NCG210219_MONITORING INFO_20190812

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
E)CMONITORING REPORTS
DOC DATE
❑ a��� b /�
YYYYM M D D

S'I'ORMWA'fER D[SCIIAI� \pUl'FALL (Sll0)
MONITORING lx ,PORT
GENERAL PERMIT NO. NCG210000 SAMPLES COLLECTED DURING CALENDAR YEAR: of
ct
CERTIFICATE OF COVERAGE NO. NCG219®©[t] (This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory,)
FACILITY NAME 6-IdC4 L, COUNTY a
PERSON COLLECTING SAMPLES in�4�ni�:zr°j- PHONE
CERTIFIED LABORATORY o__4— 2rA ab #_ 14,5 Lab # PLEASE SIGN ON THE REVERSE
Part A: Specific Monitoring Requirements'
Outfall Date 00530 00400,. 00340.
No. Sample Collected; total Rainfall, Total Suspended Solids, p13; Chemical Oxygen Demand (COD);
trio(dd/ r inches m Standiird units
hi
'Benchmark'": .100 - Within.6.0.-90-..120;.. .
o .-19 7 r7
Monitoring is required only if the facility stores exposed piles of sawdust, wood chips, bark, mulch, or other similar material on site for longer than seven (7) days.
__ ,___ .,._ ,.e..:a,..,a..., t.Pt..,v ..,st he signed. The facility shall
1 1'•�r�
If the facility elects not to monitor because accumutatea material is icuiuvcu j- --------- -- - -
also record and maintain a log in its SPPP (Stormwater Pollution Prevention Plan) of dates when material is generated and removed, how, and by whom. -
*Note: If you report a value in excess of the benchmark value, or outside the benchmark range (for pH), you must implement Tier 1 or Tier 2 responses in the General Permit.
Facilities that do not store exposed (either exposed to incident precipitation or exposed to stormwater inn on) piles of sawdust, wood chips, bark, mulch, or other similar material for
longer than seven (7) days on site may so certify, and the requirement for analytical monitoring may be waived. For those facilities that qualify for the analytical 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 requirement for
analytical monitoring, I certify that to the best of my knowledge and belief, no piles of sawdust, wood chips, bark, mulch or
other similar materials were stored exposed (either to incident precipitation or to stormwater run on) for longer than seven (7)
days before removal since filing the last discharge monitoring report."
Name (Print name)
Title (Print title)
(Signature)
(Dale)
o
X
CC
i3
e-)
i J
�
Z
G)
v
S W U-245-072808
Page I of 2

STORNMAIIIERD. �ARGIOOtJTFALL(YD))
MONITORING TORT
" 1 certify, under penalty of law, that this document and all attachments were prepared under my direction rir .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 imfoemutior submitted.is; to the best
of my knowledge and bclicf,'true,'uc urute,'and complete, I am aware that there are significant penalties for submillhig false infiiirmatioin,
including -the possibility of fines and imprisonment for knowing violations."
(Signature c permdtee) - (Date)
Perm SNVIJ-254-071400
Pagc 2 of 2

CE44
{IFF�ry+.f
urn?"
Contact: Dale Mathews
Client: M & M Water
3191 Gela Dr.
Oxford, NC 27565
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Report Date: 7/1/2019
Date Sample Rcvd: 6/20/2019
Meritech Work Order # 06201966 Sample: Toney Lumber Stormwater Grab 6/20/19
Parameters
Result
Analysis Date
Regulatory Limi
Method
COD
71 mg/L
6/21/19
15 mg/L
EPA 410.4
Total Suspended Solids
19 mg/L
6/24/19
2.5 mg/L
SM 2540 D
G
I hereby certify that] have reviewed and approve these data. 4j, —Z
L oratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Chain of Custody Record (COQ
ERITECH, INC.
` ENVIRONMENTAL LABORATORIES
•i 642 Tamco Rd. Phone: [phone]
Reidsville NC 27320 Fax: [phone]
Email: [e-mail]
www.meritechlabs.com
Sampling Dates & Times
Phone:
Dn: bAe- MaAeu` Turn Around Time'
HOW would you like your report sent? 'RUSH work needs prior approval.
Circle all that apply: Email (preferred , Fax, Mail 5td 10 da s) 1 "11aKs I Zan
Sample Location and/or ID # .11
Start End T'
Comp. 4of on lce� pH OK
Date Time q Date R Time Grab? Co1nt. Test(s) Required - Na1
6i.e
Method of
Shipment:
Lzi UPS
Fed Ex
1 1b m-r7 I q.-o,,,.l G— I t l Cv 17 S I
'•' Dechlorination (<C
"7> o4
,Are these results for ree
t7
JII�—C- �6
r purposes? Yes 4,,,.1 No
D „Ra' 1 Time: 7
—Date: -- Time: c
f
KN samples must be done in the
C(�- d .l J- "3It
by Lab:
results in: mg/L
Date: / Time:

4
a
Stormwate>r Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/C/G /,A/1/ CK&D-10—/
Facility Name: 7nwx L..
County: F 77i
Inspector:
Date of Inspection: ram
Time of Inspection:
i
or Certificate of Coverage No.: N/C/G/ 2/ I l O/ ULI�I
Total Event Precipitation (inches): YZ
No.
Was this a Representative Storm Event? (See information below) 2/yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
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
By this signatur9!I�certify thy"is report is accurate and complete to the best of my knowledge:
(Signature of PermitteC or Designee)
1. Outfall Description: \ ,
Outfall No. I_ Structure (pipe, ditch, etc.) J
Receiving Stream:
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:
3. Odor: Describe any distinct odors that
chlorine odor, etc.):
discharge may have (i.e., smells strongly of oil, weak
SWU-242-051308
Page 1 of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: ^
�`jj') 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:
1 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:,
2 3 4, 5
7. Is there any foam in the stormwater discharge? Yes
j 8. Is there an oil sheen in the stormwater discharge? Yes /rvo)
j 9. Is there evidence of erosion or deposition at the outfall? Yes 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
b
SWU-242-051308

STORMWATER DISCHAk. �)UTFALL (SDO) 1
MONITORING r., PORT
GENERAL PERMIT NO. NCG210000 SAMPLES COLLECTED DURING CALENDAR YEAR: of t —
CERTIFICATE.OF_COVERAGE.NO. NCG210®QF11 (This monitoring report is due at the Division no later than 30 days from
the date the facility receives —the results Ino n the Fabio atory.)
FACILITY NAME e COUNTY �✓ a
PERSON COLLECTING SAMP ES t. PHONE NO. (-TV) is <
CERTIFIED LABORATORY o: r ftA, ab #� _ Lab # PLEASE SIGN ON THE REVERSE
Part A: Specific Monitoring Requirements
Outfall
No.
Benchmark*..
Date
Sample Collected;
itio/dd/ r
..
Total Ramfallr ..
ihches
00530 ,.
00400:...
00340.
Total Suspended Solids$
ni'
100
pH;
Standidrd obits
Withhi b.0= 9.0
r Chemical Oxygeh 17emand (COI)
}
vi
120:..: .:..: ...::..
it
Monitoring is required only if the facility stores exposed piles of sawdust, wood chips, bark, mulch, or other similar material on site for longer than seven (7) days
h, s,onrtl. The facilitv shall
If the facility elects not to monitor because accumulates matenai is re❑iuvcu wiuuu O�.�., k.) u"Jo •••-------------- also record and maintain a log in its SPPP (Stormwater Pollution Prevention Plan) of dates when material is generated and removed, how, and by whom.
*Note: If you report a value in excess of the benchmark value, or outside the benchmark range (for pH), you must implement Tier I or Tier 2 responses in the General Permit.
Facilities that do not store exposed (either exposed to incident precipitation or exposed to stormwater run on) piles of sawdust, wood chips, bark, mulch, or other similar material for
longer than seven (7) days on site may so certify, and the requirement for analytical monitoring may be waived. For those facilities that qualifyforthe analytical 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 requirement for
y .
analytical monitoring, I certify that to the best of my knowledge and belief, no piles of sawdust, wood chips, bark, inueve ur
� o
other similar materials were stored exposed (either to incident precipitation or to stormwater run on) for longer than seven (7)
days before removal since filing the last discharge monitoring report."
o
tv
i-j
Name (Print name)
�p
y
H y
4'.�
n
r-tY
Z �
�
Title (Print title)
0
(Date)
(Signature)
SWU-245-072808
Page I of 2

STORnnvnTrRD, IRGEOUTFALI,(.SDO)
MONITORING REPORT
"I ccrti y�der penally ()flaw, that -this —do cument and all attaeluucuts were prepared under my direction or supervision a of ccordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Bused 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 signifcunt penalties for submitting false infornintion,
including the possibility of fines and imprisonment for knowing violations."
(Signature c Porm ttce) (Date)
Forot SWU-254-071400
Page 2 of 2

Contact: (Dale Mathews
Client: �M & M Water
�3191 Gela Dr.
Oxford, NC 27565
COD
Total
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Report Date: 7/1/2019
Date Sample Rcvd: 6/20/2019
: Order # 06201966 Sample: Toney Lumber Stormwater Grab
esult Analysis Date Reeulatory Limit
71 mg/L 6/21/19 15 mg/L
Solids 19 mg/L 6/24/19 2.5 mg/L
I hereby certify that I have reviewed and approve these data.
6/20/19
Method
EPA 410.4
SM 2540 D
LlaboFatory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Chain of Custody Record (COC)
Al
Y
MERITECH, INC.
ENVIRONMENTAL LABORATORIES
642 Tamco Rd. Phone: [phone]
Reidsville NC 27320 Fax: [phone]
Email: [e-mail]
www.meritechlabs.com
Sampling Dates & Times
Sample Location and/or ID # Start I End
Date I Time I Date IT
Method of
*** Dechlorination (<o
Shipment:
Comments:
�\L,� ��} ; -m4
UPS
] Fed Ex
A Are
hes results for reg
Hand Delivery
;V4
Other
RdllnquisteA.
,n1VAv
Relinquished y:
Project:
P.O.#:
How would you like your report sent?
Circle all that apply: mail (preferred , Fax, Mail
Comp?I Cont. Grab?Test(s) Required
Yes V No
Time:
CN samples must be done in the
Lab:
results in:
Turn Around Time*
-RUSH work needs prior approval.
Time:
Time:

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
NO.: or Certificate of Coverage No.: N/C/G/ 2/ 1 / O/ Z/L/�,/
Name: 7anwa
County: F �✓ ' Phon
Inspector:
Date of Inspection:
Time of Inspection: 0 Al i
!Total Event Precipitation (inches): XZ
No.
this a Representative Storm Event? (See information below) (_y' Yes ❑ No
check your permit to verify if Qualitative Monitoring must be performed during a representative
event (requirements vary).
"Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
A single storm event may contain up to 10 consecutive hours of no
By this signatur�!%Certify this report is accurate and complete to the best of my knowledge:
I
(Signature of Permits or Designee)
1. Outfall Description:
Outfall No. �__ Structure (pipe, ditch, etc.) cx 4,W,
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Z. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint i
(light, medium, dark) as descriptors:
Odor: Describe any distinct odors that thQ discharge may have (i.e., smells strongly of oil, weak
odor, etc.): AJi�7�
Page 1 of 2
SWU-242-0513DB

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
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 3 4 5
6.
P
Suspended Solids: Choose the number which best describes the amount of suspended solids in
th
P
Suspended Solids: Choose the number which best describes the amount of suspended solids in
e stormwater discharge, where 1 is no solids and 5 is extremely muddy:
2 3 4. 5
I
Is there any foam in the stormwater discharge? Yes
Is there an oil sheen in the stormwater discharge? Yes /No 1
Is there evidence of erosion or deposition at the outfall? Yes No
0. Other Obvious Indicators of Stormwater Pollution:
.ist and describe
I
lote: 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
j 8WU-242-051308
j 8WU-242-051308