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HomeMy WebLinkAboutNCG060030_MONITORING INFO_20181203STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE ❑HISTORICAL FILE 1�, MONITORING REPORTS DOC DATE ❑ � � f ° 1 � � � YYYYM M D D Baxter November 21, 2018 Division of Water Quality Attn: Central Files RECEIVED /CC� 1617 Mail Service Center C. Raleigh, NC 27699-1617 DEC 0 3 2018 RE: Certificate of Coverage No. NCG060030 CENTRAL FILES Year 6 — Period 2 DWR SECTION Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation Enclosed is the semiannual SDO monitoring report as required by the General Stormwater Permit NCG060030, Part II, Section B. Sample values at all outfalls were observed below benchmark limits. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Corey Carpentier at 828-756-6636. 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. Sincerely, Corey Carpentier EHS Enclosures: Semiannual DMR (Original and one Copy) Baxter Healthcare Corporation PO Box 1390 Marion. NC 28752 T 828.756.4151 NO MW Storniw ' ater Discharge Outfall (SDO) Qualitative Monitoring Report. For, guidance on filling out this form, filiase risiiJi Permit No.: tj LQ!_ Facility Name: County: Inspector: Date of inspection; Time of Inspection Total tvent precipitation (inches) - Was this a-Repies.ehtative 8tortri-Event? (See inforinaflo . n below) & Yes 0 No Please check your permit to verify fQualit4tiveUonitoiing must be performe d during a representative stonn evenf(re4tdrements vary)., A 'RepresentatiVe Storm Evdnl" is a storm event that measures. greater than 0.1 iriches'of rainfall and that is preceded by at-ic.as.1,72 hours.(3 days) in which fib.storin cyent-ineasuring greater than..0"A inchesbas, POLiffed. A single storm Event ri*ycontain up.to-ibconsecui ve.Flours of,jioprec ipitation, By this signature, I certify that this rtpbrt is accurate and complete to the best,of my knowledge: (Signature ,ofYeriWi_ttee'or 1. Outfall Description. Ouffall No. ICL� 1. Structure (Pipe, ditch, etc.-) L Receiving Stneam: I Describe the industrial activities that occur with_ in the outfall dz*n�age.Wa: I Color: Describe the color of the (light, medi'Umi dark), as'descriPtors: _-LI usingbasic colors (red, brown, blue, etc.) -and tint 3. , -Odor: Describe any distinct odors that the'discharge may have (i.e., smells strongly ofoil, weak chlorine odor, etc.)',, _Wo 6bQ P_ Page I of 5WU-242-201206 I 3 4. Clarity: Choose the number which best describes the clatity of the discharge, where I is cle3i and 5 is-vuyclo4dy- 0 2 3 4 5 5. Floating golli6i Choose the number 'Which best describes the amount of floating solids in.the ston-n,water dikhaTgej where I is no solids and 5 is the surface coveted With flokink solids' 2 3 4 G. -Suspended Solids: Choose the number which ,best describes the mount of suspended solids in the stormWiter di'sc*ge, where I is no solids and 5 is extremely muddy: (D .2 3 4 5- 7. Is there any team in the s1.QrmmTq.ter:discharg6? Yes 3N S. Is there an '01-1 sheeii in the ston.­6Water discharge? Yes No % 'Is there evidence of erosion oi'dep6sifi.dn at the outfal I? Yes. 10. Other Obvious ifid"Wrs of-StOmwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam; oil sheen,. or erosion/deposition m­ moray be indicative of poMitant exposure. Th&e conditions warrant further invesftation. Page 2 of 2 SWU-242-20120613 SEMI-ANNUAl.STORMWATERDISCHARGE .MONITORING REPORT for, North- Carolina DiVislon of Water a ality General Permit No..N'CG060000 Date submitted 0 CERTIFICATE OF COVERAGE NO.WCG06 0 () 10 FACILITY. -NAME A COUNTY O PERSONLCOLLECTING SAMPLES LABORATORY N7E r. WM16j4,,CT- QW3 Lab Cert., # 4T\C.E �NWP N! \�A 1 40 Part A:. Stormwater.Benchmarks,and Manitarinit Results SAMPLE COLLECTION'YEAR 20 FACILITY.ACTIVMIIES INCLUDE~ (check all that,apply): Q use/process-meats ❑ use animal ats/byproducts DI5CHARGING,TOSALTWATERS? AYES [2]NO- PLEASE- REMEMBER10 SIGN ON THE REVERSE 3 Total event rainfall'? 2 or .❑ No discharge, this peftd3 Outfall No. Sample Collected, nrio/ed/yr TSS, mg/L pH, standard units - COD,.. mg/L Oil and Grease, mg/L Fecal Caiiform , Coloriies,per 160 rhi tnteracocci , Colonies per, 100:ml . . Benchmark :10Q,or56 J' Withlh'64=;9:0 120 30 10D0 SOe to 2 2 , ,`i 3 c < ' Only applies to,facilities that use/process meats.. ZThe total precipitation must be recorded using data from an an-site.rain gauge. G) NO T rJ 3' For sampling periods with no discharge of any outWls: You must still submit this disch_arge;rrionitoring report with a checkmarkhefe. -4See General Permit text, Table 3, identifying the especially sensitive. receiving water>"classifications-where the more protective benchmark applies. -Did this facility perform Vehicie•Malhtenance Activities using more than 551allons'of new motor oil per month? o yes (3/no Des complete Part.B) Part'B:.Vehicle.Maintenance:Area,MonitoririR.Results:.oniv for facilitiesaveraeine>'SS tal-of new motor oil/month: .Outfall No: 'Sample Collected, mo/dd/ r Oil an'd Grease_, _ rhg/L, TSS,. ' �OrOL pH, .Standard'units. New MotorOlItUsage, 'Annual'average 'I/ino .Benchmark - •30 100 0c,50 ' Only applies to facilities that us_e/process meats: The'total precipitation must be recorded using data from an ran -site rain gauge. 3 For sampling;periods with no discharge atany outfalls, you must still submit this.disdiarge monitoring repomwlth,a checkmark here. 'See General Permit text; Table 3, identifying the especially sensitive receiving water-classill6tions. Where the -more protective benchmark applies. SWU=249 Last Revised: October I$: 2012 Page I -of 2 *FOR PART A AND PART B-MONITORING;RESULTS: A,BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS'. SEE:PERMIT PART II,SECTIQN='8. • 2 fXCEEDANCE5 IN A ROW FOR THE SAME PARAMETER AT THE SAME�OUTFALL TRIGGER'TIER 2•REQUIREMENTS SEE PERMIT PART II:SECTION a 6 TIER 3: 'HASYOUR FAGIL'ITY HAD 4 ORVORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES- O NO'y IF YES, HAVE YOU CONTACTED TF1E DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an orldinal anffonexoov of this DMR.'includhe all Vo Discharge'." reports within 30 days.nf recelat of theYab results:for at,end of monitorinayefiod'in the case.af No Discharge"reports, to: Division -of Water.Quallty Attn: DWQ Centraffiles ,1617 Mail Service -Center Raleigh, NC: 27699-1617. . "I certify; under,penalty,of.law, that this,docurrient 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 foregathering the'Information, the information submitted; is, to the, best of my:knowledge;and, belief, true, accurate,.and complete. I am aware thatthere-:are sigh ificant,pen alties foe. submitting false information, Including the possibility of fines and imprisonment,for knowing violations. (Signature df.�Permittee) to Z 1 -(pate). ► I i ( i, x NrKR RCc4; PT eF o;{ d- G.KF\(C @zrLjis . Additional,copies of this form -may be downloaded.at:-http://portaizficdenr:Qrg/iNeb wg/ws/su/`npdessw#tab-4• +►jI`1!1$ MU-249 Last Revised: October 18, 2412 'Oage2 of2 NCDENR StorWwater Discharge, Outfafl. (SD®) Qualitative Monitoring Roport For, guidance on filling out this farm, pliase visit: hup' Permit No.: -NICI Facility Name: County: Inspector:. Date of inspection: Time of Inspection: 05 so tl Total Evdnt,Precipitation (inches)- 'L Was this a-Represefitative Storm Event? (See information helow) E(Yes El No .Please check your permit to verify i f Qualitative Monitoring Must be performed during a repreientarive jtdnn event (re'quirethents vary), A 'Represdntative Storm Event" is a storm event that measures.greater than O.A iriches ot. rainfall and that is preceded by at ie'a*st.'7'2 hours.(3 days) in which no storm event, measuring greater than.6. Finches has ,occurred. A single storm event rhj'a-y' contain up to J 0 consecuiive hours 6f.A;D precipitation. I$y this signature, I cer�fy that this report is accurate and complete to the best -of my knowled&.- (Signature -6f Perrnittee'or besi& A. Outfall Description: Outfall No.S�Structure (pipe, ditch, etc-) Receiving Stii&am: ��Fl- R�_ (_E\-TN(,jt, 7, Descri6e the industrial activities that occur withinthe outflall draiRagc.ar.ex _WcN- %ij N AE, (L- 2. Color: Describe the color of the (light, Medium, dark) as'desbrilptors: EL using basic colors (red, brown, blue, etc.) -and tint 3. Odor. Describe any distinct odors that the discharge may have (i.e;, smells strongly of -oil, weak chlorine odor, etc.): 0 qt Page I of 2 SWU-242-20120 B 4. Clarity: Choose the number which best &scribes the clarity of the di.wharge,whae I is ckat and 5 is-vay.clo4dy'. 5. Floating Solids: Choose the number which best describes the amount of floating solids in the storm,watpr &6haTge, where I is no solids and 5 is the surfaibe covered With flokin solids- O 23 4 Suspended S61ids: Choose the number wbi&h best describes the amount of suspended :solids in . the ston-nWiter'dikeharge, where I is no solids and 5 is extremely muddy: 4 5- 7. Is there any fbarn in the stormWaterdikharge? Yes Na 8. Is there an 61 sheen in the stortnWater discharge? oil Yes No 9; Is there 6vidence of erosion oi'deposition at the outfall? Yes, 10. Other Obvious lilditators of-StOrniwater Pollution: List and describe Note: Low clarity,, high'soli6, and/or the presence of fom-, oil sheen, -or erosjen/4eposltibn may be indicative of pollutant �exposure. These conditioM warrant further investigatiop. Page 2 of 2 5WU-242-20120613 SEMI-ANNUAL STORMWATER:01SCHARGE.MONITORING REPORT for. North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF C VERAGE NO. NCGO66 0 3 0 FACILITY'NAME _ L COUNTY E PERSON. COLLECTING 'SAMPLES r LA80RAT0RY_WSC N L &-LL -r, 6f& Lab Cert: # R M Part -A: Stormwater. Benchmarks. and Monitorine Results SAMPLE COLLECTION YEAR 2 ( 4 i. FACiL1TY.ACTIVITIIES IN CLUD E'Icheck all. that -apply); -use/process meats ❑ use animal. is/byproducts DISCHARGING TO SALTWATERS7 QYES 10 PLEASE REMEMBER -TO SiGN ON THE REVERSE 4 U Total event rainfall z 2 or :n No discharge this period' •Otltfall No. Sample.611eoid, mo/dd/yr Tss,. mg/L pH,. :standard units COO, • mg/L 01[and Grease, mg/L Fecal C61Iform , Colonies: er 100 ml fnterocotcl , Colonies per lap ml_ Benchrnaek AdoQr5o .. Wlthlji'6i0-9.0 126 30 -1000 - Sao 'Only applies to1adlities that use/process meats. i zThe total precipitation must be recorded using.data.from anon-site.rafn gauge. K E o . S , For, sampling periods with no dikharge atan outfalls: You must still submit thfs discharge;rrionitodrig repnrtwith a checkmark'here: °See General Permit text, Table 3, identifying the especially sensitive•receiving water'classifications,where the more protective' benchmark applie . Dtd this facility perform Vehicle Maintenance Activities using more than•55•gailonsofnew matoroi! per rnonth� [] yes if es complete Part -By Part:B: Vehicle..Maintenance:Area-Monitoring. Res ults:. only for facilities averaging>.55 gal'of new motor oil/month: .Outfall Nb: 'sample Coilected, mo/dd/ r. 011 and'.Grease, - -•mg/L TSS,• ritsgl pH, .5taridbrd-units_ New Motor Oil Usage, `Annual aeveragI/mo Benchmark _ t30 100 of.150° 6.0 -- 9.0, - ' 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.wlth no discharge at-ppat-ppA outfalls, you must still submit this:disth6rge monitoring report,withia checkmark here. 4See General Permit text.'Table 3, identifying the especially sensitive receiving water•classifi:ations where the more protective:benchmark applies. S WU-249 Last Revised' October 18. 2012 Page Lof 2 *FOR.PART A AND:PART &MONITORINGAESULTS: A'BENCHMARK EXCEEDANCE TAIGGEIRS .TIER l REQUIREMENTS. SEETERMIT PART II;SECTION`•B. + 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE.SAME�OUTFALL TRIGGER'TIER 2-REQUIREMENTS. SEE PERMIT PART WSECfION. . TIER-3: HAS'YOUR FACILITY HAD 4 OR°WIORE BENCHMARK-EXCEEDENCES FOR THE SAME PARAMETER AT'ANY,ONE OUTFALL? YES ❑ NO' IF YES, HAVE YOU CONTACTED,TE DWQ REGIONAL OFFICE? YES ❑'NO ❑ .REGIONAL OFFICE CONTACT NAME: Mail an on inal'and one copV of thfs-DWIncluding j all "No Discha e" me arts :within 30'dim,of reogl t o . theaab.results. for at end a monitorinmeeriyd_in the_mse.of "No Discharge"'reortsl to: Division -of Water:.Quality Attn:- D.WQ Central Files ;1617 Mail Service,Center Raleigh,.NC 2760-1617 YOU -MUST SIGN THIS: CERTIFICATION FOR ANYMFORMATION.REPQRTLm: f certify; under,penalty.of.law; that this.docunyient and all attachments were prepared:urider my direction or supervision -in accordance with a system designed td assure that qualified personnel'properly gather and evaluate'the-information submitted': Sased.on my inquiry:oUthe person -or persons who -manage the. system,,orthose,persons, directly:responsible forgathering-the;informatiort,the information submitted -is, to the,best of myknowledge,and belief, true, accurate,•and complete. I1am aware that•there�are sigrilficant,penalties for submitting false information, Including the possibility of -fines and imprisonment -for knowing violations. (SignaW i � S -(Date) ii�rq�I�{ nrTEP_ RCCE. P i ,r o1JTS , Additional,copies of this form -maybe downloaded.at.-http://Portai;nc-denr.:arg/web Wq/wslsu/` npdessw#tab-4- � I11li I I� SWU-249 Last Revised: October 18, 2012 'Page-2 oft NCDENR StoribWaier Discharge Outfaff,(SDQ) Qualitative Monitori,ng Report. 'ror guidance 'nit f!ilirigout iltisf&rtn,,plioses.lisii: ,Permit Na.: fjl6l orCertificate.ofCoverage Ni).,: N/CIG/O/_6/0/0?3/D/' 17-4dity Name: County: __ Mc Phon,6,: In ' skctor.. Dat�e, bf lrfs-p6c tion: I ­2_I% TiineofInspection: 09;3_- it "Total Event fte6oitatloq (inches) -. Was this a,Repres.efitative Storm EvenO (See information bi06W) No Please check yvttr permit io.'verify fMo nitoring itofin§ trifist be performed -during a re&esehraliiii: . Stann event (reqidre?hei!q vary.),, A "Representative Storm tVent' , is a storm eventthat measur _s.grqater than 01 irichesb('hd;hftLll and that is-,prieccded by -at least 72 fiours.,( days) in wfiIch,fi6,s[6rrn event. measuring greater than.6, Finches has, occurred. A,ginglel-stormdventibaycontaitiup.to,ideo'nsecuiivehoutsof.rfopre'eipiWtio'n., By this signature, i certify that this jr&p6rt is accurAte-and coinplcte to the be-srof my kn6wie-d&% (Signature�R. PermitteebrOeQn6c 1. (jd(fail'0escflpIi4n:, St 0 fal I No: P. Structure (pipe,ditchjetc,,) me?_A(.r U)T bpA� Receivitig Sti-&dm: tj Oq_IH r� Describe the industrial activities that occur within the 6utfall drainage area: TM 2., C61or: Describe the.color of Ifie di (light; Medi'um,.dark),,asdescriptors:. N using basic:colots (red, brbwn, bILIC; etc;)-apd tint 3. OdR-'r: Des.O.b& any -distinct 6dors.that the"discharge-may hpve (i.e:.; smells -strongly pfoil, weak- chlorine'odor, No Page I oft 'SWIJ-242-201'66l3 4. Clarity: Choose the number wfii6 best.describes tfie clarity of the discharge „ where ;I is clear and 5 i_s'very,cloudy: l 3 4 5 5:. Floating Solids: Choose the number which best describe's the amount of Iloating':solids in4}ie stonnwater discharge; where I is no -solids -and 5 is the. surface.covcred with floating solids: ID2 3 I41 5 G. -Suspended Solids: Choose the number which best describes the anioiint.of suspended solids -in ifi6,stormw4tee dikh:irge. where 1 is no solids and 5 is extremely muddy: I C) :3 4 5,1 7. Wthere any foam in tfie stQrmwater discharge? Yes No. fl. Js there an oil sheen in�the storniwater discharge?' Yes NQ 9. 'ls there evidence of erosion or'depositiori-at the outfal I? Yes, No 10:: Qther-Obvious Indicators of St6rmwater Pollution: Lisi and describe' Note: %.ow clarity,; high solids, and/or the presence of foam; oil'sheen,,or erosioii/depositiomiriay- be indicative of pollutant ixposure. These conditions warrant: further investigation. Page.2 of 2 9WU-242 0126613 SEMI=ANNUAL.STORMWATER,DISCHARGE MONITORING REPORT for,North' Carolina Division of Water Q ali y General Permit No. NCG060000 Date submitted.. - CERTIFICATE OF COVERAGE NO.:NCG06 0.0 3 Ca SAMPLE COLLECTION'YEAR 2y iq, !FACILITY NAME _ FACILITYACTiVITIESJNCLUDE-(ch'eck all that apply): COUNTY �_'�c B(,z.1E-1 i ❑'use/process meats [] use animal_fats/byproducts PERSON COLLECTING SAMPLES DISCHARGINGTO SALTWATERS?. []YES. [ZNO LABORATORY___ _ N_N Lab�Cert. $t f Part-A: Stormwater•Benchmarks and Monitoring. Results PLEASE REMEMBERrTO SIGN ON THE REVERSE 4 rl Total event roinfoll z or No dischdrge this period3 -0utfali No. 'Sample Collected_, mo/dd/yr TSS, mg/L pH,, Standard units • COD,, mg/L Oil'and Grease, _ nig/L. Fecal C61iform., Colonies per 100 ml Enterbcocci , . Colonies per-100:ml . . .Benchmark - .100_0r50 '­ Withln'6.0=9:0 .126 `m '1000 _ Soo �` 0113> -' Only applies to -facilities that use/process meats. 2.The total precipltatimmustbe recorded using datxfrom an on-site:raln gauge: -'"For sampling.periods with no.discharge at•aMoutfalls: You.niust still submit this discharge,rrionitoririg report with a checkmark here: '4See General Permit text; Table 3, identifying the especially sensitive receiving water.'Classifications.where the mare protective'benchmark' applies. ,laid this facility perform Vehicle,Maintenance.Activities using more than 55.gallons of new motor oil per month? Dyes [2/no Part'& Vehicle, Maintenance:Area,Monitorbig Results: only for. facilities. averaging? 55,gal'of new motor oil/month: ,Odtfall:No .. - ' 'Sari,ple Collected, mo/dd/ r Olfan'd'Grease, .-mg/L TSS; , mg/L PH, ..:Staridardunits_ I 'New Mofor 011Usage, Annual average 10I%mo :benchmark; - .30 100 oi_ 6.0:-'9.0, - Only applies to facilities that use/process.meatss 2The.total precipitation must be recorded using data from an on -site rain gauge. a For sampling periods:with no discharge at AM outfails, you must still,submit this.discharge monitoring report,with'a checkmark here., tee General Permit text; Table-3, identifying the, ,especially -sensitive receiving waterclassificatidns where themore protective' benchmark applies. if, es complete Part 6} 'SWU-249 (�u�Nr,in� E S+1srQi N{s No-f QE��1R�p �(ZUS`"� 5� Last Revised:: October I$:20.12' y Io1L611% Page l.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'R0W FOR THE SAME PARAMETER AT THE SAME,OUTFALL TRIGGER` 1ER 2-REQUIREMENTS..SEE PERMIT PART II:SECTION.B. • TIEkJ; HAS YOUR FACILITY HAD 4 OR`MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES• ❑ NO'[z IFYES, HAVE YOU CONTACTED THE DWQ'.REGIONAL OFFICE?' YES n NO Q REGIONAL' OFFICE CONTACT NAME: Mdi! an orici'inal'and one copV of ihis, DMR °including all VaDischar4e" reports; tvirhih_30_d6ys o[rereipt of thi Jab,results:for ac.end of monitoring,weriod'in the -case -of "No Discharge='reports}'tor Division,of Water,,QuaJity Attn: DWQ CentraL,Files 1.617 Mail Service -Center Raleigf ,.NC 27699-1617 '.1 certify; under;penalty:of,law� that this document and all attachments were prepared.untle� my directii3n ocsupervision in accordance With a system designedta assure that qualified personnel.properly-gather and evaluate the -,information submitted': Based. -on my inquiry-of:the: ..person or persons,who-manage the-system,,oir-those persons.directly.responsible. for gathering the'info rmation, 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 V!61l tions:` (Signature of.P.ermittee) 2 ] ,(Date)i Additional copies of this form may be downloaded:at: http:lluortal:ncdenr.:6re weh/virc /" ws/su" nodesswOtab-4• SWU?49 Last Revised: Oeiober 18, 2012 'Pagc-2 oft Baxter May 23, 2018 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Certificate of Coverage No. NCG060030 Year 6 — Period 1 Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation Enclosed is the semiannual SDO monitoring report as required by the General Stormwater Permit NCG060030, Part 11, Section B. Sample values at STOI and STO2 for TSS were observed to be above benchmark limits. A Tier I response was performed with details recorded in the facility SPPP. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Corey Carpentier at 828-756-6636. 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. Sincerel , Corey Carpentier EHS Enclosures: Semiannual DMR (Original and one Copy) RF—:C1��D MAY 3 b 2018 CENTRAL FILE CVI/R SECTS ION. Baxter Healthcare Corporation Po Box 1390 Marion, NC 28752 T 828,756.4151 NCDENR Stormwater Discharge Outfall (SDQ) Qualitative Monitoring Report For guidance on filling orrt thisform, please visit: httn://pt.rru,i.nrdcnr.nr�Jwct�/«<y/wsl.� /npcless�#iah=t Permit No.: NICIGI 01 610/ 0 /0/ O/ or Certificate. of Coverage No.: NICIGI C)16 /0/0l ld l Facility Name: CA County: Phone No. Inspector:. Date of inspection: Time of Inspection: n,t Total Event Precipitation (inches):. J Was this a Representative Storm Event? (See information below) [( Yes ❑ No Please check your permit to verify if Qualitative Monitoring must be perfonned during. a representative storm event (reguirerirentc vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event, measuring greater than 0.1 inches has. occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge:. (Signature of Perm(ke or Designee) 1. Outfall Description: Outfall No. STD Structure Receiving Stream: , ditch; etc.) ^PiL>(, Describe the industrial activities that occur within the outfall drainage area: kF..C_-C.,'i 1NLr bo � Lo�O�N La 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: rRt�wN�K C a�ntz_ l.a,�N `I 1.._., 3. Odor: Describe any distinct odors.that the discharge may have (i.e.,. smells strongly of oil, weak chlorine -odor, etc,): tom} (}1,1 L Page I of 2 'S W U-242-20! 206 t3 4. Clarity: Choose the number which hest describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 O 4 5 -----------5.-----Fioating-Solids:-Choose-the-number which -best -describes the-am"aunl of nutting solids in the stormwater discharge, where I is no solids and 5 is the.surface covered with floating solids: I 2 3 4 5 G. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 2 3 G4 5 7. is there any foam in the stormwater discharge? Yes S. Is there an oil sheen in the stormwater discharge? Yes No 4. 'Is there evidence of erosion or deposition at the outfall? Yes; (3 10.. Other Obvious Indicators of Stbrmwaler Pollution: List and describe �i� L 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. Page 2 of 2 5WU-242 _012}613 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water qua ity General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO.,NCGR60 al. O FACILITY NAME F_ ti8 rJ COUNTY M c I PERSON COLLECTING SAMPLES Qa[S+`.i As lL� LABORATORYR,p, -�CR Wt&l L Lab Cert. # Pe"(L ANC L'-4 I ; LD� 1 H o Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR ?_O I FACILITY.ACTIVITIE5 INCLUDE (check all that apply): 11 use/process meats ❑ use animal ats/byproducts DISCHARGING,TO SALTWATERS? []YES ENO PLEASE REMEMBER TO SIGN ON THE REVERSE -3 2 Total event rainfall 1 3 11or ❑ 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 C60form , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 5Q Within 6.0 — 9.0 120 30 1000 Soo 2 to PSN 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, 45ee General Permit text, Table 3, identifying the especially sensitive receiving water classificationswh ere the more protective'benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than SS,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/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Maim oil Usage, Annual average al/mo Benchmark - 30 100 or 501 6.0 — 9.0 - ' 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. Km complete Part B) SWU-249 last Revised: October 18, 2012 Page I of 2 *FOR PART A AND PART B MONITORING RESULTS: O 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 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 on final and one coof this DMR including all "Na Discharge reports within 30 days o recei t o the'lab results. for at end o monitoringperiod 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 ofthe 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) sl td I g (Date). Additional copies of this form may be downloaded at: http://portal;ncdenr:org/wei)/wq/ws/su/npdesswfttab-4 S W U-249 Last [devised: October 18, 2012 Page 2 of 2 � Ay WA ENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forgiddance on filling oui th sform, please visit' htttT/// urtal.ill'L1L'Fn'.INS_/NL'b�VIS IVtiI�LI�nF7CtCtiti4ti#lah t Permit No.: NIC1610161 Facility Name: -g County: _ n(Bc Inspector: Date of Inspection: Ol )/ or Certilicatc.of Coverage No.: NIC1G/QI b L0 /013 /0/ Phone No.. Time of Inspection: i d 3 0 Total Event Precipitation (inches):. Was this a Representative Storm Event? (See information below) dYes ❑ No Please check your permit to verify iMtf oring must he performed during a representative storm event (reguireMents vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours Q days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signaturehl certify that this report is accurate -and complete to the best of my knowledge: (Signature of Permittee 4 Designee) 1. Outfall Description: Outfall No. , 1e_ -2- Structure (pipe, ditch; etc.) P I 6 Receiving Stream: i,�ogjkj C6-jhWLa_ Describe the industrial activities that occur within the outfall drainage area: Rt& Lai -- 2. Colon: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: h)6Q 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _1l10nt Page I of 2 S W U-242-201'_()6 0 4. Clarity: Choose the number which best describes tfie clarity of the discharge, where .1 is clear and 5 is very cloudy: 1 O 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stonnwater discharge, where I is no solids and 5 is the surface covered with floating solids: I 3 4 5 G. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where l is no solids and 5 is extremely muddy: 1 (D 3 4 5 7. is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in -the stormwater discharge) Yes 9. 'Is there evidence of erosion o.e deposition at the outfall? Yes: 10. Other Obvious indicators of Stormwater Pollution: List and describe N4+k Note: Low clarity, high solids, and/or the presence of foam; oil sheen, or erosion/deposition'nay beindicative of pollutant exposure. These conditions warrant further investigation. Page 2 of Z S WU 242-2012 613 SEMI—ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Q al' y General Permit No. NCG060000 Date submitted Jr - CERTIFICATE OF COVERAGE NO. NCG06QQQsQ SAMPLE COLLECTION YEAR 2012 FACILITY NAME _ ��)[t[ �_ �¢��1(R� Cpg�O_ ,o FACILITY. ACTIVITIES INCLUDE (check ail that apply): COUNTY t l Cti )bW(_. i\ [] use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES N _ DISCHARGING,TO SALTWATERS? [-]YES E610 LABORATORY M A Lab Cert. #_ Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 t� Total event rainfall "3 or ❑ No discharge this period3 Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Celiform , Colonies per 100 mi Enterococcl , . Colonies per. 100 ml Benchmark - 100 or SO Within 6.0 - 9.0 120 30 1000 Soo ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. a For sampling periods with no discharge at a_,,,Y 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 2/no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfali No. Sample Collected,. mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor 011,Usage, Annual average gal/mo Benchmark - 30 100 or SO° 6.0 - 9.0, - if es complete Part Bj ' 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 and 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. Si0 �— S NOT Q tLPRC,SEniYP���l� Sir-�P11�G 51 iE '1<q-C.f0RE,On1 �''° Caw, I ITrw,4e, SWU-249 IE P P gS4+\J� f i 6'x r'iQ� 1 if?5{3 T -t�1C LoCq`i p,J Last Revised: October 18.2012 N� l Page I -of 2 41zJ311�6 ' *FOR.PART A AND PART B MONITORING. RESULTS: o A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION-B. O 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II -SECTION 0 TIER 3: HAS YOUR FACILITY HAD 4.ORWORE BENCHMARK EXCEEdENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑. NO IF YES, HAVE YOU CONTACTED THE OWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Dlschorae" reports; wi[hiri 30 days of receipt of theJab.results.lar at end of monitorina 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 ofthe 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) shda__ (Date). Additional copies of this form may be downloaded at: http:/Lpartal.ncdenr.ore/wel?Zwu/ws/sulnpdesswhtab-4 5 WU-?49 Last Revised. October 18, 2012 'Page 2 of 2 A NCbU #R Storr>r>twater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this fnrtn, please riser_ ht[ :I/ r.�rtai.ttcdcnr.r}rJwt b/� /ws/suln ZEcssti#tali- Permit No.: NICI&lO161 01010101 or Facility Name: ZR► In County: Inspector: +� Date. of Inspection: Time of inspection:201-0. Total Event Precipitation (inches):. icatc of Coverage No.: NICIGI OI I �L 4131�1 Phone No.. Was this a Representative Storm Event? (See infonnation below) EdYes ❑ No Please check your permit to verify f Qualitative Monitoring must be performed during a representative storm event (regrtireinent v Mary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signalure of PermitttN or Designee) 1. Outfall Description: OutfalI No. SIO ,A ' Structure (pipe, ditch, etc..) Receiving Stream: _N a1'1 ..(4?&-, Pg 1&N Describe the industrial activities that occur within the outfall drainage area: �1t��E�L.➢W1E,f� rtR'Etirt`f.N� Z. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark).as descriptors: VL N r i N-,%' o w tqi h ` 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine -odor, etc.): _ N 0 t..lj Page 1 of 2 '3WU•242-20!2&13 a. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is�very cloudy: 1 2 3 O 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stonnwater discharge, where I is no solids and 5 k the surface covered with floating solids: I O 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 2 3 4@ 5 7. Is there any foam in the stormwater discharge? Yes No S. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes, No id. Other Obvious Indicators or Stormwater Pollution: List and describe KI C, 1L Note: Low clarity, high solids, and/or the presence of roam; oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 swu-242 2012t}613 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Q allty General Permit No. NCG060000 Date submitted - 5�1 O CERTIFICATE bF COVERAGE NO. NCG06 0 0 3 O FACILITY NAME .Q�1kSL� k �4{AR.E_. Cr��Q_O�fl _�0 COUNTY MC PERSON COLLECTING SAMPLES N LABORATORY Qi -J_ l M-V_ NOL� Lq\l Lab Cert. # Q �� Part A. Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 106 FACILITY,ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal f is/byproducts DISCHARGING.TO SALTWATERS? ❑YES [V�NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 —) I� Total event rainfall ��_ or [[] No discharge this period' Outfali No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Conform', Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark 100orS0 Within 6.0 — 9.0 120 30 1000 Soo 0 3 N ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. a For sampling periods with no discharge at 2ny outfalls. You must still submit this discharge monitoring report with a checkmark here. a 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 2'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/yr oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor 011•Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0- - Only applies to facilities that use/process meats. 2 The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at aU outfails, 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 11 SECTION.B. e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11-SECTION o 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 REGIONALOFFICE CONTACT NAME: Mail an original and one cook of this DMR including all "No Dischar e" re arts within 30 dog qL receipt of theJob results or at end a monitoring period in the case.of "No Discharge" reeortsl 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." s I I 66 - (Date) Additional copies of this form may be downloaded at: http:llportai.ncdenr:orelweh/wglwslsuZnpdesswHtab-4 MU-249 Last Revised; October 18, 2012 Page 2 of SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water quality General Permit No. NCGO60000 Date submitted 511 11 Y, CERTIFICATE OF COVERAGE NO. NCG06_Q a O SAMPLE COLLECTION YEAR ?0I K FACILITY NAME - T 1 FAC I LITY. ACTIVITIES INCLUDE (check all that -apply) - COUNTY � ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES tyKV'& ai PL?—V411 _ DISCHARGING.TO SALTWATERS? ❑YES [ZNO LABORATORY9N'<�V_ �, Lab Cert. # Q 3 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE -i Total event rainfall 2 ) 14 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 C611form , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark 100or50 With In6.0-9.0 120 30 1000 Soo ' 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 classi fi cations, 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 E? no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Dutfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/t TSS, mg/L pH, Standard -units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 - ' Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. B For sampiing periods with no discharge at M 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 8) S WU-249 Last Revised: October 18, 2012 *FOR PART A AND PART B MONITORING RESULTS: * A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION.B. e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. o TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK•EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE 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, including all "No Discharge" reports; within 30 days bf receipt of the'lab results.jor 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 MUSTSIGN 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." 5/2-3 A (Date). Additional copies of this form may be downloaded at: hEp://portal:ncdenr.orgfweh/wq/ws/su/npdessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 December 4, 2017 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Certificate of Coverage No. NCG060030 Year 5 — Period 2 Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation Baxter RECEIVEED DEC 1 1 Z017 CENTRAL FILES DWR SECTION Enclosed is the semiannual SDO monitoring report as required by the General Stonnwater Permit NCG060030, Part II, Section B. All sample values are within permit limits. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Corey Carpentier at 828-756-6636. I certify, under penalty of law, that this document and all attaclunents 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.. Sincerely, Cor Carpentier EHS Enclosures: Semiannual DMR (Original and one Copy) Baxter Healthcare Corporation PO Box 1390 Marion. NC 28752 T 828,756,4151 a�w�rawwo� NCDENR Stormwater Discharge Outfall (SD4) Qualitative Monitoring Report Forguidance. on ftlling.our thisfnrm, plecise visit.` fill rL//ert.rl.nrdcur.nrJwch/wuhvs/su/n(�it�tisri#t �b �t Permit No.: NlClisl dl �i I O/OI C7/ / or Certificate of Coverage No.: NICIGI OI 61 Q 0/ 3/0 / Facility Name: County: ri c Inspector: 0 - Date of Inspection: 0 Time of Inspection: 2 Phone No Esc_-mc-uA __.. Total Event Precipitation (inches):. d , 4 { C Was this a Representative Storm Event? (See information below) [� Yes ❑ No Please check your permit to verify if Qualitative Monitoring must he perforirred during a representative storm event (regttirethentq vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours,(3 days) in which no storm event. measuring greater than 0.1 inches has occurred. A singe storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permitter Designee) 1. Outfall Description: Outfal I No. QM :I- Structure (pipe, ditch, etc.) LiQt;., Receiving Stream: (, (a Describe the industrial activities that occur within_ the outfail drainage area: $LC,6,4WS,_ 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e:, smells strongly of oil, weak chlorine odor, etc,): . No 61' Page 1 of 2 swtl•2a2-2o 1206 0 4. Clarity: Choose the number which best describes the clarity of the discharge, where.l is cleat and 5 is very cloudy: I O 3 4 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: 1 Q 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: I D 3 4 5 7. Is there any foam in the stormwaler.d&harge? Yes No 8. Js there an oil sheen in the stormwater discharge? Yes No 9. -is there evidence of erosion or deposition at the outfal P Yes. No 10.. Other Obvious Indicators of Stormwater. Pollution. - List and describe NlUt116— Note: Low clarity, high solids, and/or the presence of foam; oil sheen, or erosion/deposition inay be indicative of pollutant exposure. These conditions warrant further investigation. Page 2of2 SWU-?42-'_t112U513 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date:submitted J-1 CERTIFICATE OF COVERAGE NO. NCG06_Q Q.1 Q FACILITY NAME f\ COUNTY L Dta PERSON COLLECTING SAMPLES Pb?E.g f�,L� LABORATORY Bft(k(Z WASti eNTCf; Lab Cert. fi _9 , PP+CC- PA'j (�V-e T " CN I 40 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR _7-W-1 FACILITY, ACTIVITIES INCLUDE {check all that apply): Q use/process meats ❑ use animal fats/byproducts DISCHARGING,TO SALTWATERS? ❑YES 1gNO PLEAS£'REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall ().4 orEl No discharge this perioa3 Outfall No. 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 mi Benchmark - 200 or 50 Within 6.0 — 9.0 120 30 1000 Soo AL U -I.. < S 1 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 a___y outfalls. You must still submit this discharge monitoring report with a checkmark here. ASee 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 - -90 100 or 50 6.0 — g.o, - 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. Km complete Part Bj S WU-249 Gast Revised: October 18, 2012 Page 1,of 2 *FOR PART A AND PART 8 MONITORING•RESULT5: o 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 . e TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEE15ENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES Q NO [yJ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an oriai►ial and one cony of this DMR, including all "No Discharge" reports within 30 days of receipt of the lab results (or.at end o 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) . -, � t I IL_� (Date) Additional copies of this form may be downloaded at: http://portal;ncdenr.c)rg/wel)/wq/ws/su/npdesswHtab-4 SWU-Za9 Last Revised: October 18, 2011 'Page2 0172 A� NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: hit :ll. urlitl.nriicur.nrJwcE�lwul�vtilsu/�dessw#tab-^4 Permit No.: NICI &10l �10101010l or Certificate of Coverage No.: NIC/GIO 16 Id la 13J01 Facility Name: ' County: M tAn Inspector: �A Date of Inspection: I A iI�.,.�Time of inspection: 13 Total Event Precipitation (inches): Q,� �ttjtl l Was this a Representative Storm Event? (See information below) d Yes ❑ No Please check >>vur permit to verify if Qualitative Monitoring must lip performed during a representative stonn event (requirements vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has ! i occurred: A.single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee 1. Outfall Description: Outfall Na-� Structure (pipe, ditch, etc.) Receiving Stream: _ h49W } V6e(_.N--jfNWLP% Describe the industrial activities that occur within the outfalI drainage area: -TRAA(K TID+B--- � C 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: h1ON L 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _ _Lore.. Page 1 of 2 S W U-242-201206 f 3 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy- 1 O 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids- I O 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 1 O 3 4 5 7. Is there any foam in the stormwater-discharge? Yes No S. Is there an oil sheen in the stormwater discharge'? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious indicators of Stormwater Pollution: List and describe U 01, 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. Page 2 of 2 5 WU 242-20120613 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Qualk General Permit No. NCG060000 Date submitted 1 —1 CERTIFICATE OF COVERAGE NO. NCG06C,� 0 3 � SAMPLE. COLLECTION YEAR 0 FACILITY NAME 1-+i�r>..4'i i1�p, �S 2i +n,J FACILITY ACTIVITIES INCLUDE(check all that apply): COUNTY - [� use/process meats ❑ use animal is/byproducts PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES LZNO LABORATORY KI i F�' Lab Cert. # W � P\ Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE --) I Total event roinfall' or ❑ No discharge this period' Outfall No. 1 Sample Collected, mo/dd/yr TSS, rn L pH, Standard units COD, m L Oil and Grease, m .! Fecal C611form , Colonies per 100 mil Enterococci , Colonies per 100 mil Benchmark 100or50 ' Within'6.0 — 9.0 12o 30 1000 Soo 2WIN 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 5no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor Gil/month. Outfali No. Sample Collected, mo/dd/ r Oil and Grease, mg/l. TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average. al/ma Benchmark - 30 100 or 5 6.0 — 9.0 3 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. MoN�fo!~1aG iS itLC3�nIRt-D� Last Revised: October 1 S; 2012 swig -tag � S-Ta -2— ks NoT N RC,I�C L01f.1i11'—� �h41-tNIr S;- L ,-(K-K.�of-C , oWl &� A^1 ir�-c,"i , 40,1 E�fPlicnii�L {-Y iR{{ Loch?ron+- � 111311-1 (if es complete Part B) *FOR PART AND PARTS MONITORING RESULTS: •' A BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS. SEE PERMIT PART II SECTION S. • 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 FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALO YES 0 NO U IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [] NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an odaMal and one copy of this DMR, including of "No Discharge reports, within 30 days of receipt oj the:lab results for at end a monitoring oeriod 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 ofthe person or persons who manage the system, or those persons directly responsible for gathering the information, the Informationsubmitted is, to,thebest 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 I (Date). Additional copies of this form may be downloaded at: httpl/portal.ncdenr:orglWeb/wg(wslsu/npdesswtttab-4 SWU-249 Last [devised: October 18, 2012 pnof.- I nrl r ?: &I�YA NCDENR Stormwater Discharge Outfa ISDD.) Qualitative Monitoring Report For guidance on filling out dris form, please visit. hum://pun.il.rut#err.uri/wcEi/w�/►vxls�/n cytiw#ta#�- Permit No.: mcfC t () / � 1 o I U � —1 " I or Cert if icate .of Coverage No.: WC_!GI Q! Facilitv Name: County: Inspecto Date or I Time of Inspection: 13 Total Event Precipitation (inches): 0,4 ;,4u4c s Was this a Representative Storm Event? (See information below) [2(Yes ❑ No Please check your permit to verify if Qualiturive Monitoring must be performed during a representative storm event (requiretnents vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that �. is preceded by at least 72 hours (3 days) in which no storin event measuring greater than 0.1 inches. has !occurred. A single storm event may contain up to 10 consecutive hours of no.precipitation. By this signature. I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or 1. Outfall Description: Outfall No. r- O Structure (pipe, ditch, etc.) Receiving Stream: N6P,1H_ R&L �,MC-,w 6 UN - - DescAe the industrial activities that occur within the outfall drainage area linS�C w�7C �R t tv i 2. ' Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, ntedium, dark) as descriptors: _Iit- Nj off\M� 3. Odor: Describe any distinct odors that the discha �e may have (i.e., smelIs strongly of oil, weak chlorine odor, etc.): t An Page 1 012 SWU-242-20120013 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: V 2 _3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where, I is no solids and 5 is the surface covered with floating solids: 2 3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 01 2 3 4 5 7. is there Any foam in the stormwater discharge? Yes S. Is there an oil sheen in the stormwater discharge? Yes N� 9. Is there evidence of erosion or deposition at the outfalI? Yes No I0. Other Obvious Indicators of Stortnwater Pollution: List and describe U n ��S �.i��R Pat 1"� S;TC-- ' -- - - Note: Low clarity, high solids, and/or the presence of foam, oil sheer,, or erosion/deposition. may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242-20120613 SEMI-ANNUAL STORMWATER. DISCHARGE MONITORING REPORT for North Carolina Division of Water Q iity General Permit No. NCGO60000 Date submitted 11,, "1 CERTIFICATE OF COVERAGE NO-. NCG06 O & 3 b SAMPLE COLLECCION YEAR.i.- FACILITY NAME zFACIuTY ACTIVITIES INCLUDE (check all that apply): COUNTY 1 [] use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES i�k{�DISCHARGING.TOSALTWATERS? []YES [NO LABORATORYl i it Lab Cert. # _hi Fl PLEASE REMEMBER TO SIGN ON THE REVERSE � Part A: Stormwater Benchmarks and Monitoring. Results Total event rainfall" OA" or ❑ No discharge this period; Outfail No. Sample Collected, mo/dd/yr TS51 hl L pH, Standard units COD. mWL Oil and Grease, rngIL Fecal Col�, iform Colonies per 1010 mi Enterococc , Colonies & 160 mi Berchmark - 100 or S4 Within' G.0 — 9.0 ].20 30 1000 Sao 3 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 M outfalis, You must stilt 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 0 gallons of new motor oil per month? ❑ yes vQ/no (ifYes, complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging)- S5 gal of new motor oil /month. Outfall No. Sample Collected, rno/dd1 r oil and Grease, mg/t TSS, M91L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 3o 100 or 50 6.0 — 9.0 - a Only applies to facilities that use/process meats. The total precipitation must be recorded using data from an on -site rain gauge. 3For sampling periods with no discharge at &nj outfails, you must still submit thisbischarge monitoring report with a checkmark here. °See General Permit text, 'fable 3, identifying the especially sensitive receiving water classifications -where the more protective benchmark applies, Hof i�E,�!`�' ENaVGs1 io CafiEP,-Tr~ D;SC�IE�RI� F11 �;(i S SW.U-249 ©QA� N C�tE ►�� Lim i.:3St i?EVISCd: Ortfnhor 112 zAI 1 "FOR PART A AND PART B MONITORINGRESULTS: •` 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 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES a ND IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO [] REGIONAL OFFICE CONTACT NAME: Mail an on final and one govy 9f thIsDMR lncludin all "No aiseha e" re arts within 30 da s o recei t o the lob results or at end o monitoLl—ng pe&d in the ccrs o "No Discha e" re orts 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 vl6lations." (Signature of Permittee) 3 ( Date) Additional copies of this form maybe downloaded at: htlp:l/i3ortal.ncdL2nr;oriz/webLwci/ws/su/npAessk b-4 SWU-249 Last Revised: October IS, 2012 Baxter July 21, 2017 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Certificate of Coverage No. NCG060030 Year 5 — Period I Stormwater Discharge Out -fall Monitoring Report Baxter Healthcare Corporation Enclosed is the semiannual SDO monitoring report as required by the General Stormwater Permit NCG060030, Part II, Section B. Please note that there is no stormwater data available for STOI as we were unable to draw samples from a measureable event. We implemented a Tier One response in accordance with Part 11, Section B to identify any immediate risks to our stormwater discharge. Our subsequent stormwater management inspection did not identify any conditions that would have impacted our discharge parameters. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Mike Pisarik at 828-756-6618 or michael_pisarik@baxter.com. I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or 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. Sincerely, B an Sm EHS Die recto Semiannual DMR (Original and one Copy) Baxter Healthcare Corporation PO Box 1390 Marion, NC 28752 T 828.756,4151 RECEIVED JUL 2 7 2017 CENTW%L FILES DWR SECTION SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCGO60000 Date submitted _ 07 / 'Z l / ? CERTIFICATE OF COVERAGE NO. NCGO 0 -30 SAMPLE COLLECTION YEAR 'Z O 1 7 FACILITY NAME RoJ 'It~� FACILITY. ACTIVITIES INCLUDE Icheck ail.that apply): COUNTY ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES. DISCHARGING TO SALTWATERS7 OYES ONO LABORATORY 4,r 14#J Lab Cert. # IV C QQ 9 3 s PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results Totel event rainfall 2 or n No-dischame this period' Outfall No. 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 S Within 6.0— 9.0 120 30 1000 Soo o 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 any outfalls, You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the espedally sensitive receiving water classifications where the more protective'benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than SS.gallons of new motor oil per month? Oyes ❑ no if es complete Part Bj Part B:.Vehicle Maintenance Area Monitoring Results:, only for facilities averaging > SS gal of new motor oil/month. Outfall No. 'Sample Collected, mo/dd/ r Oil and Grease, m L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average i/mo Benchmark - 30 100orS0 6.0-9.0 - '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 outfails, 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. SWU-249 Last Revised: October 18.2012 Page 1.of 2 *FOR PART A AND PART B•MONITORING RESULTS: o A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART iI SECTION•B. e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2•11EQUIREMENTS. SEE PERMIT PART II. SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEbENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES Q KO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an orfainal_and _one My of this OMR: including aU "No Dischorgergports, within 30 days of ecel t 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 properlylgather 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,,jru�uding theylossi�' of fines and imprisonment for knowing violations." re 7— Z/— f7 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.orp/web/wci/ws/su/nRdessw#tab-4 S W U-249 Last Revised; October 18, 7012 Page 2 of 2 'f e SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 0/ 1.2 CERTIFICATE OF COVERAGE NO, NCGO6 D 0 FACILITY NAME 6kx4-�s1rcttr� COUNTY %r .Z"tAj' PERSON COLLEC ING SAMPLES <n pd4 i LABORATORY i \��kKI iML-ab Cert. t# Part A: Stormwater Benchmarks and Monitoring Results RECEIVE-- FEB 0 3 2017 SAMPLE COLLECTION YEAR O'er / Lo CENTRAL FILES FACILITY ACTIVITIES INCLUDE (check all that apply): DWR SECTION ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? DYES [ONO PLEASE REMEMBER TO SIGN ON THE REVERSE --> if Total event rainfaNz )..n 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 Coliform , Colonies per 100 ml Enterococci`, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 500 5'C' I► 2� t , 7. N 570 h N I mo/dd/yr mg/L mg/L Standard units Annual average gal/mo Benchmark - 30 100 or 504 6.0 - 9.0 - ' Only applies to facilities that use/process meats. AND z "Fhe total precipitation must be recorded using data from an on -site rain gauge. . a For sampling periods with no discharge at any outfails. You must still submit this discharge monitoring report with a checkmark her 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchm applies. Did Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes r�46 0 ryes, 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, Oil and Grease, TSS, pH, New Motor Oil Usage, Only applies to f;,ciiilics lh;,t use/process meats. 27he total prcCipit;ilion must be rr_cordt'd using data from an on -site rain gauge. 3 For sarnplin(; poriorls with no tiisrh;u at any nutf,alls, you must still submit this discharge monitoring report with a checkmark here. 45ee General I'ra-roil texl, Tablfl 3, icit:nlilyinl�. the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 I.asl Iluvisc,l: fk•l{,her I�4, 21112 • *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 EXCEEDANCES 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 original and one 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 Dischar e" 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." (SigKature of Perm Q/12w1i 7 ( Date) Additional copies of this form may be downloaded at: http:/Zportal.ncdenr.org/web/wq/ws/sir/npdessw4tab-4 SWU-249 I,;rti1 Ruviscdl Ocloh,:r 18, 2012 I',iAc 2 ol'2 Baxter January 26, 2017 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Certificate of Coverage No. NCG060030 Year 4 (2016) - Period 2 Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation Enclosed is the stormwater discharge outfall monitoring report and a copy as required by the general stormwater permit Part II, Section B. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Mike Pisarik at 828-756-6017. 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. Sincerely, 9--1V Jon Rushford VP Operations — North Cove Enclosures: Original and one Copy for DWQ cc: Stephen Taylor Baxter Healthcare Corporation PO Box 1390 Marion, NC 28752 i 828.756.4151 9 • NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: http:f l portal. naienr.orgf web/lrhipdes-stormwa,ber/ Permit No.: N/C/�/�/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/ O/-/ Facility Name: li U I -RIP, (%eyc. County: AkC P&J-0&(k Phone No. Inspector: Date of Inspection: i11LA � I Time of Inspection: Total Event Precipitation (inches): a o Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) = a I I z W71c, Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office, By this signature, I cey-to that this report is accurate and complete to the best of my knowledge: (Signatu(,6 of Permittee 4 Designee) Pagel of 2 SWU-242, Last modified 7/31/2013 1. Outfall Description: n . Outfall No. 51D 1 Structure (pipe, ditch, etc.) Receiving Stream: [J & R^ 7o.r �a— G A-- � Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: C`ItAt'z 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the -surface covered with floating solids: 1) 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 6) 3 4 5 7. Is there any foam in the stormwater discharge? Yes 8. Is there an oil sheen in the stormwater discharge? Yes E�lo 9. Is there evidence of erosion or deposition at the outfall? Yes XNo 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. Page 2 of 2 SWU-242, Last modified 7/31/2013 • G �Ala NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: httR(/aortal.ncdenr.org/wefs%l� /Hades stormwater Permit No.: Facility Name: County: 1M,f. 7dassCJQ k Inspector: 6F-� ` t ace 4✓ Date of Inspection: 1 q 7A t' k Time of Inspection: old 3` or Certificate of Coverage No.: N/C/CC/ 0/ 1/ D/ Q/-3/ 0/ it , ct,� Total Event Precipitation (inches): o" Phone No. T D 6 7 5-& 4 Le I$ Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Quolitotive Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this-s*ature, ) eer)tify that this report is accurate and complete to the best of my knowledge: (SignOure of Permittee or Designee) Pagel of 2 SWU-242, fast modified 7/31/2013 1. Outfall Description: • Outfall No. 5 To }- Structure (pipe, ditch, etc.) Receiving Stream: ! t-A e, �U P- Dk- k- Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: C(&-Af 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 'f\1kzq\C- 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: �1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1) 2 3 4 5 7, Is there any foam in the stormwater discharge? Yes 6) 8. Is there an oil sheen in the stormwater discharge? Yes (N) 9. Is there evidence of erosion or deposition at the outfall? Yeso 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, Page 2 of 2 SWU-242, fast modified 7/31/2013 • • • �k�w M • NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: - .nc wr wa Permit No.: N/C/_/_/_/_/_/_/ or Certificate of Coverage No.: Facility Name: i # Caunty: +vi(- -k6-L�L Phone No. Inspector: hlrt►—��-► �� Date of Inspection: Time of Inspection: u __ Total Event Precipitation (inches): ),0 3'2-fi 75(p 6te Irs Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this ri ature, 12ctify that this report is accurate and complete to the best of my knowledge: f-eq/`ZCp�7 (Signature of Pernlittee or Designee) Page 1 of 2 sWU-242, last modified 7/31/2013 1. Outfall Description: Outfall No. 6T6,3 Structure (pipe, ditch, etc.) { �Z Receiving Stream: _ i N � &L C 0h-W b A - Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: kA, 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): n 1- v 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 2 3 4 V 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: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 2 O3 4 5 7. is there any foam in the stormwater discharge? Yes a B. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfalf? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe n (11-� 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. Page 2 of 2 SWU-242, Last modified 7/31/2013 July 21, 2015 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Certificate of Coverage No. NCG060030 Year 4 (2016) - Period 1 Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation JUL Z 6 2016 WtSJREIoN Barer Enclosed is the stormwater discharge outfall monitoring report and a copy as required by the general stormwater permit Part II, Section B. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Mike Pisarik at 828-756-6017. 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. Sincere' , eter Jarvis ` lant Manager Enclosures: Original and one Copy for DWQ cc: Stephen Taylor Baxter Healthcare Corporation PO Box 1390 Marion, NC 28752 T 828.756.4151 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG063 0 FACILITY NAME e A- COUNTY PERSON COLLECTINGSAMPLES 4—w-c. LABORATORY 6&v,(4., Ned&- xtab Cert. # /I/C 6D 3 5-- ncr A-0h(yt'C-XA /YC 600 30 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR a0/6 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? ❑YES [ rNO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 3 n 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 Coliform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1006 Soo 15 Q 1 S, D 1 Only applies to facilities that use/process meats. .:,ENTRAL FILES ZThe total precipitation must be recorded using data from an on -site rain gauge. �;1V ,^-,ECl�� 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 R'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/yr 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 - N 1 Only applies to facilities that use/process meats. 2Tt7e 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. 4Se General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Page 1 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 ANY ONE 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, within 30 days of receipt of the lab resultslor at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1.617 Mail Service Center Raleigh, NC 27699-1617 11 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 bestmy knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false informatioh, Including the possibility of fines and imprisonment for knowing violations." (Signalture of Permi�tee) (Date) Additional copies of this form may be downloaded at: http://portal,ncdenr.org/web/­wq/"ws/`­su/npdesswgtab-4 SWU-249 Last Revised: October 18` 2012 Page 2 of'2 9-0/ it ATLA. RECEIVED NCDENR JUL 262016 Stormwater Discharge Outfall [SDO] L FILES Qualitative Monitoring Report DWRECTION For guidance on filling out this form, please visit: http://poi,tal.ncdenr.ot,g/weh/w,4i/w,s/._5Ai/nijdes,,w#tab-4 Permit No.: N/C/_/_/ Facility Name: County: Ae- Inspector: _ x,�-e Date of Inspection: Time of Inspection: /_/_/_/ or Certificate of Coverage No.: N/C/G/6ho/Q/Q/-3/Q/ Le 1571 �3Ll0 Total Event Precipitation (inches): 3 Phone No. ig,ZrS 7 5 & & (4 ( � Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) [dyes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements var)4 depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 qpproval from the local DWQ Regional Office. By th s si n ture, [ certify that this report is accurate and complete to the best of my knowledge: (Sign Iature oiPermittee or Designee) Page 1 of 2 SWU-242, Last modified 10/25/2012 I., Outfall Description: Outfall No. STo 1 Structure (pipe, ditch, etc.) r n� 12ec6vi6g•Stream: _ `�yJ k e- Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: C.�QiR.f _ 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): h6-f\ -c— 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 3 4 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: 2 3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 7 8 9 10 3 Is there any foam in the stormwater discharge? 4 5 Yes Is there an oil sheen in the stormwater discharge? Yes Is there evidence of erosion or deposition at the outfall? Yes CD 10. Other Obvious Indicators of Stormwater Pollution: List and describe n 8-— 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. Page 2 of 2 SWU-242, Last modified 10/25/2012 1� NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: htti)://Voi,tal.ticclent-.org/we w ws/su/n Ades, yw#tab_4 Permit No.: N/C/_/_/T/_/_/_/_/ or Certificate of Coverage No.: N/C/C/ Facility Name: County: O\c- Dew e. L,� _ Phone No. 812—9- ?5 6 Za 6 Inspector: Date of Inspection: Time of Inspection: 3 3 r1 Total Event Precipitation (inches): 8- Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 2/yes ❑ No Please verify whether Qualitative Monitoring must be performed during o "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this si to e, I certify that this report is accurate and complete to the best of my knowledge: �e�--i 2o21f (Si iature of Pert ittee or Designee) Pagel of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. Structure (pipe, ditch, etc.) ' L Receiving Stream: N " f 4^ F&-s- (2— 11� b $ Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: c�-Q-+4✓ 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 0 S-n-r- 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4_ 5 S. 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: V 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: D2 3 4 5 7. Is there any foam in the stormwater discharge? Yes 8. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes 10. Other Obvious Indicators o€Stormwater Pollution: List and describe iI s 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. Page 2 of 2 SWU-242, Last modified 10/25/2012 For guidance on filling out this form, please visit, h t a: J/VgrLa1.ncdenr.or web wt ws s i n )des w#ta -4 Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/ D/-&/A/ Q/3/C7/ Facility Name: 9 xg JA e-R- County: ��L Phone No. Z(S 7S6 4e_& I Inspector: Date of Inspection: 1 Time of Inspection: 1 1 l 3 r, Total Event Precipitation (inches): Y Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See i6fornlation below.) [(Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this signature, I A--tify that this report is accurate and complete to the best of my knowledge: Z-Qun Ll (Signature�of PermitOTr Designee) Page 1 of 2 5WU-242, Last modified 10/25/2012 1. Outfall Description: ' Outfall No. 5p ?� Strlucture (pipe, ditch, etc.) Receiving Stream: N 0—H-,+t— Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the ditch rge usin basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 8tJ 3. Odor: Describe any distinct odors thaX the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 4. Clarity: Choose the number which best escribes the clarity of the discharge, where 1 is clear and 5 is very cloudy: / o ►qAd 1 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5ois the 4fface covered with floating solids: 1 2 3 !'5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: no F� 1 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes LJ B. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes 10. Other Obvious Indicators of Stormwater Pollution: List and describe n Dote: 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. Page 2 of 2 5WU-242, Last modified 10/25/2012 January 11, 2015 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Certificate of Coverage No. NCG060030 Year 3 (2015) - Period 2 Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation RECEIVED JAN 2 5 2016 CENTRAL FILES DWR SECTION Baxter Enclosed is the stormwater discharge outfall monitoring report and a copy as required by the general stormwater permit Part 1I, Section B. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Mike Pisarik at 828-756-6017. 1 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. Sincerely, an Weiler Plant Manager Enclosures: Original and one Copy for DWQ cc: Stephen Taylor Baxter Healthcare Corporation Po Box 1390 Marion, NC 28752 T 828.756.4151 ALTI-F;wj U'Ar CDENR Stormwater Discharge Outfall [SDO] Qualitative Monitoring Report For guidance on filling out this form, please visit: htti},//nortaLncden�'.orgf webjwcG/ws/stt/nudessw#tah 4 Permit No.: N/C/_ Facility Name: County: Itlspectar: Date of Inspection: Time of Inspection: or Certificate of Coverage No.: N/C/G/-O/-�/ 6'/ 0/3/C1/ -L �✓ 4�-c-�- � IPin t r�.-c..1 Total Event Precipitation (inches): I- `- Phone No. I!?2{K - 7 - & b ! Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) [V/Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: ature of Permittee or Designee) Pagel of 2 5WU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. S� O Structure (pipe, ditch, etc.) Receiving Stream: _� <<-! ��� ( �b ts— Describe the industrial activities that occur within the outfall drainage area: ~' 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: C-14� 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): !\`-vim 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: Q 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where l is no solids and 5 is the surface covered with floating solids: 0 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes B. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes No 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. al Page 2 of 2 SWU-242, Last modified 10/25/2012 N County: _ Inspector: "®r Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: h P: rtaLn , leo -.or gw b ws i n pd es w#tab-4 Permit No.: N/C/_ / or Certificate of Coverage No.: N/C/G/ D/4i/D/ D/ 3/ 4/ Facility Name:>v(-� f ^r— C C-, Phone No. ,- 2-cd -? 6 LD f t� Date of Inspection: I1 1 -i� 1 ,5-- Time of Inspection: 10 Z Total Event Precipitation (inches): f � `- 4 Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) cj Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Sign4tu)re of Permittee or Designee) SWU-242, last modiried 10/25/2012 Pagel of 2 1. Outfall Description: Outfall No. 6—r b Structure (pipe, ditch, etc.) Receiving Stream: . 1 Ow "N '�(- L('J-�bq— Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the (light, medium, dark) as descriptors: arge using basic colors (red, brown, blue, etc.) and tint 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): nv,.�- 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: C1% 2 3 4 S 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and S is the surface covered with floating solids: 0 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 2 3 4 S 7. Is there any foam in the stormwater discharge? Yes INo j S. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes 10. Other Obvious Indicators of Stormwater Pollution: List and describe � D4,k-- 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. Page 2 of 2 SWU-242, Last modified 10/25/2012 Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit. h r i-tal.ilcl nr.or web w ws u n des sw#ta -4 Permit No.: N/C/�/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/-6/-6/ 1/0/J/�2/ Facility Name: County: _ j Inspector: Date of Inspection: Time of Inspection: Total Event Precipitation (inches): 1 • b( Phone No. 92r< 21�-Cv 1a(019 Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) dyes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: ture of Permittee or Designee) Page Z of 2 SWU-242, Last modified 10/25/2012 I 1. Outf 1 Description: Outfall No. Z2 TC) Structure (pipe, ditch, etc.) � � � -- � 1 Receiving Stream: o,- lam_.A— ,b Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: S%r(riJj� 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 4 1_ 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 0"3 4 5 7. Is there any foam in the stormwater discharge? Yes (No] 8. Is there an oil sheen in the stormwater discharge? Yes �No 9. Is there evidence of erosion or deposition at the outfall? Yes (No 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. Page 2 of 2 SWU-242, Last modified 10/25/2012 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted _ I I I l to 1 I<_ CERTIFICATE OF COVERAGE NO. NCG06 3 O FACILITY NAME k� � j� C M clwlt_ COUNTY % C DW t t\ ^ PERSON COLLECTING SAMPLES LABORATORY S "�,X Lab Cert. # Inc tDdq�S 1� +na 11 ca-� NC 000 3 0 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR J_ln IS FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? DYES KNO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall2 /. y it 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 Coliform , Colonies per 100 ml EnterococciI, Colonies per 100 ml Benchmark - 100 or 50 Within 6.0-9.0 120 30 1000 500 5 ) I r ao. aG. s o 3 rl3 fD 1 Only applies to facilities that use/process meats. Z 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. 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/yr 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 - 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 yes, 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 ANY ONE 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, 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, 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." ature of Permittee) (Date) Additional copies of this form may be downloaded at: http://portal,ncdenr.org/web/wq/ws/su/npdessw#tab-4 SW U-249 Last Revised: October 18. 2012 Pabc 2 ol'2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06_� �✓ O FACILITY NAME COUNTY PERSON COLLECTING SAMPLES ISI n—/ LABORATORY WILNW,.c ate Lab Cert. ii NCD�Q3 Kle._ 14 0 0 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR o1p(S_ FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal f is/byproducts DISCHARGING TO SALTWATERS? []YESdNO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall z a �� S or ❑ No discharge this period3 Outfall No. 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 EnterococciI, Colonies per 100 ml Benchmark 100 or 504 Within 6.0 — 9.0 , 120 30 1000 500 ST 1 7.1C1 <S n 0 t 0 37 c 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 9no 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, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 �. 100 or 50' 6.0 — 9.0 - ' Only applies 10 f,rciliticls tliat usc:/process meats. 'The total prccipil,nion must he r(!rord(,d using dati Irom an on -site rain gauge. 3 For sampling; periods with no rli;;ch;rrg i; at Lmy Ow 1")%' you nwr t still submit this discharge monitoring report with a checkmark here. /ISee Goneml i'crnrif lexl,'I'abh::l, idunillyinll, thr_ especially sensitive receiving water classifications where the more protective benchmark applies. (if ye_�, complete Part B) S W U-2119 I .;rsl Ruvincd: t li'Iohcl 18, 2012 I':1gc 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 ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME:, Mail an original and one c9py of this DMR ,including al! "No Dischar e" reports within 30 days of receipt of the lab results or at end o monitoring period in the case of "No Discharge" re orb: 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." ure of Permittee) 7 %Z4/'5— (Date) Additional copies of this form may be downloaded at: ht L/porl-al-ncdenr.org/web/wqLws/su/npdesswHtab-4 S W U-249 Iasi Kcviscd: Oclohcr Ih, 2012 • • • For guidance on filling out thisform, please visit: 1L3://portal.ncdenr.org/web/wq/ws/su/npdessw#tah-4 Permit No.: N/C/_/_/_/ _/_/_/_/ or Certificate of Coverage No.: N/C/G/ Facility Name: 3►�x �u l��a i�{n [.arc County: Phone No. Inspector: Date of Inspection: I +<— Time of Inspection: _ Q t iD n Total Event Precipitation (inches): O i 914-9 7�-& bb 1 �? Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 0 Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (SigMature of Permittee or Designee) SWU-242, Last modified 10/25/2012 Pagel of 2 1. Outfall Description: Outfall No. S 1 0 3 Structure (pipe, ditch, etc.) Deceiving Stream: A M 0n, f 0-r'V-- -riuJ , r� Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors:%G�i hlu`w. 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 1)t:j1:f , 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 6) 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes G 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: Dist and describe ()1) Nt, 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. 0 Page 2 of 2 SWU-242, last modified 10/25/2012 • LJ • County: _ Inspector: AVia NCDNR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out thisform, please visit: littp://Vortal.ticcleni-.oi-g/web/wq/ws/su/npdessw#tab-4 Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/ (�11p/ /�/,�/�/ Facility Name: 1-WcrtJ e _ mC,�&we l� Phone No. 9,)K. 75 & Lola./, Date of Inspection: `I E -A I Time of Inspection: O , 0 � Total Event Precipitation (inches): 0 . C; Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) [/Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this signature, 1 certify that this report is accurate and complete to the best of my knowledge: ature of Permittee or Designee) SWU-242, Last modified 10/25/2012 Page 1 of 2 1, 1. Outfall Description: Outfall No. 5T0 t Structure (pipe, ditch, etc.) Q��t' —_ • Receiving Stream: A ®� C l'HVA' U k Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: ��iq�(-�k Cl"4�t 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): AMS-Z 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 Z� 3 4 5 S. 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: O2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: is 0] 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes (No 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. 0 Page 2 of 2 SWU-242, Last modified 10/25/2012 a NCDENR i Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report • • For guidance on filling out this form, please visit: htt 1: portal.ncdennoi-g/web/wct/ws/su/nudessw#tab-4�1 Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/ Mel alb 3/U / Facility Name: 01&n1Nnr-fO L County: �\ Phone No. Inspector: , Date of Inspection: t[ Time of Inspection: Total Event Precipitation (inches): 0,�; �I Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 2f Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on.the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (SUlature of Permittee or Designee) SWU-242, Last modified 10/25/2012 Page 1 of 2 0 1. Outfall Description: Outfal} No. STO L Structure (pipe, ditch, etc.) Q • Receiving Stream: A-rk-t\ l� . C k� b k Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: C (PAN 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): ntF-n;-4— 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: a 2 3 4 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: 1� 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 0 0 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes o B. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe n 4-* 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. 0 Page 2 of 2 SWU-242, Last modified 10/25/2012 July 24, 2015 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Certificate of Coverage No. NCG060030 Year 3 (2015) - Period 1 Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation Baxter RFECEIVED JUL 2 9 2015 CENTL FILES DR SE WCY ON Enclosed is the stormwater discharge outfall monitoring report and a copy as required by the general stormwater permit Part II, Section B. We will continue to monitor the outfails as required. If you have any questions or require additional information, please contact Mike Pisarik at 828- 756-6017. 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. Sincerely, Alan Weiler Plant Manager Enclosures: Additional Copy for DWQ cc: Stephen Taylor Baxter Healthcare Corooration PO Box 1390 Marion. NC 28752 T 828.756.4151 Baxter December 10, 2014 RECEIVED Division of Water Quality DEC 15 2014 Attn: Central Files 1617 Mail Service Center CEN7-R4L FILES Raleigh, NC 27699-1617 DWR.SjeCTi' N RE: Certificate of Coverage No. NCG060030 Year 2 (2014) - Period 2 Stormwater Discharge Outfall Monitoring Report Baxter Healthcare Corporation Enclosed is the stormwater discharge outfall monitoring report and a copy as required by the general stormwater permit Part II, Section B. We will continue to monitor the outfalls as required. If you have any questions or require additional information, please contact Mike Pisarik at 828- 756-6017. 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. Sincerely, Ian Weiler Plant Manager Enclosures: Additional Copy for DWQ cc: Stephen Taylor Baxter Healthcare Corporation PO Box 1390 Marion, NC 28752 T 828,756.4151 came NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidanceonfillingoul thrsforrn, please vish: hltna/0urti�l.ncdcm.orJ��d�lr�ulws/sa/n�dessw�tati t Permit No.: NIC/. J 1`hl_I_I or Certificate of Coverage No.: N/C/G1©I 6I ©I DI 3l 0/ Facility Name: c tnr t� County: _ ��C A.,) e V� _ Phone No. Inspector: Date.of Inspection: ^ _ 1� 1wC--'sea./ 2Ca Time: of Inspection: - _- !1 E,- its. - - — Total Event Precipitation (inches): ��— Was this a Representative Storm Event? (See information below) 1 Yes ❑ No Please check yqur pernnitto verify'if Qualitative Monitoring must be pe)fbrmed during a rehresentalive storm eveni (requirements vc�ry),. A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and -that is.preceded by at least 72 hours.(3 days) in which no storm event measuring greater than 0.1 inches has. occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and -complete to the best of my knowledge: (SigWure of Permittee or Designee) 1. Outfall Description: OUtfI111 No. k Structure (pipe, ditch, etc.) 7-L Receiving Stream: _-_ .-- -� `�_ rV— CJIA_� (V—_ Describe the. industrial activities that occur within the outfall drainage area: 2. Color:' Describe the cof.or of the discharge using ba (tight, mcdiium, dark) as'descriptors: C �,) colors (red, brown, blue, etc.) and tint 3- Odor: Describe.any distinct'odors.that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Page I or S W U-242-2012061:3 ;0 4. Clarity: Choose the number which_ best describes the clarity of the discharge, where I is clear and5 is very cloudy: 1 2 � 4 5 5. Floating'Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge,. where I is no solids and 5 is the surface covered with floating solids: ill 2 3 4 5 fi. Suspended Solids: Choose the. number which best describes the amount of suspended solids in the stornnvater discharge, where l is no solids and 5 is extremely muddy: 0 2 3 4 5 7. Is there any foam in the stormwater discharge'? Yes 8. Is there an oil sheen in the,.stormwater discharge? Yes 9. Is therc.cvidence of erosion or deposition at the outUI ? Yes No 10. Other Obvious Indicators or Stor(mwater Pollution: List and,tlescribe 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. Page 2 of 2 SW U-242-20120613 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For'guidance on filling out this form, please visit: htlpa/hurt.:Lncctcnr.orJ��ch/wet/4vshuln�tless�� #I;Ib- 3 Permit No.: NICI I I_I Facility Name: _fli County: n t �. &,A,3 E Inspector:. Date of Inspection: Time>of Inspection: 1 l l or Certificate of Coverage No.: NIC/G/ 0l bl 01 mI 31D1 1 Total Event Precipitation (inches): Z Phone No. gig' -) i - Cn (d 1 S Was this a Representative Storm Event? (See information below) E(Yes ❑ No Please check ),pur permit to vet•ify if Qdalitative Monitoring must be petfat•tned during a representative stonn ei nl (requirements vat y).. A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours.(3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By°this signature, I certify that this report is accurate and complete to the best of my knowledge: of Permittee,or Designee) 1. Outfall Description:' Outfall No. .5` -o Structure (pipe, ditch, etc.) t `� Receiving Stream:.LtLKJj Ch- Describe.the industrial activities that occur within the out fall Arainage -area: 2. Color- Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors:�^�+�� 3: Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Page 1 of 2 SWIJ-242-20120613 4. Clarity: :Choose the. number which best describes the clarity of the discharge, where 1 is clear and 5 is very, cloudy: O 2 3 4. 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the storntwater discharge, where I is no solids and 5 is the surface covered with floating solids: 2 .3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the storinwater discharge, where 1. is no.solids and 5 is extremely muddy: 2 3 4 5 7. Is there any foam in the siormwater discharge? Yes No 8. Is there an oil sheen in the. storrnwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes. �'O to. Other Obvious Indicators of Stormwater Pollution: List and describe n1),A-e 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. Page 2 of,2 SWU 242-201206M NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Deport Forguidance onftlling out thisform, please visit: htt r//�nrl I,ncdcnr.orJwch/w Iwslsuln dcssu#C,tb t Permit No.: NICI�I_l�hl l _l�l or Certificate of Coverage No.: N/CLG/ 0l 4l 0/013101 Facility Name: "-t -t— County: _ I!'�� O-tY��� _ Phone No. _ c)-S G W 6 _. Inspector: Q5-— Date.of Inspection: tJ "t,--b e.�- Zo, j `'I Time of Inspection: q D 2 k"v\� Total Event Precipitation (inches): Was this a Representative Storm Event? (See infonnation below) dYes ❑ No Please check your perinit to verify if Qualitative Monitoring must be performed during a representative storm event (requirements :airy). A "Representative Storm'Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours.(3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single -storm event -may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and -complete to the best of my knowledge: (Sig6at lie of Perruittee. or Designee) 1. Outfall Description: Outfall.No. 4Tb 3 Structure (pipe, stitch, etc. Receiving Stream: _ N " � �`�� � tz� W It Describe,the, industrial activities that occur within the outfall drainage area: 2. Color'-.' Describe the color of the discharge using basic.colors (red, brown, blue, etc.) and tint (light, medium, dark) as'descriptors:�- 3. Odor: Describe any distinct odors-t it the discharge may have (Le., smells strongly of oil, weak chlorine odor, etc.). �191� Page 1 or S WU-242-26120613 a 4. Clarity: :Choose the. number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 2 3 4 5 5. Floating. Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where l is no solids and 5 is the surface covered with floating, solids; 2 3 4 5 G. Suspended Solids: Choose the..number which best describes the amount of suspended solids in the stormwater discharge, where I is no solids and 5 is extremely muddy: 0 2 3 4 5 7. Is there any foam in [he stormwater discharge? Yes0 8. Is there an oil sheen in the stormwater discharge? Yes Na 9. Is there evidence of erosion or deposition at the outfall? Yes CNo) 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. Page 2 of,2 S WU-242-20120613 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06y_d FACILITY NAME D ky+ COUNTY Y1c \ P_ \ PERSON COLLECTING SAMPLES — LABORATORY "(4 *--c— Lab Cert. # NC OO IVC © pO 3 6 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 1�i_b t 9 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? DYES [ONO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2—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 Coliform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 Soo 1� 2Lu \ le S Lv, i to S `T� \� 'Llp �'[ • U. 3 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? ❑ 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/yr 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 - 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 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 B) SWU-249 Last Revised: October Ili, 2012 Pane 1 42 *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 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: Mail an original and one 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, 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." (Sig'Oture of Permittee) I Z_110f 1 (Date) T� Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 S W U-249 Last Revised: October 18, 2012 Page 2 J 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No: NCGO60000 Date submitted CEktfnC,4TE bkOVERAGE NO: NCG06_0 _L _I L) .FACILITY NAME _ �2 ��+C ��f 14,Kc-hitCOUNTY- PERSON COLLECTING SAMPLES LAB(jRATORY Lab Cert. # N6 60 :, r, eke- �zC,-` I NC00030 Part A. Stormwater Benchmarks. and Monitoring. Results SAMPLE COLLECTION'YEAR )-b I y FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ pse/process meats Eluse animal fats/byproducts DISCHARGING TO SALTWATERS? AYES �NO PLEASE REMEMSERIO SIGN ON THE REVERSE 4 RECE1\/F r MAY Ali CENTR/jL bwolqoG Total event rainfall Nr� hor No -discharge this, period' Outiall;No. sample,Collected, rrid/dd/yi T5S;, mg/L pH, Standard,units COD, mg/L Oil and Grease; rndL, . _ Fecal Coliform" Colonies per.100 ml , Enterococci , Colonies per'100 ml .. Bendirriark. `-' 106or;50. Within Fi 0-:9:0 : ' 120 30' `1000 500 5 ,qL, 31 4, N N Ll 7. S I' Lo < a MAY 0 6 2014 , Only applies to facilitiesthat use/process`meats.. CENTRAL FILES The total precipitation must be recorded using data from an on -site rain gauge. pWajBQG 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,:1dentifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform.Vehicle Maintenance. Activities using more:tharr55 gallons of new motor oil'per month? ❑ yes [✓ no if yes complete Part Bj Part B: Vehicle Maintenance Area Monitoring Results:.only for facilities averaging > 55 gal.of new motor oil/month. Outfall NO. Sample. Collected, iiioJdd/yr„ . - "Oil and;Grease, �g%L, TSS, mg/l pH, standard unitsz New, Motor Oil Usage, Annual average gal/mo Benchmark' - 30 100 or 50 6.0-9.0 - ' 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 Perriiit text, Tattle 3, identifying the especially sensitive receiving water classifications where the.more protective -benchmark applies. SWU-249 Last Revised: October 18, 2012 Page 1 of.2 w *FOR PARTA AND PART B.MONITORING RESULTS: A BENCHMARK EXCEE DANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTIONS. •. 2°EXCEEDANCES IN A ROW FOR THE SAMEIPARAMETER AT THE SAME OU.TFALL TRIGGER TIER 2,REQUIREMENTS. SEE,PERM IT- PART II.SECTION B. • • TIER 3: HAS YOUR.FACILITY HAD 4 OR MORE'BENCH MARK"EXCEEDENGES FOR THE SAME•PARANIETER`AT ANY ONE OUTFALI ? YES []NO'[] IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES. ❑ NO Q REGIONAL'OI=FICE CONTACT NAME: Mail ah oriQinaland'one copy of this QMR,.ineluding all "No -Discharge" reports, within 30 days of recut of the• lab`results I& at end o� monitoring period in the case of "No Discharge"reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Ma_ il'Service Center Raleigh, NC:.27699-1617 tPf YOU MUST SIGN THIS cFRTIFlcATION FOR ANY INFORMATION REPORTED: 'Tcertify: underpenalty of law, that this -document and. aII.attachments were prepared under my direction -or supervision.inaccordance.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,th.e 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 Pdrmittee) (Date) Additional copies of this form may be downloaded at: http://portal;6cdenr.org/well/wowsisu/npd6sw#tab-4 S W U-249 Last Revised: October 18, 2012 Page 2 of 2 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out thisform, please visit: huts://nE�rt:il.n�dcnr.prJtivef�/uc{/+vti/sulnpdes��+#taE� � Permit No.: NICI_I_l l_l l�l I or Certif icate of Coverage No.. NICIGI d l �Y DID l 31 0l Facility Name: ft )4-eV PA-i c e— County: 11;e Dry-LOett Phone No. S6 6, Inspector: Date.of Inspection: Time: of Inspection: Tyl�l�t� .' ,5 Total Event Precipitation (inches) Was this a Representative Storm Event? (See information below) [r]'�Yes ❑ No Please check your permit to verify if Quafitatii,e Monitoring must be pe.tfortned during a representative storm event (requirentetnts vary). A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least.72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By'this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) 1. Oulfall Description: Outfall No. : 7j ! AM (pipe, ditch, etc.) p'P� Receiving Stream: %rem' f A 1-ollf2 Describe.the industrial activities that occur within the outtall drainage area: 2: Color: Describe the color of the discharge using basic.colors (red, brown, blue, etc.) and tint (light, mcdium, dark)'as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (Le., smells strongly of oil, weak chlorine odor, etc.): PM Page I or SWU-242 26120613 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5'is very cloudy: 5. Floating; Solids: Choose the number which best describes the. amount offloating solids in the stormwater discharge, where l is no solids and 5 is the surface covered with floating solids: (T 2 '3 4 5 6. Suspended Solids: Choose the. number which best describes the amount of suspended solids in the stornnvater discharge, where I is no solids and 5 is extremely muddy: 0 2 3 4 5 7. Is.there.any foam in the stormwater discharge.? Yes oNo 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Isthere evidence of erosion or deposition at the outfall? Yes No to. 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. Page 2 of,2 SWU-242 20120613 li f NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Deport Forgulddneeonfilling out thisform, please visit: httri://rn�rtal.n�cicnr.or��hvch/uultvslsuln�cicssu#tab=4 Permit No.: NICI 1 I_I_I 1 I I or Certificate of Coverage No.: NICIG/ 19I iP 10l 013l o/ Facility Name: i4 K er C tlk �. County: _ " Phone No. Z1� - 7Sto — le191 Inspector: !S W&. 7—" 1 w Date.of Inspection: _ q 1 7 f ly Time<of Inspection: n Total Event Precipitation (inches): i ' S Was this a Representative Storm Event? (See information below) 1� Yes ❑ No Please check your pertnit to verify if Qualitative Monitoring must be. performed during a representative storm event (requirements vary). A "Representative Storm.Event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least.72 hours (3 days) in which no storm event measuring greater than.0:1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By -this signature, I certify that this report is accurate and complete to the best of my knowledge - JW*C (Signature of Permittee or 1. Outfall Description: ��11 Outfall No. Structure (pipe, ditch, etc.) _ I►`i �� Receiving Stream: -h g _ CA=E"J A-_ Describe,the industrial activities that occur within the outfull drainage area: 2. Colter:' Describe the color. of the discharge using basic colors (red, brown, blue, etc.) and tint. (light, medium, dark) as -descriptors: _C4e� _ R 3. Odor:. Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Page 1 of 2 S W U-242-201206 t 3 4. Clarity: Choose thenumber which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: of 1 '3 4. -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: (fIJ 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 0 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes (9 8. Is therean oil sheen in- the stormwater discharge? Yes (Nti 9. Is there evidence of, erosion or deposition at the outfall? Yes CN ) 10. Other Obvious Indicators or Stormwater Pollution: 'List and descrihe �w Note: Low clarity, High solids, and/or the presence of foam, oil sheen, or erosion/deposition may be.indicatiye of.pollutant,exposure. These conditions warrant further investigation. Page 2 of,2 SWU-242720120613 AG';'A' R C®ENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report l or gxidanee on filling oJrl this form, please visit: hlll?a/ urtaf.ncctcnr.or�J+veta/wetlws/su/npdcssw#tab =t Permit No.: N/CII. Facility Name: County Inspector: I_I l�l I P_ \. or Certificate of Coverage No.: N/C/G/ dl &/ 61 UI 310l -\ (IV e_ Phone No. ... g J_� 7s% (gO ll Date.of Inspection: _ H 1-7 I t 4 - -- -- Time of Inspection: ��__., Total Event -.Precipitation (inches):. I • s It Was this a Representative Storm Event? (See information below) 9 Yes. ❑ No Please check your pennit-to verify'if Qualitative Monitvl-ing mast he petfornned during a representative storm event (requirements vary). A "Representative Storm Event`is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. By this signature, I certify that this report is accurate and complete to the best of trey knowledge: (Signature of Permittee or Designee) 1. Outfall Description: Outfali No. 5 D 3 Structure (pipe, ditch, etc.) - -P'p-C Receiving Stream:. Alot ffn dc�_ CLEhy bP, I �^ Describe the industrial activities that"occur within the outfali drainage area. 2. -Color: IDscri.be the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: t r. 3: Odor: Describe any distinct odors°that the discharge may have (i.e., smells strongly of oil, weak chlorinc odor, etc.)- n b n t✓ _ Page 1 of 2 SwU-342-20120617 f 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: a E 1 2, 4 5 5. Ooating.Solids: Choose the number which best describes the amount of floating solids in the stonnwater discharge, where I is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose,the number which bcst describes the amount of suspended solids in the stormwater discharge, where 1. is -no solids and 5-is extremely muddy: 1 2 � 4 5 7. Is there any foam in the storm.water discharge`? Yes No 8. r Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List.and,describe _ _ A 6-(-ve— 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. Page 2 of 2 SWU-242-20120613 April 30, 2014 Division of Water Quality NCDENR 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files: Reference: Quantitative and Qualitative Storm Water Inspection Reports per COC Number NCG060030 Enclosed are the Qualitative Storm Water Inspection Forms (three forms- the original and one copy of each) for our North Cove Facility at STO 1, ST02, and STO 3. Also enclosed please find our Quantitative Storm Water Discharge Outfall Monitoring Report (one form- the original and one copy). If you have any questions, please give me a call at 828-756-6618 Sin erely, Steve ylor Wastewater Treatment Supervisor ST/cw enclosures Baxter Neanhcare Corporation PO Sax 1390. Marion. NC 28752 T 828.758.415 i