. A. 11. of
the air permit.
The two boilers are subject to NSPS, Subpart Dc-"Standards of Performance for Small-
Industrial-Commercial-Institutional Steam Generating Units" because the boiler was constructed
after June 9, 1989 with a maximum heat input capacity greater than 10 million Btu per hour. The
requirements of the NSPS Subpart Dc to the subject boiler are discussed below in Specific
Condition and Limitation No. A. 6.
Observed.The Cleaver Brooks model boilers(ID Nos. B1 or#1 and B2 or#2)were operating on
natural gas.No visible emissions were observed by me from the roof line of this hospital.
EG1 diesel-fired emergency
generator(800 kW rated N/A N/A
capacity)
The diesel-fired generator(ID No. EG1)provides emergency power to critical areas and
equipment essential for life safety at the hospital. The generator is not being used as a peak shaver
or for demand response. The toxic air pollutant permit condition A. 9. requires that the hours
operated for the two diesel-fired generators(ID Nos. EG1 and EG4)be recorded monthly and
totaled annually by this hospital. The operating hours for generator(ID No. EG1)were 20 in 2019;
17 in 2020 and 4 from January 1 through May 31, 2021. The generator was not used for
emergency purposes in 2019,2020 and from January 1 through May 31,2021.
The diesel fuel for three emergency generators(ID Nos. EG1,EG4 and IEG5)is stored in two
underground storage tanks with capacities of 10,000 and 15,000 gallons, each. The diesel-fired
generators also share the two fuel oil storage tanks with the two boilers(ID Nos. B 1 and 132). The
generator(ID No. EG1)has an aboveground day tank with a capacity of 100 gallon to store the
diesel fuel.
On the engine/generator plate,I observed the following information:
Emergency generator(ID No. EG1; 800 kW)—engine plate: manufacturer, Caterpillar;model#
3412; serial#2WJ01393 and rating, 1180 hp@1800 rpm; and generator plate: manufacturer,
Caterpillar; model#3412; stator#40927034;rating, 800 kW;year,1997 and run hours on digital
readout 594. The previous run hours on digital readout were 551 hours during an inspection on
February 14,2019. The generator stack can be viewed on the side of the boiler room building. The
stack of the generator(ID No. EG1) is horizontal and uncapped.
The engine was manufactured in 1997. The engine is considered an existing area source if
construction commenced before June 12,2006 at this institutional facility and used only in case of
emergencies. According to 40 CFR 63.6585, existing emergency engines at institution facilities
are not subject to NESHAP Subpart ZZZZ(4Z). The generator is also not subject to 40 CFR Part
60,NSPS, Subpart IIII(4I)because the applicability dates of the NSPS Subpart 4I is constructed
(ordered) after July 11,2005 and manufactured after April 1,2006.

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Observed.The Caterpillar model diesel-fired emergency generator(ID No. EG1)was not in
operation at the time of the inspection.
EG4 diesel-fired emergency
generator(1500 kW rated N/A N/A
capacity) I F
The diesel-fired generator(ID No. EG4)provides emergency power to critical areas and
equipment essential for life safety at the hospital. The generator is not being used as a peak shaver
or for demand response. The toxic air pollutant permit condition A. 9. requires that the hours
operated for the two diesel-fired generators(ID Nos. EG1 and EG4)be recorded monthly and
totaled annually by this hospital. The operating hours for generator(ID No. EG4)were 18 in 2019,
18 in 2020 and 4 from January 1 through May 31,2021. The generator was not used for
emergency purposes in 2019,2020 and from January 1 through May 31,2021.
The diesel fuel for three emergency generators is stored in two underground storage tanks with
capacities of 10,000 and 15,000 gallons, each. The diesel-fired generators also share the two fuel
oil storage tanks with the two boilers (ID Nos. B 1 and B2). The generator(ID No. EG4)has an
aboveground day tank with a capacity of 100 gallon to store the diesel fuel.
On the engine/generator plate,I observed the following information:
Emergency generator(ID No. EG4; 1500 kW)—engine plate: manufacturer, Caterpillar;model#
3512; serial# 1GZ01395,rating 1620 kw@l800 rpm;no horsepower rating listed but calculated
at 2011 hp by Mr. Cook and generator plate: manufacturer, Caterpillar; model#3512; serial#
7GM01010;rating, 1500 kW; standby;year,2003 and run hours on digital readout 452. The
previous run hours on digital readout were 408 hours during an inspection on February 14,2019.
The generator stack can be viewed on the side of the boiler room building. The stack of the
generator(ID No. EG4)is horizontal and uncapped.
The engine was manufactured in 2003. The engine is considered an existing area source if
construction commenced before June 12,2006 at this institutional facility and used only in case of
emergencies. According to 40 CFR 63.6585, existing emergency engines at institution facilities
are not subject to NESHAP Subpart ZZZZ(4Z). The generator is also not subject to 40 CFR Part
60,NSPS, Subpart 1111(41)because the applicability dates of the NSPS Subpart 41 is constructed
(ordered) after July 11,2005 and manufactured after April 1,2006.
Observed.The Caterpillar model diesel-fired emergency generator(ID No. EG2)was not in
operation at the time of the inspection.
5. Observations of insignificant air emission sources and control devices listed on the current permit:
Source Exemption Source of Source of Title V
Regulation TAPS? Pollutants?
I-EOS—four(4)ethylene oxide sterilizers
(4.95 cubic feet capacity each) subject to 2Q .0102
NESHAP 40 CFR Part 63 Subpart (c)(2)(E)(i) Yes Yes
VIVVWWW
This office received emails dated May 6 and 7,2021 from Mr. Todd Cook and Tiffany Phillips,

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sterile processing supervisor stating that the four ethylene oxide sterilizers for the sterilization and
fumigation of surgical instruments ceased operations on August 18,2020 and were removed by
this hospital. This hospital is no longer subject to 40 CFR 63 NESHAP, Subpart WWWWW or
5W"National Emission Standards for Hospital Ethylene Oxide Sterilizers" (also known as
Generally Achievable Control Technology or GACT Subpart WWWWW or 5W). The
requirements of the NESHAP Subpart WWWWW(5W)to the ethylene oxide sterilizers are no
longer applicable in Specific Condition and Limitation No.A. 10. of the air permit.
Observed.The four ethylene oxide sterilizers are no longer at this hospital. During the next
revision,the four ethylene oxide sterilizers should be removed by MRO permitting from the
insignificant/exempt activities in the permit attachment.
I-EG5—diesel-fired emergency generator
(500 kW rated capacity) subject to NSPS 40 2Q .4102 No Yes
CFR Part 60 Subpart IIII and NESHAP 40 (c)(2)(B)(v)(III)
CFR Part 63 Subpart ZZZZ
The exempt diesel-fired generator(ID No. I-EG5)provides emergency power to critical areas and
equipment essential for life safety at the hospital. The generator is not being used as a peak shaver
or for demand response.
The diesel fuel for the three emergency generators(ID Nos. EG1,EG2 and I-EG5)is stored in two
underground storage tanks with capacities of 10,000 and 15,000 gallons, each. The three diesel-
fired generators also share the two fuel oil storage tanks with the two boilers (ID Nos. B 1 and B2).
The generator(ID No. I-EG5)has a day tank with a capacity of 100 gallon to store the diesel fuel.
On the engine/generator plate,I observed the following information:
Emergency generator(ID No. I-EG5; 500 kW) -engine plate: manufacturer,Caterpillar;model#
C15; serial#FSE 02357,rating adv: 762 hp and 568 kW; engine 8CPXL15.2EI.W; displacement
15.2;year,2008 and generator plate: manufacturer, Caterpillar;model#C 16; serial#G8B 15174;
rating, 500 kW; standby;year,2008 and run hours on digital readout 114.6. The previous run
hours on digital readout were 85.8 during an inspection on February 14,2019. The stack of the
generator is located on the top right side. The stack is vertical and capped.
The generator has a 2008 model year engine. The emergency generator(ID I-EG5) is subject to 40
CFR Part 63,NESHAP, Subpart ZZZZ(4Z) as a new source because the applicability date of the
NESHAP Subpart 4Z rule is commenced construction of the engine on or after June 12, 2006.
This generator is also subject to 40 CFR Part 60,NSPS Subpart IIII(4I)because the applicability
dates of the NSPS Subpart 1111(41)rule is constructed(ordered)after July 11, 2005 and
manufactured after April 1,2006 of the engine. According to 40 CFR 63.6590(c),the new engine
complies with 4Z RICE NESHAP by meeting the requirements of NSPS Subpart 4I. The
requirements of NESHAP 4Z and NSPS Subpart 41 are discussed in Specific Condition and
Limitation No. A. 10.
Observed.The Caterpillar model diesel-fired emergency generator(ID No. I-EG5)was not in
operation at the time of the inspection.

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6. Observations of air emission sources and control devices not listed on the current permit:
a. The fuel oil for the two boilers(ID Nos. B 1 and 132) and three emergency generators (ID
Nos. EG1,EG4 and I-EG5)is stored in two underground storage tanks with capacities of
10,000 and 15,000 gallons. The tanks are exempted from permitting per 15A NCAC 2Q
.0102 (g)(4).
b. Each emergency generator(ID Nos. EG1, EG4 and I-EG5)has an aboveground day tank.
Each day tank contains 100 gallons of diesel fuel. The three aboveground day tanks (100
gallon capacity, each)are exempt from permitting per 15A NCAC 2Q .0102 (g)(4).
C. This hospital has an electric fire pump that is not subject to NESHAP Subpart 4Z, since it
is electrically powered.
d. This hospital also has two cooling towers, two bulk liquid oxygen tanks, and three steam
sterilizers.
7. Compliance with specific permit conditions and limitations:
a. Condition A. 2. Permit Renewal and Emission Inventory Requirement-The permittee at
least 90 days prior to the expiration date of this permit shall request permit renewal by
letter with application form and submit the air pollution emission inventory report
with certification sheet for 2020 calendar year to MRO DAQ.
Observed. I informed Mr. Cook and Mr. Braswell that the air permit expires on May 31,
2022, and the air pollution emission inventory report with certification sheet for 2020
calendar year and an application form must be submitted with the permit renewal request.
I advised Mr. Cook and Mr. Braswell to contact Jennifer Womick or Denise Hayes if he
has any questions regarding air quality permitting. Compliance with this stipulation is
indicated.
b. Condition A. 3. Particulate Control Requirement - As required by 15A NCAC 2D .0503
"Particulates from Fuel Burning Indirect Heat Exchangers," particulate matter emissions
from the fuel burning indirect heat exchangers shall not exceed the allowable emission
rates listed below:
Source Emission Limit
(lbs/million Btu)
natural gas/No. 2 fuel oil-fired boiler(14.29 million Btu per 0.46
hour maximum heat input)(B 1)
natural gas/No. 2 fuel oil-fired boiler(14.29 million Btu per 0.42
hour maximum heat input)(132) F
Observed. The particulate matter emissions from the two boilers(ID Nos. B 1 and 132)
while combusting natural gas and No. 2 fuel oil are not exceeding the allowable emission
rates as indicated in the permit review. Compliance with this stipulation was indicated
during the permit application process.

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C. Condition A.4. Sulfur Dioxide Control Requirement-As required by 15A NCAC 2D
.0516 "Sulfur Dioxide Emissions from Combustion Sources," sulfur dioxide emissions
from the combustion sources shall not exceed 2.3 pounds per million Btu heat input.
Observed.Per MRO memo"2D .0516 analysis"dated 04/10/97,compliance is indicated
for No. 1 fuel oil,No. 2 fuel oil,natural gas,butane,propane, and wood fuel. Compliance
with this stipulation was indicated during the permit application process.
d. Condition A. 5. Visible Emissions Control Requirement-As required by 15A NCAC 2D
.0521 "Control of Visible Emissions",visible emissions from the emission sources,
manufactured after July 1, 1971, shall not be more than 20 percent opacity when
averaged over a six-minute period.
Observed.No visible emissions were observed by me from this facility. Compliance
with this stipulation is indicated.
e. Condition A. 6. 15A NCAC 2D .0524 "New Source Performance Standards" -For the
boiler(ID No. B 1) and boiler(ID No. 132),the permittee shall comply with all applicable
provisions, including the notification,testing,reporting,recordkeeping, and monitoring
requirements contained in Environmental Management Commission Standard 15A
NCAC 2D .0524 "New Source Performance Standards" (NSPS)as promulgated in 40
CFR 60, Subpart Dc,including Subpart A"General Provisions."
i. The sulfur content of the distillate oil combusted in an affected source shall not
exceed 0.5 percent by weight. Within 30 days after each six-month period of the
calendar year(by January 30 for the previous six-month period between January
and June),the permittee must submit in writing to the regional supervisor,DAQ,
the sulfur content of the distillate oil combusted in an affected source. If fuel
supplier certification is used to demonstrate compliance, fuel supplier
certification shall include the following information:
A. The name of the oil supplier;
B. A statement from the oil supplier that the oil complies with the
specification under the definition of distillate oil in 40 CFR 60.41(c); and
C. A certified statement signed by the owner or operator of an affected
source that the records of fuel supplier certification submitted represent
all of the fuel combusted during the reporting period.
Observed. This office received the fuel supplier certification semi-annual
reports on January 14,2021; July 13,2020; January 9,2020;July 11,2019; and
January 8,2019 within the allotted time frame. The fuel supplier certification
submitted by this hospital indicated that all the No. 2 fuel oil received from
Bumgarner Oil Company had a maximum sulfur content of 15 ppm or 0.0015
percent by weight; and then combusted in boilers(ID Nos. B 1 and B2)did not
exceed the 0.5 percent by weight of sulfur as specified by this condition.
Compliance with this stipulation is indicated.

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ii. NSPS Recordkeeping Requirements -In addition to any other recordkeeping
requirements of the EPA,the permittee is required to maintain records as
follows:
A. the amounts of each fuel combusted during each month; and
B. All records required under this section shall be maintained for a period
of two years following the date of such record.
Observed. The records of the natural gas and No. 2 fuel oil combusted in the
two boilers(ID Nos. B 1 and B2) are tracked monthly and annually by this
company. The natural gas combusted in the two boilers was 44,259 dekatherms
in 2019;48,150 dekatherms in 2020 and 21,965 dekatherms from January 1
through May 31,2021.No. 2 fuel oil was not combusted in the two boilers for
curtailment purposes in 2019,2020 and January 1 through May 31,2021.
Compliance with this stipulation is indicated.
iii. NSPS Emissions Limitations -As required by 15A NCAC 2D .0524, the
following permit limits shall not be exceeded:
Affected Source(s) Pollutant Emission
Limit
natural gas/No. 2 fuel oil-fired boiler(20.4 million Btu Sulfur 0.5%by
per hour maximum heat input)(ES-B3) content weight
natural gas/No. 2 fuel oil-fired boiler(20.4 million Btu Sulfur 0.5%by
per hour maximum heat input)(ES-134) content weight
natural gas/No. 2 fuel oil-fired boiler(21.0 million Btu Sulfur 0.5%by
per hour maximum heat input)(ES-B5) content weight
Observed. This company submitted the fuel supplier certification on January 14,
2021;July 13,2020; January 9, 2020; July 11,2019 and January 8,2019 to this
office indicating that all the No. 2 fuel oil(ultra low sulfur diesel-ulsd)received
from Bumgarner Oil Company contained 15 ppm or 0.0015 percent by weight of
sulfur and was less than 0.5 percent by weight of sulfur as required by this
condition. The last shipment of fuel oil received from Bumgarner Oil Company
was on January 3, 2019. Compliance with this stipulation is indicated.
f. Condition A. 7. Notification Requirement - As required by 15A NCAC 2D .0535, the
permittee of a source of excess emissions that last for more than four hours and that
results from a malfunction, a breakdown of process or control equipment or any other
abnormal conditions, shall notify the Director or his designee of any such occurrence by
9:00 a.m. Eastern time of the Division's next business day of becoming aware of the
occurrence.
Observed.Based on a records review and conversation with Mr. Cook and Mr. Braswell,
no excess emissions have occurred at the facility. Compliance with this stipulation is
indicated.

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Page 10
g. Condition A. 8. Fugitive Dust Control Requirement-As required by 15A NCAC 2D
.0540 "Particulates from Fugitive Dust Emissions Sources",the permittee shall not cause
or allow fugitive dust emissions to cause or contribute to the substantive complaints or
excess visible emissions beyond the property boundary. If substantive complaints or
excessive fugitive dust emissions from the facility are observed beyond the property
boundaries for six minutes in any one hour(using Reference Method 22 in 40 CFR,
Appendix A),the owner or operator may be required to submit a fugitive dust plan as
described in 2D .0540(f).
Observed. MRO DAQ has not received any fugitive dust emissions complaints regarding
this facility. This company has paved roads at this facility. During the inspection, I
observed no fugitive dust or visible emissions from this facility. Compliance with this
stipulation is indicated.
h. Condition A. 9. Toxic Air Pollutant Emission Limitation and Reporting Requirement-
Pursuant to 15A NCAC 2D .1100 "Control of Toxic Air Pollutants," and in accordance
with the approved application for an air toxic compliance demonstration,the following
permit limits shall not be exceeded:
Affected Source(s) FToxic Air Pollutant Emission
Limit
natural gas/No. 2 fuel oil-fired boiler Arsenic&Compounds (total
(14.29 million Btu per hour maximum mass of elemental AS,arsine 0.482 lbs/yr
heat input) (B 1) and all inorganic compounds)
(ASC(7778394))
natural gas/No. 2 fuel oil-fired boiler Arsenic& Compounds (total
(14.29 million Btu per hour maximum mass of elemental AS,arsine 0.482 lbs/yr
heat input) (132) and all inorganic compounds)
(ASC(7778394))
Arsenic& Compounds (total
diesel-fired emergency generator(800 mass of elemental AS,arsine 0.017 lbs/yr
kW rated capacity) (EG1) and all inorganic compounds)
(ASC(7778394))
Arsenic& Compounds (total
diesel-fired emergency generator(1500 mass of elemental AS,arsine 0.032 lbs/yr
kW rated capacity) (EG4) and all inorganic compounds)
(ASC(7778394))
natural gas/No. 2 fuel oil-fired boiler
(14.29 million Btu per hour maximum Benzene(71-43-2) F245 lbs/yr
heat input) (B 1)
natural gas/No. 2 fuel oil-fired boiler
(14.29 million Btu per hour maximum Benzene(71-43-2) F2.45s/yr
heat input) (B2)
diesel-fired emergency generator(800 Benzene(71-43-2) 1.3.....3 lbs/yr
kW rated capacity) (EG1)
diesel-fired emergency generator(1500 lBenzene(71-43-2) 16.2 lbs/yr

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Page 11
kW rated capacity) (EG4)
natural gas/No. 2 fuel oil-fired boiler Cadmium Metal, elemental,
(14.29 million Btu per hour maximum unreacted(Component of CDC) 0.375 lbs/yr
heat input) (B1) (7440-43-9)
natural gas/No. 2 fuel oil-fired boiler Cadmium Metal, elemental,
(14.29 million Btu per hour maximum unreacted(Component of CDC) 0.375 lbs/yr
heat input) (B2) (7440-43-9)
diesel-fired emergency generator(800 Cadmium Metal, elemental,
kW rated capacity) (EG1) unreacted(Component of CDC) 0.013 lbs/yr
(7440-43-9)
diesel-fired emergency generator(1500 Cadmium Metal, elemental,
kW rated capacity) (EG4) unreacted(Component of CDC) 0.024 lbs/yr
(7440-43-9)
i. Recordkeeping Requirements -The permittee shall record monthly and total
annually the following:
A. The hours operated for the emergency generators(ID Nos. EG1 and
EG4).
Observed.Arsenic,benzene, and cadmium have the potential to emit above the annual
TPER limits. This facility has triggered air toxics for arsenic,benzene and cadmium.
The air toxics were triggered by a Director's call in 2Q .0712. This facility is tracking
the natural gas usage and fuel oil usage from the two boilers and two diesel-fired
emergency generators(ID Nos. EG1 and EG4). The natural gas combusted by the boilers
was 44,259 dekatherms in 2019; 48,150 dekatherms in 2020 and 21,965 from January 1
through May 31,2021. The No. 2 fuel oil burned by the boilers for curtailment was 0
gallons in 2019, 2020 and January 1 through May 31,2021.
The hours of operation for generator(ID No. EG1)were 20 in 2019; 17 in 2020 and 4
from January 1 through May 31, 2021. The hours of operation for generator(ID No.
EG4)were 18 in 2019; 18 in 2020 and 4 from January 1 through May 31,2021. Based on
the actual fuel usage from the two boilers and actual hours of operation from the two
emergency generators,the emission limits for 2Q .0711 are not being exceeded.
Compliance with this stipulation is indicated.
i. Condition A. 10. Federal and State Rules Applicable to Sources Exempted from Air
Permitting Requirements -Your facility is subject to the following federal and state rules:
40 CFR 60 -NSPS - Subpart IIII- Standards of Performance for Stationary
Compression Ignition Internal Combustion Engines
40 CFR 63 -NESHAP/MACT- Subpart WWWWW-Hospital Ethylene Oxide
Sterilizers Area Sources
40 CFR 63 -NESHAP/MACT- Subpart ZZZZ-Reciprocating Internal Combustion
Engines

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June 17,2021
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which are applicable to some of the emission sources at your facility listed on the
"Insignificant/Exempt Activities" list attached to this permit. The purpose of this permit
condition is to inform you of your compliance obligations to these applicable rules as
they are enforceable.
Observed. The exempt diesel-fired generator(ID No. I-EG5)at this institutional facility
provides emergency power to critical areas and equipment essential for life safety at the
hospital. The generator is not being used as a peak shaver or for demand response.
The exempt diesel-fired emergency generator(ID No. I-EG5)has a 2008 model year
engine. The emergency generator is subject to 40 CFR Part 63,NESHAP, Subpart ZZZZ
(4Z)as a new source because the applicability date of the NESHAP Subpart 4Z rule is
commenced construction of the engine on or after June 12, 2006.
The exempt diesel-fired emergency generator (ID No. I-EG5) is also subject to 40 CFR
Part 60, NSPS Subpart 1111 (41) because the applicability dates of the NSPS Subpart 1111
(41)rule is constructed(ordered) after July 11,2005 and manufactured after April 1,2006
of the engine. According to 40 CFR 63.6590(c), the new engine complies with 4Z RICE
NESHAP by meeting the requirements of NSPS Subpart 41.
The NSPS Subpart 1111(41)requirements for this engine are to purchase a certified engine
to the appropriate tier standard for the model year engine per 60.4205(b)&40 CFR 1039;
using diesel fuel with a maximum sulfur content of 15 ppm(0.0015)per 60.4207(b) and
80.510(b); and non-resettable hour meter per 60.4209(a).
This hospital purchased a certified engine. The EPA certificate of conformity(CPX-
NRCI-08-10 and EPA engine family 8CPXL15.2ESW) for a 2008 model year Caterpillar
engine was provided by Mr. Cook during an inspection on October 7,2015. This
information indicates that the engine meets the EPA tier emission levels for model year
2008.
The maximum sulfur content of the nonroad diesel fuel has to be 15 ppm per 60.4207(b)
and 80.510(b). The fuel oil certification records submitted semiannual indicted that the
sulfur content of the non-road diesel fuel received from the fuel oil supplier,Bumgarner
Oil Company,and combusted by the generator is 15 ppm. The maximum sulfur content
of 15 ppm is not being exceeded. The last shipment of fuel oil received from Bumgarner
Oil Company was on January 3,2019.
The engine has a non-resettable hour meter and meets the monitoring requirement in
60.4209(a). The engine meets the requirements in 60.411(f)by limiting the non-
emergency usage to 50 hours per calendar year and the maintenance checks and readiness
testing to 100 hours per calendar year. This hospital appeared to be complying with the
NSPS 41 and NESHAP 4Z.
The four exempt sterilizers(ID No. I-EOS)for the sterilization and fumigation of surgical
instruments ceased operations on August 18,2020 and were removed by this hospital.
This hospital is no longer subject to 40 CFR 63 NESHAP, Subpart WWWWW or 5W
"National Emission Standards for Hospital Ethylene Oxide Sterilizers" (also known as
Generally Achievable Control Technology or GACT Subpart VIWWWW or 5W).

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j. Condition A. 11. Avoidance Condition for Area Sources Subject to 40 CFR 63 Subpart
JJJJJJ 6 -In accordance with 15A NCAC 2Q .0317,the Permittee is avoiding
applicability of 40 CFR 63 Subpart JJJJJJ(6J) "Industrial,Commercial, and Institutional
Boilers Area Sources." The permittee is permitted to operate natural gas/No. 2 fuel
oil-fired boilers(ID Nos. B1 and B2). Per 40 CFR 63.11195(e),these/this source(s)
is/are exempt from this Subpart because they are defined as gas-fired boilers in 40 CFR
63.11237. In order to maintain this exemption,the permittee is allowed to fire liquid fuel
only during periods of gas curtailment, gas supply interruptions, startups, or for periodic
testing on liquid fuel(periodic testing not to exceed a combined total of 48 hours during
any calendar year).
i. The permittee shall maintain records that document the time periods when liquid
fuel is fired and reasons the liquid fuel is fired.
ii. If the permittee fires liquid fuel for reasons other than gas curtailment,gas supply
interruptions, startups, or for periodic testing on liquid fuel,the Permittee is no
longer exempt from Subpart JJJJJJ(6J).As required by 40 CFR 62.11225(g),the
Permittee must provide notice within 30 days of the fuel switch. The notification
must identify:
A. The name of the owner or operator of the affected source, the location of
the source,the boiler(s)that have switched fuels, and the date of the
notice.
B. The date upon which the fuel switch occurred.
C. As required by 40 CFR 63.11210(h),the permittee must demonstrate
compliance within 180 days of the effective date of the fuel switch.
Observed.This hospital will only burn No. 2 fuel oil in times of curtailment,gas supply
interruptions, startups, or for periodic testing.No curtailment of the two boilers(ID Nos.
B1 and 132)occurred in 2019,2020 and from January 1 through May 31,2021. The
periodic testing for the tune-up of each boiler is conducted for two hours once a year by
an outside contractor. The periodic testing is not exceeding 48 hours per boiler during
any calendar year.
Therefore,the two natural gas/No. 2 fuel oil-fired boilers(ID Nos. B 1 and 132) are not
subject to the National Emission Standards for Hazardous Air Pollutants (NESHAP) for
Industrial, Commercial, and Institutional Boilers Area Sources (40 CFR Part 63, Subpart
JJJJJJ or 6J). Compliance with this stipulation is indicated.
k. Condition A. 12. Toxic Air Pollutant Emissions Limitation Requirement-Pursuant to
15A NCAC 2Q .0711 "Emission Rates Requiring a Permit" for each of the below listed
toxic air pollutants (TAPS),the permittee has made a demonstration that facility-wide
actual emissions,where one or more emission release points are obstructed or non-
vertically oriented, do not exceed the Toxic Permit Emission Rates(TPERs) listed in 15A
NCAC 2Q .0711(a). The facility shall be operated and maintained in such a manner that
emissions of any listed TAPs from the facility, including fugitive emissions,will not
exceed TPERs listed in 15A NCAC 2Q .0711(a).

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Carcinogens Chronic Acute Systemic Acute
Pollutant (lb/yr) Toxicants Toxicants Irritants
(lb/day) (lb/hr) (lb/hr)
Acetaldehyde(75-07-0) 1 6.8
Acrolein(107-02-8) 0.02
Benzo(a)pyrene(Component
of 83329/POMTV& 2.2
56553/7PAH) (50-32-8)
Beryllium Metal(unreacted)
(Component of BEC) (7440- 0.28
41-7) -F
Chromium(VI) Soluble
Chromate Compounds 0.013
(Component of CRC)
(So1CR6)
Fluorides (sum of all fluoride
compounds as mass of F ion) FO3 0.064
(16984-48-8)
Formaldehyde(50-00-0) 1 0.04
H2,3,6, ,8 (57 53-85-dioxin 0.0051
exach1,2,3,6,7,8 (57653-85-7)
Hexane,n-(110-54-3) 23
Hydrogen chloride
(hydrochloric acid) (7647- 0.18
01-0)
Manganese&compounds Fo
.63
(MN C) 7
Mercury,vapor(Component
of HGC) (7439-97-6) FO-013
Methyl chloroform(71-55-6) 250 64
Nickel metal(Component of 0.13
NIC) (7440-02-0)
Tetrachlorodibenzo-p-dioxin,
2,3,7,8- (Component of 0.0002
CLDC& 83329/POMTV)
(1746-01-6)
Toluene(108-88-3) 98 14.4
Xylene(mixed isomers) -F-1� 57 16.4
(1330-20-7)
Observed. In the past,this hospital operated a medical waste incinerator,which emitted
TAP emissions above its TPERs limits. The medical waste incinerator was removed in
July 2000. Historically, once a facility is triggered into the toxics program for specific

Frye Regional Medical Center
June 17,2021
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toxic air pollutants (TAPS)then the TAPS remain on the permit regardless of the emission
rates. The combustion of natural gas and fuel oil does emit specific TAPs listed in the
above table.
The last air permit review for 2Q .0711 indicated that this facility combusted 63.67
million scf of natural gas and 408 gallons per year of No. 2 fuel oil in the boilers (ID Nos.
B 1 and B2)and 24 hours per year of operation for each emergency generator(ID No.
EG1 and EG4)in 2013. The two boilers combusted less natural gas and fuel oil in 2019
and 2020 than in 2013. The hours of operations for each emergency generator(ID Nos.
EG1 and EG4)were less in 2019 and 2020 than in 2013.
The emergency generator(ID No. I-ES5) is exempt from air toxics because it is subject to
40 CFR Part 63 Subpart ZZZZ. Revisions to 15A NCAC 2Q .0702 "Exemptions"became
effective on May 1, 2014. Paragraph (27) of this rule deems sources subject to 40 CFR
Part 63 not subject to air toxics.
The emission limits for 2Q .0711 are not being exceeded. Compliance with this
stipulation is indicated.
8. NSPS/NESHAP Review:
a. The two diesel-fired engines(ID Nos. EG1 and EG4) at this institutional facility are only
used in case of emergencies. The two diesel-fired engines meet the definition of an
emergency RICE in 40 CFR 63.6675. The two engines are considered existing area
sources in 40 CFR Part 63,NESHAP, Subpart ZZZZ(4Z)because these engines
commenced construction before the rule applicability date of June 12,2006. According
to 40 CFR 63.6585, existing emergency engines at institutional facilities are not subject
to NESHAP Subpart ZZZZ(4Z). Therefore,the two diesel-fired engines(ID Nos. EG1
and EG4) are not subject to 40 CFR Part 63,NESHAP, Subpart ZZZZ(4Z).
b. The exempt emergency diesel-fired generator(ID No. I-EG5)is subject to 40 CFR Part
63,NESHAP, Subpart ZZZZ(4Z)as a new source because the applicability date of the
NESHAP Subpart 4Z rule is commenced construction of the engine on or after June 12,
2006.
C. The exempt emergency diesel-fired generator(ID No. I-EG5)is also subject to 40 CFR
Part 60,NSPS Subpart 1111(41)because the applicability dates of the NSPS Subpart 1111
(4I)rule is constructed(ordered) after July 11, 2005 and manufactured after April 1,2006
of the engine. According to 40 CFR 63.6590(c),the new engine complies with 4Z RICE
NESHAP by meeting the requirements of NSPS Subpart 41.
d. The four ethylene oxide sterilizers(ID No. IEOS)for the sterilization and fumigation of
surgical instruments ceased operations on August 18,2020 and were removed by this
hospital. This facility is no longer subject to 40 CFR 63 NESHAP, Subpart WWWWW
or 5W"National Emission Standards for Hospital Ethylene Oxide Sterilizers."
e. The two boilers (ID Nos. B1 and B2)are subject to 40 CFR Part 60, Subpart Dc—
"Standards of Performance for Small-Industrial-Commercial-Institutional Steam
Generating Units" because these boilers were constructed after June 9, 1989 with a
maximum heat input capacity greater than 10 million Btu per hour.

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June 17,2021
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f. The two boilers (ID Nos. B1 and 132)are not subject to 40 CFR Part 63,National
Emission Standards for Hazardous Air Pollutants(NESHAP) for Industrial, Commercial,
and Institutional Boilers Area Sources Subpart JJJJJJ or 6J because the two boilers are
only burning natural gas. This hospital will only burn No. 2 fuel oil in the two boilers(ID
Nos. B 1 and B2) during times of gas curtailment,gas supply interruptions, startups, or for
periodic testing(not to exceed combined total of 48 hours per boiler during any calendar
year).
g. The fire pump engine at this hospital is not subject to NESHAP Subpart 4Z, since it is
electrically powered.
9. Summary of changes needed to the current permit:
a. The underground fuel oil storage tanks (10,000 and 15,000 gallons) for the boilers (ID
Nos. 131 and 132) and emergency generators (ID Nos. EG1, EG4 and I-EG5) should be
listed in the insignificant/exempt activities during the next permit revision.
b. The three aboveground day tanks(100 gallons capacity, each) store diesel fuel for each of
the emergency generators(ID Nos. EG1,EG4 and I-EG5). The three diesel fuel
aboveground day tanks should be listed in the insignificant/exempt activities during the
next permit revision.
C. The four ethylene oxide sterilizers are no longer at this hospital. During the next revision,
the four ethylene oxide sterilizers should be removed by MRO permitting from the
insignificant/exempt activities in the permit attachment and from Specific Condition and
Limitation No.A. 10.
d. The electronic yellowsheet for permit changes needed has been completed and placed in
the facility's electronic file.
10. Compliance assistance offered duringtpection:
None.
11. Section 112(r)gpplicability:
This facility does not appear to be subject to the requirements of the Chemical Accident Release
Prevention Program, Section 112(r)of the Clean Air Act.
12. Compliance determination:
Based on my observations, this facility appeared to be in compliance with the applicable air
quality regulations at the time of the inspection.
DLC:dlc
c: MRO File
https://ncconnect.sharepoint.com/sites/DAQ-MRO/Counties/CATAWBA/00194/INSPECT_20210617.doex