NCG030612_MONITORING INFO_20180822

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v (Q � a
DOC TYPE
❑HISTORICAL FILE
� MONITORING REPORTS
DOC DATE
❑ aDIK DS! as
YYYYMMDD

A;A
NCDENR R Et E j \/ C,
Stormwater Discharge Outfall (SDO) AUG 2 2 2018
Qualitative Monitoring Report CENTRAL FILES
DWR SECTION
Forguidance on filling out this form, please visit. hUp:llportal.ncdenr.org/web/wg/­ws/su/npdessw#_tab-4
Permit No.: or Certificate of Coverage No.: N/C/G/0 /J-/D/lo /-L/-2/
Facility Name:y au ld5 4'� s
County: dui o Phone No. 33(o - Co 6 a O + 1.3 - --
inspector: A i P.dZP T
Date of Inspection: 8 - � -18
Time of Inspection: +'•
Total Event Precipitation (inches): 1. 9
- "Was this a "Representative SCo rri Everit" or "Meas-u—redbN Storm Event"' as defined by tlie p6Fniit?-- ---
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to he r
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement Please refer to these definitions, if applicable.
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.
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. Structure (pipe, ditch, etc.)
Receivine Stream:
Describe the industrial activities that 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:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 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 solidsand 5 is the surface covered with boating solidsr
1 2 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 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
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.

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 6/26/18
CERTIFICATE OF COVERAGE NO. NCG030612
FACILITY NAME GOULDS PUMPS
COUNTY; GUILFORD
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
- SAMPLE COLLECTION YEAR 2017
SAMPLE PERIOD ® Jan -June ❑July -Dec
RECEIVED or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
- JUN 2 8 2018 ❑Zero -flow ❑Water Supply ESA
CENTt<AL I=iLES ❑Other
DVVR SECTION
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
® No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
i Inches
Total Suspended Solids
pH,
Standard units
Copper
Lead
rNon-Polar
Zinc
O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organicss
Benchmarks y-_>
-
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 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.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 1
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CPR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CPR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CPR 469,31).
Permit Date: 11/1/2012-10/31/2018 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I Further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Al Bader
Name (Print name)
Facility Manager
Title (Pri itle)
D6 25 18
(Signat r (Date)
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 firer 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2018 SWU-245, last revised 10/25/2012
Page 2 of 3

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 11 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 OMR, including all "No Discharge" reports, 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, 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 thatAere are s*ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Perm
6/26/2018
(Date)
Permit Date: 11/1/2012-10/31/2018 SWU-245, last revised 10/25/2012
Page 3 of 3

MCD�
Stormwater.Discharge Outfall (SDO)
Qualitative Monitoring ]Report
Forguidance on filling out this form, please visit: http: f /nortaI.ncdenr.org/web/wgZws/�uf nndessw#talz4
Permit No.: or Certificate of Coverage No.:
Facility Name: C cat c 1d ;5 Pwc pS _
county: G fi6Qd Phone No. (n - (o(o0113
Inspector: A I ZAd Etz �" i~' 1=11 /[= n
Date of Inspection:
Time of Inspection: „ JUN 2 2r71$
CENTRAL FILES
Total Event Precipitation (inches): • 03 DV+JR SFCTIO; .'
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
❑ Yes 9 No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement_ Please refer to these definitions, if applicable.
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 1.0 consecutive hours of no
precipitation.
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 DWQ Regional Office.
By this
(Signature of Perm
is accurate and complete to the best of my knowledge:
SWU-242, Last modified 10/25/2012
Pagel of 2

I A,
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfali drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc,) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 4 5
S. 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 2 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 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
$. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
M.
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.
SWU•242, LasCmodi6ed 10/25/2012
Page 2 of 2

Weather History for Greensboro, NC I Weather Underground
Page 1 of S
New X Ad closed by Goo t� e
We'll trgch ibtashov+�hattM again
Stop seeing this ad AdChoices t3
Greensboro, NC A
Piedmont Triad International O 12:07 PM EDT on June 26, 2018 (GMT -0400)
Weather History for KGSO - June, 2018
View
Tuesday. June 26, 2018
Daily I Weekly I Monthly Custom
Actual Average Record
Temperature
Mean Temperature
70 °F
77 °F
Max Temperature
73 °F
87 °F 102 `F (1914)
Min Temperature
68'F
68 °F 50 °F (1979)
Degree Days
Heating Degree Days
0
0
Month to date heating degree days
5
Since 1 June heating degree days
5
Since 1 July heating degree days
3617
Cooling Degree Days
6
12
Month to date cooling degree days
255
Year to date cooling degree days
414
Since 1 June cooling degree days
255
Growing Degree Days
20 (Base 50)
http://www.wtindrground.com/history/airport/KGS0/201 S/6/26/DailyHistory.htrnI?recLeit... 6/26/2018

Weather History for Greensboro. NC I Weather Underground
Page 2 of 5
Actual
Moisture
Dew Point
69 °F
Average, Humidity
96
Maximum Humidity
100
Minimum Humidity
87
Precipitation
Precipitation
0.06 in
Month to date precipitation
Year to date precipitation
Sea Level Pressure
Sea Level Pressure
30.13 in
Wind
Wind Speed
5 mph O
Max Wind Speed
9 mph
Max Gust Speed
-
Visibility
9.9 miles
Events
Rain
T = Trace of Precipitation, MM = Missing Value
Daily Weather History Graph
Average
0.12 in
3.26
19.96
Record
1.72 in (1918)
Source: Averaged Metar Reports
http:llww« wnndrground.comlhistorylairportlKGSO1201816126IDailyHistory.html?req_cit,.. 6/26/2018

Weather History for Greensboro, NC I Weather Underground
Page 3 of 5
F TmWaUe Dew Pon Awage
7470
I - 72
fia
miduigM1 2 3 4 5 6 7 6 9 10 11 naon 1 2 3 4 5 6 7 8 9 10 11
in Hg �� __
30-2
30 -1
30 0
midnightl 2 3 4 5 6 7 8 9 10 11 loon 1 2 3 4 5 6 7 8 9 10 11
mph AInd Speed Ul+ind Gust
180 — f
.18
3 a I
a.a - -..
3A
nidnVit1 2 3 4 5 6 7 8 9 10 11 noon 1 2 3 4 5 6 7 8 9 10 11
360.0
270.0
180,0
90.0
00
m0d*t1 2 9 4 3 6 1 6 9 10 11 noon 1 2 3 4 5 6 7 8 9 10 IAM ur
Ad closed by Go R'Iw
Stop seeing this ad
AdChoices
Search for Another Location
Airport or City:
KGSO
Submit
Astronomy
Jun. 26, 2018 Rise
Actual Time 6,04 AM EDT
Set
c
23
22
21
20
hAa
1023
1019
1016
mrh
29
>i
13
5
8 40 PM EDT
http : //www. wundrground. com/history/airport/KG SO/2018/6/26/DailyHistory. html?req—cit... 6/2 6/20 I 8

Weather History For Greensboro, NC I Weather Underground
Page 4 of 5
Jun. 26, 2018
Rise
Set
Civil Twilight
.............
5:34 AM EDT
9:11 PM EDT
Nautical Twilight
4:56 AM EDT
9:48 PM EDT
Astronomical Twilight
4:14 AM EDT
10:30 PM EDT
Moon 7:25 PM EDT 4:59 AM EDT
Len th of Visible Li ht 15h 36m
Length of Qay 14h 36m
....................
Waxing Gibbous, 98% of the Moon is Illuminated
Today
Jun 28
Jul 6 Jul 12
Jul 19
Waxing Gibbous
Full
Last Quarter New
First Quarter
Hourly Weather History & Observations
Time
Temp.
Dew
Humidity
Pressure
Visibility
wind
Wind
Gust Precip
Events Conditions
(EDT)
Point
Dir
Speed
Speed
12-27
69.1 °F
69.1 'F
100%
30.14 in
10.0 mi
WNW
9.2 mph
NIA
Mostly
AM
Cloudy
12.39
69.1 °F
69.1 °F
100%
30.14 in
10.0 mi
NW
6.9 mph
NIA
Overcast
AM
12:54
69.1 °F
69.1 °F
100%
30.12 in
10.0 mi
NW
5.8 mph
NIA
Overcast
AM
1:38
69.1 °F
69.1 "F
100%
30.14 in
10.0 mi
WNW
4.6 mph
NIA
Mostly
AM
Cloudy
1:54
69A °F
69.1 °F
100%
30.11 in
10.0 mi
West
6.9 mph
- N!A
Overcast
AM
2.22
69A °F
68.0 °F
96%
30.14 in
10.0 mi
NW
6.9 mph
NIA
Overcast
AM
2:32
69.1 °F
68.0 °F
96%
30.14 in
10.0 mi
WNW
6.9 mph
- NIA
Overcast
AM
2:54
69.1 °F
68.0 °F
96%
30.11 in
10.0 mi
NW
6.9 mph
- NIA
Overcast
AM
3:43
69.1 °F
68.0 'F
96%
30.12 in
10.0 mi
NW
6.9 mph
- NIA
Overcast
AM
AM4
69.1 °F
68.0 °F
96%
30.09 in
10.0 mi
NW
5.8 mph
- NIA
Overcast
4A6
69.1 °F
68.07
96%
30.12 in
10.0 mi
NNW
4.6 mph
NIA
Overcast
AM
4:54
AM
69.1 °F
68.0 °F
96%
30.09 in
10.0 mi
NNW
6.9 mph
NIA
Overcast
http:llw,Arw.vvundrground.con lhistorylairport/KGS0/2018/6/26/Dailyl-listory.htnil?rer_cit... 6/26/2018

Weather History for Greensboro; NC I Weather Underground
Page 5 of 5
Time
Temp.
Dew
Humidity
Pressure
Visibility
wind
Wind
Gust Precip
Events
Conditions
(EDT)
Point
Dir
Speed
Speed
5:06
68.0 °F
68.0 "F
100%
30.12 in
9.0 mi
North
5.8 mph
0.00 in
Rain
Light Rain
AM
5,54
AM
69A °F
68.0 "F
96%
30.10 in
9.0 mi
North
4.6 mph
0.01 in
Rain
Light Rain
6:54
69.1 °F
68.0 °F
96%
30.11 in
10.0 mi
NE
5.8 mph
0.03 in
Rain
Light Rain
AM
7:23
69.1 °F
68.0 °F
96%
30.15 in
10.0 mi
ENE
4.6 mph
0.00 in
Overcast
AM
7:54
69.1 °F
68.0 °F
96%
30.13 in
10.0 mi
NNE
3.5 mph
0.00 in
Rain
Light Rain
AM
8:54
69.1 °F
69.1 °F
100%
30.14 in
1D.0 mi
NE
4.6 mph
0.00 in
Overcast
AM
9:54
71.1 "F
70.0 °F
96%
30.13 in
9.0 mi
East
5.8 mch
0.02 in
Overcast
AM
10.54
72.0 °F
69.1 `F
91%
30.13 in
10.0 mi
ENE
4.6 mph
NIA
Overcast
AM
11 A5
73.0 °F
69.1 °F
87%
30.16 in
10.0 mi
ENE
3.5 mph
NIA
Overcast
AM
11:54
73.0 °F
70.0 °F
90%
30.14 in
10.0 mi
Variable
3.5 mph
NIA
Overcast
AM
http://wtivw.wundrground.com/history/airportIK.GS0/2018/6/26/Dal lyH istory.html?req_cit... 6/26/2018

Shipping: UPS
Page 1 o1' 2
Review Your Shipment Details
Please review your shipping information for accuracy. Select Edit to modify information.
O ADDRESS INFORMATION
Ship To: Edit
Division of Water
Quality
DWQ Central Files
1617 Mail Service
Center
RALEIGH NC 276991
600
Telephone:919-791-
4200
Ship From: Edit
ITT INDUSTRIES NC
PRO
Deborah McCollum
1115 Pleasant Ridge
Road
Greensboro NC 2740
9
Telephone:336-662-
0113
email:deborah.mccol
[e-mail]
0 PACKAGE INFORMATION
Return Address: Edit
ITT INDUSTRIES NC
PRO
Debbie McCollum
1115 Pleasant Ridge
Road
GREENSBORO NC 27
409
Telephone:336-662-
0113
email:deborah.mccol
lumeitt.com
WEIGHT DIMENSIONS / DECLARED VALUE
PACKAGING
1. Letter UPS Letter
(Letter billable)
3 UPS SHIPPING SERVICE AND SHIPPING OPTIONS
Service: UPS Next Day Air
Guaranteed By: 10:30 AM Thursday, Jun 28,
2018
DO YOU NEED IT THERE SOONER?
* UPS Next Day Air
0 UPS Next Day Air® Early
REFERENCE NUMBE
Reference#1- Semi-.
Rpfprpnrp#? - Mnnit
currently select-
32.40 USD me
littps:Hw\vNtir.Lips,coiii/iiis/create
6/27/2018

Shipping: UPS
Page 2 of 2
DO YOU WISH TO OFFSET THE CLIMATE IMPACT OF THIS SHIPMENT?
Guarantees and Notices L,
Shipping Fees Subtotal:
Show Shipping Fees Subtotal Details
Additional Shipping Options
Quantum View Notify E-mail Notifications: Edit Cancel
1 deborah.mccollumoitt.com: Ship, Exception, Delivery
40 PAYMENT INFORMATION
Bill Shipping Charges to:
Shipping Charges:
Subtotal Shipping Charges:
Daily rates were applied to this shipment
Total Charged:
Shipper's Account 50A85R
https:/hvWW.ups.com/uis/create 6/27/2018

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
CERTIFICATE OF COVERAGE NO. NCG030612
FACILITY NAME GOULDS PUMPS
COUNTY: GUILFORD
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
Date submitted 11/10/17
SAMPLE COLLECTION YEAR 2017
SAMPLE PERIOD ❑ Jan -June © July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
;�;D ❑Zero -flow ❑Water Supply ❑SA
E CC ❑Other
CENTRAL FILES
DWR SECTION
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
0 No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics5
Benchmarks =__>
_
-
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z 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 raingauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/J/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Al Bader
Name (Print name)
Facility Manager
Title (Print title)
I' )z 11 10 17
(Signature) (Date)
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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period:
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

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 it 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" re ogs within .30 days of receipt of the lab results or at end of monitoring period
in the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Servfce 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,"
11/10/2017
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted Co - 3 0 - I q
CERTIFICATE OF COVERAGE NO. N0003 0 L I3`l
FACILITYNAME Goulds _ Pun-,Q1
COUNTY _ G f-,Li _i FO v-d
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. #
Comments on sample collection or analysis:
')art A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR l
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RI�C'�Iy' ❑Z��o��low [:]Watersupply [:]SA
ii V �® ❑O
`(U� 14 1'rjll PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Dwp RAL fiiLES
SFCripN
® No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
inche53
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organicss
Benchmarks
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
[he 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.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (far metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the stormwater Pollution Prevention Plan."
FBI at;dZ
Name (Print name)
-F-A C� 114 \1 Mnr- gEtZ
Title (Print title) _
(Signature)
Ca -3(-l7
(Date)
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 me/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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period ?2
Outfail No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Ikon -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

r. .
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 AAND PART B MONITORING RESULTS;
e A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
a 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 (or at end of monitoring period
in the case of "No Discharge" reports) to:
)ivision of Water Quality
An: 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."
(Signature of Perm
-30!'7
(Date)
Permit Date:11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Aft
RMENR
Stormwater Discharge Outfall (SOO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://portal,ncdenr.orgjweb.jwq_/wsLsu /nndessw#tah-4
Permit No.: N/C/G / 0/3 / a / o/ o/ o/ or Certificate of Coverage No.: N/C/G/Q/3 /o /fo / I /2/
Facility Name: Golds puyyi p5
County: 6 (LLi ( FQfZd Phone No. 33(o- Lo pa - O 1 l3
Inspector: _ H .L
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): • P?
Was this a "Representative Storm Event" or "Measureable Storm Event" as defitnIff[PE SIn
(See information below.) JUL 14 2017
❑ Yes [K No
CENTRAL FILES
DWR SECTION
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
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 DWQ Regional Office.
By this signaturejjertify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
5 WU-242, Cast modified 10/25/2012

1. OutfaIl Description:
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that 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:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and S is very cloudy:
1 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the storrnwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 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 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
No
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, Last modified 10/25/2012

Semi --annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Qwi ity General Permit No. NCGO3E 000
'late submitted ia- 0�0 _ i Co
CERTIFICATE OF COVERAGE NO. NCG03 !'� Cv i o? SAMPLE COLLECTION YEAR 0 O I {A
FACILITY NAME G' OLEOS PL.Lrn S� SAMPLE PERIOD ❑ Jan-3une 0 July-DeC
COUNTY GL7i I Toizd or ❑ Monthly' fmonthl
PERSON COLLECTING SAMPLES ,I ryDISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY Lab Cert. if EI V ED ❑Zero -flow ❑water Supply ESA
Comments on sample collection or analysis: DEC 2 2. 2N ❑Other
c�IRNTRAL FILES
JWR SECTION
Part A. Stormwater Benchmarks and Monitoring Results
PLI ASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 .i>
a.
© No discharge this period?`' T1,
Outfali No.
Date Sample
Collected'
fmo/dd/yr)
24-hour rainliIl
amount,
Inches;
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Nan -Polar 0&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organicss
Benchmarks ===>
_
100 mg/L or So rng/L'Q
6,0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
3 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benclimarlc exceedance for the same parameter at the sarne outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
a The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites maybe eligible for a waiver of the rain gauge requirement.
A See General Permit, Table 3 identifyingthe especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433,11; for semiconductor
manufacture use the definition as found in 44 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.2.2; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/20! 2
Page 1 ot` 3

Facilities that ineorl;orate a solvent management plan ililo the Ston-riv;ater Pollution Prevention Wan may so certify, and the requirement fnrT O monitoring
may be waived. The solvent management Man shall include a list of the total toxic organic cornpotinds used and the ether elements listed in the General
Permit. For those facilities electing to employ the TI'O monitoring waiver, the discharger shall sign the following certification statement:
"Rased upon my inquiry of the person or persons directly responsible for managing compliance with the permit inonitoring retluii cnrent for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no durnping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
storniwater runoff has occurred since filing the last discharge monitoring report. 1 further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Af (�')Ade4z
!+tame (Print name
)
Title (Pri ` title)
(Signature) (Date]
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or othersimllar non -numerical
format. When results are below the applicable limits, they must be reported in the format "<XX rn 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 bericlimark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Perna! text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging y 55 gal of new oil per month.
❑ No discharge this period:`
Outfall No.
Date Sample
Collected,
(moldd/yr)
24-hour rainfall
amount,
lnche?
Non -polar a&G/TPHby
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks -_>
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 5U
Footnotes from Part A also apply to this Part 0
See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permlt Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 2 of 3

Note: If you report cr SamjAl v011e itr access of the frenchrnark, you r;tusr irar�ierrrr rrt: 'iier .I, i ic:r t or 7inr.3 responses. Sege Gcrlr:rcal PerrrriE �c,tr.
FOR PART A AND PART B MONITORING RESULTS:
A BENCHMARK, EXCEEDANCE TRIGGERS TIER 1 RrQUIREMENTS_ SEE PERMIT PART II SI=CTION 3.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMFTFR ATTHF SAME OUTFAI.L TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
e TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFAL12 YES ❑ NO ❑
If-' YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [] NO n
REGIONAL OFFICE CONTACT NAME:
Mail tin original and cony,_of this DMR, including all "No Discharge" rerjoris, within 30 toys of receint 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, 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 wnrr, prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. leased 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 hest cf my knowledge and belief, true, accurate, and complete. I
am aware that q4eje are sign f cant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Perrnittee)
Permit Date; 11/1/7012-10/31/2017
1a-
(Date)
5WU-245, last revised 10/25/2012
Page 3 of 3

RECEIVED
DEC 2 2 2016
gY,,,111-___rrr///••-
• f�rMr•� �L^-�-:1
I'MCDER CENTRAL FILES
Storfiuwater Dischai-ge Outfall (SDO) DWR SECTION
QuAtativeM011ft0R'h1g Report
For fluidance onfilling out this form, please visit: ltttl� //ginrt_al..n.4ti+;rtt',o4'I;/< gel t�q Sr f pdessw#tah-ri•
pertnit No.: N/.M/u
Facility Name: C
Ii spector: _ P ( .
Date of Inspection:
Time of Inspection;
or Certificate of Coverage No.: N/C /Cs'/,.Q/3/ Q f (A/ 1 / 9/
ouldS Pumps
Phone No, 33(0 - (O 69 of - O 1/
'1'otal Event Precipitation (inches): . �-3 (/�- /�-2ele.
Was this a "representative Storm Event" ur "Nleasureable Storm Event" as defined by the permit?
(Sec: information below.)
Ys s E No
Please verify V"Nether Qualitative Monitoring must he peijbrnied during a "representative storm
event" or "measureable storni event" (requirements vcrrs, depending On the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to he
perfornied during a "representative storm event" or during a "measureable storm event." However, 1
some permits do not have this requirement. Please refer to these definitions, if applicable, i
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 1.0 c011socutive Hours of no i
ht-ecipitation.
A "measurable storin 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
I 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 focal DWO. Regional Office.
By this sig;natufcj I certif4 that this report is accurate and complete to the hest of my lznowledge:
(Signature of Permittee or Designee)
11age 1 of Z
SWU-212, Last modirted'i0/25/2012

I. Outirall Description:
Outratl No, Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that. occur within the outf ill drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc) and tint
mediunI, dark) as descriptors:
3. 4ldor: Describe;my distinct odors that the disrliarge may have (i.e., sill ells strongly ofoil,
weds (lllmitle odor, etc.):
4. Clarity:' ChousC the number WlIIch best describes the clarity of the discharge, where 1. is
cleat• and S is very cloudy:
3 2 :i 4 5
S. bloating Solids: Choose the ►►Umber Whlch best describes the a►nount of i'loating solids in
the stormwater discharge, where I is no solids and 5 is the surface covered with (lotting solids:
1 2 3 4 5
b. Suspended Solids: Choose the number which best describes the arnount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4• 5
7. Is there any foam in the stormwater discharge? Yes No
U. Is there nu oil sheen in the storiltwater discharger Yes No
9. is there evidence of erosion or deposition at the outfall7 Yes
10. Other Obvious hidicators of Stormwater Pollution:
List and describe
No
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or eroslo►i/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of)
SwU-242, Last modified 10/2512012

Semi-annual Stormwater DischargelMonitoring Report
for North Carolina Division of dilater Quality General Permit No. NCGO30000
Date submitted Ca - 6
CERTIFICATE OF COVERAGE NO. NCG03 {) Yo
FACILITY NAME (;0L, !J5 �G rn f� -- --- ------ .------ -
COUNTY GIs i I fc713d �—
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
• Part A. Stormwater Benchrnarks and Monitoring Results
SAMPLE COLLECTION YEAR aOl tl
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly" - _(month)
RECEII%L� i�GING TO CIAss ❑ORW ❑F{QW QTrout ❑PN�i
JUN +✓ ❑Zero-f low ❑Water Supply ❑SA
07
I- b []Other
CENTRAL TILES
D1NR SECTION � PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
[S No discharge this period?
Outfall No.
Date Sample
'
24-hour rainfall
Total Suspended solids
pH,
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Total Toxic
s
Collected
amount,
Standard units
ydrocarbcns
Qrganics
(mo/dd/yr)
Inchesa
V
Benchmarks
100 mg/L or 50 mg{l!
6.0 — 9.0
0.007 tng{L
0.033 mgfl
,0.067 rng/tLi
�' 15 mg/L
3 rng/L
XY
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmarks exceedance for the same parameter at the same ouffall.
2For 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.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies,
-'Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes, For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit late. 11/1/2012-10/31/2017 SWU-245, last revised 10/251201 2
Page 1 of 3

Z. .Ik
0
FFrrcilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Ilan may so certify, and the r-ecluirement for"7p monitoring
may be waived. The solvent managerent Man shall include a list of the total toxic organic compvr.rnd; used and the other elements listed in the General
.permit. for those facilities electing to employ the Tl*O monitoring waiver, the discharger shall sign the following certification staternent:
"Based upon, my inquire of the person or persons directly responsible for managing compliance with the permit ironitor ing, requirement for total toxic organics
(70), 1 certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or
storrnwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
P I 13aje2
Name (Print name)
P_ACI / 14 V (Yllnaq e 2
Title (Pr' t title)
�u�r��
(Signature) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non-nurerical
format. When results are below the applicable limits, ahQy_must be reported in the format, "Q(X nzgW 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 Tier3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new oil per month.
❑ No discharge this period?'
Outfali No.
Date Sample
Date
(mo/dd/yr)
24-hour rainfall
amount,
Inche?
Non -polar O&G/TPH by
EPA 1664 (5GT-HEM)
Total Suspended Solids
pH
Benchmarks ==>
-
15 mg/L
100 mg/L or 50 mg/L*7
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* see General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017
SWU-245, East revised 10/25/2012
Page 2- of 3

Now: 1j yott rei7ort a sarriple Veda -' in excess of the bendiinark, you truist itTplei7)ent Tier 1, Tier 1, or Tier a r4'sf)onses. iee Genercil Perrrit teyt.
0
FOR PART AAND PARTS MONITORING RESULTS:
O A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART li SECTION 6,
0 2 EXCEEDANC£S IN A ROW FOR THE SAME PARAMETER ATTIIE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
6 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALI_? YES ❑ NO ❑
IF YFS, HAVI: YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO �]
REGIONAL 01-FICE CONTACT NAME:
Mail an original and one copy of this MR, inchidinq_all "No DischarrLe" reports, within 30 da s of receipt of the lab results or at end of monitorin eriod
in the case of "No Discfrarge" reports) -to,
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1.617
YOU MUST" SIGN PHIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"l 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 Kest 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."
I
/010/k
(Signature of Perrnit ee) (Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 1.0/2.5/2012
Page 3 of 3

NCDENR IUN 0 7 ZO1
Qualitative Monitoring Report DLA/R SEC ILES
TION
For guidance on filling out this form, please visit: lei://portalm eni,M/watt wn/4v.s/su/nudessw#,ltql)-
Permit No.: lUILI,G
Facility Plane: �
County: taw !
hispector: Q l
or Certificate of Coverage No.: N1C/C10 /3/0 & 1 11A1
LL Ids P"-, S
Date of Inspection,
Tinie of Inspection:
Total (vent Precipitation (inches):
Phone No, 3 3L, — b (n -� - O 1 ! 3
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
❑ Yes Z No
Please verify whether Qualitative Monitoring inust be pet/brined during a "representative storm
event" or "rrxeastrreable storrr2 event" (requirements vary, dependingon the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during; a "representative storm event" or during a "measureable storm event." However, }
some permits do not have this requirement. please refer to these definitions, if applicable.
A "Representative storm event" is a storm event that measures greater than OJ inclies 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 flours of no i
precipitation.
i A "measurable storm event' is a storm event that results in an actual discharge from the l
I permitted site outfall. The previous measurable storm event must have been at least 72 hours
g prior. The 72-hour storm interval does not apply if the perrnitxee 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 DWQ Regional Office.
By this signature
,,4 certifyylpt this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Pagel of 2
SWU-24Z, Last mudifieri 10/25/2012

I. Outfall Description:
Outfall No. StrUCtUre (pipe, ditch, etc.)
Receiving Stream.
Describe the industrial activities that 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;
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.).-
4. Clarity:- Choose the number which best describes the clarity of the discharge, where 1 is
elcar Mld 5 is very cioudy:
1 2 ;3 4 5
S. bloating Solids: Choose the n11111Jer 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 2 3 4 5
G. 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 2 3 4. 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the Outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
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, Last modified 10/2S/2012

.,
Semi-annual Storrnwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted G -,Q - 15
CERTIFICATE OF COVERAGE NO. NCG03 O b ! a
FACILITY NAME GDLr-icln PLtrnQ5 Ine
COUNTY GLLi I f7o-Rci
PERSON COLLECTING SAMPLES
LABORATORY
U
�0
SAMPLE COLLECTION YEAR aQ 15
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
Comments on sample collection or analysis: RECEIVED ❑Other
DEC 0 4 2015 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES
n\NR SECTION
® No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks
100 mg/L or 50 mg/L°
6.0-9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 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.
4 See General Permit, Table 3 identifyingthe especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform meta[ finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal: finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469,31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement forTTO monitoring
may be.svaived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
i5ermit. For those facilities electing to employ the TE-O monitoring waiver, the discharger shall sign the following certification statement: '
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(70),1 certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
P I ZigJe2
Name (Print name) /y-h
Title (Prin tIe)
•a-a-�s
(Signature) (Date)
Note: Results must be reported in numerical format. Do not report Below Deflection 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 me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
(Vote: 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.
Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
0 No discharge this period?
Outfall No.
Date Sample
Collected}
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
PH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part 3
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

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.
a 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 EXCEEDENCFS FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mai! an on inal and onecopyof this DMR including all "No Discharge" re orts within 30 days of recei t of the lob results or at end of menftring 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:
N 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.
am aware that thereAre significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1a-cQ-15
(Signature of 4rmittee) (Date)
Permit Date: 1111/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No. NCG03LI�_ / �—
FACILITY NAME GOL.LIJ5 Pum 5 1r)(L
COUNTY GLLi I old
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR a®i 5
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly" (month)
RECE SING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Suppi ❑SA
JUL 0 8 ❑Other
CENTRAL FILES
DWR SECTION
PLEASE REMEMBER TO SIGN ON PAGES Z AND/OR 3 i
® No discharge this period?z
mow.
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar o&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organicss
Benchmarks =-_>
-
-
100 mg/L or 50 mg/L'
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' 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 maybe eligible for a waiver of the rain gauge requirement.
"See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(70), 1 certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report, I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
P 1 6 ACje2
Name (Print name)
T__1q611414 mo-nMeA
Title (Prin title)
(Signature) (Date)
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/U' 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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period-?2
Ouffal! No.
Date Sample
[ollectedl
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (5GT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table S, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

„ Nate: if you report a sample value in excess of the benchmark, you must implement Tier I, Fier 2, or Tier 3 responses. See General Permit text
FOR PART A AND PART B MONITORING RESULTS:
a A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II sECT10N B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER ATTHE 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 ❑
tF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of_this MR, including all "No Discharge” reports, within 30 days of recebtt of the lob 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, 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 significanApenalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 8 of 3