NCG090023_Representative Outfall Status Renewal_20210903

FOR AGENCY USE ONLY
NC
ARO FRO MRO RRO WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
Representative Outfall Status (ROS) Renewal Certification Form
Please complete this form if you want to maintain current ROS designations.
Directions: Print or type all entries on this certification form. Attach this form and a copy of the original ROS
approval documentation to the Stormwater Upload Form.
North Carolina General Statute 143-215.6E (i) provides that: Any person who knowingly makes any false
statement, representation, or certification in any application, record, report, plan, or other document filed or
required to be maintained under this Article or a rule implementing this Article ... shall be guilty of a Class 2
misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, 1 certify that:
I, as an authorized representative, request renewal of the ROS designations currently granted to the subject
facility.
❑✓ No site or activity modifications that impact the characteristics of stormwater discharges from the
representative outfalls have occurred at the subject facility.
0✓ I am familiar with the information contained in this request and to the best of my knowledge and belief such
information is true, complete, and accurate.
Facility Name: The Sherwin Williams Manufacturing Company
Permit Number: NCGO90023
Printed Name of Person Signing: Barry Sparks
Title: EHS Manager
(Signature of Permitt a (Date Signed)
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j�;A* FILE
NCDENR
North Carolina Department of Environment and Natural Resources
L�141�IOn 03 wo"i2r 4t1GlKy
Eeverly Faves Perdue Coleen H. Sullins
Governor Director
March 14, 2011
Mr. Sam Belding, Site Manager
Valspar
188 Side Track Drive
Statesville, North Carolina 28625
Subject.- Representative Outfall Status Request
Engineered Polymer Solutions d/b/a Valspar
188 Side Track Drive, Statesville
NPDES General Stormwater Permit NCG090000
Certificate of Coverage — NCGO90023
Iredell County
Dear Mr. Belding. -
flee reeman
Secretari
The Mooresville Regional Office staff have reviewed your request dated February 23, 2011, for a
determination that stormwater discharge outfall (SDO) 002 be granted representative outfall status for
stormwater outfall 003. Based on the information and maps provided and the site inspection on February
16, 2011, we are approving this request. In accordance with 40 CFR §122-21(g)(7), you are authorized
to sample outfall number 002 as a representative outfall. This approval is effective with the next
sampling event. We also want to remind you that the permit still requires Qualitative Monitoring be
performed at all SDOs, regardless of representative status_
Please remember that any actions you initiate in response to benchmark exceedances as directed in the
tiered response provisions of your permit must address all drainage areas represented by SDO 002,
where appropriate.
Please append this letter to your Stormwater Pollution Prevention Plan (SPPP) or permit to document
that representative outfall status has been approved. If changes in drainage areas, structures,
processes, storage practices, or other activities occur that significantly alter the basis of this approval,
representative outfall status may no longer be valid_ You should either resume sampling at all SDOs, or
reapply to this office for representative outfall status based on updated information. If you have any
questions or comments concerning this letter, please contact our Office at [phone].
Sincerely,
Z' r3 1:!f-------
Robert B. Krebs, Regional Supervisor
Surface Water Protection
Mooresville Regional Office
CC" Centrai Office/Stormwater Permitting Unit
Stormwater permitting file NCG090023
Mooresville Regional Orrice
Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115 NorthCarolina
Phone: [phone]Fax: [phone] h Customer Service: 1-877-623-5748 � 1 /I
Internet: www.ncwaterquality.org / atura l �/

NCDENR
NORTH C—O ._ DEReRTMENT OF
ENVIRONMENT MD N�RESOURCE$
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
REPRESENTATIVE OUTFALL STATUS (ROS)
REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year Month Day
RECEIVED
DIVISION OF WATER QUALITY
FEB 2 3 2011
avw�
If a facility is required to sample multiple discharge locations with very similar stormwb`t$f'ifiirfi gl�ihiDFFIC
permittee may petition the Directar for Representative Outfall Status (ROSI. DWQ may grant Representative
Outfall Status if storm water discharges from a single outfall are representative of discharges from multiple
outfalls. Approved ROS will reduce the number of outfalls where analyticasampling requirements apply.
If Representative Outfall Status is granted, ALL outfalls are still subject to the qualitative monitoring
requirements of the facility's permit —unless otherwise allowed by the permit (such as NCG020000) and DWQ
approval. The approval letter from DWQ must be kept on site with the facilit)'s Storm water Pollution
Prevention Plan. The facility must notify DWQ in writing if any changes affect representative status.
For questions, please contact the DWQ Regional Office for your area (seepage 3).
(Please print or type)
1) Enter the permit number to which this ROS request applies:
Individual Permit (or) Certificate of Coverage
N I C 1 5 1 1 1 1 N [C- G, C-) I q I b D
2) Facility Information:
Owner/Facility Name _ V 0L\ ( C0.r\ SU,MeC`
Facility Contact
Street Address
City
County
Telephone No.
7L3
3) List the representative outfall(s) information (attach additional sheets if necessary):
Outfall(s) a is representative of Outfall(s) a $ - _
Outfalls' drainage areas have the same or similar activities? wlqes ❑ No
Outfalls' drainage areas contain the same or similar materials? WY'es ❑ No
Outfalls have similar monitoring results? 104es ❑ No ❑ No data*
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities?
❑ Yes
❑ No
Outfalls' drainage areas contain the same or similar materials?
❑ Yes
❑ No
Outfalls have similar monitoring results?
❑ Yes
❑ No ❑ No data*
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities?
❑ Yes
❑ No
Outfalls' drainage areas contain the same or similar materials?
❑ Yes
❑ No
Outfalls have similar monitoring results?
❑ Yes
❑ No ❑ No data*
MMAM
*Non-compliance with analytical monitoring prior to this request may prevent ROS approval. Specific
circumstances will be considered by the Regional Office responsible for review.
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SWLJ-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
4)
Detailed explanation about why the outfalls above should be granted Representative Status:
(Or, attach a letter or narrative to discuss this information.) For example, describe how activities and/or
materials are similar.
r
F,-,A S
3.
5) Certification:
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record,
report, plan, or other document filed or required to be maintained under this Article or a rule implementing this
Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case
under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device
or method required to be operated or maintained under this Article or rules of the [Environmental Management)
Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed
ten thousand dollars ($10,000).
I hereby request Representative Outfall Status for my NPDES Permit. I understand that ALL outfalls are still
subject to the qualitative monitoring requirements of the permit, unless otherwise allowed by the permit
and regional office approval. I must notify DWQ in writing if any changes to the facility or its operations
take place after ROS is granted that may affect this status. If ROS no longer applies, I understand I must
resume monitoring of all outfalls as specified in my NPDES permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing:A+A- _
Title: 5'ur MAMA,&cr
(Signature of Applicant) (Date igned)
Please note: This application for Representative Outfall Status is subject to approval by the
NCDENR Regional Office. The Regional Office may inspect your facility for compliance with the
conditions of the permit prior to that approval.
Final Checklist for ROS Request
This application should include the following items:
This completed form.
gel Letter or narrative elaborating on the reasons why specified outfalls should be granted representative
status, unless all information can be included in Question 4.
Two (2) copies of a site map of the facility with the location of all outfalls clearly marked, including the
drainage areas, industrial activities, and raw materials/finished products within each drainage area.
Summary of results from monitoring conducted at the outfalls listed in Question 3.
❑ Any other supporting documentation.
Page 2 of 3
SWU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
Mail the entire package to:
NC DENR Division of Water Quality
Surface Water Protection Section
at the appropriate Regional Office (See map and addresses below)
Notes
The submission of this document does not guarantee Representative Outfall Status (ROS) will be granted as
requested. Analytical monitoring as per your current permit must be continued, at all outfalls, until written
approval of this request is granted by DWQ. Non-compliance with analytical monitoring prior to this request
may prevent ROS approval. Specific circumstances will be considered by the Regional Office responsible for
review.
For questions, please contact the DWQ Regional Office for your area.
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Washington Regional Office
943 Washington Square Mall
Phone [phone]
Washington, NC 27889
FAX [phone]
Phone [phone]
Fayetteville Regional Office
FAX [phone]
Systel Building,
225 Green St., Suite 714
Wilmington Regional Office
Fayetteville, NC 28301-5094
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone [phone]
FAX [phone]
Phone [phone]
FAX [phone]
Mooresville Regional Office
610 East Center Ave.
Winston-Salem Regional Office
Mooresville, NC 28115
585 Waughtown Street
Winston-Salem, NC 27107
Phone [phone]
Phone [phone]
FAX [phone]
Water Quality Main FAX [phone]
Raleigh Regional Office
Central Office
1628 Mail Service Center
1617 Mail Service Center
Raleigh, NC 27699-1628
Raleigh, NC 27699-1617
Phone [phone]
Phone [phone]
FAX [phone]
FAX [phone]
Page 3 of 3
SWU-ROS-2009 last revised 12/30/2009