NC0087912_Application_20231024

112S East Morehead Street, Suite #104
Charlotte, NC 28204
office 980.S8S.1271
facsimile 980.S8S.1272
MAAONLINE.COM
October 24, 2023
Central Files
North Carolina Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: NPDES PERMIT RENEWAL APPLICATION
SPEEDWAY #6973 FACILITY
13960 CAPITAL BOULEVARD
YOUNGSVILLE, FRANKLIN COUNTY, NORTH CAROLINA
NPDES PERMIT NO. NCO087912
To Whom It May Concern:
On behalf of Speedway, LLC, Mid Atlantic Associates, Inc. is submitting the enclosed renewal
application for the above -referenced facility. Please contact us at 980-585-1271 if you have any
questions or need additional information.
Sincerely,
Mid Atlantic Associates, Inc.
AX
Cameron D. Moore, P.G.
Project Geologist
Enclosure: NPDES Application — Form 1, Form 2C, Form 2E
EXPERIENCED CUSTOMER FOCUSED INNOVATIVE

United States Office of Water EPA Form 3510-1
Environmental Protection Agency Washington, D.C. Revised March 2019
Water Permits Division
� E�► Application Form 1
General Information
NPDES Permitting Program
Note: All applicants to the National Pollutant Discharge Elimination System (NPDES) permits
program, with the exception of publicly owned treatment works and other treatment works treating
domestic sewage, must complete Form 1. Additionally, all applicants must complete one or more of the
following forms: 2B, 2C, 21), 2E, or 2F. To determine the specific forms you must complete, consult the
"General Instructions" for this form.

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NA
NCO087912
Speedway #6973
OMB No. 2040-0004
Form
U.S. Environmental Protection Agency
t
\.EPA
Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
SECTION•
•• r
1.1
Applicants Not Required to Submit Form 1
1.1.1
Is the facility a new or existing publicly owned
1.1.2
Is the facility a new or existing treatment works
treatment works?
treating domestic sewage?
If yes, STOP. Do NOT complete 0 No
If yes, STOP. Do NOT 0 No
Form 1. Complete Form 2A.
complete Form 1. Complete
Form 2S.
1.2
Applicants Required to Submit Form 1
1.2.1
Is the facility a concentrated animal feeding
1.2.2
Is the facility an existing manufacturing,
operation or a concentrated aquatic animal
commercial, mining, or silvicultural facility that is
a
production facility?
currently discharging process wastewater?
o
❑ Yes 4 Complete Form 1 0 No
0 Yes -* Complete Form ❑ No
a
and Form 2B.
1 and Form 2C.
z
R
1.2.3
Is the facility a new manufacturing, commercial,
1.2.4
Is the facility a new or existing manufacturing,
mining, or silvicultural facility that has not yet
commercial, mining, or silvicultural facility that
commenced to discharge?
discharges only nonprocess wastewater?
Yes 4 Complete Form 1 0 No
0 Yes 4 Complete Form No
and Form 2D.
1 and Form 2E.
1.2.5
Is the facility a new or existing facility whose
'—
discharge is composed entirely of stormwater
a
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
Yes -* Complete Form 1 0 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x) or
b (15).
SECTIOND••
AND LOCATION
Facility Name
2.1
7C
Speedway #6973
0
2.2
EPA Identification Number
Y
J
NA
2.3
Facility Contact
L
Name (first and last)
Title
Phone number
Q
Andrew McMillan
Regional Gas Env. Compliance Manager
[phone]
Email address
[e-mail]
2.4
Facility Mailing Address
ZStreet
or P.O. box
500 Speedway Drive
City or town
State
ZIP code
Enon
OH
45323
EPA Form 3510-1 (revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NA
NCO087912
Speedway #6973
OMB No. 2040-0004
y
2.5
Facility Location
rStreet,
route number, or other specific identifier
Q 0
13960 Capital Blvd.
a�
c
County name
County code (if known)
Franklin
E
City or town
State ZIP code
z
Youngsville
INC 27587
SECTION•D
I
3.1
SIC Code(s)
Description (optional)
E551
Gasoline Service Stations
a
v
0
U
N
U
Z
3.2
NAICS Code(s)
Description (optional)
U
457000
Gasoline Stations and Fuel Dealers
N
4.1
Name of Operator
Speedway LLC
0
4.2
Is the name you listed in Item 4.1 also the owner?
cc
c
El Yes ElNo
r_
L
4.3
Operator Status
M
❑ Public —federal ❑ Public —state ❑ Other public (specify)
o
❑� Private ❑ Other (specify)
4.4
Phone Number of Operator
[phone]
=
4.5
Operator Address
r
Street or P.O. Box
M
E
500 Speedway Drive
City or town
State
ZIP code
0 0
� U
Enon
OH
45323
Q
Email address of operator
O
[e-mail]
SECTION1
I
=
5.1
Is the facility located on Indian Land?
❑ Yes 0 No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
NA
NCO087912 Speedway #6973 OMB No. 2040-0004
SECTION••
1
6.1 Existing Environmental Permits (check
all that apply and print or type the corresponding permit number for each)
✓❑ NPDES (discharges to surface
❑ RCRA (hazardous wastes)
❑ UIC (underground injection of
r_
water)
fluids)
•
> E
NCO087912
NA
NA
w a
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
=
NA
NA
NA
x
❑ Ocean dumping (MPRSA) ❑ Dredge or fill (CWA Section 404) ❑ Other (specify)
LU
NA NA NA
SECTIONI
7.1
Have you attached a topographic map containing all required information to this application? (See instructions for
C
specific requirements.)
r❑ Yes ❑ No ❑ CAFO—Not Applicable (See requirements in Form 213.)
SECTIONOF
I CFR 122.21ft8))
8.1
Describe the nature of your business.
Retail gasoline sale and convenience store.
C
.y
3
m
O
L
Z
SECTION••
1
9.1 Does your facility use cooling water?
L
L
❑ Yes ❑r No -* SKIP to Item 10.1.
a
9.2
Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
a,
40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122.21(r). Consult with your
oY
NPDES permitting authority to determine what specific information needs to be submitted and when.)
U
NA
SECTIONI
VARIANCE
REQUESTSI I
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
y
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors (CWA ❑ Water quality related effluent limitations (CWA Section
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
NPDES Permit Number
Facility Name Form Approved 03/05/19
NA
NCO087912
Speedway #6973 OMB No. 2040-0004
SECTION1
CERTIFICATION STATEMENT (40
11.1
In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1
Column 2
❑r Section 1: Activities Requiring an NPDES Permit
❑ w/ attachments
Section 2: Name, Mailing Address, and Location
❑ w/ attachments
0 Section 3: SIC Codes
❑ w/ attachments
❑✓ Section 4: Operator Information
❑ w/ attachments
❑✓ Section 5: Indian Land
❑ w/ attachments
❑✓ Section 6: Existing Environmental Permits
❑ w/ attachments
❑ Section 7: Map
w/ topographic
❑ ❑ w/ additional attachments
map
C
c
•R
Z Section 8: Nature of Business
Elw/ attachments
w
❑✓ Section 9: Cooling Water Intake Structures
❑ w/ attachments
a�
❑✓ Section 10: Variance Requests
❑ w/ attachments
�_,
❑✓ Section 11: Checklist and Certification Statement
❑ w/ attachments
Y
11.2
Certification Statement
U
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information, the information submitted is, to the best of my knowledge and
belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Andrew L. McMillan
Regional Gasoline Environmental Compliance Manager
Signature
Date signed
0"'" /4�
10/11/2023
EPA Form 3510-1 (revised 3-19) Page 4

United States Office of Water EPA Form 3510-2C
Environmental Protection Agency Washington, D.C. Revised March 2019
Water Permits Division
�E�► Application Form 2C
Existing Manufacturing,
Commercial, Mining, and
Silvicultural Operations
NPDES Permitting Program
Note: Complete this form and Form 1 if your facility is an existing manufacturing, commercial, mining,
or silvicultural facility that currently discharges process wastewater.

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
NA NCO087912 Speedway #6973 OMB No. 2040-0004
Form U.S. Environmental Protection Agency
2C flaw Application for NPDES Permit to Discharge Wastewater
NPDES ` A EXISTING MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURE OPERATIONS
SECTIONOUTFALL LOCATION1
1.1 Provide information on each of the facility's outfalls in the table below.
Outfa
Nu ber Receiving Water Name Latitude Longitude
U
J
001 Richland Creek 36° 0' 48.25" N 78° 31' 0.90" W
7
0
o o "
SECTION1- 1
CM 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
_ 3 balance? (See instructions for drawing requirements. See Exhibit 2C-1 at end of instructions for example.)
12
J o ❑ Yes ❑✓ No *Site is a'no discharge' facility.
SECTION• 1 1
3.1 For each outfall identified under Item 1.1, provide average flow and treatment information. Add additional sheets if
necessary.
**Outfall Number** 001
Operations
Operation Average Flow
NA - No Discharge o mgd
c
mgd
d
mgd
y mgd
3
0 Treatment Units
L
a, Description Code from Final Disposal of Solid or
(include size, flow rate through each treatment unit, Table 2C-1 Liquid Wastes Other Than
> retention time, etc.) by Discharge
NA - No Discharge NA - No Discharge NA - No Discharge
EPA Form 3510-2C (Revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05119
NA
NCO087912
Speedway #6973
OMB No. 2040-0004
3.1
**Outfall Number** 001
Cont.
Operations,
Operation
Average Flow
NA - No Discharge
o mgd
mgd
mgd
mgd
Treatment
Description
Units
Code from
Final Disposal of Solid or
(include size, flow rate through each treatment unit,
Table 2C-1
Liquid Wastes Other Than
retention time, etc.)
by Discharge
NA - No Discharge
NA - No Discharge
NA - No Discharge
c
0
U
c
a>
E
is
a>
L
_
**Outfall Number** 001
Cn
Operations Contributing
to Flow
0
Operation
Average Flow
U-
NA - No Discharge
o mgd
L
a'
mgd
mgd
mgd
Treatment
Description
Units
Code from
Final Disposal of Solid or
(include size, flow rate through each treatment unit,
Table 2C-1
Liquid Wastes Other Than
retention time, etc.)
by Discharge
NA - No Discharge
NA - No Discharge
NA - No Discharge
3.2
Are you applying for an NPDES permit to operate a privately owned treatment works?
d
❑ Yes ❑✓ No 4 SKIP to Section 4.
cn M
3.3
Have you attached a list that identifies each user of the treatment works?
❑ Yes El No
EPA Form 3510-2C (Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
NA NCO087912 Speedway #6973 OMB No. 2040-0004
SECTION• 1
4.1 Except for storm runoff, leaks, or spills, are any discharges described in Sections 1 and 3 intermittent or seasonal?
❑ Yes ❑r No 4 SKIP to Section 5.
4.2
Provide information
on intermittent or seasonal flows for each applicable outfall. Attach additional pages, if In cessar .
Outfall
Operation
Frequency
Flow
Rate
Average
Average
Long -Term
Maximum
Number
(list)
Duration
Da sMeek
Months/Year
Average
Dail
NA - No Discharge
0 days/week
0 months/year
0 mgd
0 mgd
0 days
0
001
days/week
months/year
mgd
mgd
days
U_
days/week
months/year
mgd
mgd
days
r
E
days/week
months/year
mgd
mgd
days
r
c
days/week
months/year
mgd
mgd
days
days/week
months/year
mgd
mgd
days
days/week
months/year
mgd
mgd
days
days/week
months/year
mgd
mgd
days
days/week months/year mgd mgd days
SECTION'-•1
• I
5.1
Do any effluent limitation guidelines (ELGs) promulgated by EPA under Section 304 of the CWA apply to your facility?
❑ Yes 0 No 4 SKIP to Section 6.
5.2
Provide the following information on applicable ELGs.
ELG Category
ELG Subcategory
Regulatory Citation
w
as
R
t)
Q
Q
Q
5.3
Are any of the applicable ELGs expressed in terms of production (or other measure of operation)?
❑ Yes ❑ No 4 SKIP to Section 6.
0
;g
5.4
Provide an actual measure of daily production expressed in terms and units of applicable ELGs.
J
Outfall
Operation, Product, or Material
Quantity per Day
Unit of
Number
Measure
a�
cc
R
m
C
O
Cs
7
O
L
a
EPA Form 3510-2C (Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
NA NCO087912 Speedway #6973 OMB No. 2040-0004
IMPROVEMENTSSECTION 6. I
6.1 Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing,
upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes 0 No 4 SKIP to Item 6.3.
6.2
Briefly identify each applicable project in the table below.
Affected
Final Compliance Dates
E
Brief Identification and Description of
Outfalls
Source(s) of
c
Project
(list outfall
Discharge
Required
Projected
C-
number
E
ca
R
bl
N
cc
!Q
L
0)
Q
6.3
Have you attached sheets describing any additional water pollution control programs (or other environmental projects
that may affect your discharges) that you now have underway or planned? (optional item)
❑ Yes ❑ No ❑ Not applicable
SECTION 7. EFFLUENT AND INTAKE CHARACTERISTICS i
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must
complete. Not all applicants need to complete each table.
Table A. Conventional and Non -Conventional Pollutants
7.1
Are you requesting a waiver from your NPDES permitting authority for one or more of the Table A pollutants for any of
your outfalls?
❑ Yes No -* SKIP to Item 7.3.
7.2
If yes, indicate the applicable outfalls below. Attach waiver request and other required information to the application.
Outfall Number Outfall Number Outfall Number
7.3
Have you completed monitoring for all Table A pollutants at each of your outfalls for which a waiver has not been
y
requested and attached the results to this application package?
L
❑ Yes *Facility does not discharge* ❑� No; a waiver has been requested from my NPDES
R
permitting authority for all pollutants at all outfalls.
R
Table B.
Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants
7.4
Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
listed in Exhibit 2C-3? (See end of instructions for exhibit.)
❑ Yes El No 4 SKIP to Item 7.8.
3
7.5
Have you checked "Testing Required" for all toxic metals, cyanide, and total phenols in Section 1 of Table B?
LU
❑ Yes ❑ No
7.6
List the applicable primary industry categories and check the boxes indicating the required GC/MS fraction(s) identified
in Exhibit 2C-3.
Primary Industry Category
Required GC/MS Fraction(s)
Check applicable boxes.
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
EPA Form 3510-2C (Revised 3-19) Page 4

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05119
NA
NCOO87912
Speedway #6973
OMB No. 2040-0004
7.7
Have you checked 'Testing Required" for all required pollutants in Sections 2 through 5 of Table B for each of the
GC/MS fractions checked in Item 7.6?
❑ Yes ❑ No
7.8
Have you checked "Believed Present' or "Believed Absent' for all pollutants listed in Sections 1 through 5 of Table B
where testing is not required?
❑ Yes 0 No *Facility does not discharge*
7.9
Have you provided (1) quantitative data for those Section 1, Table B, pollutants for which you have indicated testing is
required or (2) quantitative data or other required information for those Section 1, Table B, pollutants that you have
indicated are "Believed Present' in your discharge?
❑ Yes 0 No *Facility does not discharge*
7.10
Does the applicant qualify for a small business exemption under the criteria specified in the instructions?
❑ Yes + Note that you qualify at the top of Table B, ❑ No
then SKIP to Item 7.12.
=
7.11
Have you provided (1) quantitative data for those Sections 2 through 5, Table B, pollutants for which you have
c
determined testing is required or (2) quantitative data or an explanation for those Sections 2 through 5, Table B,
y
pollutants you have indicated are `Believed Present' in your discharge?
y
El Yes El No *Facility does not discharge*
Table C. Certain Conventional and Non -Conventional Pollutants
7.12
Have you indicated whether pollutants are "Believed Present' or "Believed Absent' for all pollutants listed on Table C
for all outfalls?
Y
❑ Yes 0 No *Facility does not discharge*
7.13
Have you completed Table C by providing (1) quantitative data for those pollutants that are limited either directly or
indirectly in an ELG and/or (2) quantitative data or an explanation for those pollutants for which you have indicated
w
"Believed Present'?
❑ Yes 0 No *Facility does not discharge*
LU
Table D. Certain Hazardous Substances and Asbestos
7.14
Have you indicated whether pollutants are "Believed Present' or "Believed Absent' for all pollutants listed in Table D for
all outfalls?
❑ Yes 0 No *Facility does not discharge*
7.15
Have you completed Table D by (1) describing the reasons the applicable pollutants are expected to be discharged
and (2) by providing quantitative data, if available?
❑ Yes 0 No *Facility does not discharge*
Table E. 2,3,7,8-Tetrachlorodibenzo- -Dioxin 2,3,7,8-TCDD
7.16
Does the facility use or manufacture one or more of the 2,3,7,8-TCDD congeners listed in the instructions, or do you
know or have reason to believe that TCDD is or may be present in the effluent?
❑ Yes + Complete Table E. ❑r No 4 SKIP to Section 8.
7.17
Have you completed Table E by reporting qualitative data for TCDD?
❑ Yes ❑ No
SECTION
8. USED
OR i
8.1
Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
an intermediate or final product or byproduct?
3
❑ Yes No 4 SKIP to Section 9.
8.2
List the pollutants below.
_ -
1. 4. 7.
0
2. 5. 8.
N
3. 6. 9.
EPA Form 3510-2C (Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
NA NCOO87912 Speedway #6973 OMB No. 2040-0004
SECTION• BIOLOGICAL TOXICITY1
9.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made
within the last three years on (1) any of your discharges or (2) on a receiving water in relation to your discharge?
�, ❑ Yes ❑✓ No 4 SKIP to Section 10.
r
bl
9.2
Identify the tests and their
purposes below.
.5
Test(s)
Purpose of Test(s)
Submitted to NPDES
Date Submitted
x
Permitting Authority?
0
H
ElYes ElNo
M
_o
'm0
ElYes ElNo
❑ Yes ❑ No
SECTIONi
CONTRACT
ANALYSES (40
10.1
Were any of the analyses reported in Section 7 performed by a contract laboratory or consulting firm?
❑ Yes ❑- No 4 SKIP to Section 11.
10.2
Provide information for each contract laboratory or consulting
firm below.
Laboratory Number 1
Laboratory Number 2
Laboratory Number 3
Name of laboratory/firm
y
TLaboratory
address
a
Y
L
Phone number
Pollutant(s) analyzed
SECTIONDD
• •- • i
11.1
Has the NPDES permitting authority requested additional information?
❑ Yes No SKIP to Section 12.
0
L
11.2
List the information requested and attach it to this application.
O
1. 4.
0
2. 5.
3. 6.
EPA Form 3510-2C (Revised 3-19) Page 6

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05119
NA
NCO087912 Speedway #6973 OMB No. 2040-0004
SECTION 12. CHECKLIST AND CERTIFICATION STATEMENT 1
12.1
In Column 1 below, mark the sections of Form 2C that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to complete all sections or provide attachments.
Column 1
Column 2
❑✓ Section 1: Outfall Location
❑ w/ attachments
❑✓ Section 2: Line Drawing
❑ w/ line drawing ❑ w/ additional attachments
Section 3: Average Flows and
w/ list of each user of
❑ w/ attachments ❑ privately owned treatment
Treatment
works
❑✓ Section 4: Intermittent Flows
❑ wl attachments
❑✓ Section 5: Production
❑ wl attachments
w/ optional additional
❑✓ Section 6: Improvements
El w/ attachments ❑ sheets describing any
additional pollution control
plans
❑ w/ request for a waiver and ❑ w/ explanation for identical
supporting information outfalls
E
w/ small business exemption
Elrequest El w/ other attachments
Section 7: Effluent and Intake
❑ w/ Table A Elw/ Table B
Characteristics
❑ wl Table C ❑ w/ Table D
w
d
w/ Table E w/ analytical results as an
❑ ❑
attachment
RSection
8: Used or Manufactured ❑
❑ w/ attachments
�,
Toxics
❑ Section 9: Biological Toxicity
❑ w/ attachments
Tests
U
❑✓ Section 10: Contract Analyses
❑ w/ attachments
✓❑ Section 11: Additional Information
❑ w/ attachments
❑ Section 12: Checklist and
❑ w/ attachments
Certification Statement
12.2
Certification Statement
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Andrew L. McMillan
Regional Gasoline Env. Compliance Mgr.
Signature
Date signed
ajv,;O,/—
10/11/2023
EPA Form 3510-2C (Revised 3-19) Page 7

United States Office of Water EPA Form 3510-2E
Environmental Protection Agency Washington, D.C. Revised March 2019
Water Permits Division
V^EPA Application Form 2E
Manufacturing, Commercial,
Mining, and Silvicultural
Facilities Which Discharge
Only Nonprocess Wastewater
NPDES Permitting Program
Note: Complete this form and Form 1 if your facility is a new or existing manufacturing, commercial,
mining, and silvicultural facility that discharges only nonprocess wastewater.

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NA
NCO087912
Speedway #6973 7
OMB No. 2040-0004
U.S. Environmental Protection Agency
FORM
n
Application for NPDES Permit to Discharge Wastewater
NPDES
��•EPA
MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURAL FACILITIES WHICH
DISCHARGE ONLY NONPROCESS WASTEWATER
SECTIONOUTFALL
LOCATIONI
1.1 Provide information
on each of the facilit 's outfalls in the table below.
o
—
•R
O
Number
Receiving Water Name
Latitude
Longitude
0
J
001
Richland Creek
36' 0' 48.25" N
78' 31' 0.90" W
,F
o
o „
7
0
SECTIONo
DISCHARGE
1 1
2.1
Are you a new or existing discharger? (Check only one response.)
❑ New discharger ❑r Existing discharger -* SKIP to Section 3.
y
2.2
Specify your anticipated discharge date:
0
SECTIONI
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 nonprocess wastewater (describe/explain
❑ Restaurant or cafeteria waste directly below)
w
n
* Site does not generate discharge
❑ Non -contact cooling water
1>
3.2
Does the facility use cooling water additives?
CD
❑ Yes ❑✓ No -* SKIP to Section 4.
3::
3.3
List the cooling water additives used and describe their com
osition.
Cooling Water Additives
Composition of Additives
list
if available toyou)
SECTIONI
4.1
Have you completed monitoring for all parameters in the table below at each of your outfalls and attached the results to
this application package?
❑ Yes 0 No; a waiver has been requested from my NPDES permitting authority
attach waiver request and additional information -* SKIP to Section 5.
4.2
Provide data as requested in the table below.
See instructions for specifics.
Number of
Maximum Daily
Average Daily
Source
y
Parameter or Pollutant
Analyses
Discharge
Discharge
(use codes
(if actual data
s ecif units
(specify units
per
Mass
Conc.
Mass Conc.
reported)
instructions)
R
Biochemical oxygen demand (BOD5)
NA - No Discharge
NA
NA
NA NA
NA
Total suspended solids (TSS)
NA - No Discharge
NA
NA
NA NA
NA
Oil and grease
NA - No Discharge
NA
NA
NA NA
NA
w
Ammonia (as N)
NA - No Discharge
NA
NA
NA NA
NA
Discharge flow
NA - No Discharge
NA
NA
pH (report as range)
NA - No Discharge
NA
]c
NA
Temperature (winter)
NA - No Discharge
NA
NA
Temperature (summer)
NA - No Discharge
NA
NA
' 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 3510-2E (revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number Facility Name
Form Approved 03/05/19
NA
NCO087912 Speedway #6973
OMB No. 2040-0004
4.3
Is fecal coliform believed present, or is sanitary waste discharged (or will it be discharged)?
❑ Yes ❑ No 4 SKIP to Item 4.5.
4.4
Provide data as requested in the table below.' (See instructions forspecifics.)
Number of
Maximum Daily
Average Daily
Source
Parameter or Pollutant
Analyses
Discharge
Discharge
(use codes
(if actual data
(speci' units)
(specify units)
per
Mass
Conc.
Mass
Conc.
reported)
Instructions.)
Fecal coliform
NA - No Discharge
NA
NA
NA
NA
NA
E. colt
NA - No Discharge
NA
NA
NA
NA
NA
Enterococci
NA - No Discharge
NA
NA
NA
NA
NA
0
4.5
Is chlorine used (or will it be used)?
Cn
❑ Yes ❑ No 4 SKIP to Item 4.7.
�+
4.6
Provide data as requested in the table below. See instructions forspecifics.)
Number of
Maximum Daily
Average Daily
Source
Parameter or Pollutant
Analyses
Discharge
Discharge
(use codes
L)
(if actual data
s eci units
sped units)
per
Mass Conc.
Mass
Conc.
reported)
instructions)
c
Total Residual Chlorine
NA- No Discharge
NA NA
NA
NA
NA
w
4.7
Is non -contact cooling water discharged (or will it be discharged)?
❑ Yes ❑ No 4 SKIP to Section 5.
4.8
Provide data as requested in the table below. See instructions for specifics.
Number of Maximum Daily Average Daily Source
Parameter or Pollutant Analyses Discharge Discharge (use codes
(if actual data sec' units s eci units per
reported) Mass Conc. Mass Conc. instructions)
Chemical oxygen demand (COD)
NA - No Discharge
NA NA
NA NA
NA
Total organic carbon (TOC) NA - No Discharge NA NA NA NA NA
SECTION
5. FLOW
5.1
r
Except for stormwater water runoff, leaks, or spills, are any of the discharges you described in Sections 1 and 3 of this
application intermittent or seasonal?
❑ Yes 4 Complete this section. ❑ No 4 SKIP to Section 6.
0
5.2
Briefly describe the frequency and duration of flow.
LL
SECTION
6. TREATMENT
SYSTEM 1
E
6.1
Briefly describe any treatment system(s) used (or to be used).
yThe
treatment works at the facility consists of an ABT, Inc. S 12AF Ductile Iron Frame and Grate installed around the
Cn
east, west, and south sides of the diesel fuel canopy. The trench drain is installed inside the drip -line of the canopy and
c
43
sloped so rainfall and/or surface water does not enter the drain. Flow captured by this grate is discharged through
E
six-inch diameter PVC piping to a 1,S00-gallon capacity, pre -cast concrete oil/water/sand separator. Discharges from
5
this unit are directed to a 2,000-gallon capacity Kleerwater oil/water separator. Discharges from this unit are directed
through six-inch diameter PVC piping, which ultimately ties into the existing storm sewer line at the southeast corner of
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 3510-2E (revised 3-19) Page 2

EPA Identification
Number NPDES Permit Number Facility Name Form Approved 03/05/19
NA
NCO087912 Speedway #6973 OMB No. 2040-0004
SECTIONOTHER
INFORMATION1
7.1
Use the space below to expand upon any of the above items. Use this space to provide any information you believe the
reviewer should consider in establishing permit limitations. Attach additional sheets as needed.
o
As noted in section 6.1, the treatment system is inspected weekly and pumped on an as -needed basis such that
discharge does not occur.
E
`o
c
m
O
SECTIONI
CERTIFICATION STATEMENT (40
8.1
In Column 1 below, mark the sections of Form 2E that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that
not all applicants are required to provide attachments.
Column 1
Column 2
0 Section 1: Outfall Location
❑ w/ attachments (e.g., responses for additional outfalls)
0 Section 2: Discharge Date
❑ w/ attachments
0 Section 3: Waste Types
❑ w/ attachments
_
a�
❑� Section 4: Effluent Characteristics
❑ w/ attachments
0 Section 5: Flow
❑ w/ attachments
in
c
Section 6: Treatment System
❑ w/ attachments
❑� Section 7: Other Information
Elw/ attachments
V_
a�
❑� Section 8: Checklist and Certification Statement
❑ w/ attachments
8.2
Certification Statement
1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties for submitting false information, including the
of fine and imprisonment for knowing violations.
-possibility
Name (print or type first and last name)
Official title
Andrew L. McMillan
Regional Gasoline Environmental Compliance Manager
Signature
Date signed
10/11/2023
EPA Form 3510-2E (revised 3-19) Page 3

e
IN
�L Outfa11001
[flows south]
350
Get! C
u.
o�
Capital Blvd
P T
US Hwy 1
1)
Speedway, LLC - Speedway #6973
NPDES Permit NCO087912
13960 Capital Boulevard, Youngsville 27587
Receiving Stream: UT to Richland Creek
Stream Segment: 27-21-(1.5) Stream Class: WS-IV;NSW
River Basin: Neuse Sub -Basin #: 03-04-02
County: Franklin HUC: 030202010701
N
SCALE
1:24,000
southwest]Richland Creek
115,000,000
36.01330 N,-78.51670 W
NC Grid: C24SE
USGS Quad: Grissom, NC