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HomeMy WebLinkAboutNCG060175_MONITORING INFO_20190403STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V U& (xc) v- S DOC TYPE ❑ HISTORICAL FILE I� MONITORING REPORTS DOC DATE ao /IQ voz ❑ QjatCRtM YYYYM MDD E for North Carolina Division of Water Quality General Permit No. N Date submitted 3//09 CERTIFICATE OF COVERAGE NO. NCG06b J ? S' FACILITY NAME Fr, Ya L44I TnG COUNTY r'I) PERSON COLLECTING SAMPLES _lyll a,l I�il rt k LABORATORY qie4fy &OL4 Vw "j Lab Cent. d 32 q LerUe,$, Tno_ Part A: Stormwater Benchmarks and Monitoring Results CEIV.En APR 0 8 2M SAMPLE COLLECTION YEAR CENTRAL FACILITY ACTIVITIES INCLUDE {check all that apply}.�1� ���� rlUi i ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? EYES ®NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 or ❑ Na discharge this period' 141' Outfali'No. '' t it '.I. i , 'Sample Collected, , .. .. t• 's s �,mo/tld/yr:: tSS„ "i' ., ,. S mg/L' :._ + k "'�''"i' pIH, �,f �:�-., is Standard urilts f :COD; .• .d� " mg/L' 0114and Gtease, .., -.� - s, ir' mg/t� ,,; i; Fecal'Caliform , , �']s� ii i, i � !i1S •ut4':,�, uq f? i Colnnie`s p6FI00 ml ' Ent' , E�.,,Sll s t.: a .{33'{1• Coioriies.per 100 ml :Benchrttiark i...r,.i it. i.. r- „ r.. ' or'S0° �. i ],00 u ; Within,6 0,= 9 01, l :;+ 12p ,.., ..5' �;.,,1 30 tw w w r� ns u„�sA �: i + ire , ,,, �{{qlu(• swo 3-r- 21.1 -z IVD All) S000 2 3-1-1 .260 6,7 2-O gle,n/NIA as 3-i-1 f7 N Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Q yes [:]no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall:No , 4 :;Sample Collected, mo/dd/yr` Oil and Grease; mg/L' �, Ei .i, :TSS;. a i mg/L: '" r, pH ,i i Standartl,.units+;,�,: iE+�tN ew Motoc0il"LIsa'ge; a' �iAnnual average gal/mo: Benchmark 30 i.100 or 50 ... 6:0 - slJbo? 3- -19 ND 13.25 1 Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at aM outfalls, you must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if es, complete Part B) SWU-249 Last Revised: October 18. 2012 Page I of 2 *FOR PART A 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 ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "'No Discharge„ reports, withrn__3.0 days of receipt of, the lab results for 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, NC 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. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Sr. S1`fe Dre.c4or (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.o[g/web/wp/ws/su/npdessw#tab-4 S W U-249 Last Revised: October 18, 2012 Page 2 of 2 SHEALY ENVIRONMENTAL SERVICES, INC. Report of Analysis Frito-Lay Inc, 2911 Nevada Blvd. Charlotte, NC 28273 Attention: Devin Brooks Project Name: Stormwater Lot Number:UC03004 Date Completed:03/08/2019 03/11/2019 3:12 PM Approved and released by: Project Manager: Kelly M. Nance The electronic signature above is the equivalent of a handwritten signature. This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc. Shealy Environmental Services, Inc, 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheaMab.com Page i of 10 SHEALY ENVIRONMENTAL SERVICES, INC. SC DHEC No: 32010001 NELAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639 Case Narrative Frito-Lay Inc. Lot Number: UC03004 This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary following this Case Narrative. The sample receiving date is documented in the header information associated with each sample. All results listed in this report relate only to the samples that are contained within this report. Sample receipt, sample analysis, and data review have been performed in accordance with the most current approved NELAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality Assurance Management Plan (QAMP), standard operating procedures (SOPS), and Shealy policies. Any exceptions to the NELAC standards, the QAMP, SOPS or policies are qualified on the results page or discussed below. If you have any questions regarding this report please contact the Shealy Project Manager listed on the cover page. Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Page 2 of 10 SHEALY ENVIRONMENTAL SERVICES, INC. Sample Summary Frito-Lay Inc. --- Lot Number: UC03004 Sample Number Sample iD Matrix Date Sampled Date Received 001 001 Aqueous 03/01120191210 03/03/2019 002 002 Aqueous 03/01120191230 03/03/2019 003 003 Aqueous 03/01/20191218 03/03/2019 (3 samples) Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheatylab.com Page 3 of 10 Inorganic non-metals Client; Frito-Lay Inc. Laboratory I D: U C 03004-001 Description: 001 Matrix: Aqueous Date Sampled:0310112019 1210 Date Received:0310312019 Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 03/01/2019 1210 MLK 1 (Temperature ) SM 25503-2010 1 03101/2019 1210 MLK 1 (COD) SM 5220D-2011 1 03/07/2019 2213 HET 99509 1 (TSS) SM 2540D-2011 1 03/06/2019 0222 AMR 99404 1 (SGT - HEM (n) 16648 1 03/07/2019 0957 ARP 99550 CAS Analytical Parameter Number Method Result Q LOQ Units Run pH - Field SM 4500-H B-2 7.2 su 1 Temperature - Field SM 2550B- 21.0 ° C 1 COD SM 5220D- ND 20 mg/L 1 TSS SM 254013- 2.1 1.6 mg/L 1 SGT - HEM (non -polar material) 1664E ND 5.0 mg1L 1 LOG = Umit of Quandtation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range ND = Not detected at or above the LOG N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40% H = Out of holding time W = Reported on wet weight basis Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791.9111 www.shealylab.com Page 4 of 10 Inorganic non-metals Client: Frito-Lay Inc. Laboratory ID: UC03004-002 Description: 002 Matrix: Aqueous Date Sampled:0310112019 1230 Date Received:0310312019 Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 03/01/2019 1230 MLK 1 (Temperature ) SM 25506-2010 1 03/01/2019 1230 MLK 2 (COD) SM 52200-2011 1 03/07/201912220 HET 99616 2 (TSS) SM 254OD-2011 1 03/06/2019 1933 AMR 99493 1 (HEM (oil and) 1664B 1 03/06/2019 1005 ARP 99425 CAS Analytical Parameter Number Method Result Q LOG Units Run pH - Field SM 4500-H B-2 6.7 su 1 Temperature - Field SM 255013- 21.0 ° C 1 COD SM 5220D- 290 20 mg1L 2 TSS SM 254013- 260 24 mg1L 2 HEM (oil and grease) 1664B 48 5.0 mg1L 1 LOQ = Limit of Quantitation • 8 = Detected in the method blank E = Quantitation of compound exceeded the calibration range NO = Not detected at or above the LOCI N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40% H = Out of holding time W = Reported on wet weight basis Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Page 5 of 10 Inorganic non-metals Client: Frito-Lay Inc. Laboratory I D: UC 03004-003 Description: 003 Matrix: Aqueous Date Sampled:0310112019 1218 Date Received:0310312019 Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-20i 1 1 03/01/2019 1218 MLK 1 (Temperature ) SM 2550E-2010 1 03/0112019 1218 MLK 1 (COD) SM 52200-2011 1 03/07/2019 2213 HET 99509 1 (TSS) SM 2WO-2011 1 03/06/2019 0222 AMR 99404 1 (HEM (oil and) 1664E 1 03/06/2019 1005 ARP 99425 CAS Analytical Parameter Number Method Result Q "LOQ Units Run pH - Field SM 4500-H B-2 6.9 su 1 Temperature - Field SM 255013- 21.0 ° C 1 COD SM 5220D- 60 20 mg1L 1 TSS SM 254013- 17 5.0 mglL 1 HEM (oil and grease) 1664E ND 5.0 mg1L 1 LOQ = Limit of Quantitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range ND = Not detected at or above the LOQ N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40% H = Out of holding time W = Reported on wet weigh: basis Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.she*Lab.com Page 6 of 10 Chain of Custody and Miscellaneous Documents Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Page 7 of 10 o rn � a w � Er 0 °a b, o• 3 �CD o' �CD 2 n� o a C 3 m n V N Chain of Custody Record Shealy Environmental Services, Inc. 106 Vantage Poird DrOm West Columbia. South Carolina 29172 Telephone No. (803) 701-9700 Fox No, (803) 791-9111 www.aheetyleb.com Number Client Report to Contact I Simpler lPdnlad Name) Quote No. Frita Lay Mare0440 f)eula L . �� • �,� Address Telephone No, ! Fax No. ! Errol' waybig No. Pap 1 Of 1 City Stela ZIP Coda Pre mveflve 1 t i 1 NA NA MA Nwnberof Containers Chatlons NC 1. Unpre9, 4. HNO3 7. N80H 2. NA(]KFZnA s. HCL J K n J liaitla Peoiod Nonr: 5 1 3 5 Pteservetiae aw 3. H2SO4 S. No Thio. II jj IIuu Proled Number P.0 Number Matrix a ' o U ('i030a4 9empli lDr De6a1pllon . a a (Ccnlelnars inr each sample maybe Date Time ` CW ow lAhAf S C eonlbined an one Ik.el Qs J Sex ski w CL 001�10 G X � X X X X X X 002 yyj G X X X x X X i] - �. -7 T t. 003 v>-\t G X X X X X X 2-1. Cl Ysa i� I 'L11 Tuyr mt.nJT1aeRepaired+Ffiaflilt opualre*oredtor axpodmaiTAT) SampleDlgmol '�DapOsal QCRoquin:rnonlslweaseSpeeffy) Po ibleHazardIdearU�llon on Hard PAMmabla Skin Irritant brrvJard 0quit (96010 Spoer) ❑ Return to Giant by l ab ottlaen BUnkno%VA 1. r;ellmquished by/ +� - nnte 1lma 1. Roca' d by Ca 'I'Ima 2. Re&quishod by Data 3-- [9 Tlme 1 - Lf LA 2. Hecelved Cy Uata Timt! S r Ufa, .a4 3 - rX 9, ReUnqulahad by Date Timo 3. Rrxo1v0d by note TMe 4. ROHn #411ed by Daly 7tme 4. Laboratory Rso*ad by Dais tuna �fj �-- 3"(- yj Note: AI I samples are retained for six weeks from receipt unless other I W UStt ONLY RBOC 7eI'M Temp. t�tank arrangements are made Received w 1co (Cheri) or -ON n1cePack or N LY H ,3 0 "C_ 1 7.3 Etfediva Mtn , &27-2012 M M C n U) SHEALY ENVIRONMENTAL SERVICES, INC. ..Vx-,dv N.en,nuurkat*: staxi= Ieo ssxrm aA N'Ambcs: J 1tMI SC-14 Sample Receipt Checklist {SRC) client: 11•1UTO LAY Coulrr Inswult:d by-'datc- LKH , U3-03-2019 UC03004 ?P�� I of t E:114:sre Date. eans of receipt: SESI ❑ Client ❑ UPS ❑ Feda ❑ Olhcr: 1,es ® No 1. W ere custody seals prescnt on the cooIcr Yct IC 1`In WA 2. If custody scale wcm present were they !tract and unhtnken?l Strip 1D: 19-2225 Chlorine Strip JID- 19-152 Tested by:1.KH Original temperature upon r 'D.-Mled (Corrected) temperature upon receipt %Solid Snap -Cup IR NA 3.0 i 3.0 �c JJ" NA ;NA- nC NA .- A e.C. cthod: ®Tcmp� rile Against Bottles IR Gun ID: c let butt ConWion Facurr. 0 'C i ethod ufevalunl.: 0 Wet Icr ❑ icrPuxlb ❑ Da IW ❑ lyo= ❑ Yes ❑ No ®VA If temperature. of any cooler cxccedcd 61M. was Prajec-t Man"-Nrrtiiit;cl? I'M wa3 Notified by! phone . email ! liwe to -elect (circle one). ❑ Yea ❑ Ne O NA 4. Is the commercial courier's packing slip att:adicd W this Conn? ® Yes ❑ No 5. V,'cre proper custody procedures (Minquishedrreceived) tollnwed? ® Yes Ala 6, ltl'4'c1: =mplc ales iiAW un the COC? ® Ye ❑ NO 17. Were v-mple I Os listed an all ;ample containers? ® Yesl ❑ No 8. W-ms collection date & time listed on the CUC' Yens ❑ No 9- Was colimthirl dwr &_ 1;inC listen on all bampic: containcrs't ® Ycs ❑ No 10_ Did all container label infannatinn (ID, drrlc. lim-0 agtn'r widh the C'UC9 ® Yes ❑ No 11. Were tests to be perfonncd listed on the COC"? ® Yt.s ❑ No 12, DiJ all mmpks arrive in the proper conminers for each teat andfor in gone entli ilicm (unhmken, lid- on, etc.)? Yes ❑ No 13. Wu adequate sample volume available'? Yes ❑ No 14_ Were all bumph rcceivcx1 within 14, the bolding time or 48 hours, whicheVer L(I111C� firsl? Yes ® No ? 5_ Were any samples containers {circler unc) samples'Nut listed on CUC! ❑ Y'em ®RR ❑ NA 6. ror VOA and RSK-175 ucmples, uvrc bubbl,s present ,"pea -sue" (1411or 6r1un in diunietcr) in anv ofthc h'UA Aak? ® Yec = No El NA 17. Were all D1t0:rnetal4nu1rian1nampla, rmieivcd at a pH of -12? ❑ Yes ❑ No ® NA 18. Wurc all cyanid: samples received at a pl I > 12 end snl li4de."mples rnccivcd at a pH> 97 ® Ycs ❑�l:o ©NA 19. Were applicable N1 h!TKN.-r,;'a❑k1t!-phtmoV6=5 (--: 0 5mg'L) sampics frce of residual - cl,lorin�'? ❑ yes ❑ No ®KA 20. W;= clieznl-n-murtis-'n.Nuests (i.e. mquested dilutions, N-I vVISD desigriaticrnc, etc,..) eon-ectly uajrmr bed IRIM 11m COC init, the comment szction in LIMS7 ❑ Ycs Kn 121. Wae the me number limlad on the t:tmlaincr label? If ycs. Quote ? So-arnple Prexer-varliaa (Must be eompIctcd for any sarnple(s) incorrertiy preserved or with IPCW- Samplc(s) NA were.-aceived i1wor=tly prus%:rvexl rind wt:re adjusted accordingly iu saanlple mvviving wit'n NA rnL of circle one: H21I504, l IN03, I ICI-. NzOl 1 using SR g N1 7111le of preservation NA If rnun than um presurvativu is nocded, please note in the comments below. alnplc(s) NA weer. rcccivcd with bubbIcs .-6 rrun in diameter. Samples(3) NA %enc rlx:rrivW- with. ZRC - 0.5 mg`L (if flY i3 no) and were adjarslcd accordingly in sampic rccciving with sodiam thiosulfwe (INa;S�tl_) with Shealy ID: NA SR harende lapel.; applied hv: LKH _ Date: 03-03-2014 Comments; Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealyiab.com Page 9 of 10 SHEALY ENVIRONMENTAL SERVICES INC. �,.. �, t"•flvironmrnti] cervices, Inc. Dc-rin Bnmkx+Robcn 13rasley Frito-Lay bc,. 2911 '_\_cvad;i Blvd. Charrxte, NC 43273 ]oyantage1'dati:a.2•.4cstC=x:�rd:a,_Suidl {.d,oli�iaTvll� rh3ne. bu:.rJ' h7,C • rar. xs3a:.rt 1 t • www'.3hn,tYt+t,•�� u+� Eritu-Ltiy ltac.2911 _',Zz►ad.. Blvd_ Facility Charlotte, NC Stork wULZ•r Qualitative lriunituring Rcyuir=tuls, I' Setui-annual event 1-019 tilan-Ai 1, 20) 9 I -None 2-Faint 3- odemic 4-Strong Pipe fill] natfall Color- 1 0clar-1 Clarity- ) Flooiing Solidi- 1 Suspended Solid- 1 Foaw- 1 Oil Shcon- 2 Estinuded Flow: 3.0 GIs per minute.' 1.01 Inches ENtllnkL( Xl EvL( 11.' Disc taargc 9.01`lr':+S F.stim;atal 7btnl F1t1}v: 2,'700 Cit.; Pipe 002 olrtfail Colo-- 2 Odor- 1 Cbrity- 2 Floatingr Solids- t Suspradcd Solids- 1 Foam- I Oil gheen- 2 F-stimat:tA Flow. 3.0 0h pix minute ? 1.01 Inuhc 3 Estimated Events Discharge: 9.0 I Irs Estimated Total Flow: 1,620 (As Pipe 003 ondan Color- 2 Odor- 1 Clariiv- 2 I'lo ing Solids-1 Scl_'pcndCd Solids-1 ]roam-1 Oil Shm-n- 2 Estimated Flow: 1.5 GIs per minute?" 1.01 Inches Estimated Evcrit:' Discharge: 9.0 Hrs Estimated Total Flow : 810 GIs Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Page 10 of 10 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted z.t — Z.-->( k CERTIFICATE OF COVERAGE NO. NCG060L2 IT - FACILITY NAME"C...s- COUNTY Y'1�--(4.+ �wr PERSON COLLECTING SAMPLES LABORATORY S' (,, 15;--, Lab Cert. # 2 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR - Z '-" FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fat's/byproducts DISCHARGING TO SALTWATERS? DYES ®NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 1 o-G or ❑ No discharge this period Outfall No "', Sample Collected, : .. °r mo/dd/yr '` ' T5S, - mg/L pH, Stand',. , and units COD, rtg/L . Dil-and Grease, mg/1 ,: , , , Fecal•Coliform , Caionies per 100 ml •�- ° Enterococci , Colonies per;100 ml Benchmark. . ` - 10.0 or S0 Within 5.0 — 9A 120< 30 ,! , 1000 S�_jCia7 ( a i —e Vi a 7.G7 WL".) /V t'14- 5 t* Z,4 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at AU outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?[ y s 215'o Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month Outfall No. ` Sample Collected , ' . .Grease,. ...Oil and. :. mg/L � , TSS, m /L pH, Standard units New Motor Oil Usage, Annual a'verii ge gal/mo,ma/dd/yr. 'Benchmark , _ 30 .. z . , ... 100 or 50 6.0 = 4.0 ` Only applies to facilities that use/process meats. I., 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here, 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. FEB 2 5 2019 CCNTRAL FILC;; C�inrR S� C�'lW.1 (�'f ems, complete P5rt B) SWU-244 Last Revised: October 18, 2012 Page I of 2 *FOR PART A 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 11 SECTION B. * TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO i� IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy o this_DMR, including al! "No Discharge" reports, within 317 days of receipt of the lab results tor at endue monitoring period in the case "No Discharge" report to. Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC, 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. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." - 21gt / 9 (Signature of Permittee) _ (Date) 5g. S i T'r /J„¢CGraP- Additional copies of this form may be downloaded at: http://postal.ncdenr.org/web/wci/ws/su/npdessw#tab-44 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 • SHEALY ENVIRONMENTAL SERVICES, INC. Report of Analysis Frito-Lay Inc. . 2911 Nevada Blvd. Charlotte, NC 28273 Attention: Daniel Ransome Project Name: SW Lot Number.TH02078 Date Completed:08/14i2018 08/14/2018 4:30 PM Approved and released by: Project Manager: Kelly M. Nance AJM lC C.EGITE� C , The etedronic signahue above Is the equivalent of a handwritten signature. - This report shall not be reproduced, except in its entirety, vWftW the written approval of Shealy Environmental Services. be. Shealy Emuormwfl al Services. Inc. 108 Vantage Point Drive WWI Columbia, SC 29172 (803) 791-9700 Fax (803) 79"111 www.sheal&b.com Page I of 10 • SHEALY ENVIRONMENTAL SERVICES, INC. SC DHEC No. 32010001 NELAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639 Case Narrative Frito-Lay Inc. Lot Number: TH02078 This Report of Analysis contains the analytical resutt(s) for the sample(s) listed on the Sample Summary following this Case Narrative. The sample receiving date is documented in the header information associated with each sample. All results listed in this report relate only to the samples that are contained within this report. Sample receipt, sample analysis, and data review have been performed in accordance with the most current approved NELAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality Assurance Management Plan (QAMP), standard operating procedures (SOPs), and Shealy policies. Any exceptions to the NELAC standards, the QAMP, SOPs or policies are qualified on the,results page or -discussed below. If you have any questions regarding this report please contact the Shealy Project Manager listed on the cover page. Shealy Environmental Services, tnc. 106 Vantage Point Drive V*W Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.ahealylab.00m Page 2 of 10 SHEALY ENVIRONMENTAL SERVICES, INC. Sample Summary Frito-Lay Inc. Lot Number: TH02078 Sample Number Sample ID Matrix Date Sampled Date Received 001 001 Aqueous 08/01/20181802 08/02/2018 002 002 Aqueous 08/01/20181824 08102/2018 003 003 Aqueous 08101/20181635 08/02/2018 (3 samples) Shealy Environmental Services. inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Page 3 of 10 Inorganic non-metals Client Frito-Lay Inc. Laboratory ED:TH02078-001 Description: 001 Matrix: Aqueous Date Sampled:0810112018 1802 Date Received:0810212018 Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 08/01/2018 1802 MLK 1 (Temperature ) SM 2550E-2010 1 08/01/2018 1802 MLK 1 (COD) SM 522OD-2011 '1 08/07/2018 0811 AMM1 08/06/2018 1742 1 (TSS) SM 254OD-2011 1 08/03/2018 1814 AMM1 79749 1 (SGT - HEM (n) 1664B 1 08/04/2018 0148 CRD 79788 CAS Analytical Parameter Number Method Result Q LOQ Units Run pH - Field SM 450" B-2 6.8 su 1 Temperature - Field SM 255013- 32.0 " C 1 COD SM 5220113- 20 20 m91L 1 TSS SM 2540D- 27 1.7 mg1L 1 SGT - HEM (non -polar material) 1664E ND 4.6 mg/L 1 LOG = Limn of Quantitation B = Detected in the medmd blank E = Quantifation or compound exceeded the calibration range NO = Not detected at or above the LOQ N = Recovery is out of criteria P = The RPD between two GC columns exoseds 40% H = Out of holding time W = Reported on wet weight basis Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheat&b.com Page 4 of 10 Inorganic non-metals client Frito-Lay Inc, Laboratory ID:TH02078-002 Description: 002 Matrix: Aqueous Date Sampled:0810112018 1824 Date Received:0810212018 Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 08/01/2018 1824 MLK 1 (Temperature ) SM 255OB-2010 1 08/01/2018 1824 MLK t 1 (COD) SM 5220D-2011 1 08107/2018 0811 AMM1 08/06/2018 1742 1 (TSS) SM 254OD-2011 1 08/03/2018 1814 AMM1 79749 1 (HEM (oil and) 1664E 1 08/03/2018 2350 CRD 79789 CAS Analytical Parameter Number Method Result Q LOQ Units . Run pH - Field SM 4500-H B-2 6.6 su 1 Temperature - Field SM 2550B- 30.0 " C 1 COD SM 522013- 29 20 mg1L 1 TSS SM 25400- 17 2.5 mg1L 1 HEM (oil and grease) 1664B ND 4.4 mglL 1 LOQ = Limit of Quantitation $ = Detected in the method blank E = Quantitation of compound exceeded the calibration range ND = Not detected at or stove the LOQ N = Recovery is out of criteria P = The RPD between two GC columns exceeds 4D% H = Out of holding time W = Reported on wet weight basis Shealy Environmental Servkces, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 . www.sheatylab.com Page 5 of 10 Inorganic non-metals Client Frito-Lay Inc. LaWratory ID: TH0207"03 Description: 003 Matrix: Aqueous Date Sampled:0810112018 1835 Date Reteived:0810212018 Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 08/01/2018 1835 MLK 1 (Temperature ) SM 2550E-2010 1 08/01/2018 1835 MLK 1 (COD) SM 522OD-2011 1 08107/2018 0811 AMM1 08/06/2018 1742 1 (TSS) SM 254OD-2011 1 08/03/2018 1814 AMM1 79749 i (HEM (oil and) 1664E 1 08/03/2018 2350 CRD 79789 CAS Analytical Parameter Number Method Result Q LOQ Units Run pH - Field SM 4500-H B-2 6.6 su 1 Temperature - Field SM 2550B- 30.0 ° C 1 COD SM 5220101- 22 20 mg1L 1 TSS SM 2544D- 18 2.7 mg1L 1 HEM (oil and grease) 1664E 4.5 4.3 mg1L 1 LOQ = t.bnit of QuantitaWn a = Detected in the method blank E = Quantilatien of compound exceeded the calibration range ND = Not detected at or above the LOQ N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40% - a N = Out of holding time W = Reported on wet weight basis Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheatyUb.com Page 6 of 10 Chain of Custody and Miscellaneous Documents Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealybb.corn Page 7 of 10 0 0 e Chain of Custody Record Shealy E nvirunmenta I Services, Inc. 108 Ventage Paint Drive Weat Columble. South Caroline 20172 Telephone No. (803) 701-0700 i:ex No. (803) 791-Q111 msnr.rheatYee,eom Number Clem Fdlo Lay Repert to Comaat Mw= Pitts f P ts,�lte) ir wo dress T Na, J r,1Xft 1 bUl No. Pape � a City Chadbxs Slake NC ip Ceda PY988rY8tllla 1. Urtpres. S. FDfQ3 1. hlaON 2. NapHtZmu\ S, riGL 3. H2W4 &his Thia, j 1 1 1 1 NW NA NA Number of canta reams J K 0 J doH1e PwJM Noma SKY IOWI�t Ul THI?2478 KraH; I I I I a PMleet M,ynbor P.0 NLrftr matrix sample ID1 Duvion aa IWAoirmn lereseb sample may ba Ombkwd an *no het Data Time aW DW WW 3 001 X 'X X X X X X �-(e�r ?s;, ow Gi x 1. x x x X x x x x X x 6:r3 003 -' O x w• TrmMrued 11in.rNqulnn4�fo.labs}�pMvslisq�jradremeaPen11, TAT) d pflxh Glees fta"M Smlpla EftpoW Relumn to all t Y""'""'Id by Leh 4C Requiiwnenta fPleasc 8paft In rla:ard hlem*JOwflon w B 01Mtbla in hlit9nk 1.Umknow uw ! p L �� Tmro I 1, Rawh vd by Dole Time 7. IMd by Gate Time t RoaMued eM Dale Time, 3. Helinquiahea by OWe 3. ftoaiwrd by Tina 4, ReWxtuithed by Date Ylrne 1. LebouloryR ov ad by Note: All samples are retained for six weeks from receipt uniesa afar ILAS USE MY OrMFMQMnJM ag Rm=Iw d do tca fChea) Qif P, lee Pack RereW Tmmp. 3.C3 e Temp.8dak Y n N Cr Whm Date 0827 2012 Z 0 SHEALY ENVIRONMENTAL SERVICES INC. &CMY I1vi:m+ X1$W Snvi L% lac. raft. 1 +d 1 OnuaoexNma6er miTUlso14 EfoovtUde fr2 AMA rr ) Sample Receipt Checklist (SRQ (7 ruent' Tt Ae% Lsui rr,nu,r lnv.cef+yi hvltl�ts i v %A - Q-`a - 19 l� *f' —rUt .A^!1 R Means ofreccipt: 5F,'SJ iJ Qfew U1'S ❑ Fe dOx ❑ Otlret: C 1 YV51 21kol1- %V= custody seats present on the cooper? Yest i7 Kn1jMZ lict>st t seeds wom sent, were theti mtacl and unbroken? Strip ID: Chlorin-- Strip ID: Tm,:d by: igirlal 1--mper ute upon reveipl r Derived (Ctmwed) temperature upon etch %Solid Smy-Cep ID: od;,Rfempe ature Alank r ,Against Bottim iR Ciun ID: i IR Gun Curr; ction Factor. _>- "C Method of uu,lan t: Wet lee n Its Pact 0Dry1ce . 0 None © Ya Cl ,,n 3. if rrmpttatum of arty cooler caccudad 6.00C-. ►.as Project Manager Nazified? PM was Notified by: phon: i email 1 face-tofkt (circle otte)_ C Yes 0 No CAA 4. is the comme n:W coariar's pa ling %lip attad:Ied to this form? Ya ❑ N 5_ Were custody praoes4lres (relltuluislled�reoeived) followed? es No 6. Weak sample IDs listed on the C'.OM. &-yesl ❑ No 7. Were swap!: Ives listed an all x mple contahm?• Lgotcs ❑ No S. Was collection dze & time listed an the COL'? es No 91 was collection date dt time listed on all sample containers? c5 ; No 10. Did all container label informardon (113. dare, time) agree with tlee C,' . W f es No I I _ Wei tests to be performed listed on the CI7C? .eyes ❑ No 12. Did all samples arrive in the piper Bonin, k is for errh WV ttnd4lr in good condition (unbroken, lids on, etc.r es F1 No 13. Was adequate saw le vellume available? Yes ❑ No 14- We v all swnpks received within ri the holdingbete ear 4S hours, whichever comes f ro? Yes ONO 15. Were any samples containers rnisshtgJezcess (cirt*- one) samples Not listed on CM ❑ Yes ❑ No j NA 16. For WA and RS14-175 samp1m, were huhNa present>"pea-size" (::"err Timm in diameter) in any of the VOA vials? es .. No UNA 17. Wtrc all iJRilvnwtaisfnutrlmvr samples re=ivcd rat a 11 of r. r r Yes ❑ No TA 19. Were all cyanidemuplexi ive+d ata > 12 and sulfide smnples received at a H > 9? is ❑ No ❑ NA 1199 a all applicableNHy 1 ettnl'62i {< 0.5m&'L) samples ofresidual ❑ Yea ❑ No ErM leanvedy 20. Wise client nnnw cs'lequiests (La. requaei dilutions, MSiMSD designatituls, etc...} trsuscrl'bed from the COC ittto the emment sxtron in MIS? ❑ Yes Nu 2). Was the SLiSw member listed on the container label'? If M Quote 6 ple Prt•Itervatkm (`Rust be compicted For any sampk(s) incorrectly pm--,-- xl or with headspacc.) Sttmplr,(s) were attired huorrmily ptrescrved and %ere adjusted accordingly in smttpl a receivirty witt. mL of electc one: 117-SO4, FN03, HCI, NVa01HI u-ing Sk 1'mle of pre,smwitm if more than one prescirvative is r*v& , please ram in the cammm a below. Sample(S) were received with bubbles >{, enrn in diameter'. were =eivicel*ith'l'RC > 0.5 MI aft] 9 is ern) turd urea jusW accordingly in sampic receNing with m-hum Nosultate (Na2. ,t);) with Shealy ID: R burcode label% applied by:.. LK _ Dare: .a -.I Cornments• Shealy Environmental Services, Inc. 106 Vantage Paint Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Page 9 of 10 SHEALY ENVIRONMENTAL SERVICES, INC. �;irnnn>e�a�1 SHF�i;Y Soxvlc Ian. f%vantnemrtorh*- wait CiluferiadSwathc.-r..min ?T9ne.MX7519MQ • Fax, W.'.M1.9111- wo*_dvtu1yiuiLL= n Daniel Ransomc/Robert Beasley Fritr�Laay Inc. 2911 Nevada Blvd. Charlotte, NC 29273 Frito-Lay Inc.2911 Nevada Blvd. Finality Charbne, NC; Sturmwater Qualitative Monitoring Requiro*ana-nts, 2'd Semi-annual evenuh I It August 1, 2018 i-Norio 2-Faint 3-Moderate 4-Srrong Pipe 001 outiall Color- 2 Odor- 1 Clarity, i Floating SMids- I Suspended Solids- I Foram- I Oil Slum- l Estimated Flow : 5-11) oils per minute ! 0.6 Inches Estimated Event' Discharge : 3.0 Hrs Estimated Total Flow: 900 GLa Pipe 002 outftall Color- 2 Odor- 1 Claritti- I Fbating Solids- I Suspended Snlitls- 1 Foam- 1 Oil Shcen- 2 Estimated Flow: 2.0 GIs per minute 10-6 Inches Estimated Event/ Dischm-W : 3.0 Hrs Estimated Tntal Flow ; 360 GIs Pipe 003 outran Color- 2 Clarily- I Floating Solids- I Suspeudod SOW- 1 Fawn- I Oil Shawn- 1 Estimated Flaw : 2.0 GIs per minute . 0-6 incises Estimated Evcnil Discharge : 10 Hrs Estimated Total Flow; 360 GIs Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheatyWb.corn Page 10 of 10 Frito [Iay Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT To whom it may concern; My name is Daniel Ransome, the EHS Manager for Frito Lay — Charlotte site. I am writing in regards to our Semi -Annual Stormwater Discharge Report. While we were auditing our SWPPP we realized that we had not mailed a copy of our Semi -Annual Stormwater Discharge Report for 2018. The samples were taken on time but due to a staff change the reports did not get. mailed. This was an oversight on our behalf and we have implemented corrective measures to address this event. I have attached a copy of the 2018 reports and truly apologize for the inconvenience. Regards, Daniel Ransome Frito Lay —Charlotte Office: 704-369-8560 Mobile: 678-209-4398 SEMI—ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06_2_ 7FACILITY NAME• _ A_2�-:17,� COUNTY PERSON COLLECTING SAMPLE9 LABORATORY s si fy r=r,%4 WOW) o.hfCab Cert. # Str✓t,r� �...,� Part A: Stormwater Benchmarks and Monitorine Results + SAMPLE COLLECTION YEAR -0 S� FACILITY ACTIVITIES INCLUDE (check all that apply): , [� use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? []YES �ONO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall z O.ZS or i1 No cl&horae• this aeriod3 OutfaiLNt: o ;ASampie :Collected,w mo/dd/yr T55, mg/L pH, Standard units , mg/L OII and`Grease,Fecal. mg/L_ _ Coliform: Colonies per 100 ml En roc Colonies per100 mil 8enchmarkr 100 or 50 Within 5.0 - 9.0 . 120, .n , 30 3 s. 1040. 9 500 5W c5a i Z - ZG - tr St Cp. S`rf D it/ p Al Sl,1t�,,2 Z- 26--,fr- /_2_ &"? Z p .. Z -240 -(ir C. 7 P ND ` Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this d isch arge'rhon ito ring report with a-checkmark here. 4See General,Permit text; Table 3, identifying the especially seriiltive'recL-Mng water classifications'where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor-oil,.per.month? i 'Yes Part B: Vehicle Maintenance Area Monitorine Results: oniv for facilities averaeine >.SS eal of new motor oil/month. Outfall,No. ' .sample Collected, ` mo/dd/yr .Oil and Grease, mg/L .- :.. TSS; mg/L pH, Standard units . ; New Motor Oil Usage, Annual, average. gal/mo. Benchmark _ :. 46 100 or Sle 6.0 - 9.0 5 k ,., -PC) l Z _ 2G -19' A/ Sl G. S_-f _ f!a lic, • a " Only applies to facilities that use/process meats. The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) FEB 2 5 2019 CENTRAL FILES UVIR SECTION SWU-249 Last Revised: October 18, 2012 Page I of 2 *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART If SECTION B. 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO [ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy o this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results (or at end of monitoring period in the case of "No Discharge" reportsl to: _ Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) SFr. S/TE r7r,eEc roR Additional copies of this form may be downloaded at: http://oortal.ncdenr.orp/web/wq/ws/su/npdesswi tab-4 SWU-249 last Revised: October 18, 2012 Page 2 of 2 . 4 SHEALY ENVIRONMENTAL SERVICES, INC. Report -of Analysis Frito-Lay Inc. 2911 Nevada Blvd. Charlotte, NC'28273 Attention: Daniel Ransome Project Name: Stormwater F Lot Number.TB27033 Date Completed:03/0512018 03/07/2018 12:20 PM Approved and released by: Project Manager Kelly M. Nance lili. A A • ACC ED I TED' The elecbwk signat" above is the equivalent of a handwritten slonatlrre. : This report shall not be reproduced. except in its entirely, without the written approval of Shealy�riwonmental Services Inc. 4 Shealy Envmxu mdd Servim. Inc. 106 Ventage Pont Drive vYest Co ffnbin. SC 29172 (803) 791-9706 Fax (803) 791-9111 www.shaalylab.Com Page 1 of 10 SHEALY ENVIRONMENTAL SERVICES, INC. SC DHEC No: 32010001 NELAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639 Case Narrative Frito-Lay Inc. Lot Number: TB27033 This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary following this Case Narrative. The sample receiving date is documented in the header information associated with each sample. All results listed in this report relate only to the samples that are contained within this report. Sample receipt, sample analysis, and data review have been performed in accordance with the most current approved'NELAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality Assurance Management Plan (QAMP), standard operating procedures (SOPS), and Shealy policies. Any exceptions to the NELAC standards, the QAMP, SOPS or policies are qualified on the results page or discussed below. If you have any questions regarding this report please contact the Shealy Project Manager listed on}the cover page. Shealy Environmental Services, Inc. 106 Vantage Pant Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheehUb.com Page 2 of 10 SHEALY ENVIRONMENTAL SERVICES, INC. Sample Summary Frito-Lay Inc. Lot Number: TB27033 Sample Number Sample ID Matrix Date Sampled Date Received 001 001 Aqueous 02/26120181115 02/27/2018 002 002 Aqueous 02/26120181125 02/27/2018 003 003 Aqueous 02/26120181138 02/27/2018 (3 samples) Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheaNUb.corn Page 3 of 10 Inorganic non-metals ClientFrito-Lay Inc. Laboratory ID:TB27033-001 Description: 001 Matrix: Aqueous Date Sampled:0212612018 1115 Date Received-,0212712018 ' Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 02/26/2018 1115 MLK 1 (Temperature) SM 25508-2010 1 02/26/2078 1115 MLK 1 (COD) SM 5220D.2011 1 03/01/2018 1522 AMM1 03/01/2018 1216 1 (TSS) SM 254OD-2011 1 02/28/2018 1158 MSG 65665 1 (SGT - HEM (n) 1664B 1 03/01/2018 1008 ARP 65769 T CAS Analytical Parameter Number Method Result Q LOO . Units Run pH - Field SM 4500-H B-2 6.54 su 1 Temperature - Field SM 2550B- 29.9 ° C 1 COD SM_522013- ND 10 mg1L 1 TSS SM 2540D- 51 6.7 mg/L 1 SGT - HEM (non -polar material) 16648 ND 4.4 mglL 1 LOG = Limit of Quantitation 6 = Detected in the method blank E = Quantitation of compound exceeded the calibration range ND = Not detected at or above the LOG N = Recovery Is out of criteria P = The RPD between two GC columns exceeds 40% H = Out of holding time W = Reported on wet weight basis . Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 wvwv.shealylab.com Page 4 of 10 Inorganic non-metals Client Frito-Lay Inc. Laboratory I D: TB27033-002 Description: 002 Matrix: Aqueous Date Sam pled:02126120181125 Date Received:0212712018 ' Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 02/2612018 1125 MLK 1 (Temperature ) SM 2550E-2010 1 02/2612018 1125 MILK 1 (COD) SM 522OD-2011 1 03/01/2018 1522 AMMi 03/01/2018 1216 1 (TSS) SM 254OD-2011 1 02/28/2018 1158 MSG 65665 1 (HEM (oil and) 1664E 1 03101/2018 1008 ARP 65770 CAS Analytical Parameter Number Method Result Q LOQ Units Run PH - Field SM 4500-H B-2 6.78 su 1 Temperature - Field SM 2550B- 30A o C 1 COD SM 5220D- 12 _ 10 mg1L 1 TSS SM 2540D- 12- 4.0 mg1L 1 HEM (oil and grease) 1664E ND 4.3 mg1L 1 * LOQ = Limit of Quantitadon B - Detected in the method blank E = Quantitation of compound exceeded the calibration range •+ ND = Not detected at or above the LOG N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40%, H = Out of holding time W = Reported on wet weight basis Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www_sheaWb.corn Page 5 of 10 Inorganic non-metals Client:Frito-Lay Inc. Laboratory ID:TB27033-003 Description: 003 Matrix: Aqueous Date Sampled:0212612018 1138 Date Received'0212712018 Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch 1 (pH - Field) SM 4500-H B-2011 1 02/26/2018 1138 MLK 1 (Temperature ) SM 2550E-2010 1 02/26/2018 1138 MLK 1 (COD) SM 52200-2011 1 03/01/2018 1522 AMM1 03/01/2018 1216 1 (TSS) SM 254OD-2011 1 02/28/2018 1158 MSG 65665 1 (HEM (oil and) 1664B 1 03/01/2018 1008 ARP 65770, CAS Analytical Parameter Number Method Result Q LOQ Units Run pH - Field SM 4500-H B-2 6.67 su 1 Temperature - Field SM 25506- 30.1 " C 1 COD SM 5220D- ND 10 _ mg1L 1 TSS SM 2540D- 17 2.0 mg/L 1 HEM (oil and grease) 1664B ND 4.3 mg1L 1 LOQ = Limit of Quantitation B = Detected In the method blank E = Quantitation of compound exceeded the calibration range ND = Not detected at or above the LQQ N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40% •+ H = Out of holding time W = Reported on wet weight basis Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab_com Page 6 of 10 Chain of Custody and Miscellaneous Documents Shealy Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheatylab.com Page 7 of 10 m 0 0 Cha:rtn of CuMody Reeard Shealy Environmental Services, Inc. 106 Vantage Pdrd Drive Weal Columbte. South Cardin 29172 Telephone No. (803) 791-9700 Fax No. (803) 791-9111 verw-0waVob.eom Number Ciionl ften m canted SIMON (Printed Noma) CuatO No. Rto Lay Maim. I. Address aphene Na. 7 Far No,1 ema9 wwarm Na. Pago W City Mate tip owe pfggeryg(jye i 1 1 1 I NA I NA NA I Numbar of Gantd an Charhme NC 1. Unpns. 4. MND3 7. NDCH y. NpOWInA $, HCL 1 K 0 1 Bolds Pmjed Naas sw 3. H2604 B. No Thin. IpIfiIltIF1lltfiill�Il*r It,�®lr1�f IIUII II#i�! Projecl Nrm'.bw P.0 Number M9b1)i I1 t! UIH 11 71327033 Sample ID! [7eetriptien (Camahtsn for ends sample may be are) Llate F-FM, Gw aw W W a corribud an a m 001 {9 �rf G X X X X X X X , f/ s • vY� i 002 z o X X X X X X �, 7y f 003 •p 0 X X X X X X R urn Around Torn Rogdmd (Prior Inh wnpDMmwi ad (at exoadhedTAT) Sam* diepaeei 0C R Poestft H=d Idwillftation llaedwd ❑Rush (Plemaspecilm ❑ iaetum Lo Chard ❑ UlEaaap1 by Lob ��Ptan-iliamd 8LK ❑Side trtttsnt nown 1. RAM by Somplar Ott limo , 1. d by ` 3A,c rime I ►r 2. Rornaa1004 by Data ?• Z 7./ Time ��r� 7. M 96 °r+ Z 7. Th" pi a 2. ulh by * Trig 3. Rea"d by e We T;m. a. Fttft shod try Date Tens 4. oratory Ci0 y by(j`,1 Dale ,7 Time {a t Nobs: All samples are retained for six weeks from recefpt unless other LA14 UFJP_ (MLY arm. aria. k Racolrod an lee (Creak? Y N toe Paid CP . �; a 0 Y N Eftativa hero 00-27-2012 rn a Z C) SHEALY ENVIRONMENTAL SERVICES INC. M Sic y ErwirownTo Serv=s, W. Pon 1 of i tlnS.=Ncmba.7 EM[ar_t: FffmirrnwdL.Uw"Ig Sample Receipt Checklist (SRQ cooker Inspme;d byldate: Ci37� + E?- p � � [ sd g: 7�i o��'t4`'� of rc=pn L? 5E5! ;Clecui - UPS ! FWEa Other; Yes ' p I- Were c=ody s=h pTcs=k an dw L'W� Ycs � Fln A 2. If+wtodv seoU were . were th irgact and rr rlunken? 1.1 Strip ID: $ Chlorine Strip ID: J PJ 34 `i Cooler ID } original tergrerature upon recW i Dmved (Conwcd) teraperttture: upon re'-*t etbrxi 'I r BlankyAphm Bottles IR Can a. fr: Ut Gun Cormtlon Furor: C:j_°C Of ct+alsrrl:-R-iVat [cc G Ice PWU ❑ Dry ke ❑ None ❑ Yes Ci No ONA I. if fro of any oeoler cu=dcd 6.01C;. was Projmt Manager Notified? pad %M Notified by. ptoae i earnail f face-ta-fax (6rck unc). LJ Yes ❑ No AAA 4. Is the onmrrcrt:inl ornaia'+ pueUng blip atladwd to this form? Yam No S. W= proper cmu dy procedures (rd' ieeeived) folloarod7 gYes ! No 6. Wcre sample U) s listerd on dm Coo. es ! No 17, Were srmrptc IM lined on all &ample containem-9 T.TY.,F0 No S. Wns cdk ction date tit time listed an the COC? IZYesl L No 9. Was collection date lit tithe listed tint sli s�rmpk containers? EHYesi ❑ No 10, Did all container label infortandon (1D. date. time) aw= with the Yes ❑ NO 11. Were twee to lrc per funned listed on the 000 Yes L'� N o 12. Did al I sarnp ics anivr in the proper contninere for ezeh t -st and=`or in good cosrdition (unbroken, lids on, M.Y1 Yes ❑ No 113. Was adequate sample voturne available?! Yes U-No 14. Wm all mtnplcs rtaived within K thr hu!dirrg time of 48 hours, w'hichnrr CmnCf, fV$17 ' Yes 'P 'Ka 15. Wcre auv saw cazrtaine+s raissin�eac+e�_Cp��P_41>'c}.s T .Nr}t listed nn COC7 ❑ Yes 0 Na ;eNA 16. For VOA and RSK-17S samples, %%ere bubbks prrscnt >"pw*-size" (1a"or 6mni hi diameter) in mg of the VOA vialx. FeTYcs _' No NA 17. Were all DRQ'rueWs/notrienr samples received at a pH oft 2? Yes + Na J2 NA I a. Wera all cyanide rumple,{ rtxcivnrl at, u pH --12 and sulfide samples received at a pi I > 97. es ❑ No ❑ NA 19. Were appLicabic.NHyTXXcyOV623(<(),5mg/L)vamp es fr= u drlurine? ❑ Yes 0 ND .RTNA . W`irc (limn rexrrarkskequests(i.e. requested dilutirme, MS,m1;b desigmtioms. etc.,.) cm.ccdy tmnscribed from die COC into this comrnent section in i3MS? YesL dNp 1 r2l. Was the quatr number wed taken from the corm iner label? Samplie'PreswVation {Mist be cumphtal Cpr ouy srmple(s) irde�orroetly peesa vrtl ar w ith t►esdspacc l rise rneivrd ijs n --dy pfcactved and were: adjusted iugly n fatrtPlc rocaring with (K SQ,, HNOj, HC l,14r0I1) using SIC fimc of p�rservation , __ e{a} _ wcm received sith babbles>6 ram in diamckes. s) wsxn rrcei-.,ed w idr TRC > Uw jnVL (1 f 019 n ao) and were 'waed z=rft1y m stw Ic murivinK with sodium thiowlfW (Na=SA) wrth Shcaly ]D: !t kan=6 labels . ppiisd bar Da= Commc= Sheaty Environmental Services, Inc. 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheawb.com Page 9 of 10 SHEALY ENVIRONMENTAL SERVICES, INC. SHEAF Etrtitnnnme�thet the cage Pam Ljn e• 'A*u cne,nbb6 Sant, CWWiW 2917-A .- Phone.8a3.79t,97pp• faB03.T� ,9'I11 • arw.rtr-slydb,car. Daniel RansonkVRobcrt P.Mley Frito-Lay Inc. 2911 Nevada Blvd, Charlotte, NC 282: 3 j Frito-Lay Inc.2911 Nevada Blvd. Facility Chwiotte, NC Slannwattr Qualitative Monitoring Requires ents, 1" Semi-annual event 2018 March 26. 2018 ]-Now 2-Faint 3-hioderate 4-Strung Pipe 0011 aotfall Color- 2 Odor- 1 Clarity- 1 F1oatiifgSolids- 1 Suspended Solids- I Foam- 1 Oil Sheets- 2 Estimated Flow : 5.0 GIs pet minute / 0.21 Inches Es imated Event/ Discharge : 4.0 Ills }: Tstitnnted Tola1 Flow 12M GIs Pipe 002 antfall Color- 2 Odor- 1 Clarity--.1 Floating Solids- I Smpended Solids- I Foam - Oil Sheen- 2 Estimated Flow: 1.5 GIs per minute / 0.21 Inches !-:stitMatW Event' Discharge : 4.0 Hts EstimWed Tote! Flow: 360 GIs Pipe M outhn Color- 2 Clarity- I . Floating Solids- I Suspended Solids- 1 Foam- 1 Oil Slxxtt- ! Estimated Flow: 1.0 Gls M minute / 0.21 luches - Estimated Event/ Discharge : 4.0 Hrs _ Estimated Total Flow. 2,�o G1s ; Shealy Environmental Services, Inc. ' 106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com L Page t0 of 10 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000". DatO submitted-. 9-26-17 CERTIFICATE OF COVERAGE, NOACG060175 SAMPLE COLLECTION YEAR: 2017 FACILITY NAME Frito-Lay, Inc. FACILITY ACTIVITIES INCLUDE (check'all that apply)-' COUNTY Mecklenburg— ❑ use/process meats []'use animal fats/byproducts PERSON COLLECTING SAMPLES Michael KIIRatrIck RECEIVEPs CHARGING TO SALTWATERS? [JYES ®NO LABORATORY Shealy Environmental Services, Inc. oci 0 3 2017 Lab Cert; # 329 PLEASE REMEMBER TO SIGN ON THE REVERSE CENTRAL FILES Part A: Stormwater Benchmarks and Monitoring Results DWR SECTION o Js�p Total event rainf6112 0.52 in or dischotge,"th erioC?IL Outfill'N04"t."Sa 'S `M6/dd/ xTSSrl �dLwStanir ­ pHK i" units COD, "� M Oil a6dAre6 se mg/L Fe.c'a I,qoil f ,`i!. Colonlesper,100,ml! Col6hl[ er nc -Be hinark, 1N_6rU17_'NthI n - C'0=9.0 22 0 30', Wo Soo- !­, Swool 08/31/2017 22 6.94 29 ................ ND N/A N/A, SW002 08/31/2017 23, 6.91 '69 N D N/A N/A'. SWO03 08/31/2017 11. 6-.86 29 'ND N/A' N/A . ........... .. ....... Only applies to facilities thatus6/proCeSs'rmeats. 2 The total precipitation must be recorded',using data from an -on -site rain gauge. 3 For sampling periods with no cilicharge at o"utfalls. You'must-still submit this discharge monitoring report.with &checkmark here. See General Permit text, Table 3,1dentifVing the' specially'sensitive receiving water classifications where themore`protective benchmarlk,applies, Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? [g yes [] no (if ye s c6m plete Pak 13) Part 13-Viahicle M aintenanc'e, rea Mohitori'ng,Results:.only for facilities averaging > 55.ga1 of new motor oil/month. k, r` 4 o/dd/y 011146d-Giiaie, TS -Mg/L: p H s,.. Stindard,unit. -"Nev�;011,Usage, a Avera "A:h"'i' gejal?m6s., *XJ""',' `K304 swool 08/31/2017 -ND. zz 6.94 71 J. Only appjlies to facilities that use/process meats. 2The total precipitation must be recorded using data -from an on -site rain,gauge. 3 For sampling periods with no discharge o'utfalls, you must still submit this discharge monitoring report with a checkmark here. See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective -'benchmark applies.. SWU-249 LaA Revis ed; i OcA6r3-1 8 2012 *FOR PART A 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 11 SECTION B. TIER 3: HAS YOUR FACILITY HAD 4"OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an on anal and one cony o this DMR Including a!1 "No Discharge" re orts within 30 days of receipt of the lab results for at end o monitodggperiod In the case of "No Discharge" re�J'to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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. I am -aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." [Signature of Permitteey b7-k-7 - (Date) Additional copies of this form may be downloaded at: http:lingrtal.ncdenr.org/web[wctLws/su/npdessw#tab-4 SWU-249 Last Revised: October IS, 2012 Page 2 of 2 EP SL To: Division of Water Quality Date: 9/29/2017 From: Donald Hall Donald.Hall(@Pepsico.com To Whom It May Concern, Letter of Transmittal 704-369-8530 Please find two copies of the Semi -Annual Stormwater Discharge Monitoring Report enclosed for the Frito-Lay, Inc. — Charlotte, North Carolina facility. If you have any questions regarding this submittal, please do not hesitate to reach out to me. Regards, Don Donald Hall, EHS Supply Chain Leader SEMI-ANNUAL. STORMWATER DISCHARGE MONITORING. REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted a CERTIFICATE OF COVERAGE NO NCG06 1175 SAMPLE COLLECTION YEAR 2017 FACILITY NAME Frito-Lay. Inc. FACILITY ACTIVITIES INCLUDE (check all that -apply): COUNTY _ Mecklenburg _ „ ❑ use/process meats []use animal fats/byproducts PERSON COLLECTING SAMPLES Michael Kilpatrick DISCHARGING TO'SALTWATERS? ❑YES [gNO LABORATORY Shealy Environmental Servicesjnc. Lab Cert. 0 329 PLEASE REMEMBER TO.SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks'and Monitoring!Results Total event rainfall Z 04 in or ❑ No discharge this period rQutfall )""'�. a Sam�-Ie;C6IIiEteii f p.�. r r'. ++�,' 'TS5;' � ^`F�' H� "f a "'r u �a,' . ;;standard�,units,w,g � COD, " '• � c. .- *:- , �„ ,mg/.,' 'rP Oi!`antl;Grea eR' — a �,`i , '�tmg/L�, c.r, FecalrCo3lfo�m,, '' � 'R . , If .;.',t�, -tea =a�� y+A ;Colonies. er 100:rrel; .4Ei4terococei Wits f tip e r.. �., ,A�Colanies, er,2o0,m1 f3ericlirrtark ro3 IDO ort50 �. Witlilh;6 �,,,,9,0;, fir_ }"!r'�I; "F. ,,� �,,:1W � f :.; . t L*1.: swooi 05/01/2017 55 6.29' '28 :is N/A N/Aw 5W002 `05/01/2017 34 6.36' :61 ND N/A N/A SWO03 05/01/2017 18 6A 26 ND N/A N/A 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from anon -site rain gauge.. 3 For sampling periods with no discharge at aM outfalls. You must still submit this.discharge monitoring report with a:checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities usingmore than 55 gallons of new motor oil per.month? ® yes ❑ no Part g: Vehicle Maintenance Area Monitoring Results: only for facilities averaging >,55'gal of new motor oil/month. Outiall No r:" 5artple,Caileded�'`; r'tiirrg/L ,2412" `'`yya'Oii�andl�eaAN, rd r �4fiS5 {i' ty'v `r i" 's'm" pH,�.`1' S F A. ' New�Moto:;1OIIyUsage i r . , ., .Ks.r r e . �. •. - .�`' �.. � .�1-x. �n,rt s.50��as�., . �r—<'- "t-- S dL' ";� 6 0. 94 W ;�. r�„rcF,. _ �. ,,. �:• • a af.p-, ,�. .,:... s s.. • c. S .r 5W001 05/01/2017 '15 iss 6.29 104 1 Only applies.to facilities that use/pro.cess meats. z The total precipitation must be recorded using data:from anon=site rain gauge. wED U 2017 DWRAL FILES SECT ON (Axes, complete Part 13) 3 For sampling periods with no discharge it g_ ...outfalls, you must stlll,submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3,1dentifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: October 18, 2012 Page I of 2 *FOR PART -A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE.TRIGGERSTIER.I.REQUIREMENTS.-SEE:PERMIrPARTif SECTION B. • 2.EXCEEDANCES IN A ROW FOR THE SAME PARAMETER -AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART it SECTION B. • TIER.3: HAS YOUR FACILITY HAD 4 OR MORE JBENCHMARK'.EXCEEDENCES:FOR THE'SAME PARAMETER AT ANY ONE OUTFALL? YES [] NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE'CONTACT NAME: VvisiorrofWater Quality Attn: DWQ Central Files -1617 Mail `Service )Center 'Raleigh, NC 7699-1617 YOU -MUST SIGNTHIS CERTIFICATION"F.ORANY INFORMATION•REPORTED: "I!certify„under penalty;of lawjAharthis docurnent andyall:attachments were.prepared under MVAirection or supervision in accordance with a system designed ;to assure that qualified`peesonnel properly gather and evaluate theinformation submitted. Based on my inquiry of the person. or- persons who manage,the,system, or-tl oselpersons directly responsible forgathering the information, the information submitted is, to the best -of my knowledge'and belief, -true, aceurate;an&complete: I am aware:that<thete are�slgnificant_penaltles for submitting false information, including the.possibility'of-fines and imprisonment for knowin&violations." Sh— 9J'2. JDate} Additional copiesof this -form maybe downloaded•at: http://portal:ncdenr.ore/web"w Lws/su/npdessw#tab-4 SWU-249 . last Revised: October I ° SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED for North Carolina Division of Water Quality General Permit No. NCGO60000 MAR 3 0 2Utfi Date submitted 3l Z/ 1A CENTRAL FILES CERTIFICATE OF COVERAGE NO. NCG06 0175 SAMPLE COLLECTION YEAR 20161 DWR SECTION FACILITY NAME _Frito-Lav, Inc. FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Mecklenburg ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES _Michael Kilpatrick DISCHARGING TO SALTWATERS? ❑YES ®NO LABORATORY Shealy Environmental Services. Inc. Lab CerL 0 329 _ PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 1.1in or ❑ No discharge this perlod3 outfall No. Sample Collected, mo/dd/Yr Tn. pH, Standard units cot), mg1l. oil and Grease, L Fecal Conform", Colonies r 100 ml Enier000cci , Colonies per 100 ml Benchmark - 100 or SO Within 6.0 — 9.0 120 30 1000 5OO SW001 2/3 2016 67 7.13 70 ND N/A N/A SW002 2/3/2016 170 7.27 110 ND N/A N/A SWO03 2/3/2016 34 7.22 23 ND N/A N/A 1 Only applies to fadilties that use/process meats. rThe total precipitation must be recorded using data from an on -site rain gauge. ' For sampling periods with no discharge at pa outfalls. You must still submit this discharge monitoring report with a checkmark here. ,See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ® yes ❑ no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging:,. SS gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/ Oil and Grease, L im, rn L pH, Standard units New Motor Oil Usage, Annual aver a i/mo Benchmark - 30 100 or 60 6.0 — 9.0 - SW001 2/3/2016 NO 67 7.13 83 'Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. B For sampling periods with nn discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. `See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part 8) S'WU-249 Last Revised: October 18, 2012 PAFI., i of 7. *FOR PART A AND PA_ RT B MONITORING RESULTS: a A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oNglnol and one cwaY of this DMR, Induding all Aft Discharge" reports, wlthfn 30 days �}�er�lpt o the lob results (or at end of monitodng period In the case o 'No Discha e" its to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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 bes of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false Informallfio, including the possibility of fines and Imprisonment for knowing violations." Of � � S JD ej Additional copies of this form may be downloaded at: http://portal.ncdenLor&Lweblwa/wsLsu/npdesswl#tab-4 SWU-249 Last Revised: October 18, 2012 Paue 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted See- trnb*y 134 7-016 CERTIFICATE OF COVERAGE NO. NCG06 0175 RECEJVWNPLE COLLECTION YEAR 2016 FACILITY NAME Frito-Lay, Inc. ILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Mecklenburg SEP 19 ZUib ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Michael Kilpatrick ISCHARGING TO SALTWATERS? [:]YES ®NO LABORATORY Shealy Environmental Services, Inc. DWR RAL SECTIONS ' Lab Cert. li 329 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall z 1.1 in or ❑ No discharge this period3 Outfall No. Sample Collected," mo/dd/yr.. . TSS, mg/L ,..` pH, ;: ..,Standard units ; :COD, mg/L Oil andArease, mg/LM Fecal Coliform , ; a _Colonie"s:per 100:m1 Enterococci , : Colonies per 100 ml. Benchmark ` , - 100 or 50 4:Wfthin 6.0 ='9 120; k � 30•1 '" 1000 �' S00 sW001 8/10/2016 21 6.54 79 ND N/A N/A SWO02 - 8/10/2016 52 6.76 390 ND N/A N/A SWO03 8/10/2016 5.4 6.29 77 ND N/A N/A 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ® yes ❑ no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected,'"Oil m0 dd r / /y and'Grease, m L; TSS, "` L� pH, 1 ?.$tarid6rd,units New Motor Oil Usage, r Annual`ayerage-gal/mo. Benchmark 10 100 ar 50 :+* 6.0 = ;A - SW001 8/10/2016 ND 5.4 6.29 83 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (ides, complete Part Bj S WU-249 Last Revised: October 18, 2012 Page 1 of 2 *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER I 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 0 If YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, includin_q_a!1 "No Discharge" reports within 30 days of recelpt of the lab results for 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, NC 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. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature q11 3 (Date Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wgZws/su/npdessw#tab-4 S WU-249 Last Revised: October 18, 2012 Page 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCGO60000 Date submitted 7 1 CERTIFICATE OF COVERAGE NO. NCG06 0175 SAMPLE COLLECTION YEAR 2016 FACILITY NAME Frito-Lay, Inc. REC E IVE UCILITY ACTIVITIES INCLUDE [check all that apply]: COUNTY Mecklenburg: _ ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Michael Kilpatrick A 2016DISCHARGING t0 5ALTWATERS? []YES ®NO LABORATORY_ Shealy Environmental Services, Inc. Lab Cert. # AP CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DWR SECTION Part A. Stormwater Benchmarks and Monitoring Results Total event rain 112 1.1 in or iYa discharge this perlodr Outfall No. I Sample Collected, mo/dd/ TSS, m l pH, Standard units OOD, L Oli and Grease, l Fecal Cofliorm , Colonies per 100 ml Enterocacci , Colonies per 100 ml Benchmark - 100 or Si Within 6.0 — 9.0 120 30 1000 S00 Wool 2/3/2016 67 7.13 70 ND N/A N/A SWO02 2/3/2016 170 7.27 110 ND N/A N/A SWO03 2/3/2016 34 7.ZZ 23 ND N/A N/A f.. ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at AM outfalls. You must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ® yes ❑ no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/ r Oil and Grease, m L TSS, mg1l. pH, Standard units New Motor oil Usage, Annual averse I/mo Benchmark - 30 100 or 50 6.0 — 9.0 - SW001 2/3/2016 ND 67 7.13 63 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalis, you must still submit this discharge monitoring report with a checkmark here. `See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (ifyes, complete Part B) SWU-249 bast Revised; October 18, 2012 Psuar. i of 7 'VOR PART A AND PART B MONITORING RESULTS: A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. 0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ 1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an orlalnal and one coat' of this DMR, Induching all "No Discharae" reports, within 30 dabs of receipt of the lab results for at end of monitorl A period In the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: . N 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 bes of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false Informaji0o, including the possibility of fines and imprisonment for knowing violations." of -,�451ho, (Date) Additional copies of this form may be downloaded a#. http://Aortal.ncdenr.orglweblwa/ws/su/npdesswtttab,;,4 SWU-249 Lut Revised: October 18, 2012 Pave 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted LJCC. R_2co � CERTIFICATE OF COVERAGE NO. NCGO6 0175 SAMPLE COLLECTION YEAR 2015 FACILITY NAME Frito-Lay, Inc. FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Mecklenburg PERSON COLLECTING SAMPLESmMichael Kilpatrick RECErGl GPTO SALTWATER❑YESim®NO fats/byproducts � LABORATORY Shealy Environmental Services, Inc. DEC 14 2015 Lab Cert. # 329 PLEASE REMEMBER TO SIGN ON THE REVERSE CENTRAL FILES 2 Part A: Stormwater Benchmarks and Monitoring ResultsDVVR SECTION Total event rainfa!! _ 2.00 in or ❑ No discharge this period' Outfall No. I Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococcl , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 500 SW001 11/2/2015 40 7.19 28 ND N/A N/A SWO02 11/2/2015 12 7.04 33 ND N/A N/A SWO03 11/2/2015 9.8 7.11 14 ND N/A N/A Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at pny outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ® yes ❑ no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/ r oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 504 6.0 — 9.0 - SW001 11/2/2015 ND 12 7.04 83 ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if ves, complete Part By S WU-249 Last Revised: October 18, 2012 Page 1 of 2 *FOR PART A AND PART S 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 0 NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one corer of this DMR, lncludina all "No Discharge" reports, wlthin 30 dabs of receipt of the lab results,1or at end o Monitoring period !n the case of "Na Discharge" repor�sl to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU M M SIGN THIS CERTIFICATION FOR ANY I I�FORMALION 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. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Date) Additional copies of this form maybe downloaded at: http:1/12ortal.ncdenr.orig/web/wq/wsZsu/npdessw#tab-4 SWU-249 Last Revised: October 18.2012 Page 2 of SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT t for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06 0175 SAMPLE COLLECTION YEAR 2015 FACILITY NAME Frito-Lay, Inc. RECElii VE!fYILITY ACTIVITIES INCLUDE (check all that apply): COUNTY Mecklenburg ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Michael Kit atrick DEC 1 6 l01bISCHARGING TO SALTWATERS? []YES ®NO LABORATORY Shealy, Environmental Services, Inc. CENTRAL FILES Lab Cert. # 329 DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 2.00 in or ❑ No discharge this period; Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Collform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 500 5W001 11/2/2015 40 7.19 28 ND N/A N/A SW002 11/2/201S 12 7.04 33 ND N/A N/A SWO03 11/2/2015 9.8 17.11 114 1 ND I N/A N/A I I ----i -t- I Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ® yes ❑ no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/ r Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 - SW001 11/2/2015 ND 12 7.04 83 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. CD "w =0119 (if_yes, complete Part B) SWU-249 )Last Revised: October 18, 2012 Page I of 2 *FOR PAST AA AND PART B MONITORING RESULTS: A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART It 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 DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mai/ an origlinol and one copy of this DMA, Including all "No Discharae" revorts within 3e dais of receipt of the lab results for cat end of monitoring period in the case of "No Dischome" Megj s) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 11 YOU UST GN 1S C RT1F1 T1O FOR ANY NFD A ION 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. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Date) Additional copies of this form may be downloaded at: http:(f portal.ncdenr.orgL eb/wciiws/su/nt)dessw#tab-4 SWU-249 Last Revised: October 18. 2012 Page 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 RECEIVED ' Date submitted 11 3r/5- CERTIFICATE OF COVERAGE NO, NCG06_Q L-2. FACILITY NAME Frz%i-v - (_A,� . IN c. COUNTY M c E PERSON COLLECTING SAMPLES _ • r&r-►,Ar L- K1i-1', LABORATORY r4FA+-Y EVv yr AJi Lab Cert. # 3941 $' ' W t E 5 /A/Z— .. Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR -P-01 5r APR 2 S 2015 FACILITY ACTIVITIES INCLUDE (check all that apply): CENTRAL FILES ❑ use/process meats [D use animal fots/byprodPW SECTION DISCHARGING TO SALTWATERS? []YES &NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 D; 32 or ❑ No discharge this period3 Outfall No. Sample Collected;' Ato'cidIr TSS, pH, Standard units COD, mgjL Oil and Grease, mg/L Fecal Coliforrn ,' Colonies per loom[ Enterococcl , Colonies er lW ml Benchmark 100 or 50 Within 6.0 - 9.0 a 120 30 1000 Soo 5 �.vao t 3 ti 1 b w rJtr3-- % _ -a 1 id Swo 1 •S,a— . t N Xp " Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here, °See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies, Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Dyes ❑ no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new motor oil/month. Outfali No. ftni le Collected• mo/dd/yr .• Oil and•Grease, m L _ TSS, m L . pH, ; Standard units _ : New Motor'OII. age, Annual average gal%rrto Benchmark 30 . ' 100 or 50, 6.0 - 9.0 Swine 3/ I 1V �D Only applies to facilities that use/process meats. 'The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 1�m (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Page I of 2 *FOR PART A AND PART B MONITORING RESULTS: d A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. 0 2 EXCEEDANCES 1N A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION 11, 0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO Q REGIONAL OFFICE CONTACT NAME: Mail an orialnal and one copy of this OMR Including all "No Discharge" reports within 30 days of receipt of the lab results (or at end of mon orMa period in the case of "No Discharge' renarts) to: Division of Water Quality Attn: DWQ Central Files 1617 Mall Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTEQ! ;,I !I 1 • tl{l, "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 aril e�alula�te 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 arh -aware that there are significant penalties for submitting false information, including the possibility of fines and Imprisonment for knowing:vioiations' "+ (Signaturf?'OermitteLY) (Date) .P. Additional copies of this form maybe downloaded at: http:dportalmcdennor web/wa/wchli/r pdessw4#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 SEMI-ANNUAL. STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCGO60000 Date submitted W_ CERTIFICATE OF COVERAGE NO. NCG06 0 I FACILITY NAME _ -,r-,z�Q-�i+f; INS COUNTY PERSON COLLECTING SAMPLES MO&HAQ-, KIr ?A__rr .%L K_ LABORATORYS N6aL,,, eAo�, rwyj2e,V Ai- _ Lab Cert. #i ^J q__ _ Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR -_ 2�2 r 4 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? []YES [}40 PLEASE REMEMBER TO SIGN ON THE REVEiiRjEF CEO �b Total event rainfall 1 I , r 114 or ❑ No dischorg,� #6see„tio Outfall No. Sample Collected, mo/dd/yr TSS, mgtL pH, standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml E t rococci , Colo I Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 2000 asIsEi .SiVQ2 t! ! l 50 6, 36 1 ")] 0 N Q l✓ A SWOJqM Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies: Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes ❑ no (if es complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/ r Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average al/mo Benchmark 30 100 or 50 6.0 - 9.0 - S a� SC> Only applies to facilities that use/process meats, 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications wh ere the more protective benchmark applies. SWU-249 Last Revised: October 18, 2012 Page 1 of 2 ti *r0R PART A AND PART B MONITORING RESULTS- d 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 li SECTION B. • TIER 3: HAS YOUR FAC1LITv HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mallon oLkLngl and one c6py of th s DMR i cludin all "No Discharge" reports within 30 days of recel t ot the lab results tor at end o monitoring period In the case of 'No „Dlscharoe" repartsl to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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. I am aware that there are significant penalties for submitting false Mformation, Including the possibility of fines and imprisonment for knowing violations." (Signature of _ 11, ( (bate) Additional copies of this Form may be downloaded at: hap, YaortaL'r-(p'�-r c-; 4-." ±t,: ;rQh ;s su rt Last Revised: t, ,x 18, 20? Page " of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 6 - /—+-* ILI CERTIFICATE OF COVERAGE NO. NCG06v I S SAMPLE COLLECTION YEAR �2��• FACILITY NAME rt? ru f_Av, ivt FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY _M jFCat1,611 rt3;).:Z a ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES 4;iuZ� DISCHARGING TO SALTWATERS? ❑YES 290 LABORATORY_J70-1-2 zj& L__d 5 ; I,ye— Lab Cert. f# 1Lfa`1- i'..EASF k .NILNIBI`R TO SK.'j'1 C'N'fIL Part A: Stormwater Benchmarks and Monitoring Results Total event roinfall 1 a or n No discharge this period' Outfail No. Sample Collected, mo/dd/ TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, m /L Fecal Coliform , Colonies per 100 ml Enterbcoccl 1, Colonies per 100 ml Benchmark - 100 or 5o Within 6.0— 9.0 120 30 1000 Soo 00 01-- 100 < 5, D A! ?% 40u . i s r'94 h < S. 0 M S Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge, ' For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oft per month? Zyes ❑ no (ii yes, complete Part B) Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor off/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, m L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100or50 6.0-9.0 - a <5.0 Iva Only applies to facilities that use/process meats, 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any, outfalls, you must still submit this discharge monitoring report with a checkmark here. 45ee General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 5 W U-249 RECEIVED JUL 0I Z�'4 CENTRAL FILEc DWQ/BOG IJast Rcviscd: October 18, 2012 Page 1 of 2 t r "4 *FOR PANT A 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 I REQUIREMENTS. SEE PERMIT PART II SECTION R, 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 DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mai! an original and one copy of this 1)MR, including all "No Discharge" reports, within 30 days of recelvt I the lob results for at end of monitoring period In the case of "No Dischame" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 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. I am aware that there are significant penalties for submitting false informatlgja, jncluding the possibility of fines and imprisonment for knowing violations." I - ,1 (Date) Additional copies of this form may be downloaded at: _.,t_a:r ;.qrtai.�;;�±^� r� ;/! !C •�rLL. �.w5 �5, !li n)I�ir,c" A�c�} S W U- 249 Last Revised: 0 ;r 18. ^_012 Page 1 or 2 --moo SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 6 -1 =1y CERTIFICATE OF COVERAGE NO. NCGO60 l 'R2 SAMPLE COLLECTION YEAR 9-Of44 FACILITY NAME r- fa. t Tu - 44W. 1"4-. FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY %VICE-/G�.GAI �iiJi'•.C7_ ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES _ MA�1.u*, K�F_P5 _ DISCHARGING TO SALTWATERS? ❑YES 290 LABORATORY NL Lab Cert. # 4 0;?— Part A: Stormwater Benchmarks and Monitoring Results PLEASE. REMEMBER TO SIGN ON THE REVERSE - Total event rainfall 2 0 �qf; or No discharge this period3 Outfail No. Sample Collected, mo/dd/ r TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, m L Fecal Coliform , Colonies per 100 ml Enterbcocci , Colonies per 100 mi Benchmark - 100 or SO Within 6.0 - 9.0 120 30 1000 Soo J / ,- C. 7 �- 6 C N4 AA 00:i /KI t- I' 5,D N 03.0u /is �- Aso Ail )V t,r/I'A n, k-1 6.r < 5,0 -61 I Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site raln gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. "See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (- EA D .,,9 /1. < O. oe>5D t 0. 005-0 < 0. too; (D. or.,s-7- Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? 2f yes []no (ifyes, complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, m /L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 - 9.0 - 00 1 <5.0 1 ��1 ,�� 1,✓Ei..J Ufll� Only applies to facilities that use/process meats. r�o�n�ri(?fu °���30N SIN 2The total precipitation must be recorded using data from an on-slte rain gauge. G UNIT 3 For sampling periods with no discharge at Any outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies. S W U-249 Last Revised: October 18, 2012 Page i of 2 -yt *FOR PART A AND PART B MONITORING RESULTS: a A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. 2 EXCE£DANCES 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 DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mall an original and one copy of this DMR, Including all "No DFschargre" reports, within 311 days a receig of the lab results for at end of monitoring period In the case of "No Discha ge" reports) to: Division of Water Quality Attn; DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMAITION 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. I am aware that there are significant penalties for submitting false info rmati9A4ncluding the possibility of fines and imprisonment for knowing violations." {Signatu (Date) Additional copies of this form maybe downloaded at: �3tcn:l/-erC.�;•rc�ter�r�,/we1, '•,1+!u'wsi su,'npriesswtttah-4. SWU-249 Last Revised: 0 ;r 18, 2012 Page? of 2