NCG100147_2022 DMR_20221219

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG100000
Used Motor Vehicles
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. NCG10 l Person Collecting Samples:ir,/eb &)e66
Facility Name: U-5 •iv.c,G 57040
s a)/ aVG i Laboratory Name: P Aha/ rent
Facility County: 5-10 dre S V Laboratory Cert. No.: q 26 ,366?Soot
Discharge during this period:ESJ Yes 0 No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?D Yes ISI No
If so,which Tier(I, II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forrns/SW-DMR ®Yes ED No
Date Uploaded: /2 -/1/—ZZ.
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall I Outfall Outall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY /l—/5-2oZz
46529 24-Hour Rainfall in inches . ( "
C0530 TSS in mg/L(100 or 50*) 5.0
00400 pH in standard units(6.0--9.0 FW,
6.8-8.5SW)
00340 Chemical Oxygen Demand in mg/L O
(120)
01051 Lead,total recoverable(as Pb)in D
mg/L(0.075 FW,0.22 SW)
Ethylene Glycol in mg/L(any amount
77023 detected Tier One;8,000 mg/L Tier O . 0
Two and Three)
00552 Non-Polar Oil&Grease in mg/L(15) —0 . 0
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gal/month
* Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of 50 mg/L.All other water classifications have a benchmark of 100 mg/L
FW(Freshwater)SW(Saltwater)
Notes(optional):
"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."
/2 - ly -ZZ
Signature of Permittee or Delegated Authorized Individual Date p
�jl�4��es A.0�OSa ✓mL e Q jme,.;/. C41� 336-410S-Z0g 1
i=mail Address v Phone Number

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: NiC/G/f /0/0/ 1 A/7/ or Certificate of Coverage No.: N/C/G/l 10101414171
Facility Name: (A11�144- 'S Seev:ct s4Sicn and barn G
County: S�'Qk�s Phone No. �g'36)_ 94— 0‘8q
Inspector: , C.-hotyGe eCA I e
Date of Inspection: — /.7 `"2 2
Time of Inspection: 2 • Z e pm
L 11 •
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*41 actual disdfarge from the-permitted
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:
(Signature of Permittee or Designee)
•i
1. Outfall Description:
Outfall No. Structure(pipe, ditch, etc.):
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Page 1 of 2
SWU-242,Last modified 06/01/2018

•
2. Color: Describe the color of the disc arge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Bete'
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,weak
chlorine odor, etc.): /yOrle
•
4. Clarity: Choose the number which best describes the clarity of the discharge,where 1 is clear
and 5 is very cloudy: Q
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:
<./ 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stonnwater discharge,where 1 is no solids and 5 is extremely muddy:
/ 1J _2 4. 5
7. Is there any foam in the stormwater discharge? O Yes go No.
8. Is there an oil sheen in the stormwater discharge? 0Yes 41110 No. ;
9. Is there evidence of erosion or deposition at the outfail? Q Yes a 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,Last modified 06/01/2018

Pace Analytical Services,LLC
0 1377 South Park Drive
/fir,, aceAnalytical Kernersville,NC 27284
www.paceiatrs.com [phone]
Page 1 of 1
Laboratory Report
Keleb Webb Report Date: 12/01/2022
Date Received: 11/16/2022
2676 Mountain View Road
Germanton, NC 27019
Project: Whites Salvage
Pace Project No.:92636838
Sample: Discharge Lab ID: 92636838001 Collected: 11/15/22 14:28 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 5.0 mg/L 2.8 11/17/22 22:24 L1
EPA 1664E Total Petroleum Hydrocarbons ND mg/L 4.9 12/01/22 03:05
EPA 8015 Alcohol-Glycol Ethylene glycol ND mg/L 5.0 11/23/22 18:30
EPA 200.8 Rev 5.4 Lead ND ug/L 1.0 11/28/22 23:14
SM 5220D-2011 Chemical Oxygen Demand ND mg/L 25.0 11/23/22 14:51
ANALYTE QUALIFIERS
L1 Analyte recovery in the laboratory control sample(LCS)was above QC limits. Results for this analyte in associated
samples may be biased high.
Reviewed by: nn<a :<luee
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Indianapolis
7726 Moller Road,Indianapolis,IN 46268 Michigan Drinking Water Laboratory#9050
Illinois Accreditation#:200074 Ohio VAP Certified Laboratory#:CL0065
Indiana Drinking Water Laboratory#:C-49-06 Oklahoma Laboratory#:9204
Kansas/TNI Certification#:E-10177 Texas Certification#:T104704355
Kentucky UST Agency Interest#:80226 Wisconsin Laboratory#:999788130
Kentucky WW Laboratory ID#:98019 USDA Soil Permit#:P330-19-00257
Pace Analytical Services Charlotte
South Carolina Laboratory ID:99006 South Carolina Certification#:99006001
9800 Kincey Ave.Ste 100,Huntersville,NC 28078 South Carolina Drinking Water Cert.#:99006003
North Carolina Drinking Water Certification#:37706 Florida/NELAP Certification#:E87627
North Carolina Field Services Certification#:5342 Kentucky UST Certification#:84
North Carolina Wastewater Certification#: 12 Louisiana DoH Drinking Water#:LA029
South Carolina Laboratory ID:99006 VirginiaNELAP Certification#:460221
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#: E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden, NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025
Page 1 of 4

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�Jti ft`r rue: MIN V-r'rc141-rtvlN1-UUtS4 vUI_Tech Spec Sample Condition
ace- i Upon Receipt
..,.« , —Effective Date: 05/12i2022
Laboratory receiving samples:
Asheville j Eden 1 I Greenwood ❑ Huntersville T Raleigh- Mechanicsville Atlanta Kernersville2
'Saamp1ec ndatioreUpoe3`.. Client Name:
q p v ,. t- # ✓ e Projecttt; dt t j e .i
Courier: EFed Ex ❑UPS ❑LISPS EClient 9 C
D ❑C, �r Commercial ❑Pace rh° ; ei t L
Carrier Tracking Number:
Custody Seal Present? EYes LiNa Seals Intact? EYes ❑Nc Date/Initials Person Examining Contents: H �
Packing Material: EBubble Wrap 'i8ubb!e Bags ENone E Other Biological Tissue Frozen?
EYes ❑Na ON/A
Thermometer: 0 IR Gun ID: 11- Ca " Type of Ice: ❑wet ❑Blue ❑None
Cooler Temp(°C): 2 Correction Factor:Add/Subtract ('C) ' f
Temp should be above freezing to FC
❑Sari, les out of temperiteria.Samples on ice,co ling process
Corrected Cooler Temp(°C): P P
has begun
USDA Regulated Soil(['N/A,water sample)
Did samples originate in a quarantine zone within the United States:CA,NY,or SC(check maps)? Did samples originate from a foreign source(intarnatio Ily,
Dyes ❑No including Hawaii and Puerto R;co)?Dyes DNo
1 Comments/Discrepancy:
Chain of Custody Present? eves ONo ON/A 1.
Samples Arrived within Hold Time? +Yes fFIN° ON/A 2.
Short Hold Time Analysis(<72 hr.)? DYes ElNo ON/A 1 3.
Rush Turn Around Time Requested? Oyes ffido ❑NIA 4.
Sufficient Volume? EYes ❑No ❑NIA 5,
Correct Containers Used? ©Yes ❑No ❑N/A 6.
-Pace Containers Used? QYes ❑No ON/A
Containers Intact? QYes ❑c o ❑N/A 7.
Dissolved analysis:Samples Field Filtered? ❑Yes Ergo QN A S.
Sample Labels Match COC? p[11Yes ❑No ON/A 9.
-Includes Date/Time/ID/Analysis Matrix:
Headspace in VOA Vials(>5-6mm)? ❑Yes (Irk) ON/A 10.
Trip Blank Present? Eyes ❑r;o [�>�;a 11.
Trip Blank Custody Seals Present? Eves ❑No UN/A
COMMENTS/SAMPLE DISCREPANCY Field Data Required? Dyes ❑No
Lot ID of split containers:
Temp Log:Temp must be maintained CLIENT NOTIFICATION/RESOLUTION
at<6 C during login,record temp -
every 20 minutes.
Time opened:(j 'LIG Temp: , .•
Time: 0<: 0 U put in cooler
• Time: Temp:
Person Contacted: Date/Time;
Project Manager SCURF Review: Date:
Project Manager SRF Review: Date:
Qualtrax Document ID: 70677 Page 1 of 2
Page 3 of 4

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pH Adjustment Log. for Preserved Samples
5a-.r;eiG • Tyre a.Pre.erra:,ve 1 ph users r>_.e,pt Gate preserta:ion adjusted Time re i _p Ye vat's:n 1 Amount cf?reser,3:,ve lot;t
adjusted added
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Page 4 of 4