NCS000325 DMR SW (21)

FEHR GRAHAM
ENGINEERING&ENVIRONMENTAL
Certified Mail No.: 7015 0640 0003 8993 0137 RE
Return Receipt Requested ��'��®
JUN 2 3 6110
June 10, 2016 CENT
OWRCt-ICTIL
Division of Water Quality
Attention: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Storm Water Discharge Outfall (SDO) Monitoring Report - May 2016
Patch Rubber Company
100 Patch Rubber Road
Weldon, NC.27870
N99,910410
Dear Sir/Madam:
Enclosed please find the Storm Water Discharge Outfall (SDO) Monitoring Report for storm
water discharge from the above-referenced facility for May 2016.
Please note the following:
C,
• Storm water samples were collected during a representative storm event on
May 17, 2016.
• The results for zinc are above the facility's permit benchmark for both outfalls.
• The facility has already implemented its Tier 2 response, and will continue monthly
storm water inspections, analysis, and reporting.
If you have any questions regarding these documents, please do not hesitate to contact
this office.
Sincerely,
Amy L. Trimble, CHMM
Environmental Scientist
ALT:mll
Enclosure
cc: Marto Carter, Patch Rubber Company
0:\Patch Rubber Company\16-105\FinaLWLT 16-105-Storm Water SDO May 2016 Cover Letters.docx
221 E.Main Street I Suite 200 I Freeport,IL 61032 I p:815.235.7643 I f:815.235.4632 I www.fehr-graham.com
Insight.Experience.Results.

STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
Permit Number NG RECEIVED2 SAMPLES COLLECTED DURING CALENDAR YEAR: 2016
(This monitoring report shall be received by the Division no later than 30 days from
JUN 2 3 2016 the date the facility receives the sampling results from the laboratory.)
FACILITYNAME Patch Rubber Company CENT COUNTY Halifax
PERSON COLLECTING SAMPLE(S) Mario Carte WR SECTION PHONE NO.(2 5 2 )5 3 6—2 5 7 4 '
CERTIFIED LABORATORY(S) Pace Analytical Lab# 40
Lab#
SIGNATURE OF PERMITTEE OR DESIGNEE
REOUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements
Outfall Date 50050
No. Sample Total Total
Collected Flow(if app.) Rainfall pH COD - Zinc
mo/dd/yr MG inches units mg/L mg/L
001 05/17/16 0.3 6.0 ND 0.534
002 05/17/16 0.3 6.0 ND 0.112
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_yes Xno
(if yes,complete Part B)
Part B:Vehicle Maintenance Activity Monitoring Requirements
Outfall Date 50050 . 00556 ' 00530 00400
No. Sample Total Flow Total Oil&Grease Non-polar Total pH New Motor
Collected (if applicable) Rainfall (if appl.) O&G/TPH Suspended ' Oil Usage
• , (Method 1664 Solids -
SGT-HEM),if . ,
appl•
mo/dd/yr MG inches mg/1 mg/I unit gal/mo
Form SWU-247,last revised 2/2/2012
Page 1 of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date 05/17/2016 Attn:Central Files
Total Event Precipitation(inches): 0.3 1617 Mail Service Center
Event Duration(hours): (only if applicable—see permit.) Raleigh,North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation(inches):
Event Duration(hours): (only if applicable—see permit.)
"I certify,under a alty of law,that this document and all attachments were prepared under my direction or supervision in accordance with a
system designe �to ssure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons wh/m nage the system,or those persons directly responsible for gathering the information,the information submitted is,to the
best of my Bowl dge and belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including t e po sibility of fines and imprisonment for knowing violations."
6 //646.
(Signa re of Permittee) (Date)
Form SWU-247,last revised 2/2/2012
Page 2 of 2