NCG030710_ROS Request_20240606

FOR AGENCY USE ONLY
Division of Energy,Mineral&Land Resources Data T, eceived
Y.W Month I Day
for water Program
National Pollutant Discharge Elimination System
Envhwmental REPRESENTATIVE GUTFALL STATUS(ROS)
Quality RE VEST FORM'
if a facility is required to sample multiple discharge locations with very similar storm water discharges, the
permittee may petition the Director for Representative Outfatt Status(ROS). DEQ may grant Representative
Outfall Status if stormwater discharges from a single©utfalt are representative of discharges from multiple
outfalls. Approved ROS will reduce the number of outfalls where analytical sampling requirements apply.
If Representative OutfalJ'Status is grunted,AtL outfalls are still subject to the qualitative monitoring
requirements of the facility's permit—unless otherwise allowed by the permit(such as NCGO2Q000)and DEQ
approval. The approval letterfrom DEQ must be kept on site with the facility's Storm water Pollution
Prevention Plane. The facility must notify DEQ in writing if any changes affect representative status.
For questions, phase contact the DEQ 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
Hu I r 3 10 17 11 10
Z) Facility Information;'
Owner/Facility Name Corning Optical Communication LLCffrivium Cable Plant
Facility Contact Dalton Kaylor
Street Address 17E4 Trivium Parkway
City Newton State NC ZIP Code 28658
County Catawba E-mail Address [e-mail]
Telephone No.. 828 901-3222 Fax.
3) List the representative outfall(s) information (attach additional sheets if necessary)::
Outfall(s) 1; is representative of Outfall(s) 2
Outfalls'drainage areas have the same or similar activities? a Yes ❑No
Outfalls'drainage areas contain the same or similar materials? ®Yes ❑ No
Outfalls have similar monitoring results? z Yes ❑ No ❑No data*
Outfall(s) 1 is representative of Outfall(s) 3
Outfalls'drainage areas have the sameor similar activities? m Yes ❑ No
Outfalls'drainage areas contain the same or similar materials? v Yes ❑ No
Outfalls have similar monitoring results? a 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*'
*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.
Description in accompanying letter
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).
1 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 DEQ 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.
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: Ahmed Koilakh
Title:_Pla Mana er
i 2 3
(Signature ofA plicant) (Date Signed)
Please note: This application for Representative Outfall Status is subject to
approval by the NCDEQ 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:
o This completed form.
11 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.
—u Any other supporting documentation.

Mail the entire package to:
NCDEQ DEMLR 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 outf4lis, until written
approval of this request is granted by DEQ. 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 DEQ Regional Office for your area.
Asheville Regional Office
2090 U.S. Highway,70
Swannanoa, NC 28778 Washington Regional Office
943 Washington Square Mall
Phone [phone] Washington, NC 27889
FAX [phone] Phone[phone]
Fayetteville Regional Office FAX [phone]
Systel Building,
225 Green St., Suite 714 Wilmington Regional Office
Fayetteville, NC 28301-5094 127 Cardinal Drive Extension
Wilmington, NC 28405
Phone[phone]
FAX [phone] Phone [phone]
FAX [phone]
Mooresville Regional Office
610 East Center Ave. Winston-Salem Regional Office
Mooresville, NC 28115 585 Waughtown Street
Winston-Salem, NC 27107
Phone [phone] Phone [phone]
FAX[phone] Water Quality Main FAX [phone]
Raleigh Regional Office Central Office
1628 Mail Service Center 1612 Mail Service Center
Raleigh, NC 27699-1628 Raleigh, NC 27699-1612
Phone [phone] Phone [phone]
FAX[phone] FAX [phone]

Corning Incorporated
Ahmed Koilakh Trivium Cable Plant t 828-901-3232
Plant Manager 1764 Trivium Parkway f 828-901-6161
Newton,NC 28658 [e-mail]
www.corning.com
December 15, 2023
Mr. Jesse McDonnell
Environmental Assistance Coordinator
North Carolina Division of Environmental Assistance and Customer Service
610 East Center Avenue, Suite 301
Mooresville,NC 28115
Dear Mr. McDonnell,
This letter comes in regard to permit of coverage certificate NCG030710. Corning Optical
Communications LLC seeks that Outfall No.I represent Outfalls No.2&3. Outfall No.I activities
include waste collection, truck loading, reel storage, air handling units, and the covered site's
central accumulation area. Outfalls No.2&3 activities collectively include waste collection,truck
loading,reel storage, air handling units, and the covered site's central accumulation area. Outfall
No.I would be considered the best representation as it is a source to monitor all activities
performed at the covered site.
The covered site has not exceeded the benchmark parameters in the last two years of analytical
sampling. The covered site utilizes a proactive system to ensure risks to the stormwater quality
are mitigated through weekly trainings and maintenance activities.
If you wish to discuss this matter,please do not hesitate to contact me. I thank you in advance for
your attention to this matter.
Sincerely,
Ahmed Koilakh
Plant Manager

NPDES PERMIT NO.:NCG030710 PERMIT VERSION:2.0 PERMIT STATUS:Active
FACILITY NAME:Trivium Cable Plant CLASS:SWNC COUNTY:Catawba
OWNER NAME:Corning Optical Communications LLC ORC:Not Required ORC CERT NtiiVIBER: 100976
GRADE:SWNC ORC HAS CHANGED:No
eDiMR,PERIOD:09-2023(September 2023) VERSION:1.0 STATUS:In Progress
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
00400 C0530 01119 01051 00552 00340 46529 02094
'F F
Quarterly Quarterly Quarterly Quarterly Quarterly Quarterly Quarterly Quarterly
4 F =
Grab Grab Grab Grab Grab Grab Estimate Grab
U
a U CC C z° pit TSS-Con. Cu-TOTR LEAD OH,.GRSE COD RAINFALL Zn-TOTR
2400 daek Hrs 2400 d.ek It. Y/BIN so my1 mg1l md'1 Mjl mg1I inches mg/l
1
2
3
4
5
6
7
8
9
10
11
12
13
14
IS
16
t7 7.2 <9,259 0.0023 <0.001 <5.9 <20 0.43 0.0078
IR
19
20
21
22
23
24
25
26
27
28
24
30
31.,ohiy Average LImR:
31 M6[y Average:
0 0.0023 10 0 0 0.43 0.0018
Daily 32azimom:
7.2 0 0.0023 0 10 0 0.43 0.0018
Daily Stinimnm: 0.43 0.0078
7.2 0 0.0023 0 0 0
****No Reporting Reason:ENFRUSE=No Flow-Reuse/Recycle; ENV WTHR=No Visitation—Adverse Weather; NOFLOW=No Flow; HOLIDAY=No Visitation—Holiday

NPDES PERMIT NO.:NCG030710 PERMIT VERSION:2.0 PERMIT STATUS:Active
FACILITY NAME:Trivium Cable Plant CLASS:SWNC COUNTY:Catawba
OWNER NAME:Corning Optical Communications LLC ORC:Not Required ORC CERT NLUrvIBER:1009764
GRADE:SW-NC ORC HAS CHANGED:No
eDMR PERIOD:09-2023(September 2023) VERSION:1.0 STATUS:In Progress
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 002 NO DISCHARGE*: NO
nao0 C0530 01119 01051 00552 00340 46529 01094
= F
rz _ Quarterly Quarterly Quarterly Quarterly Quarterly Q y Quarterly
- n uanzrt uanzrl� uattert uar[zrl attzrl uanerl uarterl Quarterly
S ¢ E
Grab Grab Grab Grab Grab Grab Esii uate Grab
s z z
U t= C a C z pH TSS-Cone Cn-TOTR LEAD 011,(:RSE COD RAINFALL Zn-TOTR
2100 d-k H. 2400 clack Hrs YB/V su mgll mg1l mg/1 mUl mg,`I inches myl
i
}
a
5
6
7
8
9
10
Ii
13
fa
15
16
17 7.2 <5 <0.001 <0.001 1<5 <20 0.43 0.0093
to
19
20
21
22
23
24
25
26
27
29
29
30
M-thly Average Limit:
3ionfh[y Average:
0 0 0 0 0 0.43 0.0093
Daily Maximom:17.2 0 0 0 0 0 0.43 0.0093
Deity Minimum:
72 0 0 0 0 0 0.43 0.0093
** *No Reporting Reason:ENFRUSE=No Flow-Reuse/Recycle; ENV WTHR=No Visitation—Adverse Weather; NOFLO W=No Flow; HOLIDAY=No Visitation—Holiday

NPDES PERMIT NO.:NCG030710 PERMIT VERSION:2,0 PERMIT STATUS:Active
FACILITY NAME:Trivium Cable Plant CLASS:SWNC COUNTY:Catawba
ObVNER NAME:Corning Optical Communications LLC ORC:Not Required ORC CERT NUMBER: 1009764
GRADE:SWNC ORC HAS CHANGED:No
eDNIR PERIOD:09-2023(September 2023) VERSION: 1.0 STATUS:in Progress
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 003 NO DISCHARGE*: NO
00490 C0530 01119 01051 00552 00340 46529 01094
- E =
Quarterly Quarterly Quarterly Quarterly Quarterly Quarterly Quarterly Quarterly
- 9 — Grab Grab Grab Grab Grab Grab Estimate Grab
w c U ti
C 0
z Z' PH TSS•Conc C.-TOT R LEAD OILGRSE COD RAINFALL Z.-TOT R
24DO clock Hrs 2400a1oc1 1 H. YBiv so mfl mgtl mgtl m¢/l mg1l inches me/l
I -
2
}
4
5
6
7
8
9
10
11
12
13
IS
15
16
17 Tz <5 0,0016 <0.001 <5 <20 0.43 0.0049
19
19
20
21
22
23
21
25
26
27
2s
29
30
Monody Average Limit:
Monthly Average:
0 0.0016 0 0 0 0.43 0.0049
Daily)laxlmam: 7 0 10.0016 10 0 0 0.43 0.0049
Daily Minimum: 7.2 0 UO16 U 0 0 0.43 09049
****No Reporting Reason:ENFRUSE=No Flow-Reuse/Recycle; ENV WTHR=No Visitation—Adverse Weather; NOFLOW=No Flow; HOLIDAY=No Visitation—Holiday

NPDES PERMIT NO.:NCGO30710 PERMIT VERSION:2.0 PERMIT STATUS:Active
FACILITY NAME:Trivium Cable Plant CLASS:SWNC COUNTY:Catawba
OWNER NAMME:Coming Optical Communications LLC ORC:Not Required ORC CERT NUMBER: 1009764
GRADE:SWNC ORC HAS CHANGED:No
eDMR PERIOD:09-2023(September 2023) VERSION:1.0 STATUS:In Progress
COMPLIANCE STATUS:Compliant CONTACT PHONE#:[phone] SUBMISSION DATE:
ORC/Certifier Signature: E-Mail: Phone #: Date
I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances.A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.The written submission shall be made as required by part II.E.6 of the
NPDES permit.
Permittee/Submitter Signature: *** E-Mail: Phone #: Date
Permittee Address: 1764 Trivium Pkwy Newton NC 28658 Permit Expiration Date:06/30/2026
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 managed 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 fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME:Statesville Analytical
CERTIFIED LAB#:440
PERSON(s)COLLECTENG SAMPLES:Dalton Kaylor
PARAMETER CODES
Parameter Code assistance may be obtained by visiting https:Hdeq.nc.gov/about/divisionshvater-resources/edmr/user-documentation.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site:YES indicates that No Flow/Discharge occurred and,as a result,no data is reported for any parameter on the DMR for the
entire monitoring period.
**ORC on Site?:ORC must visit facility and document visitation of facility as required per 15A NCAC 8G.0204.
***Signature of Penmittee:If signed by other than the permittee,then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).