NCS000043_Permit application_20230919

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Stormwater Permit Renewal Antea�Group
Airgas USA, LLC
Understanding today
Goldsboro, North Carolina Improving tomorrow.
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Contents
1.0 Site Map.............................................................................................................................. .............1
2.0 Analytical Monitoring Results........................................................................................................................1
3.0 Visual Montioring Results..............................................................................................................................1
4.0 Best Management Practices..........................................................................................................................2
5.0 Significant Changes........................................................................................................................................3
6.0 Supporting Documentation............................................................................................................................3
Figures
Figure 1—Site Map
Appendices
Appendix A—Supplemental Information Required for Renewal of Individual NPDES Stormwater Permit
Appendix 13—Stormwater Pollution Prevention Plan Development and Implementation Certification
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anteaagroup
Stormwater Permit Renewal
Airgas USA, LLC
Goldsboro, North Carolina
1.0 SITE MAP
A copy of the facility's site map has been included as Figure 1.The site map includes the location of industrial
activities, drainage structures,drainage areas for each outfall, building locations,and impervious surfaces.
2.0 ANALYTICAL MONITORING RESULTS
The facility regularly samples for oil and grease and pH per their current Individual Permit.The results of the
analytical monitoring are described below in Table 1,
TABLE 1 :LABORATORY ANALYTICAL RESULTS SUMMARY 2015-2019
Sampling Date Rainfall Oil&Grease PH
Period Collected Outfall (inches) (mg/1) (std.units) Comments
BENCHMARK 30 6.0—9.0 --
2nd Half 7/23/2015 001 <5.0 6.0
None
2015 002 0.17 <5.0 7.1
1st Half 2016 -- 001 No Flow
002
2nd Half 9/29/2016 001 <5.0 7.8
None
2016 002 2'62 <5.0 8.3
1st Half 2017 -_ 001 No Flow
002
2nd Half 001
-- No Flow
2017 002
1st Half 2018 4/24/2018 001 1.43 <7.7 8.1 None
002 <11.0 8.1
2nd Half 001
-- No Flow
2018 002
1st Half 2019 -- 001 No Flow
002
2nd Half 11/20/2019 001 <5.0 7.0
None
2019 002 0.10 <5.0 7.2
3.0 VISUAL MONTIORING RESULTS
The facility regularly performs visual monitoring at the outfall per their current individual stormwater permit.The
results of their visual monitoring inspections are provided in Table Z and Table 3.
TABLE 2:VISUAL MONITORING RESULTS SUMMARY FOR OUTFALL 0012015-2019
Date Color Odor Clarity* Floating Suspended Foam Oil Sheen Erosion
Solids* Solids*
7/23/15 Clear None 1 1 1 No No No
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Stormwater Permit Renewal O
Airgas USA, LLC
Goldsboro, NC a ntea*g ro u p
Antea Group Project No. 2023-03-509173
Date Color Odor Clarity* Floating Suspended Foam Oil Sheen Erosion
Solids* Solids*
9/29/16 Clear None 1 1 1 No No No
4/24/18 Clear None 1 1 1 No No No
11/20/19 Clear none 1 1 1 No No No
* Scaled 1 to 5 where 1 is clear and 5 is very cloudy.
TABLE 3:VISUAL MONITORING RESULTS SUMMARY FOR OUTFALL 002 2015-2019
Date Color Odor Clarity* Floating Suspended Foam Oil Sheen Erosion
Solids* Solids*
7/23/15 Clear None 1 1 1 No No No
9/29/16 Clear None 1 1 1 No No No
4/24/18 Clear None 1 1 1 No No No
11/20/19 Clear None 1 1 1 No No No
* Scaled 1 to 5 where 1 is clear and 5 is very cloudy.
4.0 BEST MANAGEMENT PRACTICES
Airgas minimizes contact of significant materials with stormwater by:
1. Applying paint with brushes and rollers to avoid overspray;
2. Practicing regularly scheduled preventative maintenance on mechanical equipment, and heating and air
conditioning equipment on-site;
3. Periodically inspecting and testing fire detection and suppression equipment including smoke detectors,
fire hoses, and sprinkler systems;
4. Practicing procedures for proper handling and storage of significant materials such as acetone, acetylene,
paint and paint thinner to prevent the incidence of fire;
5. Implementing procedures for responding to spills of significant materials;and
6. Annual spill response employee training.
Existing structural and non-structural control measures at Airgas to reduce pollutants in stormwater discharges
include:
1. Secondary containment of acetone;
2. Secondary containment of heating oil;
3. Storage of paint in an enclosed structure;
4. Detention pond for erosion and sedimentation control;
5. Covered loading docks;
6. Secondary containment for drum oil storage at compressors;
7. Curbing and secondary containment around lime decant tanks;
8. Inside storage of liquid chemicals;
9. Used oil(aside from outdoor compressor oil);and
10. Gravel covered roadway and storage area
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Stormwater Permit Renewal 0
Airgas USA, LLC
Goldsboro, NC a ntea2g ro u p
Antea Group Project No. 2023-03-509173
The following BMPs were selected to minimize the impacts of the potential pollutants identified and are both
technically and economically feasible:
• All outdoor liquid chemical/oil storage shall be inspected monthly for potential or existing leaks or spills.
• The helium radiators will be inspected for cracks, leaks, spills or any signs of potential antifreeze
discharge.
• The shot blasting machine roof vent will be inspected periodically for particulate break through.The drum
storage area at the field service building is covered to eliminate exposure to stormwater and with
secondary containment.
• The miscellaneous outdoor equipment at the Field Services building are not presently considered a
significant pollutant source. Therefore,eliminating stormwater exposure is not economically feasible or
justified.This area will be inspected for signs of pollutants.
5.0 SIGNIFICANT CHANGES
There have not been any significant changes at the Airgas Goldsboro facility.
6.0 SUPPORTING DOCUMENTATION
Signed copies of the"Supplemental Information required for Renewal of Individual NPDES Stormwater Permit"and
"Stormwater Pollution Prevention Plan Development and Implementation Certification"are included in Appendix A
and Appendix B, respectively.
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Stormwater Permit Renewal
Airgas USA, LLC
Goldsboro, NC a ntea`g ro u p
Antea Group Project No. E030705122
Figures
Figure 1—Site Map
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Stormwater Permit Renewal
Airgas USA, LLC
Goldsboro, NC a ntearg ro u p
Antea Group Project No. 2023-03-509173
Appendix A — Supplemental Information Required for Renewal of
Individual NPDES Stormwater Permit
INOGEW
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SUPPLEMENTAL INFORMATION REQUIRED FOR RENEWAL OF INDIVIDUAL
NPDES STORMWATER PERMIT
Two copies of each of the following shall accompany this submittal in order for the application
to be considered complete:
(Do not submit the site Stormwater Pollution Prevention Plan)
Initials
1. A current Site Map from the Stormwater Pollution Prevention Plan. The location of
industrial activities (including storage of materials, disposal areas,process areas and
loading and unloading areas), drainage structures, drainage areas for each outfall,
building locations and impervious surfaces should be clearly noted.
2. A summary of Analytical Monitoring results during the term of the existing permit
(if your permit required analytical sampling). Do not submit individual lab reports.
The summary can consist of a table including such items as outfall number,
parameters sampled,lab results, date sampled,and storm event data.
3. A summary of the Visual Monitoring results. Do not submit individual monitoring
reports.The summary can consist of a table including such items as outfall number,
parameters surveyed,observations, and date monitoring conducted.
4. A summary of the Best Management Practices utilized at the permitted facility.
Summary should consist of a short narrative description of each BMP's in place at
the facility. If the implementation of any BMP's is planned,please include
information on these BMP's.
5. A short narrative describing any significant changes in industrial activities at the
permitted facility. Significant changes could include the addition or deletion of
work processes, changes in material handling practices, changes in material storage
practices, and/or changes in the raw materials used by the facility.
b. Certification of the development and implementation of a Stormwater Pollution
Prevention Plan for the permitted facility(Sign and return attached form).
If the final year analytical monitoring of the existing permit term has not been completed
prior to filing the renewal submittal, then the last years monitoring results should be submitted
within 30 days of receipt of the laboratory reports. (i.e. do not withhold renewal submittal
waiting on lab results)

Stormwater Permit Renewal
Airgas USA, LLC
Goldsboro, NC a ntea`g ro u p
Antea Group Project No. 2023-03-509173
Appendix B — Stormwater Pollution Prevention Plan Development and
Implementation Certification
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STORVIWATER POLLUTION PREVENTION PLAN
DEVELOPMENT AND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Energy, Mineral, and Land Resources— Stormwater Program
Facility Name: Airgas-Goldsboro Plant
Permit Number: NGS000043
Location Address: 109 Hinnant Road
Goldsboro,NC 27530
County:
Wayne
"I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all
attachments were developed and implemented under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information required by the SPPP.
Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information gathered is, to the best of my knowledge and belief, true,
accurate and complete."
And
"I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP
has been fully implemented at this facility location in accordance with the terms and conditions of the
Stormwater discharge permit."
And
"I am aware that there are significant penalties for falsifying information, including the possibility of fines and
imprisonment for knowing violations."
Sign (according to permit signatory requirements) and return this Certification. DO NOT
SEND STORMWATER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION.
Signature Date g 31Z3
#LJ. ollandera-� VP Safety and Compliance
Print or type name of person signing above Title
SPPP Certification 10/13

EPA Idenlificallon Number NPDES Permit Number Facility Name Form Approved 03105/19
NCR00D002246 NC5000043 Airgas-Goldsboro Plant OMH No.2040-0004
Form U.S.Environmental Protection Agency
t �" EPA Application for NPDES Permit to Discharge Wastewater
NPDES GENERAL INFORMATION
SECTION • •D ,
1.1 Applicants Not Required to Submit Form 1
1.1.1 Is the facility a new or existing publicly owned 1 1 2 Is the facility a new or existing treatment works
treatment works? treating domestic sewage?
If yes,STOP.Do NOT complete 0 No If yes,STOP. Do NOT 0 No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
.- 1.2.1 Is the facility a concentrated animal feeding 1.2.2 is the facility an existing manufacturing,
moperation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a production facility? currently discharging process wastewater?
o Yes 4 Complete Form 1 Ej No Yes 4 Complete Form No
z and Form 2B. 1 and Form 2C.
a 1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
Cr
Yes 4 Complete Form 1 E] No ❑ Yes 4 Complete Form No
and Form 21). 1 and Form 2E,
1.2.5 Is the facility a new or existing facility whose
'— discharge is composed entirely of stormwater
a associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
Yes 4 Complete Form 1 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2. NAME, MAILING ADDRESS, • •
2.1 Facility Name
Airgas-Goldsboro Plant
c 2.2 EPA Identification Number
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NCR000002246
2.3 Facility Contact
a Name(first and last) FArrations
Phone number
Bryan Cooke Manager [phone]
a
Email address
[e-mail]
a 2.4 Facility Mailing Address
zStreet or P.O.box
109 Hinnant Road
City or town State ZIP code
Goldsboro NC 27530
EPA Farm 3510-1(rev}sed 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105/19
NCR000002246 NCS000043 Airgas-Goldsboro Plant OMB No.204M004
" m 2.5 Facility Location
Street,route number,or other specific identifier
Q o 109 Hinnant Road
rn u
o County name County code(if known)
M Wayne
E City or town State ZIP code
Z M Goldsboro NC 27530
SECTIONAND NAICS CODES1
3.1 SIC Code(s) Description(optional)
5169 Industrial Gases-Wholesale
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z 3.2 NAICS Cade(s) Description(optional)
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4.1 Name of Operator
Airgas USA,LLC
`0 4.2 Is the name you listed in Item 4.1 also the owner?
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Yes ❑ No
4.3 Operator Status
❑ Public—federal ❑ Public—state ❑ Other public(specify)
o 21 Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
w Street or P.O.Box
109 Hinnant Road
City or town State ZIP code
`o o Goldsboro NC 27530
is U
Email address of operator
CL
O [e-mail]
SECTION + LAND +I
c 5.1 Is the facility located on Indian Land?
❑ Yes No
EPA Form 3510-1(revised 3-19) Page 2

EPA IdeniificaOon Number NPDES Permit Number Faciiity Name Form Approved G3105119
NCR000002246 NCS000043 Airgas-Goldsboro Plant OMB No.2040.0004
SECTION . '• 41
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
w NPDES(discharges to surface ❑ RCRA(hazardous wastes) ❑ UIC(underground injection of
N water) fluids)
NCS000043
❑ PSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CAA)
CD
x ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
w
SECTIONi
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
C specific requirements.)
cc
❑ Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTIONOF t ;
8.1 Describe the nature of your business.
Airgas is primarily engaged in transfill and distribution of industrial gases.This plant repackages carbon dioxide,
o nitrous oxide,helium,argon,oxygen,and nitrogen gases at the facility.These gases are placed in compressed gas
cylinders and are sold and distributed to customers.All gas cylinders are stored on-site for redistribution to
customers.Typical industrial activities include distribution of acetylene gas,refurbishing of(shot blasting and
00 painting)used gas cylinders,and filling of gas cylinders.industrial activities take place under cover.
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SECTION ',COOLING WATER INTAKE
9.1 Does your facility use cooling water?
L m ❑ Yes 0 No +SKIP to Item 10.1.
L
9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
oY NPDES permitting authority to determine what specific information needs to be submitted and when.)
0
SECTION
t VARIANCE REQUESTS .0 f
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
N apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
Section 301(n)) 302(b)(2))
QD
[] Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
NCR000002246 NCS000043 Airgas-Goldsboro Plant OMB No.2040-0004
SECTION • I i
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 I Column 2
❑ Section 1:Activities Requiring an NPDES Permit ❑ wl attachments
0 Section 2:Name,Mailing Address,and Location ❑ wl attachments
Section 3:SIC Codes ❑ wl attachments
0 Section 4:Operator Information ❑ wl attachments
❑✓ Section 5: Indian Land ❑ wl attachments
❑ Section 6: Existing Environmental Permits ❑ wl attachments
❑� wl topographic
Section 7:Map ❑ El ma wf additional attachments
U)
c ❑� Section 8:Nature of Business ❑ wl attachments
w �] Section 9:Cooling Water Intake Structures ❑ wl attachments
❑ Section 10:Variance Requests ❑ wl attachments
9 Section 11:Checklist and Certification Statement ❑ wl attachments
w 11.2 Certification Statement
U
l certify underpenalty 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 forgathering the information, the information submitted is,to the best of my knowledge and
belief, true, accurate, and complete. t 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 title
Larry Hollander VP Safety and Compliance
Signa re Date signed
EPA Form 3510.1(revised 3-19) Page 4

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USGS 7.5-minute FIGURE 1
Topographic Series SUBJECT PROPERTY LOCATION MAP
AIRGAS GOLDSBORO
Northeast Goldsboro, NC N 109 HINNANT ROAD
GOLDSBORO,NC
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PROJECT N0. PREPARED 6Y REF SCALE
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2023-03-509173 MDE 1:24,0.70
DATE REVIEWED BY MAP SCALE
0 500 1,0m 2,000 3,000 4,000 6,1712023 KS 1 INCff=ZOW FEET a n to a g ro u p
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EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05119
NCRO00002246 NC5000043 Airgas-Goldsboro Plant OMB No.2040-0004
Form U.S Environmental Protection Agency
2F ,W EPA Application for NPOES Permit to Discharge Wastewater
NPDES STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY
SECTION 1.OUTFALL LOCATIONr
1.1 Provide information on each of the facili 's outfalls in the table below
Outfall Receiving Water Name Latitude Longitude
Number
001 The Slough 35 28' 3.73" N 77° 58' 55.63" W
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002 The Slough 35a 27' 56.07" N 77' 58' 54.92" W
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SECTION 2.
n + n o + r+
IMPROVEMENTS +
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 ✓❑ No + SKIP to Section 3.
2.2 Briefly identify each applicable project in the table below.
Brief identification and Affected Outfalls Final Compliance Dates
Description of Project (list outfall numbers) Source(s)of Discharge
Required Projected
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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 NPOE3 Permit Number Facility Name Form Approved 03105119
NCR000002246 NCS000043 Airgas-Goldsboro Plant OMB No.204NO04
SECTIONDRAINAGE MAP r
0 3.1 Have you attached a site drainage map containing all required information to this application?(See instructions for
M C specific guidance.)
o Yes ❑ No
SECTIONPOLLUTANT SOURCESi
4.1 Provide information on the facility's pollutant sources in the table below.
Outfall Impervious Surface Area Total Surface Area Drained
Number (within a mile radius of the facility) (within a We radius of the facility)
specify units specify units
001 16,157 sgft 146,747 sgft
specify units specify units
002 109,861 sgft 332,913 sqft
specify units specify units
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.)
Acetone is stored in two 1,000 gallon tanks with secondary containment that is specially coated for compatibility with
acetone. There is a drain in the containment structure that remains locked in the closed position until it is opened in
0 order to drain uncontaminated accumulated stormwater. Primarily,stormwater is allowed to evaporate rather than
draining the stormwater. Scrap cylinders and scrap steel pieces are placed in uncovered dumpsters until removed for
cc off-site recycling. Various miscellaneous equipment and metal parts are stored on the ground in the scrap and surplus
3 cylinder storage area. Metals from rusted materials in these areas could contact storm water.Pleating oil is stored in
as an outdoor 500 gallon above ground storage tank. The tank has adequate secondary containment_ There is no drain
within the secondary containment structure,thus rain water accumulation will require pumping for removal.
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.)
stormwater Treatment
Codes
Outfall from
Number Control Measures and Treatment Exhibit
2F-1
list
001 Rip Rap 1-U
002 Pond&swale 1-U
EPA Form 3510.2F(Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Faality Name Farm Approved 03105I19
NCR000002246 NCS000043 Airgas-Goldsboro Plant OMB No.204NO04
5.1 1 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 NPDES Form 2C, 2D, or 2E application.
Name(print or type first and last name) Official title
Larry Hollander VP Safety and Compliance
Signature Date signed
U)
rn 5.2 Provide the testing information requested in the table below.
UOnsite Drainage Points
N
utfall
Number Description of Testing Method Used Date(s)of Testing Directly Observed
a
During Test
m
M
001 Visual Inspection 09/13/2023 No flow
A
002 Visual Inspection 09/13/2023 No flow
A
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SECTIONOR 4F
6.1 Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years.
None
oa
0
Y
dD
16
C
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SECTION • •
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn,the tables you must
o com lete.Not all applicants need to complete each table.
7,1 Is this a new source or new discharge?
❑ Yes 4 See instructions regarding submission of El actual
4 See instructions regarding submission of
m
estimated data. actual data.
Tables A,B,C,and D
7.2 Have you completed Table A for each outfall?
❑� Yes ❑ No
EPA Form 3510-2F(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NCR000002246 NC5000043 Airgas-Goldsboro Plant
OMB No.2040MM
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 ❑ No+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. 0 No
7.8 Do you know or have reason to believe any pollutants in Exhibit 2F-3 are present in the discharge?
0 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
Table C?
❑ Yes El No
0 7.10 Do you expect any of the pollutants in Exhibit 217-3 to be discharged in concentrations of 10 ppb or greater?
€ ❑✓ Yes ❑ No 4 SKIP to Item 7.12.
ws 7.11 Have you provided quantitative data in Table C for those pollutants in Exhibit 217-3 that you expect to be discharged in
�' concentrations of 10 ppb or greater?
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❑ Yes 0 No
7.12 Do you expect acrolein,acrylonitrile,2,4-dinitrophenol,or 2-methyl-4,6-dinitrophenol to be discharged in concentrations
of 100 ppb or greater?
❑ Yes 0 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 [21 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 ❑✓ No
7.15 Do you know or have reason to believe any pollutants in Exhibit 2F-4 are present in the discharge?
❑ Yes ❑✓ No+SKIP to Item 7.17.
7.16 Have you listed pollutants in Exhibit 2F4 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?
B Yes ❑ No
EPA Form 3510-2F(Revised 3-19) Page 4

EPA ldent ficaiian NumberNPDES Permit Number Faality Name Form Approved 03105119
NCR000002246 NCS000043 Airgas-Goldsboro Plant OMB No.2040-0004
.a Used or Manufactured Toxies
7.18 is any pollutant listed on Exhibits 2F-2 through 2F-4 a substance or a component of a substance used or
omanufactured as an intermediate or final product or byproduct?
c3
❑ Yes ❑ No 4 SKIP to Section 8.
0
E 7.19 List the pollutants below,including TCDD if applicable.
E
C 1. 4. 7.
co
21
2. 5. 8.
U
c 3. 6. 9.
SECTION 8. BIOLOGICAL TOXICITY TESTING DATA(40 CFR 122.21(9)(11))
M Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on
any of your discharges or on a receiving water in relation to your discharge within the last three years?
C3
c ❑ Yes No 4 SKIP to Section 9.
8.2 Identify the tests and their purposes below.
Test(s) Purpose of Test Submitted to NPIDESs) PermittingAuthority?
Date Submitted
0
F
❑ Yes ❑ No
U_
a 0: ElYes ❑ No
0
m
❑ Yes ❑ No
SECTION • INFORMATION 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 +SKIP to Section 10.
9.2 Provide information for each contract laboratory or consulting firm below.
Laboratory Number 1 Laboratory Number 2 Laboratory Number 3
Name of laboratory/firm
Prism Laboratories,Inc. Pate Analytical
0
O
Laboratory address
y 449 Springbrook Road 9800 Kincey Ave.,Suite 100
Z. Charlotte,NC 28224-0543 Huntersville,NC 28078
a
15
U
o Phone number
v [phone] [phone]
Pollutant(s)analyzed
pH pH
O&G Q&G
EPA Form 3510-2F(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NfCR000002246 NC5000043 Airgas-Goldsboro plant
OMB No.204NO04
SECTIONi AND CERTIFICATION STATEMENT(40
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 applicants are required to complete all sections or provide attachments.
Column 1 Column 2
❑ Section 1 ❑ wl attachments(e.g.,responses for additional outfalls)
El Section 2 ❑ wl attachments
Z Section 3 ❑ wl site drainage map
El Section 4 ❑ wl attachments
❑r Section 5 ❑ wl attachments
0 Section 6 ❑ wl attachments
QD
❑ Section 7 0 Table A ❑ wl small business exemption request
o ❑ Table 8 ❑ wl analytical results as an attachment
2 ❑ Table C 0 Table D
E Section 8 ❑ wlattachments
c
0 Section 9 ❑ wlattachments(e.g.,responses for additional contact laboratories or firms)
Y
CU ❑ 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 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) Official title
Larry Hollander VP Safety and Compliance
Signa a Date signed
I✓L —1 �3IW22 I
EPA Form 3510-21'(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03I05119
NCR000002246 NC5000043 Airgas-Goldsboro Plant pox OMB No.2040-0004
TABLE A.CONVENTIONAL A NON CONVENTIONALI
You must provide the results of at least one anal sis for every pollutant in this table.Complete one table for each outfall.See instructions for additional details and re uirements.
Maximum Daily Discharge Average Daily Discharge Source of
(specify units) (specify units) Number of Storm Information
Pollutant or Parameter Grab Sample Taken Flo hted Grab Sample Taken (new sourcelnew
During First w-Weig During First Flow-Weighted Events Sampled dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
1. Oil and grease <5.0 <5.0 4
2. Biochemical oxygen demand(BOD5)
3. Chemical oxygen demand(COD)
4. Total suspended solids(TSS)
5. Total phosphorus
6. Total Kjeldahl nitrogen(TKN)
7. Total nitrogen(as N)
pH(minimum) 6.0 6.0 4
S.
pH(maximum) 8.1 8.1 4
' 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 1,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 03105119
NCR000002246 NCS000043 Airgas-Goldsboro Plant 001 OMB No.2040-0004
STORMTABLE 0. O' • 1
Provide data for the storm event(s)that resulted in the maximum daily discharges for the flow-weighted composite sample.
Humber of Hours Between
Total Rainfall During Maximum Flow Rate
Duration of Storm Event Beginning of Storm Measured and Total Flow from Rain Event
Date of Storm Event (in hours) Storm Event End of Previous Measurable Rain During Rain Event (in galfons or specify units)
(in inches) Event {in gpm or specify units)
11/20/2019
0 1 7,829 gallons
Provide a description of the method of flow measurement or estimate.
The Rational Method with applied Runoff Corfficients is used to estimate the Total Flow. Runoff coefficients represent the fraction of total rainfall that will be transmitted as runoff from
the drainage area that flows into facility outfail. Runoff coefficients consider the ground surface or cover material and determine the amount of storm water flow which may infiltrate or
runoff as a discharge.
TOTAL FLOW = C x I x A
Note:The typical"C"coefficients refer to"Design and Construction of Sanitary and Storm Sewers",American Society of Civil Engineers,Manual of Practice,page 37,New York.
EPA Form 3510-2F(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105/19
NCR000002246 NCS000043 Airgas-Goldsboro Plant 002 OMB No.2040-0004
TABLE A.CONVENTIONAL A1 NON CONVENTIONAL PARAMETERS(40
You must provide the results of at least one anal sis for every pollutant in this table.Complete one table for each outfall.See instructions for additional details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
(specify units) (specify units) Number of Storm Information
Pollutant or Parameter Grab Sample Taken hted Flow-Wei
Grab Sample Taken (new sourcelnew
During First Flow-Weighted During First Flow-Weighted events Sampled dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
1. Oil and grease <s.o <5.0 4
2. Biochemical oxygen demand(BODa)
3. Chemical oxygen demand(COD)
4. Total suspended solids(TSS)
5. Total phosphorus
6. Total Kjeldahl nitrogen(TKN)
7. Total nitrogen(as N)
pH(minimum) 7.1 7.1 4
pH(maximum) 8.3 8.3 4
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 3510-21'(Revised 3-19) Page 7

EPA Identification Number NPDES Permit Number Facility name Outfall Number Form Approved 03105119
NCR000002246 NCS000043 Airgas-Goldsboro Plant 002 OMB No.204"004
TABLE D.STORM EVENT INFORMATION1
Provide data for the storm event(s)that resulted in the maximum daily discharges for the flow-weighted composite sample.
Number of Flours Between
Total Rainfall During Maximum Flow Rate
Duration of Storm Event Beginning of Storm Measured and Total Flow from Rain Event
Date of Storm Event (in sours) Storm Event End of Previous Measurable Rain During Rain Event (in gallons or specify units)
(in inches) Event (in gpm or specify uniis)
11/20/2019
0.1 17,977 gallons
Provide a description of the method of Flow measurement or estimate.
The Rational Method with applied Runoff Corfficients is used to estimate the Total Flow. Runoff coefficients represent the fraction of total rainfall that will be transmitted as runoff from
the drainage area that flows into facility outfall. Runoff coefficients consider the ground surface or cover material and determine the amount of stormwater flow which may infiltrate or
runoff as a discharge.
TOTAL FLOW = C X I x A
Note:The typical"C"coefficients refer to"Design and Construction of Sanitary and Storm Sewers",American Society of Civil Engineers,Manual of Practice,page 37,New York.
EPA Form 3510-2F(Revised 3-19) Page 13

STORM EVENT RAINFALL 1 RUNOFF CALCULATION - RATIONAL METHOD
SITE: AirGas USA, LLC
Goldsboro, NC
DATE: 11/20/2019
START TIME: DURATIOl 00:00 (HR:MIN)
END TIME: RAINFALL 0.10 INCH
Combined total flow: 0.029 MG 29,490 gallons
The Rational Method with applied Runoff Corfficients is used to estimate the Total Flow. Runoff
coefficients represent the fraction of total rainfall that will be transmitted as runoff from the drainagt
area that flows into facility outfall. Runoff coefficients consider the ground surface or cover materiE
and determine the amount of storm water flow which may infiltrate or runoff as a discharge.
OUTFALL NO.: 001 SF /AC = 43560
DRAINAGE AREA : IMPERVIOUS (ac) = 0.37 , C = 0.90
PERVIOUS (ac) = 3.00 , C = 0.85
TOTAL AREA (ac) = 3.37 , C (w)= 0.86
TOTAL FLOW : C x I x A - 7,829 ( gal.) = 0.00783 ( MG )
OUTFALL NO.: 002
DRAINAGE AREA : IMPERVIOUS (ac) = 2.52 , C = 0.90
PERVIOUS (ac) = 5.12 , C = 0.85
TOTAL AREA (ac) = 7.64 , C (w)= 0.87
TOTAL FLOW : C x I x A = 17,977 ( gal.) = 0.01798 ( MG )
003
DRAINAGE AREA : IMPERVIOUS (ac) = 0.95 , C = 0.90
PERVIOUS (ac) = 0.59 , C = 0.85
TOTAL AREA (ac) = 1.54 , C (w)= 0.88
TOTAL FLOW : C x I x A = 3,683 ( gal.) = 0.004 ( MG )
Note: The typical "C" coefficients refer to "Design and Construction of Sanitary and Storm Sewers"
American Society of Civil Engineers, Manual of Practice, page 37, New York.