NC0020401_Annual Report_20180214

HICKORY
North Carolina W
Public Utilities
February 14, 2018
Ms Vivien Zhong
NC/DWR/PERCS
Pretreatment Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
RE 2017 Pretreatment Annual Report
Dear Ms Zhong
City of Hickory
Hickory Regional Laboratory
310 Cloninger Mill Rd
Hickory, NC 28601
Phone [phone]
Fax [phone]
Email dcox@hickorync gov
Enclosed you will find two copies of the 2017 Pretreatment Annual Report
Let me know if you have any questions or require additional information
Sincerely,
David R Cox
Pretreatment Coordinator
RECEIVED/DENR/DWR
FEB 15 2018
Water Resources
Permitting Section

11 CITY OF HICKORY PRETREATMENT REPORT
The Annual Pretreatment Report submitted by the City of Hickory contains
information from January 1, 2017 — December 31, 2017 In this period of time,
15 industries were monitored.
JANUARY - JUNE 2017
• During the January — June 2017 monitoring period, thirty-three (33)
monitoring events were conducted by the City of Hickory. Zero (0)
industries were in SNC for parameters or reporting.
• Self-monitoring by fifteen (15) industries occurred. Eighty-four(84)
monitoring events occurred. Zero (0) industries were in SNC for
parameters or reporting
During January 2017, one (1) industry was sent one (1) notice of
violation with assessments of civil penalties for violation of permit
limitations due to violations that occurred in the July -December
period of 2016 This violation was documented in the 2016 PAR
The civil penalty was assessed and collected in 2017. (See
Additional Info )
• Twelve (12) industries were sent thirty-five (35) [self-monitoring
data — seventeen (17), City of Hickory data — eighteen (18)] notices
of noncompliance with the Industrial Monitoring Program
• Kleen Tech #0035 conducted TTO monitoring. (See enclosures)
• During the January — June 2017 period, there were no permit
renewals or modifications.
• Corning Optical Communications-HMTC #0024 made modifications
to their process water filtration and recirculation system resulting in
zero process wastewater discharge effective May 1, 2017. This
exempted them from the City of Hickory's monitoring event for the
2nd quarter of 2017 due to the absence of process water at the
compliance point. (See Permit Drop Info.)

Industries in "SNC" During January — June 2017

JULY - DECEMBER 2017
• During the July —December 2017 monitoring period, the City of
Hickory conducted thirty-two (32) monitoring events
• Also during this period, self-monitoring by fifteen (15) industries
occurred Eighty-six(86) monitoring events occurred One (1)
industry was in SNC for TRC limits violations for oil and grease
Zero (0) industries were in SNC for reporting (See Additional Info
• The industries were notified of the industrial monitoring test results
Fourteen (14) industries were sent thirty-one (31) [self-monitoring
data — thirteen (13), City of Hickory data — eighteen (18)] notices of
noncompliance with the Industrial Monitoring Program
• Shurtape Technologies #0022 conducted TTO monitoring The City
of Hickory also conducted TTO monitoring for Shurtape
Technologies #0022 and Kleen Tech #0035 (See Enclosures)
• During the July — December 2017 period, there were no permit
renewals or modifications
• Corning Optical Communications-HMTC #0024 continued to have
zero process discharge for the remainder of the year On October
23, 2017, they made a formal request that their permit be
rescinded An on-site inspection was conducted on November 15,
2017 and no evidence of process discharge was found going into
the sanitary sewer The City of Hickory submitted a request to
PERCS that their SIU permit be dropped This request was
approved on November 29, 2017 Henry Fork (NC0040797) POTW
AT was updated accordingly (See Permit Drop Info )

Industries in "SNC" During July — December 2017
Kleen Tech #0035:
• Kleen Tech was in SNC for a permit violation of exceeding the TRC limit
for Oil and Grease the 2nd semi-annual period of 2017
• 1 have enclosed the Compliance Judgment Worksheet that was completed
in November by the previous pretreatment coordinator to show the error
that was made The error gave the appearance that they were compliant
for the 2nd semi-annual period After noticing the error in January 2018
while completing the IDSF's for July -December 2017, 1 completed a
corrected version of the Compliance Judgment Worksheet on the latest
form that shows that there was indeed a violation exceeding the TRC limit
for Oil and Grease. I have enclosed it as well
• Had this error been discovered after the last oil and grease monitoring
event on 11/20/17, the industry could have been notified and possibly
done extra sampling and obtained enough compliant samples to avoid the
TRC violation.
• The SIU was contacted by phone and made aware of the violation and
was sent a NNC with an assessment for civil penalties on January 29,
2018 Assessment and collection of the civil penalty will be included in the
2018 PAR
• The industry was submitted for public notice on January 29, 2018
• On February 6, 2018 — February 7, 2018, Kleen Tech was listed during
public notice in the area newspaper for the July - December 2017 period
• Kleen Tech submitted a 30 -day response to the violation on February 13,
2018
• (See Additional Info.)

Kleen Tech #0035 (cont.):
• Kleen Tech, Inc was issued permit #0035, effective July 8, 2016,
with an expiration date of July 7, 2021
• Said permit contains the following relevant limitations.
Parameter Limitation
Oil & Grease 100mg/I
• City of Hickory and self-monitoring reports for the 2nd semi-annual
period of 2017 revealed the following results -
Date
Oil & Grease result
7/26/17
515 mg/I
8/21/17
19 mg/I
9/20/17
73 mg/I
10/3/17
150 mg/I
10/19/17
476 mg/I
11/19/17
25 mg/I
11/20/17
17 mg/I

Other Information
A copy of the Division's Historical SNC Report has been included.
No errors were noted Also included is the Pretreatment Program
Database No errors were noted
IDSF data listed as "not required" for a semi-annual period
indicates that the corresponding industry does not have permit
requirements for said parameter and that the monitoring for the
other semi-annual period was conducted to satisfy LTMP and/or
MMP requirements only
Susan McNeely, the previous pretreatment coordinator, retired
effective 12/22/17 David Cox assumed the role of pretreatment
coordinator effective 1/22/18
Longview Yarn #0046:
Previous SNC Information:
• SIU was not in SNC this PAR year
• Previous SNC situation (See 2016 PAR), was resolved The SIU
believed the cause of the violations and SNC in 2016 was due to
changes in their heavy chemicals (sodium chloride and sodium
sulfate). (See enclosures)
Henry Fork (NC0040797) HWA:
IWS:
• On schedule for submittal on 4/1/18.
• On schedule for submittal on 10/1/18
Northeast (NC0020401) IU Permit Renewals:
• Will begin mailing permit renewal applications (long forms) to SIU's
in July 2018

Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1 Pretreatment Town Name: City of Hickory
2 "Primary" NPDES Number NC00 20401
or Non Discharge Permit # if applicable =>
3
PAR Begin Date, please enter 01/01/yyyy
3 =>
1/1/2017
4
PAR End Date, please enter 12/31/yyyy
4 =>
12/31/2017
5
Total number of SIUs, includes CIUs
5 =>
15
6
Number of CIUs
6 =>
0
7
Number of SIUs with no IUP, or with an expired IUP
7 =>
0
8
Number of SIUs not inspected by POTW
8 =>
0
9
Number of SIUs not sampled by POTW
9 =>
0
10
Number of SIUs in SNC due to IUP Limit violations
10 =>
1
11
Number of SIUs in SNC due to Reporting violations
11 =>
0
12
Number of SIUs in SNC due to violation of a Compliance Schedule, CO, AO or similar
12 =>
0
13
Number of CIUs in SNC
13 =>
0
14
Number of SIUs included in Public Notice
14 =>
1
15
Total number of SIUs on a compliance schedule, CO, AO or similar
15 =>
0
16
Number of NOVs, NNCs or similar assesed to SIUs
16 =>
66
17
Number of Civil Penalties assessed to SIUs
17 =>
1
18
Number of Criminal Penalties assessed to SIUs
18 =>
0
19
Total Amount of Civil Penalties Collected 19 =>
$
100
20
Number of IUs from which penalties collected
20 =>
1
Motes
AO Administrative Order IUP Industrial User Pretreatment Permit POTW
CIU Categorical Industrial User NNC Notice of Non -Compliance SIU
Publicly Owned Treatment Works
Significant Industrial User
CO Consent Order NOV Notice of Violation SNC
Significant
Non -Compliance
IU Industrial User PAR Pretreatment Annual Report
revised 1/2018 PAR_PPS_2018

Pretreatment Program Info Database
for Program Name Hickory
WWTP Name Northeast
Program Approval Date
01/01/1985
Pretreatment Status
Full
Region
MRO
County
Catawba
NPDES Number
NC0020401
printed on: 1/29/2018
Stream Information -�
IWC % at 7Q10 13 40
70-FlowJ cfs / mgd
Q1
60 / 3876
1 Q1 0 Flow cfs / mgd
4915 / 31 77
Stream Classification
WS -V & B
Basin Number
CTB32
Receiving Stream Name CATAWBA RIVER
NPDES Effective Date 11 /01 /2016
Last PAR Rec
PAR Due Date 03/01/2018
mercury
1631
NPDES Expire Date
p 04/30/2020
Current Fiscal
Year PCI Done
required
es
POTW is Primary WWTP TRUE
Last Audit on 03/04/2015
Audit Year Next 19/20
Design Flow mgd 60000 % Design
mgd is SIU permitted F 6 12 Permitted SIU
flow (mgd) [Pt SIU) 367
WWTPSIU's
WWTPCIU's
5
0
Program SIUs 15
Program CIUs10
--_--�-T====_-
HWA LTMP -
IWS�
—'�--�
SUO
--���
ERP v
date Inactive Date Next Due
08/01/2019
10/01/2018
j
Date Received by DWR 07/29/2014 j 03/13/2013 JI
10/01/2013
09/20/2012
12/10/1992
Date Approved
12/01/2014
03/22/2013 ,
12/16/2013
10/22/2 1
1 03/09/1993
Adopt Date Required
L
Date Adopted
12/04/2012
Info in this Box from Pt Contacts
PT -Pro
Formal Name g Prime Phonel
Mr David Cox Prim 11828-322-4821
dcox@hickorync gov
Mr Kevin Greer, P E 1 11(828) 323-7427
Date Date Date
Attended Attended Attended
ext Fax HWA Wksp IUP Wksp PAR Wksp
1828-322-4961 11 2/28/2013 I 11/18/2017
Pretreatment Coordinator 1310 Cloninger Mill Road
1
kgreer@ci hickorync gov Asst Public Services Director jP0 Box 398 8603
Mr Mike Patton I II828-328-2024 1 1828-328-3870 11 2/24/2009
mike patton@mcgillengineers com Senior Engineering Technician jP0 Box 1136 8603
Pretreatment Related NOVs from DWQ
DWR Central Office Contact ivien Zhong
DWR Regional Contact es Bell

Pretreatment Program Inf0,Qgjtpbyase
for Program Name Hickory
WWTP Name Henry Fork
Program Approval Date 01/01/1985
Pretreatment Status
Full
Region
MRO
County
Catawba
printed on: 1/29/2018
Stream Information IWC % at 7Q10 34 04
— 7Q1`0 F ow cfs / mgd 27 / 1744
1 Q10 Flow cfs / mgd 2224 / 1437
Stream Classification C
Basin Number CTB35
Receiving Stream Name HENRY FORK RIVER
NPDES Number NCO040797
NPDES Effective Date Last PAR Rec PAR Due Date 03/01/2018 mercury
02/01 /2011 1631
Current Fiscal requiredNPDES Expire Date 07/31/2015
Year PCI Done
POTW is Primary WWTP FALSE Last Audit on 03/04/2015 Audit Year Next 19/20 es
Design Flow mgd 90000 % Design mgd is SIU permitted 12 61 Permitted SIU flow (mgd) [Pt—SIU) 1 135
WWTP SIU's 10 Program SIUs 15
WWTPCIU's 0 Program CIUsHW�: Lf MP IWS j� SU ERP
date Inactive Date Next Due 04/01/2018 10/01/2018
Date Received by DWR 04/02/2013 07/10/2002 10/01/2013 09/20/2012 12/10/1992
Date Approved 07/0a/201307/11/2002 1 12/16/2013 10/22/2012 1 03/09/1993
Adopt Date Required
Date Adopted 12/04/2012
Info in this Box from Pt Contacts
PT Pro
Formal Name g Prime Phone1
Date Date
Attended Attended
ext Fax HWA Wksp IUP Wksp
Date
Attended
PAR Wksp
Mr David Cox
1Prim 828-322-4821828-322-4961
2/28/2013
1/18/2017
dcox@hickorync gov
Pretreatment Coordinator 1310 Cloninger Mill Road IFFO,
Mr Kevin Greer, P E.
1 11(828) 323-7427
kgreer@ci hickorync.gov
Asst Public Services Director PO Box 398
8603
Mr Mike Patton
I
11828-328-2024
1 1828-328-3870 112/24/2009
mike patton@mcgillengineers com
Senior Engineering Technician jP0 Box 1136
8603
Pretreatment Related NOVs from DWQ
DWR Central Office Contact kivien Zhong
DWR Regional Contact es Bell

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name => City of Hickory
Name Catawba Valley Medical Center
Use separate forms for each industry/pipe
VvWTP Name =>
Henry Fork Plant
IUP # 3
Enter BDL values as < (value)
NPDES # =>
NCO040797
Pipe # 1
2nd 6 mon s
1st 6 months, dates =>
1/1/2017 to 6/30/17
iv,
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
* POTW must enter at least one of these
four rows, Please indicate how averages were calculated
ow, mg
mmonia
Ist 6 montlis
2ncl 6 mon ss
mon s
MT. o mon ss
mon s
27cl. 6 mon ss
mon s
2nd 6 mon s
5115
iv,
5
-11"
'45—
5—
�O.
U-a, 0
3
?
-
I,q
SS
Q
0,070
3
2.1s'
oz
I S)s
9
091")
0
0
Uro
Arsenic
Uadmium
Uhromium
LL IVIercury
st 6 months
1st 6 months
I st 6 months
2nd 6 mont s
1 st 6 months
2nd 6 months
i
I
f
i
Not required
< 0,010
Not required'
c 0., a p 1
Not required
< U, 0✓S"
Not required
0„ ovov z z,
0 (705'
010061I'
r7,,0oZ5-
O.deve Z5-2
N/A
N/A
N/A
IVA
N/A
N/A
N/A
NA
opper
Uyanide
Leacl
IMLercury
st months
n months
st mont s
2nd. 6 mont sst
mont s
2nd 6 months
I st 6 mont s
2nd 6 months
►
1
I
d, O5"v p
Not required
0,005
Notre uired
o,, 000 i
Notre uired
c 0 ov,n 2
Q
D, 0 y 1v
a-001
0, 000q
1
49,1001
n
0
N/A
N/A
N/A
!�
0
N/A
N/A
N/A
BDL => Below Detection Limit mg/l => milligrams per liter
IUP => Industrial User Permit lb/d => pounds per day
SNC => Significant Non -Compliance mgd => million gallons per day
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maxnnum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
* POTW must enter at least one of these
four rows, Please indicate how averages were calculated
Industry Name Catawba Valley Medical Center
IUP # 3
Pipe # 1
><c e
e enium
Silver
LAM
s months
n mon s
s mon s
Zrict 6 months
Ist 6 months
Zncl b months
2ncl
6 months
S_
r
Not required
tee'., 00,5
Z D CCS
C r!_ ooS
p 3ST
o, vale
0.
0115"t
N/A
--
—
N/A
—
—
0
Oil & Grease
p
ori e
Yotal Phosphorus
li st months
n months
st mont s
2nd 6 months
stmont s
n mont s
stmont s 2nd6months
�9_17
7A
'?-t g_
Not required
SstoS'
1I_7
Ss_ 3
y -z-
9.
v `r
o `
N/A—
cr
N/A
---
—
IVIBAS
st 6 months
2nd 6 mont sst
mont s
2nd 6 months
I st 6 months
2nd 6 months
I st 6 months 2nd
6 months
oZ
Z
BDL — Below Detection Limit mg/1=> milligrams per liter
IUP — Industrial User Permit lb/d => pounds per day
SNC — Significant Non -Compliance mgd => million gallons per day
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name=> City of Hickory Name Frye Regional Medical Center
Use separate forms for each industry/pipe WWTP Name => Northeast IUP # 7
Enter BDL values as < (value) NPDES # => NCO020401 Pipe # 1
lst 6 months, dates => 1/1/2017 to 6/30/17
2nd 6 months, dates => 7/1/2017 to 12/31/17 BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
ow, mgammonia
st 0 months
2ncl. 6 months
I st 0 months
2ncl. 6 months
I st 6 months
2nct 6 months
I st 0 months
Zncl (i months
,S
7
0, DO -7
0 00 5"
290'G0
z0_0
O_ va d
22.7
139
Ito
,
3
gr)
0%r
07
94s
—
or
n y.
aL1
07,
Zy°o
Arsenic
Uadmium
Uhromium
LL Mercury
st 6 months
2nd 6 months
I st 6 months
n mont s
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
Notrequired
C o,.a to
Not required
ca -do/
Not required
cv ,7ns-
Not required
0, (104
f7
2C
P.(XJOt^F
N/A
N/A
N/A
/Ii
N/A
N/A
N/A
A"4
opper
Uyanicle
Lead
Nlercury
st 6 months
2nd 6 months
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
S
1
1
1
Not re uired
O, ao
Not required
o. ovv
Not required
<a_ a a0'L
rl43
aaa
o_aao,6
p, vau/
0-9 `IV
v%
N/A
N/A
N/A
a9 9b
o°"
N/A
N/A
N/A
BDL — Below Detection Limit mg/l => milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page l of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Frye Regional Medical Center
IUP # 7
Pipe # 1
><c e
Selenium
Silver
Zine
s mon sn
mon s
s mon sn
mon
s mon777=37'7177'
s months
n months
27
IN -s
Not required
{ O. vi+ S-
G , d I
< v r d
.� P - 02
L u o s-
62, 1
o vv ?t
p CO
O, od"),
D ,
u ars'
0, 20D
o. yov
N/A
N/A
-
-
—
-
0
Uil & Urease
PH
Phenoltoluene
st months
n months
stmont s
n months
st mont s
n months
st mont s
n months
57
15r
1�6
1
19. ,
I5,Zr
.S' 7.0
D.Datp
O. a ti
Not required
c 6'Do ?
CO
to -S,
I,
O
V. o 0
1 v, va►
p c
G
r6r7F
056
N/A
917
o%
D
J"c•
o" .,
N/A
'I'ota'I'otal Phosphorus
otal Nitrogen
o y enum
st 6 months
2nd 6 mont sst
mont s
2nd 6 mont sst
mont s
2nd 6 months
stmont s
2nd 6 months
3
Z
Z
Z
.Z
3
19-?
19.
L ED
< u>oos
3 G
18.b
s.G
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page Q of 2

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Hickory Name Frye Regional Medical Center
Use separate forms for each industry/pipe WWTP Name => Northeast IUP # 7
Enter BDL values as < (value) NPDES # => NCO020401 Pipe # 2
1st 6 months, dates => 1/1/2017 to 6/30/17
2nd 6 months, dates => 7/1/2017 to 12/31/17 BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
oW, mg
mmoma
s mon s
n months
s mon s
2nct 0 months
TITMoMMs
Zncl 6 months
s mon s
Tncl b mon s
S
S
S8
z(3
0. oy o
0. WO
Q93
Z? r
7 o
Q
Zo,
101,
Arsenic
Uadinium
Uhroinium
LL IVIercury
st 6 months
2nd 6 months
2nd 6 months
2nd 6 months
1 st mont s
2nd 6 months
Not required
t c,. 0 j o
< d, 00 :
CO, OC' z
Not required
c a, vos"
Not required
v va�c"a L
0-vo"-
0,VC10
7
0 a"O 2a2
N/A
—
-
N/A
1V
N/A
-
-
N/A
Im
opper
Uyanide
Leact
Nlercury
st months
n months
st mont s
n months
stmont s
2nd 6 months
stmont s
2nd 6 months
15-
51
1
1
1
Q__
0,11g
Not required
0,010
Not required
D,O,�v ys
Not required
c u, vvvz
0.030
0-0/0
O.O�c,yS'
r7 �7✓J/
U ` ,
N/A
N/A
N/A
0/
N/A
N/A
N/A
BDL => Below Detection Limit mg/1 => milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Frye Regional Medical Center
rup # 7
Pipe # 2
INICKel
Selenium
Silver
773c
s mon s
n mon s
s mon s
n mon s
s mon
n mon s
i st o months
MCI o months
I
i
S
{'
Not required
e0, ad S,
L �,p��
Q©.0/6
LQ,a
1), U07
0 U%
0,6 Y-4
O..r7�^i5
,�i
t1.4PS
D,
U,003V
0.
49_117y
N/A
—
%
pyo
p
ej
N/A
0 7o
a °/"
U
Oil & Urease
pPhenol
o uene
st 6 months 2nd
6 mont sst
mont s
2nd 6 months
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
f:
j
3'
i
Not required
<V. 00 ,2,
1v,8
®,fl37
U.�!✓l
%
N/A
0
a`
N/A
'Yotal Phosphorus
Yotal Nitrogen
IVIOlybdenum
st 6 months 2nd.
6 months
777 mon s
2nd 6 mont s
776 mont s
2nd. 6 mont sst
mont s
2nd 6 months
:1
Z
OL
s:y8
9 . D
)r' .1
)r, *7
0-01Q3
0 sI
17
2L' If
act I 1
G
0,ovjg
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these ]UP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Hickory Name Hickory Dyeing & Winding
Use separate forms for each industry/pipe WWTP Name => Northeast IUP # 8
Enter BDL values as < (value) NPDES # _> NC0020401 Pipe # 1
1st 6 months, dates => 1/1/2017 to 6/30/17
2nd 6 months, dates => 7/1/2017 to 12/31/17 BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Ju ow, mg
mmonia
st 0 months
2nci b mon ss
mon s
Tricl 6 mon ss
mon s
2771. 15 mon ss
mon s
27cl 15 months
S
S
S'
I
OO
o va s
7
�] , d
V'
(o
d 2s'
o. ov�9
71_
. D
Q. �
v.12
0X0
'Ib
0Y"
v
°�
o`v
0/5
Arsenic
a mium
romium
ercury
st months
n mont s
st mont s
n months
st months
n mont s
st mont s
n months
I
)
$'
Not required
< o,al o
Not required
a o, C70 /
,L
t U. vos`
Notre uired
a,v✓caa�
0 ��'J
L'�UOy9j"
a. dU`S
O UOC'L'6'Ll
N/A
N/A
N/A
N/A
%
IV
opper
Uyanide
Leact
lViercury
st mont s
n mont s
st mon s
2nd 6 mont sst
mont s
2nd 6 months-
stmont s
2nd 6 months
S'
I
S
i
0,0
Notrequired
O,uo 6
L
Notrequired
<a, ocla'z-
00th
0,011
n, no
v0s,
090
o
N/A
L,
N/A
app
N/A
clG .
N/A
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Hickory Dyeing & Winding
IUP # 8
Pipe # 1
iNICKel
k5elenium
Silver
me
s months
n mon s
s mon s
s mon s
n mon s
s mon s
n mon s
l
5-
S�coc'j'
c Q,C)JONotrequired
fu,00r
J
0_21719
d, ooz
c?.00s'
a ✓c' 2S
O.
O'lb
—
—
—
-'
N/A
Gj
o
—
_
—
—
N/A
b
v"
Uil & Urease
pH
Phenolo
uene
st 6 months- 2nd
6 wont s
st 6 months
2nd 6 mont sst
mont s
2nd 6 mont sst
mont s 2nd
6 Mont s
S
Q_
1z
j
L (p
e S.G
'�
-7,11-7-6
L D, M j 0
o,o / o
Not required
Cc, de
Oma
p
O"�
--
—
N/A
o°�
O%
—
N/A
'Yotal Phosphorus.1.-"!sst
a ;t rogen
o y enum
st months
n mont s
st months
n months
months
2nd 6 months
I st 6 months 2nd
6 months
Z.
Z
_'2_
Z
u.Gs'
9
vZ
,Z
L
Co..oa
9
o,s6
'2.1
Z.z
o av
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name=> City of Hickory
Name HK Research
Use separate forms for each industry/pipe
WWTPName =>
Northeast
IiTP# 11
Enter BDL values as < (value)
NPDES # _>
NC0020401
Pipe # 1
2nd 6 months
1st 6 months, dates =>
1/1/2017 to 6/30/17
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
ow, mg
mmonla
st 0 months
2ncl b mon ss
mon s
2nci 6 months
TTSMMOMS
2ncl b months
TsT77mmoMs
2nd 6 months
,cam 1
306
q'?
y
a50
230
a LIE12
3
O"vaIDY60
06
aG&_
20/
OX
7"
0 V
r
0 X
/D
0
Arsenic
Uadmium
Uhromium
LL IVIercury
st 6 months
1 st 6 months
I st 6 months
I st 6 months
2nd 6 months
Not required
< d . o 10
Notre uired
C o v 0 J
O(7
C o„ ows-
Notre uired
tj'i vv 0) o
N/A
N/A
N/A
N/A
opper
Uyanicle
Leact
Mercury
st months
n months
st mont s
2nd 6 mont sst
mont s
2nd 6 months
stmont s
2nd 6 months
1
i
0 l
Cr.C741_
Not required
r! von;
Q ,
<a,,vo3
Not required
<G cve i
a oi3
O, acs-
'9,00)
d,arvl
OYr
N/A
O`
N/A
N/A
v °r
N/A
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these rUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR) -
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name HK Research
IUP # 11
Pipe # 1
ice
a enium><
ver
><nc
st b
months n
mon s
s mon s
s mon s
n mon s
s mon s
n mon s
61-
7mo
O.ot3
`- © L'aNot
required
c,, Oas-
c) I
O so 7
0,J10
O.00S-
rJ. 647o ts,
&7—,30L
—
—
—
N/A
0 Y
--
-'
—
N/A
U 7
(Alrease
p1i
Phenolo
uene
st
months n
months
st mont s
2nd 6 mont sst
mont s
2nd 6 months
I st 6 mont s
2nd 6 months
1
f
EK
�
11-s-
. aL
e.S 8_7_
Notrequired
co, w6
Not required
c a, let.
v. ons
U, ,76' /
t'
9""
0 vC
N/A
N/A
`
4i "�,
N/A
N/A
Yotal Phosphorus
o a it ogee
o y enum
st
months n
mont s
n months
st montsnmontsst
m
n months
Z
Z
2
Z
0,00
BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of of 2

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name => City of Hickory
Name Maple Springs Laundry
Use separate forms for each industry/pipe
WWTP Name =>
Henry Fork Plant
IUP # 15
Enter BDL values as < (value)
NPDES # =>
NCO040797
Pipe # 1
n months
1st 6 months, dates =>
1/1/2017 to 6/30/17
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Ju ow, mg
mmonia
st 0 months
2ncl 0 months
I st 6 months
2ncl. 6 months
I st 0 months
2ncl 0 months
I st 0 months
n months
O t
Uo ��
.
CPO. a
71).0
-
3
�
0.tU
0/'
%
i6,7X,
0'l,
oV"
Arsenic
Uadniftim
Uhroinium
LL IVIercury
st mont sn
mon s
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
i
I
� I
I
Not required
< a_ vl0
Not required
C0,00
Not required
< a-o6j
Not required
i vaav 2S"
O.. CJs'
D. d✓t��'
d v�+�'
O oa✓✓ 2
N/A
N/A
N/A
iv
N/A
N/A
N/A
/VA
opper
Uyanicle
Lead
IVILercury
st 6 mon ths
2ndmonths
stmont s
2nd. 6 months
stmont s
2nd 6 months
stmont s
2nd 6 months
5'J,I
I
0, rQ.5 1
61, 0 /5-1-
n, oi
Not required
O, oaa -
Not required
<o_ ace'
0_ dt 3g
0 C
o JC
o,, aw
v,, VA, i
0 X.
0 2
Q� ��
N/A
N/A
D
OZ, ,
O°
N/A
N/A
BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL , 1/2BDL, or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page l of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Maple Springs Laundry
IUP # 15
Pipe # 1
INICKel
Selenium
Silver
Zinc
s
months
n mon s
I st 0 months
2ncl. 6 months
I st 6 months
2nct
6 months
I
f
Not require
"100-511
Not required
f u_ voS
o--7.90
U,oa as'
0.00 is'
v 3G
N/A
N/A
N/A
N/A
Oil
& Urease
PH
Uhloncle
'I'otal Phosphorus'I'ota
st 6
months 2nd
6 mont sst
mont s
2nd 6 months
777 mont s
2nd 6 months
stmont s 2nd
6 mont s
15-
S
I
3
3
ti3
2
9. L I�
Notrequired
r
.0
Z77
r
Z
c
07,
2 9° 0
N/A
--
v%
c1 %
N/AIVIBAS
—
a
r`p C
months
n months
stm
2nd
n months
st months
n monthsst
Z
Q, D
BDL => Below Detection Limit mg/I => milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name=> City of Hickory
Name The Sock Factory
Use separate forms for each industry/pipe
WWTP Name =>
Henry Fork Plant
IUP # 17
Enter BDL values as < (value)
NPDES # =>
NCO040797
Pipe # 1
27cl fj mon s
1st 6 months, dates =>
1/1/2017 to 6/30/17
7
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
ow, mg
mmonia
s months--
n mon s
s mon s
Zncl 6 months
T77777rs
2ncl b mon ss
mon s
27cl fj mon s
S'
7
5
S
®,Da
a;o�0
390
?_Ls
D13
O oily
'Zoo
Gu.4
y_10
07"
—
—
OIL
rN ecn
90n
�
Arsenic
Uadinium
Uhroniluin
LL lViercury
st 6 months
2nd 6 months
2nd 6 months
st mont s
2nd 6 months
1
S
L
r
Not required
u., via
< a.. au t
ql
a, 30 y
Not required
0 Uuuvo 6 >
0,005,
0 , Q
0,0001E
,�0
L g
N/A
0
, %
1 >" .�
ivy
N/A
o'/'
Io
i > '
Nig
opper
Uyanide
Lead
lViercury
st mont s
n mont s
st mont s
2nd 6 months
777 mont s
2nd 6 months
T77 mont s
2nd 6 months
75-
1
1
0,g'1 (
6r,010
Not required
a_ at, 't-
Notre uired
Ce,.VdO Z
e `
O �. 0
, y!
U. a0
U_ UU '1?-
U, 00C I
2 o° ",
O ` �,
N/A
N/A
�o
o �,
N/A
N/A
BDL => Below Detection Limit mg/l => milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC — Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maxunum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/l) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name The Sock Factory
IUP # 17
Pipe # 1
BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2
rs=�l1115L�111111rrr:W.sir
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BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Hickory Name Shurtape Technologies
Use separate forms for each industry/pipe WWTP Name => Northeast IUP # 22NPDES # _> NC0020401 Pipe # 1
Enter BDL values as < (value) 1st 6 months, dates => 1/1/2017 to 6/30/17
2nd 6 months, dates => 7/1/2017 to 12/31/17 BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
* POTW must enter at least one of these
four rows, Please indicate how averages were calculated
Flow, mgAmmonia
st b months -
2nd 6 months
777=
257 6 mon s
T st 5 months
2nd 6 mon ss
mon s
2717 6 mon s
7
S
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st 6 months
I st 6 months
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1 st 6 months
n mont s
st mont s
n mont s
I
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Not required
c a.. o/ 0
Not required
c6?, 00 /
Not required
< a. doss
Not required
0,,0,7000 j"
0.0 Os"
01000s,
v- as 25'
0,00000
N/A
N/A
N/A
IV,4
N/A
N/A
N/A
�v,Q
Copper
Cyanide
Lead
Mercury
st months
n months
st mont s
2nd 6 mont s
1st 6 months
2nd 6 months
1777mont s
2nd 6 mont s
3
1
1
0, O) ry
DO b
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Not required
a, 90'7 12
Not required
< a- Oan-
—0.
oiz
b
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d_0001
0-00611
N/A
N/A
-
—
-
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BDL => Below Detection Limit
IUP => Industrial User Permit
SNC => Significant Non -Compliance
mg/I => milligrams per liter
Ib/d => pounds per day
mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 3

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
* POTW must enter at least one of these
four rows, Please indicate how averages were calculated
Industry Name Shurtape Technologies
IUP # 22
Pipe # 1
Nickel e
e enium Silver
pH
izine
st 6 months 2nd 6 mont s st mont s n months T:77mont s
st 6 months 2nci (i months
s mon s ITT (,) months I st 6 months
27clomontris
Istomontlis
2nd6-months
n mont sst mont s
2nd 6 months
stmont s
2nd 6 months
L4
Not required < 6;_9 L,5-
<d,o 10 Not required
O_ 0",5-D,
/ �_ 1 V
3
`l. 2-
6,719-y , Q
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67_003
O,Jr72S'
N/A
-- —
N/A
17
N/A
— —
N/A
l7 °Y'
Oil & Grease
pH
Phenol
st 6 months 2nd 6 mont s st mont s n months T:77mont s
Toluene
stmont s 2nd
st 6 months 2nd
6 mont s
st monts
n mont sst mont s
2nd 6 months
stmont s
2nd 6 months
L4
Y
7
3
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9
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o
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TTO 1/12 months Total phosphorus TKN
Total Nitrogen
st 6 months 2nd 6 mont s st mont s n months T:77mont s
2nd 6 months
stmont s 2nd
6 months
-1
Z. Z
Z
1�2_
Z
C().Oro
29_8
BDL => Below Detection Limit
IUP => Industrial User Permit
SNC => Significant Non -Compliance
mg/l => milligrams per liter
lb/d => pounds per day
mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page of of 3

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name=> City of Hickory Name Shurtape Technologies
Use separate forms for each industry/pipe WWTP Name => Northeast IUP # 22
Enter BDL values as < (value) NPDES # _> NC0020401 Pipe # 1
1st 6 months, dates => 1/1/2017 to 6/30/17
2nd 6 months, dates => 7/1/2017 to 12/31/17 BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chromc SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
* POTW must enter at least one of these
four rows, Please indicate how averages were calculated
• e • u
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BDL => Below Detection Limit
]UP => Industrial User Permit
SNC => Significant Non -Compliance
mg/1 => milligrams per liter
lb/d => pounds per day
mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page 3 of

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name => City of Hickory
Name Corning Optical C -HMTC
Use separate forms for each industry/pipe
WWTP Name =>
Henry Fork Plant
IUP # 24
Enter BDL values as < (value)
NPDES # =>
NCO040797
Pipe # 1
rrr�.rrs�a�
1st 6 months, dates =>
1/1/2017 to 6/30/17
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% v>olations,(chromc SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
BDL => Below Detection Limit mg/l — milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of _2
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rrr�.� �r.���
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W
BDL => Below Detection Limit mg/l — milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of _2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Corning Optical C -HMTC
IUP # 24
Pipe # 1
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page Q of —2—
I��i..�"iC.S'ii9i1<� rrr.�..s
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BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page Q of —2—

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name=> City of Hickory
Name Ward Hosiery
Use separate forms for each industry/pipe
WWTP Name =>
Henry Fork Plant
NP # 27
Enter BDL values as < (value)
NPDES # =>
NCO040797
Pipe # 1
2771 o months
1st 6 months, dates =>
1/1/2017 to 6/30/17
S
S'
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maxmium (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
JU ow, mg
mmonia
s months
n months
smon s
277 o months
s mon s
2na (i mon ss
mon s
2771 o months
S
S
S'
s
0 0 S -z
I U9
Z5 'z
170 o
G L
, W2,10
e/Me
' ,-0
12�r
S-0-7
Arsenic
Uadmium
Uhrommm,
st 6 mont sn
mont s
lst 6 months
2nd 6 in nt s
I st 6 months
2nd 6 months
I
S'
S
1
Not required
c o, p
L Q
co, p J/
0 , 1 O
v 0 i 7o
Not required
6?_oaj?o,71
01 vus'
0. O
0, 000,5-
N/A
a
v",,
0%
IVA
N/A
d `'c'
09,
IVA
opper
Uyanide
Lead
IVIercury
st months
n months
st mont s
2nd 6 months
stmont s
2nd 6 mont s
I st 6 months
2nd 6 months
S
S'
r
p og�0,
Q1 Q
p p y
1O.GDS
Notrequired
a Ooc,
0
0, os-.�r
0, o
o pts
o_ oaz
fl,uU v
OX,
'
0G
N/A
1171,
0,,
N/A
BDL => Below Detection Limit mg/l — milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Ward Hosiery
IUP # 27
Pipe # 1
INUa1111111111111
WAUUMNh-
Ma
'
1111L. •• . • �11111r.:rrrr,i�
��r.•rrr>i�
r•�•rrsT.rfi
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•
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BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name=> City of Hickory
Name Hickory Springs Mfg
Use separate forms for each industry/pipe
WWTP Name =>
Henry Fork Plant
IUP # 33
Enter BDL values as < (value)
NPDES # _>
NC0040797
Pipe # 1
2721 o mon s
1st 6 months, dates =>
1/1/2017 to 6/30/17
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% vlolations,(chromc SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
* POTW must enter at least one of these
four rows, Please indicate how averages were calculated
Avg nenod could be month. Otv or 6 -month & if BDL _
ill ow, mg
mmonia
st b months
2nd b mon ss
mon s
277 o months
s mon s
2771 o months
7sTrT3nMs
2721 o mon s
d,vaG I
Zia
3Z5'
0
a, E7 C1
, `
130
LVD,17
v
d
0 �c
Arsenic
Uadinium
Uhroinium
LL IVIEKUUKY
st 6 months
nmont s
I st 6 months
'2nd 6 months
I st 6 months
2nd 6 months
1
I
Not required
Co. d jd
G D, DO
< o., vv 1
Not required
c v, dv
Not required
v vvor a 13I
d d61;
, 000
U 0 OU?
v..vv
,9 DOou'7%?S
N/A
J
0 X
N/A
N/A
- 1
0/" "
N/A
Nfl
opper
Uyanide
Lead
lViercury
st months
n months
st mont s -
2nd 6 months
stmont s
2nd 6 mont sst
mont s
2nd 6 months
y
�
C), 0;G
7
- S Zt
< <
4.0o
Not required
o
Not required
O, v,? o
0, 0t j
U
,07
U,t7d�'
a. vv
4,0,70/
N/A
N/A
N/A
N/A
BDL => Below Detection Limit mg/l => milligrams per liter
IUP => Industrial User Permit Ib/d => pounds per day
SNC => Significant Non -Compliance mgd => million gallons per day
zero values used TRC => Technical Review Criteria WWTP => wastewater treatment
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe = Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
*
Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chromc SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
* POTW must enter at least one of these
four rows, Please indicate how averages were calculated
AvQ period could be month. Otr. or 6 -month & if BDL.
Industry Name Hickory Springs Mfg.
IUP # 33
Pipe # 1
or zero values used
BDL => Below Detection Limit
IUP => Industrial User Permit
SNC => Significant Non -Compliance
TRC => Technical Review Criteria
mg/l => milligrams per liter
lb/d => pounds per day
mgd => million gallons per day
WWTP => wastewater treatment
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2
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BDL => Below Detection Limit
IUP => Industrial User Permit
SNC => Significant Non -Compliance
TRC => Technical Review Criteria
mg/l => milligrams per liter
lb/d => pounds per day
mgd => million gallons per day
WWTP => wastewater treatment
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name=> City of Hickory Name Century Furniture
Use separate forms for each industry/pipe WWTP Name => Northeast IUP # 34
Enter BDL values as < (value) NPDES # _> NC0020401 Pipe # 1
1st 6 months, dates => 1/1/2017 to 6/30/17
2nd 6 months, dates => 7/1/2017 to 12/31/17 BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Ju ow, mg
mmonia
st 0 montlis
2nd b mon ss
mon s
2nd 6 months
Tsro mon s
n months
s mon s
2nct o months
rr
S
'7
s
OLOJ
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zo7CP33
L
Arsenic
Uadmium
Uhromium
LL IVJLEKUUKY
st 6 months
I st 6 months
1 st 6 months
I st 6 months
2nd 6 months
I
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Notrequired
<0_0/0
Lo, [j
4� 0,00 '
Q,
v 0,,_5r,
Notrequired
p ov,;c,pqs—
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©,
OrO"6,
aoj
Or 006'2055'
N/A
d
04z
/v
N/A
U o
OX
—
—
iv
opper
Uyanicle
Leaci
lViercury
months
n months
m
n months
st s
n monthsst
7
I
Sf
1
0,))-7
Notre utred
< o , a o�5'
L
< 0, a)
Not required
C 0, v06• L
,D`
0-1,f
0,0015
v..003G
Z " r
N/A
G'
0 "
N/A
OX
N/A
0 `
N/A
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Century Furniture
IUP # 34
Pipe # 1
1NICKel
Selenium
Sillver
zjilac
st 6 months
I st b months
2ncl. 6 mont s
2na
6 months
s mon s
7_771 o months
Not required
C o, oel
L , Q
< v, v o
Not required
0- 00.r
0, 6
J,002
U
.04V,
o vv
v
N/A
—
—
N/A
O%
N/A
—
—
N/A
Uil & Grease
p.1i
Fhenol
Yoluene
st 6 months
2nd 6 mont sst
mont s
2nd 6 mont s
st mont s 2nd
6 mont sst
mont s
2nd 6 mont s
S
I
7- 2 g_Z
Not required
O, o S-$
Not required
-C a,, o e 2
1Z.6
D %
0_/'
N/A
N/A
O%
M
a/,
N/A
N/A
l'otal Phosphorus
otal Nitrogen
lViLULYBDENUIVI
st 6 months
2nd 6 mont sst
mont s
2nd 6 mont s
stmont s 2nd
6 mont s
stmont s
n months
Z
Z
Z
12 -
G. 3
ER
Z?
ys-'6
4 Q,=
c v,, vas'
s_ "
Y-Z
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP — Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL , 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page <Q
of 2

Pretreatment Annual Report (PAR) Control Authority, Industry
Industrial Data Summary Form (IDSF) Town Name => City of Hickory Name Century Furniture
Use separate forms for each industry/pipe WWTP Name => Northeast ILJP # 34
Enter BDL values as < (value) NPDES # _> NC0020401 Pipe # 2
1st 6 months, dates => 1/1/2017 to 6/30/17
2nd 6 months, dates => 7/1/2017 to 12/31/17 BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maxnnum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
J
ow, mg
mmonia
st 6 months
)-ncl 0 mon ss
mon sn
months'
s mon s
n months
s mon s
n months
7
6
IR
5
v. o/o
s 0
sf11915S_�
G
a -00-z6
ZZO
i
'f_Z
u
d
l7 °c
Z
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o ° o
Arsenic
Uactinium
Chromium
st 6 months
I st 6 months
I st 6 months
2nd 6 months
I st 6 months
2nd 6 months
J
�
1
Not required
< o. o to
1<
a,00 i
p
o.01193
Not required
—.410,
""'Os-
©
o,, oeo3
D 103
U o I 2 c
N/A
iv
N/Ad%r
G
IVA
Copper
Uyanicle
Leaci
IVIercury
st months
n months
st mont s
n mont s
mm
stmont s
2nd 6 months
stmont s
2nd 6 months
r> Z o (
Not required
P, p 0 S—
®, 0
< v,.v !
Not required
CP, pdo'z.
Q
4 13o
a- vo;
0,00s-
.dao l
cp<y
N/A
v
O I
N/A
K)9
cf,
N/A
O "
N/A
BDL => Below Detection Limit mg/1 => milligrams per Mer
* POTW must enter at least one of these IUP => Industrial User Permit lb/d — pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Century Furniture
IUP # 34
Pipe # 2
IcKel
Selenium
Silver
Zinc
st 0 montlis
n mon s
I st 5 montlis
ME 0 month
2W 0 months
Zncl 6 months
Not required
c 0 z7 y
C e;,O/ 0
Not required
e (/. Ras-
, rf
v az)
0, 005
0,, 0 0S-
ov 00l
o v
N/A
—
N/A
N/A
N/A
`
Uil & Urease
pia
Phenolo
uene
st mon s
n mont s
st mont s
2nd 6 months
stmont s
2nd 6 mont sst
mont s
2nd 6 months
S'
7
1
3 sS'
7. y S.?'
Not required
0107
Not required
0,00-7
11'0
'f"
0.009
Q
0-/'
O7,
N/A
N/A
0
p'',;
N/A
N/A
'I'ota'I'otal Phosphorus
otal IN i rogen
st months
n months
st mont s
n mont s
stmont s
2nd 6 months
stmont s
2nd 6 months
Z
Z
Z
Z
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page O` of 2

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name => City of Hickory
Name Kleen Tech, Inc.
Use separate forms for each industry/pipe
WWTP Name =>
Henry Fork Plant
IUP # 35
Enter BDL values as < (value)
NPDES # =>
NCO040797
Pipe # 1
2nd 0 months
1st 6 months, dates =>
1/1/2017 to 6/30/17
7
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det.
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations,(chromc SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
ow, mg
mmonia
st 0 months
ncl 0 montlir
st 0 months
2ncl 0 months
I st 6 months
Zncl 6 months
TsTMoTTs
2nd 0 months
$
7
G
r
Oros -00
I
o
> F�
4.r72G6
i
s 1SQL9
f72)7
I.y3
0
Arsenic
Cadmium
Uhromium
st 6 months
I st 6 months
I st 6 months
n mont s
st mont s
2nd 6 months
S
S
i
L U,OI b
<a -a10
CO.oO
O"lly
Notre utred
0 aaoelat
O
v a®s'DM09
0, u a o:;-
O.CQ17
0, oZ
o Oaoc
Q9,
a
07"
Im
L 91Y
OY
—::
O /
S&11
4%
iv
opper
Cyanicle
Lead
NJLercury
st 6 months
2nd 6 mont sst
mont s
2nd 6 mont s
T77 mont s
2nd 6 months
st 7 mont s
2nd 6 months
S
s
3
i
O. o 3y
0,
01011
Not required
Ca~11100'
G�_ O
O.0 /
01 00 61
0-1400i
f :)/D
OX
`
2.7
O`r
N/A
o`��
c
/ i %
n
N/A
BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name Kleen Tech, Inc
IUP # 35
Pipe # 1
>ca
i ver
inc
st
n
months
s
nmonssfts
s
n months
5
1
D.
�c
,, OZ5
0_ $D
Not required
61, 0O5
3, 3
1
0,0110
0. E`60
a,00t"'
1,sf7
I,0
N/A
) 7%
N/A
Oil
& Urease
PH
Fhenolo
uene
st 6
months nd
6 months
2nd 6 months
I st 6 months
2nd 6 months
st mont s
2nd 6 months
s
SIS'
r I(0,
S_
0, 0,;"/
Cd,ds
g2
61W V7
a ao!
1!�
0`
afjb
��/{-'
7���
months
Uhloride
'.L'otal rhosphorus
st 6
months 2nd
6 mont s
stmont s
n months
st mont s
n months
st mont s
n months
I
U� v3o
Not required
/Z tj
4
Z
DT5U.vIGI
I Z-S�
--
_
N/A
—'
—
--
-
-'
_
N/A
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 3

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
*
Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Kleen Tech, Inc
IUP # 35
Pipe # 1
Molybdenum Selenium Total Nitrogen
1 st 6 months 2nd 6 months 1 st 6 months 2nd 6 months 1 st 6 months 2nd 6 months 1 st 6 months 2nd 6 months
i7,Z
7, L
1st 6 months 2nd 6 months 1st 6 months 2nd 6 months 1st 6 months 2nd 6 months 1 st 6 months 2nd 6 months
1 st 6 months 2nd 6 months 1 st 6 months 2nd 6 months 1 st 6 months 2nd 6 months 1 st 6 months 2nd 6 months
Not required
N/A
N/A
BDL => Below Detection Limit mg/1=> milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Lhi _-� n- � -)

Pretreatment Annual Report (PAR)
Control Authority,
likili
Industry
Industrial Data Summary Form (IDSF)
Town Name=> City of Hickory
Name Longview Yarns
Use separate forms for each industry/pipe
WWTP Name =>
Henry Fork
IUP # 46
Enter BDL values as < (value)
NPDES # _>
NCO0407979
Pipe # 1
2nd 6 mon s
1st 6 months, dates =>
1/1/2017 to 6/30/17
S_
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, MgC1
likili
I k13 k15
AnInionia
st 6 montlis
Zrict 6 months -'77=7777
Tricl o mon ss
mon s
277 (1 months
TsT 7777Ms
2nd 6 mon s
S_
�-
s
Q, D 13 3110
90
26o
$
3 v
Q
MD
My,
0
OXO'
an 9L,
07",
Arsenic
Uactinium
Uhromium
st 6 months
nmont s
Ist 6 months'
I st 6 months
n mont s
st mont s
2nd 6 months
I
S
I
1
Not required
u, u) D
Z , (X} D
C v, 00 le
Not required
< 0_ o C;
Notre uired
C,UUa�U>
a,Uas
0 UOC?
o ov Lr
0?75'
N/A
/
N/A
iv
N/A
v
N/A
�v
opper
Uyanicle
Leaci
IVIercury
st 6 months
2nd 6 mont sst
mont s
2nd 6 months
st mont s
2nd. 6 months
stmont s
2nd 6 months
S,
►
s
Q
o,, zo
Not required
G 0 a US-
L io ,
f v_O /
Not required
C c, v o o Z
N/A
o%
N/A
p%
N/A
P/
N/A
BDL => Below Detection Limit mg/I => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 3

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo. Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Longview Yarns
IUP # 46
Pipe # 1
IiNICKCI
belenium
Silver
LARC
ist o months
I st 0 months
2nci
6 months
I s months
n mon s
s mon s
2ncl. 6 months
I
i
Not required
< 0"70s,
Not required
<Q, oos'
©
0-620
0.00 S'
0
N/A
N/A
An 9 •
207'
N/A
N/A
01
zou
Oil & Urease
P11
Uolor Units
Uhloricle
st mont s
n mont s
st mont s
n
mont s
st mont s
2nd 6 mont sst
mont s
2nd 6 months
.. 1
4 6) .9
d o , /)
Not required
I Sl i
3�3y
o,l
I slz
Go
'
"
o "
—
—
N/A
Oyn
"/,,
I Ok
C/ %
—
—
N/A
lbtal 11hosphorus
" r f=
st 6 months
2nd 6 mont sst
mont s
2nd
6 months
st mont s
2nd 6 months
I st 6 months
I ZnZLmonths
St -
2
Z
0
7.3
o '
n
?':t
0,5
01
BDL => Below Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page GR of 2

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name => City of Hickory
Name City ofHickoryNeolia W.
Use separate forms for each industry/pipe
WWTP Name =>
NPDES # _>
Henry Fork
IUP # 50
Pipe # 1
NC0040797
Enter BDL values as < (value)
1st 6 months, dates =>
1/1/2017 to 6/30/17
n mon ss
mon s
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chromc SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
li ow, mg
mmonia
s mon s
n mon s
s mon s
n mon s
s
mon s
n mon ss
mon s
2ncl 0 months
0. DWI
0.21,7 s
30 a
0z)p
so V
a,. v
I Y1
lot
41 QZ
O
QYDr7l
Q/,
0�i.
�`,
c�
Olze
Arsenic
Uactinium
Uhromium
st 6 months
2nd 6 months
I st 6 mont sn
mont s
I st
6 months
2nd 6 months'
I st 6 months
2nd 6 months
I
I
Z,
1
Not required
< U, vl0
< 61,00 1
L
<d, pa_;
Not required
003
,
o, aaes
0.
MG5.
d, 00 Z
o.00G+i�ei -
N/A
—
—
IvA
N/A
—
r
—
IVA
opper
Uyanide
Lead
lViercury
st 6 months
2nd 6 mont sst
mont s
2nd 6 months
777
mont s
2nd 6 months
stmont s
2nd 6 months
1
I
r
a a/
Not required
0,o15-
4
<a,jos-
Notre uired
<o, oo0l
67.011f
vIa0;
o,aorr
0 /
N/A
—
—
N/A
BDL => Below Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IU? => Industrial User Permit lb/d — pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Industry Name City of HickoryNeolia W.
IUP # 50
Pipe # 1
IN ICKCI
e enium
Silver Zinc
s months
n monthis s months
n months s months n mon s s months
n mon s
2nd 6 months I st 6 months
lst 6 months
2nd 6 months
Not required C a- 0176,
'3'3 2
7, o /
o, o I
o o b 3
--
N/A71
0;/"
N/A 1991
oil & Grease
pli units
U111oricle
st 6 months - 2nd
6 months 1st 6 months
2nd 6 months I st 6 months
lst 6 months
2nd 6 months
'3'3 2
7, o /
Not required
ZSg
O /
N/A
I OA
(I % r-
—
3"
N/A
'Yotal 11hosphorus
st 6 months 2nd
6 mont sst mont s
2nd 6 months 777 mont s
2nd6months
stmont s
2nd 6 months
I
Not required
77 o
0
BDL => Below Detection Limit mg/1 => milligrams per Mer
* POTW must enter at least one of these lUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page C` of 2

Pretreatment Annual Report (PAR)
Control Authority,
Industry
Industrial Data Summary Form (IDSF)
Town Name=> City of Hickory
Name Maple Springs Laundry 2
Use separate forms for each Industry/pipe
WWTP Name =>
Henry Fork Plant
NP # 51
Enter BDL values as < (value)
NPDES # _>
NC0040797
Pipe # 1
mon s
1st 6 months, dates =>
1/1/2017 to 6/30/17
S
2nd 6 months, dates =>
7/1/2017 to 12/31/17
BDL = 1/2 det
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo. Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or 6 mo Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
ow, mg
mmonia
s months
n months
sm
monssmo
nmons17777=77
mon s
S
S
ILZ
(0
0
o 113-
0-0,110
11`9
ato
13-`
o,y/
0
Q
x
Arsenic
Uadmium
Uhromium
st 6 months
I st 6 months
list r61 monthns
2nd 6 months
st mont s
2nd 6 months
Not required
'C� u , a90
Not required
< u,. d6' /
Not required
< u, ✓0j'
Not required
v, voVO i 38
U,00_.-
O o0cl
c oOZS
1
'/)S
N/A
N/A
N/A
I..
N/A
N/A
N/A
N
opper
Uyamde
Lead
Niercury
st 6 months
2nd 6 months
stmont s
2nd 6 months
I st mont s
2nd 6 months
stmont s
2nd 6 months
0"Oily
d, ojo
Not required
Ga,oael
Notrequired
C U, gooz-
O,rJi0i
d,tici
,900
d, 0,900s -
Z2
D°u
N/A
N/A
+"d
'2�1'
1
N/A
N/A
BDL => Below Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Non -Compliance mgd — million gallons per day
Avg period could be month, Qtr, or 6 -month & if BDL, 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page I of 2

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maxunum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or 6 mo Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name Maple Springs Laundry 2
IUP # 51
Pipe # 1
IcKel Selenium Sliver
741ne
s mon s n mon s T777777777=7 77-77777=7 1 st o months
2nd 6 months
j
l
s
Not required C v, vis Not required
C o, aor
o d0 u
U. 00 zri
O_7 N 2
N/A
N/A
0 ° c
N/A
N/A Q1
0 °v
BDL => Below Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2
• V.iiTi[.1iT.Tifii�r�3ii
..TAT•Tiia.��f/.iT[..TiT.Tifai�f�3'i[..?"'iT.4'iilii�7V.iT6'iiL•Tifli�7fR�..'iiT•Tfai�f►�L:G'TiT.SifBi�
��[.rrr��r►�rrrrsr��
t�.rrrs�rs;r��
u�rr:rrrr��r�.rrrr���.rrrs�rm�
BDL => Below Detection Limit mg/l => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month Qtr, or 6 -month & if BDL 1/2BDL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatment plant
Comprehensive Guide, Chapter 9, section B, pages 12, 13, 14 Blank IDSF Form, Copy and use in your PAR Number each set for each IUP pipe - Page a of 2

Workbook Name: HWAATDesign Junejuiy Resubmission, Worksheet Name: AT Printed 1/30/201_, _ 13 AM
Page 1 of 4
Allocation Table
Headworks last approved 07/08/13
Allocation Table updated 11/29/17
Permits last modified 11/27/17
Henry Fork WWTP
NCO040797
Spreadsheet Instructions
1) Applicable Values should be entered in the Heavy Bordered cells Rest of worksheet Is protected, password is "2"
2) Formulas are discussed In the Comprehensive Guidance, Chapter 6, Section C
3) HWA and AT worksheets In this workbook are linked Pollutant Names, MAHLs, Basis, and Uncontrollable load in
this AT worksheet are automatically entered from the HWA spreadsheet This includes pollutant names in columns
AT through BK
IUP
Count
INDUSTRY NAMES
(piens IM.1phaba,dy)
Industry
Permit
number
Pipe
number
Type
of
Industry
Renewal
Effective
Date
Modification Date
Effective Permit
Date Expires
Permit Limits
MGD al/da
Permit Limits
Cone Load
ma/1 lbs/da
Permit Limits
Cone Load
mg/1 lbs/da
I
Catawba Medical Center
0003
0001
460
07/08/16
07/07/21
01800
180,000
384001
57646
25000
37530
2
Maple Springs Laun
0015
0001
0 4500
07/08/16
07/07/21
02000
200,000
200 00
33360
10000
16680
3
Sock Factory
0017
0001
410
07/08/16
07/07/21
00800
80,000
250001
16680
25000
16680
4
Ward Hosiery
0027
0001
410
07/08/16
07/07/21
00800
80,000
400001
26688
25000
16680
5
Hickory Springs
0033
0001
07/08/16
07/07/21
00200
20,000
350001
5838
30000
5004
6
Kleen Tech
0035
0001
07/08/16
07/07/21
01100
110,000
500001
45870
350 00
321 09
7
Lon View Yarn
0046
0001
07/08/16
07/07/21
00400
40,000
35000
116.76
150 00
5004
8
Regional Compost Facility
0050
0001
03/01/16
02/28/21
0 2250
225,000
100000
187650
800 00
1501 20
9
Maple Springs Laundry- 2
0051
0001
05/05/16
05/04/21
02000
200,000 2000000
33360 100 0000
166 80
Column Totals =>
1 1350
1,135,000
4188
2965
Basis=>
MAHL from HWA (lbs/day) => NPDES Permitted Flow—
Uncontrollable Loading (lbs/day) =>
Total Allowable for Industry (MAIL) (lbs/day) _>
Total Permitted to Industry (lbs/day) _>
MAIL left (lbs/day) =>
Percent Allow Ind (MAIL) still available (%) =>
Percent MAHL still available (%) =>
5 Percent MAHL (lbs/dav) =>
NPDES
Design
Design
90000
19140
17039
18600
4095
3878
71400
15045
13161
1 1350
4188
2965
60050
10857
10196
841 %
72 2 %
77 5
66 7 %
56 7 %
598%
0 4500
957
852
HWA AT
Revised November 2005

Workbook Name: HWAATDesign June-july Resubmission, Worksheet Name: AT Printed 1/30/201 13 AM
Page 2 of 4
Allocation Table
Headworks last approved 07/08/13
Allocation Table updated 11/29/17
Permits last modified 11/27/17
Po-rw=> I Henry Fork WWTP
NPDESik> NC0040797
HWA AT
Revised November 2005
Industry
Permit Limits
Permit Limits
Permit Limits
Permit Limits
Permit Limits
IUP
INDUSTRY NAMES Permit
Pipe
Cone
Load
Cone. Load
Cone
Load
Cone
Load
Cone
Load
Count (pl—Imt°Iphabd,dy) number
number
mg/1
lbs/da
mg/1 lbs/da
m l
lbs/da
m /l
lbs/da
m l
lbs/da
1
Catawba Medical Center 0003
0001
2500
3753
0 35001
05254
2
Maple Springs Laun 0015
0001
1600
2669
02000
0333
3
Sock Factory 0017
0001
1600
1068
00150
00100
0 1500
01001
08000
05338
4
Ward Hosiery 0027
0001
1600
1068
00200
00133
01000
00667
09000
06005
5
Hickory Springs 0033
0001
7500
1251
00100
00017
02500
00417
6
Kleen Tech 0035
0001 1
1600
1468
005001 00459
00250
00229
02500
02294
05000
04587
7
Long View Yarn 0046
0001
1600
534
00150
00050
08000
02669
8
Regional Compost Facility 0050
0001
30000
56295
03200
06005
9
Maple Springs Laund - 2 0051
0001
160000
2669
02000
03336
Column Totals =>
708
00459
00530
03962
36946
Class A, Mon
Class A, Mon
AS/Nit/TF
Class A, Mon
Basis=>
Design
Avg
Avg
inhibition
Avg
MAHL from HWA (lbs/day) =>
157626
05533
03535
8 1435
102357
Uncontrollable Loading (lbs/day) =>
38781
00388
00310
00388
09463
Total Allowable for Industry (MAIL) (lbs/day) =>
118845
05146
03225
8 1047
92895
Total Permitted to Industry (lbs/day) =>
70773
00459
00530
03962
3 6946
MAIL left (lbs/day) =>
48072
04687
02695
77085,
55948
Percent Allow Ind (MAIL) still available (%) =>
404%
91 1 %
836%
951 %
602%
Percent MAHL still available (%) =>
305 %
847%
76 2 %
947%
547%
5 Percent MAHL (lbs/dav) =>
78 81
0 0277
0 0177
04072
05118
HWA AT
Revised November 2005

Workbook Name : HWAATDesign June..u.y Resubmission, Worksheet Name: AT Printed 1/30/201 13 AM
Page 3 of 4
Allocation Table
Industry
Permit
number I
0003
Headworks last approved
07/08/13
Allocation Table updated
11/29/17
Permits last modified
11/27/17
PoTw Henry Fork WWTP
NPDESC— NC0040797
IUP
Count
1
2
3
4
5
6
7
8
9
INDUSTRY NAMES
(please list alphabehcly)
Catawba Medical Center
Industry
Permit
number I
0003
Pipe
number
0001
Cyanide
Permit Limits
Conc Load
mg/1 lbs/da
Lead
Permit Limits
Conc Load
m /l lbs/da
Mercury
Permit Limits
Conc Load
mg/1 lbs/da
Molybdenum
Permit Limits
Conc Load
mg/1 lbs/day
Nickel
Permit Limits
Conc Load
mgjI lbs/da
Maple Springs Laun
0015
0001
00350 00584
00771
0 1568
13694
5 8357
Sock Factory
0017
0001
00300 00200
00969
03037
Ward Hosiery
0027
0001
0 1000 00667
00080 00053
00600 00400
Hickory Springs
0033
0001
0 1500 00250
Kleen Tech
0035 1
0001 1
00250 00229
00600 00550
0 1000 00917
Loniz View Yam
0046
0001
00500 00167
Regional Compost Facility
Maple Springs Laund - 2
0050
0051 1
0001
0001 1
00350 00584
Column Totals =>
0226
00771
0000000
000001
0 1568
Basis=>
MAHL from HWA (lbs/day) _>
Uncontrollable Loading (lbs/day) =>
Total Allowable for Industry (MAIL) (lbs/day) =>
Total Permitted to Industry (lbs/day) =>
MAIL left (lbs/day) =>
Percent Allow Ind (MAIL) still available (%) =>
Percent MAHL still available (%) =>
5 Percent MAHL (lbs/day) =>
NPDES
09201
03258
05943
02264
03679
61 9 %
40 0 %
0 0460
Class A, Mon
Avg
NPDES
0033277
0003413
0029864
0000000
0029864
10000/(
89 7 %
0 001664
Sludge
Ceding
10352
02110
08242
00000
08242
10000/c
79 6 %
0 0518
Sludge Ceiling
19383
60732
04917
00807
14465
59925
00771
0 1568
13694
5 8357
947%
974%
707%
961 %
00969
03037
HWA AT
Revised November 2005

Workbook Name: HWAATDesign June...y Resubmission, Worksheet Name: AT Printed 1/30/201E 13 AM
Page 4 of 4
Allocation Table
Headworks last approved 07/08/13
Allocation Table updated 11/29/17
Permits last modified 11/27/17
NCO040797
HWA AT
Revised November 2005
Industry
Permit Limits
Permit Limits
Permit Limits
IUP
INDUSTRY NAMES Permit
Pipe
Conc Load
Conc. Load
Conc
Load
Count
(pl...hstelphabd,.1y) number
number
m /1 lbs/da
MR/1 lbs/day
m /I
lbs/da
1
Catawba Medical Center 0003
0001 1
04500
06755
2
Maple Springs Laund 0015
0001
06500
10842
3
Sock Factory 0017
0001
050001 03336
06500
04337
4
Ward Hosiery 0027
0001
1-5oobl 10008
10000
06672
5
Hickory Springs 0033
0001
08000
0 1334
6
Kleen Tech 0035
0001
08000
07339
7
Long View Yam 0046
0001
03500
01168
8
Regional Compost Facility 0050
0001
9000
16889
9
Maple Springs Laundry- 2 0051
0001
E0
0 6500
10842
Column Totals =>
0 0000
1.3344
66178
AS/Nlt/TF
Class A,
Basis=>
Sludge Ceiling
mhibdion
Mon Avg
MAHL from HWA (lbs/day) _>
12146
86433
21 8012
Uncontrollable Loading (lbs/day) =>
00807
00776
30699
Total Allowable for Industry (MAIL) (lbs/day) =>
1 1340
85657
187313
Total Permitted to Industry (lbs/day) _>
00000
13344
66178
MAIL left (lbs/day) =>
1 1340
72313
12 1135
Percent Allow Ind (MAIL) still available (%) =>
1000 %
844%
64 7
Percent MAHL still available (%) =>
934%
5 Percent MAHL (lbs/day) =>
00607
0 4322
1 0901
HWA AT
Revised November 2005

Allocation Table
Industry
Headworks last approved
12/01/14
Allocation Table updated
L22LO1/16
Permits last modified
1 09/01/16
Workbook Name: Revised NorUiwast HWA, Worksheet Name: AT
Spreadsheet Instructions
1) Applicable Values should be entered in the Heavy Bordered cells Rest of worksheet is protected, password is "2"
2) Formulas are discussed in the Comprehensive Guidance, Chapter 6, Section C
3) HWA and ATworksheets in this workbook are linked Pollutant Names, MAHLs, Basis, and Uncontrollable load in
this AT worksheet are automatically entered from the HWA spreadsheet This includes pollutant names in columns
AT through BK
HWA AT
Revised November 2005
FLOW
Industry
TSS
Type
Renewal
Modification
Date
IUP
INDUSTRY NAMES Permit
Pipe
of
Effective
Effective
Permit
Count
(al— h,1.1pb"bmdr) number
number
Industry
Date
Date
Expires
1
Century One 0034
0001
40000
07/08/14
09/01/16
07/07/19
2
Century Two 0034
0002
125 10
07/08/14
95,000
07/07/19
3
Frye Medical Center One 0007
0001
00950
07/08/14
50000
07/07/19
4
Frye Medical Center Two 0007
0002
80,000
07/08/14
333 60
07/07/19
5
Hickory Dyeing & Winding 0008
0001
35000
07/08/14
25000
07/07/19
6
HK Research 0011
0001
625501
07/08/14
10425
07/07/19
7
Shurta a 0022
0001
07/08/14
1
07/07/19
Column Totals =>
Design
60000
13261
Basis=>
16013
28173
5437
MAHL from HWA (lbs/day) _>
3 1827
NPDES Permitted Flow=
Uncontrollable Loading (lbs/day) _>
03670
1944
Total Allowable for Industry (MAIL) (lbs/day) _>
28157
5880
11027
Total Permitted to Industry (lbs/day) _>
752%
929%
469%
MAIL left (lbs/day) _>
443%
689%
0 3000
Percent Allow Ind (MAIL) still available (%) _>
663
1
801
Percent MAHL still available (%) _>
5 Percent MAHL (lbs/dav) =>
HWA AT
Revised November 2005
FLOW
SOD
TSS
Permit Limits
Permit
Limits
Permit Limits
Cone
Load
Conc.
Load
MGD
al/da
MR/1
lbs/da
mg/1
lbs/da
00140
14,000
50000
5838
40000
4670
00300
30,000
50000
125 10
50000
125 10
00950
95,000
50000
396 15
25000
19809
00950
95,000
50000
39615
25000
19908
00800
80,000
50000
333 60
25000
16680
00030
3,000
35000
8761
25000
626
005001
50,000
1500 00
625501
250001
10425
036701
367,0001
1
1944
845
NPDES
Design
Design
60000
13261
16013
28173
5437
4140
3 1827
7824
11873
03670
1944
845
28157
5880
11027
885%
752%
929%
469%
443%
689%
0 3000
663
1
801
Printed 1/30/2( ) 21 AM
Page 1 of 4

POTW=
NPDES#
1UP
Count
1
2
3
4
5
6
7
Workbook Name: Revised NoluiCdst HWA, Worksheet Name: AT
Allocation Table
Headworks last approved r-1 270-1/14
Allocation Table updated 09/01/16
Permits last modified 09!01/16
Printed 1/30/20 21 AM
Page 2 of 4
NORTHEAST
NCO020401
INDUSTRYNAMES
(please lel a1phahe4a1y)
Industry
Permit
number
Pipe
number
Ammonia
Permit Limits
Conc Load
m I lbs/day
Arsenic
Permit Limits
Cone Load
mgjI lbs/day
Cadmium
Permit Limits
Cone Load
mgjI lbs/da
Chromium
Permit Limits
Cone Load
mg/1 lbs/da
Copper
Permit Limits
Cone Load
mg/1 lbs/da
Cyanide
Permit Limits
Cone Load
mg/1 lbs/da
Century One
0034
0001
5000
584
MAHL from HWA (lbs/day) _>
0 00701 0 0008
05243
03000 0 0350
26 1125
CenturyTwo
0034
0002
1600
400
00117
0 0070 0 0018
0 0300 0 0075
0 3000 0 0751
Total Allowable for Industry (MAIL) (lbs/day) =>
Frye Medical Center One
0007
0001
1600
1268
1 1960
Total Permitted to Industry (lbs/day) =>
7068
02000 0 1585
00026
Frye Medical Center Two
0007
0002
2500
1981
04139
03207
247119
02000 0 1585
1 1960
Hicko Dein & Windin
0008
0001
2500
1668
919%
100 0 °/
2 0000 1 3344
03000 0 2002
1 789%1
HK Research
0011
0001
5000
1251
62670
1 00262
1 00167
03000 0 0075
0 4641
Shurta a
0022
0001
25001
1043
Column Totals =>
71
00000
00026
13419
0 6347
0 0000
HWA AT
Revised November 2005
AS/Nlt/rF
Class A,
Class A,
AS/Nit/TF
Class A,
Basis=>
inhibition
Mon Avg
Mon Avg
inhibition
Mon Avg
NPDES
MAHL from HWA (lbs/day) _>
1253402
05243
03350
26 1125
92816
14639
Uncontrollable Loading Obs/day) =>
60056
01104
00117
00587
14450
02679
Total Allowable for Industry (MAIL) (lbs/day) =>
1193345
04139
03232
260538
7 8366
1 1960
Total Permitted to Industry (lbs/day) =>
7068
00000
00026
13419
06347
00000
MAIL left (lbs/day) =>
1186277
04139
03207
247119
72019
1 1960
Percent Allow Ind (MAIL) still available (%) =>
1 99 4 % 1
1000%
992%
1 94 8 % 1
919%
100 0 °/
Percent MAHL still available (%) _>
946%
1 789%1
1 957%1
946%
5 Percent MARL (lbs/dav) =>
62670
1 00262
1 00167
1 3056
0 4641
0 0732
HWA AT
Revised November 2005

POTW=
NPDES#=
1UP
Count
1
2
3
4
5
6
7
Workbook Name: Revised Nor.,.`dst HWA, Worksheet Name: AT
Allocation Table
Industry
Permit
number
Headworks last approved
r 12/01/14
Allocation Table updated
09/01/16
Permits last modified
1 09/01/16
Silver
Permit Limits
Conc Load
mg1I lbs/da
Printed 1/30/20 21 AM
Page 3 of 4
NORTHEAST
NCO020401
INDUSTRY NAMES
(Pl— I'M °Iphn d,dy)
Industry
Permit
number
Pipe
number
Lead
Permit Limits
Cone Load
m 1 lbs/da
Mercury
Permit Limits
Cone Load
mg/1 lbs/da
Molybdenum
Permit Limits
Cone Load
mg/1 lbs/da
Nickel
Permit Limits
Conc Load
mg/1 lbs/da
Selenium
Permit Limits
Conc Load
m 1 lbs/day
Silver
Permit Limits
Conc Load
mg1I lbs/da
Century One
0034
0001
00500 00058
0099825
13079
57546
1 1509
65281
Century Two
0034
0002
00500 00125
0 1175
00587
16919
0095830
12491
Frye Medical Center One
0007
0001
00542
0000000
00000
00000
00000
00792
Frye Medical Center Two
0007
0002
5 6959
1 0334
63902
968%
1000%
0 1000 00792
Hickory Dyeing & Winding
0008
0001
0 0500 00334
960%
955%
990%
898%
979%
HK Research
0011
0001
0 1000 00025
0 0575
0 3264
Shurta a
0022 1
0001
Column Totals
1 005421
0000000
00000
00000
1 00000
1 00792
Basis=>
MAHL from HWA (lbs/day) =>
Uncontrollable Loading (lbs/day) =>
Total Allowable for Industry (MAIL) (lbs/day) =>
Total Permitted to Industry (lbs/day) =>
MAIL left (lbs/day) =>
Percent Allow Ind (MAIL) still available (%) =>
Percent MAHL still available (%) =>
5 Percent MAHL (lbs/dav) =>
HWA AT
Revised November 2005
Class A,
Class A,
Sludge
Sludge
Sludge
AS/NitrFF
Mon Avg
Mon Avg
Ceiling
Ceding
Ceding
inhibition
1 8563
0099825
13079
57546
1 1509
65281
01645
0003994
00587
00587
0 1175
00587
16919
0095830
12491
56959
10334
64694
00542
0000000
00000
00000
00000
00792
16376
0095930
12491
5 6959
1 0334
63902
968%
1000%
1000%
1000%
1000%
988%
882%
960%
955%
990%
898%
979%
0 0928
0004991
00654
02877
0 0575
0 3264

8
Allocation Table
Headworks last approved 12/01/14
Allocation Table updated 1 09/01/16
Permits last modified 1 09/01/16
Powv=> NORTHEAST
NPDES#=> NC0020401
IUP
Count
1
2
3
4
5
6
7
Workbook Name: Revised Nort..__st HWA, Worksheet Name: AT
Printed 1/30/201 N AM
Page 4 of 4
INDUSTRY NAMES
(plus, list,lphahetidy)
Century One
Industry
Penrut
number
0034
Pipe
number
0001
Zinc
Permit Limits
Cone Load
mg/1 lbs/day
070001 00817
Toluene
Permit Limits
Cone Load
mpjj lbs/da
Phenol
Permit Limits
Cone Load
mg/1 lbs/da
Oil & Grease
Permit Limits
Cone Load
_M911 lbs/da
1000000 1167 0
Total Nitrogen
Permit Limits
Cone Load
mg/1 lbs/da
Total Phos.
Permit Limits
Cone Load
m l lbs/da
Century Two
0034
0002
07000 0 1751
7839600
539259
1000000 250200
994%
#VALUE'
Frye Medical Center One
0007
0001
05500 04358
01000 00792
2500000 1980750
Frye Medical Center Two
0007
0002
07000 05546
01000 00792
2500000 1980750
Hickory Dyeing & Winding
0008
0001
07500 05004
4600000 3069120
HK Research
0011
0001
07000 00175
1000000 25020
Shurta a
1 0022
0001 1
0 8500 03545
07500 03128
10000 04170
10000001 417000
Column Totals =>
1
1 21196
031281
05755,
783 9600
0001
000
Class A,
Basis=> Mon Avg
MAHL from HWA (lbs/day) => 21 1316
Uncontrollable Loading (lbs/day) => 87641
Total Allowable for Industry (MAIL) (lbs/day) => 123675
Total Permitted to Industry (lbs/day) => 21196
MAIL left (lbs/day) => 102479
Percent Allow Ind (MAIL) still available (%) => 1 82 9 %
Percent MAHL still available (%) => 485%
5 Percent MAHL Obs/day) => 10566
Stream Std
Stream Std
1048 1128
04887
1047 6241
05755
1047 0486
1 99 90101
999%
1 524056
Design
35028
#VALUE'
000 000
#VALUE'
#VALUE' #VALUE'
#VALUE' #VALUE'
17 5140
549011
06626
542386
03128
7839600
539259
994%
#VALUE'
982%1
#VALUE'
r 274511
HWA AT
Revised November 2005

Hickory Daily Record
Advertising Affidavit
PO Box 968
Hickory, NC 28603
HICKORY, CITY OF
ATTN:ACCOUNTS PAYABLE
PO BOX 398
HICKORY, NC 28603
Account Number
3175407
Date
February 07, 2018
Received
l=CE3 13 ?018
Public utilities
Date Category Description Ad Number Ad Size
02/07/2018 Legal Notices Public Notice January December 2017 According to Federal F 0000433057 2 x 22 L
HICKORY
Public Notice
January - December 2017
According to Federal Regulations 40 CFR Part 403 and NC Statute 15
NCAC 2H.0900, the Industry listed below was in SNC violation of their per-
mit to discharge wastewater under the city of Hickory Industrial Pretreat-
ment Program.
July -December 2017
Henry Fork Plant
Kleen Tech Inc. - Oil and Grease
Publish: February 6 and February 7, 2018
Publisher of
Hickory Daily Record
Catawba County
�rtae l l
Before the undersigned, a Notary Public of Gatawba County, North Carolina, duly
commissioned, qualified, and authorized by law to administer oaths, in said
County and State, that he/she is authorized to make this affidavit and swom
statement; that the notice or other legal advertisement, a copy of which is attached
hereto, was published in the Hickory Daily Record on the following dates:
02106, 0 2/0 712 0 1 8
and that the said newspaper in which such notice, or legal advertisement was
published, was a newspaper meeting all the requirements and qualifications of
Section 1-597 of the General Statutes of North Carolina.
Assrstant ookkeeper
Nessspaper reference: 0000433057
Sworn to and subscribed before me, this day of 2018
, 01111111111/111/
ArotaryPublic
1 No/pry pObllc
Irecyell Coutaly
My Commission expires- `d-7. area, .2 Z
T1— i ZZ
O�
�/ y CA R O� ��P \\\\•
THIS IS NOT A BILL. PLEASE PAY FROM INVOICE. THANK YOU �ttrtMIIIllt410

P f FujimSaivIceAnamdoet& Laboratory Report
1 S M I Environental Solutions 04!07/2017
umnnmx�s
(leen-Tech, Inc
Project Wastewater (Yearly with
'Client Sample ID: Hildebran Flume
ug/L 10 1.5 1 *625 3128117 2:12 JMV P7C0424
Attn: Tim Glenn
TTO)
Prism Sample ID: 7030364-01
©, o9q
P.O. Box 1369
Project No.: IUP #0035
Prism Work Order. 7030364
yv�
Hickory, NC 28603
Sample Matrix' Water
Time Collected: 03/21/17 14:00
1
*SM4500-CN E
3127117 15:00
Time Submitted: 03122/17 1 3.01
P7C0426
Oil 3 Grease (HENq
140
mg1L
Batch
Parameter
Result Units Report ' MDL
Dilution Method Analysis Analyst
413117 10.41
Limit
Factor Date/Time
ID
General Chemistry Parameters
1,2,4-Trichlorobenzene BRL
ug/L 10 1.5 1 *625 3128117 2:12 JMV P7C0424
1,2-Dirhlorobanzene BRL
ug/L 10 1.4- 1 `625 $/28117 2:12 JMV P7C0424
1,3-Dirhtorobenzene BRL
ug/L 10 -1.3 1 •625 312817 2-12 JMV P7C0424
Cyanide
BRL
mg1L
00050
0.0010
1
*SM4500-CN E
3127117 15:00
EGC
P7C0426
Oil 3 Grease (HENq
140
mg1L
5.0
1.0
1
'16643
413117 10.41
TJY
P71)0019
Organochlorine Pesficides by GCIECD
alpha -BHC
BRL
ug/L
0.050
00099
1
*608
413117 14'41
JMC
P7C0447
beta -BHC
BRL
ug/L
0.050
0 016
1
*608
413117 14-41
JMC
PX0447
gamma -BHC
BRL
ug/L
0 050
0 013
1
*608
413117 14:41
JMC
P7C0447
delta -BHC
BRL
ug/L
0.050
0,014
1
*608
413117 14:41
JMC
F7C044T
Heptachlor
BRL
ug/L
0.050
0 017
1
*608
413117 14:41
JMC
F7C044T
Aldrin
BRL
ug/L
0 050
0.015
1
*606
413/17 14.41
JMC
P7CO447
Heptachlor Epoxide
BRL
ug/L
0 050
0 013
1
*608
413/17 14:41
JMC
P7C0447
trans -Chlordane
BRL
ug/L
0 050
0.025
1
*608
4/3/17 14.41
JMC
P7C0447
Endosulfan I
BRL
ug/L
0 05D
0 019
1
1606
413/17 14:41
JMC
P7C0447
cis -Chlordane
BRL
uglL
0,050
0 041
1
*60B
413/17 1441
JMC
P7C0447
Dieldrin
BRL
ug1L
0.050
0.014
1
'608
41311714.41
JMC
P7CD447
4,4' -DDE
BRL
ug/L
0 050
0.011
1
*608
4/3117 14AI
JMC
P7C0447
ndrin
BRL
ug/L
0 050
0-015
1
*606
413/17 14:41
JMC
P7C0447
ndosulfan II
BRLA
ug/L
0 D50
0 D16
1
*605
413117 14:41
JMC
P7C0447
4,4' --DDD
BRLA
ug/L
0.050
0.020
1
1608
41311714:41
JMC
P7C0447
Endrin Aldehyde
BRLA
ug/L
0.050
0.029
1
*608
413117 14 41
JMC
P7C0447
Endosulfan Sulfate i
BRLA
ug/L
0 05D
0 016
1
*608
4/3117 14A1
JMC
P7C0447
4,4' -DDT
BRLA
ug/L
0.050
0.024
1
BOB'
41311714.41
JMC
P7Co447
Endrin Ketone
BRLA
ug/L
0.050
0.031
1
*608
413/17 1441
JMC
P7Co447
Methoxychlor
BRLA
ug/L
0.050
0.039
1
*608
41311714.41
JMC
P7C0447
Chlordane
BRL
ug/L
0,50
0.094
1.
*608
413/1714'41
JMC
P7C0447
Toxaphene
BRLA
ug/L
o 50 -
0.074
1
*608
413117 1441
JMC
P7C0447
Aroclor 1016
BRL
uglL
0.50
024
1
*BOB
413117 14.41
JMC
P7C0447
Aroclor 1221
BRL
ug/L
1 0
0.11
1
*608
41317 14AII
JMC
P7C0447
Aroclor 1232
BRL
ug1L
0,50
0.16
1
*608
413/17 14:41
JMC
P7C0447
Aroclor 1242
BRL
ug/L
050
014
1
*60B
413117 14.41
JMC
P7C0447
Aroclor 1248
BRL
ug/L
0-50
014
1
*608
413117 14.41
JMC
P7C0447
Aroclor 1254
BRL
ug/L
0.50
016
1
*608
4/3117 14:41
JMC
P7C0447
AroclDr 1280
BRLA
ug/L
0.50
D.30
1
*608
413/17 14.41
JMC
P7C0447
Surrogate Recovery Control Limits
Tetrachloro-m-xylene 50% 40.134
Decachlorobiphenyl 8% 13-155 SE
Semivolatile Organic Compounds by GCIMS
1,2,4-Trichlorobenzene BRL
ug/L 10 1.5 1 *625 3128117 2:12 JMV P7C0424
1,2-Dirhlorobanzene BRL
ug/L 10 1.4- 1 `625 $/28117 2:12 JMV P7C0424
1,3-Dirhtorobenzene BRL
ug/L 10 -1.3 1 •625 312817 2-12 JMV P7C0424
This report should not be reproduced, except In Its entirety, without the written consent of Prism Laboratories, Inc.
449 SpringbrookRoad - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number./ -8001529-5364 - Fax: [phone]-D409 Page 3 of 20

Laboratory Report
Full -Service Analytical IS V 1 Environmental Scltlons 84107120 1 7
ueenmoai�4 inc -
deen-Tech, Inc
Attn Tim Glenn
P 0. Box 1369
Hickory, NC 26603
Project. Wastewater (Yearly with
TTO)
Project No.: IUP #0035
Sample Matrix: Water
Client Sample ID Hildebran Flume
Prism Sample ID: 7030364-01
Prism Work Order. 7030364
Time Collected 03/21/17 14:00
Time Submitted. 03122/1713:01
Parameter
Result
Units
Report
MDL
Dilution
Method
Analysis Analyst
Batch
Limit
Factor
DatelTme
ID
1,4 -Dichlorobenzene
BRL
ug/L
10
1.4
i
*625
3/2B/17 212
JMV
P7C0424
1-Methyinaphthelene
BRL
ug/L
10
22
'1
*625
3128117 212
JMV
P7C0424
2,4,6 -Trichlorophenol
BRL
ug/L
10
1.9
1
*825
3126117 212
JMV
P7C0424
2,4-Dichlorophanol
BRL
ug/L
10
1.6
1
'625
3128117 212
JMV
P7C0424
2,4 -Dimethylphenol
BRL
ug/L
10
21
1
*625
3/28117 212
JMV
P7C0424
2,4-Drnitrophenol
BRL
ug/L
10
13
1
*625
3126117 212
JMV
P7C0424
2,4-Dinilrotoluene
BRL
ug/L
10
3.0
1
`625
3/28117 2.12
JMV
P7C0424
2,6-Dinilrotoluene
BRL
ug/L
10
3.0
1
*625
3/26117 212
JMV
PX0424
2-Chloranaphthalene
BRL
ug/L
10
24
1
*625
3/28117 212
JMV
P7C0424
2 -Chlorophenol
BRL
ug/L
10
1.1
1
*625
3/28117 212
JMV
P7C0424
2 -Methylnaphthalene
BRL
ug/L
10
1.9
1
*625
3126117 212
JMV
M0424
2-Nitrophenol
BRL
ug/L
10
1.4
1
*625
3/28/17 212
JMV
P700424
3,3`-Dichlorobenzidina
BRL
ug/L
10
2B
1
*625
3126117 2:12
JMV
P7C0424
314-Methylphenol
BRL
ug/L
10
1.2
1
*625
3128117 212
JMV
P7C0424
4,6-Dinitro-2-methylphenol
BRL
ug/L
10
1.9
1
*625
3/26117 212
JMV
F7C0424
4-Bromophenyl phenyl ether
BRL
ug/L
10
3.2
i
1625
3126117 212
JMV
F7C0424
4-Chloro-3-methylphenol
BRL
ug/L
10
-7-3
1
*625
3/28/17 212
JMV
P7C0424
-Chloroandme
BRL
ug/L
10
1.7
1
*625
3128117 212
JMV
P7C0424
4-Chlorophenyl phenyl ether
BRL
ug/L
10
23
1
*625
3/213/17 212
JMV
P7C0424
4-Nttrophenol
BRL
ug/L
51
1.7
1
`625
3126117 2.12
JMV
P7C0424
Acenaphthene
BRL
ug/L
10
7-3
i
*625
3128117 2:12
JMV
P7C0424
Acenaphthylene
BRL
ug/L
10
24
1
`625
3128117 2.12
JMV
P7C0424
Anthracene
BRL
uglL
10
3.2
1
`625
3128/17 2.12
JMV
P7C0424
Benzidine
BRL
ug/L
100
14
1
*625
3128/17 212
JMV
P7C0424
Benzo(a)anthracene
BRL
ug/L
10
3.2
1
`625
3128117 212
JMV
P7C0424
Benzo(a)pyrene
BRL
ug/L
10
37
1
*625
3128117 212
JMV
P7C0424
Benzo(b)fluoranthene
BRL
ug1L
10
3.6
1
*625
3/28117 2.12
JMV
P7130424
Benzo(g,h,Qperylene
BRL
ug/L
10
3.6
1
1625
3128117 2:12
JMV
P7C0424
Benzo(l)fluoranthene
BRL
ug/L
10
3.9
1
*625
3128117 2'12
JMV
P7C0424
BenzolcAcid
BRL
ug/L
100
0.76
1
'625
3128117 2:12
JMV
P7C0424
Benzyl alcohol
21
ug/L
10
1.7
1
*625
3/28/17 2.12
JMV
P7C0424
bis{2-Chloroelhoxy)methane
BRL
ug/L
10
1.6
1
*625
3128117 2"12
JMV
P7C0424
Bis(2-ChloroethyDether
BRL
ug/L
10
1.6
1
1325
3128117 212
JMV
P7C0424
Bis(2-chloroisopropyl)ether
BRL
ug/L
10
1.7
1
*625
3128117 2:12
JMV
P7C0424
Bis{2-Ethylhexyl)phthalate
46
ug/L
10
3.2
1
*625
3128/17 2:12 _
JMV
P7C0424
Butyl benzyl phthalate
BRL
ug/L
10
213
1
*625
328117 212
JMV
P7C0424
Chrysens
BRL
ug/L
10
3.4
1
*625
328(17 212
JMV
P7C0424
Dibenze(a,h)anthracene
BRL
ug/L
10
35
1
'625
3/28117 2:12
JMV
P7C0424
Dibenzoiuran
BRL
ug/L
10
23
1
*625
3128117 212
JMV
P7C0424
Diethyl phthalate
BRL
ug/L
10
23
1
625
328/17 2:12
JMV
P7C0424
Dimethyl phthalate
BRL
ug/L
10
1.6
1
`625
3128117 2:12
JMV
P7C0424
This report should not be reproduced, except in its entirety, Without the written consent of Pnsm Laboratories, Inc.
449SprmgbrookRoad -P-0 Box 240543- Charlotte, NC 28224-0543
Phone: [phone] -Toil Free Number..1-6001529-6364. Fax: [phone] Page 4 of 20

�il�l 1 � 1 FuIf-Service Analytical& _ Laboratory Report
rS I Environmental solutions 04/07/2017
ueaR5rm14$Ne
:leen-Tech, Ina Project Wastewater (Yearly with Client Sample ID: Hfldebran Flume
Attn: Tim Glenn TTO) Prism Sample ID. 7030364-01
P.O. Box 1369 Project NO.: IUP #0035 Prism Work Order. 7030364
Hickory, NC 28603 Sample Matrix: Water Time Collected. 03/21/1714 00
Time Submitted: 03/22/1713.01
Volatile Organic Compounds by GC/MS
1,1,1-Trichloraethana
BRL
Lull.
50
0.061
1
'624
411117 6-05
KDM
Parameter
Result
Units
Report - MDL
Dliutlon
Method
Analysis Analyst
Batch
4/1117 6.05
KDM
P700521
Limit
Factor
ugfL-
DateJTme
0.066
ID
Di -n -butyl phthalate
BRL
ug/L
10 34
1
`625
3/28117 2.12 - JMV
177130424
Di-n-octyl plhalate
BRL
ug/L
10 3.7
1
`625
3/2B117 2:12
JMV
P7C0424
Fluoranthene
BRL
ug1L
10 3.6
1
•625
3/28/17 2.12
JMV
P7C0424
Fluorene
BRL
ug/L
10 2.8
1
'625
3/28117 2:12
JMV
177130424
Hexachiorobenzene
BRL
ug/L
10 2.5
1
'625
3128117 2.12
JMV
P7C0424
Hexachlorobutadiene
BRL
ug/L
10 2.1
1
'625
3128117 2.12
JMV
PM)424
Hexachlororyclopentadiene
BRL
uglL
10 1.7
1
`825
3/28117 212
JMV
P7C0424
Hemchloroethane
BRL
ug/L
1D 1.5
1
'825
3128117 2:12
JMV
P7C0424
lndano(1,2,3-cd)pyrene
BRL
ug/L
10 31
1
'625
3128/17 2.12
JMV
P7C0424
Isophorone
BRL
ug/L
10 2.2
1
`625
3128/17 2:12
JMV
P7C0424
Naphthalene
BRL
ug/L
10 2.1
1
'625
3128/17 2.12
JMV
P7C0424
Nitrobenzene
BRL
uglL
10 1.4
1
1625
3128/17 212
JMV
P7C0424
N-Ndrosodimethylamine
BRL
ug/L
10 0.85
1
`625
3128117 2i2
JMV
177130424
N-Nitroso-di-n-propylamine
BRL
Lull.
10 2.1
1
'625
3128117 2:12
JMV
P7C0424
N-Ndrosodiphenyfamine
BRL
ug/L
10 3.0
1
`625
3128117 2"12
JMV
177130424
Pentachlorophenol
BRL
u91L
10 2.1
1
'625
3128117 2:12
JMV
1`7130424
Phenan0irene
BRL
ug/L
10 3.3
1
'625
3128117 2:12
JMV
P7C0424
renal
BRL
ug/L
10 0.49
1
'625
3128117 2:12
JMV
P7C0424
. yrene.
BRL
ug/L
10 36
1
'825
3128/17 2:12
JMV
P7C0424
surrogate
Recovery
Control Limits
2,4,6 Tribromophenol
84%
31-944
2-Fluorobiphanyl
80%
49-118
2-Fluorophenol
45%
22-84
Nltrobenzenei35
65 %
43-123
Phenol -d5
34 Y.
10-63
Terphenyl-d14
95 %
49-151
Volatile Organic Compounds by GC/MS
1,1,1-Trichloraethana
BRL
Lull.
50
0.061
1
'624
411117 6-05
KDM
P7C0521
1,1,2,2-Tefrachloroathana
BRL
ug/L
5.0
0.030
1
`624
4/1117 6.05
KDM
P700521
1,1,2 -Trichloroethane
BRL
ugfL-
50
0.066
1
'624
4/1/17 6:DS
KDM
P7C0521
1,1-Dichloroethane
BRL
ug1L
50
0.063
1
'624
411/17 6:05
KDM
177130521
1,1-Dichloroethylene
BRL
ug/L
5.0
0-063
1
`624
4IV17 6:D5
KDM
P7130521
1,2 -Dichlorobenzene
BRL
ug/L
50
0.076
1
1624
411/17 6:05
KDM
177130521
1,2-Dichloroethane
BRL
ugiL
50
0.066
1
`624
4/1117 6:05
KDM
177130521
1,2-Dichlompropane
BRL
ug/L
5.0
011
1
'624
411117 6:05
KDM
P7C0521
1,3 -Dichlorobenzene
BRL
ug/L
5.0
0054
1
•624
4/1/17 6-05
KDM
177130521
1,4 -Dichlorobenzene
BRL
ug/L
5.0
0 050
1
'624
411/17 6:05
KDM
PX0521
2-Chloroethyl Vinyl Ether
BRL
ug/L
10
037
1
'624
4/1/17 6.05
KDM
177130521
Acrolein
BRL
ug/L
100
0.20
1
'624
411117 6.05
KDM
177130521
Acrylomlyde
BRL
ug/L
i00
0.20
1
'624
411117 605
KDM
P7C0521
Benzene
BRL
uglL
5.0
0 048 -
1
*624
411117 6.05
KDM
P7C0521
This report should not be reproduced, except in its entirely, without the written consent of Prism Laboratones, Inc
449 Springbrook Road - P.O. Box 240543 - charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 5 of 20

This report should not be reproduced, except In its entirety, mbout the wntien consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224.D543
Phone:7D4i529-6364-Toll Free Number. 1-80DI529.6364-F=7041525-04D9 Page 6 of 20
Laboratory Report
FuD-Service Anafyfical &
V'
Environmental Solutions
04/07/2017
ueaaaoxu:y wn
_
leen-Tech, Inc
Project: Wastewater (Yearly with
Client Sample ID. Hildebran Flume
rttn: Tim Glenn
TTO)
Prism Sample ID: 7030364-01
P.O. Box 1369
ProjectNo.. IUP #0035
Prism Work Order. 7030364
Hickory, NC 28603
Sample Matrix. Water
Time Collected: 03/21/17 14 00
Time Submitted: 0312211 7 13.01
Parameter
Result Units
Report
MDL
Dilution
Method Analysis Analyst
Balch
Limit
Factor
DatelTme
ID
Bromodlchloromethane
BRL
ugJL
50
0.052
1
`624 411117 6:05
KDM
P7C0521
Brorroform
BRL
ug/L
5.0
0 040
1
'624 411117 6.05
KDM
P7C0521
Bromomethane
BRL
ugJL
10
0.18
1
'624 411117 6-05
KDM
P7C0521
Carbon Tetrachloride
BRL
uglL
so
0.11
1
`624 411117 6-05
_KDM
P7C0521
Chlorobenzene
BRL
_ ug1L
50
0.062
1
'624 411117 6-05
KDM
P7C0521
Chloroethane
BRL
ug1L
10
0,22
1
"824 4/1117 6:05
KDM
P7Co521
Chloroform
t
32
ug/L
6.0
0.076
1
*624 411117 6;D5
KDM
P7C0621
Chloromethane
BRL
ug/L
10
D.079
1
`624 4/1/17 6-05-
KDM
PX0521
ds-1,3-Dichloropropylene
BRL
ug/L
5.0
0.079
1
4624 4/1117 6.05
KDM
P7C0521
Dibromochloromethane
BRL
ug/L
5.0
0.081
1
`624 411/17 6:05
KDM
P7C0521
Ethylbenzene
BRL
ugJL
so
0.061
1
'624 4/1117 6:05
KDM
P7C0521
Methylene Chloride
BRL
ugJL
5.0
0.063
1
'624 411/17 6:05
KDM
P7C0521
Tetrachloroethylene
BRL
u911-
5.0
0.098
1
'624 411117 6-05
KDM
P7C0521
Toluene
BRL
f`tgIL
50-
0.044
1
'624 411117 6.05
KDM
P7C0521
trans-1,2-Dichloroethylene
BRL
yglL
50
0.094
1
`624 411117 605
KDM
P7C0521
trans-11,3-Dlchloropropylene
BRL -
ugJL
5.0
0.070
1
'624 411/17 605
KDM
P7C0521
Trichloroethylene
BRL
ug/L
5.0
0.078
1
'624 4/1117 6.05
KDM
P7C0521
chlorotluornmattmne
BRL
u91L
10
0.062
1
`624 4/1/17 6.05
KDM
P7C0521
�iyl chloride
BRL
u91L
10
0.097
1
'624 4/1117 605
KDM
P7C0521
Surrogate
Recovery
Control Limits
4-Bromoguorobenzene
113%
74-126
Dibromofluoromethans
101 %
75-127
Toluene -da
98%
74-122
This report should not be reproduced, except In its entirety, mbout the wntien consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224.D543
Phone:7D4i529-6364-Toll Free Number. 1-80DI529.6364-F=7041525-04D9 Page 6 of 20

IV1r,I/SLIT; LU1 r/ 1U] UZ.JJ x,41 AICCli 1Crfll
�i ��• FFF���,,,SSSllinnnEnvironmal Solutionsentelutions
+0 -manes ,n0-
Kleen-Tech, Inc
Attn• Tim Glenn
P 0 Box 1369
Hlckoly, NC 28503
PAil NU, Oto- i i/-�01D
Project Wastewater (Yearly with
TTO)
Project NO IUP #0035
Sample Matrix, Water
r, U U D
Laboratory Report
05/00/21)17
Qr us -D
Cll9nt Sampf9 ID Flurrla Comp M�IL-Q-
Prism Sal17pf9 ID i D40384-01
Prism Work Order, 7040364
Time Collected 04/20/17 13 DO
The Submitted. 04121/1710.00
Parameter
Result
Unita
Report
MEG
Dilution
Method
Allralj'sis Analyst
Bzit
L,md
rador
DBte/Tlnle
ID
General Chemistry Parameters
Slochemlcal Oxygen Demand
240
7iy1L
2.0
_
1
•SM6210 a
0'07 12,37
SLS
1'700305
filethylane Blue Active Substances
0.3813
mglL
0.10
0.020
1
`SF45540 C
4121117 12.00
BMs
P71D0:166
Total Suspended So110s
44
mg/L
1.;
0,80
1
'SfA254013
4/24117 12,40
SLS
P7D0381
Ammams as N
0118
mg1L
0.10
0.0646
1
'SM4500-NH3 0 4127117 7.17
CLE
P7D0420
Organochloi In® Pesticides by GC/ECD
adpha•BHC
SRL
ug/L
0 050
0 0009
i�
'608
4/1'8/17 16 52
JMC
1'700395
bete -BHC
l3RL
ug/L
0-050
0,018
1
{6QB
4/20117 16-52
JMC
KD03g5
Gamma -BHC
BRL
ug/L
0 050
0013
1
'60B
4124/17 16:5;
.JMC
P7n4395
delta -BHC
5Rt-ECV
Ug1L
0,050
0,014
1
-805
412{117 16:52
JMC
1'700395
Hr,ptachlor
BRL
ug/L
0-050
0 017
1
'BOB
4426117 15.52
JMC
1'700395
Aldrin
BRL
ug/L
0 050
0 015
1
'608
4128/17 165).
J`JIC
P, D0395
Heptechlor Epoxids
BRLECV
ug&
0,050
0 013
1
1606
4126/17 10'52
JMC
1'7003`15
tram -Chlordane
BRLEry
ug/L
0.050
0 026
1
'608
4126117 16 52
JMC
P700'495
Irndosulfun I
13RLECV
rtp/L
0,050
01019
1
"BOH
4/29/17 16.52
JMC
P7D0305
aE,0hlordsna
BRLECV
uQk
0-050
0 041
1
1608
4121;(17 16.52
JMC
P7D0395
Dieldrin
SRLZpV
ug/L
0 050
0 014
1
"608
4118117 le 5z
J,MC
P715C395
44' -DDE
BRUECV
4011L
0 D50
0 011
1
',106
401/17 1052
JMC
P7D0395
Endr,n
BRLECV
ug1L
0050
0 015
1
'508
4125/17 1 B,SA
,lMr,
177D0395
9ndosulfan It
6RLECv
uq/L
01050
0,016
1
"60a
4126117 1852
JMC
1'700395
4,4' -DDD
BP,LE(y
ug/L
0 050
0 020
1
'508
4x2,8/17 10-52
JMC
P7D0395
Endrin MOO,,
BRLBCV
ug/L
0 050
0 029
1
'008
4118117 1652
JMC
Mrj m5
Endosulfan Sulfate
BRLECV
u]/L
0,050
0,016
1
1808
4128117 16.52
JMC
P7D0395
4,4' -DDT
BRLC;Ov, EC.V
ug/L
0 05u
00,-,4
1
'406
4/x6117 le,5;
JMG
P'1Dr1395
ErOrin Ketone
BRLccV, Ecv
ug/1.
01050
01031
1
'608
4128117 16 52
.IN10
P7D:395
Methoxychlor
BNLCOV,ECV
uglL
0050
0,03e
1
-BOB
AIZB/17 10.52
JMC
MOMS
Chlordane
BRLECV
ug/L
050
0 094
1
'608
4/25117 16,5;,
JMC
r7D095
ToXephene
BRLGGV
99/L
01,50
0,074
1
^006
412811716-52
JMC
P7D0395
Aroclor 1016
BRLECV
ug/l,
060
024
1
*BOB
4/k9/17 15:52
JMC
P700395
Arador1221
BRL
uglL
10
0 i 1
1
1608
4120117 It S2
JMC
P71)CUS
AreaJor 1232
BRL
ug1L
0,50
0 10
1
"BOB
4128117 16 52
JMC
PMCM,
Aroclnrl242
BRL
ug/L
0.50
01,5
1
1508
3!26117 16.52
JMC
P7D6:395
Arcclor1248
BRL
u911.
0,50
0,14
1
1608
4128117 16 52
JMC
P7DC386
Aroclor1254
BRL
Ug/J_
050
Die
1
'BOB
4x28/17 16;52
JMC
P71)0395
Msolor 1260
BRLECV
ug1L
050
030
1
1608
4126117 16.52
JNIC
1'700345
Surrogate
Rccrivery
Control Uyllo
Tetrachloro-m-xylene
73
%
SC -734
Decachlornbiphenyl
19
%
r3-166
Semlyolatile Organib Compounds by GVMS
1,2,4-Tnchloroben2ene BF?U uOIL 10 1,5 1 '625-112AJ17 2232 JL1V 1'700369
This report should not be reproditced, exaerrt in IW enllrery, WIthJUt the w/Iter, con int or Prizm Laboratories, Ino
445 springbrpok Raad - P Q, Bax 240S43 - charlotte, NC 28224-0$43
Phone; 7041526-6364 -'Yat Free Nurnlaer• 1.8901629.53134 • Fix; 7041526.17409 page 3 of 19

LV11, >> _ -,L, Ti, ini �ii".iii ��•,, t! IT -1 !9V, 7:, L' JJI :.U:J 1, 1 1
JL�L
Laboratory Report
l M I
Enolr Funonnantal anlyUcdr 9
ental sol Pions 05/091Z017
Lnuoanrowtr� me
Kleen-Tech, Inc Project Wastewater (Yearly with Client Sample IQ. Flurt e Comp
Attn: Tim Glenn TTO) Prism Sample ID, 7040384-01
P O 50x 1368 Project No„ l(JP #;•0035 Prism Work Order 7040384
Hickory, NC 28603 Sample Matrrc Water Time Collected 04/20!17 13,00
Time SLIbmitted; 04/21/1710 00
Parameter
Result
Units
Report
MDL
Dilution
Methoo
Analysis Anslyq
Batch
Limit
factor
Ddt9/Tine
ID
1,2-Dichlorabenzene
BRL
ul/„
10
14
1
1025
4124117 2[12
JMV
1371)0369
t,2-Diphenylhydmzrns (as AzobFn28ns) BRL
up/L
10
2 9
1
'61-15
41.4117 22,32
JMV
1`71)0389
1,3-Dlchlorobzn7ane
FR
uy/L
10
1,3
1
1825
4/24117 2232
JMV
P7D0369
1,4 -Dichlorobenzene
BRL
ug/L
10
14
1
1625
4124117 2232
JMV
P7D0369
2,4,6•'rrlchlarop)iei)oI
13RL
ug/L
10
1,6
1
"62`
4124117 22-32
JMV
P7D0389
2,4-Cht«Jorophenol
BRL
ug/L
12
15
1
'525
4/24/1T 82,32
JMV
1371)0269
2,4-dn,ethylphanol
CRI.
ug/L
10
2.1
1.
162F�
4124117 22 32
JMV
P7003e9
2,4-Ulnitrophenol
BRL
ug/L
10
12
1
'625
4124/1' 22'32
JMV
P7 D0269
2,4-731nOcAoluene
BRL
ug/L
10
2,9
1
'625
-1124/17 2232
JMV
P700389
2,6-Dinitmtoluena
l3P,L
u91L
10
2 9
1
*B,^,5
4/24/17 2232
JMV
P7D03bg
2-Ghlornnaphtha ane
BRL
u91L
'10
2-1
1
1625
4,124/17 22 32
JMV
177D03s9
2-0h(orcphenol
URL
Ug/L
10
1 1
1
-B25
4124117 2232
JMV
1371)0389
2-Nitrophenol
BPL
ug/L
10
14
1
`625
4/24/17 22'32
JMV
P700369
3,3'•13!1,&!41<bPrtzldlrie
BRL
ug/L
10
2-6
1
'025
4/24/17 2232
JMV
PM03e2
4,6-Dlnitro-2-methylphenol
BRL
Ug/L
10
19
11
16;:
4124/17 2232
JMV
P7110369
4-Broniophenyl phsnyl ether
BRL
ug/L
10
32
1
'625
4/24117 2232
JN1V
P7P0389
4-Chloro-3•methy(phenal
BRL
U01L
IQ
23
1
"1325
424117 2232
JMV
P7Do38a
4-Chlorophenyl phenyl other
BRL
ug/L
10
22
1
•525
4/24/17 ;Z2132
JMV
P7D03Fi4
4-4trcphimol
BRL
1-Ig/L
50
17
1
'825
424117 2232
JMV
P7bxmo
4ccalaphthans
BRL
ugrL
l0
23
1
•d25
412,4117 2272
JMV
P7D0369
Acanaphthylene
BRL
ug/L
10
23
1
'B25
4/24117 2232
JMV
1371)0369
Anthracene
BRL
u(j/L
10
3,2
1
1525
424117 2232
JMV
PM0389
8anzldme
BPL
ug/L
)GO
14
1
•B25
4124117 2232
JMV
P7D0369
8vnzo(d)e1nihracrne
BPL
ug1L
10
31
1
'625
4!24117 2232
JMV
1371)0389
Benzo(ejpyrene
BRL
ug/L
10
3,B
1
*825
424117 2232
JNIV
P7D0369
Benzo(b)fluorenthens
BP,L
uglL
10
36
1
'825
4&4/17 2232
JMV
P71)0369
Benzo(g,h,l)peryfert
BRL
ug/L
10
is
1
"625
4124/17 2232
JMV
PTDD:;69
Benzo(k)fruoranthene
BRL
4g/L
10
38
1
f87,5
41:14117 2232
JMV
PM0369
bis(2-ChJ0roathoxry)nn0hane
BRL
ug/L
10
18
1
•625
4124111 223;
JMV
P7D0389
813(2•Chloroethyl)ether
BRl-
U91L
IO
16
1
'525
4j24/17 2232
AIV
P7Du369
8is(2-chlorolsopropyl)sthar
BRL
ug/L
10
17
1
•525
4/24/17 22;32
JMV
1771D0369
r31g(2•Ethylhc)cy1)pbthx1aty
18
ug/L
10
311
1
1626
4124117 22:32
Jh1V
1'7[10909
Butyl benzyl phthalate
BiTL
tlyll
10
28
1
•B25
41:4117 22'32
J%IV
P7130369
Chryaene
BRL
ugf
10
34
1
•625
4124/17 22132
JMV
P71)0309
DlWeivo(a,h)anUuycege
BRL
ug/L
10
34
1
"825
4124117 2.2 32
JMV
F7G0369
Diethyl phthalate
BRL
ugrL
10
23
1
'625
4/24/17 22.32
JMV
P7D0369
Drmsthylph-halaa
BRL
ug/L
10
15
1
'625
4/24117;2,32
,IMV
PTD0309
DI•n-butyl phthalate
BRL
UgIL
10
34
1
"825
4124117 2232
JMV
P7Do359
DI r ootyl phthalate
BRL
ug/L
10
36
1
•625
4124/17 22
JMV
P7130369
Fluorarithene
BRL
ug/L
ID
as
1
"625
4/;4117 2232
JMV
P71)0369
Fluurut:
BRL
uglL
10
28
1
•625
4124/17 2222
JMV
P7D0309
This mport should not bx reprv1Lt rd, crcept in its enflrery, mthout the written coneant of Pram Laboratonee, Inc,
449 Upringbrook Road -F,O. Boz 240543 . Charlotte, NO 282244543
Phoi& 704/629.6384 -TQII Free Numhcr, l-1)001525-0564 -
Fax. [phone]
_
Fage 4 of 19

PIR P/,I-ly/LUI I/PU1 U_,4U riVlP h >, I P'R„ l'r0, 6Lr?'f-;'{'_15 f, U111,i
I � Laboratory Report
Full-9Hrvlr„ AAnrytical R
Envie onmcn WI 8olutlann 05/09/2017
IF
tooaeron¢; me
!{lean -Tach, Inc Project Wasiewater (Yearly ea W1 Client S;wn{:la 113, Fiume Comp
Attn: Tim Glenn TTO) Prism Sampls IQ 7040,384-01
P.O. 13ux 1389 Prcjact ND . IUP #?0035 Prism Work Orcler 7040324
Hickory, NC 2003 Sample Matrix Water Tin -is Collected 04/20117 13:00
Time Submitted: 04/21/17 10'00
Parameter
Result
(!rids
Report lylpL
Dilu•ion
Method
Analysis Ari*at
Batch
bgm
M E0003
Udnllhm
Unit
Factor
010010
Dalernme
1
ID
HexachIorcijejizeria
M
ug/L
10 2,5
1
'635
4124117 22:32
XVIV
1`71D0369
Hexaohlorobutadiend
BRL
ug/L
10 20
1
'625
4124/17 2z-32
AIV
; 709568
HeXachlaro ycfopentscticna
E+RL
ug/L
10 18
1
-625
4/24117 22,112
JMV
P7DO369
Haxachloroethans
BRL
ug/L
10 1 5
1
1625
4124/17 22.32
JMV
°709369
In4era{1,2,3-rd)pyrene
BRL
1lg!L
10 3.1
1
"025
4/24/17 2232
JMV
?730365
leophorone
BRL
ugJ!
10 21
1
•625
4124/17 2232
JMV
P700361i
NaphlhaW'+
BRL
ug/L
10 L1
1
'625
4/24/17 2232
JMV
071)09bg
Nitrobenzene
BRL
uptL
10 14
1
•625
4124117 22:12
j[kAV
P7DO369
N-N11ras9d1mothylamrnrr
BRL
ug/L
10 0183
1
'625
4r24/17 2232
JMV
P7D63b3
N-Nitroso-dl-n-propylairnllte
URL
u9/l,
10 20
1
'625
4/24/17 22,32
JMV
WD036D
01-Niirosodiphenylamine
BRL
ug/L
10 2-9
1
1625
4/24117 2z 32
JMV
P71Do313e
Penteohloroolienol
BRL
ug/L
10 2,1
1
"64,5
4/2x/17 2232
JM'4
P7D036D
Phananlhrane
BRL
ug/L
10 3:2
1.
1625
4/z4/17 2232
JA4V
v7D0389
—ter, pPenol
BRL
vVIL
10 0111 IJ
1
'625
4,2411 7 2232
JMV
'700362
Pyrans
SRL
ug/L
10 3 5
1
'625
4124/17 27„32
JMV
7DO369
Surrogate
Recovery
Con i'011 -IMM
,,4,t3-Trlbromophertol
40 `r6
31444
2-F1unmblph*ny1
73%
49 -iia
2-Fluorophenol
si %
22.54
Nltrobenzene-as
07 %
43-123
Phenol -d5
25 m
10-63
1 arphenyl-d 14
8Z `ab
4.9.131
Total Metals
Araenlc
BRL
mg/L
0 010
0-0020
1
'200 7
513117 1 13
bgm
M E0003
Udnllhm
BRL
mg/L
010010
0,000c,70
1
"240,7
513117 113
bgm
P7E0003
Chromium
BRL
Ing%L
00050
G 000:0
1
'LOD 7
5/3/17 1 13
bgm
P7E0003
Copper
0.014
mg1L
0.010
0,00040
1
'x,^00.7
511/17 1:13
bgm
N7E0003
Lasd
5M.
n1g/L
0,0050
000090
1
1200,7
513/17 113
bgm
P7ED003
Niokel
BRL
mgA-
0010
0 0017
I
100 7
5/5117 1 13
bgm
P7E0003
Zino
0158
mIl1L
0 050
0,010
1
^200,7
513/17 113
ht{m
P7E0005
This reportshould not bR roproduce4 except In its entirety, wilhoutthe %rlften consent of Pnsm l.aboretonas, [no -
449 Sprm9brook Road - P.Q. Box 240543 - Charlotte, NO 28224-0543
Phono, 704/829.036.1- Toll Fra@ Number, 1,8001525-9464 - Fax. [phone]D9 Page 5 of l 3

�LI1 1: l UD IJ[ 'tI rLVi f:l Cil l0I_%f! 1, AA 11 V, 0.0- 0UI J i L'UU
ISr Laboratory Report
�� � � �vll-: nrvl:o Mal; t'a:l &
Ervifdrrnenial Solab��nv 05/09/207
...W -x we
Kleen-Tech, Inc Project, Wastewater (Yaarly with Chant Sample 1D Flume Grab
Atin Tim Glenn 110) Pr'sm Sample ID 7040384-02
P.O. Box 1'30'0 Project Flo- IJP #+]1335 PI'sm Wom Order; 7040384
HicKary, NG 28603 Swnpla Matrix, Water Time Collected- 04/20117 13 10
Time Submitted. 04/21117 10 00
Parameter Result Units Repai MDL Duubon fvlrthocl Aralyat Batch
Limit Factor DzteiMe ID
General Chemistry Parameters
Recavery
Grirltrgl Limits
4-Br0rr0NW0r0LnnZel1e
109%
74-126
DIDr0m0nLl0r0methana
10,4 %
75-f27
_
Cyanide _ -- -
FIRL -
V
- m0/L,
0 D050
0,0010
1
'5M4B01i-rP E 4f28117 1230
EGG
P7DO480
Olt & Gr. r. (HEFA)
100
mpil.
510
0.90
1
*106421
515,1"r 9:26
T.rY
P7 -r-0112
Volatile Organic Compounds by
3C/M8
_
1,1,1 -Trichloroethane
DRL
ufl/L
5,0
O 11,61
1
'B24
4128117 23 7
KDM
P700499
1.1,2,2-TetracElloraetFane
BPL
L-9/1-
so
O C35
1
'x,24
4126117 2327
PTM
1`7 D04v9
1,1,2-Trlchlornelhenn
BRL
ug/L
5,n
000ill
1
"624
4128117 2027
K01'A
P7Do459
1,1-Drchbroethane
BRL
ug/L
50
D 08
1
'324
4128/17 23?7
KDM
P7D0/99
1,141chloinethyl=re
BRL
ug/L
50
0063
1
1524
4178117 2327
KDM
P7N*9
1,2-Dch&obonzane
BPL
uy/6,
5,0
0.076
1
"024
4128177 2327
KDM
P7110499
1,2-010101acth411r
BRL
ug/L
50
uob3
1
`824
4128117 23:27
KDM
P71)0499
1,2-Didilo,opropane
BPL
ug/L
5,0
0.11
1
"620'4
412017; 2327
KDM
P1D0499
1,3-Didibrobenzene
BRL
ug/L
so
o 051
1
'a24
4128117 2327
KDM
P71)04e9
1,4-Dlchk,i0benz, nc
BRL
up/L
s 0
0 05D
i
"424
4128117 2327
t(Phi
P7DO499
�hbrcathyl Vinyl Ether
8RL
ug1L
10
0,37
1
"824
4128117 2327
KDM
WDO499
ksileln
BRL
ugr'L
100
0?0
1
'824
4/2,8!17 2327
KDM
P7DO499
Acrrylo�itrf)e
FFL
ug/L
ion
0,20
1
"024
J12B/It 2327
I(J)M
P7139g99
Benzene
BRL
ug/L
50
0 043
1
*624
4128(17 2327
KDM
P7DO492;
Broln0tll0hlutvrnvlhen-.
BRL
uplL
5D
0 Cez
1
`624
4125/1 r 2327
Kohl
PTD0499
Bromoform
Bf?L
u9't-
5,0
0,040
1
*824
4126117 2327
KDM
P1D0499
Brbmomsthane
BRI_
uglL
10
via
1
sC4
412,sh7 23'27
KDM
P7DO499
Carbon Tetrachiorfrle
C3RL
u9/L
'I'D
0,17
1
"624
412111;" 23.27
KDM
P700499
Chlorobenzens
BPL
ug/L
5D
0 cez
1
*07-4
4120117 23-27
1 DM
P7D0490
chloroethane
BRL
up/L
10
020
1
'621
4/2e/17 23:27
KDM
P7004119
Chloroform
32
Ug/L
6-0
0,078
1
'624
4/28117 23.21
KbM
PTD0499
Cf4orarnknane
BPL
ug/L
10
o o79
1
'824
4178117 23 27
I(DPA
P7 DO499
cis"1,'� C11chlumproPr fear
DRL
up/L
go
0 079
1
"624
4128117 Z3-27
KDM
P7D0499
Dibro,rochlurometnana
SPL
ugfL
50
0,081
1
*824
4128117 2327
KDM
PPD0499
Ethylnonzuro
BRL
ug/L
110
O 061
1
1624
41„4117 23,27
KIN
FTD0499
Methylene Chloride
SRL
ug/L
5,0
O,C83
1
1024
4!'18117 23.27
KL)M
PTDC4e9
Tetra, nforclethylene
BPL
uglL
so
D-026
I
hi24
4128117 23-27
KDM
P7DO4J9
Tolupite
BRL
_up/L _
5,0
0044
1
'624
4128/l7 23,27
KDM
P7D049G
trans -1,2 -Di t,lo�oelhylena
BFI-
ug1L
3,D
D,C94
1
'824
4128/17 2327
KDM
P7DO499
Ir4rls13-Dirhiompropy1sna
BRL
ug/L
60
007u
1
'624
4/28117 23.27
I:DM
P7130499
Tilcnloroethvlene
8RL
uUIL
50
0.078
1
*624
4/28117 2327
I,bM
F7DO-192
Tnchlomfluoromethana
BFI-
ug/L
10
0 Dee
1
"824
4128117 2327
KDM
P7DO499
Vinyl chfunds
EPL
ug/L
10
0 0b7
1
*524
4/28117 23:27
KDM
P7DO49;
- Surrogate
Recavery
Grirltrgl Limits
4-Br0rr0NW0r0LnnZel1e
109%
74-126
DIDr0m0nLl0r0methana
10,4 %
75-f27
ToWene-0t1
as 70
7.4-W
This raport ahould not be reproduced Except In (m cr711fety WI(tlallt lhG WrIttmi ron96ni of Prism Laboratar199, Inc
449 Sprurgbrouk Road - P.O. Box 240543 - Charlotte, NC 28224-0543
?hone- Y0d1629-6384.7otl Free Number- 1.8001629.6364. Fax- 70415750409
Pege G of T 9

aceAnalXical
wwwpacelabs com
Pace Analytical Services, LLC
9800 KinceyAve Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS Cr60 , ( rr)3 I, Q
Project Industries 7/26
Pace Pro/ect No 92349411
Sample: KLEEN TECH GRAB
Lab ID: 92349411004 Collected
07/26/17 10 51 Received 07/28/17 09 56 Matrix Water
Parameters
Results
Units
Report Limit
DF
Prepared Analyzed CAS No Qual
HEM, Oil and Grease
Analytical Method EPA 1664B
Oil and Grease
515
mg/L
5 0
1
08/03/17 06 01
608 GCS Pesticides and PCBs
Analytical Method EPA608 Preparation Method, EPA3510
Aldnn
ND
ug1L
10
2
08/01/17 08 30 08/03/17 20 56 309-00-2
alpha -BHC
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 319-84-6
beta -BHC
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 319-85-7
delta -BHC
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 319-86-8
gamma -BHC (Lindane)
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 58-89-9
Chlordane (Technical)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 57-74-9
4,4' -DDD
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 72-54-8
4,4' -DDE
ND
ug/L
10
2
08/01/17 08 30 08/03/17 20 56 72-55-9
4,4' -DDT
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 50-29-3
Dieldrin
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 60-57-1
Endosulfan I
ND
ug/L
1 0
2
08/01/17 08 3D 08/03/17 20 56 959-98-8
Endosulfan II
NO
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 33213-65-9
Endosulfan sulfate
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 1031-07-8
Endrin
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 72-20-8
Endrin aldehyde
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 7421-93-4
tachlor
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 76-44-8
,tachlor epoxide
ND
ug/L
1 0
2
08/01/17 08 30 08/03/17 20 56 1024-57-3
r-�-.8-1016 (Aroclor 1016)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 12674-11-2
PCB -1221 (Aroclor 1221)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 11104-28-2
PCB -1232 (Aroclor 1232)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 11141-16-5
PCB -1242 (Aroclor 1242)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 53469-21-9
PCB -1248 (Aroclor 1248)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 12672-29-6
PCB -1254 (Aroclor 1254)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 11097-69-1
PCB -1260 (Aroclor 1260)
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 11096-82-5
Toxaphene
ND
ug/L
100
2
08/01/17 08 30 08/03/17 20 56 8001-35-2
Surrogates
Tetrachloro-m-xylene (S)
28
%
20-110
2
08/01/17 08 30 08/03/17 20 56 877-09-8 D3
Decachlorobiphenyl (S)
26
%
20-138
2
08/01/17 08 30 08/03/17 20 56 2051-24-3
1631 E Mercury,Low Level
Analytical Method
EPA 1631 E Preparation Method EPA 1631 E
Mercury
10.1
ng/L
50
1
08/01/17 09 02 08/01/1712 47 7439-97-6 D3
625 MSSV
Analytical Method EPA 625 Preparation Method EPA 625
Acenaphthene
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 83-32-9
Acenaphthylene
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 208-96-8
Anthracene
ND
ug/L
50
1
07/31/17 15 DO 08/02/17 04 28 120-12-7
Benzo(a)anthracene
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 56-55-3
Benzo(a)pyrene
ND
ug/L
50
1
07/31/17 15 DO 08/02/17 04 28 50-32-8
Benzo(b)fluoranthene
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 205-99-2
Benzo(g,h,i)perylene
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 191-24-2
Benzo(k)fluoranthene
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 207-08-9
4-Bromophenylphenyl ether
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 101-55-3
Butylbenzylphthalate
ND
ug/L
50
1
07/31/17 15 00 08/02/17 04 28 85-68-7
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date 08/15/2017 07 35 AM without the written consent of Pace Analytical Services, LLC Page 8 of 60

aceAnalytical
wwwpacelabs corn
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 KinceyAve Suite 100
Huntersville, NC 28078
[phone]
Project Industries 7/26
Pace Project No, 92349411
Sample: KLEEN TECH GRAB Lab ID: 92349411004 Collected 07/26/17 10 51 Received 07/28/17 09 56 Matrix Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
625 NISSV Analytical Method EPA 625 Preparation Method EPA 625
4-Chloro-3-methylphenol
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
59-50-7
bis(2-Chloroethoxy)methane
ND
ug/L
100
1
07/31/17 15 00
08/02/17 04 28
111-91-1
bis(2-Chloroethyl) ether
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
111-44-4
2-Chloronaphthalene
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
91-58-7
2 -Chlorophenol
ND
ug/L
50
1
07/31/17 15 DO
08/02/17 04 28
95-57-8
4-Chlorophenylphenyl ether
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
7005-72-3
Chrysene
ND
ug/L
50
1
07/31/17 15 DO
08/02/17 04 28
218-01-9
Dibenz(a,h)anthracene
ND
ug/L
50
1
07/31/17 15 00
08/02117 04 28
53-70-3
3,3'-Dichlorobenzidine
ND
ug/L
250
1
07/31/17 15 00
08/02/17 04.28
91-94-1
2,4-Dichlorophenol
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
120-83-2
Diethylphthalate
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
84-66-2
2,4 -Dimethylphenol
ND
ug/L
100
1
07/31/17 15 00
08/02/17 0428
105-67-9
Dimethylphthalate
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
131-11-3
Di-n-butylphthalate
ND
ug/L
50
1
07/31/1715 00
08/02/17 04 28
84-74-2
4,6-Dinitro-2-methylphenol
ND
ug/L
200
1
07/31/17 15 DO
08/02/17 04 28
534-52-1
2,4-Dinitrophenol
ND
ug/L
500
1
07/31/17 15 00
08/02/17 04 28
51-28-5
2,4-Dinitrotoluene
ND
ug/L
50
1
07/31/17 15 00
08/02117 04 28
121-14-2
2,6-Dinitrotoluene
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
606-20-2
i-octylphthalate
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
117-84-0
'2-Ethylhexyl)phthalate
146
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
117-81-7
Fluoranthene
ND
ug/L
50
1
07/31/17 1500
08/02/17 04 28
206-44-0
Fluorene
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
86-73-7
Hexachloro-1,3-butadiene
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
87-68-3
Hexachlorobenzene
ND
ug/L
50
1
07/31/17 15 DO
08/D2/17 04 28
118-74-1
Hexachlorocyclopentadiene
ND
ug/L
100
1
07/31/17 15 00
08/02/17 04 28
77-47-4
Hexachloroethane
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
67-72-1
Indeno(1,2,3-cd)pyrene
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
193-39-5
Isophorone
ND
ug/L
100
1
07/31/17 15 DO
08/02/17 04 28
78-59-1
Naphthalene
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
91-20-3
Nitrobenzene
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
98-95-3
2-Nitrophenol
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
88-75-5
4-Nitrophenol
ND
ug/L
500
1
07/31/17 15 00
08/02/17 04 28
100-02-7
N-Nitrosodimethylamine
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
62-75-9
N-Nitroso-di-n-propylamine
ND
ug/L
50
1
07/31/17 15 00
08/02/17 04 28
621-64-7
N-Nitrosodiphenylamine
ND
ug/L
100
1
07/31/17 15 00
08/02/17 04 28
86-30-6
2,2'-Oxybis(1-chloropropane)
ND
ug/L
50
1
07/31/1715 00
08/02/17 04 28
108-60-1
Pentachlorophenol
ND
ug/L
100
1
07/31/17 15 00
08/02/17 04 28
87-86-5
Phenanthrene
ND
ug/L
50
1
07/31/17 15 DO
08/02/17 04 28
85-01-8
Phenol
ND
ug/L
50
1
07/31/1715 00
08/02/17 04 28
108-95-2
Pyrene
ND
ug/L
50
1
07/31/17 15 DO
08/02/17 04 28
129-00-0
1,2,4-Trichlorobenzene
ND
ug/L
50
1
07/31/17 15 00
08/02117 04 28
120-82-1
2,4,6 -Trichlorophenol
ND
ug/L
100
1
07/31/17 15 00
08/02/17 04 28
88-06-2
Surrogates
Nitrobenzene -d5 (S)
56
%
10-120
1
07/31/17 15 00
08/02/17 04 28
4165-60-0
2-Fluorobiphenyl (S)
54
%
15-120
1
07/31/17 1500
08/02/17 04 28
321-60-8
Terphenyl-d14 (S)
61
%
11-131
1
07/31/17 15 00
08/02/17 04 28
1718-51-0
Phenol -d6 (S)
54
%
10-120
1
07/31/17 15 00
08/02/17 04 28
13127-88-3
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date 08/15/20170735 AM without the written consent of Pace Analytical Services, LLC Page 9 of 60

aceAnalytical
www,pacelabs com
ANALYTICAL RESULTS
Project Industries 7/26
Pace Project No 92349411
Pace Analytical Services, LLC
9800 KinceyAve Suite 100
Huntersville, NC 28078
[phone]
Sample: KLEEN TECH GRAB Lab ID: 92349411004 Collected 07/26/17 10 51 Received 07/28/17 09 56 Matrix. Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No Qual
625 MSSV Analytical Method EPA 625 Preparation Method EPA 625
Surrogates
2-Fluorophenol (S)
46
%
10-120
1
07/31/17 15 00 08/02/17 04 28 367-12-4
2,4,6-Tnbromophenol (S)
78
%
10-137
1
07/31/17 15 00 08/02/17 04 28 118-79-6
624 Volatile Organics
Analytical Method EPA 624
Acetone
105
ug/L
100
1
07/31/17 2126 67-64-1
Acrolein
ND
ug/L
50
1
07/31/1721 26 107-02-8
Acrylonitrile
ND
ug/L
500
1
07/31/17 2126 107-13-1
Benzene
ND
ug/L
20
1
07/31/172126 71-43-2
Bromobenzene
ND
ug/L
20
1
07/31/17 2126 108-86-1
Bromochloromethane
ND
ug/L
20
1
07/31/17 2126 74-97-5
Bromodichloromethane
ND
ug1L
20
1
07/31/17 2126 75-27-4
Bromoform
ND
ug/L
20
1
07/31/17 21 26 75-25-2
Bromomethane
ND
ug/L
20
1
07/31/17 2126 74-83-9
2-Butanone (MEK)
5.2
ug/L
50
1
07/31/17 2126 78-93-3
n-Butylbenzene
ND
ug/L
50
1
07/31/17 2126 104-51-8
sec-Butylbenzene
ND
ug/L
50
1
07/31/17 2126 135-98-8
tart-Butylbenzene
ND
ug/L
50
1
07/3111721 26 98-06-6
rbon disulfide
6.5
ug/L
50
1
07/31/1721 26 75-15-0
rbon tetrachloride
ND
ug/L
20
1
07/31/1721 26 56-23-5
Chlorobenzene
ND
ug/L
20
1
07/31/17 2126 108-90-7
Chloroethane
ND
ug/L
20
1
07/31/17 2126 75-00-3
2-Chloroethylvinyl ether
ND
ug/L
50
1
07/31/17 2126 110-75-8
Chloroform
133
ug/L
20
1
0713111721 26 67-66-3
Chloromethane
ND
ug/L
20
1
07/31/17 2126 74-87-3
2-Chlorotoluene
ND
ug/L
20
1
07/31/17 2126 95-49-8
4-Chlorotoluene
ND
ug/L
20
1
07/31/17 2126 106-43-4
Cyclohexane
ND
ug/L
50
1
07/31/17 2126 110-82-7
1,2-Dibromo-3-chloropropane
ND
ug/L
20
1
07/31/17 2126 96-12-8
Dibromochloromethane
ND
ug/L
20
1
07/31/17 2126 124-48-1
1,2-Dibromoethane (EDB)
ND
ug/L
20
1
07/31/17 2126 106-93-4
Dibromomethane
ND
ug/L
20
1
07/31/17 2126 74-95-3
1,2 -Dichlorobenzene
ND
ug/L
20
1
07/31/17 21 26 95-50-1
1,3 -Dichlorobenzene
ND
ug/L
20
1
07/31/17 2126 541-73-1
1,4 -Dichlorobenzene
ND
ug/L
20
1
07/31/17 2126 106-46-7
Dichlorodifluoromethane
ND
ug/L
20
1
07/31/17 2126 75-71-8
1,1-Dichloroethane
ND
ug/L
20
1
07/31/172126 75-34-3
1,2-Dichloroethane
ND
ug/L
20
1
07/31/172126 107-06-2
1,1-Dlchloroethene
ND
ug/L
20
1
07/31/172126 75-35-4
cis-1,2-Dichloroethene
ND
ug/L
20
1
07/31/17 2126 156-59-2
trans- 1,2-Dichloroethene
ND
ug/L
20
1
07/31/17 2126 156-60-5
1,2-Dichloropropane
ND
ug/L
20
1
07/31/17 2126 78-87-5
1,3-Dichloropropane
ND
ug/L
20
1
07/31/17 2126 142-28-9
2,2-Dichloropropane
ND
ug/L
50
1
07/31/17 2126 594-20-7
1,1-Dichloropropene
ND
ug/L
20
1
07/31/172126 563-58-6
cis- 1,3-Dichloropropene
ND
ug/L
20
1
07/31/17 21.26 10061-01-5
trans-1,3-Dichloropropene
ND
ug/L
20
1
07/31/17 2126 10061-02-6
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date 08/15/2017 07 35 AM without the written consent of Pace Analytical Services, LLC
L1
c2
Page 10 of 60

aceAnalXkal
wwwpacelabs com
ANALYTICAL RESULTS
Project Industries 7/26
Pace Project No . 92349411
Pace Analytical Services, LLC
9800 KinceyAve Suite 100
Huntersville, NC 28078
[phone]
Sample: KLEEN TECH GRAB Lab ID. 92349411004 Collected 07/26/17 10 51 Received 07/28/17 09 56 Matrix Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No Qual
624 Volatile Organics
Ethyl acetate
Ethylbenzene
Hexachloro-1,3-butadiene
n -Hexane
2-Hexanone
lodomethane
Isopropyl acetate
Isopropylbenzene (Cumene)
p-Isopropyltoluene
Methylene Chloride
4-Methyl-2-pentanone (MIBK)
Methyl-tert-butyl ether
n -amyl acetate
Naphthalene
n-Propylbenzene
Styrene
1,1,1,2 -Tetrachloroethane
1,1,2,2 -Tetrachloroethane
achloroethene
ene
1,2,3-Tnchlorobenzene
1,2,4-Trichlorobenzene
1,1,1 -Trichloroethane
1,1,2 -Trichloroethane
Trichloroethene
Trichlorofluoromethane
1,2,3-Trichloropropane
1,1,2-Trichlorotrifluoroethane
1,2,4-Tnmethylbenzene
1,3,5-Tnmethylbenzene
Vinyl acetate
Vinyl chloride
m&p Xylene
o -Xylene
Surrogates
4-Bromofluorobenzene (S)
Toluene -d8 (S)
1,2-Dichloroethane-d4 (S)
420.4 Phenolics, Total
Phenol
450OCNE Cyanide, Total
Cyanide
Date 08/15/2017 07 35 AM
Analytical Method EPA 624
ND
ug/L
100
1
07/31/17 2126 141-78-6
ND
ug/L
20
1
07/31/17 2126 100-41-4
ND
ug/L
50
1
07/31/17 2126 87-68-3
ND
ug/L
50
1
07/31/17 2126 110-54-3
408
ug/L
100
1
07/31/1721 26 591-78-6
ND
ug/L
100
1
07/31/17 2126 74-88-4
ND
ug/L
100
1
07/31/17 2126 108-21-4
ND
ug/L
50
1
07/31/17 2126 98-82-8
ND
ug/L
50
1
07/31/17 2126 99-87-6
ND
ug/L
20
1
07/31/17 2126 75-09-2
NO
ug/L
100
1
07/31/17 2126 108-10-1
ND
ug/L
50
1
07/31/17 2126 1634-04-4
ND
ug/L
500
1
07/31/17 2126 628-63-7
ND
ug/L
50
1
07/31/17 2126 91-20-3
ND
ug/L
50
1
07/31/17 2126 103-65-1
ND
ug/L
20
1
07/31/17 2126 100-42-5
ND
ug/L
20
1
07/31/17 2126 630-20-6
ND
ug/L
20
1
07/31/17 2126 79-34-5
ND
ug/L
20
1
07/31/17 21 26 127-18-4
ND
ug/L
20
1
07/31/17 2126 108-88-3
ND
ug/L
20
1
07/31/17 2126 87-61-6
ND
ug/L
20
1
07/31/1721 26 120-82-1
NO
ug/L
20
1
07/31/17 2126 71-55-6
ND
ug/L
20
1
07/31/17 2126 79-00-5
ND
ug/L
20
1
07/31/1721 26 79-01-6
NO
ug/L
20
1
07/31/17 2126 75-69-4
ND
ug/L
20
1
0713111721 26 96-18-4
ND
ug/L
20
1
07/31/1721 26 76-13-1
ND
ug/L
20
1
07/31/17 2126 95-63-6
ND
ug/L
20
1
07/31/17 2126 108-67-8
ND
ug/L
50
1
07/31/17 2126 108-05-4
ND
ug/L
20
1
07/31/17 21.26 75-01-4
ND
ug/L
50
1
07/31/17 2126 179601-23-1
ND
ug/L
50
1
07/31/17 2126 95-47-6
95
%
70-130
1
07/31/17 21.26 460-00-4
107
%
70-130
1
07/31/17 2126 2037-26-5
88
%
70-130
1
07/31/17 2126 17060-07-0
Analytical Method EPA 4204
ND mg/L 0 010 1 08/11/17 14 35 108-95-2
Analytical Method SM 4500 -CN -E
0 064 mg/L 00080 1 08/02/17 05 47 57-12-5
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC
Page 11 of 60

rA
Blue Ridge Labs
PO Box 2940
Lenoir, NC 28645
828-728-0149
Client;
1it
Shurtape Technologies, Inc.
PO Box 1530
Hickory,NC 28603
Attention:
Mr. Jerry Eplin
Date Received:
12 -Jul -17
Report bate:
31 -Jul -17
Sample Date:
12 -Jul -17
BRL #:
BRL-2017-0503
Lab Sample ID:
LSID-2017-01855
8 le ID'
pipe 001
L. 0,00 M5)Lk
blueridgelabslenoir@gmalcom
QC Data on attached vendor report.
C en
"-'" - -- - Analysis Analysis
Parameter Result MQL unit Method Time Date Analyst
1,1,1 -Trichloroethane * 5 ug/l EPA 624 1:43 7120/2017 Surnmit
1,1,2,2 Tetrachloroethane * 5 ug/1 EPA 624 1:43 7/20/2017 Summit
* 5 ug/1 EPA 624 1:43 7/2'0!2017 Summit
I,1,2 -Trichloroethane
1,1-Dichloroethane 5 ug/1 EPA 624 1:43 7/20/2017 Summit
1,1-Dichloroethene * 5 ugll EPA 624 1:43 7!2012017 Summit
1,2 -Dichlorobenzene * 5 ug/1 EPA 624 1:43 7/2-012017 Summit
1,2-Dichloroethane * 5 ug/1 EPA 624 1:43 '7120/2017 Summit
1,2-Dichloropropane * 5 ug,7 EPA- 624 1:43 7/20/2017 Summit
1,3 -Dichlorobenzene * S uo/l EPA 624 1:43 7/20/2017 Summit
1,3-Dichloropropylene 5 ugil EPA 624 1:43 7120,12017 Summit
1,4 -Dichlorobenzene * 5 ug/1 EPA 624 1:43 7/20/2017 Summit
2-Chloroethylvinyl Ether * 5 ug/1 EPA 624 1:43 7/20/2017 Summit
Acrolein 50 ug/1 LPA 624 1:43 7/20/2017 Summit
Acrylonitrile 50 ug/l EPA 624 1:43 7/20/2017 Summit
Benzene * 5 ug/l EPA 624 1.43 7/2012017 Summit
Bromoform T 5 ug/1 EPA 624 1.43 7/20/2017 Summit
Carbon Tertachloride * 5 ug/1 EPA 624 1:43 7/20/2037 Summit
Chlorobenzene * 5 ug/1 EPA 624 1.43 7/20/2017 Summit
Reported By:
S. nson, D.R. 'Wessinger
* Concentrations are7belaw inimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 13 of 16

X
Blue Ridge Labs
BD Box 2940
Lenoir, NC 28645
828-728-0148
[e-mail]
Client : Shurtape Technology es, Inc.
PO Box 1530
Hickory, NC 28603
Attention: Mr. Jerry Eplin
Date Received: 12 -rut -17
Report Date: 31 -Jut -17
Sample Date: 12 -Jul -17
RRL #: BRL-2017-0503
Lab Sample ID: LSID-2017-01855
Client Sample ID: Pipe 001
- _
—
--
--
Analysis
Analysis
Parameter Result MQL
--
Unit
Method
Time
Date
Analyst
Chlorodibromom ethane _ *
5
ug./1
EPA 624
1:43
7/20/2017
Summa
Chloroethane *
5
ug/l
EPA 624
1.43
7/20/2017
Summit
Cliloroform *
5
ub�'1
EPA 624
1:43
7/20,2017
Summit
Dlcblorobromomethane
5
ug/1
EPA 624
1:43
7/20/2017
Summit
Ethybenzene *
5
ugll
EPA 624
1.43
7/20/2017
Summit
m,p-Xylene
5
ugll
EFA 624
1:43
712012017
Summit
Methyl Bromide *
5
ug/l
EPA 624
1.43
7;2012017
Summit
Methyl Chloride *
5
ug/l
EPA 624
1:43
7120/2017
Summit
Methylene Chloride *
5
ug/l
EPA 624
1:43
7/20/2017
Sumtnit
5
ue
EPA 624
1:43
7/20,2017
Summit
o -Xylene
Tettachloroethene
5
ug/1
EPA 624
1:43
7/20/2017
Summit
*
5
ug./l
EPA 624
1:43
7;20/2017
Summit
Toluene
Trans-l,2-dichloroethene
5
uel
EPA 624
1:43
7/2012017'
Summit
Trichloroethene
5
ug/l
EPA 624
1:43
7/20/2017
Summit
Vinyl Chloride *
'5
ug/1
EPA 624
1:43
7/20/2017
Summit
Reported)3y: —_ '- — --- - -- - ----- - - -
S. J nson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 14 of 16

aceAnalytical
wwwpacelabs cram
ANALYTICAL RESULTS
Project Industries 7/19
Pace Project No 92348682
Pace Analytical Services, LLC
9800 KinceyAve Suite 100
Huntersviile, NC 28078
[phone]
L O ,Ol dn3[ \
Sample. SHURTAPE TTO LabID- 92348682003 Collected 07/19/17 09 25 Received 07/21/17 13 53 Matrix Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No Qual
608 GCS Pesticides and PCBs Analytical Method EPA 608 Preparation Method EPA 3510
Aldrin
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36 309-00-2
alpha -BHC
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
319-84-6
beta -BHC
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
319-85-7
delta -BHC
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
319-86-8
gamma -BHC (Lindane)
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
58-89-9
Chlordane (Technical)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
57-74-9
4,4' -DDD
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
72-54-8
4,4' -DDE
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
72-55-9
4,4' -DDT
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
50-29-3
Dieldrin
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
60-57-1
Endosulfan I
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
959-98-8
Endosulfan II
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
33213-65-9
Endosulfan sulfate
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
1031-07-8
Endrin
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
72-20-8
Endrin aldehyde
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
7421-93-4
Heptachlor
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
76-44-8
Heptachlor epoxide
ND
ug/L
0 050
1
07/25/17 14 00
07/26/17 19 36
1024-57-3
PCB -1016 (Aroclor 1016)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
12674-11-2
'CB -1221 (Aroclor 1221)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
11104-28-2
'CB -1232 (Aroclor 1232)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
11141-16-5
PCB -1242 (Aroclor 1242)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
53469-21-9
PCB -1248 (Aroclor 1248)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
12672-29-6
PCB -1254 (Aroclor 1254)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
11097-69-1
PCB -1260 (Aroclor 1260)
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
11096-82-5
Toxaphene
ND
ug/L
050
1
07/25/17 14 00
07/26/17 19 36
8001-35-2
Surrogates
Tetrachloro-m-xylene (S)
70
%
20-110
1
07/25/17 14 00
07/26/17 19 36
877-09-8
Decachlorobiphenyl (S)
44
%
20-138
1
07/25/17 14 00
07/26/17 19 36
2051-24-3
625 MSSV
Analytical Method EPA 625 Preparation Method
EPA 625
Acenaphthene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
83-32-9
Acenaphthylene
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
208-96-8
Anthracene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
120-12-7
Benzo(a)anthracene
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
56-55-3
Benzo(a)pyrene
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
50-32-8
Benzo(b)fluoranthene
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
205-99-2
Benzo(g,h,i)perylene
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
191-24-2
Benzo(k)fluoranthene
ND
ug/L
5 0
1
07/24/1717 00
07/26/17 02 57
207-08-9
4-Bromophenylphenyl ether
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
101-55-3
Butylbenzylphthalate
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
85-68-7
4 -Chloro -3 -methyl phenol
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
59-50-7
bis(2-Chloroethoxy)methane
ND
ug/L
100
1
07/24/17 17 00
07/26/17 02 57
111-91-1
bis(2-Chloroethyl) ether
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
111-44-4
2-Chloronaphthalene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
91-58-7
2 -Chlorophenol
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
95-57-8
4-Chlorophenylphenyl ether
ND
ug/L
5 0
1
07/24/17 17 00
07/26/17 02 57
7005-72-3
Chrysene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
218-01-9
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date 08/03/2017 07 37 AM without the written consent of Pace Analytical Services, LLC Page 7 of 53

y 1
aceAnalXical
wwwpacelabs com
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 KinceyAve Suite 100
Huntersville, NC 28078
[phone]
Project Industries 7/19
Pace Project No 92348682
Sample SHURTAPE TTO Lab ID 92348682003 Collected 07/19/170925 Received 07/21/171353 Matrix Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No Qual
625 MSSV Analytical Method EPA 625 Preparation Method EPA 625
Dibenz(a,h)anthracene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
53-70-3
3,3'-Dichlorobenzidine
ND
ug/L
250
1
07/24/17 17 00
07/26/17 02 57
91-94-1
2,4-Dichlorophenol
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
120-83-2
Diethylphthalate
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
84-66-2
2,4 -Dimethylphenol
ND
ug/L
100
1
07/24/17 17 00
07/26/17 02 57
105-67-9
Dimethylphthalate
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
131-11-3
Di-n-butylphthalate
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
84-74-2
4,6-Dinitro-2-methylphenol
ND
ug/L
200
1
07/24/17 17 00
07/26/17 02 57
534-52-1
2,4-Dlnitrophenol
ND
ug/L
500
1
07/24/17 17 00
07/26/17 02 57
51-28-5
2,4-Dinitrotoluene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
121-14-2
2,6-Dinitrotoluene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
606-20-2
Di-n-octylphthalate
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
117-84-0
bis(2-Ethylhexyl)phthalate
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
117-81-7
Fluoranthene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
206-44-0
Fluorene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
86-73-7
Hexachloro-1,3-butadiene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
87-68-3
Hexachlorobenzene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
118-74-1
Hexachlorocyclopentadiene
ND
ug/L
100
1
07/24/17 17 00
07/26/17 02 57
77-47-4
lexachloroethane
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
67-72-1
ideno(1,2,3-cd)pyrene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
193-39-5
Isophorone
ND
ug/L
100
1
07/24/17 17 00
07/26/17 02 57
78-59-1
Naphthalene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
91-20-3
Nitrobenzene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
98-95-3
2-Nitrophenol
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
88-75-5
4-Nitrophenol
ND
ug/L
500
1
07/24/17 17 00
07/26/17 02 57
100-02-7
N-Nitrosodimethylamine
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
62-75-9
N-Nitroso-di-n-propylamine
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
621-64-7
N-Nitrosodiphenylamine
ND
ug/L
100
1
07/24/17 17 00
07/26/17 02 57
86-30-6
2,2'-Oxybls(1-chloropropane)
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
108-60-1
Pentachlorophenol
ND
ug/L
100
1
07/24/17 17 00
07/26/17 02 57
87-86-5
Phenanthrene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
85-01-8
Phenol
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
108-95-2
Pyrene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
129-00-0
1,2,4-Trichlorobenzene
ND
ug/L
50
1
07/24/17 17 00
07/26/17 02 57
120-82-1
2,4,6 -Trichlorophenol
ND
ug/L
100
1
07/24/17 17 00
07/26/17 02 57
88-06-2
Surrogates
Nitrobenzene -d5 (S)
61
%
10-120
1
07/24/17 17 00
07/26/17 02 57
4165-60-0
2-Fluorobiphenyl (S)
67
%
15-120
1
07/24/17 17 00
07/26/17 02 57
321-60-8
Terphenyl-d14 (S)
65
%
11-131
1
07/24/17 17 00
07/26/17 02 57
1718-51-0
Phenol -d6 (S)
21
%
10-120
1
07/24/17 17 00
07/26/17 02 57
13127-88-3
2-Fluorophenol (S)
35
%
10-120
1
07/24/17 17 00
07/26/17 02 57
367-12-4
2,4,6-Tribromophenol (S)
74
%
10-137
1
07/24/17 17 00
07/26/17 02 57
118-79-6
624 Volatile Organics
Analytical Method EPA624
Benzene
ND
ug/L
20
1
07/24/17 21 07
71-43-2
Bromodichloromethane
ND
ug/L
20
1
07/24/17 21 07
75-27-4
Bromoform
ND
ug/L
20
1
07/24/17 2107
75-25-2
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date 08/03/2017 07 37 AM without the written consent of Pace Analytical Services, LLC Page 8 of 53

. i
aceAnapical
wwwpacelabs com
ANALYTICAL RESULTS
Project Industries 7/19
Pace Project No 92348682
Pace Analytical Services, LLC
9800 KinceyAve Suite 100
Huntersville, NC 28078
[phone]
Sample: SHURTAPE TTO
Parameters
LabID' 92348682003
Results Units
Collected 07/19/17 09 25
Report Limit DF
Received 07/21/17 13 53 Matrix Water
Prepared Analyzed CAS No Qua[
624 Volatile Organics
Analytical Method EPA 624
Bromomethane
ND
ug/L
2 0
1
07/24/1721 07 74-83-9
Carbon tetrachloride
ND
ug/L
2 0
1
07/24/1721 07 56-23-5
Chlorobenzene
ND
ug/L
2 0
1
07/24/1721 07 108-90-7
Chloroethane
ND
ug/L
2 0
1
07/24/1721 07 75-00-3
Chloroform
ND
ug/L
2 0
1
07/24/1721 07 67-66-3
Chloromethane
ND
ug/L
2 0
1
07/24/1721 07 74-87-3
Dibromochloromethane
ND
ug/L
20
1
07/24/1721 07 124-48-1
1,2 -Dichlorobenzene
ND
ug/L
2 0
1
07/24/1721 07 95-50-1
1,3 -Dichlorobenzene
ND
ug/L
2 0
1
07/2411721 07 541-73-1
1,4 -Dichlorobenzene
ND
ug/L
2 0
1
07/24/1721 07 106-46-7
1,1-Dichloroethane
ND
ug/L
2 0
1
07124/1721 07 75-34-3
1,2-Dichloroethane
ND
ug/L
2 0
1
07/24/1721 07 107-06-2
1,1-Dichloroethene
ND
ug/L
2 0
1
07124/1721 07 75-35-4
cis-1,2-Dichloroethene
ND
ug/L
2 0
1
07124/1721 07 156-59-2
trans-1,2-Dichloroethene
ND
ug/L
2 0
1
07/24/1721 07 156-60-5
1,2-Dichloropropane
ND
ug/L
2 0
1
07/24/1721 07 78-87-5
cis-1,3-Dlchloropropene
ND
ug/L
20
1
07/24/1721 07 10061-01-5
trans- l,3-Dlchloropropene
ND
ug/L
20
1
07/2411721 07 10061-02-6
:thylbenzene
ND
ug/L
2 0
1
07/24/1721 07 100-41-4
Ilethylene Chloride
ND
ug/L
2 0
1
07/24/1721 07 75-09-2
1,1,2,2 -Tetrachloroethane
ND
ug/L
20
1
07/24/172107 79-34-5
Tetrachloroethene
ND
ug/L
2 0
1
07/24/1721 07 127-18-4
Toluene
6.8
ug/L
2 0
1
07/24/1721 07 108-88-3
1,1,1 -Trichloroethane
ND
ug/L
20
1
07/24/172107 71-55-6
1,1,2 -Trichloroethane
ND
ug/L
20
1
07/24/172107 79-00-5
Trichloroethene
ND
ug/L
2 0
1
07/24/1721 07 79-01-6
Trichlorofluoromethane
ND
ug/L
2 0
1
07/24/17 2107 75-69-4
Vinyl chloride
ND
ug/L
2 0
1
07/24/1721 07 75-01-4
Surrogates
4-Bromofluorobenzene (S)
100
%
70-130
1
07/24/1721 07 460-00-4
Toluene -d8 (S)
105
%
70-130
1
07/24/17 21 07 2037-26-5
1,2-Dichloroethane-d4(S)
93
%
70-130
1
07/24/172107 17060-07-0
Date 08/03/2017 07 37 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC
Page 9 of 53

HIQK--OP-,.�06.RY
„ North Carolina �
Life Well Crafted
Public Utilities
December 1, 2017
Mr. Steve Street
Hickory Manufacturing and Technology Center
PO Box 489
Hickory, NC 28603
Re Pretreatment Review of
Industrial Permit #0024 to Rescind
Dear Mr. Street:
City of Hickory
Cloninger Mill Road
Hickory, NC 28601
Phone: [phone]
Fax [phone]
Email. smcneely@hickorync gov
The City of Hickory Pretreatment Division and the Pretreatment, Emergency Response
and Collection Systems (PERCS) Unit of the Division of Water Resources has reviewed
the request to rescind Hickory Manufacturing and Technology Centers, #0024 Industrial
PT Permit. The formal drop request received by the City of Hickory was dated October
23, 2017. The review indicates that Hickory Manufacturing and Technology Center has
ceased discharging any process waste. All process discharge will be recycled through
their new water treatment system. An on-site inspection was conducted on November 15,
2017 and no evidence of process discharge was found going into the sanitary sewer.
Therefore, the drop request is approved based on compliance with 15 NCAC 2H .0907(c)
and .0903(b)(34). If Hickory Manufacturing and Technology Center's discharge
situation changes, contact me at 828-322-4821 prior to any modifications or discharge.
(See attachment)
Should you have any questions, please feel free to contact me.
Sincerely,
�C
Susan McNeely
Pretreatment Coordinator
Sm/sm

_ 9
Nater Resources
Environmental Quality
November 29, 2017
Sent Via Electronic Mail ([e-mail])
Ms. Susan McNeely
Pretreatment Coordinator
City Of Hickory
PO Box 398
Hickory, NC 28603
ROY COOPER
Governor
MICHAEL S. REGAN
Sect etmy
S. JAY ZRVEAERMAN
Director
Subject: Pretreatment Review of Industrial User Pretreatment Permit (IUP) Drop
Program: City of Hickory
WWTP: Henry Fork WWTP - NCO040797
Catawba County
Dear Ms. McNeely:
The Pretreatment, Emergency Response and Collection Systems (PERCS) Unit of the Division of Water
Resources has reviewed the request to drop the following Industry from the list of significant industrial
users (SIUs) for the City of Hickory. This request was received November 27, 2017.
-- IUP # SIU Name
0024 1 Corning Optical Communications
The review indicates that the SIU no longer discharges process wastewater to the City's collection
system. Therefore, the SIU drop request is approved based on compliance with 15 NCAC 2H .0907(c)
and .0903(b)(34). The SIU list which is part of your approved pretreatment program has been modified.
If you have any questions or comments, please contact me at 807-6383 [email:
[e-mail]]. Thank you for your continued support of the Pretreatment Program.
Sincerely,
Deborah Gore, PERCS Supervisor
dg/h i ckory_H F_iu p_039
Cc: PERCS Unit File
Wes Bell, Mooresville Regional Office (via email)
Central Files
State of North Carolina I Environmental Quality
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-707-9000

Corning Incorporated
Ahmed Koilakh Hickory Manufacturing and t 828-901-5699
Plant Manager Technology Center f 828-901-6161
PO Box 489 KodakhAM@corning corn
Hickory, NC 28603 www corning corn
June 5h, 2017
Ms. Susan McNeely
City of Hickory, NC
Public Services Dept. — Pretreatment Division
310 Cloninger Mill Road
Hickory, NC 28601
Dear Ms. McNeely,
The purpose of this letter is to provide an update regarding the process water treatment system installed by Coming's
Hickory Manufacturing and Technology Center (HMTC).
Modifications to the system were complete in mid-April and the system was restarted on Monday, April I7 h, 2017. The
water treatment system is servicing all manufacturing and technology process Imes that utilize water for product cooling.
Three brief upset conditions have occurred since the system was brought back on-line due to the storage tank reaching full
capacity. Process wastewater was diverted to the sewer system in an effort to lower the tank's water level during each of
the three occasions. On April 20ti' and April 23rd water was diverted for approximately 1.5 hours and on May lst for
approximately one hour. Management of the system was adjusted allowing the system to obtain a balanced state and
crate without issue since May 1st, resulting in zero process water discharge from HMTC.
HMTC has removed all city water supply connections at the individual process lines and is fully committed to
maintaining a zero process wastewater discharge. HMTC is requesting an exemption from the City of Hickory's
monitoring event for the second quarter of 2017, due to the absence of process water at the compliance point. HMTC
remains committed to requesting the wastewater permit be rescinded in the coming months once the system has proven its
reliability.
We appreciate your consideration and willingness to work with us as we transition to this new system. Please contact me
if you have any questions at 828-901-5699.
Sincerely,
Ahmed Koilakh
Plant Manager
Attachments
Todd Whitaker
Steve Street
© 2017 Corning Incorporated. All Rights Reserved

Susan McNeely
om: Street, Steve L <Steve Street@corning com>
ant: Friday, June 30, 2017 2 01 PM
To: Susan McNeely
Cc: Whitaker, J Todd
Subject: Corning - HMTC Process Wastewater Update
Hello Susan,
Per our earlier conversation, I've provided an update regarding HMTC's process wastewater status below
HMTC's process water filtration and recirculation system has continued in full operation since the last update
was provided to the City of Hickory dated June 5th, 2017. The site has maintained a zero process wastewater
discharge since May 11t, 2017 Additionally, the process wastewater drain line was disconnected from the City
of Hickory's sewer on June 14th, 2017 HMTC's plan is to request the wastewater permit to be rescinded in the
coming months as previously communicated and agreed upon. HMTC will continue to provide monthly
updates until the permit is removed as requested.
Please let me know if you have any questions or require additional information
Regards,
Steve Street
Sr EHS Coordinator
ickory Manufacturing and Technology Center
rC Box 489
Hickory, NC 28603
t 828-901-6695
c 828-244-3921
f 828-901-6161
e steve street@corning corn
We're transforming the world's ability to connect and collaborate. Visit our website to learn more.

CORNING
August 15t, 2017
Ahmed Koilakh Hickory Manufacturing and t 828-901-5699
Plant Manager Technology Center f 828-901-6161
PO Box 489 koilakham@coming com
Hickory, NC 28603 www coming com
Ms. Susan McNeely
City of Hickory, NC
Public Services Dept. — Pretreatment Division
310 Cloninger Mill Road
Hickory, NC 28601
Dear Ms. McNeely,
P,YN7
AUG - 4 r
Please find the enclosed IDMR providing confirmation that the Hickory Manufacturing and
Technology Center (11MTC) did not discharge process water to the City of Hickory's
treatment system during the month of July. The process wastewater drain line was
disconnected from the sewer system in June. HMTC is in the process of sealing the
remaining floor drains around the process equipment to prevent any future release of process
water to the City of Hickory's treatment facility.
Please contact me if you have any questions at 828-901-5699.
Sincerely,
Ahmed Koilakh
Plant Manager
attachments
cc: Todd Whitaker
Steve Street
@ 2017 Corning Incorporated All Rights Reserved

Ahmed
Hickory
t 828-901-59
C®RNING Plant Manager Technology Center ang and f 828-901-6161
PO Box 489 koilakham@coming com
Hickory, NC 28603 www coming com
September 5t', 2017
SEP - 7 i017
Ms. Susan McNeely
City of Hickory, NC
Public Services Dept. — Pretreatment Division
310 Cloni.nger Mill Road
Hickory, NC 28601
Dear Ms McNeely,
Please find the enclosed IDMR providing confirmation that the Hickory Manufacturing and
Technology Center (PIMTC) did not discharge process water to the City of Hickory's
treatment system during the month of August. The water treatment system remains fully
operational providing a status of zero discharge to the City's POTW. HMTC has sealed the
remaining floor drains around its process equipment The site is currently updating internal
procedures for collecting and properly disposing of process water in the event of a spill or
cleaning activity resulting in the generation of waste. Once these actions have been
completed it is HMTC's intent to request the wastewater permit be rescinded.
Please contact me if you have any questions at 828-901-5699.
Sincerely,
Ahmed Koilakh
Plant Manager
attachments
cc: Todd Whitaker
Steve Street
@ 2017 Corning Incorporated All Rights Reserved

CORNING
October 2nd, 2017
Ahmed Koilakh Hickory Manufacturing and t 828-901-5699
Plant Manager Technology Center f 828-901-6161
PO Box 489 kodakham@corning com
Hickory, NC 28603 www corning com
Ms. Susan McNeely
City of Hickory, NC
Public Services Dept. — Pretreatment Division
310 Cloninger Mill Road
Hickory, NC 28601
Dear Ms. McNeely,
Please find the enclosed IDMR providing confirmation that the Hickory Manufacturing and
Technology Center (HMTC) did not discharge process water to the City of Hickory's
treatment system during the month of September. HMTC's water treatment system remains
fully operational providing a status of zero discharge to the City's POTW. The site is
currently updating internal procedures for collecting and properly disposing of process water
in the event of a spill or cleaning activity resulting in the generation of waste. It is HMTC's
intent to request the wastewater permit be rescinded once these actions are complete.
Please contact me if you have any questions at 828-901-5699.
Sincerely,
Ahmed Koilakh
Plant Manager
attachments
cc: Todd Whitaker
Steve Street
© 2017 Corning Incorporated All Rights Reserved

Ahmed Koilakh Hickory Manufacturing and t 828-901-5699
CORNING
Plant Manager Technology Center f 828-901-6161
PO Box 489 koilakham@coming com
Hickory, NC 28603 www coming com
November 1St, 2017
Ms. Susan McNeely
City of Hickory, NC
Public Services Dept. — Pretreatment Division
310 Cloninger Mill Road
Hickory, NC 28601
Dear Ms. McNeely,
n
BY: ........................
Please find the enclosed IDMR providing confirmation that the Hickory Manufacturing and
Technology Center (HMTC) did not discharge process water to the City of Hickory's
treatment system during the month of October. HMTC's water treatment system remains
fully operational providing a status of zero discharge to the City's POTW. A formal request
to rescind the wastewater permit was recently submitted to the City of Hickory.
Please contact me if you have any questions at 828-901-5699.
Sincerely,
(�k - �-�
Ahmed Koilakh
Plant Manager
attachments
cc: Todd Whitaker
Steve Street
@ 2017 Corning Incorporated All Rights Reserved

CORNING
October 23rd, 2017
Ahmed Koilakh Hickory Manufacturing and t 828-901-5699
Plant Manager Technology Center f 828-901-6161
PO Box 469 KOIIakhAM@corning com
Hickory, NC 28603 www coming com
Ms. Susan McNeely
City of Hickory, NC
Public Services Dept. — Pretreatment Division
310 Cloninger Mill Road
Hickory, NC 28601
Dear Ms McNeely,
The purpose of this letter is to provide a formal request to rescind the wastewater permit
issued to Coming's Hickory Manufacturing and Technology Center (HMTC).
HMTC has achieved the status of zero process water discharge to the City of Hickory's
POTW. This has been accomplished through the installation of a water treatment system
allowing HMTC to filter and reuse 100% of its process water. HMTC has removed
connections to the sanitary sewer system at each manufacturing process line. Additionally,
the main drain header that HMTC has utilized since 2005 for draining process water to the
compliance point has been fully disconnected from the sewer system. Disconnection from the
sanitary sewer system occurred on June 14t', 2017. All floor drains in manufacturing have
been sealed to prevent the release of process water should a spill or leak occur.
Manufacturing Operators have been properly trained on the use of the system and actions
required in the event of a spill or leak.
HMTC invites you and your team for a site visit to review the water treatment process and
verify all conditions required by the City of Hickory have been met to rescind HMTC's
wastewater permit. Please contact Steve Street to schedule the visit at 828-901-6695.
Sincerely,
Ahmed Koilakh
Plant Manager
attachments
cc: Todd Whitaker
Steve Street
@ 2017 Corning Incorporated All Rights Reserved

CORNING
December 4th 2017
Ahmed Kodakh Hickory Manufacturing and
t 828-901-5699
Plant Manager Technology Center
f828-901-6161
PO Box 489
koilakham@coming com
Hickory, NC 28603
www corning corn
Ms. Susan McNeely
City of Hickory, NC
Public Services Dept. — Pretreatment Division
310 Cloninger Mill Road
Hickory, NC 28601
Dear Ms. McNeely,
Please find the enclosed IDMR providing confirmation that the Hickory Manufacturing and
Technology Center (HMTC) did not discharge process water to the City of Hickory's
treatment system during the month of November. HMTC's water treatment system remains
fully operational providing a status of zero discharge to the City's POTW.
Please contact me if you have any questions at 828-901-5699.
Sincerely,
Ahmed Koilakh
Plant Manager
attachments
cc: Todd Whitaker
Steve Street
@ 2017 Corning Incorporated All Rights Reserved

HIQK-RY
��J
� North Carolina �-
Life Well Crafted
Public Utilities
January 19, 2017
Mr. John Perkins
Longview Yarns Inc.
PO Box 477
Hickory, NC 28603
City of Hickory
310 Cloninger Mill Road
Hickory, NC 28601
Phone* [phone]
Fax: [phone]
Email: [e-mail]
RE: Notice of Violation with Assessment of Civil Penalties
Pretreatment Permit #0046
Dear Mr. Perkins:
This letter transmits notice of violation with a civil penalty assessed against
Longview Yarns Inc. in the amount of $100.00 for violations of permit limitations
for Zinc.
Within thirty days, of receipt of this notice, you must do the following:
1. Submit payment of the penalty to:
The City of Hickory
Public Utilities Department
P O Box 398
Hickory, NC 28603
2. Submit a narrative stating the cause of and time needed to correct the
violation(s).
The payment of this penalty will not foreclose further enforcement action for any
continuing or new violation(s).
Remedial actions, if not already implemented, should be taken to correct the
problem(s). (See attachment)
If you have questions, please call this office at [phone].
SincerelyM
Susan McNeely
Pretreatment Coordinat r

FINDINGS OF FACT:
1. Longview Yarns Inc. was issued Permit #0046, effective July 8, 2016, with an
expiration date of July 7, 2021.
2. Said permit contains the following relevant limitations:
Parameter
Zinc
Limitation
0.35 mg/I
3. Self-monitoring reports revealed the following exceedances of the above-
cited permit effluent limit:
Date
Zinc
9/29/16
0.514 mg/I
10/6/16
0.768 mg/I
11/8/16
0.499 mg/I
12/1/16
0.938 mg/I
12/6/16
0.495 mg/I
12/7/16
0.389 mg/I
12/15/16
2.894 mg/I

ro /� //W 0.
P. O. Box 477
Hickory NC 28603
February 2, 2017
Susan McNeely
City of Hickory
310 Cloninger Mill Road
Hickory, NC 28601
PEC
FEB - 6
13Y: km. -A .►-z.....
Space Dyed - Solid Color - Combinations for Knitting and Weaving
Re: Notice of Violation dated 1/19/17 regarding zinc
Dear Mrs. McNeely,
Telephone: &yr327-8496
Fax &6 -327-9969
Beginning in mid-December we contacted vendors of some of our more heavily used products to see if
there had been any changes in their supplies or processes. We were assured there were none.
Subsequently, we have tested solutions of two products and found them to contain zinc. (At the same time
we tested incoming water and found it to contain a small amount of zinc.)
We plan during the month of February to test several more products along with incoming water. We also
plan to begin a more rigorous analysis of our production schedule and its use of the already identified
products and to directly measure the effect on that process water. We also will have our sampler re tubed
as this has not been done in several years.
By the end of February we should have identified any problematic raw materials. It would then be
necessary to find replacements. We have already begun that process on the two identified raw
materials.
We believe that we will be back in compliance on zinc no later than mid March.
John Perkins, President
LONGVIEW YARNS, INC.
ALL AGREEMENTS CONTINGENT UPON STRIKES, ACCIDENTS, OR OTHER CAUSES BEYOND OUR CONTROL UPON DEFECTIVE MATERIAL OUR LIABILITY IS LIMITED TO
VALUE OF MATERIAL OR REPLACEMENT OF SAME QUOTATIONS SUBJECT TO APPROVAL OF OUR CREDIT DEPARTMENT ALSO SUBJECT TO CHANGE WITHOUT NOTICE

CITY OF HICKORY COLLECTIONS DEPARTMENT
City of Hickory
4Lr CUSTOMER RECEIPT x=s
Oper: KPIEFNER Type: OC Drawer: 1
Date: 2 0/17 68 Receipt no: 156510
Description 1kuant ity Pa. 0unt
HB NOT BILLED!MISCELLANEGUS
1.00 100.00
G/L account number:
03000003808905
03000001010000
LONGVIEWYARNa INC
LONGVIEW YARNS INC
CIVIL PENALTIES
Tender detail
CK CHECK ZB183 $100.00
'total tendered X100.00
Total payment ,100.00
Trans daze: 2/G6/17 Time: 11:46:56
City of Hickory
310 Cloninger Mill Road
Hickory, NC 28601
Phone: [phone]
Fax: [phone]
Email: [e-mail]
h Assessment of Civil Penalties
0046
This letter transmits notice of violation with a civil penalty assessed against
Longview Yams Inc. in the amount of $100.00 for violations of permit limitations
for Zinc.
Within thirty days of receipt of this notice, you must do the following: -
�
^� ` �__�-- �_�� a _� � �'--�_� s��'.'-���.� wry-•�.�'"�-._T -•-'� � �__ ��"�� - J . y tip. -" �"�.-'�`,�,~�"�' �=^.
��`f-LOIVGV_
-
_ _ X65 219/531'-�
✓"-z.ti ��^ _� - ;�-- _-s a_� �=__� -_ �� _���,=-�� �--=1=-�_--.•:. - - �ATEL LYS' - r T-,- � -�
O T.HE'"
✓ OFtDEB OF - �� - z� _ _ _ r _'yT � ,� _ ~-y-~ ._ y - - - -�lJ+1 �,�..fs_- ,4'�-- ���- ___ "'_ _ - -- — _�` _�-
- -� x;s 1y- i ���N 7 DOMAIIiJ
— - -CommunHyOne Bank, NA—_
__�� _• .tom "'1u _ --_�-"'L�.i �i s.� .- •'`„y`�•^.� _..�- r � r� -Y � LA/!� '1_ � _ -� _"
FOR"---= _ - -
Pretreatment Coordinate

c`
Memorandum
To: Susan McNeely
CITY OF HICKORY
From: John Perkins
LONGVIEW YARNS, INC.
Date: 3/7/17
Re: Notice of noncompliance for sample date 1/24/17
Susan,
In response to the City of Hickory's "Notice of Noncompliance" dated February
21, 2017 regarding analysis of effluent samples taken by the City of Hickory on
January 24, 2017
Recently we have been having a problem with our Zinc limit. Beginning in
mid-December we contacted vendors of some of our more heavily used
products to see if there had been any changes in their supplies or
processes. We were assured there were none. Subsequently, we have
tested solutions of two products and found them to contain zinc. (At the
same time we tested incoming water and found it to contain a small
amount of zinc.)
We have prepared samples of several more raw materials and are
waiting on the results from the lab. We now believe that changes in heavy
chemicals (Sodium Chloride and Sodium Sulfate) are contributing to our
problem.
We have been running more wool in our process and that could account
for the overage on the ammonia. We have been unable to correlate the
excessive ammonia to the zinc problem. We will look at changing our
schedule in the future to spread out the amount of ammonia in our
effluent.
Our most recent self monitoring showed a zinc concentration of 0.223
mg/I and ammonia at 10.7 both within our permit limit. Unfortunately, this
sample was taken prior to our knowledge of the City's results. Hopefully
our next sample will also be within the limits. We will forward that result to
you as soon as it is available.

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ENC pE��.Jl�-i�'AT�IIN:
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te�o��bie nnnC_m�.L_snCa 4uasLarrnc
meted an the and Mist be
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R5 -rr, c vw., fj oti

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E Use separate sheets for each Pnlhiranr
SILT Name- k t rh T i r,ti IUP Number 0U)s' I Pipe Number- 00/
Parameter- 0 % 4- G 4 t ., S e Six Month SNC Determination Period. ,,, % - V t c, ZOO
See next page for definitions
Daily Max and IUP Limit * TRC criteria = TRC Limit Circle which units apply
—Ave Limits Circle 14 For TRC for BOD, TSS, oil, fat, grease; Circle 12 for all other pollutants to Limits
from 1UP TRC compliance judgement not required for pH
Daily Maximum Limit. 1 u o * 12 or 14 = TRC Daily Limit % r90 mg/l or lbs/day
Average Limit * 1 2 or 14 = TRC Avg Limit: mg/t or lbs/day
Column 1 I - Industry self P-POTW A - Average
Column 5 Use only if IUP has (monthly, or other7) average limit. Average values of all sampling events collected whhin the
"average" period (for example, for a monthly average limit, use all values collected within a calendar month) and enter
this average in column 5 Treat this average as another CJP Compare this average to the appropriate average IUP hmit
or TRC limit
Column 6 Use only if IUP has daily limits in lbs/day Formula to use is (mgd * mg/1 * 8 34 = lbs/day )
Column 7 Use only if IUP has (monthly?) average limits in lbs/day Use (mgd * mg/1 * 8 34 = lbs/day )
Column 8 Put "1" for each daily maximum or average value, tally up at bottom as "A "
Column 9 Compare daily and average values to IUP limits above,put "0" if at or below hmit, "1" if above, tally at bottom as "B "
Column 10 Compare daily and average values to TRC limits above,put "0" if below limit, "1" if at or above, tally at bottom as "C "
Col. 1•
From
IIDMRs
From
IDMRs
From
IDMRs
Col 5
Col 6:
Col 7•
Col 8.
Col 9
Col 10.
Sample or
CJP Type
Sample
Date
Daily
Flow, mad
Daily
Cone mg/1
Avg Cone
mQ J
t/
Daily
Load
lbs/day
Avg Load
lbs/day
CJP
Count
Reg ular
Violation
TRC
Violation
c�
),ht /P
5-W
W
li
N
y L
>
>
C
ii �l
f'
►
FI
0
`' ?elf?
3
I
0
0
to Gln
/S-0
)
Cl�l��/7
ZS
I
U
Q
11 dill
17
I
p
0
List these Totals on next page =>
A = 7
B=
C= 3
Title SNC With Lanus Compliance Judgement Worksheet
Filename 27blankcompludge append7-c.lan2001
Revvsion date 1/5/01

Compliance Judgement Worksheet For SNC With Limits
Use separate sheets for each Industry SNC determination for Flow optional, see Section 7-E
Use separate sheets for each Pollutant
SIU Name k 1d rx, T IUP Number D d �S 1 Pipe Number. e7e /
Parameter e I r-, 51 Six Month SNC Detemmnation Period
SIGNIFICANT NON-COMPLIANCE (SNC) LIMITS DETERMINATION Calculate % and Circle Answers
1) Calculate the % of Regular violations B/A = �%3 /, �
2) Is B/A greater than or equal to 0 66 (or 66 X10) Chronic violator? Yes /V
3) Calculate the % of TRC Violations: C/A
4) Is C/A greater than or equal to 0 33 (or 33 %) TRC Violator? es / No
5) Did any violation, alone or in combination with other discharges, cause pass-through
or interference at the POTW, or endanger the health of POTW workers or the public? Yes / to
6) Did any violation cause imminent endangerment to human health / welfare or to the
environment or has resulted in the POTW's exercise of its emergency authority to halt
or prevent such discharge? Yes /
7) If the answer to any of these questions is yes, the SIU is in Signficant Non -Compliance (SNC) for this
parameter They must be listed on tFe Significant Non -Compliance Report (SNCR) form in the Pretreatment -'
Annual Report (PAR), described in the PAR narrative (including parameter, period, and POTW actions), and
the POTW must take adequate enforcement as outlined in its Enforcement Responce Plan (ERP)
Is the SIU in SNC for this six month period? CIRCLE ONE: (9p NO
_ f
Was the SIU in SNC for THE SAME PARAMETER in the previous six month compliance
ep riod? CIRCLE ONE: YES
If YES to EITHER question, DESCRIBE IN NARRATIVE.
Please note if SIU was in SNC for the previous six month compliance period and is also in SNC for this six month
compliance period, escalated erforcement actions must be taken as soon as possible, preferably before the end
of the second consecutive penod Failure to take the action within 2 months after the end of the second
consecutive period will subject the POTW to enforcement by the Division The options are.
Consent Order with Enforceable schedule;
Administrative Order with Enforceable schedule,
Formal notice to comp'y issued, or
Permit modification.
See Chapter 9 - Pretreatment Anr_ual Reports, Chapter 8 - Enforcement, and the POTW's Enforcement Response
Plan (ERP)
� _-''ti -� _1 :_ a. v.`J'�>Zj CI:.+�•r 1 ��J "^^ a t_1z
Definitions: ;
CJP Compliance Judgement 1~o np;_ The,-&iumb�r of dally sample data vahi6s plus the number bf aver
of
samphng events used for checking coin Iia ce wit1F average limits; ; i :•z `
TRC Technical Review Criteria, Multiply the actual IUP limits by ilii pz©pr:;rRCtgna'valuejto:t a
TRC Limit.
TRC Cnteria = 1.4 for BOD, TSS, oil, fat grease
TRC Cnteria = 1.2 for all other pollutants
Not required to perform TRC compliance fudge ment for pH
SNCR SigmficantNon-Compliance Report
SNC Significant Non -Compliance (formerly called Reportable Non -Compliance or RNC)
Tale SNC With Limits Compliance Judgement Worksheet
File name 2761ankcompjudge append? -c lan2001
Revision date 1/5/01

HICKORY
�, '�� North Carolina
Life. 'Nell Crafted
Public Utilities
January 29, 2018
Mr Tim Glenn
Kleen Tech Inc
PO Box 1369
Hickory, NC 28603
RE: Notice of Violation with Assessment of Civil Penalties
Pretreatment Permit #0035
City of Hickory
Hickory Regional Laboratory
310 Cloninger Mill Rd
Hickory, NC 28601
Phone. [phone]
Fax: [phone]
Email: dcox@hickorync gov
This letter transmits notice of violation with a civil penalty assessed against Kleen Tech Inc in
the amount of $100 00 for violations of permit limitations for Oil and Grease
Within thirty days of receipt of this notice, you must do the following -
Submit payment of the penalty to -
City of Hickory
Public Utilities Department
PO Box 398
Hickory, NC 28603
2 Submit a narrative stating the cause of and time needed to correct the violation(s).
The payment of this penalty will not foreclose further enforcement action for any continuing or
new violation(s).
Remedial actions, if not already implemented, should be taken to correct the problem(s)
If you have questions, please call this office at [phone]
Sincerely,
David R Cox
Pretreatment coordinator

Meen Tech, Inc
PO Box 1369
Hickory, NC 28603
828-397-3357
February 13, 2018
David Cox
Hickory Regional Lab
City of Hickory
Fax: [phone]
This letter is in response to the Notice of Violation dated January 29, 2018.
The discharge may have been more concentrated due to the low production
volume. We have also changed to a new environmental friendly detergent
that should help lower our oil and grease levels. We have completed re -test
of the water quality from our process to confirm compliance. If you have
any questions, please contact me at 828-397-3357.
Sincerely,
Tim Glenn
Kleen Tech, Inc
[e-mail]