NC0003425_Outfalls 11 and 12B_20200529

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/29/2020 6:55:05 AM (Supplemental Submittal)
Submit by Bennett, Bradley 8/17/2020 12:51:13 PM (Supplemental Info Submittal)
• Bennett, Bradley assigned the task to Bennett, Bradley 8/17/2020 12:50 PM
• The task was assigned to Thedford, Wren, Bennett, Bradley 5/29/2020 6:55 AM

Initial Review Information
Updated ID#:* IWORTANf:FEVIBAERSl-IOLLDVERIFY and revise here ifnecessary.
NC0003425
How should this project be handled?*
r File r Discard
Information Submitted on 5/29/2020
Submitter Information
Name: Robert Howard
Vft is subrritting the inforrretion?
Email Address:* [e-mail]
Submittal Information
The Division of Water Resources (DWR) is providing this site to allow for the upload of required supplemental
information associated with discharge monitoring reports (DMR). All DMR data is required to be submitted
electronically through the eDMR system and should not be submitted here. Division staff will reviewall
uploaded documents and will only maintain required information. Documents such as laboratory reports are not required
to be submitted and will not be maintained in the system.
Project Information:
Rease SUDDly the Dernit nun ber for this
Existing ID#* PerrritNurrber
NC0003425
Exarrples: NOKxxxxxx or NO&xxxxx
Facility Name:* Roxboro Steam Plant
County: Person
Please upload all files that need to be
submited. *
dick the upload button or drag and drop files here to attach docurrent
Roxboro Steam Plant NC0003425 eDMR
Supplemental Info April 2020 Outfalls 11 and 84.47KB
12B.pdf
Only pdf files are accepted.
Comments about the attachments:
Please find attached outfalls 11 and 12B for the Roxboro Steam Plant NC0003425
* V By checking the box and signing box below, I certify that:

• I have given true, accurate, and complete information on this form;
• I agree that submission of this Supplemental Information form is a "transaction" subject to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act')
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the Supplemental Information form."
Full Name: Robert E. Howard
Signature:
Date Submitted: 05/29/2020

EFFLUENT
NPDES Permit No. NCO003425 Diicharge No, 011 Month April Year 2020
Facility Name Roxboro Steam Electric Plant Class 11 County Person
Operator In Responsible Charge Ryan S. Enoch Grade III Phone [phone]
Certified laboratories (1) Pace Analytical (2) Progress Energy Roxboro Steam Electric Plant
Check 1f ORC has Changed Person (s) Collecting Samples Ran S Enoch
Mail ORIGINAL and ON12 COPY lu
ATTN: (LNTRAl, HLES (x) 74,L 140C S L00-
DIVISION OV WATEK QUALITY 1%IGN RIi 0f 017iRATOR IN RLSPONSIBt.P. CHARGI.) hate
1617 MAIL. SI.RVICIi CIiNn7R By This Signature. I Certify That This Report Is
RAI EIGH. NC 27699.1617 Accurate And Complete To The Best Of Sly Knowledge.
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I.utin—.bkmdrWwelr—&Q —tie U Jaun.w die.hu INNR_
sin
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facility Status: (['Law Chick cmc or the following)
All monitoring data and sampling frNucm-las mevi permlt rtquh-maim
All monitoring data and sampling fmquerycks din N(ff meet permit w4uveme- s
'I certify, under penahy or law, that Ihis document and all altachntnis were pmpan:d under my direcliom or supervishm in accordance with a system dcsigned
to assure that qualifa-d persarmd properly gatlls-r and evaluate the information suhmhtcd. Uaxtd on my inquiry of row pc"m or pemini who MaMUL: LhL system,
or [hove person din+cdy wipomihk: for gatluring the information. thi: informathrn suhmitiLd Ls, to the list of my knowledge and N-W. true. a xorate. and
atmplete. Iran aware that [lure arc significant punaltim far submitting fatvc inf lroiaLhm. including the pumitay of fines and impni L far! v'
Tom Copalo b gl;kI p
H:rmime 01Iea.Se print or type] Signs m of I 'true•• Date
1700 dunnaway Road, Senora, NC 27343 (336) 597 - 6100 ###If#####
Pe mum Addrnr Arne Nwrtur 1learr Cup. laic
• URCamA not ISA NCAC rA 113021b1 fSHM
-- tf Literal 11 whiriMn into perm iw_ dekturn arsitnwey wnariiy—a k. fie with ibe.rue to I5A NLAL'?a .0506 Ibl t?I tD1.

EFFLUENT
NI'DIS Permit No. N00003425 Diaharge No. 128
Facility Name Roxboro Steam Elearic Plartl [laic Il couniv
Opertlor In Rcslxmsihle Charge Ryan S. Enoch _ Gridu III
CtT ificd I-aborahrrics (1) Duke analyllral Lab _ (2) NA
Cheek If ORC has Changt:d Ikrson (s) Collecling Samples ; fin S. Enoch
Mail ORIGINAL and ONE COPY at
ATTN:CINMALI1I1:S 1X3 rat Of
DIVLSION OF WATIJt QUAIIIY
Ih17 61AIL SERVICES Cf_NnA
RAITICH, NC 27699.1617
Month April War 2020
Person
Phone [phone]
(S1GN,V URIi OI' OPISHATOR IN RE_SPONSIBLX C11AR11 :)
By This Signature,) Certify That This Report Is
Amurale Anil Complete To The Best Of My KnuwWga.
rk— rk—.d vamuw nb-4FXAp1.-J.—
Facility Sutus- (PEue Check are of ttK following)
All m nhadnS data LW suMhag fmgtteneioa moot prnnil rcquircrrelas
All munilunng dam anJ satryt&ng frequencies do NOT meet permit requimmcros
-6.::MR.
"1 artify under penaky of law. that ihistltKv of and all attadumnis were prcpaml umLr my dircetiun or superviskm in a mnlarr2 with a system tkyigned
to assure that quakfinl perusnncl pmpoly yuhr and evaluate'.he infomralkm suhmieeti. fried on my inquiry of the perum or persrtns wta) manage the system.
or 11141se perxlm diFMAY rnptmihlc fur gathering the infumotioo. the infimnation whmivat is. to the hest of my knimi lge and hcber. true. aauraw, am
s rmpkte. I am aware that there arc siSnificant pcnakka for .uhmitfiaS false informathtn. inchuling the lxmitAbly of fires ajW WNTr snmcnt for Itnowing vitAviom.
Tam
Nrmiltec (Prose print or lypc) Signature: of
osl
Date
171N) Dunnaway Road, Simon. NC 27343 (3361597 -61(N) March 31.2D12
Ramnree A.k1rw Pere Nuaahsr tomtit lisp. 12are
•11RC m.0 rref:wrya.l�.vmentrpearnnaef f+rtlarr rcyurel per llA N�Af aA n2n2 ebr 15rtB1.
••11140M by ortwauo xr pam+w.3eklaebrdWnwes.rn.nY mur 1 we fdr.ea dww rw ISA WAC I 11506tb1.2, 0_
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DATr.