NCS000321_MONITORING INFO_20190212

M�. C
STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
nI L� O c)� � l
DOC TYPE
❑`/FINAL PERMIT
fA MONITORING REPORTS
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
o Q0, 5 b a i a
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
®E/'•+CIVaORING REPORT
Permit Number NCS 000321 FEB 12 2019
CENTRAL FILES
FACILITY NAME Lubrizol DWR SECTION
PERSON COLLECTING SAMPLE(S) Bobby Smith
CERTIFIED LABORATORY(S) Prism Labs, Inc. Lab # 402
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2018
(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 Gaston
PHONE NO. 7( 04 ) 9154165
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
SIGNATURE
DateI
•
Collected
I I
•
a
•
•
•
•
r
r it
r .
:er
•e
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 Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
.06556
005301" . ` .
,00400
Total Flow
(if applicable)
Total
Rainfall..
'Oil & Grease
(if appl.) '.
'Non=polar,
O&GITPH ° `
'(Method'1664
a 1.
TotaL-.
Suspended''
Solids.,,.
pH
-
'New,Motor
'.Oil -Usage
mo/dd/ r
MG
inches
m /I
m /I
unit
al/mo.
Form SWU-247, last revised 611212015
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date 12/5/201
Total Event Precipitation (inches): 0.44
Event Duration (hours): 24 (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
"1 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 lines and imprisonment for knowing violations."
(Signature of Permittee)'
01 /25/2019
(Date)
Form SWU-247, lust revised 611212015
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
1 `MONNITORING REPORT
Permit Number NCS000321 RECEIVED [a D SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
(This monitoring report shall be received by the Division no later than 30 days from
FEB 12 2019 the date the facility receives the sampling results from the laboratory.)
FACILITY NAME Lubrizol CENTRAL FILE
PERSON COLLECTING SAMPLE(S) David Griffith 0WR SECTION
CERTIFIED LABORATORY(S) Prism Labs, Inc. Lab #402
Lab #
Part A: Specific Monitoring Requirements
COUNTY Gaston
PHONE NO. 7t 04 915-4165
FREO
ATURE OF PERMITTEE OR DESIGNEE
UIRED ON PAGE 2.
Date'No. Sample
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Dyes &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
.(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
m
unit
al/mo
Form S W U-247, last revised 611212013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 1/7/2019
Total Event Precipitation (inches): 0.77
Event Duration (hours): 24 (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."
ec�
(Signature of Permittee) Y
01 /29/2019
(Date)
Form SWU-247, last revised 611212015
Page 2 of 2