NCG090004_DMR_20211018

a:.
SHERWIN
WILLIAMS.
October 11, 2021
Central Files
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
NC Department of
Environmental Quality
Received
OCT 18 2021
Pm to -1 - al
Winston-Salem v
Regional Office
Re: The Sherwin-Williams Company, Stagecoach Trail, Greensboro, NC
General Permit No. NCG090000
Certificate of Coverage No. NCG090004
Semi -Annual Monitoring — July 1, 2021— December 31, 2021
Dear Sir or Madam:
Please find enclosed one original and one copy of the results of the semi-annual
monitoring for the Sherwin-Williams Company facility located at 113 Stagecoach Trail in
Greensboro, N.C.
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.
Best regards,
_� t:�T2_�
Ryan D. Jones
Stage Coach Trail Plant Manager

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG090000
Date submitted October 11, 2021
CERTIFICATE OF COVERAGE NO. NCG09 0 0 0 4
FACILITY NAME The Sherwin-Williams Manufacturing Company'
COUNTY Guilford
PERSON COLLECTING SAMPLES Nicole Sweet
LABORATORY Pace Analytical Lab Cert. # 40, 37712
Comments on sample collection or analysis:
NIA
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2021
SAMPLE PERIOD ❑ Jan -June M July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
Mother wS-Ill; NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 3 0.51" ❑ No discharge this period?2
Outfall No.
Date Sample Collected i
(mo/dd/yr)
Total Cadmium a
,
mg/L
Chromium III, Total
Recoverable
mg '
Total Lead,
mg/L
pH'
Standard Units
Total Suspended Solids4
'
mg/L
Benchmarks
_
0.003 or 0.002
0.905
0.075
6.0-9.0
100 or 50
Parameter Code
_
01027
C0034
01051
00400
C0530
SDO01
9/22/2021
<0.001
<0.005
<0.005
6.7
8.9
SDO02
9/22/2021
<0.001
<0.005
1.6
6.4
8.9
SDO03
9/22/2021
<0.001
<0.005
3.2
6.4
27.5
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-05/31/2021 SWU-255, last revised 11/1/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging> 55 gal of new oil per month.
n No discharae this oeriod?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar Oil and
Grease,
mg/L
Total Suspended Solids ,
mg/L
New Motor or
Hydraulic Oil
Usage,
gal/mo
Benchmarks
_
-
15
100 or 504
Parameter Code
-
46529
00552
CO530
NCOIL
N/A
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
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 []NOD
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this OMR including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitorina period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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."
ofPermittee
Permit Date:11/1/2018-05/31/2021
G' 11
Date
SWU-255, last revised 11/1/2012
Page 2 of 2

la 'tc. t o A na ly Aca /
www.pacalabscam
Laboratory Report
Nicole Sweet
Sherwin Williams
113 Stage Coach Trail
Greensboro, NC 27409
Project: Greensboro Stormwater
Pace Project No.: 92562785
Pace Analytical Services, LLC
1377 South Park Drive
Kemersville, NC 27284
[phone]
Page 1 of 2
Report Date: 10/04/2021
Date Received: 09/22/2021
Sample: SD001 -Tank Farm
Lab ID: 92562785001
Collected: 09/22/21 07:35 Matrix: Water
Method Parameters
Results
Units
Report Limit
Analyzed
Qualifiers
SM 254OD-2011 Total Suspended Solids
8.9 mg/L
3.0
09/27/21 11:23
SM 4500-H+B-2011 pH at 25 Degrees C
6.7 Std. Units
0.10
09/28/21 10:14
H3
Sample: SD001 -Tank Farm
Lab ID: 92562786002
Collected: 09/22/21 07:40 Matrix: Water
Method Parameters
Results
Units
Report Limit
Analyzed
Qualifiers
EPA 200.8 Cadmium
ND ug/L
0.50
09/27/21 21:36
EPA 200.8 Chromium
ND ug/L
5.0
09/27/21 21:36
EPA 200.8 Lead
ND ug/L
1.0
09/27/21 21:36
Sample: S13002-Receiving Dock
Lab ID: 92562785003
Collected: 09/22/21 07:45 Matrix: Water
Method Parameters
Results
Units
Report Limit
Analyzed
Qualifiers
SM 254OD-2011 Total Suspended Solids
8.9 mg/L
6.8
09/27/21 11:23
SM 4500-H+B-2011 pH at 25 Degrees C
6.4 Sid. Units
0.10
09/28/21 10:15
H3
Sample: SD002-Receiving Dock
Lab ID: 92662785004
Collected: 09/22/21 07:50 Matrix: Water
Method Parameters
Results
Units
Report Limit
Analyzed
Qualifiers
EPA 200.8 Cadmium
ND ug/L
0.50
09/27/21 21:53
EPA 200.8 Chromium
ND ug/L
5.0
09/27/21 21:53
EPA 200.8 Lead
1.6 ug/L
1.0
09/27/21 21:53
Sample: SD003-Back Pad
Lab ID: 92562786005
Collected: 09/22/21 07:55 Matrix: Water
Method Parameters
Results
Units
Report Limit
Analyzed
Qualifiers
SM 254OD-2011 Total Suspended Solids
27.5 mg/L
4.7
09/27/21 11:24
SM 4500-H+B-2011 pH at 25 Degrees C
6.4 Std. Units
0.10
09/28/21 10:34
H3
Sample: SD003-Back Pad
Lab ID: 92562786006
Collected: 09/22/21 08:00 Matrix: Water
Method Parameters
Results
Units
Report Limit
Analyzed
Qualifiers
EPA 200.8 Cadmium
ND ug/L
0.50
09/27/21 21:59
EPA 200.8 Chromium
ND ug/L
5.0
09/27/21 21:59
EPA 200.8 Lead
3.2 ug/L
1.0
09/27/21 21:59
ANALYTE QUALIFIERS
H3 Sample was received or analysis requested beyond the recognized method holding time.
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Page 1 of 5

a1.4; y ical ®
www.pacalabs.com
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification M 37738
Pace Analytical Services Peachtree Corners
110 Technology Pkwy, Peachtree Corners, GA 30092
Florida DOH Certification M E87315
Georgia DW Inorganics Certification M 812
North Carolina Wastewater Certification #: 633
VrginiaNELAP Certification #: 460025
North Carolina Certification M 381
South Carolina Certification #: 98011001
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Page 2 of 2
Page 2 of 5

CHAIN -OF -CUSTODY / Analytical Request I
The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields m
Submitting a sample via this chain of custody constitutes acknoviledgment and acceptance of the Pace Terms and Conditions found at https:lrsnfo.pa.
Section A Section B - Section C
Rantdmd-CH^nt-1nfnrmztffnn--- - - 2PnvtIrP,+0r 1..-f, frf.;— 1.f—.#;i— .. , —
WO#:92562785
IIIIIIIIIIIIIIIIIIIIIIII III
92562785
CorrtAany.,..,-, - SherwInWilams-
RepoitTdr, a:, NWg Sweet
Attention:
ma*�ry.,` -- -113. Stage Coach Trail
Company Nam:
GreeAiboro, NC-27409
Email. NIccIe.Sweet@sher%Yin.ogm
Purchase Order 0.
Pace Quote:
-TAW
1Phone: [phone] Fax
Project Name: Stonnwater 101
!Pace FrOject Manager stephanIe.krtoVpacslqbA.00m,
Requested Datb� 1Pr0jdc-t*
1pacd 1,6611,14i 13496 7
NC
lli.=
4w
RIF91 I I
MATRIX com
o
v
COLLECTED
!2 z
Preservatives
;,Vo-
.0
Ddnldngvftw Ow
water wr
waste Water ww
Product P
SL
SAMPLE ID sawsaw OL
on
13
S!
START
END
0
U
ti
a
One Character per box. Volpe WP
w
0
w
&
(A-7, 0-9 1. Ak
other AR OT
Sample Ids must be unique rmsuo
0
w
a04
"S
z
0
w
TS
w
-
0
(0
0
(D
F-,
Cc
w
DATE
TIME
TIME
w
0
&
z
z
z
2
0
422
712-",r7
40
J12,2
I
I
it
121-kc',
C-7
la-f-
515
n
ffii-L
-Ca
2,21/1-1-3^d
-92
i VW W—wr-;?w"=9
NAM
MOB !
5
W.-Aw
-
M
W
E46 �e �5titt>t�
IG A
PRINT Name of SAMPLER:
CD
0.
C
SIGNATURE of SAMPLER: A/
L",A,d I
DATE Signed:
o 1 -L] I
Ix
L) L)
u�
(D
-V-Y
4
cis

Document Name:
Document Revised: October 18, 2020
Analytical.
Sample Condition Upon Receipt(SCURI
Page 1 of 2
Document No.:
Issuing Authority:
ace
F-CAR-CS-033
I Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville ❑ Raleigh❑ Mechanicsville❑ Atlanta[] Kernersvilleer
Client Name: � A �
Projecttl:
Courier: ❑Fed Ex ❑UPS ❑USPS 961ent
❑ Commercial ❑Pace [-]Other:_
Custody Seal Present? ❑Yes QJW Seals Intact? ❑Yes ❑No
Date/initials Person Examining Contents:_
Packing Material: ❑Bubble Wrap ❑Bubble Bags �kne ❑ Other Biological Tissue Frozen?
Thermometer: 1= ❑Blue ❑None []Yes❑No LjKrQ
ElIR Gun ID: Type of Ice:
7 l Correction Factor:
Cooler Temp: 3 .0 Add/Subtract ('C) (2) U Temp should be above freezing to 6'C
Cooler Temp Corrected ('C): []Samples out of temp criteria. Samples on ice, cooling process
3- USDA Regulated Soil (�, water sample) has begun
Did samples originate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internationally,
Ayes FIND ncl-din u,
UNO
Comments/Discrepancy:
Chain of Custody Present?
es
[]NO
❑N/A
1.
Samples Arrived within Hold Time?
Eyes
❑NO
❑N/A
2.
Short Hold Time Analysis (<72 hr.)?
❑yes
❑N/A
3.
Rush Turn Around Time Requested?
❑Yes
�2h/o
tMrro
❑N/A
4.
Sufficient Volume?
Ir es
[]NO
❑N/A
5.
Correct Containers Used?
-Pace Containers Used?
I.JftS
ElYes
[]NO
No
❑N/A
❑N/A
6.
Containers Intact?
PY6
FIND
❑N/A
7.
Dissolved analysis: Samples Field Filtered?
Yes
[]No
g A
8.
Sample Labels Match COC?
-Includes Date/T-ime/ID/Analysis Matrix:
Uy£s
❑No
❑N/A
9.
Headspace In VOA Vials(>5-6mm)?
QYes
[]No
9i/A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑Yes
Yes
❑No
[]No
UwA
N/A
il.
COMMENTS/SAMPLE DISCREPANCY
Lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
Project Manager SCURF Review:
Date/Time:
Date:
Field Data Required? ❑Yes ❑No
Project Manager SRF Review: Date: Page 4 of 5

•
aceA�7a�,ca/
Document Name:
Sample Condition Upon Receipt(SCUR)
Document Revised: October 23, 2020
Pa;e 2 of 2
Document No.:
F-CAR-CS-033-Rev.07
Issuing Authority:
( Pace Carolinas Quality Office
*Check mark top half of box if pH and/or dechlorination is Project #
verified and within the acceptance range for preservation
sa mples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/3015 (water) DOC, LLHg
**Bottom half of box is to list number of bottles
VCAJI
L C,
F
QJ
Z
N
N
u
N
a
.J
E
v,
N
>
d
m
Z
i!
N
u
N
9L
_J
E
faNn
N
>
a
m
Z
aJ
N
►.
u
N
a
�
E
a
N
>
a
m
<
Z
CSSi
e
N
N
=
a
a`
e 1
>
a
©
N
V
ter`
C
U
_
E
tin
'f Vy
Vf
d
ca
N
V
_.
C
C"
=
M
�o
C
E
o
ry
�
Z"
a
ca
to
Z
co
A
Q.
u
u
N
,�
°'
E
in
N
tN
N
d
m
A
—
C
T
u
E
Ln
N
r4
tJ
o`t.
m
d
.-
..
�.
N
s
c
E
4
�
`
u
�
N
(U
E
=
�
i
rl
C7
<
N
V
T
G
E
`a
=
�-1
i
S
ri
t7
<
2
d
is
N
L
`m
.0
E
<
E
a
N
i
M
t7
<
N
T
C
=
E
-
°'
tit
rt
O
<
V
.�
��,-
Q
Q
E
E
o
N
L7
U)
<
Z
Q
Z
.�
E
o
�^
N
¢
M
O
<
M
O
<
C
u
S
<
O
>
—►
E
Q
w
C1
C7
O
_
<
\
Z
t+i
Z
<
O
E
0
Y
Q~t
C9
>
r
<
c
<
O
—i
E
O
l7
>
\
2
a
.`
<
O
E
Q
,
C7
C
\
�
Y
Y
L
d
c
>
.0..
O
>
<Ma
Z
_
N
?
at
�
W
a
9A
`°
!+1
�"
C7
>
�`
T
Z
a
a
2
-J
E
N
��
9n
v°'i
Z
u
a
cn
J
E
N
N
H
M
C1
�
�
ry
Z
N
R
ii
_J
E
1011
N
f<*1
am
N
Z
aJ
a
L.
QJ
E
<
E
O
O
Q
1
�
N\N-
2
3
�
�
,
4
\N
I
S
'NN\
N
6
N-NN\
\1
I
\\IN\
\
\�\�\
-F
\\NN
I
N\N
I
ig
N
\1
-\\N
I
110
l\\N
I1
I
12
NI
N�\
I
I
N_N
Z
A
Z CU
A
a
`> d
o c
r �
c
�n <
E E
� C
PH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
Lot a
Note: Whenever
there is a discrepancy affecting
North Carolina
compliance samples a copy of
this form will b t th
N h C
Out of hold, incorrect preservative, out of temp, incorrect containers. I e sent o V. ort arohna DEHNR Certification Office (i.e.
Page 5 of 5

NC
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out thisform, please visit https:Hdeq.nc.gov/about/divisions/energy-mineral-land-resourcesi
npdes-stormwater-gps
Permit No.: N/C/C'/O/ or Certificate of Coverage No.: N/C/G/0/9/V /O /O / j/
Facility Name: � _n — W t I \ t nrnS
County:
Inspector:
Date of Ins
Time of In;
� I;,I-Fom Phone No. 33b-5SOA61-q
Total Event Precipitation (inches):
1.09
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. SD60 L Structure (pipe, ditch, etc.): 'Pi
Receiving Stream:
Norse ?.ey-A C,re e k
Describe the industrial activities that occur within the outfall drainage area:
Page 1 of
5 WU-242, Last modified 06/01 /201 B

2. Color: Describe the color of
(light, medium, dark) as descriptors: _
basic colors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct o ors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): j\ j A M( n r-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 0 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 I is no solids and 5 is extremely muddy:
WA
8.
9.
0 2 3 4 5
Is there any foam in the stormwater discharge? Q Yes No.
Is there an oil sheen in the stormwater discharge? QYes S (No.
Is there evidence of erosion or deposition at the outfall? Q Yes �KNo.
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
5 WU-242. Last modified 06/01/201 S

K r-O
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onftlling out thisform, please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwate r-gps
Permit No.: NICACjIO 1-t /01O /O /O / or Certificate of Coverage No.: N/C/G/©/9 /0 /0/0 /4/
Facility Name:
County:
Inspector:
Date of Ins
Time of In:
� uU (, i^ nt Phone No.
(t
Total Event Precipitation (inches): 1 t � QD
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. �SDIb�Z Structure (pipe, ditch, etc.): Fj bQ,
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Page I of 2
SWU-242, Last modified 06/01/2018

2. Color: Describe the color of the discharge u ing basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _(?,t t ,f
3. Odor: Describe any distinct odors thiA the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): V10 6nLoc
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 ® 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 0 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:
7.
8.
9.
10.
0 2 3 4 5
Is there any foam in the stormwater discharge? Q Yes XNo.
Is there an oil sheen in the stormwater discharge? QYes No.
Is there evidence of erosion or deposition at the outfall? 0 Yes �No.
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
S WU-242, Last modified 06/01201 S

NCI
Envtronmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onftlling out thisform, please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-storm wate r-gps
Permit No.: N/C/(a /0 /9 /0 /O /O /O / or Certificate of Coverage No.: N/C/G/O /L? / ()/ O/O/4/
Facility
County:
Inspecto
Date of I
Time of
/1
Total Event Precipitation (inches):
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or
1. Outfall Description:
Outfall No. SDO03 Structure (pipe, ditch, etc.): {�OQ
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Page I oft
SWU-242, Last modified 06/01/2018

2. Color: Describe the color of the
(light, medium, dark) as descriptors: _,
basic colors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): IA O OOW t-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 0 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 `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:
,p 2 3 4 5
7.
8.
9.
10.
Is there any foam in the stormwater discharge? q Yes O(No.
Is there an oil sheen in the stormwater discharge? QYes t(Io.
Is there evidence of erosion or deposition at the outfall? O Yes . No.
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, Lut modified 06/01/2018