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HomeMy WebLinkAboutNCG030661_MONITORING INFO_20190318STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. (/ (o' DOC TYPE ❑HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ c) YYYYMMDD 0 Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000 Date submitted 315119 CERTIFICATE OF COVERAGE NO. NCG03 0 6 6 1 FACILITY NAME Matiab, Inc. -Plant 16 COUNTY Guilford PERSON COLLECTING SAMPLES Tait Williams RE E I E D LABORATORY Con -test Lab Cert. # 652 Comments on sample collection or analysis: MAR 16 niq 1"r:'"TRAL FILE CWR SI✓CTIO P Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD [E]Jan-June ❑ July -Dec or ❑ Monthly' month DISCHARGING TO CLASS ❑ORW ❑HC+iW [—]Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ❑Other PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 � n No discharge this period?2 Qutfall No. Date Sample Collected' (mo/dd/yr) 24=hour rainfall amount, Inches3 Total Suspended Solids pH; `Standard units Total Copper: Total Lead Total Zinc Non-Polar.0&G/ Total Petroleum Hydrocarbons Total Toxic Organics Benchmarks _ - 100 mg/L or 50 mg/O 6.0=9.0 0:010 mg/L 0.075 mg/L 0.126 mg/L 15 mg/L 1. mg/L Parameter Code - 46529 C0530 00400 01119:' 01051 01094 00552 78141 01 2/21/19 0.83 7.6 6.8 0.0041 0.0055 0.076 1.0 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies. s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date.11/1/2018-05/31/2021 5WU-245, last revised 11/1/2018 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring - may -be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), 1 certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Pri Signature Date Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collectedl (mo/dd/yr) 24-hour rainfall amount, Inches} New Motor Oil or. Hydraulic oil Usage, Non -Polar O&G/.Total- Petroleum Hydrocarbons Total Suspended .Solids Benchmarks - - - 15 mg/L 100 mg/L or 50.mg/L° 'Parameter Code. - 46529 NCOIL 00552 C0530 Footnotes from Part A also apply to Part B Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018 Page 2 of 3 FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original c9RV of this DMIi, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case o "No Discharge" Marts) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete am aware that ther nifi penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature of Permittee Date Permit Date: 11/1/2018-0./31/2021 SWU-245, last revised 11/1/2018 Page 3 of 3 RAIN EVENT DATA FACILITY: Matlab. Inc. — Plant #16 ADDRESS: 3010 Executive Drive Greensboro, NC 27206 CONTACT PERSON; Press Bower TELEPHONE: 336- 629-4161 STORM EVENT INFORMATION, ' DATE YEAR MONTH DAY 19 2 21 HOURS MINUTES DURATION 144 0 PRECIP. AMOUNT (IN.) .83 RUNOFF VOL. M/.GAL. DAYS HOURS PRECEDING EVENT 3 0 rS�C IhL� fwr i ,j t �'.*i �" r ; . 4 y.,r T o PRINCIPLE EXECUTIVE*OFFICER,;O%U, THORIZEDAGEN1-'" t��s��w •�� - . :,�. .� i .�.�'.�r��yi' a �' r f� ��• �i. _, � � .r � , PRINT SIGNATURE DATE Paul W. Spangenberg �09W 009f 2/21/19 43560 x 5 = 261360 x 0.83 = 216928.8 x 0.0833=18070.1 x 7.48 = 135164.8 / 0.13 MIGal. STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certification of Coverage No.: Facility Name: County: Permit No: NCG0300661 Matlab, Inc. — Plant ##16 Guilford Expires: 5/31/2021 Greensboro, North Carolina Inspector Name: Date of Inspection: Tait Williams 2121/19 OUTFALL DESCRIPTION Outfall No.: Structure (pipe, ditch, etc.): Receiving Stream: 1 Pipe Buffalo Creek Describe the industrial activities that occur within the outfall drainage area: Painting & Coating Manufacturing Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Brown Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak chlorine odor, etc.): None Clarity, Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy (circle one): 1 O 3 4 5 6 7 8 9 10 Floating Solids, Choose the number which best describes the amount of floating solids in the stormwater discharge where 1 is no solids and 10 is the surface is covered in floating solids (circle one): O2 3 4 5 6 7 8 9 10 Suspended Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10 is extremely muddy (circle one): 1 O 3 4 5 6 7 8 9 10 Foam Is there any foam in the stormwater discharge (circle one)?: Yes N Oil Sheen Is there an oil sheen in the stormwater discharge (circle one)?: Yes No --Erosion De osition .: Is there evidence of erosion or deposition at the outfall? (circle one): Yes No If yes, list and describe: Other Is there other obvious indicators of stormwater pollution in the stormwater discharge (circle one): Yes No If yes, list and describe: Rain'Eiient'��, �..'�,'�'T..: �'1 l.�. 1 Y;.Y .'� is .� •17 .'�'r , h_ �. -Rain Was this a Representative Storm Event? X Yes _ No Total Event Precipitation (Inches). 0.83 A measurable storm event is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. 1 > Certificatidn i 1 zar�"!.� z� .i i ►_ By this signature I certify that this report is accurate and complete to the best of my knowledge: Inspector's Signature: T1VIKI W STORMWATER FACILITY INSPECTION FORM Facility Name: Location: Certification of Coverage No.:N00030661 Matlab, Inc. — Plant #16 Greensboro, North Carolina Expires: 5/31/2021 Number of Inspector's Name: Date: Outfalls: 1 Tait Williams 2121/19 Con ' tin 'Areas Evidence of pollutants entering system (circle one): Yes No If yes, describe: Areas of potential pollutants entering system: Describe: None Control measures present (circle one): Yes No If yes, describe: Additional control measures needed (circle one): Yes No If yes, describe: Sediment and erosion control measures present (circle one): es No If yes, describe: Rie-Rap at discharge and drainages ditches Describe any new structural stormwater management measures: None Potential Pollutant•Areas° Describe any loading/unloading operations: Trucking Describe any outdoor storage activities: Wood Pallets, Scrap Metal, Solid waste dumpsters, used equipment Describe any outdoor manufacturing or processing activities: None Describe and dust or particulate generating areas: None Describe any onsite waste disposal activities: None Significant L ks or Spills Any reportable spills or leaks in the past year (circle one): Yes No If yes, date: Impact on stormwater system(s): Certification i By this signature I certify that this report is accurate and complete to the best of my knowledge: Inspector's Signature: / cUt AIWK rrs Table of Contents c 0 n,!.- t. e S t ANALYTICAL LABORATORY 39 Spruce Street' East Longmeadow, NIA 01028 - FAX 4131525.6405' TEL. 413/525-2332 March 1, 2019 PaulSpangenberg Mid -Atlantic Associates, Inc. - Raleigh, NC 409 Rogers View Court Raleigh, NC 27610 Project Location: Plant 16-Greensboro, NC Client Job Number: Project Number: R2943.10 Laboratory Work Order Number: 19B 1031 Enclosed are results of analyses for samples received by the laboratory on February 21, 2019, If you have any questions concerning this report, please feel free to contact me. Sincerely, Kerry K. McGee Project Manager L Page 1 of 14 Table of Contents Table of Contents Sample Summary Case Narrative Sample Results 19B 103 1 -01 Sample Preparation Information QC Data Metals Analyses (Total) B224481 Conventional Chemistry Parameters by EPA/APHA/SW-846 Methods (Total) B224255 B224383 B224458 Flag/Qualifier Summary Certifications Chain of Custody/Sample Receipt 3 4 5 5 7 8 8 9 9 9 9 10 11 12 Page 2 of = Table of Contents con - to , ANALYTICAL LABORATORY 39 Spruce Street' East Longmeadow, MA 01028' FAX 4131525-8405' TEL. 4131525-2332 Mid-Adantic Associates, Inc. - Raleigh, NC 409 Rogers View Court REPORT DATE: 3/ 112019 Raleigh, NC 27610 PURCHASE ORDER NUMBER: ATTN: Paul Spangcnbcrg PROJECT NUMBER: R2943.10 ANALYTICAL SUMMARY WORK ORDER NUMBER: 1913 1031 The results ofanolyses performed on the following samples submitted to the CON -TEST Analytical Laboratory are found in this report. PROJECT LOCATION: Plant 16-Grcrmsboro, NC FIELD SAMPLE 9 LAB ID: MATRIX SAMPLE DESCRIPTION TEST SUB LAB I 19B1031-01 Water EPA I664B SM21-22 2540D SM21-22 4500 H B S W-946 6020E Page 3 of 14 A Table of Contents con-lesto do ANALYTICAL LABORATORY 39 Spruce Street' East Longmeadow, MA 01028' FAX 4131525-6405' TEL. 4131525-2332 CASE NARRATIVE SUMMARY All repotted results are within defined laboratory quality control objectives unless listed below or otherwise qualified in this report. SM21-22 4500 M B Qualifications: M-05 Holding time was exceeded, pH analysis should be performed immediately at time of sampling. Nominal 15 minute holding time was exceeded. Anstyte & Samples(s) Qualified: pll 19131031-0111] The results of analyses reported only relate to samples submitted to the Con -Test Analytical laboratory for testing. I certify that the analyses listed above, unless specifically listed as subcontracted, ifany, were performed under my direction according to the approved methodologies listed in this document, and that based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is. to the best of my knowledge and belief, accurate and complete. Tod E. Kopyscinski Laboratory Director Page 4 of 14 ,+oTable of Contents -tlest ANALYTICAL LABORATORY 39 Spruce Street' East Longmeadow, MA 01028 ' FAX 4131525-6405 . TEL, 4131525-2332 Project Location: Plant 16-Greensboro, NC Sample Description: Work Order: 19H 1031 Date Received: 2/21/2019 Field Sample N; 1 Sample ID: 19HI031-01 Start DaterFune: 2f212019 8:20:OOAM Sample Matrix: Water Stoo DateTtme: 2212019 8:30DOAM Metals Analyses (Total) Date Date/Time Analyte Results RL DL Units Dilution FlawQual Method Prepared Analyzed Analyst Copper 4.1 5.0 0.90 ugfL I J SW 946 6020B 226119 2/27119 10:25 MJH Lead 0 1.4 1.0 0.24 µ IL 1 SW-8466020B 226/19 227/1910:25 MJH Zinc 76 10 4.9 119/L 1 SW-946602013 226/19 2127/191025 MJH U, o `7 6 Page 5 of 94 Table of Contents comete-sto ANALYTICAL LABORATORY 39 Spruce Street' East Longmeadow, MA 01028' FAX 4131525-6405' TEL. 413/5252332 Project Location: Plant 16-OTeensboro, NC Sample Desorption: Work Order: 19B 1031 Date Received: 2/2112019 Field Sample #: 1 Sample ID: 19B1031-01 Start Date/Time: 2/21/2019 8:20:00AM Sample Matrix: Water Slop_ Daleffime:_ 2/21/20198:30:00AM Conventional Chemistry Parameters by EPAIAPHAISW-846 Methods (Total) Date DateMme Analyte Results RL DL Units Dilution Fhtg/Qual Method Prepared Analyzed Analyst PH @17,4°C 6,8 PH Units I H-05 SM21-22 45OG H 1] 2123/19 2123/19 13:50 AIA Total Suspended Solids 7.6 2.0 L2 m8/L I SM21-22 2540D 2/26/19 V26/19 18:47 LL Oil & Grease (HEM) 1.0 1.4 0.99 mg/L I 1 EPA 1664B 2/26119 2126/19 13:25 LL Page 6 of 14 Table of Contents ANALYTICAL LABORATORY 39 Spruce Street' East Longmeadow, MA 01028 ' FAX 4131525-6405 ' TEL. 413/525-2332 Sample Extraction Data Lab Number lFicld IDl Batch initial ImL] Date 1981031-01 [1] B224393 1000 02126/19 SM21-22 2540D Lab Number [Field IDS Batch Initial [mLl Date 19BID31-0111] , B22445e 250 02/26/19 SM21-224500 H B Lab Number jField IDl Batch Initial ]mLl Date 19B1031-01 [1] B224255 50.0 02r23119 Prep Method: SW-846 JWA-SW446 60200 Lab Number I Field ID] Batch Initial [mL] Foul lmLl Date 19BI031-01[1] B2244RI 50,0 50,0 02n6119 Page 7 of 14 Table of Contents com-Acsto ANALYTICAL LABORATORY 39 spruce Street' East Longmeadow, MA 01028' FAX 413/525-8405' TEL. 4131525-2332 QUALITY CONTROL Metals Analyses (Total) - Quality Control Rtpo—g Spike Source %REC RPD Analyze Result Limit Units Level Result %REC Limits RPD Limit Notcs Batch EU24481 - SW4146 3005A Blank (B224481-BLKi) Prepared; 0226119 Analyzed: 0227/19 Copper ND 5.0 P8f- Lead ND 1.0 µg1L Zinc ND 10 µg/L LCS(131224481-11SI) Prepared:0226/19 Analyzed:02/27/19 Copper 1000 50 µg/L 1000 t00 80-120 lead 504 t0 µRIL 500 101 M120 Zinc 1040 100 Pg/L 1000 104 80-120 LCS Dup (B224481-BS131) Prepared: 0226/19 Analyzed: 02127/19 Copper 1020 50 µg1L 1000 102 80-120 1.88 20 Lead 511 10 11SIC, 500 102 80-120 1.42 20 Zinc 1040 100 µg/L 1000 )04 80-120 0.349 20 Duplicate(11224481-DUPI) Source: 19RIO31-01 Prepared: 0226119 Analyzed:02127/19 Copper 4.08 3.0 WIL 4.11 0.789 20 1 Lead 1.37 1.0 WL 1.37 0.0750 20 Zinc 76.5 10 pg/L 76.2 0.393 20 Matrix Spike(B224481-MSI) Source: 19B1031-01 Prepared:0226/19 Analyzed:0227/19 Copper 1010 50 Pgn- 1000 ND 101 75-125 Lead 500 10 µglL 500 ND 102 75-125 Zinc 1150 101) Pg/L 1000 76,2 108 75-125 Page 8 of 14 �j Table of Contents co➢ it-Aesto ANALYTICAL LABORATORY 39 Spruce Street ' East Longmeadow, MA 01028 ' FAX 4131525- 405 ' TEL. 4131525-2332 QUALITY CONTROL Conventional Chemis" Parameters by EPAIAPHA/SW4146 Methods (Total) - QuaNw Coatmi Reporting Spike Source %REC RPD Anaiyte Result Limit Units Level Result %REC Limits RPD Limit Dotes Batch B224255 - SM21-22 4500 H B LCS (B224255-BSI) Prepared & Analyzed: 02/23/19 pH 6.02 pH Units 6,00 100 90.110 Batch B224393 - EPA 1664B Blank (B22d393-BLKI) Prepared & Analyzed: 02/26/19 Oil & Grease (HFM) ND 14 mg/L Blank (8224383-BLK2) Prepared & Analyzed: 0226/19 Oil & Grease (HEM) ND 28 -911- LCS (B224383-BSI) Prepared & Analyzed: 0226/19 Oil & Grease (HFM) 19 mg/L 20.0 93,0 78-114 LCS (B224383-BS2) Prepared & Analyzed: 0226/19 Oil & Grease (HEM) 410 OWL 400 103 78-114 Batch 8224458 - SM21-22 2540D Blank (B2244.%BLKI) Prepared & Analyzed: 0226119 Total Suspended Solids ND 2.5 m9/1. LCS (B22445&BS 1) Prepared & Analyzed: 0226/ 19 Total Suspended Solids 162 10 mg/L 200 81.0 64.3-117 Page 9 of 14 ' � �Si 1 f f � •� �_ .� �[ � -• r 1 s Table of Contents con-A-esto ANALYTICAL LABORATORY 39 Spruce Street' East Longmeadow, MA 01028' FAX 4131525-6405' TEL, 4131525.2332 FLAGMUALIFIER SUMMARY • QC result is outside ofcstablished limits. ? Wide recovery limits established for difficult compound. $ Wide RPD limits established for difficult compound. W Data exceeded client recommended or regulatory level ND Not Detected RL Reporting Limit is at the level ofquantitation (LOQ) DL Detection Limit is the lower limit of detection determined by the MDL study MCL Maximum Contaminanl Level Percent recoveries and relative percent differences (RPDs) are determined by the software using values in the calculation which have not beat rounded. No results have been blank subtracted unless specified in the case narrative section. H-05 Holding time was exceeded. pH analysis should be performed immediately at time of sampling. Nominal 15 minute holding time was exceeded. J Detected but below the Reporting Limit (lowest calibration standard); therefore. result is an estimated conccnimtion (CLP J-Flag). Page 10 of 14 con.�--testo ANALYTICAL LABORATORY Table of Contents 39 Spruce Street' East Longmeadow, AAA 01028' FAX 4131525.6405TEL, 413/525-2332 CERTIFICATIONS Certified Analyses included in this Report Analyte Certifications EPA 1664E In R titer Oil & Grease (HEM) C'f,MA,NH,NY,Ri,NC,ME VA SM21-22 25I0D in Water Total Suspended Solids CTMA,NH,NY,RI,NC,ME,VA SM21-22 45001/ 9 in Water PH Cr MA,R1 SW-946 6020H in Warm Copper CC,NH,NY,ME, VA NC Lead C-Mi.NY,ME,VA,NC Zinc CT,NH,NY,ME,VA NC The CON -TEST Environmental Laboratory operates under the following certifications and accreditation: Code Description Number Expires AIHA AIHA-LAP,LLC- ISO] 7025:2005 1OW33 03/l/2020 MA MassachusettsDEP M-MA100 06/30/2019 CT Connecticut Department of Publile Health PH-0567 09/30/2019 NY New York State Department of Health 10899 NELAP 041112019 NH-S New Hampshire Eavironmental Lab 2516 NELAP 02/5/2020 Rl Rhode Island Department of Health LAO00112 12/30/2019 NC North Carolina Div, of Water Quality 652 12/31/2019 NJ New Jersey DEP MA007 NELAP 06/30/2019 FL Florida Department of Health E871027 NELAP 06/30/2019 VT Vermont Department of Health Lead Laboratory LL015036 07/30/2019 ME State of Maine 2011 D28 06/912019 VA Commonwealth of Virginia 460217 12/14/2019 NH-P New Hampshire Environmental Lab 2357 NELAP 0916/2019 V-r-DW Vermont Department of Health Drinking Water VT-255716 06/12/2019 NC-DW North Carolina Department of Health 25703 07/31/2019 Page 11 of 14 �(7\�n 1 MW Y yal W CKAIN OF CUSTODY1•r (North Carolina) z #- n.�n - ;ieques�edutUiriaraund »p „`�.1� 7iet�e k" r ■. ■ GariipartyNaiilet"+ iW':Mid _ AtkapAk A= far . �4 rrrF� (5 _��•,^���}��.RIILiI' � YEI RCQlfIT4'd � meµ. 1 rF ■ Other;!CLP Like Data s. ExcEL ■ ■ ..� invoice Recipient psDangenb-e.` .t MV �..c10."'ira�.��`57rk��.�-w•,"�'��:3e:a'°3�.4i `+`y '� �.'.3ti��Ls�i-1�.,.fti�'�..�'.LY�.x�l.�'��n'y�71���hi5u N� t�i'�s"t�.� 'ISr ra�-wiAian�or. tecefved sfgnature) s, tetirqu . (sfgnat tecetved by; (signature) fished tr. (signaU sv ;O LD iced by: (signature) A Z. Dat Project Entity DatelTfrCl 1 ❑ GWPc SWSL Imse MCC Ga+remment Federal Doc 9 379 Rev 1 U)242017 39 Spruce Street page _7_ of —1_ fast Longmeadow, MA 01029 a of Container& r Presenation Code nl�t�-''Ina�� L Please use the following codes to indicate possible sample concentration within the Cane Code column above; H - High; M - Medium; L - Low; C - clean; U - Unknown (wa-m— Wdormatim DSG ❑ 115TFrre st Fund SW5 Landfill ❑ REC IHSB Orphaned Landfilt State Lead Other. ❑ municipality ❑ Brownfield ❑ Schooi ❑ amnauwam ❑ AM-W,UC PCB ONLY tT © Sa Net tD ❑ Non SozMet 0 C7 O 3 .w (D N 2/22/2019 Track your package or shipment with FedEx Tracking KEXtl; 411359783405� Delivered Friday 2/22/2019 at 9.05 am DELIVERED Signed for by: B.BECCA GET STATUS UPDATES OBTAIN PROOF OF DELIVERY FROM TO Raleigh, NC US East Longmeadow, MA US Shipment Facts TRACKING NUMBER SERVICE WEIGHT 411359783405 FedEx Priority Overnight 25 lbs / 11,34 kgs DELIVERED TO TOTAL PIECES TOTAL SHIPMENT WEIGHT Shipping/Receiving 1 25 Ibs / 11.34 kgs TERMS PACKAGING SPECIAL HANDLING SECTION Third Party Your Packaging Deliver Weekday, Additional Handling Surcharge STANDARD TRANSIT SHIP DATE ACTUAL DELIVERY 0 v Fri 2/22/2019 9:05 am 2/22/2019 by 10:30 am Thu 2/21 /2019 Travel History Friday, 2/22/2019 9 05 am East Longmeadow, MA Delivered 8 08 am W INDSOR LOCKS, CT On FedEx vehicle For delivery 7:58 am WINDSOR LOCKS, CT At bCal FedEx facl* 5:46 am EAST GRANRY, CT At deminatien sore f66my 4:19 am INDIANAPOLIS, IN Departed FedEx location httpsJlwww.fedex,Corn/apWodextradd7action=track&tracknumbers=411359783405&iM*ie�n_U5&Cntryoade-us Local Scan Time Table of Contents Page 13 of 14 Table of Contents 1 Have Not Confirmed Sample Container Numbers With Lab Staff Before Relinquishing Over Samples CARD IN em tc-=E'=� Ir Af�[gLlf�'ICAL. l..gBORA'i-ORY I:: ' ........ ::.:.:.::. ::.:::::::.:.:>.Doc# 2?T.: R�av417; ................ Login Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False Statement will be brought to the attention of the Client - State True or False Client M i 4 c Received By Date 1101 Time How were the samples In CoD1er j-- No Cooler On Ice T` No Ice received? Direct from Sampling Ambient Melted Ice Were samples within By Gun # ! Actual Temp -, j Temperature? 2-6'C By Blank # Actual Temp - Was Custody Seal Intact? �_ Were Samples Tampered with? /V-4-_ Was COG Relinquished ? -r Does Chain Agree With Samples? -r- Are there brokenfleaking/loose caps on any samples? Is COG in ink/ Legible? --- Were samples received within holding time? -7-- Did COC include all Client -1-- Analysis --,_ Sampler Name � pertinent Information? Project �- ID's 7 Collection DateslTimes i- Are Sample labels filled out and legible? Are there Lab to Filters? Who was noted? Are there Rushes? A Who was notified? Are there Short Holds? _ Who was notified? Is there enough Volume? T is there Headspace where applicable? �^ MSIMSng �� Proper MedWContainers Used? I- I Is splitting sam es required? Were trip blanks received? a On COG? Do all samples have the proper pH? Acid Base Un 1 Liter Amb. 500 mL Amb. 1 Liter Plastic 16 oz Amb. HCL- 500 mL Plastic 8oz AmblClear Meoh- 250 mL Amb. 250 mL Plastic 4az AmblGear Bisulfate- FlashDoint ColdBacteria 2oz AmblGear rozen: Un - 1 Liter Amb. 1 Liter Plastic 16 oz Amb. HCL- 500 mL Amb. 500 mL Plastic 8oz Amb/Clear Meoh- 250 mL Amb. 250 mL Plastic 4oz Amb/Clear Bisulfate- Col./Bacteria Flashpoint 2oz Amb/Clear DI- Other Plastic Other Glass Encore Thiosulfate- SOC Kit Plastic Bao Frozen: Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 11/29/18 CERTIFICATE OF COVERAGE NO. NCG030661 SAMPLE COLLECTION YEAR 2018 FACILITY NAME Matlab — Plant #16 SAMPLE PERIOD ❑ Jan -June ® July -Dec COUNTY Guilford or � ����1����J[ ISCHARGlNGTO❑CLASS Monthly" (month) PERSON COLLECTING SAMPLES Tait Williams ❑ORW ❑HQW []Trout ❑PNA LABORATORY Prism Lab Cert. # 402 JAN 0 2 2019 ❑Zero -flaw ❑Water Supply ❑SA Comments on sample collection or analysis: ®Other CENTRAL FILES ulvvR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 Part A: Stormwater Benchmarks and Monitoring Results n No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches' Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics Benchmarks ===> - - 100 mg/L or 50 mg/L" 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 11/13/18 .4 7.0 7 0 0 0.063 0 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. " See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Pagel of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Print 16 z�� (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mgL", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier2, or Tier responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. No discharge this period?' Outfall No. pate Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ==_> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are s' ficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." 12 .3 ff (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 (Date) SWU-245, last revised 10/25/2012 Page 3 of 3 RAIN EVENT DATA FACILITY: Matlab, Inc. — Plant #16 ADDRESS: 3010 Executive Drive Greensboro, NC 27206 CONTACT PERSON: Press Bower TELEPHONE: 336- 629-4161 ljr,�H"y..Y •}yw 1` � 1µ r� 1 3'.1�� �,,, +h:r?S y�J^^��.. i ' ��i�F ,,��''n -i,�+ �knra:.�: �uu�,:.'�e' �=;.°�r.��'r..�.rti�s.�'-�`-.a�t�l.i'�.$ru'.C......�k..�L..-n_.:_r,k.`i.�5�C 3�.T i+��.ft }):.�€��!�AY•r�IrZ r �6 r'�� -yr'-� ��' Ii'�- J�K .S�?'-�� h• � N4 h`i r� 1 Fu� lf'�� ._�k. i ^ 'i.usw�u•'3�N1_�rtjly�S.��{rgy :�.h1.,N.:�'�{�_L�=.._•a,� rh'r). .N _fs+ 1T',_�"�__—..x__q_.k FBAs .._,_.�.� *"r'3i. -4� ��$�y'�7 his �."':Y �� ? hA }Y! 5 ( N �F n Yt rl ,rf'�,�.Ljyr/y�wi.� r� 8.�."��..L.e.�.�k7?�LI�iS�,'�Pfs�S:�7_ .wn �s."�.`4._j'�'�'�{��,��ly,�.' i ■ . AMOUNT (IN.) RUNOFF HOURS PRECEDING EVENT 1 L 11/13/18 43560 x 5 = 261360 x .4 = 104544 x 0.0833 =8708 x 7.48 = 65139 / 1000000 = 0.65 MIGal. STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certification of Coverage No.: I Facility Name: County: Permit No: NCG0300661 Matlab, Inc. — Plant #16 Guilford Expires: 513112021 Greensboro, North Carolina Inspector Name: Date of Inspection: Paul W. Spangenberg 11/13/18 ou FALL -�DESCRIPTION Outfall No.: Structure (pipe, ditch, etc.): Receiving Stream: I Pipe Buffalo Creek Describe the industrial activities that occur within the outfall drainage area: Painting& Coating Manufacturing P -'P AE Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Brown Z, Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak chlorine odor, etc.): None Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy (circle one): O2 3 4 5 6 7 8 9 10 F I datkig! Sol Choose the number which best describes the amount of floating solids in the stormwater discharge where 1 is no solids and 10 is the surface is covered in floating solids (circle one): 1 3 4 5 6 7 8 9 10 4— us Choose the number which best describes the amount of suspended solids in the stormwater discharge where I is no solids and 10 is extremely muddy (circle one): 1 3 4 5 6 7 8 9 10 Ri 1; F i D' a m Is there any foam in the stormwater discharge (circle one)?: Yes Is there an oil sheen in the stormwater discharge (circle one)?: Yes No E r6is j 6 h,,r Ddpo 9 1 t 16-ft Is there evidence of erosion or deposition at the outfall? (circle one): Yes No If yes, list and describe: L.�� -a Is there other obvious Indicators of stormwater pollution In the stormwater discharge (circle one): Yes No If yes, list and describe: 1;Z X Was this a Representative Storm Event? X Yes — No Total Event Precipitation (Inchesh..4 A measurable storm event is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. By this signature I certify that this report is accurate and complete to the best of my knowledge: Inspector's Signature: ;Dmd 20. STORMWATER FACILITY INSPECTION FORM Facility Name: Location; Certification of Coverage No.:NCG030661 Matlab, Inc. — Plant #16 Greensboro, North Carolina Expires: 5/3112021 Number of Inspector's Name: Date: Outfalls: Paul W. Spangenberg 11/13/18 C U- Z"- ,q �J I on tinAreas . Evidence of pollutants entering system (circle one): Yes No If yes, describe: Areas of potential pollutants entering system: Describe: None Control measures present (circle one): Yes No If yes, describe: Additional control measures needed (circle one): Yes No If yes, describe: Sediment and erosion control measures present (circle one): es No If yes, describe: Rip -Rap at discharge and drainages ditches Describe any new structural stormwater management measures: None Describe any loading/unloading operations: Trucking Describe any outdoor storage activities: Wood Pallets, Scrap Metal, Solid waste dumpsters, used equipment Describe any outdoor manufacturing or processing activities: None Describe and dust or particulate generating areas: None Describe any onsite waste disposal activities: None xw iSi can U'Splft' Any reportable spills or leaks in the past year (circle one): Yes No If yes, date: Impact on stormwater system(s): By this signature I certify that this report is accurate and complete to the best of my knowledge: Inspectors Signature: 7)� Full -Service Analytical & Environmental Solutions �:'�iaaat►aart�s, ihrc. Mid -Atlantic Associates, Inc. - Raleigh Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 NC Certification No. 402 NC Drinking Water Cert No. 37735 SC Certification No. 99012 Project: Matlab - #16 Greensboro Lab Submittal Date: 11/14/2018 Prism Work Order: 8110240 Case Narrative 11 /28/2018 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. Angela D. Overcash VP Laboratory Services Data Qualifiers Key Reference: Reviewed By Terri W. Cole For Angela ❑. Ova rcash Project Manager HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.D. Box 240643 - Charlotte, NC 28224-0643 Phone: 7041629.6364-Ton Free Number t-6001629-6364- Fax: 7041625-0409 Page 1 of P LSM FuEnvironmenSoiutlonell-Semlce Analytical d q: Sample Receipt Summary 11/28/2018 Prism Work Order: 8110240 Client Sample ID Lab Sample ID Matrix DatelTime Sampled Daterrime Received 01 8110240-01 Water 11113/18 8:30 11/14/18 10:46 Samples were received in good condition at 3,0 degrees C unless otherwise noted. This report should not be reproduced, except in Its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.Q. Box 240643 - Charlotte, HC 28224-0643 Phone: 7041629-6364- to" Free Number: l$001629-6364- Fax: 7041625-0409 Page 2 of 6 Full-SoNloo Analyticai & 4P R I S M I Envimnmental Solutlons Mid -Atlantic Associates, Inc. - Raleigh Attn: Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 Project: Matiab - #16 Greensboro Sample Matrix: Water Laboratory Report 11/28/2018 Client Sample ID: 01 Prism Sample ID: 8110240-01 Prism Work Order: 8110240 Time Collected: 11/13/18 08:30 Time Submitted: 11114118 10:46 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor DateMme ID General Chemistry Parameters Oil & Grease (HEM) BRL mg/L 5.0 1.4 1 '1664B 11/27/18 9:02 SLS P81<0444 pH 7.0 HT pH Units 1 `SM4800-H B 11M4118 16:20 CBP POK0323 Total Suspended Solids 12 mg1L 3.6 0.40 1 'SM2640 D 11M9118 15:20 CBP PBK0337 Total Metals Copper BRL mglL 0,010 0.0010 1 '200.7 11/19/18 18:16 JAB PBK0317 Lead BRL m91L 0.0050 0.0010 1 *200.7 11/19/18 16:16 JAB P81<0317 Zinc 0.063 mg1L 0.030 0.0013 1 '200.7 11M9118 16:16 JAB PBK0317 This report should not be reproduced, except in tts entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643 Phone: 7041629-6364 - Toll Free Number: 14001629-6364 - Fax: 7041629-0409 Page 3 of 6 ?uiA� R I S M � Fullironmes al Solutions Environmental Solutions 1 LADORAIgi{CS 1NG Mid -Atlantic Associates, Inc. - Raleigh Attn: Paul Spangenberg 409 Rogers View Court Raleigh, IBC 27610 Total Metals - Quality Control Project: Matlab - #16 Greensboro Level II QC Report 11/28/18 Prism Work Order: 8110240 Time Submitted: 11/14/2018 10:46:00AM Reporting Spike Source %REC RPD Analyte Result Limit Units Level Result %REC Limits RPD Limit !Votes Batch P81<0317 - 200.7 Blank 1PSK0317-BLK1j Prepared & Analyzed: 11/19/18 Copper BRL 0.010 mg1L Lead BRL 0.0050 mg1L Zinc BRL 0.030 mg1L LCS (PgK0317-13S1) Prepared & Analyzed: 11/19/18 Copper 0.498 0.010 mglL 0.5001 100 85-115 Lead 0.507 010050 mg1L 0.5001 101 85-115 Zinc 0.525 0.030 mg1L 0.5001 105 85-115 i This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643 Phone: 7041629-6364 -Toll Free Number: 1-8001529-6364 -For: 7WS26-0409 Page 4 of 6 Foll �PpR I S M J EnviService amen Analytical s may° � Envimnmental Solutions ®' 7LAGOM m+E — Mid -Atlantic Associates, Inc. - Raleigh Attw Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 General Chemistry Parameters - Quallty Control Analyte Level II QC Report 11/28/111 Project: Matlab - #16 Greensboro Prism Work Order: 8110240 Time Submitted: 11/14/2018 10:46:00AM Reporting Spike Source %REC RP❑ Result Limit Units Level Result %REC Limits RPD Limit Notes Batch PSKD323 - NO PREP LCS (P8K0323-BSI) Prepared & Analyzed: 1111411 B pH 6.85 pH Units 6.880 100 98.5-101.5 Batch P8K0337 - NO PREP Blank (P8K0337-BLK1) Prepared & Analyzed: 11119/18 Total Suspended Solids BRL 5.0 mg/1- LCS (PgK0337-13SI) Prepared & Analyzed: 11/19/18 Total Suspended Solids 510 6.0 mg1L 477.0 107 90-110 Batch PSK0444 - NO PREP Blank (PBK0444-BLK1) Prepared & Analyzed: 11/27/18 Oil & Grease (HEM) BRL 5.0 mgIL LCS (P8K0444-BS1) Prepared & Analyzed: 11/27118 011 & Grease (HEM) 36.4 5.0 mg1L 40.00 91 78-114 Sample Extraction Data Prop Method: 200.7 Lab Number Batch Initial Final Date/Time 1311024"1 P8K0317 50 mL SO mL 11/10/13 8:30 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643 Phone: 7041829.6364 - Toll Free Number. 1-8001529-6364 - Fax: 7041626-0409 Page 5 of 6 w sm CHAIN OF CUSTODY RECORD: _ _ _ LA9DwA,'Txusr, IMF. ti. FADE OF ^ pIIOTE TO EKSLME PRGVEi1 OrLr-rMW PUS F.a sav cc A„ayti®I & ias: aemee,at sdurmns Project Name IMa11ab - ni 6 W , Re[�Ir�dON WETJCiTernpi' 449 SprImbrovk Road • P.O. SO% 240543 • Chartotts, NC 28224-W43 PF, qg.F Af.Sff." 1✓t��l� ad? Plwrlm 764/629-6164 Ft 744/`+15dt409 Short Hatd Analysis (Yesj ¢to) UST Project (Yes) (NoI t ti Y r Ratat 1vodY+7L7F1[I+1 • I?O f.D RJCi rLIMt_�3 Client Company Name. 6°'d6AuanftA'`5°e'sses 'Please ATTACH any project specific reporting (OC LEVEL i It III provlai*m and/or OC Requirements Ct�SFOEiY EALS{fTAC ; #,-;3.Y;: fiepart7olGvntactName Invoice To: ml�',kb"AkAS70=0$_- Reporting Address <aa riaticnvti .cam Address:<09 R'gerylew Car Y i PROPEL; CQh4fA lfapd2e ` _ Y - RAoc53t. NC 27310 -- - _... - - .. - . '`- - - r-r. -- x -. Phone: t9re1 zsr ss:c r-x (Y—) (No): ls,s1 zso-saso .. - rrasn3 -- - '- . mail (Y 5) {No) Pmal Address Purchase Order No1&'1!]ng Reference. TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL E Ems T Excel —Other-- Requested Due Dr* I Day 2 Days 3 trays 4 Days 5 trays Gertifrationr NELAG_LiSACE_ FL NC •� aralae-Puu0s,6 "Woridrtq Days, 6-9 Days + Standard 10 days SC OTHER N/A Site Location Name: Samples recelved alter IS:Oo will be processed nerd buskin ss day. Site Location Physical Address 0eeer4b `0• Nr Turnaround tlme is based on bust -mess days, exckxfeg weekends and holidays. Water Chlorinated: YES_ NO _ TEE REIW a FOR TERMS 1L COND=MS REGAMN6 SERVICES S (e iced U Coilaotian: YES NO RMrREU BY MMM LIUr. AaoRORM LNTC CLM" amp l TINE MATRIX ANALYSES REOUESTI:D SAMPLE CONTAIHEA to � / PRISM CL:Ew DATE COLLECTED (SOIL, PRESERVA % f SAMPLE DESCRIPTION COLLECTED OLITARY WATER OR TYPE ' - ' ' r10. S TIVES q -co % / REMARKS LAB HOURS SLUDGE) SEE BELOW -d ID NO.. f 01 uu�° 08:30 Water P t NH102 �/ p8, Cu, ZN 4 01 ^—w_ -- - `r` /3� 08:35 Water P _ I -- None 01 _ .� fig_ 08:40 Water G Y 2 HC/2 y Sa 3ersSigraiure $ .{PrirtAlamel Tait Williamson AdiGatiorl Matlab, inn. is .Upon rctinquitlling, Chain a4 CwA,ody your =Ahwixatlon for Prism to proceed with the analyses as requested dtlowi. Any changes must be submitted In wrlt}ryg to the Prism Pzalod I t)ager_There wdl be charges forany changes after analyses hove'beaiKinitlallxed. fldhpriur.'e [Iy {f,12r.� _ � � rler�v� 6!. L9gi _ Ra?e ►ttaryr�xsrs Ratsr.QMa Ey:Ls . - RQMN"ar1Sayuks<21 oats - _ pe+ishp�i Ey: 14:4nuwoy R -F I es 8 7c. t] F R A NTO ORATq Y. iL¢A G.� m .;.NAr*+CPt CRANSPq SAWLES.�RE P=Ac=pTEU A11n uMFtEo 4QAjNSTCOC LMi ATTHe LASOFtA7URY. FwF - ups . P,��SQo kf �. NpbES:. ' 'UST: t GROUNDWATER: : ORINIONG WATER: c SOLID WASTE- : RCRA: CERCLA I LANORLL I OTHER: INC _SC NC _SC; _NC _SC `: -NC _SC _NC _SC _Kc._Sd _NC _SC: _NC _SCE _NC _SC -CONTAINER TYPE CODES: A = Amber C - Glesr G = Glass P = Plasric: T L = Teflon -Lined Gap VC.4 = Volatile Organics Analysis (Zero F4ad Space) Additional Comments; Rain . r,'t_ _S�$rd,ratTtrrte: � - sae oeparwmTine: .Fa1dTeChPec: - U911w. 58k: A&vt z.&; F4R TERMS a co"DMONS a ry cz r r Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 11/29/18 CERTIFICATE OF COVERAGE NO. NCG030661 FACILITY NAME Matlab — Plant #16 COUNTY Guilford PERSON COLLECTING SAMPLES Tait Williams LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly) month RECEDIvCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA ❑Zero -flow ❑Water Supply [_]SA DEC 19 2018 ®Other CENTRAL F-iLES OR 3 4 PLEASE REMEMBER TO SIGN ON PAGES 2 AND D\r%/R SECTION: / ❑ No discharge this period?z Outfall No. Date Sample Collected) 24-hour rainfall amount, Inches3 Total Suspended Solids pN, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics-' Benchmarks ===> - - 100 mg/L or 50 mg/O 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 11/13/18 .4 7.0 7 0 0 0.063 0 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance far the same parameter at the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1of3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger small sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or Stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower _ Name (Print name) VP of Engineering Title (Print / _2 3 �� (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format,_"<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See Genera! Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 CR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ®NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results Lor at end of monitoring eriod in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 RAIN EVENT DATA FACILITY: Matlab, Inc. — Plant #16 ADDRESS: 3010 Executive Drive Greensboro, NC 27206 CONTACT PERSON: Press Bower TELEPHONE: 336- 629-4161 STORM. EVENT INFORMATION' DATE YEAR MONTH DAY 18 11 13 HOURS MINUTES DURATION 48 0 PRECIP. AMOUNT (IN.) .4 RUNOFF 0.65 VOL. MI.GAL. HOURS PRECEDING DAYS EVENT 0 3 PRINCIPLE EXECUTIVE OFFICER OR AUTHORIZED.' AGENT' PRINT SIGNATURE DATE Paul W. Spangenberg 11/13/18 43560 x 5 = 261360 x .4 = 104544 x 0.0833 =8708 x 7.48 = 65139 / 1000000 = 0.65 M/Gal. STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certification of Coverage No.: Facility Name: County: Permit No: NCGO300661 Matlab, Inc. — Plant #16 Guilford Expires: 5/31/2021 Greensboro, North Carolina Inspector Name: Date of Inspection: Paul W. 5 an enber 11l13118 OUTFALL DESCRIPTION Outfall No.: Structure (pipe, ditch, etc.): Receiving Stream: 1 Pipe Buffalo Creek Describe the industrial activities that occur within the outfall drainage area: Painting & Coating Manufacturing Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Brown Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak chlorine odor, etc.): None Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy (circle one): 2 3 4 5 6 7 8 9 10 Floating Solids Choose the number which best describes the amount of Floating solids in the stormwater discharge where 1 is no solids and 10 is the surface is covered in floating solids (circle one): 1 O 3 4 5 6 7 8 9 10 Suspended Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10 is extremely muddy (circle one): 1 O 3 4 5 6 7 8 9 10 Foam Is there any foam in the stormwater discharge (circle one)?: Yes Q N Oil Sheen Is there an oil sheen in the stormwater discharge (circle one)?: Yes No Erosion Deposition . Is there evidence of erosion or deposition at the outfall? (circle one): Yes No If yes, list and describe: Other Is there other obvious indicators of stormwater pollution in the stormwater discharge (circle one): Yes No If yes, list and describe: Rain Event. Was this a Representative Storm Event? X Yes — No Total Event Precipitation (Inches)_4 A measurable storm event is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. Certification By this signature I certify that this report is accurate and complete to the best of my knowledge: Inspector's Signature: Pad K/, S STORMWATER FACILITY INSPECTION FORM Facility Name: Location: Certification of Coverage No.:N00030661 Matlab, Inc. — Plant #16 Greensboro, North Carolina Expires: 5/31/2021 Number of Inspector's Name: Date. Outfalls: Paul W. Spangenberg 11/13/18 1 Con 'tinNting Areas Evidence of pollutants entering system (circle one): Yes No If yes, describe: Areas of potential pollutants entering system: Describe: None Control measures present (circle one): Yes No If yes, describe: Additional control measures needed (circle one): Yes No If yes, describe: Sediment and erosion control measures present (circle one): es No If yes, describe: Rip -Rap at discharge and drainages ditches Describe any new structural stormwater management measures: None Potential Pollutant Areas Describe any loading/unloading operations: Trucking Describe any outdoor storage activities: Wood Pallets, Scrap Metal, Solid waste dumpsters, used equipment Describe any outdoor manufacturing or processing activities: None Describe and dust or particulate generating areas: None Describe any onsite waste disposal activities: None Significant 6t.4ks or Spills Any reportable spills or leaks in the past year (circle one): Yes No If yes, date: Impact on stormwater system(s): ` Certification By this signature I certify that this report is accurate and complete to the best of my knowledge: Inspectors Signature: Paod70, $ v� R S M OLADMAMAIES ING Full -Service Analytical 8 Environmental Solutions Mid -Atlantic Associates, Inc. - Raleigh Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 NC Certification No. 402 NC Drinking Water Cert No. 37735 SC Certification No. 99012 Project: Matlab - #16 Greensboro Lab Submittal Date: 11/14/2018 Prism Work Order: 8110240 Case Narrative 11/2a12018 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods, Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. 6 /1 �'J Angela D. Overcash VP Laboratory Services Data Qualifiers Key Reference: % Reviewed By Terri W. Cole For Angela D. Overcash Project Manager HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlott6, NC 28224-0643 Phone: 7041629-6364 - Toll Free Number: 1-8001629-6364 - Fax: 7041625-0409 Page 1 ol� 6�'R Full-Service Analytical 6 I M Environmental solutions ueca�.omca, me Sample Receipt Summary 11/28/2018 Prism Work Order: 8110240 Client Sample ID Lab Sample ID Matrix Date/Time Sampled Date[Time Received 01 8110240-01 Water 11/13/18 8:30 11/14/18 10:46 Samples were received in good condition at 3.0 degrees C unless otherwise noted. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 5pringbrook Road -P.O. Box 240543 -Charlotte, NC 28224-0643 Phone: 704/629-6364 • Toll Free Number: 1-800/629-6364 - Fax: 704/626-0409 Page 2 of fi J Full-S vice Analytical 8R ISM Environmental SolutionsPDi.aIFA,IMQ Mid -Atlantic Associates, Inc. - Raleigh Attn: Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 Project: Matlab - 416 Greensboro Sample Matrix: Water Laboratory Report 11128/2018 - Client Sample ID: 01 Prism Sample ID: 8110240-01 Prism Work Order: 8110240 Time Collected: 11/13/18 08:30 Time Submitted: 11/14/18 10:46 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor DateMme ID General Chemistry Parameters Oil S Grease (HEM) BRL mg1L 5.0 1.4 1 '1664B 11/27118 9:02 SLS PBK0444 pH 7.0 HT pH Units 1 'SM4600-H B 11114/18 16:20 CBP PSK0323 Total Suspended Solids 12 mg1L 3.6 0.40 1 'SM2640 D 11A9118 16:20 CBP P3K0337 Total Metals Copper BRL mg1L 0.010 0.0010 1 '200,7 11119/18 16:16 JAB P81<0317 Lead BRL mg/L 0,0050 0.0010 1 '200.7 11/19/18 16:16 JAB P81<0317 Zinc 0.063 mg1L 0.030 0.0013 1 '200.7 11119/18 16.16 JAB P8K0317 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, KC 28224-0643 Phone: 7041629-6364 - Toll Free Number: 1-8001629-6364 - Fax: 7041525-0409 Page 3 of� rn� Qe-Ice Analytical aPR I S M EnvlrronmensSolutions Mid-Atlantic Associates, Inc. - Raleigh Attn: Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 Total Metals - Quality Control Analyte Batch P81<0317 - 200.7 Project: Matlab - #16 Greensboro Level II QC (Report 11/28/18 , Prism Work Order: 8110240 Time Submitted: 11/14/2018 10:46:OOAM Reporting Spike Source %REC RPD Result Limit Units Level Result %REC Limits RPD Limit Notes Blank (P8K0317-BLK1) Prepared & Analyzed: 11/19/18 Capper BRL 0.010 mg1L Lead BRL 0.0050 mglL Zinc BRL 0.030 mgfL LCS I1381<0317-13S71 Prepared 8 Analyzed: 11/19/18 Copper 0,498 0,010 mg1L 0.5001 100 85-115 Lead 0.507 0.0050 mg1L 0.5001 101 85-115 Zinc 0.525 0.030 mg1L 0.5001 105 85-115 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0543 Phone: 7041b29.6364 -Toll Free Number: 1-8001629-6364 - Fax. 7041626-0409 Page 4 of E� n� \ Full s Analytical Environmental Solutions �ueanhmhra n+c Mid -Atlantic Associates, Inc. - Raleigh Attn: Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 General Chemistry Parameters - Quality Control Analyte Project: Matlab - #16 Greensboro Level 11 QC (Report 11/28/18 - Prism Work Order: 8110240 Time Submitted: 11/14/2018 10:46:OOAM Reporting Spike Source %REC RPa Result Limit Units Level Result %REC Limits RPD Limit Notes Batch PBK0323 - NO PREP LCS JP8K0323-BSI) Prepared & Analyzed: 11/14/18 pH 6.85 pH Units 8.880 100 98.5-101.5 Batch PBK0337 - NO PREP Blank IP8K0337-BLK1) Prepared & Analyzed: 11/19118 Total Suspended Solids BRL 5.0 mg1L LCS (PSK0337-BSI) Prepared & Analyzed: 11/19/18 Total Suspended Solids 510 5.0 mg1L 477.0 107 90-110 Batch P8K0444 - NO PREP Blank (PBKD444-BLK1) Prepared & Analyzed: 11/27/18 Oil & Grease (HEM) BRL 5.0 mg1L LCS JP8K0444-BS1) Prepared & Analyzed: 11/27/18 Oil & Grease (HEM) 36.4 5,0 mg1L 40.00 91 76-114 Prep Method: 200.7 Lab Number Batch 8110240-01 PSK0317 Initial 50 mL Sample Extraction Data Final DateMme 50 mL 11/19/18 8:30 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643 Phone: 7041629-6364 - Toll Free Number: 1-8001629.6364 - Fax: 7041626.0409 Page 5 cif 6 Z: PRLSM 9-- H A! 224. OFF OCUSTOnY. 13%E1d%-107RM co Futl Servi" AnaV&zd I% F�Ironmentmd Saftitluns CU PAGE —I OF _L__ QUOTE 9 TO EASURE PROPER BILLING P— • Mallab - #16 RBCenrgdON wL 7-.IC 7 7-- -7 Phone., ?6Q529-&WA Fox,7041525-0409 A H IYS'-- (Yes) (NO) UST Puoject; (Yes) (NO) 449 Springbrook Road - P.O. Sox 240543 - Charlotte, NC 2=4-0543 Project Name:, Short old Ana P��.' F�­ Client Company Name: W.KFAttanticAssociaies 'Plea" ATTACH any PfOlOCt SPeCift reporting (QC LEVEL I it III IV) Report To/Contact Name; provisions and/or OC Requirements UTHOt&ACE? Invoice TO: Reporting Address: 40S R09emv� c�r. 4 09 ROW vlew COW. PROPMCONTAINER Raicth. NC 2790 Address: Phone: —Fax (Yes) (ND):IssalzsaBvsa Email (Y s) (No) Email Address Purchase Order NoJElilling Reference R2W TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL EDO Type: "' PDF_ Excel.Other Requested Due Date I Day 2 Days 3 Days 4 Days 5 Days Certification: NELAC—USACE—FL— NC_ Site Location Name: "tab-pftns110 'Working Days' 6-9 Days " Suindard 10 days SC OTHER N/A Safn*les received attar 15*0 will be processed next business day. Site Location Physical Address: Gmensbwa, Nc Turnaround lime is based on business days. exckxruv weekends and hc4dffp. Water Chlorinated; YES— NO — (SEE REVERSE FOR TERMS & CONOTTIONS REGARDING SER=ES Sample 1ced Upon Collection: YES NO RENDERED BY PRISM LABORATORIES. INC-TO CUEAM DATE 'COLL517fr=0 (SOIL, P CLSNT RISM TIME MATRIX SAMPLE CONTAINER ANALYSES REQUESTED PRESERVA- LAD SAMPLE DESCRIPTION COLLECTED MILITARY WATER OR' `TYPE TivEs REMARKS NO SIZE%10 NO. HOURS SLUDGE) SEE BELOW 0 01 08-30 Water P I NH/02 JP6. Cu. ZN µ 0_1 01 I f e /3+ 08.35 Water None q/ HC12 Water �i G 01 W. 08:40 2 re U Custody Lz I ,��n relin4ijl�hlng,,tliv� Chain of Cit y is your aulho�; aflon for Pri -�s rnifted in wrWR9 to the Prism Project &Janager.Theic will be chart - SVztwf/ I I Name) Tait Williamsor) Affitiallan matlab. inc. to pr&ceed with the'artatys'es"is reauestid aboi&'Any changes must be for ary changes afteranalyses'have bech inillalUed., '5]aa 0 - -I � I W. VA $�r.mPLLzAA= NuT ALL ACCEPTto ANu UERIFCED AGAINST GOC UNTIL La �gVEJ%�JLS FOR TRANSPORTAMS TO THE UNADRATOAV. Cvt�oAw MqATTWLABORATORY. Fed Ex. )(,LIPS Narw-caFve.qo P&M FW SOPk* 11 1 ) NPDES-' I UST: GROUNDWATER. DRINKING WATER, i SOLID WASTE: RCRA: CERGLA LANDFILL I OTHER. NC — SCI NC SC NC SC NC — SC _W _SC NC — SC7. — NC — SG: _NC _SC NG — SC ,CONTAINER TYPE CODES: A=Amber C = Clew G = Glass P = Plastic: TL ='"efbr.-Limed Cap VOA = Volatile Organics Analysis lk'243,o mad Space) Additional Comments: Rain .1.14 '1 8ltd Departure Time: :Fwc 1,,te6h Few - AI' DSEE REVUME FOAL JMMS&CONDMONS"I Semi-annual Stormwater Discharge Monitoring Report for Nord, Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 8/3/18 CERTIFICATE OF COVERAGE NO. NCG030661 SAMPLE COLLECTION YEAR 2018 FACILITY NAME Matlab — Plant #16 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY Guilford or ® Monthly' July (month) PERSON COLLECTING SAMPLES Tait Williams RECIEiVr IIS HARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Prism Lab Cert. # 402 ❑Zero -flow ❑Water Supply ❑SA Comments on sample collection or analysis: AUG 2 8 Z018 ®Other Part A: Stormwater Benchmarks and Monitoring Results CE,' +TRAL FILES OR 3 4 PLEASE REMEMBER TO SIGN ON PAGES 2 AND CMIR SECTIW'i / ❑ No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/Total Total Petroleum Hydrocarbons Toxic Organics' Benchmarks - - 100 mg/L or 50 mg/L° 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 7/30/18 .28 0.0 0.071 N/A ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single out#all, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. ' See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTv monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of EneineerinjZ Title (Pri ti (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format "<XX m L" where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MOMTORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART it SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMRLincluding all "No Discharge,' reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) g (Date) Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 6/15/18 CERTIFICATE OF COVERAGE NO. NCG030661 SAMPLE COLLECTION YEAR 2018 FACILITY NAME Matlab — Plant #16 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY Guilford Ki:�CE} V ED or ® Monthly' June (month) PERSON COLLECTING SAMPLES Tait Williams $ 2019 DISCHARGING TO CLASS ❑ORW ❑HQW [—]Trout❑PNA LABORATORY Prism Lab Cert. # 402 ❑Zero -flow [:]Water Supply ❑SA Comments on sample collection or analysis: CENTRAL. FILES ®Other P Y DWR SECT00" PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 Part A: Stormwater Benchmarks and Monitoring Results ❑ No discharge this period?Z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/Total Total Petroleum Hydrocarbons Toxic Organics' Benchmarks =__> - - 100 mg/L or 50 mg/L° 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 6/26/18 1 0.0 0.19 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. ' See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering _ Title (Prin title (Signature) 22 / ? (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B. Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. r c FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharae" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) 8 .z. z 16 (Date) Permit Date:11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 6M/18 CERTIFICATE OF COVERAGE NO. NCG030661 FACILITY NAME Matlab — Plant #16 COUNTY Guilford PERSON COLLECTING SAMPLES Tait Williams LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec RECEIN/=r) or ®Monthly' May (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA JUL U 5 2018 ❑Zero -flow ❑Water Supply []SA CENTRAL FILES ®Other 01N� SEC T i01,, PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this period?' Outfall No. Date Sample Collected, (mo/dd/yr) 24-hour rainfall amount, Inches; Total Suspended Solids pH, Standard units Copper . Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics Benchmarks =__> - - 100 mg/L or 50 mg/O 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 5/31/18 0.11 0.025 0 N/A ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/l/2012-10/31/2017 SWU-245, last revised 10/25/2012 Pagel of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title e) (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, „<XX me/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table S, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. + TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑ REGIONAL OFFICE CONTACT NAME: Moil an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of ( Date) Permit Date:11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 RAIN EVENT DATA FACILITY: Matlab. Inc. —Plant #16 ADDRESS: 3010 Executive Drive Greensboro, NC 27206 CONTACT PERSON: Press Bower TELEPHONE: 336- 629-4161 STORM EVENT INFORMATION DATE YEAR MONTH DAY 2018 5 31 HOURS MINUTES DURATION 24 00 PRECIP. AMOUNT (IN.) 0.11 RUNOFF 0.017 VOL. MI.GAL. HOURS DAYS PRECEDING EVENT 3 0 PRINCIPLE EXECUTIVE OFFICER OR AUTHORIZED,AGEN7 PRINT I SIGNATURE DATE Paul W. Spangenberg 1'wko„,.wAjF Orr9f 5/31 /18 43560 x 5 = 261360 x .11 = 28749.6 x 0.0833 = 2394.8 x 7.48 = 17913.41 M =0.017 MIGal. STORMWATER FACILITY INSPECTION FORM Facility Name: Location: Certification of Coverage No.:NCG030661 Matlab, Inc. — Plant ##16 Greensboro, North Carolina Expires: 12/31/2018 Number of Inspectors Name: Date: Outfalls: 1 Paul W. Spangenberg 5/31/18 Con ' tin Areas Evidence of pollutants entering system (circle one): Yes 11Noj If yes, describe: Areas of potential pollutants entering system: Describe: None Control measures present (circle one): Yes No If yes, describe: Additional control measures needed (circle one): Yes No If yes, describe: Sediment and erosion control measures present (circle one): es No If yes, describe: Rip -Rap at discharge and drainages ditches Describe any new structural stormwater management measures: None Potential Pollutant Areas Describe any loading/unloading operations: Trucking Describe any outdoor storage activities: Wood Pallets, Scrap Metal, Solid waste dumpsters, used equipment Describe any outdoor manufacturing or processing activities: None Describe and dust or particulate generating areas: None Describe any onsite waste disposal activities: None Significant ks or Spills Any reportable spills or leaks in the past year (circle one): Yes No If yes, date: Impact on stormwater system(s): Certification By this signature I certify that this report is accurate and complete to the best of my knowledge: Inspector's Signature: jTad V ,S' PRISM` ' vLJ460aATORlE9; INC.' Full Service Arlatyticai & Envtranmental Solutions 449 Sprtngbrook Road • P.O. Box 240543 • Charlotte, NC 2M4-0543 Phone:7D4/529-M o Fax.704/525-0409 Client Company Name: Mid -Atlantic Associates Report To/Contact Name: Paul Spangenberg Reporting Address: 409 Rogers View Court Raleigh, NC 27610. CHAIN OF CUSTODY RECORD t PAGE of QUOTE • TO ENSURE PROPER BILLING: Paul Project Name: Matlab - #16 fieo�a 'PROP Short Hold Analysis: (Yes) {No) UST Project: (Yes) (No) acah "Please ATTACH any project specific reporting (QC LEVEL I.TI III N1 provisions and/or OC Requirements T Invoice To: M d Atlantic AssociatesVpI P Address: 409 Roger View Court Raleigh, NC 27611) Phone: „,„ —"--"—Fax (Yes) (No): „�, � ��, Email (Y s) {Nor} Email Ad Ema T 'PDF__._ Address Emadress — el Other Site Location Name: Matlab-Plant#16 Purchase Outer No./Billing Reference R2949 Requested Due Date 1 Day 2 Days 3 Days 4 Days 5 Days ''Working Days" 6-9 Days Standard 10days ' Samples received after 15:00 will be processed next business day. TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Certification: NELAC USACE FL NC SC— OTHER N/A Site Location Physical Address: Greensboro, NC Turnaround time is based on business days, excluding weekends and holidays. (SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES RENDERED BY PRISM LABORATORIES, INC. TO CLIENT) Water Chlorinated: YES_ NO Sample IC@d Upon Collection: YES p p NO CLIENT SAMPLE DESCRIPTION DATE COLLECTED TIME COLLECTED MILITARY HOURS MATRIX (SOIL, WATER OR SLUDGE) SAMPLE CONTAINER PRESERVA- TIVES ANALYSES REQUESTED REMARKS f PRISM LAB ID NO. "TYPE SEE BELOW NO. SRE 01 5131/18 13:30 Water P 1 OZ NH/02 ./ Cu, Zn Sampler's Signature Tait Williams Matlab, Inc. r Sampled By (Print Name) Affiliation r Upon relinquishing, this Chain of Custody Is your authorization for Prism to proceed with the analyses as requested above. Any changes must be submitted in writing to the Prism Project Manager. There will be charges for any changes after analyses have been initialized. Relinquished y:(Signature) - Relinquished By: (Signature) Received By: ( Vvrturel Data NkAry ours Additional Comments: Received By: (Si Date Rain " De ;'a',f, �?.rK'RiPiSt{r Relinquished By. (Signature) Received For Prism Laboratories By: Data Field,TechFes:'- �R{ MetriOd hipmerlt: NOTE ALL SAMPLE COOLERS SHOULD BE TAPED SHUT YYITIi CUSTODY SEALS FOR TRANSFORTAMONTO THE LABORATORY. Log - in GroW No. sAMPLES ARE NOT ACCEPTED AND VERIFIED AtMUNST COC UNTIL RECEIVED AT THE LABORATORY. - - Fed Fit UPS Hand -delivered Prism Feld Service Other NNurb: I UaT: I UHUUNUWATEH: UHINRIN(i WArEH; SOLID WASTE: i RCRA: CERCLA LANDFILL I OTHER: ! NC _ SC� = NC _ SC _ NC - SC _ NC _ SC -NC -SC I -NC _ SC -NC -SC -NC -SC _ NC _ SC `CONTAINER TYPE CODES: A = Amber C = Clear G = Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) �cc nc1`n 'UK TERMS 8 CONDITIONS OR(GWAL d\ 1 aP' _ ISM =DueauTMEs wa Full -Service Analytical & Environmental Solutions Mid -Atlantic Associates, Inc. - Raleigh Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 NC Certification No. 402 NC Drinking Water Cart No. 37735 SC Certification No. 99012 Project: Matlab - #16 Greensboro Lab Submittal Date: 06/04/2018 Prism Work Order: 8060041 Case Narrative 06/ 1212018 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. 61LJ Angela D. Overcash VP Laboratory Services Data Qualifiers Key Reference: Reviewed By Angela D. Overcash VP Laboratory Services BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Sox 240543 - Charlotte, NC 28224-0543 Phone: 70V52M364 - Toll Free Number: 1.8001529-6364 - Fax: 7041525-0409 Page 1 of 5 a c� Full -Service Analytical 8 �P R ISM Y 1 Environmental Solutions Sample Receipt Summary 06/ 12/2018 Prism Work Order: 8060041 Client Sample ID Lab Sample ID Matrix Date Sampled Date Received 01 8060041-01 Water 05/31/18 06/04/18 Samples were received at 25.4 degrees C. See case narrative for further information. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224.0543 Phone: 7041529-6364 - Toll Free Number: 1-8001529-6364 - Fax: 7041525-0409 Page 2 of 5 FIR ISM F'viron i ntal S ludo s t_, Envkronmantel Solutions �iweoa,mmcI n Mid -Atlantic Associates, Inc. - Raleigh Attn: Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 Project: Matlab - 916 Greensboro Sample Matrix: Water Laboratory Report 06/12/2018 Client Sample ID: 01 Prism Sample ID: 8060041-01 Prism Work Order: 8060041 Time Collected: 05/31/18 08:15 Time Submitted: 06/0411810:30 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor Dateffime ID Total Metals Copper 0.025 mg1L 0.010 0.0010 1 '200.7 616118 14:45 JAB P8F0059 Zinc BRL mg1L 0.030 0.0013 1 '200.7 616118 14:45 JAB P8r0059 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 $pringbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1.8001529-6364 - Fax: 7041525-0409 Page 3 of 5 \ �1Full-Service Analytical d z LEnvironmental Solutions �ueon�toniEn me Mid -Atlantic Associates, Inc. - Raleigh Attn: Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 Total Metals - Quality Control Analyte Batch P8F0059 - 200.7 Project: Matlab - #16 Greensboro Level II QC Report, 6112118 Prism Work Order: 8060041 Time Submitted: 6/4/2018 10:30:OOAM Reporting Spike Source %REC RPD Result Limit Units Level Result %REC Limits RPD Limit Notes Blank (P8F0059-BLK1) Prepared: 06/05/18 Analyzed: 06/06/18 Copper BRL 0.010 mg1L Zinc BRL 0.030 mg1L LCS (PSF0059-BSI) Prepared: 06/05/18 Analyzed: 06/06/18 Copper 0.508 0.010 mglL 0,5001 102 85.115 Zinc 0.515 0.030 mglL 0.5001 103 85-115 Sample Extraction Data Prep Method: 200.7 Lab Number Batch Initlal Final Date/Time 8060041-01 P8F0059 50 mL 50 mL 06105/18 8:10 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-8364 - Toll Free Number: 1.800/529-6364 - Fax: 704/525-0409 Page 4 of 5 CHAIN OF CUSTODY RECORD. •' -�. ''SY� .. PAGE — oa 1 QUOTE 0 TO EmstntE PIioPER elU.niQ: Paw Full SwAce AnaNticel ✓i<ErmAronnUMAI ScWttom Matlab - #1 S 449 Springbrook. Road • P.O- Box 240543 • Charlotte. NC 28224-0543 Project Name: Phone: 704f529-6364 - Farc 704PS25-0409 Short Hold Analysis: (Yes) (No) UST Project: (Yes) (No) Cliont Company Name: Mid -Atlantic Assoclaues 'Please ATTACH any project specific reporting (QC LEVEL 111 III Ill) provisions and/or OC Requirements ReportTo/ContactName: Pl"spw wmam Md/or,,r,a Reporting A�,� 409 ROWM View Ccun invoice To: - _ SaChdft . �h, NC Z761O Address: 4" RaW Maw COW Ralalgh, NC 2761 D Phone: t """"�"'° Fah( (Yes) (No}- Emall (V S) (No) Email Address EDU T :—. — PflF Extxl�Othei Site location Name: Isalmo-Pumtvls Site location Physical Address: C"ecns0orck NC R2W3 Purchase Order NQJSIIIing Reference Requasted Due Data 1 Day 2 Days 9 Days a Days 5 Days "Woridngays' D6-9 Days Standard 10 days .Samples raoelved alter 16•00 Will be prcoeseed neo4 buslnees day. Turnaround time is based on business days, exchldN weekends and halidays- IXNQ SERVICES REND� aY PRISM MAea+A�Mpa cELLWn TO 8E FILLED INBY CLIENT/SAMPI<1NG PERSONNEL Certification: NE AC USACE FL NC SC_ OTHER WA Water Chlorjnate& YES_ NO— Sample Iced Upon Collection: YES NO CLIENT SAMPLE DESCRIPTION DATE COLLECTED TIME OOLLECTED MILITARY SiATRUC (SOIL, WATER OR SLUDGE) SAMPLE CONTAINER PRESERVA- TIVES ANALYSES REOt1ESTED — REMARKS PRISM I"HOURS ID NO 'TYPE SEE BELOW NO. SIZE 01 5/31/18 08:15 Water P 1 Oz NH/02 �/ Cu, Zn Samptees Signature l Tait Williamson Matlab, inc. t —Sampled By (Print Name) ,Affiliation t Upon relinquishing, Ilks Chain of Custody is your authorization for Prism to proe6od with the analyses as requested above. Any changes must be submhted In writing to the Prism Project Manager. Thera will be charges for any -changes after analyses have been Initlnnzc- ey: ire FlAcWvad ay: (ture) Ek" - —. Additions! Comments RenmquiL ar (Slgnrium) - - Re ceived ay: (Slgnetme) Harr Rain .21 OEM R Retrwp— By. (SIC—) Flecetvstl FGr l.adwwwies tiy. tlmy - Na . _ . - . _ MffnW pI hpmam OT • Ali SHOULD BE 4YtrH ODY S FOA A H TD E TO - 776 - `` / SAMPLES ARE NQr ACCEPTED AND NiRiFIED AQUNST_C_ OC U"L RECtNED AT 1HH LABORATORY. 6Feo --Priam Fx � xUPS Wnaaalwemd Reid Service Omer N NC $_ S(I ItN�I G NC No SC- I, v NG —SC SCAT EH: 5 NC WASTE:OLID SC — NC _ SG cENC LA SC I LANNCDF— SC OTHER: NC — SC -'CONTAINER-TYPE CODES- A = Amber C = Clear. G = Glass P = Plastic; TL = Teflon -lined Cap! VOA!!€= Volatile Organics Analysis (Zero Head Space) ORIGINAL Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 4/2/18 CERTIFICATE OF COVERAGE NO. NCG030661 FACILITY NAME Matlab — Plant #16 COUNTY Guilford PERSON COLLECTING SAMPLES Tait Williams LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or ® Monthly'^ April (month) DISCHARGING TOCLASS ❑ORW ❑HQW ❑Trout ❑PNA RECEIVED Eft ❑Zero -flow ❑Water Supply [:]SA JUN O 1 2019 ®Other CENTIRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 DWR SECTION ❑ No discharge this period?z Outfall No. Date Sample 1 Collected (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics Benchmarks =__> _ - 100 mg/L or 50 mg/L° 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 4/24/18 1.32 0 0.049 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. a See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ.the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Pri (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches s Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: •. A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. a 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are signitont penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of zz / (Date) Permit Date: 11/1/2012-10/31/2017 SWU-24S, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted2/16/18 CERTIFICATE OF COVERAGE NO. NCG030661 SAMPLE COLLECTION YEAR 2018 FACILITY NAME Matlab — Plant #16 w SAMPLE PERIOD ® Jan -June ❑July -Dec COUNTYGuilford rVi or [] Monthly' (month) PERSON COLLECTING SAMPLES Tait Williams NPR DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA LABORATORY Prism Lab Cert. # 402 CFAIT 2018 []Zero -flow ❑Water supply [—]SA RA CA Comments on sample collection or analysis: 1)W& SEL F SS Other C7-1PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 Part A: Stormwater Benchmarks and Monitoring Results ❑ No discharge this period? Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches; Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organicss Benchmarks =__> - - 100 mg/L or 50 mg/L4 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 1/29/18 1.25 8.1 6.3 0 0 0.089 0 N/A ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or Stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Print title) 2 �Z j (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ===> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 -- 4.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 `�- Page 2 of 3 Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. + TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an on inal and one c2py of this DMR including all "No Discharge" reports, within 30 days of recei t of the lab results or at end of monitoring eriod in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) 3 (Date) Permit Date: 11/1/2012-10/31/2017 SWLI-245, last revised 10/25/2012 Page 3 of 3 I IA P�ISM OUBOU-MME$ 1140, Full -Service Analytical & Environmental Solutions Mid -Atlantic Associates, Inc. - Raleigh Paul Spangenberg 409 Rogers View Court Raleigh, NC 27610 NC Certification No. 402 NC Drinking Water Cent No. 3T735 SC Certification No. 99012 Project: Matlab - #16 Greensboro Lab Submittal Date: 01/30/2018 Prism Work Order: 8010433 Case Narrative 02/13/2018 = This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. 6�'J Angela D. Overcash VP Laboratory Services Data Qualifiers Key Reference: HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference Reviewed By Terri W. Cole For Angela D. Overcash Project Manager * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbroolc Road - P.O. Box 240643 - Charlotte, NC 28224-0643 Phone: 7041629-6364 - Toll Free Number: 1-8001629-6364 - Fax: 7041525-0409 Page 1 of 8 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 3130/18 CERTIFICATE OF COVERAGE NO. NCG030661 SAMPLE COLLECTION YEAR 2018 FACILITY NAME Matlab— Plant #16 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY Guilford or ® Monthly) March _ (month) PERSON COLLECTING SAMPLES Tait Williams R ECENFOSCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Prism Lab Cert. # 402 ❑Zero -flow []Water Supply ❑SA Comments on sample collection or analysis: APR 3 201$ ®Other Part A: Stormwater Benchmarks and Monitoring Results `.ENTRAL I-iLES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 DWR SECTION ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches 3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics5 Benchmarks =__> - - 100 mg/L or 50 mg/L° 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L i mg/L 01 3/21/18 0.25 0 0.13 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. a See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilitic-7. that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Pei'mit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering _ Title (Print tit' 7 1 (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: "you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ®NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports] to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Perm (Date) Permit Date:11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwat_er Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 3/2/18 CERTIFICATE OF COVERAGE NO. N00030661 FACILITY NAME Matlab — Plant #16 COUNTY Guilford PERSON COLLECTING SAMPLES Tait Williams LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPK ERIOD• o,JancJune ❑ July -Dec *`%�' r �� Monthly" Feb (month] DISCHAFtGING7T,p CW�SS ❑ORW ❑HQW [—]Trout ❑PNA CENTI,'A ❑Zero -flow ❑Water Supply ❑SA i' FIL.C� ®Other cvA/R SECT10 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this period?' Outfall No. Date Sample Collected" (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/Total Total Petroleum Hydrocarbons Toxic Organicss Benchmarks ==_> - - 100 mg/L or 50 mg/L4 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 2/7/18 0.25 0.012 0.96 N/A ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition Found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title [Pr' �2 /S (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 J Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) #o: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are l&ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date:11/1/2012-10/31/2017 3 j Z (Date) SWU-245, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 1/29/1$ CERTIFICATE OF COVERAGE NO. NCG030661 FACILITY NAME Matlab — Plant #16 COUNTY Guilford PERSON COLLECTING SAMPLES Tait Williams LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A, Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or �������HaRGINGT ®LASS Monthly- Jan month ❑ORW ❑HQW ❑Trout ❑PNA FEB 0 B 2018 ❑Zero -flow [:]WaterSupply ❑SA ®Other CENTRAL FILES DWR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this period?z Outfall No. Date Sam le p Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids p H, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxi Organics' Benchmarks - - 100 mg/L or 50 mg/L4 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 1/23/18 0.35 0.012 0.15 N/A Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. i further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Ti7(Prin'Zle) (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement firer 1, Tier 2, or Tier responses. See General Permit text. ,J11 FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER ATTHE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period_ in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date:11/1/2012-10/31/2017 2 z )S (Date) SWU-245, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 9/21/17_ CERTIFICATE OF COVERAGE NO. NCG030661 FACILITY NAME Matlab — Plant #16 COLINTYGuilford PERSON COLLECTING SAMPLES Tait Williams LABORATORYPrism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2017 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or ® Monthly' December month RECGP�i(;QGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA JAIV 4 �fl18 ❑Zero -flow ❑Water Supply ❑SA ®Other CENTRAL FILES 0WR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches 3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/Total Total Petroleum Hydrocarbons Toxic Organics5 Benchmarks =__> - - 100 mg/L or 50 mg/L4 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 12/21/17 0.25 -- -- 0.014 -- 0.089 -- N/A I Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/l/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring maybe waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Print title) (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L". where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (5GT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 5u Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: If you report a sample value in excess of the benchmark, you must Implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mall an orgInal and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab resultslo_r at -end -of monitorina_period In the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mall Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature oTermittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 STORMWATER DISCHARGE OUTFALL (SDO) ANNUAL SUMMARY DATA MONITORING REPORT (DMR) 1 SWP. AMMu n)u l U date DATA REVIEW FORM Calendar Year Individual NPDES Permit No. NCS❑❑❑❑❑❑ or Certificate of Coverage (COC) No. NCG030661 CENTRAL FILES DWR SECTION This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP. Facility Name: Matlab., Inc. — Plant #16 _ County: Guilford Phone Number: (366) 629-4161 Total no. of SDOs monitored 1 .Outfall No. 01 Is this outfall currently in Tier 2 (monitored monthly)? Yes ® No ❑ Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency ❑ Received approval from DWQ to reduce monitoring frequency ❑ Other ❑ Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No Parameter, (units) Total Rainfall, inches TSS pH Copper Lead Zinc O & G TTO Benchmark N/A 100 mg1L 6.0-9.0 0.007 mg1L 0.03 mg1L 0.067 mg1L 15 mg1L 1 mg1L Date Sample Collected, mmiddlyy 4/25/17 0.32 0 6.6 0 0 0.11 0 NIA 916117 0.84 4.1 3.9 0 0 0.13 0 NIA SWU-264 - Generic Annual DMR Last revised 5/17/2013 Additional Outfall Attachment Outfall No. NIA Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No ❑ Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑ If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency ❑ Received approval from DWQ to reduce monitoring frequency ❑ Other ❑ Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ❑ Parameter, (units) Total Rainfall, inches Benchmark N/A Date Sample Collected, mmtddlyy SWU-264 - Generic Annual DMR Last revised 5/17/2013 "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and _imprisonment for knowing violations." Signature Date / ['6 /,h For questions, contact your local Regional Office: DWQ Regional Office Contact Information: ASHEVILLE REGIONAL OFFICE 2090 US Highway 70 Swannanoa. NC 28778 (828) 296-4500 RALEIGH REGIONAL OFFICE 3800 Barrett Drive Raleigh, NC 27609 (919) 791-4200 WINSTON-SALEM REGIONAL OFFICE 585 Waughtown Street Winston-Salem, NC 27107 (336) 771-5000 FAYETTEVILLE REGIONAL OFFICE 225 Green Street Systel Building Suite 714 Fayetteville, NC 28301-5043 910) 433-3300 WASHINGTON REGIONAL OFFICE 943 Washington Square Mall Washington. NC 27889 (252) 946-6481 CENTRAL OFFICE 1617 Mail Sen ice Center Raleigh, NC 27699-1617 (919) 807-6300 MOORESVILLE REGIONAL OFFICE 1 610 East Center Avenue/suite 301 1 Mooresville. NC 28115 (704) 663-1699 WILMINGTON REGIONAL OFFICE 127 Cardinal Drive Extension Wilmington. NC 28405-2845 (910) 796-7215 "To pres=ivafer..." and Norlh Car SWU-264 - Generic Annual DMR Last revised 5/17/2013 Semi-annual Stormwater„Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 5/12/17 CERTIFICATE OF COVERAGE NO. NCG030661 FACILITY NAME __ Matlab, Inc. — Plant 16 COUNTY Guilford — PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert. i# 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2017 SAMPLE PERIOD ® Jan -June ❑ July -Dec or [] Monthly' - (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply [:]SA RECEIVED ❑Other MAY 3 0 2017 CENTRAL FILES DWR SECT)oN PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this period?' Outfall No. Date Sample Collected l (mo/dd/yrj 24-hour rainfall amount,Total Inches 3 Suspended Solids an Standard d units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics5 Benchmarks =_-> _ - 100 mg/L or 50 mg/L° 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 4/25/17 0.32 0 6.6 0 0 0.11 0 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. a See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433,11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 5WU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement forTTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), l certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Print title) _. 22 (Signature) (Date) Note: Results must be reported in numerical format. Do_not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 rng/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ®NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) ,'5' ZZ / 7 (Date) Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 MATLAB, INC. — PLANT #16 GREENSBORO, NORTH CAROLINA TIER I PERMIT COMPLIANCE INSPECTION As required by General Stormwater Permit No. NCG030661, a compliance evaluation was conducted on 5I12/17 in response to stormwater analytical parameter exceedence. Present during the inspection were: Paul Spangenberg Consultant (Environmental Compliance Manager) Tait Williams Plant Manager 1) Areas where industrial activities are exposed to stormwater. a) Scrap metal storage west of main building. Scrap metal was observed to be oil free. No obvious signs were found of an impact to stormwater from the storage of scrap metal. b) Used equipment. No evidence was found that an impact to stormwater has occurred in this area. c) Solid Waste Dumpster Area: The waste was confined to the closed top dumpster. No evidence was seen of any impacts to stormwater in this area. d) Compressor Area: The area was clean with no staining. No evidence was seen of any impacts to stormwater in this area. e) Loading Dock Area: "the area was clean with no staining. No evidence was seen of any impacts to stormwater in this area. Summary: Except for some oil leakage from the yard crane, the following were not found during the inspection: a) leaks or spills from equipment, drums, barrels, or containers b) off site tracking of industrial materials c) tracking or blowing of raw, final, or waste materials d) evidence or, or the potential for, pollutants entering the drainage system. 2) Analytical monitoring results from sampling conducted on September 25, 2015 indicated the following exceedance. Date .. - _ _ _ Parameter Bench Mark Outf it l 1 4/25/16 Zinc 0.067 mg/L 0.11 No sources were found to elevate the zinc to exceed the range was found during the inspection. 3) There are no structural BMP's present at the facility. No retention ponds or collection basins are present. The facility captures compressor condensate and discharges it back to the city. None structural BMP's include the minimization of outdoor storage, the frequent disposal of accumulated wastes, and the elimination of any oily wastes. These non-structural BMP's appear to be adequate. 4) The stormwater discharge outfall was inspected. No evidence was seen of any non-stormwater impacts at the outfall. RECOMMENDATIONS l) Continue to BPM's in accordance with the permit. 2) Remove the stormwater exposed galvanized scrap metal stored outside the building near the loading dock. 3) No evidence was found that the current SWPPP has any deficiencies. No changes to the SWPPP are recommended now. All current initiatives appear adequate to meet the goals of the SWPPP. Note that the SWPPP was implemented on - 4/21 /2017, prior to the date that the inspection was conducted. CERTIFICATION This inspection did not reveal any violations of the permit. No areas of non-compliance with the SWPPP were noted. Certified by: Name: Paalk mar Date: _fZ2�7 r - Title: fTari�r�r�s��a �Q.rce /�2ra RAIN EVENT DATA FACILITY: Matlab.Inc. ADDRESS: 3010 Executive Dive Greensboro, NC 27406 CONTACT PERSON: Press Brower TELEPHONE: (336) 629-4161 STORM EVENTINFORMATION DATE YEAR MONTH DAY 2017 4 25 HOURS MINUTES DURATION 120 0 PRECIP. AMOUNT (1N.) 0.32 RUNOFF VOL. (M/GAL, 0.04 HOURS DAYS PRECEDING EVENT G 0 PRINCIPLE EXECUTIVE OFFICER.OR AUTHORIZED AGENT PRINT SIGNATURE DATE Paul W. Spangenberg 1'& k _ vvA07 02ylJ Plant — 16 4/25/17 5 Acres x 43,560 = 217800.0 x 0.32 = 169696 x .0833 = 5805.6 x 7.48 = 43426.4 / mg = 0.04 Aism OLAINC, Full -Service Analytical 8 Environmental Solutions Leonhardt Environmental, P.G- Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 NC Certification No. 402 NC Drinking Water Cert No. 37735 SC Certification No. 99012 Project: Matlab - Plant 16 Lab Submittal Date: 04/25/2017 Prism Work Order: 7040438 Case Narrative 05/09/2017 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. a__J Angela D. Ovei VP Laboratory Services Data Qualifiers Key Reference: Reviewed By Angela D. Overcash VP Laboratory Services HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529.6364 - Toll Free Number: 1-8001529-6364 - Fax: 704152"409 Pagel of 6 &AR -I n �[Fu11-Service Analytical & Sample Receipt Summary SVfvironmentat Solutions 05/09/2017 ~�LAeOF�TOAIES ING Prism Work Order: 7040438 Client Sample ID Lab Sample ID Matrix Date Sampled Date Received 01 7040438-01 Water 04/24/17 04/25117 Samples were received in good condition at 2.9 degrees C unless otherwise noted. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224.0543 Phone: 7041529.6364 - Toll Free Number: 1-8001529-6364 - Fax: 704/525-0409 Page 2 of 6 R� I S M Pull -Service Analytical Environmental Solutions ,!_'-'- `�%LABCIIATOFIEM1 ,NC Leonhardt Environmental, P.C. Project: Matiab - Plant 16 Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Sample Matrix: Water Laboratory Report 05/09/2017 Client Sample ID: 01 Prism Sample ID: 7040438-01 Prism Work Order: 7040438 Time Collected: 04/24/17 09:00 Time Submitted: 04/25/17 09:30 Parameter Result Units Report MDt_ Dilution Method Analysis Analyst Batch Limit Factor Datelrime ID General Chemistry Parameters Oil 8 Grease (HEM) BRL mg/L 5.0 0.98 1 '1664B 518117 9:56 TJY P7E0138 pH 6.6 HT pH Units 1 'SM4500-H B 4/25117 13:30 SLS i Total Suspended Solids BRL m91L 3.1 0.80 1 *Si D 4127117 11:40 SLS P7D0471 Total Metals Copper BRL mg1L 0.010 0.00040 1 '200.7 513117 2:10 bgm P7E0003 Lead BRL mg/L 0.0050 0.00090 1 '200.7 513117 2:10 bgm P7E0003 Zinc 0.11 mg1L 0.030 0.010 1 *200.7 513117 2:10 bgm P7E0003 This report should not be reproduced, except in its entirety, without the written consent of prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224.0543 Phone: 704/529-6364 - Toll Free Number: 1-800/529-6364 - Fax: 704/525-0409 Page 3 of 6 d P R ! S M Full -Service Analytical Environmental Solutions NQ Leonhardt Environmental, P.C. Attri: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Total Metals - Quality Control Analyte Project: Matlab - Plant 16 Level II QC Report 519117 Prism Work Order: 7040438 Time Submitted: 4/25/2017 9:30:00AM Reporting Spike Source %REC RP❑ Result Limit Units Level Result %aREC Limits RPM Limil Notes Batch P7E0003 - 200.7 Blank (P7E0003-BLK1) Prepared: 05/01/17 Analyzed: 05/03/17 Copper BRL 0.010 mglL Lead BRL 0.0050 mglL Zinc BRL 0.030 mglL LCS (P7E0003-13S1) Prepared: 05/01/17 Analyzed: 05/03/17 Copper 0.264 0.010 mg1L 0.2500 105 85-115 Lead 0.259 0.0050 mglL 0.2500 104 85-115 Z ric 0.278 0.030 mg1L 0.2500 111 85-115 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1-8001529.6364 - Fax: 704/525-0409 Page 4 of 6 a IR Full -Service Analytical & Ism Environmental Solutions Leanhardt Environmental, P.C. Attrl: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 General Chemistry Parameters - Quality Control Analyte Batch P7DO404 - NO PREP Project: Matlab - Plant 16 Reporting Result Limit Units Level 11 QC Report 519117 Prism Work Order: 7040438 Time Submitted: 4/25/2017 9:30:OOAM Spike Source %REC RPD Level Result %RLC Limits RPD Limit Notes LCS (P7D0404.13S1) Prepared & Analyzed: 04/25/17 pH 6.89 pH Units 6.880 100 98.5-101.5 Duplicate (P700404-OUP1) Source: 7040438-01 Prepared & Analyzed: 04/25/17 pH 6.55 pH Units 6.55 0 10 Batch P700471 - NO PREP Blank (P700471-BLK1) Prepared & Analyzed: 04/27/17 Total Suspended Solids 8RL 5.0 mg/L LCS (P700471-BS1) Prepared & Analyzed: 04/27/17 Total Suspended Solids 460 5.0 mg/L 477.0 97 90-110 Batch P7EO138 - NO PREP Blank (P7E0138-BLK1) Prepared & Analyzed: 05/08/17 Oil & Grease (HEM) 8RL 5.0 mg1L LCS (P7E0138-BS1) Prepared & Analyzed: 05/08/17 Oil & Grease (HEM) 35.2 5.0 m911- 40,00 68 78-114 Duplicate (P7E0138-DUP1) Source: 7040438.01 Prepared & Analyzed: 05/08/17 Oil & Grease (HEM) 1.38 5.0 mg1L 1.25 10 18 Sample Extraction Data Prep Method: 200.7 Lab Number Batch Initial Final DaterTime 7040438-01 P7E0003 50 mL 50 mL 051D1117 8:00 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224.0543 Phone: 7041529-6364 - Toll Free Number: I.8001529.6364 - Fax: 704/525-0409 Page 5 of 6 J f �J :C- _.:.sLtr}.. _�^isa:11..3::�.- � PAGE � OF i QUOTE t TO ENSORE Pp OPER 81LLING: — , Et $ MIN Full Service Anatytical B. Environmental Solutions''"' ��` �' Ihlla[lab-Plant 16 13ecenrod ON WET ICE?rTemp� �,r r , � 449 Springbrook Road • P.O. Box 240543 •Charlotte, NC 28224-U543=PRIDPER PRESERVATIVES IndlcatadY Phone: 7041529 6364 Fax: 7041525 0409 Sham Hold Analysis: (Yes} {Nc} UST Project: [Yes) {No) t34t t 4 t J d ± Fiecoe `ed WITHI OLDiNC7 TIMFS7Leonhard[ Env. , P.C. 'please ATTACH any project specific reporting (QC LEVEL 111 ill 1V) •+- +�< -, ' .+ '� ti� _ , r - Client Company Name: provisions and/or QC Requirements : a Cu,TODY SELS IyNTACTQ F�� S tN g� itLi Oerr Leonhard) p.. E I _ ♦}r - Report To/Contact Name; invoice To: Leonhardr Environmental, P c. r VC ATILES reed wH10 iT cADSPACE , Reporting Address: 6392 six Forks Road, Suite 10 i)392 Six Forks Raod, Suite 101 3 tr PRUPER CONTAIi�ER5,l15ed�� ' Pair Raleigh, NC 27615 Address: -r?h Phone' (919)1145.7492 .---Fax (Yes) (No): piut e4!-er 12 Derr 16"vice" betrsouth-"at Purchase Order No./Biliing Reference Email (Yx s) {No) Email Address Requested Due Dale 1 Da 2 Days 3 Days 4 Days 5 Days EDD Type: ,' PDF_ Excel —Other q y Y "Working Days" 6 9 Days / Standard 10 days Site Location Name: Mathtl - Pray 1e Samples received oiler 15:00 wits be processed next business day. Site Location Physical Address. Grensboro, Nc Turnareund time is based on business days, excluding weekends and holidays. {SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES RENDERED BY PRISM LA.BORATORtES, INC. TO CLIENT} TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Certification: NELAC USACE FL NC SC OTHER NIA Water Chlorinated: YES— NO � Sample Iced Upon Collection: YES � NO CLIENT SAMPLE DESCRIPTION DATE COLLECTED TIME COLLECTED MILITARY HOURS MATRIX (SOSL, WATER OR SLUDGE) SAMPLE CONTAINER PRESERVA- T1VES ANALYSES RE(]UESTED / IL..77 REMARKS / Z / PRISM LAB ID NO. `TYPE SEE BELOW No. SIZE 01 6115/15 1 08:00 Water G 2 Qt HCL 01 6/15/16 08:05 Water P 1 Pt None 01 6/15/16 08A0 Water P 1 Pt HNO 3 ,/ Zn, Pb, Cu Sampler's Signature amTait WilfiaTsts�;, p d By {Print Name) Affiliation Matlab_ Upon relinquishing, is Chain of Custody is your authorization for Prism to proceed with the analyses as requested above. Any changes must be suhmftied in writing to the Prism Project Manager, There will be charges for any changes after analyses have been initialized, Relinquished By- (Signature) Recewed Ry'. (Sipnaturo) pate AI11i;aryl5-1curs Additional Comments - " �- Site Arrival,Tiime: -Site Depbrtura Time_: Relinquished 13y: (Signor .e) Recorvad By- (Signature) Date Field -Tech Fee: . - - e Petiriwished By (Signature) Retaiv.ed For Prism Labor ies By:.- I�� Dale--11 Cc 7 I `L �" ✓ 1 c_)�1� Mileage: Melhod of Shipment: NOTE: ALL SAMPLE C�0 LERS S OB4D OF TAPED SHUT WITH CUSTODY SEALS FORTRAN SPORTATION TO THE LABORATORY. SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST COC UNTIL RECEIVED AT THE LABORATORY. Fad Ex UPS Hand -delivered Prism Field Service Orhu1 Log -In Group No, /� � (� o 'J 0 L13 r� y INYUt7: I UST: 6HOUNDWATER: DRINKING WATER: SOLID WASTE: I RCRA: CERCLA LANDFILL I OTHER: NC - SCI NC _ SG _ NC _ SC I _ NC _ SC _ NC _ SC 1 _NC _ SC -NC _ SC NC _ SC _NC _SG 'CONTAINER TYPE CODES: A = Amber C - Clear G = Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) 'rt SEC REVERSE FOR ',y DH r; iFAMS &-CDMCHS; ORIGIINAL MATLAB, INC. — RT. 49 S. CAMPUS ASHEBORO, NORT14 CAROLINA TIER I PERMIT COMPLIANCE INSPECTION As required by General Stormwater Permit No. NCG030661, a compliance evaluation was conducted on 4/29/17 in response to stormwater analytical parameter exceedence. Present during the inspection were: Paul Spangenberg Consultant (Environmental Compliance Iv nage�,��� Press Brower VP of Engineering 1• L. Jeremy Coble Plant #11 Manager MAY 1 6 W / 1) Areas where industrial activities are exposed to stormwater. CENTRAL FILES DWR SECTION a) Scrap metal storage areas. Scrap metal was observed to be oil free. No obvious signs were found of an impact to stormwater from the storage of scrap metal. b) Used equipment storage areas. No evidence was found that an impact to stormwater has occurred in this area. c) Solid Waste Dumpster Areas: No evidence was seen of any impacts to stormwater in this area. d) Compressor Areas: Some minor staining was present. A separator is being implemented for the condensation. e) Loading Dock Areas: The area was clean with no staining. No evidence was seen ol'any impacts to stormwater in this area. f) There was erosion occurring in and around the outfall and at several point in the stormwater drainage systems throughout the property. Summary: With the exception of some oil leakage from the yard crane, the following were not found during the inspection: a) leaks or spills from equipment, drums, barrels, or containers b) off site tracking of industrial materials c) tracking or blowing of raw, final, or waste materials d) evidence or, or the potential for, pollutants entering the drainage system. 2) Analytical monitoring results from sampling conducted on April 7, 2017 indicated the following exceedance. Date Parameter Bench Mark Outfall I 4/7/17 Copper 0.007 m L 0.011 4/7/17 H 6-9 Units 4/7/17 'I'SS 100 m L 340 m L It has been determined that the rain fall was acidic causing the elevated level copper and the lower level of pH. "There was no possible source copper. it is suspected of a possible cross contamination during sampling procedures. There was erosion occurring at the outfall discharge point and in the stormwater drainage systems throughout the property. 3) 'There are no structural BMP's present at the facility. No retention ponds or collection basins are present. The facility captures compressor condensate and discharges it back to the city. None structural BMP's include the minimization of outdoor storage, the frequent disposal of accumulated wastes, and the elimination of any oily wastes. These non-structural BMP's appear to be adequate. 4) The stormwater discharge outfall was inspected. No evidence was seen of any non-stormwater impacts at the outfall. RE -COMMENDATIONS 1) Continue to BPM's in accordance with the permit. 2) Implement erosion control measures (Rip Rap) in the areas of the outfall discharge and the stormwater drainage systems where needed throughout the property. 3) No evidence was found that the current SWPPP has any deficiencies. No changes to the SWPPP are recommended at this time. All current initiatives appear adequate to meet the goals of the SWPPP. Note that the SWPPP was implemented on 4/19/2017, prior to the date that the inspection was conducted. ChRTIFICATION This inspection did not reveal any violations of the permit. No areas of non-compliance with the SWPPP were noted. Certified by: Name: �a��/f'��r T Date: Title: ��sr�.r,�rerta�G'a �aree /L1W. '_ RAIN EVENT DATA FACILITY: Matlab.Inc. ADDRESS: 1 112 Hwy. 49 South NC 27204 CONTACT PERSON: Press Brower TELEPHONE: (336) 629-4161 STORM FVEN ANFORMA] ION DATE, YEAR MONTH DAY 2017 4 7 HOURS MINUTES DURATION 72 00 PRECI P. AMOUNT (IN.) 2.25 1.43 RUNOFF VOL. (MIGAL.) I4OURS DAYS PRECEDING EVENT 3 00 PRINT Paul W. Spangenberg PRINCIPLE EXECUTIVE OFF1 M:OR AUTHORIZED AGEN SIGNATURE P&// DATE Plant —11 4/7/17 23.5 Acres x 43,560 = 1023660 x 2.25 = 2303235 x .0833 = 191859.4 x 7.48 = 1435108.8 / mg = 1.43 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 4/29/17 CERTIFICATE OF COVERAGE NO. NCG030660 FACILITY NAME Matlab, Inc. — Plant 11 COUNTY Guilford PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2017 SAMPLE PERIOD ® Jan -June ❑ July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA []Zero -flow ❑Water Supply ❑SA ❑Other PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No dischorge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/Total Total Petroleum Hydrocarbons Toxic Organics5 Benchmarks ===> _ - 100 mg/L or 50 mg/L4 6.0 — 9.0 0,007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 4/7/17 2.25 340 5.3 0.011 0.0058 0.033 0 N/A 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark mere. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (P ' (Signature) (Date) Note: Results must be reported In numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported „in the format, "<XX me/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See Genera! Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?-' Outfail No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (sGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 5U Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ®NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one -copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results or at end olmonitoring period in the case o "No Dischar e" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are si nifg icant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) Permit Date:11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 v a� � PIDRISM �LABORAI'eRl[:S, INC Full -Service Analytical 8 Environmental Solutions Leonhardt Environmental, P.C. Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 INC Certification No. 402 INC Drinking Water Cert No. 37735 SC Certification No. 99012 Project: Matlab - Plant 17 Lab Submittal Date: 04/12/2017 Prism Work Order: 7040228 Case Narrative 04/25/2017 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. Angela D. Overcash VP Laboratory Services Data Qualifiers Key Reference: Reviewed By Terri W. Cole For Angela D. Overcash Project Manager HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0643 Phone: 7041529-6364 -Toll Free Number: 1-8001529-6364 - Fax: 7041525-0409 Page 1 of 6 �I} Ism Full Service Analytical 8 ® Environmental Solutions QuaauttM>� iHc Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Project: Matlab - Plant 17 Sample Matrix: Water Laboratory Report 04/25/2017 Client Sample ID; 01 Prism Sample ID: 7040228-01 Prism Work Order: 7040228 Time Collected: 04/07/17 08:00 Time Submitted: 04/12/17 08:00 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor Date/Time ID General Chemistry Parameters Oil 8 Grease (HEM) BRL mg1L 5.0 1.0 1 '16648 4124/17 10,50 TJY P7D0375 pH 5.3 HT pH Units 1 'SM4500-H B 4r12117 14:01 BM$ P7D0215 Total Suspendod Solids 340 mgli- 25 0.80 1 "SM2540 D 4112117 11:38 SLS P700182 Total Metals Copper 0.011 mglL 0.010 0.00040 1 '200.7 4117117 17:29 bgm P7D0228 Lead 0.0058 mglL 0.0050 0.00090 1 '200.7 4117/17 17:29 bgm P7D0228 Zinc 0.033 mglL 0.030 0.010 1 '200.7 4117117 17:29 bgm P7Q0228 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.D. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1-800/529-6364 - Fax: 7041625-0409 Page 3 of 6 e �P R I S M Fullironmeo Analytical s Environmental Solutions �iVI oW"TMES. PH Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Total Metals - (Quality Control Analyte Batch P7D0228 - 200.7 Project: Matlab - Plant 17 Level II QC Report 4l25117 Prism Work Order: 7040228 Time Submitted: 4/12/2017 8:00:00AM Reporting Spike Source %REC RPD Result Limit Units Level Result %REC Limits RPD Limit Notes Blank (1P7D0228-BLK1) Prepared & Analyzed: 04/17/17 Copper BRL 0.010 mg/1- Lead BRL 0.0050 mg1L Zinc BRL 0.030 mglL LCS (P7D0228-BSI) Prepared & Analyzed: 04/17/17 Capper 0,252 0,010 mgfL 0.2500 101 85-115 Lead 0.264 0.0050 mgfL 0,2500 105 85-115 Zinc 0.251 0.030 mg1L 0.2500 100 85-115 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Fro* Number: 1.8001529-6364 - Fax: 7041525.0409 Page 4 of 6 &dll LevelII QC Report IS M Futl-Service F n Soudan SF: 0-Se ice A SoWtlons4/25/17 iv�eon�roniei iNc Leonhardt Environmental, P.C. Project: Matlab - Plant 17 Prism Work Order: 7040228 Attm Derr Leonhardt Time Submitted: 4/12/2017 8:0100AM Suite 101, 8392 Six Forks Road Raleigh, NC 27615 General Chemistry Parameters - Quality Control Reporting Spike Source %REC RPD Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes Batch P7D0182 - NO PREP Blank (P7D0182-BLK1) Prepared & Analyzed: 04/12/17 Total Suspended Solids BRL 5.0 mg1L LCS (P7D0182-BSI) Prepared & Analyzed: 04112/17 Total Suspended Solids 460 5.0 mg1L 477.0 97 90-110 Batch P7D0215 - NO PREP LCS (P7D0215-BS1) Prepared & Analyzed: 04112117 pH 6.83 pH Units 6.850 99 98,5-101,5 Duplicate (P7D0215-DUP1) Source: 7040228-01 Prepared & Analyzed: 04/12/17 pH 4.91 pH Units 5.29 7 10 Batch P7D0375 - NO PREP Blank (P7130375-81-K1) Prepared & Analyzed: 04124/17 Oil & Grease (HEM) eRL 5.0 mg/L LCS (P7D0375-BS1) Prepared & Analyzed: 04I24117 Oit & Grease (HEM) 35.0 5,0 mg1L 40,00 88 78-114 Sample Extraction Data Prep Method: 200.7 Lab Number Batch Initial Final Date/Time 7040228-01 P7130228 50 mL 50 mL 04/17/17 8:05 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364-Tall Free Number: l-8001529-6364- Fax: 704152"409 Page 5 of 6 - r1- .J: .. .__—__.....�i.,�1.�.�,,.��—.vie.u._���..,..._.._.....__._...........................v—.,..�..,....,v�_.�.�,.,..�..... _. _.. __.—...:... _._ —�.. .. ..�. . 1 a r- �..LA90RATOFISES�INC- r { Full Service Analytical & Environmental Solutions 449 Springbrook Road • P.O. Box 240543 • Charlotte, NC 28224-OW Phone:7041529-6364 • Fax:704/525-0409 Client Company Name: Leonhardt Env. , P.C. Report To/Contact Name: DeLeonhardt Reporting Address; 8392 Si- Forks Road, Saito 10 Raleigh, NC 27E15- Phone. (919)846-749l 2 Fax ryes) (NO); (919)847.6112 Email (YXs) (No) Email Address le�nvron@nbellsouth.net EDD Type: PDF_ Excel —Other Site Location Name: Manst -Fna: aBs Site Location Physical Address: Asheboro. NC TIME MATRIX CLIENT DATE COLLECTED (SOIL, SAMPLE DESCRIPTION COLLECTED MILITARY WATER OR HOURS SLUDGE) CHAIN OF CUSTODY RECORD Q0 PAGE OF QUOTE A TO ENSURE PROPER BILLING: O E No.'-'"'�WA �.4:SamPlea y �j 'r ''t�r�� "F Ear INTACT uppn atT1V817 +- _"' x '�'' (p Matlab-Plant 495 Project Name: Received ON 1NET ICE?Temp 3 Short Hold Analysis: (Yes) (No) UST Project: (Yes) (No) �rPRCPER PAESERVA33VES I dlcaled� r w°y `ate ear r r s, t v , 3 r-3 �Recelved ro D *Please ATTACH any project specific reporting (QC LEVEL I.Ef III IV) WITN(N`FiOLD1NCiT1MESv` „ y,'� - rs � . � � � �� n � � � � � �- � 3yfT r 11 ,GLJSTODY�SEALS INTAC ?Li Requirements provisions and/or QC Re 9 > �. T a.. �i f..r .rv'�. 3 r� 3 r47 i � ✓7j n tLr.471T Invoice To: Leonhardt Fnvironinental,?.C. �1V0 ES,ttd,W10UT IiEADSPACE7,1� �, �'--=-.y> '� 9392 Six Forks Raod, Suite 101 'PROPER C TAiNER3ryused7 Address: Raleigh. NC 27815 Purchase Order NoJBilling Reference °eQ TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Requested Due Date 1 Day 2 Days 3 Days 4 Days 5 Days . Certification: NELAC USACE FL NC "Working Days" 6-9 Days / Standard 10 days SC OTHER N/A Samples received after 15:00 will be processed next business day. Turnaround time is based on business days, excluding weekends and holidays. Water Chlorinated: YES— NO ✓ tSEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES sample Iced Upon Collection: YES NO RENDERED BY PRISM LABORATORIES, INC. TO CLIE" P SAMPLE CONTAINER ANAL�ySES REQUESTED PRESERVA CY SEE NO. SIZE JIVES A ¢ 01 f 417117 JO&OD Water � G 2 Qt HCL 01 417117 108:05 1 Water I P 1 Pt None 01 4✓7117 1 08:10 1 Water J P 1 I OZ HNO 3 } ✓ i i ✓ pd By (Print Name) Paul W. Spangenberg Affiliation Leonhardt Env. amle is Chain of y is you orization for Prism to proceed with the analyses as requested above. Any changes must be to the Prism Pri5ject Manager,There will be charges for any changes after analyses have been initialized. ti,,z _ Re�Ned BY: (Signature) DL// l l/l711 RelinqW&ad t3y{Signature) Received rism Laboratories By; Date - Method of .Shi n: ,,,���AAAAAA111rrr TE' ALL SAMPLE COOLERS SHOULD BE TAPED SHUT WITH CUSTODY SEALS (OR�TRAA SSPPOORRTATION TO THE LABORATORY. Log -In Group No. SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST COC UNTIL RECEIVED AT THE LABORATORY. '—")� V�Z r\ Fed.u— UPS Rard-detive:ed Prism Field Serrice then Jr �� 3'� ! V CXl NC NPDES_ SCI NO _ SC GROUNDWATER: NSDtNOKINSWATER: SOLID NC WASTE:SC NO SO' NO LA SC NC LANDFILL OTHER: C- SC 'CONTAINER TYPE CODAS: A = Amber C = Clear G = Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (zero Head Space) PRISM REMARKS LAB }ID NO. Q 1 1 Zn, Pb, Cu Additional Comments: Site ArnvaiiTtrtte.•,�� � r r SiteOepanure Time � `' FI61dTech`Fee' 7 -x i�Fe:�SEEiREVERSp.FpR+��'' " }'�TEAlOS.& CONbrrI4NS �P R I S M E�viron en Analytical Sample Receipt Summary t-� Envlronmentvi Solutions 04/25/2017 ..���A8Or1ATOFiE9 Ma Prism Work Order: 7040228 Client Sample ID Lab Sample ID Matrix Date Sampled Date Received 01 7040228-01 Water 04/07/17 04/12/17 Samples were received in good condition at 3.1 degrees C unless otherwise noted. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1-8001529-6364 - Fax: 704/525-0409 Page 2 of 6 A��ME' LABORATORIES; INC.- Full Service AnaryUcal S Environmental Solutions 449 Springbrook Road • P.O. Box 240543 • Charlotte, NC 28224-0543 Phone:7041529-6364 Fax:7041525-0409 Client Company Name: Leonhardt Env., P.C. Report To/Contact Name: Derr Leonhardt Reporting Address: 8392 Six Forks Road. Suite I Raleigh, NC 27615 " CHAIN OF CUSTODY RECORD PAGE OF OUOTE M TO ENSURE PROPER BILLING: Project Name: Matlab-Plant 49S Short Hold Analysis: (Yes) (No) UST Project: (Yes) (No) *Please ATTACH any project specific reporting (QC LEVEL I.II III IV) provisions and/or QC Requirements Invoice Tyre Leonhardt Environmental, P.C. Address: 9392 Six Forks Raod, Suite 101 Raleigh. NC 27815 Phone: I—' "'" " 1-ax (Yes) (No): ""I....... "iron@bellsouth.net Email (Y,c s} (No) Email Address EDD Type: PDF_ Excel_Other Site Location Name: Matlab-Pnata9s Site Location Physical Address: Asheboro. NC Derr Purchase Order No./Billing Reference Requested Due Date 1 Da 2 Days 3 Days 4 Days 5 Da q y y y "Working Days" 6-9 Days � Standard 10 days Samples received after 15:00 will be processed next business day. Turnaround time is based on business days, excluding weekends and holidays. TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Certification: NELAC USACE FL NC ✓ SC OTHER N/A Water Chlorinated: YES_ NO ✓ - (SEE REVERSE FOR TERMS & CONDMONS REGARDING SERVICES RENDERED BY PRISM LABORATORIES, INC. TO CLIENT) Sam le Iced Upon Collection: YES P P ✓ NO CLIENT SAMPLE DESCRIPTION PATE COLLECTED T1MF COLLECTED MILITARY HOURS MATRIX (SOIL, WATER OR SLUDGE) SAMPLE CONTAINER PRESERVA- TIVES ANALYSES REQUESTED QQ U� U) / REMARKS /Q CF /� Q PRISM LAB ID NO. -TYPE SEE BELOW NO. SIZE 01 417117 08:00 Water G 2 Qt HCL 01 417117 08:05 Water P 1 Pt None 01 417117 08:10 Water P 1 OZ HNO 3 V( Zn, Pb, Cu Sampler's Signal a mpled By (Print Name) Paul W. Spangenberg Affiliation Leonhardt Env. Upa quis ng is Chain i ustod s orization for Prism to proceed with the analyses as requested above. Any changes must be sub i din wr(ti to the Pri Proje nager. There will be charges for any changes after analyses have been initialized. P - ui : ( n re) elinquish By: (Sign re) Receive y: (Signature) Date 240",Iflr C 17)5 R eived By: (Signature) Date MllitaryrHours Additional Comments: v"''%5i"=r..:='«:'.'.°?:'"c'"'.F'+s Site Amval"Tiii_me-i , `x .Slle Departure Time'. __- FiTech;FeeI'_.e Relinquished By: (Signature) Received For Prism Laboratories By: Date eld Metbcd of Shipment: NOTE: ALL SAMPLE COOLERS SHOULD BE TAPED SHUT WITH CUSTODY SEALS FOR TRANSPORTATION 70 THE LABORATORY. Log -In Group No.�- dux se Mileage'^" � SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST COC UNTIL RECEIVED AT THE LABORATORY. Fed Ex UIPS Hand�elivered Prism Field Service Other N GROUNDWATER: DRINKING WATER: SOLID WASTE: LA LANDFILL OTHER: S_ NO SC NC _ SC I NO NO _ SC C NC SC NC C NC _ SC I J - — - -- nt?rr_Ilanl *CONTAINER TYPE CODES: A = Amber C = Clear G = Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) Semi-annual Stormwater Discharge Monitoring Report � for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 12/21/16 CERTIFICATE OF COVERAGE No. NCG030661 FACILITY NAME Matlab. Inc. — Plant 16 COUNTY Guilford PERSON COLLECTING SAMPLES Tait Williams LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2016 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' (month) �E��p ARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA ICI vV CC ❑Zero -flow ❑Water Supply ❑SA JAN 2 3 20i7 [—]Other CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 DWR SECTION ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/Totai Total Petroleum Hydrocarbons Toxic Organicss Benchmarks =__> - - 100 mg/L or 50 mg/L4 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 12/6/16 0.70 7.2 6.0 0 ^ 0 0.66 5.8 N/A ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same a ' t1pat the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkroark here. 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. ° See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. Fo,%those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no durnping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower .� teas 1,� r4-0;r C7 r�- Name (Print name) VP of Engineering Title (Print title) (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ===> - - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A ATv`5i PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [:]NON IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DM& including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) /// //7, (Date) Permit Date:11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO3OOOO Date submitted 6115/16 CERTIFICATE OF COVERAGE NO- CGO3O661 SAMPLE COLLECTION YEAR 2016 FACILITY NAME Matlab, Inc. — Plant 16 SAMPLE PERIOD ❑ Jan -June ® July -Dec COUNTY Guilford or ElMonthly" (month) PERSON COLLECTING SAMPLES Tait Williams DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA RECEIVED ❑Zero -flow ❑Water Supply []SA LABORATORY Prism Lab Cert. # 402 ❑Other Comments on sample collection or analysis: JUL 2 � ���� CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 DWR SECTION Part A: Stormwater Benchmarks and Monitoring Results No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids.f j/ r/ pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics s Benchmarks =__> - - 100 mg/L or 50,ri g/L° 6.0 — 9.0 0,007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 6/15/16 0.08 5.3/;f 6.6 0 0 0.037 0 N/A i I6 H 9 l i .7 1� U If L1101 6= F Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. IFor sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Ensineering TitleEin e (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART AAND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Il SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case o "No Discharge" rg orts to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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 fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date:11/1/2012-10/31/2017 % 8 J� (Date) SWU-245, last revised 10/25/2012 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 6/15/16 TRTIFICATE OF COVERAGE No. NCG030661 ACILITY NAME Matlab, Inc. — Plant 16 :OUNTY Guilford 'ERSON COLLECTING SAMPLES Tait Williams SAMPLE COLLECTION YEAR 2016 SAMPLE PERIOD ® Jan -June ❑ July -Dec or ❑ Monthly' _ (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ABORATORY Prism Lab Cert. #E 402 ❑Other :omments on sample collection or analysis: RE��'j'�D .m PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 Part A: Stormwater Benchmarks and Monitoring Results ;�:,, Al Fll F119 :.'.'i I SECTION ❑ No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches' Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics ;enchmarks =__> - - 100 mg/L or 50 mg/L^ 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 6/15/16 0.08 5.3 6.6 0 0 0.37 0 N/A l� r 5Piv(tom"`rLuiu Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedanceiforithE-same parameter at the same outfall. For sampling periods with no discharge at any single outfall, you must still submit this discharge maiaitoFing=reportEwith a checkmark here. The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture -lectronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA ffluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor ianufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray ube manufacture use the definition found in 40 CFR 469.31). ermit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 acilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring iay'be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General 'ermit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Print title (Signature) v (Date) Jote: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical :)rmat. When results are below the applicable limits, they must be reported in the format, "<_XX mdL", where XX is the numerical value of the detection mit, reporting limit, etc. in mg/L. late: if you report a sample value in excess of the benchmark, you must implement tier 1, Ter 2, or Tier 3 responses. See General Permit text. ,art B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 mg/L• 6.0 — 9.0 SU ootnotes from Part A also apply to this Part B See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. ermit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2of3 late: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier2, or Tier 3 responses. See General Permit text. OR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO EGIONAL OFFICE CONTACT NAME: Mail an on final and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lob results or at end of monitoring period the case of "No Discharge" reports) to. - Division of Water Quality Atn: DWQ Central Files 617 Mail Service Center .aleigh, North Carolina 27699-1617 OU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to ssure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or hose persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I m aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." 8 9 lb signature of Permittee) ermit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 RAIN EVENT DATA FACILITY: Matlab, Inc. ADDRESS: 3010 Executive Dive Greensboro NC 27406 CONTACT PI.RSON: Press Brower 'ITLFTFIONE: (336)629-4161 STORM EVENT.INI{ORMATION � s~ DATE' YI:;AIt MONTH DAY 2016 6 15 HOURS MINUTES DURATION 52 40 PRICIP. AMOUNT (IN.) 0.08 RUNOFF VOL. (M/GAL.)0.01 DAYS I [OURS PRI?CEDING I"VEN"r 9 30 PRINCIPLE 1 XL'•CU'i IVE UPFICER OR-AU'l'I-�ORiZED AGENT - -- PRINT SIGNA'1'URI DATE Press Brower 4/15/16 Plant —16 6/15/15 5 Acres x 43,560 = 217800.0 x 0.08 = 17424 x .0833 = 1451.4 x 7.48 = 10856.6 / mg = 0.01 MATLAB, INC. — PLANT # 16 GREENSBORO, NORTH CAROLINA TIER II PERMIT COMPLIANCE INSPECTION RECOVED AUG 15 Z016 CENTRAL FILES DIVR SECTION As required by General Stonnwater Permit No. NCG030661, a compliance evaluation was conducted on 6/29/16 in response to stormwater analytical parameter exceedence. Present during the inspection were: Paul Spangenberg Consultant (Environmental Compliance Manager) Press Brower VP of Engineering Tait Williams Plant Manager 1) Areas where industrial activities are exposed to stormwater. a) Scrap metal storage west of main building. Scrap metal was observed to be oil free. No obvious signs were found of an impact to stormwater from the storage of scrap metal. b) Used equipment. No evidence was found that an impact to stormwater has occurred in this area. c) Solid Waste Dumpster Area: No evidence was seen of any impacts to stormwater in this area. d) Compressor Area: Some minor staining was present due to a malfunctioning separator. The area was being clean. e) Loading Dock Area: The area was clean with no staining. No evidence was seen of any impacts to stormwater in this area. Summary: With the exception of some oil leakage from the yard crane, the following were not found during the inspection: a) leaks or spills from equipment, drums, barrels, or containers b) off site tracking of industrial materials c) tracking or blowing of raw, final, or waste materials d) evidence or, or the potential for, pollutants entering the drainage system. 2) Analytical monitoring results from sampling conducted on June 15, 2016 indicated the following; exceedance. DateParameter 'Bench Mark _ Outfall I _ 9/25/15 Zinc 0.067 mg/L 0.037 6/15/16 Zinc 0.067 m Y L 0.037 It has been determined that the rain fall was acidic causing the elevated level zinc. A possible source may be runoff from the corrugated galvanized steel manufacturing building, galvanized scrap metal stored outside, or the decomposing galvanized fencing. No other sources were found to elevate the zinc to exceed the range was found during the inspection. 3) There are no structural BMP's present at the facility. No retention ponds or collection basins are present. The facility captures compressor condensate and discharges it back to the city. None structural BMP's include the minimization of outdoor storage, the frequent disposal of accumulated wastes, and the elimination of any oily wastes. These non-structural BMP's appear to be adequate. 4) The stormwater discharge outfall was inspected. No evidence was seen of any non-stormwater impacts at the outfall. RECOMMENDATIONS 1) Continue to BPM's in accordance with the permit. 2) Remove the stormwater exposed galvanized scrap metal stored outside the building near the loading dock. 3) No evidence was found that the current SWPPP has any deficiencies. No changes to the SWPPP are recommended at this time. All current initiatives appear adequate to meet the goals of the SWPPP. Note that the SWPPP was updated on - 4/15/2016, prior to the date that the inspection was conducted. CERTIFICATION This inspection did not reveal any violations of the permit. No areas of non-compliance with the SWPPP were noted. Certified by: Name: P'Z//y�Ea-•r Date: O�6 Title:4W_� V.0r—e-r a/G0rZA 0_0 Al rW V 2nOILS 4 IE& ItIC, Full -Service Analytical & Environmental Solutions Leonhardt Environmental, P.C. Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Nc Certificadon No. 402 NC Drinking Water Cert No. 37735 SC Certification No. 99012 FL NELAC Cert No. E87519 VA NELAC Cert No. 460211 Project: Matlab - Plant 16 Lab Submittal Date: 06/17/2016 Prism Work Order. 6060321 Case Narrative 07/27/2016 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. 61L� Angela D. Overcash VP Laboratory Services Data Qualifiers Key Reference: Reviewed By Angela D. Overcash VP Laboratory Services HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 704l529-6364 - Toll Free Number: 1.8001529-6364 - Fax: 7041525-0409 Pagt? 1 of 7 rr 1 �R I S M I FW6Sarmee al Solution 8 Environmental Solutions Sample Receipt Summary 07/27/2016 Prism Work Order: 6060321 Client Sample ID Lab Sample ID Matrix Date Sampled Date Received 01 6060321-01 Water 06/15/16 06/17/16 Samples were received in good condition at 1 A degrees C unless otherwise noted. This report should not be reproduced, except in Its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.Q. Box 240543 - Chartotte, NC 28224.0543 Phone: 704152M364 - Toll Free Number: 1-800152M364 - Fax: 7041525-0409 Page 2 0f 7 d i Full-6arvice Analytical 5 P.R I S M Environmental 6oiutione Leonhardt Environmental, P.C. Attn: Derr t_eonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Project: Mattab - Plant 16 Sample Matrix: Water Laboratory Report 07/27/2016 Client Sample ID: 01 Prism Sample ID: 6060321-01 Prism Work Order: 6060321 Time Collected: 06/15/16 08:00 Time Submitted: 06/17/16 10:20 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor Datelrme 10 General Chemistry Parameters Oil & Grease (ITEM) BRL mglL 5.0 1.0 1 '16648 6127116 9:08 TAY P6F0524 PH 4.6 HT pH Units 1 'SM4500-H B 6117/16 14:24 B6AS P6F0362 Total Suspended Solids 5.3 mg1L 3.6 0.80 1 'SM 2540 D 6/17116 14:45 SLS P6F0361 Total Metals Copper BRL mg1L 0.010 0.0021 1 200,7 6/24/16 21:00 bgm P61`0484 Lead BRL mg1L 0.0050 0.00070 1 '200.7 6124116 21:00 bgm P61`0484 Zinc 0.37 mg1L 0.030 0.010 1 "200.7 6129116 11:58 bgm P6F0484 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1.8001529-6364 - Fax: 7041525-0409 Page 3 of 7 9 -aP R Full -Service Analytical ISM Environmentgl solutions wron..onE� me Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Project: Matlab - Plant 16 Sample Matrix: Water Laboratory Report 07/27/2016 Client Sample ID: 01 Prism Sample ID: 6060321 -01 RE 1 Prism Work Order: 6060321 Time Collected: 06115/16 08:00 Time Submitted: 06/17/16 10:20 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor Daterrime ID Total Metals Zinc 0.39 mglL 0,030 0.010 1 *200.7 7126116 20:58 bgm P6G0396 This report should not be reproduced, except in Its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1-8001529-6i364 - Fax: 7041525-0409 Page 4 of 7 FP-R I S M FullIrommeB bi Analytical 8 Enrironmentnl Solutions /uuwwraw" Iw Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Total Metals - Quality Control Analyte Batch P6FO484 - 200.7 Project: Matiab - Plant 16 Level 11 QC Report 7127116 Prism Work Order: 6060321 Time Submitted: 6/17/2016 10:20:OOAM Reporting Spike Source %REC RPD Result Limit Units Level Result %REC Limits RPD Limit Notes Blank (P6FO484-BLK1) Prepared & Analyzed: 06/24/16 Copper BRL 0.010 mg1L Lead BRL 0.0050 mg1L Zinc BRL 0.030 mg/L LCS (P6F0484-8S1) Prepared & Analyzed: 06/24/16 Copper 0.256 0.010 mg1L 0.2500 103 85-115 Lead 0.270 0.0050 mg1L 0.2500 108 85-115 Zinc 0.275 0,030 mglL 0.2500 110 85-115 Batch P61130396 - 200.7 Blank (P6GO396-BLK1) Prepared: 07/25/16 Analyzed: 07/26/16 Zinc BRL 0.030 mglL LCS (P6G0396-BS1) Prepared: 07/25/16 Analyzed: 07126/16 Zinc 0.281 0.030 mg1L 0.2500 112 85-115 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.D. Box 240543 - Charlotte, NC 28224-0543 Phone: 704/529-6364 - Toll Free Number 1-8001529-6364 - Fax: 7041525-0409 Page 5 of 7 Level II QC Report P R I S M I Full -Service Analytical 6 7127116 Environmental al Sol gokutions �7"�.eoe•.omFr, we Leonhardt Environmental, P.C. Project: Matlab - Plant 16 Prism Work Order: 6060321 Attn. Derr Leonhardt Time Submitted: 6/17/2016 10:20MAM Suite 101, 8392 Six Forks Road Raleigh, NC 27615 General Chemistry Parameters - Quality Control Reporting Spike Source %REC RPD Anaiyte Result Limit Units Level Result %RFC Limits RPD Limit Notes Batch P6F0361 - NO PREP Stank (1361`0361-8LK1) Prepared & Analyzed: 06117/16 Total Suspended Solids BRL 5.0 mg1L LCS (P6F0361-BS1) Prepared & Analyzed: 06/17/16 Totat Suspended Solids 470 5.0 mg& 477.0 98 90-110 Batch P6F0362 - NO PREP LCS (P6F0362-BSI) Prepared & Analyzed: 06/17/16 PH 6.81 pH Units 6.880 99 98.5-101.5 Duplicate P6F0362-DUP1) Source: 6060321-01 Prepared & Analred-,. 06/17/16 pH 4.65 pH Units 4.63 0.4 10 HT Batch P6F0524 - NO PREP Blank (P6F0524-RLK1) Prepared & Analyzed: 06/27/16 Oil & Grease (HEM) BRL 5.0 mg1L LCS (P6F0524-1BS1) Prepared & Analyzed: 06/27116 Oil & Grease (HEM) 35.1 5.0 mg1L 40.00 88 78-114 Sample Extraction Data Prep Method: 200.7 Lab Number Batch Initial Final Date/Time 6060321-01 P6F0484 50 mL 50 mL 06/24/16 8:05 6060321-01 P6F0484 50 mL 50 mL 06/24/16 8:05 6060321-01RE1 P6G0396 50 mL 50 mL 07/25/16 8:10 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Tall Free Number. 1-8001529-6364 - Fax: 7041525-0409 Page 6 of 7 r: r:. r�.il.l�:�:J�••v; ... �. n.. .... _..._ 1..,..�....-1 �.�...—._d I/J_..I _..u.... �.:I,�. r..... JJcy:_l.a...r.r................... .... .... .. �..... ...... �... ... _.. .....vJ .ram. i ,>..i.�,. ..,,,,.��..,1. _.....�.J•.. .r f PRISM CHAINOF CUSTODY RECOR® s w LAOORATORIES.INC -. O aAAe _ OF w_ QUOTE / TO ENSURE PROPER SILLeVOt pfeel AG"TLllpgrigT{jlJal'I Full Service AnaWlcal 11 EnvlronmenI t Solutions . � FM' '`r'' I rr .9 v'r g Matlal -Plant 1fi BBce)ve ON� E4 ain�g Protect Name: 449 Springbrpok Road • P.O. Box 240543 • Charlotte, NC 28224 0643 t OPE R Ep RVATIVESndr� �I d Phone: 704/529-6361 • Fax: 7041525-0409 Short Hold Analysis: (Yes) (No) UST Project: (Yes) (No) "9'k �1ved WITHINFiO ifl©+YINIE�p� - Client Company Name: Lecnhardt Env., P.C. *Please ATTACH any project specific reporting (OC LEVEL i it Ill lY) GE3�9TOpYSFAt�`in[Iai� -sa k , Report To/Contect Name Derr Leonhwm provisions and/or dC Requirements Lftnhl)fd irnviror"ntal. P.C. TESrsc d /OJT;H Invoice To: A E xReporting 1101�' Address: 9392 S.x Forks Road, Stets 10 9302 51x Forks Rave, 8u'te tot EQNRuRslaVh, '� "tG; # SrtX'r.Msi;s.� NC 27615Address: � le,Y...-t`•'� Is;:;„-. Phone; (9191BA&1492 Fax (Yes) (No): 1919i 847�it2 l>aR Purchase Order NoJBllling Reference TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL x Ienvi onQbellsoulh.nel Email (Y s) (No) Email Address - EDD T ype:� PDF Excel Requested Due Date 1 Pay 2 Rays 3 Days b Gays 5 Days Certification: NELAC— USACE FL NC ✓ —Other Site Location Name; Mallet,. Pnal 16 "Working Days' "Days i Standard 10 days SC_ OTHER N/A �rombcro, NC Site Location Physical Address: - — - Samples received after 15:00 will be processe0 next business day. Turnaround time is based on buerness days. excluding weekends and holidays. Water Chlorinated: YES _ NO ✓ ey � e Y � ...._ (SEE REVERSE FOR TERMS L CONDITIONa REDARDINO 9ERVICEB Sample Iced Upon Collection: YES ✓ NO p RENDERED BY PRISM LABORATORIES. INC. TO CUEKM TIME MATRIX SAMPLE CONTAINER ANALYSES Z REOUESTED PRISM CLIENT DATE COLLECTED (SOIL. PREBERVA• � / LAB `TYPE NO. SIZE SAMPLE DESCRIPTION COLLECTED MILITARY WATER OR TIVES a REMARKS ID NO. HOURS SLUDGE) SEE BELOW a 01 6/15/15 08:00 Water G 2 COt HCL �/ u 4 01 6/15116 J 05:05 Water P 1 Pt None 01 6115116 08:10 Water p 1 Pt #ENO 3 1 ;Zn, Pb, Cu I i Sampler's Signature s d B (Print Name) Tad Williamscn Affiliation Matlab ml4C1 Upon relinquishing, kis Chain of Custody is your authorization for Prism to proceed with the analyses as requested above. Arty changes must be submitted in writing to the Prism Project Manager. There will be charges for any changes after analyses have been Initiellzed. elhquisnod B✓: nature _ , _ 1,9sceived By. Jftratwa)Date I MdNrylHouro Mr. V UJ .I�10to e Crrant T I n uraip No. SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST CDC UN RECEIVED AT The LABORATORY, Fed £� UPS Hend-dslNerod prism Field Saw 01rer bo u vl' , )i. NPOES: I UST: I GROUNDWATER; I DRINKING WATER: I SOLID WASTE: I RCRA: CERCLA LANDFILL OTHER: NC _ SC NC _ 5C _ NC SG ` _NC _SC 1 NC _ SC _ NC _ S -NC _ SC _ NC 5C _ NC _ 5C *CONTAINER TYPE CODES: A = Amber C = Clear G = Glass P = Plastic: TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) Comments: e 7- SIte;ArrivslTlme• t ';�;�, ';Slte`bepeltiiiaTlme:_ ' ;Field Tecfi Fee:' `� "}'ir Mlbape • I SEE REVERSE FOR- = TERMS & CONDITIONS a 17 Eprn RI SM ��USBORATORIE$ ING Full -Service Analytical & Environmental Solutions Leonhardt Environmental, P.C. Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 NC Certification No. 402 NC Drinking Water Cert No. 37735 SC Certification No. 99012 FL NELAC Cert No. E87519 VA NELAC Cert No, 460211 Project: Matlab - Plant 16 Lab Submittal Date: 06/17/2016 Prism Work Order: 6060321 Case Narrative 06/30/2016 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. Angela D. Overcash VP Laboratory Services Data qualifiers Key Reference: Reviewed By Cara C. Rusmisell For Angela D, Overcash Project Manager HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364- Toll FrocNumber: 1-800152M364- Fax: 7041525.0409 Page 1 of 6 a //I/III� Pt .� Full-Servica Analytical 8 LJILJR M Environmental Solutions oq.aoAnroR�E�,�� Sample Receipt Summary 06/30/2016 Prism Work Order: 6060321 Client Sample ID Lab Sample ID Matrix Date Sampled Date Received 01 6060321-01 Water 06/15/16 06/17/16 Samples were received in good condition at 1.4 degrees C unless otherwise noted. This report should not he reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041629-6364 - Toll Free Number:l-8001529.6354- Fax: 7041525-0409 Page 2 of 6 Laboratory Report �1R I S n n Full -Service Analytical - �] ' V' Environmental Solutionss 0613012016 ��umrutoniEs I.C. Leonhardt Environmental, P.C. Project: Matlab - Plant 16 Client Sample ID: 01 Attn: Derr Leonhardt Prism Sample ID: 6060321-01 Suite 101, 8392 Six Forks Road Prism Work Order: 6060321 Raleigh, NC 27615 Sample Matrix: Water Time Collected: 06/15/16 08:00 Time Submitted: 06/17/16 10:20 Parameter Result Units Report MOL Dilution Method Analysis Analyst Batch Limit Factor Date[Time ID General Chemistry Parameters Oil & Grease (HEM) BRL mg/L 5,0 1.0 1 '1664B 6127116 9;08 TJY P61F0524 pH 4.6 HT pH Units 1 'SM4500-H B 6117116 14:24 BMS P6F0362 Total Suspended Solids 5.3 mg1L 3.6 0.80 1 "SM 2540 D 611171116 14:45 SLS P6F0361 Total Metals Copper URL Lead BRL Zinc 0.37 mg/L 0,010 0,0021 1 mg/L 0.0050 0.00070 1 mg/L 0.030 0.010 1 200,7 6124/16 21:00 bgm P6F0484 200.7 6/24116 21:00 bgm P61`0484 '200.7 6129116 11:58 bgm P6F0484 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc, 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1-8001529-6364 - Fax: 7041525-0409 Page 3 of 6 a PRR I EnFull-Service Analytical 8 vironmental Solutions ��iMOMTORIE3� IxC Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 Total Motals - Quality Control Analyte Batch P6F0484 - 200.7 Project: Matlab - Plant 16 Level II QC Report 6/30116 Prism Work Order: 6060321 Time Submitted: 6/17/2016 10:20:00AM Reporting Spike Source %REC RPD Result Limit Units Level Result %REC Limits RPD Limit Notes Blank (P6F0484-BLK1) Prepared & Analyzed: 06/24/16 Copper BRL 0.010 mg1L Lead BRL 0.0050 mglL Zinc BRL 0.030 mg1L LCS (P6F0484-BS1) Prepared & Analyzed: 06/24/16 Copper 0.256 0.010 mg1L 0.2500 103 85-115 Lead 0.270 0.0050 mg1L 0.2500 108 85-115 Zinc 0.275 0.030 mglL 0.2500 110 85-115 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041529-6364 - Toll Free Number: 1-8001529-6364 - Fax: 7041525-0409 Page 4 of 6 7 R 1 S M Fun -Service Analytical & Environmental Solutions ��LA60RATORIE& ING Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 General Chemistry Parameters - Quality Control Project: Matlab - Plant 16 Level II QC Report 6130116 Prism Work Order: 6060321 Time Submitted: 6/17/2016 10:20:OOAM Reporting Spike Source %REC RPD Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes Batch P6F0361 - NO PREP Blank (P6F0361-Bi Prepared & Analyzed: 06/17/16 Total Suspended Solids BRL 5.0 mg1L LCS (136F0361-135i) Prepared & Analyzed7 06117116 Total Suspended Solids 470 5,0 mg11- 477,0 98 90-110 Batch P6F0362 - NO PREP LCS (PSF0362-BSi) Prepared & Analyzed: 06/17/16 PH 6A1 pH Units 6.880 99 9B.5-101.5 Duplicate (P6F0362-DUP11 Source: 6060321-01 Prepared & Analyzed: 06/17/16 PH 4.65 pH Units 4.63 0,4 10 HT Batch P611i - NO PREP Blank (P6F0524-<3LK11 Prepared & Analyzed: 06/27/16 Oil & Grease (HEM) BRL 5,0 mg1L LCS (P6F0524-i Prepared & Analyzed: 06/27/16 Oil & Grease (HEM) 35.1 5.0 mglL 40.00 88 7&114 Prep Method: 200.7 Lab Number Sample Extraction Data Batch Initial Final DaterTime 6060321-01 P6F0484 50 mL 6060321-01 P61`0484 50 mL 50 mL 06124H 6 8:05 50 mL 06124/16 8:05 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, lnc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 704/629-6364 - Toll Free Number: 1-800/529-6364 - Fax: 7041525-0409 Page 5 of 6 - USNL1s -_ 'i �•LABORATaRIES'INC Full Serviue Analytical & Environmental Solutions 449 Springbrook Read • P.O. Box 240M • Charlotte. NC 28224-0543 Phone:704/529.6364 Fax:704/525-0409 Client Company Name: Leonhard- Env_ . P.C. Report To/Contact Name: Derr Leonn.rot Reporting Address•- e392 Six Forks Road, Suite 1e Raleigh, NC 27615 - qpl CHAIN OF CUSTODY RECORD t3is1r' PAGE OF QUOTE 4 TO cD r�fxFl w E NO= N/A 'Samples �+ 'ar _ ENSURE PROPER BILLING: INTACT uppn.armral7 y r-. -' �tved Matlab-Plant 16 sRece ON WEIGE7Tem 1;r`� apt dnl-a ` i+ ry p Project Name: f :t d tt5 Sham Hold Analysis: (Yes) (No) UST Project: (yes) (No) PROPER PRESERVATIVES indicat � �� , s v � led VL THirS {O—pINR 'Please ATTACH any project specific reporting (OC LEVEL 1 It III IV) SEPLSNTACT� provisions and/or QC Requirements �r C(J�SyODY 1 t G Leonhardt Envimnmental, P.C. Invoice To: = VOLA71LESfec'd Wl6t3T HFJIOSPAGE7 z� r n r , " u PROPER CDNTAlNERS used7� ,�;=r +r-� v�,r t - 'I c- .�.: Address:9392 Six Forks Raod, Suite 101 Phone: ""I --" ' -" Fax (Yes) (No): " 2 """' " Purchase Order No./Billing Reference De-r TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Email (Yxs) (No) Email Address 'e"'"`°r'�dallSeu:".net Requested Due Date 1 Day 2 Days 3 Days 4 Days 5 Days Certification' NELAC USACE FL NC J EDD Type: PDF EXcel_Other `Working Days" 6-9 Days Standard 10 days Site Location Name: 1'4al1eh-Pnat16 Samples received alter 15:00 will be processed next business day. Sc OTHER N/A Gren.5orc, Nc Turnaround time is based on business days, excluding weekends and holidays. Site Location P1Tysica! Address: v. 9 y Water Chlorinated: YES NO (SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES RENDERED SY PRISM LABORATORIES, INC. TO DLIUM Sample Iced Upon Collection: YES P P ✓ NO TIME ATRIX SAMPLE CONTAINER ANA ES REQUESTED L" z ' PRISM CLIENT DATE COLLECTEDSOIL, Fs, PRESERVA- I "TYPE SEE BELOW NO. SIZE SAMPLE DESCRIPTION COLLECTED MILITARY HOURS TER OR UDGE) T1VES o� REMARKS /0 / LA9 ID NO. a 01 6/15/15 i 08:00 Water G 2 Qt HCL 01 6/15/16 108:05 I Water P 1 Pt None 01 6/15/16 108:10 I Water P 1 Pt HNO 3 Zn, Pb, Cu Tait Williamsor) Matlab I�iGtnC =3i Sampler's Signature m d By (Print Name) Aiflliation Upon relinquishing, is Ghain of Custody is your authorization for Prism to proceed with the analyses as requested above. Any changes must be submitted in writing to the Prism Project Manager. There vviil be charges for any changes after analyses have been initialized. Relmquished By. (Stgnaturel Received By. (Signa:urel � Date MGitary(Hours Additional Comments: -' '•`'<?'''c" e: '�SitaArdvaj:Time'',. Belingvished 9y: (Signal eJ Received By: (SEgnatura) pale Slte-Departure Ttr•te ' - Fletd Tech Fee Relinquished By: (Signature) RgcQ Fo risrn La6omlories By: ate , 6 _ . r / 1 DL) MI(eage Method of Shipment: NDT� ALL SAMPLE COOLERS SHOULD E TAPED SH WITH CUSTODY SEALS FOR TRANSPORTATION TO THE LABORATORY- SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST CDC UN✓ir[ RECEIVED AT THE i1lBORATORY. Log n r p No, Fed E. LIPS Hand -delivered Prism Field Service Other NPDES: UST: I GROUNDWATER: DRINKING WATER: ' SOLID WASTE: RCRA: I CERCLA I LANDFILL I OTHER: NC — SCI NC _ SC _ NO _ Sc I _NC _SC _ NC _ Sc i _ NC — SC, —NO _ SC _ NC _ SC _NC _SC *CONTAINER TYPE CODES: A = Amber C = Clear G = Glass P = Plastic; TL = Teflon-! fined Cap VDA = Volatile Organics Analysis (Zero Head Space) ORtGtNA _ Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 10/15/15 CERTIFICATE OF COVERAGE NO. NCG030661 FACILITY NAME Matlab. Inc._ - Plant 16 COUNTY Guilford PERSON COLLECTING SAMPLES Colleen McLaughlin_ LABORATORY Prism Lab Cert. # 402 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 201S SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' _ (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply [-]SA ❑Other PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this period?' Outfall No. Date Sample 1 Collected (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics-' Benchmarks ==_> - - 100 mg/L or 50 mg/O 6.0 - 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 01 9/25/15 2.11 0 6.2 0 0 0.13 0 N/A ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. ° See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Press Brower Name (Print name) VP of Engineering Title (Print -title) (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/IL", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the Benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 mg/L• 6.0 — 9.0 5U Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 2 of 3 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No _Dischar e" reports) to: _ ^ Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3of3 RAIN EVENT DATA1l l P Pa FACILITY: Matlab, Inc. ADDRESS: 1112_Hwy. 49 South Asheboro. NC 27204 CONTACT PERSON: Press Brower 'TELEPHONE: 336 629-4161 1 , ' STORM EUI✓N 11NFOR[VIA'I ION i "� , mA �' � -v �' � � { � °' _ � '�' °� ..� Px v1a < Ssy 9rw DATE YEAR MONTH DAY 2015 9 25 HOURS MINUTES DURATION 52 40 PRECIP. AMOUNT (1N.) 2,11 RUNOFF 1.34 VOL. M/GAL.) }-TOURS DAYS PRECEDING EVENT 3 20 � ,, �• . ' PRINCIPI'�E EXCCUIIVE OFFICCR OR AU'I 1-10R1ZED,AGF]*IT,� „�; � �c. �'� �� ( �'� � � � '• 41, ...� v,:�-.. •... ut". :_. 5.., •'(R[. i f�!'J-.ariR�-v.. ,.r-glt•ry ri'T-f 'N'nr1. RNai-,i;�s r?WE ���'rn �... .I .. ,.. ,.:.,i_ ': .. .5 .. .- -.f. .. ••cn ... .. .. PRINT SIGNATURE DATE �VZiZ)U� Plant—119/25/15 23.5 Acres x 43,560 = 1023660 x 2.11= 2159922.6 x .0833 = 179921.5 x 7.48 = 1345813.2 / mg = 1.34 FEE)� 2 ISM -- QLAeOAATORIE� MCI Full -Service Analytical & Environmental Solutions Leonhardt Environmental, P.C. Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 NC Certification No. 402 SC Certification No. 99012 NC Drinking Water Cert No. 37735 VA Certification No, 460211 DoD ELAP: L-A-B Accredited Certificate No. L2307 ISOlIEC 17025: L-A-B Accredited Certificate No. L2307 Project: Matlab - Plant 11 Lab Submittal Date: 09/30/2015 Prism Work Order: 5090540 Case Narrative 10/12/2015 This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed according to the referenced methods. Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this Case narrative. Please call if you have any questions relating to this analytical report. Respectfully, PRISM LABORATORIES, INC. a -,-I Angela D. Overcash VP Laboratory Services Data Qualifiers Key Reference: Reviewed By Terri W. Cole For Angela D. Overcash Project Manager HT Sample received and analyzed outside of the hold time. BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and reporting limit indicated with a J. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543 Phone: 7041629.6364 - Toll Free Number. 1-600/629.6364 - Fax: 7041525-0409 Page 1 Of G a 1�\ S M I Full -Service Analytical d 1 H P R nvlronmentel Solutions 7�woorsrronies �� Sample Receipt Summary 10/ 12/2015 Prism Work Order: 5090540 Client Sample ID Lab Sample ID Matrix Date Sampled Date Received 001 5090540-01 Water 09/29/15 09/30/15 Samples were received in good condition at 4.3 degrees C unless otherwise noted. This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte. NC 28224-0543 Phone: 704152"364 - Toll Free Number. 1-8001529-6364 - Fax: 7041625-0409 Page 2 Of 6 Laboratory Report Full u ra &ffj�'RL 10/1212015ironmealSolutions ORIEA ING Leonhardt Environmental, P.C. Project: Matlab - Plant 11 Client Sample ID: 001 Attn: Derr Leonhardt Prism Sample ID: 5090540-01 Suite 101, 8392 Six Forks Road Prism Work Order: 5090540 Raleigh, NC 27615 Sample Matrix- Water Time Collected- 09/29/15 10-00 Time Submitted: 09/30/15 09:30 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor Daterrime ID General Chemistry Parameters Oil & Grease (HEM) BRL mglL 5.0 0.48 1 '1664B 1018115 14:40 ARC P5J0161 pH 6.2 HT pH Units 1 'SM4600-H B 9130Ms 14:17 ARC PSIO677 Total Suspended Solids 23 mg1L 3.6 0.80 1 'SM 2540 D 1012116 12:30 EGC P6J0044 Total Metals Copper BRL mg1L 0.010 0.0021 1 '200.7 1016115 21:10 BGM P5J0092 Lead BRL mg1L 0.0050 0.00070 1 '200.7 1016/15 21:10 BGM P5J0092 Zinc 0.034 mg/L 0.030 0.0073 1 '200.7 1016115 21:10 BGM P5J0092 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643 Phone: 7041529-6364 - Toll Free Number. 1-8001529.6364 - Fax: 7041626-W9 Page' 3 of 6 h',� R ISM I Funi Service al Sol telo d Environmental Solutlona �aueavaon�tc we Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 6392 Six Forks Road Raleigh, NC 27615 Total Metals - Quality Control Analyte Project: Matlab - Plant 11 Level II QC Report 10/12/15 Prism Work Order: 5090540 Time Submitted: 9/30/2015 9:30:OOAM Reporting Spike Source %REC RPD Result Limit Units Level Result %REC Limits RPD Limit Notes Batch P5J0092 - 200.7 Blank (PSJ0092-BLK1) - - — — — Prepared & Analyzed: 10/06/15 - Copper BRL 0.010 mglL Lead BRL 0.0050 mglL Zinc BRL 0.030 mglL LCS (PSJ0092-BS1) Prepared & Analyzed: 101061_15 ` Copper 0.258 0.010 mglL 0.2500 103 85-115 Lead 0.26E 0.0050 mglL 0.2500 107 85-115 Zinc 0,275 0.030 mglL 0.2500 110 85-115 This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-OW Phone: 704/629-6364 - Toll Free Number. 1.8001S29-6364 - Fax: 7041625-M9 Page 4 of 6 o R Full-Service Analytical & ISM Environmental Solutions Leonhardt Environmental, P.C. Attn: Derr Leonhardt Suite 101, 8392 Six Forks Road Raleigh, NC 27615 General Chemistry Parameters - Quality Control Analyte Project: Maflab - Plant 11 Level II QC Report 10/12/15 Prism Work Order: 5090540 Time Submitted: 9/30/2015 9:30:00AM Reporting Spike Source %REC RPD Result Limit Units Level Result %REC Limits RPD Limit Notes Batch P510577 - NO PREP LCS (P510577-BS1) Prepared & Analyzed: 09/30/15 pH 6.88 pH Units 6,880 100 98.5-101.5 Batch PSJ0044 - NO PREP Blank (P5J0044-BLK1) Prepared & Analyzed: 10/02/15 Total Suspended Solids BRL 5.0 mg/L LCS (136J0044-13SI) _ Prepared & Analyzed: 10/02/15 Total Suspended Solids 490 5.0 mg/L 477.0 102 90-110 Batch MOM - NO PREP Blank JP5J0161-BLK1) Prepared & Analyzed: 10/08/15 Oil & Grease (HEM) BRL 5.0 mg1L LCS (P5J0161-BSI) Prepared & Analyzed: 10/08/15 Oil & Grease (HEM) 34.3 5.0 mg1L 40.00 86 78-114 Sample Extraction Data Prep Method: 200.7 Lab Number Batch Initial Final Daterrime 5090540-01 P5J0092 50 mL 50 mL 10/06115 8:35 This report should not be reproduced, except In its entirety, without the written consent of Prism Laboratories, Inc. 449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-OW Phone: 704/629.6364-Toil Free Number. 1-8001629-6364-Fax: 7041526-0409 Page 5 Of 6 CHAIN OF CUSTODY RECORD •` "'Y SM Full -Service Analytical & Solutions ll f S TO - 'r Environmental PAGE_k- OF QUOTE ENSURE PROPER BILLING: Samples INTACT upoci arrival?449 LnaOAATOPIE$ Inc t j Project Name: 1 �G C�%G .g_i �L� Received ON WET ICE? Springbrook Road • Charlotte, NC 28217 Phone 7041529�6364 Fax: 704152"409 , Short Hold Analysis: (Yes) (No) f `IYST Project: (Yes) (NO) PROPER PRIES ERVAl'IVES indicated? F "Please ATTACH any project speciFc reporting (QC LEVEL 1 11 111 IV) 'Received.WITHW HOLDING TIMES? Client Company Name: P'�r''`^�� provisions and/or QC Requirements CUSTODY SEALS INTACT? Report To/Contact Name: ctL.. !1 e-Ll Q��� 1 ? Invoice To: ^�� • h � � n �.-+•e VOLAT#LES reed WIOUT HEADSPACE? Reportin Address: S Ri PI / Address: tir PROPER CONTAINER used? ' TEMP: Therm €D: ' tJ Observed YES NO NIA —ZS O cc Cl) _ tT tM J�C Phone: ` Y-�M - Z±4 ZEax (Yes) (No)-'Ll`I -JVI-51f G purchase Order No./Billing Reference TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Email Address:�delS9;t 4 . "!Lf Requested Due Date ❑ 1 Day 0 2 Days O 3 Days ❑ 4 Days 0 5 Days 7 Certification: NELAC DOD FL NC Work dust Be EDD Type: PDF ' Excel_Other "Working Days" ❑ 6-9 Days ❑ Standard 10 days ❑ Rush re Site Location Name: I % tic. Samples received after 14:00 wN be processed next business day. SC OTHER NIA SitB oe tion Physical ddress: Ili' 2 &25 411-5 Turnaround time is based on business days, excluding weekends and holidays. Water Chlorinated: YES_ NO ��1 T' (SEE REVERSE FOR TERMS d CONDITIONS REGARDING SERVICES 1�t3 Ile- Z / •� z_& RENDERED BY PRISM LABORATORIES, INC. TO CLIENT) Sample Iced Upon Collection: YES NO CLIENT SAMPLE DESCRIPTION DATE COLLECTED TIME COLLECTED MILITARY MATRIX (SOIL, WATER OR SAMPLE CONTAINER PRESERVA- TIVES ANALYSIS REQUESTED REMARKS PRISM LAB -TYPE NO. SIZE ID NO. HOURS SLUDGE) SEE BELOW 7 �S q_Z1_61 1 c l cxa f" rie,�►-e 7�s �ti h J Z. y' .�� to 1.60 N,uG 3 -- ( Zfi-ts 4c1: ) y' 1I`C i C� Sampler's Signatur Sampled By (Print Name) J ^��G CO� Affiliation Upon relinqui ng, this Chain of Custody is your authorization for Prism to proceed with the analyses as requested above. Any changes must be submitted In writing to the Prism Project Manager. There will be charges for any changes after analyses have been initialized. k - Relinquished dy. (Signature) Received y: {Signature Date MilitarylHours ,Additional Comments: Site Arrival Time: Relinquished By: (Signature) Received By: (Signature) pate Site Departure,Tiime: Relinquished By: (Signature) Received -� rism Laboratories By: Fieid.Tech. Fee'. ,- �D/ate Mileage: Method of Shipment: NOTE: ALL SAMPLE COOLERS SHOULD BE TAPED SH Wyk PUS DY SEALS FOR TRANSPORTATION TO THE LABORATORY. COC Group No. SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAI T u9TlL RECEIVED AT THE LABORATORY. ryI ❑ Fed Ex ❑ UPS ❑ Hand-dellvered t7 Prism Field Service Cl Other 1 �� NPDES: UST: GROUNDWATER: I DRINKING WATER: SOLID WASTE: RCRA: CERCLA LANDFILL OTHER: •� 4 NC C2 ,C ❑ NT ❑ SC I Q INC ❑ SC i O NC ❑ SC I ❑ NC ❑ SC Q NC fl SC ❑ NC ❑ 5C I NC ❑ SC ❑ INC D SC ❑ ❑ _ ❑ I ❑_ ❑ I ❑ n 0 art *CONTAINER TYPE CODES: A =Amber C = Clear G= Glass P = Plastic: TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) ORIGINAL.