NCG030238_MONITORING INFO_20191106

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv
DOC TYPE.
.❑ HISTORICAL FILE
C�( MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

SIEMENS
RECEIVE®
November 4, 2019 NOV 0 6 2019
CENTRAL FILES
Division of Water Quality DWR SECTION
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: Semi -Annual Stormwater Monitoring Reports (COC: NCG030238)
Dear Sir or Madam:
li
In accordance with permit NC030000, the Siemens Energy facility in Rural Hall, North
Carolina is submitting the required first half of 2019 Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report and Semi -Annual Stormwater Discharge Monitoring
Report with the required analytical.
If you have any questions please contact James Whiticar, EHS Officer of Siemens WSC
at (336)-969-1265.
'I
Sincerely,
Srikanth Parvathaneni
QEHS Manager

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit: htto://oortal.ncdenr.org/web/lr/nudes-stormwater/
Permit No.: N/C/ 0/ 3/ 0/ 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0 0`
Facility Name: Siemens Energy, Inc.
County: Forsyth Phone No. 336-969-1265 NOV 06 2m
Inspector:
Date of Inspection: 10/16/2019
Time of Inspection: 1:21nm
Total Event Precipitation (inches): _0.81
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).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event' is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must 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 this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature ol;Prkm�ttee or
Pagel of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 1 Structure (pipe, ditch, etc.) Rip Rap Channel
Receiving Stream: Muddy Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: clear
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): No discharge
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with Floating solids:
l0 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

Semi-annual Stormwater Ditcharge'Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted November 4 2019
CERTIFICATE OF COVERAGE NO. NCG030238
FACILITY NAME Siemens Energy, Inc.
COUNTY Forsyth
PERSON COLLECTING SAMPLES James Whiticar
LABORATORY Research & Analytical Lab Cert. # NC34
Comments on sample collection or analysis: SDO 002 Exempt from
monitoring
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]WaterSupply [—]SA
®Other Class C
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 —>
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches':,
TotalSuspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/.
Total Petroleum
Hydrocarbons
Total Toxic
Organics'
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
SDO 001
10/16/19
0.81
6.2
6.23
<0.005
<0.005
0.027
<5
<3
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.
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.
5 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 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), 1 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."
CoZ� fiNliLLtPS
Name (Print name)
?Lat,jMANS EP_
Title (Print title)
It o5 i
(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.
I-1 Nn riicrhnrnc fhic n nrJ7z
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, you must implement Tierl, Tier 2, orTier 3 responses. -See General Permit text.
FOR PART AAND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results (or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, 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."
11 05 t9
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

�I
RESEARCh & ANAiy1reCAl
I-AbORAwRiES, INC.
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For: Siemens Energy, Inc. Winston-Salem
3050 Westinghouse Road
Rural Hall, NC 27045
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Attn: James Whiticar
Report of Analysis
11/1/2019
QG�& ADIkCYj����i�i
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NC tt37701
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Client Sample ID: Outfall #1
Lab Sample ID:
73778.01
Site: Siemens
Collection Date:
10/16/2019 13:37
Parameter
Method
Result
Units
Rep Limit Analyst Analysis Dateaime
Copper, Total
EPA 200.7
<0.005
mg/L
0.005
JF 10/2912019
;Hydrocarbon 0&G
EPA 1664 Revision B/Silica Gel
<5
mg/L
5
EE 10/24/2019
,Lead, Total
EPA 200.7
<0.005
mg/L
0.005
JF 10/29/2019
�pH
SM 4500 H+B_2000
6.23
Std. Units
AB 10/18/2019 1629
;Total Suspended Solids (TSS)
SM 2540 D-1997
6.2
mg/L
5
AW 10/22/2019
1fZinc, Total
I
EPA 200.7
0.027
mg/L
0.01
JF 10129/2019
NA = not analyzed
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P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] �.randalabs.com
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Page 1

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Analytical/Process Consultations
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Chemical Anal ysis f n- Selected Parameters and Water Sample Identified as Stornnuater - Second Half of 2019
(A Sientens, Inc. Project, collected 16 October 2019)
i
1. Pest icides/PCB's Quantization
Oulfall #1
EPA Method 608.3 Limit
parameter 111WL
nt /L
0.001
I3QL
I'Aldrin
,Alpha,B11C 0.001
I3QL
Bcta,1311C 0.001
I3QL
Delta,1311C 0.001
13QL
Ganima, l3NC 0.001
13QL
Chlorclanc 0.010
13QL
4-4'-DDD 0.001
13QL
144-DDG 0.001
I3QL
4-4'-DDT 0.001
13QL
Dieldrin 0.001
I3QL
1 I1dOSUltall 1 0.001
13QL
0 13nclosullan I 1 0.001
13QL
ji 6nc10Sulfan Sulfur 0.001
I3QL
Elldrin 0.001
13QL
,i I mirin Aldehydc 0.001
I3QL
I leptachlor 0.001
13QL
I leplachlor epoxidC 0.001
I3QL
Melhuxychlor 0.001
I3QL
I� ToxaphetIC 0.020
13QL
1'03 1016 0.005
BQL
lIC13 1221 0.005
BQI.
PCB 1232 0.005
I3QL
lIC13 1242 0.005
13QL
PCB 1254 0.005
13QL
PCB 1260 0.005
I3QL
Sample Number
j�
73778-01
Sample Date
10/16/19
Sample Time
1321
PCB = Polychlorinated Biphenyl
mg/l. = mlligrams per Liter = parts per million (ppm)
BQL = Below Quanlitation Limits
I

'RESEARCh & ANALyT9CA1
UbORAimif:St INC.
AnalytlCol/Process Consullotlorts
Analysis for Selected Parameters and Water Sample Identified as Stormwater - Second Half of 2019
Inc. Project, collected 16 Octo6er 201
IL Volatile Organics
Quamitation
Outfall a
❑I,Semi-volatile Organics
Quantitation
Outfall#1
'. EPA Method 624.1
Limit
Method 625.1
Limit
Parameter
m /l.
(me/I,)
Parameter
(mull,)
m /L
Methylene Chloride
0,010
IIQI.
4-Chloro-3-methylphenol
0,010
BQL
'I iichloro0uaromethunc
0010
BQI.
2.Chlarophenol
0,010
HQL
I,I-Uiuhlnmcthcnc
0,010
[IQ].
2,44Uichlnmphemrl
0.010
13QL
1. 1 -1) ichloroethane
0,010
BQL
24-Dimcthylphenot
0,010
13QL
Chloroform
0.010
BQL
24-Dinitrophenul
0.050
BQL
Carbon 'I'etnublmidc
0,010
BQI.
2-Methyl46-dinitrophenul
0050
13Q1-
1,2-Dichlorupropane
0.010
BQL
2-Niuophenol
0010
BQL
jl 'I richloroethene
0.010
BQL
4-Nitrophmol
0.050
BQI.
Dihromochlarumethane
0,010
BQI-
Penmchlorophenol
0,050
BQL
1,12-Trichlorocthanc
0,010
BQL
Phenol
0,010
BQI.
'I'ctruchlormthcnc
0.010
13QI,
24,6=Dichlurophenu1
0.010
HQI.
Chlorobenzcne
0.010
BQL
Acenaphthcne
0.010
BQL
'I'runs. l,2-Dichloroethene
0,010
BQI-
Acenaphthylene
0.010
BQL
12-Dichieroethane
0,010
HQI.
Anlhmcene
0010
BQI-
I,I,I=l richlumethane
0.010
BQI-
Benzidine
0,050
BQL
13ramodichluromcthanc
0.010
HQI,
Benzo(a)anthmccnc
0,010
BQ11
Cis. 1,3-Dichloropropene
0010
BQI-
Benzo(a)pyrene
0,010
BQL
„ Henzcne
0,010
HQI-
Benzo(h)Humanthene
0,010
BQL
'Trans-1,3-Dichloropropene
0010
BQI,
Benzo(ghi)perylene
0.010
IIQL
Bromoform
0.010
13QL
Benzo(A)0unrunthene
0,010
BQL
1,12,2=fctmchlomethunc
0.010
HQL
Bcnryl hutyl phthalate
0.010
BQL
Toluene
0.010
BQI-
Bis(2-ehluroethosy)methane
0.010
BQL
Ethyl Biatmnc
0,010
13QL
Bis(2chloroethyl)ether
a010
HQL
Chluromethanc
0,010
BQL
Bis(2-chloroisupropy1nihcr
0,010
BQI,
Hrnmamcthunc
0,010
13QL
13is(2-ethyl-hexyl)phthalate
0,010
BQL
Vinyl Chloride
0,010
BQL
4-Bromophenyl phenyl ether
0.010
BQL
Chlorocthane
0.010
BQL
2-Chldranuphthalenc
0.010
BQL
'I'am1 XyIL=s
0010
BQI-
4-Chlorophenyl phenyl ether
0010
BQI-
Acmlcin
0.100
BQI-
Ch tyscnc
0.010
BQL
i.
Aerylunitrile
0,100
[IQ[.
Dibenzo(u,h)anthracene
0,010
BQL
2-Cldorocthyl rims ether
0.010
BQL
12-0ichlorobenzene
0.010
BQl-
'
13QL
1,3-13ichlurubcnzcnc
0,010
BQL
1,4-Dichlorobcnzene
0.010
BQL
Sample Number
73778-01
3,3-Diehlorobenzidine
0.020
BQI-
Sample Date
10/16/19
Diethyl phthalate
0.010
I3QI-
i1 Sample Timc (hrs)
1321
Dimelhyl phthalate
0.010
BQL
Di-N-Butyl phth;0ale
0010
BQI.
2,4-Dinitrutoluene
OAM
BQL
2,6-Dinitrutolucnc
0.010
BQL
Di-N-Ociyl phthalate
0,010
BQL
12-Diphenylh3'dwinc
0.050
BQL
Fluoranthene
0.010
BQI,
Fluorenc
0010
BQL
I lexachlorobenzcne
0.010
BQL
-
Ilexachiotabutadiene
0.010
BQ11
I lexachloroc)clopcnmdicne
0,010
BQ1,
Ilexachlorocthane
0.010
9QI-
lndeno(I,?,3-cd)pyrcnc
0 DIo
BQL
Isophorone
0010
BQI.
Naphthalene
0.010
BQI.
Nitrobenzene
0.010
BQI-
�I
N-Nitmsodimethylarninc
0,010
BQI.
i,
N-narosodi-n-propylamine
0010
BQI.
N-Nitrosodiphenylamine
0.010
BQL
Phenanthrenc
0,010
BQL
�I
Pyrene
0.010
BQI.
124-1'richlorubenzcne
0,010
BQL
Dilution 10dm
1
�- BQI. Below Quantitation limits
Sample Number
73778-01
mg/l. = milligrams per Liter= pans per million(ppm)
Sample Date
10/16/19
Sample Time (hrs)
1321

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