NC0066320_Renewal (Application)_20160516

HO S OF
r
.:.... ..:.
N . 1
May 16, 2016
SUBJECT: PERMIT RENEWAL : NCO066320
To whom it may concern,
This and the attached pertain to the permit renewal for our noncontact cooling water at our Rose
Hill Plant. We do not generate any sludge in this process.
Please let me know if you have any questions or comments,
Chris Murray
Environmental Manager
910-990-7921
RECEIVED/NCDEQ/DWR
MAY 19 2015
Water Quality
Permitting Section
P. O. Box 699 . 3425 US Hwy 117 South • Rose Hill, NC 28458 • 910.289.3191

NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number INCOO 6652,p
Please print or type.
1. Contact Information:
Owner Name
Facility Name �.J�� �o6lJLL. AA4.7t—
Mailing Address � !4�
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address ��� II�✓� ��t��I�SE ; CGv✓)
�r
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road
City
State / Zip Code 0007J0
County �yspU.y
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name Ce�
Mailing Address V
city Annc RECEIVED/NCDEGYDWR
State / Zip Code y(fC MAY 19 7016
Telephone Number 9 �� ��
Water(]uality
a„ Permitting Section
E W 14-
4. Ownership Status:
Federal ❑ State ❑ Private M// Public ❑
Page 1 of 5 C-MI 10/08

NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
i
5. Standard Industrial Classification (SIC) code(s):
6. Number of employees: 6AC
7. Describe the treatment system List all installed waste treatment components with capacities,
describe the processes that generate wastewaters. If the space provided is not sufficient attach a
separate sheet of paper with the system description.
/j/D�CocP37�cT �iA/� �v�4TE12,
S. Is facility covered under federal effluent limitation guidelines? No Yes ❑
If yes, specify the category?
9. Principal product(s) produced:
Principal raw material(s) consumed:
Briefly describe the manufacturing process(es): /
.S�v6vA17LE x,1.0 G1'T
Page 2 of 5 C-MI 10108

NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
10. Amount of principal product produced or raw material consumed
Listspecific amounts consumed and/or units of roduction over the last three ears
Product Produced or Raw Material Product Produced or Raw Material
Consumed Consumed
AVERAGE PEAK
per Day O LYS /90 l
per Month
per Year
11. Frequency of discharge: Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs:_ Duration: < yie5 Y��Q
12. Types of wastewater discharged to surface waters only
Discharge Flow
GALLONS PER DAY
Sanitary - monthly average
Utility water, etc. - monthly average
�t S
Process water - monthly average
Stormwater- monthly average
Other- monthly average
Explain:
Monthly Average
total discharge (all types)
13. Number of separate discharge points: / Outfall Identification number(s)
14. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitudes
Page 3 of 5 C-MI 10108

NPDES.PERMIT APPLICATION — SHORT FORM C — Minor Industrial
Minor industrial, manufacturing and commercial facilities.
15. Effluent Data [for new or proposed discharges]
Provide data for the parameters listed. Temperature and pH shall be grab samples,for all other parameters 24-hour
composite sampling shall be used. If more than one analysis is reported, report daily maximum and monthly average.
If only one analysis is reported, report as daily maximum.
NOTE:Permittees requesting renewal should complete the table ONLY for the parameters
currently monitored. Summarize the ast 3 years of e uent data.
Daily Monthly Units of
Parameter Maximum Average Measurement
Biochemical Oxygen Demand (BODS)
Chemical Oxygen Demand (COD)
Total Organic Carbon
Total Suspended Solids
Ammonia as N
Temperature (Summer)
Temperature (Winter)
pH
Fecal Coliform (If sanitary waste is
present)
Total Residual Chlorine (if chlorine is
used)
16. List all permits, construction approvals and/or applications (check all that apply and provide permit
numbers or check none if not applicable):
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES Dredge or fill (Section 404 or CWA)
PSD (CAA) Other
Non-attainment program (CAA)
17. List any chemicals that may be discharged (Please list and explain source and potential
amounts.)
Page 4 of 5 C-MI 10/08

NPDES PERMIT APPLICATION - SHORT FORM C - Minor Industrial
Minor industrial, manufacturing and commercial facilities.
18. Is this facility located on Indian country? (check one)
Yes ❑ No
19. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Printed lname of Person Signing Title
Signature of Applicantate
North Carolina General Sta to 14 -215.6 (b)(2) provides that: Any person who knowingly makes any false
statement representation, o ce cation in any application, record, report, plan, or other document files 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. (I8 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,
for a similar offense.)
Page 5 of 5 C-MI 10/08

NC DENR/ DWR/NPDES
Renewal Application Checklist
The following items are REQUIRED for all renewal packages:
o A cover letter requesting renewal of the permit and documenting any changes at the facility since
issuance of the last permit. Submit one signed original and two copies.
o The completed application form (copy attached), signed by the permittee or an Authorized
Representative. Submit one signed original and two copies.
o If an Authorized Representative (such as a consulting engineer or environmental consultant) prepares
the renewal package, written documentation must be provided showing the authority delegated to the
Authorized Representative (see Part II.B.11.b of the existing NPDES permit).
o A narrative description of the sludge management plan for the facility. Describe how sludge (or other
solids) generated during wastewater treatment are handled and disposed. If your facility has no such
plan (or the permitted facility does not generate any solids), explain this in writing. Submit one signed
original and two copies.
The following items must be submitted by any Municipal or Industrial facilities discharging
process wastewater:
o Industrial facilities classified as Primary Industries (see Appendices A-D to Title 40 of the Code of
Federal Regulations, Part 122) and ALL Municipal facilities with a permitted flow >_ 1.0 MGD must
submit a Priority Pollutant Analysis (PPA) in accordance with 40 CFR Part 122.21.
The above requirement does NOT apply to non-industrial facilities.
Send the completed renewal package to:
Wren Thedford
NC DENR/DWR/NPDES Unit
1617 Mail Service Center
Raleigh, NC 27699-1617