NC0003549_application_20230802

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 005119
Tra nsMonta igne Selma Terminal
OMB No.2040MO4
NCO003549
U.S. Environmental Protection Agency
Form
1
Rim
ERt1
Application for NPDES Permit to Discharge Wastewater
NPDIES
GENERAL INFORMATION
t
z
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. fro NOT ❑ No
w , .
Form 1. Complete Form 2A.
complete Form 1. Complete
<�
Y �r
Form 2S.
1.2.1
Is the facility a concentrated animal feeding
1.2.2
Is the facility an existing manufacturing,
v
operation or a concentrated aquatic animal
commercial, mining, or silvicultural facility that is
,
�.. ..:
production facility?
currently discharging process wastewater?
Yes 4 Complete Form 1 No
Yes 4 Complete Form [J No
and Form 213.
1 and Form 2C.
1.2.3
Is the facility a new manufacturing, commercial,
1.2.4 Is the facility a new or existing manufacturing,
�`�="��iY�
mining, or silvicultural facility that has not yet
commercial, mining, or silvicultural facility that
commenced to discharge?
discharges only nonprocess wastewater?
Yes 4 Complete Form 1 No
rj Yes 4 Complete Form ❑ No
and Form 2f7.
1 and Form 2E.
1.2.5
is the facility a new or existing facility whose
x= _s
discharge is composed entirely of stormwater
l'
ac'
associated with industrial activity or whose
t
'
discharge is composed of both stormwater and
` ti
1 .;
Y 5
non-stormwater?
u
Yes 3 Complete Form 1 = No
h's
i
and Form 2F
f
unless exempted by
µ
=
x
40 CFR
f s
z
122.26(b)(14)(x) or
,
,s
a
• rr- r e e !
2.1
-' , X
s%t
TransMontaigne Selma Terminal
`
2.2
EPA,Identlfcatlon Number : <_
� 'xr
f
2.3
Facll! Col7tact ti ,
Name (first and last)
Title
Phone number
`Y `=
Sheila Johnsen
Fnvironmantal Coordinator (303)
860-5377
Email address
[e-mail]
2.4
all ng Address
.."
Street or P.O. box
z,
1670 Broadway, Suite 3100
City or town
State
code
4012p()
Denver
CO
2
EPA Form 3510-1 (revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
TransMontaigne Selma Terminal
OMB No.2040-0004
NC0003549
'
�.�J
Fae111 i
r ,
aCattt3r�
, z
Street, route number, or other specific identifier
s
U
2600 West Oak Street
>
County name
County code (if known)
a
Johnson,��
�,...:.,,..�
City or town
State ZIP code
Selma
NC 27576
•
E •E f
{ S1� G�de���'. r, �
�3escnpttor►�o`p#�nr�alj�=. ` �� �� ' � _ � � s '
4$��,�'�.
3.1
,�
r il�'
4226
Bulk Storage/Warehousing
w l�
i
3.2
J
493190
Bulk Storage/Warehousing
s
ertoir 3 4 fh
4.1
G4 v
I�am�2 of ci z...::
S k
Y• ti.yT.
Z f,
�
4.2
Is the name you listed in Item 4.1 also the owner?
❑ Yes ❑ No
❑ Public —federal ❑ Public ---state ❑ ©titer p ublic (specify)
0 Private ❑ Other (specify)
f
F. 5 y
;
4.5
f
©perator Ar(�drs 3 Y
Street or P.O. Box
,.
City or town
State
ZIP code
Email address of operator
y O'
Is the facility located on Indian Land?
r a
5.1
cam"
El Yes El No
EPA Form 3510-1 (revised 3-19) Page 2

EPA
antiFcation Number NPDES Permit Number Facility Name Form Approved 03105/19
NCD003549 Trans Montaigne Selma Terminal OMB No. 2040.0004
-•
6.1xtstmg I`nvrrpgmrota] PermitsoC all that apl�+ar€drtirpe the pptEspc ndcng peri number fogaira
R NPDES (discharges to surface ❑ RCRA (hazardous wastes) ❑ UIC (underground injection of
water) fluids)
❑ PSD (air emissions) ❑ Nonattainment program (CAA) ❑ NESHAPs (CAA)
❑ Ocean dumping (MPRSA) ❑ Dredge or fill (CWA Section 404) ❑ Other (specify)
7.1 Have you attached a topographic map containing all required information to this application? (See instructions for
specific requirements.)
I Yes ❑ No ❑ CAFO—Not Applicable (See requirements in Form 2B.)
8.1 Describe the nature of your business.
This facility is a "Complex" comprised of two (2) onshore, non -transportation -related, bulk -liquids storage facilities,
occupying a total of approx. 27 acres, located just northwest of Selma, NC. It engages in the receipt, storage, &
distribution of conventional refined petroleum products. All storage tanks are located within secondary containment
structures.
9.1 1 Does your facility use cooling water?
❑ Yes 21 No + 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
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.)
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)? (Check all that
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors (CWA 0 Water quality related effluent limitations (CWA Section
Section 301(n)) 302(b)(2))
❑ Non -conventional pollutants (CWA ❑ Thermal discharges (CWA Section 316(a))
Section 301(c) and (g))
❑ Not applicable
EPA Form 3510-1 (revised 3-19) Page 3

EPA Identification Number NPDE5 Permit Number Facility Name Form Approved 03105/19
TransMontaigne Selma Terminal OMB No.2040-0004
NCO003549
igig 1 11
s u. 11.1 In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
' that not all applicants are required to provide attachments
r.
i
y z
F
ElSection 1: Activities Requiring an NPDES Permit
❑ w! attachments
❑ Section 2: Name, Mailing Address, and Location
❑ wl attachments
l
ElSection 3: SIC Codes
El wl attachments
y..
k''
❑ Section 4: Operator Information
❑ wl attachments
v
❑ Section 5: Indian Land
❑ wl attachments
.W s r
❑ Section 6. Existing Environmental Permits
❑ wl attachments
YS � 4Y
❑ Section 7: Map
wl topographic
Elma ❑ wl additional attachments
,m „�
V °
❑ Section B: Nature of Business
❑ wl attachments
y 4
❑ Section 9: Coaling Water Intake Structures
❑ wl attachments
,.
❑ Section 10: Variance Requests
❑ wi attachments
�� ���,
ro S
r ..-F
❑ Section 11: Checklist and Certification Statement ❑ wl attachments
T
a
11.2
Certification Statement
l certify under penally of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
'k..;.
information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information, the information submitted is, to the best of my knowledge and
l n'
belief, true, accurate, and complete. l am aware that there are significant penalties for submitting false information,
4
including the possibility of fine and imprisonment for knowing violations.
Official title
y
Name (print or type first and last name)
Ak
.:.<;:
Sheila Marie Johnsen
Envrionmantal Coordinator
h
.
<:
Sig
Signature
Date signed
= i..
i '/
EPA Form 3510-1 (revised 3-19) Page 4

EPA Identification Number NPDE5 Permit Number Facility Name Form Approved 03105119
OMB No. 2040-0004
NC003549 TransMontaigne Selma Terminal
U.S. Environmental Protection Agency
EpaM Application for NPDES Permit to Discharge Wastewater
NPDES q"�l�� MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURAL FACILITIES WHICH
DISCHARGE ONLY NONPROCESS WASTEWATER
17FT Provide information on each of the
outfalls in the table below.
002
nnamed tirutary to Will Creel
35°
32
59.9d' N r�l78
18,
37.25" W
0133
within the Neuse River Basin
35°
33'
14.3{j' N .r;
78
18'
34.72' W
001
Unnamed tirutary MJ
35 0
3
N
78 a
18'
2.1 Are you a new or existing discharger? (Check only one response.)
❑ New discharger ❑ Existing discharger 4 SKIP to Section 3.
2.2 Specify your anticipated discharge date:
3.1 What types of wastes are currently being discharged if you are an existing discharger or will be discharged if you are a
new discharger? (Check all that apply.)
❑ Sanitary wastes © Other nanprocess wastewater (describe/explain
Restaurant or cafeteria waste directly below)
❑ Hydrostatic test water/ stormwater
❑ Non -contact cooling water
3.2 Does the facility use cooling water additives?
❑ Yes ❑✓ No 4 SKIP to Section 4.
3.3 List the cooling water additives used and describe their composition
4.1 Have you completed monitoring for all parameters in the tabie below at each of your outfalls and attached the results to
this application package?
No; a waiver has been requested from my NPDES permitting authority
❑ Yes ❑
attach waiver request and additional information 4 SKIP to Section 5.
4.2 Provide data as requested in the table below.' (See Instructions for specifics.)
Biochemical oxygen demand (BODs)
Total suspended solids (TSS)
a
Oil and grease
Ammonia (as N)
Discharge low
pH (report as range)
Temperature (winter)
w Temperature (summer)
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40
parameters or required under 40 CFR chapter I, subchapter N or O. see instructions and 40 CFR 122.21(e)(3).
136 for the analysis of pollutants or pollutant
EPA Form 3510-2E (revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03105119
NC003549
TransMontaigne Selma Terminal
OMB No, 2040-0004
'' f:
4.3
Is fecal collform believed present, or is sanitary waste discharged (or will it be discharged)?
w
s
El Yes ElNo 4 SKIP to Item 4.5.
4.4
Provide data as requested in the table below.' See instructions forspecifics.
s
tliutner of
1111AjenumMali
Average pailY .
S urge o
Analyses
�iscftarge
€�scnarges
(€isecQiiesT..,
1?arameter or Polluiant
`1
elf actual data
Y s , unds
un,ts
per
H�
rgportelil_41gssartc
instrr,aras,�
.. ,
;amass,Atc
,,...
u
Fecal coliform
+
E soli
Enterococci
4.5
Is chlorine used (or will it be used)?
t
❑ Yes ❑ No 4 SKIP to hem 4.7.
�.^
r n
4.6
Provide data as requested in the table below.t See instructions for specifics
t�
I�axl60rn Datliy
Average 13a�1y
Source
�
{ Analyses `
�1�scha�'ge < �
l��scharge
' fu;;e codes
co
ParatrlEier pC Follufatt
sec, , units
a anus
er
.�
u
h
Conc
tVfasstc
instruct,onst
reporied) z9ass
„r
Total Residual Chlorine
_.>.
t,
4.7
is non -contact cooling water discharged (or will it be discharged)?
'
® Yes ElNo 3 SKIP to Section 5.
;
4.8
Provide data as requested In the table below f See Instructions forspecifics.)
}
; i `Nurnberof ��ltlaxll>I�Etrrt l�all� � Auerage pally Sotarce
4 �
Ataa�ises D1sGharge t3rscharge'useades
Parameier`or'olluian# h>ts sr
�tf atatiata sci urns : s eaify
�f�StrUCl30�t6 t
oft edj (iitlSs Loft.,
. _ds5 _t1E1C s ,:
Chemical oxygen demand (COD)
Total organic carbon (TOC)
Except for stormwater water runoff, leaks, or spills, are any of the discharges you described in Sections 1 and 3 of this
6.1
application intermittent or seasonal?
^.;
O-,
❑✓ Yes 4 Complete this section. ❑ No 3 SKIP to Section 6.
y
'30
x 5.2
Briefly describe the frequency and duration of flow.
4
Hydrostatic test water discharges may occur approx. once per 5 years. of Approx 4,OO,000 gals.
e
t
Briefly describe any treatment system(s) used (or to be used).
6.1
We did not have any Hydrstatic Testing events in the last 5 years.
m
1 Sampling shall be canducled according to sufficiently sensitive test pmceoures l,.e., metnoosl approves underw urm aao our uie u, Nunutdilu v1 Puuu-11i
parameters or required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3590.2E (revised 3-19) Page 2

EPA
Identificati;;M'
NPIDES Permit Number Facility Name Form Approved 03105119
NCO03549 TransMontaigne Selina Terminal OMB No, 2040-0004
i
a11211111412A
Use the space below to expand upon any of the above items. Use this space to provide any information you believe the
'
7.1
y
reviewer should consider in establishing permit limitations. Attach additional sheets as needed.
i
Q<.
L.
1 A ON'
Y
8.1
In Column 1 below, mark the sections of Form 2E that you have completed and are submitting with your application.
r
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.
Potumn'i
C{)1Fliiii d
❑ Section 1: Outfall Location
❑ wl attachments (e.g., responses for additional outfalls)
❑ Section 2: Discharge Date
❑ wi attachments
r
❑ Section 3: Waste Types
❑ wl attachments
f £,.
-^'.: {"- 1. •.f..
❑ Section 4: Effluent Characteristics
0 wl attachments
El Section 5: Flow
❑ wl attachments
❑ section 6: Treatment System
❑ wi attachments
".
❑ Section 7: Other information
❑ wf attachments
y `
❑ Section 8: Checklist and Certification Statement
❑ wl attachments
r
S.2
Certification Statement
r
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
3 ••,t _.;,
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
.<
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the
s
possibility of fine and im risonment for knowin violations.
Name (print or type first and last name)
Official title
Sheila Marie Johnsen
Environmental Coordinator
jf
Signa re
Date signed
J
�M
EPA Form 3510.2E (revised 3-19) Page 3