HomeMy WebLinkAboutNCG200448_COMPLETE FILE - HISTORICAL_20180625STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
w LC 01 UD-f4 e
DOC TYPE
;?I-, HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
2)01 0 (Q
YYYYM M DD
�- I
�"� �
��w�iT.?'.— 1' rY-cat �:.a.. �.�
Industrial Er,..,onmental Consultants, LLC
2603 Fessey Park Road • PO Box 40066
Nashville, Tennessee 37204
(615) 730-5059
Received
June 18, 2018
JUN 2 5 2
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: Change of Ownership Notice
Mountain Recycling Inc. — Hickory, NC NCG200355
Mountain Recycling Inc. — Connelly Springs, NC NCG200448
Dear North Carolina Division of Water Resources,
Land Quality Section
Asheville
This letter is provided to notify your office that there has been a partial change of ownership at
the above referenced Mountain Recycling facilities. Griffin -Gordon Recycling is no longer and the
facility is now owned by L. Gordon Iron & Metal as a separate company, Mountain Recycling, Inc.
We request transfer of the NCG20 industrial stormwater permits to Mountain Recycling, Inc. if
this is necessary since Gordon was an owner of the previous holding company. The name Mountain
Recycling Inc. will continue to be used for each location. Anthony Tipps is the General Manager of
Mountain Recycling and is authorized to sign reports on behalf of the company. You may also contact
Scott Powell at 1300 Salisbury Road,' Statesville, NC for permit correspondence.
Please advise what, if any, additional notice is required for your records. If you have any
questions or require additional information about the certification, please do not hesitate to contact me.
Sincerely,
Industrial Environm tal Consult ,
Jason Winningham, P.E.
cc: Anthony Tipps, MTI Hickory
Scott Powell, L Gordon I&M Statesville
North Carolina DEMLR Mooresville
North Carolina DEMLR Ashville
Energy, Mineral
and Land Resources
EN VIPONMENTAL QUALITY
March 12, 2018
Griffin -Gordon Recycling
Attention: Lyle Powell
1581 Highway 70
Connelly Springs, North Carolina 28612
Subject: Compliance Evaluation Inspection
Permit: NCG200448
Burke, North Carolina
Dear Mr. Powell:
ROY COOPER
Governor
MICHAEL S. REGAN
Seen•lurr
WILLIAM E. VINSON, JR
hileriui 1Jil'eclor
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the inspection I conducted at
the subject facility on February 28, 2018.
The report should be self-explanatory; however, should you have any questions concerning this report,
please do not hesitate to contact me at (828) 296-4500 or by email at Isaiah.reed@ncdenr.gov.
Enclosure: Inspection Report
Sincerely,
Isaiah Reed
Environmental Specialist
Land Quality Section
Slate of North Carolina I Fnvironment;I1 Quality I FTicrgy, Mineral and band Resources
2090 US 70 Highway I S%,annanoa, NC 28778-8211
928 296 4500 T
Compliance Inspection Report
Permit: NCG200448 Effective: 02/02/15 Expiration: 12131/19 Owner: Griffin -Gordan Recycling
SOC: Effective: Expiration: Facility: Mountain Recycling, LLC
County: Burke 1581 Highway 70
Region: Asheville
Connelly Spg NC 28612
Contact Person: Lyle Powell Title: Phone: 828-397-7493
Directions to Facility:
1-40 to exit 116. Right off ramp. Left at the first light. Facility is 1 mile on the right
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 02/28/2018 Entry Time: 01:30PM Exit Time: 02:30PM
Primary Inspector: Isaiah L Reed Phone: 828-296-4614
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Wholesale Trade of Metal Waste and Scrap Stormwater Discharge COC
Facility Status: ❑ Compliant Not Compliant
Question Areas:
■ Storm Water
(See attachment summary)
Page: 1
A
Permit. NCG200446 Owner - Facility:Griffin-Gordon Recycling
Inspection pate: 02/28/2018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On February 28, 2018, this facility was inspected for compliance. The facility is not in opperation anymore, but the permit
remains active due to the storage of materials on site. The Analytical and Qualitative monitoring has not been done due to
the absence of flow. During the inspection it was observed that evidence of frequent flow at the monitoring point was present,
and that the stormwater detention basin has filled up. The facility is directed to clean out the stormwater basin, and obtain a
sample with the next rain event. Please contact this office to report the results at (828) 296 4614 or by email at
isaiah.reed@ncdenr.gov.
Page: 2
Permit: NCG200446 Owner - Facility: Griffin -Gordon Recycling
Inspection Date: 02/28/2018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
M ❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
■ ❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
M ❑ ❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
0 ❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
0 ❑ ❑ Cl
# Has the facility evaluated feasible alternatives to current practices?
0 ❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
■ ❑ ❑ ❑
# Does the Pian include a i3MP summary?
❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
M ❑ ❑ ❑
# Does the facility provide and document Employee Training?
❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑ ❑ ❑
# Is the Plan reviewed and updated annually?
■ ❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
M ❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
❑ 0 ❑ ❑
Comment: See Summary for further information.
Qualitative Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? ❑ 0 ❑ ❑
Comment•. See_ Summary for more information.
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? ❑ ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ❑ MCI
Comment:' See summary for more information.
Permit and dutfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? ❑ ❑ M ❑
# Were all outfalls observed during the inspection? ❑ 1:10 ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ M ❑
# Has the facility evaluated all illicit (non stormwater) discharges? ❑ 110 ❑
Comment:
Page: 3
Compliance Inspection_ Report
Permit: NCG200448 Effective: 02/02/15 Expiration; 12/31/19 Owner: Griffin -Gordon Recycling
SOC: Effective: Expiration: Facility: Mountain Recycling, LLC
County: Burke 1581 Highway 70
Region: Asheville
Connelly Spg NC 28612
Contact Person: Lyle Powell Title: Phone: 828-397-7493
Directions to Facility:
I-40 to exit 116. Right off ramp. Left at the first light. Facility is 1 mile on the right
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 02128/2018 Entry Time: 01:30PM Exit Time: 02:30PM
Primary Inspector: Isaiah L Reed Phone: 828-296-4614
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Wholesale Trade of Metal Waste and Scrap Stormwater Discharge COC
Facility Status: Compliant Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page: 1
Permit: NCG200448 Owner - Facility. Griffin -Gordon Recycling
Inspection Date: 02/28/2018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
inspection Summary:
On February 28, 2018, this facility was inspected for compliance. The facility is not in opperation anymore, but the permit
remains active due to the storage of materials on site. The Analytical and Qualitative monitoring has not been done due to
the absence of flow. During the inspection it was observed that evidence of frequent flow at the monitoring point was present,
and that the stormwater detention basin has filled up. The facility is directed to clean out the stormwater basin, and obtain a
sample with the next rain event. Please contact this office to report the results at (828) 296 4614 or by email at
isaiah.reed@ncdenr.gov.
Page: 2
Permit: NCG200448 Owner -Facility:Griffin-Gordon Recycling
Inspection Date: 0212812018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Does the site have a Stormwater Pollution Prevention Plan?
# Does the Plan include a General Location (USGS) map?
# Does the Plan include a "Narrative Description of Practices"?
# Does the Plan include a detailed site map including outfall locations and drainage areas?
# Does the Plan include a list of significant spills occurring during the past 3 years?
# Has the facility evaluated feasible alternatives to current practices?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# Does the Plan include a Spill Prevention and Response Plan (Si
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
# Does the facility provide and document Employee Training?
# Does the Plan include a list of Responsible Party(s)?
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment: See Summary for further information.
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Comment: See Summary for more information.
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Comment: See summary for more information.
Permit and Outfalls
# Is a copy of the Permit and the Certificate of Coverage available at the site?
# Were all outfalls observed during the inspection?
# If the facility has representative outfall status, is it properly documented by the Division?
# Has the facility evaluated all illicit (non stormwater) discharges?
Comment.
Yes No NA NE
• ❑ ❑ ❑
• ❑ ❑ ❑
❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
■❑❑❑
❑ ❑ ❑
■❑❑❑
■❑❑❑
■❑❑❑
■❑❑❑
❑ M ❑ ❑
Yes No NA NE
❑■❑❑
Yes No NA NE
❑■❑❑
❑ ❑ M ❑
Yes No NA NE
❑❑■❑
❑ ❑ M ❑
❑❑■❑
❑❑■❑
Page: 3
Alexander. Laura
From: Alexander, Laura
Sent: Monday, May 09, 2016 11:55 AM
To: Kucken, Darlene
Subject: RE: Rescission Request for NCG200448
Thankyou! O
From: Kucken, Darlene
Sent: Monday, May 09, 2016 11:21 AM
To: King, Melissa <Melissa.King@ncdenr.gov>
Cc: Alexander, Laura <laura.alexander@ncdenr.gov>
Subject: RE: Rescission Request for NCG200448
a�- Ids ar+ 7 17� i �O
As it turns out, they filled out the form incorrectly. They have closed the Surry County facility and wish to rescind that
permit. They put the wrong permit number on the rescission form. They wish to pull this request off the table and they
will resubmit for the Surry county facility.
think my job here is done
Darlene Kucken - Darlene.KUcken@ncdenr.gov
North Carolina Dept. of Environmental Quality
Asheville Regional Office
Division of Energy, Mineral, and Land Resources
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: 828-296-4500
Fax: 828-299-7043
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
may be disclosed to third parties.
`A, Go Green! Print this email only when necessary. Thank you for helping NCDENR be environmentally responsible.
From: King, Melissa
Sent: Friday, May 06, 2016 11:09 AM
To: Kucken, Darlene <darlene.kucken@ncdenr.gov>
Cc: Alexander, Laura <laura.alexander@ncdenr.gov>
Subject: FW: Rescission Request for NCG200448
Darlene
Please help Laura - I know you work with Burke County. Thanks
Melissa
ESSE QUAK VIOENI
Melissa 1. King, PE - Melissa.KingPncdenr.gov
North Carolina Dept. of Environmental Quality
Asheville Regional Office
Division of Energy, Mineral and Land Resources - Land Quality
I
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: 828-296-4500
Fax: 828-299-7043
Notice: E-mail correspondence to and from this address may be subject to the North Carolina
Public Records Law and therefore may be disclosed to third parties.
From: Alexander, Laura
Sent: Friday, May 06, 2016 11:02 AM
To: King, Melissa <Melissa.Kin ncdenr. ov>
Subject: FW: Rescission Request for NCG200448
Good Morning Melissa,
I'm going through my outstanding rescission folder and noticed this one had not been inspected. Can you take a look at
this?
Thank you,
Laura Alexander
Administrative Assistant
Stormwater Permitting Program
North Carolina Division of Energy, Mineral and Land Resources
North Carolina Department of Environmental Quality
919 807 6368 Office
919 807 6494 Fax
laura.alexander ncdenr. ov
512 North Salisbury Street
1612 Mail Service Center
Raleigh, North Carolina 27699
Nothing Compares-,.,-
r
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Alexander, Laura
Sent: Monday, February 29, 2016 9:44 AM
To: King, Melissa <Melissa,King@ncdenr.gov>
Subject: Rescission Request for NCG200448
Melissa,
I'm not sure how this one was missed but I'm thinking I sent it to the wrong region initially. Their form says Surry county
but the facility is actually in Burke county.
Thanks for your help,
2
Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
w�
NCDENRNational Pollutant Discharge Elimination System
C-- b. .r.rr....Y
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
2] Owner/Facility Information: * Final corres�
ondence will be
matted to the address noted below 1
Owner/Facility Name NAnw T'21 7G'n ,doh &gyd�na DBR• ft)WnJa-n p
Facility Contact
Street Address
City
County
Telephone No.
i t� PPs� Cm�ra ma; I , co r►-►
3) Reason for rescission request (,This is required information. Attach separate sheet if necessary):
Facility closed or is closing on iaf o'Z015 . All industrial activities have ceased such that no discharges of
Stormwater are contaminated by exposure to industrial activities or materials.
n�
❑ Facility sold to on :_� . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner
❑ Other:
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Signature Date U' f q'aa) s
Print or type name of person signing above Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: 919-807-63001 FAX: 919-807-6492
An Equal Opportunity 1 Affirmative Action Employer
RECEIVED
AUG 19 2015
DI;NR-LAND OUALITY
8TO'"ATERPERMITTING C
v
\Vf
Division of Energy, Mineral & Land Resources
Land Qualit • Section/Stormwater Permitting Program
N�DENR National Pollutant Discharge Elimination System
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
I Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
2) Owner/Facility Information: • Final correspondence will be mailed to the address noted below
—� - r,
Owner/Facility Name NAA � S GP11- n L�:a n
Facility Contact
Street Address
City
County
Telephone No.
Ira
j�t]unt Al L4 V State NC_ ZIP Code 9q 03 U
SL,MV E-mail Address EPSf?P�Mbtgmw;l, c,7,rrj
Fax-.
g�- SyOc7 T
3) Reason for rescission request (,This is required information. Attach separate sheet if necessary):
FZ(Facility closed or is closing on t c"I0�5 . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
�Y-- r,-
❑ Facility sold to D�'-.� ���::� �; on t1{"7470 If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
❑ Other:
a) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Signature Date MO) S- - - -
a5�ut�PPs �R btu
Print or type name of person signing above Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
RECEIVED
Stormwater Permitting Program
AUG
1612 Mail Service Center
19 2015
Raleigh, North Carolina 27699-1612
'STRMWAMR PERMITTING
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: 919.807.6300 ti FAX: 919.807-6492
An Equal ppportunity'i Affirmative Action Employer
Deiegation of Authority
I, LQ t, X5 l OPLDW T (name),, hereby designate the person or
specifically described position below to be a duly authorized representative for the purpose of
overseeing compliance with general permit No. NCO200000 to discharge stormwater under
Certificate of Coverage NCG200448. The designee is authorized to sign any reports, stormwater
pollution prevention plans and all other documents required by the permit.
(name of delagated person ar posltion)
(--moor) C � (�C'�-- (company)
jZlf (address)
9t nrI �f C 2S o� cGly, s1a,e, zip)
—1--11109 - (telephone)
By signing this authorization, I confirm that I meet the requirements to make such a designation
as set forth In NCG200000, and that the designee above meets the definition of a "duly
authorized representative" as set forth in NCG200000.
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
porsonnel properly gathered and evaluated the information submitted. Based on my inquiry of
the parson 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 fine and Imprisonment for knowing violations. '
��!} r {s4gnature)
v D r A`J (printed name)
(flue)
�i r;-Y'1�� �D!'r�9i1 •pL�C Cr 5 LLC (oompany)
(date)
To delegate authority this form must be completed and submitted to .the: Division of
Water Quality, North Carolina Department of Environment and Natural Resources, 1617
Mail Service Center, Raleigh, North Carolina, 27699-1617
JUN 14 2010
OENti - -A
W A rF9Q
,o
Michael F. Easley, Govemor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
June 16, 2008
Mr. Hubert P, Young
Griffin -Gordon Recycling, LLC
1581 US Highway 70
Connelly Springs, NC 28612
Dear Mr. Young:
Coleen H. Sullins, Director
Division of Water Quality
Subject: NPDES General Permit NCG200000
Certificate of Coverage NCG200448
Griffin -Gordon Recycling, LLC
Formerly C & L Scrap Metal, Inc.
Burke County
Division personnel have reviewed and approved your request to transfer coverage under the General Permit,
received on May 15, 2008.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General
Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements
of North Carolina General Statutes 143-2I5.1 and the Memorandum of Agreement between North Carolina and
the U.S. Environmental Protection Agency.
If you have any questions, please contact the Stormwater Permitting Unit at (919) 733-5083, extension 502,
Sincerely,
ORIGINAL SIGNED BY
KEN PICKLE
Coleen H, Sullins
cc: DWQ Central Files
Asheville Regional Office, Water Quality Section
Stormwater Permitting Unit
one
NpNaCarolina,
turally
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone (919) 733-7015 Customer Service
Internet: h2o.enr.state.nc.us 512 N. Salisbury St, Raleigh, NC 27604 FAX (919) 733-2496 1-877-623-6748
An Equal OpportunitylAKrmative Action Employer— 50%.Recyded/10% Post Consumer Paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG200000
CERTIFICATE OF COVERAGE No. NCG200448
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
GRIFFIN-GORDON RECYCLING, LLC
is hereby authorized to discharge stormwater from a facility located at
MOUNTAIN RECYCLING, LLC
1581 US HIGHWAY 70
CONNELLY SPRINGS
BURKE COUNTY
to receiving waters designated as Downing Creek, to Lake Rhodhiss, to Catawba River, a class WS-IV river, in the
River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, I1, 111, 1V, V, and VI of General Permit No. NCG200000 as attached.
This certificate of coverage shall become effective June 16, 2008.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 16, 2008.
ORIGINAL SIGNED BY
KEN PICKLE
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, A.E. Director
Division of Water Quality
March 9, 2007
Mr. Robert Crawley
C & L Scrap Metal, Inc.
1581 Hwy 70
Connelly Springs, North Carolina 28612
Subject: General Permit No, NCG200000
C & L Scrap Metal, Inc.
COC No. NCG200448
Burke County
Dear Mr. Crawley:
In accordance with your application for a discharge permit received on February 2, 2007, we are
forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state ---
NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US
Environmental Protection Agency dated May 9, 1994 (or as subsequently amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Water Quality. The Division of Water Quality may require modification or revocation and
reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain
other permits which may be required by the Division of Water Quality or permits required by the
Division of Land Resources, Coastal Area Management Act or any other federal or local governmental
permit that may be required.
With respect to your question concerning adding a second, new facility to this permit, the new
facility, once completed, will have to apply for a separate permit. If you have any questions concerning
this permit, please contact Bill Diuguid at telephone number (919) 733-5083 ext. 382.
Sincerely,
ar.ALDL Y BtrNNETT
Alan W. Klimek, P.E.
cc: Asheville Regional Office
Central Files
C Stormwater Permitting Unit Files
Attachments
N�e Carolina
Ntumlly
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone (919) 733-5083
Internet: www.ncwaleraualilv.ory location: 512 N. Salisbury St. Raleigh, NC 27604 Fax (919) 733-9612
An Equal Opportunity/AffirmaVve Action Employer - 50% Recycledrt 0% Post Consumer Paper
Customer Service
1-977-623-6748
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG200000
CERTIFICATE OF COVERAGE No. NCG200448
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
C & L Scrap Metal, Inc.
is hereby authorized to discharge stormwater from a facility located at
C & L Scrap Metal, Inc.
1581 Hwy 70
Connelly Springs
Burke County
to receiving waters designated as Drowning Creek, to Lake Rhodhiss, to Catawba River, a Class WS-IV river, in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11,111, IV,
V and VI of General Permit No. NCG200000, as attached.
This Certificate of Coverage shall become effective March 9, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 9, 2007.
C� IGNAL SIGNED BY
-3R' ADLEY SENNETT
Alan W. Klimek, P.E. Director
Division of Water Quality
By Authority of the Environmental Management Commission
•oul 'tlon;den '8661 (o) ly6uAdoo
Re: [Fwd: NCG200448 C&L Scrap Metal, Inc.]
Subject: Re: [Fwd: NCG200448 C&L Scrap Metal, Inc.]
From: Laurie Moorhead <Laurie.Moorhead@ncmail.net>
Date: Thu, 22 Feb 2007 08: l 1:44 -0500
To: Bill Diuguid <bill.diuguid@ncmail.net>
CC: Starr Silvis <Starr,S11vis@ncmail.net>
no
Please issue this COC. I have already visited this site which has been in operation for multiple years
without a permit.
Thanks.
Laurie
Bill Diuguid wrote:
Sorry! this one is yours.
bill
Subject:
NCG200448 C&L Scrap Metal, Inc.
From: Bill Diuguid <bill.diuguid ,,ncmail.net>
Date: Wed, 21 Feb 2007 15:44:19 -0500�
To: Corey Basinger <Corey.Basinger@nctnai1.net>
To: Corey Basinger <Corey.Basint er(cl),ncmail.net>
Corey:
Please review the attached application . In addition to the table below I've also attached a scanned
copy of the NOI for review.
COC # Facility Location City
NCG200448 C&L Scrap Metal, Inc. 1581 Hwy 70 Connelly Springs
Questions? Give me a call. If you could respond by 3/21/2007, I'd appreciate it, so I can issue their
COC.
Thanks.
Bill
William H. Diuguid, AICP
Community Planner, Wetlands and Stormwater Branch
Division of Water Quality
Department of Environment and Natural Resources
1617 Mail Service Center
of 2 3/5/2007 9:47 AM
[Fwd: NCG200448 C&L Scrap Metal, Inc.]
Subject: [Fwd: NCG200448 C&L Scrap Metal, Inc.]
From: Bill Diuguid <bill.diuguid@ncmail.net>
Date: Wed, 21 Feb 2007 15:51:11 -0500
To: Laurie Moorhead <Laurie.Moorhead@ncmail.net>
CC: Corey Basinger <Corey.Basinger@ncmai1.net>
Sorry! this one is yours.
bill
William H. Diuguid, AICP
Community Planner, Wetlands and Stormwater Branch
Division of Water Quality
Department of Environment and Natural Resources
1617 Mail Service Center
Raleigh North Carolina 27699-1617
Phone: 919-733-5083, ex 382
Fax: 919-733-9612
Subject: NCG200448 C&L Scrap Metal, Inc.
From: Bill Diuguid <bill.diuguid@ncmail.net>
Date: Wed, 21 Feb 2007 15:44:19 -0500
To: Corey Basinger <Corey.Basinger@ncmai1.net>
Corey:
Please review the attached application . In addition to the table below I've also attached a scanned copy
of the NOl for review.
COC 4
Facility
Location
; City
!NCG200448
C&L Scrap Metal, Inc.
1581 Hwy 70
Connelly Springs
Questions? Give me a call. If you could respond by 3/21/2007, I'd appreciate it, so I can issue their
COC.
Thanks.
Bill
William H. Diuguid, AICP
Community Planner, Wetlands and Stormwater Branch
Division of Water Quality
Department of Environment and Natural Resources
1617 Mail Service Center
Raleigh North Carolina 27699-1617
Phone: 919-733-5083, ex 382
Fax: 919-733-9612
. ._.,.----..............................................................."--. ._.. __ ..... ....., ...._._._..._.. -I
NCG200448 C&L Scrap Metal, Inc.' Content -Type: messagelrfc822
Content -Encoding: 7bit
k
of 2 2/21/2007 3:53 PM
Burke Co.. NC -- Printable Map
http://arcims.webgis.tiet/nc/burke/printable.asp'?process=id I Rx2= I ...
}
N
A
recnl : 38778
PIN:276303106142
Parcel Address: 1581 1629 US 70
Parcel Owner:
CRAWLEY ROBERT & OVETA JANE
RT 4 BOX 792 D
HICKORY NC 28601
Burke Co., NC
Parcels
Map: 87 Page: 60 Blk. Lot: 5 24
Deed Reference: Bk. 579 Pg. 52
Land Area: 6.50 acres
Assessed Value:$184,202
Building Value: $135,110
Land Value: $49,092
Other Value: $0
Sales Amount: $10,150
Sales Date: 11/13/1979
DISCLAIMER: The information contained on this page is NOT to be construed or used as a 'legal description", Map
information is believed to be accurate but accuracy is not guaranteed. Any errors or omissions should be reported to the
Burke County Geographic Information Systems Division of the Office of Information Technology. In no event will Burke
County be liable for any damages, including loss of data, lost profits, business interruption, loss of business information or
other pecuniary loss that might arise from the use of this map or the information it contains.
http://www.webgis.net Anderson & Associates, Inc. httpWwww.andassoc.com
1 of'] O1129/2007 1 1:49 AM
V AtDWTW
qrt-B -URx-s � C
17
-v - , 13r
rFl
ad
W.
r
. . .... Ilgr
R,
Of.
T I'll
LA
- "Vi
021
N
N *V
i/liriper
't
,-W X'. -1 rl.
v
N
F
I If,
NNOQ,, h.. MG
P
grl
Z7, X
ft,
EJ fe,
jg"
:4
11 A.
W6-
u--� v. "41
):tj
j
jW4
MI'
J—V
V— I
U'A V"I,L',:( ,�gr
7
� Oil
'0,
Z,
wN
A
. JL v,k�
41
fff
mu
S -
-IF
nq�
N,
I.
- "q;�OK
L rm
%
TN
j
M It
V-
Uo
j
, "t
mv- v 117, il n— -
rA —
g
Copvdqht (C) 1998, WPtech, Inc.
FLqa=rwjm
A,
Markers
Name: NCG110099 City of Lenoir Gunpowder Creek WWTP
Short Name" 1.Z0099 i
Coordinates: 035 50`' 388 60" N, 081 ° 27' 48.90" W
Comment: City of Lenoir Gunpowder Creek WWTP to Catawba River Basin; class C; Subbasin
03-0$=32; Quad D12NE Lenoir, Caldwell County
Name: NCG200448 C&L Scrap Metal, Inc.
Short Name: 200448
Coordinates: 0356 43' 41.16" N, 0810 28' 34.47" W
Comment: C&L Scrap Metal, Inc. Connelly Springs, Burke County, Drowning Creek to Lake
Rhodhiss, Catawba River Basin; Subbasin 03--08-32, stream index 11-52-(1),
WS-IV, quad E13NW Longview
r 4
Semi-annual Stormwater Discharge Monitoring Report DMR)
for North Carolina DEMLR General Permit No. CG200000 — Scrap Metal Recycling
Date submitted
CERTIFICATE OF COVERAGE NO. NCG20J2_ 1
SAMPLE COLLECTION YEAR 2-0 t 7
FACILITY NAME U -.t t�
l
`,n Pvt� arl,q SAMPLE PERIOD ❑ Jan -June July -Dec
"
COUNTY
rt✓J or ❑ Monthly' rmonth)
PERSON COLLE TING SAMP ES
L66 Cert. #
I44o
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
LABORATORY
—RECEIVED
Comments on sample collection or analysis:
❑Saltwater [pDther 17 creey,
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CE:ha7--�a.� ��3i_Ec
Part A: Stormwater Benchmarks and Monitoring Results
� ��� `''- �"" �'`J
No discharge this period?' �J() CICE tnJ
Uutfall No.
Dete Sample
24-flour rainfall.
-'Non polar oi1$i grease'
Collected 1`
amounts
-Total $uspe'nded,
Chefmical Oxygen .
_ EPA Nlethbc# ;1664
Copper,
tread,
Zinc,
(mo/dd/yr).
Inches3
Solids-
:z}ema'nd
=(SGT-HEM),
Total ``
Total
Total,
Benchmarks =>
_
100 Itig/L or,
O10 mg/L:oi
0.075 mg/L' or
0' 126 mg/L or
SO—rng/O .
120 mglL
35 mg/L
0.005.m$/Ls:
0.210 rsikhs
0.090 r irA
- Monthly -sampling (instead -of -semi-annual)- must -begin-with-the.second-consecutive-benchmark exeeedance-for-the-sameparameter-at the same-outfall:----------
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3 or Table 4, identifying protected receiving water classifications where the more protective TSS benchmark applies.
s Stormwater discharges into receiving waters classified as saltwater are subject to the second listed benchmark.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDi_, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note. if y, ou report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1 or Tier 3 responses. See General Permit.
Permit Date: 02/02/2015-12/31/2019 SWU-255, last revised 1/28/2015
Page 1 of 2
3 }
� f
,Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period
Outfall IVo Date Sampl, 24-hour rainfall s
Collected amount„ Non polar.0&G by EPA
(mo/8d/,yr),, InChes3 1654�(SGT,HEIYI),. _ Total SuspeniledSolids
Ber:chmarks - > 15:mg/L iQg mg/Lor 50 tng%L
_.
Footnotes from Part A also apply to this Part B
�jv 00vi
Note: if you report a sample value in excess of the benchmark, you must Implement Tier I, Tier 2, or Tier 3 responses. See General Permit.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an original and one cony of this DMR, lncludina all "No Discharge" reports. within 30 days of recent of the lab results or at end of monitoring period
in the case o "No Dischar e" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED -
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signaturb of
1 V,►
(Date)
Permit Date: 02/02/2015-12/31/2019 5WU-256, last revised 1/28/2015
Page 2 of 2
�- C.
Semi-annual Stormwater Dischar a MonitoringReport DMR
for North Carolina DEMLR General Permit No. N G200000 — Scrap Metal Recycling
Date submitted i [ 5
CERTIFICATE OF COVERAGE N NCG200—`` %
FACILITY NAME rj/ lg (140.10M"rl
COUNTY
PERSON COLLECTING SAMPLES --s�
LABORATORY fv, 11( 1YIr�L Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
C
SAMPLE COLLECTION YEAR a50 i 5
>Ir 4) SAMPLE PERIOD ❑ Jan -June July -Dec
E!cgvi1=n or ❑ Monthly)__ (month)
or
DING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
DEC 0 7 2015 ❑Zero -flow ❑Water Supply [:]SA
❑Saltwater 0Other��' �6&k
TRAL i=1LE=S T
CEN
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
ZNo discharge this period?2 No Fr w
^.j,
,,' r
- `�, 7-
-`:f -•
4 , L
-'�+�� -phi
� ��-' -� �i
�. t' i )x-.i, yi r
fr �;}�. SJ''._# 7�
'_ s _ '.r � `a
� Y: a' { s �-s, i
,?- v�:.-,i i-. j,_�
._�_
..r- _Pa.--.�t F.
a fi"..�; ry4. :�
R,-,.y,...$'i ���?. F�-
: k- Ott,. ,�'� S's.� ,�'-..� sY
#ti �£" .�t r.t � -2 -�
.`.c �_V•.r -`s ��.iaF '�.+34
5..� }. y _
� -r � -�f, :�•i.,
xi'" ..v '� �
1. 4 �
-
-�� .,., _
s'-
:�`� r-
k
•'yl `
Uate Sam�}le ,
..�,�,'a
;24-hour rainfalls
..;
i� ,.,.'.
*5'>
1 T z,?. R'r, L
- �,�
S
Non=y�'oia�:ait°& grease.
\1,
,
, t
Pe z 3
t .�?
::_:DUtf_allaNO.i:_•.
.t. .�l .�•_
_ s" ,s-..-1�.'
rr. z,r ,:-',.-....
r.�:.�
..:- .'..:.
:t'rjYNy
ry.
,y �:r..
.�.r .,FS:'
`
r
x'Colfected
amount;
Total'Suspended;+
- t
?•Chemical Oxygen _
ERA',Method�1664
.Co er •
�ps.• i
Lead' ".
•' �;Zint �=
r �.TC
:^e
'shye ,'c.:z. '.�
'
fir �f' `�.
`''
,r N. _%
` GDemand
�W- k ,.�,.,_,,�, s'c
-rSGT=HEM
_
L�
=
u 'lE.
,r i - ;
and dd r
tnch'es3:
Solids:- +
,Y :
4k.3
lfotal
Total'
Total
"S
nchm., 6ks
>•:
{ -y .--d
��".'-_�;5,�,x
i3_ _ -N F7
- �`:�a��-w�
.S' �•: .s+n
$ r.
; �`. --i TASs`r>'
n�a
-
er# .:i�1i� y-.c,:jK
:0:x010 m g/.C.o;r
=_ 01 05-r►i'
=0:r1gg/ r•ti'..-,J.,
,:B_: _e
r:s. t -� 5
�s .,-.
s -;- e.
vym:m: do
r._u .
x a' , ,r.nn,: y:grcr/.L
,,£�x�_'`_
e-.{.ih:9
k tir•.i
-"1'
i
..} -.�
:,`
.�:.ffi0S-r0 Og//LL.L
l2U3�
,i,_ .F.: .''h:
:`-
5;mg/
.210.
/LLov5:
0296:i'�m,_, n
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3 or Table 4, identifying protected receiving water classifications where the more protective TSS benchmark applies.
s Stormwater discharges into receiving waters classified as saltwater are subject to the second listed benchmark.
Note: Results must be reported in numerical format. For example, -do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark _ you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit.
Permit Date: 02/02/2015-12/31/2019 SWU-255, last revised 1/28/2015
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
41vo discharge this period?2
Y"
, Outfall N4
xs �
is •�` �,
� _
A $ •� � � �R.�,
tis rR T ",
�`r Collected$}�
.
nr�atnoun�,t
,Non polar&Gby EPA
�
' S
,. { 4 4
tal suspended ' Solijd5
r ,
U
100 mg/L or.50 mg/L
115-mg/L
Footnotes from Part A also apply to this Part B
N 0 RV4
Note: /I you report a sample value in excess of the benchmark you must implement Tier 1 Tier 2 or Tier 3 responses. See General Permit.
FOR PARTA AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS 71ER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OL!TFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [] NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES G NO [J
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copv of this DMR, includipa all "No Discharge" mports within 30 days of receipt of the lab results for at end of monitorina period
in the case of "No Discharae" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
Permit Date: 0/02/2015-12/31/2019
3G 1 5
(Dat )
5WU-256, last revised 1/28/2015
Page 2 of 2
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. N G200000 — Scrap Metal Recycling
Date submitted 5 6
CERTIFICATE OF COVERAGE NO. NCG20 0_4
FACILITY NAME C� E�,_n �ofda� Rccyci; r�g D�+a� �r10t1,�}t� ; I1
COUNTY �;Ur iC I_
PERSON COLLECTING SAMPLES `T,-PP 5
LABORATORY 5'Tv,+tS\h tte Lab Cert. # y 4 u
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR c�Q 15
F,ecrcllD SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ❑ Monthly' lmonthl
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]Water Supply ❑SA
�p ❑Saltwater ther awn^n�Gr'ezK
V e® -
JUfa 18 2015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION �No discharge this period?' No Flo rJ
�'._,cy
- Mri 'r:
r� t'ti, ,,
t
,1 6
-
L,.�C^i1'y
fiY'. t _
�. F !.
—
i
S
-
1.' •;,&grease
4., •\.
4
s -
-�.5 5
x;;
=Collectedrr
amount,t ti
;TotalSus ended
°Ghemical'Ox en=-
}:il S`
�� EPAtMethod.1664
1 .i'.
;Copper,
t
Lead,
..l ti
:.Sx
.� t -5 ^'a
Y�C',°y+4 f
-s l
r;(mo/dd/yr),,
c Y.t•:-t W_-i?T`({ � I.s
w\-r" 4, 3+"'7d.-'Y.�is
Inches
:-i :\T'"- v-� d. .
s�.- a• _ s
Solids,
Sfii-.. 3- k�70 .,�'
_�. '- - t _"
4:1.-Ki�� tic :�
S !
'rg i
-
a
> _ _
;,n, ,
,� ,y:
:Qemand_a
; [SGT-HEM] 4
Tota_I4
Total . _
,Total
8encltimarks -_>�
z 1 y
« \ 100in L,or: +�;
01 -�
r i �"
-'•i}' ;"l,- ?
k s
r-
0:010 m L or
6I. F,
0:075.mp�L or
La
i.,.r,
(�f` _
F.5
in
m
rt gL _
120;rii L�
B/
15';ni L is
l;/
0+005 >;/ LS
0 210m V =
BI
a : 0.090 >I/ L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3 or Table 4, identifying protected receiving water classifications where the more protective TSS benchmark applies.
s Stormwater discharges into receiving waters classified as saltwater are subject to the second listed benchmark.
Note: Results must be reported in numerical format. t=orexample, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or othersimilar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mR/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excesses the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit.
Permit Date: 02/02/2015-12/31/2019 SWU-256, last revised 1/28/2015
Page 1 of 2
r9r2il
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
[?fNo discharge this period?' 00 �loti.i
4
-�'r-
µ
r
Date Samples
24 hour rainfall w
Outfall Now
R
x {
Non
, -� - , `y J
Collected
./T •3L � '11� =F
x amaun3,
s� F Yt If
polar O&Gby EPA
2 1:- f C.-. Y.
Total Suspended.Solids
Y
i
tF� Inches '1`
._T�k :
:. � .,16641SGT-HEM)
4
p8enchmarks...,')
�Iryi
x15 mg/I.�:'¢r'>b�
100 mg/Lor 50 mg/L
v.'§w::t
4 ;=b4�ax'n.}
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark you must implement Tier 1,. Tier 2, or Tier 3 responses. See General Permit.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copy of this OMR, including all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitoring period
in the case of "No Discharae" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature
Permit Date: 02/02/2015-12/31/2019
& Z i5 W(5
(Date)
SWU-256, last revised 1/28/2015
Page 2 of 2
STORMWATER DISC. AGE OUTFALL (SDO)
GENERAL PERMI`1' NO. NCC200000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO..NCG200448' Ivla l bri °trial anda(tne?_ripy`(a
�eC gi r * �aC-a+Es � ..�'
FACILITY NAME Gr,}�;�� • � lZCwc �n� Dr41) ,�'�;tntc,it IP«�c ,;,,� ,17tjgi6h,i VWater Quark rr ltty�
PERSON COLLECTING SAMPLES u,«. S ,A}tii Central Ftle"s } , 1 `
CERTIFIED LABORATORY Sf44CSydQ_ ignr,lvEci I Lab # yy� 1617 Mail env ce:Ce3` }Y
�t=
V 7 Lab #R�aletghNtirtfi-Caoftn,2769'9 lib 7
COUNTY
PIiONENO.( 2F) 3C1r1-Qgg3 �
Part A: Specific Monitoring Requirements NU rl" ` j
i
SAMPLES COLLECTED DURING
CALENDAR YEAR: ,20/15
(phis monitoring report is due at the Division n79"
later than 30 days from the date the facility
receives the sampling results from the laboratorX_�
MW
Odtfall
K
No.
Date' -
Saiiiple
Collected
'Total ` <
Rainfall '
triclies,
,,00530:: _ .:.
. 00340 _ ., , <,
.,:.. 00556_ :,
_ 00400:,;-.
_ ',01113...__
:. 01119„ _
_.00980 :.
01114
01094
Total Suspended
' Sblids
X _;. �,nt l:.,.. r.,
Chciiiical Oxygen.
;. iarid.'
:, �.: itt 'll, ..
Oil &.Grea`se
-. iri /L .
'pH
a,s:U.
Cadiiiiiiin
m ` 1
Copper
ni" Il
Iron
ni 1,,
Lead
rii /l
7iiic
iii "Il
Beiicliiiiark
- t'
100
120; :,: :.»
;: _30,
6i0'=9 0
s;.0:0111—
0:007
NIA
0.03
0.067
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the "tier i or Tier 2 responses in the General Permit.
2 rota! recoverable.
01e1j, complete Part B if this facility uses more thane 55 galloies of reem motor oil per month.
Part B: Vehicle 111aiutenance Activity Monitoring Requirements
Outfall
No:
Date
Sairiple
Coilecteti
iiiioldd/'•r;
Total
-Rauifall
� l�iii`c'fies:`
:NeW�1%166r Oil`
= U.age
'aVinoiith
0040U�, , .
.;.. 00556
Total Suspended
Sohds_"
in''/1-
pI1
-s:itc
`Oil &Grease.
_ ui '/l.
Beiicluriark
-
10D
RECEIVED
FEB 0 4 2015
CENTRAL FILES
1DWR SECTION
YOU MUST SIGN 'PHIS 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. l am aware that there are significant penalties tar submitting false information,
including the possibility of tines and imprisonment for knowing violations,"
re of Permittee)
i5
(Date)
NCG200VO DMR Form SWU-256
Page 1 of I
STORMWATER DISC'_URGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
DISCHARGE MONITORING REPORT (DMR)
i
CERTIFICATE.OF COVERAGE NO. NCG200448
FACILITY NAME Q 91fid 6ebhLl '0 kCMAL�4 W#
PERSON COLLECTING SAMPLES -:T,:,
CERTIFIED LABORATORY'L-=:S�it6k-�i-e----S-.� �Vvi '-Ue-
COUNTY UA
-
PHONE NO. (%aj-)3,9Q-q311
-6- Q .1 c moniteriner Requirement
SAMPLES COLLECTED DURING
CALENDAR YEAR:
(This monitoring report is due at the Division no
later than 3Q days from the date the facility
teceives the sampling results from the laboratory.)
r
L)
k
F
to Ct4,4-
.0 0-9 0..0
4
If a _value is in excess of the 'benchmark, or outside the benchmark range (for pH), you must implbme'nt the Tier I or Tier 2 re.9ponses in the General Permit.
2 Total recoverable.
only complete Part B UWjisfacilky. uses more than 53 gallons of new W motor oll per month.
& A. v.161 A a 74'sin tann nee Activity Monitoring Requirements
al
'TRAWK., Ro &
00
Not
gas
6
IN "
41
�N_
121
&-VD1r1r1nVArM0N FOR ANY INFORMATION
REPORTED:
K 1= U t: i V t U
DE-C 0 2 2014
CENTRAL FILES
DWR SECTION
U IVIV04L Oxxxim Aim-"
eckify, 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
pyinformation,
information, the information.subWitted is, to the best of my knowledge and belief, true, -accurate, and complete. I am aware that there are significant penalties for submitting false
including the possibility of fines and imprisonment for knowing violations."
(Signat ;0ermittee) (Date)
NCG2 VR Form SWY-256
Page I 0�
STORMWATER DISC--'. d, R-GE-OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000 - -
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE. OF COVERAGE No. NCG200448
FACILITY NAME Q-1rr.A
PERSON COLLECTING SAMPLES J.-A :I: —
CERTIFIED LABORATORY- ksVJL-C Lab
Lab
COUNTY 'bVAV-Z1 -
PHONE NO. (BA1 ) 3 217-53
Pd A6 Q .01 c Monitoring Re ttirements
—
SAMPLES COLLECTF-D DIJFJNG
CALENDAR YEAR: 2—OLY
(Ibis monitoring report is due at the Division no
later than 3Q days from the date the facility
receives the sampling results from the laboratory.)
r
06 kad)
A
011� 00
To
,
7
LIM
'U
1 if a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implbin6rit the Tier I or Tier 2 responses in the General Pennit.
2 Total recoverable.
Only coniptete Part B if iris facility uses more titan 55 gallons of new motor oil per month.
13 # n• V.161AP Aal"tenance Activi Monitoring Requirements
a.
!,F
Z4
MIS
tea
r7777
5 Tl—
T,
aiie s�t?vwiiWICIATTON
rri—
FOR ANY IN
RMA ON REPORTED:
RECEIVED
Nov 0 4 2014
CENTRAL FILES
DWR SECTION
y VU IVJLSJ 0 A OJL%NA 11 A �.- --- W --U-�- - - I - - - - - - -
certify,
it fy 1; document
supervision in accordance with a system designed to assure that qualified personnel
III er i , under penalty of law, that ent and all attachments were prepared under my direction or uper sion persons property gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those p one directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief; rue; 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."
(Signatu
f Perrnit�f
NCG200or T;VForin SWY-256
Page I o�
STORMWATER DISC-iRGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE.OF COVERAGE No. NCG200448
FACILITY NAME
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORYLSjn�k
COUNTY b"Lati c;'
PHONE NO. (BaT ). 3 2 01
w—d- A - Qnpelfir Maniforing Requirements
SAMPLES COLLECTF-T) DURING
CALENDAR YEAR: 201—Li
(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.)
TI ovi. �QLArs
dllOWd';,yyy�-tilt
ei, '7
Al �91APWW
kliw
AAd
J
!�,`A;A'00
—FFf a value isinexcess of the benchmark, or outside the benclunark range (for pH), you must implement the Tier I or Tier 2 responses in the General Pennit.
Total recoverable.
Only complete Part B if this facility uses more dian 55 gallons of new motor oil per month.
Part B; Vehicle Maintenance Activit Motoring Requirements
--%-
-NW
A
No "
I gs,
MUNI 8 W90b &
ig,
Al Wiwi
gi
al
MI-d
RECEIVED
OCT 0 g Z�D!A
CENTRAL FILES
DWR SECTION
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel
property gather and evaluate the inforniation 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."
(SignaP(Vof Permit (Date)
NCG2000�1' T64 711/7 Fomi SW�1256
Page I ok
STORMWATER DISC---,-.RGROUTFALL (S-DO)
GENERAL PERMIT NO. NCG200000 - -
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE.
OF COVERAGE NO. NCG200448
FACILITY NAME Qf-ir-Fak 6 —02--s—L.-Oci D64
PERSON COLLECTING SAMPLES --rLaS
CERTIFIED LABORATORY S W, \ — Lab #
C
COUNTY
PHONE NO. 11
T) �* A - Rnpoffir Moniforlpa Rean frements
SAMPLES COLLECTED DINNG
CALENDAR YEAR:
(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.)
-* � � A -,� d, r,,rl 5 o pefr,--6),)n
id
l.
kS
AW
4f
OW
N/A
AMI.—
T If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the General Permit.
2 Total recoverable.
only colilplete Part 8 if this facility. uses more Ilfait 55 gallons of new motor oil per month.
Part B: vehicle Maintenance Activit Monitoring Requirements .
%�-4,
th -
$44,f
it 9i
S-,
KtL;t:i V t:u
SEP 0 4 2014
CENTRAL FILES;
DWQIBOG
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 0"erinittee) (Date)
114CG200001, 1=!� Form SWU.-256
Page I o�
r
STORMWATER DISE. .RGE OUTFALL (S-DO)
GENERAL PERMIT NO. NCG200000 -
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE. OF COVERAGE NO. NCG200448
FACILITY NAME Ctjr-,r.A ( ,z&00'-Re jjri'01, W4
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY -CAcLAieSV..tL4 Lab # 4
Lab #
COUNTY 'LkLkYk�
PHONE NO. 3;Q '1 -�3 1
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING
CALENDAR YEAR: 2-011
(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,)
C) ftf4'tf-r
Oda V
4
556
0 0.4 0 0
-.-00990
ffikfifol gent
D e ffiA h
Od&
2
I
iiiic,
0007
N/A
0`03
�0;06!m
917 a —value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the General Permit.
2 Total recoverable.
Only complete Part B if this facility uses more than 55 gallons of new nrotor oil per month.
Part B: Vehicle Maintenance Activitv Mo itoring Requirem nts
WW
Cd
tiioltidl
UF46
O'l
ge:-
00
.4V 0 0400
"0056;
i3e: ch
4 M
k-
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 super -vision 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."
of
01/3(jiH.
(Date) /
NCG2000r-"4MR Form SWIl-256
Page 1 of
STORMWATER DISE--.RGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG200448
FACILLITYNAMF,G�f-ir-f�,A(,bM-o'ke.o�',Or, D94 "w1k. , 0 "Xecur- I 10
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY 519"'Ile Lab# 4WA
Z" Lab ft
COUNTY
PHONE NO. (adY) 11 -q3 I I
Part A: Specific Monitoring Requirements
r
SAMPLES COLLECT�� DURING
CALENDAR YEAR: (M
(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.)
Outfdll
N
1-: 4
e,
0056
0460,
011M'
oihsi-�;
-.�-009
0094...'
9
it
A
Achdifilfiffir
WWI
,
'T046
hi -
WWI
Bionitiuk'
3 0
7,
0.00
0. 007:
0.
'03;
0;067-
T If a -value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the General Permit.
2 Total recoverable.
Only complete Part B if this facility uses more than 55 gallons of new motor oil per month.
Part B: Vehicle Maintenance Activity Monitoring Requirements
Nti
--84
X'Ai4tid
Tito/tit�l
IWA
K
r
ill
OV
6.
RECF- i\/Fp
J U N . 0
CENTRAL FILEc
DWQ/80G
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."
of
OG/'30//Y -
(Date) I /
DMR Form SWU-256
Page I of 1
STORi•'IWATER DISL _.RGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG2000448
FACILITY NAIVE Cic;f'n_GyA;,-1 gel-' J�D13A mum.",
,
PERSON COLLECTING SAMPLES Jc6'1- ,,_ 'S
CERTIFIED LABORATORY Lab # ��
Lab#
COUNTY 31LArKt
PHONE NO. (_� '� _ � 3i
Part A: S ecil'ic Monitoring Re uireinents
'Marl o'rrgrnal and oir"e copy to SAMPLES COLLECTED DURING
"7 Altii Ceoi a1'�"Y � le [a` CALENDAR YEAR:Divisito9
cfWa4er Qiaty s
nU
Ft1es s 7.
N (This monitoring report is due at the Division no
il Se« ,rx. later than 30 days from the date the facility
lfi17 lvlatvte CenterA. E�± t receives the sampling results from the laboratory.)
t'Raletgh,=NortlrCaro tna;2769 1C17
f�lo; t (.S k
Ontfall
No:
Date:
Sample -
Collected
iiiafldill"r
ai'bkal
Ritrnfalt
a nclies: _
00530-' —
. -, �00340:,;
- 00556.. ,..
-00400
.-01.113....
..,_ 01119 .
00980
01114
01094
Total Suspendeid
Solids
in "Il
Cheitical Oxygen
1Denran,
_ . nr 1 Y
Oil &Grease.
m' Il
plI
„s.ti z .:
Cadniiiirii
iii�;/1. ,
Giipper
iti"11
Iron.
ni /l
Lead
Ifi /l. ,.
Zitic
iii ' l
Be-ikhi`ark
-
-
—. ;100
120�_.
x30 ,
6:0 - 9.0
0:001..
0:0il7
NIA
0:03
0:067
' If a value is in excess of the benchmark, or outside the benchmark range (for p1d), you must implement the Tier t or -Pier 2 responses in the General Permit.
2 Total recoverable.
Only complete Part B if tltis facility rises more thane 55 gallons of new rrrotor oil per nronth.
Part B. Vehicle Maintenance Activity Monitoring Requirements
Outfall-
No:
_a._
1?ate
Samples :
Collected
ii oldd/ r
'Total
Rainfall
iiich6
New Motor Oil
Usage_
auffibiiih.
.00530-
A0400
t.-.00556
'Total Suspended
- Sbliils ;
M Il,
: pH
as.u. -
Oil & Grea'se
<Bericiimai k
6A,- 9:0
30
N'ECL=IVED
APR p g 2014
CEN7-R4L Fl c
D WQ,6, E,�
YOU MUST SIGN 'PHIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document arid 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 systern, or those persons directly responsible tier gathering the
information, the infon-nation 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."
of
�qM4
(Date)
DIVIR Form SWU-256
Pane t of I
STORNIWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
DISCHARGE MONITORING REPORT (I)MR)
CERTIFICATE OF COVERAGE NO. NCG2000448
FACILITY NAMEGn((-i, Qrc�r• Pecicli'n-) DPA f')')o'o &1/01 kecvr-1 ng
PERSON COLLECTING SAMPLES uG, t;�'?S _TT
CERTIFIED LABORATORY j — 1zjR511� Z _ Lab #f _4 ci L�
Lab #
COUNTY CC1f-n--42c-
PHONE NO. (82.q) 3• -731
Part A: S ecific Mouitoring Requirements
ivlatl arrg'iital`anid tsiii copy to >° y ' SAMPLES COLLECTED DURING
17ivtstori ofwter`Qualtiy� CALENDAR YEAR:
:�{{II Gen{rai Flies �+ t• a (This monitoring report is due at the Division no
later than 30 days from the date the facility
ry 1617 Mail Set a Censer r receives the sampling results from the laboratory.)
ti
' ltaletgli, Not kl> Croltna 27699.1 fi I7 a'
Outfall
No.
Date
Saiiiple
Collected
itiolddl.` r
Total
kAl ifall
niches
00530
00340
00556'.
00400
01113.
01119
00980
01114
01094
Total Siispended
Solids
.'In /1
Chemical Ozygeii
IDeiiiaiid
iii /L ..
Oil & Greiise
in W.I.'
pH
S.W.
Cadinititii
In it
Cooper
zn /l __
lion
m /l
Leail
zii II
Ziitc
in "/l
Bencliniark
-
-
100
129
30
6.0 = 9;0
0A01.
0:007
NIA
0.03
0.067
If a value is in excess of the benchmark. or outside the benchmark range (for pH), you niust implement the "Pier l or Tier 2 responses in the General Permit.
2 Total recoverable.
Only complete Part B if this facility uses rnare than 55 gallons of new motor nil per month.
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sainple
Collected
mo/dd/' r
Total
Raiiifall
inches
N6Mptof Oil
Usage
Ai intiilt'
00530.
00400
00556 ._.
Total Suspended
Solids
m" l
ou
s.u..
Oil & Grease
ni /i
Bencliiiiaek.
-
-
-
100
6:0 -L 9:0
30
RECF--:IVEU
7 J14
., EN i RAL FILE
DVVOJBQG
YOU Mus'1' SIGN 'PHIS 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 talse it tbrmation,
including the possibility of fines and imprisonment for knowing violations." pECOVED
of
NCG20,0[10'b DMR
(Date)
APR 01 2014
CEN-[RAL F4L.ES
DWQIEat=al' S W U-256
Page f of I