NCG060042_MONITORING INFO_20190702

vvS1� �
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
C MONITORING REPORTS
of v) 7 0 %
DOC DATE
❑
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: 020
CERTIFICATE OF COVERAGE NO. NCG06 { a' (This monitoring report is due at the Division no later than 30 days from
yt t,.i¢4 ��%1 g'(c to S the date the facility receives the s>Klttplipg re;u`t�rom the laboratory.)
FACILITYNAME COMMO Koc F h
PERSON COLLECTING SAMPLES v` PHONE NO. (33(6) 63 4-tiX3'7
CERTIFIED LABORATORY AAtv' Lab # IL 1
Lab#.ECEI VE� PLEASE SIGN ON THE REVERSE
'
Part A: Specific Monitoring Requirements
JUL 0 2 2019
Outfall
No.
Date
Sample
Collected;
mo/dd/vr
00530 '
- 00400 -_ n e .
'� t _r00340 >
00556.
31616
Total Suspended
Solids;
m i, . -
, ]?H
Standard tifiit's
'Ch'emJcil�Oxygen
Demand,
m W
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmark
100'
".NVithin6.0=9.0.
.120
..:30
1000
00
0C as T15
L40
DLIVE
37
<
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.
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 Reauirements
Outfoll
No.
Date
Sample Collected,
mo/dd/vr _
-00556.
00530
00400'
Oil and'Grease,
m /L. . -
Total Suspended Solids,
tit
pH,,.
Standard: units .,
New Motor Oil Usage,
Annual average 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 1 or I ier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date 6 0 {9 (first event sampled)
Total vent Precipitation (inches): 0-G?5
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
SWU-249-102107
Pagel of2

STORIVIWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: -1014
CERTIFICATE OF COVERAGE NO. NCG06 60q')- (This monitoring report is due at the Division no later than 30 days from
/ � ��JJ,,t�a the date the facility receives the s mp g- results from the laboratory.)
FACILITYNAME (—OM ✓7WOCh ltjt t�J5 COUNTY �VK•h
PERSON COLLECTING SAMPLES K...awlcr PHONE NO. (33G 1 G34 16432
CERTIFIED LABORATORY Mtr+ Lab # IG5
Lab # PLEASE SIGN ON THE REVERSE -i
Part A: Specific Monitoring Requirements
Outfall
No.
Date
Sample
C®ilecfed,
00530. ...
:00400 _,.:. .;'.
00340:, .. :.
00556.'.:.
31616
Total Siispended
Solids,
pH, R r
Standard umts.`;
,.r.
,.Chemical O`�ygen
. Demand,
m /L
Oil snd Greaseq
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmai`.k
100':.:..,':Wittiiti60=.9.Ox'+'u....120�:-
'30:''...
1000
Olo
I
c!
<3
N
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 ✓o
(if yes, complete Part B)
Part B: Vehicle Maintenance Actirity onitorinR Requirements
Outfall
No.
rDSte
Sample collected,,
molddl `. ,__
00556 _
00530>,:,
011 atidtGrease, .
;. .._'tn .:.� _:_..
TotaliSuspended Solids,
_ 'in /! .
pHI F
- Standard units -7;,::
New Motor Oil Usage,
-c.Annual averse aUmo
Benchmark
' —...
310._
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement -bier i or 1 ier z responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date A
`3(frrst event sampled)
Total Event recipitation(inches): &LG%-$
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
SWU-249-102107
Page 1 of

"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."
of Permittee)
G XY a ois
(Date)
SWU-249-102107
Page 2 of 2

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: NIII-0-1o10IQI or Certificate of Coverage No.: N/C/G/
Facility Name: CC&" Csied� Arr.rn�s
County: Phone No. 33to 63�f Y1�7
Inspector: S<M<> Y +(sy
Date of Inspection: , oS 2,015 -
Time of Inspection: Li oS PM
Total Event Precipitation (inches): , D, (D2 5
Was this a Representative Storm Event? (See information below) ®'Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary),
A "Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and that j
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. --
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of Permittee or Designee)
1. Outfall Description:
Outfall No. (DO(
Receiving Stream: �Ikn
Descrbe the induu��cstrial ac,u rtie that
Sup ks SG 1 a.v ( i I
ditch, etc.) 1•(3440I C!1 6 k eAsi%
within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Motilu Jccv
3. Odor: Describe any
chlorine odor, etc.): 140
that the discharge may have (i.e., smells strongly of oil, weak
Page 1 of 2
SWU-242-051308

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 'L 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 & 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes �N
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242-05I308

Permit No.:
Facility Nai
County: {
Inspector:
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Certificate of Coverage No.: N/C/G/ 0/6 /QlQ/V X
No. 334 634 Ua.3�
Date of Inspection: _�_0S 241 S -
Time of Inspection: Li' IS ?A
„
Total Event Precipitation (inches): , 17 G a5
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be perfonned during a representative
stone event (requirements vary),
A "Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may'contain up to 10 consecutive hours of no precipitation.
By this signature,tt
__ I certify that this report is accurate and complete to the best of my knowledge:
(Signatur f Permittee or Designee)
1. Outfall Description: p ((� nil
Outfall No. 00� Sret re (pipe, ditch, etc.) ROA C4&D n, �o (Agirt
Receiving Stream: 1�1Q� F 1CAZr� y
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge f1using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: /41 iSNr <Wqy.
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): jtel
Page 1 of 2
sWU-242-051308

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
b 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
I (D 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
© 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes (N
8. Is there an oil sheen in the stormwater discharge? Yes (I b
1 9. Is there evidence of erosion or deposition at the outfall? Yes O
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
a
Page 2 of 2
SWU-242-051308

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
PermitNo.: or
Facility Name: wl,wll{n g'c�
County: 1� tr�L crr�
Inspector: r — iQ6%kt1
Date of Inspection: (o O5 .2.015
Time of Inspection: 4- 51 PA
Total Event Precipitation (inches): (9. (0;65
of Coverage No.: N/C/G/Q/z/2/ Ce 111
No. 33/.- 6314 - 4?-37
Was this a Representative Storm Event? (See information below) 2 Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
stonn event (requirements vary),
A "Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature �9 Permittee or Designee)
1. Outfall Description:
Outfall No. 00�k—
Receiving Stream:
Describe the industrial :
etc.) �� �e Alck LAh roenti
occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: ,if}1T_bMUA i' 4' 40,A
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): Ai00
Page 1 of 2
sWU-242-051308

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 02 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 e 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 © 3 4 5
7. Is there any foam in the stormwater discharge? Yes Io,
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes q o
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition maybe
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242-051308

srntt..�d.,
r�l'�� _>
Storfnwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.:
Facility Nai
County:
Inspector:,
Date of Inspection: ^CIS
Time of Inspection: 4' i 1 ? M
or Certificate of Coverage No.:
Total Event Precipitation (inches): �• 6 `
No. 336• - 634- 9}.'S-)
Was this a Representative Storm Event? (See information below) 2 Yes ❑ No
Please check your permit to verify iJQualitative Monitoring must be performed during a representative
storm event (requirements vary),
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature 6Permittee or Designee)
1. Outfall Description:
Outfall No. 0014 Struct (pi
Receiving Stream: 061
Describe the industrial ac - roes that occur
ditch, etc.) Dfginxe Ak L1ti • X u; . Yoc.ki
the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: St JW brawn 4�0� . dr. •i' a s-4
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): Alaen�
Page I of 2
SWU-242-051308

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 6 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 ® 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 D 3 4 5
7. Is there any foam in the stormwater discharge?
S. is there an oil sheen in the stormwater discharge?
9. is there evidence of erosion or deposition at the outfall?
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Yes l./
Yes
Yes CN
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. 'these conditions warrant further investigation.
Page 2 of 2
SWU-242-051308

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Contact: Ken Gusler
Client: Commonwealth Brands
301 N. Scales St
Reidsville, NC 27320
Meritech Work Order # 06061911 Sample: SDO 001 Grab
Results Analysis Date
Report Date; 6/18/2019
NPDES #: NCG060042
Project: Stormwater
Date Sample Rcvd: 6/6/2019
6/5/19
110WINIff"Amm
COD
37 mg/L
6/12/19
15 mg/L
EPA 410.4
Total Suspended Solids
40 mg/L
6/7/19
2.5 mg/L
SM 2540 D
Oil & Grease (HEM)
<5 mg/L
6/10/19
5 mg/L
EPA 1664B
pH
7.0 S.U.
6/5/19
1.0 -14.0 S.U.
SM 4500-HB
Temperature
81 OF
6/5/19
- OF
SM 2550 B
thereby certify that [have revfewed and approve these data. j�i}'}'a 1-�q ff'r (or k )
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Contact: Ken Gusler
Client: Commonwealth Brands
301 N. Scales St
Reidsville, NC 27320
Report Date: 6/18/2019
NPDES #: NCG060042
Project: Stormwater
Date Sample Rcvd: 6/6/2019
Meritech Work Order # 06061912 Sample: SDO 002 Grab
6/5/19
Parameters
Results
Analysis Date
Reporting Limit
Metho
COD
49 mg/L
6/12/19
15 mg/L
EPA410.4
Total Suspended Solids
8 mg/L
6/7/19
2.5 mg/L
SM 2540 D
Oil & Grease (HEM)
<5 mg/L
6/10/19
5 mg/L
EPA 1664B
pH
6.9 S.U.
6/5/19
1.0 -14.0 S.U.
SM 4500-HB
Temperature
84 ° F
6/5/19
- ° F
SM 2550 B
herebycertifythat!have reviewed and approve these data. ��ndQ���
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Contact: Ken Gusler
Client: Commonwealth Brands
301 N. Scales St
Reidsville, NC 27320
Meritech Work Order # 06061913 Sample: SDO 003 Grab
Parameters
Results Analysis Date
Report Date: 6/18/2019
NPDES #: NCG060042
Project: Stormwater
Date Sample Rcvd: 6/6/2019
6/5/19
Reporting Limit Method
COD
39 mg/L
6/12/19
15 mg/L
EPA 410.4
Total Suspended Solids
13 mg/L
6/7/19
2.5 mg/L
SM 2540 D
Oil & Grease (HEM)
<5 mg/L
6/10/19
5 mg/L
EPA 1664B
pH
6.8 S.U.
6/5/19
1.0 -14.0 S.U.
SM 4500-HB
Temperature
79.7 OF
6/5/19
° F
SM 2550 B
1 hereby certify thatl have reviewed and approve these data. AI I L,i old 0- naffr -rj( )
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Contact: Ken Gusler
Client: Commonwealth Brands
301 N. Scales St
Reidsville, NC 27320
Meritech Work Order # 06061914 Sample: SDO 004 Grab
Parameters
Results Analysis Date
Report Date: 6/18/2019
NPDES #: NCG060042
Project: Stormwater
Date Sample Rcvd: 6/6/2019
6/5/19
Reporting Limit Method
COD
43 mg/L
6/12/19
15 mg/L
EPA 410.4
Total Suspended Solids
11 mg/L
6/7/19
2.5 mg/L
SM 2540 D
Oil & Grease (HEM)
<5 mg/L
6/10/19
5 mg/L
EPA 1664B
PH
6.8 S.U.
6/5/19
1.0 - 14.0 S.U.
SM 4500-HB
Temperature
79.4 ° F
6/5/19
- ° F
SM 2550 B
I hereby certify thatl have reviewed and approve these data. ��J-Ll r'`)
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone]fax.[phone]

Chain of Custody Record COC
Client:
Address:
Attention:
Commonwealth Brands
301 N Scales St
Reidsville,NC 27320
Ken Gusler
NPDES#: 'Al c60600gZ
Phone: [phone]'
Fax:
Email:
Project: 54cr— V"_
Po#:
MERITECH INC.
r Environmental Laboratories
AA Division of water Technology and Control, Inc.
642 Tamco Rd Phone [phone]
Reidsville, NC Fax: [phone]
27320 Email:
Web Site: vA-inertechlabs.com
Turn Around Time*
Std(10days)
3-5Day
24-48Hr
Sample
Location/ID #
Sampling Dates & Times
Person Taking Sample (Signature):
Lab Use Only
START
END
Comp?
Grab?
#of
Cents.
Tests Required-
on
Ice?
pH OK?
C12 OK?
Date
Time
Date
Time
SDO OO
G 5 Iq
1(o 03
G
TSS
110,93
G
COD (w1H2SO4)
a
N
1(903
G
Oil & Grease (w/HCI)
QQ
15
�ci7j
G
pH 'XO Temp 31 F
Method of Shipment:
mments•
�b2.$rv;n
UPS
Fed Ex
CRI Hand Delivery
— -- - -
❑Other
Will these results be used for regulatory purposes?
Yes No
*RUSH work must be approved prior to submitting samples.
Relinquts e 6 t is Time:
L'( 12A00
Received by: Date: Time:
Rellnquished by: Date: Time:
Received by: Date: Time:
Relinquished by: Date:
Time:
R eda b
L —
a[r
I�
Time:
11cL

Ghain of CustodyCOOC
Client: Commonwealth Brands
Address: 301 N Scales St
Reidsville,NC 27320 IPOtr.
Attention: Ken Gusler
IO
NPDESM
Phone: 346 tl �
Fax:
Email:
Project:r
INC.Record
MERITECH I
Environmental Laboratories
A Division of Water Technology and Control, Inc.
642 Tamco Rd Phone [phone]
Reidsville, NC Fax: [phone]
27320 Email:
Web Site: mnwmeritechlabs.cont
Turn Around Time*
Std(10days)
3-5Day
O
24. 4811r
O
Sample
Location/ID #
Sampling Dates &Times
Person Taking Sample (Signature):
Lab Use Only
START
END
Comp?
Grab?
#or
Cants.
Tests Required-
Q
on
Ice?
pH OK?
C120K?
Date
me
Date
Time
,DO 00
IS
11::\5
G
TSS
�<
G
COD(w/H2SO4)
G
Oil & Grease (w/HCI)
G
pH G.9 Temp �y F
mrwents
lethod of Shipment:
, (� y5 M-:
UPS
] Fed Ex
(Hand Delivery
Will these results be used for regulatory purposes?
Yes No
*RUSH work must be approved prior to submitting samples.
Relinq ishe by:
G ale: Time:
6 �l -PRO-
Received by: Dale: Time:
Relin fished by: Date: Time:
Received by: Date: Time:
-
_
Relinquished by: Date: Time:
RB _ b : patat I ITime-
y�

Chain of Custody Record COC
Client:
Address:
Attention:
Commonwealth Brands
301 N Scales St
Reidsville,NC 27320
Ken Gusler
NPDES#: 06W'12_
Phone: 33c 43tr 5,3.E
Fax:
Email:
Project: S�vn«trtAv
Po #:
MERITECH INC.
Environmental Laboratories
A Division of Water Technology and control, Inc.
642 Tamco Rd Phone [phone]
Reidsville, NC Fax: [phone]
27320 Email:
Web Site: www.meritechlabs.com
Turn Around Time*
Std(10days)
O
3-5Day
24-48Hr
O
Sample
Location/lD #
Sampling Dates & Times
person Taking Sample (Signature):
Lab Use Only
START
ENO
Comp?
Grab?
dof
n
cons.
Required-
On
Ice?
Ice?
pH OK?
c120K?
Date
Tme
Date
Time
10 -003,
IS
16.36
G
TSS
I
lLL
G
COD (w/H2SO4)
—
,\
G
Oil & Grease (w/HCI)
G
pH Temp 7
thod of Shipment:
Comments,
IUPS
Fed Ex
Hand Delivery
Dither
Will these results be used for regulatory purposes?
Yes No
`RUSH work must be approved prior to submitting samples.
u sh
Relinqed b : // Date: Time:
i ,�j,..,t�t., G a l.L 0
Received by. Date: Time:
Reli ished by: Date: Time:
Received by: Date: Time:
Relinquished by: Date:
Time:
Rece all by�
at
Time:
tL

Chain of Custody Record COC
Client:
Address:
Attention:
Commonwealth Brands
301 N Scales St
Reidsville,NC 27320
Ken Gusler
NPDES#: ltkc 6 0601141-
Phone: 3afv gz&4 v73i
Fax:
Email:
Project. 51+aw� fy
Po
AMERITECH INC.
Environmental Laboratories
A Division of Water Technology and Control, Inc.
642 Tamco Rd Phone [phone]
Reidsville, NC Fax: [phone]
27320 Email:
Web Site: www.meritechiabs.com
Turn Around Time*
Std (10 days)
o
3 -S Day
0
24 -48 Hr
0
Sample
Location/ID #
Sampling Dates & Times
Person Taking Sample (Signature):
Lab Use Only
sTART
END
Comp?
Grab?
#of
Conte.
Tests Required-
On
lee?
pHOK?
C12 OK?
Date
me
Date
Time
DO p
►S
1 V :-L7
G
TSS
\N
6 `> M
:Z?
G
COD (w/H28O4)
-,
Z
G
Oil 8. Grease (w/HCI)
G
pH 4.'o Temp '75-1-4
iethod of Shipment:
Commonks
UPS
] Fed Ex
.Hand Delivery
]Other
Will these results be used for regulatory purposes?
Yes No
*RUSH work must be approved prior to submitting samples,
Relinquishe by: Date: Time:
,, _ _ _ _ _ __ _ iZ'--p
Received hr. Date: Time:
Reiinquis d by: Date: Time:
Received by: Date: Time:
Retinquished by: Date:
Time:
R We by: Da
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Time:
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L%

Commonwealth Brands
MG/L MG/L
MG/L SU
(F)
2019
OIL
cart,,,ia in nn if
Data Timm TSS CREASE
COD off
Temp
1
SDO-001
6/5/2019
4:03PM
40
<5
37
7
81
2
SDO-002
6/5/2019
4715PM
8
<5
49
6.9
84
3
SDO-003
6/5/2019
4:35PM
13
<5
39
6.80
79.7
4
SDO-004
6/5/2019
4:27PM
11
<5
43
6.8
79.4
Rainfall recorded: Duration: Sampler: Ken Gusler
Estimated Inches 6.625 Hours Minutes
0 35
Limits: 100 30 120 6-9 NA
Commonwealth Brands MG/L MG/L MG/L SU (F)
2019 OIL
Rainfall recorded: Duration: Sampler:
Estimated Inches Hours Minutes

Stormwater Collection
6/5/2019
Location
pH
Temp F
Time (PM)
Description
001
7.0
81.0
4:03
Running off the road. Picking up road heat. No smell. Mostly clear
002
6.9
84.0
4:15
Running off the road. Collected from the south stream. (Concrete curbing) No smell. Mostly clear
003
6.8
79.7
4:36
Collected in pond. No smell. The area was flooded. Slightly cloudy. Some wash -out from fast rain
004
6.8
79.4
4:27
Collected in pond. No smell. Slightly cloudy Some wash -out from fast rain
Rain started: 3:35PM
Rain ended: 4:10PM .625 measured rainfall
Collected by: James K. Gusler

Dear Sirs,
Attached is storm water sampling data from our four discharges at Commonwealth
Brands Inc. collected on June 5th, 2019. Everything was within permit
requirements.
Sincerely,
#!tLLk-14-
d /may/a.o/9
James K Gusler
Ken Gusler
OHS & E Specialist
Commonwealth Brands, Inc.
An IMPERIAL TOBACCO GROUP Company
301 N Main Street,
Reidsville, NC, 27320
336-634-4237
ken.gusler(@us.imptob.com
Date