NCG030511_2023 DMR_20230426

allyirSCOTT
4/16/2021
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Subject: General Permit No: NC030000
Certificate of Coverage No: NCG030511
Quarterly Stormwater Discharge Monitoring Report
As required by General Permit No: NC030000,we are submitting the Quarterly Stormwater Discharge Monitoring Report for Certificate
of Coverage No: NCG030511.The following is a summary of our findings:
Sample Collection Year: 2023
Sample Period: January 1 —March 31 Permit No. NCG030000 Part E-1 (d):
❑ April 1 —June 30 Samples shall be collected from four separate
❑ July 1 —September 30 monitoring periods per year unless the
❑ October 1 —December 31 facility is in Tier Two or Tier Three status.
❑ Monthly sampling
Benchmark exceedance(s): IZ No exceedance(s)detected
❑ Exceedance detected
Tier Response Plan: ® No Tier response required
Part E—Permit No. NCG030000 ❑ Tier One Response for a Benchmark Exceedance(pp.1 3—Table 3)
❑ Tier Two Response: Two Consecutive Benchmark Exceedances(pp.14—Table 4)
❑ Tier Three Response: Four Benchmark Exceedances Within the Permit Term(pp.15—Table 5)
if you have any questions with reference to this report, please do not hesitate to contact via phone or email.
Best regards,
46v1/6/ L,%
Mary-Kate Scurlock
Environmental, Health and Safety Engineer
3M Scott Fire and Safety I Personal Safety Division I Safety& Industrial Business Group
4320 Goldmine Rd. I Monroe, NC 28110 I United States
Mobile:[phone]
[e-mail]
Enclosed:
1. SPPP_NCDEQ NPDES Quarterly Discharge Monitoring Report(DMR).pdf
2. Laboratory Analytical Sampling Results
3. Tier Response Summary(when applicable)

Tier Response Summary
Permit No. NCG030000 Part E-1
Copy below permit section indicating Responses or Actions(Tables 3,4,or 5)
Table 3: Tier One Response for a Benchmark Exceedance
Timeline From
Receipt of Tier One Required Response/Action
Sampling Results
Continuously i. Document the exceedance and each required response/action in the
SWPPP in accordance with E-5(b) above.
Within two weeks ii. Notify the Division's Regional Office of the exceedance date and value
via email or,when it is developed, an electronic form created by the
Division for reporting exceedances.
iii. Conduct a stormwater management inspection.
iv. Identify and evaluate possible causes of the benchmark exceedance.
Within one month v. Select specific,feasible courses of action to reduce concentrations of
the parameter(s) of concern including,but not limited to,source
controls,operational controls,or physical improvements.
Within two months vi. Implement the selected feasible actions.
Describe Action Plan below:
Not Applicable

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR)Form for
NCG030000-Metal Fabrication
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. NCG030511 Person Collecting Samples: Johnson, Mark
Facility Name: Scott Safety Laboratory Name: Waypoint Analytical
Facility County: Union Laboratory Cert. No. 402
Discharge during this period: 2 Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes 0 No
If so,which Tier(I, II,or Ill)? NA
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR E Yes ❑ No
Date Uploaded: Pending
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in -
Parameter Outfall Outfall Outfall Outfall Outfall
Code Parameter SDO-1 SDO-2 SDO-3 SDO-4 NA
NA Receiving Stream Class C C C C NA
NA Date Sample Collected MM/DD/YYYY 3/10/2023 3/10/2023 3/10/2023 3/10/2023 NA
46529 24-Hour Rainfall in inches 0.11 in. 0.11 in. 0.11 in. 0.11 in. NA in.
C0530 TSS in mg/L(100 or 50*) 6.0 mg/L 7.6 mg/L 8.1 mg/L 17.1 mg/L < mg/L
0400 pH in standard units(6.0—9.0) 6.70 *** 7.00 *** 6.80 *** 7.00 *** < ***
01119 Copper, total recoverable in mg/L(0.010) 0.007 mg/L < 0.005 mg/L < 0.005 mg/L < 0.005 mg/L < mg/L
01051 Lead,total recoverable in mg/L(0.075) < 0.002 mg/L < 0.002 mg/L < 0.002 mg/L < 0.002 mg/L < mg/L
01094 Zinc,total recoverable in mg/L(0.126) 0.067 mg/L 0.026 mg/L < 0.010 mg/L 0.016 mg/L < mg/L
00340 Chemical Oxygen Demand(COD)in mg/L(120) < 30 mg/L < 30 mg/L < 30 mg/L < 30 mg/L < mg/L
00552 Non-Polar Oil&Grease in mg/L(15) < 5.3 mg/L < 5.3 mg/L < 5.5 mg/L < 5.3 mg/L < mg/L
78141 Total Toxic Organics(TTO)in mg/L(1) < 0.00 mg/L < 0.00 mg/L < 0.00 mg/L < 0.00 mg/L < mg/L
*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 mglL
Notes
"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."
Paul Doron � C�—� Li I
Signature of Permittee or Delegated Authorized Individual Date
Email Address [e-mail] Phone Number [phone]

NGC030000 F-8 Qualitative Monitoring Reports:If no discharge occurs during the sampling period,the permiftee must record within 30 days of the end ofthe sampling
period in the facility's monitoring records. 'No Ffow'm'No Discharge"shall be reported on the Discharge Monitoring Report(DMR).
Qtonnwater Discharge OmMaU(QDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit https:l/deq.nc.gov/abouYdivisions/energy-mineral-land-resourceslnpdes-stormwater-gps
Permit No. NGG030000 Certificate of Coverage No. NCS830511
Facility County: Union Inspector: Johnson, Mark
Date ofInspection: 03/10/2023 Phone Number [phone]
Total Event Precipitation (inchox): O 11in.
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 o shorter interval io representative for
local storm events during the sampling period,and the permittee obtains approval from the local DEMLR Regional Office.
By this signature, |c y th t this report|o accurate and complete bm the best n(myknowledge:
Pau|Dornn
-
Signature ofPormittoomrDesignee
i.OuUaUDescription:
OuMal|No SDO4 Structure(pipe,ditch etc.): Pipe
Receiving Stream: SWP3§2.11:"Stormwater discharge on the east side of the facility is directed towards the East Fork of Twelve Mile Creek."
Describe the industrial activities that occur within the mutfal|drainage area: Roof, parking areas and driveways runoff.
2.Color-Describe the color of the discharge using basic colors(red, brown, blue,etc.)as descriptors: clear
Describe the color of the discharge using tint(light, medium,dark)as descriptors: none
3.Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak chlorine odor, etc,): none
4.Clarity:Choose the number which best describes the clarity of the discharge,where 1 iu clear and 5is very cloudy: 1
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|o the surface covered with floating solids: 1
6.Suspended Solids-Choose the number which best describes the amount of suspended solids in the stormwater discharge,
where 1 |ono solids and Six extremely muddy: 1
7. |o there any foam in the otonnwaterdischarge? none
8. |o there an oil sheen in the ykormwaterdischarge? »«»«
8. |o there evidence uf erosion mr deposition ot thooutfa||? none
10.Other Obvious Indicators cf ShmrmwmturPnUuUnn: not applicable
List indicators, or"Not Applicable"
1.OuUaUDescription:
Outfall No. SDO-2 Structure(pipa ditch,otc.): pipe
Receiving Stream: SVVP3§2.1:"Stormwater discharges on the N and W sides are directed towards the City POTW(discharging into Bearskin Creek)."
Describe the industrial activities that occur within the outfall drainage area: Roof, parking areas and driveways runoff.
2.Color-Describe the color of the discharge using basic colors(red,brown, blue,etc.)as descriptors: none
Describe the color of the discharge using tint(light, medium,dark)as descriptors: »»»«
3.Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil,weak chlorine odor,etc.): »«»«
4.Clarity.Choose the number which best describes the clarity of the discharge,where 1 in clear and 6io very cloudy: 1
5.Floating Solids-Choose the number which best describes the amount of floating solids in the stormwater discharge,where 1 is
no solids and 5io the surface covered with floating solids: 1
H.Suspended Solids'Choose the number which best describes the amount W suspended solids in the xb/nnwatordischarge,
where iono solids and 5io extremely muddy: 2
7. |o there any foam in the ahnrmwahardischarge? none
8. |o there an oil sheen in the aturmwutordischarge? »»»«
8. |o there evidence of erosion pr deposition at the ouKall? n»»»
1O.Other Obvious Indicators ufGtnnnm/aterPollution: not applicable

Stormwater Grab Sampling Field Sheet
General Information
Permit No. NGG030000 Certificate of Coverage No. NCG030511
Facility County: Union GPS Coordinates: Latitude 35.01, Longitude-80.64
City: Monroe Sampler Johnson, Mark
State: North Carolina, US Phone Number [phone]
Sample Date: Friday, Mar 10. 2023 Weather Conditions: Rainy
Total Event Precipitation(inches): 0.11 in. Nature of Discharge: Rainfall
Sampling Equipment
Method: Collect directly into sample bottle Transfer container: Not Applicable
Sample Collection Information
Sample Collection Time: 1000 am Weather Conditions: Rainy
Sample Observations:
Color Not Applicable
List indicators, or"Not Applicable"
Odor Not Applicable
List indicators,or"Not Applicable"
Clarity Not Applicable
List indicators,or"Not Applicable"
Foam Not Applicable
List indicators, or"Not Applicable"
Solids Not Applicable
List indicators,or"Not Applicable"
Others Not Applicable
List indicators,or"Not Applicable"
Previous Storm Ended>72 hours Before Start of This Storm
The 72-hour interval can be waived when the previous storm did not yield a measurable discharge or if you are able to document that less than a 72-hour
interval is representative of local storm events during the sampling period.
Notes
Please list additional notes or observations here or"Not Applicable"
Sample Date: 03/10/2023 Sampler Signature: Johnson, Mark

1.Outfall Description:
Outfall No. SDO-3 Structure(pipe,ditch,etc.): Pipe
Receiving Stream: SWP3§2.1:"Stormwater discharges on the N and W sides are directed towards the City POTW(discharging into Bearskin Creek)."
Describe the industrial activities that occur within the outfall drainage area: Roof, parking areas and driveways runoff.
2.Color-Describe the color of the discharge using basic colors(red, brown,blue,etc.)as descriptors: clear
Describe the color of the discharge using tint(light, medium,dark)as descriptors: none
3.Odor:Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil,weak chlorine odor,etc.): none
4.Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1
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
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
7. is there any foam in the stormwater discharge? none
8. Is there an oil sheen in the stormwater discharge? none
9. Is there evidence of erosion or deposition at the outfall? none
10.Other Obvious Indicators of Stormwater Pollution: not applicable
List indicators,or"Not Applicable"
1. Outfall Description:
Outfall No. SDO-4 Structure(pipe,ditch,etc.): pipe
Receiving Stream: SWP3§2.1:"Stormwater discharge on the east side of the facility is directed towards the East Fork of Twelve Mile Creek."
Describe the industrial activities that occur within the outfall drainage area: Roof,parking areas and driveways runoff.
2.Color-Describe the color of the discharge using basic colors(red,brown,blue,etc.)as descriptors: brown
Describe the color of the discharge using tint(light, medium,dark)as descriptors: light
3.Odor:Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil,weak chlorine odor,etc.): none
4.Clarity:Choose the number which best describes the clarity of the discharge,where 1 is clear and 5 is very cloudy: 2
5.Floating Solids-Choose the number which best describes the amount of floating solids in the stormwater discharge,where 1 is 1
no solids and 5 is the surface covered with floating solids:
6.Suspended Solids-Choose the number which best describes the amount of suspended solids in the stormwater discharge, 2
where 1 is no solids and 5 is extremely muddy:
7. Is there any foam in the stormwater discharge? none
8. Is there an oil sheen in the stormwater discharge? none
9. Is there evidence of erosion or deposition at the outfall? none
10.Other Obvious Indicators of Stormwater Pollution: not applicable
List indicators,or"Not Applicable"
Proposed Corrective and/or Preventive Actions
List action items here(EHS will record in the 3M Worldwide Incident Management System, WIMS)or"Not Applicable."