NC0004243_EPA Form 2C Tables A-C_20210727

Coats North America
, LL Coats PO Box 368
630 American Thread Road
COATS North America Marion, NC 28752
TEL[phone]
FAX[phone]
July 20, 2021
Mrs. Wren Thedford
North Carolina Department of Environmental Quality
Division of Water Resources
Industrial NPDES Permitting Unit
1617 Mail Service Center
Raleigh,NC 27699-1617 RECEIVED
JUL 2 7 2021
Reference: Coats American, Inc.—Sevier Plant
EPA ID Number: 110004015921 NCDEQ/DWR/NPDES
NPDES Permit Number:NC0004243
Permit Renewal Request
Dear Mrs. Thedford,
Please find attached the EPA Form 2C Tables A—C with the monitoring results updated from
wastewater sampling conducted on 1 July 2021. All the parameters listed in table D are believed
absent in the wastewater discharge.
For any technical questions, contact Mr. John Moss, Facilities Engineering Manager, at 828-756-
4111 extension 3258 (john.moss(cr�coats.com) or Todd Wegenast,Environmental Compliance
Manager, at 850-545-8142 ([e-mail]).
Please feel free to contact me if you have any other questions.
Than vot
E rah Bilgin
Coats American- Sevier Plant
Manufacturing Director
828-559-7698
[e-mail]
CC:John Moss,Facilities Engineering Manager-Coats American,Inc.—Sevier Plant([e-mail])
CC:Todd Wegenast,Environmental Compliance Manager—North and Central America Cluster(todd.wegenast(acoats.com)

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 Coats American,Inc, OMB No.2040-0004 1
NC0004243 001
TABLE A.CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(iii))1
Effluent Intake
Waiver (Optional)
Pollutant Requested Units Maximum Maximum Long-Term
(if applicable
) (specify) Daily Monthly Average Daily Number of Long-Term Number of
Discharge Discharge Discharge Analyses Average Value Analyses
(required) (if available) (if available)
0 Check here if you have applied to your NPDES permitting authority for a waiver for all of the pollutants listed on this table for the noted outfall.
Biochemical oxygen demand Concentration
1' El(RODS) Mass lbs/day 158.79 36.15 12
Chemical oxygen demand Concentration
2' ❑
(COD) Mass lbs/day 450.36 159.57 12
Concentration mg/I 24.1 1
3. Total organic carbon(TOC) ❑
Mass
Concentration
4. Total suspended solids(TSS) ❑
Mass lbs/day 125.1 28.81 12
Concentration mg/I 1 4
5. Ammonia(as N) 0
Mass
6. Flow 0 Rate MGD 0.458 31
Temperature(winter) ❑ °C °C
7.
Temperature(summer) ❑ °C °C 23.2 21.65 20
pH(minimum) 0 Standard units S.U. 7.16 13
8.
pH(maximum) ❑ Standard units s.u. 7.52 13
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 4AR 136 for thq�talysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). CD
m /rn�
0
6 r
N m
Z N T`
EPA Form 3510-2C(Revised 3-19) 1 ' 1 Page 9
m 0
CO

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EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Daily of of
Discharge ifavai►abllee e) Discharge Analyses AverageValue Analyses
(if available)
❑ Check here if you qualify as a small business per the instructions to Form 2C and,therefore,do not need to submit quantitative data for any of the organic toxic pollutants in Sections
2 through 5 of this table.Note,however,that you must still indicate in the appropriate column of this table if you believe any of the pollutants listed are present in your discharge.
Section 1.Toxic Metals,Cyanide,and Total Phenols
Antimony,total ❑ Concentration ug/I ND 1
1.1 (7440-36-0) Mass
- i
Arsenic,total Concentration ug/I ND 1
1.2 (7440-38-2) Mass
Beryllium,total Concentration ug/I ND 1
1.3 (7440-41-7) Mass
Cadmium,total Concentration ug/I ND 1
1.4 (7440-43-9) Mass
Chromium,total Concentration ug/I 8.0 1
1.5 (7440-47-3) Mass
Copper,total Concentration ug/I 11.0 1
1.6 (7440-50-8) Mass
Lead,total Concentration ug/I ND 1
1.7 (7439-92-1) Mass
Mercury,total Concentration ug/I ND 1
1.8 (7439-97-6) Mass
Nickel,total Concentration ug/I ND 1
1'9 (7440-02-0) Mass
Selenium,total Concentration ug/I ND 1
1.10 (7782-49-2) Mass
Silver,total Concentration ug/I ND 1
1.11 (7440-22-4) El I=1 Mass
EPA Form 3510-2C(Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l 1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge (if available) Dscharge ischarge Analyses AverageValue Analyses
(required) )
(if available)
1.12 Thallium,total Concentration ug/I ND 1
(7440-28-0) Mass
1.13 Zinc,total 0 Concentration ug/I 44.3 1
El El
(7440-66-6) Mass
1.14 Cyanide,total El � Concentration mg/I ND 1
(57-12-5) Mass
Concentration mg/I 0.023 1
1.15 Phenols,total El 0 0
Mass
Section 2.Organic Toxic Pollutants(GCIMS Fraction—Volatile Compounds)
2.1 Acrolein Concentration ug/I ND 1
(107-02-8) Mass
Acrylonitrile 0 Concentration ug/I
2.2 (107-13-1) Mass
2.3 Benzene 0 Concentration ug/I 5.9 1
(71-43-2) Mass
2.4 Bromoform Concentration ug/I ND 1
I=1 El El
(75-25-2) Mass
2.5 Carbon tetrachloride Concentration ug/I ND 1
El El El
(56-23-5) Mass
Chlorobenzene Concentration ug/I ND 1
2.6 (108-90-7) Mass
Chlorodibromomethane Concentration ug/I ND 1
2.7 (124-48-1) Mass
Chloroethane 0 Concentration ug/I ND 1 _
2.8 CI 0
(75-00-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
CAS Number,if available) Required Believed BelievedMaximum Maximum Long-
(and q (specify) Average Number Number
Present Absent Daily Monthly Daily of Term of
Dischargerequre (ifavailablle) Discharge ischarge Analyses AverageValue Analyses
(required)) ( ) (if available)
2.9 2-chloroethylvinyl ether ❑ ❑ Concentration mg/I
(110-75-8) Mass
Concentration ug/I ND 1
2.10 Chloroform(67-66-3) ❑✓ ❑ ❑
Mass
Dichlorobromomethane ❑ ❑ ❑ Concentration ug/I ND 1 1
2.11 (75-27-4) Mass
212 1,1-dichloroethane ❑ ❑ ❑ Concentration ug/I ND 1 1
(75-34-3) Mass
213 1,2-dichloroethane ❑ ❑ ❑ Concentration ug/I ND 1 1
(107-06-2) Mass
2.14 1,1-dichloroethylene CI ❑ Concentration ug/I ND 1 1
(75-35-4) Mass
2.15 1,2-dichloropropane ❑ ❑ ❑ Concentration ug/I ND 1 1
(78-87-5) Mass
2.16 13-dichloropropylene ❑ ❑ ❑ Concentration mg/I
(542-75-6) Mass
2.17 Ethylbenzene ❑ ❑ 0 Concentration ug/I ND 1 1
(100414) Mass
2.18 Methyl bromide ❑ ❑ ❑ Concentration ug/I ND 1 1
(74-83-9) Mass
Methyl chloride ❑ ❑ ❑ Concentration ug/I ND 1 1
2.1E (74-87-3) Mass
Methylene chloride ❑ ❑ ❑ Concentration ug/I ND 1 1
2.20 (75-09-2) Mass
1,1,22-tetrachloroethane ❑ ❑ ❑ Concentration ug/I ND 1 1
2.21 (79-34-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
of of
Discharge Discharge DisDcharge Analyses Average Analyses
(required) (if available) Value
(if available)
Tetrachloroethylene ElConcentration ug/I ND 1
2.22 (127-18-4) Mass
2.23 Toluene Concentration ug/I ND 1
El El 0
(108-88-3) Mass
1,2-trans-dichloroethylene Concentration ug/I ND 1
2.24 El El El
(156-60-5) Mass
1,1,1-trichloroethane Concentration ug/I ND 1
2.25 (71-55-6) Mass
2.26 1,1,2-trichloroethane Concentration ug/I ND 1
ID El 0
(79-00-5) Mass
2.27 Trichloroethylene Concentration ug/I ND 1
(79-01-6) Mass
Vinyl chloride Concentration ug/I ND 1
2.28 (75-01-4) Mass
Section 3.Organic Toxic Pollutants(GCIMS Fraction—Acid Compounds)
2-chlorophenol Concentration ug/I ND 1
3.1 (95-57-8) Mass
2,4-dichlorophenol Concentration ug/I ND 1
3.2 (120-83-2) Mass
2,4-dimethylphenol Concentration ug/I ND 1
3.3 (105-67-9) Mass
4,6-dinitro-o-cresol Concentration ug/I ND 1
3.4 (534-52-1) Mass
2,4-dinitrophenol Concentration ug/I ND 1
3.5 El El 0
(51 28 5)
Mass
EPA Form 3510-2C(Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses AValuee Analyses
( q ) (if available)
(if available)
2-nitrophenol 0 Concentration ug/I ND 1
3.6 (88-75-5) Mass
4-nitrophenol 0 Concentration ug/I ND 1
3.7 El El
(100-02-7) Mass
p-chloro-m-cresol Concentration ug/I ND 1
3.8 (59-50-7) Mass _
Pentachlorophenol 0 Concentration ug/I ND 1
3.9 0 El
(87-86-5) Mass
3.10 Phenol 0 Concentration ug/I 8.1 1
El 0
(108-95-2) Mass
2,4,6-trichlorophenol Concentration ug/I ND 1
3.11 El I=1 El
(88 05 2) Mass
Section 4.Organic Toxic Pollutants(GC/MS Fraction—Base/Neutral Compounds)
4.1 Acenaphthene 0 Concentration ug/I ND 1
(83-32-9) Mass
Acenaphthylene 0 Concentration ugh! ND 1
4.2 ID ID
(208-96-8) Mass
Anthracene ❑ Concentration ug/I ND 1
4.3 (120-12-7) Mass
Benzidine 0 Concentration ug/I ND 1
4.4 ID El
(92 87 5) Mass
Benzo(a)anthracene ❑ ❑ 0 Concentration ug/I ND 1
4.5 (56-55-3) Mass
4.6 Benzo(a)pyrene Concentration ug/I ND 1
(50-32-8) Mass
EPA Form 3510-2C(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Dail of Term of
Dischargeui ) Df available) De ischarge Analyses AValuee Analyses
(if available)
3,4-benzofluoranthene Concentration ug/I ND 1
4.7 1=I ElEl
(205-99-2) Mass
4.8 Benzo(ghi)perylene Concentration ug/l ND 1
El
(191-24-2) Mass
Benzo(k)fluoranthene ❑ Concentration ug/I ND 1
4.9 (207-08-9) Mass
Bis(2-chloroethoxy)methane Concentration ug/I ND 1
4.10 (111-91-1) Mass
Bis(2-chloroethyl)ether Concentration ug/I ND 1
4.11 (111-44-4) Mass
4.12 Bis(2-chloroisopropyl)ether 0 Concentration mg/I
(102-80-1) Mass
4.13 Bis(2-ethylhexyl)phthalate 0✓ 0 Concentration ug/I ND 1
(117-81-7) Mass
4.14 4-bromophenyl phenyl ether �✓ 0 Concentration ug/I ND 1
(101-55-3) Mass
Butyl benzyl phthalate Concentration ug/I ND 1
4.15 El El El
(85 68 7) Mass
2-chloronaphthalene Concentration ug/I ND 1
4.16 (91-58-7) Mass
4.17 4-chlorophenyl phenyl ether � Concentration ug/I ND 1
(7005-72-3) Mass
4.18 Chrysene Concentration ug/I ND 1
0 El El
(218-01-9) Mass
Dibenzo(a,h)anthracene ❑ Concentration ug/I ND 1
4.19 (53-70-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American, Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Daily Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Value
(if available)
1,2-dichlorobenzene Concentration ug/I v ND 1
4.20 (95-50-1) Mass
1,3-dichlorobenzene Concentration ug/l ND 1
4.21 El
(541-73-1) El 0 Mass
1,4-dichlorobenzene Concentration ug/I ND 1
4.22 (106-46-7) Mass
4.23 3,3-dichlorobenzidine Concentration ug/I ND 1
(91-94-1) Mass
4.24 Diethyl phthalate ❑ Concentration ug/I ND 1
(84-66-2) Mass
4.25 Dimethyl phthalate Concentration ug/I ND 1
(131-11-3) Mass
4.26 Di-n-butyl phthalate EaConcentration ug/I ND 1
(84-74-2) Mass
2,4-dinitrotoluene Concentration ug/I ND 1
4.27 0
(121-14-2) El El Mass
2,6-dinitrotoluene Concentration ug/I ND 1
4.28 (606-20-2) Mass -
4.29 Di-n-octyl phthalate Concentration ug/I ND 1
(117-84-0) Mass
4.30 1,2-Diphenylhydrazine 0 Concentration ug/I ND 1
(as azobenzene)(122-66-7) Mass
Fluoranthene Concentration ug/I ND 1
4.31 0 El El
(206-44-0) Mass _
Fluorene Concentration ug/I ND 1
4.32 0 El0
(86-73-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v)p
Presence or Absence
(check one) Effluent Intake
(optional)
PollutantlParameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge e(required)
(if available)lee
Discharge Analyses AValuee Analyses
re uired
(if available)
4.33 Hexachlorobenzene Concentration ug/I ND 1
(118-74-1) Mass
4.34 Hexachlorobutadiene Concentration ug/I ND 1
El El 0
(87-68-3) Mass
4.35 Hexachlorocyclopentadiene ElConcentration ug/I ND 1
El
(77-47-4) Mass
4.36 Hexachloroethane Concentration ug/I ND 1
El El 0
(67-72-1) Mass
Indeno(1,2,3-cd)pyrene Concentration ug/I ND 1
4.37 (193-39-5) Mass
4.38 Isophorone Concentration ugh! ND 1
(78-59-1) Mass
Naphthalene Concentration ug/I ND 1
4.39 (91-20-3) Mass
Nitrobenzene ❑ ❑ Concentration ug/I ND 1
4.40 (98-95-3) Mass
4.41 N-nitrosodimethylamine Concentration ug/I ND 1
(62-75-9) Mass
N-nitrosodi-n-propylamine 0 Concentration ug/I ND 1
4.42 (621-64-7) Mass
4.43 N-nitrosodiphenylamine Concentration ug/I ND 1
(86-30-6) Mass
Phenanthrene Concentration ug/I ND 1
4.44 (85-01-8) Mass
4.45 Pyrene Concentration ug/I ND 1
(129-00-0) Mass
EPA Form 3510-2C(Revised 3-19) Page 18

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence Intake
(check one) Effluent
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Discharge Discharge Daily of Average of
(required) (if available) Discharge Analyses Value Analyses
_ (if available)
4.46 1,2,4-trichlorobenzene ❑ Concentration ughl ND 1 1
El 0
(120-82-1) Mass
Section 5.Organic Toxic Pollutants(GC/MS Fraction—Pesticides)
Aldrin ❑ Concentration
5.1 0 El(309-00-2) Mass _
a-BHC Concentration
5.2 (319-84-6) ❑ ❑ ✓0
Mass
p-BHC 0 Concentration
5.3 (319-85-7) Mass
y-BHC � Concentration
5.4 El 0(58 89 9) Mass
6-BHC Concentration
5.5 (319-86-8) El � 0 Mass
Chlordane 0 Concentration
5.6 0 El
(57-74-9) Mass
4,4'-DDT Concentration
5.7 0 0
(50-29-3) Mass
4,4'-DDE 0 Concentration
5.8 0 El
(72-55-9) Mass
4,4'-DDD1=1 Concentration
5.9 (72-54-8) Mass
5.10 Dieldrin 0 Concentration
0 0
(60-57-1) Mass
0
a-endosulfan Concentration
5.11 (115-29-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Daily of of
Discharge Discharge Dischage Analyses Average Analyses
(required) (if available) (if available) Value
13-endosulfan CI ❑ Concentration
5.12 (115-29-7) Mass
Endosulfan sulfate ❑ ❑ ❑ Concentration
5.13 (1031-07-8) Mass
Endrin El ❑ ❑ Concentration
5.14 (72 20 8) Mass
Endrin aldehyde ❑ ❑ ❑ Concentration
5.15 (7421-93-4) Mass
Heptachlor El ❑ ❑ Concentration
5.16 (76-44-8) Mass
Heptachlor epoxide Concentration
5.17 (1024-57-3) 0 ❑ ❑
Mass
PCB-1242 Concentration
5.18 (53469-21-9) 0 ❑ 0 Mass
PCB-1254 Concentration
5.19 (11097-69-1) ❑ ❑ 0 Mass
PCB-1221 Concentration
5.20 (11104-28-2) 0 ❑ 0 Mass
PCB-1232 Concentration
5.21 (11141-16-5) 0 0 0 Mass
PCB-1248 Concentration
5.22 (12672-29-6) 0 0 0 Mass
PCB-1260 Concentration
5.23 (11096-82-5) 0 ❑ 0 Mass
PCB-1016 Concentration
5.24 (12674-11-2) 0 0 0
Mass
EPA Form 3510-2C(Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Daily of of
Discharge Discharge Dischr a Analyses Average Analyses
(required) (if available) (if available)—
Value
Toxaphene Concentration
5.25 (8001-35-2) 0 0 0 Mass
t Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 21

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EPA Identification Number NPDES Permit Number Facility Name Ouffall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence Intake
(check one) Effluent (Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
(required) Discharge Discharge Analyses Analyses
(if available) (if available) Value
❑ Check here if you believe all pollutants on Table C to be present in your discharge from the noted outfall.You need not complete the"Presence or Absence"column of Table C for
each pollutant.
❑ Check here if you believe all pollutants on Table C to be absent in your discharge from the noted outfall.You need not complete the"Presence or Absence"column of Table C for
each pollutant.
1. Bromide 0 ❑ Concentration
(24959-67-9) Mass
Chlorine,total ❑ 0 Concentration ug/I 21 16 9
2' residual Mass
3. Color 0 ❑ Concentration
Mass
4. Fecal coliform ❑ Concentration #/100 ml 15 1.97 4
Mass
5 Fluoride ❑ ❑ Concentration
(16984-48-8) Mass
6 Nitrate-nitrite 0 El
mg/I
Mass
Nitrogen,total ❑ El
mg/I 2 1
7. organic(as N) Mass
Concentration mg/I
8. Oil and grease 0 ❑
Mass
9 Phosphorus(as 0 ❑ Concentration mg/I 0.32 1
P),total(7723-14-0) Mass
10. Sulfate(as SO4) 0 ❑ Concentration mg/I 28 1
(14808-79-8) Mass
11. Sulfide(as S) 0 0 Concentration lbs/day 1.2 0.65 4
Mass
EPA Form 3510-2C(Revised 3-19) Page 23

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence Intake
(check one) Effluent (Optional)
Units
Pollutant Maximum Long-Term
Believed Believed (specify) Maximum Daily Monthly Average Daily Number of Long-Term Number of
Present Absent Discharge Discharge Discharge Analyses Average Analyses
(required) Value
(if available) (if available)
12. Sulfite(as S03) ❑ ❑ Concentration
(14265-45-3) Mass
Concentration
13. Surfactants ❑ ❑✓ Mass
14. Aluminum,total ❑ ✓❑ Concentration
(7429-90-5) Mass
15. Barium,total 0 ✓❑ Concentration
(7440-39-3) Mass
16. Boron,total ❑ ❑✓ Concentration
(7440-42-8) Mass
17. Cobalt,total 0 Concentration
(7440-48-4) Mass
18 Iron,total 0 ✓❑ Concentration
(7439-89-6) Mass
19 Magnesium,total ❑ 0 Concentration
(7439-95-4) Mass
Molybdenum, Concentration
20. total 0 ✓❑ Mass
(7439-98-7)
21. Manganese,total ❑ ✓❑ Concentration
(7439-96-5) Mass
22. Tin,total 0 ❑✓ Concentration
(7440-31-5) Mass
23. Titanium,total 0 ✓❑ Concentration
(7440-32-6) Mass
EPA Form 3510-2C(Revised 3-19) Page 24

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence Intake
(check one) Effluent
(Optional)
Units
Pollutant Maximum Lon Term
Believed Believed (specify) Maximum Daily Monthly Average Daily Number of Long-Term Number of
Present Absent Discharge Discharge Discharge Analyses Average Analyses
(required) Value
(if available) (if available)
24. Radioactivity
Concentration
0Alpha,total 0
Mass
Beta,total ❑ 0Concentration
Mass
Concentration
Radium,total 0 ✓❑ Mass
Radium 226,total 0 El
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 25

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge
(specify units)
Present Absent
1. Asbestos ❑ ❑✓
2. Acetaldehyde 0 ❑✓
3. Allyl alcohol 0 ❑✓
4. Allyl chloride ❑ ❑✓
5. Amyl acetate ❑ ❑✓
6. Aniline ❑ 0
7. Benzonitrile ❑ 0
8. Benzyl chloride ❑ 0
9. Butyl acetate ❑ ❑✓
10. Butylamine ❑ ❑✓
11. Captan ❑ ❑✓
12. Carbaryl ❑ ❑✓
13. Carbofuran ❑ ❑✓
14. Carbon disulfide ❑ ❑✓
15. Chlorpyrifos ❑ ✓❑
16. Coumaphos ❑ ❑✓
17. Cresol ❑ ❑✓
18. Crotonaldehyde ❑ ❑�
19. Cyclohexane 0 ❑✓
EPA Form 3510-2C(Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
20. 2,4-D(2,4-dichlorophenoxyacetic acid) ❑ ❑✓
21. Diazinon 0 ✓❑
22. Dicamba ❑ ❑✓
23. Dichlobenil 0 ❑✓
24. Dichlone 0 ✓❑
25. 2,2-dichloropropionic acid ❑ 0
26. Dichlorvos ❑ ✓❑
27. Diethyl amine ❑ ❑✓
28. Dimethyl amine ❑ 0
29. Dintrobenzene ❑ 0
30. Diquat 0 ❑✓
31. Disulfoton ❑ 0
32. Diuron 0 ❑✓
33. Epichlorohydrin 0 ❑✓
34. Ethion 0 - ❑✓
35. Ethylene diamine ❑ 0
36. Ethylene dibromide ❑ 0
37. Formaldehyde ❑ ❑✓
38. Furfural ❑ 0
EPA Form 3510-2C(Revised 3-19) Page 28

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))l
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
39. Guthion ❑ ❑✓
40. Isoprene ❑ ❑✓
41. Isopropanolamine ❑ ✓❑
42. Kelthane ❑ ✓❑
43. Kepone ❑ ✓❑
44. Malathion ❑ ❑✓
45. Mercaptodimethur ❑ ❑✓
46. Methoxychlor ❑ ✓❑
47. Methyl mercaptan ❑ ✓❑
48. Methyl methacrylate ❑ ❑✓
49. Methyl parathion ❑ ✓❑
50. Mevinphos ❑ ✓❑
51. Mexacarbate ❑ ✓❑
52. Monoethyl amine ❑ 0
53. Monomethyl amine ❑ ❑✓
54. Naled ❑ ❑✓
55. Naphthenic acid ❑ ❑✓
56. Nitrotoluene ❑ ❑✓
57. Parathion ❑ ❑✓
EPA Form 3510-2C(Revised 3-19) Page 29

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
58. Phenolsulfonate ❑ ✓❑
59. Phosgene 0 ❑✓
60. Propargite ❑ ✓❑
61. Propylene oxide ❑ ✓❑
62. Pyrethrins 0 ✓❑
63. Quinoline ❑ ✓❑
64. Resorcinol ❑ El
65. Strontium 0 ❑✓
66. Strychnine 0 ❑✓
67. Styrene 0 ❑✓
68. 2,4,5-T(2,4,5-trichlorophenoxyacetic ❑ ❑
acid)
69. TDE(tetrachlorodiphenyl ethane) ❑ ❑✓
70 2,4,5-TP[2-(2,4,5-trichlorophenoxy) 0 ❑
propanoic acid]
71. Trichlorofon ❑ ❑✓
72. Triethanolamine ❑ ❑✓
73. Triethylamine ❑ ❑✓
74. Trimethylamine ❑ ❑✓
75. Uranium 0 ❑✓
76. Vanadium ❑ ❑✓
EPA Form 3510-2C(Revised 3-19) Page 30

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
77. Vinyl acetate ❑ ✓❑
78. Xylene ❑ ❑✓
79. Xylenol ❑ ❑✓
80. Zirconium ❑ ❑✓
Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or O.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 31

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EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110004015921 NC0004243 Coats American,Inc, 001 OMB No.2040-0004
TABLE E.2,3,7,8 TETRACHLORODIBENZO P DIOXIN(2,3,7,8 TCDD)(40 CFR 122.21(g)(7)(viii))
TCDD Presence or
Congeners Absence
Pollutant Used or (check one) Results of Screening Procedure
Manufactured Believed Believed
Present Absent
2,3,7,8-TCDD 0 0 0
EPA Form 3510-2C(Revised 3-19) Page 33