Loading...
HomeMy WebLinkAboutNCG030027_MONITORING INFO_20191210YTO STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. �v �� O3 0 DOC TYPE. ❑y�HISTORICAL FILE ❑' MONITORING REPORTS DOC DATE ❑ YYYYMMDD F i ART*N Colin W. Betchan Environmental, Health & Safety Supervisor (919) 702-3703 (mobile) (336) 503-6562 (fax) colinwbetchan (a)eaton.com December 5, 2019 Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 RECEIVED DEC 10 2019 'NA EIbnS Attn: DWQ Central Files RE: November 2019 Monthly Tier III Discharge Monitoring Report Attached are the analytical results and associated chain of custody for the November 12, 2019, monthly Tier III stormwater outfall sampling event, submitted in accordance with Section D of the NPDES Stormwater General Permit No. NCG030000 and Certificate of Coverage No. NCG030027 issued to our facility. Additionally, attached is the applicable Discharge Monitoring Report (DMR) Form provided by the North Carolina Division of Water Quality (NCDWQ). I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with the 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 other persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Sincerely, Colin W. Betchan EHS Supervisor Attachments Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000 CERTIFICATE OF COVERAGE NO. NCG03 o 0 2 7 FACILITY NAME Eaton Corporation COUNTY Person County PERSON COLLECTING SAMPLES Colin Betchan LABORATORY Pace National Date submitted 12/05/2019 Lab Cert. # ENV375/DW21704/BI0041 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or Monthly' November (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply [:]SA *Other WS-III: NSW PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Total Suspended Solids pH, Standard units Total Copper Total lead Total Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organicss Benchmarks - - 100 mg/L or 50 mg/L4 6.0 — 9.0 0.010 mg/L 0.075 mg/L 0.126 mg/L 15 mg/L 1 mg/L Parameter Code - 46529 C0530 00400 01119 01051 01094 00552 78141 Tool Room Trench (005) 11/12/19 0.53 30.7 8.7 0.0243 0.00296 0.0505 1.17 0.03 ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. '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, Section B, Table 1 to identify 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: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018 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." Colin Betchan Name (Print name) EHS Supervisor Titl (Print title) i Lt _ la -OS ao Signature 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 discharqe this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches New Motor Oil or Hydraulic Oil Usage Non -Polar 0&G/ Total Petroleum Hydrocarbons Total Suspended Solids Benchmarks - - - 15 mg/L 100 mg/L or 50 mg/L4 Parameter Code - 46529 NCOIL 00552 CO530 Footnotes from Part A also apply to Part B Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018 Page 2 of 3 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 DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Da..Ysmith Mail an oriainal copv 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, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Cw� 44--- P-oS-0-ol4 Signature of Permittee Permit Date: 11/1/2018-05/31/2021 Date SWU-245, last revised 11/1/2018 Page 3 of 3 aceAnalytical° ANALYTICAL REPORT Neuooal Qen2resn'nga mrw-W November 19, 2019 Eaton Corporation Sample Delivery Group: Samples Received: Project Number: Description: Site: L1159977 11/13/2019 28091-R Eaton Corp Monthly Stormwater ROXBORO,NC Report To: Dustin LaClair 2564 Durham Road Roxboro. NC 27573 Entire Report Reviewed By W ZTc 3Ss [Cn SSr 6QC 7GI BAI 9SC ACCOUNT: PROJECT: SOG: DATEMME: PAGE: ,i Eaton Corporation 28091-R L1159977 11/19/191721 1 of 22 TABLE OF CONTENTS ONE LAB. NATIONWIDE, Cp:Cover Page 1 Tc: Table of Contents 2 Cp Ss: Sample Summary 3 Cn: Case Narrative 4 aSs Sr: Sample Results 5 2019-11-12.005 L1159977-01 5 QC: Quality Control Summary g Cn Gravimetric Analysis by Method 2540 D-2011 8 SSr Wet Chemistry by Method 1664E 9 Metals (ICP) by Method 200.7 10 OC Volatile Organic Compounds (GC/MS) by Method 624.1 11 Pesticides (GC) by Method EPA 608.3 13 GI Polychlorinated Biphenyls (GC) by Method EPA-608.3 15 'AI Semi Volatile Organic Compounds (GC/MS) by Method 625.1 16 GI: Glossary of Terms 20 ySC Al: Accreditations & Locations 21 Sc: Sample Chain of Custody 22 ACCOUNT: PROJECT: SDG: DATEMME: PAGE: Eaton Corporation 28091-R L1159977 ➢A911917:21 2 of 22 SAMPLE SUMMARY ONE LAB. NATIONWIDE. 2019-11-12-005 L1159977-01 WW Collected by Colin Betchan Collected clatettime 11n21909:15 Received datetlime 1113l1908:40 Method Batch Dilution Preparation Analysis Analyst Location date/time date/time Gravimelric Analysis by Method 2540 D-2011 WG1380199 �1 W1311922:22 11/14/1901:11 MIME Mt. Juliet, TN Wet Chemistry by Method 1664B WG1382689 1 11/18/19 08:07 11A8/19 70:00 MBP Mi, Juliet, TN Metals (ICP) by Method 200.7 WG1380956 1 11/17/19 08:18 11/17/19 20:29 CCE Mt. Juliet, TN Volatile Organic Compounds (GC/MS) by Method 624.1 WGI381078 1 1111511917:46 1111511917:46 ADM Mt. Juliet, TN Pesticides (GC) by Method EPA 608.3 WG1379964 1 11/13/1916 55 11117/1913:09 RP Mt. Juliet, TN Polychlorinated Biphenyls (6C) by Method EPA-608.3 WG1379964 1 1111311916:55 11114/19 05:02 RAH Mi. Juliet, TN Sent Volatile Organic Compounds(GC/MS) by Method 625.1 WG1382031 1 11117/1916:29 11/18/1900:37 AO Mt. Juliet, TN P TC aCn SSf 6QD 7G1 8AI 9s" ACCOUNT: 9 Eaton Corporation PROJECT: SDG: DATEITIME: 28091-R L1159977 11d9/1917.21 PAGE: 3 of 22 CASE NARRATIVE ONE LAG. NATIONWIDE. All sample aliquots were received at the correct temperature, in the proper containers, with the Cp appropriate preservatives, and within method specified holding times, unless qualified or notated within �Tc they report. Where applicable, all MIDI- (LOD) and RDL (LOQ) values reported for environmental samples have been corrected forthe dilution factor used In the analysis. All Method and Batch Quality Control are within established criteria except where addressed in this case narrative, a non-conformance form ASS or properly qualified within the sample results. By my digital signature below, I affirm to the best of mY knowledge, all problems/anomalies observed by the laboratory as having the potential to affect the quality of the data have been identified by the laboratory, and no information or data have been knowingly withheld that would affect the quality of the data. 1—Sr �/ �Qc 2u!.L� v 7G1 Heather J Wagner FA Project Manager 9Sc ACCOUNT: PROJECT: SCG: DATETFINIF PAGE: Eaton Corporation 28091-R L1159977 11/19/1917121 4of22 2019-11-12-005 SAMPLE RESULTS - 01 ONE LAB. NATIONWIDE. {ollected naleltime: 11/12/19 09.15 L1159977 Gravimetric Analysis by Method 2540 D-2011 Result Qualifier MDL RDL Dilution Analysis Batch Analyle mg/I mg/I mgll date/time Suspended Solids 30.7 0.350 2.50 1 11114/201901:11 WG1380199 Wet Chemistry by Method 1664B Result Qualifier MDL RDL Dilution Analysis Batch Analyle fri mg/I mg/I date/time TPH -Oil&Grease U 1.17 8,06 1 11/18/201920:00 WG1382689 Metals (ICP) by Method 200.7 Result Qualifier MDL RDL Dilution Analysis Batch Analyte mgll mg/I mg/1 date/time Copper 0.0243 0.00700 0,0100 1 11117/2019 20:29 WG1380956 Lead 0,00296 1_ 0.00200 0.00500 1 11/17/2019 20:29 WG1380956 Zinc 0.0505 0,00340 0.0500 1 11/171201920:29 WG1380956 Volatile Organic Compounds (GC/MS) by Method 624.1 Result Qualifier MDL RDL Dilution Analysis Batch Analyle mg/I mgll mg/I date/time Acrolein U 0.00887 0.0500 1 11115/201917:46 WG1381078 Acrylonilhle U 0,00187 0.0100 1 11/15/201917:46 WG1381078 Benzene U 0.000331 0.00100 1 11/15/201917.46 WG1381078 Biamodichloromethane U 0.000380 0.00100 1 11/15/201917:46 WG1381078 t. Bramoform U 0.000469 0.00100 1 11I15I201917:46 WG1381078 Bromomelhane U 0.000866 0.00500 1 11/151201917:46 WG1381078 Carhop tetrachloride U 0.000379 0.00100 1 11/15/201917:46 WG1381078 61orobenzene U 0.000348 0.00100 1 11/15/201917:46 WG1381078 Chlorodibromomethane U 0.000327 0.00100 1 11/151201917:46 WG1381078 61oroethane U 0,000453 0.00500 1 11/15/201917:46 WG1381078 2-Chloroethyl vinyl ether U 0.00301 0.0500 1 111151201917:46 WG1381078 Chloroform U 0.000324 0.00500 1 11/15/201917:46 WG1381078 Chloromelhane U 0.000276 0.00250 1 111151201917:46 WG1381078 I2-0ichlorobenzene U 0.000349 0.00100 1 11/15/201917:46 WG1381078 1,3-Dichlorobenzene U 0.000220 0,00100 1 111151201917:46 WG1381078 1,4-Dichlorobenzene U 0.000274 0.00100 1 fl/75I201917:46 WG1381076 61chlorodi0uoromethane U 0.000551 0.00500 1 1115/201917:46 WG1381078 1,1-Dichloroethane U 0.000259 0,00100 1 111151201917:46 WC31381078 1,2-Dichloroethane U 0,000361 0.00100 1 11,151201917:46 WG1381078 1,7-Dichloroethene U 0000398 0.00100 1 111151201917:46 WG1381078 trans-1,2-Dichloroethene U 0.000396 0.00100 1 11/15/2019 17:46 WG1381078 1,2-Dichloropropane U 0.000306 0.00100 1 11115/201917:46 WG1381078 cis-1,3-Dichlorapromru U 0,000418 0.00100 1 IV15/201917.46 WG1381078 trans-1,3-Dichloropropene U 0.000419 0,00100 1 11115/201917:46 WG1381078 Ethylbenzene U 0.000384 0,00100 1 11/15/201917:46 WG1381078 Methylene Chloride U 0.00100 0.00500 1 111151201917:46 WG1381078 1,1,2,2-Telamh1oroetIi U 0.000130 0,00100 1 11/15/201917:46 WG1381078 Telrachloroethene U 0.000372 0.00100 1 11/15/201917:46 WG1381078 Toluene U 0,000412 0.00100 1 1111SY201917:46 WG1381078 1,1,1-Trichloroethane U 0.000319 0.00100 1 11/15/201917:46 WG1381078 1,1,2-Trichloroethane U 0.000383 0,00100 1 11115/201917:46 WG1381078 Trichloroethene U 0.000398 0.00100 1 111151201917:46 WG1381078 Trichloro8uoromethane U 0.00120 0.00500 1 11115/201917:46 WG1381078 Vinyl chloride U 0.000259 0.00100 1 11115/201917:46 WG1381078 (S) Toluene-tl8 96.4 80.0-720 71/15/2D19 17:46 WG1381078 (S) 4-Bromolluorobenzene 99.0 80.0-120 1111512019 17.46 WG1381078 /SJ 1,2-Dichloroethone-tl4 93.7 70.0-130 1111512019 17.46 WG1381078 ACCOUNT: PROJECT: SOG: DATErIME: PAGE: Eaton Corporation 28091-R L1159977 11h9/1917:21 5 of 22 2019-11-12-005 Collected dateltime: 11/12119 09:15 Pesticides (GC) by Method EPA 608.3 SAMPLE RESULTS - 01 L1159977 Result Qualifier MDL RDL Dilution Analysis Batch Analyse mg/I mall mall date 71in1e Aldrin U 0.00000813 0.0000500 1 111171201913:09 WG1379964 Alpha BHC U 0.0000166 0,0000500 1 11/17/201913:09 WG1379964 Bela 3HC U 0,0000184 0.0000500 1 11I17/201913:09 WG1379964 Delta BHC U 0.0000197 0,0000500 1 11/17/201913:09 WG1379964 Gamma BHC U 0.0000176 0.0000500 1 11/17/201913:09 WGI379964 Chlordane U 0.0000977 0.000500 1 11/17/201913:09 WG1379964 4,4-DDD U 00000170 00000500 1 11/17/201913:09 WG1379964 44-DDE U 00000164 00000500 1 111171201913:09 WG1379964 4,4-DDT U 0.0000177 0.0000500 1 IIJ17/201913.09 WG1379964 Dlcldnn U 000000751 0.0000500 1 11/17/201913:09 WG1379964 EndosulkmI U 00000179 0.0000500 1 11/17/201913:09 WG1379964 Eldosulrnn II U 0.0000176 0.0000500 1 11/17/201913'.09 WGI379964 Pndosulfan sulfate U 00000196 00000500 1 11/17/20191309 WG1379964 Endrin U 0.0000189 0.0000500 1 11/17/201913,09 WG1379964 Endrin aldehyde U 0.0000142 0.0000500 1 11/17/201913:09 WGI379964 6ndrin ketone U 00000170 0.0000500 1 11/17/201913:09 WG1379964 Heptachlor U M000108 0,0000500 1 11/17/201913:09 WG1379964 Heptachlor epoxide U 0,0000175 0.0000500 1 11/17/201913:09 WG1379964 Hexachlorobenzene U 00000134 0,0000500 1 11/17/201913:09 WG1379964 Methoxychlor U 0.0000193 0,0000500 1 11117/201913:09 WG1379964 Toxaphene U 0.000168 0,000500 1 11117/201913:09 WGI379964 (S) Decochlo(obiphenyl 29.8 10.0-144 11117120191309 W3I379964 (S)Tatrochloro-m-rylene 60.1 10,0135 111171201913:09 WG1379964 Polychlorinated Biphenyls (GC) by Method EPA-608.3 Result Qualifier MDL RDL Dilution Analysis Balch Analyte mg/I mg/I mg/I date/time PCB 7016 U 0.000100 0.000500 1 11/14/2019 05:02 WGI379964 PC81221 U 00000730 0.000500 1 11/14/201905:02 WG1379964 PCB 1232 U 00000420 0.000500 1 11/14/201905:02 WG1379964 PCB 1242 U 00000470 0.000500 1 11/14/2019 05:02 WGI379964 PCB1248 U 0.0000860 0.000500 1 11114/201905:02 WGI379964 PCB1254 U 0.0000470 0.000500 1 11/14/201905.02 WG1379964 PCB1260 U 0000120 0.000500 1 T/14/201905:02 WG1379964 (S)Occachlorobiphenyl 354 70.0144 111141201905.02 WG1379964 (S)Telrochloro-m -rylene 715 100-135 111141201905.02 WG1379964 Semi Volatile Organic Compounds (GC/MS) by Method 625.1 Result Qualifier MDL RDL Dilution Analysis Batch Analyte mg/I moll ni date/time Acenaphthene U 0.000316 0.00100 1 11/18/201900:37 WGI382031 Acenaphthylene U 0000309 0.00100 1 11/181201900:37 WG1382031 Anthracene U 0000291 0,00100 I 11/18/201900:37 WG1382031 Benzidine U 0.00432 0.0100 1 11118/201900:37 WG1382031 Ben7o(a(anthracene U 0.0000975 0.00100 1 11/18/201)00:37 WG1382031 Ben2o(b)fluotanthene U 0.0000896 0.00100 1 11/18/201900:37 WG1382031 Benzo(krluoranthene U 0.000355 0.00100 1 11/18/201900:37 WG1382031 Benzo(g,h,i)perylene U 0.000161 0.00100 1 11/181201900.37 WG1382031 Benzo(a)pyrene U 0000340 0,00100 1 11118/201900:37 WG1382031 Bls(2-dllorethoxy)metharie U 0,000329 0,0100 1 11/18/201900:37 WG1382031 Bis(2-chloroethyl)ether U 0.00162 0.0100 1 11/18/201900:37 WG1382031 Bis(2-chlorolsopropyllethei U 0000445 0.0100 1 11/18/2019 00:37 WG1382031 4-Bromophenyl-phenylether U 0000335 0.0)00 1 11/18/201900:37 WG1382031 2-21-loronaphthalene U J4 0.000330 0.00100 1 11/18/201900:37 WG1382031 4-Chlorophenyl-phenylether U 0.000303 0,0100 1 11/18/201900:37 W61382031 ONE LAB, NATIONWIDE. ACCOUNT: PROJECT: SDG: DATEFIME: Eaton Corporation 28091-R L1159977 11/1971917:21 PAGE: 6 of 22 2019-11-12-005 SAMPLE RESULTS - 01 ONE LAB. NATIONWIDE. Collected dale/time: 11/12119 09:15 L1159977 Semi Volatile Organic Compounds (GC/MS) by Method 625.1 Result Oualifer MDL RDL Dilution Analysis Batch Analyte mgll mgll mg/I date/time Chrysene U 0.000332 0.00100 1 11/18/201900:37 WG1382031 Dibenzla,hlanthmcene U 0000279 0,00100 1 11/18/201900:37 WG1382031 3,3-Dichlorobenzidine U 0.00202 0.0100 1 11/18/201900:37 WG1382031 24-Dinitrotoluene U 000165 0,0100 1 11/181201900:37 WG1382031 2,6-Dinihotoluene 11 0.000279 0.0100 1 11/18/201900:37 WG1382031 1,2-Diphenylhydrazine U 0.000318 0.0100 1 11118/201900:37 WG1382031 Fluoranthene U 0.000310 0.00100 1 11118/201900:37 WG1382031 Fluoiene U J4 0.000323 0.00100 1 11/18/201900:37 WG1382031 Hexachlorobenzene U 0000241 0,00100 1 11/18/201900:37 WG1382031 Nexachloro-13-butadlene U 0.000329 0.0100 1 11/18/201900:37 WG1382031 I-exachlorocyclopentadiene U 0.002.33 0.0100 1 11/181201900:37 WG1382031 llexachloroethane U 0,000365 0,0100 1 11/18/201900:37 WGI382031 Indenol1,2,3-cdlpyrene U 0.000279 0.00100 1 11/18/201900:37 WG1382031 Isophorone U 0.000272 0.0100 1 11/18/201900:37 WG1382031 Naphlhalene 0 U 0.000372 0.00100 1 11/18/201900:37 WG1382031 Nitrobenzene U 0.000367 0.0100 1 111181201900:37 WG1382031 n n1Nhosodimethylamine U 0.00126 0.0100 1 W18/201900:37 WG1392031 n-Nitrosodiphenylamine U 0,00119 0,0100 1 11/18/201900*37 WG1382031 ri Nilrosodi-n-propylamine U 0.000403 0,0100 1 111181201900:37 WG1382031 Phenanthrene U J4 0.000366 0.00100 1 11/18/201900:37 WG1382031 Benzylbutyl phthalate U 0.000275 0.00300 1 1111812019 00:37 WG1382031 11 6isl2-ethylhexy1phthalate U 0.000709 0.00300 1 11/18/2019 00 37 WG1382031 Di-n-butyl phthalate U 0.000266 0.00300 1 111181201900:37 WG1382031 Diethyl phthalate U 0,000282 0,00300 1 111181201900:37 WG1382031 Dlmethyl phthalate U 0.000283 0,00300 1 11/18/201900*37 WG1382031 Di-noctyl phthalate U 0.000278 000300 1 11118/201900:37 WG1382031 Pyrene U 0.000330 0.00100 1 IIA8/201900:37 WG1382031 1,2,4-Trichloroben2ene U (1000355 0.0100 1 11/18/201900:37 WG1382031 4-610ro-3-methylphenel U 0.000263 0.0100 1 11/18/201900:37 WG1382031 2-Chlorophenol U 0.000283 0.0100 1 11118/201900:37 WG1382031 2,41chlorophenol U 0.000284 0.0100 1 1IM8/201900:37 WG1382031 2,4-Dimethylphenol U 0.000624 0,0100 1 11/18/201900:37 WG1382031 4,6-Dinitro-2-methylphenoi U 0.00262 0.0100 1 11118001900:37 WG1382031 2,4initrophenol U 0.00325 0.0100 1 11/18/201900:37 WG1382031 2-Nifophenol U 0.000320 0.0100 1 11118/201900:37 WG1382031 4-Nihophenol U 0.00201 0.0100 1 11A81201900:37 WG1382031 Pentachlorophenal U 0.000313 0.0100 1 11118/201900:37 WG1382031 Phenol 0.00269 1_ 0.000334 0,0100 1 11A8/201900:37 WG1382031 2.4,6-Trichlorophenol U 0.000297 0.0100 1 11/18/201900:37 WG1382031 (S)2-Fluorophenol 39.7 10.0-120 ID781201900.37 WG1382031 (S�Phenol-d5 270 8.00-424 1081201900.37 WG1382031 (S) Nitrobenzene-d5 49.7 15.0-314 1171181201900.37 WG1382031 (5/2-Fluorobiphenyl 60.6 22.0-127 111181201900.37 WG1382031 /S)2,4,6-Tribromophen01 66.0 10.0-153 111181201900.37 WG1382031 (S p-Terphenybd14 74.0 29.0-141 111181201900:37 WG1382031 ACCOUNT: PROJECT: SIDE: DATE/TIME: PAGE: Eaton Corporation 28091-R L1159977 11A9/1917:21 7 of 22 WG1380199 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Grovimetric Analysis by Method 2540 D-2011 L1159977-01 Method Blank (MB) (M B) R3471939-1 11/14/19 01:11 MB Result MB Qualifier MB MDL MB ROL Analyte mg/l mg/I mg/1 .......olids.0..-___ Suspended Solids U 0.350 2.50 L1159972-02 Original Sample (OS) • Duplicate (DUP) (OS) L1159972-02 11/14/19 01.11 • (DUP) R3471939-3 11/14/19 01:11 Original Result OUR Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte mg/I mg/I % % Suspended Solids 15.2 Is 0.000 S ' L1159986-01 Original Sample (OS) • Duplicate (DUP) (OS) L1159986-01 11/14/19 01:11 • (DUP) P3471939-4 11/14/19 0111 -- - - Original Result DUP Result Dilution OUR RPD DUP Qualifier DUP RPD Limits Analyze mg/I mg/I % % Suspended Solids ND 0.000 1 0.000 5 Laboratory Control Sample (LCS) (LCS) R3471939-2 11/14/19 01.11 -- Spike Amount LCS Result LCS Rea. Rec, Limits LCS Qualifier Analyte mg/I mg4 % % - ____-. ___________ ____..____-_ ------ _______________ --- -- ------ _.___-.__.__ _____________ ___ _____m_ '__. Suspended Solids 7L.804 iO4 850-ii5 — - - ----------_.____._ ______. Cp 17-71 TC 3Ss aCn SSr 7GI FAI Sc ACCOUNT: PROJECT: SDG: DATE/TIME PAGE. Eaton Corporation 28091-R L1159977 11/19/1917'. 21 8 of 22 WG1382689 QUALITY -_CONTROL SUM.MARY__ _- _ ,- -- -- -- _- ONE LAB. NATIONWIDE -- _ - -Wet -Chemistry-tiy�Method 1664B`'-' - - "' -- - _ ---- - - — — - L1159977-01 -- --- - - Method Blank (MB) (MB) R3473405-1 11/18/19 2000 MB Result Analyte m TPH - Oil 8 Grease U MB Qualifier MB MDL MB RDL 0.725 5.00 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LCS) R3473405-2 11/18/19 20:00 • (LCSD) R3473405-3 11/18/19 20:00 Spike Amount LCS Result LCSD Result LCS Rec. LCSD Rec. Rec Limits LCS Qualifier LCSD Qualifier RED RED Limits Analyte mg/I mg/I mg/I % % % % % TPH-Oil B Grease 20.0 14.2 14.8 71.0 74.0 64.0-132 4.14 34 ACCOUNT: PROJECT: SDG: Eaton Corporatlon 28091.R L1159977 DATEMM6 11/19p917:21 PAGE: 9 of 22 WG1380956 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE, Metals LCP) by Method 200.7 L1159977-01 Method Blank (MB) (MB) R3472985-1 11/17/19 19:34 MB Result MB Qualifier M8 MDL MB RDL Analyte mg/I mg/I ri Copper U 000700 0.0100 Lead U 000200 0.00500 Zinc U 0.00340 0.0500 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LCS) R3472985-2 11/17/1919:37 - (LCSD) R3472985-3 11/17/19 19:39 Spike Amount LCS Result LCSD Result LCS Rec. LCSD Rec. Rec. Limits LCS Qualifier LCSD Qualifier RPD RPD Limits Analyte mg/I mg4 mg/I __-_-__--______ % as % % % .___-__________- Copper 1.00 1.00 103 100 ___________ 103 __-____________ B5.0-115 ____-__-____________�_.______ 2.24 _ -----. 20 Lead 1L00 Tor T02 101 102 85.0-115 1.35 20 Zinc 1.00 0.994 i.01 994 lot 85.0-ii5 M. 20 L1159083-01 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD) (OS) L1159083-01 11/17/19 19:42 - (MS) R3472985-5 11/17/19 19:47 - (MSD) R3472985-6 11/17/1919:50 Spike Amount Original Result MS Result MSD Result MS Rec. MSD Rec Dilution Rec. Limits MS Qualifier MSD Qualifier RPD RPD Limits Analyze mg/I ii ri mg/I % % % % % Copper 1.00 00328 1.08 1.06 105 105 - 1 70.0-130 6751 20 Lead Loo ND 1.04 1.04 104 104 1 70.0-130 0.223 20 Zinc 1.00 0.0595 1.07 1.06 101 100 1 70.0-130 0581 20 L1159921-01 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD) (OS) L1159921-01 11/17/19 19:52 - (MS) R3472985-7 11/17/19 19:55 - (MSD) R3472985-8 11/17/19 i9:57 Spike Amount Original Result MS Result MSD Result MS Roo. MSD Rec. Dilution Rep. Limits MS Qualifier MSD Qualifier RPD RPD Limits Analyte mg/I mg/I mgP ri % % % % % Copper 1.00 0.0302 1.03 1.02 99.8 99.5 1 70.0-130 0.327 20 Lead 1.00 0.00405 L01 1,00 100 99.8 1 70.0-130 0.491 20 Zinc 100 0.221 Ms 1.17 957 95.3 1 70.0-130 0.295 20 ACCOUNT: PROJECT. SDG: DATE/TIME, PAGE: Eaton Corporation 28091-R LTS9977 11/19/191721 10 of 22 WG1381078 QUALITY_ CONTROL SUMMARY _ -,__ _ _ -ONE LAB., NATIONWIDE., -: - = - Volatile Organic -Compounds (GC/M5) by Method 624.1 L1159977-01 Method Blank (MB) Cp (MB) R3472534-2 iV15/191234 MB Result MB Qualifier MB MDL MB RDL Analyte mg/I MO mg/I ITC] Acrolem Acrylonitrile U U 0,00887 0.00187 0.0500 0.0100 a$5 Benzene U 0.000331 0.00100 Bromodichloromethane U 0.000380 0.00100 a Bromoform U 0.000469 0.00100 Cn Bromomethane Carbon tetrachloride U U 0.000866 0.000379 0.00500 0.00100 s Sr Chlorobenzene U 0.000348 0.00100 Chlorodibromomethane U 0.000327 0DOM Chloroethane U 0.000453 0.00500 2-Chloroethyl vinyl ether Chloroform U U 0.00301 0.000324 0.0500 0.00500 7GI Chloromethane U 0.000276 0.00250 1,2-Dichlorobenzene U 0.000349 0.00100 1,3-Dichlorobenzene U 0,000220 0.00100 [Al 14-Dichlorobenzene Dichlorodifluoromethane U U 0.000274 0.000551 0.00100 0.00500 9 Sc 1,1-Dichloroethane U 0.000259 0.00100 1,2-Dichloroethane U 0.000361 0.00100 1,1-Dichloroethene U 0.000398 0.00100 trans-LbDichloroethene U 0.000396 0.00100 1,2-Dichloropropane U 0.000306 0.00100 cis-1,3-Dichloropropene U 0.000418 0.00100 Ira ns-1,3-Dichloropropene U 0.000419 0.00100 Ethylbenzene U 0.000364 0.00100 Methylene Chloride U 0.00100 0.00500 1,1,2,2-Tetrachloroethane U 0.000130 0.00100 Tetrachloroethene U 0.000372 0.00100 Toluene U 0.000412 OA0100 1,1,1-Trichloroethane U 0.000319 0.00100 1,1,2-Trichloroethane U 0.000363 0LD= Trichlaraethene U 0.000398 0.00100 Trichlorofluoromethane U 0.00120 0.00500 Vinyl chloride U 0.000259 0.00100 (S) 7oluene-d8 91.9 80.0-120 (S)1,2-Dichloroelhone-tl4 95.8 70.0-130 (S)4-Bromolluorobenzene 91.8 80.0-120 ACCOUNT: PROJECT: BUG: DATEITIME: PAGE: Eaton Corporation 28091-R 1,7159977 11/1911917:21 11 of 22 WG1381078 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Volatile Organic Compounds (GC/MS) by Method 624.1 L1159977-01 Laboratory Control Sample (LCS) (LCS) R3472534-1 11/15/19 1154 Spike Amount LCS Result LCS Rec. Rea. Limits LCS Oualifier Analyte moll moll % % Acrolein 0,0250 0.0262� 705 60.0-140� Acrylonitrile 0.0250 0.0255 102 60.0-140 Benzene 000500 0.00520 104 65.0-135 Bromodichloromethane 000500 0.00510 102 700-135 Bromoform 000500 0.00448 89.6 70.0-130 Bromomethane 000500 0,00662 132 150-185 Carbon tetrachloride 0.00500 0,00519 104 70C-130 Chlorobenzene 0.00500 0,00481 96.2 65.0-135 Chlorodibromomethane 0.00500 0.00472 944 70.0-135 Chlomethane 0.00500 0.D0531 106 40.0-160 2-Chloroethyl vinyl ether 0,0250 0,0403 161 0,100-225 Chloroform 0,00500 0.00483 96.6 700-135 Chloromelhane 000500 0.00522 104 0100-205 1,2-Dichlorobenzene 000500 0.00503 101 65.0-135 1,3-Dichloroben2ene 000500 000493 98.6 70.0-130 1,4-Dichlorobenzene 0,00500 0.00505 101 65.0-135 Dichlorodifluorome'hane 0.00500 0.00580 116 490-155 71-0lchloroethane 0.00500 0.00514 103 70.0-130 1,2-Dichloroethane 0,00500 000495 99.0 70.0-130 1,1-Dichloroethene 0.00500 0,00539 108 50.0-150 trans-1.2-Dichloroethene 0.00500 How 102 700--130 1,2-Dichloropropane 0.00500 0.00507 101 35.0-165 cis-1,3-Dlchloropropene 0.00500 0.00509 102 25.0-175 trans-13-Dichloroprepene 0.00500 000455 91.0 50.0-150 Ethylbenzene 0.00500 0,00478 95.6 60.0-140 Methylene Chloride 0,00500 0.00498 99.6 60.0-140 1,122-Tetrachloroethane 000500 0.00499 99.8 60.0-140 Tetrachloroethene 000500 0.00523 IDS 700-130 Toluene 000500 0.00477 954 700-130 1,1,i-Trichloroethane 0.005D0 0,00537 107 70.0-130 1,1.2-Trichloroethane 0.00500 0.00504 101 70.0-130 Trichloroethene 0-00500 0.00549 110 65-0-135 Trichlorofluoromethane 0,00500 0.00581 116 50-0-150 Vinyl chloride 0.00500 0,00538 108 5,00-195 (S) Toluene-d8 Sara 80.0-120 (S)12-Dichloroethone-d4 98.9 70.0-730 (S)4-Bromofluorobenzene 952 90.0-120 ACCOUNT: PROJECT: SDG: DATE/TIME' Eaton Corporation 28091-R L1159977 11/19/19 17 21 ?AGE: 12 of 22 WG1379964 QUALITY_C_ ONTROL SUMMARY ONE LAB. NATIONWIDE. _*.:- ---PestlU des (GO)=by MetfibdEPA 608:3--- - "' - - L776997741 Method Blank (MB) (MB) R3473032-1 IV17/1912:07 MB Result MB Qualifier MB MDL MB RDL Analyte mg4 mgA mg/I Aldrin U 0.00000913 0.0000500 Alpha BHC U 0.0000166 0.0000500 Beta BHC U 0.0000184 0,0000500 Delta BHC U 0.0000197 0.0000500 Gamma BHC U 0.0000176 0.0000500 4.4-DDD U 0.0000170 0.0000500 4.4-DDE U 0.0000164 0.0000500 4.4-DDT U 0.0000177 0.0000500 Dieldrin U 0.00000751 0.0000500 Endosulfan I U 0.0000179 0.0000500 Endosulfan 11 U 0.0000176 0.0000500 Endosulfan sulfate U 0.0000196 0.0000500 Endrin U 0.0000189 0.0000500 Endrin aldehyde U 0.0000142 0.0000500 Endrin ketone U 0.0000170 0.0000500 Heptachlor U 0.0000108 0.0000500 Heptachlor epoxide U 0.0000175 0.0000500 Hexachlorobenzene U 0.0000134 0,00D0500 Methoxychlor U 0.0000193 0,0000500 Chlordane U 0.0000977 0.000500 Toxaphene U 0.000168 0,000500 (S) Decochlorobiphenyl 32.1 10 0-744 (S)Tetrochloro-m-xylene 82.9 10.0-135 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LCS) R3473032-2 Analyze 11/17/19 12:19 • (LCSD) R3473032-3 Spike Amount LCS Result mg/l mgll 11/17/19 12:32 LCSD Result mgA LCS Rec. % LCSD Rec. % Rec. Limits % LCS Qualifier LCSD Qualifier RPD % RED Limits % Aldrin 0.00100 0.000815 0.000700 8L5 70.0 42.0-140 15.2 35 Alpha BHC 0.00100 0.000913 0,000890 91.3 89.0 37.0-140 2.55 36 Beta BHC 0.00100 0,000902 0,000815 90.2 81.5 1T0-147 10.1 44 Delta BHC 0.00100 0.000930 0.000886 93.0 88.6 19.0-140 4.85 52 Gamma BHC 0.00100 0.000860 0,000S50 86.0 85.0 32.0-140 1.17 39 4,4-DDD 0.00100 0.000834 0.000833 83.4 83.3 31.0-141 0120 39 4,4-DDE 0.00100 0.000879 0.000806 87.9 8D.6 30.0-145 6.66 35 4,4-DDT 0.00100 0.000816 0.000718 8L6 71.8 25.0-160 12.8 42 Dieldrin 0,00100 0.000932 0.000897 93.2 89.7 36.0-146 3.83 49 Endosulfan 1 0.00100 0.000882 0.000904 88.2 90.4 45.0-153 2.46 28 ACCOUNT: PROJECT: SEC: DATEMME: PAGE: Eaton Corporation 28091-R L1159977 11/19/1917:21 13 of 22 WG1379964 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Pesticides (GC) by Method EPA 608.3 L1159977-01 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LL5) H34/3U32-2 11/1//1912:19 • (LCSU) R3473032-3 Spike Amount LCS Result Analyte mg/I mg/1 11117/1912,32 LCSD Result mg/I LCS Rec. % LCSD Rec. % Rec. Limits % Endosulfan ll 0.00100 0,000975 0000947 975 947i 1.00-202 Endosulfan sulfate 0.00100 0.00102 0.000965 102 96.5 26.0-144 Endrin n.00100 0.000901 0-000867 901 857 30.0-147 Endrin aldehyde 0,00100 000884 0,000851 884 851 56.0-128 Endrin ketone 0,00i00 0,000929 0.000893 92.9 89.3 54.0-142 Heotachlor 0.00i00 0.000818 0.000685 81.8 68.5 34.0-140 Heotachlor epoxide 0.00100 0.000977 0.000978 977 97.8 370-142 Hexachlorodenzene 0,00100 0.000781 0.000707 78.1 70.7 35.0-120 P6ethoxychlor 0,00i00 0.000^95 0.000766 89.5 76.6 440-160 (S) Demchlorobiphenvl 3a8 27.1 10.0-144 (5) 7etrochloro-m-xylene 84.2 73.7 10.0-135 LCS Oualifier LCSD Oualifier RPD RPD Limits 2.91 53 5.54 38 3.85 48 3.80 20 3.95 20 173 43 0.102 26 9.95 25 15.5 22 ACCOUNT: Eaton Corporation PROJECT: 28091-R SDG: DATE/TIME. L1159977 11/19/19 17:21 PAGE: 14 of 22 WG1379964 QUALITY CONTROL-S-UMMARY_ ONE LAB. NAnoNwIDE._:�:_ = =- Polychlorinated-Blphenyls-(GC) by -Meth ad EPA-608 3 L1159977-01 Method Blank (MB) Cp (M B) R3471820-1 11/14/19 02:45 MB Result MB Qualifier M8 MDL MB RDL Analyte mg/I mg/I mg/I PC PCB 1260 U 0.000120 PCB 1016 U 0.000i00 0,000500 0.000500 3 SS PCB 1221 U 0.0000730 0.000500 PCB 1232 U 0.0000420 0.000500 a PCB 1242 U 0.0000470 0.000500 Cn PCB 1248 U 0.0000860 PCB 1254 U 0.0000470 0.000500 0.000500 s$r (S) Decochlorobrphenyl 34.1 10.0-144 (S) Tetrochloro-m-xylene 84.4 10.0-135 • Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) 7GI (LCS) R3471820-2 11/14/19 02:58 - (LCSD) R3471820-3 11/14/19 03:10 Spike Amount LCS Result LCSD Result LCS Rec. LCSD Rea. Rec. Limits LCS Qualifier LCSD Qualifier RPD RPD Limits VAI Analyte mg/1 mg/I mg/1 % % % % % PCB 1260 0.00250 0,00203 0.00168 K2 75.2 8.00-140 Z67 38 9 PCB 1016 0.00250 0,00247 0.00209 98.8 83.6 50.0-140 16.7 36 SC (S) Decochlorobiphenyl 19.7 26.0 10.0-144 (S)Tetrochloro-m-xylene 89.9 75.3 10.0-135 ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Eaton Corporation 28091-R L1159977 11/19/1917:21 15 of 22 WG1382031 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Semi Volatile Organic Compounds (GC/MS) by Method 625.1 L1159977-01 Method Blank (MB) (MB) R3473013-2 11/18/i9 00:26 MB Result MB Qualifier MB MDL MB RDL Analyte mg/I mg/I ni Acenaph[hene U 0.000316 0.00100 Acenaphthylene U 0.000309 0.00100 An;hracene . U 0.00029i 0.00100 Azobenzene U 0.0003i8 0.0100 Benzidine U 0.00432 0.0100 Benzo(a)anthracene U 0.0000975 0.00100 Benzo(b)fluoranthene U 0.0000896 0.00ioo Benzo(k)flucranthene U 0,000355 0.00100 Benzo(g,h.)perylene U 0.000161 0.00100 Beozo(a)pyrene U 0.000340 0.00100 31s(2-chlDfethDXy)mI U 0,000329 00100 Bis(2-chloroethyl)ether U 0,00162 00100 Bis(2-chlorolsopropyl)ether U 0-000445 0,0100 4-Bromophenyl-phenylether U 0,000335 0.0100 2-Chloronaphbhaleme U 0.000230 0.00i00 4-Chlomohenyl-ohenylether U 0.000303 0.0100 Chrysene U 0.000332 0,00100 Dibenz(a,h)anthracene U 0.000279 0,00100 3,3-Dichlorobeozidine U 0.00202 0-0100 2.4-Dinitrotoluene U 0,00165 0,0100 2,6-Dinitrotoluene U 0.000279 0,0100 Fluoranthene U 0.000310 0,00100 Fluorene U 0.000323 0.00i00 Hexachlerobenzene U 0.000341 0.00100 Hexachloro-1,3-butadiene U 0,000329 0,0100 Hexachlorocyclopen,adiene U 0,00233 00100 Hexachloroethane U 0,000365 0.0100 I nde n o(1,2,3-cd) pyre no U 0.000279 0 MOO Isophorone U 0.000272 C MOO Naphthalene U 0.000372 0.00100 Nitrobenzene U 0.000367 0.0100 n-Nitrosodimethylamine U 0.00126 0.0100 n-Nitrosodiphenylamine U 0.00119 0.0100 n-Nitrosodi-n-propylarrine U 0.000403 0.0100 Phenanthrene U 0.000366 0.001o0 Benzylbutyl phmalate U 0,000275 0,00300 Bis(2-ethyl hexyl)phthalate U 0.000709 0,00300 Di-n-butyl phthalate U 0.000266 000300 Gelhyl phthalate III 0.0002R2 0.00300 Dial phthalate U 0,000283 0.00300 ACCOUNT: PROJECT: SDG: DATEFIMEPAGE: Eaton Corporation 28091-R L1159977 1V19/1917: 21 16 o.-22 WG1382031 QUALITY-CONTRQL_S.UMMARY_, _- __- ONE LAB; NATIONWIDE. -- -Semi Volatile. Orga nip -Compounds (GC/MS) by Method 625.1 L1159977.01 Method Blank (MB) (MB) R3473013-2 IV18/19 00:26 MS Result Analyte Mich Di-n-octyl phthalate U Pyrene U 1,2,4-Trichlombenzene U 4-Chloro-3-methylphenol U 2-Chorophenol U 2,4-Dichlorophenol U 2,4-Dimethylphenol U 4,6-Dinitro-2-methylphenol U 2,4-Dinitrophenol U 24trophenol U 4-Nitrophenol U Pentachiorophenol U Phenol U 2,4,6-Trichlorophenol U (S)Nwobenzene-d5 4D (S) 2-Fluorobiphenyl 50.7 (S)p-Terphenyl-d14 58.2 (S)Phenol-d5 22.2 (S) 2-Fluorophenol 34.3 (S) Z4.6-Tabromophenol 40.8 MB Qualifier Laboratory Control Sample (LCS) MB MDL ri 0.000278 0.000330 0.000355 0.000263 0.000283 0,000284 0.000624 0.00262 0.00325 0.000320 0.00201 0.000313 0.000334 0.000297 MB RDL ri 0.00300 0.00100 0.0100 0.0100 0.0100 0.0100 0.0100 0.0100 0.0100 0.0100 0.0100 0.0100 0.0100 0.0100 15.0-314 12.6127 29.0-141 8.00-424 10.0-120 10.0-153 (LCS) R3473013-1 11/18/19 00:06 Spike Amount Analyte mg/I LCS Result mg11 LCS Rep. % Red Limits LCS Qualifier % Acenaphthene 0.0500 00255 51.0 47.0-145 Acenaphthylene 0.0500 0,0271 54.2 33.0-145 Anthracene 0.0500 0.0274 54.8 27.0-133 Azobenzene 0.0500 0,0289 57.8 37.0-125 Benzicine 0.100 0,0374 374 1.00-120 Benzo(a)anthracene 0.0500 0,0272 54.4 33.0-143 Benzo(b)0uoranthene 0.0500 0.0287 57.4 24.0-159 Benzo(k)fiuoranthene 0.0500 0.0282 56.4 li.0-162 Benzo(g,h i)perylene 0.0500 0.0273 54.6 1,00-219 Benzo(a)pyrene 0,0500 0.0299 59.8 17.0-163 Bis(2-chlorethoxy)methane 0,0500 0.0244 48.8 00-219 Bis(2-chloroethyl)ether 0.0500 0.0254 50.8 33.0-185 Bis(2-chloroisopropyl(ether 0.0500 0.0252 50.4 36.0-166 ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Eaton Corporation 28091-R L11599T 11/1911917:21 17 of 22 WG1382031 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Semi Volatile Organic Compounds (GC/MS) by Method 625.1 L1159977-01 Laboratory Control Sample (LCS) (LCS) R3473013-1 11/18/19 00:06 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Oualifier Analyte mg/1 mg/I % % 4-Bromophenyl-phenylether 0.0500 _ __ --- 0.0270 _____ 54.0 53.0-127 2-Chloronaphthalene 0.0500 0.0266 51,2 60.0-12D J4 4-Chlorophenyl-phenylether 0.0500 0,0264 52.8 25.0-158 Chrysene 0.0500 0.0276 55.2 17.0-168 Dibenz(a,h)anthracene 0.0500 0.0270 54.0 1.00-227 3,3-Dichlorobenzidine 0,100 0.0539 53.9 1.00-262 2,4-Dinitrotoluene 0.0500 0.0273 54.6 39.0-139 46-Dimnotoluene 0,0500 0.0263 52.6 50.0-158 Fluoranthene 0.0500 0.0269 53.3 26.0-137 Fluorene 00500 0,0274 54.8 59.0-121 J4 Hexachlorobenzene 0,0500 0.0252 504 1.00-152 Hexachloro-T3-butadiene 0,0500 0.0214 42.8 24.0-120 Hexachlorocyclopentadiene 0.0500 0.0193 38.6 10.0-120 Hexachloroethane 0.0500 0,0234 46.8 40.0-120 Indeno(I,2,3-cd)pyrene 0.0500 0.0266 53.2 T00-17i Isophorone 0.0500 0.0250 50.0 21.0-196 Naphthalene 0.0500 0.0229 45.8 21.0-133 Nitrobenzene 0,0500 0.0244 48.8 35.0-180 n-Nitrosodimethylamine 0,0500 0,0218 43.6 10 D-120 n-Nitrosodiphenylamine 0.0500 0.0278 55.6 440-120 n-Nitrosodi-n-propylamine 0.0500 0.0276 552 100-230 Phenamhrene 0.0500 0,0263 53.6 540-120 J4 Benzylbutyl phthalate 0.0500 0,0288 5T6 i.00-152 Bis(2-ethylhexy1)phth8late 0.0500 0,0284 56.8 800-i58 Di-n-butyl phthalate 0.0500 0,0305 610 1.00-120 Diethyl phlhalate 0,0500 0.0285 5T0 1.00-120 Dimethyl phlhalate 0.0500 00276 55.2 1.00-120 Di-n-octyl phthalate 0,0500 0.0252 504 4.00-146 Pyrene 0.0500 0.0284 56.8 52.0-120 i,2,4-Trichlorobenzene 0,0500 0.0220 440 44.0-142 4-Chloro-3-methylphenol 0.0500 0.0246 49 2 22.0-147 2-Chlorophenol 0,0500 0.0252 504 230-134 24-Dichlorophenol 0.0500 0,0245 49.0 39.0-135 24-Dlmethylphenol 0.0500 0,0244 48.8 32.0-120 4,6-Dinitro-2-methylphenol 0.0500 U255 51.0 1.00-181 24-Dlnitrophenol 0.0500 0.0252 504 i.00-191 2-Nitraphenol 0,0500 0.0249 49.8 29.0-182 4-Nitrophenol 0.0500 0.0124 24.8 1.00-132 Pentacnlorephenol 0.0500 0.:238 476 14 n_175 Phenol 0.0500 0.D121 242 5.00-120 ACCOUNT: PROJECT: SDG: CAT E/TIMP PAGE: Eaton Corporation 28091-R L1159977 11/19/1917:21 18 of 22 _WG1382031 _ _ _ _, = QU.ALITY-CONT_RO,L-.SUMMARY- _. -_ _ -- --ONE LAB., NATIONWIDE-_ ._ Semi Volatile Organic Compounds (GC/MS) by Method 625.1 L1159977-01 Laboratory Control Sample (LCS) (LCS) R3473013-1 11/18/19 00:06 Spike Amount Analyte mg/I LCS Result mgll LCS Rec. % Rec. Limits LCS Oualifier % 2,4,6-Trichlorophenol 0.0500 0.0257 51.4 37.0-144 (S) Nitrobenzene-d5 42.6 15.0-314 (S) 2-Fluorobiphenyl 52.5 22.0-127 (S)p-Terphenyl-dN 54.0 29.0-141 (S)Phenol-d5 23.5 8,00424 (S) 2-Fluorophenol 34.4 10.0-120 (S) 2,4,6-Tnbromophenol 50.0 10.0-153 ACCOUNT: PROJECT: SDG: DATE/TIME: Eaton Corporation 28091-R L1159977 11/19/1917:21 PAGE: 19 of 22 GLOSSARY OF TERMS ONE LAB. NATIONWIDE. Guide to Reading and Understanding Your Laboratory Report The information below is designed to better explain the various terms used in your report of analytical results from the Laboratory. This is not intended as a comprehensive explanation, and if you have additional questions please contact your project representative. Results Disclaimer- Information that may be provided by the customer, and contained within this report, include Permit Limits, Project Name, Sample ID, Sample Matrix, Sample Preservation, Field Blanks, Field Spikes. Field Duplicates. On -Site Data, Sampling Collection Dateslfimes, and Sampling Location. Results relate to the accuracy of this information provided, and as the samples are received. Abbreviations and Definitions MDL Method Detection Limit. ND Not detected at the Reporting Limit (or MDL where applicable). RDL Reported Detection Limit. Rec. Recovery. RPD Relative Percent Difference. SDG Sample Delivery Group. Surrogate (Surrogate Standard)- Analytes added to every blank, sample, Laboratory Control Sample/Duplicate and (S) Matrix Spike/Duplicate, used to evaluate analytical efficiency by measuring recovery. Surrogates are not expected to be detected in all environmental media. U Not detected at the Reporting Limit (or MDL where applicable). Analyte The name of the particular compound or analysis performed. Some Analyses and Methods will have multiple analytes reported. If the sample matrix contains an interfering material, the sample preparation volume or weight values differ from the Dilution standard, or if cwncontrations of analytes In the sample are higher than the highest limit of concentration that the laboratory can accurately report, the sample may be diluted for analysis. If a value different than 1 is used in this field, the result reported has already been corrected for this factor. These are the target % recovery ranges or% difference value that the laboratory has historically determined as normal Limits for the method and analyse being reported Successful OC Sample analysis will target all analytes recovered or duplicated within these ranges. Original Sample The non -spiked sample in the prep batch used to determine the Relative Percent Difference (RPD) from a quality control sample. The Original Sample may not be included within the reported SDG. This column provides a letter and/or number designation that corresponds to additional information concerning the result Qualifier reported. If a Qualifier is present, a definition per Qualifier is provided within the Glossary and Definitions page and potentially a discussion of possible implications of the Qualifier in the Case Narrative if applicable. The actual analytical final result (corrected for any sample specific characteristics) reported for your sample. Ifthere was no measurable result returned for a specific analyte, the result in this column may state "ND" (Not Detected) or "BDL' Result (Below Detectable Levels). The information in the results column should always be accompanied by either an MDL (Method Detection Limit) or RDL (Reporting Detection Limit) that defines the lowest value that the laboratory could detect or report for this analyte. Uncertainty (Radiochemistry) Confidence level of 2 sigma g ma . A brief discussion about the included sample results, including a discussion of any non -conformances to protocol Case Narrative (Cn) observed either at sample receipt by the laboratory from the field or during the analytical process. If present, there will be a section in the Case Narrative to discuss the meaning of any data qualifiers used in the report. Quality Control This section of the report includes the results of the laboratory quality control analyses required by procedure or Summary (Qc) analytical methods to assist in evaluating the validity of the results reported for your samples. These analyses are not being performed on your samples typically, but on laboratory generated material. This is the document created in the field when your samples were initially collected. This is used to verify the time and Sample Chain of date of collection, the person collecting the samples, and the analyses that the laboratory is requested to perform. This Custody (Sc) chain of custody also documents all persons (excluding commercial shippers) that have had control or possession of the samples from the time of collection until delivery to the laboratory for analysis. This section of your report will provide the results of all testing performed on your samples. These results are provided Sample Results (Sr) by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for each sample will provide the name and method number for the analysis reported. Sample Summary (Ss) This section of the Analytical Report defines the specific analyses performed for each sample ID, including the dates and times of preparation and/or analysis. Qualifier Description J The identification of the analyte is acceptable: the reported value is an estimate. J4 The associated batch QC was outside the established quality control range for accuracy. ACCOUNT: PROJECT: SDG: DATEITIME: PAGE: Eaton Corporation 28091-R L1159977 11/19/1917.21 20 of 22 ACCREDITATIONS & LOCATIONS ONE LAB. NATIONWIDE. Pace National is the only environmental laboratory accredited/cerufed to support your work nationwide from one location. One phone call, one point of contact, one laboratory. No other lab Is as accessible or prepared to handle your needs throughout the country. Our capacity and capability from cur single location laboratory is comparable to the collective totals of the network laboratories incur industry. The most significant benefit to our one location design Is the design of our laboratory campus. The model is conducive to accelerated productivity, decreasing !ri ad time, and preventing cross contamination, thus protecting sample Integrity. Our focus on premium quality and prompt service allows us to be YOUR LAB OF CHOICE. Not all cenifications held by the laboratory are applicable to the results reported in the attached report. ' Accreditation is only applicable to the test methods specified on each scope of accreditation held by Pace National. State Accreditations Alabama 40650 Alaska 17-026 Arizona A20612 Arkansas 88-0469 California 2932 Colorado TN00003 Con nocticut _ PH :0197 Florida E87487 _ Georgia NELAP Georgia_ 923 Idaho TN00003 Illinois 200008 Indiana C-TN-01 Kansas E-10277 Kentucky " 90010 _Kentucky' 16 _ A130792 _Louisiana Louisiana--__.____._...__..__. LA180010 Maine --_-__—_—_ TN0002 Maryland 324 Massachusetts M-TNO03 Michigan 9958 Minnesota 047-999 395 Mississippi TN00003 Montana CERT0086 Third Party Federal Accreditations A2LA - ISO 17025 1461.01 A2LA-ISO 17025° 1461.02 Canada 1461.01 EPA-Crypto TN00003 Nebraska NEOS-15-05 Nevada TN-03-2002-34 New Hampshire 2975 New Jersey-NELAP TNO02 New Mexico_ n/a _ New York 11742 _ _ North Carolina _ _ North Carolina _ En075_- DW21704 Carolina' 41 _North _ Ncnh Dakota R-140 Ohio-VAP CL0069 Oklahoma 9915 Oregon TN200002 Pennsylvania 68-02979 Rhode Island LA000356 South Carolina 84004 South Dakota am Tennessee " _ 2006 Taus T104704245-18-15 Terms ° _ —_ LABO152 Utah TN00003 _ Vermont VT2006 Washington C847 _West Virginia233 _ Wisconsin Y 9980939910 AIHA-LAP,LLC EMLAP 100789 DOD 146101 USDA P330-15-00234 Drinking Water ° Underground Storage Tanks ° Aquatic Toxicity 'Chemical/Microbiological s Mold `Wastewater role Accreditation not applicable Our Locations Pace National has sixty-four client support centers that provide sample pickup and/or the delivery of sampling supplies. If you would like assistance from one of our support offices, please contact our main office. Pace National performs all testing at our central laboratory. WA R MT ND OR PAN ME T ID SEP T WI NY A T PA ur t NV T NE T 1 T T u Ifi on vuv T OA CO �. MO T VAT _ T • • T� NM OK M N T SC T ' MS AT GA TX �.. _. LA AK T T O FL B Hit NI ACCOUNT: PROJECT: SDG: DATE7TIME: PAGE: Eaton Corporation 28091-R L1159977 11/19/191721 21 of 22 - - ' . •:. Billing Information: ` - " ' " ) _. - Ana sis Container/Preservative - Chain of Custody: 'Vage_of_ :. Eaton Corporation. - Fires N A (manual Serves Center •4009 ' „ ! P08ox 818024 Dtk , ,r :x-� rfv ° = -�- � 2564 OUiham Road Cleveland OH 44181 8624 - ,; Roxboro NC 27573 '-t ( ,- c , (r.y� `}�,i tail r,}¢ ",HAS x„ a ..- � ,rwy�,.. Reportto Email To: dustinlaclalr@eaton.com 1, a t' _ • - '• ) uacstm Ad _a 'Y -r rA rluGes try a:lx aS(XsMsa59� 1-07 ..� Prgect+ ,.. City/State, c awl ''�� "`' =,.,'tom.. anon Descnptron'+Eaton Corp:Semi-An nual Storrnwater Coilettea:' z"''k ,+.. ro.s '3 - r ats-ne sers .:_ Phone Client Project p.. .. '. �-. Lab Prolecta ... f � Lp 1 oc i ' ��7 ., ;. Fan 28091-R *- - t EATONRNC-28091SW s =e- J O O� 2 '� i t.g vt'`S ` O , "3'' " -- ,. - a 2 3,t�1'^f As E 's Ur'.n a ° O 2 '�QsAe�; 'k y�t A4 ..: "a mur"�" �•""" Template T137602 Collected by (print) Site/Facility ID N _ ROXBORO NC.� P O x 148703:r r Colle,,,tt,,,epppd b-y(signature) Quote p" .s :..Rush? (Lab. MUST Be Notified) - same OaY v Ep Q E U Z E- k„ Frelogin =Para Day — .. „x Q E R ' t^S� ^' '_` *� - Immediatety _ " Nest Day 5 Day (Rad Only) ,. Date Results Needed _Two Dav 10 Day (RaE Onty)No . %£ " t7 .y.: "� • C#S X rum d � W C i - p _ + _ ys: °): I a 75 ' R Ne�a-t7herl WaBnerri y Packed on Ice N Y , _three Dayx .' s- .. 6 t O, j. . • Sample to, Comp/Grab Matdx ,Depth -0ate -Time ntrs sQ un, `t? S-' `'� }/ z ShippedMftt FedEX;G[OUgd;- �- a „s. _ samWaa NeoNrl :. .� T ; Nk 40 /I}� ^ ,',l -. i.t/ .. W W .. 'S - . :. . _� �.�: -a�l „ .� S ':9: X n X, j X X.H '.X, Ao ^J C >$. a ... An-, _ '-ate,+? $ t�*.,i.�S,��i _ iA`�.'•i ii. � �c..�.- cT F � �.a.. • Y?c��F�iF'-•T 4 'bi.''Sv.� _t �•'. Matrix: ,SS Sod AIR a Air F- Filter( esllarka �•.,.� 3 v COC Seal Pzesent/intac 'si'N? f� GW Groundwater 11"Woassay f pH - Temp w tOC 514nod/Accurate 'i� Y , Waste Water ; DW Drinking Water ., - S ., .. -.: Flovi. "Other Samples ietumed viak(° L''' "� �` ¢ - - } - aottleaAazziv sxiitac Cazrect boe cles usod v .` OT Other ,' Z+`� y*-SsRyiFe;9 Y' `-"'`�Sx='^b'Clclent f l r ,y d ,rek t- Trackln8tl " " `3n; s h":"'"°3*:`'Yj€AAnlicabie >r+' xs; . 'Sa`al w n ��'3- vOlUne slut 3q�h 'ld: YiRendapace'X-i±e•a�N. semry t o^Coorzeec/CheckeN NI. Re6 rs dby Sig at ) Date: .�. Time a- Received by: �' <a.r , (Signature) _ e Trip Blank Received:: tY o $b a _ f1ttU 1, S.°R <O3mFq� ' Relinquished by (Signature) •. Date: Time Received by: (Signature) . mph,- , C 11W ] Rt aeit � If presemfl9n required by Logm DateRme '� .' _..s ;_ ' Relinquished by (Signature) . Date: : Time Re d (or _ ab br (SI atbi gn )x .,.... .:�` Oate ,�. rime > Holda -Y s�,, iv<' f'�aCondihon :-.; a0.��a've+,�- fC f-v_ Jra�gr1NCF 1-y���a". + _ $ w wry ss=."V a FMITON Colin W. Betchan Environmental, Health & Safety Supervisor (919) 702-3703 (mobile) (336) 503-6562 (fax) colinwbetchan(o)eaton. com November 26, 2019 Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Attn: DWQ Central Files RE: October 2019 Monthly Tier III Discharge Monitoring Report Attached are the analytical results and associated chain of custody for the October 30, 2019 semi-annual Tier III stormwater outfall sampling event, submitted in accordance with Section D of the NPDES Stormwater General Permit No. NCG030000 and Certificate of Coverage No. NCG030027 issued to our facility. Additionally, attached is the applicable Discharge Monitoring Report (DMR) Form provided by the North Carolina Division of Water Quality (NCDWQ). I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with the 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 other persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Colin W. Betchan EHS Supervisor Attachments RE"EJvE�o r�DEC 0, `'rfCin Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000 CERTIFICATE OF COVERAGE NO. N0003 o 0 2 7 FACILITYNAME Eaton Corporation COUNTY Person County PERSON COLLECTING SAMPLES Dustin Laclair LABORATORY Pace National Date submitted 11/22/2019 Lab Cert. # ENv375/Dw2170400041 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June 0 July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply [:]SA #Other WS-III; NSW PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4 ❑ No discharge this periodj2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Total Suspended Solids PH Standard units Total Copper Total Lead Total Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics Benchmarks _ - 100 mg/L or 50 mg/L4 6.0 — 9.0 0.010 mg/L 0.075 mg/L 0.126 mg/L 15 mg/L 1 mg/L Parameter Code - 46529 C0530 00400 01119 01051 01094 0oss2 78141 Pond(001) 1 10/30/2019 1.10 9.4 7.7 0.007 0.002 0.0465 0.806 0.0327 Tool Room Trench (005) 10/30/2019 1.10 6.49 8.8 0.0310 0.002 0.0615 0.873 0.0334 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. '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. 4 See General Permit, Section B, Table 1 to identify 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: 11/1/2018-05/31/2021 SWU-24S, last revised 11/1/2018 Page `1-of3 - 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." Cm I VA �&TC \Oty� Name (Print name) E K 5 Sf iota ry isor Title (Print title) i C&P- f -a6a19 Signature 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 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?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 New Motor Oil or Hydraulic Oil Usage Non -Polar O&G/ Total Petroleum Hydrocarbons Total Suspended Solids Benchmarks - - - 15 mg/L 100 mg/L or 50 mg/L4 Parameter Code - 46529 NCOIL 00552 CO530 Footnotes from Part A also apply to Part B Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018 _ - - - - - — - - - Paget of 3` - - - - - - - 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 ANYONE OUTFALL? YES Q NO Q IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES Q NO Q REGIONAL OFFICE CONTACT NAME: Danny Smith Mail an oriainal coov 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, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature of Permittee Permit Date: 11/1/2018-05/31/2021 Date SWU-245, last revised 11/1/2018 -Page 3-of.3,- - -