NCG060230_MONITORING INFO_20180504

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ ) blB os�
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 5-4-18
CERTIFICATE OF COVERAGE NO. NCG06 0 2 3 0 SAMPLE COLLECTION YEAR 2018
FACILITY NAME Innopsec Active Chemicals FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Rowan f-cenvuse/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES Tim Mauldin DISCHARGING TO SALTWATERS? []YES ©NO
LABORATORY_ Statesville Anal tical Lab Cert. # 440 MAY 0 9 20"
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results OWR SECTIONTotal event rainfall 2 0.5 or ❑ No discharge this period'
Outfall No.
`Sample Collected,
rno/dQr
T55;
mg/L
pH,„i.'.
Standardunits:
, COD, _
g/ :4�.
Oil and Grease; ,
- .. mg/L. ..
Fecal,Coiiform ,
A.
Colonlesper•"100'ml
; ' i. i,,Enterococd , ,
Colonies peraOD)ml ."
Benchmark
-
100.or 50
Within 6A—:9:0•.,.
r120 r
;w c30 *_.,
1000 „ ,:
4 500.k'=:
001
4-4-18
20.667
6.43
38
5.89
1 Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall.No
'Sam le;Collected,
OWa,n,d.Grease,� :
/
RJSS
"
"StandardunIts
Ne.w. Mok�to.r ,,0awil'Usag�e
Ann.ual ave.rage,gal%mdma./ddlyr
Benchmark a
30
..; 100'or 50 . 9
,, :6;0,, 9 0
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 fast Revised: October 18, 2012
Page I of 2

FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS. SEE PERMIT PART 11 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case o "No Discharge" re orts to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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."
W4 A s: P P
(Signature of Per ittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/wsLsu/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 oF2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 1-29-18
CERTIFICATE OF COVERAGE NO. NCG06 0 2 3 0
FACILITY NAME Innopsec Active Chemicals
COUNTY Rowan REMvED
PERSON COLLECTING SAMPLES Tim Mauldin
LABORATORY_ Statesville Analytical Lair Cert. # 440 VFB 029 HIS
CENTRAL FILES
Part A. Stormwater Benchmarks and Monitoring Results CWR SECTION
SAMPLE COLLECTION YEAR 2017
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? [—]YES []NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall a 0.3 or 7 No discharge this Deriod3
Outfall No.
Sample Collected,
mo/dd/yr
TSS;
mg/L.
pH,
Standard units
COD,
mg/L .
Oil and Grease,
mg/L
Fecal Coliform ,
Colonles per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 5D
Within 6.0 — 9.0
120
30
1000
SO4
001
12-20-17
21.667
7.21
<25
<5
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at 2ny outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month,
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 54
6.0 — 9.0
-
'Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at and outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
I� SWU-249
(if yes, complete Part B)
Last Revised: October 18, 2012
Page 1 of 2

L
--401
1,1 *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 ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, -including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case of "No Discharge" reports to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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."
(Signature of Permittee)
/-.2f,�
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/np4essw#tab-4
S WU-249
Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /Z - 26 'Zo 7
CERTIFICATE OF COV R GE,Iy0. N GC 0 iQ
FACILITY NAME �V� Ian
COUNTY 1 YQ
PERSON COLLECTING SAMPLES.-_K&114
LABORATORY ii C n Lab Cert. ll 9
Part A: Stormwater Benchmarks and Monitoring Results
Rl�r�11I��U
JAN302018
INFOR)APO ROOF ,V
PROCESSING illV11
SAMPLE COLLECTION YEAR 12 -3 1- ZU ) -7
FACILITY ACTIVITIES INCLUDE (check all that apply):
El use/process meats ❑ use animal fat byproducts
DISCHARGING TO SALTWATERS? [-]YES O
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 .3 or F fa discharge this Period3
Outfall'No.
Sample;Collected;;
.mo/dd/, r
'TSS,
mg/L, ..
'PH;.
s Standard units..:.
COD,
a rng/L•
011'a6d Grease,
mg/L'
fecaI:Coltform:,
-Cal!onies per•306ml
Enterocacci ,
Colonies per 100 ml
.Benchmark
1006i.,56!
':Within.fiA= .0;�
1M
30 •
1000
Soo
�j-
r [
•
L
' Only applies to facilities that use/process meats. -
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per -month? D yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall-No.
•Sar*e•Collected,
mo/dd/ r-
Oilan'd:Giease,7.7 ;'
mg/L
TSS,
m' L,
tom
'Standa�d uhfts ,'.:Annual
; New' MotarOil'Usage,
avera e; al/mo
Benchmark
-
:30
100 or:50r.
t 6:0:- 9:0`T.
Only applies to facilities that uselprocess meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ifyes• complete Part B)
S W U-249
Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART S 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 ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including oil "No Discharge" reports within 30 days of receipt of the lob results for 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, NC 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."
/2 - z4.3 --2a 1 7
(Date)
Additional copies of this form may be downloaded at: htto-,//`portal.ncdenr.org/web/wg/ws/su/­npdesswhtab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

A..
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 6-6-17
CERTIFICATE OF COVERAGE NO. NCG06 0 2 3 0 SAMPLE COLLECTION YEAR 2017
FACILITY NAME Innopsec Active Chemicals FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Rowan ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES Tim Mauldin DISCHARGING TO SALTWATERS? []YES []NO
LABORATORY Statesville Analytical Lab Cert. # 440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z 1.8 or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Collform ,
Colonies per 100 ml
Enterococci ,
; Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
S00
001
5.22-17
10.814
6.37
<25
10.814
1 Only applies to facilities that use/process meats. JUN 12, Z017
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a ch6'HA''9_rKZVrLF1L.ES
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protg�t�`�ANW�anc applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
=
30
100 or 50
6.0 — 9.0
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page] of 2

*FOR PART A AND PART S MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one ggpy ot this DMR including all "No Dischar e" re orts within 30 da s a revel t o the lab results for at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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."
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at: http://portal,ncdenr,org/web/wg/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2

S
Analytical Results
Innospec Performance Chemicals US Company
500 Hinkle Lane
Salisbury, NC 28144
Receive Date: 05/25/2017
Reported: 06/02/2017
For: Stormwater
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
170525-21-01 Chemical Oxygen Stormwater <25 mg/L "ACHR" 05/31/2017 MD
Demand
170525-21-01 Oil and Grease Stormwater 10.6 mg/L EPA1664RevB 06/01/2017 CL
170525-21-01 TSS Stormwater 10.814 mg/L SM2540a1997 05/26/2017 CR
Respectfully submitted,
&'�� JT-htI
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

t
Condition of Receipt
Sample Number 170525-21-01 Temp on Arrival: 2
Parameter Schedule: Oil and Grease
Hydrochloric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: TSS
Received on Ice
Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

Client:
S C
SrATUiVlIXE ANALYTICAL
122 Court Street • P.O, sus 229
Statcsviltc, NC 28687
(70419724&17
Chain of
Custody Record
Address: SDo
t r.
Contact Person: Phone ato ' 33 3 y
PO # Requisitioned by: (lane Date)
Customer
5ampla IOs
Lalt•10 s
Time Sampled
(Grab On)
halo Sampled
(Grab Only)
Matrix
Parameters raquosted for erwrysis
V•
w
ww
1
Relinquished by
Received by: 4
Relinquished by: bra
Received by: 1
QgMRcalle Sgm Irt Inner; _ _ _
Time begin am, pm Date —1_/—
Time end am, pm Date _I_1_
s�
Time begin am, pm Date
Time end am, pm Date
�,L
-
Time am, m Date-S 1:YJ-.L2
Time '2- / Dm, m Date -L'I2�
Time// �q m, m DateLL5-L2
Time aQjq pm Date a-/�
t
�A'� 3 ?
Samples Transported on Ice
by:
Sampled b 7z
Transported by: �
Holding times met:`
. Compliance work:
Non-compliance work:
00
WO
00
N
U
z
ai
U)
41
M
lI'1
00
N
N
x
O
m
W

I -ANNUAL STORMWATER DISCHARGE MON
for North Carolina Division of Water Quality General Permit No.
Date submitted 121uly 2016
CERTIFICATE OF COVERAGE NO. NCG06 0 2 3 0
SAMPLE COLLECTION YEAR 2016
z 44"'
FACILITY NAME Innonsec Active Chemicals _ ^ _ FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Rowan ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES ®NO
LABORATORY_ Statesville Analytical Lab Cert. # 440 �+ `'
?V;0F_ V r_ PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results 3U� 15 2016 Total event rainfall 2 1.2" or n No discharge this period3
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/L
pH,
Standard units
COD;IASLG
,^rm Ljtj?RQ
W"'011-and-Grease,
�ES�" `v mg/L
Fecal Collform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
" _ 120
30
1000
Soo
001
06/16/2016
23.778
6.74
38
<5.2
N/A
N/A
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at and outfalls. You must still submit this discharge monitoring report with a checkmark he
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective bent mark applies.
r
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ®no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/ r
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil usage,
Annual average gal/mo
Benchmark
-
30
100 or SO
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
000
(ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

'FOR PART A,AND PART B MONITORING RESULTS:
• `,VBENCHMARK 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 ANY ONE OUTFALL? YES ® NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an original and one copy of this DMR, Including all "No Discharge" reports, within 30 dot's o f receipt of the lab results for at end of
monitoring period In the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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."
[Signature of Pe
7-1
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

iv C-7- a � o a �0 2�/ �
• Analytical Results
Innospec Performance Chemicals US Company
500 Hinkle Lane
Salisbury, NC 28144
Receive Date: 06/16/2016
Reported: 06/20/2016
For:
Comments:
Sample Number
Parameter
Sample ID
Result
Unit
Method
Analyzed
Analyst
160616-20-01
Chemical Oxygen
Stone Water
38
mg/L
HACH8000
06/17/2016
CL
Demand
160616-20-01
Oil and Grease
Storm Water
<5.2
mg/L
EPA1664RevB
06/16/2016
MD
160616-20-01
TSS
Storm Water
23.778
mg/L
SM254OD-1997
06/17/2016
WC
Respectfully submitted,
�01„w.f jyh t-I
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • 5tatesville,,NC 28687 • 704/872/4697
Page 1 of 2
mo

Condition of Receipt
Sample Number 160616-20-01 Temp on Arrival: 3 ,
PH on Arrival: <2 Parameter Schedule: Oil and Grease
Hydrochloric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: TSS
Received on Ice
PH on Arrival: <2 Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2
.00

Client:
STA'MVILLE ANALYTICAL
122 Court Street • P.O. Box 228
Statesville, NC 28087
[phone]
Chain of
Custody Record
Address: ' �0�
{
Y, .++.=r
(�
Contact Person:
3 G Pt�on7#SD (e I ,76 q 03 3 � �
PO # Requisitioned by: (Time Date)
Customer
Sample IN
lab -ID p
Time Sampled
(Grab Only)— ---�`
Date Sampled
(Grab Only) #
v1
Matrix
Parameters requested for analysis
Shdp.
w
- 20
0 `' 00
1't
SS
O J
d 6- Q As c.
�9
C
Relinquished b •�
q y
,ter
Time %�•j �j�am,�m Date �l�l
Sampled by: '
Received. by:
Time t' 'm Date �l�l�
Transported by:
Relinquished b :
�1
J• L
Time f am, m Date
r
(�l!;,�,
Holding times met:
Received by:
�,�LV
tuo �,L
Time k am; pm Date tU 1 ��1 V
Compliance work:
Composite Sampling #1:
Time begin am, pm
Date �1 1
Ph
Non-compliance work:
FA
Time end am, pm
Date �1_I_
Lab Comments:
Composite Sampling #2:
Time'begin am, pm
Date _I_I
k
Time end am, pm
Date

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 1-11-17
CERTIFICATE OF COVERAGE NO, NCG06 0 2 3 0 SAMPLE COLLECTION YEAR 2016
FACILITY NAME _Innopsec Active Chemicals _ FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Rowan ❑ use/process meats [] use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES ❑NO
LABORATORY— Statesville Analytical Lab Cert. # 440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z 0.5 or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 106 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
S00
001
12-7-16
10
6.41
<25
<5.1
Only applies to facilities that use/process meats. CENTRAL FILES
3The total precipitation must be recorded using data from an on -site rain gauge. DWR SECTION
3 For sampling periods with no discharge at any outfalis. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/ r
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo .:.
Benchmark
-
30
100 or 50
6.0-9.0
-
Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*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 ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Moil an original and one copy of this DMR, Including all "No Discharge" reports, within 30 days of recelpt of the lob results for at end of
monitoring period in the case of "No Discharge" reports} to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUSTSIGN 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."
(Signature of Pe(rmittee)
N/W
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wci/ws/su/nodessw#tab-4
5 WU-249
Last Revised: October 18, 2012
Page 2 of 2

Analytical Results
Innospec Performance Chemicals US Company
500 Hinkle Lane
Salisbury, NC 28144
Receive Date: 10/27/2015
Reported: 12/01/2015
For: Storm Water
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
151027-10-01 Chemical Oxygen SW
<25 mg/L HACH8000 10/29/2015 CL
Demand
151027-10-01 Oil and Grease SW
<5.1 mg/L EPA1664RevB 11/04/2015 MD
151027-10-01 TSS SW
8.333 mg/L SM2540D-1997 10/28/2015 WL
Respectfully submitted,
&I—wf k, 0 '
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC0O909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2

Condition of Receipt
Sample Number 151027-10-01 Temp on Arrival: 3
Parameter Schedule: Oil and Grease
Hydrochloric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: TSS
Received on Ice
Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
PO Box 228 a Statesville, NC 28687 a 704/872/4697
Page 2 of 2

Client:
STATESVILLE ANALYTICAL
122 Court Street • P.O. Box 228
Statesville, NC 28687
[phone]
of
Custody Record
Address: 1 1 ' t
Contact Person: F
P0 f,,M1 r— '�I '•iPhone # "!AX#Chain
PO # Requisitioned by: (Time Date)
Customer
Sample ID#
p
Lab -ID #
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
Matrix
Parameters requested for analysis
swaua
w
ww
� f
r
/ s
Relinquished byT-T-r „}
Received by: ; ��
0
Relinquished by:
Received by:
Composite Sampling #1:
Time begin am, pm Date �,-//_
Time end am, pm Date
omposite Sampilng #2:
Time begin am, pm Date __/__/_
Time end am, pm Date ��_
Time ! , am, pm Date LL22/-LI Sampled by:f j �+fiI",
Time ; : am, pm Date% ` Transported by:
Time am, pm Date �/ J_ Holding times met:
Time am, pm Date Compliance work:
�~} � �. Non-compliance work:
Lab Comments:

SEMI-ANNUAL STORMWATER ASHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCGO6.2 2_ 1_o SAMPLE COLLECTION YEAR
FACILITY NAME ,-LbJ FACILITY INCLUDE (check ail that apply):
COUNTY ti..4 ��if4ITIES
ocess meats ❑ use animal f is/byproducts
PERSON COLLECTIN1G SAMPLES �' .. I1 � _ _ _ �plsC���lf� TO 5ALTWATERS? ❑YES �t0
LABORATORY S�vi,n+- �, ��,%„a�cL Lab Cert. f# Q kl.
Part A: Stormwater Benchmarks and Monitoring Results
•
CENTRAL FRASSE REMEMBER TO SIGN ON THE REVERSE 3
DWR SECTION
Total event roinfoll 1__0 _)_ or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
Jo
C
Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes �a (if_res complete Part B)
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
outfail No.
Sample Collected,
mo/dd/ r
Oil and Grease,
mg/L
TSS,
_mglL
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 -- 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18, 2012

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER I'REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES 1N 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 ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ 111A
REGIONAL OFFICE CONTACT NAME:
Mai! an orWinal and one copy of DMR, including al! "No Discharge" nepoas, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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 personnels properly gather and evaluate theinformation 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."
(Signature of Permittee)
1.2. a?, /.S`
(Date)
Additional copies of this form may be downloaded at: http;l/portal.ncdenr.org/­wgb/­wq/ws/`su/npdessw#tab-4
SWU-249 • . Last Revised: 6, 18, M02
'Page 2 of 2

P0G0 � 03do
Eeniroehem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc. 9
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392-4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
25.5-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5943 Lab/flax
[e-mail]
Sanderson Fauns -Kinston Date of Report: Jan 08, 2016
2081 Sanderson Way Customer PO #:
Kinston NC 28504 Customer ID: 13100004
Attention: Pete Onidi Report #: 2015-17173
Project ID: Storm Water Outfall (lagoon)
Lab ID Sample ID: Collect DateTme Matrix Sampled by
15-40843 Site: SW Lagoon 12/22/2015 12:011 PM Water Pete Onidi
Test
Oil & Grease (O&G)
Residue Suspended (fSS)
COD
Fecal Coliform
Comment:
Reviewed by:
Method
Results Date Analyzed
EPA isea 9 mg/L
12f30/2015
sM 2540 p 17.3 mglL
12123/2015
W 5220D < 20 mgA.
12/24/2015
SM 92= MF 4400 Colonies/100mL
12/22/2015
Report #:: 2016-17173 page 1 Of 1

611112 Windmill Way ,
mington
ENVIRONMENTAL CHEMISTS, INC OFFICE: 9 0-3 20223i1FAX910: 924424g
Analytical & Consulting Chemists NCENR: DWQ CERTIFICATION 0 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
Cllent: Sanderson Farms -Kinston
PROJECT NAME: Storm Water Outfall (lagoon)
REPORT NO: � r I
ADDRESS: 2081 Sanderson Way
CONTACT NAME: Pete Onidi
PO NO:
Kinston, NC 28504
REPORT TO:
PHONE/FAX:
COPY TO:
email:
Sampled Bv: Vg:)( SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO m Soil, SL = Sludge, Others 5-11
Sample Identification
Collection
am
m r
n o
o
_
ct7
g o
`
d
��,
s E
"
2
m 2
g z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp3
z
i
d
�`
x
0
Y
0
0
e
Storm Water
%�/�
C
P
X
ITSS
/
G
(semi-annual
"C
1�,02
�
C
P
y,�Q
VI-U�
X
Oil and Grease, COD
2 a
G
G
H:
C
X
Fecal Col'Iform
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
Limits: TSS 100 mg1L, 011 and Grease 30 mg1L, Fecal 1000 colonieal100
ml, COD 120 m /L.
Transfer
Relinquished By:
Daterrimo
Received By:
Dato/Time
2.
Temperature when Received: Accepted: Rejected: Resample Requested:
Delivered By:. (i Recelvgd By: Date: Time:
Comments: SA, - arm �`�, A6 / (f • TURNAROUND:

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 3 •d 7 • /S
CERTIFICATE OF COVERAGE NO. NCG06_ jI—
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES T' l Ok
LABORATORY If.L.a+j,,4;,,Q Lab Cert. # 1_4O
Part A: Stormwater Benchmarks and Monitoring Results
RECEIVED
JUL 3 12015
SAMPLE COLLECTION YEAR ;)F3I.5- CENTRAL FILES
FACILITY ACTIVITIES INCLUDE (check all that apply): R SECTION
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES j'NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z 0. 0-j or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl , .
Colonies per 100 mi
Benchmark
-
100 or 50
Within 6.0 — 9.0
220
.30
' 1000
500
qA
' Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at gny outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 13/ho
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease, -'
mg/L
TSS,
mg/L
pH,
Standard units
New Motor,011 Usage,
Annual average I/mo
Benchmark
-
30
100 or S0
6.0 — 9:0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ice complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*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 ❑ NO &
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ VIA
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of
this DMR, including
all
"No Discharge" reports, within 30 days of receipt of the lab results jor at end of
monitoring period in the cased
"No Dischargae" reports
to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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."
(Signature of Permittee
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.ore/web/wa/ws/su/npdessw#tab-4
5 W U-249C
)vast Revised: G,..,,ber 18, 2012
Page Z bf 2

- "r
Analytical Results
Innospec Performance Chemicals US Company
500 Hinkle Lane
Salisbury, NC 28144
Receive Date: 06/30/2015
Reported: 07/09/2015
For: Stormwater
Comments:
Sample Number
Parameter Sample ID
Result
Unit
Method
Analyzed
Analyst
150630-21-01
Chemical Oxygen
27
mg/L
HACH8000
07/09/2015
MD
Demand
150630-21-01
Oil and Grease
<6.8
mg/L
EPA1664RevB
06/30/2015
MD
150630-21-01
TSS
13.667
mg/L
SM254OD-1997
07/01/2015
WL
Respectfully
submitted,
�Op" - 11
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2

Condition of Receipt
Temp on
Sample Number 150630-21-01 Arrival: 3
Parameter Schedule: Oil and Grease
Hydrochloric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: TSS
Received on Ice
Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2of2

Client:
n
L�
^'� "
e
--�
STATESVILLE ANAMICAL�.
% , t
122 Court Strcct • P.O: Boa 2'LQ
" Statesville, NC 28687. '.
(7W) 972-4697 r
Chain of "
Custody Record
Address: E
-SQ t (
I
!3 V [� ,� ` L
Contact Person:- j Phone # FAX#
%a e V` 33b, � -.5o ( 70633. 3�
PO # Requisitioned by: (Time Date)
Customer
Sample IN
Lab•ID #
Time Sampled
(Grab only)
Cate Sampled
(Grab Only)
Matrlx
Parameters requested for analysis
Sjudgel
w
I ww
orr N ai r
15.D{G3U 2I
V
Cpa 1 S
COD.i S
Relinquished by: �.
Received by:
Relinquished by:
Received by:
Composite Sampling #1:
Time begin am, pm
Time end am, pm
Composite Sampling #2:
Time begin am, pm
Time end am, pm
: ft
V ��
Date _ _/�_
Date /�_
Date
Date ���
m Date �p l j� Sampled b . AMPS M av eJ.
Time jo2,am
Time m Date �Trans orted b- p Y
Time am; pm Date ! 'Holding times met:
Time V am, Date
Compliance work:
Non-compliance work:
Lab comments:

1
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted - - i'
CERTIFICATE OF COVERAGE NO:NCG06-`�—-.a SAMPLE COLLECTION YEAR . r-)OIq
FACILITY NAME 17y, FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY _bs�a ,�� _ ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES _ �; .„� �.,1��,�` _ _ (;El � o TO SALTWATERS? []YES Qd0
LABORATORY r.c�L 4r,�1 ,l Lab Cert. # 1Lj +v
JAN 0 5 2015PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILFgTotal event rainfall z 1 f� or n No discharge this period?
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
EW, SECTION
mg/L
and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
Soo
D�
I :11t,
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at Wy outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 0-no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No. 1
Sample Collected,
mo/dd/ r
Oil and Grease,
mILL
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or SOr
6.0 — 9.0
-
'Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
L"
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012

*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 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO g^
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results (or at end
monitoring period in the case of "No Discharge" reportsl to: -
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 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."
(Signature of Permittee) U,
(Date)
Additional copies of this form may downloaded at: http://portal.ncdenr.org/web/wq/ws/sujnpdessw#tab-4
SWU-249
4
Last Revised: C.—joer 18, 2012
Page 2of2

Analytical Results
Innospec Performance Chemicals US Company
500 Hinkle Lane
Salisbury, NC 28144
Receive Date: 11/26/2014
Reported: 12/04/2014
For: Stormwater
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
141126-08-01 Chemical Oxygen Storm 37 mg/L HACH8000 12/03/2014 CL
Demand
141126-08-01 Oil and Grease Storm <6 mg/L EPA1664RevB 12/0212014 MD
141126-08-01 TSS Storm 18 mgJL SM254OD-1997 11/26/2014 WL
Respectfully
submitted,
LoXWOL,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 a 704/872/4697
Page 1 of 2

1
Condition of Receipt
Temp on
Sample Number 141126-08-01 Arrival: 2
PH on Arrival: <2 Parameter Schedule: Oil and Grease
Hydrochloric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: TSS
Received on Ice
PH on Arrival: <2 Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2
r .

h
.r
Client:—
fj P
3
-...-.
`mow—_,.
STATESVILLE-ANALYTICAL
l22 Court Street I',t7, Box 228
Statesville, NC 28697
(704) 8724697
.
Chain of
Custody Record
Address`.
�} () { (y
Y1
�.• r °J 1 S�i 1 \ � 1 f
Contact Person: ((�
Phone # FAX#
C stD F,% -4t 10 4 lP 3 ` � iD
PO # i Requisitioned by: (Time Date)
Customer
Sample ID#
Lab -ID # .
Time Sampled
(Grab Only)
Data Sampled
(Crab Only)
Matrix
Parameters requested for analysis
st des
w
ww
Relinquished.by:
Received by:
Relinquished by:
Received by:
Composite Sampling #1:
Time begin am, pm. Date j.__J_
Time end am, pm Date �/j_
'
Composlte-Sampling #2:
Time begin am, pm Date ��_ T
Time end am, pm Date
-
Time am, pm Date JL1�L Sampled by7. F
Time - � , Qpm Date Transported by:
Time am, pm Date Holding times met: V
Time . am, pm Date
Compliance work:
� Non-compliance work:
Cr l r
Lab Comments:
-3 t' 0 C �
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r t 4 • t (. �� •�

SEMI-ANNUAL STORMWATER- DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted t - - I
CERTIFICATE OF COVERAGE NO. NCG06 r3Lk�
FACILITY NAME
COUNTY _Rby��-_
PERSON COLLECTING SAMPLES 1 i . h. Q..11 ..
LABORATORY, fc kg% Aka. A...1�=1 Lab Cert. ii `{ 4
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR I t{
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES E�Nfl
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Total event rainfall Z1). 1_ or No discharge this period3
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120 •
30
.1000
Sao
III I
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ®-Ro
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor ail/month.
Outfall No.
Sample Collected,
ma/dd/ r
Oil and Grease,
m L, _
TSS, .
m L
pH,
Standard units
New Motor Oil Usage,
Annual avers a alLmo .
Benchmark
-
30
100 or 504
6.0 — 9.0
-
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if ves, complete Part B)
Ri.. CEiV GD
APR 11 W4
CEDWOJBOG FILES
S WU-249
Last Revised: October 18, 2012
Page 1 of 2

*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 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [.]"
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ �v
REGIONAL OFFICE CONTACT NAME:
_Mail an origlnal and one copy of this DMR, including ap "No Discharge" reports, within 30 days of receipt of the lab results for at.end.of
monitoring period in the case of "No Discharge" reports) to: _
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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."
(Signature of Permittee)
Y- 5,1�
(Date)
Additional copies of this form may be downloaded at: htt ortal.ncdenr,or web w ws su n dessw#tab-4
SWU-249 Last Revised: (, ,_,)ber 18, 2012
Page Z of 2

I
Analytical Results
Innospec Performance Chemicals
500 Hinkle Lane
Salisbury NC 28144
Entered 3/12/2014
Reported: 411 /2014
For:
Stormwater
Sample ID Parameter Cust ID Result Units Method Date Analyzed Analyst
140312-14
COD
Sw
73
mg/L
HACH8000 3/13/14
CL
140312-14
Oil & Grease
Sw
9.3
mg/L
EPA1664RevA3117/14
MD
140312-14
TSS
Sw
29.3
mg/L
SM2540D- 3112/14
HM
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCO0909
0`-" 'i ( 'V p 14
P.Q. Box 228 * Statesville, North Carolina 28687 * 704/872/4697

"' Aa r -. ..%,
Client:
, -PC
STATESVILLE ANALYTICAL
122 Court Street - P.Q. Box 228
Statesville, NC 28687
[phone]
Chain of
Custody Record
Address 1
Sin li
C\ �! ESA } N C_ ,� r� -A��
Contact Person: t I Phone # FAX#
xLI-7 <r'),t -7r)u fo ice- 1?�iin
PO # 1 Requisitioned by: (Time Hate)j
Customer
Sample Init
Lab In
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
�
Matrix
Parameters requested for analysis
Isludgel
w
I ww
Relinquished by:
Received by: .`
Relinquished by:,,
Received by:
Composite Sampling #1
Time begin am, pm Date _I_I�
Time end am, pm Date _I_
Cg,,,mnosltSampling #2:
Time begin am, pm Date
Time end am, pm Date �ll�
s a , a
Time,,. yam, pm Date 1
Time am, pm Date—1t_I4
Time am, pm Date �1 1
Time am, pm Date �1_- _I
— O s
Lab Comments:
Sampled by:
Transported by:
Holding times met:
Compliance work:
Non-compliance work: