NC0020401_Pretreatment_Annual_Report_20200123

HjCKORY
'- North Cerollna �-
Life. Well Crafted.
City of Hickory
Pretreatment Annual

Narrative

CITY OF HICKORY 2019 PRETREATMENT ANNUAL REPORT
The Annual Pretreatment Report submitted by the City of Hickory contains
information from January 1, 2019 — December 31, 2019. In this period of time,
13 industries were monitored.
JANUARY - JUNE 2019
• POTW monitoring for thirteen (13) industries occurred. Thirty-two
(32) monitoring events were conducted by the City of Hickory.
• Self -monitoring by thirteen (13) industries occurred. Seventy-six
(76) self -monitoring events were conducted.
• Zero (0) industries were in SNC for limits or reporting.
• Eleven (11) industries were sent thirty-three (33) [self -monitoring
data — sixteen (16); City of Hickory data — seventeen (17)] notices
of noncompliance with the Industrial Monitoring Program.
• During February 2019, one (1) industry was sent one (1) notice of
violation with assessment of civil penalties for violation of permit
conditions (Part 2 Section 24 — Dilution Prohibition) due to a
violation that occurred on 1/23/19. The civil penalty was assessed
and collected in 2019. (See Other Information)
Kleen Tech (IUP# 0035) conducted TTO monitoring. (See
enclosures)
The following IUP modifications were made during this semi-annual
period:
Kleen Tech (IUP# 0035) — BOD and O&G limits increased.
• The following Northeast (NC0020401) IUP's were submitted for
renewal with approval on 2/26/19:
1, Frye Regional Medical Center, Pipe 001 & 002 (IUP# 0007)
Hickory Dyeing &Winding (IUP# 0008)
*Reduction in O&G limit*
3. HK Research (IUP# 0011)
4. Shurtape Technologies (IUP# 0022)
*TTO requirement removed*
5. Century Furniture, Pipe 001 & 002 (IUP# 0034)

JULY — DECEMBER 2019
POTW monitoring for thirteen (13) industries occurred. Fifty-five
(55) monitoring events were conducted by the City of Hickory.
• Self -monitoring by thirteen (13) industries occurred. Seventy-three
(73) monitoring events occurred.
• Zero (0) industries were in SNC for limits or reporting.
Ten (10) industries were sent forty-two (42) [self -monitoring data —
twenty (20); City of Hickory data — twenty-two (22)] notices of
noncompliance with the Industrial Monitoring Program.
• The City of Hickory conducted TTO monitoring for Kleen Tech
(IUP# 0035). (See Enclosures)
• The following IUP renewals became effective on 7/8/19:
1. Frye Regional Medical Center, Pipe 001 & 002 (IUP# 0007)
2. Hickory Dyeing & Winding (IUP# 0008)
3. HK Research (IUP# 0011)
4. Shurtape Technologies (IUP# 0022)
5. Century Furniture, Pipe 001 & 002 (IUP# 0034)
Other Information:
A copy of the Division's Historical SNC Report has been included.
Please note the following correction that is needed:
Kleen Tech IUP# 0035 was in SNC for Oil and Grease
during the 2nd semi-annual period of 2017 and isn't listed on
the Historical SNC.
• A copy of the Division's Pretreatment Program Database has been
included for each WWTF with an active PT program. No
corrections are needed.
IDSF data listed as "not required" for asemi-annual period
indicates that the corresponding industry does not have permit
requirements for said parameter and that the monitoring for the
other semi-annual period was conducted to satisfy LTMP and/or
MMP requirements only.

Previous SNC Information:
NONE
Pretreatment Program Element Updates:
• Henry Fork (NC0040797) HWA was updated and approved on 7/18/19.
• Henry Fork (NC0040797) LTMP was updated and approved on 7/18/19.
• ERP was updated to comply with the Dental Amalgam Rule and approved
on 11/13/19.
• The City of Hickory has implemented the Dental Amalgam Rule by
identifying all dental dischargers in the Hickory area. Survey efforts began
on 7/16/18 by sending packets that included the model cover letter
explaining the Dental Amalgam Rule, EPA fact sheet, and One -Time
Compliance Report to 37 dental dischargers. A summary table is being
used to indicate the dates that the One -Time Compliance Reports are
being received.
Henry Fork (NC0040797) IU Permit Renewals:
• Permit renewal applications for City of Hickory c/o Veolia Water North
America Operating Services (IUP# 0050) and Maple Springs Laundry —
Plant 2 (IUP# 0051) will be sent to SIU's in 212020 and 5/2020
respectively.
• Permit renewal applications for the remainder of Henry Fork SIU's will be
sent to SIU's in 7/2020.

Pretreatment Program Information

Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
it.
12.
13.
14.
15
16,
17.
18,
19.
20.
Pretreatment Town Name: City of Hickory
"Primary" NPDES Number NCO020401
or Non Discharge Permit # if applicable =>
PAR Begin Date, please enter Ol/O1/yyyy
PAR End Date, please enter 12/31/yyyy
Total number of SNs, includes CIUs
Number of CIUs
Number of SIUs with no IUP, or with an expired IUP
Number of Ss not inspected by POTW
Number of SIUs not sampled by POTW
Number of SNs in SNC due to NP Limit violations
Number of Ss in SNC due to Reporting violations
Number of SNs in SNC due to violation of a Compliance Schedule, CO, AO or similar
Number of CIUs in SNC
Number of SIUs included in Public Notice
Total number of SIUs on a compliance schedule, CO, AO or similar
Number of NOVs, NNCs or similar assesed to SIUs
Number of Civil Penalties assessed to SIUs
Number of Criminal Penalties assessed to SNs
Total Amount of Civil Penalties Collected 19. =>
Number of Ns from which penalties collected
AO
Administrative Order
IUP
Industrial User Pretreatment Permit
CIU
Categorical Industrial Uscr
NNC
Notice ofNon-Compliance
CO
Consent Order
NOV
Notice of Violation
RI
Industrial User
PAR
Pretreatment Annual Report
3.=>
1/1/2019
4.
_>
12/31/2019
5.=>
13
6.
_>
0
7.
_>
0
8.
_>
0
9.
_>
0
10.
_>
0
11.
_>
0
12.
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0
13.
_>
0
t 4.
_>
0
15.=>
0
16.
_>
76
17.
=>
1
18.
_>
0
$
1,250
20.
_>
1
POTW Publicly Owned Treatment Works
SIU Significant Industrial User
SNC Significant Non -Compliance
revised 1/2018: PAR PPS 2018

Pretreatment Program Info I?atabase
for Program Name Hickory
WWTP Name Northeast
Program Approval Date
01/01/1985
Pretreatment Status
Full
Region
MRO
County
Catawba
NPDES Number
NC0020401
printed on: 12/20/2019
1,t'. IWC % at7Q1013.40
ow cfs / mgd 60 / 38.76
1Q10 Flow cfs / mgd 49.15 / 31.77
Stream Classification WS-V & B
Basin Number CTB32
Receiving Stream Name CATAWBA RIVER
NPDES Effective Date 11/01I2016 Last PAR Rec 01/29/2019 PAR Due Date 03/01/2020 mercury
631
Current Fiscal required
NPDES Expire Date 04/30I2020 Year PCI Done
POTW is Primary WWTP TRUE Last Audit on 07/12/2018 Audit Year Next22/23 es
Design Flow mgd 6.0000 / Design mgd is SIU permitted 6.12 Permitted SIU flow (mgd) [Pt SIU) 367
WWTP SIU's program SIUs 13 l — -.
WWTP CIU's Program CIUs 0 ��F1 �, LTMP IWS SUO 3
date Inactive Date Next Due 08/01/2023
Date Received by DWR 07/30/2018 06/01/2018 � 09/04/2018 09/20/2012 _05/30/2018
Date Approved F 08/09/2018 06/07/2018_ 11 10/09/2018 10/22/2012 06/07/2018
Adopt Date Required 1
Date Adopted 12/04/2012
Info in this Box from Pt Contacts
Date Dale Date
PT_Pro Attended Attended Attended
Formal Name g.Pdme Phone1 ext Fax HWA Wksp IUP Wksp PAR Wksp
Mr. David Cox
Prim
828-322-4821
828-322-4961
2128/2013
111812017
[e-mail]
Pretreatment Coordinator
1310 Cloninger Mill Road
8601
Mr. Kevin Greer, P.E.
1
[phone]
[e-mail]
Public Services Director
jP0 Box 398
8603
DWR Central Office Contact ivien Zhong
DWR Regional Contact FesBell

Pretreatment Program Info Database printed on: 12/20/2019
for Program Name Hickory
WWrP Name Henry Fork
Program Approval Date 01/01/1985
Pretreatment Status Full
Region MRO
County Catawba
NPDES Number NC0040797
IWC % at 7010 34.04
QTMOW cfs / mgd 27 / 17.44
1 Q10 Flow cfs / mgd 22.24 / 14.37
Stream Classification C
Basin Number CTB35
Receiving Stream Name HENRY FORK RIVER
Last PAR Rec 01/29/2019 PAR Due Date 03/01/2020 mercury
NPDES Effective Date 09/01/2018 1631
NPDES Expire Date Current Fiscal required
p 07/31/2022 Year PCI Done
POTW is Primary WWTP FALSE Last Audit on 07/12/2018 Audit Year Next22/23 es
Design Flow mgd 9.0000 / Design mgd is SIU permitted 12.17 Permitted SIU flow (mgd) [Pt SIU) 1 095
WWTP Slu's 8 Program SIUs 13 �--� 9
WWTP CIU's 0 Program CIUs 0 ' LTMP IWg 7, SUp 7
�c
NEW
date Inactive Date Next Due 04/01/2023 F
Date Received by DWR 06/27/2019 07/01/2019 09/04/2018 09/20/2012 05/30/2 118
Date Approved 07/18/2019 07/18/2019 10/09/2018 10/22/20 2 FOB/07/2018
Adopt Date Required I
Date Adopted 12/ 44/2012
Info in this Box from P1�Contacts
Date Date Date
PT —Pro Attended Attended Attended
Formal Name g.Prime Phone1 ext Fax HWA Wksp IUP Wksp PAR Wksp
Mr. David Cox
DWR Central
Prim
828-322-4821
828-322-4961
2I2812013
1/18/2017
[e-mail]
Pretreatment Coordinator
1310 Cloninger Mill Road
8601
Mr. Kevin Greer, P.E.
1
11(828) 323-7427
[e-mail]
Public Services Director
JPTBox 398
8603
Office Contact ivien Zhong
DWR Regional Contact Fes Bell

nos SU REPORT
2072
2013
2014
2015
2076
2017
2018
1st half
i 2nd half
7sl half i 2nd half
let half I2nd half
1st half
i 2nd
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lst half i 2nd
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1st half i 2nd
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1st half i 2nd
half
Ward Hosiery Co., Inc. PreviousNames.
IUP# 0027 Pipe 001 peeunpacn:
Tvue
IUP Slalus: Active
Reporting � � IX
*See Correction In Narrative*
An'X' In a seml-annual perlotl Intllcales snc for the penotl for the respecllve parameter.
PRINTED ON: 12I20/2010 Thls Inlarmatlon Is complletl from many sources, and has nol been verlfietl. PAGE 3]
Contact the local pretreatment coordinator or state pretreatment staff ff erram are no[etl.

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19 July 2018
Mr. David Cox
Pretreatment Coordinator
City of Hickory
310 Cloninger Mill Road
Hickory, North Carolina 28601
Subject: Pretreatment Audit Inspection
City of Hickory
NPDES Permit No. NCO020401
Catawba County
Dear Mr. Cox:
ROY COOPER
Governor
NIICHAEL S. REGAN
Secremri
LINDA CULPEPPER
lnierm Director
Enclosed is
a copy of the Pretreatment Audit Inspection
Report for the
inspection of the City of
Hickory's Industrial
Pretreatment Program on July 12, 2018, by
Mr. Wes Bell
of this Office.
Should you have any questions concerning this report, please do not hesitate to contact Mr. Bell
at [phone], or via email at [e-mail].
Sincerely,
� DocuSigned by:
A"UW H PU*%1.
�-- F161FB69A2D84A3...
For W. Corey Basinger, Regional Supervisor
Water Quality Regional Operarions Section
Division of Water Resources, NCDEQ
Enclosure:
Inspection Report
cc: Vivien Zhong, PERCS Unit ([e-mail])
8rate of North Carolina Environmzntal �ivalitvl Rater Resources � Water Quality Regional Operations
Mooresville Regional Office 610 Ent Center Avenue, Suite 310 I Mooresville, North Carolina 281 16
7UJ-ti63-1699

NORTHa am
'/ DIVISION OF WATER RESOURCES
AUDITPRETREATMENT /'
Backeround Information
1. Control Authority (POTW) Name: City of Hickory
2, Control Authority Representative(s): David Cox
3. Title(s): Pretreatment Coordinator
4. Address ofPOTW:
Mailing: 310 Clonineer Mill Road
City: Hickory Zip Code: 28601
Phone Number [phone] Ext. 204 Fax Number [phone] E-Mail dcox(a.hickorvneedv
5. Audit Date 07/12/2018
6. Last Inspection Date: 12/16/2016 Inspection Type: ® PCI ❑ Audit
7. Has Program Completed All Requirements from the Previous Inspection and Program .Info Sheet(s)? ® Yes ❑ No
If No, Explain.
8. In the last year has the POTW experienced any NPDES or Sludge Permit compliance problems? ®Yes ❑ No
If Yes, Explain. Northeast W WTP - Weekly Average effluent TSS violation (April2017) and pH daily minimum
violation (October 2017); Henry Fork W WTP — Chronic Toxicity failure (February 2018),
9. Is POTW under an Order That Includes Pretreatment Conditions? ❑Yes ®No
Order Type and Number: _ Are Milestone Dates Being Met? ❑ Yes ❑ No ® NA
Parameters Covered Under Order.
ICIS Codine
Main Program Permit Number
INIC101012 10 14 IO I1
MM/DDlYY
I07112118�
10.
Current Number
of Significant Industrial Users (SNs)?
14
11.
Number of SNs
with No NP, or with an Expired, NP?
0
................................................................................................._...................�......
................................................................................_...................
12.
Number of SIDS
Not Inspected by POTW, in Last Calendar Year?
0
........................................
..............-............................-..........._............................_............._......._..........._........................
13.
Number of SNs
Not Sampled by POTW in Last Calendar Year?
0
.................................
..................................... .......................................................................... .............. ............................................ ...........
as
14.
Number of SNs
in SNC for Limits Violations During Either_ of Last 2 Semi -Annual Periods?
-........ -....also.
1
............................
.........................................................................................
.................................. .._..................................................... _...................
15.
Number of SIDS
in SNC for Reporting. Do inp_Either_of Last 2 Semi -Annual Periods?
0
....................................................................a.........................
.......................... _........._................................................................--................
16.
Number of SNs
in SNC with Pretreatment Schedule?
0
...............
..... ............ .... ............ ......
..-..-..................... ....... ............. _.......................... pop ........... .............. ...... ............................ ...................... ...................................... ......... ..............
17.
Number of SNs
on Schedules?
0
..........................-
.......... ............ .... .....
.......... .......... ....... .... .-... -........... pool ........ -................. -........ .......... .................................... .................... ._.... .....................................................
18.
Current Number
of
0.
.........................
oop..........
....... ........l.......
.
.........Categorical.Industrial,Users...�CNs)?........................._.............................._.............................-...........................
19.
Number of CIUs
in SNC?
0
NC DWR Pretreatment Audit Form Revised: December'016 Pagel

20, PRETREATMENT PROGRAM ELEMENTS REVIEW:
Program Element
Northeast WWTP (NC0020401)
Last Submittal
Date In file?
Last Approval
Date In file
Date Next Due,
If Applicable
Headworks Analysis (HWA)
07/29/14
®
Yes
❑
No
12/01/14
®
Yes
❑
No
08/01/19
Industrial Waste Survey (IWS)
10/01/13
®
Yes
❑
No
12/16/13
®
Yes
❑
No
10/01/18
Sewer Use Ordinance (SUO)
09/20/12
®
Yes
ElNo
10/22/12
®Yes
El
No
Enforcement Response Plan (ERP)
05/30/18
®
Yes
❑
No
06/07/18
®
Yes
❑
No
Long Term Monitoring Plan (LTMP)
06/01/18
®
Yes
❑
No
06/07/18
®
Yes
❑
No
Program Element
Henry Fork W WTP (NC0040797)
Last
Date
Submittal
In rile?
Last
Date
Approval
In file
Date Next Due,
If Applicable
Headworks Analysis (IIWA)
03/29/18
®
Yes
❑
No
06/07/18
®
Yes
❑
No
0411123
Industrial Waste Survey (IWS)
10/01/13
®
Yes
❑
No
12/16/13
®
Yes
❑
No
10/01/18
Sewer Use Ordinance (SUO)
09/20/12
®
Yes
❑
No
10/22/12
®
Yes
❑
No
Enforcement Response Plan (ERP)
05/30/18
®
Yes
❑
No
06/07/18
®
Yes
❑
No
Long Term Monitoring Plan (LTMP)
06/20/18
®
Yes
❑
No
07/03/18
®
Yes
❑
No
Legal Authority (Sewer Use Ordinance-SUO)
21. Do you have any towns and/or areas from which you receive wastewater which are not in your annexed jurisdiction?
® Yes ❑ No If yes, Please list these towns and/or areas. Hildebran, Longview, Brookford, and Catawba (Towns);
Alexander, Burke, and Caldwell Counties.
22. If yes to
421, Do you have current Interjurisdictional Agreements (IJAs) or other Contracts?
®Yes
❑ No
❑ NA
A copy,
if not already submitted, should be sent to Division.
23. If yes to #21, Have you had any trouble working with these towns or districts? ❑Yes ®No ❑ NA
If yes, Explain.
24. Date of Last SUO Adoption by Local Council 12/04/2012
25. Have you had any problems interpreting or enforcing any part of the SUO? ❑Yes ®No
If yes, Expla n.
Enforcement (Enforcement Response Plan-ERP)
26. Did you send a copy of the ERP to your
industries?
®Yes
❑ No
If no, POTW must send copy within 30
days.
27. Have you had any problems interpreting or enforcing any part of the ERP (i.e. any adjudication, improper enforcement, etc?
❑ Yes ®No If yes, Explain.
28. List Industries under a Schedule or Order and Type of Schedule or Order. N/A
NC DWR Pretreatment Audit Form Revised: Deceiuber 20J6 Pagel

Resources
29. Please Rate the Following: S=Satisfactory M=Marginal U=Unsatisfactory
Rating
Explanation, if Unsatisfactory
Personnel Available for Maintaining
POTW's Pretreatment Program
ES ❑M ❑U
Access to POTW Vehicles for
Sampling, Inspections, and
Ns ❑M ❑U
Emergencies
Access to Operable Sampling
Equipment
NS ❑M ❑U
Availability of Funds if Needed for
Additional Sampling and/or Analysis
Ns ❑M ❑U
Reference Materials
NS ❑M ❑U
Staff Training (i.e. Annual and
Regional Workshops, Etc.)
NS ❑M ❑U
Computer Equipment (Hardware and
Software)
Ns ❑M ❑U
30. Does the POTW have an adequate
data management system to run the pretreatment program?
N
Yes ❑ No
Explain Yes or No. Excell
31. How does the POTW recover the cost of the Pretreatment Program from their industries? Explain.
Surcharges, penalties, SIU performs resampling for violations found during POTW sampling event.
Public Perception/ Participation
32. Are there any local issues affecting the prefreatment program (e.g.. odor, plant closing, new or proposed.plants)?
❑ Yes N No If yes, Explain.
33. Has any one from the public ever requested to review pretreatment program files? ❑ Yes N No
If yes, Explain procedure. If no, how would the request be addressed? Written request would have to be submitted and
reviewed/approved by POTW's Attorney. Files would be reviewed at the Pretreatment Office under the supervision of
the Pretreatment Coordinator.
34. Has any industry ever requested that certain information remain confidential from the public? N Yes ❑ No If yes, Explain
procedure for determining whether information qualified for confidential status, as well as procedure fnr keeping files confidential
from public. If no how would the request be addressed? Written request would have to be submitted and the documentation
would be reviewed by the POTW Attorney, Public Services Managers, and Pretreatment Coordinator. Confidential files
would be kept in a locked office and file cabinet.
35. In addition to annual inspection, does the POTW periodically meet with industries to discuss pretreatment? N Yes ❑ No
36. Is the public notified about changes in the SUO or Local Limits? ®Yes ❑ No
37. Were all industries in SNC published in the last notice? N Yes ❑ No ❑ N/A
Permitting (Industrial Waste Survey-IWS)
38. How does the POTW become aware of new or changed Users? The Publc Services Department including
Pretreatment Coordinator meet monthly to discuss any new users. All satellite communities contact the
Pretreatment Coordinator of any new potential users.
39. Once the POTW becomes aware of new or changed Users, how does the POTW determine which industries have the
reasonable potential to adversely impact the W WTP and therefore require a new permit or a permit revision? (Who is an
�- SIU?) IWS Short/Long Form information reviewed for type of industrial activity, flow, loading, POCs, and
categorical parameters.
NC DWR Pretreatment Audit Form Revised: December �O16 Page 3

40. Does the POTW receive waste from any groundwater remediation projects (petroleum, CERCLA) or landfill leachate?
®Yes ❑No If Yes, How many are there? 2
Please list each site and how it is permitted, if applicable. Quality Oil (groundwater remediation)/local permit and
Caldwell County Landfill Leachate
41. Does the POTW accept waste by (mark if applicable) N Truck ❑Dedicated Pipe ❑ NA
42. If the POTW accepts trucked waste, what controls are placed on this waste? (example. designated point, samples drawn,
manifests required) Henry Fork W WTP — Caldwell County Leachate hauled via tanker to designated point with
samples drawn and manifests maintained. Septage haulers have a designated point in the Henry Fork W WTP's
collection system (Brookford) with each hauler being tracked by an electronic monitoring system.
43. How does the POTW allocate its loading to industries? Mark all that apply
❑ Uniform Limits N Historical Industry Need ❑ By Surcharge N Categorical Limits ❑Other
Explain Other:
44. Review POT W's copies of current allocation tables for each W WTP. Are there any over allocatons? ❑ Yes N No
If yes, what parameters are over allocated?
45. If yes to 944, What is being done to address the over allocations? (short-term IUPs, HWA to be revised, pollutant study, etc.)
46. Does the POTW keep pollutant loading in reserve for future growth / safety? N Yes ❑ No
If yes, what percentage of each parameter 10
47. Has the POTW experienced any difficulty in allocation? (for example: adjudication by an industry) ❑ Yes N No
If yes, Explain.
48. How does the POTW decide on which pollutants to limit in the permits? Monitor for? (for example: were only those pollutants
listed on the application limited; categorical parameters; NPDES Pollutants of Concern) NPDES POCs, categorical parameters.
49. How does the POTW decide what the monitoring frequency should be for the various pollutants in industry permits? Explain.
New SW would be required to monitor monthly for one year to determine baseline. All SIUs are required to monitor three
times per six-month period at a minimum.
50. Does the POTW currently have or during the past year had any permits under adjudication? ❑ Yes N No
If yes, which industries? What was (will be) the outcome of the adjudication?
51. Demonstrate how the POTW judges compliance. This should include compliance judgment on all violations of limits, reporting
requirements, and permit conditions, as well as for SNC. Compliance Judgment Worksheet used for SNC determinations,
violations (limit, monitoring, reporting, permit conditions, etc.) are addressed per ERP.
52. Does the POTW use the Division's model inspection form or equivalent? N Yes ❑ No
If no, does the POTW form include all Division data? ❑ Yes ❑ No
53. Were all SIUs evaluated for the need of a slug/spill control plan during their most recent inspections? N Yes ❑ No
If no, Explain.
54. What criteria are used to determine if a slug/spill control plan is needed? POTW requires all SIUs to have a slug/spill control
plan.
55. What criteria does the POTW use to determine if a submitted slug/spill control plan is adequate? All emergency contacts kept
updated, proper secondary containment/chemical storage practices, presence of emergency response equipment.
56. How does the POTW decide where the sample point for an SIU should be located? Sampling is preferred only at the regulated
waste stream.
57. Has the POTW established a procedure to ensure that representative samples will be taken by the POTW or SIU each time?
(example: correct location; proper programming of sampler; clean equipment; swirling the sample bucket uniformly)
POTW: N Yes ❑ No SIU: N Yes ❑ No If yes, Explain. Sampling SOPS and sampler O&M manuals
NC DWR Pretreatment Audit Form Revised: Deeember 2016 I Page 4

58. Who performs sample analysis for the POTW for Metals: Pace Analytical Services
Conventional Parameters: POTW's on -site certified lab
Organics: Pace Analytical Services
59. Explain the Chain of Custody Procedure used for both in house and commercial lab samples.
POTW uses internal COC and/or contracted lab's COC; SIU's used contracted lab's COC.
Long/Short Term Monitoring Plan (L/STMP) and Headworks Analysis (HWA)
60a. Is LTMP/STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? N YES ❑ NO
60b. Are Correct Detection Levels being used for all LTMP/STMP Monitoring? N YES []NO
60c. Is LTMP/STMP Data Maintained in Table or Equivalent? N YES ❑ NO Is Table Adequate? ® YES ❑ NO
60d. All LTMP/STMP effluent data on Discharge Monitoring Report (DMR)? N YES ❑ NO
60e.
60f
If NO to any above, list violations
Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? ❑ YES N NO
If yes, which ones?
61. Do you complete your own headworks analysis (HWA) ? ❑ Yes N No
If no, who completes your HWA? McGill & Associates Phone [phone]
62. Do you have plans to revise your HWA in the near future? N Yes ❑ No
If yes, what is the reason for the revision? (mark all that apply) ❑Increased average flow ❑NPDES limits change
❑More LTMP data available ❑Resolve over allocation ❑5 year expiration NOther
Explain. Henry Fork W WTP's HWA will be updated once sampling for Bis (2-ethylhexyl) phthalate and oil & grease
(according to the LTMP) is performed.
63. In general, what is the most limiting criteria of your HWA? ❑Inhibition ❑Pass Through NSludge QualiTy
64. Do you
see any way
to increase your loading in the future
(Example:
obtaining.more
land for sludge
disposal)?
❑Yes
❑ No
Explain.
N/A —both
WWTPs have sufficient capacity.
NC DWR Pretrealmeat Audit Foam Revised: Decenil+er''0.1 G Page 5

65, Do you plan any significant changes to the pretreatment program or changes to the W WTP that may affect pretreatment? No
INDUSTRIAL USER YERMff lUY rll.Y tce:vrr,w
66.
67.
68.
69,
70.
71.
User Name I. Ward Hosiery 2, Catawba Valley
IUP Number
Does File Contain Current Permit?
Permit E iration Date
Cate orical Standard A lied (I.E. 40 CFR Etc.) Or N/A
Does File Contain Permit Application Completed Within One Year Prior
Medical Center
0027
®Yes ❑ No
7!7/21L
N/A
M Yes ❑ No
3. Hickory Dyeing
F no-3 IL0008
®Yes ❑ No
7/7/21
460
M Yes ❑ No
& Winding
®Yes ❑ No
E. 7/7/19
410
® Yes ❑ No
72.
73.
74.
to Permit Issue Date?
Does File Contain Inspection Completed Within Last Calendar Year?
a. Does File Contain Slug/Spill Control Plan?
b. If No, is One Needed? (See Ins ection Form from POTW)
For 40 CFR 413 and 433 TTO Certification, Does File Contain a Toxic
M Yes ❑ No
®Yes ❑ No
®Yes ❑ No
a. ®Yes ❑No
b. ❑Yes ❑No
a. ®Yes [,],No
b. ❑Yes ❑No
a. ®Yes []No
b. ❑Yes ❑No
❑YesONo®N/A
OYesONo®N/A
❑YesONo®N/A
75.
76.
Organic Management Plan (TOMP)?
a. Does File Contain Original Permit Review Letter from Division?
b. All Issues Resolved?
During Most Recent Semi -Annual Period, Did POTW Complete its
a. ®Yes ❑No
b.oYesriNo®N/A
a. ®Yes ❑No
b.oYesoNo®N/A
a. ®Yes ❑No
b.oYesoNo®N/A
M Yes ❑ No
M Yes ❑ No
M Yes ❑ No
77.
78.
Sampling as Required by IUP, including Flow?
Does File Contain POTW Sam ling Chain -Of -Custody Forms?
During Most Recent Semi -Annual Period, Did SIU Complete its
M Yes ❑ No
®YesDNo0N/A
F2 Yes ❑ No
®YesONoON/A
M Yes ❑ No
®YesONo❑N/A
79.
SamplinE as Required by IUP, includin Flow?
During Most Recent Semi -Annual Period, Did SILT submit all reports on
❑Yes®NoON/A
®YesONoClN/A
®YesONo❑N/A
time?
80a.
For categorical IUs with Combined Wastestream Formula (CWF), does
❑YespNo®N/A
OYesONoON/A
OYesONoON/A
file includeprocess/dilution flows as Re uired by 1UP?
80b. For categorical Ns with Production based limits, does file include
OYesONo®N/A
❑Yc—s No ®N/A
pYespNo®N/A
production rates and/or flows as Re aired by RTP?
81.
82.
During Most Recent Semi -Annual Period, Did POTW Identify All
Limits Non -Compliance from Both POTW and SIU Sam ling?
During Most Recent Semi -Annual Period, Did POTW Identify All
0Yes0No®N/A
®YesONoON/A
EYesONo❑N/A
OYesONo®N/A
Oyes❑NOON/A
OYesONo®N/A
83.
Reporting Non -Compliance from SIU Sampling?
a. Was POTW Notified by SILT (Within 24 Hours) of All Self-
a.DYesoNo®N/A
a.oYesoNo®N/A
a.oYesoNo®N/A
Monitoring Violations?
b. Did Industry Resample and submit results to POTW within 30 Days?
b.oYesoNo®NIA
b.®YesoNooN/A
b.oYesoNo®N/A
84.
85.
c. If applicable, did POTW resample and obtain results within 30 days of
becoming aware of SIU limit violations in the POTW's. sampling of SIM
During Most Recent Semi -Annual Period, Was SIU in SNC?
During Most Recent Semi -Annual Period, Was Enforcement Taken as
c.oYesoNo®N/A
❑ Yes M No
c.oYesotlo®N/A
❑ Yes- M No
c.DYesoNo®N/A
ElYes M No
®YesONoDN/A
OYesONOON/A
OYesONoPIN/A
86.
87.
Specified inPOTW's ERP (NOVs, Penalties, timing, etc.)?
Does File Contain Penalty Assessment Notices?
Does File Contain Proof Of Penalty Collection?
OyesONo®N/A
OyesONoON/A
OYesONo®N/A
❑YesONoON/A
E]YesoNoON/A
OYesClNo®N/A
a.oYesoNo®N/A
b.oYesoNo®N/A
88.
89.
a. Does File Contain Any Current Enforcement Orders?
b. Is SIU m Compliance with Order? -
Did POTW Representative Have Difficulty in Obtaining Any Requested
a.oYesoNo®N/A
b.OYesONo®N/A
a.oYesoNo®N'/A
b.D esoNo®N/A
El es M No
❑ Yes M No
❑ Yes M No
-
Information For You?
FILE REVIEW COMMENTS:
14. Kleen Tech was in SNC for the second half of 2017 for oil &grease TRC limit violations.
72, pOTW performed SIU inspections on 9/27/17 (Ward Hosiery), 8/15/17 (Catawba Valley Medical Center), and 10/26/17
(Hickory Dyeing & Finishing).
78. The following labs were contracted by the SIUs for sampling/analyses: Pace Analytical Services (Ward Hosiery); Statesville
Analytical (Catawba Valley Medical Center), and Water Tech Labs (Hickory Dyeing & Finishing).
NC DWR Pretreatment Audit Form Revised: Decemher 2016 Page

81185. Catawba Valley Medical Center was issued a Notice of NonCompliance (NoNC) on 2/12/18 for TSS and zinc limit violations
during the January 2018 POTW sampling event.
82/85. Ward Hosiery was issued a Notice of NonCompliance (NoNC) on 3/7/18 for the late reporting of the January 2018 self -
monitoring data.
INDUSTRY INSPECTION ICIS CODING:
Main Program Pemut Number MM/DD/YY
INIC101012 10141011I 1071121181
1. Industry Inspected: Ward Hosiery Company, Inc.
2. Industry Address: 141013tb Street SW, Hickory, NC 28603
3. Type of Industry/Product: Textile (Dyeing & Finishing)/Socks
4. Industry Contact: Richard Ward Title: Owner Phone: [phone] Fax: [phone]
5. Does the POTW Use the Division Model Inspection Form or Equivalent? ® Yes ❑ No
6. Did the POTW Contact Conduct the Following Parts of the Industrial Inspection Thoroughly?
Comments:
A.
Initial Interview
® Yes
❑
No
B.
Plant Tour
® Yes
❑
No _
C.
Pretreatment Tour
® Yes
❑
No
D.
Sampling Review
® Yes
❑
No
E.
Exit Interview
® Yes
❑
No
Industrial Inspection Comments:
The facility operates eight hours per day and five days per week with eighteen (18) employees. All wastewater flows into a trough
prior to flowing into the POTW's sewer system. There are no pretreatment processes/units.
AUDIT COMMENTS:
The POTW's
records were organized
and well maintained. This Office recommends that
the Pretreatment Coordinator be given
copies of the
IJAs (currently being
kept at the Public Services Department Office).
The POTW's Industrial Pretreatment
Program was being properly implemented.
NOD: ❑Yes ®No
NOV: ❑ Yes ® No
QNCR: ❑ Yes ® No
POTW Ratinu:
Satisfactory ® Marginal ❑ Unsatisfactory ❑
E�O/ocuSigned by:
M16ND9DGC3437... Audit COMPLETED BY: DATE: 7/18/2018
Wes Bell, WQROS, Mooresville Regional Office
NC D WR Pretreatment Audit Form Revised: December _016 Page 7

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aceAnalytical
n .Pamlabs.m
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Kleen Tech TTO
Pace Project No.: 92441771
8l15/19
0_
0 7 / ) 6aj
Sample: Kleen Tech WO Grab
Lab ID: 92441771001
Collected: 08115/19
09:05
Received:
08/16/19 09:52
Matrix: Water
Parameters
Results
Units
Report Limit
DF
. Prepared
Analyzed
CAS No. Qual
608 PCB Pest RVE
Analytical Method:
EPA 608.3
Preparation Method:
EPA 608.3
Aldrin
ND
ug/L
0.50
1
08/2011912:55
08120/1915:37
309-00-2
alpha-BHC
ND
ug/L
0.50
1
08/2011912:55
08120/1915:37
319-84-6
beta-BHC
ND
ug/L
0.50
1
08/20/19
12:55
08/20/19
15:37
319-85-7
delta-BHC
ND
ug/L
0.50
1
0812011912:55
08/2011915:37
319-86-8
gamma-BHC (Lindane)
ND
ug/L
0.50
1
08120/1912:55
08/20M915:37
58-89-9
Chlordane (Technical)
ND
ug/L
5.0
1
08/20/19
12:55
08/20/19
15:37
57-74-9
alpha -Chlordane
ND
uglL
0.50
1
08/20/19
12:55
0812011915:37
5103-71-9
gamma -Chlordane
ND
ug/L
0.50
1
0812011912:55
06120/1915:37
5103-74-2
414'-DDD
ND
ug/L
0.50
1
08120/1912:55
08120/1915:37
72-54-8
414'-DDE
ND
ug/L
0.50
1
08/20/19
12:55
08/20/19
15:37
72-55-9
4,4'-DDT
ND
uglL
0.50
1
0812011912:55
08/2011915:37
50-29-3
Dieldrin
ND
ug/L
0.50
1
08120/1912:55
08120/1915:37
60-57-1
Endosulfan I
ND
ug/L
- 0.50
1
0812011912:55
08/20/19
15:37
959-98-8
Endosulfan II
ND
ug/L
0.50
1
0812011912:55
08/20/19
15:37
33213-65-9
Endosulfan sulfate
ND
ug/L
0.50
1
08120/1912:55
08/2011915:37
1031-07-8
Enddn
ND
ug/L
0.50
1
08/20/19
12:55
08/2011915:37
72-20-8
Enddn aldehyde
ND
ug/L
0.50
1
08120/1912:55
08/2011915:37
7421-93-4
Heptachlor
ND
ug/L
0,50
1
08120/1912:55
08/2011915:37
76-44-8
Heptachlor epoxide
ND
ug/L
0.50
1
08/20/19
12:55
08/2011915:37
1024-57-3
PCB-1016 (Aroclor 1016)
ND
ug/L
5.0
1
08/20/19
12:55
08/20/19
15:37
12674-11-2
PCB-1221 (Aroclor 1221)
ND
ug/L
5.0
1
08120/1912:55
08120/1915:37
11104-28-2
PCB-1232 (Aroclor 1232)
ND
ug/L
5.0
1
08/20/19
12:55
08/20/19
15:37
11141-16-5
PCB-1242 (Aroclor 1242)
ND
ug/L
5.0
1
08/20/19
12:55
08/20/19
15:37
53469-21-9
PCB-1248 (Aroclor 1248)
ND
ug/L
5.0
1
08/20/19
12:55
08120/19
15:37
12672-29-6
PCB-1254 (Aroclor 1254)
ND
ug/L
5.0
1
08/20/19
12:55
08/20/19
15:37
11097-69-1
PCB-1260 (Aroclor 1260)
ND
ug/L
5.0
1
08/20/19
12:55
08/20/19
15:37
11096-82-5
Toxaphene
ND
ug/L
5.0
1
08/2011912:55
08/20/19
15:37
8001-35-2
Surrogates
Tetrachloro-m-xylene (3)
40
%
10-130
1
08/20/19
12:55
08/20/19
15:37
877-09-8
Decachloroblphenyl (S)
26
%
10-130
1
08/20/19
12:55
08/20/19
15:37
2051-24-3
625 MSSV
Analytical Method:
EPA 625.1
Preparation Method:
EPA 625.1
Acenaphthene
ND
ug/L
4.9
1
08/22/19
13:21
08/22/19
20:18
83-32-9
Acenaphthylene
ND
ug/L
4.9
1
08/2211913:21
0812211920:18
208-96-8
Anthracene
ND
ug/L
4.9
1
08/22M913:21
0812211920:18
120-12-7
Benzo(a)anthracene
ND
ug/L
4.9
1
0812211913:21
08122/1920:18
56-55-3
Benzo(a)pyrene
ND
ug/L
4.9
1
0812211913:21
08122/1920:18
50-32-8
Benzo(b)fluoranthene
ND
ug/L
4.9
1
08/22/19
13:21
08/22119
20:18
205-99-2
Benzo(g,h,i)perylene
ND
ug/L
4.9
1
08122/1913:21
0812211920:18
191-24-2
Benzo(k)0uoranthene
ND
ug/L
4.9
1
08/22/19
13:21
08/22/19
20:18
207-08-9
4-Bromophenylphenyl ether
ND
ug/L
4.9
1
08/2211913:21
0812211920:18
101-55-3
Butylbenzylphthalate
ND
ug/L
4.9
1
08/22/1913:21
08/2211920:18
85-68-7
4-Chloro-3-methylphenol
ND
ug/L
4.9
1
08/22/1913:21
0812211920:18
59-50-7
bis(2-Chloroethoxy)methane
ND
ug/L
9.7
1
0812211913:21
08/2211920:18
111-91-1
bis(2-Chloroethyl) ether
ND
ug/L
4.9
1
08/22/1913:21
08/2211920:18
111-44-4
2-Chloronaphthalene
ND
ug/L
4.9
1
08/22/1913:21
08/22/1920:18
91-58-7
2-Chlorophenol
ND
uglL
4.9
1
0812211913:21
08/2211920:18
95-57-8
REPORT OF LABORATORY ANALYSIS
Page 4 Of 25
This report shall not be reproduced, except in full,
Date:
08/27/2019
12:10
PM
without the written consent of Pace Analytical Services, LLC,

aceAnalytical
w,wrpsoslabs.com
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Hunlersville, NC 28078
[phone]
Project: Kleen Tech TTO
8/15/19
Pace Project No.: 92441771
Sample: Kleen Tech TTO Grab
Lab ID: 92441771001 Collected: 08/15/19
09:05
Received: 08/16/19 09:52
Matrix: Water
Parameters
Results
Units
Report Limit
OF
Prepared
Analyzed
CAS No. Oual
625 MSSV
Analytical Method:
EPA 625.1
Preparation Method:
EPA 625.1
4-Chlorophenylphenyl ether
NO
ug/L
4.9
1
08/22119
13:21
08/22/19 20,18
7005-72-3
Chrysene
NO
ug/L
4.9
1
0812211913:21
08/22/19 20:18
218-01-9
Dibenz(a,h)anthracene
NO
ug/L
4.9
1
08/22119
13:21
08122/1920:18
53-70-3
3,3'-Dichlorobenzidine
NO
ug/L
24.3
1
08/22/19
13:21
08122/19 20:18
91-94-1
2,4-Dichlorophenol
NO
ug/L
4.9
1
08/22119
13:21
08122/1920:18
120-83-2
Dielhylphthalale
NO
ug/L
4.9
1
08/22/19
13:21
08/22/19 20:18
84-66-2
2,4-Dimethylphenol
NO
ug/L
9.7
1
08/22/19
13:21
08/22M9 20:18
105-67-9
Dimethylphthalale
NO
ug/L
4.9
1
08/22/19
13:21
08/22119 20:18
131-11-3
Di-n-butylphthalale
NO
ug/L
4.9
1
08/22/19
13:21
0812211920:18
84-74-2
4,6-13inilro-2-methylphenol
NO
ug/L
19.4
1
06/22/19
13:21
08/22/19 20:18
534-52-1
2,4-Dinitrophenol
NO
ug/L
48.5
1
08/22/19
13:21
08/22/19 20:18
51-28-5
2,4-Dinitrotoluene
NO
ug/L
4.9
1
08/22M913:21
08/22119 20:18
121-14-2
2,6-Dinitrotoluene
NO
ug/L
4.9
1
08/22/19
13:21
08/22119 20:18
606-20-2
Di-n-octylphthalate
NO
ug/L
4.9
1
08/22119
13:21
08122/1920:18
117-84-0
bis(2-Ethylhexyl)phthalate
9.2
ug/L
4.9
1
0812211913:21
08/22119 20:18
117-81-7
Fluoranlhene
NO
ug/L
4.9
1
08/22/19
13:21
08/22119 20:18
206-44-0
Muorene
NO
ug/L
4.9
1
08/22119
13:21
08/22/19 20:18
86-73-7
Hexachloro-1,3-butadiene
NO
ug/L
4.9
1
08/22/19
13:21
08122/1920:18
87-68-3
Hexachlorobenzene
NO
ug/L
4.9
1
08/22119
13:21
0812211920:18
118-74-1
Hexachlorocyclopentadiene
NO
ug1L
9.7
1
0812211913:21
0812211920:18
77-47-4
Hexachlomethane
NO
ug/L
4.9
1
0812211913:21
08122/1920:18
67-72-1
Indeno(1,2,3-cd)pyfene
NO
ug/L
4.9
1
0812211913:21
0812211920:18
193-39-5
Isophorone
NO
ug/L
9.7
1
08/22119
13:21
08/22/19 20:18
78-59-1
Naphthalene
NO
ug/L
4.9
1
0812211913:21
0812211920:18
91-20-3
Nitrobenzene
NO
ug/L
4.9
1
08/22119
13:21
08/22119 20:18
98-95-3
2-Nitrophenol
NO
ug/L
4.9
1
08/22/19
13:21
08/22M920:18
88-75-5
4-Nltrophenol
NO
ug/L
48.5
1
08/22/19
13:21
08/22119 20:18
100-02-7
N-Nitrosodimethylaniine
NO
ug/L
4.9
1
08/22/19
13:21
08/22/19 20:18
62-75-9
N-Nitroso-di-n-pmpylamine
NO
ug/L
4.9
1
08/22119
13:21
08122/1920:18
621-64-7
N-Nilrosodiphenylamine
NO
ug/L
9.7
1
08/22119
13:21
0812211920:18
86-30-6
2,2'-Oxybis(t-chloropropane)
ND
ug/L
4.9
1
08/22119
13:21
08/22/19 20:18
108-60-1
Pentachlorophenol
NO
ug/L
9.7
1
08/22119
13:21
08/22/19 20:18
87-86-5
Phenanthrene
NO
ug/L
4.9
1
08/22/19
13:21
08/22119 20:18
85-01-8
Phenol
NO
ug/L
4.9
1
08/22119
13:21
0812211920:18
108-95-2
Pyrene
NO
ug/L
4.9
1
08122/19
13:21
08/22119 20:18
129-00-0
1,2,4-Trichlorobenzene
ND
ug/L
4.9
1
0812211913:21
08/22119 20:18
120-82-1
2,4,6-Tdchlorophenol
NO
ug/L
9.7
1
08122/19
13:21
08/22119 20:18
88-06-2
Surrogates
Nitrobenzene-d5(S)
63
%
10-120
1
08/22119
13:21
0812211920:18
4165-60-0
2-Fluorobiphenyl(S)
70
%
15-120
1
08/22119
13:21
08122/1920:18
321-60-8
Terphenyl-d14 (S)
68
%
11-131
1
08/22/19
13:21
08/22/19 20:18
1718-51-0
Phenol-d6 (S)
23
%
10-120
1
08/22/19
13:21
08/22/19 20:18
13127-88-3
2-Fluorophenol (S)
31
%
10-120
1
08/22/19
13:21
08/22/19 20:18
367-12-4
2,4,6-Tribromophenol(S)
92
%
10-137
1
08/22/19
13:21
08/22/19 20:18
116-79-6
624 Volatile Organics
Analytical Method:
EPA 624.1
Benzene
NO
ug/L
1.0
1
08/20/1922:33
71-43-2
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Dale: OB/27/2019 12:10 PM out the written consent of Pace Analytical Services, LLC. Page 5 of 25

aceAnalytical
wwivpace/akcom
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9000 Kincey Ave. Suite 100
Huntersville, NC 2BO78
[phone]
Project: Kleen Tech TTO 8/15/19
Pace Project No.: 92441771
Sample: Kleen Tech TTO Grab Lab ID: 92441771001 Collected: O8/15119 09:05 Received: 08116/19 09:52 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual
624 Volatile Organics
Analytical Method:
EPA 624.1
Bromodichloromelhane
ND
ug/L
2.0
1
08/2011922:33
75-27-4
Bromoform
ND
ug/L
2.0
1
08/20/19 22:33
75-25-2
Bromomethane
ND
ug/L
2.0
1 -
08/20/19 22:33
74-83-9
Carbon tetrachloride
ND
ug/L
2.0
1
08/20119 22:33
56-23-5
Chlorobenzene
ND
ug/L
2.0
1
08/20/19 22:33
108-90-7
Chloroethane
ND
ugll-
2.0
1
08/20/19 22:33
75-00-3
Chloroform
60.4
ug/L
5.0
1
08/20/19 22:33
67-66-3
Chloromethane
ND
ug/L
2.0
1
08/20/19 22:33
74-87-3
Dibromochloromethane
ND
ug/L
2.0
1
08/20/19 22:33
124-48-1
1,2-Dichlorobenzene
ND
ug/L
2.0
1
08/20/19 22:33
95-50-1
1,3-Dichlorobenzene
ND
ug/L
2.0
1
08/20/19 22:33
541-73-1
1,4-Dichlorobenzene
ND
ug/L
2.0
1
08/20/19 22:33
106-46-7
1,1.Dichloroethane
ND
ug/L
2.0
1
08120/1922:33
75-34-3
1,2-Dichloroethane
ND
ug/L
2.0
1
O6/20/19 22:33
107-06-2
1,1-Dichloroethene
ND
ug/L
2.0
1
08/2011922:33
75-35-4
cis-1,2-Dichloroethene
ND
ug/L
2.0
1
08/2011922:33
156-59-2
trans-1,2-Dichloroethene
ND
ug/L
2.0
1
08/2011922:33
156-60-5
1,2-Dichloropropane
ND
ug/L
2.0
1
08/20/19 22:33
78-87-5
cis-1,3-Dichloropropene
ND
ug/L
2.0
1
08120/1922:33
10061-01-5
trans-1,3-Dichloropropene
ND
ug/L
2.0
1
08/2011922:33
10061-02-6
Ethylbenzene
ND
ug/L
1.0
1
08/2011922:33
100-41-4
Methylene Chloride
ND
ug/L
5.0
1
08/20/19 22:33
75-09-2
1,1,2,2-Tetrachloroe(hane
ND
ug/L
2.0
1
08120/1922:33
79-34-5
Tetrachloroethene
ND
ug/L
2.0
1
08/20/19 22:33
127-18-4
Toluene
1.7
ug/L
1.0
1
08/20/19 22:33
108-88-3
1,1,1-Trichloroethane
ND
ug/L
2.0
1
08/20/19 22:33
71-55-6
111,2-Trichloroethane
ND
ug/L
2.0
1
08/20/19 22:33
79-00-5
Trichloroethene
ND
ug/L
2.0
1
08/20/19 22:33
79-01-6
Trichloro0uoromethane
ND
ug/L
2.0
1
08/20/19 22:33
75-69-4
Vinyl chloride
ND
ug/L
2.0
1
0812011922:33
75-01-4
Surrogates
4-Bromo0uorobenzene (S)
97
%
70-130
1
08/20119 22:33
460.00-4
Toluene-d8 (S)
98
%
70-130
1
08/20/19 22:33
2037-26-5
1 ,2-Dichloroethane-d4(S)
97
%
70-130
1
08/20/19 22:33
17060-07-0
420.4 Phenolics, Total
Analytical Method:
EPA 420.4
Rev 1.01993 Preparation
Method:
EPA 420.4 Rev 1.01993
Phenol
0,087
mg/L
0.040
2 0811911910:07
08/1911914:18
108-95-2
450OGNE Cyanide, Total
Analytical Method:
SM 4500-CN-E-2011 Preparation Method: SM 4500-CN-E-2011
Cyanide
0,013
mg1L
0.0080
1 08/17119
14:00 08/18/19 14:10
57-12-5
REPORT OF LABORATORY ANALYSIS
This
report shall
not be reproduced,
except in full,
Date: 08/27/2019 12:10 PM
without the written consent
of Pace Analytical
Services, LLC.
Page 6 of 25

aceAnalytical
W ..paolabs,=
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9600 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Kleen Tech TTO 8/15/19
Pace Project No.: 92441771
Sample: Kleen Tech TTO Comp Lab ID: 92441771002 Collected: 08/15/19 09:05 Received: 08/16/19 09:52 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
200.7 MET ICP Analytical Method: EPA 200.7 Rev 4.4 1994 Preparation Method: EPA 200.7 Rev 4.4 1994
Antimony
ND
uglL
5.0
1
08/2011912:41
OB/22/19
02:32
7440-36-0
Arsenic
ND
ug/L
10.0
1
08/20/19
12:41
08/22/19
02:32
7440-38-2
Beryllium
ND
ug/L
1.0
1
08/2011912:41
08/22119
02:32
7440-41-7
Chromium
16.8
ug/L
5.0
1
08/20/19
12:41
08/22119
02:32
7440-47-3
Nickel
14.1
ug/L
5.0
1
08/20/19
12:41
08/22119
02:32
7440-02-0
Thallium
ND
ug/L
10.0
1
08/20/19
12:41
08/22119
02:32
7440-28-0
Zinc
681
ug/L
10.0
1
0812011912:41
08122/1902:32
7440-66-6
200.8 MET ICPMS
Analytical Method:
EPA 200.8
Rev 5.4 Preparation
Method: EPA
200.8
Rev 5.4
Cadmium
0,60
ug/L
0.40
1
08121/1916:15
0812211908:50
7440-43-9
Copper
62A
ug/L
2.5
1
08/21/1916:15
0812211908:50
7440-50-8
Selenium
ND
ug/L
2.5
1
08/2111916:15
0812211908:60
7782-49-2
Silver
ND
ug/L
2.0
1
08121/1916:15
0812211908:50
7440-22-4
245.1 Mercury
Analytical Method:
EPA 245.1
Rev 3.0 1994 Preparation
Method:
EPA 245.1 Rev
3.0
1994
Mercury
ND
ug/L
0.20
1
0812111910:11
08/2611910:35
7439-97-6
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/27/2019 12:10 PM without the written consent of Pace Analytical Services, L-C. Page 7 of 25

IESEARCk & ANAtyTICAI
LAt?ORATORIES? INC.
Anolytical/Process Consultatlons
NC Ng4
Chem icalAnalysts far Selected Parameters and Water Sample Ident fled as Mum Tech
(A Water Tech Labs free. Project, collected 1.2 ! ebruary 1019) TTO- o.e> I10 w,!0 /1.
1, Volat11e Organics Quantitption Ween Tech 11, Semi -volatile Organics Quantimflon [(teen Tech
EPA Method 624 Limit Method 625 Limit
parnmeter m/L mUL Parameter MA rir 1
Mpthylcao Chlorlda Q,OIO BQI. 40lamq-mmhylphenol 01010 BQl,
Trichlom0uoromethone Q,010 BQL 2'Chlorophen0l 0.010 BQL
1,1-J chloroethene 0.016 dQL 2,4-1)lchlumphenol 0,010 BQL
111-01chtorwhane 0.010 BQL 2,44%nmahylphenol 010 BQL
Chlamrotm 0.010 0107X 2,41Dlnl40phonpl 040$0 BQL
cnrhop')'.etm&bludde Q,.010 BQL 2-Methyl44,6; 4ipluophenol 0,059 13QL
i'VACldoropropano 0AI0 BQL 2-14itrupbenol 6.010 B'QL
Trichlonothone O,Q.10 BQL 4-Nilmphenol Q.QSQ. BQL
Di6romochluremethunc - O,QIQ BQL P9rnaohlolophenpl 054. B.QL
1,1,�-Trichloroelhuna O.QtO 11_f3L Phenol O,OiQ I30L
Tpimchldroc0ten0 U10 qQ4 2,4,6-Triehlorophenol b6019 BQL
Chl9rdonzene 0,0)0 NL. Aeenaplithene 019.10.. BQL
Tmm°1;1Uiallorouthena tipi6 11Q4 Lca06p11y)enn 0,01Q [7 �
1,11)ichlorgmhano Q•QIO lj t, Anlhruoene 0,610 01QL
1,1,1.7Yiohimoequmn 'plow BQL BevAldm a 0*4 BQL
Bramodlchlaromolhane 0,010 BQL HenzoWunthroome O,OIg hQL
Cls•1,3.1)ichigmpmpeno OA10 BQL Benzn(a)pymno 01610 HQL
Benzine A010 BQL Bdow(b)Bttomulhahp 0,010. BQL
Trgas-I,J-Dlchlompropone 0.010 AQL Benzo.(gbi)perylenu O,OIO. BQL
Bromalbmr O,alO BQL. Bcozo(k)nuomnlhene 010. BQL
1,1,2,2-TaUachloraelbep9 OAtb BQL Benzyl Only] phlhalate 0.010 HQL
Toluene BQL Bis(2-cbiomethoxy)mc1hane 0A10 SQL
Ethyl Benzene 0.010 BQL Bh(2•chlamelhy1)61har. 0.010 BQL
Chlammelhmo AM BQL, Bin(2-dhh1ohopmpylimher 0.010 BQL
Bromgmc(pnu 019 9Q4 Bk(Uthyl•hcxyl$h{hplatr, boo BQL
Vinyl Chlgtida .0.010 ➢QL 4Ajglnophomyl phenyl other O,,, 0 BQL
chloraeth"o o:0i0 BQL 2=6Moropaphlhnlcno 0;1110 DQ4
Tulin) t. lenes 40t6 BQI, AC.hlgroplumyl phenyl other OA10 BQL
Acroleur 4,100 BQL Chrysanc 616to BQL
_Actylonbrile 0:760 IiQL D]hen;a(gh)gnthrecpno O.iltO BQL
9-010641 Vinyl ether 0,010 AOL BQL
Dilution
Paccar
Samplu NumOer
Sample0ntc.
$amptu Tlma (hm)
630504II
02/12119
1040
2,fi•1?InlUglglpano
DhN•Qctyl phUrolnti
plµorunWane
Ha xachlorohenz.9oo
Nexachferobwadleae
Hex a alaloracyclopan.hWcne
>'yrgna
I,2,4•Trichlnmbcmzune
Drathyl pbthplate
Uimclbyl phthalate
Fluotone
diphenylhydruz]ne
D]lutlon Factor
Sample Number
6nmpla bate
Snmple'Cima(hrs)
o.0z0
0:014
4:Oi0
6.1)1u
0.Oi6
Q,O50
63050.01
02/12119
1040
BQL Bulow Quanlitotian Llmits in(;/L =miillgmms per LilcF-pans par million (ppm)

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Hickory Daily Record
Advertising Affidavit
PO Box 968
Hickory, NC 28603
HICKORY; CITY OF
ATTN: ACCOUNTS PAYABLE
PO BOX 398
HICKORY, NC 28603
Account Number
3175407
Date
January 13, 2020
Received
JAN 17 Wa
puhaic Utifrt%P`
Date Category Description Ad Number Ad Size
01/13/2020 Legal Notices
ktp of Hmkery, is aaordauce wilh F¢d¢ral and Sfate Regulatiom is
y giving Puhliu NONce, Well hebw are Significant Indusldal NMM
were in Sigoiltant NoaColiphilce (SNQ Oth n6oal prelreat•
rqulafion , 40 CFR Pad 403, Stale prehealment mgula0ar6, 15
; 2N.090, and local prehealment regulifoos during the period of
HONE
NONE
PUBLIC NOTICE OF SIGNIFICANT INDUSTRIAL WASTEWAI 0000622881 2x191.
Publisher of
Hickory Daily Record
Catawba County
Before the undersigned, a Notary Public of Iredell County, North Cazolina, duly
commissioned, qualified, and authorized by law to administer oaths, in said
County and State; that he/she is authorized to make this affidavit and sworn
statement; that the notice or other legal advertisement, a copy of which is attached
hereto, was published in the Hickory Daily Record on the following dates:
01/13/2020
and that the said newspaper in which such notice, or legal advertisement was
published, was a newspaper meeting all the requirements and qualificatio of
Section 1-597 of the General Statutes of North Carolina
Assistant Bookkeeper
Newspaper reference: 0000622881
Sworn to and subscribed before me, this � day of �p�L.�, 2020
Notary Public
My Commission expires: inT�
THIS IS NOT A BILL. PLEASE
PAY FROM INVOICE, THANK YOU
,s\\\\A WAD�
Notary Public =
IredeII County

HICKORY
North Carolina
Life. Well Crafted.
PUBLIC NOTICE
OF SIGNIFICANT INDUSTRIAL
WASTEWATER PERMIT
VIOLATIONS
The City of Hickory, in accordance with Federal and State Regulations is hereby
giving Public Notice. Listed below are Significant Industrial Users that were in Significant
Non -Compliance (SNQ with national pretreatment regulations, 40 CFR Part 403, state
pretreatment regulations, 15 NCAC 211.0900, and local pretreatment regulations during
the period of January 1 through December 31, 2019:
Henry Fork WWTF: NONE
Northeast WWTF: NONE
Publish: January 13, 2020

Other Information

HjCKORY
North Carol"
Life. Well Crafted.
Public Utilities
February 6, 2019
Mr. Tim Glenn
Kleen Tech Inc.
PO Box 1369
Hickory, INC 28603
RE: Notice of Violation with Assessment of Civil Penalties
Pretreatment Permit #0035
City of Hickory
Hickory Regional Laboratory
310 Cloninger Mill Rd.
Hickory, NC 28601
Phone: [phone]
Fax: [phone]
Email: [e-mail]
This letter transmits notice of violation with a civil penalty assessed against Kleen Tech Inc. in
the amount of $1,250.00 for violation of permit conditions — Part 2 Section 24 — Dilution
Prohibition.
Within thirty days of receipt of this notice, you must do the following:
Submit payment of the penalty to:
City of Hickory
Public Utilities Department
PO Box 398
Hickory, NC 28603
2. Submit a narrative stating the cause of and time needed to correct the violation(s).
The payment of this penalty will not foreclose further enforcement action for any continuing or
new violation(s).
We request that you take immediate and appropriate action to achieve compliance with your
IUP conditions.
If you have questions, please call this office at [phone]
Sincerely,
David R. Cox
Pretreatment coordinator

Kleen Tech, Inc
PO Box 1369
Hickory, NC 28603
828=397-3357
February 06, 2019
David Cox
Hickory Regional Lab
City of Hickory
Fax:[phone]
This letter is in response to the noncompliance letter dated February 06,
2019 for Assessment to Civil Penalty.
The issue was corrected on January 28, 2019 at 14:30.
Maintenance was instructed about issue with the hose, the non-compliance
and also informed about Part 2 Section 24. This issue has been resolved.
If you have any questions, please contact me at 828-397-3357.
Since•
&O
Sean Dotson
Kleen Tech, Inc
Sean@kleentech inc. com

` �RR F AUTHOHIZEO SIGNATURE -
u"g5562411' �:O531OQ3OOr:DO586L754667�1"
KLEEN-TECH, INC. -
City of Hickory 2/6/2019
Date Type. 0 Reference Original Amt. Balance Due Discount
2I6I2019 Bill 020619 i1250.00 1,250,00
Check Amount
IBM=
055624
Payment
1,250,00
1,2W100