NCG060098_Monitoring Info_20201020

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submission Uompletect
.gage 1 of 2.
Stormwater NPDES Permit Data Monitoring
k
NORTH CAROLINA Report (DMR) Upload
£1tvir0=Lnra1 Quality
Permit and Facility Information:
Please enter the permit number and other details for this upload.
...........................................................................................................................................................................................................................................................................................................................
IMPORTANT: Until the eDMR system is implemented for DEMLR Stormwater Program
permits, an original signed hardcopy of the DMR MUST be mailed to the address in your
permit, in addition to this electronic upload.
Fields marked with a red asterisk are required.
Permit Number* Enter COC or Individual Permit Number
NCG060098
Must begin with NCS or NCG
Facility Name:* Vertellus Greensboro LLC
County: * Guilford
After uploading here, the original signed hardcopy must be mailed to:
DEQ Winston-Salem Regional Office
Attn: DEMLR Stormwater Program
450 West Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Further contact details at https://deq.nc.gov/contact/regional-
offices/winston-salem
Monitoring Period Information:
.....................................................................................................................................................................................................................................................................................................................................
Monitoring Period What is the YEAR of the sample date(s)?
Year: * 2020
Multiple DMRs from sampling periods within the same year can be uploaded together, but please
upload different Years with a new submittal form.
https://edocs.deq.nc.gov/Forms/Form/showformsubmission/4aO25b6l-6f13-47da-b3b9-ef... 10/14/2020

ouuii1155.iwj l-ompletea Page 2 of 2
DIVIR Upload* Click the upload button or drag and drop files here to attach document.
21-12020 DMR 2020 10 14,pdf 972.76KS
Only PDFs are accepted.
Comments: N/A
*
By checking the box and signing box below, I certify that:
I have given true, accurate, and complete information on this form;
agree that submission of this Data Monitoring Report (DMR) upload form is a "transaction" subject
to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
1 agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act");
1 understand that an electronic signature on this upload form has the same legal effect and can be
enforced in the same way as a written signature; AND
I intend to electronically sign and submit this DMR upload form.
Full Name:* Frank Thomas
Name of person submitting this form
Email Address:* [e-mail]
Phone Number:* 336.601.8675
Signature: *
Date: * 10/14/2020
https:Hedocs.deq.nc.gov/Forms/Form/showformsubmission/4a025b6l-6fl 3-47da-b3b9-ef... 10/14/2020

Client: Vertellus Performance
2110 High Point Rd.
Greensboro, NC 27403
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Report Date: 10/1/2020
Date Sample Rcvd: 9/24/2020
Meritech Work Order # 09242005 Sample: Stormwater Site #5 Grab
Parameters Result Analysis Date Reporting Limit
COD <15 mg/L 9/25/20 15 mg/L
Total Suspended Solids <2.7 mg/L 9/24/20 2.7 mg/L
Oil & Grease (HEM) <5 mg/L 9/28/20 5 mg/L
9/17/20
Method
EPA 410.4
SM 2540 D
EPA1664B
I hereby certify that I have reviewed and approve these data. CD4
Laboratory Re resentative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax[phone]

Client: Vertellus Performance
2110 High Point Rd.
Greensboro, NC 27403
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Report Date: 10/1/2020
Date Sample Rcvd: 9/24/2020
Meritech Work Order # 09242006 Sample: Stormwater Site #6 Grab
Parameters Result Analysis Date Reporting Limit
COD 36 mg/L 9/25/20 15 mg/L
Total Suspended Solids 22 mg/L 9/24/20 2.5 mg/L
Oil & Grease (HEM) <5 mg/L 9/28/20 5 mg/L
9/17/20
Method
EPA 410.4
SM 2540 D
EPA1664B
I hereby certify that I have reviewed and approve these data. Awwndo' �o 00A --)
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax[phone]

Client: Vertellus Performance
2110 High Point Rd.
Greensboro, NC 27403
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Report Date: 10/1/2020
Date Sample Rcvd: 9/24/2020
Meritech Work Order # 09242004 Sample: Stormwater Site #1 Grab
Parameters
Result
Analysis Date
Reporting Liinit
COD
62 mg/L
9/25/20
15 mg/L
Total Suspended Solids
12 mg/L
9/24/20
2.5 mg/L
Oil & Grease (HEM)
<5 mg/L
9/28/20
5 mg/L
9/17/20
Method
EPA 410.4
SM 2540 D
EPA1664B
I hereby certify that I have reviewed and approve these data. >-km a t� rowl ,
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax[phone]