NC0090051_Permit (Modification)_20230623

dos-6 "Noft- A.Georgia-Pacific
June 16, 2023
NC DENR/DWR/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Georgia-Pacific Wood Products LLC
Dudley Plywood Facility
NPDES Permit No. NCO090051— Permit Modification
Georgia-Pacific Wood Products LLC
Dudley Plywood
139 Brewington Road
Dudley, NC 28333
RECEIVED
J JN � 3.2023
NCDEQ/DWR/NPDES
Dear Sir or Madam:
Attached are the original and two copies of the completed NPDES Application Forms for modification of
the current permit. This permit was originally issued on July 7, 2022 for the wet deck system. During the
final design and install, it was determined that six sprinkler heads (instead of four) were required to
provide proper coverage. The pond calculations have been updated to reflect the updated operations. The
pond residence time will decrease form 88.3 hours to 53.2 hours as a result of the increase. The wet deck
system has not yet started and will commence operation upon receipt of the modified permit.
In addition to the above changes, GP is also requesting an update to the allowable non-stormwater
discharges listed in the permit to align with the allowances provided under the Industrial General Permit
for the Timber Products Sector, as well as approval to use Micro -Blaze Emergency Liquid Spill Control,
which is a biological additive used to digest organics and hydrocarbons in the event of minor petroleum
spills and leaks.
A check in the amount of $1,030 is attached for the modification fees. Should you have any questions or
need additional information, please contact Elizabeth Meyer, Complex Environmental Manager, at 910-
547-7080 or via e-mail at elizabeth.mgyerina,gapac.com .
✓'f Y
S incer*,
Mason Curry
Plant Manager
Dudley Plywood
Attachments: NCO090051 Modification Application

It
1.0
National Pollutant Discharge Elimination System
Individual Permit Application
Georgia Pacific Plywood Facility
Dudley, Wayne County, North Carolina
Prepared by:
Coury Science & Engineering, PLLC
PO Box 125
Hampstead, North Carolina, 28443
June 2023

t
Georgia Pacific Dudley NPDES Permit Application June 2023
Section1: Introduction.................................................................................................................................................3
PermitRequest and Permit Fees...............................................................................................................................3
FacilityInformation...................................................................................................................................................3
DocumentOrganization............................................................................................................................................4
Section2: Site Information...........................................................................................................................................5
SiteLocation..............................................................................................................................................................5
Description of Manufacturing Process......................................................................................................................5
SiteMap....................................................................................................................................................................6
Section 3: Effluent Description and Treatment............................................................................................................6
Description of Discharged Wastewater and Treatment and requested Modification..............................................6
EstimatedEffluent Data............................................................................................................................................6
EngineeringDesign of Settling Pond.........................................................................................................................7
Section4: Application Form.........................................................................................................................................8
Appendix1 Site Map..............................................................................................................................................9
Appendix 2 Topographic Ma 10
Appendix 3 Wastewater Flow Line Diagram...............................................................................................................11
Appendix 4 Stormwater supporting calculations........................................................................................................12
Appendix 5 micro -blaze US EPA NCP listing and SIDS ..................................................................................................14
Page 2 of 7

t
Georgia Pacific Dudley NPDES Permit Application June 2023 t
Georgia-Pacific Wood Products LLC (GP) owns and operates a Plywood manufacturing plant in Dudley, Wayne
County, North Carolina. GP operations are categorized under North American Industrial Classification System
(NAICS) code 321212 for softwood veneer and standard industrial classification (SIC) code of 2436 for softwood
veneer and plywood.
PERMIT REQUEST AND PERMIT FEES
The GP Dudley facility is covered by NPDES Permit NC00900051 with an expiration date of May 31, 2023. A renewal
application was submitted on November 22, 2022. During the final design and install, it was determined that six
sprinkler heads were required to provide proper coverage. As a result of the increase, the pond residence time will
decrease from 88.3 hours to 53.2. Therefore, GP is submitting this major permit modification to accurately reflect
the final design and installation of the wet deck system. A check in the amount of $1030 has been included with the
application.
The proposed modification is due to design changes during installation and the system has not started yet.
Therefore, the engineering alternatives analysis has not been prepared for this modification.
Additionally, GP is requesting to add the following non-stormwater discharge activities to the permit as part of the
modification:
1. Discharges from emergency/unplanned fire -fighting activities;
2. Fire hydrant flushings;
3. Potable water, including water line flushings;
4. Uncontaminated condensate from air conditioners, coolers, and other outside storage of refrigerated
gases or liquids;
5. Irrigation drainage;
6. Landscape watering, provided all pesticides, herbicides, and fertilizers applied in accordance with the
approved labeling;
7. Pavement wash waters where no detergents or cleaning products are used;
8. Routine external building washdown power/wash water that does not use cleaning products;
9. Uncontaminated ground water or spring water;
10. Foundational or footing drains where flows are not contaminated with process materials;
Included in this package is one original and two copies of the application as required.
FACILITY INFORMATION
The physical and mailing address for GP facility is as follows:
139 Brewington Drive
Dudley, North Carolina, 28333
To facilitate review of this application, please contact the following individuals identified below.
Page 3 of 7

Georgia Pacific Dudley NPDES Permit Application
Preparer's Contact Information:
Sean Coury, PE (NC)
Partner
Coury Science & Engineering, PLLC
[phone]
[e-mail]
DOCUMENT ORGANIZATION
Facility's Contact Information:
Elizabeth Meyer
Environmental Manager
Georgia-Pacific Wood Products LLC
Dudley Plywood
[phone]
[e-mail]
June 2023
This permit application is divided into five sections and various appendices. Tables are included throughout the
document and are referenced in the table of contents. The four sections and four appendices are as follows:
Section 1
Introduction
Section 2
Site Information
Section 3
Effluent Description and Treatment
Section 4
Application Form
Refer to the table of contents for a detailed listing of tables and figures.
Page 4 of 7

•
Georgia Pacific Dudley NPDES Permit Application June 2023 f
This section provides information on the site location, surrounding terrain, and description of industrial activities.
SITE LOCATION
The GP Plywood facility is located in Dudley, North Carolina in Wayne County. The approximate Universal Transverse
Mercator (UTM) coordinates of the facility are Zone 17, 769.8 km east and 3,906.1 km north, at an elevation of
approximately 180 feet above mean sea level. Refer to the Area Map in Appendix 1 for additional details.
DESCRIPTION OF MANUFACTURING PROCESS
The GP Dudley Plywood manufacturing facility operates under North American Industry Classification System
(NAICS) Code 321212, Softwood Veneer and Plywood Manufacturing, and employs up to 450 employees. Production
process areas at the plywood facility consist primarily of the logyard, green end (lathes), dryers, presses,
finishing/shipping, and the boiler. The facility operates 24 hours per day, 7 days per week.
The Plywood Plant receives pine and softwood logs and stores them on the log yard prior to processing. The logs are
debarked, cut to length, conditioned in steam -heated dryers, graded and formed into plywood panels by gluing and
pressing. After pressing, the plywood sheets are trimmed, sanded, and sorted for shipping. Finished product and
manufacturing process residuals are shipped offsite via truck and rail.
The topography of the GP Dudley Plywood Plant and surrounding area is relatively flat. Stormwater runoff from the
majority of the manufacturing areas from the Plywood Plant that is not conveyed to the wet deck pond is discharged
to Outfall 001. The outfall is located at the southwest corner of the property. Stormwater runoff from the majority
of the manufacturing areas of the Plywood site generally flows south or southwest via sheet flow, soil ditches, or
underground piping into the spill retention pond located along Brewington Road on the south side of the Plant. The
spill pond discharges into the Plant's stormwater treatment pond and then to Outfall 001. Runoff from the northern
part of the Plant flows west and then south via an open soil ditch directly to Outfall 001.
Stormwater runoff from a grassed area on the northwest corner of the Plywood facility discharges to Outfall 002
under North Carolina Department of Environmental Quality (NCDEQ) General Permit NCG210000 (COC NCG210168).
Outfall 002 discharges into an open ditch on the west side of the railroad (located on the west side of the facility).
This ditch converges with the discharge from Outfall 001, which discharges to an unnamed tributary of Brooks
Swamp.
The Plywood Plant's non discharge wastewater permit (WQ0003380) requires that all categorical non -discharge
process wastewater and the effluent from the facility's oil water separator be recycled or discharged to the county
wastewater treatment facility (POTW). All sanitary wastewater, with the exception of the training room, is
discharged to the POTW. Sanitary wastewater from the training room is discharged to an on -site septic tank/leach
field located on the east side of the office building.
Page 5 of 7

Georgia Pacific Dudley NPDES Permit Application
SITE MAP
June 2023
A site map depicting the facility and surrounding areas is located in Appendix 1. The log storage area where the wet
deck operation will take place has been outlined in red and the location of the settling basin is outlined in blue. The
facility outfall location has been denoted with a red star on the site map.
A topographic map that shows the terrain of the site and surrounding areas is included in Appendix 2.
This section describes the effluent that will be generated from the wet decking operation and the method of
wastewater treatment.
DESCRIPTION OF DISCHARGED WASTEWATER AND TREATMENT AND REQUESTED MODIFICATION
Georgia-Pacific is permitted to discharge from a wet decking operation, which is used to spray water onto the log
storage piles especially during warmer, dryer months. Water is pumped from the stormwater collection pond and
then sprayed onto logs stockpiled on the wet deck via spray nozzles. Water from the pond is supplied either via
stormwater or an adjacent groundwater withdrawal well. The wet decking pad is paved with concrete and sloped
in a manner that will ensure water flows into a detention/settling pond prior to discharge via Outfall 001, indicated
on the site map in Appendix 1.
The existing permit includes the installation and operation of four sprinkler heads. During the final design and
install, it was determined that six sprinkler heads were required to provide proper coverage. Each sprinkler head
has an approximate flow rate of 113 gallons per minute (gpm). The calculated maximum flow rate is 0.979 million
gallons per day (MGD), assuming 113 gpm from each of six sprinkler heads for 1,440 minutes per day. A water
flow line diagram is included in Appendix 3.
No chemicals will be added for the wet decking operation; however, the facility would like to permit the option of
using micro -blaze to treat minor leaks of oil from equipment on the roadways. The US EPA NCP Listing and the SIDS
for micro -blaze is included in Appendix 5
ESTIMATED EFFLUENT DATA
US EPA effluent limitations guidelines for Timber Products Processing (40 CFR 429), Subpart I, Wet Storage
Subcategory, states that there shall be no debris discharged from the wet decking operation and provides ranges
for effluent pH. As required by these federal effluent limitations guidelines, there will be no debris present in the
effluent and the pH will remain within the range of 6.0 to 9.0. To ensure that no debris will be present in the
discharge, all runoff associated with the wet decking operation will be routed to a settling pond prior to discharge.
In accordance with the Neuse River Basinwide Water Quality Plan, Brooks Swamp is classified as a NSW (Nutrient
Sensitive Water) which requires wastewater dischargers to set permitted nitrogen and phosphorus limits of 3 mg/I
and 1 mg/I, respectively. Based on the characteristics of the wastewater stream and the design of the wet settling
basin, effluent nitrogen and phosphorus quantities are expected to be well within these specified limits.
The water withdrawal/discharge system is designed to have the option of operating as a single pass system to
prevent concentrations of BOD from increasing. The wet deck operation will have the option of pulling water out
of the collection pond during wet weather periods where the pond is turning over frequently or from a
Page 6 of 7

f
Georgia Pacific Dudley NPDES Permit Application June 2023 }
groundwater well during drier periods. Additionally, incoming water will pass through a filter to minimize the
amount of bark that is introduced to the settling basin. The facility is also designed with the option of diverting
wastewater to the spill pond to provide an additional pretreatment step and reduce solids in the permanent pool.
ENGINEERING DESIGN OF SETTLING POND
The runoff from the wet decking operation will be diverted to a wet detention pond prior to discharge to surface
waters. The pond has been designed in accordance with USDA Soil Conservation Services Practice Standard Code
No. 378 and the North Carolina Department of Environment and Natural Resources (NCDENR) Practice Standards
and Specifications for Sediment Basins. Appendix 4 includes a drawing of the settling pond and supporting
calculations. The pond is designed with a 3.3:1 length to width ratio, which is greater than the recommended
minimum of 2:1. The volume of the pond is 284,000 cubic feet. The proposed modification will result in a
decrease of the hydraulic residence time 88.3 hours to 53.2 hours at maximum dry weather flows. Additionally,
the facility will be designed with the option of diverting wastewater to a 35,000 cubic foot spill pond to enhance
solids removal and reduce the cost of pond cleanouts.
Page 7 of 7

Georgia Pacific Dudley NPDES Permit Application June 2023

P
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000349855 NCO090051 Georgia-Pacific Dudley Plywood OMB No. 2040-0004
Form U.S. Environmental Protection Agency
'h'hEPA Application for NPDES Permit to Discharge Wastewater
NPDES GENERAL INFORMATION
`1 1 Apphcahts NotRequ►redto_Submit`Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 treatment works? 1.1.2 treating domestic sewage?
if yes, STOP. Do NOT complete No If yes, STOP. Do NOT No
Form 1. Complete Form 2A. complete Form 1. Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1
Is the facility a concentrated animal feeding
operation or a concentrated aquatic animal
-
production facility?
[] Yes 4 Complete Form 1 ❑ No
and Form 2B.
1.2.3
Is the facility a new manufacturing, commercial,
mining, or silvicultural facility that has not yet
commenced to discharge?
0 Yes -+ Complete Form 1 ❑ No
and Form 2D.
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
vi,
non-stormwater?
`-
Yes 4 Complete Form 1 ✓ No
-_`
and Form 2F
N ;•-
unless exempted by
40 CFR
r'
122.26(b)(14)(x) or
1.2.2 Is the facility an existing manufacturing,
commercial, mining, or silvicultural facility that is
currently discharging process wastewater?
❑ Yes 4 Complete Form ❑✓ No
1 and Form 2C.
1.2.4 Is the facility a new or existing manufacturing,
commercial, mining, or silvicultural facility that
discharges only nonprocess wastewater?
❑ Yes Complete Form ❑✓ No
1 and Form 2E.
2.1 h1FacillW1N6me� a •. t� :.± __k " .� ;r" �� ~$'
Georgia-Pacific Wood Products LLC Dudley Plywood Facility
p0 2.2 EPA Identification Number.
110000349855
2.3
Facility Cohtact
Name (first and last)
Title
Phone number
Elizabeth Meyer
Facility Environmental Manager
[phone]
Email address
[e-mail]
2.4
k -..3 'H .� 1 s -ka� ti � t \� l` -<.. • W''a y�.�.aN. .:tr. "i; ',
+aci1l.ty. Maihgn Adssdre
-
Street or P.O. box
139 Brewington Dr
City or town
State
�NC
ZIP code
128333
Dudley
EPA Form 3510-1 (revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110000349855
NCO090051
Georgia-Pacific Dudley Plywood
OMB No.2040-0004
2,5
Facility Location
a w
Street, route number, or other specific identifier
Q c
139 Brewington Dr
,rnv
o
County name
County code (if known)
Wayne
0
City or town
State
ZIP code
z �.
Dudley
NC
28333
SECTION•
>t t
Description (optional)
3.1
SIC Cotle(s)
243
Millwork, plywood, and structural members
z
3.2
NAICS Code(s)
Description (optional)
A`
321212
Softwood veneer and plywood manufacturing
4.1 Name of D erator -
Georgia-Pacific Wood Products LLC
4.2
Is the name you listed in Item 4.1 also the owner?
2c0
€
✓❑ Yes ❑ No
4.3
0 eratorStatus
❑ Public —federal ❑ Public —state ❑ Other public (specify)
o
Private ElOther (specify)
4.4
'Phone Number of:0 erator
[phone]
4.5
0 erator Address
0—Street
or P.O. Box
M
E d
139 Brewington Rd
City or town
State
ZIP code
-:o o
Dudley
NC
28333
aU `
Email address of operator
O
[e-mail]
SECTION1
1
Is the facility located on Indian Land?
-a
5.1
J
❑ Yes ❑✓ No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name
corm Approvea usru5ns
110000349855 NCO090051 Georgia-Pacific Dudley Plywood
OMB No. 2040-0004
SECTION'•
t ,
Existing Environm_ ental Permits (check all that apply and print or type the;correspontling permit Number for.each) " ,
6.1
d
❑ NPDES (discharges to surface
❑ RCRA (hazardous wastes)
❑ UIC (underground injection of
N
water)
fluids)
NCG210168
NCD000813659
❑✓ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
W W
NC0000003709600058
NC0000003709600058
❑ Ocean dumping (MPRSA)
❑ Dredge or fill (CWA Section 404)
❑✓ Other (specify)
WCt0003380
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
1
Describe the nature of your business.
8.1
-
Plywood manufacturing
6i
to
C _
—_ML
SECTION
9. COOLINGi
40
9.1
Does your facility use cooling water?
d
❑ Yes ❑✓ No 4 SKIP to Item 10.1.
9.2
Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
3�
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.)
SECTION
10. VARIANCE
REQUESTS (40 CFR 122.21(f)(10))
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
_
Consult with NPDES authority to determine what information needs to be submitted and
N
apply. your permitting
when.)
❑ 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))
CU
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 03r05119
110000349855
1 NCO090051
Georgia-Pacific Dudley Plywood OMB No. 2040-0004
SECTION•
1
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.
CoIUMnjr
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
Z Section 4: Operator Information
❑ w/ attachments
❑✓ Section 5: Indian Land
❑ w/ attachments
..
❑✓ Section 6: Existing Environmental Permits
❑ w/ attachments
c
d
❑✓ Section 7: Map
❑ w/ topographic El w/ additional attachments
o❑✓
Section 8: Nature of Business
El w/ attachments
❑✓ Section 9: Cooling Water Intake Structures
❑ w/ attachments
�'
❑✓ Section 10: Variance Requests
❑ w/ attachments
c
N
❑✓ Section 11: Checklist and Certification Statement
❑ w/ attachments
32
- d
11.2
Certification Statement
.c
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
submitted is to the best ofmy knowledge and
h information, the information u
responsible for atherin t o 9 i e tlY dr c,
Ygathering
1 m aware that there are significant penalties for submitting false information,
belief, true accurate and complete. a g p 9
P
including the possibility of fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
l
Signature
Date signed
%f
'
EPA Form 3510-1(revised 3-19) Page 4

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110000349855
NCO090051
I
Georgia-Pacific Dudley Plywood
I
OMB No.2040-0004
U.S. Environmental Protection Agency
Form
Application for NPDES Permit to Discharge Wastewater
NPDES
�"OEPA
NEW MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURAL OPERATIONS
THAT HAVE NOT YET COMMENCED DISCHARGE OF PROCESS WASTEWATER
SECTIONEXPECTED
• , • •
1.1
Provide information on each of the facility's outfalls in the table below.
Outfall
Receiving Water
Latitude
Longitude
o
—
Number
Nameco `
0
001
Brooks Swamp
I 35' 15' 36" 78' 02' 117'
SECTION
1 1
2.1 Month bay Year`s
rn
2023
SECTION
• 1
3.1 For each outfall identified under Item 1.1, provide average flow and treatment information. Add additional sheets as
necessary,
'Outfall Number** ooz'
Operations
Operation
-Average Flow
Wet Deck
0.979 mgd
Stormwater
0.203 mgd
Wmgd
mgd
mgd
3
Treatment
o
M __
Description
Code from
Final Disposal of Solid or Liquid
(include size, flow rate through each treats ent unit, _
Exhibit 2D-1
Wastes Other Than by Discharge '
>
retention time, etc.)
284,000 cubic foot retention pond (53.2 hr retention)
1-U
Land Apply
Screens
1-T
Boiler Fuel
_k
-
--; h 0
AN
EPA Form 3510-21) (Revised 3-19) Page 1

EPA Idenfificafion Number
NPDE�Permit mber
Facdliry Name
Form Approved o"J OM
OMB No.2040-0004
110000349855
N1
Georgia-Pacific Dudley Plywood
3.1
**Outfall Number'*
Cont.
Operations Contributing to Flow
0 eration 5rk..,.. Average Flow
mgd
mgd
------ —
mgd
- - — -
mgd
mgd
Treatment
Description
Units
Code from
Final Disposal of Solid or Liquid
(include size, flow rate through each treatment unit,
Exhibit 2D-1
Wastes Other Than by Discharge
retention time, etc.)
-ci
v
0
U
E
a
F-
-�
**Outfall Number"*
o
LL-
Operations
0 eratlo Mera a Flout -
-...__
mgd
v
a
mgd
mgd
-
mgd
mgd
fi
Treatment
Units
Description
Code from
Final Disposal of Solid or Liquid
( include size, flow rate through each treatment unit,
Exhibit 2D-1
Wastes Other Than by Discharge
retention time, etc.)
EPA Form 3510-2D (Revised 3-19) Page 2

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 11=5119
110000349855
NCO090051 Georgia-Pacific Dudley Plywood OMB No. 2040-0004
SECTIONDRAWING
4.1
Have you attached a line drawing to this application that shows the water flow through your facility with a water
balance? (See instructions for drawing requirements. See Exhibit 2D-2 at end of instructions for example.)
_' , `
0
❑✓ Yes ❑ No
SECTION
OR SEASONAL FLOWS
5.1
Except for stormwater runoff, leaks, or spills, are any expected discharges described in Sections 1 and 3 intermittent
or seasonal?
❑ Yes ❑✓ No 4 SKIP to Section 6.
5.2
Provide information on intermittent or seasonal flows for each applicable outfall. Attach additional pages, if
necessa .
Frequency,Rate
and Volume
Outfall
Operations
Quratton
Average
Average
Maximum Daily
Maximum Total
Number,
(list)
Da slWeek
Montf�slYear:
Discharge
Volume
days/week
months/year
myd
gallons
days
o `
days/week
months/year
myd
gallons
days
LL
days/week
monthslyear
mgd
gallons
days
R
Frequency
Rate an,
IUMe4_ '
rya
Outfall
Number
Operations
Average
Average
Maximum Dally,.�
Maxitl�iam;3b
Dt �
o
(list)
Days/Week
-MonthslYear
Dischar e.=
:--
days/week
monthslyear
mgd
gallons
days
dayslweek
months/year
mgd
gallons
days
dayslweek
months/year
mgd
gallons
days
Outfall
Operations
FrequencyRate
and Volume �1�
{
Average
Average
Maximum. Daily Maximum Total
an
Number
(list)
Days/Week
MonthslYear-
Discharge Volume
dayshveek
months/year
mgd
gallons
days
days/week
months/year
mgd
gallons
days
days/week
monthslyear
mgd
gallons
days
SECTION'•D
• 1
6.1 Do any effluent limitation guidelines (ELGs) promulgated by EPA under CWA Section 304 apply to your facility?
❑✓ Yes ❑ No 4 SKIP to Section 7.
6.2
Provide the following information on applicable ELGs.
_`ELG Category ,. _='.
, EI;G Subtaegg_ry �:
:..^ z._ ::Regulatory Citation
o
Timber Products Processing
Subpart I, Wet Storage
40 CFR 29
EPA Form 3510-2D (Revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
OMB No.2040-0004
110000349855
NCO090051
Georgia-Pacific Dudley Plywood
6.3
Are the limitations in the applicable ELGs expressed in terms of production (or other measure of operation)?
❑ Yes ❑✓ No 4 SKIP to Section 7.
6.4
Provide an expected measure of average daily production expressed in terms and units of applicable ELGs.
Expected Actual Average Daily Production for First Three Years
Outfall
Number
Year
Operation, Product, or Material
Quantity per Day
(note basis if applicable)
Unit of Measure
Year 1
Year 2
d
c
c
Year 3
,o
e
A
Year 1
v
0
n
FYear2
3
Year 1
Year 2
Year3
See the instructions to determine the parameters and pollutants you are required to monitor and, in turn, the tables you must
complete. Note that not all applicants need to complete each table.
Table A.'Conventional and Non -Conventional Parameters
7.1
Are you requesting a waiver from your NPDES permitting authority for one or more of the Table A parameters for any
of your outfalls?
❑ Yes ✓Z] No 4 SKIP to Item 7.3.
7.2
If yes, indicate the applicable outfalls below. Attach waiver request and other required information to the application.
Outfall number Outfall number Outfall number
7.3
Have you have provided estimates or actual data for all Table A parameters for each of your outfalls for which a
waiver has not been requested and attached the results to this application package?
o
No; a waiver has been requested from my
r
❑✓ Yes ❑ NPDES permitting authority for all parameters at
v.
w
all outfalls.
Table
B. Certain Conventional and Non -Conventional Pollutants
w
Haveyou checked "Believed Present"for all pollutants listed in Table B that are limited directly or indirectly by an
applicable ELG?
F
Yes No
Have you checked 'Believed Present" or "Believed Absent' for all remaining pollutants listed in Table B?
❑✓ Yes ❑ No
7.6
Have you provided estimated data for those Table B pollutants for which you have indicated are "Believed Present'
in your discharge?
Yes ❑ No
EPA Form 3510-2D (Revised 3-19) Page 4

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105/19
110000349855
I NCO090051
Georgia-Pacific Dudley Plywood
OMB No. 2040-0004
Table C. T6xi6M6tals, Total,C anide, and Total Phenols
7,7
Have you indicated whether pollutants are "Believed Present" or "Believed Absent" for all pollutants listed on Table C
for all outfalls?
_
❑✓ Yes ❑ No
7.8
Have you completed Table C by providing estimated data for pollutants you indicated are "Believed Present,"
including the source of the information, for each applicable outfall?
_:::. _:
❑✓ Yes ❑ No
,; `•.
;Table D.-Organic'Toxic Pollutants (GC/MS Fractions)
7.9
Do you qualify for a small business exemption under the criteria specified in the Instructions?
l
❑ Yes 4 Note that you qualify at the top of 0 No
Table D, then SKIP to Item 7.12.
>= _
7.10
Have you indicated whether pollutants are "Believed Present" or "Believed Absent" for all pollutants listed on Table D
for all outfalls?
Yes No
❑
7.11
Have you completed Table D by providing estimated data for pollutants you indicated are "Believed Present,"
'
including the source of the information, for each applicable outfall?
N
4
© Yes ❑ No
r
7,8•Tetrachlorodibenzo •Dioxin TCDD " u
�4*.. a
7.12
Does the facility use or manufacture one or more of the 2,3,7,8 TCDD congeners listed in the Instructions, or do you
ru c�Y;
know or have reason to believe that TCDD is or may be present in effluent from any of your outfalls?
'33"
❑ Yes ❑✓ No
r•j_
s ,
- .,; -
Table :=Certain Hazardous Substances aridAsbestos _
F
7.13
Have you indicated whether pollutants are "Believed Present" or "Believed Absent" for all pollutants listed in Table E
.A.8
for all outfalls?
�5=^
'~
© Yes ❑ No
7.14
Have you completed Table E by reporting the reason the pollutants are expected to be present and available
r =
quantitative data for pollutants you indicated are "Believed Present" for each applicable outfall?
'j?1:"
❑✓ Yes ❑ No
w'
Intake Credrts,Tables.A ftirou h E __ _ _ -
r
7,15 Are you applying for net credits for the presence of any of the pollutants on Tables A through E for any of your
;*=
outfalls?
ElYes 4 Consult with your NPDES permitting
"+
authority.No
REPORT8. ENGINEERING 1
8.1 Do you have any technical evaluations of your wastewater treatment, including engineering reports or pilot plant
studies?
s-,..a: ' "
❑ Yes ❑✓ No 4 SKIP to Item 8.3.
l find;`,
8.2
Have you provided the technical evaluation and all related documents to this application package?
❑ Yes ❑ No
8.3
Are you aware of any existing plant(s) that resemble production processes, wastewater constituents, or wastewater
>w..
treatment at your facility?
a +`: -
❑✓ Yes ❑ No 4 SKIP to Section 9.
EPA Form 3510-21) (Revised 3-19) Page 5

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110000349855
NCO090051
Georgia-Pacific Dudley Plywood
OMB No.2040-0004
8.4
Provide the name and location of the similar plants.
o <
Name of Similar Plants
Location of Similar.Plants
d .a
Ashton Lewis
Gatesville, NC
c
•� w
c
o
c U
c
w
SECTIONOTHER
INFORMATIONr
Have you attached any optional information that you would like considered as part of the application review process
9.1
(i.e., material beyond that which you have already noted in the application as being attached)?
❑
Yes
❑✓ No 4 SKIP to Section 10.
c
9.2
List the additional items and briefly note why you have included them.
E
1.
0
2.
d
3.
4.
5.
SECTIONi
CHECKLIST
AND CERTIFICATIONi .
In Column 1 below, mark the sections of Form 2D that you have completed and are submitting with your application.
10.1
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 com lete all sections or tables, or provide attachments.
Column 1 ' .
Column3;
❑
Section 1: Expected Outfall
❑
w/ attachments (e.g., responses for additional ouffalls)
Location
❑
Section 2: Expected
[]
w/ attachments
Discharge Date
❑
Section 3: Average Flows
❑
w/ attachments
d
and Treatment
E
;: _
❑✓
Section 4: Line Drawing
❑
w/ line drawing ❑ w/ additional attachments
D5
❑
Section 5: Intermittent or
El
w/ attachments
.c
Seasonal Flows
U
—
❑✓
Section 6: Production
❑
w/ attachments
w/ Table A waiver
❑
request or ✓❑ Table A
approval
MA
0
Section 7: Effluent
❑✓
Table B 0 Table C
Characteristics
❑✓
Table D ❑✓ Table E
❑
w/ other
attachments
❑
Section 8: Engineering
❑
w/ technical evaluations and related attachments
Report
❑✓
Section 9: Other Information
❑
w/ optional information
❑
Section 10: Checklist and
❑
w/attachments
Certification Statement
EPA Form 3510-21) (Revised 3-19) Page 6

G
1
EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110000349855 NCO090051 Georgia-Pacific Dudley Plywood OMB No.2040-0004
10.2 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
a information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
o a directly responsible for gathering 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 title
Signature Date signed
EPA Form 3510-21) (Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number Facility Name Outfall Number
Form Approved 03105/19
1 110000349855 1 Georgia-Pacific Dudley Plywood 1 001
OMB No. 2040-0004
TABLE A. CONVENTIONAL A ND
NON CONVENTIONAL
PARAMETER ESTIMATES
(40 CFR 12-
�_�
OeW
COW
13,
Is
I I I
N.n
16,
❑
Check here if you have applied to your NPDES authority for a waiver for all of the pollutants listed on this table for the noted ouffall.
Biochemical oxygen
Concentration
Mg/l
100
4
Yes
No
Mass
demand (BODs)
Chemical oxygen demand
Concentration
mg/i
120
4
2.
E]
❑ Yes
No
Mass
1
(COD)
Total organic carbon
Concentration
mg/l
50
4
3.
Yes
❑ No
(TOC)
Mass
Concentration
Mg/1
36
4
FTotal
suspended solids
Yes
❑
JSS)
No
Mass
Concentration
F
Ammonia (as N)
Yes
No
Mass
6.
Flow
❑
Rate
rngd
0.979
4
M Yes
❑ No
Temperature (winter)
oc
0C
60
4
F
F11
Yes
El No
Temperature (summer)
❑
0C
C
90
4
pH (minimum)
❑
Standard units
S.U.
6
4
Li
El Yes
❑ No
pH (maximum)
F-1
❑
Standard units
I s.u.
9
I-
4
' Samnlina shall be conducted according to sufficientiv
sensitive test nrocedures (i.e.. methods) aDoroved under 40 CFR 136 for the analvsis Of DO11utants or pollutant
Darameters or
required under 40 CFR chapter 1, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2D (Revised 3-19) Page 1

This page intentionally left blank.

EPA Identification Number
Facility Name Outiall Number
Form Approved 03/05/19
110000349855
Georgia-Pacifi Dudley Plywood I 001
OMB No.2040-0004
TABLE B. CERTAIN CONVENTIONAL
AND NON
CONVENTIONAL
POLLUTANTS (40 CFR 122.21 (k)(5)(ii))l
E �;� � ;. r 'p � Estimated Data�orrl?ollutantsnEx ected to�be Pi'esentoi•L`imlted�by an'�EL� '� ,
" ' � 1t F �*r ';
; �Preseri'ce or_IAbsence
FroV�de`botti'cofic2nf"rahona nd massestimatesfoneacfibollu(ant
Effluent
Intake Water' A
Believed
621ieved
t "; t
a Maximum Daily
Daily
Believed P.risent
Present's
Absent
Y�1,
rd 7 ��,.+�
iti ; ,Knits, ' r t'
r„ .
? Discharge'
,Average
Dischar e
I
Sourceof Information ;,
` (check only!one
I
r
r _..
r
re cored a;
g ,
(use codes`,n instructions)
u
response pe�'item)
❑
Check ✓ here if you believe all pollutants listed to be absent from the discharge. You need not complete Table B for the noted outfall unless
( ) y p g , p you have quantitative data available. I
Bromide
❑
Concentration
❑Yes ❑✓ No
Mass
1'
(24959-67-9)
Chlorine, total
❑
❑
Concentration
❑ Yes M-7 No
Mass
2
residual
Concentration
3.
Color
❑
�
El Yes ✓❑ No
Mass
Concentration
4.
Fecal coliform
❑
❑✓
El Yes ❑✓ No
Mass
Fluoride
❑
Concentration
El Yes No
Mass
5'
(16984-48-8)
Concentration
6.
Nitrate -nitrite
El❑✓
❑ Yes El No
Mass
Nitrogen, total
ElMass
Concentration
❑Yes ❑ No
7'
organic (as N)
Concentration
mg/l
<5 ©
4
8.
Oil and grease
✓❑
❑
❑ Yes ✓❑ No
Mass
Phosphorus (as P),
❑
Concentration
❑Yes ✓❑ No
Mass
9'
total (7723-14-0)
10.
Sulfate (as SO4)
❑
❑
Concentration
Yes ✓❑ No
Mass
(14808-79-8)
Concentration
11.
Sulfide (as S)
❑
❑ Yes ❑✓ No
Mass
EPA Form 3510-2D (Revised 3-19) Page 3

EPA Identification Number Facility Name MUM! Number Form Approved 03)05119
110000349855 Georgia-Pacific Dudley Plywood 001 OMB No.2040-0004
TABLE •. CERTAIN • •CO • POLLUTANTS
•'Presence
or Absence Estimated Data for PollutantsExpected: Lo be'Present or'L` invited by an ELG
check one Provide both concentration and mass estimates for eachpollutant)
Effluent Intake Water
Pollutant Believed Believed Maximum Daily. Average Daily Source of Information Believed Present?
Present , Absent Units ; Discharge. Discharge (check only one
(use codes in instructions)
(required) if available response per item)
12.
Sulfite (as S03)
❑
Concentration
❑Yes ONo
Mass
(14265-45-3)
13.
Surfactants
❑
✓❑
Concentration
❑Yes rX7No
Mass
14.
Aluminum, total
❑
❑
Concentration
❑Yes ONo
Mass
(7429-90-5)
15.
Barium, total
Concentration
❑Yes �No
Mass
(7440-39-3)
16.
Boron, total
❑
Concentration
❑Yes ONo
Mass
(7440-42-8)
17.
Cobalt, total
❑
❑
Concentration
❑Yes �No
Mass
(7440-48-4)
18.
Iron total
❑
Concentration
❑Yes ONo
Mass
(7439-89-6)
19'
Magnesium, total
❑
Concentration
❑Yes ONo
Mass
(7439-95-4)
20.
Molybdenum, total
❑
Concentration
❑Yes ONo
Mass
(7439-98-7)
21.
Manganese, total
❑
Concentration
❑Yes ONo
Mass
(7439-96-5)
22.
Tin total
El
ID
Concentration
❑Yes �No
Mass
(7440-31-5)
EPA Form 3510-2D (Revised 3-19) Page 4

EPA Identification Number
Facility Name Outfall Number
Form Approved 03/05/19
110000349855
Georgia-Pacific Dudley Plywood 001
OMB No, 2040-0004
TABLE+IN CONVENTIONAL
AND
•CO
VENTIONAL •• 1
?
iresene�;arlbsence
1 } r
d' �4 -�
�� �JJr :i 1 , �y:Eitimai�d Data for;Pollutants'cEx ected to berPesbnt:orl��mited 'a'rrELG;,>:r.:. �,,, of
-
fit�ec
one
}>ix�� &r+u, .� , T.. 'is. ,..,,.,.:,rM'M.t�!=� .k .rr c a.• M:d-P`�� r� .� i r •V
�.,..dProvi�enlf'abonan�•mass�stima"tesrfor�a pollutan(:)--, =,
Effluent
lntake Water
Pollutant
Believed
Believed
, f , , , x
r Ittaximum�aily
yAver�gepaily,
I�
�Behevetl Present?
Present
Absent
f�
r, Jnits r
,, 9 e ��:.:.. ;, .:.
Dtsc�arge'"±;-,;.
. r:.J. y
=D�se�hal �: y}i"h,
J�Source of1nfonatfon
��n •+r:n=^^-1�
=
(checkoNyone
I
fusecodesinmslruChons)
responseperiter
23'
Titanium, total
El❑✓
Concentration
❑Yes ONo
Mass
7440-32-6
( )
24.
Radioactivity
Concentration
24.1
Alpha, total
❑
❑✓
❑Yes �No
Mass
Concentration
24.2
Beta, total
El
0
❑Yes ONo
Mass
Concentration
24.3.
Radium, total
❑
❑✓
❑Yes Fx_1 No
Mass
[24.4M
Radium 226, total
ElConcentration
IITRi;?I?f1UV�5LTZ5ttIVE�tS5Y6T0Cff_uM
❑Yes Z No 1
., Inein
ds! aDliidV
3u lof
required under40 CFR chapter I, subchapter Nor 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-21) (Revised 3-19) Page 5

EPA Identification Number Facility Name Outfall Number
110000349855 Georgia-Pacific Dudley Plywood 001
Form Approved 03105/19
OMB No. 2040-0004
TABLE•XIC METALS,
Pollutant
(CAS Number, if available)
TOTAL CYANIDE, AND TOTAL1
:Presence or Absence :'
check one -
Estimatetl Data for Pollutants Expected to be Present iq Discharge
Provide both concentration and mass estimates for each pollutant.
Believed
Present
Believed
Absent
Effluent
Intake Water
Units
Maximum
Daily
Discharge
(required)
Average
Daily
Discharge
if available
Source of Information
(Use codes in Instructions.)
Believed Present?
(check'only one
response per pollutant)
❑
Check (✓) here if you believe all pollutants listed to be absent from the discharge. You need not complete Table C. for the noted outfall unless you have quantitative data
available.
1.
Antimony, Total
(7440-36-0)
❑
❑
Concentration
El Yes
❑ No
Mass
2.
Arsenic, Total
(7440-38-2)
❑
Concentration
El Yes
No
Mass
3.
Beryllium, Total
440-41-7
❑
❑
Concentration
El Yes
❑ No
Mass
4.
Cadmium, Total
(7440-43-9
❑
❑
Concentration
El Yes
x
❑No
Mass
5.
Chromium, Total
(7440-47-3)
El❑
Concentration
Yes
❑ No
Mass
6.
Copper, Total
(7440-50-8)
❑
Concentration
❑Yes
❑ No
Mass
7.
Lead, Total
(7439-92-1)
El
U
Concentration
❑Yes
x
❑No
Mass
8.
Mercury, Total
7439-97-6)
❑
Concentration
❑Yes
x No
Mass
9.
Nickel, Total
7440-02-0)
❑
❑
Concentration
Yes
x
Mx
Mass
10.
Selenium, Total
7782-49-2
❑
Concentration
❑Yes
0 No
Mass
11.
Silver, Total
(7440-22-4)
❑
Concentration
Yes
x No
Mass
12.
Thallium, Total
(7440-28-0)
❑
❑
Concentration
Yes
❑ No
Mass
13,
Zinc, Total
(7440-66-6)
❑
❑
Concentration
Yes
❑No
Mass
14,
Cyanide, Total
(57-12-5)
ElConcentration
El Yes
x No
Mass
15.
Phenols, Total
❑
❑
Concentration
❑ Yes
ONo
Mass
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See Instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2D (Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number Facility Name Outfall Number Form Approved 03/05/19
110000349855 Georgia-Pacific Dudley Plywood 001 OMB No. 2040-0004
•- • ••It. .. .. .• . . . 1
" Presehce:orAbsence. - Estimafed Data'foF Pollutants Expected.to`.B Present in Discharge
check one rovida both concentration and mass estimates for each pollutant)
PAllutant Effluent Intake Water
(CA§tlumber,'ifavdl•ble) Believed Believed'Maximum Average Source of Believed Present?
Present Absent Units Daily Daily Information (check only one response per
-'Discharge Discharge (use codes in instructions) pollutant)
❑✓
Check here if all pollutants listed in Table D are expected to be absent from your facility's discharge.
❑
Check here if the facility believes it is exempt from Table D reporting requirements because it is a qualified small business. See the instructions for exemption criteria and for a list
of materials you must attach to the application.
Note: If you check either of the above boxes, you do not need to complete Table D for the noted outfall unless you have quantitative data available.
1.Organic Toxic Pollutants (GC/MS Fraction -Volatile Compounds)',
1.1
Acrolein
(107-02-8)
❑
Concentration
❑ Yes No
Mass
1.2
Acrylonitrile
(107-13-1)
❑
Concentration
❑ Yes No
Mass
1.3
Benzene
(71-43-2)
❑
✓❑
Concentration
❑ Yes ✓❑ No
Mass
1.4
Bromoform
(75-25-2)
❑
Concentration
❑ Yes 21 No
Mass
1.5
Carbon tetrachloride
(56-23-5)
❑
Concentration
❑ Yes ❑✓ No
Mass
1.6
Chlorobenzene
(108-90-7)
❑
❑✓
Concentration
❑ Yes ❑✓ No
Mass
1.7
Chlorodibromomethane
(124-48-1)
❑
❑✓
Concentration
❑ Yes ❑✓ No
Mass
1.8
Chloroethane
(75-00-3)
❑
Concentration
❑ Yes ❑✓ No
Mass
1.9
2-chloroethylvinyl ether
(110-75-8)
❑
Concentration
❑ Yes ❑✓ No
Mass
1.10
Chloroform (67-66-3)
❑
Concentration
❑Yes ❑✓ No
Mass
1.11
Dichlorobromomethane
(75-27-4)
❑
Concentration
❑ Yes ❑✓ No
Mass
EPA Form 3510-2D (Revised 3-19) Page 9

EPA Identiflegon Number
110000349855
Facility Name I Outfall Number
Georgia-Pacific Dudley Plywood 001
I Form Approved 03/05/19
OMB No.2040-0004
Estimated' Datafor Pollutants Expected;to;Be Present in'Discharge
provide both concentration and mass estimates for eachpollutant)
Pollutant
(CAS Number, if available)
Presence orAbsence
check one
Believed
Present
Believed
Absent
Units
-Effluent
- Intake Water
Maximum
Daily
Discharge
Average
Daily
Discharge
Source of
information
(use codes in instructions)
Believed Present?
(check only one response per
pollutant)
1.12
1,1-dichloroethane
(75-34-3)
Concentration
El Yes ❑✓ No
Mass
1.13
1,2-dichloroethane
(107-06-2)
❑
❑✓
Concentration
❑ Yes ❑✓ No
Mass
1.14
1,1-dichloroethylene
(75-35-4)
❑
❑✓
Concentration
❑ Yes ✓❑ No
Mass
1.15
1,2-dichloropropane
(78-87-5)
❑
❑
Concentration
❑Yes ❑✓ No
Mass
1.16
1,3-dichloropropylene
(542-75-6)
❑
❑
Concentration
Yes ❑✓ No
Mass
1.17
Ethylbenzene
(100-41-4)
❑
❑
Concentration
❑Yes ✓❑ No
Mass
1.18
Methyl bromide
(7`�3-9)
El❑
Concentration
Yes ❑ No
Mass
1.19
Methyl chloride
(74-87-3)
❑
❑✓
Concentration
❑Yes ❑✓ No
Mass
1.20
Methylene chloride
(75-09-2)
❑
❑
Concentration
❑Yes 0 No
Mass
1.21
1,1,2,2-tetrachloroethane
(79-34-5)
❑
❑
Concentration
El Yes ❑✓ No
Mass
1.22
Tetrachloroethylene
(127-18-4)
❑
❑✓
Concentration
❑Yes ❑✓ No
Mass
1.23
Toluene
(108-88-3)
❑
❑✓
Concentration
❑Yes ❑✓ No
Mass
1.24
1,2-trans-dichloroethylene
(156-60-5)
❑
❑✓
Concentration
❑ Yes ❑✓ No
Mass
EPA Form 3510-21) (Revised 3-19) Page 10

EPA Identification Number Facility Name Outfall Number Form Approved 03M119
110000349855 Georgia-Pacific Dudley Plywood 001 OMB No.2040-0004
TABLE D. ORGANIC • ••LLUTANTS (Gas Chromatography/Mass S• . or . +1
Presence or Absence Estimated Data for Pollutants Expected to Be Present in Discharge`
check one rovide both concentration and mass estimates for each ollutant
Pollutant Effluent Intake Water
(CAS Number, If available) Believed . Believed Maximum Average
Units Source of Believed Present?
Present Absent Daily Daily Information (check only one response per
Discharge Discharge- (use erodes in instructions) pollutant)
1.25
1,1,1-trichloroethane
(71-55-6)
❑
❑
Concentration
Yes ❑ No
Mass
1.26
1,1, 2-trichloroethane
(79-00-5)
❑
Concentration
❑ Yes No
Mass
1.27
Trichloroethylene
(79-01-6)
❑
Concentration
❑ Yes ❑✓ No
Mass
1.28
Vinyl chloride
(75-01-4)
❑
Concentration
❑ Yes No
Mass
2. Organic Toxic Pollutants;(GC/MS Fraction -Acid Compounds)
2.1
2-ch`orophenol
(95-57-8)
❑
❑
Concentration
Yes ❑✓ No
Mass
2.2
2,4-dichlorophenol
(120-83-2)
❑
0
Concentration
❑ Yes 0 No
Mass
2.3
2,4-dimethylphenol
(105-67-9)
❑
Concentration
❑ Yes ❑✓ No
Mass
2.4
4,6-dinitro-o-cresol
(534-52-1)
❑
Concentration
❑ Yes No
Mass
2.5
2,4-dinitrophenol
(51-28-5)
❑
0
Concentration
❑ Yes ❑✓ No
Mass
2.6
2-nitrophenol
(88-75-5)
Concentration
❑ Yes ❑✓ No
Mass
2.7
4-nitrophenol
(100-02-7)
❑
Concentration
❑ Yes No
Mass
2.8
p-chloro-m-cresol
(59-50-7)
❑
Concentration
❑ Yes ❑✓ No
Mass
2.9
Pentachlorophenol
(87-86-5)
❑
Concentration
❑Yes ❑✓ No
Mass
EPA Form 3510-2D (Revised 3-19) Page 11

EPA Identification Number Facility Name Outfall Number
110000349855 1 Georgia-Pacific Dudley Plywood 001
Form Approved 03/05/19
1 OMB No. 2040-0004
lilt r-IR
I &INT-Mol DIME= Imi
=45 -
Estimated Data for Pollutants Expected to Be Present in Discharge
provide both concentration and mass estimates for each pollutant)
Pollutant
(CAS Number, if availa*)-'::,
Presence 6rAbsence
(check one
Believed
Present
Believe
Absent
U o,
Effluent i
Intake Water
Maximum
Daily
Discharge
Average
Daily
.:Discharge
Source of
Information
use codes in instructions)
Believed Present?
(check only one response per
pollutant)
2.10
Phenol
(108-95-2)
Concentration
El Yes 11 No
Mass
2.11
2,4,6-trichlorophenol
(88-05-2)
Concentration
Yes No
Mass
3. Organic Toxic Pollutants (GCIMS Fraction —Base /Neutral Compounds) .. .....
3.1
Acenaphthene
(83-32-9)
El
IZI
Concentration
❑ Yes El No
Mass
3.2
Acenaphthylene
(208-96-8)
Concentration
Yes ID No
Mass
3.3
Anthracene
(120-12-7)
Concentration
Yes El No
Mass
3.4
Benzidine
(92-87-5)
Concentration
El Yes ED No
Mass
3.5
Benzo (a) anthracene
(56-55-3)
❑
Concentration
El Yes ED No
Mass
3.6
Benzo (a) pyrene
(50-32-8)
IZI
Concentration
El Yes ED No
Mass
3.7
3,4-benzofluoranthene
(205-99-2)
rl
El
Concentration
rl Yes 10 No
Mass
3.8
Benzo (gh!) perylene
(191-24-2)
El
Concentration
❑ Yes Q No
Mass
3.9
Benzo (k) fluoranthene
(207-08-9)
❑
Concentration
❑ Yes ED No
Mass
3.10
Bis (2-chloroethoxy) methane
(111-91-1)
❑
Concentration
❑ Yes F-11 No
Mass
3.11
Bis (2-chloroethyl) ether
(111-44-4)
❑
Concentration
❑ Yes F11 No
Mass
EPA Form 3510-2D (Revised 3-19) Page 12

EPA Identification Number Facility Name Outfall Number Form Approved 03/05/19
110000349855 Georgia-Pacific Dudley Plywood 001 OMB No. 2040-0004
: •' • •• . . .� .. .-
Presence or Absence Estimated Data for Pollutants Expected to Be Present in Discharge
check one provide both concentration and mass est mates for each pollutant)
Pollutant Effluent Intake Water
(CAS Number, if available) Believed Believed Units Maximum Average Source of Believed Present? -
Present Absent Daily Daily Information (check only one response per
A Discharge Discharge (use codes In instructions) pollutant)
3.12
Bis (2-chloroisopropyl) ether
(102-80-1)
Concentration
❑ Yes ❑✓ No
Mass
3.13
Bis (2-ethylhexyl) phthalate
(117-81-7)
❑
✓❑
Concentration
❑ Yes ❑✓ No
Mass
3.14
4-bromophenyl phenyl ether
(101-55-3)
Concentration
❑ Yes No
Mass
3.15
Butyl benzyl phthalate
(85-68-7)
❑
Concentration
❑ Yes ❑✓ No
Mass
3.16
2-chloronaphthalene
(91 58-7)
❑
Concentration
❑ Yes ❑✓ No
Mass
3.17
4-chlorophenyl phenyl ether
(7005-72-3)
Concentration
❑ Yes ❑✓ No
Mass
3.18
Chrysene
(218-01-9)
❑
Concentration
❑ Yes ❑✓ No
Mass
3.19
Dibenzo (a,h) anthracene
(53-70-3)
❑
❑✓
Concentration
❑ Yes ❑✓ No
Mass
3.20
1,2-dichlorobenzene
(95-50-1)
Concentration
❑ Yes ❑✓ No
Mass
3.21
1,3-dichlorobenzene
(541-73-1)
❑
Concentration
❑ Yes ✓❑ No
Mass
3.22
1,4-dichlorobenzene
(106-46-7)
❑
Concentration
❑ Yes ❑✓ No
Mass
3.23
3,3-dichlorobenzidine
(91-94-1)
❑
❑✓
Concentration
❑ Yes ✓❑ No
Mass
3.24
Diethyl phthalate
(84-66-2)
Concentration
❑ Yes ❑✓ No
Mass
3.25
Dimethyl phthalate
(131-11-3)
❑
Concentration
❑ Yes ❑✓ No
Mass
EPA Form 3510-2D (Revised 3-19) Page 13

EPA Identification Number
Facility Name
Outfall Number
Form Approved 03/05/19
110000349855
Georgia-Pacific Dudley Plywood
001
OMB No.2040-0004
TABLEORGANIC TOXIC••
.. .p
.• I
i:.Fr P� -s ".,l,.Jri o:' .s... -.... ., -. •, ,: ; :.:•-
, :Esttmated;Data for Pollutants Fri ected to Be Rresent,in:Discharge t
tv ..� , .:p .,. S,Jr.o- J r,
-J v K ..,, n a r. �t'e -� -:' ilr.l'�, _�r�`it r s r
r J provide t oth concentration and mass estimates for each' dluta
?'.+�'r - in �'IV.,r" x p -.krr nt� S . > rcJ
,tas.�x.'tr,•;=r�:;,r..;
.,, ,r .r} �,.:s.-v d� :. .e Y' ��7
cJt tl �Wi�t {§r c; S'syyv' .f�r'.:G
"'99 tty ,�j
. �; If7Jr �.,in.,,.�t.;.:>N.y„ . ,r rai � n'.)
V�y�'rJlufib•r#elebte =r �Nr
L:, „),;: ,•
'r ""h":•:. .. �•'_:#�:.,.4.`�:,::J.?'+!..,,•:c :f �:''at: !:t„'.
s ;�. r,,..,k..., : ,r xJ
'r ril. ,,,r, .:;: ,,,, f�f .�..:`�F7•' .e
...::; . .
Presence or.- Absence
•�7r,
1dF. h. %t�,r". .i: r;
ci �.:h.', C�1•L�LOfl• u+'„'.h1
r. � F7ly a'."�..
,,,._.;Bel�eYed; -.:
a ,iYI .N.S ii't
:,;
„�..,,;;,.,a= rr'^':ts-
'Jr,
u:, ,. <i•..?tPs ,:
tirBel�eved�µ
drs,. .;p:7>iYt r�'
r r�;%?}x,..s,
� � r`Y i �F �
r ti "�, ;
yy<<> 1i m . rr� t ,
fj i.yl..f. i'fi Wasi✓n(. '=�s: }!'�1y
�z.„ rN v•r. ter:: :.{,, ...
.tee, .{ ;.
.Effluent
":-.
Intake�llafer
�,�lilazimum t
°sSs::'/J ;ry
ca ISCT1d @ , ti5.:1..J
ia;D
Average
Dail y
DISCII
_ are
Source of
Information
: (use codes in
a.
BelievedPFesent2
a .^tom... t:
checli�'
( o►>fy respbn P
UUtant
3.26
Di-n-butyl phthalate
(84-74-2)
❑
❑
Concentration
El Yes ❑✓ No
Mass
3.27
2,4-dinitrotoluene
(121-14-2)
❑
❑
Concentration
Yes ❑✓ No
Mass
3.28
2,6-dinitrotoluene
(606-20-2)
❑
❑
Concentration
❑ Yes ✓❑ No
Mass
3.29
Di-n-octyl phthalate
(117-84-0)
❑
❑
Concentration
Yes ❑✓ No
Mass
3.30
1,2-diphenylhydrazine
(as azobenzene) (122-66-7)
❑
Concentration
❑ Yes ❑✓ No
Mass
3.31
Fluoranthene
(206-44-0)
❑
❑
Concentration
Yes ❑✓ No
Mass
3.32
Fluorene
(86-73-7)
❑
Concentration
❑ Yes ❑✓ No
Mass
3.33
Hexachlorobenzene
(118-74-1)
❑
❑✓
Concentration
❑ Yes ❑✓ No
Mass
3.34
Hexachlorobutadiene
(87-68-3)
❑
❑
Concentration
El Yes El No
Mass
3.35
Hexachlorocyclopentadiene
(77-47-4)
❑
❑
Concentration
Yes ❑✓ No
Mass
3.36
Hexachloroethane
(67-72-1)
❑
Concentration
❑ Yes ❑✓ No
Mass
3.37.
Indeno (1,2,3-cd) pyrene
(193-39-5)
❑
Concentration
❑ Yes 0 No
Mass
3.38
Isophorone
(78-59-1)
❑
0
Concentration
Yes ❑✓ No
Mass
3.39
Naphthalene
(91-20-3)
❑
El
Concentration
El Yes ❑✓ No
Mass
EPA Form 3510-21) (Revised 3-19) Page 14

EPA Identification Number Facility Name Outfall Number Form Approved 03/05/19
110000349855 Georgia-Pacific Dudley Plywood 001 OMB No. 2040-0004
TABLE D. ORGANIC TOXIC'•Chromatography/Mass-Spectrometry• • 1
, r ,hu 'Presence orAbserice{xO��' �, �r EstimaEed Data for Pollutants Expectetl taBe Present in Discharge
r'' -r t^fy '�� check one F,� 7s3' provide both concentration and mass estimates for eachpollutant)
7-1.1:05 Effluent Intake Water
Pollutant rFrr�
(cam Number. If available j' Believed Believed Maximum Averaa Source of Believed Present? g
Present Absent "t`��'YF"h u'tk4f r Daily Daily Information (check only one response per
r r frr Irk 4�� 3 Jr .�k,� ry„c ,.I
J $ ..�?'.�• f JI'f : t : :'1� ':1. It'�f Lt �4 ollutant
'Discharge Discharge (use codes in instructions) P ) , .
3.40
Nitrobenzene
(98-95-3)
❑
❑
Concentration
❑ Yes ❑✓ No
Mass
3.41
N-nitrosodimethylamine
(62-75-9)
❑
❑
Concentration
❑Yes ❑ No
Mass
3.42
N-nitrosodi-n-propylamine
(621-64-7)
❑
❑
Concentration
El Yes ID No
Mass
3.43
N-nitrosodiphenylamine
(86-30-6)
❑
❑✓
Concentration
El Yes ❑✓ No
Mass
3.44
Phenanthrene
(85-01-8)
❑
❑
Concentration
Yes ID No
Mass
3.45
Pyrene
(129-00-0)
❑
❑
Concentration
Yes ID No
Mass
3.46
1,2,4-trichlorobenzene
(120-82-1)
❑
❑
Concentration
El Yes ❑✓ No
Mass
-:, . �.,.%T•
4. GrganicToxic P.ollutants:(GCIMS,Fraction=Pesticides)
„y ,
f1 Y
,; 'J.� r F,� NH":.::t+''•JJJ:t
?; w.,..
ar f. r %iU r vrt ::,
4 1.
Aldrin
(309-00-2)
❑
❑
Concentration
El Yes ❑✓ No
Mass
4.2
a-BHC
(319-84-6)
❑
El
El Yes ❑ No
Mass
4.3
fi-BHC
(319-85-7)
❑
❑
Concentration
Yes ID No
Mass
4.4
y-BHC
(58-89-9)
❑
❑
Concentration
Yes ❑✓ No
Mass
4.5
5-BHC
(319-86-8)
❑
❑
Concentration
Yes ❑ No
Mass
4.6
Chlordane
(57-74-9)
❑
❑
Concentration
Yes ❑✓ No
Mass
EPA Form 3510-21) (Revised 3-19) Page 15

EPA Idenlificabon Number
Facility Name Outfall Number
Form Approved 03105/19
OMB No.2040-0004
I
110000349855
Georgia-Pacific Dudley Plywood 001
, 96
•• .•
• • • I
Estimated Data for Pollutants Expected't6Be Present in Discharge
r r4 `
Presence or Atisence
f t
check one "
(provide both concentration and mass est mates for each pollutant
v
t Pollu4ant" r
G 'i�J
Effluent
Intake,Water.'
Maximurn
Average
Source of
Believetl Fnsent?
`onse
'r GAS f�mber ifairaieble)? r � ?
> � fBeliCved'ks
,Believed
,��rf �, u, ; =y. r
+Pre:erft<r�
'
Absent ^
a� ^ 'sod
s ,,, Et,
i�,
Daily
ly
Dail y
Information
check only one res r
( y P p-
,y'lt urn-
,
' ' ` �,.r
Dischar a
Dischar a
(use codes it instructonsj
pollutant)
4.7
4#4 DDT
❑
❑
Concentration
❑Yes ❑✓ No
Mass
(50-29-3)
4.8 14,4'-DDE
❑
❑
Concentration
❑Yes 0 No
Mass
(72-55-9)
4.9
4,4'-DDD
❑
❑
Concentration
Yes ❑✓ No
Mass
(72-54-8)
4.10
Dieldrin
❑
❑
Concentration
Yes ❑ No
Mass
(60-57-1)
4.11
a-endosulfan
Concentration
❑ No
(115-29-7)
❑
Yes
Mass
4.12
P-endosulfan
Concentration
❑ No
(115-29-7)
❑
Yes
Mass
4.13
Endosulfan sulfate
Concentration
❑
(1031-07-8)
❑
Yes No
Mass
4.14
Endrin
❑
❑✓
Concentration
❑ Yes ❑✓ No
(72-20-8)
Mass
4.15
Endrin aldehyde
Concentration
(7421-93-4)
❑
✓❑
❑ Yes � No
Mass
EPA Form 3510-21) (Revised 3-19) Page 16

EPA Identification Number Facility Name Outfall Number
Form Approved 030/19
110000349855 Georgia-Pacific Dudley Plywood 001
I
OMB No. 2040-0004
I
TABLE D. ORGANIC TOXIC POLLUTANTS
(Gas Chromatography/Mass
Spectrometry or GC/MS Fractions) (40 CFR 1122.211(k)(5)(iii)(B))'
(proVide both con centr'atioh' and mass estimates for each pollutant)
ell
A10
ii
.�"ff jVW 'W P�_
V�
A—
Units
Effluent
Maximum
Daily
D Is charge
Average
Daily
Discharge
Source of
:,Information
(Use:&�gwinst -ucdons)
Believe'
(check only oneYes
pollutarit)
4.16
Heptachlor
(7644-8)
❑❑Concentration
Yes No
Mass
4.17
Heptachlor epoxide
(1024-57-3)
❑❑Concentration
Yes No
Mass
4.18
PCB-1 242
(53469-21-9)
❑
IZI
Concentration
El Yes ED No
Mass
4.19
PCB-1 254
(11097-69-1)
El
IZI
Concentration
El Yes 121 No
Mass
4.20
PCB-1221
(11104-28-2)
❑❑Concentration
Yes ID No
Mass
4.21
PCB-1232
(11141-16-5)
❑Mass
❑Concentration
Yes 171 No
4.22
PCB-1 248
(12672-29-6)
❑❑Concentration
Yes 0 No
Mass
4.23
PCB-1 260
(11096-82-5)
❑❑Concentration
Yes ID No
Mass
4.24
PCB-1 016
(1 74-11-2)
❑
ID
Concentration
El Yes IZI No
Mass
4.25
Toxaphene
(8001-35-2)
❑
[a
Concentration
El Yes ID No
Mass _7
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 135 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter 1, subchapter N or 0. See instructions and 40 CFR 122.21 (e)(3).
EPA Form 3510-2D (Revised 3-19) Page 17

This page intentionally left blank.

EPA Identification Number
Facility Name Ouffall Number Form Approved 03)05/19
110000349855 1
Georgia-Pacific Dudley Plywood 001 OMB No. 2040-0004
TABLE E. CERTAIN HAZARDOUS SUBSTANCES
AND ASBESTOS (40
gwr&f P.%%W.g!yw
'Reason' Pollutant Believed Present in Discharge Ava b e ua ti tative Data
707,00".
WIRV (spea� units)
"Ab' ""I"" rf!"'
ent',
M
Check here if you believe all pollutants listed to be absent from the discharge. You need not complete Table E for the noted outfall unless you have quantitative data available.
1.
Asbestos
1:1
ED
2.
Acetaldehyde
El
M17
3.
Ally] alcohol
❑IZI
4.
Allyl chloride
❑
In/
5.
Amyl acetate
❑
M.,
6.
Aniline
M
M17
7.
Benzonitrile,
11
El
8.
j Benzyl chloride
E]
M17
9.
Butyl acetate
M
10,
Butylamine
1:1
11.
Captain
11
12.
Carbaryl
❑
F171
13.
Carbofuran
❑
F21
14.
Carbon disulfide
El
10
15.
Chlorpyrifos
16.
Cournaphos
❑
17.
Cresol
18.
Crotonaldehyde
M
EPA Form 3610-2D (Revised 3-19) Page 19

EPA Identification Number
110000349855
TABLE E. CERTAIN HAZARDOUS
Facility Name Outfall Number Form Approved 03105/19
Georgia-Pacific Dudley Plywood 001 OMB No.2040-0004
1 ASBESTOS (40
.j�,-43' .ES'�,f i+y}�'f+. .f 'f i < f.E r%?r.., J li: ice:IY'� r3-i-G.. -Y19 f� ,f _
Pre:sence'orAbsence y,,,�.r., n
- : w�. r ,r .. ,J.
r, ,+1a ";s -r: ���?-f4,,,, - c1n . 1 �ss� �- LY.�'`.ak ,. " '•S?J .� - c.rA:;.' :F
r3r,f r �, s,. .�r--:A r, ,�a Y; r AvatlableQuantktattfreData
}I
_ ;. ; ,r. �:;vReeson"��olluta�t�Belreved' ,`each °in�ta"cttai'g� �r �s ., f
,'N. 1�� is.7 .� d � i"y4 n 1Sa: �f. t^'- .�kkikl�S r{. I 1
,Present, . �:. Ab"sent r„ G-GR.'M Zy5.3fl
1' Le-. , .%�;3 •r T.e,;.y'Y.;' _L ..C, F
�� :,r,!:4., r.,",3.,:.:�J"•2;�..y;�i,
eF. ..;.r, 1?'x::, .•uy 1
� .,:,-. ,��- �� �o11Cti ant 3 r.,.��,,,., <, • �
k`F-:-:Y*-5 11 r' ,r �. vc .�` •. 'F �
19.
Cyclohexane
❑
✓❑
20.
2,4-D (2,4-dichlorophenoxyacetic acid)
❑
❑✓
21.
Diazinon
❑
❑✓
22.
Dicamba
❑
❑✓
23. j
Dichlobenil
❑
7
24.
Dichlone
❑
25.
2,2-dichloropropionic acid
❑
0
26.
Dichlorvos
❑
❑✓
27,
Diethyl amine
❑
28.
Dimethyl amine
❑
29.
Dintrobenzene
❑
30.
Diquat
❑
❑✓
31.
Disulfoton
❑
❑✓
32.
Diuron
❑
❑✓
33.
j Epichlorohydrin
❑
0
34.
Ethion
❑
❑✓
35.
Ethylene diamine
❑
❑✓
36.
Ethylene dibromide
❑
In,
37.
Formaldehyde
❑
✓❑
EPA Form 3510-2D (Revised 3-19) Page 20

EPA Identification Number
Facility Name Outfall Number Form Approved 03105119
110000349855
Georgia-Pacific Dudley Plywood 001 OMB No.2040-0004
TABLE E. CERTAIN HAZARDOUS
1
�; �''�
R R ir.. r t;
Presence or Absence
' Available Quantitative Data
check one) Reason Pollutant,Believed Present inbischarge
Believed Believed (specify units)
"
Present Absent
38.
Furfural
❑
✓❑
39.
Guthion
❑
❑✓
40.
Isoprene
❑
❑✓
41.
Isopropanolamine
❑
❑✓
42.
Kelthane
❑
❑✓
43.
Kepone
❑
❑
44.
Malathion
❑
45.
Mercaptodimethur
❑
❑✓
46.
Methoxychlor
❑
❑✓
47.
Methyl mercaptan
❑
❑✓
48.
Methyl methacrylate
❑
❑✓
49.
Methyl parathion
50.
Mevinphos
❑
❑✓
51.
Mexacarbate
❑
52.
Monoethyl amine
❑
53.
Monomethyl amine
❑
54.
Naled
❑
55.
Naphthenic acid
❑
0
56.
Nitrotoluene
❑
EPA Form 3510-21) (Revised 3-19) Page 21

EPA Identification Number
Facility Name Outfall Number Form Approved 03ro5119
110000349855
Georgia-Pacific Dudley Plywood 001 OMB No.2040-0004
CERTAINTABLE E. •D•
1 ASBESTOS
sence' ,0. ,
fs�r Ck
f r ,,
r` ` Pollutant
y
check one Quantitative Data
'in Ava
;.
Rea'sori Pollutant Believed Present
(speilable
units)
Believed Believed (specify units)
Present Absent
57.
Parathion
❑
❑✓
58. 1
Phenolsulfonate
❑
✓❑
59.
Phosgene
❑
0
60.
Propargite
❑
0
61.
Propylene oxide
❑
62.
Pyrethrins
❑
0
63.
Quinoline
❑
64.
Resorcinol
❑
65.
Strontium
❑
0
66.
Strychnine
❑
0
67.
Styrene
❑
✓❑
68
2,4 5-T (2,4,5-trichlorophenoxyacetic
❑
acid
69.
TDE (tetrachlorodiphenyl ethane)
❑
✓❑
2,4,5-TP [2-(2,4,5-trichlorophenoxy)
❑
ro anoic acid
r70
71.
Trichlorofon
❑
❑✓
72.
Triethanolamine
❑
73.
Triethylamine
❑
❑✓
74.
Trimethylamine
❑
✓❑
75.
Uranium
❑
❑✓
EPA Form 3510-21D (Revised 3-19) Page 22

EPA Identificafion Number
Facility Name
Outfall Number Form Approved 03/05/19
110000349855
Georgia-Pacific Dudley Plywood
001 OMB No. 2040-0004
HAZARDOUSTABLE E. CERTAIN
• 1
Presence orAbse'nce
-71_
..
Pollutant
check one
Reason Pollutant Believed Present irr Discharge Available Quantitative Data
Believed Believed
(specify units)
Present Absent
76.
Vanadium
❑
❑✓
77.
Vinyl acetate
❑
❑✓
78.
Xylene
❑
❑✓
79.
Xylenol
❑
✓❑
80.
Zirconium
❑
✓❑
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 23

EPA Identification Number
NPDES Permit Number
NCO090051
Facility Name
Georgia-Pacific Dudley Plywood
Form Approved 03/05/19
OMB No.2040-0004
110000349855
U.S Environmental Protection Agency
Form
e�
Application for NPDES Permit to Discharge Wastewater
NPDES
,r,�EPA
STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY
SECTIONOUTFALL
LOCATION
Provide information on each of the facility's outfalls in the table below
1.1
Outfatl `
Receiving Water Name
Latitude
Longitude
Number
001
Brooks Swamp
3r 15� 3fi'
79' 02' 117"
002
Brooks Swamp
3T 15 4�r
79' 02' 16"
0
• n
• r u
R
7
• r "
a r n
• r "
• r u
SECTION•
Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing,
2.1
upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes ❑✓ No 4 SKIP to Section 3.
2•2
Briefly identify each applicable project in the table below.
Final Compliance Dates
Brief Identification and
Affected Outfalls
Source(s) of Discharge
Description of Project
gist outfall numbers)
' Required
Projected
� c
C'
.tjfilti=Q.tY
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
110000349855
NCO090051
Georgia-Pacific Dudley Plywood OMB No. 2040-0004
SECTIONDRAINAGE
Have you attached a site drainage map containing all required information to this application? (See instructions for
3.1
specific guidance.)
o
® Yes ❑ No
SECTIONPOLLUTANT
SOURCESi CFR 122.26(c)(1)(i)(B))
Provide information on the facility's pollutant sources in the table below.
4.1
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
001
56
acres
acres
specify units
specify units
002
1.1
acres
10•7
acres
specify units
specify units
specify units
specify units
specify units
specify units
specify units
specify units
4.2
Provide a narrative description of the facility's significant material in the space below. (See instructions for content
requirements.)
Facility is wood products manufacturing facility that produces plywood.
N
7:
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
WWI. ,
Control Measures and Treatment
from
Exhibit
Number __
2F-1
list
001
Settling Pond
1-U
EPA Form 3510-2F (Revised 3-19) Page 2

ll mppluvm
EPA Identification Number NPDES Permit Number Facility Name ru i OMB No. 204 I-1 I4
NCO090051 Georgia-Pacific Dudley Plywood
110000349855
SECTION• •' 1
5.1 1 certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the
of non-stormwater discharges. Moreover, 1 certify that the outfalls identified as having non-stormwater
presence
discharges are described in either an accompanying NPDES Form 2C, 21), or 2E application.
Official title
Name (print or type first and last name)
5C.3
"� ti ll.
f;
iVX
� P
Signature ,,
Date signed
5.2
Provide the testin informatio requested in the table below.
t
-
Onsite Drainage Points
f OUall 3��4`
Description of Testing Method Used
Date(s) of Testing
Directly Observed
oNumbey�-M
y ---
---
est
— Durin Test
3 "
001
Visual
Yes
Ei
--
a
in
z
SECTION
I. SIGNIFICANT
LEAKS OR I
Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years.
6.1
None
r -a,
U
- o
Y
[O
N
C
f6
U
4..
rn
SECTION
INFORMATION r
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must
o
corn lete. Not all applicants need to complete each table.
7.1
Is this a new source or new discharge?
€
Yes 3 See instructions regarding submission of ❑ No 4 See instructions regarding submission of
❑ estimated data. actual data.
- -
i%,, aw .y - �. a,� ,
Tables AB, C, and D }; ..... ,.y r ar.� . G„' i rti_ 44 5—
N'
7.2
Have you completed Table A for each outfall?
G Yes ❑ No
EPA Form 3510-21' (Revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110000349855
NCO090051
(
Georgia-Pacific Dudley Plywood
OMB No. 2040.0004
7.3
Is the facility subject to an effluent limitation guideline (ELG) or effluent limitations in an NPDES permit for its process
wastewater?
❑ Yes ❑✓ 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 217-2 are present in the discharge?
A
;: :;;
❑ Yes 0 No 4 SKIP to Item 7.7.
.}z=:
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 -SKIP 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?
El Yes ❑✓ 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?
❑ Yes ❑ No
it
7.10
Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater?
Yes ❑✓ No 4 SKIP to Item 7.12,
7.11
Have you provided quantitative data in Table C for those pollutants in Exhibit 2F-3 that you expect to be discharged in
concentrations of 10 ppb or greater?
❑ Yes ❑ No
7.12
Do you expect acrolein, acrylonitrile, 2,4-dinitrophenol, or 2-methyl4,6-dinitrophenol to be discharged in concentrations
31. '=
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 2F-4 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
"Y
explanation in Table C?
"'_` :t t
❑ Yes ❑ No
-;> s-':
7.17
Have you provided information for the storm event(s) sampled in Table D?
t'`t '`-``
❑✓ Yes ❑ No
EPA Form 3510-2F (Revised 3-19) Page 4

EPA Identification Number
NPDE�Number
Facility Name
Form Approved 03/05/19
OMB No. 2040-0004
Dudley Plywood
110000349855Neorgia-Pacific
.
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
manufactured as an intermediate or final product or byproduct?
-- :
❑ Yes ❑✓ No 4 SKIP to Section 8.
7.19
List the pollutants below, including TCDD if applicable.
4. 7.
2• 5. 8.
s;
o ;
3. 6. 9.
SECTION•BIOLOGICAL
T• t
Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on
8.1
any of your discharges or on a receiving water in relation to your discharge within the last three years?
o.
€'
❑ Yes ❑✓ No 4 SKIP to Section 9.
8.2
Identify the tests and their purposes
below
Tags} a a
'Pt Purpose of Teat(a) r -
h`Submitted to NPDS
'~
Date Sub�ttjtte
x
ati=s.:,=w ,��.; ;t_�,t�
_
Permifttn: Authori ?
-
10
❑ Yes ❑ No
V:.,
II,
o:
❑ Yes ❑ No
m0
❑ Yes ❑ No
SECTION•
•- • i
Were any of the analyses reported in Section 7 (on Tables A through C) performed by a contract laboratory or
9.1
consulting firm?
Q Yes ❑ No 4 SKIP to Section 10.
w
9.2
Provide information for each contract laboratory or consulting firm below.
LatioratoryNumberlLaboratoryNumb2 q}'LabgatoryNumbe�3',
Name of laboratory/firm
pace
NCa .
.o
.m
_o
w
Laboratory address
9800 Kincey Ave, Suite 100
2`� ,11
Huntersville, NC 28078
;
C
U
16
number
oPhone
U
[phone]
Pollutant(s) analyzed
TSS, COD, Oil and Grease
a�
1.�ar
EPA Form 3510-2F (Revised 3.19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved W/Ub119
NCO09DO51 Georgia-Pacific Dudley Plywood 001 OMB No. 2040.0004
110000349855
TABLE A. CONVENTIONAL AND NON CONVENTIONAL PARAMETERS (40 CFR 122.26(c)(1)(i)(E)(3))'
You must provide the results of at least one analys"isTo—revery pollutant in this table. Complete one table for each outfall. See instructions for additional details and requirements.
::1r.,�:u..,�.r+.,.,..Hy.,
.+vy,. 't:t ,. .7c�4f J• ,. i:,d,..f
,:
J,,:,n,y- �r>..;rr r.•.�f:}-;,y',
ry,:f'.-x"r...
p"r:%.sy... n..,.,:
...!a,9:.
'Y
i''cG'.�•rt.�.
,*f.•','.1.; Maximu •Di ischar e
:; rlr
.."',
Dail D'
''^+.:i
'.ovefrdgey'
turc2fv>f^
}.,;:?;,tsr
c,:,,w,r:.,o .Yr-,-i+.Jr:,:o rJ:. r H:_'1
F; r
+T3-•:.
ar., Jil��'+�' '
,+- ,
('specify units) ;
,;�'wi^sc:.-: .:`.o :•ram•: a::':
Nki+_} .x�sr
.?r , t a ; ,x �lJ-'t
sl euls� units'f r 1�.4, r' �x
y
fr�forrnai3�-.
Y
,(Specify
umber of Storm
x
L_. ,.,
"`' Y, ' Pollutant orParameter
Grab Sample Taken s
p Flow -Wei hted
'::DuringFirst g
'Grab Sa' r .,;
mplTak€n�;;� ,( loiiWe hted.":NentsSam led
f {sir 2 g r p '
s,�>x,•
pvF(rfeirburAteuV <
e}sodl cfise
�3 Y
Composite
P
Durirrg'Frrs�., �tu ,
:, .? �� tf �,, f
rCdrpd�ite
.`ia =.
E-
' ,"r
>'x=>u.3D;Ninutes.
_�a( it yi fe rf_
3o,Mln'1i{es'.'i�„rfr.' rJ
�-:'re_..rr.>r.'���w „!.
,.:tbdes'Rt'111StfUCbOhS%:
Oil and grease
<4s.9
' 2
Biochemical oxygen demand (BODs)
�3„rA'
Chemical oxygen demand (COD)
174
86.8
7
4
Total suspended solids (TSS)
322
161
7
5 (
Total phosphorus
6
Total Kjeldahl nitrogen (TKN)
7
Total nitrogen (as N)
pH (minimum)
AN
pH (maximum)
I Qmmrsfinn
chap ho e-nnrli icferl acLordinn te, sikfFiciPntly
sPnsitivP test nrnr.PdurPs (i.e.. methods) annroved under 40 CFR
136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F (Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 031D5119
110000349855 1
NCO090051 Georgia-Pacific Dudley Plywood 001 OMB No.2040-0004
TABLE B. CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vi)(A))'
List each pollutant that is limited in an effluent limitation guideline (ELG) that the facility is subject to or any pollutant listed in the facility's NPDES permit for its process wastewater (if the
facility is operating under an existing NPDES permit). Complete one table for each outfall. See the instructions for additional details and requirements.
rkN'r,„1 `j •�gl;i h� pl„f r, �,^
Pollutant and CAS Number (if available)
Maximum Daily Discharge ; �' f;
s e ' units):
Average Daily Discharge'
speci units
Number of Storm
Events Sampled
Source of
Information
(new scurcerrevi
dischargers only; use
codes ln.instructions)-,
Grab Sample Taken
During First
30 Minutes'
f
Flow -Weighted
Composite
Grab Sample Taken
During First
30 Minutes
Flow -Weighted
Composite
i
I
�
�I
i
1 Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., metnoas) approved under 4u ct < Iso Tor ine analysis dT pouuianis or pouuTam pararne&rs 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

This page intentionally left blank.

k Identification Number NPDES Permit Number I Facility Name I Outfell Number Form Approved 03/05/19
110000949855 NCO090051 Georgia-Pacific Dudley Plywood 001 OMB No.2040-0004
TABLE C. TOXIC -POLLUTANTS, CERTAIN -HAZARDOUS SUBSTANCES, AND ASBESTOS (40 CFR 122.26(c)(I)(i)(�X4�� CFR 122.249)RviHB) and (vii))'
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.
rrF� rr cr
j 7 �`
�r Pollutantand CAS Numberavailable)
e�ar,! !•: f;' r:u ,,..:
:1 4� : ,.� •r r
NIX,S :,if' ,t? � r f ; ..wi
.2'k2 �ri ��r,W,a
Maxtmum;Daity4arg Dische
= ``P (speaNunitsT' �
GrabSalrrpleTaken low -Weighted.,
hted
urn"First :' 9
,yam 0 s:..r9a 0 J
; •y � ; Com osite . tom.
c.��3D`Mrnufes '� of p �i��
Average Daly Dischargex�str
s cifyunifs) �r�,
Grab SampleTakpr�r Flow -Wei hted;`
DuringFirst'' 5
rCompositef
� .30Minutes I ✓.1�5'rse�
;, rr rr-
o ,. F
'Number of Storm
Events •Sam led
r s r.P
�i + ,
����`
Source of
Informs{ion
(newsoitrce#�
disdli'a j�rs�on use'
codes:in'inshumons )
I
I
I
I
I
I
I
I
I
I
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 11

This page intentionally left blank.

EPA Form 3510-2F (Revised 3-19) Page 13

4.. 0. g-�
IV4,.

--
77
.,.2. F��--�_ _ ` . �` - — it �N �-' _= „ice -?" •... __..._- -- — -; = -- - -- --- 7^'"";.r.
l.,�
,.�7-�n•'1 ..:i,:J . • Jam' _ : '�.. � .y - l -,�
I toroarwNe unr euc,E cp+arear oa n� u a- oEKoo� suausr
IXMOIVYIOLBE Np.UOE: 30,JfM'/E]T d0�� ;IOFO, NC l Vitl 1971 r+a FtOURT KNE- NC 11tt.fl: i?
«_� • . TOPOGRAPHIC MAP �cn
09=W. sr , s tt HcF Dudley Plywood Facility
�...., wrNae ro�� 1# NPDES Permit Application 2
aww.tiW o.lc t39 t3relrinpton Road
CC g 2�i "'° �"° Nc xa++a Dudley, Wayne County, North Carolina

1
W,
1
Settling Pond I- :
L'I

Volume Calculations
Method: NRCS Methodology Weighted Average Volume Technique
1. CN Impervious = 98, CN Pervious 35
2. A = (Runoff) Area = 63 Acres (88% impervious)
3. 1 = Intensity, Rainfall (NOAA Atlas 14, Volume 2, Version 3 for the Dudley, NC station)
25-yr, 24hr. storm: 7.2 inches
Annual Average Precipitation: 48 inches/year
4. Impervious Area
S = 1000/CN -10
S = 0.2 inches
Impervious Area Abstraction = 0.2(S) = 0.04 inches; 0.8(S) = 0.16 inches
Pervious Area Runoff Volume = Q = (P - 0.2S)2 /( P + 0.85)
Qlmperv25yr = (7.2 - 0.04)2 / (7.2 + 0.16) = 6.97 inches
QlmpervAnn = (48 - 0.04)2 / (48 + 0.16) = 47.76 inches
5. Pervious Area - S = 18.6 inches
Impervious Area Abstraction = 0.2(S) = 3.71 inches; 0.8(S) = 14.9 inches
Qlmperv25yr = (7.2 - 3.71)2 / (7.2 + 14.9) = 0.55 inches
QlmpervAnn = (48 - 3.71)2 / (48 + 14.9) = 31.2 inches
6. Runoff Volume
55 Acres Impervious, 8 acres pervious
Runoff Volume = (rain ft x acre x 43560 sf per acre)
Runoff Volume 25 yr = (6.97/12 x 55 x 43560) + (0.55/12 x 8 x 43560) _
1,407,533 cubic feet = 10.5 million gal
Runoff Volume Annual = (47.76/12 x 55 x 43560) + (31.2/12 x 8 x 43560) _
10,441,332 cubic feet = 78 million gal

Pond Calculations
1. Pond dimensions and compare to minimum design requirements
a. Minimum Length to Width ratio is 2:1
b. The depth is 4' for the permanent pool
c. The dimensions of the pond are 350' by 170' and 130' by 100'
Surface area = 72,500 ft2
Volume = 290,000 ft3
2. Determine Hydraulic Residence Time (HRT)
a. HRT = Volume / Qavg
Qavg = 678 gpm* 60 minutes/hour * 24 hours/day * 0.134 ft3/gallon = 130,826 ft3/day
HRT = 290,000 ft3 / 130,826 ft3/day * 24 hours/day = 53 hours

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MICRO-BLAZEOO EMERGENCY
LIQUID SPILL CONTROL
TECHNICAL PRODUCT BULLETIN #13-41
USEPA, OEM REGULATIONS IMPLEMENTATION DIVISION
ORIGINAL LISTING DATE: DECEMBER 18,1991
REVISED LISTING DATE: JANUARY 21,1997
"MICRO -BLAZE° EMERGENCY LIQUID SPILL CONTROL"
I. NAME, BRAND, OR TRADEMARK
MICRO -BLAZE° EMERGENCY LIQUID SPILL CONTROL
Type of Product: Biological Additive

II. NAME, ADDRESS, AND TELEPHONE NUMBER OF MANUFACTURER/CONTACT
Verde Environmental, Inc.
9223 Eastex Freeway
Houston, TX 77093
Phone: [phone]
Phone: [phone]
Fax: [phone]
Website: micro-blaze.com Z <https://www.micro-blaze.com/>
Email: [e-mail]
(Mr. William Scogin)
111. NAME, ADDRESS, AND TELEPHONE NUMBER OF PRIMARY DISTRIBUTORS
Verde Environmental, Inc.
9223 Eastex Freeway
Houston, TX 77093
Phone: [phone] or
Phone: [phone]
Fax: [phone]
Website: micro-blaze.com Eoj?'<https://www.micro-blaze.com/>
Email: [e-mail]
(Mr. William Scogin)

IV. SPECIAL HANDLING AND WORKER PRECAUTIONS FOR STORAGE AND FIELD
APPLICATION
1. Flammability:
Non-flammable
2. Ventilation:
Normal room ventilation
3. Skin and eye contact; protective clothing; treatment in case of contact:
Avoid eye contact. Wear protective gloves, and wash hands with soap and water
after handling the product. Wash contaminated clothing and footwear before
reuse.
4.a. Maximum storage temperature: 120OF
4.b. Minimum storage temperature: 350F
4.c. Optimum storage temperature range: NA
4.d. Temperatures of phase separations and chemical changes: NA
V. SHELF LIFE
Minimum 10 years, with proper storage, in original container. Freezing will not kill
these microbes; however, extreme heat for long periods of time (over 180°F) will
kill the microbes.

VI. RECOMMENDED APPLICATION PROCEDURE
MICRO -BLAZE° is a liquid formulation of several microbial strains, surfactants and
nutrients designed to digest organics and hydrocarbons in soil and water as well as
control odors.
1. Application Method:
Use normal spray equipment, fire or response equipment, eductor setups, water
trucks, etc. as methods of application. Mix MICRO -BLAZE° EMERGENCY LIQUID
SPILL CONTROL/water mixture with contaminated soils and liquids thoroughly for
maximum contact. Pick up treated contamination after volatile hazard has been
negated per local regulatory parameters. For general bioremediation: For in -situ
soils, mix MICRO -BLAZE° EMERGENCY LIQUID SPILL CONTROL/water mixture can
be tilled into the contaminated area. For shallower contamination, areas can be
over sprayed with normal spray equipment, eductor setups, water trucks, etc. For
deeper contamination, application can be applied through underground setups
using perforated piping per regulatory recommendations. For wastewater and
other operational by-product sludges and soils extracted from contaminated areas,
a bioslurry or bioreactor can be setup using MICRO -BLAZE° EMERGENCY LIQUID
SPILL CONTROL and water in the process.
2. Concentration/Application Rate:
For more viscous or less hazardous contamination, apply MICRO -BLAZE°
EMERGENCY LIQUID SPILL CONTROL at a 3% solution mixed with water (3 parts
MICRO -BLAZE° EMERGENCY LIQUID SPILL CONTROL, 97 parts water). When
bioremediating soils, generally, per every 10 cubic yards of contaminated soils, use
one gallon of concentrate, diluted with water according to contamination type.
3. Conditions for Use:
Water Salinity: Can be mixed with any fresh, brackish or brine. However, brine
reduces the effectiveness by 10%.
Water Temperature: 35°F - 180°F
pH: 4 to 11.5
Temperature: 32°F -120OF
Nutrient Requirements: Nutrients for microbes are included in product. However,
for longer -term bioremediation projects, additional applications for Bio-Catalyst
may be added to boost microbial activity.
Type and Ages of Pollutants: For use on organics and hydrocarbon -based

VI. RECOMMENDED APPLICATION PROCEDURE
materials. These strains of bacteria provide the capability of biodegrading various
straight chained, branched chained, aromatic and polynuclear aromatic
hydrocarbons found in diesel and other fuels. Age of contamination is not a factor
as much as its density. Tar -like substances may need to be cut for timely
remediation.

VII. TOXICITY AND EFFECTIVENESS
Non -toxic, naturally -occurring spore -forming microorganisms common to soil and
water. Non-pathogenic, certified by count; will not mutate.
a. Toxicity
NA
b. Effectiveness
Bioremediation Agent Effectiveness Test (40 CFR 300,900) Federal Register
September 15,1994.
Microbiological Results -Average
Day 0-1.7x109
Day 7 - 8.43 x 108
Day 28 - 5.2 x 107
The organisms in this product convert to a spore state (dormant) to survive an
unfavorable environment and will reactivate upon favorable conditions.
Documentation available from Verde Environmental.
Summary Data Table:
TOTAL
L
PRODUCT
RED%
RED%
MEAN
MEAN
DAYS
3
28
28
ALKANES
AROMATICS
REPS/PROD
Days
DAYS
(ppm)
(Ppm)
CONTROL
31258.6
0
973
0
0
NUTRIENT
28251.8
0
976.6
0
PRODUCT
29548.9
0
1081.2
0
CONTROL
31401.73
0
990.5
0
7
NUTRIENT
20728.3
26.6
619.1
36.6
PRODUCT
12870.5
56.4
496.3
54.1

VII. TOXICITY AND EFFECTIVENESS
TOTAL
TOTAL
PRODUCT
RED%
RED%
MEAN
MEAN
DAYS
3
28
28
ALKANES
AROMATICS
REPS/PROD
Days
DAYS
(PPm)
(pPm)
CONTROL
32465.8
0
925.7
0
28
NUTRIENT
1787.2
93.7
722.6
26.0
PRODUCT
1758.2
94.1
566.9
47.6
Alkanes showed significant reductions with aromatic components less dramatic
but still significant.
Results of Gravimetric Analysis:
Percentage (%) Decrease in Weight of Oil on Day 28
CONTROL: < 1%
NUTRIENT: 17.6%
PRODUCT: 12%
CONCLUSIONS: The MICRO -BLAZE° EMERGENCY LIQUID SPILL CONTROL product
shows an initial rapid consumption of all measured hydrocarbons at seven (7)
days. This rate apparently slows over 28-day period in a closed environment which
may be due to a change in the environment of the flask due to the rapid
degradation rates. Because of the high microbial population at the end of the test,
it is to be assumed that the quantity of metabolites might account for the
increased weight as determined by the gravimetric analysis.

VIII. MICROBIOLOGICAL ANALYSIS
1. Listing of all micro-organisms by species and percentage in the composition:
CONFIDENTIAL
2.Optimum pH, temperature, and salinity ranges for use of the additive:
pH 7.5
Temperature: 450F - 1050F
Salinity: 0 -10%
3. Minimum and maximum pH, temperature, and salinity levels below or above
which the effectiveness of the additive is reduced to half its optimum capacity:
pH: <5.9, >9.0
Temperature: <32°F, >180°F
Salinity: <0%,10%
4. Special nutrient requirements: none
5. Test results regarding the determination of the presence of the following:
Salmonella: Negative
Fecal coliform: Negative
Shigella: Negative
Staphylococcus Coagulase positive: Negative
Beta hemolytic Streptococci: Negative
IX. PHYSICAL PROPERTIES
NA
X. ANALYSIS OF HEAVY METALS, CYANIDE, AND CHLORINATED HYDROCARBONS
NA
Contact US <https://epa.gov/emergency-response/forms/contact-us-about-emergency-response> to ask a
question, provide feedback, or report a problem.
LAST UPDATED ON JANUARY 3, 2023

�NoainN�
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O �
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a
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E1 D E) M 9

' Micrv-&)aze
Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
1 IDENTIFICATION OF THE SUBSTANCE
Product identifier
Product Name:
Product Code:
Micro -Blaze® Emergency Liquid Spill Control
MBELSC
Recommended use of the chemical and restrictions on use
Recommended Use:
Uses advised against:
Details of the supplier of the Safety Data Sheet
Contact Manufacturer:
Information Telephone Number:
Emergency Telephone Number:
2. HAZARDS IDENTIFICATION
Classification
Bioremediation/cleaning
Please refer to Product Data Sheet
Verde Environmental, Inc.
9223 Eastex Freeway
Houston, TX USA 77093
1-713-691-6468
1-800-424-9300 (Chemtrec) 24 hours every day
Classification of the product is in accordance with 29CFR 1910.1200
Acute toxicity — Oral
Category
5
Serious eye damage/eye irritation
Category
2A
Skin sensitization
Category
1
Label elements
Warning
Hazard statements
May cause an allergic skin reaction
Causes serious eye irritation
May be harmful if swallowed
<i>
Appearance: Opaque Physical State: Liquid Odor: Slight fermentation odor
Date Issued: 22nd January, 2021
Page 1 of 8

Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
Precautionary Statements — Prevention
Wear eye/face protection. Wear protective gloves. Avoid breathing dust/fume/gas/mist/vapors/spray.
Precautionary Statements — Response
Eyes IF IN EYES: Rinse cautiously with water for several minutes. Remove contact
lenses, if present and easy to do. Continue rinsing
Skin IF ON SKIN: Gently wash with plenty of soap and water
Inhalation IF INHALED: If breathing is difficult, remove victim to fresh air and keep at
rest in a position comfortable for breathing
Ingestion IF SWALLOWED: Call a POISON CENTER or doctor/physician if you feel
unwell
Precautionary Statements — Storage
Protect from sunlight. Do not expose to temperatures exceeding 50°C/122°F
Precautionary Statements — Disposal
Dispose of unused product and container in accordance with all applicable local and regional
requirements
Hazards not otherwise classified (HNOC)
Not applicable
Other information
0
Reactivity 0
3. COMPOSITION/INFORMATION ON INGREDIENTS 71
Name
Weight - %
Water and Proprietary Viable Spore Forming Cultures
> 80
Proprietary blend of Ethox lated Alcohols and other Organic materials
3-9
Additives
2-5
4. FIRST AID MEASURES
First aid measures
Date Issued: 22°d January, 2021 Page 2 of 8

' Micro -Beane
Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
Eye Contact Rinse immediately with plenty of water, also under the eyelids, for at least 15
minutes
Skin Contact Wash off immediately with soap and plenty of water
Inhalation Move to fresh air
Ingestion Clean mouth with water and afterwards drink plenty of water
Most important symptoms and effects both acute and delayed
Main symptoms No information available
Indication of any immediate medical attention and special treatment needed
Notes to physician Treat symptomatically
5. FIREFIGHTING MEASURES
Suitable Extinguishing Media
Use extinguishing measures that are appropriate to local circumstances and the surrounding environment
Specific Hazards Arising from the Chemical
No information available
Protective Equipment and Precautions for Firefighters
As in any fire, wear self-contained breathing apparatus pressure -demand, MSHA/NIOSH (approved or equivalent)
and full protective gear
6 ACCIDENTAL RELEASE MEASURES I
Personal precautions protective equipment and emergency procedures
Personal Precautions Ensure adequate ventilation
Environmental precautions
Environmental Precautions It is not anticipated to be hazardous for the environment
Methods and material for containment and cleaning up
Methods for Clean-up Pick up and transfer to properly labeled containers
7. HANDLING AND STORAGE
Precautions for safe handling
Handling Handle in accordance with good industrial hygiene and safety practice
Date Issued: 22°d January, 2021 Page 3 of 8

�' Micrv-$Gaze
Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
Conditions for safe storaee, includine anv incompatibilities
Storage Conditions Keep containers tightly closed in a dry, cool and well -ventilated place
Packaging Material There could be many packaging types for the product. The details are
given in other Verde Environmental, Inc. documents
Incompatible Materials Strong acids or alkali compounds and strong oxidizing agents may
inactivate biological cultures
8. EXPOSURE CONTROU/PERSONAL PROTECTION
Individual protection measures, such as personal protective equipment
Eye Protection Avoid contact with eyes
Skin and body protection No special technical protective measures are necessary
Respiratory protection In case of insufficient ventilation, wear suitable respiratory equipment
General Hygiene ConsiderationsHandle in accordance with good industrial hygiene and safety practices
9. PHYSICAL AND CHEMICAL PROPERTIES
Physical State Liquid
Appearance Tan, Opaque
Odor Pleasant (perfume)
Odor Threshold No information available
Property
Values
PH
7.0 — 8.0
Melting/freezing point
freeze at 0°C/32°F
Evaporation rate VALUE
No information available
Flammability (solid, gas)
Not flammable
Burning rate 100mm VALUE
No information available
Vapor pressure
No information available
Vapor density
No information available
Specific gravity
No information available
Water solubility
99%
Solubility in other solvents
No information available
Partition Coefficient (n-octanol/water)
No information available
Autoignition temperature
No information available
Decomposition temperature
No information available
Viscosity of product
No information available
Viscosity
No information available
Date Issued: 22nd January, 2021 Page 4 of 8

Micro-&)aze
Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
Explosive properties
Oxidizing properties
Other Information
Softening Point
VOC Content
Density
No information available
No information available
No information available
No information available
No information available
10. STABILITY AND REACTIVITY
Reactivity
No data available
Chemical stability
Stable under recommended storage conditions
Possibility of Hazardous Reactions
None under normal processing
Conditions to avoid
Extremes of temperature and direct sunlight
Incompatible materials
Strong acids or alkali compounds and strong oxidizing agents may inactivate biological cultures
Hazardous Decomposition Products
No information available
11. Toxicological Information
Information on likely routes of exposure
Inhalation There is no data available for this product
Eye contact Avoid contact with eyes. Severely irritating to eyes
Skin contact Repeated or prolonged skin contact may cause allergic reactions with
susceptible persons.
Ingestion Ingestion may cause stomach discomfort
Information on toxicological effects
Symptoms No information available
Delayed and immediate effects as well as chronic effects from short and long-term exposure
Date Issued: 221 January, 2021
Page 5 of 8

A.
' Micro-j;eaz¢
Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
Sensitization May cause sensitization of susceptible persons
Mutagenic Effects No information available
Reproductive Effects No information available
Specific target organ systemic toxicity No information available
Aspiration hazard No information available
12. ECOLOGICAL INFORMATION
Ecotoxicity
Chemical Name
Dahnia, acute
Algae, acute
Fish, acute
Proprietary blend of Ethoxylated
Alcohols
EC50 (48 hours): 5-10
m
EC50 (72 hours): 10- 100 mg/1
LC50: 1-10 mg/l
Persistence/Degradability
The organic components of the product are biodegradable.
Bioaccumulation/Accumulation
Chemical Name
Persistance and degradability
log Pow
Proprietary blend of Ethoxylated
Alcohols I
Readily biodegradable (OECD TG
301 B
<0
Other adverse effects
No known effect
13. DISPOSAL CONSIDERATIONS
Waste treatment methods
Waste Disposal Method Dispose of contents/container in accordance with local regulation
Contaminated Packaging Empty containers should be taken for local recycling, recovery or waste
disposal
14. TRANSPORT INFORMATION
Transport regulations: No dangerous goods according to transport regulations
No special precautions required
Transport hazard class(es): N/A
Packing group: N/A
Environmental hazards: N/A
Date Issued: 2211 January, 2021 Page 6 of 8

' Mery -$daze
Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
15. REGULATORY INFORMATION
International Inventories
Legend:
TSCA — United States Toxic Substances Control Act Section 8(b) Inventory
DSL/IVDSL — Canadian Domestic Substances List/Non-Domestic Substances List
Federal Regulations
SARA 313
Section 313 of Title III of the Superfund Amendments and Reauthorization Act of 1986 (SARA). This product does
not contain any chemicals which are subject to the reporting requirements of the Act and 40 CFR Part 372.
SARA 311/312 Hazardous
Categorization
Acute Health Hazard
No
Chronic Health Hazard
No
Fire Hazard
No
Sudden Release of Pressure Hazard
No
Reactive Hazard
No
CWA (Clean Water Act)
This product does not contain any substances regulated as pollutants pursuant to the Clean Water Act (40 CFR
122.21 and 40 CFR 122.42)
CERCLA
This material, as supplied, does not contain any substances regulated as hazardous substances under the
Comprehensive Environmental Response Compensation and Liability Act (CERCLA) (40 CFR 302) or the
Superfund Amendments and Reauthorization Act (SARA) (40 CFR 355). There may be specific reporting
requirements at the local, regional, or state level pertaining to releases of this material.
State Regulations
California Proposition 65
This product does not contain any Proposition 65 chemicals
State Right -to -Know
U.S. EPA Label Information
EPA Pesticide Registration Number Not Applicable
Canada
WHNHS Statement This product has been classified in accordance with the hazard criteria of the
Controlled Products Regulations (CPR) and the SDS contains all the information
required by the CPR.
Date Issued: 221d January, 2021 Page 7 of 8

r:1
Micro -$daze
Microbial Products
Safety Data Sheet
Micro -Blaze® Emergency Liquid Spill Control
16. OTHER INFORMATION
Revision date: 01.22.2021
Revision Summary
No information available
Disclaimer
The information provided on this SDS is correct to the best of our knowledge, information and belief at the date of
its publication. The information given is designed only as a guide for safe handling, use, processing, storage,
transportation, disposal and release and is not to be considered as a warranty or quality specification. The
information relates only to the specific material designated and may not be valid for such material used in
combination with any other material or in any process, unless specified in the text. Furthermore, as the conditions of
use are beyond the control of Verde Environmental, Inc., it is the responsibility of the customer to determine the
conditions of safe use of this preparation.
Date Issued: 22nd January, 2021 Page 8 of 8