NCS000107_MONITORING INFO_20191126

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STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
jv��
1
DOC TYPE
FINAL PERMIT
MONITORING REPORTS
Q APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
WYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NC.S000107 QGCEIVE® SAMPLES C;OLLECTEDDURING GALESDARYEAR: 4
��"" (This nioniloring report shall be received b)the Division no later than 30 days from
Nov2 6 Z019 the date the facility receives the sampling results from the laboratory.)
FACILITY NAME LANXESS Corporation
PERSON COLLECTING SAMPLE(S) Richard•Sland'HSEQ F11 F
CER'I'Ir1ED LAROR,1"TORY(S) Pace AnalytiLaly96rvices•rlarb4r12
Part A: Specific Monitoring Requirements
COUNTY Guilford
PHONE N0. 3( 36 ) 378-0965
SIGNATURE OF PER.NIH 'EE OR DESIGNEE
LLI LU[RED ON PAGE 2.
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Dues this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Oyes ono
(iEyes, complete Part 11)
Part It: Vehicle Maintenance Activity Moniturina Requirements
0111fall
\o.
Date
Sample
Collected
50050
00556
00530
00400
Total Floes
(ifopplicahle)
Total
Rainfall
Oil & Crease
(ifappl.)
Non -polar
O&CfTPII
(3lethod 1664
Sur-1 I if
appl.
'Total
Suspended
Solids
pit
New Motor
Oil Usage
mialddlvr
MG
inches
mo
m I
unit
arllnto
Form SW U-247, last retiised 611212015
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STORM E\'1?\'I'C[[,%RAC'I'ERISTICS:
Date 10120/20
Total Event Precipitation (inches): 2"
Event Duration (hours): 5 Hours (only il'applicable—see permit.)
(if more than one storm event was sampled)
(late 10120/20
=Total+wnt Precipitation (inches): 2"
Event Duration (houm). 5 Hours only H'applicable—see permit.)
Mail Original and one copy to:
Division of Energy Mineral and Land Resources
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"Icertify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance %%ith a
system de5ignell to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons Aho 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, aceurate, and complete. 1 am a" are that there are significant penaItics for submitting false information,
including t "wss'bilily of fines and imprisonment for knowing violations."
1112212019
(Signature of Yermittec) (Date)
Form SW 1J-247, lost revised 611212015
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