NCS000030_ROS Request_20230306

PRODUCTS
Air Products and Chemicals,Inc.1940 Air Products Boulevard Qm 3-)-Tj
Allentown, PA 18106
Telephone[phone] E NICOi epa mentof
Quality
Received
MAR 0 6 202.3
Winston-Salem
Feb 28, 2023 =_ _ Regional Office
NC DEQ
Winston-Salem Regional Office
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Subject: Air Products' Representative Outfall Status Request
225 Equity Road
Reidsville NC 27320
Dear Sir or Madam:
Please see the attached Representative Outfall Status Request and additional documentation.
If you have any questions or require additional information, please feel free to contact me at
[phone] or [e-mail].
Sincerely,
Trisha Leib
SHEQ Manager

D vision of Energy,Mineral & Land Resources ncencruseox ONLY
Stormwater Program rear elaan,
N tional Pollutant Discharge Elimination System f li�i7 i;
Environmental
Quality
PRESENTATIVE OUTFALL STATUS(ROS)Qlity
REQUEST FORM "l
If a facility is required to samp le multiple discharge locations with very similar stormwater discharges, the'
permittee may petition the Di ector for Representative Outfall Status(ROS). DEQ may grant Representative
Outfall Status if stormwater dscharges from a single outfall are representative of discharges from multiple
outfalls. Approved ROS will ri duce the number of outfalls where analytical sampling requirements apply.
If Representative Outfall Staft s is granted,ALL outfalls are still subject to the aualitatl monitoring
requirements of the facility's x ermit—unless otherwise allowed by the permit(such as NCGO20000)and DEQ
approval. The approval letter from DEQ must be kept on site with the facility's Stormwater Pollution
Prevention Plan. The facility lust notify DEQ in writing if any changes affect representative status.
For questions, please 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
N C SO 0 0 0 3 0 N C G
2) Facility Information:
Owner/Facility Name Air Pr ducts&chemicals Inc.
Facility Contact Ellen H comer
Street Address 225 Eq ity Road
City Ret —w a NC
State ZIP Code 27320
County Rockin am county E-mail Address hammerelealrp(oducts.com
Telephone No. Fax:
3) List the representative out all(s) information(attach additional sheets if necessary):
Outfall(s) 001 is representative of Outfall(s) 002
Outfalls'drainage areas hat,e the same or similar activities? a Yes ❑No
Outfalls'drainage areas car tain the same or similar materials? a Yes o No
Outfalls have similar monit ring results? ❑Yes ❑No a No data*
Outfall(s) is representative of Outfall(s)
Outfalls'drainage areas hay the same or similar activities? ❑Yes ❑ No
Outfalls'drainage areas con ain the same or similar materials? it Yes ❑ No
Outfalls have similar monitc ring results? ❑Yes ❑No ❑ No data*
Outfall(s) is representative of Outfall(s)
Outfalls'drainage areas hay the same or similar activities? ❑Yes ❑ No
Outfalls'drainage areas con ain the same or similar materials? ❑Yes ❑ No
Outfalls have similar monito ing results? ❑Yes ❑ No ❑ No data*
*Non-compliance with anal,(tical monitoring prior to this request may prevent ROS approval. Specific
circumstances will be cons dered by the Regional Office responsible for review.
SWU-ROS-2009 Page 1 of 3
Last revised 12/30/2009

Representative Outfall Status Request
4) Detailed explanation aboi it why the outfalls above should be granted Representative Status:
(Or,attach a letter or narr tive to discuss this Information.) For example,describe how activities and/or
materials are similar.
The facility manufactures atnwsphed( gases which do not Impact storm water. Our raw material is air.The manufacturing and storage of the
the final product Is In large tanks. S! t the foal products WHI imimmanely return to air 8 they coma In contact with ambient condWons,they
have w Impact on slorm water. Both 0 tlean have simifer whirl.ecavky as they are both located use to our mainkhUmce garage and loading area.
As took maintenance is conducted Insl Is,
The storage of water treatment chemicals is on the opposite side of the fad5ty and equidistant to both outfalls. Therefore,both outfalls have s4Niar
vehkte activity and chemical storage. I leasO see attached for funherdetaUs.
There Is no data from Outfall 002 as m site was granted representative status for Outfeli 002 slnca 1995,
5) Certification:
North Carolina General St tute 143-215.6 Bill provides that:
Any person who knowingly akes any false statement,representation,or certification in any application,record,
report,plan,or other docum ent filed or required to be maintained under this Article or a rule implementing this
Article;or who knowingly mi kes a false statement of a material fact in a rulemaking proceeding or contested case
under this Article;or who fat iffes,tampers with,or knowingly renders inaccurate any recording or monitoring device
or method required to be op rated or maintained under this Article or rules of the[Environmental Management]
Commission implementing tt is Article shall be guilty of a Class 2 misdemeanor which may Include a fine not to exceed
ten thousand dollars($10,00 ),
I hereby request Representative Outfall Status for my NPDES Permit. I understand that ALL outfalls are still
subject to the qualitative IT onitoring requirements of the permit,unless otherwise allowed by the permit
and regional office approval. 1 must notify DEQ in writing if any changes to the facility or Its operations
take place after ROS is gran ed 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 nformation Is true,complete,and accurate.
Printed Name of Persot Signing: Ellen L Hammer
Title: Saa Manager
(Signature of Applicant) (Date Signed)
Please note: This appti ation for Representative Outfafl Status is subject to
approval by the NCDE Regional Office. The Regional Office may inspect your
facility for compliance ith the conditions of the permit prior to that approval.
Final Checklist for ROS Request
This application should Include the following items:
❑ This completed form.
❑ Letter or narrative elation ting 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 frommonitoring conducted at the outfalls listed in Question 3.
❑ Any other supporting doct mentation.
SWt1-ROS-2009 Page 2 of 3
Last revised 12/30/2009

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Industrial activity Type of activity Outfall 001 Outfall 002
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of the facility of the facility
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storage finished product
storage
Vehicle Fueling and Truck terminal fueling x
Maintenance station
Mechanic garage and
shop
Solid waste Roll offs and bins for x
management storage of office trash,
cardboard, wood and
metal
Loading and unloading Raw material and fuel x x
operations unloading
Finished product
hydrogen, nitrogen,
oxygen, argon) loading
Manufacturing Production of industrial x
operations gases
Oil filled operational
equipment
Bulk storage and
transfers
Cooling tower and
associated chemical
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Representative Outfall tatus Request
Mail the entire package to:
NCDEQ DEMLR at the appropriate Regional Office(See map and
addresses below)
Notes
The submission of this docum nt does not guarantee Representative Outfall Status(ROS)will be granted as
requested. Analytical monito ing as per your current permit must be continued,at all outfalls,until written
approval of this request Is gra ited by DEQ. Non-compliance with analytical monitoring prior to this request
may prevent ROS approval. S1 iecific circumstances will be considered by the Regional Office responsible for
review.
For que tions,please contact the DEQ Regional Office for your area.
Mtn
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ett 14
ngton
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778 Washington Regional Office
943 Washington Square Mail
Phone [phone] Washington, NC 27889
FAX [phone]
Regional Offic Phone [phone]
Fayetteville Re
Systel Building,g FAX [phone]
225 Green St., Suite 714 Wilmington Regional Office
Fayetteville, NC 28301-5094 127 Cardinal Drive Extension
Phone [phone] Wilmington, NC 28405
FAX [phone] Phone [phone]
Mooresville Regional Offic FAX [phone]
610 East Center Ave. Winston-Salem Regional Office
Mooresville, NC 28115 585 Waughtown Street
Phone [phone] Winston-Salem, NC 27107
FAX [phone] Phone [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]
SWU-ROS-2009 Page 3 of 3
Last revised 12J3012009