NCG100197_DMR_20211101

NC Depal tment cf
Environmental Quality
Received
AIOV 0 t 2221
CONVERSION Winston-�,.1: m
TECHNOLOGY INC. ?egion=; off; partner in compNnce since 1986
Environmental 6 Safety Consulting Engineers
October 28, 2021
DEQ Winston-Salem Regional Office
Attn: DEMLR Stormwater Program
450 West Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
To whom it may concern:
Please find enclosed the Stormwater Discharge Monitoring Report (DMR) for the third quarter
of 2021 for the Pull -A -Part of Winston-Salem, LLC facility in Winston-Salem, NC as well as the
online submittal receipt.
Pull -A -Part of Winston-Salem, LLC has implemented a Solvent Management Plan satisfying Part
II Section B of the permit requirements necessary for a Total Toxic Organics (TTO) sampling
waiver. Pull -A -Part of Winston-Salem, LLC does not perform activities such as vehicle washing
that expose toxic organic compounds to stormwater run-off.
Please feel free to contact me with any questions at [phone] ext. 114.
Sincerely,
Lance Layton
Water Testing Manager
z:\pap.wncl \swt\swt21 \swt921 \pap.wncl _swt921 _dmr_Itr_ncdenr.docx; LL
2190 N. Norcross Tucker Rd., Suite 202 1 Norcross, Georgia 30071 1 770.263.6330 1

NCDEQ Division of Energy, Mineral and Land Resources NC Department of
environmental Quality
Stormwater Discharge Monitoring Report (DMR) Form for NCG100dbWeived
Used Motor Vehicles NOV 0 1 2021
Click here for instructions
r.,
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Rep,��J d form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG10 0197
Person Collecting Samples: Shane Bond
Facility Name: Pull -A -Part of Winston Salem
Laboratory Name: Pace Analytical Services
Facility County: Forsyth
Laboratory Cert. No.: 381
Discharge during this period: +
Yes
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? QYes No
If so, which Tier (I, II, or III)? Tier I
A copy of this DMR has been uploaded electronically via https:Hedocs.deg.nc.gov/Forms/SW-DMR + Yes No
Date Uploaded: 10/28/2021
Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall 1
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
9/21/2021
46529
24-Hour Rainfall in inches
0.3
CO530
TSS in mg/L (100 or SO*)
17.5
00400
pH in standard units (6.0-9.0 FW,
61
6.8 — 8.5 SW
Chemical Oxygen Demand in mg/L
00340
(120)
251
Lead, total recoverable (as Pb) in
01051
m / L(0.075 FW, 0.22 SW)
<0.025
Ethylene Glycol in mg/ L (any amount
77023
detected Tier One; 8,000 mg/L Tier
57.6
Two and Three)
00552
Non -Polar Oil & Grease in mg/L (15)
<5.6
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in al/month
4
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of SO mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional): Facility exceeded the benchmark limits for Ethylene Glycol and Chemical Oxygen Demand and will undergo a Tier 1 response.
"I certify by my signature below, 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 Permittee or Delegated Authorized Individual
[e-mail]
Email Address
10/28/2021
Date
[phone]
Phone Number

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 COG or Individual Permit Number (NOT General Permit number with all Ps)
NCGl OO197
Must begin with NCS or NCG
Facility Name:' Pull -A -Part of Winston Salem
County:' Forsyth
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
Wnston-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 dateha?
Year:" 2021
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload different years
with a new submittal form.
Also, copies of the lab results and qualitative (visual) monitoring should NOT be submitted unless specifically
requested by DEQ staff. Only upload the completed and signed DMR forms.
DMR Upload* Click the upload button or drag and drop files here to attach document,
PARWNC 1_SWT921_DMR_Signed.pdf 172.08KB
Only PDFs are accepted.
Comments:
"v By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• I 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");
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act"):
o I 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

a I intend to electronically sign and submit this DMR upload form.
Full Name:" Lance Layton
Name of person submitting this form
Email Address:" [e-mail]
Phone Number:" 7705005366
Signature:'
6/11-er O1e6/Y
Date:' 10/28/2021