HomeMy WebLinkAboutNCG500075_complete file-historical_20151019A
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Weaver, Charles
From: Weaver, Charles
Sent: Monday, October 19, 20151:43 PM
To:'tthompson@championindustries.com'
Subject: renewal of NCG500075 / Champion Industries
Attachments: NCG50 Final 093015.pdf, Technical Bulletin - NCG500000 2015.doc
Importance: High
Attached you will find the updated version of NPDES General Permit NCG500000, effective 10/1/2015. Discard any
previous versions of the General Permit and use this version until further notice.
You do not need a reprinted Certificate of Coverage, as the one issued to you in 2007 is still applicable.
Thank you for your patience during the longer -than -expected renewal period.
If you have any questions about this matter, simply reply to this message.
Charles H. Weaver
NPDES Unit
1
Weaver, Charles
From: Microsoft Outlook
To: tthompson@championindustries.com
Sent: Monday, October 19, 2015 1:44 PM
Subject: Relayed: renewal of NCG500075 / Champion Industries
Delivery to these recipients or groups is complete, but no delivery notification was sent by the
destination server:
tthompsonCabchampionindustries.com (tthompson(o)chamoionindustries.com)
Subject: renewal of NCG500075 / Champion Industries
JI
renewal of
NCG500075 / Ch...
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
October 17, 2011
Tom Thompson
Champion Industries
3765 Champion Blvd.
Winston-Salem, NC 27105
Subject: Compliance Evaluation Inspections
NPDES General Stormwater Permit NCG030000
Certificate of Coverage NCG030271 &
NPDES General Wastewater Permit NCG500000
Certificate of Coverage NCG500075
Champion Industries
Forsyth County
Dear Mr. Thompson:
Gary Hudson of the Winston-Salem Regional Office of the NC.Division of Water Quality (DWQ) conducted
compliance evaluation inspections (CEI) at the subject facility on the subject permits on September 30,
2011. Your assistance and cooperation during the inspection was greatly appreciated. Inspection
checklists are attached for your records and inspection findings are summarized below.
2. The facility is located at 3765 Champion Blvd., in Winston-Salem, Forsyth County, North Carolina.
Stormwater related to industrial activity is discharged to Lewis Creek, which is currently classified as Class
C waters in the Yadkin Pee Dee River basin.
General Stormwater Permit NCG030000, Certificate of Coverage NCG030271
Documentation & Monitoring Review
1. Permit
Champion Industries holds Certificate of Coverage # NCG030271 for the discharge of
stormwater from the facility. The General Permit became effective November 1, 2007 and
expires October 31, 2012.
2. Records/Reports
Part II, Section A of the permit requires the development of a Stormwater Pollution Prevention
Plan. A copy of the SPPP for Champion Industries was available for review during the
inspection. The plan appeared thorough and complete.
3. Facility Site Review
The site appeared clean and well managed. No concerns or problems were noted.
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St Winston-Salem, North Carolina 27107
Phone: 336-771-50001 FAX: 336-77IA6301 Customer Service: 1-877-623-6748
Intemet www.nawaterquality.org
An Equal Opportunity \ Affirmative Action Employer
NorthCarolina
Naturally
Champion Industries
Attn: Tom Thompson
Compliance Evaluation Inspections
NCG030271 and NCG500075
10/18/2011
Page 2 of 2
4. Effluent/Receiving Waters
Stormwater leaves the Champion Industries property reaching Lewis Creek, Class "C" waters in
the Yadkin Pee Dee River Basin.
5. Monitoring Program
Part II, Section C of the permit requires semi-annual qualitative (visual) monitoring to be
performed and documented once in the spring (April- June) and once in the fall (September —
November). A records review during the inspection showed that Champion Industries had
performed and documented the required qualitative monitoring in 2010 and 2011. Please note
that you are not required to submit these forms to the Division, however, the records must be
kept on file at the facility for a period of five years.
Part II, Section B of the permit requires that analytical monitoring be performed. A review of the
facility files found that the analytical monitoring has been conducted as required.
The analytical monitoring listed in Section. D of the permit for on -site vehicle maintenance
operations is not required since Champion Industries does not use more than 55 gallons of new
motor oil per month when averaged over the calendar year.
General Wastewater Permit NCG500000 Certificate of Coverage NCG500075
Documentation & Monitoring Review
All documentation and monitoring reports for this permit were complete and thorough.
Our office appreciates the efforts by Champion Industries to comply with the NPDES General
Stormwater Permit. If you have any questions concerning this letter, please contact Gary Hudson or
me at (336) 771-5000.
Sincerely,
W. Corey Basinger
Regional Supervisor
Surface Water Protection Section
cc: SWP—WSRO
Central Files
Stormwater Permitting Unit
NPDES Permitting Unit
Compliance Inspection Report
Permit: NCG030271 Effective: 11/01/07 Expiration: 10/31/12 Owner: Champion Industries Inc
SOC: Effective: Expiration: Facility: Champion Industries
County: Forsyth 3765 Champion Blvd
Region: Winston-Salem
Winston Salem NC 27115
Contact Person: Malvern K Timm Title: Phone: 910-661-1556
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 09/3012011
Primary Inspector: Gary Hudson
Secondary Inspector(s):
Certification: Phone:
Entry Time: 10:00 AM Exit Time: 11:30 AM
Phone:
J
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Metal Fabrication Stormwater Discharge COC
Facility Status: ■ Compliant Q Not Compliant
Question Areas:
N Storm Water
(See attachment summary)
Page: 1
Permit: NCG030271 Owner - Facility: Champion Industries Inc
inanarfinn nafa• nwAn»ni 1 insnsction Tvoe: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Page: 2
Permit: NCG030271 Owner- Facility: Champion Industries Inc
Inspection Date: 09/30/2011 Inspection Type: Compliance Evaluation
Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
■ n 0 Q
# Does the Plan include a General Location (USGS) map?
■ 0 11 Q
# Does the Plan include a "Narrative Description of Practices"?
■ 0 ❑ 11
# Does the Plan include a detailed site map including outfall locations and drainage areas?
■ Q ❑ 0
# Does the Plan include a list of significant spills occurring during the past 3 years? .
■ Q ❑ 0
# Has the facility evaluated feasible alternatives to current practices?
■ ❑ Q
# Does the facility provide all necessary secondary containment?
■ 0 Q Q
# Does the Plan include a BMP summary?
■ 0 Q Q
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
■ n n 0
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
■ C3 0 Q
# Does the facility provide and document Employee Training?
■ 0 Q Q
# Does the Plan include a list of Responsible Party(s)?
■ Q Q Q
# Is the Plan reviewed and updated annually?
■ 0 11 ❑
# Does the Plan include a Stormwater Facility Inspection Program?
■ Q Q 11
Has the Stormwater Pollution Prevention Plan been implemented?
■ n Q Q
Comment:
Qualitative Monitoring
Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually?
. ■ Q Q
Comment: .
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? ■ Q Q 0
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? n ❑ ■ ❑
Comment:
Permit and Outfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? ■ ❑ ❑ ❑
# Were all outfalls observed during the inspection? ■ 0 ❑ 0
# If the facility has representative outfall status, is it properly documented by the Division? 0 Q ■ 0
# Has the facility evaluated all illicit (non stormwater) discharges? ■ D 0 Q
Comment: .
Page: 3
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Wafter Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yrlmo/day Inspection Type Inspector Fac Type
1 I _I 2 1.51 31 NCG500075 Ill 121 11/09/30 117 18I Cj 19us 20U
Remarks
211111 11111111 11111111111i 11111111111111 1 I 1 11111J6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved
67I 169 70 U 711 I 72 L N I 73 W 74 751 I I I I I J-1 80
�—
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
10:00 AM 11/09/30
07/08/01
Champion Industries
Exit Time/Date
Permit Expiration Date
3765 Champion Blvd
Winston Salem NC 27115
11.30 AM 11/09/30
12/07/31
Name(s) of Onsite Representative(s)rrities(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Officialfritle/Phone and Fax Number
Malvern K Timm,PO Box 4149 Winston Salem NC Contacted
J
27115//919-661-1556/3367449673 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Operations & Maintenance
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Gary Hudson WSRO WQ///
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1
NPDES yr/mo/day Inspection Type `
3I NCG500075 I11 12) 11/09/30 1
17 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
All records were complete and accurate.
Page # 2
I
2
Permit: NCG500075 Owner - Facility: Champion Industries
Inspection Date: 09/30/2011 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 0000
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge 0 13 ■ Q
.fudge, and other that are applicable?
Comment: .
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? Q n ■
IsAhe facility as described in the permit? Q 11 ■ ❑
# Are there any special conditions for the permit? Cl ■ 0 13
Is access to the plant site restricted to the general public? ■ ❑ ❑ Q
Is the inspector granted access to all areas for inspection? ■ Q ❑ 0
Comment: .
Page # 3
eM�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Coleen H. Sullins, Director
July 23,2007
Tom Thompson
Champion Industries, Inc.
3765 Champion Boulevard
Winston-Salem, NC 27115
Subject: Renewal of coverage / General Permit NCG500000
Champion Industries
Certificate of Coverage NCG500075
Forsyth County
Dear Permittee:
In accordance with your renewal application [received on December 13, 20061, the Division is renewing
Certificate of Coverage (CoC) NCG500075 to discharge under NCG500000. This CoC is issued pursuant to the
requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit, please contact Jim
McKay [919 733-5083, extension 595 or, iames.mckav@ncmail.netl.
Sincerely,
-A�-
for Coleen H. Sullins
cc: Central Files
Winston-Salem Regional Office / Surface Water Protection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One
512 Noah Salisbury Street, Raleigh, North Carolina 27604 NofffiCarolina
Phone: 919 733-5063 / FAX 919 733-0719 / Intemet: www.ncwaterquality.org Naturally
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/100% Post Consumer Paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG500000
CERTIFICATE OF COVERAGE NCG500075
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Champion Industries, Inc.
is hereby authorized to discharge from a facility located at
Champion Industries
3765 Champion Boulevard
Winston-Salem
Forsyth County
to receiving waters designated as Leak Fork Creek in subbasin 30704 of the Yadkin River
Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective August 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 23, 2007.
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
DEC -I z zj,
NCDENR (
North Carolina Department of Environment an Rtt'lIRM's RED
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
NOTICE OF RENEWAL INTENT
Application for renewal of existing coverage under General Permit NCG500000
Existing Certificate of Coverage (CoC): NCG500 d 7S�
(Please print or type)
1) _ Mailing address' of facility owner/operator:
Company Name C(i4/+77D/On! 1�D U5/2/ES
Si I C ,
Owner Name L�4/d /An/O A6E/Z / /
Street Addressl/%y�/S%�ZEEi%lo_/s
City i b ✓>-5T&I Vr- SA Z fr' I
State (✓ C
ZIPCode
Telephone Number 33 fro /SS4
Fax: .330
/Z
! yy 7I6o 73
Email address ee11,f17P1czV.11✓Du,S7e1
i
, e-On'%
Address to which all permit correspondence should be mailed
2) Location of facility producing discharge:
Facility Name eAaI-V7>/Onl -Tl JP rivoi6S
Facility Contact l /�o�Sav�
7/ram
Street Address 3 /(,,S— CNH�'7D/OJ QL I/�.
City �JnS✓O—s,9LE1+-1
State111C_
ZIP Code
County 2 h
''fya''1\\
Telephone Number(mo
Fax(33
7VL/ - .n 6 %3
Email address % %—h/�DS �s e—C %1�1-7 'eJ .7_ Dp
3) Description of Discharge:
a) Is the discharge directly to the receiving stream? ❑ Yes .No
(If no, submit a site map with the pathway to the potential receiving waters clearly marked. This includes tracing the pathway of the
storm sewer to the discharge point, if the storm sewer is the only viable means of discharge.)
b) Number of discharge outfalls (ditches, pipes, channels, etc. that convey wastewater from the property):
c) What type of wastewater is discharged? Indicate which discharge points, if more than one.
❑ Non -contact cooling water
XBoiler Blowdown
Outfall(s) #: _
Outfall (s)
Page f of 3
a
NCG500000 renewal application
❑ Cooling Tower Blowdown Outfall (s) #:
❑ Condensate Outfall (s) #:
51 Other
Outfall (s) #:�
(Please describe "Other") B?-p C,E,S.S R- E.2
d) Volume of discharge per each discharge point (in GPD):
*001: #002: gio - #003: #004
4) Please check the type of chemical [s] added to the wastewater for treatment, per each separate discharge
point (if applicable, use separate sheet):
❑ Chlorine ❑ Biocides ❑ Corrosion inhibitors ❑ Algaecide ❑ Other
A None
5) If any box in item (4) above [other than None] was checked, a completed Biocide 101 Form and
manufacturers' information on the additive must be submitted to the following address for approval:
NC DENR / DWQ / Environmental Sciences Section
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
6) Is there any type of treatment being provided to the wastewater before discharge (i.e., retention ponds,
settling ponds, etc.)? ❑ Yes IgNo
(If yes, please include design specifics (i.e., design volume, retention time, surface area, etc.) with submittal package. Existing
treatment facilities should be described in detail. )
7) Discharge Frequency:
a) The discharge is: X Continuous .�' Intermittent ❑ Seasonal*
i) If the discharge is intermittent, describe when the discharge will occur: Pl'o c6S s w411g2 IS P,Z 4117a4
P-9j 1 Te s f / 15 N e F.S , d n e //�16 10V -D . w2.4601L 62 6lo"Art,.J
ii)'�; *Ch6ek-the inoiith(s) the-dis-charge� occurs: 0 Jan '❑ Feb"`❑'-Ma"r: ❑Apr �Vlay Jun ❑ J`ul
❑ Aug. ❑ Sept. ❑ Oct. ❑ Nov. ❑ Dec.
b) How many days per week is there a discharge? .5
c) Please check the days discharge occurs: ❑ Sat. ❑ Sun. X Mon. CKTue. X Wed. X Thu. )91 Fri.
8) Receiving stream[s]:
a) To what body or bodies of water creek, tre river, lake, etc.) does the facility discharge
wastewater? If the site discharges wastewater to a separate storm sewer system (4S), name the
operator of the 4S (e.g. City of Raleigh). C 9!,60<K
b) Stream Classification: ,G611< OrGeZ.1C
Page 2 of 3
NCG500000 renewal application
Additional Application Requirements: %JI-1 /�
The following information must be included in triplicate [original + 2 copies] with this app ic'etmn
be returned as incomplete.
➢ Site map. If the discharge is not directly to a stream, the pathway to the receiving stream must
be clearly indicated. This includes tracing the pathway of a storm sewer to its discharge point.
➢ Authorization for representatives. If this application will be submitted by a consulting
engineer (or engineering firm), include documentation from the Permittee showing that the
consultant submitting the application has been designated an Authorized Representative of the
applicant.
Certification
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: /a r r TNt7r �s�4o�
Title: /C4 e i /' i i <-- e
(Signature of Applicant) (Date Signed)
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan or other document
filed or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, or who
falsifies, tampers with or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under
Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by
a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine
of not more than $25,000 or imprisonment not more than 5 years, or both, fora similar offense.)
This Notice of Renewal Intent does NOT require a separate fee.
The permitted facility already pays an annual fee for coverage under NCG500000.
Mail the original and two copies of the entire package to:
Mr. Charles H. Weaver
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Page 3 of 3
OR
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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
March 8, 2007
CERTIFIED MAIL 7006 0100 0001 8758 6870
RETURN RECEIPT REQUESTED
Tom Thompson
Champion Industries
P 0 Box 4149
Winston Salem NC 27115
Subject: NOTICE OF VIOLATION: NOV-2007-DV-0020
Compliance Evaluation Inspection
Champion Industries
Permit No. NCG500075
Forsyth County
Dear Mr. Thompson:
Alan W. Klimek, P.E. Director
Division of Water Quality
I I 1 4 LOCI
L�6E; ia�Nii
DEtd4 — V? aTER C: Lffy
During the permit renewal process for Permit No. NCG500075 it was discovered that the
Champion facility located at 3765 Champion Blvd, Winston Salem NC was discharging contact
process water to Leak Fork Creek, a Class C water in the Yadkin River Basin. DWQ has no
record of your having a valid permit for the discharge of wastewater at the location noted above.
The facility was found to be in violation of permit NCG500075 for the following:
Compliance issues found during the inspection are:
Inspection Area Compliance Issue
Permit Illicit discharge, discharging without a permit.
Dischareint? Without a Permit
You are hereby advised that the discharge of wastewater without benefit of a permit from DWQ
constitutes a violation of North Carolina General Statute (NCGS) § 143-215,1. Control of
sources of water pollution; permits required
(a) Activities for Which Permits Required. — No person shall do any of the following things
or carry out any of the following activities unless that person has received a permit from the
Commission and has complied with all conditions set forth in the permit:
(1) Make any outlets into the waters of the State.
(2) Construct or operate any sewer system, treatment works, or disposal system within
the State.
585 Waughtovm street Winston-Salem, NC 27107 336-771-4600 (Telephone) 336-7714630 (Fax)
(6) Cause or permit any waste, directly or indirectly, to be discharged to or in any
manner intermixed with the waters of the State in violation of the water quality
standards applicable to the assigned classifications or in violation of any effluent
standards or limitations established for any point source, unless allowed as a
condition of any permit, special order or other appropriate instrument issued or
entered into by the Commission under the provisions of this Article.
The enforcement options available to DWQ for violations of the previously referenced statutes
are found at NCGS 143-215.6 A, B, and C, and include civil penalties, criminal penalties, and or
injunctive relief. The civil penalties for violations such as these may be as high as $25,000.00
Per day per violation.
You must immediately take whatever steps are necessary to stop the unvermitted discharge
of wastewater at the site.
This Office requests that you respond to this letter, in writing within 10 days of receipt of
this Notice. Your response should include the following items:
• Please clearly discuss your efforts to abate/stem impacts to surface waters. Furnish any
supporting documents that show repairs made and related services performed at that time.
If you wish to present any additional explanation for the violations cited, or if you believe there
are other factors which should be considered, please send such information to me in writing
within (10) days following receipt of this letter. Any additional information will be reviewed,
and, if an enforcement action is deemed appropriate, this information, along with other relevant
information, will be forwarded to the Director of DWQ with the enforcement package for his
consideration.
Should you have any questions on this matter, contact Rose Pruitt at (336) 771-5000.
Sincerely,
r
Steve W. Tedder
Water Quality Supervisor
Winston-Salem Region
Division of Water Quality
Cc: Charles Weaver, NPDES
Central Files
WSRO
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 U 2 I5I 31 NCG500075 Ill 121 07/03/08 117 181C 191GI 201
�! �.! U 1=! LJ
Remarks
2111111111IIIIIIIIII111 1111IIIIII111111IIIll 1 Ills
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved
671 169 70 U 71 U 72I NI 73 LU 74 75I I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
12:00 AM 07/03/08
02/08/01
Champion Industries
Exit Time/Date
Permit Expiration Date
3765 Champion Blvd
Winston Salem NC 27115
12:00 AM 07/03/08
07/07/31
Name(s) of Onsite Representative(syTides(syPhone and Fax Number(s)
Other Facility Data
Name, Address of Responsible OffciaUfitie/Phone and Fax Number
Malvern K Timm,PO Box 4149 Winston Salem NC Contacted
27115//919-661-1556/3367449673 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Pollution Prevention Facility Site Review
Section D: SummarV of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Rose Pruitt WSRO WQ//336-771-5000/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1
NPDES . yr/mo/day .' Inspection Type 1
3I NCG500075 I11 12I 07/03/08 117 18' C
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
During permit renewal process permitee indicated the facility was discharging "process water". Process
water from daily testing of dishwashing machines being discharged to Leak Fork Creek. Water from WS
Utilities is sent to boiler then to dishwashing machines for test then to stream. Illicit discharge of process
waste water.
Page # 2
Permit. NCG500075 Owner -Facility: Champion Industries
Inspection Date: 03/08/2007 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? ■ O
Is the facility as described in the permit? 0 ■ Q Q
# Are there any special conditions for the permit? 0 O ■ 0
Is access to the plant site restricted to the general public? 0 Q Q 0
Is the inspector granted access to all areas for inspection? 0000
Comment: Discharging process wastewater to stream.
Page # 3
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Alan W. Klimek, P.E. Director
July 26, 2002
MALVERN K TIMM
CHAMPION INDUSTRIES
P0BOX 4149
WINSTON SALEM, NC 27115
4 ••
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Wastewater Discharge Permit
Champion Industries
COC Number NCG500075
Forsyth County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG500000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection Agency,
dated May 9, 1994 (or as subsquently amended).
The following information is included with your permit package:
A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCG500000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG500000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Aisha Lau of the Central Office Stormwater
and General Permits Unit at (919) 733-5083, ext. 578
Sincerely,
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater & General Permits Unit Files
Winston-Salem Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone 919-733-5083 FAX 919-733-0719
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG500000
CERTIFICATE OF COVERAGE No. NCG500075
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
CHAMPION INDUSTRIES
is hereby authorized to discharge
NON -CONTACT COOLING WATER / CONDENSATE AND
BOILER BLOWDOWN
water or similar wastewater from a facility located at
CHAMPION INDUSTRIES
3765 CHAMPION BLVD
WINSTON SALEM
FORSYTH COUNTY
to receiving waters designated as Leak Fork Creek, a class C water, in the Yadkin - Pee Dee River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, H, III,
and IV of General Permit No. NCG500000 as attached.
This certificate of coverage shall become effective August 1, 2002.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 26, 2002.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
David E. Hill
Champion Industries
P.O. Box 4149
Winston-Salem, NC 27115
Dear Permittee:
e��
E:)EHNR
July 24, 1997
Subject: Certificate of Coverage No. NCG500075
Renewal of General Permit
Champion Industries
Forsyth County
In accordance with your application for renewal of the subject Certificate of Coverage, the Division is forwarding
the enclosed General Permit. This renewal is valid until July 31, 2002. This permit is issued pur§uant to the
requirements of North Carolina General Statute 143-215 .1 and the Memorandum of Agreement between North
Carolina and the U.S. Environmental Protection Agency dated December 6,1983. If any parts, measurement
frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to request
an individual permit by submitting an individual permit application. Unless such demand is made, this certificate
of coverage shall be final and binding.
The Certificate of Coverage for your facility is not transferable except after notice to the Division. Use the enclosed
Permit Name/Ownership Change form to notify the Division if you sell or otherwise transfer ownership of the
subject facility. The Division may require modification or revocation and reissuance of the Certificate of Coverage.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the Regional
Office listed below at (910) 771-4600. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, the Division of Land Resources, Coastal Area Management Act or any other Federal or Local
governmental permit that may be required.
If you have any questions concerning this permit, please contact the NPDES Group at the address below.
Sincerely,
4
A. Preston Howard, Jr., P.E.
cc: Central Files
Winston-Salem
NPDES File
Regional Office
Facility Assessment Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 (919) 733-5083 FAX (919) 733-0719 p&e®dem.ehnr.state.nc.us
An Equal Opportunity Affirmative Action Employer 50% recycled / 10% post -consumer paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG500000
CERTIFICATE OF COVERAGE NO. NCG500075
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE, W(E M PT STORMWATER, COOLING WATERS ASSOCIATED WITH
HYDROELECTRIC OPERATIONS, AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Champion Industries
is hereby authorized to discharge
non -contact cooling water, condensate, boiler blowdown and other similar wastewaters
from a facility located at
Champion Industries
3765 Champion Boulevard
Winston-Salett,
Forsyth County
to receiving waters designated as subbasin 30704 in the Yadkin River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV of General Permit No. NCG500000 as attached.
'his certificate of coverage shall become effective August 1,1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day July 24,1997.
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
DEM-P & E Fax:919-733-0719 Mar 7 '97 17:10 P.02i02
Letter to RANDAL G DUGGINS Jan_ 9; 1 7
NCG500075 lvweFl ?/ /?7/7
INVOICE FOR RENEWAL OF
NPDES PERMTr
❑ Check here if:you do NOT wish to renew this permit. J} J�[pOZO
Please return this page along with a letter documenting your reasons
for not requesting renewal to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
[t]Check here if you wish to renew this permit.
Please verify that the following information is documented accurately:
.y
RANDAL G DUGGINS
CHAMPION INDUSTRTES
P.O. Box 4149
WINSTON-SALEM, NC 27115
Phone number-. (919) 661-1556
Fax number:
e-mail address:
RANDAL G DUGGINS
CHAMPION INDUSTRIES
3765 CHAMPION BOULEVARD
WINSTON-SALEM, NC 27115
No revision required.
D-Revision required. (Please specify below-)
�A u,�l
r
Pz 13-x
\azinl5� f S,1.ley .(QC.oZi//J
®+No revision required.
P'lfevision required. (Please specify below.)
7-bAUiI E a,,//
blttrx u S-�r'�e5
W.rgs,lv,u • SA/em Me J-210s—
Please return this page with your letter requesting renewal, and $400 fee (payable to NCDEHNR) to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 79535
Raleigh, NorthCarolina 27626.0535
Signature of applicant or authorized representative£'r""
Date 3 —/0 -7 7
Champion
The Dishwashing Machine Specialists
March 10, 1997
Mr. Charles H Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
P O Box 29535
Raleigh, NC 27626-0535
RE: NPDES Permit No. NCG500075
Dear Director:
P.O. Box 4149
Winston-Salem, North Carolina 27115-4149
Tel: 910 661-1556
Fax: 910 661-1979
J y✓
S trn
This letter and information attached is a request for renewal of our dis-
charge permit.
I would like to thank you for your assistance in this renewal.
Sincerely,
Q�1£
David E. Hill
Facility Manager
Enclosures
State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management
512 North Salisbury Street - Raleigh, North Carolina 27604
James B. Hunt, Jr., Governor
Randal G. Duggins
P0Box 4149
Winston-Salem, NC 27115
Dear Mr. Duggins:
Jonathan B. Howes, Secretary
March 19, 1993
Subject: General Permit No. NCG500000
Champion Industries, Inc.
COC NCG500075
Forsyth County
In accordance with your application for discharge permit received on December 4, 1992, we
are forwarding herewith the subject certificate of coverage to discharge under the subject state -
NPDES general permit. Issuance of this certificate of coverage supercedes the individual NPDES
permit No. NC0006718. This permit is issued pursuant to the requirements of North Carolina
General Statute 143-215 .1 and the Memorandum of Agreement between North Carolina and the
US Environmental Protection agency dated December 6,1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, this certificate of coverage shall be final and
binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Environmental Management. The Divsion of Environmental Management may require
modification or revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be
required by the Division of Environmental Management or permits required by the Division of
Land Resources, Coastal Area Management Act or any other Federal or Local governmental
permit that may be required.
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-733-7015
An Equal Opportunity Affirmative Action Employer
If you have any questions concerning this permit, please contact Mr. Greg Nizich at telephone
number 919/733-5083.
Sincerely,
original Si nediBs
Coleen H.
A. Preston Howard, Jr.
Director
cc:
Winston-Salem Regional Office
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
-�-- �--- 1 / --�: _ ►i ► III
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER BLOWDOWN,
CONDENSATE AND SIMILIAR WASTEWATERS UNDER THE
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Champion Industries, Incorporated
is hereby authorized to continue operation of a treatment system for the generation of non -contact cooling waters,
boiler water blowdown or similar waste streams with the discharge of treated wastewater from a facility located at
Champion Boulevard
Winston - Salem
Forsyth County
to receiving waters designated as Leak Fork Creek in the Yadkin -Pee Dee River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III
and IV of General Permit No. NCG500000 as attached.
This certificate of coverage shall become effective March 19, 1993
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 19, 1993
Signed BY
Coieen H. Sullins
A. Preston Howard, Jr., P.E., Acting Director
Division of Environmental Management
By Authority of the Environmental Management Commission
304
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`lick r Y.�_ NPDES WASTE LOAD ALLOCATION r J veer 7
a4Rg� 2"
Facility Name: �/10 m i n fr & n F
r
Existing r1CGS00e) -15
Proposed O Permit No.: Pipe No.: County:
Design Capacity (MGD) : _ J. Industrial (% of Flnn
ow) : � �, i Q f��a�P/ Lbmestic ( % of Flow)
i
Receiving Stream: _ -; r �,�r Class:
Reference USGS Quad: C.to ot-2 (Please attach)
L Sub -Basin:
Requestor: i :�>;° f J, Regional Office %i Mo
(Guideline limitations, if applicable, are to be listed on the back of this form.)
Design 2bmp.:
Drainage Area (mi2):
Avg. Streamf low (cfs):
7Q10 (cfs) 0 , ( e:�5 Winter 7Q10 (cfs) 30Q2 (cfs )
Location of D.O. minimum (miles below outfall):
Slope (fpm)
Velocity (fps): K1 (base e, per day): K2 (base e. Der day):
L-SY
Effluent
Characteristics
Monthly
Average
Comments
le w
a.�4V2 `(� C lA
�J C. vja`' `i�V' 01
Allocation
Revised Allocation
OComments:
O
Effluent
Characteristics
:'onthly
Lverage
Comments
-t recea• �
.�;1_ .
9S�1�IN�1
� Confirmation O
ed B I t f vvl Reviewed By: 1 F a _Date: � , �o � &
Prepared y —�
to
4003.
10
41 C3
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10 A
L. 4100 v Knotl OeRno
'` l Sd03fn
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•
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44
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FEET irld r�(71
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419
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see ell
REQUEST NO. 121.1
** *********** *#* WASTELOAD ALLOCATION APPROVAL FORM
FACILITY NAME
TYPE OF WASTE
COUNTY
REGIONAL OFFICE
DECEIVING STREAM
7010 1 0.1 CFS
DRAINAGE. AREA
CHAMPION INDUSTRIES,INC.
BOILER BLOWDOWN
FORSYTH
WINSTON-SALEM REOUESTOR : HEL..EN
LEAK FORK CREEK SUBBAST.N : 030704
W7010 : CFS 3002
SO.MI. STREAM CLASS :C
RECEIVED
N.C. Dept. NRCD
AUG 6 1984
Vivr
Enviromr:'nAl Management
Winston-Salem Reg. Office
CFS
kK************#*** RECOMMENDED EFFLUENT LIMITS #*KK**********#*****k**
WASTE:FL_OW(S)
(MGD)
.01
TEMPERATURE: DISCHARGE SHALL
DOD-5
(MG/L)
:
NOT CAUSE THE RECEIVING WATERS
(MG/ L_)
R E C E
EED 2.8C
E TO CWATER
I
D.O.
gB¢VtJTHEfiNATURAL TEMP.?
PH
(SU)
: 6-4
AND AT NO TIME TO EXCEED 29C.
FECAL COLIFORM
(/100ML):
_a+g84
TSS
(MG/L)
:
11'ATER QUALITY SECTION
OPEWATO nRANCH
FACILITY IS : PROPOSED
( 7
EXISTING
{ NEW ( )
LIMITS ARE : REVISION
( >/
CONFIRMATION
( ) OF THOSE PREVIOUSLY ISSUED
REVIEWED AND RECOMMENDED BY:
MODELER --.- --- - DATE 0_.3 -h —
v
SLIF'ERVISORrMODEL.ING GROUP..........
REGIONAL SUPERVISOR : !.:� i_.d 'G � DATE 4071_
PERMITS MANAGER :.._... �G_ _........._DATE
State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27604
James B. Hunt, Jr., Governor
Randal G. Duggins
P0Box 4149
Winston-Salem, NC 27115
Dear Mr. Duggins:
Jonathan B. Howes, Secretary
March 19, 1993
Subject: General Permit No. NCG500000
Champion Industries, Inc.
COC NCG500075
Forsyth County
In accordance with your application for discharge permit received on December 4, 1992, we
are forwarding herewith the subject certificate of coverage to discharge under the subject state -
NPDES general permit. Issuance of thiscertificate of coverage supercedes the individual NPDES
permit No. NC0006718. Ti
This permit s issued pursuant to the requirements of North Carolina
General Statute 143-215 .1 and the Memorandum of Agreement between North Carolina and the
US Environmental Protection agency dated December 6, 1983.
If any parts, measurement frequencies or samplingrequirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, this certificate of coverage shall be final and
binding. .
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Environmental Management. The Divsion of Environmental Management may require
modification or revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be
required by the Division of Environmental Management or permits required by the Division of
Land Resources, Coastal Area Management Act or any other Federal or Local governmental
permit that may be required.
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-7j3-7015
An Equal Opportunity Affirmative Action Employer
If you have any questions concerning this permit, please contact Mr. Greg Nizich at telephone
number 9191733-5083.
cc:
Winston-Salem Regional Office
Sincerely,
original Signed BY
Coe,estonlHoward, Jr.
Director