NCG140215_MONITORING INFO_20190201

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO
IV C& lyu a 1,5
DOC TYPE
❑HISTORICAL FILE
�I MONITORING REPORTS
DOC DATE
p � �� � o a � I
YYYYMMDD

f - RROCIESSASTEWATER -- Quarterly Discharge Monitoring Report
GENERA. PERMIT IVO NCG140000
CERTIFICATE OF COVERAGE No NCG14
FAsCllll-Y NAME t`TG
PERSON COLLECTING SAMP1 ES
CERTIFIED LABORATORY Lab #
Lab #
LIMIT VIOLATIONS? YES []NO
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR
SAMPLE QUARTER Jul -Sept [Oct -Dec Elan -March ❑April -June
COUNTY�� � I i
PHONE NO (__'?r�S
ADD TO LISTSERVE7 ❑YES ❑NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQMI ❑PNA ❑Trout ❑Other
OPTIONAL INFO
Outfal; Na
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
5GT NEM6
(mg/I.)
Duration
(minutes)
Total Flour
(gallons/day),
6 934
3035
53
(15),
-
�,3
rI
cVCIiO�I
r-r-
' V LUI
VR J r
' If wastewater systems have not discharged in this quarter— report "No Flow or' No Discharge here Please make sure to mark the sample quarter above
2 Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM) Mixing Drum
Cleanout (MD) Report more than one type if the waste stream is commingled
3If an effluent limit is exceeded twice in a row the permittee is required to institute monthly monitoring for that parameter for six months unless DWQ RO staff
notifies you to continue monitoring
` pH limits are 6 9 5 U for wastewater discharges to freshwaters and 6 8-8 5 5 U for discharges to saltwaters
s T55 limas are 20 mg/L for wastewater discharges to HQW waters 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications
Permit Date 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2
Date of last pH meter calibration /.- O �C�

Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastL%mater
but instead is subject to benchmarks and provisions of Part IV Section A including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE IOR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
(919) 8D7 6379
YOU MUST SIGN THU CERTIf1CAT1QN FOR ANY INFQRMATION 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
ignature of Permittee)
Permit Date 7/1/201D 06/3D/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

- RESEARCh & ANA YTiCA1
�jl LAb®RAT®RiESr ONC.
For Ready Mixed Concrete Company (Williamson)
1590 Williamson Street
Winston-Salem NC 27107
Attn Danny Rathbone
Report of Analysis
11312019
IIIItttt,,
w I
� r
cn NC 434 z
NCt17101
r � �
Client Sample ID 6238 2 Lab Sample ID 60736 01
Site Ready boxed Concrete WS Collection Date 12/2012018 14 00
Parameter Method Result Units Rep Limit An-dVst Analysis DatelTrme
pH SM 4500 H r8 2000 8 3 Sid Units 12/20/2018 1400
Settleable Matter SM 2540 F 1997 '0 1 mill 01 SK 12/2012018 1600
Total Suspended Solids (TSS) SM 2540 D 1997 302 inglL 5 LP 1212412018
r,JA = not oni jwpci
PO Box 473 106 Short Street Kernersvrlle North Carolina 2728,' lei 336 996 2841 Fnx 336 996 0326 vAvw rind-rlabs corn Page 1
d I ' i

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING, FORM
GENERAL. PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 P_') IL 1
FACILITY NAME N I
PERSON COLLECTING SAMPLES. 4"? le ►-
CERTIFIED LABORATORY �� {�[N-1T Lab # v q
Lab #
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR C.-2ro/ g_
SAMPLING PERIOD July- ecember ❑January -June
COUNTY
PHONE NO
ADD TO LISTSERVE? ❑YES ❑NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(standard
Units)}
TSS
(mg/L)
Event
Dur4
tuteession
(minutes
Total
Rainfall
(an)
In Tier 2
Monthly
Monitoring?
(Y/n)
# of Months to Tier
2 Samplingz
-
-
6-92
1002'3
-
-
-
1
99
Al
ED
♦t_.
J
OCT 362015
DWR S
=CTION
1 If NO FLOW" or "NO DISCHARGE Enter' NO FLOW or "NO DISCHARGE' for each outfall here Please make sure to mark the sample period above
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

PartB Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year
Outfall .`
No'f 1
Date Sam le°
p_ ,
collected 4 "
pH
, .�(Sfandard,
' �y , Y
Units}
-.M1G}'
"iPH usrngrriethod
= �
y,41664A,5GTrHEM I
_r _ �,�
r (mg/L) }
sii+r+c'"v14rmA*�g
o5uspedf
�sy'-�� xy-�
�=� Sohcjs,9" .0
L 7 r
-(mg/L) �s H ,
AV
Event
:; x
Duration-�t
�, x _
minutes
f
x "Total
- --aH
-"Ra�nfall�
- s 4
in
"New Motor`o
-Usage
_ -
al month
Ter2,,*
y
- ,
M�6tl
x�
;Monitoring?
_ y
l i_ -
#of Months"}
- -
inTiers2
- - Z
Sam lin ,
6_9 `�
� — ].5 � >a�
� ��.°00, `� �.s, �•
�'�b - ,:
� �s
�- ,�� _ ....._�
,y .�-'�i'1Sj
M
1
S
r
I
1
1
a
}
1
f
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO 12
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME
Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" reportsl within 30 days of receipt of sample for at end of monitoring period
in case of "No Flow") to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh North Carolina 27699-1617
It
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 th�tth�ere8re significant pe I es for submitting false information, including the possibility of fines and imprisonment for knowing violations / f y
(Signature of
Permit Date 7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG14_D ✓� l Sf
/
FACILITY NAME ��i)_6,c is
PERSON COLLECTING SAMPLES r4f� (I e1
CERTIFIED LABORATORY Lab # '(
Lab #
LIMIT VIOLATIONS YES ❑ NO ❑
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR
SAMPLE QUARTER ©Jul-Sgpt ❑Oct -Dec
COUNTY
PHONE NO
ADD TO LISTSERVE-0 ❑YES ❑NO EMAIL
❑Jan -March ❑April -June
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA []Trout ❑Other.
OPTIONAL INFO
Outfall No
Date Sample
Collected)
(mrn/dd/yr)
Type of Wastewater
VE, RM, MD z
{ }
PH
(standard)
Total Suspended
Solids
(rng/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
S
(mg/L) /L)
(mg/L)
Duration
(minutes)
Total Flow
7
(gallonsJday}
-
-
6 934
3035
53
(15)6
-
S
I
1 If wastewater systems have not discharged in this quarter— report "No Flow" or' No Discharge" here Please make sure to mark the sample quarter above
Z Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Maternai Stockpiles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste stream is commingled
31f an effluent limit is exceeded twice in a row, the permttee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring
4 pH limits are 6-9 S U for wastewater discharges to freshwaters, and 6 8-8 5 S U for discharges to saltwaters
S TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications
Permit Date 711/2010-06/30/2015 Last Revised 07/13/11
Page I of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater
but instead is subject to benchmarks and provisions of Part 1V, Section A, including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 0224 Permit -tees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ if the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow
report on a case by -case basis
�i
1
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO
Division of Water Quality
Alin DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS g RTIFlCATION 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
(Date)
Permit Date 7/1/2010-06/30/20I5 Last Revised 07/13/11
Page 2 of 2

RESEARCh & A►NA[yTiCA[
Qa LABORATORIES, INC.
QdQ
For Ready Mixed Concrete Company (Williamson)
1590 Williamson Street
Winston-Salem, NC 27107
Attn Danny Rathbone
Report of Analysis
10l312018
• iflIIIINl/rII
v�hrT�
ch
Y '
•fl7 NC h34 Z.
t NC 037701
Client Sample ID Outfall #1 S238 Lab Sample lD 56756 01
Site Ready Mixed Concrete Collection Date 9/27/2018 1030
Parameter Method Result Units Rep Limit Analysi Analysis Date/Time
pH SM 4500 H+g 2000 799 Std Units 9/27/2018 1030
Total Suspended Solids (TSS) SM 2540 D 1997
<5 mg1L 5 AW 1011;2018
Client Sample ID Ouifall #2 W238 Lab Sample ID 56756 02
Site Ready Mixed Concrete Collection Date 9/27/2018 1030
Parameter Method Result Units Rea Limit Analyst Analysis DatelTime
pH SM 4500 H+B 2000 882 Std Units 9/2712018 1028
Settleable Matter SM 2540 F 1997 -0 1 mill 01 AW 9/28/2018 0930
Total Suspended Solids (TSS) SM 2540 D 1997 <5 mg/L 5 AW 10/112018
NA = not analyzed
P 0 Box 473 106 Short Street Kernersvdie North Carolina 27284 Tel [phone] Fax [phone] vwvw randatabs corn Page 1
z'i$ coy bgS1C v W

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 6 d2 1
FACILITY NAME 1)2St!� {_ X"
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Lab # AK — 3y
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR CA0I9
SAMPLING PERIOD Jul( -December 2j January -June
COUNTY &0 � 1 �2t� _
PHONE NO (33(z-,) `'? -
ADD TO LISTSERVE7 ❑YES [:]NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units}
TSS
(mg/L)
Event
Duration
(minutes}
Total a
Rainfall
(in)(y/n)
In Tier 2
Monthly
Monitoring?
# of Months in Tier
2 Samplinga
-
-
6 92
1002 3
-
-
/
:JULLU
6
i
1 If 'NO FLOW or NO DISCHARGE Enter NO FLOW' or NO DISCHARGE for each outfall here Please make sure to mark the sample period above
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH) you must Implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
s TSS benchmark values are 100 mg/l, except when discharging to ORW HQW, Trout and PNA waters where they are 50 mg/I
° For each sampled measurable storm event the total precipitation must be recorded using data from an on site rain gauge
Permit Date 7/1/2011 60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averalzed over a calendar vear
Outfall
No
-
Date Sample
Collected
_=(mo/dd/yr)�-
pH
(Standard_
Units)_
- r-x
TPH using method
1664ASGT HEM
-
={mg/L) -L{mg/L)4Tf
-r
r P fi-r �n i .as
Total 5uspended$'3
s L,
Solids-,
i
P a
- Event
Duration
(minutes)
a
Total
4
Rainfall
{in)-
New Motor Oil
r
Usage
-(gal/month)
InTier 2
Monthly
Monrtoring?
(y/ n
# of Months
in tier 2
z
Sampling
ii
r
_16f97
2 .x
1i70z ���,
x
_ _
-
Y _ -',ter
�o
N
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware_that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signatu a of Perniiittee)
Permit Date 7/1/2011-60/30/2015
.,-) o9 -i
(Date)
Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000 I
CERTIFICATE OF COVERAGE NO NCG14 0_-A f S SAMPLE COLLECTION YEAR _
FACILITY NAME `�1 c� t/`n irc SAMPLE QUARTER Jul -Sept
PERSON COLLECTING SAMPLES COUNT! GU +� V"r'ck
CPHONE NO (: 3L ), '`7 9 ,SCERTIFIED LABORATORY �p,(�. (�1�Gr a.�c�- c� ,Lab 9 �� '
Lab # ADD TO LISTSERVE? []YES ❑
LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS ❑5A
OPTIONAL INFO
Part A Wastewater Monitoring Requirements
C
Oct -Dec
Itarch QApril-June
EMAIL i -
JHQW ❑PNA []Trout []Other
Outfall No
Date Sample
Collected'
(rnm/dd/yr)
Type of Wastewater
VE, RM, MD)'
{ )
pH
(standard)
Total Suspended
Solids
(mg,/L)
Settleable
solids
(mUL)
TPH usingDischarge
method1664A
5GT-HEAe
Duration
(minutes)
Total Flow
r
(gallons/day)
6-g3
—AM-
DCt-.i
I�u1
IS 1
V L
^� i4 t�F,l
ILES
D'VR SECTION
f
I
E
I
I
I
I
rr wastewaters ystems nave na[ discharged in this quarter— report "No Flow" or "No Discharge" here Please make sure
Z Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), A
Cleanout (MD) Report more than one type if the waste -stream is commingled
'If an effluent limit is exceeded twice in a row, the permrttee is required to Institute monthly monitonng for that paramet
notifies you to continue monitoring
` pH limits are 6-9 S U for wastewater discharges to freshwaters and 6 8-8 5 S U for discharges to saltwaters
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 3o mg/L for all
Permit Date 7/1/2014-06/30/2015
mark the sample quarter above
r Material Stockpiles (RM), Mixing Drum
for six months, unless DWQ RO staff
water classiftcatronsy�
Last Revised 07/13/11
Page 1 of 2

° Process wastewater discharges shaft only be monitored for TPH when commingled with stormwater discharges from VMA
but instead is subject to benchmarks and provisions of Part IV, 5ectlon A, including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset t
NCAC 02B 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this it
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DW
report on a case -by -case basis
E
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO
Division of Water Quality
Attn DWQ Central Files
1617 Mall Service Center
Raleigh, North Carolina 27699-1617
[phone]
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
assure that qualified personnel properly gather and evaluate the information submitted Based on my Inquiry of the-pe
those persons directly responsible, for gathering the information, the Information submitted Is, to the best of my knowle
complete I am aware that there are significant penalties for submitting false Information, Including the possibility of fin
violatio "
(5ignature`of Permittee)
Permit Date 7/1/2010-06/30/201.5
'7-o9-/�
(Date)
i~
TPH does not have admit for wastewater,
50% of the Summer 7Q10 Flow as per 15A
'ormation to DWQ If the permittee cannot
� Regional Office may require an annual flow
T
"FIPT OF SAMPLE
n accordance with a system designed to
m or persons who manage the system, or
;e and belief, true, accurate, and
and imprisonment for knowing
,Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG144 Ir
FACILITY NAME CaZ R�v,,
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY _(Z C-A Lab #t pje .314
Lab #
LIMIT VIOLATIONS? YES []NO
PartA Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR _� b l g
SAMPLE QUARTER D4Jul-Sept ❑Oct -Dec ©Jan -March ❑April -June
COUNTY Go" IQonol
PRONE NO Qj� , } `T$S '15`75
ADD TO LISTSERVE? [:]YES ❑NO EMAIL t �
DISCHARGING TO CLASS ❑5A ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO --'---___-- -.
Outfall No
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method I664A
SGT HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)
-
6 934
3035
53
(15),
-
C
03 c) 4.J I S>
8;F
<5
< o l
N JA
0 tote
i
lr=
AR[
027 18
C,twN
KI-L SILL
iaVV"
il�V ! kV
r
f
' If wastewater systems have not discharged in this quarter— report "No Flow or' No D15charge" here Please make sure to mark the sample quarter above
2 Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Clearing (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste -stream is commingled
3 If an effluent limit is exceeded twice in a row, the permittee ks required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring
° pH limps are 6-9 5 U for wastewater discharges to freshwaters, and 6 $-$ 5 S U for discharges to saltwaters
5 TS5 limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications .
Permit Date 7/l/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, lnduding the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Plow as per 15A
NCAC 028 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow
report on a case -by -case basis z
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY fINCWDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO
Division of Water Quality
Attn DWQ Central Files -
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MU5T 5*N TH1S 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 imprisonmentfor knowing
violations "
(5�a at Permittee) (Date)
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

RESEARCh & ANALyTiCA[ Report of Analysis
{V {
LAbORATORiESP INC,
3/1412018
41,516a108toe,.*
For Ready Mixed Concrete Company (Williamson) �0`((G;�
1590 Williamson Street 0,
Winston-Salem, NC 27107 NC d34 0, to
' NC937701
Attn Danny Rathbone i s
Client Sample Ili Outfall#t2 W238 Lab Sample ID 47462-01
Site Ready Mixed Concrete Collection Date 3/6/2018 1345
Parameter Method Result Units Rep Limit Analyst Analysis DatelTime
pH SM 4500 H+8-2000 881 Std Units 3/6/2018
Settleable Matter SM 2540 F-1997 <0 1 m1/1 01 AA 3/6/2018 1530
Total Suspended Solids (i'SS) SM 2540 D-1997 <5 mglL 5 AA 3/8/2018
NA = not analyzed
P 0 Box 473 106 Short Street Kernersvdle North Carolina 27284 Tel [phone] Fax [phone] www randalabs corn Page 1
r�I_raa_b�sw_v1d

RESEARCh & ANA[yTtCAI
UbORATORiES, INC.
Aoalytloai / Process Consultations
Phone [336) 996-3841
CO sPANY
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J09 NO
rREETA DRESS
so ,r1.�.►, C
PROJECT / ���
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CITY STATE,.ZIP
SAMPLE SiA3vSE (PLEASE'PRJNi)
CONTACT PHONE
SAMPLl±R SI p E
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SAJIPLEhU&WER
(LAF3 USE ONLY)
DATE
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SA}1?LI:LOCA7IQN!!4
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RELINQUISHED BY
DATEfTIhII;
RECEIVED BY
REMARKS
5MIPl_E TEMPERANREAT RECEIP'
RELINQUISHED BY
DATEMAIE
RECEIVED BY I
CHAIN OF CUSTODY RECORD

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
a
GENERAL�PER�M�TW'%N G140000
JAN 19 2013
CERTIFICATE OF COVERAGE NO NCG14 V I 5 ORSUMPLE COLLECTION YEAR
lf`'FQRMATIn�� p}'lf'CC
FACILITYNAME b6 5AMPLE QUARTER[]Jul-ept Oct -Dec ❑!an -March ❑April -lone
PERSON COLLECTING SAMPLES COUNTY �o
CERTIFIED LABORATORYLab # �4 PHONE NO
Lab # ADD TO LISTSERVE7 []YES ONO EMAIL
LIMIT VIOLATIONS? YES ❑ NO ® DISCHARGING TO CLASS ❑SA ❑FIQW ❑PNA ❑Trout ❑other
OPTIONAL INFO
Part A Wastewater )Monitoring Requirements
Outfall No
Date Sample
Collected)
(mm/dd/yr)
Type of Wastewater
z
(VF, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/Lj
TPH usingDischarge
method 1664A
SGT-NEVI'
(mg/Ll
Duration
(minutes)
Total Flow
7
(gallons/day)
-
6-934
3035
53
(15)6
-
-
Ti FloW
l
1 If wastewater systems have not discharged in this quarter— report "No Flow or No Discharge" here Please make sure to mark the sample quarter above
2 Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste stream is commingled
31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring
4 pH limits are 6-9 5 U for wastewater discharges to freshwaters and 6 8-8 5 5 U for discharges to saltwaters
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications .
Permit Date 7/1/2010-06/30/2015 last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 026 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE fQR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO _
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CLRTIFICATION 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 signifi ant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations "
(Signatur of Permitte (Date)
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 6 -2 1 5r
FACILITY NAME c I
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY ll t Lab # _y
_ Lab #
LIMIT VIOLATIONS? YES ❑ NO X ^—
PartA Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR D) `7
SAMPLE QUARTER hh®J��I-Sept ❑Oct -Dec ❑Jan -March
COUNTY --
PHONE NO (Al trr_� 79<—'
ADD TO LISTSERVE? []YES ❑NO EMAIL
DISCHARGING TO CLASS ❑5A ❑HQW ❑PNA ❑Trout
OPTIONAL INFO i -
❑April -June
❑Other
Outfall No
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
VE, RM, MD)'
{ )
pH
(standard)
Total Suspended
Solids
(rng/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
sGr-HEm'
(mg/L)
Discharge
Duration
(minutes)
Total Flow
r
(gallons/day)
-
6-9} 4
303 s
S3
(15)6
-,
-
C9 0(v f
"T z?q
3b
D�3
0
1^
I l L�
D
1
i 1f wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here Please make sure to mark the sample quarter above
2 Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material stockpiles (RM�, Mixing Drum
Cleanout (MD) Report more than one type if the waste stream is commingled
31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring z�
" PH limlts are 6-9 5 U for wastewater discharges to freshwaters and 6 8-8 5 S U for discharges to saltwaters
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications,
Permit Date 7/l/2010-06130/2D1S
Last Revised 07/13/11
Page 1of2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part 1V, Section A, including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flaw limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY IINCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO
Division of Water Quality -
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MU5T SIGN THIS CER77FICATION FOR ANY WFORNMTION 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 1 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)
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 O A j_S
FACILITYNAME 2,hwm (\7, %e
PERSON COLLECTING SAMPLES Oourk 2 I� ep �ciZ
CERTIFIED LABORATORY�n r l.) Lab #_
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR aI-, i I i
SAMPLE QUARTER ❑J I -Sept ❑Oct -Dec ❑Jan -March XApnl-tune
COUNTY
PHONE NOTq
ADD TO LISTSERVE? OYES ONO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO
Outfall No
Date Sample
Collected'
(min/dd/yr)
Type of Wastewater
VE, RMD a
{M, )
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(MLA)
TPH using
method 1664A
SGT-NFM'
{Trig/L)
Discharge
Duration
{minutes)
Total Flow
�
(gallons/day?
-
6 93 4
303 5
53
{15)6
-
oL
7
< 0
hc' I 0
""
— 1 V
�t1i
aS 7f17
n,
tL FIL-7^
r J 1\ �
II nn
_V 11V 1•�
1
If wastewater systems have not discharged in this quarter— report "No Flow or "No Discharge" here Please make sure to mark the sample quarter above
z Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste -stream is commingled
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months unless DWQ RO staff
notifies you to continue monitoring
" pH limlts are 6 9 S U for wastewater discharges to freshwaters, and 6 8-8 5 S U for discharges to saltwaters
5 TSS limits are 20 mg/L for wastewater discharges to 14QW waters, 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications
Permit Date 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50V. of the Summer 7Q10 Flow as per 15A
NCAC 02S 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the. DWQ Regional Office may require an annual flow
report on a case by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE fOR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUSTSIGN THIS CLR77FICATIQN 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 systt em 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 "
J— 3 Z>
(Signature of Permittee) (Date)
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALLf (SDO) - Semi-AnnuaI,MONITORING, FORM
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG1l4_0 ak { S
FACILITY NAME
PERSON COLLECTING SA PLES _
CERTIFIED LABORATORYt%c_4ab # _ 3 r{
Lab #
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR L
5AMPLINGPERIOD duly -December 0January3une
COUNTY
PHONE NO
ADD TO LISTSERVE7 ❑YES ❑NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout
❑Other
Outfap Na
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
units)
TSS
-
(mg/L)
Event
Duration
(minutes)
Total 4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months .n Tier
2 Samplingz
-
-
6-9 2.
1002'3
-
-
-
-
c�
_2_
10 - q
tv
, '7s —
A4
J L LV I!
C[[-"Nf i RAL FIDE[
UJVI( vt [, I ION
a If NO FLOW or 'NO DISCHARGE Enter 'NO FLOW or NO DISCHARGE for each outfall here Please make sure to mark the sample period above '
z If a value is in excess of the benchmark or outside the benchmark range (for pH), you must Implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 TSS benchmark values are 100 mg/1, except when discharging to ORW HQW, Trout, and PNA waters where they are So mg/l
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge
C
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Pagel of 2

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year
-
Outfall
-No
'k
..may r i
V , i
,� .,,$ i� v-.-.A�''
Date Sample
-
Collected r-
4'x
F {mo/dd/yrj
f c � f
.r- S- -
, ,. ,y µ
' "pH _
A, Standar&
r r
Units)
e. r :r,�Y,i,,,,�
.`.' +s T `-, � �,
�„ S .., � xi•. . KF_=r
TPH using meihody
r�� �''�
1664A SGT HEM
r; ,��� f
-.`, W�mg/L7 fir'
r u
'ti _���"a.�'.a-�' s*k
� s�-n"S-•� 7 � P Aso �:.
y
s Zy
otat�5vspended#
�� x�
Salids;
z2 +
r ~={mg%L) Y¢:�
y +, � ^s��`�i ��,•t
�'�`- r �� �1��'�.
Event
''cti `
`� aDuratian�
'�f f a a.a « -
z� 4{iinutesj.-_ "
��..ri'i q�t �3<�`n
T '4J) 1 � 1
�To afF�
# a£`
;7 RainfalE;r
uy -
(ink,,.
f` s: c �,
'i a
r2"L7c
New, Motor Odd
- j
�tJsage
_ -
t
-(gal/month) z
_.�.".7
t •---+-+-.. m`ii�'
ter
- I-;u--~
Y�Month[y, -
- ��
Monrtonng�
�4- st, ' `
�$ 7+' 7 � �
� i, f' �
# of Months
m iiers2
- 2
Sampling r -
-.n`a µ :�- c.e«'.c .c'
`�v
��_ t
,. µ J '-�
'T'��Ts st�2�,�,• Y}„`
r '.i 3.00
.�
�f✓7� 7
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail Oripinal and one copv of this DMR bricludrriR all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitorine' period
in case of "No_ Flow" to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify under penalty of law that this document and all attachments were prepared under my direction or -supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathpring the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am awareTat there are significant al es for submitting false information, including the possibility of fines and imprisonment for knowing violations "
i
(Signature of Permittee) (Date)
Permit Date 7/1/2011 60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14,0 d 1
FACILITY NAME
PERSON COLLECTING SAMPLES R ici
CERTIFIED LABORATORYIZ�--l-,IeC►dl l�,4--P-i Lab # 3y
Lab #
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR
SAMPLING PERIOD 4 July -December January -June
COUNTY �r E Cold
PHONE NO
ADD TO LISTSERVE7 ❑YES ❑NO EMAIL
DISCHARGING TO CLASS []SA ❑HQW ❑PNA ❑Trout
❑Other
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)
pH
(Standard
Units]
TSS
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly
Monitoring
(y/n)
# of Months in Tier
2 Samplingz
6-9Z
1002 3
}�
i
APR 0
DW
1 If 'NO FLOW or "NO DISCHARGE, Enter NO FLOW or NO DISCHARGE for each outfall here Please make sure to mark the sample period above
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH) you must implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthty sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 TSS benchmark values are 100 mg/I except when discharging to ORW, HQW, Trout, and PNA waters where they are S0 mg/l
`For each sampled measurable storm event the total precipitation must be recorded using data from an on -site ram gauge
QED
?01%
ILES
ION
Permit Date 7/1/2011 60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year
Outfall-
- No
Date Sample
Collected 1
(mo/dd/yr)i�
pH -
(Standard
Y Units)
7PH using method=
-
11664A SGT HEM
-(mg/L)
rf
Total Sus`peAded >
- ,�_ v
Sohds N -
v (mg/L)
l� ` i s
i
h< Event
_ Duration
1 (mnutes)
F�.
xr `,-
r Total
- a
Rainfall
(in) -
New Motor Oil,
r
` Usage
I
_(gal/month)
STwr�n'
InTidrz
-Monthly—
- Monitoring'?
# of Months
m Tier 2
z
Sampling
00Z'��_s
v ' _
V e_k i C�[.
iM A m i
C C- c
Or-t
f
3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME
Mail Onizlnal and one cor)v of this DMR (includinLy all "No Flow" & "No Dischame" reports) within 30 days of receipt of samole for at end of monitonne period
in of "No Flow") to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center i
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief, true, accurate and complete
am aw hat there are significaryt perpaltjes for submitting false information, including the possibility of fines and imprisonment for knowing violations '
I
1
(Signature of Permittee)
3-31 -1
(Date)
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER —Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 O ,Z I
FACILITY NAME N�_ atS rZ" _1.y( T
PERSON COLLECTING SAMPLES �at,.a► ,l�,ti�pl.t.2 _
CERTIFIED LABORATORY [LsaaUj cA.jLab # 34
Lab #
LIMIT VIOLATIONS? YES �K NO ❑
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR r? D 117 _ 1
SAMPLE QUARTER ❑ ul-Sept ❑Oct -Dec NJan-Marct
COUNTY Ct.s , f Qo
PHONE NO (13 1
ADD TO LISTSERVE? []YES ❑NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout
OPTIONAL INFO
❑April -June
❑Other,
Outfall No
Date Sample
Collected'
(min/dd/yr)
Type of Wastewater
( UE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
5GT HEN
(mg/L)
Duration
(minutes)
Total Flow
r
(gallons/day)
6-934
3035
53
(15)6
-
-
I
' If wastewater systerns have not discharged in this quarter— report "No Flow or "No Discharge here Please make sure to mark the sample quarter above
2 Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste stream is commingled
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring
° pH limits are 6-9 S U for wastewater discharges to freshwaters and 6 8-8 5 5 U for discharges to saltwaters
5 T5S limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications x
Permit Date 711/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a )imit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUALS MMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO
Division of Water Quality
Attn DWQ Central Files
1617 Mad Service Center
Raleigh, North Carolina 27699-1617
[phone]
YQij MUST 51GN 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 ' i
(Signature of Permittee)
Permit Date 711/2010-06/30/2015
3- 3i E r7
(Date)
Last Revised 07/13/11
Page 2 of 2

RESEARCh & ANAlyTiCAI
LABORATORIES, INC.
For Ready Mixed Concrete Company f ,2,60s)
4O (, o in M ; n,son Street
4 J: G H Fbjrr., NC 27260
Attn Danny Rathbone
Report of Analysis
1 /26/2017
.' kid C "�li►�' • 1
=�4 NCIt34 Zf
NC#37701
Client Sample ID Outfall #1 Lab Sample ID 29935-01
Site Ready Mixed Concrete Collection Date 1/20/2017 1005
ea ter Method fiaWft UjIb Rep Limit Analvat Analysis DatelTime
pH SM 4500 H+B-2000 755 Sid Units 1/20/2017 1005
Total Suspended Solids (TSS) SM 2540 D-1997
Client Sample ID Outfall #2
64 mg/L 5 JB 1/23/2017
Lab Sample ID 29935-02
site Ready Mixed Concrete Collection Date 1/20/2017 1005
Parameter Method Result Units ep_i�imltAnal s Analylls DateMme
pH SM 4500 H+3 2000 888 Std Units 1/2012017 1005
Settleable Matter SM 2540 F-1997 <0 1 mlfl 01 SK 1/20/2017
Total Suspended Solids (TSS) SM 2540 D-1997 536 mg/L 5 JB 1/2312017
NA = not analyzed
P 0 Box 473 106 Short Street Kemersville, North Carolina 27284 Tel [phone] Fax [phone] www randalabs corn Page 1
ral_coa bask, .;od

i —
t
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report --
GENERAL KERMIT No NCG140000
CERTIFICATE OF C VE��``GE NO -N G14_Q_2 {
FACILITY NAME fFWJ'4 M:yeb
PERSON COLLECTING SAMPLES Ic5
CERTIFIED LABORATORY V4,SfM ► 4;ti uf} y� , _ Lab # C_
'Lab#
LIMIT VIOLATIONS? YES ONO Z
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR. A 1 to _ 1 N `
SAMPLE QUA ER aJ Sept ®Oct -Dec ❑Jan -March ❑April -tune
COUNTY
PHONE Ni?. o _(a a
AD13 TOILISTSERVE? ❑YES ❑NpF EMAIL- f
DISCHARGING TO CLASS [:]SA ❑HQW� ❑PNA ❑Trout []Other
OPTIONAL INFO' t r r�—
Outfali No
Date Sampl6
Collected
(mm/dd/yr)
of Wastewater
(VE, RM, MD)Z
pH
(standard]
Total Suspended
solids
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH uslnQ
method 1664A
SGT HEe
(mg/L)
Discharge
} r
Du ra Linn
(minutes)
Total Flow
(gallons/day)'
-
-
-
6-9"
303's
59
usf
-
H F-- (' #-
I V I'- i J
.-.r►Trz s
rep rr.
Y
S
4
r+snm C^c
el-IIrani
1 If wastewater systems have not discharged In this quarter— report "No Flow" or "No Discharge" here Please make sure to mark the sample quarter dbove
a Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stock des (RMj, Mixing Drum
Cleanout (MD) Report more than one type if the waste -stream Is commingled
s If an effluent limit is exceeded twice In a row, the permittee is required to institute monthly monitoring for -that parameter for six months, L Mess DWQ RO staff
notifies you to continue monitoring
4 pH limas are 6-9 S U for wastewater discharges to freshwaters, and 6 8-8 5 5 U for discharges to saltwaters
5 TSS limits are 20 mg/L for wastewater discharges to 14QW Waters,10 mg/L forTrout and PNA waters, and 3a mg/L for all other water classi icatIons r J
Permit Date 7/l/2010-06/30/2015 " _ " t ast Revised 07/13/11
Page 2 of 2
{

S
6 Process wastewater discharges shall only be monitored for TPH when commingled lnnth stormv;ater discharges from VMA areas TPH does not havei limit for wastewater,
but Instead is subject to benchmarks and provisions of Part IV, Section A, Including the Tiered Response Action t i
' Flow rate can be measured continuously or calculated Flow limits For wastewater discharges to HQW waters shall be set to SO% of the Summer Flow as per 15A
NCAC 0213 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer7Q10 flow and report this information to DWQ. If th4 p�ermittee cannot
obtain a Summer 7Q10 flow for the receiving waters"at the discharge`locatlon, the permittee shall notify DWQ, and the DWQ Regional Office may retlaire an annual flow
report on a case -by -case basis - -
r
MAIL ORIGINAL AR "-NE COPY OF THIS ANNUAU SSUMMARY fINCLUDING ALL "NO FLOW. "NO I)ISCHARGEE") WITHIN 34 DAYS OF RECEIPT OF SAMPLE (OR
'AT -END QF ITV 01V1">wORING PERIOD IN CASE OF -"'NO FLOW'—) TO x
_
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
nkx
a �
�r
1 �
YO MOTSIGN TFf! ER77FICA770N FOR ANY IIVFORMA77ON 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 personTel 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 lnfornYhUon submitted,isrtorthe best of,my knowledge and belief, true, accurate, and
complete I am aware that there are si nificant penalties for submitting false Information, Including the possibility offines and imprisonment for knowing
violations
x
— Q / - J
(Signature of Permittee) s
(Date) "
Permit Date 7/1/2010-06/30/2015
Revised 07/13/11
,iLast
Page 2 of 2
Y

STORM WATER -DISCHARGE OUTFALyL (SDO) - Semi-Annual`MONITORING FORM
GENERAL PERMIT NO NeG140000
CERTIFICATE OF COVERAGE NO NG�,4 0 2FACILITY NAME K �l; kc�-J.� f C./1ee_
PERSON COLLECTING SAMPLES 4
CERTIFIED LABORATORYR l cMZ I I Lab #
Lab #
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR A1C) I (
SAMPLING PERIOD Ju y-December El January -June
COUNTY ems- I_r
PHONE NO
ADD TO LISTSERVE7 ❑YES [:]NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout
❑Other.
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW}1
pH Y
- (Standard
Units}
TSS
(mg/L)
Event
Duration-
(minutes}
Total 4
-Rainfall -
(in}
In Ter 2
Monthly
Monitoring
(y/n'
# of Months in Tier
2 Sampling x
-
-
6-92
10023-
D d YJ
7 All
CENT"3Al mi
>=C
5EC1 ft
}N
1 If NO FLOW" or "NO DISCHARGE, Enter 'NO FLOW' or 'NO DISCHARGE' for each outfall here Please make sure to mark the sample period above
2 If a value is in excess of the benchmark or outside the benchmark range (for pH) you must implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 TSS benchmark values are 100 mg/l, except when discharging to ORW HQW, Trout, and PNA waters where they are 50 mg/l
° For each sampled measurable storm event the total precipitation must be recorded using data from an on site rain gauge
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2 1

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month -averaged over a calendar year
�ti � ��-
tf
„a
- No - r'
tf =.w
-=a'''�� ��r ��
rye=
" `
r Date 5amleis
�t�
=r;P Collected'
r P
Y
� �,,^ t
i
� ��L��, � � ^,
��.�.'pHW ,��
Ai Standard=�-1664ASGT-HEMS
{
-- —� ,� a �
-��Units), x
}'..ax "'ri """'-
�= . rr �,:-r�'i r
�-TPH using methods
x awe
y �. t� -,
7 �,
(mg/L} 4
>=^'�+.fm-•�
� a,"s�'-p -'" �
--Total Suspended
-
,solids rf�-�
d -.ram . y,
(mg/L)' ��v�
` Y''#. cF„
=r ��r�' ' �d,,l•.
�Event� a
=+, -x-�
D`urativn�iR
��.. A� � ;,
{minutes}c
" 7�
„r � a�r
��Totalr "
-�
M Ramfallaw
.r , � _Try
rt '
x
3 sr4
�`4 � 'L �=�..� t. a�
New Motor Oi[�:
�,��� _
a Usa
s g
�-
�galJmonth)
f'
Y �
-In AT2 1
r ` � rt 4���=�-�.. h
Monthly'
� Y�
a MOnItQing-, r#M�
7Lx
�YJ }�"�r»�i"'
*�$- i::�� 9"� 1
�s rrI
` tl of Months,,}
s •?�
�In. ierc2
a iAsr2� ac
5ampling,�
§F
C
3�, r +..,�
6-9 .f
.-.r•?' Ali;£ r $
i5.na� 3 r
�" "s •2 '" �
r IUD
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1 t = w
x
x'
w „_ &
�� �'� '
�'
l
t �.'�n
r
s
r
yf
l
�
5F
v
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ;
REGIONAL OFFICE CONTACT NAME
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitonne oenod
in case of "No Flow") to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699 1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law, that this document and all attachments were prepared under my direction orsupervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware there are signifiLca alties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
/"Di —/7
(Date)
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
5
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF C VE GE NO NCG141 1 _i'
FACILITY NAME C� Cc
PERSON COLLECTING SA LES
CERTIFIED LABORATORY- 1 ab # C3
Lab #t
LIMIT VIOLATIONS) YES ❑ NO Dq
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR c:R01 4, _ _
SAMPLE QUARTER �Of-ept ❑Ott -Dec ❑ian-March
COUNTY11
PHONE NO (3W `p j& -
ADD TO LISTSERVE) ❑YES ❑NO EMAIL
❑April -June
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO i
I
4utfall No
Date Sample
Collected
(min/dd/yr)
Type of Wastewater
z
(VE, RM, MD}
pH
(standard}
Total Suspended
So lids
(rng/L)
Settleable
Solids
(mL/L)
TPH usrnpDischarge
method 1664A
SGT-HEAL'
{mg/L)
Duration
(minutes)
Total Flow
�
(gallons/day}
6 934
3035
53
(15)6
-
b
I
C11 CC
n
vR ;PCTION
I
1 If wastewater systems have not discharged in this quarter— report "No Flow" or No Discharge" here Please make sure to mark the sample quarter above
z Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD} Report more than one type if the waste -stream is commingled
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring
pH limits are 6-9 S U for wastewater discharges to freshwaters and 6 8-8 S 5 U for discharges to saltwaters
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q1© Flow as per 15A
NCAC 028 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" WITHIN_ 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST S16N THIS CERTMICATlON 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 "
lb�o3_-
( i ure of Permitteej (Date)
Permit Date 7/1/2010-06/30/201S Last Revised 07/13/I1
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report 4
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO-- CG14 0
FACILITY NAME fZcw�� M:Xre� t+ca
I fir-,
_C� 0
SAMPLE COLLECTION YEAR
SAMPLE QUA TER _]Jul -Sept ❑Oct -Dec ❑lair -March ®April-lunemn
COUNTY I
PERSON COLLECTING SAMPLES VAa04
(c
L3Cl
„
CERTIFIED LABORATORY t e1 .'f'
Lab # 3�=
PHONE NO, r� y S 3 - 3 _
ADD TO USTSERVE? [_]YES ONO EMAIL
LIMIT VIOLATIONS? YES ❑'NON
Lab #
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout []Other
Part A WastewaterMonitorinIgReq.uirements
OPTIONAL INFO•
Outfall Ha
Date Sample
Collected)
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD}
PH
(standard)
Total Suspended
Solids
(mgjl.)
Settleable
Solids
(mLJL}
TPH using
method1664A
SGT HEV
(mg/L)
Dischi4ge
Duration
(minutes}
Total Flow r
(gallons/day}
-
-
-
6-g"
3
5'
(1S}6
-
b
'1
�
l 0
P►
D
cb
M �
C I
' C I"1
..� v
o
S3
MAY 2 r
018
Z,EN I RAL F
LES
14
Y 2 1
UVVK SEMUN
_
i filSlb r ILA
J
I
1 If wastewater systems have not discharged In this quarter— report'No Flow' or 'No Discharge' here Please make sure to mark the sampi quarter above
Z Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stock iles (RM); Munng Drum
Cleanout (MD) Report more than one type If the wast"tream is commingled L
B If an effluent limit is exceeded twice In a row, the permittee is required to Institute monthly monitoring for that parameter for six months, L nless DWQ RO staff
notifies you to continue monitoring E{
" pH limits are 6-9 S Ll for wastewater discharges to freshwaters, and 6 M S S U for discharges to saltwaters te,
s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water class[ nations r
Permit Date 7/1/2010-06/30/2015 " Last Revised 07/13/11
Page 1 of 2
ry

S `
s Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not haves limit for wastewater,
but instead is subject to benchmarks and provisions of Part N, Section A, Including the Tiered Response Action ' `
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 026 0224 Pennittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this Information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis
J
MAIL ORIGINAL. AND -ONE COPY OF TH15ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", -"NO DISCHARGE-) WjTdM3Q ,PAYS OF RECEIPT OF SAMPLE, (OR
'-AT END OF MONITO JhG PERIOD IN CASE OF -"NO FLOW") TO F
Division of Water Quality
Attn DWQ Central Files -
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone] --
r
U'
YOU MUST SIGN THIS CERTIFICA-nbN 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 inforrriation submitted Is, to the best of my knowledge and belief, true, accurate, an;d
complete! I am aware that there are significant penalties for submitting false information, including the possibility of fines and Imprisonment for knowing
violations-
f?
f
(Signature of Permittee) (Date)
Permit Date 7/l/2010-06/3D/2015 _ Last Revised 07/13/11
Page 2 of 2

RESEARCI7 & ANALyTICAI
LAbORATOR1E5i INC.
�)06�/
For Ready Mixed Concrete Co -High Point
406 Tomlinson Street
High Point, NC 27260
Attn Danny Rathbone
Report of Analysis
3/7/2016
s�;.•�.t 4- CH,q' . Sri
�� c►� NC#34 ��N
NC #37701
Client Sample ID Outfall #1 Lab Sample ID 15474-01
Site Ready Mixed Concrete Collection Date 2/24/2016 1040
Parameter Method Result Units Rep Limit Analyst Analysis Dateffime
pH SM 4500 H+B 2000 732 Sid Units 2/24/2016 1040
Total Suspended Solids (TSS) SM 2540 0-1997
112 mg/L 5 AW 2/29/2016
Client Sample ID Outfall #2 Lab Sample ID 15474 02
Site Ready Mixed Concrete Collection Date 2/24/2016 1040
Parameter Method Result Units Rep Limit Analyst Analysis Date/Time
pH SM 4500 H+B 2000 874 Std Units 2/24/2016 1040
Settleable Matter SM 2540 F 19G7 <0 1 mill 01 YJ 2/25/2016
Total Suspended Solids (TSS) SM 2540 D 1997 250 mg/L 5 AW 2/29/2016
NA = not onolyzed
_
IN
Z2N
P 0 Box 473 106 Short Street Kernersville North Carolina 27284 Tel [phone] Fax [phone] www randalabs corn Page 1
ral_coa_basic_vt d

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO NCG140000
CERTIFICATE OF CRVE_R\ GE NO NpCG14 0 A J S
FACILITY NAME tl (V),/.d �crcR-�7� Ca
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORYLab # 34
Lab #
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR a� 1
SAMPLING PEIOD J ly-December January -June
COUNTY V IF
PHONE NO �3C=-A :�Z �R<
ADD TO LISTSERVE7 ❑YES ❑NO EMAIL a�
DISCHARGING TO CLASS []SA ❑HQW ❑PNA ❑Trout ❑MW
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
{Standard
Units)
TSS�
(mg/L)
Event
Duration
{minutes)
Total 4
- Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
6-92
1002 3
-
-
-
-
oZ
t RS
��
N
A
21 2016
DWR
SECTION
F
f
1 If NO FLOW or "NO DISCHARGE Enter' NO FLOW" or'NO DISCHARGE' for each outfall here Please make sure to mark the sample period above
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 TSS benchmark values are 100 mg/I except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year
� � �
' f
Outfall -.
No
ri
} frsc lc
�Sh` �i' r
-
Date Sample-
vCollected
t M
- r}✓Fi..
�
- -°� �" _ _
� �
t`
pH
„�
{Standard
r
Units)
r N
£v ��i"
— � hs. act y ...R ,+�
� n. f i•- N _m
! l� y
TPIi usrngi mettiodTotai
m
1664A SGT_-HEM -
_ =�r,�~
�(nig/L) - '--+
s .- ..
-..�.k
'ti2ay Yv � 3" �tya a+�.Y�
,�ce�
d+-f " Y .+`r.2.F`f
Suspended,F
,� ^ U r
-;� fAsolids i
_ '�- _�
''{mg/�L) -t» ,
isr1+!?rr+.._ yr-Cn �E7�
' Esr.,a �F 3,y tSr
YY Event` �+'TotaE-`"rt
=
Duration
i>" man
i�f:{minute`sj4
ii "� � � �.S � �
4,-ss�'S2 ��
- r as
Rainfall ;
.f a
�- _{inj y w�,
-r�� � " r' q
New Motor Ody
^_ LL_ w
_Usage _
t� _� s
(galjmonthj� __
?'�:' H'�`w''•dnls�.4+7 �?a
U x °•-�"
-Monthlys�
}Monitoring7<
K{Y/m
� i z ::1,a�
# of,Months
r F
rsamp6ng
r ti t k
N
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ i
REGIONAL OFFICE CONTACT NAME
Mail Original and one copy of this DMR (includini? all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to
Division of Water Quality
Attn DWQCentral Files `
1617 Mail Service Center -
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law that this document and all attachments were prepared under my direction orsupervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief true, accurate, and complete
am aw�hat there are significan alties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
re of Permittee)
3-1i31
(Date)
Permit Date 7/1/2011 60/30/2015 Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No -NCG14 a vA
FACILITY NAME VN 3 'i`
PERSON COLLECTING SAMPLES laow4;0, l
CERTIFIED LABORATORY 3 ; cFt/ Lab # .,aU_
{ Lab #
LIMIT VIOLATIONS? YES ❑'NO
11
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: �I G
SAMPLE QUAD TER ❑M-Sept []Oct -Dec ®Jan -March
COUNTY T
PHONE NO. 3[3 tp
ADD TO USTSERVE? ❑YES ❑NO, EMAIL_- i v
DiSCHAAGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout []Other
OPTIONALINFO, i rjF
t
Qutiall Na
Date Sampl6'
1
collected' 4
(mm/dd/yrl
Type of Wastewater
(VE, RM, MD)z
pH
(standard)
Total Suspended
Solids
(mg/0
Settleable
Solids
(mLIL)
TPH using
method 1664A
5GT HEM'
(m L)
Discharge
aura L
(minutes)
Total Flow
(gallons/day)'
-
-
-
6-93.4
_ 3oi -
s'
(15)6
-"
-
O b 3
�Y
"i
r
� x-
-
If wastewater systems have not discharged In this quarter— report "No Floyd' or "No Discharge" here Please make sure to mark the samplquarter above
2 Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stock Iles (RM); Mixing Drum
Cleanout (MD) Report more than one type If the waste -stream is commingled L
' If an effluent limit is exceeded twice in a row, the permittee is required to Institute monthly monitoring forthat parameter far six months, L Ness DWQ RO staff
notifies you to continue monitoring ¢C
4 pH limits are 6-9 S U for wastewater discharges to freshwaters, and 6 8-8 5 S U for discharges to saltwaters tl
s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L forTrout and PNA waters, and 30 mg/L for all other water ciassi nations r
Permit Date 7/1/2010-0SJ3o/261s w Last Revised 07/13/11
s�
Page I of 2
K

.L
6 Process wastewater discharges shall only be monitored for7PH when commingled with stormwater discharges from VMA areas TPH does not have"a'llmlt for wastewater,
but instead is subject to benchmarks and provisions of Part N, Section A, includtng the Tiered Response Action `
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q16 Flow as per ISA
NCAC 028 02-24 Perm,ttees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the recewuigwaters at the ducharge`loration, the permlttee shall notify DWO, and the DWQ Regional Office may reguire an annual flow
report on a case -by -case basis
1
l � _
t
MAIL ORIGINAL ANDQNE COP FO THIS ANNUAL SUMMARY (INCLUDING AL -- FLOW" "NO DISCHARGE- 3 YS OF RECEIPT F SAMPLE OR
-AT-END OF MONITORING PERIOD IN CASE OF ENO FLOW) TO-
Division of Water Quality ,
Attn DWQ Central Files _
1617 Mall Service Center
Raleigh, North Carolina 27699-1617 _
[phone] rikt
t
u
1 3
YOU M ! N MU OffIVIC4770N FORANYMRMA77ON REP RT D
'l certify, under penalfy of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that quaiifiio�d person?' el properly gather and evaluate the information submitted based on my inquiry of thetperson 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 possibllity of fines and Imprisonment for knowing
violations
— - - (Signat'Gre of Permittee) (Date) Y
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 D S W SAMPLE COLLECTION YEAR ao+s I
FACILITY NAME R A µ iyccj o +c,2dYc eo SAMPLING PERIOD July -December QJanuary-June
PERSON COLLECTING SIMPLES COUNTY Chs i06
CERTIFIED LABORATORY rRr�cy�i Aitriyf'c,f-/ _ _ Lab I#
Lab # ADD TO LISTSERVE7 []YES [:]NO EMAIL
OPTIONAL INFO DISCHARGING TO CLASS ❑5A ❑flQW ❑PNA ❑Trout ❑Other 0
Part A Stormwater Monitoring Requirements
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
pHEvent
(Standard
Units)
TSS
(mg/t)
Duration
(minutes)
Total
a
Rainfall
(m)
In Ter 2
Monthly
Monitoring?
(y/n)
A of Months in Teer
2 Sampling2
-
6 9
100 3
-
-
0
C
3
DWR SEC
i
' If NO FLOW or NO DISCHARGE Enter NO FLOW or NO DISCHARGE for each outfall here Please make sure to mark the sample period above
i If a value is in excess of the benchmark, or outside the benchmark range (for pH) you must implement the Tier 1 or Tier 2 responses in the General permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 TSS benchmark values are 100 mg/1 except when discharging to ORW HQW Trout and PNA waters where they are 50 mg/1
For each sampled measurable storm event the total preopitation must be recorded using data from an on site rain gauge
(ED
015
LES
ON
Permit Date 7/1/2011 60/30/2015 J Last Revised 7/13/11
q Page 1 of 2
0

Part B ]Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year
Outfall
No
Date Sample
Collected
[mo/dd/yr}I
pH
{Standard
Units}
FPH using method
16644 SGT HEM
{mgJL}
Total Suspended
Solids
{mg/i}
Event
Duration
{minutes}
Total
Rainfall'
(in)
New Motor Oil
Usage
(gal/month)
In Fier 2
Monthly
Mo nitoring>
ty/n}
{
# of Months
in Tier 2
SamplingZ
6-9
15
21
100
-
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE QUTFALL [INCLUDING VEHICLE MAINTENANCE}? YES []NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME
Mail Original and one coAv of this DMR [including all No Flow' & 'No Discharge' reportsl within 30 days of receipt of sample [or at end of monitoring period
in case of 'No Flow ] to
Division of Water Quality
Attn DWQ Central Files
1617 Marl Service Center
Raleigh North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATIOIy 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 forgathering the information the information submitted is to the best of my knowledge and belief true accurate and complete I
am aware that there are significagrt p��alttes for submitting false information, including the possibility of fines and imprisonment for knowing violations
(Signature of Permittee]
Permit Date 7/1/2011 60/30/201S
3-19-1-A0LJ6._
{Date}
Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report F
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NgqCG14 O .gL
FACILITY NAME a4 of �oxitwa-ht
PERSON COLLECTING SAMPLES IAO
CERTIFIEDIASORATORY ht,du-I1� SAJLab# t-3
Lab #
LIMIT VIOLATIONS? YES 0 NO [4
Part A Wastewater Monitoring Reguirements
SAMPLE COLLECTION YEAR 1
SAMPLE QUARTER []Jul -Sept [KOct-Dec ❑tan-Marct
COUNTY
PHONE NO
ADD TO LISTSERVE? []YES ❑NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA []Trout
OPTIONAL INFO ' iR
i
RECEIVED
DEC 16 2015
CENTRAL FILES
DWR SECTION
❑April -June
❑Other,
Outfall No
Date Sample
Collected"
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD),
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT HEAe
mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day)'
-
-
-
6-9P
30"'
59
(25), �
-
-
I
a
h
1,
1
}
I If wastewater systems have not discharged to this quarter— report "No Flow" or "No Discharge" here Please make sure to mark the sample quarter above
a Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stock Iles (11M), Mixing Drum
Cleanout (MD) Report more than one type if the waste -stream is commingled +
3If an effluent limit is exceeded twice in a row, the permittee Is required to Institute monthly monitoring for that parameter for six months, Lniess DWQ RO staff
notifies you to continue monitoring
A PH limits are 6-9 S U for wastewater discharges to freshwaters, and 6 8-8 5 S U for discharges to saltwaters is
S TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classi ications r
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
t

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not haven lirrilt for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action ' `
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q1O flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may retluire an annual flow
report on a case -by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDINg ALL "NO FLOW". "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF-M-0NITORING PERIOD IN CASE OF "NO FLOW") TO
Division of water Quality
Attn DWQ Central Files
1617 Mall Service Center ` -
Raleigh, North Carolina 27699-1617
[phone] s
YOU M SIGN THIS R o AN Y INFORMA n N REPORTED
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision In accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my Inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the Information, the Information submitted is, to the best of my knowledge and belief, true, accurate, and
complete I am aware that there are significant penalties for submitting false Information, Including the possibility of fines and Imprisonment for knowing
violations "
(Signature of Permittee) (date)
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11'
Page 2 of 2
IM

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 D ,4 LS
FACILITY NAME r",4 Co.1C9-V't Co
PERSON COLLECTING SAMPLES t{o&J,w& c
CERTIFIED LABORATORY A„u_iiA4,c61 Lab # n�L 3y
Lab #
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR oZ 016--
SAMPLING PERIOD July -December ❑ January -June
COUNTY C u � -ia�
PHONE NO (Zar_ } Oi A-
ADD TO LISTSERVE7 ❑YES ❑NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)�
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly
MonitonngO
(y/n)
# of Months in Tier
2 Samplmgz
-
-
6-92
100 3
-
-
-
t"
i ti57
A
CENTRAL FILE
DWR SECTION
1 If NO FLOW or 'NO DISCHARGE Enter NO FLOW or NO DISCHARGE for each outfall here Please make sure to mark the sample period above
2 If a value is m excess of the benchmark, or outside the benchmark range (for pH) you must implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or withm the benchmark range
3 TSS benchmark values are 100 mg/I except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I
For each sampled measurable storm event the total precipitation most be recorded using data from an on site rain gauge
Permit Date 7/1/21311 60/30/2015 Last Revised 7/13/11
Page 1 of 2

PartB Vehicle Maintenance Activity Monitoring Reouirements for facilities using > SS oral of npw mntnr nd/mnnth -- avpragpd nvpr a ralpndar vpar
-
Outfall
-No
_
Date Sample
-Collected s
1
(mo/dd/Yr)
pH
(Standard
_ 1 -
Units) _
TPH using method
-1664A SGT-HEM
_ s
x (mg/L)
ti�
"Total Suspe'n_ded
- l
SAds'-
- -
{mg/L)
r = Events `k
r -
- Duration _
(minutes)
- ~` TotaF_
a
Rainfall
- 6
(in)°
�% J�
New Motor Oil
-
Usage-_ -
(gal/month)
�ln Tier'2
-
r5 Monthly - -
4 11
Monitoring?
- -
# of Months
-
in Tier 2- -
- 2
Sampling
6'92-
15z-ti -�r
- 100z s_ �,z
v� f -
- -
-
F� - -
- --A4 Y
s
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN CES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME
Mail Original and one copy of thisiDMR f including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to
Division of Water Quality
Attn DWQCentral Files
1617 Mail Service Center `
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information the information submitted is, to the best of my knowledge and belief, true, accurate, and complete I
am aware that there are significant }enalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signature of Permittee)
Permit Date 7/1/2011 60/30/2D15
)-2-sr-/s
(Date)
Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCGI40000
CERTIFICATE OF COVE GE NO N G14_ ,g _, ,�
FACILITY NAME )Z -� 0) Y-,°.3 C tctt-.-fc Le
PERSON COLLECTING SAMPLES v
CERTIFIED LABORATORY Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR D1 1
SAMPLE QUARTER �u�Sept ❑Oct -Dec []Jan -March OAprll-June
COUNTY
PHONE NO (,g).
ADD TO LISTSERVE7 []YES ONO EMAIL
DISCHARGING TO CLASS. []SA ❑HQW ❑PNA [Trout ❑Other
OPTIONAL INFO i
Outfail No
Date Sample
collected 1
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)Z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT HEA f
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)7
t7W
p,� fifi
1 1�
R
i
l
l L iJ
1
11 1`
tnrir
1 If wastewater systems have not discharged In this quarter-- report "No Flow" or "No Discharge" here Please make sure to mark the sample quarter above
Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stock Iles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste -stream Is commingled
If an effluent limit is exceeded twice In a row, the permittee is required to institute monthly monitoring forthat parameter for six months, L nless DWQ RO staff
notifies you to continue monitoring e
a pH limits are 6-3 S U for wastewater discharges to freshwaters, and 6 8-8 5 S U for discharges to saltwaters x
s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/l. for Trout and PNA waters, and 30 mg/L for all other water class[ ications r
Permit Date 7/1/2010-06130/2015 1 - Last Revised 07/13/11
Page 1 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a�{tmit far wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action '
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 0224 Permttees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow
report on a case -by -case basis
MAIL ORIGINAL AND QNE COP OF THIS ANNUAL SUMMARY 1INCLUDING ALL "NO FLOW" "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF 5AMPLE OR
AT ND QF OO_MIORING PERIOD IN CASE OF "NO FLOW"i TO
Division of water Quality
Attn DWQ Central Files -
1617 Mail Service Center a
Raleigh, North Carolina 27699-1617
[phone] x
YOU M ! NTH! R FOR ANYINFORMATION 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 "
4
(Signature of Permittee) (Date)
Permit Date 7/1/2010-09/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG140 o 1 S
FACILITY NAME vl ��
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY I✓ b # L�
Lab #
LIMIT VIOLATIONS? YES ❑ NO Ea
PartA Wastewater Monitoring Reauirements
RECEIVED
JUL 66 z0115
CENTRAL FILES
SAMPLE COLLECTION YEAR LAD IS I
DUVR SECTION
SAMPLE QUARTER Jul -Sept ❑Oct -Dec ❑Jan -March April -June
COUNTY but l �u
PHONE: NO
ADD TO LISTSERVE? ❑YES [:]NO EMAIL
DISCHARGING TO CLASS ❑SA HQW []PNA []Trout ❑Other
OPTIONAL INFO
Outfail No
Date Sample
Collected"
(mmJdd/yr)
Type of Wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Salads
[mg/L)
Settleable
Solids
(mLJL)
TPH usIngDischarge
method 1664A
SGT-HEM'
(m
Duration (minutes)
Total Flow
[gallons/day]'
-
-
-
6-934
3035
53
(15),
-
-
I
" If wastewater systems have not discharged In this quarter — report "No Flow" or "No Discharge here Please make sure to mark the sampl quarter above
s Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning [VE), Raw Material Stock Iles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste stream is commingled
31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, L nless DWQ RO staff
notifies you to continue monitoring -
4 pH limits are 6-9 S U for wastewater discharges to freshwaters, and 6 8-8 5 S U for discharges to saltwaters
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/t for Trout and PNA waters, and 30 mg/L for all other water class+ +cations a
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

1b
6 Process wastewater discharges shall only be monitored forTPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but Instead is subject to benchmarks and provisions of Part IV, Section A, Including the Tiered Response Action
Flow rate cpn be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NC4C 028 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case bans
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE") WIT IN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MON110—RINGPERIOD IN CASE OF "NO FLOW") TO
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST IGN TH15 CER77F1G4TION FOR ANY IIVFORMA77ON REPORTED
"1 certify, under penaky 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 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and Imprisonment for knowing
violations " 1 /
&---32DO-)
(5ignatu a of Permi tee) ., (Date)
Permit Date 7/l/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
y GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG14 0 9 I S`
FACILITY NAME
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY R-tx Lab # 3L4
Lab # �^
LIMIT VIOLATIONS? YES ❑ NO Q
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR O 15
SAMPLE QUARTER YJul-Sept []Oct -Dec g1an-March
COUNTY
PHONE NO -
ADD TO LISTSERVE7 []YES [:]NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout
OPTIONAL INFO
[]April June
❑Other
Outfall No
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
PH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)
6 934
303S
53
(15),
O
�3- «1 i,
L O
U7
!TD
D
LES
I
1 if wastewater systems have not discharged in this quarter-- report No Flow or No Discharge here Please make sure to mark the sample quarter above
Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE) Raw Material Stockpiles (RM) Mixing Drum
Cleanout (MD) Report more than one type if the waste stream is commingled
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months unless DWQ RO staff
notifies you to continue monitoring
° pH limits are 6 9 S U for wastewater discharges to freshwaters and 6 8 8 5 S U for discharges to saltwaters
5 TSS limits are 20 mg/L fo'r wastewater discharges to HQW waters 10 mg/L for Trout and PNA waters and 30 mg/L for all other water classifications
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

,6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater
but instead is subject to oenchmarks and provisions of Part IV Section A including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 1Q10 Flow as per 15A
NCAC 028 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case basks
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MQUITORING PERIOD IN CASE OF "NO FLOW" TO
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699 1617
[phone]
r
YOU MUST SIGN THIS CERTIFTAT1�11 FOR ANY lNF RMATlON 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)
3-/9-1,5'-
(Date)
Permit Date 7/1/2010 06/30/2015 Last Revised 07/13/11
Page 2 of 2

K
e
PROCESS WASTEWATER --- Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG14 4 a i .S-
FACILITY NAME f A&-er,
PERSON COLLECTING SAMPLES )AaNrAI
CERTIFIED LABORATORY 4 oc A Lab # _,q
Lab #
LIMIT VIOLATIONS? iES ❑ NO Q-'
Part A Wastewater Moniforing Requirements
SAMPLE COLLECTION YEAR c-A019 -
SAMPLE QUARTER ❑J I -Sept gOct-Dec ❑Jan -March ❑April -June
COUNTY
PHONENO
ADD TO LISTSERVE? ❑YES [:]NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA []Trout ❑Other
OPTIONAL INFO
Outfall No
Date Sample
9
Collected
(mm/dd/yr)
Type of Wastewater
RMM{3} z
{VE, ,
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Sohds
(mL/L)
TPH using
method 1664A
SGT NENIG
(mg/L)
Discharge
Duration
(minutes)
Total Flow
7
(gaElons/day}
-
-
-
6 934
3035
53
(15)6
-
,d -r
o I r+t
3o
a
f
rr
� .J-isr r
4 q c+
EG;
i rvJ
...
f e
E
I
1 If wastewater systems have not discharged in this quarter— report "No Flow or' No Discharge here Please make sure to mark the sample quarter above
2 Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD} Report more than one type if the waste stream is commingled
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter For six months unless DWQ RO staff
notifies you to continue monitoring
a pH limits are 6 9 S U for wastewater discharges to freshwaters and 6 8-8 5 S U for discharges to saltwaters
5 TSS limits are 20 mg/L fo} wastewater discharges to HQW waters 10 mg/L forirout and PNA waters and 30 mg/L for all other water classifications
Permit Date 7/1/2010-06�30/2015 Last Revised 07/13/11
Page 1 of 2
�i

a Process wastewater discharges shall only be monitored for TAN when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject tolbenchmarks and provisions of Part IV Section A including the Tiered Response Action
' Flow rate can be measured continuously or calculated Flow limits For wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flaw for the Feceiving waters at the discharge location the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case basis
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE"I WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW"I TO
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699 1617
[phone]
t
YOU MU5T51GN THIS ERTIF! AT! N F06 ANYINFORMATION 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)
1
r
Permit Date 7/1/2010-06/3012015
I
(Date)
Last Revised 07/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000 `
CERTIFICATE OF COVERAGE NO NCG14 d A_ --5-
FACILITY NAME lr: 0onppea-+c_ o
PERSON COLLECTING SAMPLESwA . l�•.A.%
CERTIFIED LABORATORY Lab #�
Lab #
OPTIONAL IN FO
PartA Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR A C;1 y
SAMPLING PERIODn [� �uly-December ❑ January -June
COUNTY e � ti &_,j
PHONE NO (,Mlo_] ��Sa-3]8�I
ADD TO LISTSERVE= ❑YES ❑NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout [—]Other
Outfail No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units]
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall.
(in)
In Tier 2
Monthly
Monitoring�
(y/n)
# of Months in Tier
2 Sampling"
1
I
1 if "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here Please make sure to mark the sample period above
2 If a value is In excess of the benchmark, or outside the benchmark range (for PH), you must Implement the Tier 1 or Tier 2 responses in the General Permit Tler 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3TSS benchmark values are 100 mg/I except when discharging to ORW, HQW, Trout and PNA waters where they are SO mg/1
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge
Permit Date 7/1/201160/30/2015 Last Revised 7/13/11
Page 1 of 2

y I 4
Part B Vehicle Maintenance Activity Monitoring Requirements for fadlitles using > 55 gal of new motor oil/month —averaged over a calendar year
Outfall
No
Date Sample
Collected j
(mo/dd/yr)
PH
(Standard
Units)
TPH using method
1664ASGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall"
(in)
New Motor OilIn
Usage
(gal/month)
Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampiing2
6-9
15
100
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME
Mad Original and one copv of this DMR (including all "No Flow' & "No Discharge" reports) within 30 days_of receipt of sample for at end of monitoring period
In case of "No Flow") to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete I
am aware that there are significant p�,Kaltlps for submitting false Information, Including the possibility of fines and imprisonment for knowing violations "
(Signature of
Permit Date 7/1/2011-60/30/2015
_? -30 -Le-Z
(Date)
Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report RECEIVED
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG14�2,a L
FACILITY NAME -,D F,:, �.
_PERSON COLLECTING SAMPLES 1 t q
CERTIFIED LABORATORY cA JWFCV4-,,ALab # Ali—
- Lab#-
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A Wastewater Monitoring Reauirements
MAY 2 2 1u 4
CENTRAL FILES
SAMPLE COLLECTION YEAR e�D}�j
DWO/BOG
SAMPLE QUARTER ❑J Sept» ❑Oct -Dec ❑Jan -March
COUNTY 6 V. � � c iZ
PHONE NO i31C, 9 6:2,- 17Kt4
ADDJO LISTSERVE7 ❑YES ❑NO EMAIL
®Apriwune
DISCHARGING TO CLASS [—]SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO
v -s
` _
-
µ "1,
_
Outfall,No
.�i"
1 - _ ;an
VrD tea—
��_ ate Sampler �
n -- 1� -
i=
Coleected
kT' �3
r
-�1 -- �_ = #=
-F = _ -R
��-.:��-
��-=-, ���_ ��,- ��T�
�TYpe of�Wastewater M
j
z"
__
s VE RM MD
Y-Y�{ r/i Y l =AYE _
7T� v,
�,�
tr-
_ _pH=
.�J".LT--.
-r
=fr-k='
�t standard s�z
�j {4 -• Re.t�..� --9�
_=TPliusrng
�Total'`s ` n d�s
us a de
p
Sniid"sue
�Settleabie
���
�SohdsDuratron
�✓i� d }�.�••-
�--•
�-�--� ;
-method 1664A�
'� t
r�
-SGT-HE
-Sw.T— T
��----
=Discharge
�- „
i
� ,
otal �lowa
"
allons da
_
09P y}
z�-.�_� �""--�''`�P
tE5 - _
"' - T
� L=
�`-��� -�-��
� �' 34 'Tz
'��+�r-� Sgy, _-�
��
3
M
ob
0
1 If wastewater systems have not discharged in this quarter -- report "No Flow" or "No Discharge" here Please make sure to mark the sample quarter above
Z Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste -stream is commingled
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring = W y
4 pH limits are 6-9 S U for wastewater discharges to freshwaters, and 6 8-9 5 S U for discharges to saltwaters
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L` for all othervater classifications'
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action
' Flow rate can be measured continuously br calculated Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B 0224 Permittees who discharge wastewater to HQW waters -shall obtain a Sumni6r 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis
s
I MAIL ORIGINAL -AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING -ALL "NO FLOW" -"NO DISCHARGE'-' WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO -
Division of Water Quality r -
Attn DWQCentral Files -
1617 Mail Service Center
Raleigh, North Carolina 27699-1617 - - - - - - - -
[phone] - - - - - - -
3 y,-
_.
rh 4
I YOU MUST SIGN THIS CERTIFICATION FOR ANY -INFORMATION REPORTED M '
"I certify, under penalty of law, that this document and -all attachments were prepared under my'direction or supery SLon in accordance with a system designed to
assure that qualified'per'so'nnel properly gather and evaluate tf a information -submitted `used 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=offines andfimprisonment for knowing
violations
(Signature of Permittee) (Date)
Permit Date 7/1/2010-06/30/2015 + - 4 i - a ri _ , �' --` - - -- J Last Revised 07/13/11
Page 2 of 2

STORMWATER DISCHARGE DUTFALL (SDO)
GENERAL PERMIT NO
I
CERTIFICATE OF COVERAGE NO NCG14 O S l
FACILITY NAMEM.KaoL P,a�ert 'cep l _
PERSON COLLECTING SAMPLES lftiuttf I�ixyle I
CERTIFIED LABORATORY i!rs,e;4V, "I - Lab # IjLA C &3 t4
Lab #
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
- Semi -Annual MONITORING FORM
N CG 140000
SAMPLE COLLECTION YEAR c20 t y
SAMPLING PERIOD July -December January -June
COUNTY C-u (a4
PHONE NO a6 BD� � by
ADD TO LISTSERVE7 ❑YES ❑NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout ❑Other
-��
,gs3=
i.. r'� -
�- - -�
mil 3 ��-Crr--
�, NO FLOW].-
r�
pH=� _
-(Standard `�
4j,;��' �
- `w-'- -
_
- -_�
- - -= _ �*=���~
_ -
�_ !s rq �C.Rr •��
_� -
- =s= �
��''�Event�`£-�-,—__=�Tota1=--�=-
- `Duration
e~ -��
f1/ C !
� 3{minute SJ r
- �s -'
_ -_
-_ = }' a
IQ_nfall-
_ �_ 4-
'rr _ 3
�_ 1{ink
-�
,
fn Tier Z a
� ��1=z���-�-
Morithly ,
�� 1 y
;Monit6nng7
r r -
-# of Months in Tie
x - - - z�s -
2 Sampling- r�Y
=B 9�€100��:a
--
0 oly
L3C,
1 o M
! o
s'o
NO
I
I
'
i
i
�E
OWOBOG
E
ffE
fi
I
i
I
I If "NO FLOW or 'NO DISCHARGE, Enter' NO FLOW" or "NO DISCHARGE" for each outfall here Please make sure to mark the sample period above
2 If a value is in excess of the benchmark or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
a TSS benchmark values are-100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I r
°For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge
E
Permit Date 7/1/2011-60/30/2015 I Last Revised 7/13/11
Page 1 of 2

Part B Vehicle Maintenance Activity Monitoring Requirements Ifor facilities using > 55 gal of new motor oil/month — averaged over a calendar year
4tti7 3r it'
, OutfaI
No'�Cu
''dam^>j
_ -
Date Sample
ollected�
--��;�
d/Yr}�
py�.KaO
r ''.Y.�"
`,.
p H
(Standard
=-
Units)
`�wi�
4 .iTy,ti-f7;J
Miwi="v"i-•f.-' I
€�ss^ I-�
TPH usrn methodTotaliSus
g
1664�1°SG7-NEM
s r
r
r ;��
yY "'[[� "r Y.z�`Hd
i 'k_�f`y�j_.i�,ya,-A'�.
p ended
�=� s
Sohds­
F '>
mg/L}
4 : Event
��
Durations
(minutes]
r't
Sr.
TotalK
-- a
Rainfall `�
�Monrtoring?k�-z
(in)
i
"'_"..�-i
•
New Motor OII�=
, _ F#
• ,;
Usag(
(gal/month}
aiw3.�'�
4v
r In Tier 2x
*���-
nthly
��
�- �Y/n}
—....-w-
of Months
dL� r-
_yin Tier 2
y "
�Samphng�.
I
�jek.c��
wTe�4++ce
,00141t 4-F
C
I
I
I
f
I
I
HAS YOUR FACILITY HAD a OR MORE BENCHMARK EXCEEDENCESIAT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME -
f
Mail Original and one coot/ of this DMR {including all "No Flow" & "No Discharge" reports] within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to
Division of Water Quality 1 i
Attn DWQ 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
am aware that there are signific nt �e alties for submitting false information, including the possibility of fines and Imprisonment for knowing violations "
>
(Signature of Permittee) (Date)
Permit Date 7/1/2011-60/30/2015 I Last Revised 7/13/11
Page 2 of 2

E
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
E 5
CERTIFICATE OF COVERAGE NO NC 1/4,Q � 1
FACILITY NAME l+�d �1 �1L c C��"e �o,
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY n(� cc% Lab #,�AIC !tjq
- Lab#- w---
LIMIT VIOLATIONS? YES ❑ NO ❑ 1,
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR a01`f
SAMPLE QUARTER Jul -Sept ❑Oct -Dec ®San -March ❑April -June
COUNTY G u,1;oro x
`PHONE NO LM3 m i 'Zg�_ _a3lel.i
AflD,TO LISTSERVE? ❑YES [—]NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO
of-Wastewatet
#� � ;�
�ToS-nded
{mg/L]
s[minutes)
ha`r�—ge -
�'
_ =
a��-ow—
7
d allons a
{g- /- Y�y,
;
�mL%L]�
35:-
/����
LL
ari 1
s.i'
MAR
.1 � Cw
CEN
k +
r
fir4
1 if wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here Please make sure to mark the sample quarter above
Z Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD) Report more than one type if the waste -stream is commingled
3if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies youto continue monitoring
pH limits are 6-9 S U for wastewater discharges to freshwaters, and 6 8-8 5 S.0 for discharges to saltwaters
s TSShmits are 20 mg/L for wastewater dischargesto HQW wate—s,10 mg/L forTrout and PNA waters; and 30 mg/L' for all other water classifications
Permit Date 7/1/2010-06/30/2015 `, f Last Revised 07/13/11
Page 1 of 2

6 Process_ wastewater discharges shall only be monitored for TPH vIrhen commingled with stormwater discharges from VMA areas TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action
' Flow rate can be measured continuously ar calculated Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis -
1
i
MAIL ORIGINAL -AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING -ALL "NO FLOW". -"NO, DISCHARGE"WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO -
Division of Water Quality - -
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone] - - - -
i ti i
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
N certify, under penalty of law, that this document andall at#acliments were prepared'under my direction or -supervision in accoraance with a system designed to
assure that qualified personnel properly gather and evaluate the�informationsubmitted zased'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 offines and imprisonment for knowing
violations "
(Signature of Permittee) (Date)
I
Permit Date 7/1/2010-06/30/2015 _ _ , ,y - Last Revised 07/13/11
Page 2 of 2