NCG050431_ROS Request_20231002

FOR AGENCY USE ONLY
A770,ADivision of Water Qualit / Water Date Received
Quality Surface ProtectionYear Month Day
NCDENR National Pollutant Discharge Elimination System
Nairn GROuan DEPORTMENT OF
ENVIRONMEIrt AND NATURAL RESOURCES REPRESENTATIVE OUTFALL STATUS(ROS)
REQUEST FORM
If a facility is required to sample multiple discharge locations with very similar stormwater discharges, the
permittee may petition the Director for Representative Outfall Status(ROS). DWQ may grant Representative
Outfall Status if stormwater discharges from a single outfall are representative of discharges from multiple
outfalls. Approved ROS will reduce the number of outfalls where analytical sampling requirements apply.
If Representative Outfall Status is granted,ALL outfalls are still subject to the qualitative monitoring
requirements of the facility's permit—unless otherwise allowed by the permit(such as NCG020000)and DWQ
approval. The approval letter from DWQ must be kept on site with the facility's Storm water Pollution
Prevention Plan. The facility must notify DWQ in writing if any changes affect representative status.
For questions, please contact the DWQ Regional Office for your area(see page 3).
(Please print or type)
1) Enter the permit number to which this ROS request applies:
Individual Permit (or) Certificate of Coverage
N C S N C G 0 5 0 4 3 1
2) Facility Information:
Owner/Facility Name PPG -Thomasville Todd Ct
Facility Contact Pat Moseley
Street Address 115 Todd Ct
City Thomasville State NC ZIP Code 27360
County Davidson E-mail Address [e-mail]
Telephone No. 904 335-7841 Fax:
3) List the representative outfall(s)information (attach additional sheets if necessary):
Outfall(s) 003,004,and 006 is representative of Outfall(s) 001,002,005,and 007
Outfalls' drainage areas have the same or similar activities? Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? pi Yes ❑ No
Outfalls have similar monitoring results? ❑Yes ❑ No pi No data*
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities? ❑Yes o No
Outfalls' drainage areas contain the same or similar materials? ❑Yes ❑ No
Outfalls have similar monitoring results? ❑Yes ❑ No ❑ No data*
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities? ❑Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? ❑Yes ❑ No
Outfalls have similar monitoring results? ❑Yes ❑ No ❑ No data*
Page 1 of 4
SWU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities? o Yes o No
Outfalls' drainage areas contain the same or similar materials? o Yes ❑ No
Outfalls have similar monitoring results? ❑Yes ❑ No ❑ No data*
*Non-compliance with analytical monitoring prior to this request may prevent ROS approval. Specific
circumstances will be considered by the Regional Office responsible for review.
4) Detailed explanation about why the outfalls above should be granted Representative Status:
(Or, attach a letter or narrative to discuss this information.) For example,describe how activities and/or
materials are similar.
See attached.
5) Certification:
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 this Article or a rule implementing this
Article;or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case
under this Article;or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device
or method required to be operated or maintained under this Article or rules of the[Environmental Management]
Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed
ten thousand dollars($10,000).
I hereby request Representative Outfall Status for my NPDES Permit. I understand that ALL outfalls are still
subject to the qualitative monitoring requirements of the permit, unless otherwise allowed by the permit
and regional office approval. I must notify DWQ in writing if any changes to the facility or its operations take
place after ROS is granted that may affect this status. If ROS no longer applies, I understand I must resume
monitoring of all outfalls as specified in my NPDES permit.
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: PoSe,I4.'
Title: b tM.'LA , Vtik ay.C�CA'/.4 "I r%) rite 3.0 P"
2o 23
(Signa of Applicant) (Date Signed)
Please note: This application for Representative Outfall Status is subject to approval by the
NCDENR Regional Office. The Regional Office may inspect your facility for compliance with the
conditions of the permit prior to that approval.
Final Checklist for ROS Request
This application should include the following items:
Page 2 of 4
SWU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
❑ This completed form.
❑ Letter or narrative elaborating on the reasons why specified outfalls should be granted representative
status, unless all information can be included in Question 4.
❑ Two(2)copies of a site map of the facility with the location of all outfalls clearly marked, including the
drainage areas, industrial activities, and raw materials/finished products within each drainage area.
❑ Summary of results from monitoring conducted at the outfalls listed in Question 3.
❑ Any other supporting documentation.
Mail the entire package to:
NC DENR Division of Water Quality
Surface Water Protection Section
at the appropriate Regional Office (See map and addresses below)
Notes
The submission of this document does not guarantee Representative Outfall Status (ROS)will be granted as
requested. Analytical monitoring as per your current permit must be continued,at all outfalls, until written
approval of this request is granted by DWQ. Non-compliance with analytical monitoring prior to this request
may prevent ROS approval. Specific circumstances will be considered by the Regional Office responsible for
review.
For questions,please contact the DWQ Regional Office for your area.
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Asheville Regional Office FAX [phone]
2090 U.S. Highway 70
Swannanoa, NC 28778 Raleigh Regional Office
1628 Mail Service Center
Phone [phone] Raleigh, NC 27699-1628
FAX [phone]
Phone [phone]
Fayetteville Regional Office FAX [phone]
Systel Building,
225 Green St., Suite 714
Fayetteville, NC 28301-5094
Washington Regional Office
Phone [phone] 943 Washington Square Mall
FAX [phone] Washington, NC 27889
Mooresville Regional Office Phone [phone]
610 East Center Ave. FAX [phone]
Mooresville, NC 28115
Page 3 of 4
SWU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
Wilmington Regional Office Phone [phone]
127 Cardinal Drive Extension Water Quality Main FAX [phone]
Wilmington, NC 28405
Central Office
Phone [phone] 1617 Mail Service Center
FAX [phone] Raleigh, NC 27699-1617
Winston-Salem Regional Office Phone [phone]
585 Waughtown Street FAX [phone]
Winston-Salem, NC 27107
Page 4 of 4
SWU-ROS-2009 Last revised 12/30/2009

ROS Request Form Supporting Information
PPG—Thomasville Todd Court Facility
August 7,2023
Site Overview/Narrative
The PPG Thomasville Todd Ct facility is utilized by PPG for the manufacture of preformed thermoplastic pavement
marking products.The facility consists of two main structures: 1)a building used to manufacture the thermoplastic
pavement markings;and 2)a larger structure containing spaces for sizing,boxing/packaging,and shipping the
markings,as well as offices and other administrative areas.The two buildings are separated by a paved
driveway/parking area,with a marked access path/route for facility forklift traffic. Site activities related to materials
handling for the thermoplastic pavement parking products include production of the product within the
manufacturing building,transferring the raw final product to the converting area of the second site building(to the
west)for sizing,delivery of raw materials(including powdered calcium carbonate and sand to outdoor storage
silos),storage of raw materials,and shipment/storage of the finished goods.A summary of major structures located
on the site(as shown in Figure 2),are as follows.
• Manufacturing Building: An approximately 37,400 square foot building,used for the
manufacture of thermoplastic pavement marking products(made primarily of powdered calcium
carbonate). Includes exterior areas where raw materials, semi-finished goods,and wasted products
are temporarily stored,handled,and/or transferred. Semi-finished goods are transferred via an
outdoor route from the manufacturing building to the converting area,located in a second building
west of the manufacturing building,for further processing.
• Converting Area: Part of an approximately 75,000 square foot building,the space is utilized for
trimming/cutting the sheets of thermoplastic pavement markings into specified dimensions using a
die press or water jets.The finished goods are then transferred to an adjacent packaging area to the
north.An enclosed tractor trailer is staged outside of the converting area,for the storage of used
wooden pallets.
• Packaging Area: Located adjacent to the converting area,the space is utilized for packaging the
finished goods.The preformed thermoplastic pavement markings are packed into gaylord boxes
placed onto pallets.They are then transferred to an adjacent shipping and finished goods storage
area to the east/northeast.
• Shipping and Finished Goods Storage Area: Located adjacent to the packaging area,the space
is utilized for shipping the finished goods(via a loading dock situated near the southeastern corner
of the area/building)as well as finished goods storage. An enclosed tractor trailer is staged outside
of the shipping/finished goods storage area,for the storage of new wooden pallets.
• Storage Silos: Two raw materials storage silos are located along the northern exterior of the
manufacturing building.One silo is used for the storage of powdered calcium carbonate and the
other is used for the storage of sand,both of which are used in production of the thermoplastic
pavement markings.
• Waste/Chemical Storage Shed: A covered shed/shelter area is located immediately east of the
manufacturing building and is used for the storage of various maintenance/hydraulic oils, facility
floor-mop water generated during cleanings,waste/bad product mixes,and any other flammable
and/or hazardous chemicals/wastes that may be generated as part of facility operations.
Stormwater across the site is conveyed to one of seven outfalls(Outfall-001 through Outfall-007)via various
systems of underground stormwater piping or flows directly over the land surface to the unnamed tributaries of
North Hamby Creek,as generalized in Figure 4.
Representative Outfall Status Notes
Outfall-003,Outfall-004,and Outfall-006 are representative of Outfall-001,Outfall-002, Outfall-005,and Outfall-
007.The three subject outfalls are all associated with the site manufacturing building,outdoor material storage
areas,the waste/chemical storage shed,plus outdoor materials transfer routes between the manufacturing building
and the main building containing indoor finished goods packaging and storage areas.No raw materials,finished

ROS Request Form Supporting Information
PPG—Thomasville Todd Court Facility
August 7,2023
goods,or intermediate materials that could be exposed to stormwater are stored in the drainage areas for Outfall-
001,Outfall-002, Outfall-005, or Outfall-007.

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SITE LOCATION MAP
GEOLOGICScale(feet) PPG-Todd Court Facility
115 Todd Court
Data Sources:USGS US Topo 7.5-min maps for High Point West Thomasville,North Carolina 27360
SMART EARTH SOLUTIONS and Fair Grove NC(2019).

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FIGURE 3
t q � t LOCATIONS OF IDIPERVIOUS SURFACES
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ti l PPG-Todd Court Facility
raj '. 'F� > 115 Todd Court,Thomasville,NC 27360
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FIGURE 4
1 t� STORM WATER DRAINAGE BASINS AND
! "'���111 FLOW DIRECTIONS
O ' 1: ),. .. ll PPG-Todd Court Facility I
,, ,xIn) 115 Todd Court,Thomasville,NC 27360
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