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Home My WebLink AboutNC0028916_Annual Report_20180703 • ROY MANESS _. OV TROD MAYOR gillIA , ORPROE M cf TONVN OF TROYJAMES 1 Er h[I `T I \ 'Z COMMISSIONERS: _ . _ , ANGELA ELKINS ' ��`� 0• O 1852 G�l'G OA\,itt BRUCE HAMILTON WALLACE JONES DAMON PRINCE GREG ZEPHIR TOWN MANAGER 11 CATHY M.MANESS TOWN CLERK RECEIVED/DENR/DWR July 3, 2018 JAN 1 8 2019 Wright foods Water Resources 1Wright Way Permitting Section Troy, NC 27371 Subject: SIU Permit This document certifies the SIU permit for Wright Foods dated July 1, 2018 was hand delivered on this date July 3, 2018. Di ector TW Joseph Shields / 315 NORTH MAIN STREET TROY,NC 27371 PHONE:(910)572-3661 FAX:572-3663 www.troy.nc.us TOWN OF TROY Control Authority andlor Municipality PERMIT - - Industrial User Pretreatment Permit(IUP) To Discharge Wastewater Under the Industrial Pretreatment Program 0003 NA tUP Number 40 CFR Category(ifApplicable) In compliance with the provisions of North Carolina General Statute 143-215.1, any applicable federal categorical pretreatment regulations, all other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Control Authority and/or Municipality Sewer Use Ordinance. The following Industry,hereafter referred to by name or as the'permittee: Industry name.permittee: Wright Foods Fealty located at Street Address 1 Wright Way City -- Troy - ---- - - - - - - State,Zip NC 27371 is hereby authorized to discharge wastewater from the facility located at the above listed address into the sanitary sewer collection system and the wastewater treatment facility of the Control Authority and/or Municipality listed below: IUP Control Authority and/or Municipality W WIP name: Town of Troy NPDES Number NC0028916 WIMP Address 315 N Main St. city,State,ZIP Troy,North Carolina 27371 in accordance with effluent limitations,monitoring requirements, and all other conditions set forth in Parts I,II,and HE of this Industrial User Pretreatment Permit(IUP). Effective date,this permit and the authorization to discharge shall become effective at midnight on this dates August 1, 2018 Expiration date,this perm/and the authorization to discharge shall expire at midnight on this date: August 1, 2023 w( I 2016 LiJf Li- 1 t sigma DirectoIPOTW Workbook Name : Troy.HWA.AT.2014.Approved (1)2018DRAFT, mlorkkheet Name: ATPrinted: 1/16/2019, 9.14AM Page 1 of 6 Allocation Table Spreadsheet Instructions Headworks last approved: 04/11/14 1)Applicable Values should be entered in the Heavy Bordered cells Rest of worksheet is protected,password is 2" Allocation Table updated: 11/15/18 2)Formulas are discussed in the Comprehensive Guidance,Chapter 6,Section C Permits last modified: 12/01/16 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 POTw=>Town of Troy NPDEs#=> NC00028916 FLOW BOD TSS Industry Type Renewal Modification Date Permit Limits Permit Limits Permit Limits IUP INDUSTRY NAMES Permit Pipe of Effective Effective Permit Conc. Load Conc. Load Count (please lot alplabeucly) number number Indus Date Date Expires MGD gal/day mg/1 lbs/da mg/1 lbs/day 1 Wright Foods 0003 0001 Food 08/15/13 03/01/15 08/01/18 125,000 600.00 625.50 3® 312.75 2 Uwharrie Environmental 0004 0001 Leachate 12/01/16 12/20/2017 11/30/21 0.0200 20,000 2400.00;- 400.32 300.00 50.04 3 4 , 5 7 8 U, 9 10 Column Totals=> 1 0.1450 145,0004 1026 I 363 Basis=> NPDES Design Design MARL from HWA(lbs/day)=> NPDES Permitted Flow=> 1.2000 3002 3002 Uncontrollable Loading(lbs/day)=> 0.3950 876 626 Total Allowable for Industry(MAIL)(lbs/day)=> 0.8050 2126 2376 Total Permitted to Industry(lbs/day)=> 0.1450 1026 363 MAIL left(lbs/day)=> 0.6600 1100 2014 Percent Allow.Ind.(MAIL)still available(%)=> 82.0% 51.8% 84.7% Percent MARL still available(%)_> 55.0% 36.6% 67.1% 5 Percent MAID,(lbs/day)=> 0.0600 150 150 HWA.AT Revised•November 2005 Workbook Name : Troy.HWA.AT.2014.Approved (1)2018DRAFT, Worksheet Name: ATPrinted. 1/16/2019, 9:14 AM Page 2 of 6 Allocation Table Headworks last approved: 04/11/14, Allocation Table updated: 11/15/18 Permits last modified: 12/01/16 Pores=>Town of Troy NPDESS=' NC00028916 Ammonia Arsenic Cadmium Chromium Copper Cyanide Industry Permit Limits Permit Limits Permit Limits Permit Limits Permit Limits Permit Limits IUP INDUSTRY NAMES Permit Pipe Conc. Load Conc. Load Conc. Load Conc. Load Conc. Load Conc. Load Count (please list alphabebcly) number number mg/1 lbs/day mg/1 lbs/day mg/1 lbs/day mg/I lbs/day mg/1 lbs/day mg/1 lbs/day 1 Wright Foods 0003 t 0001 2 Uwharrie Environmental 0004 0001 750.00 125.10 3 4 P� 5 6me , , ---- 7 8 9 10 Column Totals=> 125 0.0000 0.0000 0.0000) 0.0000 0.0000 AS/Nit/TF Stream Stream AS/Nit/TF Stream Basis=> NPDES inhibition Std Std inhibition Std MAHL from HWA(lbs/day)=> 400.32 0.4420 0.0382 1.7514 4.4202 0.1017 Uncontrollable Loading(lbs/day)_> 83.02 0.0109 0.0033 0.1647 _ 0.1654 0.0059 Total Allowable for Industry(MAIL)(lbs/day)=> 317.30 0.4311 0.0349 1.5867 4.2548 0.0958 Total Permitted to Industry(lbs/day)=> 125.10 0.0000 0.0000 0.0000 0.0000 0.0000 MAIL,left(lbs/day)=> 192.20 0.4311 0.0349 1.5867 4.2548 0.0958 Percent Allow.Ind.(MAIL)still available(%)=> 60.6% 100.0% 100.0% 100.0% 100.0% 100.0% Percent MARL still available(%)_> 48.0% 97.5% 91.4% 90.6% 96.3% 94.2% 5 Percent MARL(lbs/day)_> 20.02 0.0221 0.0019 0.0876 0.2210 0.0051 HWA AT Revised'November 2005 Workbook Name : Troy.HWA.AT.2014.Approved (1)2018DRAFT, Worksheet Name: ATPrinted: 1/16/2019, 9.14AM Page 3 of 6 Allocation Table Headworks last approved: 04/11/14 Allocation Table updated. 11/15/18 Permits last modified: 12/01/16 •Pores., Town of Troy • NPDES#=> NC00028916 Lead Mercury Molybdenum Nickel Selenium Sit Industry Permit Limits Permit Limits Permit Limits Permit Limits Permit Limits Permit IUP INDUSTRY NAMES Permit Pipe Conc. Load Conc. Load Conc. Load Conc. Load Conc. Load Conc. Count (please hetalphabebcly) number number mg/1 .. lbs/day mg/1 lbs/days mg/1 lbs/day mg/1 lbs/days mg/1 lbs/day, mg/1 1 Wright Foods 0003 0001 _ 2 Uwharrie Environmental 0004 0001 3 4 5 6 7 8 i O 9 10 Column Totals=> 1 0.0000' 0.0000001 I 0.0000I I 0.00001 ) 0.0000 Stream Stream Stream Basis=> Std Stream Std Std Std MARL from HWA(lbs/day)=> 0.4042 0.075660 0.9566 0.0631 Uncontrollable Loading(lbs/day)_> 0.1614 0.000527 0.0089 7.4613 Total Allowable for Industry(MAIL)(lbs/day)=> 0.2427 0.075133 -6.5046 ####### Total Permitted to Industry(lbs/day)_> 0.0000 0.000000 0.0000 0.0000 0.0000 MAIL left(lbs/day)_> 0.2427 0.075133 -6.5046 ####### Percent Allow.Ind.(MAIL)still available(%)_> 100.0% 100.0% ####### 100.0% ####### Percent MARL still available(%)_> 60.1% 99.3% ####### -680.0% ####### 5 Percent MARL(lbs/day)=> _ 0.0202 0.003783 0.0478 0.0032 HWA.AT Revised:November 2005 Workbook Name : Troy.HWA.AT.2014.Approved (1)2018DRAFT, Worksheet Name: AlPrinted• 1/16/2019, 9.14 AM Page 4 of 6 Allocation Table Headworks last approved: 04/11/14 Allocation Table updated 11/15/18, Permits last modified: 12/01/16 Pores., Town of Troy NPDES#=> NC00028916 ver Industry Limits HIP INDUSTRY NAMES Permit Pipe Load Count (please list alphabehcly) number number lbs/day 1 Wright Foods 0003 0001 2 Uwharrie Environmental 0004 0001 3 N 4 5 6 7 8 9 10 Column Totals=> 0.0000 Stream Basis=> Std MARL from HWA(lbs/day)_> 0.0015 Uncontrollable Loading(lbs/day)=> 0.0086 Total Allowable for Industry(MAIL)(lbs/day)=> -0.0071 Total Permitted to Industry(lbs/day)_> 0.0000 MAIL left(lbs/day)_> -0.0071 Percent Allow.Ind.(MAIL)still available(%)=> 100.0% Percent MAHL still available(%)=> -466.0% 5 Percent MARL(lbs/day)_> 0.0001 HWA.AT Revised.November 2005 Workbook Name : Troy.HWA.AT.2014.Approved (1)2018DRAFT, Worksheet Name: ATPrinted: 1/16/2019, 9.14AM Page 5 of 6 Allocation Table Headworks last approved: 04/11/14 Allocation Table updated: 11/15/18 Permits last modified: 12/01/16 Pores=>Town of Troy NPDESit» NC00028916 Zinc Total Nitrogen Total Phos. c d e Industry Permit Limits Permit Limits Permit Limits Permit Limits Permit Limits Permit Limits IUP INDUSTRY NAMES Permit Pipe Conc. Load Conc. Load Conc. Load Conc. Load Conc. Load Conc. Load Count (please listslphabetscly) number number m 1 lbs/day mg/I lbs/day mg/1 lbs/da mg/1 lbs/da mg/1 lbs/da mg/I lbs/da 1 Wright Foods 0003 0001 —. 2 Uwharrie Environmental 0004 0001 10 Column Totals=> 0.0000 0.00 0.00 0.0000 0.0000 0.0000 AS/Nit/TF Basis=> inhibition MARL from HWA(lbs/day)_> 4.4202 Uncontrollable Loading(lbs/day)=> 0.0339 Total Allowable for Industry(MAIL)(lbs/day)_> 4.3863 Total Permitted to Industry(lbs/day)_> 0.0000 0.00 0.00 0.0000 0.0000 0.0000 MAIL left(lbs/day)_> 4.3863 Percent Allow.Ind.(MAIL)still available(%)_> 100.0% ####### ####### ####### ####### ####### Percent MAHL still available(%)_> 99.2% ####### Hi/ Nl## ####it## #tttNt### #tt##### 5 Percent MAHL(lbs/day)_> 0.2210 HWA AT Revised•November 2005 Workbook Name : Troy.HWA.AT.2014.Approved (1)2018DRAFT, Worksheet Name: Arrinted 1/16/2019, 9.14AM Page 6 of 6 Allocation Table Headworks last approved: 04/11/14 Allocation Table updated: 11/15/18 Permits last modified: 12/01/16 POTW=>Town of Troy NPDES#k> NC00028916 f g h I Industry Permit Limits Permit Limits Permit Limits Permit Limits IUP INDUSTRY NAMES Permit Pipe Conc. Load Conc. Load Conc. Load Conc. Load Count (please list alphabeticly) number number _ mg/1 lbs/day mg/I lbs/day mg/1 lbs/day mg/I lbs/day 1 Wright Foods 0003 0001 2 Uwharrie Environmental 0004 0001 _,-',- 3 4 -- �� 5 -6 -.- /8 MI MOM, 9 �- 10 �� .-. �. Mii=1 Column Totals=> 0.0000 0.0000 0.0000 0.0000 Basis=> MAHL from HWA(lbs/day)_> Uncontrollable Loading(lbs/day)_> Total Allowable for Industry(MAIL)(lbs/day)=> Total Permitted to Industry(lbs/day)=> 0.0000 0.0000 0.0000 0.00.00 MAIL left(lbs/day)_> Percent Allow.Ind.(MAIL)still available(%)_> ####### ####### ####### ####### Percent MARL still available(%)_> ####### ####### ####### ####### 5 Percent MARL(lbs/day)=> HWA.AT Revised.November 2005 Industrial User Wastewater Survey & Permit Application COVER PAGE Company Name-Wright Foods Name of responsible person on site at the facility authorized to represent the Name of alternative on site person familiar with the day to day operations, company in official dealings with the Sewer Authority and/or the City environmental permitting requirements, monitoring, record keeping, and Rick Anton data management Steve Hellenschmidt Title Plant Manager Years with firm 4.5 Title V.P.Operations Years with firm 1.5 Phone#208-293-5534 Fax#N/A Phone#940-312-2044 Fax#N/A Physical street address of facility Official mailing address,if different Note if same 1 Wright Way Same Troy,NC 27371 City Troy State NC Zip 27371 City State Zip The information provided by you on this questionnaire serves two functions: 1. The information is used to determine if your facility needs an Industrial User Pretreatment Permit (IUP) for the discharge of wastewater to the local sewer. 2. If an Industrial User Pretreatment Permit (IUP) is required, this survey serves as the application for an Industrial User Pretreatment Permit(IUP). Requests for confidential treatment of information provided on this form shall be governed by procedures specified in 40 CFR Part 2. In accordance with Title 40 of the Code of Federal Regulations Part 403, Section 403.14 and the Local Sewer Use Ordinance (SUO), information and data provided in this questionnaire which identifies the content, volume and frequency of discharge shall be available to the public without restriction. This is to be signed by an authorized official of your firm, as defined in the Local Sewer Use Ordinance or the NC Model Sewer Use Ordinance, Section 1.2, after completion of this form. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based upon my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and/or imprisonment for knowing violations. Signature of Authorized Representative Date listed above (seal if applicable) Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 1 of 198 Industrial User Wastewater Survey & Permit Application 1. Provide a brief narrative description of the type of business, manufacturing processes, or service activities your firm conducts at this site. Wright Foods is Aseptic Food Manufacturer. 2. List the primary products produced at this facility: Tomato Sauce Chicken Broth Coffee 3. List raw materials and process additives used: Tomato Paste Chicken Base Coffee bean Extract 4. Are biocides added to any water discharged to the POTW, if yes describe: Yes No X 5. Describe weekly production schedule, including shifts worked per day, employees per shift, and primary operation during shift. Monday-Friday 1st Shift 6am-2:30pm Food Manufacturing 25 employees 2nd Shift 2pm-10:30pm Food Manufacturing 11 employees 3rd Shift 10pm-6:30am Sanitation 3 employees 6. Production process is: Check, if all continuous X Check, if all batch If both please enter, % continuous = % % Batch= Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 2 of 198 Industrial User Wastewater Survey & Permit Application 7. Does production vary significantly (+- 20 %) by season. Describe. Yes No x 8. Are any significant (+- 20 %) changes in production that will affect wastewater discharge expected in the next 5 years. If yes, please describe. Yes x Possible Addition of four new Production lines.Not Confirmed Yet.Should No Confirm Q1 2019 _ 9. List all current waste haulers. Give name, address, phone numbers, volume and materials hauled off. RF Waste Water 919-615-1205 15,0001bs/Month 733 W. Johnson St. #200 Raleigh,NC. 27603 10. Attach a copy of laboratory analyses performed in the last year on the wastewater discharge(s) from your facilities. Summarize data on the attached Data Summary Form. Done by City of Troy 11. Attach sketch or schematic showing sampling points and all connections to the sewer. 12. Complete the Wastewater Pollutants Checklist attached to this Survey. Title. IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 3 of 198 Industrial User Wastewater Survey & Permit Application 13. Do you have, or have you ever applied for, been issued, or been denied an NPDES permit to discharge to the surface waters or storm sewers of North Carolina? If yes, list all other NPDES permits, permit numbers, dates, and names used to apply for them, or reason denied. If yes Permit,#,date,applicant name Yes If yes Permit,#,date,applicant name No 14. Do you have, or have you ever applied for or been issued an Industrial User Pretreatment Permit (IUP) to discharge wastewater to the sewer collection system. If yes, list all other IUP permits, permit numbers, dates, and names used to apply for them. If yes Permit,#,date,applicant name IUP#003 Wright Foods 8-1-2018 X Yes If yes Permit,#,date,applicant name No 15. Do you have, or have you ever applied for or been issued any other Environmental Permits (for example; air, RCRA, groundwater, stormwater, general, Non-Discharge, septic tank, etc.). If yes, list all other permits, permit numbers, dates, and names used to apply for them. If yes Permit type,#,date,applicant name Yes If yes Permit type,#,date,applicant name No X If yes Permit type,#,date,applicant name 16. Is a Spill Prevention Control and Countermeasure (SPCC) Plan prepared for this facility? Yes X No 17. Is a Spill /Slug Control Plan required by the POTW, prepared for this facility? Yes X No 18. Do you have any underground storage tanks at your facility? If yes, list contents and volume of each tank. Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 4 of 198 Industrial User Wastewater Survey & Permit Application 500ga1. Yes X 1000 gal. No 19. Do you have any above ground storage tanks at your facility? If yes, for each tank, list the contents, volume, whether the tank has any spill prevention or containment devices, such as dikes, and procedures for draining any containment devices. DAF System Yes X #of Tanks 1 8,000ga1. No Drains back into underground Tanks Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 5 of 198 Industrial User Wastewater Survey & Permit Application PART II, Water Supply, Use, & Disposal Worksheet: Water Used for: Water Avg. Max. M E Disposal Avg. Max. M E gal/day gal/day e st gal/day gal/day e st Source(s) a i Method(s) a i s m s m u at u at re e re e d d d d (see Source List below) (see Disposal List below) 1. Process water City/Public supply Sanitary sewer,with pretreatment 2. Washdown water City/Public supply Sanitary sewer,with pretreatment 3. Water into product City/Public supply Sanitary sewer,with pretreatment 4. Air Quality Permitted units N/A N/A 5. Domestic-toilets, drinking, cafe City/Public supply Sanitary sewer, without pretreatment 6. Cooling water, Process NON-Contact City/Public supply Sanitary sewer,with pretreatment 7. Boiler/Cooling tower blowdown City/Public supply Sanitary sewer,with pretreatment 8. Cooling water, HVAC City/Public supply Sanitary sewer,with pretreatment 9. Other: , Totals=> Totals=> Typical Water Sources: Possible Water Disposal Methods 1. City/Public supply 1. Sanitary sewer, with pretreatment 2. Private wells, drinking 2. Sanitary sewer, without pretreatment 3. Groundwater remediation wells 3. Storm sewer 4. Private ponds 4. Surface waters of NC 5. Surface waters of NC, please identify 5. Evaporation 6. Include others if applicable 6. Land applied Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 6 of 198 7. To groundwater 8. Septic Tank 9. Waste Haulers(identify) 10. Water into Product 11. Include others, if applicable Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 7 of 198 PART III, PRETREATMENT FACILITIES: Are there any pretreatment devices or processes used for treating wastewater before being discharged to the sewer? Check all that are present, and describe. No pretreatment facilities => 1. Flow equalization Aerated equalization=> X NON-Aerated equalization=> Total volume of equalization (million gal.) _> 2. Activated Carbon Yes No X Describe any, if present. 3. Activated Sludge Yes X No 4. Air Stripping Yes No X 5. Centrifugation Yes No X 6. Chemical Precipitation Yes X No 7. Chlorination Yes No X 8. Cyanide Destruction Yes No X 9. Cyclone Yes No X 10. Dissolved Air Floatation Yes X No 11. Filtration Yes X No 12. Flocculation Yes X No 13. Grease Trap Yes X No 14. Grit Removal Yes X No 15. Ion Exchange Yes No X 16. Neutralize, pH adjust Yes X No 17. Other Biological Treatment Yes X No 18. Ozonation Yes No X 19. Reverse Osmosis Yes No X 20. Screening Yes X No 21. Sedimentation Yes X No 22. Septic Tank Yes No X 23. Silver Recovery Yes No X 24. Solvent Separation Yes No X 25. Spill protection Yes X No List any others. Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 8 of 198 PART IV, CATEGORICAL INFORMATION: 1. When were operations started at this facility Facility start up date 2013 2. List all Standard Industrial Classification(SIC) codes for your facility. These may be found on State Unemployment forms, tax forms, accounting records, or from the Chamber of Commerce. 3. Has this facility ever been considered a Categorical Industrial User (CIU) as described by the Code of Federal Regulations (40 CFR)? If yes, give complete 40 CFR number=> No 4. Are any other facilities owned and/or operated by your company permitted as Categorical Industrial Users (CIUs) as described by the Code of Federal Regulations (40 CFR)? If yes please give name(s), location, and 40 CFR number. Yes No Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 9 of 198 PART IV, CATEGORICAL INFORMATION: (continued) 5. Check any activities listed below that are performed at your facility: Check 40 Industrial Activity Check 40 Industrial Activity below CFR# below CFR# 467 Aluminum Forming X 432 Meat products 427 Asbestos Manufacturing 433 Metal finishing 461 Battery Manufacturing 464 Metal molding and casting 431 Builders paper&board mills 436 Mineral mining and processing X 407 Canned&preserved fruits&veg. 471 Nonferrous Metal,Form&Powders 408 Canned&preserved seafood 421 Nonferrous Metals Manufacturing 458 Carbon black Manufacturing 414 OCPSF, Organic Chemicals,Plastics, 411 Cement Manufacturing &Synthetic Fiber Manufacturing 437 Centralized Waste Treatment 435 Oil&gas extraction 434 Coal Mining 440 Ore mining and dressing 465 Coil Coating 446 Paint formulating 468 Copper Forming 443 Paving and roofing materials Mfg. X 405 Dairy products processing 455 Pesticide Manufacturing 469 Electrical,electronic components 419 Petroleum Refining 413 Electroplating 439 Pharmaceutical Manufacturing 457 Explosives Manufacturing 422 Phosphate Manufacturing 412 Feedlots 459 Photographic supplies 424 Ferro allay Manufacturing 463 Plastics molding and forming 418 Fertilizer Manufacturing 466 Porcelain enameling 464 Foundries,Metal Mold&Casting 430 Pulp,paper,and paperboard 426 Glass Manufacturing 428 Rubber Manufacturing 406 Grain mills 417 Soap&Detergent Manufacturing 454 Gum&Wood Chemicals Mfg. 423 Steam Electric power Generation 460 Hospitals 409 Sugar processing 447 Ink formulating 410 Textile Mills 415 Inorganic chemical Manufacturing 429 Timber products processing 420 Iron& Steel Manufacturing 442 Transportation Equipment Cleaning 425 Leather Tanning&Finishing Others Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 10 of 198 Wastewater Pollutant Checklist Chemical Name EPA Check if Check if Check if Check if Concentration Storet Present at Absent at Present in Absent in in Discharge, Code Facility Facility Discharge Discharge if Known (mg/1) Acid Extractable Organics 2-Chlorophenol 34586 X 2,4-Dichlorophenol 34601 X 2,4-Dimethylphenol 34606 X 2,4-Dinitrophenol 34616 X 2-Methyl-4,6-dinitrophenol 34657 X 4-Chloro-3-methylphenol 34452 X 2-Nitrophenol 34591 X 4-Nitrophenol 34646 X Pentachlorophenol 39032 X Phenol . 34694 X 2,4,6-Trichlorophenol 34621 X Base Neutral Organics 1,2,4-Trichlorobenzene 34551 1,2-Dichlorobenzene 34536 1,2-Diphenylhydrazine 34346 1,3-Dichlorobenzene 34566 1,4-Dichlorobenzene 34571 2,4-Dinitrotoluene 34611 2,6-Dinitrotoluene 34626 2-Chloronaphthalene 34581 3,3-Dichlorobenzidine 34631 4-Bromophenyl phenyl ether 34636 4-Chlorophenyl phenyl ether 34641 Acenaphthene 03405 Acenaphthylene 34200 Anthracene 34220 Benzidine 39120 Benzo (a)anthracene 34526 Benzo(a)pyrene 34247 Benzo(b)fluoranthene 34230 Benzo(ghi)perylene 34521 Benzo(k)fluoranthene 34242 Bis(2-chloroethoxy)methane 34278 Bis(2-chloroethyl)ether 34273 Bis(2-chloroisopropyl)ether 34283 Bis(2-ethylhexyl)phthalate 39100 Butyl benzyl phthalate 34292 Chrysene 34320 Di-n-butyl phthalate 39110 Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 11 of 198 Wastewater Pollutant Checklist Chemical Name EPA Check if Check if Check if Check if Concentration Storet Present at Absent at Present in Absent in in Discharge, Code Facility Facility Discharge Discharge if Known (mg/1) Base Neutral Organics (continued) Di-n-octyl phthalate 34596 Dibenzo (a,h) anthracene 34556 Diethyl phthalate . 34336 Dimethyl phthalate 34341 Fluoranthene ° 34376 Fluorene 34381 Hexachlorobenzene 39700 Hexachlorobutadiene 34391 Hexachlorocyclopentadiene 34386 Hexachloroethane 34396 Indeno(1,2,3-cd) pyrene 34403 Isophorone 34408 N-nitroso-di-n-propylamine 34428 N-nitrosodimethylamine 34438 N-nitrosodiphenylamine 34433 Naphthalene 34696 Nitrobenzene 34447 Phenanthrene 34461 Pyrene 34469 Metals Aluminum 01104 Antimony 01097 Arsenic 01002 Beryllium 01012 Cadmium 01027 Chromium 01034 Copper 01042 Lead 01051 Mercury 71900 Molybdenum 01062 Nickel 01067 Selenium 01147 Silver 01077 Thalium 00982 Zinc 01092 Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industnal Wastewater Survey&IUP Permit Application(Long Form)(I)docx Revision date 12/30/97 Page 12 of 198 Wastewater Pollutant Checklist Chemical Name EPA Check if Check if Check if Check if Concentration Storet Present at Absent at Present in Absent in in Discharge, Code Facility Facility Discharge Discharge if Known (mg/1) Other Inorganics Barium 01007 Chloride 00940 Cyanide 00720 Fluoride 00951 Purgeable Volatile Organics 1,1,1-Trichloroethane 34506 1,1,2,2-Tetrachloroethane 34516 1,1,2-Trichloroethane 34511 1,1-Dichloroethane 34496 1,1-Dichloroethvlene '34501 1,2-Dichloroethane 34531 1,2-Dichloropropane 34541 2-Chloroethvl vinyl ether 34576 Acrolein 34210 Acrylonitrile 34215 Benzene 34030 Bromodichloromethane 32101 Bromoform 32104 Bromomethane 34413 Carbon tetrachloride 32102 Chlorobenzene 34301 Chloroethane 34311 Chloroform 32106 Chloromethane 34418 cis 1,3-Dichloropropene 34704 Dibromochloromethane 32105 Ethvlbenzene 34371 Methylene chloride 34423 Tetrachloroethvlene 34475 Toluene 34010 trans 1,3-Dichloropropene 34699 trans-1,2-Dichloroethvlene 34546 Trichloroethvlene 39180 Trichlorofluoromethane 34488 Vinyl chloride 39175 Others Xylene Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industnal Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 13 of 198 Data Summary Form <= Receiving POTW <= Receiving NPDES # <= Specific Sample Location! i.e., Give IU Name, IUP#, and/or pipe# BOD TSS Ammonia Lab => Laboratory performing analysis=> MDL=> Laboratory Method Detection Limits=> Notes=> Notes=>_ Q = Flow Sample Date Notes about Sample M =Metered Conc. Results Conc. Results Conc. Results ID, or Sample E=Estimated from Lab from Lab from Lab Count Collected mgd gal/day <? mg/1 <? mg/1 <? mg/1 1 2 3 4 5 6 7 8 9 10 11 12 etc TNS => Total number of samples => Max. value=> Maximum data value (mg/1)=> Avg. (use 1/2 BDL)_> Avg. data value, Include BDL values as 1/2 detection limit=> Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 14 of 198 Data Summary Form <= Receiving POTW <= Receiving NPDES # <= Specific Sample Location! i.e., Give IU Name, IUP#, and/or pipe# Arsenic Copper Chromium Cadmium COD Copper Lab => MDL=> Notes => Sample Date Sample Conc. Results Conc. Results Conc. Results Conc. Results Conc. Results Conc. Results ID or Collected from Lab from Lab from Lab from Lab from Lab from Lab Count <? mg/1 <? mg/1 <? mg/1 <? mg/1 <? mg/1 <? mg/1 1 2 3 4 5 7 8 9 10 11 12 etc TNS => Max. Value=> Avg. (use1/2 BDL) => Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industnal Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date- 12/30/97 Page 15 of 198 Data Summary Form <= Receiving POTW <= Receiving NPDES # <= Specific Sample Location! i.e., Give IU Name, IUP#, and/or pipe# Cyanide Lead Mercury Nickel Silver Zinc Lab => MDL => Notes=> - Sample Date Sample Conc. Results Conc. Results Conc. Results Conc. Results Conc. Results Conc. Results ID or Collected from Lab from Lab from Lab from Lab from Lab from Lab Count <? mg/1 <? mg/1 <? mg/1 <? mg/1 <? mg/1 <? mg/1 1 2 3 4 5 6 7 8 9 10 11 12 etc TNS => Max. Value=> Avg. (usel/2 BDL) => Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(I).docx Revision date 12/30/97 Page 16 of 198 Data Summary Form <= Receiving POTW <= Receiving NPDES # <= Specific Sample Location! i.e., Give IU Name, IUP#, and/or pipe# Other Other Other Other Other Other Lab => MDL=> Notes=> Sample Date Sample Conc. Results Conc. Results _ Conc. Results Conc. Results Conc. Results Conc. Results ID or Collected ' from Lab from Lab from Lab from Lab from Lab from Lab Count <? mg/1 <? mg/1 <? mg/1 <? mg/1 <? mg/1 <? mg/1 1 2 3 4 5 6 7 8 9 10 11 12 etc TNS => Max. Value=> Avg. (use1/2 BDL) _> Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 - Page 17 of 198 Industrial User Wastewater Survey & Permit Application Part V, Waste Reduction Information : State Pretreatment Rule 15A NCAC 2H.0916 (c)(1)(M) requires Significant Industrial Users to include a description of current and projected waste reduction (pollution prevention) activities. The codes listed are standard EPA codes found on Toxic Release Inventory and other environmental forms. Please check all applicable codes for your facility related to wastewater discharge. Current Projected Code Description X W 13 Improved maintenance scheduling recordkeeping, or procedures X W14 Changed production schedule to minimize equipment and feedstock changeovers W 19 Other changes in operating practices (explain briefly in comments) X W21 Instituted procedures to ensure that materials do not stay in inventory beyond shelf-life W22 Began to test outdated material-continue to use if still effective W23 Eliminated shelf-life requirements for stable materials X W24 Instituted better labeling procedures W25 Instituted clearinghouse to exchange materials that would otherwise be discarded W29 Other changes in Inventory control (explain briefly in comments) X W31 Improved storage or stacking procedures W32 Improved procedures for loading, unloading and transfer operations X W33 Installed overflow alarms or automatic shutoff valves X W34 Installed secondary containment W35 Installed vapor recovery systems W36 Implemented inspection or monitoring program of potential spill or leak sources W39 Other spill and leak prevention(explain briefly in comments) W41 Increased purity of raw materials W42 Substituted raw materials W49 Other raw material modifications (explain briefly in comments) W51 Instituted recirculation within a process Title IU Wastewater Survey&Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 18 of 18 Industrial User Wastewater Survey & Permit Application Current Projected Code Description X W52 Modified equipment, layout, or piping W53 Use of a different process catalyst X W54 Instituted better controls on operating bulk containers to minimize discarding of empty containers W55 Changed from small volume containers to bulk containers to minimize discarding of empty containers W58 Other process modifications (explain briefly in comments) W59 Modified stripping/cleaning equipment W60 Changed to mechanical stripping/cleaning devices (from solvents or other materials) W61 Changed to aqueous cleaners ( from solvents or other materials) W62 Reduced the number of solvents used to make waste more amenable to recycling X W63 Modified containment procedures for cleaning units W64 Improved draining procedures W65 Redesigned parts racks to reduce dragout W66 Modified or installed rinse systems W67 Improved rinse equipment design W68 Improved rinse equipment operation W71 Other cleaning and degreasing operation(explain briefly in comments) W72 Modified spray systems or equipment W73 Substituted coating materials used W74 Improved application techniques W75 Changed from spray to other system W78 Other surface preparation and finishing (explain briefly in comments) W81 Changed product specifications W82 Modified design or composition of product W83 Modified packaging W89 Other product modifications (explain briefly in comments) W99 Other(specify in comments) Comments (Please list corresponding code) Title IU Wastewater Survey & Permit Application File name C\Users\ranton\Documents\Industrial Wastewater Survey&IUP Permit Application(Long Form)(1)docx Revision date 12/30/97 Page 19 of 198