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HomeMy WebLinkAboutNCG060264_MONITORING INFO_20181204STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE ❑HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ 0A yYYYMMDD PSG The Procter & Gamble Manufacturing Co. Greensboro Site 100 Swing Road November 16, 2018 Greensboro, NC 27409 North Carolina Department of Environment Division of Water Resources Attn: DWR Central Files 1617 Mail Services Center Raleigh, NC 27699-1617 Subject: NPDES General Permit: NCG060264 The Procter and Gamble Manufacturing Company (P&G) Greensboro Personal Health Care (GBO PHC) 100 Swing Road, Greensboro, North Carolina 27409 RE CA F Discharge Monitoring Report DEC 0 4 241b CENTRAL FILES To Whom It May Concern: DyJR 5CC C101'1 Attached, please find Procter and Gamble's submission of: • Semi -Annual Storm Water Discharge Monitoring Report for reporting period July 1 to Dec. 31, 2018 • Storm Water analytical report • Permit Owner Affiliation Designation Form • Delegation of Authority documentation for Ron Matusiak, Plant Manager The report finds all parameters below storm water benchmarks. Should you have any questions on this report please contact the site Health, Safety and Environmental Technical Contact, Tracy Davis at (336) 315-6903 or davis.t.26 cr,pg.com. Sincerely, Ron Matusiak GBO PHC Plant Manager NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form (if no Facility Nance/Ownership Change) Person legally responsible for this permit 5) Reason for this change: Ronald L . Matusiak First M 1 Las( Plant Manager Title 100 S. Swine Rd. Mailing Address Greensboro N.C. 27409 City State Zip (336)315-6854 tnatusiak.rl@pg.com Telephone E-mail Address (336)315-6937 Fax Number ® Employee or management change A result of: ❑ Inappropriate or incorrect designation before ❑ Other IJ'other please e_tplain: The certification below must be completed and signed by the permit holder. PERMITTEE CERTIFICATION: 1, Ronald Matusiak , attest that this application for this change in Owner Affiliation (person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my knowledge. 1 understand that if all required parts of this form are not completed, this change may not be processed. I1-16-2018 Signature Date PLEASE SEND THE COMPLETED FORM TO: Division of Energy, Mineral, and Land Resources Stornwaler Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 For more information or staff contacts, please call (919) 707-9220 or visit the website at: http:///deq..nc.gov/about/divisions/energy-mineral-land-resources/stoI-mwater Page 2 of 2 SW U-OW NERAFFIL-23Mar2D17 Division of Energy, Mineral, and Land Resources ~� Land Quality Section 1 Stormwater Program i National Pollutant Discharbe Elimination System (NPDES) Energy. Mineral & PERMIT OWNER AFFILIATION DESIGNATION FORM Land Resources ENV IRONMENTAL QUALITY (individual Legally Responsible for Permit) Use this form if there has been: FOR AGENCY USE ONLY Date Received Year Month Da NO CHANGE in facility ownership or facility name, but the individual who is legally responsible for the permit has changed. If the name of the facility has changed, or if the ownership of the facility has changed, do NOT use this form. Instead, you must fill out a Name -Ownership Change Form and submit the completed form with all required documentation. What does "legally responsible individual" mean? The person is either: • the responsible corporate officer (for a corporation); • the principle executive officer or ranking elected official (for a municipality, state, federal or other public agency); • the general partner or proprietor (for a partnership of sole proprietorship); • or, the duly authorized representative of one of the above. 1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation") applies: Individual Permit (or) Certificate of Coverage N I C I S N I C I G 1 0 1 6 0 2 6 4 2) Facility Information: Facility name: Procter and Gamble Manufacturing Coin an Company/Owner Organization: Procter and Gamble Manufacturing Company Facility address: 100 South Swing Road Address Greensboro N.C. 27409 City State Zip To find the current legally responsible person associated with your permit, go to this website: http:/lcleq,nc.gov/about/divisions/energy-mineral-land-resources/enter^y r��incral-I.tnd-permits/storm«ater-program and run the Permit Contact Summary Report. 3) OLD OWNER AFFILIATION that should be removed: Previous legally responsible individual Kevin M. First Apt 1 4) NEW OWNER AFFILIATION (legally responsible for the permit): Hazel Last Page l of 2 SW U-OWNERAFFIL-23March2017 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 11-16-2018 CERTIFICATE OF COVERAGE NO. NCGO60264 FACILITY NAME Procter and Gamble COUNTY Guilford PERSON COLLECTING SAMPLES _Tracy Davis LABORATORY —Pace Analytical Services_ Lab Cert. # —12— Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? []YES ®NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall a 0.40 or ❑ No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliforml, Colonies per 100 ml Enterococcil, Colonies per 100 ml Benchmark - 100 or 50' Within 6.0 — 9.0 120 30 1000 500 #1 10/11/18 32 7.0 25 NO n/a n/a 1 Only applies to facilities that use/process meats. 'The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ®no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 504 6.0 — 9.0 - ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 'For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Page 1 of 2 *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 0 NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: _Mail an oriainal 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, NC 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) 11-16-2018 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.orp/web/wg/+ws/su/npdessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 � aceAnalytical wwwpacelabs.com Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704 )875-9092 October 26, 2018 Mr. Tracy Davis Procter and Gamble 100 Swing Road Greensboro, NC 27409 RE: Project: STORM WATER SAMPLES Pace Project No.: 92403270 Dear Mr. Davis: Enclosed are the analytical results for sample(s) received by the laboratory on October 12, 2018. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, (� Matthew Brainard matthew.brainard@pacelabs.com (704)875-9092 Project Manager Enclasures Q 'CO? REPORT OF LABORATORY ANALYSIS c TNI % This report shall not be reproduced, except in full, (9 ! without the written consent of Pace Analytical Services, LLC, B A- ` Page 1 of 14 Pace Analytical Services, t -C 9800 Kincey Ave. Suite 100 laceAnalytical huntersville, NC 28078 www pacefabs, com (704 )875-9092 Project: STORM WATER SAMPLES Pace Project No.: 92403270 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 Louisiana/NELAP Certification # LA170028 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 FloridalNELAP Certification #; E87648 Massachusetts Certification #: M-NC03D North Carolina Drinking Water Certification #: 37712 CERTIFICATIONS South Carolina Certification #: 99006001 FloridalNELAP Certification #: E87627 Kentucky UST Certification #: 84 VirginiaNELAP Certification #: 460221 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 VirginiaNELAP Certification #: 460222 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 2 of 14 aceAnalytical www.pacelabs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 {704)875-9092 SAMPLE ANALYTE COUNT Project: STORM WATER SAMPLES Pace Project No.: 924D3270 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92403270001 HEM 1 & 2 EPA 1664E JMS 1 PASI-C 92403270002 TSS #3 SM 254OD-2011 CRV 1 PASI-A 92403270003 COD #4 SM 5220D-2011 GC 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 3 of 14 Pace Analytical Services, LQC lacmnalj4ical 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 mwrpacefabs,com (704)875-9092 ANALYTICAL RESULTS Project; STORM WATER SAMPLES Pace Project No.: 92403270 Sample: HEM 1 & 2 Lab ID: 92403270001 Collected: 10/11/18 11:00 Received: 10/12/18 11:21 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease NO mg/L 4.8 1 10/26/18 04:44 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/26/2018 02:06 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 14 aceAnalytical www.pacetabs.com Pace Analytical Services, LLC 9800 Ki ncey Ave. Suite100 Huntersville, NC 28078 (704)875-9092 ANALYTICAL RESULTS Project: STORM WATER SAMPLES Pace Project No.: 92403270 Sample: TSS #3 Labill): 92403270002 Collected: 10/11/18 11:05 Received: 10/12/18 11:21 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D-2011 Total Suspended Solids 32.0 mg/L 10.0 1 10/15/18 19:41 Date: 10/26/2018 02:06 PM REPORT OF LABORATORY ANALYSIS This report shall not oe reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 5 of 14 aceAnalytical www.pacelabs.cam ANALYTICAL RESULTS Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: STORM WATER SAMPLES Pace Project No.: 92403270 Sample: COD #4 Lab ID: 92403270003 Collected: 10/11/18 11:06 Received: 10/12/18 11:21 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011 Chemical Oxygen Demand 41.4 mg/L 25.0 1 10/15/18 20:00 10/16/18 20:16 Date: 10/26/2018 02:06 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 6 of 14 aceAnaIXical www.pacelabs.com Pace Analytical Services, LLC 9800 Kincey Ave, Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Project: STORM WATER SAMPLES Pace Project No.: 92403270 QC Batch: 438522 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 924032700C1 METHOD BLANK: 2410946 Associated Lab Samples: 92403270001 Parameter Units Oil and Grease mglL Matrix: Waller Blank Reporting Result Limit Analyzed Qualifiers ND 4.8 10/26/18 04:43 LABORATORY CONTROL SAMPLE: 2410947 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Oil and Grease mglL 38.5 37.2 97 78-114 MATRIX SPIKE SAMPLE: 2410948 92403270001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qua4ifiers Oil and Grease mglL ND 38.5 37.8 98 78-114 Results presented on this page are in the units indicated by the "Units" column excopt where an alternate unit is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/26/2018 02:06 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 14 aQ laceAnalyfical wwwpacerahs.cam QUALITY CONTROL DATA Project: STORM WATER SAMPLES Pace Project No.: 92403270 QC Batch: 436322 Analysis Method: SM 2540D-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92403270002 METHOD BLANK: 2400698 Matrix: Water Associated Lab Samples: 92403270002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 10/15/18 19:39 Pace Analytical Services, LLC 9800 Kincey Ave. Suite100 Huniersville, NC 28078 (704)875-9092 LABORATORY CONTROL SAMPLE: 2400699 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 261 244 97 90-110 SAMPLE DUPLICATE: 2400700 92403218004 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 52.8 55.0 4 SAMPLE DUPLICATE: 2400701 92403281002 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 29.0 33.0 13 D6 Results presented on this page are In the units indicated by the "Units" column except where an alternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/26/2018 02:06 PM without the written consent of Pace Analytical Services, LLC, Page 8 of 14 ;a'ceAnalyfical wwwpacetabs.com Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huniersville, NC 28078 (704 )875-9092 Project: STORM WATER SAMPLES Pace Project No.: 92403270 QC Batch: 436320 QC Batch Method: SM 5220D-2011 Associated Lab Samples: 92403270003 METHOD BLANK: 2400694 Associated Lab Samples: 92403270003 Parameter Units Chemical Oxygen Demand mg1L LABORATORY CONTROL SAMPLE: 2400695 Parameter Units Chemical Oxygen Demand mg/L QUALITY CONTROL DATA Analysis Method: SM 5220D-2011 Analysis Description: 5220D COD Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 25.0 10/16/18 20:14 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 750 756 101 90-110 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2400696 2400697 MS MSD 92403213001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mglL 88.7 10D 10D 228 226 140 137 90-110 1 M1 Results presented on this page are in the units indicated by the "Units" column except where an alternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/26/2018 02:06 PM without the written consent of Pace Analytical Services, LLC. Page 9 of 14 Pace Analytical Services, LLC ®9800KinceyAve. Suite100 lac, Huntersvile, NC 28078 t cal wmpacelabs.c= (704)875-9092 QUALIFIERS Project: STORM WATER SAMPLES Pace Project No.: 92403270 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. ND - Not Detected at or above adjusted reporting limit. TNTC - Too Numerous To Count J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL-Adjusted Method Detection Limit, POL- Practical Quantitation Limit. RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and bias for a specific analyte in a specific matrix. S - Surrogate 1,2-Diphenylhydra7ine decomposes to and cannot be separated from Azobenzene using Method 8270, The result for each analyte is a combined concentration. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values. LCS(D) - Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) DUP - Sample Duplicate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - C(ean-Up U - Indicates the compound was analyzed for, but not detected. Acid preservation may not be appropriate for 2 Chloroethylvinyl ether. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitri)e by EPA Method 8260. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI -The NELAC Institute. LABORATORIES PASI-A Pace Analytica) Services -Asheville PASI-C Pace Analytical Services - Charlotte ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/26/2018 02:06 PM without the written consent of Pace Analytical Services, LLC. Page 10 of 14 !;a'ce Analytical wwwpacefabs.com Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORM WATER SAMPLES Pace Project No.: 92403270 Lab ID Sample ID QC Batch Method QC Batch Analytical Method 92403270001 HEM 1 & 2 EPA 1664E 438522 92403270002 TSS #3 SM 2540D-2011 436322 92403270003 COD #4 SM 5220D-2011 436320 SM 5220D-2011 Date: 10/26/2018 02:06 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Analytical Batch 436533 Page 11 of 14 ,t — GBA�alytrCal Document Name: Sample Condition Upon Recei t(SCUR) Document Revised: February 7, 2018 P.Itro t of 2 Document No.: F-CAR-CS-033-Rev.06— Issuing Authority: Race.Caralinas.4ualit _Office -4! Laboratory receiving samples: Asheville ❑ Eden❑ Greenwood ❑ Huntersvllle 0 Raleigh[] Mechanicsville[] Client Name; Project W®# : 9240327a Courier: ❑Fed Ex []UPS ❑LISPS []Client ❑ Commercial QPace []Other: Ii k 92403270 Custody Seal Present? Des ❑i No Seals Intact? []Yes ❑No � Date/Initials Person Examining Coolants; Packing Material: []Bubble Wrap '[Bubble Bags ❑None ❑ Other Biological Tissue Frozen? Thermometer: []Yes [2]No ❑N/A ©TR Gun ID: 92TO45 Type of Ice: n�- Wet ❑Blue ❑None Cooler Temp ('Cl: 1-1^r 5 Correction Factor: Add/Subtract ('C) -0.1 Tempshould be above iree2ing to 6'C Cooler Temp Corrected ('C): �' ❑samples out of temp criteria. Samples an ice, cooling process hasbegun USDA Regulated Soil (Q N/A, water sample) Did samples originate in a quarantine tone within the United 5tates: CA, NY, or 5C (check maps)? Did samples originate from a foreign source lintematlonaliy, r lYes r INo inCludine Hawaii and Puerto Rical? nYes nNo Comm ents/Disc re pa ncy: Chain of Custody Present? DYes No NIA I. Samples Arrived within Hold Time? Ors ONO j]N/A 2. Short Hold Time Analysts (<72 hr.)? ❑Yes B No ❑N/A 3. Rush Turn Around Time Requested? []Yes NB ❑N/A 4. Sufficient Volume? - es No ❑N/A 5- Correct Containers Used? -Pace Containers Used? Ores 0?es ❑No ONO ❑N/A El N/A 6. Containers Intact? Yes No ❑N/A 7. Dissolved analysis. Samples Field Filtered? ❑Yes No ©N]A a. Sample Labels Match COC? -IncludesDate/Time/lD/Analysis . Malrix: QTes []Na ❑N/A 9. Headspace in VOA Vials (>5-5mm)? ❑Yes No QN/A 10, Trip Blank Present? Trip Blank Custody Seals Present? ❑Yes ❑Yes ©OO Hn ❑N/A ❑NIA 11, COMMENTS/SAMPLE DISCREPANCY Lot 1D_of.Split rnntainara- CLIENT NOTIFICATION/RESOLUTION Field Data Required? Oyes [-]No Person contacted: Date/Time: Project Manager SCURF Review: Date: C Project Manager SRF Review: i' Date: Page 12 of 14 a O 0 v n n S n a 2 0 m � s D � VI v y er m v m to � r. d r O o 3 CQ a c O '+ M n � � ro V1 rb P t! v CL a � M (� re m a 3 » � o � %n N c a a a � n ro n � n i O a i O lb m V w w A w N r ItEmp zzz— zzzzz zz BP411-125 mL Plastic Unpreserved (N/A) (CI-) BP31.1-250 mL Plastic Unpreserved (N/A) BP21.1-500 mL Plastic Unpreserved (N/A) SP1U-1 liter Plastic Unpreserved (N/A) ` BP4S-125 mL Plastic HZSO4 (pH < 21 (Cl-) BP3N-250 ml plastic HNO3 (pH < 21 8P42-125 mt Plastic ZN Acetate & NaOH 1>91 BP4C-125 ml. Plastic NaOH (PH > 12) (Cl-) WGFU•Wide•mouthed Glass jar Unpreserved AMU-1 liter Amber Unpreserved (N/A) (Cl-) 1 AGIH-1 liter Amber HCI (pH <2) AG3U-2S0 mL Amber Unpreserved (N/A) (CI-) AG15-1 liter Amber H2SO4 (pH < 2) AG3S-250 mL Amber H2SO4 {pH < 2) A453AIlX3A)-250 mL Amber N1440 (N/A)(CI-) OG9H-40 mL VOA NCI (N/A) VG9T-40 mL VOA Na2S203 (N/A) VG9U-40 mL VOA Unp (N/A) DG9P-40 mL VOA H3PO4 (N/A) VOAK (6 vials per kit)-5035 kit (N/A) V/GK (3 vials per kitj-VPH/Gas kit (N/A) SP5T-125 ml Sterile Plastic (N/A — lab) SP2T-250 ml. Sterile Mastic (N/A —lab) SP3A-250 mL Plastic (NH2)2504 (93-9.7) AGOU-100 mL Amber Unpreserved vials (N/A) VSGU-20 mL Scintillation vials (N/A) OG9U-40 ml. Amber Unpreserved vials (N/A) A CHAIN -OF -CUSTODY 1 Analytical Request Document q,c���7l;?rGrf The Chain -of -Custody is a LEGAL DOCUMENT. Aft relevant fields must be Completed accurately. Section A Section 8 Section C Required Client Information: Required Project Information: invoice Information: Pagic : 1_ Of Report 10: Tracy Davis Athmtion: lCopy To. CamPany Namv. 1 Company: Procter and Gamble Actd,,;,b IGO Swing Road Greensboro, NC 27409 i ACIMC ; Re Mato Agency i Ematl: aaviS126 .Pg.coM Purchase Order F: Pace Ouolc; Phone 913b19-5501 Far Project Name: 5 Pace Project Manager: mat lhOw,brainartl (ppacelabs.com. State 1 Location f Requested Duo Dale: Project #: Pace Profile a: 8440-5 NC Requested Anal VS Filtered IN - _ a Z F.Tplr COPE Ei COLLECTED x Preservatives } inciMJ VJat^f DW Wt 1 ^ a�trVJ31rf NfJJ n _ m © U - � 1� SAMPLE ID�°�° oe�+c+ aL o � �_ START END OJ } ., One Character per box. �rx Wa w o w 01 o (A-Z, 0-9 1, •l c fk, or V '+r r 'c ? 2.T Sample Ids must be unique T Ts p c co Uj H Y v H DATE TIME DATE TIME z s z s''' a \� stir: f'SC, 1G 1i ;k:n 06 x E AS t-10u a' •s�12 ;x:RE1.lNgU1SHEp BY AFFR,IATiON .,' ! ';DATE Mg, `^«`,T'IME '�C's'ti_'.,5.-'•.. :'A CCEPT£08YJAFFILIATIONT4:'%.; :: DATE;W: %T1MEr� ='�.f•,�,.: •. S/iMPLE CON6f719M1S5'.. _ :�.: rI.iwi- a f !i s^X. �.j. •,+^r.a•/� :.<,n• .'��. ,t, _ ae. .. r �. I �' L- f � - Jam•- � vr� l �L� )2i a r3 SAMPLER NAME AND SIGNATURE- q 0 n m PRI N me of SAMPLER: p CD m c, P o ro m Y c SIGNATUR f SAf11PLER: ' �X• S'i; DATE Signed: iS 1� G LL^.t( 1� ll 1K1 � ¢ y t� rn _ PSG The Procter &Gamble Manufacturing Co. Greensharo Site 100 Swing Road Greensboro, NC 27409 May 25, 2018 North Carolina Department of Environment Division of Water Quality Attn: DWQ Central Files 1617 Mail Services Center Raleigh, NC 27699-1617 Subject: NPDES General Permit: NCG060264 The Procter and Gamble Manufacturing Company (P&G) Greensboro Personal Health Care (GBO PHC) 100 Swing Road, Greensboro, North Carolina 27409 Discharge Monitoring Report To Whom It May Concern: Attached, please find Procter and Gamble's submission of its Semi -Annual Stone Water Discharge Monitoring Report for reporting period Jan. 1 to June 1, 2018. Please find the DMR report and analytics attached. Note that all parameters are below benchmarks. Should you have any questions on this report please contact the site Health, Safety and Environmental Technical Contact, Tracy Davis at (336) 315-6903 or davis.t.26 @ pg.com. Sincerely, Kevin Hazel GBO PHC Plant Manager SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 5-25-2018 CERTIFICATE OF COVERAGE NO. NCG060264 _ FACILITY NAME _Procter and Gamble COUNTY Guilford PERSON COLLECTING SAMPLES _Tracy Davis LABORATORY _Pace Analytical ServicesLab Cert. # —12— Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? ❑YES ®NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Totol event rainfoll' 0.40 or ❑ No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliformi, Colonies per 100 ml Enterococcil, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 500 #1 5/18/18 85.5 6.0 ND ND n/a n/a 1 Only applies to facilities that use/process meats. 'The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at aM outfalls. You must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 504 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. ' For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Page I of 2 *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 the _lab results or at end of monitoring period in the case o "No Discharge-" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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/,2, S/ijy (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SW U-249 Last Revised: October 18, 2012 Page 2 42 N aceAnalytical www.pscerabs com May 24, 2018 Mr. Tracy Davis Procter and Gamble 100 Swing Road Greensboro, NC 27409 RE: Project: Stormwater Pace Project No.: 92385469 Dear Mr. Davis: Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 HLntersville, NC 28078 (704)875-9092 Enclosed are the analytical results for sample(s) received by the laboratory on May 21, 2018. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, Matthew Brainard matthew.brainard@pacelabs.com (704)875-9092 Project Manager Enclosures REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 1 of 12 aceAnalyfical� www.pacefabs, com Pace Analytical Services, LLC% 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875�092 CERTIFICATIONS Project: Stormwater Pace Project No.: 92385469 Charlotte Certification Ids 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 South Carolina Certification #: 99006001 Louisiana/NELAP Certification # LA170028 FloridalNELAP Certification #: E87627 North Carolina Drinking Water Certification #: 37706 Kentucky UST Certification #: 84 North Carolina Field Services Certification #: 5342 VirginiaNELAP Certification #: 460221 North Carolina Wastewater Certification #: 12 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 Eden Certification IDs 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Drinking Water Certification #: 37738 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 VirginiaNELAP Certification #: 460222 North Carolina Wastewater Certification #: 633 VirginiaNELAP Certification #: 460025 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 2 of 12 c aceAnalytical www.pacelabs.com SAMPLE ANALYTE COUNT Project: Stormwater Pace Project No.: 92385469 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92385469001 5-18 SM 2540D NMH 1 PASI-E EPA 16648 JMS 1 PASI-C SM 5220D EWS 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 3 of 12 Pace Analytical Services, LLC, aceAnalytical 9800 KinceyAve. Suite 100 Huntersville, NC 28078 www.pacelabs.com (704 )875=9092 ANALYTICAL RESULTS Project: Stormwater Pace Project No.: 92385469 Sample: 5.18 Parameters Lab ID: 92385469001 Collected: 05/18/18 04:15 Results Units Report Limit OF Received: 05/21/18 13:07 Matrix: Water Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 85.5 mg/L 7.6 1 05122/18 14:17 D6 HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease NO mg/L 5.0 1 05/23/18 05:17 5220D COD Analytical Method: SM 5220D Chemical Oxygen Demand NO mg/L 25.0 1 05/23/18 14:30 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full. Date: 05/24/2018 03:06 PM without the written consent of Pace Analytical Services, LLC, Page 4 of 12 aceAnalytical www.pacelabs.com QUALITY CONTROL DATA Project: Stormwater Pace Project No.: 92385469 QC Batch: 411826 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92385469001 METHOD BLANK: 2284672 Associated Lab Samples: 92385469001 Parameter Units Total Suspended Solids mglL LABORATORY CONTROL SAMPLE: Parameter 2284673 Units Total Suspended Solids mg1L SAMPLE DUPLICATE: 2284674 Parameter Units Total Suspended Solids mg/L SAMPLE DUPLICATE: 2284675 Parameter Units Total Suspended Solids mg/L Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 05122/1814:17 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 248 99 90-110 92385469001 Dup Result Result 85.5 60.3 92385246017 Dup Result Result ND ND RPD Qualifiers 35 D6 RPD Qualifiers Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in Full, Date: 05/24/2018 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 12 Pace Analytical Services, LL% lac, 9800KineyAve. S Huntersville, NC 28078 www.pacelabs.com (704)875 3092 QUALITY CONTROL DATA Project: Stormwater Pace Project No.: 92385469 QC Batch: 411929 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92385469001 METHOD BLANK: 2285081 Matrix: Water Associated Lab Samples: 92385469001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mg/L ND 5.0 05/23/18 05:16 LABORATORY CONTROL SAMPLE; 2285082 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Oil and Grease mg/L 38.5 38.0 99 78-114 MATRIX SPIKE SAMPLE: 2285083 92384276002 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mg/L <5.0 38.5 38.5 97 78-114 Results presented on this page are In the units indicated by the "Units" column except where an alternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 05/24/2018 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 12 aceAnalytical *wwpacelabs.cam Project: Stormwater Pace Project No.: 92385469 QC Batch: 411875 QC Batch Method: SM 5220D Associated Lab Samples: 92385469001 METHOD BLANK: 2284923 Associated Lab Samples: 92385469001 Parameter Units Chemical Oxygen Demand mg/L LABORATORY CONTROL SAMPLE: 2284924 Parameter Units Chemical Oxygen Demand mg/L Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Analysis Method: SM 5220D Analysis Description: 5220D COD Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 25.0 05/2311814:30 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 750 771 103 90-110 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2284925 2284926 MS MSD 92383836001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg/L 68.0 100 100 173 173 105 105 90-110 0 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2284927 2284928 MS MSD 92384971002 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc, Conc. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg1L 133 100 100 238 238 105 105 90-110 0 Results presented on this page are in the units indicated by the "Units" column except where an alternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 05/24/2018 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 12 Pace Analytical Services, LLQ, aceAnalytical 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 www.pacelabs.com (704)875-9092 QUALIFIERS Project: Stormwater Pace Project No.: 92385469 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. ND - Not Detected at or above adjusted reporting limit, TNTC - Too Numerous To Count J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL -Adjusted Method Detection Limit. PQL- Practical Ouantitation Limit. RL - Reporting Limit. S - Surrogate 1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is a combined concentration. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values. LCS(D) - Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) DUP - Sample Duplicate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - Clean -Up U - Indicates the compound was analyzed for, but not detected. Acid preservation may not be appropriate for 2 Chloroethylvinyl ether. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA Method 8260. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services -Asheville PASI-C Pace Analytical Services - Charlotte PASI-E Pace Analytical Services - Eden ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 05/24/2018 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 12 an eAnalytical www.pacefabs cam QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Stormwater Pace Project No.: 92385469 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Lab ID Sample ID QC Batch Method QC Batch Analytical Method 92385469001 5-18 SM 2540D 411826 92385469001 5-18 EPA1664B 411929 92385469001 5-18 SM 5220D 411875 Date: 05/24/2018 03:06 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Analytical Batch Page 9 of 12 Uuuulliellt IYdrilu. ' - Sample Condition Upon Receipt(SCUR) Page 1 of 2 0ceMaVICal Document No.: Issuing Authority: .- .- - -_ Pace Carolinas Quality office F-CAR-CS-033-Rev.06 Laboratory receiving samples: ---1 Asheville ❑ Eden[] Greenwood ❑ Huntersville'0 Raleigh[] Mechanicsville❑ IBMCli ntName: W® : 92385459 �� ? Project: I k I I Courier: []Fed Ex ❑UPS ❑LISPS []Client 92385469 [� Commercial -gPff'ce ❑Other: Custody Seal Present? ❑Yes Q+yo-' Seals Intact? ❑Yes Q,IoA bate/Initials Person Examining Contents: [ 1 Packing Material: ❑Bubble Wrap f Bubble Bags ❑done ❑ Other Thermometer:: Type of fce: Qwat ❑Blue � iR Gun Io; 92TO40 I Cooler Temp ('CI: Correction Factor: Add/Subtract (°Cj +0,4 Cooler Temp Corrected ('C): T USDA Regulated Soil (a -WA, water sample) Did samples origi�te in a quarantine zone within the United States: CA, NY, or SC (check maps)? mv— ritnr_ Biological Tissue Frozen?_ ❑yes ❑No Q A ❑tfcne Temp should be above freezing to 6'C (]Samples out of temp criteria. Samples on ice, cooling process has begun Oid samples originate from a foreign source (internationa iy,-•. inc'.uding Hawaii and Puerto Rico)? Dyes []No Camments/Discrepancy: Chain of Custody Present? 'F yes ❑No [I NIA 1• Samples Arrived within Hold Time? yeses [-]No ❑NIA 2. Short Hold Time Analysis (<72 hr.)? ❑Yxs , Iqr ❑N/A 3. Rush Turn Around Time Requested? []yes DNo ❑N/A 4. Sufficient Volume? s' ❑No ❑N/,a 5. CerrectContainers Used? ©> ❑No ❑N/A 6. -Pace Containers Used? [-]Yes ❑No ❑N/A . Containers Intact? Yes ❑tfo ❑Cl/A 7. Dissolved analysis: Samples Field Filtered? ❑Yes ❑t:o EII/A S. 9. Sample Labels klatch CDC? ©Ye9 ❑No ❑N/A Includes Date/Time/lO/Anaiysis Matrix: Headspace in VOA Vials (>5-bmm)? ❑Yes , ❑Na /❑N/A S0. Trip Blank Present? oyes ❑No, Trip Blank Custody Seals Present? ❑Yes ❑No Orr1 COMMENTS/SArNIPLE DISCREPANCY CLIENT NOTIFICATION/RESOLUTION -4 r Lot ID of split containers: Field Data Required? ❑Yes ❑ io Person contacted: Date/Time: ��Project Manager SCURF Review: Date: r Project Manager SRF Review: Lt Date: Page 10 of 12 0 n a C v m v N t c' z 0 Zn CL o c ro v [D N m rt d r o 7 E w On R m a � fD ro 1 C n Q ry � tZ �N l/1 w " 3 b ? @ N C w i y rL 0. v N � 0. Ib d C. R 1 I 5 0 wo '-v w � m 4n a W N r• lternq / BP41.1-125 ml. Plastic Unpreserved (N/A) (Cl-) BP3U-250 mL Plastic Unpreserved (N/A) BP21-1-500 rnL Plastic Unpreserved (NIA) BPIU-1 liter Plastic Unpreserved (NIA) BP45-125 mL Plastic H2504 (pis < 2) (Cl-) BP3N-250 mL pla$Elc HNO3 (pH < 2) XIV BP4Z-125 mL Plastic ZN Acetate & NaOH (>9) BP4C-125 mt. Plastic NaOH (pH > 12) (CI-) WGFU-Wide-mouthed Glass jar Unpreserved AGIU-1 liter Amber Unpreserved (N/A) (Cl-) AGIH-1 liter Amber HCI (pH < 2) AG3U-250 mLAmber Unpreserved (N/A) (Cl-) AG1S-1 liter Amber H2SO4 (pH < 2) .K7 AG35.250 mL Amber H2SO4 (pH < 2) AG3A(DG3A)-250 mL Amber NH4C1 (NIA)(CI-) DG9H-4G mL VOA HCI (N/A) VG9T-40 mL VOA Na2S203 (N/A) VG9 U-40 mL VOA Unp (N/A) 7-1 UGBP-40 mL VOA H3PO4 (N/A) VOAK (6 vials per klt)-5035 kit (NIA) V/GK (3 vials per kit)-VPH/Gas Solt (N/A) 5PST-12S mL Sterile Plastic (N/A— tab) 1 SPIT-250 mL Sterile Plastic (N/A — tab) BP3A-250 mL Plastic (NH2)2SO4 (93-9.7) AGOU-100 mL Amber Unpreserved vials (N/A) VSGU-20 mL Scintillation vldls (N/A) DG9U-40 mL Amber Unpreserved vials (N/A) 9f K N C • * n 41 [t1 ry o N Q s S 0 Q n 0% r O Ci. 0 3 m X h y O (D 0 rt n III � 0 0 n G N• y fD X t7• io -� � rp 61 3 0 0 ao 0 Cr 00g 0CL t V S m 4 W 2 � N• fJQ 1 m cc N 11 F� M C3 t7 ilr r• (n N p OD 0 rD n at U:) 7 v S 110 ■ L 9 m rn W �r CHAIN -OF -CUSTODY 1 Analytical Request Document f C'Anah�tG7f The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Section A Section B Section C Required Client Information: Required Project information: Invoice Information[ Company: Procter and Gamble Report To: Tracy Davis Atlontiom Address: 100 Sw[M Road Copy To: Comparry Name: Greensboro, NC 27409 Address' i- RegWatory Agency _ Emaik davis.t.26 .pg.cam Purchase Order ff: Pace Quote, Phone: 9 1 JFax Project Name: Slormwater Pace Project Manager: malthew,brainard pacelabs.cam. - i - State r Location Requested Due Date: Project it: Pace Profile rt: 8440.2 Ne Requested Anal la Fillered rN I ! t i bSaTpLY coot 9 zi O u COLLECTED z Preservatives r i rank'" W.1n DW Wa ;. w"", 1rJ1V b_ 4 CC V Praa�ct P SAMPLE ID oil oL V e START END U N y One Character per box. WtW WP — a a a. z .n 40 m c t (A-Z. 0-9 1. -1 x" ux Outer OT Sample Ids must be unique T.— TS pO U X r r F c Z O m b v 0 6 w 1 e7 m U U j ¢ a a O O p H m t c a a crs � —1 N DATE TIME DATE TIME N a n rail r z z z:E O a rn �..�U•�« 1 t' 7 C0� G��tl��.j ,��:.�— �— ��� _Tt 2 �� �� G" �i,I2� rlRf�S q"D T1 x 3 } id 5 s. 7 B 9 10 11 12- -'AODITIONALCOMMENTS„ - 'RELWQtI HED BY t AFFI6ATI0N. -'DATE ,' TIME - ACCEPTED BY t AFFILIATION DATE nME SA.MPCE CONDITIONS �tle.l 51s GL�1 le-rc \`L�/' I'4ili .2. 6o'n <��� fi' '.iL4� - SAMPLER NAME AND SIGNATURE PRINT Name of SAMPLER: SIGNATURE of SAMPLER: DATE Signed: - Jv - ✓ - N W Sept. 25, 2017 North Carolina Department of Environment Division of Water Quality Attn: DWQ Central Files 1617 Mail Services Center Raleigh, NC 27699-1617 The Procter & Gamble Manufacturing Co. G.reensbero Site ice Swirc Read Greensboro. NC 27409 RECEIVED o v 0 3 Z017 pWTAL FILES R SECTION Subject: NPDES General Permit: NCG060264 The Procter and Gamble Manufacturing Company (P&G) Greensboro Personal Health Care (GBO PHC) 100 Swing Road, Greensboro, North Carolina 27409 Discharge Monitoring Report To Whom It May Concern: Attached, please find Procter and Gamble's submission of its Semi -Annual Storm Water Discharge Monitoring Report for reporting period July 1 to Dec. 31, 2017. Please find report and analytics attached. Note that all parameters are below benchmarks. Should you have any questions on this report please contact the site Health, Safety and Environmental Technical Contact, Tracy Davis at (336) 315-6903 or davis.t.26@p2.com. Sincerely, "55 Kevin Hazel GBO PHC Plant Manager SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 9-11-2017 CERTIFICATE OF COVERAGE NO. NCGO60264 _ SAMPLE COLLECTION YEAR 2017 FACILITY NAME ,Procter and Gamble FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Guilford ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES —Tracy Davis DISCHARGING TO SALTWATERS? ❑YES ®NO LABORATORY _Pace Analytical Services Lab Cert. # _12 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 10.30 or No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliforml, Colonies per 100 ml Enterococcil, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 5o0 #1 911/17 54.0 6.0 85.0 ND n/a n/a 3 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at aM outfalls. You must still submit this discharge monitoring report with a checkmark here. 45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 504 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: October 18. 2012 Page 1 of 2 *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) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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) (Date) Additional copies of this form may be downloaded at: htt ortal.ncdenr.or web/wq/wssu n dessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 42 0 aceAnalytical wwwpacelabs cam September 15, 2017 Mr. Tracy Davis Procter and Gamble 100 Swing Road Greensboro, NC 27409 RE: Project: STORMWATER SAMPLING Pace Project No.: 92353910 Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NG 28078 (704)875-9092 Dear Mr. Davis: Enclosed are the analytical results for sample(s) received by the laboratory on September 05, 2017, The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, Matthew Brainard matthew.brainard@pacelabs.com (704)875-9092 Project Manager Enclosures PCCR� NI` . REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 1 of 12 laceAna0cal www.pacelabs.cam Project: STORMWAI ER SAMPLING Pace Project No.: 92353910 Pace Analytical Services, LLC 9800 K'nceyAve. Suite 300 Huntersville, NC 28078 (704)875-9092 Charlotte Certification IDs 9800 KinceyAve. Ste 100, Huntersville, NC 28078 LouisianalNELAP Certification # LA170028 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 CERTIFICATIONS South Carolina Certification #: 99006001 Florida/NELAP Certification #: E87627 Kentucky UST Certification #: 84 VirginiaNELAP Certification #: 460221 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40 Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001 Massachusetts Certification #: M-NC030 VirginiaNELAP Certification #: 460222 North Carolina Drinking Water Certification #. 37712 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC, Page 2 of 12 l ' aceAnalytifcal J www.pacelabs.com SAMPLE ANALYTE COUNT Project: STORMWATER SAMPLING Pace Project No.: 92353910 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92353910001 P+G SAMPLE #1- EPA 1664B JMS 1 PAS!-C SM 2540D WC 1 PASI-A SM 5220D NAL 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 3 of 12 (�IaneAnalyfica( www.pacelabs.com ANALYTICAL RESULTS Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: STORMWATER SAMPLING Pace Project No.: 92353910 Sample: P+G SAMPLE #1-4 Lab ID: 92353910001 Collected: 09/01/17 15:56 Received: 09/05/17 09:43 Matrix: Water Parameters Results units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease ND mg1L 5.0 1 09/15/17 05:47 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 54.0 mg1L 16.7 1 09106/17 16:51 5220D COD Analytica# Method: SM 5220D Chemical Oxygen Demand 85-0 mg/L 25.0 1 09/07/17 15:27 REPORT OF LABORATORY ANALYSIS This report shad not be reproduced, except in full, Date: 09/15/2017 03:48 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 12 aceAnalytical www.pacelabs.own Project: STORMWATER SAMPLING Pace Project No.: 92353910 QC Batch: 377847 OC Batch Method: EPA 1664B Associated Lab Samples: 92353910001 METHOD BLANK: 2093523 Associated Lab Samples: 92353910001 Parameter Oil and Grease QUALITY CONTROL DATA Analysis Method: EPA 1664E Analysis Description: 1664 HEM, Oil and Grease Matrix: Water Blank Reporting Units Result Limit Analyzed Qualifiers mg/L ND 5.0 09/15/17 05:43 Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28076 (704)875.9092 LABORATORY CONTROL SAMPLE: 2093524 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Oil and Grease mg/L 40 37.3 93 78-114 MATRIX SPIKE SAMPLE: 2093525 92353910001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Oil and Grease mg/L ND 40 39.8 97 78-114 Qualifiers Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/15/2017 03:48 PM without the written consent of Pace Analytical Services, LLC, Page 5 of 12 Pace Analytical Services, LLC leac,Analyfical 9800 KinCey Ave. Suite 100 Nuntersville, NC 28078 xww.paceiabs.com (704)875-9092 QUALITY CONTROL DATA Project: STORMWATER SAMPLING Pace Project No.: 92353910 QC Batch: 376565 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92353910001 METHOD BLANK: 2086265 Matrix: Water Associated Lab Samples: 92353910001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 09/06/17 16:49 LABORATORY CONTROL SAMPLE: 2086266 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 258 103 90-110 SAMPLE DUPLICATE: 2086267 92353534001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 8.2 7.6 8 D6 SAMPLE DUPLICATE: 2086268 92354071001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 13300 14500 9 D6 Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full. Date: 09/15/2017 03:48 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 12 e ----..aceAnalyfrcaI www.pecerabs.WM QUALITY CONTROL DATA Project: STORMWATER SAMPLING Pace Project No.: 92353910 QC Batch: 376598 Analysis Method: SM 5220D QC Batch Method: SM 5220D Analysis Description: 5220D COD Associated Lab Samples: 92353910001 METHOD BLANK: 2086465 Matrix: Water Associated Lab Samples: 92353910001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Chemical Oxygen Demand mg1L ND 25.0 09/07/17 15:27 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 i704)875-9092 LABORATORY CONTROL SAMPLE: 2086466 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Chemical Oxygen Demand mg/L 750 751 100 90-110 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2086467 2086468 MS MSD 92353353001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg/L 643 750 750 1380 1380 98 98 90-110 0 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2086469 2086470 MS MSD 92354029007 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc, Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg/L 130 750 750 891 894 101 102 90-110 0 Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/15/2017 03:48 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 12 aceAnalytical www pacefebs.=n QUALIFIERS Project: STORMWATER SAMPLING Pace Project No.: 92353910 DEFINITIONS Pace Analytical Services, LLC 9800 Kincey Ave, Suite100 Huntersville, NC 28078 (704)875-9092 DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. ND - Not Detected at or above adjusted reporting limit. TNTC -Too Numerous To Count ,1 - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL- Adjusted Method Detection Limit. POL - Practical Quantitation Limit. RL - Reporting Limit. S - Surrogate 1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is a combined concentration. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values. LCS(D) - Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) DUP - Sample Duplicate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - Clean -Up U - Indicates the compound was analyzed for, but not detected. Acid preservation may not be appropriate for 2 Chloroethylvinyl ether. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA Method 8260. N•Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services -Asheville PASI-C Pace Analytical Services - Charlotte ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/15/2017 03:48 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 12 aceAnalytical www.pacelabs.com QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORMWATER SAMPLING Pace Project No.: 92353910 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Lab ID Sample ID QC Batch Method QC Batch Analytical Method 92353910001 P+G SAMPLE #1-4 EPA 1664E 377847 92353910001 P+G SAMPLE #1-4 SM 2540D 376565 92353910001 P+G SAMPLE #1-4 SM 5220D 376598 Date: 09/15/2017 03A8 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Analytical Batch Page 9 of 12 Document Name: Document Revised August 4, 2017 r7G6Aflafykal� Sam ie Condition Upon Receipt(SOUR) Page 1 of 2 Document No.: Issuing Authority: F-CAR-CS-033-Rev.04 Pace Quality Office Laboratory receiving samples: Asheville ❑ Eden❑ Greenwood ❑ Huntersvil1e.f::1— Ui t Name: Wo# : 9235391 m SProject Upon Receipt Courier: EfFed Ex UP5 ❑LISPS []Client 92333910 ❑ Commercial rt>Vace ❑Other: Custody Seal Present? Yias Seais Intact? es ❑No \ � . �^ 77 tID C7 ` i —} Dale/initials Person Exam[ning contents: I I 1 � i! Packing Material: ❑Bubble Wrap i lubble Bags []None E other Biological Tissue Frozen? Thermometer. 1— ❑Yes-0176 ❑N/A �ORGunID: we ❑ t blue []None Type of I e: � Correction Factor: Cooler Temp Corrected ('C): Temp should be above freezing to 6°C ❑samples out of temp criteria. Sampleson ice, cooling process has begun USDA Regulated Soll,j N/A, water sample) Did samples origin in a quarantine zone within the United States: CA, NY, or SC (check maps]? Did samples originate from a foreign source (internationally, r I rYPS Pv inriudinc Hawaii and Puerto Ricnl? nYes _-.C:bl-o- Comments/Mscre anry: Chain of Custod Present? es ONO N/A 1. Sa m pies Arrived within Hold Time? es No N/A 2. Short Hold rime Analysis (c72Inr, ? QYes -Bfs ❑N/A 3. Rush Turn Around Time Requested? QYes N/A 4. Sufficient volume? -94V% ONO ❑N/A S. Correct Containers Used? -Pace Containers Used? Yes ❑No DNO ❑NJA N/A 6. Containers Intact? es QNo QNJA 7. Dissolved analysis: Samples Field Filtered? Elves ONO fdEtm7t a. Sample Labels Match COC? -Includes DateMme/IDJAnalysls Matrix: Jr -BYA Y J ONO ❑N/A g. Heads ace In VOA Vials (>5-6mm)? [-]Yes ONO 10. Trip Blank Present? Trip Blank Custody Seals Present? ❑Yes Yes ONO ONO 2M7r— 11. CLIENT NOTIFICATION/RESOLUTION Person Contacted: Comments/Sample Discrepancy: Lot ID of split containers: Date/Time: Field Data Acquired? ❑Yes ❑No Project Manager SCURF Review: rG Date: `i J R Project Manager SRF Review: Date: Now Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR Certification Office (i.e. Out of hold, incorrect preservative, out of temp, incorrect containers) Page 10 of 12 w va m m n O - 0 v n A 2 Y C n s ga m v = .. q C. o P C N n v PT � 3 d A g r a Y c Ca � m � n CD N � C � ft) rL to _ W Cr. 2 a � 30 a M O R q n � rb 2 c M rr 0 m Item# BP4U-125 mL Plastic Unpreserved (N/A) (CI-) BP3U-250 ml. Plastic Unpreserved (N/A) BPZU-500 mL Plastic Unpreserved (N/A) BP1U-] titer Plastic Unpreserved (N/A) - BP45.125 mL Plastic H2504 (pH < 2) (CI-) BP3N.2S0 mL plastic HNO3 (pH < 2) BP4Z-125 mL Plastic 7N Acetate & NaOH (?9) 8P4C-125 mL Plastic NaOH (pH > 12) (CM WGW-Wide-mouthed Glass jar Unpreserved AG1U-1 liter'Amber Unpreserved (N/A) (Cl-) AG1H-1 liter Amber MCI (PH < 2) AGIU-250 ml.Amber Unpreserved {N/A) (CI-) AG15-1 liter Amber HZ504 (pH < 2) AG35-M mL Amber 442SO4 (pH < z) AG3A(DG3A)-250 mL Amber N H40 (N/A) (C I-) DG91-11-40 mt. VOA HO (N/A) VG9T-40 mL VOA Na2S203 (N/A) V69U-40 mL VOA Unp (N/A) DG9P-40 mL VOA H3PO4 (N/A) VOAK (6 vials per kit)-5035 kit (N/A) V/GK 13 vials per kit)-VPH/Gas kit (N/A) SP5T-125 mL Sterile Plastic (N/A - lab) SPZT-250 mL Sterile Plastic (N/A - tab) SP3A-250 mL Plastic INH2)2SO4 (9-3-9.7) Cubitainer VSGU-20 mL Scintillation vials (N/A) GN v C m v m e� A f1 {tt 3 w 0 s to O Cr 0 x a Cu a 0 a 10 n 7 a 1 7 Di r► 0 9 O A n O� RiceiLslhlx.lf Se-Ctinn A Rcqulfed Client Inforsrufion: Section B Required Project Inform. lion: CHAIN -OF -CUSTODY 1 Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be compleled accurately. Scctian C Invoice Informahnn: Pane • I Of 1 s:.enp,-y fl—la and G wI0 RrsprnI Id I I 11ty Davis Atlnnnon Anriresc 100 Swim R4ai1 Copy Ta C,nrnfsaRy NmTo l-areensboru. NC 274W Address' "R eto A enc� .''i �S%V r-rAni IIIn:NI. r1.ryVL5I 2�Q. CnrT1 F'llfl:lk•ISR CIlgL`r Y r�nrit Dllotn Phone Prolncl Name V-0 Pfger-t WNW, nwlis 'l sytwhepmellbs tom, - t State r R..rytsr'. sled D1A. Tlnlp-- P1oP:rl a Pnrn. Prntda b 84a0.3 NC Requestsd Anal als F1ltemd Yrtt pwm-, unsgrr r.nln. n ewe CbLLECTEO o Preservatives Wr.un wr Mir °wr,"r m i V o SAMPLE ID H ^ 7 START END One Ctwacterpor ha, 11.1 vtn ru W h # tA.Z. O.9l. •) �».. A, �I a w ' v 1 Sample kds must be unique pt;; r,r ui J O ~ DATE TIME DATE 11ME us x T z 2 z o r R 1 1- Z :.3' �s 5w lP_ it, 13 it, 3S X : a' '6^ •rye':, `1a `14 12 ADDITIONAL COMMENTS RELLWU SHED 9Y t AFFILIATION DATE TIME ACCEPTED DY l AFFgJATION DATE TIME . SAMPLE CONDITIONS -36 .3 ' SAMPLER NAME AND SIGNATURE N �� ; �• PRINT Name of SAMPLER: np 0 IGNAT Aµ PL�E�R; (h' '7 {1 q� DATE July 24, 2017 North Carolina Department of Environment Division of Water Quality Surface Water Protection Section 1601 Mail Services Center Raleigh, NC 27699-1650 Subject: NPDE5 General Permit: NCG060264 The Procter and Gamble Manufacturing Company (P&G) 100 Swing Road, Greensboro, North Carolina 27409 Discharge Monitoring Report To Whom It May Concern: Attached please find Procter and Gamble's submission of its Semi -Annual Storm Water Discharge Monitoring Report (no flow) for reporting period ending June 30, 2017. Unfortunately, no stormwater sample was able to be collected for the reporting period. I plan to obtain a sample during the July — September timeframe for the current reporting period and promptly submit those results to your office. Should have any questions on this report please contact the site Health, Safety and Environmental Technical Contact Tracy Davis at (336) 315-6903 or davis-t-262pg,com. Sincerely, Kevin Hazel Site Plant Manager JUL 27 2017 .,C=NT+,AL FILES %i%V? SECTION SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 7-24-2017 CERTIFICATE OF COVERAGE NO. NCG060264 SAMPLE COLLECTION YEAR 2017 FACILITY NAME _Procter and Gamble FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Guilford ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES _Tracy Davis DISCHARGING TO SALTWATERS? DYES ®NO LABORATORY Jancaster Laboratories Environmental Lab Cert. ## _521_ Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall Z or ® No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliforml, Colonies per 100 ml EnterococcV, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 500 1 only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at q y outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 504 6.0-9.0 - i Only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Page I nit *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 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 o-f 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, NC 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) //� y// 7 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-249 Lass Revised: October 18, 2012 Page 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 12-27-2016 CERTIFICATE OF COVERAGE NO. NCG060264 SAMPLE COLLECTION YEAR 2016 FACILITY NAME _Procter and Gamble FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Guilford i�'�❑ruse/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Tracy DavisECEDISCHARGING TO SALTWATERS? DYES ®NO LABORATORY _Lancaster Laboratories Environmental_ Lab Cert. # DEC 2 9 2016 _521_ PLEASE REMEMBER TO SIGN ON THE REVERSE 4 CENTRAL FILES Part A: Stormwater Benchmarks and Monitoring Results MRSECTION Total event rainfo!! 2 0.91 or ® No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 500 #1 12/6/16 10.2 7.0 <50.0 <5.0 n/a n/a 1 Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at 2ny outfalls. You must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Pa,e 1 of 2 *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 o "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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) (L ( 2 P16 (Date) Additional copies of this form may be downloaded at: http: 2portal.ncdenr.orgZweblwq/ws/su/npdessw#tab-4 S W U-249 Las[ Revised: October 18, 2012 Pace 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 11-29-2016 ' CERTIFICATE OF COVERAGE NO. NCG060264 _ SAMPLE COLLECTION YEAR 2016 FACILITY NAME _Procter and Gamble FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Guilford ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES _Tracy Davis �3 (�' DISCHARGING TO SALTWATERS? [:)YES ®NO LABORATORY Lancaster Laboratories Environmental Lab Cert.r#.,EcEi V ED _521_ DEC Q 6 Z016 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES Total event rainfall Z or ® No discharge this period3 Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units 6Od}, mg/L IVNI and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0-9.0 120 30 1000 500 #1 09/28/16 86.5 8.0 <50.0 N.D. n/a n/a 1 Only applies to facilities that use/process meats. Z The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at anyoutfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (ice complete Part B) SWU-249 Last Revised: October 18, 2012 Page 1 of 2 *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, NC 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 (1/1) 2 /� (Date)' Additional copies of this form may be downloaded at: http://portal.ncdenr.orp/web/wq/ws/su/npdessw#tab-4 S W U-249 Last Revised: October 19, 2012 Page 2 42 .r PSG The Procter & Gamble Manufacturing Co. Nov. 29, 2016 Greensboro site 100 Swing Road Greensboro, NC 27409 North Carolina Department of Environment Division of Water Quality Surface Water Protection Section RECEIVED 1601 Mail Services Center DEC 0 6 2016 Raleigh, NC 27699-1650 CENTRAL ��FfLES SECTION Subject: NPDES General Permit: NCG060264 The Procter and Gamble Manufacturing Company (P&G) 100 Swing Road, Greensboro, North Carolina 27409 Discharge Monitoring Report To Whom It May Concern: Attached, please find Procter and Gamble's submission of its Semi -Annual Storm Water Discharge Monitoring Report for reporting period ending Dec. 31, 2016. While preparing the submission for reporting period ending Dec. 31, 2016, our analytical lab missed the hold time by 3 hours for Total Suspended Solid (TSS). We will attempt to gather another sample and submit to your office prior to December 31, 2016. The history for Greensboro Piedmont Triad International Airport recorded a rain fall event of 0.91 inches for September 28, 2016. Please find report and analytics attached. Note that all parameters are below benchmarks. If P&G is unable to complete additional sampling for TSS we will communicate via a No Flow report. Should you have any questions on this report please contact the site Health, Safety and Environmental Technical Contact, Tracy Davis at (336) 315-6903 or davis.t.26(@Vp-.com. Sincerely, Phillip Burns Site General Manager 11 i July 19, 2016 North Carolina Department of Environment Division of Water Quality Surface Water Protection Section 1601 Mail Services Center R C'.`_ I V E D Raleigh, NC 27699-1650 JUL 2 2 'L6s0 CENTRAL FILES m, E!ECTION Subject: NPDES General Permit: NCG060264 The Procter and Gamble Manufacturing Company (P&G) 100 Swing Road, Greensboro, North Carolina 27409 Discharge Monitoring Report To Whom It May Concern: Attached please find Procter and Gamble's submission of its Semi -Annual Storm Water Discharge Monitoring Report (no flow) for reporting period ending June 30, 2016. Unfortunately, no stormwater sample was able to be collected for the reporting period. I plan to obtain a sample during the July — September timeframe for the current reporting period and promptly submit those results to your office. While preparing the submission for reporting period ending June 30, 2016, 1 also realized that I inadvertently failed to submit the discharge monitoring report and analytical monitoring results for the last reporting period (ending December 31, 2015). The site did not measure rain fall for this event. The history for Greensboro Piedmont Triad International Airport recorded a rain fall event of 0.96 inches for September 29, 2015. Please find report and analytics attached. Note that all parameters are below benchmarks. Should have any questions on this report please contact the site Health, Safety and Environmental Technical Contact Tracy Davis at (336) 315-6903 or davis.t.26@pgcom. Sincerely, � HL C06P­bp Phillip Burns Site General Manager SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Wa`teruality General Permit No. NCG060000 Date su�bmitte IU 07=i9-2016 CERTIFICATE OF COVERAGE NO. NCG060264 FACILITY NAME _Procter and Gamble COUNTY Guilford PERSON COLLECTING SAMPLES _Tracy Davis J'JL 2 2 /SAMPLE COLLECTION YEAR 2016 fuN i f�AL REA-GILITY ACTIVITIES INCLUDE (check all that apply): -�v1 R SECTION ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? OYES ®NO LABORATORY _Lancaster Laboratories Environmental_ Lab Cert. # 42705 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE —) Total event rainfall Z or ® No discharge this period3 Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 500 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. s For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See�General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Page 1 of 2 *FC,Zi 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" r_eport_s, 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, NC 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 Permitfee) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/weblwg/ws/sulnpdessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 RECEIVED Date submitted -7 — 19 - 16 JUL 2 2 2016 CERTIFICATE OF COVERAGE NO. NCG06 0 Q -1 FACILITY NAME Gcan, COUNTY c>r PERSON COLLECTING SAMPLES ZA, i$ _ LABORATORY ��<; Lab Cert. # q ai D-r. Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 0 y5 CENTRAL FILES FACILITY ACTIVITIES INCLUDE (check all that apply): '—A' ? SECTION ❑ use/process meats [] use animal fats/byproducts DISCHARGING TO SALTWATERS? [-]YES ENO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 or F] No discharge this period Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or S0 Within 6.0 -- 9.0 120 30 1000 50D ►� 1 - �► -" 1S 3c. Io N. a N• D. N filli Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no (if yes' complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: oniv for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 - - Unly applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 bast Revised: October 18, 2012 *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 li 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 on 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" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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 Perm a (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-249,-� List Revised: OcV-",s-r 18, 2012 �.✓ t� �,lage 2, of 2 tiff eurofins Lancaster Laboratories Environmental Analysis Report 2425 Hew Holland Pike, Lancinter, PA 17601 • 7174W2700 • Fax: 717-OW2591 • www.LanrasterLetn.com . ANALYTICAL RESULTS Prepared by: Prepared for: Eurofins Lancaster Laboratories Environmental P&G Paper Products Co 2425 New Holland Pike PO Box 5584 Lancaster, PA 17601 Cincinnati OH 45201 October 14, 2015 RECEIVED Project: 100 Swing Rd - Greensboro, NC Jul 2 9 zoic Submittal Date: 09/30/2015 Group Number: 1597062 PO Number: N611-4504505499 State of Sample Origin: NC Client Sample Description #1/#2 Stormwater Ponca Grab Water Sample #5/#6 pl-I Retention Pond (Basin) Grab Water Sample CENTRAL FILES DWR SECTION Lancaster Labs (LL) # 8069810 8069811 The specific methodologies used in obtaining the enclosed analytical results are indicated on the Laboratory Sample Analysis Record. Regulatory agencies do not accredit laboratories for all methods, analytes, and matrices. Our scopes of accreditation can be viewed at http://www.eurotatstis.cotn/eii ironment-testinL,/laboratoriesieurofins- lancaster-laboratories-environ mental/resourccslcert i I ica t iousl . ELECTRONIC TEVA Pharmaceuticals COPY TO Attn: Tracy Davis Respectfully Submitted, t r Angela M. Miller Specialist (717) 556-7260 Page 1 of 8 eurof ins Lancaster Laboratories Environmental Analysis Report 2425 New Holland Pike, Lancaster, PA 17601 • 717-656-2300 • Fax: 717-656-2681 • www.LancaslerLabs,com Sample Description: #1/#2 Stormwater Pond Grab Water Sample 100 Swing Rd - Greensboro, NC Project Name: 100 Swing Rd - Greensboro, NC Collected: 09/29/2015 10:00 by TD P&G Paper Products Co Submitted: 09/30/2015 08:40 Reported: 10/14/2015 16:12 12SW- PO Box 5584 Cincinnati OH 45201 LL Sample # WW 8069810 LL Group # 1597062 Account # 10956 CAT No. Analysis Name CAS Number Result Limit of Dilution Factor Quantitation Wet Chemistry EPA 1664A mg/1 mg/1 09079 HEM (oil & grease) n.a. N.D. 5.0 1 EPA 170.1 Degrees C Degrees C 12151 Temperature of pH n.a. 22.9 0.010 1 EPA 410.4 mg/1 mg/1 04001 Chemical Oxygen Demand n.a. N.D. 50.0 1 SM 2540 D-1997 mg/l mg/1 10457 Total Suspended Solids n.a. 31.8 6.00 1 SM 4500-H+ B-2000 std. Units Std. Units 12152 pH n.a. 6.8 0.010 1 The 40 CFR Part 136 requires that this analysis be performed immediately (within 15 minutes) upon sample collection. Because this was not possible, the result may not be used for reporting purposes. General Sample Comments State of North Carolina Lab Certification No. 521 All QC is compliant unless otherwise noted. Please refer to the Quality Control Summary for overall QC performance data and associated samples. Laboratory Sample Analysis Record CAT Analysis Name Method Trial# Batch# Analysis Analyst Dilution NO. Date and Time Factor 08079 HEM (oil & grease) EPA 1664A 1 15279907901A 10/06/2015 18:36 Michelle L Lalli 1 12151 'Temperature of pH EPA 170.1 1 15290003107A 10/06/2015 10:07 Michele L Graham 1 04001 Chemical Oxygen Demand EPA 410.4 1 1527440010113 10/01/2015 07:15 Susan A Engle 1 10457 'Total Suspended Solids SM 2540 D-1997 1 15274145701A 10/01/2015 08:08 Nathan T Morgan 1 12152 pH SM 4500-14+ B-2000 1 1529DO03107A 10/06/2015 10:07 Michele L Graham 1 Page 2 of 8 tia;o eurofins Lancaster Laboratories Analysis Report Environmental 2425 New Holland Pike, Lancaster, PA 17601 • 717-656 2300 • Fax: 717-656-2681 - www.LancasterLabs.com Sample Description: 45/#6 pH Retention Pond (Basin) Grab Water Sample LL Sample # WW 8069811 100 Swing Rd - Greensboro, NC LL Group # 1597062 Account # 10956 Project Name: 100 Swing Rd - Greensboro, NC Collected: 09/29/2015 12:00 by TD P&G Paper Products Co PO Box 5584 Submitted: 09/30/2015 08:40 Cincinnati OH 45201 Reported: 10/14/2015 16:12 56RET CAT Dilution No. Analysis Name CAS Number Result Limit of Factor Quantitation GC/MS Semivolatiles SW-846 8270C ug/l ug/l 04678 1,4-Dioxane 123-91-1 N.D. 5 1 General Sample Comments State of North Carolina Lab Certification No. 521 All QC is compliant unless otherwise noted. Please refer to the Quality Control Summary for overall QC performance data and associated samples. Laboratory Sample Analysis Record CAT Analysis Name Method Trial# Batch# Analysis Analyst Dilution No. Date and Time Factor 04676 TCL SW846 8270C Water SW-846 6270C 1 15279WAD026 10/11/2015 18:47 Linda M 1 Hartenntine 00613 BNA Water Extraction SW-646 3510C 1 15279WA➢026 10/06/2015 20:00 Samantha L Bronder 1 Page 3 of 8 tiff eurofins Lancaster Laboratories Environmental Analysis Report 2425 New Holland Pike, Lancaster, PA 17601 • 717-656.2340 - Fax: 717.656-2681 - www.LancasterLabs.com Quality Control Summary Client Name: P&G Paper Products Co Reported: 10/14/2015 16:12 Group Number: 15970G2 Matrix QC may not be reported if insufficient sample or site -specific QC samples were not submitted. In these situations, to demonstrate precision and accuracy at a batch level, a LCS/LCSD was performed, unless otherwise specified in the method. All Inorganic Initial Calibration and Continuing Calibration Blanks met acceptable method criteria unless otherwise noted on the Analysis Report. Laboratory Compliance Quality Control Blank Blank Report LCS LCSD LCS/LCSD RPD Analysis Name Result Loo Units %REC %REC Limits RPD Max Batch number: 15279WAD026 Sample number(s): 8069811 1,4-Dioxane N.D. 5. ug/1 49 54 19-100 9 30 Batch number: 15274145701A Sample number(s): 8069810 Total Suspended Solids N.D. 3.00 mg/1 92 101 91-105 9 20 Batch number: 15274400101D Sample number(s): 8069810 Chemical oxygen Demand N.D. 50.0 mg/1 104 94-110 Batch number: 15279807901A Sample number(s): B069810 HEM (oil & grease) N.D. 5.0 mg/l 95 93 78-114 2 11 Batch number: 15280003107A Sample number(s): 8069810 pH 100 100 95-105 0 3 Sample Matrix Quality Control Unspiked {UNSPK) = the sample used in conjunction with the matrix spike Background (BKG) = the sample used in conjunction with the duplicate MS MSD MS/MSD RPD BKG DUP DUP Dup RPD Analysis Name REC REC Limits RPD MA% Conc. Cone RPD Max Batch number: 15274145701A Sample number(s): 8069810 BKG: P069320 Total Suspended Solids 817,000 864,000 6* 5 Batch number: 15274400101E Sample number(s), 8069810 UNSPK: P070066 BKG: P070066 Chemical Oxygen Demand 101 99 94-110 2 5 N.D. N.D. 0 (1) 9 Batch number: 15279807901A Sample number(s): 8069810 UNSPK: P077105 BKG: P077105 HEM (oil & grease) 88 78-114 N.D. N.D. 0 (1) 18 Batch number: 15280003107A Sample number(s): 8069810 BKG: P073088 pH 7.7 7.7 1 3 Temperature of pH 22.9 22.4 2 5 Surrogate Quality Control *- Outside of specification (1) The result for one or both determinations was less than five times the LOQ. (2) The unspiked result was more than four times the spike added. Page 4 of 8 eurofins Lancaster Laboratories Environmental Analysis Report 2425 New Holland Pike, Lancaster, PA 17601 • 717.656-2300 • Fax: 717.656.2681 - www.LancasterLabs.com Quality Control Summary Client Name: P&G Paper Products Co Reported: 10/14/2015 16:12 Group Number: 1597062 Surrogate Quality Control Surrogate recoveries which are outside of the QC window are confirmed unless attributed to dilution or otherwise noted on the Analysis Report. Analysis Name: TCL SW046 8270C Water Batch number: 15279WAD026 Nitrobenzene-d5 2-Fluorobiphenyl Terphenyl-d14 8069811 81 81 _ 89 Blank 85 77 100 LCS 81 90 98 LCSD 85 87 97 Limits: 46-128 61-112 43-131 *- Outside of specification (1) The result for one or both determinations was less than five times the LOQ. (2) The unspiked result was more than four times the spike added. Page 5 of 8 GME10 nm eurofins For Eurofins Lancaster Laboratories Environmental use onl' Acct, # 1y l �YCc� Group # (.i 9 7DCLSample i# 1 i LillCiftbr L.aborlYEpli�e Emlionitmi I InsWcdons an revere side correspond with cycled numbers. For Lab Use Only FSC: j Client Information a Matrix s) Analysis Requested Ghent: P� m�nU& Acct,#: Preservation Codes SCR#: G I V 1 '4 ro Project Name/#: PWSID #: Preservation Codes 1oo oivl r- YQkp w Dty(' C E o ? U) H=HCI T="I'hicsulf3fe N=HNOu B=Na0I-I I Pm)eclManager'. P.D. "IS(m {� p� �t d cn ❑ ❑ 2 In .ro r s=H2SO4 O=othar awplgr`a , quote#: s Remarks j l rR n to (aO c G H Name of erg slate samples were collected: , .�. } H � Z � ? I a ❑ aO 4 Collected Sample Identification o o Date Time C7 u to O I— A,- rti, c,r . 2 S r x/ a •� -'4� ro ,w— '1'2`t i 7t i >r� 9-2. -is it X f t i 3 T Turnaround Time (TAT) Requested (please circle) Ralin ha Dale Time Received by DaI TTrna I Standard Rush Q-:n 'el'Nl (Rush TAT is subject to laboralary approval and surcharge.) Relinquished byll Date TimA Received by S�Pla­ Time Date results are needed: Oct � 2 , 7 Relinquished by Dale Time Received 6y Dale Time E-mail address: C t1V ] ((�iv� Relinquished by Dale Time Received by Date I into , e Data Package Options (circle ll required) Rallnquished by Dale Time Race! ed by Date Time ; Type I (Validation#non-CLP) Type VI (Raw Data Only) r1• jo $� ` Type III (Reduced non-CLP} TX TRRP-13 EDD Required? Yes No Relinquished by Commercial Carrier: If yes, format: UPS FedExV Other NYSDEC Category A or B MA MCP CT RCP Site -Specific QC (MSIMSDIDup)? Yes No Temperature upon receipt S". �C , (if yes, Indicate QC sample and submit triplicate sample volume.) Eurofins Lancaster Laboratories Environmental, LLC • 2425 New Holland Pike, Lancaster, PA 17501 • 717-656-2300 The white copy should accompany samples to Euroflns Lancaster Laboratories Environmental. The yellow copy should be retained by the client. 7044oa 14 Page 6 of 8 Sample Adminisirailo I Receipt Documentation Lop -----Client: --P+G,Manufatturina Doc Log ID: 109317 Group Number(s).- Delivery and Receipt Information Delivery Method: Fed Ex Arrival Timestarnp: 09/30/2015 8A0 Number of Packages: 1 Number of Projects: 1 Arrival Condition Summary Shipping Container Sealed: Yes Sample IDs on COC match Containers: Yes Custody Seal Present: Yes Sample DateMmes match COC: Yes Custody Seal Intact: Yes VOA Vial Headspace ? 6mm: NIA Samples Chilled: Yes Total Trip Blank Qty: 0 Paperwork Enclosed: Yes Air Quality Samples Present: No Samples Intact: Yes Missing Samples: No Extra Samples: No Discrepancy in Container Qty on COC: No Unpacked by Timothy Cubberley (6520) at 09:59 on 0913012015 Samples Chilled Details Thermometer Types: DT = Digital (Temp. Bottle) IR = Infrared (Surface Temp) All Temperatures in 'C. Cooler # Thermometer ID Corrected TT mo Therm. TV9e Ice Tvae Ice Present? Ice container Elevated Temp? 1 DT131 5,2 DT Wet Y Bagged N Page 1 of 1 2425 New Holland Pike T 717-656-2300 Lancaster, PA 17505-2425 F 717-656-2681 Page 7 of 8 vnvw.Lancastut-aos. tiff eurofins Lancaster Laboratories Environmental Explanation of Symbols and Abbreviations The following defines common symbols and abbreviations used in reporting technical data RL Reporting Limit BMQL Below Minimum Quantitation Level N.D. none detected MPN Most Probable Number TNTC Too Numerous To Count CP Units cobalt-chloroplatinate units lU International Units NTU nephelometric turbidity units umhos/cm micromhos/cm ng nanogram(s) C degrees Celsius F degrees Fahrenheit meq milliequivalents lb. pound(s) g gram(s) kg kilogram(s) pg microgram(s) mg milligram(s) mL milliliter(s) L liter(s) m3 cubic meter(s) pL microliter(s) pg1L picogramlliter < less than greater than ppm parts per million - One ppm is equivalent to one milligram per kilogram (mg/kg) or one gram per million grams. For aqueous liquids, ppm is usually taken to be equivalent to milligrams per liter (mg/1), because one liter of water has a weight very close to a kilogram. For gases or vapors, one ppm is equivalent to one microliter per liter of gas. ppb parts per billion Dry weight Results printed under this heading have been adjusted for moisture content. This increases the analyte weight basis concentration to approximate the value present in a similar sample without moisture. All other results are reported on an as -received basis. Laboratory Data Qualifiers: B - Analyte detected in the blank C - Result confirmed by reanalysis E - Concentration exceeds the calibration range J (or G, I, X) - estimated value > the Method Detection Limit (MDL or DL) and the < Limit of Quantitation (LOQ or RL) P - Concentration difference between the primary and confirmation column >40%. The lower result is reported. U - Analyte was not detected at the value indicated V - Concentration difference between the primary and confirmation column >100%. The reporting limit is raised due to this disparity and evident interference... Additional Organic and Inorganic CLP qualifiers may be used with Form 1 reports as defined by the CLP methods. Qualifiers specific to Dioxin/Furans and PCB Congeners are detailed on the individual Analysis Report. Analytical test results meet all requirements of the associated regulatory program (i.e., NELAC (TNI), DoD, ISO17025) unless otherwise noted under the individual analysis. Measurement uncertainty values, as applicable, are available upon request. Tests results relate only to the sample tested. Clients should be aware that a critical step in a chemical or microbiological analysis is the collection of the sample. Unless the sample analyzed is truly representative of the bulk of material involved, the test results will be meaningless. If you have questions regarding the proper techniques of collecting samples, please contact us. We cannot be held responsible for sample integrity, however, unless sampling has been performed by a member of our staff. This report shall not be reproduced except in full, without the written approval of the laboratory. Times are local to the area of activity. Parameters listed in the 40 CFR Part 136 Table II as "analyze immediately" are not performed within 15 minutes. WARRANTY AND LIMITS OF LIABILITY - In accepting analytical work, we warrant the accuracy of test results for the sample as submitted. THE FOREGOING EXPRESS WARRANTY IS EXCLUSIVE AND IS GIVEN IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, WE DISCLAIM ANY OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING A WARRANTY OF FITNESS FOR PARTICULAR PURPOSE AND WARRANTY OF MERCHANTABILITY. IN NO EVENT SHALL EUROFINS LANCASTER LABORATORIES ENVIRONMENTAL, LLC BE LIABLE FOR INDIRECT, SPECIAL, CONSEQUENTIAL, OR INCIDENTAL DAMAGES INCLUDING, BUT NOT LIMITED TO, DAMAGES FOR LOSS OF PROFIT OR GOODWILL REGARDLESS OF (A) THE NEGLIGENCE (EITHER SOLE OR CONCURRENT) OF EUROFINS LANCASTER LABORATORIES ENVIRONMENTAL AND (B) WHETHER EUROFINS LANCASTER LABORATORIES ENVIRONMENTAL HAS BEEN INFORMED OF THE POSSIBILITY OF SUCH DAMAGES. We accept no legal responsibility for the purposes for which the client uses the test results. No purchase order or other order for work shall be accepted by Eurofins Lancaster Laboratories Environmental which includes any conditions that vary from the Standard Terms and Conditions, and Eurofins Lancaster Laboratories Environmental hereby objects to any conflicting terms contained in any acceptance or order submitted by client. P3768 age 8'of48 1 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCGO6O000 Date submitted December 17, 2014 CERTIFICATE OF COVERAGE NO. NCG060254 SAMPLE COLLECTION YEAR 2014 FACILITY NAME U.S. Flue —Cured Tobacco Growers, Inc. _FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Person ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Derrick Sims DISCHARGING TO SALTWATERS? ❑YES ®NO LABORATORY ENCO Laboratories Lab Cert. # 591 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE --> Total event rainfall z 0.73 " or ❑ No discharge this period Outfall No. -Sample Collected, mo/dd/yr TSS, mg/L. pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliforml, Colonies.per 100 ml Enterococci', Colonies. per 100 ml Benchmark - .100 or.504 Within-6.0 — 9.0 120 30 1000 500 001 11/17/14 14 7.4 77 6.70 NA NA 002 11/17/14 24 7.6 35 12.2 NA NA 1 Only applies to facilities that use/process meats. �������� ZThe total precipitation must be recorded using data from an on -'site �+ ite rain gauge. 3 For sampling periods with no discharge at qny outfalls. You must still submit this discharge monitoring report with a checkmark here. Z�i4 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark app CENTRAL FILES Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ®MVR 'rj jCggiplete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, standard units New Motor Oil.Usage, Annual average gal/mo Benchmark - 30 100.or,504 6.0 -- 9.0 - 1 Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. S Wli -249 Last Revised: October 18, 2012 Page 1 of 2 h �L *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, NC 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) / 2-- (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web%wq/ws/spLnpdessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 A." RCDEHR North Carolina Department of Environment and Natural Resources Pat McCrory John E. Skvarla, III Governor Secretary August 21, 2014 Ms, Janeen Lyle The Proctor & Gamble Manufacturing Company 8700 Mason -Montgomery Road Mason, OH 45040 Dear Ms. Lyle: RECEIVED SEP 0 9 2014 CENTRAL FILES DWR SECTION Subject: NPDES General Permit NCG060264 The Proctor & Gamble Manufacturing Company Formerly Teva Pharmaceuticals USA, Inc. Certificate of Coverage NCG060264 Guilford County Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215. l and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. Note that the 2013 and 2014 permit fees are past due. Enclosed are the past due invoices as well as a return envelope for you to mail payment. Also, we are returning check #7209403131 in the amount of $40.00, Please re -submit payment in the amount of $200.00 attached with the enclosed invoices. Division of Energy, Mineral, and Land Resources Energy Section - Geological Survey Section - Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX: 919-715-8801 512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: hfto;llgortal.ncdenr.org/webAr/ An Equal Opportunity I Affirmative Action Employer — 50% Recycled L 10% Post Consumer Paper If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 707-9220. Sincerely, wA64 ( _� - for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Winston-Salem Regional Office, M. Gantt Stormwater Permitting Program Files Central Files STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL, RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE No. NCG060264 STORM WATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, The Proctor & Gamble Manufacturing Company is hereby authorized to discharge stormwater from a facility located at 100 Swing Road Greensboro Guilford County to receiving waters designated as South Buffalo Creek, a class WS-V;NSW water, in the Cape Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 1I, III, and IV of the General Permit No. NCG060264 as attached. This certificate of coverage shall become effective August 21, 2014. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day August 21, 2014, For Tracy E. Dav' irector Division of Energy, Mineral and Land Resources By Authority of the Environmental Management Commission r REMITTANCESTATEMENT: Check'No. Source Tracer No. Page 2 of 2 NORTH CAROLINA DEPARTMENT OF 7209403131 1181828332 7209403131 000084 The P&G Company P.O. BOX 599 CINCINNATI, OH 45201 oMV For inquiries, please contact the Procter & Gamble Accounts Payable staff at 9-888-839-9059 ° 0 1 z /}�V June 12, 2014 I G.\ UV4ul IACl I L UCi'LC 1-(XU UIJU IVV . 1 UI VJ5 11111VUl I L IVC L 11111VU111 v 898480 06/11/14 9911402232G4P 40.00 4 00 Stormwater Permit Ownersh Total ' �e 40.00 1 Withholding Tax 0.00 Total Remit Amount 4�> 40.00 t { J � v i I 4 t DETACH AND RETAIN FOR YOUR RECORDS' YEflIFY THE AUTHENTICITY OF THIS MULTI TONE SECURITY DOCUMENT. 0 CHECK BACKGROUND AREA CHANGES <The'PG=•C:om an } Ir.,� r•:� ':u,� zlt:- ��tc3 s<�-i]une I=�� �;. R�<��M �1'Uy4Ui� ` I-`:' ..�_�,;. ,Y:�,ti �� ..ti\ ::�`.:� -.. ';; /4 Gorpo�ate Disbursements .• a �I t 1;= ! �� - ;; ram• ..,., 3,rf%1 := „ .Ih'FDIVERT01 H 452Q1 'b1' �' r ; . ;; • ;, ,� ;•f :+,62 002010311' :< /CINCINNATI .�,\.' �w\. T.i. ii.W.. `< �...i�� ://.a... •,,.,.•� . ; .2 h�. �\\ ��\\(� �.�' �/� //, \ ..�L� `"\ \ it _`�\ and.00/,1 ollur,5 CIIICenk .. .. .. •\ . 3 Pay NORTH CAROLINA DEPARTMENT OF 000084 CHECK AMOUNT To The ; ENVIRONMENT AND NATURAL RESOURCES v°+oniler Order,, 585 WAUGHTOWN STREET s" "'°"cns /of WINSTON-SALEM, NC 27107 f ; ,..,SR`.VP., Compt'. 8�'. easurer , ,. 1 • Janeen Lyle Director, Personal Health Care Mason Business Center 8700 Mason -Montgomery Rd. Mason, OH 45040 Telephone: +1-513-622-4818 July 3, 2014 The Procter & Gamble Manufacturing Company 1 Procter & Gamble Plaza Cincinnati, OH 45202 www.pg.com ` RECEIVED N.C. Dept. of ENR JUL 14 2014 EG O � L OFF CE North Carolina Department of Environment and Natural Resources Winston-Salem Regional Office Division of Water Quality 585 Waughtown Street Winston-Salem, NC 27107 RE: Attachments and Fee for Stormwater Permit Name/Ownership Change Form The Procter & Gamble Manufacturing Company, 100 Swing Road, Greensboro, NC To Whom It May Concern: The Procter S Gamble Manufacturing Company ("PSG") submits to the Department the enclosed State Stormwater Permit Name/Ownership Change Form ("Application") for the above -referenced facility ("Facility"), which was purchased by PSG from Teva Pharmaceuticals USA, Inc. on July 1, 2014. Also enclosed is a check for the Application fee and supporting attachments. PSG appreciates your assistance and consideration of the Application. Please contact me if you have any questions regarding the enclosed. Respectfully Submitted, Janeen Lyle Director, Personal Health Care Enclosures Cc: Carolyn Straton (Carolyn.Straton@tevapharm.com) I RECEIVED _ N.C_ Dept of ENR NCDENR North Carolina Department of Environment and Natural Resources o °" OFFICE Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM I. CURRENT PERMIT INFORMATION N(606 0 -�6q 1. Stormwater Management Permit Number: NCG060000 2. Project Name: N/A 3. Current Permit Holder's Company Name/Organization: 4. Signing Official's Name: Karin Shanahan 5. Mailing Address: 1090 Horsham Rd., PO Box 1090 City: North Wales 6. Phone: 2( 15 591-3000 Teva Pharmaceuticals USA, Inc. Title: SVP, Head of Regional. Tech Ops Americas State: PA Zip: Fax: ( 215 } 591-8600 19454-1090 ll. PROPOSED PERMITTEE 1 OWNER 1 PROJECT 1 ADDRESS INFORMATION This request is for: (please check all that apply) ❑ Name change of the owner (Please complete Items 1, 2 and 3 below) ❑ Name change of project (Please complete Item 5 below) ® Change in ownership of the property/company (Please complete Items 1, 2, 3, ❑ Mailing address 1 phone number change. (Please complete Item 4 below) ❑ Other (please explain): 1. Proposed permittee's company name/organization: The Procter & Gamble Manufacturing co. 2. Proposed permittee's signing official's name: _ 3. Proposed permittee's title: Plant Manager 4. Mailing Address: 100 Swing Road City: Greensboro Phone: (336 ) 315-6903 5. New Project Name to be placed on permit: Anthony Freve G State: NC Zip: 27409 FJU1 7i014 Fax: ( Please check the appropriate box. The proposed permittee listed above is: ❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a recorded easement for all areas that contain stormwater system features. Print name of HOA or POA in #f above and provide name of HOA/POA's authorized representative in #2 above) ® The property owner ❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on Page 4) ❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be granted upon receipt of a copy of the recorded deed) ❑ Developer (Complete Property Owner Information on page 4) SSW NIO Change Rev15Feb2011 Page 1 of 4 III. REQUIRED ITEMS A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all of the applicable required items listed below are included with the submittal. Failure to provide the listed items may result in processing delays or denial of the transfer. 1. This completed and signed form. This certification must be completed and signed by both the current permit holder and the new applicant if this is a change of ownership. 2. Legal documentation of the property transfer to a new owner. 3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit. 4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from each DWQ Regional office), if required by the permit and if not already submitted to DWQ. 5. if the proposed permittee is a firm, partnership, association, institution, corporation, limited liability company, or other corporate entity, provide documentation showing the authority of the named representative to act on behalf of the proposed permittee. - 6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing fee is not required. Subsequent ownership transfers will require the $40.00 processing fee. IV. CURRENT PERMITTEE'S CERTIFICATION Please check one of the following statements and fill out the certification below that statement: ❑ Check here if the current permittee is only changing his/her/its name, the project name, or mailing address, but will retain the permit. I, , the current permittee, hereby notify the DWQ that I am changing my name and/or I am changing my mailing address and/or I am changing the name of the permitted project. I further attest that this application for a name/ownership change is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed or if all required supporting information and attachments listed above are not included, this application package will be returned as incomplete. ® Check here if current permittee is transferring the property to a new owner and will not retain ownership of the permit. 1, Teva Pharmaceuticals USA, Inc. , the current permittee, am submitting this application for a transfer of ownership for permit # NCGo60000 . I hereby notify DWQ of the sale or other legal transfer of the stormwater system associated with this permit. I have provided a copy of the most recent permit, the designer's certification for each BMP, any recorded deed restrictions, covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved operation and maintenance agreement, past maintenance records, and the most recent DWQ stormwater inspection report to the proposed permittee named in Sections II and V of this form. further attest that this application for a name/ownership change is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed or if all required supporting information and attachments listed above are not included, this application package will be returned as incomplete. 1 assign all rights and obligations as permittee to the proposed permittee named in Sections II and V of this form. I understand that this transfer of ownership cannotibe by the DWQ unless and until the facility is'in compliance with the permit. f' Sig Date: I, U M b I C , a Notary Public for the State of Cn Gam. , County of ftnklomrru , do hereby certify that G�Mwn personally appeared before me this the day of , 20_L4_, and acknowledge the due execution of the forgoing in trument. Witness my hand and official seal, (Notary Seal) Notary S gnature ODW40NWEALTH of PEWMLVANIA Not " seal Debbie L Sdwbe t Notay Pubes SSW N/0 Change Rev15Feb2011 Page 2 of 4Morqomey ,' MEMBER, PEW4S 1JAN?a ASSOCIATION OF NOTARIES V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the Proposed Permittee for all transfers of ownership) 1 The Procter & Gamble Manufacturing co hereby notify the DWQ that I have acquired through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted stormwater management system, and, if applicable, constructing the permitted system. acknowledge and attest that i have received a copy of: (check all that apply to this permit) the most recent permit the designer's certification for each BMP ❑ any recorded deed restrictions, covenants, or easements ❑ the DWQ approved plans and/or approved as -built plans ❑ the approved operation and maintenance agreement ❑past maintenance records from the previous permittee (where required) DWQ stormwater inspection report showing compliance within 90 days prior to this transfer I have reviewed the permit, approved plans and other documents listed above, and I will comply with the terms and conditions of the permit and approved plans. I acknowledge and agree that I will operate and maintain the system pursuant to the requirements listed in the permit and in the operation and maintenance agreement. I further attest that this application for a name/ownership change is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed or if all required supporting information and attachments listed above are not included, this application package will be returned as incomplete. Signature: Date:.. _ 2/3, /J� a Notary Public for the State of County of ��1tr�r��7 do hereby certify that V r7 r personally appeared before me this the .3q day of u /, 20A, and acknowl0ge, the dwe execution of the forgoing i strument. fitness my hand and official seal, ��°\1l�ll/ T,qp. r� - Notary Signature 1 10 Additional copies of the original permit and the approved Operation and Maintenance agreement can be obtained from the appropriate Regional Office of the Division of Water Quality. This completed form, including all supporting documents and processing fee (if required), should be sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural Resources, Division of Water Quality, as shown on the attached map. Please note that if the Proposed Permittee listed above is not the property owner, the property owner must complete and sign page 4 of this document. Both the lessee /developer and the property owner will appear on the permit as permittees. SSW N/0 Change Rev1 5Feb2011 Page 3 of 4 `i �1t�1f, fl `� �''-aL': �''� �w� _����� �ff'��� � � y� {��� � 111�' `` �� J � � E t ` a''`.. y'�, �*fir 1 of ,�, VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION If the Proposed Permittee listed in Sections lI and V of this form is not the Property Owner, the Property Owner must provide hislher Contact Information below and sign this form: Printed Name: Organization: Title within the Organization: Street Address: City: Mailing Address: City: Phone: Email: State: (if different from street address) State: Fax: Zip: Zip: I certify that I own the property identified in this permit transfer document and have given permission to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy of the lease agreement or other contract, which indicates the party responsible for the construction and/or operation and maintenance of the stormwater system, has been provided with the submittal. As the legal property owner I acknowledge, understand, and agree by my signature below, that I will appear as a permittee along with the lessee/developer and l will therefore share responsibility for compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify DWO by submitting a completed Name/Ownership Change Form within 30 days of procuring a developer, lessee or purchaser for the property. I understand that failure to operate and maintain the stormwater treatment facility in accordance with the permit is a violation of NC General Statute (NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6. Signature of the property owner Date: I, , a Notary Public for the State of County of , do hereby certify that personally appeared before me this the day of , 20 , and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, (Notary Seal) otary Signature SSW N/O Change Rev15Feb2011 Page 4 of 4 SPECIAL WARRANTY DEED Excise Tax: $37,235.00 Tax Parcel ID No. 0074573 Verified by Guilford County on the day of , 2014 By: Mail/Box to: Dinsmore & Shohi LLP, One S. Main Street, Suite 1300, Dayton, Ohio 45402 This instrument was prepared by: Steven D. Buck, 111 N. Sixth Street, Reading, PA 19601 Brief description for the Index: THIS DEED, made this the -An day of �[�(i 2014, by and between GRANTOR: TEVA PHARMACEUTICALS USA, INC., a Delaware corporation whose mailing address is 1090 Horsham Road, North Wales, PA 19454 (herein referred to collectively as Grantor) and GRANTEE: THE PROCTER & GAMBLE MANUFACTURING COMPANY, an Ohio corporation whose mailing address is P.O. Box 599, Cincinnati, Ohio 45201 (herein referred to collectively as Grantee) and WITNESSETH: For valuable consideration from Grantee to Grantor, the receipt and sufficiency of which is hereby acknowledged. Grantor hereby gives, grants, bargains, sells and conveys unto Grantee in fee simple, subject to the Exceptions and Reservations hereinafter provided, if any, the following described property located in the City of Greensboro, County of Guilford, State of North Carolina, more particularly described on the attached Exhibit A. Said property having been previously conveyed to Grantor by instrument recorded in Book R7289, Page 1698. All or a portion of the property herein conveyed does not include the primary residence of a Grantor. TO HAVE AND TO HOLD unto Grantee, together with all privileges and appurtenances thereunto belonging, in fee simple, subject to the Exceptions and Reservations hereinafter and hereinabove provided, and as described on the attached Exhibit B. And Grantor hereby warrants that Grantor has done nothing to impair the title as received by Grantor and that Grantor will forever warrant and defend the title against the lawful claims of all persons claiming by, through or under Grantor. All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written. TEVA PHARMACEUTICALS USA, INC_, a Delaware corporation By Na e: Title: ;1 ` teC . � 1 STATE OF COUNTY OF I, t� 0 She, a Notary Public of the County of State of q W.,.do hereby certify that -be kj)C the IQ-k 1(�n(g EVA PHARMA UTICALS USA, INC., a Delaware corporation, personally known to me, to be the person described, personally appeared before me this day and acknowledged that (s)he voluntarily signed the foregoing instrument for the purpose stated therein. Witness, my hand and official seal, this ? day of June, 2014, SEAL Notary Public My commission expires: COMMONWEALTH OF PENNSYLtIy & rlal SW ag PubBc . lJlj 3638690 1;X111BIT A Located in Guilford County, North Carolina, and described as follows_ Beginning at a point in the center line of Swing Road at its intersection with the Center line of the Southern Railway main track, said beginning point being the northeast corner of that certain 13.(13 acre parcel of land conveyed to Richardson -Merrill Inc. by D.E. Pettey and wife, Elinor L. Pettey, by deed recorded in Book 2238, Page 17, Guilford County Registry, and running thence from said beginninq point along the center line of the Southern Railway main track between Greensboro and Winston-Salem South ST) 15' West 1181 feet to a point; thence still with the centerline of said Railway, South 880 07' 30" West 241.30 feet to a nail in ti)e center line of said Railway; thence along the eastern line of property now or formerly belonging to Persimmon Grove A.M.E. Church South n" 51' East 223,05 feet to an existing stone, the northeast corner of the property of Texaco, Inc..; thence with the eastern line Texaco, Inc. South 0' 49' 20" East 184.33 feet an existing iron pipe; thence along the southern line Texaco, Inc. South 8511 36' III" West 1279.26 feet to an existing iron pipe; thence continuing with line of Texaco, Inc. South 59° 27' West 46.86 feet to an existing iron pipe in the line of Southern Facilities, Inc.; thence with Southern Facilities, Inc. South 390 18' 10" East 754.63 feet to a stone; thence continuing with Southern Facilities, Inc. South 541 47' 10' East 39.73 feet to an existing iron pipe, a corner with Coca-Cola Co.; thence with the North tine of Coca-Cola Co. and B.C. Alley South 790 03' ln" East 2161.25 feet to an old iron pin in the center line of Swing Road; thence with the center line of Swing Road North ()1" 57' 30" East 1682.09 feet to the point and place of Beginning, the same containing 65.6261 acres, more or less (exclusive of the right-of-way of Swing Road) Save and Except land conveyed in Deeds Recorded in Book 5484 at Paqe 1176, Book 5484 at Paqe 1180, and Book 6925 at Page 490, Guilford County Registry. BXEIll3l�l� l3 E . ItIght of way to the State Highway Commission recorded in Book 2367, Page 67, GuillUrd County Registry. 2. Deed to Southern Railway Company recorder! in Book 2792, Page 232, Guilford County Registry. 3. Right of way For railroad, switch tracks, spur tracks, railway facilitics and other related easements, if any, on and across the Property. 4. Baserrrents to Duke Power recorded in Book 4314, Page 1179 and in Book 4519, Page 1124, Guilford County Registry. S. Corporation Authorization recorded in Book 5484, Page 1174, Guilford County Registry. 6. Rights of way to the Department of Transportation recorded in Book 5484, Page 1 176 and in Book 6925, Page 490, Guilford County Registry. 7. Basement to Greensboro Transit Authority recorded in Book 5687, Page 371, Guilford County Registry. 8. All legal highways, building lines, conditions and covenants of record. 9. All zoning ordinances and restrictions, matters created by or resulting from the acts or omissions of Grantee. 10. All taxes and assessments not yet payable. THE PROCTER & GAMBLE MANUFACTURING COMPANY Cincinnati, Ohio DELEGATION OF AUTHORITY TO EXECUTE CONTRACTS AND OTHER ENVIRONMENTAL DOCUMENTS Pursuant to Bylaw 15 of the Board of Directors of The Procter & Gamble Manufacturing Company, I hereby delegate to the following employees of either this Company or The Procter & Gamble Company the right to execute contracts for the purchase of environmental services, permit applications and permit application renewals, periodic or special reports, questionnaires, notices, statements or certifications required or authorized by any environmental law and/or regulation administered by any Federal, State or Local governmental agency: 1. Product Supply Managers; Directors, Product Supply; and Plant Managers, for any plant or facility within their area of responsibility. 2. Director, Product Supply -- Engineering, Health, Safety and Environmental — North America, for new plants or facilities not yet completed. This supersedes authority granted on February 8, 1995 May 28, 2014 THE PROCTER & GAMBLE MANUFACTURING COMPANY Cincinnati, Ohio 1, Susan S. Felder, DO HEREBY CERTIFY that I am Assistant Secretary of The Procter & Gamble Manufacturing Company, an Ohio Corporation, and I DO HEREBY CERTIFY as follows: That the below is a true and exact copy of By Law 15 of the By Laws of The Board of Directors of The Procter & Gamble Manufacturing Company and that said By Law is still in full force and effect. 15. Authority to Execute Contracts and Other Documents Contracts, deeds, mortgages, leases, bonds, powers of attorney (except those otherwise provided for in these By Laws), bills of sale, proxies (other than those provided for in By Law 8 above), and all documents and papers requiring the signature of the Company shall be executed by the President of the Company or by another employee of the Company who has the title of Vice President, where such person's primary office is located in a state where the Company is authorized to do business. Any of such officers may, by designation in writing (through a power of attorney or delegation of authority as appropriate), delegate to other employees of the Company or its subsidiaries the right to execute: (a) Contracts for the purchase or sale of raw materials; (b) Contracts for the purchase or sale of finished products; (c) Contracts for the purchase of supplies, equipment and insurance; (d) Contracts for the purchase of services (including research performed by universities, foundations, commercial laboratories and consultants); (e) Contracts for the purchase and lease of real estate or for the rental of warehouse space or other storage facilities and services; (f) Agreements for promotional merchandising, advertising, sponsorship and related marketing agreements; (g) Agreements involving the receipt or disclosure of confidential technical and business information; (h) Agreements for collaboration in the areas of research or development of products, services, or capabilities (including joint development agreements); W Agreements necessary to clear rights or settle intellectual property disputes in the ordinary course of business, such as co -existence agreements; 0) Such instruments as may be necessary in connection with the operation and fulfillment of the above -named contracts and agreements; (k) Tax returns and such instruments as may be necessary in connection with the settlement of any tax claims; (1) Notices, statements and certifications required by regulatory agencies of Federal, State and Foreign Governments; (m) Documents pertaining to the furnishing of surety bonds. A copy of each such delegation shall be deposited with the Secretary of the Company. The Secretary or an Assistant Secretary may execute powers of attorney and other documents for the prosecution and maintenance of patent, trademark, copyright and other intellectual property rights. I DO FURTHER CERTIFY, that the below -named person has been duly appointed, has qualified, and this day is an officer of The Procter & Gamble Company holding the respective office below set opposite her name; Name Title Janeen Lyle Director Product Supply I DO FURTHER CERTIFY that the attached is a true and exact copy of a Delegation of Authority signed by Yannis Skoufalos, dated May 28, 2014, and that said delegation is still in full force and effect. WITNESS my hand and official seal of The Procter & Gamble Manufacturing Company as of this 30t' day of May, 2014. IF usan S. Felder Assistant Secretary Cincinnati, Ohio May 30, 2014 GENERAL ASSIGNMENT AND BILL OF SALE This GENERAL ASSIGNMENT AND BILL OF SALE (this "Bill of Sale") is made and delivered as of the 1st day of July, 2014 by Teva Pharmaceuticals USA, Inc., a Delaware corporation (the "Seller"), in favor of The Procter & Gamble Manufacturing Company, an Ohio corporation (the "Purchaser"). RECITALS A. This Bill of Sale is delivered pursuant to a Transaction Agreement by and between The Procter & Gamble Company, an Ohio corporation ("P&G"), and Seller, dated April 1, 2014. B. Under the terms of the Transaction Agreement, Seller agreed to, or to cause the applicable member of the Teva Group to, assign, transfer, deliver and convey to P&G (or P&G's designated Affiliate) all right, title and interest of every kind and nature in, to and under the Purchased Assets. C. P&G has designated the Purchaser to acquire and accept from the applicable member of the Teva Group, all of such member's right, title and interest in, to and under the Purchased Assets. D. Seller is delivering this Bill of Sale to consummate the assignment, transfer, delivery and conveyance of the Purchased Assets to Purchaser. Accordingly, Seller and Purchaser agree as follows: 1. Defined Terms. Capitalized terms used herein and not defined have the meanings given to such terms in the Transaction Agreement, 2. Bill of Sale. Seller irrevocably assigns, transfers, delivers and conveys to Purchaser all of its right, title and interest of every kind and nature in, to and under the Purchased Assets, free, and clear of all Liens, other than Permitted Liens; and Seller for itself and for its successors and assigns, warrants and defends the transfer of said property, rights, business and assets unto the Purchaser and its successors and assigns, against all and every Persons whomsoever. 3. Excluded Assets. The Purchased Assets do not include any Excluded Assets. 4. No Waiver or Modification-, Subiect to Transaction Agreement. Nothing contained in this Bill of Sale shall be (a) construed as a waiver of or limitation upon any of the rights or remedies of the parties hereto as set forth in, or arising in connection with, the Transaction Agreement, or any instrument or document delivered pursuant to the Transaction Agreement; (b) construed to create any broader obligations DLI-6471622v3 of the parties hereto than those contemplated in the Transaction Agreement. If there is any ambiguity or conflict between the terms hereof and the Transaction Agreement, the terms of the Transaction Agreement shall govern and control. This Bill of Sale is subject to all of the representations, warranties, covenants, exclusions and indemnities set forth in the Transaction Agreement, all of which are incorporated herein by reference. 5. Further Assurances. From and after the date hereof, each party hereto shall take, or cause to be taken, such actions, or execute and deliver, or cause to be executed and delivered, to the other party such other agreements or instruments, in each case as the other party may reasonably request, in order to further evidence the sale and transfer of the Purchased Assets in accordance with the terms of the Transaction Agreement. 6. Headings. The descriptive headings contained in this Bill of Sale are inserted for convenience of reference only and are not intended to be a substantive part of or to affect the meaning or interpretation of this Bill of Sale. 7. Governing Law. The validity, interpretation and enforcement of this Bill of Sale will be governed by the Laws of the State of Delaware, other than any choice of Law provisions thereof that would cause the Laws of another state to apply. 8. Counterparts; Electronic Signatures. This Bill of Sale may be executed in multiple counterparts (any one of which need not contain the signatures of more than one party), and counterparts may be exchanged by electronic transmission, each of which will be deemed to be an original but all of which taken together will constitute one and the same instrument. [Signature Pages Follow] DLI-64716224 Seller's Signature Page IN WITNESS WHEREOF, Seller has executed this Bill of Sale as of the day and year first above written. TEVA PHARMACEUTICALS USA, INC., a Delaware corporation Name: Title: J {' Name: Js"j %v I Title: [Signature Page to Bill of Sale] Purchaser's Signature Page, IN WITNESS WHEREOF, Purchaser has executed this Bill of Sale as of the day and year first above written. THE PROCTER & GAMBLE MANUFACTURING COMPANY, an Ohio corporation By'�---- Name: L 0- A ra- c ke� r' Title: u 'iP55 & [Signature Page to Bill of Sale] STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO- NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: 2010 CERTIFICATE OF COVERAGE NO..NCG06O1-LP'{_ - - (This monitoring report is due at the Division no later than 30 days from ter- — .._. .__.._ 5} � �t)e date the facility receives the sampling re Its from the laboratory.) FACILITY NAME Prcc+,e T 4 _�+.. 1t �y W,� �ks� % COUNTY C-yi l -z �c7 PERSON COLLECTING SAMPLES PHONE NO. (33i,) �l S�_i_� 14 1 7 t, CERTIFIED LABORATORY ,,,, t- ( ti.l Lab # 3 i+_ - _ Lab # PLEASE SIGN ON THE REVERSE Part A: Specific Monitoring Requirements Outfall °Date : mple Collected„ moldtlJ' r . 00530 ',::- : 00400 - 00340 .00556 __ a. 31616: Total'•Suspended ".; SoLdg, m IL - pH,.: ' ._.. 'Standard uuttg c Chemical Oxygen llemand, m.:JL �h �d Os1 a�id.Grease; mgJL ' `' Fecal Coliform, Colonies per 100 nil Benchmark` = ; >-._= .':,.. •:. 100,' ; Witliin;6.0; 9.0 12U 1000.. .S ov,c d li i-7 16 2 L 09 Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes V11no (if yes, complete Part 13) Part B: Vehicle Maintenance Activity Monitoring Requirements :;.... 0_utfall,- , No:.:. ;: ::_ Date ;; Sample Collected, r< flOS3D 00400, F Oil and' Grease, :. Total Suspended Saiids, ;pH, _ :'Standard hits .: " ,New Motor OiLUgage, Annual aver a a aunio 'Benchmark ' ,30 `� :' 100' !. , :=6:Q 9.0°° - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. RECEIVED STORM EVENT CHARACTERISTICS: Mail Original and one copy to: L_ C 0 7 0 I0 Division of Water Quality Date l 9 10(first event sampled) Attn: DWQ Central Files Total Event Precipitation (inches): > 2 ,. Information Processing Unit 1617 Mail Service Center DWQIBOG Raleigh, North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): .� S WU-249-102107 "l 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 Phmittee) (Date) S WU-2a9-102107 Page 2 of 2 RESEARCh & ANA[yTICAL 1 LAbORATWES, INC. ' Analytical/Process Consultations PROCTOR & GAMBLE 100 Swing Rd. Greensboro, NC 27409 Attn: Myra Gore Date Sample Collected Date Sample Received Date Sample Analyzed Date of Report Analyses Performed by Lab Sample Number 689106 Parameter Storet # Results TSS (00530) 22.0 mg/1 pH (00400) 6.09 Std. Units COD -HIGH (00340) 18 mg/1 Oil & Grease (00556) c5.0 mg/7. -------------------- Clients Sample Source SR POND Number Time Collected (Hrs) 0930 typ' r �♦i NC 4.CA� #34 z_ 11/17/10 11/17/10 11/17/10 12/02/10 YJ -TP -AR -SK P.O. Sox 473 • 106 Short street • Kernersville. North Carolina 27264 • 336-996-2841 • Fax 336-996-0326 www,randalabs.com RESEARCh & ANA[yTICA[ LAbORATWES, INC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD I WATER I WASTEWATER 1 MISC. I c0 ANY JOB NO. _ (,' � � �1 �- CG C O # y s 0-1c>7 ct f 3-2- STREET ADDRESS ``11 n �}J PROJECT lea �r� Z2 V S� � n 1 Ol SL'�v�, �'.Ylry �' it W —i <� "" �y� �'' ej e5" p� CITY, STATE, ZIP C SAMPLER NAME (PLEASE PRINT) w �` JcQ�� Q� Crean _� w !U C- �� 10 1 r � x 1e, O � � �.�' O `��,• ? C,o CONTACT " PHONE SAMPLER ftTURE i `��°}�p�' l3�vr�LfI��-''U Q� �Qrti ti ti Q CHLORINE SAMPLE Cc Q� C7 Q • Q • Q , C`O SAMPLE NUMBER TEMP RES v p p o m {LAB USE ONLY) DATE TIME COUP GRAB .0 GI raNJ IS W1 SAMPLE LOCATIONII.D. _ � ry ry� nF' �` � �" � � h` REQUESTEDANALYStS r r f'7 / c `r 3J ✓ 5 2 M� C" �c RELINQUISHED RY DATEITIME CEIVED BY ARKS: RELINQUISHED BY DATElTIME R CEIVED BY SAMPLE TEMPERATURE AT RECEIPT °C STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: )�O ) 0 CERTIFICATE OF COVERAGE,NO..NCGU6 -I' ~_ (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME- �_ is acme r c y?'L ' �c, �-� .... CouNTY PERSON COLLECTING SAMPLES ri ., C � c _ PHONE NO. 3 `t CERTIFIED LABORATORY i2_e_sr< . <L_ , f�_r :�1.�#; r�l Lab # Lab # PLEASE SIGN ON THE REVERSE -� Part A. Specific Monitoring Requirements Outfall No. Date Sample Collected, moldd! 00530 00400 00340 00556 31616 Total Suspended Solids, pH,, Standard units Chemical Oxygen Demand, Oil and Grease, mg/L Fecal Colfform, Colonies per 100 ml Benchmark - t00 Within &0 - 9.0 120 30 1000 - L U• Ui C3 C- Vote: if yuu report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses. See Gcncr-al Permit text. Did this facility perform Vehicle Maintenance .Activities using more than SS gallons of new motor oil per mouth? _ yes Zo (if yes, complete Part 81 Part 8: Vehicle Maintenance Activity MonitorinE Requirements Outfall No. Date Sample Collected, moldd/ r W556 00530 00400 Oil and Grease, Tot*[ Suspended Solids, - pH, Standard units New Motor Oil Usage, Annual averse al/mo I3rnchu►ark - 30 too 6.0 - 9.0 - Dote: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier i or Tier 2 responses. See Genera! Permit text. STOX-NI EVENT CHARACTERISTICS: Date (first event sampled) Tutal Event Precipitation (inches): t T` Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Mail Original and one copy to: Division of Water Quality Attu: DWQ Central Files Ifni Mail Service Center Raleigh, North Carotina 27699-16I7 "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 Yermittee) (Date) SVdU-240-1 FM O RESEARCh & ANALyTICAt UbORATO&S, INC. Analytical/Process Consultations A�YTi •• �•. ICI A i . Cr . 6 CA wNO #34 M '�•,� EDrAN �� � • Proctor & Gamble Date Sample Collected 05/18/10 PO Box 18647 Date Sample Received 05/18/10 Greensboro, NC 27419 Date Sample Analyzed 05/18/10 Attn: Myra Gore Date of Report 06/01/10 Analyses Performed by YJ -TP -AR -AA _.-. Lab Sample Number ----------------- 673979 Parameter Storet # Results TSS (C0530) 15.5 mg/l pH (00400) 6.02 Std. Units COD -HIGH (00340) 30 mg/l Oil & Grease (00556) <5.0 mg/l Clients Sample Source -------------------- SR S'TORMPOND Number Time Collected (fors) 1015 P. D, Box 473 • 106 Short Street • Kernersvilie, North Carolina 27284 • 336-996-2641 • Fax 335-996-0326 www,randelabs.com RESEARCh & ANAlyTiCAt LABORATORIES, INC. f Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD WATER i WASTEWATER MISC. l CrOMPANY Y-� Cv' - Ta4tiJ 4 [ �C JOB IN �i�C� 13 I f �11 i O _ a %Q' _O' a`' Gv oy Per my O `Nq. q L � O� F � Q. � QQQ" C S ry� ry,�o � � �� � �9 REQUESTED ANALYSIS STREETADDRESS 10 C5 w. r.. 1� a PROTECT y y S i �c Cf iY, STATE, ZIP SAMPLER NAME PLEA E PRI. CONTACT r PHONE 7/ ( 1 -KA-MPICER SIGNATUR , ✓ SAMPLE NUMBER {LAgUSEONLY) DATE TIME COI1 Grua M 'C RES Cl �rl�n d �n �`r SAMPLE LOCAMN If.D. p sa i i RELINQUISH $Y DATE/iINi% C IVECBY MARKS: U Ci/V l6 y Ti SAMPLE TEMPERATURE AT RECEIPT 3' 3 °C RELINQUISHED BY DATE/TIME lCOVED a lr*, �'. (h STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERA-, PERMIT NO. NCGO60000 CERTIFICATE OF COVERAGE NO: NCG06 C).2,Co dt- fir ---- FACILITY NAME The Qrae+ev PERSON COLLECTING SAMPLES M v r L Ga v- r- _ CER-rmED LABORATORY jZcSer---T ? kKgA7j-•'cat Lab # _3'� Lab # Part A: Specific Monitoring Requirements swi'vti9 RGa ci F,:,Le � SAMPLES COLLECTED DURING CALENDAR YEAR: 3.G01 (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) COUNTY Gv: I --v,k PHONE NO. 3(_ 3 4 ) 9 9' 4 - -7 PLEASE SIGN ON THE REVERSE 4 Outfall No. Date Sample Collected, moldd/ r 00530 00400 00340 00556 31616 Total Suspended Solids, mgfL p1H,,. ,' - =,' Standard -units Chemical Oxygen • Demand, Oil and Grease, mg Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 =.9.0 • 120 , ' 30 1000 i.59'7 u-% i 1• J• a q I- S- 7. 3 Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes Vso (I - S. complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected, mo/dd/ r 00556 00530 00400 Oil and Grease, m Tota1'Suspended-Solids, '• pH, - Standard units New Motor Oil Usage, Annual averse allmo Benchmark - .30 • - 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses. See General Permit text. S rO1LNI EVENT CIIARACTERISTICS: Date 11 •.2 -01 (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Mail Original and one copy to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 tD M c-3 f�. fit; ME S W U-2.39-102107 "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." Iz /M loLA (Signature o ermittee) (Date) Swu-249-1021 m RESEARCh & ANA[yTICA[ •' ••" .�'• yam. • .• 4 Ciy ' .• 10'. 1 N � LAbQRATQRIES� INC. NCB i.cn Analytical/Process Consultations : '� e 4t11+lalst++ Proctor & Gamble Date Sample Collected 11/02/09 PO Sox 18647 Date Sample Received 1.1/02/09 Greensboro, NC 27419 Date Sample Analyzed 11/02/09 Attn: Andria Oyola Date of Report 11/13/09 I Analyses Performed by YJ -AR -IA Lab Sample Number --------------- 659700 Parameter Storet # Results TSS (00530) COD -HIGH (00340) Oil & Grease (00556) 21.5 mg/l 14 mg/1 c5.0 mg/l -------------------- Clients Sample Source SR STORMPOND Number Time Collected (Hrs) 1315 P 0, Box 473 • 106 Short Street • Kernarsville, North Carolina 27284 • 336.996.2B41 , Fax 336-996-0326 www,randalabs,com r RESEARCh & ANAlyriCAl LAbORATORiES, INC. Analytical / PrOCess COnsultabons Phone (3361 996-2841 IPANY JOB NO t=ET AOORESS I PROJECT I STATE. ZIP SAMALERh LTACT PHONE SAMp ER1! /1 MPL ENUM ABUSONLYDATE TIME TFMFl RES a�uQFo iu i GI nM Isorq I I, AME (PLEASE PRINT) SAMPLE LKATON L L D. S Trv>� ter` gQUISHE} BY DALEITIfAE RECEIVED BY � REMARKS: 4QUISHED BY DATEMME RE JE BY CHAIN OF CUSTODY RECORD WATER 1 WASTEWATER MlSC. ///Z.�,7, 0. ob y a2�Gaa o ti 0 aoF hoF hoF� q U q' a'. a' c C I F ON jLr- SAMPLE TEMPERATURE AT RECEIPT / REQUESTED ANALYSIS Cc }-] STORMWATER DISCHARGE MONITORING REPORT (DMR) Please Mail Original And One C2a To Mailing Address On Back Of This Form GENERAL PERMIT NO. NCG060000 Part A: Facility Information S `~ S Samples Collected In Calendar Year: 9C-011 (all samples shall be reported following receipt from lab, but no later than January 31 of the rollowing year) Certificate Of Coverage No. E` NCG06-_026 `l - --1 County of Facility Cl—i I �.J Facility Name Ll p�r- '-6tc — . Co - Name of Laboratory Facility Contact _t- 7� G. _ _ Lab Certification # 3 L+ Facility Contact Phone No. 3! 3 & ) `-1- -+ - ` f r `7 6 Part B: Specific Monitoring Requirements Outfall No. Date Sample Collected 50M 00" 00556 00545 00340 31616 Total Flow I pH Oil and Grease Total Suspended Solids Cbemlesd Oxygen Demand Fecal CWOM1 mold!L/a I MG I unit MRA I M911 I Mtn I per 100 mL I 1-70 9 0 S 1:A. If la Footnote 1 Fecal Coliform sampling applicable only to facilities processing meats. Does the facility perform vehicle washing and fueling?� yes ;?no Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes �O no (if yes, complete Part Q Part C: Vehicle Maintenance Activity Monitoring Requirements Outfad No. Date Sample Collected 50M M556 00545 00400 .. Total Flow 041 and Grease Total Suspended Solids pH New Motor on U molddlyr MG MCA I nw unit safto Fr— DMR06 Ar Part D: Storm Event Characteristics Total Event Precipitation (inches): 3 Event Duration (hours): 2' (if more than one storm event was sampled) Total Event Precipitation (inches): Event Duration (hours): "I certify, under penalty of law, that this document and all attachments were prepared under y direction alr the supervision in accordance with a system designed to assure that qualified Personnel properly gather and information submitted. Based on my inquiry of the person or persons who manage the system, or taw persons directlyresponsible for gathering the information, the information submitted is, to the best of my knowledge false information, including tiding p° ties for submitting true, accurate, and complete. I am aware that there are significant penal the possibility of fines and imprisonment for knowing violations." (Signature of MAILING ADDRESS: Attn: Central Files Division of Water Quality, DENR 1617 Mail Service center Raleigh, NC 27699-1617 (Date) Form DMR06 PSG The Procter &Gamble Manufacturing Co. 100 Swing Road Greensboro, NC 27409 (336) 954-0000 www.p9.Com May 5, 2009 NCDENR Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699 Subject: General Permit No, NCGO60000 Certificate of Coverage No. NCG060264 The Procter and Gamble Manufacturing Company Greensboro, NC 27409 Guilford County Enclosed is the 2009 first semiannual sampling results for the Swing Road stormpond. Should you have questions or comments concerning this report please contact me at (336) 954-4176. Sincerely, Myra Gore Environmental Leader RESEARCh & ANA[yTICAL LkoRATORIES, INC. Analytical/Process Consultations `00111111121?4" .� 60 A Yryi #',. . CF�,q`( Sri cc C* 0 (J) x = NC #34 z y PROCTOR & GAMBLE Date Sample Collected 01/07/09 620C BRYAN PARK RD Date Sample Received 01/07/09 BROWN SUMMIT, NC 27214 Date Sample Analyzed 01/07/09 Attn: MYRA GORE Date of Report 01/16/09 Analyses Performed by YJ -TP -AR -IA -Si Lab Sample Number ----------------------- 636060 Parameter Storet # Results TSS (00530) 124 mg/1 pH (00400) 6.18 Std. Units COD -HIGH (00340) Oil & Grease (00556) Fec Coli-MF (31616) Clients Sample Source Number Time Collected (Hrs) 6 mg/l <5.0 mg/l 168 col./100 ml -------------------- SR POND 1400 P.O. Box 473 • 106 S` ort Street • Kernersvilla, North Carolina 27204 • 336-996-2841 • Fax 336-996-0326 www,randalabs.rom RESEARCh & ANA[yTICA1 LABORATORIES, INC. Analytical / Process Consultations Phone (336) 996-2$41 CHAIN OF CUSTODY RECORD i WATER 1 WASTEWATER L MISC._j COMPANY JOB NO. w fe z Z v � � gyp` y Z' ¢m Zp y0' �wL° 0��� U � ry ry ti w w � REQUESTED ANALYSIS STREET AOpRESS !` i__: � L. �.: -. �tiC 1 �-�- PROJECT SC.' -.� - �.,. �' •_` � �Z'L , ` CITY, STATE, ZIP (( v ✓Z� rSLliv� i�'C� zi �G�� SU AMPLER NAME (PLSE PRINT) Jv1 a �t� CONTACT r PHONE SAMPLER SIGNATURE SAMPLE NUMBER (LAB USONLY)DATE TOME GRAB 14 ,G RES CI CKDRINE REMOVED SAMPLEo s4 S`AMPLELL�OCATIONILO. y O I } Q� [_.' ✓ ` !? LIfCA/1.4-` I 5 -J L J 7 p�' 2': E+- � S iti �C�c�- I 1 L� ut�: t- I �T}U`4 �',✓L �� _�r� IyC7vt.o 1 !`�5�-�-.��✓d4 CG �J F`'+.`� � �' 1 tF- ' c5l�:r`s TSer iCU�--{ RELINOUISHE Y DATE/TWE BZCEIVED REMARKS: SAMPLE TEMPERATURE AT RECEIPT _ °C �TD T", �='� RE>_IIZQUISHED BY DATEl71ME RECEIVED BY !* tOU CC LL^LS ✓C^t. G� Iv G���0 L! STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO: NGG06-�2X;' FACILITY NAME_ Pru -e.- w C "I , V � _ 01 PERSON COLLECTING SAMPLES CERTIFIED LABORATORY Lab # Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampiing results from the laboratory.) COUNTY PHONE NO. 3( L )`l S:j -mot r `7 Ca PLEASE SIGN ON THE REVERSE 4 Outfall - No Date,, T,•Sample Collected,t mo/dil/vi , a OQ530 , . A0400 - -00340 :- 00556 , 31616 ' w. Total Suspended ", oltds:'— S :'in /l.:' { , 4 i : :� pliI Standard units nucal Oxygen Demand. m',,,,�` Oil and Grease; 'he . Fecal Coliform, ' r Colonies per 100 rril - -. Benchmark 100.„ : �' : Within 5'0 9 0 . 30 r �` 1004 Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? (if yes, complete Part B) Part B: Vehicle Maintenance Activitv Monitoring Requirements yes _no Outfall :' -No w.- Date f ' `: ,•. Sample`,Collected, . mo/dd/ r.,r `- .,.fm `�: °00556 ,, . OOS30 . 00400 _.; Otl and Grease, Total Suspended Solids, m /L:- =' H, Standard units New.,Motor.;0il Usage, Annual'avera a aUmo„ Benchmark: ; . _ u - 30'r:.. 10t1''. 6:0. 9 0; Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: ��,.�,fy-�-r ,�( * -`: S Mail Original and one copy to: f� Division of Water Quality Date (first event sampled) r e- rya r ��" }� e : U C` Attn: DWQ Central Files Total Event Precipitation (inches): 1 J z _ ,� 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): S WU-249-102107 Pai>_e 1 of 2 .r. s - 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) (Date) S WU-249- I 02107 Page 2 of 2 r� til�vCA 1 L�z.••4 K` STORMWATER DISCHARGE OUTFALL (SDO) [, 1jAAl ILL Z'7-to ei MONITORING REPORT it C �L'l}'C.1 �, GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. NCG06 Y.c FACILITY NAME tV\ 4h CO; -- PERSON COLLECTING SAMPLES CERTIFIED LABORATORY Lab # Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: (D (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) COUNTY PHONE NO. (L6 ) 1 5- Y -7 U7 _ PLEASE SIGN ON THE REVERSE 4 Outfall No. Date Sample Collected,::,. , . mo/dd/ r 00530���.'...::,.:: ' 00400. 00340 :. 00556',. , 31616 Total Suspended "Solids, iri pH, :!`Standard units Chemical Oxygen ':. Demand; mWL Oil and.Grease; mg/L. Fecal Coliform, Colonies per 100 ml Benchmark - 100 `,.Within 6.0 — 9.0 '. 120, 30 .. 1000 Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected, moldd/ r E 00556 + <:: ;', 00530' .. • ::' .. " 00400 Oil -and -Grease., -_;, m _Total Suspended Solids, ,: m /L ' ` ,-;..:: pH ; Standard'unitsm New Motor Oil Usage, Annual averse al/mo Benchmark - 30. 100 . .6,0 — 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses. See General Permit text. S w �� c;( � 1 c, , t A)) F- uV c k—) STORM EVENT CHARACTERISTICS: Date (first event sampled) r e �1 {"c e cl Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Mail Original and one copy to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Total Event Precipitation (inches): SWU-249-102107 "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) (Date) S WU-249-102107 . I Page 2 of