NC0080853_Regional Office Historical File Pre 2016

Division of Water Resources
October 26, 2015
ATEM-R-ANDIN-1
To: Corey Basinger fil [ A/ G ' ` /
Water Quality Supervisor, WSRO C ` F/
Through: Cindy A. Moore a V
Supervisor, Aquatic Toxicology Branch
From: Carol Hollenkamp c �l
Quality Assurance Officer, Aquatic Toxicology Branch
Subject: Whole effluent toxicity test results
Alcatel Lucent Technologies
NPDES Permit # NC0080853/001
Forsyth County
The aquatic toxicity test using grab samples of effluent discharged Alcatel Lucent Technologies has been
completed. Alcatel Lucent Technologies has a permitted flow of 0.302 million gallons per day (MGD)
discharging into an unnamed tributary to Salem Creek (7Q10 of 0.05 CFS). Whole effluent samples were
collected on September 1 and September 3 by facility representative Greg Stephenson and then transferred to
Jennifer Carter and Ron Boone for use in a chronic Ceriodaphnia dubia pass/fail toxicity test. The test using
these samples resulted in a pass. Toxicity information follows.
Test Type
Test Concentrations
Test Result
Control Survival
Control Mean Reproduction
Test Treatment Survival
Treatment Mean Reproduction
First Sample pH
First Sample Conductivity
First Sample Total Residual Chlorine
Second Sample pH
Second Sample Conductivity
Second Sample Total Residual Chlorine
3-Brood Ceriodaphnia dubia pass/fail
90%
Pass
92%
19.3
100%
22.9
7.8 SU
329 micromhos/cm
<0.10 mg/L
7.80 SU
335 micromhos/cm
<0.10 mg/L
Test results for the above samples indicate that the effluent would not be predicted to have water quality
impacts on receiving water. These samples were split and tested by ETS, Inc. The chronic Ceriodaphnia
dubia pass/fail toxicity test run by ETS, Inc. also resulted in a pass. Please contact us if further effluent
toxicity monitoring is desired. We may be reached at [phone].
Basin: YAD04
cc: Central Files
Aquatic Toxicology Branch
Water Sciences Section

W,ICIT-Y SAWLE COLLECTION FORM page f ARO FRO MRO 1R0 WaRO WiRO
MW
Facility/Water Bodyt'�i�
NPDES # NC 0 0 'Y L,' Outfall #
��'S ' f/'i Basin/Sub-basin
County
Receiving Stream
Collector(s) (print)
C•
Grab Sample - Composite Sample ❑ Composite Type:
L] Constant Time/ Volume: samples/hour for
❑ Flow Proportional
Sampling Equipment Used: ❑ DWQ Portable Sampler or ❑ Facility's Sampler
Date Began Time Began Date End Time End
r
Sampling Site
Description
� d-
hours
Container: Z"iL (1 gal) PE cubitainer ❑Other (describe) # of containers /
Chlorinated: ❑ Yes [!Ko ollected on Ice or in Refrigerated Sampler: ElYes ❑ No A�"IShipped on Ice: E1❑ No
Method of Shipment: Courier 0 Bus ❑ Staff ❑ O; qr (eiqlaia):
Date/time of transfer to shipper or courier box: ,) 7,, Gj��r`iS
r
�6?T A4 l �'C', . G7Gt 'PGr ti ��1� /� % %i/?;� l � % �iC �� a
1. Did DWQ staff perform the
If NO, then did DWQ staff witness the
Collector(s)
Si ature: �� � �/!� /�� � .r� � --- Date: Z) / Of
Additional sample andler records:. %
Relinquished by: by:
Received. by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received -by:
Date:
Time:
DWQ/Environmental Sciences Section
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
ESS Courier #: 520101
Use street address only if shipping FedEx or UPS
Street address: 4401 Reedy Creek Road
Raleigh, NC 27607
phone: [phone]

A ' `- �F. .MCITY SAMPLE COLLECTION F+'OkR page 1 of ARO FRO MRo IRO WaRO Wi120 CWSRO)+ 160 g;
Facility/WaterBody 1��� —� ��i� f ASW ke,
NPDES # NC 0 0 3 Outfall #
County �cS �� Basin/Sub-basin
Receiving Stream 0 7— '-JD c�--
Collector(s) (print) 1�i2Qj Lr Avis S`O i1
Grab Sample ❑Composite Sample ❑ Composite Type:
❑ Constant Time/Constant Volume: samples/hour for
❑ Flow Proportional
Sampling Equipment Used: ❑ DWQ Portable Sampler or ❑ Facility's Sampler
Date Began Time Began Date End Time End
OV/ /o/ 1-5
Sampling Site
Description
hours
Container: ZJL (1 gal) PE�ubitainer ❑Other (describe) # of containers /
Chlorinated: Yes LM Collected on Ice or in Refrigerated Sampler: ❑ Yes ❑ No N/,� Shipped on Ice: [I] -Yes ❑ No
Method of Shipment: Courier D-­13us ❑ , Staff ❑ Othe (e lain):
Date/time of transfer to shipper or courier box: O /...
Comments: 6fD Kew
[]'lS lit'sample, splitting lab name:
Did DWQstaff perform the split? _ ) f If NO then did DWQ staff witness the split?
./.".;.�f=;�:il'.?!'L{+y'P„'
Collector(s) ;:
Si afore: _ r....,. ,;...,, ht_, :al!1 . ;;::rt: `,u1r =�s.i_:3{; ; Date:
' �. - .
Additional samnle ndlP.rrPcuirlc r1
�Re�linquishe�dby:
Received by:
Time:
d 3 /
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received by:
Date:
Time:
Relinquished by:
Received b :
Date,:
Time:
_ `. . . " S£ a DWQ/Environmental Sciences Section
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
ESS Courier #: 520101
Use street address only if shipping FedEx or UPS
Street address: 4401 Reedy Creek Road
Raleigh; NC 27607
phone: [phone]

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
June 11, 2015
Alcatel -Lucent USA, Inc.
Attn: Gary M. Fisher, Owner
600-700 Mountain Avenue
Mail Stop 7F-407A
New Providence, NJ 07974-2070
Subject: Compliance Evaluation Inspection
Permittee: Alcatel -Lucent USA Inc.
Facility: Salem Business Park Remediation Site
NPDES Permit #: NCO080853
Forsyth County
Dear Mr. Fisher:
Donald R. van der Vaart
Secretary
Mr. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or
the Division) conducted a compliance evaluation inspection (CEI) of the Salem Business Park Remediation
Site on May 28, 2015. The assistance and cooperation of Greg Stephenson, Operator in Responsible Charge
(ORC), was greatly appreciated. An inspection checklist is attached for your records and inspection findings
are summarized below.
General Information
The Salem Business Park Remediation Site is located at building #46 of Salem Business Park at
approximate coordinates of 36.056473, 80.230281. The permit authorizes Alcatel -Lucent USA Inc. to operate
this 0.302 MGD groundwater remediation system, which consists of extraction wells, bag filters, a tray air
stripper, and activated carbon filters, and discharge the treated effluent via outfall 001 to Salem .Creek, which
is currently classified as Class C waters in the Yadkin Pee Dee River basin:
Site Review
Mr. Stephenson has done an excellent job of operating and maintaining the plant. The entire plant was
clean and appeared to be in excellent working order. Mr. Boone noted no discrepancies.
Documentation Review
All required documentation was reviewed. All of Mr. Stephenson's records were available, in order,
complete and current. No discrepancies were noted.
450 West Hanes Mill Road, Suite #300, Winston-Salem, North Carolina 27105
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

Thank you and please continue to operate the plant at optimum efficiency and in full compliance with
permit NC0080853. If you have any questions regarding the inspection or this letter, please call Mr. Boone or
me at [phone].
Sincerely,
s <.J
�Y W. Corey Basinger
i Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments:
I. BIMS Inspection Report
CC: O'SR:Q i�� Sal' ,,f,R
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN 1 2 15 I 3 I NC0080853 I11 12 15/05/28 17 18 L ci 19 L s j 20I
211111 1 1 I I I I II I1 I I I I I I I I I I I I I I I I I I I I I II I I I I I f6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 CIA -------------Reserved --- --------
67
70I ' 71 I Il72 L Ln, � 731 I 174 75I III I I I I80
LJ -1 I I I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
10:OOAM 15/05/28
09/07/01
Salem Business Park remediation site
Exit Time/Date
Permit Expiration Date
3370 Lexington Rd
Winston Salem NC 27107
11:OOAM 15/05/28
14/06/30
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
///
Gregory Martin Stephenson/ORC/336-784-2716/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Fred Bleach inger,3370 Lexington Rd Winston Salem NC 27107//336-784-2716/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boone WSRO WQ//336-776-9690/
IS
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
F0
'✓Syar,iy=�, o•.fi 3. �,.+'.-'� y.,y *'vi`.ir.ry=i''"r',., ``^9"f'.�!
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

It
NPDES yr/mo/day Inspection Type
31 NCo080853 I11 121 15/05/28 I 1 % 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Treatment process now consists of carbon filters, bag filters, and air scrubbers. All appears to be
operated and maintained very well.
Please refer to the attached inspection summary letter.
1
Page# 2

Y
Permit: NCO080853 Owner - Facility: Salem Business Park remediation site
Inspection Date: 05/28/2015 Inspection Type: Compliance Evaluation
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
M
❑
application?
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
0
❑
❑
Is access to the plant site restricted to the general public?
M
❑
❑
❑
Is the inspector granted access to all areas for inspection?
M
❑
❑
❑
Comment: None
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
0
❑
❑
❑
Is all required information readily available, complete and current?
0
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
M
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
0
❑
❑
❑
Is the chain -of -custody complete?
M
❑
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
0
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
0
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
0
❑
❑
on each shift?
Is the ORC visitation log available and current?
M
❑
❑
❑
Is the ORC certified at grade equal to or higher than the facility classification?
M
❑
❑
❑
Is the backup operator certified at one grade less or greater than the facility classification?
0
❑
❑
❑
Is a copy of the current NPDES permit available on site?
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
M
❑
Comment: None
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ❑ ❑ ❑
Are all other parameters(excluding field parameters) performed by a certified lab? M ❑ ❑ ❑
Page# 3

Permit: NCO080853 Owner - Facility: Salem Business Park remediation site
Inspection Date: 05/28/2015 Inspection Type: Compliance Evaluation
Laboratory Yes No NA NE
# Is the facility using a contract lab?
0
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
0
❑
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees?
❑
❑
M
❑
Comment: None
Effluent Sampling
Yes No NA NE
Is composite sampling flow proportional?
❑
❑
N
❑
Is sample collected below all treatment units?
❑
❑
❑
Is proper volume collected?
M
❑
❑
❑
Is the tubing clean?
❑
❑
0
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
❑
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
❑
❑
❑
representative)?
Comment: None
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
N
❑
❑
❑
Is flow meter calibrated annually?
M
❑
❑
❑
Is the flow meter operational?
M
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
N
❑
❑
❑
Comment: None
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? 0 ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? M ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ 0 ❑
Comment: None
Operations $ Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? M ❑ ❑ ❑
Page# 4

Permit: NCO080853
Owner - Facility: Salem Business Park remediation site
Inspection Date: 05/28/2015 Inspection Type: Compliance Evaluation
Operations & Maintenance
Yes No NA NE
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ ❑
Solids, pH, DO, Sludge Judge, and other that are applicable? .
Comment: None
Page#

M �
NCENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
June 24, 2014
Alcatel -Lucent USA, Inc.
Attn: Gary M. Fisher, Owner
600-700 Mountain Avenue
Mail Stop 7F-407A
New Providence, NJ 07974-2070
Subject: Compliance Evaluation Inspection
Permittee: Alcatel -Lucent USA Inc.
Facility: Salem Business Park Remediation Site
NPDES Permit #: NCO080853
Forsyth County
Dear Mr. Fisher:
John E. Skvarla, III
. Secretary
Mr. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Resources (DWR or
the Division) conducted a compliance evaluation inspection (CEI) of the Salem Business Park Remediation
Site on June 18, 2014. The assistance and cooperation of Greg Stephenson, Operator in Responsible Charge
(ORC), was greatly appreciated. An inspection checklist is attached for your records and inspection findings
are summarized below.
General Information
The Salem Business Park Remediation Site is located at building #46 of Salem Business Park at
approximate coordinates of 36.056473, 80.230281. The permit authorizes Alcatel -Lucent USA Inc. to operate
this 0.302 MGD groundwater remediation system, which consists of extraction wells, bag filters, a tray air
stripper, and activated carbon filters, and discharge the treated effluent via outfall 001 to Salem Creek, which
is currently classified as Class C waters in the Yadkin Pee Dee River basin.
Site Review
Mr. Stephenson has done an excellent job of operating and maintaining the plant. The entire plant was
clean and appeared to be in excellent working order. Mr. Boone noted no discrepancies.
Documentation Review
All required documentation was reviewed. All of Mr. Stephenson's records were available, in order,
complete and current. No discrepancies were noted.
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmafive Action Employer— Made in part by recycled paper

Thank you and please continue to operate the plant at optimum efficiency and in full compliance with
permit NC0080853. If you have any questions regarding the inspection or this letter, please call Mr. Boone or
me at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments:
BIMS Inspection Report
CC: ,ROd Sly
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National. Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type
Inspector Fac Type
1 IN f 2 15 f 3 I N00080853 111 12 14/06/18 17 18I, I
19 I S I 201
211111 1 I I I I I II 1 1 I I I I I I I I I I I I I I I I I I I I
III I I I I 1 f6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA --------Reserved----------
67 70 71 I I 72 I �, l 73I I 174 751 I I I I I I I80
LJ I I I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:OOAM 14/06/18
09/07/01
Salem Business Park remediabon site
Exit Time/Date
Permit Expiration Date
3370 Lexington Rd
Winston Salem NC 27107
11:OOAM 14/06/18
14/06/30
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Numbeks)
Other Facility Data
Gregory Martin Stephenson/ORC/336-784-2716/
Name, Address of Responsible Official/Tifie/Phone and Fax Number
Fred Bleachinger,3370 Lexington Rd Winston Salem NC 27107//336-784-2716/ Contacted
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit E Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program 0 Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers
Date
Ron Boone WSRO WQ//336-771-4967/
�12
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
�J o
Ae ) — IJ �fJ�C �l �f �
4—jo-2
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type
31 NCO080853 I11 12 14/06/18 17 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page#
1�Q

r
Permit: NCO080853
Inspection Date: 06/18/2014
Owner - Facility: Salem Business Park remediation site
Inspection Type: Compliance Evaluation
Operations & Maintenance
Is the plant generally clean with acceptable housekeeping?
Does the facility analyze process,control parameters, for ex: MLSS, MCRT, Settleable
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: None
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new
application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment: None
Yes No NA NE
■ ❑ ❑ ❑
M ❑ ❑ ❑
Yes No NA NE
M ❑ ❑ ❑
❑ M ❑ ❑
❑ N ❑ ❑
■ ❑ ❑ ❑
❑ ❑ ❑
Page# 3

A
4 • . RECEIVEDL DIVI:SIONN OF 'Ir1!ATER QUAL1 d Y
WC®ENR JAN 14 2014
North Carolina Department of Environment and Natural Resources
Division of Water Resources M ,€oESVf1LrIO;AL OFFICE
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Director Secretary
January 03, 2014
Attn: Erin Stewart, P.G.
AECOM
701 Corporate Center Drive, Suite 475
Raleigh, NC 27607
,. RECEIVED
N.C. Dept. of FNR
• JAI 16 2014
WINSTON-SHLLN1
REGIONAL OFFICE
Subject: Receipt of permit renewal
PMrmit NCOO8O853--i
Forsyth County
Dear Mr. Stewart:
The NPDES Unit received your permit renewal application on January 03, 2014. A member of the
NPDES Unit will review your application. They will contact you if additional information is required to
complete your permit renewal. You should expect to receive a draft permit approximately 30-45 days
before your existing permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact Ron
Berry [phone].
Sincerely,
e*f` /41 ox
Wren Thedford
Wastewater Branch
cc: Central Files
aW�i�asto. S=a1 R gional Office
NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] Fax: [phone]Customer Service:1-877-623-6748
Internet:: www.ncwater.orq
An Equal OpportunityMrmative Action Employer

A=COM
December 31, 2013
AECOM 919.854.6200 tel
701 Corporate Center Drive, Suite 475 919c654F6259D fax
Raleigh, North Carolina, 27607 DIVISION OF tiNf,''% T ER QUALITY
JAIL 14 2014
6 c
M0ORESV?ILLE RE„ P'DN'AL 0FFICE
FJ A N 3 2014
Wren Thedford RECEIVED
r. N.C. Dept. of ENR
N.C. Department of Environment and Natural Resources
Division of Water Resources, NPDES Unit JAN 16 2014
1617 Mail Service Center
WINSTON-SA..i.c;
Raleigh, North Carolina 27699-1617 REGIONAL OFFICE
Subject: Request for Renewal of NPDES Permit NCO080853
Salem Business Park Remediation Site
Alcatel -Lucent USA Inc.
3370 Lexington Road, Winston-Salem, Forsyth County, North Carolina
Dear Ms. Thedford:
On behalf of Alcatel -Lucent USA Inc., AECOM North Carolina Inc. (AECOM) is requesting renewal
of National Pollutant Discharge Elimination System (NPDES) Permit NCO080853 for the
groundwater treatment system located at the former Alcatel -Lucent facility, now known as the
Salem Business Park Remediation Site, in Winston-Salem, Forsyth County, North Carolina. The
completed application is enclosed as Attachment 1.
Recent Changes to Facility
Since the last issuance of the NPDES permit, the groundwater treatment system was replaced and
a minor permit modification was issued November 12, 2012. There were no changes to the
contaminants the system is treating, the basic treatment technology, permit effluent limits, or
permitted outflow location. The prior NPDES permit (dated June 12, 2009) specified that the
remediation system consists of the following components:
• Extraction wells
• Oil/water separator
• Granular media filtration
• Feed -water storage and equalization
• Parallel filtration and air -stripping treatment trains receiving segregated flow
• Activated carbon
• Solids removal (filter press)

AECOM
2
The early 1990s design of the original remediation system was based on using parallel treatment
systems for different contaminant types, with System A receiving flow from diesel fuel extraction
wells and perimeter volatile organic compound (VOC) extraction wells, and System B receiving flow
from interior VOC extraction wells. Twenty years of system data indicate that contaminant
concentrations and flow rates are significantly lower than anticipated during the original remediation
system design. As a result, a new single -stream remediation system was designed and installed to
treat the extracted groundwater. The new system consists of the following components:
• Extraction wells
• Feed -water equalization
• Bag filtration
• Low profile air stripper
• Granular activated carbon
The system component list on the "Supplement to Permit Cover Sheet" portion of the NPDES
permit was modified in the November 12, 2012 minor permit modification to reflect the new
components listed above (Attachment 2).
In addition to the minor changes described above, AECOM also began using oxidizing biocides
(sodium hypochlorite and hydrogen peroxide) and a biodispersant (Redux-620) to prevent biological
fouling of treatment system unit processes and piping. The biocide and biodispersant application
and associated approval for use from the Division of Water Quality are included as Attachments 3
and 4, respectively.
Authorized Representative
Attached is the previous signature authority letter from Alcatel -Lucent dated November 25, 2008,
delegating signature authority for NPDES correspondence to the ENSR Project Manager
(Attachment 5). ENSR was purchased by AECOM, so an updated letter is also included in this
submittal delegating signature authority to the AECOM project manager.
Sludge Management
This facility is a groundwater remediation system and does not have a Sludge Management Plan;
however, a small volume of solids (spent bag filters) are generated and managed as hazardous
waste. Two parallel bag filters provide particulate filtration and require changing approximately
once per week. Spent bag filters are placed in a labeled, covered 55 gallon drum. To date, less
than one drum of spent bag filters has been generated. Once a full drum accumulates, the drum
will be sealed and moved from the Satellite Accumulation Area to the Temporary Storage Area.
Within 90 days of being moved to the Temporary Storage Area the drummed spent bag filters will
be picked up, transported and disposed of as hazardous waste. Annual generation of spent bag
filters is expected to be approximately one to two drums, or 500 to 1,000 pounds.

AECOM
If you have any questions or require any additional information, please contact Erin Stewart at
[phone] or Mr. Gary Fisher at [phone].
Yours sincerely,
Erin Stewart, P.G.
Project Manager
Christopher Mason
Project Manager
Attachments: Attachment 1 — NPDES Permit Application
Attachment 2 — Minor Permit Modification issued November 12, 2012
Attachment 3 — Biocide and Biodispersant Application
Attachment 4 — Biocide Use Approval
Attachment 5 — Signature Authority Delegation Letters

Attachment 1
NP®ES Permit Application

NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number INCO080853
If you are completing this form in computer use the TAB key or the up - down arrows to moue from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
Alcatel -Lucent USA Inc.
Salem Business Park Remediation Site
600 Mountain Avenue
Murray Hill
New Jersey 07974
[phone]
[phone]
[e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code
County
3370 Lexington Road
Winston-Salem .
North Carolina
Forsyth
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator. in Responsible Charge or ORC)
Name AECOM
Mailing Address 701 Corporate Center Drive, Suite 475
City Raleigh
State / Zip Code North Carolina
Telephone Number [phone]
Fax Number [phone]
4. Ownership Status:
Federal ❑ State ❑ Private ® Public ❑
Page 1 of 3 C-GW 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
5. Products recovered:
Gasoline ❑ Diesel fuel ❑ Solvents ❑ Other groundwater impacted
with chlorinated solvents and petroleum hydrocarbons
6. Number of separate discharge points: 1
Outfall Identification number(s) 001
7. Frequency of discharge: Continuous ® Intermittent ❑
If intermittent:
Days per week discharge occurs: Duration:
8. Treatment System Design flow avg 0.095 MGD (66 gpm); peak 0.130 MGD (90 gpm) MGD
9. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
Salem Creek (see attached Figure 1)
10. Please list all additives to the treatment system, including chemicals or nutrients, that have
the potential to be discharged.
Kuene Strong Bleach - sodium hypochlorite aqueous solution 10-20% (w/w) and sodium
hydroxide aqueous solution 1% (w/w)
hydrogen peroxide 35% aqueous solution
Redux-620 - aqueous solution of acrylate copolymer (6%), proprietary organic phosphorous
compound (60/o), and proprietary sulfonated phosphonium salt (10%)
Please refer to AECOM's April 9, 2013 letter titled "Proposed Biocide and Biodispersant
Application at Salem Business Park Rememdiation Site" and the NCDENR DWQ acceptance
of these proposed additives (enclosed).
11. Is this facility located on Indian country? (check one)
Yes ❑ No
12. Additional Information
All applicants (including renewals):
A USGS topographical map (or copy of the relevant portion) which shows all outfalls
A summary of the most recent analytical results (effluent data, if available) containing the
maximum values for each chemical detected
NEW Applicants only:
Engineering Alternative Analysis
Description of remediation treatment system components, capacities, and removal efficiency
for detected compounds.
If the treatment system will discharge to a storm sewer, written approval from the
municipality responsible for the sewer.
A list of any chemicals found in detectable amounts at the site, with the maximum observed
concentration reported for each chemical (the most recent sample must be collected less
than one year prior to the date of this application)
Page 2 of 3 C-GW 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
• For petroleum -contaminated sites - Analyses for Volatile Organic Compounds (VOC) should
be performed. Analyses for any fuel additives likely to be present at the site and for phenol
and lead should also be performed.
• For sites contaminated with solvents or other contaminants - EPA Method 624/625
analysis should be performed.
13. Applicant 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, complete, and accurate.
evdv c�aVk- ��;e c Nlav�a (ana)
Printed name of Person Signing Title
of Applicant
Date
Za h
North Carolina General Statute 143-215.6 (b)(2) provides that: Any person who knowingly makes any false
statement representation, or certification in any application, record, report, plan, or other document files or
required to be maintained under Article 21 .or regulations of the Environmental Management Commission
implementing that Article, or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section
1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more than 5 years, or both,
for a similar offense.)
Page 3 of 3 C-GW 03/05

iikw-
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ILI
tt
i
4
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lowRd
Ur
VA
fill
dev
Alcatel -Lucent USA Inc.
Winston-Salem, North Carolina
Project No.: 60265073 Date: 2013-07-25
Discharge Location Map
AZCOM
Figure 1

Table 1
Summary of Effluent Volatile Organic Compound Analytical Results
Salem Business Park Remediation Site
Alcatel -Lucent USA Inc.
Winston-Salem, North Carolina
1,1,1,2-Tetrachloroethane
< 0.50
1,1,1-Trichloroethane
< 0.50
1,1,2,2-Tetrachloroethane
< 0.50
1,1,2-Trichloroethane
< 0.50
1,1-Dichloroethane
< 0.50
1,1-Dichloroethylene
< 0.50
1, 1 -Dichloropropylene
< 0.50
1,2,3-Trichlorobenzene
< 2.0
1,2,3-Trichloropropane
< 1.0
1,2,4-Trichlorobenzene
< 1.0
1,2,4-Trimethylbenzene
< 0.50
1,2-Dibromo-3-chloropropane
< 2.0
1,2-Dibromoethane
< 0.50
1,2-Dichlorobenzene
< 0.50
1,2-Dichloroethane
< 0.50
1,2-Dichloropropane
< 0.50
1,3,5-Trimethylbenzene
< 0.50
1,3-Dichlorobenzene
< 0.50
1,3-Dichloropropane
< 0.50
1,4-Dichlorobenzene
< 0.50
2,2-Dichloropropane
< 2.0
2-Chloroethyl Vinyl Ether
< 2.0
2-Chlorotoluene
< 0.50
4-Chlorotoluene
< 0.50
4-Isopropyltoluene
< 0.50
Acetone
< 5.0
Acrolein
< 20
Acrylonitrile
< 20
Benzene
< 0.50
Bromobenzene
< 0.50
Bromochloromethane
< 0.50
Bromodichlorom ethane
< 0.50
Bromoform
< 1.0
Bromomethane
< 1.0
Carbon disulfide
< 5.0
Carbon Tetrachloride
< 0.50
Notes:
Sample collected on October 31, 2013
Sample analyzed for volatile organic compounds by EPA Method 8260
µg/L - micrograms per liter
Chlorobenzene
< 0.50
Chloroethane
< 0.50
Chloroform
< 0.50
Chloromethane
< 0.50
cis-1,2-Dichloroethylene
< 0.50
cis-1,3-Dichloropropylene
< 0.50
Dibromochloromethane
< 0.50
Dibromomethane
< 0.50
Dichlorodifluoromethane
<. 1.0
Ethylbenzene
< 0.50
Hexachlorobutadiene
< 2.0
Isopropyl Ether
< 0.50
Isopropylbenzene (Cumene)
< 0.50
m,p-Xylenes
< 1.0
Methyl Butyl Ketone (2-Hexanon(
< 5.0
Methyl Ethyl Ketone (2-Butanone
< 5.0
Methyl Isobutyl Ketone
< 5.0
Methylene Chloride
< 1.0
Methyl-tert-Butyl Ether
< 0.50
Naphthalene
< 1.0
n-Butylbenzene
< 1.0
n-Propylbenzene
< 0.50
o-Xylene
< 0.50
sec-Butylbenzene
< 0.50
Styrene
< 0.50
te rt- Butyl benzene
< 0.50
Tetrachloroethylene
< 0.50
Toluene
< 0.50
trans-1,2-Dichloroethylene
< 0.50
trans- 1, 3-Dichloropropylene
< 0.50
Trichloroethylene
< 0.50
Trichlorofluoromethane
< 0.50
Vinyl acetate
< 2.0
Vinyl chloride
< 0.50
Xylenes, total
< 3.0
AECOM

Attachment 2
Minor Permit Modification issued November 12, 2012

Received
NOV 2 0 201
AECOM
NCDENR Raleigh, NC
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
November 15, 2012
Ms. Erin Stewart
AECOM
8540 Colonnade Ctr Dr / Ste 306
Raleigh, NC 27615
Subject: Modification of NPDES Permit N00080853
Salem Business Park remediation site
Forsyth County
Dear Ms. -Stewart:
The Division has reviewed the modification request you submitted on November 2, 2012. The
Division has no objection to your request. This modification is issued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the
U.S. Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
This modified permit includes the following changes from your current permit:
The list of installed components on the Supplement to Permit Cover Page limit has been
updated.
If any parts, measurement frequencies or sampling requirements contained in this modification are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty (30)
days following receipt of this letter. This request must be in the form of a written petition, conforming to
Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative Hearings
(6714 Mail Service Center, Raleigh, North Carolina 27699-6714). Unless such demand is made, this
decision shall be final and binding.
This permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit. 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 Land
Resources, the Coastal Area Management Act or any other Federal or Local governmental permit that may
be required. If you have any questions concerning this matter, please contact Charles H. Weaver at (919)
807-6391 or via e-mail [[e-mail]].
Sincer ly, f
i Charles Walcild, P.E.
cc: Central Files
Winston-Salem Regional Office / Surface Water Protection
NPDES Unit
Gary Fisher / Alcatel -Lucent USA, Inc. [600-700 Mountain Ave / Mail Stop 7F-407A, Murray Hill, NJ 07974]
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One 1 512 North Salisbury Street, Raleigh, North Carolina 27604 NOrthCarohna
Phone: [phone] / FAX [phone] / Internet: www*.ncwaterquality.org An Equal Opportunity/Affirmative Action Employer — 50'/o Recycled/101/o Post Consumer Paper ;Vatwpally

Permit NCO080853
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked. As of this
permit issuance, any previously issued permit bearing this number is no longer effective. Therefore, the exclusive
authority to operate and discharge from this facility arises under the permit conditions, requirements, terms, and
provisions included herein.
Alcatel -Lucent USA, Inc. is hereby authorized to:
1. Continue to operate an existing 0.302 MGD groundwater remediation treatment
system consisting of the following components:
Extraction wells
• Feed -water equalization
• Bag filtration
• Low profile air stripper
• Granular activated carbon
The facility is located at the Salem Business Park remediation site (3370 Lexington
Road, Winston-Salem) in Forsyth County.
2. Discharge from said treatment works at the location specified on the attached map
into Salem Creek, currently a class C stream in subbasin 03-07-04 of the Yadkin -
Pee Dee River Basin, at the location specified on the attached map.

Attachment 3
Biocide and Biodispersant Application

A.3C0M AECOM 919.872.6600 tel
8540 Colonnade Center Drive, Suite 306 919.872.7996 fax
Raleigh, North Carolina, 27615
April 9, 2013
Ms. Cindy Moore
Aquatic Toxicology Unit Supervisor
N.C. Department of Environment and Natural Resources
Division of Water Quality, Environmental Sciences Section
1621 Mail Service Center
Raleigh, North Carolina 27699-1621
Subject: Proposed Biocide and Biodispersant Application at Salem Business Park
Remediation Site, Discharge #NC0080853
Dear Ms. Moore:
AECOM North Carolina, Inc. (AECOM) currently operates and maintains a groundwater remediation
system on behalf of Alcatel -Lucent USA, Inc. (Alcatel -Lucent) at the Former North Carolina Works —
Lexington Road Plant in accordance with Resource Conservation and Recovery Act permit NCD
003 213 907. The groundwater remediation system uses a combination of air stripping and
granular activated carbon (GAC) to treat volatile organic compounds in extracted groundwater prior
to discharging to an unnamed tributary of Salem Creek under National Pollutant Discharge
Elimination System (NPDES) Permit #NC0080853. To prevent biological fouling of treatment
system unit processes and piping, AECOM requests permission to apply the following oxidizing
biocides to above -ground treatment unit processes and piping:
• Sodium hypochlorite
• Hydrogen peroxide
AECOM also requests permission to apply the following biodispersant to above -ground treatment
unit process and piping for the same reason:
• Redux-620
Enclosures provided with this letter include materials safety data sheets (MSDS) for a typical high
strength sodium hypochlorite and typical hydrogen peroxide product, the manufacturer's MSDS and
fate -and -transport statement for Redux-620, and the Aquatic Toxicology Unit's biocide application
worksheet and spreadsheet.
It is anticipated that complete or nearly complete reduction of applied oxidizing biocides will occur
within the. GAC unit process prior to discharge. It is also .expected that catalytic hydrolysis of the
iron dispersant within Redux-620 (tetrakis hydroxymethyl phosphonium sulfate, or THPS) to occur
within the GAC unit process. Therefore, AECOM has completed the enclosed spreadsheet and
worksheet as a calculation of the maximum discharge concentration of sodium hypochlorite,
hydrogen peroxide, and Redux-620 product that may be discharged to the.NPDES outfall assuming
decomposition or adsorption with the GAC unit process, no 7Q10 flow, and negligible product
decay. AECOM proposes to monitor the GAC unit process' effluent using field test kits for free and
residual chlorine, for peroxide, and for THPS in order to maintain discharge concentrations below
that which would result in the dosage rate specified on the enclosed spreadsheet and worksheet.

AECOM
Monitoring of the active ingredients hypochlorite, peroxide, and THPS is proposed as a real-time
method for estimating the amount of applied whole product that is discharged to the NPDES outfall.
The proposed action levels are:
Sodium hypochlorite: 1 milligram per liter (mg/L) as OCI-
• Hydrogen peroxide: 0.35 mg/L H2O2
• Redux-620: 10 mg/L as THPS
The proposed action levels correspond to the concentrations used to calculate the dosage rate on
the enclosed biocide application spreadsheet and worksheet. At the proposed action levels,
discharge of the measured components of strong bleach, hydrogen peroxide, and Redux-620 can
be sustained for up to 1 minute, 5 minutes, and 60 minutes, respectively, without exceeding or
potentially exceeding the whole -product mass discharge limits as defined by the enclosed
worksheets and spreadsheet. Real-time monitoring is therefore proposed at a frequency of one half
the maximum sustained discharge time at the action level concentration, or every 30 seconds
during sodium hypochlorite application, every 2.5 minutes during hydrogen peroxide application,
and every 30 minutes during Redux-620 application. Testing will be conducted at the onset of the
application period, throughout the application period and for 20 minutes following the application
period, which is approximately enough time for 1,000 gallons to be conducted through the treatment
unit processes at an influent flow rate equivalent to the current system throughput (0.075 MGD).
Discharge of effluent with concentrations of monitored constituents above the proposed action
levels will be discontinued immediately if monitoring indicates that action levels are exceeded.
Application of the proposed biocides or biodispersant is proposed daily for one week each and on
an as -needed basis thereafter. The testing rigor outlined in this letter is proposed as an initial
assessment. One-time spot checking is proposed for subsequent, as -needed applications that may
follow the initial treatment if complete treatment of the monitored constituents can be demonstrated
by the initial assessment. Please contact Chris Brownfield at [phone] with questions.
Yours sincerely,
Erin Stewart, P.G. Christop r S. Brownfield, .E.
Project Manager Staff Engineer
Enclosures (8): Biocide Spreadsheet
Hydrogen Peroxide Biocide Worksheet
Hydrogen Peroxide MSDS
Redux-620 Biocide Worksheet
Redux-620 MSDS
Sodium hypochlorite Biocide Worksheet
Sodium hypochlorite MSDS
Redux-620 Fate and Transport Documentation

Dishcharger Name BIOCIDE WORKSHEET
PERMIT#: NC0080853
RECEIVING STREAM: unnamed tributary of Salem Creek (Middle Fork Muddy Creek)
7Q10 (cfs): 0.00
I . W. C. %: 100.00
PRODUCT: Redux 620
ACTIVE INGREDIENT: Aqueous solutions of acrylate copolymer (6%), proprietary
organic phosphorous compound (6%), and proprietary sulfonated
phosphonium salt (10%)
HALF LIFE (DAYS): 1000.00 STEADY STATE DISC CON(4.1604
LC50/EC50 OF SELECTED TOX DATA (MG 700 DEGRADATION FACTOR: 75.000
DECAY RATE: 0.0000 APPLICATION FACTOR: 0.010.
DOSAGE RATE (GRAMS/DAY): 1181.0448
AVG DAILY DISCHARGE (MGD): 0.075 INSTREAM BIOCIDE CONC:4.1604
VOLUME OF SYSTEM (MIL. GAL'S): 0.001 REGULATED LIMITATION: 7
PASS/FAI L: PASS
PRODUCT: Kuene strong bleach or eq.
ACTIVE INGREDIENT: sodium hypochlorite aqueous solution 10-20% (w/w)
and sodium hydroxide aqueous solution 1 % (w/w)
HALF LIFE (DAYS): 1000.00 STEADY STATE DISC CON(0.0069
LC50/EC50 OF SELECTED TOX DATA (MGi 0.9 DEGRADATION FACTOR: 75.000
DECAY RATE: 0.0000 APPLICATION FACTOR: 0.01
DOSAGE RATE (GRAMS/DAY): 1.968408
AVG DAILY DISCHARGE (MGD): 0.075 INSTREAM BIOCIDE CONC:0.0069
VOLUME OF SYSTEM (MIL. GAL'S): 0.001 REGULATED LIMITATION: 0.009
PASS/FAIL: PASS
PRODUCT: Hydrogen Peroxide
ACTIVE INGREDIENT:
35% aqueous solution of hydrogen peroxide
HALF LIFE (DAYS):
1000.00
STEADY STATE DISC CON(0.0104
LC50/EC50 OF SELECTED TOX DATA (MGi
1.38
DEGRADATION FACTOR: 75.001
DECAY RATE:
0.0007
APPLICATION FACTOR: 0.01
DOSAGE RATE (GRAMS/DAY):
2.952612
AVG DAILY DISCHARGE (MGD):
0.075
INSTREAM BIOCIDE CONC:0.0104
VOLUME OF SYSTEM (MIL. GAL'S):
0.001
REGULATED LIMITATION: 0.0138
PASS/FAI L: PASS

BIOCIDE/CHEMICAL TREATMENT
WORKSHEET-FORM 101
The following calculations are to be performed on any biocidal products ultimately discharged to the surface waters of
North Carolina. This worksheet must be completed separately for each biocidal product in use. This worksheet is to be
returned with all appropriate data entered into the designated areas with calculations performed as indicated.
Facility Names et�a�sS®D 1L RED f�'Ro� S I TE
NPDES # NC QQeOSS3 Outfall # NA.
County
Receiving Stream TP-j>aLA_-rA2q of SD.LFN& 7Q10 o (cfs)
C 4E Y
(All above information supplied by the Division of Water Quality)
What is the Average Daily Discharge (A.D.D.) volume of the water handling systems to the receiving water body?
A.D.D. = ®- 0-4 S (in M.G.D.)
Please calculate the lnstream Waste Concentration (IWC in percent) of this discharge using the data entered
above.
(A.D.D.) X 100
Iwc =
;MO)(0.646)+(A.D.D)
(.015) X 100 = I oo
(a )(0.646) + (.o-+s)
This value (IWC) represents the waste concentration to the receiving stream during low flow conditions.
Il. What is the name of the whole product chemical treatment proposed for use in the discharge identified in Part I?
Please list the active ingredients and percent composition:
�A,rF— "" 6:�' %
02G-,A�t L c
i,t i►F�n1 l�.t� �(r4t��P►1 ►J 1 �. S tea—` �-'® %
What feed or dosage rate (D.R.) is used in this application? The units must be converted to maximum grams
of whole product used in a 24hr period.
D.R.= 1 ► 1 Q, grams/24hr period
Please note, fluid ounces (a volume) must be converted to grams (a mass). The formula for this conversion is:
rcQM6 Qj.PMdLj& = fll11H n7 of p rQrj1 in X 1_qa24 I�g.___,1(_ c�ricrifir ra ii�odUCt X 45� 5�
128 fl. oz. 1 gal. water 1 lb.
L �OW
J
loco 1'11� r`^ , vn 24 V^

Facility Name: QA--P� NPDES#: NCOo95S;:E-,
Estimate total volume of the water handling system between entry of biocidal product and NPDES discharge point.
On an attached sheet please provide justification for this estimate (system volume, average cycles per blow.down,
holding lagoon size, etc.)'
Volume= 'cp Oo I million gallo ,�---------
What is the pH of the handling system prior to biocide addition? If unknown, enter N/A. A,
What is the decay rate (D.K.) of the product? If unknowt assume no decay (D.K.-0 and proceed to asterisk.
The degradation must be stated at pH level within 1/2 pH standard unit wit i handling in system. Enter the half life
(Half Life is the time required for the initial product to degrade to half of its original concentration). Please provide
copies of the sources of this data.
H. L. = Days
The decay rate is equal to H1L X 0.69 = =Decay Rate (D.K.)
Calculate degradation factor (D.F.). This is the first order loss coefficient.
D.F. __ ((A. o( .DmD.) + (D.K.) _ (p.00) + ( o ) _ -4
Calculate Steady State Discharge Concentration:
(D.R.) ( I I tle
Dischg Conc. _ (D.F.)(Volume)(3785) - (-qS )(o.col)(3785) t mg/I
Calculate concentration of biocide instream during low flow conditions.
(Receiving Stream Concentration)
(Dischq. Conc.) x (IWC%) _ q.l(a) x ( i®O) _ mg/I
100 - 100
Receiving Stream Concentration
III. Calculate regulated limitation.
List all LC50 and EC50 data available for the whole product according to the following columns. (Note that units
should be in mg/1). Please provide copies of the sources of this data.
Organism
Test Duration
LC50/EC50 (mg/I)
900
D. W Q. Form 101 (612000) 2

1760111ty Name; 15Nm NC'Oqr 'C'
<S
Chow the lowogf LCOO/E060 -Ilmt@d Move; yv-wS
antor the 1.060/13060,
If tho halt life ([I,L,) le Im than 4 dop, perform the follwmny coloulotion
Rqulof@d Umliallon $ 0,00 x LOW � , -- .,,. I
a
If Ov holf life (H,L,) 16 grader thm or aquol W 4 doy§ 0 �-Orform file (0116YAng Gploulptiop
Roguintod UmItotion Ln a
61100m IM Oppropmato fr@m ft §911601dom Im-madlatoly Obovo ond pies In thig blOnkif
From Pan if enter the facolving krmn woontrolon
If tho resolving stream weanOtlon le greeter man Im oploulawd ragul@Wd IlmlMlon, thon (hip blooldo IR
en�dee�febie far one, ,
Pmom In R.Ggp@nolbl@ Charp
11b
diffomn t fFafreesa
Nom (Print),
DOW
Piwo-pubm it to; viviolon of WOW OURY!y
Aquotia Toxicology unit
1601 Moil .901000- 0@11top
Roloigh, NO RFW-101
Contact lhfo 1 C111dy Moore or john, eflopR1110

BIOCIDE/CHEMICAL TREATMENT
WORKSHEET-FORM 101
The following calculations are to be performed on any biocidal products ultimately discharged to the surface waters of
North Carolina. This worksheet must be completed separately for each biocidal product in use. This worksheet is to be
returned with all appropriate data entered into the designated areas with calculations performed as indicated.
Facility Name S t-r-
NPDES # NC Outfall #
County Vze!E=-WrrI
Receiving Stream JA1ArAvL7E-�> cps 7Q10 (cfs)
(All above information supp]ied by the Division of Water Quality) b� IFEA?—
What is the Average Daily Discharge (A.D.D.) volume of the water handling systems to the receiving water body?
A.D.D. = e-®`45- (in M.G.D.)
Please calculate the Instream Waste Concentration (IWC in percent) of this discharge using the data entered
above.
A.D.D.) X 100
IWC = (7 0)(0.646) + (A. D. D)
4
_ (►0)X100
( 0)(0.646) +
(v0 %
This value (IWC) represents the waste concentration to the receiving stream during low flow conditions.
II. What is the name of the whole product chemical treatment proposed for use in the discharge identified in Part I?
Please list the active ingredients and percent composition:
% j&-j
ofo
What feed or dosage rate (D.R.) is used in this application? The units must be converted to maximum grams
of whole product used in a 24hr period.
D.R.= 2- -"'IS grams/24hr period
Please note, fluid ounces (a volume) must be converted to grams (a mass). The formula for this conversion is:
Uullflu YIdVIIY of PI
128 fl. oz. 1 gal. water 1 lb.
p . ®t 2 c�i lo�S �(a>� 5 .14& 1 S mrvt '-

Facility Name: �L FAk 13y-goPAIF4-995, FArF—It; NPDES #: NC
Estimate total volume of the water handling system between entry of biocidal product and NPDES discharge point.
On an attached sheet please provide justification for this estimate (system volume, average cycles per blowdown,
holding lagoon size, etc.)
Volume= ®• ®® (
7 t , o oct C-7 AcL- . c--A.';-A%c (TY
million gallons ©r- SlfS
What is the pH of the handling system prior to biocide addition? If unknown, enter N/A.
What is the decay rate (D.K.) of the product? If unknown, �ume�nodecayandproceed to asterisk.
The degradation must be stated at pH level within 1 /2 pH standard unit within handling system. Enter the half life
(Half Life is the time required for the initial product to degrade to half of its original concentration). Please provide
copies of the sources of this data.
H.L. = o.o Days
The decay rate is equal to H1L X 0.69
=Decay Rate (D.K.)
Calculate degradation factor (D.F.). This is the first order loss coefficient.
* D.F. = A� - D. D.) + () + 0
D K = o, o�
(Volume) (6. oo0 ( )
Calculate Steady State Discharge Concentration:
Dischg Conc. _ (D.R.) - ( _ ®- 0101-img/I
(D.F.)(Volume)(3785) - ( -4S )(ozol )(3785)
Calculate concentration of biocide instream during low flow conditions,
(Receiving Stream Concentration)
(Dischg. Conc.) x (IWC%) _ ([5.01 x ( i0G) _ O pt mg/1
100 100
Receiving Stream Concentration
III. Calculate regulated limitation.
List all LC50 and EC50 data available for the whole product according to the following columns. (Note that units
should be in mg/1). Please provide copies of the sources of this data.
Organism Test Duration LC50/EC50 (mg/1)
Fist-( '1�� � � times t7 r�n� -ems q& 14 . Rv .14
Ft5k4 -4,2-NR. 3S'
7VN0 4 F-)I la. Vu te.)C. 45;; 4 R- 2
DAP a--tMIMA'r.,r'tA 21't H9,
D. W. Q. Form 101 (612000) 2

Facility Marne;
w"I'j swl- NPDES it; NC
Choosw the lowoBt I.CG6/E060 listedabovo;
Enter the LC60/EC60;
If tiro half life (VIL) I* low, than 4 dayb, perform th@ following OnIcUlPtion,
Regulatod 1.1mitailon r. 0,05 x LOW
It the half life (HL) Is gro-Worth@n or equal to 4 dkiya'6 tho follovilng coloulaflon.
Ragulotod Umltoflon o 0,01 x LC60 la 40, 0 ( 171, 1 g1l
Choow, tho approprioto roplatod III-nitotion from the WoUlatlong IMMOdlotoly Wow and pla@@ In thif, blank'
—P —� �k - - .1, -O—L:,to
From Part 11 ntor tho racigiving *@arfl cong@ntration;
0 ( + mollitrar
IV Analplo,
If the. recelving Wow conoontrotion It, granter than tho coloolotod roplotod lim1fdon, thw thN blooldo W
unaccoptablo for wo;
ftmon In Roponolblo 0harp
Sig Moro Date
Poroon omploting ThI@ Worlolwat (if dIffowt from above)
egiewi, pwgvjmr-m��
Nam@ (Print)
girl )Woro Dato
Plea*@ f3uhmit ft, MOW of Wotor QuolitY
Aquatic TaxiaWou Unit
1621 mail SOMIN Gontff
Raloigh, NO R70,99-51621
Contact Info: Cindy Moor@ (Wady,ti,tw) re( 1110 r(plo)TIR11,110t)
or J01111 03ioreloo (JOIT11,81org
n fM n Wnw" M I AVWIM . . 13

BIOCIDE/CHEMICAL TREATMENT
WORKSHEET-FORM 101
The following calculations are to be performed on any biocidal products ultimately discharged to the surface waters of
North Carolina. This worksheet must be completed separately for each biocidal product in use. This worksheet is to be
returned with all appropriate data entered into the designated areas with calculations performed as indicated.
Facility Name 'SALEAX t.AESs PA2eL RZA&k—TIMtJ '- I1-r-
NPDES # NC�raIaO53E77a Outfall # �A
County ��_ T�
Receiving Stream (A9-Wo F 7Q10 d 4% (cfs)
OZ�
(All above information supplied by the Division of Water Quality) � ��� Ali— T4
What is the Average Daily Discharge (A.D.D.) volume of the water handling systems to the receiving water body?
A.D.D. _ ® •o'TS— (in M.G.D.)
Please calculate the Instream Waste Concentration (IWC in percent) of this discharge using the data entered
above.
A.D.D. X 100
IWC = (7 nA 0)(0.646) + (A.D.D)
0
(,03) X 100
)(0.646) + ( )
This value (IWC) represents the waste concentration to the receiving stream during low flow conditions.
11. What is the name of the whole product chemical treatment proposed for use in the discharge identified in Part I?
Please list the active ingredients and percent composition:
i yp` a cft'.o SUS I a,- SAct_T 10 - 7-0 % my WPi'
6 CFC i VL" ` C to -'- , % a'f �1T-
�Ofl) q A/` _C9 % S-e WT
What feed or dosage rate (D.R.) is used in this application? The units must be converted to maximum grams
of whole product used in a 24hr period.
D.R.= ( •Q(aS grams/24hr period
Please note, fluid ounces (a volume) must be converted to grams (a mass). The formula for this conversion is:
128 fl. oz. 1 gal. water 1 lb.
i
�� ,r Prmduta
I
I
6 2' ��ct.��ml ,
it
IJ "
L C(avi
L F10'
t
24

Facility Name: SP�L.CJK& Ec-S,g..IESS P.e,R-K— NPDES
RE►.�.Tr�l P�T�or-� S o T�
Estimate total volume of the water handling system between entry of biocidal product and NPDES discharge point.
On an attached sheet please provide justification for this estimate (system volume, average cycles per blowdown,
holding lagoon size, etc.) > l,vv­T CP<� qTL_aiN4 (r-:dkRAr—iv' of
Volume= million gallons TPF-AT "7— Sr'S7-J;-M
What is the pH of the handling system prior to biocide addition? If unknown, enter N/A. N/Ac
What is the decay rate (D.K.) of the product? If unknow assume no decay (D.K.=O id proceed to asterisk.
The degradation must be stated at pH level within 1 /2 pH standard unit within handling system. Enter the half life
(Half Life is the time required for the initial -product to degrade to half of its original concentration). Please provide
copies of the sources of this data.
H.L. _ 040 Days
The decay rate is equal to H1L X 0.69 =
=Decay Rate (D.K.)
Calculate degradation factor (D.F.). This is the first order loss coefficient.
* D.F. = A.D.D. + ( D K.) _ '0$� +
(Volume) (.oA 9 )
Calculate Steady State Discharge Concentration:
(D.R.) ( Ii, (A)
Dischg Conc. _ (D.F.)(Volume)(3785) _ ( -.5• )(o.o®i )(3785) _ ®• mg/I
Calculate concentration of biocide instream during low flow conditions.
(Receiving Stream Concentration)
Gl
(Dischg. Conc.) x (IWC%) x ( I�c�) _ O _ mg/I
100 = 100
Receiving Stream Concentration
III. Calculate regulated limitation.
List all LC50 and EC50 data available for the whole product according to the following columns. (Note that units
should be in mg/1). Please provide copies of the sources of this data.
Organism
911111111
Test Duration
O. S KV__
LC50/EC50 (mg/1)
®•Gt00
D. W. Q. Form 101 (612000) 2

Facility Name: � NPDES
R��► 6�"C t Co 1J 11�> c`Tr—
Choose the lowest LC50/EC50 listed above:
Enter the LC50/EC50 4:p "`" t c
If the half life (H.L.) is less than 4 days, perform the following calculation
Regulated Limitation = 0.05 x LC50
If the half life (H.L.) is greater than or equal to 4 days Pdrir,rin the following calculation.
Regulated Limitation = 0.01 x LC50 = 6:1 • mg/I
Choose the appropriate regulated limitation from the calculations immediately above and place in this blank:
�• ®��- rnglliter
From Part II enter the receiving stream concentration
_.._mg/liter
IV. Analysis.
If the receiving stream concentration is greater than the calculated regulated limitation, then this biocide is
unacceptable for use.
Person in Responsible Charge
ri t)
Sig ature Date
Person C mpleting This Worksheet (If different from above)
rr Name (Print)
nnRIre Date
Please sulsmlt to: Division of Water Quality
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
Contact info: Cindy Moore (rind}[e-mail]) or John Giorgino [e-mail])
7 ii' I. F'::, nT i (f i i"') 7 iY? 3

fiffly)4 1Z _� EMIR 99100'
Division of Azure Water Services, LLC
Material Safety Data Sheet
Product Name: Redux 620 Effective date: 9/15/2012
MSDS #: 55 Page 1 of 6
SECTION 1 -- CHEMICAL PRODUCT AND COMPANY IDENTIFICATION
IDENTIFICATION
Product Name Redux 620
Chemical Name Aqueous Blended Deposit Control Agent
Chemical Family
Formula
Synonym
COMPANY IDENTIFICATION
Redux Technology
Division of Azure Water Services, LLC
550 VT Rte. 30, P.O. Box 331
Newfane, VT 05345
Phone: [phone]
Fax: [phone]
Email: [e-mail]
EMERGENCY TELEPHONE NUMBER
24 hours a day: CHEMTREC 1-800-424-9300.
Number for non -emergency questions concerning MSDS: [phone]
SECTION 2.-- COMPOSITION / INFORMATION ON INGREDIENTS
Component CAS # Amount (%oW[W )
Water 7732-18-5
Acrylate Copolymer Not -Hazardous
Organic Phosphorous Compound Proprietary
Sulfonated Phosphonium Salt Proprietary
^-78%
—6%
—6%
—10%

)It ay.MIt-all Lfu. Material Safety Data Sheet
Product Name: Redux 620 Effective date: 9/15/2012
MSDS #: 55 Page 2 of 6
SECTION 3 -- HAZARDS IDENTIFICATION
EMERGENCY I Eye and skin irritant. Prolonged or repeated skin may cause irritation.
OVERVIEW
POTENTIAL HEALTH EFFECTS.
INGESTION .................
May cause severe and permanent damages to mouth throat and
stomach. May be fatal if swallowed.
INHALATION ............. .
Damages airways and lungs, depending upon amount and duration
of exposure. Effects- can vary from irritation to bronchitis or
pneumonia.
EYE CONTACT............
May cause permanent damage, including blindness.
SKIN CONTACT..........
Harmful contact, but may not cause immediate pain.
SECTION 4 -- FIRST AID MEASURES
INGESTION
If swallowed, DO NOT induce vomiting. Immediately drink a large quantity of water.
If available, give large quantities of milk. Never give anything by mouth to an
unconscious person. Get medical attention immediately. If vomiting occurs
s ontaneousl , keep airway clear.
INHALATION
Get person out of contaminated area to fresh air. If breathing has stopped,
resuscitate and administer oxygen if readily available. Get medical attention
immediately.
EYE CONTACT
Immediately flush eye with plenty of cool, running water. Remove contact lenses if
applicable and continue flushing for at least 15 minutes, holding eyelids apart to
ensure thorough rinsing of the entire eye. Get medical attention immediate) .
SKIN CONTACT
Immediately flush skin with plenty of cool running water for at least 15 minutes. Wash
with soap and water. If irritation develops or persists, get medical attention.
Remove contaminated clothing and.shoes; wash before reuse.
NOTE TO
Information pertaining to ingestion toxicology, therapy, symptomatology and treatment
PHYSICIAN
can be found in Clinical Toxicology of Commercial Products, authored by Gosselin,
Smith and Hodge and published by Williams & Wilkins, Baltimore, Maryland.

/1fDUX4[fal flu. Material Safety Data Sheet
Product Name: Redux 620 Effective date: 9/15/2012
MSDS #: 55 Page 3 of 6
SECTION 5 -- FIRE FIGHTING MEASURES
FLASH POINT/METHOD
None/N.A.
FLAMMABLE LIMITS JNotflammableor
combustible
EXTINGUISHING MEDIA
Use extinguishing media appropriate for surrounding fire.
SPECIAL FIRE FIGHTING
Pressure demand self-contained respiratory protection and protective
PROCEDURES
clothing should be worn by fire fighters.
FIRE AND EXPLOSION
Not a fire or explosion hazard
HAZARDS
SECTION 6 -- ACCIDENTAL RELEASE MEASURES
RESPONSE Absorb with inert material such as vermiculite, shovel into closeable container for
TO SPILLS disposal. Thoroughly flush residual with water.
SECTION 7 -- HANDLING AND STORAGE
HANDLING
Wear proper safety equipment. Mix only with water. Follow appropriate tank entry
PRECAUTIONS
procedures (ANSI Z117) and OSHA Confined Space Regulations.
STORAGE
Store in a cool, dry and well -ventilated place. Keep from freezing.
PRECAUTIONS
Keep container tightly.closed when not in use.
SECTION 8 -- EXPOSURE CONTROLS / PERSONAL PROTECTION
HYGIENIC PRACTICES
Observe label precautions; use personal protective equipment.
Avoid breathing mists or vapors of this. product.
ENGINEERING CONTROLS
Facilities using this product must be equipped with an eyewash
station.
Local Exhaust: None.

/1fDyllA[T B/101OOv. Material Safety Data Sheet
Product Name: Redux 620 Effective date: 9/15/2012
MSDS #: 55 Page 4 of 6
PERSONAL PROTECTIVE EQUIPMENT
X
RESPIRATOR
NIOSH/MSHA approved respirator where mists or sprays may be
enerated.
X
GOGGLES / FACE
SHIELD
Chemical splash goggles required; also use face shield if exposure is
severe
X
APRON
Required; PVC, Neoprene or Vinyl acceptable
X
GLOVES
Required; use PVC, Neoprene or Nitrile with long gauntlet or protective
cuff
X
I BOOTS
Rubber
SECTION 9 -- PHYSICAL AND CHEMICAL PROPERTIES
APPEARANCE
Clear pale yellow liquid
BOILING POINT
> 2120 F
ODOR
Slight Odor
FREEZING _POINT
< 320 F
H
Approx. 4.3
VAPOR PRESSURE
Similar to water
SPECIFIC GRAVITY
1.1
VAPOR DENSITY
Similar to water
SOLUBILITY IN WATER
Complete
EVAPORATION RATE
Similar to water
SECTION 10 - STABILITY AND REACTIVITY
CHEMICAL STABILITY ISTABLE IX I JUNSTABLE
CONDITIONS TO . AVOID Do not mix with anything but water.
INCOMPATIBILITY Do not mix with quaternay amines, acids, sulfides and strong oxidizers.
HAZARDOUS PRODUCTS Carbon dioxide and carbon monoxide.
OF DECOMPOSITION
POLYMERIZATION WILL NOT IX I MAY
OCCUR OCCUR
CONDITIONS TO AVOID Not applicable

Material Safety Data Sheet
Product Name: Redux 620 Effective date: 9/15/2012
MSDS #: 55 Page 5 of 6
SECTION 11 -- TOXICOLOGICAL INFORMATION
Oral: Rat LD50 = 4,300 mg/kg
Dermal: Rat LD50=.15,000 mg/kg
Eye Irritation: Corrosive
Skin irritation Mild Irritant
CARCINOGENICITY
THIS PRODUCT CONTAINS A KNOWN OR SUSPECTED CARCINOGEN
X
THIS PRODUCT DOES NOT CONTAIN ANY KNOWN OR ANTICIPATED CARCINOGENS
ACCORDING TO THE CRITERIA OF THE NTP ANNUAL REPORT ON CARCINOGENS AND
OSHA 29 CFR 1910, Z
OTHER EFFECTS
ACUTE
May be corrosive to all body tissues which it comes in contact.
CHRONIC
The chronic local effect may consist of multiple areas of superficial destruction of the
skin or of primary irritant dermatitis. Similarly, inhalation of dust, spray, or mist may
result in varying degrees of irritation or damage to the respiratory tract tissues and an -
increased susceptibility to respiratory illness.
SECTION 12 -- ECOLOGICAL INFORMATION
BIODEGRADABILITY
CONSIDERED
X
NOT BIODEGRADABLE
BIODEGRADABLE
BOD / COD VALUE
Not established
ECOTOXICITY
Rainbow trout: 96 hr LD50 = 900 mg/I
Blue ill sunfish: 96 hr LD50 = 700 m /I

BEOU,r4rMt/U®t®0K. Material. Safety Data Sheet
Product Name: Redux 620 Effective date: 9/15/2012
MSDS #: 55 Page 6 of 6
SECTION 13 -- DISPOSAL -CONSIDERATIONS
WASTE DISPOSAL
METHOD
Product that cannot be used according to the label must be disposed of permanufacturers
recomendations. Empty containers may be triple rinsed, then offered for recycling or
reconditioning; or puncture and dispose of in.a sanitary landfill.
RCRA CLASSIFICATION Non -Hazardous
RECYCLE CONTAINER I YES I X CODE 2 - HDPE NO
SECTION 14 -- TRANSPORT INFORMATION
DOT CLASSIFICATION
HAZARDOUS
NOT
HAZARDOUS
X
DESCRIPTION
SECTION 16 =- REGULATORY INFORMATION
REGULATORY STATUS
EPA REGISTERED (UNDER
FIFRA
Not Applicable
FDA REGULATED
Some components FDA approved for food operations
KOSHER
Not Applicable
SARA- TITLE III MATERIAL
Not Applicable
USDA AUTHORIZED
I Not Applicable
NSF APPROVAL
Not Applicable
SECTION 16 -- OTHER INFORMATION
NFPA CLASSIFICATION .
1
BLUE
HEALTH .HAZARD
0
RED
FLAMMABILITY
1
YELLOW
REACTIVITY
C
WHITE
SPECIAL HAZARD

-fly) 4 rfcffffaz a 5.7o,
Division of Azure Water Services, LLC
Redux 620 — Fate and Transport Information
Redux 620 should be properly referred to as an organic dispersant. It is formulated to minimize
the formation of semi-solds and solids characterized as organic deposits. This type of deposition
occurs when polysaccharides ("slime" secreted by natural microbial action) and other organic
material coat treatment system surfaces, acting as a "glue" to capture inorganic solids that would
otherwise retain mobility. The product contains sequestering agents and dispersants intended to
solubilize such a deposit matrix, and reduce the likelihood of its initial formation.
Redux 620 contains three ingredients: 1) a phopshonate sequestering agent to prevent iron and
calcium ions from forming insoluble salts, 2) a polymeric dispersant to keep organic and inorganic
solids mobile, and prevent their agglomeration, and 3) a phosphonate-based iron dispersant. The
dispersant ingredients also act upon the polysaccharide slime produced by microbes (particularly
iron -related microbes which are often termed "slime -forming") to prevent its accumulation on
system surfaces.
Discharge concerns might include phosphorous concentrations, as well as fate and degradation
of components. As for the former concern, it is important to note that the phosphorous -bearing
molecules used in this formulation are phosphonates, not phosphates. Phosphate molecules
degrade to form orthophosphate, which is the source of excess nutrient loading which drives the
regulation of phosphorous. Phosphonate deposit control chemicals.were developed in the 1970's
and 1980's to replace phosphates, and do not degrade to orthophosphate in natural aquatic
systems, and thus do not cause excess nutrient loading.
Components of Redux 620 are chosen for the deposit control performance, but also for their fate
and degradation characteristics. All product ingredients are considered readily biodegradable.
Mechanisms involved in reducing the impact of Redux 620 ingredients include sorption on soil
mass, and subsequent degradation by hydrolysis, UV oxidation and biologically mediated
degradation reactions. In general, dispersants sorbs reasonably strongly to soil components.
The polymeric dispersant used in Redux 620 is essentially non -toxic, and is widely used in
detergents and other products where it is discharged to the environment. The sequestering agent
is a phosphonate that has also been widely used in dishwashing and laundry detergents, and has
been shown in various studies to sorb to soil materials. The sorption of these two ingredients on
soils is important, in that it creates a chromatographic effect, slowing the transport of ingredients,
until they degrade to small organic molecules and subsequently desorb.
The iron dispersant component (THPS) does not sorb to soils as strongly as the other two
ingredients and it contributes virtually all of the limited aquatic toxicity of the product. In systems
utilizing activated carbon, its hydrolytic degradation is catalyzed by the activated carbon resulting
in no discharge of THPS, and no toxicity impact on the discharge. Also, THPS oxidizes rapidly in
aquatic systems. THPS degradation by-products are non -toxic. Field testing for THPS to verify
its absence in discharged water is simple and inexpensive.
280 Callegari Drive, West Haven, Connecticut 06516
Phone: [phone] Fax: [phone] www.reduxtech.com

Material Safety Data Sheet
HYDROGEN PEROXIDE 35%
+PAC
MSDS th 7722-84-1--35
Revision Date: 2013-02-12
Version 2
This MSDS has been prepared to meet U.S. OSHA Hazard Communication Standard 29 CFR 1910.1200
and Canada's Workplace Hazardous Materials Information System (WHMIS) requirements.
1. PRODUCT AND COMPANY IDENTIFICATION
Product name HYDROGEN PEROXIDE 35%
Formula HO - OH
Recommended use
Manufacturer
FMC CORPORATION
FMC Peroxygens
1735 Market Street
Philadelphia, PA 19103
Phone: [phone] (General
Information)
E-Mail: [e-mail]
FMC of Canada Ltd.
FMC Peroxygens
PG Pulp Mill Road
Prince George, BC V2N2S6
1+ 250/ 561-4200 (General Information)
Emergency telephone number
For leak, fire, spill or accident emergencies, call:
+1 800 / 424 9300 (CHEMTREC - U.S.A.)
+1 703 / 527 3887 (CHEMTREC - Collect - All Other Countries)
1 613/ 996-6666 (CANUTEC - Canada)
+l 303 / 595 9048 (Medical - U.S. - Call Collect)
1 281 / 474-8750 (Bayport, Texas Plant)
1250 / 561-4221 (Prince George, BC, Canada Plant)
2. Hazards identification
Emergency Overview
Clear, colorless liquid
Oxidizer; Contact with combustible material may cause fire
Decomposes under fire conditions to release oxygen that intensifies the fire
Decomposes yielding oxygen that can cause overpressure if confined
Potential health effects
Principle Routes of Exposure
Eyes
Skin
Inhalation
Ingestion
Eye contact; Skin contact
Corrosive, Causes serious eye damage.
Causes moderate skin irritation.
Irritating to respiratory system.
Harmful if swallowed. Ingestion may cause gastrointestinal irritation, nausea, vomiting and diarrhea.
Page I / 8

HYDROGEN PEROXIDE 35%
Tnrr Aiantc
MSDS #: 7722-84-1--35
Revision Date: 2013-02-12
Version 2
Chemical Name
CAS -No
Weight %
Hydrogen peroxide
7722-84-1
35
Water
7732-18-5
65
4. First aid measures
Eye contact Rinse immediately with plenty of water, also under the eyelids, for at least 15 minutes. Remove
contact lenses, if present, after the first 5 minutes, then continue rinsing. Seek immediate medical
attention/advice.
Skin contact
Take off contaminated clothing. Rinse skin immediately with plenty of water for 15-20 minutes.
Call a poison control center or doctor for treatment advice.
Inhalation
Move to fresh air. If person is not breathing, contact emergency medical services, then give artificial
respiration, preferably mouth-to-mouth if possible. Call a poison control center or doctor for further
treatment advice.
Ingestion
Rinse mouth. Do not induce vomiting. If conscious, give 2 glasses of water. Get immediate medical
attention. Never give anything by mouth to an unconscious person.
Notes to physician
Hydrogen peroxide at these concentrations is a strong oxidant. Direct contact with the eye is likely
to cause corneal damage especially if not washed immediately. Careful opthalmologic evaluation is
recommended and the possibility of local corticosteroid therapy should be considered. Because of
the likelihood of corrosive effects on the gastrointestinal tract after ingestion, and the unlikelihood of
systemic effects, attemps at evacuating the stomach via emesis induction or gastric lavage should be
avoided. There is a remote possibility, however, that a nasogastric or orogastric tube may be
required for the reduction of severe distension due to gas formation.
5. Fire -fighting measures_
Flammable properties
Contact with combustible material may cause fire.
Flash Point Not combustible
Suitable extinguishing media Water. Do not use any other substance.
Uniform Fire Code Oxidizer: Class 2--Liquid
Hazardous combustion products On decomposition product releases oxygen which may intensify fire.
Explosion Data
Sensitivity to Mechanical Impact Not sensitive.
Sensitivity to Static Discharge Not sensitive.
Specific hazards arising from the In closed unventilated containers, risk of rupture due to the increased pressure from decomposition.
chemical
Protective equipment and precautions Use water spray to cool fire exposed surfaces and protect personnel. Move containers from fire area
for firefighters if you can do it without risk. As in any fire, wear self-contained breathing apparatus and full
protective gear.
NFPA Health Hazard 3 Flammability 0 r Stability 1 Special Hazards OX
Page 2 / 8

HYDROGEN PEROXIDE 35% NISDS #: 7722-84-1--35
Revision Date: 2013-02-12
Version 2
6. Accidental release measures
Personal precautions Avoid contact with skin, eyes and clothing. Wear personal protective equipment. Isolate and post
spill area. Keep people away from and upwind of spill/leak. Eliminate all sources of ignition and
remove combustible materials.
Methods for containment Dike to collect large liquid spills. Stop leak and contain spill if this can be done safely. Small
spillage: Dilute with large quantities of water.
Methods for cleaning up Flush area with flooding quantities of water. Hydrogen peroxide may be decomposed by adding
sodium metabisulfite or sodium sulfite after diluting to about 5%.
Other Combustible materials exposed to hydrogen peroxide should be immediately submerged in or rinsed
with large amounts of water to ensure that all hydrogen peroxide is removed. Residual hydrogen
peroxide that is allowed to dry (upon evaporation hydrogen peroxide can concentrate) on organic
materials such as paper, fabrics, cotton, leather, wood or other combustibles can cause the material to
ignite and result in fire.
7. Handling and storage
Handling Keep/Store away from clothing/ combustible materials. Wear personal protective equipment.
Reference to other sections. Never return unused hydrogen peroxide to original container.
Contamination may cause decomposition and generation of oxygen gas which could result in high
pressures and possible container rupture. Hydrogen peroxide should be stored only in vented
containers and transferred only in a prescribed manner (see FMC Technical Bulletins). Empty drums
should be triple rinsed with water before discarding. Utensils used for handling hydrogen peroxide
should only be made of glass, stainless steel, aluminum or plastic. Pipes and equipment should be
passivated before first use. Use only in well -ventilated areas.
Storage Keep containers in cool areas out of direct sunlight and away from combustibles. Provide mechanical
general and/or local exhaust ventilation to prevent release of vapor or mist into work environment.
Containers must be vented. Store in original container only. Store rooms or warehouses should be
made of non-combustible materials with impermeable floors. In case of release, spillage should flow
to safe area. Containers should be visually inspected on a regular basis to detect any abnormalities
(swollen drums, increases in temperature, etc.).
8. Exposure- controls/personal protection
Exposure guidelines
Ingredients with workplace control parameters.
Chemical Name
ACGIH TLV
OSHA PEL
NIOSH
Mexico
Hydrogen peroxide
TWA: 1 ppm
TWA: 1 ppm
IDLH: 75 ppm
Mexico: TWA 1 ppm
7722-84-1
TWA: 1.4 mg/m3
TWA: 1 ppm
Mexico: TWA 1.5 mg/m3
TWA: 1.4 mg/m3
Mexico: STEL 2 ppm
Mexico: STEL 3 mg/m3
Chemical Name
British Columbia
Quebec
Ontario TWAEV
Alberta
Hydrogen peroxide
TWA: 1 ppm
TWA: 1 ppm
TWA: 1 ppm
TWA: I ppm
I
7722-84-1
TWA: 1.4 mg/m3
TWA: 1.4 mg/m3
Occupational exposure controls
Engineering measures Showers. Eyewash stations. Ventilation systems.
General Information Protective engineering solutions should be implemented and in use before personal protective
equipment is considered.
Respiratory protection If concentrations in excess of 10 ppm are expected, use NIOSH/DHHS approved self-contained
breathing apparatus (SCBA) or other approved air -supplied respirator (ASR) equipment (e.g., a
full -face airline respirator (ALR)). DO NOT use any form of air -purifying respirator (APR) or
filtering facepiece (dust mask), especially those containing oxidizable sorbants such as activated
carbon.
Page 3 / 8

HYDROGEN PEROXIDE 35%
MSDS #: 7722-84-1--35
Revision Date: 2013-02-12
Version 2
Eye/face protection
Use chemical splash -type monogoggles and a full -face shield made of polycarbonate, acetate,
polycarbonate/acetate, PETG or thermoplastic.
Skin and body protection
For body protection wear impervious clothing such as an approved splash protective suit made of
SBR rubber, PVC (PVC Outershell w/Polyester Substrate), Gore -Tex (Polyester trilaminate
w/Gore-Tex), or a specialized HAZMAT Splash or Protective Suite (Level A, B, or Q. For foot
protection, wear approved boots made ofNBR, PVC, Polyurethane, or neoprene. Overboots made of
Latex or PVC, as well as firefighter boots or specialized HAZMAT boots are also permitted. DO
NOT wear any form of boot or overboot made of nylon or nylon blends. DO NOT USE cotton, wool
or leather as these materials react rapidly with higher concentrations of hydrogen peroxide.
Completely submerge hydrogen peroxide contaminated clothing or other materials in water prior to
drying. Residual hydrogen peroxide, if allowed to dry on materials such as paper, fabrics, cotton,
leather, wood or other combustibles, can cause the material to ignite and result in a fire.
Hand protection
For hand protection, wear approved gloves made of nitrile, PVC, or neoprene. DO NOT use cotton,
wool or leather for these materials react RAPIDLY with higher concentrations of hydrogen peroxide.
Thoroughly rinse the outside of gloves with water prior to removal. Inspect regularly for leaks.
Other Protective Equipment
Ensure that eyewash stations and safety showers are close to the workstation location
Hygiene measures
Avoid breathing vapors, mist or gas. Clean water should be available for washing in case of eye or
skin contamination.
9. Physical and chemical properties
9.1 Information on basic physical and chemical properties
Appearance
Clear, colorless liquid
Physical state
Liquid
Odor
odorless
pH
<= 3.7
Melting Point/Range
not applicable
Freezing point
-33 °C
Boiling Point/Range
108 °C
Flash Point
Not combustible
Evaporation rate
>1 (BuAc= 1)
Flammable properties
Contact with combustible material may cause fire.
Oxidizing properties
Strong oxidizer
Vapor pressure
23 mmHg @ 30 °C
Vapor density
No information available.
Specific Gravity
1.13
Bulk density
not applicable
Water solubility
Completely Soluble
Percent volatile
100%
Partition coefficient:
log Kow = -1.5 @ 20 °C
Viscosity
L I cP @ 20 °C
9.2 Other information
Autoignition Temperature Not combustible
�10. Stability_ and reactivity_
Stability Stable under normal conditions. Decomposes on heating. Stable under recommended storage
conditions.
Conditions to avoid Excessive heat; Contamination; Exposure to UV -rays; pH variations.
Page 4 / 8

HYDROGEN PEROXIDE 35% MSDS #: 7722-84-1--35
Revision Date: 2013-02-12
Version 2
Materials to avoid Combustible materials. Copper alloys, galvanized iron. Strong reducing agents. Heavy metals. Iron.
Copper alloys. Contact with metals, metallic ions, alkalis, reducing agents and organic matter (such
as alcohols or terpenes) may produce self -accelerated thermal decomposition.
Hazardous decomposition products
Hazardous polymerization
Hazardous reactions
:11. Toxicological information
Acute effects
Eye irritation
Skin irritation
LD50 Oral
LD50 Dermal
LC50 Inhalation
Sensitization
Chronic Toxicity
Oxygen which supports combustion. Liable to produce overpressure in container.
Hazardous polymerization does not occur.
Contact with organic substances may cause fire or explosion. Contact with metals, metallic ions,
alkalis, reducing agents and organic matter (such as alcohols or terpenes) may produce
self -accelerated thermal decomposition.
Corrosive
Moderate skin irritation
50% solution: LD50 > 225 mg/kg bw (rat)
35 % solution:LD50 1193 mg/kg bw (rat)
70 % solution: LD50 1026 mg/kg bw (rat)
35% solution: LD50 > 2000 mg/kg bw (rabbit)
70 % solution: LD50 9200 mg/kg bw (rabbit)
50% solution: LC50 > 170 mg/m3 (rat) (4-hr)
Hydrogen Peroxide vapors: LCO 9400 mg/m3 (mouse) (5 - 15 minutes)
Hydrogen Peroxide vapors: LC50 > 2160 mghn3 (mouse)
Did not cause sensitization on laboratory animals.
Carcinogenicity This product contains hydrogen peroxide. The International Agency for Research on Cancer (IARC)
has conculded that there is inadequate evidence for carcinogenicity of hydrogen peroxide in humans,
but limited evidence in experimental animals (Group 3 - not classifiable as to its carcinogenicity to
humans). The American Conference of Governmental Industrial Hygienists (ACGIH) has concluded
that hydrogen peroxide is a'Confirmed Animal Carcinogen with Unknown Relevance to Humans'
(A3)
Chemical Name
ACGIH
IARC
NTP
OSHA
Hydrogen peroxide
A3
3
Mutagenicity This product is not recognized as mutagenic by Research Agencies. In vivo tests did not show
mutagenic effects.
Target Organ Effects Eyes, Respiratory system, Skin.
Page 5 / 8

HYDROGEN PEROXIDE 35%
f2. Ecological information
MSDS #: 7722-84-1--35
Revision Date: 2013-02-12
Version 2
Ecotoxicity
Hydrogen peroxide is naturally produced by sunlight (between 0.1 and 4 ppb in air and 0.001 to 0.1 mg/L in water). Not expected to have
significant environmental effects.
Active Ingredient(s)
n aro en veroxiae //LL-64-1
Active Ingredient(s)
Duration
Species
Value
Units:
Hydrogen Peroxide
96 h LC50
Fish Pimephales promelas
16.4
mg/L
Hydrogen Peroxide
72 h LC50
Fish Leuciscus idus
35
mg/L
Hydrogen Peroxide
48 h EC50
Daphnia pulex
2.4
mg/L
Hydrogen Peroxide
24 h EC50
Daphnia magna
7.7
mg/L
Hydrogen Peroxide
172 h EC50
lAlgae Skeletonema costatum
11.38
mg/L
Persistence and degradability Hydrogen peroxide in the aquatic environment is subject to various reduction or oxidation processes
and decomposes into water and oxygen. Hydrogen peroxide half-life in freshwater ranged from 8
hours to 20 days, in air from 10 - 20 hours, and in soils from minutes to hours depending upon
microbiological activity and metal contamination.
Bioaccumulation Material may have some potential to bioaccumulate but will likely degrade in most environments
before accumulation can occur.
Mobility Will likely be mobile in the environment due to its water solubility but will likely degrade over time.
Chemical Name log Pow
Hydrogen peroxide -1.57 @ 25°C
Other adverse effects Decomposes into oxygen and water. No adverse effects.
13. Disposal considerations
Waste disposal methods Dispose of in accordance with local regulations. Can be disposed as waste water, when in
compliance with local regulations.
RCRA D Waste Code
Contaminated packaging
14. Transport information
DOT
UNAD No
Proper shipping name
Hazard Class
Subsidiary Class
Packing group
Additional information
TDG
UN/ID No
Proper shipping name
Hazard Class
Subsidiary Class
Packing group
D001 (ignitable)
Dispose of in accordance with local regulations.
Drums - Empty as thoroughly as possible. Triple rinse drums before disposal. Avoid contamination;
impurities accelerate decomposition. Never return product to original container.
2014
HYDROGEN PEROXIDE, AQUEOUS SOLUTION
5.1
8
II
DOT Spec: stainless steel/high purity aluminum cargo tanks and rail cars. UN Spec: High Purity
Aluminum drums and IBCs. Contact FMC for specific details.
UN 2014
HYDROGEN PEROXIDE, AQUEOUS SOLUTION
5.1
8
II
Page 6 / 8

HYDROGEN PEROXIDE 35%
MSDS #: 7722-84-1--35
Revision Date: 2013-02-12
Version 2
ICAO/IATA Air regulation permit shipment of Hydrogen Peroxide (<=40%) in non -vented containers for Air
Cargo Only aircraft, as well as for Passenger and Cargo aircraft. HOWEVER, all FMC Hydrogen
Peroxide containers are vented and therefore, air shipments of FMC H2O2 are not permitted. IATA
air regulations state that venting of packages containing oxidizing substances is not permitted for air
transport.
UNAD No UN 2014
Proper shipping name HYDROGEN PEROXIDE, AQUEOUS SOLUTION
Hazard Class 5.1
Subsidiary hazard class 8
Packing group II
Other information Protect from physical damage. Keep drums in upright position. Drums should not be stacked in
transit. Do not store drums on wooden pallets.
- - - --- - - - --
i15. Regulatory information
International Inventories
TSCA Inventory (United States of America)
Complies
DSL (Canada)
Complies
NDSL (Canada)
Complies
EINECS/ELINCS (Europe)
Complies
ENCS (Japan)
Complies
IECSC (China)
Complies
KECL (Korea)
Complies
PICCS (Philippines)
Complies
AICS (Australia)
Complies
NZIoC (New Zealand)
Complies
U.S. Federal Regulations
SARA 313
Section 313 of Title III of the Superfund Amendments and Reauthorization Act of 1986 (SARA). This product does not contain any chemicals
which are subject to the reporting requirements of the Act and Title 40 of the Code of Federal Regulations, Part 372.
SARA 311/312 Hazard Categories
Acute Health Hazard yes
Chronic Health Hazard no
Fire Hazard yes
Sudden Release of Pressure Hazard no
Reactive Hazard no
CERCLA-
This material, as supplied, does not contain any substances regulated as hazardous substances under the Comprehensive Environmental
Response Compensation and Liability Act (CERCLA) (40 CFR 302) or the Superfund Amendments and Reauthorization Act (SARA) (40 CFR
355). There may be specific reporting requirements at the local, regional, or state level pertaining to releases of this material.
Chemical Name Hazardous Substances RQs Extremely Hazardous Substances RQs
Hydrogen peroxide 1000 lb
SARA 302/CERCLA 355 Extremely Hazardous Substances
International Regulations
Mexico - Grade Slight risk, Grade 1
Hydrogen Peroxide RQ is for concentrations of> 52% only
Page 7 / 8

HYDROGEN PEROXIDE 35%
MSDS #: 7722-841--35
Revision Date: 2013-02-12
VPrcinn 7
Chemical Name
Carcinogen Status
Mexico.
Hydrogen peroxide
A3
Mexico: TWA 1 ppm
Mexico: TWA 1.5 mgJm3
Mexico: STEL 2 ppm
Mexico: STEL 3 mgJm3
uanacla
This product has been classified in accordance with the hazard criteria of the Controlled Products Regulations (CPR) and the MSDS
contains all the information required by the CPR.
WHMIS Hazard Class
C Oxidizing materials
D1B Toxic materials
E Corrosive material
F Dangerously reactive material
16 t0 her information �� � � $
HMIS Health Hazard 3 Flammabilit 0 Stability 1 Special precautions H
Revision Date: 2013-02-12
Reason for revision: Initial Release.
Disclaimer
FMC Corporation believes that the information and recommendations contained herein (including data and statements) are accurate as of the date
hereof. NO WARRANTY OF FITNESS FOR ANY PARTICULAR PURPOSE, WARRANTY OF MERCHANTABILITY OR ANY OTHER
WARRANTY, EXPRESSED OR IMPLIED, IS MADE CONCERNING THE INFORMATION PROVIDED HEREIN. The information provided herein
relates only to the specified product designated and may not be applicable where such product is used in combination with any other materials or in any
process. Further, since -the conditions and methods of use are beyond the control of FMC Corporation, FMC corporation expressly disclaims any and'all -
liability as to any results obtained or arising from any use of the products or reliance on such information.
Prepared By
FMC Corporation
Oxypure and FMC Logo - Trademarks of FMC Corporation
C 2013 FMC Corporation. All Rights Reserved. . .
End.of"Material-Safety Data.Sheet

[3 KuehfteCOMPANY
86 North Hackensack Avenue, South Kearny, New .Jersey 07032-4673
MATERIAL SAFETY DATA SHEET
Phone: [phone]
Fax: [phone]
(This MSDS follows the ANSI Z400.1-1993 format)
SODIUM HYPOCHLORITE
MSDS NUMBER:
MSDS DATE:
(High Strength)
KCC — HYPO - 100
July 01, 2011
24 HOUR EMERGENCY PHONE NUMBER: [phone]
Alt. [phone]
CHEMTREC — [phone]
SECTION 1 — CHEMICAL PRODUCT AND COMPANY IDENTIFICATION
Product Name:
Chemical Name:
CAS Number:
Common Names:
Chemical Formula:
Hypochlorite Solution
Sodium Hypochlorite
7681-52-9
Chlorine Bleach, Soda Bleach
NaOCI
Manufacturer: Kuehne Chemical Company, Inc.
86 North Hackensack Avenue
South Kearny, New Jersey 07032-4673
[phone] Fax: [phone]
SECTION 2 — COMPOSITION, INFORMATION OR INGREDIENTS
CAS Number Name Common Names
7732-18-5 Water Water
Percentage Exposure Limits
VOL. 70 - 87 PEL: Not Established
WT. 80 - 90 TLV: Not Established
STEL: Not Established
IDLH: Not Established
�WV II,W COMPANY �� �)
Sodium Hypochlorite MSDS
Revision C - 01 July 2011 ��o' Page 1 of 14

SECTION 2 — COMPOSITION, INFORMATION OR INGREDIENTS (Continued)
CAS Number Name Common Names
7681-52-9 Hypochlorous Acid, Sodium Salt Sodium Hypochlorite
Percentage Exposure Limits
VOL. 30 - 13 PEL: 1 ppm ceiling (as C12)
WT: 20 - 10 TLV: 1 ppm TWA (as C12)
STEL: 1 ppm ceiling (as C12)
IDLH: Not Established
Listed on: - The EINECS inventory, or in compliance with. the inventory.
- The TSCA inventory.
- The AICS inventory, -or in compliance with the inventory.
- The DSL list.
- The ENCS inventory, or in compliance with the inventory.
- The KECI inventory, or in compliance with the inventory.
- The PICCS inventory, or in compliance with the inventory.
- The IECSC inventory, or in compliance with the inventory.
- The NZIoC inventory, or in compliance with the inventory.
CAS Number
Name
Common Names
1310-73-2 Sodium Hydroxide (NaOH) Caustic Soda, Lye
Percentage
Exposure Limits
VOL. 1
PEL: 2 ppm ceiling
WT. 1
TLV: 2 ppm ceiling
STEL: Not Established
IDLH: 10 ppm
Listed on: - The TSCA Inventory, or in compliance with the inventory.
- PA Requirement -
3% or greater.
- NJ Requirement -
1 % or greater
CAS Number
Name
Common Names
7647-14-5
Sodium Chloride (NaCI) Salt
Percentage
Exposure Limits
VOL. >1
PEL: Not Established
WT. . >1
TLV: Not Established
STEL: Not Established
IDLH: Not Established
d _PL 14Apr�a.
Kue�sa� GCIMIPANY
Sodium Hypochlorite MSDS
$, i
°;
u+rcKiifiucnn�
Revision C - 01 July 2011
Q,
Page 2 of 14

SECTION 2 — COMPOSITION, INFORMATION OR INGREDIENTS (Continued)
CAS Number Name Common Names
497-19-8 Carbonic Acid Disodium Salt Carbonic Acid Sodium Salt
Percentage Exposure Limits
VOL. >1 PEL: Not Established
WT. >1 TLV: Not Established
STEL:- Not Established
IDLH: Not Established
SECTION 3 — HAZARD IDENTIFICATION
Based
HMIS HAZARD RATINGS
NFPA HAZARD RATINGS
ystem Chemical not listed. Ratings based on NFPA guidelines
Effects of Overexposure
Acute: Inhalation — Inhalation of vapors is irritating to the respiratory system,
may cause throat pain and cough, severe respiratory tract irritation and
pulmonary edema.
Eves — May cause severe irritation, burns, and/or corrosion. May
cause vision impairment, corneal damage and blurred vision.
Skin May cause severe irritation and burns or dermatitis. Prolonged
skin exposure may cause destruction of the dermis with impairment of
the skin to regenerate at site of contact.
Ingestion — Ingestion of high concentrations may cause injuries to,
liver, kidneys, central nervous system and gastrointestinal tract pain
and inflammation, burns and perforation of the esophagus or stomach.
Ingestion may cause gastrointestinal irritation, nausea, vomiting and
diarrhea, circulatory collapse, confusion, delirium and coma.
Kue4Ke COMPANY
�•�
Sodium Hypochlorite MSDS Al
Rurokeiou Gai
Revision C - 01 July 2011 , ,y+ f
Page 3 of 14

SECTION 3 — HAZARD IDENTIFICATION (Continued)
Chronic: Repeated inhalation exposure may cause impairment of lung function
and permanent lung damage. Effects from chronic skin exposure
would be similar to those from single exposure except for effects
secondary to tissue destruction.
Note: Corrosive and strongly irritating to the eyes, skin, and respiratory tract.
Inhalation of fumes may cause pulmonary edema. Ingestion may
cause burns to the mouth and digestive tract, and abdominal distress.
Appearance: .Colorless to light yellow-green.liquid
Routes of Entry: Inhalation, Eye Contact, Skin, Ingestion
Target Organs: Eyes, Skin, Respiratory Tract, and Gastrointestinal Tract.
Cancer Information: This product has not been listed as carcinogenic by the following
agencies: IARC, NTP, and OSHA
Mutagenicity: Sodium hypochlorite has tested positive in in -vitro test systems and
negative in in -vivo test systems. These results.are consistent with other germicides.
Medical Conditions Aggravated by Exposure: Asthma, Heart disease, Respiratory.
disorder
SECTION 4 — FIRST AID MEASURES
Inhalation: Remove to fresh air. If breathing is difficult, have qualified person
administer oxygen. If respiration stops, give mouth-to-mouth
resuscitation. SEEK MEDICAL ATTENTION IMMEDIATELY.
Eyes: OBJECT IS TO FLUSH MATERIAL OUT IMMEDIATELY AND THEN
SEEK MEDICAL ATTENTION. IMMEDIATELY, flush eyes with a
directed stream of water for at least 15 minutes while forcibly holding
eyelids apart to ensure complete irrigation of all eye and lid tissue.
Washing eyes within one (1) minute is essential to achieve maximum
effectiveness. -SEEK MEDICAL ATTENTION IMMEDIATELY.
Skin: Flush thoroughly with cool water- under shower while removing
contaminated clothing and shoes. Discard non -rubber shoes. Wash
clothing before reuse. Continue to flush until medical attention arrives.
SEEK MEDICAL ATTENTION IMMEDIATELY.
Xuahs'Le COMPANY �•�
Sodium Hypochlorite MSDS �, RnroN mCnaA
Revision C - 01 July 2011 Page 4 o 14

SECTION 4 — FIRST AID MEASURES
(Continued)
Ingestion: NEVER GIVE ANYTHING BY MOUTH TO AN UNCONSCIOUS
PERSON. If swallowed. DO NOT INDUCE VOMITING. Give large
quantities of milk. If this is not available, give large quantities of water.
If vomiting occurs spontaneously, keep airway clear and give more
milk or water. SEEK MEDICAL ATTENTION IMMEDIATELY. Avoid
vomiting, lavage or acidic antidotes.
Note to Physician
Sodium Hypochlorite is an alkaline corrosive. For exposure by ingestion do not use
emesis, lavage or acidic antidotes. Dilute immediately by giving milk, melted Ice cream,
beaten egg white, starch paste or antacids such as milk of magnesia, aluminum
hydroxide gel or magnesium trisilicate gel. Avoid sodium bicarbonate because of
carbon dioxide release. Sodium thiosulfate solution may prove beneficial by reducing
unreacted material.
SECTION 5 — FIRE -FIGHTING MEASURES
Flash Point: N/A
Auto -ignition Temperature: N/A
Flammable Limits in Air - % by Volume - Upper: N/A
Lower: N/A
Sensitivity to Mechanical Impact: Not Sensitive
Sensitivity to Static Discharge: Not Sensitive
Extinguishing Media
Use water spray, fog, foam, dry chemical, or carbon dioxide or agents suitable for
materials in surrounding fire. Do not use Mono Ammonium Phosphate (MAP) type
extinguishers directly on this product.
Fire Fighting Procedures
Use self-contained breathing apparatus and full protective equipment. Acid
contamination will produce very irritating fumes similar to chlorine..
Fire and Explosion Hazard
Sodium Hypochlorite or its solutions decompose when heated. Decomposition products
may cause containers to rupture or explode. Vigorous reaction is possible with organic
materials or oxidizing agents and may result in fire, may release toxic gases.
KUe6e COMPANY 1 � � �•471
Sodium Hypochlorite MSDSAl
Revision C - 01 July 2011 ��,�p;. Page 5 of 14

SECTION 6 —ACCIDENTAL RELEASE MEASURES
Steps to be Taken if Material is Released or Spilled
Contain the spilled material in the smallest possible area.
to enter sewers, streams or unpaved land. Flush with
possible and pump into polyethylene containers for
contamination with acid materials. Do not use combustib
to absorb Sodium Hypochlorite Solution.
Do not allow spilled material
water to dilute .as much as
disposal. Avoid heat and
le materials such as sawdust
Ventilation Requirements
Provide good general room ventilation plus local exhaust at points of emission.
SECTION 7 — HANDLING AND STORAGE
Handling Precautions
Do not store adjacent to chemicals that may react if spillage occurs. Comply with DOT
regulations when shipped. If closed containers become heated, vent to release
decomposition products (mainly oxygen under normal decomposition). Do not mix or
contaminate with ammonia, hydrocarbons, acids, alcohols or ethers.
Do Not Reuse Containers: Product residues may remain in containers: AII- labeled
precautions must be observed. Dispose of container in a manner meeting government
regulations.
SECTION 8 — EXPOSURE CONTROLS AND PERSONAL PROTECTION
Specific Personal Protective Equipment
Respiratory: NIOSH/MSHA approved respirator with N95 (dust, fume, mist)
cartridges may be permissible under certain circumstances where
airborne concentrations are expected to exceed exposure limits. Acid
gas cartridges may be required if decomposition products are present.
A respiratory protection program that meets 29 CFR 1910.134 must be
followed_ whenever workplace conditions warrant use of a respirator.
Eye: Wear chemical safety goggles plus full face shield to protect against
splashing when appropriate.
Gloves: Wear impervious gloves such as rubber, neoprene or vinyl.
Other: Wear impervious protective clothing including rubber safety shoes.
Eye wash facility and emergency shower should be in close proximity.
KU04KC COMPANY
K
Sodium Hypochlorite MSDS.
Revision C 01 July 2011
nixrn++inu Cnui
6
-
Page of 14

SECTION 9 — PHYSICAL AND CHEMICAL PROPERTIES
Appearance:
Colorless to light yellow -green
Odor:
Pungent chlorine like odor
Physical State:
Liquid
pH:
12 @ 100 g/L
Vapor Pressure:
Temperature mm Hq
PSIA
48.2 OF (9 °C) 3.7
0.071
60.8 OF (16 °C) 8.0
0.15
68.0 OF (20 °C) 12.1
0.23
89.6 OF (32 °C) 31.1
0.60
118.4 OF (48 °C) 100.0
1.93
Boiling Point: Decomposes above 230 OF (110 °C)
(@760 mm Hg)
Freezing/Melting Point: - 14 OF to 30 OF (-25.6 °C to -1.1 °C)
(@14 to 20 weight %)
Solubility in Water: 100%
(by weight)
Specific Gravity: 1.155 - 1.410
(Hz0 = 1)
Odor Threshold (ppm): 0.9 ppm approximate
SECTION 10 —STABILITY AND REACTIVITY
Conditions Contributing to Instability
Strong Oxidizer, stability decreases with concentration, heat, light, decrease in pH and
contamination by metals.
Incompatibility
Avoid contamination with heavy metals, reducing agents, organics, ether, ammonia, and
acids.
Reacts With:
Acids — A serious chlorine release can result.
Ammonia Compounds — Both toxic and hazardous gases can be formed.
�g'[�B/�a
/Lil ehKe COMPANY
Sodium HypochloriteMSDS�:/
Revision C - 01 July 2011:���,.•'` Page 7 of 14

SECTION 10 — STABILITY AND REACTIVITY (Continued)
Organic Compounds — May react violently with many organic compounds including
greases, oils, fuels, etc. Care must be taken to avoid contact with these types of
compounds unless . you .are certain they are compatible or adequate engineering
controls and personal protective equipment (PPE) are employed.
Other Chlorinating Compounds — Care must be taken when storing or using with other
Chlorinating compounds. In swimming pool applications, never attempt to pre -blend
with concentrated forms of any chemicals including other chlorinating compounds.
Concentrated forms of these compounds may react violently.
Hazardous Decomposition Products: Acid fumes, Hydrogen chloride and Chlorine.
Hazardous Polymerization: Material is not known to polymerize.
SECTION 11 — TOXICOLOGICAL INFORMATION
CAS Number Name Common Names
7681-52-9 Sodium Hypochlorite Bleach
Acute Oral.LD50: (rat) 3-5 mg/kg
Primary Skin Irritation: (rabbit) > 2 mg/kg
The toxicity and corrosivity of Sodium Hypochlorite is a function of concentration.
Industrial grades of higher concentrations than household bleach are more toxic and
corrosive.
SECTION 12 — ECOLOGICAL INFORMATION
Aquatic Ecotox Data
Fish: LC50 (96 hr.)
LC50 (96. hr.)
LC50 (0.5 hr.)
(Bluegill sunfish)
2.90 mg/L
(Fathead minnow)
1.40 mg/L
(Rainbow trout)
0.90 mg/L
Biodegradation: This material -is inorganic and not subject to biodegradation.
Persistence: This material is believed not to persist in the environment.
Bioconcentration: This material is not expected to bioconcentrate in organisms.
NOTE: This material is harmful to fish, invertebrates, amphibians, and plants.
Kue�sKe �
COMI�ANY f
���
Sodium Hypochlorite MSDS��
k,'.—
srnHeinu G_ai
Revision C 01 July 2011 +
Page 8 of 14

SECTION 13 — DISPOSAL CONSIDERATIONS
Waste Disposal Method
Reduce with agents such as bisulfites or ferrous salt solutions. Some heat will be
produced. Keep on alkaline side and dilute with copious amounts of water. Main end
product is salt water. Comply with all applicable governmental regulations.
Product Disposal
Product should be completely removed from containers. Material that cannot be used
or chemically reprocessed should be disposed of in a manner meeting government
regulations.
SECTION 14 —TRANSPORT INFORMATION
DOT Proper Shipping Name:
DOT Hazard Class:
DOT ID Number:
DOT Packing Group:
DOT Hazardous Substance:
DOT Marine Pollutant:
Additional Description:
Hypochlorite Solutions
8
UN1791
I
RQ 100# (Sodium Hypochlorite).
N/A
SECTION 15 — REGULATORY INFORMATION
U.S. Federal Regulations
Section 311 of The Clean Water Act lists this product as a hazardous substance, which
If discharged to water; may require immediate response to mitigate danger to public
health and welfare. Spills of 100 pounds or more must be reported to the National
Response Center at the following number:
1-800-424-8802
Material is contained on a composite list as required under 101 (14) of-CERCLA.
Sodium Hypochlorite Solution is regulated by the USEPA under the Federal Insecticide,
Fungicide and Rodenticide Act (FIFRA) as a pesticide product.
Kue�r><e 40
.11ANY �
Sodium Hypochlorite MSDS �:�K nage� 9 of 14
µ'.o" GR�
Revision C - 01 July 2011 ,y+ P

SECTION 15 — REGULATORY INFORMATION (Continued)
High Strength Sodium Hypochlorite Solution produced by Kuehne Chemical Company,
Inc. is registered with the USEPA under. Registration Numbers 35317-00006 & 35317-
00007.
OSHA: This material is considered hazardous by the, OSHA Hazard Communication
Standard (29 CFR 1910.1200) (US).
TSCA (Toxic Substances Control Act): This product is not subject to export
notification.
Other Regulations/Standards.
NSF Certification: This -product has been classified as an approved drinking water
treatment chemical under ANSI/NSF Standard 60 by Underwriters
Laboratories (reference number: MH17612).
USDA Approvals: B-1, .D-2, L-1, Q-4 & Fruit and Vegetable washing compounds.
SECTION 16 — OTHER INFORMATION
Prepared By: Kuehne Company's Environmental, Safety & Security Department
Revision C — 01 July 2011
For additional non -emergency health, safety or environmental information, telephone:
(973) 589 - 0700 or write to:
Kuehne Chemical Company, Inc:
86 N. Hackensack Avenue
South Kearny, New Jersey 07032-4673
MSDS Legend:
ACGIH
American Conference of Governmental Industrial Hygienists
CAS
Chemical Abstracts Service Registry Number
CEILING
Ceiling Limit (15 Minutes)
OSHA
Occupational Safety and Health Administration
PEL
Permissible Exposure Limit (OSHA)
STEL
Short Term Exposure Limit (15 Minutes)
TLV
Threshold Limit Value (ACGIH)
TWA
Time Weighted Average (8 Hours)
Kuehkfol CCM PANY
� J
Sodium Hypochlorite MSDS
Revision C - 01 July 2011
ti;�� Page 10 of 14

SECTION 16 — OTHER INFORMATION
(Continued)
IMPORTANT: The information contained herein is offered only as a guide to the
handling of this specific material and has been prepared in good faith by technically
knowledgeable personnel. It is not intended to be all-inclusive and the manner and
conditions of use and handling may involve other and additional considerations.
The information presented herein, while not guaranteed, was prepared by competent
technical personnel and is true and accurate to the best of our knowledge.
NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR PURPOSE, OR OF ANY
OTHER KIND, EXPRESS OR IMPLIED, IS MADE REGARDING PERFORMANCE,
STABILITY OR OTHERWISE.
This information is not intended to be all-inclusive as to the manner and conditions of
handling and storage. Other factors may involve other or use additional safety or
performance considerations. While our technical personnel will be happy to respond to
questions regarding safe handling and use procedures, safe handling and use remains
the responsibility of the customer. No suggestions for use are intended as, and nothing
herein shall be construed as a recommendation to infringe any existing patents or
violate any federal, state or local laws, rules, regulations or ordinances.
No warranty of any kind is given or implied and Kuehne Chemical Company, Inc. will not
be liable for any damages, losses, injuries or consequential damages that may result
from the use of or reliance on any information contained herein.
This Material Safety Data Sheet (MSDS) covers the following materials:
Sodium Hypochlorite - Liquid: High Strength.
REFERENCES:
American National Standard, Z400.1-1993
Chlorine Institute Pamphlet 96 (Sodium Hypochlorite Manual), Edition 3, April, 2006.
National Institute for Occupational Safety and Health, US Dept. of Health & Human Services, Cincinnati, June, 1994.
Supplier's Material Safety Data Sheets.
Windholz, Martha, Ed, The Merck Index, 111h ed., Merck and Co, Inc., Rahway, New Jersey, 1989.
f�I1L, KS COMPANY �e�
KUee ��,eeK&I
Page 11 of 14
Sodium Hypochlorite MSDS
Revision C - 01 July 2011
`
''

WARNING LABEL INFORMATION
Active Ingredient: Sodium Hypochlorite (NaOCI)................... 10 - 20 % (by weight)
Inert Ingredients...........................................90 - 80 %
Total 100.0 %
KEEP OUT .OF REACH OF CHILDREN
DANGER
FIRST AID
IF INHALED: Move to fresh air. If person is not breathing, call 911 or an ambulance
thengive, artificial respiration,. preferably month -to -mouth if possible. Call a poison
control center or doctor for further treatment advice.
IF IN EYES: Hold eye open and rinse slowly and gently with water for 15 — 20 minutes.
Remove contact lenses, if present, after the first. 5 minutes, then continue to rinse eye.
Call a poison control center.or doctor for treatment advice.
IF ON SKIN OR CLOTHING: Take off contaminated clothing. Rinse skin immediately
with plenty of water for 15 — 20 minutes. Call a poison control center or doctor for
treatment advice.
IF SWALLOWED: Call a poison control center or doctor for treatment advice. Have
person sip a glass of water if able to swallow. Do not induce vomiting unless told to do
so by a poison control center or doctor. Do not give anything by mouth to an
unconscious person.
NOTE TO PHYSICIAN: Probable mucosal damage may contraindicate the use of
gastric lavage.
HOT LINE NUMBER: 1-800-POISON-1
Have product container or label with you when calling a poison control center or doctor,
or going for treatment.
Kue ae COMPANY Sri
Sodium Hypochlorite MSDS ��- nismn5inyceu�
Revision C - 01 July 2011 , ,9 Page 12 of 14

PRECAUTIONARY STATEMENTS
HAZARDOUS TO HUMANS AND DOMESTIC ANIMALS
DANGER: Corrosive may cause severe skin and eye irritation or chemical burns to
broken skin. Causes eye damage. Wear safety glasses or goggles and rubber gloves
when handling this product. Wash after handling. Avoid breathing vapors. Vacate
poorly ventilated areas as soon as possible. Do not return until strong odors have
dissipated.
Environmental Hazards: This pesticide is toxic to fish and aquatic organisms. Do not
discharge effluent containing this product into lakes, streams, ponds, estuaries, oceans,
or public waters unless this product is specifically identified and addressed in an
NPDES permit. Do not discharge effluent containing this product to sewer systems
without previously_ notifying the sewage treatment plant authority. For guidance, contact.
your State Water Board or Regional Office of the EPA.
Physical and Chemical Hazards: STRONG OXIDIZING AGENT. Mix only with water
according to label directions. Mixing this product with chemicals (e.g. ammonia, acids,
detergents, etc.) or organic matter (e.g. urine, feces, etc.) will release chlorine gas,
which is irritating to eyes, lungs and mucous membranes.
DIRECTION FOR USE
IT IS A VIOLATION OF FEDERAL LAW TO USE THIS PRODUCT IN A MANNER
INCONSISTENT WITH ITS LABELING.
Re -formulators and Re -packagers of this product must obtain their own registrations
from the United States Environmental Protection Agency (USEPA).
For manufacturing use in the formation of end -use products
NOTE: This product degrades with age. Use a Chlorine test kit and increase dosage
as necessary, to obtain the required level of available Chlorine.
For specific use directions, see KUEHNE Circular for each particular application.
CIRCULAR NUMBERS K587A, AK588A: SANITIZATION OF HARD NONPOROUS
SURFACES
CIRCULAR NUMBERS K58713, K58813: COMMERCIAL LAUNDRY SANITIZERS
CIRCULAR NUMBERS K587C, K588C: AGRICULTURAL USES
CIRCULAR- NUMBERS K587D, K588D: DISINFECTION OF DRINKING WATER
(EMERGENCY/PUBLIC/INDIVIDUAL SYSTEMS)
�Cue�NB .061PANY � � l•�
Sodium Hypochlorite MSDS
Revision C - 01 July 2011 Pa4
ge 13 of 1

CIRCULAR NUMBERS K587E, K588E: DISINFECTION OF NONPOROUS NOW
FOOD CONTACT SURFACES
CIRCULAR NUMBERS K587F, K588F: SEWAGE & WASTEWATER EFFLUENT
TREATMENT
CIRCULAR NUMBERS K587G, K588G: COOLING TOWER & EVAPORATIVE
CONDENSER WATER
CIRCULAR NUMBERS K587H, K588H: SANITIZATION OF POROUS FOOD
CONTACT SURFACES
CIRCULAR, NUMBERS K5871, K5881: SANITIZATION OF POROUS NON-FOOD
CONTACT SURFACES
CIRCULAR NUMBERS K587J, K588J: DISINFECTION OF SWIMMING POOLS,
SPAS/HOT TUBS, AND HYDROTHERAPY POOLS_
STORAGE AND DISPOSAL
Store this- productin "a cool -dry area away from direct sunlight and heat to prevent
deterioration. In case of a spill; flood areas with large quantities of -water. Product or
rinsates that cannot be used should be diluted with water before disposal in a sanitary
sewer. Do not contaminate food or feed by storage, disposal or cleaning of equipment.
Large storage containers should be rinsed thoroughly with water and returned to .
manufacturer for reconditioning. Large storage containers should be thoroughly rinsed
with water before reuse.
IN CASE OF
FIRE: Use self-contained breathing apparatus and full protective equipment. 'Use
water spray, foam, dry chemical or CO2. Fire.may liberate toxic gases.
SPILL OR LEAKAGE: Get protective equipment. Contain spill and pump into marked
container for reclamation for disposal. Avoid discharges to sewers and streams. Spills .
of. 100 pounds or .more must -be reported to the National Response Center at the .
followingnumber:
1-800-424-8802
State and .local regulations may have additional- reporting requirements, check with the
proper state and local authorities. Wear neoprene or rubber gloves.
IN CASE OF CHEMICAL EMERGENCIES CALL:
24 HOUR EMERGENCY PHONE [phone]
Alt. [phone]
ALL64/II,,..ee W ee Cd��
14!\
DIAPANY _ y
Sodium Hypochlorite MSDS iii �� �sro� nu cai .
Revision C - 01 July 2011 Page 14 of 14

Attachment 4
Biocide Use Approval

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E.
Governor Director
MEMORANDUM
To: Chris Brownfield
Salem Business Park Remediation Site
AECOM
Staff Engineer with AECOM
From: Susan Meadows
Aquatic Toxicity Unit
Subject: Biocide Use Review
Salem Business Park Remediation Site
NPDES # NC80853
Forsyth County
John Skvarla
Secretary
Salem Business Park Remediation Site has requested approval of the following chemicals,
Redux 260, Hydrogen Peroxide, & Kuene Strong Bleach. These products will be discharged into
their Outfall 001 and in to an unnamed tributary of Salem Creek.
Calculations predict the use of these products, at the stated dosage rates, will not cause toxic
impacts to aquatic life in the receiving stream, unnamed tributary of Salem Creek. Therefore, the
use of these products as an additive to their cooling water system at Salem Business Park
Remediation Site is acceptable.
cc: Tom Belnick, Western NPDES Program
Central Files
Environmental Sciences Section
1621 Mail Service Center, Raleigh, North Carolina 27699-1621
Location: 4401 Reedy Creek Road, Raleigh, North Carolina 27607
Phone: [phone] \ FAX: [phone]
Internet: http://i3ortal.ncdenr.org/web/wa/ess/home
Noi thCarolina
An Equal Opportunity \ Affirmative Action Employer

Attachment 5
Signature Authority Delegation Letters

Alcatel -Lucent GO
600 Mountain Avenue
Room 7F-407A
Murray Hill, NJ 07974
November 25, 2008
Ms. Dina Sprinkle
NCDENR, DWQ, Point Source Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: REQUEST FOR DIVIR SIGNATURE AUTHORITY
Lucent Technologies, Inc.
3370 Lexington Rd, Winston-Salem, NC
NPDES Permit No. NCO080853
Dear Mrs. Sprinkle:
As the Permittee and as a representative of Lucent Technologies, Inc., now known as Alcatel -
Lucent USA Inc. (Alcatel -Lucent). I am requesting that the signature authority for the above
referenced facility continue to be delegated to the ENSR Consulting and Engineering (NC), Inc.,
Project Managers for the Alcatel -Lucent Winston-Salem Facility (currently David H. Simpson,
P.G. and Erin Stewart, P.G.), duly authorized representatives of Alcatel -Lucent. -This
representative will continue to review, determine compliance status, and certify by signature
monthly monitoring reports. I recognize that pursuant to 15A NCAC 2B .0506 (b) (2) (D), that the
process of authorizing another individual or position to sign as a representative in no way
relinquishes any responsibility for the permit or responsibility to remain familiar with the permit
conditions, limits, including any modifications, and for the compliance data reports for the
permit.
If you have any questions regarding this request please contact me at [phone].
Thank you.
Since ely,
Ga M. Fisher
Permittee
Cc: David Simpson / ENSR

Alcatel -lucent
600 Mountain Avenue
Room 2A-359
Murray Hill, NJ 07974
December 23, 2013 .
Wren Thedford
N.C. Department of Environment and Natural Resources
Division of Water Resources,.NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: REQUEST FOR DMR SIGNATURE AUTHORITY
Salem Business Park Remediation Site
Alcatel -Lucent USA Inc.
3370 Lexington Road, Winston-Salem, Forsyth County, North Carolina
Dear Ms. Thedford:
As the Permittee and as a representative of Alcatel -Lucent USA Inc., I am requesting that
the signature authority for the above referenced facility continue to be delegated to the
AECOM North.Carolina Inc-. Project Manager for the Facility (currently Erin Stewart,
.P.G.), duly authorized representatives of.Alcatel-Lucent. This representative will
continue to review, determine compliance status, and certify by signature monthly. .
monitoring reports. I -recognize that pursuant to 15A NCAC 2B .0506 (b) (2) (D), that the
process of authorizing another individual or position to sign as a representative in no way
relinquishes any responsibility for the permit or responsibility to remain familiar with the
permit conditions, limits, including any modifications, and for the compliance data
reports for the permit.
If you have any questions regarding this request please contact me at [phone].
Thank you.
Sincerely,
Gary Fisher
Environmental Engineering Manager
'Permittee
Cc: Erin -Stewart - AECOM

MCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E. John E. SI<varla, III
Governor Director Secretary
May 23, 2013
Alcatel -Lucent USA, Inc. AECOM
Attn: Gary M. Fisher, Owner Attn: Erin Stewart
600-700 Mountain Avenue 8540 Colonnade Ctr Dr/Ste 306
Mail Stop 7F-407A Raleigh, NC 27615
New Providence, NJ 07974-2070
Subject: Compliance Evaluation Inspection
Permittee: Alcatel -Lucent USA Inc.
Facility: Salem Business Park Remediation Site
NPDES Permit #: NCO080853
Forsyth County
Dear Mr. Fisher/Ms. Stewart:
Mr. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality (DWQ or
the, Division) conducted a compliance evaluation inspection (CEI) of the Salem Business Park Remediation
Site on May 21, 2013. The assistance and cooperation of Greg Stephenson, Operator in Responsible
Charge (ORC), was greatly appreciated. An inspection checklist is attached for your records and inspection
findings are summarized below.
General Information
The Salem Business Park Remediation Site is located at building #46 of Salem Business Park at
approximate coordinates of 36.056473, 80.230281. The permit authorizes Alcatel -Lucent USA Inc. to
operate this 0.302 MGD groundwater remediation system, which consists of extraction wells, oil/water
separator, granular media filtration, feed water storage and equalization, parallel filtration and air stripping
treatment trains, activated carbon, and a filter press, and discharge the treated effluent via outfall 001 to
Salem Creek, which is currently classified as Class C waters in the Yadkin Pee Dee River basin.
Site Review
Mr. Stephenson has done an excellent job of operating and maintaining the plant. The entire plant
was clean and appeared to be in excellent working order. Mr. Boone noted no discrepancies.
Documentation Review
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service;1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity l Affirmative Action Employer
One
Nofth Ca.rollna
Xwyllral'lff

Alcatel -Lucent USA, Inc,, Attn: Gary M. Fisher, Owner
Compliance Evaluation Inspection
Salem Business Park Remediation Site, NCO080853
May 23, 2013, Page 2 of 2
All required documentation was reviewed. All of Mr. Stephenson's records were available, in order,
complete and current. No discrepancies were noted.
It is noted that the plant has recently undergone significant modifications in an effort to reduce
operational costs. The new system will consist of only bag filters, air strippers, and carbon filters. An
Authorization to Construct (AtC) permit was not required for these modifications because it is defined by the
Division to be an industrial waste facility. However, please ensure the new plant configuration is updated in
the permit during the next permit renewal cycle.
Thank you and please continue to operate the plant at optimum efficiency and in full compliance
with permit NC0080853. If you have any questions regarding the inspection or this letter, please call Mr.
Boone or me at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
Attachments:
BIMS Inspection Report
CC: Mi - A
Central Files
NPDES Unit

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C: 20460
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I N I . 2 1.51 31 NCO080853 111 121 13/05/21 I .17 18I C I 19I S I 20I I
Remarks
2111_IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII16
Inspection Work Days Facility Self=Monitoring Evaluation Rating 131 QA --------------------------Reserved-------------- --
67 I 169 70 I_I 711 j 72 I N I 73 LJJ 74 751 I I I I I I I $0
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
Salem Business Park remediation site
01:00 PM 13/05/21
09/07/01
Exit Time/Date
Permit Expiration Date
3370 Lexington•Rd
Winston Salem NC 27107
01:30 PM 13/05/21
14/06/30
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Gregory Martin Stephenson/ORC/336-784-2716/
.Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Fred Bleachinger,3370 Lexington Rd Winston Salem NC 27107//336-784-2716/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boone WSRO WQ//336-771-4967/
S`2 3113
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
� o
�'
-4,14aw
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

. v
NPDES yr/mo/day Inspection Type 1 ,
3I NC0080853 I11 12, 13/05/21 117 18I CI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page # 2

Permit: NCO080853 Owner - Facility: Salem Business Park remediation site
Inspection Date: 05/21/2013 Inspection Type: Compliance Evaluation .
Permit Yes No NA NE
(If the present permit expires in 6. months or less). Has the permittee submitted a new application? n n ■ n
Is the facility as described in the permit? ■ n ❑ n
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment: Please refer to the attached inspection summary letter.
Record Keeping
Are records kept and maintained as required by the permit?
Is all required information readily available, complete and current?
Are all records maintained for 3 years (lab. reg. required 5 years)?
Are analytical results consistent with data reported on. DMRs?
Is the chain -of -custody complete?
Dates, times and location of sampling
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters?
Has the facility submitted its annual compliance report to users and DWQ?
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
Is the ORC visitation log available and current?
Is the ORC certified at grade equal to or higher than the facility classification?
Is the backup operator certified.at one grade less or greater than the facility classification?
Is a copy of the current NPDES permit available on site?
Facility has copy of previous year's Annual Report on file for review?
Comment: Please refer to the attached inspection summary letter.
Laboratory
Are field parameters performed by certified personnel or laboratory?
.LIE nn
■nnn
■00.n,
Yes No NA NE
.nnn
■nnn
■nnn
■n.nn
■nnn
■
■
■
■
■
■nnn
nrl■n
n■nn
■nnn
■nnn
■nnn
■nnn
nn■n
Yes No NA NE
nn■n
Page # 3

Permit: NCO080853 Owner - Facility: Salem Business Park remediation site 4
Inspection Date: 05/21/2013 Inspection Type: Compliance Evaluation
Laboratory
Are all other parameters(excluding field parameters) performed by a certified lab?
# Is the facility using a contract lab?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
Comment: Please refer to the attached inspection summary letter.
Effluent Sampling
Is composite sampling flow proportional?
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
Comment: Please refer to the attached inspection summary letter.
Flow Measurement - Effluent
# Is flow meter used for reporting?
Is flow meter calibrated annually?
Yes No NA NE
Yes No NA NE
Yes No NA NE
®nnn
®nnn
Is the flow meter operational?
®
n
n
n -
(If units are separated) Does the chart recorder match the flow meter?
n
n
®
n
Comment: Please refer to the attached inspection summary letter.
Effluent Pipe
Yes
No
NA
NE
Is right of way to the outfall properly maintained?
N
0
n
n
Are the receiving water free of foam other than trace amounts and other debris?
®
n
n
n
If effluent (diffuser pipes are required) are they operating properly?
n
n
®
n
Comment: Please refer to the attached inspection summary letter.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ® n n n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge n n ® n
Judge, and other that are applicable?
Comment: Please refer to the attached inspection summary letter.
Page # 4

ALITe"
NC®EN�
RECEIVED
N.C.Dept. of ENR
MOO 2 2012
Winston-Salem
Regional Office
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
November 15, 2012
Ms. Erin Stewart
AECOM
8540 Colonnade Ctr Dr / Ste 306
Raleigh, NC 27615
Subject: Modification of NPDES Permit NCO080853
Salem Business Park remediation site
Forsyth County
Dear Ms. Stewart:
The Division has reviewed the modification request you submitted on November 2, 2012. The
Division has no objection to your request. This modification is issued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the
U.S. Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
This modified permit includes the following changes from your current permit:
➢ The list of installed components on the Supplement to Permit Cover Page limit has been
updated.
If any parts, measurement frequencies or sampling requirements contained in this modification are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty (30)
days following receipt of this letter. This request must be in the form of a written petition, conforming to
Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative Hearings
(6714 Mail Service Center, Raleigh, North Carolina 27699-6714). Unless such demand is made, this
decision shall be final and binding.
This permit is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the permit. 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 Land
Resources, the Coastal Area Management Act or any other Federal or Local governmental permit that may
be required. If you have any questions concerning this matter, please contact Charles H. Weaver at (919)
807-6391 or via e-mail [[e-mail]].
Sincer ly,
Charles Wakild, P.E.
cc: Central Files
W'Msion--SalemRegional Office / Surface Water Prot ectioii
NPDES Unit -
Gary Fisher / Alcatel -Lucent USA, Inc. [600-700 Mountain Ave / Mail Stop 7F-407A, Murray Hill, NJ 079741
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One
512 North Salisbury Street, Raleigh, North Carolina 27604 1VorihCarolina
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org y�
An Equal Opportunity/Affirmative Action Employer - 501/6 Recycled/101/o Post Consumer Paper ;vaha 974

Permit NCO080853
SUPPLEMENT TO PERMIT COVER SHEET
All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked. As of this
permit issuance, any previously issued permit bearing this number is no longer effective. Therefore, the exclusive
authority to operate and discharge from this facility arises under the permit conditions, requirements, terms, and
provisions included herein.
Alcatel -Lucent USA, Inc. is hereby authorized to:
1.. Continue to operate an existing 0.302 MGD groundwater remediation treatment
system consisting of the following components:
• Extraction wells
• Feed -water equalization
• Bag filtration
• Low profile air stripper
• Granular activated carbon
The facility is located at the Salem Business Park remediation site (3370 Lexington
Road, Winston-Salem) in Forsyth County.
2. Discharge from said treatment works at the location specified on the attached map
into Salem Creek, currently a class C stream in subbasin 03-07-04 of the Yadkin -
Pee Dee River Basin, at the location specified on the attached map.

A=COM AECOM 919.872.6600 tel
8540 Colonnade Center Drive, Suite 306 919.872.7996 fax
Raleigh, North Carolina 27615
RECEIVED
N.C. Deot. of ENR
FED 2 5 !01�
Winston-Sam
Regional Office
February 22, 2011
Ron Boone
Division of Water Quality
585 Waughtown Street
Winston Salem, NC 27107
Subject: Response to Compliance Evaluation Inspection (Conducted January 26, 2011)
NPDES Permit No. NCO080853
Alcatel -Lucent USA, Inc.
3370 Lexington Road, Winston-Salem, NC
Dear Mr. Boone:
On behalf of Alcatel -Lucent USA, Inc., AECOM North Carolina, Inc. has prepared the following
response to address comments from the compliance evaluation inspection (CEI) conducted by Mr.
Ron Boone of the North Carolina Department of Water Quality (NCDWQ),on January 26, 2011 at
the Alcatel -Lucent groundwater treatment facility (ALU facility) located in Winston Salem, North
Carolina.
The ALU facility discharges treated effluent water to an unnamed tributary of Salem Creek adjacent
to the site. During the inspection a "slight sheen" was observed in the tributary of Salem Creek near
the facility's effluent pipe, as noted in the CEI. The source of the sheen could not be immediately
determined but visual observations suggested it may have originated from the large parking lot .
located upstream and the rain/snow that the facility received the day prior. It is unlikely that the
sheen originated from the ALU facility based on the types of contaminants that the facility treats.
Further investigation was conducted at the outfall and throughout the plant to assess a potential
source of the sheen. As noted in the CEI, facility equipment was not identified to be a source and
there was no indication that the sheen was coming from the effluent outfall. Attachment 1 is a photo
of the effluent outfall facing downstream with the sheen visible upstream of the effluent outfall. .
Three samples were collected by the Operator in Responsible Charge (ORC) on January 26, 2011
(FE-151 North) and January 27, 2011 (FE-151 South and Upstream). Sample "FE-151 North" was
collected inside the treatment system building at the flume where the regular monthly effluent
samples are collected. Sample "FE-151 South" was collected outside the treatment system building
from the effluent pipe that discharges into the tributary of Salem Creek. Sample "Upstream" was
collected from the tributary of Salem Creek at a location approximately seven feet upstream of the
facility's effluent discharge pipe. Samples were sent to Prism Laboratories, Inc. to be analyzed for
oil and grease (O&G) and diesel range organics (DRO). Analytical data are summarized in the
table below and laboratory analytical reports are included as Attachment 2.

AECOM
Table 1 — Summary of Analytical Data
Sample
Diesel Range
Oil & Grease'
Oil & Grease
Identification
Organics
(mg/L)
(mg/L)
FE- 151 North
< 1.0
<5.0
<5.0
FE- 151 South
< 1.0
<5.0
<5.0
Upstream
3.5
<5.0
<5.0
Notes:
1 indicates n-hexane extractable material
2 indicates silica gel treated n-hexane extractable material
mg/L = miligrams per liter
These data demonstrate that concentrations of O&G and TPH were below reporting limits for
sample locations FE-151 North and FE-151 South. At the upstream location (upstream of the ALU
effluent outfall), the O&G concentration was below reporting limits; however, the concentration of
DRO at this location was 3.5 mg/L. These results indicate the source of the sheen originated
upstream of the effluent discharge outfall and likely resulted from parking lot runoff.
ALU will continue to monitor the quality of treated water as required by NPDES# NC0080853. If
you have any questions or require any additional information, please contact Erin Stewart at
[phone].
Yours sincerely,
(�",V_Wuk
Erin Stewart, P.G.
Project Manager
Attachments
cc: G. Fisher, Alcatel -Lucent
G. Stephenson, AECOM
J:\Projects\L\Alcatel-Lucent-04364\Winston-Salem\60194417 - 2011 FP
OW4.0 Reference Materials\4.4 Permits\4.4.1 NPDES\012511 DWQ
Inspection\Response to CEI.docx

AECOM
NPDES Effluent Outfall (Facing Downstream)
J:\Projects\L\Alcatel-Lucent-04364\Winston-Salem\60194417 - 2011 FP
O&M\4.0 Reference Materials\4.4 Permits\4.4.1 NPDES\012511 DWQ
Inspection\Response to CEI.docx

Case Narrative
NC Certification No. 402
SC Certification No. 99012
Full -Service Analytical & NC Drinking Water Cert No. 37735 02/03/2011
S M � Environmental Solutions
'�LABORATORIES, INC.
AECOM (ENSR) Project: FE151 North & South
Erin Stewart
8540 Colonnade Center Drive SUITE 306 Lab Submittal Date: 01/27/2011
Raleigh, NC 27615 Prism Work Order: 1010596
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
President/Project Manager
Data Qualifiers Key Reference:
Reviewed By
BRL Below Reporting Limit
MDL Method Detection Limit
RPD Relative. Percent Difference
* Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0643
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] page Of %

- L'+ Full -Service Analytical &
P"P} , Environmental Solutions
��"V LAB00.4TORIES ING
Sample Receipt Summary
02/03/2011
Prism Work Order: 1010596
Client Sample ID
Lab Sample ID
Matrix
Date Sampled
Date Received
FE-151 NORTH
FE-151 SOUTH
1010596-01
1010596-02
Water
Water
01/26/11
01/27/11
01/27/11
01/27/11
Samples received in good condition at 0.8 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone]
Page 2 of 7

Laboratory Report
Lis.
II
Full -Service Analytical &
( Environmental Solutions
02/03/2011
�'�1+130RATORIES IhG
'
AECOM (ENSR) Project: FE151 North & South
Client Sample ID: FE-151 NORTH
Attn: Erin Stewart
Prism Sample ID: 1010596-01
8540 Colonnade Center Drive SUITE 306
Prism Work Order: 1010596
Raleigh, NC 27615 Sample Matrix: Water
Time Collected: 01/26/11 15:40
Time Submitted: 01/27/11 16:45
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor Date/Time ID
Diesel Range Organics by GC/FID
Diesel Range Organics BRL mg/L 1.0 0.039 1 `8015C 1/31/11 20:52 JMV PlAO524
Surrogate Recovery Control Limits
o-Terphenyl 94 % 50-144
General Chemistry Parameters
Oil & Grease (HEM) BRL mg/L 5.0 1.2 1 '1664A 1/31/11 14:50 CDE PlAO543
Oil & Grease (SGT-HEM) BRL mg/L 5.0 0.61 1 '1664A 2/2111 12:30 CDE P1 BO067
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 3'Of %

ism J
4` Full -Service Analytical &
Environmental Solutions
AECOM (ENSR) Project: FE151 North & South
Attn: Erin Stewart
8540 Colonnade Center Drive SUITE 306
Raleigh, NC 27615 Sample Matrix: Water
Laboratory Report
02/03/2011
Client Sample ID: FE-151 SOUTH
Prism Sample ID: 1010596-02
Prism Work Order: 1010596
Time Collected: 01/27/11 13:20
Time Submitted: 01/27/11 16:45
Parameter
Result
Units
Report
MDL
Dilution
Method Analysis Analyst
Batch
Limit
Factor
Date/Time
ID
Diesel Range Organics by GC/FID
Diesel Range Organics
BRL
mg/L
1.0
0.039
1
'8015C 1/31/11 21:28
JMV
PlAO524
Surrogate
Recovery
Control Limits
o-Terphenyl
106 %
50-144
General Chemistry Parameters
Oil & Grease (HEM)
BRL
mg/L
5.0
1.2
1
'1664A 1/31/11 14:50
CDE
P1A0543
Oil & Grease (SGT-HEM)
BRL
mg/L
5.0
0.61
1
'1664A 2/2/11 12:30
CDE
P1 B0067
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 4 of 7

f �.._ ;,
Full -Service Analytical &
t� y; �, I Environmental Solutions
Level II QC Report
2/3/11
AECOM (ENSR) Project: FE151 North & South Prism Work Order: 1010596
Attn: Erin Stewart Time Submitted: 1/27/11 4:45:OOPM
8540 Colonnade Center Drive SUITE 306
Raleigh, NC 27615
Diesel Range Organics by GC/FID - Quality Control
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch P1AO524 - 3510C GC
Blank (P1A0524-BLK1)
Prepared & Analyzed: 01/31/11
Diesel Range Organics
BRL
1.0 mg/L
Surrogate: o-Terphenyl
0.0366
mg/L
0.0400 97
50-144
LCS (P1A0524-BS1)
Prepared & Analyzed: 01/31/11
Diesel Range Organics
1.60
1.0 mg/L
2.00 80
53-135
Surrogate: o-Terphenyl
0.0412
mg1L
0.0400 103
50-144
LCS Dup (P1A0524-BSD1)
Prepared & Analyzed: 01/31/11
Diesel Range Organics
1.77
1.0 mg/L
2.00 88
53-135 10 200
Surrogate: o-Terphenyl
0.0440
mg/L
0.0400 110
50-144
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 5' Of 7

li
td
` 7R I ( Full -Service Analytical &
a_. Environmental Solutions
-°�`�=�„��.� LABORATORIES INC
Level II QC Report
213/11
AECOM (ENSR) Project: FE151 North & South Prism Work Order: 1010596
Attn: Erin Stewart Time Submitted: 1/27/11 4:45:OOPM
8540 Colonnade Center Drive SUITE 306
Raleigh, NC 27615
General Chemistry Parameters - Quality Control
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch P1A0543 - NO PREP
Blank (P1A0543-BLK1)
Prepared & Analyzed: 01/31/11
Oil & Grease (HEM)
BRL 5.0 mg/L
LCS (P1A0543-BS1)
Prepared &Analyzed: 01/31/11
Oil & Grease (HEM)
37.0 5.0 mg/L
40.0 92 78-114
Batch PlBO067 - NO PREP
Blank (P1B0067-BLK1)
Prepared & Analyzed: 02/02/11
Oil & Grease (SGT-HEM)
BRL 5.0 mg/L
LCS (P1130067-BS1)
Prepared &Analyzed: 02/02/11
Oil & Grease (SGT-HEM)
18.4 5.0 mg/L
20.0 92 64-132
Sample Extraction Data
Prep Method: 3510C GC
Lab Number
Batch
Initial
Final
Date
1010596-01
PlAO524
1000
mL
2 mL
01/31/11
1010596-02
PlA0524
1000
mL
2 mL
01/31/11
NO PREP
Lab Number
Batch
Initial
Final
Date
1010596-01
P1 B0067
900
mL
900 mL
02/02/11
1010596-01
PlA0543
900
mL
960 mL
01/31/11
1010596-02
PIB0067
900
mL
900 mL
02/02/11
1010596-02
P1A0543
900
mL
900 mL
01/31/11
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 6 of 7

a . CHAIN OF CUSTODY RECORD
G r�"% ::::. Full -Service Analytical & :: :.::....:;.. :
=` Environmental Solutions
PAGE of Y S . No NIA
ISM
QUOTE q TO ENSURE PROPER BILLINGt �;�SSlT1PleS:INTACT:llpon: arrIV81?
LABORATORIES, ING
449 Springbrcok Road • •543
Project Name: ::.
Short Hold Analysis: (Yes) (No) UST Project (Yes) (No) PROPER RRESERVATIVES.indicated?
P.O. Box 240543 Charlotte, NC 28224.0
Phone: [phone] • Fax: [phone]
.......;;:R:HQLDING T.iMES?,
Client Company Name: *Please ATTACH any project specific reporting (QC LEVEL 111111 IV).-:. ;
p
provisions and/ Requirementsa� .. ---- : -�•—
Report To/Contact Name d ��� /\�9� is VQIATjLESrec'd W10.1J7 H�AbSPACE4 ...
Invoice To: :...:::...... :..::: ,:.
Reporting Address: 11L_� 11 r _ 7l/ AtKVI, tIVreA /yVryf ' Pp0)?ER CONTA
INERS'used4: ;. ;; ....
..' — —
Phone: Fax (Yes) (No);
Purchase Order No./Billing Reference ����� 2
Email (Yes) (No) Email Address
Requested Due Date ❑ 1 Day ❑ 2 Days CI Days ❑ 4 Days ❑ 5 Days
EDD Type: PDF— Exe IOther
WorkMust B
"Working Days" ❑ 6-9 Days ❑ Standard 10 days ❑ Pre -Approved Flush
Site Location Name:
Samples received after 15:00 will be processed next business day.
Site Location Physical Address:
Turnaround time Is based on business days, excluding weekends and holiday
(SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT)
CLIENT
DATE
TIME
COLLECTED
MATRIX
(SOIL,
SAMPLE CONTAINER
PRESERVA-
*TYPE
SAMPLE DESCRIPTION
COLLECTED
MILITARY
HOURS
WATER OR
SLUDGE)
SEE BELOW
NO.
SIZE
TIVES
0�4*
F� N
-z6 I.._..��`y6
war
C G
2
�►r�c
��
X
_..._
16-40
Ab
�
I —A G
JL '
NO
-v
--
%�� TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL
Certification: NELAC USACE FL NC�
e
SC OTHER N/A.
s. Water Chlorinated: YES_ NO
Sample Iced Upon Collection: YES NO_
ANALYSES REQUESTED
PRISM
REMARKS LAB
ID NO.
0 *1 L(IAU-) lz+(Amb� (I
axli,C�au_� , �xil,(ATb� D2.
Sampler's Signatu a Sampled By (Print Name) EA*.4 ffi*A 1ation
Upon relinquishing, t hain of Cu dy is your authorization for Prism to proceed with the analyses as requested above. Any changes must be
suhmrtted in writina to the Prism Pr Iect Manager. There will be charges for any changes after analyses have been Initialized.
Additional Comments:
11 /6 "yS
���AMPLE$rARE ACC D AND VERIFIED AGAINST C UNTIL RECEIVED AT THE LABORATORY. C L
❑ Fed Ex ❑ UPS ❑ Hand -de liv Prism Field Service ❑ Other
NPDES: UST: I GR U DWATER: DRINKING WATER: SOLID WASTE: RCRA: CERCLA LANDFILL OTHER:
❑ NC ❑ SC ❑ NO
❑ SC ❑ NO ❑ SC ❑ NO ❑ SC ❑ NO ❑ SC ❑ NO ❑ SC ❑ NC ❑ SC ❑ NC ❑ SC' ❑ NO ❑ SC
❑� ❑ 1 ❑ ._..._.__.._..-- ❑ ❑ —_.. ❑ _- ... ❑ ❑ I ❑ --
*CONTAINER TYPE CODES: A = Amber C = Clear G = Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space)

ff , NC Certification No.402 Case Narrative
SC Certification No. 99012
Full -Service Analytical &
MNC Drinking Water Cert No. 37735 02/03/2011
Environmental Solutions
LABORATORIES, INC.
AECOM (ENSR) Project: Upstream Sample
Erin Stewart
8540 Colonnade Center Drive SUITE 306 Lab Submittal Date: 01/27/2011
Raleigh, NC 27615 Prism Work Order: 1010597
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
President/Project Manager
Data Qualifiers Key Reference:
Reviewed By
DL Sample concentration too low for RPD evaluation.
BRL Below Reporting Limit
MDL Method Detection Limit
RPD Relative Percent Difference
* Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 1 of 6

c�
.+ ".; Full -Service Analytical &
� I I Environmenta( Solutions
'�~'�.%L0.BOWiTOflIB'y lu0.
Sample Receipt Summary
02/03/2011
Prism Work Order: 1010597
Client Sample ID Lab Sample ID Matrix Date Sampled Date Received
UPSTREAM 1010597-01 Water 01/27/11 01/27/11
Samples received in good condition at 0.8 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1.8001529-6364 - Fax: [phone] Page 2 of 6

�.Y J
I Full -Service Analytical &
I
Environmental Solutions
�LAIWgATORiCS IN0.
AECOM (ENSR) Project: Upstream Sample
Attn: Erin Stewart
8540 Colonnade Center Drive SUITE 306
Raleigh, NC 27615 Sample Matrix: Water
Laboratory Report
02/03/2011
Client Sample ID: UPSTREAM
Prism Sample ID: 1010597-01
Prism Work Order: 1010597
Time Collected: 01/27/11 14:40
Time Submitted: 01/27/11 16:45
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor Date/Time ID
Diesel Range Organics by GC/FID
Diesel Range Organics 3.5 mg/L 1.0 0.039 1 '8015C 1/31/11 22:03 JMV P1A0524
Surrogate
Recovery Control Limits
General Chemistry Parameters
Oil & Grease (HEM) BRL mg/L 5.0 1.2 1 '1664A 1/31/11 14:50 CDE PlA0543
Oil & Grease (SGT-HEM) BRL mg/L 5.0 0.61 1 '1664A 2/2/11 12:30 CDE PlBO067
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224.0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 3 O �'.

� Full -Service Analytical &
It , - I S M ( Environmental Solutions
."'�_:Ai LAAORAiORiCS, INC.
Level II QC Report
2/3/11
AECOM (ENSR) Project: Upstream Sample Prism Work Order: 1010597
Attn: Erin Stewart Time Submitted: 1/27/11 4:45:00PM
8540 Colonnade Center Drive SUITE 306
Raleigh, NC 27615
Diesel Range Organics by GC/FID - Quality Control
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch P1AO524 - 3510C GC
Blank (P1A0524-BLK1)
Prepared & Analyzed: 01/31/11
Diesel Range Organics
BRL
1.0 mg/L
Surrogate: o-Terphenyl
0.0386
mg/L
0.0400 97
50-144
LCS (P1A0524-BS1)
Prepared & Analyzed: 01/31/11
Diesel Range Organics
1.60
1.0 mg/L
2.00 80
53-135
Surrogate: o-Terphenyl
0.0412
mg/L
0.0400 103
50-144
LCS Dup (P1A0524-BSD1)
Prepared & Analyzed: 01/31/11
Diesel Range Organics
1.77
1.0 mg/L
2.00 85
53-135 10 200
Surrogate: o-Terphenyl
0.0440
mg/L
0.0400 110
50-144
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001629-6364 - Fax: [phone] Page 4 of 6

Full -Service Analytical 8
Environmental Solutions
LABOftATOR1ES,INC. '
AECOM (ENSR) Project: Upstream Sample
Attn: Erin Stewart
8540 Colonnade Center Drive SUITE 306
Raleigh, NC 27615
General Chemistry Parameters - Quality Control
Analyte
Batch P1AO543 - NO PREP
Reporting
Result Limit Units
Level II QC Report
2/3/11
Prism Work Order: 1010597
Time Submitted: 1/27/11 4:45:00PM
Spike Source %REC RPD
Level Result %REC Limits RPD Limit Notes
Blank (P1A0543-BLK1) Prepared & Analyzed: 01/31/11
Oil & Grease (HEM) BRL 5.0 mg/L
LCS (P1A0543-BSI) Prepared & Analyzed: 01/31/11
Oil & Grease (HEM) 37.0 5.0 mg/L 40.0 92 78-114
Duplicate (P1A0543-DUP1) Source: 1010597-01 Prepared & Analyzed: 01/31/11
Oil & Grease (HEM) 1.33 5.0 mg/L 1.78 29 16 DL
Batch P1BO067 - NO PREP
Blank (P1B0067-BLK1) Prepared & Analyzed: 02/02/11
Oil & Grease (SGT-HEM) BRL 5.0 mg/L
LCS (P1B0067-BSI) Prepared &Analyzed: 02/02/11
Oil & Grease (SGT-HEM) 18.4 5.0 mg/L 20.0 92 64-132
Duplicate (P1130067-DUP1) Source: 1010597-01 Prepared & Analyzed: 02/02/11
Oil & Grease (SGT-HEM) BRL • 5.0 mg/L 1.33 34
Sample Extraction Data
Prep Method: 3510C GC
Lab Number Batch Initial Final Date
1010597-01 PlAO524 1000 mL 2 mL 01/31/11
NO PREP
Lab Number Batch Initial Final Date
1010597-01 PlB0067 900 mL 900 mL 02/02/11
1010597-01 PlA0543 900 mL 900 mL 01/31/11
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] ',':. P6�6,'5-0

ISM
LABORATORIEF6 INC,
Full -Service Analytical &
Environmental Solutions
i 449 Springbrook Road • P.O. Box 240543 - Charlotte, NO 28224-0543
I. Phone:[phone] e Fax: [phone]
Client Company Name:
Report To/Contact Name: S
Reporting Address: 13F26 QCD ZZXM oJ
CHAIN OF CUSTODY RECORD
PAGE —L OF I QUOTE # TO ENSURE P'OPEER��,pBILLING:
Project Name: — /�' tZLaAXr of
Short Hold Analysis: (Yes) UST Project: (Yes) (No)
*Please ATTACH any project specific reporting (QC LEVEL 1 II 111 ry}
provisions and/or n0G.Requirenne
Invoice
Address: CAI al
Phone: i s) (No) mil Add Fax (Yes) (No}: Purchase Order NaJBilling Reference 4 �% - 6
Email (Yes) (No} Email Address Requested Due Date ❑ 1 Day ❑ 2 Days ❑ 3 Days ❑ 4 Days ❑ 5 Days
EDD Type: PDF_ Excel_Other "Working Days" ❑ 6-9 Days ❑ Standard 10 days ❑ Rush Work Must Be
Site Location Name: �1y� r lI tL� O Pre -Approved.
I`7 i T� Samples received after 15:00 will be processed next business day.
Site Location Physical Address: Turnaround time is based on business days, excluding weekends and holidays.
(SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT)
TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL
Certification: NELAC USACE FL NC X
SC OTHER N/A
—
Water Chlorinated: YES_ NOY—
Sample Iced Upon Collection: YES NO
P P
CLIENT
SAMPLE DESCRIPTION
DATE
COLLECTED
TIME
COLLECTED
MILITARY
HOURS
MATRIX
(SOIL,
WATER OR
SLUDGE)
SAMPLE CONTAINER
PRESERVA-
TIVES
ANALYSES REQUESTED
(� REMARKS
PRISM
LAB
ID NO.
`TYPE
SEE BELOW
NO.
SIZE
axI HLI-) ay, 0Ar-b)
Sampler's Signatu
Sampled By (Print Name)6%V 10 •
Affiliation
PRESS ,.COPIES
PRISM USE ONLY'
"''•=`::M==`""tt?u�%�•;::i:.:,:c:.
Upon nquis g, s aln of Cus dy is your authorization for Prism to proceed with the analyses as requested above. Any changes must be
sub tiled in ri ng to t is o' ct Manager. There will be charges for any changes after analyses have been initialized.
Relln ulshedBy ( )
Rellnqulshed B (Signature)
Recel i al
( gnat e)
D to
at
Military/Hours
Additlonal Comments:
� �
j Slte;tiepartiire Tune; `" % `'%
Rellnquis tur j
Received For rls`L ratori By:
13 to
-
OULD BE APED SHUT W IT CUSTODY SEALS FOA TRANSPORTATION TO THE LABORATORY. 14
•�LTED
SA PLEND VERIFIED AGAINST CDC UNTIL RECEIVED AT THE LABORATORY.
❑ Fed Ex ❑UPS ❑ Hand•delService ❑ Other
C oup No.
7q
NPDES:1 UST: 1 GRrUlWATER: DRINKING WATER: SOLID WASTE: RCRA: j CERCLA LANDFILL OTHER: ,
❑ NC ❑ SCj ❑ NC El SC ❑ C a SC (❑ NC ❑ SC ❑ NC ❑ SC ❑ NC ❑ SCI [INC ❑ SC ❑ NC ❑ SC ❑ NC ❑ SC
❑ ❑—_...... ❑ .—_ ❑ . . ._ . 1 ❑ ❑ ❑ ❑ ..-- ... ❑
*CONTAINER TYPE CODES: A = Amber C = Clear G = Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space)

NCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
January 31St, 2011
Alcatel -Lucent USA Inc.
Attn: Fred Bleachinger
3370 Lexington Road
Winston-Salem, NC 27107
Subject: Compliance Evaluation Inspection
Permittee: Alcatel -Lucent USA Inc.
Facility: Salem Business Park Remediation Site
NPDES Permit #: NCO080853
Forsyth County
Dear Mr. Bleachinger:
Resources
Dee Freeman
Secretary
Mr. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water
Quality (DWQ or the Division) conducted a compliance evaluation inspection (CEI) of the
Salem Business Park Remediation Site on January 26th, 2011. The assistance- and
cooperation of Mr. Greg Stephenson, Operator in Responsible Charge (ORC), was greatly
appreciated. An inspection checklist is attached for your records and inspection findings are
summarized below.
General Information
The Salem Business Park Remediation Site is located at building #46, of Salem
Business Park at approximate coordinates of 36.056473, 80.230281. The permit authorizes
Alcatel -Lucent USA Inc. to operate this 0.302 MGD groundwater remediation system, which
consists of extraction wells, oil/water separator, granular media filtration, feed water storage
and equalization, parallel filtration and air stripping treatment trains, activated carbon, and a
filter press, and discharge the treated effluent to Salem Creek via outfall 001, which is currently
classified as Class C waters in the Yadkin Pee Dee River basin.
Site Review
Mr. Stephenson has done an excellent job of operating and maintaining the plant. The
entire plant was very clean and appeared to be in excellent working order. The only issue
noted was sheen on the water at the outfall. It could not be determined where the sheen was
coming from but there is a very large parking lot just upstream of the outfall that it may have
been coming from. Mr. Stephenson examined that entire plant in detail after the inspection
and found nothing that may have caused the sheen at the outfall. Mr. Boone requested that he
take a sample from the flow measurement flume and have it analyzed for oil and grease (0&G)
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: www,ncwaterquality.org
Nne
orthCarolina
Naturally
An Equal Opportunity 1 Affirmative Action Employer

Alcatel -Lucent USA Inc.
Attn: Fred Bleachinger
Compliance Evaluation Inspection
NC0080853, Salem Business Park Remediation Site
Page 2 of 2, January 31s`, 2011
and total petroleum hydrocarbons (TPH). Results of those tests are forthcoming.
Furthermore, results of all previous analyses do not indicate any contamination.
Documentation Review
All required documentation was reviewed. All of Mr. Stephenson's records were
available, in order, complete and current. No discrepancies were noted.
Please let Mr. Boone know the results of the O&G and TPH analyses as soon as you
have received them, as well as any other developments regarding the sheen at the outfall. If
you have any questions regarding the inspection or this letter, please call Mr. Boone or me at
[phone]. Thank you for your cooperation in this matter.
Sincerely,
W. Corey Basinger
Interim Regional Supervisor
Surface Water Protection Section
Attachments:
BIMS Inspection Report
CC: R© SW=P-
Central Files
NPDES Unit
1.

r United States Environmental Protection Agency
Form Approved.
Ep nH Washington, D.C. 20460
f—
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 INI 2 I5I 31 N00080853 Ill 121 11/01/26 117 18ICI 19ISI 20I II
Remarks
2,111111111111111111111111111111111111111111111_111
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------Reserved-----
67 I 169 701 I 711 I 721 NJ 73 I I 174 711 I I I I I I 180
W
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
03:00 PM 11/01/26
09/07/01
Salem Business Park remediation site
Exit Time/Date
Permit Expiration Date
3370 Lexington Rd
Winston Salem NC 27107
04:00 PM 11/01/26
14/06/30
Name(s) of Onsite Representative(s)fTitles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Fred Bleachinger,3370 Lexington Rd Winston Salem NC Contacted
27107//336-784-2716/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boone WSRO WQ%/704-663-1699 Ext.2202/
I �
/a-
SignatLreAof ManagemQ A Reviewer Agency/Office/Phone and Fax Numbers Date
Af C. bC-k -L vRX
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

b
NPDES yr/mo/day Inspection Type
3I NCO080853 I11 12I 11/01/26 1
17 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Please refer to the attached inspection summary letter.
Page # 2

Permit: NCO080853 Owner - Facility: Salem Business Park remediation
site
Inspection Date: 01/26/2011 Inspection Type: Compliance Evaluation
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
n
n
■
❑
Is the facility as described in the permit?
■
n
n
n
# Are there any special conditions for the permit?
n
■
n
n
Is access to the plant site restricted to the general public?
■
n
n
n
Is the inspector granted access to all areas for inspection?
■
n
n
❑
Comment: Please refer to attached inspection summary letter.
Laboratory
Yes
No
NA
NE
Are field parameters performed by certified personnel or laboratory?
n
n
■
o
Are all other parameters(excluding field parameters) performed by a certified lab?
■
❑
n
n
# Is the facility using a contract lab?
■
n
n
n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n
n
n
■
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
n
n
■
n
Incubator (BOO) set to 20.0 degrees Celsius +/-1.0 degrees?
n
n
■
n
Comment: Please refer to attached inspection summary letter.
Influent Sampling
Yes
No
NA
NE
# Is composite sampling flow proportional?
n
n
n
n
Is sample collected above side streams?
n
n
n
n
Is proper volume collected?
In
n
n
n
Is the tubing clean?
n
n
n
n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n
n
n
n
Is sampling performed according to the permit?
n
n
n
Comment:
Effluent Sampling
Yes
No
NA NE
Is composite sampling flow proportional?
❑
❑
■
❑
Is sample collected below all treatment units?
■
n
n
n
Is proper volume collected? IN n n n
Is the tubing clean? n n ■ n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)? n n n ■
Is the facility sampling performed as required by the permit (frequency, sampling type representative)? IN ❑ ❑ n
Comment: Please refer to attached inspection summary letter.
Page # 3

Permit: NCO080853
Inspection Date: 01/26/2011
Owner - Facility: Salem Business Park remediation site
Inspection Type: Compliance Evaluation
Record (Seeping _
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
n
❑
n
Is all required information readily available, complete and current?
■
n
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
■
n
n
n
Are analytical results consistent with data reported on DMRs?
■
n
n
n
Is the chain -of -custody complete?
■
n
n
n
Dates, times and location of sampling
■
Name of individual performing the sampling
■
Results of analysis and calibration
■
Dates of analysis
■
Name of person performing analyses
■
Transported COCs
■
Are DMRs complete: do they include all permit parameters?
■
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
n
n
■
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
■
n
n
Is the ORC visitation log available and current?
®
n
n
n
Is the ORC certified at grade equal to or higher than the facility classification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
■
n
n
n
Is a copy of the current NPDES permit available on site?
■
n
n
n
Facility has copy of previous year's Annual Report on file for review?
n
n
■
n
Comment: Please refer to attached inspection summary letter.
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
n
n
n
Is flow meter calibrated annually?
■
n
n
n
Is the flow meter operational?
■
n
n
n
(If units are separated) Does the chart recorder match the flow meter?
■
n
n
n
Comment: Flow meter last calibrated in Jan 2010. Mr. Stevenson stated the contractor
would be coming out to the plant next week for a recalibration. Please refer to the
attached inspection summary letter.
Effluent Pipe
Yes
No
NA NE
Is right of way to the outfall properly maintained?
■
n
n
n
Page # 4

Permit: NCO080853
Inspection Date: 01/26/2011
Effluent Pipe
Owner - Facility: Salem Business Park remediation site
Inspection Type: Compliance Evaluation
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are required) are they operating properly?
Comment: There was a slight sheen in the creek at the outfall pipe but it is believed
that it originated from the large parking lot upstream. We are currently in the process of
investigating the matter. There was no Indication of the sheen coming from their outfall
pipe or any plant equipment inside the plant. Mr. Stevenson did take samples and have
them tested for O&G and TPH. He also stated that they are currently not treating water
contaminated with petro hydrocarbons which would create a sheen on the water
surface, indicating the sheen is either coming from malfunctioning plant equipment
(which none was identified during or after the Inspection) or from the parking lot
upstream of the outfall. It had been raining/snowing all day prior to the.lnspection.
Please refer to the attached inspection summary letter.
Operations & Maintenance
Is the plant generally clean with acceptable housekeeping?
V-- K1- AIA K1C
■ ❑ ❑ ❑
nn■n
Yes No NA NE
■ n n n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ■ ❑ El n
Judge, and other that are applicable?
Comment: Please refer to the attached inspection summary letter.
Page # 5

Ale—
A�catel•Lucent
November 30, 2009
Mr. Charles Weaver
NCDENR, DWQ, Point Source Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: REQUEST FOR DMR SIGNATURE AUTHORITY
Alcatel -Lucent USA Inc.
3370 Lexington Rd, Winston-Salem, NC
NPDES Permit NoNC008:0�5
Dear Mr. Weaver:
600 Mountain Avenue
Room 1F-102G
Murray Hill, NJ 07974
- .rNR
DEC 10 2009
'vY-ns,,on-6aiam
Regional office
As the Permittee and as a representative of Alcatel -Lucent USA Inc. I am requesting that
the signature authority for the above referenced facility be delegated to the AECOM
North Carolina, Inc. Project Managers for the Alcatel -Lucent Winston-Salem Facility
(currently David H. Simpson, P.G. and Erin Stewart, P.G.) as duly authorized
representatives of Alcatel -Lucent USA. This change in delegation of authority
represents a name change only, from ENSR Consulting and Engineering (NC), Inc. to
AECOM North Carolina, Inc.
These representatives will continue to review, determine compliance status, and certify
by signature monthly monitoring reports. I recognize that pursuant to 15A NCAC 2B
.0506 (b) (2) (D), that the process of authorizing another individual or position to sign as
a representative in no way relinquishes any responsibility for the permit or responsibility
to remain familiar with the permit conditions, limits, including any modifications, and for
the compliance data reports for the permit.
If you have any questions regarding this request please contact me at [phone].
Thank you.
Sincerely,
ry M. Fisher
Permittee
Cc: Erin Stewart / AECOM
RECEIVED
oec - 3 2009
DENR ,.\IATER OUALITY
POINT SOURCE BRANCH

ATM�
WC-6ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
April 22, 2009
Mr. David H. Simpson
ENSR Consulting and Engineering
7041 Old Wake Forest Rd
Raleigh, N.C. 27616-3013
Subject: Draft NPDES Permit NC0080853
Salem Business Park Remediation site.
Forsyth County
Dear Mr. Simpson:
The Division has reviewed your request to renew the subject permit. Please review this draft carefully
to ensure your thorough understanding of the information, conditions, and requirements it contains.
The draft permit includes no significant changes from the existing permit.
With this notification, the Division will solicit public comment on this. draft permit by publishing a
notice in newspapers having circulation in the general Forsyth County area, per EPA requirements.
Please provide your comments, if any, to me no later than 30 days after receiving this draft
permit.
Following the 30-day public comment period, the Division will review all pertinent comments and take
appropriate action prior to issuing a final permit. If you have questions concerning the draft, please
contact me at the telephone number or e-mail address listed at the bottom of this page.
Sincerely,
Charles H. Weaver, Jr.
NPDES Unit .
cc: Central Files
NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org
[e-mail]
No thCarohna
Natzmally
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

4%
t3
NCDE R
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
April 21, 2009
Fred Bleachinger
Lucent Technologies Inc
3370 Lexington Rd
Winston Salem NC 27107
SUBJECT: Compliance Evaluation Inspection
Lucent Technologies Inc
Salem Business Park remediation site
Permit No: NCO080853
Forsyth County
Dear Mr Bleachinger:
Enclosed please find a copy of the Compliance Evaluation Inspection form from the inspection conducted on April 21, 2009. The
Compliance Evaluation Inspection was conducted by Rose Pruitt of the Winston-Salem Regional Office. Greg Stephenson, ORC was
present for the inspection. The facility was found to be in Compliance with permit NC0080853. The inspection consisted of two
parts: an on -site inspection of the treatment facility and a file review. The following are the findings from the subject inspection:
Permit
The current permit became effective July 1, 2004 and expires on June 30, 2009. A renewal application has been received by the
Division.
The remediation site has a permitted flow of .302 MGD.
i
Operations and Maintenance
Maintenance is performed as needed. There is a routine maintenance program in place.
Record Keeping
A review of laboratory reports and Discharge Monitoring Reports (DMRs) revealed no discrepancy between the generated data and
the data submitted to DWQ.
A copy of the laboratory data and historical flow charts are kept on file. The lab used by this facility is Pace Analytical.
Maintenance records are available for review.
Self -Monitoring Program
There were no NPDES limits violations from January 2008 thru December 2008.
Facility Site Review
Facilities are well maintained.
The effluent was clear with no visible solids.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NorthCarohna
Natllt" ilb,

U
I
Flow Measurement
An inline Stevens flow meter model 61M, is used and calibrated annually. Calibration records were available for review. The meter
was last calibrated 1/29/09 by BW Allen.
The Division of Water Quality greatly appreciates your continued oversight at this facility. The Division also encourages you to
continue to be proactive in your efforts to maintain compliance.
Please refer to the enclosed inspection report for additional observations and comments. If you or your staff have any questions,
please. call Rose Pruitt at 336-771-5000.
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality .
Attachments
cc: Greg Stephenson, 1870 Angell Rd, Mocksville NC 27028
Central Files
WSRO

*1 -
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 31 N00080853 111 121 . 09/04/21 1.17 181 CI 191 SI 20III
Remarks
21I111IIIIIIII1111111111111111111111111111 IIIII_1J6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QP---
671 'I 69 701 I 711 I 72I N I 73I I 174 751 I I I I I I 180
W
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
11:30 AM 09/04/21
05/05/01
Salem Business Park remediation site
Exit Time/Date
Permit Expiration Date
3370 Lexington Rd
Winston Salem NC 27107
11:45 AM 09/04/21
09/06/30
Name(s) of Onsite Representative(s)/Titles(spPhone and Fax Number(s)
Other Facility Data
Gregory Martin Stephenson/ORC/336-784-2716/
Name, Address of Responsible Official/Title/Phone and Fax.Number
Fred Bleachinger,3370 Lexington Rd Winston Salem NC Contacted
27107//336-784-2716/ No
Section C: Areas Evaluated During Inspection (Check only -those areas evaluated)
Permit Flow Measurement ® Operations & Maintenance ® Records/Reports
Self -Monitoring Program Facility Site Review Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Rose Pruitt WSRO WQ//336-771-5000/
Signature of M ement Q A sewer Agency/Office/Phone and Fax Numbers Date
L
tea` 'GS
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

4
NPDES yr/mo/day Inspection Type
3I NC0080853 I11 12I 09/04/21 1
17 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The inspector was met at the facility by the ORC Greg Stephenson. All records were available and the
facility appeared well maintained at the time of the inspection. The receiving stream appeared clear at the
time of the inspection.
Page # 2

Y
b
Permit: NCO080853 Owner - Facility: Salem Business Paris remediation site
Inspection Date: 04/21/2009 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ n ❑ Cl
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge n 0 ■ ❑
Judge, and other that are applicable?
Comment:
V— Nn NG NF
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
■
n
n
n
Is the facility as described in the permit?
■
.n
n
n
# Are there any special conditions for the permit?
❑
n
■
n
Is access to the plant site restricted to the general public?
■
n
n
n
Is the inspector granted access to all areas for inspection?
■
❑
n
❑
Comment:
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
■
n
n
n
Is all required information readily available, complete and current?
■
n
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?'
n
n
n
■
Are analytical results consistent with data reported on DMRs?
®
n
n
n
Is the chain -of -custody complete?
■
Dates, times and location of sampling
Name of individual performing the sampling
S
Results of analysis and calibration
■
Dates of analysis
Name of person performing analyses
■
Transported COCs
,Are DMRs complete: do they include all permit parameters?
®
n
n
n
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
■
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
n
■
n
Is the ORC visitation log available and current?
®n
In
n
Is the ORC certified at grade equal to or higher than the facility classification?
■
n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
n
n
n
■
Is a copy of the current NPDES permit available on site?
■
n
n
n
Page # 3

Permit: NCO080853 Owner - Facility: Salem Business Park remediation site
Inspection Date: 04/21/2009 Inspection Type: Compliance Evaluation
Record Keeping
Yes
No
NA
NE
Facility has copy of previous year's Annual Report on file for review?
El
El
■
0
Comment:
Effluent Pipe
Yes
.No
NA
NE
'Is right of way to the outfall properly maintained?
■
n
00.
Are the receiving water free of foam other than trace amounts and other debris?
■
•n
n
n
If effluent (diffuser pipes are required) are they operating properly?
n
n
■
n
Comment:
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
■
n
n
n
Is flow meter calibrated annually?
■
n
n
n
Is the flow meter operational?
■
n
n
F1
(If units are separated) Does the chart recorder match the flow meter?
n
n
n
■
Comment:
Effluent Sampling
Yes
No
NA
NE
Is composite sampling flow proportional?
❑
n
❑
■
Is sample collected below all treatment units?
■
n
n
n
Is proper volume collected?
❑
❑
n
■
Is the tubing clean?
n
n
n
■
# Is proper temperature set for sample storage (kept at less Phan or equal to 6.0 degrees Celsius)?
❑
❑
fl
■
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
■
n
n
n
Comment:
Page # 4

Faxed To: Greq Stephenson
Fax #: [phone] Phone [phone]
Ilf-zof-o91:40
WWTP Annual Inspection Checklist
This information should be available to the inspector at inspection time.
Facility: Lucent NPDES: NCO080853
Permit Effective Dates: 5/01/2005 to 6/30/2009
Inspection Date: April Z- I 2009 Inspection Time: // • 3() am
1 DMRs (Dates: January 2008 to December 2008 )
,L) Lab Data (per DMR dates)
4-3) Laboratories used for analysis & certification #'s PAGE
✓4) Chain of Custody forms (per DMR dates)
'j Complete copy of current NPDES permit
C or Moratorium issuance (if applicable)
- 7y ORC and Back-up ORC current certification C­Q;e� g
or calendar year - if applicable)
°--9) Daily Operator's log / ORC visitation log
✓i 0) Maintenance log
(which includes field parameters tested and equipment
calibrations)
12}cation (if applicable)
f3) Flow meter calibration records (if applicable l- 2-9 UT
ent samplers (-5-
-45)- Flow charts (if applicable)
16) ction d checks
uc. M
, P) Spill Response Plan (with current emergency contact numbers)
1 ecor Usif applicable) `/d,"
plant visual inspection of treatment units
.f0) Stream accessible for inspection (at effluent discharge pipe)
Please call with questions:
Rose Pruitt
NC Department of Environment & Natural Resources
Division of Water Quality
Winston-Salem Regional Office
[phone]
Fax: [phone]
r/A
�C,
/Yj 2�
2

WATF9Q Michael F. Easley, Governor
William G. Ross Jr., Secretary
rNorth Carolina Department of Environment and Natural Resources
O 'N� Coleen H. Sullins, Director
Division of Water Quality
December 30, 2008
RECEIVED
N.C, Deot. of ENR
DAVID H SIMPSON PG
SENIOR PROGRAM MANAGER DEC 3 1 20��
ENSR CONSULTING AND ENGINEERING (NC) INC Winston-Salem
7041 OLD WAKE FOREST ROAD Regional Office
RALEIGH NC 27616-3013
Subject: Receipt of permit renewal application
NPDES Permit NCO080853
Salem Business Park Remediation Site
Forsyth County
Dear Mr. Simpson:
The NPDES Unit received your permit renewal application on December 30, 2008. A
member of the NPDES Unit will review your application. They will contact you if additional
information is required to complete your permit renewal. You should expect to receive a draft
permit approximately 30-45 days before your existing permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact
Charles Weaver at [phone].
Sincerely,
Dina Sprinkle
NPDES Unit
cc: CENTRAL FILES
Winston=Salem.Regionai-.Q.ffice/Surface Water Protection
NPDES Unit
Mailing Address Phone [phone] Location NorthCarolina
1617 Mail Service Center Fax [phone] N. Salisbury St. �VQtIlili!lZ,�
Raleigh, NC 27699-1617 Raleigh, NC 27604
Internet: www.ncwaterguality.org Customer Service 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

ENSR Consulting and.Engineeri,ng (NC) Inc.
7041 Old Wake Forest Road, Raleigh, North Carolina, 27616-3013
T 919.872.6600 F 919.872.7996 www.ensr.aecom.com
December 23, 2008
Mrs. Dina Sprinkle
NCDENR, DWQ, Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Request for Renewal of NPDES Permit NCO080853
Alcatel -Lucent USA Inc.
3370 Lexington Road, Winston-Salem, NC
Dear Mrs. Sprinkle:
ENSR .
RECEIVED
N.C. pept of ENR
DEC 3 1 2008
Winston-Salem
RERegional
C
office
DEC 3 0 2008
DENR - WATER QUALITY
POINT SOURCE BRANCH
On behalf of Alcatel -Lucent USA Inc. (Lucent), ENSR Consulting and Engineering (NC) Inc. (ENSR) is
requesting renewal of .NPDES Permit NCO080853 for the groundwater treatment system located at the
former Lucent facility, now known as the Salem Business Park, in Winston-Salem, Forsyth County, North
Carolina. No changes or additions have been made to the treatment system as covered by the current
_permit.
The treatment system consists of extraction wells, oil/water separator, granular media filtration, feed -water
storage and equalization, parallel filtration and air stripping treatment trains receiving segregated flow
(System.. receives flow from TPH wells and perimeter extraction wells while System B receives flow from
interior VOC extraction wells) activated carbon, and solids removal (via filter press).
This facility is a groundwater remediation system and does not have a Sludge Management Plan, however, a
small volume of solids are generated and managed as hazardous waste. Approximately every four months
sludge is pumped from the settling tank (ST-157) through the filter press (FP-160). After drying in the filter
press the filter cake is placed in a labeled, covered 55 gallon drum. The quantity generated per filter press
run is generally.less than a full drum. Once a full drum has been accumulated the drum is sealed and moved
from the Satellite Accumulation Area to the Temporary Storage Area. Within 90 days of being moved to the
Temporary Storage Area the drummed filter cake is picked up, transported and disposed of by Veolia
Industrial Services Inc. Annual generation offilter press solids is approximately five drums or 2,250 lbs.
Attached is an updated letter from Lucent dated November 25, 2008, delegating signature authority for
NPDES correspondence to the ENSR Project Manager. Also attached are the required application and
documentation necessary for renewal of the permit. If you have any questions or require any additional
information, please contact David Simpson at [phone] or Mr. Gary Fisher at [phone].
Sincerely, - --
ENSR Consulting and Engineering (NC), Inc.
Erin Stewart, P.G. David . i ,
Project Manager Senior Program Ma ager
Attachments
cc: G.. Fisher, Alcatel -Lucent
G. Stephenson, ENSR

Alcatel -Lucent
600 Mountain Avenue
Room 7F 407A
Murray Hill, NJ 07974
November 25, 2008
Ms. Dina Sprinkle
NCDENR, DWQ, Point Source Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: REQUEST FOR DIVIR SIGNATURE AUTHORITY
Lucent Technologies, Inc.
3370 Lexington Rd, Winston-Salem, NC
NPDES Permit No. NC0080863
Dear Mrs. Sprinkle:
As the Permittee and as a representative of Lucent Technologies, Inc., now known as Alcatel -
Lucent USA Inc. (Alcatel -Lucent). I am requesting that the signature authority for the above
referenced facility continue to be delegated to the ENSR Consulting and Engineering (NC), Inc.,
Project Managers for the Alcatel -Lucent Winston-Salem Facility (currently David H. Simpson,
P.G. and Erin Stewart, P.G.), duly authorized representatives of Alcatel -Lucent. This
representative will continue to review, determine compliance status, and certify by signature
monthly monitoring reports. I recognize that pursuant to 15A NCAC 2B .0506 (b) (2) (D), that the
process of authorizing another individual or position to sign as a representative in no way
relinquishes any responsibility for the permit or responsibility to remain familiar with the permit
conditions, limits, including any modifications, and for the compliance data reports for the
permit.
If you have any questions regarding this request please contact me at [phone].
Thank you.
Sincerely,
Z
G Ga M. Fisher
Permittee
Cc: David Simpson / ENSR

13J0-/o4-LyUy 1 PA
NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundivater treatment facilities.
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number INCOO 8o653
If you are completing this form in computer use the TAB key or the up — down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. 01h.erwise, please print or type.
1. Contact Information:
Owner Name A )Ca ��� ' L(,tC2�� (� � i/iC•
Facility '-Name
Mailing Address
City
State i Zip Code
Telephone Number
�_c47170l05,y-1i )4C)
Lt,tcei] t Sa;f erl Bc-ts 1 n-eSS Pe�/K
60 - J-7D0 MDWI fn r'✓g 4A.
A) Z 0-H qj
(100) 5e2- 54-41
Fax Number
e-mail Address S� eT@ a,1 �fi�(—1�tC��lf . CoM
2. Location of facility producing discharge:
Check here if same as above ❑
Svreet Address or State Road 3 3 -4o L4->,, 9
Sateg,
�o�S y i'L► .
City
State / Zip Code
County
((4 LwcA�
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name �Q ✓" G( 91 M PSa/1 , t�%1I,54 COW ytf � �/l q 1�� e �/,��5 �it1C� (/1C .
Mailing Address qf 01d,WaKc &Iesa/
City ko(, te
State / Zip Code /V(_ Z� l
Telephone Number ( )
qlq g�z -((goo
Fax NumberI V
4. Ownership Status:
08
Federal ❑ State ❑ Private [� DEC 3 OPublic
,E N R e. WATE R QUALITY i
Page 1 oc3 POINT SOURCE BRANCH
C-GWJ 05108

V VI. LJ VV VJ,VLF/ LI YJI\VIJLI\
Y
JJV-! V't'LJJJ FJ,V
NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
5. Products recovered:
Gasoline ❑ Diesel fuel ❑ Solvents ❑ Other
6. Number of separate. discharge points: Outfall Identification number(s) 001
7. Frequency of discharge: Continuous Intermittent ❑
If intermittent: Z /
Days per week discharge occurs: 7 Duration: � L( lirS o(o--�
8. Treatment System Design flow 0, 30Z MGD
9. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
5.4 (e/v' cvQ-. k
10. Please list all additives to the treatment system, including chemicals or nutrients, that have
the potential to be discharged.
11. Is this facility located on Indian country? (check one)
Yes ❑ No Ea"
12. AdditionaIInformation
All applicants (including renewals.
➢ A USGS topographical map (or copy of the relevant portion) which shows all outfalls
➢ A summary of the most recent analytical results (effluent data, if available) containing the
maximum values for each chemical detected
NEW Applicants only:
Engineering Alternative Analysis
v Description of reirnediation treatment system components, capacities, and removal efficiency
for detected compounds.
v If the. treatment system will discharge to a storrrn sewer, written approval from the
municipality responsible for the sewer.
P. A list of any chemicals found in detectable amounts at the site, with the maximum observed
concentration reported for each chemical (the most recent sample must be collected less
than one year prior to the date of this application)
For petroleum -contaminated sites — Analyses for Volatile Organic Compounds (VOC) should
be performed. Analyses for any fuel additives likely to be present at the site and for phenol
and lead should also be performed.
n For sites contaminated with solvents or other contaminants - EPA Method 624/625
analysis should be performed.
Page 2 of 3 C-G67 05108

.. � ., ,... ...,..,ter �� ....� ...,..�� .
'Juu- / u`T-r-Ouo f.l . V
NPDES PERMIT APPLICATION - SHORT FORM C - GW
For discharges associated with groundwater treatment facilities.
13. Applicant 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, complete, and accurate -
Printed name of Person
Signature of
Title
1z123
ate
North Carolina General Statute 143-213,13(b)(2) provides that: Any person who knowingly makes any false statdment representation, or
certification in any application, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of
the Environmental Managernent Commission implementing that Artide, or who falsities, tempers with, or knowingly renders inaccurate any
recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of the Environmental
Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by
imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than $25,000 or
imprisonment not more than 5 years,'or both, for a similar offense.)
Page 3 or3 C-GVV 05!08

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RECEIVED
N.C. Dept of ENR
Wvv
NCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Michael F. Easley, Governor
October 20, 2008
Mr. Fred Bleachinger
Lucent Technologies, Inc.
3370 Lexington Rd
Winston-Salem, NC 27107
OCT 2 2 2008
Winston-Salem
Regional Office
William G. Ross, Jr., Secretary
Coleen H. Sullins, Director -
Subject: Renewal Notice
NPDES Permit NCO080853
Salem Business Park remediation site
Forsyth County
Dear Permittee:
Your NPDES permit expires on June 30, 2009. Federal (40 CFR 122.41) and North Carolina (15A
NCAC 2H.0105 (e)) regulations state that permit renewal applications must be filed at least 180 days prior
to expiration of the current permit. If you have already mailed your renewal application, you may
disregard this notice.
Your renewal package must be sent to the Division postmarked no later than January 1, 2009.
Failure to request renewal by this date may result in a civil penalty assessment. Larger penalties may be
assessed depending upon the delinquency of the request.
If any wastewater discharge will occur after June 30, 2009, the current permit must be renewed.
Discharge of wastewater without a valid permit would violate North Carolina General Statute 143-215.1;
unpermitted discharges of wastewater may be assessed civil penalties of up to $25,000 per day. .
If all wastewater discharge has ceased at your facility and you wish to rescind this permit, contact
me at the telephone number or address listed below.
Use the enclosed checklist to complete your renewal package. The checklist identifies the items you
must submit with the permit renewal application. If you have any questions, please contact meat the
telephone number or e-mail address listed below.
Sincerely,
Charles H. Weaver, Jr.
NPDES Unit
cc: eotr
�x<s1n- alem e on Office, Surface Water Protection `:.
NPDES File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One 1
512 North Salisbury Street, Raleigh, North Carolina 27604 NorthCarolina
Phone: [phone] / FAX [phone] / [e-mail] Nawrally
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

NPDES PERMIT NCO080853
SALEM BUSINESS PARK REMEDIATION SITE
FORSYTH COUNTY
The following items are REQUIRED for all renewal packages:
➢ A cover letter requesting renewal of the permit and documenting any changes at the facility since
issuance of the last permit. Submit one signed original and two copies.
➢ The completed application form (copy attached), signed by the permittee or an Authorized
Representative. Submit one signed original and two copies.
➢ If an Authorized Representative (such as a consulting engineer or environmental consultant) prepares
the renewal package, written documentation must be provided showing the authority delegated to any
such Authorized Representative (see Part II.B.1 Lb of the existing NPDES permit).
➢ A narrative description of the sludge management plan for the facility. Describe how sludge (or other
solids) generated during wastewater treatment are handled and disposed. If your facility has no such
plan (or the permitted facility does not generate any solids), explain this in writing. Submit one signed
original and two copies.
The following items must be submitted by any Municipal or Industrial facilities discharging
process wastewater:
Industrial facilities classified as Primary Industries (see Appendices A-D to Title 40 of the Code of Federal
Regulations, Part 122) and ALL Municipal facilities with a permitted flow >_ 1.0 MGD must submit a
Priority Pollutant Analysis (PPA) in accordance with 40 CFR Part 122.21.
The above requirement does NOT apply to privately owned facilities treating 100%
domestic wastewater, or facilities which discharge non process wastewater (cooling
water, filter backwash, etc.)
Send the completed renewal package to:
Mrs. Dina Sprinkle
NC DENR / DWQ / Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1617

4
of WA T�9
� r
March 12, 2008
CERTIFIED MAIL 70071490 0004 9565 0740
RETURN RECEIPT REQUESTED
Fred Bleachinger
Lucent Technologies Inc
3370 Lexington Rd
Winston Salem NC 27107
SUBJECT: Compliance Evaluation Inspection
Lucent Technologies Inc
Salem Business Park remediation site
Permit Into: NCO080853
Forsyth County
Dear Mr Bleachinger:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
,nment and Natural Resources,
Coleen H. Sullins, Director
Division of Water Quality
Enclosed please find a copy of the Compliance Evaluation Inspection form from the inspection
conducted on March 11, 2008. The Compliance Evaluation Inspection was conducted by Rose
Pruitt of the Winston-Salem Regional Office. Greg Stephenson, ORC was present for the .
inspection. The facility was found to be in Compliance with permit NC0080853. The inspection
consisted of two parts: an on -site inspection of the treatment facility and a file review. The
following are the findings from the subject inspection:
Permit
The current permit became effective July 1, 2004 and expires on June 30, 2009.
The remediation site has a permitted flow of .302 MGD.
Operations and Maintenance
Maintenance is performed as needed. There is a routine maintenance program in place.
Record Keeping
A review of laboratory reports and Discharge Monitoring Reports (DMRs) revealed no
discrepancy between the generated data and the data submitted to DWQ.
A copy of the laboratory data and historical flow charts are kept on file. The lab used by this
facility is Pace Analytical.
Maintenance records are available for review.
Self -Monitoring Program
There were no NPDES limits violations from January 2007 thru December 2007.
CDENR.
585 Waughtown Street Winston-Salem, NC 27107 Phone [phone] Fax [phone]

Lucent Technologies ! .
Page 2 _
March 12 20618 r '
Facility Site Review
Facilities are well maintained.
The effluent was clear with no visible solids.
Flow Measurement
An inline Stevens flow meter model 61M, is used and calibrated annually. Calibration records
were available for review. The meter was last calibrated 1/16/08 by BW Allen.
The Division of Water Quality greatly appreciates your continued oversight at this facility. The
Division also encourages you to continue to be proactive in your efforts to maintain compliance.
Please refer to the enclosed inspection report for additional observations and comments. If you or
your staff have any questions, please call Rose Pruitt at 336-771-5000.
Sincerely,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: Greg Stephenson, ORC
Central Files
MaWtSM

_ ._tinited States..EnvirnnmentalP�°teehon.AAenGY
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 151 31 N00080853 111 121 08/03/11 117 181 CI 191SI 201
Remarks
21IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII6
Inspection Work Days Facility Self -Monitoring Evaluation Rating 131 QA --------------------------- Reserved ----------------------
80
67I 169 701 I 711 I 72 I N I 73 L1J 74 711 I I I I I 11
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
05/05/01
08:3.0 AM 08/03/11
Salem Business Park remediation site
Exit Time/Date
Permit Expiration Date
3370 Lexington Rd
Winston Salem NC 27107
09:15 AM 08/03/11
09/06/30
Name(s) of Onsite Representative(s)R"itles(s)/Phone and Fax Number(s)
Other Facility Data
Gregory Martin Stephenson/ORC/336-784-2716/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Fred Bleachinger,3370 Lexington Rd Winston Salem NC
NO
27107//336-784-2716/
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Lr9 Flow Measurement BE Operations & Maintenance So Records/Reports
Facility Site Review Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Rose Pruitt WSRO WQ//336-771-5000/
1,4
Signature of Managemo Q A Reviewer Agency/Office/Phone and Fax Numbers Date
r
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES �yr/mo/day Inspection Type 1
3I NCO080853 I11 12I 08/03/11 I17 181
CI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Site inspection conducted 03/11/2008, ORC Greg Stephenson present during inspection. The facility
appeared well maintained during the inspection. The stream appeared clean at the effluent pipe at the time
of the inspection. Effluent flow was at a minimum at that time due to backwashing.
Page # 2

Permit: NCO080853 Owner - Facility: Salem Business IJarK reme is iion si e
Inspection Date: 03/11/2008 Inspection Type: Compliance Evaluation
Operations & Maintenance
Yes
No
NA
NE
Is the plant generally clean with acceptable housekeeping?
IM
n
n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge
n
n
®
n
Judge, and other that are applicable?
Comment:
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permit tee submitted a new application?
n
n
®
n
Is the facility as described in the permit?
®
n
n
n
# Are there any special conditions for the permit?
Fl
❑
Is access to the plant site restricted to the general public?
n
n
n
Is the inspector granted access to all areas for inspection?
®n
n
n
Comment:
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
W
nEn
❑
❑
Is all required information readily available, complete and current?
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
❑
❑
n
l
Are analytical results consistent with data reported on DMRs?
❑
n
Q
Is the chain -of -custody complete?
❑
❑
Dates, times and location of sampling
Name of individual performing the sampling
02
Results of analysis and calibration
n
Dates of analysis
n
Name of person performing analyses
n
Transported COCs
Are DMRs complete: do they include all permit parameters?
n
n
❑
Has the facility submitted its annual compliance report to users and DWQ?
n
n
®
n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift?
n
n
r
n
Is the ORC visitation log available and current?
®
o
n
n
Is the ORC certified at grade equal to or higher than the facility classification?
®n
n
n
Is the backup operator certified at one grade less or greater than the facility classification?
®n
n
n
Is a copy of the current NPDES permit available on site?
n
n
n
Page # 3

Permit: NC0080853 Owner - Facility: Salem Business Park remediation site ' —+
Inspection Date: 03/11/2008 Inspection Type: Compliance Evaluation
Record Keeping
Facility has copy of previous year's Annual Report on file for review?
Comment. -
Effluent Pipe
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are required) are they operating properly?
Comment:
nn■n
Page # 4

:ed To: CA_e�C
Fax #: -7 !Ft - 30 & U Phone q/GI - -2-V l - 0 9�3 6
WWTP Annual Inspection Checklist
This information should be available to the inspector at inspection time.
Facility: LLJC f NPDES: AC00 �;OS5 F
Permit Effective Dates:
to
Inspection Date: 3- / 1 -o O Inspection Time:
-1) DMRs (Dates: January 2007 to December 2007 )
=�-2) Lab Data (per DNIR dates) Q
✓3) Laboratories used for analysis & certification #'s C�'IV-0Ll4 `,-�"
v-4) Chain of Custody forms (per DMR dates)
✓5) Complete copy of current NPDES permit
of SOC or Moratorium issuance (if applicable)
:-/-7) ORC and Back-up ORC current certification
8) Wastewater Annual Report (fiscal or calendar year - if applicable)
✓9) Daily Operator's log / ORC visitation log
✓10) Maintenance log
11) Process control data (which includes field parameters tested and equipment
calibrations)
ie d Parameter certification (if applicable)
✓13) Flow meter calibration records (if applicable) r �ajw
nt and/or effluent samplers `/vl
­15) • Flow charts (if applicable),
or Inspection / under load checks
�1'7) Spill Response Plan (with current emergency contact numbers)
4$}�S u ge / Residuals hauling records (if applicable) 7fc Z Iti�c p
19) Plant visual inspection of treatment units
✓ZO) Stream accessible for inspection (at effluent discharge pipe)
Please call with questions:
Rose Pruitt
NC Department of Environment & Natural Resources
Division of Water Quality
Winston-Salem Regional Office
[phone]
Fax: [phone]
A Y�
`V ors
/� w

i CAROLINA
;TMENT OF
ENVIRONMENT AND
NATURAL RESOURCES
FAX TRANSMITTAL
Water Quality Section
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, N.C. 27107
Phone: [phone]
A4 -too VIA
C)ENR
Fax: [phone]
TO:jG
FAX NUMBER: 79 '/ - 30
FROM:
DATE:
Number of pages (including cover page):
COMMENTS: l�lJ f j
L �C­5p�C -T --ram

WASTEWATER TREATMENT PLANT INSPECTION CHECKLIST
EMAIL TO: AT
NAME EMAIL
OR
FAX TO: AT
NAME FAX #
FACILITY NAME: NPDES #:
PERMIT -'EFFECTIVE DATES, FROM: TO:
INSPECTION DATE: INSPECTION TIME:
PLEASE HAVE THE FOLLOWING RECORDS AVAILABLE FOR REVIEW ON THE ABOVE INSPECTION DATE.
1 DMRs DATES FROM TO: (�� ./hv �iUco��✓ .
2 LAB DATA (SAME AS DIVIR DOES):
3 LABORATORIES USED FOR ANALYSIS &.THEIR CERTIFICATION #s:
4 CHAIN OF CUSTODY FORMS: L/
5 DAILY OPERATOR'S LOG & ORC VISITATION LOG:
6 MAINTENANCE LOG: t/
7 COMPLETE COPY OF CURRENT NPDES PERMIT:
8 FLOW METER CALIBRATION RECORDS, IF APPLICABLE: yyi
9 FLOWCHARTS, IF APPLICABLE:
10 PROCESS CONTROL DATA, INCLUDING FIELD PARAMETERS TESTED AND EQUIPMENT CALIBRATIONS: N A
11 FIELD PARAMETER CERTIFICATION, IF APPLICABLE: jim
12 CURRENT SLUDGE/RESIDUALS PERMIT, IF APPLICABLE: jV /¢
13 SLUDGE/RESIDUALS HAULING RECORDS: N
14 SLUDGE/RESIDUALS ANNUAL REPORT: /Y
15 CURRENT PERM ITTEE/ORC/BACKU P ORC INFORMATION V
16 GENERATOR INSPECTION/UNDER LOAD CHECK RECORDS 016
17 SPILL RESPONSE PLAN (CURRENT EMERGENCY CONTACTS/PHONE NUMBERS): /lloj-
18 STATUS OF SOC OR MORATORIUM ISSUANCE, IF APPLICABLE r/ lq
19 WASTEWATER ANNUAL REPORT (FISCAL OR CALENDAR YEAR), IF APPLICABLE: 41)w
20 COPY OF LAST INSPECTION BY THE DIVISION: '
21 VISUAL INSPECTION OF TREATMENT UNITS, INCLUDING COMPOSITE SAMLERS/STREAM MONITOR LOCATIONS
22 STREAM ACCESSIBLE FOR INSPECTION (AT EFFLUENT DISCHARGE PIPE):
23
24 NOTES:
25 WWTP NPDES RECORDS ARE TO BE KEPT FOR 3 YEARS
26 LAB AND SLUDGE RECORDS ARE TO BE KEPT FOR 5 YEARS
27
28 QUESTIONS CALL INSPECTOR: RON BOONE AT 336-771-4967, OR
29 FAX [phone], OR
30 EMAIL AT [e-mail]
NOTES:

UNITED
NCDENR-Water Quality Section
V- &C cf .
585 Waughtown Street
Winston-Salem, NC 27107
K°
i

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
I. Article Addressed to:
FRED BLEACHINGER
LUCENT TECHNOLOGIES, INC.
3370 LEXINGTON ROAD
WINSTON-SALEM, NC 27107
J,�� v' ❑ Agent
❑ Addressee
by (Pnnt§Name) C. Date of Delivery
rvice Type
Certified Mail
from item 17 ❑ Yes
ass below: ❑ No
a Mail
Receipt for Merchandise
(Extra Fee) ❑ Yes
Art�ol�tu 7017 �1�490' `'''41 9-SU5 07�4011 11 i 11 t s
IS Form 3811, February 2004 Domestic Return Receipt z ) — g4V1 102595-02-M-1541