NCG030695_MONITORING INFO_20200129

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V C& Lv U
DOC TYPE
❑HISTORICAL FILE
(L( MONITORING REPORTS
DOC DATE
❑ rUa Ii co 1 a 1
YYYYMMDD

�ATI
January 23, 2020
Division of Energy Mineral and Land Resources
Attn: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files:
P.D. Box 5030
2020 Ashcroft Avenue
Monfoc, NC 29111-5030
Phone: [phone]
Fax: [phone]
!;mail: Danielle.RunockCC atimcttrls,coro
Attached, please find stormwater monitoring data for Permit No NCG030695. The originals and
one copy are included. The monitoring data is for the following monitoring schedule:
Monitoring Period
Sample Number.
Start
End
Year I — Period 2
1
July 1, 2019
1 December 31, 2019
Analytical monitoring includes:
• Outfall #01: Under Construction
• Outfal1 #02
• Outfall #03. No Flow
Il' you have any questions or need additional information, please contact me at 704-289-451 1
x3998. Thank you.
Sincerely,
Danielle Barrack
Manager, EH&S
RE C
"FI ED
JAN 2 9 2020
CENTRAL FILE,
DV" :1±Lr1o�1

Specialty Materials
ATi (Allvac) - --Bakers Campus (BPO & EIGA)
Stormwater Monitoring Report Form
Sample Date:
Sample Time:
Sample Location:
Stormwater Discharge Outfall # 01
Drainage Area= 1,809,000 sq. ft. = 25 Acres
% Impervious= 30%
Person Collecting Samples:
Laboratory Performing Analysis:
Analytical Techniques and Methods:
40 CFR Part 136
Results of Sample Analysis:
Parameter
Results (mg/I)
Benchmark Values (mg/1)
pH
(std units)
6-9
TSS
�
100
Copper, Total Recoverable
CD/��rdc�� a�
0.010
Lead, Total
-I�
0.075
Zinc, Total Recoverable
/Le, 1
0.126
Non -Polar Oil & Grease/TPH
D�, �,�,
15
Temperature
Deg. elsius
Storm Date:
Storm Duration:
Duration of time preceding rain event exceeding 0.1":
Estimated Flow Calculation:
(Hrs.) Inches of Rainfall:
(Hrs.)
Q=CIA
Q (Total) = Q (Pervious Area) + Q (Impervious Area)
Q (Tot., cfs) = (A x inches rain/12 inches/ft. x 25 acres x .70) + (.9 x inches rain/12 inches/ft. x 25 x .30)
Q (Tota I, cfs) = 0.5833 x
cfs
(Inches of rain) + 0.5625 x
(Inches of rain)
Rev. 01
Date of Rev.: 1/22/2020

-**- ATI
Specialty Materials
AT) (Allvac) — Bakers Campus (BPO & EIGA)
Stormwater Monitoring Report Form
Sample Date: _
Sample Time: P
Sample Location:
Stormwater Discharge Outfall # 02
Drainage Area= 217,800 sq. ft. = 5 Acres
% Impervious= 30%
Person Collecting Samples:
�?
Laboratory Performing Analysis:
ace i�•�
Analytical Techniques and Methods:
40 CFR Part 13
Results of Sample Analysis:
Parameter
Results (mg/1)
Benchmark Values (mg/1)
pH
(std units)
ZZ
6-9
TSS
%8•
100
Copper, Total Recoverable
N
0.010
Lead, Total
/VD
0.075
Zinc, Total Recoverable
0.126
Non -Polar Oil & Grease/TPH
15
Temperature
13.6 Deg. Celsius
Storm Date: la-10:z Storm Duration: /•a2 (Hrs.) Inches of Rainfall: O 3o
Duration of time preceding rain event exceeding 0.1": / AR (Hrs.)
Estimated Flow Calculation:
Q=CIA
Q (Total) = Q (Pervious Area) + Q (Impervious Area)
Q (Tot., cfs) = (A x inches rain/12 inches/ft. x 5 acres x .70) + (.9 x inches rain/12 inches/ft. x 5 x .30)
Q (Total, cfs) = 0.1167 x (Q. -O (Inches of rain) + 0.1125 x Q •.30 (Inches of rain)
0.06385 cfs
Rev. 01
Date of Rev.: 1/22/2020

0
acmnalytical
NWW.pacalsbs,cam
December 20, 2019
Scott Ryan
Allvac
Monroe, NC
RE: Project: SW OUTFALL#02
Pace Project No.: 92456941
Dear Scott Ryan:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on December 11, 2019.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNUNELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely, n
Matthew Brainard
[e-mail]
[phone]
Project Manager
Enclosures
cc: Danielle Barrack, Allvac
Tyler Mercer, ATI Specialty Materials
David Pope, Allvac
pCCRFO
TNI
;4g�A�pQ�
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 12

aceAnalytical
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Project: SW OUTFALL#02
Pace Project No.: 92456941
Pace Analytical Services, LLC
9800 KinceyAve. Suile 100
Huntersville, NC 28078
(704 )875-9092
Pace Analytical Services Charlotte
9800 KinceyAve. Ste 100, Huntersville, NC 28078
LouisianalNELAP Certification # LA170028
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
FloridalNELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
South Carolina Certification #: 99006001
FloridalNELAP Certification #: E87627
Kentucky UST Certification #: 84
Virginia/VELAP Certification #: 460221
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
VirginialVELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, LLC. Page 2 of 12

aceAnalytical
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SAMPLE ANALYTE COUNT
Pate Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 26078
[phone]
Project:
Pace Project No.:
SW OUTFALL#02
92456941
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
Laboratory
92456941001
BPO SW02
EPA 1664B
HH
1
PASI-C
EPA 200.7 Rev 4.4 1994
SH1
3
PASI-A
SM 2540D-2011
GJL
1
PASI-A
REPORT OF LABORATORY ANALYSIS
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without the written consent of Pace Analytical Services, LLC. Page 3 of 12

aceAnalytical
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ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: SW OUTFALL#02
Pace Project No.: 92456941
Sample: BPO SW02 Lab ID: 92456941001 Collected: 12/10/19 09:40 Received: 12/11/19 08:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
Field Data
Analytical Method:
Collected By
DPJ
1
12/10/19 09:52
Collected Date
12/10119
1
12/10/19 09:52
Collected Time
09:46
1
12/10119 09:52
pH
7.1 Std. Units
1
12/10119 09:52
Temperature
13.6 deg C
1
12110/19 09:52
HEM, Oil and Grease
Analytical Method: EPA 1664B
Oil and Grease
ND mg/L
4.8
1
12/20/19 07:39
200.7 MET ICP
Analytical Method: EPA 200.7 Rev 4.4
1994 Preparation
Method: EPA 200.7 Rev 4.4 1994
Copper
ND ug1L
5.0
1
12/14/19 02:13 12/17/19 10:20 7440-50-8
Lead
ND u91L
5.0
1
12/14/19 02:13 12MV19 10:20 7439-92-1
Zinc
ND ug1L
10.0
1
12/14/19 02:13 12/17/19 10:20 7440-66-6
2540D Total Suspended Solids
Analytical Method: SM 2540D-2011
Total Suspended Solids
18.2 mg1L
4.2
1
12/17/19 11:32
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/20/2019 02:19 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 12

laneAnalytical"
wwwpecalab.com
QUALITY CONTROL DATA
Project SW OUTFALL#02
Pace Project No.: 92456941
QC Batch: 515959 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease
Associated Lab Samples: 92456941001
METHOD BLANK: 2764710
Associated Lab Samples: 92456941001
Parameter Units
Oil and Grease mg/L
LABORATORY CONTROL SAMPLE: 2764711
Parameter Units
Oil and Grease mg/L
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
{704)875-9092
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 5.0 12/20/19 07:37
Spike LCS LCS % Roc
Cone. Result % Rec Limits Qualifiers
38.5 38.5 100 78-114
MATRIX SPIKE SAMPLE: 2764712
92456978001 Spike MS MS % Rec
Parameter Units Result Cone. Result % Rec Limits Qualifiers
Oil and Grease mg/L ND 38.5 9.9 16 78-114 M1
Results presented on this page are in the units indicated try the "Units- column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report Shall not be reproduced, except in full,
Date: 12120/2019 02:19 PM without the written consent of Pace Analytical Services, LLC, Page 5 of 12

laneAnalytical"
vnmf.pacela0s.com
Project: SW OUTFALL#02
Pace Project No.: 92456941
OC Batch: 514803
QC Batch Method: EPA 200.7 Rev 4.4 1991
Associated Lab Samptes: 92456941001
METHOD BLANK: 2759197
Associated Lab Samples: 92456941001
Parameter
Copper
Lead
Zinc
QUALITY CONTROL DATA
Analysis Method: EPA 200.7 Rev 4.4 1994
Analysis Description: 2007 MET
Matrix: Water
Blank Reporting
Units Result Limit Analyzed
uJL ND 5.0 12/17/19 09:33
ug/L NO 5.0 12/17/19 09:33
ug/L NO 10.0 12/17/19 09:33
Qualifiers
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE:
2759198
Spike
LCS LCS % Rec
Parameter
Units
Cone.
Result % Rec Limits Qualifiers
Copper
ug/L
500
479 96 85-115
Lead
ug/L
500
485 97 85-115
Zinc
ug/L
500
475 95 85-115
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
2759199
2759200
MS
MSD
92456799006
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter Units
Result
Cone.
Cone.
Result
Result
% Rec
% Rec
Limits RPD Qual
Copper ug/L
NO
500
500
483
480
96
96
70-130 1
Lead ug/L
NO
500
500
488
488
97
97
70-130 0
Zinc ug/L
NO
500
500
487
488
97
97
70-130 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
2759201
2759202
MS
MSD
92457038002
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter Units
Result
Cone.
Cone.
Result
Result
% Rec
% Rec
Limits RPD Qual
Copper ug/L
NO
500
500
550
488
110
97
70-130 12
Lead ug/L
NO
500
500
492
484
98
97
70-130 2
Zinc ug/L
NO
500
500
525
483
105
96
70-130 8
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12l2012019 0219 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 12

lce
Analytica!
www.pacolabs.com
QUALITY CONTROL DATA
Project: SW OUTFACE#02
Pace Project No.: 92456941
Pace Analytical Services, LLC
9800 Klncey Ave. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 515128
Analysis Method:
SM 25400-2011
QC Batch Method: SM 254OD-2011
Analysis Description:
25400 Total Suspended Solids
Associated Lab Samples: 92456941001
METHOD BLANK: 2760630
Matrix: Water
Associated Lab Samples: 92456941001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
ND
2.5 12/17/19 11:32
LABORATORY CONTROL SAMPLE: 2760631
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Total Suspended Solids
mg/L
250 226
90 90-110
SAMPLE DUPLICATE: 2760632
92457023001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids ni 95.0 251 90 1
SAMPLE DUPLICATE: 2760633
92457338001 Dup
Parameter Units Result Result RPD 'Qualifiers
Total Suspended Solids mg/L 232 206 12
Results presented on this page are in the units indicated by the "Units- column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 1212012019 02:19 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 12

� ace
Analytical
www.pacetabs.com
QUALIFIERS
Project: SW OUTFALL#02
Pace Project No.: 92456941
DEF1141TIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
PQL - Practical Quantitation Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI -The NELAC Institute.
LABORATORIES
PAASI-A Pace Analytical Services -Asheville
PASI-C Pace Analytical Services - Charlotte
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
M I Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
REPORT OF LABORATORY ANALYSIS
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Date: 12/20/2019 02:19 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 12

aceAnalytical
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QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: SW OUTFALL#02
Pace Project No.: 92456941
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Hunlersville, NC 28078
[phone]
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method Batch
92456941001
BPO SW02
92456941001
BPO SW02
EPA 1664B
515959
92456941001
BPO SW02
EPA 200.7 Rev 4.4 1994
514803 EPA 200.7 Rev 4.4 1994 514814
92456941001
BPO SW02
SM 2540D-2011
515128
Date: 12/20/2019 02:19 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 9 of 12

Document Name:
Document Revised: February 7, 2018
2ceAna1YhCd1-
Sample Condition Upon Recei t(SCUR)
Pa e 1 of 2
Document No.:
Issuing Authority:
J
F-CAR-CS-033-Rev.06
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden[] Greenwood ❑ Huntersville Raleigh[] Mechanicsville[]
Client Name: `WQ# : 92456941
/j /' Project
Courier: []Fed Ex ❑UPS ❑U5P5 Ilent �,�Ili lil fyN 1 it 4l I �I
❑ Commerciat ❑Pace ❑Other;
� 92458941
Custody Seal Presents []Yes�N-`O. Seals Intact? ❑Yes �]No
oate/Initiels Peron Examining Contents.���� 411E J
Packing Material: ❑Bubble Wrap ubble Bags ❑None ❑ Other Biological tissue F ozen?
Thermometer: [:]Yes❑No/A
�unID: 92T05O_ Type olIce: wet []Blue ❑None
Cooler Temp ('Cl: 1 3 Correction Factor: Add/Subtract i'Cj O.O°C
� Temp should be above freezing to 6'C
Cooler Temp Corrected ('C):
❑Samples out of temp viteriz. Samples on ice, cooling process
has begun
USDA Regulated Soil jQ-VA, water sample)
Md samoies oriainate in a ouarantine lone within the United Stator CA NY. or SC (chock Mond? Did a amnlacorielnate from a fnrrlen teurce finternationaliv.
Yes No
Including Hawaii and Puerto Rico)? [JYes [-]NO
Comments/Discrepancy:
Chain of Custody Present?
Yes
No
NIA
1.
Samples Arrived within Hold Time?
ETYeS
[:]No
N/A
2.
Short Hold Time Analysis 1<72 hr.)?
Yes
No
NIA
3,
Rush Turn Around Time Requested?
Elves
No
[]N/A
4.
Sufficient Volume?
2 es[:]No
N/A
_
5.
Correct Containers Used? .�
-Pace Containers Used?
_MY
ems
❑No
❑No
❑N/A
N/A
_
6. �-
Containers Intact?
13fes
DNO
CINJA
7.
Dissolved analysis: Samples Field Filtered?
❑Yes
_QNo ❑N/A
8.
Sample Labels Match Coe? Yes ❑No
-Includes Date/Time/ID/Analysis Rlatrix:
,❑N/A
9. 1
1
Heads ace �n VOA Vials (>5-6mm)?
Yes
QNO
/
10.
Trip Blank Present?
Trl Blank ustody Seals Present?
❑Yes
Yes
[:]No
No
/A
A
It. •
COMMENTS/SAMPLE DISCREPANCY
Lot 10 of split containers:
CLIENT NOTIFICATION/RESOLUTION
Field Datetleclutred? Oyes ONO
Person Contacted: Date/Time: �� W
1
Project Manager SCURF Review: /_. _ Date:
Project Manager SRF Review: _ % i� Date:
Page 10 of 12

Document Name:
Document Revised: February 7, 2018
aceAnalyflca!
Sample Condition Upon Recei t SCUR
Page 1 of 2
Document No.:
Issuing Authority:
F-CAR-Cs-033-Rev.06
Pace Carolinas Quality Office
*Check mark top half of box If pH and/or dechlorination Is
verified and within the acceptance range for preservation
samples.
Exceptlons: VOA, Conform, TOC, Oil and Grease, SRO/9015 (water) DOC, LLHg
**Bottom half of box is to list number of bottle
Project # �WO# : 92456941
PM: MWB Due Date: 12/20/19
CLIENT: 92-Allvae NC
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pH Adjustment Log for Preserved Samples
Sample tD
Type of Preservative
pH upon receipt
Late preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
lot It
Note: whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will bt sent to the North Carolina DEHNR Cenlrication Office ILe.
Out of hold, incorrect preservative, out of temp, incorrect containers.
Page 11 of 12

Stormwater Monitoring
Chain of Custody Record
Project Number/Name: SW Outfall 02 1project Location:ATI SM-Bakers Powders
Sampler's Signature:
Date: - O-
L-
n,
o
U
o. �j
u
�
w
�
L
"
c
�
—
�
Re uested Test Parameters
q
0
y
C
a
U
L
v
9
q.,W
G
G /0
FfNO3
Y
Total Recoverable: Lead,Copper, Zinc �
a?
G
G m
None
Y
TSS
9. yg
G
©/ P
HCL
Y
Oil & Grease
Onsite Field pH Analysis
Onsite Field Temperature Analysis
pH: 7.1 Sample Time: yl�
Tcrnp: lam, (°C) Sample Time: 9..38
Analysis Time: :S'o?
Analysis Time:
Meter Calibrated: O / N
ITherrnorneter Calibrated:® / N
Sampling and field analysis completed by:
Relinquished By: -
Received By: L,G. %
Date: -/� -�
Time: ?f ; `j Al ml
Date: I .� I � Time:
Relinquished By:
Received By:
Date:
Tintc:
Datc:
Time:
EHS-SW-Chain of Costody Outfall 02-Rev 001
Page 12 of 12

AT I
Specialty Malcnals
ATI (Allvac) — Bakers Campus (BPO & EIGA)
Stormwater Monitoring Report Form
Sample Date:
Sample Time:
Sample Location:
Stormwater Discharge Outfall # 03
Drainage Area= 130,680 sq. ft. = 3 Acres
% Impervious= 50%
Person Collecting Samples:
Laboratory Performing Analysis:
Analytical Techniques and Methods:
40 CFR Part 136
Results of Sample Analysis:
Parameter
Results (mg/1)
Benchmark Values (mg/1)
pH
(std units)
6-9
TSS
100
Copper, Total Recoverable
0.010
Lead, Total
O
0.075
Zinc, Total Recoverable
O W
0.126
Non -Polar Oil & Grease/TPH
15
Temperature
Deg. Celsius
Storm Date:
Storm Duration:
Duration of time preceding rain event exceeding 0.1"
Estimated Flow Calculation:
(Hrs.) Inches of Rainfall:
(Hrs.)
Q=CIA
Q (Total) = Q (Pervious Area) + Q (Impervious Area)
Q (Tot., cfs) = (.4 x inches rain/12 inches/ft. x 3 acres x .50) + (.9 x inches rain/12 inches/ft. x 3 x .50)
Q (Total, cfs) = 0.05 x
cfs
(Inches of rain) +0.1125 x
(Inches of rain)
Rev. 01
Date of Rev.: 1/22/2020

�`111 M-2
Environmental
Quauty
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance wi filling out this form, please >,isit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stonnwater-gps
Pennit No.: N_IC/ I I 1 I I 1 1 or Certificate of Coverage No.: NICIG_IO131016191,S1
Facility Name: _ %`S ��l!/uC -xzleu
County: DQ Phone No. 74�/ -afg - yS//
Inspector: �iwi� `pQ e-
T2
Date of Inspection: 9
Time of Inspection:
Total Event Precipitation (inches): ©. gD
All pen -nits 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 pennitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour stonn
interval does not apply if the pennittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the pennittee obtains approval from the local DIMLR
Re6onal Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Pennittee or
1. Outfall Description:
Outfall No. mpaO , , ,�ct!i�c.L
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Dla-,4- YP 1l rile- 7LI-a40iG . x-,,OeA-
Page t of 2
SWU-242, Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Gear
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): AIVI -6-
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 the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
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.
8.
9.
Q 2 3 4 5
Is there any foam in the stormwater discharge? o Yes SNo.
Is there an oil sheen in the stonnwater discharge? oYes (fDNo.
Is there evidence of erosion or deposition at the outfall? O Yes Do.
14. Other Obvious Indicators of Stormwater Pollution:
List and describe %'�©A- P—
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, Las( modilied 06/01/2018

STORNINVATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS LI), 9S _
FACILITY NAME S BCJa� e7 .ls
PERSON COLLECTING SAM1 LE S)
CERTIFIED LABORATORY(S) ita Lab #_
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 11?40/ 9
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY GLie sort
PHONE NO.
LREQUIRED
NATURE OF PERMITTEE OR DESIGNEE
ON PAGE 2.
Outfall
No.
Date
Sample
Collected
II I
Total
Rainfall
Fil On
��I�
r R + �
/
_
/
I
I
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Qy no
(if yes, complete Part B)
Part B. Vehicle Maintenance Activitv Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
i 00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m
mg/l
unit
allmo
Form SWU-247, last remised 611212015
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date /O /9
Total Event Precipitation (inches): Q ..30
Event Duration (hours): Z, a (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Energy Mineral and land Resources
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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. 1 am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
�-9�1
(Signature of Per it e) (Date)
Form SWU-247, lust revised 611212015
Page 2 of 2