NCG510390_Regional Office Historical File Pre 2018

o
CDE ,.....
North Carolina Department of Environment and NatdiilA 0,"`FIC
Divisionof Water Resources
Pat McCrory Thomas A. Reeder John E, Skvarla,111
Governor Director Secretary
NOTICE OF RENEWAL INTENT
[ltegarfred by to CAC: {ll[ .27d1; [term defirrati�t see 15r NCAC (1tli3tlil
Application for renewal of existing coverage under General Permit NCG5I R 0
Existing Certificate of overa 'e'(CoQ: NCG510
(Please print or type)
1) Mailing address of site Owner: (address to which all correspondence should be rnailea)
Company Name Phillips 66 Company
Company Contact Ed Kuhn
Street Address 1335 Hundred Oaks give; Suite
City Charlotte State NC ZIP 25217
Telephone # [phone] Fax # [phone]
Cell/Mobile # [phone] Email d. uhn*cootras tor. 6. om
2) Location ofreediation site producing discharge:
Facility Contact See System Operator/Consultant ID Section
Street Address 101 Belmont -Mt. Hotly Road
City Belmont State NC ZIP 2 012
County Gaston.
Telephone # See Sect 3 Fax #- See Sect
3) System operator 1 Consultant ID: (if different fi°crag avner)
Company -Marne ATC Associates of North CarolinaP.C.
Street Address 7606 Whitehall Executive Center Drive, Suite 800
City Charlotte State NC ZIP 25273-
County Mecklenburg
Telephone # [phone] Fax [phone]
Email franc.lc►rvrn @,atcassocia a .corm
Page 1€rf 2 Revised 9&13

NCG510000 Renewal Application
4) Site ranking & ID: GW incident 9: 10848
Site Ranking (ifavailable): H180D
Date of most recent discharge: March 11.,2016
Additional Application Requirements:
The following information must be included in duplicate [original + I copy] with this application or
it will be returned as incomplete.
Site map: Clearly showing the path of the remediation system effluent from the site to
its discharge point
Authorization for representatives. If this application will be submitted by a consulting
engineer (or engineering firm), include documentation from the Perntittee showing that
the consultant submitting the application has been designated an Authorized
Representative of the applicant.
CERTIFICATION
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: William Beck
Title: East Region Manager, RM&R
March 11, 2016
(Signature of Applicant) (Date Signed)
North Carolina General Statute 143-215.6 b (i) provides that:
any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan or other
or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, o
tampers with or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained undi
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,)
This Notice of Renewal Intent does NOT require a separate fee.
The -oermitted facility already -vays an annual fee for coverage under NCG5 10000.
Mail this application and one copy of the entire package to:
NC DENR / DWI / Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attn: Charles Weaver
Page 2 of 2 Revised 911113

LATITUDE N 35' 15' 52" MAP PRODUCED USING 2010 7.5 MINUTE MOUNT HOLLY,
LONGITUDE W 81* 02' 31" NORTH CAROLINA USGS QUADRANGLE
UTM COORDINATES. ZONE 17 496115E 3902074N
SCALE 1:24 000
L5.5 p KILOMETERS I
10(11J 500 0 METERS 1000 2000
1 05 0 1
MILES
vmmmon low a low 20(1) S1lIJ 4t11 50M 6000 7000 gxri ww lowo
----
FEET
TITLE FIGURE 1
SITE LOCATION MAP
PHILLIPS 66 RI 2748
101 MT. HOLLY RD. ASSOCIATES OF NORTH CAROLINA, P.C.
BELMONT, NC 28012 CbWioft "h CArOWA 28W MW 52"M FAX VIX) M-W72
'AD F �LE
PR7TT" -7, --CA 1WFC FRC)JECT NO
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RMR2748SLM AF BC AS SHOWN 05/26/11 1 08935118.2748

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SITE MAP (MkTc
PHILLIPS 66, RM 748
101 MT. HOLLY R D. ' ASSOCIATtS OF NORTH CAROLINA Q.c,
BELMONT, NC 28012 ChalloaW N.1tn caronn. M17 [phone] FAX [phone]
CAD FIU� PREP sy RIB S1 SIAi.E. DAM
20110525_RMR2748 AF BC A SHOWN 05 25 11 089:75118.2748

I LIPS Risk Management and Remediatio
Philips 66 Company
420 B. feeler, 1670 P
Bartlesville, OK 74004
March 11, 201
Charles Weaver
:North Carolina Department of Environmental Quality
Division of Waste Resources -- eater Quality Permitting Section
11`7 Mail Service Center
Raleigh, NC 27-117
i?v- ( rm 'eiFaarai f Uhill sae (ef. i.i#ns i 7�, h (n nln a
Since rtely>
c
William Beck
East Regional Manager
Risk Management and Reme iatiort
cc: Edward M. Kuhn, Contract Program Manager for Phillips 66
ATC Associates ofNorth Carolina, P.C.
Mecklenburg County Department of Enviromnental Protection

/IWO
NC MR
North Carolina [department of Environment and Natural Resources
Division of Wafer Resources
Water Quality Programs
Pat McCrory Thomas A. Reeder John E.'Skvarl , III
Governor Director Secretary
February 21, 2014
Ed Kuhn
Phillips 66 Company
421-1 Stuartdrew Blvd.
Charlotte, North Carolina 28217
Subject. Certificate of Coverage (COC) NC+G510540
Under General Permit NCG510000 for the
former Star-Brite Laundry Facility
5639 Statesville Rd, Charlotte 28269
Mecklenburg County
Dear Mr. Kuhn:
General Permit iCovera e. In accordance with your application to discharge treated
groundwater contaminated with fuel hydrocarbons, the Division of Water Resources (DWR or
the Division) hereby forwards this Certificate of Coverage (COC) to discharge under the subject
PDES general permit. We issue this COC pursuant to the requirements of North Carolina
General Statue 143-215.1 and the Memorandum of Agreement between North Carolina and the
US Enviromnental Protection Agency (1.ISEPA) dated. October 15, 2007 (or as subsequently
amended).
The following information is included with your permit package:
A copy of the Certificate of Coverage for your treatment facility
■ A copy of General Wastewater Discharge, Permit NCG51 gtl00
A copy of a 'Technical Bulletin for General Wastewater Discharge PemlitNCG510000
Engineer's Certification., to be signed and returned to DW upon completion
The Division understands from your Notice of Intent (N01) received December 27, 2013 that
you are authorized by the property owner, Phillips 66 Company, as consultant for this
groundwater remediation project. We also note that your site-remediation Corrective Action Plan
(CAP) was approved February 30, 1998 by the N'CDENR IGST Section, Mooresville Regional
Office.
Future reporting under this COC shall compare all analytical results to Surface Water -Quality
Standards appropriate to a receiving -stream classified C. We note that site -assessment analytical
1617 tail Service Center, Raleigh, North Carolina 27699.1617
Location: 512 N. Salisbury St Raleigh, North Carolina 27604
Phone; 9IM07-6300 t Fax: [phone] Customer Service: 1-877-623-6748
Internet:: Ar ncwiateruuafity.org
An Equal opportunit&ffirmative Action Employer

data (October 16, 2013) affirms your assertion that gasoline, diesel fuel, kerosene, heating oil
and waste oils are the sources of site contamination, and that chlorinated solvents are not of
concern in the subsurface. If chlorinated solvents are detected in the future, you must apply
itinnediately for an individual DES permit.
Based on the above, the General Permit's effluent monitoring Table A. (3.) applies to your
facility as having been impacted by combined sources of hydrocarbons such as gasoline and
diesel fuel, aviation fuel, kerosene, or fuel oil. Monitoring Tables A. (L) and A. (2.) do not
apply.
At no time shall treatment -system operators allow contaminated (untreated) water to discharge to
surface waters of the State. At no time shall treated water discharge such that sediment is
transported and/or erosion occurs. The Measurement Frequency "Monthly Flow" is defined as
total treated effluent not -to -exceed one million gallons (1.0 MG) per month. This assumes that
the system utilize a totalizing flow meter (or equivalent method) to determine and record total
flow, and report this value on quarterly Discharge Monitoring Reports (DMRs).
In accordance with your application for discharge and Corrective Action Plan (CAP), the
Division understands you propose to construct and operate a groundwater remediation system
consisting of:
• groundwater recovery wells
• two (2) Grundfos Redi-flow electrical pumps
• air stripper [EZ-Tray 8.x] six -tray; rate 30 gpm; air max @420 efin; air -
to -water ratio 14:1 (99.007%,reinoval efficiency)
• two (2) bag filters in parallel; 30 gpm
• remedial equipment housed in a Class I Division 11 enclosure
• effluent discharge line with totalizing flow meter
• discharge connection to stomiwater line
The above treatment works, located at Former Star-Brite Laundry Facility located at 5639
Statesville Rd, Charlotte 28269, will be installed and operated in accord with your discharge
application, Notice of Intent (NOI), and as described on your schematic and site plan. Treated
groundwater shall discharge under receiving stream zero -flow conditions (7Q 10 and 30Q2 = 0.0
ets) ultimately to an unnamed tributary (UT) to Irwin Creek [Stream Segment 11-137-1], a
waterbody currently classified C within Subbasin 03-08-34 of the Catawba River Basin, as
documented on the attached Site Map.
In the event that treatment facilities fail to perforin satisfactorily, to include creating nuisance
conditions, the Permittee shall take immediate corrective action, including those actions as may
be required by this Division, such as the construction of additional or replacement wastewater
treatment or disposal facilities. Failure to abide by the requirements contained in this ATC may
subject the Pertnittee to an enforcement action by the Division of Water Resources in accordance
with North Carolina General Statute 143-215.6A to 143-215.6C.
Please notify Michael Parker of the Division's Mooresville Regional Office (MRO) by telephone
919-791-4200 at least three (3) working days in advance of operating the treatment -system, so
that he may determine the need for final inspection requirements. Please contact MRO during the

nortnal office hours from 8:00 a.m. until 5:00 pm. Monday through Friday, excluding State
Holidays.
NPDES Permit Contact. If you have questions concerning the requirements of this permit,
please contact the MRCS or Derek Denard of the NPDES Unit, Raleigh at 919-807-6394.
If any parts, measurement frequencies or sampling requirements contained in this general permit
are unacceptable, you have the right to request an individual permit by submitting an individual
NPDES permit application. Unless such demand is made, the certificate of coverage shall be
final and binding.
Please note that this COC is not transferable except after notice to the Division of Water
Resources. The Division of Water Resources may require modification or revocation mid
reissuance of the certificate of coverage. This permit does not affect the legal requirements to
obtain other permits which may be required by the Division of Water Resources or permits
required by the Division of Land Resources, Coastal Area Management Act or any other Federal
or Local governmental permit that may be required.
Since�rd y
Thomas A. Reeder
he: NPDES General Permit Files
M No WPu e ry sorLater�ual,!�Regional Operations Section
AT"Csosoc"iates of North Caro M&iina, TC., atto do C�u son, Project Engineer,
7606 Whitehall Executive Dr. Suite 800 Charlotte, NC 28273
ec: David Hunter, PG, RSM, Cardno ATC [dave.hunter(ocardno.conil

STATE OF NORTI]
DEPARTMENT OF ENVIRONMENT
NMENT
DIVISION OF ATE]
CERTIFICATE OF COV
Under GE1ERAL""'•
TO DISCIIARGE'1tEME MATED GRO . DW TE
WITU PE't`RO
UNI
NATIONAL POLLUTANT ITS{
(XI
In compliance with the provisions of North taro
and regulations promulgated and adopted h
d th F d l W
'DES)
omm ss on, an e e era "LVI x W
Phillips
Former Staff
(CIA
NATURAL RESOURCES
lOURCES
100
'ontrol Act, as amended
any
►rite Laundry facility, site located
Statesville Road, Charlotte
Mecklenburg County
ul IV of General Permit NCG5 10000, as attached.
ificate of coverage shall become effective February 21, 2014.
Signed this day February 21, 2014.
9`l' as A. Reeder, Dire for
vision of Water Resources
By Authority of the Environmental Management Commission

Pace
SOC Priority Project: No
To: Division of Water Resources
NPDES Compliance & Expedited Permit Unit
Tate: February 7, 2014
NP ES STAFF REPORT AND RECOMMENDAT
County: Mecklenburg
Permit No NCG 10540 —72
FEBi
PART I - +GENE L INFORMATION
CiJ f iy
Ix Facility address: Former Star- Brite Laundry Facility �
5639 Statesville Road, Charlotte, NC 226
2. Date of investigation: February 6, 2014
. Report prepared by: Suatha R. Nagulapally, Environmental Specialist:
4. Persons contacted and telephone number: Ed Kuhn, [phone], (704) 9 5-3000
5. Directions to site: Heading South on 1-77, take Exit 16A for US 21 NJSunset Rd. East, Merge
onto Sunset Rd for 0.6 miles, Sharp right onto Statesville Rd,, destination will be 0.8 miles on
right at corner of I3urmth Ave. and Statesville Rd, 5639 Statesville Rd.
6, Discharge point(s), list for all discharge points: Storm Sewer
7. Receiving; stream or affected surface waters: Irwin Creek
a. Classification:
PART II --DESCRIPTION OF DISCHARGE AND TREATMENT
1. Volume of treated groundwater to be permitted: 8,640 GPD
Please provide a description of existing or substantially constructed ground water treatment
system: The groundwater treatment system consists of two Grundfos edi-flow electrical pumps,
one 6 Tray QED Air Stripper, two bag filters in parallel. The remedial equipment will be housed
in a Class Division 11 enclosure. Groundwater extracted from the recovery wells will be
collected and introduced into the QED air stripper of 75 gallons a minute. A pump will collect
the water from the air stripper sump and route the flow through two parallel filtration units to
remove sediment. The water will then will flow through underground piping to a nearby storm
sewer:

Page
PART III -EVALUATION I AND RECOMMENDATIONS
The permitt e, Philips 66 Company of NC has applied for a NPDES permit application for the
discharge of treated groundwater to City of Charlotte's storm sever at the above referenced project site.
Derek Denard from Raleigh gh office and SaJatha, Nagulapally from Mooresville office have met
with the Engineer and Contractor at the site. Site appeared to be clean and ready for the installation of
proposed groundwater treatment system. Additional information, updated site map and outal l
coordinates are requested from the permittee for permit approval.
t this time there are no additional comments, hence it is recommended that the permit to be issued as
requested.
u"ata lea ula all ;�17f l
Signature of report preparer hate
rygc r by signed by Andbe H Pftw
y pDNC-AndrCw N,Ptnc O=UCOENR, ov=DWRtAARQ,
Andrew H. it a emalK_andrrw Dr¢nee ancderrr 4bv US
Date1 7t2.4i34-tS5'b@'
Water Quality Regio' u' is `
l „

FILE
Page 1
SOC Priority Project: No
To: Division of Water Resources
NPDES Compliance & Expedited Permit Unit
Attention: Derek Denard
Date: February 7, 2014
NPDES STAFF REPORT AND RECOMMENDATION
County: Mecklenburg
Permit No. NCG510540
PART I - GENERAL INFORMATION
1. Facility address: Former Star- Brite Laundry Facility
5639 Statesville Road, Charlotte, NC 28269
2. Date of investigation: February 6, 2014
3. Report prepared by: Sujatha R. Nagulapally, Environmental Specialist
4. Persons contacted and telephone number: Ed Kuhn, [phone], [phone]
5. Directions to site: Heading South on 1-77, take Exit 16A for US 21 N/Sunset Rd. East, Merge
onto Sunset Rd for 0.6 miles, Sharp right onto Statesville Rd., destination will be 0.8 miles on
right at corner of Burmith Ave. and Statesville Rd., 5639 Statesville Rd.
6. Discharge point(s), list for all discharge points: Storm Sewer
7. Receiving stream or affected surface waters: Irwin Creek
a. Classification: C
PART I
1, )
2. F
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lease provide a description of existing or substantially constructed ground water treatment
,stem: The groundwater treatment system consists of two Grundfos Redi-flow electrical pumps,
ie 6 Tray QED Air Stripper, two bag filters in parallel. The remedial equipment will be housed
a Class I Division 11 enclosure. Groundwater extracted from the recovery wells will be
)Ilected and introduced into the QED air stripper of 75 gallons a minute. A pump will collect
e water from the air stripper sump and route the flow through two parallel filtration units to
move sediment. The water will then will flow through underground piping to a nearby storm
wer.

PART III - EVALUATION ARIA RECOMMENDATIONS
The pertrtittee, Philips 66 Company of NC has applied for a NPDES permit
discharge of treated groundwater to City of Charlotte's storm sewer at the above
Derek Denard from Raleigh office and Sujatha Nagulapally from Nlooresvil
with the Engineer and Contractor at the site. Site appeared to be clean and ready f
proposed groundwater treatment system. Additional information, updated site mal
coordinates are requested from the permittee for permit approval.
At this time there are no additional comments,, hence it is recommended that the pm
requested.
Su'atha Na u'lapally 21 f14
Signature of report prearer
ftrgkPadS' §ryrt2d Oy RtM[ew N. i
�N<� R��
Andrew H. Pitner ,F t:
0v1Yr5NT$ttllNt-PYthkS�YGd@Flt„
Water Quality Region l`u r isor
t;
I%

United States Environme
EPA Washington, I
Water Compliance In
Section A: National Da
Transaction Code NPDES
2 1. 1 3 NCG510540 Ill 12
21
action Agency Form Approved.
`o OMB No 2040-0057
Jon Report Approval expires 8-31-98
tern gliding (i.e., PS)
to/day Inspection Type inspector Fee Type
09121 117 18 19 20
Li
Inspection Work Days Facility Self -Monitoring Evaluation Rating Fit CA --_Reserved --------- --
S7 10 70 L_j71 72 l 731 1 174 i 80
Section 8: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number) 10:00AM 17#09121 16/10/13
former Star -ante Laundry
5639 Statesville Rd Exit Time/Date Permit Expiration Date
Charlotte NC 28269 11 0A 17109#21 20109130
Names) of Onsite Representative(s)tTitles(s){Phone"and Fax Number(s) Other Facility Data
#1#
e
w w ww.e w w w www 3 w .aw w w. ®♦ w^ w a
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) AgencylOf€ice/Phone and Fax Numbers Date
Edward Watson MRO GVV///
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers 16ate
+C
EPA Form 3560-3 (Ill 9-94) Previous edit s are obsolete.
Page# 1

40
NPDES yr/mo/day Inspection Type (Cont)
31 NCG610540 11 12 17/09/21 17 18 Lj
C---- nf tAffnph atiriffinnni chopfq of mirmthip and (,hP(*fistq as necessarv)
On September 21, 2017, Edward Watson of the MRO performed a compliance inspection for permit
NGC510540,
Present on site for the inspection were Frans Lowman and Joe Vickers of ATC.
The system was reviewed and found to operating within the limits of the permit.
O&M records and laboratory analytical data were reviewed during the site visit.
Comments were made regarding the C.O.C. as to marking the preservation method as being
preserved on ice.
Also, there should be a year on the table for the monthly maintenance log sheet.
Overall, the facility was found to be in compliance with the permit.
Page# 2

Permit: NCG51€ 540 Owner - Facilitin farmer Star-Brite Laundry
Inspection Date: 09/21/2017 inspection Type: Compliance Evaluation
Permit
Yes No NA NE
(If the present permit expires in 6 months or less), Has the perrrittee submitted a new
■
0
11
application?
Is the facility as described in the permit?
Are there any special conditions for the permit?
El
9
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El
Is access to the plant site restricted to the general public?
■
El
E
Is the inspector granted access to all areas for inspection?
0
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11
Comment: There are nos eecal conditions re aired for this ermit. The ermit was resent and able to
be viewed durin the site visit.' The eemit recentl renewed and will not ex iced until
9/30/2020.
Flow Measurement - Effluent
Yes Nos NA NE
# Is flow meter used for reporting?
a
0
1:1
El
Is flow meter calibrated annually?
0
11
11
Is the flaw meter operational?
0
E
(if units are separated) Does the chart recorder match the flow meter?
El
11
■
Q
Comment. The flow meter is cha ed annuall . 'The Ourchase recei t is bein used as roof calibration.
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
Are all other porameters(excluding field parameters) performed by a certified tab?
■
El
1:1
11
# Is the facility using a contract lab?
■
Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
9
D
El
13
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0 2 degrees?
11
13
■
11
Incubator (BOD) set to 20.0 degrees Celsius +/- 1,0 degrees?
Comment: The C,O.C, needs to reflect the samples are bein reserved on ice a a method of
preservation,
Operations & Maintenance
Yes No NA NE
Is the plant generally clean with acceptable housekeeping?
■
0
1:1
11
[does the facility analyze process control parameters, for e: MLS, MCT, Settleable
0
El
■
0
Solids, pH, CC, Sludge Judge; and other that are applicable?
Comment: General house kepoinn is nnrd. The rs'around -the treatments stem;should pe bein
maintained as part of the permit.
Effluent Pie
Yes No NA NE
Page#
' 3

Permit NCG510540 Owner . Facility: former Star-Brfte Laundry
Inspection Date., 09/21/2017 Inspection Type: Compliance Evaluation
Effluent Pive
Yes No NA N
Is right of way to the outfall properly maintained?
■
0
11
11
Are the receiving water free of foam other than trace amounts and other debris?
0
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C3
El
If effluent (diffuser pipes are required) are they operating property?
Cl
0
■
11
Comment: The effluent oiDe is located in the storm drain at the North end of the orODertv aloe
Statesville Rd, which empties into an unnamed tributary of Irwin Creep Stream Se meet
11-1 -1 which is olassifl d as class°`C'" within the Catawaba River Basin,
Page#
4

t 410 7606 Whitehall Executim
C
N
N.C. Engineering I
k kw
iral Resources
D E C
2
P
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I Ar It I q
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101 =-H�- �11- �
On behalf of Phillips 66 Company, ATC Associates of North Carolina, P.C. (ATC) is
submitting three copies of the National Pollutant Discharge Elimination System (NPDES)
Permit Application for the discharge of treated groundwater at the above referenced project
site. Attached you will find the NPDES pennit application form NCG51 000 and a check for
payment of the NPDES permit application fee, on behalf of the Phillips 66 Company.
In addition, ATC has evaluated the alternatives to surface water discharge, as required in the
case of any NPDES pen -nit application, in accordance with the Engineering Alternatives
Analysis Guidance Document. If you have any questions or comments, please contact our
office at [phone].
Sincerely,
ATC Associates of North Carolina, P.C.
Brandon Culberson, E.I.T.
Project Engineer
cc: Mr. Ed Kuhn, Contract Program Manager for Phillips 66 Company

Chad
NCI
I
AT]
ll c nlb i19,zul-i
jA

Engineering Alternatives alysi ' and NPDESe Application
Former Star- rite Laundry Facility
Phillips 66 RM No. 0528
5639 Statesville Road
Charlotte, North Carolina 8269
NCDENR Incident No. 15635
Risk Classification: Mgh
ATC Project No. 089.75118 0528
Prepared by:
Submitted to:
North Carolina epart ent of Environment and
Natural Resources
Division of Water Quality
NP13ES Pe it Emit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
On Behalf of. -
Phillips fib Company
Attn: Ed Kuhn
Brandon Crulberson, E.I.T.
4215-1 Stuart Andrew'Boulevard
Protect Engineer
Charlotte, North Carolina 281'
Submitted by.
TC Associates of North Carolina, P.C.
/osephC3
7606 WItitehall Executive Drive Suite 800
Schold, P.E.
Charlotte, North Carolina 2873
NC Licensed Engineer ##21736
Phone: [phone]
Fax: [phone]
December 19, 2013

TA
SITE INFORMATION ..............
1.1 Site Description......
I E OF CON"
low Projectio
,4. 1 tv an u xizau:r, vv azv�-,atv
2.2 Land Application..
.3 Infiltration Galleries...... .
APPENDICES
Appendix A NPDES Permit Application — N 'G 1000

EAA & NPDES Pennit Application
1.0 SITE INFO
1.1 Site Description
i houses the site remediation system.
Statesville Road. The remaining vicinity land usage is primarily residential.
1.2 Site Background
submitt,
most fe
Feb'
ASNE
2006 a
...- -.7-1
1995.
occurred, Because remaining impact was limited to deep over burden and upper bedrock zones
beyond the influence of the remedial system, the NCDFNR UST Section allowed development of a
New Technology Cleanup Plan (NTCP) to address the remaining impact. Additionally, a road
widening project required abandonment of monitoring and remedial system wells, which would
have also disrupted remedial operations.
On November 6, 2012, the NTCP was submitted to NCDENR addressing the elevated
concentrations in the deep saprolite and upper bedrock zones. The N'FCP specifies a Pump and
Treat (Pi system that removes and cleans groundwater fi-om two deeper zones with discharge
into a storm drain via an NPDES permit.
AT C Associates of North Carolina, P.C.

EAA & NPDES Permit Application
1.3 Dewatering Conditions and Flow Projections
The step test at recovery well RW-1 indicated that puti
)umping rates.
DeceLnber 19,2QI3
; 5.0 gpm, if the pi
ATC conducted an z
on of yield (pumpin
[uifer conditions. T1
iid 140ft2/day.
loll, I IN
11
a
a
e
1.
d
Ir
2.0 ENGINEERING ALTERNATIVES ANALYSIS
The North Carolina Division of Water Quality Engineering Alternatives Analysis (EAA) Guidance
Document, dated June 23, 2005, requires an evaluation of wastewater disposal alternatives in
addition to direct discharge. The subject discharge will be from a groundwater remediation system
and the following wastewater disposal alternatives are therefore being evaluated:
• Connection to an existing wastewater treatment system
• Land application
4* Infiltration galleries
2 AT C Associates of North Carolina, P.C.

EAA & NPDES Permit Application
ATC Project No. 89.75118.0528
.1 Connection to an Existing Wastewi
ATC contacted the Charlotte-ecklebur
onste treatment; system could be cdischaj
December 19 2013
dent System
c
' x ! ! 4 x l •' ! ! i
!
3 ATC Associates ofNorth Carr

EAA & NPDES Permit Application
A TCPrnie rt Nn R9 75 i 1 R 05?R
of 2014. The discharge point of ; the
tributaries.
December 19 2013
4 ATC Associates of North Caroli

AyT.Irm FAA Division of Water Resources FOR
National Pollutant Discharge Elimination System (NPDES)
NCDENR Application for Coverage Under General Permit Year
NCG510000 Ce
Authorization to Construct groundwater remediation projects designed =C1
to treat petroleum-containinatedgrouna�4,ater. Check
Assigned "rt
NOTICE OF INTENT
[Required by 15A NC AC 0214 .0 j 27 d ]; [ten-n, definition see 15A NCAC 021-1.0103 Q
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will I
Company Name Phillips 66 Company
Company Contact Ed Kuhn
Street Address 4215-1 Stuart Andrew Blvd.
City Charlotte State NC ZIP 28217-
Telephone # [phone] Fax [phone]
Cell/Mobile # [phone] Email cd.kuhn@contractor
2) Location of facility producing discharge:
Facility Name Fortner Star-Brite Laundry Facility
Facility Contact System Operator, Brandon Culberson
Street Address 5639 Statesville Road
City Charlotte State NC ZIP 28269-
County Mecklenburg
Telephone [phone] Fax [phone]
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street naines, state road in
and direction from a roaaWay intersection).
Page 1 of 5 Revised

NCG 10000 New A
`the following:
posed
ended.
1: 1635
o
plume of discharge per each discharge point (in GPI )-. 8640
large frequency* [Required by 15A NCAC 02H.105(c 1)]
he discharge is; ® Continuous
El Intermittent -Describe when the discharge will occur:
measurable accumulation of 1/8" or more in a well or floating on surface water'.
No
Page 2 of 5 Revised 911113

NCG510000 Nei
wek all of the following that
Evil/Water Separator
Other:
[pply:
® Air Stripper
thud:
ease provide the followi
for stripping (in CFM): 420
ratio: 14
ay (if applicable):
aces for all chemicals of concern shi
,reentage i.e. 98% or 0.98)
known.
Carbon Adsorption Filter.,
flowing information:
nfo ation:
used, please provide the following information:
sew capacity of each unit(s) (in GPM): 30
disposal method: Approved landfill
r components to be included, please specify
waters: [Required by 1 A NCAC 021-1 .tl l05' e l ]
ux c41— ,s.,.v. xx «c. ..cw .r ......... wx,.xv+..ux b"' .v a.....« w.,.�.+....--- -----
(e.g. City ofRaleigl ). Cily of Charlotte discharge into Irwin Creek
b) Stream Classification (i.e. WS-IV, C, SA, etc): C
0) Alternatives to direct discharge:
[Evaluation required by QIS " 143-215a l b 5 a and 15A NCAC 02H .t} 145tc}C2)]
Andress the feasibility of implementing each of the following non -discharge alternatives:
a) Connection to a Municipal or Regional Sewer Collection System'
b) Subsurface disposal ;(including nitrification field, infiltration gallery, injection wells, etc.)
c) Spray irrigation
Page 3 of 5

The alternatives to discharge analysis she
ated.
Dichlorethane.
Page 4 of 5 Ravk

NCG510000 Nem
CERTIFICATION
I certify that I am familiar with the informationcontained in this application and that to the best of
and belief such information is true, complete, and accurate.
Printed Name of Person Signing; Brandon Culberson
Title.
(Please review 15A NCAC 02N .010t5 Up. for authorized signing officials)
December 19, 201
(Signature ofApplican�) (`Date Signed)
North Carolina. General Statute - 1 ,EA provides than:
Any person who knowingly makes any false statement representation, or certification in any application, re+
plan, or other document filed or required to be maintained under this Article or a rule implementing this Art
knowingly makes a false statement of a material fact in a rlemakig proceeding or contested case under thi
who falsifies,' tampers with, or knowingly renders inaccurate any recording or monitoring device or meth&
e operated or maintained under this Article or roles of the Commission implementing this Article, shall b+
Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). 18 U.S.C.
provides a punishment by a fine or imprisonment not more than 5 years, or both, for a similar offense.
This application must be accompanied by a check or money order for $100.00 leer G.. ' 1,
made payable to:
DENR
Mail this application and one copy of the entire package (with check) t
NC' DENR l DR 1 Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 76 -1617
Attn: Charles Weaver
Final Checklist
This application will be returned as incomplete as allowed by 1 A NCAC 0211.0107(bunless at',
following items have been included:
Complete application with all supporting documents (plus one copy of entire package)
Check or money order for 110.00, payable to NCDENR
3 copies of county map or U GS quad sheet with location of facility clearly marked on map
3 sets of plans and specifications signed and sealed by a North Carolina. P.E. (if new or mod'ifi
Thoroughh responses to items I -I I on this application
Alternatives analysis including present value of costs for all alternatives
Dote,: The submission of this document does not guarantee the issuance of an NPDES ermit
Page 5 of 5

bi
N $CALE � III

OCTOBER 2013 GROUNDWATER ANALYTICAL RESULTS
Fortner Star- rite Laundry
5639 Statesville Road
Charlotte, North Carolina
NCDENR Incident No: 1 635
IM No: 0528
Monitoring, Sampting
Welf
..
..
-«
AbandonedWell
s
!
u
NS = Not Sampled
N = Not analyzed
Concentrations are reported in micrograms per liter (m /1) or parts per billion (ppb)
Concentrations expressed in highlighted, bold print exceed the January 1, 2010 15A NCAC 2L Groundwater Quality Standard (21, Standard)
BTEX = Benzene, Toluene, Ethylbenzene, Total Xylenes
MTBE = Methyl Tertiary Butyl Ether
IPE = Isopropyl Ether
DB Ethylene Dibrc mile (1 2-Dibromoethane)
GCL = Gross Contamination Level
analyised using; EPA > Method 504.1
J = Estimated Value

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SITE MAP
FORMER STAR-BRITE LAUNDRY FACILITY (RM 0528) (VkTc
5639 STATESVILLE ROAD ASSOCIATES OF NORTH CAROLINA, P.C.
CHARLOTTE, NORTH CAROLINA 28269 Charlotte, North Carolina 28217 [phone] FAX [phone]
CAD HLE PREP, BY REV, BY SCALE DATE I PROJECT NO,
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RECMV EDINCDE,NRIDIN R 1�eo
Weaver, Charles
From: Weaver, Charles WOROS
Sent: Thursday, October 13, 2016 1:45 PMOORE.SVILLE rit!G,1,01NIAL of ICE
To: I ed.kuhn@contractor,p66.com'
Cc: 'Frans Lowman'
Subject: renewal of NCG510540 / former Star-Brite Laundry
Attachments: NCG510000 Tech Bulletin Final 2016.pdf, NCG510000 Final Signedpdf
Importance: High
Attached you will find the updated version of NPDES General Permit NCG510000, effective 10/1/2016. Discard any
previous versions of the General Permit and use this version until further notice.
You do not need a reprinted Certificate of Coverage, as the one issued to you in 2014 is still applicable.
If you have any questions about this matter, simply reply to this message.
0
Charles H. Weaver via
Environmental Specialist x CD
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919-807-6391 t�J
cm
chades.weaver(a)ncqgnL,goy a 4(Z-'-
C"
(physical address) 512 North Salisbury Street, Raleigh, NC 27604
(mailing address) 1617 Mail Service Center, Raleigh, NC 27699-1617
E"mail correSP017dence to and from this address is subject to the North Carolina PUblic Records Law and may be disclosed
to third parties.