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HomeMy WebLinkAboutNCG140246_MONITORING INFO_20190305STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE O HISTORICAL FILE C� MONITORING REPORTS DOC DATE ❑ aolq 03 05. YYYYMMDD i. ti ANNUAL SUMMARY DISCHARGE MONITORING REPORT ( MR) -- WASTEWATER SUBMIT TO CENTRAL OFFICE` General Permit No. NCG140000 Calendar Year 2018 *Report ALL WASTEWATER monitoring data on this form (include "No FloVf'No Discharge" and Limit Violations) from the previous calendar year to the DEQ by MARCH 1 of each year. Certificate of Coverage No. NCG14 ] ] Facility Name: Arrowood Plant County: Mecklenburg Phone Number: { 704 ) 529-6364 Certified Laboratory Prism Lab 0 Lab # 402 Lab # Total no. of outfalls monitored 2 Wastewater (WW) Discharge Outfall No. 001 Does this outfall discharge WW to SA waters? Yes ❑ No E Does this outfall discharge WW to SB or PNA waters? Yes ❑ No 0 Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑✓ If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑ Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No❑ Were there any limit violations in the calendar year? Yes ✓❑ No ❑ Outfall No, 001 Daily Flow Rate, cfs pH, SU TSS, mgll SS, mill it applicable Non -Polar O&G (EPA Method 1664 (SGT-HEM)), mg/1 Effluent Limitations Daily Maximum HOW or ORW 50% of 7Q10 lntlica[e NO FLOW if applicable freshwater 6.0-9.0 saltwater u u.s 6.-8PNA Standard 30 HOW 20 HOW l ORW and Tr, or 1 O HOW, ORW, SA, SB,PNA,orany Trout a 5 No Limit Samples above Benchmark subject to Tiered Responses 15 Date Sample1h Collected, molddl r ems. W ems_" t e . 14 • € i = fu u - F�Ff'.�=I1iFi� 3/6/2018 PW 001 7.9 190 1 MA U 6/27/2018 PW 001 NO FLOW rr- 1�1f �fY(T f1Al 9/10/2018 NO FLOW 10/26/2018 001 NO FLOW Permit Date 811I2017 — 6/30/2022 Last Revised 8-22-2017 Certificate of Coverage No. NCG14 0❑Q®® Additional Outfall Attachment (make copies as needed for additional outfalls) Wastewater (WW) Discharge Outfall No. oat Does this outfall discharge WW to SA waters? Yes ❑ No ❑ Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑ Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑ If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑ Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑ Were there any limit violations in the calendar year? Yes ❑ No ❑ Outfall I�p. QO Daily Flow Rate, cfs pH, SU TSS, mgll SS, mlll if applicable Non -Polar O&G (EPA Method 1664 (SGT-HEM)), mg11 Effluent Limitations Daily Maximum HOW or ORW 50% of 7Q10 indicate NO FLOW if applicable freshwater 6.0-9.0 saltwater 6.8-$.5 Standard HOW 20 HOW 1 ORA�Tr, or P 10 HOW, ORW, SA, SB, PNA, or any Trout 5 No Limit Samples above Benchmark subject to Tiered Responses 15 Date Sample Collected,' molddlyr .:Y •: E' C ,� f R - 'Y t,se _.. �% 9 �::. T' �:, ,� J:, �bti �„ --4Y ¢ _ ba' S_°i t: Y: :. �. 6/27118 PW 002 7.8 BRL 10/26118 PW 002 11 BRL Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2017 Certificate of Coverage No. NCG14 2Fa-RZ' CERTIFICATION "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." (Required 6y 40 CFR §122.221 Signature Date Mail Annual Summary Wastewater DMR to the NCDEQ Central Office: Note the address is correct -- Central Files is housed in DWR (not DEMLR) N.C. Department of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files Telephone (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2017 ANNUAL SUMMARY DISCHARGE MONITORING REPORT DMR—STORMWATER SUBMIT TO CENTRAL OFFICE'' General Permit No. NCG140000 Calendar Year 2017 "Report ALL STORMWATER monitoring data on this form (include "No Flow'T'No-Discharge" and Benchmark Exceedances) from the previous calendar year to the DEQ by MARCH• of eac17 year n Certificate of Coverage No. NCG 14 ®2❑®© "Ir,ll v 14U 16 CENTRAL FILES Facility Name: Arrowood DWR SFrTlnK1 County: Mecklenburg Phone Number: (704 ) 587-7080 Total no. of SDOs monitored 2 Certified Laboratory Prism Lab Lab # 402 Lab # Stormwater Discharge Outfall (SDO) No. 001 & 002 VMA Outfall? Yes ❑ No ❑✓ Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑✓ Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑✓ If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency ❑ Yes, received approval from DEMLR to reduce monitoring frequency Other d Outfall No. Total Rainfall, inches Total Suspended Solids ( ) m 11 pH, SU Non -polar O&G (EPA Method 1664TSS, ( SGT-HEM)), mgll (VMA) !f applicable New Motor Oil Usage (gallmo.) lrapplicable Stormwater Benchmarks Indicate NO FLOW H applicable Circle Benchmark 100150 6.0-9.0 15 >55 gaUmo. average requires TSS and Non -polar O&G monitoring Date Sample Collected, _. A ap 3/28/2017 001 No Flow 3/28/2017 002 No Flow 6/30/2017 001 No Flow 6/30/2017 002 No Flow 9/11/2017 001 No Flow 9/11/2017 002 No Flow 12/20/2017 001 No Flow Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2015 i . i Certificate of Coverage No. NCG14 O❑RIE® CERTIFICATION " 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." [Required by 40 CFR §122. Signature Date �) 0 Mail Annual Summary Stormwater DMR to the NCDEQ Central Office: Note the address is correct — Central Files is housed in DWR (not DEMLR) N.C. Department of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files Telephone (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 8/112017 — 6/30/2022 Last Revised 8-22-2015 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG140246 SAMPLE COLLECTION YEAR: 2017 FACILITY NAME: Arrowood "" _ SAMPLE QUARTER: []Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June PERSON COLLECTING SAMPLES: Rik Jones �`"���V COUNTY: Mecklenburg CERTIFIED LABORATORY: Prism Lab # 402 JUL 21 2017 PHONE NO. (704) 372-2930 E LES ADD TO LISTSERVE? []YES ®NO EMAIL: LIMIT VIOLATIONS? YES ❑ NON CENTRAL TI Db'VR SECTION I DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA —]Trout ®Other OPTIONAL INFO: Part A: Wastewater Monitorine Requirements Outfall No. Date Sample a Collected (mm/dd/yr) Type of Stormwater (VI:, RM, MD)' pH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH usingDischarge method 1664A S (mg/LGT-HEM' Duration (minutes) Total Flow � (gallons/day) RM, MD- 6-93'4 303'5 53 (15)s - - PW 001 6/30/2017 RM 7.5 BRL BRL >1 PW 002 6/30/2017 NO FLOW 1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. 2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. 4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. 5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to SO%of the Summer 7Q10 Flow as per 1SA NCAC 028.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. 1f the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOC TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 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 directl responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am awarg that ther)pare significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." klw --,/// Y/ 7 ignature k Permittee) (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report CERTIFICATE OF COVERAGE NO. NCG140292 FACILITY NAME: GB#1/Edwardia PERSON COLLECTING SAMPLES: Daniel Brown CERTIFIED LABORATORY: Prism Lab # 402 LIMIT VIOLATIONS? YES ❑ NO Part A: Wastewater Monitorine Reauirements GENERAL PERMIT No. NCG140000 MECEIVED JUL 2 7 2017 CENTRAL FILES DWR SECTION SAMPLE COLLECTION YEAR: 2017 SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June COUNTY: Guilford PHONE NO. (704) 372-2930 ADD TO LISTSERVE? DYES ®NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW OPTIONAL INFO: ❑PNA ❑Trout ®Other Outfall No. Date Sample 1 Collected (mm/dd/yr) Type of Wastewater z (VERMMD} , , pH (standard] Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH usingDischarge method 1664A S (mg/L) Duration (minutes) Total Flow 7 (gallons/day} - - RM, MD- 6-93,4 303,5 53 (15)6 - - 001 6/30/2017 RM 8.52 12.6 <0.1 >1 002 6/30/2017 NO FLOW 1 If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. 2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. 4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. 5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: Division of water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 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 d' ctly r onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that ere re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." of Permittee) Permit Date:7/1/2010-06/30/2015 Ir--(fr-7 (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT No. NCG140000 CERTIFICATE OF COVERAGE NO. NCG140246 SAMPLE COLLECTION YEAR: 2017 FACILITY NAME: Arrowood SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -tune PERSON COLLECTING SAMPLES: Rik Jones COUNTY: Mecklenbu r CERTIFIED LABORATORY: Prism Lab # 402 PHONE NO. (704) 372-2930 ADD TO LISTSERVE? ❑YES ®NO EMAIL: LIMIT VIOLATIONS? YES ® NO ❑ Part A: Wastewater Monitoring Requirements DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA []Trout ®Other OPTIONAL INFO: Outfall No. Date Sample 1 Collected (mm/dd/yr) Type of Stormwater (VE, RM, MD)' pH (standard) Total Suspended Solids- (mg/L) Settleable Solids (mL/L) TPH using method 1664A SGT HEIW (mg/L) Discharge Duration (minutes) Total Flow �' (gallons/day) RM, MD- 6-93'4 303,5 53 (15)6 - - SW 001 ' 3/28/2017 RM 9.01 BRL BRL 002 3/28/2017 NO FLOW U17 CENTRAL F ILES DWRS If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. 4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. S TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 5 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. 7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 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 4 significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." of -!�-(l It 7 (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report ` GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG140246 FACILITY NAME: Arrowood RECEIVED PERSON COLLECTING SAMPLES: Rik Jones CERTIFIED LABORATORY: Prism Lab # 402 JAN 2 3 2017 CENTRAL FILES LIMIT VIOLATIONS? YES ❑ NO ® DWR SECTION Part A: Wastewater Monitoring Rectuirements SAMPLE COLLECTION YEAR: 2016 SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June COUNTY: Mecklenburg PHONE NO. (704) 372-2930 ADD TO LISTSERVE? [—]YES ®NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [—]Trout ®Other OPTIONAL INFO: Outfall No. Date Sample Collected' (mm/dd/yrI Type of Stormwater r (VE, RM, MD} pH (standard) Total Suspended Solids (mg/L} Settleable Solids (mL/L) TPH using method 1664A S (mg/L) Discharge Duration (minutes) Total flow 7 (gallons/day} RM, MD- 6-93.4 303'5 53 (15)6 - - N/A SW 001 11/29/2016 Water 8.5 1300 9.0 N/A .4 PH 002 11/29/2016 NO FLOW u 6 �- pU` -� vnOWN ' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. 2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. 4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 6 Process>2stewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. 7 Flom rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE IOR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 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." re of Permittee) Permit Date: 7/1/2010-06/30/2015 1It7It? (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS STORMWATER -- Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG140246 FACILITY NAME: Arrowood PERSON COLLECTING SAMPLES: Scott Miller CERTIFIED LABORATORY: Prism Lab # 402 LIMIT VIOLATIONS? YES ® NO ❑ Part A: Wastewater Monitorine Reauirements SAMPLE COLLECTION YEAR: 2016 SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June COUNTY: Mecklenburg PHONE NO. (704) 372-2930 ADD TO LISTSERVE? DYES ®NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW OPTIONAL INFO: ❑PNA ❑Trout ®Other Outfall Na. Date Sample Collected' (mm/dd/yr) Type of Wastewater 2 (VE, RM, MD) pH {standard] Total Suspended Solids {mg/L} Settleable Solids (mL/L) TPH using method 1664A 6 SGTmNEM [mg/L] Discharge Duration (minutes) Total Flow 7 {gallons/day} - - RM, MD- 6-93,4 303's 53 {15}6 - - 001 9/22/2016 RM 10.4 BRL .10 <5 >1 >1 002 9/22/2016 No FLow w � 1 FECEIVED ENTRAL F SECTION ' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. a pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. S TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 a Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. ' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 70.10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE-) WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 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 thatjlherpare significant penalties for submitting false information, including the possibility of fines and imprisonment for Knowing violations." (Signatu're of Permittee) Permit Date: 7/1/2010-06/30/2015 o ,"dt¢ (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT No. NCG140000 CERTIFICATE OF COVERAGE NO. NCG140246 FACILITY NAME: Arrowood PERSON COLLECTING SAMPLES: Rik Jones CERTIFIED LABORATORY: Prism Lab # 402 LIMIT VIOLATIONS? YES ❑ NO Part A: Wastewater Monitorine Reauirements SAMPLE COLLECTION YEAR: 2016 SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June COUNTY: Mecklenburg PHONE NO. (704) 372-2930 ADD TO LISTSERVE? ❑YES ®NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW OPTIONAL INFO: ❑PNA ❑Trout ®Other Outfall No. Date Sample Collected' (mm/dd/yr) Type of Wastewater z (VE, RM, MD) pH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH using method 16b4A 6 5 {T Discharge Duration (minutes) Total Flow 7 (gallons/day) - - RM, MD- 6-93,4 303,5 53 (15)6 - - SW 001 6/30/2016 BRL 7.7 .8 i\ ir. n ct-,c �e ALIG 0 $ '4 lb rn CC .,,qm ccrT , N ` If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. 2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. 4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. 5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 a Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END OF MONITORING PERIOD IN CASE _O_F "NO FLOW") TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 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 direct*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 thefb aSR-gnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." of Permittee) Permit Date: 7/1/2010-06/30/2015 �z r 4 (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE N0. NCG140246 FACILITY NAME: Arrowood PERSON COLLECTING SAMPLES: Rik Jones CERTIFIED LABORATORY: Prism Lab # 402 LIMIT VIOLATIONS? YES _�§ NO Part A: Wastewater Monitorine Requirements SAMPLE COLLECTION YEAR: 2016 SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June COUNTY: Mecklenburg PHONE NO. (704) 372-2930 ADD TO LISTSERVE? ❑YES ®NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW OPTIONAL INFO: ❑PNA ❑Trout ®Other Outfall No. Date Sample 1 Collected (mm/dd/yr) Type of Wastewater Z (VE, RM, MD} pH {standard} Total Suspended Solids {mg/L} Settleable Solids (mL/L) TPH usingDischarge method 1664A 6 SGT HEM (mg/L) Duration {minutes} Total Flow 7 (gallons/day) - - RM, MD- 6-93'4 3031S 53 (15)6 - - 001 1/15/2016 RM 10.9 420 2.0 N/A CLI . �Ul CENTRAL R SECTION If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. 2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. 4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. 5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HOW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 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 dir.Ictly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature of Permittee) Permit Date: 7/1/2010-06/30/201.5 f-f! ttl/�- (Date) Last Revised 07/13/11 Page 2 of 2 i ik PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG140246 RECEIVED FACILITY NAME: Arrowood C4,✓C V PERSON COLLECTING SAMPLES: Rik Jones OCT 2 3 Z015 CERTIFIED LABORATORY: Prism Lab # 402 CENTRAL, FILES LIMIT VIOLATIONS? YES ®NO ❑ DWR SECTION Part A: Wastewater Monitorine Reauirements SAMPLE COLLECTION YEAR: 2015 SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec Dian -March ❑April -June COUNTY: Mecklenburg PHONE NO. (704) 372-2930 ADD TO LISTSERVE? DYES ®NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other OPTIONAL INFO: Outfall Na. Date Sample 1 Collected (mm/dd/yr) Type of Wastewater � (VE, RM, MD) PHmethod (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH usingDischarge 1664A SGT-HEM6 (mg/L) Duration (minutes) Total Flow (gallons/day)' - - RM, MD- 6-93'4 303's 53 (15)6 - - PW001 09/24/2015 RM 7.3 BRL BRL N/A >1 >1 SW001 09/24/2015 RM 8.6 BRL BRL N/A >1 >1 If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3It an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. 4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. 5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 6 Process -wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. ' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to S0% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flaw and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLU AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 ALL "NO FLOW". "NO DISCHARGE"1 WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR 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 girectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware th# there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." of Permittee) Permit Date:7/1/2010-06/30/2015 (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT No. NCG140000 CERTIFICATE OF COVERAGE NO. NCGi140246 FACILITY NAME: Arrowood PERSON COLLECTING SAMPLES: Rik Janes CERTIFIED LABORATORY: Prism Lab # 402 LIMIT VIOLATIONS? YES ® NO ❑ Part A: Wastewater Monitoring Reauirements SAMPLE COLLECTION YEAR: 2015 SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March []April -June COUNTY: Mecklenburg PHONE NO. (704) 372-2930 ADD TO LISTSERVE? []YES ®NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW OPTIONAL INFO: ❑PNA [—]Trout ®Other Outfall No. Date Sample Collected (mm/dd/yr) Type of Wastewater z (VE, RM, MD) pH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH usingDischarge method 1664A SG7-HEMS (mg/L) Duration (minutes) Total Flow 7 (gallons/day) - - RM, MD- 6-93,4 303,5 53- PW001 10/27/2015 NO FLOW ' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. ° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. S TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/201S Last Revised 07/13/11 Page 1 of 2 Proccs wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, tut instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to SO% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 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 erectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1 am ativare th t thg ore significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." a'111� of Permitteej (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 1 PROCESSWASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 - CERTIFICATE OF COVERAGE No. NCG.140246 FACILITY NAME: Arrowood PERSON COLLECTING SAMPLES: Rik Jones CERTIFIED LABORATORY: Prism Lab # 402 LIMIT VIOLATIONS? YES.® NO ❑ Part A: Wastewater Monitoring Requirements SAMPLE COLLECTION YEAR: 2015 RECEJ1 ELSAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -Marsh ❑April -June COUNTY: Mecklenburg MAY 13 zo15 PHONE NO. (704) 372-2930 CENTRAL FILES ADD TO LISTSERVE? DYES ZNO EMAIL: DU/R S CTICW DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other OPTIONAL INFO: outfall No. Date Sample Collected' (mmlddlyr) Type of Wastewater z (VE, RM, MD) pH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH using method 3664R 5 (mg/L) (mmg f L� Discharge Duration (minutes) Total Flow 7 (gallons/day) - RM, MD- 6-93'4 303,5 53 (15)6 - - PWO01 03/11/15 RM 11 BRL BRL N/A >1 >1 SW001 03/11/15 RM 10 BRL BRL N/A >1 >1 1 if wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above. z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. 5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 „-.4 4 .-A, 6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case -by -case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT.OF SAMPLE (OR AT END OF •fVlON1TORiNG'AElilOi] IN CASE OF "NO FLOW") TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1,617 (919) 807-6379 YOU MUST SIGN THIS CERTIFIGU40N FOR ANY INFORMATION REPORTED: '"I certify, under penalty of law, thatthis document.and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualifie personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons dlreiMy responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am ajuaAe that t remsignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." of Permittee! Permit Date: 7/1/2010-06/3012015 s- (Date) Last Revised 07/13/11 Page 2 of 2