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HomeMy WebLinkAboutNCG060205_MONITORING INFO_20190618STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT N0. �V CCU CIQ Da 05 DOC TYPE ❑HISTORICAL FILE �. MONITORING REPORTS DOC DATE ❑ �b �� b �0 � O WYYMMDD STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000 Date submitted rp'/(]�� CERTIFICATE OF COVERAGE NO. NCG06 FACILITY NAME Ct/5 ty. /� -� ,s z� •S J,, c COUNTY �ui {+►/mil PERSON COLLECTING SAMPLES i LABORATORY geStA-f t { [L- Lab Cert. ## NG 3q RECEIVED JUN 18 2019 GEIITF: Al_ FILES DWR SECTION Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR �Ol q SAMPLE PERIOD Jan -June [] July -Dec or Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA [ 0therSur-ore 4611 W Alc- FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall z, 2C- or [:]No discharge this period3 Outfall No.: Date Sample Collected, mo,/dd/yr TSS, "'mg/L pH; Standard units COD mg/C Oil and Grease mg/L ..Coloniesper100.m' Fecal Coliform, Enterococci, olonieper 100 ml I Benchmark - 160 or 50' Within 6.0 — 9.6 120 30 10001 5001 Parameter Code - C0530 00400 00340 00556 31616 61211 s ! a 3 r <5 '7, 0 7 4�S NtA 1 Only applies to facilities that use/process meats. 'The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes [9"no (if yes, complete Part B) Permit Date: 11/l/2018-05/31/2021 SWU-249, Last Revised 11/5/2018 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, Inchesz 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 „' NC.0IL 00552 C0530 Footnotes from Part A also apply to Part B *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ® NO REGIONAL OFFICE CONTACT NAME: Mail an original copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "l certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the 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 4/AE�� 6-((- � Date Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018 Environmental Quality Stormwater Discharge Outfall (SDQ) Qualitative Monitoring Report For guidance on filling out this form, please visit hops://deq.nc.gov/about/divisions/energy-mineral-]and-resourcest npdes-stormwater-gps Permit No.: N_ICI Z I 161 0l pl ol0 / or Certificate of Coverage No.: NICIGI 1 10 1 1 pl Facility Narne: �'✓s �^' >C^ ; �-•-s SM� — — — County: Inspector: Date of Inspection: s-/;? 3119 Time of Inspection: � � ql� A Total Event Precipitation (inches): Phone No, 3 3�- `- 3 1 714 1 All permits require qualitative monitoring to be performed during a "measurable storm event." A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DEMLR Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Pen-Attee or Designee) 1. Outfall Description: Outfall No. 5? :2- Structure (pipe, ditch, etc.): { Receiving Stream: the industrial activities that occur within the outfall drainage area: dr1.eL� + CnGl�r* Page 1 of 2 S W U-242, Last modified 06/0 U2018 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: \/C- V- � jk-t�U oLK 11 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): /lln '4J6�� L.3�- 4e,:1-4 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 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: p 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 D2 3 4 5 7. Is there any foam in the stormwater discharge? O Yes ® No. 8. Is there an oil sheen in the stormwater discharge? OYes ® No. 9. Is there evidence of erosion or deposition at the outfall? o Yes ® No. 10. Other Obvious Indicators of Stormwater Pollution: List and describe ! D t�r-� a-r v" d #-,%C-e a -f .0 It "h �- Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 06/01/2018 RESEARCh & ANAIYACA1 LkORATORiES, INC. Analytical / Process Consultations Phone 1336) 996-2841 CHAIN OF CUSTODY RECORD WATER ! WASTEWATER I misc. •NY• • • • • • • i, • SAMPLER NAME (PLEASE PRINT) `� � m- mmomm ■■■■■■■■■■■■MINI■ ��■■■■■■ ■■■■■■■■■■OMENS mm MINI■■■ ■SEMMEMMS■SENSE _- N■NEE EOMM■MM■ME■■ MEN mm MINI■■■ ■■■■■■■■MIS■■■■■ i�■MINI■■■ ■■EMEMEE■OM■ ■■■ ��■■■■■■ ■■■■■■■■■■■■ MINI■ MEMORIES ■■■■■■■■■■■■■■■ 11110011100 N■■MM NONE ■■■■■■■■ ■ME MM ■EEME SIMEON■MIS■■■■■■■■ mm■EE■mm ■■■■■MIN■ME■■ MIN■ MMMMMIMM■MMMIMM ■■MEMMMMMMME■M■ �� O■Emm ■■■MEMO■■■■■ EM■ �� ■NEON ■M■MM■O■■EMI■MIN■ mi ■MEmm ■MMXMMMEMMMMNM■ MMESEEMM ■■■OMEMMOME■ ■■■ MME�EMM■■ ■ ■■MISMIN■■■■�■�■■ D: ,: SAMLEr TEMr i k�' k ; inRESEARCh & ANAIyTiCA1 LAboRAToRIES, INC. For: Custom finishers, Inc 2213 Shore Street High Point, NC 27263, Attn: Dennis Dzielski Report of Analysis 5/30/2019 Jpunetp'4 Ole i 4i op NC #34 =. ._ NC #37701 1 Client Sample ID: SD02 Lab Sample ID: 67117-01 Site: Custom Finishers Inc Collection Date: 5/23/2019 7:45 Parae r Method Result Units Rap Limlt Analvst Analysis Data/Time COD EPA 410.4 7 mg/L 5 HW 5/28/2019 Oil & Grease EPA 1664 8 <5 mg/L 5 EE 5/29/2019 Total Suspended Solids (i"SS) SM 2540 D-1997 <5 mg/L 5 AW 5/28/2019 NA = not analyzed P.O. Box 473 106 Short Street Kemersville, North Carolina 27284 Tel: 336-986-2841 Fax: 336-99B-032b www.randalabs.corr� Page 1 ral coa basic v1d STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: Zo i `6 CERTIFICATE OF COVERAGE NO. NCG060205 (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME: Custom Finishers, Inc. COUNTY: Guilford PERSON COLLECTING SAMPLES: em"Is -D-4.160k) RECEI PHONE NO.: (3361431-7141 CERTIFIED LABORATORY: Research R Analytical Lab #: NC34 Part A: Specific Monitoring Requirements AUG 3 o z018 CENTRAL PILES DWR SECTION PLEASE SIGN ON THE REVERSE --> Outfall No. Date Sample Collected, molddlyr 00530 00400 00340 00556 31616 Total Suspended Solids, mglL pH, Standard Units Chemical Oxygen Demand, mg1L Oil and Grease, mg1L Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 - 9.0 120 30 1000 SD02 B -;k- - IS .19 ?.o 121 -< N/A Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes X no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfalt No. Date Sample Collected, molddlyr 00556 00530 00400 Oil and Grease, mglL Total Suspended Solids, mg1L pH, Standard Units New Motor Oil Usage, Annual average gallmo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Mail Original and one copy to: Division of Water Quality Date (first event sampled) Attn: DWQ Central Files Total Event Precipitation (inches):_ 1.9 in"es 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): SWU-249-102107 Page 1 of 2 "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 poss*bility of fines and imprisonment for knowing violations." 17 (Signature of Permittee (Date) J5Arr . ST ORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certificate of Coverage No. NCG Ow o Z -� Facility Name: C v s -tn,m. ,t u County: C i P. Phone No.: 3 3 Li 3 I - '7 I,4 1 Inspector: -betiN is Date of Inspection: B - 2 - tg By this signature, I certify that this report is accurate and complete to the best of my knowledge: L Z' k'� (Signature of Permiuee or De gnee) Outfall Description Outfall No.: 5t7 I- Structure (pipe, ditch, etc.):_'?, PC IN LE T Receiving Stream: A U P e I-trGV-- Describe the industrial activities that occur within the outfall drainage area: PAL.t C'i S �_ !,c T1�4 «� I T►y r�� H 0 G,c,y o < d Cs u_Cz T1..J 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: y4 L1 c rt , 6,2Ay Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak Chlorine odor, etc.): Ala o p ojLs D E 7y-.-- 7-E 0 8/22/97 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: v 1 K2) 3 4 5 6 7 8 9 10 5. Floating Solids Choose the number which best describes the amount of floating solids in the storm water Discharge where 1 is no solids and 10 is the surface covered in floating solids: 1 ("29 3 4 5 b 7 8 9 10 b. Suspended Solids Choose the number which•best describes the amount of suspended solids in the Storm water discharge where 1 is no solids and 10 is extremely muddy. 1 0 3 4 5 b 7 8 9 10 7. Foam Is there any foam in the storm water discharge? YES (NO ) S. Oil Sheen Is there an oil sheen in the storm water discharge? YES (DO 9. Other Obvious Indicators of Storm water Pollution: List and describe: '17fE2E WLwz' A" cL uorcotT /2s or fir! Y KerrD. T E W 19-4 A4-0 V 106 NC- E OF SWft 7riL %ao LLu I`7c1N. NOTE; Low clarity, high solids and/or presence of foam or oil sheens may be Indicative of pollutant exposure. These conditions may warrant further Investigation. 8/22/97 RESEARCh & ANA[YfiCAI UboRATQRiES, INC. Analytical / Process Consultations Phone (386) 996-2841 CHAIN OF CUSTODY RECORD WATER! WASTEWATER I MISC. COMPANY 4 Li i ir{ -- 1 I'jis1.1.1: g j _ t ' JOB NO: m � z ti y0' O^ ,may?a�.y� h v c� �'" y � O�� \Qm�O rq0� J Q robC 1� �W o� �'j o� z•`z �`°�ca' �� ro 0��0� m Q� O` G .� Q p0 O� O Q Q' Q. `� ry ryy ryh ^ �v v �.: y REQUESTED ANALYSIS STREET ADDRESS •]•'1 � S i�G t:•a=. `s'T: PROJECT[ .:.)�Y>'vW�l CITY, STATE, ZIP INCv'L1Cl.s�, SAMPLER NAME (PLEASE PRINT) CONTACT PHONE ll 7 { SAMP ER SIGNATURE -- SAMPLENUMBER (LAB 115E ONLY) DATE TIME COY GRAB TEMP C FlES .G I �i GdOR F_ R�tta c� ramp 1AU ntnrrtn is SAMPLE LOCATION! LD- �3 S fS COO OIL f CAcA!;L;' R Q.UISHEED BY. DATE/i E. RECEIVED BY. REMARKS: SAMPLE TEMPEURE AT. RECEIPT RELINOUISHE BYi DATEITIME RECEIVED BY FL ESEA Ch .ANA1YTiCA�.Report of nalysis ., LA ORA-�OfiIES8 rN.c, 8i812018' �tt�u.�errr� For: Custom Finishers. Inc tr CH q 2213 Snore Street Ai High Point, NC 27263 L9 �, C9 NC934 ; Attn: Dennis Dzielski 4 Nesi37701 Y r�rrrrif �tNt client Sample ID: SD02 Lab Sample iD: 54163-01 Site: Custom Finishers Inc Collection Date: 8/2/2018 9:30 Pararmeter — Method Result Units Rena Limit An6l•sf Analysis'DatelTime-.. COD EPA 41D.4 22 mg/L 5 HW 'Mao78 Hydrocarbon O&G EPA 1664-Revision 8/Silica Gel <5 mg/L 5 EE 8/6/.2018 Total Suspended'Solids-(T5S) SM 2540 D-1997 6.19' mglL 5 LP 81612018 NA = not onalyzed, PA. Box 473 106.Short Street Kerriersvilla, North Carolina 27284 Tel:-336-996-2841 Fax: 336-996-0326 www.randolabs.com Page 1 . . '....lmaia-.�8tla�.�,..`.`�.w.,..,'+n adcvuC-i€,a�`iC?...-n.n.�ff �e .'r.�._..u.ti•.5.. ,..ss,,.:� -' „ -, .__..-- Custom Finishers, Inc. eagle C LASER Division of Water Quality ATTN: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 ,SUBJECT: Storm water Monitoring Report To Whom It May Concern: P.O. Box 7008 High Point, North Carolina 27264 Phone (336) 431-7141 FAX: (336) 434-5868 May 8, 2018 Enclosed is an original and a copy of our Storm water Discharge Outfall Monitoring Report and supporting documents. The period of coverage is January 1, 2018, through June 30, 2018. Please feel free to contact me at (336)431-7141 with any questions or concerns regarding this submission. Sincerely, Chris Wilkins General Manager STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. NCG060205 FACILITY NAME: Custom Finishers, Inc. PERSON COLLECTING SAMPLES: DENNIS 'Dz1f-i tut CERTIFIED LABORATORY: Research & Analytical Part A: Specific Monitoring Requirements Lab #: NC34 SAMPLES COLLECTED DURING CALENDAR YEAR: �O 1 0- (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) COUNTY: Guilford PHONE NO.: (336)431-7141 PLEASE SIGN ON THE REVERSE —). Outfall No. Date Sample Collected, molddl r 00530 00400 00340 00556 31616 Total Suspended Solids, mglL pH, Standard Units Chemical Oxygen Demand, mg1L Oil and Grease, mg1L Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 - 9.0 120 30 1000 SD02 15-- IV 1-5- ? o L 5- L NIA Note: if you report a sampled value in excess of the benchmark value, or outside tha 6brFc ff-Vra g for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. U MAY 18 �0�8 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor of per month? yes X no (if yes, complete Part 6) �,ENTRAL FILES DWR SECTION Part 13: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected, molddl r 00556 00530 00400 Oil and Grease, mg1L Total Suspended Solids, mglL pH, Standard Units New Motor Oil Usage, Annual average gallmo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Mail Original and one copy to: Division of Water Quality Date �� 18 (first event sampled) l Attn: DWQ Central Files Total Event Precipitation (inches): l 3 inc5 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): SW U-249-102107 Page 1 of 2 "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." I (Signature of Permittee (Date) STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certificate of Coverage No. NCG : 060205 Facility Name: Custom Finishers, Inc. County: Guilford Phone No.. 336-431-7141 Inspector: Dennis L. Dzielski Date of Inspection: Y- 2-57-16 By this signature, I certify that this report is accurate and complete to the best of my knowledge- A— Z N (Signature of PermitteP or Designee) 1. Outfall Description Outfall No.: SD02 Structure (pipe, ditch, etc.): Pipe Inlet Receiving Stream: Muddy Creek Describe the industrial activities that occur within the outfall drainage area: Pallet Storage, Tractor Trailer Activity, MDF Grinding, and Collection Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: e �'�♦ S��rGly 4o�or- J� �Y'O�y+.t l]0.1�C..+1^1S Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak Chlorine odor, etc.): /L�ta odQv�s w-e!� cl/ -e_�en_'fe121 8/22/97 4. Clarity Choose the nurnbcr which best describes the clarity of the discharge where i is clear and 10 is very cloudy: 1 0 3 4 5 6 7 8 9 10 5. Floating Solids Choose the number which best describes the amount of floating solids in the storm water Discharge where 1 is no solids and 10 is the surface covered in floating solids: Q 2 3 4 5 6 7 8 9 10 6. Suspended Solids Choose the number which best describes the amount of suspended solids in the Storm water discharge where 1 is no solids and 10 is extremely muddy: 1a 2 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the storm water discharge? YES NO 8, Oil Sheen Is there an oil sheen in the storm water discharge? YES 9. Other Obvious Indicators of Storm water Pollution: Listrand describe: —1 l /fte-t (..�a/e h.D Inf �GQ'ForJ !rr e— i �[O tj a-4,, NOTE: Low clarity, high solids and/or presence of foam or oil sheens may be Indicative of pollutant exposure. These conditions may warrant further Investigation. 8/22/97 RESEARCh & HNA1yTICA1 LABORATORIES, INC. Analytical / Process Consultations. Phone 1336) 996-2841 CHAIN OF CUSTODY RECORD WATER 1 WASTEWATER MISC. COMPANY CIJSTa�n i nA3 C JOB NO. w z o LL o o z - 01 �mD ��� S= 'Q��Ov �01 J�Q�0 ��Q ac�� �� .. - o va m 0 `�i o 5 o 0OC? 0p a �00 �� Q O�Qrc) 0 �� Q O Q `1" `�� `� " " REQUESTED ANALYSIS R ry ^ y STREETADDRESS PROJECT0. CITY, STATE, ZIP {-LG� N P61 u.r ,1-�24. to ev SAMPLER NAME (PLEASE PRINT) � NN1S `l�-ILL$Kr CONTACT PHONE Gil rzi 5 -714 SAM GNATUR SAMPLE NUMBER (LAB USE ONLY) DATE TIME COGP GRAB TEMP 'C RES [ � REMOVED n a xl SAMPLE Is a W] SAMPLE LOCATION ! I.D. 4 2S'!fi 7:3nn.. RELINOUISHEDBY s d� DATEMME a `��``� RECEIVED BY REMARKS: SAMPLE TEMPERATURE AT RECEIPT 0 , `t °C RE INOUISHED DATErTIME RECEIVED BY lj RESEARCh & ANA[yTICA1 LAbORATORIESF INC. For: Custom Finishers, Inc 2213 Shore Street High Point, NC 27263, Attn: Chris Wilkins Report of Analysis 5/2/2018 i M NC U34 Z. - NC 937701 ~ri � sfi : O�,q��pg•,r,� ,�� ru n Client Sample ID: S002 Lab Sample 1D: 49754-01 Site: Custom Finishers Inc Collection Date: 4/25/2018 7:30 Parameter Method Result Units Rep Limit Analyst Analysis Dateliime COD EPA 410.4 <5 mg/L 5 JF 4/30/2018 Hydrocarbon O&G EPA 1664 Revision B/Silica Gel Total Suspended Solids (TSS) SM 2540 D-1997 <5 mg/L 5 AW 4/27/2018 <5 mg/L 5 AA 4/26/2018 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 rs coa basic v',d Custom Finishers, Inc. Division of Water Quality ATTN: DWQ Central Files 1617 Mail Service Center Raleigh, NC 2.7699-1617 SUBJECT: Storm water Monitoring Report To Whom It May Concern: P.O. Box 7008 High Point, North Carolina 27264 Phone (336) 431-7141 FAX: (336) 434-5868 R ECEIVEL OCR U 3 Z017 CENTRAL FILES DWR SECTION Sept 26, 2017 Enclosed is an original and a copy- of our Storm water Discharge Outfall Monitoring Report and supporting documents. The period of coverage is July 1, 2017, through December 31, 2017. Please feel free to contact me at (336)431-7141 with any questions or concerns regarding this submission. Sincerely, Chris Wilkins General Manager �/• STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: ;�o) -7 CERTIFICATE OF COVERAGE NO. NCGO60205 (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME: Custom Finishers, Inc. COUNTY: Guilford PERSON COLLECTING SAMPLES:-Dt4,.,,s -MqELai=} PHONE NO.: (336)431-7141 CERTIFIED LABORATORY: Research $ Analytical Lab #: NC34 PLEASE SIGN ON THE REVERSE —). Part A: Specific Monitoring Requirements Outfall No. Date Sample Collected, moldd! r 00530 00400 00340 00556 31616 Total Suspended Solids, mglL pH, Standard Units Chemical Oxygen Demand, mglL Oil and Grease, mglL Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 - 9.0 120 30 1000 SD02-11 Z. o Z5 NIA Note: it you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement I ier 1 or I ier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes X no (if yes, complete Part B) Part 6: Vehicle Maintenance Activitv Monitoring Requirements Outfall No. Date Sample Collected, molddlyr 00556 00530 00400 Oil and Grease, mglL Total Suspended Solids, mglL pH, Standard Units New Motor Oil Usage, Annual average gallmo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Date '91 0 4-7 (first event sampled) y Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Mail Original and one copy to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 SWU-249-102107 Page 1 of 2 "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." ature of Permittee (Date) STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certificate of Coverage No. NCG : 060205 Facility Name: Custom Finishers, Inc. County: Guilford Phone No.: 336-431-7141 inspector: Dennis L. Dzielski Date of Inspection:_ C} 6 / -7 By this signature, I certify that this report is accurate and complete to the best of my knowledge: LLtdr-- (Signature of Permittee or signee) Outfall Description Outfali No.: SD02 Structure (pipe, ditch, etc.): Pipe Inlet Receiving Stream. Muddy Creek Describe the industrial activities that occur within the outfall drainage area: Pallet Storage, Tractor Trailer Activity, MDF Grinding and Collection 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Tr�f �(sC/f.42 c E L-( -5 c L E Iq r� 3. Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak Chlorine odor, etc.): A)o 5 dolz S ktI&�t 6 7- -c 7-6 P — 8/22/97 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 0 2 3 4 5 6 7 8 9 10 5. Floating Solids Choose the number which best describes the amount of floating solids in the storm water Discharge where 1 is no solids and 10 is the surface covered in floating solids: 0 2 3 4 5 6 7 8 9 10 6. Suspended Solids Choose the number which best describes the amount of suspended solids in the Storm water discharge where 1 is no solids and 10 is extremely muddy: 1 02 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the storm water discharge? YES NO 8. Oil Sheen Is there an oil sheen in the storm water discharge? YES NO 9. Other Obvious Indicators of Storm water Pollution: List and describe: � 7`r1 1-EI-E V J C9-C Al o Tn! J) 72 a a1 S if — NOTE: Low clarity, high solids and/or presence of foam or oil sheens may be Indicative of pollutant exposure. These conditions may warrant further Investigation. 8/22/97 RESEARCh & ANAIYACA1 LAbORATORIES� INC. f, Analytical / Process ConsuluaCions Phone (3361 996-2841 CHAIN! OF CUSTODY RECORD WATER I WASTEWATER I misc. COMPANY C €k .JOB NO, ,, i u d e� eb- . o' `Qm �� CV Jr C�� +`L�z M Q �• .5 �O �0 m � c� a � Q` �,� � ci �- rypcti�e hQ" a ' h REQUESTED ANALYSIS STREETADDRESS�]� 13 S 440 P-'C� �-'T PROJECT CITY. STATE, ZIP 416Vj- poI"r N L i �26 3 SAMPLER NAME {PLEASE PRINT) �C�t Is 'UZl � CONTACT PHONE ��r•fnils b�i�'c..S k1 3341 Ll 3 ! 71 q( SAMPLER SIGNATURE (� �C`��-.�-.-�...►- � SAMPLE NUMBER (LAB USE ONLY) DATE TIME :qup GRR9 T;M� U a s [i ,C.I ctflr.lrs rUWAD rpN� sAT;ti[ V F 3l �saw1 SAMPLE LOCA1 1I.D. Cif !� !') (: pb, i�— `�?��� _— — --- — - ss Coo RELI UISHEDB/Y DATE NMI RECEIVED a REMARKS. SAMPLE TEMPERATURE AT RECEIPT �• °C RELINQUISHED CIATWIME RECEIVED 8 RESEARCH & ANAyTiCAL LAbORATORIES� INC. For: Custom Finishers, Inc 2213 Share Street High Point, NC 27263, Attn: Tom Crane Report of Analysis 9/15/2017 1.11t13IIfloe A� w i tr C NC JR34 w NC 937701 Client Sample ID: SD02 Lab Sample ID: 39619-01 Site: Custom Finishers Inc Collection Oate: 9/6/2017 13:30 Parameter Method Result Units Rep Limit Analyst Analysls DateE:Ime COD EPA 410.4 7 mg1L 5 SK 9/812017 Hydrocarbon O&G EPA 1664 Revision BlSilica <5 mg1L 5 AW 9/11/2017 Gel Total Suspended Solids (TSS) SM 2540 D-1997 <5 mg1L 5 AA 9/8/2017 NA = not cno yzecf P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 338.996.2841 Fax: 336-996-0326 "^v.randalabs.conn Page 1 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: go t� CERTIFICATE OF COVERAGE NO. NCG060205 (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME: Custom Finishers, Inc. COUNTY: Guilford PERSON COLLECTING SAMPLES: _ v4ii(CS f2 ewp( PHONE NO.: (336)431-7141 CERTIFIED LABORATORY: Research & Analytical Lab #: NC34 PLEASE SIGN ON THE REVERSE Part A: Specific Monitoring Requirements Outfall No. Date Sample Collected, molddl r 00530 00400 00340 00556 31616 Total Suspended Solids, mglL pH, Standard Units Chemical Oxygen Demand, mg1L Oil and Grease, mg1L Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 - 9.0 120 30 1000 SD02 H 4- '-1 v L G r NIA Note: if you report a sampled value in excess of the benchmark value, or o t-4t tF `tbi V rk range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. MAY 23 2D17 Did this facility perform Vehicle Maintenance Activities using more than 55 a�r� f new motor oil per month? yes X no (if yes, complete Part B) �.EN RAL FILES DWR SECTION Part B: Vehicle Maintenance Activity Monitoring Requirements Outfal I No. Date Sample Collected, molddlyr 00556 00530 00400 Oil and Grease, mg1L Total Suspended Solids, mglL pH, Standard Units New Motor Oil Usage, Annual average gallmo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Mail Original and one copy to: Division of Water Quality Date Y4 Iq (first event sampled) Attn: DWQ Central Files Total E ent Precipitation (inches): � A q 1410�S _ 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): SWU-249-102107 Page 1 of 2 "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) STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certificate of Coverage No. NCG : 060205 Facility Name: Custom Finishers Inc. County: Guilford Phone No.: 336-431-7141 Inspector. Dennis L. Dzielski Date of Inspection:( I By this signature, I certify that this report is accurate and complete to the best of my knowledge: .' --- Q" 5L� (Signature o Permittee Designee) 1. Outfall Description Outfall No.: SD02 Structure (pipe, ditch, etc.): Pipe Inlet Receiving Stream: Muddy Creek Describe the industrial activities that occur within the outfall drainage area: Pallet Storage, Tractor Trailer Activity, MDF Grinding and Collection 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as de criptors: V f- -,, Ai %!Lt— 3. Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak Chlorine odor, etc.): 8/22/97 4. Clarity El Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 3 3 4 5 6 7 8 9 10 5. Floating Solids Choose the number which best describes the amount of floating solids in the stonn water Discharge where 1 is no solids and 10 is the surface covered in floating solids: (D 2 3 4 5 6 7 8 9 10 6. Suspended Solids Choose the number which best describes the amount of suspended solids in the Storm water discharge where 1 is no solids and 10 is extremely muddy: ei/ 2 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the storm water discharge? YES NO 8. Oil Sheen Is there an oil sheen in the storm water discharge? YES NO 9. Other Obvious Indicators of Storm water Pollution: List and describe: NOTE: Low clarity, high solids and/or presence of foam or oil sheens may be Indicative of pollutant exposure. These conditions may warrant further Investigation. 8/22/97 RESEARCh & ANAIYf ICAI LABORATORIES, INC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD WATER I WASTEWATER I MISC. COMPANY JOB NO. y o _ m y .. `��0 �� 0ac� pr \Qm ZG°' JcQ� °� ao t� c� Q• C9 ¢ Q ¢ ��. `� n q� 'L� �" *" *" �` REQUESTED ANALYSIS STREET ADDRESS r 3 Sto PROJECT CITY, STATE, ZIP 14 !� PD 1 N T iV L SAMPLER NAME (PLEASE PRINT) DL r E-GJfU CONTACT PHONE %Om :336 (-t3 i -7r 4f SAMP ER SIGNATURE SAMPLE NUMBER pw USE ONLY) DATE TIME COUP GRAB TEMP ,C RES l CWCRINE REMOVED SAMPLE Ig UX SAMPL LOCATION I I.D. TO co® GRme+ OIL RE UISHEO BY y- DATIJTIME C'��Ad �R}EECCEIVED BY " V REMARKS: va — SAMPLE TEMPERATURE AT RECEIPT ✓ °C RELINQUISHED BY DATEMME RECEIVED BY RESEARCh & ANAtyTICA1 UboRATORIES, INC. For: Custom Finishers, Inc 2213 Shore Street High Point, NC 27263, Attn: Tom Crane Report of Analysis 5/4/2017 �ti*ttlnnr�r� A• b A LYTj�r�i� �': •• F y2j,P Ja0 NC #34 NC#37701 Client Sample ID: SD02 Lab Sample ID: 338ST-01 Site: Custom Finishers Inc Collection Date: 4/24/2017 20:45 Parameter Method Result Units Rep Limi Analyst Analysis Date/Time 7] COD EPA 410.4 <5 mg/L 5 BR 4/27/2017 Hydrocarbon O&G EPA 1664 Revision Mika <5 mg/L 5 JF 4/28/2017 Gel Total Suspended Solids (TSS) SM 2540 D-1997 <5 mg/L 5 AA 4/26/2017 NA = not analyzed P.O. Sox 473 IN Short Street Kemeraville, North Carolina 27284 Tel: 336-9M2841 Fax: 336-996-0326 www.randalabs.com Page 1 rat coa basic yid STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCGD60000 SAMPLES COLLECTED DURING CALENDAR YEAR: CERTIFICATE OF COVERAGE NO. NCG060205 (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME: Custom Finishers, Inc. ;� COUNTY: Guilford PERSON COLLECTING SAMPLES: ��NNlS J�1LSI�I PHONE NO.: (336)431-7141 CERTIFIED LABORATORY: Research & Analytical Lab #: NC34 PLEASE SIGN ON THE REVERSE —), Part A: Specific Monitoring Requirements Outfall No. Date Sample Collected, molddl r 00530 00400 00340 00556 31616 Total Suspended Solids, m !L pH, Standard Units Chemical Oxygen Demand, m lL Oil and Grease, mg/L Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 - 9.0 120 30 1000 SD02 . - r L G 5- NIA Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. RECEIVED Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes X no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements DEC 2 0 2016 CENTRAL FILES DWR SECTION Outfall No. Date Sample Collected, molddl r 00556 00530 00400 Oil and Grease, m IL Total Suspended Solids, m !L pH, Standard Units New Motor Oil Usage, Annual average allmo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Mail Original and one copy to: Division of Water Quality Date_!2- `}- I (first event sampled) Attn: DWQ Central Files Total Event Precipitation (inches): . 37 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): SWU-249-102107 Page 1 of 2 " 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 Pefmiltee (Date) SWU-249-102107 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT G6JERAL^�PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: .2° k4 CERTIFICATE OF COVERAGE NO. NCG060205 (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME: Custom Finishers, Inc. COUNTY: Guilford PERSON COLLECTING SAMPLES: '�>zrE VS1-f PHONE NO.: 336 431-7141 CERTIFIED LABORATORY: Research & Analytical Lab #: NC34 RECEIVED PLEASE SIGN ON THE REVERSE � MAY 18 Z015 Part A: Specific Monitoring Requirements CENTRAL FILES Outfall No. Date Sample Collected, molddl r 00530 00400 0 00556 31616 Total Suspended Solids, m 1L pH, Standard Units Chemical Oxygen Demand, m lL Oil and Grease, mg1L Fecal Coliform, L Colonies per 100 ml c Benchmark - 100 Within 6.0 - 9.0 120 30 1000 SD02 6-3114- ?.2 41c> 2< 5 NIA Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes X no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected, molddl r 00556 00530 00400 Oil and Grease, m lL Total Suspended Solids, m lL pH, Standard Units New Motor Oil Usage, Annual average al/mo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Date S -3 1 1G (first event sampled) Total Event Precipitation (inches): i 33 -(Advs Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Mail Original and one copy to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 SWU-249-102107 Page 1 of 2 I o-atify, 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." r (Sig re oi Permittee (Date) SWU-249-102107 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONIz G Rone Certificate of CoverageG : 0 Facility Name: Customrs In County: Guilford 336-431-7141 Inspector: Dennis L. Dzielski Date ofInspection: 513 [ 1�- By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee A Designee) Outfall Description OutfalI No.: SD02 Structure (pipe, ditch. etc.): Pipe Inlet Receiving Stream: Muddy Creek Describe the industrial activities that occur within the outfall drainage area: Pallet Storage, Tractor Trailer Activity, MDF Grinding and Collection 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Lt4 i 62-t`t F(Z=' (:��uskv) 40,-v— 114 L6 3. Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak Chlorine odor, etc.): T*f /j-E c S tiL a ai)o(L 8/22/97 4 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 2 y 4 5 6 7 8 9 10 5. Floating Solids Choose the number which best describes the amount of floating solids in the storm water Discharge where i is no solids and 10 is the surface covered in floating solids: (D 2 3 4 5 6 7 8 9 10 6. Suspended Solids Choose the number which best describes the amount of suspended solids in the Storm water discharge where 1 is no solids and 10 is extremely muddy: 2 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the storm water discharge? YES 8. Oil Sheen Is there an oil sheen in the storm water discharge? YES NO 9. Other Obvious Indicators of Storm water Pollution: List and describe: t (ZIC o nA V.0us bre-fF7aO-1 OF :5_lbrLn, �t A ,2 f bL-t-y R o,'J P&N T' NOTE: Low clarity, high solids and/or presence of foam or oil sheens may be Indicative of pollutant exposure. These conditions may warrant further Investigation. 8/22/97 RESEARCh & ANAIYACAI f kboRATORIES, INC. Analytical / Process Consultations Prone (3361 996-21341 CHAIN OF CUSTODY RECORD WATER I WASTEWATER I MISC, COMPANY v5 �m NrS;fT25 yNc JOB NO, „ o z l u' O• d � �A r20, y �ScS s� g0"- Q° rU yp• Jcd (?` •`bc $a �� O}`Ov�O� O�O`Q � Q Q, ¢oF R F Q� 0 4' Q' Q' m� ry ry� ry + �" �" �` REQUESTED ANALYSIS STREET 2113 5 i- o a-,6 tsi PROJECT CITY, STATE• ZIP lkl�K pbImT 1�C i �S SAMPLER NAME (PLEASE PRINT) ��N At '{7-2-Ic-"w-, CONTACT PHONE SAMPLER SIGNATURE SAMPLE NUMBER (LAB USE ONLY) DATE TIME COw GRAS TEMP .0 Res CI 4-..ur raw rt � �� ttdrn sAx cif �� Isawf SA PLELOCATIONILD. R INQUISHED 13Y AT- IME R D REMARKS: �s w SAMPLE TEMPERATURE AT RECEIPT 3 3 °C RELINQUISHED BY DATE/TIME R CEi E KESEARCh & ANAl1riW - :'{fit LAb®R,4T®R9ESoIC. For: Custom Finishers, Inc 2213 Shore Street Hiah Point, NC 27263, Attn: Tom Crane Report of Analysis 5/12/2016 cli : o•.�Y ) Z. wI NC.137701 5 , Client Sample ID: SD02 Lab Sample ID: 18560-01 Site: Custom Finishers Inc Collection Date: 5/312016 9:00 Parameter Method Result Units Rep Limit Analyst Analysis Date/Time COD EPA 410.4 9 n1glL 5 KN 5/5/2016 Hydrocarbon O&G EPA 1664 Revision BlSilica <5 mg/L 5 ON 515/2016 Gel Total Suspended Solids (TSS) SM 2540 0-1997 7.2 me3/L 5 SK 5/512016 P.O. Bor, a73 106 Snort Street Kemersville. North Carolina 27284 Tel: 336.996-2841 Fax: 336-996-0326 V.ww.randalabs.com Page STORMWATER DISCHARGE OUTFALL (SDO) GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. NCG060205 FACILITY NAME. Custom Finishers, Inc. PERSON COLLECTING SAMPLES: CERTIFIED LABORATORY: Research & Analytical Part A: Specific Monitoring Requirements MONITORING REPORT SAMPLES COLLECTED DURING CALENDAR YEAR:y (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) COUNTY: Guilford e7Z1t►jV- RECEIVE [IONE NO.: (336)431-7141 Lab #: NC34 NOV 17 2015 PLEASE SIGN ON THE REVERSE � CENTRAL FILES DWR SECTION Outfall No. Date Sample Collected, mold d! r 00530 00400 00340 00556 31616 Total Suspended Solids, m /L pH, Standard Units Chemical Oxygen Demand, m 1L Oil and Grease, mglL Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 - 9.0 120 30 1000 SD02 . c7 I < NIA Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes X no (if yes, complete Part 8) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected, molddl r 00556 00630 00400 Oil and Grease, m IL Total Suspended Solids, m 1L pH, Standard Units New Motor Oil Usage, Annual averse gallmo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Mail Original and one copy to: Division of Water Quality Date 106/f%)-- (first event sampled) Q / Attn: DWQ Central Files Total. E ent Precipitation (inches): • "t 5 1617 Mail Service Center Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Raleigh, North Carolina 27699-1617 SWU-249-102107 Page 1 of 2 " 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." �L/4-,� � l�//Ch (Signatu f Permittee (Date) SWU-249-102107 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITORING REPORT Certificate of Coverage No. NCG : 060205 Facility Name: Custom Finishers. Inc. County: Guilford Phone No.: 336-431-7141 Inspector: Dennis L. Dzielski Date of Inspection: By this signature, I certify that this report is accurate and complete to the best of my knowledge: k- "e D,-a- (Signature of Permitte or Designee) I . Outfall Description Outfall No.: SD02 Structure (pipe, ditch, etc.): Pipe Inlet Receiving Stream: Muddy_Creek Describe the industrial activities that occur within the outfall drainage area: Pallet Storage. Tractor Trailer Activity, MDF Grindiny, and Collection 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: C Odor Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak Chlorine odor, etc.): 8/22/97 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 Q 3 4 5 6 7 8 9 10 5. Floating Solids Choose the number which best describes the amount of floating solids in the storm water Discharge where 1 is no solids and 10 is the surface covered in floating solids: 0 2 3 4 5 6 7 8 9 10 6. Suspended Solids Choose the number which best describes the amount of suspended solids in the Storm water discharge where 1 is no solids and 10 is extremely muddy: V 2 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the storm water discharge? YES �10 8. Oil Sheen Is there an oil sheen in the storm water discharge? YES NO 9. Other Obvious Indicators of Storm water Pollution: List and describe: W AT�,--q %JDL.,Jilo,3 je/-E36,,j i NOTE: Low clarity, high solids and/or presence of foam or oil sheens may be Indicative of pollutant exposure. These conditions may warrant further Investigation. 8/22/97 [ ESEAR6 & ANAlyrlcAl LABORATORIES, INC. Analytical / Process Consultations Phone (336) 995-2841 CHAIN OF CUSTODY RECORD WA'W0 fWAATP AWR I wi MUSEUM -era- •' �rn ' wool -_-MINE■■■■ ■■.■■■■■■■■■■■■■ �■■■■■MINE■ MINE■■■■■ ■�■■■■■ ■ ,■■■■.■■■■M■■ ..■...■....■.■ ■EM■■■■NE■ ■■■■r■■■■■■■■■■ �■�i■�riiiii� iiiiiiiiiiii■ii MI■■�■■■■■■■■MI■■i■ ■■■■■■■■■■■■■■■ RE5EARCh & ANALyTICA[ LAbomoRIES, INC. For: Custom Finishers, Inc 2213 Shore Street High Point, NC 27263, Attn: Tom Crane Report of Analysis 11 /512015 `fo ap NCtt34 y1 NC937701 } -��'QECNQ'9 ' Client Sample ID: SM tab Sample ID: 10853-01 Site: Custom Finishers Inc Collection Date: 10272015 15.00 Parameter Method Result Unita Rep Llmft AnalvQt Anaivefa DalefTlme CAD EPA 410.4 19 mg/L 5 KN 1029/2015 Hydrocarbons, Oil & Grease EPA 1W4 Revision A/Silica 45 mg& 5 JB 11P.12015 Gat Total Suspended Solids (TSS) SM 2540 D•1997. <5 ffv& 5 JB 10/292015 NA - nol onolyied A.O. Boz 173 'IN Short Street Kamersvlss, Nonh Carollne 27284 Tot; 336-06-2841 Fas:336.996-0326 www.randalebs.com Page 1 rat ma basi4 v1A P-&'5 T STORMWATER DISCHARGE OUTFALL (SDO) QUALITATIVE MONITOR Certificate of Coverage CG : 060205 Facility Name: Custom shers Inc. County: Guilford ne o.: 336-431-7141 Inspector: Dennis L. Dzielski Date of Inspection: By this signature, I certify that this report is accurate and complete to the best of my knowledge: � z D'k - (Signature of Permittee or Desi nee) 1. Outfall Description Outfall No.: SD02 Structure (pipe, ditch, etc.): Pipe Inlet Receiving Stream: Muddy Creek Describe the industrial activities that occur within the outfall drainage area: Pallet Storage, Tractor Trailer Activity, MDF Grinding and Collection 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.): �rr 8/22/97 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 0;) 3 4 5 6 7 8 9 10 5. Floating Solids Choose the number which best describes the amount of floating solids in the storm water Discharge where 1 is no solids and 10 is the surface covered in floating solids: 0 2 3 4 5 6 7 8 9 10 6, Suspended Solids Choose the number which best describes the amount of suspended solids in the Storm water discharge where 1 is no solids and 10 is extremely muddy - a, 2 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the storm water discharge? YES 8. Oil Sheen Is there an oil sheen in the stone water discharge? YES 9. Other Obvious Indicators of Storm water Pollution: List and describe: OP t t u -H V, ,fir es S-K,A' NOTE: Low clarity, high solids and/or presence of foam or oil sheens may be Indicative of pollutant exposure. These conditions may warrant further Investigation. 8/22/97 RESEARCh &. ANA1yTiCA1 } UbORATORIES, INC. Analytical / Process Consultations Phone (336) 995-2841 CHAIN OF CUSTODY RECORD 1 WATER l WASTEWATER 1 MISC. I COMPANY JOBNC. u i p_. $ 'r 5 y r �U rGS :.�yy C�`pU pp• GOO m �� (� y Um Qr U� 0 U y' U 2' Q' Q 'dry ,y� ti = REQUESTED At`IA�YSIS STREET ADDRESS PROJECT CITY, STATE, ZIP roe- "7 Z 3 SAMPLER NAn7E (PLEASE PRINT) C: rl nL' 5 19 41 L-Sr ( CONTACT {'NONE 1m G%Grwi 34 q 3 + �t tl SAMP .ER SIGNA7(IR(�{7 tom. 4V . $AMPLE. NUMBER (LAB USE ONLY) } BATE TIME Y uR46 fFM ,L R[9 1•[ill ^�.wra ivniii� s:.v� n'r. vq SAMPLE LOCATION 11D.. J) 1- S5 R LI QUISNED BY DATEMME I 00" RECEIVED BY `" REMARKS: ' 4 t�- SAI PLE TEMPERATURE AT RECEIPT 2?--L or, RELINpl;15HED ATENWE R E C IVED BY RESEARCh & ANA1YT9CA[ LABORATORIES? INC. For: Custom Finishers, Inc 2213 Shore Street High Paint, NC 27263, Attn: Tom Crane Report of Analysis 7/13/2015 A11A1Z(gY"�`�(ii�i -���q�� 1• C 'a14 : ': s Zo NC u34 y: NCn37701 DrA�1O a Client Sample ID; SD02 Lab Sample 10: 5B91-01 Site: Custom Finishers Inc Collection Date: 6/27/2015 17:40 Parameter Method Result Units Ron Limit Analyst Analysis Datefiime I COD EPA 410.4 10 mgtL 5 KN 6130/2015 Hydrocarbons, Oil B Grease EPA 1664 Revision A/Silica <5 mg/L 5 J8 7/8/2015 Gel Total Suspended Solids (TSS) 5M 2540 D-1997 <5 mg/L 5 JIB 6/30/2015 NA = not an��yzeC P.O. Box G73 10fi Shod Street KernersviUe, North Carolina 27284 Tel. 336-996-2841 Fax. 336-996-0326 www.randalabs,cam Page t rat cns ba_i: v1d i� GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. NCGO60205 FACILITY NAME: Custom Finishers, Inc. PERSON COLLECTING SAMPLES: 'D ENrA i 5 CERTIFIED LABORATORY: Research & Analytical Part A: Specific Monitoring Requirements STORK%EVJMGEPORT ALI_ (SDO) JUL 17 2015 SAMPLES COLLECTED DURING CALENDAR YEAR: CENTRAL FILES(This monitoring report is due at the Division no later than 30 days from DWR SECTION the date the facility receives the sampling results from the laboratory.) COUNTY: Guilford PHONE NO.: (336)431-7141 Lab #: NC34 PLEASE SIGN ON THE REVERSE —* Outfail No. Date Sample Collected, molddl r 00530 00400 00340 00556 31616 Total Suspended Solids, m IL pH, Standard Units Chemical Oxygen Demand, m IL Oil and Grease, mg1L Fecal Coliform, Colonies per 100 ml Benchmark - 100 Within 6.0 - 9.0 120 30 1000 S002 S < 5 , o a < S NIA 0 Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses See General Permit text. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes X no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected, molddl r 00556 00530 00400 Oil and Grease, m IL Total Suspended Solids, m IL pH, Standard Units New Motor Oil Usage, Annual average gallmo Benchmark - 30 100 6.0 - 9.0 - Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Mail Original and one copy to: }} Division of Water Quality Date IN -(first event sampled) , Attn: DWQ Central Files Total Event Precipitation (inches): . �� 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): SWU-249-102107 Page 1 of 2 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." 113�/S (Signatur f Permittee (Date) SW U-249-102107 Page 2 of 2