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NCG030660_COMPLETE FILE - HISTORICAL_20190201
PERMIT NO. DOC TYPE STORMWATER DIVISION CODING SHEET NCG PERMITS /V ❑ "ONITORING HISTORICAL FILE REPORTS DOC DATE ❑ ao 12 Da O YYYYMMDD Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No NCG030000 Date submitted 1/15118 CERTIFICATE OF COVERAGE NO NCG03 0 6 6 0 SAMPLE COLLECTION YEAR 2018 FACILITY NAME Matiab Inc 49S Campus SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY Rancloiph or ❑ Monthly' !month] PERSON COLLECTING SAMPLES Paul spangenberg in i�� C } DISCHARGING TO CLASS ❑ORW �HQW Trout QPNA LABORATORY Pnsm Lab Cert # 402 "XGCEL-1 [_]zero -flow QWaterSupply ESA Comments on sample collection or analysts FEB 01 Z019 ❑Other Fart A Stormwater Benchmarks and Monitoring Results CEN-I i<AL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 UNR SECT10ti No discharge this period;" Outfall No Date Sample F Collected (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids pH, units Standard Total Copper Total Lead Total Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total To Organicsx5 Benchmarks _ - 100 mg/L or 50 mg/O 6 0 — 9 0 0 010 mg/L 0 075 mg/L 0126 mg/L 15 mg/L 1 mg/L Parameter Code - 46529 C0530 00400 01119 01051 01094 OOSS2 78141 01 12120/18 225 200 62 0 028 0 007 060 0 N/A ' 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 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 a See General Permit, Section B, Table 1 to identify 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 11/1/2018 05/31/2021 SWU-245, last revised 11/1/2018 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 Press Brower Name (Print name) VP of Engineering Title (Pn ti`7� 22 / `/ 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, Inches' New Motor Oil or Hydraulic Oil Usage Non -Polar O&G/ Total Petroleum Hydrocarbons Total Suspended Solids Benchmarks - - 15 mg/L 100 mg/L or 50 mg/L° Parameter Code 46529 NCOI L 00552 C0530 Footnotes from Part A also apply to Part B Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text Permit Date 11/1/2018 05/31/2021 SWU-245 last revised 11/1/2018 Page 2 of 3 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 DEMLR REGIONAL OFFICE? YES ©NO ❑ REGIONAL OFFICE CONTACT NAME Marl an original copy of this DMR, including aft "No Discharge" reports, within 30 days of receipt of the lob results (or at end -of monitonna period In the case of "No Discharge" reports) o 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 property 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 there ace` nt penalties for submitting false information, including the posstbdity of fines and imprisonment for knowing violations " Signature of Permittee Date Permit Date 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018 Page 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No NCG030000 Date submitted 9/4/18 CERTIFICATE OF COVERAGE NO NCG030660 SAMPLE COLLECTION YEAR 2019 FACILITY NAME Matlab —49S Campus SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY Randolph or ® Monthly' Aug _ month) PERSON COLLECTING SAMPLES Colleen McLaughlin DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Prism Lab Cert # 402 - ❑Zero -flow ❑Water Supply [:]SA Comments on sample collection or analysis ®Other Part A Stormwater Benchmarks and Monitoring Results 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, Inches" Total Suspended Solids PH, Standard units Copper Lead Zinc Non -Polar O&G/To#al Total Petroleum Hydrocarbons Toxic Organics Benchmarks - - 200 mg/L or 50 mg1V 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 8/21/18 5o is 68 00 0 037 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 'The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the rain gauge requirement ° See General Permit, 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 rn 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 l further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan " , Press Brower Name (Print name) VP of Engineering Ti (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, "<U 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 penod72 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 SO mg/L* S 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/l/2012-10/31/2017 5wU-245, last revised 10/25/2012 Page 2 of 3 Note !f you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text FOR PART A AND PART B MONITORING RESULTS • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS SEE PERMIT PART II SECTION B • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS SEE PERMIT PART II SECTION B • TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFAL0 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 Division of Water Quality Attn DWQ Central Files 1617 Mad 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 Permittee) F a I'd (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 8/13/18 CERTIFICATE of COVERAGE NO NCG030660 FACILITY NAME Matlab — 49S Campus COUNTY Randolph PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis Part A Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or ® Monthly' July month) R DISCHARGING TO CLASS ❑ORW ❑HQW [—]Trout❑PNA a u EZI♦ VED ❑Zero -flow ❑Water Supply ❑SA AUG 2 8 2018 ®Other CC-rYTFML F•1yE.PJEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 GW'R SECT10k1 ❑ No discharge this period 22 Outfali No Date Sample P Collected (mo/dd/yr) 24-hour rainfall amount, Inches Total Suspended Solids P H, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total To x5 Organics Benchmarks =__> - - 100 mg/L or 50 mg/O 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 7/26/18 2 26 00 0 032 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 ° 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 meta: 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 1of3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring t 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 5tormwater Pollution Prevention Plan " Press Brewer Name (Print name) VP of Engineering Title {Pr i (Signature) (Date) Note Results must he 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/h.", 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 2z 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 li 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 all "No Discharge" reports, within 30 days of recent of the lab results for at end of monitoring period in the case of "No Discharge" reports) to Division of Water Quality Attn DWO 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 " taignaiure or rerminee) (Date) Permit Date 11/1/2012 10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 U Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 7/10/19 CERTIFICATE OF COVERAGE NO NCG030660 FACILITY NAME Matlab - 49S Campus COUNTY Randolph PERSON COLLECTING SAMPLES Colleen McLaughlin _ LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis Part A Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec �f ` J\Jor ® Monthly' June _ _ month) DISCHARGING TO CLASS ❑ORW ❑HQW [-]Trout ❑PNA Auk 18 Z418 ❑Zero -flow ❑Water Supply [-]SA ®Other RAL �i;..l~S SCTI YNI PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this periadaz Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Total Suspended Solids PH, Standard units Copper Lead Zinc Non -Polar O&GJ Total Petroleum Hydrocarbons Total Toxic Orgamcss Benchmarks =-_> - - 100 mg/L or 50 mg/L4 6 0 - 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 1s Mg/L 1 mg/L 01 6/26/18 1 55 0 011 0 040 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 rain gauge 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 :n the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 43311, 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 5WU-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 m the stormwater Pollution Prevention Plan " Press Brower Name (Print name) VP of Engineering Title (Pr (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 m 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 Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' 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 5U 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 il/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 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 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, 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 am aware that there are significant (Signature of for submitting false information, including the possibility of fines and imprisonment for knowing violations " a2213 (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 6 15 18 CERTIFICATE OF COVERAGE NO NCG030660 SAMPLE COLLECTION YEAR 2018 FACILITY NAME Matlab — 495 Campus SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY Randolph or ® Monthly' May ___ (month) PERSON COLLECTING SAMPLES Colleen McLaughlin DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Prism Lab Cert # 402 ECEIVED ❑Zero -flaw [:]Water Supply ❑SA Comments on sample collection or analysis H ®Other J L 0 2 2018 CENTRAL FILES DWR SECTION Part A Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this penod 2l Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches" Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics 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 01 5/31/18 21 34 0 0 ' 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 '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 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 (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 (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 " Press Brower Name (Print name) VP of Engineering Title (Print ti (Signature) 6 �. / (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 1, 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 21 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 =__> _ - 1s 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/l/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 • 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 Marl an original and one co2F 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 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 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) 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 5/11/18 CERTIFICATE OF COVERAGE NO NCG030660 FACILITY NAME Matlab-49S Campus COUNTY Randolph PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis Part A Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or ® Monthly' April_ _(month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply []SA R82CwI ED ®Other MAY S 1 2018 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 DERV FILES CTiQN ❑ No discharge this period?' Outfall No Date Sample ate Collected' (mo/dd/yr) 24-hour rainfall amount, Inches; Total Suspended Solids PH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics Benchmarks =__> - - 100 mg/L or 50 mg/L° 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 4/26/18 50 10 00054 0 019 I 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 ram gauge Unattended sites may be 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 (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 " Press Brower Name (Print name) VP of Engineering Title (Print 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 m 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 2z Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches 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 z, or Tier 3 responses See General Permit text FOR PART A AND PART B MONITORING RESULTS • A BENCHMARK EXCEEDANCE TRIGGERS TIER I 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 it SECTION B • TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL7 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 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 Mad 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 am aware that there are significant penalties for submitting false information, including the possib(lity of fines and imprisonment for knowing violations " J (Signature of Permittee) (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 3 30 18 CERTIFICATE OF COVERAGE No-NCG030660- FACILITY NAME Matlab-49S Campus COUNTY Randolph PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis hWA Cora Part A Stormwater Benchmarks and Monitoring Res@WF? S CTION SAMPLE COLLECTION YEAR_2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or ® Monthly'_ March (month] DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout []PNA ❑Zero -flow ❑Water Supply ❑SA ®Other PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ® No discharge this period a1 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 Organics-' Benchmarks =__> - - 100 mg/L or 50 mg/O 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 No Flow ' 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 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 (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 maybe 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 " Press Brower Name (Print name) VP of Engineering Title (Print title (Signature) S 2.2— 1® (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 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 5U 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 5WU-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 II SECTIONS • 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 Mall 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" reparts)_to Division of Water Quality Attn DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699 1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the Information submitted Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations " (Signature of Permittee) Permit Date 11/1/2012 10/31/2017 (Date) 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 3/2/1 CERTIFICATE OF COVERAGE NO NCG030660 FACILITY NAME Matlab - 49S Camaus COUNTYGuilford PERSON COLLECTING SAMPLES Colleen McLaughlin _ LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis Part A Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ® Jan -June ❑ July -Dec or ❑ Monthly' _ (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA RECEIVED ❑Zero -flow [-]WaterSupply ❑SA APR 10 2018 ®Other CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 UPIR SECTlorJ' ❑ No discharge this period?z Outfall No Date Sample Collectedi (mo/dd/yr) 24-hour rainfall amount, In€heS3 Total Suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organi& Benchmarks - - 100 mg/L or 50 mg/O 6 0 - 4 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 2/12/18 025 55 63 0 032 0 0 036 0 N/A 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 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 46912, 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-gas, 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), 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 5tormwater Pollution Prevention Plan " Press Brower Name (Print name) VP of Engineering Title 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/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 dischorge this period?2 Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches 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 5U 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 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 TAME Mail an original and one copy of this DMR,_mcludlnm 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 am aware that there aFe4imficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations " (Signature of Permittee) -s Z.Z / 9 ( 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 2109118 CERTIFICATE OF COVERAGE NO NCG030660 FACILITY NAME Matlab —49S Campus COUNTY Randolph _ PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis Part A, Starmwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or ® Monthly'_ Jan _ _ tmonth) RECEbI,4$ A .GING TO CLASS ❑ORW^❑HOW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA FEB 21 2018 ®Other CENTRAL FILES MR SECTION' PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 No discharge this erlod?2 Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches' Total Suspended Solids PH. Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics; Benchmarks ===> - - 100 mg/L or 50 mg/L' 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg%L 15 mg/L 1 mg/L 01 1/23/18 2 24 0 075 029 ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall zFor 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 a 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 44 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 TCO 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 " Press Brower Name (Print name) VP of Engineering Title (Print 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 m 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 Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches' Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ 1S 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 1, or Tier 3 responses See General Permit text FOR PART A AND PARTS 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 Mall 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" rei?orts)_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 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations " (Signature of Permittee) 7 �� 1 (Date) Permit Date 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certification of Coverage No Facility Name County Permd No NCG03000 Matlab Inc - Plant Hwy 49S Randolph res. 10/31/18 Asheboro North Carolina Inspector Name Date of Inspection Paul W S an enber 1123/18 OUTFALL DESCRIPTION Outfall No Structure (pike ditch etc) Receiving Stream 1 Pipe Hasketts Creek Describe the industrial actrndes that occur within the outfall drainage area Painting 8 Coating Manufacturing Color Describe the color of the discharge using basic colons (red brawn blue etc) and tint (light medium dark) as descriptors Light Tart Odor Describe any distinct odors that the discharge may have (i a smells strongly of oil weak chlorine odor etc ) None Clanty Choose the number which best describes the clarity of the discharge where 1 is dear and 10 is very cloudy (circle one) 1 a2 3 4 5 6 7 8 9 10 Floabn Solids _ Choose the number which best describes the amount of floating solids in the storrawater discharge where 1 is no solids and 10 is the surface is covered in floating solids (circle one) iO 2 3 4 5 B 7 8 9 10 Suspended Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10 is extremely muddy (circle one) 1 9 3 4 5 6 7 8 9 10 Foam Is Cherie any loam in the stormwater discharge (circle one)? Yes 1-19 Oil Sheen Is there an oil sheen in the stormwater discharge (circle one)? Yes No Erosion Depositiog.,y Is there evidence of erosion or deposition at the outfall? (circle one) Yes No If yes list and describe In drainages ditches preceding and proceding outfa Other Is there other obvious indicators of stormwater pollution in the stormwater discharge (circle one} Yes No If yes list and describe Rain Event Was this a Representative Storm Event? X Yes No Total Event Precipitation (tnchesL2 A measurable storm event is a storm event that results in an actual discharge from the permetted site outfalL The previous mi asurable storm event must have been at least 72 hours poor Certification By this signature 1 certify that this report is accurate and complete to the best of my knowledge Inspector's Signature PaId STORMWATER FACILITY INSPECTION FORM Facility Name Location Certification of Coverage No NCG030660 Matlab Inc —Plant Hwy 49S Asheboro North Carolina Expires 10/31/2018 Number of Inspector's Name Date Qutfalls Paul W Spangenberg 1 /23118 1 Con ng Areas Evidence of pollutants entering system (circle one) Yes No If yes describe Areas of potential pollutants entering system Describe None Control measures present (circle one) Yes No If yes describe Additional control measures needed (circle one) Yes No It yes describe Erosion control in drainage ditches Sediment and erosion control measures present (circle one) es No T It yes describe Rip7lRap at dischaEge and drainages ditches Describe any new structural stormwater management measures None — Potential Pollutant Areas _ Descnbe any loading/unloading operations Trucking Tank Truck Describe any outdoor storage actiwhes Wood Pallets Scrap Metal Solid waste dumpsters, used equipment Descnbe any outdoor manufacturing or processing activities None Descnbe and dust or particulate generating areas None Descnbe any onsite waste disposal activities - - — — -- None Significant V.Aks or Spills _ Any reportable spills or leaks in the past year (circle one) Yes No If yes date Impact on stormwater system(s) Y Certification _ By this signature I certify that this report is accurate and complete to the best of my knowledge Inspector's Signature P"I W RAIN EVENT DATA FACILITY Matlab Inc - Plant Hwy 49S Campus ADDRESS 1112 Highway 49 South Asheboro, NC 27204 CONTACT PERSON Press Bawer TELEPHONE 336- 629-4161 STORM EVENT INFORMATION YEAR MONTH DAY DATE 2018 1 23 HOURS MINUTES DURATION 4 30 PRECIP AMOUNT (IN) 2" RUNOFF 013 VOL M/GAL HOURS DAYS PRECEDING 0 _ EVENT 7 PRINCIPLE EXECUTIVE OFFICER OR AUTHORIZED AGENT PRINT SIGNATURE DATE Paul W Spangenberg n/// ,o _ _ _ 012y4f �rnniaM ®©LABORATOWS, 1wc Full Service Analytical & Environmental Solutions Mid -Atlantic Associates Inc -Raleigh Paul Spangenberg 409 Rogers View Court Raleigh NC 27610 NC Certification No 402 Case Narrative NC Drinking Water Cert No 37735 02/05/2018 SC Certification No 99012 Protect Matlab - #11 Asheboro N Fayetteville St Lab Submittal Date 01/25/2018 Prism Work Order 8010361 This data package contains the analytical results for the project identified above and includes a Case Narrative Sample Results and Chain of Custody Unless otherwise noted all samples were received in acceptable condition and processed according to the referenced methods Data qualifiers are flagged individually on each sample A key reference for the data qualifiers appears at the end of this case narrative Please call of you have any questions relating to this analytical report Respectfully PRISM LABORATORIES, INC Angela D Overcash VP Laboratory Services Data Qualifiers Key Reference Reviewed By Angela D Overcash VP Laboratory Services HT Sample received and analyzed outside of the hold time BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference * Results reported to the reporting limit All other results are reported to the MDL with values between MDL and reporting limit indicated with a J This report should not be reproduced except in its entirety without the written consent of Prism Laboratories Inc 449 Springbrook Road P O Box 240543 Charlotte NC 28224-0543 Phone 7041529 6364 Toll Free Number 1-8001529-6364 Fax 7041525-0409 Fl LROR,I �, Y , E Eovimnmiental 5 to ions Sample Receipt Summary 02/05/2018 Prism Work Order 8010361 Client Sample 10 Lab Sample ID Matrix date Sampled Date Received 01 8010361-01 Water 01123118 01/25/18 01 8010361-02 Water 01123118 01/25/18 Samples were received In good condition at 2 5 degrees C unless otherwise noted This report should not be reproduced except in its entirety without the written consent of Prism Laboratories Irrc 449 Spnngbrook Road P 0 Box 240543 Charlotte NC 28224-0543 Phone 7041529 6364 Toll Free Number 1-8001529.6364 Fax 7041525-0409 G t S M Full Service Analytical Environmental Satutlons Di.eowre�a Me Mid -Atlantic Associates Inc -Raleigh Attn Paul Spangenberg 409 Rogers View Court Raleigh NC 27610 Project Matlab - #11 Asheboro N Fayetteville St Sample Matrix Water Laboratory Report 02/0512018 Client Sample ID 01 Prism Sample ID 8010361-01 Prism Work Order 8010361 Time Collected 01/23/18 08 30 Time Submitted 01/25118 08 45 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor Datetrime ID Total Metals Copper 0 075 mg1L 0 010 00010 1 2007 1/31118 20 55 JAB P8A0462 Zinc 029 mgli- 0 030 00013 1 *200 7 1131118 20 55 JAB PSA0462 This report should not be reproduced except in its entirety without the written consent of Prism Laboratones Inc "0 Springbrook Road P O Box 240543 Charlotte NC 28224-0543 Phone 7041529-6364 Toll Free Number 1 800/529 6364 Fax 7041525-0409 Ar RISM Furl Service al Solutions d Environmental Solvtlone �+�eonhTdllEA NIG Mid Atlantic Associates Inc -Raleigh Attn Paul Spangenberg 409 Rogers View Court Raleigh NC 27610 Project Matlab - #11 Asheboro N Fayetteville St Sample Matrix Water Laboratory Report 02/05/2018 Client Sample ID 01 Prism Sample ID 8010361-02 Prism Work Order 8010361 Trme Collected 011231180835 Time Submitted 01125/18 08 45 Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch Limit Factor DatelTime ID General Chemistry Parameters PH 6 5 HT pH Units 1 SM4500 H 9 1125118 14 29 BMS P8A0375 Total Suspended Sollds 24 mg1L 50 040 1 SM2540 D 1129/18 12 22 SLS P8A0425 This report should not be reproduced except in its entirety without the written consent of Prism Laboratories Inc 449 Springbrook Road P O Box 240543 Charlotte NC 28224-0543 Phone 7041529-6364 Toll Free Number 1 800/529 6364 Fax 7041525-0409 i� ti n n Full s Analytical 8 Environmeronmental Solutions ��aon�iaaca Y+c Mid -Atlantic Associates Inc -Raleigh Attn Paul Spangenberg 409 Rogers View Court Raleigh NC 27610 Total Metals Quality Control Analyte Project Matlab - #11 Asheboro N Fayetteville St Level II QC Report 215/18 Prism Work Order 8010361 Time Submitted 1/25/2018 8 45 OOAM Reporting Spike Source %REC RFD Result Limit Units Level Result %REC Limits RFD Limit Notes Batch PBA0462 200 7 Blank (P8A0462 BLK1) Prepared & Analyzed 01/31/18 Copper BRL 0 010 mg/L Zinc BRL 0 030 mg/L LCS (PBA0462 13S1) Prepared & Analyzed 01/31/18 Copper 0 529 0 010 mg/L 05001 106 85 115 Zinc 0 537 0 030 mg1L 05001 107 85 115 This report should not be reproduced except in its entirely without the written consent of Prism Laboratories Inc "0 Springbrook Road P O Box 240543 Charlotte NC 28224 0543 Phone 7041529-6364 Toll Free Number 1-8001529 6364 Fax 7041525-0409 Lk'_�R, I S M Full Service Analytical & I=vEnvironmental Solutions uao�rne Level II QC Report 215/ 18 Mid Atlantic Associates Inc -Raleigh Project Matlab - #11 Asheboro N Prism Work Order MOW Attn Paul Spangenberg Fayetteville St Time Submitted 1125/2018 8 45 OOAM 409 Rogers View Court Raleigh NC 27610 General Chemistry Parameters Quality Control Reporting Spike Source %REC RPD Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes Batch P8AO375 • NO PREP LCS (P8A0375 861) Prepared iS Analyzed 01/25/18 pH 690 pH Units 6 880 100 98 5-101 5 Duplicate (PBA0375 DUPI) Source 8010381 02 Prepared & Analyzed 01/25/18 pH 658 pH Units 654 06 10 Batch PSA0425 NO PREP Blank (P8A0425 BLKI) Prepared & Analyzed 01/29/18 Total Suspended Solids BRL 50 mg1L LCS (PBA0425 BSI) Prepared & Analyzed 01/29/18 Total Suspended 5oWr, 460 so mg/L 4770 97 90 110 Sample Extraction Data Prep Method 200 7 Lab Number Batch Initial Final aatelrims 8010361 01 PBA0462 50 mL 50 mL 01/31/18 8 30 This report should not be reproduced except in its entirety without the written consent of Prism Laboratories Inc 449 Springbrook Road P O Box 240543 Charlotte NC 28224.0543 Phone 704/529 6364 Toll Free Number 1 800/529 6364 Fax 704152"409 a I PRISM tJ400f1ATOhiBa INC CHAIN OF CUSTODY RECORD --a5zL6k PAGE OF I QUOTE N TO ENSURE PROPER BILLING PaIA Full Service Analytical s Environmental Solutiom Matlab #11 Project Name 449 Springbrook Road • P O Box 240543 • Charlotte, NC 29224-0543 Phone 7041529-5364 • Fax 704/525-0409 Short Hold Analysis (Yes) (ND) LIST Project: (Yes) (No) Client Company Name Mid-AtIantic Associates "Please ATTACH any project specific reporting (QC LEVEL f II III M Report To/Contact Name Pau' Sp-9enh°`s provisions and/or OCReequirements Invoice To�Uwia s soclatos 4oRo�nvwC deiD Address Address 41I3 Roger View Court R9ietgh NC 2761e Rme ph Nc reto Phone (919) 250-Mli Fax (Yes} (ND) (9t91 MO'9S50 z.r_ 3 wk Email (Y s} (NO) Email Address Purchase Order NoJOilling Reference R2a43 TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Requested Due Date 1 Day 2 Days 3 Days 4 Days 5 Days Certification NELAC USACE rL NC It EDD Type PDF Exeel_Other "Working Days" 6-9 Days 1 Standard t0 days Site Location Name WOO Pranl0ll SC_ OTHER N/A Samples received After 15 00 will be processed next business day Site Location Physical Address Asheboro NC Tumaround time Is based on business days excluding weekends and holidays Water Chlorinated YES— NO _ (SEE REVERSE Pop TERNS A CONOMONB REiMARDING SERVICES Sample Iced Upon Collection YES NO RENDERED BY PRISM LABORATORIE3, INC TO CLIENT) TIME MATRIX SAMPLE COf+ITAINER ANALYSES REQUESTED CLIENT SAMPLE DESCRIPMN DATE COLLECTED COLLECTED MILn'ARY HOURS (SWL WATER OR SLUDGE) PRESERVA TiVES REMARKS QAof./Z PRISM ID `TYPE SEE BELOW NO SIZF 01 1/23/2018 08 30 Water P 1 OZ NFV02 ,% Cu ZN 01 1/23/2018 08 35 Water P 1 Pt None Water IG S ' Colleen McLaughlin Matlab, Inc ampled By {Pr[nt Name) Affiliation this Chain of Custody s your authomation for Prism to proceed With the analyses as requested above Any changes must be to the Prism Prolect Manager There will be charges for any changes afterlwaWaasi have been Initialized y.� SAMPLES ARE NOT ACCEPTED AND VERIRED AQAIN IME LABORATORY ^i FedFed Ex� UPS Hann-awxrora Prfsm serf se>vra an«ILANDFILL N NDC S Sq UST C _ SC GRIOUNDSCTER ` D[NICKiNSCATER SOLID WASTESC J R NC _ SC C NC LA SC LAN — SC I OTHER SC CONTAINER TYPE CODES A = Amber C = Clear G = Glass P = Plastic TL = Teflon Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) Additional Comments Rain" ORIGWAI_ Semi-annual Stormwater L _narge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 1/10/18 CERTIFICATE OF COVERAGE NO NCG030660 FACILITY NAME Matlab _49S Campus COUNTYGuilford PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism _ _ Lab Cert # 402 Comments on sample collection or analysis Part A Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2017 �E��IVMfb PERIOD ❑ Jan -June ® July -Dec �/ LJ or ❑ Monthly' _ (month) JAN 2 4 DJ�TARGING TO CLASS ❑ORW ❑HQW [--]Trout ❑PNA ❑Zero -flow ❑Water Supply []SA CENTRAL FILES ®Other DWR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this period;2 Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Total suspended Solids pH, Standard units Copper Lead Zinc Non -Polar O&G/Total Total Petroleum Hydrocarbons Toxic Organics' Benchmarks 100 mg/L or 50 mg/L° 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 12/20/17 1 140 7 1 0 022 00072 0 078 0 N/A ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfail 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 rain gauge requirement ° 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 11/1/2012 10/31/2017 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities t icurporate a solvent management plan into the Stormwater PL on Prevention Plan may so certify, and the requirement for TTO i toring 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 l further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan Press Brower Name (Print name) VP of Engineering__ Title (P 1, z-6 13 (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 !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 8• 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, Inches' Non -polar 0&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 y ,port a sample value in excess of the benchmark, you mast imp ent Tier 1, Tier 2, or Tier 3 responses See Genera! 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 ANYONE 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, with►n 30 days of recut +? f the lab resalts1or at end of monitoring period in the _case _of "No Discharge" reports) to Division of Water QualityT ^ 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 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations " 16 /� (Signature of Permittee} (Date) Permit Date 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 STORMWATER DISCHARGE OUTFALL (SDO) ANNUAL SUMMARY DATA MONITORING REPORT (DMR) ! SPPP Annual Update DATA REVIEW FORM Calendar Year 2017 ti" r Individual NPDES Permit No NCS❑❑[]F7E or Certificate of Coverage (COC) No NCG030660 RECEIVED This monitoring report summary of the calendar year should be kept on file on -site withA4 &611W ?SPPP CENTRAL FILES Facility Name Matlab. Inc — 49 S Campus DWR SECTION County Randolph Phone Number (3361629.4161 Total no of SDOs monitored 1 Outfall No 1 Is this outfall currently in Tier 2 (monitored monthly)? Yes ® No ❑ Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency ❑ Received approval from DWQ to reduce monitoring frequency ❑ Other ❑ Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No SWU-264 - Generic Annual DMR Last revised 511712013 Additional Outfall Attachment Outf,7ll No Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No ❑ Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑ If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency ❑ Received approval from DWQ to reduce monitoring frequency ❑ Other ❑ Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ❑ SWU-264 - Generic Annual DMR Last revised 5Vf712013 Additional Gutfall Attachment Outfall No Is this outfall currently in Tier 2 (monitored monthly)? Yes [] No ❑ Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑ If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency ❑ Received approval from DWQ to reduce monitoring frequency ❑ Other ❑ Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ❑ Total Rainfall, inches Parameter, (units) TSS pH Copper Lead Zinc O & G TTO Benchmark N/A 100 mg1L 6 0-9 0 Units 0 007 mg1L 0 03 mg1L 0 067 mg1L 15 mg1L 1 mg/L Date Sample Collected, mmiddryy SWU-264 - Generic Annual DMR Last revised 5/17/2013 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 " Print Press Brower. VP c Signature Date / 1-6 /R For questions, contact your local Regional Office DWQ Reamnal Office Contact Information ASHEVILLE REGIONAL OFFICE 2090 US Highway 70 Swannanoa, NC 28778 (828) 296-4500 RALEIGH REGIONAL OFFICE 3800 Barrett Drive Raleigh, NC 27609 (919) 791-4200 WINSTON-SALEM REGIONAL OFFICE 585 Waughtown Street Winston-Salem, NC 27107 (336) 771-5000 FAYETTEVILLE REGIONAL OFFICE 225 Green Street Systel Building Suite 714 Fayetteville, NC 28301-5043 _ (910) 433-3300 WASHINGTON REGIONAL OFFICE 943 Washington Square Mall Washington, NC 27889 (252) 946-6481 CENTRAL OFFICE 1617 Mail Service Center Raleigh, NC 27699-1617 (919) 807-6300 MOORESVILLE REGIONAL OFFICE 610 East Center Avenue/Suite 301 Mooresville, NC 28115 (704) 663-1699 WILMINGTON REGIONAL OFFICE 127 Cardinal Drive Extension Wilmington, NC 28405-2845 (910) 796-7215 'To preserve, protect and enhance North Ceram s water i SWU-264 - Generic Annual DMR Last revised S/17/2013 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 9_/ 9116 CERTIFICATE OF COVERAGE NO NCM0660 FACILITY NAME Matlab, Inc — Plant 11 COUNTY Guilford PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis Part A Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2016 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' _ (month), DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA RECEIVED ❑Zero —low ❑Water Supply ❑SA Other NOV 0 7 2016 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 CENTRAL FILES DWR SECTION ❑ No discharge this penod ';1 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 Total Petroleum Hydrocarbons Toxic Organicss Benchmarks ==-> _ - 100 mg/L or 50 mg/1.4 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 9/19116 100 66 0 0 0 0 N/A ' 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 'The 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 (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 (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 " Press Brower Name (Print name) VP of Engineering Title (Print title) fvA-A (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?2 Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches-3 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 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 Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text FOR PART A AND PART B MONITORING RESULTS • ' A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS SEE PERMIT PART II SECTION B • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS SEE PERMIT PART II SECTION B • TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL7 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, 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 1017 J6 (Da e) 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 5125/16 CERTIFICATE OF COVERAGE NO NCG030660 SAMPLE COLLECTION YEAR 2016 FACILITY NAME Matlab Inc —Plant 11 SAMPLE PERIOD ® Jan -June ❑ July -Dec COUNTY Guilford jj1 'C or ❑ Monthly' (month) PERSON COLLECTING SAMPLES Colleen McLaughlin EC E I V E DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA JUN 14 2616 ❑Zero -flow ❑Water Supply ❑SA LABORATORY Prism Lab Cert # 402 ❑Other Comments on sample collection or analysis � CENTRAL FILE DWR SECTIQ PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 w� , Part A Stormwater Benchmarks and Monitoring Results ❑ No discharge th1slperrod?2 Non -Polar O&G/ Outfall No Date Sample 24-hour rainfall Total Suspended Solids pH, Copper Lead Zinc Total Petroleum Total Toxic 1 Collected' , amoun Standard units � Hydrocarbons3 Organics s (mo/dd/yr) Inches Benchmarks =__> - - 100 mg/L or 50 mg/O 6 0 — 9 0 0 007 mg/L 0 03 mg/L mg/L 15 mg/L i mg/L l0V067 01 4/22/16 52 62 0 0 / 0 0 N/A 1i 4 1U/ 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 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 (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 5tormwater 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 5tormwater 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 " Press Brower Name (Print name) VP of Engineering Title (Print title {S�gnature) G 1 16 (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 mi"/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, Inches' 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 8 * 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 • 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 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 that there are significant penalties 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 3 of 3 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG030000 Date submitted 10/15/15 CERTIFICATE OF COVERAGE NO NCG030660 FACILITY NAME Matlab, Inc —Plant 11 COUNTY Guilford^T PERSON COLLECTING SAMPLES Colleen McLaughlin LABORATORY Prism Lab Cert # 402 Comments on sample collection or analysis Part A Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2015 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA"—� ❑Zero -flaw [:]water Supply ❑SJ� RECEIVE® ❑Other 0V 2 3 zolb PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 CENTRAL. FILES DWR SEC' ION ❑ No discharge this period?' Outfall No Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids P pH' Standard units co Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics5 Benchmarks ===> _ - 100 mg/L or 50 mg/L° 6 0 — 9 0 0 007 mg/L 0 03 mg/L 0 067 mg/L 15 mg/L 1 mg/L 01 9/25/15 2 11 23 62 0 0 0 034 0 N/A 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 'The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may he 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 (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 " Press Brower Name (Print name) VP of Engineering Title (Print 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/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 22 Outfall No date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 1S mg/L 100 mg/L or SO mg/L* 6 0 — 4 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/i/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 11 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 OUTFALL7 YES ®NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ED REGIONAL OFFICE CONTACT NAME Mail an original and one copy of this DAM including all "No Discharge" reports, within, 30 do vs of receiptof 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, 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 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations " (Signature of Permittee) // /6-- lS (Date) Permit Date 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012 Page 3 of 3 RAIN EVENT DATA r � rn. a ui FACILII'Y Matlal, Inc ADDRESS 3010 Executive Dive Greensboro, NC 27406 _T _ CONTACT PERSON Press Brower T1~LEPHONI (3„36) 629-4161 _ DATE, I YEAR MONTH DAY 2015 9 25 HOURS MINUTES DURATION - 52 40 PRECIP AMOUNT (IN) 2 11 RUNOFF 028 VOL M/GAL _ _.. HOURS DAYS PRECEDING — EVENT 3 20 &,]L-3 Laboratory Report Ri ISM Fun n d Env�ranmenlel Solutions 10I1212015 .Taxes i+e Leonhardt Environmental PC Project Matlab -Plant 16 Client Sample ID 01 Attn Derr Leonhardt Prism Sample ID 5090505-01 Suite 101 8392 Six Forks Road Prism Work Order 5090505 Raleigh NC 27615 Sample Matrix Water Time Collected 09/25/15 09 30 Time Submitted 09/2911510 08 Parameter Result Unts Report MDL Dilution Method Analysis Analyst Batch Limit Factor DatefTime ID General Chemistry Parameters Oil & Grease (HEM) BRL mg1L 50 048 1 1664B 1018/15 11 35 ARC P5J0161 PH 6 2 HT pal Units 1 SM4600-H B 9129/16 111103 ARC P610654 Total Suspended Sobds BRL mg1L 30 080 1 SM 2540 D 1011115 1 D 15 EGC P5J0015 Total Metals Lead BRL mg1L 00050 000070 1 2007 1016/15 19 37 BGM P5J0092 Zinc 013 mg1L 0 030 00073 1 2007 1016li6 19 37 BGM P6JO092 This report should not be reproduced except in its entirety without the wntten consent of Prism Laboratories Inc 449 Spnngbrook Road P O Box 240643 Charlotte NC 28224-0643 Phone 7041629-0364 Tall Free Number 1-8001529-0364 Fax 70416264409 Page 3 of 6 4 PiiVLABORATORIES, �c ISM iNG Full Service Analytical 8 Environmental Solutions Leonhardt Environmental PC Derr Leonhardt Suite 101 8392 Six Forks Road Raleigh NC 27615 NC Certification No 402 SC Cerbficabon No 99012 NC Drinking Water Cert No 37735 VA Certification No 460211 DoD ELAP L-A B Accredited Certificate No L2307 ISO/IEC 17025 L A B Accredited Certificate No L2307 Project Matlab -Plant 16 Lab Submittal Date 09/29/2015 Prism Work Order 5090505 Case Narrative 10112/2015 This data package contains the analytical results for the project identified above and includes a Case Narrative Sample Results and Chain of Custody Unless otherwise noted all samples were received in acceptable condition and processed according to the referenced methods Data qualifiers are flagged individually on each sample A key reference for the data qualifiers appears at the end of this case narrative Please call if you have any questions relating to this analytical report Respectfully PRISM LABORATORIES, INC a --.-I Angela D Overcash VP Laboratory Services Data Qualifiers Key Reference �r- Reviewed By Tern W Cole For Angela D Overcash Project Manager HT Sample received and analyzed outside of the hold time BRL Below Reporting Limit MDL Method Detection Limit RPD Relative Percent Difference Results reported to the reporting limit All other results are reported to the MDL with values between MDL and reporting limit indicated with a J This report should not be reproduced except in its entirety without the written consent of Prism Laboratones Inc 449 Springbrook Road P O Box 240643 Charlotte NC 28224-0643 Phone 70*529.6364 Toll Free Number 1-8001529-0364 Fax 7041525-0409 Page 1 of 6 _PRISM Erwlronnnen+al Solutions 7uaoa�To�aen i++c Sample Receipt Summary 10/12J2015 Prism Work Order 5090505 Client Sample ID Lab Sample ID Matrix Date Sampled Date Received 01 5090505-01 Water 09/25/15 09/29/15 Samples were received In good condition at 2 0 degrees C unless otherwise noted This report should not be reproduced except in its entirety without the wntten consent of Prism Laboratories Inc 449 Springbrook Road P 0 Box 240643 Charlotte NC 28224-0643 Phone 70NS29.6364 Toll Free Number 1.8001529-0364 Fax 7041626-0d09 Page 2 of 6 dhEnSL1P R 1 r i ervice Analytical & rvkrpnmanlal Sote�lgns mot,, L.eonhardt Environmental PC Project Matlab -Plant 16 Attn Derr Leonhardt Suite 101 8392 Six Forks (toad Raleigh NC 27615 Total Metals - Quality Control Level II QC Report 10112115 Prism Work Order 5090505 Time Submitted 9/29/2015 10 08 OOAM Reporting Spike Source %REC RPD Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes Batch MOM - 200 7 Blank (P5J0092-BLK1j Prepared & Analyzed 10/06115 Lead 13RL 0 0050 mg1L Zinc BRL 0 030 mg1L LCS (PSJ0092-BS1) Prepared & Analyzed 10106115 Lead 0 268 Coosa mg1L 02500 107 85-115 Zinc 0 275 0 030 mg1L 0 2500 110 65 115 This report should not be reproduced except in its entirety without the wntten consent of Prism Laboratories Inc 449 Springbrook Road P O Box 240643 Charlotte NC 28224-0543 Phone 7041629.6364 Toll Free Number 14001529-0364 Fax 7041625-0409 Page 4 of 6 n Service S Zn'_ ISM f Enwonaental Solutions usoiu70A,M m Leonhardt Environmental PC Project Matlab -Plant 16 Attn Derr Leonhardt Suite 101 8392 Six Forks Road Raleigh NC 27615 General Chemistry Parameter& - Quality Control Analyte Batch P510554 - NO PREP Reporting Result Limit Units Level II QC Report 10112115 Prism Work Order 5090505 Time Submitted 9/29/2015 10 08 OOAM Spike Source %REC RPD Level Result %REC Limits RPD Limit Notes LCS (P510654-BS1) Prepared & Analyzed 09/29/15 pH 6613 pH Units 6 880 99 985 1015 Batch P5J0015 - NO PREP Blank (P5J0015 BLKI) Prepared & Analyzed 10/01/15 Total Suspended Solids BRL 50 mg1L LCS (PSJ0015-13SI) Prepared & Analyzed 10/01/15 Total Suspended Solids 460 50 mglL 4770 97 90-110 Batch PSJ0161 - NO PREP Blank (PSJ0161-BLK7) Prepared & Analyzed 10108/15 Oil & Grease (HEM) SRL 50 mgfL LCS (P5.10161-BS1) Prepared & Analyzed 10108/15 Oil & Grease (HEM) 343 50 mglL 4000 86 78-114 Sample Extraction Data Prep Method 200 7 Lab Number Batch Initial Final DatefIrime 5090505-01 P5J0092 50 mL 50 mL 10106I15 8 35 This report should not be reproduced except in its entirety without the written consent of Prism Laboratories Inc 449 Springbrook Road P O Box 240643 Charlotte NC 28224-0543 Phone 7041629-6364 Toll Free Number, 1-8001529-6364 Fax 7041526-0409 Page 5 o 66 Full Service Analytical & CHAIN OF CUSTODY RECORD .r,1 S M I Environmental Solutions PAGE_ OF — QUOTE 0 TO ENSURE PROPER BILLING �` NO WA � ttil ri ,�e, t n, + LAOcRATORIES imC II .1 Samples INTACT upon arrival? `\ Y p 449 Spnngbrook Road Charlotte NC 28217 Project Name ab - T ` Received ON WET ICE? Phone 704/529 6364 Fax 704l525-0409 Short Hold Analysis (Yes) (No) UST Project (Yes) (NO) PROPER PRESERVATIVES indicated? a Client Company Name t"O p, "Please ATTACH any project specific reporting (QC LEVEL 1 II I1I IV) Received WITHIN HOLDING TIMES? _ t cc provisions and/or QC Requirements CUSTODY SEALS INTACT? Report To/Contact Name Y Invoice To Ltor, krA (-A + EAVJ rahn 04c, VOLATILES recd WIOUT HEADSPACE? Reporting Address pe V"Arc 12 A& Address � 3 � a� S l 1t f 6-f k(S (AJ Sill : j 6 { PROPER CONTAINERS usrd7 TEMP Therrn ID IMYiJ O6servLd �_v °C r Corr 2 � °C Phone -r x 11 as) No) Purchase Order No 1BEliing Reference �� r�" TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL Email Address bGI 1 S Requested Due pale ❑ 1 Day E] 2 Pays 03 Days p a Days ❑ s Days Certification NELAC bob FL NC EDD Type PDF�Excel ther Working Days ❑ 6-9 Days O Standard 10 days ❑ pre h WorkMdust Be Site Location Name i — iG Samples received after 14 00 will be processed next business day $�% OTHER NIA Site Location Physical Address N Turnaround time is based on business days excluding weekends and holRfays Water Chlorinated YES— NO� (SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES RENDERED BY PRISM LABORATORIES INC TO CLIENT) Sample Iced Upon Collection YES NO — TIME MATRIX SAMPLE CONTAINER LYSIREQUESTED CLIENT DATE COLLECTED (SOIL { PRESERVA +++,,, SAMPLE DESCRIPTION COLLECTED MILITARY WATER OR TYPE NO E E TIMES , �y� Q��/ / / /l REA1At2lCS PRISM HOURS SLUDGE) SEE BELOWID NO 01 -25-15 61 3 n 9-A-IS 041 W ►boar { P 1 ? JJN0 3 s Sampler s Signature Sampled By (Print Name) Q/)1Sgl Affiliation ` ' Upon relinquishing III Chain of Custody Is your authorization for Prism to proceed with the analyses as requested above Any changes must be ` submitted In writing to the Priam Project Manager There will be charges for any changes after analyses have been Initialized Comments l� ft,01 SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST COC UNTIL RECEIV D AT THE LABORATORY ❑ Fed Ex P5 4 Hand-dalivared O Prism Field Service p gther. NPDES UST GROUNDWATER DRINKING WATER SOLID WASTE RCRA CERCLA LANDFILL OTHER QNCDSC ❑NC ❑SC ONG OSC ❑NC 0SC ❑NC OSC ❑NCC]5C LING ❑SC ❑NC ©SC ❑NC ❑SC ❑ D D ❑ D o ❑ ❑ D "CONTAINER TYPE CODES A = Amber C = Clear G= Glass P = Plashc TL = Teflon Lined Cap VGA = Volatile Organics Analysis (Zero Head Space) RE r • $ Site Arnva4 Time Site Departure Time Field Tech Fee Mileage (-)PIr INA1