NCG100079_Representative Outfall Status Initial Request_20260420

FOR AGENCY USE ONLY
Division of Energy, Mineral & Land Resources Date Received
Year Month Day
� Stormwater Program
National Pollutant Discharge Elimination System
Environmental REPRESENTATIVE OUTFALL STATUS (ROS)
Quality REQUEST FORM
If a facility is required to sample multiple discharge locations with very similar storm water discharges, the
permittee may petition the Director for Representative Outfall Status(ROS). DEQ may grant Representative
Outfall Status if storm water discharges from a single outfall are representative of discharges from multiple
outfalls. Approved ROS will reduce the number of outfalls where analytical sampling requirements apply.
If Representative Outfall Status is granted,ALL outfalls are still subject to the qualitative monitoring
requirements of the facility's permit—unless otherwise allowed by the permit(such as NCG020000)and DEQ
approval. The approval letter from DEQ must be kept on site with the facility's Stormwater Pollution
Prevention Plan. The facility must notify DEQ in writing if any changes affect representative status.
For questions, please contact the DEQ Regional Office for your area (see page 3).
(Please print or type)
1) Enter the permit number to which this ROS request applies:
Individual Permit (or) Certificate of Coverage
N C S N C G 1 0 0 0 7 9
2) Facility Information:
Owner/Facility Name Green's Auto Salvage Inc.
Facility Contact Debbie G Lassiter
Street Address 2646 NC Hwy 222 E
City Fremont State ZIP Code 27830
County E-mail Address [e-mail]
Telephone No. 919 242-6154 Fax:
3) List the representative outfall(s) information (attach additional sheets if necessary):
Outfall(s) 002 is representative of Outfall(s) 003
Outfalls' drainage areas have the same or similar activities? x Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? x Yes ❑ No
Outfalls have similar monitoring results? ❑ Yes ❑ No x No data*
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities? ❑ Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? ❑ Yes ❑ No
Outfalls have similar monitoring results? ❑ Yes ❑ No ❑ No data*
Outfall(s) is representative of Outfall(s)
Outfalls' drainage areas have the same or similar activities? ❑ Yes ❑ No
Outfalls' drainage areas contain the same or similar materials? ❑ Yes ❑ No
Outfalls have similar monitoring results? ❑ Yes ❑ No ❑ No data*
*Non-compliance with analytical monitoring prior to this request may prevent ROS approval. Specific
circumstances will be considered by the Regional Office responsible for review.
Page 1 of 3
SWU-ROS-2009 Last revised 12/30/2009

Representative Outfall Status Request
4) Detailed explanation about why the outfalls above should be granted Representative Status:
(Or, attach a letter or narrative to discuss this information.) For example,describe how activities and/or
materials are similar.
The production processes and exposed materials are similar at Outfalls 002 and 003.The determination was made that
Outfalls 002 and 003 will discharge substantially identical effluents.Samples will be collected from Outfall 002,with Outfall 002 serving as
a Representative Discharge for Outfall 003.
5) Certification:
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement,representation,or certification in any application, record,
report, plan,or other document filed or required to be maintained under this Article or a rule implementing this
Article;or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case
under this Article;or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device
or method required to be operated or maintained under this Article or rules of the[Environmental Management]
Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed
ten thousand dollars($10,000).
I hereby request Representative Outfall Status for my NPDES Permit. I understand that ALL outfalls are still
subject to the qualitative monitoring requirements of the permit, unless otherwise allowed by the permit
and regional office approval. I must notify DEQ in writing if any changes to the facility or its operations
take place after ROS is granted that may affect this status. If ROS no longer applies, I understand I must
resume monitoring of all outfalls as specified in my NPDES permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete,and accurate.
Printed Name of Person Signing: Debbie 0 Lassiter
Title: Owner/Manager
1)-M6
(Signature of Applicant) (Date Signed)
Please note: This application for Representative Outfall Status is subject to
approval by the NCDEQ Regional Office. The Regional Office may inspect your
facility for compliance with the conditions of the permit prior to that approval.
Final Checklist for ROS Request
This application should include the following items:
❑ This completed form.
❑ Letter or narrative elaborating on the reasons why specified outfalls should be granted representative
status, unless all information can be included in Question 4.
❑ Two(2) copies of a site map of the facility with the location of all outfalls clearly marked, including the
drainage areas, industrial activities, and raw materials/finished products within each drainage area.
❑ Summary of results from monitoring conducted at the outfalls listed in Question 3.
El Any other supporting documentation.
Page 2 of 3
SWU-ROS-2009 Last revised 12/30/2009

0
_ _ _ _ /
a
N -
N L 3n 3n 3n 3n I
a 0 Ix m m m m m m M m T m m
o E E min-
O G N O G m O G m I r n
X:. — Ill c m o m C m c x I I
mZ f n m �,,O N �,,O m m 0 N I I I
I—
Ill A T A T N T L J r /
m
Z n m n� n, or D -Z m n n co cno z
L 0 m� m� m o m m n D OL F A m Z <
- CO en CO No A m G m o mn =
XOC m Z 1 1 r r m z n� D
�aZ Z 0 0 0 z o 0 m0 X M D 03 TI. N N D N W D A T D W A C m D A Z m D G
�, _ e r N N r O r O T z m Z O D _1 r
� 07 � Z Z o D m C �
CO n
D
0 I—
I
* m 0D. m
i c) cnc)
m m Z 0 F
j z ri5i v
0o G) mm = n
D m _ w I
z D m `2z I
2 s D
73 0 x z
N y TI, rn
3 m D z g
r-� X X X
z A 1- 0 * r•
D oZ -I
m CO � �' � x :♦ D D x
v
2 Z x ♦♦�• z cn
iD I♦♦ Z
m 0 C
m m = I1: z x
Dom cn
xSiD I
Dm xj ml ��
v I♦ � *1 I
• I
♦
♦♦ D
1>
X X '♦ -1
m - - -X r X -1
- -
Z I N CC)
O 6 _ I D
Z xzD73
() zA I cn
z
_
Z O m ,\ - y
Oc
c m
O D cn v ^'
m
D N n Ncn
= r Z v �
U
m
\xc n c`n m —
m - I Ir-1
r v �z
Z pl r II I C cn
Z Dc NAid: - 1�� DDD • x0 0 ��� ; A A "
nZ
i'latt, ki,
A D r- , to I
ID
o
D. ���♦�♦♦� N \ m z l
7i I ( O \ ♦♦♦♦ \ \ C
x� N� › `,♦♦♦♦♦♦♦♦♦ \
X -TII-- ----- ,N.r1\-. ` 1 1- 1- 0) 0) 0
V01
Z 0 r2 o30, N0o
ea to 0 O
N A D ao -. N -1
it Z
0 m 0
- o >z 3 m GI N
m
0 0 cD co0
-I m I- m D *
m m cz z _1
v � DCm = x
D
r 7JmD
o Z m -<
N 0 v
N 0
N m
D Z N C
r = E x
0 5Fr
m = mD
m * cnX
N 0 � Dcn
Gill) I
r Nam
m "
/� w
W
N a)

HIGHWAY 222
�� DITCH
MAIN GATE 7 GATE X X X GATE X X
SITE OUTFALL 003 SHEET FLOW
1.2 MILES x SIC CODE 5015 x 35°33.027
WEST LAT:35.549097°N 77°51.881
LONG:-77.865777°W
DETAIL-
SEE FIGURE 35°32.960
2 77°51.958
MISC.TRUCK MISC.TRUCK x
x PARTS AND PARTS AND
SCRAP SCRAP
HEAVILY
VEGETATED x
AREA
x
/ \
/
/
/ x
x
/(/
MISC.TRUCK
PARTS AND
SCRAP /
/ 0 MISC.TRUCK
/ / PARTS AND
SCRAP
/
x
x /
/ ADJACENT
AGRICULTURAL
MISC.TRUCK
PARTS AND
SCRAP
/ x
x
x
MISC.TRUCK
PARTS AND MISC.TRUCK
SCRAP PARTS AND
x /
SCRAP
/ \ x
/ \ 0 O i r 1 LEGEND
© u : STORAGE . DIRECTION OF
I SURFACE RUNOFF
>` MISC.TRUCK 1 . UNDER SHED
PARTS AND © BUILDING
HEAVILY SCRAP INSIDE
VEGETATED BATTERY STO IDEA --
/ _ ',� x L__J COVERED AREA
AREA STORAGE NM �_��������
�����.� 1
r-_J cm SECONDARY
L _ CONTAINMENT
SILT FENCING& ©O 0 WASTE OIL
x GROUND MATT HEATER ASPHALT
MISC.TRUCK
PARTS AND WORK AREA
SCRAP AND 35°32.824 x CONCRETE
X X STAGING 77°51.588
DRAINAGE
35°3 .744 I BOUNDARY
77°51.697 OUTFALL 002 MISC.TRUCK X FENCE LINE
SAMPLE POINT PARTS AND UNDERGROUND
SIC CODE 5015 SCRAP H HPIPE
LAT:35.545444°N
LONG:-77.861583°W HEAVILY
TOTAL
VEGETATED
ACRES 46
AREA IMPERVIOUS 30%
OUTFALL 001
(FIGURE 2;6 ACRES TOTAL)
TO WATERY ACRES 6
BRANCH FACILITY HAS NON-STORMWATER DISCHARGE 1 1,000-GALLON TANK USED OIL IMPERVIOUS 40%
ASSOCIATED WITH A/C CONDENSATE IN THE 2 150-GALLON TANK USED OIL
DRAINAGE AREA OF OUTFALL 001. OUTFALL 002
3 150-GALLON TANK ANTIFREEZE (FIGURE 3;40 ACRES TOTAL)
4 2x330-GALLON TOTES ANTIFREEZE ACRES 35
RECEIVING WATER IS WATERY BRANCH. IMPERVIOUS 25%
5 250-GALLON TANK DIESEL
WATERY BRANCH IS NOT IMPAIRED. 6 6x55-GALLON DRUMS DIESEL OUTFALL 003
7 150-GALLON TANK GASOLINE ACRESURE 3;40 ACRES TOT5L)
8 5x275-GALLON TOTES USED OIL IMPERVIOUS 25%
JAMES ENVIRONMENTAL SITE PLAN N.T.S. 172-186
MANAGEMENT, INC. ti
GREEN'S AUTO SALVAGE, INC. DD FIG 3
12600 HILL COUNTRY BLVD.
STE. R-130, #148 FREMONT, NORTH CAROLINA 02/26
Google Verified AUSTIN, TX 78738