NCS000087_Renewal application_20240320

RECE1 ��E
Brianna Young JAN 17
1612 MSC
Raleigh, NC 27699-1612
Re: NPDES Permit NCS000087
Pentair Water Pool and Spa, Inc.
1620 Hawkins Ave
Sanford, NC 27330
Following is the necessary EPA Form 1 for NPDES Permit NCS000087. When analytical data is available,
EPA form 2F will be forwarded as well. Please let me know should you require any additional
information at this time.
Best regards,
�N a'a--
Kenneth Waldrum, CSNI, CSHO
Environmental, Health, & Safety Manager
'll
Pentair Water, Pool, and Spa, Inc.
1620 Hawkins Avenue
Sanford, NC 27330
Direct 919.566.8260
Mobile [phone]
kenneth.waldrum(d,)pentair.com

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110055094240 NCSOO: Pentair Water Pool and Spa,Inc OMB No.2040-0004
Form U.S.Environmental Protection Agency
�* Application for NPDES Permit to Discharge Wastewater
NPDES '~,EPA �
GENERAL INFORMATION
SECTION ' •r
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment Works
1.1.1 treatment works? 1.1.2 treating domestic sewage?
i
If yes,STOP. Do NOT complete No If yes,STOP.Do NOT 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,
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a production facility? currently discharging process wastewater'? i
a ❑ Yes 4 Complete Form 1 0 No ❑ Yes 4 Complete Form 0 No.
z and Form 2B, 1 and Form 2C.
r- 1.2.3 Is the facility a new manufacturing,commercial. 1.2.4 Is the facility a new or existing manufacturing,
CID mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
CrF1 Yes 4 Complete Form 1 No Yes Complete Form No!
and Form 2D. 1 and Form 2E.
°' 1.2.5 is the facility a new or existing facility whose
} discharge is composed entirely of stormwater
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
0 Yes 4 Complete Form 1 No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
SECTI• 2,NAME,MAILING ADDRESS, • • r
2.1 Facility Name
Pentair Water Pool and Spa,Inc
0 2.2 EPA Identification Number
CU
ro
U
J
110055094240
'O
ro 2.3 Facility Contact
Name(first and last) Title Phone number
Kenneth Waldrum EHS Manager I919i 566-8260
a
Email address
[e-mail]
2.14 Facility Mailing Address
zStreet or P.O.box
1620 Hawkins Ave
City or town State ZIP code
Sanford NC 27330
EPA Form 3510-1(revised 3-19) Pagel

i
EPA Identification Number NPDES Permit Number Facility Name I Form Approved 03105119
110055094240 NC5000087 Pentair Water Pool and Spa,Inc OMB No.204Q-00114
H 2.5 Facility Location
Street,route number,or other specific identifier
Q a 1620 Hawkins Ave
�U
o County name County code(if known)
Lee
R City or town State ZIP code - 1
Sanford NC 27330
CODESSECTION 3.SIC AND NAICS E
3.1 SIC Code(s) Description(optional)
2821 Plastics Material and Resin Manufacturing
3561 Pumps and Pumping Equipment
m —
w
-a
0
U '
Cn
U
Z 3.2 NAICS Code(s) Description(optional)
� I
t° 325211 Plastics Material and Resin Manufacturing
0
co
.1
1
4 i
4.1 Name of Operator
Pentair
0 4.2 Is the name you listed in Item 4.1 also the owner?
€ ❑ Yes ❑ No
4.3 Operator Status
O
❑ Public—federal ❑Public—state ❑1Other public(specify)
Cj _❑ Private ❑ Other(specify)
4A Phone Number of Operator
[phone]
4.5 Operator Address
Street or P.O.Box
m
9500 Wayzata
-� City or town State ZIP code
4 o Golden Valley MN 55416
� U
o Email address of operator
0
SECTIONi >
= '0 5.1 Is the facility located on Indian Land?
❑Yes ❑ No
EPA Form 3510-1(revised 3-19) Page 2 ,

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
110055094240 NCS000087 Pentair Water Pool and Spa,Inc OMB No.2040-0004
SECTION •r
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
© NPDES(discharges to surface 0 RCRA(hazardous wastes) ❑ UIC(underground injection of
water) fluids)
p NCS000087 NCD986182368
a
W a ❑ PSD(air emissions) ❑ Nonattainment program(CAA) NESHAPs(CAA)
c 04065RIS
❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
SECTION 7. MAP Ul
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
C specific requirements.)
❑r Yes ❑No ❑CAFO—Not Applicable(See requirements in Form 2B.)
SECTIONOF r
8.1 Describe the nature of your business.
Pentair manufactures pool products,such as filters,pumps,and cleaners for swimming pools and spas.
Cn
N
C
U)
3
C
3
N
Z
ECTION 9.COOLING1
9.1 Does your facility use cooling water'?
a ❑ Yes ❑ No 4 SKIP to Item 10.1.
E 9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
a,: 40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
•
C% NPDES permitting authority to determine what specific information needs to be submitted and when.)
� Y
�j N/A
SECTIONi VARIANCE REQUESTSI i
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
a when.)
d ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
m
Section 301(n)) 302(b)(2))
Q ❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
0 Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03106119
110055094240 NCS000087 Pentair Water Pool and Spa,Inc OMB No.2040004
SECTIONAND CERTIFICATION
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
0 Section 1:Activities Requiring an NPDES Permit ❑ wl attachments
Section 2:Name,Mailing Address,and Location ❑ wi attachments
❑✓ Section 1 SIC Codes ❑ wl attachments
❑ Section 4:Operator Information ❑ wl attachments
❑ Section 5:Indian Land ❑ wl attachments
0 Section 6: Existing Environmental Permits ❑ wl attachments
E wl topographic
❑ Section 7:Map 0 map ❑ wl additional attachments
cn
0 0 Section&Nature of Business Elwl attachments
❑ Section 9:Cooling Water Intake Structures ❑ wl attachments
C
0 ❑ Section 10:Variance Requests ❑ wl attachments
c
�_ ✓ Section 11:Checklist and Certification Statement ❑ wi attachments
Y
11.2 Certification Statement
U
1 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 orpersons 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,l 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
Kenneth Waldrum EH5 Manager
SignatVre Date signed
�nr
EPA Farm 3510-1(revised 3-19) Page 4 1
'1

`SECTION Q'LOCATION MAP
Permit No.NCS000087
Yap
$ ' _ Pentair Water
Pool and Spa. Inc.
S Z` �13,
•t,LI I, ,•t..i._,F3 y _ PORD
-
I
Latitude:35'30' 14"N NCS000087
Longitude:790 10'30"W Facility t
Pentair Water Pool
County: Lee and Spa,Inc. Location
Stream Class:C ',4 4•
.-Receiving Stream:Little Buffalo Creek
wo ftft �-
pub-basin:03-06-11 (Cape Fear River Basin)
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Otth Not to ScaleI
Part] Page 2 of 2

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FIGiJRE 3: SITE MAP FOR PENTAiR W�TER PQOL.AND SPA,INC rv�
April 20,2015
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United States Office of Water EPA Form 3510-2F
RrGG 1��� Environmental Protection Agency Washington, D.C. Revised March 2019
Cp81 Water Permits Division
..EPA Application Form 2F
Stormwater Discharges
Associated with Industrial
Activity
NPDES Permitting Program
Note: Complete this form and Form 1 if you are a new or existing facility whose discharge is composed
entirely of stormwater associated with industrial activity, excluding discharges from construction
activity under 40 CFR 122.26(b)(14)(x) or (b)(15). if your discharge is composed of stonmwater and
non-stormwater, you must complete Forms 1 and 2F, and you must complete Form 2C, 21), or 2E, as
appropriate. See the "Instructions" inside for further details.

Paperwork Reduction Act Notice
The U.S. Environmental Protection Agency estimates the average burden to collect and complete
Form 2F to be 28.1 hours. The estimate includes time for reviewing instructions, searching existing data
sources, gathering and maintaining the needed data, and completing and reviewing the collection of
information. Send comments about the burden estimate or any other aspect of this collection of
information, including suggestions for reducing the burden,to the Chief, Information Policy Branch
(PM-223), U.S. Environmental Protection Agency, 1200 Pennsylvania Avenue,NW, Washington, DC
20460, and to the Office of Information and Regulatory Affairs, Office of Management and Budget,
725 17th Street,NW, Washington, DC 20503,marked"Attention: Desk Officer for EPA."

FORM 2F—INSTRUCTIONS
General Instructions Where to File Your Completed Form
Who Must Complete Form 2F? Submit your completed application package(Forms 1 and 2F plus
You must complete Form 2F if you answered"Yes"to Item 1.2.5 on any other applicable forms)to your NPDES permitting authority.
Form 1—that is,you are a new or existing facility and your Consult Exhibit 1-1 of Form 1 s General Instructions"to identify
discharge is composed entirely of stormwater associated with your NPDES permitting authority.
industrial activity(excluding discharges from construction activity Public Availability of Submitted Information
under 40 CFR 122.26(b)(14)(x)or(b)(15))or composed of The U.S.Environmental Protection Agency(EPA)will make
stormwater and non-stormwater and are seeking coverage under information from NPDES permit application forms available to the
an individual National Pollutant Discharge Elimination System
(NPDES)permit.Note that applicants in the latter category must public for inspection and copying upon request.You may not claim
also complete Forms 2C,2D,or 2E,as applicable.See inset any information on Form 2F(or related attachments)as confidential.
below. You may make a claim of confidentiality for any information that you
submit to EPA that goes beyond the information required by Form
Notes 2F.Note that NPDES permitting authorities will deny claims for
• Form 2F must be completed by any operator of treating any effluent data(estimated or actual)as confidential. If you
a facility that discharges stormwater associated do not assert a claim of confidentiality at the time you submit your
with industrial activity or the operator of any information to the NPDES permitting authority,EPA may make the
stormwater discharger that EPA is evaluating for information available to the public without further notice to you.EPA
designation as a significant contributor of will handle claims of confidentiality in accordance with the Agency's
pollutants to waters of the United States,or as business confidentiality regulations in Part 2 of Title 40 of the Code
contributing to a violation of a water quality of Federal Regulations(CFR).
standard. Completion of Forms
• For discharges composed entirely of Print or type in the specified areas only. If you do not have enough
stormwater,the operator must complete space on the form to answer a question,you may continue on
Form 2F in conjunction with Form 1. additional sheets,as necessary,using a format consistent with the
• For discharges of stormwater combined with form.
process wastewater,the operator must Provide your EPA Identification Number from the Facility Registry
complete and submit Form 2F,Form 1,and Service,NPDES permit number,and facility name at the top of each
Form 2C.Process wastewater is water that
comes into direct contact with or results from page of Form 2F and any attachments. If your facility is new(i.e.,
the production or use of any raw material, not yet constructed),write or type"New Facility"in the space
intermediate product,finished product, provided for the EPA Identification Number an NPDES permit
byproduct,waste product,or wastewater. number.If you do not know your EPA Identification Number,contact
your NPDES permitting authority.See Exhibit 1-1 of Form 1's
• For discharges of stormwater combined with "General Instructions"for contact information.Additionally,for
nonprocess wastewater,the operator must Tables A through D,provide the applicable outfall number at the top
complete Form 2F,Form 1,and Form 2E. of each page.
Nonprocess wastewater includes noncontact
cooling water and sanitary wastes that are not Do not leave any response areas blank unless the form directs you
regulated by effluent guidelines,except to skip them.If the form directs you to respond to an item that does
discharges by educational,medical,or not apply to your facility or activity,enter"NA"for"not applicable"to
commercial chemical laboratories. show that you considered the item and determined a response was
• For new discharges of stormwater associated not necessary for your facility.
with industrial activity that will be combined with The NPDES permitting authority will consider your application
other new non-stormwater discharges,the complete when it and any supplementary material are received and
operator must submit Form 2F,Form 1,and completed according to the authority's satisfaction.The NPDES
Form 2D. permitting authority will judge the completeness of any application
independently of the status of any other permit application or permit
for the same facility or activity.
Definitions
The legal definitions of all key terms used in these instructions and
Form 2F are in the"Glossary"at the end of the"General
Instructions"in Form 1.
2F-1

FORM 2F—INSTRUCTIONS CONTINUED
Line-by-Line Instructions Section 3.Site Drainage Map
Section 1.Outfall Location Item 3.1 Attach a site drainage map showing the topography of the
Item 1.1. Identify each of the facility's outfalls by number. For each facility. If a topographic map is unavailable, you may provide an
outfall,specify the latitude and longitude to the nearest 15 seconds outline of drainage areas served by the outfall(s)covered in the
and name of the receiving water, Latitude and longitude application.The site map must include the following information:
coordinates may be obtained in a variety of ways, including use of 9 Each of its drainage and discharge structures.
hand held devices(e.g.,a GPS enabled smartphone), internet 0 The drainage area of each stormwater outfall.
mapping tools(e.g.,
https:llmynasadata.larc.nasa.gov/latitudelongitude-finder/), Paved areas and buildings within the drainage area of each
geographic information systems(e.g.,ArcView),or paper maps stormwater outfall;each past or present area used for outdoor
from trusted sources(e.g., U.S.Geological Survey or USGS).The storage or disposal of significant materials;each existing
location of each outfall(i.e.,where the coordinates are collected) structural control measure to reduce pollutants in stormwater
shall be the location where collected and concentrated stormwater runoff; materials loading and access areas; and areas where
Flows are discharged from the facility such that the first receiving pesticides, herbicides,soil conditioners,and fertilizers are
water body into which the discharge flows,either directly or applied.
through a separate storm sewer system, is a water of the United Each hazardous waste treatment, storage,or disposal facility
States. If you need further guidance in responding to Item 1.1, refer (including each area not required to have a Resource
to hUp:llwww.epa.govl9eospatiallfatitudelongitude-data-standard. Conservation and Recovery Act permit and is used for
Note: In EPA's stormwater permits,"outfalls"are referred to as accumulating hazardous waste for less than 90 days under
"discharge paints."
40 CFR 262.34).
•Nate that space has been provided on the form for six outfalls. if Each well where fluids from the facility are injected
underground.
you have more than this number,type your information on a
separate sheet of paper in a format similar to that of the form. Springs and other surface water bodies that receive stormwater
Make sure you note the EPA Identification Number, NPDES permit discharges from the facility.
number,and facility name at the top of the page and indicate the When you have completed and attached your site map to Form 2F,
specific item of the form to which you are responding—Item 1.1 in answer"Yes"to Item 3.1.
this case. In other sections of the form,you will be asked to provide Section 4.Pollutant Sources
information by outfall number(Sections 2,4,5, and 7). Item 4.1.List all outfalls discharging stormwater. Provide an
Section 2.Improvements estimate of the impervious surface area drained by the outfall.
Item 2.1. Indicate if you are required by any federal,state,or local Specify units of measure.(Impervious surfaces are surfaces where
authority to meet an implementation schedule for constructing, stormwater runs off at rates significantly higher than background
upgrading,or operating wastewater treatment equipment or rates—e.g., predevelopment levels.They include paved areas,
practices or any other environmental programs that could affect the building roofs,parking lots, and roadways.)
discharges described in this application.The requirements include, Provide an estimate of the total surface area(impervious and
but are not limited to,permit conditions, administrative enforcement pervious areas)drained by each outfall(within a mile radius of the
orders,enforcement compliance schedule letters,stipulations, facility).You may use the site map developed under Item 3.1 to
court orders,and grant or loan conditions. If yes,continue to Item estimate the total area drained by each outfall. For areas under
2,2. If no,skip to Section 3. 5 acres,consult your NPDES permitting authority to determine
Item 2.2.Briefly identify and describe each applicable project(e.g., whether the area should be reported to the nearest tenth of an acre
consent decree,enforcement order,or permit condition). For each or nearest quarter of an acre.
condition,specify the affected outfall number(s),the source(s)of Item 4.2.Provide a narrative description of the following:
the discharge,the required final compliance date,and the
projected final compliance date. Significant materials that in three years prior to the submittal of
this application have been treated,stored,or disposed of in a
Item 2.3.OPTIONAL ITEM. Indicate if you have attached any manner to allow exposure to stormwater.
sheets describing any additional water pollution control programs
(or other environmental projects that could affect your discharges) Method of treatment,storage,or disposal of such materials.
that you may now have underway or planned. If you attach 0 Materials management practices employed,in the three years
additional sheets,indicate in the attachment whether each program prior to the submittal of this application,to minimize contact by
is actually underway or is planned,and indicate your actual or these materials with stormwater runoff.
planned schedule for construction. Be sure to note your EPA a Materials loading and access areas.
Identification Number, NPDES permit number,and facility name at , The location, manner, and frequency in which pesticides,
the top of any attached pages. herbicides,soil conditioners,and fertilizers are applied.
You should identify your significant materials by chemical name,
2F-2

FORM 2F—INSTRUCTIONS CONTINUED
form(e.g.,powder,liquid,etc.),and type of container or treatment Tables A,B,C,and D
unit. Indicate any materials treated,stored,or disposed of Items 7.2 to 7.17.These items require you to collect and report data
together.The term"significant materials"includes,but is not in Tables A through D,at the end of Form 2F,for the parameters and
limited to:raw materials;fuels;materials such as solvents, pollutants listed in Exhibits 2F-2,2F-3,and 2F-4(at the end of the
detergents,and plastic pellets;finished materials such as metallic instructions).The instructions for completing Tables A through D are
products;raw materials used in food processing or production; table-specific,as are the criteria for determining who should
hazardous substances designated under Section 101(14)of the complete them.
Comprehensive Environmental Response,Compensation,and
Liability Act;any chemical the facility is required to report pursuant Important note:Read the"General Instructions for Reporting,
to Section 313 of Title III of the Superfund Amendments and Sampling, and Analysis"below before completing Items 7.2 to 7.17.
Reauthorization Act;and fertilizers;pesticides;and waste products Item 7.2 and Table A.All applicants must complete Table A. If the
such as ashes,slag,and sludge that have the potential to be discharge is an existing discharge and your discharge is composed
released with stormwater discharges. exclusively of stormwater(i.e.,no process or nonprocess
Item 4.3.For each outfall,list the location and type of existing wastewater)then you only need to provide monitoring data for oil and
structural and non-structural control measure(s)to reduce grease,total phosphorus,total Kjeldahl nitrogen,and total nitrogen.
pollutants in stormwater runoff.Structural controls include Indicate"NA"for"not applicable"in the columns for all other
structures that enclose materials handling or storage areas; parameters.Answer"Yes"to Item 7.2 once you have completed this
structures that cover materials;and berms,dikes,or diversion task.
ditches around manufacturing,production,storage,or treatment Item 7.3 and Table B.Indicate whether the facility is subject to an
units and retention ponds.Spill prevention plans,employee effluent limitations guideline(ELG)(see 40 CFR Subchapter N to
training,visual inspections,preventive maintenance,and determine which pollutants are limited in ELGs)or if the facility is
housekeeping measures are examples of non-structural controls. subject to effluent limitations in an NPDES permit for its process
wastewater or stormwater(if the facility is operating under an existing
Describe the treatment,including the schedule and type of NPDES permit). If yes,continue to Item 7.4.If no,skip to Item 7.5.
maintenance activities performed,and the ultimate disposal of any
solid or fluid wastes other than by discharge.For each structural Note:stormwater discharges from certain industrial sources or
control identified,indicate the type of treatment the stormwater activities have specific ELGs for which they must comply.These
receives using the codes in Exhibit 2F-1,at the end of the stormwater-speck ELGs include:
instructions.For each non-structural control identified,indicate Regulated Discharge 40 CFR Section
"Not Applicable"in the"Codes from Exhibit 2F-1"column. Discharges resulting from spraydown or intentional Part 429,Subpart I
Section 5.Non-Stormwater Discharges wetting of logs at wet deck storage areas
Item 5.1.Provide a certification that all ouffalls that should contain Runoff from phosphate fertilizer manufacturing facilities Part 418,Subpart A
that comes into contact with any raw materials,finished
stormwater discharges associated with industrial activity have product,byproducts or waste products(SIC 2874)
been tested or evaluated for the presence of non-stormwater Runoff from asphalt emulsion facilities Part 443,Subpart A
discharges.Tests for such non-stormwater discharges can include Runoff from material storage piles at cement Part 411,Subpart C
smoke tests,fluorometric dye tests,analysis of accurate manufacturing facilities
schematics,and others. Mine dewatering discharges at crushed stone, Part 436,Subparts B,
lion of the method used,the date of an construction sand and gravel,or industrial sand mining C,and D
Item 5.2.Include a description Y tacilities
testing,and the onsite drainage points that were directly observed Runoff from hazardous waste and non-hazardous waste Part445,Subparts A
during a test used to support the certification in Item 5.1.All non- landfills and B
stormwater discharges must be identified in a Form 2C,2D,or 2E. Runoff from coal storage piles at steam electric Part 423
See"Who Must Complete Form 2F?"above for more information. generating facilities
Section 6.Significant Leaks or Spills Runoff contalnfng urea from airfield pavement deicing at Part449
9 p existing and new primary airports with 1,000 or more
Item 6.1.Describe any significant leaks or spills of toxic or annual non-propeller aircraft departures
hazardous pollutants at the facility within the three years prior to Item 7.4.In Table B,list all pollutants that are limited in an ELG to
the submittal of this application. Include the approximate date and which the facility is subject and all pollutants listed in the facility's
location of the spill or leak and the type and amount of material NPDES permit for its process wastewater(if the facility is operating
released. under an existing NPDES permit)and provide quantitative data for
Section 7.Discharge Information each pollutant(provide actual data for existing dischargers and
Item 7.1.Answer whether you are a new source or new discharge. estimated data for new sources and new dischargers). If a pollutant
Contact your NPDES permitting authority to determine if you are a in Exhibits 2F-2 or 2F-3 is indirectly limited by an ELG through an
new source or new discharge. indicator(e.g.,use of total suspended solids as an indicator to
control the discharge of iron and aluminum),you must provide data
for the pollutant in Table B.Complete one table for each outfall.
Answer"Yes"to Item 7.4 once you have completed this task.
2F-3

FORM 2F--INSTRUCTIONS CONTINUED
Item 7.5 and Table C.Table C requires you to address the Item 7.11. Provide quantitative data in Table C for those pollutants
pollutants in Exhibits 2F-2, 2F-3, and 2F-4 for each outfall. in Exhibit 2F-3 that you expect to be discharged in concentrations
Pollutants in each of these exhibits are addressed differently, of 10 ppb or greater(provide actual data for existing dischargers
Indicate whether you know or have reason to believe any pollutants and estimated data for new sources and new dischargers).Answer
°Yes"to Item 7.11 once you have completed this task.
in Exhibit 2F-2 are present in the discharge. If yes,continue to Item
7.6, If no,skip to Item 7.7. item 7.12, Indicate whether you expect acrolein, acrylonitr'tle,2,4-
Item 7.6.For each outfall,list all pollutants in Exhibit 2F-2 that you dinitrophenol,or 2-methyl-4,6-dinitrophenol to be discharged in
know or have reason to believe are present in the discharge in concentrations of 100 ppb or greater. If yes,continue to Item 7.13.
Table C(except pollutants previously listed in Table B that are If no,skip to Item 7.14.
limited directly or indirectly by an ELG)and either report quantitative Item 7.13.Provide quantitative data in Table C for the pollutants
data or briefly describe the reasons the pollutant is expected to be identified in Item 7,12 that you expect to be discharged in
discharged.Answer"Yes"to Item 7.6 once you have completed this concentrations of 100 ppb or greater(provide actual data for
task. existing dischargers and estimated data for new sources and new
Item 7.7.This item asks if you qualify as a"small business."If so, dischargers).Answer"Yes"to Item 7.13 once you have completed
you are exempt from the reporting requirements for the organic toxic this task.
pollutants listed in Exhibit 2F-3. Item 7.14.For any pollutants you expect to be present in the
You can qualify as a small business in two ways: (1) If your facility is discharge at concentrations less than 10 ppb(or less than 100 ppb
far the above four pollutants),either submit quantitative data or
a coo[mine and if your probable total annual production is less than briefly describe the reasons the pollutant is expected to be
100,000 tons per year,you may submit past production data or discharged in Table C.Answer"Yes"to Item 7.14 once you have
estimated future production(such as a schedule of estimated total completed this task.
production under 30 CFR 795.14(c))instead of conducting analyses
for the organic toxic pollutants; (2) if your facility is not a coal mine Item 7.15. Indicate whether you know or have reason to believe
and if your gross total annual sales for the most recent three years any pollutants in Exhibit 2F4 are present in the discharge. If yes,
average less than$100,000 per year(in second quarter 1980 continue to Item 7.16. If no,skip to Item 7.17.
dollars),you may submit sales data for those years instead of Item 7.16.For each outfall,list any pollutant in Exhibit 2F-4 that
conducting analyses for the organic toxic pollutants.The production you know or believe to be present in the discharge in Table C and
or sales data must be for the facility that is the source of the explain why you believe it to be present. No analysis is required,
discharge.The data should not be limited to production or sales for
the process or processes that contribute to the discharge, unless but if you have analytical data, you must report it.Answer"Yes"to
those are the only processes at your facility. For sales data,in Item 7.16 once you have completed this task.
situations involving intra-corporate transfer of goods and services, Note:Under40 CFR 117.12(a)(2),certain discharges of hazardous
the transfer price per unit should approximate market prices for substances(listed in Exhibit 2F-5)may be exempted from the requirements of
those goods and services as closely as possible. Sales figures for CWA Section 311,which establishes reporting requirements,civil penalties,
years after 1980 should be indexed to the second quarter of 1980 by and liability for cleanup costs for spills of oil and hazardous substances.A
using the gross national product price deflator(second quarter of discharge of a particular substance can be exempted if the origin,source,and
amount of the discharged substances are identified in the NPDES permit
1980=100).This index is available online from the U.S. Department application or in the permit,if the permit contains a requirement for treatment
of Commerce, Bureau of Economic Analysis at of the discharge,and if the treatment is in place.U you would like to apply for
http:llwww.bea.goy/national/Ddf/SNTables.l)df. an exemption from the requirements of CWA Section 311,attach additional
sheets of paper to your application,setting forth the following information:
If you qualify as a small business according to the criteria above, 1. The substance and the amount of each substance that might be
answer"Yes"to Item 7.7 and skip to Item 7.18.Otherwise, answer discharged.
"No"and continue to Item 7.8. 2. The origin and source of the discharge of the substance.
Item 7.8. Indicate whether you know or have reason to believe any 3. The treatment to be provided for the discharge by:
pollutants in Exhibit 2F-3 are present in the discharge. If yes, a. An onsite treatment system separate from any treatment system
treating your normal discharge;
continue to Item 7.9. If no,skip t0 item 7,10. b. A treatment system designed to treat your normal discharge and that
Item 7.9.For each outfall,list all pollutants in Exhibit 2F-3 that you is additionally capable of treating the amount of the substance
know or have reason to believe are present in the discharge in identified under paragraph 1 above;or
Table C(except pollutants previously listed in Table B).Answer c. Any combination of the above
"Yes"to Item 7.9 once you have completed this task. See 40 CFR 117.12(a)(2)and(c)or contact your NPDES permitting authority
for further information on exclusions from CWA Section 311.
Item 7.10. Indicate whether you expect any of the pollutants from
Exhibit 2F-3 to be discharged in concentrations of 10 parts per Item 7.17 and Table D.Provide data for the storm event(s)that
billion(ppb)or greater. if yes,continue to Item 7.11, If no,skip to resulted in the maximum daily discharges for the flow weighted
Item 7.12. composite sample in Table D. If sampling is conducted during more
than one storm event, you only need to report the information
2F-4

FORM 2F—INSTRUCTIONS CONTINUED
requested on Table D for the storm event(s)that resulted in any Section 10.Checklist and Certification Statement
maximum pollutant concentration reported on Tables A through C. Item 10.1.Review the checklist provided on the application.In
Provide flow measurements or estimates of the flow rate,as well as Column 1,mark the sections of Form 2F that you have completed
the total amount of discharge for the storm event(s)sampled,the and are submitting with your application.For each section in
method of flow measurement,or estimation.Provide the data and Column 2,indicate whether you are submitting attachments.
duration of the storm event(s)sampled,rainfall measurements,or Item 10.2.The Clean Water Act(CWA)provides for severe
estimates of the storm event that generated the sampled runoff and penalties for submitting false information on this application form.
the duration between the storm event sampled and the end of the Section 309(c)(2)of the CWA provides that,"Any person who
previous measurable(greater than 0.1 inch rainfall)storm event. knowingly makes any false material statement,representation,or
Answer"Yes"to Item 7.17 once you have completed this task. certification in any application, ...shall upon conviction be punished
Used or Manufactured Toxics by a fine of not more than$10,000 or by imprisonment for not more
Item 7.18.Review Exhibits 2F-2 through 2F-4 and determine if you than six months or both."
currently use or manufacture any of the pollutants listed as FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS
intermediate or final products or byproducts. If so,answer"Yes." APPLICATION TO BE SIGNED AS FOLLOWS:
You should also answer"Yes"if you know or have reason to
believe that 2,3,7,8-tetrachloro-dibenzo-p-dioxin(TCDD)is A. For a corporation,by a responsible corporate officer.For the
discharged or if you use or manufacture 2,4,5-tdchlorphenoxy purpose of this section,a responsible corporate officer means:
acetic acid(2,4,5-T);2-(2,4,5-b ichlorophenoxy)propanoic acid (1)a president,secretary,treasurer,or vice-president of the
(Silvex,2,4,5-TP);2-(2,4,5-tdchlorophenoxy)ethyl,2,2- corporation in charge of a principal business function,or any
dichloropropionate(Erbon);0,0-dimethyl 0-(2,4,5-trichlorphenyl) other person who performs similar policy-or decision-making
phosphorothioate(Ronnel);2,4,5-bichlorophenol(TCP);or functions for the corporation,or(2)the manager of one or
hexachlorophene(HCP).If your answer to Item 7.18 is"No,"skip to more manufacturing,production,or operating facilities,
Section 8. provided the manager is authorized to make management
decisions which govem the operation of the regulated facility
Item 7.19.List all of the toxic pollutants identified under Item 7.18, including having the explicit or implicit duty of making major
including TCDD.Note that the NPDES permitting authority may capital investment recommendations,and initiating and
waive or modify the requirement if you demonstrate that it would be directing other comprehensive measures to assure long term
unduly burdensome to identify each toxic pollutant and the NPDES environmental compliance with environmental laws and
permitting authority has adequate information to issue your permit. regulations;the manager can ensure that the necessary
You may not claim any information submitted in response to Item systems are established or actions taken to gather complete
7.18 as confidential;however,you do not have to distinguish and accurate information for permit application requirements;
between use or production of the pollutants or list the amounts. and where authority to sign documents has been assigned or
Section 8.Biological Toxicity Testing Data delegated to the manager in accordance with corporate
Item 8.1.Answer whether you know of or have reason to believe procedures.
that biological toxicity testing has been conducted of your B. For a partnership or sole proprietorship,by a general partner
wastewater treatment,including engineering reports or pilot plant or the proprietor,respectively.
studies.If no,skip to Section 9.Otherwise,continue. C. For a municipality,state,federal,or other public facility,by
Item 8.2.List any tests of which you are aware and their purposes. either a principal executive officer or ranking elected official.
For purposes of this section,a principal executive officer of a
Section 9.Contract Analysis Information federal agency includes:(1)The chief executive officer of the
Item 9.1.Indicate if any of the analyses performed in Section 7 agency,or(2)a senior executive officer having responsibility
were performed by a contract laboratory or consulting firm. If no, for the overall operations of a principal geographic unit of the
skip to Section 10. If yes,continue to Item 9.2. agency(e.g.,Regional Administrators of EPA).
Item 9.2.Provide the name,address,phone number,and pollutants END
analyzed by the laboratory or consulting firm(s)in the spaces Submit your completed Form 1,Form 2F,and
provided. all associated attachments
(and any other required NPDES application forms)
to your NPDES permitting authority.
2F-5

General Instructions for Reporting,Sampling,and Analysis
Important note:Read these instructions before completing Tables byproducts,and any previous analyses known to you of your
A through C and Section 7 of Form 2F. effluent or similar effluent.
General Items Sampling
Complete the applicable tables for each outfall at your facility.Be The collection of the samples for the reported analyses should be
sure to note the EPA Identification Number,NPDES permit supervised by a person experienced in performing sampling of
number,facility name,and applicable outfall number at the top of industrial wastewater or stormwater discharges.You may contact
each table page and any associated attachments. your NPDES permitting authority for detailed guidance on sampling
You may report some or all of the required data by attaching techniques and for answers to specific questions.See Exhibit 1-1 of
separate sheets of paper instead of completing Tables A through C Form 1 for contact information.Any specific requirements in the
for each of your outfalls so long as the sheets contain all of the analytical methods—for example,sample containers,sample
required information and are similar in format to Tables A through preservation,holding times,and the collection of duplicate
C. For example,you may be able to print a report in a compatible samples—must be followed.
format from the data system used in your gas chromatography/ The time when you sample should be representative of your normal
mass spectrometry(GCIMS)analysis completed under Table B. operation,to the extent feasible,with all processes that contribute
If you are an existing discharger,you are required to report actual wastewater in normal operation,and with your treatment system
quantitative data.See"Use of Historic Data"below for use of operating properly with no system upsets.Collect samples from the
historic data.If you are a new source or discharge,you may supply center of the flow channel,where turbulence is at a maximum,at a
estimated data along with the source of each estimate. If you have site specified in your present NPDES permit,or at any site adequate
quantitative data available,however,you must provide it.Base for the collection of a representative sample.
estimates on available,in-house or contractor engineering reports, Grab samples must be taken in the first 30 minutes of discharge(or
or any other studies performed on the proposed facility.Use the as soon thereafter as practicable)for pH,temperature,cyanide,total
following codes to report your source information in the'Source of phenols,residual chlorine,oil and grease,fecal coliform(including
Information"column: E.cols)and enterococci(previously known as fecal streptococcus at
Data Source Code 40 CFR 122.26(d)(2)(iii)(A)(3)),and volatile organic compounds.
Engineering reports 1 You are not required to analyze a flow-weighted composite for these
Actual data from pilot plants 1 parameters.
Estimates from other englneering 2 For all other pollutants,both a grab sample collected during the first
reports 30 minutes(or as soon thereafter as practicable)of the discharge
Data from other similar plants 3 and a flow-weighted composite sample must be analyzed.However,
Best professional estimates 4 a minimum of one grab sample may be taken for effluents from
Others 5 and specify on holding ponds or other impoundments with a retention period of
the table
greater than 24 hours.
No later than 24 months after your facility commences to
discharge,you must complete and submit sampling and analysis All samples must be collected from the discharge resulting from a
data for the pollutants and parameters in Tables A through C. storm event that is greater than 0.1 inches and at least 72 hours
However,you need not report results for tests you have already from the previously measurable(greater than 0.1 inch rainfall)storm
performed and reported under the discharge monitoring event.Where feasible,the variance in the duration of the event and
requirements of your NPDES permit. the total rainfall of the event should not exceed 50 percent from the
Table A requires you to report at least one analysis for each average or median rainfall event in that area.
pollutant listed.Tables B and C require you to report analytical data A grab sample must be taken during the first 30 minutes of the
in two ways.For some pollutants addressed in Tables B and C,if discharge(or as soon thereafter as practicable),and a flow-
you know or have reason to know that the pollutant is present in weighted composite must be taken for the entire event or for the first
your discharge,you may be required to list the pollutant and test three hours of the event.
(sample and analyze)and report the levels of the pollutants in your Grab and composite samples are defined as follows:
discharge.For all other pollutants addressed in Tables B and C,
you must list the pollutant if you know or have reason to know that Grab sample:An individual sample of at least 100 milliliters
the pollutant is present in the discharge,and either report collected during the first 30 minutes(or as soon thereafter as
quantitative data for the pollutant or briefly describe the reasons practicable)of the discharge.This sample is to be analyzed
the pollutant is expected to be discharged.(See Items 7.2 through separately from the composite sample. 1
7.17 of the instructions for completing Tables A through C.).Base Flow-weighted composite sample:A flow-weighted composite
your determination that a pollutant is/will be present in your sample may be taken with a continuous sampler that proportions the
discharge on your knowledge of the facility's raw materials, amount of sample collected with the flow rate or as a combination of
material management practices,maintenance chemicals,history of a minimum of three sample aliquots taken in each hour of discharge
spills and releases,intermediate and final products and
2F-6

General Instructions for Reporting,Sampling,and Analysis Continued
for the entire event or for the first three hours of the event,with All reporting of values for metals must be in terms of"total
each aliquot being at least 100 milliliters and collected with a recoverable metal"unless:
minimum period of 15 minutes between aliquot collections.The
composite must be flow proportional;the time interval between An applicable,promulgated E specifies the limitation for the
either each aliquot or the volume of each aliquot must be metal in dissolved,valent,or total form;
proportional to either the stream(effluent)flow at the time of • All approved analytical methods for the metal inherently
sampling or the total stream(effluent)flow since the collection of measure only its dissolved form(e.g.,hexavalent chromium);
the previous aliquot.Aliquots may be collected manually or or
automatically.Where GC/MS volatile organic analysis is required, . The NPDES permitting authority has determined that in
aliquots must be combined in the laboratory immediately before establishing case-by-case limitations it is necessary to express
analysis.Cnly one analysis for the composite sample is required. the limitations of the metal in dissolved,valent,or total form to
Use of Historical Data carry out the provisions of the CWA.
Existing data may be used,if available,in lieu of sampling If you measure only one grab sample and one flow-weighted
conducted solely for the purposes of this application,provided it is composite sample for a given outfall,complete only the"Maximum
representative of the present discharge and was collected within Daily Discharge"columns in the tables and enter"1"in the"Number
3 years of the application due date. If you sample for a listed of Storm Events Sampled"column.The NPDES permitting authority
pollutant on a monthly or more frequent basis,summarize the data may require you to conduct additional analyses to further
collected within one year of the application for the pollutant(s)at characterize your discharges.
issue. If you measure more than one value for a grab sample or a flow-
Among the factors that would cause the data to be weighted composite sample for a given outfall and those values are
unrepresentative are significant changes in production level; representative of your discharge,you must report them.You must
changes in raw materials,processes,or final products;and describe your method of testing and analysis.
changes in stormwater treatment.The NPDES permitting authority The"Average Daily Discharge"column on Tables A to C is not
may request additional information,including current quantitative compulsory but should be filled out if data are available.To
data,if they determine it to be necessary to assess your complete the"Average Daily Discharge"column,determine the
discharges.The NPDES permitting authority may allow or establish average of all values within the last year and report the
appropriate site-specific sampling procedures or requirements concentration and mass.Report the total number of storm events
including sampling locations,the season in which the sampling sampled under the"Number of Storm Events Sampled"column.
takes place,the minimum duration between the previous
measurable storm event and the storm event sampled,the Substantially Identical Outfalls
minimum or maximum level of precipitation required for an If you have two or more substantially identical outfalls,you may
appropriate storm event,the form of precipitation sampled(snow request permission from your NPDES permitting authority to sample
melt or rainfall),protocols for collecting samples under 40 CFR 136, and analyze only one outfall and submit the results of the analysis
and additional time for submitting data on a case-by-case basis. for all substantially identical outfalls. If your request is granted,
Reporting submit the following information on a separate sheet attached to the
Report sampling results for all pollutants in Tables A through C as application form:the identity of the outfall you did test and an
concentration and mass,with the exception of flow,temperature, explanation of how it is substantially identical to the outfall(s)that
pH,color,and fecal coliform organisms. you did not test.
Flow,temperature,pH,color,and fecal coliform organisms must Analysis
be reported as million gallons per day(mgd),degrees Celsius Except as specified below,all required quantitative data shall be
(°C),standard units,color units,and most probable number per collected in accordance with sufficiently sensitive analytical methods
100 milliliters(MPN/100 mL),respectively.Use the following approved under 40 CFR 136 or required under 40 CFR chapter I,
abbreviations in the columns requiring"units"in Tables A through subchapter N or 0.A method is"sufficiently sensitive"when:
C.
• The method minimum level(ML)is at or below the level of the
Concentration Mass applicable water quality criterion for the measured pollutant or
m=pans per million lbs=pounds pollutant parameter.
mqiL=milligrams per liter ton=tons(English tons) The method ML is above the water quality criterion,but the
b=parts per billion m_q=milligrams amount of the pollutant or pollutant parameter in the facility's
!L=micrograms per liter q=grams discharge is high enough that the method detects and
MPN=most probable number per kq=kilograms quantifies the level of the pollutant or pollutant parameter in the
100 milliliters T=tonnes metric fnn-Q1 discharge.
2F-7

General Instructions for Reporting,Sampling,and Analysis Continued
The method has the lowest ML of the analytical methods select a different method from the remaining EPA-approved
approved under 40 CFR 136 or required under 40 CFR methods that is sufficiently sensitive consistent with 40 CFR
chapter I,subchapter N or 0,for the measured pollutant or 122.21(e)(3)(i).Where no other EPA-approved methods exist,you
pollutant parameter. must select a method consistent with 40 CFR 122.21(e)(3)(ii).
Consistent with 40 CFR 136,you may provide matrix-or sample- When there is no analytical method that has been approved under
specific MLs rather than the published levels.Further,where you 40 CFR 136;required under 40 CFR chapter I,subchapter N or 0,
can demonstrate that,despite a good faith effort to use a method and is not otherwise required by the NPDES permitting authority,
that would otherwise meet the definition of"sufficiently sensitive," you may use any suitable method but shall provide a description of
the analytical results are not consistent with the quality assurance the method.When selecting a suitable method,other factors such
(QA)Jquality control(QC)specifications for that method,then the as a method's precision,accuracy,or resolution,may be considered
NPDES permitting authority may determine that the method is not when assessing the performance of the method.
performing adequately and the NPDES permitting authority should
2F-8

Exhibit 2F-1.Codes for Treatment Units and Disposal of Wastes Not Discharged
1. PHYSICAL TREATMENT PROCESSES
1-A.................Ammonia stripping 1-M................Grit removal
1-B.................Dialysis 1-N................Microstraining
1-C................Diatomaceous earth filtration 1-0................Mixing
1-D................Distillation 1-P................Moving bed filters
1-E.................Electrodialysis 1-Q................Multimedia filtration
1-F.................Evaporation 1-R................Rapid sand filtration
1-G................Flocculation 1-S................Reverse osmosis(hyperfrltration)
1-H................Flotation 1-T................Screening
1-1..................Foam fractionation 1-U................Sedimentation(settling)
1-J.................Freezing 1-V................Slow sand filtration
1-K.................Gas-phase separation 1-W...............Solvent extraction
1-L.................Grinding(comminutors) 14................Sorption
2. CHEMICAL TREATMENT PROCESSES
2 A.................Carbon adsorption 2-G................Disinfection(ozone)
2-B.................Chemical oxidation 2-H................Disinfection(other)
2-C................Chemical precipitation 2-1..................Electrochemical treatment
2-D................Coagulation 2-J.................Ion exchange
2-E.................Dechlorination 2-K................Neutralization
2-F.................Disinfection(chlorine) 2-L.................Reduction
3. BIOLOGICAL TREATMENT PROCESSES
3-A.................Activated sludge 3-E................Pre-aeration
3-13.................Aerated lagoons 3-F................Spray irrigationlIand application
3-C................Anaerobic treatment 3-G................Stabilization ponds
3-D................Nitrification-denitrification 3-H................Trickling filtration
4. WASTEWATER DISPOSAL PROCESSES
4-A.................Discharge to surface Water 4-C................Reuse/recycle of treated effluent
4-13.................Ocean discharge through outfall 4-D................Underground injection
5. SLUDGE TREATMENT AND DISPOSAL PROCESSES
5-A.................Aerobic digestion 5-M................Heat drying
5-13.................Anaerobic digestion 5-N................Heat treatment
5-C................Belt filtration 5-0................Incineration
5-D................Centrifugation 5-P................Land application
5-E.................Chemical conditioning 5-Q................Landfill
5-F.................Chlorine treatment 5-R................Pressure filtration
5-G................Composting 5-S................Pyrolysis
5-H................Drying beds 5-T................Sludge lagoons
5-1..................Elutriation 5-U................Vacuum filtration
5-J.................Flotation thickening 5-V................Vibration
5-K.................Freezing 5-W...............Wet oxidation
5-L.................Gravity thickening
2F-9

Exhibit 2F-2.Conventional and Nonconventional Pollutants(40 CFR 122.21,Appendix D,Table IV)
Bromide
Chlorine,total residual
Color
Fecal coliform
Fluoride
Nitrate-nitrite
Nitrogen,total organic(as N)
Oil and grease
Phosphorus(as P),total -
Radioactivity(as alpha,total;beta,total;radium,total;and radium 226,total)
Sulfate(as SO4)
Sulfide(as S)
Sulfite(as SO3)
Surfactants
Aluminum,total
Barium,total
Boron,total
Cobalt,total
Iron,total
Magnesium,total
Molybdenum,total
Manganese,total
Tin,total
Titanium,total
2F-10

Exhibit 2F-3.Toxic Pollutants(40 CFR 122.21,Appendix D,Tables II and III)
Toxic Pollutants and Total Phenol
Antimony,total Copper,total Silver,total
Arsenic,total Lead,total Thallium,total
Beryllium,total Mercury,total Zinc,total
Cadmium,total Nickel,total Cyanide,total
Chromium,total Selenium,total Phenols,total
GCIMS Fraction—Volatile Compounds
Acrolein Dichlorobromomethane 1,1,2,2-tetrachloroethane
Acrylonitrile 1,1-dichloroethane Tetrachloroethylene
Benzene 1,2-dichloroethane Toluene
Bromoform 1,1-dichloroethylene 1,2-trans-dichloroethylene
Carbon tetrachloride 1,2-dichloropropane 1,1,1-bichloroethane
Chlorobenzene 1,3-dichloropropylene 1,1,2-tichloroethane
Chlorodibromomethane Ethylbenzene Trichloroethylene
Chloroethane Methyl bromide Vinyl chloride
2-Chloroethylvinyl ether Methyl chloride
Chloroform Methylene chloride
GCIMS Fraction—Acid Compounds
2-chlorophenol 2,4-dinitrophenol Pentachlorophenol
2,4-dichlorophenol 2-nitrophenol Phenol
2,4-dimethylphenol 4-nitrophenol 2,4,6-tdchlorophenol
4,6-dinitro-o-cresol P-chloro-m-cresol
GCIMS Fraction—Base/Neutral Compounds
Acenaphthene 4-chlorophenyl phenyl ether Hexachlorobenzene
Acenaphthylene Chrysene Hexachlorobutadiene
Anthracene Dibenzo(a,h)anthracene Hexachlorocyclopentadiene
Benzidine 1,2-dichlorobenzene Hexachloroethane
Benzo(a)anthracene 1,3-dichlorobenzene Indeno(1,2,3-cd)pyrene
Benzo(a)pyrene IA-dichlorobenzene Isophorone
3,4-benzofluoranthene 3,3-dichlorobenzidine Naphthalene
Benzo(ghi)perylene Diethyl phthalate Nitrobenzene
Benzo(k)fluoranthene Dimethyl phthalate N-nitrosodimethylamine
Bis(2-chloroethoxy)methane Di-n-butyl phthalate N-nitrosodi-n-propylamine
Bis(2-chloroethyl)ether 2,4-dinitrotoluene N-nitrosodiphenylamine
Bis(2-chloroisopropyl)ether 2,6-dinitrotoluene Phenanthrene
Bis(2-ethylhexyl)phthalate Di-n-octyl phthalate Pyrene
4-bromophenyl phenyl ether 1,2-diphenyfhydrazine(as azobenzene) 1,2,4-tichlorobenzene
Butyl benzyl phthalate Fluoranthene
2-chloronaphthalene Fluorene
GCIMS Fraction—Pesticides
Aldrin Dieldrin PCB-1254
a-BHC a-endosulfan PCB-1221
R-BHC R-endosulfan PCB-1232
y-BHC Endosulfan sulfate PCB-1248
b-BHC Endrin PCB-1260
Chlordane Endrin aldehyde PCB-1016
4,4'-DDT Heptachlor Toxaphene
4,4'-DDE Heptachlor epoxide
4,4'-DDD PCB-1242
2F-11

Exhibit 2F4.Certain Hazardous Substances and Asbestos(40 CFR 122.21,Appendix D,Table V)
Toxic Pollutant
Asbestos
Hazardous Substances
Acetaldehyde Dintrobenzene Naphthenic acid
Allyl alcohol Diguat Nitrotoluene
Allyl chloride Disulfoton Parathion
Amyl acetate Diuron Phenolsulfonate
Aniline Epichlorohydrin Phosgene
Benzonitrile Ethion Propargite
Benzyl chloride Ethylene diamine Propylene oxide
Butyl acetate Ethylene dibromide Pyrethrins
Butylamine Formaldehyde Quinoline
Captan Furfural Resorcinol
Carbaryl Guthion Strontium
Carbofuran Isoprene Strychnine
Carbon disulfide Isopropanolamine Styrene
Chlorpyrifos Kelthane 2,4,5-T(2,4,5-trichlorophenoxyacetic
acid)
Coumaphos Kepone TDE(tetrachlorodiphenyl ethane)
Cresol Malathion 2,4,5-TP 12-(2,4,5-tdchlorophenoxy)
propanoic acid]
Crotonaldehyde Mercaptodimethur Trichlorofon
Cyclohexane Methoxychlor Triethanolamine
2,4-D(2,4-dichlorophenoxyacetic acid) Methyl mercaptan Triethylamine
Diazinon Methyl methacrylate Trimethylamine
Dicamba Methyl parathion Uranium
Dichlobenil Mevinphos Vanadium
Dichlone Mexacarbate Vinyl acetate
2,2-dichloropropionic acid Monoethyl amine Xylene
Dichlorvos Monomethyl amine Xylenol
Diethyl amine Naled Zirconium
Dimethyl amine
2F-12

Exhibit 2F-5.Hazardous Substances
1.Acetaldehyde 73,Captan 144.Ferrous sulfate
2.Acetic acid 74.Carbaryl 145.Formaldehyde
3.Acetic anhydride 75.Carbofuran 146.Formic acid
4.Acetone cyanohyddn 76.Carbon disulfide 147.Fumadc acid
5.Acetyl bromide 77.Carbon tetrachloride 148.Furfural
6.Acetyl chloride 78.Chlordane 149.Guthlon
7.Acrolein 79.Chlorine 150.Heptachlor
8.Acrylonihiie 80.Chlorobenzene 151.Hexachlomcyclopentadiene
9.Adipic acid 81.Chloroform 152.Hydrochloric add
10.Alden 82.Chloropyrifos 153.Hydrofluoric acid
11.Aliyl alcohol 83.Chlorosulfonic acid 154.Hydrogen cyanide
12.Allyl chloride 84.Chromic acetate 155.Hydrogen sulfide
13.Aluminum sulfate 85.Chromic acid 156,Isoprene
14.Ammonia 86.Chromic sulfate 157.Isopropanolamine dodecylbenzenesulfonate
15.Ammonium acetate 87.Chromous chloride 158.Kelthane
16.Ammonium benzoate 88.Cobaltous bromide 159.Kepone
17.Ammonium bicarbonate 89.Cobaltous formate 160.Lead acetate
18.Ammonium bichromate 90.Cobaltous sulfamate 161.Lead arsenate
19.Ammonium bifluodde 91.Coumaphos 162.Lead chloride
20.Ammonium bisulfite 92.Cresol 163.Lead fluoborate
21.Ammonium carbamate 93.Crotonaldehyde 164.Lead fluorite
22.Ammonium carbonate 94.Cupric acetate 165.Lead iodide
23.Ammonium chloride 95.Cupric acetoarsenite 166.Lead nitrate
24.Ammonium chromate 96.Cupric chloride 167.Lead stearate
25.Ammonium citrate 97.Cupric nitrate 168.Lead sulfate
26.Ammonium fluoroborate 98.Cupric oxalate 169.Lead sulfide
27.Ammonium fluoride 99.Cupric sulfate 170.Lead thiocyanate
28.Ammonium hydroxide 100.Cupric sulfate ammoniated 171.Lindane
29.Ammonium oxalate 101.Cupric tartrate 172.Lithium chromate
30.Ammonium silioofluodde 102.Cyanogen chloride 173.Malathlon
31.Ammonium sulfamate 103.Cyclohexane 174.Malelc acid
32.Ammonium sulfide 104.2,4-D acid(2,4-dichlorophenoxyacetic acid) 175.Malelc anhydride
33.Ammonium sulfite 105.2,4-D esters(2,4-dichlorophenoxyacetic acid esters) 176.Mercaptodimethur
34.Ammonium tartrate 106.DDT 177.Mercuric cyanide
35.Ammonium thiocyanate 107.Diazinon 178.Mercuric nitrate
36.Ammonium thiosulfate 108.Dicamba 179.Mercuric sulfate
37.Amyl acetate 109.Dichlobenil 180.Mercuric thiocyanate
38.Aniline 110.Dichlone 181.Mercurous nitrate
39.Antimony pentachloecle 111.Dichlorobenzene 182.Methoxychlor
40.Antimony potassium tartrate 112.Dichloropropane 183.Methyl mercaptan
41.Antimony tribromide 113.Uchloropropene 184.Methyl methacrylate
42.Antimony tichlorde 114.Dichloropropene-dichloproropane mix 185.Methyl parathion
43.Antimony trifluoride 115.2,2-dichloroproplonic acid 186.Mevinphos
44.Antimony trioxide 116.Dichlorvos 187.Mexacarbate
45.Arsenic disulfide 117.Diekdrin 188.Monoethytamine
46.Arsenic pentoxide 118.Diethylamine 189.Monomethylamine
47.Arsenic tichloede 119.Dimethylamine 190.Naled
48.Arsenic trioxide 120.Dinitrobenzene 191.Naphthalene
49.Arsenic hisulfide 121.Dinitrophenol 192.Naphthenic acid
50.Barium cyanide 122.Dinitrotoluene 193.Nickel ammonium sulfate
51.Benzene 123.Diquat 194.Nickel chloride
52,Benzoic acid 124.Disulfoton 195.Nickel hydroxide
53.Benzonitrile 125.Diuron 196,Nickel nitrate
54.Benzoyl chloride 126.Dodecyibenzesulfonic acid 197.Nickel sulfate
55.Benzyl chloride 127.Endosulfan 198.Nitric acid
56.Beryllium chloride 128.Enddn 199.Nitrobenzene
57.Beryllium fluoride 129.Epidtlorohydrin 200.Nitrogen dioxide
58.Beryllium nitrate 130.Ethion 201.Nitrophenol
59.Butylacetate 131.Ethylbenzene 202.Nitrotoluene
60.n-butylphthalate 132.Ethylenediamine 203.Paraformaldehyde
61.Butylamine 133.Ethylene dibromide 204.Parathon
62.Butyric acid 134.Ethylene dichloride 205.Pentachlorophenol
63.Cadmium acetate 135.Ethylene diaminetetracetic acid(EDTA) 206.Phenol
64.Cadmium bromide 136.Ferric ammonium citrate 207.Phosgene
65.Cadmium chloride 137.Ferric ammonium oxalate 208.Phosphoric acid
66.Calcium arsenate 138.Ferric chloride 209.Phosphorus
67.Calcium arsenite 139.Ferric fluoride 210.Phosphorus oxychloride
68.Calcium carbide 140.Feric nitrate 211.Phosphorus pentasulfide
69.Calcium chromate 141.Ferric sulfate 212.Phosphorus trichloride
70.Calcium cyanide 142,Ferrous ammonium sulfate 213.Polychlorinated biphenyls(PCB)
71.Calcium dodecylbenzenesulfonate 143.Ferrous chloride 214.Potassium arsenate
72.Calcium hypochlorite 215.Potassium arsenite
2F-13

Exhibit 2F-5.Hazardous Substances
216.Potassium bichromate 245.Sodium phosphate(dibasic) 271.Uranyl acetate
217.Potassium chromate 246.Sodium phosphate(tribasic) 272.Uranyl nitrate
218.Potassium cyanide 247.Sodium selenite 273.Vanadium penoxide
219.Potassium hydroxide 248.Strongum chromate 274.Vanadyl sulfate
220,Potassium permanganate 249.Strychnine 275.Vinyl acetate
221.Propargite 250.Styrene 276.Vinylidene chloride
222.Propionic acid 251.Sulfuric acid 277.Xylene
223.Propionic anhydride 252.Sulfur monochloride 278.Xylenol
224.Propylene oxide 253.2,4,5-T add(2,4,5-hichlorophenoxyacetic acid) 279.Zinc acetate
225.Pyrethrins 254,2,4,5-T amines(2,4,5-Mchlorophenoxy acetic add 280.Zinc ammonium chloride
226.Quinoline amines) 281.Zinc borate
227.Resorcinol 255.2,4,5-T esters(2,45-trichlorophenoxy acetic acid 282.Zinc bromide
228.Selenium oxide esters) 283.Zinc carbonate
229.Silver nitrate 256.2,4,5-T salts(2,4,5-trichlomphenoxy acetic acid 284.Zinc chloride
230.Sodium salts) 285.Zinc cyanide
231.Sodium arsenate 257.2,4,5-TP acid(2,4,5-trichlorophenoxy propanoic 286.Zinc fluoride
232.Sodium arsenate acid) 287.Zinc formate
233.Sodium bichromate 258.2,4,5-TP add esters(2,4,5-Mchlorophenoxy 288.Zinc hydrosulfite
234.Sodium bifluodde propanoic add esters) 289.Zinc nitrate
235.Sodium bisufflte 259.TDE(tetrachlorodiphenyl ethane) 290.Zinc phenofsulfonate
236.Sodium chromate 260.Tetraethyl lead 291.Zinc phosphide
237.Sodium cyanide 261.Tetraethyl pyrophosphate 292.Zinc silicofluodde
238.Sodium dodecylbenzenesulfonate 262.Thallium sulfate 293.Zinc sulfate
239.Sodium fluoride 263.Toluene 294.Zirconium nitrate
240.Sodium hydrosulfide 264.Toxaphene 295.Zirconium potassium fluoride
241.Sodium hydroxide 265.Tdchlorofon 296.Zirconium sulfate
242.Sodium hypochlorite 266.Trichloroethylene 297.Zirconium tetrachloride
243.Sodium methylate 267.Tdchlorophenol
244.Sodium nitrite 268.TOethanolamine dodecylbenzenesulfonate
269.Triethylamine
270.Trimethylamine
2F-14

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105/19
110055094240 NC5000097 Pentair Water Pool and Spa ]- OMB No.2040-0004
Form U.S Environmental Protection Agency
2F SOV EPA Application for NPDES Permit to Discharge Wastewater
NPDES STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY
LOCATIONr
1.1 Provide information on each of the facilit 's outfalls in the table below
Outfall Receiving Water Name Latitude Longitude
Number
A Little Buffalo Creek 35' 30 16.1d N 79' 10' 314' W
c
0
a B Little Buffalo Creek 35° 30' 18.4t' N 79' 10' 25.6i' W
0
C Little Buffalo Creek 35' 30' 30.3i' N 79° 10' 39.06' W
Q D Little Buffalo Creek 35° 30' 8,816' N 79' 10' 35.16' W
N d W
SECTIONo
••
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 Ht 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 (listoutfall numbers) Source(s)of Discharge
Required Projected
m
r=
d
a
n
E
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 03105119
110055094240 NCS000087 Pentair Water Pool and Spa OMB No.2040.0004
SECTIO 3.SITE D' 1
W 3.1 Have you attached a site drainage map containing all required information to this application?(See instructions for
cm
2 M R specific guidance.)
® Yes ❑ No
SECTIONPOLLUTANT SOURCES1 CFR 122.26(c)(1)(1)(13)) �Ll
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 mile radius of the facility)
specify units specify units
A 287,000 sq ft 600,000 sq-ft
specify units specify units
B 97,500 sq ft 390,000 sq.ft
specify units specify units
C 35,000 sq ft 82,500 sq ft
specify units specify units
D 41,250 sq ft 80,000 sq ft
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.)
Oils,fuels,grease,fiberglass/resin product,paper, plastic pellets,sediments,treated water,diatomaceous earth,
sodium hypochlorite,acetone,salt,particulates,isocyanates,packaging material
0
rn
0
tL
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
A Inspection,Housekeeping,Secondary containment,Enclosed structures,Training,spill kits cc N/A
B Inspection,Housekeeping,Secondary containment,Enclosed structures,Training,spill kits cc N/A
C Inspection,Housekeeping,Secondary containment,Enclosed structures,Training,spill kits cc N/A
D Inspection,Housekeeping,Secondary containment,Enclosed structures,Training,spill kits cc N/A
EPA Form 3510-2F(Revised 3-19) Page 2

EPA Identification Number NPOES Permit Number Facility Name Form Approved 03/05/19
110055094240 NCS000087 Pentair Water Pool and Spa OMB No.2040-0004
SECTION •N STORMWATER r 1
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, l certify that the ouffalls 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
Brian Frost Site Leader
Signature Date signed
Cn 5.2 Provide the testing information requested in the table below.
Outfall Onsite Drainage Points
o Number Description of Testing Method Used Date(s)of Testing Directly Observed
During Test
m
ro
3 A Visual 03/06/2024 Reinforced Concrete Pipe
a
B Visual 03/06/2024 Reinforced Concrete Pipe
0
z
C Visual 03/06/2024 Corrugated Plastic Pipe&
D Visual 03/06/2024 Corrugated Plastic Pipe&
SECTIONOR i r
6.1 Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years.
to
= None
71
co
0
m
m
c
cv
U
.0
Q7
to
SECTIONDISCHARGE INFORMATIONi
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?
o El estimated
4 See instructions regarding submission of ❑ No 4 See instructions regarding submission of
estimated data. actual data.
CD
Tables A,B,C,and D
7.2 Have you completed Table A for each outfall?
�✓ Yes ❑ No
EPA Form 3510-217(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105/19
110055094240 NCS000087 Pentair Water Pool and Spa OMB No.2040-0004
11 7.3 Is the facility subject to an effluent limitation guideline(ELG)or effluent limitations in an NPDES permit for its process
wastewater?
Cl 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 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
Table C?
0
❑ Yes ❑ No
U
0 7.10 Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater?
E ❑ Yes ❑✓ No 4 SKIP to Item 7.12.
.o
7.11 Have you provided quantitative data in Table C for those pollutants in Exhibit 2F-3 that you expect to be discharged in
m concentrations of 10 ppb or greater?
is
` ❑ Yes ❑ 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 ❑✓ 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 ❑ No
j 7.15 Do you know or have reason to believe any pollutants in Exhibit 2F-4 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 3510-21F(Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03105119
110055094240 NCS000087 Pentair Water Pool and Spa OMB No.2040-0004
D Used or Manufactured Toxics
CD
7.18 Is any pollutant listed on Exhibits 2F-2 through 217-4 a substance or a component of a substance used or
manufactured as an intermediate or final product or byproduct?
0
❑ Yes No 4 SKIP to Section 8.
0
7.19 List the pollutants below, including TCDD if applicable.
1. 4. 7.
CD
m` 2. 5. 8.
c�
0 3. 6. 9.
BIOLOGICALSECTION 8. i
8.1 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?
M
0
CD ❑ Yes ✓❑ No 4 SKIP to Section 9.
8.2 Identify the tests and their purposes below.
Test(s) Purpose of Test(s) Submitted to NPDES Date Submitted
x Permitting Authority?
0
~ ❑ Yes ❑ No
�o
U
0 ❑ 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?
l Yes ❑ No 4 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
PACE Analytical Services PACE Analytical Services
o Charlotte Asheville
E
y
O
C
�, Laboratory address 9800 Kincey Avene Suite#100 2225 Riverside Drive
N
Huntersville,NC,28078 Asheville,NC,28804
c
Q
y
(7
o Phone number
v [phone] [phone]
Pollutant(s)analyzed
Oil and Grease Total suspended solids
Total nitrogen calculation
Total kjeldahl nitrogen
Nitrogen,NO2/NO3
Phosphorus,Total
Chemical oxygen demand
EPA Form 3510-2F(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Farm Approved 03105/19
110055094240 NCS000087 Pentair Water Pool and Spa OMB No.2040-0004
SECTION •
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 com fete all sections or provide attachments.
Column 1 Column 2
✓❑ Section 1 ❑ w/attachments(e.g., responses for additional outfalls)
❑ Section 2 ❑ w/attachments
❑ Section 3 21 w/site drainage map
✓❑ Section 4 ❑ w/attachments
❑ Section 5 ❑ w/attachments
❑ Section 6 ❑ w/attachments
❑ Section 7 ❑ Table A ❑ wl small business exemption request
CU
U)
o [ITable B Elwl analytical results as an attachment
✓❑ Table C ❑ Table D
U ❑ Section 8 ❑ wlattachments
✓❑ Section 9 ❑ wlattachments(e.g.,responses for additional contact laboratories or firms)
Y
❑ Section 10 ❑
U
10.2 Certification Statement
1 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
Brian Frost Site Leader
Si Date signed
EPA Form 3510-2F(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
110055094240 NCS000087 Pentair Water Pool and Spa A OMS No.2040-0004
CONVENTIONALTABLE A. •N 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 Flow-Weighted Grab Sample Taken Flow Weighted Events Sampled (new sourcelnew
During First During First dischargers only;use
34 Minutes Composite 34 Minutes Composite codes in instructions)
1. Oil and grease ND ND 1 N/A
2. Biochemical oxygen demand(BODs) N/A N/A NIA N/A N/A N/A
3. Chemical oxygen demand(COD) 31.3 mg/L N/A 31.3 mg/L N/A 1 N/A
4. Total suspended solids(TSS) 91.4 mg/L N/A 91.4 mg/L N/A 1 N/A
5. Total phosphorus 0.077 mg/L N/A 0.077 mg/L N/A 1 N/A
6. Total Kjeldahl nitrogen(TKN) 0.56 mg/L N/A 0.56 mg/L N/A ] N/A
7. Total nitrogen(as N) 1.4 mg/L N/A 1.4 mg/L N/A 1 N/A
pH (minimum) 6.9 s.0 6.9 s.0 1 N/A
6.
pH (maximum) 6.9 s.0 6.9 s.0 1 N/A
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 O.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F(Revised 3-19) Page 7

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EPA Identification Number NPIDE5 Permit Number Facility Name Outfall Number Form Approved 03105/19
110055094240 NCS000087 Pentair Water Pool and Spa A OMB No.2040-0004
TABLE B.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CIFIR 122.26(c)(1)(i)(E)(4)and 40 CFR 122.21(g)(7)(vi)(A))1
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.
Maximum Daily Discharge Average Daily Discharge Source of
(specify units) specify units? Information
Pollutant and CAS Number if available Grab Sam Grab Sam Number of Storm
( ) Sample Taken Flow-Weighted Sample Taken Flow-Weighted Events Sampled (new source/new
During First During First dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
N/A
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

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EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
110055094240 NCS000087 Pentair Water Pool and Spa A 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 2F-2,2F-3, and 2F4 that you know or have reason to believe is present.Complete one table for each outfall. See the instructions for additional
details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
s eci units s eci units Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Grab Sample Taken (new sourcelnew
During First Flow-Weighted During First Flo Composite
Events Sampled dischargers only,use
30 Minutes Composite 30 Minutes Composite codes in instructions)
Oil and Grease ND N/A ND N/A 1 N/A
Phosporus,total 0.077 mg/L N/A 0,077 mg/L N/A 1 N/A
Nitrate-nitrite 0.80 mg/L N/A 0.80 mg/L N/A 1 N/A
Nitrogen,total organic(as N) 1.4 mg/L N/A 1.4 mg/L N/A 1 N/A
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

t This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility name Outfall Number Form Approved 03/05/19
110055094240 NCSO00087 Pentair Water Pool and Spa A OMB No.2040-0004
STORMTABLE D. •' + • 1
Provide data for the storm event(s)that resulted in the maximum daily discharges for the flow-weighted composite sample.
Number of Hours Between
Total Rainfall During Maximum Flow Rate
Date of Storm Event Storm Event During Rain Event
Duration of Storm Event Beginning of Storm Measured and Total Flow from Rain Event
(in hours) End of Previous Measurable Rain (in gallons or specify units)
{in inches} Event (in gpm or specify units)
03/06/2024
7 0.14 >72 hours N/A N/A
Provide a description of the method of flow measurement or estimate.
No flow meters to measure flow rate.
EPA Form 3510-2F(Revised 3-19) Page 13

f3
EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
110055094240 NCS000087 Pentair Water Pool and Spa B OMB No.2040-0004
TABLE A. • • 1 NON CONVENTIONAL1
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
(specifyunits) (specify units) Number of Storm Information
Pollutant or Parameter Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new sourcelnew
During First During First dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
1. Oil and grease 5.5 mg/L 5.5 mg/L 1 N/A
2. Biochemical oxygen demand(BOD5) N/A N/A N/A N/A N/A N/A
3. Chemical oxygen demand(COD) 31.3 mg/L N/A 31.3 mg/L N/A 1 N/A
4. Total suspended solids(TSS) 14.8 mg/L N/A 14.9 mg/L N/A 1 N/A
5. Total phosphorus ND N/A N0 N/A 1 N/A
6. Total Kjeldahl nitrogen(TKN) ND N/A ND N/A 1 N/A
7. Total nitrogen(as N) 0.28 mg/L N/A 0.28 mg/L N/A 1 N/A
pH(minimum) 6.8 s.0 6.8 s.0 1 NIA
s.
pH(maximum) 6.8 S.0 6.8 s.0 1 N/A
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

This page intentionally left blank.

15
EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105I19
110055094240 NC5000087 Pentair Water Pool and Spa B 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))1
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.
Maximum Daily Discharge Average Daily Discharge Source of
s eci units s eci units Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Grab Sample Taken (new sourcelnew
During First Flow-Weighted During First Flow-Weighted Events Sampled dischargers only;use
30 Minutes Composite 3D Minutes Composite codes in instructions)
N/A
1 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

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EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03l05119
110055094240 NCS000087 Pentair Water Pool and Spa B OMB No.204HOO4
TABLE C.TOXIC POLLUTANTS, '!• ! ASBESTOS(40 CFR 122.26(c)(1)(i)(E)(4) •F and
List each pollutant shown in Exhibits 2F-2,2F-3,and 2F4 that you know or have reason to believe is present.Complete one table for each outfall.See the instructions for additional
details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
s eci units s eci units Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Grab Sample Taken (new source/new
During First Flo Composite
Flow-Weighted During First Flow-Weighted Events Sampled dischargers only;use
30 Minutes Composi#e 30 Minutes Composite codes in instructions)
Oil and Grease 5.5 mg/L N/A 5.5 mg/L N/A 1 N/A
Phosporus,total ND N/A ND N/A 1 N/A
Nitrate-nitrite 0.28 mg/L N/A 0.28 mg/L N/A 1 N/A
Nitrogen,totat organic(as N) 0.28 mg/L N/A 0.28 mg/L N/A 1 N/A
' 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

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EPA Identificadon Number NPDES Permit Number Facility name outfall Number Form Approved 03I05119
110055094240 NCS000087 Pentair Water Pool and Spa B OMB No.2040-0004
TABLEI STORM EVENT INFORMATIONi CFR 122.26(c)(1)(i)(E)(6))
Provide data for the storm event(s)that resulted in the maximum daily discharges for the flow-weighted composite sample.
Number of Hours Between
Total Rainfall During Maximum Flow Rate
Date of Storm Event Storm Event During Rain Event
Duration of Storm Event Beginning of Storm Measured and Total Flow from Rain Event
(in hours) End of Previous Measurable Rain {in gallonsorspecityunits)
(in inches) Event (in gpm or sgecify units)
03/06/2024
7 0.14 >72 hours N/A N/A
Provide a description of the method of flow measurement or estimate.
No flow meters to measure flow rate.
EPA Form 3510-2F(Revised 3-19) Pace 13

r,)
EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
110OSS094240 NCS000087 Pentair Water Pool and Spa C OMB No.2040.0004
TABLE A.CONVENTIONAL AND NON • • i
You must provide the results of at least one anal sis for every pollutant in this table. Complete ane 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 Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new sourceinew
During First During First dischargers only,use
30 Minutes Composite 30 Minutes Composite codes in instructions)
1. Oil and grease 5.3 mg/L 5.3 mg/L 1 N/A
2. Biochemical oxygen demand(BODs) N/A N/A N/A N/A N/A N/A
3. Chemical oxygen demand(COD) 35.9 mg/L N/A 35.9 mg/L N/A 1 N/A
4. Total suspended solids(TSS) 45.7 mg/L N/A 45.7 mg/L N/A i N/A
5. Total phosphorus 0.059 mg/L N/A 0.059 mg/L N/A 1 N/A
6. Total Kjeldahl nitrogen(TKN) ND N/A ND N/A 1 N/A
7. Total nitrogen(as N) 0.79 mg/L N/A 0.79 mg/L N/A 1 N/A
pH(minimum) 6.8 s.0 6.8 s.0 i N/A
8.
pH(maximum) 6.8 s.0 6.8 s.0 i N/A
s 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 3610-2F(Revised 3-19) Page 7

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SPA[denGficaGon Number NPDES Permit Number Facility Name Outfalt Number Form Approved U3/05/19
110055094240 NCS000087 Pentair Water Pool and Spa C OMB No.2040-0004
TABLE B.CERTAIN CONVENTIONAL AND NON CONVENTIONAL •• r r
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.
Maximum Daily Discharge Average Daily Discharge Source of
s eci units speci units Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new source/new
During First During First dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
N/A
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

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1-
EPA Identification Number NPOES Permit Number Facility Name Outfall Number Form Approved 03105/19
11GOS5094240 NCS000087 Pentair Water Pool and Spa C OMB No.2040-0004
TABLE C.TOXIC POLLUTANTS,CERTAIN HAZARDOUS SUBSTANCES,AND ASBESTOS(40 CFR 122.26(c)(I)(i)(E)(4)and 40 CFR 122.21(g)(7)(vi)(B)and(vii))'
List each pollutant shown in Exhibits 2F-2,2F-3,and 2F4 that you know or have reason to believe is present.Complete one table for each outfall. See the instructions for additional
details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
s eci units s eci units Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Grab Sample Taken (new source/new
Gomosite
During First Flow-Weighted During First Flow-Weighted Events Sampled dischargers only;use
30 Minutes Composite 30 Minutes p codes in instructions)
Oil and Grease 5.3 mg/L N/A 5.3 mg/L N/A I N/A
Phosporus,total 0.059 mg/L N/A 0.059 mg/L N/A I N/A
Nitrate-nitrite 0.57 mg/L N/A 0.57 mg/L N/A 1 N/A
Nitrogen,total organic(as N) 0.79 mg/L N/A 0.79 mg/L N/A 1 N/A
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

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EPA Identification Number NPOES Permit Number Facility name Outfall Number Form Approved 03/05/19
IIOOSS094240 NCS000087 Pentair Water Pool and Spa C OMB No.2040-0004
STORMTABLE D. O•
Provide data for the storm event(s)that resulted in the maximum daily discharges for the flow-weighted composite sample.
Number of Hours Between
Total Rainfall wring Maximum Flow Rate
Duration of Storm Event Beginning of Storm Measured and Total Flow from Rain Event
Date of Storm Event (in houfs) Storm Event End of Previous Measurable Rain poring Rain Event (in gallons or specify units)
(in inches) Event (in gpm or specify units)
03/06/2024
7 0.14 >72 hours N/A N/A
Provide a description of the method of{low measurement or estimate.
No flow meters to measure flow rate.
EPA Form 3510-2F(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03f05119
110055094240 NCS000087 Pentair Water Pool and Spa D OMB No.2040.0004
TABLE A.CONVENTIONAL AND NON • • 1
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 Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new sourcelnew
During First During first dischargers only,use
30 Minutes Composite 30 Minutes Composite codes in instructions)
1. Oil and grease ND ND i N/A
2. Biochemical oxygen demand(BOD5) N/A N/A N/A N/A N/A N/A
3. Chemical oxygen demand(COD) 38.2 mg/L N/A 38.2 mg/L N/A 1 N/A
4, Total suspended solids(TSS) 17.3 mg/L N/A 17.3 mg/l. N/A 1 N/A
5. Total phosphorus 0.075 mg/L N/A 0.075 mg/L N/A 1 N/A
6. Total Kjeldahl nitrogen (TKN) ND N/A ND N/A 1 NIA
7. Total nitrogen(as N) 0.60 mg/L N/A 0.60 mg/L N/A 1 N/A
pH(minimum) 6.9 s.0 6.9 s.0 1 N/A
8.
pH(maximum) 6.9 s.0 6.9 s.0 1 N/A
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

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EPA Identification Number NPOES Permii Number Facility Name Outfall Number Form Approved 03/05/19
110055094240 NC5000087 Pentair Water Pool and Spa D OMB No.2040-0004
ulgl[flegwmay► I I I a • II rI I . �J
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 NPIDES permit).Complete one table for each outfall.See the instructions for additional details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
speci units s eci units Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Flow-Weighted Drab Sample Taken Flow-Weighted Events Sampled (new source/new
During First During First dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
N/A
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

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S
EPA Identifcaiion Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
110055094240 NCS000087 Pentair Water Pool and Spa D OMB No.2040-0004
TABLE C.TOXIC POLLUTANTS,CERTAIN HAZARDOUS SUBSTANCES,AND ASBESTOS(40 CFR 122.26(c)(1)(i)(E)(4)and 40CFR 122.21(g)(7)(vi)(B)and(vii))'
List each pollutant shown in Exhibits 2F-2,2F-3,and 2F4 that you know or have reason to believe is present.Complete one table for each outfall. See the instructions for additional
details and requirements.
Maximum Daily Discharge Average Daily Discharge Source of
s eci units s eci units Number of Storm Information
Pollutant and CAS Number(if available) Grab Sample Taken Grab Sample Taken (new sourcetnew
During First Flo Composite
Flow-Weighted During First Flo Composite
Events Sampled dischargers only;use
30 Minutes Composite 30 Minutes Composite codes in instructions)
Oil and Grease ND N/A ND N/A 1 N/A
Phosporus,total 0.075 mg/L N/A 0.075 mg/L N/A 1 N/A
Nitrate-nitrite 0.34 mg/L N/A 0.34 mg/L N/A 1 N/A
Nitrogen,total organic(as N) 0.60 mg/L N/A 0,60 mg/L N/A 1 N/A
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 d. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2F(Revised 3.19) Page 11

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EPA Identification Number NPDES Permit Number Facility name Outfall Number Form Approved 03105/19
110055094240 NCS000097 Pentair Water Pool and Spa D OMB No.2040-0004
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 Hours Between
Total Rainfall During Maximum Flow Rate
Duration of Storm Event (in inches) (in gpm or specify units}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 gallons or specify units)
Event
03/06/2024
7 0.14 >72 hours N/A N/A
Provide a description of the method of flow measurement or estimate.
No flow meters to measure flow rate.
EPA Form 3510-2F(Revised 3.19) Page 13

'SECTION C:LOCATION MAP
Permit Rio.NCS000087
T"4
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Pentair Neater
T _ _ Pool and Spa, Inc. r
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Cam ,.
44
I,
Latitude:35'30' 14"N NCS000087 Facility
Longitude:79°10'30"W
County: Lee Pentair Water Pool
and Spa,Inc. Location
Stream Class- C -
'tteceiving Stream:Little Buffalo Creek
,sub-basin:03'-06-11 (Cape Fear River Basin) Not�O SCale f
Part I Page 2 of 2

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0040 \�_
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FIGURE 3: 6ITE MAP FOR P6t�iPAIR W# n MAL AND$r , \�� W°bD'p
April A 2015
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