NCG060098_DMR_20210211

Submission Completed
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Stormwater NPDES Permit Data Monitoring
tT
NC Department of
Report (DMR) Upload Environmental Quality
NORTH CARQUHq Received
GWomwnbl QYOltly
FEB 11 2021
Permit and Facility Information:
Winston-Salem
Regional Office
Please enter the permit number and other details for this upload.
..... ..I...... ........ ......_ .....I.... ......... ....._..._... _..... ...___ _......_.... _.__.. .... .........
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 (NOT General Permit number with all 0's)
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)7
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.
https://edocs.deq.nc.gov/Fonns/Form/showformsubmissionle463c230-1989-4607-a2l 6-2fe... 2/ 10/2021

Submission Completed
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Also, copies of the lab results and qualitative (visual) monitoring should NOT be submitted
unless specfcally requested by DEQ staff. Only upload the completed and signed DMR forms.
DIVIR Upload* Click the upload button or drag and drop files here to attach document.
NCG06-SDO-DMR-Vertellus-January 2021.pdf 315.61 KB
Only PDFs are accepted.
Comments:
* 0 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");
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");
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
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:* 3366018675
Signature:*
Date: * 02/10/2021
https:Hedocs.deq.nc.gov/Forms/Form/showformsubmissionle463c230-1989-4607-a2l 6-2fc... 2/10/2021

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT NC Department of
for North Carolina Division of Water Quality General Permit No. NCG0600ovironmental Quality
Date submitted 02/09/2021 Received
CERTIFICATE OF COVERAGE NO. NCG06 0098
FACILITY NAME Vertellus Greensboro LLC
COUNTY Guilford
PERSON COLLECTING SAMPLES Frank Thomas
LABORATORY Meritech Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall' 0.25"
FEB 11 2021
Winston-Salem
Regional Office
or ❑ No discharge this period]
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliforml,
Colonies per 100 ml
Enterococcir,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
500
01
01/25/2021
20
6.78
60
<5
n/a
n/a
13:30 — 13:35
--
--
--
--
n/a
n/a
05
01/25/2021
8
7.11
36
<5
n/a
n/a
13:40 —13:45
---
---
--
---
n/a
n/a
O6
O3/25/2021
262
6.87
380
<5
n/a
n/a
13:50 — 13:55
1
n/a
n/a
' 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 (if ves. complete Part B)
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
1.00or504
6.0-9.0
' 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.
SWU-249 Last Revised: October 18, 2012
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4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
*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 ® NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑
REGIONAL OFFICE CONTACT NAME: _Winston Salem Regional Office
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."
7M4 74m" (Date) 02/09/2021
(Signature of Permittee)
Additional copies of this form may be downloaded at: http://Dortal.ncdenr.oriz/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
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