NCG030005_MONITORING INFO_20191217

Vvc, IV
—I IV
STORMWATER DIVISION CODING SHEET:
NCG PERMITS
PERMIT NO.
Iv C�c, 3 O b 6 S
DOC TYPE
EOHISTORICAL FILE
MONITORING REPORTS
DOC DATE
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Resoiurcesl General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. N0003-c V E 1
FACILITY NAME _EtJGtyE VKEAt.E C'V41xLXi
COUNTY iaL<- ¢T
PERSON COLLECTING SAMPLES t T
LABORATORY M Lab Cert. ft
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR ao 19
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
RECOVER or 9-0onthly' K)0OUPnii,Z(month)
r� DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
DEC 2 3 ZO ❑zero -flow ❑water Supply ❑SA
❑Other
p��1R SL( T10;1�
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
n No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches's
Total Suspended Solids
pH.
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks =__>
100 mg/L or SO mg/L
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
71 t
I lie, 119
L_.o s. a
. ®o
1, OCT©S
-
5
3
L005q
-7 Cn
.(97
.
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent managementplan into -the Stormwater'Pollution-Prevention Plan may so certify, and the requirement.for TTOmonitoring- -
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
�\_0 �frttr Q w ecio
Name (Print name)
1 a Lf. St.t ut v tsoR
LoPrint title)
«IIture) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks ==_>
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Note: If you report a sample value in excess of the benchmark;oumust implement Tier 1, Tier 2, or 3 responses. See: General Permit text. -_--
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 SE5PON B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE5,FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ErNO ❑
IF YES, HAVE YOU CONTACT THE DWQ REGIONAL OFFICE? YES NO El
REGIONAL OFFICE CONTACT NAME 11 I'll L- -TW -Stt4C' 313I(�
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
in the case of "No Discharae" reports) to:
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

MW® VR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out thisform, please visit: http,//­poEtal.i3gdenr.org/wgb/lr/npdes-stormwatgr/
PermitNo.: N/(y/k/Q/3/jQ1-01-C?/Q/ or Certificate ofCoverage rNo.:
Facility Name: -U
County: ? --,4�
Inspector:>E
Date of Inspection:
Time of Inspection:
Phone No. o2ba -3(02�
Total Event Precipitation (inches): - 23_
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
r
litative monitoring requirements vary. Most permits require qualitative monitoring to be
ormed during a "representative storm event' or during a "measureable storm event" However,
e permits do not have this requirement. Please refer to these definitions, if applicable.
epresentative storm event' is a storm event that measures greater than 0.1 inches of rainfall
that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event' is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By th, s,signature,,,l certify that this report is accurate and complete to the best of my knowledge:
of Permidee or Designee)
Pagel of 2
SWU-242, Last modified 7/31/2013

'! 1, Outfall Description:
outfall No. k— I Structure
Receiving Stream: L' K11212V !
Describe the industrial activks that
(pipe, ditch, etc.)
the outfall drainage
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: �1 AC)
tIJD-Vkt-Ti
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): oy��` Q-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 et3 4 5
S. Floating Solids: Choose tth-ee 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:
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:
1 e 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 evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
i
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
mAni.949 lacy mndified 7/31/2013

m
1. Outfall Description:
outfall No-4 `
Receiving Stream:
Describe the industrial activ;
(pipe, ditch, etc.)
%o TQAwCt t
that occur witbiq the outfall drainage
wz �aa+A
2. Color: Describe the color of the discharge
(light, medium, dark) as descriptors: Q
3. Odor: Describe any distinct odors that
weak chlorine odor, etc.): 1J0 CV-G
basic colors (red, brown, blue, etc.) and tint
nint2 VCD ^
may have (i.e., smells strongly of oil,
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy: 01
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
01 11 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 0 3 4 5
7. Is there any foam in the stormwater discharge? Yes 6NOo
g. Is there an oil sheen in the stormwater discharge? Yes
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.
cXnmas? I.actmndified7/31/2013
Page 2 of 2

(W Flo
0�
114 OAKMONT DRIVE
II
i�
i
u CLARCOR EMS (STORMWATER)
DWIGHT ALLIGOOD !!
P.O. BOX 1105
WASHINGTON ,NC 27889
l
I�
i
n
I'
PARAMETERS
I'.
Total Suspended Residue, mg/I
Copper, ug/I'
Lead, ug/I
Zinc, ug/I
� TPH (1664B), mg/I
ID#: 385
DATE COLLECTED: 11/15/19
DATE REPORTED : 12/10/19
REVIEWED BY:
Stormwater Stormwater Analysis Method
(NI, Crab) (#2, Crab) Date Analyst Code
<5.2 <5.4 H119/19 MAR 2540D-11
7 7 12/04/19 LrJ EPA200.7
<5.0 <5.0 11/21/19 MTM 3113B-10
68 74 12/04/19 LFJ EPA200.7
<5 <5 11/19/19 SEJ EPA1664B

C
C
P
V
11
Environment 1, Inc. -- - - — - CHAIN OF CUSTODY -RECORD _ - - - - - - - -
P.O. Box 7085, 114 Oakmont Dr. - Page 1 of 1 --
<TiRnVIUZ, IN1 L/OJo
environment 1 inc.com
DISINFECTION
CHLORINE NEUTF AIJZEDAT COLLECTION
Phone [phone] • Fax [phone]
CHLORINE
CLIENT: 385 Week:50
LlLI
ti
v
pHCHECK (LAB)
LARCOR EMS (STORMWATER)
❑.1 NONE
P
P
P
G
CONfNN NEAPE,PIG
WIGHT ALLIGOOD
.O. BOX 1105
ri
CHEMICALPRESERVATION
IASHINGTON NC 27889
l.J
A
A
A
C
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A -NONE D-NAOH
975-9224
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zo
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Ci
w
B-HNO, E-HCL
w o
¢
Z
a
C-HMSO, F-ZINC ACETATEMAOH
COLLECTION
it
$
m
y
G-NATHIOSULFATE
o
a
SAMPLE LOCATION
DATE
TIME
o
3
�
�
�
CL.ASSIFICAPON:
Stormwater (#I, Grab)
1111611g
WASTMTER(NPDES)
Ll DRINIONGWATER _
Stormwater (r12, Grab)
(450
14.0
3
Lj OWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENTIDELIVERY
Q N
SAMPLES COLLECTED BY:
1 t;
SAMPLES FIBCOM INLABA 'C
RELINQUISHED BY(SIG-)(SAMPL.ER)
DATE rrIME
RECEIVED .)
i/% TFIf1ME
COMMENTS:
R&INQUISHEDBY(SIG.)
DATurm
17rB
DATEMME
t
�1
REIINOUISHEDBY(SIG.)
DATEM ME
RECEIVED BY(SIG.)
DATErnME
Sampler must place a'C' for composite sample or a'G' for
PLEASE READ Instructions for completing this form on the reverse side.
FORM es Grab sample in the blocks above for each parameter requested. N0 371436

pH Meter Calibration for Storm Water Sampling
Cal off 4.01 I @pHZOO I @PH 10.00
Date
Time
Reading
Calibrated
Reading
Calibrated
Reading
Calibrated
Operator
Comments
Il IS 19
IN�.o
�{.o
qtS
-7•00
1 Nt
lo•oo
1 4&5
f}
Thermo Scientific pH Meter Operation and Calibration Operation and Calibration
Calibration
1. Prepare buffers that bracket the expected sample pH (pH 7.0, 4.0, 50.0)
2. Turn the meter on, and wait for the display to stabilize.
3. Press the "Calibration" button.
4. Rinse the electrode with DI water, shake off excess water, blot dry and then place into first buffer solution (7.0).
5. After the meter has stabilized and the result has been displayed, record the result and then press the "Calibration" button.
6. Rinse the electrode with DI water, then gently shake off excess water and blot dry. Place electrode into second buffer solution (4.0).
7. After the meter has stabilized and the result has been displayed, record the result and then press the "Calibration" button.
B. Rinse the electrode with DI water, then gently shake off excess water and blot dry. Place electrode into second buffer solution (10.0).
9. After the meter has stabilized and the result has been displayed, record the result and then press the "Calibration" button.
10. Press the "Measure" key, and record the slope. The slope should always be between 92 - 102%. If not, repeat the calibration. If the slope is still outside the range, contact the EHS
Specialist.
11. The meter is now in measurement mode, and samples can be analyzed.
pH Measurement
1. If power is off, press the power key.
2. Press the "Measure" key.
3. Rinse the electrode with DI water, gently shake off excess water and blot dry.
4. Place electrode into sample, gently stir and then allow meter to stabilize and display results.
S. Repeat as needed.
NOTES:
When not taking measurements, the pH electrode should be kept in the storage solution, not in DI water or buffer solution.
When ready to take measurements, rinse the electrode with DI water, and then gently shake of the excess water and blot the electrode with a clean, dry tissue. DO NOT RUB the electrode
as this may cause static build up. Then place the electrode into the sample or pH buffer for calibration.
When placing the electrode into a sample or buffer solution, gently stir with the electrode for a few seconds, and then wait for the meter to stabilize and for the display to stop flashing and
to display the result.
Fresh buffer solution must be used each day. Throw out old buffer solution.
WES-Form-062 rev 01 (03/21/2016)
Page 1 of i

Semi-annual Stormwater Discha
Monitoring
for North Carolina Division of Water
Date submitted
CERTIFICATE OF COVERAGE NO. NCGi03 0 L9 V 5
FACILITY NAME ( J.ARWQ !?tJbIVG Me &U4 k'TWlf.P
COUNTY J7LFf1Ay�71:��
PERSON COLLECTING SAMPLES
Lab Cert. #
Comments on sample collection or a
Part A: Stormwater Benchmarks and Monitoring Results
Permit No. NCG030000
SAMPLE COLLECTION YEAR 20k I
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or D-Monthly' &CL (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVE® ❑Zero -flow ❑Water Supply ❑SA
DEC 06 2019 []Other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWR SECTION
No discharge this period?Z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
PH
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics 5
Benchmarks =__>
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfaii.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 . _ ___ - - - _ - - SWU-2451 last: revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
.�� A�� �c Name (Prin name)
��Atw7C'z�A►.x,£, �Jl�tPs-�J�oG�.
Print title) q
t I t I
re) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharge this period?z
Outfall No.
Date Sample
i
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L'
6.0 - 9.0 SU
Footnotes from Part A also apply to this Part B
• See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-2451 last revised 10/25/2012
- — - - - - - Page 2 of 3

Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART It SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART It SE ION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTA THE DWQ REGIONAL OFFICE? YES [ NO ❑ I�7
REGIONAL OFFICE CONTACT NAME: cnb L�S.Q� 2S4.f�C -S L3 1
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
in the case of "No Discharge" reports) to:
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
a are that there are ignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
V-5�jk LYL I (I :it (l
lG,onafuro of ermitteel (Date)
Permit Date: 11/1/2012-10/31/2017 _ -- - - - -- - ` — SWUZ45,last revised 10/25/2012
— — — Page 3 of 3