NCS000325_COMPLETE FILE - HISTORICAL_20190213

FEHRGRAm 'I
ENGINEERING & ENVIRONMENTAL
Certified Mail No. 7019 0140 0000 6059 3522
Return Receipt Requested
February 6, 2020
Division of Water Quality
Attention: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RECEIVED
FEB 19 2019
CEWFRJ L FILE—D
DWR SECTiOT.I
RE: Stormwater Discharge Outfall (SDO) Monitoring Report - January 2020
Patch Rubber Company
100 Patch Rubber Road
Weldon, NC 27870
NCS000325
Dear Sir/Madam:
Please find enclosed the Stormwater Discharge Outfall (SDO) Monitoring Report for storm
water discharge from the above -referenced facility for January 2020.
n
Please note the following:
• The facility was not able to collect the required samples from a "Representative
Storm Event" for the month of January 2020.
• The facility will continue monthly collection of storm water samples for analysis.
If you have any questions regarding these documents, please do not hesitate to contact
this office.
Sincerely,
amd -FA�-fmu-t�
Amy L. Trimble, CHMM
Environmental Scientist
ALT:dep
Enclosure
cc: Mr. Marto Carter, Patch Rubber Company
0:1Patch Rubber Company120-105 - Environ. Outsourcing Annuai\PA Final120-105 Patch Rubber Co. - 2020.02.06 - Storm
Water SDO January 2020 tetter.docx
221 E. Main Street I Suite 200 1 Freeport, IL 61032 1 p:815.235.7643 I f:815.235.4632 I www.fehr-graham.com
insight. Experience. Results.

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000325
FACILITYNAME Patch Rubber Company
PERSON COLLECTING SAMPLE(S) Not applicable
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2020
(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 Halifax
PHONE NO. 2( 52 )536-2574
aREO
ATURE OF PERMITTEE OR DESIGNEE
UIRED ON PAGE 2.
Outfall
No.
Date
Sample
Collected
II I
Total
Flow (if no
.
•
•�
•
•
it
is
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes Xno
(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'.
a 1.
Total'
Suspended ,:
Solids'
pl-I
New Motor
+Oil.Usage
mo/dd/ r
MG
inches
m C
ni l
unit
al/mo
Form SWU-247, last revised 21212012
Page l of 2

STORM EVENT CHARACTERISTICS:
Date
Total Event Precipitation (inches): N/A
Event Duration (liours): (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 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."
1UU 02/07/2020
(Signature of Permittee) (Dnte)
The Facility was unable to collect the required samples from a "Representative Storm Event"
for the month of January 2020 "No Flow"
Form SWU-247, last rrvised 21212012
Page 2 of 2