NC0003425_Outfalls 11 and 12B_20200326

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 3/26/2020 7:24:36 AM (Supplemental Submittal)
Submit by Thedford, Wren 5/12/2020 9:17:28 AM (Supplemental Info Submittal)
• Thedford, Wren assigned the task to Thedford, Wren 5/12/2020 9:17 AM
• The task was assigned to Thedford, Wren, Bennett, Bradley 3/26/2020 7:24 AM

Initial Review Information
Updated ID#:* IWORTANf:F;EVIBAERSl-IOLLDVERFYand revise here ifnecessary.
NC0003425
How should this project be handled?*
r File r Discard
Information Submitted on 3/26/2020
Submitter Information
Name: Robert Howard
Who is subrritting the inforrretion?
Email Address:* [e-mail]
Submittal Information
The Division of Water Resources (DWR) is providing this site to allow for the upload of required supplemental
information associated with discharge monitoring reports (DMR). All DMR data is required to be submitted
electronically through the eDMR system and should not be submitted here. Division staff will reviewall
uploaded documents and will only maintain required information. Documents such as laboratory reports are not required
to be submitted and will not be maintained in the system.
Project Information:
Rease SUDDly the Dernit nun ber for this
Existing ID#* PerrritNurrber
NC0003425
Exarrples: NOKxxxxxx or NO&xxxxx
Facility Name:* Roxboro Steam Electric Plant
County: Person
Please upload all files that need to be
submited. *
dick the upload button or drag and drop files here to attach docurrent
Roxboro Steam Plant NC0003425 outfalls 11 and 12
83.72KB
B February 2020.pdf
Only pdf files are accepted.
Comments about the attachments:
Please find attached outfalls 11 and 12B DMRs for February 2020 from Roxboro Steam Electric Plant NC0003425.
* V By checking the box and signing box below, I certify that:
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- I IICIVC IY.IVCII II UC, Cll.l.UI CIIC, CII IU I.VI I IF/ICLC II IIVI I I ICIIIVI I VII LI IIJ IVI II I,
• I agree that submission of this Supplemental Information form is a "transaction" subject to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act)
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit the Supplemental Information form."
Full Name: Robert Howard
Signature:
Date Submitted: 03/26/2020

NPDF-S Permit No. NCOD03425
EFFLUENT
Facility Name Roxboro Steam Electric Plant
Operator In Responsible Charge
Certified Laboratories
Discharge No. O11 ML nth February Year 2020
Class II County Person
Ryan S. Enoch Grade Ill Phone [phone]
(1) Duke Analytical Lab (2) Progress Energy Roxboro Steam Electric Plant
Check If ORC has Changed Person (s) Collecting Samples Ran S. Enoch
Mail ORIGINAL and ONE COPY to: A A I a t
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
OF OPERATOR IN RESPONSIBLE CHARGEI
By This Signature, I Certify That This Report Is
Accurate And Complete To The Best Of My Knowledge.
Ikk== [,f 4L911%W cd vatiainm in M=wn and has it EPA rinmitm
it is n i rx=ibk et ahstAt1dy aanfy the Incisc aonrwy d arc data ataairtnl in this MOIL
Date
Facility Status; (Please Check one of the following)
All monitoring data and sampling frequencies mat permit requirements �X
All monitoring data and sampling frequencies do NOT meet permit requirements
"1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel property gather and evaluate the information submittal. 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."
Tom Copolo
Permittee (Please print or type) Signat i R-' • Date
1700 Dunnaway Road, Semora. NC 27343 [phone] March 31, 2012
Permit m Addmu finite NumtLT Pcrmit Exp. Date
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EFFLUENT
NI'[lE•.S Permit No NC0003425 1hsc%arEc No. 12B Month February YCar 2020
Facility Name Roxbom Steam Electric Plant Class II rounty Person
Olicralur In Resptmsible Charge Ryan S. Enoch (irate III Phone [phone]
Certified lahurrlorics (1) Duke analyllcal Lab (2NA
Check if ORC has Changed Pt;twn I O Cullmling Samples Flyan S. 5noch
Mall ORIOINAI atttd ONE COPY u•
ATfN CEN—MAL fl[J:S W
MVISION 01- WA-FTA QUAIM iSIGNA 1: 01, OPERATOR IN REMNINSIBU CHARM)
1617 MAIL SLRVICL• CINfI;R By This Signature, 1 Certify Thal This Report Is
RAIJ710H. NC 276".1617 Arctrrate Aril Complete To The Best Of My Knimittlge.
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Facility Slams: (please Check on: of the following)
All maiihoring dam and sampling frcquenciea inset pemtii roquiremerfts
AN muninoting data and sampling fscyuencies do NOT meet permit requirements
'I certify, uaxlrr penahynf law, f i this "t mcm and all anachmems wen: ptcpaml under my dirmthm or superviritm in =%mlancc with a system designed
to assure dot gtulirwd Pcfstmrrcl Pngcrlygmhcr and cvaltuic the infumtatiton suhmilled. Rased nn my irtqutrynf th perxm orperxom whts manage fla: system
ur those persnm direnly msyxtmibk for gathering the Inft)m l ton, the infumulion suhmiltal is. In the beat mf my knuwkxlge aml helief, true, accurate, arks
cu"TWlc. I am aware that there ase slgnificant pcnallics fire suhnditing false infnmuti m including the ptrsrihiGty offAWVnl impriu mrent for knowing var[ukms."
Tom
Penniftce I1'Icaw prinl ortypc)
0 31a
Date
17(III Dunaway Road. Semttra, NC 27343 (336 d 597 -61 f10 March 31. 2012
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