NCG060114_DMR_20201130

DocuSign Envelope ID: 66F8234E-88D4-48AF-8945-F49912C32FA4
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STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO60000
Date submitted I ilqD 2,)20
CERTIFICATE OF COVERAGE NO. NCG06 0 ( 1 4
FACILITY NAME U rli ICV(Ur VVl-W L _Ehtt j, LLS
COUNTY HC (ZE
PERSON COLLECTING SAMPLES =o kr (ej LSW O UXC,IU.c_n d,, ,
LABORATORY M, uLoloac Cabo r&fevi t,, Lab Cert. # Ki , 4 I I ,�� 7 711
us1)A # 3787
RECEIVED
DEC 14 2020
GEN-IRAL FILES
DWR SECTION
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2 D 27 O
SCANNED
MAR 2 6 2021
SAMPLE PERIOD ❑ Jan June ® July -Dec
or ❑ Monthly' lmonth)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
FACILITY ACTIVITIES INCLUDE (check all that apply): N/A No W-0-
use/process meats ❑ use animal fats/byproducts aVu "
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Total event rainfnll2 3.1 `f" or ❑ No dischar a th's g d3
Outfall No.
Date Sample.
Collected, mo/dd/yr
TSS,
L
pH,
Standard units
COD,
m L
Oil and Grease,
m L
Fecal Coliform,
Colonies per 100 ml
� peso
Enterococci,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 - 9.0
120
30
10001
swig
Parameter Code
-
C0530
00400
00340
00556
31616
61211
l
it Z uw
5.05
(,•(o
Iz.l
.7
N A
N A
1
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfali.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes ® no if yes complete Part B)
Permit Date: 11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
Dann 1 of 7

DocuSign Envelope ID: 66F8234E-88D4-48AF-8945-F49912C32FA4
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Date Sample Collected
(mo/dd/yr)
24-hour rainfall amount,
Inchesz
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/Total
Petroleum Hydrocarbons
Total Suspended Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or SO mg/O
Parameter Code
-
46S29
NCOIL
00S52
C0530
Footnotes from Part A also apply to Part B
*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 11 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 DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME: I\i
Mail an original 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, NC 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 for submitting false information, including the possibility of fines and
imprisonment for knowing violations."
_DocuSigned by:
l
Signature of Permittee
30 November 2020
Date
Pet -nit Date:11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
0— 1 nF 1

DocuSign Envelope ID: 66F8234E-88D4-48AF-8945-F49912C32FA4
*MICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOK0218
Analytical Testing Parameters
Client Sample ID: Storm water, grab
Sample Matrix: Aqueous Collected By: Unilever
Lab Sample ID: KOK0218-01 Collection Date: 11/12/2020 18:30
Inorganics Total
Result
RL
Units
Dilution Note
Prepared Analyzed
Analyst
EPA 1664B
Oil & Grease (HEM)
5.7
5.3
mg/L
1
11/19/20 0831
TBM
SM 2540 D-2011
Total Suspended Solids
5.05
2.63
mg/L
1
11/17/20 1356
BNS
SM 4500-H+ B-2011
pH at 25 °C
6.6
1.0
S.U.
1 H
11/24/20 1139
BNS
SM 5210 B-2011
BOD
<2.00
2.00
mg/L
1 G1, G3
11/13/20 1655 11/18/20 1242
MT
SM 5220 D-2011
COD, Total
12.1
10.0
mg/L
1
11/20/20 0915
MT
A
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 283061910.864.1920 p I www.microbac.com
t
Page 3 of 7

DocuSign Envelope ID: 66F8234E-88D4-48AF-8945-F49912C32FA4
FAYETTEVILLE DIVISION - 2592 Hope Mills Road - Fayetteville, NC 28306 - (910) 864-192i
CHAIN OF CUSTODY RECORD
PAGE
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OF
''CLIENTitIAME &"ADDRESS:
L10 #:.
'PROJECT', -LOCATION E
m
TYPE
OF
ANALYSIS
PRESERVATION (CODE)
UNILEVER HPC
100 Faberge Blvd.
Raeford, NC 28376
Raeford
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CODE: A = <4 C ONLY
B = HNO3 (ph<2) + <4°C
C = H2SO4 (ph<2) + <4°C
D = NaOH + <4°C
E = ZN Acetate + °
F = Sodium Thio.
;, O'tW T ON:.
Amy Dorne
sIiMP�Et�;:
9 0 875-1240
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MEL Pick-up
LAB ID #
Sample Type
Start Date
Start Time
End Date
End Time
COMP
GRAB
pH
D.O
TEMP °C
Rm cHummE
X
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6
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Temp:
pH:
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Flow: 1 y �
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Additional Sample Comments:
R0115WE
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