NC0027103_Renewal Application_20190124

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ROY COOPER 4- '
Governor ~a .41_ g
MICHAEL S.REGAN `.� , „
&crtlary
LINDA CULPEPPER NORTH CAROLINA
Director Environmental Quality
January 24, 2019
Tyler Thomas, Manager Town
Town of Pembroke
100 Union Chapel Rd
Pembroke, NC 28372
Subject: Permit Renewal
Application No. NC0027103
Pembroke WWTP
Robeson County
Dear Applicant:
The Water Quality Permitting Section acknowledges the January 23, 2019 receipt of your permit renewal,application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit.The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information'necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,in�
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Wren Thedford
Administrative Assistant
Water Quality Permitting Section
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POST OFFICE BOX 866
PEMBROKE, NORTH CAROLINA
-I895, 28372
OFFICE OF THE MANAGER MUNICIPAL BUILDING
100 SOUTH UNION CHAPEL ROAD
January 16th,2019 RECEIVED/DENR/DWR
NCDEQ/DWR JAN 2 3 20L9
Attn: NPDES Unit
1617 Mail Service Center Water Resources
Permitting Section
Raleigh,NC 27699-1617
Subject: NPDES Permit Renewal
Town of Pembroke
NPDES Permit#NC0027103
Robeson County
Dear Permitting Unit:
The Town of Pembroke is submitting the renewal application for NPDES permit #NC0027103.
The permit expiration date is July 31, 2019. The permit application consists of:
- Cover letter
- One original of Form 2A—NPDES Application for Permit Renewal
- Supplemental Application Information—Parts D, E& F
- Topographic Map
- Process Flow Schematic
- Three PPA results
- Three 2"d species toxicity testing results
- Industrial User Information for Part F
- One copy of Renewal Package
The Town has the following comments regarding the NPDES permit:
- The permit requires that a 2"d species toxicity test be performed four times prior to the
permit renewal. The requirement to perform the 2"d species toxicity testing was missed
by staff. A sampling schedule was established to perform the 2"d species testing each
month for four months, beginning in October 2018. The fourth 2"d species testing will be
completed in January 2019 and we will forward the results to your office.
- We are requesting the daily effluent monitoring of temperature be removed from the
permit or that the monitoring be reduced. There are no operational aspects that can
influence the temperature of the discharge.
PHONE (910) 521-9758 • FAX (910) 521-0472

- It is requested that upstream/downstream monitoring be eliminated. With the many
"outside" influences such as stormwater runoff from urban areas and other nonpoint
discharges to the river, taking dissolved oxygen levels and temperatures serve no useful
purpose as to determining discharge impacts upon the receiving stream. Permit limits
were established to protect the receiving stream and the plant is achieving these limits.
- We are requesting to retain reduced monitoring as an "exceptionally performing facility"
for BOD5, Ammonia Nitrogen, Fecal Coliform and Total Suspended Solids (TSS). For
TSS there were a number of samples that exceeded 200% of the monthly average due to
impacts from named storms and hurricanes. A review and analysis of testing results for
the past three years:
- Percent of Monthly Average Limit
Parameter Most Restrictive 3-Year Average % of Limit
Monthly Limit
BOD5 18.0 mg/L 3.8 mg/L 21.1%
TSS 20.0 mg/L 4.9 mg/L 24.5%
Ammonia N 12.0 mg/L 0.72 mg/1 6.0%
Fecal Coliform 200/100 ml 6.6/100 ml 3.3%
- Number of Samples Over 200% of Monthly Average Limit
Parameter 200% of Monthly Limit Number of Samples Over
BOD5 36 mg/L 12
TSS 40 mg/L 18
Ammonia N 24.0 mg/L 0
- Number of Samples Over 200% of Weekly Average Limit
Parameter 200% of Weekly Limit Number of Samples Over
Fecal Coliform 800/100 ml 0
We thank you for your consideration in these matters. If you have any additional questions or
comments,please call Jason Deese, WWTP Director, at 910/521-2989.
Sincerely,0 j(
/
Tyler Thomas, Town Manager
Town of Pembroke

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
FORM 2A NPDES FORM 2A APPLICATION OVERVIEW
NPDES
APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 mgd must also complete Part B. Some applicants must also complete the Supplemental
Application Information packet. The following items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12.
B. Additional Application Information for Applicants with a Design Flow>_0.1 mgd. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions B.1 through B.6.
C. Certification. All applicants must complete Part C(Certification).
SUPPLEMENTAL APPLICATION INFORMATION:
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D(Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1mgd,
2. Is required to have a pretreatment program(or has one in place),or
3. Is otherwise required by the permitting authority to provide the information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E(Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 mgd,
2. Is required to have a pretreatment program(or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users(Sills)or receives RCRA or CERCLA wastes must complete Part F(Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations(CFR)403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25,000 gallons per day or more of process wastewater to the treatment works(with certain
exclusions); or
b. Contributes a process wastestream that makes up 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant;or
c. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G(Combined Sewer
Systems).
ALL APPLICANTS MUST COMPLETE PART C (CERTIFICATION)
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 1 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
BASIC APPLICATION INFORMATION
PART A. BASIC APPLICATION INFORMATION FOR ALL APPLICANTS:
All treatment works must complete questions A.1 through A.8 of this Basic Application Information Packet.
A.1. Facility Information.
Facility Name Pembroke WWTP
Mailing Address PO Box 866
Pembroke, NC 28372
Contact Person Jason Deese
Title WWTP Director
Telephone Number [phone]
Facility Address 8257 Deep Branch Road
(not P.O.Box) Pembroke,NC
A.2. Applicant Information. If the applicant is different from the above,provide the following:
Applicant Name Town of Pembroke
Mailing Address PO Box 866
Pembroke,NC 28372
Contact Person Tyler Thomas
Title Manager
Telephone Number [phone]
Is the applicant the owner or operator(or both)of the treatment works?
® owner ❑ operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ facility ® applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state-issued permits).
NPDES NC0027103 PSD
UIC Other WQCS0013729
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and,if known,provide information on the type of collection system(combined vs.separate)and its ownership(municipal,private,etc.).
Name Population Served Type of Collection System Ownership
Town of Pembroke 3,016 Separate Municipal
Total population served 3,016
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 2 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
A.5. Indian Country.
a. Is the treatment works located in Indian Country?
❑ Yes ® No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from(and eventually flows
through)Indian Country?
El Yes ® No
A.6. Flow. Indicate the design flow rate of the treatment plant(i.e.,the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and maximum daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12th month of"this year"occurring no more than three months prior to this application submittal.
a. Design flow rate 1.33 mgd
Two Years Apo Last Year This Year
b. Annual average daily flow rate 0.98 0.80 0.78
c. Maximum daily flow rate 3.80 2.30 3.66
A.7. Collection System. Indicate the type(s)of collection system(s)used by the treatment plant. Check all that apply. Also estimate the percent
contribution(by miles)of each.
® Separate sanitary sewer 100
❑ Combined storm and sanitary sewer NA
A.8. Discharges and Other Disposal Methods.
a. Does the treatment works discharge effluent to waters of the U.S.? ►.I Yes ❑ No
If yes,list how many of each of the following types of discharge points the treatment works uses:
i. Discharges of treated effluent 1
ii. Discharges of untreated or partially treated effluent NA
iii. Combined sewer overflow points NA
iv. Constructed emergency overflows(prior to the headworks) NA_
v. Other NA
b. Does the treatment works discharge effluent to basins,ponds,or other surface impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes ❑ No
If yes,provide the following for each surface impoundment:
Location: NA
Annual average daily volume discharge to surface impoundment(s) NA mgd
Is discharge ❑ continuous or ❑ intermittent?
c. Does the treatment works land-apply treated wastewater? ❑ Yes ® No
If yes,provide the following for each land application site:
Location: NA
Number of acres: NA
Annual average daily volume applied to site: NA mgd
Is land application ❑ continuous or ❑ intermittent?
d. Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works? ❑ Yes No
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
If yes,describe the mean(s)by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g.,tank truck,pipe).
If transport is by a party other than the applicant,provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number (
For each treatment works that receives this discharge,provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number (
If known,provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility. mgd
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.8.through A.8.d above(e.g.,underground percolation,well injection): ❑ Yes ® No
If yes,provide the following for each disposal method:
Description of method(including location and size of site(s)if applicable):
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or ❑ intermittent?
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22. Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
WASTEWATER DISCHARGES:
If you answered"Yes"to question A.8.a,complete questions A.9 through A.12 once for each outfall(including bypass points)through
which effluent is discharged. Do not include information on combined sewer overflows in this section. If you answered"No"to question
A.8.a,go to Part B,"Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 mgd."
A.9. Description of Outfall.
a. Outfall number 001
b. Location Pembroke 28372
(City or town,if applicable) (Zip Code)
Robeson NC
(County) (State)
34°39'55" 79°12'00"
(Latitude) (Longitude)
c. Distance from shore(if applicable) NA ft.
d. Depth below surface(if applicable) NA ft.
e. Average daily flow rate NA mgd
f. Does this outfall have either an intermittent or a periodic discharge? 0 Yes ® No (go to A.9.g.)
If yes,provide the following information:
Number f times per year discharge occurs: NA
Average duration of each discharge: NA
Average flow per discharge: NA mgd
Months in which discharge occurs: NA
g. Is outfall equipped with a diffuser? 0 Yes ® No
A.10. Description of Receiving Waters.
a. Name of receiving water Lumber River
b. Name of watershed(if known)
United States Soil Conservation Service 14-digit watershed code(if known):
c. Name of State Management/River Basin(if known):
United States Geological Survey 8-digit hydrologic cataloging unit code(if known):
d. Critical low flow of receiving stream(if applicable)
acute cfs chronic cfs
e. Total hardness of receiving stream at critical low flow(if applicable): mg/I of CaCO3
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
❑ Primary ® Secondary
❑ Advanced 0 Other. Describe:
b. Indicate the following removal rates(as applicable):
Design BOD5 removal or Design CBOD5 removal 91
Design SS removal 90
Design P removal NA 943
Design N removal 60
Other NA
c. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season,please describe:
Chlorination
If disinfection is by chlorination is dechlorination used for this outfall? ►ti Yes ❑ No
Does the treatment plant have post aeration? ® Yes C? No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the indicated effluent testing required by the permitting authority for each outfall through which effluent is
discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition,this data must comply with QA/QC requirements of
40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a
minimum,effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number: 001
MAXIMUM DAILY VALUE AVERAGE DAILY VALUE
PARAMETER
Value Units Value Units Number of Samples
pH(Minimum) 6.23 s.u.
����
pH(Maximum) 7.57 s.u.
Flow Rate 3.66 MG 0.78 MG 365
Temperature(Winter) 22.0 °C 27.7 °C 12
Temperature(Summer) 30.0 °C 18.1 °C 12
*For pH please report a minimum and a maximum daily value
MAXIMUM DAILY AVERAGE DAILY DISCHARGE
POLLUTANT DISCHARGE ANALYTICAL ML/MDL
Number of METHOD
Conc. Units Conc. Units Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN BOD5 23.0 mg/L 3.98 mg/L 104 SM5210B 2.0
DEMAND(Report one) CBOD5 NA NA NA NA NA NA NA
FECAL COLIFORM 435 colony/10o ml 9.78 coi m'noo 104 SM9222D 1
TOTAL SUSPENDED SOLIDS(TSS) 58.6 mg/L 5.58 mg/L 104 SM2540D 2.5
END OF PART A.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 6 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
BASIC APPLICATION INFORMATION
PART B. ADDITIONAL APPLICATION INFORMATION.FOR APPLICANTS WITH;A DESIGN FLOW-GREATER THAN OR
EQUAL~TO 0.1 MGD(10C?NO gallon,per day}.
All applicants with a design flow rate z 0.1 mgd must answer questions B.1 through B.6. All others go to Part C(Certification).
B.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the treatment works from inflow and/or infiltration.
42,000 gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
The collection system was evaluated via an AIA grant. Results of evaluation will be used to complete funding application
Smoke testing will be scheduled in the next year.
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant,including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include outfalls from bypass piping,if applicable.
c. Each well where wastewater from the treatment plant is injected underground.
d. Wells,springs,other surface water bodies,and drinking water wells that are: 1)within 1/4 mile of the property boundaries of the treatment
works,and 2)listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored,treated,or disposed.
f. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act(RCRA)by truck,rail,
or special pipe,show on the map where the hazardous waste enters the treatment works and where it is treated,stored,and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant,including all bypass piping and all
backup power sources or redunancy in the system. Also provide a water balance showing all treatment units,including disinfection(e.g.,
chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
B.4. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects(related to wastewater treatment and effluent quality)of the treatment works the responsibility of a
contractor? ❑ Yes No
If yes,list the name,address,telephone number,and status of each contractor and describe the contractor's responsibilities(attach additional
pages if necessary).
Name:
Mailing Address:
Telephone Number: ( )
Responsibilities of Contractor:
B.5. Scheduled improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment,effluent quality,or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements,submit separate responses to question B.5
for each. (If none,go to question B.6.)
a. List the outfall number(assigned in question A.9)for each outfall that is covered by this implementation schedule.
b. Indicate whether the planned improvements or implementation schedule are required by local,State,or Federal agencies.
❑ Yes ❑ No
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 7 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
c. If the answer to B.5.b is"Yes,"briefly describe,including new maximum daily inflow rate(if applicable).
d. Provide dates imposed by any compliance schedule or any actual dates of completion for the implementation steps listed below,as
applicable. For improvements planned independently of local,State,or Federal agencies,indicate planned or actual completion dates,as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYYY MM/DD/YYYY
-Begin Construction / / / /
-End Construction / / / /
-Begin Discharge / / / /
-Attain Operational Level / / / /
e. Have appropriate permits/clearances concerning other Federal/State requirements been obtained? 0 Yes 0 No
Describe briefly:
B.6. EFFLUENT TESTING DATA(GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the indicated
effluent testing required by the permitting authority for each outfall through which effluent is discharged. Do not include information
on combine sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition,this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on-half years old.
Outfall Number: 001
MAXIMUM DAILY AVERAGE DAILY DISCHARGE
DISCHARGE ANALYTICAL
POLLUTANT METHOD ML/MDL
Conc. Units Conc. Units Number of
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA(as N) 10.6 mg/L 0.79 mg/L 104 SM4500 0.100
CHLORINE(TOTAL 28 ug/L 0.90 ug/L 156 SM4500 CL G- 20
RESIDUAL,TRC) 2000
DISSOLVED OXYGEN 11.2 mg/L 8.51 mg/L 156 SM4500 O C 0.1
TOTAL KJELDAHL 17.6 mg/L 5.31 mg/L 12 SM4500 1.00
NITROGEN(TKN)
NITRATE PLUS NITRITE 29.3 mg/L 13.89 mg/L 12 EPA300.0 0.500
NITROGEN
OIL and GREASE ND mg/L ND mg/L 3 2540C 5.88
PHOSPHORUS(Total) 5.31 mg/L 2.43 mg/L 12 SM4500-P 0.050
TOTAL DISSOLVED SOLIDS 330 mg/L 258 mg/L 3 2540C 10.0
(TDS)
OTHER
END OF PART B.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 8 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
BASIC APPLICATION INFORMATION
PART C. CERTIFICATION
All applicants must complete the Certification Section. Refer to instructions to determine who is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A,as explained in the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement,applicants confirm that they have reviewed
Form 2A and have completed all sections that apply to the facility for which this application is submitted.
Indicate which parts of Form 2A you have completed and are submitting:
t7 Basic Application Information packet Supplemental Application Information packet:
El Part D(Expanded Effluent Testing Data)
El Part E(Toxicity Testing: Biomonitoring Data)
k4 Part F(Industrial User Discharges and RCRA/CERCLA Wastes)
© Part G(Combined Sewer Systems)
ALL APPLICANTS MUST COMPLETE THE FOLLOWING CERTIFICATION.
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 on my inquiry of the person or persons who
manage the system or those persons directly responsible for gathering the information,the information 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 imprisonment
for knowing violations.
Name and official title Tyler Thomas,Town Manager I
Signature
Telephone number [phone]
Date signed
Upon request of the permitting authority,you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: l RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
SUPPLEMENTAL APPLICATION INFORMATION
PART D. EXPANDED EFFLUENT TESTING DATA
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 mgd and Pretreatment Works. If the treatment works has a design flowgreater than or equal to 1.0 mgd or it has(or is required
9 9 9 q 9 q
to have)a pretreatment program,or is otherwise required by the permitting authority to provide the data,then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition,these data must comply with QA/QC requirements of 40 CFR Part 136 and
other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum,effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL MUMDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
METALS(TOTAL RECOVERABLE),CYANIDE,PHENOLS,AND HARDNESS.
ANTIMONY ND mg/L ND mg/L 3 200.7 0.0100
ARSENIC ND mg/L ND mg/L 3 200.7 0.0100
BERYLLIUM ND mg/L ND mg/L 3 200.7 0.00200
CADMIUM ND mg/L ND mg/L 3 200.7 0.00200
CHROMIUM ND mg/L ND mg/L 3 200.7 0.0100
COPPER ND mg/L ND mg/L 3 200.7 0.0100
LEAD ND mg/L ND mg/L 3 200.7 0.00500
MERCURY 0.904 ng/L 0.301 ng/L 3 EPA1631E 0.2
NICKEL ND mg/L ND mg/L 3 200.7 0.0100
SELENIUM ND mg/L ND mg/L 3 200.7 0.0100
SILVER ND mg/L ND mg/L 3 200.7 0.00500
THALLIUM ND mg/L ND mg/L 3 200.8 0.00100
ZINC 0.092 mg/L 32.13 mg/L 3 200.7 0.0500
CYANIDE ND mg/L ND mg/L 3 2540C 0.00500
TOTAL PHENOLIC 0.007 mg/L 0.002 mg/L 3 2540C 0.0400
COMPOUNDS
HARDNESS(as CaCO3) 32.9 caco3 31.7 CaCO3 3 2540C 30.0
Use this space(or a separate sheet)to provide information on other metals requested by the permit writer
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 10 of 22

1
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
Number ANALYTICAL
POLLUTANT METHOD MUMDL
Conc. Units Mass Units Conc. Units Mass Units of
Samples
VOLATILE ORGANIC COMPOUNDS
ACROLEIN ND mg/L ND mg/L 3 EPA624 0.0500
ACRYLONITRILE ND mg/L ND mg/L 3 EPA624 0.0100
BENZENE ND mg/L ND mg/L 3 EPA624 0.00100
BROMOFORM ND mg/L ND mg/L 3 EPA624 0.00100
CARBON ND mg/L ND mg/L 3 EPA624 0.00100
TETRACHLORIDE
CHLOROBENZENE ND mg/L ND mg/L 3 EPA624 0.00100
CHLORODIBROMO- ND mg/L ND mg/L 3 EPA624 0.00100
METHANE
CHLOROETHANE ND mg/L ND mg/L 3 EPA624 0.00500
2-CHLOROETHYLVINYL ND mg/L ND mg/L 3 EPA624 0.0500
ETHER
CHLOROFORM 0.005 mg/L 0.002 mg/L 3 EPA624 0.00500
DICHLOROBROMO-
ND mg/L ND mg/L 3 EPA624 0.00100
METHANE
1,1-DICHLOROETHANE ND mg/L ND mg/L 3 EPA624 0.00100
1,2-DICHLOROETHANE ND mg/L ND mg/L 3 EPA624 0.00100
TRANS-I,2-DICHLORO- ND mg/L ND mg/L 3 EPA624 0.00100
ETHYLENE
1 1,1-DICHLORO- ND mg/L ND mg/L 3 EPA624 0.00100
ETHYLENE
1,2-DICHLOROPROPANE ND mg/L ND mg/L 3 EPA624 0.00100
1,3-DICHLORO- ND mg/L ND mg/L 3 EPA624 0.00100
PROPYLENE
ETHYLBENZENE ND mg/L ND mg/L 3 EPA624 0.00100
METHYL BROMIDE ND mg/L ND mg/L 3 EPA624 0.00500
METHYL CHLORIDE ND mg/L ND mg/L 3 EPA624 0.00500
METHYLENE CHLORIDE ND mg/L ND mg/L 3 EPA624 0.00500
1,1,2,2-TETRA- ND mg/L ND mg/L 3 EPA624 0.00100
CHLOROETHANE
TETRACHLORO- ND mg/L ND mg/L 3 EPA624 0.00100
ETHYLENE
TOLUENE 105 mg/L 35 mg/L 3 EPA624 0.00100
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 11 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL ML/MDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
1,1,1 ND mg/L ND mg/L 3 EPA624 0.00100
TRICHLOROETHANE
1,1,2 ND mg/L ND mglL 3 EPA624 0.00100
TRICHLOROETHANE
TRICHLOROETHYLENE ND mg/L ND mg/L 3 EPA624 0.00100
VINYL CHLORIDE ND mg/L ND mg/L 3 EPA624 0.00100
Use this space(or a separate sheet)to provide information on other volatile organic compounds requested by the permit writer
ACID-EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL ND mg/L/L ND /L 3 EPA625 0.0100
9 9
2-CHLOROPHENOL ND mg/L ND mg/L 3 EPA625 0.0100
2,4-DICHLOROPHENOL ND mg/L ND mg/L 3 EPA625 0.0100
2,4-DIMETHYLPHENOL ND mg/L ND mg/L 3 EPA625 0.0100
4,6-DINITRO-O-CRESOL ND mg/L ND mg/L 3 EPA625 0.0100
2,4-DINITROPHENOL ND mg/L ND mg/L 3 EPA625 0.0100
2-NITROPHENOL ND mg/L ND mg/L 3 EPA625 0.0100
4-NITROPHENOL ND mg/L ND mg/L 3 EPA625 0.0100
PENTACHLOROPHENOL ND mg/L ND mg/L 3 EPA625 0.0100
PHENOL ND mg/L ND mg/L 3 EPA625 0.0100
2,4,6- ND mg/L ND mg/L 3 EPA625 0.0100
TRICHLOROPHENOL
Use this space(or a separate sheet)to provide information on other acid-extractable compounds requested by the permit writer
BASE-NEUTRAL COMPOUNDS
ACENAPHTHENE ND mg/L ND mg/L 3 EPA625 0.00100
ACENAPHTHYLENE ND mg/L ND mg/L 3 EPA625 0.00100
' ANTHRACENE ND mg/L ND mg/L 3 EPA625 000100
BENZIDINE ND mg/L ND mg/L 3 EPA625 0.0100
BENZO(A)ANTHRACENE ND mg/L ND mg/L 3 EPA625 0.00100
BENZO(A)PYRENE ND mg/L ND mg/L 3 EPA625 0.00100
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 12 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL MUMDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
3,4 BENZO- ND mg/L ND mg/L 3 EPA625 0.00100
FLUORANTHENE
BENZO(GHI)PERYLENE ND mg/L ND mg/L 3 EPA625 0.00100
BENZO(K) ND mg/L ND mg/L 3 EPA625 0.00100
FLUORANTHENE
BIS(2-CHLOROETHOXY) ND mg/L ND mg/L 3 EPA625 0.0100
METHANE
BIS(2-CHLOROETHYL)- ND mg/L ND mg/L 3 EPA625 0.0100
ETHER
BIS(2-CHLOROISO- ND mg/L ND mg/L 3 EPA625 0.0100
PROPYL)ETHER
BIS(2-ETHYLHEXYL) 0.009 mg/L 0.003 mg/L 3 EPA625 0.0100
PHTHALATE
4-BROMOPHENYL ND mg/L ND mg/L 3 EPA625 0.0100
PHENYL ETHER
BUTYL BENZYL ND mg/L ND mg/L 3 EPA625 0.0100
PHTHALATE
2-CHLORO- ND mg/L ND mg/L 3 EPA625 0.00100
NAPHTHALENE
4-CHLORPHENYL ND mg/L ND mg/L 3 EPA625 0.0100
PHENYL ETHER
CHRYSENE ND mg/L ND mg/L 3 EPA625 0.00100
DI-N-BUTYL PHTHALATE ND mg/L ND mg/L 3 EPA625 0.00300
DI-N-OCTYL PHTHALATE ND mg/L ND mg/L 3 EPA625 0.00300
DIBENZO(A,H) ND mg/L ND mg/L 3 EPA625 0.00100
ANTHRACENE
1,2-DICHLOROBENZENE ND mg/L ND mg/L 3 EPA625 0.0100
1,3-DICHLOROBENZENE ND mg/L ND mg/L 3 EPA625 0.0100
1,4-DICHLOROBENZENE ND mg/L ND mg/L 3 EPA625 0.0100
3,3-DICHLORO- ND mg/L ND mg/L 3 EPA625 0.0100
BENZIDINE
DIETHYL PHTHALATE ND mg/L ND mg/L 3 EPA625 0.00300
DIMETHYL PHTHALATE ND mg/L ND mg/L 3 EPA625 0.00300
2,4-DINITROTOLUENE ND mg/L ND mg/L 3 EPA625 0.0100
2,6-DINITROTOLUENE ND mg/L ND mg/L 3 EPA625 0.0100
1,2-DIPHENYL- ND mg/L ND mg/L 3 EPA625 0.0100
HYDRAZINE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 13 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
Outfall number: 001 (Complete once for each outfall discharging effluent to waters of the United States.)
MAXIMUM DAILY DISCHARGE AVERAGE DAILY DISCHARGE
POLLUTANT Number ANALYTICAL ML/MDL
Conc. Units Mass Units Conc. Units Mass Units of METHOD
Samples
FLUORANTHENE ND mg/L ND mg/L 3 EPA625 0.00100
FLUORENE ND mg/L ND mg/L 3 EPA625 0.00100
HEXACHLOROBENZENE ND mg/L ND mg/L 3 EPA625 0.00100
HEXACHLORO- ND mg/L ND mg/L 3 EPA625 0.0100
BUTADIENE
HEXACHLOROCYCLO- ND mg/L ND mg/L 3 EPA625 0.0100
PENTADIENE
HEXACHLOROETHANE ND mg/L ND mg/L 3 EPA625 0.0100
INDENO(1,2,3-CD) ND mg/L ND mg/L 3 EPA625 0.00100
PYRENE
ISOPHORONE ND mg/L ND mg/L 3 EPA625 0.0100
NAPHTHALENE ND mg/L ND mg/L 3 EPA625 0.00100
NITROBENZENE ND mg/L ND mg/L 3 EPA625 0.0100
N-NITROSODI-N- ND mg/L ND mg/L 3 EPA625 0.0100
PROPYLAMINE
N-NITROSODI- ND mg/L ND mg/L 3 EPA625 0.0100
METHYLAMINE
N-NITROSODI- ND mg/L ND mg/L 3 EPA625 0.0100
PHENYLAMINE
PHENANTHRENE ND mg/L ND mg/L 3 EPA625 0.00100
PYRENE ND mg/L ND mg/L 3 EPA625 0.00100
1,2,4 ND mg/L ND mg/L 3 EPA625 0.0100
TRICHLOROBENZENE
Use this space(or a separate sheet)to provide information on other base-neutral compounds requested by the permit writer
Use this space(or a separate sheet)to provide information on other pollutants(e.g.,pesticides)requested by the permit writer
END OF PART D.
REFER TO THE APPLICATION OVERVIEW(PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 14 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
SUPPLEMENTAL APPLICATION INFORMATION
PART E. TOXICITY TESTING DATA
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1)POTWs with a design flow rate greater than or equal to 1.0 mgd;2)POTWs with a pretreatment program(or those that are
required to have one under 40 CFR Part 403);or 3)POTWs required by the permitting authority to submit data for these parameters.
• At a minimum,these results must include quarterly testing for a 12-month period within the past 1 year using multiple species(minimum of two
species),or the results from four tests performed at least annually in the four and one-half years prior to the application,provided the results
show no appreciable toxicity,and testing for acute and/or chronic toxicity,depending on the range of receiving water dilution. Do not include
information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition,this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate QA/QC
requirements for standard methods for analytes not addressed by 40 CFR Part 136.
• In addition,submit the results of any other whole effluent toxicity tests from the past four and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity,provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation,if one was conducted.
• If you have already submitted any of the information requested in Part E,you need not submit it again. Rather,provide the information
requested in question E.4 for previously submitted information. If EPA methods were not used,report the reasons for using alternate methods.
If test summaries are available that contain all of the information requested below,they may be submitted in place of Part E.
If no biomonitoring data is required,do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.1. Required Tests.
Indicate the number of whole effluent toxicity tests conducted in the past four and one-half years.
chronic ❑ acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity test conducted in the last four and one-half years. Allow one
column per test(where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number: Test number: Test number:
a. Test information.
Test Species&test method number
Age at initiation of test
Outfall number
Dates sample collected
Date test started
Duration
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s)used. For multiple grab samples,indicate the number of grab samples used.
24-Hour composite
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all that apply for each.
Before disinfection
After disinfection
After dechlorination
Page 15 of 22
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22.

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
f. For each test,include whether the test was intended to assess chronic toxicity,acute toxicity,or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static-renewal
Flow-through
h. Source of dilution water. If laboratory water,specify type;if receiving water,specify source.
Laboratory water
Receiving water
i. Type of dilution water. If salt water,specify"natural"or type of artificial sea salts or brine used.
Fresh water
Salt water
j. Give the percentage effluent used for all concentrations in the test series.
k. Parameters measured during the test. (State whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100%
effluent
LC50
95%C.I.
Control percent survival
Other(describe)
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke WWTP, NC0027103 Renewal Lumber
Chronic:
NOEC
IC25
Control percent survival 0/0
Other(describe)
m. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant test
run(MM/DD/YYYY)?
Other(describe)
E.3. Toxicity Reduction Evaluation. Is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes ® No If yes,describe:
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomonitoring test information,or information regarding the
cause of toxicity,within the past four and one-half years,provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: For this permit cycle, chronic toxicity results were summited each year for the months of:January,
April,July and October
Summary of results: (see instructions)
All submitted chronic toxicity results were a"PASS"
END OF PART E.
REFER TO THE APPLICATION OVERVIEW (PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
Page 17 of 22
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22.

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke VWVTP, NC0027103 Renewal Lumber
SUPPLEMENTAL APPLICATION INFORMATION
PART F.INDUSTRIAL USER DISCHARGES AND RCRAICERCLA WASTES
All treatment works receiving discharges from significant industrial users or which receive RCRA,CERCLA,or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.1. Pretreatment program. Does the treatment works have,or is subject ot,an approved pretreatment program?
Yes ❑ No
F.2. Number of Significant Industrial Users(Sills)and Categorical Industrial Users(ClUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non-categorical SlUs. 2
b. Number of CIUs. NA
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works,copy questions F.3 through F.8 and
provide the information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name: ATTACHED
Mailing Address:
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
F.5. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s):
Raw material(s):
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day(gpd)and whether the discharge is continuous or intermittent.
gpd ( continuous or intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process wastewater flow discharged into the collection system
in gallons per day(gpd)and whether the discharge is continuous or intermittent.
gpd ( continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ❑ Yes ❑ No
b. Categorical pretreatment standards ❑ Yes ❑ No
If subject to categorical pretreatment standards,which category and subcategory?
EPA Form 3510-2A(Rev. 1-99). Replaces EPA forms 7550-6&7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Pembroke VVVVTP, NC0027103 Renewal Lumber
F.8. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU caused or contributed to any problems(e.g.,
upsets,interference)at the treatment works in the past three years?
❑ Yes ❑ No If yes,describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past three years received RCRA hazardous waste by truck,rail or dedicated pipe?
❑ Yes ® No(go to F.12)
F.10. Waste transport. Method by which RCRA waste is received(check all that apply):
❑ Truck 0 Rail 0 Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount(volume or mass,specify units).
EPA Hazardous Waste Number Amount Units
CERCLA(SUPERFUND)WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER,AND OTHER REMEDIAL ACTIVITY WASTEWATER:
F.12. Remediation Waste. Does the treatment works currently(or has it been notified that it will)receive waste from remedial activities?
❑ Yes(complete F.13 through F.15.) ® No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates(or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received(or are expected to be received). Include data on volume and concentration,if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated(or will be treated)prior to entering the treatment works?
❑ Yes ❑ No
If yes,describe the treatment(provide information about the removal efficiency):
b. Is the discharge(or will the discharge be)continuous or intermittent?
0 Continuous 0 Intermittent If intermittent,describe discharge schedule.
END OF PART F.
REFER TO THE APPLICATION OVERVIEW(PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
SUPPLEMENTAL APPLICATION INFORMATION
PART G. COMBINED SEWER SYSTEMS
If the treatment works has a combined sewer system,complete Part G.
G.1. System Map. Provide a map indicating the following: (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs(e.g.,beaches,drinking water supplies,shellfish beds,sensitive aquatic ecosystems,and
outstanding natural resource waters).
c. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram,either in the map provided in G.1 or on a separate drawing,of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines,both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
c. Locations of in-line and off-line storage structures.
d. Locations of flow-regulating devices.
e. Locations of pump stations.
CSO OUTFACES:
Complete questions G.3 through G.6 once for each CSO discharge point.
G.3. Description of Outfall.
a. Outfall number
b. Location
(City or town,if applicable) (Zip Code)
(County) (State)
(Latitude) (Longitude)
c. Distance from shore(if applicable) ft.
d. Depth below surface(if applicable) ft.
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume 0 Receiving water quality
f. How many storm events were monitored during the last year?
G.4. CSO Events.
a. Give the number of CSO events in the last year.
events (0 actual or 0 approx.)
b. Give the average duration per CSO event.
hours (❑actual or 0 approx.)
Page 20 of 22
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22.

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
c. Give the average volume per CSO event.
million gallons(❑actual or❑approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.5. Description of Receiving Waters.
a. Name of receiving water:
b. Name of watershed/river/stream system:
United State Soil Conservation Service 14-digit watershed code(if known):
c. Name of State Management/River Basin:
United States Geological Survey 8-digit hydrologic cataloging unit code(if known):
G.6. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO(e.g.,permanent or intermittent beach closings,permanent or
intermittent shell fish bed closings,fish kills,fish advisories,other recreational loss,or violation of any applicable State water quality standard).
END OF PART G.
REFER TO THE APPLICATION OVERVIEW(PAGE 1) TO DETERMINE WHICH OTHER PARTS
OF FORM 2A YOU MUST COMPLETE.
EPA Form 3510-2A(Rev.1-99). Replaces EPA forms 7550-6&7550-22. Page 21 of 22

Additional information, if provided,will appear on the following pages.
NPDES FORM 2A Additional Information

Influent Flow
Mechanical .83 MOD
Attachment Order 2®b: /Manual 3-3611p
Town of Pembroke NC0027103 Screening Pumps
Process Flow Diagram
Influent
Grit/ Pre- Pump Station
Grease rleratiori
removal
Digester
Return
Line
Return Activated Sludge
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Chlorine Contact I
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Waste Sludge
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Cl`i3uent
17ischart.le

Fayetteville Division
Certificate of Analysis
Envirolink Date Reported: 11/08/16
Mr.Tony Baldwin Project:WW samples-Town of Pembroke Date Received: 10/25/16
4700 Homewood Court,Suite 108 Date Sampled: 10/25/16
Raleigh NC,27609 Sampled By:Deese
Effluent,composite
K6J0927-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by:Miaobac Laboratories,Inc.-Chicagoland
Copper 0.0041 mg/L 10/31/16 19:05 RM EPA 200.7 Rev 4.4 J
--1,1,1-Trichloroethane <0.00019 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
1,1,2,2-Tetrachloroethane <0.00020 mg/L 10/31/16 18:25 jin EPA 624 Rev 7/95 U
-1,1,2-Trichloroethane <0.00039 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
-1,1-Dichloroethane <0.00016 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
1,1-Dichloroethene <0.00019 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
1,2-Dichlorobenzene <0.00026 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
--1,2-Dichloroethane <0.00014 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
1,2-Dichloropropane <0.00015 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
1,3-Dichlorobenzene <0.00032 mg/L 10/31/16 18:25 jln EPA624 Rev 7/95 U
1,4-Dichlorobenzene <0.00021 mg/L 10/31/16 18:25 jin EPA 624 Rev 7/95 U
--2-Chloroethyl vinyl ether <0.00038 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
2-Hexanone <0.00022 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Acetone <0.0010 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
-Benzene <0.00018 mg/L 10/31/16 18:25 jln EPA624 Rev 7/95 U
Bromodichloromethane <0.00030 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
'Bromoform <0.00027 mg/L 10/31/16 18:25 fin EPA 624 Rev 7/95 U
Bromomethane <0.00037 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Carbon Disulfide <0.00026 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Carbon tetrachloride <0.00016 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
^Chlorobenzene <0.00016 mg/L 10/31/16 18:25 jln EPA624 Rev 7/95 U
-Chloroethane <0.00041 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
'Chloroform 0.0017 mg/L 10/31/16 18:25 fin EPA 624 Rev 7/95
Chloromethane <0.00033 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
cis-1,3-Dichloropropene <0.00023 mg/L 10/31/16 18:25 fin EPA 624 Rev 7/95 U
-.Dibromochloromethane <0.00022 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
1"•••Ethylbenzene <0.00015 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Methylene chloride <0.00031 mg/L 10/31/16 18:25 jln EPA624 Rev 7/95 U
Methyl-t-Butyl Ether <0.00011 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Tetrachloroethene <0.00032 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
I Page 1 of 13 I

Fayetteville Division
Certificate of Analysis
Envirolink Date Reported: 11/08/16
Mr.Tony Baldwin Project:WW samples-Town of Pembroke Date Received: 10/25/16
4700 Homewood Court,Suite 108 Date Sampled: 10/25/16
Raleigh NC,27609 Sampled By:Deese
Effluent,composite
K6J0927-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by:Microbac Laboratories,Inc.-Chicagoland
Toluene <0.00015 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Total 1,2-Dichloroethene <0.00038 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Total Xylenes <0.00063 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
trans-1,2-Dichloroethene <0.00023 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
trans-1,3-Dichloropropene <0.00018 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Trichloroethene <0.00029 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Trichlorofluoromethane <0.00030 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Vinyl Acetate <0.00020 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Vinyl chloride <0.00017 mg/L 10/31/16 18:25 jln EPA 624 Rev 7/95 U
Surrogate:1,2-Dichloroethane-D4 104% 74.5%-132% 10/31/16 18:25 jln EPA 624 Rev 7/95
Surrogate:4-Bromofluorobenzene 93.0% 80%-120% 10/31/16 18:25 jln EPA 624 Rev 7/95
Surrogate:Dibromofuoromethane 101 % 80%-120% 10/31/16 18:25 jln EPA 624 Rev 7/95
Surrogate:Toluene-D8 98.7% 80%-120% 10/31/16 18:25 jln EPA 624 Rev 7/95
1,2,4-Trichlorobenzene <0.00061 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
1,2-Dichlorobenzene <0.00075 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-1,2-Diphenylhydrazine <0.0010 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-1,3-Dichlorobenzene <0.00066 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-1,4-Dichlorobenzene <0.00064 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
2,2'-oxybis(1-chloropropane) <0.00070 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
2,4,5-Trichlorophenol <0.00078 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
--2,4,6-Trichlorophenol <0.00076 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-2,4-Dichlorophenol <0.00063 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-2,4-Dimethylphenol <0.00070 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-2,4-Dinitrophenol <0.00031 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-2,4-Dinitrotoluene <0.00048 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
2,6-Dichlorophenol <0.00073 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
.-2,6-Dinitrotoluene <0.00059 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-2-Chloronaphthalene <0.00073 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-2-Chlorophenol <0.00074 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
2-Methylnaphthalene <0.00071 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Page 2 of 13

Fayetteville Division
Certificate of Analysis
Envirolink Date Reported: 11/08/16
Mr.Tony Baldwin Project:WW samples-Town of Pembroke Date Received: 10/25/16
4700 Homewood Court,Suite 108 Date Sampled: 10/25/16
Raleigh NC,27609 Sampled By:Deese
Effluent,composite
K6J0927-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by:Microbac Laboratories,Inc.-Chicagoland
2-Methylphenol <0.00078 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
2-Nitroaniline <0.00051 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
_2.-Nitrophenol <0.00094 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
.-3,3'-Dichlorobenzidine <0.0013 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
3/4-Methylphenol <0.00086 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
11 3-Nitroaniline <0.00082 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
4,6-Dinitro-2-methylphenol <0.00035 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
1 -4-Bromophenyl phenyl ether <0.00069 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
4-Chloro-3-methylphenol <0.00078 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
4-Chloroaniline <0.00071 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
'4-Chlorophenyl phenyl ether <0.00071 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
4-Nitroaniline <0.0010 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
4-Nitrophenol <0.00086 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Acenaphthene <0.000012 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Acenaphthylene <0.0000031 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Acetophenone <0.00082 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Aniline <0.0015 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Anthracene <0.0000072 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Benzidine <0.052 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Benzo[a]anthracene <0.0000041 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Benzo[a]pyrene <0.0000062 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Benzo[b]fluoranthene <0.0000062 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
"Benzo[g,h,i]perylene <0.0000052 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Benzo[k]fluoranthene <0.0000072 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Benzoic acid <0.00052 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Benzyl alcohol <0.00068 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
_Bis(2-chloroethoxy)methane <0.00088 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95 I
^-Bis(2-chloroethyl)ether <0.00079 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-,Bis(2-ethylhexyl)phthalate 0.0096 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95 J
Butyl benzyl phthalate <0.00094 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Page 3 of 13

Fayetteville Division
Certificate of Analysis
Envirolink
Date Reported: 11/08/16
Mr.Tony Baldwin Project:WW samples-Town of Pembroke Date Received: 10/25/16
4700 Homewood Court,Suite 108 Date Sampled: 10/25/16
Raleigh NC,27609 Sampled By:Deese
Effluent,composite
K6J0927-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by:Mianbac Laboratories,Inc.-Chkagoland
Carbazole <0.00074 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Chrysene <0.0000062 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Dibenz[a,h]anthracene <0.0000062 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Dibenzofuran <0.00070 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Diethyl phthalate <0.0013 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Dimethyl phthalate <0.00070 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
•-Di-n-butyl phthalate <0.00085 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Di-n-octyl phthalate <0.00072 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
.Fluoranthene <0.0000052 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
"Fluorene <0.0000041 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Hexachlorobenzene <0.00099 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Hexachlorobutadiene <0.00099 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
--Hexachlorocyclopentadiene <0.00041 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
^Hexachloroethane <0.0010 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
--Indeno[1,2,3cd]pyrene <0.0000041 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
"-Isophorone <0.00082 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
"Naphthalene <0.0000062 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
=Nitrobenzene <0.00081 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
--N-Nitrosodimethylamine <0.00094 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-N-Nitrosodi-n-propylamine <0.0010 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
--N-Nitrosodiphenylamine <0.00074 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Pentachlorophenol <0.00032 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Phenanthrene <0.0000072 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
-Phenol <0.00038 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
^Pyrene <0.0000052 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Pyridine <0.0013 mg/L 11/02/16 20:34 CLR EPA 625 Rev 7/95
Surrogate:2,4,6-Tribromophenol 44.9% 47.8%-138% 11/02/16 20:34 CLR EPA 625 Rev 7/95
Surrogate:2-Fluorobiphenyl 20.2% 10%-110% 11/02/16 20:34 CLR EPA 625 Rev 7/95
Surrogate:2-Fluorophenol 19.5% 10%-110% 11/02/16 20:34 CLR EPA 625 Rev 7/95
Surrogate:Nitrobenzene-d5 26.0% 10%-110% 11/02/16 20:34 CLR EPA 625 Rev 7/95
1 Page 4 of 13 I

Fayetteville Division
Certificate of Analysis
Envirolink Date Reported: 11/08/16
Mr.Tony Baldwin Project:WW samples-Town of Pembroke Date Received: 10/25/16
4700 Homewood Court,Suite 108 Date Sampled: 10/25/16
Raleigh NC,27609 Sampled By:Deese
Effluent,composite
K6J0927-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by:Microbac Laboratories,Inc.-Chicagoland
Surrogate:Phenol-d5 15.2% 10%-60.8% 11/02/16 20:34 CLR EPA 625 Rev 7/95
Surrogate:Terphenyl-d14 45.3% 16.8%-110% 11/02/16 20:34 CLR EPA 625 Rev 7/95
Mercury 0.904 ng/L 11/03/16 12:00 SJE EPA 1631E
Analyzed by:Microbac Laboratories,Inc.-Fayetteville
Ammonia as N <0.100 mg/L 10/26/16 14:45 DSK SM 4500 NH3 C-1997
Antimony <0.003 mg/L 11/01/16 11:19 AC EPA 200.7 Rev 4.4 1994
Arsenic <0.003 mg/L 11/01/16 11:19 AC EPA 200.7 Rev 4.4 1994
Beryllium <0.00100 mg/L 11/01/16 11:19 AC EPA 200.7 Rev 4.4 1994
Cadmium <0.001 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Chlorine Residual(Total) 0.040 mg/L 10/31/16 11:35 ELM SM 4500-CI G-2000 H
Chromium <0.001 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Cyanide,Total 0.0108 mg/L 11/03/16 11:26 DSK EPA335.4,Rev 1.0-1993 S1,B
Dissolved Oxygen 12.0 mg/L 10/27/16 09:00 ELM SM 4500-0 G-2001
Hardness(As CaCO3) 31.7 mg CaCO3/L 10/25/16 13:40 DSK SM 2340 C-1997
Lead <0.003 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Nickel <0.001 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Nitrate as N 0.520 mg/L 10/25/16 16:53 AC EPA 300.0,Rev.2.1(1993)
Nitrite as N 0.243 mg/L 10/25/16 16:53 AC EPA 300.0,Rev.2.1(1993)
Oil&Grease(HEM) <5.00 mg/L 10/31/16 10:30 SW EPA 1664 Rev.B B25
-Phenolics,Total Recoverable 0.00700 mg/L 11/01/16 16:00 SW EPA 420.1 (1978)
Phosphorus,Total <0.050 mg/L 10/26/16 11:51 DSK SM 4500-P F-1999 Al2
Selenium <0.010 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Silver <0.003 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Total Dissolved Solids 254 mg/L 10/26/16 13:52 JR SM 2540 C-1997
Thallium <0.005 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Total Kjeldahl Nitrogen <1.00 mg/L 10/28/16 08:13 AC SM 4500-Norg C-1997
Zinc 0.049 mg/L 10/28/16 10:53 AC EPA 200.7 Rev 4.4 1994
Effluent,composite
K6J0927-01RE1
'Page 5 of 13

EFFLUENT SAMPLE RESULTS - 01 ONE LAB.NATIONWIDE.
Collected date/time: 08/03/17 08:54 L926898
Gravimetric Analysis by Method 2540 C-2011 1
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Dissolved Solids 240 10.0 1 08/09/2017 21:50 WG1007382 'Tc
Wet Chemistry by Method 130.1 3
Ss
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time 3
Cn
Hardness(colorimetric)as CaCO3 31.8 8 30.0 1 08/08/2017 21:28 WG1006956
5
Wet Chemistry by Method 1664E Sr
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time QC
' Oil&Grease(Hexane Extr) ND 5.62 1 08/09/201710:52 WG1007497
GI
Wet Chemistry by Method 300.0
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time AI
Nitrate as(N) 0.565 0.100 1 08/04/201717:28 WG1005948
Nitrite as(N) ND 0.100 1 08/04/201717:28 WG1005948 Sc:
Wet Chemistry by Method 350.1
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Ammonia Nitrogen ND 0.100 1 08/08/2017 20:02 WG1006937
Wet Chemistry by Method 351.2
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Kjeldahl Nitrogen,TKN 1.07 B 0.250 1 08/09/2017 22:45 WG1007917
Wet Chemistry by Method 365.4
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Phosphorus,Total 0.714 0.100 1 08/07/201717:21 WG1006911
Wet Chemistry by Method 420.4
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Total Phenol by 4AAP ND 0.0400 1 08/08/201718:56 WG1006626
Wet Chemistry by Method 4500CN E-2011
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Cyanide ND 0.00500 1 08/04/2017 20:25 WG1005854
Mercury by Method 245.1
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Mercury ND 0.000200 1 08/09/2017 07:50 WG1006610
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
TBL Laboratory TBL 27786 L926898 08/14/1711:33 5 of 35

ONE LAB.NATIONWIDE.EFFLUENT SAMPLE RESULTS - 01 *
Collected date/time: 08/03/17 08:54 L926898
Metals (ICP) by Method 200.7
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time a�
Antimony ND 0.0100 1 08/09/201717:01 WG1007518
Arsenic ND 0.0100 1 08/09/201717:01 WG1007518
c
Beryllium ND 0.00200 1 08/09/201717:01 WG1007518
Cadmium ND 0.00200 1 08/09/201717:01 WG1007518 Ss
Chromium ND 0.0100 1 08/09/201717:01 WG1007518
Copper ND 0.0100 1 08/09/201717:01 WG1007518 4
Cn
Lead ND 0.00500 1 08/09/201717:01 W61007518
Nickel ND 0.0100 1 08/09/201717:01 WG1007518 5
Selenium ND 0.0100 1 08/09/201717:01 WG1007518 Sr
Silver ND 0.00500 1 08/09/201717:01 W61007518
Zinc 0.0919 0.0500 1 08/09/201717:01 WG1007518 c.
`QC
Metals (ICPMS) by Method 200.8
Result Qualifier RDL Dilution Analysis Batch GI
Analyte mg/I mg/I date/time
Thallium ND 0.00100 1 08/10/201719:54 WG1006980 Al
Volatile Organic Compounds (GC/MS) by Method 624 9Sc
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Acrolein ND 0.0500 1 08/06/201711:55 WG1006442
Acrylonitrile ND 0.0100 1 08/06/201711:55 W61006442
Benzene ND 0.00100 1 08/06/201711:55 W61006442
Bromodichloromethane ND 0.00100 1 08/06/201711:55 WG1006442
Bromoform ND 0.00100 1 08/06/201711:55 WG1006442
Bromomethane ND 0.00500 1 08/06/201711:55 WG1006442
Carbon tetrachloride ND 0.00100 1 08/06/201711:55 WG1006442
Chlorobenzene ND 0.00100 1 08/06/201711:55 WG1006442
Chlorodibromomethane ND 0.00100 1 08/06/201711:55 WG1006442
Chloroethane ND 0.00500 1 08/06/201711:55 WG1006442
2-Chloroethyl vinyl ether ND 0.0500 1 08/06/201711:55 WG1006442
Chloroform 0.00538 0.00500 1 08/06/201711:55 WG1006442
Chloromethane ND 0.00250 1 08/06/201711:55 WG1006442
1,1-Dichloroethane ND 0.00100 1 08/06/201711:55 WG1006442
1,2-Dichloroethane ND 0.00100 1 08/06/201711:55 WG1006442
1,1-Dichloroethene ND 0.00100 1 08/06/201711:55 WG1006442
trans-1,2-Dichloroethene ND 0.00100 1 08/06/201711:55 WG1006442
1,2-Dichloropropane ND 0.00100 1 08/06/201711:55 WG1006442
cis-1,3-Dichloropropene ND 0.00100 1 08/06/201711:55 WG1006442
trans-1,3-Dichloropropene ND 0.00100 1 08/06/201711:55 WG1006442
Ethylbenzene ND 0.00100 1 08/06/201711:55 WG1006442
Methylene Chloride ND 0.00500 1 08/06/201711:55 WG1006442
1,1,2,2-Tetrachloroethane ND 0.00100 1 08/06/201711:55 WG1006442
Tetrachloroethene ND 0.00100 1 08/06/201711:55 WG1006442
Toluene ND 0.00100 1 08/06/201711:55 WG1006442
1,1,1-Trichloroethane ND 0.00100 1 08/06/201711:55 WG1006442
1,1,2-Trichloroethane ND 0.00100 1 08/06/201711:55 WG1006442
Trichloroethene ND 0.00100 1 08/06/201711:55 WG1006442
Vinyl chloride ND 0.00100 1 08/06/201711:55 WG1006442
(S)Toluene-d8 103 80.0-120 08/06/201711:55 WG1006442
(S)Dibromofluoromethane 100 76.0-123 08/06/201711:55 WG1006442
(S)4-Bromofluorobenzene 109 80.0-120 08/06/201711:55 WG1006442
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
TBL Laboratory TBL 27786 L926898 08/14/1711:33 6 of 35

1
1

EFFLUENT SAMPLE RESULTS - 01 ONE LAB.NATIONWIDE. .41
Collected date/time: 08/03/17 08:54 L926898
Pesticides (GC) by Method EPA 608 ,y
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Aldrin ND 0.0000500 1 08/08/201712:40 WG1006151 Tc
Alpha BHC ND 0.0000500 1 08/08/201712:40 WG1006151
Beta BHC ND 0.0000500 1 08/08/201712:40 WG1006151
Delta BHC ND 0.0000500 1 08/08/201712:40 WG1006151 SS
Gamma BHC ND 0.0000500 1 08/08/201712:40 WG1006151
Chlordane ND 0.000500 1 08/08/201712:40 WG1006151 4
Cn
4,4-DDD ND 0.0000500 1 08/08/201712:40 WG1006151
4,4-DDE ND 0.0000500 1 08/08/201712:40 WG1006151
4,4-DDT ND 0.0000500 1 08/08/201712:40 WG1006151 Sr
Dieldrin ND 0.0000500 1 08/08/201712:40 WG1006151
Endosulfan I ND 0.0000500 1 08/08/201712:40 WG1006151 `QC
Endosulfan II ND 0.0000500 1 08/08/201712:40 WG1006151
Endosulfan sulfate ND 0.0000500 1 08/08/201712:40 WG1006151
Endrin ND 0.0000500 1 08/08/201712:40 WG1006151 GI
Endrin aldehyde ND 0.0000500 1 08/08/201712:40 WG1006151
Endrin ketone ND 0.0000500 1 08/08/201712:40 WG1006151 s r
Heptachlor ND 0.0000500 1 08/08/201712:40 WG1006151 lI's,
Heptachlor epoxide ND 0.0000500 1 08/08/201712:40 WG1006151
Hexachlorobenzene ND 0.0000500 1 08/08/201712:40 WG1006151 SC
Methoxychlor ND 0.0000500 1 08/08/201712:40 WG1006151
Toxaphene ND 0.000500 1 08/08/201712:40 WG1006151
(S)Decach/orobipheny/ 92.7 10.0-144 08/08/201712:40 WG1006151
(5)Tetroch/oro-m-xylene 55.2 10.0-135 08/08/201712:40 WG1006151
Polychlorinated Biphenyls (GC) by Method EPA-608
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
PCB 1016 ND 0.000500 1 08/09/201713:33 WG1006151
PCB 1221 ND 0.000500 1 08/09/201713:33 WG1006151
PCB 1232 ND 0.000500 1 08/09/2017 13:33 WG1006151
PCB 1242 ND 0.000500 1 08/09/201713:33 WG1006151
PCB 1248 ND 0.000500 1 08/09/201713:33 WG1006151
PCB 1254 ND 0.000500 1 08/09/201713:33 WG1006151
PCB 1260 ND 0.000500 1 08/09/201713:33 WG1006151
(S)Decach/orobiphenyl 71.1 10.0-144 08/09/201713:33 WG1006151
(S)Tetrachloro-m-xylene 77.0 10.0-135 08/09/201713:33 WG1006151
Semi Volatile Organic Compounds (GC/MS) by Method 625
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Acenaphthene ND 0.00100 1 08/08/2017 22:39 WG1006270
Acenaphthylene ND 0.00100 1 08/08/2017 22:39 WG1006270
Anthracene ND 0.00100 1 08/08/2017 22:39 WG1006270
Benzidine ND 0.0100 1 08/08/2017 22:39 WG1006270
Benzo(a)anthracene ND 0.00100 1 08/08/2017 22:39 WG1006270
Benzo(b)fluoranthene ND 0.00100 1 08/08/2017 22:39 WG1006270
Benzo(k)fluoranthene ND 0.00100 1 08/08/2017 22:39 WG1006270
Benzo(g,h,i)perylene ND 0.00100 1 08/08/2017 22:39 WG1006270
Benzo(a)pyrene ND 0.00100 1 08/08/2017 22:39 WG1006270
Bis(2-chlorethoxy)methane ND 0.0100 1 08/08/2017 22:39 WG1006270
Bis(2-chloroethyl)ether ND 0.0100 1 08/08/2017 22:39 WG1006270
Bis(2-chloroisopropyl)ether ND 0.0100 1 08/08/2017 22:39 WG1006270
4-Bromophenyl-phenylether ND 0.0100 1 08/08/2017 22:39 WG1006270
2-Chloronaphthalene ND 0.00100 1 08/08/2017 22:39 WG1006270
4-Chlorophenyl-phenylether ND 0.0100 1 08/08/2017 22:39 WG1006270
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
TBL Laboratory TBL 27786 L926898 08/14/1711:33 7 of 35

EFFLUENT SAMPLE RESULTS - 01 ONE LAB.NATIONWIDE. 1111
Collected date/time: 08/03/17 08:54 L926898
Semi Volatile Organic Compounds (GC/MS) by Method 625
_a
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time --
Chrysene ND 0.00100 1 08/08/2017 22:39 WG1006270 'Tc
Dibenz(a,h)anthracene ND 0.00100 1 08/08/2017 22:39 WG1006270
3,3-Dichlorobenzidine ND 0.0100 1 08/08/2017 22:39 WG1006270 3
2,4-Dinitrotoluene ND 0.0100 1 08/08/2017 22:39 WG1006270 Ss
2,6-Dinitrotoluene ND 0.0100 1 08/08/2017 22:39 WG1006270
Fluoranthene ND 0.00100 1 08/08/2017 22:39 WG1006270 4
Cn
Fluorene ND 0.00100 1 08/08/2017 22:39 WG1006270
Hexachlorobenzene ND 0.00100 1 08/08/2017 22:39 WG1006270 s
Hexachloro-1,3-butadiene ND 0.0100 1 08/08/2017 22:39 WG1006270 Sr
Hexachlorocyclopentadiene ND 0.0100 1 08/08/2017 22:39 WG1006270
Hexachloroethane ND 0.0100 1 08/08/2017 22:39 WG1006270 `Cc
Indeno(1,2,3-cd)pyrene ND 0.00100 1 08/08/2017 22:39 WG1006270
Isophorone ND 0.0100 1 08/08/2017 22:39 WG1006270
7
Naphthalene ND 0.00100 1 08/08/2017 22:39 WG1006270 GI
Nitrobenzene ND 0.0100 1 08/08/2017 22:39 WG1006270
n-Nitrosodimethylamine ND 0.0100 1 08/08/2017 22:39 WG1006270 1 Ai
n-Nitrosodiphenylamine ND 0.0100 1 08/08/2017 22:39 WG1006270 i
n-Nitrosodi-n-propylamine ND 0.0100 1 08/08/2017 22:39 WG1006270 9
Phenanthrene ND 0.00100 1 08/08/2017 22:39 WG1006270 SC
Benzylbutyl phthalate ND 0.00300 1 08/08/2017 22:39 WG1006270
Bis(2-ethylhexyl)phthalate ND 0.00300 1 08/08/2017 22:39 WG1006270 I
Di-n-butyl phthalate ND 0.00300 1 08/08/2017 22:39 WG1006270
Diethyl phthalate ND 0.00300 1 08/08/2017 22:39 WG1006270
Dimethyl phthalate ND 0.00300 1 08/08/2017 22:39 WG1006270
Di-n-octyl phthalate ND 0.00300 1 08/08/2017 22:39 WG1006270
Pyrene ND 0.00100 1 08/08/2017 22:39 WG1006270
1,2,4-Trichlorobenzene ND 0.0100 1 08/08/2017 22:39 WG1006270
4-Chloro-3-methylphenol ND 0.0100 1 08/08/2017 22:39 WG1006270
2-Chlorophenol ND 0.0100 1 08/08/2017 22:39 WG1006270
2,4-Dichlorophenol ND 0.0100 1 08/08/2017 22:39 WG1006270
2,4-Dimethylphenol ND 0.0100 1 08/08/2017 22:39 WG1006270
4,6-Dinitro-2-methylphenol ND 0.0100 1 08/08/2017 22:39 WG1006270
2,4-Dinitrophenol ND 0.0100 1 08/08/2017 22:39 WG1006270
2-Nitrophenol ND 0.0100 1 08/08/2017 22:39 WG1006270
4-Nitrophenol ND 0.0100 1 08/08/2017 22:39 WG1006270
Pentachlorophenol ND 0.0100 1 08/08/2017 22:39 WG1006270
Phenol ND 0.0100 1 08/08/2017 22:39 WG1006270
2,4,6-Trichlorophenol ND 0.0100 1 08/08/2017 22:39 WG1006270
1,2-Diphenylhydrazine ND 0.0100 1 08/08/2017 22:39 WG1006270
(5)2-Fluorophenol 55.0 10.0-120 08/08/2017 22:39 WG1006270
(5)Phenol-d5 40.1 10.0-120 08/08/2017 22:39 WG1006270
(S)Nitrobenzene-d5 80.3 10.0-126 08/08/201722:39 WG1006270 1
(5)2-Fluorobiphenyl 74.4 22.0-127 08/08/2017 22:39 WG1006270
(S)2,4,6-Tribrornophenol 77.8 10.0-153 08/08/201722:39 WG1006270 1
(S)p-Terphenyl-d14 73.7 29.0-141 08/08/201722:39 WG1006270
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
TBL Laboratory TBL 27786 L926898 08/14/1711:33 8 of 35

1

EFFLUENT SAMPLE RESULTS - 01 ONE LAB.NATIONWIDE. 4111
Collected date/time: 08/23/18 09:48 L1020307
Gravirnetric Analysis by Method 2540 C-2011
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Dissolved Solids 280 10.0 1 08/28/201817:35 WG1157949 I!. C 1
._!
Wet Chemistry by Method 130.1
Ss
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I
.- 9 mg/I date/time 4
Hardness(colorimetric)as CaCO3 32.9 H 30.0 1 08/29/2018 15:33 WG1158603
Cn
Wet Chemistry by Method 1664B ;l.
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time 'Qc
oil&Grease Extr)
(Hexane ) ND 5.88 1 08/28/201815:07 WG1158129
7
Wet Chemistry by Method 300.0 GI
Result Qualifier RDL Dilution Analysis Batch �`"_..=1
Analyte mg/I mg/I date/time
'f1~I
Nitrate as(N) 12.3 0.500 5 08/24/2018 16:26 WG1156784
Nitrite as(N) ND
0.100 1 08/24/2018 15:42 WG1156784 Sc
Wet Chemistry by Method 350.1
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Ammonia Nitrogen ND 0.100 1 08/28/2018 16:02 WG1157405
Wet Chemistry by Method 351.2
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Kjeldahl Nitrogen,TKN ND j6 0.250 1 08/29/2018 08:28 WG1158770
Wet Chemistry by Method 365.4
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Phosphorus,Total 3.70 J6 0.100 1 08/28/2018 14:14 WG1158474
Wet Chemistry by Method 420.4
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Total Phenol by 4AAP ND .14 0.0400 1 08/29/201810:44 WG1157906
Wet Chemistry by Method 4500CN E-2011
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Cyanide ND 0.00500 1 08/29/201812:16 WG1157854
Mercury by Method 245.1
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Mercury ND 0.000200 1 08/27/2018 10:44 WG1157574
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
TBL Laboratory TBL 28438 L1020307 09/04/18 08:31 5 of 35
i

i
EFFLUENT SAMPLE RESULTS - 01 ONE LAB.NATIONWIDE ',
Collected date/time: 08/23/18 09:48 L1020307
Metals (ICP) by Method 200./
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Antimony ND 0.0100 1 08/29/2018 15:17 WG1156859 i C. I
Arsenic ND 0.0100 1 08/29/2018 15:17 WG1156859 I
____
Beryllium ND 0.00200 1 08/29/201815.17 WG1156859
Cadmium ND 0.00200 1 08/29/201815:17 WG1156859 Ss
Chromium ND 0.0100 1 08/29/201815.17 WG1156859
Copper ND 0.0100 1 08/29/201815:17 WG1156859 4
Cn
Lead ND 0.00500 1 08/29/2018 15:17 WG1156859
Nickel ND 0.0100 1 08/29/2018 15:17 WG1156859
Selenium ND 0.0100 1 08/29/2018 15:17 WG1156859 SI
Silver ND 0.00500 1 08/29/2018 15:17 WG1156859
Zinc 0.0561 0.0500 1 08/29/2018 15:17 WG1156859
I
Metals (ICPMS) by Method 200.8
GI
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Thallium ND 0.00100 1 08/28/2018 02:27 WG1158058 AI i
Volatile Organic Compounds (GC/MS) by Method 624 ScV
Result Qualifier RDL Dilution Analysis Batch Analyte mg/I mg/I date/time
Acrolein ND 0.0500 1 08/24/2018 22:42 WG1157080
Acrylonitrile ND 0.0100 1 08/24/2018 22:42 WG1157080
Benzene ND 0.00100 1 08/24/2018 22:42 W61157080
Bromodichloromethane ND 0.00100 1 08/24/2018 22:42 WG1157080
Bromoform ND 0.00100 1 08/24/2018 22:42 WG1157080
Bromomethane ND 0.00500 1 08/24/2018 22:42 WG1157080
Carbon tetrachloride ND 0.00100 1 08/24/2018 22:42 WG1157080
Chlorobenzene ND 0.00100 1 08/24/2018 22;42 WG1157080
Chlorodihromomethane ND 0.00100 1 08/24/2018 22:42 WG1157080
Chloroethane ND 0.00500 1 08/24/2018 22:42 WG1157080
2-Chloroethyl vinyl ether ND 0.0500 1 08/24/2018 22:42 WG1157080
Chloroform ND 0.00500 1 08/24/2018 22:42 WG1157080
Chloromethane ND 0.00250 1 08/24/2018 22:42 WG1157080
1,1-Dichloroethane ND 0.00100 1 08/24/2018 22:42 WG1157080
1,2-Dirhloroethane ND 0.00100 1 08/24/2018 22:42 WG1157080
1,1-Dichloroethene ND 0.00100 1 08/24/2018 22:42 WG1157080
trans-1,2-Dichloroethene ND 0.00100 1 08/24/2018 22:42 WG1157080
1,2-Dichloropropane ND 0.00100 1 08/24/2018 22:42 WG1157080
cis-1,3-Dichloropropene ND 0.00100 1 08/24/2018 22:42 WG1157080
trans-1,3-Dichloropropene ND 0.00100 1 08/24/2018 22:42 WG1157080
Ethylbenzene ND 0.00100 1 08/24/2018 22:42 WG1157080
Methylene Chloride ND 0.00500 1 08/24/2018 22:42 WG1157080
1,1,2,2-Tetrachloroethane ND 0.00100 1 08/24/2018 22:42 WG1157080
Tetrachloroethane ND 0.00100 1 08/24/2018 22:42 WG1157080
Toluene ND 0.00100 1 08/24/2018 22:42 WG1157080
1,1,1-Trichloroethane ND 0.00100 1 08/24/2018 22:42 WG1157080
1,1,2-Trichloroethane ND 0.00100 1 08/24/2018 22:42 WG1157080
Trichloroethene ND 0.00100 1 08/24/2018 22:42 WG1157080
Vinyl chloride ND 0.00100 1 08/24/2018 22:42 WG1157080
(5)Toluene-d8 106 80.0-120 08/24/201822:42 WG1157080
(S)Dibromofluoromethone 98.8 75.0-120 08/24/2018 22:42 WG1157080
(5)4-Bromofiuorobenzene 103 77.0-126 08/24/2018 22:42 WG1157080
ACCOUNT: PROJECT: 5DG: DATE/TIME: PAGE:
TBL Laboratory TBL 28438 L1020307 09/04/18 08:31 6 of 35

EFFLUENT SAMPLE RESULTS - 01 ONE LAB.NATIONWIDE ,
Collected date/time: oe/23/18 09:48 11020307
Pesticides (GC) by Method EPA 608.3
Result Qualifier RDL Dilution Analysis Batch l
Analyte mg/I mg/I date/time
Aldrin ND • 0.0000500 1 08/29/201815.27 WG1158589
TG
Alpha BHC ND 0.0000500 1 08/29/2018 15:27 WG1158589
Beta BHC ND 0.0000500 1 08/29/201815:27 WG1158589
Delta BHC ND 0.0000500 1 08/29/201815:27 WG1158589 Ss
Gamma BHC ND 0.0000500 1 08/29/2018 15:27 WG1158589
Chlordane ND 0.000500 1 08/29/201815:27 WG1158589 4Cn
4,4-DDD ND 0.0000500 1 08/29/201815:27 WG1158589
4,4-DDE, ND 0.0000500 1 08/29/201815:27 WG1158589
4,4-DDT ND 0.0000500 1 08/29/2018 15:27 WG1158589 Sr
Dieldrin ND 0.0000500 1 08/29/2018 15:27 WG1158589
Endosulfan I ND 0.0000500 1 08/29/201815:27 WG1158589
QC1
Endosulfan II ND 0.0000500 1 08/29/2018 15:27 WG1158589
Endosulfan sulfate ND 0.0000500 1 08/29/2018 15:27 WG1158589
7
Endrin ND 00000500 1 08/29/201815:27 WG1158589 GI
Endrin aldehyde ND 0.0000500 1 08/29/2018 15:27 WG1158589
Endrin ketone ND 0.0000500 1 08/29/201815:27 W01158589 l
Heptachlor ND 0.0000500 1 08/29/201815:27 WG1158589 j
Heptachlor epoxide ND 0.0000500 1 08/29/20181527 WG1158589
Hexachlorobenzene ND 0.0000500 1 08/29/201815:27 WG1158589 SC
Methoxych(or ND 0.0000500 1 08/29/2018 15:27 WG1158589
Toxaphene ND 0.000500 1 08/29/2018 15:27 WG1158589
(5)Decachlorobiphenyl 84.9 100-144 08/29/2018 15:27 WG1158589
(S)Tetrachloro-m-xylene 64.9 10.0-135 08/29/2018 15:27 WG1158589
Polychlorinated Biphenyls (GC) by Method EPA-608.3
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
PCB 1016 ND 0.000500 1 08/29/2018 14:58 WG1158589
PCB 1221 ND 0.000500 1 08/29/201814:58 WG1158589,
PCB 1232 ND 0.000500 1 08/29/2018 14:58 WG1158589
PCB 1242 ND 0.000500 1 08/29/201814:58 WG1158589
PCB 1248 ND 0.000500 1 08/29/2018 14:58 WG1158589
PCB 1254 ND 0.000500 1 08/29/201814:58 WG1158589
PCB 1260 ND 0.000500 1 08/29/201814:58 WG1158589
(5)Decachlorobiphenyl 80.3 10.0-144 08/29/2018 14:58 WG1158589
(S)Tetrochloro-m xylene 79.3 10.0-135 08/29/201814.58 WG1158589
Semi Volatile Organic Compounds (GC/MS) by Method 625
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time
Acenaphthene ND
0.00100 1 08/3112018 02:16 WG1158699
Acenaphthylene ND 0.00100 1 08/31/2018 02:16 WG1158699
Anthracene ND 0.00100 1 08/31/2018 02:16 WG1158699
Benzidine - ND 0.0100 1 08/31/2018 02:16 WG1158699
Benzo(a)anthracene ND 0.00100 1 08/31/2018 02:16 WG1158699
Benzo(b)fluoranthene ND 0.00100 1 08/31/2018 02:16 WG1158699
Benzo(k)fluoranthene ND 0.00100 1 08/31/2018 02:16 WG1158699
Benzo(g,h,i)perylene ND 0.00100 1 08/31/2018 02:16 WG1158699
Benzo(a)pyrene ND 0.00100 1 08/31/2018 02:16 WG1158699
Bis(2-chiorethoxy)methane ND 0.0100 1 08/31/2018 02:16 WG1158699
Bis(2-chloroethyl)ether ND 0.0100 1 08/31/2018 02:16 WG1158699
Bis(2-chloroisopropyl)ether ND` 0.0100 1 08/31/2018 02:16 WG1158699
4-Bromophenyl-phenylether ND 0.0100 1 08/31/2018 02:16 WG1158699
2-Chloronaphthalene ND 0.00100 1 08/31/2018 02:16 WG1158699
4-Chlorophenyl-phenylether ND 0.0100 1 08/31/2018 02:16 WG1158699
..... ..................... ........................... .......
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE
TBL Laboratory TEL 28438 L1020307 09/04/18 08:31 7 of 35

IP
EFFLUENT SAMPLE RESULTS - 01 ONE LAB.NATIONWIDE.
Collected date/time: 08/23/18 09:48 L1020307
[ ._...._..-..
Semi Volatile Organic Compounds (GC/MS) by Method 625
k_
Result Qualifier RDL Dilution Analysis Batch
Analyte mg/I mg/I date/time _�
Chrysene ND 0.00100 1 08/31/2018 02:16 WG1158699 I': i
Dibenz(a,h)anthracene ND 0.00100 1 08/31/2018 02:16 WG1158699
3,3-Dichlorobenzidine ND 0.0100 1 08/31/2018 02:16 WG1158699 ,Ss
2,4-Dinitrotoluene ND 0.0100 1 08/31/2018 02:16 WG1158699
2,6-Dinitrotoluene ND 0.0100 1 08/31/2018 02:16 WG1158699
1 1,2-Diphenylhydrazine ND 0.0100 1 08/31/2018 02:16 WG1158699 n Ca
Fluoranthene ND 0.00100 1 08/31/2018 02:16 WG1158699
Fluorene ND 0.00100 1 08/31/2018 02:16 WG1158699
Hexachlorobenzene ND
0.00100 1 08/31/2018 02:16 WG1158699 Sr
Hexachloro-1,3-butadiene ND 0.0100 1 08/31/2018 02:16 WG1158699
Hexachlorocyclopentadiene ND 0.0100 1 08/31/2018 02:16 WG1158699 Cic.
Hexachloroethane ND 0.0100 1 08/31/2018 02:16 WG1158699
Indeno(1,2,3-cd)pyrene ND 0.00100 1 08/31/2018 02:16 WG1158699 GI
Isophorone ND 0.0100 1 08/31/2018 02:16 W01158699
Naphthalene ND 0.00100 1 08/31/2018 02:16 WG1158699
Nitrobenzene ND 0.0100 1 08/31/2018 02:16 WG1158699 Al
n-Nitrosodimethylamine ND 0.0100 1 08/31/2018 02:16 WG1158699 i
n-Nitrosodiphenylamine ND 0.0100 1 08/31/2018 02:16 WG1158699 �i
n-Nitrosodi-n-propylamine ND
0.0100 1 08/31/2018 02:16 WG1158699 Sc
Phenanthrene ND 0.00100 1 08/31/2018 02:16 WG1158699
Benzylbutyl phthalate ND 0.00300 1 08/31/2018 02:16 WG1158699
Bis(2-ethylhexyl)phthalate ND 0.00300 1 08/31/2018 02:16 WG1158699
Di-n-butyl phthalate ND 0.00300 1 08/31/2018 02:16 WG1158699
Diethyl phthalate ND 0.00300 1 08/31/2018 02:16 WG1158699
Dimethyl phthalate ND 0.00300 1 08/31/2018 02:16 WG1158699
Di-n-octyl phthalate ND 0.00300 1 08/31/2018 02:16 WG1158699
Pyrene ND 0.00100 1 08/31/2018 02:16 WG1158699
1,2,4-Trichlorobenzene ND 0.0100 1 08/31/2018 02:16 WG1158699
4-Chloro-3-methylphenol ND 0.0100 1 08/31/2018 02:16 WG1158699
2-Chiorophenol ND 0.0100 1 08/31/2018 02:16 WG1158699
2,4-Dichlorophenol ND 0.0100 1 08/31/2018 02:16 WG1158699
2,4-Dimethylphenol ND 0.0100 1 08/31/2018 02:16 WG1158699
4,6-Dinitro-2-methylphenol ND 0.0100 1 08/31/2018 02:16 WG1158699
2,4-Dinitrophenol ND 0.0100 1 08/31/2018 02:16 WG1158699
2-Nitrophenol ND 0.0100 1 08/31/2018 02:16 WG1158699
4-Nitrophenol ND 0.0100 1 08/31/2018 02:16 WG1158699
Pentachlorophenol ND 0.0100 1 08/31/2018 02:16 WG1158699
Phenol ND 0.0100 1 08/31/2018 02:16 WG1158699
2,4,6-Trichlorophenol ND 0.0100 1 08/31/2018 02:16 WG1158699
(S)2-Fluorophenol 39.1 10.0-120 08/31/2018 02:16 WG1158699
(S)Phenol-d5 22.9 10.0-120 08/31/2018 02:16 WG1158699
(S)Nitrobenzene-d5 51.6 10.0-127 08/31/2018 0216 WG1158699
(S)2-Fluorobiphenyl 54.0 - 10.0-130 08/31/2018 02:16 ;WG1158699
(S)2,4,6-Tribromophenol 59.3 10.0-155 08/31/2018 02:16 WG1158699
(S)p-Terphenyl-d14 69.8 10.0-128 08/31/2018 02:16 W01158699
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
TBL Laboratory TBL 28438 L1020307 09/04/18 08:31 8 of 35

Effluent Toxicity Report Form-Chronic Fathead Minnow Multi-Concentration Test
Date:10/26/2018
NPDES#NCO() 27103 Pipe#: 001 County: Robeson
Facility: Pembroke
Comments
Labo tory: Meritech, Inj��
x J(t` N J"`1{,®J11
Signature Operator in Respo Bible Charge`
Signature of Laboratory Supervisor
MAIL ORIGINAL TO: Water Sciences Section
Aquatic Toxicology Branch
Division of Water Resources
1621 Mail Service Center
Raleigh,N.C.27699-1621
Test Initiation Date/Time 10/16/2018 3:23 PM Avg Wt/Surv. Control! 0.666 ! Test Organisms
2 3 4 I- Cultured In-House
Eff. Repl. 1
!Control! Surviving# 10 10 10 10 %Survival' 100.0 I 7 Outside Supplier
Original# 10 10 10 10
Wt/original(mg) 0.674 0.686 0.656 0.648 Avg Wt(mg) 0.666 Hatch Date: 10/15/18
! 0.425 I Surviving# 10 10 10 10 %Survival! 100.0 I Hatch Time: 2:00 pm CT
Original# 10 10 10 10
Wt/original(mg) 0.718 0.632 0.690 0.639 Avg Wt(mg)1 0.670 I
! 0.85 ! Surviving# 10 10 10 10 %Survival 100.0
Original# 10 10 10 10
Wt/original(mg) 0.600 0.768 0.653 0.655 Avg Wt(mg) 0.669
! 1.7 I Surviving# 10 10 10 10 %Survival 100.0
Original# 10 10 10 10 ! 0.719 '
Wt/original(mg) 0.669 0,765 0.743 0.698 Avg Wt(mg)
3.4 Surviving# 10 10 9 10 %Survival 97.5
Original# 10 10 10 10
Wt/original(mg) 0.558 0.590 0.567 0.642 Avg Wt(mg) 0.589
6.8 Surviving# 10 10 10 10 %Survival 100.0
Original# 10' 10 10 10
Wt/original(mg) 0.694 0.595 0.732 0.583 Avg Wt(mg) 0.651
Water Quality Data Day
Control 0 1 2 3 4 5 6
pH(SU)Init/Fin 8.12 / 7.84 8.19 / 8.01 7.95 / 7.84 8.06 / 8.09 8.15 / 8.15 8.19 / 7.80 8.10 / 7.79
DO(mg/L) Init/Fin 7.75 / 6.67 7.70 / 7.35 7.98 / 6.92 7.62 17.83 7.81 / 7.78 7.87 / 7.43 7.83 / 7.13
Temp(C)Init/Fin 25.1 / 24.8 24.3 / 24.2 25.4 / 25.1 24.8 / 24.1 25.2 124,7 25.1 / 24.4 24.1 / 24.5
High Concentration o 1 2 3 4 5 6
pH(SU)'nit/Fin 8.04 / 7.70 8.15 / 7.95 7.98 / 7.78 7.99 / 8.12 8.14 / 8.07 8.27 / 7.84 8.05 / 7.74
DO(mg/L) 'nit/Fin 7.73 / 6.86 7.70 / 7.54 7.96 / 6.79 7.50 / 7.74 7.73 / 7,65 7.82 / 7.35 7.79 / 6.79
Temp(C)Init/Fin 25.1 / 24.8 24.3 / 25.7 25.0 / 25.5 24.8 / 24.1 25.2 / 24,9 24.5 / 24.9 24.8 / 24.1
Sample 1 2 3 Survival Growth Overall Result
Collection Start Date 10/15/2018 10/17/2018 10/18/2018 Normal ri Fl ChV >6.8
Grab Horn.Var. ri P.1
Composite(Duration) 24.0 24.0 24.0 NOEC 6.8 6.8
Hardness(mg/L) 26 28 26 LOEC >6.8 >6.8
Alkalinity(mglL) 76 88 98 ChV >6.8 >6.8
Conductivity(umhos/cm) 326 361 377 Method Steel's Dunnett's
Chiorine(mg/L) <0.1 <0.1 <0.1
Temp.at Receipt(°C) 1.7 1.7 0.4 Stats Survival Growth
Conc. Critical Calculated Critical Calculated
Dilution H2O Batch# 1321 1322 1323 1324 1325 0.425 10 18 2.41 -0.1037
Hardness(mg/L) 42 44 46 44 42 0.85 10 18 2.41 -0.0830
Alkalinity(mg/L) 53 52 52 52 49 1.7 10 18 2.41 -1.4588
Conductivity(umhos/cm) 192 202- 185 171 210 3.4 10 16 2.41 2.1226
6.8 10 18 2.41 0.4148

Effluent Toxicity Report Form-Chronic Fathead Minnow Multi-Concentration Test Date:11126/2018
Facility: Pembroke NPDES#NCOO 27103 Pipe#: 001 County: Robeson
Labatory: Meritech, Inc Comments µ,.i2tL'
Signature f Operator in Respons' le Char
Signature of Laboratory Supervisor
MAIL ORIGINAL TO: Water Sciences Section
Aquatic Toxicology Branch
Division of Water Resources
1621 Mail Service Center
Raleigh,N.C.27699-1621
Test Initiation Date/Time 11/13/2018 5:28 PM Avg Wt/Surv. Control 0.767 Test Organisms
%Eff. Repl. 1 2 3 4 C' Cultured In-House
Control Surviving# 10 10 10 10 %Survival 100.0 7 Outside Supplier
Original# 10 10 10 10
Wt/original(mg) 0.735 0.830 0.724 0.777 Avg Wt(mg) 0.767 Hatch Date: 11/12/18
0.425 Surviving# 10 10 10 10 %Survival 100.0 Hatch Time: 3:00 pm CT
Original# 10 10 10 10
Wt/original(mg) 0.752 0.971 0.703 0.612 Avg Wt(mg) 0.760
0.85 Surviving# 10 10 10 10 %Survival 100.0
Original# 10 10 10 10
Wt/original(mg) 0.819 0.771 0.794 0.714 Avg Wt(mg) 0.775
1.7 Surviving# 10 10 10 10 %Survival 100.0
Original# 10 10 10 10
Wt/original(mg) 0.696 0.738 0.755 0.816 Avg Wt(mg) 0.751
3.4 Surviving# 10 10 10 10 %Survival 100.0
Original# 10 10 10 10
Wt/original(mg) 0.760 0.833 0.878 0.824 Avg Wt(mg) 0.824
6.8 Surviving# 10 10 10 10 %Survival 100.0
Original# 10 10 10 10
Wt/original(mg) 0.725 0.856 0.736 0.813 Avg Wt(mg) 0.783
Water Quality Data Day
Control 0 1 2 3 4 5 6
pH(SU)!nit/Fin 8.30 / 7.81 8.13 / 8.01 7.97 / 7.83 8.09 / 8.03 8.15 / 8.11 8.26 / 7.87 8.01 / 7.66
DO(mg/L) Init/Fin 7.83 / 7.08 7.71 / 7.42 7.83 / 7.07 7.68 I 7.86 7.92 / 7.57 8.24 / 7.16 7.65 / 6.14
Temp(C)!nit/Fin 25.2 / 24.7 25.6 / 24.6 24.3 / 24.3 24.6 / 24.7 24.8 / 24.7 24.7 / 24.6 24.5 / 24.6
High Concentration o 1 2 3 4 5 6
pH(SU)hilt/Fin 8.09 I 7.91 8.04 / 7.91 7.89 / 7.82 8.03 / 8,07 8.11 / 8.05 8.20 / 7.78 7,98 / 7.58
DO(mg/L) 'nit/Fin 7.67 / 7.14 7.69 / 7.33 7.82 / 6.86 7.77 / 7.78 7.87 / 7.54 8.02 / 7.03 7.56 / 6.13
Temp(C)!nit/Fin 24.1 / 25.0 25.3 / 24.9 24.6 / 25.1 25.6 / 24.2 24.5 / 24.8 24.7 / 24.2 24.5 / 25.1
Sample 1 2 3 Survival Growth Overall Result
Collection Start Date 11/12/2018 11/14/2018 11/15/2018 Normal rl PIl ChV ( >6.8
Grab Horn.Var. f Fl`
Composite(Duration) 24.0 24.0 24.0 NOEC 6.8 6.8
Hardness(mg/L) 28 28 30 LOEC >6.8 >6.8
Alkalinity(mg/L) 73 43 50 ChV >6.8 >6.8
Conductivity(umhos/cm) 332 188 213 Method Steel's Dunnett's
Chlorine(mg/L) <0.1 <0.1 <0.1
Temp.at Receipt("C) 0.8 1.7 0.8 Stats
Survival Growth
Conc. Critical Calculated Critical Calculated
Dilution H2O Batch# 1332 1333 1334 1335 1336 0.425 10
Hardness(mg/L) 44 42 44 44 44 0.85 18 2.41 0.1272
0.145
10 18 2.41 -0.1454
Alkalinity(mg/L) 54 53 52 55 48 1.7 10 -
Conductivity(umhos/cm) 207 193 199 215 195 18 2.41 0.2771 3.4 10 18 2.41 -1.0402
6.8 10 18 2.41 -0.2907
thole c,,,,„ AT A'/4in,1%

Effluent Toxicity Report Form-Chronic Fathead Minnow Multi-Concentration Test Date:1/8/2019
Facility: Pembroke NPDES#NCOO 27103 Pipe#: 001 County: Robeson
Laborat : Meritech, Inc. Comments) Second Copy
x �. . '
Signature of perator in esponsi a Charge
Signature of Laboratory Supervisor
MAIL ORIGINAL TO: Water Sciences Section
Aquatic Toxicology Branch
Division of Water Resources
1621 Mail Service Center
Raleigh,N.C.27699-1621
Test Initiation Date/Time 12/11/2018 5:47 PM Avg Wt/Surv.Control 0.781 Test Organisms
%Eff. Repl. 1 2 3 4 7 Cultured In-House
Control Surviving# 10 8 10 10 %Survival 95.0 ' i7 Outside Supplier
Original# 10 10 10 10
Wt/original(mg) 0.807 0.676 0.745 0.726 Avg Wt(mg) 0.739 Hatch Date: 12/10/18
0.425 Surviving# 10 10 10 10 %Survival 100.0 Hatch Time: 3:00 pm CT
Original# 10 10 10 10
Wt/original(mg) 0.757 0.760 0.704 0.693 Avg Wt(mg) 0.729
0.85 Surviving# 10 10 9 9 %Survival 95.0
Original# 10 10 10 10
Wt/original(mg) 0.646 0.845 0.687 0.576 Avg Wt(mg) 0.689
1.7 Surviving# 10 10 10 9 %Survival 97.5
Original# 10 10 10 10
Wt/original(mg) 0.797 0.797 0.679 0.724 Avg Wt(mg) 0.749
3.4 Surviving# 10 10 10 10 %Survival 100.0
Original# 10 10 10 10
Wt/original(mg) 0.661 0.769 0.694 0.679 Avg Wt(mg) 0.701
6.8 Surviving# 10 10 9 10 %Survival 97.5
Original# 10 10 10 10
Wt/original(mg) 0.758 0.720 0.730 0.860 Avg Wt(mg) 0.767
Water Quality Data Day
Control 0 1 2 3 4 5 6
pH(SU)Init/Fin 8.01 / 7.77 7.98 / 7.96 8.08 / 7.65 8.14 / 7.98 8.15 / 8.04 8.41 / 7.96 8.18 / 7.87
DO(mg/L) !nit/Fin 7.52 / 7.21 7.67 / 7.30 7.90 / 6.88 7.78 / 7.67 7.72 / 7.71 7.93 / 7.44 7.78 / 7.81
Temp(C)Init/Fin 24.5 / 24.5 24.9 / 24.2 24.8 / 24.1 24.8 / 25.1 24.0 / 25.3 24.7 / 24.0 24.3 / 24.1
High Concentration o 1 2 3 4 5 6
pH(SU)Init/Fin 7.95 / 7.78 7.92 / 7.87 7.95 / 7.73 7.97 / 8.02 8.16 / 8.09 8.23 / 7.92 8.15 / 7.76
DO(mg/L) Init/Fin 7.48 / 7.14 7.58 / 7.27 7.71 / 6.99 7.75 / 7.52 7.68 / 7.64 7.83 / 7.34 7.73 / 6.97
Temp(C)Init/Fin 24.4 / 24.5 24.2 / 24.2 24.3 / 24.5 24.2 / 24.0 24.6 / 24.1 25.2 / 24.4 24.9 / 24.1
Sample 1 2 3 Survival Growth Overall Result
Collection Start Date 12/10/2018 12/12/2018 12/13/2018 Normal "'",(¢I1, ChV >6.8
Grab Horn.Var. ri P-1
Composite(Duration) 24.0 24.0 24.0 NOEC 6.8 6.8
Hardness(mg/L) 26 26 32 LOEC >6.8 >6.8
Alkalinity(mg/L) 44 57 67 ChV >6.8 >6.8
Conductivity(umhos/cm) 199 241 285 Method Steel's Dunnett's
Chlorine(mg/L) <0.1 <0.1 <0.1
Temp.at Receipt(°C) 2.2 1.7 1.7 Stats Survival Growth
Conc. Critical Calculated Critical Calculated
Dilution H2O Batch# 1342 1343 1344 1345 1346 0.425 10 20 2.41 0.2113
Hardness(mg/L) 44 44 44 46 44 0.85 10 17 2.41 1.0566
Alkalinity(mg/L) 53 46 50 53 52 1.7 10 18.5 2.41 -0.2272
Conductivity(umhos/cm) 189 194 212 204 209 3.4 10 20 2.41 0.7977
6.8 10 18.5 2.41 -0.6023
DWQ Form AT-5(1/04)

TOWN OF PEMBROKE
PEMBROKE WWTP
NC0027103
PERMIT RENEWAL INFORMATION
PART F—INDUSTRIAL USER DISCHARGES
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit
additional pages as necessary.
Name: Trinity Frozen Foods, LLC
Mailing Address: 6064 Deep Branch Road
Pembroke,NC 28372
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Steam sweet potatoes to remove peelings, slice potatoes, fry potatoes prior to freezing
F.S. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the
SIU's discharge.
Principal product(s):Sweet potato french fries
Raw material(s): Sweet potatoes
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater
discharge into the collection system in gallons per day(gpd)and whether the discharge is
continuous or intermittent.
36,000 (permitted)gpd ( continuous or XX intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process
wastewater flow discharged into the collection system in gallons per day(gpd)and whether the
discharge is continuous or intermittent.
2,000 gpd (xxx continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ® Yes L.] No
b. Categorical pretreatment standards Yes No
If subject to categorical pretreatment standards, which category and subcategory?
F.B. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU
caused or contributed to any problems(e.g., upsets, interference)at the treatment works in the
past three years?
® Yes ( No If yes, describe each episode.
On one occasion Trinity pulled the plug in the manhole sending us their peelings and sweet
potatoes to the WWTP causing an upset. Another occasion, Trinity had an issue with their
lagoon. It had an algae problem causing issues at the plant with higher TSS and BOD well
over the norm.

TOWN OF PEMBROKE
PEMBROKE WWTP
NC0027103
PERMIT RENEWAL INFORMATION
PART F—INDUSTRIAL USER DISCHARGES
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit
9 9 9
additional pages as necessary.
Name: Steven Roberts Original Desserts, LLC
Mailing Address: 701 South Jones Street
Pembroke,NC 28372
F.4. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
Mix ingredients to make cake batter. Bake cakes, pastries, etc. Apply frosting.
F.S. Principal Product(s)and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the
SIU's discharge.
Principal product(s):Cakes,pastries, etc.
Raw material(s): Flour, sugar, margarine, frosting, eggs, dry mix, oils,milk
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater
discharge into the collection system in gallons per day(gpd)and whether the discharge is
continuous or intermittent.
36,000(permitted) gpd(XXX continuous or _ intermittent)
b. Non-process wastewater flow rate. Indicate the average daily volume of non-process
wastewater flow discharged into the collection system in gallons per day(gpd)and whether the
discharge is continuous or intermittent.
3000 gpd (xxx continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ® Yes _f No
b. Categorical pretreatment standards Yes ►1 No
If subject to categorical pretreatment standards, which category and subcategory?
F.B. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has the SIU
caused or contributed to any problems(e.g., upsets, interference)at the treatment works in the
past three years?
C Yes It1 No If yes, describe each episode.