NCG210028 DMR SW (6)

Baxter
January 26, 2017
NCDENR Division of Water Quality C10
Attn: Central Files 3 20\1
1617 Mail Service Center F � L�1��S
Raleigh,NC 27699-1636 G �iCiJ
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RE: Certificate of Coverage No. NCG210028
Year 4—Period 1
Stormwater Discharge Outfall Monitoring Report
Baxter Healthcare Corporation
Enclosed is the semiannual SDO monitoring report as required by the General Stormwater Permit, Part
II, Section B. We will continue to monitor the outfalls as required.
If you have any questions regarding this application,please contact Mike Pisarik at 828-756-6017 or
michael_pisarik(a�baxter.com
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 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 the 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.
Sincerely,
J n Rushford
VP Operations-North Cove
Enclosures: Semiannual DMR(Original+ Copy)
Cc: Rick Styles
•
Baxter Healthcare Corporation
PO Box 1390,Marion,NC 28752
T 828 756 4151

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina DEMLR General Permit No. NCG210000
Date submitted v/ 44,// 7
CERTIFICATE OF COVERAGE NO. NCc�j 21 0//0 `� SAMPLE COLLECTION YEAR ()--© I
FACILITY NAME ac`xter (A)az, )3o�[4� SAMPLE PERIOD ❑Jan-June July-Dec
��/ or ❑ Monthly1 (month)
PERSONOUNTY e.IN r SA Gt DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
PERSON COLLECTINGffSAM/PrLES Sa.So� //IRS��5
LABORATORY &oder- f-'J ce-re Lab Cert.# /)C�o %3 S ❑Zero-flow ❑Water Supply OSA
Comments on sample collection or analysis: RECEIVED ❑Other
FE O . PLEASE REMEMBER TO SIGN ON THE REVERSE -
Part A: Stormwater Benchmarks and Monitoring Results (Monitoring is ISVrIEWIryipw facility stores exposed accumulations of sawdust,wood chips,
bark,mulch, or other similar material on site for longer than seven (7) days.) R SECTION
El No discharge this period?2
Date Sample 24-hour rainfall
Outfall No. Collected) amount,
(mo/dd/yr) Inches3 Chemical Oxygen Demand Total Suspended Solids
Benchmarks===> - - 120 mg/L 100 mg/L or 50 mg/L4
A.1J &,'ler d?h,7/) (a 1")., `7`
1 Monthly sampling(instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text,Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example,do not report Below Detection Limit, BDL,<PQL, Non-detect, ND,or other similar non-
numerical format. When results are below the applicable limits,they must be reported in the format,"<XX ms/L",where XX is the numerical value of the
detection limit, reporting limit,etc. in mg/L.
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2,or Tier 3 responses. See General Permit text.
Permit Date:8/1/2013-7/31/2018 SWU-245,last revised 7/31/2013
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Part B: Vehicle Maintenance Area Monitoring Results:only for facilities averaging>55 gal of new oil per month.
n No discharge this period?2
Date Sample 24-hour rainfall
Outfall No. 1
Collected amount, Non-polar O&G by,EPA
(mo/dd/yr) Inches3 1664(SGT-HEM) Total Suspended Solids
Benchmarks===> - - 15 mg/L 100 mg/L or 50 mg/L°
/VA- N At N A N 71/
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2,or Tier 3 responses. See General Permit text.
FOR PARTA AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑NO❑
IF YES,HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑NO❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR,including all"No Discharge"reports, within 30 days of receipt of the lab results(or at end of monitoring period
in the case of"No Discharge"reports)to:
Division of Water Quality
Attn:DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 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.
am aware that there are sig ' icant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations."
W26 2
(Signature of f rmittee) (Date)
Permit Date:8/1/2013-7/31/2018 SWU-245,last revised 7/31/2013
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