NCG030650_COMPLETE FILE - HISTORICAL_20180410

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
N CC'� O 3 0 S-6
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ � o'
YYYYMMDD

ROY COOPER
Governor
' MICHAEL S. REGAN
� ' Secrerery
WILL JAM E. (TOBY) VINSON,- JR.
lnrerirn DireCIOr
Energy, Mineral
and LandResourcu
EN VIRONMENTA4 OVALITY
April 10, 2018 RECEIVED
Commscope, Inc
APR 2 3 2010
Attention: Jim Streetman DENR-LANI) QUALITY
3642 East US Highway 70 STORMWATER PERMITTING
Claremont, North Carolina 28610-0879
Subject: NPDES Stormwater Permit
Stormwater Certificate of Coverage No. NCG030650
Representative Outfall Status Request
Catawba County
Dear Mr. Streetman:
The Mooresville Regional Office staff have reviewed your March 16, 2018 request for a determination that
stormwater discharge outfall 3 be granted representative outfall status for stormwater outfalls 1 and 2. Based on
the information provided and a January 25, 2018 site inspection, we are approving this request. In accordance
with 40 CFR § 122.2 1 (g)(7), you are authorized to sample outfall number 3 as representative for the entire site.
This approval is effective with the next sampling event.
Please append this letter to your Stormwater Pollution Prevention Plan (SPPP) or permit to document that
representative outfall status has been approved. if changes in drainage areas, structures, processes, storage
practices, or other activities occur that significantly alter the basis of this approval, representative outfall status
may no longer be valid; You should either resume sampling at all SDOs, or reapply to this office for
representative outfall status based on updated information. If you have any questions or comments concerning
this letter, please contact our Office at [phone].
Sincerely,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
cc: Stormwater Permitting Program, Raleigh Central Office - NCG030650
Sixe of North Carolina I Environmental Quality I Fnergy, Mineral and land Resources
Mooresville Regional Office 1 610 Fast Center Ave Ste 301 I Mooruvills, NC 28113
704 663 1699 T

ROY COOPER
cov<mff
r;.
Energy. Mineral
and Land Resources
ERVIROKMENTAL QURLETY
March 20, 2018
Commscope, Inc
3642 East US Hwy 70
Attention: Kisten L. Yost
Claremont, North Carolina 28610
Subject: NPDES Stormwater Permit
MICHAEL S. REGAN
se--ry
WILLIAM E. (TOBY) VINSON, JR.
brterim Director
1 C Ili D
MAR 2 6 ZO18
CENTRAL FILES
DWR SECTION
Stormwater Certificate of Coverage No. NCG030650
Representative Outfall Status Request
Catawba County
Dear Ms. Yost:
The Mooresville Regional Office staff have reviewed your January 30, 2018 request for a determination that
stormwater discharge outfall 003 be granted representative outfall status for stormwater outfalls 001 and 002.
Based on the information provided and a January 25, 2018 site inspection, we are approving this request. In
accordance with 40 CFR § 122.21(g)(7), you are authorized to sample outfall number 003 as representative for
the entire site. This approval is effective with the next sampling event.
Please append this letter to your Stormwater Pollution Prevention Plan (SPPP) or permit to document that
representative outfall status has been approved. If changes in drainage areas, structures, processes, storage
practices, or other activities occur that significantly alter the basis of this approval, representative outfall status
may no longer be valid_ You should either resume sampling at all SDOs, or reapply to this office for
representative outfall status based on updated information. If you have any questions or comments concerning
this letter, please contact our Office at [phone].
Sincerely,
3Ak-kAAL,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
cc: Annette Lucas, Stormwater Permitting Prograrn,.NCG030650
State of North Carolina I Environmental Quality I Energy, Mineral and land Resources
Mooresville RegiorW Office 1 610 East Center Ave Ste 301 I Mootcsville, NC 29115
704 663 1699 T

ti
Compliance Inspection Rep2rt
Permit: NCGNE1249 Effective: Expiration:
Owner., Commscope Inc
SOC: Effective: Expiration:
Facility: Commscope - Claremont Operations
County: Catawba
3642 E US Hwy 70
Region: Mooresville
Claremont NC 28610
contact Person: Kristen L Yost Title:
Phone: [phone]
Directions to Facility:
proceed one mile east on us 70 from intersection win oxford st facility is on left.
System Classifications:
Primary ORC: Certification:
Phone:
Secondary ORG(s):
On -Site Representative(s):
Related Pernnits:
Inspection date: 01C W018 Entry Time: 09:30AM Exit Tine: 11:30AM
Primary Inspector. James D Moore Phone:
Secondary Inspector(s):
Angela Y Lee
Reason for inspection: Routine Inspection Type: Technical Assistance
Permit Inspection Type: Stamrwater Discharge, No Exposure Certificate
Facility Status: E Compliant Not Compliant
Question Areas:
Miscellaneous Questions
(See attachment summary)
Page: 1

permit NCGNE1249 Owner- Facility: Convnscope Inc
inspection Date: 01/251201 S Inspection Type. Technical Assistance Reason for Visit: Routine
Inspection Summary:
The inspection was a result of a no exposure request. Based on the inspection, no exposure cannot be granted at this
time.A pallet management system would need to be implemented to keep all pallets under cover and all open top waste
containers would need to be covered before no exposure could be granted. An example of an approved container cover will
be emailed to Jim Streetman. Also, during the inspection I advised Mr. Streetman that the site would be a candidate for
representative outfall status (see attached form) and that I would support Tier 2/3 monitoring relief. Please call James Moore
at 704.235.2138 if you have any questions.
Page: 2

s
C0MMSCI*PE'
CommScope — Claremont Facility
3642 U.S. Hwy. 70 East
P.O. Box 879
Claremont, NC 28610-0879
Date: January 30', 2018
Attention: Stormwater Permitting Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, NC 27699-1612
RECEIVED
MAR 16 2010
GENR-LAND QUALITY
STORMWATER PERMITTING
RE-0FIUED
APR 0 4 z018
CENTRAL FILES
DWR SECTION
Subject: Representative Outfall Status (ROS) Request Form for
COMMSCOPE, INC. — CLAREMONT
NCDWQ General Permit No. NCG030000
Certificate of Coverage No. NCG030650
To Whom It May Concern:
I have enclosed the Representative Outfall Status (ROS) Request form (SWU-ROS-
2009) for CommScope, Inc. - Claremont. Per the ROS form, I have enclosed the
following for your review:
• Completed ROS Request Form;
• Narrative elaborating on the reasons why Outfall 003 should be granted
representative status for the entire site (including Outfalls 001 and 002);
• Two (2) copies of a site map for the facility marking the location of all three (3)
outfalls and their respective drainage areas and industrial activities; and
• A Summary of test results from monitoring conducted at all respective outfalls.
If you need any further information, please feel free to call me at 336-366-0870 to
discuss at your convenience.

Please let me know if you have any questions or concerns with this ROS request form.
Thanks for your time and assistance.
Sincerely,
Nicole B. 3ohnston
Environmental Consultant
For CommScope Inc,
Burch Environmental, LLC
5087 Icard Ridge Road
Hickory, NC 28601
Phone: [phone]
nicole johnston@a yvsa.oM
cc: Mr. Jim Streetman, CommScope, Inc. - Claremont

NCD.ENR
N;Ai�+ Y"+OLJN4 �NITTCM 01
t�+VINO�.�EM •ND fiAZJRIL RE'�a�CS
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
REPRESENTATIVE OUTFALL STATUS (ROS)
REQUEST FORM
FOR AGENCY USE ONLY
Elate Received
Year
I Month
I Day
If a facility is required to sample multiple discharge locations with very similar storm water discharges, the
permittee may petition the Director for Representative Outfall Status (ROS). DWQ may grant Representative
Outfall Status if stormwater discharges from a single outfoll are representative of discharges from multiple
outfalls. Approved ROS will reduce the number of outfalls where analytical sampling requirements apply.
If Representative Outfa!! Status is granted, ALt out are still subject to the qualitative monitoring
requirements of the facility's permit —unless otherwise allowed by the permit (such as NCGD20000) and DWQ
approval. The approval letter from DWQ must be kept on site with the facility's Stormwater Pollution
Prevention Plan. The facility must notify DWQ in writing if any changes affect representative status.
For questions, please contact the DWQ Regional Office for your area (see page 3).
(Please print or type)
1) Enter the permit number to which this ROS request applies:
Individual Permit (or) Certificate of Coverage
N I C I S I I I I I I J N C G 0 3 0 6 S 0
2) Facility Information:
Owner/Facility Name CommScope, Inc. — Claremont Facility
Facility Contact
Street Address
City
County
Telephone No.
Mr. Jim Streetman / Ms. Nicole Johnston
3642 U_ S. highway 70 East
Claremont State NC ZIP Code 28610-0879
Catawba E-mail Address [e-mail]
[phone] or [phone] Fax: [phone]
3) List the representative outfalls) information (attach additional sheets if necessary):
Outfall(s) 003 is representative of Outfall(s) 001 and 002
Outfalls' drainage areas have the same or similar activities? ❑ Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? o Yes ❑ No
Outfalls have similar monitoring results? © Yes ❑ No o No data*
Outfall(s) is representative of Outfall(s)
outfalls' drainage areas have the same or similar activities? ❑ Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? ❑ Yes ❑ No
Outfalls have similar monitoring results? ❑ Yes ❑ No ❑ No data*
Outfall(s)
is representative of Outfall(s)
outfalls' drainage areas have the same or similar activities? ❑ Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? a Yes ❑ No
Outfalls have similar monitoring results? ❑ Yes ❑ No ❑ No data*
*Non-compliance with analytical monitoring prior to this request may prevent ROS approval. Specific
circumstances will be considered by the Regional Office responsible for review.
Page i of 3
SWU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
4) Detailed explanation about why the outfalls above should be granted Representative Status:
(Or, attach a letter or narrative to discuss this information.) For example, describe how activities and/or
materials are similar.
See attached letter.
5) Certification:
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record,
report, plan, or other document filed or required to be maintained under this Article or a rule implementing this
Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case
under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device
or method required to be operated or maintained under this Article or rules of the [Environmental Management]
Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed
ten thousand dollars ($10,000).
I hereby request Representative Outfall Status for my NPDES Permit. I understand that ALL outfalls are still
subject to the qualitative monitoring requirements of the permit, unless otherwise allowed by the permit
and regional office approval. I must notify DWQ in writing if any changes to the facility or its operations
take place after ROS is granted that may affect this status. If ROS no longer applies, I understand I must
resume monitoring of all outfalls as specified in my NPDES permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing:
Title: Environmental Consultant
(Signature
Nicole Johnston
O1/30/2018
(Date Signed)
Please note: This application for Representative Outfall Status is subject to approval by the
NCDENR Regional Office. The Regional Office may inspect your facility for compliance with the
conditions of the permit prior to that approval.
Final Checklist for ROS Request
This application should include the following items:
❑ This completed form.
❑ Letter or narrative elaborating on the reasons why specified outfalls should be granted representative
status, unless all information can be included in Question 4.
❑ Two (2) copies of a site map of the facility with the location of all outfalls clearly marked, including the
drainage areas, industrial activities, and raw materials/finished products within each drainage area.
❑ Summary of results from monitoring conducted at the outfalls listed in Question 3.
❑ Any other supporting documentation.
Page 2 of 3
5WU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
Mail the entire package to:
NC DENR Division of Water Quality
Surface Water Protection Section
at the appropriate Regional Office (See map and addresses below)
Notes
The submission of this document does not guarantee Representative Outfall Status (ROS) will be granted as
requested. Analytical monitoring as per your current permit must be continued, at all outfalls, until written
approval of this request is granted by DWQ. Non-compliance with analytical monitoring prior to this request
may prevent ROS approval. Specific circumstances will be considered by the Regional Office responsible for
review.
For questions, please contact the DWQ Regional Office for your area. �I
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Washington Regional Office
943 Washington Square Mall
Phone [phone]
Washington, NC 27889
FAX [phone]
Phone [phone]
Fayetteville Regional Office
FAX [phone]
Systel Building,
225 Green St., Suite 714
Wilmington Regional Office
Fayetteville, NC 28301-5094
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone [phone]
FAX [phone]
Phone [phone]
FAX [phone]
Mooresville Regional Office
610 East Center Ave.
Winston-Salem Regional Office
Mooresville, NC 28115
585 Waughtown Street
Winston-Salem, NC 27107
Phone [phone]
Phone [phone]
FAX [phone]
Water Quality Main FAX [phone]
Raleigh Regional Office
Central Office
1628 Mail Service Center
1617 Mail Service Center
Raleigh, NC 27699-1628
Raleigh, NC 27699-1617
Phone [phone]
Phone [phone]
FAX [phone]
FAX [phone]
Page 3 of 3
SVVU-ROS-2009 Last revised 12130/2009

COMMSC(,5PE°
CommScope — Claremont Facility
3642 U.S. Hwy. 70 East
P.O. Box 879
Claremont, NC 28610-0879
Date: January 30', 2018
Representative Outfail Status (ROS) Request Form
For Question 4 -> Detailed explanation about why the outfalls above should
be granted Representative Status:
This is a brief narrative elaborating on the reasons why Stormwater Discharge Outfall
(SDO) 003 should be granted representative status for the entire CommScope, Inc. —
Claremont site.
• SDO 003 encompasses approximately 10.44 acres of the Claremont site.
• SDO 003 provides a clear representation of all the industrial activities that occur
at the facility.
• SDO 001 has a pervious area of only 1.73 acres and mainly represents activities
that occur as a result of a main thoroughfare or highway (Highway 70 in
Claremont).
• SDO 002 has a pervious area of only 0.74 acres and has a very close proximity to
SDO 003.
• Both SDOs 001 and 002 are represented via SDO 003 (as was noted via Mr.
James Moore and Angela Lee of NCDEQ via an inspection visit on 1/25/2018).
If you need any further information, please feel free to call Nicole Johnston at 336-366-
0870 to discuss at your convenience.

LEGEND
CONYEYANM srsrw
• DRUM
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- _
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- \
Tom
MW
st>esu S 0-002 It �� DRAINAGE AREA l J j
_ M
DRAINAGE AREA 2
Gl1nROliOM o
'i NORTH PLANT al j SOUTH PLANT �
k 1 x o
DRAINAGE AREA 3 s j
y — s _ — ..._. _._
to
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"ypFyf, [ PS 5 �'. �2 CIA UDE E. L13Ti.E
f ` ryl � �''� - } A'
S.
All lt
CNORM
4
DRAINAGE AREASM
OUTFAL_L_
LATITUDE
LONGITUDE
IMPERVIOUS
PERVIOUS
AREA
AREA
SL)0 - 0 0 1
11 3`_>'43 tin
oK 6L 1)i'5"-'
.4 5 n,=
1.' ; ;,:_
SDO-002
N 35`43'20'
W 81'08'02'
5.49 a{
0.74 ac
SD❑-003
N 35'43'20'
W 81408'06`
14 35 4c
10.44 ac
IMN C9
WALE IN fr
so G ao
t�
4, x
--r� MAP 2 - FACILITY SITE PLAN
rr deveMped for
NOTE: BASE MAP ORIGINALLY CREATED BY ERM, INC. APRIL 2002. �. � � COMMSCOPE, INC
_ Claremont, North Carolina
NPDES Permit No. NCGO30650
Map Date: JCLti' 3©, 241d Rev iced Br Jim Frei
l Map Scale: See Bar Scale Checked By: Sim Frei
Sw SG Sinrmwawr Services Group. LLC Raleigh. `C [phone]

ZZ sew
s � ` �FOM+LER Ttnsa+ IW -
a
PEUEr
\ / slow GE
i
/ rD
DRAINAGE AREA 2
NORTH PLANT
LEGEND SrOMMTER
k \
coW&rAnce sSTeu
•
z $$
TA)K
41? TAW
u
4 .. _ ... ,/'t!
mWD
�.�
f[ S
/-mil.,• •.
DRAINAGE AREAS M. s
m• s -
OUTFALL
LATITUDE LONGITUDE
IMPERVIOUS
PERVIOUS
AREA
AREA
SDO-001
N 35.43'06' W 81.07'59'
3.45 r„-
1 ; ui=
SDO-002
N 35'43'20' W 81.08'02'
5.49 ac
0.74 ac
SDO-003
N 35'43'20' W 81e08'06'
14.35 ac
10.44 ac
NOTE: BASE MAP ORIGINALLY CREATED BY ERM, INC. APRIL 2002
II
I DRAINAGE AREA 1
II
I
� II
II
L-- ----_ — — — —
SOUTH PLANT
DRAINAGE AREA 3
Tt i
ceuer
RAM
�`-a cprA.,e ero
y
cl
�l
i
a
CLAUDE E. LRTLE
MAP 2 - FACILITY SITE PLAN
Ia
COMMSCOPE, INC
Claremont, North Carolina
NPDES Pemdt No. NC6050650
MLp Date: JL-LY 30, 2013 Rerhed W. dim Frei
MLp s-I.':: See Bu Sole Checked By: Jim FM
`' SWSbrtewetee S—w. Greep, LLC R.Idgh,.V'C (919)661-99E1

COMMSCOPE - CLAREMONT OPERATIONS
GENERAL PERMIT NO. NCG030000
COC NCG030650
APPLICATION FOR DISCHARGE PERMIT RECEIVED BY NCDEQ ON JUNE 20, 2014
PERMIT EFFECTIVE DATE: JULY 10, 2014
PERMIT EXPIRATION: OCTOBER 31, 2017
24-hour rainfall amount TSS pH
Copper
Lead
Zinc
Oil & Grease
DATE SDO ## (Inches) (mg/L) (units)
(mg/L)
(mg/L)
(mg/L)
(mg/L)
Benchmarks - - 100 mg/L 6.0 - 9.0
0.007 mg/L
0.030 mg/L
0.067 mg/L
15 mg/L
12/6/2014
003
0.18
<50.0
7.16
0.0080
<0.0050
0.012
<5.0
5/27/2015
003
0.41
27.9
7.28
0.0068
<0.0050
0.016
<5.0
10/2/2015
003
0.34
33.8
7.05
0.0085
<0.0050
0.045
<5.0
NO DATA FOR FIRST PART OF 2016
12/6/2016
001
0.70
6.625
7.10
0.007
<0.0025
0.129
<5.1
002
0.70
<2.5
6.85
0.0043
<0.0025
0.099
<5.0
003
0.70
<2.857
6.97
0.0083
<0.0025
0.098
<5.1
6/5/2017
001
1.00
14.8
7.29
0.02
0.014
0.16
12.5
002
1.00
<3.704
7.02
0.04
<0.0025
0.056
5.64
003
1.00
<2.941
7.03
0.02
<0.0025
0.085
5.12
12/20/2017
001
0.40
<3.030
7.11
0.014
<0.0025
0.21
<5.1
002
0.40
<2.976
7.46
0.014
<0.0025
0.106
<5.1
003
0.40
5.951
7.47
0.02
<0.0025
0.108
<5

COMMSCI*PE 0
CommScope — Claremont Facility
3642 U.S. Hwy. 70 East
P.O. Box 879
Claremont, NC 28610-0879
Date: January 3011, 2018
Mr. James Moore
Assistant Regional Engineer (MRO-LQ)
Mooresville Regional Office
Division of Energy, Mineral and Land Resources
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Subject: Representative Outfall Status (ROS) Request Form for
COMMSCOPE, INC. — CLAREMONT
NCDWQ General Permit No. NCG030000
Certificate of Coverage No. NC6030650
Dear Mr. Moore:
I have enclosed the Representative Outfall Status (ROS) Request form (SWU-ROS-
2009) for CommScope, Inc. - Claremont. Per the ROS form, I have enclosed the
following for your review:
• Completed ROS Request Form;
• Narrative elaborating on the reasons why Outfall 003 should be granted
representative status for the entire site (including Outfalls 001 and 002);
• Two (2) copies of a site map for the facility marking the location of all three (3)
outfalls and their respective drainage areas and industrial activities; and
• A Summary of test results from monitoring conducted at all respective outfalls.

If you need any further information, please feel free to call me at 336-366-0870 to
discuss at your convenience.
Please let me know if you have any questions or concerns with this ROS request form.
Thanks for your time and assistance.
Sincerely,
Nicole B. ]ohnston
Environmental Consultant
For CommScope Inc,
Burch Environmental, LLC
5087 Icard Ridge Road
Hickory, NC 28601
Phone: [phone]
nicole.johnston(@yysa.org
cc: Mr. Jim Streetman, CommScope, Inc. - Claremont

�F
NCDENR
Division of Water Quality / Surface Water Protectioo
National Pollutant Discharge Elimination System
REPRESENTATIVE OUTFALL STATUS (RO�) �
REQUEST FORM Mo,,.ad
FOR AGENCY USE ONLY
Date Received
Month Uay
if a facility is required to sample multiple discharge locations with very similar stbflay,&�tjd�schorges, the
permittee may petition the Director for Representative Outfall Status (ROS). DWQ may iy4t Representative
Outfall Status if stormwater discharges from a single outfall are representative of dischargesfrom multiple
outfalls. Approved ROS will reduce the number of outfalls where analytical sampling requirements apply.
if Representative Outfall Status is granted, ALL outfalls are still subject to the qualitative monitoring
requirements of the facility's permit --unless otherwise allowed by the permit (such as NCG020000) and DWQ
approval. The approval letter from DWQ must be kept on site with the facility's Stormwater Pollution
Prevention Plan. The facility must notify DWQ in writing if any changes affect representative status.
For questions, please contact the DWQ Regional Office for your area (see page 3).
(Please print or type)
1) Enter the permit number to which this ROS request applies:
Individual Permit (or) Certificate of Coverage
N C S I I I I N C G. 0 3 0 6 5 0
2) Facility Information:
Owner/Facility Name CommScope, Inc. —Claremont Facility
Facility Contact
Street Address
City
County
Telephone No.
Mr. Jim Streetman / Ms. Nicole Johnston
3642 U. S. Highway 70 East
Claremont State NC ZIP Code 28610-0879
Catawba E-mail Address [e-mail]
[phone] or [phone] Fax: [phone]
3) List the representative outfall(s) information (attach additional sheets if necessary):
Outfall(s) 003 is representative of Outfall(s) 001 and 002
Outfalls' drainage areas have the same or similar activities? o Yes ❑ No
Outfalls' drainage areas contain the same or similar materials?
Outfalls have similar monitoring results?
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities?
Outfalls' drainage areas contain the same or similar materials?
Outfalls have similar monitoring results?
Outfall(s)
is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities?
Outfalls' drainage areas contain the same or similar materials?
Outfalls have similar monitoring results?
o Yes ❑ No
o Yes ❑ No ❑ No data*
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No ❑ No data*
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No ❑ No data*
*Non-compliance with analytical monitoring prior to this request may prevent ROS approval. Specific
circumstances will be considered by the Regional Office responsible for review.
Page I of 3
SWU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
4) Detailed explanation about why the outfalls above should be granted Representative Status:
(Or, attach a letter or narrative to discuss this information.) For example, describe how activities and/or
materials are similar.
See attached letter.
5) Certification:
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record,
report, plan, or other document filed or required to be maintained under this Article or a rule implementing this
Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case
under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device
or method required to be operated or maintained under this Article or rules of the [Environmental Management]
Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed
ten thousand dollars ($10,000).
I hereby request Representative Outfall Status for my NPDES Permit. I understand that ALL outfalls are still
subject to the qualitative monitoring requirements of the permit, unless otherwise allowed by the permit
and regional office approval. I must notify DWQ in writing if any changes to the facility or its operations
take place after ROS is granted that may affect this status. if ROS no longer applies, I understand i must
resume monitoring of all outfalls as specified in my NPDES permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Nicole Johnston
Title: Environmental Consultant
(Signature
01/30/2018
(Date Signed)
Please note: This application for Representative Outfoli Status is subject to approval by the
NCDFNR Regional Office. The Regional Office may inspect your facility far compliance with the
conditions of the permit prior to that approval.
Final Checklist for ROS Request
This application should include the following items:
❑ This completed form.
❑ Letter or narrative elaborating on the reasons why specified outfalls should be granted representative
status, unless all information can be included in Question 4.
❑ Two (2) copies of a site map of the facility with the location of all outfalls clearly marked, including the
drainage areas, industrial activities, and raw materials/finished products within each drainage area.
❑ Summary of results from monitoring conducted at the outfalls listed in Question 3.
a Any other supporting documentation.
Page 2 of 3
5WU-ROS-2009 Last revised 12/30/2009

Representative Outfalll Status Request
Mail the entire package to:
NC DENR Division of Water Quality
Surface Water Protection Section
at the appropriate Regional Office (See map and addresses below)
Notes
The submission of this document does not guarantee Representative Outfall Status (ROS) will be granted as
requested. Analytical monitoring as per your current permit must be continued, at all outfalls, until written
approval of this request is granted by DWQ. Non-compliance with analytical monitoring prior to this request
may prevent ROS approval. Specific circumstances will be considered by the Regional Office responsible for
review.
For questions, please contact the DWO Regional Office for your area.
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Washington Regional Office
943 Washington Square Mall
Phone [phone]
Washington, NC 27889
FAX [phone]
Phone [phone]
Fayetteville Regional Office
FAX [phone]
Systel Building,
225 Green St., Suite 714
Wilmington Regional Office
Fayetteville, NC 28301-5094
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone [phone]
FAX [phone]
Phone [phone]
FAX [phone]
Mooresville Regional Office
610 East Center Ave.
Winston-Salem Regional Office
Mooresville, NC 28115
585 Waughtown Street
Winston-Salem, NC 27107
Phone [phone]
Phone [phone]
FAX [phone]
Water Quality Main FAX [phone]
Raleigh Regional Office
Central Office
1628 Mail Service Center
1617 Mail Service Center
Raleigh, NC 27699-1628
Raleigh, NC 27699-1617
Phone [phone]
Phone [phone]
FAX [phone]
FAX [phone]
Page 3 of 3
5WU-ROS-2009 Last revised 12/30/2009

COMMSCI*,PE 0
CommScope -- Claremont Facility
3642 U.S. Hwy. 70 East
P.O. Box 879
Claremont, NC 28610-0879
Date: January 301, 2018
Representative Outfall Status (ROS) Request Form
For Question 4 4 Detailed explanation about why the outfalls above should
be granted Representative Status:
This is a brief narrative elaborating on the reasons why Stormwater Discharge OutFall
(SDO) 003 should be granted representative status for the entire CommScope, Inc. —
Claremont site.
SDO 003 encompasses approximately 10.44 acres of the Claremont site.
SDO 003 provides a clear representation of all the industrial activities that occur
at the facility.
• SDO 001 has a pervious area of only 1.73 acres and mainly represents activities
that occur as a result of a main thoroughfare or highway (Highway 70 in
Claremont).
• SDO 002 has a pervious area of only 0.74 acres and has a very close proximity to
SDO 003.
Both SDOs 001 and 002 are represented via SDO 003 (as was noted via Mr.
James Moore and Angela Lee of NCDEQ via an inspection visit on 1/25/2018).
If you need any further information, please feel free to call Nicole Johnston at 336:-366-
0870 to discuss at your convenience.

1----SDO-001
s aas� s r"rn � �TarM. R7'g y..MrMnc �-,. 1 - / • \ � �
a♦ei _ - `" _ � _ � _ .. _ - -� - t ,— — -- j� OFFS , �`-'"
via S 002 DRAINAGE AREA 1 \
FEIM
sramce
D. DRAINAGE AREA 2
/ NN
� NORTH PLAT i "1 SOUTH PLANT 1. �
LEGEND
MORWWATE1i W 1 V
♦ CONVEYANCE SYSTEM $$ °e I �1 t aDRUM
I' a
TAM(
DRAINAGE AREA 3 •
» ' ` FCC ! - �9•
STORAGE
(I- _
pw-.
aers,. '�.. s �, ca ♦ __._.- - '"--� d C—E E..11LE
cNewK No
DRAINAGE AREAS
Mcw _ Ms G` !� r,
OUTFALL LATITUDE LONGITUDE IMPERVIOUS PERVIOUS
AREA AREA
SDO-001 N 35°43'06' W 81'07'59' 3.45 ac 1.73 ac k�
SDO-002 N 35.43'20' W 81'08'02' 5.49 ac 0.74 ac b
SDO-003 N 35'43'20' W 81'08'06' M35 ac 10.44 ac MAP 2- FACILITY SITE PLAN
d--Lopedf-
NOTE: BASE MAP ORIGINALLY CREATED BY ERM, INC. APRIL 2002. COMMSCOPE, INC,
\ Claremont, North Carolina
NPDES Permit No. NCGO30650
M.p D.W JULY 30, 2014 Rnised By: Jim Frei
Nf.p Snk: See Bar Suk Chmked *: Jim Frei
SWSG Smrmw. er Seniea Group. iJC R.Idgh,.0 [phone]

LLULNU
STCtRMYATER
CDNYEYANCE SYSTEM
• DRUM
_ TANK
■ PALLET
5 !BLS
DUMPSTFR/COMPACTOR
PI W&
mom aiwt
[JTP OF forlam
. y� E tfo�■
sue` sssd� 1'E1t�� ylftllll!ll'4 ���giiis
r lil!'•k S � ,1 '
i
S Z MEWPOLYPROPYLOC
00 a PEUEF
DID
sTnw
~ ' t1 ` ` DRAINAGE AREA 2
�X�
'NORTH PLANT
um
I [
p CB
win
5 Sf?7,.� • �� s
main
Leo "'�,• � � �. �- :� ��
DRAINAGE AREAS RAF
OUTFALL
LATITUDE
LONGITUDE
IMPERVIOUS
PERVIOUS
AREA
AREA
SDD-001
N 35'43'06`
W 81'07'59'
3.45 ac
1.73 ac
SDO-002
N 35043'20'
W 81°08'02`
5.49 ac
0.74 ac
SDO-003
N 35043'20'
W 81°08'06
14.35 ac
10.44 ac
NOTE: BASE MAP ORIGINALLY CREATED BY ERM, INC. APRfL 2002.
` 1
`1 DRAINAGE AREA I
! , I h
SOUTH PLANT
J l
I4
DRAINAGE AREA 3
t4 1 Pvc &
\ ! PEuFrSTOWE
a -- i �� / aorw wur
I c / f v Z v
` saw.
SCALE IN Ft'ET
■1 9 10
M4P 2 - FACILITY SITE PLAN
&Wrvafor
COMMSCOPE, INC
Claremont, North Carolina
NPDES FL-mW Na NCG030M30
Map Date: dU'LY 3©, 2A14 Rev NO i3y: Jim Frei
Aiap Sccale. See Bar Scale Checked Eh-: Jim Frei
SWSG Stoemwater Services Group, LLC Raleigh, NC (919) 661-99-1-1

COMMSCOPE - CLAREMONT OPERATIONS
GENERAL PERMIT NO. NCG030000
CDC NCG030650
APPLICATION FOR DISCHARGE PERMIT RECEIVED BY NCDEQ ON JUNE 20, 2014
PERMIT EFFECTIVE DATE: JULY 10, 2014
PERMIT EXPIRATION: OCTOBER 31, 2017
DATE
Benchmarks
24-hour rainfall amount TS5 pH Copper Lead Zinc Oil & Grease
SDO #I (Inches) (mg/L) (units) (mg/L) (mg/L) (mg/L) (mg/L)
100 mg/L 6.0 - 9.0 0.007 mg/L 0.030 mg/L 0.067 mg/L 15 mg/L
12/6/2014
003
0.18
<50.0
7.16
0.0080
<0.0050
0.012
<5.0
5/27/2015
003
0.41
27.9
7.28
0.0068
<0.0050
0.016
<5.0
10/2/2015
003
0.34
33.8
7.05
0.0085
<0.0050
0.045
<5.0
NO DATA FOR FIRST PART OF 2016
12/6/2016
001
0.70
6.625
7.10
0.007
<0.0025
0.129
<5.1
002
0.70
<2.5
6.85
0.0043
<0.0025
0.099
<5.0
003
0.70
<2.857
1 6.97
0.0083
<0.0025
0.098
<5.1
6/5/2017
001
1.00
14.8
7.29
0.02
0.014
0.16
12.5
002
1.00
<3.704
7.02
0.04
<0.0025
0.056
5.64
003
1.00
<2.941
7.03
0.02
<0.0025
0.085
5.12
12/20/2017
001
0.40
<3.030
7.11
0.014
<0.0025
0.21
<5.1
002
0.40
<2.976
7.46
0.014
<0.0025
0.106
<5.1
003
0.40
5.951
7.47
0.02
<0.0025
0.108
<5

out
COMMSCU--PE
CommScope — Claremont Facility
3642 U.S. Hwy. 70 East
P.O. Box 879
Claremont, NC 28610-0879
Date: January 30`h, 2018
Attention: Stormwater Permitting Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, NC 27699-1612
E�J-r 'To
74AL'o&0
Subject: Representative Outfall Status (ROS) Request Form for
COMMSCOPE, INC. — CLAREMONT
NCDWQ General Permit No. NCG030000
Certificate of Coverage No. NCG030650
To Whom It May Concem:
I have enclosed the Representative Outfall Status (ROS) Request form (SWU-ROS-
2009) for CommScope, Inc. - Claremont. Per the ROS form, I have enclosed the
following for your review:
• Completed ROS Request Form;
• Narrative elaborating on the reasons why Outfall 003 should be granted
representative status for the entire site (including Outfalls 001 and 002);
• Two (2) copies of a site map for the facility marking the location of all three (3)
outfalls and their respective drainage areas and industrial activities; and
• A Summary of test results from monitoring conducted at all respective outfalls.
If you need any further information, please feel free to call me at 336-366-0870 to
discuss at your convenience.

Please let me know if you have any questions or concerns with this ROS request form.
Thanks for your time and assistance.
Sincerely,
Nicole B. Johnston
Environmental Consultant
For CommScope Inc.
Burch Environmental, LLC
5087 Icard Ridge Road
Hickory, NC 28601
Phone: [phone]
[e-mail]
cc: Mr. Jim Streetman, CommScope, Inc. - Claremont

he" 15106 50
November 3, 20I6
Wastewater Branch
Water Quality Permitting Section
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of Signature Authority
COMMSCOPE CLAREMONT FACILITY
NPDES Permit Number NCG030000
To Whom It May Concern:
By notice of this letter, I hereby delegate signatory authority to the following individual for all permit
applications, discharge monitoring reports, and other information relating to the operations at the subject
facility as required by all applicable federal, state, and local environmental agencies specifically with the
requirements for signatory authority as specified in 15A NCAC 2B.0506.
Name:
Jim Streetman
Title:
Senior EHS Facility Engineer
Mailing Address:
3642 U.S. Hwy. 70 East
Claremont, NC 28610-0870
Physical Address:
i di erent
Email Address:
"im.streetman commsco e.cum
Office Phone:
82$ 459-5153
Mobile Phone:
82$ 303-9381
P ` 12017
DENR•
STORM WA CR ERM, N
G
If you have any questions regarding this letter, please feel free to contact me at [e-mail]
or (+353) l 2042027.
Sincerely,
Ciaran Doyle
Director, Global Environmental and Health & Safety (EHS)
Corke Abbey Avenue
Bray
Co. Dublin
Ireland
A98 Fy03
[e-mail]
T: ([phone]
M: ([phone]
cc: Mooresville Regional Office, Water Quality Permitting Section

Central Files: APS — SWP
7/10/2014
Permit Number NCG030650r
Permit Tracking Slip
Program Category
Status Project Type
NPOES 5W
Active New ProjProjectRECEIVED
Permit Type
� � � � � � �
Version Permit Classification
Metal Fabrication Storrnwater Discharge COC
1.00 COC
JUL i o 2014
Primary Reviewer
Permit Contact Affiliation
larry-wade -
CENTRAL FILES
DWQIBQG
Coastal SWRute
Permitted Flow
Facility
Facility Name
Major/Minor Region
Commscope - Claremont Operations '
Minor Mooresville
Location Address
County
3642 E US Hwy 70
Catawba
Facility Contact Affiliation
Claremont NC 28610
Kristen L. Yost
EHS Engineer
3642 US Hwy 70 E
Owner
Claremont NC 28610
Owner Name
Owner Type
Commscope Inc
Non -Government
Owner Affiliation
George Crosby
EHS Engineer
6519 Commscope Rd
Dates/Events
Catawba NC 28609
Scheduled
Orig Issue App Received Draft Initiated
Issuance Public Notice
issue Effective Expiration
711012014 6120/2014 7/9/2014
7110/2014 7/10/2014 1013112017
Regulated Activities
Requested !Received Events
Rolling, drawing, and extruding of nonfe
RO staff report received 711114
RO staff report requested 6124114
O utfa l l 100
Waterbody Name
Streamindex Number
Current Class Subbasin
Lyle Creek
11-76-(3 5)
WSW 03-08-32

.
a.
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kristen Yost
Commscope Inc.
3642 US 70 E
Claremont, NC 28610-8530
Dear Ms. Yost:
John E. Skvarla, III
Secretary
July 10, 2014
Subject: General Permit No. NCG030000
Commscope -- Claremont Operations
COC NCG030650
Catawba County
In accordance with your application for a discharge permit received on June 20,
2014, we are forwarding herewith the subject certificate of coverage to discharge
under the subject state - NPDES general permit. This permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between North Carolina and the US Environmental Protection Agency
dated October 15, 2007 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except
after notice to the Division of Energy Mineral & Land Resources (DEMLR). If the facility
changes ownership or is closed, DEMLR may require modification, revocation, or
reissuance of the certificate of coverage. ,
Per the requirements of the Catawba Riparian Buffer Rule, all stormwater
drainage to stream buffers, from portions of this site that have been constructed after
June 30, 2001, must be discharged through a correctly designed level spreader or
another device that meets diffuse flow requirements per 15A NCAC 2B.0243. Diffuse
flow requirements are described in Chapter 8 of the North Carolina Stormwater BMP
Manual, available at: ht,tR; /1portal.ncdenr.org/web/wgJws/su Ibmp-manual.
This permit does not affect the owners legal obligation to obtain other permits
which may be required by DEMLR, or permits required any other federal, state, or local
governmental authorities.
Division of Enemy, Mineral, and Land Resources
Energy Section • Geological Survey Section - Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http://Portal.ncdenr.org/webArl
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

If you have any questions concerning this permit, please contact Larry Wade PE
at telephone number [phone], or email at larry.wade@ncdenr gov .
Sincerely,
for Tracy E. Davis, P.E.
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Program Files

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO, NCG030000
CERTIFICATE OF CUVERAGE No. NCG030650
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Commscope Inc.
is hereby authorized to discharge stormwater from a facility located at
Commscope - Claremont Operations
3642 US 70 E
Claremont
Catawba County
to receiving waters designated as Lyle Creek, a class WS-IV water in the Catawba River
Basin, in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I,11, III, IV, V, and VI of General Permit No. NCG030000 as
attached.
This certificate of coverage shall become effective July 10, 2014.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 10, 2014.
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

NCGO3O650
Map Seale I24, 000
Commscope Inc.
Commscope - Claremont Operations
Latitude: 350 43 13" N
Longitude: -810 08' 07" W
County: Catawba
Receiving Stream: Lyle Creek
Stream Class: WS - IV
Sub -basin: 03-08-32 (Catawba River Basin)
Facility Location

Wade, Lar
From:
Khan, Zahid
Sent:
Monday, July 07, 2014 8:51 AM
To:
Wade, Larry
Cc:
Kormanik, Ryan
Subject:
FW: NCG030650 Commscope, Inc.
La rry,
Please see comments from Ryan. Thanks
Zahid
From: Kormanik, Ryan
Sent: Tuesday, July 01, 2014 4:02 PM
To: Khan, Zahid
Subject: RE: NCG030650 Commscope, Inc.
Zahid,
I met with Kristen Yost at Commscope this afternoon. We went around the site and only have a couple of items which
need further follow-up. Commscope has closed their facility in Illinois and is moving equipment to this facility. They
need to store extra fiber and fiber storage rolls on site. These will be exposed to stormwater, hence the need to change
their permit from a No Exposure Certification back to NCG030000.
1. There is a 20,000 gallon propane tank located at the North Plant. This tank is still in operation. It was unknown at
the time of this site visit if the tank was a single wall or double wall tank. There is no secondary containment around the
tank. Ms. Yost will confirm with the propane provider as to the construction of the tank and get back with us.
2. There is a 20,000 gallon propane tank located at the South Plant. This tank has been decommissioned, cleaned, and
all hoses and pipes removed. However, where the piping came out of the top of the tank is open to the elements. Again,
the construction of this tank is unknown as to being single or double walled and there is no secondary containment.
Commscope has not decided whether they are going to keep the tank on site or not.
3. Just for clarification purposes, there is an offsite drainage feature below the South Plant (just beyond the paved road)
that brings in stormwater flow from a wooded area. This ties in with the stormwater system which discharges at SDO-
003.
If you have any questions or need further assistance, please do not hesitate to contact me.
Thank you,
Ryan Kormanik
Environmental Senior Specialist
Division of Energy, Mineral, and Land Resources
NCDENR Land Quality Section
704.663.1699 - Office
828.461.3445 - Cell
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
IWAPlease consider the environment before printing this e-mail

From: Khan, Zahid
Sent: Thursday, June 26, 2014 12:12 PM
To: Kormanik, Ryan
Subject: FW: NCG030650 Commscope, Inc.
Deadline is July 21, 2014.
From: Wade, Lang
Sent: Wednesday, June 25, 2014 1:54 PM
To., Khan, Zahid
Subject: NCG030650 Commscope, Inc.
Hello Zahid,
Pease review the attached Not for the subject facility and let me know if your have any concerns issuing a permit.
If you need additional information please let me know.
Thanks,
Larry W. Wade PE Telephone: [phone]
Fax: [phone]
Stormwater Permitting Program
North Carolina Department of Environment & Natural Resources
Division of Energy Mineral and Land Resources
1612 Mail Service Physical Address - 512 N. Salisbury St. Room
942S
Raleigh, NC 27699-1612
Raleigh, NC 27604
************************This is a government E-mail address****************************
*********E-mails sent and received from this address can be disclosed to third parties************
2

Services Gro
8916 Oregon Inlet Court
Raleigh, North Carolina 27603
Phone: [phone]
Fax: [phone]
May 27, 2014
Mr. Bradley Bennett, PE
Stormwater Permitting Unit
NCDENR
1617 MSC
Raleigh NC 27699-1617
RE: Notice -of -Intent
NPDES General Permit NCGO30000
CommScope, Inc — Claremont Operations
Dear Mr. Bennett:
Enclosed please find one original of the NOI for the subject facility.
Prior to 2009, this facility was operating under NPDES General Permit NCG030112. In 2009,
this facility applied for and obtained the No Exposure exemption NCGNE0501.
Subsequent changes at the facility have resulted in exposure of industrial activity requiring the
re -activation of General Permit NCG030000 coverage. We are not aware of your policy of re-
issuing an existing facility its previous certificate -of -coverage number. It would be more
convenient if this facility kept its previous COC number, but we'll leave that decision to you.
If you have any questions, do not hesitate to call us.
S' ely,
O
1_ SERVICES GROUP, LUC
ames D. Frei
Sr. Project Manager
Enclosures.
cc: K. Yost, CommScope
File
Thank you for allowing us to assist with your environmental compliance activities.

MR AGENCY USE ONLY I
Division of Water QuaUty % Surface Water
Protection Section
NCDENRNational Pollutant Discharge Elimination System
'L�N c.—ovw..ue.a of
F�+nran+rvr wn „any. r5ae.:�rra
NCG030000
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG030000:
STORMWATER DISCHARGES associated with activities classified as:
In
SIC (Standard Industrial Classification) 335 Rolling, Drawing, and Extru I iQI-YoDbi:Lous-Metais_
SIC 3398 Metal Heat Treating E 0 � (� �[�/
SIC 34 Fabricated Metal Products
SIC 35 Industrial and Commercial Machinery
SIC 35 Electronic and Other Electrical Equipment JUN i 4 2014
SIC 37 Transportation Equipment
SIC 38 Measuring, Analyzing, and Controlling Instruments Nk - WA QUALrrY
*- ` For questions, please contact the DWO Regional Office for your area. See page 4.
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name Co M 4GOPc , I "'-- _
Street Address
City GL ARZ-MmNT
Telephone No. Goo
2) Location of facility producing discharge:
State M(f- ZIP Code Z�CP10
Fax:
Facility Name ,GOMi�l�iG4l -T 7tA1Z MVhjT _M3ERAc7flr&j
Facility Contact 1?.1 S 1`1 ?'�T
Street Address 3 <o 4Z E V HWY 7©
City CLA FaE1M 0xj T State _ ZIP Code Zf ,;' id - 8530
County A\N F�A _
Telephone No. Qj_� 4 qln-5O 71 Fax:
Email }L Gv1,ry 5e `
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). F12 5C� oN e M l (,--- g�sS't o1V
(A copy of a county map or USGS quad sheet with the tactility clearly located must be submitted with this application.)
t
4) Latitude 41*�y 4S"I tl Longitude 10 d 0 107 I (deg, ruin, sec)
Page 1 of 4
SW U-2 t 8-071408 Last revised 711448

NCG030000 N.O.I.
S) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
6a"'Existing
6) Standard Industrial Classification:
Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility.
SIC Code: ;l ?�
7) Provide a brief narrative description of the types of Industrial activities and products manufactured at
this facility: EACk U M PV-OWCF_s -re LE,:�oMn4UAJLCATioA/s G
8) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? V 7 To L-1 L e L-—EK
Receiving water classification: G
Is this a 303(d) listed stream? N 0 Has a TMDL been approved for this watershed? 0
If the site stormwater discharges to a separate storm sewer system, name the o erator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer). Qr, 0:1 M �
9) Does this facility have any other NPDES permits?
@'No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
10) Does this facility have any Non -Discharge permits (ex: recycle permit)?
O No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
11) Does this facility employ any Kest management practices for stormwater control?
❑ No
EJ"�Yes (Show any structural BMPs on the site diagram.)
If yes, please briefly describe: SA N
12) Does this facility have a Stormwater Pollution Prevention Plan?
Cl No
2res
If yes, when was it implemented? 1-O0
13) Are vehicle maintenance activities occurring at this facility?
VNo ❑ Yes
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
P/No ❑ Yes
Page 2 of 4
SWU-21M71408 Last revised 7/14108

NCG030000 N.D.I.
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
❑ No ['Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
RzaNo ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
M No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b, or c., please provide the following information:
Type(s) of waste: U 1J ! 9 '2, E44mmu Li so i f3 Nb 1?, DOOR l W3!9, FOP6-dd5
How is material stored: _ f Al PgU MA, I ill NAAmAi-M s��&3�
Ta� l (61 N 6x
Where is material stored: bN -*ITE
How many disposal shipments per year: -f WO 117 S
Name of transport / disposal vendor: I[�r rZ1�i
Vendor address: VARIEh
15) Certification:
North Carolina General Statute 143-215.613 (1) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report,
plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who
knowingly makes a false statement of a maternal fad in a rulemaking proceeding or contested case under this Article; or
who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under this Article or rules of the Commission implementing this Article shaJl be guilty of a Gass 2
misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit -
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: _ i"11�c T_
(Sign of Applicant) (Date Signed)
This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to:
NCDIENR
Page 3of4
SWU•218-071408 Last revised 7i14108

NCG030000 N.O.l.
Final Checklist
This application will be returned as Incomplete unless all of the following items have been Included:
❑ Check for $100 made payable to NCDEN R.
l2f This completed application and all supporting documents.
A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls
corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored,
(f) impervious areas, (g) site property lines.
f r( Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee coverage under the General Permit.
For questions, please contact the DWO Regional Office for your area.
DW+O Regional Office Contact Information:
Asheville Office ...__
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ------
[phone]
Central Office .........[phone]
Page 4 of 4
SWU-218-071408 Last revised 7/14/08

0
h t \ e i
!�' T� 8 5 _ _ • • 0
NEWTON, NC (1"3) QUADRANGLE
7.5 MINUTE SERIES, 1:24000
MAP 1- Sac LocAnON MAP
CommBcope, Inc. - Claremont Stormwater Pollution Prevention Plan
NPDF-5 Permit No. NC'G030111 Page 4

calls
ORIIIXMOE
d, ��,
1 I I I4 1R�
` `' IV •.I 1
I
• ? lilt
w
�'icla '
mom .IA--
DRAINAGE AREAS
OUTFALL
LATITUDE LONGITUDE IMPERVIOUS
PERVIOUS
AREA
AREA
SDO-001
I'l 35'43'06" W 81'07'59' 3.45 ac
1.73 nc
SDO-002
N 35'43'20' W 81'08'02' 5.49 QG
0,74 ac
SDO-003
N 35'43'20' W 81'08'06' 14.35 ac
1044 ac
NOTE; EASE
MAP ORIGINALLY CREATED BY ERM, INC. APRIL 2002.
qr-�
MAP 2 - FACILITY SITE PLAN
dc.clopcd f-
COMMSCOPE, INC.
CFnremont, North Cermtlae
NPDES Permit Na NCGO30112
Nn DmW 0....I w ^ »K e..r.r pl+l-rrr
At., S." A. re S.A. O..k.. M A. red
svvsG W..w s.m . c..., t1.e amw'A 14C (019) e06.09l1

A�
F4CDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Kristen Yost
Commscope Inc.
3642 US 70 E
Claremont, NC 28610-8S30
Dear Ms. Yost:
John E. Skvada, III
Secretary
July 10, 2014
Subject: General Permit No. NCG030000
Commscope - Claremont Operations
COC NCG030650
Catawba County
In accordance with your application for a discharge permit received on June 20,
2014, we are forwarding herewith the subject certificate of coverage to discharge
under the subject state - NPDES general permit. This permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between North Carolina and the US Environmental Protection Agency
dated October 15, 2007 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except
after notice to the Division of Energy Mineral & Land Resources (DEMLR). If the facility
changes ownership or is closed, DEMLR niay require modification, revocation, or
reissuance of the certificate of coverage.,
Per the requirements of the Catawba Riparian Buffer Rule, all stormwater
drainage to stream buffers, from portions of this site that have been constructed after
June 30, 2001, must be discharged through a correctly designed level spreader or
another device that meets diffuse flow requirements per 15A NCAC 2B .0243. Diffuse
flow requirements are described in Chapter 8 of the North Carolina Stormwater BMP
Manual, available at: htW: /Iportal.ncdenr.org f web f wq jws f sm/hmp-manual.
This permit does not affect the owners legal obligation to obtain other permits
which may be required by DEMLR, or permits required any other federal, state, or local
governmental authorities.
Division of Energy, Mineral, and Land Resources
Energy Section - Geological Survey Section - Land Quality Section
1612 Mail Servioe Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAK 919-715-8801
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: h :11 rtal.ncdenr.or IwebArl
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

If you have any questions concerning this permit, please contact Larry Wade PE
at telephone number [phone], or email at larry.wadeC-ncdenr.goy .
Sincerely,
for Tracy E. Davis, P.E.
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Program Files

STATE OF NORTH CAROLINA -
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
!_Alx3l�ll
IN,
STORMWATER DISCRARGES
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as arhended,
Commscope Inc.
is hereby authorized to discharge stormwater from a facility located at
Commscope - Claremont Operations
3642 US 70 E
Claremont
Catawba County
to receiving waters designated as Lyle Creek, a class WS-IV water in the Catawba River
Basin, in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, 11, III, IV, V, and VI of General Permit No. NCG030000 as
attached.
This certificate of coverage shall become effective July 10, 2014.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 10, 2014.
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

NCG030650
Map Seale 1: 24, 000
Commscope Inc.
Commscope - Claremont Operations
Latitude: 350 43 13" N
Longitude: -811 08' 07" W
County: Catawba
Receiving Stream: Lyle Creek
Stream Class: WS - IV
Sub -basin: 03-08-32 (Catawba River Basin)
Facility Location

Wade, Lar
From:
Khan, Zahid
Sent:
Monday, July 07, 2014 8:51 AM
To:
Wade, Lary
Cc:
Kormanik, Ryan
Subject:
FW: NCG030650 Commscope, Inc.
Larry,
Please see comments from Ryan. Thanks
Zahid
From: Kormanik, Ryan
Sent: Tuesday, July 01, 2014 4:02 PM
To: Khan, Zahid
Subject: RE: NCG030650 Commscope, Inc.
Zahid,
I met with Kristen Yost at Commscope this afternoon. We went around the site and only have a couple of items which
need further follow-up. Commscope has dosed their facility in Illinois and is moving equipment to this facility. They
need to store extra fiber and fiber storage rolls on site. These will be exposed to stormwater, hence the need to change
their permit from a No Exposure Certification back to NCG030000.
x 1. There is a 20,000 gallon propane tank looted at the North Plant. This tank is still in operation. It was unknown at
the time of this site visit if the tank was a single wall or double wall tank. There is no secondary containment around the
tank. Ms. Yost will confirm with the propane provider as to the construction of the tank and get back with us.
ar 2. There is a 20,000 gallon propane tank located at the South Plant. This tank has been decommissioned, cleaned, and
all hoses and pipes removed. However, where the piping came out of the top of the tank is open to the elements. Again,
the construction of this tank is unknown as to being single or double walled and there is no secondary containment.
Commscope has not decided whether they are going to keep the tank on site or not.
3. Just for clarification purposes, there is an of -site drainage feature below the South Plant (just beyond the paved road)
that brings in stormwater flow from a wooded area. This ties in with the stormwater system which discharges at SDO-
003.
If you have any questions or need further assistance, please do not hesitate to contact me.
Thank you,
Ryan Kormanik
Environmental Senior Specialist
Division of Energy, Mineral, and Land Resources
NCDENR Land Quality Section
704.663.1699 - Office
828.461.3445 - Cell
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
Please consider the environment before printing this e-mail

From: Khan, Zahid
Sent: Thursday, June 26, 2014 12:12 PM
To: Kormanik, Ryan
Subject: FW: NCG030650 Commscope, Inc.
Deadline is July 21, 2014.
From: Wade, Larry
Sent: Wednesday, June 25, 2014 1:54 PM
To: Khan, Zahid
Subject: NCG030650 Commscope, Inc.
Hello Zahid,
Pease review the attached NOI for the subject facility and let me know if your have any concerns issuing a permit.
If you need additional information please let me know.
Thanks,
Larry W. Wade PE Telephone: [phone]
Fax: [phone]
Stormwater Permitting Program
North Carolina Department of Environment & Natural Resources
Division of Energy Mineral and Land Resources
1612 Mail Service Physical Address - 512 N. Salisbury St. Room
9425
Raleigh, NC 27699-1612
Raleigh, NC 27604
is a government E-mail addreSS****************************
*********E-mails sent and received from this address can be disclosed to third parties************

8916 Oregon Inlet Court
Raleigh, North Carolina 27603
Phone: [phone]
Fax: [phone]
May 27, 2014
Mr. Bradley Bennett, PE
Stormwater Permitting Unit
NCDENR
1617 MSC
Raleigh NC 27699-1617
RE: Notice -of -Intent
NPDES General Permit NCGO30000
CommScope, Inc — Claremont Operations
Dear Mr. Bennett:
Enclosed please find one original of the NOI for the subject facility.
Prior to 2009, this facility was operating under NPDES General Permit NCG030112. In 2009,
this facility applied for and obtained the No Exposure exemption NCGNE0501.
Subsequent changes at the facility have resulted in exposure of industrial activity requiring the
re -activation of General Permit NCG030000 coverage. We are not aware of your policy of re-
issuing an existing facility its previous certificate -of -coverage number. It would be more
convenient if this facility kept its previous COC number, but we'll leave that decision to you.
If you have any questions, do not hesitate to call us.
Si ly,
0 _ �SExv us GnouP, LLC
ames D. Frei
Sr. Project Manager
Enclosures.
cc: K. Yost, CommScope
File
Thank you for allowing us to assist with your environmental compliance activities.

ADivision of Water Quality / Surface Water
Protection Section
NCD04RNational Pollutant Discharge Elimination System
NCGO30000
NOTICE OF INTENT
I Ym 1 Mouth i Dav I
catifrcee of CDVMZM I
National Pollutant Discharge Elimination System application for coverage under General Permit
NCGI 3M=:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) 335 Rolling, Drawing, and Extru J�?nfei[QWS_Melais—
SIC 3398 Metal Heat Treating t�
SIC 34 Fabricated Metal Products
SIC 35 Industrial and Commercial Machinery
SIC 38 Electronic and Other Electrical Equipment J U N 2 0 2014
SIC 37 Transportation Equipment
SIC 38 Measuring, Analyzing, and Controlling Instruments 0 R wadmula � �
*- For questions, please contact the DWQ Regional Office for your area. See page 4.
(Please print or type)
1) Mailing address at owner/operator (address to }which a m percorrespon _ante willmailedl: be
Name COM M GiGOPc
Street Address
City
Telephone No.
C-LARz-M0AjT State NG ZIP Code 00640 -0N 3'::)
9j20- 1 - GO75 - Fax:
2) Location of facility producing discharge:
Facility Name
GaM My�
Facility Contact
P� 15 ►`I
Street Address
3& 7- E V y
City
CL,A pt-M 0"
County
e-WrAW P-w-A
Telephone No.
�� 40w' O
Email
14YOS'T 99 G©M M
3) Physical Location Information:
HWY ^7-e .
State -t!�Le
Fax:
_ ►��T
J
ZIP Code ZW47 Ia - P 53a
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). -.6 oN e 7+�116- EA5t !T ON
V � 74 U,
o>J Le �=T
(A copy at a county map or USGS quad sheet with the facility dearly located must be submitted with taus application.)
t
4) Latitude% 71 ?7 I Longitude Q 0 O I R 7 i (deg, min, sec)
Page t of 4
SWU-218-071408 Last revised 7/14108

NCG030000 N.O.I.
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed facility Date operation is to begin
VExisting
6) Standard Industrial Classification:
Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility.
SIC Code: .;77 ?7 `?
n Provide a brief narrative description of the types of Industrial activities and products manufactured at
this facility: I;=i4C t t i '!�j QROW CEew -FeLE- M M U N tCpTto0�S GA i3(ae�
8) Discharge points I Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?
What is the name of the body or bodies of water (creek, stream, Over, lake, etc.) that the facility stormwater
discharges end up in? V o L K
Receiving water classification: G
Is this a 303(d) listed stream? 0 Has a TMDL been approved for this watershed? D
If the site stormwater discharges to a separate storm sewer system, name the o rator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer), Q C 1>6 7 M
- 9) Does this facility have any other NPDES permits?
O'No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
10) Does this facility have any Non -Discharge permits (ex: recycle permit)?
NI No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
11) Does this facility employ any best management practices for stormwater control?
❑ No
El"Yes (Show any structural BMPs on the site diagram.)
If yes, please briefly describe:yF_T6mTtoN 73A51 W
12) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
EKes
If yes, when was it implemented? 200 4- - - - -
13) Are vehicle maintenance activities occurring at this facility?
PrNo ❑ Yes
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
V'No ❑ Yes
Page 2of4
5W U-21 "71408 Last revised 7114M

NCGO30000 N.O.I.
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
❑ No Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
&rzaNo ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
153 No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: UN
How is material stored:
Where is material stored: 6" -SITE
How many disposal shipments per year: -f WO Ty
Name of transport / disposal vendor: VA1121,E4
Vendor address: IF/7
15) Certification:
North Carolina General Statute 143-215.8E (1) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report,
plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who
knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or
who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under this Article or rules of the Commission implementing this Article shall be guilty of a Gass 2
misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000),
hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name o1 Person Signing: Kaa�� 1 r
Title: P:M � S
(Sig-n—xne of Applicant) Q� (Date Signed)
This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to:
NCDENR
Page 3 of 4
SWU-218-071408 Last revised 7/14108

NCG030000 N.O.I.
Final Checldist
This application will be retumed as Incomplete unless all of the following Items have been Included:
❑ Check for $100 made payable to NCDENR.
Pf This completed application and all supporting documents.
A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater out€alls
corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored,
(f) impervious areas, (g) site property lines.
( Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
-Note
The submission of this document does not guarantee coverage under the General Permit.
For questions, please contact the DWO Regional Office for your area.
DWO Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 4 of 4
S W U-218-071408 Last revised 7/14108

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