NC0049905_Application_20230303

February 16, 2023
North Carolina Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: NPDES Renewal Application for Associated Asphalt Salisbury, LLC
Dear Mr. Dowden:
Please find the enclosed renewal application for National Pollutant Discharge
Elimination System (NPDES) Permit Number NC0049905 for Associated Asphalt
Salisbury, LLC. The facility is located at 1825 Jake Alexander Boulevard, West;
Salisbury, NC 28147.
The application includes Form 1, Form 2C, a general site map, a specific site map
indicating outfall locations and a site drainage map. Through this submission Associated
Asphalt Salisbury, LLC requests renewal of NPDES Permit Number NC0049905.
Should you have questions or require more information, please don't hesitate to contact
me at [phone] or [e-mail]
Sincerely,
67
��/1?/x��� /
Karen Murphy
EHS Manager
110 FRANKLIN ROAD SE, 9T" FLOOR • ROANOKE, VIRGINIA 24027 • [phone]
www.associatedasphalt.com

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105119
NCO049905
Associated Asphalt Salisbury, LLC
OMB No. 2040-0004
Farm
U.S. Environmental Protection Agency
1
\-/EPA
Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
•
•
1
Required to Submit Form 1
1.1
Applicants Not
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,
E '
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 0 No
Yes 4 Complete Form ❑ No
n.
and Form 28.
1 and Form 2C.
1.2.3
Is the facility a new manufacturing, commercial,
1.2.4
Is the facility a new or existing manufacturing,
._,
o> :
mining, or silvicultural facility that has not yet
commercial, mining, or silvicultural facility that
commenced to discharge?
discharges only nonprocess wastewater?
n Yes 4 Complete Form 1 ❑✓ No
Yes 4 Complete Form No
Of
and Form 2D.
1 and Form 2E.
tl
,'-
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?
❑ Yes 4 Complete Form 1 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x) or
b 15).
Facility Name
21
Associated Asphalt Salisbury, LLC
o
2.2
EPA Identification Number:
U
O
J
m
2.3
Facility Contact
w
Name (first and last)
Title
Phone number
"a
Richard Seville
Terminal Manager
[phone]
Email address
�,...
[e-mail]
d
2.4
Facility Mailing Address
M
Street or P.O. box
1825 Jake Alexander Boulevard, West
City or town
State
ZIP code
Salisbury
North Carolina
28147
EPA Form 3510-1 (revised 3-19) Page 1

EPA Identificafion Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
NCO049905
Associated Asphalt Salisbury, LLC
OMB No. 2040-OW4
i
2.5
Facility Location
wStreet,
route number, or other specific identifier
.,:a:. o.-
1825 Jake Alexander Boulevard, West
rnU
0
County name
County code (if known)
Rowan
080
E v:
City or town
State ZIP code
z m ,
Salisbury
North Carolina 28147
3.1
SIC Code(s)
Description (optional)
5171
Petroleum Bulk stations and Terminals
w
a
0
U_
U
Z
3.2
NAICS Code(s)
Description (optional)
a
c
1O
424710
Petroleum Bulk stations and Terminals
U
4.1
Name of Operator
Associated Asphalt Salisbury, LLC -
o
4.2
Is the name you listed in Item 4.1 also the owner?
E
✓❑ Yes ❑ No
w
as
4.3
Operator Status
m
❑ Public —federal ❑ Public —state ❑ Other public (specify)
b,,, ;
❑✓ Private ElOther (specify)
4.4
Phone Number of Operator
[phone]
4.5
Operator Address
.0
Street or P.O. Box
6
E. y
1825 Jake Alexander Boulevard, West
o
5 `
City or town
State
ZIP code
0 0
Salisbury
North Carolina
28147
A
n
Email address of operator
o
[e-mail]
SECTION1
1 1
0
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 MOM
NCO049905
Associated Asphalt Salisbury, LLC OMB No. 2040-0004
6.1 Existing Environmental Permits (check all that
apply and print or type the corresponding permit number for each)
d
m NPDES (discharges to surface
❑ RCRA (hazardous wastes)
❑ UIC (underground injection of
o
water)
fluids)
N00049905
c r
w n
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑✓ NESHAPs (CAA)
c
08428R04
❑ Ocean dumping (MPRSA) ❑ Dredge or fill (CWA Section 404) ❑ Other (specify)
•
I
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 28.)
8.1
Describe the nature of your business.
Liquid asphalt is received by rail, transfered to storage tanks and distributed by truck.
N_
N
N
C
J
O_
N
J
CS
Z
•
••
I
9.1
Does your facility use cooling water?
d
❑ Yes ❑✓ No 4 SKIP to Item 10.1.
3 3
9.2
Identify the source of cooling water. (Note that facilities that use a waling water intake structure as described at
o, —
40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122,21(r). Consult with your
c 5
NPDES permitting authority to determine what specific information needs to be submitted and when.)
O Y
C f-
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
42
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
d j
❑ 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 349) Page 3

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
NCO049905 Associated Asphalt Salisbury, LLC OMB No. 204OMN
SECTION1
CERTIFICATION STATEMENT (40
11.1
In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1
Column 2
❑✓ Section 1: Activities Requiring an NPDES Permit
❑ w/ attachments
❑✓ Section 2: Name, Mailing Address, and Location
❑ w/ attachments
❑✓ Section 3: SIC Codes
❑ w/ attachments
❑✓ Section 4: Operator Information
❑ w/ attachments
❑✓ Section 5: Indian Land
❑ w/ attachments
❑✓ Section 6: Existing Environmental Permits
❑ w/ attachments
d
❑✓ Section 7: Map
❑✓laopographic ❑ w/ additional attachments
o
❑✓ Section 8: Nature of Business
❑ w/ attachments
w
❑ Section 9: Cooling Water Intake Structures
❑ w/ attachments
d
❑ Section 10: Variance Requests
❑ w/ attachments
v
C
;
❑✓ Section 11: Checklist and Certification Statement
❑ w/ attachments
Y
c
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 property gather and evaluate the
information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible forgathering the information, the information submitted is, to the best of my knowledge and
belief, true, accurate, and complete./ 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 titre
4Aw tJ&J J'M
\j I CC- ?Re%I t> 3 6itowlbt55
Si natu���
Dale signed
1
2-rS- 23
EPA Form 3510-1 (revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03N5119
NCO049905 Associated Asphalt Salisbury, LLC OMB No. 2040-0004
Form U.S. Environmental Protection Agency
2C \".EPA Application for NPDES Permit to Discharge Wastewater
NPOES EXISTING MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURE OPERATIONS
SECTIONOUTFALL LOCATION•r
1.1 Provide information on each of the facifl 's outfalls in the table below.
OutfaNumber Receiving Water Name Latitude Longitude
0 al)qnainerl n 6a ar
J 001 �i C-�Ci/v/S -�LrY�k / 35" 41' 6.5' N El 8rP 30' 36.2$' W
42
0 002 / 35' 41' 10.67' N 80' 30' 34.1g' W
SECTIONo
•' I
M 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
3 balance? (See instructions for drawing requirements. See Exhibit 2C-1 at end of instructions for example.)
J N
o ❑✓ Yes ❑ No
SECTION• r
3.1 For each outfall identified under Item 1.1, provide average flow and treatment information. Add additional sheets if
necessa
"Outfall Number" 001
Operations
Operation Average Flow
Boiler blowdown 0,000042 mgd
c
E Water Softener blowdown 0.000065 mgd
A
w
Stormwater runoff Variable mgd
v
c
N mgd
Treatment Units
0
LL
Description Final Disposal of Solid or
v (include size, flow rate through each treatment unit, Code from Liquid Wastes Other Than
a
retention time, etc. Table 2C-1 by Discharge
Retention Pond (controlled by valve) 1-U, 1-F Sedimentation/Evaporation
EPA Form 3510-2C (Revised 3.19) Page 1

EPA Identification Number
NPDES Permit Number
Fadlity Name
Form Approved 03105119
N00049905
Associated Asphalt Salisbury, LLC
OMB No. 2040-0004
3.1
"Outfall Number" 002
Cont.
• . • . .
Operation Average Flow
Stormwater runoff
Variable mgd
mgd
mgd
mgd
Treatment
Description
Units
Final Disposal of Solid or
fromealment
(include size, flow rate through each treatment unit, '
Liquid Wastes Other Than
Table 2C-1
retention time, etc.
by Discharge
Retained within berm surrounding tank 5 (controlled by vat
I-F
Evaporation, Soil absorption
V
,.:.
-E
E
m
"Outfall Number"
0
Operations Contributing to Flow
o
`Operation ->'-Average Flow
LL f
mgd
¢'
mgd
mgd
mgd
Treatment
Description
Units
fromeatmenl
Final Disposal of Solid or
(include size, Flow rate through each treatment unit,
Table 2C•1
Liquid Wastes Other Than
retention time, etc.
by Discharge
3.2
Are you applying for an NPDES permit to operate a privately owned treatment works?
E E
❑ Yes ❑✓ No 4 SKIP to Section 4.
m
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 03105119
NC0049901. Associated Asphalt Salisbury, LLC OMB No. 2040MM
SECTION• 1
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 n cessary.
Outfall
Operation
Fret
uenc
Flow Rate
Average
Average
Long -Term
Maximum
Number
(list)
Duration
Da slWeek
MonthslYear
Average
Dail
Boller blowdown
7 daystweek
12 monthslyear
,0000112 mild
.00005 mgd
1 days
N
0
001
Water softener
3 daysAveek
12 months/year
,000065rn9d
.00013 m9d
1 days
wdays/week
i;
monthsyear
mgd
mgd
days
E
NA
days1week
mon0u/year
mild
mgd
days
d
c
daystweek
monthslyear
mgd
mgd
days
002
daystweek
monthslyear
mgd
mild
days
days/week
monthslyear
mgd
mild
days
day shveek
monthsryear
mild
mild
days
daysMeek months/year mgd mild days
SECTION•1
• 1
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.
w
5.2
Provide the following information on applicable ELGs.
wELG
Category
ELG Subcategory
Regulatory Citation
m
a
a
.n
o.
Q
5.3
Are any of the applicable ELGs expressed in terms of production (or other measure of operation)?
❑ Yes ❑ No 4 SKIP to Section 6.
0
5.4
Provide an actual measure of daily production expressed in terms and units of applicable El -Gs.
J
Outfall
Operation, Product, or Material
Quantity per Day
dolt of
Number
Measure
m
0
0
T—i
0
0
a`
EPA Form 3510-2C (Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105/19
NCO049905 Associated Asphalt Salisbury, LLC OMB No. 204OZO04
SECTION• I
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 4 SKIP to Item 6.3.
6.2
Briefly identify each applicable project in the table below.
Affected
Final Compliance Dates
E
Brief Identification and Description of
Outfalls
Source(s) of
o
Project
(listoutfall
Discharge
Required
Projected
z
number
_E
a
c
m
a
v
a
A
rn
n
6.3 Have you attached sheets describing any additional water pollution control programs (or other environmental projects
that may affect your discharges) that you now have underway or planned? (optional item)
❑ Yes ❑ No ❑✓ Not applicable
SECTION•
i
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 -* 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 OulfallNumber OutfallNumber
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?
❑ Yes ❑ No; a waiver has been requested from my NPDES
ermitlin authorit for all pollutants at all outfalls.
Table B. Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants
7.4
Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry tegories
c
listed in Exhibit 2C-39 (See end of instructions for exhibit.)
❑ Yes We- �i�'a e /lo Slim b"i ❑ No 4 SKIP to Item 7.8.
7.5
Have you checked 'Testing Required' for all toxic metals, cyanide, and total phenols in Section 1 of Table B?
w
❑ 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
P
Required GCIMS Fraction(s)
Check applicable boxes.
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
EPA Form 3510-2C (Revised 3-19) Page 4

EPA Idenfificafion Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
NCO049905
Associated Asphalt Salisbury, LLC
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?
❑ 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
0
determined testing is required or (2) quantitative data or an explanation for those Sections 2 through 5, Table B,
you have indicated are "Believed Present" in your discharge?
8pollutants
N
❑ Yes ❑ No
Table C. Certain Conventional and Non -Conventional Pollutants
R
7.12
Have you indicated whether pollutants are "Believed Present' or 'Believed Absent" for all pollutants listed on Table C
for all outfalls?
x
❑✓ Yes ❑ No
7.13
Have you completed Table C by providing (1) quantitative data for those pollutants that are limited either directly or
indirectly in an ELG and/or (2) quantitative data or an explanation for those pollutants for which you have indicated
'Believed Present"?
❑ Yes ❑ No
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• -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&
USED
OR • 1
8.1
Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
2!an
intermediate or final product or byproduct?
❑ Yes ❑✓ No 4 SKIP to Section 9.
2
8.2
List the pollutants below.
c .—
ro
1. 4. 7.
0
d
a
2. 5. 8.
3. 6. 9.
EPA Form 3510-2C (Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number FacilityName Form Approved 03/05119
NCO049905 Associated Asphalt Salisbury, LLC OMB No. 2040-0004
• • • • I
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?
y ❑ Yes ❑✓ No 4 SKIP to Section 10.
9.2
Identify the tests and their
Durposes below.
;o
Test(s)
Purpose of Test(s)
Submitted to NPDES
Date Submitted
Permittin Authority?
0
$
❑ Yes ❑ No
0
0
ro
❑ Yes ❑ No
❑ Yes ❑ No
SECTIONr
CONTRACT
ANALYSES (40
10.1
Were any of the analyses reported in Section 7 performed by a contract laboratory or consulting firm?
❑ Yes 0 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
N
d
Laboratory address
R
C
Q
U
N
C
Phone number
Pollutant(s) analyzed
SECTIONDD
• • • .r
11.1
Has the NPDES permitting authority requested additional information?
o
❑ Yes ❑✓ No 4 SKIP to Section 12.
11.2
List the information requested and attach it to this application.
0
1. 4.
C
0
a
2. 5.
v
Q
3. 6.
EPA Form 3510-2C (Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Fadlity Name Form Approved 03/05/19
NCO049905 Associated Asphalt Salisbury, LLC OMB No. 204OMN
SECTION•
CERTIFICATION STATEMENT (40 , ,
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 com late all sections or provide attachments.
Column 1
Column 2
❑✓ Section 1: Outfall Location
❑ w/ attachments
❑✓ Section 2: Line Drawing
❑✓ w/ line drawing ❑ w/ additional attachments
Section 3: Average Flaws and
❑✓
w/ list of each user of
❑ wl attachments ❑ privately owned treatment
Treatment
works
❑✓ Section 4: Intermittent Flows
❑ w/ attachments
❑ Section 5: Production
❑ w/ attachments
wl optional additional
❑ Section 6: Improvements
❑ w/ attachments ❑ sheets describing any
additional pollution control
Tans
❑ wl request for a waiver and ❑ wl explanation for identical
supporting information outfalls
EEl
w/ small business exemption ❑ w/ other attachments
v
request
❑ Section 7: Effluent and Intake
❑ wl Table A ❑✓ w/ Table B
Characteristics
0
❑✓ w/ Table C wl Table D
w
❑✓ wl Table E Elw/ analytical results as an
attachment
Section 8: Used or Manufactured
❑
El w/ attachments
N
Toxics
Section 9: Biological Toxicity
ElTests
E]wlattachments
a
s
U
❑ Section 10: Contract Analyses
❑ w/ attachments
❑ Section 11: Additional Information
❑ wl attachments
❑✓ Section 12: Checklist and
❑ wl attachments
Certification Statement
12.2
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
511' kCL L.
UICr Pee;Ak"n-AmIrl
Sigaah:�
Date signed
u
G
EPA Form 3510-2C (Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name
Ouffall Number
Form Approved 03/05/19
NCO049905 Associated Asphalt Salisbury, LLC
001
OMB No. 2040.0004
MM•
•e,r
Effluent
Intake
Pollutant
VE:3Check
Waiver
Requested
Units
Opt ral
Maximum
Maximum
Long -Term
applicable)
(specOY)
Daily
Monthly
Average Daily
Number of
Long -Term
Number ofes
Discharge
Discharge
Discharge
Analys
Average Value
Analyses
reui
If available
if available
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
Mass
(BOD5)
Chemical oxygen demand
2'
El
Concentration
Mass
(COD)
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.
oampung snan oe conauctea accoramg to sumcienuy sensmve test prooeoures p.e., memoas) approvea unaer 4u crK tss for the analysis or pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
No /)4�7/'� I�Wi%i),6TD SLOWIVl vW f4TG %IV
SL��TN�R �LrJl1/ 1 ✓W j1(�ULU /�/SGffi�RC--� F%o� TstE/�crvv X14 AZeW o41cV 7/1,!F_ 6;eeaW/-) _STt k 4PV4T£,'
TZ6WS 7G 14 i2 76E_ '770/1/ /&VJ C'OUGD f�E /�/SCf`/�iCG'—£1� Tll*UC/f A
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EPA Form 3510-2C (Revised 3.19)/, Q iJISCE//-r'KG� f� s el)enzs6 £D /�1f�, �� l��/T/CS �f�!l�/% i%T/7tK �)`//'JC�4LL.

This page intentionally left blank.

EPA Identification Number NPDES Permit Number
Facility Name
Outfall Number Foam Approved 03/05/19
NCO049905
Associated Asphalt Salisbury, LLC
001 OMB No. 2040-0004
TABIE TOXIC•E,
TOTAL PHENOLS,AND
ORGANIC TOXICPOLLUTANTSr
Presence or Absence
Intake
check one
Effluent
(optional)
Pollutant/Parameter
(and CAS Number, aavailable)
Testing
Required
Believed Believed
Units -
(specify)
Maximum
Maximum
Long -Term
Average
Number
Long -
Number
I
Present Absent
" Daily
Discharge
Discharge
Monthly >
Discharge
Daily
of
Term
Average
of
-
:,.(required)
(if available)
Discharge
Analyses
Value
Analyses
(if
El
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
El
❑
❑✓
Concentration
(7440-36-0)
Mass
1.2
Arsenic, total
Concentration
(7440-38-2)
Mass
1.3
Beryllium, total
❑
✓❑
Concentration
(7440-41-7)
Mass
1.4
Cadmium, total
Concentration
(7440-43-9)
Mass
1.5
Chromium, total
Concentration
(7440-47-3)
Mass
1.6
Copper, total
❑
Concentration
(7440-50-8)
Mass
1.7
Lead total
Concentration
(7439-92-1)
Mass
1.8
Mercury, total
✓❑
Concentration
(7439-97-6)
Mass
1.9
Nickel, total
Concentration
(7440-02-0)
Mass
1.10
Selenium, total
Concentration
(7782-49-2)
Mass
1.11
Silver, total
El
j ❑
IZI
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 03/05/19
NC0049905
Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
Presence or Absence
Intake
check one
Effluent
(optional)
Pollutant/Parameter
Testing
'
Units
Maximum
Maximum
Long -Term
Long-
and CAS Number,'rfavailable
( )
Required
q
Believed
Believed
s
(pedfy) `
Daily
Monthly
Average
Number
Term
Number
Present
Absent
Discharge
Discharge
Dail y
of
Average
of
(required)
(a available)
Discharge
Analyses
Value
Analyses
if available
1.12
Thallium, total
❑
❑
❑
Concentration
Mass
(7440-28-0)
1.13
Zinc, total
❑
❑
❑
Concentration
Mass
(7440-66-6)
1.14
Cyanide, total
El
❑
❑
Concentration
Mass
(57-12-5)
1.15
Phenols, total
El
El
❑✓
Concentration
Mass
Section 2.Organic Toxic Pollutants (GCIMS Fraction —Volatile Compounds)
21
Acrolein
❑
❑
❑
Concentration
Mass
(107-02-8)
2.2
Acrylonitrile
❑
❑
0Concentration
Mass
(107-13-1)
2.3
Benzene
El
❑
❑
Concentration
Mass
(71-43-2)
2.4
Bromoform
El
❑
❑
Concentration
Mass
(75-25-2)
2.5
Carbon tetrachloride
❑
❑
❑
Concentration
Mass
(56-23-5)
2.6
Chlorobenzene
El
❑
❑
Concentration
Mass
(108-90.7)
2.7
Chlorodibromomethane
El
❑
IZI
Concentration
Mass
(124-48-1)
2.8
Chloroethane
❑
❑
❑
Concentration
Mass
(75-00-3)
EPA Form 3510-2C (Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number
Facility Name
Outfall Number Form Approved 03/05/19
NCO049905
Associated Asphalt Salisbury, LLC
001 OMB No. 2040-0004
• •
•
• • ••
Presence or Absence
• •• •r
Intake
check one
Effluent
(optional)
PollutantlParameter
Testing
Units
Maximum
Maximum
Long -Term
Long-
(andCAS Number,'rfavailable)
Required
Believed
Believed
(specify).
Daily
Monthly c
Average
Number
Term
Number
Present
Absent
Discharge
Dail
of
Average
of
(if available)
Discharge
Analyses
Analyses
if available
2 9
2-chloroethylvinyl ether
❑
❑
❑
Concentration
(110-75-8)
Mass
2.10
Chloroform (67-66-3)
❑
❑
0
Concentration
Mass
2.11
Dichlorobromomethane
❑
❑
❑
Concentration
(75.27-4)
Mass
212
11-dichloroethane
❑
❑
❑
Concentration
(75-34-3)
Mass
2.13
1 2-dichloroethane
El
❑
IZI
Concentration
(107-06-2)
Mass
2.14
11-dichloroethylene
❑
❑
❑
Concentration
(75-35-4)
Mass
2.15
1,2-dichloropropane
❑
❑
❑✓
Concentration
(78-87-5)
Mass
216
13-dichloropropylene
El
❑
❑
Concentration
(542-75-6)
Mass
217
Ethylbenzene
❑
❑
❑
Concentration
(100-41-4)
Mass
218
Methyl bromide
❑
❑
❑
Concentration
(74-83-9)
Mass
219
Methyl chloride
❑
❑
✓❑
Concentration
(74-87-3)
Mass
2.20
Methylene chloride
❑
❑
❑✓
Concentration
(75-09-2)
Mass
221
1,1,22-tetrachloroethane _T_❑
❑
❑
Concentration
(79-34-5)
Mass
EPA Form 3510-2C (Revised 3-19) Page 13

Identification Number NPDES Permit Number
NC0049905
Facility Name Outfall Number Form Approved 03/05/19
Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
(2.22
• •
Pollutant/Parameter
(and CAS Number, if available)
(and
•
Testing
Required
• • •-
Presence or Absence
check one
• -•r
Units
(specify)
Effluent
Intake
(optonal)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(if available)
Long -Term
Average
Discharge ily
'a
Number
of
Analyses
Long -
Term
Average
Value
of
Analyses
rachloroethylene
7-18-4)
Concentration
Mass
2.23
Toluene
(108-88-3)
❑
❑
❑
Concentration
Mass
2.24
12-trans-dichloroethylene
(156-60-5)
0Concentration
Mass
225
11,1-trichloroethane
(71-55-6)
❑✓
Concentration
Mass
226
11,2-trichloroethane
(79-00-5)
O
Concentration
Mass
227
Trichloroethylene
(79-01-6)
❑
❑
o✓
Concentration
Mass
2.28
Vinyl chloride
(75-01-4)
❑✓
Concentration
Mass
Section 3.Organic Toxic Pollutants GCIMS Fraction —Acid Compounds
31
2-chlorophenol
(95-57-8)
Concentration
Mass
3.2
2,4-dichlorophenol
(120-83-2)
❑
❑
❑
Concentration
Mass
3.3
24-dimethylphenol
(105-67-9)
❑
❑
❑
Concentration
Mass
3.4
4 6-dinitro-o-cresol
(534-52-1)
Concentration
Mass
3.5
2,4-dinitrophenol
(51-28-5)
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 14

Identification Number NPDES Permit Number
Facility Name
Outfall Number Form Approved 03/05/19
NC0049905
Associated Asphalt Salisbury, LLC
001 OMB No. 2040-0004
• •
•
• • • •
• • • 1
Presence or Absence
check one
Effluent
Intake
(optional)
(3.6
PollutantfParameter
Testing
'
Units
Maximum
Maximum
Long -Term
Long-
and CAS Number, if available
. ( )
Required
q
Believed
Believed
(specify)
Daily
Monthly
Average
Number
Term
Number
Present
Absent
Discharge
Discharge
aily
of
Average
of
-
' (required)
(if available)
Discharge
'a
Analyses
Value
Analyses
itrophenol
El
El
0
Concentration
Mass
-75-5)
37
4-nitrophenol
El
El
El
Mass
Mass
(100-02-7)
3.8
p-chloro-m-cresol
❑
El
El
Concentration
Mass
(59-50-7)
3.9
Pentachlorophenol
El
❑
❑
Concentration
Mass
(87-86-5)
3.10
Phenol
❑
❑
Q
Concentration
Mass
(108-95-2)
3.11
24,6-trichlorophenol
Concentration
Mass
(88-05-2)
Section 4.Organic Toxic Pollutants GCIMS Fraction —Base [Neutral Compounds
4.1
Acenaphthene
❑
El
0
Concentration
Mass
(83-32.9)
4.2
Acenaphthylene
Concentration
Mass
(208-96-8)
4.3
Anthracene
Concentration
Mass
(120-12-7)
4.4
Benzidine
Concentration
Mass
(92-87-5)
4.5
Benzo (a) anthracene
❑
El
[a
IConcentration
Mass
(56-55-3)
4.6
Benzo (a) pyrene
Concentration
Mass
(50-32-8)
EPA Form 3510-2C (Revised 3-19) Page 15

EPA Identifc9on Number NPDES Permit Number facility Name Outfall Number Form Approved 03/05/19
NCO049905 Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
Presence or Absence
check one Effluent Intake
(optional)
Pollutant?arameter - Testing Units MaxLong-Term Long -
Maximum Maximum
c (an CAS Number, if available) Required Believed Believed (specify) .Average. .Number Number
Term
Daily Monthly Term
Present Absent Daily Average
Discharge Discharge
(required) ' ('rf available) Discharge Analyses Analyses
value
ifavailable
4.7
34-benzofluoranthene
❑
❑
❑
Concentration
Mass
(205-99-2)
4.8
Benzo (ghi) perylene
❑
❑
❑
Concentration
Mass
(191-24-2)
4.9
Benzo (k) fluoranthene
Concentration
Mass
(207-08-9)
4.10
Bis (2-chloroethoxy) methane
Concentration
Mass
(111-91-1)
4.11
Bis (2-chloroethyl) ether
El
El
O
Concentration
Mass
(111-44-4)
4.12
Bis (2-chloroisopropyl) ether
❑
❑
❑
Concentration
Mass
(102-80-1)
4.13
Bis (2-ethylhexyl) phthalate
Concentration
Mass
(117-81-7)
4.14
4-bromophenyl phenyl ether
Concentration
Mass
(101-55-3)
4.15
Butyl benzyl phthalate
ElConcentration
El
21
Mass
(85-68-7)
4.16
2-chloronaphthalene
El
El
0
Concentration
Mass
(91-58-7)
4.17
4-chlorophenyl phenyl ether
❑
11
❑
Concentration
Mass
(7005-72-3)
4.18
Chrysene
O
Concentration
Mass
(218-01-9)
4.19
Dibenzo (a,h) anthracene
Concentration
Mass
(53-70-3)
EPA forth 3510-2C (Revised 3-19) Page 16

EPA Identifca&on Number NPDES Permit Number
Facility Name
Outfall Number Form Approved 03/05/19
NCO049905
Associated Asphalt Salisbury, LLC
003. OMB No. 2040-0004
Presence or Absence
Intake
check one
Effluent
(optional)
Pollutant/Parameter`
Testing
Units
Maximum
Max
i M
Maximum
Long -Term
Long -
1(and CAS Number, ifavailable)
Required
Believed
Believed
(speafy)
Daily
Monthly
Average
Number
`
Term
Number
Present
Absent
Discharge
Discharge
Daily
of
Average
of
(required)
(if available)
Discharge
Analyses
Value
Analyses
if available
4.20
12-dichlorobenzene
11
El
El
Concentration
Mass
(95-50-1)
1
4.21
1 3-dichlorobenzene
®
El
El
Concentration
Mass
(541-73-1)
4.22
1,4-dichlorobenzene
El
❑✓
Concentration
Mass
(10646-7)
4.23
3 3-dichlorobenzidine
Concentration
Mass
(91-94-1)
4.24
Diethyl phthalate
Concentration
Mass
(84-66-2)
4.25
Dimethyl phthalate
El
El
IZI
Concentration
Mass
(131-11-3)
4.26
Di-n-butyl phthalate
❑
El
0Concentration
(84-74-2)
Mass
4.27
2 4-dinitrotoluene
❑
❑
❑✓
Concentration
Mass
(121-14-2)
4.28
2 6-dinitrotoluene
El
Q
Concentration
Mass
(606-20-2)
429
Di-n-octylphthalate
El
El
IZI
Concentration
Mass
(117-84-0)
4.30
1,2-Diphenylhydrazine
El
El
Concentration
Mass
(as azobenzene) (122-66-7)
4.31
Fluoranthene
❑
Concentration
Mass
(206-44-0)
4.32
Fluorene
Concentration
Mass
(86-73-7)
EPA Form 3510-2C (Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCOO499O5 Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
TOXIC�TABLE B. •E, TOTAL PHENOLS,AND ORGANIC TOXICPOLLUTANTSr
Presence or Absence
Intake
check one Effluent
(optional)
PollutantlParameterTesting Units Long -Term
Maximum Maximum Long-
(and Required Believed Believed s
( q ' (specify) ; Average Number Number
Daily Monthly - Term
Present Absent
Discharge Discharge Daily of Average of
(required) (if available) Discharge Analyses Value Analyses
'rf
available
4.33
Hexachlorobenzene
Concentration
Mass
(118-74-1)
4.34
Hexachlorobutadiene
El
El
El
Concentration
Mass
(87-68-3)
4.35
Hexachlorocyclopentadiene
El
El
IZI
Concentration
Mass
(77-47-4)
4.36
Hexachloroethane
Concentration
Mass
(67-72-1)
4.37
Indeno (1,2,3-cd) pyrene
Concentration
Mass
(193-39-5)
4.38
Isophorone
Concentration
Mass
(78-59-1)
4.39
Naphthalene
Concentration
Mass
(91-20-3)
4.40
Nitrobenzene
❑
Concentration
Mass
(98-95-3)
4.41
N-nitrosodimethylamine
El
El
El
Concentration
Mass
(62-75-9)
4.42
N-nitrosodi-n-propylamine
❑
❑
Concentration
Mass
(621-64-7)
4.43
N-nitrosodiphenylamine
❑
El
El
Concentration
Mass
(86-30-6)
4.44
Phenanthrene
❑
❑
❑
Concentration
Mass
(85-01-8)
4.45
Pyrene
El
El
0
Concentration
Mass
(129-00-0)
EPA Form 3510-2C (Revised 3-19) Page 18

EPA Identifration Number NPDES Permit Number
Facility Name
Outfall Number Form Approved 03105119
NC0049905
Associated Asphalt Salisbury, lLC
001 OMB No. 2040-0004
Presence or Absence
Intake '
check one
Effluent
(optional)
Pollutant/Parameter
Testing
Units
Maximum
- Maximum
Long -Term
Long-
(and CAS Number, if available)
Required
Believed
Believed
(specify)
Daily
Monthly-
Average
Number
Term
Number
Present
Absent
Discharge
Discharge
Dail
of
Average
of
Discharge
Analyses
Analyses
if available
12,4-trichlorobenzene
4.46
El1
Concentration
1 Mass
(120-82-1)
1
Section 5.Organic Toxic Pollutants GCIMS Fraction —Pesticides
5.1
Aldrin
El
❑
Concentration
(309-00-2)
Mass
5.2
a-BHC
❑
❑
❑✓
Concentration
(319-84-6)
Mass
5.3
R-BHC
❑
El
❑�
Concentration
(319-85-7)
Mass
5.4
y-BHC
❑
El
❑�
Concentration
(58-89-9)
Mass
5.5
S-BHC
El
s
Concentration
(319-86-8)
Mass
5.6
Chlordane
Concentration
(57-74-9)
Mass
57
44'-DDT
El
❑
Concentration
(50-29-3)
Mass
58
44'-DDE
0✓
Concentration
Mass
(72-55-9)
5.9
44'-DDD
❑
Concentration
(72-54-8)
Mass
5.10
Dieldrin
❑
❑
❑
Concentration
(60-57-1)
Mass
5.11
a-endosulfan
El
El
Concentration
(115 29 7)
Mass
EPA Form 3510-2C (Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number
NCO049905
Facility Name Outrall Number Form Approved 03/05/19
Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
PollutantlParameter
,(and CAS Number, if available)
Testing
Required
Presence or Absence
check one
Units
(spec,y)
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
.Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(ifavailable)
Long -Term
Average
Daily
Discharge
if available
Number
of
Analyses
Long-
Term
Average
Value
Number
of
Analyses
5.12
R-endosulfan
(115-29-7)
❑
❑
❑✓
Concentration
Mass
5.13
Endosulfan sulfate
(1031-07-8)
El
El
D
Concentration
Mass
5.14
Endrin
(72-20-8)
❑
❑
❑✓
Concentration
Mass
5.15
Endrin aldehyde
(7421-93-4)
s
Concentration
Mass
5.16
Heptachlor
(76-44-8)
El
El
El
Concentration
Mass
5.17
Heptachlor epoxide
(1024-57-3)
®
❑
❑✓
Concentration
Mass
5.18
PCB-1242
(53469-21-9)
❑
El
❑✓
Concentration
Mass
5.19
PCB-1254
(11097-69-1)
❑
❑
El
Concentration
Mass
5.20
PCB-1221
(11104-28-2)
❑
❑
E✓
Concentration
Mass
5.21
PCB-1232
(11141-16-5)
❑
❑
✓❑
Concentration
Mass
5.22
PCB-1248
(12672-29-6)
❑
Concentration
Mass
5.23
PCB-1260
(11096-82-5)
❑
❑
❑✓
Concentration
Mass
5.24
PCB-1016
(12674-11-2)
❑�
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 20

NCO049905 I Associated Asphalt Salisbury, LLC I 001
Form Approved 03/05/19
OMB No, 2040-0004
TABLE Be TOXIC METALS, CYANIDE,
TOTAL PHENOLS,
AND ORGANIC TOXIC
POLLUTANTS (40 CFR
122.21(g)(7)(v))'
Presence or Absence
Intake
check one
Effluent
(optional)
Pollutant/Parameter
Testing
Units
Maximum
Maximum
Long -Term
Long-
and CAS Number, if available
( )
Re wired
q
Believed
Believed
sea
(p h)
Daily
Monthly
Average
Number
Term
Number
15.25(g001-35-2)
Present
Absent
Discharge
Discharge
Daily
of
Average
of
(required)
(if available)
Discharge
Analyses
Value
Analyses
if available
Toxaphene
E3
o
o
Concentration
Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 21

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCOO499O5 Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
Presence or Absence Intake
checkone Effluent
(Optional)
Pollutant Units Maximum Long -Term
Believed Believed (specify) Maximum Dail Long -Term
y Monthly Average Daily Number of Number of
Present Absent Discharge Average
Discharge Discharge Analyses Analyses
(required). Aavailable 'rf 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
El
❑
Concentration
(24959-67-9)
Mass
z
Chlorine, total
El
❑
Concentration
Mass
residual
3.
Color
❑
❑
Concentration
Mass
4.
Fecal coliform
❑
ElConcentrationMass
5
Fluoride
El❑
Concentration
(16984-48-8)
Mass
6
Nitrate -nitrite
El
ElConcentrationMass
7.
Nitrogen, total
❑
❑
Concentration
organic (as N)
Mass
8.
Oil and grease
El❑
Concentration
Mass
9
Phosphorus (as
El
❑
Concentration
P), total(7723-14-0)
Mass
10.
Sulfate (as SO4)
❑
❑
Concentration
(14808-79-8)
Mass
11.
Sulfide (as S)
El❑
Concentration
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
NCO049905 Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
JABLE C. CERTAIN CONVENTIONAL AND NON CONVENTIONAL• r
Presence or Absence
check one Effluent Intake
(Optonal)
Pollutant Units Maximum Long -Term
Believed Believed (specify) Maximum Daily Long -Term
Present Absent Discharge 'Monthly Average Daily Number of Average Numberof
Discharge Discharge Analyses Analyses`
(required) if available if available >. Value
12
Sulfite (as S03)
(14265-45 33)
❑
Concentration
Mass
13.
Surfactants
El
El
ConcentrationMass
14
Aluminum, total
(7429-90-5)
Concentration
Mass
15.
Barium, total
(7440-39-3)
El
El
Concentration
Mass
16.
Boron total
(7440-425)
El
El
Concentration
Mass
17
Cobalt, total
(7440-08-4)
❑
❑
Concentration
Mass
18
Iron total
(7439-89 s)
El
11
Concentration
Mass
19
Magnesium, total
(7439-954)
Concentration
Mass
20.
Molybdenum,
total
7439-98-7
El
11Mass
Concentration
21
Manganese, total
(7439-965)
Concentration
Mass
22
Tin, total
(7440,315)
El
El
Concentration
Mass
23
Titanium, total
(7440-32-6)
❑
El
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 24

EPA Identification Number
NPDES Permit Number
Facility Name
Outfall Number
Form Approved 03/05/19
NCOO499O5 Associated Asphalt Salisbury, LLC
001
OMB No. 2040-0004
r TABLE C. CERTAIN CONVENTIONAL
AND NON CONVENTIONAL
POLLUTANTS
(40 CFR 122.21(g)(7)(vi))'
Presence or Absence
check one
Effluent
Intake
(Optional)
Pollutant
Believed
Believed
Units
(specify)
Maximum Daily
Maximum
Long -Term
Long•Term
Present
Absent
Discharge
Monthly
Average Daily Number of
Average Number of
:.(required) -'.
Discharge
Discharge Analyses
Analyses
' Velpe
available)(I
available)
24. Radioactivity `>
Alpha, total
El
Concentration
Mass
Beta, total
El
❑
Concentration
Mass
Radium, total
El
❑
Concentration
Mass
Radium 226, total
❑
Concentration
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 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 25

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name I Outfall Number Form Approved 03/05/19
NCO049905 Accnrintrd Acnhnit',nimb rv. I C 001 OMB No. 2040-0004
D. CERTAIN HAZARDOUSAND
Pollutant
ASBESTOS (40
Presence or Absence
check one
Reason Pollutant Believed Present in Discharge
Available Quantitative Data
(specify units)
Believed
Present
Believed
Absent
1.
Asbestos
El
2.
Acetaldehyde
❑
0
3.
Allyl alcohol
❑
❑✓
4.
Allyl chloride
❑
❑✓
5.
Amyl acetate
❑
❑✓
6.
Aniline
❑
❑✓
7.
Benzonitdle
❑
✓❑
8.
Benzyl chloride
❑
❑�
9.
Butyl acetate
❑
❑✓
10.
Butylamine
❑
❑✓
11.
Captan
❑
0
12.
Carbaryl
❑
❑✓
13.
Carbofuran
❑
❑✓
14.
Carbon disulfide
❑
❑�
15.
Chlorpyrifos
❑
✓❑
16.
Coumaphos
❑
❑✓
17.
Cresol
❑
❑�
18.
Crotonaldehyde
❑
IZI
19.
1 Cyclohexane
❑
1❑✓
EPA Form 3510-2C (Revised 3-19) Page 27

Identification Number NPDES Permit Number Facility Name Uuttail Nu
NCO049905 Associated Asphalt Salisbury, LLC 1 001
Form Approved 03105119
OMB No. 2040-0004
Pollutant
low
Presence or Absence
checkone
Reason Pollutant Believed Present in Discharge
Available Quantitative Data
(specify units)
Believed
Present
Believed
Absent
20.
2,4-D (2,4-dichlorophenoxyacetic acid)
❑
❑✓
21.
Diazinon
❑
❑�
22.
Dicamba
❑
0
23.
Dichlobenil
❑
❑�
24.
Dichlone
❑
❑�
25.
2,2-dichloropropionic acid
❑
0
26.
Dichlorvos
❑
❑✓
27.
Diethyl amine
❑
EI
28.
Dimethyl amine
❑
❑✓
29.
Dintrobenzene
❑
❑✓
30.
Diquat
❑
❑✓
31.
Disulfoton
❑
❑✓
32.
Diuron
❑
❑�
33.
Epichlorohydrin
❑
❑�
34.
Ethion
❑
0
35.
Ethylene diamine
❑
❑�
36.
Ethylene dibromide
❑
❑✓
37.
Formaldehyde
❑
❑✓
38.
Furfural
❑
0
EPA Form 3510-2C (Revised 3-19) Page 28

EPA Identification Number NPDES Permit Number FacilityName Outran Number roanpprovea usium is
NCO049905 Associated Asphalv,
t Salisbury, LLC 001 OMB No. 2040-0004
Presence or Absence
check one Available Quantitative Data
Pollutant Reason Pollutant Believed Present in Discharge
Believed `, Believed (specify units)
Present Absent
Guthion
❑
❑�
I
Isoprene
❑
❑✓
Isopropanolamine
❑
❑s
Kelthane
❑
❑�
Kepone
❑
44.
Malathion
❑
❑�
45. 1
Mercaptodimethur
❑
❑✓
46.
Methoxychlor
❑
❑�
47.
Methyl mercaptan
❑
❑✓
48.
Methyl methacrylate
❑
❑�
49.
Methyl parathion
❑
ID
50.
Mevinphos
❑❑
51.
Mexacarbate
❑
❑�
52.
Monoethyl amine
❑
❑✓
53.
Monomethyl amine
❑
0
54.
Naled
❑
ED
55.
Naphthenic acid
❑
0
56.
Nitrotoluene
❑
❑�
57.
Parathion
❑
0
EPA Form 3510-2C (Revised 3-19) Page 29

EPA Identification Number NPIDES Permit Number Facility Name Outall Number Form Approved 03I05119
NCO049905 Associated Asphalt Salisbury, LLC 001 OMB No. 2040-0004
•�• 11• 111119
Presence or Absence
Pollutant Available Quantitative Data
(check net Reason Pollutant Believed Present in Discharge
Believed Believed (specify units)
Present Absent
58.
Phenolsulfonate
❑
0
59.
Phosgene
❑
0
60.
Propargite
❑
❑✓
61.
Propylene oxide
❑
❑�
62.
Pyrethrins
❑
❑✓
63.
Quinoline
❑
❑�
64.
Resorcinol
❑
❑�
65.
Strontium
❑
❑✓
66.
Strychnine
❑
❑✓
67.
Styrene
❑
❑✓
68.
2,45-T(2,4,5-trichlorophenoxyaceiic
acid
❑
❑
69.
TIDE (tetrachlorodiphenyl ethane)
❑
ED
70
2,4,5-TP [2-(2,4,5-trichlorophenoxy)
o anoic acid
❑
a
71.
Trichlorofon
❑
0
72,
Triethanolamine
❑
0
73.
Triethylamine
❑
0
74,
Trimethylamine
❑
0
75.
Uranium
❑
0
76.
Vanadium
❑
❑✓
EPA Form 3510-20 (Revised 3-19) Page 30

EPA Identifimdon Number
NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
NCO049905 Associated Asphalt Salisbury, LLC 001
OMB No. 2040-0004
••
• • I
Presence or Absence "
Pollutant
check one Reason Pollutant Believed Present in Discharge
Available Quantitative Data
FVinyl
Believed Believed
(specify units)
Present Absent
acetate
❑
El
78.
Xylene
❑
El
79.
Xylenol
❑
F/1
80.
Zirconium
❑
IzI
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 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 31

This page intentionally left blank.

EPA form 3510-2C (Revised 3-19) Page 33

;0 —A. /\\
Associated Asphalt. ,." `r
Salisbury - Stormwater �s sheet
Runoff Map ,�
— r Flow
r
All
41
Earthen Berm w f
yet Outfall 002 (Through Valve
low in Berm) Lat 35° 41' 11" N,
Long 80° 30' 34.2" W
I
Discharges Through i N 0 Sheet
Valle in Souteast Comer Flow
d
Approximate
Property
Boundary Jake Alexander
Boulevard
i
Stormwater
Retention Pond
Outfall 001(Through Valve
at Pond) Lat 35° 41' 6.5" N,
Long 80° 30' 36.3" W
A -%A 7
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v0pow..Adw

Hot Oil
Hot Oil Heater 02 -
Recycle & Toot
ISO it
Figure B-2. Site Drainage Map
Berm 1 \ ✓ \ \
Big Tank Farm
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3 1 ,
eaG
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Ra I Un'ad�ng
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Contalnment Pond
0,41AWl
— — — Edge of Pavement
Aboveground Piping
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>
Site Location
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