NCG060359_MONITORING INFO_20190205

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V Ci&UCn
DOC TYPE
❑�HISTORICAL FILE
I�M'ONITORING REPORTS
DOC DATE
❑ Oa OS
YYYYMMDD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
03.0001(?
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ clug aLP Dcc
YYYYM M DD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 1-31-19
CERTIFICATE OF COVERAGE NO. NCG0600359 SAMPLE COLLECTION YEAR 2"d Half 2018
FACILITY NAME Inno sec Active Chemicals FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Guiford CIVED ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES C DISCHARGING TO SALTWATERS? []YES ®NO
LABORATORY Lab Cert. # FEB 0 5 2019
CENTRAL FiLlys PLEASE REMEMBER TO SIGN ON THE REVERSE 4
MAIR Sl`rTiOP
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfallz 0.5 or ❑ No discharge this period3
Outfall No,
Sample Collected,
mo/dd/yr
T55,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
Soo
N/A Unable to
collect sample
from Qualifying
Event
' Only applies to facilities that use/process meats.
zThe total precipitation must be recorded using data from an on -site rain gauge.
For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 —9.0
-
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
SWU-249 Last Revised: October 18, 2012
Page I of 2

3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
i °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge '"re orts within 30 da s of receipt of the lab results or at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
2M
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at; http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

r*
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCGO60OOO
Date submitted
I
CERTIFICATE OF COVERAGE NO. NCG06 0 3 5 9 y., SAMPLE COLLECTION YEAR +��1
FACILITY NAME Innopsec Performance Chemicals REIVECFACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Guilford JUL 24 2018 ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? ❑YES �NO
LABORATORY Pace Analytical Lab Cert. # 12 CENTRAL FILES
— DWR SECTIC N PLEASE REMEMBER To SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event roinfoll z or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
Only applies to facilities that use/process meats. V-'N%QZ S t
Z The total precipitation must be recorded using data from an on -site rain gauge. ""p L fib 4j 4y-0,�( w4^j
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. �1
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes �no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part Bj
SWU-249 Last Revised: October 18, 2012
Pale 1 of 2

CA
t�
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
+ 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO�
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
IL —
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Pe
7' 41
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/`wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October I & 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted � - 3A - 1%
CERTIFICATE OF COVERAGE NO. NCG06 0 3 5 9
FACILITY NAME Innopsec Performance Chemicals
COUNTY Guilford
PERSON COLLECTING SAMPLES
LABORATORY Pace Analytical Lab Cert. #f 12
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR D". Q ( "'�O��
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? -❑YES KNO
,.
NED
E� p 6 ZA
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
EN } M=�
VCTIO
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 504Within
6.0 — 9.0
120
30
1000
500
1 Only applies to facilities that use/process meats. . \J, f,.,
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes N�no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
cif
S W U-249
Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑r
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results ror at end of
monitoring period in the case of "No Discharge" reports) to: -
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
ij
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
i ` �-v
- /I -
(Date)
Additional copies of this form may be downloaded at: http://pprtal.ncdenr.org/web/wcl/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 19, 2012
Pale 2 of 2

4
July 28, 2017
NC DEQ
Division of Water Quality
Attn: DWQ Central Files
161 7 Mail Service Center
Raleigh, NC 27699-1617
innospec�oo,-
performancei
RECEIVE®
AUG 082017
CF-NTRAL F11-F-a
DWR SEOON
Subject: January -June 2017 Semi Annual Stormwater Discharge Monitoring Report
Innospec Performance Chemicals
NCG060359
To whom it may concern:
Please find attached the original and one copy of the reference report. Please be advised that
while there were discharges from the site, none of them were able to be sampled for the following
reasons:
• They were not a measurable storm event
• They occurred within 72 hours of the previous event OR
• They occurred during adverse weather events (lightning storms) OR
• They occurred outside the facility's normal operating hours.
Please contact me at the numbers or email below if you have any questions.
[ certify under penalty of law that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief; true, accurate, and complete. I am aware that there are
siL�nificant penalties for submitting false information, including the possibility of fine and
imprisonment for knowing violations.
Utz 44 _
Signature ff
Allen Robev
SHE Manager
Innospec Performance Chemicals
Hirsh Point Office: [phone]
Spencer Office: [phone]
Mobile: +I 336-847-506 t
a][e-mail]
Date
�O> Innospec Active Chemicals LLC
510 W. Grimes Ave
High Point, NC 27260
Innospec Active Chemicals LLC doing business as Innospec Performance Chemicals

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted _� -
1
CERTIFICATE OF COVERAGE NO. NCG06 O S SAMPLE COLLECTION YEAR Js 114i h n
FACILITY NAME ��,..� �, �P��CC.L� 4i FACILITY ACTIVITIES INCLUDE (check', all that apply):
COUNTY ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES _. NJA._ DISCHARGING TO SALTWATERS? ❑YES �10
LABORATORY' 1j�A Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REWERSE
Total event rainfo1, z or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or S4
Within 6.0— 9.0
120
30
1000
500
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge. 4J 5ewp�. S 1>3C,l,iRi Q VA-1A
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
`See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes k!�no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
30
100 or 50
6.0 — 9.0
-
t only applies to facilities that use/process meats.
7The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at gny outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 L,as1 Rcvised: October 18. 2012

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original -and one copy of this OMR,_including all "No Discharge" reports, within 30 days of receipt of _the lab results (or at end o f
monitoring period in the case of "No Discharge" reports] to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of-Permittee)�
'4• a%-))
(Date) T
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/W6/­ws/su/n.j?dessw#tab-4
S W U - 249
Iuast Revised: Oclober ... 2012

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted �h'I
CERTIFICATE OF COVERAGE NO. NCG06 SAMPLE COLLECTION YEAR 15x 11 cg )n12.
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES ti_-- DISCHARGING TO SALTWATERS? ❑YES �O
LABORATORY' AI iA Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
.�Li-,:•.7r F:EJMENIBER 1'0 SIGN ON THE ;�F1IFRSE
Total event rainfall z or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100.or 50
Within 6.0— 9.D 1
120
30
1000
500
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge. U �h� �a Sc'��,Q'
3 For sampling periods with no discharge at any outfa(ls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes F�no
Part B: Vehicle Maintenance Area Monitoring. Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkrnark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18. 2012

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS. SEE PERMIT PART II SECTION B
e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TiER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
a TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OLJTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results Lor at end o
monita_ ring periodin the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 persorinel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of-Permittee)-
• a% -)
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/W6/ws/su/npdessw#tab-4 .
SWU-249 .
Last Revised: October , '2012

_40
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted %�_� v� >7
CERTIFICATE OF COVERAGE NO. NCG06_ 2 ,ice
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY_ NJ Lab. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR A01 �'� h� � I � 6) CE� �
FACILITY ACTIVITIES INCLUDE (check all that apply): FEB D 7 2017
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? [:]YES� owFt YES NO VVR SECTION
PLri:SE REMEMBER TO SIGN ON THE REVERSE
Total event roinfall z or ❑ No discharge this period;
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Col+form ,
Colonies per 100 ml
Enterococcil,
Colonies per 100 ml
Benchmark
-
160 or 50
Within 6.0 — 9.0
120
30
1000
500
2 Only applies to facilities that use/process meats. \j"'Oka— 1,
The total precipitation must be recorded using data from an on -site rain gauge. U
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 1� no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor oil Usage,
Annual average gal/mo
Benchmark
30
100 or 50
6.0 -- 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
`See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 19. 2012

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end o
monitoring eriod in the case o "No Discharge" re arts) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date) !/
Additional copies of this form may be downloaded at: http Z/portal.ncdenr.org/�vebZwg/ws/su/npdessw4tab-4
• 1 T
S W U-249
Last Reviscd: Octobet 2012*'
n...,,. .,I' �

! 1�
SEMI-ANNUAL STO_RMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted >7
CERTIFICATE OF COVERAGE NO. NCGO6 2 7'r, SAMPLE COLLECTION YEAR
FACILITY NAME 'C+sr�,G'c IQ?irl-o��r Cls rU FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY �v:I'- - _ ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES A/l�.,�'n1, ,,_ DISCHARGING TO SALTWATERS? ❑YES 4NO
LABORATORY 10�44 t; _ Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
PLF,:%-E REitiiDM13ER. TO SIGN ON THE `t FEVERSE 1
Total event rainfall 2 or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
300.or504
Within 6.0 — 9.0
120
30
1000
500
1 Only applies to facilities that use/process meats. v�th� I.A
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes no
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging.> 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18. 2012

(Signature of Permittee)
*FOR PART A AND PART 8 MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
p TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [] NO N
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME: r
t;
Mail an on inal and one copy of this DMR inciudin all "No Dischar e" re orts within 30 days of receipt of the lab results or at end o
monitoring period in the case of "No Discharge" reports] to. -
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law,.that this document and all attachments were prepared under- my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
UL
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 C
0
Last Revised: October . ,: 201 '

innospec�oo-
Performance chemicals
January 30, 2017
NC DEQ
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleioh. NC 27699-1617
Subject: July -December 2016 Semi Annual Stormwater Discharge Monitoring Report
Innospec Performance Chemicals
NCG060359
To whom it may concern:
Please find attached the orluinal and one copy of the reference report. Please be advised that
while there were discharges from the site, none of them were able to be sampled for the following
reasons:
• They were not a measurable storm event
• They occurred within 72 hours of the previous event OR
• They occurred during adverse weather events (lightning storms) OR
• They occurred outside the facility's normal operating hours. While the facility does
operate 24/7, the rain events occurred outside the hours when trained personnel are on
site to pull samples. We are evaluating training off hours shift personnel to take samples
that may occur outside normal business hours.
We will be pulling samples as soon as possible during the first half of 2017.
Please contact me at the numbers or email below if you have any questions.
I certify under penalty of law that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons directly responsible for gathering the information; the information submitted is, to the
best of my knowledbe and belief, true, accurate, and complete. 1 am aware that there are
significant penalties for Submitting false information, including the possibility of fine and
imprisonment for knowing violations.
CII & - /:1
3'2�nutimre
Allen Robey
SHE Manager
Innospec Performance Chemicals
High Point Office: [phone]
Spencer Office: [phone]
Mobile: [phone]
al len.robey0ainnospecinc.com
Date
r0> Innospec Active Chemicals LLC
510 W. Grimes Ave
High Point, NC 27260
Innospec Active Chemicals LLC doing business as Innospec Performance Chemicals

li-
July 15, 2016
i nnos eco>
performance chemicals
NC DE `
Division of Water Quality 1 JUL 2
Attn: DWQ Central Files 0 2U16
1617 Mail Service Center CENTRAL FILES
Raleigh, NC 27699-1617 DwR SECTf
Subject:
ON
January— June 16 Semi Annual Stormwater Discharge Monitoring Report
Innospec Perf trance Chemicals f'
NCG060359 /
To whom it may concern:
Please find attached the original and one copy of the reference report. Please be advised that
while there were discharges from the site, none of them were able to be sampled for the following
reasons:
They were not a measurable storm event meaning they occurred within 72 hours of the
previous event OR
They occurred during adverse weather events (lightning storms) OR
They occurred outside the facility's normal operating hours. While the facility does
operate 24/7, the rain events occurred outside the hours when trained personnel are on
site to pull samples. We are evaluating training off hours shift personnel to take samples
that may occur outside nonnal business hours.
We will be pulling samples as soon as possible during the second half the year.
Please contact me at the numbers or email below if you have any questions.
I certify under penalty of law that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons directly responsible for gathering the information, the infonnation submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the possibility of fine and
imprisonment for knowing violations.
gnatui e
Allen Robey
SHE Manager
lnnospec Performance Chemicals
High Point Office: +l 336-882-3308
Spencer Office: [phone]
Mobile: [phone]
[e-mail]
Dale
PO> Innospec Active Chemicals LLC
510 W. Grimes Ave
High Point, NC 27260
Innospec Active Chemicals LLC doing business as Innospec Performance Chemicals

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted _"__rA _ �, —A s -�_ �. ) L
CERTIFICATE OF COVERAGE NO. NCG06 0 3 5 9 SAMPLE COLLECTION YEAR —]O) (, _
FACILITY NAME _Innopsec Performance_ Chemicals FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Guilford ❑ use/process meats [] use animal fats/byproducts
PERSON COLLECTING SAMPLES A14_DISCHARGING TO SALTWATERS? OYES [gNO
LABORATORY_ Pace Analytical Lab Cert. # 12
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z or No discharge this period' Ji o K2L1v.,,, I L
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge ate outfalls. You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes .�no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 FoN.-ampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Ak
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Pagel of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
+ 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR includin all "No Discharge" re orts within 30 days of receipt of the lab results Lor at end o
monitoring period in the case o "No Discharge" reports] -to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
'If'
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for Morth Carolina Division of Water Quality General Permit No. NCG060000
` Date submitted a- I - l 1.
CERTIFICATE OF COVERAGE NO. NCG06 c3:1 SAMPLE COLLECTION YEAR �)-01-5
FACILITY NAME _ �•...�sa�` Qa �_„�,,�� L -, �.; _� FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY C4go.. ,, a _ ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES PiN Vo _-, r,.('� �(H, GING TO SALTWATERS? DYES UKO
LABORATORY � c � A�v.. — Lab Cert-. I
FEB Q 2Q16 >LFi`,'SE REMEMBER TO SIGN ON THE R2 MERSE
Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FIl F'G Total event rainfall z_LZ_T_P or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
, SE
mg/L
TI(D iI and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
100 or 50
Within 6.0--9.0
120
30
1000
500
r
S"SJ
I
e
Only applies to facilities that use/process meats.
zThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes no (ifyes, complete Part By
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor oil Usage,
Annual average gal/mo
Benchmark
30
100 or 50
6.0 — 9.0
-
' Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at anv outfalls, you must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: Oc(ober 19. 2012

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• Z EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ['
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ A114
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, includin_g_a_ll_"No Discharge" reports, within 30 days of receipt of the lob results (or at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY 110ORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted: Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature -of Permittee)
2-1-
(Date)
Additional copies of this form may be downloaded at:'http://portal.ncdenr,orgweb/wp ws/su/npdesswittab-4
S W U-249
Last Revised: Octohcr IS. 2012

r
Central Files: APS _ SWP _
6/1112015
Permit Number NCG060359'
Permit Tracking Slip
Program Category
Status Project Type
NPDES SW
In review New Project
Permit Type
Version Permit Classification
FoodrrobaccolSoapslCosmeticslPublic Warehousing Slormwater Discharge COG
COC
Primary Reviewer RECEIVED
PermttContactAffiliation
bill.diuguid '
CoastalSWRufe JUN 15 2015
Permitted Flow CENTRAL FILESDWR SECTION
Facility
Facility Name
Innospec Performance Chemicals
Location Address
510 W Grimes Ave
High Point
NC 27260
Owner
Owner Name
Innospec Performance Chemicals
DateslEvents
MajorlMinor Region
Minor Winston-Salem
County
Guilford
Facility Contact Affiliation
Allen Robey
510 W Grimes Ave
High Point NC 27260
Owner Type
Non -Government
Owner Affiliation
Allen Robey
510 W Grimes Ave
High Point NC 27260
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice Issue/
Effective
Expiration
11/13/2014
6/t'! / Lar
�pl�%(S
[[
/D
Regulated Activities
Requested /Received/Events
Toiletries manufacture
RO staff report requested
5113115
RO staff report received
6111115
Outfall 1
Waterbody Name Streamindex Number Current Class Subbasin
Richland Creek 17-7-(0.5) WS-IV:' 03-06-08

4
12
A&& A
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
June 11, 2015
Mr. Allen Robey
Innospec Performance Chemicals
510 West Grimes
High Point, North Carolina 27260
Subject: General Permit No. NCGO6OOOO
lnnospec Performance Chemicals
COC No. NCGO6O359
Guilford County
Dear Mr. Robey:
In accordance with your application for a discharge permit received on November 13, 2014, we
are forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state
- NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US
Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Energy, Mineral and Land Resources (Division). The Division may require modification or
revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division or permits required by
the Division of Water Resources, Coastal Area Management Act or any other federal; state or local
governmental permit that may be required.
If you have any questions concerning this permit, please contact Bill Diuguid, Stormwater
Program Planner at telephone number [phone].
Sincerely, J
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and
Land Resources
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-9200 / FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: hftp://portal.ncdenr.org/webl
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE No. NCG060359
STORMWATER DISCHARGES
NATIONAL POLLUTANT. DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Innospec Performance Chemicals
is hereby authorized to discharge stormwater from a facility located at
Innospec Performance Chemicals
510 West Grimes Avenue
High Point
Guilford County
to receiving waters designated as an unnamed tributary to Richland Creek, a Class WS-IV waterbody to Cape Fear
River Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, II, III, IV, V and VI of General Permit No. NCG060000, as attached.
This Certificate of Coverage shall become effective June 11, 2015.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 11, 2015.
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission

'-.r41
31 � s** ; .4_ + ! Iw{Ta d'1►rF -i/ eId� ` •" E
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1 Allen
• ni. � _ r. �R4. � ;�h �.. � � �„�,• � � �. � i/Q'�t'i^i1 h '`'�� �x .'' •k.
MOO
- S t Y a j ir•f ., . }^' tr_=. � ..e,w...-��' cCY A ' � SS _/.p� `lam •"]r. ts{
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�.�+._• � __.. �.Ys. _�.r"��-�?_._.tir-. �.. tip. ti��.,;J, :_e..�__ �'�,. _ �.�t �... �t��°5� �«.�s`-�, ..... �i-',�

'WJ
Division of Energy, Mineral and Land Resources
Land Quality Section
RIC-DENR
National Pollutant Discharge Elimination System
NCG060000
—0 Ha Rca CE]
NOTICE OF INTENT
FORAGENCY USEONLY
Date Received
Year
I Month
Da
Certificate of Coverage
N
Check #
mount
emtit Assigned to
LA L
National Pollutant Discharge Elimination System application for coverage under General Permit
NCGO60000: RECEIVED
S I r%lvl TER DISCHARGES associated with activities classified as:
NU V I Q gni
SIC (Standard Industrial Classification) 20 Food and Kindred Products 1 u It
SIC 21 Tobacco Products e DENR-LAND QUALITY
SIC 283 Drugs 'TOR"ATER PER[vlj �t
SIC 284 Soaps, Detergents, & Cleaning Preparations; Perfumes, Cosmetics, & Other Toilet Preparatisns
SIC 422 Public Warehousing and Storage (except 4226)
For questions, please contact the DEMLR Regional Office for your area. See page 4.
Do Not use this NOI for renewals.
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name Innospec Performance Chemicals_
Street Address 510 West Grimes Ave.
City High Point State NC ZIP Code 27260
Telephone No. 336-882-3308 Fax: [phone]
2) Location of facility producing discharge:
Facility Name
Facility Contact
Facility Address
Facility City
Facility County
Telephone No.
Innospec Performance Chemicals
Allen Robev, SHE Manager
510 West Grimes Ave.
High Point
Guilford
336-847-5061
Email allen.robeyCa)innospecinc.com
3) Physical Location Information:
State NC _ ZIP Code 27260
Fax: [phone]
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). From Winston Salem, take 311 into High Point on N.
Main. Go through downtown and turn right on W. Grimes Ave. Cross Elm Street and continue aoproximately
500 vards. Plant is at the bottom of the hill on the right
(A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.)
4) Latitude 35 57' 1.69" N
Longitude 80 0' 34.04" W
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
x Existing
(deg, min, sec)
Page 1 of 4
SWU-221 ?V 'er V 0 .7
Last revised 6124/14

NCG060000 N.O.I.
6) Standard Industrial Classification:
Provide the 4-digit Standard Industrial Classification code (SIC code) that describes the primary industrial
activity at this facility.
SIC code: 2 8 6 9 (2843)
7) Activities
a) Provide a brief narrative description of the types of industrial activities and products manufactured
at this facility: Innospec Performance Chemicals High Point manufactures specialty chemicals for the
personal care other industries
b) Check all activities occurring at this facility:
❑ use or process meats ❑ use or process animal fats/byproducts
8) Discharge points I Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 4
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormvater
discharges end up in? Tributary to Richland Creek cv4-ra- PF_4-V -- '6 A'.5+
Receiving water classification: WS-IY4 Su60. 0 3 d 6 — O B STD-. Up , t r?-7- (01
Is this a 303(d) listed stream? Yes Has a TMDL been approved for this watershed? Fecal Coliform
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer). 2 outfalls discharge to the City of High Point
municipal storm sewer and 2 discharge directly to a tributary to Richland Creek. The MS4 also discharges to
the same tributary
9) Does this facility have any other NPDES permits?
❑ No
X Yes
If yes, list the permit numbers for all current NPDES permits for this facility: City of High Point IUP# 0120
10) Does this facility have any Non -Discharge permits (ex: recycle permit)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
11) Does this facility employ any best management practices for stormwater control?
❑ No
X Yes (Show any structural BMPs on the site diagram.)
If ves. Dlease briefly describe: emolovee training, spill prevention and response. SPCC Plan, good housekeepina. riD-
rap for TSSlerosion control, all products and raw materials stored indoors, secondary containment roof drains located
near outside processing equipment discharge to the plant's Wastewater s s} tem
12) Does this facility have a Stormwater Pollution Prevention Plan?
X No
❑ Yes
If yes, when was it implemented? Under development
Page 2 of 4
SWU-221 Last revised 6124/14

NCG060000 N.O.I.
13) Are vehicle maintenance activities occurring at this facility?
X No ❑ Yes
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
❑ No X Yes
d) Is hazardous waste stored in the 100-year flood plain?
-X No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: Solvents tri-chrome wastewater, various caustics/acids filter wastes
How is material stored: Totes and drums
Where is material stored: Inside the main production area in a secondary containment structure
How many disposal shipments per year: approximately 8
Name of transport 1 disposal vendor: Nexeo Solutions
Vendor address: 3930 Glenwood Drive, Charlotte, NC 28206
15) Certification:
North Carolina General Statute 143-215.613 (1) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report,
plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who
knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or
who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under this Article or rules of the Commission implementing this Article shall be guilty of a Class 2
misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Allen Robey_
Title: Safety, Health, and Environmental Manager
G'2,;.�.
(Signature of Applicant) (Date Signed)
This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to:
NCDENR. Do not send the check or money order separately.
Page 3of4
SWU-221 Last revised 6124114

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500 HINKLE LANE
SAUSBUAY, NC 28144
704-633-8028
PAY
Wells Fargo Bank, N.A.
INNorth Carolina
wellsfargo.com DATE CHECK NO.
55-2-212
November 07 2014 74362
CHECK AMOUNT
1100.60...
*** One Hundred and 00/100 US Dollar
INIJOSPEC ACTIVE CHEMICALS LLC.
TO THE L
OOFDER NCDENR-DIV OF ENERGY MINERAL & LAND `„S, F r
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1612 MAIL SERVICE CENTER
RALEIGH,NC 27699-1612