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HomeMy WebLinkAboutNCG060042_MONITORING INFO_20181203STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V C&v� �y a DOC TYPE ❑HISTORICAL FILE I�MONITORING REPORTS DOC DATE ❑ 3UKQO�; YYYYMMDD SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Qu lity General Permit No. NCG060000 Date submitted ) 017 aZ d 1 g CERTIFICATE OF COVERAGE NO. NCG06 Oro 4 a- SAMPLE COL N YE' C:l1.2v1,r `� FACILITY NAME �thA�OhtJda� FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY �dGLCi c►r \ 1 use/pr -'ss lea#'. 180 use animal fats/byproducts RECEIVE EM_ []YES �NO PERSON COLLEC7IN AMPLES _ICc... (,,,,�.r DISCHARGING TO SALTWATER ? LABORATORY /4i � � Lab Cert. a _ I65 T) C 0 3 2018 LtN i KAL i_,L� --�* - DWR SECTION CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE -� � �� Part A: Stormwater Benchmarks and Monitoring Results DWR SECTION Total event rainfall z +y or ❑ No discharge this period' Outfall No. Sample Collected,. mo/dd/yr TSS, mg/L pH, 5tandard'units COD, mg/L Oil and Grease, _ mg/L Fecal Coiiform , . Colonies*per.100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 -- 9:0 120 30 1000 500 SW 00 1 11 06 LK 3 '? < <$ <5 AIA AA .7 3 S fe It .co A Cf 11 19 19 G 1 Only applies to facilities that use/process meats. zThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any autfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes [X no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, rno/dd/yr Oil -and Grease,' mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or SO 6.6 — 9.0 - 1 Only applies to facilities that use/process meats. zThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWLJ-249 Last Revised: Oct, 18, 2012 ti t ;L L.. - 4 I 1 ' Commonwealth Commonwealth B R A N D S. I N C. B R A N D S. i N C. Scott Townson Ken Gusler Facility Manager OHS8.E Specialist 301 North Scales Street, PO Box 2236 Reidsville, NC 27323-2236 301 North Scales Street, PO Box 2236 Reidsville, NC 27323-2236 Direct - 1-336-634-4456 Fax - 1-336-634-4290 Direct - 1-336-634-4237 Fax - 1-336-634-4294 Mobile- 1-336-613-1183 scott.town son4us.imptob.com ken.gusler@us.imptob.com An IMPERIAL TOBACCO GROUP company An IMPERIAL TOBACCO GROUP company *FOR PART A AND PART B MONITORING RESULTS: • I 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 DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail a _ one copy of this DMR, including all "No Discharge" reports, within _30 days of recei t o the_lab results or at end n original and monitoringperiod in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1517 YOU MUST SIGN THIS CERTIFICATION FOR ANYINFORMATION 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." jM%4LC ,l. (Sign ure of Permittee) 11 ;Z09 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 S W U-249 Last Revised: October 18. 2012 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: http:lllx:�rtal.ncdenr.c�r�lwc l�/��yhvti/tiulnt�dcssw#lttb-4 Permit No.: or Facility Name: 4 County: planki Inspector: _ Date of Inspection: Time of Inspection of Coverage No.: NIC/G I�IQ/QI[�l�l Phone No. 33f,-IN LN- 6 ILA-0AAA _ _-- -- {1 Total Event Precipitation (inches): a Was this a Representative Storm Event? (See information below) VYes ❑ No Please check your pennit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative StorinYEvent" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, l certify that this report is accurate and complete to the best of my knowledge: ff (Signa(gre of Permittee or Designee) ]. Outfall Description: ` - Outfall No. oo l Struct re (pipe, ditch, etc.) 64 e r„�'�s Receiving Stream: •{ Describe the industri,d activities that occur tw�ithin the outfallydrainage area: ' 1._ .l AA. u,i AL.0 - t n P � AV i-�110lTi VU"O f �T_._0 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Ji 41y 3. Odor: Describe any dtsInct chlorine odor, etc.): %llO e that Ole discharge may have (i.e., smells strongly of oil, weak Page 1 of 2 5WU-242-20120613 Ir 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 02 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: (1) 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stonnwater discharge, where 1 is no solids and 5 is extremely muddy: DI 2 3 4 5 7. Is there any foam in the stonnwater discharge? Yes No S. is there an oil sheen in the storrnwater 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 2of2 5WU-242-20120613 A 2:= NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: htlp;llpr>r[al.ncdc�tr.car�l��cblwyhvs/su/nhdessti�#tap-4 Permit No.: NICI�sIQ/fo/ LY�10 1 or C,ertifieate of Coverage No.: NIC/GI�I�I - 0l4l�( Facility Name: S County: Inspector: Date of Inspection: Time of Inspection: t% Total Event Precipitation (inches): s e No. V1.6 63i4 '445L Was this a Representative Storm Event? (See information below) 0 Yes ❑ No Please check your pernnit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (SignatutWof Permittee or Designee) 1. Outfall Description: Outfall No. Dena. 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 u ing basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: AO�yif 3. Odor: Describe any distinct chlorine odor, etc.): None , hF the discharge may have (i.e., smells strongly of oil, weak Page 1 of 2 $ WU-2a2-20120613 ,-' -or. , ) I- ) -!, I I - : 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 © 3 4 5 t 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: O3 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: El 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. is there an oil sheen in the stormwater discharge? Yes Rio 9. Is there evidence of erosion or deposition at the outfall? Yes G 10. Other Obvious Indicators oi' 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 5 WIJ-242-201206l 3 Aj'A NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance au filling out this fonn, please visit: ht(»a/perta].naienr.orJwebl�+y/ws/su/nndcssw#t�ih-4 Permit No.: or Certificate of Coverage No.: NICIG/Q/ 610 10-1A1-( Facility Name: roMiMa uA%H-y% I'Srr*& s County: "c W% Phone No. 33G bay kit Sb Inspector: (tr Date of Inspection: Il m.12!!qtg Time of Inspection: _1. is 40kAA Total Event Precipitation (inches) it Was this a Representative Storm Event? (See information below) ,8 Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0 1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (SignatujVof Permittee or Designee) 1, Outfall Description: Outfall No. W3k— Receiving Stream: 001 Describe the industrial activit Structure (pipe, ditch, etc.) A AtY es that occur within the outfall drainage area: "r__ 1�r: w.�.,� CD2 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint k (light, medium, dark) as descriptors: ho cob 1 � L f f'jnf- , ,ti,., 3. Odor: Describe any distinct chlorine odor, etc.): JVo dtor aUhe discharge may have (i.e., smells strongly of oil, weak Page ] oi' 2 SWU-242-20120613 S, � 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 1 2 O 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: 1 aL 3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stonnwater discharge, where 1 is no solids and 5 is extremely muddy: I 'a) 3 4 5 7. Is there any foam in the stormwater discharge? Yes 6 8. Is there an oil sheen in the stormwater discharge? Yes S 9. Is there evidence of erosion or deposition at the outfail? Yes KO) 10. Other Obvious Indicators of Stormwater Pollution: List and describe f Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 I S WU-242-201206 i 3 LWIWA ,iAll ass NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: h1t �:/13orlal.r3cdent'.cx',/�� ebh� /3� shu/n dessa #taU-4 permit No.: or Certificate of Coverage No.: N/C/GI 01610/01.�,L1�1 Facility Name: ..gr" County: Rac.kting l ,,yi Phone No `3Ua 434-4q!;6 w Inspector: _ � ,CA Date of Inspection: 11 O(, Time of Inspection: t?•-40 A144ul \1 Total Event Precipitation (inches): • Li Was this a Representative Storm Event? (See information below) © Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be petforrned during a representative storm event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, 1 certify that this report is accurate and complete to the best of my knowledge: (Signature4f Permittee or Designee) 1. Outfall Description: A Outfall No. � Structt> e (pipe, ditch, etc.) D tLh jidt'C�C +1a V."Receiving Stream: Llof� bs cti Y� Describe the industrial acti hies that occur within the outfall drainage area: Alga 1-k— SMbs 'g�Y, 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Abn kY T,. t,,Ir ��8(2— AE� 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): /N.9 ,o.&- e�,ltd-.rX Page l of 2 S W U-242-20 120613 ,' , .��: � `'� •_ c`. `^ a 3 a, _` �. � t �: [y • .r- .�, -, -S i :_ �s �S i �; 1� 5' / ,• :i t 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 1 3 4 5 s 5. )Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: b3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 �2 3 4 5 7. Is there any foam in the stormwater discharge? Yes ?o 8. Is there an oil sheen in the stormwater discharge? Yes NN 9. Is there evidence of erosion or deposition at the outfall? Yes (5 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 S W U-242-20120613 Meritech, Inc. Environmental Laboratory Laboratory Certification No.165 Contact: Ken Gusler Client: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Meritech Work Order # 11061817 Parameters Results Report Date: 11/15/2018 Date Sample Rcvd: 11/6/2018 Sample: SDO 001 Grab Analysis Date RegaUng Limit 11/6/18 Method COD <15 mg/L 11/12/18 15 mg/L EPA 410.4 Total Suspended Solids 3 mg/L 11/7/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) <5 mg/L 11/12/18 5 mg/L EPA 1664B pH 6.78 S.U, 11/6/18 1.0 -14.0 S.U. SM,4500-HB Temperature 70 OF 11/6/18 - ° F SM 2550 B I hereby certify that I have reviewed and approve these data. � fr)AN 6% n� k - Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)3424748 fax.(336)342-1522 Meritech, Inc. Environmental Laboratory Laboratory Certification No.165 Contact: Ken Gusler Report Date: 11/15/2018 Client: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Date Sample Rcvd: 11/6/2018 Meritech Work Order # 11061818 Sample: SDO 002 Grab 11/6/18 paraMgters Results Analysis Date Repgj:ing Limit Method COD 31 mg/L 11/12/18 15 mg/L EPA 410.4 Total Suspended Solids 12 mg/L 11/7/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) 7 mg/L 11/12/18 5 mg/L EPA 1664E pH 6.75 S.U. 11/6/18 1.0 -14.0 S.U. SM 4500-HB Temperature 66 OF 11/6/18 - ° F SM 2550 B I hereby certify that I have reviewed and approve these data. Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Meritech, Inc. Environmental Laboratory Laboratory Certiflcation No.165 Contact: Ken Gusler CIient: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Report Date; 11/15/2018 Date Sample Rcvd: 11/6/2018 Meritech Work Order # 11061819 Sample: SDO 003 Grab 11/6/18 Parameters Results Analysis Date Reporting Limit eM #hQd COD 22 mg/L 11/12/18 15 mg/L EPA 410.4 Total Suspended Solids B mg/L 11/7/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) 9 mg/L 11/12/18 5 mg/L EPA 1664E pH 6.60 S.U. 11/6/18 1.0 -14.0 S.U. SM 4500-HB Temperature 64.8 OF 11/6/18 - ° F SM 2550 B I hereby certify that I have reviewed and approve these data. �(� }eAffin Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Meritech, Inc. Environmental Laboratory Laboratory Certiflcation No.165 Contact: Ken Gusler Client: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Report Date: 11/15/2018 Date Sample Rcvd: 11/6/2018 Meritech Work Order # 11061820 Sample; SDO 004 Grab 11/6/18 Parameters Results Analysis Date Reporting Limit Method COD 67 mg/L 11/12/18 15 mg/L EPA 410.4 Total Suspended Solids 18 mg/L 11/7/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) 7 mg/L 11/12/18 5 mg/L EPA 1664B pH 6.53 S.U. 11/6/18 1.0 -14.0 S.U. SM 4500-HB Temperature 64.6 ° F 11/6/18 - ° F SM 2550 B I hereby certify that I have reviewed and approve these data. Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Chain of Custody Record COC Client: Commonwealth Brands Address: 301 N Scales St Reidsville,NC 27320 Attention: Ken Gusler NPDES #: Phone: rax: Email: Project: Po M. MERI'TECH INC. Environmental Laboratories A Division of Water Technology and Control, Inc. 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1622 27320 Email: Web Site: www,meritechlabs.com Turn Around Time* Std (10 days) 3 - 5 Day © 24 - 48 Hr Q Sample p Location/lD # Sampling Dates & Times p g Person Taking Sample (Signature): Lab use only START END comp? Grab? #of Gonts Tests Required- [On � z Date ime Date Time SDO CIO 4 of 4 -'X0 G TSS G COD wIH2SO4) G Oil & Grease (wIHCI) t G pH Temp '7 4 Method of Shipment: Comments: ❑ UPS ❑ Fed Ex Hand Delivery [_]other Will these results be used for regulatory purposes? Yes I I No *RUSH work must be approved prior to submitting samples. Ra[[ ui ed by: Daat� rime: l �iSr Received by: Data: Time: Re nquished by: Date: Time: Received by: Date: Time: Relinquished by: Date: Time: JR:cdGed�t b : D , T[me: � r Chain of Custody Record COC Client: Address: Attention: Commonwealth Brands 301 N Scales St Reidsvilie,NC 27320 Ken G usler NPDES #: Phone: Fax: email: Project Po#: MERI'TECH INC. Environmental Laboratories " -A A Division of Water Technology and Control, Inc. 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336.342-1622 27320 Email: Web Site: www.merftechiatLcom Turn Around Time* Std (10 days) © 3 - 5 Day © 24 -48 Hr C� Sample LocationllD # Sampling Dates & Times Person Taking Sampie (Signature): Lab Use Only START END Comp? Grab? #or Conte. Tests Required- ,On eiz K? Date me Date -rime SDO G TSS.3�� G COD (w1H2SO4 G Oil & Grease (wlHCl) 00D4 G pH 7fS Temp a Method of Shipment: Comments: UPS Fed Ex 2� Hand Delivery ❑Other - Will these results be used for reguiatory purposes? Yes No *RUSH work must be approved prior to submitting samples. Relinquish Gate: Time: 13J e,e i? 06 ! Received by: Date: Time: Relinquished by: Date: Time: Received by: Date: Time: Relinquished by: Date: Time: R d b by ate: J Time: zSS Chain of Custody Record CQC Client: Address: Attention: Commonwealth Brands 301 N Scales St Reidsville,NC 27320 Ken Gusler NPDES #: Phone: Fax: Email: Project: PO #: MERITECH INC. Environmental Laboratories A Division of Water Teebaology and cone, Inc. 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1622 27320 Email: Web Site: www.merEtech abr Turn Around Time* Std (10 days) 3 - 5 Day 24 - 48 Hr Q Sample Location/ID # Sampling Dates & Times Person Taking Sample (Signature): Lab Use Only START ND comp? Grab? not Conte. Tests Required- On tee? pH OK? C12 OK7 Date Time Date Time SDO OQ 1 i tg i[� a G TSS 3 c NN ~ G COD (wlH23O4) w' G Oil & Grease wIHC[ G pH 4,,4 O Temp Method of Shipment: Comments: - UPS Fed Ex Hand Delivery QOther VYill these results be used for reguiatory purposes? Yes No *RUSH work must be approved prior to submltUng samples. Relinqu' by: Date: Time: !1 D 6 ns Received by: Date: Time: Re mquished by: Date: Time: Received by: Date: Time: Relinquished by: pate: Time: IRJIn lab by: D "me: .. Chain of Custody Record COC Client: Address: Attention: Commonwealth Brands 301 N Scales St Reidsviile,NC 27320 Ken Gusler NPDES li: Phone: Fax: Email: Project: Po#: MERITECH INC. Environmental Laboratories A Division of Water Technology and Control, Inc. -� 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1522 27320 Email: We[s Site: www,mehtechlabs_com Turn Around Time* Std (10 days) 3.5 Day 24-48 Hr Sample P LocationliD # Sampling Dates & Times P 9 Person Taking Sample (Signature): tab Use Only START 17JD comp? Grab? act tts Cor. Tests Required- ,On cuoKY date Time Date Time SDO 00'4 I 6� IIf ID-10 3 G TSS I !� 3 t G COD (w1H2SO4) G Oil & Grease (wiHCI) I G pH S3 Temp {� Method of Shipment: Comments: UPS ❑ Fed Ex [%J Hand Delivery ❑Other Will these results be used for regulatory purposes? Yes No *RUSH work must be approved prior to submitting samples. Rol quis d Date: Time: 6� J S5 IRIZquished Received by: Date: Time: by: Date: Tlme: Received by: Date: Time: Relinquished by: Date: Time: JRVJZZ4: Date: Time: Z Stormwater Monitoring Commonwealth Brands 2018 Sample ID MG/L MG/L MG/L SU (F) OIL RA # Date Time TSS GREASE COD PH Temp 1 SDO 001 6/21/2018 10:55P 4.3 <5 39 6.5 81.517 2 SDO 002 6/21/2018 11:05P 25.7 <5 53 6.4 76.01' 3 SDO 003 6/21/2018 10:40P 29.6 <5 111 6.6 76.5F 4 SDO 004 6/21/2018 11:25P 109 <5 68 6.5 76.OF Rainfall recorded: Estimated Inches Limits: Commonwealth Brands 2018 Sample ID RA # Duration: 1 40 2.4" Hours Minutes 100 30 120 Sampler: Ken Gusler 6-9 NA MG/L MG/L MG/L SU (F) OIL Date Time TSS GREASE COD PH Temp 1 SDO 001 11/6/2018 11:20A 3 <5 <15 6.78 70.01' 2 SDO 002 11/6/2018 11:31A 12 7 31 6.75 66.OF 3 SDO 003 11/6/2018 11:40A 8 9 22 6.60 64.8F 4 SDO 004 11/6/2018 12:OOP 18 7 67 6.53 64.6F Rainfall recorded: Duration: Sampler: Ken Gusler Estimated Inches .4" Hours Minutes 2 20 Certificate No. 165 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES LABORATORY CERTIFICATION BRANCH In accordance with the provisions of N.C.G.S. 143-215.3 (a) (1), 143-215.3 (a)(10) and NCAC 2H.0800: Merltech Inc. Is hereby certified to perform environmental analysis as listed on Attachment I and report monitoring data to DEC? for compliance with NPDES effluent, surface water, groundwater, and pretreatment regulations. By reference 15A NCAC 2H .0800 is made apart of this certificate. This certificate does not guarantee validity of data generated, but indicates the methodology, equipment, quality control procedures, records, and proficiency of the laboratory have been examined and found to be acceptable. This certificate shall be valid until 12/31/2018 Dana 8. Satterwhite _ J Dear Sirs, Attached is storm water sampling data from our four discharges at Commonwealth Brands Inc. collected on June 21 512018. There was a slight exceedance of the TSS limit on Discharge 004. The limit is 100 mg/l, and the rain run-off tested at 109 mg/l. This has initiated a Tier 1 response and we will monitor that discharge to make sure that elevated TSS is not an on -going issue. Sincerely, James K Gusler Ken Gusler OHS & E Specialist Commonwealth Brands, Inc. An IMPERIAL TOBACCO GROUP Company 301 N Main Street, Reidsville, NC, 27320 336-634-4237 ken.p,usler@ us. imptob.com Date SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 7 11 901 K CERTIFICATE OF C FACILITY NAME t COUNTY t�ocf! PERSON COLLECT] LABORATORY M Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR "zol s__ FACILITY ACTIVITIES INCLUDE (check all that apply): E/process meats ❑ use animal fats/byproducts ��iG TO SALTWATERS? ❑YES LZNO �UL 1 2�1 PLEASE REMEMBER TO SIGN ON THE REVERSE -3 CENTp,AL FILES ¢ qFC-TIOtfoto/ event rainfall -'Z y" or ❑ No discharge this period? Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard'units cob," mg%I_ Oil aiiOrease, mg/L Fecal Coliform , Colonies per.100,ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 • Within 6.0 — 9.'0 120 30 Am Soo O 001 Sd 4. sria 0101 L 3.1 lb .75.1 41q � A At 003, 4 2.1 lg A. 4 j.f. 1 t5 4 D o 004 1, al 115 104 w <S A44 W I Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. i For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ;<no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected,' mo/dd/yr Oil-and-Greasd,= mg/L TSS, -.mg%L: pH, Standard units, New Motor Oil -Usage, Annual -average gal/mo Benchmark - 30 100 or 50 6.6 -- 9.0 - i Only applies to facilities that use/process meats. zThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. (if es, complete Part B) 45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: Oct. .r 18, 2412 *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. 0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipts the lab results or at end of monitorin.q period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signs&re of Permittee) 7 Il AL01g (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web1wg/ws/su/npdessw#tab-4 S W U-249 Last Revised: October 18, 2012 1p- '7 -F 7 ,,.� r ..�_1.� NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance nufilling our this form, please visa: htlpa/prra'lal.rcdettr.a�rJw�b/wulwa/stElnlae3essw#ta'h-4 Perrivt No.: N/C/G /0/1b QI, Facility Name: [e�mH10Y1W� County: 110r-Vv354kWM Inspector: _ Kej%t% 4k Jey Date of Inspection: Time of Inspection: Total Event Precipitation (inches): 2LA or Certificate of Coverage No.: NICIGIQI�I d/� I�IJ No. 336 6h yWSb Was this a Representative Storm Event? (See information below) Z Yes 0 No Please check your permit to verify if Qualitative Monitoring must he pe)fonned during a representative iiorni eveni (requirements vary). A "Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: .. rs- &nk (Signature o ermittee or Designee) 1. Outfall Description: Outfall No. 00 k Receiving Stream: Des c 'be the industrial activ t Structure (pipe, ditch, etc.) Rog A 1,11 4060 r s s 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: VAL s r .-.At &t 3. Odor: Describe any distinct odors that the dischargc may have (i.e., smells strongly of oil, weak chlorine odor, etc.): /Ve St"'w Page 1 of 2 S%VU-242-2012061 � 4. Clarity: Choose the number which best describes the clarity of the discharge. where I is clear and 5 is very cloudy: 1 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge. where. i is no solids and 5 is the surface covered with floating solids: ] Q 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: Q 2 3 4 5 7. is there any foam in the stormwater discharge? Yes 0 8. is there an oil sheen in the stormwater discharge? Yes g 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 I SWU-242-20120613 � r �. rc a��A� �i ' �'CDieI11FRiCp� R Storinwater Discharge Outfall (SDO) Qualitative Monitoring Report FOi" j,�illd(ilif.L' (7ii ?,ow ihis_f( rm' please VJsil: 13�J:III]O1'I1�.)iC(iC1}F'.S)1! WC�)I1V I14 Itiliin)7CjtSSwi 1111)- Pernvt No.: N/C/G /Q1j(Q1�1Q101 Q/ or rtificate of Coverage No.: NICIG1011l 0/0 /I/If Facility Name: 661?trnd6WGa 1;YSrt1 County: t�l�� 'r�f1e�+► Phone No. n& 63q _ ykG4 Inspector: 'Kew% 64 jry r Date of Inspection: Time of Inspection: Total Event Precipitation (inches): a1 H Was this a Representative Storm Event? (See information below) V Yes ❑ No Please check your permit la verify if Qualitative Monitoring must he performed during a represenuative sroi-lh'event (requirements vary). _ A "Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and dial 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 howl of no precipitation. By this signature; I certify that this report is accurate and complete to the best of my knowledge: r,. (Signature 4+ermittee or Designee) 1. Outfall Description: Outfall No. M a.— Stru Receiving Stream: lrl#� In Describe the industrial activities that Ew"A, Me. r~V114+.4e. 1h (pipe, ditch, etc.) Ro-' s -A CL 1 Y1e �>_�tl� within the outfall drainage area: 2. Color: Describe the color of the discharger using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: M --Lir - I uhi' �-r,+ _ 3. Odor: DeSCIibe any distinct odors ghat the discharge may have. (i.e.. smells strongly of oil, weak chlorine odor, etc,): NO SWWO Page ] of 2 S WU-24 2-2012061 ? PPP1- 4. Clarity: Choose the number which best describes the clarity of the discharge; where 1 is clear and 5 is very cloudy: ] 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floannt solids in the stormwater discharge. where i is no solids and 5 is the surface covered with floating solids: 1 2 4 5 6. Suspended Solids: Choose the number which best describes the amourit of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 (D 3 4 5 7. Is there any foam in the stormwater discharge? Yes So 8. Is there an oil sheen in the stormwater discharge? Yes N 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page. 2 of 2 SwU-242-201206 i 3 PPP- . ,ij- NCDENR Stormwvater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance nn.illint ow this form, please xjc�sw4t-M-4 Permit No.: N/C orI-- rtifcate of Coverage No.: NICIGIQf6I OIO Facility Name: C. -- WEe n county:.-ADZY, Isa6m _Phone No. 3310 63q .41456 Inspector: xJ Date of Inspection: 1 Time of Inspection: Total Event Precipitation (inches): _ a•H Was this a Representative Storm Event? (See information below) Z Yes ❑ No Please check your pe»nii io verify if Quality ive Monitoring muse be performed during a representative sto7w event �iequireif�ents vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours Q days) in which no storm event measuring greater than 0.1 inches has occurred. A single stonn event may contain up to 10 consecutive hours of no precipitation. By this signature. I certify that this report is accurate and complete to the best of my knowledge: r,. (Signature o+ennittee or Designee) I. Outfall Description: Outfall No.� Receiving Stream: fi+ie Describe the industrial act viI S{ tru ore. (pipe, ditch, etc.) , _A5 r&-k% es that occur within the outfall drainage area: �r7+o.� �n ri�ert��r:hc 2. Color: Describe the color of the discharge using (light� ., medium, dark) as descriptors: (e<Wk <42s colors (red, brown, blue, etc.) and tint 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor. etc.): Page ] of 2 51Vt_1-24 2-201205 13 -t. l.laFlly: 1.11nUSC MC IIC1111UCI WI11C11 UCJL UCJCIIUCS LIIC C:lallly U1 LIX UiJCIlalgc. WiIC1C I 16 C:ICUI and 5 is very cloudy: 1 2 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwaier discharge, where I is no solids and 5 is the surface covered with floating solids: 1 2 4 5 6. Suspended Solids: Choose the number which best describes the arnou3it of suspended solids ill the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 3 D 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes Nn 9. Is there evidence of erosion or deposition at the outfall? Yes 'o 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 Swu-242-20 ] 20613 DEP Stornmater Discharge Outfall (SDQ.) Qualitative Monitoring Report Far gi idance onfilling our Mis form. please r;i.sii: i��:l/mortal.rcdcr,r.UrJwebhvcl��<ISiIlnpdes. lvwh-4 Permit No.: NIC/G /O/j(QIor Certificate of Coverage NO.: N/C/G/Q/6/ 06 l� l,kl Facility Name: _C6►?irt�YlWra�1-4ftn County: L�&Xml, Inspector:. _ X Date of Inspection: Time of Inspection: Total Event Precipitation (inches): a+ q Phone No. D& bag _ ggE;A Was this a Representative Storm Event? (See information below) Pf Yes ❑ No Please check your permit to verify if Quahialive Monitoring mast be pelfornaed during a rePresentafive s1o1�a3 eve�a7 (requiremelils nary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours Q days) in which no storm event measuring greater than 0,1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature; I certify that this report is accurate acid complete to the best of my knowledge: r,. (Signature oi+cnnittee or Designee) 1. Outfall Description: Outfall No. 00 St ru t.ure (pipe, ditch, etc.) J,AtL, Voka _:rM,- pa"je Receiving Stream: �i � ' " . Describe the industrial activities that occur within the outfall drainage area: —IZccr Dim Encnv S& o 2. Color: Describe the color of the ditch 00 (light, medium, dark) as descriptors: 1�,t< using basic colors (red, brown, blue, etc.) and tint 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): )&AC Page ] of 2 SWU-242-2012(YA 3 pp� 4. %-sarity: t-noose the nurnDer wrath nest aescrioes tile ciarny of ine uiscilarge where i is clear and 5 is very cloudy: 1 2 0 4 5 A 5. Floating Solids: Choose the nuinber which best describes the amount of floating solids in the storrnwater discharge, where i is no solids and 5 is the surface covered with floating solids: 1 2 © 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the storrnwater discharge, where i is no solids and 5 is extremely muddy: 1 2 3 � 5 7. Is there any foam in the storrllwater discharge? Yes S. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes UN 10. Other Obvious Indicators of Stormwater Pollution: ti List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 S'ArIJ-242-2512tib 13 Meritech, Inc. Ali Environmental Laboratory Laboratory Certification No.165 i-o� Contact: Ken Gusler Report Date: 7/5/2018 Client: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Date Sample Rcvd: 6/25/2018 Meritech Work Order # 06251807 Sample: SDO 001 Grab 6/21/18 Parameters Results Analysis Date Reporting Limit Method COD 39 mg/L 6/25/18 15 mg/L EPA 410.4 Total Suspended Solids 4.3 mg/L 6/25/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) <5 mg/L 6/25/18 5 mg/L EPA 1664B PH 6.5 S.U. 6/21/18 1.0 -14.0 S.U. SM 4500-HB Temperature 81.5 ° F 6/21/18 - ° F SM 2550 B I hereby certify that 1' have reviewed and approve these data. 0? Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Meritech, Inc. t Environmental Laboratory Laboratory Certification No.165 Contact: Ken Gusler Report Date: 7/5/2018 Client: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Date Sample Rcvd: 6/25/2018 Meritech Work Order # 06251808 Sample: SDO 002 Grab 6/21/18 COD 53 mg/L 6/25/18 15 mg/L EPA 410.4 Total Suspended Solids 25.7 mg/L 6/25/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) <5 mg/L 6/25/18 5 mg/L EPA 1664B pH 6.4 S.U. 6/21/18 1.0 -14.0 S.U. SM 4500-HB Temperature 76.0 ° F 6/21/18 - ° F SM 2550 B I hereby certify that I have reviewed and approve these data. Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Meritech, Inc. _ Environmental Laboratory Laboratory Certification No.1.65 Contact: Ken Gusler Report Date: 7/5/2018 Client: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Date Sample Rcvd: 6/25/2018 Meritech Work Order # 06251809 Sample: SDO 003 Grab 6/21/18 Parameters Results Analysis Date Rellordng LIM[ Method COD 111 mg/L 6/25/18 15 mg/L EPA 410.4 Total Suspended Solids 29.6 mg/L 6/25/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) <5 mg/L 6/25/18 5 mg/L EPA 1664B pH 6.6 S.U. 6/21/18 1.0 -14.0 S.U. SM 4500-HB Temperature 76.5 ° F 6/21/18 - ° F SM 2550 B 1 hereby certify that 1 have reviewed and approve these data. (/) �G Laboratory Representative 642 Tameo Road, Reidsville, North Carolina 27320 tel.(336)342-4748 Fax.(336)342-1522 Meritech, Inc. Environmental Laboratory Laboratory Certification No.165 Contact: Ken Gusler Client: Commonwealth Brands 301 N. Scales St Reidsville, NC 27320 Report Date: 7/5/2018 Date Sample Rcvd: 6/25/2018 Meritech Work Order # 06251810 Sample: SDO 004 Grab 6/21/18 Parameters Results Analysis Date RepQ�'ng Limit MQthod COD 68 mg/L 6/25/18 15 mg/L SPA 410.4 Total Suspended Solids 109 mg/L 6/25/18 2.5 mg/L SM 2540 D Oil & Grease (HEM) <5 mg/L 6/25/18 5 mg/L EPA 1664B PH 6.5 S.U. 6/21/18 1.0 -14.0 S.U. SM 4500-HB Temperature 76 OF 6/21/18 - OF SM 2550 B I hereby certify that I have reviewed and approve these data. Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Chain of Custody Record COC Client: Address: Attention: Commonwealth Brands 301 N Scales St Reidsville,NC 27320 Ken Gusler NPDES #: Phone: 6 634 4 Fax: Email., Project PO #: MERITECH INC. Environmental Laboratories �� A Division. of Water Technology and Control, Inc. 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1622 27320 Email: Web Site: www.meritechiabs.com Turn Around Time Std (10 days) 3 -5 Day 24-48 Hr Sample LocationllD # Sampling Dates & Times Person Taking Sample (Signature): Lab use Only VART END Comp? Grab? #of Conts. Tests Required- , e7 pH K? c 2 Daw Time Data uae SDO G TSS " G COD w1H2SO4 G Oil & Grease w1HCl •` (V bU G pH 4eenp- Sr1.5 ° ax Method of Shipment:`}' Comments: td. P.tv► ave..+_ A-4 G 119 to I-ctrr [] UPS Fed Ex Hand Delivery Other Will these results be used for regulatory purposes? Yes I I No *RUSH work must be approved prior to submitting samples. Relinquished by: Date: Time: Y(, l4=.4 Received by: Date: Time: Relinquished by: Date: Time: Received by: Date: Time: ReGnquishedby: Date: lime: Recei at lobe Tlme:/� Ed Chain of Custody Record CQC . Client: Commonwealth Brands Address: 301 N Scales St Reidsville,NC 27320 Attention: Ken Gusler NPDES #: Phone: 434 ') Fax: Email: Project: PO #: MERI'TECH INC. s Environmental Laboratories A Division of water Technology and Control, Inc. 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1622 27320 Email: Web Site: www_ edLetgbl bs m Turn Around Time" Std (10 days) 3 - 5 Day 24 - 48 Hr r Sample LocationllD # Sampling Dates & Times Person Taking Sam le(Signature): Lab Use Only START °''° Comp? Grab? #of Cmft. Tests Required- i n e�soKi7 Date me Me SDO 601 Oaxk ltdsp G TSS c3 G COD (wlH2SO4)�— G Oil & Grease (w/HCQ N G PH &.4 O Method of Shipment: Comments: K..,% .t��' S�crb� 10:,s��+ p a. 6 IA 118 5 `i JJ:2WM ❑ UPS [] Fed Ex rf] Hand Delivery [other Will these results be used for regulatory purposes? Yes No *RUSH work must be approved prior to submitting samples. Relinquished by: Dete: Time: gh., %.. 16wd� fr Ls le la: La *r+'1 Received by: Date: Ttme: Relinq hed by: Date: Tima: Received W. Date: Time: Relinquished by: Data: Time: Receive u Chain of Custody Record COC Client: Address: Attention: Commonwealth Brands 301 N Scales St Reldsville,NC 27320 Ken Gusler NPDES #: Phone: jX. 04 (06) Fax: Email: Project PO #: MERI'TECH INC. Environmental Laboratories A Division of Water Technology and Control, Inc. 642 Tamco Rd Phone 1-336442-4748 Reidsville, NC Fax; 1-336-342-1622 27320 Email: Web Site: www.meritechiabs.com Turn Around Time* Std (10 days) 3 -5 Day 24-48 Hr Sample LocationllD # Sampling Dates & Times Person akin Sam le (Signature): Lab Use Only START END Comp? Grab? &or Conte. Tests Required- uired- on Ice? pH OK? C12 OK? Time a e SDO G TSS G Inv A G COD w1H2SO4 G Oil & Grease wiHCi --W-" (9 1 , G PH . �o -' Method of Shipment: Co ments: *} 0: (S ,;,,, v'14- 1OA e' 61 Lit J IDS 5''7 PM a.y �� ❑ UPS ❑ Fed Ex Q Hand Delivery ❑Other Will these results be used for regulatory purposes? Yes 1 1 No *RUSH work must be approved prior to submitting samples. Refinquiahed by: Date: Time: r. G Received by: Date: Time: Refinquishad by: Date: Time: Received by: Data: Time: Re[Inqutshed by: Date: Tlme: Raceiv /w /�K� e: Time: � J Chain of Custody Record COC Client: Address: Attention: Commonwealth Brands 301 N Scales St Reidsville,NC 27320 Ken Gusler NPDES #: Phone: 34 631W Fax: Email: Project Po #: MERITECH INC. Environmental Laboratories w Division of Water Technology and Control, Inc. 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1622 27320 Email: Web Site: www,meaNblabs.com Turn ArounTime* Std (10 days) © 3 - 5 Day © 24 - 48 Fir r-= Sample LocationilD # Sampling Dates & Times Person Taking Sample (Signature): Lab Use Only START END comp? Grab? nor Corns. Tests Required- Tests pH OK? C12 OK? Gate Time a sme SDO OOE-{ 6 11:xs G ITSS. rr v1 i G COD (wlH2SO4)--- �� Olt J� G Oil & Grease wfHCl G PH 6.S Method of Shipment: Comments:} i4'. LS ?'C n cw. t 6 &`i8 S ifi r'M ;L_ tot u ❑ UPS Fed Ex Hand Delivery ❑t?ther . Will these results be used for regulatory purposes? Yes r No *RUSH work must be approved prior to submitting samples. Reiinquls�f d by: Date: Time: r ..s,A r� y��CV 6 IZ r �O'i�i AAA Jr Received by: Date: Time: Relinquished by: Date: Time: Received by: Date: Time: Relinquished by: Date: Time: IMEby.. Time: / Jr r� Stormwater Monitoring Commonwealth Brands 2018 Sample ID RA # MG/L MG/L MG/L OIL Date Time TSS GREASE COD SU (F) pH Temp 1 SDO 001 6/21/2018 10:55P 4.3 <5 39 6.5 81.5F 2 SDO 002 6/21/2018 11:05P 25.7 <5 53 6.4 76.01F 3 SDO 003 6/21/2018 10:40P 29.6 <5 111 6.6 76.517 4 SDO 004 6/21/2018 11:25P 109 <5 68 6.5 76.01F Rainfall recorded: Duration: i 1 40 Estimated Inches 2.4" Hours Minutes Limits: 100 30 Commonwealth Brands 2018 Sample ID RA # 1 2 3 4 Rainfall recorded: Estimated Inches Sampler: ,Ken Gusler 120 6-9 MG/L MG/L MG/L SU OIL Date Time TSS GREASE COD pH Duration: Sampler: Hours Minutes (C) Temp NA Certificate No. 165 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES LABORATORY CERTIFICATION BRANCH In accordance with the provisions of N.C.G.S. 143-215.3 (a) (1), 143-215.3 (a)(10) and NCAC 2H.0800: Meritech Inc. Is hereby certified to perform environmental analysis as listed on Attachment I and report monitoring data to DEQ for compliance with NPOES effluent, surface water, groundwater, and pretreatment regulations: By reference 15A NCAC 2H .0800 is made a part of this certificate. This certificate does not guarantee validity of data generated, but indicates the methodology, equipment, quality control procedures, records, and proficiency of the laboratory have been examined and found to be acceptable. Thiscertificateshall be valid until 12/31/2018 n �• - c7 Dane B. Satterwhite ,�• Dear Sirs, Attached is storm water sampling data from our four discharges at Commonwealth Brands Inc. collected on November $`h, 2017. There were no exceedances of our discharge permit. Sincerely, � A. -. 1�,06 -2p1-) James K Gusler Date Ken Gusler OHS & E Specialist Commonwealth Brands, Inc. An IMPERIAL TOBACCO GROUP Company 301 N Main Street, Reidsville, NC, 27320 336-634-4237 ken.eusler@us.imptob.com SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted W. 0(0 X017 ay./p 'r I. CERTIFICATE OF COVERAGE NO.l NCG06A—9- 41 Mr—ka SAMPLE COLLECTION YEAR 0%017 FACILITY NAME �i0rM�10nJca�m-�+LthdS iKc_ C I FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY w\ ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTI G SAMPLES _ -f Gi NTH DISCH _hGING TO SALTWATERS? ❑YES [4NO LABORATORY►'-- �.+ Lab Cert. t# J314 UWZ Ot:"� Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 A or ❑ No discharge this period3 Outfall No. Sample Collected,. mo/dd/yr TSS, mg/L :pH, Standard units COD, mg/L Oil and.Grease, mg/L- Fecal Coliform., Colonies -per 100 ml Enterococci •, Colonies per lOD ml Benchmark - 100 bf;50 -Within 6.D�— 9.0 120 30 1000 500 001CK 13 &0,41 <S ,r► UN l? . 1 (191 < A 1 W 1'7 45 <y A A tit ow 0 S5 .5 < c!; NA NA 1 Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes [K no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. •Outfall No: _ Sample Collected, trio%dd/yr Oil and.Grease - mg/L ', -. TSS, mg/L. ' • : pH, Standerid units, New.Motor Oil —Usage,; 'Annual average "gal/mo _4 Benchmark - 30 100 or 50 6.0 — 9.0 - Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at Any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yES complete Part B) S W U-249 Last Revised: Oct. j 18, 2012 Paw 1 of �^ *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL. OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original_and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN TH15 rdRTIFICATION-FOR ANY INFORMATION REPORTED: yS' "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." ` (Signat a of• P_e,irmittpe) T a Lo6Lxov? (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw4tab-4 I S W U-249 Last Revised: October 18, 2012 Page 2 of 2 of W A IN i? r Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit hM2:*otMl.nWmr.2rgLwehLvyA/ws/su/nRdessw#tab-4 Permit No.: N/C or Certificate of CovergNIC/G qo 004'a, Facility Name: Commonwealth Brands County: Rockingham Phone No. 2,16 63q 4X3i Inspector. Steven Yarbrough Date of Inspection: November 8, 2017 Time of Inspection: 0800 Total Event Precipitation (inches): 0.9 Was this a "Representative Storm Event" as defined by the permit? 7yes reformation below.) o 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certifM hat this report is accurate and complete to the best of my knowledge: of Permitee or Designee) SWU-242-020705 1.0utfall Description Outfall No. 001 Receiving Stream: 00 Describe the industrial activities that Structure (pipe, ditch, etc.) Storm Drain 6�-.1 IN221 within the outfall drainage area: Parking Lot 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Grey I Odor. Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where l is clear and 5 is very cloudy: 0 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: L�..,.:.....J 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where l is no solids and 5 is extremely muddy: l 2 1 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions wan -ant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this farm, please visit hn.//nls0cdenr.om/web/w4/ws/su/npdessw##tabA Permit No.: N/C or Certificate of Cover& fN/C/G 0b004)- Faeility Name: Commonwealth Brands County: Rockingham Phone No. 136 &Vi h2.37 Inspector: Steven Yarbrough Date of Inspection: November 8, 2017 Time of Inspection: 0810 Total Event Precipitation (inches): 0.9 Was Is a "Representative Storm Event" as defined by the permit? (Se information below.) es o No Please verity whether Qualitative Monitoring must be performed during a "representative storm even( or "meacureable 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 outfail. The previous measurable storm event must h able to document that a shorter approval from the local DWQ Regional Office. By thishignature, I cert* that this report is accurate and complete to the best of my knowledge: of Permitee or Designee) swu-2+2-020ro3 1.OutfaIl Description Outfall No. 002 Receiving Stream: Describe the industrial activities t (pipe, ditch, etc.) Storm Drain occur within the outfall drainage area: Parking Lot 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Clear 3. Odor: Describe any distinct colon; that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: l 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: l 1 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: ] 2 0 4 7. Is there any foam in the stormwater discharge? 8. Is there an oil sheen in the stormwater discharge? 9. Is there any evidence of errosion or deposition at the outfall? 10. Other Obvious Indicators of Stormwater Pollution: List and describe None 5 Yes No Yes No Yes No Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance onfilling filling out this form, please visit htty:ftertal.nedenr.gWLiy&b/wa/wslsulnndessw#tab-4 Permit No.: NIC or Certificate of CovergN/GG 6603(7.. Facility Name: Commonwealth Brands County: Rockingham Phone No. It 4 634 41)3-) Inspector: Steven Yarbrough Date of Inspection: November 8, 2017 Time of Inspection: 0820 Total Event Precipitation (inches): 0.9 Was 0a "Representative Storm Event" as defined by the permit? { nformation below.) es o No Please verify whether Qualitative Monitoring must be performed during a "represernative storm event or "measureable storm event" (requirements vary, depending on the permit.) dive monitoring requirements vary. Most permits require qualitative monitoring to be performed during a entative storm event' or during a "measurable storm event.` However, some permits do not have this requirement. refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify tkat this report is accurate and complete to the best of my knowledge: (SignatureW Permitee or Designee) SwU-242-020705 ]. Outfall Description Outfall No. 003 Receiving Stream: LA Describe the industrial activities Structure (pipe, ditch, etc.) Storm Drain occur within the outfall drainage area: Parking Lot 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Clear 3. Odor.. Describe any distinct colors that the discharge may have (i.e., smeIls strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1271 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 2 1 4 5 7. is there any foam in the stormwater discharge? Yes No 8. is there an oil sheen in the stormwater discharge? Yes No 4. is there any evidence of errosion or deposition at the outfalI? Yes No 10.Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this farm, please visit httn: ZMttal.nedenr.oMLwhta/ws/su/npdessmlka-li!4 Permit No.: N/C or Certificate ofCovera;WUG4Ody7- Facility Name: Comrnonwealth Brands County: Rockingham Phone No. V to (63q LI).J') Inspector: Steven Yarbrou h Date of Inspection: November 8, 2017 Time of Inspection: 0930 Total Event Precipitation (inches): 0.9 Was this a "Representative Storm Event" as defined by the permit? (S information below.) Yes o No Please verb whether Qualitative Monitoring must be performed during a "representative storm event or "measureable storm event" (requirements vary, depending an the permit.) Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, If applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify dw this report is accurate and complete to the best of my knowledge: or Designee) SWU-242-020705 1.Outfall Description Outfall No. 004 Receiving Stream: lad Describe the industrial activities Structure (pipe, ditch, etc.) Ditch 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, darn) as descriptors: Brown 3. Odor. Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 1J 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where l is no solids and 5 is the surface covered with floating solids: 1 2 1 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where l is no solids and 5 is extremely muddy: 1 1 2 -1 3 4 5 7. Is there any foam in the stormwater discharge? Yes No B. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion or deposition at the outfall? Yes No 10.Other Obvious indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. RESEA Ch & ANAYTiCAt s E3ODLAboumToRQiEg, INce Analytical/Process Consultatlons November 29, 2017 Commonwealth Brands, inc. P.O. Box 2236 Reidsville, NC 27323-2236 Attention: Mr. Scott Townson Chemical Analysis for Sampling identified as Stormwater, collected 08 November 2017 I• Project Number: N/A Sample Identification RAL Sample Number Sampling Date Sampling Time Total Suspended Solids (mg/L) Oil & Crease (mg/L) COD (mg/L) pH (SU) Date Anal) -zed Analysts 001 42522-01 11/08/17 0800 20.8 <5 41 6.7 1 1108-11/15/17 SY. SK. AW & AA 002 42522-02 11/08/17 0810 23.1 <5 61. 6.5 1 1/08-11115/17 SY, SK. AW & AA 003 42522-03 11/08/17 0820 <5 <5 <5 6.5 11J08-11/15/17 SY. SK. A A' & AA 004 42522-04 11/08/17 0830 <5 <5 <5 6.5 11/08-1 1/15/17 SY. SK. AW & AA Rain Amount 0.9 in. Rain Duration I hr. 20 min. mg/L = milligrams per Liter = parts per million (PPM) < = less than or Below Quantitation Limit (BQL) SU = Standard Units RESEARCh & ANA1yTICA[ LAb4RATORIES, INC. �. Analytical 1 Process Consultations Phone 1336) 996-2841 CHAIN OF CUSTODY RECORD WATER 1 WASTEWATER I IWISC- . l f f ... REQUESTED ANALYSIS ,_ i CITY, STATE, ZIP' CONTACT PHONE ,. ,. / WX 60m ■� REBENION10 Miumm ��W I m.:PI ■a■■ ., ■■r■no■■■■■ ■■ ■■■i■■■■��■ ■■■■■■■■■■■■ ■o■ NESS ��r■■■■■ ■■■ ■■■■ ■ ■■ ■�SE�■■�■■ ■ ia■■■�■■■■■■ ir■ _.■MISNE ■■■■■r■■.■■ ■r� ■ E ■■■■i ■■■■■■■■mm■ ■■ ■■=■■■01r■ ■■■.■■■■r■■ ■■■ =mmimmmEEMmomm ■■■■■■■■■■■■ ■■■ ■■■■ommmm■■ ■■■■■■■■.r■ ■■ ..10SEN mImmmommommom ■■■ r■ r..■m■ ■■■■■■■■■■■■■■■ ■■ ■■■■m ■■■■■■■■■■■ ■■■ ■.■■■■■■■■ ■■■■■■■.■■■ ■.■ IEESIMSEM ■iiIN mimiiiei■iiiiPop .: , j Teme r , f RELINQUIA-,ED By RECEIVED BY/ RESEARCh & ANA[yTICA[ 210 LAbORATORiES, INC. For: Commonwealth Brands, Inc. P.O. Box 2236 Reidsville, NC 27323-2236 Attn: Scott Townson Report of Analysis 11/17/2017 f�1fiN!!f�ll rq NC a34 °' N z;• NC p37701 i 4 Client Sample ID: Outfall 001 Lab Sample ID: 42522-01 Site: Commonwealth Brands Collection Date: 11/8/2017 8:00 Parameter Method Result Units Rep Limit Analyst Analysis DatelTime COD EPA 410.4 41 mg/L 5 SK 11/12/2017 Hydrocarbon OSG pH Temperature (Thermometric) Total Suspended Solids (TSS) EPA 1664 Revision B/Silica Gel SM 4500 H+B-2000 SM 2550B SM 2540 D-1997 <5 mg1L 5 6.7 Std. Units 18.7 °C 20.8 mglL 5 AW 11/15/2017 11/8/2017 11/8/2017 AA 11 /13/2017 Client Sample ID: Outfall 002 Lab Sample ID: 42522-02 Site: Commonwealth Brands Collection Date: 11/8/2017 8:10 Parameter Method Result Units Rep Limit Analyst Analysis Dateaime COD EPA 410.4 61 mg/L 5 SK 11112/2017 Hydrocarbon O&G EPA 1664 Revision B/Silica <5 mg/L 5 AW 11/15/2017 Gel pH SM 4500 H+B-2000 6.5 Std. Units 11/8/2017 Temperature (Thermometric) SM 2550B 19.1 'C 11/8/2017 Total Suspended Solids (TSS) SM 2540 D-1997 23.1 mglL 5 AA 11/13/2017 Client Sample ID: Outfall 003 Lab Sample ID: 42522-03 Site: Commonwealth Brands Collection Date: 11/812017 8:20 Parameter Method Result Units Re2 Limit Anal s Analysis DatelTimo COD EPA 410.4 <5 mg/L 5 SK 11/12/2017 P.O. Box 473 106 ShortStreet Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www,randalabs.com Page 1 RESEARCh & ANALYTICAL Report of Analysis LAbORATORiESi INC. 11/17/2017 Client Sample ID: Outtall 003 Lab Sample ID: 42522-03 Site: Commonwealth Brands Collection Date: 11/8/2017 8:20 Parameter Method Result Units Rea Limit Analyst Analysis DateiTime Hydrocarbon 08G EPA 1664 Revision B/Silica <5 mg/L 5 AW 11/15/2017 Gel pH SM 4500 H+B-2000 6.5 Std. units 11/8/2017 Temperature (Thermometric) SM 2550B 19.7 °C 11/8/2017 Total Suspended Solids (TSS) SM 2540 0-1997 <5 mg1L 5 AA 11/13/2017 Client Sample ID: Outfall 004 Lab Sample ID: 42522-04 Site: Commonwealth Brands Collection Date: 11/8/2017 8:30 Parameter Method Result Units Rep Limit Analyst Analysis DatelTime COD EPA 410.4 <5 mg/L 5 SK 11/1212017 Hydrocarbon O&G EPA 1664 Revision BlSilica <5 mg/L 5 AW 11/15/2017 Gel pH SM 4500 H+B-2000 6.5 Std. units 11/812017 Temperature (Thermometric) SM 2550B 18.5 °C 11/8/2017 Total Suspended Solids (fSS) SM 2540 D-1997 <5 mg/L 5 AA 11/13/2017 NA = not analyzed PA Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT r for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 06 0l X0I) R t C t i V Et-) CERTIFICATE OF COVERAGE NO. NC906 0 49�- FACILITY NAME C0M0h4 lawkk S NhL. COUNTY Ae k:�.k,.,% PERSON COLLECTING SAMPLES bra,. LABORATORY R+A Wbs Lab Cert. Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR aol-) II II I 14 2017 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use anima aLE6 DISCHARGING TO SALTWATERS? [:]YESN CTION PLEASE REMEMBER TO SIGN ON THE REVERSE -) Totol event rainfall z i Y7 l or ❑ No discharge this period3 Outfall No. Sample Collected.. mo/dd/yr TSS; mg%L pH; Standard units „-,COD, mg/L Oil and Grease, -mg/L Fecal Coliform , : Colonies per 100 ml . Enterococ6' ". Colonies per.100 ml Benchmark f 100 or 50 Within 6:0 - 9:0 120 30 1000 50d- p0 17 1+.53 73 a. c- AIA NA - 111,10 2.1 S$ NA NA o y &14 1 4. MA NA 4ro (a <5 ' Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes �1 no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. ,Outfall No. Sample Collected, • mo%dd/yr Oil and Grease, mg/ _ TSS, mg/L` pH, 5#andard units, New Motor Oil,Usage,' Annual average gal/mo `} Benchmark - 30 100 or 50 6.0 — 9.0 - (ifyes• complete Part B) 1 Only applies to facilities that use/process meats. Z The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at g y outfalls, you must still submit this discharge monitoring report with a checkmark here. 45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: Oct., j 18, 2012 pane I of') *FOR PART A AND PART 8 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 [Q IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOUR T SIGN- THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, thatxhis document:and all attachments were prepared under my direction or supervision insaccordance 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 r. information, including the possibility of fines and imprisonment for knowing violations." ,. (SignatuNof Permittep) 06 0-) ao 17 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/nRdessw#tab-4 S W U-249 Last Revised: October 18, 2012 Page 2 of 2 "OF WO TSgO Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit h=llportal.ncdenromLwebLU/ws/su/nRdessw#tab4 Permit No.: N/C or Certificate of CoveralNIC/G cO(p nOL-A Facility Name: Commonwealth Brands County: Rockingham Phone No. 33to 634 tjXS Inspector: Steven Yarbrough Date of Inspection: May 23, 2017 Time of Inspection: 0800 Total Event Precipitation (inches): 1.71 Was this a "Representative Storm Event" as defined by the permit? (See information below.) dyes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event or "measureable storm event" (requiremems 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify Opt thisAvport is accurate and complete to the best of my knowledge: Permitee or Designee) SWU-242-020705 1.Outiall Description Outfall No. 001 Structure (pipe, ditch, etc.) Storm Drain Receiving Stream: LZ Mc lta,,Ac5 m e C.r,rtK Describe the industrial activities that occur within the outfall drainage area: Factory 2. Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Medium Brown 3. Odor. Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy 13 3. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: L� 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 2 1 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion or deposition at the outfall? Yes No 10.Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. O+O� W n r T rTi �. O� V. Stormwater Discharge Outiall (SDO) Qualitative Monitoring Report For guidance onfilling out this form, please visit I.n enr.o eblw / s n Permit No.: N/C Facility Name: Commonwealth Brands or Certificate of Coverat N1CIG CG 0041 County: Rockingham Phone No. -S-kt,. (qliy t{)37 Inspector: Steven Yarbrough Date of Inspection: May 23, 2017 _ Time of Inspection: 0810 Total Event Precipitation (inches): 1.71 Was this a "Representative Storm Event" as defined by the permit? (See information below.) w es o 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 "repres,entative storm event" or during a "measurable storm event." However, some permits do not have this requirement. refer to these definitions, if applicable. 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 h able to document that a shorter aMroval from the local DWQ Regional Office. By this signature,l certify that this (Signature of PcAtee or Designee) SWU-242-020703 accurate and complete to the best of my knowledge: 1.Outfall Description Outfali No. 002 Structure (pipe, ditch, etc.) Storm Drain Receiving Stream: L014, G.V, Describe the industrial activities that occur within the outfall drainage area: Factory 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Medium Brown 3. Odor. Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 1 4 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where i is no solids and 5 is the surface covered with floating solids: 1 3 4 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1=J 3 4 5 7. is there any foam in the stormwater discharge? Yes No 8. is there an oil sheen in the stormwater discharge? Yes Na 9. is there any evidence of errosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfal! (SDO) Qualitative Monitoring Report For guidance on filling out this farm, please visit hgp: ftg[igl.ncdenr.org(weblw ws/su/npdesswtftab-4 Permit No.: N/C Facility Name: Commonwealth Brands or Certificate of Covera N/C/G 01p 0 County: Rockingham Phone No. $3to bay 4�•j') _ Inspector: Steven Yarbrough _ Date of Inspection: May 23, 2017 Time of inspection: 0820 Total Event Precipitation (inches): 1.71 Was this a "Representative Storm Event" as defined by the permit? (See information below.) AS o No Please very whether Qualitative Monitoring must be performed during a "representative storm event or "measureable storm even!" (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 "measurable storm event" However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify that is r9port is accurate and complete to the best of my knowledge: (Signature of PeNtee or Designee) SWU-242-020705 1. Outiall Description 0utfall No. 003 Structure (pipe, ditch, etc.) Ditch Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: factory 2. Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Clear, Medium 3. Odor. Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where l is clear and 5 is very cloudy: 5. Floating Solids: Choose the number which best describes the amount of footing solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwatcr discharge, when I is no solids and 5 is extremely muddy: 1 3 4 5 7. is there any foam in the stormwater discharge? Yes No S. Is there an oil sheen in the stormwater discharge? Yes No 9. is there any evidence of errosion or deposition at the outfall? Yes No 10.Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. 0 00 W A TF90 r o s Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance onfilling out This form, please visit }/nortai.ncdenr.orglweb/w su/npdesswlitab4 Permit No.: N/C Facility Name: Commonwealth Brands County: Rod Inspector: Stev Date of Inspection: Time of inspection: 0830 Total Event Precipitation (inches): 1.71 or Certificate of Covera f N/C/G 64001-4 �1. Was this a "Representative Storm Event" as defined by the permit? (See information below.) As o No Please verb 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 l0 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature. I certify that iris report is accurate and complete to the best of my knowledge: (Signature Of Pcrmitee or Designee) SWU-242-020705 1.OutfalI Description Outfall No. 004 Structure (pipe, ditch, etc.) Pipe Receiving Stream: 'Tw460""� %"ttcV, .....-- Describe the industrial activities that occur within the outfall drainage area Factory 2. Collor. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Clear, Medium 3. Odor. Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where l is clear and 5 is very cloudy: 1 3 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: l �.J 3 4 5 7. is there any foam in the stormwater discharge? Yes No 8. is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. �ESEARCh & ANA1yTOCA1 Cho LAboRAToRks, INC. 0 LO Analytical/Process Consultations June 6, 2017 Commonwealth Brands. Inc. P.O. Box 2236 Reidsville, NC 27323-2236 Attention: Mr. Scott Townson Chemical Analysis for Sampling identified as Stormwater, collected 23 May 2017 Project Number: NIA Sample RAL Sampling Sampling Total Oil COD p11 Date Analysts Identification Sample Date Time Suspended & Analyzed Number Solids Grease (mg/L) (mg/L) (mg/L) (SU) UI}I 35031-01 05/23/17 0800 11.8 <5 32 7.3 05/23-06101/17 SY. 13R. JF & AA 002 35031-02 05/23/17 0810 12.8 <5 21 7.1 05/23-06101/17 SY, 13R,JF & AA 003 35031-03 05/23/17 0820 8.4 <5 18 6.4 05/23-06/01/17 SY, BR, JF& AA 004 35031-04 05/23/17 (1830 8.6 <5 36 6.6 05/23-06101/17 SY. BR. JF & AA Rain Amount 1.71 in. Rain Duration I 1 hrs. 40 min. mg/L = milligrams per Liter = parts per million (PPM) < = less than or Below Quantitation Limit (BQL) SU = Standard Units RESEARCh & ANA1yTICA1 LAbORATO&S, INC. Analytical 1 Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD WATER ! WASTEWATER I misc. • .. • • • STEDANALYSIS D•• CITY, STATE, ZIP SAMPLENUMBER USE ONLY) SAMPLE LOCATION I LO, c��■ .. , ■■■■■■■r.■r.��■■■■■non■■■■ ■■■ , • • "O' � ' ■�MM�� ' � �' �r.. • ■ ■■■■ : M■ ■■■non■■■■■■■� �M■■■■■■■ . ._ M■■■■eon■■■■ ■■■���mmommomm ■� mommimmommmomm OM 10011 EN �■M■■iiii i■■■■■■■■■■■ ■■■ ■■�■■■■■■■ ■■■■■■■■■ ■ ■■■ ■■�■■■■■■■ ■■■■■■■■■■■■ ■■■ ■■�■■■■■■ ■■■■■■■■■om■ o■■ ■■■■■■ ■■■■■■■■■ ■ ■■ IMMIMM■■■■■E■■ ■■■■■■■■■■■� ■■■ ■■■■■■■■■■■ ■■■■■■■■■■■■ ■■ 11MEME■■■■■■■ ■■■■■■■■■■■■ ■■■ R. R : �'7.3 In. 1 , + • 1 • •Ij 1 I 1 Stormwater Monitoring Commonwealth Brands MG/L MG/L MG/L SU (C) 2017 OIL Sample ID RA # Date Time TSS GREASE COD pH Temp 001 35031-01 5/23/2017 0800 11.8 <5 32 7.3 16.1 002 35031-02 5/23/2017 0810 12.8 <5 21 7.1 16.5 003 35031-03 5/23/2017 0820 8.4 <5 18 6.4 16.1 004 35031-04 5/23/2017 0830 8.6 <5 36 6.6 16 Rainfall recorded: Duration: 11 40 Sampler: Steven Yarbrough Estimated Inches 1.71 Hours Minutes Limits: 100 30 120 6-9 NA Commonwealth Brands MG/L MG/L MG/L SU (C) 2017 OIL Sample ID RA # Date Time TSS GREASE COD pH Temp 001 002 003 004 Rainfall recorded: Duration: Sampler: Estimated Inches Hours Minutes Dear Sirs, Attached is storm water sampling data from our four discharges at Commonwealth Brands Inc. collected on May 23rd, 2017. There were no exceedances of our discharge permit. Sincerely, James K Gusler Ken Gusler OHS & E Specialist Commonwealth Brands, Inc. An IMPERIALTOBACCO GROUP Company 301 N Main Street, Reidsville, NC, 27320 336-634-4237 ken.gusler@us.imptob.com 06 0-) obi 7 Date STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. NCG06 001ASIz FACILITYNAAIE C-0ybM011Vk-Rk PERSON COLLECTING SAMPLES GV-eve- CERTIFIED LABORATORY Lab # Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: g (This monitoring report is due at the Division no later than 30 days from REtE-1-le ,�Yity receives the sampling results from the laboratory.) COUNTY— Pzx-V,yv, DEC 2 2 Z016 PHONE NO: (_13:[. )W3,k %L-IV) CENTRAL FILES PLEASE SIGN ON THE REVERSE DWR SECTION -.0. tf. 0 00400'�- �-; --z 15'00346:� 51. TL Sanriple usiy and -Grease, Colonies onies. per, 100'.ml- ffio/dd/ft- m 4 t filifI69.0�� I'M 507Z .A .! 0 00 .0-- - I �q'9 1� 1 �19 el 7 :4 L4 < Z� I C�j I < 5 + 3 < 5 Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I 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 Ino (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements . ....... .. . No Da" Sample Collected, 09556�6-,:E `1�- i-4v, 053QI,-�- Oil and Grease mk10;"- 4Ai � otal Suspended p H IVMotor Oil 1: age nnua --averageigal/m'o % .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 I or Tier 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Date 11 )-`I i� (first event sampled) Total Event Precipitation (inches): 'XIi 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." 19 (Sig"tune of Permittee) la A5 I (Dat ) S WU-249-102107 Page 2 of 2 ®r'... ' STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCGO60000 CERTIFICATE OF COVERAGE NO. NCG06 00!� FACILITY NAAIE PERSON COLLECTING SAMPLES CERTIFIED LABORATORY k, -A— Lab # 5"A Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: 1?;1 (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 — PHONE NO. PLEASE SIGN ON THE REVERSE —> "`0053KK�W ti-�2z 7UP"a 'w4oW,&U- "31616 ;Dine -`: No Sample:j f"I S' Fecal im W—.,-Standar- d-un Demand; "C-onlesTe-r:100"ml -,. Bcnchmi&aik'­1"':.':"!­'.' 6 9 4000 L no -17 If-14 -I- :'L% NA 004 1 kZ. Pq3. <5 Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I 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 dino (if yes, complete Part 13) Part B: Vehicle Maintenance Activity Monitoring Requirements Date ".. Collected,Oil"ain'&G-i-ea'as 00556­ -"n."--A-"005X,�j-�.;' - - ---- -- --------------- - m g/L'!' �ESt�' a uspen -e a„ Total t M 9 ng' 'pH Standir"d1units N U nii[7 efaLe. ;Bini6hrnark 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 I or Tier 2 responses. See General Permit text, STORM EVENT CHARACTERISTICS: Date (first event sampled) 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 I 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." Vaflffl��"I= (Signat'f�-e of Permittee) —0- / (Date) SWU-249-102107 Page 2 of 2 _ SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted _& ?-(;L61(a CERTIFICATE OF COVERAGE NO. NCG06_D O SAMPLE COLLECTION YEAR col FACILITY NAME CommatjWtJ�k n c.. FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Ra '-RECtSCHARGING lv® uDe/process meats ❑ use animal fats/byproducts PERSON COLLECTING AMPLES '(V-( Vl ��� r flo, h _ TO SALTWATERS? [:]YES[�NO LABORATORY 9, + A Lc. or�.s Lab Cert. # 3 1UN 2 4 2016 CENTRAL FILES PLEASE REMEil9BER TO SIGN ON THE REVERSE Part A: Stormwater Benchmarks and Monitoring Results DVVR SECTIONTotal event rainfall a O. ? or n No dischorae this period' Out'fall No. Sample Collected, . mo/dd/yr TSS, mg/L pH, Standard units coo, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0-9.0 120 30 1000 S00 01 lo 14 (o. 6 7. 5i ;1- .5 1 N A N.4 o I 6 7L-5.5 1H 1V < S NA IVA 0 05 6 -1.0 10 SS Na -4 0 W 05 i� < S.'0 4 -7 13 t 5 A- b j Only applies to Facilities that use/process meats. z The total precipitation must be recorded using dak 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 Perrnit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than S5 gallons of new motor oil per month? ❑ yes ®,no Part B: Vehicle Maintenance Area Monitoring Results. only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr. . Oil.and Grease, mg/L TSS, mg/L. pH, Standard units New Motor Oil Usage, Annual average gal/ma Benchmark - 30 100 or 50 6.0 — 9.0 - Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Perrnit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: Oct, 18, 2012 page I of 2 *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 DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERT)FICATION 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." (SignatAJ of Permittee) _ G �Zl .z 016 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.ot-g/web/wq/ws/su/­npdessw#tab-4 SWU-249 i.ast Rcvised: October 18, 2012 Pagc 2 of 2 L STORMWATER DISCHARGE OUTFALL (SDO) • MONITORING REPORT GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. NCG06 06!j�= FACILITY NAME C40"MOAUCJ[k RikeSS PERSON COLLECTING SAMPLES Nec.1 CERTIFIED LABORATORY -IZ)I- (.,6*ejorjr s Lab # -J-.H Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: AQ!5 (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.) RE - 1 0 CEIWOuNE NTY PHONO. (3-y. �. 631f c? 2-00 NOV 2 4 21`i`` PLEASE SIGN ON THE REVERSE 4 CENTRAL FILES DWR SECTION Qutfall Dates &�.''r.n � 00530, V W,-=z i r00400,,.. N .?Lyg rease,�-,n grin R ........... ,o T . k" S ri i d n. t i s �'vty 'P - Mi ema!!P;t5W g�.2,.g7 mg1L Colonies--per.4 O:ffil.-.!: .1 �11 10 0 1 -0: 120L -0 ox A000`-. 03,6 14 Y <!5 AIA 0 L4 10 X-1 r-.2 < S <15 At& Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I 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 L<,po (if yes, complete Part B) Part B- Vehicle Maintenance Activity Monitoring Requirements �O'ftWF D­ -"08t "I.; k 0 0 5 505, 00530.�" -IFS '4 R 'k TJ-ii MOW,, K." -N U if: ��w -7�() `G� illfid� rease; de 'Sbli&Z25 I Wi.!Newmot6i'-Oillu- j.,- 'A rd�unitszj J-67gfll mo, I i i fta r k 2 M "Eff- TE-� §ua Iff; i NT '00-1 7-6 Q. 9;0'K F% Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses. See General Permit text. STORIN11 EVENT CHARACTERISTICS: Date jj%X�- 15 (first event sampled) Total Event Precipitation (inches): Date k)-L)- (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): I- L,; Mail Original and one copy to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 1--� F=O�3 FFFT SWIJ-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." (Sigi6ture of Permittee) II - I - 90 �s (Date) SWU-249-102107 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. NCG06 FACILITYNAME L44liss-1 P; PERSON COLLECTING SAMPLES F )'A r- N CERTIFIED LABORATORY _� k LJ�' 11 Lab # 344 Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DUPING CALENDAR YEAR: A(315 (This monitoring report is due at the Division no later than 30 days from the date the facility receives th li g results from the laboratory.) KVIPT COUNTY 5'1"C�ncrn PHONE NO. (13.4 T63i4 4f2-00 PLEASE SIGN ON THE REVERSE --> 00530-�F NgMW004 00K�-,PfR %011�` 00340W- M 7%. , 0556 6" -Sampl T�tiiF if6dg, F—. SUi� MC61ifffili H �fe -r!nji,&G" 5t� -.1C hiffil6iFoiy-,en,-Oil r.k7 --j IKE w. Aibtandard—... 'd MON AC 0-to'-fide r-,100-ffil, ,'ER. f Offi&dkl -M jilov 9- 0 -:1000 1!7 1 D ;Y) 1c; 71 16<SJAA 0 aao is 12. s &'7 3 -79< h Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I 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 j,/no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitorin-z Requirements 0 AAW- �i ,7 0 0 5 5 6J � �--40` ���00530, w TTR 0040W,-,� P , - PP� ?4 OiFiEd-i"C, 'Fi 'T - o a uspen H he NeW-M6t6i'Oil`U '.. -EE i - .4 , -�' -j- A-'L-�![-.' --A-Annual, 0 --tag unitspqV average: gal mo'---.., .5 10C 6 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 1041 - [;(first event sampled) 14 Total Event Precipitation (inches): L X5 Date 1041- (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 I 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." re of Permittee) 11 -lb- -,5�015 (Date) SWU-249-102107 Page 2 of 2 0 151� -,z Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit hqp://portal.nedenr.org/web/wq/ws/su/nt)dessw#tab-4 Permit No.: NIC Facility Name: Commonwealth Brands or Certificate of Covera€N/C/G O{ 00 County: Rockingham Phone No. i.N 1UL00 Inspector: Neal McDuffie _ Date of Inspection: October 27, 2015 Time of Inspection: 1333 Total Event Precipitation (inches): 1.25 Was this a "Representative Storm Event" as defined by the permit? 7es 'formation below.) ❑ 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify that (Signature 4APermitee or Designee) is accurate and complete to the best of my knowledge: 5 WII-242-020705 1. Outfall Description Outfall No. 001 Structure (pipe, ditch, etc.) Pipe Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 1�,he Pkjr IN., e. eah ,1 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Grey 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 3 4 5 7. is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. is there any evidence of errosion or deposition at the outfali? Yes No 10, Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit http.//portal.ncdenr.oreweb/wq/ws/su/npdessw#tab-4 Permit No.: N/C or Certificate of CoveralN/C/G 06 0. 04 Facility Name: Commonwealth Brands County: Rockingham Phone No. 33t (v2M 1{100 Inspector: Neal McDuffie Date of Inspection: October 27, 2015 Time of Inspection: 1315 Total Event Precipitation (inches): 1.25 Was this a "Representative Storm Event" as defined by the permit? (See information below.) r"Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event or "measureahle 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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. "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must h to document that a shorter )val from the local DWQ Regional Office. By this Permitee or Designee) is accurate and complete to the best of my knowledge: SWIJ.242.020705 1. Outfall Description Outfall No. 002 Structure (pipe, ditch, etc.) Pipe Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: Te6b�'Z4. -z; 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Grey 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids; 1 12 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit hM://portal.ncdenr.org_/web/wq/ws/su/npdcssw#tab-4 Permit No.: N/C Facility Name: Commonwealth Brands or Certificate of Covera� N/C/G 06 OOLJ j)— County: Rockingham Phone No. Inspector: Neal McDuffie _ Date of Inspection: October 27, 2015 Time of Inspection: 1347 Total Event Precipitation (inches): 1.25 Was this a "Representative Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verb whether Qualitative Monitoring must he performed during a "representative storm event or "measureahle 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify that th)p repprt is accurate and complete to the best of my knowledge: (Signature of fformitee or 5 WL-242-020705 1. Outfall Description Outfall No. 003 Structure (pipe, ditch, etc.) Pipe 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: Light Green 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: I 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit bft://portal.ncdenr.orglwcb/wq/ws/su/npdessw#tab-4 ://portal.ncdenr.org_lwcb/wq/ws/su/npdessw#tab-4 Permit No.: N/C or Certificate of Covera€N/C/Gd�a. _ Facility Name: Commonwealth Brands County: Rockingham Phone No. 3(o Inspector: Neal McDuffie Date of Inspection: October 27, 2015 Time of Inspection: 1324 Total Event Precipitation (inches): 1.25 Was this a "Representative Storm Event" as defined by the permit? (Sege information below.) Yes ❑ No Please verb whether Qualitative Monitoring must he performed during a 'representative storm event or "measureahle 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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. "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous .asurable storm event must h able to document that a shorter approval from the local DWQ Regional Office. By this signature, ) certify that thisAeport * accurate and complete to the best of my knowledge: (Signature of l9rmitee or SWU-242-020705 1.'Outfall Description Outfall No. 004 Structure (pipe, ditch, etc.) Pipe Receiving Stream: Describe the industrial activities that occur within the outfalll drainage area: t C{ ,. Ik c 1, 4- 69-ftu 7�4]3Z�,J r e105-c- 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Green 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 11 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids- 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion or deposition at the outfall? Yes Na 10. Other Obvious Indicators of Stormwater Pollution: List and describe None Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. e F1 Analytical/Process Consultations p a _ • �....ECe� °9/;D��t1aR�s��. November 10, 2015 Commonwealth Brands, Inc. P.O. Box 2236 Reidsville, NC 27323-2236 Attention: Mr. Scott Townson Chemical Analysis for Sampling identified as Stormwater, collected 01 June 2015 i• Project Number: N/A Sample RAL- Sampling S mplmg Total bil COD:: pH: Date Analysts. Identification Sample: Date Time Suspended & Analyzed Number; Solids Grease .I' {mgI[) OWL){mg/L} (Slis U )r 001 10898-01 10/27/15 1315 7.8 <5 45 7.21 10/27-11/02/15 KN, JB, YJ & NM 002 10898-02 10/27/15 1324 17.5 <5 79 6.73 10/27-11/02/15 KN, JB, YJ & NM 003 10898-03 10/27/15 1347 8.2 <5 44 6.31 10/27-11/02/15 KN, JB, YJ & NM 004 10898-04 10/27/15 1333 <5 <5 26 6.53 10/27-11/02/15 KN, J13, Y1 & NM Rain Amount 1.25 inches Rain Duration 21 hours mg/L = milligrams per Liter = parts per million (PPM) < — less than or Below Quantitation Limit (BQL) SU = Standard Units RESEARCh & ANAIYACAI LAbORATORiES, INC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD I WATER ! WASTEWATER 1 misc. I COMPANY C n W2.� l �. f i�..,� JOB NO. z Z U p� M1 _ ma' gym g yg S m`�� ,�� �m�,p `Q r ry0' JeQ Q� ly - m� O� M1 `aCT 0 ?' r p� 00 � Q O of F F Q� _C9 Q' 4Z Q' c V ry ry`� 1` �" ^" ^" �`m REQUESTED ANALYSIS STREET ADDRESS PROJECT S --- CITY, STATE, ZIP SAMPLER NAME ((PLEASE PRINT) `r CONTACT PHONE SAMPLER SIGNATURE SAMPLE NUMBER (LAB USE ONLY)BATE TIME COMP GRAB TEM "C Ras � } CFfORNE REMOVED NjD WF�E Ms QFiX SAMPLE LOCATION ! I.D. /3,2 05— /A/71 a a 3 RELINQUISHED BY DATEM4 RECEIVED BY REMARKS: 0d"j, SAMPLE TEMPERATURE AT RECEIPT °C a 0 �{ " ! = • ! fp • S 3 RELINQUISHED ITY DATEfrIME RECEIVEDB Commonwealth B R A N D S, I N C. An IMPERIAL TOBACCO GROUP company P.O. Box 2236, Reidsville, NC 27323 Ph. (336) 634-4200 Dear Sirs, Attached is storm water sampling data from our four discharges at Commonwealth Brands Inc, collected on October 27th. All of the tested parameters were within permit limits. Sincerely, " . 4� 1j,4- Ken Gusler Ken Gusler OHS & E Specialist Commonwealth Brands, Inc. An IMPERIAL TOBACCO GROUP Company 301 N Main Street, Reidsville, NC, 27320 336-634-4237 ken.gusler@us.imptob.com BSi ' Iso9wI:2008 ® FM s47481 ISO 14001:2004 EMS 547476 l///V�o�lS- Date The Reidsville Factory of Commonwealth Brands, Inc. is an ISO certified manufacturing facility. SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted NCCs6�t1t1`�2 CERTIFICATE OF COVERAGE NO. NCG06DQ Q SAMPLE COLLECTION YEAR -2d tS FACILITY NAME ('f ►�orlt.>ec.� SnJS FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY i! I use/process meats ❑ use animal fats/byproducts PERSON COLLE- IN SAMPLES -.1 su( RE1 V ARGING TO SALTWATERS? ❑YES L&NO ip LABORATORY Z- - Lc6*g,,+o.tis (rrc_Lab Ce . # %� ILL44 7 Z015 PLEASE REMEMBER TO SIGN ON THE REVERSE -4 CENTRAL FILES Part A: Stormwater Benchmarks and Monitoring Results DWR SECTION Total event rainfa!! Z .6 r ,. or ❑ No discharge this period3 bytfall_No. Sample,Collegt ,d-' . TSS,' mg/L . pH; _ Standard units, :.:, COD, mg/L Oil and Grease,..-; mg/L Fecal'Coliform. ,. r'Colonies per.100 mI , Enterococci•, Colonies: per 100 ml ,. Benchrriark - - . 160 or Within 6.0 = 9.0 °' ., 120 _. 30 _ .: 1400 °500 co 01 Ity Mt.re. 745 A 002. I o i -CS. c--;, o1 15 45.0 We 1i <� 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 1z no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No.' - = Sample Collected; 'mo/dd/yr Oil and.Grease, "' r mg%t=' TS5, riig/L• pH, .--.Standard units"..':' New Motor Oil Usage, Annual average gal/mo Benchmark - 30.. 100 or 50 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (ice complete Part B) •rJ SWU-249 Last Revised: Oct. 18, 2012 Gana 1 nF 7 *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 If 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 DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case o "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." W011111111ill (Signat& of Permittee) ,6 A d (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 5 WU-249 Last Revised: October 18, 2012 Page 2 of 2 Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this farm, please visit hgp:Hportal.ncdenr.orp-/web/wg/ws/su/npdesswgtab-4 Permit No.: NIC (.O (o MO or Certificate of Covera€NICIG Facility Name: Commonwealth Brands County: Rockingham Phone No. N!e `;4 La.33 Inspector: Neal McDuffie Date of Inspection: June 1, 2015 Time of Inspection: 1525 Total Event Precipitation (inches): 0.61 Was this a "Representative 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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. "measurable storm event' is a storm event that results in an actual discharge from the permitted site outfall. "rhe previous ,asurable storm event must b le to document that a shorter from the local DWQ Regional Office. By this sinaturg, 1 ce4fy the this report is accurate and complete to the best of my knowledge: Permitee or Designee) S W U-242-020705 1. Outfall Description Outfall No. 001 Structure (pipe, ditch, etc.) Storm Drain/Grate Receiving Stream: _ fI1Ra�4 Ci<ck Describe the industrial activities that occur within the outfall drainage area: 6,jt y 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Gray I Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 3 4 7. Is there any foam in the stormwater discharge? 8. Is there an oil sheen in the stormwater discharge? 9. Is there any evidence of errosion or deposition at the outfall? 10. Other Obvious Indicators of Stormwater Pollution: List and describe 5 Yes No Yes No Yes No Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit htW://portal.ncdenr,orp,/web/wg/ws/su/npdessw#tab-4 Permit No.: N/C (, O(n pp00 Facility Name: Commonwealth Brands or Certificate of Covera� N/C/G _ _ County: Rockingham Phone No. 'SV. ti),3-1 Inspector: Neal McDuffie -- Date of Inspection: June 1, 2015 Time of Inspection: 1530 Total Event Precipitation (inches): 0.61 Was this a "Representative Storm .Event" as defined by the permit? 7*yee formation below.) ❑ 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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. "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous storm event must h able to document that a shorter approval from the local DWQ Regional Office. By this signature, 1 certi4y thaWhis report is accurate and complete to the best of my knowledge: (Signature of $ermitee or Designee) S WU-242-020703 1. Outfall Description Outfall No. 002 Structure (pipe, ditch, etc.) Storm Grate Receiving Stream: Describe the industrial activities that occur within the outfal) drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Green/Gray 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: l ` _.1 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 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 7. is there any foam in the stormwater discharge? 8. is there an oil sheen in the stormwater discharge? 9. is there any evidence of errosion or deposition at the outfal]? 10. Other Obvious Indicators of Stormwater Pollution: List and describe 5 Yes No Yes No Yes No Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit httn:/Iaortal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 Permit No.: N/C V Ob 001�0 Facility Name: Commonwealth Brands or Certificate of Covera N/C/G County: Rockingham Phone No. Milq 4133 Inspector: Neal McDuffie Date of Inspection: June 1, 2015 Time of Inspection: 1545 Total Event Precipitation (inches): 0.61 Was this a "Representative Storm Event" as defined by the permit? (See ' formation 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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. 'I'he previous measurable storm event must h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify tDat this report is accurate and complete to the best of my knowledge: Permitee or Designee) S W U-242-020705 1. Outfall Description Outfall'No. 003 Structure (pipe, ditch, etc.) Pipe Receiving Stream: �,I�s�i�ic�p�yc G"n 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: Clear 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,ete.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 1 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. is there any evidence of errosion 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 errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. �dF w a ad(t- 0 Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit h!W://I)ortal.nedenr,org/web/wo/ws/su/npdessw#tab-4 Permit No.: NIC (,0(.0000 Facility Name: Commonwealth Brands or Certificate of CoverafNlC/G County: Rockingham Phone No. OVVo Glq %139 Inspector: Neal McDuffie Date of Inspection: June 1, 2015 Time of Inspection: 1540 Total Event Precipitation (inches): 0.61 Was this a "Representative Storm Event" as defined by the permit? Ze 'formation below.) n❑ No Please verb whether Qualitative Monitoring must be performed during a "representative .storm event or "measureahle 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 outfali. The previous measurable storm event must h able to document that a shorter 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 P&mitee or Designee) swv242-020705 1. vuunu a�ca�raYuuu Outfall No. 004 Structure (pipe, ditch, etc.) Pipe Receiving Stream: `tw oast 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: Clear 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 3 4 7. Is there any foam in the stormwater discharge? 8. Is there an oil sheen in the stormwater discharge? 9. Is there any evidence of errosion or deposition at the outfall? 10. Other Obvious Indicators of Stormwater Pollution: List and describe E Yes No Yes No Yes No Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. RESEARCh & ANA[yTICA[ LABORATORIES, INC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD WATER! WASTEWATER I MISC. COMPANY Com.,en wst- }-f- rG,,, - JOB N0. rn o z �� °' oA mc'may r0* Q@y ��`� o! c� p�°m �• CQ'yy=O� ti Gj J ti A "�g� O _ ` Z U Q ?\o m�cc • 0}�00Q, Co OQ. a 1� 0 �o r0\` V -OF b� OR Q• Q' Q • Q • qC ry ryh }h y v v y ^v REQUESTED ANALYSIS STREET ADDRESS PROJECT r �O r M CITY, STATE, ZIP SAMPLER NAME (PLEASE PRINT) Pli T' � � i CONTACT PHONE SAMPLER SIGNATURE ER (LAB 5E ONSAMPLE LYJ DATE TIME COUP GRAB TECP AES ( CHLORNE REMOVED ON D SAMP[E MATRIX SAMPLE LOCATION ! 1 L c-,- 03 x ur t RELINQUISHHEyD BY DATE/YME REC�EIVEIDD�BY REMARKS: o o t � oo�F _ 2TV . Lam. co SCAMPLE TE ERATURE AT RECEIPT °C RELINQUISHED B DATEITIME RECEIVED BY f ''�y{1111111��rI RIESEARCh CAI ZA Ana lyt€cal/Process Consultations June 10, 2015 Commonwealth Brands, Inc. P.O. Box 2236 Reidsville, NC 27323-2236 Attention: Mr. Scott Townson Chemical Analysis for Sampling identified as Stormwater, collected 01 June 2015 [5".lae OilrlC8i1011 ]'Jam lel_ P a p UATe -..-'llme - L11i5 C11ueu P -.I+PG .=-Anal LCU n Y k Numbe ;r Solid s .Grease 001 4879-04 06/01/15 1545 19.6 <5 49 6.7 06/01-06/04/15 KN, JB & NM 002 4879-03 06/01/15 1540 13.8 <5 32 6.5 06/01-06/04/15 KN, JB & NM 003 4879-02 06/01/15 1530 <5 <5 10 6.7 06101-06/04/15 KN, JB & NM D04 4879-01 06/01/15 1525 <5 <5 9 6.6 06/01-06/04/15 KN, JB & NM Rain Amount 0.61 Rain Duration I hr. 20 min. mg!L = milligrams per Liter = parts per million (PPM) < = less than or $elow Quantitation Limit (BQL) SU = Standard Units 4% jT1perial Commonwealth B R A N D S, 1 N C. bacco An IMPERIAL TOBACCO GROUP company Dear Sirs, Attached is storm water sampling data from the four discharges at Commonwealth Brands Inc. collected on June 151, 2015. All of the tested parameters within permit limits. Sincerely, 4., (,, jj- A - Ken Gusler Ken Gusler OHS & E Specialist Commonwealth Brands, Inc. An IMPERIAL TOBACCO GROUP Company 301 N Main Street, Reidsville, NC, 27320 336-634-4237 ke n.g us I e rP us. im tob.com G Ll a,) is - Date Olympus••• EMI -ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 3 c;L4l4f CERTIFICATE OF COVERAGE NO. NCG06_61 Q1 FACILITY NAME C-Onm r We'A. RnA ihc. COUNTY ,604 PERSON COLLECTINIG SAMPLES LABORATORY. ."cTr�+ Lab Cert. # 311 Part A: Stormwater Benchmarks and Monitoring Results R'Ecelvi D SAMPLE COLLECTION YEAR P41q AtoV 0 7 2014 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/ byprtm rRAL FIL DISCHARGING TO SALTWATERS? ❑YES XNO R SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 _I or ❑ No discharge this period3 Outfall No. Sample Collected,; mo/dd/yr : , TSS, mg/L.. _ pH, , Standard units COD, mg/L Oil_. and Grease,.:. mg/L_ -Fecal Coliform , Colonies per 100 ml' ; - "Enterococci , , c Colonies per 100. mE Berictirnark .: •: .: s :.10Tor 50 Within,6.0'=?9.0 ". _120 =: 30 r1000 _ 500'.. 0 /Lf t4 r If 6 0 6,VV (93 04 Aj I'{ S.A a cT.O 01i o`t 9 Iq LS, O S. $3 ! < ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Q no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Ovtfa_II No. - 'Sample Collected, ' mo/ad/yr !- _= Oil -and Grease, . mg/L TSS, mg/L. .' pH, . 'Standard units, '� -New Motor Oil Usage, .Annual average gal/rho' Benchmark 30 l00 or 50 6.0 — 4.0 (if yes, complete Part B) ' Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 � � Last Revised: Oct. _? 18, 2012 Paee 1 of 2 `FOR PART A AND PART B MONITORING RESULTS: 0 A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. 0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR including all "No Dischar e" re arts within 30 days of receipt of the lab results or at end o monitoring period in the case of Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (SignaturQ of Permittee) l/ d3 b 0 (Date) 4L Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 S WU-249 Last Revised: October 18, 2012 Page 2 of 2 ` Commonwealth Brands, Inc. Stormwater Sampling Data Pipe Day Year S.U. 004 19-Jun 2009 7.40 / 004 23-Nov 2009 7.70 004 17-May 2010 6.56 004 12-Dec 2010 8.10 004 28-Jun 2011 6.59 004 16-Nov 2011 6.86 004 9-May 2012 6.30 004 15-Oct 2012 8.27 004 26-Feb 2013 7.36 004 26-Nov 2013 6.84 004 15-May 2014 6.73 004 29-Sep 2014 5.83 Tier I Action plan: A review of the test results from September 29th did not indicate any reason for the pH to be below 6.0. The Stormwater Pipe 004 is located a considerable distance from the manufacturing area. The technician who collected the sample indicated the water clarity was a "1" There were no visible "floating solids" or "suspended solids." All other parameters were completely "normal." 1) Inspect area to see if any noticeable changes have occurred 2) Do process monitoring pH checks to determine if the pH is above or below parameters 3) Increase regulatory pH monitoring if process monitoring indicates an issue 4) Complete process monitoring by November 28th to verify if the pH is staying within limits 5) Actions to be fully documented and maintained with the SPPP RESEARCh & ANA[yiricAL L LAboRATORiESP INC. Analyflcalj Process ConsuRctions October 9,7014 Commonwealth Brands, Inc. P.O. Box 2236 Reidsville, NC 27323-2236 Attention. Mr. Scott Townson Chemical Analysis for Sampling identified as Stormwater, conected 29 September 2014 stir 8AN.1qN 6. 1W NO NU Project Number. MA IQ lyli( 4, ------------ ----------- Z'r 11 J, -31 J., 5. F 7 --- 7 'Ni �S5 !!!j t1f OW 09/29, 09n0, 001 795916 09129A 4 1331 16.3 5.47 70 6-15 ZP, sx, in & JP 10101 & HY106114 OW29& 09130, CO2 79.5917 0912.9114 1337 63.0 6.95 109 6.80 , ZP, SK, M & JP i(VOI 10AW14 OW29, 09/30, 003 795918 09129114 1400 52 <3.0 23 6-39 ZP, 5Y, JB & JP t0f0l & 1 0106J1 4 09/29, 09130 004 795919 09r29114 I 1342 I <5.0 I <5.0 17 I 5.83 I ZF, SK, JR & JP 1 I0101 & 10/0�14 Rain Amount 0.10 inches Rain Duration 5 hrs. mg/L = milligrams per Liter = parts per million (PPM) < = Im than or Below Quantitation Limit (BQL) SU = Standard Units 10/13/2014 15:49 336-9960326 R & A LABORATORIES PAGE 03/11 r� T � r w a � Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling our this foist, please visit http1/Portsi.ncdeuur.orgLv eb/wq/wslsu/npdessw#tab-4 Permit No.: N/C or Certificate of Covers N/C/G Facility Name: Commonwcalth Brauds County: Rockingham Phone No. Inspector: ,Zack Powell Date of Inspection: September 29, 2014 Time of Inspection: 1331 Total Event Precipitations (inches): 0.1 Was this a "Representative Storm Event" as defined by the permit' (See information below.) 0 Yes ❑ No Please verb whether Qualitative Monitoring must be performed during a "representative storm event ar "mearureable storm event" (requirements very, depending on the permit.) Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is puceded by at ]cast 72 hours (3 days) in which no storm event measuring greater than 0.1 inthes 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 octfall. The previous measurable storm event must h able to document that a Shorter approval frm the local DWQ Regional Office. By this signature, I cq�ity that this (Signature of Permit& or Desigatee) S WU.242-020705 and complete to the best of my knowledge: 1011312014 15:43 336-9960326 R & A LABORATORIES PAGE 04/11 JL. "Udall Uescrtption Outfall No. 001 Structure (pipe, ditch, etc.) Ditch 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 (ligbt, medium, dark) as descriptors: Light Gray 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: I 3 4 5 5. Floating Solids: Mose the number which best describes the amount of foating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: L."�.....J 2 3 4 5 b. Suspended Solids: Choose the number which best describes the arnount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 2 3 4 $ 7, is there any loam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwaaer discharge? Yes No 9. is there any evidence of errosion or deposition at the outWI7 Yes No 10, Other Obvious Indicators of 5tormwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosioWdeposition may be indicative of pollutant exposure. These conditions warmt further investigation. R g A LABORATORIES PAGE 05/11 10/13/2014 15:49 335-9960326 a _N 7' P Stormwater Discharge Dutfall (SDQ) Qualitative Monitoring Report For guidance on filling out this form, please visit htt :2V2rga ncA nr, web/wq/wslsufgpde$sw#tab-4 Permit No.: N/C or Certificate of Covers N/C/G Facility Name: Commonwealth Frauds— County: RockiuSham. — — Phone No. Inspector: Zach. POWCO Date of Inspection: Se ebnber 29, 2014 Time o(Inspection: 1337 Total Event Precipitation (inches): 0A Was thi$ a "Representative Storm Event" as defined by the permit? (See information below.) is Yes ❑ No Please verb whether Qualitative ,ifomtoring 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 "rcpresentativc storm event" or during a "measurable storm event" However, some permits do not have this regL irernent. Please refer to these definitions, if applicable. 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 atom event that mquits in an actual discharge from the permitted site cutfall. The previous measurable storm event trust h able to document that a shorter approval from the local DWQ Regional Office. By this signatwc, I certify that this report iq acculatc and complete to the best of my knowledge; (Signature of Permit= S WU-242-020705 10/13/2014 15:49 336-9960326 R & A LABORATORIES PAGE 06/11 A. UUMAl 1Je3Cr pt10n Outfall No. 002 Structurc (pipe, ditch, etc.) Drain 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: Light Gray 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of all, weak chlorine odor,etc) None 4: Clarity. Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1- -. :3 S. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 2 3 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extrmely muddy: 2 3 4 5 7. Is there any Foam in the stormwater discharge? Yes No 9. is there an oil sheen in the stormwater discharge? Yes No 9. is there any evidence of errosive or deposition at the outfall7 Yes Na 10. Other Obvious Indicators of Stormwater Pollution: List and describe NOW Low clarity, high solids, and/or the presence of foam, oil sheen, or erxosion/deposition may be indicative of pollutant exposure. These conditions warren further bivestigation, 10/13/2014 15:49 336-9960326 R & A LABORATORIES PAGE 07/11 wA rf ,��c Stormwater Discharge Outfall (SDD) Qualitative Monitoring Report For guidance on filling out this farm, please visit h •// nerte . web/w s/S a sw#M 4 Pertuit No.: N/C or Certificate of Cover$ N/C/G Facility Name: Commonwealth Brands County: Rockingham _ _ _ Phone No. Inspector: Zach Powell Date of Inspection: September29,2014 Time of Inspection: 1400 Total Event Precipitation (inches): 0.1 was this a "Representative Storm Event" as defined by the permit? (See information below,) Ge Yes c No Fleare verify whether Qualitative Monitoring must be performed during a "representative storm even or "measumable storm event" (requirements vary, depen&ng an the permit.) Qualitative monitoring requir cmenis vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or daring a "measurable storm event." However, some permits do not have this requirement Please refer to these definitions, if applicable. A "representative storm evetrt" 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 gre=r than 0.1 inches has occurred. A single storm. evcni may contain up to 10 consecutive hours of no precipitation. A "mensereble storm event" is a sw= event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must h able to document that a shorter approval from the local DWQ Regional Office. By this Signature, l certify that this repot is aecurgtc andAompjcte to the best of my knowledgc: (Signature of Petmitee or Designee) SWU-Z�42-02070 10l13l2014 15:49 336-9960326 R & A LABORATORIES PAGE 08/11 ,.. vuiran 1jescription Outfall No. 003 structure (pipe, ditch, etc.) Pipe 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: Light Brown 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weals chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 3 4 5 S. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: L�..J 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: �.� 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes Na S. Is there an oil sheen in the stot vnm discharge? Yes Na 9. Is there any evidence of errosion or deposition at the outM? Yes No lb. Other Obvious Indicators of Stormwater Pollution; List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure_ These conditions warrant further investigation. 10/13/2014 15:49 336-9960326 R & A LABORATORIES PAGE 09/11 �F VWVA r,�A Y' Stolrlmwatear Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on fillrng aut this form, please visit htt=ortal.tacdenr.orgbMgb/wgl,38r_slsu/%! essMtUb-4 Permit No.: N/C _ or Certificate of Coveraf N/C/G Facility Name: Commonwealth Brands County; Ruddnghano Phone No. Inspector. Zach Powell _ Date oflnspection: September 29, 2014 - -� Time of Inspection: 1342 Total Event Precipitation (Inches): 0.1 Was this a "Representative Storm Event" as defined by the permit? (See information below.) rdYes ❑ No Please verb whether Quolitutive ,llanitdrirrg must be performed cl:ving a "representative storm even or "mearweahle storm event" (requirements vary, depending on the permit.) Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be perforated during a "representativo storm event" or during a "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that Mcasures 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. "treasurable storm evert" is a storm event that results in an actual discharge from the permitted site outfall. The previous 3urablc storm event must h to documem that a shorter oval fxom the local DWQ Regional Office. By this signature, I certify that this report is accurate anA complete to the best of my knowledge: (Signature of P=itec or Designee) 3WU-242-02a7415 10/13/2014 15:49 336-9960326 R & A LABORATORIES PAGE 10/11 JL- uutAx" Uesertption Outfall No. 004 Structure (pipe, ditch, etc.) Drain 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: Clear 3. Odor- Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine ador,ete.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, wbem I is no solids and 5 is extremely muddy: 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes IVo S. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of erroslen or depWtion 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 errosion/deposiition may be indicative of pollutant exposure. These conditions warrant fiuther investigation. Permit No. NCG060000 If: The first valid sampling results are above a benchmark value, or outside of the benchmark range, for any meter at a Then: The permittee shall: 1. Conduct a stormwater management inspection of the facility within two weeks of receiving sampling results. 2. Identify and evaluate possible causes of the benchmark value exceedance. 3, Identify potential and select the specific: source controls, operational controls, or physical improvements to reduce concentrations of the parameters of concern, and/or to bring concentrations within the benchmark range. 4. Implement the selected actions within two months of the inspection. S. Record each instance of a Tier One response in the SPPP. Include the date and value of the benchmark exceedence, the inspection date, the personnel conducting the inspection, the selected actions, and the date the selected actions were implemented. Tier Two If. During the term of this permit, the first valid sampling results from two consecutive monitoring periods are above the benchmark values, or outside of the benchmark range, for any specific parameter at a specific discharge outfall; Then: The permittee shall: 1. Repeat all the required actions outlined above in Tier One. 2. Immediately institute monthly monitoring for all parameters. The permittee shall conduct monthly monitoring at every outfall where a sampling result exceeded the benchmark value for two consecutive samples. Monthly (analytical and qualitative) monitoring shall continue until three consecutive sample results are below the benchmark values or within benchmark range. 3. If no discharge occurs during the sampling period, the permittee is required to submit a monthly monitoring report indicating "No Flow" to comply with reporting requirements. 4. Benchmark exceedances for a different parameter separately trigger a tiered response. S. Maintain a record of the Tier Two response in the SPPP. {� Tier. Three s , During the term of this permit, if the valid sampling results required for the permit monitoring periods exceed the benchmark value, or are outside the benchmark range, for any specific parameter at any specific outfall on four occasions, the permittee shall notify the DWQ Regional Office Supervisor in writing within 30 days of receipt of the fourth analytical results. DWQ may but is not limited to: • require that the permittee revise, increase, or decrease monitoring frequency for some or all parameters; • rescind coverage under the General Permit, and require that the permittee apply for an individual stormwater discharge permit; • require the permittee to install structural stormwater controls; • require the permittee to implement other stormwater control measures; • require the permittee to perform upstream and downstream monitoring to characterize impacts on receiving waters; or • require the permittee implement site modifications to qualify for a No Exposure Exclusion. Part 11 Page 8 of 12 RESEARCh & ANA1yTICA1 LAbORATORiES, INC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD I WATER I WASTEWATER I MISC. I COMPANY C WNnGI\ WG t' JOB NO. LU o z y� gyp' p� ma ti Z= \y 04 pp q,co pp� ~ Q ' O 0 of F F Q C9 Q" Q' Q c ti� ti N� �� �" �`� REQUESTED ANALYSIS STREET ADDRESS PROJECT 1 CITY, STATE, ZIP SAMPLER NAME (PLEASE PRINT) CONTACT PHONE SA PLER SIGNAT E ER (LAB USSAMPLEE ONLY) DATE TIME COMP GRAB TEMP P R IS ��p am (saw) SAMPLE LOCATION I I.D. T&SP Cot), 6 +� x ouf�G RELINQUISHED DATEITIME RECEIVED BY •III L REMARKS: bo 1 ��'� �• 3S ^ D 1 ' bra SAMPLE TEMPERATURE AT RECEIP a '' °6C ;' 2r 3 R LINQUIS ED BY DATEITIME RECEIVED BY Dear Sirs, Attached is storm water sampling data from the four discharges at Commonwealth Brands Inc. collected on September 291h, 2014. All parameters that participated a Tier I response from the May 15`h testing were resolved; however the pH on Pipe 4 was 5.83, below the benchmark of 6.0 S.U. which initiates another Tier I response for that result. Please see the accompanying documentation. Sincerely, 1.11, 4j4-,- Ken Gusler Ken Gusler OHS & E Specialist Commonwealth Brands, Inc. An IMPERIAL TOBACCO GROUP Company 301 N Main Street, Reidsville, NC, 27320 336-634-4237 ken. usler us.im tob.com 1 i %31aoq Date Dear Sirs, Attached is storm water sampling data from the four discharges at Commonwealth Brands Inc. taken on May 15`h, 2014. We noted several abnormalities and have initial a "Tier One" response. A summary is attached. Sincerely, Ken Gusler Ken Gusler OHS & E Specialist Commonwealth Brands, Inc. An IMPERIAL TOBACCO GROUP Company 301 N Main Street, Reidsville, NC, 27320 336-634-4237 ken.gusler@us.imptob.com Date SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted & S o1JfLI CERTIFICATE OF COVERAGE NOW.. NCG060 ��U--'4 )— FACILITY NAME C.�A7)710I1b& 1 % �l S k e COUNTY I�pc_jr�uclticrti PERSON COLLECTING SAMPLES LABORATORY Alt5t�ock AIIa. Iv }',j Lab Ced! #i 3y Part A: Stormwater Benchmarks and Monitoring Results RECEIVED JUN 12 2014 CENTRAL FILES DWQ{BOG SAMPLE COLLECTION YEAR _ a0114 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? ❑YES ZNO PLEASE REMEMBER TO SIGN ON THE REVERSE Total event rainfall zD 1% or ❑ No discharge this period' Outfall"No. Sample Collected, mo/dd/yr TSS,. mg/L _ OHJ ,;" Standard units COD, mg/L Oil,and Grease, mg/L Fecal.Coliformk, , Colonies per 100 ml ... Enterococci , Colonies,p& 100 ml Benchmark - 100 ar 504 Within 5.0 - 9..0. 120 30 y 1000 500 01 05 6 ilf 10h s.(A 44-7 s A 1 16 b ! tiff � � o 0 o AC 0AIA Oq 06 is Iq o 1.73 - a V A- I only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 9 no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No.- .°Sanip le Collected, ";mo/dd/yr Oil and Grease; ° ,mg/L', _=' TSS, mg%L pH, Standard units New Motor Oil Usage, -Annual average gal/mo• Benchmark - 30 100 or 50 ix— 9.0 - I only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 i Last Revised: Oct 18, 2012 I'nyr. 1 of 2 *FOR PART A AND PART 6 MONITORING RESULTS- * A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all ."No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-161.7 YOU MUST SIGN THIS-CERTIFICATION,FOR ANY INFORMATION REPORTED: .. "I certify, under penalty.oflaw, thaefhis document and all attachments were prepared under my direction or supervision in accordance with a system designed to'assure'that qualified personri.el-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." (Signat 6nPz--, - x. - Al't L - - of Permittee) ` 6105 fao'Y (Date) Additional copies of this form may be downloaded at: http1/portal.ncdenr.org/webjwq/ws/sujnpdessw#€tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 r Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit htto://Aortal.ncdenr.orgLweb/wq/ws/su/npdessw#tab-4 Permit No.: N/C or Certificate of Cove rag N/C/G0(o 004 Facility Name: Commonwealth Brands County: Rockingham Phone No. 33(, OAJ Inspector: Neal-McDuffie Date of Inspection: Time of Inspection: May 15, 2014 1038 Total Event Precipitation (inches): 0.96 Was this a "Representative Storm Event" as defined by the permit? (See information below.) e Yes ❑ No Please verb whether Qualitative Monitoring must be performed during a "representative storm event or "measureahle 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I ►. ✓ (Signature of Per tee or Designee) and complete to the best of my knowledge: t'v 47 o�Olif 5 WU-242-020705 1. Outfall Description Outfall No. 001 Structure (pipe, ditch, etc.) Storm Drain/Grate Receiving Stream: Tr�N ,n�, C'ke Describe the industrial activities that occur within the outfall drainage area: [:care' * .�elti : pro .,nKch cif-C.cJ�y r iyw 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Green/Gray 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 2 3 4 5 7. is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion 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 errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit http://portal.ncdenr.orp/web/wg/ws/su/npdessw#ltab-4 Permit No.: N/C or Certificate of CoverNNlC/G®_ (aO LJX Facility Name: Commonwealth Brands County: Rockingham Phone No. 336 63.1 14d-37 Inspector: Neal McDufFie Date of Inspection: Time of Inspection: May 15, 2014 1048 Total Event Precipitation (inches): 0.96 Was this a "Representative Storm Event" as defined by the permit? (See information below.) 6/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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify that this reportos ac9prate and complete to the best of my knowledge: (Signature of Permitee 4Designee) 5 W U-242-020705 1. Outfall Description Outfall No. 002 Structure (pipe, ditch, etc.) Storm Drain/Grate Receiving Stream: T,r A6-011. C9.11-K _ Describe theindustrialactivities 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: Light Green/Gray 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 1 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 1 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: 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion 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 errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. 0 ii�V• Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this farm, please visit htti)://Dortal.ncdenr.orgJweb/wq/ws/su/npdcssw#tab4 Permit No.: N/C or Certificate of Covera NICIG0600'l Facility Name: Commonwealth Brands County: Rockingham - Phone No. (o 61M 1' 3 Inspector: Neal MCDuffte Date of Inspection: May 15, 2014 Time of.Inspection: 1054 Total Event Precipitation (inches): 0.96 Was this a "Representative Storm Event" as defined by the permit? (See information below.) 3,Ves © No Please verb whether Qualitative Monitoring must he 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 12 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, I certify that this reporAis acAurate and complete to the best of my knowledge: (Signature of Permitee sWU-242-020705 1. Outfall Description Outfall No. 003 Structure (pipe, ditch, etc.) Pipe Receiving Stream: ram. "4"ft ce.-K Describe the industrial activities that occur within the outfall drainage area: C. f!�Gy,aft!s M„t hs4' T 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Clear 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: lI 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes Na 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there any evidence of errosion 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 errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. of wA tF9 0 G Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit http://portal.ncdertr.org/web/wq/ws/su/npdessw#tab-4 Permit No.: N/C or Certificate of Covera�W G ObOO l a. Facility Name: Commonwealth Brands County: Rockingham Phone No. �3(, (. 3►� �W,3 ] Inspector: Neal McDuffie Date of Inspection: May 15, 2014 Time of Inspection: 1101 Total Event Precipitation (inches): 0.96 Was this a "Representative Storm Event" as defined by the permit? (See information below.) / Yes ❑ No Please verb 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 "measurable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. 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 h able to document that a shorter approval from the local DWQ Regional Office. By this signature, 1 certify that this reporhis accurate and complete to the best of my knowledge: (Signature of Permitee 4f Designee) S W U-242-020705 1. Outfall Description Outfall No. 004 Structure (pipe, ditch, etc.) Pipe Receiving Stream: Tf*0Acyoy1s Describe the industrial activities that occur within the outfall drainage area: c.'chrt ��� re , L^ 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Clear 3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.) None 4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 2 3 4 7. Is there any foam in the stormwater discharge? 8. Is there an oil sheen in the stormwater discharge? 9. Is there any evidence of errosion or deposition at the outfall? 10. Other Obvious Indicators of Stormwater Pollution: List and describe W Yes No Yes No Yes No Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. RESEARCh & ANA[yTICA1 b! .' ' '( 1 • C •rrr aQa LAbORATORIES� INC.' Q Analytical/process Consultations NCi1134 .;��EDrANr� r►`� May 2, 2014 Commonwealth Brands, Inc. P.O. Box 2236 Reidsville, NC 27323-2236 Attention: Mr. Scott Townson Chemical Analysis for Sampling identified as Stormwater, collected 15 May 2014 I• Project Number: NIA Sample IiA1. Siimplrngl _Sampling Total oilCOD` pH Date Analysts Identification Sample Date. Time' Suspended & Analyzed NumberAl Solids Grease ,,,,nn 001 785405 05/15/14 1038 104 <5.0 447 5.68 05/18 & 05/19/14 YJ, JB & SK 002 785406 05/15/14 1048 316 <5.0 495 6.31 05/18 & 05/19/14 YJ, JB & SK 003 785407 05/15/14 1054 <1.0 <5.0 88 6.93 05/18 & 05/19/14 Y1, JB & SK 004 785408 05/15/14 1101 7.0 <5.0 84 6.73 05/18 & 05/19/14 YJ,113 & SK Rain Amount 0.96 Rain Duration 10 hrs. 30 min. mg/L = milligrams per Liter = parts per million (PPM) < = less than or Below Quantitation Limit (BQL) SU = Standard Units RESEARCh & ANA1yTICA[ LABORATORIES, INC. Analytical 1 Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD I. WATER 1 WASTEWATER 1 MISC. COMPANY Con/"e w-C ,l JOB NO. W z z 0. roo, ry ` y `Qm�G ��' Jc' Q �T, �• `C��O� O 00' VOA m� �� �j� Q� Q� C� C� C�� Q yoF F F� Q Q • Q' Q' m� `� ry� ry�.� ^ " h REQUESTED ANALYSIS STREETADDRESS PROJECT4P CITY, STATE, ZIP SAMPLER NAME (PLEASE PRINT) CONTACT PHONE SAMPLER SIGNATURE / '�'�� / ' SAMPLE NUMBER (LAB USE ONLY) DATE TIME COUP GRAB EMP .0 RE5 CI c"�aa"E nQ�p &AJPLE Is m SAMPLE LOCATION ILD. 5--15-1 103 `� �C b r� 4 f z T G C O b 106-9 003 r + , t /!K o oL4i RELINQUISHED BY DATEMME �-,M5 RECEIVED BY 4i��s•co4� REMARKS: �o l 14.Le 0 Z 4 I G• 3 l 06 0 3 a• �l i, . q 3 SAMPLE TEMPERATURE AT RECEIPT d C 3 RELINQUISHED BY DATEmME RECtIVED BY Commonwealth Brands MG/L MG/L MG/L SU (C) 2014 OIL Sample ID RA # Date Time TSS GREASE COD pH Temp 001 785405 5/15/2014 1038 104.0 <5.0 447 5.68 24.6 002 785406 5/15/2014 1048 316.0 <5.0 495 6.31 24.1 003 785407 5/15/2014 1054 <1.0 <5.0 88 6.93 21.8 004 785408 5/15/2014 1101 7.0 <5.0 84 6.73 21.5 Rainfall recorded: 0.96 Duration: 10.5 Estimated Inches Hours Limits: 100 30 120 6-9 NA Commonwealth Brands MG/L MG/L MG/L SU (C) 2104 OIL Sample ID RA # Date Time TSS GREASE COD pH Temp Rainfall recorded: Duration: Estimated Inches Hours Commonwealth Brands, Inc. Tier One Report Ken Gusler (OHS &E Specialist) 6/9/2014 Permit: NCG060042 Stormwater samples taken: 5/15/2014 Laboratory: Research Analytical Technician: Neal McDuffie Rain event: 0.96" Exceeded benchmarks. Sample Outfalls TSS pH COD 001 104 5.68 447 002 316 495 10:38-11:01AM Lab cert: 34 Time: 10.5 Hours Action Plan: 1) Inspect systems for leaks and infiltration 2) Do analyses to determine what caused the discharges to exceed benchmarks 3) Review operational controls and processes and determine what physical improvements are needed (if any) 4) Implement corrective actions within 60 days of being notified of the exceedance (July 27th, 2014) 5) Document the findings and solution in the SPPP plan.