NCG140012_MONITORING INFO_20190305

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v '� � yDt7I a
DOC TYPE
❑HISTORICAL FILE
% MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2018
Report ALL WASTEWATER monitoring data on this form (include "No Flow"P'Npthohargefi and-Qr, it Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 ®00 2❑ w
AN
CENTRAL FILES
Facility Name: Mt. Airy ,
11n7n C'c—nrCa
County: Surry
Phone Number: (336 983 2181 Total no. of outfalls monitored 1
Certified Laboratory Prism Lab Lab # 402
Lab #
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No 0
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ✓LJ
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑✓
Were there any limit violations in the calendar year? Yes ❑ No ✓0
Outfall No.
001
Daily Flow Rate,
cfs
i pH,
SU
TSS,
mg/1
SS,
mlll
Mappticable
Non -Polar O&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
Daily Maximum
HQW or ORW
50% of 7Q10
Indicate NO PLOW it
applicable
freshwater
6.0-9.0
saltwater
6.8-8.5
Standard
30
HOW
20
HQW ! ORW and Tr, or
PNA
10
HOW, ORW, SA,
SB,PNA,orany
Trout
5
No Limit
Sampled above Benchmark
subject to Tiered Responses
15
Date
Sample
Collected,`
molddlyr
E
3• •• i
6 rti {�..A"?,
P��
a f,°'�.
s $ ..s[ z r.:c d e4iry" ,' .rt -s
�
3/6/2018
NO FLOW
6129120188
NO FLOW
9/3/2018
NO FLOW
12/3/2018
NO FLOW
Permit Date 8/112017 — 6/3012022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 [i bCF
CERTIFICATION
"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."
[Required by 40 CFR §122.22]
Signature
Date o
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEML.R Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 -- 6/30/2022
Last Revised 8-22-2017

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2018
'Report ALL STORMWATER monitoring data on this form (include "No Flov/'I"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 ®© 1❑ 2❑
Facility Name: Mount Airy
County: Surry
Phone Number: (704 ) 353-2025
Certified Laboratory Prism Lab
Lab # 402
Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑✓
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑�
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency El
Yes, received approval from DEMLR to reduce monitoring frequency Q
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids TSS ,
( �
mg/1
pH,
��
Non -polar O&G
(EPA Method
1664 SGT-HEM ,
( ))
mgll (VMA)
ff appficabfe
New Motor Oil
Usage (gallmo.)
if applicable
Stormwater
Benchmarks
Indicate NO f=10W %
applicable
Circle Benchmark
1 fl0150
I1 IS
6.0-9. d
15
?55 gallmo. average requires TSS and
Non -polar O&G monitoring
Date Sample
Collected,
molddlyr
316118
NO FLOW
0612012018
NO FLOW
1 k i r—
r
9/3/2018
NO FLOW
AAR 0 4 M iq
121312018
NO FLOW
to
AS I "L HL E(
+r�c�
v
ut..4iiVt
Permit Date 811/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 6,7F
CERTIFICATION
"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."
[Required by 40 CFR §122.22]
Signature
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Flies Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 811/2017 — 6/30/2022
Last Revised 8-22-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2017
"Report ALL STORMWATER monitoring data on this form (include "No FloW'P'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1,of. each, yearn, r.,
MIMU LIVi
Certificate of Coverage No.' NCG14 OQ
MAR 0 7 2018
Facility Name: Mt. Airy i-CIPOTDni Mi CC
County: Sum+ DWR SECTION
Phone Number: (704 ) 400-5239 Total no. of SDOs monitored 2
Certified Laboratory Prism Lab Lab # 402
Lab #
Stormwater Discharge Outfall (SDO) No. 001 & 002 VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No Q
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑�
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency []
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids (TSS),
m %I
pH,
SU
Non -polar O&G
(EPA Method
1664 SGT-HEM ,
( })
mgll (VMA)
lfapplicable
New Motor Ciii :
Usage (gal/mo.)
!!applicable
Stormwater
Benchmarks
lndicare NO FLOW rf �
applicablo.
Circle Benchmark
e
1 00I50
c n
6.0'9.0
1.5
>55 gallmo. average requires 7SS and
Non -polar Od,G monitoring
Date Sam ple
Collected,.a
mo/cIcityr
- " M1.
3/31/2017
001 No Flow
3131/20V
002 No Flow
6/30/2017
001 No Flow
6/30/2017
002 No Flow
9/27/2017
001 No Flow
9/27/2017
002 No Flow
12/14/2017
001 No Flow
Permit Date 8/112017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 ©❑O IPQ
CERTIFICATION
"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."
[Required by 40 CFR §122.
Signature
Date 2
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEML.R Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/112017 — 6/30/2022
Last Revised 8-22-2015

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTI FICATE OF COVERAGE NO. N CG 140012
FACILITY NAME: Mt. Airy PERSON COLLECTING SAMPLES: Mike Holt ' �I lEC—LIVED
CERTIFIED LABORATORY: Research and Analytical Labjt342 7 2017
LIMIT VIOLATIONS? YES ® NO ❑
Part A: Wastewater Monitorine Reouirements
CENTRAL FILES
DWR SECTION
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept []Oct -Dec ❑Jan -March ®April -June
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
i
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
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
6-93'4
303.5
53
(15),
-
-
001
6/30/2017
NO FLOW
002
6/30/2017
NO FLOW
' 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.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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 for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
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 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 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 S1GN 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 dir ly resp Bible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware that t(Nere 4Wsignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signatud 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. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Mike Holt
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES P�QNORA
Part A: Wastewater Monitorine Requirements
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: []Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date P
Collectedle
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)
pH
(standard}
Total Solids �ded
P
(mg/L)
SeSollids
{mL/L}
TPH using
method 1664A
SGT-HEM'
(mg/L)
g
Duration a
{minutes}
Total Flow
(gallons/day)'
RM, MD-
6-93,4
303,5
53
(15),
Jlf�
002
3/31/17
RM
9.3
28.8
<0.1
M
(] 5 GU /
DWFI?
SECTION
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.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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.
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 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 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_(QR
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 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 dir ctly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awarA that there areAnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Permittee)
Permit Date:7/1/2010-06/30/2015
.� 2 1
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Mike Holt RECEIVED
CERTIFIED LABORATORY: Research and Analytical Lab # 34
JAN 2 3 2017
LIMIT VIOLATIONS? YES ❑ NO ® CENTRAL FILES
DWR SECTION
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: []Jul -Sept ®Oct -Dec []Jan -March ❑April -June
COUNTY: 5urry
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
1
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
SGT-HEMG
(mg/L)
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
RM, MD-
6-93,4
303,
53
(15)6
-
-
001
12/7/2016
No Flow
002
12/7/2016
No Flow
If,
Z>
" !f
' 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.
4 pH limits are 6-9 S-U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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.
5 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 be set to 50% of the Summer 70.10 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 (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
[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 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 direct) 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 theryarenificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature df Permittee)
Permit Date: 7/1/2010-06/30/2015
t I r7
(Date)
Last Revised 07/13/11
Page 2 of 2

Ab-
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. Nf G140000
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Mike Holt
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: [:]SA ❑HQW
OPTIONAL INFO:
❑PNA [—]Trout ®Other
Outfall No.
Date Sample
a
Collected
(mm/dd/yr)
Type of Wastewater
z
(VERMMD}
, ,
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM'
(mg/L}
Duration
(minutes)
Total Flow
7
(gallons/day}
-
-
RM, MD-
6-93'4
303'5
53
(15)6
-
-
001
8/31/2016
No Flow
C F
002
8/31/2016
No Flow
NOV Julb
LNR SE
It 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.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.S S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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.
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VIVA 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 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 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
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 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 1Ihere-are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Perrnittee)
Permit Date: 7/1/2010-06/30/2015
/olzyffio
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NICG140000I �e
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd
CERTIFIED LABORATORY: Research and Analytical Lab #i 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Mnnitnrine Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept ❑Oct-1
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
1
Collected
(mm/dd/yr}
Type of Wastewater
z
(VE, RM, MD)
pH
(standard}
Total Suspended
Solids
(mg/0
Settleable
Solids
(mL/L)
TPH using
method 1664A
s
SGT-HEM (mg/L)
Discharge
Duration
}minutes)
Total Flow
gallons/day]
-
-
RM, MD-
6-93''
303'5
53
(1S)6
-
-
001
6/24/2016
No Flow
Oo'ti
(p Z'i 2ar!<.
IVY �uw
fin
NTRAL F
ILES
DWR SECTION
N
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 S.U. for wastewater discharges to freshwaters, and 6.8-8.S S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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.
6 Process vastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but in is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuousiy or 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 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
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 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 awgre�that t+re are�ignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signatu,(e of Permittee)
Permit Date: 7/1/2010-06/30/2015
Y/ Z / /Y -
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd
CERTIFIED LABORATORY: Research and Analytical Lab ## 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reouirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: []Jul -Sept []Oct -Dec ®Jan -March ❑April -June
COUNTY: Surry
PHONE 140. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®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 usingDischarge
method 1664A
SGr-HEM'
(mg/L)
Duration
(minutes)
Total Flow
�
(gallons/day)
-
-
RM, MD-
6-93'4
303'5
53
(15)6
-
-
001
3/27/2016
No Flow
REGO
n
ti rJ
CENTR
i iz,
CENTRf.I.
F11 Rq
VVVR SECTION
DWR S.
=CTION
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.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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.
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormvrater 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.
7 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 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 {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 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 direct ly 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 thA are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ature'of Permittee)
Permit Date: 7/1/2010-06/30/2015
i z
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd FF� /C
CERTIFIED LABORATORY: Research and Analytical LRErZ E 1 1/ ED
LIMIT VIOLATIONS? YES ❑ NO ® FEB 2 4 20%
CENTRAL FILES
Part A: Wastewater Monitorine Reauirements DWG: SECTION
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY: 5urry
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
i
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
SGT-HEM'
(mg/L)
Duration
(minutes]
Total Flow
,
(gallons/day]
-
-
RM, MD-
6-93.4
303'5
53
(15)6
-
-
001
12/30/15
No Flow
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.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

TS*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.
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.
7 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 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 (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 MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those per ons erectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
lama yvWe tlJ t ther"e 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. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Renuirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW
OPTIONAL INFO:
❑PNA []Trout ®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 c'
(mg/L)
Duration
(minutes)
Total Flow
7
(gallons/day)
-
RM, MD-
6-93,4
303.5
53
(15),
-
-
001
12/30/15
No Flow
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.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
I

5 TSSljmits 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.
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 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 (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 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 direct) responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware thatCher are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(SigVature of Permittee)
Permit Date: 7/1/2010-06/30/2015
f' Z7
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
RECEIVED
CERTIFICATE OF COVERAGE NO. NCG140012 OCT 2 3 Z015
FACILITY NAME: Mt. Airy CENTRAL FILES
PERSON COLLECTING SAMPLES: Casey Byrd DbW# SECTION
CERTIFIED LABORATORY: Research and Analytical Lab 4
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorina Reauirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec Dian -March []April -June
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE7 [—]YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
1
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
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)7
-
RM, MD-
6-93'4
303$
53
(15)6
-
-
001
9/17/15
No Flow
002
9/17/15
No Flow
' 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.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

s 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.
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 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 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 MAST 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 erectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awpre th� there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
(C9ILCIr)-'
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd
CERTIFIED LABORATORY: Research and Analytical
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
GENERAL PERMIT NO. NCG140000
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: []Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
�CO NTY: Surry
Lab # 34 RECEIVOW NO. [phone]
JUL 2 4 20'lD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW ❑PNA ❑Trout ®Other
CENTRP.L FILF�pTIONAL INFO:
DWR 51 CTI01
Outfall No.
Date Sample
i
Collected
(mm/dd/yr)
Type of Wastewater
x
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
sGT HEV
(mg/L)
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
RM, MD-
6-93.4
303'5
53
(15),
-
-
001
6/29/15
No Flow
002
6/29/25
No Flow
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.
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 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwater$.
Permit Date:7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2

s lss•tiM, s 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.
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 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 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 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 ay%roe that JliereaVe significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of Permittee]
Permit Date: 7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
Rec,S
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reouirements
'SAMPLE COLLECTION YEAR: 2015
CE{�TR&I FSAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
SIECICOUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA []Trout ®Other
Dutfall No.
Date Sample
1
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
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day),
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
001
3/4/15
No Flow
002
3/4/15
No Flow
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 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
ism

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.
,,.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 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 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 annuai 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 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 qualifie Oersonnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons direofyresp . le for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am a*va ft that Jh e y4sjgr1ficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee}
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd
CERTIFIED LABORATORY: Research and Analytical
LIMIT VIOLATIONS? YES NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: EJu4-Sept ®Oct -Dec ❑Jars -March April -June
pp pp►► COUNTY:5urry
Lab # 3RECEIUE&NE N0. [phone]
ADD TO LISTSERVE? [:]YES ®NO EMAIL:
BAN 22��5DISCHARGING TO CLASS: []SA E]HQW [-]PNA Trout ®Other
CENTRAL FILEcPPTIONAL INFO:
DWR SECTION
Outfali No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)2
pH
Istandard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
method .1664A TPH using
SGT-HEM5
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day)'
-
-
RM, MD-
6-93''
303,5
53
(15)6
-
-
001
12/22/2014
RM
No Flow
002
12/22/2014
RM
No Flaw
' 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 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
IM"

-
F
{
e

..5 FSS 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.
r, 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 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 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 SIGN THIS CERTIFICA TION 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 qualifi, d personnel properly gather and evaluate the Information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dir ctly onsible for gathering the information, the Information submitted Is, to the best of my knowledge and belief, true, accurate, and complete.
I am gWke thq� . e, are significant penalties for submitting false information, Including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG 140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Casey Byrd
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? [—]YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
[:]RNA ❑Trout ®Other
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
RMMD)
(VE, ,
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
SGT HF
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day}
-
-
RM, MD-
6-93'4
303.5
53
(15)6
-
-
001
9/24/2014
RM
No Flow
002
9/24/2014
RM
No Flow
RE
ZO
4
D
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.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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.
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.
7 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 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 (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 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 esponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware t"t these re;ignlficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re 0 Permittee)
Permit Date:7/1/2010-06/30/2015
( Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140013
FACILITY NAME: Albemarle
PERSON COLLECTING SAMPLES: Ken Lowder
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: Stanly
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
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-HEM6
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day)7
-
-
RM, MD-
6-93,4
303'5
S3-
001 & 002
9/16/2014
RM
No Flow
u
6 2014
D
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.
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: 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 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 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 shell 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 ONCLUDING 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 MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awareAhat thgf6 arAsignificant penalties for submitting false Information, including the possibility of fines and Imprisonment for knowing violations."
of Permitteej
Permit Date: 7/1/2010-06/30/2015
C1 C lq
(Date)
Last Revised 07/13/11
Page 2 of 2

f ..
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140012
FACILITY NAME: Mt. Airy
PERSON COLLECTING SAMPLES: Tony Hardison
CERTIFIED LABORATORY: Prism Lab f# 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reouirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: Surry
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
i
Collected
(mm/dd/yr)
Type of Wastewater
z
RMMDl
(VE, ,
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
S
(mg/L)J6
I mg/ll
Duration
(minutes)
Total Flow
(gallons/day]
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
001
6/26/2014
RM
9.13
3.S
N/A
N/A
>1
>1
002
6/26/2014
RM
9.2
4.5
N/A
N/A
>1
>1
Sample for Both Outfalls were sampled in the wrong
location, they were sampled from onsite holding areas,
not at thepoint of discharge.
c
` 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.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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 for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
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 be set 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 (OR
AT END OF MONITORING PERIOD IN 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 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 qualifie ersonnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dire(ftjy res nsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aw1reAhat #1e significant penalties for submitting false information, including the possibility of fines and Imprisonment for knowing violations."
Permittee)
Permit Date: 7/1/2010-06/30/2015
< <7
(Date)
Last Revised 07/13/11
Page 2 of 2