NC0055786_Pretreatment_Annual_Report_20210225

City of Lexington
Pretreatment Program Annual Report
January 1, 2020 to December 31, 2020

LEXINGTON
NORTH CAROLINA
WATER RESOURCES
QUALITY FIRST
2/25/20
Mr. Michael Montebello
NC DENR
DWQ/PERCS Unit
1617 Mail Service Center
Raleigh, N.C. 27699-1617
Re: City of Lexington's Pretreatment Program Annual Report 2020
Dear Sir,
Attached is a copy of the City of Lexington's Pretreatment Program Annual Report
for the period of January 1, 2020 to December 31, 2020.
Sincerely,
Eglantina Minerali
Lab Supervisor/ Pretreatment Program Coordinator
cc: WSRO
500 Glendale Road - Lexington, NC 27292 • 336.357.7889
vv v'v.LExINGTONNC.Gov

Annual Pretreatment Program Report
POTW Name: City of Lexington
Report Date: February 25, 2021
Report Covered By This Report: From 01/01/2020 to 12/31/2020
Period Covered By Previous Report: From 01/01/2019 to 12/31/2019
Name of Wastewater Treatment Plant(s): Lexington Regional WWTP
NPDES Permit Number: NC0055786
Person to Contact Concerning Information Contained In This Report: Eglantina Minerali
Title: Lab Supervisor/Pretreatment Program Coordinator
Mailing Address: 28 West Center Street, Lexington, NC 27292
Telephone: [phone], Ext. 5091
I have personally examined and am familiar with the information submitted in this document and
attachments. Based upon my inquiry of those individuals immediately responsible for obtaining the
information reported herein, I believe that the submitted information is true, accurate, and complete.
I am aware that there are significant penalties for submitting false information.
'f:(L4-jC
Signature of Official
Title: Lab Supervisor/Pretreatment Program Coordinator
Date: 02/25/2021

L
l: •,1 1 1 [r II
LEXINGTON
NORTH CAROLINA
WATER RESOURCES
QUALITY FIRST
January 28, 2019
NC Division of Water Resources - PERCS Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of Pretreatment Program Signatory Authority
City of Lexington (NPDES Permit NC0055786)
Davidson County
Dear PERCS:
As the Mayor of City of Lexington, I hereby delegate responsibility for overall operation of the
City of Lexington's Pretreatment Program to Eiantina Minerali, Laboratory Supervisor /
Pretreatment Coordinator.
This designation will provide Ms. Minerali with the authority to sign all required documents
under the Pretreatment Program, including the authority to sign the Pretreatment Annual Report
(PAR) and submit it to NC DWR PERCS.
If you have any questions, please contact me at [phone] or Eglantina Minerali at
[phone].
Sincerely,
••"1.Y-°-Are'e"
Newell Clark,
Mayor
cc: Tom Johnson, Water Resources Utility Director, Public Services Admin
50(I Glendale Road Lexington, N(' 27292 - 336.357.7889
WWW.1J?\IN(;•l'ONNC.(;OV

Narrative Summary
January 1, 2020 — December 31, 2020
City of Lexington
I. General Program Information:
A. AT, LTMP, HWA, SUO, ERP, IWS and IUP are up to date.
B. ERP was approved on 2/13/2020 Aproval letter is enclosed.
C. HWA was approved on 6/26/2020. Approval letter is enclosed.
D. LTMP was updated and sent to the Municipal Permitting Unit for approval on 9/24/2020.
Additional information was requested on 2/5/2021 and will be provided by 3/8/2021
E. IWS was approved on 12/2/2020. That included 144 commercial establishments/industries
contributing approximately 285,313 gpd (0285 MGD), 4.4% of the City's WWTP permitted flow
of 6.5 MGD. Approval letter is enclosed
F. All dates on the Divisions Database Program Info Sheet are correct. A copy of our Program Info
Sheet is enclosed.
G. A total of 37 active dentists in Davidson County were contacted during the year of 2020,
including 5 oral surgery offices. The OTCR was received from 14 of 32 required active dentists
with a 44% response rate.
II. Toxicity_ Bioassay Analyses:
During the year of 2020, Lexington Regional WWTP has passed February (Ceriodaphnia Dubia),
May (Ceriodaphnia Dubia), August (Ceriodaphnia Dubia) and November (Ceriodaphnia Dubia)
bioassay.
III. Letter of Delegation of Pretreatment Signatory Authority: Enclosed
IV. Asco Power Technologies — IUP #0038
A. SIU was not on SNC this PAR year.
B. Half of the BDL was used for the IDSF.
C. A letter requesting an Authorization to Construct was received on November 20th, 2019. More
information was requested and received on March 3rd, 2020. The final plans and specifications
were reviewed and found to be satisfactory. Authorization to Construct was granted on March
6th, 2020 for the installment of the new parts wash and wastewater pretreatment system to
replace the old systems. The IUP was modified, approved and became effective 10/13/2020
with no changes in permit limits and monitoring. Approval letter is enclosed

D. Annual and new wash/paint line inspection was performed on 9/18/2019. Inspection form is
enclosed.
E. Certification letters for TTO are enclosed.
V. Cardinal Container Service — IUP #0010
A. SIU was not on SNC this PAR year.
B. The IDSF for Cardinal's reflects monthly averages and half of BDL
C. Annual inspection was performed on 12/29/20. Inspection form is enclosed
VI. Hollywood Bed & Spring Mfg. Co, — IUP #0028
A. SIU was not on SNC this PAR year
B. Half of the BDL was used for the IDSF.
C. Annual inspection was performed on 12/22/2020. Inspection form enclosed.
D. Certification letters for TTO are enclosed
E. 1UP was modified and sent for approval on 10/14/2020 with the name change from Linwood
Hospitality LLC, to Hollywood Bed & Spring Mfg. Co.
VII. Matcor Metal Fabrication — IUP #0012
A. SIU was not on SNC this PAR year.
B. Half of the BDL was used for the IDSF.
C. A NOV was issued on 10/9/2020 for exceeding their Zn and Cu permit during routine monitoring
from the City of Lexington. The situation was assessed and corrected measurements were taken
to resolve and prevent the problems.
D. Annual inspection was performed on 12/18/2020. Inspection form is enclosed
E. Certification letters for TTO are enclosed
VIII. Tier Rack — IUP #0045
A. The IDSF for Tier Rack is not enclosed. No discharge has occurred in 2020. Tier Rack is
continuing to pump and haul to HAZMAT. The manifest is enclosed.
B. Annual inspection was performed on 12/15/2020. Inspections enclosed.
C. Certification letters for TTO are enclosed.

Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1. Pretreatment Town Name: City of Lexington
2. "Primary" NPDES Number NCO() 55786
or Non_Discharge Permit # if applicable => N/A
3. PAR Begin Date, please enter 01/01/yyyy
4. PAR End Date, please enter 12/31/yyyy
5. Total number of SIUs, includes CIUs
6. Number of CIUs
7. Number of SIUs with no IUP, or with an expired IUP
8. Number of SIUs not inspected by POTW
9. Number of SIUs not sampled by POTW
t0. Number of SIUs in SNC due to IUP Limit violations
11. Number of SIUs in SNC due to Reporting violations
12. Number of SIUs in SNC due to violation of a Compliance Schedule, CO, AO or similar
13. Number of CIUs in SNC
14. Number of SIUs included in Public Notice
15 Total number of SIUs on a compliance schedule, CO, AO or similar
16. Number of NOVs, NNCs or similar assesed to SIUs
17. Number of Civil Penalties assessed to SIUs
18. Number of Criminal Penalties assessed to SIUs
19. Total Amount of Civil Penalties Collected
20. Number of IUs from which penalties collected
19. =>
3. => 1/1/2020
4. => 12/31/2020
5. _> 5
6. => 4
7. => 0
8. => 0
9. => 0
10. => 0
11.=> 0
12. => 0
13. => 0
14. => 0
15. => 0
16. => 0
17. => 0
18. => 0
$ 0
20. => 0
Foot Notes:
AO
CIU
CO
IU
Administrative Order
Categorical Industrial User
Consent Order
Industrial User
IUP Industrial User Pretreatment Permit
NNC Notice of Non -Compliance
NOV Notice of Violation
PAR Pretreatment Annual Report
POTW Publicly Owned Treatment Works
SIU Significant lndustrial User
SNC Significant Non -Compliance
revised 1/2018: PAR PPS 2018

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Pretreatment Program Info Database
for Program Name Lexington
WWTP Name City of Lexington
Program Approval Date 06/10/1983
Pretreatment Status Full
Region WSRO
County Davidson
NPDES Number NC0055786
NPDES Effective Date 02/01/2016
NPDES Expire Date 04/30/2019
POTW is Primary WWTP TRUE
Design Row mgd 6.5000
WWTP SIU's
WWTP CIU's
date Inactive
5
4
printed on: 12/22/2020
Stream information
7Q10 Flow cfs / mgd
1Q10 Flow cfs / mgd
Stream Classification
IWC % at 7Q10 60.03
6.7
5.57
WS-V & B
/ 4.33
/ 3.60
Basin Number YADO7
Receiving Stream Name ABBOTTS CREEK
J
Last PAR Rec 02/17/2020 PAR Due Date 03/01/2021
Current Fiscal 09/10/2019
Year PCI Done
Last Audit on 09/21/2017
% Design mgd is SIU permitted
Program Sills
Program ClUs _
Date Next Due
Date Received by DWR
Date Approved
Adopt Date Required
Date Adopted
1.78
Audit Year Next 21 /22
Permitted SIU flow (mgd) [Pt_SIU)
HWA LTMP IWS
07/01/2024 11/23/2025
mercury
1 831
required
!yes
.116
SUO ERP
01/30/2020 , 09/24/2020 11/28/2020 01/08/2013 02/03/2020
07/16/2020 1 12/02/2020 01/09/2013 02/13/2020
Info in this Box from Pt_Contacts Date Date
Date
PT_Pr7 Attended Attended Attended
Formal Name g.Prime Phonel ext Fax HWA Wksp IUP Wksp PAR Wksp
Ms. Eglantine Minerali
!Prim II(336)
357-788D I l
it 1/30/2019 15/17/2016 11/29/2019
[e-mail] If Pretreatment Program
28 W. Center Street
27292
IPretreatment Related NOVs from DWQ
6/11 /2010
NOV: Failure to provide information upon request which
DWR Central Office Contact
DWR Regional Contact
Monti Hassan
Jim Gonsiewski
N s+ov c

DocuSign Envelope ID: 2B92A7F1-4F50-4D06-B72B-1D3F5DCF8AOC
STATE
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
February 13, 2020
Via Electronic Mail ([e-mail])
Eglantina Minerali
Chemist
City of Lexington
28 W. Center Street
Lexington, NC 27292
Subject: Pretreatment Review of Enforcement Response Plan (ERP)
City of Lexington - NPDES Number NC0055786
Davidson County
Dear Ms. Minerali,
The Pretreatment, Emergency Response, and Collection Systems Unit (PERCS) of the Division of
Water Resources has reviewed the updated Enforcement Response Plan (ERP) for the City of
Lexington. The updated ERP was in response to the Dental Amalgam Rule (40 CFR 441) and was
received by the Division on February 3, 2020.
The review indicates that the ERP is adequate and meets the requirements of 15A NCAC 02H .0905
and 40 CFR 403.8 (f)(5). Proper implementation is also required by the City's NPDES permit. The
Division expects you to follow this approved ERP for all enforcement actions. Modifications to this ERP
must be approved by the Division.
If you have any questions or comments, please contact Monti Hassan at [phone] [email:
[e-mail]]. Thank you for your continued support of the Pretreatment Program.
ks l/lexington. erp.2 02 0
Ec: PERCS Unit File
Jim Gonsiewski, WSRO
Central Files (Laserfische)
N:,t� � `E` �/
0101~M 01 bwrmwwr aurtY
Sincerely,
CDocuSigned by:
M` Ham.
866374CA4137482...
for S. Daniel Smith, Director
Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11611 Mail Service Center I Raleigh, North Carolina 27699-1611
919.707.9000

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
(sent via email: [e-mail])
NORTH CAROLINA
rvironmental Quality
June 16, 2020
Eglantina Minerali, Pretreatment Program Coordinator
City of Lexington
28 W. Center Street
Lexington, NC 27292
Subject:
Pretreatment Review of Headworks Analysis (HWA)
City of Lexington (NPDES Number: NC0055786)
Davidson County
Dear Ms. Minerali:
The PERCS Unit of the Division of Water Resources has reviewed the Headworks Analysis (HWA) submitted
by the City of Lexington. The HWA was initially received by the Division on January 30, 2020, followed by
additional information received on May 15, 2020, and June 12, 2020.
The Division concurs with the HWA calculations for all pollutants of concern, with corrections below.
These approved Maximum Allowable Headworks Loadings (MAHLs), Maximum Allowable Industrial
Loadings (MAILs), and the basis for these values are found on the last page of the attached HWA
spreadsheet which has the corrections marked. The results of the HWA are also listed in the bottom
section of the attached allocation table (AT).
1. HWA Corrections: Please do not hesitate to contact PERCS if you have any questions or concerns
regarding the changes made outlined below, or if the POTW does not agree these modifications. All
corrected spreadsheets were emailed to you for your files, with the changes highlighted. Please
ensure the POTW's paper and electronic HWA, AT, and other supporting documents contain these
corrected documents, especially the allocation table (AT).
a) POTW Average Flow: POTW average flow was corrected based on DMR monthly averages
data pull from the Division's compliance database (see updated removal rate spreadsheet).
b) NPDES Limits:
i. BOD — Used more stringent Summer limit of 5 mg/I.
ii. Ammonia — Used more stringent Summer limit of 1 mg/I.
iii. Total Phosphorus - Used Summer seasonal total of 4,910 Ibs and converted to
concentration -based limit (0.43 mg/I), by dividing 210 days (April through October),
WWTP permitted flow, and 8.34 (conversion factor).
c) Stream Standards: Stream standards for several parameters were updated based on the
dissolved water quality standards, site -specific stream information, and effluent and instream
hardness, submitted by the POTW (see attached calculator spreadsheet).
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street , Ibtl Mail Service Center I Raleigh, North Carolina 27b9916II
919.707.9000

d) Removal Rates:
i. Total Suspended Solids (TSS) — Updated TSS removal rate based on DMR effluent data.
Please note that, while recalculating DMR monthly effluent averages using 1/2
detection level (DL), it was noticed that DL was not consistent throughout the HWA
sampling period. Please ensure that laboratory meets the correct DL consistently as
listed in the Division -approved LTMP for all DMR and LTMP samplings in order to
be able to calculate correct removal rates.
ii. Total Phosphorus (TP) — Recalculated removal rate using DMR monthly average
effluent as the POTW samples weekly effluent TP, required by NPDES permit.
e) WWTP Design Criteria:
i. BOD, TSS — PERCS approves POTW's using of 1.5 multiplier option to currently
available design criteria, since the WWTP has been in full NPDES permit compliance
for the previous two years (2018-2019) for BOD and TSS, per PERCS 2007-2008 design
memorandum.
ii. Ammonia — Calculated NH3 design value, 13.125 mg/I, usingTKN value of 21 mg/I and
by applying NH3/TKN ratio of 25/40 (Metcalf and Eddy). PERCS chose to select design
loading as AHL as it appears to be more conservative than the calculated NPDES
loading. This selection did not cause ammonia overallocation. See more discussion
below in item 2.
f) Silver Inhibition Concentration: Silver inhibition concentration in the Inhibition Loading
Calculation table was corrected as this appears to be a typographical error.
g) Uncontrollable Concentrations: Uncontrollable concentrations for several parameters were
updated on the Mass Balance spreadsheet (see attached) and carried over to HWA
spreadsheet. PERCS chose not to use zero for silver uncontrollable concentration as it was
noticed that not all the samples were measured using best available detection label (currently
1 ug/I). POTW may be able to use uncontrollable as zero if all the influent sample data is less
than 1 ug/I.
2. WWTP Design Criteria: WWTP design values for BOD and TSS, provided by the POTW, were calculated
in 2002 by Pease architect & engineers. PERCS was notified that there were no design changes since
then. Please keep PERCS informed regarding any WWTP design changes or plant upgrades in future.
PERCS highly recommends POTW to obtain design values from design consultants for ammonia as it
was calculated by PERCS this time, as well as TP, and use the design numbers in the next HWA
calcuilation.
3. Overallocation:
a) Influent Loadings and TS5 Overallocation — During the review, it was noted that influent BOD
ant TSS concentrations were much higher than the ones from previous HWA period, causing
TSS overallocation on the AT, even though the POTW has not had any BOD or TSS permit
violations during the previous two years. According to POTW, for the last several years some
of the sludge had been recirculated through the influent sampling point, which appears to be
the reason for increased loadings at the influent. Per POTW, sludge recirculation has been
stopped as of end of 2019. PERCS is approving this HWA with the following
recommendations:
I. POTW should not recirculate return sludge at the influent. Influent should be true
influent without mixing with any side stream or return activated sludge, per your LTMP.

II. In order to resolve TSS overallocation, calculate DMR monthly average TSS as well as BOD
influent and effluent from January through December 2020, and overall removal rates
and submit updated HWA by April 1, 2021.
b) Silver Overallocation — Silver appears to be overallocated based on dissolved metals stream
standard. PERCS is approving this HWA with following recommendations:
i. Start all LTMP samplings using PERCS recommended lower DL of 1 ug/I.
ii. Review IUP limits and compare with discharge data to lower silver limits.
4. Detection Levels (DLs): During the review of removal rates, it was noticed that detection levels for
several parameters, such TSS (5 mg/I, 2.5 mg/I, 1mg/i), As (5 ug/I, 3 ug/I), Cr (5 ug/I, 2 ug/I), Se (5 ug/I,
3 ug/I), and Ag (5 ug/I, 1 ug/l) were not consistent throughout the sampling period. Please review
currently recommended lower PQLs (see attached) with your LTMP DLs, follow-up with your contact
lab, and submit updated LTMP by September 30, 2020.
5. Allocation Table: Allocation table (AT) has been updated, per IUP limits. Please ensure to keep the
AT updated as the IUPs get modified or renewed.
6. Next HWA Due: The HWA approved today is primarily based on DMR/LTMP data for the period of
February 2018 through August 2019. Unless conditions at the POTW change significantly and thus
warrant an earlier submittal (see Comprehensive Guide, Section B), the POTW must submit the next
updated HWA due by July 1st, 2024. Please note that, permittee must submit updated HWA to the
Division within 180 days of the effective date of a new permit, per Part IV, Section D.4, of your permit.
Federal and State pretreatment regulations require the local delegated pretreatment program to
effectively control and document the discharge of wastewater from Significant/Categorical Industrial
Users to the POTW. It is the POTW's responsibility to ensure that these objectives are consistently met.
Thank you for your continued cooperation with the Pretreatment Program. If you have any questions or
comments, please contact Monti Hassan at [phone] [email: [e-mail]].
m h/Lexington. H WA.review.005
attachments:
HWA AT Approved
HWA Removal Rate
Dissolved Metals Calculator
Uncontrollable Mass Balance
PERCS Recommended PQLs
ec:
Laserfiche
Jim Gonsiewski (WSRO)
PERCS Unit
Sincerely,
CDocuSigned by:
M04.xc. Ham•
866374CA4137482...
for S. Daniel Smith, Director
Division of Water Resources

DocuSign Envelope ID: CAB10D20-7F0B-483C-A464-E26DDE492427
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
12/2/2020
Via Electronic Mail ([e-mail])
Ms. Eglantina Minerali
Pretreatment Program Coordinator
City of Lexington
500 Glendale Road
Lexington. NC 27292
Subject: Pretreatment Review of Industrial Waste Survey (IWS)
Program: City of Lexington
WWTP: City of Lexington WWTP - NPDES Number NC0055786
Davidson County
Dear Ms. Minerali:
The Municipal Unit of the Division of Water Resources has reviewed the Industrial Waste Survey (IWS) for the
City of Lexington and the area of Welcome. The IWS was received by the Division on August 28, 2020. Additional
information was requested by the Division and the revised IWS was submitted on November 18, 2020.
Proper completion of an IWS is required by your NPDES permit. The review indicates that the IWS is adequate
and meets the minimum requirements of 40 CFR 403.8 (1) (2).
The City's IWS included 144 commercial establishments/industries that contribute approximately 285,313 gpd
(0.285 MGD), 4.4 % of the City's WWTP permitted flow, 6.5 MGD. The City has 5 Significant Industrial Users
(SIUs) and 4 industries with a local permit.
Please remember it is the responsibility of the POTW to continue efforts to ensure that any SIUs, as defined by
NCAC 15A 2H .0903(b)(30) (A) through (D), are identified and subsequently added to the City's pretreatment
program. This includes evaluation of new industrial users (Ills) before they commence discharge and evaluation
of existing lUs determined to be not SIUs that make changes to their process.
Next IWS Due Date: Your next updated IWS is due on November 23, 2025 unless conditions at the POTW change
significantly and thus warrant an earlier submittal.
Regardless of this approval action today, within 180 days of the effective date of any reissued NPDES permit (or
any subsequent NPDES permit modification) the Permittee would be required to submit to the Division a written
technical evaluation of the need to revise local limits (i.e., an updated IWS, or documentation of why one is not
needed). This action may include revising, updating or adding to the list of Significant Industrial Users (Snits).
Pursuant to 15A NCAC 02H .0907(b) either the Division or the permittee may initiate pretreatment program
revisions. Any additional conditions or requirements provided to the pennittee related to pretreatment or
pretreatment program updates must be complied with separately from this approval action.
If you have any questions or comments, please contact Diana Yitbarek at [phone] [email:
[e-mail]].
1:1 NCRTH CAROLINA�1E1 Qi
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street i 1611 Mail Service Center I Raleigh, North Carolina 27699-1611
919.707.9000

DocuSign Envelope ID: CAB10D20-7F0B-483C-A464-E26DDE492427
Thank you for your continued cooperation with the Pretreatment Program.
Sincerely,
�— DocuSigned by:
C464531431644FE...
for S. Daniel Smith, Director
Division of Water Resources
Attachments: Revised IWS
Correspondence
File name: dy/lexington.iws.2020
Copied to: Municipal Unit File
Alexander Lowe, WSRO
Central Files (Laserfische)

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* * * * * * * *

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0.0309

ASCOPower
Technologies -
June 10, 2020
Mrs. Eglantine Minerali
Pretreatment Coordinator
Water Resources Department
500 Glendale Road
Lexington, NC 27292
RE: Permit (IUP #0038) TTO Statement
Dear Mrs. Minerali,
Per the requirements of our TTO program 1 am submitting the following statement:
ASCO Power Technologies
PO Box 689
325 Welcome Center Blvd
Welcome, NC 27374
USA
T [phone]
"Based on my inquiry of the person or persons directly responsible for managing compliance with the
standards for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of
concentrated organics into the waste -streams has occurred since filing the last discharge monitoring report. I
further certify that this facility is implementing the toxic organic management plans submitted to the Control
Authority."
Best regards,
/ '
niel Clark
Environmental Health and Safety Manager
Life Is On Schneider
9Electric

Power
L c.Technologies-
December 17, 2020
Mrs. Eglantine Minerali
Pretreatment Coordinator
Water Resources Department
500 Glendale Road
Lexington, NC 27292
RE: Permit (IUP #0038) TTO Statement
Dear Mrs. Minerali,
Per the requirements of our TTO program I am submitting the following statement:
ASCO Power Technologies
PO Box 689
325 Welcome Center Blvd
Welcome, NC 27374
USA
T [phone]
"Based on my inquiry of the person or persons directly responsible for managing compliance with the
standards for total toxic organics (TTO), 1 certify that to the best of my knowledge and belief, no
dumping of concentrated organics into the waste -streams has occurred since filing the last discharge
monitoring report. I further certify that this facility is implementing the toxic organic management plans
submittedtothe Control Authority,"
Best regards,
0
Matthew Market
Environmental Health and Safety Manager
Life Is Schneider
rEleccrrc

c
c
f
LEXINGTON
NORTH CAROLINA
WATER RESOURCES
Q1'AI.1TS F1Its'I'
3/6/2020
Mr. Randy Steen
Manufacturing Engineering Manager
Mr. Van Sullivan
Environmental Health and Safety Manager
ASCO Power Technologies
Subject: Authorization to Construct Pretreatment System
IU Permit Number: 0038
Dear Mr. Sullivan:
A letter requesting an Authorization to Construct was received on November 20, 2019 by the
City of Lexington. More information has been requested and received on March 3, 2020.
The final plans and specifications for the subject project have been reviewed and found to be
satisfactory. Authorization is hereby granted for the installment of the new parts wash and
wastewater pretreatment system to replace the old systems.
The Authorization to Construct is issued in accordance with Part II, Paragraph 26 of
Pretreatment Permit Number 0038, and shall be subject to revocation unless the wastewater
treatment facilities are constructed in accordance with the conditions and limitations specified in
Permit Number 0038, and in accordance with the final plans and specifications submitted for
review. A copy of the authorized plans and specifications shall be maintained on file at the
pretreatment facility by the Permittee for the life of the facility.
Upon completion of construction and prior to operation of this permitted facility, a
certification must be received by the City of Lexington from you or a Professional Engineer
certifying that the permitted facility has been installed in accordance with the Pretreatment
Permit, this Authorization to Construct, and the approved plans and specifications.
ASCO Power Technologies must notify Eglantina Minerali, of the City of Lexington at
telephone number [phone] Ext.5091 or email at emineralira lexin2tonnc. ov, at least one
week in advance of operations of the installed system so that an in -place inspection can be made.
Such notification shall be made during normal office hours of 8:00 a.m. until 5:00 p.m. on
Monday through Friday, excluding City Holidays.
500 Glendale Road I exington Nl 2/292
\V'\\ \\.1.1'\1\G 1l1'V\(2.1;( 1\
336.35 /. /889

. • IJE II C
LEXINGTON
NORTH CAROLINA
WATER RESOURCES
Q t AI.ITS' FI tt sT
The sludge generated from these treatment facilities must be disposed of in accordance with G.S.
143-215.1 and in a manner approved by the North Carolina Division of Environmental
Management. The issuance of this Authorization does not preclude the Permittee from
complying with any and all statutes, rules, regulations, or ordinances of the City of Lexington,
the State of NC, or the Federal Government. Failure to abide by the requirements contained in
the Authorization to Construct may subject the Permittee to an enforcement action by the City of
Lexington, the State of NC, or the Federal Government in accordance with Lexington's Sewer
Use Ordinance, North Carolina General Statutes 143-215.6A to 143-215.6C, and Federal
Regulations.
In the event that the facilities fail to perform satisfactorily, including the creation of nuisance
conditions, the Permittee shall take immediate corrective action and notify City of Lexington.
Construction of additional or replacement pretreatment facilities requires another Authorization
to Construct.
If you have any questions or need additional information, please contact Eglantina Minerali, of
the City of Lexington at [phone] Ext.5091.
Sincerely,
(- ,c, -, 3 / E / 0 4,2,0
Eglantina Minerali
Lab Supervisor/Pre-treatment Program Coordinator
Lexington Regional Wastewater Treatment Plant
500 Glendale Road, Lexington, NC 27292
Phone: [phone] Ext 5091 Fax: [phone]
emineralifa.lexingtonnc.gov
500 Glendale Road I exington, NC 27292 336.357.7889
\\\\ \\.J.i:\ltic; I't INNC.c;c�\

SIU INSPECTION FORM
Name Of Industry: 5 CO C)1,ill Te o 'es IUP # EO 3?
Address Of Industry: IUP Expiration Date:
=sa s Uhl CO 1A-e s--j 31 /.202-
w+ 'ow...0_ ,.14 34-�
Industry Repre ntatives: Title
Ze . iel C• S M giAc
POTW Representatives: Title
.a_v' % - H ► n eA.uL LQ h U i SoA -
r Pee - k,-P.t,,f C oz t.c i.:.
Date Of Inspection: 9 ( (g [,,f Time Of Inspection: i' am/eii
Purpose of Inspection: Annual ,/ Other (Describe) tte..v..) toc4-1/pc &. 4 �:..a-e_. i m_g
POTW to which IU discharges i 4JS..b i to TP NPDES # NG n0 5 5 k,
Is SIU currently in SNC? No If yes, for what?
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the following:
COMMENTS
Product
Raw materials used
Manufacturing processes
Categorical, if applicable
Production rate
Number of employees
Number of shifts YES /
Comments:
YES
YES
Y/
/NO
NO
NO
--'
3-1(
tr-�—
t pA rAo Ch.-s.e d
J
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the POTW.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS //��.�� � ��
1. Are there floor drains in the production area? YES NO Where do they go? l;1/C�`�-
2. Are production areas diked, co • , or otherwise constructed in such a way as to prevent harm to the WWTP,
especially from spills or slugs? f NO Comments:
3. Are there floor drains in the storage area? YES ,410J Where do they go?
4. Are storage tanks and areas diked, contained, erwise constructed in suck a way as to prevent harm to the
WWTP, especially from spills or slugs? YES 'Rf1�/ Comments: (n,._
5. Are process and storage tanks and pipes labeled? / NO
6. How are off -spec raw w�ials, and products dispose. of?
7. When is the production area cleaned? P
8. Is the wastewater from cleaning the production alea discharged to the POTW? YES
9. What non -process wastewaters are discharged to POTW?
Comments:
Title: SIU Inpsection Form
File name: COMP.INSP App 7-D
Revision data: August 1, 1994
Page 1

SIU INSPECTION FORM
PART II - Plant Tour Section B - PRETREATMENT SYSTEM
Ask the operator to describe pretreatment system.
1. Does operator seem knowledgable about the system? / NO Comments:
2. Are all units operational? / NO
3. How often does operator/maintenanc
4. Is there an operator for each shift?
5. How and when is sludge disposed of?
on check system?
/NO
6. Is there a schedule for preventative maintenance? YES / NO
Comments:
-2. tAilgok
PART II - Plant Tour Section C - SAMPLING POINT(S) AND FLOW MEASUREMENT
(Collect a sample if desired.) p
1. Does an outside lab complete sampling? NO If yes, name of lab. YLg a ta3
2. If industry completes sampling, ask the industry representative to describe sampling procedures. Comments:
3. Is flow measurement equipment operational? F/ NO Comments:
4. Is there a calibration log for the flow meter?
NO Comments:
Comments:
PART III - EXIT INTERVIEW
Review monitoring records and_Asr SIU records required by IUP.
1. Are files well organized? / NO Comments:
2. Are sample collection / chain -of -custody forms filled out properly?/ NO Comments:
3. Do results in files agree with reports sent to POTW?
NO Comments:
4. Who has authority to shut down production should a spill or slug discharge occur?
5. How does SIU inform employees of whom to call at POTW in case of spill/slug?
If slug/spill plan is already required by PO review procedures.
6. Is SIU implementing slug/spill plan? / NO Comments:
Comments:
INSPECTION RESULTS
Slug/Spill Control Plan Needed? Y / NO
Comments, Required Or Recommen ed Actions:
Signature Of Inspector(s)
Date:
Date:
Title: SIU Inpsection Form
File name: COMP.INSP App 7-D
Revision data: August 1, 1994
Page 2

DocuSign Envelope ID: DCE1 F055-A2D5-463D-A912-008AB27372B1
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
11/12/2020
Via Electronic Mail ([e-mail])
Ms. Eglantina Minerali
Pretreatment Program Coordinator
City of Lexington
28 W. Center Street
Lexington, NC 27292
Subject: Pretreatment Review of Industrial User Pretreatment Permit Modification
Program: City of Lexington
WWTP: City of Lexington WWTP, NPDES #: NC0055786
Davidson County
Dear Ms. Minerali:
The Municipal Unit of the Division of Water Resources has reviewed the Industrial User Pretreatment Permit
(IUP) modification submitted by the City of Lexington for the following Significant Industrial User (SIU). The
IUP was received by the Division on October 13, 2020.
SIU #
SIU NAME
0038
Asco Power Technologies
The review indicates that with the following observation, the IUP is adequate and meets the minimum
requirements of 15A NCAC 2H .0905 and .0916 and 40 CFR 403.8(f)(1)(iii). The allocation table, maintained in
the Division's database, has been updated accordingly.
Please correct the following items and submit the new pages:
• Throughout the permit, update the effective date to October 13, 2020 to reflect the modifications.
Regardless of this approval action today, within 180 days of the effective date of any reissued NPDES permit (or
any subsequent NPDES permit modification) the Permittee would be required to submit to the Division a written
technical evaluation of the need to revise local limits (i.e., an updated IWS, or documentation of why one is not
needed). This action may include revising, updating or adding to the list of Significant Industrial Users (SLU's).
Federal and State pretreatment regulations require the local delegated pretreatment program to effectively control
and document the discharge of wastewater from Significant/Categorical Industrial Users to the POTW. It is the
POTW's responsibility to ensure that these objectives are consistently met.
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1611 Mail Service Center I Raleigh, North Carolina 27699.1611
919.707.9000

DocuSign Envelope ID: DCE1F055-A2D5-463D-A912-008AB27372B1 ?age 2 of 2
City of Lexington
Asco Power Technologies IUP Modification
If you have any questions or comments, please contact Michael Montebello at (919) 707 -3624 [email:
[e-mail]]. Thank you for your continued support of the Pretreatment Program.
Sincerely,
by:
A4 rVWV���C L
'— C4645 31431644 F E...
for S. Daniel Smith, Director
Division of Water Resources
ksl/lexington.iup. mod.020
Ec: Municipal Unit File
Jim Gonsiewski, WSRO
Central Files (Laserfische)

CARDINAL CONTAINER SERVICE
I U P #0010

* * * * * * * *
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Chapter: PAR Guidance File name: PABorHpfdlefisitelaiudeli aftt stclfi91lB, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page
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Used in Calculated
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Used in Calculated
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0.11341
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n
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Used in Calculated
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Used in Calculated
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cm
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N
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11 / 19-11 /20/20
11/18-11/19/20
11/17-11/18/20
11/16-11/17/20
9/17-9/18/20
9/16-9/17/20
9/ 15-9/ 16/20
9/14-9/15/20
Sample Date
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SIU INSPECTION FORM
Name Of Industry: 6,A.,d2.A.,31 Co -'A K.u. IUP # CIO t 0
Address Of Industry: r IUP ExpirationDate:Da!t
13S kid c+ e.t- at p 13 /nT
Industry Representatives: ITitle
•
•
POTW Representatives: Title
' ki.,0- ['41'
IQ�a r0..�...�sue
,F.-
Date Of Inspection: j242J) Zo?A Time Of Inspection: 2 o.0 am:
Purpose of Inspection: Annual % Other (Descri )
POTW to which IU discharges Z-. lit% Vi NPDES # t'V C 0055404
Is SIU currently in SNC? /110 If yes, for what?
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the following:
COMMENTS
Product YES /
Raw materials used YES /
Manufacturing processes YES
Categorical, if applicable YES /
Production rate YES
Number of employees YES /
Number of shifts / NO
Comments:
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the POTW.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS
1. Are there floor drains in he production area? 0 NO Where do they go? 411 v( I
c sue.. .0_t,r0- a 4 de.... -
2. Are productio areas diked, c p a d, or otherwise co structed in such a way as tovent harm to the WWTP,
especially from spills or slugs? Y / NO Comments:
3. Are there floor drains in the storage area? NO Where do they go?
4. Are storage tanks and areas diked, contai •r otherwise constructed in such a way : s to prevent harm to the
WWTP, especially from spills or slugs? NO Comments: !
5. Are process and storage tanks and pipes labeled? CiY
6. How are off -spec raw material and products disposed of?
NO
7. When is the production area cleaned?
8. Is the wastewater from cleaning the production are ischarged to the POTW? NO
9. What non -process wastewaters are discharged to POTW?
,�. C_
Comments:
Title: SIU Inpsection Form
File name: COMP.INSP App 7-D
Revision data: August 1, 1994
Page 1

SIU INSPECTION FORM
PART II - Plant Tour Section B - PRETREATMENT SYSTEM
Ask the operator to describe pretreatment system.
1. Does operator seem knowledgable about the system? NO Comments:
2. Areoall o units ton? / NO G 8 3. How often does operator/maintenance on check system? t]p ,
4. Is there an operator for each shift? Lam'' / NO (A.-off4^
: ^-
rec
5. How and when is sludge disposed of? � i 4 j g d+� # 7 I►� +
6. Is there a schedule for preventative maintenance? NO
Comments: =
PART II - Plant Tour Section C - SAMPLING POINT(S) AND FLOW MEASUREMENT
(Collect a sample if desired.)
1. Does an outside lab complete sampling? YES / If yes, name of lab.
2. If industry completes sampling, ask the industry representative to describe sampling procedures. Comments:
3. Is flow measurement equipment operational?
4. Is there a calibration log for the flow meter?
Comments:
Y
/ NO Comments:
NO Comments:
�GP 1 s .2.014,
PART III - EXIT INTERVIEW
Review monitoring records and . SIU records required by IUP.
1. Are files well organized? / NO Comments:
2. Are sample collection / chain -of -custody forms filled out properly?
YES / NO Comments:
►VIA-
3. Do results in files agree with reports sent to POTW? )(Es/ NO Comments:
4. Who has thority to shut own production sh Id a spill o slug discharge occur?
K�c t"fu--trDC—1e.[ �i4—
5. How does SIU inform employees of w m t call at POTW in case of spill/slug?-riso-i /L-
If slug/spill plan is already required by POT eview procedures.
6. Is SIU implementing slug/spill plan?NO Comments:
Comments:
INSPECTION RESULTS
Slug/Spill Control Plan Needed? E O
Comments, Required Or Recommended Actions:
Signature Of Inspector(s) �D ?(i-� /Lr--�h_ Date: % /1
2-0
Title: SIU Inpsection Form
File name: COMP.INSP App 7-D
Revision data: August 1, 1994
Page 2

Hollywood Bed & Spring Mfg. Co.
I U P #0028

Chapter: PAR Guidance File name: PAPAPorIffkiiImisitelCdUidedaftafitcgliktdectRA413, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page
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Linwood Hospitality Data Summary 2020-1.xls

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Column Averages =>
Maximum
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12/27-2/28/20
2/26-2/27/20
12/25-2/26/20 1
12/24-2/25/20
Sample Date
Linwood Hospital.
Sample Location:
N m la G
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0.0000
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Linwood Hospitality Data Summary 2020-1.xls

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Linwood Hospitality Data Summary 2020-2.xls

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10/13-10/14/20
10/14-10/15/20
110/12-10/13/20
7/14-7/15/20
7/15-7/16/20
7/16-7/17/20
17/13-7/14/20
Sample Date
ILinwood Hospital
Sample Location:
LSD 1a2E'4 -<_`' nv Na-ofT1o72m-.-g'
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Used in Calculated
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0.0000
0.0000
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0.0000
0.0000
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Linwood Hospitality Data Summary 2020-2.xls

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Linwood Hospitality Data Summary 2020-2.xls

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10/14-10/15/20
110/13-10/14/20
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Sample Date
rLinwood Hospital
Sample Location:
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0.015 0.015 0.0000
0.022 0.022 0.0000
0.02 0.02 0.0000
0.019 0.019 0.0000
0.01 0.005 0.0000
0.01 0.005 0.0000
0.01 0.005 0.0000
0.01 0.005 0.0000
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Linwood Hospitality Data Summary 2020-2.xls

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Linwood Hospitality Data Summary 2020-2.xls

Total Toxic Organics Certification Statement
Based on my inquiry of the person or persons directly
responsible for managing compliance with pretreatment
standard for TTO's, I certify that to the best of my
knowledge and belief, this facility, Hollywood Bed Mfg.
Co. Inc., Proctor, does not store, use, or discharge to the
sanitary sewer system any toxic organic chemicals.
Certifying Official:
7
2-17-ZL 2v
Signaure Date
Randy E Everhart
Human Resources Manager
Printed Name and Title

Total Toxic Organics certification Statement
..a ..+ ,.� ...i.. � s r +� . � :..;.. .srw the
.r. w1 � s+r� v� !'! Y` r N1 r
Based on. o I �y inquda �- of �e pc � son or po sons directly
responsible for managing compliance with pretreatment
standard for TTO's, I certify that to the best of my
knowledge and belief, this facility, Leggett & Platt,
Proctor, does not store, use, or discharge to the sanitary
sewer system any toxic organic chemicals.
Certifying Official:
Signature
Randy E Everhart
Date
Human Resources Manager
Printed Name and Title
P.O. BOX 140 • LINWOOD, NORTH CAROLINA 27299.336/956-5000

SIU INSPECTION FORM
Name Of Industry: L-4 u! ppp( 14 S r I*-# -:
Address Of Industry: [ Pr 0 11
Industry Representatives: Title
PA t� °i H-g. fi"� Ol YILi
IUP # ClZ 24
IUP Expiration Date:
5/5//242tt
POTW epres latives: Title
a -- Nf i ►l 'oL f t /
20'z.� P( *— tiro,
Date Of Inspection: i 2-2�Time Of Inspection: a -s+� am/�
Purpose of Inspection: Annual k7 Other (Describe
POTW to which IU discharges L _ VJ W l f-" NPDES # Ni C-- 00 55 7.g a
Is SIU currently in SNC? Ain If yes, for what?
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the following:
COMMENTS
Product YES /
Raw materials used YES /
Manufacturing processes YES /
Categorical, if applicable YES / NO
Number of employees
Production rate / NO
C./ 0 2 �
Number of shifts `+�/ NO 1 5
Comments:
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the POTW.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS
1. Are there floor drains in the production area?
NO Where do they go?
2. Are production areas diked, core a171, or otherwise constructed in such a way as to prevent harm to the WWTP,
especially from spills or slugs?
0 Comments:
3. Are there floor drains in the storage area? YES (NOO Where do they go?
4. Are storage tanks and areas diked, conta
WWTP, especially from spills or slugs?
or otherwise constructed in such a way as to prevent harm to the
/ NO Comments:
5. Are process and storage tanks and pipes labeled? YES NO
6. How are off -spec raw materials, and products disposed of?
7_ When is the production area cleaned? w 8. Is the wastewater from cleaning the production area d harged to the POTW? YES / 10
9. What non -process wastewaters are discharged to POTW?
Comments:
Title: SIU Inpsection Form
File name: COMP.INSP App 7-D
Revision data: August 1, 1994
Page 1

•
SIU INSPECTION FORM
PART II - Plant Tour Section B - PRETREATMENT SYSTEM
Ask the operator to describe pretreatment system.
1. Does operator seem knowledgable about the system? NO Comments:
2. Are all units operational? / NO
3. How often does operator/maintenance
4. Is there an operator for each shift?
5. How and when is sludge disposed o
n check system?
/NO
(...cam-...c1 if-2" r
6. Is there a schedule for preventative maintenance? ( YES J NO
Comments:
w
PART II - Plant Tour Section C - SAMPLING POINT(S) AND FLOW MEASUREMENT
(Collect a sample if desired.)
1. Does an outside lab complete sampling? YES /0 If yes, name of lab.
2. If industry completes sampling, ask the industry representative to describe sampling procedures. Comments:
3. Is flow measurement equipment operational?
4. Is there a calibration log for the flow meter?
Comments:
NO Comments:
NO Comments:
PART III - EXIT INTERVIEW
Review monitoring records and SIU records required by IUP.
1. Are files well organized NO Comments:
2. Are sample collection / c -of-custody forms filled out properly? YES / NO Comments:
3. Do results in files agree with reports sent to POTW? YES / NO Comments:
4. Who has authority to sh t down production shouljd a spill or slug discharge occur?
Qs� gv
inform em yees of
whom How does SIU to call at POTW in case off i11/slug?
If slug/spill plan is already required by PP0W, eview procedures.
6. Is SIU implementing slug/spill plan ES NO Comments:
Comments:
INSPECTION RESULTS
Slug/Spill Control Plan Needed? / NO
Comments, Required Or Recomme s Actions:
Signature Of Inspector(s)
Title: SIU lnpsection Form
File name: COMP.INSP App 7-D
Revision data: August 1, 1994
Date:
l Z •-12-2•-o 21
Page 2
O20

DocuSign Envelope ID: 14757C61-68BA-49AB-A817-73B512F1E236
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
a SfiT5'
to o M,
,07/1
4.2
NORTH CAROLINA
Environmental Quality
2/5/2021
Transmitted via Email to [e-mail]
City of Lexington
Attn: Eglantina Minerali, Pretreatment Program Coordinator
28 W. Center Street
Lexington, NC 27292
Subject: Pretreatment Review of Industrial User Permit Modification
Program: City of Lexington
WWTP: Lexington Regional WWTP, NPDES #:NC0055786, 6.5 MGD
Davidson County
Dear Eglantina Minerali:
The Municipal Unit of the Division of Water Resources has reviewed the Industrial User Pretreatment Permit
(IUP) modification submitted by the City of Lexington for the following Significant Industrial User (SIU). The
IUP modification was received by the Division on October 14, 2020.
IUP #
SIU NAME
0028
Hollywood Bed & Spring MFG. CO., LLC.
The review indicates that the IUP is adequate and meets the minimum requirements of 15A NCAC 2H .0905 -
.0916 and 40 CFR 403.8(f)(1)(iii). The IUP was modified to change the business name from Linwood Hospitality
LLC. to Hollywood Bed & Spring MFG. CO., LLC.
Regardless of this approval action today, within 180 days of the effective date of any reissued/modified NPDES
permit, the Permittee would be required to submit to the Division a written technical evaluation of the need to
revise local limits (i.e., an updated IWS, or documentation of why one is not needed). This action may include
revising. updating, or adding to the list of Significant Industrial Users (SIU's).
Federal and State pretreatment regulations require the local delegated pretreatment program to effectively control
and document the wastewater discharge from SIUs to the POTW. It is the POTW's responsibility to ensure that
these objectives are consistently met.
Thank you for your continued support of the Pretreatment Program. If you have any questions or comments,
please contact Diana Yitbarek at 919 707-9130 [diana.vitbarekt ncdenr.aov] or the Unit Supervisor, Michael
Montebello, at 919 707-3624[michael.montebello(a'ncdenr.jov].
dy/lexington.iup.mod.022.hollywood
Ec: Jim Gonsiewski, WSRO
Central Files (Laserfische) and Municipal Unit File
etEC):"
NORTH CAROLINA
DiprbM.nt al Eftirom Yhtl iWty
Sincerely
CittickAd.jDocuSignedby�:
,,- jat jt
foray. DarneElESmith, Director
Division of Water Resources
North Carolina Department of Environmental Quality 1 Division of Water Resources
512 North Salisbury Street 1 1611 Mail Service Center I Raleigh, North Carolina 27699-1611
919.707.9000

MATCOR METAL FABRICATIONS
I U P #0012

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IUP => Industrial User Permit
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6/18-6/19/20
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0
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Used m Calculated
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0.0001
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O
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Matcor Data Summary 2020-2.xls

4010WCOR
METAL FABRICATION
June 5, 2020
City of Lexington
Ms. Eglantina Minerali
Pretreatment Program Coordinator
28 W. Center Street
Lexington, NC 27292
835 Salem Road
Post Office Box 729
Welcome, NC 27374
Phone: [phone]
"I certify under penalty of law that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fine and imprisonment for knowing violations."
"Based upon my inquiry of the person or persons directly responsible for managing compliance
with the permit limitation for Total Toxic Organics (TTO), I certify that, to the best of my
knowledge, no dumping of concentrated toxic organics into the wastewater has occurred since
filing of the last monitoring report. I further certify that this facility is implementing the Toxic
Organic Management plan submitted to the Control Authority".
Signed:
Print Name: Joe Edwards
Title: EHS/Maintenance Supervisor
Date Signed: June 5, 2020

41141COR
METAL FABRICATIONCAT!
December 17, 2020
City of Lexington
Ms. Eglantina Minerali
Pretreatment Program Coordinator
28 W. Center Street
Lexington, NC 27292
835 Salem Road
Post Office Box 729
Welcome, NC 27374
Phone: [phone]
"I certify under penalty of law that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fine and imprisonment for knowing violations."
"Based upon my inquiry of the person or persons directly responsible for managing compliance
with the permit limitation for Total Toxic Organics (TTO), I certify that, to the best of my
knowledge, no dumping of concentrated toxic organics into the wastewater has occurred since
filing of the last monitoring report. I further certify that this facility is implementing the Toxic
Organic Management plan submitted to the Control Authority".
Signed:
Print Name: Joe Edwards
Title: EHS/Maintenance Supervisor
Date Signed: December 17, 2020

SIU INSPECTION FORM
Name Of Industry: Matcor Metal Fabrication IUP # 0012
Address Of industry: 835 Salem Rd. IUP Expiration Date:
Lexington, NC. 27295
Industry Representatives: Title
Joseph Edwards EHS/Maintenance Supervisor
POTW Representatives: Title
Eglantina Minergli Lab Supervisor/Pretreatment Coordinator
Date Of Inspection: &2. / 3 .y f ,Z.C) ,2,0 Time Of Inspection: 0/4 00 am/ m
Purpose of Inspection: Annual X Other (Describe)
POTW to which IU discharges LR WWTP NPDES # r' •' 1''h`:,'; 7 `:'
Is SIU currently in SNC? MO If yes, for what?
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the following:
COMMENTS
Product YES /y •
Raw materials used YES /tt!
Manufacturing processes YES 00
Categorical, if applicable YES
Production rate YES / \
Number of employees / NO 275 1/ �Z, •�ti # 7 A 4 . 513 )
Number of shifts YES /
Comments:
,+i - 1 '•G
%, C`t
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the POTW.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS
1. Are there floor drains in the production area? YES , 0, Where do they go?
2. Are production areas diked, co ed, or otherwise constructed in such a way as to prevent harm to the WWTP,
especially from spills or slugs? YES,/ NO Comments:
3. Are there floor drains in the storage area? YES,/ NQ-. Where do they go?
4. Are storage tanks and areas diked, coned, or otherwise constructed in such a way as to prevent harm to the
WWTP, especially from spills or slugs? t; YE / NO Comments:
5. Are process and storage tanks and pipes labeled? YES / NO
6. How are off -spec raw materials, and products dispose of? Recycled
7. When is the production area cleaned? Daily
8. Is the wastewater from cleaning the production area discharged to the POTW? YE ; NCB
9. What non -process wastewaters are discharged to POTW?
Domestic Wastewater
Comments:
Title: SIU lnpsection Form
File name• COMP.INSP App 7-D
Revision data: August 1. 1994
Page 1

SIU INSPECTION FORM
PART II - Plant Tour Section B - PRETREATMENT SYSTEM
Ask the operator to describe pretreatment system. I. Does operator seem knowledgeable about the system'.( YES ?NO Comments:
2. Are all units operational? YE J NO
3. How often does operator/maintenance person check system?
4. Is there an operator for each shift? YES / NO
5. How and when is sludge disposed of? Landfill
6. Is there a schedule for preventative maintenance? Y NO
Comments:
Weekly as needed
PART II - Plant Tour Section C - SAMPLING POINT(S) AND FLOW MEASUREMENT
(Collect a sample if desired.) <<'
1. Does an outside lab complete sampling? YE / NO If yes, name of lab.
2. If industry completes sampling, ask the industry representative to describe sampling procedures. Comments:
3. Is flow measurement equipment operational? (YE$ / NO Comments:
4. Is there a calibration log for the flow meter? (YES / NO Comments:
Comments:
Calibration of Flow Meter Due 12/31/2020
PART III - EXIT INTERVIEW
Review monitoring records a her SIU records required by IUP.
1. Are files well organized / NO Comments:
2, Are sample collection / chain -of -custody forms tilled out properly? YES / NO Comments:
,t fir
3. Do results in files agree with reports sent to POTW?
YE
/ NO Comments:
4. Who has authority to shut down production should a spill or slug discharge occur?
Tony Coomer — Joseph Edwards
5. How does SIU inform employees of whom to call at POTW in case of spill/slug?
Training
If slug/spill plan is already required by POTW, review procedures.
6. Is SIU implementing slug/spill plan YES /NO Comments:
Continents:
INSPECTION RESULTS
Slug/Spill Control Plan Needed? YES NO
Comments, Required Or Recomm Actions:
Signature Of Inspector(s)
Title: SIU Inpsection Fomi
File name. COMP INISP App 7-D
Revision data August I. 1994
Date:
�a -'g-z,0
Page 2

TIER RACK
IU #0045

NAME OF FACILITY: TIER -RACK
Business Address: 200 Prospect Drive, 4exington, NC 27292
Discharge Address Of different from above):
TOTAL TOXIC ORGANICS CERTIFICATION STATEMENT
Based on my inquiry of the person or person directly
best myle for managing compliance knowledge and belief, this with
pretreatment standard for TTOs, I certify that tothe
facility does not store, use, or discharge to the sanitary sewer system any toxic organic
chemicals.
CERTIFYING OFFICAL:
Signature
Printed Name &Title.
EXECUTIVE OFFICER:
Signature
�r-5 7 P
Printed Name & Title
Date
Date oli%,alaaa

NAME OF FACILITY: TIER -RACK
Business Address: 200 Prospect Drive, Lexington, NC 27292
Discharge Address (if different from above):
TOTAL TOXIC ORGANICS CERTIFICATION STATEMENT
Based on my inquiry of the person or person directly responsible for managing compliance with
pretreatment standard for TTOs, I certify that to the best of my knowledge and belief, this
facility does not store, use, or discharge to the sanitary sewer system any toxic organic
chemicals.
CERTIFYING OFFICAL:
Signature Date
Printed Name & Title
EXECUTIVE OFFICER:
‘-/-/.77
Signature Date
1.2-'7-.55 7*, 120,449e447)S7
Printed Name & Title
1 o2-I197 /i19.AD
Y

Address Of lndustrn :
SIU INSPECTION FORM
Name Of Industry: -rim? 4,
Zae ti-opregi 67"
Industrti Representatives:
btei, -Fhp
IUP # ooy5
IUP Expiration Date:
Title
RSA rorl"
POTW Representatives: Title
2wc.
Date Of Inspection: 1,2i / 5 XD2A Time Of Inspection:
Purpose of Inspection: Annual V Other (Describe
POTW to which ILI discharges £. R. 1Ai W T"F NPDES e: N L co 5-57i 84
Is SIU currently in SNC? N 0 if ves. for what?
am'ef)
PART I - INITIAL INTERVIEW
Has anything changed since the last inspection or IUP application in the tbtlow ing:
COMMENTS
Product YES
Raw materials used YES
Manufacturing processes YES
Categorical, if applicable YES
Production rate YES
Number of employees YES
Number of shins YES '
Comments:
PART II - PLANT TOUR - Visit all areas where wastewater is generated or where there are
drains to the PO"E'\V.
Plant Tour Section A - PRODUCTION AND STORAGE AREAS
I. Are there floor drains in the production area? YES
Where do they go'?
2. Are production areas diked. con '.ed. or otherwise constructed in such a way as to prevent harm to the WWTP.
especially from spills or slues? ( NO Comments:
3. Are there floor drains in the storage area?
N(.) Where do they go?
4. Are storage tanks and areas diked. contained, herw ise constructed in such�a vt' v as o preve t harm to the
WWTP, pecA� ial`y from spills or slugs? YES NO Comments: Sty' _ I. )7045
5. Are process and storage tanks and pipes labeled? YES NO t7 G ! L.
i.r
6. How are off -spec raw materials. and pmducts disposed of?
7. When is the production area cleaned?
8. Is the wastewater from cleaning the production rea discharged to tit, ?O] W? YES
9. What no -process wastewaters are discharged to POTW? ,�q1fj A'+ /Id4 .1rMt 1
4 7 -tQ1kK G s'iI'
Comments:
tiu•,.a. 4 e w.5y t&, c
Title. SIU lnpsection Lore
1•ile name: COMP INS!' App 7-I)
Reeision data. August t, JQ)d
Page 1

SIU INSPECTION FORM
PART II - Plant Tour Section B - PRETREATMENT SYSTEM
Ask the operator to describe pretreatment system.
1. Does operator seem knowledgable about the ,) stem?
2. Are all units operational? NO
3. How often does operator:matntenance�
4. Is there an operator for each shift?
5. How and when is sludge disposed of
on check system?
NO
Al I 4— 9iro e..00
NO Comments:
6. Is there a schedule for preventative maintenance? YES NO
Comments:
(Ai o-
I4o,Z —�`'�
PART II - Plant Tour Section C - SAMPLING POINT(S) AND FLOW MEASUREMENT
(Collect a sample if desired.)
I. Does an outside lab complete sampling? YES 'O !ryes. name of lab.
2. If industry completes sampling. ask the industry re . esentative to describe sampling procedures. Comments:
(Vtlq- _
3. Is Clow measurement equipment operational? YES 'NO Comments:
I 1 —
1. Is there a calibration log for the flow meter? YES NO Comments:
rV I 4--
Comments:
PART I1I - EXIT INTERVIEW
Review monitoring records an/d� S1U records required by IUP.
1. Are tiles well organized?anii NO Comments:
2. Are sample collection ; chain -of -custody forms tilled out properly? YES NO Comments:
3. Do results in files agree with reports sent to POTW? YES NO Comments:
I. Who has authority to shut down production should a spill or slug dis harg occur'.
5. How does SIU inform employees of whom to call at POTW in case of spill slug?
If slug'spill plan is already required by POT review procedures.
6. Is SIU implementing slug°spill plan? 'F) , NO Comments:
Comments:
INSPECTION RESULTS
Slug/Spill Control Plan Needed? NO
Comments. Required Or Recomntensed Actions:
Signature Of Inspector(s) J /k•2._ 111 ‘ Date:
Date:
I itle: Sll Inpseetiun Form
File name: c'OMP.INSP App 7-1)
Revibion .iuta: Augu,t 1 14
--/$ - o� 0
Page 2

tt� NI T
SL(.1101) L.
GENERATOR LOCATION
NAtvE _.
ORIGINATING ADDRESS __
HAZ- MAT
ENVIRONMENTAL SERVICES
P.O. BOX 37392 • CHARLOTTE. N.C. 28237
704) 332-5600
FAX [phone]
NON -HAZARDOUS SPECIAL WASTE
(;I..'►RAM Ii
Manif8tt No.
P.O, No.____
Job No._.__
WORK CONTRACTED Sy
8, To ill ctremnt from to ma;io * at left;
MAILING /ADDRESS lADDRESS
CITY STATE ZIP CITY _ STATE ZIP
PHONE No
..- 7Lt.T NAPaf .... _-_
oHCNE NO 7,-
CONTACT NAME..
DES OF WASTE
Section @[1. 1170 )It E I I-ORM 1TLON GAL
1. PETROLEUM CONTACT WATER
2 OFF -SPEC LIGHT OIL. DIESEL OR GAS
3. NON -HAZARDOUS LIQUIDS
4. SEDIMENT OR SOLIDS
5. 55-GALLON DRUM REMOVED - SOLID OR EMPTY
8 55-GALLON DRUM REMOVED - LIQUID
7
8
9
10 ARRIVALTIME
DEBAR PURE TIME
{
Quantity
ONS DRUMS
QUANTITY
LINE TOTAL
GENERATOR'S CERTIFICATION 1 herepy Can y •-+3t the above named error is no a ara•dori, nasty as det r.ed ny 40 CFR Par' 26' or any dpptcable state 'a><, has been property
described. ttassitied and packaged and in proper con0,tx,r for transponato •scorn rig to app tetOte reyl atone Generator Ct$tO.rPer stialt re,mburse HAZ-MAT its reasonable expenses
and charges for handl ng arratyz ng. loading. pvepar rag ars ,or ng stonnrg or ca ng tor nor:convorm -g n• ff sec .vaste uhrg casts of de ratan r' 1mr and cleaning of eq pfnEri
Generator must notify HAZ-MAT of ary charges tot thk..rasie strean: ono in a
Generator Authorized Agent Name
Section II. 1 Et NSPOII.TERR
HAZ-MAT
ENVIRONMENTAL SERVICES
P.D. BOX 37392 • CHARLOTTE N C 28237
a Dover Nams Tide .s_
0 Phone No
Hazardous Waste Tanspnle Permits
EPA NCD048461370
d_
_ —suds 4o
Srgratura
TRANSPORTER II
Name. —
• Address__
g. Driver Name T,tte—_.____..
n Phone No _- .—._ _
Transporter II Permit Nos
— _.....I Truck No
r&etion IV. Y INFORMATION AND CERTIFICATE OF DISPOSAL
Site Name
Physical Address
tiOZ:Atit En i*QnCr ntiti SCrv7 .5
21( %140El AY'.^s1s
Chtirio e.._N 4 � 24'v
a Poore No
b Mailing Address
PO. Box 37392
Ch< rlot!e.
1
e Discrepancy 'meat on Space. — — — _
Ns a t0 wily tut al n7 -r13 115m r. gas ter mama ire , v rlsposed or n aoaroate art . 4...111r rxe Stag aid Were •egIlaia n t'e Wang nvrea. (It Pettrm putris
are bey a ti nU a Weir., rye 21 wawa sewn se t bit • ...: coiyrnes Ira awe are a iruararc. 9ien be Arutpn a asoked at Ictio t *tee ix t» fin.
Teo ma= NE LAUD sar.ranan •ew•• 5y5 1, !3r Su** lretit kearnent - : ;ems are haute, E P A approv,7i faatites for roper drsOosal Manliest aM c&lix a Pt drspcsat ate On t.e
zI AU . . syskun CON lir . 6 _ ..., rr '-i , r' . days
SIGNATURE or FAC m•-
_ DATEkt0. TH 1DAY ;YEAR
ORIG+4IeL • FINAL T.S D _ YELLOW • DISPOSER • PINIc - IST TS 0 • COL0 • GENERATOR

ariffir
LSeLLIon 1.
GENERATOR
NAME
ORIGINATING ADDRESS
MAILING ADDRESS
CITY
PHONE No .
CONTACT NAME
DES OF WASTE -
HAZ-MAT
ENVIRONMENTAL SERVICES
P.O BOX 37392 • CHARLOTTE. N.0 28237
(7041332-5800
FAx [phone]
NON -HAZARDOUS SPECIAL WASTE
STATE
CENER:VP
[Set:1km II. 1NVOICL FORM..‘TI(Y.\,
IEFf_sr4V1
_
1. PETROLEUM CONTACT WATER
2 OFF -SPEC LIGHT OIL, DIESEL OR GAS
3 NON -HAZARDOUS LIQUIDS
4. SEDIMENT OR SOLIDS
5 55-GALLON DRUM REMOVED - SOL ID OR EMPTY
6 55-GALLON DRUM REMOVED - LIQUID
7.
ZIP
WORK CONTRACTED BY
S Tc tf 9 en/ ,n'or o al on at left,
Manifest No.
P.O. No.
Job No.
NAME
AtERES$
CITY
PHONE NO _
CONTAC 1 NAME.
1 I
9,
10 ARRIVAL TIME DEPARTURETIME:
•
STATE ZVI
El 1
No Type Units quantify
GALLONS DRUMS
QUANTITY 4i
GENERATORS CERTFICATION hereeetAN :hatne above Ted miena is nc: a azardous •Aaste as 40 CFR Part 261 or any applicable stale tart has been properly
Oesatbeo. crasstfied taxi packaged and is in nroper Condit on 10 transport • ac.cou • apclic.aoie revat ons GerloratonCe.srlmFr sr- reimburse NAZ.MAT its reasonable expenses
and gnaws for handbag anairing call% prep& n9 t:a sport rig rn or ,annn to' I • ' . ng Or .• •• spec vostc ud.,V cOstS Of deconlamiratiOn end deenin9 of equipment
Generator must notify riAZ-MAT of any changesin as ;area ono? 1• . , •
Generator Authorized Agenr Ni-he
Sixtion Jil. 1R.-NSP()RTLR
HAZ-MAT
ENVIRONMENTAL SERVICES
P.O 804 373cI2 • CHARLOTTE N C 28237
a Dever Name 'TRIO
Pnone No Trick No
Hazardous Waste Transporter Peurn
EPA NO0048461370
d
PR.*, lIcrain
[
Site Name
Physical Address
S
LLILLL
SNP,ftnI aid*
TRANSPORTER II
e Name ,
AdareSs
g Drner Name Title
Prone No
tra)sporter II Perrnt Nos
FACILITY INFORMA1 ION AND CERTIFICAI E Of DISPOSAL
ljazzArlat EnvTar_lmtateLavraict.L*,
Z I Q_Dalt.gti AvedIJ'
Chatiztle_LNS
e Discrepancy irtd c.ation Space
Tnt.olOGenty tkr 3.1n4kidardote "lam Ircogc rx. a:, Icr.aio -mall aumar ,v• osciae V& at tag iajlitn5i tie 1361410 maw 1.)Petoitur ink&
..se, weed s tenesoa • • . ocr espc raw., . • . r.airin • .• ar rkzrFant. iron Imis nu sil a cisscAsts ar Imam swornITpeitearrent reperseon then .ntu the CfAuD sanoaton whe, sr/Wm Leder ;Nara 4w1 tet.art:.: sown are r_ 10 Net. lac s fo: or Manifest sic cedoesal am on Ne 41 Oil starlet seiwn wales Ant in, int GA taws ar,/ vr-rnr..,Yo11 be rimmed tern edam
Truck No
1
rGNAPJPE OF &CL 1 GMT
Pt--Nt.
b
EATF-
MONTH DAY
ODiCrvAi. crit41. TS . Yial:15111 • esellori: • PINK ,ST T.5 0 • GOr.r) GEMERATOrr-
7114-1,152 ftQQ
Qtaimotc.,, 74 C 2jya7
YEAR