NCS000202_COMPLETE FILE - HISTORICAL_20190723

- -- STORMWATER DIVISION CODING -SHEET-
RESCISSIONS.
PERMIT NO.
DOC TYPE
�t, COMPLETE FILE- HISTORICAL
DATE OF
RESCISSION
❑ ��� / � � `� 3
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS 000202 or SAMPLES COLLECTED DURING CALENDAR YEAR: 20l°t ,)urJE
Certificate of Coverage Number: NCG (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.)
FACILITYNAME United States Gypsum Co. RECF"M COUNTY Mitchell
PERSON COLLECTING SAMPLE(S) AJ L 1.51jler PHENZ�
N.V za ) ass-saaI
CERTIFIED LABORATORY(S) FftLtAtJALYtlGkL Lab# Y0 2 ��°'
Lab # (SIGNAT _ OF PERMITTEE OR DESIGNEE)
--- eENTKkkL r'LE( ; By this signature, I certify that this report is accurate
D" SECTION, complete to the best of my knowledge.
Part A: Specific Monitoring Requirements
Outfall
No.
Date
Sample
Collected
1 1
-
Total■
Flow (if pp
Rainfall
tiTotal
Solids (TSS)
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month.' _ yes I./no
(if yes, complete Part $)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
moldd/ r
MG
inches
m
mgA
units
al/mo
Form SWU-246-112608
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date a/s/19 I / %%
Total Event Precipitation (inches): j Z
Event Duration (hours): r (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 Water Quality
Attn: Central Files
1617 1\9ail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under nay 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 Fief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
incjwkng tke po..-ibil y of fines and imprisonment for knowing violations."
(Signature or
7 It j Iq
(Date
Form SWU-246-112608
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS 000202 or SAMPLES COLLECTED DURING CALENDAR YEAR: 1011 MA 1
Certificate of Coverage Number: NCG (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.)
FACILITY NAME United States Gypsum Co.
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S)
Part A: Specific Monitoring Requirements
O FLD t'j
cot 4tchell
PHO, q • �l 826 ) 765 —9491
(SIGNATUIUV: OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
—du—tfall-
No.1.
I
iWOM
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ ves 'V/no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
MG
inches
mgA
mo
Units
gallmo
Form S WU-246-1 12608
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date MAY 10II
Total Event Precipitation (inches):
Event Duration (hours): (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.)
'r
0
Mail Original and one copy to:
Division of Water Quality
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 tha ualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the tem, or those persons directly responsible for gathering the information, the information submitted is, to the best
of m�wledge an by lie , t ue, accurate, and complete. I am aware that there are significant penalties for submitting false information,
incl dm h rltir _`Gsibi t o fi es aqd imprisonment for knowingviolations."
(Signature of
Form SWU-246-112608
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS 000202 or
Certificate of Coverage Number: NCG
FACILITY NAME United States Gypsum Co.
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S)
Part A: Specific Monitoring Requirements
-,-. ^ i L,
SAMPLES COLLECTED DURING CALENDAR YEAR: -201q APR1`
(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.)
_ itchell
P { 828 ) 765 - 9491
(SIGN RE OF PERMITTEE OR DESIGNEEI
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
Outfall
No.
Date
Sample
Collected
50050
Total
Flow (if app.)
Total
Rainfall
Oil & Grease
Total
Suspended
Solids (TSS)
Total Lead
pH
mo/dd/ r
MG
inches
m
MgA
Units
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes —no
(if yes, complete Part B)
Part B. Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
MG
inches
m
m
Units
al/mo
Form SWU-246-1 12608
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date A PK4 .L 7-00
Total Event Precipitation (inches):
Event Duration (hours): (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.)
tt
0 r4-ovo I/
Mail Original and one copy to:
Division of Water Quality
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 ass that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who mans a he system, or those persons directly responsible for gathering the information, the information submitted is, to the best
of nyy4powledge�andfb4ief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
incl di fMVos%ibi its of fines and imprisonment for knowing violations."
(Signature of
1/5 !1
(Da )
Form S W U-246-112608
Page 2 of 2

Permit Number: NCS 0Q0202
Certificate of Coverage Number: w
or
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
FACILITY NAME United States Gypsum Co.
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S)
Part A: Specific Monitoring Requirements
``Nd FLowII
SAMPLES COLLECTED DURING CALENDAR YEAR: 2 oil MAILL u
(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.)
COUKTX itchell
828 j 765 - 9481
{ A E OF PERMITTEE OR DESIGNEE}
By this si ature, I certify that this report is accurate
complete to the best of my knowledge.
Outfall
No.
Date
Sample
Collected
50050
Total
Flow (if app.)
Total
Rainfall
Oil & Grease
Total
Suspended
Solids (TSS)
Total Lead
pH
mo/dd/ r
MG
inches
m
MO
m
Units
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes /o
(if yes. complete Part 13)
Part B: Vehicle Maintenance Activity Monito ing Requirements
Outfall
No.
Date
Sample
Collected
50050
06556
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
MG
inches
mgA
MgA
Units
al/mo
Form SWU-246-112608
Page l of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
a�QGK ,LO4� Division of Water Quality
Date Attn: Central Files
Total Event Precipitation (inches): 1617 Mail Service Center
Event Duration (hours): (only if applicable — see permit.) Raleigh, North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
�t�
"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. Rased 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, t , accurate, and complete. I am aware that there are significant penalties for submitting false information,
incl the o 'biiit of irlhesland imprisonment for knowing violations." l
4 19 / f
(Signature of Permi t
e)' (Dat
Form S W U-246- l 12608
Page 2 of 2