NCG210050_MONITORING INFO_20190705

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
L MONITORING REPORTS
DOC DATE
❑ ab��ti��S
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina DEMLR General Permit No. NCG210000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG21D O S O
FACILITY NAME kTL-Awl 1 L L Vtc. VE%
COUNTY GAZT$�z�
PERSON COLLECTING SAMPLES SCc>—rT
LABORATORY I Lab Cert. # LC>
Comments on sample collection or analysis
LA) l OD
SAMPLE COLLECTION YEAR Zo 16l
SAMPLE PERIOD ❑ Jan -June ❑ Jul -Dec
or `® Monthly' month
RE(� DISCHARGING TO CLASS ❑ORW HQW []Trout❑PNA
v�IVED ❑Zero -flow ❑Water Supply MSA
JUL 0 5 2019 ❑Other
CENTF�Ai_ FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DlryR secrFory
Part A: Stormwater Benchmarks and Monitoring Results (Monitoring is required only if the facility stores exposed accumulations of sawdust, wood chips,
bark, mulch, or other similar material on site for longer than seven (7) days.)
❑ No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Chemical Oxygen Demand
,
Total Suspended Solids
Benchmarks =__>
-
-
120 mg/L
100 mg/L or 50 mg/L"
2
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
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 text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, 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.
Permit Date: 8 1 2018-7 3112023 SW U-245, last revised 81 /2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L"
Footnotes from Part A also apply to this 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.
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:
Mail an original and one copy of this DMI
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
all 'No Discharge" reports, within 30 do
the lab results (or at end
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-fb7submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Page 2 of 2

1MU-7 IM
Cnvironmentul
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit hugs://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/ / / / / / / / or Certificate of Coverage No.: N/C/G/'L/ 1 /O/O/S/G)
Facility Name: A-4a T-L C— \l £.3rA.
County: Phone No. ZSZ 7K3 ``f Z4
Inspector: 5c-C;x i V/3��D£2L lr2 (—
Date of Inspection: /f
Time of Inspection:
Total Event Precipitation (inches): v Z
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:
ittee or
1. Outfall Description:
Outfall No. 3 Structure (pipe, ditch, etc.):
Receiving Stream: /—
�Yc...�f2.S
Describe the industrial activities that occur within the outfall drainage area:
Lotti �-rocz aF,rl, lycf� A woo TlZ.�ti b Q T2.�� �t c_
Page I of 2
SWU-242, Last modified 06/01/2019

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct
chlorine odor, etc.): '-t �
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 I is clear
and 5 is very cloudy: C)
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:
0 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:
7.
9
9.
/1 1 2 3 4 5
Is there any foam in the stormwater discharge? O Yes No.
Is there an oil sheen in the stormwater discharge? 0Yes No.
Is there evidence of erosion or deposition at the outfall? O Yes 10 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
SwU-242, Last modified 06/O1/2019

El oP0mH&W alp hmpwd( d
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone]
ATLANTIC VENEER CORP.
RON SMITH
457 LENNOXVILLE ROAD
]3EAUFORT ,NC 28516
PARAMETERS
COD, mg/l
Total Suspended Residue, mg/l
Oil & Grease (HEM), mg/l
Stormwater Analysis Method
(#3, Grab) Date Analyst Code
39 06/07/19 SEJ H8000-79
12 06/07/19 JMH 2540D-11
< 6 06/06/19 SEJ 1664B
ID#: 430
DATE COLLECTED: 06/05/19
DATE REPORTED : 06/10/19
REVIEWED BY:

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O. Box 7085, 114 Oakmont Dr. Page 1 of 1
Greenville NC 27858
environment I inc.com
Phone [phone] • Fax [phone]
DISINFECTION
CHLORINE
CHLORINE NEUTAALIZEDATCOLLECTION
CLIENT: 430 Week:19
Ij UV
it
pHCHECK (LAB)
P
P
G
CONTAINER TYPE,P/G
TLAN71C VENEER CORP.
❑ NONE
ON SMITH
C
A
C
CHEMICAL PRESERVATION
157 LENNOXVILLE ROAD
EAUFORT NC 28516
52)728-3169
COLLECTION
F A -NONE D-NAOH
C B-HNO E-HCL
3
C-H,SO, F-ZINC ACETATENAOH
� G-NATHIOSULFATE
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a �
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❑
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SAMPLE LOCATION
DATE
TIME
Stormwater (N3, Grab)
Gongi
J ) '!r
0
3
-
.....
CLASSIFICATION:
WASTEWATER(NPDES)
L) DRINKINGWATER
DWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING HIPMENT/DELIVERY
Y N
SAMPLES COLLECTED BY:
(Please Print)
SAMPLES RECEIVED IN LAB AT 3' (o °C
RELINQUISH DBY(S .)( LER)
DATEITIME
RECE ED Y(SIG.) („
DATEf1ME
QQMMENTS:
Awn]-inc
�(�
DATEIIME
RECEIVED BY(SIG.
DATE (TIME
REUNQUISHEDBY(SIG.)
RELINQUISHED BY (SIG.)
DATEf1ME
RECEIVED BY (SIG.)
DATEfIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a T" for composite sample or a "G" for
FORM as Grab sample in the blocks above for each parameter requested. N U 363606

SAMPLING INSTRUCTIONS AND FORM COMPLETION
FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE
TYPE$, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE
SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING
REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE.
1) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any
deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current
samples. Any samples analyzed outside of the required guidelines will be "qualified". This means that a note will be included on the
sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the
deviations.
2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is
not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the
temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there
is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed in wet ice using as
much ice as will fit in the cooler.
3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium Hydroxide. The
laboratory will either provide the preservative in the sample bottle, or in the case of 40 mi. Volatiles Vials, provide a bottle of Acid with
detailed descriptions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the
bottle is required for proper chemical preservation. The lab must verify proper chemical preservation upon arrival in the lab and will note
this information in the spaces provided on the front of this form.
4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will
provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen
and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the
dechlorinating agent. Therefore, these samples must be de -chlorinated at the time ofcolleclion before being placed in our sample bottles.
Sodium Thiosultate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for
Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total
Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must put his initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Colilbrms (which have
Thiosultate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you
note the "Total Chlorine at Collection' on the front of this form for any sample locations applicable. This value would be before any
neutralization is performed.
5) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box total] requested parameters. Grab temperatures
as well as Composite start dales and times can be recorded in the `comments" section.
6) Other information required to be completed by the client are:
Collection Date and Collection Time for each sample location Temperature at Time of Collection
Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished
Other added sample locations and analyses required Type OP Disinfection
Deletion on the form for any samples which are not needed (example: dry upstream location)
Any other information felt to be pertinent should be included in the "Comments" section
CONSIDERATIONS:
Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should
be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis.
BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and MBAS samples have a 48 hour holding time. The lab reserves the
right to establish required sample collection and delivery dates in order to meet the required holding times.
CAUTION
Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals
for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping
container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical
attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection.

W�P-a
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina DEMLR General Permit No. NCG210000
Date submitted 9 ?- )mil
CERTIFICATE OF COVERAGE NO. NCG21 D 2— 3 SAMPLE COLLECTION YEAR Zo 19
FACILITY NAME JAJ 'S f Fry -( SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY C.aLurhtx^a / or Q onthly' b1un2— (month)
PERSON COLLECTING SAMPLES M'• e 17 e Pc+� fZ�REGElNECQISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
LABORATORY Lab Cert. # JUL 23 2019 F::3-'v' �yi n e real_
,(,
Comments on sample collection or analysis:
CENTRAL FILES
SWR SECTION
th
ey .
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results (Monitoring is required only if the facility stores exposed accumulations of sawdust, wood chips,
bark, mulch, or other similar material on site for longer than seven (7) days.)
F\:�No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,Chemical
Inches
Oxygen Demand
Total Suspended Solids
Benchmarks =__>
-
-
120 mg/L
100 mg/L or 50 mg/L"
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 text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, 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 m¢/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.
Permit Date: 8/1/2018-7/31/2023 SW U-245, last revised 8/6/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
0 No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__> -
_
-
15 mg/L
100 mg/L or 50 mg/0
Footnotes from Part A also apply to this 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.
FOR PART 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 ❑91
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO 2-
REGIONAL OFFICE CONTACT NAME:
Mail an original and one
to:
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
all "No
ports, within 30 do
the lab results !or at end
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 forgathering 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: 8/1/2018-7/31/2023
(Date)
SWU-245, last revised 8/6/2018
P-I-fI