NCS000092_MONITORING INFO_20151203

STORMWATER-DIVISION-CODING"SHEET --
PERMIT NO.
N U�
DOC TYPE
❑ FINAL PERMIT
CR MONITORING INFO
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ a o 1 5- (`, - Q3
YYYYM M DD

v
December 3, 2015
Marsh Furniture Company
P.O. Box 970
High Point, NC 27261
Attention: Mr. Bruce Braswell (transmitted by email to [e-mail])
Reference: Stormwater Sampling Results
Marsh Furniture Company
High Point, NC 27261
S&ME Project No. 1584-99-082A
Dear Mr. Braswell:
Please find attached a copy of the analytical results for the stormwater sampling event completed on
October 27, 2015. This stormwater sampling event was conducted in general accordance with Marsh
Furniture Company's NPDES Permit # NCS000092, issued on September 26, 2005. Appended to this letter
(Appendix > is Table 1 which summarizes the stormwater analytical data set for the period 2005 through
2015. You will also find appended to this letter (Appendix I) a Stormwater Discharge Outfall (SDO) -
Qualitative Monitoring Report for each of the three stormwater outfalls. The full analytical report for this
event can be found in Appendix U. ,Please note that the Event Duration and Total Rainfall data presented
in Table 1 are not site specific data, rather it is data from the USGS Ryan Creek weather station and/or
other local weather data sources. Your on -site rainfall data may be more accurate. 1 want to point out
that this was a slow steady rainfall event and water flow observed at each outfalls was steady, but the flow
was less than many of the prior events. Event conditions like this may in part explain some of the
variability in the laboratory analytical results, both current and historic.
As always we appreciate this and every opportunity to assist Marsh Furniture Company. If you have
questions regarding this project, please contact me at 336-288-7180 at your convenience.
Sincerely,
S&ME, Inc.
�a2.
Edmund Q.B. Henriques
Senior Geologist / Project Manager
S&ME, Inc. 18646 W Market SG Ste 1051 Greensboro, NC 27409 1 p 336.288.7180 1 f 336.288,8980 1 www.smeinc.com

TABLE
STORM WATER ANALYTICAL SUMMARY (2005 - 2015)
MARSH FURNITURE COMPANY
HIGH POINT, NORTH CAROLINA
S&SIE PROJECT NOS. 1584-05-099 & 1584-99-082A
Parameter
Date
Collected
Sample Locations
Benchmark
Values
(mg/L)
Event
Duration
(hours)
Total
Rainfall
(inches)
F-2
(mg1L)
OF-3
(mg/L)
F-4
(mgjL)
pH
11/21/2005
� 5!84M
6,31
6-9
-15
1.39
S ring 2006
'
*
6-9
*
+
8/30/2006
S7
6.18
6-9
-6
2.28
12/22/2006
6.23
6.69
6.7
6-9
- 13
0.53
6/28/2007
5!33
5.69
5t89
6-9
-2
0.2
1 U15C2007
�5!951
6.06
6.08
6-9
-8
0.46
Spring 2008
*
*
•
6-9
9/10/2008
no data
no data
no data
6-9 _
Spring 2009
'
"
+
6-9
'
9/17/2009
6.92
6.22
6 -
711212010
IM4198
5!56
5161
6-9
5/6/2013
no data
no data
no data
6-9
- 7
0.99
9/16/2014
10/27/2015
jaj5.0
6.1
lij 5!S8
6.17
jffi5li9
6.53
6-9
6-9
-- I
-48
0.75
1,75
BOD
11/21/2005
4.65
3.35
<2.0
30
-15
1.39
Spring 2006
*
*
•
30
8/30/2006
3.32
5.22
7.46
30
-6
2.28
1212212006
4.02
6.08
13.8
30
- 13
0.53
6/28/2007
696
7.24
8.44
30
-2
0.2
11/15/2007
2.61
<2.0
5A3
30
-8
0.46
Spring 2008
*
*
'
30
+
9/10/2008
3.82
5.61
5.94
30
Spring 2009
'
'
•
30
9/17/2009
4.42
3.84
7.47
30
7/12/2010
8.22
10.1
26.6
30
5/6/2013
< 2.00
4.33
2.54
30
_ 7
0.99
9/16/2014
19.8
6,63
4.67
30
- 1
0.75
10/27/2015
7.14
16.8
6OW
30
-48
1.75
COD
11/21/2005
12
19
17.0
120
-15
1.39
Spring 2006
*
*
*
•
'
8/30/2006
19
35
36.0
-6
2,28
12/22/2006
30.5
51
175
-� 13
0.53
6/28/2007
49.5
47.0
44.0
E126
--2
0.2
11/15/2007
26.0
37.0
33.0
-8
046
S ring 2009
"
«
«
9/10/2008
22.0
19.0
27.0
120
Spring 2009
*
'
*
120
'
+
9/17/2009
29
40
61
120
7/12/2010
117
94.0
jjj270
120
5/6/2013
13
26.0
19
120
- 7
0.99
9/16/2014
42
38.0
113
120
-- 1
0.75
10127l2015
38
61.0
24
220
-48
1.75
TKN
11/21t2005
0.999
1.22
2.51
20
-15
1.39
Spring 2006
'
*
20
*
'
8/30/2006
0.973
2.41
4.91
20
-6
2.28
1212212006
1.2
1.51
8.14
20
- 13
0.53
6/28/2007
2.99
1.94
4.54
20
-2
0.2
t1/]512007
1.74
1.45
3.55
20
-8
0.46
Spring 2008
*
'
*
20
9/10/2008
2.22
0.686
2.91
20
Spring2009
•
«
a
20
•
s
9/17/2009
1.90
1.83
3.91
20
7112I2010
9.46
5.10
20
5/6/2013
1.85
2.22
2.66
20
- 7
0.99
9/16/2014
2.69
1.79
15.8
20
- 1
0,75
10/27/2015
2.21
<1
20SM
20
-48
L75
Phosphorous
11/21/2005
0.079
0.128
<0.050
2
--15
1.39
(total)
5 rin 2006
*
*
*
2
'
8/30/2006
5R6
611 SM
2
-6
2.28
12/22/2006
0.083
0,408
0.458
2
- 13
0.53
6/28/2007
0.141
0.458
0.548
2
-2
0.2
11/15/2007
0.130
0.207
0.129
2
-8
0.46
Spring 2008
'
*
2
•
«
9/10/2008
0.102
0.106
0.088
2
Spring2009
'
*
+
2
'
9/17/2009
0.090
0.281
0.159
2
7/12/2010
0.803
0.894
0.482
2
5/6/2013
< 0.050
0.113
< 0.050
2
- 7
0.99
9/16/2014
0.0B4
0.146
0.193
2
- I
0.75
10/27/2015
O.l9l
0.299
0.141
2
-48
1.75
* = No success sampling a representative storm event
BOD = Biological Oxygen Demand COD = Chemical Oxygen Demand TKN = Total Kjeldahl Nitrogen
®orange shaded cells contain values that exceed or fall outside ofthe Permit specified benchmark values
TAPMjeds11999XENVOR2q Marsh star aler0ata Table-Stor aler (updated 11-20151.z1az

AiMWA
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit: http://portal.ncdenr.org//web/lr/nudes-stormwater4
Permit No.: lv C/S/0/0/0/0/9/2/ or Certificate of Coverage No.:
Facility Name: Marsh Furniture Company
County: Guilford
Inspector: Ed Henriques
Date of Inspection: October 27, 2015
Time of Inspection: 1320 hours to 1345 hours
Total Event Precipitation {inches): > 0.5 inch
Phone No. 336-288-7180
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
X 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:
(Signature of Permittee or Designee)
Page 1 of 4
5WU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. OF-2 Structure (pipe, ditch, etc.) Pine
Receiving Stream:
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: turbid very low, slight light brown tint, no foam, no solids
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): none
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 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the storm water discharge, where 1 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? YesVIM
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: None. Noted that this is a very slow. light but steady rain event,
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 4
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. OF-3 Structure (pipe, ditch, etc.) Pine
Receiving Stream:
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: moderate turbidity, medium blown _
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): none
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and S is very cloudy:
1 2 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 9 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 9 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
o
9.
Is there evidence of erosion or deposition at the outfall?
Yes Nd
10.
Other Obvious Indicators of Stormwater Pollution:
List and describe: None. Note this outfall appears to also collect street storm water.
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 3 of 4
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. OF-4 Structure (pipe, ditch, etc.) Pipe
Receiving Stream:
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: mostly clear, low turbidity, faint brown tint,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): none
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
N 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:
P 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
H
8.
Is there an oil sheen in the stormwater discharge? Yes
l�ja
9.
Is there evidence of erosion or deposition at the outfall?
Yes
10.
Other Obvious Indicators of Stormwater Pollution:
List and describe: None
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 4 of 4
SWU-242, Last modified 10/2S/2012

RESEARCh & ANA1YTiCA Report of Analysis
Q
QQ LAbo1UT0Ri1N, INC. 11/18/2015
0
For: SBME, Inc (Greensboro)
••• �. ••., �.�
8646 W. Market Street Suite 105
`�/ 'Tyti: i
;�
Greensboro, NC 27409
f is NC'#34 °' • w
�2
Attn: Ed Henriques
« t NC#37701
?
.
Client Sample ID: Marsh Lumber OF-4
Lab Sample ID:
10832-01
Site: SWE, Inc
Collection Date:
10/27/2015 13,22
Parameter ,Method
Result
Units
Reo1L'imit An_ - alyst AhalVilsiDate/Time
BOO-5 SM 5210 B-2001
60.0
mg/L
2
KN 10128/2015 0935
COD EPA 410.4
249
mg/L
5
KN 1111612015
pH SM 4500 H+13-2000
6.53
Sid. Units
AP 1 b127/2015 1700
Total Kjedjahl Nitrogen Hach 10242
20.5
mg/L
1
KL 10/29/2015
Total Phosphorous SM 4500 P E-1999
0.141
mg1L
0,05
KH 10129/2015
Client Sample ID: Marsh Lumber OF-3
Lab Sample ID:
10832-02
Site: S&ME, Inc
Collection Date:
10/27/2015 13:30
,Parameter' _ ettiod
:Result
Units
'Reb%lmit Anal s Analysis Date1Time
BOD-5 SM 5210 B-2001
16.8
mg/L
2
KN 10/28/2015 0955
COD EPA 410.4
61
mgtL
5
KN 11/16/2015
pH SM 4500 H+B-2000
6.17
Std. Units
AP 10/2712015 1703
Total Kjedjahl Nitrogen Hach 10242
<1
mg/L
1
KL 10129/2015
Total Phosphorous SM 4500 P E-1999
0.299
mg/L
0.05
KH 10129/2015
Client Sample 10: Marsh Lumber OF-2 Lab Sample ID: 10832-03.
Site: S&ME, Inc Collection Date: 10/27/2015 13:38
Raramete� - Meth - Res 'Units �-ReA�Lim{t ,Analsist Anal`sis Datel'iime
BOO-5 SM 5210 B-2001 7.14 mg/L 2 KN 10128/2015 0955
COD EPA 410.4 38 mg/L 5 KN 11116/2015
P.O. Box 473 106 Short Street Kemersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randatabs.com Page 1
ral -coo basic Od

RESEARCH & ANA1yTiCA1 Report of Analysis
l.AboRATORIES, INC. 11/18/2015
Client Sample ID: Marsh Lumber OF-2 •
Lab Sample ID:
10832-03
Site: S&ME, Inc
Collection Date:
10/27/2015 13:38
ararrteter
Method
Result
Units Rep Limit An_ alyst Ana sis.DateJTime
PH
SM 4500 1-11+13-2000
6.08
Std. Units
AP� 10/27/2015 1704
Total Kjedjahl Nitrogen
Hach 10242
2,21
mg/L 1
KL 10129/2015
Total Phosphorous
SM 4500 P E-1999
0.191
mg/L 0.05
KH 10/2912015
NA = not anotyzed
P.O. Box 473 106 Short Street Kemersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 2
ral coo basic v1d

RESEARCh & ANA1}/TICA1
"LABORATORIES, INC.
Analytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
WATER I WASTEWATER I misc.
_
�' •
•
r • ' •
• • • r
•
3TED ANALYSIS
ADDRESS
i / I
PROJECT
[�
SAMPLER NAME (PLEASE PRINT)
r
CT PHONE
I
MISS
REU •HEDRECEIVED:
WILA-
SAMPLE

r 1%
August 7. 2009
NCDENLR-D\1rQ
585 Waughtown Road
Winston-Salem, NC 28405
Attention: ,NIr. Corey Basinger
Reference: NOTICE OF NO SPRING SAMPLING EVENT
NPDES PERMIT NCS000092
Marsh Furniture Company
High Point, North Carolina
S&NIE Project No. 1584-05-099
Celebrating 35 Years
1973.2008
RECEIVED
N.C. Deoc. of EN,R
AUG 17 2009
','r-nscon-Salem
Regional Qf Ice
Dear II\ B'asingerr
On behalf` of Marsh Furniture Company, S&ME, Inc. (S&Ml:) provides services associated with the
analytical monitoring required in accordance with NPDES Permit 9 NCS000092, issued on September 26,
2005. This letter is provided to document that S&ME did not obtain the Permit required analytical
monitoring for the Spring 2009 storm event. A number of factors contributed to this unintended
occurrence. S&ME shares Marsh Furniture Company's ongoing desire to maintain compliance. To
demonstrate Marsh Furniture Company's and S&ME's commitment to stormwater compliance, plans
have been made to sample the next representative storm event although it would occur outside of the
Permit specified monitoring schedule.
As you can see from the attached analytical summary table, historic analytical monitoring at the facility
indicates that with the exception of pH and one COD value in OF-4, analytical monitoring for the prior 4
events suggests that the stormwater quality generally meets or exceeds the established "Benchmark
far
r water quality. As such, the hope and intent is to obtain sufficient data to support an
application for coverage under the NCGI80000 General Stormwater Permit. This would be done by
submitting a Notice of Intent to the Stormwater Permitting Unit.
If you have any questions regarding this document, please feel free to contact the undersigned and/or
Bruce Braswell with Marsh Furniture Company at 336-819-4035. We appreciate you support and
assistance with this matter.
S&ME, Inc.
Edmund Q.B. Henriques, L.G. °
Environmental Department Manager
Attachments: Table 1, Storm water Analytical Summary
CC. Bruce Braswell, Marsh Furniture Company, P.O. Box 870, High Point, NC 27261
S&ME, INC. / 3718 Old Battleground Road I Greensboro, SEC 27410 / p 336,288.7180 f 336.288.8980 1 www.smeim.com

-10
TABLE I
STORM WATER ANALYTICAL SUMMARY (2005 - 2009)
MARSH FURNITURE
HIGH POINT, NORTH CAROLINA
S&ME PROJECT NO. 1584-05-099
;Parameter `"Collictid,
Pq=.-1
Sam)MR.353
K
OF!2 OF 3 0 Q
M"O.13
--2q) M L '(rVWL) All,
wd(mg/ M; A
I
ftin-
jn,kf0"M�
g S
Ll I Values
(i5k/V)&J!
-ICZ!Mj
k A(hour
I -,
ai
Rainfall,
PH
11/21/2005
3.1=
RL8 4"
5.76
6.69
6.31
6-9
6-9
-15
1.39
Spring 2006
813012006
12/22/2006
4.24
6.23
6.18
6.7
6-9
6-9
-6
- 13
2.28
0.53
6/2812007
11/15/2007
5.33
5.95
jj5.69
6.06
jj5.89
6.08
6-9
-2
0.2
6-9
-8
0.46
Spring 2008
6-9
9/10/2008
no data
no data
no data
6-9
Spring 2009
6-9
BOD
11/21/2005
4.65
3.35
<2.0
30
-15
1.39
Spring 2006
30
00/2006
3.32
5.22
7.46
30
-6
2.29
12/22/2006
4,02
6.08
13,8
30
- 13
0.53
6/28/2007
6.96
7.24
8.44
30
-2
0.2
11/15/2007
2.61
< 10
5.43
30
-8
0.46
Spring 2008
30
9/10/2008
3.82
5.61
5.94
30
Spring 2009
30
COD
11121/2005
12
19
17.0
120
-15
1.39
Spring 2006
120
8/30/2006
19
35
36.0
120
-6
2.28
12/22/2006
30.5
51
REL7,51M
120
- 13
0.53
6/2812007
4%5
47.0
44.0
120
-2
0.2
11/15/2007
26.0
37.0
33.0
120
-8
0.46
Spring 2008
120
9/10/2008
22.0
19.0
27.0
120
Spring 2009
120
TKN
11/21/2005
0.999
1.22
2,51
20
-15
1.39
Spring 2006
20
8/30/2006
0.973
141
4,91
20
-6
2.28
12/22/2006
1.2
1.51
8.14
20
- 13
0.53
6/28/2007
2.99
1.94
4.54
20
-2
0.2
11/15/2007
1.74
1,45
3,55
20
-8
0.46
Spring 2008
20
9/10/2008
2.22
0.686
2,91
20
Spring 2009
20
Phosphorous
11/21/2005
0.079
0.128
<0.050
2
-15
1.39
001al)
Spring 2006
2
8/30/2006
4.240=Ej5.76ME6..18
2
-6
2.28
12/22/2006
0.083
0.408
0.458
2
- 13
0.53
6/28/2007
0.141
0.458
0.548
2
-2
0.2
11/15/2007
0.130
0.207
0.129
2
-8
0.46
Spring 2008_
2
9/10/2008
0.102
0-106
0.088
2
Spring 2009
1
2
* = No success sampling a representative storm event
BOD = Biological Oxygen Demand
COD = Chemical Oxygen Demand
TKN = Total Kjeldahl Nitrogen
- orange shaded cells contain values that exceed or fall outside of the Permit specified benchmark values
S:11 58MPROJECTS MASTERFrojects 20051099 Marsh StormwateASIormwater-High PointkData Table-StormwaterAs

Permit: NCS000092 Owner - Facility: Marsh Furniture Co
Inspection Date: 05/0312016 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? ■ ❑ ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ❑ ® ❑
Comment: Monitoring as required. Samples contain contamination from outside sources Streets & traffic).
Where the facility _is located, it would be inpossible to sample without outside contamination
sources. No deficiencies notes.
Permit and OutfaIIs Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? ■ ❑ ❑ ❑
# Were all outfalls observed during the inspection? 00011
# If the facility has representative outfall status, is it properly documented by the Division? ❑ 0 ❑ ❑
# Has the facility evaluated all illicit (non stormwater) discharges? ❑ ❑ 0 ❑
Comment: All outfalls were observed. No deficiencies noted.
Qualitative Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? 0 ❑ ❑ ❑
Comment: No deficiencies noted.
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
0 ❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
® ❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
® ❑ ❑ ❑
# Does the Plan include a detailed site map including cutfali locations and drainage areas?
® ❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
❑ ❑ ® ❑
# Has the facility evaluated feasible alternatives to current practices?
® ❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
S ❑ ❑ ❑
# Does the Plan include a BMP summary?
® ❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
M ❑- ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
® ❑ ❑ ❑
# Does the facility provide and document Employee Training?
® ❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
® ❑ ❑ ❑
# Is the Plan reviewed and updated annually?
® ❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
® ❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
® ❑ ❑ ❑
Page: 3

Permit: NCS000092 Owner • Facility: Marsh Furniture Co
Inspection Date: 0510312016 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan Yes No NA NE
Comment: No deficiencies noted.
Page: 4