NCG060391_MONITORING INFO_20191204

/ Z�) P�.,\
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
lY C b�p o
DOC TYPE
❑ HISTORICAL FILE
[YMONITORING REPORTS
DOC DATE
❑ �a
YYYYMMDD

ETC
ENVIRONMENTAL • GEOTECHNICAL
BUILDING SCIENCES - MATERIALS TESTING
November 25, 2019
2725 E. Millbrook Rd., Ste. 121
Raleigh, NC 27604
"telephone [phone]
Fax [phone]
www. atcgro apse ry ices. c om
North Carolina Department of Environmental Quality (NCDEQ)
Division of Water Quality
AT.TN: DWQ Central Files
1617 Mail Service Center RECEIVED
Raleigh, NC 27699-1617
DEC 0 4 2019
Re: Stormwater Discharge Monitoring Report CEN I W\L FILES
Certificate of Coverage NO. NCG060391 DIAIR SL=CT10N
Pepsi Bottling Ventures, LLC
390 Business Park Drive
Winston-Salem- NC
To Whom It May Concern:
ATC Associates of North Carolina, P.C. (ATC), on behalf of Pepsi Bottling Ventures, LLC is
submitting the Semiannual Storm Water Sampling Report for the above referenced site. One
original and one copy of the certified Discharge Monitoring Report (DMR) is included in
Attachment C of the report.
Sincerely,
ATC Associates of North Carolina, P.C.
Gabriel Araos, P.L.
Senior Project Manager
Attachment: Semiannual Stormwater Sampling
cc: Bill Peterson, Pepsi Bottling Ventures, LLC

i
PYRAM 1 D
ENVIRONMENTAL & ENGINEERING, P.C.
November 8, 2019
Mr. Gabe Araos
ATC Group Services, LLC
2725 Millbrook Road
Raleigh, NC 27604
RE: Semi -Annual Stormwater Sampling —2nd Half 2019
Pepsi Bottling Ventures, 390 Business Park Drive, Winston-Salem, NC
Pyramid Project # 2019-234
Mr. Araos:
As requested by ATC Group Services, LLC, Pyramid Environmental & Engineering, P.C. has
completed the stormwater sampling and analysis for the referenced site. The location of the site
is shown on the USGS topographic map presented as Figure 1. A site map showing the existing
building and stormwater outfall locations is presented as Figure 2.
As shown on the site plan, the site includes three outfalls. Stormwater from the west side of the
facility flows to Outfall 401 on Business Park Drive. Stormwater from the east side of the facility
flows to Outfall #02 and stormwater from the truck parking area on the east side of the property
flows to a retention pond on the northwest side of the parking area. Water from the retention
pond discharges to an overflow catch basin on the northwest side of the pond and drains
northwest to a pond on the adjacent property to the north. Outfall 403 is the discharge point for
the retention pond. The receiving stream for all stormwater run-off from the site is Sawmill
Branch.
Sample Collection and Laboratory Analysis
On October 30, 2019, Alan McFadden of Pyramid successfully collected stormwater samples
from Outfall #01 and 402 during a representative rain event. Samples were not collected from
Oudall 403 during this sampling event. Outfall #03 is the discharge pipe for the retention pond
on the eastern portion of the site. No stormwater flow was occurring at Outfall #03 at the time of
the sampling event on 10/30/19.
The qualitative monitoring reports were completed for OLltfall #01 and #02 by Pyramid and are
included in Attachment A. The qualitative monitoring report describes the visual appearance of
the stormwater run-off at the outfalls at the time of the sampling event. No unusual conditions
were observed by Pyramid. The total event precipitation included on the qualitative form is from
the Smith Reynolds Airport and was obtained from the North Carolina Climate Office, Weather
and Climate Database.
P.O. [lox 16265 • Greensboro, NC 27416
503 Industrial Ave • Greensboro, NC 27406
Phone [phone] • Fax[phone]• Toll Free(866)545-9507
Email: lnfo, yramidenvironmenlal com
�v%%w.m'mmidenvironmental com

The stormwater samples were placed on ice and transported to Research and Analytical
Laboratories, Inc. in Kernersville, North Carolina. The samples were analyzed for oil & grease,
chemical oxygen demand (COD), total suspended solids (TSS) and PH.
The laboratory results of the stormwater samples are presented in 'fable 1, which is included in
Attachment 13 with a copy of the lab report. As shown in Table 1, the detected concentrations of
oil & grease, COD and TSS in the samples collected from OUtfalls #01 and #02 do not exceed
the benchmark values specificd in General Permit NCG060000 and the laboratory pH reading
was within the specificd range of 6.0 — 9.0 specified in the permit.
Pyramid also completed the stormwater discharge monitoring report for Outfall #01 and 402 as
specified in General permit NCG060000. The completed monitoring report are included as
Attachment C. A representative of Pepsi Bottling Ventures is required to sign page two of the
monitoring report and send the original and one copy to the address shown on page two.
The next semi-annual sampling event will be performed between January I and June 30, 2019.
The samples will be analyzed for the compounds as specified in the general permit. Please
review this information and call me at 335-3174 if you have any questions.
Sincerely,
Brett S. Higgins
Project Manager
Figure I & Attachments A, B, & C
Pepsi Bouling Ventures - 390 Business Park Dr., Winston-Salem, NC - Stornnrater Sampling 11108/19
Pyramid Project it 2019-234 2

PYRAMID
ENVIRONMENTAL& ENGINEERING, P.C.
ATC Group Services LLC
390 Business Park Drive
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o
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report.
For guidance onfi//ing out thisform, please visit https://deg.nc.izov/aboiit/divisions/enerev-mineral-land-
resources/enerev-mineral-land-permits/slormwater-permits/nodes-industrial-sw#tab 4
Pennit No.: N/C/0 / 6 / 0 / 0 / 0/ 0 /_/ or Certificate of Coverage No.: N/C/O/ 0 / 6 / 0 / 3 / 9 / 1 /
Facility Name: Pepsi Bottling Ventures - 390 Business Park Drive Winston-Salem NC
County: Forsyth
Inspector:
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): ,�- -b L
No. [phone]
All permits require qualitative monitoring to be performed during a "measurable storm event."
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 pernittee 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 DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. #01 Structure (pipe, ditch, etc.): Manhole in Business Park Dr. near entrance
Receiving Stream:
Sawmill Branch
Describe the industrial activities that occur within the outfall drainage area: Truck and trailer parking
raw material and finished product loading and unloading
Page I oft
SWU-242, Last modified 07/28/2017

2. Color: Describe the color of the lscltarge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C1FGr c%AA lThf
3. Odor: Describe any
chlorine odor, etc.): VI Q
odors that the discharge may have (i.e., smells strongly of oil, weak
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
U2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
0 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
lO 2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes No.
8. Is there an oil sheen in the stormwater discharge? 0Yes / No.
9. Is there evidence of erosion or deposition at the outfall? o Yes No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 6) In C)4er C)�'J;o 5 6-1 " ro4oYS f1k-alleOI
(Vote: 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
St4U-242, Last modified 07/28/2017

Envfronme.mal
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance onfrlling out thisform, please visit https://de(l.ne.gov/about/divisions/energy-mineral-land-
resources/energy-mi neral-land-permits/stormwater-permits/nodes-industrial-sw#tab-4
Permit No.: N/C/ 0 / 6 / 0/ 0/ 0/ 0 /_/ or Certificate of Coverage No.: N/C/O/ 0 / 6 / 0 / 3/9/ 1 /
Facility Name: Pepsi Bottling Ventures - 390 Business Park Drive. Winston-Salem NC
County: Forsyth Phone No. [phone]
Inspector:
Date of Ins
Time of In;
Total Event Precipitation (inches): 0,1L,
All permits require qualitative monitoring to be performed during a "measurable storm event."
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 perrnittee obtains approval from the local DEMLR
Regional Office.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or
1. Outfall Description
Outfall No. #02 Structure (pipe, ditch, etc.): Manhole on east side of facility, south
Receiving Stream: side of road to truck parking lot.
Sawmill Branch
Describe the industrial activities that occur within the outfall drainage area: Truck fueling area. used
.oil filter storage and exterior material storage
Page 1 of
S WU-242. Last modified 07/28/2017

2. Color: Describe the color of the discharge using basi �jolors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ CG2 - Q �I tg C
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): — ylt prllC�
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
l� 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:
l 22 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes No.
8. Is there an oil sheen in the stormwater discharge? OYes No.
9. Is there evidence of erosion or deposition at the outfall? O Yes W No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe Nd • .' • L yinu5 i4nrl .• •
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 07282017

KICIV
En"Ironmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance mtftlling out thisform, please visit littps://deq.tic.gov/about/divisions/enerev-mineral-land-
resources/enerev-mineral-I and-oe rm its/sto rmwater-perm its/n o des-i nd ustri a1-s w#tab-4
Permit No.: N/C/0 /6 / 0 / 0/ 0/ 0 /_/ or Certificate of Coverage No.: N/C/G/0 / 6 /0/ 3/9/ 1 /
Facility Name: Pepsi Bottling Ventures - 390 Business Park Drive. Winston-Salem NC
County: Forsyth A . r Rhine No. [phone]
Inspector:
Date of Inspection: t) SV P1
Time of Inspection: I S --
Total Event Precipitation (inches): V"7
All permits require qualitative monitoring to be performed during a "measurable storm event."
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 DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. #03 Structure (pipe, ditch, etc.): 8-inch corrugated metal pipe on NW
Receiving Stream: side of retention pond
Sawmill Branch
Describe the industrial activities that occur within the outfall drainage area:
Truck and trailer parking area.
Page 1 of 2
S WU-242, Lut modified 0728/2017

2. Color: Describe the color of the
(light, medium, dark) as descriptors: _
3. Odor: Describe any distinct odors
chlorine odor, etc.):
colors (red, brown, blue, etc.) and tint
discharge may have (i.e., smells strongly of oil, weak
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
1 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? o Yes o No.
8. Is there an oil sheen in the stormwater discharge? 0Yes 9 No.
9. Is there evidence of erosion or deposition at the outfall? o Yes O No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
S WU-242, Lmt modified 07282017

TABLE 1
Stormwater Analytical Results for Outfalls #01, #02 & #03
Pepsi Bottling Ventures
390 Business Park Drive, Winston-Salem, NC
PARAMETER ,
-
-, UNITS
"
': Date ;_,
LaboratoryResults
-.
'Outfall #01 .--.Outfall #02 Outfall #03 -
y
"Benchmark .Concentration'.
Per,'-General7e­mit "
Oil'& Grease
mg/L- ".
09/26/18
<5
NS
NF
30 mg/L
04/05/19
<5
<5
NF
10/30119
<5
<5
NF
- -
Total Suspended Solids
(TSS)'
•
mg/L
09/26/18
<5
NS
NF
100 mg/L
04/05/19
18.4
24.9
NF
10/30/19
18.4
13.2
NF
f•
Chemical Oxygen Demand,
(COD)
..
. mg/L
09/26118
NA
NA
NF
120 mg/L
04/05/19
17.0
28.0
NF
`10/30/19
18.0
33.0
NF
-
pH'
-
=-
iStandard
/
-
09/26118
6.48
NS
NF
6.0-9.0
04/05/19
6.43
6.89
NF
10/30/19
6.06
6.50
NF
NS = Sampes were not collected from this outfall
NF = No flow occurred at this outfall
Page 1 Df 1

RES1EARCh & A1Wy1riCA1
�CQO UbommROES, INC.
For: Pyramid Environmental
503 Industrial Avenue
Greensboro, NC 27406
Attn: Brett Higgins
Report of Analysis
11 /6/2019
i1....1. y5er A�
ar4i�—°2�� c p 100
y4q;, N
NC#37701 j
G��A Diq�� pP �\ypC
Client Sample ID:
Pepsi Bottling Ventures Outfall #01
Lab Sample ID:
74156-01
Site:
Pyramid Environmental
Collection Date:
10/30/2019 15:10
(Parameter
Method
Result
Units
Rep Limit Analyst Analysis.Daterrime
COD
EPA410.4
18
mg/L
5
HW 11/1/2019
Hydrocarbon O&G
EPA 1664 Revision B/Silica Gel
<5
mg/L
5
EE 10/31/2019
pH
SM 4500 H+B-2000
6.06
Std. Units
LP 10/31/2019 1424
Total Suspended Solids (TSS) SM 2540 D-1997
18.4
mg/L
5
AW 11/1/2019
-lient Sample ID:
Pepsi Bottling Ventures Outfall #02
Lab Sample ID:
74156-02
Site:
Pyramid Environmental
Collection Date:
10/3012019 16:00
Parameter
Method
Result
Units
Rep Limit Analyst Analysis Dateatme
COD
EPA410.4
33
mg/L
5
HW 11/1/2019
Hydrocarbon 08G
EPA 1664 Revision B/Silica Gel
<5
mg/L
5
EE 10/3112019
pFl
SM 4500 H+B-2000
6.50
Sid. Units
LP 10/31/2019 1427
Total Suspended Solids
(TSS) SM 2540 D-1997
13.2
mg/L
5
AW 11/112019
NA = not onolyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] w .randalabs.com Page 1
rail coa basic yid'

RESEARCh A ANA1yTICA1
LZORATORIES, INC.
Analytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
WATER I WASTEWATER I misc.
OOM17PA�PyramidEnvironmental
JOB NO. 2019-234.
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'�' ry h� h� ^^' ^ �` REQUESTED ANALYSIS
STREETADDRESS
503 Industrial Avenue
PROJECT
Pepsi Bottling Ventures
CITY. STATE. ZIP Greensboro, NC 27406
SAMPLER NAME (PLEASE PRINT)
Alan McFadden
CONTACT PHONE
Brett Higgins 336-335-3174
SAMPLER SIGNATU E
/ /
SAMPLE NUMBER
(LAB USE ONLY)
DATE
TIME
COWGRAB
ENP
,C
RES
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piORJ�
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SAMPLE LOCATION I LD.
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5'O
X
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Outfall #01
1
X
X
X
I
I
I
I
10&G,TSS.00D&j2H
2
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CC
X
W
Outfall #02
1
1x1x
Ix
�.X--
W'--Outfalt-#03�
REISHED Y
n 1
DATERIME
Q��,
RECEIVED BY
REMARKS;
F
SAMPLE TEMPERATUREATRECEIPTS °C
RELINQUISHED BY
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RECEIV DBY

_7
STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO60000
Date submitted October 30, 2019
CERTIFICATE OF COVERAGE NO. NCG06 0 3 9 1
FACILITY NAME Pepsi Bottling ventures- 390 Business Park Drive, Winston-Salem, NC
COUNTY Forsyth
PERSON COLLECTING SAMPLES Alan McFadden- Pyramid Environmental
LABORATORY Research & Analytical Laboratories Lab Cert. ff 34
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
RE Other class C
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall a 2.66 or ❑ No discharge this period'
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
Soo'
Parameter Code
-
C0530
00400
00340
00556
31616
61211
01
10/30/19
18.4
6.06
18
<5
NA
NA
02
10/30/19
13.2
6.50
33
<5
NA
NA
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
' For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See 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 ❑■ no (if ves. complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/S/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/O
Parameter Code
-
46529
NCOIL
00552
CO530
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
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mallon original copy of this DMR including all "No Discharge" reportswithin 30 days of receipt of the lob results for of 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, ac e, a complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and
II impris me for 1m wi violations."
1
Slgna re ermittee D e
Permit Date: 11/l/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted October 30, 2019
CERTIFICATE OF COVERAGE NO. NCG06 0 3 9 1
FACILITY NAME Pepsi Bottling Ventures - 390 Business Park Drive, Winston-Salem, NC
COUNTY Forsyth
PERSON COLLECTING SAMPLES Alan McFadden -Pyramid Environmental
LABORATORY Research 8 Analytical Laboratories Lab Cert. # 34
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
FM�Other class C
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall' 2.66 or ❑ No discharge this period3
- .`OutfalPNo
- - ,Collected;
Da- te Sample
and/iJd/yr
'." �Tss
;- •:mg/L. - ,
,pH; -.
r,Standardiunits,
' ;COD 1
,.,mg/L-�
�, •'Ott and Grease < _
: mg/L'p ,
" "Fedal�Coliform
,Colontesiper.l00 m1:.
! : .•Eriterococci;:
-aColonies per 100.m1- .
Beric6ma�k—
i .100-od501 %
":Within`.6.0; 9 0_
_ • 120 , ,
1, -. 30}"
Pardrrieter Code;•
_
-
.'C0530,:
�00400
h00340,`. •
,'.. <00556p
r31616 _
- , 61211:
01
10/30/19
18.4
6.06
18
<5
NA
NA
02
10/30/19
13.2
6.50
33
<5
NA
NA
' Only applies to facilities that use/process meats.
2The 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.
'Monthly 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 yes, 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
Imo/dd/yrl
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/0
Parameter Code
-
46529
NCOIL
00552
0O53b
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 Q NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob 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, 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, ac e, a complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and
impriso me for known g violations."
Sa rmittee D (e . lgnre e
Permit Date: 11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
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