NCS000618_Application_20240606

RECEI RFD JUN 0 6 9n
EPA Identification Number NPDES Permit Number Facility Name Form Approved 031051l9 10z�
NCR000181313 Highline Warren,LLC OMB No.2040-0004
Form U.S.Environmental Protection Agency
1 \-/EPA Application for NPDES Permit to Discharge Wastewater
NPDE5 GENERAL INFORMATION
SECTIONf
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1'1'1 treatment works? 1.1.2 treating domestic sewage?
If yes,STOP.Do NOT complete No If yes,STOP.Do NOT 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 F1 No [] Yes 4 Complete Form �r No
a and Form 2B. 1 and Form 2C.
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 [] Yes 4 Complete Form 0 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 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
bX 15.
SECTION •r- AND LOCATION(40
2.1 Facility Name
Highline Warren LLC
0 2.2 EPA Identification Number
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0 NCR000181313
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2.3 Facility Contact
Name(first and fast) Title Phone number
Cory Rhoten EHS Coordinator [phone]
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Email address
:R [e-mail]
2.4 Facility Mailing Address
M Street or P.O.box
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112 Maxfield Road
City or town State ZIP code
Greensboro NC 27405
EPA Form 3510-1(revised 3-19) Page 1

EPA Identification Number NPDE5 Permit Number Facility Name Form Approved 03105119
NCR000181313 Highline Warren,LLC 'OMB No.204H004
2.5 Facility Location
Street,route number,or other specific identifier
Q +J 112 Maxfield Road
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County name County code(if known)
Guilford
City or town State ZIP code
z Greensboro NC 27405
SECTION1 NAICS CODESI
3.1 SIC Code(s) Description(optional)
2842 Specialty Cleaning,Polishing and Sanitation Preparations(Primary)
3085 Plastics Bottles(Secondary)
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3.2 NAICS Code(s) Description(optional)
325612 Polish and other Sanitation Good Manufacturing(Primary)
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326160 Plastics Bottle Manufacturing{Secondary)
SECTIONOPERATOR INFORMATION(40
4.1 Name of Operator
Highline Warren,LLC
0 4.2 Is the name you listed in Item 4.1 also the owner?
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0 Yes ❑ No
7 4.3 Operator Status
❑ Public—federal ❑ Public—state ❑ Other public(specify)
o ❑✓ Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
Street or PA,Box
E 112 Maxfield Road
City or town State ZIP code
o v Greensboro NC 27405
o. Email address of operator
0 [e-mail]
SECTION • -i
5.1 Is the facility located on Indian Land?
_ ❑ Yes O No
EPA Form 3510-1(revised 3.19) Page 2

EPA Identification Number NPDES Permil Number Facility Name Form Approved 03105119
NCR000181313 Highline Warren,LLC OMB No.2040-0004
SECTION '/ I
R 6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
❑ NPDES(discharges to surface [0 RCRA(hazardous wastes) ❑ UIC(underground injection of
a water) fluids)
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NCRODO181313
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Q ❑ PSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CAA)
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x ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
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SECTION
i
7.1 Have you attached a topographic map containing all required information to this applicalion?(See instructions for
C specific requirements.)
❑r Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTIONOF r
8.1 Describe the nature of your business.
Highline Warren is a manufacturer and distributor of consumable products in the automotive aftermarket.Products
include windshield washer fluid and RV antifreeze.
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SECTION ` COOLING1 CFR 122.21(ffl9))
9.1 Does your facility use cooling water?
❑ Yes ❑r No 3 SKIP to item 10.1.
R 2 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
W NPDES permitting authority to determine what specific information needs to be submitted and when.)
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SECTION
I VARIANCE REQUESTS1 1
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
N apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
d ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
m
Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
F Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
NCR000181313 Highline Warren,LLC OMB No.2040-0004
SECTION1 CERTIFICATION STATEMENT(40
11.1 In Column 1 bellow,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
0 Section 1:Activities Requiring an NPDES Permit ❑ wi attachments
❑ section 2:Name,Mailing Address,and Location ❑ wl attachments
Section 3:SIC Codes ❑ wl attachments
[) Section 4:Operator Information ❑ wl attachments
0 Section 5:Indian Land ❑ wl attachments
0 Section 6:Existing Environmental Permits ❑ wl attachments
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0 Section 7:Ma p ❑ wl topographic
mapElCn wl additional attachments
a 0 Section 8:Nature of Business ❑ wl attachments
0 Section 9:Cooling Water Intake Structures ❑ wl attachments
�] Section 10:Variance Requests ❑ wl attachments
0 Section 11:Checklist and Certification Statement ❑ wl attachments
Y
11.2 Certification Statement
U
1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted.Based on my inquiry of the person or persons who manage the system,or those persons
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
Craig Burrell Plant Manager
Sign tune Date signed
(� aog
EPA Form 3510-1(revised 3-19) Page 4

EPA Identification Number NPDES Permit Number facility Name Farm Approved 03105/19
NCRD00181313 Highline Warren,LLC OMB No.2040-0004
Form U.S Environmental Protection Agency
2F �,1 EPA Application for NPDES Permit to Discharge Wastewater
NPDES STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY
SECTIONi
1.1 Provide information on each of the facilit 's outfalls in the table below
Outfall Receiving Water Name Latitude Longitude
Number
001 South Buffalo Creek 36' 083' 994" -79' 717' 552"
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002 South Buffalo Creek 36' 084' 007" -79' 718, 888"
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003 South Buffalo Creek 36' 085" 336" -79` 718' 621"
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SECTION 'O I
2.1 Are you presently required by any federal,slate,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 ❑� No 4 SKIP to Section 3.
2-2 Briefly identify each applicable project in the table below.
Brief Identification and Affected Outfalls Source(s)of Discharge Final Compliance Dates
Description of Project (list outfall numbers) Required Projected
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2.3 Have you attached sheets describing any additional water pollution control programs(or other environmental projects
that may affect your discharges)that you now have underway or planned?(Optional Item)
❑ Yes ❑ No
EPA Form 3510.2F(Revised 3-19) Page 1

EPA Identification Number NPbES Permit Number Facility Name Form Approved 03105/19
NCR000181313 Highline Warren,LLC OMB No.2040-0004
SECTION1' i
d 3.1 Have you attached a site drainage map containing all required information to this application?(See instructions for
w W Ca specific guidance.)
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in ® Yes ❑ No
SECTIONPOLLUTANT SOURCESi
4.1 Provide information on the facility's pollutant sources in the table below.
Qutfall Impervious Surface Area Total Surface Area Drained
Number (within a mile radius of the facility) (within a mile radius of the facilil)
specify units specify units
Cal 2.5 acres 3.3 acres
specify units specify units
002 1.9 acres 4.2 acres
specify units specify units
003 0.14 acres 0.49 acres
specify units specify units
specify units specify units
specify units specify units
4.2 Provide a narrative description of the facility's significant material in the space below.(See instructions for content
requirements.)
The facility that receives bulk chemicals and combines them to make windshield wiper fluids packaged for consumer
Uuse.The raw bulk organic liquids are received by truck or railcar. Windshield wiper fluid is composed of methanol,
cpropylene glycol,ethanol,a small amount of surfactant,and water in a proprietary formulation.
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4.3 Provide the location and a description of existing structural and non-structural control measures to reduce pollutants A
stormwater runoff. See instructions forspecificguidance.)
Stormwater Treatment
Codes
Qutfail from
Number Control Measures and Treatment Exhibit
2F--t
(Ets1}
001 Basin infiltration
002 Vegetated swale
003 Gravel area
EPA Form 3510-2F(Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number =ighimr.
lity Name Form Approved 03105119
NCR000181313 Warren!lC
OMB No.2040.0004
SECTION •N STORMWATER 1 I
5.1 I certify under penalty of taw that the outfall(s) covered by this application have been tested or evaluated for the
presence of non-stormwater discharges. Moreover, I certify that the outfalls identified as having non-stormwater
discharges are described in either an accompanying NPDES Farm 2C, 2D, or 2E application.
Name(print or type first and last name) Official title
Signature Date signed
N
cn 5.2 Provide the testing information requested in the table below.
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Outfall Onsite Drainage Points
a Number Description of Testing Method Used Date(s)of Testing Directly Observed
During Test
is
E 001 Visual/dry day Infiltration basin
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c 002 Visual/dry day Vegetated swale
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003 Visual/dry day Gravel area
SECTIONOR ! 1
6.1 Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years.
'a
None.
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SECTIONDISCHARGE INFORMATION {
See the instructions to determine the pollutants and parameters you are required to monitor and,in turn,the tables you must
a complete.Not all applicants need to complete each table.
7.1 Is this a new source or new discharge?
❑ Yes 4 See instructions regarding submission of ❑ No 4 See instructions regarding submission of
m
estimated data. actual data.
Tables A,B,C,and D
7.2 Have you completed Table A for each outfall?
Mn
o ❑� Yes ❑ No
EPA Form 3510.2F(Revised 3.1S) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved G3105119
NCRDD0181313 Highline Warren,LLC
OMB No.2040-0004
7.3 Is the facility subject to an effluent limitation guideline(ELG)or effluent limitations in an NPDES permit for its process
wastewater?
❑ Yes ❑ No 4 SKIP to Item 7.5.
7.4 Have you completed Table B by providing quantitative data for those pollutants that are(1)limited either directly or
indirectly in an ELG and/or(2)subject to effluent limitations in an NPDES permit for the facility's process wastewater?
❑ Yes 0 No
7.5 Do you know or have reason to believe any pollutants in Exhibit 2F-2 are present in the discharge?
❑ Yes 0 No 4 SKIP to Item 7.7.
7.6 Have you listed all pollutants in Exhibit 2F-2 that you know or have reason to believe are present in the discharge and
provided quantitative data or an explanation for those pollutants in Table C?
❑ Yes ❑ No
7.7 Do you qualify for a small business exemption under the criteria specified in the Instructions?
❑ Yes-+SKI P to Item 7.1B. ❑✓ No
7.8 Do you know or have reason to believe any pollutants in Exhibit 2F-3 are present in the discharge?
❑ Yes ❑✓ No-*SKIP to Item 7.10.
7.9 Have you listed all pollutants in Exhibit 2F-3 that you know or have reason to believe are present in the discharge in
Table C?
o ❑ Yes ❑ No
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0 7.10 Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater?
E ❑ Yes ❑✓ No 4 SKIP to Item 7.12.
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E 7.11 Have you provided quantitative data in Table C for those pollutants in Exhibit 2F-3 that you expect to be discharged in
En concentrations of 10 ppb or greater?
❑ Yes ❑ No
7.12 Do you expect acrolein,acrylonitrile,2,4-dinitrophenol,or 2-methyl-4,6-dinitrophenoi to be discharged in concentrations
of 100 ppb or greater?
❑ Yes ❑✓ No 4 SKIP to Item 7.14.
7.13 Have you provided quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be
discharged in concentrations of 100 ppb or greater?
❑ Yes ❑ No
7.14 Have you provided quantitative data or an explanation in Table C for pollutants you expect to be present in the
discharge at concentrations less than 10 ppb(or less than 100 ppb for the pollutants identified in Item 7.12)?
❑ Yes ❑✓ No
7.15 Do you know or have reason to believe any pollutants in Exhibit 2F—4 are present in the discharge?
❑ Yes 0 No 4 SKIP to Item 7.17.
7.16 Have you listed pollutants in Exhibit 2F-4 that you know or believe to be present in the discharge and provided an
explanation in Table C?
❑ Yes ❑ No
7.17 Have you provided information for the storm event(s)sampled in Table D?
0 Yes ❑ No
EPA Form 3510-2F(Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105119
NCR000181313 Highline Warren,LLC
OMB No.2040-0004
a Used or Manufactured Toxics
7.18 Is any pollutant listed on Exhibits 2F-2 through 2F-4 a substance or a component of a substance used or
omanufactured as an intermediate or final product or byproduct?
C
❑ Yes ❑✓ No 4 SKIP to Section 8.
a
7.19 List the pollutants below,including TCDD if applicable.
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1. 4. 7.
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M 2. 5. 8.
ca 3. 6. 9.
SECTION •GICAL TOXICITY TESTING DATA i
8.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on
any of your discharges or on a receiving water in relation to your discharge within the last three years?
0
El ❑ No 4 SKIP to Section 9.
;
8.2 Identify the tests and their purposes below.
Z Submitted to NPDES
Test(s) Purpose of Test(s) Date Submitted
x Permitting Authority?
0
co ❑ Yes ❑ No
U
❑ Yes ❑ No
_0
m
❑ Yes ❑ No
SECTION • •• • i
9.1 Were any of the analyses reported in Section 7(on Tables A through C)performed by a contract laboratory or
consulting firm?
[]✓ Yes ❑ No-* SKIP to Section 10.
9.2 Provide information for each contract laboratory or consulting firm below.
Laboratory Number 1 Laboratory Number 2 Laboratory Number 3
Name of laboratory/firm
Meritech,Inc
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Laboratory address
642 Tamco Rd.
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Reidsville,NC 27320
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o Phone number
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{336}342-4748
Pollutant(s)analyzed
BOD,5 Day;COD;TSS
TKN;Nitrate/Nitrite!Nitrogen
Phosphorus;Oil&Grease,pH
EPA Form 3510-2F(Revised 3-19) Page 5

EPA Identification Number NPOES Permit Number Facility Name Form Approved 03105119
NCR000181313 Highline Warren,LLC OMB No.2040-0004
SECTION1 CHECKLIST AND CERTIFICATIONI
10.1 In Column 1 below,mark the sections of Form 2F 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 com lete all sections or provide attachments.
Column 1 Column 2
0 Section 1 ❑ wl attachments(e.g.,responses for additional outfalls)
❑ Section 2 ❑ wl attachments
❑✓ Section 3 ❑ w/site drainage map
❑� Section 4 ❑ wl attachments
0 Section 5 ❑ wl attachments
0 Section 6 ❑ wl attachments
m 0 Section 7 0 Table A ❑ wi small business exemption request
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v' ❑ Table B ❑ wf analytical results as an attachment
0
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❑✓ Table C 0 Table D
❑ Section 8 ❑ wiattachments
y ❑✓ Section 9 ❑ wlattachments(e.g.,responses for additional contact laboratories or firms)
❑� Section 10 ❑
10.2
Certification Statement
t certify underpenalty 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
TIOL� ' Qua z,-
Signaure Date signed
EPA Form 3510-2F(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NCROD0181313L Highlin I Warren LLC 001 OMB No.2040-0004
TABLE A.CONVENTIONAL AND NON • •
You must provide the results of at least one anal sis for every pollutant in this table.Complete one table for each outfall.See instructions for additional details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
(specify units) (specify units) dumber of Storm Information
Pollutant or Parameter Grab Sample Taken Grab Sample Taken (new sourcelnew
Composite During First Ffomposit ed During First Composite dischargers Events Sampled dischargers only;use
30 Minutes e 30 Minutes codes in instructions)
1. Oil and grease <5 mg/L 1
2. Biochemical oxygen demand(BODs) 4.3 mg/I 1
3. Chemical oxygen demand(COD) 47 mg/L 1
4. Total suspended solids JSS) 36 mg/L 1
5. Total phosphorus 0.214 mg/L 1
6_ Total Kjeldahl nitrogen(TKN) 1.12 mg/L 1
7. Total nitrogen(as N) 1.12 mg/t 1
pH(minimum) 7.0 1
8.
pH(maximum) 7.0 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 Farm 3510-21'{Revised 3.19) Page 7

EPA Identification Number NPDES Permit Number Facility Name Oulfall Number Form Approved 03105/19
NCR000181313 Highline Warren,LLC 002 OMB No.2040-0004
TABLE A.CONVENTIONAL AND NON • • r
You must provide the results of at least one anal sis for every pollutant in this table.Complete one table for each outfall.See instructions for additional details and requirements
Maximum Daily Discharge Average Daily Discharge Source of
(specify units) (specify units) Number of Storm information
Pollutant or Parameter Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new sourc&ew
During First During First dischargers only;use
30 Minutes Composite 3t1 Minutes Composite codes in instructions)
1. Oil and grease <5 mg/L 1
2. Biochemical oxygen demand(BOD5) 2.8 mg/I 1
3. Chemical oxygen demand(COD) 56 mg/L 1
4. Total suspended solids(TSS) 9 mg/L 1
5. Total phosphorus <0.20 mg/L 1
6. Total Kjeldahl nitrogen(TKN) 1.02 mg/L 1
7. Total nitrogen(as N) 1.29 mg/L 1
pH(minimum) 6.9 1
8.
pH(maximum) 6,9 1
Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510.2F(Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number Facility Name Outtall Number Form Approved 03/05/19
NCR000181313 Highline Warren,LLC 003 OMB No,2040.0004
TABLE A.CONVENTIONAL AND NON CONVENTIONAL
You must provide the results of at least one anal sis for evepollutant in this table.Complete one table for each outfall.See instructions for additional details and re uirements.
Maximum Daily Discharge Average Daily Discharge Source of
(specify units) (speasyunits) NumherofStorm fnformadon
Pollutant or Parameter Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new souroalnew
During First During First dischargers onry,use
30 Minutes Composite S0 Minutes Composite codes in instructions)
1. Oil and grease <5 mg/L 1
2. Biochemical oxygen demand(BODs) 1.1 mg/i 1
3. Chemical oxygen demand(COD) 133 mg/t 1
4. Total suspended solids(TSS) 94 mg/L 1
5, Total phosphorus 0.028 mg/L 1
6. Total Kjeldahl nitrogen(TKN) 0.98 mg/L 1
7. Total nitrogen(as N) 2.10 mg/L 1
PH(minimum) 7.4 1
pH(maximum) 7.4 1
Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510.2F(Revised 3-19) Page 8

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EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
NCR000181313 Highline Warren,LLC 001 OMB No.2040.0004
List each pollutant that is limited in an effluent limitation guideline(ELG)that the facility is subject to or any pollutant listed in the facility's NPDES permit for its process wastewater(if the
facility is operating under an existing NPIDES permit).Complete one table for each outfall.See the instructions for additional details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
(specify units) (specify units) Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Grab Sample Taken (new source/new
During First Flo Composite
Flow-Weighted During First Flow-Weighted site Events Sampled dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
Not applicable
Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved Under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F(Revised 3-19) Page 9

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EPA Idenfificafion Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
NCROOOIB1313 Highline Warren LLC 001 OMB No.2040-0004
TABLE • POLLUTANTS, +IN HAZARDOUS SUBSTANCES, • +i and 40
List each pollutant shown in Exhibits 2F-2,2F-3,and 2F4 that you know or have reason to believe is present.Complete one table for each outfall.See the instructions for additional
details and requirements.
aflattimu�n, ailyDischarge;:. 'A "Mill - :Source of.
a 011t1S: :.u_'. i ) C _ 1 f0
PollutantarrtlCAs�lumbe (avaDable Grab'Ti Sain to Taken �rab�5ampfe�aKepk r ,�^��". F16fg6torm I n
f P Flow kli@lgh�d , Floyd+1(Iteighfia Eilnts=Sair11@r� C ;souk ew
During+first', Corii s e During Fits' t ` angers 06k use
`......,30:Mlndtes•:;.1: .' ._.; . . codesinlnsWtdtohs).
Not applicable
'Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F(Revised 3-19) Page 11

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EPA Identification Number NPOES Permit Number Facility name Outfall Number Form Approved 03/05/19
NCR000181313 Highline Warren LLC 001 OMB No.2040-0004
TABLE D.STORM EVENT INFORMATIONI
Provide data for the storm event(s)that resulted in the maximum daily discharges for the Flow-weighted composite sample.
Number of Hours Between
Total Rainfall During Maximum Flow Rate
Duration of Storm Event Beginning of Storm Measured and Total Flow from Rain Event
Date of Storm Event ;in 11ozsj Storm Event End of Previous Measurable Rain During Rain Event tin gallons or specify units)
rin inches Event (in gpm or specify units)
May30,2023 >72 Unknown UnF:noran
Provide a description of the method of flow measurement or estimate.
EPA Form 3510-2F(Revised 3-19) Pair,13

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