NCG110042_COMPLETE FILE - HISTORICAL_20180108

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMITb
N O,
l �I L/Vr 1 0.��
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑
YYYYM M DD

Permit Coverage `
Renewal Application Form NPDES Permit Number i g
NCDENR National Pollutant Discharge Elimination System
Stormwater Individual Permit NCS NCG110042
Please provide your permit number in box in the upper right hand corner, complete the information in the space provided
below and return the completed renewal form along with the required supplemental information to the address indicated.
Owner Information
* Address to which permit correspondence will be mailed
Owner / Organization Name:
City of Roxboro
Owner Contact:
Thomas S. warren Jr.
Mailing Address:
Po Box 128
Roxboro, NC 27573
Phone Number.
336-322-6030
Fax Number:
E-mail address
Facility Information
Facility Name:
Roxboro WVVfP
Facility Physical Address:
902 Cavel-Chub Lake Rd.
Roxboro, NC 27574
Facility Contact:
Derek Clayton
Mailing Address:
PO Box 128
Roxboro, NC 27573
Phone Number:
336-599-8232
Fax Number:
E-mail address:
dcla [e-mail]
Permit Information
RECEIVE[)
Permit Contact`
Andrew Oakley
�/.
Mailing Address:
Po Box 128
42017
Roxboro, NC 27573
_.
Phone Number:
336-322-6031
Fax Number:
° _ QUALITY
E-mail address:
PERM177ING
Discharge Information
Receiving Stream:
Marlowes Creek
Stream Class:
C
Basin:
Roanoke River Basin
Sub -Basin:
Number of Outfalls:
7
Facility/Activity Changes Please describe below any changes to your facility or activities since issuance of your permit. Attached a
separate sheet if necessary.
A new dewatering facility was constructed at the Roxboro VVVVrP, this resulted in the addition of two new Stormwater ouffatls. They have been added to our
Stormwater Pollution Prevention Plan. Also, added a spilt prevention manhole pipe that witl divert digester decant 1 centrifuge centrate into the North Aeration
basin in the event of a line blockage, keeping the manhole from overflowing.
CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the best of my knowledge and belief
such information is true,``com fete and accurate.
Signature 's �J ���r��' Date I I *�_ -1 11
Print or type name of person signing above Title
SW Individual Permit Coverage Renewal
Please return this comp#eted application form
and requested supplemental information to: Stormwater 1612 Mail Service
Program
Center
Raleigh, North Carolina 27699-1612

SUPPLEMENTAL INFORMATION REQUIRED FOR RENEWAL OF INDIVIDUAL
NI'DES STORMWATER PERMIT
1:�yg copies of each of the following shall accompany this submittal in order for the application
to be considered complete:
(Do not submit the site Stormwater Pollution Prevention Plan)
Initials
DC— I . A current Site Map from the Stormwater Pollution Prevention Plan. The location of
industrial activities (including storage of materials, disposal areas; process areas and
loading and unloading areas), drainage structures, drainage areas for each outf'all,
building locations and impervious surfaces should be clearly noted.
_1VA 2. A summary of Analytical Monitoring; results during the tern of the existing permit
(if your permit required analytical sampling). Do not submit individual lab reports.
The summary can consist of a table including such items as outfal I number,
parameters sampled, lab results, date sampled; and storm event data.
�G 3. A summary of the Visual Monitoring results. Do not submit individual monitoring
reports. The summary can consist of a table including such items as outfail number,
parameters surveyed, observations, and date monitoring conducted.
f 4. A summary of the Best Management Practices utilized at the permitted facility.
Summary should consist of a short narrative description of each BMP's in place at
the facility. Ifthe implementation ofany BMP's is planned, please include
information on these BMP's.
5. A short narrative describing any significant changes in industrial activities at the
permitted facility. Significant changes could include the addition or deletion of
work processes, changes in material handling practices, changes in material storage
practices, and/or changes in the raw materials used by the facility.
6. Certification of the development and implementation of a Stormwater Pollution
Prevention Plan for the permitted facility (Sign and return attached form).
If the final year analytical monitoring of the existing permit term has not been completed
prior to filing the renewal submittal, then the last years monitoring results should be submitted
within 30 days of receipt of the laboratory reports. (i.e. do not withhold renewal submittal
waiting on lab results)

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SrM PLAN
ROX-3

Roxboro WWTP
Stormwater Permit NO. NCG110042
Visual Monitoring Results Summary _
Date
Outfall #
— Parameters Surveyed
Observations
_12/4/2013�_.
011
color, odor, clarity, floating solids,
suspended solids, foam, oil sheen
No odor, floating or suspended solids, foam, oil sheen and clear. Flow stopped, puddle at end~
I
_
.
pipe clear. Rainfall prior .35" V. Rogers
12/4/2013; 012
----- _
No odor, floating or suspended solids, foam, oil sheen and clear. No flow clear water at end of
pipe. Rainfall prior .35„ V, Rogers
_12/4/2013i 013
No odor, floating or suspended solids, foam, oil sheen and clear. Water going into drain clear
_
Mud in pipe from creek overflowing end of drain pipe. Rainfall prior .35" V. Rogers
12/412013� 0141
1
No odor, floating or suspended solids, foam, oil sheen and clear. Clear water flowing_ form pipe
Ito Marlowes Creek. Rainfall prior ,35" V. Rogers
12/4/20131_ - 015
_ _
INo odor, floating or suspended solids, foam, oil sheen and clear. No flow from pipe.
I }
j
Rainfall prior .35" V. Rogers
4/16/20141 011
I No odor, floating or suspended solids, foam, oil sheen and clear. Running light. Rainfall
prior 0.5" V. Rogers — ----
4/16/20141 012
color, odor, clarity, floating solids,
suspended solids, foam, oil sheen
No odor, floating or suspended solids, foam, oil sheen and clear. Light tint. Rainfall
_
prior 0.5" V. Rogers v
-- 4/16/2014 013
Clear trickle. No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall
i
prior 0.5" V, Rogers —
4/16/20141 0141
1 No odor, floating or suspended solids, foam, oil sheen and clear. Light tint, clear. Rainfall _
I—
I
1prior 0,5" V. Rogers
4/16/20141 0151
_
INo discharge. Rainfall prior 0.5" V. Rogers
I

Roxboro WWTP
Stormwater Permit NO. NCG110042
Visual Monitoring Results Summary
Date Outfall #
Parameters Surveyed
Observations
11/7/2014 011 j
INo
discharge. Rainfall prior 0.33" V. Rogers
11/7/20141
012
I
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior 0.33" V. Rogers
11/7/20141
0131
IClear
color, odor, clarity, floating solids,
suspended solids, foam, oil sheen
1
trickle. No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior
I
I
0.33" V. Rogers
11/7/2014
- 014
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior 0.33 V, Rogers
E
— -- ----- -
_ 11/7/20141
015�
_
No discharge. Rainfall prior 0.33" V. Rogers
11/7/20141
0161
1
No discharge. Rainfall prior 0.33" V. Rogers
11/7/2014!�
017
No discharge. Rainfall prior 0.33" V. Rogers —
4/15/201511
011
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior 0.5" V. Rogers
4/15/20151
012
ILight Brown, No odor, No floating solids, minimal suspended solids, No Foam or oil sheen.
I
I
color, odor, clarity, floating solids,
I suspended solids, foam, oil sheen
Rainfall prior 0.50" V. Rogers - - —
4/15/20151
013
-
�No discharge. Rainfall prior 0.50" V. Rogers
i
——
4/15/20151
014I
floating or suspended solids foam, oil sheen and clear. Rainfall prior 0.50" V. Rogers
No odor, g p p � g
4/15/20151
0151
INo discharge. Rainfall prior 0.50" V. Rogers
_
4/15/20151
0161
1 No discharge. Rainfall prior 0.50" V. Rogers _
I
I
I
4/15/20151
0171
IClear trickle, No odor, floating or suspended solids, foam, oil sheen and clear, Rainfall prior
I
10.50" V. Rogers-----

Roxboro WWTP
Stormwater Permit NO. NCG110042
Visual Monitoring Results Summary
Date
Out€all #
Parameters Surveyed
Observations
11/20/20151
0111
1
No odor, floating or suspended solids, foam, oil sheen and clear. Light tint. Rainfall prior
1.15" V. Rogers
11/20/20151 0121
1
_
No discharge. Rainfall prior 1.15" V. Rogers
111201201T 0131
No discharge. Rainfall prior 1.15" V. Rogers
_11/20/201'.5 E 014
color, odor, clarity, floating solids,
suspended solids, foam, oil sheen
No odor, floating or suspended solids, foam, oil sheen and clear. Light tint. Rainfall prior____
f
1 V. Rogers
15" V
11120120151 015
-
No discharge. Rainfall prior 1.15" V. Rogers
11/20/201 )i 0161
No discharge. Rainfall prior 1.15" V. Rogers
11/20/20151 017
No discharge. Rainfall prior 1.15" V. Rogers
1
_
_
I
5/13/20161 011
1 No odor, floating or suspended solids, foam, oil sheen and clear. Running light. Rainfall __
__
1 prior 0.25" V. Rogers
~5113120161 012]
No discharge. Rainfall prior 0.25"" V. Rogers
_ -
color, odor, clarity, floating solids,
suspended solids, foam, oil sheen
5/13/20161 013
No discharge. Rainfall prior 0.25"" V. Rogers
5/13/20161
014
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior 0.25" V. Rogers
5/13/20161
0151
1 No discharge. Rainfall prior 0.25"" V. Rogers _
5/13/20161
016
No discharge. Rainfall prior 0.25"" V. Rogers
I
_
5/13/20161
017
j No discharge. Rainfall prior 0.25"" V. Rogers
1
I
I

Roxboro WWTP
Stormwater Permit NO. NCG110042
Visual Monitoring Results Summary
Date
Outfall #
Parameters Surveyed I Observations
9/20/2016I
0111
No discharge. Rainfall prior 1.0" V. Rogers
9/20/20161
0121
No discharge. Rainfall prior 1.0" V. Rogers
color, odor, clarity, floating solids,
suspended solids, foam, oil sheen
912012016�
013
No discharge. Rainfall prior iZ' V. Rogers
912012016
_ I
— 014
„
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior 1.0 V, Rogers
9/20/20161
015
No discharge. Rainfall prior 1.0" V. Rogers
9/20/20161
016
1
No discharge. Rainfall prior 1.0" V. Rogers
9/20/2016
017
No discharge. Rainfall prior 1.0" V. Rogers
5/22/2017�
011
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior .625" V Rogers
^
5/22/2017
012
color, odor, clarity, floating solids,
suspended solids, foam, oil sheen
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior .625" VR_o_g_ers
No Flow.
5/22/2017
013
No odor, minimal floating or suspended solids, No foam, oil sheen. Rainfall prior.625"
V. Rogers Tint light.
5/22/20171
014
No odor, minimal floating or suspended solids, No foam, oil sheen and light brown to clear.
Rainfall prior .625" V. Rogers _
5/22/201 7
015
INocolororodor. Minimal floating and suspended solids. No foam or oil sheen. Rainfall prior
1.625" V. Rogers
5/22/201 71
016
_
1 No discharge V. Rogers Rainfall prior .625"
5/22/20171
017l
No odor, floating or suspended solids, foam, oil sheen and clear. Rainfall prior .625" V Rogers

3.3 - BMP SUMMARY (Best Management Practices)
Stormwater runoff is either from the paved areas or the plant grounds. The paved areas
are cleaned using the City's sweeper truck and/or plant personnel using brooms/blowers
on an "as needed" basis. This BMP removes possible contaminants and prevents them
from entering the stormwater system. The plant grounds are kept cleaned and properly
maintained with all the areas being grassed to control erosion. If spills occur, they will be
promptly contained and cleaned up.
Good Housekeeping: Housekeeping; duties are discussed daily. Mach shift has assigned
housekeeping duties that they are responsible for and the plant has 24-hour coverage.
Preventive Maintenance: Daily inspections of the plant site and inside of buildings are
conducted by the Maintenance Mechanic each workday. The plant has 24-hour coverage
by shift operators who can request maintenance as needed. Dumpsters are emptied once
a week or as needed.
Inspections: Each shift has assigned duties and routine checks are made by operations.
Daily plant operations logs are filled out and on file.
Spill Prevention Response: Staff has been trained in spill response, including; tracing
non -storm water discharges.
Sediment and Erosion Control: Grass or gravel have been placed throughout the plant/
silt fences and or straw bales will be used in areas where the ground has been disturbed.
Decanting the digester / Centrifuge centrate
There are two manholes located outside the digester that decant from the digester and
centrifuge centrate flow through, the second manhole was tapped and line was ran from
the manhole approximately 15ft. into the north aeration basin. This line was added as a
secondary protection to the stormwater drains in that area to keep these manholes from
overflowing in the event of a line blockage.

Stormwater Significant Changes in Industrial Activities
2017
Dewatering Facility
A new sludge dewatering facility has been constructed at the WWTP and
uses polymer in its process. Polymer is delivered by truck in approx. 330
gallon totes, unloaded in an area where storm drains are protected and
moved into the building where they will be placed on spill prevention
pallets.
DecantitIg the digester / Centrifuge centrate
There are two manholes located outside the digester that decant from the
digester and centrifuge centrate flow through, the second manhole was
tapped and line was ran from the manhole approximately 15ft. into the north
aeration basin. This line was added as a secondary protection to the
stormwater drains in that area to keep these manholes from overflowing in
the event of a line blockage.
Hauled Waste
The City of Roxboro WWTP is not receiving Landf 11 Leach ate at this time,
however our Spill Prevention and Response Plan still addresses this in the
event we accept it in the future.
Vacuum Truck Waste
The City's Public Utilities sewer vacuum truck unloads in a contained area
inside the drying bed. Operators are instructed to make sure the truck is in
the proper position to keep the contents from spilling outside the designated
area.

STORNIWATER POLLUTION PREVENTION. PLAN
DEVELOPMENT AND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Energy, Mineral, and Land Resources - Stormwater Permitting
Facility fume: Roxboro WWTP
Permit Number: NCG140042
Location Address: 902 Cavel-Chub Lake Rd,
Roxboro, NC 27574
County: Person
"I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all
attachments were developed and implemented under my direction or supervision in accordance with a system
designed to assure that qualified personne# properly gather and evaluate the information required by the SPPP.
Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information gathered is, to the best of my knowledge and belief, true,
accurate and complete."
And
I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP
has been fully implemented at this facility location in accordance with the terms and conditions of the
stormwater discharge permit."
And
"I am aware that there are significant penalties for falsifying information, including the possibility of fines and
imprisonment for knowing violations."
Sign (according.to,permit signatory requirements) and return this Certification. DO NOT
SENI) STORMWATER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION.
Signature t<
Thomas S. Warren Jr.
Print or type name of person signing above
Date 1 / - 2�= / �
Assistant City Manager
Title
SPPP Certification 10/13

A Division of Water Quality / Surface Water Protection
r
National Pollutant Discharge Elimination System
NCDENR
Dm�.��N�� . PERMIT NAME/OWNERSHIP CHANGE FORM
11
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N C S 0 1 1 1 1 1 N I C I G 1 2 1 i 10 14 1 1 18
Permit status prior to requested change.
a. Permit issued to (company name): Shaver Wood I
b. Person legally responsible for permit: Wilson C.
Inc.
Shaver
First M 1 Last
Executive Vice President
Title
14440 Statesville Blvd.
Permit Holder Mailing Address
Cleveland NC 27013
City State Zip
[phone] [phone]
Phone Fax
c. Facility name (discharge): Shaver Wood Products, Inc.
d. Facility address: 14440 Statesville Blvd
Address
Cleveland NC 27013
City State Zip
e. Facility contact person: W. Chad Shaver [phone]
First / MI / Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of:
❑ Change in ownership of the facility
Name change of the facility or owner
If other please explain: Change in management responsibilities of owners
b. Permit issued to (company name):
Shaver Wood Products, Inc.
c. Person legally responsible for permit:
Wilson C. Shaver
First MI Last
Executive Vice President
�{? i
Dv ---'
Title
14440 Statesville Blvd.
Q�
Permit Holder Mailing Address
Cleveland NC 27013
X
City State Zip
e� ��wata> an
V!�
[phone] [e-mail]
Phone E-mail Address
d. Facility name (discharge):
Shaver Wood Products, Inc.
e. Facility address:
14440 Statesville Blvd.
Address
Cleveland NC 27013
City State Zip
f. Facility contact person:
Wilson C Shaver
First MI Last
[phone] swpjimbogbeI[south, net
Phone E-mail Address

NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
+r Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: Wilson C Shaver
First MI Last
Executive Vice President
Title
14440 Statesville Blvd
Mailing Address
Cleveland NC 27013
City State Zip
[phone] swpjimbopbellsouth.net
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
x Yes
❑ No (please explain)
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
x This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, Richard W. Shaver, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information is not included, this application
package will be returned as incomplete.
2/ 14/ 13
Signature Date
APPLICANT CERTIFICATION
1, W. Chad Shaver, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information is not included, this application
package will be returned as incomplete.
WJ6U a:LL2,&�
Signature
2/14/13
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NCDENR
ENVIRONMENT AND NATLRAL ACS9 Rc E5
Division of Water Quality 1 Surface Water Protection
National Pollutant Discharge Elimination System
PERMIT NAME/OWNERSHIP CHANGE FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
I. Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N G S O N C G I 1 1 0 0 4 2
11. Permit status prior to requested change.
a. Permit issued to (company name): City of Roxboro
b. Person legally responsible for permit: Johnathan R Barlow
1�irst MI bast
City Manager
Title
PO Box 128
Permit Holder Mailing Address
Roxboro NC 27573
City State Zip
[phone] 336-599-3774
Phone Fax
c. Facility name (discharge): RoxboroWWTP
d. Facility address: 902 Cave[ Chub Lake Rd
Address
Roxboro NC 27574
City State Zip
e. Facility contact person: Derrick L Clayton 336-599-8232
First 1 MI / Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of: ❑ Change in ownership of the facility
X❑ Name change of the facility or owncr
If other please explain
b. Permit issued to (company name): City of Roxboro
c. Person legally responsible for permit: Thomas S Warren Jr
First M I Last
Assist City Manager
Title
PO Box 128
r
,� 3 �013 Permit Molder Mailing Address
Roxboro NC 27573
W�lldrf I/Vg7 , Q�k City State Zip
336-503-0489 twatTen u,cityofroxboro.corn
Phone E-mail Address
d. Facility name (discharge): Roxboro WWTP
e. Facility address: 902 Cavel Chub Lake Rd
Address
Roxboro NC 27574
City State Zip
f. Facility contact person: Derrick L Clayton
First MI East
336-599-8323 dclaytoncr,cityofroxboro.com
Phone E-mail Address
f
Revised 2012Apr23

NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
-� IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: Derrick L Clavton
First M1 Last
W WTP Superintendent
Title
PO Box 128
Mailing Address
Roxboro NC 27573
City State Zip
336-599-8232 dclayton @ c itvo froxboro.com _
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
X Yes
❑ No (please explain)
V1 Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
1, Thomas S Warren Jr, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information is not included, this application
package will be returned as incomplete.
WC',-<c— Jantta 30 2013
Signature Date
....................................
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Revised 712008

t±
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Alan W. Klimek, Director
June 13, 2003
Lindsay Mize
Citv of Roxboro
POB 128
Roxboro, North Carolina 27573
A_is
A a—M" 00=% 00ft
Nt'; D E N R
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: General Permit No. NCG110000
City of Roxboro WWTP
COC NCG 110042
Person County
Dear Mr. Mize:
In accordance with your application for discharge permit received on March 17, 2003, we are
forwarding herewith the subject certificate of coverage 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 May 9, 1994 (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 Water Quality. The Division of Water Quality 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 of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act, or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Ken Pickle at telephone number
[phone] ext. 584.
S� cerel
�RIGlllk SIGNED BY
WILLIAM C. MILLS
Alan W. Klimek, P. E.
cc: Raleigh Regional Office
Central Files
Stormwater and General Permits Unit Files
S W U-251)-0I 1UU 1
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

W
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG110000
CERTIFICATE OF COVERAGE No. NCGI10042
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,
City of Roxboro
is hereby authorized to discharge stormwater from a facility located at
City of Roxboro Wastewater Treatment Plant
902 Cavel-Chub Lake Road
Roxboro, North Carolina
Person County
to receiving waters designated as unnamed truburary to Marlowe Creek, a class C water in the Roanoke River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 1I, III,
IV, V, and VI of General Permit No. NCGI 10000 as attached.
This certificate of coverage shall become effective June 13, 2003.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 13, 2003. ORIGINAL SIGNED BY
WILLIAM C. MILLS
i� A.
' Alan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission
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Markers
Name: Discharge Site - NCG110042
Short Name: Dschrg
Coordinates: 0360 26' 38.0" N, 078' 58' 36.4" W
Comment: City of Roxboro WWTP, Subbasin 03-02-05, Roanoke River Basin, Person County,
unnamed tributary to Marlowe Creek, Class C, USGS quad B23NW