NCG060095_DMR_20211018

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000 RFrCl1 /FD
Date submitted
CERTIFICATE OF COVERAGE NO. NCGO6 OQ -5
FACILITYNAME
COUNTY Uai ne%
PERSON COLLECTING SAMPLES
LABORATORY Pnce, Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
OCT 26 2021
SAMPLE COLLECTION YEAR Zo Zl C'ENtTftAL FILES
FACILITY ACTIVITIES INCLUDE ( he k all that apply): MR SECTION
❑ use/process meats use am al fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall10,113 or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform',
Colonies per 100 ml
Entero OCcI',
Colonies per 100 ml
Benchmark
100orSW
Within 6.0 — 9.0
120
30
1000
500
21
90.
.I
1
1
.'1
I
Ll.'I
q. 00P
' Only applies to facilities that use/process meats.
'The 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.
'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
30
100or504
6.0-9.0
(if yes, complete Part B)
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at anv outfalls, you must still submit this discharge mom , mg report with a checkmark here.
'See General Permit text, Table 3, identifying the especially sensitive receiving water cla5sifitations where the more protective benchmark applies.
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*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 II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NOV
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, 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."
(Signature of
18 z
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wci/ws/su/npdessw#tab-4
RVINIVatl
Last Revised: October 18, 2012
Page 2 of 2

HCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://portal.ncdenr.or, .web/wq/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 I or Certificate of Coverage No.: NICIGI 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: '43XIII4 C�j nca.►
Date of Inspection: dil z Z 1 Z_ 1
Time of Inspection: l ; 210 R r,- _
Total Event Precipitation (inches): 10. 19 3
Was this a Representative Storm Event? (See information below) ZYes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I cep that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:—�_lf-c;r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): A0 n e
Page I of 2
swU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
(D 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:
1 2 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:
(D 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes CD
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes CNo
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
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.
Page 2of2
S W U-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goul ston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: 8ca /)
Date of Ins ection: Z._
r �t��
Time of Inspection:
Total Event Precipitation (inches): Q • l q 3
Was this a Representative Storm Event? (See information below) ❑ Y�,s/❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature
ertify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe ibththe industrial activities that occur within the outfall drainage area:
1 Ct n � ii'G r' lY"-
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C. X-fa ►r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): (b n L
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
0 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:
2 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:
Q 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 (No)
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe _ NA -
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.
Page 2 of 2
SwU-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: h=://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: St llst C"nGa n
Date of Inspection: ^{ ZZ Zi
Time of inspection: 1' 4 o D rvm .
Total Event Precipitation (inches): D. IS 3
Was this a Representative Storm Event? (See information below) PlIes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature,Jfertify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) P'Pe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
LQak1 0,741f4- near ConW.-Qr,C-4-Or
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 1 1 4 a rc.f
3. Odor: Describe any distinct odors that the discharge may have (i.e., smeIls strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 (D 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:
(D 2 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:
(D 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes (5
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
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.
Page 2of2
SWU-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: httn://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: Jam' a�i r w n C32^
Date of Inspection: 2L I Z.
Time of Inspection:
Total Event Precipitation (inches):
Was this a Representative Storm Event? (See information below) ❑ Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, Ice ' y that thi port is accurate and complete to the best of my knowledge:
(Signature of Perrnittee or Designee)
1. Outfall Description:
Outfall No. H Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
`70r k Ems. e^ -,t ?
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C \ ec r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): YNO ^ -C
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy: ,�
f 1) 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:
(2) 2 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
S. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe f\A
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.
Page 2 of 2
SWU-242-20120613

A��
Q:V=�
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: _Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: --C&AA0-, nr,z..
Date of Inspection: �j I2.2A 2-1
Time of Inspection: I : f� rvt -
Total Event Precipitation (inches): 0.)93
Was this a Representative Storm Event? (See information below) es ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I/c/e�y/L/(fy that thisreportis accurate and complete to the best of my knowledge:
1
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No.J; Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C lea t-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): CSO n R,
Page I of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
co 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:
0 2 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:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes (fNo:)
8. Is there an oil sheen in the stormwater discharge? Yes (2op
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe r\ A
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.
Page 2 of 2
SWU-242-20120613

'E
J7
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htm://portal.ncdenr.ora/web/wg/ws/su/npdessw#tab-4
Permit No.: NIC/G / 0/ 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: NIC/GI 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector:
Date of Inspection: at 127, 121
Time of Inspection: 1: 5 S o van -
Total Event Precipitation (inches): 0- 3
Was this a Representative Storm Event? (See information below) PAs ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I cey that thireport is accurate and complete to the best of my knowledge:
(Signature of Perlm'ttee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
,� wc►1 PaS�-y� raw.P
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C 1Pg, r-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): [No r ,0-
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 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:
(D 2 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 0
9. Is there evidence of erosion or deposition at the outfall? Yes (No:)
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
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.
Page 2 of 2
S WU-242-20 l 206 l 3

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on falling out this form, please visit: httn://Rortal.ncdenr.org/web/wq/ws/Su/ni2dessw#tab�
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ S/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: ."3m%f 0_, 2 r par%
Date of Inspection: '0 uj Z 1 _
Time of Inspection:
Total Event Precipitation (inches): D • 113
Was this a Representative Storm Event? (See information below) es ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I certify that thisjegort is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
Qq� Cott)
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ Y. !r:jLv�- q cc L j
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): nn C&
Page I of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 02 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:
0 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I 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 No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe n A
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.
Page 2of2
SWU-242-20120613

40A
RCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://Rortal.ncdenr.ora/web/n/ws/su/npdessw#tab4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: �t�,�c a A
Date of Inspection: q 12� 1 1-0
Time of Inspection: 6
Total Event Precipitation (inches): a 113
Was this a Representative Storm Event? (See information below) IE3"Yoes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I 7certi!f>that thisre/�ort is accurate and complete to the best of my knowledge:
/ / 1
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
00rA-11- ?As-�- c„1a-,)
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 0,e-,n C
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): ina e\k.
Page 1 of 2
SwU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
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:
0 2 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:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes S
8. Is there an oil sheen in the stormwater discharge? Yes (!0)
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe n X
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.
Page 2 of 2
SWU-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: hn://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 04 - 2 9 6- 6 4 2 7
Inspector:
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): e). 193
Was this a Representative Storm Event? (See information below) U,,Ws ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I certify that report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
Eas4s[cz r41 Cal G� S• /�
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 1 i G �% G re t_ �
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): f\a n {-
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 D 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:
0 2 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:
lT 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes oNo
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 1 A
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.
Page 2 of 2
S WU-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. http:l/portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ S/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: .6114
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): . Q- 113
Was this a Representative Storm Event? (See information below) PlIes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I certify thatthisreport is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee
1. Outfall Description:
Outfall No. ID Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
We s�- of ca- b , •�
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: (I otI
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): AO r e-
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 03 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:
(D 2 3 4 5
b. 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:
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 C9
9. Is there evidence of erosion or deposition at the outfall? Yes CNq)
10. Other Obvious Indicators of Stormwater Pollution:
List and describe _(� ,A=
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.
Page 2 of 2
SWU-242-20120613

LVIFAA
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on f lling out this form, please visit: httv://portal.ncdenr.ora/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/CIGI 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: .�
Date of Inspection:
Time of Inspection: : -A0
Total Event Precipitation (inches): �. )
Was this a Representative Storm Event? (See information below) 0Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream: Bearskin Creek
pipe
Describe the industrial activities that ccur within the outfall drainage area:
[ )nrA�N lXI&I1 - n-► o re_ L 4 o W W i
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Mr 4% u n% a re it
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): flcone_
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 � 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:
V 2 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes ®°
8. Is there an oil sheen in the stormwater discharge? Yes CD
9. Is there evidence of erosion or deposition at the outfall? Yes No
1.0. Other Obvious Indicators of Stormwater Pollution:
List and describe iN
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.
Page 2 of 2
SWU-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
Permit No.: N/C/G / Of 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: .<<�Tfl ncan
Date of Inspection: 412�j2.�1
Time of Inspection: ; a o rv\
Total Event Precipitation (inches): 0- i13
Was this a Representative Storm Event? (See information below) LJ2-Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I cep' y that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. I"L Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
iar
CmtS:�t PaVIA
- I A- nof
NJ
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Gk-c G r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): f No & &
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: ��
( 1 J 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:
(D 2 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 (±o
8. Is there an oil sheen in the stormwater discharge?
Yes CD
9. Is there evidence of erosion or deposition at the outfall?
Yes /lob
10. Other Obvious Indicators of Stormwater Pollution:
List and describe N Ok
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.
Page 2 of 2
SWU-242-20120613

IV W
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://portal.ncdenr.ora/web/wg/ws/s-u/nAdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector:
Date of Inspection: Z.1
Time of Inspection: =3c w• ,
Total Event Precipitation (inches): 0 . I rl3
Was this a Representative Storm Event? (See information below) es ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
z
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. 1 Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: k a �r- are
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): n O e% e
Page 1 of 2
S WU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 5
S. 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:
0 2 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:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes (!5)
8. Is there an oil sheen in the stormwater discharge? Yes . o
9. Is there evidence of erosion or deposition at the outfall? Yes
1.0. Other Obvious Indicators of Stormwater Pollution:
List and describe in A
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.
Page 2 of 2
SWU-242-20120613

OAI74;A
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on f lling out this form, please visit: hU://Rortal.ncdenr.orz/web/wglwslsu/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: NICIGI 01 61 0/ 0/ 9/ 5/
Facility Name: Goul ston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector:
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): _0. 1 0
Was this a Representative Storm Event? (See information below) UYe"'s ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I certif that this report is accurate and complete to the best of my knowledge:
(Signature of Permit -tee or Designee)
1. Outfall Description:
Outfall No. 14 Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
n ti -- P C4 * n cl
NJ
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: GS ear
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SwU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
0 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
U 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
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.
Page 2 of 2
SWU-242-20120613

`te4
r
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on f Ming out this form, please visit. hn:Hportal.ncdenr.or;/web/wg/ws/Su/npdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: !S.,f�, n cyan
Date of Inspection: at U=7 Z.�
Time of Inspection: 9: t o 2 -Z,
Total Event Precipitation (inches): 0.193
Was this a Representative Storm Event? (See information below) � ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I cert^fy that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream: Bearskin Creek
pipe
Describe the industrial activities that occur within the outfall drainage area:
W —( 7 e c A. Par lC , n a - C-.CA=
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C �rra
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): o Q
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
D2 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:
0) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
S. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 0 A -
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.
Page 2 of 2
SWU-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. hUR://RortaI.ncdenr.orz/web/wg/ws/Su/nRdessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 7 0 4- 2 9 6- 6 4 2 7
Inspector: \1 �,�cw•
Date of Inspection:
Time of Inspection: ry ,
Total Event Precipitation (inches): 0. Lq3
Was this a Representative Storm Event? (See information below) D4e's ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "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.
By this signature, I cert' at this report is accurate and complete to the best of my knowledge:
1
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. 16 Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial1 activities that occur within the outfall drainage area:
out r•C d D(oC y- - Coen jr- f n CA
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
rNQ c ,.7 G� r 4r s a rnSo 1%, 4 a
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 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:
1 2 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:
1 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 No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
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.
Page 2of2
S WU-242-20 1206 13