NCS000133_Renewal Application_20220523

EPA Identification Number
NPDES Perran Number T-- _ _ Faoky Name
Fan Approved 03.05/19
llDD07662779
NC5000133 lowat Corp.
OMB No. 2MC M
Form
U.S. Environmental Protection Agency
1
"EPA Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
SECTION•
• 1
1.1
Applicants Not Required to Summit Form i
i 1 1
Is the facility a new or existing publicly owned
i 1 2
I Is the facility a new or existing treatment works
treatment works?
treating domestic sewage?
If yes, STOP. Do NOT complete 21 No
If yes, STOP. Do NOT Q No
Farm 1. Complete Form 2A.
complete Form 1. Complete
Form 2S.
19
Applicants Required to -Submit Form 1
1.2.1
Is the facility a concentrated animal feeding
1.2.2
11 Is the facility an existing manufacturing,
€
operation or a concentrated aquatic animal
commercial, mining, or silvicultural facility that is
a
production facility?
• currently discharging process wastewater?
cYes
4 Complete Form 1 2] No
I
Yes 4 Complete Form Q No
z
and Form 28.
1 and Form 2C.
W
1.2.3
Is the facility a new manufacturing, commercial,
1.2A
Is the facility a new or existing manufacturing,
e
mining, or siMcultural facility that has not yet
commercial, mining, or siMoultural facility that
•5
commenced to discharge?
discharges only nonprocess wastewater?
Yes 4 Complete Form 1 Qr No
Yes 4 Complete Form 0 No
and Form 20.
1 and Form 2E.
1.2.5
Is the facility facility
_
a new or existing whose
discharge is composed entirely of stormwater
a
associated with industrial activity or whose
discharge is composed of both stonnwater and
RECEIVED
non-stonnwater?
❑ Yes + Complete Form 1 No
r1
and Form 2F�r
unless exempted by
CFR 12
122.26{b)(14)(x) or�
DEW-StommterP
b 15.
SECTION
ADDRESS,r
2.1
Facil' y Name
Jowat Corp.
`0
2.2
EPA Identification Number
q
0
J
110007662779
D
2.3
Facility Contact
N
d
_
Name (first and last)
Title
Phone number
a
Martin Lambe
VP of Manufacturing
[phone]
Email address
[e-mail]
E
2.4
Facility Mailing Address
z
---___.
Street or P.O. box
6058 Lois Lane
C ty or town
State
ZIP code
Archdale
NC
27263
EPA Fan 3510.1 (mvaed 3.19) Page 1

EPA Identification Number
NPOES Permit Number Fac ty Name
Form Approved 03/05/19
110007662779
NC5000133 Jowat Corp.
OMB No. 2040-0004
2.5
Faa#iiy Loa irvm
Street, route number, or other specific identifier
4C V
5608 Uwharrie Rd
ca
County name
County code (if known)
19
Randolph
_
ai
E
City or town
State ZIP code
a
Archdale
NC 27263
SECTION•D
1 CFR
3.1
-..• .
2891
Adhesives and Sealants
a
w
V
va
V
z
3.2
MS-Cade(s)
loorr(i. =
cc
325520
Adhesive Manufacturing
C3
y
SECTION
OPERATOR
INFORMATION (40 CIFR
t
Jowat Corp.
4.2
Is the name you listed in Item 4.1 also the owner?
0 Yes ❑ No
4.3
❑ Public —federal ❑ Public —state ❑ Other public (specify)
o
Private ❑ Other
(specify)
4.4
Pbaae Ntr Of Operator
[phone]
c
4.5
Address
Street or P.O. Box
C
5608 Uwharrie Rd.
City or town
State
ZIP code
Archdale
NC
27263
Email address of operator ^ ��
Q
www.jowat.com
SECT ION
5. INDIAN!
1 CFR
5.1
Is the facility located an Indian Land?
❑ Yes O No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identification Number NPDES Penn Number IFaaHy Name Form Approved 03105119
110DO7662779 NCSOM133 Jowat Corp. OMB No. 20404004
SECTION•
6.1 Existing Environmental Perm(ts (check all that apply and print or type the corresponding permit number for each)
❑✓ NPDES (discharges to surface
RCRA (hazardous wastes) ❑ UIC (underground injection of
E
water)
fluids)
LLI v
❑ Nonattainment program (CAA) ❑ NESHAPs (CAA)
0 PSD (air emissions)
c
e
'�
❑ Ocean dumping
p g ( MPRSA ) ❑ D redge or (CWA Section 404) ❑Other (specify)
IPlift
7.1
Have you attached a topographic map containing all required information to this application? (See instructions for
7
specific requirements.)
El Yes ❑ No ❑ CAFO—Not Applicable (See requirements in Form 2B.)
SECTIONOF
1
8.1
Describe the nature of your business.
Adhesive manufacturing. We have above ground storage tanks for raw materials. These raw materials are conveyed
in a closed piping sytem to our commerical mixers, the material is heated to form a liquid. Once the mixing process is
completed the product is then transfered over to a storage tank by a closed piping system. The product is then
cooled and pelletized, once pelletized the product will go as a finished product into a bulk bag or a bin at which time
all
the finiihed product will be packaged for shipment.
0
a
s
SECTION
9.1
flies your facility use cooling water?
❑� Yes ❑ No + SKIP to hem 10.1.
9 22
Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
a 2
40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122.21(r). Consult with your
c Y
NPDES permitting authority to determine what specific information needs to be submitted and when.)
V a
On site chillers using public water system
c
SECTION1
VARIANCE
REQUESTS1 1
10.1
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)? (Check all that
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
g
❑ Fundamentally different factors (CWA ❑ Water quality related effluent limitations (CWA Section
Section 301(n)) 302(b)(2))
to
W
❑ Non -conventional pollutants (CWA ❑ Thermal discharges (CWA Section 316(a))
Section 301(c) and (g))
❑r Not applicable
EPA Form 3510.1 (revised 3,19) Page 3

EPA idenuIpIon Numder NPOES Pemml Nurr9ler Faotiry Name - - Farm Approved 03NSr 9
110007662779 NC5000133 I lowat Corp. OMB No. 2040-0004
SECTION•
CERTIFICATION STATEMENT (40
11.1
In Column 1 below, mark the sections of form 1 that you have completed and are submitting with your application.
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1
Column 2
Section 1: Activities Requiring an NPDES Permit
❑ wl attachments
❑� Section 2: Name, Mailing Address, and Location
❑ wl attachments
Section 3: SIC Codes
❑ wl attachments
❑� Section 4: Operator Information
❑ wt attachments
Section 5: Indian Land
❑ wl attachments
A
Section 6: Existing Environmental Permits
❑ wl attachments
9
❑ Section 7: Map
w/atopographic❑ wl additional attachments
❑✓
m
U3
o
section 8: Nature of Business
❑ wl attachments
W
r0
Section 9: Cooling Water Intake Structures
❑ w/ attachments
c
❑� Section 10: Variance Requests
❑ wl attachments
A
w
❑� Section 11: Checklist and Certification Statement
❑ wl attachments
Y
8
11.2
Certification Statement
u
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 submitted is, to the best of my knowledge and
belief true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name (print or type first and last name)
Offi aat tide
Martin Lemberg
VP of Manufacturing
Signature
Date signed
5 12 2022
EPA Pone 3510.1 (revised 3-19) Page 4

f
F
300-gailo.�� .
Vf HTF System
ANNE,
Aa
.rs
Map Source: https://mappingSuDOOrt.com/p2/pissurter.php (2020)
-;:;: AERIS
ENVIRONMENTAL
Consulting. Engineered for Results.
1440 Blueberry Lane
Charlotte. NC 28226
SPCC Site Plan
DATE:
December 2020
SCALE:
1 in. =200h
Jowat Corporation
(approx)
Archdale, North Carolina
DRAWING NO.
Figure 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
110007662779 NdWIJi33 Jowat Corp. OMB No. 2040-0004
Form U.S Environmental Protection Agency
2F ISEPA Application for NPDES Permit to Discharge Wastewater
NPDES STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY
SECTIONOUTFALL LOCATION•i CFR •
1.1 Provide information on each of the facilit s outfalls in the table below
Number
Recew�(tg Waiter Name�x, ` > Lat�tt�de Longi#ud
1 Tributary of Uwharrie River 35° 9013 28' S 800 0111' 80"
2 Tributary of Uwharrie River 3T 9021' 4e S 80° 0111' 36"
J 3 Uwharrie River
3.7 9040' 67" 800 007T 95"
SECTION
'-• 4t CFR
2.1 Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing,
upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes El No 4 SKIP to Section 3.
2.2 Briefly identify each applicable project in the table below.
• �' `* � a �-� s _ ; �tr�al Go�pliance hates .
Bnef d fl a
IdeffRcai)roeAffectelbs
Desexipfion oif Project Clistoutia(fnumbers?' Scu)•ce(sj of Discharge
.. V, Require ., .Projected„
.c
L
r=
2.3 Have you attached sheets describing any additional water pollution control programs (or other environmental projects
that may affect your discharges) that you now have underway or planned? (Optional Item)
❑ Yes ❑ No
EPA Form 3510-2F (Revised 3-19) Page 1

EPA Identification
Number NPDES Permit Number Facility Name Form Approved 03105/19
110007662779
NC000133 Jowat Corp. OMB No. 2040-0004
SECTIONDRAINAGE
a• .0 CFR a
Have you attached a site drainage map containing all required information to this application? (See instructions for
.
specific guidance.)
c
® Yes ❑ No
4.1
Provide information on the facility's pollutant sources in the table below.
Outfall
impervious Surface Area , :
Total SurfaceArea Drained
Number
-(withtn a mile radlus `of the faaE y):
- . (wiffiin smile radius of the facility),
specify units
specify units
1
0.8 acres
80%
1.0 acres
specify units
specify units
2
2.0 acres
60%
3.4 acres
specify units
specify units
3
6.4 acres
35%
18 acres
specify units
specify units
specify units
specify units
specify units
specify units
4.2
Provide a narrative description of the facility's significant material in the space below. (See instructions for content
requirements.)
Significant material exposure is limited do to our manufacturing processes including storage of raw materials, waste
materials and finished products are performed indoors. Our two waste water tanks contains adequate secondary
>a,
containment. The waste water tanks are emptied by pumping to a tanker truck. Jowat uses BMPs to control and
W '
remove pollutants. Jowat does not use pesticides, herbicides etc. Jowat does not have any floor drains in the
- :
manufacturing and storage areas inside the facility.
a
a.
4.3
Provide the location and a description of existing structural and non-structural control measures to reduce pollutants in
stormwater runoff. See instructions forspecificguidance.)
.. - rmwater;Treatment-
.: Codes,
Outfa[I
from _
Number
-Control Measures and Treatment
Exhibit
IF
1
spill prevention plan, monthly inspections, water analysis bi yearly, preventive maintenance
2
spill prevention plan, monthly inspections, water analysis bi-yearly, preventive maintenance
3
spill prevention plan, monthly inspections, water analysis bi yearly, preventive maintenance,
retention pond
EPA Form 3510-2F (Revised 3-19) Page 2

EPA Idenr3rratron Number NPDES Pena Number Facl:ty Name Form Aporoved 03/05119
110007662779 NC000133 Jowat Corp. OMB No. 2040-0M
SECTION•N STORMWATER • 1
5.1 t certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the
presence of non-stormwater discharges. Moreover, I certify that the outfalls identified as having non-stormwater
discharges are described in either an accompanying NPOES Form 2C, 2D, or 2E application.
Name (print or type first and last name) Official title
I
Martin Lamberg VP of Manufacturing
Signature ( Date signed
�L tu�c6Q'1 5-13-2022
O I
L
5.2
Provide the testing information requested in the table below.
i
Onsite Drainage Points
aNumber
Description of Testing Method Used Date(s) of Testing
Directly Observed
During Test
1
collected by an outside contractor 03/09/2022
yes
6gr
2
t
collected by an outside contractor
03/09/2022
yes
0
z
3
collected by an outside contractor
03/09/2022
yes
SECTION
I
O r
6.1 FDescribe any significant leaks or spills of toxic or hazardous pollutants in the last three years.
We have not had any leaks or spills, all storm water drainage is strictly rain fall
a
fn
O
H
I
N
y
J
I
C
N
U
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SECTIONDISCHARGE
INFORMATION
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must
o
complete. Not all applicants need to complete each table.
m
o❑
7.1
is this a new source or new discharge?
Yes 4 See instructions regarding submission of O No 4 See instructions regarding submission of
m
estimated data. actual data.
Tablas A, 6, C, and D
7.2 Have you completed Table A for each outfall?
0 Yes ❑ No
EPA Form 3510-21' (Revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
110007662779
NC000133
Jowat Corp.
OMB No. 2040-0004
7.3
Is the facility subject to an effluent limitation guideline (ELG) or effluent limitations in an NPDES permit for its process
wastewater?
❑ Yes ❑ No 4 SKIP to Item 7.5.
7.4
Have you completed Table B by providing quantitative data for those pollutants that are (1) limited either directly or
indirectly in an ELG and/or (2) subject to effluent limitations in an NPDES permit for the facility's process wastewater?
❑ Yes ❑ No
7.5
Do you know or have reason to believe any pollutants in Exhibit 2F-2 are present in the discharge?
❑ Yes 0 No 4 SKIP to Item 7.7.
7.6
Have you listed all pollutants in Exhibit 2F-2 that you know or have reason to believe are present in the discharge and
provided quantitative data or an explanation for those pollutants in Table C?
❑ Yes ❑ No
7.7
Do you qualify for a small business exemption under the criteria specified in the Instructions?
❑ Yes 4SKIP to Item 7.18. ❑ No
7.8
Do you know or have reason to believe any pollutants in Exhibit 2F-3 are present in the discharge?
❑ Yes ❑✓ No 4 SKIP to Item 7.10.
m
7.9
Have you listed all pollutants in Exhibit 2F-3 that you know or have reason to believe are present in the discharge in
c
Table C?
❑ Yes ❑ No
7.10
Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater?
❑ Yes ❑ No 4 SKIP to Item 7.12.
7.11
Have you provided quantitative data in Table C for those pollutants in Exhibit 2F-3 that you expect to be discharged in
as
LM
concentrations of 10 ppb or greater?
❑ Yes ❑ No
CA
7.12
Do you expect acrolein, acrylonitrile, 2,4-dinitrophenol, or 2-methyl4,6-dinitrophenol to be discharged in concentrations
of 100 ppb or greater?
❑ Yes ❑ No 4 SKIP to Item 7.14.
7.13
Have you provided quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be
discharged in concentrations of 100 ppb or greater?
❑ Yes ❑ No
7.14
Have you provided quantitative data or an explanation in Table C for pollutants you expect to be present in the
discharge at concentrations less than 10 ppb (or less than 100 ppb for the pollutants identified in Item 7.12)?
-
❑ Yes [21 No
7.15
Do you know or have reason to believe any pollutants in Exhibit 2F4 are present in the discharge?
❑ Yes ❑ No 4 SKIP to Item 7.17.
7.16
Have you listed pollutants in Exhibit 2F-4 that you know or believe to be present in the discharge and provided an
explanation in Table C?
❑ Yes ❑ No
7.17
Have you provided information for the storm event(s) sampled in Table D?
© Yes ❑ No
EPA Form 3510-2F (Revised 3-19) Page 4

EPA Identification Number
NPOES Permit Number
Facility Name
Form Approved 03105/19
110007662779
NCO00133
Jowat Corp.
OMB No. 2040-0004
Used -or MaiiAdursd'Toxics - '
-v
7.18
Is any pollutant listed on Exhibits 2F-2 through 2F-4 a substance or a component of a substance used or
manufactured as an intermediate or final product or byproduct?
c
❑ Yes 0 No 4 SKIP to Section 8.
0
cc
7.19
List the pollutants below, including TCDD if applicable.
c
1. 4. 7.
w
2. 5. 8.
o
3. 6. 9.
SECTION
8. BIOLOGICAL
TOXICITY TESTING DATA (40 CFR 122.21 (g)(1 1))
8.1
Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on
Q
any of your discharges or on a receiving water in relation to your discharge within the last three years?
0
C
❑ Yes ❑ No 4 SKIP to Section 9.
low
8.2
Identify the tests and their purposes
below.
Z'
Purpose'of-Tes#(s)
�u to.
Au
_. ;I�ecmiftin thori y'?
Date Submitted
❑ Yes ❑ No
~
o-
❑ Yes ❑ No
0
❑ Yes ❑ No
SECTION-.
•• • .i
9.1
Were any of the analyses reported in Section 7 (on Tables A through C) performed by a contract laboratory or
consulting firm?
0 Yes ❑ No 4 SKIP to Section 10.
9.2
Provide information for each contract
laboratory or consulting firm
below.
Laborato Number 1
ry
: ' t.atirato Nurnber 2 -
rY'.
laborato Number.3
r,
Name of laboratory/firm
Pace Analytical
o-
c
Laboratory address
1377 South Park Drive
�.
Kernersville, NC 27284
-cc
4
a
Phone number
o:
[phone]
Pollutant(s) analyzed
Suspended Solids, PH
EPA Form 3510-2F (Revised 3-19) Page 5

EPA Idenblicalion Number NPOES Perms Number Fatality Name Form Approved 03,05119
110007662779 NC000133 Jowat Corp. OMB No. 2010-0OO4
SECTION1
CHECKLIST
AND CERTIFICATION STATEMENT (40 and
10.1
In Column 1 below, mark the sections of Form 2F that you have completed and are submitting with your application. For
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
all a licants are required to complete all sections or provide attachments.
Column i
Coh nm 2
❑" Section 1
w/ attachments (e.g., responses for additional outfalls)
❑� Section
❑ w/ attachments
❑� Section 3
❑✓ w/ site drainage map
21 Section 4
❑ wl attachments
El Section 5
❑ w/ attachments
El Section 6
❑ w/ attachments
v
0 Section 7
Q Table A ❑ w/ small business exemption request
N
N
`o
[ITable 8 ❑ w/ analytical results as an attachment
❑ Table C ❑� Table D
c
0 Section 8
❑ wlattachments
c
N
Section 9
❑ w/attachments (e.g., responses for additional contact laboratories or firms)
Y
z
❑� Section 10
❑
U
10.2
Certification Statement
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 property 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 submitted is, to the best of my knowledge and belief true, accurate, and
complete. 1 am aware that there are significant penalties for submitting false information. including the possibility of fine
and imprisonment for knowing violations.
Name (print or type first and last name)
Official He
Martin Lamberg
VP of Manufacturing
Signature
Date signed
5-13-2022
EPA Form 3510-21' (Resised 3-19) Page 6

EPA Identification Number NPDES Permit Number
110007662779 1 NC000133
Facility Name
Jowat Corp.
Outfall Number
Form Approved 03/05119
OMB No. 2040-0004
TABLE A. CONVENTIONAL AND NON CONVENTIONAL PARAMETERS (40 CFR 122.26(c)(1)(i)(E)(3))'
You must provide the results of at least one analysis for every pollutant in this table. Complete one table for each outfall. See instructions for additional details and requirements.
i T
P to fior;;Fa eter
of n r0 ...
f.:
, .:, ...: ,<
tlaximum hai )ty Qt," h
t .f
`uits 0 :
Da[I ; Dicha arg` e
Y.
Numberof StormInfonnatiain
EYents Sampled
Source of .
(new source) new
dischary}ers onh/ .use
in insttictions)
,
: G b.S m 1e Tak n
y ra . a e
... ...
O. is 3 i4ll in tes
�)IV , 0
Q e
. ,, .
G mp ?ken
30"Minutes'`coded
. ,
Ftaw Wei kited
0.
Com` ite
Oil and grease
0
1
2, '
Biochemical oxygen demand (BOD5)
N/A
3..
Chemical oxygen demand (COD)
N/A
4:
Total suspended solids (TSS)
32.8
mg/L
1
Total phosphorus
N/A
6,>
Total Kjeldahl nitrogen (TKN)
N/A
7:
Total nitrogen (as N)
N/A
pH (minimum)
N/A
A`
pH (maximum)
8.08
1
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F (Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
11000766277 1 NCO00133 I Jowat Corp. I I I OMB No. 2040-0004
TABLE A. CONVENTIONAL AND NON CONVENTIONAL PARAMETERS (40 CFR 122.26(c)(1)(i)(E)(3))'
You must provide the results of at least one anal is for every pollutant in this table. Complete one table for each outfall. See instructions for additional details and requirements.
f
D sG ar
i h 9
h
Air r� e g isc a e
Source of
i,
E Ez .i
., ..�.. .. . . :
%' poi �Ita t:or Pa to ...
{�+ 1" +1
7
f `
Numb r. of St' rm
_ , ... }
._: .. ..
T
r:
:. � . - , , ., ,
c
., ., . , � ., _..
. , . ;... ...:..
. Grab,Sam (� Taken ..
,,....1 r,
D ring First.
+
. �.
t hted
� g
Sam
Grab [� aken�
p
,, : ;.�•, i
:; D udng First
• �Ibw Wei hted
g r
'Even is .S ampled
u
new so rce�rtew
dlsdia` `ers:on ly; use
.,
,30Minutes�
f
,Co 'as
ti. .,.
.r:
�Ol�iuutes�
••a..
:. Com Delta
E ,y
.• -
' codes in nstn�ctlons )
Oil and grease
o
1
2;
Biochemical oxygen demand (BODs)
N/A
Chemical oxygen demand (COD)
N/A
Total suspended solids (TSS)
14.6
mg/L
1
Total phosphorus
N/A
�f
6:
Total Kjeldahl nitrogen (TKN)
N/A
7.
Total nitrogen (as N)
N/A
pH (minimum)
N/A
pH (maximum)
7.96
1
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F (Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number
110007662779 1 NC000133
Facility Name
Jowat Corp.
Outfall Number
Form Approved 03105119
OMB No. 2040-0004
TABLE A. CONVENTIONAL AND NON CONVENTIONAL PARAMETERS (40 CFR 122.26(c)(1)(i)(E)(3))'
You must rovide the results of at least one analysis for every pollutant in this table. Complete one table for each outfall. See instructions for additional details and requirements.
�Murti Dili Discha "e '
Max !S/
Awes a Daii Discharge
; 9: Y r9
Source of
ts Pa) :.0
NberoStorm
Information'
First
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03,ua.
h
flP nto
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c posits
,u
oodes„innstN9ons)ledFsi
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�1.
Oil and grease
o
1
2 "Biochemical
oxygen demand (BODs)
N/A
Chemical oxygen demand (COD)
N/A
4 :
Total suspended solids (TSS)
22.9
mg/L
1
Total phosphorus
N/A
6.`
Total Kjeldahl nitrogen (TKN)
N/A
7
Total nitrogen (as N)
N/A
pH (minimum)
N/A
r
pH (maximum)
7.74
1
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-217 (Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number
11000766277 1 NC000133
Facility Name
Jowat Corp.
Outfall Number
Form Approved 03/05119
OMB No. 2040-0004
TABLE B: CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vi)(A))'
List each pollutant that is limited in an effluent limitation guideline (ELG) that the facility is subject to or any pollutant listed in the facility's NPDES permit for its process wastewater (if the
facility is operating under an existing NPDES permit). Complete one table for each outfall. See the instructions for additional details and requirements.
-j ., ..
Po[Iutantand;CAS: Nu belr. if avai[ab��a
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:
ax[mumiDa D c fly , is arge
Y.
is
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:, Average pally Disc alrg e
sunits
, Numbeir of Storm
,:`Events S m led
a P.
: Source�af
information
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in instiui�ons)
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r
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Sa' le"I`al en.
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30�NIi�utes
:_ „ :'
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m p
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F (Revised 3-19) Page 9

EPA Identification Number NPDES Permit Number
110007662779 1 NCO00133
Facility Name
Jowat Corp.
Outfall Number
Form Approved 03/05119
OMB No. 2040-0004
TABLE C. TOXIC POLLUTANTS, CERTAIN HAZARDOUS SUBSTANCES, AND ASBESTOS (40 CFR 122.26(c)(1)(i)(E)(4) and 40 CFR 122.21(g)(7)(vi)(B) and (vii)),
List each pollutant shown in Exhibits 2117-2, 2F-3, and 2174 that you know or have reason to believe is present. Complete one table for each outfall. See the instructions for additional
details and requirements.
. _
Pollutant and D�#5 umber rf ava�able = _
N . C )
M kimum Da_aly Discharge
UR1ts �,
A * ig6.Daity Discharge
Units
Number of Storm
Events Sam fed
p
Source of
Information
( �nr3w scuroelnew
dischargers only, use
codes`in instructions )
.::Grab' [_Taken.
same
`D uric �trst ;
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3n liiitt�tesO
,
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RR
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Grab Sam is Taken :
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g
Minutes ,
_ . ` ` ` .. .
Etow,W1 kited
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C�l17 S{t9
I Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F (Revised 3-19) Page 11

EPA Identifcabon Number NPDES Permit Number Facility name Outfall Number
Form Approved 03/05119
110007662779 NC000133 Jowat Corp. 1
OMB No. 2040-0004
STORMTABLE D. • •I
Provide data for the storm event(s) that resulted in the maximum daily discharges for the
flow -weighted composite sample.
Number of Hours Between
Duration of Storm Event
Total Rainfall During
Beginning of Storm Measured and
Maximum Flow Rate
Total Flow from Rain Event
Date of Storm Event
(in hours)
Storm Event
End of Previous Measurable Rain
During Rain Event
(in gallons orspecify units)
(in inches)
Event
(in gpm or specify units)
03/09/2022
6hrs.
1.8
N/A
N/A
N/A
Provide a description of the method of flow measurement or estimate.
Our collection is performed by an outside contractor, flow rate, total flow rate is undetermined by their report.
EPA Form 3510-21F (Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility name Outfall Number Form Approved 03/05119
110007662779 NC000133 Jowat Corp. 2 OMB No. 2040-0004
TABLE D.-STORM EVENT INFORMATION4i
Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow -weighted composite sample.
: To Rai fa �Du `
Numbec of° lours Betweelt
.. tai n,., it : rin ::. Maximum Fiaw Rats,
g :: 9 Total How from Rain Event
.. ion of Stortn�Event ._.;. Qeginnin \ Qf Storma�leasured and - -: -: -
Date of:Storrrr.Event.. Durat , Storth: , Durin Rain=E�ent
((h hours) End of Previous Nleasurabie Rain gallons or s e units
in It#cites In m ors unfts (In g p diy )
( ) ( Sp Pe�N )
03/09/2022
6hrs. 1.8 N/A N/A N/A
Provide a description of the method of flow measurement or estimate.
Our collection is performed by an outside contractor, flow rate, total flow rate is undetermined by their report.
EPA Form 3510-2F (Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility name Oudall Number
Form Approved 03/05119
110007662779 NC000133 Jowat Corp. 3
OMB No. 2040-0004
TABLE D. STORM
Provide data for the storm event(s) that resulted in the maximum daily discharges for the flow -weighted composite sample.
Number of Hours Between
Duration of Storm Event
Total Rainfall During
Beginning of Storm Measured and
Maximum Flow Rate
Total Flow from Rain Event
Date of Storm Event
(in hours)
Storm Event
End of Previous Measurable Rain
During Rain Event
(in gallons or specify units)
(in inches)
Event
(in gpm or specify units)
03/09/2022
6hrs.
1.8
N/A
N/A
N/A
Provide a description of the method of flow measurement or estimate.
Our collection is performed by an outside contractor, flow rate, total flow rate is undetermined by their report.
EPA Form 3511(Revised 3-19) Page 13

Note. Property boundary definition obtained from the Randolph County, NC website at http://gis.randolphcountync.gov/randolphjs/
'�
Property Boundary
DATE:
•
December 2020
• •
Jowat Corporation
A
Approx. 1: 150
e •
FNViRDNMEN1Al
6058 Lois Lane
- --
Archdale, North Carolina
DRAWING
gure NO.

300-gaitort '
liTF3ystem
k6.,r-- -
fr
Misc Drum
Storage
v v IF
Mir . -.:..r...
a .4---,
Map Source: https:[jma2pin&supporLCom/p2/Rissurter.php (2020)
.. •.
.•;:;: AERIS
0 ENVIRONMENTAL
Consulting. Engineered for Results.
1440 Blueberry Lane
Charlotte, NC 29226
www.aensenvwo,com
,,000-gallon
vastewater
SPCC Site Plan DATE:
December 2020
lowat Corporation
Archdale, North Carolina
SCALE:
1 in. = 200 ft
(approx)
DRAWING NO.
Figure 3