NCS000325_COMPLETE FILE - HISTORICAL_20191119

FEHRGR-`t" M
ENGINEERING & ENVIRONMENTAL
Certified Mail No. 70190140000060593881
Return Receipt Requested
November 4, 2019
Division of Water Quality
Attention: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RECEIVED
NOV 19 Z019
&r TRAL FILES
60IRF SECTION
RE: Stormwater Discharge Outfall (SDO) Monitoring Report - October 2019
Patch Rubber Company
100 Patch Rubber Road
Weldon, NC 27870
NCS000325
Dear Sir/Madam:
Please find enclosed the Stormwater Discharge Outfall (SDO) Monitoring Report for storm
water discharge from the above -referenced facility for October 2019.
Please note the following:
• The facility was not able to collect the required samples from a "Representative
Storm Event" for the month of October 2019.
• The facility will continue monthly collection of stormwater samples for analysis.
If you have any questions regarding these documents, please do not hesitate to contact
this office.
Sincerely,
9,1-et To,
Amy L. Trimble, CHMM
Environmental Scientist
ALT: dep
Enclosure
cc: Mr. Marto Carter, Patch Rubber Company
0:1Patch Rubber Company\19-1051PA Finat119-105 - Patch Rubber Co. - 2019.11,04 - Stormwater SDO October 2019
tetter.docx
221 E. Main Street I Suite 200 I Freeport, IL 61032 I p:815.235,7643 I f:815.235.4632 I Fehr-graham.com
Insight. Experience. Results.

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000325
FACILITYNAME Patch Rubber_ Company
PERSON COLLECTING SAMPLE(S) Not applicable
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY Halifax
PHONENO. 2( 52)536-25-/4
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED Old' PAGE 2.
Outfall
No.
Date
Sample
Collected
50050
Total
Flow ifa
Total
Rainfall
pH
COD
Zinc
mo/dd/yr
MG
inches
Mg L
mg =L
001
N/A
002
N/A
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes X no
(if yes, complete Part B)
Part B. Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date:
Sample
Collected
50050'
0U556 ..:.....
N
665A0'. '-
`00400.
Total Flow
►f a licable
( pp. )
Total
Rainfall
T
Oil &`:Grease.
(if.appl:)
Non -polar
O&GfI PH
(Metli 1664`
appl.
Total: ` ' .
Suspended
Solids
ply:.
-°New Mo"for
Oil Usage:
mo/dd/yr
MG
inches
m " I
m `/l
unit'
gaumG
Form SWU-247, last remised 21212012
Page I of 2

STORM EVENT CHARACTEIUSTICS:
Date
Total Event Precipitation (inches): N/A
E%rent Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Hail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 kno vied a and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the p ility of fines and imprisonment for knowing violations."
(Siggature of Permittee)
f t f �r g
(Date)
The Facility was unable to collect the required samples from a "Representative Storm Event"
for the month of October 2019 "No Flow"
Form SWU-247, last revised 21212012
Page 2 of 2