NCS000325_COMPLETE FILE - HISTORICAL_20190612

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ENGINEERING & ENVIRONMENTAL
Certified Mail No.: 7018 1830 0001 4853 6025
Return Receipt Requested JON
June 5, 2019 C E- i4EAL F11.-E
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Division of Water Quality
Attention: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: Stormwater Discharge Outfall (SDO) Monitoring Report - May 2019
Patch Rubber Company
100 Patch Rubber Road
Weldon, NC 27870
NCS000325
Dear Sir/Madam:
Please find enclosed the Stormwater Discharge Outfall (SDO) Monitoring Report for storm
water discharge from the above -referenced facility for May 2019.
Please note the following:
• The facility was not able to collect the required samples from a "Representative
Storm Event" for the month of May 2019.
The facility will continue monthly collection of storm water samples for analysis.
If you have any questions regarding these documents, please do not hesitate to contact
this office.
Sincerely,
a,md TA&mULL)
Amy L. Trimble, CHMM
Environmental Scientist
ALT: apw
Enclosure
cc: Mr. Marto Carter, Patch Rubber Company
Certified Mail No.: 7018 1830 0001 4853 6032
O:IPatch Rubber Company119-1051PA Final119-105 - NC Div of Water Quality - 2019-06-05- Storm Water SDO May 2019
letter.docx
221 E. Main Street I Suite 200 1 Freeport, IL 61032 I p:815.235-7643 I f:815.235.4632 I fehr-graham.com
Insight. Experience. Results.

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000325
FACILITYNAME Patch Rubber Company _
PERSON COLLECTING SAMPLE(S) Not applicable
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY Halifax
PHONE NO. 2�� 52 )536-2574
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfall
1.
Date
sample
' 1
II I
Total1
k , ,
Rainfall•'
1 1 1 1
'.. S
•
•
a
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes X no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended .
'Solids
pH'
New Motor
Oil Usage
mo/dd/yr
MG
inches
m /l
m
unit
gal/mo
Form SWU-247, last revised 21212012
Page 1 of 2

STORTNI EVENT CHARACTERISTICS:
Date
Total Event Precipitation (inches): N/A
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
The Facility was unable to collect the required samples from a "Representative Storm Event"
for the month of May 2019 "No Flow"
Form SWU-247, last revised 21212012
Page 2 of 2