NCG100192_MONITORING INFO_20170815

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ � � � � � � 5
YYYYMMDD

NCCT-iowgZ
Ri ESEARCh & ANAIYTBCA[
LAbORATOR1ESy IlyC. NC Departmlent of
Environmental
y
AUG 15 20V
For: Central Recycling LLC Winston-Salem
1597 Kennedy Road }regional Office
Thomasville, NC 27360
Attn: Megan Foglesong
Report of Analysis
6/15/2017
an8iraaaa
A►aACrl/''•�.
vs NC #34 z
r
NC 437701
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Client Sample ID: 001 Lab Sample ID: 35414-01
Site: Central Recycling LLC Collection Hate: 6/5/2017 9:30
Parameter Method Result Units Rep Limit Analyst Analysis Dateaime
Hydrocarbon O&G EPA 1664 Revision B/Silica <5 mg/L 5 JF 6/12/2017
Gel
Lead, Total
PH
Total Suspended Solids (fSS)
EPA 200.7
SM 4500 H}8-2000
SM 2540 0-1997
0.061 mg/L 0.005 SK
9.34 Std. Units AP
269: ' mg/L
6/7/2017
6/5/2017 1545
5 AA 6/6/2017
NA = not onolyzed
P.O. Box 473 106 Short Street Kernersville, North Carofina 27284 Te1:,336-996-2841 Fax: [phone] www.randalabs.com Page 1
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RESEARCh CAI. ANAIYACAI
LABORATORIES, INC.
Analytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
WATER 1 WASTEWATER IMISC.
COM"NY
JOB NO,
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�� ti ryh� ." �" �� �`� REQUESTED ANALYSIS
4 T5S r1niV �1c::�� t
57 EETAQOR SS
PROJECT
CI STATE, ZIP
SAMPLER NAME (PLEASE PRINT)
CONTACT PHONE
�� tr, I•s: n LiC �31D,�13LL
SAMPLER SIGNATURE
SAMPLENUMBER
(LAB USE ONLY),
PATE
TIME
LGraA
GRAB
TEMP
C
HES
�W.Itf
GAOPIAE
�fy. I
SAMPLE
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SAMPLE LOCATION II.D,
,214 N _ 'A
L-5,17
12D
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RELINQUISHED BY
OATEITIME
RECEIVED BY
REMARKS:
� ` �{ G'r, �'lfi�t� Co A/-\,
SAMPLE TEMPERATURE AT RECEIPTS °C
RELI OUISHED BY
��
DATEIiIME
CSC
RE IVED BY
T �J
M

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100 SAMPLES COLLECTED DURING CALENDAR YEAR: _0_
(This monitoring report shall be received by the Division no later than 30 days
4 ` from the date the facility receives the sampling results from the laboratory.)
FACILITY NAME C�qnt'r � 1 ��-\IC-Lt P,IZ, LL COUNTY, C ,
PERSON COLLECTING SAMPLE(S) ;sip PHONE NO, n }
CERTIFIED LABORATORY(S)! <<_Lrtl\ �i��:�.�! �h�Lab # 5L- 1 -o i (
Lab # PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Part A: Stormwater Benchmarks and Monitoring Results
For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
Outfall
NO. ;
bate'
Sample Collected,
mo/dd/year ,
Total
Rainfall,
Inc.t es
'00400
00530
----
77023
01051
78142
-pH,
Standard.
` Units, -,
Total Suspended
Solids,(TSS),
mg/G
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), mg/L
Ethylene Glycol,-
mg/L
Lead, Total
Recoverable,
mg/L
Total Toxic
Organics3,
mg/L
Benchmark
r
- 47-7
-
i .
6 0-9 0
2
100/50
15
8,000
(Tiers 2 and 3)
0.03
1.0
7
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 in the General
Permit.
1See If pH values outside this range are recorded In sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this
benchmark range is the pH of the precipitation (within instrument accuracy) Instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be
documented to demonstrate background concentrations were below the benchmark pH range of 6-9.
?See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated In Appendix D, Table 11 of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, lost revised October 25, 2012
Page 1 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. The solvent
management plan shall include a list of the total toxic organic compounds used and the other elements listed In the General Permit. For those facilities allowed such a waiver, tide
discharger shall sign the following certification statement:
Solvent Management Plan Certification Statement
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I
certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the solvent
management plan included In the Stormwater Pollution Prevention Plan."
Name'(Pri name)
VI
Title (P nt titIee)
Signature Date
Mall Original and one copy to:
Division of Water Quality
Attn: Central Flies
1617 Mail Service Center
Ralellgh, North Carolina 27699-1617
"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 or Designee)
(Date)
Form SWU-251, lost revised October 25, 2TI2
( °age 2 cfl2

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 fin
Signature _
Date �0
DWQ Regional Office Contact Information_
ng violations."
For questions, contact your local Regional Office:
ASHEVI ;LE;;REG10iVAL OFFtCC
IiAYCTMTGVlI. C!RCGIONAL OFFICE
MOQRiSVIEEE?1t GiONAG0�1r1C
2090 US Highway 70
y
22-5 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone] -
[phone]
RTALCfGH`RCCfONAL„�FF1CG
WASHINGTOt;RCG:IOiVALQFF[CC
WLLM{NGTON,IZCGIONA.L'Of f ICC
3806 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTONkSAL]V3RRClONA"L QFFECiG
CE�fTRAL OFFICC
585 Waughtown Street
Winston-Salem, NC 27107
1617 Mail Service Center
Raleigh, NC 27699-1617
�s� ^To.Freserve,''prafect
11662� �iandenl�a►rc+e
336 771-5000
919 807-6300
JUorth.Csnofil?a'stuater..,"
SWU-264 - Generic Annual DMR
Last revised 5/1712013

"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 fi
Signature
Date �0
DWQ Regional Office Contact Information:
violations."
For questions, contact your local Regional Office:
ASHEVI LE:I2EG10NAL O F.ICE
W~ 4YCT CCVIL_L' C R) GIOIVAL O F CE
MOQRCSy_[LLE RCG16NAL^QFF+ICE
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043 1
[phone] -
_
(9� 433-3300
RALEiTt FItEG[0N—L ICii
WASHING7O 'SRGCIONpLAQFFICE
WILMINGTON;R GfONAL OFI?IC.r
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
(919) 791 -4200
[phone]
[phone]
;WINSTON SALEM,RE CIONAL OFFICE
,CENTRAL QFFICE
585 VJaughtown Street
1617 Marl Service Center
"To prese►ve,'prolec! f
Winston-Salem, NC 27107
Raleigh, NC 27699-1617
`E �t1AX a»d enhance E
{336} 771-5000 ,:
[phone] =-
�' J�lor�h.'Csro�iria's tivaler..:"
---- -------- -= - - ---1
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DN�R) 1 SPPP Annual -Update DATA REVIEW FORM
Calendar Year ��?? ID 1-11.
Individual NPDES Permit No. NCS� or
Certificate of Coverage (COC) No. NCG�IO®®©M
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility N
County:
Phone Number:
r _-> Total no. of 5DU5 monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Total
Rainfall,
inches
Parameter, units
6 pCGr
[`]r C-1
I oW
5.S
�.
Benchmark
N/A
Date Sample
Collected,
YY
,,,
•� a ���
_
��3 -:.
�; - �•. ; „
n �-
1011
� f:_
''�'�
5WU-Zb4 - Generic Annual DMR
Last revised 5/1712013

Additional Outfall Attachment
Outfall No.[��3�
Is this outfall currently in Tier 2 (monitored monthly)? Yes ® No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes a No ❑
Rainfall,
Inches
Parameter, units
"'
`Benchmark
N/A' r
Date Simple
Collected,
mmlddlyy.
{
SWU-264 - Generic Annual DMR
Castq'"5/1712013

0�t RIVIWAT111 I:: 111CIIA1.1 0 1)(01141. (11100)
MON11:0111Nti 11111t010
Faeiillies that lncoii orntc• a !colvf;nt nmttt;+Ht:rnantplan litter tlw tllrinwrrlc,r ViAl ttirni I'i'aovullllon 011111 nNiy rofill ot+l 111a1 0w(l w;llvla nr,inllctrlrrg nl total toxic orgatrll -, I I,,! solvent
manigernent p1mi shall inc:ludcr .i lim of Ill tt:oull ft:txlc In1{,111ir; r'rrttlpoilml:, 11ho(I rtricl 011i olhur olumi;litr. Visit d lts Iltf; c:;aijrtt,il 1'1;i'ii1K 174.1r• (how" f;iialltli ;illowc;d sut It o w-liver, the
discharger shall sign the f(Illowicil; rt;rllffcrtkian st;itc;nic:nt;
Solvent Management Plan Certlflralloo StMement
"Based upon my Inquiry of the person or persons clrectly rrapernslltlu for ittarrat{Irtµ ccnIII tllnroct; with Zhu punt►lt. monitorinfy rcxlulrunwilt for total tox
certify that to the best of my knowledge and belief', no dtimping of cotict,rttraled Irtxlr. orf{nttir.:; into Ihc; stormwater or nrens which are exposed to r;
stormwater runoff has occurred since filing the last discharge monitoring report. I further rr:rllfy III -at this facllity Is implementing all the provisions c
management plan included in the Stormwater Pollution Prevention Plan."
Name (POW name)
Title (Print title) ff
_ L
Signature Date
Mail Original and one copy to: .
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I,certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system des.
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the s
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, ant
am aware that there are significant penalties for submitting false Information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee or Designee) (Date)
Form SWU-251, lost revise
1.0), I
2012
7,of2.

AMR 1.7; WA
5
rA
MCDENll�
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report.
For guidance on filling out this form, please visit: h o tal.ncdenr.or /oueb I lr Inp des-storrr waterj
Permit No.: NJQ�/ �10'-ff"4La-
( or Certificate of Coverage No.: ����c/ E f2/ L/Facility Name: a +r f
County: �':. •• Phone No. �. ' , -7 au13
Inspector: *r f _lel � L_ _na*
Date of Inspection:,_.Time of Inspection; _ yt': �►► _
Total Event Precipitation (inches): i�fl
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
® Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
I some permits do not have this requirement Please refer to these definitions, if applicable.
i
j A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to_.10 consecutive hours of no
! precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The '72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Pbrmitte&or Designee)
Pagel of 2
SWU-242. Cast modified V31/2013

1. Outfall Description:
0utfaII No. in, C-_, I Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: I I l -,;. r — .-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear.and 5 is very cloudy:
1 (2D 3 4 5
S. Floating Solids:. Choose the number which best describes.the.amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
�D 2 3 4 5
G. Suspended Solids: Choose the number which best describes.the-amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 ( 3 4 5
7. Is there any foam in the stormwater discharge? Yes lEv,
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
5wU-242, last modified 7/31/2013