NCG030596_Monitoring Report_20210902

Permit and Facility Information:
please enter the pemit number and ctl� details fa ais 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 OCCatdividualparitlAinber(NJr Gene-J Fhrnit nunba with at Os)
NCG030596
Mist begin with ISS a t(
Facility Name:* Controls Southeast, Inc.
County:" Mecklenburg
600Pa�ao,�� � Q
After uploading here, the original signed hardcopy must be mailed
Re9ySP (�
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program cp
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Further contact details at https://deq.nc.gov/contact/regional-offices/mooresville
Monitoring Period Information:
Monitoring Period Nhatisthe YEARdtltesanpledate(s)?
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* Oicktheupoad button or drag and drop files heretoattachdocunent.
20210803 Stormwater Discharge Monitoring
1.17MB
Report.pdf
0* plSs are accepted.
Comments:
* W By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o 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");
e 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

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NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload 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. NCG03 0596
Person Collecting Samples: S. Houff
Facility Name: Controls Southeast Inc
Laboratory Name: Par Labs
Facility County: Mecklenburg
Laboratory Cert. No.: 20
Discharge during this period: ✓❑ Yes
❑
No (if no, skip to signature and date)
Has your facility implemented mandatoryTier response actions this sample period for any benchmark exceedances? ❑ Yes ✓❑ No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ❑✓ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
OutfallI
Outfall2
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
C
C
N/A
Date Sample Collected MM/DD/YYYY
08/03/2021
08/03/2021
46529
24-Hour Rainfall in inches
0.57
0.57
C0530
TSS in mg/L(100 or 50*)
21
27
00400
pH in standard units (6.0-9.0)
6.08
6.84
-Z
01119
Copper, total recoverable in mg/L
0.003
0.011
s�
(0.010)
Day
01051
Lead, total recoverable in mg/ L
0.002
0.002
uPcl�,
(0.075)
o
01094
Zinc, total recoverable in mg/ L
0.440
0.144
p
(0.126)
e
78141
Total Toxic Organics (770) in mg/L(1)
N/A
N/A
(if required)
00552
Non -Polar Oil & Grease in mg/L (15)
5.3
5.4
Additional parameters for outfaIIs in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
N/A
N/A
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary NurseryAreas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional): Elevated zinc levels previously reported to Mr. Zahid Khan
"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."
23-August-2021
of PetmiAee or Delegated Authorized Individual Date
Email Address [e-mail] Phone Number (704)-644-5002

Total Toxic Organics Certification:
"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 leak, spill, or dumping of
concentrated toxic organics into the stormwater or onto 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 all the provisions of the Solvent
Management Plan included in the Stormwater Pollution Prevention Plan."
of P6,rmiyee or Delegated Authorized Individual
23-August-2021
Date
Email Address [e-mail] Phone Number 704-644-5002

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PROM PT•ACCURATE -RE L[ABLE
LABORATORIES, INC
W W W.PARLARS.CONI
REPORT OF ANALYSES
Attn: SAM HOUFF
CONTROLS SOUTHEAST, INC
PO BOX 7500
CHARLOTTE, NC 28241-
PROJECT NAME: AUG 21
DATE: 08/17/21
SAMPLE NUMBER-
142262
SAMPLE ID- CSI RUNOFF #2
SAMPLE MATRIX- WW
DATE SAMPLED-
08/03/21
TIME SAMPLED- 1250
DATE RECEIVED-
08/03/21
SAMPLER- SH
RECEIVED BY- DJ
TIME RECEIVED-
1310
DELIVERED BY- SH
TYPE SAMPLE- Grab
Page 2 of 2
ANALYSIS
ANALYSIS
METHOD
DATE
TIME
BY
RESULT UNITS
PH VALUE
SM 4500H+B
08/03/21
1315
DJ
6.84 units
OIL & GREASE
EPA 1664
08/11/21
1010
CT
< 5.4 mg/L
TOTAL SUSPENDED SOLIDS
SM 2540 D
08/09/21
0820
DJ
27 mg/L
COPPER, TOTAL
EPA 200.7
08/05/21
2036
EV
0.011 mg/L
LEAD, TOTAL
EPA 200.7
08/05/21
2036
EV
< 0.002 mg/L
ZINC, TOTAL
EPA 200.7
08/05/21
2036
EV
0.144 mg/L
LABORATORY DIRECTOR �-/ �Y"!/✓
2217 Graham Park Drive • Charlotte. NC 28273
Phone: [phone] • Fax: [phone]

P .RPROM PT•A OW ATE RE
LABORATORIES, INC
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
Shipping:
2217 Graham Park Drive
Charlotte, NC 28273
It is essential that all Information be recordeo on it,,, ranm of custody document for acceptance by PAR Laboratories. Inc and the North
Carolina Department of Environmental and Natural Resources.
Company Name (billing) Commentsl Special Instructions
CONTROLS SOUTHEAST, INC
Address
12201 NATIONS FORD ROAD
City, State & zip code
PINEVILLE, NC 28134
Point of Contact a Telephone Number
SAM HOUFF 336-978-1752
Taken By: SIGNATURE f�i1i� PRINTED
ARE SAMPLES FOR STATE or EPA REPORTING? YES _NO
*Sample Type: Dw WW GWMW HW soil other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
**Field Preserved: Yes No Teflon LinerlZero Headspace: Yes No nla
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
li ibt Sample l.D.
Semple Location! Number)
Comp Grab
Preserv.
< 4° C
Set Up
Daterl ime
- Collection
DatefFime
Analyses
Requested
STORM WATER RUNOFF #1
X
$f 3,w
12:YS PM
PH, TSS
X
H,SO,
OfeG
X
HNO,
Pb, Cu, Zn
< 4= c
STORM WATER RUNOFF #2
X
6131 Lst
H, TSS
X
H2S0
OEtG
X
HNO,
Pb, Cu, Zn
Nenngwsnea oy: ueter I mie r.=w•=--.-......_ /
¢ll- T/3l2m1 I. lu
Relinquished by: Datelrime Received by: Date rime
•C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

KC-0 Ir %�
Envi'"au"tal o ! s ��
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onfilling out thisform, please visit littps:Hdeq.nc.gov/x
npdes-stormwater-gps
Permit No.: N/C/ 6 /0 /3 /0 /0 /0 /0 / or Certificate of Coverage No.: N/C/G/ 0 /3 /0 /5 /9 /6 /
Facility Name: Controls Southeast, Inc.
County: Mecklenburg Phone No. [phone]
Inspector: ILPc-m f—t+ I n1 E F1�T
Date of Inspection: D / - 1 2..a'L
Time of Inspection: I z= 4 5 P i-i
Total Event Precipitation (inches)
All permits require qualitative monitoring to be performed during a "measurable storm event."
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 DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
Laz"
of Pellniftee or Designee)
Page 1 of 2
SWU-242, Last modified 06/012018

1. OutfallDescription: L' S 1 2 J rJ �F o 11 1
Outfall No. —/' Structure (pipe, ditch, etc.): Pipe to Ditch
Receiving Stream: McCullough Branch
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 I?A r 0 r'!psLrk- -yi V'+
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): VLo V.
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 G) 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 Q 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 b 3 4 5
7. Is there any foam in the stormwater discharge? O Yes "lo.
8. Is there an oil sheen in the stormwater discharge? oYes O-Flo.
9. Is there evidence of erosion or deposition at the outfall? O Yes GO -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, Lut modified 06/012018

1. Outfall Description: C$ I Jeu No eF
Outfall No. Z Structure (pipe, ditch, etc.):
Receiving Stream: McCullough Branch
AL --2—
Pipe to Ditch
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: G I C0.Y I • al F -i'9 '4.
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): v%. r..t
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 0 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 0 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:
7.
8.
VA
1 G, ) 3 4 5
Is there any foam in the stormwater discharge? O Yes Qr No.
Is there an oil sheen in the stormwater discharge? OYes 0 No.
Is there evidence of erosion or deposition at the outfall? O Yes erNo.
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, Last modified 06/0112018