NC0075701_Renewal (Application)_20230317

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Raymond Allen
City of Albemarle
PO Box 190
Albemarle, NC 28002-0190
Subject: Permit Renewal
Application No. NCO075701
Tuckertown WTP
Stanly County
Dear Permittee:
NORTH CAROLINA
Environmental Quality
March 17, 2023
The Water Quality Permitting Section acknowledges the March 17, 2023 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 15OB-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•//deg.nc gov/permits-regulations/permit-ciuidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
Sincerely,
(—h1411- ( A41y
Cynthia Demery
Administrative Assistant
Water Quality Permitting Section
North Carolina Department of Environmental Quality I Division of Water Resources
Mooresville Regional Office 1 610 East Center Avenue, Suite 301 1 Mooresville, North Carolina 28115
704.663.1699

A
hIAi'. 17 � 13
EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NCO075701
Jack F Neel Water Treatment
ry _
OMB No. 2040-0004
Form
U.S. Env rtYerrt i ge
t
\=EPA
Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
SECTION•
-• i
Applicants Not Required to Submit Form 1
1.1
1.1.1
Is the facility a new or existing publicly owned
1.1.2
Is the facility a new or existing treatment works
treatment works?
treating domestic sewage?
If yes, STOP. Do NOT complete No
If yes, STOP. Do NOT No
Form 1. Complete Form 2A.
complete Form 1. Complete
Form 2S.
1.2
Applicants Required to Submit Form 1
1.2.1
Is the facility a concentrated animal feeding
1.2.2
Is the facility an existing manufacturing,
operation or a concentrated aquatic animal
commercial, mining, or silvicultural facility that is
a
production facility?
currently discharging process wastewater?
oYes
4 Complete Form 1 0 No
Yes 4 Complete Form 0 No
a
and Form 213.
1 and Form 2C,
1.2.3
Is the facility a new manufacturing, commercial,
1.2.4
Is the facility a new or existing manufacturing,
a�
mining, or silvicultural facility that has not yet
commercial, mining, or silvicultural facility that
=
commenced to discharge?
discharges only nonprocess wastewater?
d
Yes 4 Complete Form 1 0 No
Yes 4 Complete Form 0 No
and Form 2D.
1 and Form 2E.
N
1.2.5
Is the facility a new or existing facility whose
'—
discharge is composed entirely of stormwater
a
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
Yes 4 Complete Form 1 Fv7I No
and Form 2F
La'3erfichp
unless exempted by
40 CFR
122.26(b)(14)(x) or
SECTION
••- AND LOCATION (40
Facility Name
2.1
Jack F Neel Water Treatment Plant
0
2.2
EPA Identification Number
0
0
J
2.3
Facility Contact
Name (first and last)
Title
Phone number
Jason Culp
ORC
[phone]
Q
Email address
[e-mail]
6
2.4
Facility Mailing Address
ZStreet
or P.O. box
PO Box 190
City or town
State
ZIP code
Albemarle
NC
23002-0190
EPA Form 3510-1 (revised 3-19)
Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NCO075701
Jack F Neel Water Treatment
OMB No.2040-0004
CD
2.5
Facility Location
Street, route number, or other specific identifier
a o
U
36576 INC Highway 49 North
o
County name
County code (if known)
Stanly
J
E -a
City or town
State ZIP code
z
New London
NC 28127
SECTION1
NAICS CODES1
Description (optional)
3.1
SIC Code(s)
4941
Water Supply
y
N
O
U
co
U
Z
3.2
NAICS Code(s)
Description (optional)
c
f°
221310
Water treatment and distribution
U
Name of Operator
4.1
The City of Albemarle
co_
4.2
Is the name you listed in Item 4.1 also the owner?
E
`
❑✓ Yes ElNo
o
w
4.3
Operator Status
R
❑ Public —federal ❑ Public —state 0 Other public (specify) City of Albemarle
o
❑ Private ❑ Other (specify)
4.4
Phone Number of Operator
10`1 - qs'-1 - 9N to
4.5
Operator Address
=
w
Street or P.O. Box
15
PO Box 190
m
City or town
State
ZIP code
`o o
Albemarle
NC
28002
� U
o
address of operator
O
FErail
[e-mail]
SECTION1
1 1
Is the facility located on Indian Land?
5.1
❑ Yes ❑ No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment OMB No. 2040-0004
SECTION••
1
all that apply and print or type the corresponding permit number for each)
6.1
Existing Environmental Permits (check
d
❑✓ NPDES (discharges to surface
❑ RCRA (hazardous wastes)
❑ UIC (underground injection of
c
water)
fluids)
w
NCO075701
w
as
❑ PSD (air emissions)
❑ Nona ttainment program (CAA)
❑ NESHAPs (CAA)
c
w
ElOcean dumping (MPRSA)=redge or fill (CWA Section 404) ElOther (specify)
SECTIONi
Have you attached a topographic map containing all required information to this application? (See instructions for
7.1
C
specific requirements.)
❑✓ Yes ❑ No ❑ CAFO—Not Applicable (See requirements in Form 26.)
SECTIONOF
r
Describe the nature of your business.
8.1
Producing 6.0 MGD of potable drinking water for municipal distribution
fN
to
01
C
N
m
O
d
7
!O
Z
SECTION••
1 '
Does your facility use cooling water?
9.1
d
❑ Yes ❑ No -* SKIP to Item 10.1.
9.2
Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
a,
40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122.21(r). Consult with your
Y
NPDES permitting authority to determine what specific information needs to be submitted and when.)
o
o �
SECTION
r VARIANCE
REQUESTSr r
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)? (Check all that
10.1
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
y
d
when.)
❑ Fundamentally different factors (CWA ❑ Water quality related effluent limitations (CWA Section
Section 301(n)) 302(b)(2))
❑ Non -conventional pollutants (CWA ❑ Thermal discharges (CWA Section 316(a))
Section 301(c) and (g))
❑r Not applicable
EPA Form 3510-1 (revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility -Nam Form Approved 03/05/19
NCO075701
Jack F Neel Water Treatment OMB No.2040-0004
SECTION•
11.1
I
In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1
Column 2
❑✓ Section 1: Activities Requiring an NPDES Permit
❑ w/ attachments
❑ Section 2: Name, Mailing Address, and Location
❑ wl attachments
❑ Section 3: SIC Codes
❑ wl attachments
❑ Section 4: Operator Information
❑ w/ attachments
❑ Section 5: Indian Land
❑ w/ attachments
❑ Section 6: Existing Environmental Permits
❑ w/ attachments
E
R
❑ Section 7: Map
w/ topographic
Elma ❑ w/ additional attachments
.r
`o
w
❑ Section 8: Nature of Business
El w/ attachments
❑ Section 9: Cooling Water Intake Structures
❑ w/ attachments
❑ Section 10: Variance Requests
❑ w/ attachments
,3
c
H
ElSection 11: Checklist and Certification Statement
❑ w/ attachments
Y
d
11.2
Certification Statement
s
c.�
1 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 fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
City Manager
��t, Fe
f"l-ij-
Signature
Date signed
/ 3 Z
EPA Form 3510-1 (revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment OMB No. 2040-0004
Form U.S. Environmental Protection Agency
2C 40EPA Application for NPDES Permit to Discharge Wastewater
NPDES EXISTING MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURE OPERATIONS
SECTIONOUTFALL LOCATIONi
1.1 Provide information on each of the facility's outfalls in the table below.
Outfa
Number Receiving Water Name Latitude Longitude
R
U
0 001 UT to Tuckertown Reservoir 35' 29' 42" N 80' 11' 33" W
0
2
j o o
O
SECTIOND' 1
a, 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
C .3 balance? (See instructions for drawing requirements. See Exhibit 2C-1 at end of instructions for example.)
M
C3 ❑✓ Yes ❑ No
SECTION• i
3.1 For each outfall identified under Item 1.1, provide average flow and treatment information. Add additional sheets if
necessary.
**Outfall Number** 001
Operations
Operation Average Flow
3 Yr Alum Sludge & Filter Backwash Settling Basin Decant 0.183 mgd
c
E mgd
ca
d
mgd
a
c
(n mgd
3
0 Treatment Units
u-
a, Description Code from Final Disposal of Solid or
(include size, flow rate through each treatment unit, Table 2C 1 Liquid Wastes Other Than
a' retention time, etc.) by Discharge
Alum Flocculation 1-G Contract Disposal Synagro
Media Fillters 1-R Contract Disposal Synagro
EPA Form 3510-2C (Revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NCO075701
Jack F Neel Water Treatment
OMB No. 2040-0004
3.1
**Outfall Number**
Cont.
Operations
Operation
Average Flow
mgd
mgd
mgd
mgd
Treatment
Description
Units
Code from
Final Disposal of Solid or
(include size, flow rate through each treatment unit,
Table 2C-1
Liquid Wastes Other Than
retention time, etc.)
by Discharge
d
0
U
.r
c
m
E
r
.a
m
L
**Outfall Number**
R
Operations
Operation Average Flow
U-
mgd
L
d
a'
mgd
mgd
mgd
Treatment
Description
Units
Code from
Final Disposal of Solid or
(include size, flow rate through each treatment unit,
Table 2C-1
Liquid Wastes Other Than
retention time, etc.)
by Discharge
3.2
Are you applying for an NPDES permit to operate a privately owned treatment works?
0
❑ Yes ❑ No 4 SKIP to Section 4.
3.3
Have you attached a list that identifies each user of the treatment works?
❑ Yes ❑ No
EPA Form 3510-2C (Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment OMB No. 2040-0004
SECTION• 1
4.1 Except for storm runoff, leaks, or spills, are any discharges described in Sections 1 and 3 intermittent or seasonal?
❑ Yes ❑r No 4 SKIP to Section 5.
4.2
Provide information
on intermittent or seasonal flows for each applicable outfall.
Attach additional pages, if n cessary.
Freq
uency
Flow
Rate
Outfall
Operation
Duration
Average
Average
Long -Term
Maximum
Number
(list)
Da s[Week
MonthsNear
Average
Dail
days/week
months/year
mgd
mgd
days
odays/week
monthslyear
mgd
mgd
days
LL
days/week
months/year
mgd
mgd
days
days/week
months/year
mgd
mgd
days
c
days/week
months/year
mgd
mgd
days
days/week
months/year
mgd
mgd
days
days/week
months/year
mgd
mgd
days
days/week
months/year
mgd
mgd
days
days/week months/year mgd mgd days
SECTION•-•D
• 1
Do any effluent limitation guidelines (ELGs) promulgated by EPA under Section 304 of the CWA apply to your facility?
5.1
❑ Yes ❑✓ No -+ SKIP to Section 6.
w
5.2
Provide the following information on applicable ELGs.
w
ELG Category
ELG Subcategory
Regulatory Citation
d
CL
0_
a
5.3
Are any of the applicable ELGs expressed in terms of production (or other measure of operation)?
❑ Yes ❑� No SKIP to Section 6.
0
%
5.4
Provide an actual measure of daily production expressed in terms and units of applicable ELGs.
J
Outfall
Operation, Product, or Material
Quantity per Day
Unit of
Number
Measure
a�
m
c
0
Y
c.�
O
L
0-
EPA Form 3510-2C (Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment OMB No. 2040-0004
IMPROVEMENTSSECTION 6. 1
6.1 Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing,
upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes ❑✓ No 4 SKIP to Item 6.3.
6.2
Briefly identify each applicable project in the table below.
Affected
Final Compliance Dates
E
Brief Identification and Description of
Outfalls
Source(s) of
e
Project
(list outfall
Discharge
Required
Projected
`0.
number
E
-o
cc
cc
U)
v
o
rn
c.
6.3
Have you attached sheets describing any additional water pollution control programs (or other environmental projects
that may affect your discharges) that you now have underway or planned? (optional item)
❑ Yes ❑ No ✓❑ Not applicable
SECTION 7. EFFLUENT AND INTAKE CHARACTERISTICS (40 CFR 122.21(g)(7))
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must
complete. Not all applicants need to complete each table.
Table A. Conventional and Non -Conventional Pollutants
7.1
Are you requesting a waiver from your NPDES permitting authority for one or more of the Table A pollutants for any of
your outfalls?
❑ Yes ❑✓ No 4 SKIP to Item 7.3.
7.2
If yes, indicate the applicable outfalls below. Attach waiver request and other required information to the application.
Outfall Number Outfall Number Outfall Number
7.3
Have you completed monitoring for all Table A pollutants at each of your outfalls for which a waiver has not been
requested and attached the results to this application package?
cu cu
❑✓ Yes ❑ No; a waiver has been requested from my NPDES
permitting authority for all pollutants at all outfalls.
cc
Table B.
Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants
Y
7.4
Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
c
listed in Exhibit 2C-3? (See end of instructions for exhibit.)
❑ Yes 0 No -+ SKIP to Item 7.8.
y
7.5
Have you checked "Testing Required" for all toxic metals, cyanide, and total phenols in Section 1 of Table B?
w
❑ Yes ❑ No
7.6
List the applicable primary industry categories and check the boxes indicating the required GC/MS fraction(s) identified
in Exhibit 2C-3.
Primary Industry Category
Required GC/MS Fraction(s)
Check applicable boxes.
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
EPA Form 3510-2C (Revised 3-19) Page 4

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NCOO757O1
Jack F Neel Water Treatment
OMB No. 2040-0004
7.7
Have you checked "Testing Required" for all required pollutants in Sections 2 through 5 of Table B for each of the
GC/MS fractions checked in Item 7.6?
❑ Yes ❑ No
7.8
Have you checked `Believed Present' or "Believed Absent' for all pollutants listed in Sections 1 through 5 of Table B
where testing is not required?
0 Yes ❑ No
7.9
Have you provided (1) quantitative data for those Section 1, Table B, pollutants for which you have indicated testing is
required or (2) quantitative data or other required information for those Section 1, Table B, pollutants that you have
indicated are "Believed Present' in your discharge?
❑✓ Yes ❑ No
7.10
Does the applicant qualify for a small business exemption under the criteria specified in the instructions?
❑ Yes 4 Note that you qualify at the top of Table B, ❑ No
then SKIP to Item 7.12.
7.11
Have you provided (1) quantitative data for those Sections 2 through 5, Table B, pollutants for which you have
c
determined testing is required or (2) quantitative data or an explanation for those Sections 2 through 5, Table B,
pollutants you have indicated are 'Believed Present' in your discharge?
y
N
Yes ❑ No
w;
Table C. Certain Conventional and Non -Conventional Pollutants
7.12
Have you indicated whether pollutants are 'Believed Present' or "Believed Absent' for all pollutants listed on Table C
for all outfalls?
U
❑✓ Yes ❑ No
7.13
Have you completed Table C by providing (1) quantitative data for those pollutants that are limited either directly or
indirectly in an ELG and/or (2) quantitative data or an explanation for those pollutants for which you have indicated
'Believed Present'?
0 Yes ❑ No
w
Table D. Certain Hazardous Substances and Asbestos
7.14
Have you indicated whether pollutants are 'Believed Present' or "Believed Absent' for all pollutants listed in Table D for
all outfalls?
❑ Yes 0 No
7.15
Have you completed Table D by (1) describing the reasons the applicable pollutants are expected to be discharged
and (2) by providing quantitative data, if available?
❑ Yes ❑✓ No
Table E. 2,3,7,8-Tetrachlorodibenzo- -Dioxin 2,3,7,8-TCDD
7.16
Does the facility use or manufacture one or more of the 2,3,7,8-TCDD congeners listed in the instructions, or do you
know or have reason to believe that TCDD is or may be present in the effluent?
❑ Yes 4 Complete Table E. ❑✓ No 4 SKIP to Section 8.
7.17
Have you completed Table E by reporting qualitative data for TCDD?
❑ Yes ❑✓ No
SECTIONOR
8.1
MANUFACTURED TOXICSi
Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
an intermediate or final product or byproduct?
w
❑ Yes ❑✓ No 4 SKIP to Section 9.
3 u
8.2
List the pollutants below.
1. 4. 7.
0
U)
2. 5. 8.
M
3. 6. 9.
EPA Form 3510-2C (Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment OMB No. 2040-0004
SECTION' BIOLOGICAL TOXICITY1
9.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made
within the last three years on (1) any of your discharges or (2) on a receiving water in relation to your discharge?
❑✓ Yes ❑ No 4 SKIP to Section 10.
(n
,°7
9.2
Identify the tests and their
Durposes below.
Test(s)
Purpose of Test(s)
Submitted to NPDES
Date Submitted
x
Permitting Authority?
0
r—
cv
WET - May P/F 90%
Ceriodaphnia
❑ Yes ❑ No
0
0)
report quarterly
0
0
ca
❑ Yes ❑ No
❑ Yes ❑ No
SECTIONr
CONTRACT
ANALYSES (40
Were any of the analyses reported in Section 7 performed by a contract laboratory or consulting firm?
10.1
❑✓ Yes ❑ No -* SKIP to Section 11.
10.2
Provide information for each contract laboratory or consulting
firm below.
Laboratory Number 1
Laboratory Number 2
Laboratory Number 3
Name of laboratory/firm
Environment 1 Inc
U)
Laboratory address
114 Oakmont Drive
Q
Greenville NC
U
f9
w
C
c0
Phone number
[phone]
Pollutant(s) analyzed
All
SECTIONDD
• •- •
information?
11.1
Has the NPDES permitting authority requested additional
❑✓ Yes
❑ No 4 SKIP to Section 12.
0
E1
E
..2
List the information requested and attach it to this application.
0
1 Hardness- Quarterly- Upstream & Effluent 4
c
0
2 Turbidity Monthly 5.
a
v
Q
3. 6.
EPA Form 3510-2C (Revised 3-19) Page 6

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment OMB No. 2040-0004
SECTION•
1
In Column 1 below, mark the sections of Form 2C that you have completed and are submitting with your application.
12.1
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to com lete all sections or provide attachments.
Column 1
Column 2
✓❑ Section 1: Outfall Location
❑✓ w/ attachments
❑✓ Section 2: Line Drawing
❑✓ w/ line drawing ❑ w/ additional attachments
Section 3: Average Flows and
w/ list of each user of
E]w/ attachments ❑ privately owned treatment
Treatment
works
❑✓ Section 4: Intermittent Flows
❑ w/ attachments
❑✓ Section 5: Production
❑ w/ attachments
w/ optional additional
❑✓ Section 6: Improvements
❑ w/ attachments ❑ sheets describing any
additional pollution control
tans
❑ wl request for a waiver and ❑ w/ explanation for identical
supporting information outfalls
wl small business exemption
El ❑ w/ other attachments
E
request
❑ Section 7: Effluent and Intake
❑ w/ Table A ❑✓ w/ Table B
c
Characteristics
0
❑✓ w/ Table C ❑ w/ Table D
V
w/ analytical results as an
E] w/ Table E ❑
attachment
0
Section 8: Used or Manufactured
✓❑
❑ w/ attachments
Toxics
❑ Section 9: Biological Toxicity
❑ w/ attachments
Tests
U
❑✓ Section 10: Contract Analyses
❑ w/ attachments
❑� Section 11: Additional Information
w/ attachments
❑ Section 12: Checklist and
❑ w/ attachments
Certification Statement
12.2
Certification Statement
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 fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
� f J
F�✓ril
City Manager
I( - &Ie�
Signature
Date signed
L
t
EPA Form 3510-2C (Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE
A. CONVENTIONAL AND NON•
• •• 1
Effluent
Intake
Waiver
o tional
Maximum
Maximum
Long -Term
Pollutant
Requested Units
(if applicable) (specify)
Daily
Monthly
Average Daily
Number of
Long -Term
Number of
Discharge
Discharge
Discharge
Analyses
Average Value
Analyses
(required)
if available
if available
❑
Check here if you have applied to your NPDES permitting authority for a waiver for all of the pollutants listed on this table for the noted outfall.
1'
Biochemical oxygen demand
El
Concentration
Mass
(BOD5)
2'
Chemical oxygen demand
El
Concentration
Mass
(COD)
Concentration
3.
Total organic carbon (TOC)
❑
Mass
Concentration
mg/L
3200
3200
63.28
122
4.
Total suspended solids (TSS)
El
Mass
Concentration
mg/L
4.13
4.13
1.16
27
5.
Ammonia (as N)
❑
Mass
6.
Flow
❑
Rate
mgd
1.65
0.617
0.183
1554
Temperature (winter)
❑
°C
°C
7.
Temperature (summer)
❑
°C
°C
pH (minimum)
❑
Standard units
S.U.
6.1
6.1
187
8.
pH (maximum)
❑
Standard units
S.U.
8.9
8.9
187
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 9

W.
P
2
RECEIVED
M,;d 1 7 2023
NCDEQ/DWR/NPDES

LHA idenntication Number NYutJ rermit Number Facility Name Outfall Number
NCO075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
Pollutant/Parameter
(and CAS Number, if available )
1El
Testing
Required
q
Presence or Absence
check one
Units
(specify)
Effluent
Intake
(optional)
Believed
Present
Believed
Absentof
Maximum
Daily
Discharge
requiredavailable)
Maximum
Monthly
Discharge
Long -Term
Average
DisDcharge
if available
Number
Analyses
Long-
Term
Average
Number
Analyses
Check here if you qualify as a small business per the instructions to Form 2C and, therefore, do not need to submit quantitative data for any of the organic toxic pollutants in Sections
2 through 5 of this table. Note, however, that you must still indicate in the appropriate column of this table if you believe any of the pollutants listed are present in your discharge.
Section 1. Toxic Metals, Cyanide, and Total Phenols
1.1
Antimony, total
(7440-36-0)
Concentration
Mass
1.2
Arsenic, total
(7440-38-2)
El
Concentration
Mass
1.3
Beryllium, total
(7440-41-7)
El
El
✓
Concentration
Mass
1.4
Cadmium, total
(7440-43-9)
El
El
Concentration
Mass
1.5
Chromium, total
(7440-47-3)
El
El
El
Concentration
Mass
1.6
Copper, total
(7440-50-8)
Concentration
ug/L
1704
1704
5304
62
Mass
1.7
Lead, total
(7439-92-1)
El
❑
Concentration
Mass
1.8
Mercury, total
(7439-97-6)
El
❑
El
Concentration
Mass
1'9
Nickel, total
(7440-02-0)
❑
El
El
Concentration
Mass
1.10
Selenium, total
(7782-49-2)
El
El
El
Concentration
Mass
1.11
Silver, total
(7440-22-4)
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 11

NPDES Permit Number Facility Name Outfall Number
NC0075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
�:
•
•
• •'
• '• 1
Presence or Absence
check one
Effluent
Intake
(optional)
Poll utantlParameter
Testing
Units
Maximum
Maximum
Long -Term
Lon
(and CAS Number, if available
Required
Believed
Believed
(p �v)
(specify)
Daily
Monthly
Average
Number
Term
Number
Present
Absent
Discharge
ae
Discharge
aily
of
Average
of
(required)
available)
( )
DisDcharge
Analyses
Value
Analyses
if available)
1.12
Thallium, total
El
El
0
Concentration
Mass
(7440-28-0)
1.13
Zinc total
Concentration
ug/L
276
276
24.6
Mass
(7440-66-6)
1.14
Cyanide, total
Concentration
Mass
(57-12-5)
1.15
Phenols, total
El
Concentration
Mass
Section 2.Organic Toxic Pollutants (GCIMS
Fraction
—Volatile Compounds)
2.1
Acrolein
El
1:1
El
Concentration
Mass
(107-02-8)
2.2
Acr&nitrile
El
El
❑
Concentration
Mass
(107-13-1)
2.3
Benzene
El
❑
El
Concentration
Mass
(71-43-2)
2.4
Bromoform
El
❑
❑
Concentration
Mass
(75-25-2)
2.5
Carbon tetrachloride
Concentration
Mass
(56-23-5)
2.6
Chlorobenzene
El
El
ID
Concentration
Mass
(108-90-7)
2.7
Chlorodibromomethane
El
❑
✓
Concentration
Mass
(124-48-1)
2.8
Chloroethane
El
❑
❑
Concentration
Mass
(75-00-3)
EPA Form 3510-2C (Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
Poll utant/Parameter
(and CAS Number, if available)
Testing
Required
Presence or Absence
check one
Units
(specify)
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(if available)
Long -Term
Average
Daily
Discharge ch
le
if available
Number
of
Analyses
Long•
Term
Average
Value
Number
of
Analyses
2'9
2-chloroethylvinyl ether
(110-75-8)
Concentration
Mass
2.10
Chloroform (67-66-3)
El
z
Concentration
Mass
2.11
Dichlorobromomethane
(75-27-4)
F-11
Concentration
Mass
2.12
1,1-dichloroethane
(75-34-3)
Concentration
Mass
2.13
1,2-dichloroethane
(107-06-2)
El
El
21
Concentration
Mass
2.14
11-dichloroethylene
(75-35-4)
Concentration
Mass
2.15
12-dichloropropane
(78-87-5)
1:1
El
Concentration
Mass
2.16
13-dichloropropylene
(542-75-6)
El
El
✓
Concentration
Mass
2.17
Ethylbenzene
(100-41-4)
✓
Concentration
Mass
2.18
Methyl bromide
(74-83-9)
✓
Concentration
Mass
2.19
Methyl chloride
(74-87-3)
✓
Concentration
Mass
2.20
Methylene chloride
(75-09-2)
Concentration
Mass
2.21
1,1,2,2-tetrachloroethane
(79-34-5)
El
1
El
1
El
1
Concentration
1 Mass
EPA Form 3510-2C (Revised 3-19) Page 13

ENA Ioenuticabon Number NruEJ Fermi[ Number Facility Name Outfall Number Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment Plant 001 OMB No. 2040-0004
• 1
Pollutant/Parameter
(and CAS Number, if available)
•
Testing
Required
• 011617tyl kill•
Presence or Absence
check one
•• I
Units
(specify)
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
available)
Long -Tenn
Average
Daily
Discharge
if available)
Number
Analyses
Long-
Term
Average
Value
Number
of
Analyses
2.22
Tetrachloroethylene
(127-18-4)
❑
❑
❑
Concentration
Mass
2.23
Toluene
(108-88-3)
❑
11
❑�
Concentration
Mass
2.24
1,2-trans-dichloroethylene
(156-60-5)
El
ID
Concentration
Mass
2.25
1,1,1-trichloroethane
(71-55-6)
El
❑
ID
Concentration
Mass
2.26
1,1,2-trichloroethane
(79-00-5)
El
El
El
Concentration
Mass
2.27
Trichloroethylene
(79-01-6)
Concentration
Mass
2.28
Vinyl chloride
(75-01-4)
El
El
El
Concentration
Mass
Section 3.Organic Toxic Pollutants (GCIMS
Fraction
—Acid Compounds)
3.1
2-chlorophenol
(95-57-8)
❑
Concentration
Mass
3.2
2,4-dichlorophenol
(120-83-2)
El✓
0
Concentration
Mass
3.3
2,4-dimethylphenol
(105-67-9)
El
El
Concentration
Mass
3.4
4,6-dinitro-o-cresol
(534-52-1)
❑
El
El
Concentration
Mass
3.5
2,4-dinitrophenol
(51-28-5)
El
❑
❑
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name I Outfall Number Form Approved 03/05/19
NC0075701 Jack F Neel Water Treatment Plant 001 OMB No. 2040-0004
Pollutant/Parameter
(and CAS Number, if available)
Testing
Required
Presence or Absence
check one
Units
(specify)Maximum
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Dail Y
Discharge
(required)
Maximum
Monthly
Y
Discharge
Long -Term
Average
aily
DisDcharge
if available
Number
of
Analyses
Long -
Term
Average
alue
Number
of
Analyses
3.6
2-nitrophenol
(88-75-5)
Concentration
Mass
3.7
4-nitrophenol
(100-02-7)
❑
Concentration
Mass
3.8
p-chloro-m-cresol
(59-50-7)
❑
Concentration
Mass
3.9
Pentachlorophenol
(87-86-5)
❑
❑
❑�
Concentration
Mass
3.10
Phenol
(108-95-2)
El
❑
✓❑
Concentration
Mass
3.11
2,4,6-trichlorophenol
(88-05-2)
El
El
Concentration
Mass
Section 4.Organic Toxic Pollutants (GCIMS
Fraction
—Base (Neutral
Compounds)
4.1
Acenaphthene
(83-32-9)
El
❑
❑
Concentration
Mass
4.2
Acenaphthylene
(208-96-8)
❑
❑
Concentration
Mass
4.3
Anthracene
(120-12-7)
El
El
El
Concentration
Mass
4.4
Benzidine
(92-87-5)
❑
0
Concentration
Mass
4.5
Benzo (a) anthracene
(56-55-3)
El
❑
❑
Concentration
Mass
4.6
Benzo (a) pyrene
(50-32-8)
❑
❑�
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
•
Poll utant/Parameter
(and
(and CAS Number, if available)
•1 FTI %:I m 1:
Testing
Required
10 [$1 apm••
Presence or Absence
check one
• ••
Units
(specify)Maximum
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Dail Y
Discharge
(required)
Maximum
Monthly
Y
Discharge
acailablge)
Long -Term
Average
aily
Di D harge
if available
Number
of
Analyses
Long -
Term
Average
Number
of
Analyses
4.7
3,4-benzofluoranthene
(205-99-2)
El
El
El
Concentration
Mass
4.8
Benzo (ghi) perylene
(191-24-2)
Concentration
Mass
4.9
Benzo (k) fluoranthene
(207-08-9)
✓
Concentration
Mass
4.10
Bis (2-chloroethoxy) methane
(111-91-1)
Concentration
Mass
4.11
Bis (2-chloroethyl) ether
(111-44-4)
El
❑
Concentration
Mass
4.12
Bis (2-chloroisopropyl) ether
(102-80-1)
❑
❑
❑�
Concentration
Mass
4.13
Bis (2-ethylhexyl) phthalate
(117-81-7)
El
❑
ID
Concentration
Mass
4.14
4-bromophenyl phenyl ether
(101-55-3)
❑
❑
Z
Concentration
Mass
4.15El
Butyl benzyl phthalate
(g5-68-7)
❑
Concentration
Mass
4.16
2-chloronaphthalene
(91-58-7)
❑
El
Concentration
Mass
4.17
4-chlorophenyl phenyl ether
(7005-72-3)
El❑
Concentration
Mass
4.18
Chrysene
(218-01-9)
❑�
Concentration
Mass
4.19
Dibenzo (a,h) anthracene
(53-70-3)
❑
❑
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name
Outfall Number Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment Plant
001 OMB No. 2040-0004
Presence or Absence
check one
Effluent Intake
(optional)
Poll utant/Parameter Testing Units
Maximum
Maximum
Long -Term
Long -
(and CAS Number, if available Required Believed Believed
(and q (specify)
11,2-dichlorobenzene
Average
Number
Term
Number
Present Absent
Daily
Monthly
Daily
°f
of
Discharge
Discharge
Discharge
Analyses
Average
Analyses
(required)
(if available)
if available
Value
4.20
Concentration
Mass
(95-50-1)
4.21
13-dichlorobenzene
El❑
Concentration
Mass
(541-73-1)
4.22
1,4-dichlorobenzene
❑
❑
❑
Concentration
Mass
(106-46-7)
4.23
3 3-dichlorobenzidine
Concentration
Mass
(91-94-1)
4.24
Diethyl phthalate
❑
Concentration
Mass
(84-66-2)
4.25
Dimethyl phthalate
El
❑
❑
Concentration
Mass
(131-11-3)
4.26
Di-n-butyl phthalate
El
❑
❑
Concentration
Mass
(84-74-2)
4.27
2 4-dinitrotoluene
El❑
Concentration
Mass
(121-14-2)
4.28
2,6-dinitrotoluene
Concentration
Mass
(606-20-2)
4.29
Di-n-octyl phthalate
❑
❑
❑
Concentration
Mass
(117-84-0)
4.30
1,2-Diphenylhydrazine
El
❑
❑
Concentration
Mass
(as azobenzene) (122-66-7)
4.31
Fluoranthene
El❑
Concentration
Mass
(206-44-0)
4.32
Fluorene
El
❑
❑
Concentration
Mass
(86-73-7)
EPA Form 3510-2C (Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
14.33
Poll utant/Parameter
(and CAS Number, if available)
Testing
Required
Presence or Absence
check one
Units
(specify)
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Dail y
Discharge
(required)
Maximum
Monthl y
Discahrge)
Long -Term
Average
D ail
Discharge
if available
Number
of
Analyses
Long -
Term
Average
Value
Number
of
Analyses
Hexachlorobenzene
(118-74-1)
El
El
Concentration
Mass
4.34
Hexachlorobutadiene
(87-68-3)
El
❑
❑
Concentration
Mass
4.35
Hexachlorocyclopentadiene
(77-47-4)
❑
Concentration
Mass
4.36
Hexachloroethane
(67-72-1)
❑
Concentration
Mass
4.37
Indeno (1,2,3-cd) pyrene
(193-39-5)
El
❑
El
Concentration
Mass
4.38
Isophorone
(78-59-1)
El
El
El
Concentration
Mass
4.39
Naphthalene
(91-20-3)
El
El
El
Concentration
Mass
4.40
Nitrobenzene
(98-95-3)
El
El
Concentration
Mass
4.41
N-nitrosodimethylamine
(62-75-9)
El
El
Concentration
Mass
4.42
N-nitrosodi-n-propylamine
(621-64-7)
✓
Concentration
Mass
4.43
N-nitrosodiphenylamine
(86-30-6)
ElElConcentration
Mass
4.44
Phenanthrene
(85-01-8)
El
❑
❑
Concentration
Mass
4.45
Pyrene
(129-00-0)
❑
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 18

EPA Identification Number NPDES Permit Number Facility Name
Outfall Number Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment Plant
001 OMB No. 2040-0004
�' • I • • I •' • '• 1
Presence or Absence
check one
Effluent Intake
(optional)
Pollutant/Parameter Testing Units
Maximum
Maximum
Long -Term
Lon
(and CAS Number, if available) Required Believed Believed (specify)
q (P �Y)
Daily
Monthly
Average
Number
Term
Number
Present Absent
Discharge
scharge
of
Average
of
(required)
(if available)
DisDcharge
Analyses
Analyses
if available
4 446 1,2,4-trichlorobenzene
0
El
IDConcentration
1 Mass
(120-82-1)
Section 5.Organic Toxic Pollutants (GC/MS Fraction
—Pesticides)
5.1
Aldrin
❑
❑
❑�
Concentration
Mass
(309-00-2)
5.2
a-BHC
Concentration
Mass
(319-84-6)
5.3
(3-BHC
✓
Concentration
Mass
(319-85-7)
5.4
y-BHC
El❑
Concentration
Mass
(58 89 9)
5.5
b-BHC
❑
❑
❑�
Concentration
Mass
(319-86-8)
5.6
Chlordane
❑
❑
0
Concentration
Mass
(57-74-9)
5.7
4 4'-DDT
El
❑
El
Concentration
Mass
(50-29-3)
5.8
4,4'-DDE
✓
Concentration
Mass
(72-55-9)
5.9
4 4'-DDD
❑
❑
Concentration
Mass
(72-54-8)
5.10
Dieldrin
❑
❑
Concentration
Mass
(60-57-1)
5.11
a-endosulfan
El❑
❑
Concentration
Mass
(115-29-7)
EPA Form 3510-2C (Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
15.12(115-29-7)
•
Pollutant/Parameter
(and CAS Number, if available)
•] C-1
Testing
Required
I*]•-
Presence or Absence
check one
0YADJ261,1
Units
(specify)
,
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
i
Maximum
Monthly
Discharge
(if available)
Long-Term
Average
Daily
Discharge
if available
Number
Analyses
Lon g-
Term
Average
Value
Number
of
Analyses
R-endosulfan
El
❑
❑
Concentration
Mass
5.13
Endosulfan sulfate
(1031-07-8)
❑
El
El
Concentration
Mass
5.14
Endrin
(72-20-8)
❑
❑
❑
Concentration
Mass
5.15
Endrin aldehyde
(7421-93-4)
El
❑
❑
Concentration
Mass
5.16
Heptachlor
(76-44 8)
❑
❑
✓
❑
Concentration
Mass
5.17
Heptachlor epoxide
(1024-57-3)
❑
❑
El
Concentration
Mass
5.18
PCB-1242
(53469-21-9)
❑
❑
Concentration
Mass
5.19
PCB-1254
(11097-69-1)
❑
❑
Concentration
Mass
5.20
PCB-1221
(11104-28-2)
❑
❑
❑''
Concentration
Mass
5.21
PCB-1232
(11141-16-5)
❑
❑
0
Concentration
Mass
5.22
PCB-1248
(12672-29-6)
❑
❑
0
Concentration
Mass
5.23
PCB-1260
(11096-82-5)
❑
❑
ID
Concentration
Mass
5.24
PCB-1016
(12674-11-2)
❑
❑
0
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NCO075701 Jack F Neel Water Treatment Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
Presence or Absence
check one
Effluent
Intake
(optional)
Pollutant/Parameter
Testing
Units
Maximum
Long -Term
Lon
(and
(and CAS Number, if available)
Required
Believed
Believed
(specify)Maximum
Average
Number
Term
Number
Absent
Daily
Monthly
Dailyof
Discharge
Discharge
Discharge
Analyses
Average
Analyses
f available
Toxaphene
5.25
El
❑❑
Concentration
Mass
(8001-35-2)
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 21

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment Plant OMB No. 2040-0004
jr • • • • • '• 1
Presence or Absence
check one Effluent Intake
(Optional)
Pollutant Units Maximum Long -Term
Believed Believed (specify) Maximum Daily Long -Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
(required) Discharge Discharge Analyses Value Analyses
if available if available
Check here if you believe all pollutants on Table C to be present in your discharge from the noted outfall. You need not complete the "Presence or Absence" column of Table C for
each pollutant.
Ej Check here if you believe all pollutants on Table C to be absent in your discharge from the noted outfall. You need not complete the "Presence or Absence" column of Table C for
each pollutant.
1
Bromide
❑
ID
Concentration
Mass
(24959-67-9)
2
Chlorine, total
❑�
Concentration
ug/L
48
48
16.8
157
Mass
residual
3.
Color
❑
❑�
Concentration
Mass
4.
Fecal coliform
Concentration
Mass
5'
Fluoride
Concentration
mg/L
0.74
0.74
0.14
27
Mass
(16984-48-8)
6
Nitrate -nitrite
0
Concentration
Mass
7'El
Nitrogen, total
El
Concentration
mg/L
178
178
9.95
21
Mass
organic (as N)
8.
Oil and grease
Concentration
Mass
9
Phosphorus (as
Concentration
mg/L
6.19
6.19
0.63
21
Mass
P), total (7723-14-0)
10.
Sulfate (as SO4)
Concentration
Mass
(14808-79-8)
11.
Sulfide (as S)
El
0
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 23

JEPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCO075701 Jack F Neel Water Treatment Plant OMB No. 2040-0004
Presence or Absence
check one Effluent Intake
(Optional)
Pollutant Units Maximum Long -Term
Believed Believed (specify) Maximum Daily Long -Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
(required) Discharge Discharge Analyses Value Analyses
if available if available
12
Sulfite (as S03)
(14265-45-3)
❑
❑
Concentration
Mass
13.
Surfactants
El
21
Concentration
Mass
14.
Aluminum, total
(7429-90-5)
Concentration
ug/L
879726
879726
41891
21
Mass
15.
Barium, total
(7440-39-3)
❑
❑
Concentration
Mass
16.
Boron, total
(7440.42-8)
Concentration
Mass
17.
Cobalt, total
(7440-48-4)
❑
O
Concentration
Mass
18
Iron total
(7439-89-0)
Concentration
Mass
19
Magnesium, total
(7439-954)
Concentration
Mass
20.
Molybdenum,
total
7439-98-7
Concentration
Mass
21.
Manganese, total
(7439 96-5)
✓
Concentration
ug/L
7462
7462
642.6
21
Mass
22
Tin, total
(7440-31-5)
El
Concentration
Mass
23.
Titanium, total
(7440-32-6)
El
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 24

EPA Identification Number
NPDES Permit Number
Facility Name
Outfall Number
Form Approved 03/05/19
NCO0757O1 Jack F Neel Water Treatment Plant
OMB No. 2040-0004
Presence or Absence
check
one
7Maximum
Effluent
Intake
(Optional)
Pollutant
Believed
Believed
Units
(specify)
Daily
Maximum
Long -Term
Long -Term
Present
Absent
Discharge
Monthly
Average Daily Number of
Average Number of
(required)
Discharge
Discharge Analyses
Value Analyses
f available
if available
24. Radioactivity
Alpha, total
El
ID
Concentration
Mass
Beta, total
El
ID
Concentration
Mass
Radium, total
❑
�
Concentration
Mass
Radium 226, total
El0
ConcentrationMass
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 25