NCG060105_MONITORING INFO_20191120

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV '�c,
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ a � 111 1 / `yL
YYYYMMDD

November 11, 2019
Central Files
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
SUBJECT: Permit No. NCG060000
Certificate of Coverage No. NCG060105
GlaxoSmithKline, Zebulon Facility
Stormwater Sampling — 2019, Period 2
V
GlaxoSmithKline
RECTIVED
NOV 2 0 2019
CEN I r-PL FILES
DWR SECTION
Please find enclosed two copies of the SDO Monitoring Report and analytical results for the 2019 — Period 2
monitoring period at representative outfall #5.
We have noted that the COD level was found to be 133 mg/L just barely over the benchmark value of 120
mg/L.
We have begun our Tier I response today, and will keep documented in our SPPP.
If you have any questions, please contact me at [phone].
Sincerely,
David Schaefer
EHS Engineer
GSK
1011 N. Arendell Ave
Zebulon, NC 27597

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 Glaxosmithkiine
COUNTY Wake
PERSON COLLECTING SAMPLES MarkPoythress
LABORATORY Microbac Lab Cert. # 11
Part A: Stormwater Benchmarks and Monitoring Results
Date submitted 11Nov2019
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June ■❑ July -Dec
or ❑ Monthly' _(month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow nE 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 4
Total event roinfoll '0-1 in 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
genchmork
-
100 or 504
Within 6.0 — 9.0
120
30
10001
5001
Parameter Code
-
C0530
00400
00340
00556
31616
61211
5 (Representative)
10/30/2019
<4.17
8.4
133
<5
nla
nla
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
a 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 a no
Permit Date: 11/1/2018-05/31/2021
(if yes, complete Part By
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/0
Parameter Code
-
46529
NCOIL
00552
C0530
Footnotes from Part A also apply to Part B
*FOR PART A AND PART 8 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 EXCEEDANCES 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" resorts, 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 MUSTSIGN 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 or knowing violations."
Signature of Perm
Permit Date: 11/1,1�_ET8-05/31/2021
1 3 �juv t
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

�VMICROBAC
°
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9JO456
Project Description
Stormwater Sample - Semiannual
For:
Mr. David Schaefer
GSK
1011 N. Arendell Avenue
Zebulon, NC 27597
Administration
Brittany Smith
Friday, November 8, 2019
Please find enclosed the analytical results for the samples you submitted to Microbac Laboratories. Review and compilation of
your report was completed by Microbac Laboratories, Inc. - Dayville. If you have any questions, comments, or require further
assistance regarding this report, please contact your service representative listed above.
I certify that all test results meet all of the requirements of the accrediting authority listed within this report. Analytical results are
reported on a 'as received' basis unless specified otherwise. Analytical results for solids with units ending in (dry) are reported
on
a dry weight basis. A statement of uncertainty for each analysis is available upon request. This laboratory report shall not be
reproduced, except in full, without the written approval of Microbac Laboratories. The reported results are related only to the
samples analyzed as received.
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p 1 www.microbac.com
Page 1 of 7

&)MICROBAC"
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9J0456
GSK Project Name: Stormwater Sample - Semiannual
Mr. David Schaefer Project 1 Pb Number: 3001743196 (2019)
1011 N. Arendell Avenue Received: 10/30/2019
Zebulon, NC 27597 Reported: 11/08/2019
Project Special Information
Sample Summary Report
Sample Name Laboratory ID Client Matrix Sample Type Sample Begin Sample Taken Lab Received
Stormwater, grab K9J0456-01 Stormwater Grab 10/30/19 10:00 10/30/19 14:00
Page 2 of 7

&DMICROBAC"
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9J0456
Analytical Testing Parameters
Client Sample ID: Stormwater, grab
Sample Matrix: Stormwater Collected By: Poythress
Lab Sample ID: K9J0456-01 Collection Date: 10/30/2019 10:00
Wet Chemistry
Result RL
Units
Dilution Note
Prepared Analyzed
Analyst
EPA 1664 Rev. B
Oii & Grease (SGT-HEM)
<5.00 5.00
mglL
1
10/30119 1329
TBM
SM 2540 D-2011
Total Suspended Solids
<4.17 4.17
mg1L
1
10/31/19 1046
CLB
SM 5220 D-2011
COD, Total
133 10.0
m91L
1
11101119 0832
MT
Field Sampling/Testing
Field
Rainfall
Field Observation
Color
Odor
Clarity
Floating Solids
Suspended Solids (Residue,
Non -Filterable)
Foam
Oil Sheen
Erosion Evidence
Other Pollution Indicatots
SM 2550 B-2010
Temperature, Field
SM 4500 H+B-2011
pH, Field Test
0.050
Result RL Units Dilution Note Prepared Analyzed Analyst
inches 1 10/30119 1634 10130119 1634 BNS
Clear
1
10130/19 1634
10130119 1634
BNS
None
1
10130/19 1634
10/30119 1634
BNS
Clear
1
10/30/19 1634
10130119 1634
BNS
Some
1
10/30/19 1634
10130119 1634
BNS
None
1
10/30/19 1634
10/30119 1634
BNS
None
1
10/30/19 1634
1013CI19 1634
BNS
None
1
10/30119 1634
10/30/19 1634
BNS
None
1
10/30119 1634
10/30/19 1634
BNS
None
1
10130/19 1634
10/30/19 1634
BNS
19
0.1 °C 1
10130/19 1000
JMP
8.4
1.0 pH Units 1
10130119 1000
JMP
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1 910-864.1920 p I www.microbac.com Page 3 of 7

OMICROBAC('
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9JO455
Batch Quality Control Summary: Microbac Laboratories, Inc. - Fayetteville
Spike Source %REC RPD
Wet Chemistry Result RL Units Level Result %REC Limits RPD Limit Notes
Batch KJ92920 - Wet Chem Aqueous - SM 2540 D-2011
Blank (KJ92920-BLK1)
Prepared & Analyzed: 10/31/2019
Total Suspended Solids
<2.50 2.50
mg/L
Blank (KJ92920-BLK2)
- _
_Prepared & Analyzed: 10/31/2019
_
Total Suspended Solids
<2.50 2.50
mg1L
LCS (KJ92920-BS1) ._................._...,_,........,..-..
---._._............._..,................................._._.__.....------._.....
Prepared &Analyzed: 10/31/2019
- ---------- - -----._.._...._.__..............--.............._................,....._.............,..,..,..,.........................
Total Suspended Solids
33.9 2.50
mglL 35.3 96 94.5-105.4
Duplicate (KJ92920-DUPi)
Source: K9J0469-01
Prepared &Analyzed: 10/31/2019
--�- -- -^-�-��--
Total Suspended Solids
42.3 2.50
mglL 51.420 10
Batch KK90002 - Wet Chem Aqueous - EPA 1664 Rev. B
Blank (KK90002-BLK1)
Prepared &Analyzed: 10/30/2019
Oil & Grease (SGT-HEM)
<5.00 5.00
mglL
LCS (KK90002-BSI)
_.._._._. _ - - -
-_ - - - --- --- --- -- -
Prepared & Analyzed: 10/30/2019
------ - - - ...- -- _._.. ._.._. ...... _.._......
Oil & Grease SGT-HEM)
21.3 5.00
mgL 20.4 104 64-116
Matrix Spike (KK90002-MS1)
Source: K9J0456-01
----- - -- - --- ------
Prepared &Analyzed: 10/30/2019 -._._._._._._....._...._.__..._._._.......- --
-- ----- --- _ - _ ...-....-----
(----
Oil & Grease SGT-HEM)
16.6 5.00
g /L 22.2 ND 75 64-132
Batch KK90007 - Wet Chem Aqueous - SM 5220 D-2011
Blank (KK90007-SLK1) Prepared &Analyzed: 1110112019
--------------
COD, Totai <10.0 10.0 mg/L
Blank (KK90007-BLK2) Prepared &Analyzed: 11/01/2019
----- ----------------------
COD, Total <10.0 10.0 mglL
LCS(KK90007:BS1)_....._...................__........_........_. _. _........ Prepared.&.Analyzed:.. ..2D19.
COD, Total 499 10.0 mglL 500 100 95-105
Duplicate (KK90007-DUPi) Source: K9J0485-01 Prepared &Analyzed: 11101/2019
COD, Total 60.0 10.0 mg1L 60.0 0 20
M. ........................_...._......_.._._ ----- ._ -T -_ _ - _ - --- — ----- ._._............._._..---............_.._.__.._
COD, Tota4 82.1 10.0 mg/L 25.0 60.0 88 80-120
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page 4 o 77

VMICROBAC"
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9J0456
Definitions
MDL: Minimum Detection Limit
RL: Reporting Limit
RPD: Relative Percent Difference
Cooler Receipt Log
Cooler ID: Default Cooler
Temp; 4.6°C
Cooler Inspection Checklist
Ice Present or not required?
Yes
Shipping containers sealed or not required?
Yes
Custody seals intact or not required?
Yes
Chain of Custody (COC) Present?
Yes
COC includes customer information?
Yes
Relinquished and received signature on COC?
Yes
Sample collector identified on COC?
Yes
Sample type identified on COC?
Yes
Correct type of Containers Received
Yes
Correct number of containers listed on COC?
Yes
Containers Intact?
Yes
COC includes requested analyses?
Yes
Enough sample volume for indicated tests received?
Yes
Sample labels match COC (Name, Date & Time?)
Yes
Samples arrived within hold time?
Yes
Correct preservatives on COC or not required?
Yes
Chemical preservations checked or not required?
Yes
Preservation checks meet method requirements?
Yes
VOA vials have zero headspace, or not recd.?
Yes
Project Requested Certifications)
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 otherwise noted.
The data and information on this, and other accompanying documents, represents __JI
only the sample(s) analyzed. This report is incomplete unless all pages indicated Brittany Smith
in the footnote are present and an authorized signature is included. Administration
Reported: 11 /08/2019 16:06
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1 910.864,1920 p I www.microbac.com
Page 5 of 7

<tDMICROBACe
csr- _
tell /✓ fsrcn R�'�
v le <
LA13 ID
NUMBEIR
SAMPLE TYPE
STofn cj,4cP-
'K9J0456-
Fayetfeville Division 2592 Hope Mills Road — Fayetteville, NC 28306 [phone] ! 864-BTT4 �aX
.
CHAIN OF CUSTODY RECORD
PAGE OF
i�e2Lu
0
_ m
� y O
r ]rC�c/�'I�1G
DATE TIME coMY exAe
l .? 44,
3o lu= Date Tlme
3 Ih --Z;
ph Field: ph Held: Water Level #1
Temp Field 4: / �J. Temp Field 2: Water Level #2
4
TYPE ❑F ANALYSIS
t Kr-,3r-gcVra,
C DE: A = Mone
4�
B = + <6"C
=pH<2)
C = (pH<2) + <B-C
L
D NZO} + <6°C
E = ZN Aoetate + <6`C
F = HCI $l$
_ V
G = Sadie m Thlo ;
RES. Sl1LrIDE i
PH FLOW 7F,F11P'G LRR]
GFiME
f/
Lc
Irm Tum round lima: REGULAR RUSH
/0: /- I
nnn Col'rlmentS or Seeciaf Hazard l
I4
'Ima i
,
. I
IS DATA FOR REG. COMI LIANCE PURPOSE?
NO YES WHICH:
Page 6 0# 7
I

C--"Sk- s1LJ
STORM WATER - QUALITATIVE MONITORING
`K9J0456`
e*j, 0� -L, -
STORM
SITE #
DATE
SAMPLED
COLOR
ODOR
CLARITY
FLOATING
SOLIDS
SUSPENDED
SOLIDS
FOAM
OfL SHEEN
EROSION OR
DEPOSITION AT
THE OUTFALL
OTHER OBVIOUS
INDICATORS OF
STORMWATER
POLLUTION
1
Cle
Ct-A2
s�.
o
ll U
fro
�ane
t4 e-
2
3
TOTAL RAINFALL (inches): ptmrf &Y-tit11097b�.
Page 7of7