WQCS00150_Pretreatment Compliance Inspection_20210506

DocuSign Envelope ID: 6A5B6271-E8E5-4212-817F-2CA46B55D8F7
r C'. NORTH CAROLINA DIVISION OF WATER RESOURCES
PRETREATMENT COMPLIANCE INSPECTION (PCI) REPORT
Water Resources
ENVIRONMENTAL QUALITY
BACKGROUND INFORMATION [Complete Prior To PCI; Review Program Info Database Sheet(s)l
1. Control Authority (POTW) Name: Town of Burgaw Collection Syste
2. Control Authority Representative(s): Robert Moore, Lisa Osthues
3. Title(s): Director of Public Works, Pretreatment Contractor
4. Last Inspection Date: 08/29/2019 Inspection Type (Check One): ® PCI ❑ Audit
5. Has Program Completed All Requirements from the Previous Inspection and Program Info Sheet(s)? ® YES ❑ NO
6. Is POTW under an Order That Includes Pretreatment Conditions? ❑ YES ® NO
Order Type, Number, Parameters:
ICIS CODING
Main Program Permit Number MM/DD/YY
M1, K11MKM1VM[1 MCI �t.�[I���IL�<IL�t►�17►�I
Are Milestone Dates Being Met? ❑ YES ❑ NO
7. Current Number Of Significant Industrial Users (SIUs)?
3
8. Number of SIUs With No IUP, or With an Expired IUP?
0
9. Number of SIUs Not Inspected By POTW in the Last Calendar Year?
0
10. Number of SIUs Not Sampled By POTW in the Last Calendar Year?
F 0
11. Number of SIUs In SNC For Limits Violations During Either of the Last 2 Semi -Annual Periods?
0
12. Number of SIUs in SNC For Reporting During Either of the Last 2 Semi -Annual Periods?
0
13. Number of SIUs in SNC with Pretreatment Schedule?
0
14. Number of SIUs on Schedules?
0
15. Current Number Of Categorical Industrial Users CIUs ?
1
16. Number of CIUs in SNC?
0
POTW INTERVIEW
17. Since the Last PCI, has the POTW had any NPDES Limits Violations?
If Yes, What are the Parameters and How are these Problems Being Addressed?
The Town of Wallace WWTP (NC0003450) receives the flow from the
Burgaw CS. Wallace had limit violations for BOD, ammonia in 2019 due to a
mechanical problem that has been addressed.
18. Since the Last PCI, has the POTW had any Problems Related to an Industrial
Discharge (Interference, Pass -Through, Blockage, Citizens' Complaints, Increased
Sludge Production, Etc.)?
If Yes, How are these Problems Being Addressed?
19. Which Industries have been in SNC for Limits or Reporting during SNC for
either of the Last 2 Semi -Annual Periods? Not Been Published for SNC for
Public Notice?(May refer to PAR if Excessive SIUs in SNC) Not Put
20. Which Industries are on Compliance Schedules or Orders? For all SIUs on an
Order, Has a Signed Copy of the Order been sent to the Division?
21. Are Any Permits or Civil Penalties Currently Under Adjudication? If Yes, Which
Ones?
® YES ❑ NO
[—]YES ® NO
Limits: N/A
Reporting: N/A
fished: N/A
N/A
❑ YES ❑ NO
NC DWR Pretreatment Compliance Inspection (PCI) Form Updated December 2016 Page 1

DocuSign Envelope ID: 6A5B6271-E8E5-4212-817F-2CA46B55D8F7
LTMP/STMP FILE REVIEW: N/A Does not apply to the Burgaw Collection System
22. Is LTMP/STMP Monitoring Being Conducted at Appropriate Locations and Frequencies? ❑ YES ❑ NO
23. Are Correct Detection Levels being used for all LTMP/STMP Monitoring? ❑ YES ❑ NO
24. Is LTMP/STMP Data Maintained in a Table or Equivalent? ❑ YES ❑ NO Is Table Adequate? ❑ YES ❑ NO
25. All LTMP/STMP effluent data reported on Discharge Monitoring Report? ❑ YES ❑ NO Division Inspector, please verify yourself
26
27
IfNO to 23 - 26, list violations
Should any Pollutants of Concern be Eliminated from or Added to LTMP/STMP? ❑ YES ❑ NO
If yes, which ones? Eliminated: Added:
28. PRETREATMENT PROGRAM ELEMENTS REVIEW— Please review POTW files, verify POTW has copy of Program Element in
their files, complete with supporting documents and copy of PERCS Approval Letter, and dates consistent with Program Info:
Program Element
Last Submittal
Date In file?
Last Approval
Date In file
Date Next Due,
If Applicable
Headworks Analysis (HWA)
N/A
❑ Yes ❑ No
❑ Yes ❑ No
Industrial Waste Survey (IWS)
11-4-19
® Yes ❑ No
3-4-20
® Yes ❑ No
10-1-24
Sewer Use Ordinance (SUO)
1-11-13
® Yes ❑ No
2-6-13
® Yes ❑ No
Enforcement Response Plan (ERP)
5-15-20
® Yes ❑ No
8-11-20
® Yes ❑ No
Long Term Monitoring Plan (LTMP)
N/A
❑ Yes ❑ No
❑ Yes ❑ No
NC DWR Pretreatment Compliance Inspection (PCI) Form Updated December 2016 Page 2

DocuSign Envelope ID: 6A5B6271-E8E5-4212-817F-2CA46B55D8F7
INDUSTRIAL USER PERMIT (IUP) FILE REVIEW (3 IUP FILE REVIEWS OR 1 FILE REVIEW AND 1 IU INSPECTION)
29. User Name
1. American Skins
2. LL Building Products
3. Cardinal Foods
30. IUP Number
0004
0006
6007
31. Does File Contain Current Permit?
® Yes ❑
I ® Yes ❑
I ® Yes
❑
No
32. Permit Expiration Date
12-31-21
F 12-31-21
10-5-21
33. Categorical Standard Applied I.E. 40 CFR, Etc.) Or N/A
N/A
433.17
N/A
34. Does File Contain Permit Application Completed Within One Year Prior
® Yes ❑ No
® Yes ❑ No
® Yes ❑ No
to Permit Issue Date?
35. Does File Contain an Inspection Completed Within Last Calendar Year?
I ® Yes ❑ No
® Yes ❑ No
® Yes ❑ No
36. a. Does the File Contain aSlug/Spill Control Plan?
a. ®Yes ❑No
a. ®Yes ❑No
a. ®Yes ❑No
b. If No, is One Needed? (See Inspection Form from POTW)
b. ❑Yes []No
b. ❑Yes ❑No
b. []Yes []No
37. For 40 CFR 413 and 433 TTO Certification, Does File Contain a Toxic
0Yes0No[9
®Yes❑No❑N/A
❑Yes❑No®N/A
Organic Management Plan (TOMP)?
38. a. Does File Contain Original Permit Review Letter from the Division?
a. ❑Yes ®No
a. ®Yes []No
a. ®Yes ❑No
b. All Issues Resolved?
b.❑Yes❑No❑N/A
baYes❑No❑N/A
b.®Yes❑No❑N/A
39. During the Most Recent Semi -Annual Period, Did the POTW Complete
®Yes ❑ No
® Yes ❑ No
1
® Yes ❑ No
11
its Sampling as Required b IUP, includingflow?
40. Does File Contain POTW Sampling Chain -Of -Custody Forms?
I ® Yes ❑ Nol
® Yes ❑ No
® Yes ❑ No
41. During the Most Recent Semi -Annual Period, Did the SIU Complete its
®Yes❑No❑N/A
®Yes❑No❑N/A
®Yes❑No❑N/A
Sampling as Required by IUP, including flow?
41b. During the Most Recent Semi -Annual Period, Did SIU submit all reports
®Yes❑No❑N/A
®Yes❑No❑N/A
®Yes❑No❑N/A
on time?
42a. For categorical IUs with Combined Wastestream Formula (CWF), does
❑Yes❑No[g
❑Yes❑NOON/A
❑Yes❑No®N/A
1
file include process/dilution flows as Required b IUP?
42b. For categorical IUs with Production based limits, does file include
❑Yes❑No®N/A
❑Yes❑No®N/A
❑Yes❑NoON/A
production rates and/or flows as Required by IUP?
43a. During the Most Recent Semi -Annual Period, Did the POTW Identify
® Yes ❑ No
® Yes ❑ No
® Yes ❑ No
All Limits Non -Compliance from Both POTW and SIU Sampling?
43b. During the Most Recent Semi -Annual Period, Did the POTW Identify
®Yes❑No❑N/A
®Yes❑No❑N/A
®Yes❑No❑N/A
All Re porting_Non-Compliance from SIU Sampling?
44. a. Was the POTW Notified by SIU (Within 24 Hours) of All Self-
a.❑Yes❑No®N/A
a.❑Yes❑No®N/A
a.❑Yes❑No®N/A
Monitoring Violations?
b. Did Industry Resample and submit results to POTW Within 30 Days?
h ❑Yes❑No®N/A
b.❑Yes❑No®N/A
b.❑Yes❑No®N/A
c. If applicable, Did POTW resample within 30 days of becoming aware
c.❑Yes❑No®N/A
of SIU limit violations in the POTW's sampling of the SIU?
c.❑Yes❑No®N/A
c.❑Yes❑No®N/A
46. During the Most Recent Semi -Annual Period, Was the SIU in SNC?
❑
Yes
®
No
❑
Yes
®
No
❑
Yes
®
No
47. During the Most Recent Semi -Annual Period, Was Enforcement Taken
❑Yes❑No®N/A
❑Yes❑No®N/A
❑Yes❑No®N/A
as Specified in the POTW's ERP (NOVs, Penalties, timing, etc.)?
48. Does the File Contain Penalty Assessment Notices?
❑Yes❑No®N/A
❑Yes❑No®N/A
❑Yes❑No®N/A
49. Does The File Contain Proof Of Penalty Collection?
❑Yes❑No[D
❑Yes❑No[D
❑Yes❑No®N/A
50. a. Does the File Contain Any Current Enforcement Orders?
a.❑Yes❑No®N/A
a.❑Yes❑No®N/A
a.❑Yes❑No®N/A
b. Is SIU in Compliance with Order?
b.❑Yes❑No®N/A
b.❑Yes❑No®N/A
b.❑Yes❑No®N/A
51. Did the POTW Representative Have Difficulty in Obtaining Any of This
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Requested Information For You?
FILE REVIEW COMMENTS:
#38. American Skins -It was discovered during preparation for this inspection, that the 2019 IUP modification review from the Division
was missing in the Town's files. After checking WIRO files and Lisa Osthues verifying with the Municipal Unit that it was not
submitted, Lisa submitted all documentation to the Division for review on 5/11/21 and is waiting for approval.
NC DWR Pretreatment Compliance Inspection (PCI) Form Updated December 2016 Page 3

DocuSign Envelope ID: 6A5B6271-E8E5-4212-817F-2CA46B55D8F7
INDUSTRY INSPECTION ICIS CODING: N/A
Main Program Permit Number MM/DD/YY
1. Industry Inspected:
2. Industry Address:
3. Type of Industry/Product:
4. Industry Contact:
Phone: Fax:
Title:
5. Does the POTW Use the Division Model Inspection Form or Equivalent? ❑ YES ❑ NO
6. Did the POTW Contact Conduct the Following Parts of the Industrial Inspection Thoroughly?
Comments:
A. Initial Interview
❑ YES ❑ NO
B. Plant Tour
❑ YES ❑ NO
C. Pretreatment Tour
❑ YES ❑ NO
D. Sampling Review
❑ YES ❑ NO
E. Exit Interview
❑ YES ❑ NO
Industrial Inspection Comments:
OVERALL SUMMARY AND COMMENTS:
Comments: The Town of Burgaw continues to manage an effective Pretreatment Program. The Town no longer operates it's POTW
but instead pumps its wastewater to the Town of Wallace (NC0003450) for treatment and disposal. The Town of Burgaw maintains
their own Pretreatment Program associated with their Collection System Permit WQCS00150. Currently, the Towns are locating the
inter -local agreement to establish what requirements each Town is responsible for in regards to their respective Pretreatment
Programs.
Requirements: None
Recommendations: None
NOD: ❑ YES ® NO
NOV: ❑ YES ® NO
QNCR: [—]YES ® NO
POTW Rating:
Satisfactory X Marginal UnSatisfactory
PCI COMPLETED BY: Helen Perez, Wilmin tog n Regional Office DATE: 5/12/2021
/—DocuSigned by:
1D645B4A39694BE...
NC DWR Pretreatment Compliance Inspection (PCI) Form Updated December 2016 Page 4