NCG100112_COMPLETE FILE - HISTORICAL_20170317

PERMIT NO.
DOC TYPE
DOC DATE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
_)( HISTORICAL FILE
- MONITORING REPORTS
YYYYMMDD

j'-VLL—
.., ,r, M.4;:�.�
R
Energy, Mineral &
Land Resources
ENVIRONMENTAL OUALITY
Bill Dougherty
P & D Automotive Systems, Inc.
P. O. Box 210
Pelham, NC 27311
March 17, 2017
Subject: Compliance Inspection
Permit No. NCG 100112
P & D Automotive Systems, Inc.
Caswell County
Dear Mr: Doughtey:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
TRACY DAVIS
Director
On March 15, 2017 Glen White of the North Carolina Department of Environmental Quality —
Division of Energy, Minerals and Land Resources met with you at the facility located at 194 Red
Marshall Road, to conduct a compliance inspection. This inspection consists of review of the
Stormwater Pollution Prevention Plan and all of its components as well as facility outfalls and
any possible stormwater exposures. Your assistance with inspection was greatly appreciated.
Permit:
This facility holds General Stormwater Permit NCG100112 to discharge stormwater from
industrial activity associated with Used Motor Vehicle Parts and Automobile Wrecking for
Scrap under the National Pollutant Discharge Elimination System (NPDES). The permit
became effective November 01, 2012 and expires on October 31, 2017. The current permit was
available for review and was included in the SPPP.
Records/Reports:
This facility was required to develop and maintain a Stormwater Pollution Prevention Plan
(SPPP) in accordance with Part 11, Section A of the permit. All qualitative and analytical
monitoring records are required to be maintained with the SPPP for a minimum of five (5) years.
Records appear to be current and complete.
Facility Site Review:
This facility is a full service scrap metal and used auto parts dealer. When vehicles are brought
onto the site, fluids are removed under roof. Gas tanks are removed first. Good gas is used in
service vehicles and bad gas is picked up by Universal Refiners for recycling as is antifreeze and
oil. Batteries are charged and tested. Good batteries are placed in sales and are quickly sold.
Bad batteries are picked up for recycling once a pallet is full.
State of \orth Carolina # Environmental Quality I Energy, Mineral and Land Resource's
Winston-Salem Regionai Office i 450 Manes Mill Road. Suite WO I Winston-Salem. NC 27103
336'l76 980E

Cars typically stay onsite for approximately 18 months, Crushing is done onsite by a contracted
vendor and around 600 cars are crushed with each visit. Crushed cars are shredded at the
Newcorp Foundary in Monroe, NC. Good tires are stored inside and are sold to the general
public. Bad tired are stored under roof delivered to the landfill periodically. Car parts are
cataloged and stored in the warehouse.
All cars are on stored on gravel. Gravel is in good condition and free of fluid spills. All fluids
are removed from vehicles before they go on the yard.
Effluent Receiving Waters:
Effluent from this facility discharges via two outfalls. Outfall 001-is at the front of the facility
and drainage from the parking lot and traffic coming onto and leaving the site. Outfall 002 is at
the back corner of the facility and receives water from the salvage vehicle yard. Effluent
discharges to Tardy Branch — Class "C" waters of the Roanoke River Basin.
Self -Monitoring Program:
This facility is required to provide Qualitative and Analytical Monitoring on a semi-annual basis.
Monitoring has been performed as per the permit. Analytical samples are collected and
delivered to Meritech in Reidsville for testing. Results appear to fall within parameters with the
exception on one exceedance at Outfall 001, The next monitoring period showed the exceedance
was correct.
The facility was found to be compliant with its industrial stormwater permit. If you have
questions or need additional information, please contact Glen White at [phone].
Enclosures:
Inspection Report
Sincerely,
dw
Matthew E. Gantt, P.E.
Regional Engineer
Land Quality Section
Winston-Salem Regional Office
cc: Division of Mineral and Land Resources (WSRO)
State ol'North Carolina I Envtronmcntal Quality I Energy, Mineral and Land Reswirtes
Winston-Salem Rtglonal Office 1 450 Hanes Mill Road, Suitt 300 I Winston-Salem. NC 27103
33b 776 9800

Compliance Inspection Report
Permit: NCGlOO112 Effective:. 11/01/12 Expiration: 10131/17 Owner: P and D Automotive Systems
SOC: Effective: Expiration: Facility: P and D Automotive Systems
County- Caswell 194 Red Marshall Rd
Region: Winston-Salem
Pelham NC 27311
Contact Person: William Dougherty Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 0311512017
Primary Inspector: Glen White
Secondary Inspector(sl:
Certification:
Phone:
Entry Time: 10:OOAM Exit Time: 11:30AM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Used Motor Vehicle Parts Stormwater Discharge COC
Facility Status: Compliant [] Not Compliant
Question Areas:
■ Storm Water
(See attachment summary)
Page: 1

permit: NCGI O0112 Owner - facility: p and D Automotive Systems
Inspection Date: 0311.512017 Inspection Type: Compliance Evaluation Reason for Visit: Routine
inspection Summary:
See Compliance Letter in DEMLR (WSSRO) hard file. Compliant
Page: 2

Permit NCG10o112 Owner - Facility: P and D Automotive Systems
Inspection Data: 0311512017 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Yes No NA NE
® ❑ ❑ ❑
❑ ❑ ® ❑
Comment: Monitorina twice annually as oer the Dermit. Results within Darameters except for one elevated
TSS. The next sample showed reduced TSS to well below parameters. No deficiencies.
Permit and OutfalIs Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? 0000
# Were all outfalls observed during the inspection? ®❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ® ❑
# Has the facility evaluated all illicit (non stormwater) discharges? N ❑ ❑ ❑
Comment: Mr. Doughefty walk facility with inspector. Facility appears to be well maintained. No
deficiencies.
Qualiitatiye Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? ® ❑ ❑ ❑
Comment: Monitoring twice annually as per the permit.
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
®❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
® ❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
®❑ ❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
■ ❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
®❑ ❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
N ❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
®❑ ❑ ❑
# Does the Plan include a BMP summary?
®❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
■ ❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
■ ❑ ❑ ❑
# Does the facility provide and document Employee Training?
®❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑ ❑ ❑
# Is the Plan reviewed and updated annually?
® ❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
®❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
®❑ ❑ ❑
Page: 3

Permit: NCG100112 Owner - Facility; P and D Automotive Systems
Inspection Date: 03/15/2017 Inspection Type : Compliance Evaluation Reason for Melt: Routine
Stormwater Pollution Prevention Plan
Comment: SPPP complete and maintained. No deficiency, observer!.
Yea No NA NE
Page: 4

N
WA
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
William Dougherty
P and D Automotive Systems
1860 Horseshoe Rd
Danville, VA 24541
Dear Permittee:
Division of Water Quality
Charles Wakild, P. E.
Director
December 4, 2012
Dee Freeman
Secretary
Subject: NPDES Stormwater Permit Coverage Renewal
P and D Automotive Systems
COC Number NCG100112
Caswell County
In response to your renewal application for continued coverage under stormwater General Permit NCG100000
the Division of Water Quality (DWQ) is forwarding herewith the reissued General Permit. This permit is
reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between the state of North Carolina and the U.S. Environmental Protection Agency, dated October
15, 2007 (or as subsequently amended).
The following information is included with your permit package:
• A new Certificate of Coverage (COC)
• A copy of General Permit NCG100000
• A copy of the Technical Bulletin for the General Permit
• Two copies of the Discharge Monitoring Report (DMR) Form
• Two copies of the Qualitative Monitoring Report Form
The General Permit authorizes discharges of stormwater, and it specifies your obligations for discharge
controls, management, monitoring, and record keeping. Please review the new permit to familiarize yourself
with all the changes in the reissued permit. Your facility has six (f) months from the time of receipt of the
permit to update your current SPPP to reflect all new permit requirements.
The first sample period of your permit begins January 1, 2013. Your facility must sample a "measureable
storm event" beginning during the periods beginning January 1 and July 1 of every year (or, if applicable,
report "No Flow," as outlined in Part III, Section E). Also, please note that Tier 3 Actions in Part 11 of your
permit are triggered by benchmark exceedances on four occasions beginning on the effective date of this
permit and do not count prior exceedances.
The more significant changes in the General Permit since your last COC was issued are noted either in the
Draft Permit Fact Sheet that accompanied the public notice (http://portal,ncdenr.org/web/wq/ws/su/current-
notices), or in the Response to Comments / Summary of Changes and Technical Bulletin documents that are
posted on the Stormwater Permitting Unit's website with the new General Permit. Please visit
http://Portal.ncdenr.org/web/wq/ws/su/npdessw (click on 'General Permits' tab) to review that information
for your specific General Permit carefully.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Sallsbury St. Ralegh, North Carolina 27604
Phone: 91 M07-Q001 FAXT 91 M07-6492
Internet: www.nc:vaterauality.ora
One
:\IorthCaro Iin _i
An Equal Opportunii} 1,!�lTrma;iveAction Employer

William Dougherty
December 4, 2012
Page 2 of 2
Some of the changes include:
• Part II:
• Section A: The Stormwater Pollution Prevention Plan (SPPP) section, if applicable, has been updated
to the most current language of our permits. Additional conditions for specific industry sectors have
been added to the SPPP requirements in some cases-
• Sections B, C: Failure to perform analytical Stormwater monitoring may result in the Division requiring
that the permittee begin a monthly sampling scheme.
• Sections B, C: A lower TSS benchmark of 50 mg/I for HQW, ORW, PNA and Tr Waters applies to these
more sensitive waters.
• Sections B, C: The monitoring parameter Oil & Grease (O&G) has been replaced by the parameter
Total Petroleum Hydrocarbons (TPH) for vehicle maintenance areas, and in some cases, other
analytical monitoring requirements.
• Sections B, C, D: Inability to sample due to adverse weather must be recorded in the SPPP, or in
separate on -site records if your General Permit does not require an SPPP. Adverse weather is defined
in the "Definitions" section of the permit.
• Sections B, C. The term "Representative Storm Event" has been replaced by "Measurable Storm
Event," A measurable storm event is defined in the permit.
• Section D: If the permittee fails to respond effectively to problems identified by qualitative
monitoring, DWQ may require the permittee to perform corrective action.
Please review Parts III and IV to understand the Standard Conditions of your new NPDES General Permit,
including Compliance and Liability, Reporting, Monitoring and Records requirements; Operation and
Maintenance obligations; and Definitions. Please note that all samples analyzed in accordance with the terms
of this permit must be submitted to the Division on Discharge Monitoring Report (DMR) forms available on
the Stormwater Permitting Unit's website above. DMR forms must be delivered to the Division no later than
34 days from the date the facility receives the sampling results from the laboratory. Also note that existing
permittees do not need to submit a renewal request prior to expiration unless directed by the Division.
Your coverage under the General Permit is transferable only through the specific action of DWQ. This permit
does not affect the legal requirements to obtain other permits which may be required by DENR, nor does it
relieve the permittee from responsibility for compliance with any other applicable federal, state, or local law,
rule, standard, ordinance, order, judgment, or decree. If you have any questions regarding this permit
package, please contact the Division's Stormwater Permitting Unit at [phone].
Sincerely,
for Charles Wakild, P.E.
cc: DWQ Central Files
Stormwater Permitting Unit Files
Winston-Salem Regional Office

I
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG100000
CERTIFICATE OF COVERAGE No. NCG100112
STORMWATER
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
P and D Automotive Systems
is hereby authorized to discharge stormwater from a facility located at:
P and D Automotive Systems
194 Red Marshall Rd
Pelham
Caswell County
to receiving waters designated as Tardy Branch, a class C waterbody in the Roanoke River
Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, 11, III, and IV of General Permit No. NCG100000 as attached.
This certificate of coverage shall become effective December 4, 2012.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this 411, day of December, 2012.
for Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

NCDEN R
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Suliins Dee Freeman
Governor Director Secretary
January 8, 2010
Mr. Bill Dougherty
P & D Automotive Systems, Inc
Post Office Box 210
Pelham, North Carolina 27311
Subject: General Stormwater Permit Inspection
NPDES General Permit # NCG100112 -- P & D Automotive Systems, Inc
Caswell County
Dear Mr. Dougherty:
On January 6, 2010, Jenny Graznak of this office performed a Stormwater Permit
Inspection at P & D Automotive located at 194 Red Marshall Road in Pelham, North Carolina.
This facility holds General Stormwater Permit No. NCG100112 under the National Pollutant
Discharge Elimination System (NPDES) to discharge Stormwater discharges associated with
activities classified as Used Motor Vehicle Parts, You were present for the inspection, This
type of inspection consists of two basic parts: a review of facility files and self -monitoring data
and an inspection of the facility's discharge points. This particular inspection evaluated five (5)
areas, and observations from each area are addressed below:
1. Permit
The permit became effective November 1, 2007 and expires October 31, 2012. A copy of the
current permit was available during the inspection.
2. RecordslReports
As required by the Permit, the facility has a Stormwater Pollution Prevention Plan (SPPP) that
was available for review during the inspection. The SPPP includes a location map of the site
and outfalls, along with a site plan listing potential stormwater pollutants and best management
practices used at the site. There is also a Spill Prevention and Response Plan. Employee
Training of the SPPP occurs on an annual basis.
3. Facility Site Review
When a car arrives in the front lot, all of the parts are inventoried and labeled. From there, the
car is moved inside where fluids are drained and engines are removed- Motor oil, antifreeze,
brake fluid, etc. are stored in a tank awaiting pick-up by Noble Oil, which visits the site once per
year. Noble's last site visit occurred on December 28, 2009 according to facility receipts, which
are stored with the SPPP. Gasoline is siphoned from the cars and is either used on -site or if it
the gasoline is dirty or contaminated, it is removed by Noble Oil. Unusable tires are stored
inside and delivered to the county landfill at 3-month intervals. Batteries are stored inside and
any unusable batteries are sold to Battery Masters out of Lexington for recycling. All car parts
are kept inside in parts storage. 'Cars on the back lot are empty. The car crusher visits the site
North Carolina Division of Water quality, Winston-Salem Reglorak Office
Location: 585 Waughtewn St, Winston-Salern, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877.623-6748
Inlemet; www.rtcwaterqualitp.org
Nne
orthCarolina
An Equal Opportunity 1 Affirmative Action Employer

approximately 1.5 - 2 years depending on inventory. The yard is re -graveled after every visit
from the car crusher.
4. Effluent/Receiving Waters
The facility has two stormwater discharge outfalls. Outfall 001 is in the front of the facility and
drains storm water from the receiving lots and parking lots. Outfall 002 is in the back corner of
the property and drains storm water from the back lot of empty cars. Stormwater from the
property discharges to Tardy Branch (Class C) in the Roanoke River Basin. The outfalls
appeared to be well maintained. Outfall 002 is located outside the fence in a vegetated area.
5. Self -Monitoring Program
An on -site review of the analytical and qualitative monitoring reports during the inspection
showed that all parameters were evaluated per the specifications of the permit. The most
recent analytical monitoring events occurred on May 20, 2008, January 6, 2009, and November
11, 2009. Meritech Laboratories performed the analyses and the results were within permit
limits. You remarked during the inspection that the test for Ethylene Glycol is an expensive one
(over $500 for both outfalls) and questioned the requirement for semi-annual sampling since
you have never received a result over the permit benchmark value. As you know, ethylene
glycol is a toxic organic compound typically found in antifreeze. This particular general permit
(NCG100000) is up for renewal in 2012 and you are encouraged to submit comments to the
Stormwater Permitting Unit at that time. You can either submit these comments to our office for
forwarding or you can send them directly to the Stormwater Permitting Unity at the following
address:
NC DENR-DWQ
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Our office appreciates your efforts to comply with permit requirements and for helping
other auto salvage yards seek compliance. If you have any questions concerning this letter or
the attached inspection report, please contact Ms. Graznak or me at [phone]_
Sincerely,
Steve W. Tedder
Regional Supervisor
Surface Water Protection Section
cc: SWP - Central Files
SWP - WSRO
NPS Assistance and Compliance Oversight

r, . .
Permit: NCG100112
SOC:
County: Caswell
Region: Winston-Salem
Compliance Inspection Report
Effective: 11/01/07 Expiration: 10l31112 Owner: P and D Automotive Systems
Effective: Expiration: Facility: P and D Automotive Systems
194 Reel Marshall Rd
Contact Person: William Dougherty Title:
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
24 hour contact name William Dougherty
Related Permits:
Inspection Date: OV0612010 Entry Time: 10:00 AM
Primary Inspector: Jennifer F Graznak
Secondary Inspector(s):
Pelham NC 27311
Phone: [phone]
Certification:
Exit Time: 11:30 AM
Phone:
Phone: [phone]
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Used Motor Vehicle Parts Stormwater Discharge COC
Facility Status: ® Compliant ❑ Not Compliant
Question Areas:
M Storm Vlater
(See attachment summary)
Page. 1

Permit: NCO100112 Owner - Facility: P and D Automotive Systems
Inspection Date: 0110612010 Inspection Type: Compliance Evaluation
Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Yes
No
NA
NE
Does the site have a Stormwater Pollution Prevention Ptan?
®
n
n
n
# Does the Plan include a General Location (USGS) reap?
®❑
n
n
# Does the Plan include a "Narrative Description of Practices•'?
■
n
❑
n
# Does the Plan include a detailed site map including outfall locations and drainage areas?
n
n
n
# Does the Plan include a list of significant spills occurring during the past 3 years?
■
n
n
n
# Has the facility evaluated feasible alternatives to current practices?
❑
n
n
# Does the facility provide all necessary secondary containment?
■
n
n
n
# Does the Plan include a BMP summary?
n
n
rl
# Dees the Plan include a Spill Prevention and Response Plan (SPRP)?
■
n
❑
n
# Does the Plan include a Preventative Maintenance and Good Housekeeping Ptan?
■
n
n
n
# Does the facility provide and document Employee Training)
■
n
n
n
# Does the Ptan include a list of Responsible Party(s)?
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment:
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Comment:
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Comment
Permit and Outfalls
# Is a copy of the Permit and the Certificate of Coverage available at the site?
# Were all outfalls observed during the inspection?
# If the facility has representative outfall status, is it properly documented by the Division)
# Has the facility evaluated all Illicit (nor) stormwater) discharges?
Comment:
Yes No NA NE
■flnn
■ n n n
nn■n
Yes No NA NE
Faye: 3

NC®EHR
North Carolina Department of Environment and Natural Resources
Division of water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
February 9, 2009
Mr. Andy Smith
City of Statesville
P.O. Box 1111
Statesville, NC 28687
Dee Freeman
Secretary
Subject: General Permit COC No. NCGII OI12
Fourth Creek WWTP
SPPP Review
lredell County
Dear Mr. Smith:
We received a copy of Stormwater Pollution Prevention Plan (SPPP) prepared by McGill Associates
on the City of Statesville's behalf on October 6, 2008. We are providing our review comments to you. Please
address deficiencies and consider revisions to address the following concerns.
• General Comments: This SPPP uses the template SPPP forms available for the Auto Salvage industry
under NCG100000. It is not a problem to borrow from that template; however, several references -to
terms specific to that industry were not removed or modified.. For example, the document references
"Yard Areas" and "Salvage Yard List of Significant Spills," as well as the Total Toxic Organics
(TTO) certification that is not applicable to the Stormwater. Permit for W WTPs. We are advising you
to edit the SPPP more appropriately. Also, please note that the NCG110000 General Permit has a
more recent version of SPPP requirements (although similar to NCG 100000). It is the permittee's
responsibility to ensure its Plan is consistent with the details in the right permit.
• General Location Map (Page 2): The receiving waters are not filled in on the table under the map.
Also, the map (or the site plan) did not•identify that this segment of Fourth Creek is on the 303d
List of Impaired Waters (Please see: http://h2o.enr,state.ne.us/tmdl/documents/303d_Report.pdt).
This receiving stream was listed as impaired in the 2006 report because of fecal coliform and turbidity
standard violations, as well as impaired biological integrity. This information should be recorded in
the SPPP. (Attached is an excerpt from the 303(d) List for your reference.)
• Storage and Activities Description (Page 3): This section includes areas of storage but does not
describe any of the areas that drain to stormwater discharge outfalls. The narrative description section
should also identify activities, storage, loading, disposal, etc. in each of the areas draining to SDO-1, -
2, and -3.
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Aalelgh, North Carolina 27604
Phone: 91M07-63001 FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal opportunity 4 Affirmative Action Employer
NonhCarolina
Naturally

City of Statesville — Fourth Creek WWTP, SPPP Review
February 6, 2009
p. 2 of 3
• Site Map (Page 4); This map is shown at a small scale, and it is difficult to read the detail. Also, the
area numbers on Page 3 do not appear to match any numbered areas on this map (the previous page is
set up to correspond areas.by numbers). We cannot read the notations on map to see where materials
are stored; drainage directions; etc. Consider including a larger copy (for example, a folded 1 I" x 14"
size) in the SPPP and ensure that the items checked are clearly shown and labeled.
• Stormwater Discharge Outfall Certification Statement (Page 5A): This certification references "the
salvage yard listed below." Please make revisions as appropriate for this type of facility.
• Feasibility Study (Page 6): We recognize that at most WWTPs, expansive stormwater BMP
improvements (such as eliminating all exposure) will not be feasible. However, at the very least this
section of the SPPP could address eliminating exposure. It is acceptable to document it is impractical
and too expensive to place the entire treatment plant, or portions of the plant, under cover at this time.
Perhaps there are smaller areas that could be considered for cover?
• Secondary Containment (Page 7): We noted "5 or less 55 gallon drums of New/Used Oil" listed in
this section. However, this material is not mentioned earlier in the storage areas described on Page 3.
• BMP Summary, Maintenance & Housekeeping (Page 8): You included BMPs currently in practice.
However, this section should also address other BMPs under consideration (both structural, such as
vegetated filters, detention ponds, etc., and non-structural, such as good housekeeping). This section
of the SPPP mirrors the requirement in Part 1I, 2. (c) `BMP Summary'. If there are no new BMPs
under consideration for this year of the plan, it should be noted.
• BMP Summary, Maintenance & Housekeeping (cont.): The `Preventative Maintenance and Good
Housekeeping Program' SPPP requirement of your General Permit (Part 11, 4.) addresses regular
inspections of material handling areas and cleaning schedules. You should note here where records of,
those regular inspections are kept. In addition, the program should specifically identify areas that have
the potential for soil erosion. Have these been identified, or are there no areas at the plant where this
is a potential problem? Also, positions responsible for the implementation of the SPPP are not named
(this would fulfill the requirement in Part II, 6.). The `Responsible Employees' column of this section
only has `YES' noted (meaning trained?) instead of what employee position is responsible.
• Employee Training: Facility personnel or teams responsible for implementing Stormwater
Management Training are not identified in this SPPP (See Part H, 5.), nor is any information included
that demonstrates training is scheduled on an annual basis.
• Spill Prevention and Response Plan (SPRP) (Page 9A): The facility personnel or team responsible for
implementing the SPRP are not identified (as per Part II, 3. of the permit).
• FacilityInspection Program: This requirement of the SPPP (see Part 11, 8.) specifies semi-annual
inspections of Stormwater systems (collection points, conveyances, treatment devices, etc.),
Inspections of these systems may be part of the plant area and equipment inspections already listed on
Page 10 (Stormwater Area Inspection Checklist) of the SPPP, but it is not clear. Ensure that Page t0
of the SPPP you submitted includes inspection schedules of stormwater systems. Note also that the
template used is not consistent with the current text of NCG 110000—these inspections are not
restricted to "once in the spring and once in the fall" as the footnote reads, and the permit does require
they be separated by at least 60 days unless performed more frequently.
• Stormwater Discharge Monitoring Report (DMR) (Page 11): This form is set up for the Auto Salvage
permit. If you ever need to fill out a DMR because of vehicle maintenance activities (the only trigger
for analytical monitoring under this permit), please modify this form as necessary or use the generic
DMR form on our website: http*//h2o.enr.state.nc.us/su/Forms_Documents.htm#stormwaterGP
• TTO List, Solvent Management Plan, and .TTO Certification Form (Pages 12-13): These do not apply
to the General Permit under which this plant is covered.

City of Statesville — Fourth Creek WWTP, SPPP Review
February S, 2009
p. 3 of 3
• SDO Qualitative Monitoring Report (Page 14): This form is not the current Qualitative Monitoring
Form this facility should be using. You should have received the more recent form with the renewal
permit package, but you may also access the form on our website. Note that the NCG110000 General
Permit now specifies the Permittee record monitoring observations on a standard SDO Qualitative
Monitoring Report form provided by the Division (see Part III, Section E, 1.). You can find that form
and a guidance document on Qualitative Monitoring here:
http://h2o.enr.state.ne.us/su/Forrns_Documents.htm#m iscforms
• Vehicle Check -in Sheet (Page 15): This section is not applicable to this permit.
Please address the deficiencies in your SPPP and make any other necessary revisions or updates.
Attention to the issues described -above will help you comply with the requirements of your NPDES
Stormwater Permit, but it is important to familiarize yourself with General Permit NCG110000. If you have
any questions about this letter, please contact Bethany Georgoulias at telephone number [phone].
Sincerely,
Bethany A. orgoulias
Environmental Engineer,
Stormwater Permitting Unit
cc: Mooresville -Regional Office/Attn: John Lesley
Stormwater Permitting Unit Files
Joel A. Whitford, P.E./ McGilI Associates, P.A./ P.O. Box 1136/ Hickory, NC 28603
Central Files
Attachment

Yadkin River Basin Subbasin 03-07-04
Assessment Impaired Year
Waterbody and Description Unit (AU) Class Subbasin Use Listed Category and Reason for Listing Potential Source(s) Miles or Acres
YADKIN RIVER (including 12-(114) WS-IV&B 03-07-04 5 4,870.1 FW Acres
lower portion of High Rock
Lake)
From a line across High Rock lake from the downstream side of mouth of Crane AL 2004 5 Standard violation: Turbidity Source Unknown
Creek to the downstream side of mouth of Swearing Creek to a point 0.6 mile
upstream of dam of High Rock lake, except for the Abbotts Creek Arm of High
Rock lake upstream of Davi
YADKIN RIVER (including 12-(124.5)a WS-IV&B 03-07-04 5 10.8 FW Acres
lower portion of High Rock CA
Lake)
From a point 0.6 mile upstream of dam of High Rock Lake to High Rock Dam AL 2004 5 Standard violation; Turbidity Source Unknown
YADKIN RIVER (including 12-(108.5)b WS-V 03-07-04 5 5,568.8 FW Acres
upper portion of High Rock
Lake below normal operating
'From mouth of Grants Creek to a line across High Rock Fake from the downstream AL 2004 5 Standard violation: Turbidity Source Unknown
side of mouth of Crane Creek to the downstream side of mouth of Swearing Creek AL 2004 5 Standard violation: Chlorophyll a
YADKIN RIVER (including 12-(124.5)b WS4V&13 03-07-04
5
3.5 FW Miles
upper portion of Tucktertown CA
Lake)
From High,Rock Dam to mouth of Cabin Creek
AL
2004
5
Standard violation: Low Dissolved
Hydromodiftcation: Dam Release
Oxygen
Yadkin River Basin
Subbasin
03-07-06
Fourth Creek 12-108-20a C 03-07-06
5
23.8 FW Miles
From source to SR 1972
O
1998
4a
Standard violation: Fecal Coliform
Urban Runoff/Storm Sewers
AL
1998
6
Impaired biological integrity
Agriculture
O
1998
5
Standard violation: Turbidity
Fourth Creek 12-108-20c C 03-07-06
6
5.5 FW Miles
From SR 1985 to South Yadkin River
AL
1998
6
Impaired biological integrity
North Carolina 303(d) List- 2006
Yadkin Basin 03-07.06
Tuesday, June 19, 2007
Page 119 of 125

0
r"%M1�m C
A S S O C I A T E S
January 6, 2009
Ms. Bethany Georgoulias
Stormwater and General Permits Unit
Division of Water Quality
1617 Main Service Center
Raleigh, North Carolina 27699-1617
Dear Ms. Georgoulias:
JAN G 7 buy J'
DFNR
Wesater &anah
RE: Stormwater Permit # NCG1101 12
Fourth Creek Wastewater Treatment Plant
Stormwater Pollution Prevention Plan
City of Statesville, North Carolina
On behalf of the City of Statesville, enclosed for your review is the Stormwater Pollution
Prevention Plan for the Fourth Creek Wastewater Treatment Plant. This Stormwater Pollution
Prevention Plan is required for Stormwater Permit # NCG110112,
If you have any questions or need additional information during your review, please do
not hesitate to contact either Dave Richmond or me at [phone].
Sincerely,
McGILL ASSOCIATES, P,A.
. /!/" .
JOEL A. WHITFORD, P.E.
Project Manager
Enclosures
cc: Ms. Marcia Alloco, DWQ-Mooresville
Mr. Joe Hudson, City of Statesville
Mr. Jerry Byerly, City of Statesville.(1/encl.)
Mr. Andy Smith, City of Statesville (1/encl.)
Mr. Dave Richmond, McGill Associates, P.A.
PA09,01072 CITY OF STATESVILLE- Fourth Creek WWTP SPPRN—Design PhaselCorrespondencelDWQ submittal 2009-01-06.doe
E n g i n e e r i n g P l a n n i n g 0 F i n a n c e
McGill Associates, P.A. • P.O. Box 1136, Hickory, NC 28603 • 1240 19rh St. Lane NW, Hickory, NC 28601
828-328.2024 • Fax: [phone]

Page 1: Stormwater Pollution Prevention Plan (SPPP)
for
City of Statesville
Fourth Creek WWTP
693 Bell Farm Road
Statesville, NC 28625
As Required on the Stormwater General Permit No. NCG 110112
Permit Certificate of Coverage No: I COC110112
Permit Permit Expiration SPPP SPPP
Effective Date Date Initial Date Amend Date
8/17/07 1 4130/08
S,O i y y� .f ' V,1 F S 13,.Ii ;..
`Page #
' "' ,
° ,� ` r� �ll SPPP'SeGtiori Title, r, .' . •f.
rT} }9�'. ..Y• i'1 '., .ela.S �{ '• 1 1
91�S�Si._.� v�aTif-Q.[
I Permit #s;
^/R ✓i. 1
2
General Location Map
1a
3
Yard Areas
1 b, 1 c
4
Site Map
1 c
5
List of Significant Spills & Certification Statement
1d, le, 7
6
Feasibility Study
2a
7
Secondary Containment Schedule
2b
8
BMP Summary, Maintenance & Housekeeping and Other
Stormwater Pollution Prevention Measures
2c, 4, 5, 6
8 Info
Types of BMPs Which Can be Used Do Not Fill Out
2c
9
- Spill Prevention and Response Plans
- List of Significant SpjIls
3
10
Inspection Checklist
8
11
Annual Analytical Quantitative Monitoring Log
9
12
TTO List
9
13 ITTO
TTO Solvent Management Plan
Certification Form
9
14
Semi -Annual onitorin Log
e Monitoring
oI
9
R�Qu�ca4ol�it+r##.at"ivr
;•4�r �r, t` "', { !." s ti a
so4SPPPlmplementatEon
." P.,e.,E mw' it #��_?
15
Vehicle Check in Sheet
NA
16 ITank
Inspection Checklist
NA

�,,` � JJ w r� ��� • . tip.' ''rl
1ti�j•��ti �
SME 1:24000
1
# 1000 o IOM 7000 3000 r000 woo um moo FEET
MM l 5 0 1 KILOWER
CONTOUR INTERVAL 10 FE6T
1M fAr NATIONAL GEODETIC VERTWAL DATUM OF 1929
M4i
STAMVILLF EAST, NC
3508D-G 7•TF-02a
I EDA "Areum I aF ElalrrN 1993
oECI►r~t1oN uCEMRRQ •tFF
DMA 1[5.55 TV SE•SrAM vR42
Check Boxes to veri items have been identified on map or are listed below
(] Site Pro Line
El Adjacent Street Names
ElIm aired Streams
21 Name of receiving Municipal Storm Sewer (MSW) and eventual MSW Receiving Water:
❑ Name of receiving waters if no MSW (streams, ponds, rivers, lakes, etc):
SDO #1 SDO #2
SDO #3
f] Latitude: 35.774112° 0 Latitude: 35.774517°
E] Latitude: 35.774779
Ej Longitude:-80.791537° 0 Longitude:-80.7891010
(] Longitude:-80.787169
Page 2: General Location Map (Include information requested by
checkboxes). Site Name: Fourth Creek WVffP
Page l of 1

r�
q
I
% of Drainage Area
Jg
That is Paved or Hard
!
Surface:
V a
SDO-1: 10%
- '
SDO-2:45%
SDO-3: 14%
♦
II j
�J
�
v
rr,
0 Site Property Boundary Stormwater Controls BMPs
[] Stormwater Discharge outfall(s)
Location of Material Storage
E
Building Locations
0 Drainage Areas & Direction
0 Material Disposal Areas
E
Intake structures
Adjacent Creeks & Ponds
E] Material Process Areas
[]
Hazardous Waste Storage Areas
Page 4: Site Map (number each area according to pages 3 & 4).
Site Name: Fourth Creek WWTP
Page 1 of 1

Paqe 3: Yard Areas (as Listed in Site Mat). 41
Area #
Area Title
Area Amount ft2
Drains
(same
8
Possible Contaminants & Containers
to SDO
as
Activity Description
(stored or used)
Indoors
Outdoors
# ?
pg 4)
(Loading I Unloading, etc)
Terpene Drip Degreaser, Flocculant
Polymer, Bioenzymes (Dry and
2000
1
Main Pump Station
Liquid), Caustic Soda (Liquid),
sq.ft.
q'
NO
Sodium Bicarbonate (Dry). All
Items stored in Fire Cabinets.
Above ground storage of 6000
2
gallons (max) of diesel fuel for
Diesel Fuel
160 sq.ft.
NO
facility stanby power
Generator Building (inside).
Diesel Fuel, Muriatic Acid, And
Generator day tank storage of 100
Sodium Bicarbonate D
( ry)'
3500
3
gallons (max) of diesel fuel for
Gasoline. All items are stored in
sq.ft.
NO
facility standby power and
Fire Cabinets
Maintenance Shed
4
Administration Building
See Attached Spread Sheet for 4�'
11000
NO
Creek Lab: Incoming Supply Log
sq.ft.
TOTAL SURFACE AREAS
SDO #1
SDO #2
NA
Both
(ft2)
SDO = Stormwater Discharge Outlet
Page 1

Page 5A: Stormwater Discharge Outfall Certification Statement
React and`` sign the fallowing certification statement each year.
I, So-_ 9tAo-c3oo) certify, that the Stormwater Discharge outfall(s) (SDO) located at the salvage yard listed
below, only contains stormwater runoff from said property. The SDO does not contain waters originating
from any of the following sources:
- domestic waste water sources (i.e,, toilets, sinks, kitchen sinks, washing machines, etc.
- process wastewater from equipment operation, wash down, fluid removal, etc
- other non-stormwater discharges
NOTE: Washdown water from vehicle washing is considered "wastewater" and is regulated by NC
Wastewater Requirements (not Stormwater rules). It is not allowed to be discharged - by the
Stormwater permit or by this Stormwater SPPP.
Name:
Signature:
Title:
r � � .c
Date:
,7 L
Page B: True & Accurate Information Certification Statement
Tom, �so1. certify, under penalty of law, that this document and all attachments were prepared under
my direction or supervision in accordance with a system designed to assure that qualified personnel properly
gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage
the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations.
Name:
Signature:
Title:
�G r �C
Date:
Page 5C: Plan Amendment Certification Statement
Ii�F_ certify, that if changes occur at this facility that could significantly affect the potential for
stormwater pollution, this plan will be amended as needed.
Name:
�J
Signature:
Title:
. �e�i��/
Date:
Page 1

Page 6: Feasibility Study
Area #
Comment on - if you can change or improve existing operations or stormwater controls to reduce stormwater pollution,
(Same as
AND if there are obstacles to making these changes. (i.e., Are these changes affordable? Can employees be expected
pg 4)
to perform these changes?, etc)
All
Affected
There are no changes or improvements that can be made at this time. We will continue to properly train the
Areas
Fourth Creek WYVTP Staff on storage and containment of potential hazards and non-stormwater runoff.
Page 1 of 1

Page 7; Secondary Containment Schedule
Secondary Containment (1) , (2)
Rainwater Release'lhformation (2)
Type of
If No Secondary Containment,
Can Rainwater
If Yes, List procedure
Area #
Description 8� Size
of Storage Tank or .
Secondary
d
What are "Equal Measures of
Fill -Secondary
.(inspections, valving, etc) which
(same as
Container
Containment (see
Spill Prevention including
Containment
will verify that no contaminated
P9 4)
below)
,plans to construct.
Area ?
rainwater will be released to the
containment
environment
2
6,000 gallon diesel
DW
NO
fuel tank.
3
100 gallon diesel
DW
NO
fule tank
5 or less 55 gallon
3
drums of
S
NO
New/Used Oil
(1): If the facility stores oils, fuels, or other liquid petroleum based liquids in above ground tanks, containers, drums or other - then
some form of secondary containment around containers is required. Secondarycontainment types are defined below:
Retairnng Wails (RW)
Curbing (C)
Weirs / Booms (WB) I DW = Double Walled Tank
Dikes (D)
Sorbents (S)
Gutters I Culverts (GC lRetention Ponds (RP) Containment Pits (CP)
(2) The size of Secondary Containment structure needed = the contents of the single largest tank within the containment structure
plus sufficient freeboard to allow for the 25 > year / 24 hour storm event.
Information on a 24 hr/25 Year Flood event can be found at - http://www.erh.noaa.gov/er/hq/Tp40s.htm , OR
http-//hdsc,nws.noaa.gov/hdsc/pfds/
Page 1 of 1

Page 8: BMP Summary, Maintenance & Housekeeping and Other Stormwater Pollution
Prevention Measures
Area #
(same as pg 4)
Stormwater Pollution Prevention Procedures including:
- BMPs (1);
- Maintenance & Housekeeping;
- Inspections (3);
Responsible
Employees -
Trained if
Necessary (2)
Records Demonstrating
Completion- of. Procedures (3)
(NOTE: Use,'SPPP Page#'s if
Applicable)
3
All used oil is recylced, all drums of chemicals are emptied
during plant process and sent to vendor when new shipment
arrives.
YES
E
(1) BMP is a Best Management Practice for preventing stormwater pollution (see# 2C2 for BMP Glossary)
(2) Employees who may need training in procedures.
(3) All areas will have inspections as scheduled and completed in SPPP#S Page 1 of 1

Page 9A: Spill Prevention & Response
Page 1
" Area #
Describe Potential Spill
Spill Team
Other Spill
(same as
' (Material, Container,
Incident, Potential
Spill Prevention Procedures.
Spill Response & Clean -Up
Leader/
Team. Members
a)
Consequences)
Procedures
Phone#
1 Phone #s
2
Chlorine, Sodium
Fire Department/ Hazmat
N/A
NIA
Bisulfite, Polymer
1 Ton Cylinders
2
Chlorine 55 Gallon
Employee Evacuate
drums of Sodium
2
275 Gallon Totes of
Call 911
Polymer
NOTE on Spill Response or Spill CleanUp
- Employees who may expose themselves to hazardous chemicals such as oils, gasoline, battery acids, etc - should receive
"Hazard Communication" training, at least once. This informs them of the potential health risks associated with these
materials AND how to find out more information on preventing these risks & responding to accidents. For example,
"HazComm" training informs employees on how to get information from a Material Safety Data Sheet (IUISDS). For small
spills (typically less than 5-gal) of common materials, Haz Comm training may be sufficient as spill prevention and clean-up
training.
- For more serious spills, outside agencies may need to be notified (Fire Dept, 911, etc). Employees need to be trained in
notification procedures as well.
- If a facility designates its own employees as the "spill response team" for all types of spill (including larger, more serious
spills), then more extensive training may be required (i.e., HazWOPER)

Page913: Salvage Yard List of Significant Spills Calendar Year Covered:
List all the Significant Spills that have occurred at this Salvage yard during the specified calendar year.
Page 2
Area #
Area Title
Material Spilled
Size of Spill /.Date of Spill.
Other Comments
(same as
Activity Description
# 4)
(Loading 1 Unloading, etc)
All
Affected
NIA
NIA
N/A
NIA
Areas
There are no spills to report
NOTE: Significant Spills is defined as those that exceed the "Reportable Quantities" or RQ for pollutants as listed in CERCLA
legislation (found in 40 CFR 117 and 40 CFR 302)
NOTE: IF AN OIL SPILL OCCURS THAT MEETS THE BULLETS LISTED BEIOW -- YOU HAVE A LEGAL OBLIGATION TO
REPORT IT TO YOUR REGIONAL DENR OFFICE or THE DEPARTMENT OF EMERGENCY MANAGEMENT,
• Any spill > 25 gallons
• Any spill regardless of amount that causes a sheen on surface waters
• Any spill regardless of amount that occurs within 100 feet of surface waters
• Any oil spill < 25 gallons that cannot be cleaned up within 24 hours
Contact Information Fayetteville Regional Office
Asheville Regional Office [phone]
Mooresville Regional Office [phone]
Winston-Salem Regional Office [phone]
Raleigh Regional Office - [phone]
Wilmington Regional Office
Washington Regional Office
[phone]
[phone]
[phone]
NC Emergency Mgt (after hrs) [phone]
National Response Center [phone]

Page 10: Stormwater Area Inspection Checklist
Choose One Below
(Complete a copy at least two times per year)
Fall Inspection for YEAR 2008
❑ Spring Inspection for YEAR
Area #
Actual
Clean-up
(As listed on
Inspection
-
Comments
Completed
pgs 3 & 4)
Date (1)
Condition of Area At time of Inspection
(Clarify Findings Noted in Previous Column)
Date
El
Clean, Uncluttered (acceptable)
❑
Some debris, but no exposed stormwater
1
12/4/2008
contaminants
❑
Stormwater contaminant exposed (unacceptable)
❑
No Spill Clean -Up Equipment is Available for this
area
❑
Clean, Uncluttered (acceptable)
❑
Some debris, but no exposed stormwater
2
12/4/2008
contaminants
❑
Stormwater contaminant exposed (unacceptable)
❑
No Spill Clean -Up Equipment is Available for this
area
El
Clean, Uncluttered (acceptable)
❑
Some debris, but no exposed stormwater
3
12/4/2008
contaminants
❑
Stormwater contaminant exposed (unacceptable)
❑
No Spill Clean -Up Equipment is Available for this
area
12/4/2008
0
Are all containers properly labeled?
Are containers closed, covered, in good condition,
All Areas
12/4/2008
and away from equipment that can cause them to
tip?
12/4/2008
Is equipment well maintained to prevent leaks and
spills?
(1) Inspections must be completed an a semi-annual basis (at least once in the spring and once in the fall Print out and complete a copy for each insf
TBD = To Be Determined; NA = Not Applicable ----
Page 1 of 1

Page 11: STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address On Back Of This Form
GENERAL PERMIT NO. NCG100000
Part A: Facility information
Samples Collected In Calendar Year: (all samples shall be reported following receipt from lab, but no later than no later than 30 days from the date
the facility receives the sampling results,)
Certificate Of Coverage No.
Facility Name
Facility Contact
Facility Contact Phone No.
Part B: Specific Monitoring Requirements
NCG10
Fourth Creek WWTP
Andy Smith
704-878-3438
County of Facility
Name of Laboratory
Lab Certification #
,Outfall
No.
Date
Sample
Collected
00400
00556
01051
00530
77023
78I41
pH
Oil and
Grease
Lead, Total
Recoverable
Total
Suspended
Solids
Ethylene
Glycol
Total Toxic
Organics'
mo/ddl r Itandard
uni
m l
m l
m Ll
m /l
m l
Benchmark
-
6.0-9.0
30
0.03
100
14
1
lredell
If no discharge occurs during
sampling period, must submit
form indicating "No Flow"
within 30 days of end of the
sampling period.
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit,
Does the facility perform vehicle washing and fueling? _ yes X no
Part C. Storm Event Characteristics
List each addional event sampled this reporting period adapted front
Date: (first event sampled) Date: Form SWU-251-102107
Total Event Precipitation (inches): Total Event Precipitation (inches): Page 1 of 2

STORMWATER DISCHARGE MONITORING REPORT (DMR)
'For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Fede
Regulations (CFR) Part 122.
'"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement fo:
total toxic organics (TTO), I certify that, to the best of my knowledge and belief, no leak, spill, or dumping of concentrated toxic organics i
stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I
further certify that this facility is implementing the solvent management plan included in the Stormwater Pollution Prevention Plan."
orB .re,
Name (=U,
rint)
Title (please print)
/ ,Ptw a
Signature Me
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or p
who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, includi:
possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
MAILING ADDRESS: Attn: Central Files
NCDENR 1 DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
adapted from
Form SWU-251-102107
Page 2 of 2

Page 12: TTO List: List any Total Toxic Organics (TTOs), by number, that are contained in any
solvents used at the facility. If TTOs are present, check off the individual TTO and keep as a record
(only include top of form in SPPP)
N
-A�'
40t4. 4.
0
'
-a—m'e, -W A
WIN W W
kcO
U11 0
NIA
This list of TTOs can be viewed below (Page 12 on the this spreadsheet file)
Page lof I

Page 13A: TTO - Solvent Management Plan
If the facility uses any organic chemical (i.e., solvent, degreaser, etc) that contain toxic pollutants in 40 CFR
401.15 (TTOs as listed on page# 12), they will be identified.
Solvents which contain TTOs will be stored in labeled drums or containers designed to prevent spills and in no
way, allowed to contaminate stormwater.
The facility has implemented an Emergency Preparedness and Response procedure (page# 9) which provides
;facility personnel with instructions to prevent spills and effectively respond to any spill emergencies.
All facility personnel will receive training in the proper handling, storage and disposal of hazardous chemicals in
their workplace.
Page 13B: TTO Certification Form
Read and sign the following certification statement.
I, , based upon my inquiry of the person or persons directly responsible for managing
compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that, to the best of my
knowledge and belief, no leak, spill, or dumping of concentrated toxic organics into the stormwater or onto areas
which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I
further certify that this facility is implementing the Solvent Management Plan (above) included in the Stormwater
Pollution Prevention Plan (above)."
Name: Signature:
Title: Date:
Page 1 of 1

wnrERQ.
p liip�'Mivow Ic
Page 14: Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: NICI_ 1_ 1_I 1_ 1_I_ 1 or Certificate of Coverage No.: NICIGI 1 11 1 d 11 11 121
Facility Name: City of Statesville - Fourth Creek WWTP
County: Iredell Phone No.704-878-3438
Inspector:
Date of Inspection:
By this signature, I certify that this report is accurate and complete to the best of my Knowledge:
(Signature of Permittee or Designee)
1. Outfall Descriptio
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage an
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.):
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 3 4 5 6 7 8 9 10
Page 1
SWU-242-020705

S. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes No
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes No
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
5W U-242-020705

Page 15: Vehicle Check -in Sheet
fate
Task to be Performed
Comments
Type of Vehicle (Model/Year)
NIA
El
1
Date of Vehicle Reception
❑
2
Gasoline Removed
31
1
Brake Fluid Removed
4
Power Steering Fluid Removed
5
❑
Anti -Freeze Removal
6
❑
Battery Removed
7
❑
Mercury Switches Removed
8
❑
Catalytic Converter Removed
9
❑
Refrigerant Removed
10
❑
Transmission Fluid Removed
11
❑
Engine Oil Removed
❑
Store Above Materials that were
Removed - in a sealed, labeled
12
1
Icontainer, in a sheltered area
Page 1 of 1

Page 16: Tank 1 Container Inspection Checklist
#
Y
N.
Date
Task to be Performed
'-Comments,) Action Takeri>to.Fix Issue
El121412008
Does the tank or nearby ground/pad, show any sign of
Double wall tanks. If in building, floor
1
leakage?
drains drain to head of facility.
❑
E
12/412008
Is your view of the tank bottom obscured in any way
2
(can't really check to see if its leaking)?
❑
❑
12/412008
3
Is the tank rusty, damaged or deteriorating?
❑
El
12/4/2008
4
Are any bolts, rivets, or seams damaged?
❑
M
12/4/2008
5
Are tank supports deteriorated or buckled?
❑
�
12/4/2008
b
Is secondary containment damaged or stained?
❑
El
12/412008
7
Is there oil in the secondary containment area?
❑
0
121412008
8
Are any fill ports uncapped?
❑
�
12I412008
9
Are any vents obstructed
NOTE: If the facility stores oils, fuels, or other liquid petroleum based liquids in above ground tanks, containers, drums or other -
then some form of secondary containment around containers is required. Secondary containment types are defined below:
Retaining Walls (RW) Weirs 1 Booms (WB) Curbing (C) Containment Pits (CP)
Dikes (D) Gutters 1 Culverts (GC) Sorbents (S) Retention Ponds (RP)
Page 1 of 1

Dye Testing Verification Results
On December 2, 2008 the City of Statesville Water/Sewer Maintenance Department assisted the 4«
Creek WWTP Senior Operator in conducting some dye tests. The dye test is required for the Storm
Water Permit. The following floor drains were tested:
❖ Maintenance/Generator building.
❖ Chlorine building.
RAS/WAS building.
* Dewatering building.
All of the above drains go back to the headworks of the WWTP.
The following storm drains were tested:
❖ Secondary Clarifier's #1, 2 & I
❖ Area in front of Dewatering building.
All of the above drains flow down to the lower portion of the WWTP. This drainage system carries
the storm water runoff to the outer perimeter of the WWTP.

PLANT INFLUENT
* FLOW
❑ISTRIBUTION
BOX
COVERED
ENT STALIME SLUDGE
SLUDGE STORAGE
TREATMENT
FACILITIES
LIME
SLUDGE
STORAGE
PAD
I BELT I
j PRESS
SLUDGE
PUMPS
AEROBIC
SLUDGE
I DIGESTER
AERATORS
L - J
FLOW SCHEMATIC & WATER BALANCE
FOURTH CREEK WASTEWATER TREATMENT PLANT
CITY OF STATESVILLE

4`h k ;ek Lab
Incoming Supply Log
Chemical/Ilem Name
Location
Test Used In
Supplier/
Manufacture
Quantity
Lot
Number
Cat. CAS 4
Number
Date
Received
Date
Opened
Expiration
Date
Discarded
Acetone
Wooden Flame Cabinet
TCN
Fisher
1(500mi)
043853
G3025 67-64-1
2116/2005
N/A
Acetone
Wooden Flame Cabinet
TCN
J.T. Baker
i (500m1)
Y36B28
G3025 67-64.1
3/1212004
M16I-004
N/A
Acetylene
Outside of Sample Room
Medial
Machine & Welding
1 Tank
NIA
N/A 74-86.2
NIA
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
l (18 oz.)
BIC6
1500 See MSDS
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
1 (18 oz.)
BIC6
1500 See MSDS
}
r
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
1 (18 oz.)
B1C6
1500 See MSDS
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
1 (18 oz.)
BlC6
1500 See MSDS
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
1 (18 oz.)
BIC6
1500 See MSDS
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
t (Is oz.)
BIC6
1500 See MSDS
AlcoTabs
D•14 Cabinet
pipenes
Alconox
1 (18 oz.)
BIC6
1500 See MSDS
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
I (18 oz.)
BIC6
-1500 See MSDS
AlcoTabs
D-14 Cabinet
Pipettes
Alconox
1 (18 oz.)
BIC6
1300 See MSDS
Alkaline-Azide Powder Pillows
D-7 Cabinet
Winker
HACH
I pk. (50)
A6214
1072.66 NIA
9/5/1006
11/27/2006
8/31/2009
Alkaline-Azide Powder Pillows
D-7 Cabinet
Wilikv
HACK
I pk. (50)
A6214
1072-66 NIA
9/5/2006
8131/2009
Alkaline-Azide Powder Pillows
D-7 Cabinet
Winker
14ACH
I .-k. (50)
A6214
1072-66 N/A
9/5/2006
8/31/2309
Alkaline-Azide Powder Pillows
D-7 Cabinet
Winker
EACH
I pk. (50)
A6214
1072.66 NIA
9/5/2006
8/31/2009
Ammonia Ref. Fill Solution
A-2 Cabinet
NH3 Meter
Fished Thermo
1 (2 oz)
5318-04
900011 See MSDS
1/26/2006
11/] Sn007
Ammonia Internal Fill Solution
A-2 Cabinet
NH3 Meter
Fisher
I (SOOmI)
4607109
R3161200 See MSDS
7120/2006
7/31/2007 I
Ammonia Ref, Fill Solutiolt
A-2 Cabinet
NN3 Meter
Fisher/ Thermo
5 (2 oz)
12641686
90001 1 See MSDS
31412007
Ammonium Choride
2"d Shelf Chemical Cabinet
NM,TxN,NmuTe
Fisher
I (500g)
995958
A661-500 12125.02.9
2/29/2000
2/28/2000
NIA
Ammonium Chloride
2"a Shelf Chemical Cabinet
Ntu,TKKNrrnATE
Fisher
l (500g)
996969
A641-500 12125.02-9
2/1712000
2l1712000
NIA
Ammonium Chloride
21ShelfChemicalCabinet
NJOTKN,Y[MTE
Fisher
l(500g)
996969
A661-500 12125-02-9
2/17r000
6/13/2001
NIA
Ammonium Chloride
2iid Shelf Chemical Cabinet
NM TKN,NrrRATe
Fisher
l (500g)
996969
A661.500 12125-02-9
2/17/2000
NIA
Ammonium Chloride
2" Shelf Chemical Cabinet
WD,TRN,NIrBATE.
Spectrum
1 (500 g)
VTO510
Al 165 12125.02.9
10l2512006
I012512006
NIA
Ammonium Chloride
VO Shelf Chemical Cabinet
NNXma,.KmrnAM
Spectrum
1 (500 g)
VTO510
A1165 12125-02-9
10125/2006
NIA
Ammonium Hydroxide (28-30%)
On Top Flame Cabinet
Nitrate
J.T, Baker
1 (5001D1)
Al1045 1
9.733-01 1 7336.21-6
9/2712002
4/12/2006
NfA
Argon
Outside of Sample Room
Metals
Machine & Welding
2 Tanks
N/A
NIA 7440-37-1
N/A

4th t-_.,ek Lab
Incoming Supply Log
Chemical/lretn Name
Location
Test Used In
Supplier/
Manufacture
Quantity
Lot
*lumber
Cat.
Number
CAS N
Date
Received
Date
O ened
Cxpiratictn
Date
discarded
Ascorbic Acid (-L)
6' Shelf Chemical Cabinet
TCN
J.T. Baker
I (500g)
K48604
B581-01
50-81-7
8/5/1998
12/ 1912002
NIA
BAB-O Chlorine Bleach
A -I I Cabinet
Clearing
Purex Industry
I Can
NIA
NIA
See MSDS
BarbiturieAcid
6°ShelfChemicalCabinet
TCN
Spectrum
1 (125g)
UB0500
Ba120
67.52-7
7/612006
NIA
BOD Nutrient Pillows
D-lOCabirru
SOD
HACH
I pk. (50)
A6251
1486266
NIA
10lI9r201?6
10/23/2006
9/30/20f i
BOD Nutrient Pillows
Storage Room
BOO
I
HACH
I pk. (50)
A6251
1486266
N/A
10/23/2006
9/30/201 1
BOD Nutrient Pillows
Storage Room
13OIJ
HACH
l pk. (50)
A6332
1486266
N/A
1/3/2007
11/30/201 1
BOD Nutrient PillowS
Storage Room
BOD
HACH
1 pk. (50)
; 1 pk. (50)
A6332
A6332
1486266
1486266
NIA
N/A
1/3/2007
1I3I2007
11/30/2011
11130/20i 1
BOD Nutrient Pillows
Storage Room
BOD
HACH
Boiling Granules(Hengar)
F4 Cabinet
TKN
Reagcnts k i (500g)
NIA
136-C
1344-28-1
9/1/2006
1 12/11/2006
NIA
Boiling Granules (Heugar)
F-I Cabinet
TKN
Reagents
l (500g)
NIA
136-C
I344.29-1
9I111006
NIA
Boric Acid (Granular)
6'a Shelf Chemical Cabinet
TKN
},T, Baker
l (2.5kg)
V42621
0084-05
10043-35.3
12/14/2001
1123/2004
NIA
Cadmium Metal Granules
2"'t Shelf Chemical Cabinet
Nitrate
Fisher
1 (500g)
033742
C3500
7440.43-9
7/7/2003
4/23/2004
NIA
Cadmium Standard 1000 ppm
AA Metals Room
Metals
Ricca
1 (120 ad)
2603614
1700
See MSDS
10/12/2006
9/30/2007
Chlorimitte-T
2n° SheffChemicalCabinet
TCN
4lailbncrorkt/3T
I (250g)
06I4B21HI1
0614
127-65-1
1/19/2006
w412706
N/A
Chloroform
Wooden Flame Cabinet
Nitrate
VWR
I (4L)
39040912
VW1430
67-66-3
8117/1999
9/10/2000
N/A
Chloroform
Wooden Flame Cabinet
Nitrate
VWR
I(4L)
39040912
VW1430
67-66.3
8/171099
NIA
Chloroform
Wooden Flame Cabinet
Nitrate
HACH
I (500mi)
Q8170
1445849
67-66-3
8/25/1998
9/11/1998
NIA
Chlorox Bleach
D-12 Cabinet
Glassware
Chlorox
1 (5.14 L)
N/A
NIA
NIA
Chlorox Bleach
D-12 Cabinet
Glassware
Chlorox
1 (5.14 L)
NIA
NIA
NIA
Chromium Standard 1000 ppm
AA Metals Room
Metals
Ricca
] (120snp
2601100
2100
See WDS
61I0006
S/R/2006
7131/2007
COD Vials (High Range)
F= I Cabinet
COD
HACH
1 pk. (150)
A6239
2125915
N/A
9/8/2006
1/1612007
8131I2011
COD Vials (High Range)
Storage Rcom
COD
HACH
I pk. (150)
A6239
2125915
N/A
9/8/2006
9/31/2011
COD Vials (High Range)
Storage Room
COD
HACH
I pk. (150)
A6239
2125915
NIA
91812006
8131/7011
COD VWs (Low Range)
F-1Cabinet
COD
HACH
!pk. (150)
A5256 12125915
NIA
912MOD5
12/712006
95012010
COD Vials (Low Mange)
Storage Roam
COD
HACH
I pk, (150)
A5256
2725915
N/A
9129/2005
9/30(Wil)
COD Vials (Low Range)
Storage Roam
COD
HACH
I pk. (150)
A6236
2125915
NIA
9/8/2006
8/31/2011
Conductivity Slaudard (100 umhos)
1-2 Chemist Roam
Conductivity
Ricca/Reagents
1 (4L)
2604003
2237-1
Sec MSDS
1/11,2106
4/21/2006
3/3IrOO7

4th L :,ek Lab
Incoming Supply Lop-
( hemicallltern Nance
Location
Test Used In
Supplier/
Manufacture
Quantity
Lot
Number
Cat.
Number
CAS 9
Datc
Received
I Dale
I Opened
Expiration
Date
Discarded
Conductivity Standard (100 tamos)
1 2 Chemis(Room
Conductivity
Ricca/Reagents
1 (4L)
2609328
2237-1
See MSDS
1/18/2007
10/31/2007
Conductivity Standard (1412 umhus)
1-2 Chemist Roam
Conductivity
Ricca/Reagents
1 (4L)
2602192
5890-1
See MSDS
8/212006
9/29/2006
2/28/2007
Conductivity Standard (1412 umhus)
1-2 Chemist Room
Conductivity
RiccalReagents
t (4L)
2610293
5990-1
Sea MSDS
1/19/2007
9/30207
Conductivity Standard (50M umhus)
1-2 Chemist Room
Conductivity
Ricca/Rcagenm
1 (4L)
2603413
2245-1
See MSDS
7MI2006
8/3ln0I)6
3/31/2007
Comet
A -I I Cabinet
Cleaning
Prestige Brand Inter.
I Can
NIA
NIA
See MSDS
Copper Standard 1000 pptn
AA Metals Room
Metals
Ricca
1 (120ml)
2605498
2300-4
See MSDS
6/2/2006
9/13/2006
100/2007
Cupric Sulfate (Crystals)
Zed Shelf Chemical Cabinet
TKN
J.T. Baker
1 (500g)
Y42614
I843-01
7758-98-7
5/14/2004
5/20/2004
NIA
Cupric Sulfate (Crystals)
tad Shelf Cbemical Cabinet
TKN
J.T. Baker
) (500g)
Y36602
1844.01
7758-98-7
5/1712M4
6/2/2004
N/A
Cupric Sulfate (Powder)
2"d Shelf Chemical Cabinet
TKN
J-T. Baker
I (500g)
C01634
1941-01
7758-98-7
412412006
10/27R006
NIA
Dextrose
2' Shelf Chemical Cabinet
BOD
J.T. Baker
1 (500g)
Y05333
1916-01
50-99-7
4114/2004
4/14I2004
NM
Dextrose
Zed Shelf Chemical Cabinet
BOD
Reagents
1 (500g)
0212EF
1-19500-1
50.99.7
12/I3/1005
4/4/2006
NIA
2/28/2007
Discover Disinfectant
A-1 I Cabinet
Air Freshener
States Ltdustrial
1 Can
N/A
NIA
See MSDS
DPt3Chlorine Pilluws (IC all Sample)
Refrigerator
Chlorine
HACH
I Pk, (1000)
2105623
2105528
NIA
1/1112007
6/30/2011
DPDChlorinePillows(25misample)
Refrigerator -
Chlorine
HACH
1Pk. (1000)
1406428
1406428
NIA
1/1t12007
SM/2011
Drierite (Indicating)
C-1 I Cabinet
Desicator
W.A. Hammond
1 (1 lb)
N/A
24001
See MSDS
9232003
10/1 MOM
Drierite (Indicating)
C-I I Cabinet
Desicator
W.A. Hammond
I (I 1b)
NIA
24001
See MSDS
9/23/2003
6/26/2006
Drierite (Indicating)
C-I I Cabinet
Desicator
W.A. Hammond
1 (i Ib)
NIA
24001
See MSDS
9/23/2003
Drierite (indicating)
C-11 Cabinet
Desicator
W.A. Hammond
1 (5 lb)
NIA
24001
See MSDS
8/23/2005
11232005
EDTA
6mShelf Chemical Cabinet
Nitrate
Spectrum
1 (125g)
SV0547
E1010
60-00-4
71612006
8/1712006
N!A
Ethyl Alcohol
Wooden Flame Cabinet
A)1
V WR
1 (4L)
45011513
EX0295
See MSDS
7B12005
NIA
Favor Polish
A-11 Cabinet
Pledge
2 Can
NIA
N/A
See MSDS
Ferrous Sulfide
2"d Shelf Chemical Cabinet
COD
Fisher
1 (SOOg)
010553
11500-500
1317.37-9
7/26/2002
6/9/2004
N/A
Glulamie Acid (L-)
6" ShelfChemical Cabinet
TKN, BOD
J.T. Baker
1 (50Dg)
V38613
M756
56-86-0
1132003
1/3/2003
NIA
Glutamic Acid (L-)
61R Shelf Chemical Cabinet
TKN, BOD
J.T. Batter '. (50og)
Y35603
M756
56-86-0
4/142004
4/1412004
NIA
Hexane (95% N-Hexane)
Wooden Chemical Cabinet
Oil & Grease
VWRI Mallinerockt
1 (4L)
PSJV05
9262-03
110-54-3
1122006
1)1212206
Hexane (95°/a N•Hexane)
Wooden Chemical Cabinet
Oil & Grease
VWR/Mallincrockt
1 (4L)
PSJV05
62-03
110-54.3
11/2/2006
Hydrochloric Acid
Corrosive Cabinet
All
EM Science/ EMI)
1 (2.5L)
38156
:::[A�C
5393
7647.01-0
8/5/1998
82612004
NIA

4th t,_ jek Lab
Incoming Supply Loa
Chenaical/Item Name
Location
'Ff!st Used In
Supplier/
Manufacture
Quantity
Lot
Number
Cat.
Number
CAS 4
Dale
Received
Date
O ened
Expiration
Date
Discarded
Hydrochloric Acid
Corrosive Cabinet
All
Fisber
1 (2L)
041774
A144S-212
See MSDS
9123/2004
3/16/2005
NIA
Hydroe111orie Acid
Corrosive Cabinet
All
Fisher
I (2L)
041774
A144S-212
See MSDS
9/43/2004
NIA
Hydrochloric Acid
Corrosive Cabinet
All
Fisher
1 (21.)
041774
A144S-212
See MSDS
9/23/2004
NIA
Hydrochloric Acid
Corrosive Cabinet
All
€ Fisher
1 (2L)
041774
A144S-212
See MSDS
9123/2004
WA
Iodate-lodide Sid, Solution
D-7 Cabinet
Winkler
HACH
I (SOOmI)
A5244
1400153
See MSDS
9119/2005
12112/d0D5
9130/2001
Iodate -Iodide Sid. Solution
D-7 Cabutet
Winkler
HACH
1 (500ml)
A5244
1400153
See MSDS
9/19/2005
9/30/2407
Isopropyl Alcohol
Wooden Flame Cabinet
All
EM Science/EMD
I (4L)
PX1835
PX1835
67.63.0
7/2611994
9111/2003
N/A
isopropyl Alcohol
Wooden Flame Cabinet
All
EM Science/ EMD
1(4L)
PX1835
PX1835
67.63-0
7/26/1994
NIA
isnpropy) Alcohol
Wooden Flame Cabinet
All
FM Science/ EMD
1 (4L)
PX1835
PX1835
67-63-0
7/26/1994
NIA
LabConco Dishwasher Detergent
E-3 Cabinet
Glassware
LabConco
1 (77.5 kg)
61547
4422100
See MSDS
111812007
Lead Standard 1000 ppm
AA Metals Room
Metals
Ricca
1 (120ml)
2603224
4300
See MSDS
10/12/2006
11nn106
8/31/2007
Linseed Oil (Bailed)
A-1 1 Cabinet
Counter Tops
Klean 5irip WM Barr
1 Can
NIA
NIA
66071-03-2
Magnesium Chloride
3"1 Shelf Chemical Cabinet
TCN, Fecal
Fisher
1 (500g)
995874
M33-500
7791-18-6
411112000
4/7/2004
N/A
Magnesium Chloride
3" Shelf Chemical Cabinet
TCN, Fecal
Fisher
1 (500g)
995874
M33-500
1791-1"
4/11/2000
NIA
Magnesium Chloride
3`s Shelf Chemical Cabinet
TCN, Fecal
J.T. Baker
1 (500g)
K34348
2444-01
7786-30-3
1111911997
3/23/2006
NIA
Magnesium Chloride
3b Shelf Chemical Cabinet
TCN, Fecal
J.T. Baker
1 (500g)
K34348
2444-01
7786-30-3
11/19/1997
NIA
Magnesium Chloride
Yd Shelf Chemical Cabinet
TCN, Fecal
J.T- Baker
I (500g)
K34349
2444-01
7786.30.3
11/19/1997
NIA
Manganous Sulfate Pillows
D-7 Cabinet
Winkler
HACEJ
1 pk. (50)
A6199
107166
778.59-77
915/2006
11/27/2006
7131/2011
Manganous Sulfate Pillows
D-7 Cabinet
Winkler
HACH
1 pk, (50)
A6198
107166
778-58-77
915ROD6
7/31/2011
Mangarious Sulfate Pillows
D-7 CaNaci
Winkler
HACH
l pk. (50)
A6)98
107166
779.59-77
9/5/2006
7/31/20t I
Mangaaous Sulfate Pillows
D4 Cabinet
Winkler
HACH
I pk. (50)
A6198
107166
778-58-77
9/5/2006
7/31/2011
Matrix Modifier
AA Metals Room
Metals
Env, Express
I (250 ml)
607402
HP1916-250
See MSDS
61212006
10/1 112006
6/30/2007
Mehl QC Standard
AA Metals Boom
Metals
Env. Express
I (250ml)
619310
tiP1832-A-250
7697.37-2
7/1712006
7/24/2006
8/3112OD7
Metal QC. Standard (Zn)
AA Metals Room
Metals
Env- Express
1 (250i^.J)
619310
HP1832-B-250
See MSDS
7117/2006
7124,2005
&'3112007
Methanol
Wooden Flame Cabinet
Oil & Grease
VWR/ JT Baker
I (4L)
C10E76
9263-03
67-56-1
7110/2006
i
10/19/2006
6130/2007
Methyl Red
3" Shell'Chemical Cabinet
TKN
Reagents
t (I0g)
0307GA
6-11850
493-52-7
7/20/2006
3/31/2009
Methylene Blue
3'a Shelf Chemical Cabinet
TKN
Fisher
1 (IODg)
954122
M235-100
7220-79-3
1/23/1996
4/15/1996
NIA

4th Lf eek Lab
Incoming Supply Log
Chemical/ftem Name
Location
Test Used In
Supplier/
Manufacture
Quantity
Lot
Number
Cat.
Number
CAS #f
Date
Received
Date
Opened_
Expiration
Date
Discarded
MFC Broth
C-11 Cabinet
Fecal
Dirco
1 (500g)
5186933
288330
7647-14-5
12116R005
9/4/2006
5/31/2009
M-1 Mouse Wash
A -I I Cabinet
Cleaning
lomaps, Inc.
1 Can
NIA
NIA
See MSDS
Nit-Napmyilt aanytcmtiandneninrd—h1c6&
3'ShelfChemicalCabinet
Nitrate
Reagents
i (25g)
0617EU
2-25-330
1465-25-4
4124/2006
8/iW006
7/31/2007
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
MI903003IC
3003
NIA
open
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M18030031C
3003
NIA
open
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M1803003IC
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
MI8030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M18030031C
3003
N/A
Neutrad Glassware Soap -
C-28 Cabinet
Glassware
Fisher
l (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
l (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
Ml803003IC
3003
N/A
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
l (32 oz.)
M1803003IC
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
l (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
I (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M18030031C
3003
NIA
Neutrad Glassware Soap
C-28 Cabinet
Glassware
Fisher
1 (32 oz.)
M18030031C
3003
NIA
Nickel Standard 1000 ppm
AA Metals Room
Metals
Ricca
1 (I20ml)
2508263
5300
See MSDS
9/16/2005
9/16/2005
2/28/2007
Nickel Standard 1000 ppm
AA Metals Room
Metals
Ricca
I (120m1)
2609430
5300
See MSDS
1/8/2007
3/3112008
Nitric Acid
Corrosive Cabinet
All
Fisher
l (2.5L)
1101010
A509SK-212
See MSDS
7/11/2001
N/A
Nitric Acid Omni Trace Ultra
Corrosive Cabinet
Metals
EM Science/ ENID
l (500m1) ,
44313
NX0408
7697-37-2
1 1/4/2005
6t9/2006
NIA
Nitric Acid Omni Trace Ultra
Corrosive Cabinet
Metals
EMD
I (500m1)
46073
NX0408
7697-37-2
10123/'2006
NIA
Oil & Grease Standard
G-I I Cabinet
Oil & Grease
],T, Baker
I (4pk)
C15N00
8030
67-64-1
7/27/2006
7/27t2046
NIA
Oil & Grease Standard
G-1 l Cabinet
Oil & Grease
J.T. Baker
1 (4pk)
JT8030-0
8030
67-64-1
1/312007
NIA
Oil & Grease Standard
G-II Cabinet
Oil & Grease
J.T. Baker
1 (4pk)
JT8030-0
8030
67-64-1
113720o7
NIA

0 reek Lab
Zncomina Supply Loy
Chemical/Item ,Name
Location
Test Used In
Supplier/
Manufacture
Quantity
Lot
Number
Cat.
Number
CAS 9
Date
Received
Date
Opened
Expiration
Date
Discarded
Oil & Grease LCS Standard
Refrigerator
Oil & Grcase
Env, Express
7 (10tn1)
113377
G3025
NIA
8123/2005
9i712005
8119200E
Parsons Ammonia
A - II Cabinet
Cleaning
Church & DwightCQ.
I Can
NIA
NIA
001336.21-6
Ph Buffer (4.00)
Storage Ruom
Ph
Spectrum
1 (20L)
6131-13
131166
See MSDS
1 7/11/2006
711 112006
7/31/2007
Ph Buffet (7,00)
Storage Room
Ph
Fisher
1 (20L)
063902-24
Bl 163
See MSDS
I0113/2006
10/132006
7/3112008
Ph Buffer (10.00)
Storage Room
Ph
Fisher
I(20L)
063113-24
S3107.20
See MSDS
10/13/2006
1011:3120M
6/3020D8
Ph Huffer(12.45)
A-2 Cabinet
Ph
Ricca
1 (500 ml)
2507067
SRI15-20
See MSDS
1/5/2005
7/31/2006
Ph Electrode Storage Solution,
A-2 Cabinet
Ph
Fisher/ Thermo
I (475ml)
910001
910001
See MSDS
7/20/2D06
NIA
Ph Electrode Storage Solution.
A-2 Cabinet
Ph
Fisher/ Thermo
1 (475m1)
91DO01
910001
See MSDS
712012006
N/A
Ph Electrode Storage Solution.
A-2 Cabinet
Ph
Fisher/ Thermo
1 (475ml)
910001
910001
See MSDS
1142007
Phosphate Standard Solution
B-2 Cabinet
Phosphonts
HACH
1 (500 ml)
A$133
17149
N/A
12/27/2005
4/11/2006
5/312010
Phosver3 Pillows 10 ml
B-2 Cabinet
Phosphorus
HACH
1 pk (100)
A6199
2106069
NIA
8/17(2006
11/62006
12131/2009
Phosver3 Pillows 10 ml
B-2 Cabinet
Phosphorus
HACH
I pk (100)
A6199
2106069
NIA
8/17/2006
12/3l/2009
Potassium Chloride
I" Shelf Chemical Cabinet
Fisher
l (500 g)
015555
P217-500
7447-40-7
7/27/2DOl
5/28/2005
Potassium Nitrate
4" Shelf Chemical Cabinet
Nitrate
J.T. Baker
I (500 g)
Y37150
3190.0)
7757-79.1
5/14/2004
41132005
NIA
Potassium Nitrate
4u` Shelf Chemical Cabinet
Nitrate
EMD
1 (500 g)
43009401
PX1520
7757.79.1
6/172004
4/132005
NIA
Potassium Nitrite
4 h Shelf Chemical Cabinet
Nitrate
J.T. Baker
1 (500 g)
N24602
3202
7758.09.0
6/820D0
6/16/2000
NIA
Potassium Nitrite
O'She lfChemical Cabinet
Nitrate
Fisher
1(250g)
930626
P267-250
7758-09-0
11/11/1993
1lit5/1993
N/A
Potassium Permanganate
I" Shelf Chemical Cabinet
Chlorine
Mallinckrodt
1 (125 g)
706SX46HO9
7068-02
7722-64-7
721/2003
8I12003
NIA
Potassium Permanganate
I" Shelf Chemical Cabinet
Chlorine
Mallinekrodt
1 (125 g)
706SN30612
7069.02
7722-64-7
2/21/2000
3/12000
NIA
Potassium Persulfate Pillows
B-2 Cabinet
Phosphorus
HACH
I pk (100)
A6262
2084769
7727.21.1 1
10/18/2006
12/18/2006
9/302010
Potassium Persulfate Pillows
B-2 Cabinet
Phosphorus
HACH
I pk (100)
A6262
2084769
7727-21-1
t0/182006
9/30/2010
Potassium Persulfate Pillows
B-2 Cabinet
Phosphorus
HACH
I pk (100)
A6262
2084769
7727.2t-t
10I182006
9/302010
Potassium Phosphate Monobasic
1" Shelf Chemical Cabinet
Fecal
EMTI
1 (500 g)
432al349
PX 1565
7778.77-0
5/142004
NIA
Potassium PhosphateMonobasic
I" Shelf Chemical Cabinet
Fecal
J.T. Baker
1(500g)
V)3146
3246-01
7778-77.0
7A01200)
9/1412003
NIA
Potassium Sulfate
I" Shelf Chemical Cabinet
TKN
Spectrum
1 (500 g)
UP0767
P1410
777MO-5
1/312007
NIA
Potassium Sulfate
I't Shelf Chemical Cabinet
TKN
Spectrum
1 (500 g)
UP0767
P1410
7778-80-5 11l/3/2007
N/A
Potassium Sulfate
I" Shelf Chemical Cabinet
TKN
Spectrum
1 (500 g)
IJP0767
P1410
7778-80-5
10/252006
11/912006 1
NIA
W

4t' reek Lab
Incoming Supply Log
Chemical/Item Name
Location
Test Used In
Supplier/
Manufacture
Quantity
Lot
Number
Cat.
Number
CAS H
Date
Received
Date
Opened
Expiration
Date
Discarded
Propane
Outside of Sample Room
Fecal
Suburban Propane
2 Tanks
NIA
N/A
74-98-6
NIA
NIA
NIA
Py[adine
Yellow Flame Cabinet
TCN
J.T. Baker
1 (500 ml)
C04471
3348-1 t
110-86-1
7/14/2006
NIA
Renuzyme Foam Spray
A-11 Cabinet
Cleaning
Getinge
2 Can
NIA
61301604584
See MSDS
Rhodanine
3`aShelf Chemical Cabinet
TCN
Kodak
1(Ng)
Ai5K
2749
536-)7.4
2/1/1990
2/1/1990
NIA
Rosolic Acid
C-11 Cabinet
Fecal
Spectrum
1 (25 g)
UVO024
R0135
603-45-2
12/13/2005
10/30/2006
N/A
See Thru Glass Cleaner
A-11
Cleaning
Share Corp.
1
NIA
N/A
See MSDS
Silver Nitrate
4" Shelf Chemical Cabinet
TCN, Chlorine
1,T, Baker
1 (30 g)
Y44615
3426-00
7761-88-8
6/l/2004
5/4/2005
N/A
Silver Nitrate
4" Shelf Chemical Cabinet
TCN, Chlorine
VWR
i (30g)
B46624
3426-00
7761-89-8
7/25/2005
NIA
Silver Standard 1000 pprn
AA Metals Room
Metals
Ricca
1 (120 rrrl)
2605654
7100
See MSDS
6/2212006
9/13/2006
11/30/2007
Sodium Borate
4'h Shelf Chemical Cabinet
Ammonia
Spectrum
1 (25.g)
OROO89
Sl I87
16941-66-2
7/6/2006
NIA
Sodium Carbonate
4' Shelf Chemical Cabinet
TKN, Alkalinity
EM Sciencel EMD
1 (500 g)
33198344
SX0400
497-19-8
2/25/1994
12/28/2001
N/A
Sodium Chloride
5" Shelf Chemical Cabinet
COD, Chloride
Reagents
1 (500 g)
1018EV
1-313-001
7647-14-5
1114/2004
1 llll2007
Sodium Chloride
5" Shelf Chemical Cabinet
COD, Chloride
Reagents
1 (500 g)
0425GW
1-313-001
7647-14-5
7/20/2006
9/30/2006
5/31/2009
Sodium Chloride
5°i Shelf Chemical Cabinet
COD, Chloride
Reagents
1 (500 g)
0425GW
1-313-001
7647-14-5
7/2012006
5/31/2009
Sodium Hydroxide
5" Shelf Chemical Cabinet
ALL
Fisher
1 (2,5 L)
B40476
3722-05
See MSDS
5/25/2006
10/17/2006
9/30/2007
Sodium Hydroxide
5ih Shelf Chemical Cabinet
ALL
Fisher
I (2.5 L)
B40476
3722-05
See MSDS
5/25/2006
9/30/2007
Sodium Phosphate Monobasic
4 h Shelf Chemical Cabinet
TCN
Fisher
1 (500 g)
052767
5369-500
10049-2.1-5
9/19/2005
1/19/2005
N/A
Sodium Phosphate Monobasic
4 h Shelf Chemical Cabinet
TCN
Fisher
1 (500g)
061137
5369-500
10049-21-5
6/19/2006
1/2/2007 1
N/A
Sodium Sulfate
4' Shelf Chemical Cabinet
Oil & Grease
EM Science/Fisher
1 (500 g)
37JO7736
SX0760-1
7757-82-6
12/31/1997
1/4/1998
N/A
Sodium Sulfate
4" Shelf Chemical Cabinet
oil & Grcesc
Spectrum
1 (500g)
UV0371
51450
7757-82-6
716l2006
N/A
Sedinm Sulfite
4ih Shelf Chemical Cabinet
Chlorine
Fisher
1 (500 g)
006226
-S430-500
7757-83-7
2/28/2002
4/25/2005
NIA
Sodium Thio Tablets
D-22 Cabinet
Fecal
Nasco
1 pk (1000)
B01293
H51-02F
3/31/2006
3/31/2006
NIA
Sodium Thiu Tablets
D-22 Cabinet
Fecal
Nasco
t pk (1000)
B01293
H51-02F
119I2007
N/A
Sodium Thiosulfate Anhydrous
51° Shelf Chemical Cabinet
Winkler
I.T. Baker
l (500 g)
M20602
3954-01
7772-98.7
9/18/1998
10/10/2006
N/A
Sodium Thiosulfate Caruidges
D-7 Cabinet
Winkler
HACH
l Cartridge
A5244
2267501
N/A
9/19/2005
10/9/2006
12/31/2007
Sodium Thiosulfate Cartridges
D-7 Cabinet
Winkler
HACH
1 Cartridge
A5244
2267501
N/A
91t912005
12/31/2007
Sodium Thiosulfate Cartridges
D-7 Cabinet
Winkler
HACH
1 Cautidge
A5244 1
2267501 1
N/A
9/19/2005
12/31/2007
.a

4'r :eek Lab
Incoming Supply Log
Chemical/Item Narue
Location
Test Used In
Supplier/
1lanufacture
Quantity
Lot
Number
Cat.
Number
CAS #
Date
Received
Date
Opened
Expiration
Date
Discarded
Sodium Thiosulfate Cartridges
D-7 Cabinet
Winkler
HACH
1 Cartridge
A5244
2267501
NIA
9/19/2005
12/31/2007
Sodium Thiosulfate Cartridges
D-7 Cabinet
Winkler
HACH
1 Cartridge
A5244
2267501
NIA
9/19/2005
12/31/2007
Starch Indicator Solution
D-7 Cabinet
Winkler
HACH
1 (100 ml)
A4233
34932
N/A
9/22/2004
7/31/2206
MI/2009
Sulfamic Acid
6" Shelf Chemical Cabinet
TCN
VWR
1 (100 g)
44337502
SXI 140
5329-14-6
4/11/2005
9129/2006
NIA
Sulfamic Acid
6s Shelf Chemical Cabinet
TCN
VWR
1 (100 g)
44337502
SXl 140
5329-14-6
4/11/2005
NIA
Sulfamic Acid
6^Shelf Chemical Cabinet
TCN
VWR
1(100g)
44337502
SX1140
5329-14.6
4/11/2005
NIA
Sulfamic Acid
61' Shelf Chemical Cabinet
TCN
VWR
l (100 g)
44337502
SX1140
5329-14-6
4/11/2005
N/A
Sulfamic Acid
6" Shelf Chemical Cabinet
TCN
VWR
l (100 g)
44337502
SX1140
5329-14-6
4/1112005
NIA
Sulfamic Acid Pillows
D-7 Cabinet
Winkler
HACH
1 pk (100)
5195
107399
5329-19-6
9119/2005
]13/2006
7/31/2010
Sulfamilamide
4i° Shelf Chemical Cabinet
TCN
Reagents
1 (1008)
0805EX
2-3351.0
63.744
1/26/2005
4/12/2006
8/1/2009
Sulfuric Acid
Corrosive Cabinet
All
VWR/EMD
1 (2.5 L)
EM-SX1247-2
SX1247
7644-93-9
1/812007
Sulfuric Acid
Corrosive Cabinet
All
VWRIEMD
1 (2,5 L)
EM-SX1247-2
SX1247
7644-93-9
1/8/2007
Sulfuric Acid Omni Trace
Corrosive Cabinet
All
END
1 (2.5 L)
SX1247
SX1247
7644-93.9
5/13/2004
it2312006
N/A
Sulfuric Acid 0.2 N
A-19 Cabinet
TKN, Alkalinity
Spectrum
1 (4 L)
VQ0680
5-605
See MSDS
8/8/2006
12/5/2006
31M008
Teachers Pet
A-11
Cleaning
Handi-Clean
I Can
NIA
NIA
See MSDS
Turtle Wax -Palish Cleaner Compound
C-I2 Cabinet
Counters
Turtle Wax
1 Can
NIA
NIA
NIA
Versiblube Silicon Lube Grease
F-5 Cabinet
Auto Clave
General Electric
I Tube
NIA
G-322L
See MSDS
Wile -Out
Through Out Lab
NIA
Wite-Out
4 Bottles
NIA
NIA
See MSDS
Zinc Standard 1000 ppin
AA Metals Room
Metals
Ricca
i (120 in[)
2601184
9500
See MSDS
10/12/2006
6/30/2007
Zep Glass Cleaner
A-1 I Cabinet
Cleaning
Zep Manf. Co.
I Can
NIA
NIA
See MSDS

Ike: [Fwd: Storm Water Permit Extension]
FoO-r{ -e-�L—
Subject: Re: [Fwd: Storm Water Permit Extension]
From: Bethany Georgoulias<[e-mail]> (/ 'N�r'�ztt'� ?-Doc
�
Date: Wed, 01 Oct 2008 08:46:39 -0400
6 Cn�
To: Marcia Allocco <[e-mail]>
CC: Jennifer Jones <Jennifer.Jones a ncmai].net>, John Lesley <[e-mail]>
Marcia,
I talked to John Lesley about this one and still have
letter in my office. All I remember is the first date
remember an extension request before this one? (Maybe
recently?) Anyway, if MRD is okay with the extension,
Thanks,
SG
Marcia Allocco wrote:
I Ladies,
So,-�v-eL 4 SR 19-77,
cal,-h,,r6 , &�o, iAk�r, IY
Statesville's initial response
set of December 31st -- T don't
Jennifer talked to him more
we don't have a problem with it.
I was just chatting with John Lesley and he stated that it was the permitting group
that has imposed the December 31st deadline for the City of Statesville's Fourth
Creek WWTP to have their SPPP plan completed. He couldn't remember which one of you
had given the extension so I'm forwarding the attached request to extend their
deadline to January 30th.
MRO does not have a problem with granting the extension but wanted to get your
blessing before responding.
Marcia
Marcia Allocco - [e-mail]
Environmental Chemist
North Carolina Department of Environment & Natural Resources
Division of Water Quality - Surface Water Protection Group
610 East Center Ave., Suite 301
Mooresville, NC 28115
Ph: [phone] Fax: [phone]
Subject:
Storm Water Permit Extension
From:
"Andy Smith" <andy [e-mail]>
Date. - -
Tue, 30 Sep 2008 14:35:49 -0400
To:
<[e-mail]>
To:
<[e-mail]>
CC:
<joe [e-mail]>, "'Jerry Byerly "'
<jerry [e-mail]>
Marcia, per our conversation on September 30, 2008 regarding the extension for the
Storm water permit # NCG110112. The City of Statesville's Fourth Creek WWTP is
requesting a 30 day extension for submitting a Pollution Prevention Plan and Storm
Water program. This is due to the protocol that the City Council has established
for hiring engineering firms. This will put us over the original due date of
December 31,2008. Therefore, I am requesting that the due date to be moved to
1 of 2 10/1/2008 8:47 AM

Re: [Fwd: Slums Water Permit Extension]
January 31, 2009.
Speaking on my behalf`as well as the City of Statesville water Resources Director,
Joe Hudson, thank you for.this consideration.
If you need more information, please do not hesitate to contact me.
Thank you
Andy.Smith
Fourth Creek WWTP Supervisor
P.Q. Box 1111
City of Statesville
Statesville, NC 28687-1111
Phone: [phone]
Fax: [phone]
Andy [e-mail]
Bethany Georgoulias
Environmental Engineer
NC DENR Division of Water Quality
Stormwater Permitting Unit
tel. [phone]
fax [phone]
2 of
10/1/2008 8:47 AM

V. (9. Nux 1111 • �§tatesuille. Nartll &rulina Z8587
August 26, 2008 (�
Ms. Bethany Georgoulias
Stormwater Permitting Unit �p 6
Raleigh Central Office
1617 Mail Service Center
Raleigh, NC 27699-1617
CC: Files
Re: Letter of Response
Compliance Evaluation Inspection
Stornw ater Permit # NCG110112
Fourth Creek VVWTP
Dear Ms.Georgoulias:
This is a letter in response to the Notice of Violation regarding the Stornw ater Permit #
NCG110112. As of August 22, 2008 1 have mailed a Permit Renewal Application form to the Central
Office of DWQ.ln regards to the Pollution Prevention Plan and the overall Stormwater program, we
have contracted McGill Associates Engineers to have this plan completed on or before the December
31, 2008 due date.
Should you require more information, or if further action is required, please contact me at 878-3438
Sin re 7
Andy S ith
Plant Supervisor, Fourth Creek VWVTP

c)� wAr�Rp�
D 'C
Michael F. Easley, Governor
William G. Ross Jr., secretary
North Carolina Departrnent of Gnvironnienl and Natural Resources
Coleen H. Sullins, Oirector
Division of Water Quality
August 18, 2008
CERTIFIED MAIL
RETURN RECEIPT REQUESTED 7007 14900004 4510 0271
Mr. Joe Hudson, Director Water Resources
City of Statesville
Post Office Box 1 I 1 I
Statesville, North Carolina 28687-1111
Dear Mr. Hudson:
Subject: Notice of Violation
G.S. 143-215.1(a)(6)
Compliance Evaluation Inspection
Tracking No. NOV-2008-PC-0598
Statesville 4th Creek Stormwater WWTP
NPDES Permit No. NCG110112
Iredell County, NC
Enclosed is a copy of the Compliance Evaluation Inspection Report for the inspection
conducted at the subject facility on August 15, 2008 by John Lesley of this Office. Please
inform the facility's Operator -in -Responsible Charge of our findings by forwarding a copy of the
enclosed report.
This Report is being issued as a Notice of Violation (NOV) because of violations of the
subject permit and North Carolina General Statute (G.S.) 143-215.1, as detailed in the
Stormwater Pollution Prevention Plan and Qualitative Monitoring heading of the report. The
cited violations had not previously been cited under either a Notice of Violation (NOV) or a civil
penalty assessment document.. Pursuant to G.S. 143-215.6A, a civil penalty of not more than
twenty-five thousand dollars ($25,000.00) may be assessed against any person who violates or
fails to act in accordance with -the terms, conditions, or requirements of any permit issued
pursuant to G.S. 143-215.1..Should this Office make an enforcement recommendation relative
to the violations,'.yo.0 will -be advised in writing.
It is required that'a response,to this Notice be submitted by no later than September 18,
2008 addressing the deiicieiicies.notcd in the subject report. In responding, please address your
response to Ms. Marcia Allocco of this Office and Ms. Bethany Georgoulias of the Division's
Stormwater Permitting'�Unit in the Central Office.
Mailing Address Phone [phone] Location
610 East Center Avenue, Suite 301 Fax [phone] last Center Avenue, Suite 301
Mooresville, NC 28115 Mooresville, North Carolina
OOnneCatoH
w9
Internet; www.newaterauality.orta Customer Service t-877-623.6748
An Equal Opportunity/Affirmative Action Employer - 50% Recycled110% Post Consumer Paper

N
The following requirements must be also be met by the date indicated:
I . The completed Stormwater Pollution Prevention Plan must be submitted to Ms.
Georgoulias by no later than December 31 2008.
2. Be advised your Stormwater Permit No. NCGI 10112 has expired and you not currently
compliant with G.S 143-215.1. This Office is coordinating with the Central Office to
send you a renewal notice and application, The completed application must be
submitted to the Stormwater Permitting Unit in the Central Office within 15 days
of receipt of the application,
The report should be self-explanatory; however, should you have any questions
concerning this report, please do not hesitate to contact Mr_ Lesley or me at [phone],
Sincerely,
Robert B. Krebs
Surface Water Protection Section.
Regional Supervisor
Enclosure
cc: Iredell County Health Department
Bethany Georgoulias, Stormwater Permitting Unit
C� 6
6'

Compliance Inspection Report
Permit: NCG110112 Effective: 08/17/07 Expiration: 04/30/08 Owner: City of Statesville
5OC: Effective: Expiration: Facility: Statesville-4th Creek WWTP
County: Iredell 693 Bell Farm Rd
Region: Mooresville
Statesville NC 28625
Contact Person: Andy Smith Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORCIs):
On -Site Representative($):
24 hour contact name Andy Smith
Belated Permits:
Inspection date: 08115/2008 Entry Time: 11:00 AM
Primary Inspector: John E Lesl
Secondary Inspector(s): '
Certification: Phone:
Exit Time: 12:15 PM
Phone: [phone]
Phone: [phone]
Ext.2198
Reason for Inspection:. Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Municipal VWtITP > 1MGD, Stormwater Discharge, COC
Facility Status: n Compliant ■ Not Compliant
Question Areas:
■ Storm Water
(See attachment summary)
Page: 1

Permit: NCG110112 Owner - Facility: City of Statesville
Inspection Date: 08/15/2008 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility applied for Certification of Non -Exposure on 9/10/08. The inspection found that the qualifications for
non -exposure are not met by the facility (see Permt and Outfall Section comments below). This office recommends that
the City utilize a consultant to prepare the Stormwater Pollution Prevention Plan due to limited access to required
materials (maps, etc) and time constraints on the WIIVTP staff.
The Division's Stormwater Permitting Unit is sending a permit renewal application. It is required that the facility submit the
completed application by no later than 15 days after receipt of the application. In addition, the Stormwater Pollution
Prevention Plan must be submitted to the Stormwater Permitting Unit by no later than December 31, 2008.
Page: 2

Permit: NGG110112 Owner - Facility: City of Statesv'Ale z
Inspection Date: 0811512008 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
n
■
n.
n
# Does the Plan include a General Location (USGS) map?
❑
■
# Does the Plan include a "Narrative Description of Practices"?
n
■
n
n
# Does the Ran include a detailed site map including outfall locations and drainage areas?
❑
e
❑
n
# Does the Plan include a list of significant spills occurring during the past 3 years?
0
❑
■
11
# Has the facility evaluated feasible alternatives to current practices?
n
■
0
# Does the facility provide all necessary secondary containment?
®n
n
n
# Does the Plan include a BMP summary?
n
■
Q
n
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
n
■
n
n
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
n
■
n
# Does the facility provide and document Employee Training?
n
■
n
n
# Does the Plan include a list of Responsible Party(s)?
n
■
n
n
# Is the Plan reviewed and updated annually?
n
■
n
n
# Does the Plan include a Stormwater Facility Inspection Program?
n
■
n
n
Has the Stormwater Pollution Prevention Plan been implemented?
n
■
n
n
Comment: The elements of the Stormwater Pollution Prevention Plan has not been
completely developed within 12 months as required by the permit. In addition, the
current permit has expired and no renewal application has been received. Therefore,
the facility is currently operating without a valid stormwater permit.
Qualitative Monitoring
Yes
No
NA
NE
Has the facility conducted its Qualitative Monitoring semi-annually?
❑
■
❑
❑
Comment: Qualitative monitoring has not been conducted in the past 12 months.
Permit and Outfalls
Yes
No
NA
NE
# Is a copy of the Permit and the Certificate of Coverage available at the site?
■
Q
n
n
# Were all outfalls observed during the inspection?
■
n
❑
n
# If the facility has representative outfall status, is it properly documented by the Division?
❑
❑
■
# Has the facility evaluated all illicit (non stormwater) discharges?
❑
■
❑
n
Page: 3

Permit: NCG110112 Owner - Facility: City of Statesvilie
Inspection Date: 08/1512008 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Comment: Stormwater runoff is collected from the aeration basins and digester area
and conveyed through a series of culverts and ditches to Fourth Creek. Three storm
drains are located in the vicinity. of the final clarifiers that discharge to a culvert and ditch
to Fourth Creek. The equipment fueling area stormwater flows down grade to a culvert
and ditch to Fourth Creek. The stormwater from the dewatering, sludge storage, and
bar screen is conveyed to the head of the VWV"P for treatment according to site
drawings of the facility The stormwater collection system from the sludge dewatering
builiding, sludge storage areas, and bar screen have not been evaluated by testing and
there is no documention to show' that the stormwater is actually going back into the
VWVi-P for treatment.. This portion of the stormwater collection system must be
properly tested and documented to show that it does not discharge to the envronment.
Page: 4

Michael F. Easley, Governor
William G. Ross Jr„ Secretary
North Carolina Department of Environment and Natural Resources
March 9, 2004
Mr. Bill Dougherty
P & D Automotive Systems, Inc.
194 Red Marshall Road
Pelham, NC 27311
Subject: Compliance Evaluation Inspection
NPDES Stormwater Permit No. NCG100112
P & D Automotive Systems, Inc.
Caswell County
Dear Mr. Dougherty:
Alan W. Klimek, P.E. Director
Division of Water Quality
MAR 10 2004
A Compliance Evaluation Inspection was performed at P & D Automotive by .fenny
Freeman and Jenifer Krearner on March 4, 2004. This inspection was in response to a complaint
alerting our office to a possible violation of your NPDES General Stormwater Permit No.
NCG 100112 at the above -mentioned property.
The complaint received by this office reported that engines are being pressure washed in
the gravel lot in the front of your facility. It was learned from the inspection that cars are indeed
being hosed off in the front parking lot, but only to rinse off mud. It appears that no soap or oil
and grease are being rinsed off into the storm drain. This practice is allowable by your permit as
long as this condition continues to be met, and if the water drains only into one of your monitored
drainage ditches.
The remainder of the inspection revealed that P & D Automotive Systems is in
compliance with its General Stormwater Permit. This particular inspection evaluated seven (7)
areas. The respective rating for each area is noted in Section C of the attached EPA inspection
report, and the observations during the inspection of each area are addressed in the summary
section. If you have any questions concerning this report, please contact Jenny Freeman or me at
[phone],
Sincerely,
Steve Tedder
Water Quality Supervisor
cc: &orirtwater'. and_General Permits Unit_
Central Files
W SR4
N.C. Division of Water Quality /585 Waughtown Street Winston-Salem, NC 27107 [phone] Customer Service
1(8W) 623-7748

Form Approved
OMB No.2040-0057
r
l
I Water Compliance Inspection Report
Approval Expires
8-3 t -98
Section A: National Data System Coding
Transaction Code NPDES No. Yr/Mo/Day Inspection Type Inspector FacilityType
N 5 NCO 100112 04-03-09 W S
Facility Evaluation Rating BI QA ..........Reserved...........
5 N
Section B: Facility Data
Name and Location of Facility Inspected:
Entry Time:
Permit Effective
P & D Automotive Systems, Inc.
1300 hrs.
Date: Sept 1, 2002
194 Red Marshall Road
Pelham, NC 2731 l
Caswell County
Exit Time:
Permit Expiration
1500 hrs.
Dale: Aug30, 2007
Name(s) of On -Site Representative(s): Title(s): Phone No(s):
Bill Dougherty & Dawn Parks Co -Owners [phone]
Name, Address of Responsible Official:
Title: Owner
Bill Dougherty
Phone No, (336) 388-988t
Contacted? Yes
Section C: Areas Evaluated During Inspection (check only those areas evaluated)
S Permit NA Flow Measurement NA Operations/Maintenance NA Sewer Overflow
S Records/Reports S Self -Monitoring Program NA Sludge Handling/Disposal S Pollution Prevention
S Facility Site Review NA Compliance Schedules NA Pretreatment NA Multimedia
S Effluent/Receiving Waters NA Laboratory S Stormwater NA Other:
Section D: Summary of Findings/Comments
Permit..................................The current general permit became effective September 1, 2002. It will expire August 31,
2007,
Records/Reports................. Stormwater records are maintained as required by the permit.
Facility Site Review ............ The facility appeared to be well maintained and operated.
Effluent/Receiving Waters.The receiving waters are Tardy Branch, Class C, in the Roanoke River Basin.
Self -Monitoring Program ... The monitoring has been carried out as required by the permit, with lab work performed by
Merritech.
Stormwater ....................It appears that stormwater is well -maintained at this facility.
Pollution Prevention ......... The Stormwater Pollution Prevention Plan (SPPP) has been developed and includes all of the
necessary sections.
Name(s) and Signature(s) of Inspectors:
Agency/Office/Telephone:
Date:
��+ H./] _
DWQ I WSRO I [phone]
- /q
Signature of eviewer:
Agency/Office:
Date:
DWQ 1 WSAO / [phone]

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
O�O� W A -F�7RQG
65 r
-wwU4i0� �5
WILLIAM DOUGHERTY
1' AND D AUTOMOTIVE SYSTEMS
1860 HORSESHOE ROAD
DANVILLE, VA 24541
Dear Permittee:
Alan W. Klimek, P.E., Director
Division of Water Quality
August 23, 2002
Subject: NPDES Stormwater Permit Renewal
P AND D AUTOMOTIVE SYSTEMS
COC Number NCg 100112
Caswell County
In response to your renewal application for continued coverage under general permit NCG100000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December G, 1983.
The following information is included with your permit package:
* A new Certificate of Coverage
* A copy of General Stormwater Permit NCG 100000
* A copy of the Analytical Monitoring Form (DMR)
A copy of a Technical Bulletin for the general permit
Your Coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, slate, or local law, rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Aisha Lau of the Central Office Stormwater
and General Permits Unit at [phone], ext. 578
Sincerely,
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
cc: Central Files
Stormwater & General Permits Unit Files
Winston-Salem Regional Office
�VA
NCDENR
N_ C_ Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1- 800-623-7748

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
December 27, 2001
WILIJAM DOUGHERTY
P AND D AUTOMOTIVE SYS'hEl``'lS
1860 H(WESHOE RD
DANVILLE. VA 24541
Subject: NPDI S stormwater Pc;rn:it Renewal
P AND D AUI-Oh'1OTIVL SYSTEMti
COC Nurnhcr NCB 1001 12
Caswell County
Door PCrniittCe:
Your f:.tcility is Currently covered for storniwatur discharge under General Permit NCG 100000. This Permit expires
on August 31, 2002. The Division staff is Currently in the process Oli rewriting [his PCCnnil and is SCIMIuled 10 have
the permit rciSSUCII by kilo Sumner of 2002. Once the periltit is rcissuC(l, your Ilrcifity would be eligible lOF
cgntimtcd Coycrage under the reissued perrnit.
In order to assure your continued coverage under the general permit, you must apply to the Division of Water
Qu;rlity (DWQ) for renewal of" yrxrr permit covor111*C. To make this rcncw,d process easier. We arc infurrnind you in
advance that your permit will he expiring. Er1C1OSCd you will find a General 11'ernnit Coverage Renewal
Alzplicaitioii Pbrn1. The application must be completed and returned by March 4, 2002 in order to assure continueel
Covcra�"e under the ��eneral permit.
EkilurC to request renewal within this linic Period clay result in a civil assessment of at least $250.00. U.urger
Penalties may he assessed dcpcndirlg on the delinquency ol'ihc request. Discharge of storniwater front your facility,
without coverage undera Valid stormwater NPDI S Permit Would cuMtitutC a violation ol' NCGS 143-215.1 and
Could result in assessnients of civil penalties of up to $10,000 PCr rltry.
Please note that recent federal legislation has extended the "no Cxpnsure C,rclusion" it) all operators Of industrial
facilities in any of the I 1 categories of "stornn water discharges associated with industrial activity," (except
construction activities). Il'you feCI your facility can certify a Condition ol' "no CxPosurc", i.c, the faWilty indusH-ial
materials and operations are not CxPosed for stormwater. you Can apply ftir the na exposure exclusion. For additional
inlirrnlalion contact the Central Office Storrrlwaier Staff nicmber listed below or Check the Suirnnwater &L General
Perinks Unit Web Site at hllpalh2o.enr,state.nc.uslsu/storrllW',iIII III l
II' the subject stormwater discharge to waters of the suite has been lernlinated. Please complete the enclosed
Rescission Request horn. Mailing instructions are listed on the; bottom eel -the form. You will be notified when the
rescisSion process has bccil Conlplelell,
if you hLtVC any questions rc4e irtling the put rnit renewal procctlures please cuntact Curvy Basin-cr ol' the
Winston-Salem Reoional Office at 36-771-4600 or Aisha Lau of the Central Office StOrnnwater Unit of (919)
733-5083. cxt. 578
Sincerely,
Bradley Bennett. Supervisor
Storniwater:ind Gcncral Permits Unit
cc: Central Files
Winston-Salem Rcoional (thee
A��
NCDENR
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1- 800-523-7748

5M�
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Mr. William Dougherty
P and D Automotive Systems
1860 Horseshoe Road
Danville, Virginia 24541
Dear Mr. Dougherty:
ALTI.KXA
NCDENR
November 13, 1998
Subject: General Permit No. NCG100000
P and D Automotive Systems
COC NCG 100112
Caswell County
In accordance with your application for discharge permit received on September 21, 1998 we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable
to you, you have the right to request an individual permit by submitting an individual permit application. Unless
such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division of
Water Quality. The Division of Water Quality may require modification or revocation and reissuance of the
certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management Act
or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Tony Evans at.telephone number
919/733-5083 ext. 584.
Sincerely,
ORIGINAL SIGNED BY
WILLIAM C. MILLS
A. Preston Howard, Jr., P. E.
cc: Winston-Salem Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

r �•
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG100000
CERTIFICATE OF COVERAGE No. 100112
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
P and D Automotive Systems
is hereby authorized to discharge stormwater from a facility located at
P and D Automotive Systems
194 Red Marshall Road
Pelham, NC
Caswell County
to receiving waters designated as Tardy Branch, Class C, in the Roanoke River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II,11I,
IV, V, and V1 of General Permit No. NCG100000 as attached.
This certificate of coverage shall become effective November 13, 1998.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 13, 1998.
oRIGmx SIGNED BY
WILLiAM C. MILLS
A. Preston Howard, Jr.,Director
Division of Water Quality
By Authority of the Environmental Management Commission

32':,
70000 Fl
36
�PJ*`a� Contprol bdy'edited, and U56S and NOS Nobllshed by the Geological Survey
�' AA
Topography by photogrammetric methods from aerial
,photographs taken 1963. Field checked 1965
Polyconic projection. 10,000-foot grid ticks based on Virginia
coordinate system, south zone, and North Carolina coordinate system
1000-meter Universal Transverse Mercator grid ticks,
zone 17, shown in blue
1927 North American Datum
To place on the predicted North American Datum 1983
move the projection lines 11 meters south and
21 meters west as shown by dashed corner ticks
Fine red dashed lines indicate selected fence and field lines where
generally visible on aerial photographs. This information is unchecked
Red tint indicates areas in which only landmark buildings are shown
MN
GN
61/2
116 MILS 0.56'
7 MILS
UTM GRID AND 1984 MAGNETIC NORTH
DECLINATION AT CENTER OF SHEET

FACILITY: Ak A oam
COUNTY: GAS W d(
NPDES: N G G ) U C) l I aZ,
MAP#:
DSN FLOW:
�ZLIJGNMA-1 IN
LATITUDE:
ACD, 15w
LONGITUDE:
NIA
C3—oD—-43
(,° 30 , L16 r
i
RECEIVING STREAM: -'ckr d� �> t-ao c h
STREAM CLASS: [;
DISCHARGE CLASS:
EXPIRATION DATE:
STORMWATER