NC0003425_Outfalls 11 and 12B_20200706

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/6/2020 9:28:30 AM (Supplemental Submittal)
Submit by Bennett, Bradley 8/17/2020 1:00:48 PM (Supplemental Info Submittal)
• Bennett, Bradley assigned the task to Bennett, Bradley 8/17/2020 1:00 PM
• The task was assigned to Thedford, Wren, Bennett, Bradley 7/6/2020 9:28 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 7/6/2020
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 Electric Plant
County: Person
Please upload all files that need to be
submited. *
dick the upload button or drag and drop files here to attach docurrent
Roxboro Steam Plant NC0003425 eDMR
Supplemental Info May 2020 Outgalls 11 and 73.07KB
12B.pdf
Only pdf files are accepted.
Comments about the attachments:
Please find attached Roxboro Steam Electric Plant outfalls 11 and 12B for May 2020.
* 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 Howard
Signature:
Date Submitted: 07/06/2020

NPDES Permit No.
Facility Name
EFFLUENT
NC0003425 Discharge No. O11 Month May Year 2020
Roxboro Steam Electric Plant Class 11 County Person
Operator In Responsible Charge
Certified Laboratories
Cheek If ORC has Changed
Ryan S. Enoch Grade III Phone [phone]
(1) Dube Analytical Lab (2) Progress Energy Roxboro Steam Eledric Plant
person (s) Collecting Samples Ran S. Ertoth
Mail ORIGINAL and ONE COPY to: (7
ATTN:CI-:NTRAl.1.11.1:5 ixl r--
111VLSIONOFWATER QUAIKY (SIGNAT E'sof;OP1'mATORINRESPONSIBLECHARGE) [)arc
1617 MAIL SERVICE C13NTER By This Signature. I Cerllry That This Report Is
RALEIGH, NC 27699-1617 Accurate And Complete To The Best Of Sly Knowledge.
Ifaau.e d ,kawswd miatm. in F-6k,. r.4 as d EPA p..r..hue..
ai....Pr"watrdueelrwnifeekt .ems dthe.We.antaiWinthi.nMR.
Facility Status: 4111=c Check one of the following)
All monitoring data and sampling fequencics meet permit requirements
All monitoring data and sampling frequencies der NOT mecl permit requirements
"I certify. under perulty Of law, Ih:x This document and all attxhtWnts were prepared under my direction or supervision in aeconlaelce with a system designed
to assure that qualirwd penwinwl properly gather and ev-.daatc the infutmminn submitted. ]lased on my Inquiry of the person or persons who manage the system.
w those persons directly resptmsible for gathering the inftrmeatEon. the information submitted is. to the hest of my kmtwledge and belief, true. accumic. and
complete I am aware that Ihere are significant pcnaltlea fret sohmiuing false infimnatiom including the possibility of fines and impAmin4itt fur in viall�
Tom Copolo _ �'�'1 a b lasl
Pcnnince Me= print or typef Signature: of IvemkLg6ji, Date
1700 Dunaway Road. Scmora. NC 27343 (336) 597 - 6100 _ Mash 31. 2012
E•en itwe,%MM. ., FUM NWAS" I'm I T p. fart
•r1RCm rS.ttr Pity r d dk ument.wtuiuwNlwil:iy a.4W riper. 13A NCACSAMM the M mr
•• ff ip W",Arise Om ate rtewhter. dek=atkn d aiptwry autlweity t t M u hie tith the ttue per ISA 14CAC 20 mat MGM)
The muddy aeaage At teal coltA m ie w he rer-rkd m a GIEUSIMIC nee. UK tetlytlwiIDutal wein in the reprrtiag taaliry'e panic ftr trprling dsu-

EFFLUENT
NI'OGS 11crmil 14I1. NC0003425 Di+charge No. 12S
Fieihiv NaRv Roxboro Steam Electric Plant (lars II Couniv
M.r,lh_ May Year 2020
Person
Operator In ReslltmAble Charge Ryan S. Enoch tirade III Mime 13361 59&7609
Cenifrcd l.ab)rawrics (1) Duke analytical Lab Ili NA
Check If ORC has Changed 1'erwm (s) Collecting Samples Ryan S. Enoch
Alail ORIGINALaW ONE COVY to: L
A'ITN: CIE MAE.1111_S (x) �a�� 6IZ3
UIWSION Oil WATER QUAIM
1617 MAIL SI'.RVICEE CEENTUR
RAILIGII. NC 27699.1617
I51GNA'jfRI: OI IH'1:RAWR IN RESPONSIRI-1. CHARGLI
By This Signature, I Certify That Thin Report Is
Accurate And Complete To The Rest Of Sly KnllwkrlBe.
]!coot tar Jammlrl.vvr nr n prmasa a.I M1SH t?PA M'�
tl r nr pw8k nah�nh unei tlrr l�,.a auyrx9 N tlr.t a uwund n ihu UMR.
Facility Status: (I&:ase Check one. or the futHwinyl
All mmimring data and sampling frequencies meet peradl mplircmcnu
All Inmitnring data and sampling fmilwsicks do NOT meet pe mil requirements
9 certify, colder penally of law, that this tkummcra and all atls lmtcnts were prepared unkr my dltectk)n 0r.uperyi1kl1.n ararrdancs with a system do o-jrletl
Itl awrrc that quaGFinl personwl pnVoly gather and eraluat- dsc infomutkm suhmiaed Rased./n my Iraluiry..f the pl mm.)r pentms wix: maseSe the system.
of dxrse petatms dimily rcNii tsihle for yalhcrina the infomm.kln the infunnvkm s wadi! d is. to the licit of my km:wkdr and twher. mic. accurate and
cumpletc. I am aware that there are siyniGcam pcnakks &n ..bmitang false infumutkln. including the p:r41hriklyof uses sSPfiwrnmrnt for knowing yMations.'
Tom
BItec (lrkase print .rr ty71e) Sipnatorc of Date
171NE 1)uanaw2y Road. mnumb, NC 27343 (3161597 -61 W March 31. 2012
Itrmiaw A6lw I'htno Nwahr llawt F:sp Dale
• ORC rtl vet Iri}ty a.l Jxvuas, rrcvam N IxJry r ipyv�sl pv {tA jt('M: aA D3o3 bi !}/ j!;
•• tf np.et bi I'dw Wit dw permute, drW MM N SW=vy WdWsy nun tr- rk rrb M, .ual plr 13A W AL :9 DNA b:. 211n1
The minrhly arrnac f fasal a+likmr is w fIC rrlartal as a GI:IIMI:Ili1[' mean Clue mly doiana W w» rs m dw mprtma fan .'r . palm l kr mpatins data.