NCG060105_MONITORING INFO_20190712

Z-0/6
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
A/c G b �p b 1 S
DOC TYPE
[I HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ Vl 1
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06 0 1 0 5
FACILITY NAME Giaxosmithkline
COUNTY Wake
PERSON COLLECTING SAMPLES Mark Poythress
LABORATORY Microbac
Date submitted 01JUIy2019
Lab Cert. # r1
RECEIN✓E®
JUL 12 2019
CC-r $ 14AL FILES
D NR SECTION
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 ❑■ Water Supply ❑SA
❑Other
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE —)
Total event rainfall z 0.4 in or ❑ No discharge this period3
Outfall No.
Date Sample
Collected, mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Enterococci,
Colonies per 100 ml
Benchmark
-
100or504
Within 6.0 — 9.0
120
30
10001
5001
Parameter Code
-
C0530
00400
00340
00556
31616
61211
5 (Representative)
4.17
7.5
35.6
<5
n/a
n/a
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SMonthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes Q no
Permit Date: 11/1/2018-05/31/2021
(if )Les, complete Part B)
SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
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
C0530
Footnotes from Part A also apply to Part B
*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 ❑ NO 0
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 (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, NC 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 knoking violations."
Signature of
U xSvz- I �
Date
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 2 of 2

VMICROBACG
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9F0092
GSK Project Name: Stormwater Sample - Semiannual
Mr. David Schaefer Project / PO Number: 3001572317 (2019)
1011 N. Arendell Avenue Received: 06/10/2019
Zebulon, NC 27597 Reported: 06/24/2019
Project Special Information
Analytical Testing Parameters
Client Sample ID: Stormwater, grab
Sample Matrix: Stormwater Collected By: Poythress
Lab Sample ID: K91`0092-01 Collection Date: 06/07/2019 11:35
Wet Chemistry
Result RL
Units Dilution Note
Prepared Analyzed
Analyst
EPA 1664 Rev. B
Oil & Grease (SGT-HEM)
<5.00 5.00
mg/L 1
06/21/19 0843
TAB
SM 2540 D-2011
Total Suspended Solids
9.17 4.17
mg/L 1
06/11/19 1035
CLB
SM 5220 D-2011
COD, Total
35.6 10.0
mg/L 1
06/11/19 0854
MT
Field Sampling/Testing Result RL Units Dilution Note Prepared Analyzed Analyst
Field
Rainfall
0.40
inches
1
06/10/19 1651
06/10/19 1653
MCI
Field Observation
Color
Gray
1
06/10/19 1651
06/10/19 1653
JMO
Odor
None
1
06/10/19 1651
06/10/19 1653
JMO
Clarity
Some
1
06/10/19 1651
06/10/19 1653
JIMO
Floating Solids
None
1
06/10/19 1651
06/10/19 1653
JMO
Suspended Solids (Residue,
None
1
06/10/19 1651
06/10/19 1653
JMO
Non -Filterable)
Foam
None
1
06/10/19 1651
06/10/19 1653
JMO
Oil Sheen
None
1
06/10/19 1651
06/10/19 1653
JMO
Erosion Evidence
None
1
06/10/19 1651
06/10/19 1653
JMO
Other Pollution Indicators
None
1
06/10/19 1651
06/10/19 1653
JIMO
SM 2550 B-2010
Temperature, Field
26
0.1 °C
1
06/07/19 1135
JMP
SM 4500 H+9-2011
pH, Field Test
7.5
1.0 pH Units
1
06/07/19 1135
JMP
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page 1 Of 4

(VMICROBAC°
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9F0092
Definitions
MDL: Minimum Detection Limit
RL: Reporting Limit
Project Requested Certification(s)
Microbac Laboratories, Inc. - Fayetteville
11 North Carolina DENR NPDES
Report Comments
Reviewed and Approved By:
Samples were received in proper condition and the reported results conform to
applicable accreditation standard unless othenvise noted. CL1L/u= LcriG,9.Zm.
The data and information on this, and other accompanying documents, represents ((ll
only the samples) analyzed. This report is incomplete unless all pages indicated Jeanne Overstreet
in the footnote are present and an authorized signature is included. Client Relationship Specialist, Environmental
Reported: 06/24/2019 13:34
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com page 2 of 4

Fayetteville Division 2592 Hope Mills Road — Fayetteville, NC 28306 (910) 864-19201864.8774 fax
`,D MICROBACO
CHAIN OF CUSTODY RECORD
PAGE 1 OF _
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Turnaround time: REGULAR RUSH
Comments or Spaclal Hazards: RV'IEWED
IS DATA FOR REG. COMPLIANCE PURPOSE?
NO YES WHICH:
Page 3 of 4

C31E
STORM WATER - QUALITATIVE MONITORING
STORM
SITE #
DATE
SAMPLED
COLOR
ODOR
CLARITY
FLOATING
SOLIDS
SUSPENDED
SOLIDS
FOAM
OIL SHEEN
EROSION OR
DEPOSITION AT
THE OUTFALL
OTHER OBVIOUS
INDICATORS OF
STORMWATER
POLLUTION
2
3
TOTAL RAINFALL (inches): o .'7 .gym--L,
Page 4 of 4