NCS000209_MONITORING INFO_20191211

STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
IV1��
DOC TYPE
0 FINAL PERMIT
Ig MONITORING REPORTS
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS000209
FACILITY NAME Haynes International dba Haynes wire Company
PERSON COLLECTING SAMPLE(S) Angela Beok and Dennis Holden
CERTIFIED LABORATORY(S) James and ,lames Environmental Lab #482
Lab #�
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
(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 Henderson
PHONE NO. 82( 8 )393-1258
E
GNATURE OF PERMITTEE OR DESIGNEEEQUIRED ON PAGE 2.
Outfall
No.
Date
Sample
Collected
50050
Total
Flow if a
Total
Rainfall
pH
TSS, mglL
mo/dd/ r
MG
inches
1
10/30/2019
1.50
6.51
23
2
10/30/2019
1.50
7.26
5.12
H
f _ I i/ i
)
Utz 1 1 lul
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Oyes Ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity MonitoringRe uirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
-00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
a 1.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/ddl r
MG
inches
mg/1
mg/1
unit
al/mo
Form SWU-247, last revised 611212015
Page] of 2

STORM EVENT CHARACTERISTICS:
Date 10/30/19
Total Event Precipitation (inches): 1.50
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.)
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. 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) (Date)
Form SWU-247, Iasi remised 611212015
Page 2 of 2

JJEM AQUEOUS SAMPLE COLLECTION/LAB- REPORT FORM (NC CERT 482)
Regulated by NCDENRIDW"roundwater section !
To assign test, label shaded area with sample type (C=composite; G=grab)
CHAIN OF CUSTODY i
LOCATION HAYNES WIRE COUNTY HENDERSON
SPECIALINFORMATION(S)
_ . ' `" :I
OUTFALL # 1 JOUTFALL
#
'
Monthly
PO # `107761
ID NO.
HWC-�31)i9
INITIAL TEMP
°
GRm B time
COMP start
sample time
COMP end
date/ time
.nOOLER
#2
TEMP @RECEIPT: °C
NOTE: THE ABOVE TEMP INDICATES THE TEMP. TEMP @RECEIPT: °C
FOR ALL CONTAINERS) WITHIN. NOTE: THE ABOVE TEMP INDICATES THE TEMP.
FOR ALL C 6NTAINERIS) WITHIN.
4
AMMONIA SAMPLES PRESERVED WITH H2SO4, pH=<2.0
AMMONIA SAMPLES NEUTRALIZED WITH Na2SO3, CI=< 0.1
FECAL SAMPLES PRESERVED WITH Na2S03, CI=< 0.1
YES NOI
DES NO
YES NOS
COLLECTED BY: m wx-k
ALL SAMPLES COLLECTED AND PRESERVED AT TIME OF COLLECTION IN PLASTIC CONTAINERS UNLESS NOTED OTHERWISE BY: I
RELINQUISHED BY
DATE 1+�TIME
RECEIVED BY
SPLIT SAMPLE(S) INF
1
f
�
ANALYSES.'.:-
RESULT: `'',
..RESULT,.,,, ,,..
;RESULT,-.
RESULT"
DATE: t.
INiTG-;
PH
G 6.`JI
G -Z�,o
icAzoriI
�J
TSS ppm
G a3 o
G 5,1
t 31 1g
jj-
i
By the above signature I certify that all information is accurate to the best of my knowledge, j
COMMENTS © means CIC not met.