NCG030246_Representative Outfall Status Renewal_20210811

FOR AGENCY USE ONLY
NC
ARO FRO MRO RRO WARD WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
Representative Outfall Status (ROS) Renewal Certification Form
Please complete this form if you want to maintain current ROS designations.
Directions: Print or type all entries on this certification form. Attach this form and a copy of the original ROS
approval documentation to the Stormwater Upload Form.
North Carolina General Statute 143-215.613 (i) provides that: Any person who knowingly makes any false
statement, representation, or certification in any application, record, report, plan, or other document filed or
required to be maintained under this Article or a rule implementing this Article ... shall be guilty of a Class 2
misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
I, as an authorized representative, request renewal of the ROS designations currently granted to the subject
facility.
21 No site or activity modifications that impact the characteristics of stormwater discharges from the
representative outfalls have occurred at the subject facility.
I am familiar with the information contained in this request and to the best of my knowledge and belief such
information is true, complete, and accurate.
Facilitv Name: Hickory Manufacturing and Technology Center
Permit Number: NCG030246
Printed Name of Person Signing: Ahmed K011akh
Title: Rant Manager
(Signature of Permittee) (Date Signed)
DE
Qrpartment of Envwfonmental Quality

Georgoulias, Bethany
From: Street, Steve L. <[e-mail]>
Sent: Tuesday, April 5, 2022 11:13 AM
To: Georgoulias, Bethany
Subject: RE: [EXTERNAL] --RE: ROS Renewal Upload for Stormwater Permit NCG030246
Attachments: NCDEQ_ROS_Renewal_Certification 04052022.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
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Hello Bethany,
I apologize for the delay, the revised copy is attached.
Regards,
Steve Street
Sr. EHS Coordinator
Laser Safety Officer (LSO)
Radiation Safety Officer (RSO)
Hickory Manufacturing and Technology Center
(o) 828-901-6695
(c) 828-244-3921
From: Georgoulias, Bethany <[e-mail]>
Sent: Tuesday, April 5, 2022 10:58 AM
To: Street, Steve L. <[e-mail]>
Subject: [EXTERNAL] --RE: ROS Renewal Upload for Stormwater Permit NCG030246
Hi,
I am just checking in about this again. Do you have a revised copy of this form?
From: Georgoulias, Bethany
Sent: Friday, April 1, 2022 5:50 PM
To: [e-mail]
Subject: ROS Renewal Upload for Stormwater Permit NCG030246
Good afternoon,
We are working through ROS documents uploaded last year, and we noticed this certification form was not
completed. Only one of the boxes is checked. Can you please send a revised copy?
Thank you,
Bethany Georgoulias (she/her)
Environmental Engineer

Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
E�
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North Carolina Public Records Law and may be disclosed to third parties
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.

Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
August 18, 2017
Corning Incorporated
Hickory Manufacturing and Technical Center
Attention: Steve Street
Post Office Box 489
Hickory, North Carolina 28603
Dear Mr. Street:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
TRACY E. DAVIS
Director
Subject: NPDES Stormwater Permit
Stormwater Certificate of Coverage No. NCG030246
Representative Outfall Status Request
Catawba County
The Mooresville Regional Office staff have reviewed your 2017 request for a determination that stormwater
discharge outfall (SDO) 003 be granted representative outfall status for stormwater outfalls 001 and 002. Based
on the information provided and a June 27, 2017 site inspection, we are approving this request. In accordance
with 40 CFR § 122.21(g)(7), you are authorized to sample outfalls number 003 and 005 as representative for the
entire site, .This approval is effective with the next sampling event.
Please append this letter to your Stormwater Pollution Prevention Plan (SPPP) or permit to document that
representative outfall status has been approved. I1' changes in drainage areas, structures, processes, storage
practices, or other activities occur that significantly alter the basis of this approval, representative outfall status
may no longer be valid. You should either resume sampling at all SDOs, or reapply to this office for
representative outfall status based on updated information. If you have any questions or comments concerning
this letter, please contact our Office at [phone].
Sincerely,
3r-�A- -S V--
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
ZSK/cys
cc: Bethany Georgoulias, Stormwater Permitting Program, NCG030246
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
Mooresville Regional Office 1 610 East Center Ave Ste 301 1 Mooresville, NC 28115
704 663 1699 T