NCG030451_MONITORING INFO_20191209

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv C& 0 3 p LI'�)I
DOC TYPE,
❑ HISTORICAL FILE
TA MONITORING REPORTS
DOC DATE
❑ a\i )
YYYYMMDD

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted 11/15/19
CERTIFICATE OF COVERAGE NO. NCG03 0 4 5 1
FACILITY NAME ILL Building Products, Inc.
COUNTY Pender PERSON COLLECTING SAMPLES Paul Spangenberg RECEIVED
LABORATORYcontect Lab Cert. #402 BEC 09 2019
Comments on sample collection or analysis:
CENTRAL FILES
DWR SECTlo"j
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June Q July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
(—I No dischoroe this period 22
Outfall No.
Benchmarks
Date Sample
Collected'
(mo/dd/yr)
-
24-hour rainfall
amount,
Inches3
-
Total Suspended Solids
100 mg/L or 50 mg/L°
pH.
Standard units
6.0 — 9.0
Total Copper
0.010 mg/L
Total Lead
0.075 mg/L
Total Zinc
0.126 mg/L
Non -Polar O&G/
Total Petroleum
Hydrocarbons
1s mg/L
Total Toxic
Organicss
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
00552
78141
01
10/29/19
.1
1.2
7.5
0
0
0.0088
0
N/A
' Monthly sampling (instead of semi-annual) must begin with the second consecutive DencnmarK exceeuance rur ure DdnIC Pdl d111CLel Gl 1.�O gal ll�
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
=Pagel 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."
Trevor Simmons
Name (Print name)
Environmental Coordinator
Title rinttitie)
II Zl 19
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,
Inches;
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.
SWU-245, last revised 11/1/2018
Page 2 of 3
Permit Date: 11/1/2018-05/31/2021

FOR PART A AND PARTS MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Q
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitoring Period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, 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."
Signature of Permittee
Permit Date: 11/1/2018-05/31/2021
1 I 2? 119
Date
SWU-245, last revised 11/1/2018
-Page 3 of3-- - - — - - -- --

APPENDIX A
SEMI-ANNUAL QUALITATIVE, MONITORING' REPORT,
LL BUILDING PRODUCTS, INC.
295 MCKOY ROAD
EBURGAK NORTH CAROLINA
MID -ATLANTIC JOB NUMBER: OOOR3196.00
Inspector Name:
Date of Inspection:
Paul W. Spangenberg
10/29/19
OUTFALL DESCRIPTION
Outfall No.:
Structure (pipe, ditch, etc.):
Receiving Water Body:
1
Pipe
Burgaw Creek
Describe the industrial activities that occur within the outfall drainage area:
Fabricated coated metal products
Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors:
Clear
Odor
Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak chlorine odor, etc.):
None
Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy (circle one):
1 2 3 4 5 6 7 8 9 10
Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where 1 is no solids and 10 is the
surface is covered in floating solids ' cIs one
1 2 3 4 5 6 7 8 9 10
Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10 is
extremely muddy (circle one):
1 2 3 4 5 6 7 8 9 10
Foam
Is there any foam in the stormwater discharge (circle one)?: Yes
Oil Sheen
Is there an oil sheen in the stormwater discharge (circle one)?: Yes N
Erosion Deposition
Is there evidence of erosion or deposition at the outfall? (circle one): Yes
If yes, list and describe:
Other
Is there other obvious indicators of stormwater pollution in the stormwater discharge (circle one): Yes ©o
If yes, list and describe:
Rain Event
Was this a Representative Storm Event? X Yes _ No Total Event Precipitation (Inches): .1
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.
Certification
By this signature I certify that this report is accurate and complete to the best of my knowledge:
Inspector's Signature: Pold W. 5�
Mid Atlantic

APPENDIX C-
SEMI-ANNUAL STORMWATER SYSTEM`INSPECTION REPORT.'`
LL BUILDING PRQDUCT$; INC
295MCKOY:ROAD'.
pBURGAW, NOR<TH CAROLINA
MID -ATLANTIC JOB NUMBER: 0004319600 ;
Facility Name:
Location:
Certification of Coverage No.:
LL Building Products, Inc.
Burgaw, North Carolina
NCG030451
Expires: 5/31/2021
Number of Outfalls:
Inspector's Name:
Date:
Paul W. Spangenberg
1
10/29/19
Cont! ing Areas
Evidence of pollutants entering system (circle one): Yes o
If yes, describe:
Areas of potential pollutants entering system:
Describe: None
Control measures present (circle one): a No
If yes, describe:
Additional control measures needed (circle one): Yes N
If yes, describe:
Sediment and erosion control measures present (circle one): Yes
If yes, descdbe:
Describe any new structural stormwater management measures:
None
Potential Pollutant Areas
Describe any loading/unloading operations:
Trucking
Describe any outdoor storage activities:
Wood Pallets, Scrap Metal, Empty Containers, Used Equipment, Municipal waste, General Refuge
Describe any outdoor manufacturing or processing activities.
None
Describe and dust or particulate generating areas:
None
Describe any onsite waste disposal activities:
None
Si nificant Le or Spills
Any reportable spills or leaks in the past year (circle one): Yes o
If yes, date: Impact on stonmwater system(s):
Certification
By this signature I certify that this report is accurate and complete to the best of my knowledge:
Inspectors Signature: 1110eK:
Mid Atlantic

APPENDIX D
RAIN EVENT DATA REPORT
LL BUILDING PRODUCTS, INC.
295 MCKOY ROAD
BURGAW, NORTH CAROLINA
MID -ATLANTIC JOB NUMBER: 000113196.00
STORM EVENT INFORMATION
DATE
YEAR
MONTH
DAY
2019
10
29
HOURS
MINUTES
DURATION
48
0
PRECIP.
AMOUNT (IN.)
.1
RUNOFF
0.08
VOL. M/GAL
HOURS
DAYS
PRECEDING
EVENT
4
0
PRINCIPLE EXECUTIVE OFFICER OR AUTHORIZED AGENT
PRINT
SIGNATURE
DATE
Paul Spangenberg
�
iw kovwA�
Formula for calculating stormwater runoff in Millions of gallons.
Acres of Property
X 43,563 (Square Foot Per Acre)
Total Square Feet of Property
x Rain Fall in Inches
Total Feel/Inches of Rain Fall
X .0833 (Inches in each square Feet)
X 7.48 (Gallons Per Square Foot)
Total of Gallons in the Total Square Foot/Inches of the Property)
/ (Divided by a Million 1,000,000)
Millions of Gallons Discharged
/ Divided by the Number of Outfalls
Millions of Gallons Per Outfall.
Mid Atlantic

Table of Contents
i
39 Spruce Street' East Longmeadow, MA01028 *FAX [phone]' TEL.
November 13, 2019
!' Paul Spangenberg
Mid -Atlantic Associates, Inc. - Raleigh, NC
1 409 Rogers View Court
Raleigh, NC 27610
Project Location: 295 McKoy Rd. Burgaw, NC
i. Client Job Number:
Project Number: R3196.00
Laboratory Work Order Number: 19J 1992
i
I
�i Enclosed are results of analyses for samples received by the laboratory on October 31, 2019. If you have any questions
concerning this report, please feel free to contact me.
i
Sincerely,
it
i
Kerry K. McGee
Project Manager
I'
Page 1 of 14
i
i

Table of Contents
Table of Contents
Sample Summary
3
Case Narrative
4
I' Sample Results
5
19JI992-01
5
Sample Preparation Information
7
l QC Data
8
Metals Analyses (Total)
8
B244906
8
i
Conventional Chemistry Parameters by EPA/APHA/SW-846 Methods (Total)
9
B244793
9
B244884
9
B245495
9
Flag/Qualifier Summary
10
Certifications
11
Chain of Custody/Sample Receipt
12
i
4
I, I
i
I I
II
Page 2 of 14

Table of Contents
'{I III{Ij Iy I}� conAlest°
y�II I'';', ANALYTICAL LABORATORY
6
li 39 Spruce Street' East Longmeadow, MA 01028 *FAX [phone] * TEL, 413/525-2332
Mid -Ad antic Associates, Inc. -Raleigh. NC
409 Rogers View Court REPORT DATA: 11/13/2019
Raleigh, NC 27610 PURCHASE ORDER NUMBER:
ATI'N: Paul Spangenberg
PROJECT NUMBER: R3196.00
ANALYTICAL SUMMARY
WORK ORDER NUMBER: 19J 1992
The results of m.1yoci perfermed on the fallowing samples submitted to the CON -TEST Analytical Laboratory are found in this mpon.
PROJECT LOCATION: 295 McKoy Rd. Burgin , NC
I°IIi I,D SAMPLE N LAB ID: MATRIX SAMPLE D17SCRIPTION 'TIiST SUIJ LAB
19J1992-01 Water
FPA 1664B
SM21.22 2540D
SM21-22 4500I I B
S W-846 6010D
Page 3 of 14

Table of Contents
j con-testA
ANALYTICAL LABORATORY
39 Spruce Street' East Longmeadow, MA 01028' FAX [phone] * TEL. [phone]
CASE NARRNI'IVE SUMMARY
I�
All reponed results arc within defined laboratory quality control objectives unless listed below or otherwise qualified in this report.
SM21-22 450011 B
I
Qualifications:
II-05
i Holding time was exceeded, pH analysis should be performed immediately at time of sampling. Nominal IS minute holding time was
ceded.
Analpto & Samples(s) Qualified:
kill
licit 1992-t1 l [I j
The results of analyses reported only rclatc to samples submitted to the Con -Test Analytical Laboratory for testing.
I certify that the analyses listed above, unless specifically listed as subcontracted, if any, were performed under my direction according to the approved methodologies listed
in this document, and thm based upon my inquiry of those individuals immediately responsible for obtaining the information, the moterial contained in this report is, to the
best of my knowledge and be]i cf, accurate and complete.
Lisa A. Worthington
j� Technical Representative
Page 4 of 14

Table of Contents
39 Spruce Street' East Longmeadow, MA 01028' FAX [phone]' TEL. [phone]
Project Location: 295 Mc Kny Rd. Bmgaw, NC Sample Description: Work Ordcv 19JI992
iDate Received: I0/31/2019
Field Sample W: 1 Sampled: 10129/2019 15:00
'Sample ID: 19J 1992-01
� Sanple M.nm Water
r Metals Anolyses (Total)
Date
Dale/1'imc
Analyle
Results
RI,
DL
Units Dilution Flag/Qual
Method
Prepared
Analyzed
Analyst
'Copper
ND
0010
00068
mg/L 1
SW-846601OD
11/2119
11/411916:07
MJH
Lead
ND
0.010
0.0060
mglL 1
SW-8466010D
IIl2/19
II/4/1916:07
M1Ii
Zme
0.0088
0.010
0,0051
mg/L 1 J
SW-84660101)
1112/19
11/411916:07
MJH
Page 5 of 14

Table of Contents
39 Spruce Street' East Longmeadow, MA 01028' FAX [phone]' TEL. [phone]
Project Locution: 295 McKay Rd. Burguw, NC Sample Description: Work Order: 1931992
Data Received: 10/31/2019
Ficid Sample k: I Sampled: 10/29/2019 15:00
Semnla ID: 19d1992-01
Satanic Matrix: Water
Conventional Chemistry Parameters by EPA/APIIA/SW-846 Methods Q'olal)
Dale
Delefpimc
Anah'm
Results RI-
DI, Units Dilution Flag/Qual
Method
Prepared
Anal)eed Analyst
pH r@I9.2°C
Z5
pH Units I H-05
SM21-224500UB
II/1/19
11/1/1917:00 MG2
Total Suspondcd Solids
1.2 1.0
0.41 mg/L 1
SM21-222540D
H/1/19
1UI/1912:35 I'll
,Oil&Grease (HEM),
ND 1,6
1.2 mWL I
EPA 1664B
11/8/19
11/3/1912:55 LL
Page 6 of 14

Table of Contents
E'PA 1664B
I�ab Nambor lField till
39 Spruce Street' East Longmeadow, MA 01028 *FAX [phone] * TEL. [phone]
Sample Extraction Data
Batch Initial lml,l Dale
1931992-01 I❑
B245495
850
11/08/19
I'
I
Sp121-22 2WI)
I
Imb Number lFicld ml
Bmch
Initiollml,l
Ualr
19J1992-01 [11
B244793
500
11/01/19
it
Sb121-22 4500 D R
Lub Number 1110d till
Balch
Initiullml,l
Datc
I �9J1992-01III
B244984
50,0
11,01/19
Prop Method: S W-846 3005A-S W-846 60]0D
I I
I,
Lah Number [Field IDI
Batch
InlOul ImLl Final ImLI
Date
19J1992.01 [11
B244906
50.0 50.0
11/02/19
�II
4
I
i
i
i
i
I Page 7 of 14

Table of Contents
'J 39 Spruce Street' East Longmeadow, MA 01028' FAX [phone]' TEL, 4131525-2332
q QUALITY CONTROL
Mctnls Analyses (Total) - Qualil5Control
i
Reporting Spike Source %RF.0 RPD
A lytc Result Limit Units Level Result %It I7C Limits RPD Limit Notes
Batch B244906 - S W-846 3005A
Blank(R244906-BLKI) Prepared: 11/02/19 Analyzed: 11/04/19
Copper ND 0.010 howl,
1
Lead ND 0.010 teg/I,
Zinc ND 0,010 mg/L
LCS (0244906-BSq Prepared: 11l02/19 Analyzed: II104/19
Copper
1.05
o.0I0
mg/I.
1.00 105
80-120
Lead
0.536
0.010
mg/1.
0.500 107
80-120
Zinc
1.01
0.010
mg/L
1.00 101
80-120
LCS Dup (8244906-BSDI)
Prepared: II/02/19 Analyzed: II/04119
Copper
1.03 0.010
mg/I,
1.00
103 80-120 1.71 20
Lead
0.530 0.010
mgIL
0.500
106 80-120 1.14 20
Zinc
O,970 0.010
mgll-
1.00
97.0 80-120 3.62 20
Duplieale(11244906-DUPI)
Source: 19J1992-01
Prepared: 11/02/19
Analyzed: 11/04/19
Copper
ND
0.010
mg/1-
ND NC 20
Lead
ND
0.010
mgIL
ND NC 20
Zinc
0.00815
0.010
mg/l,
0.00876 7.31 20 1
Mvtrix Spike (8244906-MSO
Source:
1931992-0]
PrcpareJ:ll/112/19
Analyzed: I1/04/19
Copper
1.05
0.010
mg/L
1.00
ND 105 75-125
I
j Lead
0.537
0.010
mg/L
0.500
ND 107 75-125
Iliac
0,990
0.010
mWL
I
0.00876 98.1 75-125
Page 8 of 14

Table of Contents
39 Spruce Street' East Longmeadow, MA 01028 *FAX [phone] * TEL. [phone]
QUALITY CONTRo 1,
l
Conscall onnl Chemistry Parameters by EPA/APHA/SN'-846 \Icthods CI'otapj - Qnal!1•' Oontml
Reporting Spike Source %REC RPD
A—Wo, Result Limit Units Level Result %RFC Limits RPD Limit Notes
B244793 - SM21-22 240D
Blank (8244793-BLKI)
Prepared & Analyzed:
11/01/19
Total Suspended Solids
ND 2.5 mg/L
LCS (B244793-BSI)
Prepared & Analyzed:
11/01/19
Total Suspended Solids
180 In mg)L
200
90.0 57,6-118
Batch R2448M - SM21-22 4500 11 B
LCS (B244XX4-BSI)
Prepared & Analped:
11/01/19
riH
6.03 pH Units
6.00
100 90-110
Batch B245495- EPA 166 B
& Analyzed: 11/08/19
Oil & Grease (HEM)
ND 1.4
mg/L
Blank (B245495-BLK2)
Prepared & Analyzed: 11/08/19
Oil & Grease (HEM)
ND 56
mg/L
LCS (1245.195-BSH
Prepared & Analyzed: 11,08/19
Oil & Grcnsc (HEM)
1'
21
mg/L
20.0 107 78-114
LCS (B245495-BS2)
Prepared & Analyzed: 11 /08/19
Oil & Grease (ITEM)
720
mWL
800 89.5 78-114
Matrix Spike(8245495-MSq
Source: 19J1992-01
Prepared&Analyzed: I U08/19
'Oil & Goose (HE•M)
200 14
mg/L
200 NO 102 78-114
• Page 9 of 14

O
Table of Contents
East Longmeadow, MA 01028' FAX [phone]' TEL. [phone]
FLAC/QUALIFIER SUMMARY
• QC result is outside of established limits.
t Wide recovery limits established for difficult compound.
j Wide RPD limits established for difficult compound.
q Data exceeded client recommended or regulatory level
ND Not Detected
RL Reporting Limit is at the level of yuanlitation (LOQ)
DL Detection Limit is the lower limit ofdetaction determined by the MDL study
MCL Maximum Contaminant Level
Pencent recoveries and relative percent differences (RPDs) are determined by the software using values in the
calculation which have not been rounded.
No results have been blank subtracted unless specified in the case narrative section.
H-05 Holding time was exceeded. pH analysis should be performed immediately at time ofsampling. Nominal 15
minute holding time was exceeded.
J Detected but below the Reporting Limit (lowest calibration standard); therefore, result is an estimated
concentration (CLP J-Flag).
Page 10 of 14

fl
-1111111t, conAlest -
ANALYTICAL LABORATORY
I
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028 *FAX [phone]' TEL. [phone]
CERTIFICATIONS
q
Certified Analpxrs included in this Report
Analvle Ceniflemions
EPA 1664B in Rarer
Oil & Grease (11 EM) CT,MA,NH,NY,RI,NC,ML,VA
53121-222540D in Rarer
,'I'olal Suspended Solids CT,MA,NII,NY,RI,NC,ME,VA
if
S1121-22 450011 B in I1'ater
,I pit CT,MA,RI
SII'-846 6010D in Ilater
l' Copper CT,NII,NY,ME,VA,NC
1-cad Ci',NI I,NY,Ml:,VA,NC
Zinc CT,NIi,NY,M1i,VA.NC
�. The CON -TEST' Environmental Laboratory operates under the following ceniGcations and acefeditations:
i
Code Description
Number
Expires
AIIIA AIIIA-LAP, LLC-ISO17025:2017
100033
03/1/2020
it
MA Maxsachusetts DEP
M-MAI00
06/30/2020
CT Connecticut Department of Publile Health
PH-0567
09/3012021
NY New York State Department of l lcalth
10899 NELAP
04/1/2020
NH-S New Ilampshim Environmental Lab
2516 NELAP
02/5/2020
RI Rhode Island Department of Health
LAO00112
12/30/2019
NC North Carolina Div. of Water Quality
652
12/31/2019
p, NJ New Jersey DEP
MA007 NELAP
06/30/2020
it pl. Florida Depanmcmof Health
E871027 NELAP
06/30J2020
VT Vermont Department of health Lead Laboratory
LL015036
07/30/2020
Mli State of Maine
2011028
06/9/2021
VA Commonwealth of Virginia
460217
12/14/2019
� NH-P New Hampshim Environmental Lab
2557 NI7LAP
09/6/2020
VT-DW Vermont Department of Hcahh Drinking Water
VT-255716
06/12/2020
NC-DW North Carolina Department of Health
25703
07/31/2020
PA Commonwealth of Pennsylvania DEP
68-05812
06/30/2020
Page 11 of 14

hLtp:1/wnvw.contmtiabs.com
Doc # 379 Rev 103242017
con -test*
Phone: Ll T i ICI
CHAIN OF CUSTODY RECORD (North Cuolt�)
39 Spruce Street
East Longmeadow, MAGI028
Page —I- of -I—
F": 41
. . .. 1 1. ..
Email: Info0contestlabircom
7-Day 0
10-Day
0
11 2 11 11 11 11 1 1
j# of Containers
mid Atlantic AzodaLfts
Due Date:
S N IN IN I I I
Preservation Code
Address: 409 Rogers �Mew Court, Ra
I -Day
2-Day
0 ]-Day
0 4-Day
0
0
P +P
1P
1P
I
lne ' Contar Code
Phone: [phone]
ANALYSIS REQUESTED
za��
Field Filtered
Lab It Filter
LL guiding Products
Project Location: 295 McKoy Road, Burgaw, SC
Forrrimt! POP F41 EXCEL
R3196.00
Con -Test Quote Name/Number:
Imice Redolent: I
tetinquished by; (Signature)
/...o. >;,.. -x 6V
tecelved by- (VAture) (01
)5E' 5- � -I'.
Trevor Simmons
BRAVO
Like Data Pk& RWred:
It To:
To #:
10/29/19, 3:00 10/29/19, 3:00
10/29/19, 3:00 10129119,3:00
10/29/19, 3:00 10/29/19. 3:00
El Government
El Federal
- - - - -
- - - -
LJ .:FWd Filtered
Ean [e-mail]
250-"50
„7jww'
PERM
I
0 Lab to Filter
(919)
7 0
GRIM
V PMRIN
it
WW - Wait Water
P
x
I
DW - DrinkingWater
A - Air
A
0
G
x
Sm 5oi1
SL- Studio
x
0
P
x
x
x
SOL - Sotid
0 - Other (pLma.
define)
2 Frarsennatlon Codes:
I - Iced
H-HCL
M : Methanot
N • Nitric Acid
•S -SLdfuricAcid
B - Sodium Stsulfate
X - Sodium Hydroxide
T - Sodium
Thimulfate
.'0 - Other (Please
Please use the (ollawing codes to indicate possible sample concentration within the
'. define)
Cone Code column above:
H - High; M - Medium; L - Low; C - Clean; U - Unknown
'3 Cotalillf Codes
A - Amber Glass
- Gla
Glass
pr" Irdormat
tograin
0 LrTtTmt Fund
P ' Plastic
SWS Landfill REC
SWS landfill
IHSB Orphaned Landfill
SB Orphaned Lea,
State Lead
ar.
OtSher:
: ST - Sterile
V - VI&I
5 - Summa CerIlster
T - Tartar Bag
0 Other (please
.:Wine)
OtIW
PCB ONLY
❑ Municipality CD Chromatogram
7
(D
El soxhtet
❑ Brownfield ED AINA-L.4P,:UC
❑ Non S"htet
❑ so"
0
R

Table of Contents
10/31/2019 Track your package or shipment with FedEx Tracking
!I IMPORTANTI
The wildfires are causing hazardous conditions in California. Learn More
i
47725554756511�s
i'
Delivered
Thursday 10/31/2019 at 9:17 am
FROM
;I Raleigh, NC US
Shipment Facts
TRACKING NUMBER
477255547565
it
DIMENSIONS
18x11 x16 in.
TOTAL SHIPMENT WEIGHT
. 15 lbs / 6.8 kgs
DELIVERED
Signed for by: R.PETRAITIS
GET STATUS UPDATES
OBTAIN PROOF OF DELIVERY
SERVICE
FedEx Priority Overnight
DELIVERED TO
Shipping/Receiving
TO
East Longmeadow, MA US
WEIGHT
15lbs/6.8 kgs
TOTAL PIECES
1
.. PACKAGING___
TERMS � .. -> - --
Third Party .; - Your Packagin - - - -
SPECIAL HANDLING SECTION STANDARD TRANSIT " - SHIP DATE_
Deliver Weekday, Additional Handling O .. .. .. Q --
Surcharge 10/31/2019 by 10:30 am Wed 10/30/2019
ACTUAL DELIVERY
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Travel History
Thursday. 10/31/2019 -
9:17am East Longmeadow, MA Delivered
757 am WINDSORLOCKS.CT On Fed Ea vehicle for delivery
7.47 am WINDSOR LOCKS. CT Al local FedEx facility
https:/hw .fedex.conVappstfodextracW?action=track&Vackingnumber-477255547565&mtry_pode us&locale=en US
Local Scan Time
Page 13 of 14

Table of Contents
I Have Not Confirmed Sample Container
Numbers With Lab Staff Before Relinquishing
Over Samples
ANALYTICAL LABORATORY
Login Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False
Statement will be brought to the attention of the Client - State True or False
Client AA AA
l; Received By
How were the samples
received?
�l
Were samples within
Dale
In Cooler I No Cooler
Direct from Sampling
By Gun# Z
rime F ,f7
On Ice T— No Ice
Ambient Melted Ice
Actual Temp - � S'
Temperature? 2-6°C T By Blank # Actual Temp -
Was Custody Seal Intact? /V Were Samples Tampered with? Lvf
Was COC Relinquished ? 7- Does Chain Agree With Samples? T
Are there broken/leaking/loose caps on any samples?
Is COC in ink/ Legible? I Were samples received within holding time? T
,; Did COC include all Client Analysis Sampler Name
'I pertinent Information? Project ID's Collection Dates/Times T
;;Are Sample labels filled out and legible?
Are there Lab to Filters?
Are there Rushes?
!Are there Short Holds?
Is there enough Volume?
Is there Headspace where applicable? N/A -
Proper Media/Containers Used? S_
Were trip blanks received?
Do all samples have the proper pH?
Who was notified?
Who was notified?
Who was notified?
MS/MSD? F
Is splitting samples required? (=
On COC? F_
Acid Base
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Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted 11/25/19
CERTIFICATE OF COVERAGE NO. NCG03 0 2 7 2
FACILITY NAME Baly Refrigerated Boxes, Inc.
COUNTY Carteret
PERSON COLLECTING SAMPLES Ted Jennings
LABORATORY Con -test Lab Cert. # 652
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ lan-June Q July -Dec
or ❑ Monthly' (month)
o �� E DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
R ❑Zero -flaw ❑Water Supply [:]SA
DEC 0 6 2019 ❑■ Other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWR SECTION
n No dischorge 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
Organicss
Benchmarks
_
-
100 mg/L or 50 mg/L"
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
01
1 11/14/19
.90
0
6.7
0
0
0.0027
0
N/A
0
N/A
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outran.
Z For sampling periods with no discharge at any single outtall, 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."
Michael Coyle
Name (Print name)
President
Title (Print title)
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 discharge 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 O&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
- -
-
-
15 mg/L
100 mg/L or 50 mg/L"
Parameter Code
-
46529
NCOIL
00552
C0530
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 Q
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitoring period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, 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."
Signature of Permittee
Permit Date: 11/1/2018-05/31/2021
(2'2 —/9
Date
SWU-245, last revised 11/1/2018
Page 3 of 3

November 2019
Central Files
NCDEQ
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
peratlons
,inc. RECEIVED
DEC 0 6 2019
CENTRAL FILES
OVIR SECTION,
Subject: Report of Stormwater Sampling —Second Ilalf 2019
Commercial Fabricators, Inc.
2045 Industrial Drive
Newton, Catawba County, North Carolina
NCDEQ Certificate of Coverage #NCG030394
Ladies/Gentlemen:
Attached is a stormwater sampling report for the subject facility. If you have any questions regarding this
submittal, please contact the undersigned at 336-382-6849.
Sincerely,
(; , 07'ljd�l—
Jeffcerloek, L.G.
NC Licensed Geologist #1 141
Attachments — SW Discharge Monitoring Report Fonn
Cc: Mr. John R. Tucker, Jr, Commercial Fabricators
Operations Excellence, Inc., 2235-E Leivisville-Clemmons Road,, Clemmons, North Carolina 27012-336-766-2913

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted November2019
CERTIFICATE OF COVERAGE NO. NCG03 0 3 9 4
FACILITY NAME Commercial Fabricators 2045 Industrial Dr. Newton
COUNTY Catawba
PERSON COLLECTING SAMPLES Jeff Garlock
LABORATORY Mentech Lab Cert. # 165
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑Ian -June ❑x 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 4
❑ No discharge this periodj2
Outfall No.
Date Sample
i
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
Or anicss
g
Benchmarks
-
-
100 mg/L or 50 mg/L'
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
OF-1A
10/30/2019
1.1
<5
&62
0.002
<0.010
0.059
<5
NA
OF-2
10/30/2019
1.1
57
7.40
0.019
<0.010
0.653
<5
NA
OF-3
10/30/2019
1.1
<2.9
7.34
<0.002
<0.010
0.035
<5
NA
DC
06 aij
"^'R
SECTIO^i
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outtall.
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.
'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), 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."
R. John Tucker, Jr.
Name (Print name)
Vice President
Title (Print title)
/�J�--��/ 11/19/2019
Signatu 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?z
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches'
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/L"
Parameter Code
-
46529
NCOIL
00552
CO530
Not Applicable
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 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 ONEOUTFALL? YES Q NO ❑
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE? YES ❑ ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal copv 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. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
N/ 11/19/2019
Signature Permittee Date
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 3 of 3