NC0000019_Fact Sheet_20201109

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
DEQ/DWR/NPDES
FACT SHEET FOR NPDES RENEWAL
NPDES PERMIT NC0000019
24Sep2020
Facility Information
Applicant/Facility Name:
United Chemi-Con, Inc.
Applicant Address:
185 McNeil Road; Lansing, NC 28643-8300
Facility Address:
Same
Facility/Permit Status:
Four (4) active outfalls / Renewal
County:
Ashe County
Outfall 001
Permitted Flow:
0.200 MGD
I IWC (%):
0.75% s / 0.55% w
Type of Wastes:
Non -contact cooling water, boiler blowdown, deionization
backwash wastewater (<3% of discharge); A/C condensate &
stormwater, episodic process wastewater, stormwater
Outfall 003
Permitted Flow:
(not limited)
I IWC (%):
NA
Type of Waste:
(Intermittent discharge) A/C condensate, stormwater
Outfall 006
Permitted Flow:
0.018 MGD
I IWC (%):
NA
Type of Waste:
(Sinks with grease traps) Treated domestic wastewater
Outfall 007
Permitted Flow:
(not limited)
I IWC (%):
NA
Type of Waste:
(Annual maintenance discharge) Recycled non -contact cooling
water, filtered surface water overflow
Miscellaneous
Receiving Stream:
N. Fork New River
Stream Class:
C, HQW
Subbasin:
05-07-02
Index No.
10-2-(19.5)
Drainage Area (mi):
142
HUC:
05050001
Summer 7Q10 (cfs):
41
303(d) Listed?
No
Winter 7Q10 (cfs):
56
Regional Office:
Winston Salem
30Q2 (cfs):
79
State Grid /
USGS Quad:
B12NE /
Warrensville, NC
Average Flow (cfs):
240
Permit Writer:
Joe R. Corporon, P.G.
IWC (%)
(summer / winter)
0.75% / 0.55%
Date:
24Sep2020
BACKGROUND
United Chemi-Con, Inc. of Ashe County owns and operates a facility manufacturing aluminum
electrolytic capacitators. This industrial process is not listed by the Environmental Protection
Agency (EPA) as a categorical manufacturer under 40 CFR, and thus is not governed under
designated federal effluent guidelines. Currently, this permit covers four (4) outfalls, only one of
which potentially discharges to the environment. The Division has determined that this facility
meets criteria as a minor discharger.
Fact Sheet — 24Sep2020
NPDES NC0000019
Page I of 4

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
Outfall Flow Summary - Per the Permittee's flow schematic (typical flow):
1)
Intermittent deionization backwash
0.016 MGD — 0.06% IWC**
2)
Boiler blowdown:
< 0.002 MGD
3)
Non -contact cooling water:
0.100 MGD
4)
A/C condensate:
0.004 MGD
5)
Spills/process wash water:
< 0.002 MGD
6)
Sinks and Traps/stormwater:
0.020 MGD
7)
Potential episodic process wastewater:
< 0.010 MGD estimate
** Based on North Fork New River flow data
Outfall 001 discharges continuously and includes non -contact cooling water, A/C condensate,
boiler blowdown, deionization backwash wastewater, potential episodic process wastewater,
potential spills/wash water, and stormwater. While some chemical additives may be detected
[ethylene glycol and gamma-butyrolactone] in the boiler blowdown, the Permittee uses no
biocides or chlorination. There are no treatments associated with Outfall 001 wastewater,
however process operations may spill or add condensate in trace amounts from various
wastestreams. A priority pollutant analyses (PPA) for Outfall 001 was submitted with the
renewal application suggesting no contaminates of concerns were present at sampling.
By design, the facility collects process wastewater and transports it offsite for disposal but may
temporarily add process wastewater to Outfall 001 to sustain operations. The Division has granted
this flexibility as an Emergency Contingency Plan. In this event, the Permittee shall inform the
Winston-Salem Regional Office (WSRO) of any such discharge from Outfall 001, and
immediately sample, evaluate and report toxicity using Acute WET -test TAA6C [see A. (6.)].
Outfall 003 discharges may occur intermittently, although no discharge has been reported in
recent years. Wastewater sources for 003 include A/C condensate and stormwater. There is no
associated chlorination or treatment.
Outfall 006 regularly discharges treated, 100%-domestic wastewater, but with an IWC less than
0.1 %. There are grease traps on kitchen sinks. Treatment includes an influent screen, followed by
an Imhoff Cone, collection /dosing tank, and two -parallel sand filters. There is no
disinfection/chlorination required of this effluent. The stream dilution factor meets guidance
criteria for not imposing fecal limits. [for exception, see permit A. (8.)].
Outfall 007 (Episodic) discharges either non -contact cooling water, as dictated by maintenance
schedules, or filtered river water, an overflow from sand filters. The Permittee uses filtered river
water for non -contact cooling water. Backwash from these filters collects in onsite ponds and is
then recycled for cooling. There is no treatment process and no discharge from these ponds.
This facility discharges stormwater under separate permit.
PERMITTING STRATEGY
Reasonable Potential Analysis (RPA) There are currently no Parameters of Concern
requiring RPA.
Fact Sheet — 24Sep2020
NPDES NC0000019
Page 2 of 4

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
Data Review - Instream Data Impact - Outfalls 001, 003, and 007 have both a maximum effluent
temperature limit and a maximum receiving -stream temperature impact limit. The Permittee
measured Temp U/D of Outfall 001 (the only active discharge). No temperature violations occurred
during the previous permit cycle.
COMPLIANCE
Previous compliance issues were resolved [Frequency Violations] with Chemi-Con's contention
that it does not generate parameters of concern identified by testing Total Toxic Organics (TTOs).
Renewal does not require TTO monitoring but includes a disclaimer to be submitted by the
Permittee, "In lieu of Total Toxic Organics Monitoring..." to be attached to each Monthly DMR
[see footnote, Section A. (1.)]
The WSRO issued no other NOVs and no penalty assessments during the previous permit cycle.
The WSRO recommends renewal of this permit. DMRs were reviewed for the period of January
2016 to May 2020. No process -contact discharges were reported to Outfall 007. DMR data are
summarized below in Table I (Outfall 001) and in Table II (Outfall 006):
Table I: Outfall 001 (Presents monthly average values for Flow and Oil & Grease)
Flow
BOD5
TSS
pH
Oil &
Temperature
(MGD)
(mg/L)
(mg/L)
(S.U.)
CC)
(mg/L)
Average
0.038
2.03
5.02
7.0
5
16.02
Maximum
0.659
2.7
5.8
7.7
5.0
32.7
Minimum
0.003
< 2
< 5
6.26
< 5
0.4
n
1,562
52
52
195
52
707
Table II: Outfall 006 (Presents monthly average values for Flow, BOD, and TSS)
Flow
(MGD)
BOD5
(mg/L)
TSS
(mg/L)
pH
(S.U.)
NH3-N
(mg/L)
Temperature
CC)
Average
0.003
2.73
5.05
6.9
1.16
Maximum
0.022
20
7.5
7.44
9.3
Minimum
0.0002
2.0
< 5
6.4
0.10
n
246
104
104
190
53
Whole Effluent Toxicity (WET) Chronic Testing - Outfall 001 requires chronic WET testing
[TGP3B] Quarterly using Ceriodaphnia dubia, at 0.75% effluent concentration. This facility
conducted 18 Chronic WET tests since October 2016 — each of 18 indicating "Pass."
Concerning Acute WET Testing - Based on the possible addition of process wastewater to
Outfall 001, and its presumed impact to the effluent characteristics, this renewal will continue to
require additional Acute WET testing [TAA6C] concurrent with discharge. The Permittee shall
initiate Acute WET testing upon any discharge of process wastewater to 001 (with a test
frequency not to exceed one Acute test per calendar month). The Division will use results to
evaluate future permit conditions.
Reporting - The Permittee is required to notify the Winston-Salem Regional Office (WSRO)
upon release of any process -contact wastewater to Outfall 001 [see A. (9.)]. If no discharge
occurs at any outfall, the Permittee shall report "No Flow" or "No Discharge" on all eDMRs
unless granted a Reporting Waiver by the Division [see section A. (10.)].
Fact Sheet — 24Sep2020
NPDES NC0000019
Page 3 of 4

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
SUMMARY OF CHANGES
In keeping with Division permitting strategies:
• Updated permit text to include eDMR certification statement, "In lieu of Total
Toxic Organics monitoring..." [see footnote A. (1)].
• Required monthly eDMR reporting of "No Flow" for any outfall not discharged.
• Added parameter codes to the effluent pages [See sections A. (1.), (2), (3.), and (4)].
• Updated WET -testing text [Acute and Chronic].
• Updated Electronic Reporting Requirements [section A. (10.)]
PROPOSED SCHEDULE FOR PERMIT ISSUANCE
Draft Permit to Public Notice:
Scheduled to Issue [tentative]:
Scheduled Effective Date [tentative]:
DIVISION NPDES CONTACT
August 5, 2020
October 2, 2020
November 1, 2020
If you have questions regarding the above information or the attached permit, please contact
Joe R. Corporon, P.G. [e-mail]].
NAME:
DATE: 24SEP2020
Fact Sheet — 24Sep2020
NPDES NC0000019
Page 4 of 4

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
ROY COOPER
Governor
MICHAEL S. REGAN
sccrrtar)
LINDA CULPEPPER
Director
United Chemi-Con, Inc.
Attn: Steve V. Katz, Plant Manager
185 McNeil Rd
Lansing, NC 28643
Subject: Permit Renewal
Application No. NC0000019
United Chemi-Con
Ashe County
Dear Applicant:
NORTH CAROLINA
Environmental Quality
October 09, 2019
The Water Quality Permitting Section acknowledges the October 8, 2019 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
D_E Qr;
Sincerely,
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
North Caro raDepartroentofEnv ronrrents'QuaR} I Dv.sionofWater Resouroes
1': rstonSs em Fegora Off�oe 1 45D Vest Hanes N : Road, Sute 300 1 WrnstorSa*m, North Carolina 27105
936 776-993O

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial 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 NC0000019 RECEIVED
Please print or type. OCT 08 2019
1. Contact Information: NCDEQ/DW.R/NPDE$
Owner Name
Steve V. Katz
Facility Name
United Chemi-Con, Inc.
Mailing Address
185 McNeil Rd
City
Lansing
State / Zip Code
North Carolina/28643
Telephone Number
336-384-6918
Fax Number
336-384-6927
e-mail Address
[e-mail]
2. Location of facility producing discharge:
Check here if same as above �
Street Address or State Road
City
State / Zip Code
County
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 United Chemi-Con, Inc.
Mailing Address 185 McNeil Rd
City Lansing
State / Zip Code North Carolina/28643
Telephone Number 336-384-2551
Fax Number 336-384-6927
4. Ownership Status:
Federal ❑ State ❑ Private xx Public ❑
Page 1 of 5 C-MI 10/08

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
5. Standard Industrial Classification (SIC) code(s): 3675
6. Number of employees: 160
7. Describe the treatment system All domestic type wastewater is discharged from an Imhoff style
solids settling and anaerobic digestion tank, using pH adjustment followed by sand filter treatment
identified as outfall 006. Non -contact cooling water, A/C condensate, deionizer backwash/reject
water, and storm water are discharged from outfall 001 with occasional pH adjustment. Outfall 003 is
A/C condensate and storm water only. Outfall 007 discharges filtered surface water (during
maintenance periods only).
Since the last permitting process, the use of boilers has ceased (note that no boiler blowdown water is
mentioned above). Therefore, UCC requests that the Chronic Toxicity requirement for outfall 001 be
eliminated.
S. Is facility covered under federal effluent limitation guidelines? No x❑ Yes ❑
If yes, specify the category?
9. Principal product(s) produced: Aluminum Electrolytic Capacitors
Principal raw material(s) consumed: aluminum foil, ethylene glycol
Briefly describe the manufacturing process(es):_Master aluminum foil rolls are slit into width
consistent with various design specs, then rolled into a coil with separator paper between anode and
cathode aluminum sheets. The coiled units are then impregnated with propriety electrolyte(s)
consisting of either an ethylene glycol base or a gamma-butyrolactone base. The units are then
assembled into an aluminum can with a phenolic cover assembly.
Page 2 of 5 C-MI 10108

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
10. Amount of principal product produced or raw material consumed
(List specific amounts consumed and/or units of production over the last three years)
Product Produced or Raw Material
Consumed
AVERAGE
Product Produced or Raw Material
Consumed
PEAK
per Day
19,155 produced
22,503 produced
per Month
379,267 produced
447,532 produced
per Year
14,551,200 produced
5,370,388 produced
11. Frequency of discharge: Continuous ❑
If intermittent:
Days per week discharge occurs: 7
Intermittent x❑
Duration: 24/ hrs. / day
12. Types of wastewater discharged to surface waters only
Discharge
Flow
GALLONS PER DAY
Sanitary - monthly average
410 gpd
Utility water, etc. - monthly average
40,250 gpd
Process water - monthly average
500 gpd
Stormwater - monthly average
180 gpd
Other - monthly average
Explain:
0
Monthly Average
total discharge (all types)
41,340 gpd
13. Number of separate discharge points: 4 Outfall Identificationumber(s)001,003,006,
007
14. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude): North Fork New River N36.28 W81.30
Page 4 of 5 C-MI 10/08

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
15. Effluent Data [for new or proposed discharges]
Provide data for the parameters listed. Temperature and pH shall be grab samples, for all other parameters 24-hour
composite sampling shall be used. If more than one analysis is reported, report daily maximum and monthly average.
If only one analysis is reported, report as daily maximum.
NOTE: Permittees requesting renewal should complete the table ONLY for the parameters
currentlu monitored. Summarize the Past 3 uears of effluent data.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
20
95.25
lbs.
Chemical Oxygen Demand (COD)
Total Organic Carbon
Total Suspended Solids
7.5
8
lbs.
Ammonia as N
5.3
2
lbs.
Temperature (Summer)
30.3
25.2
Degrees centigrade
Temperature (Winter)
22.6
17.8
Degrees centigrade
pH
7.7
6.9
Standard units
Fecal Coliform (If sanitary waste is
present)
Total Residual Chlorine (if chlorine is
used)
16. List all permits, construction approvals and/or applications (check all that apply and provide permit
numbers or check none if not applicable):
Type
Hazardous Waste (RCRA)
UIC (SDWA)
NPDES
PSD (CAA)
Non -attainment program
Permit Number Type
NCD3367715000 NESHAPS (CAA)
none Ocean Dumping (MPRSA)
NC0000019 Dredge or fill (Section 404 or
none Other
none
Permit
Number
none
none
none
none
17. List any chemicals that may be discharged (Please list and explain source and potential
amounts.)
Ethylene glycol - formulation component
Gamma-butyrolactone - formulation component
Page 5 of 5 C-MI 10/08

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
18. Is this facility located on Indian country? (check one)
Yes ❑ No x❑
19. 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.
Steve V. Katz Plant Manager
Printed name of Person Signing Title
of Applicant
Date
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 6 of 5 C-MI 10/08

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
NJ f
001
001
007
North Fork New River
(flows west) r' _!� G raw
7 / •�' ' ; \ • Jam••• � / �•�/ ��� ' • � 5
01
/ /
S.
(/ .� `� 1 � 1 �r - J-w � Jr I� } � �` �~tii// / i� —tea„ .,;.%�/, � � / '` 'l j...�--• � , �!, t
/
NC Hwy194
Outfall Latitude Longitude
- - ' C`\—��-���,}� ( 001 360 28' 44.4"N 810 30' 20.8"W
003 360 28' 48.8"N 810 30' 23.1 "W I t
• �- •� , ,.,, ° 006 360 28' 53.6"N 810 30' 15.7"W
_V�1 ;f �.� 007 360 28' 41.5"N 810 30' 18.5"W
\
'�,
United Chemi-Con, Inc.
Latitude: 360 28' 47"
Subbasin: 05-07-02
Stream Class:
Receiving Stream:
4uad/State Grid:
Longitude: 81 ° 30' 19"
HUC: 05050001
C; HQW
North Fork New River
B 12NE/Warrensville, NC
Facility Location
(not to scale)
North NPDES Permit NC0000019
Ashe County

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
AFFIDAVIT OF PUBLICATION
Acct. Name: NORTH CAROLINA-WATAUGA COUNTY
DEQ - DIVISION OF WA Before the undersigned, a Notary Public of said County
and State, duly commissioned, qualified and authorized by the
Acct. # 265236 law to administer oaths, personally appeared;
COST OF PUBLICATION
ram.
Total $187.57
Public Notice
Who being first duly sworn, deposes and says: that he (she) is
North Caroline Environmental
Management
CommissionlNPOES Unit
REPRESENTATIVE
1617 Mail Service Center
Raleigh, NC 27699-1617
of a newspaper known as ASHE MOUNTAIN TIMES, published,
Notice of Intent to Issue a
NPDES Wastewater Permit
issued and entered as second class mail in Town of West
NC0000019 United Chemi-Con.
Jefferson, in said County and State; that he (she) is authorized to
Inc.
make this affidavit and sworn statement; that the notice of other
Environ-
The North Carolina commis -
mental Management Commis-
legal advertisement, a true co E
g copy of which is attached hereto, wa..
sion proposes to issue a
published in ASHE MOUNTAIN TIMES the following dates
NPDES wastewater discharge
permit to the person(s) listed
below. Written comments re-
WASTEWATERPERMITNC0000019
garding the proposed permit will
08/ 1 9/2020
be accepted until 30 days after.
the publish date of this notice.
The Director of the NC Division
of Water Resources (DWR)
may hold a public hearing
should there be a significant de-
gree of public interest. Please
mail comments and/or informa-
tion requests to DWR at the
above address. Interested per-
sons may visit the DWR at 512
N. Salisbury Street, Raleigh,
NC to review information on file.
Additional information on
NPDES permits and this notice
may be found on our website:
and that the said newspaper in which such notice, paper,
si : /w er-r ovurces/ ate
sions/water-resou rces/water-re-
document or legal advertisement was published was, at the time
sources-permits/wastewater-
of each and every such publication, a newspaper meeting all of
branchlnpdes-wastewater/pub-
the requirements and qualifications of Section 1-597 of the
lic notices,or by calling (919)
707-3601. United Chem! -Con,
General Statutes of North Carolina and was a qualified
Inc. requested renewal of
newspaper within the meaning of Section 1-597 of the General
NPDES permit NCO000019 to
Statutes of North Carolina.
manage waste waters and
stormwater discharging to the
North Fork New River, New Riv-
er Basin.90
This 21 st day of Aust, 2020
1
\All 11111,,,
I ARy '-Sworn
Al =O .® st
4, PU5\-�G
e
'��ll1i 11111\!
to and subscribind before me, this
day of Auust, 20 w
Notl)Public `lIiy0"a4.VA`0v
My Commission Expires:
IVA

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
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 u 3 I NC0000019 I11 121 18/08/21 I17 18I � I 19 I s I 201 I
211IIIII 111111III II III III1 I I IIIII IIIIIIIII II r6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved -------------------
67
I 72 I n, I 71 I 74 79 I I I I I I I80
701 I 71 I LL -1 I I
LJ
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)
10:30AM 18/08/21
16/10/01
United Chemi-Con
185 McNeil Rd
Exit Time/Date
Permit Expiration Date
Lansing NC 28643
12:OOPM 18/08/21
20/03/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
John Turner/ORC/336-384-2551/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Gale D Howell,185 McNeil Rd Lansing NC 28643/Environment Health/Safety
Manager/336-384-6917/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Flow Measurement Operations & Maintenar 0 Records/Reports
Self -Monitoring Progran 0 Facility Site Review Effluent/Receiving Wate
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
Gary Hudson DWR/Division of Water Qua Iity/336-776-9694/
Kelli A Park DWR/WSRO WQ/336-776-9689/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
NPDES yr/mo/day Inspection Type
NC0000019 I11 12I 18/08/21 117 18 i c i
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page#

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
Permit: NC0000019 Owner -Facility: United Chemi-Con
Inspection Date: 08/21/2018 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
❑
❑
0
❑
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?
0
❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment:
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)?
0
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
0
❑
❑
❑
Is the chain -of -custody complete?
0
❑
❑
❑
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 operatc
❑
❑
0
❑
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?
M
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
0
❑
Comment:
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 0 ❑ ❑ ❑
Page# 3

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
Permit: NC0000019 Owner -Facility: United Chemi-Con
Inspection Date: 08/21/2018 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:
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
❑
0
❑
❑
Is flow meter calibrated annually?
❑
❑
0
❑
Is the flow meter operational?
0
❑
❑
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
❑
Comment: Measuring scale next to parshall flume to measure flow for outfall 006
Stevens Model 61 R meter for outfall 001
Bar Screens
Yes
No
NA
NE
Type of bar screen
a.Manual
b.Mechanical
❑
Are the bars adequately screening debris?
0
❑
❑
❑
Is the screen free of excessive debris?
0
❑
❑
❑
Is disposal of screening in compliance?
0
❑
❑
❑
Is the unit in good condition?
0
❑
❑
❑
Comment:
Sand Filters (Low rate)
Yes
No
NA
NE
(If pumps are used) Is an audible and visible alarm Present and operational?
❑
❑
❑
Is the distribution box level and watertight?
0
❑
❑
❑
Is sand filter free of ponding?
0
❑
❑
❑
Is the sand filter effluent re -circulated at a valid ratio?
❑
❑
0
❑
# Is the sand filter surface free of algae or excessive vegetation?
0
❑
❑
❑
# Is the sand filter effluent re -circulated at a valid ratio? (Approximately 3 to 1)
❑
❑
0
❑
Comment: not recirculated, goes straight to effluent pipe 006
Effluent Sampling
Yes
No
NA
NE
Is composite sampling flow proportional?
❑
❑
0
❑
Is sample collected below all treatment units?
0
❑
❑
❑
Page# 4

DocuSign Envelope ID: 3CFA46CO-A58B-4B79-8F23-4DBACOF13A59
Permit: NC0000019 Owner -Facility: United Chemi-Con
Inspection Date: 08/21/2018 Inspection Type: Compliance Evaluation
Effluent Sampling
Yes
No
NA
NE
Is proper volume collected?
0
❑
❑
❑
Is the tubing clean?
0
❑
❑
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
0
❑
❑
❑
Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type
M
❑
❑
❑
representative)?
Comment: outfall 001 has a composite sampler that sampled 300ml every 30 minutes. This is
acceptable due to flow variation related to non -contact cooling water tied to plant production
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: for outfall 001 and 006
Yes
No
NA NE
❑
❑
❑
❑
❑
❑
❑
❑
❑
Page# 5