NCG030103_MONITORING INFO_20190521 (2)

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�V�U- j
DOC TYPE
❑.�`HISTORICAL FILE
4YmONITORING REPORTS
DOC DATE
❑
YYYYMMDD

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
CERTIFICATE OF COVERAGE NO. NCG03 0 1 0 3
FACILITY NAME Moen Incorporated
COUNTY Lee
PERSON COLLECTING SAMPLES John West
LABORATORY Prism
Date submitted 5/20/19
Lab Cert. # 402
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or El Monthly' '.)a,,, u , r (month)
DISCHARGING TO CLASS ❑ORW ❑HQW(❑Trout ❑PNA
❑Zero -flow ❑Water Supply ESA
Mother C
`l-° c i v
MAY 21 Z019
Part A: Stormwater Benchmarks and Monitoring Results
CENTiaA>,. FILES
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
n No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
pH,
Standard units
Total Copper
Total Lead
Total Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks
_
-
100 mg/L or 50 mg/L4
6.0 — 9.0
0.010 mg/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
00552
78141
01
01/24/19
0.5
3.1
7.4
0.01
<0.0010
0.083
<5.0
NA
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Chris Gundler
Name (Print name)
Plant Manager
Title (P itle)
Signature Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?Z
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches'
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/L4
Parameter Code
-
46529
NCOIL
00552
C0530
Footnotes from Part A also apply to Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3

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 DEMLR REGIONAL OFFICE? YESCINOrl
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharge" reports, within 30 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, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware at there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
r`
Signature of Permittee
Permit Date:11/1/2018-05/31/2021
Date
SWU-245, last revised 11/1/2018
Page 3 of 3

Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report
Permit No.: NCG030000 or Certificate of Coverage No.: NCG030103
Facility Name: _Moen Incorporated
County: _Lee Phone No. _(919)258-3341
Inspector:
Date of Inspection: 11A!�/ J
Time of Inspection: e'oU AW
Total Event Precipitation (inches): C, S
All permits require qualitative monitoring to be performed during a "measurable storm event. "
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The
previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply
if the permittee is able to document that a shorter interval is representative for local storm events during the
sampling period, and the permittee obtains approval from the local DEMLR Regional Office.
By this signature, I certify that t 's re rt is accurate and complete to the best of my knowledge:
(Signature of hermittee or Designee)
I.Outfall Description:
Outfall No. O / Structure ipe itch, etc.):
Receiving Stream: Unname ributary of Carrs Creek
Describe the industrial activities that occur within the outfall drainage area: _Transportation, Storage,
Manufacturing
2.Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint(light,
medium, dark) as descriptors: CiP"s"
3.Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weakchlorine odor, etc.): /I/vvt , .
4.Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clearand 5 is
very cloudy:
102345
5.Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
103 4 5
6.Suspended Solids: Choose the number which best describes the amount of suspended solids inthe
stormwater discharge, where 1 is no solids and 5 is extremely muddy:
10345
7. Is there any foam in the stormwater discharge? Yes o
8. Is there an oil sheen in the stormwater discharge? Yes T1Ng
9. Is there evidence of erosion or deposition at the outfall? Yes o.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.

Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report
Permit No.: NCG030000 or Certificate of Coverage No.: NCG030103
Facility Name: _Moen Incorporated
County: _Lee Phone No. _(919)258-3341
Inspector: .� �� V\, ✓t Wea; -
Date of Inspection:
Time of Inspection: 00,4!'i'I
Total Event Precipitation (inches): 0-
All permits require qualitative monitoring to be performed during a "measurable storm event. "
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The
previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply
if thepermittee is able to document that a shorter interval is representative for local storm events during the
sampling period, and the permittee obtains approval from the local DEMLR Regional Office.
By this signature, I cgtifV that this report is accurate and complete to the best of my knowledge:
(Signature of Pex(ittee or Designee)
I.Outfall Description:
Outfall No. 02 Structure i e' itch, etc.):
Receiving Stream: Unnamed tributary of Carrs Creek
Describe the industrial activities that occur within the outfall drainage area: _Transportation, Storage,
Manufacturing
2.Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint(light,
medium, dark) as descriptors: C 1« i
3.Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weakchlorine odor, etc.): &..
4.Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clearand 5 is
very cloudy:
02345
5.Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
?3 4 5
suspended Solids: Choose the number which best describes the amount of suspended solids inthe
Uormwater discharge, where 1 is no solids and 5 is extremely muddy:
12345
7. Is there any foam in the stormwater discharge? Yes To
8. Is there an oil sheen in the stormwater discharge? Yes G
9. Is there evidence of erosion or deposition at the outfall? YeS600
10.Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.

Storrnwater Discharge Outfall (SDO) Qualitative Monitoring Report
Permit No.: NCG030000 or Certificate of Coverage No.: NCG030103
Facility Name: _Moen Incorporated
County: _Lee Phone No. _(919)258-3341
Inspector:,1.�
Date of Inspection: 1
Time of Inspection: P!0D Awl
Total Event Precipitation (inches): o
All permits require qualitative monitoring to be performed during a "measurable storm event. "
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The
previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply
if the permittee is able to document that a shorter interval is representative for local storm events during the
sampling period, and the perm ittee obtains approval from the local DEMLR Regional Office.
By this signature, I certifx that this report is accurate and complete to the best of my knowledge:
(Signature of Permi e or Designee)
l.Outfall Description:
Outfall No. C��g Structure ipe ditch, etc.):
Receiving Stream: Unnamed tributary of Carrs Creek
Describe the industrial activities that occur within the outfall drainage area: _Transportation, Storage,
Manufacturing
2.Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint(light,
medium, dark) as descriptors: 15 A.-/-
3.Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weakchlorine odor, etc.):
4.Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clearand 5 is
very cloudy:
1 2(034 5
5.Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
123C4)5
6.Suspended Solids: Choose the number which best describes the amount of suspended solids inthe
stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2C3) 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Ye
9. Is there evidence of erosion or deposition at the outfall. Ye b
10.Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.

Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report
Permit No.: NCG030000 or Certificate of Coverage No.: NCG030103
Facility Name: _Moen Incorporated
County: _Lee Phone No. _(919)258-3341
Inspector: 3-- Lew W ,,�
Date of Inspection: //.z, / i
Time of Inspection: oo Ww
Total Event Precipitation (inches): 0
A11 permits require qualitative monitoring to be performed during a "measurable storm event. "
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The
previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply
if the permittee is able to document that a shorter interval is representative for local storm events during the
sampling period, and the permittee obtains approval from the local DEMLR Regional Office.
By this signa re.I certify that thi§ jg�,port is accurate and complete to the best of my knowledge:
(Signat of Permittee or Designee)
l.Out all Description:
Outfall No. U 1Y Structure ipe ditch, etc.):
Receiving Stream: Unnamed tributary of Carrs Creek
Describe the industrial activities that occur within the outfall drainage area: _Transportation, Storage,
Manufacturing
2.Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint(light,
medium, dark) as descriptors: `Xl 7 :. 1'--
3.Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weakchlorine odor, etc.):
4.Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clearand 5 is
very cloudy:
12045
5.Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1C2)345
6.Suspended Solids: Choose the number which best describes the amount of suspended solids inthe
stormwater discharge, where 1 is no solids and 5 is extremely muddy:
126345
7. Is there any foam in the stormwater discharge? Yes 1�
8. Is there an oil sheen in the stormwater discharge? Yes®o
9. Is there evidence of erosion or deposition at the outfall? Yes o.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.

aP� ISM
��LABORATORIE3, INC.
Moen, Inc
John West
2609 Cox Mill Rd.
Sanford, NC 27330
NC Certification No. 402
Full -Service Analytical & NC Drinking Water Cart No. 37735
Environmental Solutions SC Certification No. 99012
Project: Stormwater
Project No.: Jan 2019
Lab Submittal Date: 01/29/2019
Prism Work Order: 9010420
Case Narrative
02/11 /2019
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
�1 I
Terri W. Cole
Project Manager
Data Qualifiers Key Reference:
Reviewed By Jackie Ziner For Terri W. Cole
Project Manager
BRL Below Reporting Limit
MDL Method Detection Limit
RPD Relative Percent Difference
* Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] -Toll Free Number: 1-800/529.6364 - Fax: [phone] Page 1 of 5

P
r hIRC Full -Service Anal ical &
I S M Environmental Solutions
✓ueoruronies, we
Sample Receipt Summary
02/11 /2019
Prism Work Order: 9010420
Client Sample ID Lab Sample ID Matrix Date/Time Sampled Date/Time Received
01
9010420-01 Water 01/24/19 7:50 01/29/19 12:50
Samples were received in good condition at 4.4 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] -Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 2 of 5

itP� RFwl-servloe AnalyticalLaboratory Report
a
f ip'n F� ISM Environmental Solutions 02/11/2019
Y IABORATORIF9, ING
Moen, Inc Project: Stormwater Client Sample ID: 01
Attn: John West Prism Sample ID: 9010420-01
2609 Cox Mill Rd. Project No.: Jan 2019 Prism Work Order: 9010420
Sanford, NC 27330 Sample Matrix: Water Time Collected: 01/24/19 07:50
Time Submitted: 01/29/19 12:50
Parameter Result
Units
Report
MDL Dilution
Method Analysis Analyst
Batch
Limit
Factor
Date/Time
ID
General Chemistry Parameters
Oil & Grease (HEM) BRL
mg/L
5.0
1.4 1
*1664B 2/7/19 8:48 SLS
P960114
Total Suspended Solids 3.1
mg/L
2.5
0.40 1
*SM2540 D 1131/19 15:55 CBM
1391910015
Total Metals
Copper 0.010 mg/L 0.0050 0.00012 1 *200.8 2/4/19 20:14 JAB P9B0034
Lead BRL mg/L 0.0010 0.00013 1 *200.8 2/4/19 20:14 JAB P9130034
Zinc 0.083 mg/L 0.010 0.0012 1 *200.8 2/4/19 20:14 JAB P91130034
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 3 of 5

Sample Extraction Data
Prep Method: 200.8
Lab Number Batch Initial Final Date/Time
9010420-01 P980034 50 mL 50 mL 02/04/19 8:40
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] -Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 4 of 5

Full -Service Analytical &
j RISMI Environmental Solutions
iAaOnATORIES, INC.
449 Springbrook Road • Charlotte, NC 28217
Phone [phone] Fax: [phone]
Client Company Name:. e�99C9e_H •-� 4
Report To/Contact Name: '!!tJc 5
Reporting Address: Q1 C9, . , ` •
' c- -2
CHAIN OF CUSTODY RECORD
PAGE OF I QUOTED TO ENSURE NWPER BILLING:
Project Name: ja' : 'Zo I / STolLnt:J� 't✓
Short Hold Analysis: (Yes) (No) UST Project: (Yes) (NO)
'Please ATTACH any project specific reporting (QC LEVEL 111111 IV)
provisions and/or QC Requirements
Invoice To:
Address:
Samples INTACT upon arrival?
Received ON WET ICE?
PROPER PRESERVATIVES indicated?
Received WITHIN HOLDING TIMES?
CUSTODY SEALS INTACT?
VOLATILES rec'd W/OUT HEADSPACE?
PROPER CONTAINERS used?
0 N/A LO
O
yCDy 0
PhontYf17-1�8-3._W Fax (Yes) (Norsz24C
Purchase Order NoMiUing Reference
Email Address -- i w cs'�`(ae1-+ .. Cosh Requested Due Date ❑ 1 Day ❑ 2 Days ❑ 3 Days ❑ 4 Days ❑ 5 Days
EDD Type: PDF ✓E�cel_Other _ "Working Days" ❑ 6-9 Days ❑ Standard 10 days ❑ ��p� Must Be
Site Location Name: Samples received after 14:00 will be processed next business day.
_
TO BE FILLED IN BY CLIENTISAMPLING PERSONNEL
Certification: NELAC DOD FL NC
SC OTHER NIA
Site Location Physical Address: Turnaround time is based on business days, excluding weekends and holidays.
(SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT)
Water Chlorinated: YES_ NO_
Sample Iced Upon Collection: YES NO,
CLIENT
SAMPLE DESCRIPTION
DATE
COLLECTED
TIME
COLLECTED
MILITARY
HOURS
MATRIX
(SOIL,
WATER OR
SLUDGE)
SAMPLE CONTAINER
PRESERVA-
TIMES
ANALYSIS REQUESTED
REMARKS
/ /
PRISM
LAB
ID NO.
*TYPE
SEE BELOW
NO.
SIZE
oW66
W_
G
I z
0—
of
I
I hw
I
la_.
I/oly
I
I
i
I
l
Sampler's Signature az�tSampled By (Print Name), Affiliation,.
Upon relinquishing, thi hain of Custody is your authorization for Prism to proceed with the analyses as requested above. Any changes must be PRISM USE ONLY
submitted in writing 3plhe Prism Project Manager. There will be charges for any changes after analyses have been initialized.
Relinqu shed 8y (S[gna of Received
txas'
By: (Signature) Date I Additional Comments: Site Arrival Time:
lmquishe By. (S�gnature) Received By. (Signature) Data She Departure Time:
Relinquished By: (Signatu A
edf r Prism Laboratories By: Dam Field Tech Fee:
L Z=5 V 2 1 j Mileage:
Method of Shipment NOTE: ALL SAMPLE COOLERS SHOULD BE TAPED SHUT WITH
ICUSTODY SEALS FOR TRANSPORTATION TO THE LABORATORY COc Group Ito. iT
SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST CDC UNTIL RECEIVED AT THE LABORATORY.
O Fed Et O UPS O Hand -delivered O Prism Feld Service 0 Other.
GKOLINUWA
NU
UMO
a NC ❑ SC o NC ❑ SC I o NC ❑ C�K I
❑❑ NC I❑ SCAIEK: I 0 NC ❑ SC I ❑❑ NC ❑ SC I ❑❑ NC ❑ SC I O❑ NNCr❑ SC) El
❑ SC
*CONTAINER TYPE CODES: A = Amber C = Clear G= Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space)
ORIGINAL

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted 5/20/19
CERTIFICATE OF COVERAGE NO. NCG03 0 1 0 3
FACILITY NAME Moen Incorporated
COUNTY Lee
PERSON COLLECTING SAMPLES John West
LABORATORY Prism Lab Cert. # 402
Comments on sample collection or analysis:
1 Zti i9
FILEZ
Part A: Stormwater Benchmarks and Monitoring ResultsVy!?�
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ® Jan -June ® July -Dec
or Monthly'_ F- ri (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
❑■ Other C
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
pH,
Standard units
Total Copper
Total Lead
Total Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organics5
Benchmarks
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.010 mg/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
00552
78141
01
02/20/19
0.14
4.8
6.9
0.012
0.0018
0.078
<5.0
NA
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Chris Gundler
Name (Print name)
Plant Manager
P
Title (Prin'tltitle) `
Signature Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall, amount,
Inches'
New Motor Oil or
Hydraulic Oil Usage
'Non -Polar O&G/ Total
Petroleum Hydrocarbons
Total Suspended
_ Solids
Benchmarks
_
-
-
15 mg/L .
100 mg/L or"50 mg/0
Parameter Code
- ,
46529
NCOIL
00552
C0530_
Footnotes from Part A also apply to Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3

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 r7
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES [] NO
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware�t tJ�iere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee
Permit Date: 11/1/2018-05/31/2021
5//(00
Date
SWU-245, last revised 11/1/2018
Page 3 of 3

Storm Water Discharge ®utfall
Qualitative Monitoring Report
(To be completed during a rainfall.)
For: Moen Incorporated, 2609 Cox Mill Road, Sanford, NC 27332 [phone]
Certificate of Coverage No.: NCG030103 Receiving Stream: Trib. Of Carrs Creek
Time: Ins ector: Date: o? �D i �.��5 �6v
P V �H �V r
Weather Conditions: A. ,'�, , L D, i �f
By this signature, I certify that this report is accurate and complete to the best of my
Knowledge:
ZZ
Inspector
Outfall Number
1
2
3
4
Color: Describe the color of the discharge using basic colors
(,14041
(red, blue, brown, etc. and tint (light, medium, dark) as
Write "None"
f«l
Cat et
5
1-e-
descriptors. if no color is present.
,A)k,
Odor: Describe any distinct odors that the discharge may
have (i.e., smells strongly of oil, weak chlorine odor, etc.).
AJdfVZ
AlollcG
06,,ke
Write "None" is no odor is present.
Clarity: Choose the number which best describes the clarity
the discharge 1 is 10 is
3
of where clear and very cloudy.
--
Floating Solids: Choose the number which best describes
the amount of floating solids in the stormwater discharge
where 1 is no solids and 10 is the surface covered in floating
solids.
Suspended Solids: Choose the number which best
describes the amount of suspended solids in the stormwater
discharge where 1 is no solids and 10 is extremely muddy.
Foam: Is there any foam in the stormwater discharge? YES
NO
Alr,
Ad
or
Oil Sheen: Is there an oil sheen in the stormwater discharge?
YES NO
�D
/�,/
Al/V
/
" �
or
v
/
Other Obvious Indicators of Stormwater Pollution: YES or
NO. "YES," list the describe below.
,,
A)0
A)v
/U
lVo
If outfall number and
•
rAC �
v
i a,l
Comments: '
Note: Low clarity, high solids, and/or the presence of foam or oil sheens may be indicative of pollutant
exposures. These conditions must be reported to the Environmental Coordinator and warrant further
investigation.

tr ISM
LABORATORIES, ING
Moen, Inc
John West
2609 Cox Mill Rd.
Sanford, NC 27330
NC Certification No. 402
Full -Service Analytical & NC Drinking Water Cart No. 37735
Environmental Solutions SC Certification No. 99012
Project: Stormwater
Project No.: Feb 19
Lab Submittal Date: 02/22/2019
Prism Work Order: 9020389
Case Narrative
03/06/2019
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
Terri W. Cole
Project Manager
Data Qualifiers Key Reference:
Reviewed By Jackie Ziner For Terri W. Cole
Project Manager
BRL Below Reporting Limit
MDL Method Detection Limit
RPD Relative Percent Difference
* Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] -Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 1 of 5

&AC11n1PU3iqM
Full -Service Analytical &
Environmental Solutions
Sample Receipt Summary
03/06/2019
Prism Work Order: 9020389
Client Sample ID Lab Sample ID Matrix Date/Time Sampled Date/Time Received
01 9020389-01 Water 02/20/19 13:45 02/22/19 14:00
Samples were received in good condition at 5.2 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 2 of 5

Laboratory Report
I` n Pull -Service Analytical 9
izjmo�41�
-.=-s J'v' Environmental Solutions 03/06/2019
J LABORATORIES INC
Moen, Inc Project: Stormwater Client Sample ID: 01
Attn: John West Prism Sample ID: 9020389-01
2609 Cox Mill Rd. Project No.: Feb 19 Prism Work Order: 9020389
Sanford, NC 27330 Sample Matrix: Water Time Collected: 02/20/19 13:45
Time Submitted: 02/22/19 14:00
Parameter Result
Units
Report
MDL Dilution
Method Analysis Analyst
Batch
Limit
Factor
DateMme
ID
General Chemistry Parameters
Oil & Grease (HEM) BRL
mg/L
5.0
1.4 1
*1664B 3/5/19 9:22 SLS
P9C0077
Total Suspended Solids 4.8
mg/L
2.5
0.40 1
*SM2540 D 2/26/19 16:02 CBM
P980501
Total Metals
Copper 0.012 mg/L 0.0050 0.00012 1 *200.8 2126/19 16:12 JAB PgB0475
Lead 0.0018 mg/L 0.0010 0.00013 1 *200.8 2/26/19 16:12 JAB P9B0475
Zinc 0.078 mg/L 0.010 0.0012 1 *200.8 2126/19 16:12 JAB P9B0475
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 3 of 5

Prep Method: 200.8
Lab Number Batch
9020389-01 P9130475
Initial
50 mL
Sample Extraction Data
Final DateTme
50 mL 02/26/19 7:40
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] -Toll Free Number: 1-800/529-6364 - Fax: [phone] Page 4 of 5

•
Full -Service Analytical 8 CHAIN OF CUSTODY RECORD
IS M Environmental Solutions PAGE OF /— QUOTE 0 TO ENSURE PROPER eILLING: Samples INTACT upon arrival?
'. `LABORATORIES. INQ
449 Springbrook Road Charlotte, NC 28217 Project Name: - .S/rrJrya / Ii' %e�Ei ! / Received ON WET ICE?
Phone [phone] Fax: [phone] Short Hold Analysis: (Yes) (No) UST Project: (Yes) (NO) PROPER PRESERVATIVES indicated?
*Please ATTACH any project specific reporting (QC LEVEL 1 II 111 IV) Received WITHIN HOLDING TIMES?
Client Company Name: ���1�� �✓ltG' provisions and/or QC Requirements CUSTODY SEALSiNTgCT?
Invoice To:
Report To/Contact Name: ``�-lil/ VOLATILES read W/OUT HEADSPACE?
_ -- z -. --
Reporting Address: Address: PROPERZONTAINERSused?.
� � = ,...
TEMP:_Thenn (Or)°2t I;
3 :Observe
YES NO N/A
�a �O
..►�- in
N
Cis
Phone( y -Z—'- 4 Z Fax`(Yes) (No . 5/ ��iF-f�.27/ _ _ _ _
Purchase Order No./Billing Reference
TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL
Email Address:, , iw �s f�: ;.. ✓H. c�.¢.r-„ Requested Due Date ❑ 1 Day O 2 Days O 3 Days El Days ❑ 5 Days
Certification: NELAC DaD FL NC
uWorMust Be
EDD Type: PDF�t:eL_Other "Working Days" ❑ 6-9 Days (3 Standard 10 days O Rush
v
Pre-Approved
Site Location Name:. Samples received after 14:00 will be processed next business day.
SC OTHER N/A
Site Location Physical Address: Turnaround time is based on business days, excluding weekends and holidays.
Water Chlorinate&YES_ NO
(SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT)
Sample Iced Upon. Collection: YES_ NO
CLIENT
DATE
TIME
COLLECTED
MATRIX
(SOIL,'
SAMPLE CONTAINER
PRESERVA-
ANALYSIS'REQUESTEO
/ f
PRISM
*TYPE
NO.
I SIZE
SAMPLE DESCRIPTION
COLLECTED
MILITARY
WATER OR
TIMES
REMARKS
LAB
ID NO.
HOURS
SLUDGE)
SEE BELOW
I Ile�.
-I
f Ia.
C
i
i
Sampler's Signature d By (Print Name) Affiliation
Upon relinquishing, this Sin of Custody is your authorization for Prism to proceed with the analyses as requested above. Any changes must be PRISM- USE ONLY
submitted in writing a Prism Project Manager. There will be charges for any changes after analyses have been initialized.
ReMqUiShed By: (Fignature) Received By. (Signature) Date m1utOryll'icum Additional Comments: Site Arrival Time:
Relinquished Sr. (Sirmure) Received By. (Signature) - - Date Site Departure Time:
Field Tech Fee:
Relinquished By: (Signature) Received For Prism Date-U-1
q
1 Mileage:
fetethod of -Shipment NOTE: ALL SAMPLE COOLERS SHOULD BE TAPED. SHUT WITHIjCUSTODY SEALS FOR TPJWSPORTATION THE 0MORA R . mupNo_ - - - -
T _
SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST CDC UNTIL RECEIVED AT TH LABORATORY.
�} if f
ed Et O UPS O Hand-derrvered ❑ Prism Field Service O Other 01, 3
DES: UST: -GROUNDWATER: DRINKING WATER: I SOLID WASTE: RCRA-. CERCLA LANDFILL OTHER:
UNC❑SC11 I UNC ❑SC I UNC ❑SC oNC ❑SC ! 0NC ❑SC I ANC❑SC� ANC ❑SC LINC ❑SCI ONC OSC
*CONTAINER TYPE CODES: A = Amber C = Clear G= Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) ORIGINAL