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HomeMy WebLinkAboutNCG060026_MONITORING INFO_20160204a O SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 1 - 2 1 - ) (,p RECEIVED FEB 0 4 2016 CERTIFICATE OF COVERAGE NO. NCG06 O SAMPLE COLLECTION YEAR ;2-o l� CENTRAL FILES FACILITY NAME e LA -_-a e NO A�: "C-e. FACILITY ACTIVITIES INCLUDE (check all that apply): ,1NIR SECTIOt" COUNTY ant « ❑ use/process meats ❑ use animal fats/byproducts PERSON COL CTEL 114G SAMPLES 1.Q 44L- DISCHARGING TO SALTWATERS? ❑YES 2gNO LABORATORY Cy%� r7t: Lab Cert. # 3-7-2-2-1 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 a� Total event rainfall 2 Z or ❑ No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L p Standard units COD, mg/L Oil and Grease, mg/L. _ Fecal Coliform ,. Colonies_per 100 ml �nterococH, .ci , Colonles;per 100 ml Benchmark - 100 or 564 Within 6.0'- 9:0 ' 120' 30 1000 500 j i Z/ o S (4 a Z- I 30 ,a S ,a 4.L 4 5 2_/3o,s 14.0 4?.1 �d �- 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at A" outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Eno Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil"end'GA ase, Mg/L TSS, ._mg/L'- �- ; pH, _ r=- Standa�d:unitst ; New Motor Oil Usage, v Anndal-ave�agegal/mo Benchmark - 30 100 or SO 6.0 — 9.0 - Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at anv outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 11� (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 D­ 1 .,r *FOR PART A -AND PART BNONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART li SECTION B. • 2 EXC£EDANCES 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-onexopy of this DMR; including all "No Discharge" reports; -within 30_days of'receipt`of the4lab results for at end of monitoring period -in the case of "No 'Discharge" reports to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC -27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR,ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with;a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for -gathering the -information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that -there are significant penalties for -submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) - Additional copies of this form may be downloaded at: htt ortai.ncdenr.or web w ws su n dessw#tab-4 SWU-2, — Last Revised�ober 18, 2012 9 ' ~J Page 3 of 2 Inspection Report and Certification form For Storm Water Pollution Prevention Plan Evaluation Owner andlor Operator: Bung_e North America, Inc. „ Facility Name: Meal Transfer Facility Facility Location: Rose Hill, North Carolina T Date and Time: —I1 Inspector(s): �''^ � '4ZI,. � cx Date of Last Rainfall: �_y 2� — is Deficiencies Noted During the Inspection (attach additional sheets if necessary): 001 - 002 - 003 Corrective Action Needed (attach additional sheets if necessary): _ 001= =9� 002 - —4''p- 003 - _ __ 0-- Corrective Action Compliance Schedule: Based upon this inspection which I or personnel under my direct supervision conducted, I certify that all pollution control measures are adequate and have been implemented and maintained, except for those deficiencies noted above, in accordance with the Storm Water Pollution Prevention Plan filed with the Office of Pollution Control and good engineering practices as required by the above referenced permit. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision is 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 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. , Mike Sprinkle llta4 a 44f�-12- Authorized Name (Print) nature Date u r N u HC®ENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: http://portat.ncdenr.or�-,/web/wg/ws/su/npdessw#tab-4 Permit No.: NIC/6' ID IIQI IQI olQl or Certificate of Coverage No.: NIC/G/o /lo I col Facility Name:4•-+, County: A Phone No. 910 -SSZ 002Co Inspector: Date of Inspection: 3d - r Time of Inspection: 1I k-L, z Total Event Precipitation (inches): Was this a Representative Storm Event? (See information below) 'S Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this re ort is accurate and complete to the best of my knowledge: (Signature of Permittee or Designel) 1. Outfall Description: Outfall No. _ :3Structure (pipe, ditc ,etc.) Receiving Stream: _ 04,,<2 Describe the industrial activities that occur within the outfall drainage area: — 2. Color: Describe the color of the discharge usin basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: tcl 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): N 0- SWU-242-20120613 Page I of 2 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: t 20 31 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the O stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stonnwater discharge, where 1 is no solids and 5 is extremely muddy: I L2D 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes 60) 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe__ Note: Low clarity, high solids, and/or the. presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 swU-242-20120613 • Xj7i NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this fonn, please visit: hitn://Portal.nedetir.orJweb/wg/ws/su/nntiessw#tab-4 Permit No.: NICI11 vl (PIel of Facility Name: County: Lnj - Inspector: U-� or Certificate of Coverage No.: N/C/GlL)l (a/Cl/ 3/2-I(J Date of Inspection: I ;� 10 ^tom Time of Inspection: &S6� Total Event Precipitation (inches): 2`' No. 2/ `0 - 5,T2- 60.2(o Was this a Representative Storm Event? (See information below) [f Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0. l inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signat'jurre,- I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or besignee) 1. Outfall Description: n , Outfall No. L Structure (pipe, ditch, etc.) �(�!►--e _ Receiving Stream: �bt+J"._ Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Wu-c�2 �JV`auM� 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 74,- 5WU-242-20120613 Page I of 2 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: r 5. Floating Solids: Choose the number which best describes the amount of floating solids in the O stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: 1 2 6 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 �J 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes N� 9. Is there evidence of erosion or deposition at the outfall? Yes oNo 10. Other Obvious In��drricators of Stormwater Pollution: List and describe I.` Note: Low clarity, high solids, and/or the. presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 i SWU-242-20120613 C� x Ar-W NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: http://Vortal.ncdenr.or<_,/web/wg/ws/su/np(lessw#tab-4 Permit No.: NIC/G Facility Name: County: Inspector: Date of Inspection: Time of Inspection: old /Qlcal 'otr Certificate of Coverage No.: NIC/G/D /f916131 ZI Q lI h-CAA tt Total Event Precipitation (inches): Phone No. 91 o ` 5Q- — 60 zb Was this a Representative Storm Event? (See information below) T. Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify Pat this report is accurate and complete to the best of my knowledge: (Signature of PermitteIor Designee) 1. Outfall Description: Outfall No. t Structure (pipe, ditch, etc.) Receiving Stream: arc � : -�-� L Describe the industrial activities that occur within the outfall drainage area: oaj�:,.�, � 126 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: _ h!'L tifJlrac. 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 1 0-� r 5 WU-242-20120613 Page I of 2 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 0 3. 4 5 �J 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 a 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 (�2) 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. 1s there an oil sheen in the stormwater. discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the -presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5WU-242-20120613 X, .^......� ]ram NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this fonn, please visit: hup:HVortal.ncdenr.or_,/web/wg/ws/su/np(lessw#tab-4 Permit No.: NIC/G IOICo/ D/0/ol01 or Certificate of Coverage No.: NICIG/01(0/0131 z l 6l Facility Name: Nor-(-., 6P— J c.,- - County: Phone No. 910 — SSZ — 0 o 2- L o Inspector: Date of Inspection: Time of Inspection 015 Total Event Precipitation (inches): �� CENTRAL FI DINR SECTION Was this a Representative Storm Event? (See information below) ❑ Yes ®- No Please check your permit to verify if Qualitative Monitoring must be performed during a representative rV storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and th, is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has` R occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or De, ignee) 1. Outfall Description: Outfall No. I Structure (pipe, dii h, etc.) . /"1 Oe Receiving Stream: `�z ,,,_PCttLd Describe the industrial activities that occur within the outfall drainage area:_,Q,�,,= �0� 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: G P--,2� — V"( u" 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): t401-c-P S W U-242-201206 13 Page I of 2 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 0 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: I (D 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy- 1 (D 3 4 5 7. Is there any foam in the stormwater discharge? Yes No S. Is there an oil sheen in the stormwater discharge? Yes O 9. Is there evidence of erosion or deposition at the outfall? Yes ONo 10. Other Obvious Indicators of Stormwater Pollution: 1 _J List and describe a Note: Low clarity, high solids, and/or the.presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. r Page 2 of 2 SWU-242-20120613 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: http://portal.nc(lenr.orJwei)/wq/ws/su/npdessw#tab-4 Permit No.: NICI19 l01 6 Facility Name: _ County: Inspector: Date of Inspection: Time of Inspection: 'o /o / or Certificate of Coverage No.: N/C/G/a 1(Q /O /312-161 U ^ 6ro r.. (.30 -rs Total Event Precipitation (inches): -&-� Phone No. 910 -5 L Was this a Representative Storm Event? (See information below) ❑ Yes &[ No Please check your pennit to verify if Qualitative Monitoring must he performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: R _ ,.. A n (Signature of Permittee or De'gignee) 1. Outfall Description: ,Q , Outfall No. 2—Structure (pipe, ditch, etc.) ! - t � Receiving Stream: t4c.� Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the (light, medium, dark) as descriptors: _ using basic colors (red, brown, blue, etc.) and tint J 3. Odor: Describe any distinctodorsthat the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): t� t�t��o �j Page 1 of 2 Swt3-242-201206 i 3 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 111A 1 2 3 4 5 ' �J 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: !~/R- 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: �/r} 1 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the, presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. M1 Page 2 of 2 5wU-242-20120613 U U A NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: htip:/Iportal.ncdenr.or<_,/web/wq/ws/su/npdessw#tab-4 Permit No.: N1C16 Facility Name: County: Inspector: . Date of Inspection: _ Time of Inspection: or Certificate of Coverage No.: NIC/G/o l6 / o / 31-2-I Q Total Event Precipitation (inches): Phone No. 71 O - Z— o a Was this a Representative Storm Event? (See information below) ❑ Yes E�-No Please check your pertnit to verify if Qualitative Monitoring must be perforned during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3. days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: S (Signature of Permittee or Designee 1. Outfall Description: Outfall No. 3 Structure (pipe, ditch, etc.) Receiving Stream: Describe the industrial activities that occur within the out�fall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: zcqx--- S t� AL-Qc.,AA — 144- Ar 1.,-- . 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): / �iT n < 5 W U-242-20120613 Page I of 2 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: I 2 � 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 0 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: ,. 3 4 5 T 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes ONO to. Other Obvious indicators of Storrmwater Pollution: List and describe d�rA[� D 1� G A 1 Note: Low clarity, high solids, and/or the.presence offoam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. r t Page 2 of 2 SWU-242-20120613 7A O Inspection Report and Certification Form For Storm Water Pollution Prevention Plan Evaluation Owner and/or Operator: Facility Name. - Facility Location: Date and Time: Bunge North America, Inc. RECEIVED JUL 2 7 2015 Meal Transfer Facility CENTRAL FILES Rose Hill, North Carolina DWR SECTIOn, Inspector(s):1`� Date of Last Rainfall:n"�- Deficiencies Noted During the Inspection (attach additional sheets if necessary): 001 - �� 002 - tgall-e, 003 - /4 a-l—f- Corrective Action Needed (attach additional sheets if necessary): 001 - l`,�1QWp 002__ 003 - Corrective Action Compliance Schedule: Based upon this inspection which I or personnel under my direct supervision conducted, I certify that all pollution control measures are adequate and have been implemented and maintained, except for those deficiencies noted above, in accordance with the Storm Water Pollution Prevention Plan filed with the Office of Pollution Control and good engineering practices as required by the above referenced permit. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision is 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 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. Mike Sprinkle /' 3d --rS Authorized Name (Print) gnature Date o 'D SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted _ 4 - !o ~- ( 9- CERTIFICATE OF COVER�GE NO. NCG06 SAMPLE COLLECTION YEAR O I FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING AMPLES U. DISCHARGING TO SALTWATERS? DYES ENO, LABORATORY Lab Ce . # Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Totol event rainfall z or tg No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L. Fecal Coliform , IEnterococci Colonies. per 100 ml , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120' 30 1000 500 I Only applies to facilities that use/process meats. zThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes K_no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, ma/dd/yr Oil and Grease, mg/L TSS, mg/L - pH, O'Standard uhitsl� - New Motor Oil Usage, -`Annuai-ave'age gal/ino ' Benchmark - 30 100 or 50 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. zThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (Lies , complete Part 8) o SWU-249 Last Revised: October 18. 2012 n___ + _r *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 II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NOK 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`ot the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified 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 1016fmittee) (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-2 Last Revised ober ]8, 2012, \—/ Page 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted $ - -j-& - CERTIFICATE OF COVERAGE NO. NCG06 o SAMPLE COLLECTION YEAR -2a Ilz FACILITY NAMEFACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY(, _ ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Ga �, �►-a.-, s_�... DISCHARGING TO SALTWATERS? DYES ONO LABORATORY E, rd L Lab Cert. # 37 7 217 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE -i Total event rainfoll 2 or ❑ No discharge this period Outfall No. I Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, rrig/L. Fecal Coliform , Colonies.per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 - 9.0 120 30 1000 Soo I & / q I t711 -7. OQ Sz, 4 S/G 6121 7. to - '2-8 `ice < � -7.0 s 4j L 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes �9 no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, _ mg/L pH, -'Standard units. - New Motor Oil Usage, � 'Annda average gal/mo Benchmark - 30 100 or SO 6.0 - 9.0 - (i-f Yes' complete Part B) RECEIVED AUG 2 G 2014 CENTRAL FILES DWQ/SQG 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SW U-249 Last Revised: October 18. 2012 *FOR PART A -AND PART B&MONITORING RESULTS: ! A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE'PERMIT PART II SECTION B. 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE -SAME PARAMETER AT ANY ONE OUTFALL? YES [-]NOS 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, withiw30 days of'receipt-ofthe-Ia6 results for at end of monitoring period -inn -the case o "No Discharge" reports to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for -gathering the -information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that -there are significant penalties for.submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of P66'hittee) —2-0 - (Date) _ Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/ngdessw#tab-4 SW U-249 Last Revised: October 18, 2012" Page 2 of 2 ALTTJ`�-A` NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out thisform, please visit: hunt//portal.ncdenr.orJweb/vvq/ws/su/nVdcssw#tab-4 Permit No.: NICI -el of h/ 0101 o/ o/ or Certificate of Coverage No.: N1C1G1 o/ 610/ 3121 GI Facility Name: 6"!t No r' `(, County: Tl, .,� Phone No. 9 f o - 5 2 - oo z (o Inspector: of Date of Inspection: G �2 Time of Inspection. Total Event Precipitation (inches): I "I- ' Was this a Representative Storm Event? (See information below) Y Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements nary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittet,-'dr Designee) 1. Outfall Description: Outfall No. "W-) Structure (pipe, ditch, etc. I-t -� Receiving Stream: t `� v�.~.,�� i A�� Describe the industrial activities that occur within the outfall drainage area: I ^C I A I n 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: tJ►-,� 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): /4111 2- Page t of 2 SWU-242-20120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 6) 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 0 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 L2) 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the. presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 444a NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this fonn, please visit: hilp.//Vortal.nc(leiir-.or�Jwc[Vw(j/ws/sti/npcicssw#tai)-4 Permit No.: NICI6101 G/01 d/ al Facility -Name: � � Y County: Inspector: Date of Inspection: -31- / 9 Time of Inspection: A A-L- or Certificate of Coverage No.: NICIG/0/ 6/0 / 3/ Zl U Total Event Precipitation (inches): 1 tfz " Phone No, Qt 0 - 92 - ego 2-(o Was this a Representative Storm Event? (See information below) E�4 Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of PermitWor Designee) 1. Outfall Description: Outfall No. -0` 7i Structure (pipe, ditch, etc.) Receiving Stream: 0t d, _ Describe the industX al activities that occur within the outfail drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: PDr1Cn,.,kti 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): rV 0% e— Page I of 2 SWU-242-20120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 30 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 C/ 3 4 5 7. Is there any foam in the stormwater discharge? Yes S. is there an oil sheen in the stormwater discharge? Yes fo 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the. presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 • , NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out thisform, please visit: hti :II ortal.ncdeiir.or�Jwcb/w /ws/su/n cicssw#tab-4 Permit No.: NICI�I pl Facility Name: County: _ *b; a 1nl Inspector: _( Date of Inspection: Time of Inspection: ' Dl a/ W ca�fJ or Certific(/att]e� of Coverage No.: NIC/G/0 6o 0 3 4 /C f' i� Total Event Precipitation (inches): 1 '/2- " Phone No. 410--oaZ.(" Was this a Representative Storm Event? (See information below) Eg Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or IAignee) 1. Outfall Description: , OutfaIl No. Structure (pipe, ditch, etc. Receiving Stream: �Uk.'�v�-ati. 1s Describe the industrial activities that occur within the outfall drainage 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: ovo � 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): NI Page 1 of 2 S wU-242-20 i 206 i 3 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 1 2 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where l is no solids and 5 is the surface covered with floating solids: V 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where i is no solids and 5 is extremely muddy: 1 2 0 4 5 7. Is there any foam in the stormwater discharge? Yes (P S. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the.presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 S W U-242-20120613 Inspection Report and Certification Form For Storm Water Pollution Prevention Plan Evaluation Owner and/or Operator: Bun a North America Inc. Facility Name: Meat Transfer Facility Facility Location: Rose Hill, North Carolina Date and Time: 4 -02 9 -I - _ Inspector(s): to---56 Date of Last Rainfall: 4 -22 -i Deficiencies Noted During the Inspection (attach additional sheets if necessary): 001 - 1� rr."-a 002 - _ N j� T 003 - T1011--e- Corrective Action Needed (attach additional sheets if necessary): 001 - 002- Corrective Action Compliance Schedule: Based upon this inspection which 1 or personnel under my direct supervision conducted, I certify that all pollution control measures are adequate and have been implemented and maintained, except for those deficiencies noted above, in accordance with the Storm Water Pollution Prevention Plan filed with the Office of Pollution Control and good engineering practices as required by the above referenced permit. i certify under penalty of law that this document and all attachments were prepared under my direction or supervision is 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 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 violatiols. Mike Sprinkle 'j,/ O �� Authorized Name (Print) nature Date Environmental Chemists, Inc. • 6602 Windmill Way * Wilmington, NC 28405 (910) 392-0223 (Lab) • (910) 392-4424 (Fax) ® 710 Bowsertown Road • Manteo, NC 27954 (252)473-5702 ANALYTICAL & CONSULTING CHEMISTS NCDENR: DWQ CERTIFICATE #94. DLS CERTIFICATE #37729 Bunge North America Date of Report: Jul 21, 2014 4600 South US Highway 117 Customer PO #: Teachey NC 28464-9459 Customer ID: 12010010 Attention: Mike Sprinkle Report #: 2014-07867 Project ID: Storm Water Lab 1D Sample ID: Collect DateMme Matrix Sampled by 14-19345 Site: Outfall #1 6/29/2014 11:00 AM Water G. Branson/ M. Tracey Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 07/17/2014 Residue Suspended (fTSS� SM 25r40 D 17.7 mg/L 07/07/2014 Analyzed outside o hold ng time. pH SM 4500 H B 7.09 units 07/10/2014 COD SM 62ND 56 mg/L 07/07/2014 Lab ID Sample ID: Collect Date/Time Matrix Sampled by 14-19346 Site. Dull #2 6/2912014 11:00 AM Water G. Branson/ M. Tracey Test Method Results Date Analyzed Oil & Grease (O&G) EPA 16B4 <5 mg/L 07/17/2014 Residue Suspended (TSS) SM 2fAO D 7.6 mg/L 07/07/2014 An8Vzed outside of hold Ing time. pH SM 450o H B 7.28 units 07/10/2-014 COD SM 5220D 46 mg/L 07/07/2014 Lab ID Sample ID: Collect Date/Time Matrix Sampled by 14-19347 Site: Outfall #3 6/29/2014 11:00 AM Water G. Branson/ M. Tracey Test Method Results Date Analyzed Oil & Grease (O&G) EPA IW4 <5 mg/L 07/17/2014 Residue Suspended (TSS� SM 264o D 7.2 mg/L 07/07/2014 Analyzed outside of hold ng time. pH SM 4500 H B 7.05 units 07110/2014 COD SM 5220D 450 mg/L 07/07/2014 Comment: s Reviewed by: U, Report#:: 2014-07887 Page 1 of i Analytical & Consulting Chemists Way Witon, NC ENVIRONMENTAL CHEMISTS, INC 20405OFFICEf19103920223gFAX 9 NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION 0 37729 392- 424 COLLECTION AND CHAIN OF CUSTODY CLIENT; BUNGS North America PROJECT NAME: Storm Water REPORT NO: ADDRESS: 4600 South US Highway 117 CONTACT NAME: Mike Sprinkle PO NO: Teache , NC 28464-9459 REPORT TO: PHONEIFAX:910.552.002410025 COPY TO: E-MAIL: mike.sprin'kle@bunge.com Sa111 ieta uy:Haft, n 1VLt 4 V.A SAMPLE TYPE: I influent, E = Effluent, W = Well, ST = Stream, sQ = Soil, 5L = tiluege, tinter: Sample Identification Collection -S A - f !ao g o 7-3 t I; W x . PRESERVATION ANALYSIS REQUESTED Date Time Temp" x Z I a s g Y Q o 5 Outfall # I 90 C P � X X TSS, Oil & Grease, COD G N: C P G G Outfall # 7- IQ-ty t Anq 300 C P xqv' ` X X � SS; ail &Grease, COI] CG7 G H: C P G G Outfall # gJ ° C P X I X L TSS, Oil & Grease, COD G M: C P G G C P G G C P G G C P G G C P G G NOTICE - DECHLORINATION: Samples For Ammonia, TKN, Cyanide, Phenol and Bacteria must he dechlorinaled (0.2 ppm or leas) In the field at the time of conft- lon. See reverse for Instructions Transfer Relinquished By: Date/Time Received By*'. 1. 2. .I I emperature when L— Delivered By: Received Comments; mple Re tad: MON ate: L Time: 3--- T AROUND: s Analytical & Consulting Chemists ton, NC ENVIRONMENTAL CHEMISTS, INC 28405OFFICE: 910392-0223gFAXe 0- NCDENR: DWO CERTIFICATION 4 94 NCDHHS: OLS CERTIFICATION # 37729 392-4424 COLLECTION AND CHAIN OF CUSTODY CLIENT; BUNGS North America PROJECT NAME: Storm Water REPORT NO: ADDRESS: 4600 South US Hijhway 117 CONTACT NAME: Mike Sprinkle PO NO: Teach , NC 28464-9459 REPORT TO: PHONEIFAX:910.552.002410025 COPY TO: E-MAIL: mikes rinkie buts e.com sam leQ tly:Haft4 10 1Vk Ice 1"d SAMPLE TYPE: I a Influent, E Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: Identification Collection Q 8 ° " o PRESERVATION ANALYSIS REQUESTEDSample Date Time Temp z o _ a x i x Outfall # $o C P X TSS, Oil & Grease, COD G H: C P G G Outfall # Z 16 - 4:1 11 A,,j pjo C I P ` X X TSS; 0i1.& Grease, COD G Fi: C P G G Outfall # gv ° C P X I X TSS, Oil 8 Grease, COD G H: C P G C G P G G C P G G C P G G C P G G NOTICE - DECHLORWATION: Samples for Ammonia, TI(N, Cyanide, Phenol and Bacteria must be dechlorinetad (0.2 ppm or less) In the fleld at the time of conectlon. See reverse for instructions Transfer Relinquished By: Datefrime Received By:'. 1. 2. J Temperature when Received:_ Accepted: ejected: Resample Re ted: delivered -By: Received By: Date: Time: Comments- T AROUND: Environmental Chemists, Inc. • � 6602 Windmill Way • Wilmington, NC 28405 ® (910) 392-0223 (Lab) (910) 392-4424 (Fax) 710 Bowsertown Road • Manteo, NC 27954 (252)473-5702 ANALYTICAL & CONSULTING CHEMISTS NCDI!tvIz DWQ CER=CATE fl94. OLS C$RTIFiCATE 037729 Bunge North America 4600 South US Highway 117 Teachey NC 28464-9459 Attention: Mike Sprinkle Date of Report: Jul 21, 2014 Customer PO #: Customer ID: 12010010 Report #: 2014-07867 Project ID: Storm Water Lab ID Sample ID: Collect DateMme Matrix Sampled by 14-19345 Site: Outfall #1 6/29/2014 11:00 AM Water G. Branson/ M. Tracey Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1684 <5 mg/L 07/17/2014 Residue Suspended (TSS) SM2W1) 17.7mg/L 07/07/2014 Analyzed outside of hold ng time. PH SM4500 H s 7.09 units 07/10/2014 COD SM 52MD 56 mg1L 07/07/2014 Lab ID Sample ID: Collect Date/Time Matrix Sampled by 14-19346 Site: Outfall #2 5/29/2014 11:00 AM Water G. Branson/ M. Tracey Test Method Results Date Analyzed Oil & Grease (O&G) EPA1684 <5 mg/L 07117/2014 Residue Suspended (rTSS) SM 2540 D 7.6 mg/L 07/07/2014 Analyzed outside o hold ng time. pH SM 4500 H B 7.28 units 07/10/2014 COD SM 5220D 45 mg/L 07/07/2014 Lab ID Sample ID: Collect Date/Time Matrix Sampled by 14-19347 Site: Outfall #3 6/29/2014 11:00 AM Water' G. Branson/ M. Tracey Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 07/17/2014 Residue Suspended (TSS� time. SM 2540 D 7.2 mg/L 0710712014 Analyzed outside of hold ng PH SM 4500 H B 7.05 units 07/10/2014 COD SM 5220D 450 mg/L 07/07/2014 Comment. Reviewed by: 1 Report X:: 2D14-07867 Page 1 of t inspection Report and Certification Form For Storm Water Pollution Prevention Plan Evaluation Owner and/or Operator: Bunpe North America, inc._ Facility Name: _ Meat Transfer Facility Facility Location: _ Rose Hill, North Carolina Date and Time: _ --,2 9 -1 t Inspector(s): V.!3 Y7 �-t�Sa Date of Last Rainfall: 4 Deficiencies Noted During the Inspection (attach additional sheets if necessary): 001 - 002 - 003 Corrective Action Needed (attach additional sheets if necessary): 001 - 002- 003 - Corrective Action Compliance Schedule: Based upon this inspection which I or personnel under my direct supervision conducted, I certify that all pollution control measures are adequate and have been implemented and maintained, except for those deficiencies noted above, in accordance with the Storm Water Pollution Prevention Plan fried with the Office of Pollution Control and good engineering practices as required by the above referenced permit. i certify under penalty of law that this document and all attachments were prepared under my direction or supervision is 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 responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violati7L-Z s Mike S rinkle D —Z — I p Authorized Name (Print) Wriature Date A!4',"-Pr-A NC®ENR Stormwater Discharge OutfaIl (SDO) Qualitative Monitoring Report For guidance on filling out this form, please ►visit: http://nortal.ncdcnr.orL,/web/%vq/t%,s/su/npdcssw#tab-4 Permit No.: N/C/ of/ Facility Name: r County: Inspector: Date of Inspection: _ Time of Inspection: - f %/ o/ o/ o/ o/ or Certificate of Coverage No.: N/C/G/o/ fa/o/ 3 / Z/ 61 Cf r Total Event Precipitation (inches): 1 `/I- " Phone No. 9 t a- 5, 2- d 0 2 ca Was this a Representative Storm Event? (See information below) E�r Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permitt0n-'dr Designee) L Outfall Description: n� OutfaIl No. 'W-) Structure (pipe, ditch, etc. _ I 1 R Receiving Stream: �_`%u-emu.-•-..� AA,-e Describe the industrial activities that occur within the outfall drainage area: t ^C ► . t n 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: rJ ,&L-J — 3. Odor: Describe any distinct odors that the discharge may have (i.e., smeIls strongly of oil, weak chlorine odor, etc.). _ -u+ Page I of 2 SWU-242-20124513 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: ( 2 3 4 5 6. Suspended Solids: Choose the Number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 t _) 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes oNo 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the, presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: http://portal.ncdenr.orJweb/ti�,q/wshu/nUdesstiv#tab-a Permit No.. N/C/ -el of W o/ d/ o/ 0/ or Certificate of Coverage No.: NIC/GI0/ b/ o 1.3 / zl 61 Facility Name: _ County: Inspector: Date of Inspection: Time of Inspection et r G Total Event Precipitation (inches). I t11 I/ Phone No. 9 t o- t a 2- oco z (a Was this a Representative Storm Event? (See information below) [2' Yes ❑ No Please check your permit to verify if Qualitative Monitoring must he performed during a representative storm event (requirements vary), A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: 1/ l (Signature of Permittet-14 Designee) 1. Outfall Description: Outfall No. Structure (pipe, ditch, etc. Receiving Stream: Describe the industrial activities that occur within the outfall drainage area. j 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 1411� Page t of 2 SWU-242-20120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 6) 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge,'where 1 is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 L2) 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. is there an oil sheen in the stormwater discharge? Yes DNo 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the, presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 A1',1;A NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: ham://portal.nedeiir.oroweb/wu/�ys/su/npcicssw4tal)-4 Permit -No.: NIC16101. Facility Name: { County: . < Inspector: a Date of Inspection: J 'o/ a/ al D/ or Certificate of Coverage No.: NIC/G/o/ G/o / 3/ Z/ U _11v Phone No. t o - SS2 - C90 z(o Time of Inspection: A/ t�— Total Event Precipitation (inches) I t/L I' Was this a Representative Storm Event? (See information below) � Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of PernvtWor Designee) 1. Outfall Description: n Outfall No. `f- ?/ Structure (pipe, ditch, etc.) Receiving Stream: Describe the Indust, ill activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): r, cr,.,;e. Page 1 of 2 sWU-242-20120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 1 2 C3) 4 S 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 0 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 3 4 5 7. Is there any foam in the stormwater discharge? Yes LV S. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes oNo 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the. presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted _ $ - -A-w —I CERTIFICATE OF COVERAGE NO. NCG06 a SAMPLE COLLECTION YEAR _ _ 2s 1q _ _ FACILITY NAME _ r,�o�--.�.�.� e�a _ _ FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY _ ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES GQ►- �S�a,..sr•._ DISCHARGING TO SALTWATERS? []YES NNO LABORATORY i�..+i� rpLt L,n Lab Cert. # 3-7 7 2 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE -i Total event rainfoll z or ❑ No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, Fecal'Coliform , mg/L. Colonies per 100 ml Enterococcl , Colonles.per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 1 30 1000 500 &l 5 1I -j.Oq S(o Ls /L 612-11 -7.16 1 7-19 Lt' / . 71 7. j S L J L— '-Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at p.0 outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? [] yes tAno (if es complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, Oil and Grease, TSS, pH, New Motor Oil Usage, mo/dd/yr mg/L mg/L -'-,'Standard units'-?Mnual,average.gal%mo Benchmark - 30 1 100 or 50 6.0 — 9.0 - ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. - SWU-249 Last Revised: October 18. 2012 *FOR PART A -AND PART &MONITORING RESULTS: A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE'PERMIT PART II SECTION B. 0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. 0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE -SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an on finaland-oneicopy of this DMR jncludin all "No Dischar e" re arts ­wlthin,30 da s-o `recei t-a the'lab results for at end o monitoring period -in -the -case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for -gathering the. -information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for. submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of _S-20-1 �{ (Date) Additional copies of this form may be downloaded at:.http://Portal.ncdenr.org/web/wc[/ws/su/­npdes.sw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 Inspection Report and Certification Form For Storm Water Pollution Prevention Plan Evaluation Owner and/or Operator: Buncte North America, Inc. - Facility Name: Meal Transfer Facility Facility Location: Rose Hill, North Carolina Date and Time: Inspector(s): _ - WIS,6 U Date of Last Rainfall: Deficiencies Noted During the Inspection (attach additional sheets if necessary): _002 -a 003= Corrective Action Needed (attach additional sheets if necessary): 001 - 002- 003 - Corrective Action Compliance Schedule: Based upon this inspection which I or personnel under my direct supervision conducted, I certify that all pollution control measures are adequate and have been implemented and maintained, except for those deficiencies noted above, in accordance with the Storm Water Pollution Prevention Plan filed with the Office of Pollution Control and good engineering practices as required by the above referenced permit. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision is 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 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. C _ Mike Sprinkle Authorized Name (Print) Svvfdture Date REemvm) uAlk-A ee .v. ,FEB 12 2015 �fC®r��� . rF Stormwater Discharge Outfall (SDO) 2EtQN Qualitative Monitoring Report Forguidance on filling out this fonn, please visit: htln://portal.ncdenr.org/web/wc1/ws/su/npdess.v-#tah-4 Permit No.: NIC/G/d/to/ o/o l o / o/ or Certificate of Coverage No.: N/ClGlo l fhID/312 141 Facility Name: i~`"Lt County: Phone No. 9 J e -SS2- - oo2-(p Inspector: V-"Q�' Date of Inspection: 11- 31 - Time of inspection: 7:3o ►----. Total Event Precipitation (inches): )- Was this a Representative Storm Event? (See information below) a Yes ❑ No Please check your permit to verify, if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certifv that this report is accurate and complete to the best of my knowledge: 1 A. A I \ te n (Signature of Permittee`d Designee) 1. Outfall Description: Outfall No. Structure (pipe, ditch, etc.) P. ,rk Receiving Stream: 4L Ao.A Describe the industrial activities that occur within the outfall drainage area: . i . .. r1 t n , . I , 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: W-ItAi�111 _ _ 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Page 1 of 2 S WU-242-20120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where l is no solids and 5 is the surface covered with floating solids: (9 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 0 4 5 7. Is there any foam in the stormwater discharge? Yes 0 S. Is there an oil sheen in the stormwater discharge? . Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of 5tormwater Pollution: List and describe 9VUe_. Note: Low clarity, high solids, and/or the. presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5WU-242-20120613 Alf,'xi-A& NCDE Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: http://portal.ncdenr.ortz/web/wq/ws/su/npciessw#tab4 G Permit No.: NlC161 Al f 16 O1D /OI or Certificate of Coverage No.: NICIG16 / d / 0l 312 / 61 Facility Name:_ r�L, County: _ �.., I&St,. _ _ � Phone No. 110 - S.S2 - oo zC. _ Inspector: .o Date of inspection: 12 `3i - f t- Time of Inspection: 7' '3P V91- Total Event Precipitation (inches): 2 !I Was this a Representative Storm Event? (See information below) & Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of PerinitteeV& Designee) 1. Outfall Description: /� Outfall No. 7� Structure (pipe, ditch, etc.) $Le Receiving Stream: + icL_ Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: �_�g _Ent 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Page 1 of 2 S WU-2a2-20120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 � 3. 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 3 4 ..5 7, is there any foam in the stormwater discharge? Yes No $, is there an oil sheen in the stormwater discharge? Yes No 9. is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious indicators of Stormwater Pollution: List and describe &;rl. Note: Low clarity, high solids, and/or the.presence df foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 WDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out thisfonn, please visit: hilp-.//portal,ncdetir.orWwel)/wq/ws/so/nr)dessw#tai)4 Permit No.: NIC/G/ o/ 6161 o/ 61 of or Certificate of Coverage No.: NIC/GI d 1401013 1 Z I G Facility Name: _ County: �u Inspector: Phone No. 9/0 - SSZ- 0 ou, Date of Inspection: Time of Inspection: Zap Total Event Precipitation (inches): �r v Was this a Representative Storm Event? (See information below) [f Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0:1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. j By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Perms{tee or Designee) 1. Outfall Description: Outfall No. _{_ Structure (pipe, ditch, etc.) _ (`'. e Receiving Stream: A ---a Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Page I of 2 S W U-242-20120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 1. % 3. 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 V 4 5 7. Is there any foam in the stormwater discharge? Yes N 8. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes nNo 10. Other Obvious Indicators of Stormwater Pollution: List and describe _ _140A o Note: Low clarity, high solids, and/or the. presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 r-1 �:. -,-- -1 Environmental Chemists, Inc. envirochem 6602 Windmill Way - Wilmington, NC 28405 (910) 392-0223 (Lab) e (910) 392-4424 (Fax) SM 710 Bowsertown Road • Manteo, NC 27954 (252)473-5702 ANALYTICAL & CONSULTING CHEMISTS NCDENR: DWQ CERTIFICATE #94. DI.S CERTIFICATE #37729 Bunge North America Date of Report: Jan 14, 2015 4600 South US Highway 117 Customer PO #: Teachey NC 28464-9459 Customer ID: 12010010 Attention: Mike Sprinkle Report #: 2015-00012 Project ID: Storm Water Lab ID Sample ID: Collect Date/Time Matrix Sampled by 15-00015 Site: Outfall #1 12/31/2014 7:30 AM Water Mike Sprinkle Test Method Results Date Analyzed Oil & Grease (O&G) EPA 16" <5 mg/L 01/12/2015 Residue Suspended (TSS) sM 2W D 33.5 mg/L 01/02/2015 pH SM 4500 H B 7.02 units 01/09/2015 COD SM522015 81 mg/L 01/05/2015 Lab ID Sample ID: Collect DatelTime Matrix Sampled by 15-00016 Site: Outfall 2 12/31/2014 7:30 AM Water Mike Sprinkle Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 01/12/2015 Residue Suspended (TSS) SM 2540 D 23.0 mg/L 01 /0212015 pH SM 4500 H B 7.00 units 01/09/2015 COD SM5220D 72 mg/L 01/05/2015 Lab ID Sample ID: Collect Date/Time Matrix Sampled by 15-00017 Site: outfall 3 12/31/2014 7:30 AM Water Mike Sprinkle Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 01112/2015 Residue Suspended (TSS) SM 2540 D 71.0 mg/L 01/02/2015 pH SM 4500 H B 6.93 units 01/09/2015 COD SM5220D 110 mg/L 01/05/2015 Comment: Reviewed by: _ M adO Reparl #:: 2015-00012 Page 1 of 1 � , � -• � � . �. .e . � ' . s ,` ,. • �. • r i� �� i t 602 ill Way ENVIRONMENTAL CHEMISTS, I N C OFFICE 9r10 392-0 23 FIAX 910-3 2-4424 Ana!$WE emists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info@environmentalchemists.com COLLECTION AND CHAIN OF. CUSTODY CLIENT: A e- Nord{ r4,,,,.nc `_ PROJECT NAME: .( //► l� REPORT NO: 1!;---000 12_ ADDRESS: CONTACT NAME: PO NO: REPORT TO: PHONE/FAX: COPY TO: email: Sampled By: r, SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: Sample Identification Collection y r 2 w C E o d .. E- c o U a CDIr e J r E V O LU mQ g J z PRESERVATION ANALYSIS REQUESTED Date Time Temp z 0 u = y = o z a0 Y 0_ w O 3$ 4 P x ,� TS C P G G %31-►`f 7: a fly ° C P r t` y G G C P G G koo Iq G C I - P-G G C P G G C P G G C P G G C P G G Transfer Relinquished By: Date/Time Received By: DatelTime 1. 2: r Temperature when Received: _Accepted: 'Lf- Re' Resample Re u sted: 06livered By: Received By: Date: Time: Comments: TU N ROUND: I MPORANT NOTICE Carnfi=Division oaf Water QoaIity (NMWQ) is sadly enforcing -EPA regd2ii=s far.sample cailechan and preso vaf on- Clignt Mud Pravidc.Ih6EpUqTrjqg Inform fioe l _ SAMPLE IDENTIFICATION (Cmd=nnr Assommmed with requested tesfing) 2_ SAJPLE TYPE (ClampositcCrab, Water_ Sail, ems) 3_ DATE COLLECTED TltidE COLLECTED S. SAMPLE COLLECTOR i_ PRESERVATION (LcrdimgTairperadurr+eand pH) T�pgngrm Sanq&s MUST' be ra fterated ar received m ice betmm 2 and 6"C_ SanWIes retxia d within two (2) bun ofcalleafim midst show a downward trend � . Z'bcra!`cmc, piassc retard tempacatore at � aaEian in spin pntugidad m mllcdion sheet s A lava (2) haartimit to rbemira1t91mscrv'�e �pti b9'PHis allmwed. ea�pt farmetals samplas reported to die Grumduoatcr Serbnumbich be acidified at the time ofcasliertioa cantiom 'Phase sample bold cs may contain smcM amounts of and or other aarasiae. and potentially barm5d chumicak, Laberahnies are required to add these cbemicals lhr c Wt om maty ms fie miler to comply vim EPA pr escrvab on regcireascat& Use eaiseme one whey opening and handmg the batfles- Haay cbdumId get m your sbu or dathms flnsh hb r "milh water and seekmadicsl-ate: L III CAIMON: DO NOT MIXthimsWatewilb micM in hWSebdrmmi WMmdmts pImasa vhdkW rmcdmii mom. Deddai inatiez Sa•ples that ifegolreA id ltvsa-sat!$am I- Add 4 S grAnides of thi osuY" to a baffle with an acrid preservative- 2- After mixing to dissolve ih a thi asulf ft. poor half of the srmnpie into, a battle cout iming acid d as aprrservative_ (Ammani2'TIN) 3 _ Then c outpletely fill both bottles with fin& sample -A memo d dale teach *me oottecA =woe cdlertm, and of peeper pa�es mua be m mi r Eawtc ample meg deactyiadica>c 75r Stale etwar&Cara edlecfim ske on ai mmdtranma fi=n- Ref. WC,AC 2H 0S0S (a) M RWD. 'At mW feu e a hbantmy recdves �ptm wbkh & not m eel •aa * cdsafion, bAirmg timm cr pmseraatemreq in= onto, the Iaboratmymuo naeff fie maple cM ca is car Clad and M=e ammis sample iipaaaU& if.a MAW sample aamatbe seemed ffieaci�.l asaaple rracybe amlyzedbd zt1rgmbdmustbe q=Xffmdivi Qmn*m of rbn inhw inaKs) mid to lobo ntory arrcrl naffy am Sltf a Labam"y about &a i"Ecacsion(s)L Ilm mfiffmmfim Mud beiade a sbtlement ieaamf"g cm .aims trim to prevee< fie problraa far lhhm mmgdm- tt E WCAC 2H 0205 (a) Cn Qij ::� SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted I - al j S CERTIFICATE OF COVERAGE NO. NCG06 d 32 4- SAMPLE COLLECTION YEAR FACILITY NAME �p _L�for-!._ .�� FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY u ni. H ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES [NNO LABORATORY Gv% u', ro rA&.,,.,,,, Lab Cert. # 3 77 Z `� Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall z or ❑ No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, Fecal Coliform , mg/L, Colonies per 100 ml Enterococc , Colonies per 100 ml Benchmark 100 or 50 Within 6.0 — 9A 120 30 1000 500 # 1 33.5 g I e- 5 a .A z— -e—s- ix - r_)y `71. 1 Only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? 11 yes ® no (if aes, complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Imo/dd/yr Sample Collected, I Oil'and Grease, mg/L TSS, pH, _rng/L -Standard units: New Motor Oil Usage, Annualaveiage.galfino Benchmark - 30 100 or 504 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: October 18, 2012 *FOR PART.A AND PART, &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 II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE, BENCHMARK EXCEEDENCES FOR -THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO F IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one;cou of this DMRrincluding all "No Discharge" reports;-within�30 days of�recei t•of the -lab results for at end of monitoring period Iwthe-cose of "No Discharge reportsl to: Division of Water Quality Attn: DWQ Central Files 1617-Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR,ANY: INFORMATION REPORTED: "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 forgathering 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 1--27- J.S (Date) Additional copies of this form may be downloaded at: http:/Iportal.ncdenr.org/­web/wct/ws/su/npdessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2