NC0037834_Annual Report_20180219

Winston -Salem - Forsyth County
City/County
SUblities
February 15, 2018
Water r Sewer r Solid Waste Disposal
Mr. Monti Hassan
Environmental Specialist
NC DENR-DWQ-PERCS
Manson Meads Complex 1617 MAIL SERVICE CENTER
City of Winston-Salem
27 99 Griffith Road
Winston-Salem, NC 27103
CiryLrnk 311 (336 727 8000)
Fax [phone]
www crtyof vi org
Call 311 or 336-727-8000
[e-mail]
RALEIGH, NORTH CAROLINA 27699-1617
Dear Mr. Hassan,
RECEIVED/DENR/,DwR
FEB 2 9 2018
Water Resources
Permitting Section
The City of Winston- Salem's Industrial Pretreatment Program is submitting its annual
report for 2017. This submittal will comply with NPDES Permits NCO037834 and
NCO050342 Part IV, Section D (10). Enclosed are the following:
• Narrative
• Pretreatment Program Summary(PPS)
• Significant Non -Compliance Report(SNCR)
• SIUs In SNC Historical Report
• Industrial Data Summary Forms (IDSF)
• Allocation Tables for Permits NCO037834 and NCO050342
• SIU's Inspection Summary
Sincerely, �Z/
Joel Freeman/IWC Supervisor
City Council Mayor Allen Jomes, Vivian H Burke, Mayor Pro Tempore, Northeast Ward, Denise D Adams, North Ward, Dan Besse, Southwest Ward, Robert C Clark, West Ward,
John C Larson, South Ward, JeffMacIntosh, Northwest Ward, Derwin L Montgomery, East Ward, James Taylor, Jr, Southeast Ward, City Manager Lee D Garrity
County Commissioners David R Plyler, Chairman, Don Martin, Vice Chair, Fleming El-Amm, Ted Kaplan, Richard V Linville, Glona D Whisenhunt, Everette Witherspoon,
County Manager Dudley Watts, Jr
City/County Utility Commission Randall S Tuttle ,Chairman, Wesley Curtis, Jr, Vice -Chair, Harold E Day, Tom Griffin, Yvonne H Hines, Duane Long, Paul S McGill, David Neill,
Chris Parker, Jim Ruffin, Donald R Stewart

PEO 9be
' III*Nul
ester • Sower • Saud Wame Disposal
2017 Annual Pretreatment Report
NPDES Permit Holder: City of Winston-Salem
Period Covered: January 1, 2017 to December 31, 2017
NPDES Permits: Archie Elledge WWTP NCO037834
Muddy Creek WWTP NCO050342
Sludge Permit: Class A — Thermal Dryer
Distribution and Marketing / Surface Disposal
WQ0029804
Person to contact concerning information contained in this report:
Joel Freeman
Utility Plant Supervisor / IWC
City of Winston-Salem
City / County Utilities
2799 Griffith Road
Winston-Salem, NC 27107
[phone]
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.
The information submitted is, to the best of my knowledge, and belief, true,
accurate and complete based upon my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information. I am aware that there are significant penalties for submitting false
information, including the possibility of assessment of fines and/or imprisonment
for knowing violations.
Joel Freeman Date

NARRATIVE
GENERAL PROGRAM INFORMATION
On April 10, 2017 Joel Freeman was hired on as the Industrial Waste Chemist. The IWC
Supervisor had passed away during this time Joel Freeman filled in and assumed the role
and responsibilities of the program. Duties were accomplished under the guidance of
the Utility Wastewater Plant Superintendent and Utility Assistance Plant Superintendent
GENERAL PERMIT INFORMATION
Renewals- Effective July 1, 2017 Expiration June 30, 2022
Permit
Company
Name
State Approval
Date
#2019
Adele Knits
June 1, 2017
#3010
Ardagh
June 1, 2017
#2018
Bekaert
June 1, 2017
#3100
Crothall Laundry
June 7, 2017
#2014
Deer -Hitachi
June 1, 2017
#2103
Grass America
June 1, 2017
#1155
Hanes Dye and Finishing
June 1, 2017
#2001
Herbalife
June 14, 2017
#2010
Highland
May 15, 2017
#1998
HOH
June 1, 2017
#3050
HP Fabrics
June 20, 2017
#1191
Ingredion
June 1, 2017
#1044
Johnson Controls
June 1, 2017
#1154
Kaba Ilco
June 1, 2017
#3102
Lantal
June 1, 2017
#2020
Liquid Environmental
Solutions
June 12, 2017
#1036
Pepsi Bottling
May 15, 2017
#1038
Progress Rail
June 1, 2017
#3001
RJR Tobaccoville
June 7, 2017
#3014
RJR Whitaker Park
June 7, 2017
#1037
Rockwell Collins
June 1, 2017
#3026
Siemens Energy
June 1, 2017
#1042
Sonoco Display &
Packaging
June 1, 2017
#1152
Stratford Metal
June 12, 2017
#1189
Suiza Dairy Group
June 1, 2017
#3101
Superior
June 7, 2017
#2015
UnFirst
June 1, 2017
#23041
WestRock
May 15, 2017
0)

Modifications:
Permit
Company
Name
Permit
Information
State Approval
Date
#2019
Adele Knits
Sampling frequency has changed
June 1, 2017
#2018
Bekaert Textiles
Sampling frequency has changed
June 1, 2017
#3100
Crothall Laundy
Sampling frequency has changed
June 7, 2017
#2014
Deer -Hitachi
Sampling frequency has changed
June 1, 2017
#2103
Grass America
Sampling frequency has changed
June 1, 2017
#1155
Hanes Dye
Sampling frequency has changed
June 1, 2017
#2010
Highland
Sampling frequency has changed
May 15, 2017
#1998
HOH
Sampling frequency has changed
June 1, 2017
#3050
HP Fabrics
New Industry
June 1, 2017
#1154
Kaba Ilco
Sampling frequency has changed
June 1, 2017
#3102
Lantal
Sampling frequency has changed
June 1, 2017
#2020
LES
Sampling frequency has changed
June 12, 2017
#1036
Pepsi
Sampling frequency has changed
May 15, 2017
#1038
Progress Rail
Name change to Progress Rail
January 1, 2017
#3001
RJR Tobaccoville
Changed flow limit
June 7, 2017
#3014
RJR Whitaker Park
Changed flow limit
June 7, 2017
#1037
Rockwell Collins
Name change and sampling
frequency has changed
June 1, 2017
#1042
Sonoco
Sampling frequency has changed
June 1, 2017
#1152
Stratford Metals
Sampling frequency has changed
June 12, 2017
#1189
Suiza Dairy Group
Sampling frequency has changed
June 1, 2017
#3101
Superior
Sampling frequency has changed
June 7, 2017
#2015
UniFirst
Sampling frequency has changed
June 1, 2017
#3041
WestRock
Sampling frequency has changed
May 15, 2017
The Industrial Waste Control Program regulated 28 Significant Industrial Users (SIU) during
this reporting period. Federal Categorical Pretreatment Standards (CIU) applied to 12
facilities in five (5) different categories. Local limits applied to the remaining 16 industries
which included food processing, textile, industrial laundry and tobacco processing.

GENERAL PRETREATMENT PROGRAM INFORMATION
The City of Winston-Salem's Industrial Waste Control Section conducted all sampling
requirements in accordance with the Significant Industrial User's permits monitoring
requirements. Violations were assed for multiple SIU's. Inspections for SIU's were performed
for the year.
The City of Winston-Salem's Industrial Waste Control Section completed the Headworks
Analyses (HWA) for both POTW's in 2017. The Headwork's was submitted October 2, 2017
and resubmitted January 22, 2017 as a requirement of the City's NPDES permit. Mercury
Minimization Plan was also, submitted January 22, 2017.
AUTHORIZATION TO CONSTRUCT
There was one Authorizations to Construct (A to C) issued.
Siemens Energy on May 11, 20J 7 for Nitric Acid Stem Drilling.
RJR Tobaccoville has completed installation of flow meter from 2016 A to C.
SPECIAL SIU COMMENTS
There were no special SIU comments.
SIGNIFICANT NON-COMPLIANCE (SNC)
There were no SIU's in SNC.
0

SIGNIFICANT INDUSTRIAL USER INFORMATION
The beginning of January 2017, the City's outside laboratory changed During the change
it was noticed higher results for Mercury were being submitted to the City's laboratory
These results became questionable Industries that were affected by the laboratory change
and had questionable Mercury results are as follows -
Hanes Dye and Finishing #1155
• HOH #1998
• Ingredion #1191
• Lantal #3102
• Liquid Environmental Solutions #2020
• Rockwell Collins #1037
• Siemens Energy #3026
• Sonoco Display and Packaging #1042
• Superior #3101
• UniFirst #2015
• WestRock 93041
The following SIU's had a change in Authorized Representative for report monitoring and
submittal:
• Deer -Hitachi #2014
• Ingredion 91191
• Hanes Dye and Finishing #1155
• Progress Rail #1038
The City of Winston Salem's Pretreatment Program had one S1U submit proper
documentation for ceasing all processing waste into the collection system to the POTW.
On December 2, 2017 HP Fabrics Pen -nit #3050 submitted their final report. Operations at HP
Fabric ceased on November 29, 2017 Closing inspection was performed by the City of
Winston-Salem's Industrial Waste Control on November 30, 2017. Division of Water Quality
was notified on Decemberl 1, 2017
5

Pre
ireatmet PrQgram nfoatabae printed on: 12/18/2017
for Program Name Winston-Salem*"�"```� IWC % at 7Q10 5 54
r , r1k%OHg,A-�
WWTP Name Muddy Creek
357 88
Program Approval Date 06/15/1983 7Q10 F�ow cfs /mgd 554 /
1Q10 Flow cfs / mgd 44682 / 28878
Pretreatment Status Full Stream Classification WS -IV
Region WSRO Basin Number YAD04
County Forsyth Receiving Stream Name YADKIN RIVER
NPDES Number NCO050342
NPDES Effective Date 09/01/2017
Last PAR Rec 03/01/2017
PAR Due Date 03/01/2018
mercury
NPDES Expire Date 06/30/2022
Current Fiscal
Year PCI Done
1631
required
POTW is Primary WWTP FALSE
Last Audit on 09/16/2013
Audit Year Next 17/18
es
Design Flow mgd 21 0000 % Design mgd is SIU permitted F79-9-6-1
Permitted SIU flow (mgd) [Pt SIU) 091
WWTP SIU's
WWTP CIU's
7
Program SIUs
11
Ai LTMP
IWS
'�
PT Pro
Attended
Attended
Program ClUs
A'
SUO
IERP�
DAD \A/Lem-
date Inactive Date Next Due
07/01/2021
r
Date Received by DWR
10/0212017 08/29/2014
07/01/2016 01/13/2012
03/14/2012
Date Approved
11/06/2012 10/27/2014
09/02/2016
02/09/2012 104/18/2012
Adopt Date Required
Ms Cheryl Tilley 1 11(336) 397-7620 1 1336-659-4320 4/12/2007 2/4/2004
Date Adopted
11/14/2011
Info In this Box from Pt Contacts
Date
Date
Date
PT Pro
Attended
Attended
Attended
Formal Name q Prime Phone1
ext Fax HWA Wksn
II ID \AAIr
DAD \A/Lem-
Mr Joel Freeman
1Pnrn (336)-397-7621 336-659-4320 1/30/2008 1 6/11/20121/24/2012
joelf@cityofws org SeniorChemist/IWC 12799 Griffith Road 27103
Ms Cheryl Tilley 1 11(336) 397-7620 1 1336-659-4320 4/12/2007 2/4/2004
Pretreatment R
NOVs from
DWR Central Office Contact Imonti Hassan
DWR Regional Contact Pim Gonsiewski

re re tme t Prog
ram 111foT�i� #t Obo- a printed on: 12/18/2017
for Program Name Winston-Salem
W
IWC % at 7Q10 75.59
WWTP Name Archie Elledge =e �°
Program Approval Date 06/15/1983
7Q 0 ow cfs /mgd 15 / 9.69
Pretreatment Status1 Q10 Flow cfs / mgd 12.41 / 8.02
Full Stream Classification C
Region WSRO Basin Number YAD04
County Forsyth Receiving Stream Name SALEM CREEK
NPDES Number NCO037834
NPDES Effective Date 08/01/2017 Last PAR Rec 03/01/2017 PAR Due Date 03/01/2018 mercury Current Fiscal Iasi
NPDES Expire Date 06/30/2022 Year PCI Done required
POTW is Primary WWTP TRUE Last Audit on 09/16/2013 Audit Year Next 17/18 es
Design Flow mgd 30.0000 % Design mgd is SIU permitted 10.12 Permitted SIU flow (mgd) [Pt SIU) 036
WWTP SIU'sB program SIUs 8 A.,
r'a"'ct cr
WWTP CIUs Program CIUs ` ry
9 W LTMP TM 11Ng SUpp°-{
11
date Inactive Date Next Due - 07/01/2021
Date Received by DWR 10/02/2017 108/29/20_14 07_/01/2016 01/13/2012 ! 03/14/2012
Date Approved : 11/06/2012 i 1 10/27/2014 -! 09/02/2016- 02/09/2012- 04/18/2012
Adopt Date Required
Date Adopted 11/14/2011
Info in this Box from Pt Contacts Date Date Date
PT Pro Attended Attended Attended
Formal Name a.Prime Phone1 ext Fax Hwe wleomn 11 101AA— MAMMA—
Mr. Joel Freeman Prim (336)-397-7621 336-659-4320 1/30/20086/11/2012 1/24/2012
[e-mail] SeniorChemist/IWC 2799 Griffith Road 127103
Ms. Cheryl Tilley 1 11(336) 397-7620 36-659-4320 4/12/2007 2/4/2004
Related NO Vs from
DWR Central Office Contact JMonti Hassan
DWR Regional Contact Pim Gonsiewski

Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1 Pretreatment Town Name: City of Winston-Salem
2 'Primary" NPDES Number NC00 37834
or Non—Discharge Permit # if applicable =>
3 PAR begin Date, please enter 01/01/yy
4 PAR end Date, please enter 12/31/yy
5 Total number of SIUs, includes CIUs
6. Number of CIUs
7. Number of SIUs with no IUP, or with an expired IUP
8 Number of SIUs not inspected by POTW
9. Number of SIUs not sampled by POTW
10. Number of SIUs in SNC due to IUP Limit violations
11 Number of SIUs in SNC due to Reporting violations
12 Number of SIUs in SNC due to violation of a compliance schedule, CO, AO or similar
13 Number of CIUs in SNC
14. Number of SIUs included in public notice
15 Total number of SIUs on a compliance schedule, CO, AO or similar
16 Number of NOVs, NNCs or similar assesed to SIUs
17 Number of Civil Penalties assessed to SIUs
18 Number of Criminal Penalties assessed to SIUs
19 Total Amount of Civil Penalties Collected 19 =>
20 Number of IUs from which penalties collected
AO Administrative Order
CIU Categorical Industrial User
CO Consent Order
W Industrial User
revised 1/2018 PAR—PPS-2018
IUP Industrial User Pretreatment Permit
NNC Notice of Non -Compliance
NOV Notice of Violation
PAR Pretreatment Annual Report
3 => 1/1/2017
4 => 12/31/2017
5 =>
28
6 =>
12
7 =>
0
8 =>
0
9. =>
0
10. =>
0
11 =>
0
12 =>
0
13 =>
0
14 =>
0
15 =>
0
16. =>
32
17 =>
0
18 =>
0
$
0
20. =>
0
POTW Publicly Owned Treatment Works
SIU Significant Industrial User
SNC Significant Non-CompLance

Pretreatment Annual Report (PAR)
Significant Non -Compliance Report (SNCR)
WWTP = Wastewater Treatment Plant, use separate form for each WWTP.
SIU = Significant Industrial User
SNC = Significant Non -Compliance
PAR covers this calendar year => 2017
Control Authority=Program=Town Name => City of Winston-Salem
WWTP Name => Archie Elledge
NPDES # => NCO037834
A SNCR Form must be submitted with every PAR- nlence write "Alnno " if vnn hart _XTn QTT To ;- QAT!` A,, -:--
SNC?
,,-:—
IUP
#
Pipe
#
Industry Name
None
Parameter
or "Reporting"
SNC? ( Yes / No)
for each 6 -month period.
Jan. - June
July - Dec.
A u.__7-
_r•n
11.LG1V11 u ..vYy „� nuc Livi�tt�ii JluS 111 aINC rustoricai Kepor[" tor your Fol W's S1Us behind this page.
Is the database correct ? Notify the Division of any errors ! Database indicates SNC history for previous years.
EVERY SNC MUST be explained in the Narrative, How was, is, or will it be resolved?
REPEAT SNCs are serious matters that MUST be explained in the Narrative.
Form name PAR SNCR,2001
Date Revised 1/4/2001

Pretreatment Annual Report (PAR)
Significant Non -Compliance Report (SNCR)
WWTP = Wastewater Treatment Plant, use separate form for each WWTP.
SIU = Significant Industrial User
SNC = Significant Non -Compliance
PAR covers this calendar year => 2017
Control Authority=Program=Town Name => City of Winston-Salem
WWTP Name => Muddy Creek
NPDES # _> NCO050342
A SNCR Form must be submitted with every PAR, please write "None " if you had Nn qTT Tc in CNC rltirina ralPnrlar vPar
IUP
#
Pipe
#
Industry Name
None
Parameter
or "Reporting"
SNC? ( Yes / No)
for each 6 -month period.
Jan. - June
July - Dec.
riudL;ii d Uupy Vi lne ijrvision s ;anus in aiNL Historical Keport" for your POTW's SIUs behind this page .
Is the database correct ? Notify the Division of any errors ! Database indicates SNC history for previous years.
EVERY SNC MUST be explained in the Narrative, How was, is, or will it be resolved?
REPEAT SNCs are serious matters that MUST be explained in the Narrative.
Fonn name PAR,SNCR,2001
Date Revised 1/4/2001

REPORT
2010 2011 2012 2013 2014 2015 2016
1st half 12nd half 1st half 2nd half 1st half 12nd half 1st half 2nd half 1st half l 2nd half 1st half 1 2nd half 1st half i 2nd half
Sonoco Display & Packaging PreviousNames Sonoco CorrFlex, LLC
IUP # 1042 Pipe # 01 CorrFlex Display SIU Word Description
IUP Status. Active Chesapeak Display & Pack paper, corrugated displays, packaging
Reporting I X1
Grass America Inc. PrevlousNames
IUP # 2103 Pipe # 01 i SIU Word Description
metals
IUP_Status Active
Cyanide I Ix
Highland Industries Inc.
IUP # 2010
IUP Status: Active
PrevlousNames
Pipe # 01
EPA 624
slU Word Description
textile
IX IX
HOH Corporation
PrevlousNames
IUP # 1998
Pipe # 01
SIU Word Description
CWT-ww/sludge trtmt
IUP Status: Active
Arsenic
X I
Titanium
X I X
Zinc
IX
Johnson Controls Battery Group PrevlousNames
IUP # 1044
Pipe # 01
SIU Word Description
metals, battery- 461 34C
IUP Status Active
Lead I IX
IX I
An'X' in a semi-annual period indicates snc for the period for the respective parameter.
PRINTED ON 12/18/2017
This information is compiled from many sources, and has not been verified.
PAGE 76
Contact the local pretreatment coordinator or state pretreatment staff if errors are noted.

hist '
§146
REPORT
Progress Rail
IUP # 1038 Pipe # 01
IUP—Status Active
Reporting
Zinc
P�ViousNames
CATERPILLAR, INC
SIU Word Description
metals
XI I
X�
An W in a semi-annual period indicates snc for the period for the respective parameter.
PRINTED ON 12/18/2017 This Information is c�mpiled from many sources, and has not been verified.
Contact the local pretreatment coordinator or state pretreatment staff if errors are noted.
PAGE 77

Permit
Number
Industrial User
SIU Status
Inspection Date
Elledge WWTP
2019
Adele Knits
> 25,000, Potential to Impact
August 17,2017
3010
2018
ArdaghGroup
Bekaert
465 Coil Coating
> 25,000, Potential to Impact
August 16, 2017
August 29,2017
3100
Crothall Laundry
> 25,000, Potential to Impact
August 31,2017
2014
Deere -Hitachi
433 Metal Finishing
August 3,2017
2103
Grass America
433 Metal Finishing
August 8,2017
1155
Hanes Dye and
Finishing
> 25,000, Potential to Impact
August 23,2017
2001
Herbalife
>25,0000
July 11,2017
2010
Highland Indsutries
> 25,000, Potential to Impact
July 17, 2017
1998
HOH
437 Centralized Waste — Existing
July 19, 2017
3050
HP Fabrics
> 25,000, Potential to Impact
June 9, 2017
November 30, 2017
1191
Ingredion
> 25,000, Potential to Impact
June 12, 2017
1044
Johnson Controls
461 Battery Manufacturer
August 24, 2017
1154
Kaba Ilco
433 Metal Finishing
July 20, 2017
3102
2020
Lantal
Liquid
Environmental
Solutions
>25,000, Potential to Impact
403 Grease Waste
> 25,000, Potential to Impact
August 30, 2017
July 12, 2017
1036
Pepsi Bottling
> 25,000, Potential to Impact
August 1,2017
1038
Progress Rail
433 Metal Finishing
July 24, 2017
3001
RJR Tobaccoville
>25,000, Potential to Impact
May 24, 2017
3014
RJR Whitaker Park
>25,000, Potential to Impact
May 24,2017
1037
Rockwell Collins
433 Metal Finishing
August 22, 2017
3026
Siemens Energy
433 Metal Finishing
May 11, 2017
1042
Sonoco Display and
Packaging
>25,000, Potential to Impact
October 11, 2017
1152
Stratford Metals
433 Metal Finishing
July 27, 2017
1189
Suiza Dairy Group
>25,000 Potential to Impact
August 9, 2017
3101
Superior
Manufacturing
433 Metal Finishing
August 10, 2017
2015
UmFirst
>25,000 Potential to Impact
October 19,2017
3041
WestRock
>25,000, Potential to Impact
July 26, 2017

POTW=
NPDrS#=
IUP
C ount
2
3
4
5
6
7
8
9
10
12
13
I4
15
16
17
Workbook Name: WS.HWA.Muddy.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 1 of 6
IIIIVI LIVI I I QUIC
NI'DE5
Spreadsheet Instructions-
Design
21 0000
51316
80389
Headworks last approved11
/06/12
26000
t) Applicable Values should be entered o the
Heavy Bordered cells, Rest of
worksheet is protected, password is
3 6620
Allocation Table updated_
07/02/17
3 9580
„2"
2) Formulas
are discussed in the Comprehensive Guidance; Chapter 6 Section G
519%
-86 1 %
Permits last modified
07/01/17
-670%
3) HWA and
AT worksheets in this workbook are linked Pollutant
Names, MAHLs, Basis, and Uncontrollable load
4019
in this AT worksheet are alltoMatically entered from the HWA spreadsheet
This includes pollutant names in
columns AT
through BIC
Muddy
NCO050342
FLOW
CBOD
TSS
Industry
type
Renewal MOdlfleatlon
Date
Permit
I Imits
Permit ]units
Permit 1 units
INDUS I RY NAMI S
Permit
Pipe
of
1 ffective I.ffechve
Permit
Cone I oad
Cone I oad
(please I, sl aipi,abeuch)
number
number
Industry
Date Date
1 xpires
MGD
gal/day
mg/1 lbs/da)
mg/I lbs/day
Crothall Laundry
3100
0001
1 1 aund
07/01/17
06/30/22
0 1000
100 000
Lantal Textiles
3102
0001
1 'Textile
07/01/17
06/30/22
0 1650
165 000
2000 0 2752 20
RJR Iobaccoville
3001
0001
tobacco
07/01/17
06/30/22
07500
750 000
1500 0 9382 50
150000 9382 50
IZJR Whitaker Park
3014
0001
tobacco
07/01/17
06/30/22
1 0000
1 000 000
3500 0 2919000
4200 00 35028 00
Siemens Lner y
3026
0001
Metal
07/01/17
06/30/22
00200
20.000
Superior Manufacturing
3101
0001
Metal
07/01/17
06/30/22
00060
6 000
WestRock
3041
0001
Box
07/01/17
06/30/22
0 0500
50 000
3500 01 1459 50
350000 1459 50
Ards h Metal Bevcra&c USA
3010
0001
'Textile
07/01/17
06/30/22
02000
200 000
Bekaert
2018
0001
1 extilG
07/01/17
06/30/22
00750
75 000
achi
2014
0001
Metal
07/01/17
06/30/22
00100
10.000
erica
2103
0001
Metal
07/01/17
06/30/22
0,0030
3,000
2001
0001
Drink
07/01/'17
06/30/22
0.0670
67,000
10000 558 78
100000 558 78
Ibland
2010
0001
Textile
07/01/17
06/30/22
00160
16000
1191
0001
Starch
07/01/17
06/30/22
1 0000
1 000 000
3000 0 25020
150000 1251000
vironmental Solutions
2020
0001
Grease
07/01/17
06/30/22
0.0750
75 000
7500 0 4691
100000 625 50
Rai1
1038
0001
Meatal 1
07/01/17
06/30/22
0.0500
50,000
- 1 aulluiy I vflu iiii I vo/oulz/ I U.0/3U /SMU 2000 1251 UU
Column Totals > 1 3 66201 3 662 0001 1 74305 59564
Basis-->
MAI IL from IIWA (lbs/day)> NPDhS Permitted I low��
Uncontrollable I oadmg (lbs/day) >
I otal Allowable for Industry (MAIL) (Ibs/day) _>
Total Permitted to Industry (Ibs/day)
MAIL left (lb,;/day) >
Percent Allow Ind (MAIL) still available (%) >
Percent MAI 11, still available (%) >
5 Percent MAIIL, (Ibs/day) >
NI'DE5
Design
Design
21 0000
51316
80389
13 3800
11382
26000
76200
39934
54389
3 6620
74305
59564
3 9580
-34371
-5175
519%
-86 1 %
-95 %
18 8 %
-670%
-64%
1 0500
2566
4019
HWA AT
Revised November2005

NPDES#=
IUP
C punt
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
Workbook Name: WS.HWA.Muddy.2017, Worksheet Name: AT Printed 2/9/2018, 2'11 PM
Page 2 of 6
Allocation Table
Headworks last approved11/06/12
v ww v v2 i Y
1 UUUU 062551
Column I otals =>
0
0 0000
00701
1 2951
Allocation Table updated,
07/02/17
13asiS=>
Design
Digester
Digester
Act
Sludge
Digester
Digester
MAI It. from HWA (lbs/day) =>>
6655 32
3 6918
Permits last modified
07/01/17
48 2944
6 0193
Uncontrollable Loading (lbs/da}') =>—
0 3571
0 0781
0 1562
3 7382
02901
I otal Allowable for Industry (MA[I) (lbs/day) =�>4345
Muddy
3 3348
30 9168
64 4827
44 5562
5 7292
Total Pernitted to Industry' (lbs/day) =>
0 00
0 0000
0 0701
1 2951
3 3860
NCO050342
MALI left (lbs/da)) _�
43 45 42
3 3348
108468
63 1875
41 1701
5 0832
Percent Allow Ind (MA[I_) still available (%) _>
100 0%
99 8 %
98 0 %
9240%
ON
Ammonia Arsenic
Cadmium
Chromium
Copper
97 8 %
Cyanide
844%
MO3
Industry
Permit 1 emits Permit I units
Permit
Limits
Permit
I emits
Permit
Limits
Permit
Limits
INDUS IRY NAMI S
Permit
Pipe
Cone Load Conc I odd
Colic
I oad
Conc
I odd
Cone
I oad
Cone
Load
(picavc i'si aiphab'cd')
number
number
mg/I lbs/day mg/1 lbs/day
mg/1
lbs/dav
mg/I
lbs/day
mg/1
lbs/day
mg/1
lbs/day
Crothall I aundry
3100
0001
I antal -1 ertilcs
3102
0001
RJR "1 obdccovillc
3001
0001
RJIZ Whitaker Park
3014
0001
Siemens Energy
3026
0001
00700
0 0117
1 7100
02852
20700
0 3453
06500
0 1084
Superior Manufacturing
3101
0001
00500
0 0025
0 50001
0 0250
0 5000
0 0250
0 6500
0 0325
WestRock
3041
0001
2 5000
1 0425
1 0000
0 4170
Arda h Metal Beverage USA
3010
0001
0 15001
0 2502
0 0500
0 0834
Bekaert
2018
0001
05000
0 3128
Deere-Ihtaclu
2014
0001 1
005001
00042
02500
0 0209
1 0000
00834
00500
00042
Grass America
2103
0001
0 0250
00006
0 0300
0 0008
0 2000
000501
00200
0 0005
Herbal ifc
2001
0001
i Mand
2010
0001
In redion
1191
0001
Li uid Environmental Solutions
2020
0001
ro ess Rail
1038
0001
0 0700
0 0292
1 7100
0 7131
2 0700
0 8632
020001
00834
7mFtret
�n t c
nnn
-
v ww v v2 i Y
1 UUUU 062551
Column I otals =>
0
0 0000
00701
1 2951
1 3 38601
1 064601
13asiS=>
Design
Digester
Digester
Act
Sludge
Digester
Digester
MAI It. from HWA (lbs/day) =>>
6655 32
3 6918
309949
64 6389
48 2944
6 0193
Uncontrollable Loading (lbs/da}') =>—
0 3571
0 0781
0 1562
3 7382
02901
I otal Allowable for Industry (MA[I) (lbs/day) =�>4345
42
3 3348
30 9168
64 4827
44 5562
5 7292
Total Pernitted to Industry' (lbs/day) =>
0 00
0 0000
0 0701
1 2951
3 3860
06460
MALI left (lbs/da)) _�
43 45 42
3 3348
108468
63 1875
41 1701
5 0832
Percent Allow Ind (MA[I_) still available (%) _>
100 0%
99 8 %
98 0 %
9240%
ON
Percent MAIIL still available (%) _�
L33
903 %
99 5 %
97 8 %
85 2 %
844%
MO3
5 Percent MAI IL (lbs/dd)) =>
0 1846
15497
3 2319
2 4147
HWA AT
Revised, N overn ber 2005

POTW
NPDES*
IUP
Count
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
Workbook Name: WS.HWA.Muddy.2017, Worksheet Name: AT
Allocation Table
Printed 2/9/2018, 2 11 PM
Page 3 of 6
Headworks last approved
11/06/12
1 v vvvvvvl
1 V VVuul
I U 4Y141
L00000
J
Basis >
Stream
Std
Act Sludge
Nitrification
Allocation Table updated
07/02/17
28 6568
13 306933
=20% Flow from South Fork
13 1434
26 7628
Uncontrollable Loading (lbs/day) —>
03794
0 003348
Permits last modified
07/01/17
05468
1 otal Allowable for Industry (MAIL) (lbsiday) —>
28 2773
13 303586
12 8421
262160
Total Permitted to Industry (lbs/day) —>
1 8269
> Muddy
00000
04924
00000
MAIL lett (lbs/day) _>
264505
13 303586
123497
262160
Percent Allow Ind (MAIL ) still available (%) —>
NCO050342
100 0 0/1
#######
96 2 %
100 0%
Percent MARL still available (%) _>
014312/8
100 0 %
#######
98 0 %
5 Percent MARL (lbs/day) _>
0 665347
Lead
Mercury
Molybdenum
Nickel
Sill
Industry
Permit Limits
Permit Limits
Permit Limits
Permit
L emits
�Selenium
Permit
INDUS] RY NAMES
Permit
Pipe
Cone
L oad
Cone I oad
Cone I oad
Cone
Load
oncoad
Cone
(p[—a fistaIphabnd,)
number
number
mg/1
lbs/day
m /I lbs/day
mg/1 lbs/day
mg/I
lbs/day
mg/1 lbs/day
mg/1
Crothall I aundry
3100
0001
Lantal -1 c\tiles
3102
0001
RJR Tobaccoville
3001
0001
RJR Whitaker Park
3014
0001
Siemens Energy
3026
0001
04300
00717
2 3800
0 3970
0240
Superior Manufacturing
3101
0001
00500
00025
05000
00250
00100
WestRock
3041
0001
Ardagb Metal Sever e USA
3010
0001
ekaert
2018
0001
Deere -Hitachi
2014
0001
0 1000
00083
04000
00334
00500
Grass America
2103
0001
00500
0 0013
1-4800
00370
00500
Herbalife
2001
0001
Mand
2010
0001
IRgredion
1191
0001
Liquid Environmental Solutions
2020
0001
Pro ass Rad 1
1038
0001
04300
0 1793
niFirst 2015
0001
2500-0-
1 5638
1
1
0 2400
HWA AT
Revised November 2005
I 'i
1 v vvvvvvl
1 V VVuul
I U 4Y141
L00000
J
Basis >
Stream
Std
Act Sludge
Nitrification
Stream
Std
MARL from HWA (lbs/day) =>
28 6568
13 306933
13 1434
26 7628
Uncontrollable Loading (lbs/day) —>
03794
0 003348
0 1 1 I6
0 3013
05468
1 otal Allowable for Industry (MAIL) (lbsiday) —>
28 2773
13 303586
12 8421
262160
Total Permitted to Industry (lbs/day) —>
1 8269
0 000000
00000
04924
00000
MAIL lett (lbs/day) _>
264505
13 303586
123497
262160
Percent Allow Ind (MAIL ) still available (%) —>
93
100 0 0/1
#######
96 2 %
100 0%
Percent MARL still available (%) _>
014312/8
100 0 %
#######
98 0 %
5 Percent MARL (lbs/day) _>
0 665347
0 65721
1 3381
HWA AT
Revised November 2005

POTW=
NPDES#—
IUP
Count
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Workbook Name: WS. HWA.Muddy. 2017, Worksheet Name: AT Printed 2/9/2018, 2.11 PM
Page 4 of'6
Allocation Table
Headworks last approved
Allocation Table updated
Permits last modified
Muddy
NCO050342
INDUS I RY NAM] S
iPic,se iisi aiPhabeticw
11/06/12
07/02/17
07/01/17
Industry
Permit
number
Pipe
number
ver
I emits
Load,
lbs/day
Crothall Laundry
3100
0001
99 5
I antal I extiles
3102
0001
RJR Iobaccoville
3001
0001
RJR Whitaker Park
3014
0001
Siemens Lnergy
3026
0001
1 0 0400
Superior Manufacturing
3101
0001
1 0 0005
WestRock
3041
0001
Ardalgh Metal Beverage USA
3010
0001
ekaert
2018
0001
eere-Hitachi
2014
0001
00042
Grass America
2103
0001
0 0013
crbahfe
2001
0001
M Mand
2010
0001
-fn&redion
1191
0001
Liquid Environmental Solutions
2020
0001
Progress Rail
1038
0001
0 1001
aiFu-st
2015
0001
Column Iotals-> 1 0 1460
Basis=>
MAHL from IIWA (lbs%day) —>
Uncontrollable I oadmg (lbs/day)
1 btal Allowable for Industry (MALL) (lbs/day) >
notal Permitted to Industry (lbs/day)=>
MAID lett (lbs/day) ->
Percent Allow Ind (MAIL) still available (%) >
Percent MAI IL still available (°io) —>
5 Percent MAID, (lbs/day) _>
Digester
269966
0 1116
268850
0 1460
26 7390
99 5
990%
13498
HWA AT
Revised November 2005

POTW=
NPDES#=
IUP
Count
2
3
4
5
6
7
8
9
12
13
14
'15
16
17
Workbook Name: WS.HWA.Muddy.2017, Worksheet Name: AT Printed 2/9/2018, 2,11 PM
Page 5 of 6
Allocation'Table
Headworks last approved
11/06/12
#REFI
#REF'
#REFI
#REF'
Allocation Table updated
07/02/17
475 2626
#RFF1
#RII I
#RI Li
#RLFi
#RI Fi
27 7522
#RI F I
Permits last modified
07/01/17
#RLFi
#RLFI
4475104
#RLFi
#RF 1 i
#RLL"
#RLFi
#Ri H
Muddy
00-0
0 00
00000
00000
00000
410 6724
#Rl 1 I
#RFs i
#RFI i
NCO050342
#RI l i
91 8 %
#RI Fi
#RFI i
#RFI I
#RLFI
# R I I'
864%
#RI FT
#REF i
#RI I i
#RFLi
Zinc
#REF!
#REF!
#REF!
#REF!
#REF!
#RFI
industry
Permit Limits
Permit I emits
Permit Limits
Permit I emits
Permit 1 units
Permit Limits
INDUS I RY NAMES
Permit
Pipe
Cone
I oad
Conc Load
Cone Load
Cone I oad
Cone I oad
Cone I oad
iPi,aschstalpliae,t,ahi
number
number
mg/I
lbs/day
mg/l lbs/day
mg/I lbs/day
mg/l lbs/day
mg/I lbs/day
mg/I lbs/day
Crothall I aundry
3100
0001
Lantal fertiles
3102
0001
RJR Fobaccoville
3001
0001
1 5000
9 3825
RJR Whitaker Park
3014
0001
1 0000
8 3400
Siemens Energy
3026
0001
1 4800
02469
Superior Manufacturing
3101
0001
1 4800
0 0741
WestRock
3041
0001
1 0000
04170
Arda h Metal Bevcra e USA
3010
0001
05000
0 8340
Bekaert
2018
0001
15000
0 9383
Deere -Hitachi
2014
0001
14800
01234
Grass America
2103
0001
07500
0 0188
erbalife
2001
0001
2010
0001
1191
0001
1 7500
14 5950
R,nrcd�onand
d Environmental Solutions
2020
0001
ess Rail
1038
0001
1 4800
0 6172
—t
nic
nnni
Column I otals _>36 8380 0 00 0 00 0 0000 00000 0 0000
Basis=>
,MAI iLfrom IIWA (Ibs/day)-�>
Uncontrollable I oading (lbs/day) =>
l otal AllmNable for industry (MAIL ) (Ibs/day)F>
I otal Permitted to Industry (lbs/day) _>
MAiI left (Ibs/day)t>
Percent AlloNN Ind (MAI[ ) still available (%) >
Percent MAIL still available (%o) _>
5 Percent MAI II (lbs/day)
Nitrification
#REFI
#REF'
#REFI
#REF'
#REFI
475 2626
#RFF1
#RII I
#RI Li
#RLFi
#RI Fi
27 7522
#RI F I
#R[ I i
#RI Fi
#RLFi
#RLFI
4475104
#RLFi
#RF 1 i
#RLL"
#RLFi
#Ri H
36 8380
00-0
0 00
00000
00000
00000
410 6724
#Rl 1 I
#RFs i
#RFI i
#RI I�I
#RI l i
91 8 %
#RI Fi
#RFI i
#RFI I
#RLFI
# R I I'
864%
#RI FT
#REF i
#RI I i
#RFLi
#RI 1-1
23 7631
#RLFi
#REi i
#RF 1
#RLFi
#RFI
H WA AT
Revised.November 2005

Workbook Name: WS.HWA.Muddy.2017,, Worksheet Name: AT Printed 2/9/2018, 2'11 PM
Page 6 of 6
Allocation'Table
Headworks last approved 11/06/12
Allocation Table updated, 07/02/17
Permits fast modified 07/01/17
POTW-1 Nfuddy
NPDEs#=> NC0050342
1CP
Count
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
INDUS I RY NAM] S
iai— At aiph.k6d,>
Industry
Permit
number
Pipe
number
#REF!
Permit I imrts
Cone Load
mg/I lbs/day
#REF!
Permri Limits
Cone Load
mg/I lbs/day
#REF!
Permit Limit,,
Cone I oad
m /l lbs/da)
#REF!
Permit Limits
Conc I oad
mg/I lbs/day
Crothall Laundry
3100
0001
#RI 1-1
#)RCF'
#RFI I
#REI'
I antal l eatiles
3102
0001
#REF!
#RFFt
#RCF
00000
RJR I obac,covillc
3001
0001
#'RF I I
#RLI'I
#RF I I
RI 1
RJR Whitaker Park
3014
0001
#RLFl
#RFI
#RLF I
#RI 1
Siemens Energy
3026
0001
#RI I t
#RIaF
Superior Manufacturing
3101
0001
WestRock
3041
0001
Arda h Metal Beverage USA
3010
0001
ckaert
2018
0001
Gere -Hitachi
2014
0001
Grass America
2103
0001
Herbalife
2001
0001
i Mand
2010
0001
n redion
1191
0001
,i utd Environmental Solutions
ro ress Rail
mFirst
2020
1038
2015
0001
0001
0001
W000
Column I otals =>
00000
000001
00000
Basi,;—, >
MAUL from FIWA (Ibs/day)F-->
Uncontrollable Loading (lbs/day) _>
I otal Allowable for Industry (MAIL) (lbs/day) =>
7 otal Permitted to Industry (lbs/day) =>
MAIL left (lbs/da)) �>
Percent Allow Ind (MAIL ) still available (°l) -a>
Percent MAI 11 still available (%) j�>
5 Percent MAI (Ibs/day)�>
#REFI
#REFI
#FIEF!
#REFI
#RCE'f
#RFI I
#RI 1-1
#)RCF'
#RFI I
#REI'
#RI I"
#REF
#Rl'I I
#REF!
#RFFt
#RCF
00000
00000
00000
0 0000
#'RF I I
#RLI'I
#RF I I
RI 1
4RCF1
4REFI
#RI 1-1
#RLFl
#RFI
#RLF I
#RI 1
#RE I A
#REFSI
#RI I t
#RIaF
H WA AT
Revised -November 2005

POTW-
NPDESSF
IUP
Count
2
3
4
5
6
7
8
9
10
Il
12
13
14
15
16
17
18
19
20
21
22
Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed, 2/9/2018, 2-11 PM
Page 1 of 12
Allnrnfinn Tnhlo
Headworks last approved-
11/06%12
Spreadsheet Instructions
1) Applicable Values should be entered in the Heavy Bordered cells Rest of worksheet is protected password is
Allocation Table updated
07/07/17
2
2) Formulas
are discussed
m the Comprehensive Guidance, Chapter 6, Section C
Permits last modified
07/01/17
3) HWA and
ATworksheets in this workbook are linked Pollutant Names, MAHLs, Basis,
and UncontroTable load
in this AT worksheet are automatically
entered from the NWA
spreadsheet
This includes
pollutant names in
> Elledge
columns AT
through BK_
> NCO037834
FLOW
BOD
TSS
Industry
I ype
Renewal
Modification Date
Permit
I imils
Permit Limits
Permit I units
INDUS FRY NAMES
Permit Pipe
of
I ffective
I Yfective Permit
Cone I oad
Cone load
rpica,'hst alphibamh)
number number
Industy
Date
Date E\pires
MGD
gal/day
m /I lbs/day
rng/1 `lbs/day
Adele Kmus Inc
2019 1
r 777 e
07/01/17
06/30/22
0 15001
150,000
Ardagh tal Beverage USA
3010 1
Can
07/01/17
06/30/22
0 20001
200 000
Bekaert Deslee, USA
2018 1
f ext;le
07/01/17
06/30/22
007501
75 000
Deere -Vitae i
2014 1
Meta
07/01/]7
06/30/22
00100
10,000
Grass America
2103 1
Meta
07/01/17
06/30/22
00030
3 000
I lanes Dyc & Einishmg Co
1 155 1
1 esti e
07/01/17
06/30/22
03000
300 000
250000 6255 00
100 001 25020
I[e =ale
2001 1
Di in
07/01/17
06/30/22
0 0670
67 000
1000 00 5,58 78
100000 558 78
I lighland Indutries __7179_8
2010 l
Tex
07/01117
06/30/22
00160
16,000
110H
1
Waste
07/01/17
06/30/22
0 1000
100 000
500000 417000
111' Fabrics
3050 1
Icrti e
06/20/17
06/30/22
0 3500
350,000
200000 5838 00
1000 00 2919 00
Ingredion
1 1 1 1
Starch07/01/17
06/30/22
1 0000
1 000,000
300000 25020 00
1500 00 1251000
Johnson Battery
1=4 1
Battery
07/0]/17
06/30/22
00250
25,000
Kaba Ilco
54 1
Meta
07/01/17
06/30/22
00400
40 000
LiquidEnvironmental Solutions
202 1
reale
07/01/17
06/30/22
0 0750
75,000
7500-0 0 4691 25
1000 00 625 50
Pepsi Bottling Ventues
1036- 1
Drin
07/01/17
06/30/22
0 1750
175 000
600000 8757 00
Progress Rai
10 1
Meta
07/01/17
06/30/22
00500
50 000
Rockwell Collins
037 1
Meta
07/01/] 7
06/30/22
00200
20,000
Sonco Display and Packaging
1 1
Boa
07/01/17
06/30/22
00300
30 000
200001 500 40
2000 00 50040
Stratford Metals
1152 1
Meta
07/01/17
06/30/22
00250
25 000
Suva Dairy Group
1189 1
1 Dairy
07/01/17
06/30/22 1
025001
250 000
5000 00 10425 00
2000 00 4170 00
UnFirst
15 1
Faun ry
07/01/17
06/30/22
007501
75,000
200000 1251 00
VVIJUILL
Column T Dials —> 3 03601 3 036.0001 67466 1 21534
Basis > NPDF'S Design Design
MAI` If from H\VA (lbs/day) —> NPD1 S Permitted How--> 300000 142364 132856
Uncontrollable Loading (lbs/day) - > 167600 35224 43471
Total Allomable for Industry (MAII ) (lbs/day) _> 13 2400 107140 89385
Fotal Permitted to Industry (lbs/day) --> 3 0360 67466 21534
HWA AT
Revlsed'December 2017

Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT
MAIL left (lbs/day) =>
Percent Allow Ind (MAIL) still available (%) =>
Percent MAHL still available (%) =>
5 Percent MAHL (lbs/dav) =>
HWA AT
Revised December 2017
1020401
771%1
340%
I 1 50001
Printed 2/9/2018, 2 11 PM
Page 2 of 12
39673 67851
370% 759%
279% 511%
7118 6643

POTW=
NPDES#=
IUI'
Count
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
18
19
20
21
22
Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 3 of 12
Allocation Table
Headworks last approved
11/06/12
Allocation Table updated
07/07/17
80% Flow from South Fork
Permits last modified
07/01/17
Elledge
NCO037834
Ammonia Arsenic
Cadmium
Chromium
Copper
Cyanide
industry
Permit Limits Permit I imit5
Permit
Limits
Permit
Limits
Permit
Limits
Permit
I units
INDUS fRY NAMI S
Permit Pipe
Cone Load Cone Load
Cone
I oad
Cone
i oad
Cone
I oad
Conc
I oad
uricase list alpbabcocw
number number
mg/1 lbs/day mg/I lbs/day
mg/1
lbs/day
mg/I
lbs/day
mg/1
lbs/day
mg/I
lbs/day
Adele Kraits Inc
2019 1
Ardagh Metal Beverage USA
3010 1
0 1500
02502
00500
00834
Bekaert Deslee, USA
2018 1
05000
03128
Deere -Hitachi
2014 l
005001
00042
0 2500
0 0209
1 0000
0 0834
0 0500
00042
Grass America
2103 1
002501
00006
0 0300
0 0008
02000
00050
0 0200
0 0005
Manes Dye & Finishing Co
1 155 1
Herbalife
2001 1
Highland Indutries
2010 1
11011
1 98 1
0 1040 00867
0 0960
00801
04870
04062
0 3010
02510
00200
00167
I iP I abrics
3050 1
1 7100
49915
05000
1 4595
Ingredion
1 1 1
lohnson Battery
144 1
05000
0 1043
Kaba Ilco
1 154 1
00250
00083
1 6720
0 5578
2 0240
06752
06360
02122
Liquid Environmental Solutions
2020 1
Pepsi Bottling Ventues
1036 1
—7173-8
Progress Rat
1
00700
00292
1 7100
0 7131
20700
08632
Rockwell Collins
037 1
—7-0
0 0250
00042
1 7100
0 2852
20700
0 3453
0 0200
0 0033
Sonco Display and Packagmg
=2 1
05000
0 1251
Stratford Metals
152 1
00700
00146
1 7100
03565
20700
04316
0 4316
00900
Suiza Dairy Group
1189— 1
UnFtrst
2015 1 1
0 0350
002191
1 00001
62551
062551
0 3913
Column I otals —> 0 008671 0 1630 1 7 5821 5 3652j 0 7181
Stream Stream Stream Stream Stream
B asi S—> Design Std Std Std Std Std
MAI [L from i IWA (lbs/day) —> 9757 801 3 98351 0 8764 13 3889 30 6259 N07
7
Uncontrollable Loading (lbs/day) _> 3186 95 0 3075 0 1 1 18 0 9505 5 2836 6Iotal Allowable for Industry (MAIL) (lbs/day) => 6570 85 3 6760 07645 12 4385 25 3423 1
1 otal Permitted to Industry (lbs/day) _> 0 00 00867 0 1630 7 58215 3652 1
HWA AT
Revised December 2017

Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 4 of 12
MAIL left (lbs/day) => 657085 35892 06015 48564 199771 25640
Percent Allow Ind (MAIL) still available (%) => 1000% 976% 787% 390% 78 8% 78.1 %
Percent MARL still available (%) => 673% 901 % 686% 363% 65.2% 726%
5 Percent MARL, (lbs/day) => 48789 0 1992 00438 06694 15313 0 1767
HWA AT
Revised December 2017

POTW
NPDES#
IUP
Coun
2
3
4
5
6
7
8
9
10
11
'12
13
14
15
16
17
18
19
20
21
22
Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 5 of 12
Allocation Table
Headworks last approved
11/06/12
Allocation Table updated
07/07/17
1
Permits last modified
07/01/17
Pledge
> NCO037834
Lead
Mercury
Molybdenum
Nickel
Selenium
Sil
Industry
Permit Limits
Permit Limits
Permit I tmits
Permit
I imits
Permit Limits
Permit
INDUS I RY NAMES
Permit Pipe
Cone
I odd
Cone Load
Cone Load
Cone
l odd
Conc L oad
Cone
(plwsc hst aiphabmmw
number number
mg/I
lbs/day
m /I lbs/day
mg/I lbs/day
mg/I
lbs/day
mg/I lbs/day
mg/1
Adele Kinits Inc
2019 1
Ardagh Metal Beverage USA
3010 1
Bekaert Deslee, USA
2018 1
Deere-tfitac i
2014 1
0 1000
00083
04000
0 0334
00500
Grass America
2103 1
00500
00013
1 4800
(To —,-7 o
0 0500
Manes Dye & I inishmg Co,
1155 1
Her alt e
2001 1
ndutnes
2010 1
19 8 1
0 1720
0, 1434
000074 0 00062
1 4500
1 2093
0 0350
P
3050 1
00500
0 1460
0 00075 000219
0 1000 02919
0 0100
1 1ttery
104 1
0 5980
0 1247
Kaba Ilco
1 154 1
00500
001670
3280
07766
0 0100
Liquid Environmental Solutions
2020 1
Pepsi Bottling Ventues
1036 1
Progress Rat
1 8 1
04300
0 1793
2 3800
09925
02400
Rockwell Collins
1037 1
00500
00083
20000
033361
0 0100
Sonco Display and Packaging
1 1
Stratford ,Metals
115 1
04300
00897
2 3800
04962
02400
Group
1 j 1
EsnFustDairy
2015 1
2 5000
1 56388
4 LolY I v w/auol I U zViq J NY86 0 0000
Stream Sludge Stream Stream
Basis > Std Stream Std Ceiling Std Std
MAIM from FIWA (lbs/da})�> 5 40621 0 006573 199370 A9443 2 1909
Uncontiollable I oading (lbs/day,) �> 1 0064 0004193 0 5032 1otal Allowable for Industry (MAII ) (lbs/day) > 4 3998 0 002379 19 4338 I otdI Pennitted to Industry (lbs/day) >0 002806 0291 0 0000
HWA AT
Revised December 2017

Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 6 of 12
MAIL left (lbs/day) => 2 1184 -0000427 19 1419 49500 2 1769
Percent Allow Ind (MAIL) still available (%) => 481 % -179% 985 % 561 % 1000%
Percent MAHL still available (%) => 392% -65% 960% 524% 994%
5 Percent MARL (lbs/day) => 02703 0000329 09968 04722 0 1095
HWA AT
Revised December 2017

POTW
NPDES#
1UP
Count
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
18
19
20
21
22
Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed: 2/9/2018, 2 11 PM
Page 7 of 12
Allocation Table
Headworks last approved
Allocation Table updated
Permits last modified
Elledge
> NCO037834
INDUS I RY NAMI S
(Pl'-1.st aIPhnbnd')
Adele Kinits Inc
11/06/12
07/07/17
07/01/17
Industr)
Permit Pipe
number number
2019 1
ver
Limits
I oad
lbs/day
�Ardagh Metal Beverage USA
3010 1
Bekaert Deslee, USA
2018 1
Deere -Hitachi
2014 1
00042
rass America
2103 1
0 0013
I lanes Dye & Finishing Co
1 155 1
Herbalife
2001 1
fig land Indutnes
2010 1
]1 11
1998 1
0 0292
11 1 abrics
3 =5 1
0 0292
ngredton
1 191 1
Johnson Battery
104 1
Kaba Ilco
54 1
0 0033
Liquid Environmental Solutions
2020 1
Pepsi Bottling Ventues
—77730--1
Progress Rai
8 1
0 1001
Rockwell Collins
1737 l
00017
Sonco Display and Packaging
1042 1
Stratford Metals
1152 1
0 0500
Sura Dairy Group
] ] g9 ]
UnFtrst
2015 I
Column Fotals t> 0 2189
HWA AT
Revised December 2017
Stream
Basis >
Std
MAI 11 from I IWA (Ibs%da)) >
0 0526
Uncontrollable Loading (lbs/da))
1 0 1398
Iota] Allowable for Industry (MAIL) (lbs7da)) —>
-0 0872
Total Permitted to Industry (lbs/da)) >
02189
HWA AT
Revised December 2017

Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 8 of 12
MAIL left (lbs/day) => -03061
Percent Allow Ind (MAIL) still available (%) => 3511 %
Percent MARL still available (%) => -5822%
5 Percent MAHL (lbs/day) => 00026
HWA AT
Revised December 2017

POTW=
NPDES#=
IUP
Count
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
18
19
20
21
22
Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 9 of 12
Allocation Table
Headworks last approved-
11/06/12
Allocation Table updated,
07/07/17
Permits last modified
07/01/17
Elledge
NCO037834
Zinc
Fluoride
#REF!
#REF!
#REF!
#REF!
Industry
Permit 1 imits
Permit Limits
Permit Limits
Permit I emits
Permit I imrts
Pcrmit Limits
INDUS I RY NAMI S
Permit Pipe
Cone
I oad
Cone Load
Conc I oad
Cone Load
Cone I oad
Cone 1 oad
inic—Im aiph.bLucili
number number
mg/1
lbs/day
mg/I lbs/day
mg/I lbs/day
m /I Ibstday
mg/1 lbs/day
mg/1 Ib�/day
Adele Kmits, Inc
2019 l
Ardagh Metal Beverage USA
3010 1
05000
0 8340
2620 43 70
Bekaert Deslee, USA
2018 1
1 5000
0 9383
Deere-Httac t
2014 1
1 4800
0 1234
Grass America
2103 1
0 7500
0 0188
1lanes Dye & 1 mishmg Co
1 155 ]
Herbalife
2001 1
1 lighland Indutnes
2010 1
HOI I
1998 1
06410
0 5346
IIP Uabrics
3050 1
0 5000
1 4595
Ingredion
1 191 1
1 7500
14 5950
Johnson Battery
1044 1
Kaba Ilco
1154
1 4470
048271
Liquid Environmental Solutions
2020
Pepsi Bottling Ventues
1036 1
Progress Rai
713 8 1
1 4800
06172
Rockwell Collins
1037 1
1 4800
02469
Sonco Display and Packaging
l 1
Stratford Metals
E52 1
1 4800
03086
Suiza Dairy Group
1
UnFirst
2 1
2 0000
1 2510
Column 1 otals => 1 1 21 4099 1 43 70 1 000 1 000001 00000 1 000001
Act, Stream
Basis=> Sludge Std #REFI #REFI #REFI #REFI
MAIII from I IWA (lbs/day) —> 219 80481 #RI I I #RI I"I #RI 1 I E#RRLIUncontrollable Loadmg (lbs/day) �> 41 0250 51 4524 #RI 1 I #SRI 1'I #RI Pi Iotal Allowable for Industry (MAIL) (lbs/day) �> 178 7798 95974 #RF 1 I #RLI I #RLFI I oral Permitted to Industry (lbs/day) => 21 4099 43 70 000 0 0000 00000 0
HWA AT
Revised December 2017

Workbook Name: WS.HWA.EIIedge.2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 10 of 12
MAIL left (lbs/day) => 1573700 91604 #REF1 #REF1 #REF1 #REFI
Percent Allow Ind (MAIL) still available (%) => 880% 954%- #REF1 #REF1 #REF1 #REF1
Percent MAHL still available (%) => 716% 906% #REF1 #REF1 #REF1 #REF?
5 Percent MAHL (lbs/day) => 109902 5056 #REFI #REF1 #REF? #REF1
HWA AT
Revised December 2017

POTW
NPDES#
IUP
Count
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
18
19
20
21
22
Workbook Name: WS. HWA.EIledge. 2017, Worksheet Name: AT Printed 2/9/2018, 2 11 PM
Page 11 of 12
Allocation Table
Headworks last approved
Allocation Table updated
Permits last modified
> Elledge
> NCO037834
INDUS FRY NAMLS
(Pl—Iistalphabctia)
Adele Kraits Inc
11/06/12
07/07/17
07/01/17
Industry
Permit Pipe
number number
2019 1
#REF!
Permit I emits
Cone Load
mg/I lbs/day
#REF!
Permit 1 units
Conc, I oad
mg/I lbs/day
#REF!
Permit I imrts
Conc 1 oad
mg/1 lbs/day
#REF!
Permit Limits
Com, I oad
mg/I lbs/day
rda Meta Beverage USA
3010 1
ekaert Deslee, USA
Deere—Hitachi
Grass Amenca
2018 1
2014 1
2103 1
Ilanes Dye & Finishing Co
1155 1
I lerbalif6
2001 1
Highland Indutnes
2010 1
HOII
g ]
I IP 1 abrics
3050 1
Ingredion
l =9 1
Johnson Battery
1044 1
Kaba Ilco
54 1
Liquid Environmental Solutions
220 1
Pepsi Bottling Ventues
1036 1
rogress Rai
103 1
Rockwell Collins
1037 1
Sonco Display and Packaging
1 4 1
Stratford Metals
1 152 1
Suva Dairy Group
I 9 1
UnFirst
2 5 1
— -- I Mall =- I I v uuuk) I U VUUUI U 0000 1 0 000
Basis�> #REFI #REFI #REFI #REFI
MAUI from IIWA (lbs/da))=> #RI,1 #RI 1 I #RLI I 41ZI F?
1Jncontrollable I oadmg (lbs/day) => #RI I #RI 1 #KLF� #RFF�
Fotal Allowable for Industry (MAII ) (lbs/day) _> #RI 1 I #RLI I #RLI I #RI F1
Total Permitted to Industry (lbs/day) _> 0 0000 0 0000 0 0000 0 0000
HWA AT
Revised December 2017

Workbook Name: WS.HWA.EIIedge.2017,
Worksheet Name: AT
MAIL left (lbs/day) _>
#REF'
EFI
Percent Allow Ind (MAIL) still available (%) =>
M#REF1
#REFS
P#
!!#REFI
n#REFI
Percent MAHL still available (%) =>
PR,
#REFI
#REF'l
5 Pei cent MARL (lbs/dav) =>
H WA AT
Revised December 2017
#REFIT I #REF11 F #REFI #REFI
Printed 2/9/2018, 2 11 PM
Page 12 of 12

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maxunum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (]b/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Control Authority, Industry
Town Name => City of Winston-Salem Name Adele Knits
WWTP Name => Archie Elledge IUP # 2019
NPDES # _> NCO037M Pipe # 1
1 st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
002114
001432
138
145
25
12
8.5
8
st mon t s
n mo nt s
st mont s
n mon s
st mont s
2nd6months
st7N/A
n months
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/.A
N/A
rsenic
a mium
romium
UUIj
st mon t s
n mo nt s
st mont s
n mon s
st mont s
2nd6months
st7N/A
n months
I
1
1
1
1
1
N/A
<0.01
<0 002
<0.001
<0 002
<0 005
0 075
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
per
7st6ont s
n s mont
yani a
st mont s
n mont s
ea
st mont s
n mont s
Mercury
st mont s
n ont s M
1
1
N/A
1
1
1
1
<0 005
00040
<0.008 1
<0 005
0.0270
0.0676
00000172
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
iiiA
XT/A
AT/A
BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d — pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PP6?j?diO£MakkeNCmcde¢EMhaotqptE *ctwgB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Adele Knits
NP # 2019
Pipe # 1
lee
1< otai rnospnorus
Selenium
Sliver
V luoricle
><ne
st months 2nd6months
Ist 5 months'
n mon s
s mon s
2na 6 months
s mon s
27721 () months-
s months
2na (i months
1
1
1
1
1
1
1
1
125
1
12 8
23
<0 005
<0 01
<0 01
<0 01
<0 005
<0 005
0.269
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
NI/A
XT/A
PXX
1< otai rnospnorus
V luoricle
st months 2nd6months
Ist6months n
mont sst
mont s
n mont s
st mont s
n mont s
4
7 1
1
1
1
1
1
71
10
125
1
12 8
23
<0 005
0.72
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
ganese
o y enummonths
2nd
7st
6 months I st 6 mont s ' 2nd
6 mont s
77rmonths
2nd 6 months'
7777onths
2nd 6 mont s
1
1 1
1
00138
001 <0005
<0005
0
0 0
0
N/A
N/A N/A
nrr -
N/A
,��.. nU1Vw Lciccnon 1.imu mg/l => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd — million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P?Bodi��he�i%e�iarmlella¢tcl&iir1B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (Ib/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Control Authority, Industry
Town Name => City of Winston-Salem Name Ardagh
WWTP Name => Archie hilecIge IUP # 3010
NPDES # _> NCO03 Pipe # 1
1 st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
ow, mg
mmonia
st 0 Months
2na 6 monMS'
I st 0 months
12na 0 mon ss
mon s
n months
s months
n months
6
6
1
1
1
1
1
1
0.1392
0 1296
66
80
16
74
<0 5
09
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
Uadmium
uliromium
st 6 mont s
n mont sst
mont s
2nd 6 mont sst
mont s
n Monts
I st 6 months
n mon s
1
1
4
5
12
12
<0.01
<0 002
70 001
<0 002
<0 005
00086
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
vY LL.WLiL1V11 Lllllll mgi1— milligrams per Mer
* POTW must enter at least one of these IUP => Industr1al User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAGotIVSAmkkeGucdeli,�MaftttgLW*ctWAB, pages 12, 13, 14 Blank IDSF Form, Copy and use In your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum (mg/1) _>
or Maximum (lb/d) _>
or Average (mg/1) _>
or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Ardagh
1UP # 3010
Pipe # 1
I'NICKCI
Scienfunt--Sliver
LAM
st 0 mon sn
mon=s
s mon s n
mon s
s mon s
n 7MOn
s mon s n
mon s
4
5
1
1
4
5
12
12
0 021
0
<0 01
<0.01
<0 005
<0.0005
0.1008
0.0899
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P
st 6 months
2nd 6 Monts
_V luoricle
mrsTrMontlis 2nd
6 mont s
lWanganese
I st 6 months
I I otal Fhosphorus
2nd 6 months st mont s n
months
8
5
6
7
8
12
6
8
87
88
12
11
0 1901
00922
0 0803
0 149
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Violybdenum
exane)
U &
U HydroM
ar
st Monts
1
2nd 6 months
5
I st 6 months ! 2nd
1
6 months
3
1 st 6 months
4
2nd 6 mons s
4
st mont s 2nd
1
6 mont s
1
0 016
<0.0084
<5 0
<5.0
<5 0
<5 0
4.8
5
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
UVL -- Doluw LGLCciion Limn mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PPOodio mbkev roo OCha¢tig**cIRJMB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Bekaert
Use separate forms for each industry/pipe WWTP Name => Archie Elledge IUP # 2018
Enter BDL values as < (value) NPDES # _> NUO037M Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, g
COMM
U11romium
mmon><a
St Months
6
Zna b mon s
6
s mon s
8
ZnU 6 months
7
I st 0 monms
8
zna (a months
8
I st 6 months -,ZnU
1
0 months
1
000253
000259
812
803
332
599
124
136
0
0
0
0
0
1n
n
n
N/A N/A N/A N/A N/A N/A N/A N/A
rsenic
COMM
U11romium
st 6 mont sn
I
mont sst
1
mont s
1
2nd 6 montl7s
1
TSMMMMrs
1
2nd 6 months
1
I st 6 months
N/A
2nd 6 months
N/A
<0 01
<0 01
<0 001
<0 002
<0 005
<0 005
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
oppe
Uyanicle
eaMercury
St 6 months
I
2nd 6 months
I
st mon s
1
2nd 6 mons sst
N/A
mont s
1
2nd 6 mont s
1
I st 6 months
1
2nd 6 months
1
0 064
0
<0 005
<0 005
<0 005
252
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
1JLL -� BOVW Luiucuun Lima mg/1=> milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAiBodi13&Uimkite j3uckOEMaftt *cIWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Industry Name Bekaert
IUP # 2018
Pipe # 1
><c e
Selenium - Sliver Zinc
st 0 mon
s n mon s MrMmOmnlrs w znctmonths s mon s Tnor67mono=s I St 0 Months 2nd 6 months
8 8 1
1 1 1 1 1 1 1 1
83 78
<0.005
<0 01 <0 01 <0 01 0 18 <0 005 055 1
0
0 0 0 0 0 0 0
N/A N/A N/A N/A N/A N/A N/A N/A
P F uU aanMolybdenum
st mont s n mont s st mont s n moffiviganese
monts n
mont s st mont s n mont s
8 8 1
1 1 1
83 78
<0 1 1 0.014
0 <0.005 <0 005
0 0 0
0 0 0
N/A N/A N/A N/A
N/A N/A 7.IiA
Chapter PAR Guidance File name P.KB iBPEAa&ReNarah�¢2fta¢tq�LW*ctRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Crothall
Use separate forms for each Industry/pipe WWTP Name => Muddy Creek NP # 3100
Enter BDL values as < (value) NPDES # _> NCO050342 Pipe # 1
Ist 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Io i
001588
0 016
181
111
92
84
0.9
2
mont s
2nd 6 mont sst
mont s
2nd 6 mont sst mont sn mont s
1
1
1
1
0
0
0
00
1
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
COMM
EEO
unromium
ULJV
st 6 mont sn
mont sst
mont s
2nd 6 mont sst
mont s
2nd 6 mont sst mont sn mont s
1
1
1
1
1
1
1
1
1
000055
<0 002
0000081
<0 002
0.0026
<0 005
0
<0 008
0.00096
0
234
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
uyanicle -
EEO
Ntercury
st 6 months
2nd 6 months'
7 st mont s
2-nd 6 mo it s st mont s
2nd 6 mont s
I st 6 months
2nd 6 mont s
1
1
1
N/A 1
1
1
1
00087
0
<0 008
0.00096
0
234
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
L.1-1 mgn _- muugrams per iter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAGoiBPFAakReCmuck¢aTha¢tgpW*c18@AB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Crothall
IUP # 3100
Pipe # 1
1 e
e e llull
11 ver
Zine
s s mon n
mon s
s mon s
n mon s
s mon s
n mon s
s months n
mon s
1
1
1
1
1
1
1
1
00019
<0 01
<0.0005
<0 01
<0.0005
<0 005
0 311
0
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P
V luoricle
Nlolybdenum
I o
a FIftosphorus
st 6 months 2nd
6 mont s
Tst rMonths
2nd6months
Ist6months
2nd6mont s
Ist6months 2nd6months
7
8
1
1
1
1
1
1
101
10.2
03
0.732
<0 0005
<0 005
8
10
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
anganese
ff1st6months n
monss
st mont s
n mont s
st mont s
n mont s
st mont s n
mont s
1
1
1
742
8
00062
0 0090
0
0
0
0
N/A
N/A
N/A
N/A
— Dciuw Detection Limit mg/1— milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/21313L or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAikd4)&Ma&ReNGockIieOha¢ittg*skctR@4B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Deere -Hitachi
Use separate forms for each Industry/pipe WWTP Name => Arcliie Elledge IUP # 2014
Enter BDL values as < (value) NPDES # _> NCO037 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
rsenic
MOM
unromium
st 6 mont sn
Montsst
mont s
2nd 6 months
I st 6 mont sn
mont s
7 st mont sn
mont s
1
1
2
10
12
19
N/A
N/A
006
<0 0025
<0 0015
<0.002
<0 0038
00356
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
Uyanicle
Leacl
Ntercury
st 6 mont s
2nd 6 mont s
Ist6months
2nd6months
Ist6months
2nd6months
Ist6months
2nC16months
7
19
1
6
2
8
1
1
00877
00769
<0 008
000780
<0 0075
0.0096
<12.5
000000542
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
DLL -> Dejow Detection Limit mg/1=> milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P?18orliliMwkkeN arcdcOEMhaotgLksi;cIWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Deere -Hitachi
IUP # 2014
Pipe # 1
o y enum
st mont s
2ncl 6 months
i I st 6 months
2nd 6 months I st 6 months 2nd 6 months I st-6 months 2nd 6 months
1
3
1
3
0028
<0005
106
29
0
0
0
0
N/A
N/A
N/A
N/A
BDL —> Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit
ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg penod could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pilikd4)& im6ReCmuc OCidla¢tg**cIRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Grass
Use separate forms for each industry/pipe WWTP Name => Archie Elledge IUP # 2103
Enter BDL values as < (value) NPDES # _> N C 0 037M Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, in
Ammonia
lSt6n1Ontfts
ZnaOmon=s
IStOMOnths-2na0months
istomontns
znaomontns
TsTrm"onTlIs
277calftimon s
3
1
2
1
2
1
2
1
00017
00025
11643
7,420
<6
15
9.5
118
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
uacimium
unromium
UUD
st 6 mont s
n mont s
I st 6 mont s
n mont s
st mont s
2nd 6 months
I st 6 month s
n mont s
1
NA
2
1
2
1
<0 01
<0.002
<0.002
<0 005
<0 005
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
Uyanicle
ea
ercury
st 6 months
2nd 6 Monts
st mont s
2nd 6 M=ons
I st 6 months
2nd 6 months'
I st 6 months
2nd 6 months
2
1
2
1
2
1
1
1
0.008
00030
<0.005
0
<0 01
<0.01
0.00051
000004460
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
Nie
ive
BDL — Below Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P.iodipMeftikev@uadcOaha¢t *ctwB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (Ib/d) _>
* or Average (mg/1) _>
* or Average Loading (Ib/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Grass
IUP # 2103
Pipe # 1
><c a
enium
Silver
Zine
s mon s n
mon s
s mon s
/-nci 0 months'
s mon s
znQ 0 months
I st 0 months Zncl
6 mon s
2
1
1
NA
2
1
2
1
0 041
0 148
<0 01
<0.005
0.008
<0 01
<0 01
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P
V luoride
Manganese
otal rhospliorus
st 6 montlis 2nd
6 mont s
I st 6 months-
n months2nd
6 months
I st 6 months- n
mont s
1
72
1
6.7
2
1
1
1
6
8
28
3
039
00810
00803
0 149
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
o y enum
st mon s 2nd
6 months
stmont s I
2ndmonts
st mon s
n mont s
st months n
mont s
1
1
2
1
039
0 033
206
164
0
0
0
0
N/A
N/A
N/A
N/A
uVLOW UUMULIuu 1AMA mg/1=> milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/21313L or zero values used TRC => Technical Review Criteria WWTP > wastewater treatment plant
Chapter PAR Guidance File name PAGdio&MakReNaaodc¢araftttgLw*ctkWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Hanes Dye
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge IUP # 1155
Enter BDL values as < (value) NPDES # _> NUO03783T Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
, AxAr"
DV"
mm nla
on s
n mon s
s mon s
n mon s
s mon s
n mon s
s mon s
n mon s
r
6
10
13
10
13
1
1
02407
0.2464
1177
1,513
206
386
3.4
3
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
DLL — Delow IJetectlon Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/21313L or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pj6GB dip okkeN&uckd2ta¢t *ctRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/I) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name HanesDye
IUP # 1155
Pipe # I
rrrr��MEM MEMO Tier," timrrrr�■��rrrr�r. ��
--- -/ nUIV W ueiccuon i,imir mg/I => milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d — pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pt'Ooffipl&mkReNG�ladc¢ffiraotigLktctNAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Herbalife
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge NP # 2001
Enter BDL values as < (value) NPDES # _> Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, mg
I Ca mmm
unromium,
Ammonia
s months
n mon s
s mon s
n months
s mon s
n months' s months
n mon s
6
6
4
5
4
6 N/A
1
1
N/A
N/A
001324
0.01547
620
460
1139
908
71
<0 002
<0 005
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
I N/A
Arsenic
I Ca mmm
unromium,
st 6 months
2nd 6 months
1 st 6 months
n mont s
st mont s
2nd 6 mont s
I st 6 months
n mont s
N/A
1
N/A
1
N/A
1
N/A
N/A
<0.01
<0 002
<0 005
0
0
0
NIA
N/A
N/A
opperyani
a
ea
ercury
st months
n wont s
st 6 months
2nd 6 months
2nd 6 months
I st 6 months
2nd 6 months
N/A
1
N/A
N/A
N/A
1
N/A
1
0 109
<0 005
0.0000145
0
0
N/A
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P) GG rn' SEWsRc%Gmoole¢a'Rrafttq&4 *ciWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
*
or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Herbalife
IUP # 2001
Pipe # 1
AICKVI
Sellenfullni v r
In
s mon s n mon s
s mon s n mon s s mon s
n months s mon s
n mon s
N/A 1
N/A 1 N/A
1 N/A
1
<0 01
<0 01
<0 005
0-
0
0
0
0
N/A
N/A
N/A
N/A
"�DcIuw Lctecnon Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P.iod@Ma&Re,�GuakOEMhaotq�LW*ciRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Highland
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge IUP # 2010
Enter BDL values as < (value) NPDES # _> Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
9
6 6 7 8 7 8 1 1
0.0081
00089
337
363
71
73
32
206
st 6 mont s
777Mo7tTs
Ist 6 mont s
2nd 6 months-
st mont s
2nd 6 months
ist 6 months'
2nd 6 months
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
COMM
unromium
UUM
st 6 mont s
777Mo7tTs
Ist 6 mont s
2nd 6 months-
st mont s
2nd 6 months
ist 6 months'
2nd 6 months
1
N/A
1
1
1
1
<0 01
<0.001
<0 002
<0.005
0 015
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
opper
Uyanide
Ueacl
IVIercury
st 6 months
2nd 6 mont s
I st 6 months
2nd 6 mont sst
mont s
n months
st months
n Mont s
1
1
1
N/A
1
1
1
1
0 039
00130
<0 008
<0 005
0.0370
<5
0.00008240
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
—... . mgii — muugrams per uter
* POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/21313L or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P)NM rdIOSd mkRex(DucdcoE ta¢tgL$t*cIRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
*
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Mmunum =>
* or Average (mg/1)
* or Average Loading (Ib/d)
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6 mo_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Industry Name Highland
NP # 2010
Pipe # 1
I'NICKC1
Scienfulln
81111ver
inc
St months
n mon s
s mon s
n months s mon s
n months
s mon s
n monis
1
1
1
N/A 1
1
1
1
<0 005
0 013
<0 01
<0 005
<0 005
0.15
2.06
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Chapter PAR Guidance File name P �oFe>�i�e�odElia¢tsc19RAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name HOH
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge IUP # 1998
Enter BDL values as < (value) NPDES # => NCO037 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or _6_ Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or _6_ Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6_ Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
ow, mg
Uyanicle
Lead
Mercury
mmonia
st 6 months I 2ndmont s
st 6 months
2na 6 months'
I st o months
Tria F, months—
st o months
27cl o months
I st 6 months
2na 6 months
6
8
9
8
8
8
1
2
004863
00429
662
2,136
283
439
618
4900
00623
<0 0065
<0 005
<0 06983
<0 0068
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rseme
uacimium
Uftrommm
UW
1 Uertilication
st 6 mont sn
mont s
TsTrMoMIrs
2nd 6 months'
st mont s
2nd 6 months
I st 6 months
2nd 6 months
6
9
6
9
6
9
<0 022
<0 01559
<0 02275
<0.002
03613
<0 05791
Certification
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
k,opper
Uyanicle
Lead
Mercury
st 6 months I 2ndmont s
1 st 6 months
2nd 6 months I
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
N/A 9
2
8
6
8
2
8
00623
<0 0065
<0 005
<0 06983
<0 0068
10.4
<0.00018
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL — Below Detection Limit mg/1=> milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pt�4giBOS heftReiCiemdoIlahaobgLk*c18IAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
*
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) =>
* or Average Loading (Ib/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or _6 mo_ Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name HOH
IUP # 1998
Pipe # 1
ICKCI
e enlum
Silver
zAnc
s months n
mon s
s s mon
n months
s mon s
n months
s months n
mon s
6
9
6
3
5
9
6
9
03393
0.091
<0.0092
<0 0083
<0.005
<0 005
142
0.26
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
uor>< a
anganese
o a osp orus
st mont s n
7p
months
st mont s
n months
st months
n months
st months n
months
5
9
1
2
4
2
1
2
95
98
<0.5
0.60
1.663
04
362
17.800
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
o y enum
st mont s 2nd
6 months=
I st 6 months
2nd 6 months
st mont s
2nd 6 months
I st 6 months 2nd
6 months
6
3
1
3
N/A
3
1
1
0.0617
<0 005
<0 05
<0 017
<0.0233
560
670
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL — below Detection Limit mg/1=> milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P. ffkdfP ffiukKeAGHadeIl2&afttgiW ciWMB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name HOH
IUP # 1998
Pipe # 1
n imony
arium
Conalt
lin
st 6 months
2nd 6 months'
st mont s
2nd 6 mont s
I st 6 months
2nd 6 months
st 6 months
2nd 6 months
1
3
1
3
1
3
1
3
<0 005
<0.183
0.019
0 023
<0 005
0 016
<0.05
0 033
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
1 anium
V ana ium
st 6 months
1
'2nd 6 mont s
3
Ist 6 months
1
2nd 6 mont sst
3
mont s
n months
st months
n months
0.042
0 015
<0.005
<0.028
0
0
0
0
N/A
N/A
N/A
N/A
st 6 months
2nd 6 mont sst
mont s
2nd 6 mont s
st mont s
2nd 6 months'
I st 6 months
2nd 6 months
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File nameP?Bodilifdh�ide�adeli�llt ra¢tsi�ct&BilB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Ingredion
Use separate forms for each industry/pipe WWTP Name => Archie Elledge IUP # 1191
Enter BDL values as < (value) NPDES # _> Pipe # 1
I st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
°W, M
IMUM
I non
AMMonia
st o months
Tncl o mon s
1 st 0 months —
-2na 0 mon ss
mon s
n months
s months
n months
6
6
1
1
1
1
1
1
06939
07409
66
80
16
74
<0.5
0.9
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
I NT/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP > wastewater treatment plant
Chapter PAR Guidance File name PAGorBliSJhslskeV$ucdc¢ahaatfglwsi;ciRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of
MM
romium
UOD
Frimnic
month=s
n mons
st mon
n months
smons
n months
st months'
n months
1
1
4
5
12
12
N/A
N/A
<0 01
<0 002
<0 001
<0 002
<0 005
00086
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A I
N/A
opper
Uyanicle
lLeacl
lViercury
st 6 months
2nd 6 mont s
7s7770riths
2nd 6 mont s
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
12
12
1
1
4
5
1
1
00151
00127
0 015
<0 005
0.0057
00230
17.3
0.00000162
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP > wastewater treatment plant
Chapter PAR Guidance File name PAGorBliSJhslskeV$ucdc¢ahaatfglwsi;ciRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
* or Minimum =>
* or Average (mg/1)
* or Average Loading (lb/d)
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
0
Industry Name Ingedion
IUP #
Pipe #
1.iMskVi
Selenium
>< ver
><nc
St months
n months
s months
n months
s mon s
n mon s
s months
n mon s
4
5
1
1
4
5
12
12
0 021
0
<0 01
<0 01
<0 005
<0 0005
0 1008
00899
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
1 0016 I <00084 1 <50 1 <50 1 <50 <50 48 5
/o violations, (chronic SNC is >= 66%) _> 0 1 0 0 0 0 0 0 0
% TRC violations, (SNC is >= 33 %) _> N/A N/A N/A N/A N/A N/A N/A N/A
BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
I
Chapter PAR Guidance File name PAGodIPSMmkReNG�radeOEMha¢ttg**cIWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Johnson Controls
Use separate forms for each industry/pipe WWTP Name => Archie Elledge IUP # 1191
Enter BDL values as < (value) NPDES # _> Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
°W, g
mmonla
Istomontlis
n
mon s
s mon s
n
mon s
I st 6
months_
n 6-month
I st 13 montlis
2na 6 months
6
6
1
1
1
1
1
1
0.0081
0 0098
78
70
7
2.8
17
1.3
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
a mium
romimI
stmonths'
ffrsenic
n
mnt s
st on
n
months
n month
n months
1
N5 /A
N/A
<0 01
<0 01 <0.001
<0 00009
<0 005
<0 0065
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper ,
0
yani a -
Leacl
Ntercury
st 6 months
2nd 6
months
TsIrm'On"trs
2nd 6
mont s
I st 6
months
2nd 6 months
Ist6months
2nd6months
11
11
1 N/A
11
14
1
1
<0 0045
<0.0060
<0.008
02095 <0 4398
<0 5
0.00000270
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BLL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PP�orH�f�hidedierade¢ta¢tgsl�clRBr1B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
*
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
* or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Johnson Controls
IUP # 1191
Pipe # 1
i'NICKel Selenium Suver
LAnc
St monttis 77JEMIM7 TSTf rm=`!Ms� 2 ncl 6 months— s mon
s /-na 13 months st 0 months Inct o months
1 5 1 1
1 5 1 5
st
mont s
n
months st mont s'2nd 6 months
<0.005 <0 0064 <0 1 <0 01 <0 005
<0.0005 0 013 <0.01
IN/A
0
N/A N/A N/A N/A
N/A N/A uiA
P
uori aanganese
o a osp orus
st months n mons s
st
mont s
n
months st mont s'2nd 6 months
lst 6 months 2nd 6 months
7 9
1
1 1 5
1 1
89 9.4
<0.5
1.24 <0.005 <0 0038
<0.16 0.274
0
0 0 0
0 0
N/A
N/A
N/A
N/A N/A
N/A N/A
o y enum
st 6 months 2nd 6 mont sst
mont s
n
mont s st mont s n months
st mont s n months
1 5
1
1
0 019 <0 0026
76
6 1
0 0
0
0
N/A N/A
N/A
N/A
D610w LJOLrUL1U11 1,111II mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month _Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P.)fflod ipEdhmkReiGhiadeli Mhaotg**cIWAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each NP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Kaba Ilco
Use separate forms for each industry/pipe WWTP Name => Archie Elledge NP # 1154
Enter BDL values as < (value) NPDES # _> NCO037837 Pipe # 1
1 st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (Ib/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
oW, in
JOVIO
IK153
mmonia
st 0 montIns
6
12na 5 mon s
6
s mon s
1
7711 o months 1
1
1 st o months
1
Tncl o months
1
I s months —
1
Ina o months
1
00303
00306
18
3
0
3
49
29
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
st 6 mont s
n mons s
Uactmium
st mont s
2nd 6 mont sst
unromium
mont s
2nd 6 months
UUD
I st 6 months
2nd 6 months
1
<0 0001
3
<0 002
6
<0.0173
6
<0 002
14
01677
17
05724
N/A
N/A
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
yani a
ea(U
IVILercury
st 6 months
2nd 6 mons sst
mont s '2nd
6 mons
TS77MMonths I
2ndmont s
I st 6 months
2nd 6 months
15
17
12
7
5
6
1
1
14183
05724
12353
<0 0257
00113
<0 0175
0 632
0.00000420
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PFgFort4)SJhmkkexGuadeOEMha¢ugLWsiqcIRNB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Industry Name Kaba Ilco
IUP # 1154
Pipe # 1
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>0
% TRC violations, (SNC is >= 33 %) _>
11
17
1
1
5
6
13
16
6 months'
6
96
I st 6 months-
1
n months
1
I st 6 months
1
08025 1 00071 <0.01 <0 005 <0 005 0 043
0.1039
6 montlism
1
0 0 0 0 0 0
0
N/A N/A N/A N/A I N/A N/A N/A
N/A
Total # of samples =>
* Maximum =>
or Minimum =>
* or Average (mg/1)
* or Average Loading (lb/d)
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
P
Fluoricle
Manganese
o al
Fftospnorus
st 6 months 2nd
6
10
6 months'
6
96
I st 6 months-
1
n months
1
I st 6 months
1
2nd 6 months I st
6
6 months - 2nd
1
6 montlism
1
3.2
3.4
00008
<0 005
<0 16
<0 02
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Vllolybctenum
I KIN
st mont s 2nd
1
6 months
1
I st 6 months
1
2nd 6 mon s
I st 6 months
2nd 6 mont s I st
6 months 2nd
6 months
00185
<0 005
693
0
N/A
„ign — muugrams per icer
* POTW must enter at least one of these IUP => Industrial User Permit lb/d — pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAGodf)j &Mmkkediluulr iEfflhaftttgiW*ctRMB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Lantal
Use separate forms for each industry/pipe WWTP Name => Muddy Creek NP # 3102
Enter BDL values as < (value) NPDES # _> NUO050347 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017•
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, mg
Ammonia
st 0 months
znct 0 mon s
s mon s
MI. 6 mon=s
I st IS months
271 IS months
st 6 months
ZITO 6 months
6
6
1
1
1
1 N/A
N/A
00082
000255
109
57
53
12
0
0
0
0
01
0
N/A
rsenic
N/A
N/A
a inium
N/A
N/A
rommin
N/A
st 6 mont sn
1
mont sst
N/A
mont s
7
2nd 6 months
8
st mont 7s
7
2nd 6 months
8
I st 6 months '2nd
N/A
6 months
N/A
<0 001
<0 0046
<0 002
<0 0099
<0 0079
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
opper
Uyanicle
Lead
IVIercury
st mont s
2nd 6 mont sst
mont s
2nd 6 months 1
Tst mont s
2nd 6 months m
I st 6 months
2nd 6 months
7
8
1 N/A
7
8
1
1
00318
0.0451 <0 008
<0 01
<0 0131
288
00000035
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
DLL => tseiow Detection Limit mg/I => milligrams per Mer
* POTW must enter at least one of these IUP — Industrial User Permit lb/d — pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P �orli�fi�t�ediara�Ilta¢t�tBscI1B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Lantal
IUP # 3102
Pipe # 1
I'NICKCI
st 5
months'
n mon
s
Selenium
s mon s 2 na
o months'
Wiver
Tsf tMoInTs'
2ncl ()
mon s
Zinc
I st 0 months
2_nO
0 months
7
8
1 N/A
5
8
7
8
<0 0079
<0 011
<0 005
<0 005
<0 005
0 1922
0 267
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
INA
P
JV luoride
Ivianganese
Nlolybdenum
st 6
months
n months'
st months n
months
st mont s
n
months
st months
n
months
8
8
1
1
1
8
1
8
91
85
2.6
06
0 0066
0.0341 <0 005
<0 005
0
0
0
0
0
0
N/A
N/A N/A
N/A
N/A
N/A
N/A
oaosp orus
st
mont s
n mont s
st mn
mont s
st m
n
mont s
st months
n
months
1
1 N
1
11.7
9
12
0
0
0
N/A
N/A
N/A
BDL — Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P[G�dff)F&mkkeNaaadcoalfihafttqRW*cIWAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Liquid Environmental
Use separate forms for each industry/pipe WWTP Name => Archie Elledge ATP # 2020
Enter BDL values as < (value) NPDES # _> Pipe # 1
1 st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, mg
m UFFIR
s mon s
n mon s
IstOmontns
71ornontfis
IstOmonths
2naomontlis
s mon sn
mon s
6
6
11
7
11
7
1
1
0.0416
0.05
5975
5,946
328
522
11
223
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
Uacilmium
uIllromium
UUD
st 6 montlism
n mont s
I st 6 months'
2nd 6 months
st mont s
2nd 6 months
I st 0 monthst
s
1
1
1
1
1
1
N/A
<0 01
0 002
<0 001
00070
<0 005
0 007
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
Uyanide
Leacl
Ntercury
st 6 months '2nd
6 mont s
77T MoMtTs
Ind 6 mont sst
mont s
2nd 6 mont s
I st 6 months
2nd 6 months
1
1
N/A
N/A
1
1
1
1
0.015
00710
<0 005
0 1660
11.9
0000058
0
0
0
0
0
I
0
N/A
N/A
N/A
N/A
N/A
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL , 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pt(orl4)&MakRexCmcdcO2Ma¢tq $LW*cIWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
* or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Liquid Environmental
IUP # 2020
Pipe # 1
1 e
k5elenium
Sliver
Zine
s months n
n s mo
s mon s n
months
s s mon
n months
s months n
mon s
1
1
1
1
1
1
1
1
0.044
0 034
<0 01
<0 01
<0 005
<0.005
0 13
02060
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P
Yluorlde
Manganese
J otal rnospWo'rus
st 6 months 2nd
11
6 mont sst
8
mont s 2nd
1
6 mont s
1
I st 6 months
1
2nd 6 months
1
I st 6 months 2nd
1
6 months
1
109
85
<0 1
109
0 078
00820
9.34
3 610
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
vtolybclenumG(Hexane)
st 6 months 2nd
6 months
1 st 6 months 2nd
6 mont s
st mont s
n months
st mont s n
mont s
1
1
13
7
1
1
<0 005
<0 005
<31
<35
492
94
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
BOL => tserow Detection Limit mg/l => milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d — pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/21313L or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAIR riioM kRev(�mde¢alfitafttq BLk*ciNAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Pepsi
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge IUP # 1036
Enter BDL values as < (value) NPDES # _> NCO03 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, mg
mmonia
ist 6 months
2113 5 months'
ist (i months
Tna o mon ss
mo7ns
n mon s
s mon s
n months
6
6
22
18
22
18
1
1
0 1388
0 1574
3880
2,546
58
70
07
<0 5
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rseme
Uadmium
Uliromium
st 6 mont sn
Montsst
mont s
2nd 6 months
st Monts
2-nd 6 montlism
Ist 6 months'
2nd 6 months
1
1
1
1
1
1
N/A
N/A
<0 05
<0 01
,0.005
<0 002
<0 025
<0 005
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
opper
yani a
ea
ercury
st months
n wont s
st Monts
n mont s
st mont s
n moots
st mon s
n mon s
1
1
1
N/A
1
1
1
1
<0 025
00250
<0.008
<0.025
00310
<5 0
0000009
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL — Below Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P?d3 ii[OS mkReNGuab�Ii&ha¢tq�LW*cIW4B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Pepsi
IUP # 1036
Pipe # 1
..JtkUl
Selenium
wiver
fdlnc
St months n
months
i st IS months
znci 5 months 0
TsErr'M11Ts
77naTIMMOMER s
I st 0 mon s 2173
6 months
1
1
1
1
1
1
1
1
<0 025
<0 01
<0 05
<0.01
<0 025
<0 0005
<0 05
06130
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P
Ylluoride
Ntanganese
I o al rhospnorus
st 6 months n
23
10 3
mon s
18
9.4
st months
1
n months
st months
1
n months
1
st months n
1
months
N/A
14
<0.025
00120
5 53
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
o y enum
st mont s 2nd
6 months'
TTMMMOMs
2nd 6 months'
I st 6 months
2nd 6 mont
I st 6 months 2nd
6 months
1
1
1
N/A
<0 025<0
005
5
0
0
0
N/A
N/A
N/A
]JUL => Below Detection Limit mg/I — milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PPIBodilif mkkev@uah ldaMaottgtfg*ctW4B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Progress Rail
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge IUP # 1038
Enter BDL values as < (value) NPDES # _> NCO037 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, m
13VO
mmonia
s months
n mon s
s mon s
n mon s
s mon s
n mon s
s mon s
n mon s
1
1
N/A
8
1
8
1
1
003039
0 027
363
2700
73
378
1610
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
senic
a mium
rommm
UOD
I stmonths
s
n mont s
st m
n mont s
st mont s
n mont s
1
1
3
2
3
2
N/A
N/A
<0.01
0 006
<0.00088
<0 0013
0.0287
<0 0071
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
Uyanide
Leacl
IVILercury
st 6 months
2nd 6 mont sst
mont s
n mont s
Ist6months
2nd6months
I st 6 months
2nd 6 months
3
2
2
2
3
2
1
N/A
0.3507
02520
<0.013
<0 0075
<0.012
0 1340
0 000214
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL — Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PFGoff@8 a&fteQrudcIiefflha¢tq**ctWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6 mo_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Progress Rail
IUP # 1038
Pipe # 1
1 e
Selenium
Silver
inc
s months n
mon s
s mon s
n months
s mon s
n months— s
months n
mon s
3
2
1
1
3
2
1
2
0 1083
0 039
<0 01
0 014
<0 0023
<0.003
486
1 86
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P
r luoride
mrs=114777Ms
Manganese
I otal IrIftosphorus
st 6 months I 2ndmont
1
88
s
N/A
2nd 6 mons sst
1
mont s
N/A
2nd 6 months I st
1
6 months 2nd
N/A
6 mons s
1
0.52
0.4
3.550
0
0
0
N/A
N/A
N/A
N/A
Wolybdenum
st Monts 2nd
6 months'
I st 6 months
2nd 6 mont sst
Monts
n months st
months n
months
N/A
1
1
2
1
2
1
1
0.031
<0.2
<0 02
0.79
0 12
827
223
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
DDL. —> iseiow Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pfiikdi)MmbsRexGmd;¢EEta¢tgLkslgctR)WB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name RJR Tobaccoville
Use separate forms for each Industry/pipe WWTP Name => Muddy Creek IUP # 3001
Enter BDL values as < (value) NPDES # _> NCO050347 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (Ib/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, in
uyan>< anLeactercuryst
mmoni
St Months
n s mon
s mon s
n mon s
s mon s
n mon s
s mon s
n mon s
6
6
10
8
10
1
1
1
0.2455
0 1838
681
954
587
415
93
6
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
uaamium
unromium
st 6 mont s
777MMMrs
stmont s
2nd 6 months'
77MoMtrs
2nd 6 months"
Ist 6 mont s
n mont s
1
1
1
1
1
1
N/A
N/A
<0 001
<0 01
<0.0008
<0.002
0.0099
0 007
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
%-opper
uyan>< anLeactercuryst
mont s
n mont s
st mont s
n mont snt
s
n mont s
st in i s
n mont s
I
1
1
1
0.154
0.162
<0 008
<0 008
00052
0 015
1.38
0000123
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
iiiiL => rseiow Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/21313L, or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P.God]OSMmtsiteiGraieOdMa¢UgiW*ctW4B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name RJR Tobaccoville
IJP # 3001
Pipe #
I'MCKel
Seleniulw
ilver
inc
st b months
n mon s
TST9=M=O=nTfflsEm
2na 0 months
s mon s
2na 6 months
IStomontns
2nd6morittis
1
1
1
1
1
1
1
1
00086
<0 01
<0 005
<0 01
<0 005
<0 005
0 379
0 268
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
111r�l. ui,i1i61M11b Pct iiLcr
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PA d4)F iwkReNaackOv iaOtq**clW4B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name RJR Whitaker Park
Use separate forms for each Industry/pipe WWTP Name => Muddy Creek IUP # 3014
Enter BDL values as < (value) NPDES # _> NUO050342 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (Ib/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maxunum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
oW, mg
mmonia
s mon s
n
monMs'
s
months n
mon ss
mon s
n
mon s
s mon s
n
mon s
6
6
19
20
19
20
1
1
03175
02906
1131
917
1180
964
5
7
0
N/A ]N/A
0
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
rsemc
'Uacimium
Uhrolimum
UqJD
st 6 months'
n
mon s
Tst
mon?s 2nd 6
months
TST
mont s
2nd 6
months
I st 6 months
2nd
6 months
I
1
1
1
1
1
N/A
N/A
<0001
<001
00017 <0002
0.012
0014
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
Uyanide
'months
Eead
Iviereury
st 6 months
2nd 6
mont s
TsM
2nd 6
mont sst
mont s
n
months
st months
n
months
1
1
1 N/A
1
1
1
1
0 042
0.066
0.0086
0 0099 <0 005
<2.5
0.000060
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
t3LL => Below Detection Limit mg/1=> milligrams per Mer
* POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P,GodioSAw keAGaodcllaRhaotgt$ *cIW4B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
* or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name RJR Whitaker Park
IUP # 3014
Pipe #
I'NICKCI
-'7!`3T=m7O=n7S=
Sclenium
Silver
><nc
st 0
months
TTSrrmMOn=s
2na 6
months
TmMmMmmonn=
2nd ()
Months
I st 0 months
2ncl 6
months
1
1
1
1
1
1
1
1
0 011 <0 01
<0.005
<0.01
<0 005
<0.005
028
0 258
N/A
0
N/A
0
0
N/A
N/A
0
0
N/A
N/A
0
0
N/A
N/A
0
Pff6months
uori a
anganese
o y enum
n
mont s
st mont s
n
mont s
st mont s
n
months
st months
n
months
19
20
1
1
1
1
1
1
644
94
11.1
1 100
0.35
0.44 <0.005
<0.005
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
o a osp orus
I KA
st 6
months 2nd 6
monts
st mont s
n
months
st mont s
n
months
st mont s
n
months
1
1
1
1
11.47
14.60
42 1
59
0
0
0
0
N/A
N/A
N/A
N/A
trut, -- tseiow tuetection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d — pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAG�ti4)SffimkkexGuade02ffihaftttg**ctMMB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Rockwell Collins
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge IUP # 1037
Enter BDL values as < (value) NPDES # _> NCO03 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chromc SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
BDL — Below Detection Limit mg/I — milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P orH >rHi�i$edihio>>eli�t iaQt s>yct&BiIB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each NP pipe - Page of
mmoiala
months
n monMs"
s months
n months
n months
s months-
n months
7
1
1
1
1
1
00003
0.0031
44
37
8
<2.5
<0.5
<0.5
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
st mont sn
1
mont s
4
Laamium
st mont s
7
2nd6months
8
unromium
st mon s
13
2nd6months
15
Ist6months
N/A
2nd 6 months
N/A
00001
<0.002
<0.00118
<0 002
<0 0840
<0.012
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
opper
Uyanide
'months
Lead
Iviercury
st 6 months
2nd 6 mont s
MIT
2nd 6 mons sst
mont s
n mont s
st months
n months
15
15
8
8
7
8
1
1
02363
02363
<0 00563
<0 0056
<0.0084
<0 0104
309
000001280
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL — Below Detection Limit mg/I — milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P orH >rHi�i$edihio>>eli�t iaQt s>yct&BiIB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each NP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
*
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Rockwell Collins
IUP # 1037
Pipe # 1
114ILWu1
I otal Urganies
aelenlum
suver
6 months I st 6 months I 2ndmonthsT
7dinc
2nd 6 months
st 6 months 2na
0 months
I st F months =
n mon s
T791MMIR s
TnTffTOmmT5n=s
I st 6 months 2ncl
6 months
13
15
1
1
7
8
13
15
0
0
0
0
N/A
N/A
N/A
N/A
00731
0 053
<0 0005
<0 0203
<0.0024
<0 0005
<0.033
0.0899
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P
uori aanganese
o a osp orus
st mont s n
12
89
mont s
13
88
st mont s
1
n mont s
1
st mon s
1
n mont s
8
st mont s n
1
mont s
1
11
<0 1
3
0.0022
00324
055
0 459
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A I
N/A I
N/A
Vlolybdenum
I otal Urganies
st mont s 2nd
6 months I st 6 months I 2ndmonthsT
I st 6 months 2nd 6 months I st 6 months
2nd 6 months
1
8 1
1 1
1
0.002
<0 0048
1 07
09
0
0
0
0
N/A
N/A
N/A
N/A
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pt6oriioFMakkev@uod;¢ahaotq�**cIRNB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each NP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Siemens
Use separate forms for each industry/pipe WWTP Name => Muddy Ureek IUP # 3026
Enter BDL values as < (value) NPDES # _> NCO050347 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
* POTW mustenter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
ow, mg
mmon><a
St Months
2na (i mon s
s mon s
2na o montrs m
I st 0 months
Tna 15 months'
1 st 0 months
12na 6 months
6
6
1
1
1
1
1
1
00014
00004
39
37
142
10
13
2
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Chapter PAR Guidance File name PA ( dip&MakRevSiade¢EMiafttgp-W*cIRWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
To
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Siemens
IUP # 3026
Pipe # 1
><c e
Selenium—
11 ve
lnc
1StOu1OntIis=nmTrmmmoT=s
s mon s
n mon s
s mon s
n mon s
lstOmonttis 277clomontfis
1
14
1
N/A
11
14
13
14
02327
0 12
0 007
<0.0337
<0 025
<0 088
<0 079
0
0
0
0
0
0
0
N/A
uori a
anganese
o y enum
s n
ff
mon s
stmont s
n Monts
st mont s
n mont s
st mont s
n mont
8
1
1
1
8
1
8
88
<0 1
32.000
00059
<0 005
3
2090
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
al r1losphorus
st 6 months-- n
months
st mont s
2nd 6 mont s
7 stmont s
Ind 6 months'
I st 6 months
2nd 6 mont s
1
1
1
1
3 5
0.41
59
6
0
0
0
0
N/A
N/A
N/A
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAkd4)FffiwkRe-,CRualLO&hafttqP.Wsl4c]:WAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Sonoco
Use separate forms for each industry/pipe WWTP Name => Archie Elledge IUP # 1042
Enter BDL values as < (value) NPDES # _> NCO037 Pipe # 1
1 st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
oW, mg
mmo la
st IS months
2nZI 6 mon=s
TTsr Tors
2-na o mon s
st F months
2711 o months
I st o months
Ina Zj months
6
6
9
12
9
12
1
1
000179
0.00294
737
565
698
567
64
17
0
N/A
rsenic
0
N/A
0
N/A
Uadmium
0
N/A
0
N/A
Uftromium,
0
N/A
0
N/A
0
N/A
st 6 mont s
1
n mont s
1
1
2nd 6 mont s
1
st mont s
1
2nd 6 months
1
I st 6 months
N/A
n mont s
N/A
<0 01
<0.002
0.001
<0 002
<0 005
<0.005
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
Uyanide
]Lead
Ntercury
st 6 months
2nd 6 mont sst
mont s
2nd 6 mont s
st mont s
2nd 6 months
stmont s
Ind 6 months
7
6
1
n/a
1
1
1
1
00623
0 041
<0 008
<0 005
<0 01
199
0.000004
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
nut, _> tseiow Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P.Moillo& mkRe%Gmcdeli,�MhaotigLW*ctWMB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
*
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
* or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
To
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Sonoco
IUP # 1042
Pipe # 1
51 jrnospiftorus
st 6 months- n
months'
MM7777s
2nd 6 months st mont s 2nd 6 months 1st 6 months 2nd 6 months
1
1
1
1
632
6
74
27
0
0
0
0
N/A
N/A
N/A
N/A
DLL below Leiecnon Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP > wastewater treatment plant
Chapter PAR Guidance File name PAi dlpF mkkeN&acdelieEhafttq tLk*ctWB, pages 12, 13, 14 Blank IDSF Form, Copy and use to your PAR Number each set for each NP pipe -Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Stratford Metals
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge IUP # 1152
Enter BDL values as < (value) NPDES # _> NUO03793q Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, mg
13nmmonia
Ist o months
2na o months'
TsT7mo7nrs
2na 6 monNs"
ist o montns
2na 6 months
ist 15 months
MR 6 months
5
7
n/a
n/a
n/a
n/a
n/a
n/a
002
002
0
0
N/A
N/A
rsemc
Uacilmum
uliromium
st 6 months
n mont sst
mont s
2nd 6 months
"MT Tont s
2-nd 6 months
I st 6 months
2nd 6 months
n/a
n/a
5
8
4
7
N/A
N/A
<0 0024
<0 00276
0 099
<0.048
0
0
0
0
N/A
N/A
N/A
N/A
opperyani
a
ea
ercury
st months
n months
st mont s
n month s
st mont s
n months
st mont s
n mont s
4
7
4
10
1
8
1
n/a
00208
00627
<0.005
<0 399
<0 01
<0.0069
0000028
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BUL _> Below Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P?LBndlpF&mkRe%Cmcde le&a¢tq dLW*ciwB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe -Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Stratford Metals
IUP # 1152
Pipe # 1
INICKC1
SeleniumSliver
1-5151
osp orus
zMne
mont s 2nd 6 mont sst mont s
s mon s
n mon mo
s s n s
n mon s s mon s
n mon s
s mon s
n mon s
4
7 n/a
n/a 4
7
4
7
<0 0065
0 1913
0.1376
<0 0275
001453
0 275
0.2081
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
P
F moricle Twanganese
1-5151
osp orus
st 6 months 2nd 6 monthsIst
mont s 2nd 6 mont sst mont s
2nd 6 months I I st
6 months 2nd 6 months
6 7
n/a n/a n/a
4
n/a n/a
99 98
0
N/A
<0 0065
0
N/A
N/A
viorynaenum
1
st mont s : 2nd
6 months I st 6 mont s 2nd 6 months' st mont s 2nd 6 months stmon s 2nd 6 mons s
n/a
4 1 1
0 045
0
N/A
uliL => neiow Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these NP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P)5i rHOSMmkRexGmoic¢2Mha¢t *cI B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Suiza Dairy Group
Use separate forms for each industry/pipe WWTP Name => Archie Elledge IUP # 1189
Enter BDL values as < (value) NPDES # _> NUO03783q Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chromc SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Copper
Cyanicle
Leacl
Mercury
st 6 months I
2ndmonths'
7st mont s
2nd 6 mont s 7st 7 mont s
2nd 6 months 1
1 st 6 months
n months
1
1
1
N/A 1
1
I
1
0 023
00190
<0 008
<0.005
<0 005
<2 5
0.00005230
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rJUi, —> rseiow Detection Limit mg/I => milligrams per Itter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P.GodtPSMaisReGacdL-OEMa¢ttg**ctRNB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
*
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Ivinivnnennm
Industry Name Suiza Dairy Group
IUP # 1189
Pipe # 1
BDL — Below Detection Limit mg/I — milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAGodipfdhmkReQacdc laUiafttq�,Wsi;ciWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of
st mont s
2nd 6 months
I st 6 months
2nd 6 months I st 6 months 2nd 6 months I st 6 months 2nd 6 Montds
1
1
1
1
<0.005
<0 005
72
86
0
0
0
0
N/A
N/A
N/A
N/A
BDL — Below Detection Limit mg/I — milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PAGodipfdhmkReQacdc laUiafttq�,Wsi;ciWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name Superior
Use separate forms for each Industry/pipe WWTP Name => Muddy Ureek IUP # 3101
Enter BDL values as < (value) NPDES # _> NCO050342 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximumm /1
( g )_>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
w, mg
mon><a
st 0 months
Zrict 0 months'
1 st 0 months
MI. o mon ss
mon s
n mon s
s mon s
n mon s
2
4
1
1
1
1
1
1
00003
0.0002
600
51
<42
27
614
44
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsen><c
Uaammm
Uhromium
UOD
st 6 months'
1
777=0777
1
7ST =onmtrs
2
2nd 6 months I
1
MMMOMrs
2
2nd 6 months
1
I st 6 months
N/A
2nd 6 months
N/A
<0.01
<0.01
<0 0011
<0 002
0.03
0 031
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
opper
Uyanide
ea
ercury
st 6 months
2nd 6 months
st mont s
2nd 6 mont s
1 st 6 months
2nd 6 mont s
I st 6 months
2nd 6 months
2
1
1
1
2
1
1
1
0.0115
00014
<0 005
0 084
002
004
234
0 00007
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
ISDi, _> below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name Pt�o�Fdheti�idemhe}iia�t�s�c}B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Superior
IUP # 3101
Pipe # 1
1.1L11G1
aellenium
E
siliver
2nd 6 months
Zine
2nd 6mont s st mont s 2nd 6 mons sst mont s 2nd 6 mont s
st 0 months
2
2na (i months
1
I st 6 months
1
rnT7M=On=s
1
s mon s
2
n mon s
1
st o months
2
27116 months
3
74
188
0 023
00140
0 014
0
<0 01
0 026
<0 005
<0 005
0 263
0 704
N/A
N/A
N/A
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
0
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PABorHVfslhm[sReiGamie¢ftchafttq B**ctWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of
anganese
st 6 months
2nd 6 months
I st 6 months
2nd 6mont s st mont s 2nd 6 mons sst mont s 2nd 6 mont s
1
1
1
1
74
188
0 023
00140
0
0
0
0
N/A
N/A
N/A
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PABorHVfslhm[sReiGamie¢ftchafttq B**ctWB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name UniFirst
Use separate forms for each Industry/pipe WWTP Name => Archie Elledge NP # 2015
Enter BDL values as < (value) NPDES # _> NCO03783T Pipe # i
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or _6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
°w, 11191t
Ammonia
s mon s
n mon s
s mon s
n months
s mon s
n mon s
s mon s
n mon s
6
6
5
8
7
8
1
1
0.0528
00562
1279
1,180
480
458
1
1 8
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
Uadmium
Uiromium
UUD
st 6 months'
n mont sst
mont s
2nd 6 months'
st Mont s
2nd 6 months'
I st 6 months
2nd 6 months
1
1
1
1
1
1
N/A
N/A
<0 05
<0.01
002
<0 002
0 028
0 042
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
Uopper
Uyanide
1jeaclercury
st 6 months I
2ndmonths
777 7MMMIrs
Ind 6 months
stMonts
2nd 6 months'
TST rmontrs
2nd 6 monts
1
1
1
n/a
1
1
1
1
0.25
0 284
<0 008
0 053
0 078
52 8
0.000123
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL _> Below Detection Limit mg/I — milligrams per Mer
* POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P.GoIOF&wbsideNGuck ah;*tq**ctBBr1B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
T
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name UniFirst
NP # 2015
Pipe # 1
114]MA G1
3cienium
suver
Zinc
s mon s
2na 6 montns
Ist 0 mon s
2-na 5 momns
2-na 6 montinis
TsTMoMrs m
Trictmontfis
1
1
1
1
1
1
1
1
0 028
0 040
<0 05
<0 01
<0 025
0 019
1
1.2
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
111611 uuu1g1aiub Pct IILCI
POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name P)6i d ioMdsKeN araduOaha¢tgik*ctW4B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Winston-Salem Name WestRock
Use separate forms for each Industry/pipe WWTP Name => Muddy Creek IUP # 3102
Enter BDL values as < (value) NPDES # _> NCO05 Pipe # 1
1st 6 months, dates => 6/30/2017
2nd 6 months, dates => 7/1/2017 12/31/2017
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6_ Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow,
DUO
1 Z56
m nia
Ist 0 months
2-na 6 montftsm
s mon s
2711 o mon s
Ist 6 months
/-nct F mon s
Ist 6 months
n 6 months
6
6
5
7
5
7
1
1
000532
000509
482
1,829
582
2,652
0.8
17
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
rsenic
Uacimium
romium
st 6 in sn
mont sst
mont s
2nd 6 mont sst
mon s
2nd 6 mont s I
TST mont s
2nd 6 months
I
1
1
1
1
1
N/A
N/A
0.00047
<0.002
<0 00008
<0.002
0.0007
0 008
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
opper
Uyanicle
head
lViercury
st 6 months
2nd 6 mont sst
mont s
2nd 6 months'
I st 6 months
Ind 6 months'
I st 6 months
2nd 6 months
5
7
1
1
1
1
1
0.1226
0 072
<0 008
00012
0.068
1.38
0000123
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
BDL — Below Detection Limit mg/l => milligrams per titer
* POTW must enter at least one of these NP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PtiodipFJhuhERCV&acd.¢EOhafttgRW*ciWAB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each Industry/pipe
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum =>
or Minimum =>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
TO
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name WestRock
IUP # 3102
Pipe # 1
IMCKer—
Selenium—
Suver
><nc
st 0 mon s n
mon s
s mon s
zna () months
s mon s
n mon s
I st 0 months 2ncl
0 months
1
1
1
1
1
1
5
7
00012
<0.01
<0.0005
<0 01
<0.0005
<0.005
0.1874
0 365
0
0
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
uori a
anganese
o y enum
in
I stt s n
mont s
st months
n mo
st months-
n months
st mont s
n mont s
10
1
1
1
1
1
1
8
<0 1
0 747
0.0071
007
00007
0.014
0
0
0
0
0
0
N/A
N/A
N/A
N/A
N/A
N/A
N/A
al IrIlosphorus
st 6 months 2nd
6 mon s
1 st 6 months 1
2ndmont sst
mont s
n months
st months
n months
1
1
1
1
<0 16
1 18
5 9
51
0
0
0
0
N/A
N/A
N/A
N/A
BDL — Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Chapter PAR Guidance File name PA012dilpMmkke%Gmode¢ahafttg*si4ciMMB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of