NC0088919_Renewal Application_20140922

Pat McCrory
Governor
A�
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NCDENR
North Carolina Department of Environment and Natural Resources
September 22, 2014
Mr. Ryan D. Kerins
Terraquest Environmental Consultants, P.C.
100 East Ruffin Street
Mebane, NC 27302
John E. Skvarla, III
Secretary
Subject: Issuance of NPDES Permit NCO088919
Quality Oil Company — Former Coliseum Shell GW Remediation System
Forsyth County
Dear Mr. Kerins:
Division personnel have reviewed and approved your application for renewal of the subject permit.
Accordingly, we are forwarding the attached NPDES discharge 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 U.S. Environmental Protection Agency dated October 15, 2007 (or as
subsequently amended).
This final permit contains significant changes to its terms from those found in the draft permit sent to
you on February 26, 2014. These changes have been made based upon use of corrected low flow data
for the receiving stream and in response to comments received during the permit's public notice period.
A summary of those changes is listed below.
• The facility's flow limit has been changed from 0.036 MGD to 0.004 MGD.
• The Whole Effluent Toxicity limit has been changed from 90% to 8.1 %. The lower limit is
reflective of a lower instream waste concentration resulting from the discharge that takes into
account a corrected (higher) stream flow within the unnamed tributary to Silas Creek and the
reduced flow limit. The test method has been changed from a pass /fail test to full range toxicity
testing with the reporting of the chronic value derived from the test. Toxicity testing months have
been changed to March, June, September and December.
• The effluent limits for lead as found in the previous permit have been retained in this final version of
the permit in response to commentt received during the draft permit's public notice.
You are also reminded of the new condition requiring electronic reporting of discharge monitoring
report (DMR) data using the Division's eDMR internet application. This new requirement will become
effective on August 1, 2015 (approximately 270 days or nine months following the effective date of the
permit).
1617 Mail Service Center, Raleigh, North Carolina 27699 -1617
Phone: 919 - 807 - 6300 \Internet: www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer — Made in part by recycled paper

Mr. Ryan Kerins
NC0088919 Permit Renewal 2014
p. 2
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty
(30) days following receipt of this letter. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of
Administrative Hearings (6714 Mail Service Center, Raleigh, North Carolina 27699 - 6714). Unless
such demand is made, this decision shall be final and binding.
Please note that this permit is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the permit. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Resources or
permits required by the Division of Land Resources, the 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 Bob Sledge at telephone number (919)
807 -6398, or via e-mail at bob.sledge @ncdenr.gov.
Incer ly,
41 f
Thomas A. Reeder, Dire r
Division of Water Resources
cc: Central Files
Winston -Salem Regional Office/Water Quality
NPDES File
ec: Aquatic Toxicology Unit

Permit NCO088919
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions 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,
Quality Oil Company
is hereby authorized to discharge wastewater from a facility located at the
Former Coliseum Shell
3009 University Parkway
Winston -Salem
Forsyth County
to receiving waters designated as an unnamed tributary to Silas Creek in the Yadkin River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts
I, II, III, and IV hereof.
The permit shall become effective November 1, 2014.
This permit and the authorization to discharge shall expire at midnight on June 30, 2019.
Signed this day September 22, 2014.
(Z- zz�
mas A. Reeder, Director
Division of Water Resource
By Authority of the Environmental Management Commission
Page 1 of 7

Permit NCO088919
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under the
permit conditions, requirements, terms, and provisions included herein.
Quality Oil Company
is hereby authorized to
Continue to discharge treated, gasoline contaminated groundwater from a groundwater remediation
system that includes the following components:
• Oil -water separator
• Air stripper
• High pressure sand filter
• Particulate bag filters
• Activated carbon filters
• Associated tanks, pumps and piping
This facility is located at the former Coliseum Shell, at 3009 University Parkway, in Winston -
Salem, in Forsyth County.
2. Discharge from said treatment works at the location specified on the attached map into unnamed
tributary to Silas Creek, a class C water in the Yadkin River Basin.
Page 2 of 7

Permit NCO088919
PART I
A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
Beginning on the effective date of this permit and lasting until expiration, the Permittee is authorized to
discharge treated groundwater from Outfall 001. Such discharges shall be limited and monitoredt by
the Permittee as specified below:
EFFLUENT CHARACTERISTICS
Parameter Code
EFFLUENT LIMITATIONS
MONITORING REQUIREMENTS
Monthly
Average
Daily
Maximum
Measurement
Frequency
Sample
Type
Sample
Location
Flow2 50050
0.004 MGD
Continuous
Recording
Effluent
Total Suspended Solids C0530
30.0 mg /L
45.0 mg /L
Monthly
Grab
Effluent
Ethylbenzene 34371
Quarterly3
Grab
Effluent
Xylenes 81551
Quarterly3
Grab
Effluent
MTBE 22417
Quarterly3
Grab
Effluent
Isopropyl Ether 77117
Quarterly3
Grab
Effluent
Naphthalene 34696
Quarterly3
Grab
Effluent
Isopropyl Benzene 77223
Quarterly3
Grab
Effluent
Tetrachloroethylene 34475
Quarterly3
Grab
Effluent
Acetone 81552
Quarterly3
Grab
Effluent
1, 2, 4- Tri methyl benzene 77222
Quarterly3
Grab
Effluent
1, 3, 5- Tri meth ylbenzene 77226
Quarterly3
Grab
Effluent
Toluene 78131
Quarterly3
Grab
Effluent
Benzene 34030
Quarterly3
Grab
Effluent
2- Butanone 78356
Quarterly3
Grab
Effluent
1, 2 cis - Dichloroethylene 81574
Quarterly3
Grab
Effluent
Lead 01051
25.0 pg /L
67.0 pg /L
Quarterly3
Grab
Effluent
Chronic Toxicity4 THP3B
Quarterly
Grab
Effluent
Nntee-
1. No later than August 1, 2015 (270 days from the effective date of this permit), begin submitting
discharge monitoring reports electronically using NC DWR's eDMR application system. See
Condition A. (3.).
2. Flow may be measured using a totalizing flow meter.
3. Monitoring is to be conducted in conjunction with whole effluent toxicity monitoring.
4. Chronic Toxicity (Ceriodaphnia dubia) full range testing with chronic value limit of 8.1 %. Testing is to be
conducted during the months of March, June, September and December (see A. (2.)).
There shall be no discharge of floating solids or visible foam in other than trace amounts.
Page 3 of 7

Permit NCO088919
A. (2.) CHRONIC TOXICITY PERMIT LIMIT (Quarterly)
The effluent discharge shall at no time exhibit observable inhibition of reproduction or significant mortality to
Ceriodaphnia dubia at an effluent concentration of 8.1 %.
The permit holder shall perform at a minimum, quarterly monitoring using test procedures outlined in the
"North Carolina Phase II Chronic Whole Effluent Toxicity Test Procedure" (Revised- December 20 10) or
subsequent versions. The tests will be performed during the months of December, March, June, and
September. These months signify the first month of each three month toxicity testing quarter assigned to the
facility. Effluent sampling for this testing must be obtained during representative effluent discharge and shall
be performed at the NPDES permitted final effluent discharge below all treatment processes.
If the test procedure performed as the first test of any single quarter results in a.ChV below the permit
limit, then multiple- concentration testing shall be performed at a minimum, in each of the two following
months as described in "North Carolina Phase H Chronic Whole Effluent Toxicity Test Procedure"
(Revised- December 2010) or subsequent versions.
All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge
Monitoring Form (MR -1) for the months in which tests were performed using the parameter code T1HP3B for
the Chronic Value. Additionally, DWQ Form AT -3 (original) is to be sent to the following address:
Attention: North Carolina Division of Water Resources
Water Sciences Section
1621 Mail Service Center
Raleigh, North Carolina 27699 -1621
Completed Aquatic Toxicity Test Forms shall be filed with the Water Sciences Section no later than 30 days
after the end of the reporting period for which the report is made.
Test data shall be complete, accurate, include all supporting chemical/physical measurements and all
concentration/response data, and be certified by laboratory supervisor and ORC or approved designate
signature. Total residual chlorine of the effluent toxicity sample must be measured and reported if chlorine is
employed for disinfection of the waste stream.
Should there be no discharge of flow from the facility during a month in which toxicity monitoring is required,
the permittee will complete the information located at the top of the aquatic toxicity (AT) test form indicating
the facility name, permit number, pipe number, county, and the month /year of the report with the notation of
"No Flow" in the comment area of the form. The report shall be submitted to the Water Sciences Section at the
address cited above.
Should the permittee fail to monitor during a month in which toxicity monitoring is required, monitoring will be
required during the following month. Assessment of toxicity compliance is based on the toxicity testing quarter,
which is the three month time interval that begins on the first day of the month in which toxicity testing is
required by this permit and continues until the final day of the third month.
Should any test data from this monitoring requirement or tests performed by the North Carolina Division of
Water Resources indicate potential impacts to the receiving stream, this permit may be re- opened and modified
to include alternate monitoring requirements or limits.
NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum control
organism survival, minimum control organism reproduction, and appropriate environmental controls, shall
constitute an invalid test and will require immediate follow -up testing to be completed no later than the last day
of the month following the month of the initial monitoring.
Page 4 of 7

Permit NCO088919
A. (3.) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs)
and specify that, if a state does not establish a system to receive such submittals, then permittees must
submit DMRs electronically to the Environmental Protection Agency (EPA). The Division anticipates
that these regulations will be adopted and is beginning implementation in late 2013.
NOTE: This special condition supplements or supersedes the following sections within Part II of this
permit (Standard Conditions for NPDES Permits):
• Section B. (11.)
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Signatory Requirements
Reporting
Records Retention
Monitoring Reports
1. Reporting (Supersedes Section D. (2.) and Section E. (5.) (a)1
Beginning no later than August 1, 2015 (270 days from the effective date of this permit), the
permittee shall begin reporting discharge monitoring data electronically using the NC DWR's
Electronic Discharge Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and
submitted electronically using eDMR. The eDMR system allows permitted facilities to enter
monitoring data and submit DMRs electronically using the internet. Until such time that the state's
eDMR application is compliant with EPA's Cross -Media Electronic Reporting Regulation
(CROMERR), permittees will be required to submit all discharge monitoring data to the state
electronically using eDMR and will be required to complete the eDMR submission by printing,
signing, and submitting one signed original and a copy of the computer printed eDMR to the
following address:
NC DENR / DWR / Information Processing Unit
ATTENTION: Central Files / eDMR
1617 Mail Service Center
Raleigh, North Carolina 27699 -1617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the
facility being physically located in an area where less than 10 percent of the households have
broadband access, then a temporary waiver from the NPDES electronic reporting requirements may
be granted and discharge monitoring data may be submitted on paper DMR forms (MR 1, 1. 1, 2, 3)
or alternative forms approved by the Director. Duplicate signed copies shall be submitted to the
mailing address above.
Requests for temporary waivers from the NPDES electronic reporting requirements must be
submitted in writing to the Division for written approval at least sixty (60) days prior to the date the
facility would be required under this permit to begin using eDMR. Temporary waivers shall be
valid for twelve (12) months and shall thereupon expire. At such time, DMRs shall be submitted
electronically to the Division unless the permittee re- applies for and is granted a new temporary
waiver by the Division.
Page 5 of 7

Permit NCO088919
A. (3.) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS, continued
Information on eDMR and application for a temporary waiver from the NPDES electronic reporting
requirements is found on the following web page:
http://Portal.ncdenr.org/web/wq/adminibog/ipu/edmr
Regardless of the submission method, the first DMR is due on the last day of the month following
the issuance of the permit or in the case of a new facility, on the last day of the month following the
commencement of discharge.
2. Signatory Requirements [Supplements Section B. (11.) (b) and supersedes Section B. (11.) (d)1
All eDMRs submitted to the permit issuing authority shall be signed by a person described in Part
I1, Section B. (I 1.)(a) or by a duly authorized representative of that person as described in Part 11,
Section B. (11.)(b). A person, and not a position, must be delegated signatory authority for eDMR
reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR user
account and login credentials to access the eDMR system. For more information on North
Carolina's eDMR system, registering for eDMR and obtaining an eDMR user account, please visit
the following web page:
http: / /portal.ncdenr.org /web /wq /admin/bog/ipu/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall
make the following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations. "
3. Records Retention [Supplements Section D. (6.)]
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR
submissions. These records or copies shall be maintained for a period of at least 3 years from the
date of the report. This period may be extended by request of the Director at any time [40 CFR
122.41].
A. (4.) NUTRIENT REOPENER FOR HIGH ROCK LAKE
This permit may be reopened and modified to implement nutrient requirements in accordance with any
future TMDL and /or nutrient management strategy for High Rock Lake.
Page 6 of 7

Permit NCO088919
Page 7 of 7
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Latitude� 36*07'54"
Quality Oil Company
Facility
Longitude: 80015AT
Location
71
Quad
Former •
Stream Class: C
GW Remediation
Receiving Stream: UT to Silas Creek
0410tth
Forsyth
County
Page 7 of 7

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Bob Sledge 2/21/2014; updated 9/22/2014
Permit Number
NCO088919
Facility Name
Quality Oil Company — Former Coliseum Shell GWR
Basin Name /Sub -basin number
Yadkin -Pee Dee 030704
Receiving Stream
UT to Silas Creek
Stream Classification in Permit
C
Does permit need Daily Max NH3 limits?
No
Does permit need TRC limits /language?
No
Does permit have toxicity testing?
Yes
Does permit have Special Conditions?
Added eDMR condition and High Rock Lake
reo ever
Does permit have instream monitoring?
No
Is the stream impaired (on 303(d ) list)?
No
Any obvious compliance concerns?
Toxicity. Facility has been issued a SOC to address
tox. Compliant with parameters of concern
Any permit mods since last permit?
No
Current expiration date
June 30, 2014
New expiration date
June 30, 2019
Comments received on Draft Permit?
Yes, from Clean Water For North Carolina
This permit is for a groundwater remediation system in Winston - Salem. The site is a former gas station.
The groundwater is contaminated by gasoline, but groundwater monitoring also detected the presence of
PERC (thought to have migrated to the site from a nearby dry cleaner). This is why the individual permit
has been issued instead of the general permit for remediation of petroleum contaminated groundwater.
The treatment system contains multiple components, and is well operated and maintained. The effluent
quality is excellent. Apart from some higher numbers associated with startup, the facility typically yields
non - detect results for constituent parameters. A RPA was run for those parameters for which discreet
values were reported. No reasonable potential for violating water quality standards was shown per the
analysis for all the parameters, with the exception of lead. For these reasons, limits have been removed
from the permit or all the organic compounds and monitoring frequencies have been reduced to quarterly,
to be conducted along with toxicity testing. Both the Winston -Salem Regional Office and the Aquatic
Toxicology Unit have been consulted about this change and both have noted their approval.
Lead did show reasonable potential with the inclusion of a 140 gg/L value associated with the start up of
the system on July 25, 2011. If this value is removed, the maximum predicted value drops from 267.4
gg/L to 38.5 gg/L. Because the first sampling event is seen as not representative of the facility's standard
and long term performance, the decision regarding the limit is based upon the RPA not including that
value. The limit has been removed and monitoring frequency has been reduced to quarterly.
It is forecast that remediation at the site will soon be concluded and improvement at the site will be left to
natural attenuation. If this occurs, the GWR system will be removed and the permit rescinded.
UPDATE (9/22/2014)
Comments were received from Clean Water For North Carolina requesting most constituent parameter
limits be retained in the permit and that monitoring frequencies either be retained or increased. Most of
the CWFNC recommendations were not adopted because they were not grounded in the facts and history
of the situation, but were based upon emotional speculation. For most parameters, monitoring

frequencies and limits were kept as they were set in the draft permit, with reduced frequencies and no
effluent limits as guided by results of reported data and the RPA. The exception to this is that limits have
been restored for lead in response to the CWFNC comments.
Another parameter that is significantly changed in the final version of the permit is Whole Effluent
Toxicity. During the initial evaluation of the situation it was believed the effluent failed tox tests because
the treated groundwater did not contain sufficient nutrient value to sustain the test organisms during the
test cycle. However, extensive testing and analysis by the facility consultant and the Aquatic Toxicology
Branch indicate other factors may be contributing to toxicity (mostly likely some form of ion imbalance).
The toxicity monitoring requirement was looked at from many angles in an effort to keep meaningful
toxicity testing in the permit without leading the facility into permit noncompliance and placing it into
jeopardy of receiving civil penalties. Civil assessments would cause the owner to shut down the
remediation system, thus denying the environment the benefits of a process that has made significant
progress in cleaning up the contaminated groundwater in the area.
At the same time those factors were being considered, other factors surrounding the discharge were
examined. In initial permitting, USGS calculated stream flow was not used in establishment of the IWC
and development of the tox limit; instead the discharge was assumed to be 100% of stream flow during
low flow conditions. Additionally, the actual discharge volume of the discharge was considered instead
of the design flow of the system. Actual flow values were consistently about one -tenth of the permitted
flow. In the renewed permit, the permitted flow has been reduced to near the flow values reported during
the last permit cycle (0.004 MGD). Considered with positive stream flow, this yields an IWC and
toxicity limit of 8.1 %, which should be attainable by the permittee.
The test has been changed to full range testing (code THP3B) in March, June, September and December,
with the result reported as a chronic value.
All changes to the permit have been discussed with the permittee and the Aquatic Toxicology Branch.
All parties are satisfied with the terms of the final permit.

Former Coliseum Shell 2014 Freshwater RPA- 95% Probability/95% Confidence Outfall 001
NC0088919 MAXIMUM DATA POINTS = 58 Qw= 0.004 MGD
•
Qw(MGD)= 0.00 W WTP/WTP Class: PC-1
1Q10S(cfs)= 0.06 IWC ®1Q10S = 9.37%
7Q10S(cfs)= 0.07 IWC (4)7Q10S= 8.14%
7Q1OW(cfs)= NO 7Q10w DATA IWC(4)7Q1OW= N/A
30Q2(cfs)= 0.17 IWC(a3 30Q2= 3.52%
Avg.Stream Flow,QA(cfs)= NO QA DATA IWC®QA= N/A
Receiving Stream: UT to Silas Creek Stream Class: C
PARAMETER TYPE STANDARDS&CRITERIA(2) J F REASONABLE POTENTIAL RESULTS RECOMMENDED ACTION
(1) NC WQS/ Applied r/2 FAV/ Z
Chronic Standard Acute n #Det. Max Pred Cw Allowable Cw
Acute: 360.73
Lead NC 25 FW(7Q 10s) 33.8 ug/L 25 5 267.40 _ _
Chronic: 307.13 Quarterly monitoring;retain limit
No value>Allowable Cw
Acute: NO WQS
Acetone NC 2000 FW(7Q10s) ug/L 25 4 1049.20
Chronic: — — — — — — — — — — — — --- — —
24570.02 Quarterly Monitoring
No value>Allowable Cw
Acute: NO WQS
MTBE NC 1500 HH(7Q10s) ug/L 25 2 7.70
Chronic:
18427.52 Quarterly Monitoring
No value>Allowable Cw
Acute:
0 0 N/A
Chronic — — - ---------------
Acute:
0 0 N/A - - ------- - - - - - - - - - - -
Chronic
•
•
•
NC0088919 RP 2014 v4(0.004),rpa
Page 1 of 1 9/23/2014

Sledge, Bob
From: Hollenkamp, Carol
Sent: Thursday, September 18, 2014 2:59 PM
To: Ryan Kerins; Sledge, Bob; Moore, Cindy
Cc: Moore, Thomas; Hennessy, John
Subject: RE: shell coliseum conference call
Hi everyone,
We can use this number for a conference call tomorrow to discuss the permit for Shell Coliseum (NC0088919).
Let's plan on 1030. If anyone has any time conflicts, just let me know.
Ryan, could you call into this number instead of us calling you?
1. Dial 1-919-743-8484
2. You will be prompted to enter a pass code. Enter 000111, then press #. Enter the number 000111 somewhat
slowly. For some reason, we get an error if typed in too rapidly.
3. You will be welcomed to the conference bridge and asked to say your name, then press #.
4. You will be announced to the conference call and will be told what number caller you are.
Thanks,
Carol Hollenkamp
Aquatic Toxicology Branch /Water Sciences Section
North Carolina Division of Water Resources /DENR
1621 Mail Service Center, Raleigh, NC 27699 -1621
Please NOTE NEW PHONE #
Phone: [phone]
Fax: [phone]
Website: http: / /portal.ncdenr.org /web /wq /ess /atu
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Ryan Kerins [ mai Ito: rdkerins @terraquestpc.comI
Sent: Thursday, September 18, 2014 2:34 PM
To: Hollenkamp, Carol
Cc: Moore, Thomas
Subject: RE: shell coliseum conference call

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Clean Water for North Carolina
291/2 Page Ave
Asheville NC 28801
Bob Sledge
DWR /Water Quality Permit Section
Wastewater Branch
1617 Mail Service Center
Raleigh, NC 27699 -1617
Dear Mr. Sledge,
�"'.' I � ''`"J � ` `•"'tai
March 26, 2014
Please accept this document as the official comments of Clean Water for NC regarding draft Permit # NC0088919 for
the Quality Oil Company LLC's Former Coliseum Shell Station. Clean Water for NC is an environmental justice
nonprofit organization with members statewide who care about the state's water resources, including over 40
supporters in the greater Winston -Salem area.
We are aware that this facility has been remediating groundwater polluted with PERC and petroleum related
chemicals, and discharging the wastewater in a storm drainage tunnel that leads into Silas Creek. We are also aware
that limits are proposed to be removed for several parameters, including lead.
After having reviewed the discharge data for this facility, we offer the following comments about this draft permit:
- Limits for lead should not be removed for this facility, as it has surpassed allowed daily values for 5 months
since it started reporting in July 2011. The facility last surpassed maximum values in December 2012.
Although they have been in compliance with lead limits since then, this does not constitute sufficient time
in compliance to justify lifting limits for lead.
- Monitoring and testing requirements should continue to be on monthly time period, not reduced to a
quarterly, for the following parameters: Ethylbenzene, xylenes, MTBE, Isoproply Ether, Naphthalene,
Isopropyl Benzene, Tetrachloroethylene, Acetone, 1,2,4- Trimethylbenzene, 1,2,5 - Trimethylbenzene,
Toluene, Benzene, 2- Butaone, 1,2 cis- Dichloroethylene, Lead, and Chronic Toxicity. We understand the
Division's determination to remove limits based on reasonable potential to exceed water quality standards,
but lowering the frequency of monitoring of these parameters would reduce the Division's ability to quickly
act if certain parameters become problematic once again and warrant reinstated limits.
It is the responsibility of NC DENR's Department of Water Resources to protect the integrity of our state's surface
water. Though the remediation system appears to be functioning efficiently, DWR must hold Quality Oil Company
LLC accountable to the fullest extent of Clean Water Act standards. We believe continuing monthly testing and
including an enforceable limit for Lead are necessary to protect Silas Creek for downstream uses. Thank you for this
opportunity to submit comments.
Respectfully,
Sally Morgan
Energy & Water Justice Researcher
Clean Water for NC
sally @cwfnc.org

NORTH CAROLINA
FORSYTH COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified, and authorized by law to administer oaths, personally
appeared D.H. Stanfield, who being duly sworn, deposes and says: that he is
Controller of the Winston -Salem Journal, engaged in the publishing of a
newspaper known as the Winston -Salem Journal, published, issued and
entered as second class mail in the City of Winston - Salem, in said County and
State: that he is authorized to make this affidavit and sworn statement: that the
notice or other legal advertisement, a true copy of which is attached hereto,
was published in the Winston -Salem Journal on the following dates:
March 1, 2014
and that the said newspaper in which such notice, paper document, or legal
ldvertisement was published was, at the time of each and every such
publication, a newspaper meeting all the requirements and qualifications of
Section 1 -597 of the General Statutes of North Carolina and was a qualified
iewspaper within the meaning of Section 1 -597 of the General Statutes of
forth Carolina.
PUBLIC NOTICE
his 3rd day of March, 2014
North Carolina Environmental
Management Commission/NPDES Unit
1617 Mail Service Center
(signature of pe so making affidavit)
Raleigh, NC 27699 -1617
Notice of Intent to Issue a
i NPDES Wastewater Permit
worn to and subscribed before me, this 3rd day of March 2014
'The North Carolina Environmental Management
Commission proposes to issue a NPDES wastewa-
ter discharge permit to the person(s) listed below:'
Written comments regarding the proposed permit
will be accepted until 30 days after the publish
date of this notice. The Director of the NC Div
of Water Resources (DWR) may hold a public f
Nota P ZlC
ing should there be a s eg
ignificant dree of p l
interest. Please mail comments and /or informal
tion requests to DWR at the above address. Inters?
ly Commission expires: September 28, 2015
ested persons may visit the DWR at 512 N. Salis -it
bury Street, Raleigh, NC to review information ont
file. Additional Information
on NPDES permits and
this notice may be found on our website: http: //.t
portal.ncdenr.org /web /wq /swp /ps /npdes /calenj
dar, or by calling (919) 807 -6390. The City of Kind,
(P.O. Box 719, King, NC 27021) has requested 9t
permit NCO088897 for its Water Treatment Plane
in Forsyth County. This permitted facility will dis:�
charge treated wastewater to old Richmond Cree
in the Yadkin -Pee Dee River Basin. Total residu
chlorine is a parameter regulated in the permits
which is water quality limited. This discharge mays
affect future allocations in this segment of Olds
KIMALEY JOHNSON
appliednfor Crenewaluof NPDESCpermit NC 0889 0..
NOTARY PUBLIC
for the Former Coliseum Shell Station in Forsyth
'
FORSYTH COUNTY
County. Thi s P4r
+ „� �❑
STATE OF NORTH CAR LI
MY COMMISSION EXPIRES
named tribut
Basin. Currently,
-
es, naphtalene, isopropyl benzene tetrachoro=,
ethylene, acetone, trimethylbenzene 1,2 4, tol-
uene, and benzene are water quality limited.
However due to the performance of the treatment
system, limits are proposed to be removed in the
draft permit. This discharge may affect future al-
locations in this portion of the Yadkin River Basin.
The Town of East Bend has applied for renewal of
NPDES permit NCO064726 for its East Bend Indus-
trial Park WWTP in Yadkin County. This permitted
facility discharges treated domestic and commer-
cial wastewater to an unnamed tributary to the
Yadkin River in the Yadkin -Pee Dee River Basin.
Currently ammonia nitrogen, dissolved oxygen
and total residual chlorine are water quality limit-
ed. This discharge may affect future allocations In
this portion of the watershed.
WSJ: March 1, 2014

NCDENR
North Carolina Department of Environment and
Division of Water Resources
Water Quality Programs
Pat McCrory Thomas A. Reeder
Governor Director
February 26, 2014
Mr. Ryan D. Kerins
Terraquest Environmental Consultants, P.C.
100 East Ruffin Street
Mebane, NC 27302
Subject: Draft NPDES Permit
Permit Number NCO088919
Dear Mr. Kerins:
Natural Resources
John E. Skvada, III
Secretary
OPOE s %lam Cady
Quality Oil Company — Former Coliseum Shell G., -- ....,.. 0y3«111
Facility Rating: PC -1
Forsyth County
Enclosed with this letter is a copy of the draft permit for your facility. Please review the draft very
carefully to ensure thorough understanding of the conditions and requirements it contains. The draft
permit contains a number of changes in its terms from those found in your current permit. A summary
of those changes follows:
• For most of the constituent parameters that contain limits in the existing permit, those limits have
been removed, and their monitoring frequencies have been reduced to quarterly, with monitoring to
be performed in conjunction with whole effluent toxicity testing
• A new condition requiring electronic reporting of data collected pursuant to the terms of this permit
has been added.
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs)
and specify that, if a state does not establish a system to receive such submittals, then permittees
must submit DMRs electronically to the Environmental Protection Agency (EPA). The Division
anticipates that these regulations will be adopted and is beginning implementation.
The requirement to begin reporting discharge monitoring data electronically using the NC DWR's
Electronic Discharge Monitoring Report (eDMR) internet application has been added to your
NPDES permit. [See Condition A. (3.)] For information on eDMR, registering for eDMR and
obtaining an eDMR user account, please visit the following web page:
http: / /portal.ncdenr. org /web /wq /admin/bog/ipu/edmr.
1617 Mail Service Center, Ralegh, North Carolina 27699 -1617
Location: 512 N. Salisbury St Raleigh, North Carolina 27604
Phone: [phone] FAX: 919 - 807 -6492
Intemet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer

Mr. Ryan Kerins
NC0088919Renewal Draft
p. 2
For information on EPA's proposed NPDES Electronic Reporting Rule, please visit the following
web site:
http: / /www2.epa.p,ov /compliance /proposed- npdes- electronic- reportin -rule.
• A new condition has been added to the permit stating "This permit may be reopened and modified to
implement nutrient requirements in accordance with any future TMDL and/or nutrient management
strategy for High Rock Lake."
Please submit any comments to me no later than thirty days following your receipt of the draft.
Comments should be sent to the address listed at the bottom of this page. If no adverse comments are
received from the public or from you, this permit will likely be issued in April 2014, with an effective
date of July 1, 2014.
If you have any questions or comments concerning this draft permit, call me at (919) 807 -6398, or via e-
mail at bob.sledge @ncdenr.gov.
Sincerely,
'e-
Bob Sledge
Compliance & Expedited Permitting Unit
cc: NPDES Files
ec: Winston -Salem Regional Office — DWR Water Quality Programs
Aquatic Toxicology Unit
Steve Reid

Permit NCO088919
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
199RUVW1
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions 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,
Quality Oil Company
is hereby authorized to discharge wastewater from a facility located at the
Former Coliseum Shell
3009 University Parkway
Winston -Salem
Forsyth County
to receiving waters designated as an unnamed tributary to Silas Creek in the Yadkin River Basin
in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts
I, Il, Ill, and IV hereof.
The permit shall become effective
This permit and the authorization to discharge shall expire at midnight on June 30, 2019.
Signed this day
1111t,"K, all
Thomas A. Reeder, Director
Division of Water Resources
By Authority of the Environmental Management Commission
Page 1 of 7

Permit NCO088919
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby
revoked. As of this permit issuance, any previously issued permit bearing this number is no longer
effective. Therefore, the exclusive authority to operate and discharge from this facility arises under the
permit conditions, requirements, terms, and provisions included herein.
Quality Oil Company
is hereby authorized to
1. Continue to discharge treated, gasoline contaminated groundwater from a groundwater remediation
system that includes the following components:
• Oil -water separator
• Air stripper
• High pressure sand filter
• Particulate bag filters
• Activated carbon filters
• Associated tanks, pumps and piping
This facility is located at the former Coliseum Shell, at 3009 University Parkway, in Winston -
Salem, in Forsyth County.
2. Discharge from said treatment works at the location specified on the attached map into unnamed
tributary to Silas Creek, a class C water in the Yadkin River Basin.
Page 2 of 7

Permit NCO088919
A. (2.) CHRONIC TOXICITY PERMIT LIMIT (Quarterly)
The permittee shall conduct acute toxicity tests on a guarterlX basis using protocols defined in the North
Carolina Procedure Document entitled "Pass /Fail Methodology For Determining Acute Toxicity In A Single
Effluent Concentration" (revised December 2010 or subsequent versions). The monitoring shall be performed
as a Ceriodaphnia dubia 24 -hour static test. The effluent concentration at which there may be at no time
significant acute mortality is 90% (defined as treatment two in the procedure document). The tests will be
performed during the months of January, April, July and October. These months signify the first month of
each three -month toxicity testing quarter assigned to the facility. Effluent sampling for this testing must be
obtained during representative effluent discharge and shall be performed at the NPDES permitted final effluent
discharge below all treatment processes.
Should any single quarterly monitoring indicate a failure to meet specified limits, then monthly
monitoring will begin immediately until such time that a single test is passed. Upon passing, this monthly
test requirement will revert to quarterly in the months specified above.
All toxicity testing results required as part of this permit condition will be entered on the Effluent Discharge
Monitoring Form (MR -1) for the month in which it was performed, using the parameter code TGE313.
Additionally, DWR Form AT -2 (original) is to be sent to the following address:
Attention: NC DENR / DWR / Environmental Sciences Section
1621 Mail Service Center
Raleigh, NC 27699 -1621
Completed Aquatic Toxicity Test Forms shall be filed with the Environmental Sciences Section no later than 30
days after the end of the reporting period for which the report is made.
Test data shall be complete and accurate and include all supporting chemical /physical measurements performed
in association with the toxicity tests, as well as all dose /response data. Total residual chlorine of the effluent
toxicity sample must be measured and reported if chlorine is employed for disinfection of the waste stream.
Should there be no discharge of flow from the facility during a month in which toxicity monitoring is required,
the permittee will complete the information located at the top of the aquatic toxicity (AT) test form indicating
the facility name, permit number, pipe number, county, and the month /year of the report with the notation of
"No Flow" in the continent area of the form. The report shall be submitted to the Environmental Sciences
Section at the address cited above.
Should the permittee fail to monitor during a month in which toxicity monitoring is required, then monthly
monitoring will begin immediately until such time that a single test is passed. Upon passing, this monthly test
requirement will revert to quarterly in the months specified above. Assessment of toxicity compliance is based
on the toxicity testing quarter, which is the three month time interval that begins on the first day of the month in
which toxicity testing is required by this permit and continues until the final day of the third month.
Should any test data from either these monitoring requirements or tests performed by the North Carolina
Division of Water Resources indicate potential impacts to the receiving stream, this permit may be re- opened
and modified to include alternate monitoring requirements or limits.
If the Permittee monitors any pollutant more frequently than required by this permit, the results of such
monitoring shall be included in the calculation & reporting of the data submitted on the DMR & all AT Form
submitted.
NOTE: Failure to achieve test conditions as specified in the cited document, such as minimum control
organism survival and appropriate environmental controls, shall constitute an invalid test and will require
immediate follow -up testing to be completed no later than the last day of the month following the month of the
initial monitoring.
Page 4 of 7

Permit NCO088919
A. (3.) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS
Proposed federal regulations require electronic submittal of all discharge monitoring reports (DMRs)
and specify that, if a state does not establish a system to receive such submittals, then permittees must
submit DMRs electronically to the Environmental Protection Agency (EPA). The Division anticipates
that these regulations will be adopted and is beginning implementation in late 2013.
NOTE: This special condition supplements or supersedes the following sections within Part II of this
permit (Standard Conditions for NPDES Permits):
• Section B. (11.) Signatory Requirements
• Section D. (2.)
• Section D. (6.)
• Section E. (5.)
Reporting
Records Retention
Monitoring Reports
1. Reporting [Supersedes Section D. (2.) and Section E. (5.) (a)1
Beginning no later than 270 days from the effective date of this permit, the permittee shall begin
reporting discharge monitoring data electronically using the NC DWR's Electronic Discharge
Monitoring Report (eDMR) internet application.
Monitoring results obtained during the previous month(s) shall be summarized for each month and
submitted electronically using eDMR. The eDMR system allows permitted facilities to enter
monitoring data and submit DMRs electronically using the internet. Until such time that the state's
eDMR application is compliant with EPA's Cross -Media Electronic Reporting Regulation
(CROMERR), permittees will be required to submit all discharge monitoring data to the state
electronically using eDMR and will be required to complete the eDMR submission by printing,
signing, and submitting one signed original and a copy of the computer printed eDMR to the
following address:
NC DENR / DWR / Information Processing Unit
ATTENTION: Central Files / eDMR
1617 Mail Service Center
Raleigh, North Carolina 27699 -1617
If a permittee is unable to use the eDMR system due to a demonstrated hardship or due to the
facility being physically located in an area where less than 10 percent of the households have
broadband access, then a temporary waiver from the NPDES electronic reporting requirements may
be granted and discharge monitoring data may be submitted on paper DMR forms (MR 1, 1. 1, 2, 3)
or alternative forms approved by the Director. Duplicate signed copies shall be submitted to the
mailing address above.
Requests for temporary waivers from the NPDES electronic reporting requirements must be
submitted in writing to the Division for written approval at least sixty (60) days prior to the date the
facility would be required under this permit to begin using eDMR. Temporary waivers shall be
valid for twelve (12) months and shall thereupon expire. At such time, DMRs shall be submitted
electronically to the Division unless the permittee re- applies for and is granted a new temporary
waiver by the Division.
Page 5 of 7

Permit NCO088919
A. (3.) ELECTRONIC REPORTING OF DISCHARGE MONITORING REPORTS, continued
Information on eDMR and application for a temporary waiver from the NPDES electronic reporting
requirements is found on the following web page:
http: / /portal.nedenr.org /web /wq /admin/bog /ipu/edmr
Regardless of the submission method, the first DMR is due on the last day of the month following
the issuance of the permit or in the case of a new facility, on the last day of the month following the
commencement of discharge.
2. Signatory Requirements [Supplements Section B. (11.) (b) and supersedes Section B. (11.) (d)1
All eDMRs submitted to the permit issuing authority shall be signed by a person described in Part
II, Section B. (11.)(a) or by a duly authorized representative of that person as described in Part II,
Section B. (I 1.)(b). A person, and not a position, must be delegated signatory authority for eDMR
reporting purposes.
For eDMR submissions, the person signing and submitting the DMR must obtain an eDMR user
account and login credentials to access the eDMR system. For more information on North
Carolina's eDMR system, registering for eDMR and obtaining an eDMR user account, please visit
the following web page:
http: / /portal.ncdenr.or web /wq /adminibo ipu/edmr
Certification. Any person submitting an electronic DMR using the state's eDMR system shall
make the following certification [40 CFR 122.22]. NO OTHER STATEMENTS OF
CERTIFICATION WILL BE ACCEPTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information,
including the possibility offines and imprisonment for knowing violations. "
3. Records Retention [Supplements Section D. (6.)]
The permittee shall retain records of all Discharge Monitoring Reports, including eDMR
submissions. These records or copies shall be maintained for a period of at least 3 years from the
date of the report. This period may be extended by request of the Director at any time [40 CFR
122.41].
A. (4.) NUTRIENT REOPENER FOR HIGH ROCK LAKE
This permit may be reopened and modified to implement nutrient requirements in accordance with any
future TMDL and/or nutrient management strategy for High Rock Lake.
Page 6 of 7

Permit NCO088919
Page 7 of 7
!` '-� ?� - •u- .-�',; V ���<�' -•�-'' i �..t 1'� i 1s7,1�"l sryy'6' /t � ��`� \'"!- ,.J�jf is •;��� � %jj t`_'.y •'!" '
V
...............
IVA
VM
j
YUI 1 )I
Latitude: 36007'54" Quality Oil Company
Facility
Longitude: 80015'47"
Location
Quad #: C1 7SE Former Coliseum Shell
Stream Class: C GW Remediation
NPDES Permit NCO08891
Subbasin: 030704
Receiving Stream: UT to Silas Creek
cft -0 t tIL
Forsyth County
Page 7 of 7

FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc) that can be administratively renewed with minor changes, but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Bob Sledge 2/21/2014
Permit Number
NCO088919
Facility Name
Quality Oil Company — Former Coliseum Shell GWR
Basin Name /Sub -basin number
Yadkin -Pee Dee 030704
Receiving Stream
UT to Silas Creek
Stream Classification in Permit
C
Does permit need Daily Max NH3 limits?
No
Does permit need TRC limits/language?
No
Does permit have toxicity testing?
Yes
Does permit have Special Conditions?
Added eDMR condition and High Rock Lake
reo ever
Does permit have instream monitoring?
No
Is the stream impaired on 303(d) list)?
No
Any obvious compliance concerns?
Toxicity. Facility has been issued a SOC to address
tox. Compliant with parameters of concern
Any permit mods since last permit?
No
Current expiration date
June 30, 2014
New expiration date
June 30, 2019
Comments received on Draft Permit?
Yes No If Yes, discuss response with Supervisor
This permit is for a groundwater remediation system in Winston - Salem. The site is a former gas station.
The groundwater is contaminated by gasoline, but groundwater monitoring also detected the presence of
PERC (thought to have migrated to the site from a nearby dry cleaner). This is why the individual permit
has been issued instead of the general permit for remediation of petroleum contaminated groundwater.
The treatment system is contains multiple components, and is well operated and maintained. The effluent
quality is excellent. Apart from some higher numbers associated with startup, the facility typically yields
non - detect results for constituent parameters. A RPA was run for those parameters for which discreet
values were reported. No reasonable potential for violating water quality standards was shown per the
analysis for all the parameters, with the exception of lead. For these reasons, limits have been removed
from the permit or all the organic compounds and monitoring frequencies have been reduced to quarterly,
to be conducted along with toxicity testing. Both the Winston -Salem Regional Office and the Aquatic
Toxicology Unit have been consulted about this change and both have noted their approval.
Lead did show reasonable potential with the inclusion of a 140 µg/L value associated with the start up of
the system on July 25, 2011. If this value is removed, the maximum predicted value drops from 267.4
gg/L to 38.5 pg/L. Because the first sampling event is seen as not representative of the facility's standard
and long term performance, the decision regarding the limit is based upon the RPA not including that
value. The limit has been removed and monitoring frequency has been reduced to quarterly.
It is forecast that remediation at the site will soon be concluded and improvement at the site will be left to
natural attenuation. If this occurs, the GWR system will be removed and the permit rescinded.

A
t"A"
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Director Secretary
December 17, 2013
Attn: Ryan D. Kerins
Terraquest Environmental Consultants, P.C.
100 E. Ruffin St
Mebane, NC 27302
Subject: Receipt of permit renewal
Permit NCO088919
Forsyth County
Dear Mr. Kerins:
The NPDES Unit received your permit renewal application on December 16, 2013. A member of the
NPDES Unit will review your application. They will contact you if additional information is required to
complete your permit renewal. You should expect to receive a draft permit approximately 30 -45 days
before your existing permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact Bob
Sledge (919) 807 -6398.
Sincerely,
k' 4W
Wren Thedford
Point Source Branch
cc: Central Files
Winston -Salem Regional Office
NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699 -1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] Fax: 919 - 807- 6492/Customer Service: 1-877-623-6748
Internet: www.ncwater.oro
An Equal OpportunitylAffirmative Action Employer

TERRA uest
ENVIRONMENTAL CONSULTANTS, P.C.
December 11, 2013 CERTIFIED MAIL ARTICLE NO.: 701
Wren Thedford NC DENR / DWR / NPDES Unit
1617 Mail Service Center DEC 1. 6 2013 I
Raleigh, North Carolina 27699 -1617 —UA 1
DENR- WAl'E�: C)JALITY
POINT SOURCE BRANCF
Re: Permit Renewal Request
NPDES Permit NC0088919,
Former Coliseum Shell Station, Winston - Salem, Forsyth County, NC
NCDWM -UST Incident No.: 15260 Terraquest Project No.: 01195
Dear Mr. Thedford:
Terraquest Environmental Consultants, P.C. hereby requests renewal of the subject permit as
detailed on the enclosed application form including Figure 1 — Site Location Map and
Groundwater Analytical History - Effluent. Terraquest is authorized to make this renewal
request as evidenced by the enclosed Delegation of Signature Authority. Additionally enclosed
is the Special Order by Consent EMC SOC WQ S -12 -004 that this facility operates under.
The minor volume of sludge that accumulates at this facility is removed by a vacuum truck
subcontractor. Vacuum events are typically scheduled every six months but are adjusted as
needed. Terraquest generally uses Shamrock Environmental Corporation who removes the
sludge and disposes of it in an environmentally - friendly manner. Waste manifests and disposal
sheets are routinely provided to NCDENR following the events.
I can be reached at 919 563 -9091 or [e-mail] terraquestpc.com with any questions or
concerns you may have. Thank you.
Sincerely,
TERRAQUEST ENVIRONMENTAL CONSULTANTS, P.C.
1 certify under penalty of law that this document and all attachments were prepared under my
!i 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,
j accurate, and complete. 1 am aware that there are significant penalties for submitting false
information, including the possibility of fine and imprisonment for knowing violations.
Ryan D. Kerins
Project Manager
Enclosed: NPDES Permit Application - Short Form C — GW, Figure 1— Site Location Map (topographic map), Groundwater Analytical
History - Effluent , Delegation of Signature Authority, Special Order by Consent EMC SOC WQ S -12 -004
cc: Quality Oil Company, LLC — BradleySnover, NCDWM- UST — Thomas Moore, NCDENR -DWQ — Ron Boone
100 E. Ruffin Street • Mebane, North Carolina 27302
Telephone [phone] • Facsimile (919) 563 -9095
www.terraquestpc.com

NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699 -1617
NPDES Permit Number INCO088919
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e -mail Address
Quality Oil Company
Former Coliseum Shell
PO Box 2736
Winston -Salem
NC 27102 -2736
(336)722 -3441
(336)721 -9520
rdkerins@terraque stpc. com
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code
County
3009 University Pkwy
Winston -Salem
NC 27105
Forsyth
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Terraquest Environmental Consultants, P.C.
Mailing Address 100 E Ruffin St
City Mebane
State / Zip Code NC 27302
Telephone Number (919)563 -9091
Fax Number (919)563 -9095
4. Ownership Status:
Federal ❑
State ❑
Private
Public ❑
Page 1 of 3 C -GW 03105

NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
5. Products recovered:
Gasoline ® Diesel fuel ❑ Solvents ❑ Other
6. Number of separate discharge points: 1
Outfall Identification number(s) "Effluent"
7. Frequency of discharge: Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: 7 Duration: effluent pumps several
times per hour for 5 -15 minutes a cycle.
8. Treatment System Design flow 0.036 MGD
9. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
Silas Creek (36.132173,- 80.262971)
10. Please list all additives to the treatment system, including chemicals or nutrients, that have
the potential to be discharged.
11. Is this facility located on Indian country? (check one)
Yes ❑ No
12. Additional Information
All applicants (including renewals):
A USGS topographical map (or copy of the relevant portion) which shows all outfalls
A summary of the most recent analytical results (effluent data, if available) containing the
maximum values for each chemical detected
NEW Applicants only:
y Engineering Alternative Analysis
Description of remediation treatment system components, capacities, and removal efficiency
for detected compounds.
y If the treatment system will discharge to a storm sewer, written approval from the
municipality responsible for the sewer.
A list of any chemicals found in detectable amounts at the site, with the maximum observed
concentration reported for each chemical (the most recent sample must be collected less
than one year prior to the date of this application)
For petroleum- contaminated sites - Analyses for Volatile Organic Compounds (VOC) should
be performed. Analyses for any fuel additives likely to be present at the site and for phenol
and lead should also be performed.
For sites contaminated with solvents or other contaminants - EPA Method 624/625
analysis should be performed.
Pa-e 2 of 3 C -GW 03105

NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
13. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Printed
Signature cf Applicant
Title
Date
!1/13
North Carolina General Statute 143 -215.6 (b)(2) provides that: Any person who knowingly makes any false
statement representation, or certification in any application, record, report, plan, or other document files or
required to be maintained under Article 21 or regulations of the Environmental Management Commission
implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section
1001 provides .a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both,
for a similar offense.)
Page 3 of 3 C -GW 03105

CONTOUR INTERVAL = 10 FEET
N
MAP SOURCE: USGS 7.5 MINUTE TOPOGRAPHIC MAP - RURAL HALL, WALKERTOWN, WINSTON -SALEM EAST, AND WINSTON -SALEM WEST, NC
GRAPHIC SCALE
0' 2,000' 4,000'
SITE LOCATION MAP
ue COLISEUM SHELL SERVICE
3009 UNIVERSITY PARKWAY, WINSTON- SALEM, NC
QUALITY OIL COMPANY, LLC WINSTON -SALEM NC
ENVIRONMENTAL CONSULTANTS, P.C. PROJECT NO. 01195 DRAWN BY; RDK DATE: 12/11/13
SCALE: 1" = 2,000' CHECKED BY: MJB I FIGURE NO. 1

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November 22, 2011
Point Source Branch
Surface Water Protection Section
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699 -1617
Subject: Delegation of Signature Authority
Coliseum Shell
NPDES No. NC 88919 _
To Whom It May Concern:
By notice of this letter, I hereby delegate signatory authority to each of the following
individuals for all permit applications, discharge monitoring reports, and other
information relating to the operations at Coliseum Shell as required by all applicable
federal, state, and local environmental agencies specifically with the requirements for
signatory authority as specified in 15A NCAC 2B.0506.
Name
Ryan Kerins
Andy Wrenn
Megan Webster
Title
Operator in Responsible Charge
Backup ORC
Support Staff
If you have any questions regarding this letter, please feel free to contact me at 919 -563-
9091.
Sincerely,
Ernie Rhymer
Senior lice President
cc: Winston -Salem Regional Office, Surface Water Protection Section
Technical Assistance and Certification Unit