NCS000325 DMR SW (20)

FEHRGRA'AM
ENGINEERING&ENVIRONMENTAL
Certified Mail No.: 7015 0640 0003 8992 9957
Return Receipt Requested
May 10, 2016
Division of Water Quality
Attention: Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Storm Water Discharge Outfall (SDO) Monitoring Report - April 2016
Patch Rubber Company
100 Patch Rubber Road
Weldon, NC 27870
Dear Sir/Madam:
Enclosed please find the Storm Water Discharge Outfall (SDO) Monitoring Report for storm
water discharge from the above-referenced facility for April 2016.
Please note the following:
0
• Storm water samples were collected during a representative storm event on
April 2, 2016.
• The results are below the facility's permit benchmark for each outfall.
If you have any questions regarding these documents, please do not hesitate to contact
this office.
Sincerely,
Ctd fy-Y,
r
Amy L. Trimble, CHMM :ENTLF121.Es
CIV 'D
Environmental Scientist 1►�AY 16 016ALT:mll WR SECTl
Enclosure
cc: Marto Carter, Patch Rubber Company
0:\Patch Rubber Company\16-105\Finat\ALT 16-105-Storm Water SDO April 2016 Cover Letters.docx
221 E.Main Street I Suite 200 I Freeport,IL 61032 I p:815.235.7643 I f:815.235.4632 I www.fehr-graham.com
Insight.Experience.Results.

STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
Permit Number NCS 0 00325 SAMPLES COLLECTED DURING CALENDAR YEAR: 2016
(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 Patch Rubber Company COUNTY Halifax
PERSON COLLECTING SAMPLE(S) Mario Carter PHONE NO.(2 5 2)5 3 6—2 5 7 4
CERTIFIED LABORATORY(S) Pace Analytical Lab# 40 1
Lab#
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A:Specific Monitoring Requirements
Outfall Date 50050
No. Sample Total Total
Collected Flow(if app.) Rainfall pH COD - Zinc
mo/dd/yr MG inches , units mg/L mgIL �
001 4/2/16 0.5 7.0 11.0 0.0245 YY
002 4/2/16 0.5 7.0 ND 0.0056 MAY 16 2g16
CENTRAL FILES
DWR SECTION
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_yes Xno
(if yes,complete Part B)
Part B:Vehicle Maintenance Activity Monitoring Requirements
Outfall Date 50050 00556 00530 00400 (
No. Sample Total Flow. Total Oil&Grease Non-polar Total i pH New Motor
Collected (if applicable) Rainfall (if appl.) O&G/TPH Suspended Oil Usage
(Method 1664 Solids
SGT-HEM),if
appl.
mo/dd/yr MG inches mg/1 mg/I unit j gal/mo
_
_
Form SWU-247,last revised 2/2/2012
Page 1 of 2
i

STORM EVENT CHARACTERISTICS: - Mail Original and one copy to:
Division of Water Quality
Date 4/2/2016 Attn:Central'Files
Total Event Precipitation(inches): 0.5 1617 Mail Service Center
Event Duration(hours): (only if applicable—see permit.) Raleigh,North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation(inches):
Event Duration(hours): (only if applicable—see permit.) -
"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 toi:'ure that qualified personnel properly gather and evaluate the information submitted. Based oh my inquiry of the person
or persons who min age the system,or those persons directly responsible for gathering the information,the information submitted is,to the
best of my know :s ge and belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including the p 2:sibility of fines and imprisonment for knowing violations."
(Signatur .. ,r///°//-‘
of Permittee (Date)
Form SWU-247,last revised 2/2/2012
Page 2 of 2