NCS000354_2022 DMR_20221027

Permit No.: N/C/
Facility N me:�
County: ��
Inspector: '� : Y
Date of Inspection:
Time of Inspection:
NCDEEIR
Stormwater Discharge Outfail (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit.
http l/portal.ncdenr.or web'wq,/w su n �dessw#tali-4
or Certificate of Coverage No.:
Phone No. 3 3t� - i - 6
��on
,�-nA �
rr
Total Event Precipitation (inches): a. 1
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See
information below.)
0 Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or
"measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be -�
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
I 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 1
from the local DWQ Regional Office. __j
By this s4gnature, I c -tify that this repo:-t is accurate and complete to the best of my knowledge:
sr ,r
(Sig'), ure of Permittee or Designee)
PACE 1 OF 2
SWU-242, LAST MODIFIED 10/25/2012

1. Outfall Description:
Clutfall No. I Structure(pipe, ditch, etc.) i �ctrn
Receiving Stream: 13ri
Describe the industrial activities th t occur within the outfall drainage area: _
�-ruck , Co 1 Va(-d
2. Color: Describe the color of the discharge usin basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Vim_, �� �+ raffia
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): M o n 2
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2Q 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:
01 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 3 4 5
7. Is there any foam in the stormwater discharge? Yes ONO
8. Is there an oil sheen in the stormwater discharge? Yes o0
9. Is there evidence of erosion or deposition at the outfall? Yes
14. Other Obvious Indicators of Stormwater Pollution:
List and describe
No
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 10/25/2012

STORMWATER DI. BARGE OUT�SDO'
MONITORING REPORT
Permit Number NCS000354 SAMPLES COLLECTED DURING CALENDAR YEAR; a a
(This monitoring report shall be received by the Division no later than 30 days
from the date the facility receives the sampling results from the laboratory.)
FACILITY NAME
PERSON COLLECTING SAMPLES) COUNTY ItQ !4�1
CERTIFIED LABORATORY(S)I . �n Lab # PHONE NO. (33�-� 1�7-p (p
Lab #
SIGNATURE OF PERMITTEE OR DESIGNEE
Part A: Specific Monitoring Requirements REQUIRED ON PAGE 2.
Outfall i Date
No. Sample Total TSS Oil & pH BODS COD Total Total Ethylene MBAS Collected Rainfall Grease Phos horus Nitro Cobalt
en GI col
m d inches m m
N A Ir N pr �11
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, complete Part B)
Part B: Vehicle Maintenance
Outfall Date
No. Sample
Collected
A
Total Flow Total Oil & Grease Non -polar Total H
P
(if Rainfall (if appl.) O&G(TPH Suspended
applicable) (Method 1664 Solids
SGT-HE",
if appl.
MG I inches
unit
New Motor
Oil Usage
FORM SWU-247, LAST REVISED 2/2/2012
PAGE 1 OF 2

STORM E', 4"r CHARACTERISTICS:
Date 10 LQ�a)-
Total Event Precipitation inches • + ��
Event Duration (hours): (only if applicable - see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable - see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"r 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."
(Si tare of Permittee) o'
(Date)
FORM SWU-247, LAST REVISED 2/2/2012
PAGE 2OF2

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
r
I
Contact: Natasha Cannen Report Date: 10/25/2022
Client: Star Pet INC
801 Pineview Rd
Asheboro, NC 27204 Date Sample Rcvd: 10/14/2022
Meritech Work Order # 10142298 Sample: Stormwater ID# 892098 Grab 10/13/22
Parameters Results Analysis Date Reporting Limit Method a Qu lifter
BOD, 5 day 32.5 mg/L 10/14/22 2.0 mg/L SM 5210 B G8
COD <15 mg/L 10/18/22 15 mg/L EPA 410.4
Total Suspended Solids 7 mg/L 10/18/22 2.5 mg/L SM 2540 D
pH 7.4 S.U. 10/18/22 1.0 -14.0 S.U. SM 4500-HB
G8 Oxygen usage is less than 2 mg/L for all dilutions set The reported value is an estimated less than value
and is calculated for the dilution using the most amount of sample.
I hereby certify that I have reviewed and approve these data. ..Ll,iiid���
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]