NC0004626_Renewal (Application)_20211029

,...7.''''' _
ROY COOPER i t
Governor v3 t Ii 1
ELIZABETH S.BISER . . „r
Secretary "° " "�•
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
October 29, 2021
Electric Glass Fiber America, LLC
Attn: Kurt Christian, Plant Manager
473 New Jersey Chruch Rd
Lexington, NC 27292
Subject: Permit Renewal
Application No. NC0004626
PPG Industries Fiber Glass Products, Inc.
Davidson County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 29, 2021 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
3gerqt646
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Terry Steinert, Environmental Manager
ec: WQPS Laserfiche File w/application
DEW)
_E Q North Carolina Department of Environmental Quality I Division of Water,
ater Resources
�wvJJ//q Winston-Salem Regional Office 450 West Hanes MITI Road.Suite 3 iWinston-Salem,North Carolina 27I05
6.."%,u..�......w\ e" 336 776 9800

• Nippon Electric Glass
Electric Glass Fiber America, LLC
473 New Jersey Church Road Lexington, NC 27292 Tel: [phone]
October 26, 2021
Via Federal Express
RECEIVED
Dr. Sergei Chernikov O C T 2 9 2021
Environmental Engineer III
Industrial NPDES Permitting Unit
1617 Mail Service Center NCDEQ/DWR/NPDES
Raleigh,NC 27699-1617
Re: Electric Glass Fiber America, LLC - Lexington,NC facility
NPDES Permit No. NC0004626
Dear Dr. Chernikov:
Electric Glass Fiber America, LLC. (EGFA) operates a WWTP authorized by NPDES Permit
NC 0004626. This permit expires May 31, 2022.
To renew the permit, a renewal package is enclosed which consists of two signed copies of EPA
Forms 1 and 2c. Per your request, an electronic copy of the permit application is also being sent.
EGFA appreciates the opportunity to submit this application and your review of same. Should
you have any questions,please contact me at [e-mail] or 336-357-8151
x22007.
Kindest Re
erry Steinert, Envi nmental Manager
Electric Glass Fiber America, LLC
encl.

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 Electronic Glass Fiber America, LLC OMB No.2040-0004
Form U.S.Environmental Protection Agency
1 4w/EPA Application for NPDES Permit to Discharge Wastewater
NPDES GENERAL INFORMATION
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 1
treatment works? 1. .2 treating domestic sewage?
If yes,STOP.Do NOT complete ® No If yes,STOP. Do NOT E No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
Q. production facility? currently discharging process wastewater?
❑ Yes 4 Complete Form 1 2 No 0 Yes 4 Complete Form El No
z and Form 2B. 1 and Form 2C.
R 1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
mining,or silvicultural facility that has not yet commercial, mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
dYes 4 Complete Form 1 0 No ❑ Yes 4 Complete Form 0 No
cc and Form 2D. 1 and Form 2E.
:: 1.2.5 Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
a associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
Yes 4 Complete Form 1 ❑✓ No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
ELECTRIC GLASS FIBER AMERICA,LLC
2.2 EPA Identification Number
110000346082
2.3 Facility Contact
Name(first and last) Title Phone number
Terry Steinert Environmental Manager [phone]
c Email address
irs
[e-mail]
2
2.4 Facility Mailing Address
o Street or P.O.box
473 New Jersey Church Road
City or town State ZIP code
Lexington North Carolina 27292
EPA Form 3510-1(revised 3-19) Page 1
_J

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 Electronic Glass Fiber America, OMB No.2040-0004
y d 2.5 Facility Location
Street, route number,or other specific identifier
a 473 New Jersey Church Road
rn
5 c County name County code(if known)
M0Davidson
0
E _1 City or town State ZIP code
co z R Lexington North Carolina 27292
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
3229 Pressed and Blown Glass and Glassware,NOC
Vl
°
U
U)
3.2 NAICS Code(s) Description(optional)
-o
327212 Other Pressed and Blown Glass and Glassware Manufacturing
N
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
Electric Glass Fiber America,LLC
0 4.2 Is the name you listed in Item 4.1 also the owner?
❑ Yes ❑ No
4.3 Operator Status
❑ Public—federal ❑ Public—state ❑ Other public(specify)
o ❑� Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
° Street or P.O.Box
E 473 New Jersey Church Road
o = —
City or town State ZIP code
o V Lexington North Carolina 27292
co
a Email address of operator
0 [e-mail]
SECTION 5.IND AN LAND(40 CFR 122.21(f)(5))
c 5.1 Is the facility located on Indian Land?
c ❑ Yes E No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 Electronic Glass Fiber America, OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
d ❑✓ NPDES(discharges to surface © RCRA(hazardous wastes) ❑ UIC(underground injection of
water) fluids)
ENC0004626 NCD043712298 NA
w a ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
NA NA NA
w ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑� Other(specify)
NA NA Air Permit 02688T43
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
0 specific requirements.)
❑r Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
Continuous Strand fiber glass manufacturing.For NPDES purposes,the site wastewater treatment plant(WWTP)also
co receives and treats wastewater from the American Children's Home.The flow from the American Children's home
represents only one percent(1%)of the total flow to the WWTP.
RECEIV
0o
"6
OCT 292021ED
NCDEQ/DWR/NPDES
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
❑ Yes 0 No 4 SKIP to Item 10.1.
R 9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
cto NPDES permitting authority to determine what specific information needs to be submitted and when.)
o R
c
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
Section 301(n)) 302(b)(2))
CD
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
to Section 301(c)and(g))
2 Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 Electronic Glass Fiber America, OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below,mark the sections of Form 1 that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note
that not all applicants are required to provide attachments.
Column 1 Column 2
El Section 1:Activities Requiring an NPDES Permit ❑ w/attachments
O Section 2:Name,Mailing Address,and Location ❑ wl attachments
❑r Section 3:SIC Codes ❑ wl attachments
❑r Section 4:Operator Information ❑ w/attachments
❑✓ Section 5: Indian Land ❑ w/attachments
❑ Section 6:Existing Environmental Permits ❑ w/attachments
❑ Section 7:Map ❑ wl topographic ❑ w/additional attachments
map
cn
o CI Section 8:Nature of Business ❑ wl attachments
❑ Section 9:Cooling Water Intake Structures ❑ w/attachments
CD
CD
�' ❑� Section 10:Variance Requests-0 El w/attachments
c
❑ Section 11:Checklist and Certification Statement ❑ wl attachments
d 11.2 Certification Statement
c.)
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted. Based on my inquiry of the person or persons who manage the system,or those persons
directly responsible for gathering the information, the information submitted is,to the best of my knowledge and
belief, true,accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Kurt Christian Plant Manager
Signature Date signed
(at C/ /01.161
EPA Form 3510-1(revised 3-19) Page 4

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BASE MAPS TAKEN FROM NATIONAL GEOGRAPHIC USGS TOPOGRAPHIC N
MAP OF SOUTHMONT,NORTH CAROLINA.DATED 2019. 9CRLB 1" 2000' OMBON a`
♦FISS ELECTRIC GLASS FIBER AMERICA, LLC SITE LOCATION MAPKs
111
11 _ 473 NEW JERSEY CHURCH ROAD FORM 1-7.1 ,00 APRL 2p2 moo ^
2000 1000 0 2000 4000 LEXINGTON, NORTH CAROLINA 27293 EPA ID# no DOD 346082
NPDES # NC 0004626 259-38 FIGURE 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
Form U.S.Environmental Protection Agency
2C \'"/EPA Application for NPDES Permit to Discharge Wastewater
NPDES EXISTING MANUFACTURING,COMMERCIAL,MINING,AND SILVICULTURE OPERATIONS
SECTION 1.OUTFALL LOCATION(40 CFR 122.21(g)(1))
1.1 Provide information on each of the facility's outfalls in the table below.
0 Numbelr Receiving Water Name Latitude Longitude
Co.
001 North Potts Creek 35.00° 45.00' 18.00" 30.00° 19.00' 32.00"
co
III o ' u o r n
7
0
SECTION 2.LINE DRAWING(40 CFR 122.21(g)(2))
p, 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
G) .3 balance?(See instructions for drawing requirements.See Exhibit 2C-1 at end of instructions for example.)
J R
Yes ❑ No
SECTION 3.AVERAGE FLOWS AND TREATMENT(40 CFR 122.21(g)(3))
3.1 For each outfall identified under Item 1.1,provide average flow and treatment information.Add additional sheets if
necessary.
**Outfall Number" 001
Operations Contributing to Flow
Operation Average Flow
See attached sheet mgd
mgd
mgd
mgd
o Treatment Units
LL
Description Final Disposal of Solid or
p Code from p
(include size,flow rate through each treatment unit, Table 2C-1 Liquid Wastes Other Than
retention time,etc.) by Discharge
Electric Glass Fiber America operates a 0.6 MGD 1G,1L,1M,1O,1T,1U,2C,20 Davidson County Landfill
treatment facility-see attached process flow schematic 2E,2F,3A,4A,4C,5C,5E,5L,
5Q
EPA Form 3510-2C(Revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
3.1 **Outfall Number**
cont. Operations Contributing to Flow
Operation Average Flow
NA mgd
mgd
mgd
mgd
Treatment Units
Description Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Table 2C-1 Liquid Wastes Other Than
retention time,etc.) by Discharge
m NA
c
C
0
(..)
c
E
m
**Outfall Number**
Operations Contributing to Flow
0 Operation Average Flow
U-
c NA mgd
mgd
mgd
mgd
Description Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Table 2C-1 Liquid Wastes Other Than
retention time,etc.) by Discharge
NA
3.2 Are you applying for an NPDES permit to operate a privately owned treatment works?
E
0 Yes ❑ No 4 SKIP to Section 4.
cn 3.3 Have you attached a list that identifies each user of the treatment works?
❑r Yes ❑ No
EPA Form 3510-2C(Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
SECTION 4.INTERMITTENT FLOWS(40 CFR 122.21(g)(4))
4.1 Except for storm runoff,leaks,or spills,are any discharges described in Sections 1 and 3 intermittent or seasonal?
❑ Yes ❑ No 4 SKIP to Section 5.
4.2 Provide information on intermittent or seasonal flows for each applicable outfall.Attach additional pages,if necessary.
Outfall Operation Frequency Flow Rate
Number (list) Average Average Long-Term Maximum Duration
Days/Week Months/Year Average Daily
days/week months/year mgd mgd days
days/week months/year mgd mgd days
u-
days/week months/year mgd mgd days
E days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
SECTION 5.PRODUCTION(40 CFR 122.21(g)(5))
5.1 Do any effluent limitation guidelines(ELGs)promulgated by EPA under Section 304 of the CWA apply to your facility?
0 Yes 0 No 4 SKIP to Section 6.
5.2 Provide the following information on applicable ELGs.
w ELG Category ELG Subcategory Regulatory Citation
o-
a
5.3 Are any of the applicable ELGs expressed in terms of production(or other measure of operation)?
0 Yes ❑ No 4 SKIP to Section 6.
0
5.4 Provide an actual measure of daily production expressed in terms and units of applicable ELGs.
Outfall Unit of
Operation,Product,or Material Quantity per Day
Number Measure
co
O
O
CI-
EPA Form 3510-2C(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
SECTION 6.IMPROVEMENTS(40 CFR 122.21(g)(6))
6.1 Are you presently required by any federal,state,or local authority to meet an implementation schedule for constructing,
upgrading,or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes ❑ No 4 SKIP to Item 6.3.
6.2 Briefly identify each applicable project in the table below.
f/1
a Affected Final Compliance Dates
Brief Identification and Description of Outfalls Source(s)of
Project (list outfall Discharge Required Projected
number)
Nf
lC
a.
C.
6.3 Have you attached sheets describing any additional water pollution control programs(or other environmental projects
that may affect your discharges)that you now have underway or planned?(optional item)
❑ Yes ❑ No r❑ Not applicable
SECTION 7.EFFLUENT AND INTAKE CHARACTERISTICS(40 CFR 122.21(g)(7))
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn,the tables you must
complete.Not all applicants need to complete each table.
Table A.Conventional and Non-Conventional Pollutants
7.1 Are you requesting a waiver from your NPDES permitting authority for one or more of the Table A pollutants for any of
your outfalls?
❑ Yes ❑ No 4 SKIP to Item 7.3.
7.2 If yes,indicate the applicable outfalls below.Attach waiver request and other required information to the application.
Outfall Number Outfall Number Outfall Number
7.3 Have you completed monitoring for all Table A pollutants at each of your outfalls for which a waiver has not been
� requested and attached the results to this application package?
9 Yes No;a waiver has been requested from my NPDES
❑ permitting authority for all pollutants at all outfalls.
5 Table B.Toxic Metals,Cyanide,Total Phenols,and Organic Toxic Pollutants
7.4 Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
c listed in Exhibit 2C-3?(See end of instructions for exhibit.)
❑ Yes ❑ No 4 SKIP to Item 7.8.
7.5 Have you checked"Testing Required"for all toxic metals,cyanide,and total phenols in Section 1 of Table B?
w ❑ Yes ❑ No
7.6 List the applicable primary industry categories and check the boxes indicating the required GC/MS fraction(s)identified
in Exhibit 2C-3.
Primary Industry Category Required GC/MS Fraction(s)
(Check applicable boxes.)
❑Volatile 0 Acid 0 Base/Neutral 0 Pesticide
❑Volatile 0 Acid 0 Base/Neutral 0 Pesticide
❑Volatile 0 Acid 0 Base/Neutral 0 Pesticide
EPA Form 3510-2C(Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
7.7 Have you checked"Testing Required"for all required pollutants in Sections 2 through 5 of Table B for each of the
GC/MS fractions checked in Item 7.6?
❑ Yes ❑ No
7.8 Have you checked"Believed Present"or"Believed Absent"for all pollutants listed in Sections 1 through 5 of Table B
where testing is not required?
El Yes ❑ No
7.9 Have you provided(1)quantitative data for those Section 1,Table B,pollutants for which you have indicated testing is
required or(2)quantitative data or other required information for those Section 1,Table B,pollutants that you have
indicated are"Believed Present"in your discharge?
0 Yes ❑ No
7.10 Does the applicant qualify for a small business exemption under the criteria specified in the instructions?
❑ Yes 4 Note that you qualify at the top of Table B, ❑ No
d then SKIP to Item 7.12.
c 7.11 Have you provided(1)quantitative data for those Sections 2 through 5,Table B,pollutants for which you have
c determined testing is required or(2)quantitative data or an explanation for those Sections 2 through 5,Table B,
pollutants you have indicated are`Believed Present"in your discharge?
en
Table ID No
Table C.Certain Conventional and Non-Conventional Pollutants
"T.')
7.12 Have you indicated whether pollutants are"Believed Present"or"Believed Absent"for all pollutants listed on Table C
to
for all outfalls?
U
❑r Yes ❑ No
7.13 Have you completed Table C by providing(1)quantitative data for those pollutants that are limited either directly or
indirectly in an ELG and/or(2)quantitative data or an explanation for those pollutants for which you have indicated
"Believed Present"?
❑ Yes ❑ No
F. Table D.Certain Hazardous Substances and Asbestos
7.14 Have you indicated whether pollutants are"Believed Present"or"Believed Absent"for all pollutants listed in Table D for
all outfalls?
El Yes ❑ No
7.15 Have you completed Table D by(1)describing the reasons the applicable pollutants are expected to be discharged
and(2)by providing quantitative data,if available?
O Yes ❑ No
Table E.2,3,7,8-Tetrachlorodibenzo-p-Dioxin(2,3,7,8-TCDD)
7.16 Does the facility use or manufacture one or more of the 2,3,7,8-TCDD congeners listed in the instructions,or do you
know or have reason to believe that TCDD is or may be present in the effluent?
❑ Yes 4 Complete Table E. El No 4 SKIP to Section 8.
7.17 Have you completed Table E by reporting qualitative data for TCDD?
El Yes El No
SECTION 8.USED OR MANUFACTURED TOXICS(40 CFR 122.21(g)(9))
8.1 Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
d an intermediate or final product or byproduct?
w ❑ Yes ❑ No 4 SKIP to Section 9.
8.2 List the pollutants below.
1. Total Phenol 4. 7.
L
2. Phenol 5. 8.
3. Toluene 6. 9.
EPA Form 3510-2C(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
SECTION 9.BIOLOGICAL TOXICITY TESTS(40 CFR 122.21(g)(11))
9.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made
within the last three years on(1)any of your discharges or(2)on a receiving water in relation to your discharge?
❑✓ Yes ❑ No 4 SKIP to Section 10.
CD
9.2 Identify the tests and their purposes below.
0 Test(s) Purpose of Test(s) Submitted to NPDES Date Submitted
o Permitting Authority?
Ceriodaphnia Chronic NPDES Criteria ✓❑ Yes ❑ No 02/28/2021
0
0 Ceriodaphnia Chronic NPDES Criteria
m ❑ Yes El No 11/28/2020
Ceriodaphnia Chronic NPDES Criteria ✓❑ Yes ❑ No 08/28/2020
SECTION 10.CONTRACT ANALYSES(40 CFR 122.21(g)(12))
10.1 Were any of the analyses reported in Section 7 performed by a contract laboratory or consulting firm?
El Yes ❑ No 4 SKIP to Section 11.
10.2 Provide information for each contract laboratory or consulting firm below.
Laboratory Number 1 Laboratory Number 2 Laboratory Number 3
Name of laboratory/firm Statesville Analytical Research and Analytical Pace Analytical
Laboratories Inc
CD
Laboratory address 122 Court Street 105 Short Street 9800 Kincey Avenue-Suite
= Statesville,NC 28677 Kernersville,NC 27254 100
Huntersville,NC 28078
c
Phone number
[phone] [phone] [phone]
Pollutant(s)analyzed See attached Sheet Ceriodaphnia Chronic Temp,pH,Chlorine,BOD,NH
3-N,TSS,Fecal C,P,Copper,
F,NO2/NO3,TKN,Se
SECTION 11.ADDITIONAL INFORMATION(40 CFR 122.21(g)(13))
11.1 Has the NPDES permitting authority requested additional information?
o ❑ Yes ❑ No 4 SKIP to Section 12.
11.2 List the information requested and attach it to this application.
1. 4.
0
2. 5.
3. 6.
EPA Form 3510-2C(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040 0004
SECTION 12.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
12.1 In Column 1 below,mark the sections of Form 2C that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note
that not all applicants are required to complete all sections or provide attachments.
Column 1 Column 2
✓❑ Section 1:Outfall Location 0 w/attachments
❑✓ Section 2:Line Drawing Elw/line drawing ❑ wl additional attachments
.171 Section 3:Average Flows and w/list of each user of
Treatment 0 w/attachments 2 privately owned treatment
works
El Section 4: Intermittent Flows ❑ wl attachments
❑ Section 5:Production El w/attachments
w/optional additional
ElSection 6: Improvements ❑ w/attachments ❑ sheets describing any
additional pollution control
plans
❑ w/request for a waiver and ❑ w/explanation for identical
supporting information outfalls
wl small business exemption w/other attachments
E ❑ request ❑
N ❑ Section 7: Effluent and Intake El w/Table A ❑
Characteristics wl Table B
0
." 2w/Table C 2w/Table D
d 0 wl Table E ❑ w/analytical results as an
o attachment
c ❑ Section 8:Used or Manufactured ❑ wl attachments
�, Toxics
0 ❑re Section 9: Biological Toxicity ❑ w/attachments
sw Tests
U
✓❑ Section 10:Contract Analyses 0 w/attachments
El Section 11:Additional Information ❑ wl attachments
❑ Section 12:Checklist and El wl attachments
Certification Statement
12.2 Certification Statement
/certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted.Based on my inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate,and complete. I am aware that there are significant penalties for submitting false information,including the
possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Kurt Christian Plant Manager
Signature _/ Date signed A rifv,
1(
/0/ 6/C),0 A (
EPA Form 3510-2C(Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE A.CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(iii))I
Effluent Intake
Waiver (Optional)
Pollutant Requested Units Maximum Maximum Long-Term
(if apt:
uestle) (specify) Daily Monthly Average Daily Number of Long-Term Number of
Discharge Discharge Discharge Analyses Average Value Analyses
(required) (if available) (if available)
❑ Check here if you have applied to your NPDES permitting authority for a waiver for all of the pollutants listed on this table for the noted outfall.
Biochemical oxygen demand Concentration mg/I 4 4 2.23 22
1' El(BOD5) Mass lbs/day <10 <10 ,6.12 22
Chemical oxygen demand Concentration mg/I 160 160 160 1
El
2. (COD) Mass lbs/day 445.6 445.6 445.6 1
Concentration mg/I 27.1 27.1 27.1 1
3. Total organic carbon(TOC) 0
Mass lbs/day 75.5 75.5 75.1 1
Concentration mg/I 25 25 4.63 20
4. Total suspended solids(TSS) ❑
Mass lbs/day <72 <72 <11.7 20
Concentration mg/I 3.3 2.1 <0.39 101
5. Ammonia(as N) ❑
Mass lbs/day 10.2 6.1 0.82 101
6. Flow ❑ Rate MGD 0.663 0.543 0.334 690
Temperature(winter) ❑ °C °C 23.8 23.2 17.8 48
7.
Temperature(summer) ❑ °C °C 29.3 28.0 24.8 48
pH(minimum) ❑ Standard units S.U. 6.54 6.54 6.54 100
6.
pH(maximum) ❑ Standard units S.U. 7.49 7.49 7.49 100
'Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or O.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 9

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant]Parameter Testing Units Long-Term _
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Value
(if available)
❑ Check here if you qualify as a small business per the instructions to Form 2C and,therefore,do not need to submit quantitative data for any of the organic toxic pollutants in Sections
2 through 5 of this table.Note,however,that you must still indicate in the appropriate column of this table if you believe any of the pollutants listed are present in your discharge.
Section 1.Toxic Metals,Cyanide,and Total Phenols
1.1 Antimony,total Concentration
(7440-36-0) Mass
Arsenic,total Concentration mg/I <0.005 <0.005 <0.005 1
1.2 '(7440-38-2) Mass lbs/day 0 0 0 1
1.3 Beryllium,total ❑ ❑ ❑ Concentration
(7440-41-7) Mass
Cadmium,total Concentration
1.4 (7440-43-9) Mass
Chromium,total Concentration mg/I <0.002 <0.002 <0.002 1
1.5 (7440-47-3) Mass lbs/day 0 0 0 1
1.6 Copper,total ❑ Concentration mg/I 0.0157 0.0157 <0.0085 22
(7440-50-8) Mass lbs/day 0.22 0.22 0.035 22
1.7 Lead,total Concentration mg/I <0.002 <0.002 <0.002 1(7439-92-1) Mass lbs/day 0 0 0 1
1.8 Mercury,total ❑ El ❑ Concentration
(7439-97-6) Mass
1 9 Nickel,total ❑ ❑ 0 Concentration mg/I 0.0051 0.0051 0.0051 1
(7440-02-0) Mass lbs/day 0.014 0.014 0.014 1
1.10 Selenium,total Concentration mg/I <0.010 <0.010 <0.010 22
(7782-49-2) ✓ Mass lbs/day 0 0 0 22
1.11 Silver,total Concentration
0 0
(7440-22 4) ✓ Mass
EPA Form 3510-2C(Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0OIM
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent
(optional)
Pollutant/Parameter Testing Units Long-Term
Long-
(and CAS Number,if available) Required Believed Believed Maximum Maximum q (specify) Daily Monthly Average Number Term Number
Present Absentof of
Discharge Discharge Daily
Analyses Average Analyses
(required) (if available) (if available) Value
1.12 Thallium,total Concentration
(7440-28-0) Mass
Zinc,total Concentration mg/I 0.018 riots 0.018 1
1.13 0 El El
(7440-66-6) Mass lbs/day 0.05 0.05 0.05 1
1.14 Cyanide,total Concentration
(57-12-5) ✓ Mass
Concentration mg/I <0.050 <0.050 <0.050 1
1.15 Phenols,total 0 El 0Mass lbs/day o 0 0 1
Section 2.Organic Toxic Pollutants(GC/MS Fraction Volatile Compounds)
Acrolein Concentration
2.1 El El El
(107-02-8) Mass
2.2 Acrylonitrile Concentration
El 0 El
(107-13-1) Mass
2.3 Benzene Concentration
El El El
(71-43-2) Mass
2.4 Bromoform Concentration
El 0 El
(75-25-2) Mass
Carbon tetrachloride El � ❑ Concentration
2.5 (56-23-5) Mass
Chlorobenzene Concentration
2.6 (108-90-7) Mass
Chlorodibromomethane Concentration
2.7 (124-48-1) Mass
2.8 Chloroethane Concentration
El CI 1 0
(75-00-3) I Mass
EPA Form 3510-2C(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long Number
Present Absent Daily Monthly Term
of of
Discharge Discharge Di Average
Analyses Average Analyses
(required) (if available) Value
(if available)
2.9 2-chloroethylvinyl ether ❑ ❑ ❑ Concentration
(110-75-8) Mass
Concentration
2.10 Chloroform(67-66-3) ❑ 0 ❑ Mass
2.11 Dichlorobromomethane El
o
(75-27-4) ✓ Mass
2.12 11-dichloroethane El ❑ Concentration
(75-34-3) Mass
2.13 12-dichloroethane El ❑ Concentration
(107-06-2) Mass '
2.14 11-dichloroethylene El 0
Concentration
(75-35-4) Mass
2.15 12-dichloropropane � � tEl
Concentration
(78-87-5) Mass
2.16 13-dichloropropylene ❑ ❑ Concentration
(542-75-6) Mass
2.17 Ethylbenzene ❑ 0 a Concentration
(100-41-4) Mass
2.18 Methyl bromide 0 Concentration
0(74-83-9) Mass
2.19 Methyl chloride Concentration
(74-87-3) Mass
2.20 Methylene chloride ❑ ❑ Concentration
(75-09-2) Mass
2.21 1,1,2,2-tetrachloroethane Concentration
(79-34-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number FacilityName Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) (if available) Value
2.22 Tetrachloroethylene ❑ Concentration
(127-18-4) Mass
Toluene Concentration mg/I <0.001 <0.001 <0.001 1
2.23 (108-88-3) Mass lbs/day 0 0 0 1
2.24 1,2-trans-dichloroethylene 0 ❑ ❑ Concentration
(156-60-5) Mass
2.25 1 1,1-trichloroethane � Concentration
(71-55-6) Mass
2 26 1,1 0 ❑ tEl
(79-00-5) Mass
2.27 Trichloroethylene ❑ ❑ Concentration
(79-01-6) Mass
2 28 Vinyl chloride ❑ Concentration
(75-01-4) Mass
Section 3.Organic Toxic Pollutants(GC/MS Fraction—Acid Compounds)
3.1 2-chlorophenol Concentration
(95-57-8) Mass
2 4-dichbrophenol Concentration
3.2 (120-83-2) Mass
2 4-dimethylphenol Concentration
3.3 1=1 El(105-67-9) Mass
3.4 4,6-dinitro-o-cresol 0 D Concentration
(534-52-1) Mass
3.5 2,4-dinitrophenol ❑ ❑ ❑ Concentration
(51-28-5) Mass
EPA Form 3510-2C Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term _
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long Number
Present Absent Daily Monthly Term
Daily of of
Discharge Discharge Discharge Analyses Average Analyses
(required) (it available) (if available) Value
2-nitrophenol Concentration
3.6 (88-75-5) r Mass
4-nitrophenol Concentration
3.7 (100-02-7) ❑ ❑ r
Mass 1
3.8 p-chloro-m-cresol ❑ Concentration 1
(59-50-7) Mass 1
3.9 Pentachlorophenol ❑ 0 Concentration
(87-86-5) Mass
3.10 Phenol Q Concentration mg/I <0.050 <0.050 <0.050 1
(108-95-2) Mass lbs/day 0 0 0 1
3.11 2,4,6-trichlorophenol Concentration
(88-05-2) Mass
Section 4.Organic Toxic Pollutants(GC/MS Fraction—Base/Neutral Compounds)
4.1 Acenaphthene Concentration
(83-32-9) Mass
4.2 Acenaphthylene ❑ ❑ Concentration
(208-96-8) r Mass
Anthracene Concentration
4.3 El El 0
(120-12-7) Mass
4.4 Benzidine Concentration
(92-87-5) Mass
4.5 Benzo(a)anthracene ❑ Concentration
El l=1(56-55-3) Mass
Benzo(a)pyrene r Concentration
4.6 (50-32-8) Mass
EPA Form 3510-2C(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040.0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence take
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Value
(if available)
4.7 3,4-benzofluoranthene Concentration
(205-99-2) ✓ Mass
4.8 Benzo(ghi)perylene Concentration
(191-24-2) Mass
Benzo(k)fluoranthene Concentration
4.9 El El El
(207-08-9) Mass
4.10 Bis(2-chloroethoxy)methane El 0 0Concentration
(111-91-1) Mass
4.11 Bis(2-chloroethyl)ether El o e Concentration
(111-44-4) Mass
4.12 Bis(2-chloroisopropyl)ether ❑ ❑ ❑� Concentration
(102-80-1) Mass
4.13 Bis(2-ethylhexyl)phthalate ❑ ❑ ❑� Concentration
(117-81-7) Mass
4.14 4-bromophenyl phenyl ether ❑ ❑ ❑ Concentration
(101-55-3) Mass
4.15 Butyl benzyl phthalate O Concentration
(85-68-7) Mass
4.16 2-chloronaphthalene ❑ ❑ ❑ Concentration
(91-58-7) Mass
4.17 4-chlorophenyl phenyl ether 0 0 ❑� Concentration
(7005-72-3) Mass
4.18 Chrysene Concentration
(218-01-9) Mass
4.19 Dibenzo(a,h)anthracene ❑ ❑ 0Concentration
(53-70-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Duffel)Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHBJOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v)),
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Term Number
Present Absent Daily Monthly Daily of of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Value
(if available)
4.20 1,2-dichlorobenzene ❑ 0 Concentration
(95-50-1) r Mass
4.21 1 3-dichlorobenzene El 0Concentration
(541-73-1) El Mass
4 22 14-dichlorobenzene ❑ Concentration
(106-46-7) r Mass
4.23 3,3-dichlorobenzidine ❑ 0 ❑ Concentration
(91-94-1) Mass
4.24 Diethyl phthalate � ❑✓ Concentration
(84-66-2) Mass
4.25 Dimethyl phthalate Concentration
(131-11-3) r Mass
4.26 Di-n-butyl phthalate Concentration
(84-74-2) Mass
4.27 2 4-dinitrotoluene ❑ Concentration
(121-14-2) r Mass
4.28 2,6-dinitrotoluene 0 ❑ ❑ Concentration
(606-20-2) Mass
4.29 Di-n-octyl phthalate El ❑ ❑r Concentration
(117-84-0) Mass
4.30 1,2-Diphenylhydrazine Concentration
El 0
(as azobenzene)(122-66-7) r Mass
4.31 Fluoranthene Concentration
0 El
(206 44-0) r Mass
4.32 Fluorene Concentration
0 El
(86-73-7) El Mass
EPA Form 3510-2C(Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHBJOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v)),
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Average
(required) (if available) Discharge Analyses Value Analyses
(if available)
4.33 Hexachlorobenzene Concentration
(118-74-1) ✓ Mass
4 Hexachlorobutadiene � 0 Concentration
(87-68-3) Mass
4.35 Hexachbrocyclopentadiene 0 Concentration
(77-47-4) Mass
4.36 Hexachloroethane ❑ 0 0Concentration
(67-72-1) Mass
4.37 Indeno(1,2,3-cd)pyrene ❑ ❑ ❑ Concentration
(193-39-5) Mass
4.38 Isophorone Concentration
El o(78-59-1) Mass
4.39 Naphthalene Concentration
(91-20-3) Mass
4.40 Nitrobenzene O Concentration
(98-95-3) Mass
4.41 N-nitrosodimethylamine ❑ Concentration
(62-75-9) Mass
4.42 N-nitrosodi-n-propylamine 0 0 Concentration
(621-64-7) Mass
4.43 N-nitrosodiphenylamine 0 El Q Concentration
gill -I-
(86-30-6) Mass
4 Phenanthrene Concentration
(85-01-8) Mass
Pyrene Concentration
4.45 0 ID(129-00-0) Mass
EPA Form 3510-2C(Revised 3-19) Page 18

EPA Identification Number NPDES Permit Number Facility Name DuffelNumber Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))r
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
aily of of
Discharge Discharge Disc Average
Anayses Average Analyses
(required) (if available) Value
(if available)
1,2,4-trichlorobenzene Concentration
4.46 (120-82-1) ❑ ❑ ❑ Mass
Section 5.Organic Toxic Pollutants(GC!MS Fraction—Pesticides)
51 Aldrin ❑ ❑ ❑ Concentration
(309-00-2) Mass
a-BHC Concentration
5.2 (319-84.6) ❑ 0 r
Mass
5.3 (3-BHC 0
0 Concentration
(319-85-7) Mass
y-BHC Concentration
5.4 (58-89-9) ❑ 0 ❑ Mass
b-BHC Concentration
5.5 (319-86-8) El 0 ❑ Mass
5.6 Chlordane ❑ 0 ❑ Concentration
(57-74-9) Mass
5.7 4 4'-DDT ❑ 0 ❑ Concentration
(50-29-3) Mass
4,4'-DDE El ❑ 0Concentration
5.8 (72-55-9) Mass
5.9 4 4'-DDD ❑ 0 ❑ Concentration
(72-54-8) Mass
5.10 Dieldrin Concentration
(60-57-1) Mass
5.11 a-endosulfan ❑ ❑ Concentration
(115-29-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105/19
' 110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))r
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (speci(y) Maximum Maximum Average Number Long-
Number
Term
Present Absent Daily Monthly Daily of of
Discharge Dfavalablle) Dscharge ischarge Analyses Average
Analyses
(required) (if available)
5.12 R-endosulfan ❑ 0
❑ Concentration
(115-29-7) Mass
5.13 Endosulfan sulfate ❑ ❑ ❑ Concentration
(1031-07-8) Mass
Endrin Concentration
5.14 (72-20-8) ❑ 0 CI
Mass
5.15 Endrin aldehyde ❑ ❑ ❑ Concentration
(7421-93-0) Mass
5.16 Heptachlor 0
❑ ❑ Concentration
(76-44-8) Mass
Heptachlor epoxide Concentration
5.17 (1024-57-3) ❑ 0 C Mass
PCB-1242 Concentration
5.18 (53469-21-9) ❑ 0 0 Mass
PCB-1254 Concentration
5.19 (11097-69-1) ❑ 0 ❑`'
Mass
PCB-1221 Concentration
5.20 (11104-28-2) 0 0 0 Mass
PCB-1232 Concentration
521 (11141-16-5) 0 0 0 Mass
PCB-1248 Concentration
5.22 (12672-29-0) ❑ 0 CI Mass
PCB-1260 Concentration
5.23 (11096-82-5) 0 El 0 Mass
PCB-1016 Concentration
5.24 (12674-11-2) 0 0 CI Mass
EPA Form 3510-2C(Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA 001 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long-
Number
Present Absent Daily Monthly Term
of of
Discharge Discharge DisDche�ge Analyses Average Analyses
(required) (if available) Value
(if available) _
Toxaphene Concentration
5.25 (8001-35-2) ❑ ❑ 0 Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 21

EPA Identification Number NPDES Pent Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))'
Presence or Absence Intake
(check one) Effluent (Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
(required) Discharge Discharge Analyses Value Analyses
(if available) (if available)
❑
Check here if you believe all pollutants on Table C to be present in your discharge from the noted outfall.You need not complete the"Presence or Absence"column of Table C for
each pollutant.
❑
Check here if you believe all pollutants on Table C to be absent in your discharge from the noted outfall.You need not complete the"Presence or Absence"column of Table C for
each pollutant.
1 Bromide 0 Concentration
(24959-67-9) ✓ Mass
Chlorine,total Concentration mg/I <0.025 <0.025 <0.025 46
2. residual 0CI Mass lbs/day 0 0 0 46
Concentration
3. Color 0 ❑� Mass
Concentration 8/100m1 7/100 7/100 1.5/100 23
4. Fecal coliform ❑'' Mass
5 Fluoride El 0 Concentration mg/I 1.7 1.7 0.78 23
(16984 48-8) Mass lbs/day 5.06 5.06 2.27 23
Concentration mg/I 15.4 11.75 2.91 100
6 Nitrate-nitrite ❑� Mass lbs/day 34.2 32.1 7.47 100
Nitrogen,total Concentration mg/I 3.2 1.86 1.77 21
7' CI 0
organic(as N) Mass lbs/day 12 8.64 3.23 21
Concentration mg/I <5 <5 <5 4
8. Oil and grease ❑r 0 Mass lbs/day o 0 0 4
9 Phosphorus(as Concentration mg/I 9.2 3.56 <0.74 101
El 0
P),total(7723-14-0) Mass lbs/day 16.7 7.0 1.69 101
10. Sulfate(as SO4) ❑� ❑ Concentration mg/I 32 32 32 1
(14808-79-8) Mass lbs/day 89.1 89.1 89.1 1
Concentration
11. Sulfide(as S) 0 ❑� Mass
EPA Form 3510-2C(Revised 3-19) Page 23

EPA Identficaton Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))i
Presence or Absence
(check one) Effluent Intake
(Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
(required) Discharge Discharge Analyses Value Analyses
(if available) (if available)
12. Sulfite(as S03) r Concentration
(14265-45-3) Mass
Concentration mg/I 0.14 0.14 0.14 1
13. Surfactants 0 0Mass Ibd/day 0.39 0.39 0.39 1
14. Aluminum,total ❑ 0 Concentration mg/I <0.005 <0.005 <0.005 1
(7429-90-5) Mass Ibs/day 0 0 0 1
15. Barium,total ❑ ❑ Concentration
(7440493) Mass
16. Boron,total r� 0 Concentration mg/I 0.355 0.355 0.355 1
(744042-8) Mass lbd/day 0.98 0.98 0.98 1
17. Cobalt,total ❑ r� Concentration
(7440484)
Mass
•
18. Iron,total ❑ 0 Concentration mg/I <0.050 <0.050 <0.050 1
(7439-9-6) Mass lbs/day 0 0 0 1
Magnesium,total r Concentration mg/I 4.47 4.47 4.47 1
19' (7439-954) Mass lbs/day 12.45 12.45 12.45 1
Molybdenum, Concentration
20. total 0 0 Mass
(7439-98-7)
Manganese,total r Concentration
21. (7439.965) Mass
22 Tin,total Concentration mg/I <0.025 <0.025 <0.025 1
(7440-31-5) r Mass lbs/day 0 0 0 1
23. Titanium,total 0 ❑ Concentration
(7440325)
Mass
EPA Form 3510-2C(Revised 3-19) Page 24

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence
(check one) Effluent Intake
(Optional)
Units
Pollutant Maximum Long-Term
Believed Believed (specify) Maximum Daily Monthly Average Daily Number of Long-Term Number of
Present Absent Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) (if available) Value
24. Radioactivity
Concentration
Alpha,total ❑ 0 Mass
Concentration
Beta,total ❑ 0 Mass
Concentration
Radium,total ❑ 0 Mass
Concentration
Radium 226,total ❑ 0 Mass
Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 25

EPA Identification Number NPDES Permit Number Facility Name Outlall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLED.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge (specify units)
Present Absent
1. Asbestos ❑ ❑r
2. Acetaldehyde ✓❑ 0 Byproduct of diesel combustion,possible binder use
3. Ally!alcohol ❑ ❑✓
4. ABA chloride 0 0
5. Amyl acetate ❑ ❑✓
6. Aniline ❑
7. Benzonitrile ❑ ❑r
8. Benzyl chloride ❑ ❑r
9. Butyl acetate 0 CI
10. Butylamine ❑ ❑r
11. Captan ❑ ❑r
12. Carbaryl 0 CI
13. Carbofuran ❑ El
14. Carbon disulfide ❑ ❑r
15. Chlorpyrifos 0 0
16. Coumaphos 0 0
17. Cresol ❑ 0
18. Crotonaldehyde ❑ ❑r
19. Cyclohexane 0 ❑✓
EPA Form 3510-2C(Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
20. 2,4-D(2,4-dichlorophenoxyacetic acid) 0 ❑r
21. Diazinon 0 ❑✓
22. Dicamba 0
23. Dichlobenil 0 ❑r
24. Dichlone ❑ ❑✓
25. 2,2-dichloropropionic acid ❑ El
26. Dichlorvos ❑ ❑
27. Diethyl amine ❑ ❑r
28. Dimethyl amine 0 ❑✓
29. Dintrobenzene ❑ El
30. Diquat ❑ ❑
31. Disulfoton ❑ ❑r
32. Diuron ❑ ❑r
33. Epichlorohydrin ❑ Q
34. Ethion 0 ❑r
35. Ethylene diamine ❑ 0
36. Ethylene dibromide ❑ 0
37. Formaldehyde ❑✓ ❑ Combustion byproduct,possible use as binder
38. Furfural ❑ ❑r
EPA Form 3510-2C(Revised 3-19) Page 28

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLED.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
39. Guthion ❑ ❑
40. Isoprene ❑ El
41. Isopropanolamine ❑ ❑✓
42. Kelthane ❑ 0
43. Kepone 0 ❑r
44. Malathion ❑ 0
45. Mercaptodimethur ❑ ❑r
46. Methoxychlor 0 ❑✓
47. Methyl mercaptan 0 ✓❑
48. Methyl methacrylate 0 El
49. Methyl parathion 0 ❑✓
50. Mevinphos ❑ ❑r
51. Mexacarbate 0 ❑r
52. Monoethyl amine 0 ❑r
53. Monomethyl amine 0 ❑✓
54. Naled 0 0
55. Naphthenic acid 0 ❑✓
56. Nitrotoluene 0 El
57. Parathion 0 ❑✓
EPA Form 3510-2C(Revised 3-19) Page 29

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))l
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
58. Phenolsulfonate ❑ ❑✓
59. Phosgene 0 ❑r
60. Propargite ❑ ❑o
61. Propylene oxide ❑✓ ❑ Possible use as binder
62. Pyrethrins ❑ ❑r
63. Quinoline ❑ ❑r
64. Resorcinol 0 ❑r
65. Strontium ❑ El
66. Strychnine ❑ ❑r
67. Styrene ❑ ❑r
68. 2,4 5-T(2,4,5-trichlorophenoxyacetic ❑ 0
acid)
69. TDE(tetrachlorodiphenyl ethane) ❑ 0
70 2,4,5-TP[2-(2,4,5-trichlorophenoxy) 0 ❑
propanoic acid]
71. Trichlorofon ❑ ❑r
72. Triethanolamine ❑ ❑r
73. Triethylamine ❑ El
74. Trimethylamine ❑ 8
75. Uranium ❑ 0
76. Vanadium ❑ E
EPA Fonn 3510-2C(Revised 3-19) Page 30

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLED.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
77. Vinyl acetate ✓❑ ❑ Possible use as binder
78. Xylene ❑ ❑r
79. Xylenol ❑ ❑r
80. Zirconium 0 ❑r
I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 31

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Fadlityty Name Outfall Number Form Approved 03/05/19
110000346082 NC0004626 ELECTRIC GLASS FIBER AMERICA OMB No.2040-0004
TABLE E.2,3,7,8 TETRACHLORODIBENZO P DIOXIN(2,3,7,8 TCDD)(40 CFR 122.21(g)(7)(viii))
TCDD Presence or
Congeners Absence
Pollutant Used or (check one) Results of Screening Procedure
Manufactured Believed Believed
Present Absent
2,3,7,8-TCDD ❑ � ❑�
EPA Form 3510-2C(Revised 3-19) 'zge 33

Linwood
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SITE \
Jar /,;
LOCAONOUTFALLOO1 4. ER R, W
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FOXCROET OR.
\
UEpEEy CHURCH AD
ry" "-N,`
p /
s
! _ // / / j ` "en
{
REFERENCE:
IS MAPS TAKEN FROM AL GEOGRAPHIC USGS TOPOGRAPHIC N
MAP OF SOUTHMONT,NORTHTH CA CAROLINA,DATED 2019.
p 6 F'C C SITE LOCATION MAP DM00 I-=2000 .R.S.
! JJ ELECTRIC GLASS FIBER AMERICA, LLCp�
I l 473 NEW JERSEY CHURCH ROAD FORM 2C SECTION 1 eA�AFRIL 2021 I 2000 1000 0 2000 4000 ti LEXINGTON, NORTH CAROLINA 27293 EPA IOp ito C 0 04626 PROJECT x-3AWR DRAWING no.
NPoes NC 0004szs 259-38 FIGURE 1

CAUaan\Rwtn\n55 ENVIRONMENTAL 503911ON5,INC\Matt Pas-P an.a\CAO Piss\259\259-32\2593ep04.g Keatn 10/12/21 -9.34 P
0.02 MGD I 0.02 MGD NOTE:
-JI BOILER FEED BASED ON AVERAGES FROM JANUARY 2018
THROUGH AUGUST 2021.
AMERICAN
CHILDRENS
HOME
0.32 MGD I PROCESS 0.31 MGD
L WATER
0.004 MGD
0.57 MGD EVAPORATION o.08 MGD '
CITY OF _ 0.48 MGD _ WASTEWATER 0.48 MGD + STORMWATER
LEXINGTON i TREATMENT
-i PLANT DISCHARGE
0.20 MGD 0.12 MGD STORM WATERed
0.093 MGD
NON CONTACT MAX.
COOLING
0.004 MGD
SLUDGE
0.03 MGD I 0.03 MGD
SANITARY
• F I SS ELECTRIC GLASS FIBER AMERICA, LLC FORM 2c.2.1 SCALE N.T.S. DRAWN BY:K.S.FLOW DIAGRAM DATE APRIL 2021 APPROVED BY
— ENVIRONMENTAL LEXINGTON, NORTH CAROLINA EPA ID# 110 000 346082 PROJECT NUMBER DRAWING NO.
1251 Pineville-Malt11ew5 Rd
5oae'°° NPDES #: NC 0004626 259-38 FIGURE 2
Charlotte N 2R225

CHEMICAL CHLORINE
BAR EQUALIZATION ADDITION PRIMARY ACTIVATED SLUDGE SECONDARY
HYDRASIEVE SCREEN TANKS REACTOR CLARIFICATION AERATION BASINS CLARIFICATION CONTACT
3 TANKS TANKS CIA-45 FT. OLD.DIA.-31 FT. TANK
TOTAL VOL= SWU=16.7 FT. OLD NEW NEW:DIA=50 FT. VOL-10,220 GAL
91,750 GAL VOL= VOL= VOL.=0.275 MG VOL=0.432 GAL
28,775 GAL 28,775 GAL. (BLOWER AIR-2675 SCFM)
WET 1FERRIC I INUIRIENT� I CHLORINE)—
WELL AGO
OWE 1\CNLCRINE ADDITON DI IX1 ADDI110N
Q 0
PROCESy // J L I J I✓ I DISCHARGE
WASTE ��/U/— '�^ I 1 1 - . �Ery I ROCK HIGH
BISULFITE ANAL pH
EFFLUENT ADJUSTMENT
1„„„ W // OECHLORINAl10N
PPG AND AMERICAN X �L1`_[I/I/I�Y\I�IyIJY BLOWER BLOWER
CHILDREN'$HOME // a
SANITARY WASTE /
///
COMMINUTOR F_ ^
L_ _
6
.
-.IL._
F.
POLYMER
FEED
L • ,(0 .,
g STABILIZATION
A DECANT/THICKENER \ / E
00 s
5
BELT FILTER HAULTO
PRESS LANDFILL
i LEGEND
7 WASTEWATER FORM 2c.3.1 5001E N.T.S. a'^"e;K.S.
——_— F SS ELECTRIC GLASS FIBER AMERICA, LLC. PROCESS
TREATMENT p^TE APRIL 2021 P^ D
SLUDGE M .«YIR««HF«.^ LEXINGTON, NORTH CAROLINA PROCESS FLOW SCHEMATIC PNUMBER
R»1 nmI D05: EPA IOIT 110 C 0 346062
aIIninw NC26105 NPDES t NC 0004626 �259 38 D FIGURE 3

SECTION 10.2 POLLUTANTS ANALYZED-STATESVILLE ANALYTICAL
EPA ID# 110000346082
NC 0004626
BOD, COD,TOC, TSS, pH,Temp.
AMMONIA
ARSENIC
CHROMIUM
COPPER
LEAD
NICKEL
SELENIUM
ZINC
TOTAL PHENOLS
CHLORINE
FECAL COLIFORM
FLUORIDE
NITRATE-NITRITE
ORGANIC N
OIL AND GREASE
PHOSPHORUS
SULFATE
SURFGACTANTS
ALUMINUM
BORON
IRON
MAGNESIUM
TIN

SECTION 3.3 USERS OF TREATMENT PLANT EPA ID# 110000346082
NPDES#NC0004626
1. ELECTRIC GLASS FIBER AMERICA, LLC
2. AMERICAN CHILDERN'S HOME

SECTION 3.1 OUTFALL 001 EPA ID# 110000346082
NPDES# NC0004626
OPERATION AVERAGE FLOW
Fiberglass Manufacturing 0.31 MGD
Boiler Feed 0.02 MGD
Stormwater 0.093 MGD (max)
American Children's Home 0.004 MGD
Non-Contact Cooling 0.120 MGD
Plant Sanitary 0.03 MGD