NCG210288_ROS Request to RRO_20181114

MR AOFNCY USE3 ONLY
Division of Energy, Mineral & Land Resources Date Remsved
KID.
Stormwater Program
National Pollutant Discharge Elimination System
Environmental REPRESENTATIVE OUTFALL STATUS (ROS)
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if a facility is required to sample multiple discharge locations with very similar starmwater discharges, the
permittee may petition the Director for Representative Outfall Status (RDS). DEQ may grant Representative
Outfall Status if starmwater discharges from a single outfall are representative of discharges from multiple
outfalls. Approved ROS will reduce the number of outfalls where analytical sampling requirements apply.
if Representative Outfall Status is granted,Ait out are still subject to the qualitative monitoring
requirements of the facility's permit—unless otherwise allowed by the permit (such as NCG020000) and DEQ
approval. The approval letter from DEQ must be kept on site with the facility's Storm water Pollution
Prevention Plan. The facility must notify DEQ in writing if any changes affect representative status.
For questions, please contact the DEQ Regional Office for your area (see page 3).
(Please print or type)
1) Enter the permit number to which this ROS request applies:
individual Permit (or) Certificate of Coverage
N I C I 5 N C G 2 1 0 0 0 0
2) Facility Information:
Owner/Facility Name Boise Cascade Wood Products, LLC - Roxboro Engineered Wood Products
Facility Contact
Street Address
City
County
Telephone No.
Brian Van Gelder
1000 North Park Drive
Roxboro
Person
803 385.4957
State NC ZIP Code 27573
E-mail Address [e-mail]
Fax:
3) List the representative outfall(s) information (attach additional sheets if necessary):
Outfall(s) 1 is representative of Outfall(S) 2. 3, and 4
Outfalls' drainage areas have the same or similar activities? es ❑ No
Outfalls' drainage areas contain the same or similar materials? yy.
s c3 No
Outfalls have similar monitoring results? ❑ No ❑ No data*
Outfall(s)
Is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities?
Outfalls' drainage areas contain the same or similar materials?
Outfalls have similar monitoring results?
Outfall(s)
Is representative of Outfall(s)
❑ Yes
❑ No
❑ Yes
o No
❑ Yes
❑ No ❑ No data*
Outfalls' drainage areas have the same or similar activities? ❑ Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? o Yes ❑ No
Outfalls have similar monitoring results? ❑ Yes ❑ No ❑ No data*
*Non-compliance with analytical monitoring prior to this request may prevent ROS approval. Specific
circumstances will be considered by the Regional Office responsible for review.
Pagel o1`3
SWU-ROS-2009 Last revised 12/30/2004

(1)
Boise Cascade
Roxboro EXT
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
1000 Nnnh Puk Drive
Rnxborn. NC 27573
(803Y385-4957
rAR (803)-581.4036
Re: Boise Cascade Wood Products —Roxboro EWP
NPDES Permit: NCG2I0000 - Representative Outfall Status
Roxboro, Person County, NC
CERTIFIED MAT 1, / RETURN RECEIPT REQUEST
7013 2250 00001834 4998
To Whom it May Concern:
This is an explanation of the reasons Boise Cascade Wood Products — Roxboro
Engineered Wood Products believes Outfall qualifies for Representative Outfall Status.
Outfalls 1, 2, 3 and 4 have similar industry activities and have similar material stored in
their respective basins. Outfalls 1, 2, 3, and 4 also have similar analytical results.
The analytical results for the 2nd half of 2017 and the 151 half of 2018 are attached along
with the map the shows the outfall locations. NC DEQ Form SWU-ROS-2009 is also
attached.
If you have any questions regarding the information in this letter or about the information
provided, please contact Brian Van Gelder at 803-385-4957.
w
eBleu
Plant Manager
Boise Cascade Wood Products

Representative Outfall Status Request
4) Detailed explanation about why the outfalls above should be granted Representative Status:
(Or, attach a letter or narrative to discuss this information.) For example, describe how activities and/or
materials are similar.
See attached letter.
5) Certification:
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record,
report, plan, or other document filed or required to be maintained under this Article or a rule implementing this
Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case
under this Article; o- who falsifies, tampers with, or knowingly renders Inaccurate any recording or monitoring device
or method required to be operated or maintained under this Article or rules of the (Environmental Management]
Commisslon Implemcnting-this-Article shall be guilty of Class -2 misdemeanor -which- may. include 0 fine -not to exceed
ten thousand dollars )$10,000}.
I hereby request Representative Outfall Status for my NPDES Permit. I understand that ALL outfalls are still
subject to the qualitative monitoring requirements of the permit, unless otherwise allowed by the permit
and regional office approval. I must notify DEQ in writing if any changes to the facility or its operations
take place after ROS is granted that may affect this status. If ROS no longer applies, I understand I must
resume monitoring of all outfalls as specified in my NPDES permit.
I certify that I am familiar with the information contained In this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Herman LeBleu
Title: aiant4g4g-
(Signature of Applicant)
.5h- h,g _
Dae Signed)
Please note: This application for Representative Outfall Status Is subject to
approval by the NCDEQ Regional Office. The Regional Office may inspect your
facility for compliance with the conditions of the permit prior to that approval.
Final Checklist -for ROS Rgguest
This application should include the following Items:
/I This completed form.
m/ Letter or narrative elaborating on the reasons why specified outfalls should be granted representative
i status, unless all information can be included in Question 4.
ii/ Two (2) copies of a site map of the facility with the location of all outfalls clearly marked, including the
ildrainage areas, industrial activities, and raw materials/finished products within each drainage area.
Summary of results from monitoring conducted at the outfalls listed in Question 3.
o Any other supporting documentation.
}'age 2 of 3
SWU•ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
Mail the entire package to:
NCDEQ DEMLR at the appropriate Regional Office (See map and
addresses below)
Notes
The submission of this document does not guarantee Representative Outfall Status (ROS) will be granted as
requested. Analytical monitoring as per your current permit must be continued, at all outfalls, until written
approval of this request is granted by DEQ. Non-compliance with analytical monitoring prior to this request
may prevent ROS approval. Specific circumstances will be considered by the Regional Office responsible for
review.
For uestions, please contact the DEQ,Regional Office for your area.
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Phone [phone]
FAX [phone]
Fayetteville Regional Office
Systel Building,
225 Green St., Suite 714
Fayetteville, NC 28301-5094
Phone [phone]
FAX [phone]
Mooresville Regional Office
610 East Center Ave.
Mooresville, NC 28115
Phone [phone]
FAX [phone]
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Phone [phone]
FAX [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone [phone]
FAX [phone]
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone [phone]
FAX [phone]
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Phone [phone]
Water Quality Main FAX [phone]
Central Office
1612 Mail Service Center
Raleigh, NC 27699-1612
Phone [phone]
FAX [phone]
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5WU-ROS-2009 East revised 42/30/2009