NC0072664_Regional Office Historical File Pre 2018 (194)

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SOC Priority Project: No
To: Western NPDES Unit
Surface Water Protection Section
Attention: Charles Weaver
Date: October 22, 2008
NPDES STAFF REPORT AND RECOMMENDATIONS
County: Alexander
Permit No.: NCO072664
PART I - GENERAL INFORMATION
Physical Location
Facility and address: Shurtape Technologies, LLC 8510 Highway 90 East
Post Office Box 1530 Stony Point, NC 28678
Hickory, North Carolina 28603
2. Date of investigation: October 21, 2008
3. Report prepared by: Michael Parker, Environmental Engineer II
4. Persons contacted and telephone number: Mark Hawes, [phone], ext. 5428.
5. Directions to site: From the intersection of NC Hwy. 90 and SR 1628 (Hunter Bridge Road)
in eastern Alexander County near the community of Stony Point, travel west on NC Hwy. 90
approximately 0.15 mile. The Shurtape Plant is located on the left side of the Hwy. 90.
6. Discharge point(s), list for all discharge points:
Latitude: 350 51' 36"
Longitude: 810 03' 23"
USGS Quad No.: D14SE USGS Quad Name: Stony Point, NC
7. Receiving stream or affected surface waters: Third Creek
a. Classification: C
b. River Basin and Subbasin No.: Yadkin - Pee Dee 030706
C. Describe receiving stream features and pertinent downstream uses: The discharge
enters a small stream that has a 7Q 10 flow of 0.17 cfs. Stream has moderate gradient
and a sandy bottom. General "C" classification uses downstream..
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of wastewater: 0.010 MGD (Design Capacity)
b. Current permitted capacity: 0.010 MGD

Y .
Page Two
2. Type of treatment (specify whether proposed or existing): Existing treatment consists of a
10,000 gpd extended aeration package plant, which includes a flow meter, an aeration tank,
clarifier, sludge holding tank and. chlorination with a tablet type chlorinator, contact tank,
and a tablet dechlorination unit*. There are no proposed WWT facilities at this time.
*Added since the permit was last renewed.
Treatment plant classification: No change from current rating (Class II).
4. Compliance history: This facility has a very good compliance history.
PART III - OTHER PERTINENT INFORMATION
1. Special monitoring/effluent limit requests: None at this time.
2. Alternative analysis: Municipal sewer is not available to the site nor is there sufficient area
for the construction of a surface or subsurface disposal system.
PART IV - EVALUATION AND RECOMMENDATIONS
The permittee, Shurtape Technologies, LLC, has applied for renewal of the subject Permit.
Changes to the existing WWT facility since the Permit was last issued are noted in Part II, No. 2
above. Additional flow in the form of cooling tower blowdown and air wash wastewater have also
been connected to the WWTP since the permit was last renewed. Both of these waste streams are
chlorinated, however, dechlorination is provided prior to their introduction into the WWTP (see
biocidal data for both of these flows included in the company's renewal application).
The most recent inspection report indicates that the facility is being well maintained and able
to meet existing effluent limits.
It is recommended that the Permit be renewed as requested.
7 .
Signature of Report Preparer Dat
Water Quality Regional Supervisor Date
hAdsr\dsr08\shurtape. doc

a`.
OF WAr
Michael F. Easley, Governor
O�
y William G. Ross Jr., Secretary
> r North Carolina Department of Environment and Natural Resources
Coleen H. Sulli r
V
er i
R E
I'
" October 3, 2008
MARK E HAWES OCT - 6 2008
DIRECTOR OF ENVIRONMENT AND SAFETY
SHURTAPE TECHNOLOGIES LLC
PO BOX 1530
HICKORY NC 28603 M-Surface Wd r Protection
Subject: Receipt of permit renewal application .
NPDES Permit NCO072664
Stony Point Tape Plant
Alexander County
Dear Mr. Hawes:
The NPDES Unit received your permit renewal application on October 2, 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
Mgt eresv�MCR7 onaaFOTRE e/Surface Water Protection
NPDES Unit
Mailing Address Phone [phone] Location P oOe Carolina
1617 Mail Service Center Fax [phone] N. Salisbury St. �tmhallff
Raleigh, NC 27699-1617 Raleigh, NC 27604
Internet: www.ncwateroualitv.ore Customer Service 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer— 50% Recyded/10% Post Consumer Paper

Shurtap'e
29 September 2008
NCDENR/DWQ/Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Attention: Ms. Dina Sprinkle
RE: Renewal Application .
NPDES Permit NCO072664
Shurtape Technologies, LLC
Stony Point Tape Plant
Alexander County
Dear Ms. Sprinkle:
RECEIVED
OCT - 2 2008
DENR - WATER QUALITY
POINT SOURCE BRANCH
Enclosed, please find the completed renewal application for the referenced discharge
permit. The following information is also provided, as required:
• Documentation of changes since last permit was issued.
o Since the last permit was issued, a dechlorination system was installed, as
required. The dechlorination system consists of a simple tablet
dechlorinator. The dechlorination system was permitted under the "fast
track" program and required documentation was submitted. Good
performance of the dechlorination system is documented by continual
compliance as reported in DMRs.
o Also since the last permit was issued, the water discharged from the
facility's cooling tower and air wash systems has been routed to the
wastewater treatment plant. Because chlorine tablets are used in these
systems, the water is dechlorinated prior to discharge to the wastewater
treatment system. Total wastewater flow is still well below the permitted
10,000 gallons per day, and continued compliance has been demonstrated
as reported in the DMRs.
Sludge Management Plan.
HOLD STRONG.
o The referenced wastewater treatment plant is relatively small; sl
generation is minimal. When needed, -sludge is pumped out by contract
Shurtape Technologies, LLC PO Box 1530 Hickory, NC 28603 www.shurtape.com

4
haulers who deliver the sludge to appropriate wastewater facilities.
During 2007, there were only three such shipments, totaling
approximately 8,000 gallons.
Renewal of the referenced discharge permit is hereby requested. Please contact me at-
[phone], or via email at mhawesOshurtape.com if you have any questions.
Sincerely,
Mark E. Hawes
Director of Environment and Safety
Encl
cc: David Neff
Jerry Eplin
Travis Brannon

s
NPDES PERMIT APPLICATION — SHORTFORM 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 INCO072664
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. 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
Shurtape Technologies, LLC.
Shurtape Technologies, LLC - Stony Point Tape Plant
P.O. Box 1530
Hickory
NC 28603
[phone] ext. 5428
[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
8510 Highway 90 East
Stony Point
NC 28678
Alexander
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 Shurtape Technologies, LLC.
Mailing Address P.O. Box 1530
City Hickory
State / Zip Code North Carolina,, 28603
Telephone Number [phone] ext. 5428
Fax Number [phone]
Page 1 of 4 C-MI 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
4. Ownership Status:
Federal ❑ State ❑ Private ® Public ❑
5. Standard Industrial Classification (SIC) code(s): 2672 (NAICS 322222)
6. Number of employees: 155
7. Describe the treatment system List all installed waste treatment components with capacities,
describe the processes that generate wastewaters. If the space provided is not sufficient attach a
separate sheet of paper with the system description.
Wastewater is primarily domestic wastewater from the facility restrooms. A small amount of
additional flow results 'from the discharge of non -contact water from the. facility's cooling
towers and air wash stations.
Treatment is a package activated sludge treatment plant with the following units: Aeration
tank, Clarifier, Sludge holding tank, Tablet chlorinator, Chlorine contact tank, and tablet
dechlorination unit.
The capacity of the facility is 0.010 MGD.
S. Is -facility covered under federal effluent limitation guidelines? No ® Yes ❑
If yes, specify the category?
9. Principal product(s) produced: Duct Tape
Principal raw material(s) consumed: LDPE Resin and Natural Rubber
Briefly describe the manufacturing process(es):
Adhesive "duct" tape is manufactured by applying a release coat and a rubber -based 'adhesive to a poly
and/or cloth substrate. with subsequent slitting and packaging activities.
'10. Amount of principal product produced or raw material consumed
fList snecific amounts rnn_c7imerl nnrl/nr units of nrnrlurfinn m)or fho In-cf fhroo 7ionrc)
Product Produced or Raw Material-
Product. Produced or Raw Material
Consumed
Consumed
AVERAGE
PEAK
per Day
Not Applicable. No Process Water
Not Applicable. No Process Water
Discharge.
Discharge.
Fier Month
Not Applicable. No Process Water
Not Applicable. No Process Water
Discharge.
Discharge.
per Year
Not Applicable. No Process Water
Not Applicable. No Process Water
Discharge..
Discharge.
Page 2 of 4 C-MI 03/05

NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
11. Frequency of discharge: Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs:_ up to 7 Duration: Up to 24 hrs/day
12. Types -of wastewater discharged to surface waters only
Discharge
Flow
GALLONS PER DAY
Sanitary - monthly average
2,000 (all flows are approximated)
Utility water, etc. - monthly average
1,100
Process water - monthly average
0 GPD
Stormwater - monthly average
0 GPD
Other - monthly average
Explain:
Monthly Average
total discharge (all types)
F3,10
13. Number of separate discharge points: 1
Outfan Identification number(s) 001
14. Name of receiving stream(s) (Provide a map shouring the exact location of each outfall, including
latitude and longitude):
Third Creek in the Yadkin -Pee Dee River Basin See attached map
15. Effluent Data
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.
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
14.4
<4.3
mg/L
Chemical Oxygen Demand (COD)
Not in current
Permit
Not in current
Permit
Not in current
Permit
Total Organic Carbon
Not in current
permit
Not in current
Permit
Not in current
Permit
Total Suspended Solids
18.0
<5.9
mg/ L
Ammonia as N
4.95
< 1.1 '
mg/ L
Temperature (Summer)
26.8
24.6
Degrees C
Temperature (Winter)
10.3 (MIN)
13.0
Degrees C
pH
7.8
7.0
SU
Page 3 of 4 C-MI 03/05

` NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
Fecal Coliform (If sanitary waste is
135
< 14.4
Colonies / 100 mL
present)
Total Residual Chlorine (if chlorine is
<50
<50
ug/L
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 Permit Number Type Permit Number
No "permit", but EPA
Hazardous Waste (RCRA) ID# NCD986166031 NESHAPS (CAA)
UIC (SDWA) None Ocean Dumping (MPRSA)
NCG500000„ Dredge or fill (Section 404 or
NPDES NCG050000` CWA)
PSD (CAA) None Other
Non -attainment program None
NC Air Permit #
0646T08
None
None
17. List any chemicals that may be discharged (Please list and explain source and potential
amounts.)
BOD, TSS, Ammonia Nitrogen, Fecal Coliform, Phosphorus — from typical sanitary sources (see herein for amounts)
Sodium Tolytriazole, phosphonic acid pentasodium, sodium polyacrylate — AWC 487 and 488 used for corrosion prevention in
Cooling tower and air, wash systems. These were previously discharged under NCG500000 and biocide 100 forms were submitted
For these chemicals. A copy of the biocide 100 form is attached.
Tetrapotassium etidronate, sodium glucoheptonate, sodium polyacrylate - AWC 331 used for solids removal in the cooling tower.
And air wash systems. These were previously discharged under NCG500000 and biocide 100 forms were submitted
For -these chemicals. A copy of the biocide 100 form is attached.
2,2-dibromo-3-nitrilopropionamide.— Sump Buddy used as a biocide I algaecide in the cooling tower and air wash systems.
These were previously discharged under NCG500000 and biocide 100 forms were submitted
For these chemicals. A copy of the biocide 100' form is attached.
Di and Tri-chloroisocyanuric Acid — Chlorinating Tablets, used as a biocide / algaecide in the cooling tower and air wash systems.
This chemical was not used when discharging under NCG500000. Chemical dissolves in water to form hypochlorous acid (HOCL)
and cyan uric acid. Only approximately 1 pound of tablets per day, worst case, are utilized. Flow is dechlorinated using sodium
sulfite tablets prior to entry into the wastewater treatment system.
Calcium hypochlorite — Chlorinating Tablets used to chlorinate the wastewater.
Sodium sulfite — Dechlorinating Tablets used to dechlorinate the wastewater, after chlorine contact. Also used to dechlorinate the
discharge from.cooling tower and air wash systems prior to entry into the wastewater treatment system.
18. Is this facility located on Indian country? (check one)
Yes ❑ No
Page 4 of 4 C-M 103/05

NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
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.
David Neff Plant Manager "
Printed name of Person Signing Title
ignature of App t Da e
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 5 of 4 C-MI 03/05

;*U'SUS Stony Point, North Carolina, United States 01 Jul 1998
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FIGURE NUMBER: 1 SITE LOCATION MAP
Shurtape Technologies, LLG
QUAD: 1970 Stony Point, NC Stony Point Plant #3 1L
PROJECT NUMBER: 8510 NC Highway 90 East
SCALE: As Shown Stony Point, North Carolina
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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.,
I. Facility Name Shurtape Technologies LLC — Stony Point Plant
NPDES # NC 6500323 Outfall #001
County ALEXANDER
Receiving Stream THIRD CREEK 7Q10 0.96 ,•:(cfs) OBTAINED FROM.USGS
(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. = 0.00114 (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 (0.00114)X100 = 0.165 %
IWC = (7910)(0.646) + (A.D.D) (0.96)(0.646)+(0.00114)
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?
SUMP BUDDY WT
Please list the active ingredients and percent composition:
2 2-DIBROMO-3-NITRILOPROPIONAMIDE 40 %
INACTIVE INGREDIENTS' 60%
210
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.= 908 grams/24hr period NOTE: AVERAGE DOSING RATE IS MUCH LESS. HOWEVER, USED A
HIGHER/MORE CONSERVATIVE NUMBER TO ACCOUNT FOR POSSIBLE UNEQUAL DISSOLUTION.
Please note, fluid ounces (a volume) must be converted to grams (a mass). The formula for this conversion is:
Grams of product = fluid oz. of product X 1 gal. water X 8.34 lbs. X specific gravity of product X 453.59g.
128 fl. oz. 1 gal. water 1 lb.

Facility Name: Shurtape Technologies LLC - STONY POINT PLANT . NPDES #: NCG500323
Estimate total volume of the water handlingsystem 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= 0.0154 million gallons
What is the pH of the handling system prior to biocide addition? If unknown, enter N/A. Average pH .-8.0
What is the decay rate (D.K.) of the product? If unknown, assume no decay (D.K.=O) and proceed to asterisk.
The degradation must b6 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. = 0.417 Days SOURCES ATTACHED.
The decay rate is equal to H1L X 0.69 = 1.655 =Decay Rate (D.K.)
Calculate degradation factor (D.F.). This is the first order loss coefficient.
_ A.D.D. _
D.F. - (Volume) + (D.K.) -
(0.00114) + (1.655) = 1.73
(0.0154)
Calculate Steady State Discharge Concentration:
(
908)
Dischg Conc..- (D.F.)(Vollume)(3785) _ (1.73)(0.0154)(3785) = 9.0 mg/I
Calculate concentration of biocide instream during low flow conditions.
(Receiving Stream Concentration)
(Dischg. Conc.) x (IWC%). _ (9.0)x(0.185) 0.017 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/I). Please provide copies of the sources of this data.
Organism
RAINBOW TROUT
FATHEAD MINNOW
DAPHNIDS
Test Duration
96-HR
96-HR
48-HR
LC50/EC50 (mg/1)
1_0
1.36
1.24
D. W. Q. Form 101(612000) 2

acilin� f Eerrjr.• j1Z� . I N,'5 T PLkN"r F,aP0 S :..f+�tw� raS"- -� '
Choose -the lowest LC50/EC50 listed above:
Enter the LC50/EC50: 1.0 MG/L
If the half life (H.L.) is less than 4 days, perform the following calculation.
Regulated Limitation = 0.05 x LC50 = 0.05 mg/I
If the half life (H.L.) is greater than or equal to 4 days or unknown, perform the following calculation.
Regulated Limitation = 0.01 x LC50 = mg/I
Choose the appropriate regulated limitation, from the calculations immediately above and place in this blank:
0.06 mg/liter
From Part II enter the receiving stream concentration:
0.017 rrig/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
Name (Print)
i nature Date
Person Completing This Worksheet (If different from above)
Name (Print)
6A- 1 - 9-- 4l- 07
Signatu a Date.
Please submit to: Division of Wafer Quality
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
Attn: Todd Christenson
D.W.Q. Forrn 101 (612000) 3

Facility Flame: Shurtape Technologies. LLC — STONY POINT PLANT NPDES 0: NCG500323
Supplemental Metals Analysis
If copper, zinc, or chromium are present in the proposed biocidal compound, complete. this worksheet. A separate form
must be used for each metal and/or metal compound ,present in the biocide. List the metal, its chemical formula, molecular
weight (MW), formula weight (FW), and the concentration of the metal compound in the biocide (MCC). Complete a
separate form for every metal present in the biocide. NO METALS ARE KNOWN, OR BELIEVED, TO BE IN THIS
CHEMICAL. FORM IS NOT APPLICABLE. .
Metal Chemical Formula Molecular Weight of Metal Formula Weight Concentration in Biocide
EXAMPLE
Copper CuSO4 5H2O 63.546 g/mole 249.680 g/mole 0.2
Dosage rate of Biocide (DR) (from page 1):
DR = crams/day
Average Daily Discharge (ADD) (from page 1):
ADD = million gallons/day
Discharge Concentration (DC) of Biocide:
DR ( grams/day)
DC = ADD = ( million gallons/day) = grams/million gallons
Convert DC to micrograms/liter (ppb):
DC (Ng/1). = DC (grams/million gal) x 1 x 106 hg/g = ug11
3.785 x 106 liters/million gal.
Calculate the fraction of metal in the metal -containing compound (MF):
MW ( grams/mole)
MF = FW = ( grams/mole) _
Calculate the fraction of metal in the biocidal compound (BF):
BF=MFxMCC N = x % _
100 (100)
Calculate the concentration of metal in the discharge (M):
M = DC x BF = Ng/I x = Pg/I
Calculate the instream metal concentration (IMC) at low -flow conditions:
IMC M x IW- 0 . _ ug/I x 100 % = Ng/I
Regulated limitation of metal (from below): ug/l
NC General Statutes 15A NCAC 213.0211 define:
Copper- 7 Ng/I water quality action level* Zinc- 50 pg/I water quality action level*
Chromium- 50 pg/l water quality standard
(*Values which exceed action levels must be addressed directly by aquatic toxicity testing.)
D.W.Q. Form 101(612000) 4

Cy 0
MaterW Safety Data Sheet
1. CHEMICAL PRODUCT & COMPANY IDENTIFICATION
24-Hour Emergency Phone Number: 989-636�4400
Product: SUMP BUDDY* WT
Product Code: 63619
Effective Date: 04/11/03 Date Printed: 05/07/03
The Dow Chemical Company, Midland, MI.48674
Customer Information Center: 800=258-2436
2. COMPOSITION/INFORMATION ON INGREDIENTS
Active ingredient:
2,2-Dibromo-3-nitrilopropionamide
Inert ingredients:`
Hydroxypropyl
methylcellulose
Lactose
Stearic acid
3. HAZARDS IDENTIFICATION
The Dour Chemical Company
Midland, Michigan 48674
CAS# 010222-01-2
CAS# 009004-65-3
CAS# 000063-42-3
CAS# 000057-11-4
Page: 1
MSD: 002968
40%
Go%
EMERGENCY OVERVIEW
• Off-white solid. Mild, disinfectant odor. Causes severe eye burns.
• Avoid temperatures above 158F, 70C. Highly toxic to fish and/or,
• aquatic organisms. May cause allergic skin reaction.
�•:Y�t4e:E�; � �;c::�i:'::c9c�F��:t�c�t9ejcic�Y4; �i�t�t�Y�tiik3rk�:k��:Yic� k�Ct�F�Y:'c9c�Y�k9cfe�t�t�cic�'r:'c�C�t9n'n'c�:c�ic:c:2:t:c:c
POTENTIAL'HEALTH EFFECTS (See Section 11 for toxicological data.)
EYE: May cause severe irritation with corneal in which may
result in permanent impairment of vision, even blindness.
Chemical burns may occur..
SKIN: Prolonged or repeated exposure may cause skin irritation,
even a burn. Skin contact may cause"an allergic skin reaction.
Prolonged skin contact is unlikely to result in absorption of
harmful amounts. "
INGESTION: Moderate toxicity if swallowed. Small amounts
swallowed incidental" to normal handling operations are not
(Continued on page 2 , over)
* OR" (R) INDICATES A TRADEMARK OF THE DOW CHEMICAL COMPANY

NATE11IAL SAFETY 0A-rA SHEET PAGES 2
Product: SUMP BUDDY* WT
Product Code: 63619
Effective Date: 04/11/03 Date Printed: 05/07/03 MSO: 002968
------------------------------------------------------------------------
likely to cause injury; however, swallowing larger amounts may
cause serious injury, even death.
INHALATION: Oust may cause irritation to upper respiratory tract
(nose and throat). Exposure to dust from the tablets is however
unlikely.
SYSTEMIC (OTHER TARGET ORGAN) EFFECTS: 'Excessive exposure may
increase the blood and tissue levels of bromine. Observations
in animals include kidney effects following repeated ingestion
of active ingredient, but no evidence of systemic toxicity
following repeated dermal exposure at maximum attainable doses.
For the minor component(s): In humans. symptoms may include
decreased blood clotting time.
CANCER.INFORMATION: No relevant information found.
TERATOLOGY (BIRTH DEFECTS) : For the active-ingredient(s) . Did
not cause birth defects in laboratory animals. Has been toxic
to the fetus in lab animals at doses toxic to the mother.
REPRODUCTIVE EFFECTS: Contains component(s). which died not
interfere with reproduction in animal studies. The component(s)
is/are DBNPA.
4. FIRST AID
EYE: Wash immediately and continuously with flowing water for at
least 30 minutes. Remove contact lenses after the first 5
minutes'and continue washing. Obtain.prompt medical
consultation. preferably from an ophthalmologist.
SKIN: Remove material from skin immediately by washing with soap
and plenty of water. Remove contaminated clothing and shoes
while washing.' Seek medical attenti.on if irritation persists.
Wash clothing before reuse. Discard items which cannot be
decontaminated, including leather articles such as shoes, belts,
and watchbands.
INGESTION: Call a poison control center or doctor immediately
for treatment advice. Have person sip a glass of water if able
to swallow. Do not induce vomiting unless told to do so by the
poison control center or doctor. Never give anything by mouth
to an unconscious person.
INHALATION: Move person to fresh air; if effects occur, consult a
(Continued on page 3)
OR .(R) INDICATES A TRADEMARK OF,THE DOW CHEMICAL COMPANY

ATERIAL SACEJY 0A'rA SHEET PAGE:3
Product: SUMP BUDDY* WT .. ,
Product Code: 63619
Effective Date: 04/11/03 Date Printed: 05/07/03 MSD: 002968
physician.
NOTE.TO PHYSICIAN: If burn is present, treat as any thermal burn,
after decontamination. No specific antidote. .Treatment of
exposure should be directed at the control .of symptoms and the
clinical condition of the patient.
5. FIRE FIGHTING MEASURES
FLAMMABLE PROPERTIES
FLASH POINT:' Not.applicable.
METHOD USED: Not applicable.
AUTOIGNITION TEMPERATURE: Not applicable.
FLAMMABILITY LIMITS
LFL: Not app.licable.
UFL: Not'app)icable.
HAZARDOUS COMBUSTION PRODUCTS: Under fire conditions some
components of this product may decompose. The smoke may
contain unidentified toxic and/or irritating compounds.
EXTINGUISHING MEDIA: This material does not burn. If exposed
to fire -from another source, use suitable extinguishing
agent for that fire.'
FIRE FIGHTING INSTRUCTIONS: This material.does.not-burn. Fight
fire for other material that is burning.
PROTECTIVE EQUIPMENT FOR FIRE FIGHTERS: Wear posi.tive-pressure
self-contained breathing apparatus (SCBA) and protective fire
fighting clothing (includes fire fighting helmet, coat, pants,
boots, and gloves).
6. ACCIDENTAL.RELEASE MEASURES (See Section 15 for Regulatory
Information)
PROTECT PEOPLE: Use.appropriate safety equipment. For additional
information, refer to "Exposure Controls/Personal Protection",
MSDS Section 8.- Avoid any contact.
PROTECT THE ENVIRONMENT: Contain material to prevent
contamination of soil, surface water or ground water.
CLEANUP: Sweep up. Collect material in suitable and properly
labeled open containers'. Contact the Dow Chemical Company
(Continued on page.4 , over)
* OR (R) INDICATES A TRADEMARK OF THE DOW CHEMICAL COMPANY

MA'CERIA.L.- SAf= E T Y U.ATA SHEE"r FACE.' 4
Product: SUMP BUDDY* HT
Product Code: 63619
Effective Date: 04/11/03 Date Printed: 05/07/03 MSO: 002968
------------------------------------------------------- -----------------
at 989-636-4400.
7. HANDLING AND STORAGE
HANDLING: Avoid.contact with dusts from head space of containers.
Refer to,"Exposure Controls/Personal Protection", Section 8,
of the MSDS.
STORAGE: Store below 95F/35C. Storage must only,be in original
container. Keep container tightly closed when not -in use.
a. EXPOSURE CONTROLS/PERSONAL PROTECTION.
ENGINEERING CONTROLS: Provide general and/or local exhaust
ventilation to control airborne levels below the exposure
guidelines.
PERSONAL PROTECTIVE EQUIPMENT
EYE/FACE PROTECTION: Use chemical goggles. Eye wash fountain
should be located in immediate work area.
SKIN PROTECTION: When prolonged or frequently repeated contact
could occur,,use chemically protective clothing resistant to
this material. Selection of specific items such as
faceshield,,gloves, boots, apron, or full -body suit will
depend on operation. Remove contaminated clothing
.immediately, wash skin area with soap and water, and launder
clothing before reuse -or dispose of properly. Items which
cannot be. decontaminated, -such as shoes, belts and watch-
bands,' should be removed and disposed of properly.
RESPIRATORY PROTECTION: Atmospheric levels should be maintained
below the exposure guideline. When respiratory protection is
required for certain operations, use an approved air -purifying
respirator. 'In dusty or misty atmospheres, use an approved
particulate respirator.
EXPOSURE GUIDELINES:
Dibromonitrilopropionamide': Dow IHG' is 2 mg/m3.Ceiling.
Stearic,acid: Dow IHG is 10 mg/m3.
Methocel: Dow IHG for cellulose ethers is 10 mg/m3.
9. PHYSICAL AND CHEMICAL PROPERTIES
APPEARANCE/PHYSICAL STATE: Off-white solid.
(Continued on page 5)
;t OR (R) INDICATES A TRADEMARK OF THE DOW CHEMICAL COMPANY

MATERIAL SAFETY DA'rA SHEET PAGE:5
Product: SUMP BUDDY* NT
" Product Code: 63619
Effective Date: 04/11/03 Date Printed: 05/07/03 MSD: 002968
------------------------ ----------------------------------------------
ODOR: Mild, disinfectant odor.
VAPOR PRESSURE: 4x 10 (-5) mmHg @ .25C
VAPOR DENSITY: <1
BOILING POINT: Not applicable.
SOLUBILITY IN WATER/MISCIBILITY: Slowly soluble in more than
10 times its own volume.
SPECIFIC GRAVITY OR DENSITY: 1.3-1.4 g/cc
10. STABILITY AND REACTIVITY
CHEMICAL STABILITY: Stable under recommended storage conditions.
See storage section.
CONDITIONS TO AVOID: Avoid temperatures above 158F/70C.
INCOMPATIBILITY WITH OTHER MATERIALS: Avoid contact with strong
bases.
HAZARDOUS DECOMPOSITION PRODUCTS: Gases are released during
decomposition. Hazardous decomposition products may include
and are not limited to bromine (Br2), cyanogen bromide, dibro
moacetonitrile, carbon dioxide.
HAZARDOUS POLYMERIZATION: Will not occur.
11. TOXICOLOGICAL -INFORMATION (See Section 3 for Potential Health
Effects.,For. detailed toxicological data, write or call the
address or non -emergency number shown in Section 1)
SKIN: The LD50 for skin absorption in rabbits is >2000 mg/kg.
INGESTION: The. oral L050 for rats is 224 mg/kg.
MUTAGENICITYz In vitro mutagenicity studies were negative.
(active ingredient, DBNPA). No relevant information found.
(other -ingredients).
12. ECOLOGICAL INFORMATION, (For detailed Ecological data, write -or call
the address or non-emergency.number shown in Section 1)
ENVIRONMENTAL FATE:
MOVEMENT & PARTITIONING: Based on; information for stearic acid.
Bioconcentration potential is low (BCF less than 100,or Log
Pow greater than 7). Based on information for remaining
comobnents.- Bioconcentration potential is low (BCF less than
(Continued on page 6 ., over
* OR (R) INDICATES A TRADEMARK OF THE DOW CHEMICAL COMPANY.

MATERIAL SAI-E T R 0A i A SitCE T PAGE :6
Product: SUMP BUDDY* U
Product Code: 63619
Effective Dateo'04/11/03 Date Printed: 05/01/03._ MSD: 002968
------------------------------------------------------------------------
100 or Log Pow less than 3).
DEGRADATION 6 PERSISTENCE: Based on information for DBNPA.
Chemical degradation (hydrolysis) .is expected in the environ-
ment within minutes to hours. Degradation is expected in the
soil environment within minutes to hours. Based on informa-
tion for stearic acid and methylcellulose. Biodegradation
may occur under aerobic conditions (in the presence of
oxygen) .
ECOTOXICITY: Based on information for DBNPA. Material is highly
toxic to aquatic organisms on an acute basis (LC50 or EC50
between 0.1 and 1 mg/L in the most sensitive species. tested).
Material is practically non -toxic -to birds on a dietary basis
(LC50 greater than 5000 ppm). Based largely or completely on
information for stearic acid.. Material is practically non -toxic
to fish on an acute basis (LC50 >100 mg/L.) Based largely or
completely on information for methylcellulose. Not expected to
be acutely toxic to aquatic organisms.
13. DISPOSAL CONSIDERATIONS (See Section 15 ffor Regulatory Infformation)
DISPOSAL: DO NOT DUMP INTO ANY SEWERS, ON THE 'GROUND, OR INTO ANY
BODY OF WATER. All disposal methods must be in compliance with
all Federal, State/Provincial. and local laws and regulations.
Regulations.may vary in different locations. Waste characteriz-
ations and compliance with applicable laws are the responsi-
bility solely'of the waste generator. THE DOW CHEMICAL COMPANY
HAS NO CONTROL OVER THE MANAGEMENT PRACTICES OR MANUFACTURING
PROCESSES OF PARTIES HANDLING OR USING THIS MATERIAL. THE
INFORMATION PRESENTED HERE PERTAINS ONLY TO THE PRODUCT AS
SHIPPED IN ITS INTENDED CONDITION AS DESCRIBED IN MSDS• SECTION
2 (Composition/Information On Ingredients)..
FOR UNUSED & UNCONTAMINATED"PRODUCT,*the preferred option is to
contact your State Pesticide or Environmental Control Agency,
or the Hazardous Waste representative at the nearest EPA
Regional Office for guidance. The preferred option in other
jurisdictions is to contact the regulatory authority for this
product for guidance.
As a service to its customers, Dow can provide names of
information resources to help identify waste management
companies and other facilities which recycle, reprocess.or
manage chemicals or plastics, and that manage used.drums.
Telephone Dow's Customer Information Center at
(Continued on page 7)
* OR (R) INDICATES A TRADEMARK OF THE DOW CHEMICAL COMPANY

MATERIAL SAFETY D A *r A SHEET P. AG' E.: 7
'Product::SUNP MOP WT
Product Code: 63619..
.Effective Dates 04/11/03 Date Printed: 05/07/03 MSD: 002968
---------------------------------------------------------------- --------
800-258-24,36 or 989"832� 1556 f or further details.
14. TRANSPORT INFORMATION
DEPARTMENT OF TRANSPORTATION - (D.O.T.)': For D.O.T.. regulatory
information, -if.' requjred, consult transportation regulations,
product shipping papers or contact your.Dow representative.'
15. REGULATORY INFORMATION (Not meant to -be all-in'clus'ive--sele6ted
regulations represented)
NOTICE: The information herein is presented in good faith and
believed to be accurate as of the effective date shown above. However,
no warranty, express or implied is given. Regulatory'requirements
a , re subject to change and may differ from one location to another;'
it is'the buyer's responsibility to ensure that its activities comply
with federal, state or provincial, and local laws- The following
specific information is made for the purpose of complying with
numerous federaI4 state or provincial, and Iota) laws and regulations.
See other sections for health and safety information.
U.S. REGULATIONS
SARA' 313 INFORMATION: This product contains the
he foll,owing-substances
subject to the, reporting requirements of Section '313 of Title III of
the Superfund Amendments and Reauthorization Act of 1986 and 40 CFR-1
Part, ',372:
CHEMICAL NAME CAS NUMBER CONCENTRATION
------------------------- 77 ---------------------7--------- ; ----------------
DIBROMONITRILOPROPIONAAIDE 0102221-01-2 40 %
SARA HAZARD CATEGORY: This product has been reviewed according to the
EPA "Hazard Categories" promul gated under , Sect i ons 311' and 312 of the
Superfund Amendment, and Reauthorization Act of 1986 (SARA Title IAA) and
is considered, under applic'able'definitions, to meet. the following
.categories:
6at eg or i es:
An ' immediate health hazard
A'delayed health hazard
--------------------
-,STATE, RIGHT -TO -KNOW: This product 1 s not known to contain any
(Continued on'page 8 over)
'OR (R) INDICATES A TRADEMARK OF THE DOW CHEMICAL COMPANY

S A F E 'F Y D A T. A , H E .E T PAGE: 8
Product: SUMP BUDDY* WT
Product Code: 63619
EffectiveDate:
/
04 11 Date Printed: 05/07/03 MSD: 002968
------------------------------ ---------------------------
REGULATORY INFORMATION (CONTINUED)
substances subject to the disclosure requirements of
New Jersey
Pennsylvania
OSHA HAZARD COMMUNICATION STANDARD:
This product is a "Hazardous Chemical" as defined by the OSHA Hazard
Communication Standard, 29 CFR 1910.1200.
COMPREHENSIVE ENVIRONMENTAL RESPONSE COMPENSATION AND LIABILITY ACT
(CERCLA, or SUPERFUND) :
To the best of our knowledge, this product contains no'chemical subject
to reporting under CERCLA.
16. OTHER INFORMATION
EPA Registration Number 464-624
REVISION INDICATOR: Revised Sections 3, 4 and 8.
OR (R) INDICATES A TRADEMARK OF THE DOW CHEMICAL COMPANY
The Information Herein Is Given In Good Faith, But No Warranty,
Express Or Implied, Is Made. Consult The Dow Chemical Company
For Further Information.

•',.' 2,
Ga Ca s=
'Aft values hared on active
D13NPA
'18k curVidence interval
'Perct:ntage ujah,rnr,nall}•
de►oloped lary a (trot
mw�trlih•1
Table 20 provides information about the
toxicity of DOW DRKPA to aquatic, marine,
and avian wildlife.
'gable 20 —Evaluation of H=rds of
2a-dlbroma 3-
nitrilopropionamide (DBNPA)
to Wildlife
Aquatic Life
Blucgill sunfish, %hour LCA 4.3' (l.0-L6)= mg/I
Rainbow trout. 96bour LC„ 1.0 (0.6-1.5) mg/1
Fathead minnow, 9Cthour LCm 1.36 (1.24-1.48) mg/l
Daphrrids, 48-hour LC, 1.24 (I A6.1.941 mg/1
Largemouth bass fingerlinys,
96rhour LCm 1.63 (154.1.731 mg/i
Marine Life
YO?-U t, hward f li
Based on'the several degradation path.
v<,aysof DBN'f'Aanditsintermediatscdegrafates,
the proper uSe`of DUNPA in industrial water
systems results only in traces of the compound
in discharge water. Chemical and biological
decomposition, and dilution of'thd effluent
water, result in rapid disappea ranee of these
traces. Therefore, DBNPA does not present a
serious fish taxigity hazard when used properly.
However, all discharges of DENPA into lakes,
streams, ponds, or public waters must be in
aceordancevvith&NadonallbiOntantDischa.rge
Elimination system (NPDES) permit The cur~
renidataindicate thutDBNPA has the potential
for localized fish kill only if a large amount
of biocide is discharged into a lakee or river.
For further guidance, contact your local RPA
regional office.
Fistero oystci' (larvae),
4"our'LCm
Addlcr crab, 9irhour LC,a
14 (5.3-361 tno
Pink shrimp, 96•hour LCM
>14 C.'13 mg/I
Glass shrimp, 96•hour LC..
11.518.69-15.nI mg,/1
AsMe clam, 9friiour LCA
ESQ tng/I
Brackish watet clam.
24-hour Lem
20 mg/1
Shcgnhcad ntinnow,
96-hour LCN
1.41 1.0-2.01 mgtl
Avian We
Mallard duck, oral LDm
Male
3(15 mg/kg
Femalc
216 mg/ks
cab White quail, oral LDS
.Malts
165 mg/k; .
Female
15t) nig/kg
33

ADE Ake TITY. diblo! kysl o (4 Dw MIN TIA
9 .10
Source: HOUGHTON C]HEAECAL.COM

RIve1L tt i_dallin.ig v7att.4: r
f:�'1!}1 ing tol wens
)rCS .ivs7'tt
�-�C�UG�iti fi%� C t�11='niCf1L
13A7 6, iv�L.L SSE
!v NP-S /) s jtrC /=-LI�CL- .
Recirculating water systems are coin- .
monly contaminated with fungal, and -bacterial
organisms. and occasionally with algae. In
addition, their spores and reproductive cells
are continuously present in the air, so the Uc-
lihood of repeated innoctilatian is extremely
high from a biological standpoint.
With their extremely fast killing action,
DOW Antimicrobials 7287 and 8536 effectively
control entering microorganisms before they
can create problems. Because most microorgan-
isms are killed very soon after`exposure, there
usually isn't time for daughter generations to
develop. Fast kill means first generation kill,
which goes a long way toward preventing adap-
tation to the biocide or defense through secre-
tion of biofUm.
Kill rate outpaces degradation me
- DOW DBNPA typically yields a 99.999
percent kill before it degrades sufficiently to
lose effectiveness. Figure 1 shows the degrada-
tion profile of DOW DBNPA for various tem-
perature and pH combinations.
At neutral pH and normal system oper-
ating temperatures, DOW DBNPA exhibits a
half-life of about -nine hours. As pH increases,
the rate of degradation of DOW DBNPA in -
crams, but virtually complete microbial kill
is achieved well before significant degradation
occurs. As shown in Figure 2. DOW DBNPA
easily achieves 99.999% kill in under three
hours even in alkaline systems.
7;i_O6ijre 6-3 1e-lu'JG t7f 9.r?.�?!ail>Ck; i . ac.
100
Figure 2 - Rate of Microorganism Kill by
2.5 ppm DOW DBNPA in
High pH (8.5) Sy%lem
Ix viable mganismi remaining
100
10
1
.1
.01
.001
23 ppm DBNPA
.11001 0 40 80 12t! 160
Time (minutesl
100 ppm Alkalinity pH = 8.5
311t1 ppm Haninesr :?EMI lnidal CFVhnI
Compatible and s)mergWic Mth
ehlor'ine treatment
DOW Antimicrobial 7287 and DOW
Antimicrobial 8536 provide excellent results
in co -treatment programs with chlorine.
Neither substance reacts with degrades, or
inhibit-, the antimicrobial activity of the other.
In combined treatment programs in
larger systems, DOW DBNPA antimicrobials
help control a broader variety of microorgan-
isms than chlorine treatment alone.

131OCIDE/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.
I. Facility Name Shurtape Technologiesm LLC — Stony Point Plant
NPDES # NC G500323 Outfall #001
r
County ALEXANDER
Receiving Stream THIRD CREEK 7Q10 0.96 (cfs) ,OBTAINED FROM USGS
(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. = 0.0005 (in M.G.D.) NOTE: This chemical used. only in cooling tower.
Please calculate the Instream Waste Concentration (IWC in percent) of this discharge using the data entered
above.
(A.D.D.) X 100 (0.0005)X100 = 0.08
IWC _. (7Q10)(0.646) + (A.D.D) (0.96)(0.646)+(0.0005)
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?
AWC #488
Please list the active ingredients and percent composition:
SODIUM TOLYLTRIAZOLE 10% %
PHOSPHONIC ACID PENTASODIUM 20% %
SODIUM POLYACRYLATE 25% %
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.= 45.4 grams/24hr period NOTE; The most toxic ingredient of AWC #488 is Sodium Tolyltriazole.
The LC 50 for sodium tolytriazole and the dosing rate for sodium tolyltriazole were used herein. LC50
data for the entire product was not available, however the other two ingredients have much higher LC 50's
than the sodium tolyltriazole.
Please note, fluid ounces (a volume) must be converted to grams (a mass). The formula for this conversion is:
Grams of. product = fluid oz. of product X 1 gal. water X 8.34 lbs. X specific gravity of product X 45359g•
128 fl. oz. 1 gal. water . . 1 lb.

Facility Name: Shurtape Technologies LLC — STONY POINT PLANT NPDES #: KICG500323
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= 0.00160 million gallons NOTE. Since this is only used in the, cooling tower, only the cooling
tower volume was utilized.
What is the pH of the handling system prior to, biocide addition? If unknown, enter N/A. Average off —8.0
What is the decay rate (D.K.) of the product? If unknown, assume no decay (D.K.=O) and 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. = unknown Days
The decay rate is equal to H.L.X 0.69 = 0 =Decay Rate (D.K.)
Calculate degradation factor (D.F.). This is the first order loss coefficient.
* D.F. = A.D.D. + (D.K.) _ (0.0005) + (0) = 0.3125
(Volume) (0.0016)
Calculate Steady State Discharge Concentration:
_ (D.R') _ (45.4)
Dischg Conc. = 23.989 mg/I
(D.F.)(Volume)(3785) - (0.3125)(0.0016)(3785)
Calculate concentration of biocide instream during low flow conditions.
(Receiving Stream Concentration)
(Dischg. Conc.) x (IWC%) _ (23.989)x(0.08) . =0.019 mg/l
100 100
Receiving Stream Concentration
III. Calculate regulated limitation.
List all LC50 and E050 data available for the whole product according to the following columns. (Note that units
should be in mg/l). Please provide copies of the sources of this data.
Organism Test Duration, LC50/EC50 (m4/I1
RAINBOW TROUT 96-HR 23.7 (based on TOLYLTRIAZOLE)
B
D.W.Q. Form 101(612000) _ 2

h s F - o'tg ;rye?,;, �;� �_+ I''�[- i NUG4h�'��i32
`s'Mility MEM-19: ShUrta. Technologies. tl C - � L• t a'� � � r -xd'_
Choose the lowest LC50/EC50 listed above.:
Enter the LC50/EC50: 23.7 MG/L
If the half life (H.L.) is less than 4 days, perform the following calculation.
Regulated Limitation = 0.05 x LC50. = mg/I
If the half life (H.L.) is greater than or equal to 4 days or unknown, perform the following calculation.
Regulated Limitation = 0.01 x LC50 = 0.237 mg/I
Choose the appropriate regulated limitation from the calculations immediately above and place in this blank:
0.237 mg/liter
From Part II enter the receiving stream concentration:
0.019 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
vi~
Name (Print)
ture _ ate
Person Completing This Worksheet (If different from above)
�Crry "V L-P�• 1
Name (Print)
CA
i 2y_ 07
Signatu a Date
Please submit to: Division of Water Quality
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
Attn: Todd Christenson
D. W. Q. Form 101 (612000) 3

Facility Dame: Shurtape "rechnoloaies. LLC - S'rONY POIN-r PLAN`r NPDES #: , NCG500323
Suptlemental Metals Analwsis ,
If copper, zinc, or chromium are present in the proposed biocidal compound, complete this worksheet. A separate form
must be used for each metal and/or metal compound present in. the biocide. List the metal, its chemical formula, molecular
weight (MW), formula weight (FW),.and the concentration of the metal compound in the biocide (MCC). Complete a
separate form for every metal present in the biocide. NO METALS ARE KNOWN, OR BELIEVED,'TO BE IN THIS
CHEMICAL. FORM IS NOT APPLICABLE.
Metal Chemical Formula Molecular Weight of Metal Formula Weight Concentration in Biocide
EXAMPLE
Copper CuSO4 5H20 63.546 g/mole 249.680 g/mole -0.2 %.
Dosage rate of Biocide (DR) (from.page 1):
DR =. grams/day
Average Daily Discharge (ADD) (from page 1):
ADD _ million gallons/day.
Discharge Concentration (DC) of Biocide: .
DC = DR _ (' grams/day) _ grams/million gallons'
ADD - ( million gallons/day)
Convert DC to micrograms/liter (ppb):
1 x`.106 u9/g
DC (pg/l) = DC (grams/million gal) x = pg/I
3.785 x 106�liters/million gal.
Calculate the fraction of metal in the metal -containing compound (MF):
MW (, grams/mole)
MF = FW = ( grams/mole) _
Calculate the fraction of metal in the biocidal compound (BF):
MCC % %
BF = MF x 100 = x (100) _
Calculate the concentration of metal in the discharge (M):
M = DCXr BF = pg/I x = . ug/l
Calculate the instream metal concentration (IMC) at low -flow conditions:
IMC. = M x IW100, . = pg/I x 100 % Ng/I
Regulated limitation of metal (from below): pgll
NC General Statutes 15A NCAC 26.0211 define:.
Copper- 7 pgll water quality action level* Zinc-.50 pgll water quality action level*
Chromium- 50 pgll water quality standard
("Values which exceed action levels must be addressed directly by aquatic toxicity testing.)
D.W.Q. Form 101(612000) . 4

i trtTE dAL SAFETY DATA SHEET
ASSOCIATED WATER. CONDITIONERS, INC.
23 GREEN LANE. SUCCASUNNA, NJ. 07876
PHONE: [phone]
PAGE: 1
PRODUCT IDENTIFICATION
NAME: AWC #488
CHEMICAL FAMILY: Mixture
TRADE NAMES AND SYNONYMS: Cooling Tower Inhibitor
FORMULA: N/A
Monson ■■■■■■■■■■■■■■■■•ei■r■r■■■■■■•■■■■■■■■■■■■■■■■■re■■■■■■■er■■■■■r■e■r■
HAZARDOUS COMPONENTS: (This may not be a complete list of components)
Chemical CAS # .
Approx: % . Exposure Criteria
SODIUM POLYACRYLATE 9003-04-7
25%
PHOSPHONIC ACID PENTASODIUM 223543-0
20%
SODIUM TOLYLTRIAZOLE 64665-57-2
10%.,
WATER 7732-18-5.
�r■■■�■■�■■■■e■■■�r�r■■r■■•rrrrr■rr■■r■■■•■■•Lr■■■�■■■■r■■■rrrr■rrrrr■rr�r■■
-PHYSICAL DATA:
BOILING POINT: 212f APPROXIMATE pH: 11.5
SOLUBILITY IN WATER: Complete . % VOLATILE BY VOLUME: N/A
ODOR: NONE MELTING POINT: N/A
FORM: Liquid DENSITY: .10 lbs/g
COLOR: YELLOW FLASH POINT:. N/A
HEALTH HAZARD = 1, FIRE HAZARD = 0. REACTIVITY = 0. SPECIFIC HAZARD = N/A
�■■■■■•■r■r■■■■■r■■■.■r.■■■■r■■■e■■■■•■■■■■■••■■■r■e■rrr■■e■■rr�re■■■■�■■orrre
HAZARDOUS REACTMTY:
STABILITY: Stable
INCOMPATABILITY: ' Acids
DECOMPOSTION: None
HAZARDOUS POLYMERIZATION: Will not occur
■■■■■■■■r■r■■■■r■■■■r■r■■�r'■■r■■■■■r■e■■r■e■■■■rr■rrr■■■■re■■r■■r■■er■■�r■■
FIRE AND EXPLOSION INFORMATION:
FIRE AND EXPLOSION HAZARDS:
This material is non flammable. See HAZARDOUS-DECOMPOSTION above for
possible decomposition products if this material is involved in a fire.
EXTINGUSIHING MEDIA:
N/A
SPECIAL FIRE FIGHTING INSTRUCTIONS:
N/A
HEALTH HAZARD INFORMATION:
Health effects of PHOSPHONIC ACID PENTASODIUM from Mfgr. MSDS
EYES: 3.7 on a scale of 110, slightly irritating
SKIN. ABSORPTION:.3 on a scale of 8.0, practically. non -irritating
INGESTION: 17800mg/kg. Practically non toxic
INHALATION: No information available
PHOSPHONIC ACID PENTASODIUM is not a carcinogen.
Health effects of SODIUM TOLYLTRIAZOLE from Mfgr. MSDS
EYES: Corrosive (Rabbit)
SKIN ABSORPTION: LD50:2g/kg(rabbit) Not a primary skin irritant
INGESTION: LD50: 675mg/kg. (Rat)
INHALATION: LC50: 1.73 mg/I, toxic
SODR MTOLYLTRIAZOLE is not a listed carcinogen.

MATERIAL SAFETY DATA SHEET
ASSOCIATED WATER CONDITIONERS, INC.
23 GREEN LANE. SUCCASUNNA. NJ 07876
PHONE: [phone]
PAGE: 2
PRODUCT: AWC #488
..................•mmmmmmm■...mme'm■fmmmm'mm.mmmmm mmm mmm m a am mam a■ass a ee mm,e.3m
FIRST AID INFORMATION:
-INHALATION:
If inhaled remove to fresh air. If any difficulties encountered contact a
Physician.
SKIN CONTACT:
Flush skin with water. If irritation develops, contact. a physician.
EYE CONTACT:
Flush eyes with water for at least 15, minutes. 1f irritation persists.
Contact a physician.
INGESTION:
If swallowed seek emergency treatment. Contact a physician.
� .. ■ m m ■ .. ■ m m m m m m m m m ■ .. ■ ■ .. m .... ■ m m m m m e .. ■ � ■ ■.• ■ m ■ .. • ■ .. m ...... m ■ m'f ■ ... ■ ... ■ m ■
PROTECTION INFORMATION:
EYE PROTECTION:
Use eye glasses or face shield when handling -this product! in case of
Accidental eye contact.
SKIN PROTECTION:
Wear protective. gloves to minimize skin contact with this product.
RESPIRATORY PROTECTION:
Use appropriate equipment if misting is a problem.
VENTILATION:
Use local exhaust if conditions warrant.
/m■....■..■■...■m■..■mmmmmmmmmmmmmmmmsmm■..■mmmemm•.. ■...emmmm...mm...m...■m
SPILL, LEAK OR RELEASE
Contain and dike any spills. Transfer any excess material to a clean
container. Do not allow incompatible substances to come into contact writh
this material.
AWC #488 component aquatic environmental information:
SODIUM TOLYLTRIAZOLE: 96-hr LC50 ( Rainbow Trout) : 23.7 ppm
WASTE DLSPOSAL INFORMATION:
Dispose of in accordance with ail Local, State and Federal regulations.
AWC #488 contains the following EPA hazardous components. Releases
To the environment of " REPORTABLE QUANTITIES" (RQ) must be reported.
Contact ASSOCIATED WATER CONDITIONERS, INC. for assistance:
SHIPPING INFORMATION:
DOT SHIPPING NAME: INDUSTRIAL PROCESS WATER TREATMENT COMPOUND.
DOT HAZARD CLASS: NOT REGULATED
....................................................................mmm....
STORAGE CONDMONS:
Keep container closed when not in use.

MATERIAL SAFETY DATA SHEET.
ASSO� T A'i`ED WATER �_:®ND I T 10l\IEp�S a INC.
23 green Lane, SUCCasunP Ztr , N.-J.' 1787E
PHONE 1-20 1'-9 7-0-100
PA13E: 1
,RODUCT IDENTIFICATION
NAME.-, AWC . #488
CHEMICAL FAMILY: mixture
TRADE NAMES AND SYNONYMS: cooling tower inhibitor
FORMULA: 6/a
HAZARDOUS COMPONENTS: (This -..,may not be a complete list of components)
Chemical CAS,# - Approx X Exposure.Criteria
SODIUM.POLYACRYLATE 9003-04-7 25%
PHOSPHON I C ACID PENTASOD I' ". 2235-43-0 20
SODIUM TOLYLTRIAZOLE. .` 64665-57-2 5%
:,```
WATER .1 7732-18-5
f•�t••�•�•�•�jt••��•at••x••�•��t•�••�•x,•x••�•�t••gat•�••�•��•aE••x••�a�•x-•���•�•tt•�##•�•tt•�•tt•�•�••�•�•�••�•gat•�•x•a4••�•�•�•��•�•�••rF•it••�:�•tt••x••�#-�t••�•�•�a�•3s•�•�#•�
PHYSICAL DATA:
BOILING POINT: 212 APPROXIMATE pH:. 11.5
SOLUBILITY IN WATER: complete •% VOLATILE BY VOLUME: n/a
ODOR:, none MELTING. POINT: n/a
FORM: liquid DENSITY: 10lbs/gal
COLOR: pale yellow FLASH POINT: n/a
#•k�E�3E•iF••lE��'�•x�•?e•�•jt••1t•�;f••)E•�1E�fr•%•x•�FiF#•lF�F�F#a: •lFit•�•�•u�•.,�.�..�s•�•:�•#••x•.�..�#•?�•#•�r�(••3�••x•a�••?E••1t••1�?E•x•�•74•iE3t--�•'�•�••x••lF••u••Y•�E••tt•����-%•tt•�•tEas•�t•
HAZARDOUS REACTIVITY
STABILITY: stable
INCOMPATABILITY: acids
DECOMPOSITION: none
HAZARDOUS POLYMERIZATION: will.not occur
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FIRE AND -EXPLOSION INFORMATION y
FIRE AND EXPLOSION HAZARDS:
This material is non flammable. See HAZARDOUS DECOMPOSITION above for
possible decomposition products if .this material is involved in a fire.
EXTINGUISHING. MEDIA:
_ n/a -'
SPECIAL FIRE FIGHTING INSTRUCTIONS:
n/a .
•��t•�•�t•�•��t••x••x••�•��•gat••x•�t••at••x•�•�•�•x••�•x••�••x•�•���c•��[••�•�•�•ie••�•�at•ai••x•�•�a%at••x••i��••x••��t•�•�••�•x••x••��t••x••�•��•x•�•�t••�•�•��••�•�•x••�ic••x••x•at•�••�•�
HEALTH HAZARD INFORMATION
Health effects of PHOSPHONIC ACID PENTASODIUM from mfq
EYES: 3.7 ,gin a scale of 110, slightly ir.ritating
SKIN ABSORPTION: .ion a scale of 8.0,practically nonirritating
INGESTION:- 17,800.mg/kg, practically nontoxic
INHALATION: no information ,available
PHOSPHONIC ACID PENTASODIUM is nat.a listed carcinogen.
Health effects of SODIUM TOLYLTRIAZOLE.from Mfgr.MSDS
EYES: Corrosive (Rabbit)
SKIN ABSORPTION: LD50:2g/kg(rabbit)Not a primary skin irritant
INGESTION:• LDSO: 675 mg/kg (Rat)
INHALATION: LC50: 1.73 mg/l, toxic
SODIUM TOLYLTRIAZOLE is not a listed carcinogen.

l" ATEIP: I AL SAFETY D(--ETA . SHEET
ASSOC I Al ED , WATER. OOND I T I ONER'S y INC.
23 Green Laney Succasunnay N.J. 07876
PHONE: 01 Du
RODUCT: AWC #488 PAGE
###3E#######it'####•ids•#####i�##3E###•�3E########•tE•lf•###•t�#•1�###�E##•1E##•�•H-t�3E•k###########•�####
IR,:ST AID INFORMATION
INHALATION:
If inhaled remove to fresh air. I'f any difficulties encountered contact a
physician.
SKIN CONTACT. --
Flush skin with water. if irritation develops, contact.a physician.
EYE CONTACT
Flush eyes with water. far at least 15 minutes. If irr-itatictn persists,
contact a physician.
INGESTION:
,If swallowed seek emergency treatment. Contact a physician.
E•IE####.•if•####•)E#•lf•####,iE##9(-###•3Fat•#df•#iE1E##########aE•iESt•######•k•###iE#•lE•iE#)f••!F####•)t•#•3E�E•##•)f•######,
'ROTECTION.INFORMATION
EYE PROTECTION:
Use eye glasses or face shield when handling this product in case of
.accidental eye contact.
SKIN PROTECTION:
Wear protective .gloves to minimize skin contact with this product.
RESPIRATORY PROTECTION:
Use appra.p.ri.ate equipment if misting isa problem.
VENTILATION:
Use local exhaust i f conditions warrant.
)E.x•.IE dE• •1F 9E• jE• 9F dF •)F •!E iE # dE # •)E �lE dE # •lE• �E # # •lE •iE # 9E # # iF # dF # # •1E •1F # # # # # dE iE # dE # # # �E # •1 E •ri• # # aE 1F # li •x• # # •!F # •1F •1F # # •tE •iF dE •iE # iE # •lE iF •lt• iF;t•
SPILL,•LEAK OR RELEASE
Contain'and dike any spills. Transfer any excess material to a clean
container. Do not allow incompatable substances to come into contact with
this material.
AWC #488 component aquatic environmental.information:
PHOSPHONIC ACID PENTASODIUM: 96-hr L.C50 .(Rainbow Trout): >"330 mg/1
SOD IUM`TOLYLTRIAZOLE: 96=hr LCSD.(Rainbow Trout): 23.7 ppm
�E•�EaE#•iE••�c•aE##�E•x•x•##aE�•�aE###�[•#�E�E*•�##aE•�•x•�#�E##•�##aE�#a��E#�E�E##a�•#�•x•##�E#�•##�###�E�E#�E##x••�#�E##�Ea�
WASTE DISPOSAL INFORAMATION
Dispose of in "accordance with all Local, State and Federal regulations.
Contact .ASSOCIATED -WATER CONDITIONERS, INC. for assistance.
i(�•1ELF•iFiF•!E•xiF•1EdE•x••x•#9FlE�FiE•)EiEIf••lE•)E#dE•)i•#•3f•##•1F•i(••x••iE�F•)E9F•lt•9E#•lE•1F# �F�t•#•K••3EiF•lf•iF•iE9E•x-iFit••lt•#•1Fif•�[•�t•9F�E•x#dF#9E•1F9E#•)E#•1F•1FiE##•lf•
SHIPPING ,INFORMATION
DOT SH.IRPING NAME: INDUSTRIAL PROCESS WATER TREATMENT COMPOUND
DOT HAZARD CLASS: NOT REGULATED
##•IEEE# ^1P iE#•IF�F�E�F •iE•iE •)E•1E•x• 9E• # iE•1F#•iE �E�EiF###•1FiE •it• •1F•x��)EiE •1F•lF •tt• # if•#•x�•)E •lE•x••x�9F�E# •x-# iF# •%•1F•lE •1E•1E•1E# •3E# •lE�E#•iE�E•1F#iE�IEiF•1F•1t•iE #•1F•lE
STORAGE CONDITIONS
Keep.container closets .when not in use. Keep.from freezing.
•gat-�E�E�•���••��E•x••�•�•�E•�a�•��E�E�E#aE�E�E�E•�#�E���E����E�E�E�E�•�aE�•�E��EaE�E#•x��••�#��EiE�E�•�E•�#•�•�#�aE#•��•��E�##a�#�#��E
OTHER INFORMATION
�E•����*•��E•�•��•����E�-•��E�E#•���•�•���E�•�•��•�•�•���E�E#�E•��-•�•��E�E•�•��E��aE•��#�E•�#•���E*�E•���E�E•�•�*#•��E•��E�#���E

MATERIAL SAFETY DATA SHEET
ASSOCIATED WATER CONDITIONERS, I MC .
23 Green Lane, Succasunna, N.J. 07876
PHONE : j "201- 27-0 i 00
EODUCT: AWC #488 PAGE: 3
Information and data herein are believed to be accurate and compiled fr6m..
reliable sources. Buyer assumes all risk of use, storage. and handVinq to
comply with State, Federal and Local regulations. ASSOCIATED WATER
CONDITIONERS, INC. makes no warranty express or implied concerning - the
accuracy -or completeness of .the information supplied.
ATE PRINTED: 11/16/95 DATE PREPARED: 02/07/95 SUPERCEDES: 04/12/94

v; ��fQ• - 4 i I I.
` g -,
EinerrWiing Tech mi lo0qinc.
SECTION I — CHEMICAL PRODUCT AND COMPANY IDENTIHCATION
PRODUCT NAME: Norsocryl® S-35 EFFECTIVE DATE: 16 June 2005
CHEMICAL FAMILY: Polyacrylate salt
CHEMICAL NAME: Sodium polyacrylate
COMPANY IDENTIFICATION:
Emerging Technologies Inc.
1005 Norwalk Street
Greensboro, NC 27407 USA
EMERGENCY TELEPHONE: 24 hours a day, 7 days a week
CHEMTREC 1-800-424-9300 COMPANY CODE: EMTE
SECTION 2 — COMPOSITION / INFORMATION ON INGREDIENTS
INGREDIENT NAME CAS NUMBER Typical % OSHA Hazard
Sodium Polyacrylate 9033-79-8 >99 Y
The substance(s) marked with a"Y" in the OSHA. column are identified as hazardous chemicals according to the
criteria of the OSHA Hazard Communication Standard (29 CFR 1910.1200).
The components of this product are all on the TSCA Inventory list.
SECTION 3 — HAZARDS IDENTIFICATION
Emergency Overview
White Odorless Powder
CAUTION!
MAY CAUSE EYE AND SKIN IRRITATION
MAY FORM EXPLOSIVE DUST -AIR MIXTURES
IMPROPER TRANSFER MAY CAUSE ELECTROSTATIC SPARK
Potential Health Effects
Inhalation and skin contact are expected to be the primary routes of occupational exposure to this material. Based
on its composition, it is anticipated,to be slightly irritation to eyes and skin.. Repeated or prolonged inhalation may
cause cough, shortness of breath, wheezing, and impairment of lung function. Medical conditions that may be
aggravated by exposure to this material include lung disease or limited respiratory capacity.
Effective Date: 06/16/05 Revision: 4 Page 1 of 6 .

MSDS: Norsocryl® S-35 wri ,_. ,
l F.nierl;ing'!'eehnr�IcM�s inc.
SECTION 4 —FIRST AID MEASURES
IF IN EYES: Immediately flush with plenty of.water. Remove particles remaining under the eyelids. Get medical
attention if irritation persists. .
IF ON SKIN, immediately wash with soap and plenty of water. Remove contaminated clothing and shoes. Get
medical attention if symptoms occur. Wash clothing before reuse. Thoroughly clean shoes before reuse.
IF SWALLOWED, do NOT induce vomiting. Give water to drink. Get medical attention immediately. NEVER GIVE
ANYTHING BY MOUTH TO AN UNCONSCIOUS PERSON.
IF INHALED: Remove to fresh air. If breathing is -difficult, get medical attention.
SECTION 5 — FIRE -FIGHTING MEASURES
Fire and Explosive Properties
Auto —Ignition Temperature > 440 °C
Flash Point NA Flash Point Method
Flammable Limits - Upper NA
Lower NA
Extinguishing Media
Use water spray, carbon dioxide, foam or dry chemical.
Fire Fighting Instructions
Do NOT use a -solid stream of water. A solid stream of water can cause.a dust explosion. Fire fighters and others
who may be exposed to products of combustion should wear full fire fighting turn out gear (full Bunker Gear) and
self-contained breathing apparatus (pressure demand NIOSH approved or equivalent). Fire fighting equipment
should be thoroughly decontaminated after use.
Fire and Explosion Hazards
Dust can ignite or explode under extreme conditions. NOTE: For any operation involving this product, use only
Class II electrical equipment. Ensure that all equipment is adequately grounded. As with any dry material, pouring
this product orallowing it to free fall or to be conveyed through chutes or pipes can accumulate and generate
electrostatic sparks, potentially causing ignition of the material itself, or of any flammable materials which may
come in contact with the material or its container.
SECTION 6, - ACCIDENTAL RELEASE MEASURES
In Case of Spill oir Leak
Stop the leak, if possible. Ventilate the space involved. Absorb, sweep up, place in container for disposal. Reduce
dust spreading with a water spray. Shut off or remove all ignition sources. Prevent waterway contamination.
Construct a dike to prevent spreading. Protect workers with water spray. Collect run-off water and transfer to
drums or tanks for later disposal. Avoid creating a dusty atmosphere. Consult a regulatory specialist to determine
appropriate state or local reporting requirements, for assistance in waste characterization and/or hazardous waste
disposal and other requirements listed in pertinent environmental permits.
Clean up procedures: Transfer to containers, preparatory for later disposal. Avoid generation of dusts. Place in
non -sparking containers for recovery or disposal. Remove from spill location. Flush area with water spray, collect
rinsate.
Effective Date: 06/15105 Revision: 4 Page 2 of 6

MSDS: NorsocryB® S-35
E".merging'rechnokMies inc.
SECTION 7 — HANDLING AND STORAGE
Handling
Avoid contact with eyes, skin and clothing. Wash thoroughly after handling. Avoid breathing dust'and processing
.vapors. Keep container tightly closed. Process using adequate ventilation. Avoid creating dusts in handling,
transfer or clean up. ,Keep away from heat, sparks, and flames. Avoid breathing dust. Dust particles absorb water
and swell upon contact with moist tissue. CONTAINER HAZARDOUS WHEN EMPTY. Emptied container retains
product residual. FOLLOW LABELED WARNINGS EVEN AFTER CONTAINER IS EMPTIED. RESIDUAL DUSTS
MAY EXPLODE ON IGNITION. DO NOT CUT; GRIND, OR WELD ON OR NEAR THIS CONTAINER. Improper
disposal or reuse of this container may be dangerous and/or illegal. .
Storage
Store in a cool dry' place. This material is not hazardous under normal storage conditions; however, material
should be stored in closed containers, in a secure area to prevent container damage and subsequent spillage.
SECTION 8 — EXPOSURE CONTROL / PERSONAL PROTECTION
Ennineerina Controls
Investigate engineering techniques to reduce exposures. Provide ventilation if necessary to minimize exposure.
Dilution ventilation acceptable, but local mechanical exhaust ventilation preferred, if practical, at sources of air
contamination such as open process equipment.
Eye Protection
Where eye contact may be likely, wear chemical goggles and have eye -flushing equipment available.
Skin Protection
Minimize skin contamination by following good industrial practice. Wearing protective gloves is recommended for
substances in solid form (i.e., powders, pellets, and granules). Wash hands and contaminated skin thoroughly after
handling.
Respiratory Protection
Avoid breathing fumes. Use NIOSH approved respiratory protection equipment appropriate to the material and/or
its components where airborne exposure is'likely. If exposures cannot be kept at a minimum with engineering
controls, consult respirator manufacturer to determine appropriate type equipment for given application. Observe
respirator use limitations specified by NIOSH or the manufacturer.
For emergency and other conditions where there may be a potential for significant exposure, use an approved. full -
face positive -pressure, self-contained breathing apparatus or positive -pressure airline with auxiliary self-contained
air supply. Respiratory protection programs must comply with 29 CFR 1910.134.
Other Exposure Limits — Ingredients
*OSHA and ACGIH have not established specific exposure limits for this material:. However, OSHA and ACGIH
have established limits for nuisance dusts or which are the least stringent exposure limits applicable to dusts. The
OSHA PEL/TWA for nuisance dusts is 15 mg/ma total dust (TD), and 5 mg/m9 respirable dust (RD). The ACGIH
TLV/TWA for Particles (insoluble or poorly soluble) Not Otherwise, Specified (PNOS) is 10 mg/m3 inhalable
particulate. and 3 mg/e respirable particulate.
Airborne Exposure Guidelines for Ingredients
The components of this product have no established Airborne Exposure Guidelines.
-Only those components with exposure limits are printed in this section.
-Skin contact limits. designated with a "r above have skin contact effect. Air sampling alone Is insufficient to accurately quantitate exposure.
Measures to prevent significant cutaneous absorption may be required.
-ACGIH Sensitizer designator with a value of "Y° above means that exposure to this material may cause other allergic reactions.
WEEL-AIHA Sensitizer designator with a value of "Y° above means that exposure to this material may cause allergic skin reactions.
Effective Date: 06/15/05 Revision: 4 Page 3 of 6

MSI�S: l�r�rse�ceirF© Sa�'S i.:. :io
G
Emerging Technnlgfte h1c.
SECTION 9 — PHYSICAL AND CHEMICAL PROPERTIES
Appearance/Odor
White Odorless Powder
pH
NE
Specific Gravity
NE
Vapor Pressure
NA
Vapor Density
NA
Melting Point
NE
Freezing Point.._-
NA
Boiling Point. -,
NA
Solubility in Water
Insoluble
Bulk Density
400 - 500 kg/m'
SECTION 10— STABILITY AND REACTIVITY
Stability
This material is chemically stable under normal and anticipated storage and handling conditions.
Incompatibility
Contact with acids and strong oxidizing agents may cause a low energy release in the presence of air. Product
swells in presence of water.
Hazardous Decomposition Products
Oxides of carbon and nitrogen can be liberated at high temperatures.
SECTION 11— TOXICOLOGICAL INFORMATION
Toxicological Information
Data on this material and/or its components is summarized below.
Sodium polyacrylate
Single exposure (acute) studies indicate that this material is no more than slightly toxic to rats if swallowed (LD50
2,000 mg/kg) or is absorbed through skin (LD50 > 2,000 mg/kg), slightly irritating to rabbit eyes, and non -irritating to
rabbit skin. No skin allergy was observed in guinea pigs or humans following repeated exposure. No adverse
effects were observed following repeated application to the skin of rats. Repeated inhalation produced an
increased incidence of lung tumors related to chronic alveolar inflammation in rats. No birth defects were observed
in the offspring of rats following exposure during pregnancy. No genetic changes were observed in tests using
bacteria or animals.
SECTION 12 — ECOLOGICAL INFORMATION
Ecotoxicological Information
Sodium Polyacrylate
This material is practically non -toxic to Daphnia magna (48-hr EC50 > 1000 mg/1), trout (96-hr LC50 700 mg/1),
bluegill sunfish (96-hr LC50 > 1000 mg/1), zebra fish (96-hr LC50 > 200 mg/I), earthworms (96-hr LC50 > 1000 .
mg/1), and algae (EC10180 mg/1). The EC50 value for bacteria (sludge 02/glucose consumption) was > 100 mg/I.
Effective Date: 06/15/05 - Revision: 4 Page 4 of 6

6WDS: Nofsocry/® S-25
Emerging Tcclindogiec inc.
SECTION 12 - ECOLOGICAL:. INFORMATION, continued
In a 21-day daphnia magna reproductive study, the NOEC was 6/6 mg/I.. The NOEC value in a chronic early life
stage with fathead minnows was 56 mg/I.
Chemical Fate Information
Sodium polyacrylate
This material was evaluated in a semi -continuous activated sludge (SCAS) test, and 37.5% removal was noted. In
the continuous activated sludge (CAS) test, there was 75% overall removal with 3 mg/I test concentrations and 62%
overall removal with 10 mg/I test concentration. Lowering the molecular weight by ozonization improved the
biodegradability. Materialof molecular weight 1000 to 100 biodegraded during 34 days of incubation in riverbed
mud, but some of the lower molecular weight compounds produced in the ozonization process remained. In CO2
evolution assays, COZ evolution ranged from 8.1 to 15.6%.
SECTION 13 — DISPOSAL CONSIDERATIONS
Waste Disposal
Recover, reclaim, or recycle when practical.
Disposal via incineration is recommended. Appropriate pretreatment and disposal in an authorized landfill is
acceptable. In all cases, dispose of material in accordance with all applicable federal, state, and local laws and
regulations. Consult appropriate regulatory officials or your attorney for information on such disposal. .
Note: Chemical additions to, processing of, or otherwise, altering this material may make this waste management
information incomplete, inaccurate, or otherwise inappropriate. Furthermore, state and local waste- disposal
requirements may be more restrictive or otherwise different from federal laws and regulations.
SECTION 14 — TRANSPORTATION INFORMATION
DOT Name Not regulated
DOT Technical Name
DOT Hazard Class
UN Number
DOT Packing Group PG
RQ.
Effective Date: 06/15/05 Revision: 4 Page 5 of 6

ItflSDS: Norsocry9® S-36
Fauerging'recIrnokvies Inc.
SECTION 16 -REGULATORY INFORMATION
Hazard Categories Under Criteria of SARA Title III Rules (40 CFR Part 370)
Immediate (Acute) Health Y Fire - N
Delayed (Chronic) Health N Reactive N
Sudden Release of Pressure N
INVENTORIES: EINECS (EU): conforms
TSCA (USA): conforms
AICS (Australia): conforms
ECL (Korea): conforms
Ingredient Related Regulatory Information:
SARA Reportable Quantities
CERCLA RQ SARA TPQ
Sodium polyacrylate NE
SECTION 16 — OTHER INFORMATION
Revision Information:
Revision Date: 16 June 2005
Supercedes Revision Dated: 1 December 2004
Reason for Revision: Update Section 1 and 8..
Key: N/A — Not Applicable NE — Not Established
IMPORTANT: The following supercedes Buyer's documents. SELLER MAKES NO REPRESENTATION OR WARRANTY,
EXPRESS OR IMPLIED, INCLUDING OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. No
statements herein are to be construed as inducements to infringe any relevant patent. Under no circumstances_ shall Seller be
liable. for incidental, consequential or indirect damages for alleged negligence, breach or warranty, strict liability, tort or
contract arising in connection with the product(s). Buyer's sole remedy and Seller's sole liability for any claims shall be
Buyer's purchase price. Data and results are based on controlled or lab work and must be confirmed by Buyer by testing for
its intended condition of use. The product(s) has not been tested for, -and is.therefore not recommended for, uses for which
prolonged contact with mucous membranes, abraded skin, or blood is intended; or for uses for which implantation within the
human body is.intended.
Page 6 of
Effective bate: 06/15/05 Revision: 4 6

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 Shurtape Technologies LLC — Stony Point Plant
NPDES # NC G500323 Outfall #001
County ALEXANDER
Receiving Stream THIRD CREEK 7Q10 0.96 ' (cfs) OBTAINED FROM USGS
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. = 0.0005 (in M.G.D.) NOTE: This chemical used only in cooling tower.
Please calculate the Instream Waste Concentration (IWC in percent) of this discharge using the data entered
above.
(A.D.D.) X 100. (0.0005)X100 _
'WC = (7Q10)(0.646) + (A.D.D) (0.96)(.0.646)+(0.0005) — 0.08
This value (IW.C) 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?
AWC #487
Please list the active ingredients and percent composition:
SODIUM TOLYLTRIAZOLE 10% %
PBTC-POTASSIUM SALTS 10% %
SODIUM POLYACRYLATE 25%
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.= 45.4 grams/24hr period NOTE: The most toxic ingredient of AWC #487 is Sodium Tolyltriazole.
The LC 50 for sodium tolytriazole and the dosing rate for sodium tolyltriazole were used herein. LC50
data for the entire product WAS available for fathead minnow. That LC50 was 425,000 mg/L. We believe
that using the more conservative tolyltriazole dose and Ic50 are more appropriate.
Please note, fluid ounces (a volume) must be converted to grams (a mass). The formula for this conversion is:
Grams of product = fluid oz. of product X 1 gal. water X 8.34 lbs. X specific gravity of product X 453:59a•
128 fl..oz. . 1 gal. water 1 Ib.

Facility Name: Shurtape Technologies LLC - STONY POINT PLANT NPDES #: NCG500323
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= 0.00160 million gallons NOTE: Since this is only used in the cooling tower, only the cooling
tower volume was utilized.
What is the pH of the handling system prior to biocide addition? If unknown, enter N/A. Average pH -8.0
What is the decay rate (D.K.) of the product? If unknown,, assume no decay (D.K.=O) and 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. unknown Days
The decay rate is equal to H.L. X 0.69 = 0 =Decay Rate (D.K.)
Calculate degradation factor (D.F.). This is the first order loss coefficient. .
A.D:D: + (D.K.) _ (0.0005) + (0) = 0.3125
(Volume) (0.0016)
Calculate Steady State Discharge Concentration:
(D.R.) (45.4) 23.989 mg/l
Dischg Conc. _ (D.F.)(Volume)(3785) _
=
(0.3125)(0.0016)(3785)
Calculate concentration of biocide instream during low flow conditions.
(Receiving Stream Concentration)
(Dischg. Conc.) x (IWC%o) . _ .(23.989)x(0.08) = 2.019 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 dma/Il
RAINBOW TROUT 96-HR 23.7 (based on TOLYLTRIAZOLE)
D.W..Q. Form 101(612000) 2

EE t 1 (� ) l
�n,P 1 a f�' !,'" �r- ��r' �C��Px LLB m a�3 h...i �z�R� i�'1f+1 PLANT v0` R� PD S ELF: kl-ct 401011323
e4,wty marns: Sh s aoc ego C, � � � P � t�`i' r�, al m � � I� ��
Choose the lowest LC50/FC50 listed above:
Enter the LC50/EC50: 23.7 MG/L
If the half life (H.L.) is less than 4 days, perform the following calculation.
Regulated Limitation = 0.05 x LC50 = mg/I
If the half life (H.L.) is greater than or equal to 4 days or unknown, perform the following calculation.
Regulated Limitation = 0.01 x LC50 = 0.237 mg/I
Choose the appropriate regulated limitation from the calculations immediately above and place in this blank:
0.237 mg/liter
From Part II enter the receiving stream concentration:
0.019 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
Name (Print)
ature bate
Person Completing This Worksheet (If different from above)
Name (Print)
Signature Date
Please submit to: Division of Water Quality
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
Attn: Todd Christenson
D.W.Q. Form 101 (612000) 3

Facility fume: Shurtape Technologies LLC — S'rOmy P0If4T PLAINT NPDES #: NCG500323
supplemental Metals Analysis
If copper, zinc, or chromium are present in the proposed biocidal compound, complete this worksheet. A separate form
must be used: for each. metal and/or metal compound present in the biocide. List the metal, its chemical formula, molecular
weight (MW), formula weight (FW), and the concentration of the metal compound in the biocide (MCC). Complete a
separate form for every metal present in the biocide. NO METALS ARE KNOWN, OR BELIEVEDJO BE IN THIS
CHEMICAL. FORM IS NOT APPLICABLE.
Metal Chemical Formula Molecular Weight of Metal Formula Weight
EXAMPLE
Copper CuSO4 5H20 63.546 g/mole 249,680 g/mole
Dosage, rate of Biocide (DR) (from' page 1):
DR = grams/day
Average Daily Discharge (ADD) (from page 1):
ADD = million gallons/day
Discharge Concentration (DC)*of Biocide:
Concentration in Biocide
0.2 %
DR ( grams/day)
DC = ADD = ( million gallons/day) - prams/million gallons
Convert DC to micrograms/liter (ppb):
- . 1 x 106 ug/q
DC (Ng/1) = DC (grams/million gal) x 6 = pg/I
3.785 x 10 liters/million gal.
Calculate the fraction of metal in the metal -containing compound (MF):
MW ( grams/mole)
MF = FW = ( grams/mole)
Calculate the fraction of metal in the biocidal compound (BF):
BF=MFxMCC M = x % _
100 (100)
Calculate the concentration of metal in the discharge (M):
M = DC x BF = pg/I x = ug/I
Calculate the instream metal concentration (IMC) at low -flow conditions:
IMC = M x IWIW = !fig/I x 100 % = ug/I
Regulated limitation of metal (from below): yg/l
NC General -Statutes 15A NCAC 213.0211 define:
Copper- 7 pgll water quality action level* Zinc- 50 pg/l water quality action level*
Chromium- 50 pgll water quality standard
(*Values which exceed action levels must be addressed directly by aquatic toxicity testing.)
D.W.Q. Form 101(612000) 4

MATERIAL SAFETY DATA SHEET
ASSOCIATED WATER CONDITIONERS., INC.
23 GREEN LANE, SUCCASUNNA, NJ.07876
PHONE: [phone]
Product Name: AWC #487 Page 1 of 3
24 Hr Emergency Response Number: 1-800-255-3924
PRODUCT IDENTIFICATION:
CHEMICAL FAMILY: Mixture
TRADE NAMES AND SYNONYMS: Cooling Tower Inhibitor
FORMULA: N/A "
HAZARDOUS COMPONENTS: (This may not be a complete list 0ooNNNNoof components)
Chemical .
CAS # Approx.: % Exposure Criteria .
PBTC-POTASSIUM SALTS
N/A 10% .
SODIUM POLYACRYLATE
9003-04-7 20%
SODIUM TOLYLTRIAZOLE
64665-57-2 10%
WATER
7132-18-5
PHYSICAL DATA:
BOILING.POINT: 212f
APPROXIMATE pH: 11.1
SOLUBILITY IN WATER:' Complete
% VOLATILE BY VOLUME: N/A
ODOR NONE
MELTING POINT: N/A
FORM: Liquid
DENSITY: 9 "lbs/g
COLOR: ' Yellow
FLASH POINT: N/A
HEALTH HAZARD =1, FIRE HAZARD = 0, REACTIVITY =, 0, SPECIFIC HAZARD = N/A
HAZARDOUS REACTIVITY:
STABILITY: 'Stable
INCOMPATABILITY:' Acids
DECOMPOSTION: None
HAZARDOUS POLYMERIZATION: Will not occur.
FIRE AND, EXPLOSION INFORMATION:
FIRE AND EXPLOSION HAZARDS:
This material is non flammable. See HAZARDOUS DECOMPOSTION above for
possible decomposition products if this material is involved in a fire. -
EXTINGUISHING MEDIA:
N/A
SPECIAL FIRE FIGHTING INSTRUCTIONS:
N/A
HEALTH HAZARD INFORMATION: `
Health effects of SODIUM TOLYLTRIAZOLE from Mfgr. MSDS
EYES: Corrosive (Rabbit)
SKIN ABSORPTION: LD50:2g/kg(rabbit) Not a primary skin irritant
INGESTION:. LD50: 675mg/kg (Rat)
INHALATION: No information available.
SODIUM TOLYLTRIAZOLE is not a listed carcinogen

MATERIAL SAFETY DATA SHEET
ASSOCIATED WATER CONDITIONERS, INC.
23 GREEN LANE, SUCCASUNNA; NJ 07876
PHONE: [phone] ,
Product AWC 9487. Page 2 of 3,
FIRST AID INFORMATION:
INHALATION If inhaled remove to fresh air. If any difficulties encountered contact a
Physician.
SKIN CONTACT:
Flush skin with water. If irritation develops, contact a physician.
EYE CONTACT:
Flush eyes with7water for at least 15 minutes. If irritation persists, -
Contact a physician.
INGESTION:
If swallowed seek emergency treatment. Contact a physician.
PROTECTION INFORMATION:
EYE PROTECTION:
Use eye glasses or face shield when handling this product in case of
Accidental eye contact. .
SKIN PROTECTION:
Wear protective gloves to, minimize skin contact with this product.
RESPIRATORY PROTECTION:
Use appropriate equipment if misting is a problem.
VENTILATION:
Use local exhaust if conditions warrant.
SPILL, LEAK OR RELEASE
Contain and dike any spills. Transfer any excess material to a clean
container.. Do not allow incompatible substances to come into contact with
This material.
AWC 9487 component aquatic environmental information:
SODIUM TOLYLTRIAZOLE: 96-hr LC50 ( Rainbow Trout) : 23.7 ppm
WASTEMISPOSAL INFORMATION:
Dispose of in accordance with all Local, State and Federal regulations.
AWC #487 contains the following EPA hazardous components. Releases
To the: environment of " REPORTABLE QUANTITIES" (RQ) must be reported.
Contact ASSOCIATED WATER CONDITIONERS, INC. for assistance.
SHIPPING INFORMATION: -
DOT SHIPPING NAME: INDUSTRIAL PROCESS WATER TREATMENT COMPOUND.
DOT HAZARD. CLASS: NOT REGULATED
i■■■■■■.■■.■.■■.■■■i■■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■■■■■�r■■■■■■■■■■�■■■�
STORAGE CONDITIONS:
Keep container closed when not in. use.

MATERIAL SAFETY DATA SHEET
ASSOCIATED WATER CONDITIONERS; INC.
23 GREEN LANE, SUCCASUNNA, NJ 07876
PRONE: 1-973-987-0100
PRODUCT AWC #487 Page 3 of 3
■eeeeeeeeeeeeeeeeeeeeeoeeeeneeeeeeeeoee■eeeeeoeeeeeeeeeee�eeeeeaeeeoeeen
OTHER INFORMATION:
INFORMATION AND DATA HEREIN ARE BELIEVED TO BE ACCURATE AND COMPLIED
FROM RELIABLE SOURCES. BUYER ASSUMES ALL RISK OF USE, STORAGE AND
HANDLING TO COMPLY WITH STATE, FEDERAL AND LOCAL REGULATIONS. ASSOCIATED
WATER CONDITIONERS, INC. MAKES NO WARRANT' EXPRESS OR IMPLIED
CONCERNING THE ACCURACY OR COMPLETENESS OF THE INFORMATION SUPPLIED.
■■eeeeeeie�eeeeee�ee�e��eeeee��eeeeeeee�eeeeeeeeeeee�e���eeeeeee�eeeeee�
DATE PRINTED: 5/4/03 DATE PREPARED: 5/4/03 SUPERCEDES: 10/06/00

i .
RESEARCH AND CONSULTING, INS.
Sol 8!0 t KC ffiTRBET, NORTH PL.41N IELb, N. J. 07080 (a41) ?rO-119J
may-8. 1981
Associated Water Conditioners, Inc.
23 Green Cane '
Succasunna, NJ 07876
Gentlemen.
Herewith our findings for the Bioassay analysis of .a sample of liquid.
Please note that•the sample was pH neutralized prior to beginning the
test in order.to eliminate pH as the causative agent in the Bioassay.
TRC,Sampla: 3494
AWC No.: 04363 ,
Source: 487
Bioassay, Fathead Minnow 4.25%
LC 50-48 hr.
very tr 1Y VOLAPS,
Gar Gilbert
oi0�J MUM allVIDOGGV CM LZ6 916 jVJ £O:II 4009/0VTO

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.
I. Facility Name Shurtape Technologies, LLC — Stony Point Plant
NPDES # NC G500323 Outfall #001
County ALEXANDER
Receiving Stream THIRD CREEK 7Q10 0.96 (cfs) OBTAINED FROM USGS
(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. = 0.00114 (in M.G.D.)
Please calculate the Instream Waste Concentration (IWC in percent) of this discharge using the data entered
above.
IWC_ _ (A.D.D.) X 100 — (0.00114)X100 = 0.185 %
(7Q10)(0.646) + (A. D. D) — (0.96)(0.646) + (0.00114)
This value (IWC) represents the waste concentration to the receiving stream during low flow conditions.
What is the name of the whole product chemical treatment proposed for use in the discharge identified in Part I?
AWC #331
Please list the active ingredients and percent composition:
TETRAPOTASSIUM ETIDRONATE 10% %
SODIUM GLUCOHEPTONATE 5% %
SODIUM POLYACRYLATE 20% %
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.= . 1020 grams/24hr period
Please note, fluid ounces (a volume) must be converted to grams (a mass). The formula for this conversion is:
Grams of product = fluid oz. of product X 1 gal. -water X 8.34 lbs. X specific gravity of product X 45359a.
128 fl. oz. 1 gal. water 1 lb.

Facility Name: Shurtape Technologies, LLC - STONY POINT PLAun IdPDES #: NICG500323
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= 0.0154 million gallons
What is the pH of the handling system prior to biocide addition? If unknown, enter N/A. Average pH -8.0
What is the decay rate (D.K.) of the product? If unknown, assume no decay (D.K.=O) and 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. = unknown Days
The decay rate is equal to H.L. X 0.69 = 0 =Decay Rate (D.K.)
Calculate degradation factor (D.F.). This is the first order loss coefficient.
* D.F. = A.D.D. + (D.K.) _ (0.00114) + (0) = 0.074
(Volume) (0.0154)
Calculate Steady State Discharge Concentration:
Dischg Conc. _ (D.R.) (1020) = 236 mg/I
(D.F.)(Volume)(3785) (0.074)(0.0154)(3785)
Calculate concentration of biocide instream during low flowbonditions.
(Receiving Stream Concentration)
(Dischg. Conc.) x (IWC%) _ (236)x(0.185) _ 0.437 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. Based on MSDS.
Organism Test Duration LC50/EC50 (ma/1)
RAINBOW TROUT 96-HR 368
D. W. Q. Form 101 (612000) 2

i°acilliy Name: Shurte e Technologies, LLQ — STOMP,( POINT ePIOLA,1.1' NiIDE t: MQ-2600323
Choose the lowest 1-05 EC50 listed above:
Enter the LC50/EC50: 368 MG/L
If the half life (H.L.) is less than 4 days, perform the following calculation.
Regulated Limitation = 0.05 x LC50 = mg/I
If the half life (H.L.) is greater than or equal to 4 days or unknown, perform the following calculation.
Regulated Limitation = 0.01 x LC50 = 3.68 mg/I
Choose the appropriate regulated limitation from the calculations immediately above and place in this blank:
3.68 mg/liter
From Part II enter the receiving stream concentration:
0.437 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
2)wl yll • /Ve7�
Name (Print)
Si ture Date
Person Completing This Worksheet (If different from above)
J. W, (`
Name (Print)
V1, i - LL(-o ff
Signaturd Date
Please submit to: Division of Water Quality
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
Attn: Todd Christenson
D. W.Q. Form 101 (612000) 3

Facility lgame: Shurtape Technologies LLC — STONY POINT PLANT 14PDES #: NCEr 500323
Supplemental Metals Analysis --
If copper, zinc, or chromium are present in the proposed biocidal compound, complete this.worksheet. A separate form
must be used for each metal and/or metal compound present in the biocide. List the metal, its chemical formula, molecular
weight (MW), formula weight (FW),, and the concentration of the metal compound in the biocide (MCC). Complete a
separate form for every metal present in the biocide. NO METALS ARE KNOWN, OR BELIEVED, TO BE IN THIS
CHEMICAL. FORM IS NOT APPLICABLE.
Metal Chemical Formula Molecular Weight of Metal Formula Weight
EXAMPLE
Copper CuSO4 5H2O 63.546 g/mole 249.680 g/mole
Concentration in Biocide
0.2
Dosage rate of Biocide (DR) (from page 1):
DR = grams/day
Average Daily Discharge (ADD) (from page 1):
ADD = million gallons/day
Discharge Concentration (DC) of Biocide:
DR ( grams/day) r
DC =ADD = ( million gallons/day) = prams/million gallons
Convert DC to micrograms/liter (ppb):
DC (Ng/1) = DC (grams/million gal) x 1 x 106 ug/g = ug/I
3.765 x 106.11ters/million gal.
Calculate the fraction of metal in the metal -containing compound (MF):
MW ( grams/mole)
MF = FW = ( grams/mole) _
Calculate the fraction of metal in the biocidal compound (BF):
MCC % %
BF = MF x 100 = x (100) _
Calculate the concentration of metal in the discharge (M):
M = DC x BF = Ng/I x = Ng/I
Calculate the instream metal concentration (IMC) at low -flow conditions:
IMC = M x IWC = Pg/I x 100 % = Ng/I
Regulated limitation of metal (from below): pg/I
NC General Statutes -15A NCAC 213.0211 define:
Copper- 7 p91l water quality action level" Zinc- 50 p91I water quality action level"
Chromium- 50 pgn water quality standard
("Values which exceed action levels must be addressed directly by aquatic toxicity testing.)
D.W.Q. Form 101(612000) 4

MA'PERLAL SiZ4 ETY D)A ,A SHEET
Associated Water Conditioners. Inc.
23 Creen. Lane, Succasunna, ICJ 07876
[phone]
Droduct Name: AWC # 331
Product Identification
Chemical Family Mixture
Trade Names/Synonyms Boiler sludge/scale inhibitor, polymer.
Formula Mixture
Page I of 2
24 Hour Emergency Phoney 1.800.255.3924
Hazardous Components (This may not be a complete list of components)
Chemical
CAS#
Approx% Exposure Criteria
Sodium Polyacrylate
9003-04-7
20%
Sodium Glucoheptonate -
31-138-65-5
5% N/A
Tetrapotassium Etidronate
14860-53-8
10% N/A
Water
7732-18-5
Physical Data:
Boiling Point
212F -
Approximate PH
Solubility in Water
Complete
% Volatile by volume
Odor
None
Melting Point
Form
Liquid
Density
Color
Amber
Flash Point
EINIIS Ratings: Health = i
Hazardous Reactivity:
Stability ...
Incompatibility:
Decomposition:
Hazardous Polymerization:
Flammability =0
Stable
Acids, cationic materials
None
.Will not occur
Reactivity = 0
11.3
N/A
N/A
91bs./gal
N/A
Specific Hazard = N/A
Fire and Explosion Hazard: _
Fire and Explosion Hazards:
This material is non flatnmable. See Hazardous Decomposition above for possible decomposition products if this material is
involved in a fire.
Extinguishing Media: N/A
Special Fire Fighting Instructions:. N/A
Health Hazard Information:
Health effects of Sodium Glucoheptonate from MFG. MSDS
Eyes: Irritant
Skin Absorption: Moderately irritating
Ingestion: no information found
Inhalation: no information found
Sodium Glucoheptonate is not a listed carcinogen.
Health effects of Tetrapotassium Etidronate from Mfg. MSDS
Eyes: An eye irritant, this is a caustic material
Skin Absorption: no information available
Ingestion: LD50: 520 mg/kg
Inhalation: no information available
Tetrapotassium Etidronate is not a listed carcinogen.

T� ii ..P E-@dLAL Sla-F E TY .DAT, A SHE E T
Associated Water Canditioners, Inc.
23 Green Lane, Succasunna, NJ 07876
[phone]-.
)roduct Name: AWC # 331
First Aid Information:
Inhalation:
If inhaled remove to fresh air. If any difficulties encountered contact a physician.
Skin Contact:
Flush skin with water. If irritation develops, contact a physician.
Eye contact:
Flush eyes with water for at least 15 minutes. If imitation persists, contact a physician.
Ingestion:
If swallowed seek emergency treatment. Contact a physician
Personal Protection Information:
Eye Protection:
Use eye glasses or face shield when handling this product in case of accidental eye contact
Skin Protection:
Wear protective gloves to minimize skin contact with this product
Respiratory Protection:
Use appropriate equipment if misting is a problem.
Ventilation:
Use local exhaust if conditions warrant.
Spill, Leak or Release:
Contain and dike any spills. Transfer any excess material to a clean container. Do not allow
incompatible substances to come into contact with this material.
AWC #331 component aquatic environmental information:
Tetrapotassium Etidronate: 96-hr LC50 (60% act. acid) Rainbow Trout: 368mg/l
Waste Disposal Information: .
Dispose of in accordance with all Local, State and Federal regulations.
Contact Associated Water Conditioners, Inc. for assistance
Shipping Information:
DOT Shipping Name: Boiler Cleansing Compound - Liquid
DOT Hazard Class: Not regulated
Storage Conditions:
Keep container closed when not in use. Keep from freezing.
Other Information:
The components contained in this product are FDA listed acceptable boiler water additives per CFR 21
subpart 173.310 'Boiler Water Additives.:'
Page 2 of 2
Information and data herein are believed to be accurate and compiled from reliable sources. Buyer assumes all risk of use,
storage and handling to comply with State, Federal and Local regulations. Associated Water Conditioners, Inc. makes no
warranty express or implied concerning the accuracy or completeness of the information supplied.
Date Prepared: 5/4/03 Supercedes: 1016//00

04-24-02 15:33 ID= PG2/E3
Material Safety Data Sheet U.S. DOp adment of Labor
Maybe used to comply with Occupational Safety and Health Administration
OS"e H=rd Communication Standard, (Non -Mandatary Form)
28 CFR 1910.1200. Standard must be Form Approved
consulted for epeelfic requirements. OMB No. 1218-0072
IDiENTM (As used on Label and Liar) N019:81ank spaews ate not pormi G. lfarryaem is not 5pplieable, or no lnrotmai4n
3 PI ILR It avbilab/o. rho spat& Must" m&Aad ro ladicare met.
Section I
ManuibcWrees Name
Emergency Telephone Number
Natural Chemist Inc
[phone]
Address (Number, Street, City, State, and ZIP Code)
Telephone Number for Information
76 Progress Drive
(800)..753-1233
Date Prepared
Stamford CT 06902
JANUARY 1, 2002
Signature of Preparer (optional)
section n - rlazardous Ingredients/identity Information
Huardous Components (Specific Chemical Identity. Common Name(s)) OSHa PEL ACGIH TLV Reoommtanded %
roptlonaq
-- none -
Section III - PhysieaVChemical Characteristics
Boiling Point
Specific Gravity (N20 = 1)
212OF
1.0
Vapor Pre$Sure (mm Hg.)
Melting Point
as Hz0
n/a
Vapor Density (AIR =1)
Evaporation Rate .
1
swunility in water
inf inite
Appearance and Odor
straw colored clear liquid
Section IV - Fire and Explosion Hazard Data
Flash Point (Method Used) I I
Flammable Limits LEL I UEL
none n/a n/a n/a
Media
non-flammable
Special Fine Fighting Procedures
n/a
Unusual Fine and Explosion Hazards
none
(Reproluce rocally) OSHA IU. Sapt. IOaS

a
94-24-02 IS:33 FA=° PE€3/03
Seett®n V. uWaethrt Data stability Unstable Conditions t0 Avoid
none
stable
x
Inoornpadbility Wat®nals to Avoid)
Hazardous Oeoomposition or Bylfroducts none determined
F �
merizatim
May Occur
Conditions to Avoid
none
Will Not Occur
- E.0 ria"Fu Yalta --
Routa{S) OtEntry: Inhalation? Skin? Ingestion?
Health Hazards (Acute and Chronirl X
Carcinogenicity N7P? IARC Monographs? OSHA Regulated?
n a .
Signs and Symptoms of Exposure
none: a Cessive in estion.may cause mild nausea or diarrhea
Medical Conditions
Generally Aggravated by Exposure none
Emergency and First Aid Procedures
none reo fired
Waste Disposal Method
flush to amy sewage or dis os 1 system
PreCautims, to Be Taken in Handling and storing
none • but eaz at .c activity may be lost if tem eratures
exceed 120 F 50°C or it pH exposure is below 3.5 or above
9.0
Other Precautions
none
rage z ' U.S.G.h.O.: 1986-491529(a5775

JeTTY VV.
�(�cjliiffi: Ed SpeVlc;e
Sent: Tuesday, January 15, 2007 9:48 AM
To: Jerry VV. Epfin
Subject FW: MSDS copies for review
> Date: Tue, 16 Jan 2007 09:16:35 -0500
> From: [e-mail]
> To: [e-mail]
> Subject: Re: MSDS copies for review
> Ed Spencer wrote:
> hello Cindy,'
> My customer wants to mail in their application for the discharge permit.
any more thoughts regarding #383 steam boiler additive and the Biocide 101
were no LC50 data for the product as a whole or half life data.
> thank you,
> Ed Spencer
> Consolidated Water Conditioners
> (704)-873-5413
> Date: Fri, 5 Jan 2007 13:32:53 -0500
> From: [e-mail]<mailto:[e-mail]>
> To: cwcwatgrahotmail.com<mailto:[e-mail]>
r•--
> Subject: Re: MSDS copies for review
Do you have
form, as there
> In looking at the Enzyme MSDS sheet I wouLd consider that a non -issue in regards to it
hPinrr a hazard. I will look over the other MSDS and see what we need to do.
> Thanks
> i� n�dv
> d Spencer wrote:
> AWC #383 component aquatic environmental information:
> Sodium Metabisufite: 120ppm/24,48,96 hr/mosquito fish/TL/fresh H2O
> Sodium Tripolyphosphate: 96-hr LC-50 (trout): 5600 mg/l
> Morpholine: Minnow LC-50 > 500mg/1.
> I would use the 12Oppm as your LC50 and put " NA" for the half life .
> Let me know if you have questions hello Cindy, As per our conversation
> on Thursday afternoon, I have attached 2 MSDS.
> The first is #383, a multi -blend steam boiler additive. It has 5 ingredients
(not
including water), and it has LC50 data for 3 of those ingredients on the bottom
of page 3
under SPILL, LEAK OR RELEASE. There is no LC50 data for the product as a whole,
can you
advise me for filling out Biocide 101 form.
> The second MSDS is for IS-3 Plus, (an enzyme.product from Natural Chemistry, the makers
of "Pool Perfect" enzyme). It has no hazardous ingredients but there is no LC50
data for
it.
> If the IS-3 enzyme is going to be a "non -issue", could you email me as such so
that I
may forward that info to my customer.
> thank you for you help,
> Ed Spencer
> Consolidated Water Conditioners
> (704)7873-5413
>
> Try amazing new 3D maps Check it out!<http://maps.live.com/?wip=51>
1

It
> Cindy Moore
> Aquatic Toxicity Unit/ESB
> Division of Water Quality/DENR
> 1621 Mail Service.Center.
> Raleigh, NC 27699-1621
> Physical address
> 4401 Reedy Creek Rd.
> Raleigh, NC 27607
> Phone: [phone]
> e-mail: [e-mail]<mailto:[e-mail]>
> View Athletes' Collections with Live Search. See
> it!<http://sportmaps.live.com/index.html?source=wlmemailtaglinenov06>'
> Cindy Moore
> Aquatic Toxicity Unit/ESB
> Division of Water Quality/DENR
> 1621 Mail Service Center
> Raleigh, NC 27699-1621
> Physical address
> 4401 Reedy Creek Rd.
> Raleigh, NC 27607
> Phone: [phone]
> e-mail: [e-mail]<mailto:[e-mail]>
Try amazing new 3D maps..
http://maps.live.com/?wip=51
2

b . '
MATERIAL SAFETY DATA SHEET
ASSOCIATED WATER CONDITIONERS, INC.
23 GREEN LANE, SUCCASUNNA, NJ 07876
1-973-927-0100
Page 1 of 2
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24 Hour Emergency Phone: [phone]
PRODUCT IDENTIFICATION:
NAME: AWC #490
CHEMICAL FAMILY: Mixture
TRADE NAMES AND SYNONYMS: Antifoam
FORMULA: N/A
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HAZARDOUS COMPONENTS: (this may not be a complete list of components)
Chemical Cas # Approx.: % Exposure Criteria
Water 7732-18-5 95 %
Polydimethysiloxane 63148-62-9 3 %
Hydroxyethyl Cellulose 9004-62-0 1 %
Mono-DI-Tri- Tallow Glycerides 68308-54-3 1 %
Treated Amorphous Silica N/A 1 %
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PHYSICAL DATA:
BOILING POINT: 212F APPROXIAMATE pH: 7.5
SOLUBILITY IN WATER complete % VOLATILE BY VOLUME: N/A
ODOR None MELTING POINT: N/A
FORM: Liquid DENSITY: 8.311bs./gal
COLOR: White FLASH POINT: N/A
HEALTH HAZARD =1, FIRE HAZARD = 0, REACTIVITY = 0, SPECIFIC HAZARD = N/A
■■eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee■■eeeeeeeeeeeee`eeeeeeYeeeeeeee
HAZARDOUS REACTIVITY:
STABILITY: Material is Stable
INCOMPATIBILITY: Oxidizing materials may cause reaction.
DECOMPOSITION:
Sulferoxides, nitrogen oxides, chlorine compounds, CO2, and carbon products.
HAZARDOUS POLYMERIZATION: will not occur
FIRE AND EXPLOSION INFORMATION:
FIRE AND EXPLOSION HAZARDS:
This material is non flammable. See HAZARDOUS DECOMPOSITION above for possible
Decomposition products, if this material is involved in a fire.
EXTINGUISHING MEDIA: N/A
SPECIAL FIRE FIGHTING INSTRUCTIONS: N/A
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FIRST AID INFORMATION:
INHAIf,ATION:
If inhaled remove to fresh air. If any difficulties encountered contact a physician.
SKIN CONTACT:
Flush skin with water. If irritation develops, contact a physician.
EYE CONTACT:
Flush eyes with water for at least 15 minutes, If irritation persists, contact a physician.
INGESTION:
If swallowed seek emergency treatment. Contact a physician.

Material Safety Data Sheet
Associated Water Conditioners, Inc.
23 Green Lane, Succasunna, NJ 07876
[phone]
Product Name: AWC # 490 Page 2 of 2
Protection Information.
Eye Protection: Use glasses or face shield when handling this product in case of accidental eye contact.
Skin Protection: Wear Protective gloves to minimise skin contact with'this product.
Respiratory Protection: Use appropriate equipment if misting is a problem.
Ventilation: Use local exhaust if conditions warrant.
Spill, Leak or Release:
Contain and dike any spills. Transfer any excess material to a clean container. Do not allow incompatible
substances to come into contact with this material.
Waste Disposal Information;
Dispose of in accordance with all Local, State and Federal regulations. Contact Associated Water
Conditioners, Inc. for assistance.
Shipping Information:
DOT Shipping Name: Industrial Process Water Treatment Compound.
DOT Hazard Class: Not Regulated.
Storage Conditions;
Keep container closed when not in use. Keep from freezing.
Information and data herein are believed to be accurate and compiled from reliable
sources. Buyer assumes all risk of use, storage and handling to comply with State, Local and
Federal. regulations. Associated Water Conditioners, Inc. makes no warranty ezpress or
implied concerning the accuracy or completeness of the information supplied.
Date Prepared: 0.1/22/01 Supercedes: 04/12/94