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HomeMy WebLinkAboutNCG080018_COMPLETE FILE - HISTORICAL_20181127STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V U& os() Op DOC TYPE HISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ (90I Eli a 1 YYYYMMDD ALIT Division of Energy, Mineral & Land Resources Land Quality Section/Stormwater Permittin NCDENR National Pollutant Discharge Elimination System or E-0.,C--DNS. R- PERMIT NAME/OWNERSHIP CHANGE FORM I. Please enter the permit number for which the change is requested. FOR AGENCY USE ONLY Date Received Year Month Day NPDES Permit (or) Certificate of Coverage N I C 18 1 ,Q N C G, 0 1 8 10 10 1 ] 1 8 11. Permit status t rite• to requested change. a. I'el-11111 issued to (company name): Old Dominion Freight Line, hlc. b. Person legally responsible for permit: Sam Faucette First MI Last Title 500 Old Dominion Wav Permit I lolder Mailing Address Thomasville NC 27360 Cite State Zip (336) 822-5332 ( ) Phone Fax c. Facility name (discharge): Old Dominion Freight Line -Guilford d. Facility address: 4715 Evanstown Road Address Greensboro NC 27406 City State "Lip e. Facility contact person: ( ) F i rst / M I 1 Last Phone 111, Please provide the following for the requested change (revised permit). a. Request for change is a result of: ❑ Change in ownership of the facility ® Name change of the facility or owner 'Volher please explain: This is only to update the LRP and facility contact person b. Permit issued to (company name): Old Dominion Freight Line_ Inc. c. 1'erson legally responsible for permit: Terry Hutchins First M] Last Vp - Real Estate Title 500 Old Dominion Wav Permit holder iNlailing Address Thotnasvillc NC 27360 Cite State Zip (336) 822-5225 tet•ry.hutchins rr odll.com Phone F-nail Address d. Facility name (discharge): Old Dominion Freis1jht Line -Guilford e. Facilily address: 4715 Evans -Town Road Address Greensboro NC 27406 City State Zip f. Facilitvcontact person: Joseph Fuhr_ First NIl] Last (336) 822-1745 joseph.Ibhr a,odtl.com Phone E-mail Address IV. Permit contact information (it'differetrt from the person legally responsible for the permit) Revised Jan. 27, 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact: Joseph Fuhr Firsi LM I Last Mana} er - Real Estate Environmental Services Title 500 Old Dominion Way Mailing Address Thomasville NC 27360 City State Zip (336) 822-1745 'ose h.fuhr a odil.com Phone F-mail Address V. Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? ® Yes ❑ No (please explain) V1 Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: ❑ This completed application is required for both name change and/or ownership change requests. ❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill ol'sale) is required for an ownership change request. Articles of incorporation are not sufficient for an ownership change. The certifications below must be completed and signed by both the permit holder prior to the change, and the new applicant in the case ofan ownership change request. For a name change request, the signed Applicant's Certification is sufficient. PERMITTEE CERTIFICATION (Permit holder prior to ownership change): 1, Joseph Fuhr, attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that ifall required supporting information is not included, Ihis application package will be turned as incomplete. Signature A CANT CERTIFICATION 11 �z��I8� Date I, , attest that this application fora name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if al I required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as incomplete. Signature Date PLEASE SEND THE COMPLETE APPLICATION PACKAGE. TO: Division of Energy, Mineral and Land Resources Stortmvater Permitting Program 1612 Mail Set -vice Center Raleigh, North Carolina 27699- l6 ] 2 Revised Jan. 27, 2014 —. W1=0135 ENVIRONMENTAL September 22, 2017 Division of Energy, Mineral, and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 RE: PERMIT NAME/OWNERSHIP CHANGE FORM Old Dominion Freight Line, Inc. Greensboro, North Carolina Facility 4715 Evans Town Road Greensboro, North Carolina 27406 Certificate of Coverage NCG080018 On behalf of Old Dominion Freight Line, Inc., the attached Permit Name/Ownership Change Form is being submitted by GEOS Environmental, Inc. (GEOS) for the above -referenced site. Ownership of the facility has not changed; this form is only to update the Legally Responsible Person and Facility Contact person currently listed by the Division. If you have any questions, please do not hesitate to call me at (813) 523-5408. Sincerely, Joseph M. Fuhr, P.G. Sr. Project Manager R' CCE Viz� Sip 2 9 20p 87ORMWAT69 O`JAL1xY cc: Bob Christie, Old Dominion Freight Line, Inc., 500 Old Dominion Way, Thomasville, NC 27360 Attachments GEOS Environmental, Inc. 13014 N. Dale Mabry Hwy, No. 117 Tampa, FL 33618 wxvw.geoscrivironiiiental.coni Division of Energy, Mineral & Land Resources Land QualitySection/Stormwater Permitting g NCDENRNational Pollutant Discharge Elimination System N= flnq .. DePu�. — or �,aa»M� 0N..�..,Re�R PERMIT NAME/OWNERSHIP CHANGE FORM J1, jo 1319 R AG CYUSEONLY Date Received ar Month P Day 1. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate of Coverage N C S O N G G 0 1 8 1 0 0 1 8 11. Permit status prior to requested change. a. Permit issued to (company name): Old Dominion Freight Line, Inc. b. Person legally responsible for permit: Jayna Long p"E CI\IED first MI Last SEP 29 2011 Title ND QUALM 500 Old Dominion Way n�l�ii�-LA Permit [folder Mailing Address STORMWATftPEFtM1TT1NG Thomasville NC 27360 City State Zip (336) 822-5565 ( ) Phone Fax c. Facility name (discharge): Old Dominion Freight Line -Guilford d. Facility address: 4715 Evanstown Road Address Greensboro NC 27406 City State Zip e. Facility contact person: { ) First / MI 1 Last Phone 111. Please provide the following for the requested change (revised permit). a. Request for change is a result of: ❑ Change in ownership of the facility ® Name change of the facility or owner If other please explain: This is only to update the LRP and facility contact person b. Permit issued to (company name): Old Dominion Freight Line, Inc. T c. Person legally responsible for permit: Sam Faucette First MI Last Vp - Safety & Compliance Title 500 Old Dominion Way Permit Holder Mailing Address Thomasville NC 27360 City State 'Lip (336) 822-5332 Sam. Faucettepodfl.com �W Phone E-mail Address d. Facility name (discharge): Old Dominion Freight Line -Guilford e. Facility address: 4715 Evans Town Road Address Greensboro NC 27406 City State Zip f. Facility contact person: Bob Christie First MI Last (336) 822. 1385 Bob.Christie@odfl.com Phone E-mail Address I V. Permit contact information (if different from the person legally responsible for the permit) Revised Jan. 27. 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact: Bob Christie First M 1 Last Manager - Safety & Driver 'Training Title 500 Old Dominion Wa Mailing Address Thomasville NC 27360 Laity State "Lip (336) 822-1385 Bob.Christie@odfl.com Phone E-mail Address V. Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? ® Yes ❑ No (please explain) VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: ❑ This completed application is required for both name change and/or ownership change requests. ❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is required for an ownership change request. Articles of incorporation are not sufficient for an ownership change. "The certifications below must be completed and signed by both the permit holder prior to the change, and the new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification is sufficient. PERMITTEE CERTIFICATION (Permit holder prior to ownership change): I, , attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as incomplete. Signature Date APPi�CANT CERTIFICATION I, �, attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as incomplete. 6(zz ((-I Signature Date PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Division of Energy, Mineral and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Revised Jan. 27. 2014 NC& TestAmerica THE LEADER IN ENVIRONMENTAL TESTING ANALYTICAL REPORT TestAmerica Laboratories, Inc. TestAmerica Savannah 5102 LaRoche Avenue Savannah, GA 31404 Tel: (912)354-7858 TestAmerica Job ID: 680-120407-1 Client Project/Site: ODFUGreensboro For: GEOS Environmental Inc. 13014 N Dale Mabry Hwy #117 Tampa, Florida 33618 Attn: Joseph M Fuhr Authorized for release by 1213012015 2:10:45 PM Matt Jones, Project Manager 1 (850)878-3994 matt.jones@testamericainc.com The test results in this report meet all 2003 NELAC and 2009 TNl requirements for accredited parameters, exceptions are noted in this report. This report may not be reproduced except in full, and with written approval from the laboratory. For questions please contact the Project Manager at the e-mail address or telephone number listed on this page. This report has been electronically signed and authorized by the signatory. Electronic signature is intended to be the legally binding equivalent of a traditionally handwritten signature. Results relate only to the items tested and the sample(s) as received by the laboratory. Definitions/Glossary] Client: GEOS Environmental Inc, Project/Site: ODFL/Greensboro TestAmerica Job ID: 680-120407-1 Qualifiers General Chemistry Qualifier Qualifier Description U Indicates the analyte was analyzed for but not detected. Glossary ^, Abbreviation These commonly used abbreviations may or may not be present in this report. a Listed under the "D" column to designate that the result is reported on a dry weight basis Tl %R Percent Recovery CFL Contains Free Liquid CNF DER Contains no Free Liquid Duplicate error ratio (normalized absolute difference) Dil Fac Dilution Factor DL, RA, RE, IN Indicates a Dilution, Re -analysis, Re -extraction, or additional Initial metalslanion analysis of the sample DLC Decision level concentration MDA Minimum detectable activity EDL Estimated Detection Limit MDC Minimum detectable concentration MDL Method Detection Limit ML Minimum Level (Dioxin) NC Not Calculated ND Not detected at the reporting limit (or MDL or EDL if shown) PQL Practical Quantitation Limit QC Quality Control RER Relative error ratio RL Reporting Limit or Requested Limit (Radiochemistry) RPD Relative Percent Difference, a measure of the relative difference between two points TEF Toxicity Equivalent Factor (Dioxin) TEO Toxicity Equivalent Quotient (Dioxin) TestArnerica Savannah Page 2 of 15 12/30/2015 Sample Summary Client: GEOS Environmental Inc. Project/Site: ODF L/Greensboro Lab Sample ID Client Sample ID 680-120407-1 Outfalt 1 680.120407-2 Outfall2 TestAmerica Job ID: 680-120407-1 Matrix Collected Received Water 12/22/15 11:00 12/23/15 15:15 Water 12122/ 15 11:00 12/23/ 15 15:15 TestAmerica Savannah Page 3 of 15 12/30/2015 Case Narrative Client: GEOS Environmental Inc. Project/Site: O D F UGree n sboro Job ID: 680-120407-1 Laboratory: TestAmerica Savannah Narrative Job Narrative 680-120407-1 Comments No additional comments. TestAmerica Job ID: 680-120407-1 Receipt The samples were received on 12/23/2015 11:35 AM; the samples arrived in good condition, properly preserved and, where required, on ice. The temperature of the cooler at receipt was 1.80 C. General Chemistry No analytical or quality issues were noted, other than those described in the Definitions/Glossary page. TestAmerica Savannah Page 4 of 15 12/30/2015 Client Sample Results M Client. GEOS Environmental Inc. Project/Site: O DFUGreensboro TestAmerica Job ID: 680-120407-1 R I Client Sample ID: Outfall 1 Lab Sample ID: 680-120407-1 Date Collected: 12/22/15 11:00 Matrix: Water Date Received: 12/23/15 15:15 M General Chemistry Analyte Result Qualifier PQL MDL Unit D Prepared Analyzed Oil Fac HEM (Oil 8 Grease) 1.3 U 4.7 1.3 mglL 12128/15 08:36 12128I15 11:57 1 Total Suspended Solids 15 2.0 2.0 mglL 12/29/15 14:29 1 Client Sample ID: Outfall 2 Lab Sample ID: 680-120407-2 Date Collected: 12/22/15 11:00 Date Received: 12/23115 15:15 Matrix: Water IC General Chemistry fl Analyte Result Qualifier PQL MDL Unit D Prepared Analyzed Oil Fac HEM (Oil 8 Grease) 1.3 U 4.7 1.3 mglL 12/28/15 08:36 1212$!15 11:57 i Total Suspended Solids 11 4.0 4.0 mglL 12129/15 15:18 1 IL11 M TestAmerica Savannah Page 5 of 15 12/30/2015 QC Sample Results M Client: GEOS Environmental Inc. TestAmerica Job ID: 680-120407-1 Project/Site: ODFL/Greensboro Method: 1664A - HEM and SGT-HEM Lab Sample ID: MB 680-416273122-A Matrix: Water Analysis Batch: 416314 MB MB Analyte Result Qualifier HEM (Oil & Grease) 1.4 U Lab Sample ID: LCS 680-416273123-A Matrix: Water Analysis Batch: 416314 Analyte HEM (Oil & Grease) Lab Sample ID: LCSD 680-416273/24-A Matrix: Water Analysis Batch: 416314 Analyte HEM (oil & Grease) Spike Added 40.0 Client Sample ID: Method Blank Prep Type: Total/NA Prep Batch: 416273 PQL MDL Unit D Prepared Analyzed Dil Fac 5.0 1.4 mglL 12/28/15 08:36 12/28/15 11:57 1 Client Sample ID: Lab Control Sample Prep Type: Total/NA Prep Batch: 416273 0 LCS LCS %Rec. Result Qualifier Unit D %Rec Limits J 33.4 mg1L 84 78 - 114 Client Sample ID: Lab Control Sample Dup Prep Type: Total/NA Prep Batch: 416273 Spike LCSD LCSD %Rec_ RPD Added Result Qualifier Unit ❑ %Rec Limits RPD Limit 40.0 36.2 mglL 91 78- 114 8 18 Method: 2540 D-2011 - Total Suspended Solids Dried at 103-1050C Lab Sample ID: MB 680-41647611 Client Sample ID: Method Blank Matrix: Water Prep Type: Total/NA Analysis Batch: 416476 MB MB Analyte Result Qualifier Total Suspended Solids Lab Sample ID: LCS 680-416476/2 Matrix: Water Analysis Batch: 416476 Analyte Total Suspended Solids Lab Sample ID: LCSD 680-416476/3 Matrix: Water Analysis Batch: 416476 Analyte Total Suspended Solids Lab Sample ID: MB 680-416477/1 Matrix: Water Analysis Batch: 416477 Analyte Total Suspended Solids 1.0 U PQL MDL Unit D Prepared Analyzed Dil Fac 1.0 1.0 mg/L 1212911514:29 1 Client Sample ID: Lab Control Sample Prep Type: Total/NA Spike LCS LCS %Rec. Added Result Qualifier Unit D %Rec Limits 20.0 23.5 mglL 118 80 -120 Client Sample ID: Lab Control Sample Dup Prep Type: Total/NA Spike LCSD LCSD %Rec. RPD Added Result Qualifier Unit D %Rec Limits RPD Limit 20.0 23.5 mglL 118 80 - 120 0 25 Client Sample ID: Method Blank Prep Type: Total/NA MB MB Result Qualifier PQL MDL Unit D Prepared Analyzed Dil Fac 1.0 U 1.0 1.0 mglL 12/29/15 15:18 1 TestAmerica Savannah Page 6 of 15 12/30/2015 QC Sample Results Fq Client: GEOS Environmental Inc. ProjecUSite: ODFLIGreensboro TestAmerica Job ID: 680-120407-1 w Method: 2540 D-2011 - Total Suspended Solids Dried at 103-105°C (Continued) Lab Sample ID: LCS 680-41647712 Client Sample ID: Lab Control Sample (�l Matrix: Water Prep Type: Total/NA Analysis Batch: 416477 ❑ Spike LCS LCS %Rec. Analyte Added Result Qualifier Unit D %Rec Limits Total Suspended Solids 20.0 19.0 mg/L 95 80- 120 Lab Sample ID: LCSD 680-41647713 Client Sample ID: Lab Control Sample Dup Matrix: Water Prep Type: Total/NA Analysis Batch: 416477 Analyte Spike LCSD LCSD Added Result Qualifier %Rec. RPD Unit D %Rec Limits RPD Limit ❑ Total Suspended Solids 20.0 21.5 mg/L 108 80_ 12D 12 25 Lab Sample ID: 680-120407-2 DU Matrix: Water Analysis Batch: 416477 Sample Sample Analyte Result Qualifier Total Suspended Solids 11 Client Sample ID: Outfall 2 Prep Type: Total/NA DU DU — RPD Result Qualifier Unit D RPD Limit 11.2 mg1L 4 5 TestAmerica Savannah Page 7 of 15 12/30/2015 Client: GEOS Environmental Inc. Project/Site: ODFL/Greensboro General Chemistry Prep Batch: 416273 Lab Sample ID 680-120407-1 680-120407-2 LCS 680-416273123-A LCSD 680-416273/24-A MB 680-416273122-A Analysis Batch: 416314 QC Association Summary Client Sample ID Outfall 1 Outfall 2 Lab Control Sample Lab Control Sample Dup Method Blank TestAmerica Job ID: 680-120407-1 Prep Type Matrix Method Prep Batch TotalINA Water 1664A Total/NA Water 1664A TotalINA Water 1664A TotallNA Water 1664A Total/NA Water 1664A Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 680-120407-1 Outfall1 Tota11NA Water 1664A 416273 680-120407-2 Outfali 2 TotalfNA Water 1664A 416273 LCS 680416273/23-A Lab Control Sample Total/NA Water 1664A 416273 LCSD 680-416273124-A Lab Control Sample Dup Total/NA Water 1664A 416273 MB 680-416273122-A Method Blank TotalINA Water 1664A 416273 0 u 0 0 0 Analysis Batch: 416476 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batcht: �2 680 120407 1 O ti II 1 u a I ota11NA Water 2540 D-2011 LCS 650-416476/2 Lab Control Sample TotaliNA Water 2540 D-2011 LCSD 680-416476/3 Lab Control Sample Dup Total/NA Water 2540 D-2011 MB 680-416476/1 Method Blank Total/NA Water 2540 D-2011 Analysis Batch: 416477 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 680-120407-2 Outfall 2 Total/NA Water 2540 D-2011 680-120407-2 DU Outfall 2 Total/NA Water 2540 D-2011 LCS 680-416477/2 Lab Control Sample Total/NA Water 2540 D-2011 LCSD 680-41647713 Lab Control Sample Dup TotallNA Water 2540 D-201- I MB 680-41647711 Method Blank Total/NA Water 2540 D-2011 TestAmerica Savannah Page 8 of 15 12/30/2015 Lab Chronicle f Client: GEOS Environmental Inc. TestAmerica Job ID: 680-120407-1 Project/Site: ODFLIGreensboro ill Client Sample ID: Outfall 1 Date Collected: 12/22/15 11.00 Date Received: 12/23/15 15:15 Lab Sample ID: 680-120407-1 �) Matrix: Water Batch Batch Dil Initial Final Batch Prepared Prep Type Type Method Run Factor Amount Amount Number or Analyzed Analyst Lab Totil/NA Prep 1664A 531 mL 500 mL 416273 12/28/15 08:36 DLG TAL SAV f l a TotaIINA Analysis 1664A 1 531 mL 500 mL 416314 12/28/15 11:57 DLG TAL SAV Instrument 10: NOEQUIP I - TotallNA Analysis 2540 D-2011 1 500 mL 1000 mL 416476 12/29/15 1 4:2 9 LAF TAL SAV •- --- .......... Instrument ID: NOEQUIP -- . . ....... .... ............ .... .-- ---- . r Client Sample ID: Outfall 2 Date Collected: 12/22115 11:00 Date Received: 12/23/15 15:15 Lab Sample ID: 680-120407-2 L Matrix: Water Batch Batch Dil Initial Final Batch Prepared Prep Type Type Method Run Factor Amount Amount Number or Analyzed Analyst Lab TotatlNA Prep 1664A 530 mL 500 mL 416273 12/28115 08:36 DLG TAL SAV Total/NA Analysis 1664A 1 530 mL 500 mL 416314 12/28115 11:57 DLG TAL SAV - Instrument ID: NOEQUIP Total/NA ........... ........ Analysis 2540 D-2011 ... ... 1 .. .. 250 mL 1000 mL 416477 12/29115 15:18 LAF TAL SAV Instrument ID: NOEQUIP Laboratory References: TAIL SAV = TestAmerica Savannah, 5102 LaRoche Avenue, Savannah, GA 31404, TEL (912)354-7858 TestAmerica Savannah Page 9of15 12/30/2015 Client: GEOS Environmental Inc. Project/Site: O D F L/Greensboro Laboratory: TestAmerica Savannah The certifications listed below are applicable to this report. Authority Program North Carolina (WW1SW) State Program Laboratory: TestAmerica Tampa The certifications listed below are applicable to this report. Authority Program Florida NEtAP Certification Summary EPA Region Certification ID 4 269 R-1 TestAmerica Job ID: 680-120407-1 t - I:K Expiration Date H 12-31-16 IC IN EPA Region Certification ID Expiration Date 4 E84282 06-30-16 I T� a TestAmerica Savannah l v�! Page 10 of 15 12/30/2015 Method Summary Client: GEOS Environmental Inc. TestAmerlca Job ID: 680-120407-1 Project/Site: ODFLIGreensboro Method Method Description Protocol Laboratory 1664A HEM and SGT-HEM 1664A TAL SAV 2540 D-2011 Total Suspended Solids Dried at 103-105°G SM TAL SAV Protocol References: 1664A = EPA-821-98-002 SM = "Standard Methods For The Examination Of Water And Wastewater", Laboratory References: TAL SAV = TestAmerica Savannah, 5102 LaRoche Avenue, Savannah, GA 31404, TEL (912)354-7858 TestAmerica Savannah Page 11 of 15 12/30/2015 Ai TestAmerica Tampa 6712 Benjamin Road Surte 100 Tarnpa. FL 33634 Phone (8113) 886-7427 Fax (813) 865-7049 Chain of Custody Record TeeAmedca —4E Crdcr . C—I1G*f ILAb PM: Career TraodN NO(q), CAC Na: Client Information AAAAVA� Atkins, Amy M-6366(3-20429.1 CI�IGOrftact 151 ` E-Ma : Page Joseph Fuhr La 0'7 1amy.atkInsQtastaMericafnc.com Page 1 of 1 CnMD2ny. Job 0 EDS Erwironmertal Inc. Analysis Requested Mdre= Dee E12t& PjMuust*d-. Preservation Codas: 13014 N Dale Mabry Hvq # i 17 j- A -MO PA - Hexane B - MOH. N-Nemec cry TAT Ftq—t�d (days); Tampa K. C - Zn Acatift 0 - AXNaOZ D - Mt7c ACd P Na2045 state, Zn; FL, 33618 NaHSO4 Q N22$C3 F flaOH R N=US03 Phvila PO Purchase order not required S - F12SC14 H -.44wrbic A&I 7 - 75P DodaoahydraW i - %oo Email WO #k �UhrggeOsenVjQnmental.com M V- MCAA j water K- LDTA W - ph 4-5 L - rMA 2 - other ilspecffy; FYOIO,-- ODFUGreensboro,NI 66004163 Other Art Sample Matrix Z 'i -DE Type 7 Sample (C-Comp, 0--WK Sample identification Sample Date Time 1 G-grab a.au) Simcial Instructions/Note: Outfall I water OU1211 2 Water -.2 WO-7 2W7 Chain of Custody Sample Disposal (A fee may be assessed ffsamble� am retained longer Man 1 month) L A Possible Hazard IdanOWcadan Non -Hazard ©Flammable :qidn Irritant C;Ioison B L=bnkncwn =�"'Yv.gloal Rolum To Uemt L=Disposal By Lab =A,01- For Months Deliverable Requested: 1, 11, 111, N, Other (specify) Special Jnstrucbons/QC Requirements: I Emily 1Kjt Relinquished by. -nrre. %wv�d of Sh]:I'mm -1 IMt :7 - 1 1 h I - az.:-:, 0 - - I I I--, --- I&-4K Re'. ^-".ed yy v D21vT1,-.w, - cmpdw -- Reserved bT Company rC',IeL gy 12-.22 -LS LAW FZ.tqqx5hed by. Dixelrrna Company Reoffed by Daterime: Company Rej:nq=nea by Company PONT I - eel No.: infectVpm_ CcKAgrTemMraWle(j) 'C artd I Li No L2C2�= 15;, Login Sample Receipt Checklist Client: GEOS Environmental Inc. Job Number: 680-120407-1 Login Number: 120407 List Number: 1 Creator: Murray, Thomas J Question List Source: TestAmerica Savannah Answer Comment Radioactivity wasn't checked or is <1= background as measured by a NIA survey meter. The cooler's custody seal, if present, is intact. True Sample custody seals, if present, are intact. True The cooler or samples do not appear to have been compromised or True tampered with. Samples were received on ice. True Cooler Temperature is acceptable. True Cooler Temperature is recorded. True COC is present. True COC is filled out in ink and legible. True COC is filled out with all pertinent information. True Is the Field Sampler's name present on COC? NIA There are no discrepancies between the containers received and the COC. True Samples are received within Holding Time. True Sample containers have legible labels. True Containers are not broken or leaking. True Sample collection dateltimes are provided. True Appropriate sample containers are used. NIA Sample bottles are completely filled. True Sample Preservation Verified. True There is sufficient vol. for all requested analyses, incl. any requested True MSIMSDs Containers requiring zero headspace have no headspace or bubble is NIA <6mm (114"). Multiphasic samples are not present. True Samples do not require splitting or compositing. True Residual Chlorine Checked, NIA TestAmerica Savannah Page 15 of 15 12/30/2015 NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen K Sullins Governor Director 16 September 2009 Mr. Roland Hince Old Dominion Freight Line 500 Old Dominion Way Thomasville, North Carolina 27360 SUBJECT: Compliance Evaluation Inspection Old Dominion Freight Line NPDES Permit No. NCGO80018 Guilford County Dear Mr. Hince: Dee Freeman Secretary A Compliance Evaluation Inspection was performed on the Old Dominion Freight Line's stormwater treatment facilities on September 9, 2009 by Corey Basinger of the Winston-Salem Regional Office. The inspection consisted of two parts: an on -site inspection of the stormwater facilities and an in -office file review, The following are the findings from the subject inspection. I. Permit The NPDES permit for Old Dominion Freight Line became effective on November 1, 2007 and expires on October 31, 2012. A copy of the permit was available at the corporate'ofiice. H. Records/Reports A review of the Stormwater Pollution Prevention Plan (SPP Plan) revealed that all areas of concern had been addressed. The SPP Plan was very comprehensive and well organized. 111. Facilitv Site Review All outfalls noted in the SPP Plan were inspected and found to be satisfactory. IV. Effluent & Receiving Waters Old Dominion Freight Line discharges stormwater to Hickory Creek in the Cape Fear River Basin. V. Self-Monitoring_Propram A review of the discharge monitoring reports (DMRs) showed that Old, Dominion Freight Line was in compliance with the self -monitoring requirements contained in the NPDES General Permit. Qualitative monitoring data was reviewed and it demonstrated compliance with pen -nit requirements Overall, the facility was deemed to be in compliance with NCGO80018. In order to ensure that personnel are familiar with the Stormwater Pollution Prevention Plan and the NPDES General Stormwater Permit requirements, it will be necessary maintain a copy of all permit documents at the Evanstown Road facility. The Division greatly appreciates your continued efforts to maintain compliance with the subject permit and solicits any input you may have regarding this inspection report. 1f you should have any questions or concerns regarding this report, please contact this Office at (336) 771-5000, Sincerely, Steve W. Tedder Water Quality Supervisor Cc: Central Files, WSRO Guilford County Health Department North Carolina Division of Water Qua €ity, Winston-Salem Regional Office Location: 585 Waughtown St, Winston-Salem, North Carolina 27107 Ol1C Phone: 336-771-50001 FAX: 336-771-46301 Customer Service: 1-877-623-6748 NorthCarolina Internet: wmv.ncwaterquallty.org Natimallry An Equ,� Opi Affrmalive Action Employer Form Approved �i OMB No.2040-0057 Approval Expires 8-31-98 IJnited States Environmental Protection Acenev. Washineton. D.C.. 20460 Section A: National Data System Codinp- Transaction Code NPDES No. Yr/NlolDay Inspection Type Inspector FacilityType N 5 NCGO80018 09-09-09 C S 2 Facility Evaluation Rating BI QA .......Reserved........... 4 N N Section B: Facility Data Name and Location of Facility Inspected: Entry Time: Permit Effective Old Donunion Freight Line 1000 hrs. Date: Nov 1, 2007 Located at 4715 Evanstown Road Greensboro, NC Exit Time: Permit Expiration 1105 hrs. Date: Oct 31, 2012 Name(s) of On -Site Representative(s): Title(s): Phone No(s): Mr. Roland Hince Manager of Construction Area B 336-822-5778 (cell 336-202-3056) Name, Address of Responsible Official: Title: Manager of Construction Area B Phone No. Contacted' Yes Mr. Roland Hince Old Dominion Freight Line 336-822-5778 500 Old Dominion Way Thomasville, NC 27360 Section C: Areas Evaluated During Inspection (check only those areas evaluated) X Permit X Flow Measurement X Operations/Maintenance NA Sewer Overflow X Records/Reports X Self -Monitoring Program NA Sludge Handling/Disposal _ Pollution Prevention X Facility Site Review NA Compliance Schedules NA Pretreatment X Effluent/Receiving Waters NA Laboratory Stormwater Section D: Summary of Findings/Comments See attached letter for further details regarding the subject inspection. Name(s) and Signature(s) of Inspectors: Agency/Office/Telephone: Date: DWQ / WSRO / (336)771-5000 /G Sir T z� Q 9 Signature of Revi er: Agency/Office: Date: DWQ / WSRO / (336)771-5000 914r Permit: NCGO80018 Owner - Facility: Old Dominion Freight Line Inspection Date: 09/09/2009 Inspection Type: Compliance Evaluation Reason for Visit: Routine Stormwater Pollution Prevention Plan Yes No NA NE Does the site have a Stormwater Pollution Prevention Plan? ■ ❑ ❑ ❑ # Does the Plan include a General Location (USGS) map? ■ ❑ ❑ ❑ # Does the Plan inciude a "Narrative Description of Practices"? ■ ❑ ❑ ❑ # Does the Plan include a detailed site map including outfall locations and drainage areas? ■ ❑ ❑ ❑ # Does the Plan include a list of significant spills occurring during the past 3 years? ■ ❑ ❑ ❑ # Has the facility evaluated feasible aitematives to current practices? ■ Cl Cl ❑ # Does the facility provide all necessary secondary containment? ■ ❑ ❑ Cl # Does the Plan include a BMP summary? ■ ❑ ❑ ❑ # Does the Plan include a Spill Prevention and Response Plan (SPRP)? ■ ❑ ❑ ❑ # Does the Plan include a Preventative Maintenance and Good Housekeeping Plan? ■ ❑ ❑ ❑ # Does the facility provide and document Employee Training? ■ ❑ ❑ ❑ # Does the Plan include a list of Responsible Party(s)? ■ ❑ ❑ ❑ # Is the Plan reviewed and updated annually? ■ ❑ ❑ ❑ # Does the Plan include a Stormwater Facility Inspection Program? ■ ❑ ❑ ❑ Has the Stormwater Pollution Prevention Plan been implemented? ■ ❑ ❑ ❑ Comment: Qualitative Monitorin Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? ■ ❑ ❑ ❑ Cam ment: Analytical Monitorin Yes No NA NE Has the facility conducted its Analytical monitoring? ■ ❑ Cl ❑ # Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ■ ❑ Cl ❑ Comment: Permit and Outfalls Yes No NA NE # Is a copy of the Permit and the Certificate of Coverage available at the site? ■ ❑ ❑ ❑ # Were all outfalls observed during the inspection? ■ ❑ ❑ ❑ # If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ■ ❑ # Has the facility evaluated all illicit (non stormwater) discharges? ■ Cl ❑ ❑ Comment: Page: 3 Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources W A rF9P6 r VINCENT GROSS August 23, 2002 OLD DOMINION FREIGHT LINE-GUILFORD 500 OLD DOMINION WAY THOMASVILLE, NC 27360 Dear Permittee: Alan W. Klimek, P.E., Director Division of Water Quality Subject: NPDES Stormwater Permit Renewal Old Dominion Freight Line -Guilford COC Number NCG080018 Guilford County In response to your renewal application for continued coverage under general permit NCG080000, the Division of Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This permit is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983, The following information is included with your permit package: A new Certificate of Coverage A copy of General Stormwater Permit NCGO80000 A copy of a Technical Bulletin for the general permit Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility for compliance with any other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or decree. If you have any questions regarding this permit package please contact Delonda Alexander of the Central Office Stormwater and General Permits Unit at (919) 733-5083, ext. 584 Sincerely, Bradley Bennett, Supervisor Stormwater and General Permits Unit cc: Central Files Stormwater & General Permits Unit Files Winston-Salem Regional Office NCDENR N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 (919) 733-7015 Customer Service 1-800-623-7748 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCGO80000 CERTIFICATE OF COVERAGE No. NCG080018 STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215. I, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, OLD DOMINION FREIGHT LINE is hereby authorized to discharge stormwater from a facility located at OLD DOMINION FREIGHT LINE-GUILFORD 4715 EVANSTOWN RD GREENSBORO GUILFORD COUNTY to receiving waters designated as Hickory Creek, a class C stream, in the Cape Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, IV, V, and VI of General Permit No. NCG080000 as attached. This certificate of coverage shall become effective September 1, 2002. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day August 23, 2(})2. for Alan W. Klimek, P.E., Director Division of Water Quality By Authority of the Environmental Management Commission Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Gregory J. Thorpe, Ph.D. Acting Director Division of Water Quality December 27. 2001 VINCI NT CROSS OLI) DOMINION FREIGI-I`I' LINE -GULL 1730 WI STCHEST[ R DR HIGH POINT, NC 27261 Subject: NPDCS Stortnwatcr Permit Renewal OLD DOMINION FREIGHT LINE --GULL COC Nulit her NC6080018 Guilford Counly Dcar Pernriltce: Your facilily is currently covered for suxrnwater discharge under General Perini( NCG0S0000. This perntit expires on August 31. 2002. The Division staff is Currently in the process of rewriting this permit and is scheduled to have the permit rcissucd by [ale summer of 2002. Once the permit is reissued. your facility would he cligihle For Continued CovcragC under the reissued perntit. In order to assure your Continued coveragC under the gater'al permit, you trust apply to the Division of Water Quality (DWQ) for renewal of your perntit coverage. To stake this renewal process -cosier. we are inlornting you in advance that your permit will he expiring. I-nClosed you will find a General Permit Coverage Renewal Application Forni. The application must hC contplCted and returned by March 4. 2002 in order to aISSnr'C continued CovcruUC under the general permi(. FailurC to rceluest renewal within this time period may result in a civil assessment of al least $250,00. Largur penalties may he assessed depending on the delinquency of the rctlueS1. DiSCIMr4C ol' sturnnvater front your 1.tcility without coverage under a valid siormwater NPD S permit wotdd Constitute a violal ion of NCGS 143-215.1 and could result in assessments of civil penalties of up to $10.000 per day. Please vole that recent federal ICgiSkItion ItaS 0Xlertded tltC "nu CxposurC CxClaSion" 10 all operulor:S of industrial facilities in any of the 1 1 categories of "storm waler dischar'Cs associalcd with industrial activity," (except Construction aclivitiCS). If you I'cel your facility can CCrtif'y a Condition of "no CxposurC", ix. the; facilty industrial materials and operations arc 1101 exposed 10 storntwatcr. you Can apply for the no Cxpnsure exclusion, For additional infcn-ntation Corllact (lie Central Office Stornnvatcr Staff member listed below or check the Storntwatcr �\, General Permits Unit WCh Site at httpa/h2o.Cnr.statc.nc.us/su/sturruwater.html If the suhject stormwater discharue to waters ol'thc state has been terminated, please complete (hc enclosed Rescission Request Form, Mailing instructions arc listed on the bottom of the forth. You will be notified when the rescission process has heen completed. If you havC any questions 1-COardin« the pernti( renewal proCCdurcS plCasC COHtact Corey Basinger of the Winston-Salent Reuional 01,fice at 336-771-41600 or Delundat AIMUIder of the CCntratl 00)CC Storrnwutcl' Unit at (91 J) 733-5083, exi. 584 Sincerely. BradlCy BCItn C11, Supervisor Stormwatcr and General PCrrttltS Unit cc: Central Filers Winston-Salem Rc�ional Office ern NCDENR N. C. Division of Water Quafily 1617 Mail Service Center Raleigh, NC 27699-1617 (919) 733-7015 Customer Service 1-800-623-7748 .A .:State of North Carolina Department of Environment, Health and Natural Resources Division of Environmental Management James B. Hunt, Jr., Governor Jonathan B. Howes, Secretary A. Preston Howard, Jr., P.E., Director July 23, 1993 John J. Pye Old Dominion Freight Line, Inc. 1730 Westchester Drive High Point, NC 27261 AI"V [, IDEHNR Subject: General Permit No. NCG080000 Old Dominion Frieght Line, Inc. COC NCG080018 Guilford County Dear Mr. Pye: In accordance with your application for discharge permit received on September 28, 1992, we are forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated December 6, 1983. If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to request an individual permit by submitting an individual permit application. Unless such demand is made, this certificate of coverage shall be final and binding. Please take notice that this certificate of coverage is not transferable except after notice to the Division of Environmental Management. -The Division of Environmental Management may require modification or revocation and reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain other permits which may be required by the Division of Environmental Management or permits required by the Division of Land Resources, Coastal Area Management Act or any other Federal or Local governmental permit that may be required. If you have any questions concerning this permit, please contact Mr. Bill Mills at telephone number 919/733- 5083. Sincerely, original signedil13 col n H- A. Preson oward; Jr., P. E. cc: Winston-Salem Regional Office P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-733-5083 ' FAX 919-733-9919 An Equal Opportunity Affirmative Action Employer 50% recycled110% post -consumer paper .A STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL MANAGEMENT ' :.. i 1 I� ►1 ► I:II STORMWATER DISCHARGES In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, Old Dominion Freight Line, Inc. is hereby authorized to continue operation of an oil water separator and discharge stormwater ffom'a facility located at Old Dominion Freight Line, Inc. 4715 Evanstown Road Greensboro Guilford County to receiving waters designated as Hickory Creek in the Cape Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 1I, II1 and IV of General Permit No. NCG080000 as attached. This certificate of coverage shall become effective July 23, 1993. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day July 23, 1993. Original Sigdin8 Coleen H. Su A. Preston Howard, Jr., P.E., Director Division of Environmental Management By Authority of the Environmental Management Commission w UNITED STATES C ` o DEPARTMENT OF THE INTERIOR p s� GEOLOGICAL' SURVEY - 79'52'30" 602000m,E a R�Ch',�i F3 U:2D fi NOD" N. � / //I y, °s�l�S3.� r /( .i ^a 1. "f .7�0 10 yT 3983 3982 ✓� (1 \\✓l ,'�, \Q} ``A `��2`\�\l , � �J89/ rr it ! i�,!/ 3981 a 3980 AY 57'30"ze 3 ',� Z/2 979 1J �•f �� C �_ ,t793 rl: 604 6651 50' �'�C- J� 1 � y\� ��'�, �5 Sao.—�j',�r7 �-j �• �1..�� ME ���� ,�� ���. ,, � i ���'' r. Aso � ^ � � � ���1 • i j'(• ! ..\, lcor `r CeIn 000 10 -- •�V �I ( :�•l ! d — -,a-< � 1 . �;. , J� �� ;'',•• ti.l= Via' �•�� 'M— ,•rt- ifr" \2 tiRC rm' •Cc�{nmunit��\ IIr/�, %!1� ��� \ ^•' •. `y �_�II'� ��� •,J'/11 1� �1[82��«;��J�' .yam h ' }/� �A •t�� 1' � �\J-�� Q� il/'`9�i1 �. �,�� J��V � ^lil � `� ilk ' 3l1 '�V' -� %�� � -j---•,l,is FACILITY ()/d &41.121�17 COUNTY NPDES MAP # DSN FLOW SUB BASIN .>3 - a 6 - ©f LATTITU DE *& 3 LONGITUDE '77 � DECEIVING STREAM Cie I' F&"r 0 9 H(,4ory c(pek STREAM CLASS G DISCHARGE CLASS 6-ldty, o'&r EXPIRATION DATE 0� 1V ),/ e J 1V]L,