NCS000132_Renewal Application_20220721

SUPPLEMENTAL INFORMATION REQUIRED FOR RENEWAL OF INDIVIDUAL
NPDES STORMWATER PERMIT
Two copies of each of the following shall accompany this submittal in order for the application
to be considered complete:
(Do not submit the site Stormwater Pollution Prevention Plan)
Initials
DT 1. �A current Site Map from the Stormwater Pollution Prevention Plan. The location of
industrial activities (including storage of materials, disposal areas, process areas and
loading and unloading areas), drainage structures, drainage areas for each outfall,
building locations and impervious surfaces should be clearly noted.
DT 2.UA summary of Analytical Monitoring results during the term of the existing permit
(if your permit required analytical sampling). Do not submit individual lab reports.
The summary can consist of a table including such items as outfall number,
parameters sampled, lab results, date sampled, and storm event data.
DT 3. A summary of the Visual Monitoring results. Do not submit individual monitoring
reports. The summary can consist of a table including such items as outfall number,
parameters surveyed, observations, and date monitoring conducted.
DT 4. A summary of the Best Management Practices utilized at the permitted facility.
Summary should consist of a short narrative description of each BMP's in place at
the facility. If the implementation of any BMP's is planned, please include
information on these BMP's.
DT 5. A short narrative describing any significant changes in industrial activities at the f
permitted facility. Significant changes could include the addition or deletion of
work processes, changes in material handling practices, changes in material storage
practices, and/or changes in the raw materials used by the facility.
DT 6. certification of the development and implementation of a Stormwater Pollution
Prevention Plan for the permitted facility (Sign and return attached form).
If the final year analytical monitoring of the existing permit term has not been completed
prior to fling the renewal submittal, then the last years monitoring results should be submitted
within 30 days of receipt of the laboratory reports. (i.e. do not withhold renewal submittal
waiting on lab results)
RECEIVED
u
DEMLR-Stormw,,ter Program

STORMWATER POLLUTION PREVENTION PLAN
DEVELOPMENT AND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Energy, Mineral, and Land Resources -- Stormwater Program
Facility blame:
C.M. Tucker Lumber of NC,LLC- Henderson Plant
Permit Number:
NC5000132
Location Address:
100 Tucker Lumber Rcad
Henderson, NC 27537
County:
Vance
"I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all
attachments were developed and implemented under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information required by the SPPP.
Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information gathered is, to the best of my knowledge and belief, true,
accurate and complete."
And
"I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP
has been fully implemented at this facility location in accordance with the terms and conditions of the
stormwater discharge permit."
And
"I am aware that there are significant penalties for falsifying information, including the possibility of fines and
imprisonment for knowing violations."
Sign (according to permit signatory requirements) and return this Certification. DO NOT
SEND STORMWATER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION.
Signaturepcj ly
David Tucker
Print or type name of person signing above
DateJA,,�x
CEO
Title
SPPP Certification 10/13

- - Topo rranh America
r y:
IC
C. PA Tucker Lumber of
t Worth Carolina LLG
f/ a,-• I
ye.
I
5D0 001
r1istas
ng Waters Fishing Greek (listed on 3531di
impaired for Benthos however; facility
t discharge to impaired stream segment.i
Drawing Na,re.
C.M TtlCs R LUMBER OF NORTH
CAROLINA LLC
FACILITY LOCATION TOPOGRAPHICA
r �
MAP
�
Scale
Lalrtude
Longitude
See
3d= 23' 14"
78= 19 5a,
_20Ered
Data ux to ►teme �
Cf)Nurrlc ic TON
pofio[ihAnxrxa"'5
JIM
www ddAme cover FaH lB ti' LNI Data?.-,un 13 41

GRAVEL
` I 5
r • r- _ `� p I `ail
12
WETLAND
GRASS
HEAVY VEGETATION 2= y
I GRAVEL � r � � O o a
i I Jul,
GRASS I O SHE -_ la
I O O
HEAVY VEGETATION ,�' O ! ® TREATING PLANT
HEAVY VEGETATION
_
© 7 ASPHALT
SDO 001,},�, �, L- — _ 4 ® Q
DRAINAGE AREA=44.3 ACRES--��}
24% IMPERVIOUS c=0.375 COMMENTS:
1. 500-gallon used oil lank (decomissioned).
-� 2. 500-gallon off -road diesel fuel tank in containment. LEGEND.
3. Primary treating plant tank form containing the fallowing:
NOTES:
1. Loading/unloading may occur at the locations of items 1-4 and 7.
2. There are no dust/particulote generating processes at the facility
other than trucks traveling on plant roads
-
3. Non-hozordous waste is disposed of from the treating plant.
4. The receiving water, Fishing Creek, is listed on the state 303(d) 1isl
as impaired for Benthos. The facility does not dischorge to the
impaired stream segment.
Two 39.000-gallon tanks
OUTFALL POINT LOCATION
Two 27,000-gallon tanks
STORMWATER FLOW
One 22,000-gallon tank
- - - - - - -
OUTFALL DRAINAGE AREA
One 9,500-gallon lank
- - - - -
FENCE LINE
4. Two 9,500-g0on tanks in secondary containment.
-----
PROPERTY LINE
5. Lumber splitter hydraulic unit.
�{ } {
RAILROAD TRACKS
6. Crane hydraulic units.
_____f
CULVERT PIPE
7, Tanker truck unloo&ng area.
`
8. Outside storage of lumber.
9. 12,000 gallon double walled diesel tank
nsa N. Norcraas Tucka Rd
Sake �, �, Xp»
and fuel pump,
GRAPHIC SCALE (IN FT.)
i0�6EOSIDt7
�.w—(11a) l�Jnnoloq —
� 1��a1 z�-�
10. Empty tole storage.WE
11. Roil tie storage.
s , zosz
ORMAGE W
12. Gfovel pi€es.
0 200 400
800
Nv
u. s N u
N .-
a

Supplemental Information for CM Tucker Lumber of North Carolina, LLC
Page 1 of 2
Summary of Analytical Results for Outfall #1
Date
Sampled
Parameter
Lab Result
(ug)
Storm Event Data
6/22/17
BODS
<2,000
$' of rainfall resulting in 3,608,553 gallons of discharge
COD
<10,000
TOTAL NITROGEN
4,100
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
<20
pH
NS
12/29/2417
BOD5
<2,000
0.1" of rain€all resulting in 45,106 gallons of discharge
COD
<10,000
TOTAL NITROGEN
3,300
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
<20
pH
7.02 s.u.
6/29/1$
BOD5
<2,000
1" of rainfall resulting in 451,000 gallons of discharge
COD
10,200
TOTAL NITROGEN
3,590
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
<20
pH
N5
12/23/18
BOD5
<2,000
2.25" of rainfall resulting in 1,014,905 gallons of discharge
COD
<10,000
TOTAL NITROGEN
14,000
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
<20
pH
7.0 s.u.
7/30/19
BOD5
<2,000
7" of rainfall resulting in 3,157,484 gallons of discharge
COD
<10,000
TOTAL NITROGEN
2,660
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
<20
pH
7.3 s.u.
6/29/20
RODS
<2,000
7" of rainfall resulting in 3,157,484 gallons of discharge
COD
<10,000
TOTAL NITROGEN
2,660
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
<20
pH
7.3 s.u.
12/31/20
BOD5
<2,000
3.5" of rainfall resulting in 1,578,742 gallons of discharge
COD
<25,000
TOTAL NITROGEN
4,000
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
<20
pH
6.1 s.u.
6/30/21
BOD5
<2,000
4.5" of rainfall resulting in 2,029,812 gallons of discharge
COD
<2S,000
TOTAL NITROGEN
2,900
TOTAL PHOSPHOROUS
53
T. REC. COPPER
30
pH
6.9 s.u.
3/04/22
BOD5
<2,000
0.16" of rainfall resulting in 72,171 gallons of discharge
COD
<25,000
TOTAL NITROGEN
4,104
TOTAL PHOSPHOROUS
<50
T. REC. COPPER
11
pH
7.1 s.u.
NS: Not Sampled

Supplemental Information for CM Tucker Lumber of North Carolina, LLC
Page 2 of 2
Summary of Visual Monitoring Results for Outfall #1
Quantitative Analysis
for Outfall #1
Average Summary of Analysis
Color
Color varied from clear to light amber to brown depending on the amount of sediment in
the discharge.
Odor
No distinct odors were recorded or observed.
Clarity
Clarity ranged from 1 to 3 on the provided scale on the SDO Qualitative Monitoring Report.
Floating Solids
Floating solids was recorded as 1 on the provided scale on the SDO Qualitative Monitoring
Report.
Suspended Solids
Suspended solids ranged from 1 to 3 on the provided scale on the SDO Qualitative
Monitoring Report.
Foam
No Foam was observed.
Oil Sheen
No oil sheen was observed.
Erosion
No Erosion was observed,
Other Indicators
No other obvious indicators of stormwater pollution was observed.

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
110004037612
NCS000132
C.M. TUCKER LUMBER OF NC,
I
OMB No.2040-0004
Form
U.S. Environmental Protection Agency
1
:.EPA
Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
SECTION
1. ACTIVITIES
REQUIRING AN •Di
1.1
Applicants Not Required to Submit Forth 1
1.1.1
Is the facility a new or existing publicly owned
1.1.2
Is the facility a new or existing treatment works
treatment works?
treating domestic sewage?
If yes, STOP. Do NOT complete 0 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,
operation or a concentrated aquatic animal
commercial, mining, or silvicultural facility that is
rz
production facility?
currently discharging process wastewater?
a
❑ Yes -+ Complete Form 1 ❑✓ No
❑ Yes 4 Complete Form �]✓ No
a
and Farm 213,
1 and Form 2C.
a
1.2.3
Is the facility a new manufacturing, commercial,
1.2.4
Is the facility a new or existing manufacturing,
mining, or silvicultural facility that has not yet
commercial, mining, or silvicultural facility that
—
commenced to discharge?
discharges only nonprocess wastewater?
C
❑ Yes -+ Complete Form 1 ❑� No
E] Yes 4 Complete Form []✓ No
and Form 2D.
1 and Form 2E.
1.2.5
Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
a
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
F/1 Yes -+ Complete Form 1 ❑ No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x) or
b 15).
2. NAME,
ADDRESS,SECTION
MAILING . LOCATION (40
2.1
Facility Name
C.M. TUCKER LUMBER OF INC, LLC
0
2.2
EPA Identification Number
R
110004037612
2.3
Facility Contact
N
Name (first and last)
Title
Phone number
a
DAVID
TUCKER
[phone]
=
Email address
[e-mail]
2A
Facility Mailing Address
zStreet
or P.O. box
100 TUCKER LUMBER ROAD
City or town
State
ZIP code
i1ENDERSON
INC
27536
EPA Form 3510.1 (revised 3-19) Page 1

EPA identiicaLon Number
NPDES Permit Number
Facility Name
Form Approved 03105119
110004037612
NC5000132
C.M. TUCKER LUMBER OF NC,©
OMB No. 2440-00D4
H
2.5
Facility Location
yStreet,
route number, or other specific identifier
a 0
U
100TUCKER LUMBER ROAD
m
o
County name
County code (if known)
g
VANCE
0
£ _j
City or town
State ZIP code
z
HENDERSON
NC 27536
SECTION•D
I
3.1
SIC Code(s)
Description (optional)
2491
WOOD PRESERVING
N
Gl
0
O
U
U
U
3.2
NAICS Code(s)
Description (optional)
c
321114
WOOD PRESERVING
SECTIONOPERATOR
INFORMATION
4.1
Name of Operator
C.M. TUCKER LUMBER OF North Carolina, LLC
0
4.2
Is the name you listed in Item 4.1 also the owner?
€
❑✓ Yes ❑ No
w
z
4.3
Operator Status
0
❑ Public --federal ❑ Public —state ❑ Other public (specify)
o
❑✓ Private ❑ Other (specify)
4.4
Phone Number of Operator
[phone]
4.5
Operator Address
Street or P.O. Box
100 TUCKER ROAD
r
City or town
State
ZIP code
o v
HENDERSON
NC
25736
R
a
Email address of operator
O
[e-mail]
SECTION1
Is the facility located on Indian Land?
5.1
c
❑ Yes ❑✓ No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110004037612 NC5000132 C.M. TUCKER LUMBER OF NC,O OMB No. 2040-0004
ENVIRONMENTALSECTION 6. EXISTING 1
6A Existing Environmental Permits (check all that apply and print or type the corresponding permit number for each)
m NPDES (discharges to surface ❑ RCRA (hazardous wastes) ❑ UIC (underground injection of
water) fluids)
NC5000132 NCD982168460
w ❑ PSD (air emissions) ❑ Nonattainment program (CAA) ❑ NESHAPs (CAA)
CL
c
❑ Ocean dumping (MPRSA) ❑ Dredge or fill (CWA Section 404) ❑ Other (specify)
ul
7.1 Have you attached a topographic map containing all required information to this application? (See instructions for
C specific requirements.)
ID Yes ❑ No ❑ CAFO—Not Applicable (See requirements in Form 213.)
8.1 Describe the nature of your business.
The facility is a standalone wood preserving plant. Untreated lumber is transported to the facility where it is stored
w until it is pressure treated with a wood treating formulation. The treated lumber is stored at the facility prior to
N
transport.
N
7
Cd
9A Does your facility use cooling water?
d
v ❑ Yes ❑ No i SKIP to Item 10.1.
9.2 Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
a, 40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122.21(r). Consult with your
NPDES permitting authority to determine what specific information needs to be submitted and when.)
•fl Y
o U N/A
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
N apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
w when.)
v ❑ Fundamentally different factors (CWA ❑ Water quality related effluent limitations (CWA Section
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 Identiflcation Number
NPDES Permit Number
Facility Name Form Approved 03/05/19
110004037612
NCS000132
C.M. TUCKER LUMBER OF INC, LLC OMB No.2040-0004
SECTION1
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
❑ wl attachments
ED Section 2: Name, Mailing Address, and Location
❑ wl attachments
❑✓ Section 3: SIC Codes
❑ wl attachments
❑ Section 4: Operator Information
❑ wl attachments
[✓, Section 5: Indian Land
❑ wl attachments
❑✓ Section 6: Existing Environmental Permits
❑ wl attachments
❑ Section 7: Map
wl topographic
❑✓ Elwl additional attachments
map
0 Section 8: Nature of Business
❑ w/ attachments
w
❑✓ Section 9: Cooling Water Intake Structures
❑ wl attachments
a�
`'
❑✓ Section 10: Variance Requests
❑ wl attachments
C
�,
[]✓ Section 11: Checklist and Certification Statement
❑ wl attachments
Y
11.2
Certification Statement
1 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
DAVID TUCKER
CEO
Signat re
Date signed
�I
EPA Form 3510-1 (revised 3-19) Page 4

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110004037612
NCS000132
C.M. TUCKER LUMBER OF NC, LLC
OMB No.2040.0004
Form
U.S Environmental Protection Agency
2F
"EPA
Application for NPDES Permit to Discharge Wastewater
NPDES
STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY
LOCATION
i
1.1 Provide information
on each of the facilit 's ouffalls in the table below
Outfall
Receiving Water Name
Latitude
Longitude
Number
SDO 001
FISHING CREEK
36' 23' 14" N
78° 19, 56" W
e
0
U
O
A
SECTION'•
4
2.1
Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing,
upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes ✓❑ No 4 SKIP to Section 3,
2.2
Briefly identify each applicable project in the table below.
Brief Identification and
Affected Outfalis
Source(s) of Discharge
Final Compliance Dates
Required
Projected
Description of Project
(Iist outfall numbers)
.N
c
ar
E
m
0
n
E
2.3
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
EPA Form 3510-2F (Revised 3-19) Page 1

EPA Identificabon Number NPDES Permit Number Facifty Name Form Approved 03/05/19
110004037612 NCS000132 C.M. TUCKER LUMBER OF NC, LLC OMB No. 2040.0004
SECTIONDRAINAGE
d 3.1 Have you attached a site drainage map containing all required information to this application? (See instructions for
M CL specific guidance.)
R
cn'�u n
o ® Yes ❑ No
SECTIONPOLLUTANT SOURCES
4.1 Provide information on the facility's pollutant sources in the table below.
Outfall
Impervious Surface Area
Total Surface Area Drained
Number
(within a mile radius of the facility)
(within a mile radius of the facility)
specify units
specify units
SDO 001
10.63
ACRES
44.3
ACRES
specify units
specify units
specify units
specify units
specify units
specify units
specify units
specify units
specify units
specify units
4.2
Provide a narrative description of the facility's significant material in the space below. (See instructions for content
requirements.)
THE SIGNIFICANTY EXPOSED MATERIAL ON SITE IS TREATED LUMBER, AND THIS AMOUNT OF THE SIGNIFICANTLY
a�
EXPOSED MATERAL HAS STAYED CONSISTENT OVER THE PAST 3 YEARS. POST TR£ATMENT THE LUMBER IS STORED ON
A DRIP PAD THAT 15 UNDER COVER AND BERMED TO NOT ALLOW THE TREATMENT CHEMICALS FROM COMING INTO
CONTACT WITH STORMWATER. ONCE THE TREATED LUMBER IS COMPLETED DRIP DRYING ON THE PAD, THE LUMBER
IS THEN STORED ON GRAVEL/PAVED LOTS THROUGHOUTTHE PROPERTY.
0
a.
4.3
Provide the location and a description of existing structural and non-structural control measures to reduce pollutants in
stormwater runoff. See instructions forspecificguidance.)
Stormwater Treatment
Codes
Outfall
from
Number
Control Measures and Treatment
Exhibit
2F-1
list
SDO 001
COVERED TREATMENT AREAS, CONCRETE BERMED DRIP PADS, SPCC PLAN, EMPLOYEE
TRAiNiNG, VISUAL INSPECTIONS
EPA Form 3510-2F (Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105/19
110004037612 NCS000132 C.M. TUCKER LUMBER OF NC, LLC OMB No. 2040-0004
W
5.1 I certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the
presence of non-stormwater discharges. Moreover, I certify that the outfells identified as having non-stormwater
discharges are described in either an accompanying NPDES Form 2C, 2D, or 2E application.
Name (print or type first and last name)
Official title
DAVID TUCKER
CEO
Signature
Date signed
U ) Q - �'Vui-
5.2
Provide the testing information requested in the table below.
Outfall
Onsite Drainage Points
Number
Description of Testing Method Used
Date(s) of Testing
Directly Observed
During Test
SDO 001
VISUAL
03/02/2022
OUTFALL
SDO 001
VISUAL
6/30/2021
OUTFALL
SOO 001
VISUAL
12/25/2020
OUTFALL
SDO 001
VISUAL
6/29/2020
OUTFALL
SDO 001
VISUAL
7/30/2019
OUTFALL
SDO 001
VISUAL
12/23/2018
OUTFALL
6.1 Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years.
NO SIGNIFICANT LEAKS OR SPILLS OF TOXIC OR HAZARDOUS POLLUTANTS IN THE LAST THREE YEARS.
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must
o complete. Not all applicants need to complete each table.
7.1 Is this a new source or new discharge?
❑ Yes 4 See instructions regarding submission of ✓❑ No 4 See instructions regarding submission of
v
estimated data. actual data.
Tables A, 13, C, and D
N 7.2 Have you completed Table A for each outfall?
a ✓ Yes ❑ No
EPA Form 3510-2F (Rev{sed 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110004037612
NC5000132
C.M. TUCKER LUMBER OF INC, U-C
OMB No.2040-0004
7.3
Is the facility subject to an effluent limitation guideline (ELG) or effluent limitations in an NPDES permit for its process
wastewater?
❑ Yes 0No 4 SKIP to Item 7.5.
7.4
Have you completed Table B by providing quantitative data for those pollutants that are (1) limited either directly or
indirectly in an ELG and/or (2) subject to effluent limitations in an NPDES permit for the facility's process wastewater?
g._..
-:,�-::::_ �_:
❑ Yes ❑ No
7.5
Do you know or have reason to believe any pollutants in Exhibit 2F-2 are present in the discharge?
==.
❑✓ Yes ❑ No 4 SKIP to Item 7.7.
7.6
Have you listed all pollutants in Exhibit 2F-2 that you know or have reason to believe are present in the discharge and
_
provided quantitative data or an explanation for those pollutants in Table C?
❑✓ Yes ❑ No
V
7.7
Do you qualify for a small business exemption under the criteria specified in the Instructions?
=a
❑ Yes 4SKIP to Item 7.18. ❑✓ No
7.8
Do you know or have reason to believe any pollutants in Exhibit 2F-3 are present in the discharge?
="
❑✓ Yes ElNo SKIP to Item 7.10.
t�, r
P `
7.9
Have you listed all pollutants in Exhibit 2F-3 that you know or have reason to believe are resent in the discharge in
Y Po Y P 9
M.W
w
Table C?
❑✓ Yes ❑ No
o
7.10
Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater?
-emu
❑✓ Yes ❑ No 4 SKIP to Item 7.12.
-�
7.11
Have you provided quantitative data in Table C for those pollutants in Exhibit 2F-3 that you expect to be discharged in
concentrations of 10 ppb or greater?
a;=
❑✓ Yes ❑ No
_�=`-
7.12
Do you expect acrolein, acrylonitrile, 2,4-dinitrophenol, or 2-methyl-4,6-dinitrophenol to be discharged in concentrations
of 100 ppb or greater?
❑ Yes ❑✓ No 4 SKIP to Item 7.14.
-
=-- -°
t
7.13
Have you provided quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be
�=-
discharged in concentrations of 100 b or greater?
g PP
� _ R
❑ Yes ❑ No
=—_
7.14
Have you provided quantitative data or an explanation in Table C for pollutants you expect to be present in the
discharge at concentrations less than 10 ppb (or less than 100 ppb for the pollutants identified in Item 7.12)?
❑✓ Yes ❑ No
_
-
7.15
Do you know or have reason to believe any pollutants in Exhibit 2F4 are present in the discharge?
— _
❑ Yes ❑✓ No 4 SKIP to Item 7.17.
7.16
Have you listed pollutants in Exhibit 2F4 that you know or believe to be present in the discharge and provided an
—
explanation in Table C?
❑ Yes ❑ No
7.17
Have you provided information for the storm event(s) sampled in Table D?
❑✓ Yes ❑ No
�,
EPA Form 3510-2F (Revised 3-19) Page 4

EPA Identification Number
NPOES Permit Number
Facility Name
Form Approved 03/05119
110004037612
NCS000132
C.M. TUCKER LUMBER OF NC, LLC
OMB No, 204MOD4
Used or Manufactured Toxics
7.18
Is any pollutant listed on Exhibits 2F-2 through 2F4 a substance or a component of a substance used or
manufactured as an intermediate or final product or byproduct?
0
`-'
❑ Yes ElNo SKIP to Section B.
c
0
7.19
List the pollutants below, including TCDD if applicable.
0
1. Copper 4. 7.
m
2. 5. 8.
0
3. 6. 9.
SECTION•
•GICAL TOXICITY TESTING DATA I
Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on
8.1
M
any of your discharges or on a receiving water in relation to your discharge within the last three years?
0
❑ Yes ❑✓ No 4 SKIP to Section 9.
8.2
Identify the tests and their purposes below,
ZTest(s)
Purpose of Test(s)
Submitted to NPDES
Date Submitted
x
Permitting Authority?
0
~
❑ Yes ❑ No
R
U
o
❑ Yes ❑ No
0
m
❑ Yes ❑ No
SECTIO
N 9. CONTRACT•-
9.1
• I
Were any of the analyses reported in Section 7 (on Tables A through C) performed by a contract laboratory or
consulting firm?
❑✓ Yes ❑ No 4 SKIP to Section 10.
9.2
Provide information for each contract laboratory cr consulting firm below.
Laboratory Number 1
Laboratory Number 2
Laboratory Number 3
Name of laboratory/firm
CONVERSION TECHNOLOGY
PACE ANALYTICAL SERVICES,
o
INC.
INC.
(CONSULTING FIRM)
0
Laboratory address
.y
2190 N. NORCROSS TUCKER
110 TECHNOLOGY PARKWAY,
co
RD, NORCROSS, GA 30071
NORCROSS, GA 30092
c
R
o
Phone number
v
t770)263-6330
(7701734-4200
Pollutant(s) analyzed
N/A
pH
Boa
TOTAL NITROGEN
TOTAL PHOSPHOROUS
COD
TOTAL_ COPPER
EPA Form 3510-21' (Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 030/19
110004037612 NCS000132 C.M. TUCKER LUMBER OF NC, LLC OMB No. 2040-0004
SECTION
M CHECKLIST
10.1
AND 1
In Column 1 below, mark the sections of Form 2F 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
ID Section 1
❑ wl attachments (e.g., responses for additional outfalls)
M Section 2
❑ wl attachments
✓❑ Section 3
❑ wi site drainage map
✓❑ Section 4
❑ wl attachments
R1 Section 5
❑ wl attachments
0 Section 6
❑ wl attachments
E
0 Section 7
❑ Table A ❑ wl small business exemption request
m
❑ Table B ❑ wl analytical results as an attachment
2
0 Table C ❑ Table D
❑✓ Section 8
❑ wlattachments
r
N
n✓ Section 9
❑ wlattachments (e.g., responses for additional contact laboratories or firms)
Y
❑✓ Section 10
❑
U
10.2
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
DAVID TUCKER
CEO
Signature
Date signed
-0,� 6 ��
-?IIID0a.a
EPA Form 3510-2F (Revised 3.19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
�nnnn n�7c�n I .1rI r nn ri erveo i "nnnro nr nir r r enn not OMB No. 2040-0004
TABLE A. CONVENTIONAL AND NON CONVENTIONALI
You muss provide the results of at least one anal sis for every pollutant in this table. Complete one table for each outfall. See instructions for additional details and re uirements.
Pollutant or Parameter
Maximum Daily Discharge
(specify units)
Average Daily Discharge
(specify units)
Number of Storm
Events Sampled
Source of
Information
(new sourcelnew
dischargers only; use
codes in instructions)
Grab Sample Taken
During First
30 Minutes
Flow -Weighted ed
Composite
Grab Sample Taken
During First
30 Minutes
Flow -Weighted
Composite
1.
Oil and grease
N/A
NOT REQUIRED
2.
Biochemical oxygen demand (BOD5)
<2,000 ug/L
5
HISTORICAL DATA
3.
Chemical oxygen demand (COD)
<25,000 ug/L
5
HISTORICAL DATA
4.
Total suspended solids (TSS)
N/A
NOT REQUIRED
5.
Total phosphorus
10.6 ug/L
5
HISTORICAL DATA
6.
Total Kjeldahl nitrogen (TKN)
<50 ug/L
5
7.
Total nitrogen (as N)
3,372 ug/L
5
HISTORICAL DATA
pH (minimum)
6.1 s.u.
5
HISTORICAL DATA
$.
pH (maximum)
7.1 s.u.
S
HISTORICAL DATA
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 3510-2F (Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
110004037612 NC5000132 C.M. TUCKER LUMBER OF NC, LLC I SDO 001
Form Approved 03/D5/19
OMB No. 2040-0004
TABLE B. CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 1122.211(g)(7)(vi)(A))'
List each pollutant that is limited in an effluent limitation guideline (ELG) that the facility is subject to or any pollutant listed in the facility's NPDES permit for its process wastewater (if the
facility is operating under an existing NPDES permit). Complete one table for each outfall. See the instructions for additional details and requirements.
Pollutant and CAS Number (if available)
Maximum Daily Discharge
(spedf units
Average Daily Discharge
speci units)
Number of Storm
Events Sampled
Source of
Information
(new source/new
dischargers only; use
codes in instructions)
Grab Sample Taken
During First
30 Minutes
Flo
omposit Flow -Weighted
e
Composite
Grab Sample Taken
During First
30 Minutes
Comosite Flow -Weighted
p
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 3510-2F (Revised 3-19) Page 9

This page intentionally left blank.

1 Ideniftation Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
110004037612 NCS000132 C.M. TUCKER LUMBER OF NC, LLC I SDO 001 OMB No.2040-0004
TOXICTABLE C. POLLUTANTS,"1• AND ASBESTOS (40 . 40
List each pollutant shown in Exhibits 2F-2, 2F-3, and 2F4 that you know or have reason to believe is present. Complete one table for each outfall. See the instructions for additional
details and requirements.
Pollutant and CAS Number (if available)
Maximum Daily Discharge
s ea units
Average Daily Discharge
s eci units
Number of Storm
Events Sampled
Source of
Information
(new sourcelnew
dischargers only; use
codes in instructions)
Grab Sample Taken
During First
30 Minutes
Flow -Weighted
Composite
Grab Sample Taken
During First
30 Minutes
flow -Weighted
Composite
p
Total Copper
N/A
N/A
60 ug/L
N/A
5
HISTORICAL DATA
' 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 1, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F (Revised 3-19) Page 11

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility name Ouffall Number Form Approved 03105/19
110004037512 NC5000132 C.M. TUCKER LUMBER OF NC, LLC 5DO 001 OMB No. 2040.0004
TABLE D. STORM EVENT INFORMATION1 ,
Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow -weighted composite sample.
Number of Hours Between
"total Rainfall During Maximum Flow Rate
Duration of Storm Event Beginning of Storm Measured and Total Flow from Rain Event
Date of Storm Event (in hours] Storm Event End of Previous Measurable Rain During Rain Event (in gallons or specify units}
(in inches) Event (in gpm or specify units)
Provide a description of the method of flow measurement or estimate,
EPA Form 3510.2F (Revised 3-19) Page 13