NC0027103_NPDES Permit App_20131231

ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Director Secretary
December 31, 2013
Attn: Marie Moore, Manager
Town of Pembroke
PO Box 866
Pembroke, NC 28372
Subject: Receipt of permit renewal
Permit NC0027103
Robeson County
Dear Ms. Moore:
The NPDES Unit received your permit renewal application on December 30, 2013. A member of the
NPDES Unit will review your application. They will contact you if additional information is required to
complete your permit renewal. You should expect to receive a draft permit approximately 30-45 days
before your existing permit expires.
If you have any additional questions concerning renewal of the subject permit, please contact Charles
Weaver [phone].
Sincerely,
e)1
Wren Thedford
Point Source Branch
cc: Central Files
-Fayetteville-Regional-Office-j
NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] Fax: [phone]JCustomer Service: 1-877-623-6748
Internet:: www.ncwater,orq
DENR-FRO
JAN 0 6 2013
o Q
An Equal OpportunityVAffirmative Action Employer

Town of Pembroke
POST OFFICE BOX 866
PEMBROKE, NORTH CAROLINA
28372
MILTON R. HUNT
MAYOR
ORYAN D. LOWRY
MANAGER
AMIRA HUNT
CLERK
December 23, 2013
NC Department of Environment and Natural Resources
Division of Water Quality/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Dear Permitting Unit:
COUNCILMEN:
LARRY BROOKS
ALLEN G. DIAL
RYAN SAMPSON
E..m.©E•ow
DEC 31 2013
DENR-WATER QUALITY
POINT SOURCE BRANCH
Subject: NPDES Permit Renewal
Town of Pembroke
NPDES Permit #NC0027103
Robeson County
The Town of Pembroke is submitting the renewal application for NPDES permit #NC0027103.
The permit application consists of:
- Cover letter
One original of Form 2A — NPDES Application for Permit Renewal
Supplemental Application Information— Parts D & E
Topographic Map
- Process Flow Schematic
Annual Pollutant Scan for the years 2011, 2012, and 2013
- Two copies of Form 2A — NPDES Application for Permit Renewal

The Town was unaware that a second species toxicity test was required for the permit renewal.
Once we were told of this requirement, we made arrangements to conduct the tests. One second
species test has been concluded and the other three are scheduled to be concluded prior to permit
expiration.
The Town would like to request that the following modifications be made to the permit:
- We request that monitoring for BOD, TSS, Ammonia Nitrogen and Fecal Coliform be
reduced under the "exceptionally performing facilities" criteria. The attached data
(summarized in the following table) indicates that the WWTP effluent has exceeded the
minimum criteria for reduced monitoring. In addition to the monitoring results, the plant
meets the other listed criteria.
Analysis of testing results for the past three years:
- Percent of Monthly Average Limit
Parameter
Monthly Limit
3-Year Average
% of Limit
BOD5
18.0 mg/L
4.6 mg/L
24%
TSS
20.0 mg/L
2.4 mg/L
12%
Ammonia N
12.0 mg/L
0.55 mg/L
12%
Fecal Coliform
200/100 ml
3 colonies/100 ml
2%
- Number of Samples Over 200% of Monthly Avera
Parameter
200% of Monthly Limit
Number of Samples Over
BOD5
36 mg/L
0
TSS
40 mg/L
3
Ammonia N
24.0 mg/L
0
Four (4) Fecal Coliforms exceeded 200% of the weekly average limit
It is requested that upstream/downstream monitoring be eliminated. We feel that
monitoring the stream for temperature and dissolved oxygen provides no useful data
regarding the WWTP impacts upon the receiving waters. Permit limitations are issued to
protect water quality, including a minimum effluent dissolved oxygen. "Outside"
influences such as stormwater runoff and reduced velocity in the swampy areas that are
subject to decay and placid conditions makes taking dissolved oxygen levels and
temperatures inconclusive in determining wastewater impacts
If second species monitoring is to be continued to be required for permit renewal, we
request that one per year be included in the permit.

We thank you for your consideration in these matters. If you have any additional questions or
comments, please call Rhonda Locklear at 910/521-2989.
Sincerely,
Marie Moore, Manager
Town of Pembroke

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
FORM
2A
NPDES
APPLICATION OVERVIEW
arm 2A''has,-been developed in a
modular format and consists of a "Basic Application Information" packe
and a "Supplemental Application Information" packet The:Basic Application Information packet is,divide
•
into two.parts All applicants must;complete Parts A and C :;Applicants with a design flow'greater than'or
equal to 01 mgd must also complete Part B Some applicants must also,complete the Supplemental
Application Information packet The following items explain'which parts of Form 2A you must complete
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow >_ 0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions 6.1 through 6.6.
C. Certification. All applicants must complete Part C (Certification).
SUPPLEMENTAL APPLICATION INFORMATION:
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (Sills) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b_ Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
c. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
BASIC APR CAT! IINFORMATIQNg y
-... ��fi�,rs'�i1?4...`..�1.. ._ Fc".zf=
3q
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.. �. �'ti ...3d'':`-. .a. a.,�:�.
PART A BAS 0,7,A , Li ATtON': 1FORMA, ,1 OR ALi 4CANTS '4y s
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet.
A.1. Facility Information.
Facility Name Pembroke WWTP
Mailing Address PO Box 866
Contact Person Marie Moore
Title Interim Manager
Telephone Number [phone]
Facility Address 8257 Deep Branch Road
(not P.O. Box) Pembroke, NC 28372
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name Town of Pembroke
Mailing Address PO Box 866
Pembroke, NC 28372
Contact Person Rhonda Locklear
Title Wastewater Plant Superintendent
Telephone Number [phone]
Is the applicant the owner or operator (or both) of the treatment works?
® owner ❑ operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ facility ® applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -issued permits).
NPDES NC0027103 PSD
UIC Other WQCS0013729
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
Town of Pembroke 4111 Separate Municipal
Total population served 4111

FACILITY NAME AND PERMIT NUMBER:
Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
A.5. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes ® No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes ® No
A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12th month of this year" occurring no more than three months prior to this application submittal.
a. Design flow rate 1.33 mgd
Two Years Ago
b. Annual average daily flow rate 0.77
c. Maximum daily flow rate 2.38
Last Year This Year
0.84 0.73
1.89 2.66
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant. Check all that apply. Also estimate the percent
contribution (by miles) of each.
® Separate sanitary sewer 100
❑ Combined storm and sanitary sewer NA %
A.8. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? ® Yes ❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
i. Discharges of treated effluent
ii. Discharges of untreated or partially treated effluent
iii. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
v. Other
b. Does the treatment works discharge effluent to basins, ponds, or other surface impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes
If yes, provide the following for each surface impoundment:
Location: NA
1
NA
NA
NA
NA
►1
No
Annual average daily volume discharge to surface impoundment(s) NA mgd
Is discharge ❑ continuous or ❑ intermittent?
c. Does the treatment works land -apply treated wastewater? ❑ Yes ® No
If yes, provide the following for each land application site:
Location: NA
Number of acres: NA
Annual average daily volume applied to site:
NA mgd
Is land application ❑ continuous or ❑ intermittent?
d. Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
❑ Yes El No

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
e.
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g., tank truck, pipe).
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number ( )
For each treatment works that receives this discharge, provide the
following:
Name
Mailing Address
Contact Person
Title
Telephone Number ( )
If known, provide the NPDES permit number of the treatment works
Provide the average daily flow rate from the treatment works into
Does the treatment works discharge or dispose of its wastewater
in A.8. through A.8.d above (e.g., underground percolation, well
If yes, provide the following for each disposal method:
that receives this discharge
the receiving facility. mgd
in a manner not included
injection): ❑ Yes ® No
Description of method (including location and size of site(s) if applicable):
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or 0 intermittent?

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
WASTEWATER DISCHARGES:
If you answered "Yes" to question A.8.a, complete questions A.9 through A.12 once for each outfall (including bypass points) through
which effluent is discharged. Do not include information on combined sewer overflows in this section. If you answered "No" to question
A.B.ago to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number 001
b. Location Pembroke
28372
(City or town, if applicable) (Zip Code)
Robeson
(County)
NC
(State)
34'39'55" 79° 12'00"
(Latitude) (Longitude)
c. Distance from shore (if applicable) NA ft.
d. Depth below surface (if applicable) NA ft.
e. Average daily flow rate NA mgd
f. Does this outfall have either an intermittent or a periodic discharge? ❑ Yes ® No (go to A.9.g.)
If yes, provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge: mgd
Months in which discharge occurs:
g. Is outfall equipped with a diffuser? ❑ Yes ® No
A.10. Description of Receiving Waters.
a. Name of receiving water Lumber River
b. Name of watershed (if known) Lumber
United States Soil Conservation Service 14-digit watershed code (if known):
c. Name of State Management/River Basin (if known): Lumber
United States Geological Survey 8-digit hydrologic cataloging unit code (if known):
d. Critical low flow of receiving stream (if applicable)
acute cfs chronic cfs
e. Total hardness of receiving stream at critical low flow (if applicable): mg/I of CaCO3

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
A.11. Description of Treatment
a. What level of treatment
❑ Primary
❑ Advanced
b. Indicate the following
Design BOD5
Design SS
Design P
Design N
Other
c. What type of disinfection
Chlorination
are provided? Check all that apply.
® Secondary
0 Other. Describe:
removal rates (as applicable):
removal or Design CBOD5 removal
removal
removal
removal
outfall? If disinfection
varies
91 %
90 %
NA %
60 %
%
is used for the effluent from this
by season, please describe:
If disinfection is by chlorination is dechlorination used for this outfall? ® Yes 0 No
Does the treatment plant have post aeration? ® Yes 0 No
A.12. Effluent Testing Information.
parameters. Provide
discharged. Do not include
All Applicants that
the indicated effluent testing
information on combined
conducted using
other appropriate QAIQC
data must be based
discharge to waters of the US must provide
required by the permitting authority
sewer overflows in this section.
40 CFR Part 136 methods. In addition, this
requirements for standard methods for analytes
on at least three samples and must be no
effluent testing data for the following
for each outfall through which effluent is
All information reported must be based on data
data must comply with QAJQC requirements of
not addressed by 40 CFR Part 136. At a
more than four and one-half years apart.
collected through analysis
40 CFR Part 136 and
minimum, effluent testing
Outfall number. 001
ET PARAMER
MAXIMUM DAILY7VALUE
AVERAGE DAILY VALUE
Value
Units
Value
i Unrts =;
Number of Samples
pH (Minimum)
6.32
s.u.
j //
pH (Maximum)
7.98
s.u.
°
jjj j/
Flow Rate
2.66
MGD
0.73
MGD
365
Temperature (Winter)
19.0
°C
25.9
°C
60
Temperature (Summer)
28.2
°C
17.6
°C
60
' For pH please report a minimum and a maximum daily value
POLLUTANT
MAXIMUM
DISCHARGE
DAILY
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
`;
MUMDL
„. ...
Conc.
Unrts
Conc
Unrts
Numbers
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
DEMAND (Report one)
BOD5
8.3
Mg/L
3.9
Mg/I
72
52106
2.0
CBOD5
FECAL COLIFORM
720
Col/100 ml
4.7
come
nil
72
9222D(MF)
1
TOTAL SUSPENDED SOLIDS (TSS)
11.4
Mg/L
3.1
Mg/L
27
2540(D)
1
$ 4 n _ ' -. _ a i } �'' , ?. ,_ `, 3f }j .1-T$
4END OF PART A,
FE..W ICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH.OTHER PARTS
J
OF FORM,- A; U, MUST COMPL

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
3 a -ga.... Frxe IO-N
BACACATION INFORMAT-
.t-¢ . i Y €
rc''E`4 ��-
PART B. ADDITIONAL APPLICATION INFORMATION FOR APPLICANTS$WITH A DESIGN FLOW GREATER THAN OR=
. 7 ✓ { i.. F r ,�
EQUAL TO 01 MGD (100�000 gallons perday) "•
All applicants with a design flow rate >_ 0.1 mgd must answer questions B.1 through B.6. All others go to Part C (Certification).
B.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
10 000 gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
During this permit period, sewer lines have been rehabilitated and manholes have been repaired. There is an on -going
Program to identify and repair I&I sources.
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping, if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within ''/ mile of the property boundaries of the treatment
works, and 2) listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units, including disinfection (e.g.,
chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
B.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works the responsibility of a
contractor? 0 Yes ® No
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary).
Name:
Mailing Address:
Telephone Number. ( )
Responsibilities of Contractor:
B.5. Scheduled improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment, effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
a. List the outfall number (assigned in question A.9) for each outfall that is covered by this implementation schedule.
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
0 Yes 0 No

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
c. If the answer to B.5.b is "Yes," briefly describe, including new maximum daily inflow rate (if applicable).
d. Provide dates imposed
applicable. For improvements
applicable. Indicate
Implementation Stage
- Begin Construction
- End Construction
- Begin Discharge
- Attain Operational
e. Have appropriate
Describe briefly:
by any compliance schedule
planned independently
dates as accurately as possible.
Level
permits/clearances conceming other
or any actual dates of completion for the implementation steps listed
of local, State, or Federal agencies, indicate planned or actual completion
Schedule Actual Completion
MM/DD/VYYY MM/DD/YYYY
below, as
dates, as
Yes 0 No
/ / / /
/ / / /
/ / / /
/ / / /
Federal/State requirements been obtained? 0
B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD
Applicants that discharge to waters of the US must
effluent testing required by the permitting authority
on combine sewer overflows in this section. All information
using 40 CFR Part 136 methods. In addition, this data
QA/QC requirements for standard methods for analytes
based on at least three pollutant scans and must be
Outfall Number. 001
ONLY).
provide effluent testing data for the following parameters. Provide
for each outfall through which effluent is discharged. Do not include
the indicated
information
conducted
other appropriate
data must be
reported must be based on data collected through analysis
must comply with QA/QC requirements of 40 CFR Part 136 and
not addressed by 40 CFR Part 136. At a minimum effluent testing
no more than four and on -half years old.
MAXIMUM DAILY
DISCHARGE
AVERAGE DAILY DISCHARGE`
ANALYTICAL
Y METHOD
ML/MDL
POLLUTANT °
Conc
Units : y
Conc
Units
Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
5.2
Mg/I
0.74
Mg/I
72
SM 4500(NH3)F.
0.1
CHLORINE (TOTAL
RESIDUAL, TRC)
43
Ug/L
4.0
Ug!L
72
SM 4500(CL2)G
10
DISSOLVED OXYGEN
8.7
Mg/L
8.1
Mg/L
72
SM 4500(0) C.
1
TOTAL KJELDAHL
NITROGEN (TKN)
4.23
Mg/I
1.6
Mg/I
6
EPA 351.2
0.5
NITRATE PLUS NITRITE
NITROGEN
11.2
Mg/I
5.0
Mg/l
6
EPA 353.2
0.1
OIL and GREASE
<5
Mg/I
<5
Mg/I
3
1664A
5
PHOSPHORUS (Total)
4.38
Mg/l
1.8
Mg/I
6
EPA 365.2
0.1
TOTAL DISSOLVED SOLIDS
(TDS)
200
Mg/L
170
Mg/L
3
SM 2540 C.
10
OTHER
_
MRqEFO TIO,OVEW
END OF PART B
TEETREIGOLNE�WHICH OTst ER
PARTS

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
BASIC APp,P,�LICATIONINFOkigRMAT- lO� w Y�g ���A
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,, ', . ..CERTIFICATI011t- �2 � w �{ sir to ssf.r (r n r _3 hrx° � zrr s ,-„ ta` o,,a
d. '. :vY' (N. , ,,,, ,i_,_,.., ,,,. ,, Pft. L.e •R..5 = ..r. `/ M1"`c ti} ... �-w •"ti .n'4`.'nt3::,. I.l}-&Y:..i'., s[6:
All applicants must complete the Certification Section. Refer to instructions to determine who is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
® Basic Application Information packet Supplemental Application Information packet:
® Part D (Expanded Effluent Testing Data)
® Part E (Toxicity Testing: Biomonitoring Data)
❑ Part F (Industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G (Combined Sewer Systems)
`� yy l-.}
, '(,..:,* ice' -ss .g +X a.r 4 'r-v r� W, mkt, 3, A 0 L. x+ , A` i r '�' -4 f_ - P4+ r rs 7u
ALL?:APPl:ICANTS II(Ilt)ST GOMPLETEA7HEFOLLOWINGCERTIFICATIOIIt` �,� �.>
I certify under penalty of law that this document and all attachments were prepared
designed to assure that qualified personnel property gather and evaluate the information
manage the system or those persons directly responsible for gathering the information,
accurate, and complete. I am aware that there are significant penalties for submitting
for knowing violations.
Name and official title Mane Moore, Interim Manager
under my direction or supervision in accordance with a system
submitted. Based on my inquiry of the person or persons who
the information is, to the best of my knowledge and belief, true,
false information, including the possibility of fine and imprisonment
!1 I , Signature L _ YA Q'el_!,.
Telephone number [phone] -
Date signed i 1 — 01%. 3 — / 3
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements. ,
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
SUPPLEMENTAL APPLICATION INFORMATION � �.
'. , fi r,as.+ 3 er 4s('"x 7��5„v r ,''. € 3? -. t ,, a ..ro h .R r rr,� fi �-„ r�'7 2t �.
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PART I EXPANDED EFFLUENT TESTING DATA `*+ _, ,-. T <-< ,�z
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flow greater than or equal to 1.0 mgd or it has (or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and
other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number:001 (Results attached per discussion with NC DWR(Complete once for each outfall discharging effluent to waters of the United States.)
`POLLUTANT
.MAXIMUM DAILY DISCHARGE
: ;AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Conc
Units,
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
METALS (TOTAL RECOVERABLE), CYANIDE,
PHENOLS,
AND HARDNESS.
ANTIMONY
ARSENIC
BERYLLIUM
CADMIUM
CHROMIUM
COPPER
LEAD
MERCURY
NICKEL
SELENIUM
SILVER
THALLIUM
ZINC
CYANIDE
TOTAL PHENOLIC
COMPOUNDS
HARDNESS (as CaCO3)
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
Outfall number: 001 (Results attached) (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM,DAILYDISCHARGE
Mass
VOLATILE ORGANIC COMPOUNDS
Units
AVERAGE
Units
Mass
Units
ACROLEIN
ACRYLONITRILE
BENZENE
BROMOFORM
CARBON
TETRACHLORIDE
CHLOROBENZENE
CHLORODIBROMO-
METHANE
CHLOROETHANE
2-CHLOROETHYLVINYL
ETHER
CHLOROFORM
DICHLOROBROMO-
METHANE
1,1-DICHLOROETHANE
1,2-DICHLOROETHANE
TRANS-1,2-DICHLORO-
ETHYLENE
1,1-DICHLORO-
ETHYLENE
1,2-DICHLOROPROPANE
1,3-DICHLORO-
PROPYLENE
ETHYLBENZENE
METHYL BROMIDE
METHYL CHLORIDE
METHYLENE CHLORIDE
1,1,2,2-TETRA-
CHLOROETHANE
TETRACHLORO-
ETHYLENE
TOLUENE

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
Outfall number:001 (Results attached) (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE
ERAGE DAILY DISCHARGE E{
ANALYTICAL
METHOD
� ....,�..
MLlMDL
__
POLLUTANT
Conc
Units
Mass
Units
Conc
Units
Mass
Units
Number
of
.Samples
1,1,1-
TRICHLOROETHANE
1,1,2-
TRICHLOROETHANE
TRICHLOROETHYLENE
VINYL CHLORIDE
Use this space (or a separate
sheet) to
provide information
on
other volatile organic
compounds
requested
by the permit
writer
ACID -EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
2-CHLOROPHENOL
2,4-DICHLOROPHENOL
2,4-DIMETHYLPHENOL
4,6-DINITRO-O-CRESOL
2,4-DINITROPHENOL
2-NITROPHENOL
4-NITROPHENOL
PENTACHLOROPHENOL
PHENOL
2,4,6-
TRICHLOROPHENOL
Use this space (or a separate
sheet) to
provide information
on
other acid-extractab e compounds
reques
ed by the permit
writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
ACENAPHTHYLENE
ANTHRACENE
BENZIDINE
BENZO(A)ANTHRACENE
BENZO(A)PYRENE

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
Outfall number: 001 (Results attached) (Complete once for each outfall discharging effluent to waters of the United States.)
IMUM DAILY DISCHARGE :
3,4 BENZO-
FLUORANTHENE
ERAGEeDAILY DISCHAR
BENZO(GHI)PERYLENE
BENZO(K)
FLUORANTHENE
BIS (2-CHLOROETHOXY)
METHANE
BIS (2-CHLOROETHYL)-
ETHER
BIS (2-CHLOROISO-
PROPYL) ETHER
BIS (2-ETHYLHEXYL)
PHTHALATE
4-BROMOPHENYL
PHENYL ETHER
BUTYL BENZYL
PHTHALATE
2-CHLORO-
NAPHTHALENE
4-CHLORPHENYL
PHENYL ETHER
CHRYSENE
DI-N-BUTYL PHTHALATE
DI-N-OCTYL PHTHALATE
DIBENZO(A,H)
ANTHRACENE
1,2-DICHLOROBENZENE
1,3-DICHLOROBENZENE
1,4-DICHLOROBENZENE
3,3-DICHLORO-
BENZIDINE
DIETHYL PHTHALATE
DIMETHYL PHTHALATE
2,4-DINITROTOLUENE
2,6-DINITROTOLUENE
1,2-DIPHENYL-
HYDRAZINE

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
Outfall number: 001 (Results attached) (Complete once for each outfall discharging effluent to waters of the United States.)
'*410,i44#;,1-;:01i01400C-;
AVERAGE
DAILY
NIVIVID1_,:'.,
PO,_ _ ,
kuITA
' , ' '4-k-'
.,,,
..?"--''' E-..-.J.
01*,,,,
lYt21':',.:`,;;"3:::
,.„.:„.,;.„:,
'''-'''''''!'-':':;;
•utift:0--,-,:,::**-:
S';',41.4'1.-
:;"' Y '- ',---'::;.
1:1;:' -- : Y-;;;
,.,.„ ,
- ,--
'''-PE14-l'i,
4.:.6,44-t.:'%:;14:„..,
.,,.,,
.,--(, 6‘,:%`$',-
:-C°1*A'''"Vnil:4':-..
::: .-:f:4;f':_';`,7.,'
X' .--.1';:in,:
d',,,,,',2K:i,
,,„,.,.:..,r..
N,-.;14--;,.:-,"‘4.
Mass
f:.':•:7';', :',:.t:
f'-'__.'- ''' - '':
';Orifrg'''
:"irj::
Number-,---,,
'.''
] -:''',':;;PC':','"2,.T
• :44):ill:
.,A144yTia*L„,...;:::.-Y,::-..---;_-,--:-:::,,
. ' cr .. ,-. r.'-:.,
- ' rtIF.!-.7‘":1:.:"
FLUORANTHENE
FLUORENE
HEXACHLOROBENZENE
HEXACHLORO-
BUTADIENE
HEXACHLOROCYCLO-
PENTADIENE
HEXACHLOROETHANE
INDEN0(1,2,3-CD)
PYRENE
ISOPHORONE
,
NAPHTHALENE
NITROBENZENE
N-NITROSODI-N-
PROPYLAMINE
N-NITROSODI-
METHYLAMINE
N-NITROSODI-
PHENYLAMINE
PHENANTHRENE
PYRENE
1,2,4-
TRICHLOROBENZENE
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use this space (or a separate sheet) to provide information on other pollutants (e.g , pesticides) requested by the permit writer
•,‘401-c'';;;--'--,-,"
TO THE APPLICATJON
OF
OVERVIEW
DETERMINEREFER
,:-.'
FORM ' ' - COMPLETEMUST
'5Wi'i-'1,f1:Y5f,:;1:,:lwgW=it-Z,,,,:-4k:Z4,'W:,;a1-,0:,.-"A:,,:-AS.,

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
' UPPLEMENTALAPPLICrATION INFORMATION
;l
. y. t ..>_ ,...
i(, 'Rr'' ,,,, „,.. �¢`5z'ex. "``5'S'U 9Zv7 P43r�i' y ^ !r y�'3 t J l ..k "w Kc 1 '/. e'z"s: - -FY �As✓ �x
PART E TOXICiT1F TESTINGrD T�A
a!:�1?.t. h„'�-....,t's?,..�^.,.ti .;tit..a t �..'''?, � ., w'X.'S 1�M.
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 mgd; 2) POTWs with a pretreatment program (or those that are
required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters.
• At a minimum, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least annually in the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include
information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC
requirements for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition, submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity, provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested in question E.4 for previously submitted information. If EPA methods were not used, report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomonitoring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete. .
E.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
® chronic 0 acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
' Test number: Test number. Test number.
a. Test information.
Test Species & test method number
Age at initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s)
used. For multiple grab samples,
indicate the number of grab samples
used.
24-Hour composite
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
'
After disinfection

After dechlorination

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:,
f. For each test, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
i. Type of dilution water. If salt water, specify "natural" or type of artificial sea salts or brine used.
Fresh water
Salt water
j. Give the percentage effluent used for all concentrations in the test senes.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100°%
effluent
LC50
95°% C.I.
%
%
%
Control percent survival
%
%
%

Other (describe)

FACILITY NAME AND PERMIT NUMBER:
Town of Pembroke, NC0027103
PERMIT ACTION REQUESTED:
Renewal
RIVER BASIN:
Lumber
Chronic:
NOEC
ICn
%
%
%
Control percent survival
%
%
Other (describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation.
o Yes ® No
Is the treatment works involved in a Toxicity Reduction Evaluation?
If yes, describe:
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information, or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted:Per permit requirements. results have been submitted each year in the months of January. April. July, October
Summary of results: (see instructions)
All biomonitoring have been a "pass". One 2"d species (Fathead Minnow) has been completed and was a "pass"
y.. x ,c `s..s h s.�.- 1 9' y 4p�, -.[ ` >cc �,: * -, .:_ i �, ;; s,.� •-i 'A,� € ''
r Jet E DO .A .� __
REFER TO T E . PLICATIO OVE VI (PAG 1'j TO ® E ERMIN ICH ()THEPARTS
, s OF FORM2'A OF U�MUST _COMPLETE
,`f � 't . W .l s„ ' . , fi,' F' .', "S 'tt "Ra ? i ' 5..{�� �..4_ ,r x.., fi '� `'$ -. v' ?vi ±' 2

Li
Attachment Order 2-6:
Town of Pembroke NC0027103
Process Flow Diagram
Generator
Mechanical- —�
/Manual
Screening__—
.
Grease.—
- removal
Pre. -
Aeration
Influent Flow
.83 MGD.
Return Activated Sludge
Waste Sludge
Influent
Pump Station
Digester
Return
Line
Chlonne Contact
Effluent
Discharge
.83 MGD
1

Y
cka i K-brk4lw .: o rrnw 3 rzp h. +c,
%SC 14
a
•
•\
\\--� �'
52
ea
Pembroke WWTP - NC0027103
USGS Quad Number: 122 NW
Receiving Stream: Lumber River
Stream Class: WS-IV B Sw HOW
Subbasin: Lumber - 030751
Lat.: 34°39'55"
Long.: 79°12'00"
r.
North
j i
oke
Outfall 001
166
• Lod1 oUt ..
`.7bwe;ld.
•
(33�
SCALE 1:24,000

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Three Year Data Summary - Pembroke NC0027103

Permit No: NC0027103
Outfall: 001
Facility Name: Town of Pembroke
Date of Sampling:
Analytical Laboratory:
Parameter
Ammonia (as N)
Dissolved Oxygen
Nitrate/Nitrite
Total Kjeldahl Nitrogen
Total Phosphorus
Total Dissolved Solids
Hardness
Chlorine (total residual,TRC)
Annual Monitoring and Pollutant Scan
01/06/2011
Town of Pembroke, TBL, ESC, Meritech
• Sample Analytical;
.Type 1 Method
Composite ISM4500-NH3F
Grab SM4500-OG
Composite 1 9056
Composite
EPA. 351.2
Composite 365.1
Composite 1 2540C
Composite i 130.1
Oil and Grease Grab 1664A
Metals (total recoverable), cyanide and total phenols
Antinomy
Arsenic
Beryllium
Cadium
Chromium
Copper
Lead
Mercury
Mercury
Nickel
Selenium
Silver
Thallium
Zinc
Cyanide
Total phenolic compounds
Volatile -.organic •compounds
Acrolein
Acrylonitrile
Bromoform
Carbon tetrachloride
Chlorobenzene
Ch lorodibromomethane
Chloroethane
2-chloroethylvinyl ether
Chloroform
Dichlorobromomethane
1,1-dichloroethane
1,2-dichloroethane
Trans-1,2-dichloroethylene
Form-DMR-PPA-1
Grab SM 4500 CIG
Composite
Composite
Composite
Composite
Composite
Composite
Composite
Grab
Composite
Composite
Composite
Composite
Composite
Composite
Grab
Composite
Quantitatian.
Level
0.1
1.0
0.10
0.1
0.1
10.0
30
10
5.3
200.7
200.7
200:7
200.8
200.7
200.7
200.7
1631 E
245.1
200.7
200.7
200.7
200.8
200.7
4500 CN-E
420.1
0.020
0.020
0.0020
1.0
0.010
0.020
0.0050
1.0
0.00020
0,020
0.020
0.010
0.0200
0.030
0.005
0.040
0.0010
0.0010
0.0050
0.0025
0.0010
0.0010
0.0010
0.0010
Month: January
Year. 2011
ORC: Rhonda H.Locklear
Phone: [phone]
Sample,•
Result:
< 0.10
9.83
0.43
9.30
1.10
150.0
39.0
• 10.0
• 5.3
- Units of
Measurement
< 0.020
< 0.020
▪ 0.0020
< 1.0
< 0.010
• 0.020
< 0.0050
< 6.99
0.020
< 0.020
0.010
< 0.0200
0.038
< 0.0050
< 0.040
< 0.050
< 0.010
• 0.0010
< 0.0010
▪ 0.0010
< 0.0010
< 0.0010
< 0.0050
< 0.050
< 0.0025
< 0.0010
< 0.0010
• 0.0010
0.0010
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
ug/I
mg/I
mg/I
mg/I
mg/I
ug/I
mg/1
mg/I
mg/I
ng/I
ng/I
mg/I
mg/I
mg/I
mg/I
mg/I
mgll
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/1
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
Number of
Samples
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Page 1

L_J
Permit No: NC0027103
Outfall: 001
Annual Monitoring and Pollutant Scan
Month: January
S
Sample
Analytical
Quantitation
Sample
rear. LUI1
Units of
Number
Parameter
Type
Method
Level
Result
Measurement
of
Samples
Volat,le:-:organc'compounds(Cont.)
1 1-dichloroeth
., .
Y lene
1,2-dichloropropane
Grab
624
0.0010
� < 0.0010
� mg/I
s:
1
Grab
624
0.0010
< 0.0010
mg/I
1,3-dichloropropylene cis, trans
Grab
624
1
0.0010
< 0.0010
Ethylbenzene
Grab
mg/I
1
624
0.0010
< 0.0010
mg/I
Methyl bromide
Grab
624
1
Methyl
0.0050
< 0.0050
mgn
1
Chloride
Methylene
Grab
624
0.0025
< 0.0025
mg/I
1
Chloride
Grab
624
0.0050
< 0.
mgn
1,1,2,2-tetrachloroethane
Grab
624
1
Tetrachloroethylene
0.0010
< 0.00100010
10
mg/I
1
Grab
624
0.0010
< 0.0010
mg/I
Toluene
1,1,1-trichtoroethane
Grab
624
0.0050
< 0.0050
mg/I
1
1
1,1,2-trichloroethane
Grab
624
0.0010
< 0.0010
mg/I
1
Trichloroethylene
Grab
624
0.0010
< 0.0010
mg/I
1
Vinyl Chloride
Grab
624
0.0010
< 0.0010
mg/I
1
Acid -extractable
Grab
624
0.0010
< 0.0010
mg/I
1
compounds
p-chloro-m-creso
2-chlorophenol
Comp
625
0.010
< 0.010
mg/I
1
2,4-dichlorophenol
Comp
625
0.010
< 0.010
mg/I
1
2,4-dimethylphenol
Comp
625
0.010
< 0.010
mg/I
1
Comp
625
0.010
< 0.010
4,6-dinitro-o-cresol
Comp
625
mg/I
1
2,4-dinitrophenol
0.010
< 0.010
mg/I
1
P henol
2-nitro henol
Comp
625
0.010
< 0.010
mg/1
1
p
4-nitrophenol
Comp
625
0.010
< 0010
.
mg/I
Pentachlorophenol
Comp
625
0.010
< 0.010
mg/I
1
Phenol
Comp
625
0.010
< 0.010
1
2,4,6-trichlorophenol
Comp
625
0.010
< 0.010
mg/I
1
Base
Comp
625
0.010
< 0.010
mg/I
1
-neutral compounds
Acenaphthene
Acenaphthylene
Comp
625
0.010
< 0.010
mg/I
Comp
625
0.010
< 0.010
1
Anthracene
Comp
625
m•/I
1
Benzidine
0.010
< 0.010
mg/I
Benzo(a)anthracene
Comp
625
0.050
<
1
Benzo(a)
Comp
625
0.010
< 0.010
mg/I
1
pyrene
3,4-benzofluoranthene
Compmg/I
625
0.010
< 0.010
mg/I
1
Benzo(ghi)perylene
Comp
625
0.010
< 0.010
mg/I
1
Benzo(k)fluoranthene
Comp
625
0.010
< 0.010
mgn
1
Bis(2-cMoroethoxy)
Comp
625
0.010
< 0.010
mgn
1
methane
Bis(2-chloroethyl)
Comp
625
0.010
<
mg/I
1
ether
Bis(2-chloroisopropyl)
Comp0.010
625
0.010
< 0.010
mg/I
1
ether
3is(2-ethylhexyl)
Comp
625
0.010
< 0.010
mg/I
1
phthalate
1-bromophenyl
Comp625
.010
< 0.010
mg/I
1
phenyl ether
3utyl benzyl
Comp
625
0.010
mg/I
1
phthalate
?-Chlorona hthalene
Comp0.010
625
0.010
< 0.010
mg/I
1
p
625
0.010
1
I- chlorophenyl phenyl ether
Form-DMR-PPA-1
Comp
625
0.010
< 0.010
< 0.010
mg/I
mg/I1
1
Page 2

Permit No: NC0027103
Outfall: 001
Parameter
Annual Monitoring and Pollutant Scan
lummummumu
Type
Base -neutral compounds (Cont.)
Chrysene
Di-n-bu 1 •hthalate
Di-n-oc I •hthalate
Dibenzo a,h anthracene
1,2-dichlorobenzene
1,3-dichlorobenzene
1,4-dichlorobenzene
3, 3-dich lorobenzidine
Dieth I •hthalate
Dimeth ! • htha(ate
2,4-dinitrotoluene
2,6-dinitrotoluene
1,2-di • hen lh drazine
Fluoranthene
Fluorene
Hexach(orobenzene
Hexachlorobutadiene
Hexachloroc clo- • entadiene
Hexachloroethane
Indeno 1,2,3-cd • rene
!so. horone
Naphthalene
Nitrobenzene
N-nitrosodi-n-•ro• (amine
N-nitrosodimeth 'amine
N-nitrosodi• hen famine
Phenanthrene
P rene
1,2,4,-tichlorobenzene
Corn
Com
Comp
Com
Com
Com
Comp
Com
Com
Com
Com
Com
•
Comp
Com
Com
Com
Com
Com
Com
Com
Com
Com
Com
Com
Com•
Com
Com
Comp
•
•
•
Method
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
625
Quantftation
Level
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
Month: January
Year: 2011
Sam • le
Result
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
< 0.010
Units of
mg/I
1 certify under penalty of law that this document and all attachments were prepared under my
direction and supervision in accordance with a system to design to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons that manage the system, or those persons directly responsibility for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate and
complete. ! am aware that there are significant penalties for submitting false information, includin
the possibility of fines and imprisonment for knowing violations. g
Form-DMR-PPA-1
MCDuffle Cummings (Permittee)
Authorized Represent Name
Signature
Number
of
Samples
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Page 3

Permit No: NC0027103
Outfall: 001
Facility Name: Town of Pembroke
Date of Sampling:
Annual Monitoring and Pollutant Scan
04/19/2012
TBL ESC Meritech
Month: April
Year: 2012
ORC: Rhonda H.Locklear
Phone: [phone]
Analytical Laboratory:i own or r•ernbroke
J
Y4C
ic=
+
s.®.
» 4.4 f3
w1:,p p,0
b ofilif om
i ES
6a
imatitigi
�''f
p,Ifz a I I,.Px"
,,,61ampiw
�
=�,� hY
j�G4
• .4-
t .
't
at
7L J.6t`„1
,;
1J' 1pAY,
,S3W31
y;I ,..,, b ^
Yy �1Mf1fV
SU C> t
. ,Gff 5CC
::. 7t u[ili'}
v, ri
Sqmg
1^, r„t,
IFA�ys9
W ch,_,e�,f
�
;
Ammonia (as N)
Composite
SM4500-NH3F
0.1
0.63
mg/I
.
1
Dissolved Oxygen
Grab
SM4500-OG
1.0
8.10
mg/I
1
Nitrate/Nitrite
Composite
9056
0.10
11.00
mg/I
1
Total Keldahi Nitrogen
Composite
EPA. 351.2
0.1
1.90
mg/I
1
Total Phosphorus
Composite
365.1
0.1
1.10
mg/I
1
Total Dissolved Solids
Composite
2540C
10.0
200.0
mg/I
1
Hardness
Composite
130.1
30
37.0
mg/I
1
Chlorine (total residual,TRC)
'Grab
• SM 4500 CIG
10
10.0
ug/I
1
Oil and Grease
Grab,-r16
64A
5.3
53
mg/I
1
1 tart _vim.a rGvcbe
sS,WW, t,*,AVi
iy ar
e„a.lrirr4; .
lW's f
/.
fiS1,7 buf0,
Y��
rie t .
Antinomy
Composite
200.7
0.020
< 0.020
mg/I
1
Arsenic
Composite
200.7
0.020
< 0.020
mg/I
1
Beryllium
Composite
200:7
0.0020
< 0.0020
mgll
1
Cadium
Composite
200.8
1.0
< 1.0
ug/l
1
Chromium
Composite
200.7
0.010
< 0.010
mg/I
1
Copper
Composite
200.7
0.020
< 0.020
mg/I
1
Lead
Composite
200.7
0.0050
< 0.0050
mg/I
1
Mercury
Grab
1631 E
1.0
< 6.99
ng/I
1
Mercury
Composite
245.1
0.00020
7.3
ngll
1
,Nickel
Composite
200.7
0.020
< 0.020
mg/I
1
'Selenium
Composite
200.7
0.020
< 0.020
mgll
1
Silver
Composite
200.7
0.010
< 0.010
mg/I
1
Thallium
Composite
200.8
0.0200
< 0.0200
mg/I
1
Zinc
Composite
200.7
0.030
0.081
mg/I
1
Cyanide
Grab
4500 CN-E
0.005
< 0.0050
mg/I
1
Total phenolic compounds
Composite
420.1
0.040
< 0.040
mg/I
1
rrr r yrJ'rrt
art,O iti C© 0,..,.isu<
�: �. �. .f. : ..._F!+.,.. f.
sit
1'
,_, .. )) .:. ..:�
"it t �.
i u� a�
�{^_..,x ,♦I r5 .:: ..( r,
I 1 J. �.
f
t. ., r�Y St f.H :. r, .:^r �
t _...r k S r
r t F ti I ��,f
....a...., r, .,>tia:;. �nl 5� fy
tmrhl, �,+-�
u r,�n �s�II
r h4 ,.x; � I{: �A.. is ,��4
r r r
s,,� +; e�M
Al�, Tq.v.:I. tt. ty
Acrolein
Grab
624
0.050
< 0.050
mg/I
1
Acrylonitrile
Grab
624
0.010
< 0.010
mg/I
1
Benzene
Grab
624
0.0010
: < 0.0010
mg/I
1
Bromoform
Grab
624
0.0010
< 0.0010
mg/I
1
Carbon tetrachloride
Grab
624
0.0010
< 0.0010
mg/I
1
•Chlorobenzene
Grab
624
0.0010
< 0.0010
mg/I
1
Chlorodibromomethane
Grab
624
0.0010
< 0.0010
mgll
1
:Chloroethane
Grab
624
0.0050
< 0.0050
mg/I
1
2-chloroethylvinyl ether
Grab
624
0.050
< 0.050
mg/I
1
Chloroform
Grab
624
0.0025
< 0.0025
mg/I
1
Dichlorobromomethane
Grab
624
0.0010
< 0.0010
mg/I
1
1,1-dichloroethane
Grab
624
0.0010
< 0.0010
mg/I
1
1,2-dichloroethane
Grab
624
0.0010
, < 0.0010
mg/I
1
Trans-1,2-dichloroethylene
Grab
624
0.0010
< 0.0010
mg/I
1
Form-DMR-PPA-1
Page 1

r•
Annual Monitoring and Pollutant Scan
Permit No: NC0027103
Month: April
Year: 2012
Outfall: 001
S
Sample
analytical
Quantiiation
Sample
Units of
Number of
Type T e
Method
Level
Result
Measurement
Samples
n.
NiAilatil�'giOni rl.#10 1•j '.....(940 `l��r .rn?' N S
t � as �';."1:4
7'.a. , kp:: 1 p16v41.;'�efzai,;
0.0010
:.. yr,',+,,,r,,q �i,,,,,T.
r' W7,,, ,g{,4. )v�N,M,k` `i:'t,G.JA14`,I,r;,j
trr
< 0.0010
mg/I
1
1,1-dichloraet%yiene
Grab
624
1,2-dichloropropane
Grab
624
0,0010
< 0.0010
mg/I
1
1,3-dichloropropylene cis, trans
Grab
624
0.0010
< 0.0010
mgll
1
Ethylbenzene
Grab
624
0.0010
< 0.0010
mg/I
1
Methyl bromide
Grab
624
0,0050
< 0.0050
mg/I
1
Methyl Chloride
Grab
624
0.0025
< 0.0025
mgll
1
Methylene Chloride
Grab
624
0.0050
< 0.0050
mg/I
1
1,1,2,2-tetrachloroethane
Grab
624
0.0010
< 0.0010
mg/I
1
Tetrachloroethylene
Grab
624
0.0010
< 0.0010
mg/I
1
Toluene
Grab
624
0.0050
< 0.0050
mg/I
1
.1,1,1-trichloroethane
Grab
624
0.0010
< 0.0010
mg/I
1
1,1,2-trichloroethane
Grab
624
0.0010
< 0.0010
mg/I
1
Trichloroethylene
Grab
624
0.0010
< 0.0010
mg/I
1
Vinyl�ChlorideJJ
Grab
624
0.0010
< 0,0010
mg/1
1{
, y� y' 1
liill54Kti4',34WL� ��Co# 01011f�3}�
, t 1, 'v , ..,,;G•.r
ra t+,.e:: �t f
�. , ,� .i.. C w h o-)?,� t'1i r�,aV ,.�,. f•� l ri, '�,:;ai
)r, o., t:-;2 i, ,, , ,dial o..4- .�t.�. i x
,,,,:.**,,),,,,,,,,,,.:4ag
p-chfaro-rn-creso
Comp
625
0,010
< 0.010
mg/I
1.
2-chlorophenol
Comp
625
0.010
< 0.010
mgll
1
2,4-dichlorophenol
Comp
625
0.010
< 0.010
mgll
1
2,4-dimethylphenol
Comp
625
0.010
< 0.010
mg/I
1
4,6-dinitro-o-cresol
Comp
625
0.010
< 0.010
mg/l
1
2,4-dinitrophenol
Comp
625
0.010
< 0.010
mg/I
1
2-nitrophenol
Comp
625
0.010
< 0.010
mg/I
1
4-nitrophenol
Comp
625
0.010
< 0.010
mg/I
' 1
I( Pentachlorophenol
Comp
625
0.010
< 0.010
mg/I
1
Phenol
Comp
625
0.010
< 0.010
mg/I
1
2,4,6-trichloro�phenrol
Comp
625
0.010
< 0.010
mg/I
(: 1
C�'^7I ..-rigi'Itr 7ifi ui�sr
P.v�?.3�bo.�,w, .'�-a<•.�r,���.��,..,....,-..t.��„�,th..,-
1f(.�As. )S I� Sl,rit
.�, r,
!'fo IiarriiAh
rd <t"�n,,.,,, _�!,�
�.� i 5',y, ,,,flaw,“
.,mlt..�.1 .....v a.vl�.t
4fY.�:� iiV
,.� „+ i.n. h40 w.�
"� 6 Fug? I�Y1, hU�n(yN)Cd ((.^1,-; ,.���
�„ '� .. r�. 3
h }�,n'.�d i7 S3iNq
5., �I"d�i .r
Acenaphthene
Comp
625
0,010
< 0.010
mgA
1
Acenaphthylene
Comp
625
0.010
< 0.010
mgA
1
Anthracene
Comp
625
0.010
< 0.010
mg/I
1
Benzidine
Comp
625
0.050
< 0.050
mg/I
1
Benzo(a)anthracene
Comp
625
0.010
< 0.010
mg/I
1
Benzo(a) pyrene
Comp
625
0.010
< 0.010
mg/I
1
3,4-benzofluoranthene
Comp
625
0.010
< 0.010
mg/I
1
Benzo(ghi)perylene
Comp
625
0,010
< 0.010
mg/I
1
Benzo(k)fluoranthene
Comp
625
0.010
< 0.010
mg/I
1 t,
Bis(2-chloroethoxy) methane
Comp
625
0.010
< 0.010
mg/I
1
Bis(2-chloroethyl) ether
Comp
625
0.010
< 0.010
mg/1
1
Bis(2-chloroisopropyl) ether
Comp
625
0.010
< 0,010
mg/I
1
Bis(2-ethylhexyl) phthalate
Comp
625
0.010
< 0.010
mg/I
1
4bromophenyl phenyl ether
Comp
625
0.010
< 0.010
mg/I
1
Butyl benzyl phthalate
Comp
625
0.010
< 0.010
mgA
1
2-Chloronaphthalene
Comp
625
0.010
< 0.010
mg/I
1
4- chlorophenyl phenyl ether
Comp
625
0.010
< 0.010
mg/I
1
orm-D M R-PPA-1
Page 2

Annual Monitoring and Pollutant Scan
Permit No: NC0027103
•
Month: April
Year: 2012
JULIdU. UU 1
Sample
Analytical
Quantitation Sample
Units. of
Number of
Parameter
Type
Method
Level Result
easuremei
Samples
y� yJj
A etrt'aF
iaYCCbci'p Ijl. A .n . -.. n ��� .7 ......,,.-�n.,��at
, _
t
� � .���lt�l�' , v �
Cornp
l -df,� ('..
}
�1. i � 5Ib} /L btt ..
tM1Ftt414. i{ �„� t
� I .. �i , ., )I, �.Y �i
t �.i M,�(y{.'d� t�l��l k .*i 4 N `
, F � 6k�� 1 � ? I?.i'�M .. �i v"�17:4
-0. {.^ E< !`'W � 1
. p
Yi! ,'3 S(;i .s.Jr i
ff �'Mi^�tXi t,
.�tl%f�(�(: f-
.,r..:..
Cltrysene W
625
0.010
< 0.010
rnglt
1
Di-n-butyl phthalate
Comp
625
0.010
< 0.010
mg/I
1
Di-n-octyl phthalate
Comp
625
0.010
< 0.010
mg/I
1
Dibenzo(a,h)anthracene
Comp
625
0,010
< 0.010
mg/I
1
1,2-dichlorobenzene
Comp
625
0.010
< 0.010
mg/I
1 4
1,3-dichlorobenzene
Comp
625
0.010
< 0.010
mg/I
1
1,4-dichlorobenzene
Comp
625
0.010
< 0.010
mg/I
1
3,3-dichiorobenzidine
Comp
625
0.010
< 0.010
mg/I
1
,Diethyl phthalate
Comp
625
0.010
< 0.010
mg/I
1
Dimethyl phthalate
Comp
625
0.010
< 0.010
mg/1
1
2,4-dinitrototuene
Comp
625
0.010
< 0.010
mg/I
1
2,6-dinitrotoluene
Comp
625
0.010
< 0.010
mg/I
1
1,2-diphenylhydrazine
Comp
625
0.010
< 0.010
mg/1
1
'Fluoranthene
Comp
625
0.010
< 0.010
mg/I
1
Fluorene
Comp
625
0.010
< 0.010
mg/I
1
!Hexachlorobenzene
Comp
625
0.010
< 0.010
mg/I
1
Hexachlorobutadiene
Comp
625
0.010
< 0,010
mg/1
1
Hexachlorocyclo-pentadiene
Comp
625
0.010
< 0.010
mg/I
1
Hexachloroethane
Comp
625
0.010
< 0.010
rng/I
1
Indeno(1,2,3-cd)pyrene
Comp
625
0.010
< 0.010
mg/I
1
,Isophorone
Comp
625
0.010
< 0.010
mg/I '
1
Naphthalene
Comp
625
0.010
< 0.010
mg/I
1
Nitrobenzene
Comp
625
0.010
< 0.010
mg/I
1
'N-nitrosodi-n-propylamine
Comp
625
0.010
< 0.010
mg/I
1
;N-nitrosodimethylamine
Comp
625
0.010
< 0.010
mg/I
1
:N-nitrosodiphenylamine
Comp
625
0.010
< 0.010
mg/I
1
Phenanthrene
Comp
625
0.010
< 0.010
mg/I
1
Pyrene
Comp
625
0.010
< 0.010
mg/I
1
1,2,4,-trichlorobenzene
Comp
625
0.010
< 0.010
mg/I
1
I certify under penalty of law that this document and all attachments were prepared under my
direction and supervision in accordance with a system to design to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons that manage the system, or those persons directly responsibility for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate and
complete. I am aware that there are significant penalties for submitting false information, including
the possibility of fines and imprisonment for knowing violations.
Maire Moore (Permittee)
Authorized Representative Name
Nit*10
Signature
Form-DMR-PPA-1
Page 3

| Permit No: mon027103
Facility Name: Town ofPembroke
Date of Sampling:
Analytical Laboratory:
Annual Monitoring and Pollutant Scan
o4ne/2u1u
Town mPembroke, TaL, ESm
Month: April
Year: 2013
ORC: Rhonda H.Locklear
Ammonia (aom)
Composite
anw*500-NM3r
0.1
9.80
mQ0
1
Dissolved Oxygen
Grab
Sm4*00-oo
1.0
8.70
mg0
1
Nitrate/Nitrite
Composite
9056
��
�
o80
mgU
1
Total KjomamNitrogen
_
Composite
sPA.as1.o
01
1.2.00
mox
�
Total Phosphorus
Composite
365.1
uA
0.93
mox
1
Total Dissolved Solids
Composite
oo*oc
10.0
160.0
mux
�
Hardness
omnpvuuo
1301
on
39.0
mu/l
�
Chlorine (total moiuua|.TgC)
Grab
oM *580o\G.
25
<
25.0
u0/|
Oil and Grease
Grab
1664A
5.0
<
5.0
'n08
�
Andnamy
Composite
2007
0.028
<
0.820
mg8
1
amonio
oamn000a
200.7
0.020
<
0.020
nnn/|
�
Beryllium
Composite
uouJ
0.0020
<
0.0020
mox
�
Cauium
Composite
200.8
1.0
<
to
ug8
�
Chromium
Composite
280J
0.010
«
0\01:0
mg8
�
Copper
Composite
200.7
0.020
<
o-000
mo/|
�
b,ao
Composite
2007
0.0050
<
0.0050
mg0
�
Mercury
Gn,u
1631s
0.5
3.03
ng8
1
Mercury
Composite
245./
um} oo
|«
u.808e0
m0/l
�
w/cm,/
Composite
200.7
0.020
<
0.020
mox
�
Selenium
Composite
200.7
0.020
<
0.020
mg0
1
Gi|,a,
Composite
200.7 .
0.010
<
0D10
mo0
1
Txumum
composite
200.8
0z200
x
0-0200
mux
�
Zinc
Composite
uouJ
0`030
0.048
mo0
1
Cyanide
emu
4500cw`s
0.005
x
0.0050
mo/l
�
Total phenolic compounds
Composite
420.1
0.040
^
0.040
m8/|
1
.
acmlein
Grab
824
8.050
<
0.858
mgN
1
acrymnxmo
m,ou
624
0.010
<
0.010
mg8
1
.
Benzene
Grab
624
0-0010
«
0.0010
mox
�
ommmonn
Grab
62*
0`0010
^
0.0010
mgx
�
Carbon tetrachloride
Grab
824
0.0010
<
0.0010
m0/i
1
omomuanzaoo
emu
e24
0u010
"
0.0010,
mox
Omnmdibmmomethooe
Grab
824
0.0010
<
8.0010
mg/|
1
�
cxmmemano
Grab
624
0.0050
^
unoso
mox
'2'cNomsuhylvinylaLhor
Grab
624
OO�0
�
�
0O5�
'
m0�
1
' ohmmfonn
Grob
824
0.8025
<
'
0.0025
mg0
1
`
oioh|nmummometxane
Grab
624
0.0010
<
0.0010
mg8
1
'1.1'd/oh|omothane
Grab
624
0.0010
<
0.0010
mg8
�
1.2-mcx|onoethane
mrou
624
0o010
<
0.0010
mox
�
_
Trans'1.2-ummiomenv�ne
~"="'..""~`"""^
emu
n�*
uoo1u
.mu0
�
0.0010
�

Annual Monitoring and Pollutant Scan
Permit No: NC0027103
Outfatl: 001
Month: April
Year: 2013
Sample
Analytical
Quantitation
Sample
Units of
Number of
Parameter
Type
Method
Level
Result
Measurement
Samples
Volatile;org0.1,:0001prounds,(CoMA . ;;
�k ;r', ..r; r?;
,.._.,. ` ,` '
„,,A, .ti, {ym,
' `{ 4 ,r
1,1-dichloroethylene
:Grab
624
0.0010 •
< 0.0010
mg/I
1
1,2-dichloropropane
Grab
624
0.0010
< 0.0010
mg/I
1
1,3-dichloropropylene cis, trans
Grab
624
0.0010
< . 0.0010
mg/I
1
Ethylbenzene
Grab
624
0.0010
< 0.0010
mg/I
1
Methyl bromide
Grab
624
0.0050
< 0.0050
mg/I
1
Methyl Chloride
Grab
624
0.0025
< 0.0025
mg/I
1
Methylene Chloride
Grab
624
0.0050
< 0.0050
mg/I
1
1,1,2,2-tetrachloroethane
:Grab
624
0.0010
< 0.0010
mg/I
1
Tetrachloroethylene
Grab
624
0.0010
< 0.0010
mg/I
1
Toluene
Grab
624
0.0050
< 0.0050
mg/I
1
1,1,1-trichloroethane
Grab
624
0.0010
< 0.0010
mg/I
1
1,1,2-trichloroethane
Grab
624
0.0010
< 0.0010
mg/I
1
Trichloroethylene
Grab
624
0.0010
< 0.0010
mg/1
1
Vinyl Chloride
Grab
624
0.0010
< 0.0010
mg/I
1
hcid-extractabl0 Gbmpotthdsk
sr a k, . !Yrr,
, 3 ;''
. , t, . i,+:
a,
" 4.. ,' *.t
. , `. .;
p-chloro-m-creso
Comp
625
0.010
< 0.010
mg/I
1
2-chiorophenol
Comp
625
0.010
< 0.010
mg/I
1
2,4-dichlorophenol
Comp
625
0.010
< 0.010
mg/I
1
2,4-dimethylphenol
Comp
625
0.010
< 0.010
mg/I
1
4,6-dinitro-o-cresol
Comp
625
0.010
< 0.010
mg/I
1
2,4-dinitrophenol
Comp
625
0.010
< 0.01•0
mg/I
1
2-nitrophenol
Comp
625
0.010
< 0.010
mg/I
1
4-nitrophenol
Comp
625
0.010
< 0.010
mg/I
1
Pentachlorophenol
Comp
625 -
0.010
< 0.010
mg/I
1
Phenol
Comp
625
' 0.010
< 0.010
mg/I
1
2,4,6-trichlorophenol
Comp
625
0.010
< 0.010
mg/I
1
.` "Base -neutral c k 7:0nds,
t1 ; f :g'
Grr 1,...-,,r si;r...,.
1{, , '' 1
n y{::
f n }S
Acenaphthene
Comp
• 625
0.010
< 0.010
mg/I
1
Acenaphthylene
Comp
625
0.010
< 0.010
mg/1
1
Anthracene
Comp
625
0.010
< 0.010
mg/I
1
Benzidine
Comp
625
0.050
< 0.050
mg/I
1
Benzo(a)anthracene
Comp
625
0.010
< 0.010
mg/I
1
Benzo(a) pyrene
Comp
625
0.010
< -0.010
mg/I
1
3,4-benzofluoranthene
Comp
625
0.010
< 0.010
mg/I
1
Benzo(ghi)perylene
Comp
625
0.010
< 0.010
mg/I
1
Benzo(k)fluoranthene
Comp
625
0.010
< 0.010
mg/I
1
Bis(2-chloroethoxy) methane
Comp
625
0.010
< 0.010
mg/I
1
Bis(2-chloroethyl). ether
Comp
625
0.010
< 0.010
mg/I
1
Bis(2-chloroisopropyl), ether
Comp
625
0.010
< 0.010
mg/I.
1
Bis(2-ethylhexyl) phthalate
Comp
625
0.010
< 0.010
mg/I
1
4-bromophenyl phenyl ether
Comp
625
0.010
< 0,010
mg/1
1
Butyl benzyl phthalate
Comp
625
0.010
< 0.010
mg/1
1
2-Chloronaphthalene
Comp
625
0.010
< 0.010
. mg/I
1.
4- chlorophenyl phenyl ether
Gnrm_r111/10_DDA d
Comp
625
0.010
< 0.010
mg/1
1
Page 2

Annual Monitoring and Pollutant Scan
Permit No: NC0027103
Outfall: 001
Month: April
V.......
Sample
Analytical
Quantitation
Sample
Units of
Number of
Parameter
Type
Method
Level
Result
leasuremei
Samples
Base -neutral coat; ounds :(,c
..,. . ..�._ �..,,... ... ,.
ontsl. , j ,.i
`r '..,v , .' ,
� a_ .{s.
, , ,
�<, os= ., i,�
, } s
� ;. <
,e��{.0 4 {h,'
F
..[
7wi ._ ., r.,�
sue. '���� ,v
.. :_tea h.,Asy
Chrysene
Comp
625
0.010
<
0.010
mg/I
1
Di-n-butyl phthalate
Comp
625
0.010
<
0.010'
mg/1
1
Di-n-octyl phthalate
Comp
625
0.010
<
0.010
mg/I
1
Dibenzo(a,h)anthracene
Comp
625
0.010
<
0.010
mg/I
1
1,2-dichlorobenzene
Comp
625
0.010
<
0.010
mg/I
1
1,3-dichlorobenzene
Comp
625
0.010
<
0.010
mg/I
1
1,4-dichlorobenzene
Comp
625
0.010
<
0.010
mg/I
1
3,3-dichlorobenzidine
Comp
625
0.010
<
0.010
mg/I
1
Diethyl phthalate
Comp
625
0.010
<
0.010
mg/I
1
Dimethyl phthalate
Comp
625
0.010
<
0.010
mg/I
1
2,4-dinitrotoluene
Comp
625
0.010
<
0.010
mg/I
1
2,6-dinitrotoluene
Comp
625
0.010
<
0.010
mg/I
1
1,2-diphenylhydrazine
Comp
625
0.010
<
0.010
mg/I
1
'Fluoranthene
Comp
625
0.010
<
0.010
mg/I
1
Fluorene
Comp
625
0.010
<
0.010
mg/I
1
Hexachlorobenzene
Comp
625
0.010
<
0.010
mg/I
1
Hexachiorobutadiene
Comp
625
0.010
<
0.010
mg/I
1
Hexachlorocyclo-pentadiene
Comp
625
0.010
<
0.010
mg/I
1
Hexachloroethane
Comp
625
0.010
<
0.010
mg/I
1
Indeno(1,2,3-cd)pyrene
Comp
625
0.010
<
0.010
mg/I
1
Isophorone
Comp
625
0.010
<
0.010
mg/I
1
Naphthalene
Comp
625
0.010
<
0.010
mg/I
1
Nitrobenzene
Comp
625
0.010
<
0.010
mg/I
1
N-nitrosodi-n-propylamine
Comp
625
0.010
<
0.010
mg/I
1
N-nitrosodimethylamine
Comp
625
0.010
<
0.010
mg/I
1
N-nitrosodiphenylamine
Comp
625
0.010
<
0.010
mg/I
1
Phenanthrene
Comp
625
0.010
<
0.010
mg/I
1
Pyrene
Comp
625
0.010
<
0.010
mg/I
1
1,2,4,-trichlorobenzene
Comp _
625
0.010
<
0.010
mg/I
1
I certify under penalty of law that this document and all attachments were prepared under my
direction and supervision in accordance with a system to design to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons that manage the system, or those persons directly responsibility for gathering the
information, the information submitted is,. to the best of my knowledge and belief, true, accurate and
complete. I am aware that there are significant penalties for submitting false information, including
the possibility of fines and imprisonment for knowing violations.
Oryan D. Lowry (Perrnittee)
Authorized Representative Name
Lure
Form-DMR-PPA-1
Page 3