NCG030238_DMR_20201103

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted October 21, 2020
CERTIFICATE OF COVERAGE NO. NCG030238 SAMPLE COLLECTION YEAR 2020
FACILITY NAME Siemens Energy, Inc. SAMPLE PERIOD D Jan-June ®July-Dec
COUNTY Forsyth or ❑ Monthly1 (month)
PERSON COLLECTING SAMPLES James Whiticar DISCHARGING TO CLASS ❑ORW EIHQW ETrout ❑PNA
LABORATORY Research&Analytical Lab Cert.# NC34 EZero-flow ['Water Supply ESA
Comments on sample collection or analysis: SDO 002 Exempt from ®Other Class C
monitoring
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 -
Part A: Stormwater Benchmarks and Monitoring Results
❑ No discharge this period?2
Date Sample 24-hour rainfall pH, Non-Polar O&G/
P
Outfall No. Total Suspended Solids Copper Lead Zinc Total Petroleum Total Toxic
Collectedl amount, Standard units Hydrocarbons Organics5
(mo/dd/yr) inches3
Benchmarks===> - - 100 mg/L or 50 mg/L4 6.0—9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L
SDO 001 9/29/20 1.18 <5 5.71 <0.005 <0.005 0.017 <5 <1
" I
1 Monthly sampling(instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from anon-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit,Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11;for semiconductor
manufacture use the definition as found in 40 CFR 469.12;for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Unrestricted Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver,the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
l .oi2=1 P I+IL-LA t PS
Name(Print name)
? r ) r Mu -
Title(Print title)
11/03C
(Signature) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL,<PQL, Non-detect, ND,or other similar non-numerical
format. When results are below the applicable limits,they must be reported in the format,"<XX me/I.",where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging> 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No. Date Sample 24-hour rainfall
Collected' amount, Non-polar O&G/TPH by Total Suspended Solids pH
(mo/dd/yr) Inches3 EPA 1664(SGT-HEM) _
Benchmarks===> - - 15 mg/I. 100 mg/L or 50 mg/L* 6.0—9.0 SU
Footnotes from Part A also apply to this Part B
Unrestricted Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

*See General Permit text,Table 5,identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2,or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO❑
IF YES,HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑NO❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all"No Discharge"reports, within 30 days of receipt of the lab results(or at end of monitoring period
in the case of"No Discharge"reports)to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 c,,for submitting false information,including the possibility of fines and imprisonment for knowing violations."
i 1/03/�0
(Signature of P ' e (Date)
g
Unrestricted Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

RESEARCh & ANAL TICAL
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LABORATORIES, INC. 1,o i
Analytical/Process Consultations *St ,
oil eig ate
Chemical Analysis for Selected Parameters and Water Sample Identified as Stormwater-Second Half of 2020
(A Siemens,Inc.Project,collected 29 September 2020)
I.Pesticides/PCB's Quantitation Outfall#1
EPA Method 608.3 Limit
Parameter (mt/L) (mt/L)
Aldrin 0.001 BQL
Alpha,BHC 0.001 BQL
Beta,BHC 0.001 BQL
Delta,BHC 0.001 BQL
Gamma,BHC 0.001 BQL
Chlordane 0.010 BQL
4-4'-DDD 0.001 BQL
4-4'-DDE 0.001 BQL
4-4'-DDT 0.001 BQL
Dieldrin 0.001 BQL
Endosulfan 1 0.001 BQL
Endosulfan 11 0.001 BQL
Endosulfan Sulfate 0.001 BQL
Endrin 0.001 BQL
Endrin Aldehyde 0.001 BQL
Heptachlor 0.001 BQL
Heptachlor epoxide 0.001 BQL
Methoxychlor 0.001 BQL
Toxaphene 0.020 BQL
PCB 1016 0.005 BQL
PCB 1221 0.005 BQL
PCB 1232 0.005 BQL
PCB 1242 0.005 BQL
PCB 1254 0.005 BQL
PCB 1260 0.005 BQL
Sample Number 88327-01
Sample Date 09/29/20
Sample Time 0905
PCB=Polychlorinated Biphenyl
mg/L=mlligrams per Liter=parts per million(ppm)
BQL =Below Quantitation Limits

•
RESEARCh ANALyTICAl _ ?��°4» .
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- LAI�ORATORIES, INC. N.tef
Analytical/Processv ne Consultations •+��' wt'
Chemical Analysis for Selected Parameters and Water Sample Identified as Stormwater-Second Half of 2020
(A Siemens,Inc. Project,collected 29 September 2020)
11, Volatile Organics Quantitation Outfall#1 III.Semi-volatile Organics Quantitation Outfall#1
EPA Method 624.1 Limit Method 625.1 Limit
Parameter (me/L) (me/LiParameter (me/L) f me/L)
Methylene Chloride 0.010 SQL 4-Chloro-3-methylphenol 0.010 BQL
Trichlorofluoromethane 0.010 SQL 2-Chlorophenol 0.010 BQL
l,1-Dichloroethene 0.010 SQL 2,4-Dichlorophenol 0.010 BQL
1,1-Dichloroethane 0.010 BQL 2,4-Dimethylphenol 0.010 BQL
Chloroform 0.010 BQL 2,4-Dinitrophenol 0.050 BQL
Carbon Tetrachloride 0.010 BQL 2-Methyl-4,6-dinitrophenol 0.050 SQL
1,2-Dichloropropanc 0.010 SQL 2-Nitrophenol 0.010 BQL
Trichloroethene 0.010 SQL 4-Nitrophenol 0.050 SQL
Dibromochloromethane 0.010 BQL Pentachlorophenol 0.050 SQL
1,1,2-Trichloroethane 0.010 BQL Phenol 0.010 BQL
Tetrachloroethene 0.010 SQL 2,4,6-Trichlorophenol 0.010 BQL
Chlorobenzene 0.010 BQL Acenaphthene 0.010 BQL
Trans-1,2-Dichloroethene 0.010 SQL Acenaphthylene 0.010 BQL
1,2-Dichloroethane 0.010 BQL Anthracene 0.010 BQL
1,1,1-Trichloroethane 0.010 BQL Benzidine 0.050 BQL
Bromodichloromethane 0.010 BQL Benzo(a)anthracene 0.010 SQL
Cis-1,3-Dichloropropene 0.010 BQL Benzo(a)pyrene 0.010 BQL
Benzene 0.010 BQL Benzo(b)lluoranthene 0.010 SQL
Trans-1,3-Dichloropropene 0.010 BQL Benzo(ghi)perylene 0.010 BQL
Bromoform 0.010 SQL Benzo(k)fluoranthene 0.010 BQL
1,1,2,2-Tetrachloroethane 0.010 BQL Benzyl butyl phthalate 0.010 BQL
Toluene 0.010 BQL Bis(2-chloroethoxy)methane 0.010 SQL
Ethyl Benzene 0.010 SQL Bis(2-chloroethyl)ether 0.010 SQL
Chloromethane 0.010 SQL Bis(2-chloroisopropyl)ether 0.010 BQL
Bromomethane 0.010 BQL Bis(2-ethyl-hexyl)phthalate 0.010 BQL
Vinyl Chloride 0.010 BQL 4-Bromophenyl phenyl ether 0.010 SQL
Chloroethane 0.010 SQL 2-Chloronaphthalene 0.010 BQL
Total Xylenes 0.010 BQL 4-Chlorophenyl phenyl ether 0.010 BQL
Acrolein 0.100 BQL Chrysene 0.010 BQL
Acrylonitrile 0.100 BQL Dibenzo(a,h)anthracene 0.010 BQL
2-Chloroethyl vinyl ether 0.010 BQL 1,2-Dichlorobenzene 0.010 BQL
BQL l,3-Dichlorobenzene 0.010 SQL
1,4-Dichlorobenzene 0.010 BQL
Sample Number 88327-02 3,3-Dichlorobenzidine 0.020 BQL
Sample Date 09/29/20 Diethyl phthalate 0.010 BQL
Sample Time(hrs) 0938 Dimethyl phthalate 0.010 BQL
Di-N-Sutyl phthalate 0.010 BQL
2,4-Dinitrotoluene 0.010 BQL
2,6-Dinitrotoluene 0.010 BQL
Di-N-Octyl phthalate 0.010 BQL
l,2-Diphenylhydrazine 0.050 BQL
Fluoranthene 0.010 BQL
Fluorene 0.010 BQL
Hexachlorobenzene 0.010 BQL
Hexachlorobutadiene 0.010 SQL
Hexachlorocyclopentadiene 0.010 BQL
Hexachloroethane 0.010 BQL
lndeno(1,2,3-cd)pyrene 0.010 BQL
Isophorone 0.010 SQL
Naphthalene 0.010 BQL
Nitrobenzene 0.010 BQL
N-Nitrosodimethylamine 0.010 SQL
N-nitrosodi-n-propylamine 0.010 BQL
N-Nitrosodiphenylamine 0.010 BQL
Phenanthrene 0.010 BQL
Pyrene 0.010 BQL
1,2,4-Trichlorobenzene 0.010 BQL
Dilution Factor 1
BQL = Below Quantitation Limits Sample Number 88327-01
mg/L =milligrams per Liter=parts per million(ppm) Sample Date 09/29/20
Sample Time(hrs) 0905

RESEARCh & ANALyTICAL Report of Analysis
, 1 •
LABORATORIES, INC. 10/15/2020
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For: Siemens Energy, Inc. Winston-Salem er...-z
•',•., ,$•3050 Westinghouse RoadTo
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Rural Hall, NC 27045 `ar:e b:cn it
toy NC#34 zt•
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NC#37701
Attn: James Whiticar
4' #: D A r''t. •i
Client Sample ID: Outfall#1 Lab Sample ID: 88327-01
Site: Siemens Collection Date: 9/29/2020 9:05
Parameter Method Result Units Rep Limit Analyst Analysis Date/Time
Copper,Total EPA 200.7 <0.005 mg/L 0.005 MM 10/5/2020
Hydrocarbon O&G EPA 1664 Revision B/Silica Gel <5 mg/L 5 EE 10/8/2020
Lead,Total EPA 200.7 <0.005 mg/L 0.005 MM 10/5/2020
pH SM 4500 H+B-2011 5.71 Std. Units AB 10/5/2020 1627
Total Suspended Solids SM 2450 D-2011 <5 mg/L 5 AW 10/6/2020
Zinc,Total EPA 200.7 0.017 mg/L 0.01 MM 10/5/2020
NA=not analyzed
P.O.Box 473 106 Short Street Kernersville,North Carolina 27284 Tel:[phone] Fax:[phone] www.randalabs.com Page 1

RESEARCIi & ANAlyTICAL
LABORATORIES, INC. CHAIN OF CUSTODY RECORD
. Analytical /Process Consultations
Phone [phone]
WATER I WASTEWATER MISC.
COMPANY JOB NO.
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SIEMENS
Tier One Report—Stormwater Issue
Purpose:
The following report is to address the pH being lower than 6.0. The analytical result for pH was 5.71.
This report will serve as a response and evaluation to the Tier One parameters and will be filed with
the Stormwater documents.
Scope:
This analysis is required per the facility's Stormwater permit and in accordance with performing the
first half analysis.
Tier One Parameters:
The following parameters were noted on page seven of the permit:
1. Conduct a Stormwater management inspection of the facility within two weeks of receiving
sampling results.
2. Identify and evaluate possible causes of the benchmark value exceedance.
3. Identify potential and select the specific: source controls, operational controls, or physical
improvements to reduce concentrations of the parameters of concern and/or to bring
concentrations within the benchmark range.
4. Implement the selected actions within two months of the inspection.
5. Record each instance of a Tier One response in the SWPPP. Include the date and value of
the benchmark exceedance, the inspection date, the personnel conducting the inspection,
the selected actions, and the date the selected actions were implemented.
Responses to Tier One Parameters:
In accordance with the facility's stormwater permit, a rainfall sample was taken on October 23, 2020
to determine if the rainfall pH is below 6.0. The test result shows a pH of 3.95 for the rainfall sample.
There were no physical observations at the facility to indicate an influence at the lowering the pH of
the water at the outfall area, such as burnt vegetation or change of color in the water.
However, large portions of the western United States have forest fires raging at the time. The
contaminants from these forest fires could easily act as constituents for creating acid rain in this
area. Based upon the recent analytical, the facility believes that this is the case.
Unfortunately, due to the source of the acid rain, there can be no corrective action at this time.
Unrestricted

RESEARCh & ANALyTICAL Report of Analysis
0 t 0 LABORATORIES, INC. 10/27/2020
0014
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For: Siemens Energy, Inc. Winston-Salem ��.pt
;��t-�•y.ti. i,�3050 Westinghouse Road .• 4 -"'�►,�;d'„
Rural Hall, NC 27045
S�Sop NC#34 11• w
S NC#37701 .r
Attn: James Whiticar : 's
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S.d.%•.7ECTI.P.4* <0
Client Sample ID: Rain Sample Lab Sample ID: 89409-01
Site: Siemens Collection Date: 10/23/2020 9:40
parameter Method Result Units Rep Limit Analyst Analysis DatetTime
pH SM 4500 H+B-2011 3.95 Std.Units AB 10/27/2020 1045
NA=not analyzed
P.O.Box 473 106 Short Street Kemersvife,North Carolina 27284 Tel:[phone] Fax [phone] www.randalabs.com Page 1
ral coa baic: v1d

,1 . .,.,, RESEARCH v ANA[yfiCA� ;
. %5;..- LAbORATORjE5, INC. ivi" A ��,�a� OF CUSTODY RECORD
01.'M��; Analytical / Process Consultations
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COMPANY 1 ` JOB NO. WATER I WASTEWATER MISC.
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NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit: http://portal.ncdenr.org/web/lr/npdes-stormwater/
Permit No.: N/C/0/3/0/0/0/0/0/ or Certificate of Coverage No.: I I/C/G/0/3/0/ 2 /3/8
Facility Name: Siemens Energy.Inc.
County: Forsyth Phone No. 336-969-1265
Inspector: lames Whiticar
Date of Inspection: 09/29/2020 RECEIVED
Time of Inspection: 9:05am NOV 0 9 2020
Total Event Precipitation(inches):_1.18 CENTRAL FILES
DWR SECTION
Was this a"Representative Storm Event"or"Measureable Storm Event"as defined by the permit?
(See information below.)
® Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event"or"measureable storm event"(requirements vary,depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a"representative storm event" or during a"measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions,if applicable.
"representative storm event)is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours(3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A"measurable storm event"is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period,and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature f tip ee or Des ei e)
Unrestricted Page 1 of 2
SWU-242,Last modified 10/25/2012

1. Outfall Description:
Outfall No. 1 Structure (pipe,ditch,etc.) Rip Rap Channel
Receiving Stream: Muddy Creek
Describe the industrial activities that occur within the outfall drainage area:
Metal fabrication
2. Color: Describe the color of the discharge using basic colors (red,brown,blue,etc.) and tint
(light,medium,dark) as descriptors: Clear
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil,
weak chlorine odor,etc.): No discharge
4. Clarity: Choose the number which best describes the clarity of the discharge,where 1 is
clear and 5 is very cloudy:
V 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge,where 1 is no solids and 5 is the surface covered with floating solids:
J2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge,where 1 is no solids and 5 is extremely muddy:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
o
10. Other Obvious Indicators of Stormwater Pollution:
List and describe None
Note: Low clarity,high solids,and/or the presence of foam,oil sheen,or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Unrestricted Page 2 of 2
SWU-242,Last modified 10/25/2012