NC0000311_Renewal (Application)_20220505

EM) M - B INDUSTRIES, INC.
BSERVING 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
WO 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,
Edwin Morrow
President
MITCHELL-BISSELL CO.DIVISION SUNBELT SPRING&STAMPING CORP.DIVISION
[phone] [phone]

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 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.
Outfa
c Number Receiving Water Name Latitude Longitude
001 West Fork French Broad 82° 50' 56" N 35° 8' 21" W
002 West Fork French Broad 82° 50' 56" N 35° 8' 21" W
0
003 West Fork French Broad 82° 50' 56" N 35° 8' 21" W
SECTION 2.LINE DRAWING(40 CFR 122.21(g)(2))
co 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
c 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
Effluent results form Burnishing,Chrome Plating,Zinc .017 mgd
Plating,Tin Plating,and Black Oxide Finishing mgd
mgd
mgd
Treatment Units
Description Final Disposal of Solid or
Code from
(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 3510-2C(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 FinaFDisposal of Solid
(include size,flow rate through each treatment unit, Table 2C-1 Liquid Wastes Other Than
retention time,etc.) by Discharge
No Treatment 4A
0
V
m
E
iv
4t` **Outfall Number**
Operations Contributing to Flow
Operation I' at .. Average Flow
u.
Ground Water Remediation .04 mgd
co
mgd
mgd
mgd
Treatment Units
Description '"" Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Liquid Wastes Other Than
Table 2C•1
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?
CD ❑ Yes ❑✓ No SKIP to Section 4.
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.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
DaysiWeek .' Months/Year Average Daily
days/week months/year mgd mgd days
days/week months/year mgd mgd days
o
6. days/week months/year mgd mgd days
0
days/week months/year mgd mgd 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
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?
❑ Yes ❑✓ No 4 SKIP to Section 6.
to 5.2 Provide the following information on applicable ELGs.
w ELG Category ELG'Subcategory Regulatory Citation
w
CO
O.
¢ ;
5.3 Are any of the applicable ELGs expressed in terms of production(or other measure of operation)?
c ❑ 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.
£ Outfali: r , .= ..1 ; 4, N= iA.s '.;l ate* Umtsof
e _ : k� g. Operation,Product,orrMatenal 4`��ts uantaty per Day i qir
d Number ,,tkI .z �, �A N A kFt � IMPit ,x4.�� 'k mt es ,, . Mea§Ufe
f/1
{o
co
O
3
0
O..
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?
❑ Yes ❑✓ No-A SKIP to Item 6.3.
6.2 Briefly identify each applicable project in the table below.
tu, Affected Final Compliance Dates
Brief Identification and Description of Outfalls Source(s)of
c Project (list outfall Discharge Required Projected
number)
v
ttY
0
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 El No ❑ 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-3 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 o01 Outfall Number 002 Outfall Number 003
11 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
ID Yes ❑ permitting authority for all pollutants at all outfalls.
Table B..Toxic Metals,Cyanide,Total Phenols,and Organic Toxic Pollutants
Ae 7.4 Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
its
listed in Exhibit 2C-3?(See end of instructions for exhibit.)
03
❑✓ Yes ❑ No-3 SKIP to Item 7.8.
4.0
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.
Primary Industry Category Required GC/MS Fraction(s)
(Check applicable boxes.)
Copper&Steel Manufacturing ❑Volatile ❑Acid 0 Base/Neutral ❑Pesticide
0 Volatile 0 Acid 0 Base/Neutral ❑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
NCD05516324 NC0000311 M-B Industries,Inc. 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?
O 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?
❑✓ 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?
❑ 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
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
determined testing is required or(2)quantitative data or an explanation for those Sections 2 through 5,Table B,
N pollutants you have indicated are"Believed Present"in your discharge?
`—' ❑ Yes ❑✓ No
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
U for all outfalls?
d E Yes ❑ No
c 7.13 Have you completed Table C by providing(1)quantitative data for those pollutants that are limited either directly or
c indirectly in an ELG and/or(2)quantitative data or an explanation for those pollutants for which you have indicated
"Believed Present"?
❑✓ Yes ❑ No
w 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.
8.2 List the pollutants below.
r° 1. Zinc 4. 7.
L.0
1.1
2. 5. 8.
en
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+SKIP to Section 10.
N s
I 9.2 Identify the tests and their 3urposes below.
Submitted to NPDES
o Test(s) Purpose of Test(s) permitting Authority? Date Submitted
❑ Yes ❑ No
an
m ❑ Yes ElNo
❑ 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?
❑ 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
T Laboratory address
R
° Phone number
Pollutant(s)analyzed
SECTION 11.ADDITIONAL INFORMATION(40 CFR 122.21(g)(13))
11.1 Has the NPDES permitting authority requested additional information?
c ❑ Yes ❑✓ No 4 SKIP to Section 12.
g11.2 List the information requested and attach it to this application.
1. 4.
0
o, 2, 5.
-a
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 0 w/attachments
❑✓ Section 2:Line Drawing ✓❑ w/line drawing ❑ wl additional attachments
1-71 Section 3:Average Flows and w/list of each user of
0Treatment w/attachments El privately owned treatment
works
❑✓ Section 4: Intermittent Flows ❑ wl attachments
p Section 5:Production ❑ wl attachments
wl optional additional
✓ Section 6:Improvements0 sheets describing any
❑ p 0 wl attachmentsadditional pollution control
plans
❑ w/request for a waiver and ❑ w/explanation for identical
'd
supporting information outfalls
w/small business exemption
E ❑ request El w/other attachments
w Section 7: Effluent and Intake
✓❑ Characteristics El w/Table A 0 w/Table B
0
❑ w/Table C ❑ w/Table D
El wl Table E ❑ w/analytical results as an
U attachment
c Section 8:Used or Manufactured
❑✓ ❑ w/attachments
Toxics
Y
Section 9:Biological Toxicity
a °i ❑ Tests ❑ w/attachments
w y
4" ❑✓ Section 10:Contract Analyses 0 w/attachments
% r; Q Section 11:Additional Information 0 w/attachments
r Section 12:Checklist and
0 Certification Statement ❑ w/attachments
*`3 12.2 Certification Statement
`4v I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
kt kkOZ'Zii, , accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
-td, 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,
Wig
'. M accurate,and complete.I am aware that there are significant penalties for submitting false information,including the
'4,-;., possibility of fine and imprisonment for knowingviolations.
p Y p
Name(print or type first and last name) Official title
Edwin Morrow President/Owner
a. �. , Signature Date signed
''ttivflttp
Zipt".. �'r'lK/'� 04/27/2022
EPA Form 3510-2C(Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number Facility Name 0utfa1l Number Form Approved 03/05119
NCD05516324 NC000031 M-B Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE A.CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(9)(7)00)
Effluent Intake
r er ` � WaklEfsrx (Optional)'
k� Poi Retquested# Unf� Maximum Maximum Long-Term
f afP� gspeaty) . Daily Monthly Average Daily Number of Long-Term Number of
Discharge Discharge Discharge Analyses Average Value Analyses
t 1 u #;` a tir ieW �„p s. 4 "`,iz ,,: (required) Of 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) ❑ Standard units s.u.
8.
pH(maximum) ❑ Standard units s.u.
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 OulfaII 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))1
r a `�li" al cot,, Presence or Absence
' � , ` ,: (checkone) Effluent Intake
}? 6t,Sa t y fi ra-`�'� a.3 � 4 y�' �too.,q k, ,i tr.t,gg'.y',L xjS. 4' h� -''e:. (optional)
Pollutant!Parameter Testing" "> w, - `,.,•Units . ,`'Vi M3 ztmumi Maximum Long-Term
(and CAS Number,if available) Required Believed B He i g 7 )m -�� n Average Number Long. Number
Present Abser;rt C � � � DatIV:' Monthly Dailey of Term of
'- ,7 ° ,r�r j�4-$ Disc(reqharge
Drfovalabs) Discharge Analyses Average
: Analyses
(t 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 0 0✓ Concentration
(7440-36-0) Mass
1 2 Arsenic,total El El E✓ Concentration
(7440-38-2) Mass
1.3 Beryllium,total Concentration
(7440-41-7) Mass
Cadmium,total 0 Concentration
1.4 (7440-43-9) Mass
Chromium,total El
1.5 (7440-47-3) Mass
Copper,total Concentration
1.6 (7440-50-8) Mass
17 Lead,total Concentration
El El(7439-92-1) Mass
1 8 Mercury total 0 0 Concentration
(7439-97-6) Mass
El
1 9 Nickel,total El
Ei
(7440-02-0) Mass
1.10 Selenium,total Concentration
(7782-49-2) Mass
1.11 Silver,total ❑ 0 Concentration
(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 03/95/19
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
(check one) ' Effluent Intake
jai' y r y a
y 'c ,s's«..q 3 vzr txcq �o n 4€ �'�`'P' ,:,� ts' cf :0011 . ",��` • t kd4,f�ift s 1;,`.7*,2ea6„- .,f'.+E! f 17.a;--A, ,.—a,.,9Yt �.,� �a`.,-u.� :r„ � :' . :.
PoilutantlParaineter 'Testing" �T' Pam▪' ;Units`i�,,` : ':Long•Term e
(and CAS Number,if available) f Required Believed Believed nt cpe cty) ' ', Maximum Maximum Average Number Tee W Number
Present Absent 'V „ A �d1» * � Daily Monthly g
"�:'::'. fiS' +',x x 4-04k il `" x i' Fax kmt7477N,i 2,` i ,a tIVAIIs`.ag x,.> 's' ? ;Deily
Of Of
t ' r Ar .DischargeDischarge •Discharge Analyses Average Analyses
(requiredy (it available) (f available) Velue
1 12 Thallium,total El1 Concentration
(7440-28-0) Mass
1.13 Zinc,total Concentration
(7440-66-6) Mass
1.14 Cyanide,total Concentration
(57-12-5) Mass
Concentration
1.15 Phenols,total ✓ Mass
Section 2.Organic Toxic Pollutants(GCIMS Fraction—Volatile Compounds)
21 Acrolein r✓ Concentration
(107-02-8) Mass
Acrylonitrile Concentration
2.2 (107-13-1) © Mass
2.3 Benzene Concentration
(71-43-2) I:IMass
2 4 Bromoform El 0 El Concentration
(75-25-2) Mass
2.5 Carbon tetrachloride Concentration
El El El
(56-23-5) Mass
Chlorobenzene Concentration
2.6 (108-90-7) ✓0 Mass
2.7 Chlorodibromomethane Concentration
El E3 El
(124-48-1) Mass
2.8 Chloroethane ElConcentration
E3 El(75-00-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 12

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.2D40-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v)p
Presence or Absence
check one intake
( ) Effluent' ,....��.
iMiN ', k f i r'`' ax„{',a g'S k' kF," .s4,, €�R" y�6 .,cv�' �x i '.:, T c"' ,,$r'''.'Lk' �`iiii L'F y, e.M,r ib✓ `'3''-'' '`y£ng•:iu�'sa'
PoltutantParameter Testing s Units Lo'ng-Term
(and CAS Number;ava>Iable)� Required Believed Believed ` (specify) i Maximum Maximum Avera a Number Long•` Number`" Present Abse d�� Daily Monthly Term •
1 ' `"1 " S `�a:. 11-1 f r4x 1 3 Dailyof of
r � ��, G �� }���� �11 ��� Discharge DischargeAverage
i ry, ti (regafn;4) of available) Discharge Analyses Value Analyses
ftseatlable).sK.u-.K...w .�.s.,. .. s.�-...rr.,.�.s
2.9 2-chloroethylvinyl ether ❑ ❑ ❑ Concentration
(110-75-8) Mass
2.10 Chloroform(67-66-3) ❑ ❑ ❑ Concentration
✓
Mass
Dichlorobromomethane ID El Concentration
2'11 (75-27-4) Mass
212 1,1-dichloroethane Concentration
(75-34-3) El ❑ ❑✓ Mass
1,2-dichloroethane El El
❑ Concentration
2.13 (107-06-2) Mass
2.14 1,1-dichloroethylene ❑ El
❑ Concentration
(75-35-4) Mass
2.15 1,2-dichloropropane El ❑ Concentration
(78-87-5)
Mass
1,3-dichloropropylene ❑ ❑ IT,
Concentration
2'16 (542-75-6) Mass
217 Ethylbenzene El ❑✓ Concentration
(100-41-4) Mass
Methyl bromide El ❑ ❑ Concentration
2.18 (74-83-9) Mass
2.19 Methyl chloride El ✓❑ Concentration
(74-87-3) Mass
2 20 Methylene chloride El ❑ ❑ Concentration
(75-09-2) Mass
2.21 1 1,2 2-tetrachloroethane El El ❑ Concentration
(79-34-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outrall 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))I
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter .Testing Units' Lon Term
(and CAS Number,if avalabie)va,' Required Believed, Believed (specify) Maximum Maximum g Long.
(p h) Average Number Number
x DailyMonthlyDaily of Term of present', Absent
�1 itr" ,h ,�1 t y �', Discharge Discharge Average
yp^� 0� � $r (required) (if available) Discharge Analyses Value Analyses
.. a sax ,. t - :. risk. (if available)
Tetrachloroethylene c3 13
❑ Concentration
2.22 (127-18-4) Mass
2.23 Toluene Concentration
(108-88-3) Mass
2 24 1,2-trans-dichloroethylene ❑ 0 Concentration
(156-60-5) Mass
11,1-trichloroethane Concentration
2.25 El
(71-55-6) El CI Mass
2.26 1,1,2-trichloroethane 0 0
0 Concentration
(79-00-5) Mass
2 27 Trichloroethylene o Concentration
(79-01-6) Mass
2.28 Vinyl chloride 0 E3
0 Concentration
(75-01-4) Mass
Section 3.Organic Toxic Pollutants,(GC/MS Fraction-Acid Compounds) `, ; "-�
2-chlorophenol Concentration
3.1 (95-57-8) El ❑
Mass
3.2 2,4-dichlorophenol 0 0 © Concentration
(120-83-2) Mass
3.3 2 4-dimethylphenol ❑ El Concentration
(105-67-9) Mass
3.4 4,6-dinitro-o-cresol 0 Ei
1 Concentration
(534-52-1) Mass
3.5 2 4-dinitrophenol ❑ 0Concentration
(51-28-5) Mass
EPA Form 3510-2C(Revised 3-IS) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outlall Number Form Approved 03/05/19
NC005516324 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
(eheck one) Effluent
- -.4, A , k 2 & 4,yy* r$<.P"'n0?-1, "ll k�.� �� i f `�� A ,LA k 1j : (Op al)
Po►lutantlParameter Testing3' , v $ N 1 y
(and CAS Number if available)Wit, Requ1 d Believed Believed t l UnRs, 1 ,f „ Maximum 'Maximum LA Average Number LOOM Number
x "' - " Present Absent s4,"x a � �� ; Daily. Monthly Daily g of Term of
i s g r "i ce a,+` �_, t' 4$ z,ay"�, at Discharge Discharge. Average
.h ,� k ', p'r `" : 4 r9 �� (requlredj (if available] Discharge
Analyses Value Analyses
3.6 2-nitrophenol ❑ 0Concentration
(88-75-5) Mass
3 7 4-nitrophenol 0 0
0Concentration
(100-02-7) Mass
3 8 p-chloro-m-cresol 0 a Concentration
(59-50-7) Mass
Pentachlorophenol 0 0 Concentration
3.9 (87-86-5) Mass
3.10 Phenol CI
(108 95 2) Mass
3.11 2,4,6-trichlorophenol ❑ 17 Concentration
(88-05-2) Mass
Section 4.Organic Toxic Pollutants(GC/MS Fraction-Base/Neutral Compounds)
41 Acenaphthene CI
(83-32-9) CI
Mass
4.2 Acenaphthylene CI
(208-96-8) 1:1Mass
Anthracene 0 0 Concentration
4.3 (120-12-7) Mass
4.4 Benzidine E3 Ej
0 Concentration
(92-87-5) Mass
4.4 Benzo(a)anthracene Concentration
(56-55-3) 0 El El
Mass
4.6 Benzo(a)pyrene 0 0 0 Concentration
(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 03105I19
NCD05516324 NC000031 M-6 Industries,Inc. 001,002,&003 OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHBJOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(checkone) Effluent Intake
�XS,�Wx,K kA�'R?su'JI-l�fi� f 3"a � �2 l� i °iA
PollutanUParanneter. � Testing : ,,x �� Units Lon Term
41POl Sl� avate."4. Required Believed Believed ; (speci•fy) " Maximum " (Maximum g- Long
Average Number Number
Present, Abseit: ' � `Daily=. Monthly Daily of Term of
�* 4 ig 1 y � 1a x+ ti ---el rs1 y"'��' Discharge Discharge. Y Average
u � � (requireA) (favailab�e) Discharge Analyses Value Analyses
(favagabie)-u- ,.
4,7 3,4-benzofluorantheneEl 0
Concentration
(205-99-2) Mass
4.8 Benzo(ghi)perylene Concentration
(191-24-2) Mass
4.9 Benzo(k)fluoranthene ❑✓ Concentration
(207-08-9) Mass
Bis(2-chloroethoxy)methane ❑ Concentration
4.10 (111-91-1) Mass
4.11 Bis(2-chioroethyl)ether � 0✓ Concentration
(111-44-4) Mass
4.12 Bis(2-chloroisopropyl)ether ❑ 0✓ Concentration
(102-80-1) Mass
4.13 Bis(2-ethylhexyl)phthalate [3 El
Concentration
(117-81-7) Mass
4-bromophenyl phenyl ether ❑ Concentration
4.14 (101-55-3) Mass
4.15 Butyl benzyl phthalate El Concentration
(85-68-7) Mass
4.16 2-chloronaphthalene Concentration
0 El
(91-58-7) Mass
4.17 4-chlorophenyl phenyl ether 0 El
Concentration
(7005-72-3) Mass
El
4.18 Chrysene Concentration
(218-01-9) Mass
419 Dibenzo(a,h)anthracene ❑ Concentration
(53-70-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Oudall 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))1
1 Presence or Absence fi F -
- �:a (checkom) ` T tl� ��� • Effluent Intake
�� - ba ay5" - n ate. '1 -*." ,, r�", ',,-,to#.megi . 't i`-"-� u a y yigi: optional).
a:fg POHUtantIPar Ite r Testing #,nyi1e4i ii,k';. .t� 5,4 �, .:, "k"fi'-,' f' '.fit ''.t s?k i'iiP sLong. -ic :P�s sc.
. � � 4*,i,Umts lr� ; , .- ,:> Long Term"'
(andCABHwnPer ff'aralab� ' 4 Maximum Maximum Long-
31 Required} Believed BeUeved ( y) Average Number Number
Wan d ii"Present Absent i " �' : Daily Monthly Dailyof Term of
it, � i ,r r 6 fa s•�k ti i r x ;1 - Discharge Discharge Average
r 1 P r r„ Discharge Analyses Analyses
; (rquired); (rfavailable) (if available) Value`.
4 20 1 2-dichlorobenzene Concentration
(95-50-1) Mass
El
4.21 1,3-dichlorobenzene Concentration
El
(541-73-1) Mass
El
4 22 14-dichlorobenzene Concentration
(106-46-7) Mass
El
4.23 3 3-dichlorobenzidine Concentration
(91-94-1) Mass
4.24 Diethyl phthalate © Concentration
(84-66-2) Mass
4.25 Dimethyl phthalate ❑ 0 ❑✓ Concentration
(131-11-3) Mass
4.26 Di-n-butyl phthalateEl
© Concentration(84-74-2) Mass
El
4.27 2,4-dinitrotoluene Concentration
(121-14-2) Mass
El
4.28 2 6-dinitrotoluene Concentration
(606-20-2) Mass
Di-n-octyl phthalate Concentration
4.29 (117-84-0) Mass
4.30 1,2-Diphenylhydrazine Concentration
(as azobenzene)(122-66-7) Mass
4.31 Fluoranthene 0 0 0Concentration
(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 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
04A7 " ii , ; Presence or Absence
� � �� 1 � • Intake
li WOMrtr* '4 0 Vi, lchedrone' ' 3a v 41 zd A .0 . ' K4-Eff,,,,,w l t*�= ,.. : , s.:'.(oplfonal
- 1 x'i ,gef fi r 0Vri I g .�:K ;a x .*xi kI t' "....ems.+ r:. 'a». 1. &^ t`l o-" d `4i' 3f `7 44 5y .,,'
ts;PotlutantlParameter 4 Testing , , c5 ``a'k,r am.Units. , 2 Makimumi `Maximum "Long Term'; Long- c
an.0Xtli anbikilf:va5abtei l 1Required Believed, Believed c e (speciry"} � * t� Average Number Number
T : pul Present% A- Bent�t44,90, � Dellp:' ' °.iJlonYhijr y Term
� �, a '" f s �s x #z` k a a k 'f t Discharge Discharge Dail °t Average °f
� ''h 1., 44 (required) tdavatlable)- Discharge Analyses, value Analyses
- m .�. 4.... (if avalable)` a-
4.33 Hexachlo�benzene ❑ ❑✓ Concentration
(118-74-1) ss Concentration
4. (87-68-3)
Mass
4.35 Hexachlorocyclopentadiene Concentration
(77-47-4) Mass
4.36 Hexachloroethane Concentration
(67-72-1) Mass
4.37 Indeno(1,2,3-cd)pyrene Concentration
(193-39-5) Mass
4.38 Isophorone Concentration
(78-59-1) Mass
4.39 Naphthalene Concentration
(91-20-3) Mass
4.40 Nitrobenzene Concentration
(98-95-3) Mass
4.41 N-nitrosodimethylamine Concentration
(62-75.9) Mass
N-nitrosodi-n-propylamine ❑ ❑ Concentration
4.42 (621-64-7) Mass
4.43 N-nitrosodiphenylamine Concentration
(86-30-6) Mass
4 Phenanthrene Concentration
(85-01-8) Mass
4.45 Pyrene Concentration
(129-00-0) Mass
EPA Form 3510-2C(Revised 3-19) Page 18

EPA Identification Number NPOES 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 ors y pp � �; y�( ) y y r y Effluent i r„ w m ��, eAlronal).d
ittifi F :t Y''td,Af%e- ▪ CF▪ I 0 w k s V�!' k �iso wLit u{s"`ty to A{' ,fit oniN' k' f T:s'Mr k f k 4r{'iYll4. 4 isott l .,„&tm.,:
i ;( Nunber' aIfabl 'Required Believed iBelievev d` It u(ap cdyj U��`$ t�m x Maximum LAveragen •Number W Long=• Number
. * : .r.ol is Presents .� , # ; k Daily .., .,Monthly Term
g,�-t b ' *a-- x �1 , rW t o Daily of 9 of
Discha a Discha a Avera e
F � t . (required) (if available) Discharge Analyses Value Analyses
t. , of available)
1 2 4-trichiorobenzene Di Concentration
4.46 (120-82-1) Mass
Section 5.Organic Toxic Pollutants(GC1MS Fraction-Pesticides) ,,p
5.1 Aldrin Concentration
El El(309-00-2) Mass
5.2 a-BHC 0 Concentration
(319-84-6) 1=1 Mass
5.3 R-BHC 171
Concentration
(319-85-7) 1=1 Mass
5.4 Y-BHC 0 ❑ 0 Concentration
(58-89-9) Mass
5.5 o-BHC Concentration
(319-86-8) Mass
5.6 Chlordane Concentration
(57-74-9) Mass
5 7 4,4'-DDT r✓ Concentration
(50-29-3) 1:1 Mass
5.8 4,4'-DDE Concentration
El 0El
(72-55-9) Mass
5.9 4 4'-DDD Concentration
0 El(72-54-8) Mass
5.10 Dieldrin r 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 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)w}p
Presence or Absence
4 Intake
(check one) Effluent,. x�s `/;q . S y '�yd 'rr. y y ,, 0 1lonal
� fiz r €� �k � � �k ��,x�� �'�"1`f�l�G �k�Y ..e'' Fd"�r„5 �c a xa� ks (P )
Poilutant/Parameter ;Testing i el Unitst,� Maximum Maximum Long=Term Long-
(and CAS Number,if available) Required Believed Believed; '� (Specify) ` Average Number Number
Present Absent � Daily schafy Term
1 � Discharge Discharge Daily of Average °f
A'� '". (repairer) erevebbrgb) Discharge Analyses Value Analyses
5.12 P-endosulfan 0 ❑ ❑ Concentration
(115-29-7) Mass
5.13 Endosulfan sulfate ❑ ❑ ❑ Concentration
(1031-07-8) Mass
5.14 Endrin ❑ ❑ ❑ Concentration
(72-20-8) Mass
5.15 Endrin aldehyde ❑ ❑ ❑✓ Concentration
(7421-93-0
5.16 Heptachlor ❑ ❑ ❑ Concentration
(76-44-8) Mass
Heptachlor epoxide Concentration
5.17 (1024-57-3) 0 0 ❑✓ Mass
PCB-1242 Concentration
5.18 (53469-21-9) 0 0
Mass
PCB-1254 Concentration
5.19 (11097-69-1) 0 011-1
Mass
PCB-1221 Concentration
5.20 (11104-28-2) ❑ 0 ❑✓ Mass
PCB-1232 Concentration
5.21 (11141-16-5) El 0
❑✓
Mass
PCB-1248 Concentration
5.22 (12672-29-6) El ❑ ❑✓ Mass
PCB-1260 Concentration
5.23 (11096-82-5) ID El ✓❑ Mass
PCB-1016 Concentration
5.24 (12674-11-2) El 0
Mass
EPA Form 351 0-2C(Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 N0000031 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 t x
(checkone) Effluent Intake
x .ss t 4' ,.16 1: '
PollutantlParameter -Testing' 3 � ��Un Long•Term"
(and CAS Number,if available) Required Believed Believed Maximum Maximum" Average Numbeofr Cong Number
Present Abseirt Monthljr Term
Discharge of available) Discharge Analyses AVa aee Analyses
(if available) "
Toxaphene Concentration
5.25 (8001-35-2) ❑ ❑ Mass
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 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 Na 2040A004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))t
,t; ^ Presence or Absence Intake
(checkone) EfNuent
'''- -R ,+a. 3, -`` g y' v 5 y �, y (Optional) y y
Y k,, 4 o- Y i0 itq t to s it 7' t * ' t ,s„,s,s£'"" s s ''7 r- f;<F,r- s Y'. s 3c "" ,s <c
Poltutarrt "";Behaved' Believed1-4 r >o mts 4- a'ia�` Maxhawn Daily Max nu11341 r Long Term, .,`'
c- e -'#- h!) aW,ct. v ' r .L0119- Number T2rnt
Present Abant� a04 a Discharges Pk Discharg Average
Analyses af Average A alysesf
rk at ,a n,11 £x*410�`x. ,�+A*401�. 4: *: " ) ' trf available)' (if available) • Value
❑
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 ElConcentration
El
Mass
4. Fecal coliform 0 0 Concentration
Mass
5 Fluoride ❑ ❑ Concentration
(16984-48-8) Mass
6 Nitrate-nitrite El 0 Concentration
Mass
Nitrogen,total Concentration
7' organic(as N) ❑ ❑ Mass
Concentration
8. Oil and grease ❑ El Mass
9 Phosphorus(as El � Concentration
P),total(7723-14-0) Mass
10 Sulfate(as SO4) Concentration
(14808-7948) Mass
11. Sulfide(as S) 0 ElConcentration
Mass
EPA Form 3510.2C(Revised 3-19) Page 23

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))'
Presence or Absence intake
(check one) Effluent (opt oval}
Pollutant Units Maximum Lung-Term Believed Believed (specify) Maximum DailyLong-Term
Monthly Average Daily Number of Number of
Present Absent Discharge Discharge Discharge Analyses Average Anafyses
(required) Value
(if available" (if available)
12 Sulfite(as S03) El El Concentration
(14265-45-3) Mass
Concentration
13. Surfactants 0 ❑ Mass
14. Aluminum,total ❑ ❑ 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 ❑ ❑ Concentration
(7439-89-6) Mass
19 Magnesium,total ❑ D Concentration
(7439-9s-4) Mass
Molybdenum, Concentration
20- total 0 ❑ Mass
(7439-98-7)
21 Manganese,total ❑ ❑ Concentration
(7439-96-5) Mass
22 Tin,total ❑ ❑ Concentration
• (7440.31.5) Mass
23. Titanium,total ❑ ❑ Concentration
(7440-32-6) Mass
EPA Form 3510-2C(Revised 3-19) Page 24

EPA Identification Number NPDES Pemit Number Facility Name Outrall 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))'
Presence or Absence
(check one) Effluent Intake
(Optional
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Monthly Average Daily Number of Long-Term Number of
Present Absent Discharge Average
(required)) Discharge Discharge Analyses Value Analyses
(if available) tit available)
24. Radioactivity
Alpha,total ❑ Concentration
Mass
Concentration
Beta,total ❑ ❑ Mass
Radium,total CI Concentration
Mass
Radium 226,total ElConcentration
Mass
t 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 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 12221(g)(7)(vii))'
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Presenti n Discharge (specify units)
Present Absent
1. Asbestos ❑ 0
2. Acetaldehyde 0 El
3. Allyl alcohol ❑ El
4. Allyl chloride 0 El
5. Amyl acetate 0 Ell
6. Aniline El 0
7. Benzonitrile ❑ El
8. Benzyl chloride 0 0
9. Butyl acetate ❑ El
10. Butylamine 0 0
11. Captan 0 0
12. Carbaryl 0 0
13. Carbofuran 0 ❑✓
14. Carbon disulfide El El
15. Chlorpyrifos 0 0
16. Coumaphos ❑ El
17. Cresol ❑ ❑✓
18. Crotonaldehyde 0 0
19. Cyclohexane 0 El
EPA Form 3510-2C(Revised 3.19) Page 27

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 D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Available Quantitative Data
Reason Pollutant Believed Present in Discharge
Believed Believed (specify units)
Present Absent
20. 2,4-D(2,4-dichlorophenoxyacetic acid) ❑ El
21. Diazinon 0 El
22. Dicamba 0 ❑✓
23. Dichlobenil ❑ El
24. Dichlone ❑ p
25. 2,2-dichloropropionic acid ❑ ❑✓
26. Dichlorvos ❑ El
27. Diethyl amine ❑ 0
28. Dimethyl amine ❑ El
29. Dintrobenzene ❑ El
30. Diquat 0 El
31. Disulfoton ❑ [✓.
32. Diuron ❑ 0
33. Epichlorohydrin ❑ 0
34. Ethion 0 El
35. Ethylene diamine ❑ El
36. Ethylene dibromide ❑ ❑✓
37. Formaldehyde ❑ El
38. Furfural 0 ❑✓
EPA Form 3510-2C(Revised 349) Page 28

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
TABLED.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii)p
Presence or Absence
Pollutant {ohecY one) P: Available Quantitative Data
Believed Believed = Reason Pollutant Believed Present in Discharge (specfy units)
Present Absent
39. Guthion 0 0
40. Isoprene ❑ 0
41. Isopropanolamine 0 ❑✓
42. Kelthane ❑ 0
43. Kepone 0 0
44. Malathion 0 0
45. Mercaptodimethur 0 0
46. Methoxychlor ❑ 0
47. Methyl mercaptan ❑ 0
48. Methyl methacrylate ❑ 0
49. Methyl parathion 0 0
50. Mevinphos 0 ❑✓
51. Mexacarbate 0 0
52. Monoethyl amine ❑ 0
53. Monomethyl amine ❑ 0
54. Naled ❑ 0
55. Naphthenic acid ❑ 0
56. Nitrotoluene ❑ ✓❑
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
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 tspecify units)
Present Absent
58. Phenolsulfonate 0 0
59. Phosgene 0 0
60. Propargite 0 0
61. Propylene oxide 0 ✓❑
62. Pyrethrins 0 0
63. Quinoline 0 0
64. Resorcinol 0 0
65. Strontium ❑ 0
66. Strychnine ❑ 0
67. Styrene ❑ ❑✓
2,4 5-T(2,4,5-trichlorophenoxyacetic ❑ ❑
68. acid)
69. TDE(tetrachlorodiphenyl ethane) ❑ 0
70 2,4,5-TP[2-(2,4,5-trichlorophenoxy) ❑ 0
propanoic acid]
71. Trichlorofon ❑ 0
72. Triethanolamine 0 0
73. Triethylamine ❑ 0
74. Trimethylamine 0 0
75. Uranium ❑ 0
76. Vanadium 0 0
EPA Form 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 122.21(g)(7)(vii))r
x K s .:x, Presen ce or'Ab5Bnce, a e _" ;. nag:!,,- I'n*;'" v , , �' b.`+ ` !-'T^-b, ,.71 s f g "ice` i ` ?, g:,
Pollutant ' ;'`(cheakone) ` Reason Pollutant Believed Present in Dischaarge Available Quantitative"Data
Believed Believed (spear),"
Present Absent
77. Vinyl acetate 0 0
78. Xylene ❑ 0
79. Xylenol 0 0
80. Zirconium 0 ❑✓
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

EPA Identfication Number NPDES Pemut Number Facility Name Outfall Number Form Approved 03/05/19
NCD05516324 N0000031 M-B Industries,Inc. 001,002,&003 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
Absence
.,. _,Yts Pollutant Congeners (check one) ' tlfi Results of ScreeningProcedure 3
'4 � Used or Believed Believed
,,,* � , Manufactured Present Absent : 5, , ,,
2,3,7,8-TCDD El CI El
EPA Form 3510-2C(Revised 3-19) Page 33