NCS000133_Updated Application_20230130

Jowat as
Adhesives
RECEIVED
Jowat Corporation
P.O. Box 1368
J APA nn��
U
High Point, NC 27261
USA
DEMLR-Stornvater Program
January 19, 2023
Ms. Brianna Young
DEMLR—Stormwater Program
NC Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Re: Updated Renewal Documents
Jowat Corporation
Archdale, Randolph County, North Carolina
Permit ID NO. NCS000133
Dear Ms. Young:
The enclosed documents are updates to those previously submitted during April/May 2022 for renewal of our existing
storm water permit. The updates address the recent purchase of an adjacent parcel of property.
Electronic copies of these documents have been entailed to you at briann.voungPncdenr.aov.
Thank you for your attention to this request. Should you have any questions or require additional information, please
contact me by telephone at 336.434.9080 or by email at mlamberg(a)iowat.com. You may also contact our consultant,
Mr. Kevin Woods of AERIS Environmental, Inc. by telephone at 704.641.7003 or by email at kevin(cDaerisenviro.com.
Martin
VP of N
Enclosures: SWPPP Certification, EPA Form 1, EPA Form 2F, Property Boundary Figure
V;7V GJ
Phone: [phone]
Fax: [phone]
[e-mail]

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110007662779
NCS000133
Jowat Corporation
OMB No. 2040-0004
U.S. Environmental Protection Agency
Ferm
t
%&EPA
Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
SECTION•
1.1
r r
Applicants Not Required to Submit Farm 1
Is the facility a new or existing publicly owned
1.1.2
Is the facility a new or existing treatment works
1.1.1
treatment works?
treating domestic sewage?
If yes, STOP. Do NOT complete No
If yes, STOP. Do NOT No
Fonn 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
a
production facility?
currently discharging process wastewater?
oYes
4 Complete Form 1 ❑✓ No
Yes 4 Complete Form No
a
and Form 2B.
1 and Form 2C.
m1.2.3
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?
Yes 4 Complete Form 1 ❑✓ No
Yes Complete Form �✓ No
and Form 2D.
1 and Form 2E.
N
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-stormwatef2
Yes 4 Complete Form 1 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x) or
SECTION
ADDRESS, AND LOCATION (40
2.1
Facility Name
jowat Corporation
0
2.2
EPA Identification Number
.q
x
110007662779
,s
0
2.3
Facility Contact
Name (first and last)
Title
Phone number
v
Martin Lamberg
VP of Manufacturing
[phone]
m
Email address
c
[e-mail]
d
2.4
Facility Mailing Address
E
A
Street or P.O. box
z
6058 Lois Lane
City or town
State
ZIP code
Archdale
NC
27263
EPA Form 3510-1 (revised 3-19) Page i

EPA IdenUUcation Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110007662779
NCS000133
Jowat Corporation
OMB No. 2040-0004
2.5
Facillty Location
a S,
Street, route number, or other specific identifier
4 S
5608 Uwharrie Road
�U
g
County name
County code (if known)
Randolph
S o
City ortown
State ZIP code
z
Archdale
NC 27263
SECTION•
NAICS CODES1
3.1
SIC Code(s)
Description (optional)
2891
Adhesives and Sealants
rn
m
a
C3
to
V
z
3.2
NAILS Code(s)
Description (optional)
c
m
325520
Adhesive Manufacturing
U
N
SECTIONOPERATOR
INFORMATION (40
Name of 0 erator
4.1
Jowat Corporation
`o_
4.2
Is the name you listed in Item 4.1 also the owner?
a,r❑
Yes ❑ No
=
4.3
Operator Status
0
❑ Public —federal ❑ Public —state ❑ Other public (specify)
V
o
0Private ElOther (specify)
4.4
Phone Number of Operator
[phone]
4.5
Operator Address
Street or P.O. Box
5608 Uwharrie Road
c S
City or town
State
ZIP code
0
`o o
Archdale
NC
27263
o
Email address of operator
www.jowat.com
SECTION66
1
1 •1
facility located on Indian Land?
7Ise
Yes ❑✓ No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identificalion Number NPOES Permit Number Facility Name Form Approved 03N5119
110007662779 NC5000133 Jowat Corporation OMB No. 2040-0004
SECTION• 1
6.1 Existing Environmental Permits (check all that apply and print or type the corresponding permit number for each)
9
d
❑ NPDES (discharges to surface
❑ RCRA (hazardous wastes)
❑ UIC (underground injection of
c
water)
Fluids)
UJ
a
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
c
❑ Ocean dumping (MPRSA) ❑ Dredge or fill (CWA Section 404) ❑ Other (specify)
SECTION1
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.)
SECTIONOF
8.1
1
Describe the nature of your business.
Adhesive manufacturing. We have above ground storage tanks for raw materials. These raw materials are conveyed
in a closed piping system to our commercial mixers, the material is heated to form a liquid. Once the mixing process
is completed the product is then transfered over to a storage tank by a closed piping system. The product is then
cooled and pelletized. Once pelletized the product will go as a finished product into a bulk bag or a bin at which time
m
all the finished product will be packaged for shipment.
`o
m
Z
SECTION••
,1
9.1
Does your facility use cooling water?
❑✓ Yes ❑ No -i SKIP to Item 10.1.
A E
9.2
Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
ME
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.)
O Y
Cj
Public water supply.
SECTIONr
VARIANCE
REQUESTSt t
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)? (Check all that
10.1
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors (CWA ❑ Water quality related effluent limitations (CWA Section
d
Section 301(n)) 302(b)(2))
A
❑ Non -conventional pollutants (CWA ❑ Thermal discharges (CWA Section 316(a))
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
110007662779
NCS000133 Jowat Corporation OMB No. 2040-0004
SECTION•
r
In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
11.1
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
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
❑ w/ attachments
❑✓ Section 6: Existing Environmental Permits
❑ w/ attachments
c
❑� Section 7: Map
❑ matopographic ❑ w/ additional attachments
y
u
❑� Section 8: Nature of Business
❑ wl attachments
❑� Section 9: Cooling Water Intake Structures
❑ wl attachments
t)
❑� Section 10: Variance Requests
❑ wl attachments
v
c
H
❑� Section 11: Checklist and Certification Statement
❑ w/ attachments
d
11.2
Certification Statement
U
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
Martin Lemberg
VP of Manufacturing
Signatu
Date signed
rA
EPA Form 3510-1 (revised 3-19) Page 4

EPA Identification Number NPDES Permit Number FacilityName Form Approved 03105119
110007662779 NC5000133 Jowat Corporation 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
SECTIONOUTFALL LOCATION•r
1.1 Provide information on each of the facilit Is outfalls in the table below
Outfall Receiving Water Name Latitude Longitude
Number
01 Tributary of Uwharrie River 35° 54 4.8" N 80° 0' 40.2" W
c
0
�a 02 Tributary of Uwharrie River 35° 54 7.7" N 80° 0' 40.1" W
0
J
03 Tributary of Uwharrie River 35° 54' 14.6" N 80° 0 28.1" W
O „
SECTION
••• r
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 0 No 4 SKIP to Section 3.
2.2 Briefly identify each applicable project in the table below.
Brief Identification and Affected Outfalls Final Compliance Dates
Description of Project (list ouffall numbers) Source(s) of Discharge
Required Projected
2
E
a
0
E
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 Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No. 2040-0004
I
110007662779 NCS000133 Jowat Corporation
SECTIONDR ' 1
3.1 Have you attached a site drainage map containing all required information to this application? (See instructions for
;: specific guidance.)
o ® Yes ❑ No
SECTIONPOLLUTANT SOURCESI
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
01
0.8
acres
1.0
acres
specify units
specify units
02
2.3
acres
3.5
acres
specify units
specify units
03
7.2
acres
23.5
acres
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.)
Significant material exposure is limited due to our manufacturing processes including storage of raw materials, waste
m
materials and finished products are performed indoors. Our two waste water tanks have adequate secondary
containment. Jowat uses BMPs to control and remove pollutants. Jowat does not use pesticides, herbicides etc. Jowat
o
rn
does not have any floor drains in the manufacturing and storage areas inside the facility.
m
3
0
IL
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
from
Outfall
Control Measures and Treatmexhibit
nt
E
Number
2F-1
gist)
All
Spill prevention plan, employee training, and routine inspections.
All
Preventive maintenance and housekeeping
03
Retention pond
EPA Form 3510-2F (Revised 3-19) Page 2

t Identification Number NPDES Permit Number Fadlity Name Form Approved 03/05/19
110007662779 NCS000133 Jowat Corporation OMB No. 2040-0004
PN 5. NON• 1 1
5.1 1 certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the
presence of nonstormwater discharges. Moreover, I certify that the outfalls 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) I Official title
Martin
y
or 5.2 Provide the
L Outfall
U
o Number
v
m
E
E
`o
in
c
0
2
nation requested in the table below.
Description of Testing Method Used
Not Applicable
VP of Manufacturing
Date signed
(-26-Z023
Date(s) of Tesfng I Directly Observed
6.1 1 Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years
N
.n None
on
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.
6 7.1 Is this a new source or new discharge?
o ❑ Yes 4 See instructions regarding submission of O No 4 See instructions regarding submission of
estimated data. actual data.
q' Tables A, B, C, and D
y 7.2 Have you completed Table A for each outfall?
❑✓ Yes ❑ No
EPA Form 3510-2F (Revised 3.19) Page 3

EPA Identification Number
NPDES Permit Number
Facft Name
Form Approved 03/05119
OMB No. 2040-0004
110007662779
NCSO0O133
Jowat Corporation
7.3
Is the facility subject to an effluent limitation guideline (ELG) or effluent limitations in an NPDES permit for its process
wastewater?
❑ Yes ❑✓ No + 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 andlor (2) subject to effluent limitations in an NPDES permit for the facility's process wastewater?
❑ Yes ❑ No
7.5
Do you know or have reason to believe any pollutants in Exhibit 217-2 are present in the discharge?
❑ Yes 0 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
7.7
Do you qualify for a small business exemption under the criteria specified in the Instructions?
❑ 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 ❑✓ No 4 SKIP to Item 7.10.
M
7.9
Have you listed all pollutants in Exhibit 2F-3 that you know or have reason to believe are present in the discharge in
Table C?
0
❑ Yes ❑ No
0
7.10
Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater?
1
❑ Yes 0 No 4 SKIP to Item 7.12.
7.11
Have you provided quantitative data in Table C for those pollutants in Exhibit 217-3 that you expect to be discharged in
concentrations of 10 ppb or greater?
y
❑ Yes ❑ No
7.12
Do you expect acrolein, acrylonitrile, 2,4-dinitrophenol, or 2-methyl4,6-dinitrophenol to be discharged in concentrations
of 100 ppb or greater?
❑ Yes ❑✓ No 4 SKIP to Item 7.14.
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 ppb or greater?
❑ 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
NPDES Permit Number
Fadlity Name
Form Approved 03/05/19
110007662779
NCS000133
Jowat Corporation
OMB No. 2040-0004
o
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 No 4 SKIP to Section 8.
c
0
.€
7.19
List the pollutants below, including TCDD if applicable.
1. 4. 7.
m
m
2. 5. 8.
t
u
0
3. 6. 9.
SECTION
8. BIOLOGICAL
TOXICITY TESTING DATA (40 CFR 122.21 (g)(1 1))
8.1
Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on
m
any of your discharges or on a receiving water in relation to your discharge within the last three years?
0
c
❑ Yes ✓❑ No 4 SKIP to Section 9.
8.2
Identify the tests and their purposes below.
Z
Tests)
Purpose ofTest(s)
Submitted to NPDES
Date Submitted
Permitting Authority?
0
~
❑ Yes ❑ No
A
u
o
❑ Yes ❑ No
0
m
❑ Yes ❑ No
SECTION•
9.1
• • t
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 or consulting firm below.
Laboratory Numbed
LaboratoryNumber2
Laboratory Number)
Name of laboratory/firm
Pace Analytical
r=
0
E
`o
Laboratory address
H
1377 South Park Drive
y
Kernersville, NC 27284
c
Q
U
N
o
Phone number
c)
[phone]
Pollutant(s) analyzed
TSS, pH
EPA Foam 3510-2F (Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105/19
110007662779 NCS000133 Jowat Corporation OMB No. 2040-0004
SECTION1
AND CERTIFICATION STATEMENT (40
10.1
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 com fete all sections or provide attachments.
Column 1
Column 2
❑� Section 1
❑ wl attachments (e.g., responses for additional outfalls)
❑✓ Section 2
❑ w/ attachments
❑ Section 3
❑ w/ site drainage map
El Section 4
❑ w/ attachments
❑ Section 5
❑ wl attachments
c
❑ Section 6
❑ w/ attachments
✓❑ Section 7
❑ Table A ❑ wl small business exemption request
N
c
❑ Table B ❑ wl analytical results as an attachment
0
❑ Table C ✓❑ Table D
:
❑✓ Section 8
❑ wlattachments
a
c
w
❑� Section 9
❑ wlattachments (e.g., responses for additional contact laboratories or firms)
d
❑✓ 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. 1 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
Martin Lamberg
VP of Manufacturing
Signature
Date signed
(-ZG-ZoZ3
EPA Form 3510-2F (Revised 3-19) Page 6

110007662779
NCS000133
Jowat Corporation
01
Form Approved 03105119
OMB No. 2040-0004
TABLE A. CONVENTIONAL AND NON CONVENTIONALr
You must provide the results of at least one anab sis for every pollutant in this table. Complete one table for each outfall. See instructions for additional details and requirements.
Pollutant or Parameter
Maximum Daily Discharge
(spa* units)
Average Daily Discharge
(spa* units)
Number of Storrs
Events Sampled
Source of
Information
use
dischargers ew
codes inmstruclions)
Grab Sample
Taken First
Dur30Minutes
Flow -Weighted
Composite
GrabCSamgpleTTaaken
30Minutes First
Flow -Weighted
Composite
1.
Oil and grease
Not Analyzed
2.
Biochemical oxygen demand (BOD5)
Not Analyzed
3.
Chemical oxygen demand (COD)
Not Analyzed
4.
Total suspended solids (TSS)
32.8 mg/L
1
5.
Total phosphorus
Not Analyzed
6.
Total Keldahl nitrogen (TIW)
Not Analyzed
7.
Total nitrogen (as N)
nalyzed
No!8.08
pH (minimum)
1
8.
pH (maximum)
s.0s
1
r 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 7-01

EPA Identification Number NPDES Permit Number
110007662779 NCS000133
Facility Name Outfall Nm
Jowat Corporation 02umber
Approved 03N5/19
ForOMB No. 2040-0004
TABLE A. • • 1 NON CONVENTIONAL1
You must 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
(ne source/new
dischargers use
codes in instructions)
leTaken
GrobSample
30 Minutes
Flow -Weighted
Composite
GraleTaken
During
30 Minutes
Flow -Weighted
Composite
1.
Oil and grease
Not Analyzed
2.
Biochemical oxygen demand (BODs)
Not Analyzed
3.
Chemical oxygen demand (COD)
Not Analyzed
4.
Total suspended solids (TSS)
14.6 mg/L
1
5.
Total phosphorus
Not Analyzed
6.
Total Kjeldahl nitrogen (TKN)
Not Analyzed
7.
Total nitrogen (as N)
Not Analyzed
pH (minimum)
7,96
1
8.
pH (maximum)
7.96
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 3510-21F (Revised 3-19) Page 7-02

EPA
110007662779 1NCS000133 I Jowat Corporation 103
Form Approved 03/05/19
OMB No. 2040-0004
TABLE A. CONVENT10NAL AND NON CONVENTIONAL40
You must provide the results of at least one anall sis for every pollutant in this table. Complete one table for each outfall. See instructions for additional details and requirements.
Pollutant or Parameter
Maximum Daily Discharge
(specify units)
Average Daily Discharge
(specify units)
Number of Stone
Events Sampled
Source of
Information
dischargernew s use
codes in insbuchons)
GrabSample
Firstken
30 Minutes
Flow -Weighted
Composite
GrsDunng Firstle Taken
30 Minutes
Flow -Weighted
Composite
1.
Oil and grease
Not Analyzed
2.
Biochemical oxygen demand (BOD5)
Not Analyzed
3.
Chemical oxygen demand (COD)
Not Analyzed
4.
Total suspended solids (TSS)
22.9 mg/L
1
5.
Total phosphorus
Not Analyzed
6.
Total Kjeldahl nitrogen (TKN)
Not Analyzed
7.
Total nitrogen (as N)
Not Analyzed
pH (minimum)
7.74
1
8.
pH (maximum)
7.74
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 3510-2F (Revised 3-19) Page 7-03

EPA Identification Number
110007662779
ES Permit Number Facility Name
NCS000133 I Jowat Corporation
I Number
All
Form Approved 03/05/19
OMB No. 2040-0004
TABLE B. CERTAIN CONVENTIONAL AND NON CONVENTIONAL• a a t and s 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
(sp units _
Average Da'tly.Discharge
s units
Number of Stone
Events Sampled
Source of
Information
(new sourcelnew
dischargers only, use
codes, in instructions)
Grab Sample Taken
During FirstDuring
30 Minutes
flow -Weighted
Composite
Grab Sample Taken
First
30 Minutes
Flov+rWelghted
Composite
Not Applicable
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

EPA
110007662779
NPDES Permit Number
NCS000133
Facility Name
lowat Corporation
Ouftl Number
All
Form Approved 03105/19
OMB No. 2040-0004
TABLE C. TOXIC POLLUTANTS, CERTAIN HAZARDOUS SUBSTANCES, AND ASBESTOS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vi)(B) and �vii))'
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 . units
Average Daily Discharge
s units
Number of Storm
Events Sampled
Source of
Information
(new souroeJnew
dischargers only, use
odes in instructions)
Grab Sample Taken
During First
30 Mlntttes
Flow -Weighted
Composite
Grab Sample Taken
During First
30 Minutes
Flaw -Weighted
Composite
Not Applicable
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 11

EPA Identification Number NPDES Permit Number Facility name Outfall Number Form Approved 03N5/19
110007662779 NCS000133 Jowat Corporation All OMB No. 2D40-0004
TABLE D. STORM EVENT INFORMATION41
Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow -weighted composite sample.
Number of Hours Between
Duration of Storm Event Total Rainfall During Beginning of Storm Measured and Maximum Flow Rate Total Flow from Rain Event
Date of Storm Event Storm Event During Rain Event
(in hours) (in inches) End of Previous Measurable Rain (in gpm or specify units) (in gallons orspedry units)
Event
03/09/2022
6 Hours 1.8 in. Unknown Unknown Unknown
Provide a description of the method of flow measurement or estimate.
Sample collection is performed by an outside contractor. Their report does not indicate hours since previous event or flow information.
EPA Form 3510-2F (Revised 3-19) Page 13

STORMWATER POLLUTION PREVEN-TION'PLAN-
DEVELOPMENT A:ND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Energy, Mineral, and Land Resources — Stormwater Program
Facility Name:
Jowat Corporation
Permit Number:
NCS000133
Location Address:
6058 Lois Lane
Archdale. NC 27263
County:
Randolph
"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 STORMW4TER POLLUTION PREVENTION PLAN WITH:THIS CERTIFICATION.
Signature
Martin Lemberg
Print or type na
of person signing above
Date l V Z 6 -ZOO?
VP of Manufacturing
Title
SPPP Certification 10/13

sm
,Stormw\ater
`Uwharne Rw r
' s �etentio�n '� ,
'Pond
7ri66tary of Outfa1102
uw rrie River � t
/ J t
3
r
of
O all Coordi ales i r �
4'
t � 35.90132�,-SO!0111R0
35,9021j6,. .01113.6
l
¢3:35.9 I
09 67 - .007 t-^

Updated January 2023
10.0 CERTIFICATIONS
10.1 SPCC Engineering Certification
Pursuant to 40 CFR 112.3(d) and by means of this SPCC certification, I attest that: (1) 1 am
familiar with the requirements of the SPCC rule (40 CFR Part 112); (ii) I have visited and
examined the facility; (iii) the Plan has been prepared in accordance with good engineering
practice, including consideration of applicable industry standards, and with the requirements of
the SPCC rule; (iv) procedures for required inspections and testing have been established, and,
(v) the Plan is adequate for the facility.
This certification in no way relieves the owner or operator of the facility of his/her duty to
prepare and fully implement this SPCC Plan in accordance with the requirements of 40 CFR 112.
This Plan is valid only to the extent that the facility owner or operator maintains, tests, and
inspects equipment, containment, and other devices as prescribed in this Plan.
wool —
Signature:
CAR %.
Name: Kevin S. Woods. PE
• SE •
Company: AERIS Environmental, Inc.
mt cR ; •'
Date:
Page 36 of 37

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
110007662779
NC5000133
Jowat Corporation
OMB No. 2040-0004
U.S. Environmental Protection Agency
Form
1SEPA
Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
SECTION•UIRING
AN NPIDES PERMIT 140
1.1 Applicants Not
Required to Submit Form t
Is the facility a new or existing publicly owned
1.1.2
Is the facility a new or existing treatment works
1.1.1
treatment works?
treating domestic sewage?
If yes, STOP. Do NOT complete No
if yes, STOP. Do NOT ✓0 No
Form 1. Complete Form 2A.
complete Form 1. Complete
Form 2S.
1.2
Applicants Required to Submit Form 1
z
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
a
production facility?
currently discharging process wastewater?
w
Yes 4 Complete Form 1 Q No
Yes Complete Form No
IL
and Form 2B.
1 and Form 2C.
m1.2.3
Is the facility a new manufacturing, commercial,
1.2.4
Is the facility a new or existing manufacturing,
mining, or silvicullural facility that has not yet
commercial, mining, or silvicullural facility that
=
commenced to discharge?
discharges only nonprocess wastewater?
❑ Yes 4 Complete Form 1 No
Yes 4 Complete Form [Z] No
and Form 2D.
1 and Form 2E.
w
dp
1.2.5
Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
0 Yes 4 Complete Form 1 0 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x) or
SECTION
2.1
•• AND LOCATION (40
Facility Name
Jowat Corporation
0
2.2
EPA Identification Number
U
�
110007662779
v
m
2.3
Facility Contact
d
Name (first and last)
Title
Phone number
v
Martin Lemberg
VP of Manufacturing
[phone]
Email address
c
[e-mail]
m
2.4
Facility Mailing Address
A
Street or P.O. box
z
6058 Lois Lane
City or town
State
ZIP code
Archdale
NC
27263
EPA Form 3510-1 (revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05119
110007662779
NCS000133
Jowat Corporation
OMB No. 2040-0004
d
2.5
Facility Location
'
v
Street, route number, or other specific identifier
C
Q 0
5608 Uwharrie Road
rn
5 `o
County name
County code (if known)
Randolph
E
City or town
State ZIP code
z �
Archdale
NC 27263
SECTION1
NAICS CODES
SIC Code(s)
Description (optional)
3.1
2891
Adhesives and Sealants
ffi
v
0
U
H
U
3.2
NAICS Code(s)
Description (optional)
a
c
10
325520
Adhesive Manufacturing
v
N
SECTIONOPERATOR
• ' • 1
Name of Operator
4.1
Jowat Corporation
4.2
Is the name you listed in Item 4.1 also the owner?
❑✓ Yes ❑ No
4.3
Operator Status
❑ Public —federal ❑ Public —state ❑ Other public (specify)
o
❑✓ Private ElOther (specify)
4.4
Phone Number of Operator
[phone]
4.5
Operator Address
a'
Street or P.O. Box
5608 Uwharrie Road
c .,,'E•,
City or town
State
ZIP code
`o o
U
Archdale
INC
27263
V
n
Email address of operator
wvvw.jowat.com
SECTION1
• 1 41
m
5.1
Is the facility located on Indian Land?
❑ Yes ❑✓ No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/06119
110007662779 NCS000133 Jowat Corporation OMB No. 2040-0004
SECTION-• 1
6.1 Existing Environmental Permits (check all that apply and print or type the corresponding permit number for each)
d
❑ NPDES (discharges to surface
❑ RCRA (hazardous wastes)
❑ UIC (underground injection of
c
water)
fluids)
c
15 a
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
c
❑ Ocean dumping (MPRSA) ❑ Dredge or fill (CWA Section 404) ❑ Other (specify)
SECTIONr
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.)
SECTIONOF
1
8.1
Describe the nature of your business.
Adhesive manufacturing. We have above ground storage tanks for raw materials. These raw materials are conveyed
m
in a closed piping system to our commercial mixers, the material is heated to form a liquid. Once the mixing process
0
is completed the product is then transfered over to a storage tank by a closed piping system. The product is then
''
cooled and pelletized. Once pelletized the product will go as a finished product into a bulk bag or a bin at which time
m
all the finished product will be packaged for shipment.
0
m
z
SECTION••
r
9.1
Does your facility use cooling water?
m
❑✓ Yes ❑ No 4 SKIP to Item 10.1.
A 3
9.2
Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122.21(r). Consult with your
C fn
NPDES permitting authority to determine what specific information needs to be submitted and when.)
d
O C
V
Public water supply.
SECTIONr
a 1 r
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)? (Check all that
10.1
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
m
m
when.)
d
❑ 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 (reused 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03I05119
110007662779 NCS000133 lowat Corporation OMB No. 2040-0004
SECTION
11. CHECKLIST
AND CERTIFICATION STATEMENT r
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 7
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
❑ wl attachments
❑✓ Section 5: Indian Land
❑ w/ attachments
❑� Section 6: Existing Environmental Permits
❑ wl attachments
c
E
❑✓ Section 7: Map
wltopographic
❑✓ ❑ wl additional attachments
ma
N
`o
❑✓ Section 8: Nature of Business
❑ w/ attachments
❑✓ Section 9: Cooling Water Intake Structures
❑ w/ attachments
U
❑✓ Section 10: Variance Requests
❑ wl attachments
,e
c
m
❑✓ Section 11: Checklist and Certification Statement
❑ wl attachments
32
d
11.2
Certification Statement
t
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
Martin Lamberg
VP of Manufacturing
Signatur
Date signed
( - 26 - 2OZ
EPA Form 3510-1 (remsed 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105/19
110007662779 NCS000133 Jowat Corporation OMB No. 2040-0004
Form U.S Environmental Protection Agency
2F \"iEPA Application for NPDES Permit to Discharge Wastewater
NPDES STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY
SECTIONOUTFALL LOCATION1
1.1 Provide information on each of the facili 's ouffalls in the table below
Ouffall Receiving Water Name Latitude Longitude
Number
01 Tributary of Uwharrie River 35° 54 4.8" N 80° 0' 40.2" W
0
0
02 Tributary of Uwharrie River 35° 54 7.7" N 80° 0 40.1" W
0
03 Tributary of Uwharrie River 35° 54 14.6" N 80° 0 28.1" W
SECTION°• 1
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 0 No 4 SKIP to Section 3.
2.2 Briefly identify each applicable project in the table below.
Brief Identification and Affected Outfalls Final Compliance Dates
Description of Project (list oudall numbers) Source(s) of Discharge
Required Projected
N
C
E
E
m
o i
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 Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
OMB No. 2040-0004
110007662779 NCSOOO133 lowat Corporation
SECTIONDR 1
3.1 Have you attached a site drainage map containing all required information to this application? (See instructions for
specific guidance.)
rn•��
o ® Yes ❑ No
SECTION• • r
4.1 Provide information on the facility's pollutant sources in the table below.
OuNall
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
01
0.8
acres
1.0
acres
specify units
specify units
02
2.3
acres
3.5
acres
specify units
specify units
03
7.2
acres
23.5
acres
specify units
specify units
spedy units
specify units
specify units
spedy units
4.2
Provide a narrative description of the facility's significant material in the space below. (See instructions for content
requirements.)
Significant material exposure is limited due to our manufacturing processes including storage of raw materials, waste
ate+
materials and finished products are performed indoors. Our two waste water tanks have adequate secondary
U
�
containment. Jowat uses BMPs to control and remove pollutants. Jowat does not use pesticides, herbicides etc. Jowat
0
N
does not have any floor drains in the manufacturing and storage areas inside the facility.
m
0
a
Provide the location and a description of existing structural and non-structural control measures to reduce pollutants in
stormwater runoff. See instructions forspecific guidance.)
Stormwater Treatment
F4.3
Codes
from
OuNall
Control Measures and Treatment
Exhibit
Number
1
2F-1
gist)
All
Spill prevention plan, employee training, and routine inspections.
All
Preventive maintenance and housekeeping
03
Retention pond
EPA Fonn 3510-21F (Revised 3-19) Page 2

a
:+r
0
a
110007662779
NCSOOO133
dowat Corporation
Form Approved 03105/19
OMB No. 2040{)004
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 outfalls 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 fitle
Martin Lamberg VP of Manufacturing
Signature Date signed
(-26-2©23
5.2 Provide the testing formation requested in the table below.
Outfall Onsite Drainage Points
Number Description of Testing Method Used Date(s) of Testing Directly Observed
1 1—
Not Applicable
6.1 1Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years.
None
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.
:a
� 7.1 Is this a new source or new discharge?
o ❑ Yes 4 See instructions regarding submission of ❑✓ No 4 See instructions regarding submission of
m
estimated data. actual data.
IF Tables A, B, C, and D
y 7.2 Have you completed Table A for each outfall?
C3 ❑✓ Yes ❑ No
EPA Form 3510-2F (Revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
OMB No. 2040-0004
110007662779
NCS000133
Jowat Corporation
7.3
Is the facility subject to an effluent limitation guideline (ELG) or effluent limitations in an NPDES permit for its process
wastewater?
❑ Yes ❑ No 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?
❑ 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
7.7
Do you qualify for a small business exemption under the criteria specified in the Instructions?
❑ Yes 4SKIP to Item 7.18. ❑ No
7.8
Do you know or have reason to believe any pollutants in Exhibit 217-3 are present in the discharge?
❑ Yes 0 No 4 SKIP to Item 7.10.
7.9
Have you listed all pollutants in Exhibit 2F-3 that you know or have reason to believe are present in the discharge in
Table C?
C❑
Yes ❑ No
0
IN
7.10
Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater?
❑ Yes ❑f No 4 SKIP to Item 7.12.
5
7.11
Have you provided quantitative data in Table C for those pollutants in Exhibit 2F-3 that you expect to be discharged in
LM
concentrations of 10 ppb or greater?
=0
Yes ❑ No
Aft
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.
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 ppb or greater?
❑ 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 2F-4 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
NPDES Permit Number
Facility Name
Form Approved 03105/19
110007662779
NCS000133
Jowat Corporation
OMB No. 2040-0004
a
Used or Manufactured Toxics
7.18
Is any pollutant listed on Exhibits 2F-2 through 2F-4 a substance or a component of a substance used or
'E
manufactured as an intermediate or final product or byproduct?
0
❑ Yes No 4 SKIP to Section 8.
C
0
7.19
List the pollutants below, including TCDD if applicable.
1. 4. 7.
m
LM,
2. 5. 8.
r
u
c
3. 6. 9.
SECTIONBIOLOGICAL
T• D 41
8.1
Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on
any of your discharges or on a receiving water in relation to your discharge within the last three years?
A
c
❑ Yes ❑✓ No 4 SKIP to Section 9.
r?c
F
8.2
Identify the tests and their purposes below.
Test(s)
Purpose of Test(s)
Submitted to NPDES
Date Submitted
x
Permitting Authority?
F
❑ Yes ❑ No
�
U
e
❑ Yes ❑ No
0
'm
❑ Yes ❑ No
SECTION•
9.1
• • t
Were any of the analyses reported in Section 7 (on Tables A through C) performed by a contract laboratory or
consulting fine?
❑� Yes ❑ No 4 SKIP to Section 10.
9.2
Provide information for each contract laboratory or consulting firm below.
Laboratory Number I
Laboratory Nurri
Laboratory Number 3
Name of laboratory/firm
Pace Analytical
c
0
E
`o
H
Laboratory address
1377 South Park Drive
N
Z`
w
Kernersville, NC 27284
c
Q
u
m
o
Phone number
U
[phone]
Pollutant(s) analyzed
T56, pH
EPA Form 3510-21' (Reused 3-19) Page 5

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03105/19
110007662779
NC5000133 Jowat Corporation OMB No. 2040-0004
SECTIONr
10.1
AND CERTIFICATION STATEMENT (40
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 com fete all sections or provide attachments.
Column 1
Column 2
❑✓ Section 1
❑ wl attachments (e.g., responses for additional outfalls)
❑✓ Section 2
❑ w/ attachments
✓❑ Section 3
❑ wl site drainage map
❑ Section 4
❑ w/ attachments
✓❑ Section 5
❑ w/ attachments
❑� Section 6
❑ w/ attachments
c
v
✓❑ Section 7
❑ Table A ❑ wl small business exemption request
N
❑ Table B ❑ w/ analytical results as an attachment
0
❑ Table C ✓❑ Table D
W
U
❑✓ Section 8
❑ wlattachments
a
c
Section 9
❑ wlattachments (e.g., responses for additional contact laboratories or firms)
Mn❑�
d
Section 10
❑
10.2
Certification Statement
I certify under penally 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
Martin Lemberg
VP of Manufacturing
Signature
Date signed
4&/
(-Z6-ZoZ3
EPA Farm 3510-2F (Revised 3.19) Page 6

110007662779
NCS000133
Jowat Corporation
I Number
Form Approved 03/05/19
OMB No. 2040-0004
TABLE A. CONVENTIONAL AND NON• • r
You must provide the results of at least one anall 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
(spedlyunits)
Number of Storm
Events Sampled
Source of
Information
dischargers oumenev;
y, use
codes in instructions)
Grab Sample
pleTaken
30 Minutes
Flow -Weighted
Composite
Grab Samuring le Taken
30 Minutes First
Flow -Weighted
Composite
1.
Oil and grease
Not Analyzed
2.
Biochemical oxygen demand (BO05)
Not Analyzed
3.
Chemical oxygen demand (COD)
Not Analyzed
4.
Total suspended solids (TSS)
32.8 mg/t
i
5.
Total phosphorus
Not Analyzed
6.
Total Kjeldahl nitrogen (TKN)
Not analyzed
7.
Total nitrogen (as N)
Not Analyzed
pH (minimum)
8.08
1
8.
pH (maximum)
8.08
1
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 3510-2F (Revised 3-19) Page 7-01

� Identification Number NPDES Permit Number Fadfity Name - Outlet Number Form Approved 03/05119
110007662779 NCS000133 Jowat Corporation 1 02 OMB No. 2040-OON
TABLE A. CONVENTIONAL A• NON CONVENTIONALr
You must 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
dischargers gersceinnDurie
codes in instructions)
Grab Sample i�keh
30 Minutes
Flow Weighted
Composfte
Grab Sampleng Taken
30 Minutes
Flow -Weighted
Composite
1.
Oil and grease
Not Analyzed
2.
Biochemical oxygen demand (BOD5)
Not analyzed
3.
Chemical oxygen demand (COD)
Not Analyzed
4.
Total suspended solids (TSS)
14.6 mg/L
1
5.
Total phosphorus
Not Analyzed
6.
Total Kjeldahl nitrogen (TKN)
Not Analyzed
7.
Total nitrogen (as N)
Not Analyzed
pH (minimum)
7.96
1
8.
pH (maximum)
7.96
1
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 3510-21' (Revised 3-19) Page 7-02

110007662779
NCS000133
Jowat Corporation
03
Farm Approved 03/05119
OMB No. 2040-0004
TABLE A. CONVENTIONAL AND NON• • r
You must 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
(spedfy units)
Average Daily Discharge
(spedfy units)
Number of Storm
Events Sampled
Source of
Information
(newsoume/nm
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
1.
Oil and grease
Not Analyzed
2.
Biochemical oxygen demand (BODs)
Not Analyzed
3.
Chemical oxygen demand (COD)
Not Analyzed
4.
Total suspended solids (TSS)
22.9 mg/L
1
5.
Total phosphorus
Not Analyzed
6.
Total Kjeldahl nitrogen (TKN)
Not Analyzed
7.
Total nitrogen (as N)
Not Anal
pH (minimum)
7.74
1
8.
pH (maximum)
77410
1
r 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 7-03

EPA Identification Number
110007662779
ES Permit Number Facility Name Outfall Number
NCS000133 I Jowat Corporation All
Form Approved 03/05/19
OMB No. 2040-0004
TABLE B. CERTAIN CONVENTIONALAND / • POLLUTANTS • ' and ' • '
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
' units
Average Daily Discharge
' units
Number of Stone
Events Sampled
Source of
Information
(new soumelnew
dischargers only, use
codes in instructions)
Grab Sample Taken
During First
30`Mlnutes
Flow -Weighted
Composite
Grab Sample
During First
313 Minutes
Flow -Weighted
Composite
Not Applicable
' 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 of
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

Identfication Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
110007662779 1 NCS000133 I lowat Corporation I All OMB No. 2040-0004
TABLE ` aNTS, CERTAIN HAZARDOUSAND ASBESTOS a` CFR 122.26(c)(1)(i)(E)(4) and a • w and
List each pollutant shown in Exhibits 2F-2, 2F-3, and 2F-4 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
'(Spe*units
Average Daily Discharge
s unb
Number of Storm
Events Sampled
Source of
Information
(new sobreefiew
dischargers only, use
codes in instructons)
Grab Sample Taken
During First
30'Minutes
Flow -Weighted
Composite
Grab Sample Taken
During First
30 Minutes
Flow -Weighted
Composite
Not Applicable
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 11

1 Identification Number NPDEB Permit Number Facility name Outfall Number Form Approved 0305/19
110007662779 1 NCSO I Jowat Corporation All OMB No. 2040-0004
Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow -weighted composite sample.
Duration of Storm Event Total Rainfall During Beginning of Storm Measured and Maximum Plow Rate Total Flow from Rain Event
Date of Storm Event Storm Event During Rain Event
(in Hours) (in inches) End of Previous Measurable Rain (in gpm or ape* units) (in gallons a specify units)
Event
03/09/2022
6 Hours 1.8 in. Unknown Unknown Unknown
Provide a description of the method of flow measurement or estimate.
Sample collection is performed by an outside contractor. Their report does not indicate hours since previous event or flow information.
EPA Form 3510-2F (Revised 3-19) Page 13

STORMWATER POLLUTION PREVENTION ;PLAN 1
DEVELOPMENT AND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Energy, Mineral, and Land Resources — Stormwater Program
Facility Name:
Jowat Corporation
Permit Number:
NCS000133
Location Address:
6086 Lois Lane
Archdale, NC 27263
County:
Randolph
"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 STORMW4TER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION.
Signature
Martin Lamberg
Print or type
e of person signing above
Date
I - Z6 -Zvz3
VP of Manufacturing
Title
SPPP Certification 10/13

Tr4tary of outfall
uwlKrle River
A-74-
D
4
UwharrieRiv r
'AN
Obtfall OIL,
0

Updated January 2023
10.0 CERTIFICATIONS
10.1 SPCC Engineering Certification
Pursuant to 40 CFR 112.3(d) and by means of this SPCC certification, 1 attest that: (i) I am
familiar with the requirements of the SPCC rule (40 CFR Part 112); (ii) l have visited and
examined the facility; (iii) the Plan has been prepared in accordance with good engineering
practice, including consideration of applicable industry standards, and with the requirements of
the SPCC rule; (iv) procedures for required inspections and testing have been established, and,
(v) the Plan is adequate for the facility.
This certification in no way relieves the owner or operator of the facility of his/her duty to
prepare and fully implement this SPCC Plan in accordance with the requirements of 40 CFR 112.
This Plan is valid only to the extent that the facility owner or operator maintains, tests, and
inspects equipment, containment, and other devices as prescribed in this Plan.
Signature:
C A Ro
Name: Kevin S. Woods. PE .• Q4`
— SE •
Company: AERIS Environmental. Inc.
%, .•.• ............ N
<q r
Date: o < o O�
Page 36 of 37