NC0000311_Renewal (Application)_20220502

ROY COOPER �f)1 4 1-_;,`�
Governor %' G
ELIZABETH S.BISER QuA6• %"
Secretary "�nrt%`
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
May 02, 2022
M-B Industries, Inc.
Attn: Edwin Morrow, President
PO Box 1118
Rosman, NC 28772-1118
Subject: Permit Renewal
Application No. NC0000311
M-B Industries WWTP
Transylvania County
Dear Applicant:
The Water Quality Permitting Section acknowledges the May 2, 2022 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.
is on and sufficient application for renewal of the current permit.The
Continuation of the current permittimely pp
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/perm it-guidance/environmental-appl ication-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 V
p
3ri
Wren T edford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
D_E Q`A North
vi CarolleRegionallina DepartmentOffice12090 of Environm
US.Higentalhway Qu70alityISwannanoa.North I Division of WaterCa rolina Resources
28778
' 828 296 4500

CMM M - B INDUSTRIES, INC.
B) SERVING INDUSTRY SINCE 1894
9205 ROSMAN HWY., P.O.BOX 1118,ROSMAN,NC 28772RECEIVED
PHONE[phone], FAX[phone]
01 0 2 2022
NCDEQ/DWR/NPDES
April 27, 2022
NCDENR
Division of Water Resources -
WQ Permitting Section—NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Attn: Douglas Dowden
Subject: NPDES Permit Renewal Application for M-B Industries, Inc.
Permit# NC0000311
Doug,
Please find attached NPDES Permit Renewal Application for M-B Industries, Inc., waiver request, process
flow chart, and description of process for our WWTP. I hope you find this application complete and may
it serve its purpose well.
Best regards,
a -- /�/L64.-c-
Edwin Morrow
President
MITCHELL-BISSELL CO.DIVISION SUNBELT SPRING&STAMPING CORP.DIVISION
[phone] [phone]

1
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD055167324 NC0000311 M-B Industries,Inc. OMB No.2040-0004
U.S.Environmental Protection Agency
Form ���_ 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
1.1.1 Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
treatment works? 1.1.2 treating domestic sewage?
If yes. STOP. Do NOT complete ❑✓ No If yes, STOP. Do NOT ❑✓ 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,
1= operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a. production facility? currently discharging process wastewater?
o ❑ Yes 4 Complete Form 1 0 No 0 Yes 4 Complete Form ElNo
a and Form 2B. 1 and Form 2C.
R1.2.3 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
•7- commenced to discharge? discharges only nonprocess wastewater?
Yes-4 Complete Form 1 0 No El Yes 4 Complete Form 0No
a)
ix and Form 2D. 1 and Form 2E.
-S. 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 RECEIVED
discharge is composed of both stormwater and
non-stormwater? MAY '0 2 2022
❑ Yes 4 Complete Form 1 0 No
and Form 2F
unless exempted by NCDEOJDWRINPDES
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
M-B Industries,Inc.
0 2.2 EPA Identification Number
R
0 NCD055167324
J
v
MI 2.3 Facility Contact
d Name(first and last) Title Phone number
-0 Edwin Morrow President/Owner [phone]
Q
rn Email address
c
[e-mail]
2
CC 2.4 Facility Mailing Address
as Street or P.O. box
z
PO Box 1118
City or town State ZIP code
Rosman North Carolina 28772
EPA Form 3510-1(revised 3-19) Page 1

I
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD055167324 NC0000311 M-B Industries,Inc. OMB No.2040 0004
1g 2.5 Facility Location
28 r Street,route number,or other specific identifier
< o 9205 Rosman Hwy
0
o County name County code(if known)
Transylvania
0
E -0 City or town State ZIP code
R Rosman North Carolina 28772
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
3469
to
w
a
0
U
v)
3.2 NAICS Code(s) Description(optional)
-a
332119
U
co
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
Conrad Stafford
0 4.2 Is the name you listed in Item 4.1 also the owner?
y
0 ❑ Yes ❑✓ No
4.3 Operator Status
❑ Public—federal 0 Public—state ❑ Other public(specify)
o ❑✓ Private 0 Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
Street or P.O. Box
a�i PO Box 634
o
c w City or town State ZIP code
0 0 Rosman NC 28772
To U
n Email address of operator
O [e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
o 5.1 Is the facility located on Indian Land?
as c
-� ❑ Yes ❑✓ No
EPA Form 3510-1(revised 3-19) Page 2

r
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD055167324 NC0000311 M-B Industries,Inc. 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 m NPDES(discharges to surface m RCRA(hazardous wastes) ❑ UIC(underground injection of
o water) fluids)
L .�
►L a ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CM)
w 0 Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
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
specific requirements.)
❑✓ 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.
Metal Stampings,wire forms,and assemblies of such.Clear and Yellow Zinc plating,Hard Chrome plating,Matte Tin
plating,Burnishing,and Black Oxide finishing.
7)
C)
U)
m
O
C)
w0
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
❑✓ Yes ❑ No-'SKIP to Item 10.1.
3 P. 9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
a)w 40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
c NPDES permitting authority to determine what specific information needs to be submitted and when.)
. a,
r. .' Cooling water is pumped from Ground water.
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.)
a ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
d
Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
❑✓ Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD055167324 NC0000311 M-B Industries,Inc. 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
❑✓ Section 1:Activities Requiring an NPDES Permit ❑ w/attachments
❑✓ Section 2: Name, Mailing Address,and Location ❑ w/attachments
❑✓ Section 3: SIC Codes ❑ w/attachments
❑✓ Section 4:Operator Information ❑ w/attachments
❑✓ Section 5: Indian Land ❑ w/attachments
❑✓ Section 6:Existing Environmental Permits ❑ wl attachments
wl topographic
❑✓ Section 7:Map ❑✓ map ❑ w/additional attachments
cn
o ❑✓ Section 8:Nature of Business ❑ w/attachments
CO
❑✓ Section 9:Cooling Water Intake Structures ❑ w/attachments
0 Section 10:Variance Requests ❑ w/attachments
as
❑✓ Section 11: Checklist and Certification Statement ❑ w/attachments
Y
11.2 Certification Statement
U
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
Edwin Morrow President/Owner
Signature Date signed
A d�
1 T /14, ,e, 04/27/2022
EPA Form 3510-1(revised 3-19) Page 4

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LEGEND: NOTES:
0
U.S.Geological Survey Topographic Map-
n Property Boundary Rosman Quadrangle 1945(Revised 1990)
Eastatoe Gap Quadrangle 1946(Revised 1969)
0 2,000
fad 1
Feet
Publish Date:2021/12/06,12:28 PM I User:cpatterson
Filepath:Q:Vobs\MB_Industries_1486\Maps\2021\Figurel SiteLocationMap.mxd
}.ANCHOR Figure 1
' ,QEA Site Location Map
Anchor QEA of North Carolina,PLLC
2021 Groundwater Monitoring Report
M-B Industries,Inc.

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD05516324 NC0000311 M-B Industries,Inc. OMB No.2040-0004
Form U.S.Environmental Protection Agency
2C \r.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.
c Numbelr Receiving Water Name Latitude Longitude
0
3
J 001 West Fork French Broad 82° 50' 56" N 35° 8' 21" W
w
002 West Fork French Broad 82° 50' 56" N 35° 8' 21" W
O
003 West Fork French Broad 82° 50' 56" N 35° 8' 21 W
SECTION 2. LINE DRAWING(40 CFR 122.21(g)(2))
a, 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
.3 balance?(See instructions for drawing requirements. See Exhibit 2C-1 at end of instructions for example.)
❑✓ 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
Effluent results form Burnishing,Chrome Plating,Zinc .017 mgd
c
Plating,Tin Plating,and Black Oxide Finishing mgd
m
mgd
h mgd
Treatment Units
Description Code from Final Disposal of Solid or
4,3
(include size,flow rate through each treatment unit, Table 2C 1 Liquid Wastes Other Than
retention time,etc.) by Discharge
See Attachments A 1G,1U,11,
1V,2D,4A
5M,5R
EPA Form 3510-20(Revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD05516324 NC0000311 M-B Industries,Inc. OMB No.2040-0004
3.1 **Outfall Number** 002
cont. Operations Contributing to Flow
Operation Average Flow
Non Contact Cooling Water .0003 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
No Treatment 4A
c
0
U
E
is
m
1-
**Outfall Number**
h Operations Contributing to Flow
0 Operation Average Flow
Ground Water Remediation .04 mgd
m
' 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
Water pumped from ground and processed through 1Q,4A
air stripper and discharge to West Fork of French Broad
3.2 Are you applying for an NPDES permit to operate a privately owned treatment works?
E 12 ❑ Yes ❑✓ No-+ SKIP to Section 4.
N= 3.3 Have you attached a list that identifies each user of the treatment works?
❑ Yes ❑✓ No
EPA Form 3510-2C(Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD05516324 NC0000311 M-B Industries,Inc. OMB No.2040-0004
SECTION 4.INT RMITTENT 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 0 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
DayslWeek Months/Year Average Daily
days/week months/year mgd mgd days
days/week months/year mgd g mgd 9 days
c 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
days/week months/year mgd mgd days
SECTION 5. PRODUCTION i►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?
❑ Yes ❑✓ No 4 SKIP to Section 6.
5.2 Provide the following information on applicable ELGs.
ELG Category ELG Subcategory Regulatory Citation
R
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
o 5.4 Provide an actual measure of daily production expressed in terms and units of applicable ELGs.
Outfall Operation,Product,or Material Quantity per Day Unit of
-0 Number Measure
N
m
0
w.
O
L
Q_
EPA Form 3510-2C(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD05516324 NC0000311 M-B Industries,Inc. 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?
0 Yes ❑✓ No 4 SKIP to Item 6.3.
6.2 Briefly identify each applicable project in the table below.
Affected Final Compliance Dates
Brief Identification and Description of Outfalls Source(s)of
o Project (list outfall Discharge Required Projected
number)
d
a
a.
n.
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 0 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 001 Outfall Number 002 Outfall Number 003
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?
°' No;a waiver has been requested from my NPDES
❑ Yes ❑✓ permitting authority for all pollutants at all outfalls.
v Table B.Toxic Metals,Cyanide,Total Phenols,and Organic Toxic Pollutants
Y 7.4 Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
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?
❑✓ 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.
PrimaryRequired GC/MS Fraction(s)
Industry Category
(Check applicable boxes.)
Copper&Steel Manufacturing ❑Volatile ❑Acid 0 Base/Neutral 0 Pesticide
❑Volatile 0 Acid 0 Base/Neutral ❑ Pesticide
0 Volatile ❑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
OMB No.2040-0004
NCD05516324 NC0000311 M-B Industries,Inc.
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?
O Yes 0 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?
❑ Yes 0 No
7.10 Does the applicant qualify for a small business exemption under the criteria specified in the instructions?
❑ Yes-* Note that you qualify at the top of Table B, ❑ No
then SKIP to Item 7.12.
= 7.11 Have you provided(1)quantitative data for those Sections 2 through 5,Table B,pollutants for which you have
o 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?
❑ Yes ❑✓ No
N
a; Table C.Certain Conventional and Non-Conventional Pollutants
7.12 Have you indicated whether pollutants are"Believed Present"or"Believed Absent"for all pollutants listed on Table C
-c for all outfalls?
❑✓ Yes ❑ No
c 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
Li 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?
❑ 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?
❑ 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. ❑✓ No 4 SKIP to Section 8.
7.17 Have you completed Table E by reporting qualitative data for TCDD?
❑ Yes ✓❑ 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
an intermediate or final product or byproduct?
❑✓ Yes ❑ No 4 SKIP to Section 9.
U
8.2 List the pollutants below.
0 1. Zinc 4. 7.
- 2. 5. 8.
3. 6. 9.
EPA Form 3510-2C(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD05516324 NC0000311 M-B Industries,Inc. 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.
9.2 Identify the tests and their purposes below.
Test(s) Purpose of Test(s) Submitted to NPDES Date Submitted
X Permitting Authority?
0
R ❑ Yes ❑ No
O
❑ Yes ❑ No
❑ Yes ❑ No
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?
0 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
y, Laboratory address
0
0
c
0i Phone number
Pollutant(s)analyzed
SECTION 11.ADDITIONAL INFORMATION(40 CFR 122.21(g)(13)) 1
11.1 Has the NPDES permitting authority requested additional information?
❑ Yes ❑✓ No 4 SKIP to Section 12.
0
11.2 List the information requested and attach it to this application.
`0
1. 4.
a 2. 5.
-0
3. 6.
EPA Form 3510-2C(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 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 ❑ w/attachments
❑✓ Section 2:Line Drawing ✓❑ w/line drawing ❑ w/additional attachments
rm Section 3:Average Flows and w/list of each user of
12-1 Treatment ✓❑ w/attachments ❑ privately owned treatment
works
❑� Section 4: Intermittent Flows ❑ wl attachments
Ej Section 5:Production ❑ w/attachments
w/optional additional
0 Section 6: Improvements ❑ w/attachments ❑ sheets describing any
additional pollution control
plans
❑ wl request for a waiver and ❑ w/explanation for identical
supporting information outfalls
d w/small business exemption wl other attachments
❑ request ❑
in ❑ Section 7: Effluent and Intake ❑ w/Table A ❑ w/Table B
Characteristics
0
❑ w/Table C ❑ wl Table D
4-4
w/analytical results as an
U ❑ w/Table E ❑ attachment
❑✓ Section 8: Used or Manufactured ❑ w/attachments
Toxics
❑ Section 9: Biological Toxicity ❑ w/attachments
Tests
U
❑✓ Section 10: Contract Analyses ❑ w/attachments
❑✓ Section 11:Additional Information ❑ w/attachments
❑ Section 12: Checklist and ❑ w/attachments
Certification Statement
12.2 Certification Statement
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
Edwin Morrow President/Owner
Signature Date signed
7elee,4", fr/(e0(4-'
04/27/2022
EPA Form 3510-2C(Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE A.CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(iii))1
Effluent Intake
(Optional)
Waiver Units Maximum Maximum Long-Term
Pollutant Requested (specify) Daily Monthly Average Daily Number of Long-Term Number of
(if applicable) 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
1 (BOD5) ❑ Mass
Chemical oxygen demand Concentration
2. (COD) ❑ Mass
Concentration
3. Total organic carbon(TOC) ❑
Mass
Concentration
4. Total suspended solids(TSS) ❑
Mass
Concentration
5. Ammonia(as N) ❑
Mass
6. Flow ❑ Rate
Temperature(winter) ❑ °C °C
7.
Temperature(summer) ❑ °C °C
pH(minimum) 0 Standard units s.u.
8.
pH(maximum) ❑ Standard units s.u.
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 9

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,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 Long-
; Maximum g-
(and CAS Number,if available) Required Believed Believed (specify) Average Number Number
4 Present Absent Daily Monthly Daily of Term of
Discharge� Dd) rfavalabk) De ischarge Analyses Average
Analyses
(if available)
❑
Check here if you qualify as a small business per the instructions to Form 2C and,therefore,do not need to submit quantitative data for any of the organic toxic pollutants in Sections
2 through 5 of this table.Note,however,that you must still indicate in the appropriate column of this table if you believe any of the pollutants listed are present in your discharge.
Section 1.Toxic Metals,Cyanide,and Total Phenols
1.1 Antimony,total Concentration
(7440-36-0) Mass
Arsenic,total Concentration
1.2 (7440-38-2) Mass
1.3 Beryllium,total Concentration
(7440-41-7) Mass
Cadmium,total Concentration
1.4 (7440-43-9) Mass
1.5 Chromium,total Concentration
(7440-47-3) Mass
Copper,total Concentration
1.6 (7440-50-8) Mass
1.7 Lead,total •Concentration
(7439-92-1) Mass
Mercury,total Concentration
1.8 (7439-97-6) Mass
1.9 Nickel,total Concentration
0(7440-02-0) Mass
1.10 Selenium,total Concentration
(7782-49-2) Mass
1.11 Silver,total Concentration
(7440-22-4) Mass
EPA Form 3510-2C(Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Duffel!Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS.AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))t
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term -Lon9
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Number
Present Absent Daily Monthly Term
Daily of of
Discharge Discharge Average
(required) (if available) Discharge Analyses Value Analyses
(d available)
1.12 Thallium,total El ❑ ❑ Concentration
(7440-28-0) Mass
1.13 Zinc,total El ❑ ❑ Concentration
(7440-66-6) Mass
1.14 Cyanide,total ❑ 0 ❑ Concentration
(57-12-5) Mass
Concentration
1.15 Phenols,total 0 ❑ © Mass
Section 2.Organic Toxic Pollutants(GC/MS Fraction—Volatile Compounds)
Acrolein Concentration
El El 1:1
2.1
(107-02-8) Mass
2.2 Acrylonitrile 12 ❑ © Concentration
(107-13-1) Mass
Benzene Concentration
2.3 (71-43-2) ❑ ❑ ❑ Mass
Bromoform El ❑ ❑ Concentration
2.4 (75-25-2)
Mass
2.5 Carbon tetrachloride ❑ ❑ ❑ Concentration
(56-23-5) Mass
2.6 Chlorobenzene ❑ El Q Concentration
(108-90-7) Mass
2.7 Chlorodibromomethane ❑ El ElConcentration
(124-48-1) Mass
2.8 Chloroethane ❑ 0
❑ Concentration
(75-00-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,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 (spey) Maximum Maximum Avera a Number Long- Number
Present Absent Daily Monthly Daily of Tee of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) (if available) Value
2-chloroethylvinyl ether Concentration
2.9 (110-75-8) ❑ 0 Mass
2.10 Chloroform(67-66-3) El 2Concentration
Mass
2.11 Dichlorobromomethane El ❑ El
(75-27-4) Mass
212 1,1-dichloroethane El El ❑ Concentration
(75-34-3) Mass
2.13 1,2-dichloroethane El Concentration
(107-06-2) Mass
2.14 1,1-dichloroethylene ❑ 0 ❑ Concentration
(75-35-4) Mass
2.15 1 2-dichloropropane ❑ 0 ❑ Concentration
(78-87-5) Mass
2 16 1 3-dichloropropylene ❑ ❑ Concentration
(542-75-6) Mass
217 Ethylbenzene El ❑ ❑ Concentration
(100-41-4) Mass
218 Methyl bromide ❑ 0 ❑ Concentration
(74-83-9) Mass
219 Methyl chloride El ❑ ❑ Concentration
(74-87-3) Mass
2.20 Methylene chloride 0 ❑ ❑ Concentration
(75-09-2) Mass
2.21 1,1,2 2-tetrachloroethane ❑ 0 ❑ Concentration
(79-34-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 13

EPA Identification Number NPDES Penrrt Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-8 Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORG4NIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))r
1 Presence or Absence
(check one) Effluent Intake
(optional)
PollutantIParameter 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) Disc[rfavailharg
able)e Analyses Value Analyses
2.22 Tetrachloroethylene E3 o Concentration
(127-18-4) Mass
Toluene Concentration
2.23 (108-88-3) Mass
2.24 1 2-trans-dichioroethylene ❑ El 0Concentration
(156-60-5) Mass
2.25 11,1-trichloroethane 0 ❑ Concentration
(71-55-6) Mass
2.26 1 1,2-trichloroethane 0 0 Concentration
(79-00.5) Mass
2.27 Trichloroethylene 0 0 ElConcentration
(79-01-6) Mass
2.28 Vinyl chloride Concentration
(75-01-4) Mass
Section 3.Organic Toxic Pollutants(GCIMS Fraction—Acid Compounds)
3.1 2-chlorophenol Concentration
(95-57-8) Mass
3.2 2,4-dichlorophenol El El © Concentration
(120-83-2) Mass
3.3 2,4-dimethylphenol 0 ❑ ElConcentration
(105-67-9) Mass
3.4 4,6-dinitro-o-cresol El ❑ © Concentration
(534-52-1) Mass
2,4-dinitrophenol Concentration
3.5 (51-28-5) 0 0 ( Mass
EPA Form 3510-2C(Revised 319) Page 14

EPA Identification Number —I NPDES Pennit Number Facility Name OuIfall Number Form Approved 03105119
NCD05516324 NC000031 M-8 Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(9)(7)(v)),
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term -Lon
Maximum Maximum Long
-
(and CAS Number,if available) Required Believed Believed (specify) Daily Monthly Average Number Term Number
Present Absent Daily of of
Discharge Discharge Average
(required) (if available) Discharge Analyses Value Analyses
(if available)
3.6 2-nitrophenol ❑ 0
❑ Concentration
(88-75-5) Mass
4-nitrophenol Concentration
3.7 El
(100-02-7) ❑ 0 Mass
3.8 p-chloro-m-cresol ❑ ❑ Concentration
(59-50-7) Mass
Pentachlorophenol Concentration
3.9 (87-86-5) El ElMass
3.10 Phenol El ❑ 0 Concentration
(108-95-2) Mass
3.11 2,4 6-trichlorophenol ❑ ❑ 0 Concentration
(88-05-2) Mass
Section 4.Organic Toxic Pollutants(GC/MS Fraction—Base/Neutral Compounds)
4.1 Acenaphthene El ❑ El
(83-32-9) Mass
4.2 Acenaphthylene ❑ El ElConcentration
(208-96-8) Mass
4.3 Anthracene ❑ ❑ ❑ Concentration
(120-12-7) Mass
4.4 Benzidine ❑ ❑ ❑ Concentration
(92-87-5) Mass
4.5 Benzo(a)anthracene El El ❑✓ Concentration
(56-55-3) Mass
4.6 Benzo(a)pyrene ❑ El ElConcentration
(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
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v)p
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term Lon -
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long-
(and
Present Absent Daily Monthly Dai of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) of available) Value
4.7 3,4-benzofluoranthene El 0 0 Concentration
(205-99-2) Mass
4.8 Benzo(ghi)perylene El 13 Concentration
(191-24-2) Mass
4.9 Benzo(k)fluoranthene ❑ 0 0 Concentration
(207-08-9) Mass
Bis(2-chloroethoxy)methane Concentration
4.10 0 El ill
(111-91-1) Mass
4.11 Bis(2-chloroethyl)ether � o O Concentration
(111-44-4) Mass
4.12 Bis(2-chloroisopropyl)ether 0 ElConcentration
El
(102-80-1) Mass
4.13 Bis(2-ethylhexyl)phthalate 0 Concentration
(117-81-7) Mass
4.14 4-bromophenyl phenyl ether a Concentration
0 El(101-55-3) Mass
4.15 Butyl benzyl phthalate ❑ 0 0Concentration
(85-68-7) Mass
4.16 2-chloronaphthalene Ela Concentration
(91-58-7) Mass
4-chlorophenyl phenyl ether Concentration
4.17 El El 0
(7005-72-3) Mass
4.18 Chrysene Concentration
(218-01-9) Mass
4.19 Dibenzo(a,h)anthracene Concentration
0 El El
(53-70-3)
Mass
EPA Form 3510-2C(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,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 Long-
(and CAS Number,if available) Re uired Believed Believed (specify) Maximum Maximum Average Number Number
Q Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Of available) Value
4.20 1,2-dichlorobenzene Concentration
El El 13
(95-50-1)
Mass
4.21 1,3-dichlorobenzene El El a Concentration
(541-73-1) Mass
4.22 14-dichlorobenzene � ❑ Concentration
(106-46-7) Mass
4.23 3 3-dichlorobenzidine 0 0 ❑ Concentration
(91-94-1) Mass
4.24 Diethyl phthalate laConcentration
0 El(84-66-2) Mass
4.25 Dimethyl phthalate [aConcentration
(131-11-3) Mass
4.26 Di-n-butyl phthalate © Concentration
(84-74-2) Mass
2,4-dinitrotoluene Concentration
4.27 (121-14-2) © Mass
4.28 2 6-dinitrotoluene Concentration
(606-20-2) Mass
4.29 Di-n-octyl phthalate ElConcentration
(117-84-0) Mass
4.30 1,2-Diphenylhydrazine Concentration
(as azobenzene)(122-66-7) Mass
Fluoranthene Concentration
4.31 (206-44-0) Mass
4.32 Fluorene Concentration
(86-73-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Fenn Approved 03/05/19
OMB No.2040-0004
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003
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 (specify) Maximum Maximum Average Number Term Number
Present Absent Daily Monthly Daily of of
Discharge Discharge Average
(required) (if available) Discharge Analyses Value Analyses
(if available)
4.33 Hexachlorobenzene El 0 Concentration
(118-74-1) ✓ Mass
4 Hexachlorobutadiene El ElConcentration
(87-68-3) ✓ Mass
4.35 Hexachlorocyclopentadiene E3 ❑ 0Concentration
(77.47-4) Mass
4.36 Hexachloroethane El 0 Concentration
(67-72-1) Mass
4.37 Indeno(1,2,3-cd)pyrene E3 Concentration
(193-39-5) Mass
4.38 Isophorone ElConcentration
El 0(78-59-1) Mass
4.39 Naphthalene Concentration
(91-20-3) Mass
4.40 Nitrobenzene Concentration
(98-95-3) ✓ Mass
4.41 N-nitrosodimethylamine 0 o Concentration
(62-75-9) Mass
4.42 N-nitrosodi-n-propylamine 0 Concentration
(621-64-7) Mass
N-nitrosodiphenylamine Concentration
4.43 El 0 El
(86-30-6) Mass
4 Phenanthrene 0 0 Concentration
(85-01-8) ✓ Mass
Pyrene O Concentration
4.45 El E3(129-00-0) Mass
EPA Form 3510-2C(Revised 3-19) Page 18

a
EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS.CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(01
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
and CAS Number,if available) Required Believed Believed s Maximum Maximum Long-
(and q ( �) Daily Monthly Average Number Term Number
Present Absent Daily of of
D(required)ischarge Dfavaabe)ischarge
Discharge Analyses Avaluee Analyses
(d available)
1 2 4-trichlorobenzene Concentration
4.46 (120-82-1) El ❑ ElMass
Section 5.Organic Toxic Pollutants(GCIMS Fraction—Pesticides)
5.1 Aidrin El 0
Q Concentration
(309-00-2) Mass
a-BHC ❑ ❑ © Concentration
5.2 (319-84-6)
Mass
5.3 (3-BHC El 0
❑ Concentration
(319-85-7) Mass
y-BHC Concentration
5.4 (58-89-9) ❑ ElMass
5.5 BHC El ❑ ❑ Concentration
(319-86-8) Mass
5.6 Chlordane ❑ ❑ ❑ Concentration
(57-74-9) Mass
5.7 4 4'-DDT El 0 Q Concentration
(50-29-3) Mass
5.8 4 4'-DDE El ❑ ❑ Concentration
(72-55-9) Mass
5.9 4 4'-DDD ❑ 0 ❑ Concentration
(72-54-8) Mass
5.10 Dieldrin El ❑ ❑ Concentration
(60-57-1) Mass
511 a-endneitlfan ❑ ❑ ❑ 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 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OPdB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v)p
Presence or Absence 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) ¢f available) Value
(i-endosulfan Concentration
5.12 (115-29-7) ❑ 0 Mass
5.13 Endosulfan sulfate ❑ ❑ ElConcentration
(1031-07-8) Mass
5.14 Endrin ❑ ❑ ❑ Concentration
(72-20-8) Mass
5.15 Endrin aldehyde ❑ ❑ 0Concentration
(7421-93-4) Mass
5.16 Heptachlor ❑ ❑ ❑ Concentration
(76-44-8) Mass
Heptachlor epoxide Concentration
5.17 (1024-57-3) 0 ❑ ❑ Mass
PCB-1242 Concentration
5.18 (53469-21-9) ❑ 0 0 Mass
PCB-1254 0 0 Q Concentration
5.19 (11097-69-1)
Mass
PCB-1221 0 ❑ a Concentration
5.20 (11104-28-2)
Mass
PCB-1232 Concentration
5.21 (11141-16-5) 0 0 ❑ Mass
PCB-1248 Concentration
5.22 (12672-29-6) 0 0 0 Mass
PCB-1260 Concentration
5.23 (11096-82-5) 0 0 ❑ Mass
PCB-1016 Concentration
5.24 (12674-11-2) 0 0 ❑✓ Mass
EPA Forn 3510.2C(Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name 0utfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(0'
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term Long-
Maximum Maximum
(and CAS Number,if available) Required Believed Believed (specify) Average Number Number
Present Absent DailyMonthly Tenn
aily of of
D(requiredd)a 0f aca labk) Discharge Analyses AverageDishare Value Analyses
(rf available)
Toxaphene Concentration
5.25 (8001-35-2) 0 E I ElMass
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 O.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 21

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No,2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))p
Presence or Absence
(check one) Effluent Intake
(Optional)
Units
Pollutant Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Number of
Average
Discharge Discharge Analyses Analyses
(required) Value
(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 ❑ ❑ Concentration
(24959-67-9) Mass
2 Chlorine,total ❑ ❑ Concentration
residual Mass
3. Color 0 El
Concentration
Mass
4. Fecal coliform Concentration
El El
Mass
5 Fluoride ❑ ❑ Concentration
(16984-48-8) Mass
Concentration
6 Nitrate-nitrite ❑ ❑ Mass
Nitrogen,total Concentration
7. organic(as N) 0 0 Mass
Concentration
8. Oil and grease ❑ 0 Mass
Phosphorus(as Concentration
9. P),total(7723-14-0) ❑ ❑ Mass
10. Sulfate(as SO4) ❑ ❑ Concentration
(14808-79-8) Mass
Concentration
11. Sulfide(as S) ❑ ❑ Mass
EPA Form 3510-2C(Revised 3-19) Page 23

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 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
Discharge Discharge Analyses Analyses
(required) Value
(if available) (if available)
12. Sulfite(as SOa) ❑ ❑ Concentration
(1426545-3) Mass
Concentration
13. Surfactants 0 ❑ Mass
14. Aluminum,total ❑ 0 Concentration
(7429-90-5) Mass
15. Barium,total ❑ ❑ Concentration
(7440-39-3) Mass
16. Boron,total ❑ ❑ Concentration
(7440.42.8) Mass
17. Cobalt,total ❑ ❑ Concentration
(7440-48-4) Mass
18. Iron,total ❑ ElConcentration
(7439-89-6) Mass
19 Magnesium,total 0 0 Concentration
(7439-954) Mass
Molybdenum, Concentration
20. total 0 0 Mass
(7439-98-7)
21. Manganese,total ❑ ❑ Concentration
(7439-96.5) Mass
22. Tin total ❑ ❑ Concentration
(744031-5) Mass
23. Titanium,total ❑ ❑ Concentration
(7440-32-6) Mass
EPA Form 3510-2C(Revised 3-19) Page 24

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))r
Presence or Absence
(check one)
Effluent Intake
(Optional)
Units
Pollutant • Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
(equired) Discharge Discharge Analyses Value Analyses
(if available) (if available)
24. Radioactivity _
Concentration
Alpha,total ❑ ❑ Mass
Concentration
Beta,total ❑ ❑ Mass
Concentration
Radium,total ❑ ❑ Mass
Radium 226,total ❑ ❑ Concentration
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 Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii)),
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
1. Asbestos ❑ ✓❑
2. Acetaldehyde ❑ ❑r'
3. Allyl alcohol ❑ 0
4. Allyl chloride ❑
5. Amyl acetate ❑ 0
6. Aniline El ❑
7. Benzonitrile ❑
8. Benzyl chloride ❑
9. Butyl acetate ❑
10. Butylamine ❑ 0
11. Captan ❑ ❑✓
12. Carbaryl ❑ ❑
13. Carbofuran ❑
14. Carbon disulfide ❑
15. Chlorpyrifos ❑ ❑✓
16. Coumaphos ❑
17. Cresol ❑
18. Crotonaldehyde ❑ ❑✓
19. Cyclohexane ❑ ❑✓
EPA Form 3510-2C(Revised 3-19) Page 27

EPA Identification Number NPDES Penn*Number Facility Name Outall Number 1Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))'
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
21. Diazinon 0 0
22. Dicamba 0 0
23. Dichlobenil 0 0
24. Dichlone ❑ 0
25. 2,2-dichloropropionic acid ❑ 0
26. Dichlorvos 0 0
27. Diethyl amine 0 0
28. Dimethyl amine 0 0
29. Dintrobenzene ❑ 0
30. Diquat 0 0
31. Disulfoton 0 0
32. Diuron ❑ 0
33. Epichlorohydrin 0 0
34. Ethion ❑ 0
35. Ethylene diamine 0 0
36. Ethylene dibromide 0 0
37. Formaldehyde 0 0
38. Furfural 0 0
EPA Fonn 3510-2C(Revised 3-19) Page 28

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))'
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 0 El
41. Isopropanolamine ❑ ❑✓
42. Kelthane ❑ 0
43. Kepone ❑ 0
44. Malathion ❑ 0
45. Mercaptodimethur 0
46. Methoxychlor ❑ ❑✓
47. Methyl mercaptan ❑ 0
48. Methyl methacrylate ❑ ❑✓
49. Methyl parathion ❑
50. Mevinphos ❑ ❑✓
51. Mexacarbate ❑ ❑�
52. Monoethyl amine ❑
53. Monomethyl amine 0
54. Naled ❑ ❑✓
55. Naphthenic acid ❑
56. Nitrotoluene 0 ❑✓
57. Parathion ❑ ❑✓
EPA Form 3510-2C(Revised 3-19) Page 29

EPA Identification Number NPDES Permit Number Facility Name Dutfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))'
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present In Discharge (specify units)
Present Absent
58. Phenolsulfonate 0 El
59. Phosgene 0 El
60. Propargite ❑ ❑�
61. Propylene oxide ❑ El
62. Pyrethrins 0 El
63. Quinoline ❑ El
64. Resorcinol ❑ ❑✓
65. Strontium ❑ ❑✓
66. Strychnine ❑ ❑✓
67. Styrene ❑ El
68 2,4 5-T(2,4,5-trichlorophenoxyacetic ❑ El
aad)
69. TDE(tetrachlorodiphenyi ethane) 0 ❑�
70. 2,4,5-TP 12-(2,4,5-trichlocophenoxy) ❑ El
propanoic acid]
71. Trichlorofon 0 El
72. Triethanolamine ❑ 0
73. Triethylamine ❑ ❑✓
74. Trimethylamine ❑ El
75. Uranium ❑ El
76. Vanadium ❑ ❑✓
EPA Fume 3510-2C(Revised 3-19) Page 30

•
EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))t
Presence or Absence
Pollutant (check one) Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
77. Vinyl acetate ❑ ❑✓
78. Xylene ❑ ❑�
79. Xylenol ❑ 0
80. Zirconium ❑ ❑�
'Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter Nor 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C Revised 3-19) Page 31

•
EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.20404004
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 � ❑Q
EPA Form 3510-2C(Revised 3-19) Page 33

M - B INDUSTRIES, INC.
B SERVING INDUSTRY SINCE 1894
9205 ROSMAN HWY., P.O.BOX 1118,ROSMAN, NC 28772
PHONE [phone], FAX[phone]
April 27, 2022
NCDENR
Division of Water Resources
WQ Permitting Section—NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Request Waiver to EPA Application Form 2C Item Table A Item 7.1
Ladies and Gents,
Please accept our request for the following waiver pertaining to EPA Application Form 2C Item Table A
Item 7.1.
1) Outfall 001—Waiver all of the pollutants in Table A
2) Outfall 002—Waiver all of the pollutants in Table A
3) Outfall 003—Waiver all of the pollutants in Table A
Please find attached our March 15, 2022 Analytical Results from Pace Laboratories.
Your consideration in this matter is greatly appreciated.
King regards,‘
Edwin Morrow
President
MITCHELL-BISSELL CO.DIVISION SUNBELT SPRING&STAMPING CORP. DIVISION
[phone] [phone]

Attachment A
M-B Industries,Inc Wastewater Treatment Plant Process
Water from the lift station is pumped into a collection tank and into a 3 tier cascading treatment system.
See attachment B for treatment tank sizes and dimensions.The first treatment tank is where a coagulant
is added for precipitation and flocculation and an acid and base are added for Ph controls.Treatment
tanks 2 and 3 is where a polymer is added to aid in coagulation and flocculation.From this point water
is fed into a clarifier where solids are seperated and fed into a 630 gallon sludge holding tank where the
solids are pumped into a 4 cubic feet filter press forming a cake of sludge which is dropped into a 4
cubic feet sludge dryer for de-watering. The dried sludge is put into 55 gallon drums and shipped off
the property. Two 55 gallon drums(400 lbs each) of solids a month are disposed of in this manner. The
treated water from the clarifier is sent to a 700 gallon final settling tank and a sand filter system before
reaching the final treatment tank 4(360 gallons)where Ph controls are added along with a foam down
system to knock out foam.From treatment tank 4 water is fed into a 60 degree notch weir and onto the
receiving stream.The flow rate is 50 gpm.

M-B Industries, Inc. Waste Stream Flow Chart
NPDES Permit# NC0000311
Water Supply
Well
Ground Water
Treatment Cooling Water
I I ( I I
Chrome Vibratory Black Oxide
Plating Finishing Zinc Plating Tin Plating Finishing
WWTP
Outfall 003 (40,000 gd) Outfall 001 Outfall 002 (300gd)
West Fork of the French Broad River
_ J