NCG020206_MONITORING INFO_20161109

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V C�a oa U
DOC TYPE
❑ ISTORICALFILE
MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

NC Department of
Environmental Quality
Received
NOV p 9 2016
Winston-Salem
Regional Office
Geological Resources, Inc.
November 7, 2016
Mr. Matt Gantt/Ms. Sue White
Surface Water Protection Unit
Division of Water Quality
North Carolina Department of Environmental Quality
Winston-Salem Regional Office
450 W. Hanes Mall Boulevard, Suite 200
Winston-Salem, North Carolina 27105
RE: Jacob's Creek Stone Co. Inc. — Davidson Mine
Discharge Monitoring Report — September 2016
Davidson County
Yadkin -Pee Dee River Basin
Certificate of Coverage No. NCG020206
GRI Project No. 1517
Dear Mr. Matt Gantt/Ms. Sue White:
On behalf of Jacob's Creek Stone Co. Inc., please find attached the results of the stormwater outfall sampling
that was conducted on September 28, 2016 for the Jacob's Creek Stone Co. Inc. facility in Denton, Davidson
County, North Carolina. Water samples were collected from the outfall of Pond #1 by Jacob's Creek Stone
Co. Inc. personnel on September 28, 2016 in accordance with the NORR dated January 28, 2013. Water
samples were analyzed for pH, settleable solids, total suspended solids, turbidity and fecal coliform. Results
indicate that concentrations of requested method constituents are below the permit levels. Per email
correspondence from Ms. Jenifer Carter of NCDEQ dated March 15, 2013, only Pond #1 will continue to be
monitored. The Stormwater Discharge Outfall Monitoring Report is included in Appendix A, the Stormwater
Discharge Outfall Qualitative Monitoring Report is included in Appendix B, and a complete laboratory
analytical report is included as Appendix C.
The next sampling event is scheduled to be conducted between October and December 2016 during a
representative rainfall event. Following this sampling event, it is requested that Jacob's Creek Stone Co. Inc.
be allowed to reduce the sampling frequency to semi-annual sampling instead of the current quarterly sampling
schedule. Please do not hesitate to contact me at [phone], if you have any questions or comments.
Sincerely,
Rohit Shetty, P.E.
Senior Engineer
ec: Jeff McKinney, Jacob's Creek Stone Co. Inc.
file
enclosures
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] [phone] Fax [phone]

'r;'C Deoartmont of
Environmental Quality
Received
NOV 0 9 2016
Winston-Salem
Regional Office
DDUXTny0VQ

APPENDIX A
STORMWATER DISCHARGE OUTFALL MONITORING REPORT

STOR.WATER DISCHARGE OUTFAI.L(SDO)
MONITORING REPORT
Permit Number ISCS NC".G02f)206
FACILITI' NAME _Jacobs Creel; Stone Co. Inc — Dmidson %line
PERSON COLLECTING SA1t1PLF,(S)_JeffNIcKjnney
CERTIFIED LARORATORI'(S) _ Accutesi Laboratories Lab k i 573_
Labs! i
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR ]'EAR: 2016
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratury.l
COUNTY Dmidson
PHONE NO. 1 336 1R.57-62112
SIGNATURE OF PERMrTTEE OR DESIGNEE
LQIIIRED ON PAGE 2.
Collected
Does this facility pet form Vehicle Maintenance Activities using more than 55 gallons ofnew motof oil per month?_ yes _X_no
(if yes, complete Pan B I
Pnrr R- Whielr kidintrnnn a Activin, hinnitnrino Rennirrmrnrs
Outfall
No.
Darr
Sampli
Collected
S0050
00556'L
0000
00400
Total Flow
(if.applicabte)
Total
Rainfall
Oil & Grease
(if appl.)
Kan -polar
O&Gil-PH
(Method 1664
SGT-IIEA4 if
appl.
Totat
Suspended
Solids
pli
New Motor
Oil usage
titalddhhr
MG
inches
-All
-W1
unit
allmo
Form SW[J-247, last revised 2 _ ,2012
Page I ar2

STORM EVENT CHARACTERISTICS:
Date _0912$11 h
Taint Event Precipitation (inches):-1M
Event Duration (hours): (only ifapplicuble — see permit.)
Of more than line Storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable— see permit)
Mail Original and one copy to:
Division of Water Quality
Aim Central Files
1617 Maio Service Center
Raleigh, North Caroiim 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 deigned to assure that qualified ptrsunnel properly gaiber and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons dirrctly responsible for gathering [he 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 passibility of fines and imprisonment for knowing violations."
Al!
•� //�� /�
(Signatu ofPermi r) (Date)
Form SWU-247. lies( nnt ed 7 2 20/1
Pace 2 of 2

APPENDIX B
STORMWATER DISCHARGE OUTFALL QUALITATIVE MONITORING REPORT

I
1
SI' _ .1 4..V� •.
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form please visit: httn:/tb2o,6nr.state.ne.us/su/Fortns Documents.h€m#miscforms
Permit No.: NIC! T _ _ ! I i1 I l I_or Qrtificate of Coverage No.: NICIGk 0 / 2 1t t lLl !
Facility Name: EK S cd.,gk.— Davidson Mine
County: 9VAi0EeW Phone No. l; XS%- _ aZ - - -- —
Inspector:.. FF -
Date of Inspections: '•� /`
Time of Inspection:
Total Event Precipitation (inches):,'
Was this a Representative Storm Event? (See information below) ' Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
stone event, (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain uP to 10 consecutive hours of no precipitation:
By this signature, I certify that this report is. accurate and complete to the best of my knowledge:
c
{SignaturCkf Pet7n6ttee feignee�)
1. Outfall Description:
OutfalI No ` �w 1�z Structure (pipe, ditch, etc.)
Receiving Stream:. k4AAI CRA59el._
Describe.the industrial activities that occur within' the outfail drainage area:
2. Color: Describe the color of the
(light, medium, dark) as descriptors: _L
lors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weals
chlorine odor, etc.):
Page 1 of 2
SVJti-242-1 I26D8

a. Clarity: Choose the number wFich best describes the clarity of the discharge, w hcre I is clear
dnd 5 is cloudy:
a W 5
lrinatin- Solids: Choose the number which best describes the amount of floatinn solid's in the
star ,,.�aicr dischar�=e, whc-e I is no solids and 5 is the surface Covered with i7oatine solids:
2
6- Suspended Solids: Choose the number K`hich best descrlbt�s the anwrtt of suspended solids in
[he S!Or ,water discharge. v,-he.rc I is no so' _; and 5 is extremely muddy:
l ? 3 T 5
i. lc rhrre arty- Ioa n in the starnuater discharge? Yes
Is there an oil sheen in the ,to; water di char ye'' Yes t No
9: Is '.ere evidence of erosion or deposition ai.the outfall? Yes
10. Other Obvious Indicators of Storm ater Pollution:
List and describe.
I`*ote: i_o.� cla-it:,high sc�licls. und'or the presence of foam. oil seen, or-crosiom/depnsi:iOn ma,, be
indicative of pollutant exposure. These CUnditio*ts warmm funher investigation.
pz�2 2 of

APPENDIX C
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ACCUTE
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SGS ACCtFYES7IS.PART,OF SGS, THE WORL0'S LEPING INSPECTION,
VERIFICATION, TESTING AND CERTIFICATION COMPANY.
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Automated Report
err.-^—.—_^-^_,�,..�r^.--.T—^.^•.-[_..�. ,......—...— nl.i .. � . i �'. p..l r�
f,Techntcal Report
Jacob's. Creek Stone Company ;
Davidson Quarry; 2081 Slate Mine Rd, Denton,' NC' '
SGS Accutest Job Number: FA373I3
Sampling Date: 09/28/16
Report to:
Jacob's Creek Stone Company
PO Box 608
Denton, NC 27239
,[e-mail]', rshetty@
ATTN: Jeff McKinney
Total number of pages in report: 16
Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable.
.com
�/ Norm Farmer
Technical Director
Client Service contact: Muna Mohammed 407-425-6700
Certifications: FL (E83510), LA (03051), KS (E-10327), IA (366). IL (200063), NC (573), N] (FLO02), SC (96038001)
DoD FLAP (L-A-B L2229), CA (2937), TX (T104704404), PA (68-03573), VA (460177),
AK, AR, GA, KY, MA, NV, OK, UT, WA
This report shall not be reproduced, except in its entirety, without the written approval of SCS Accutest.
Test results relate only to samples analyzed.
Southeast • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone] • hitp://www.accuiest.com
t 1 of 16
SGS Accutest is the sole authority For authorizing edits or modifications to this document. ACCUTEST
Unauthorized modification of this report is strictly prohibited. t— FA37313

Sections:
Table of Contents
Section1: Sample Summary...................................................................................................
3
Section2: Summary of Hits....................................................................................................
4
Section3: Sample Results........................................................................................................
5
_, e
3.1: FA37313-1: POND 1....................................................................................................
6
Section 4: Subcontract Lab Data............................................................................................
7
Section5: Disc. Forms............................................................................................................
5.1: Chain of Custody...................................................................... .....
10
11
Section 6: General Chemistry - QC Data Summaries...........................................................
6.1: Method Blank and Spike Results Summary..................................................................
14
15
•
6.2: Duplicate Results Summary..........................................................................................
16
2of16
_ ACCUTEST
FA37313

4 : SGS Accutest
Sample Summary
Jacob's Creek Stone Company _.
Job No: FA37313
Davidson Quarry; 2081 Slate Mine Rd,. Denton, _NC
Sample Collected„; Matrix Client
Number Date Time By Received Code Type Sample ID
FA37313 1 09/28/16 09:15 R I . 09/29/16 AQ Water PANE 1 �`# ,*' r y,
�*
' 3of16
-GS- ACCUTEST
FA373i3

Summary of Hits Page 1 of 1
Job Number: FA37313
Account: Jacob's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Collected: 09/28/16
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA37313-1 POND 1
Turbidity Fflf9 1.0 NTU EPA 180.1
pH
99.,g_....,,..._....,...,..•.. - su SM4500H B-11/5IV9040C
(a) Field analysis required: Received out of hold time and analyzed by request.
(e* ' 4of16
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s �
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.Sample Results � i - -
J
Report of Analysis
ACGUTESTTEST
FA37313

SGS Accutest ,
r
Report of Analysis
Client Sample ID: POND 1
Lab Sample ID: FA37313-1 Date Sampled: 09/28/16
Matrix: AQ - Water Date Received: 09/29/16
Percent Solids: n/a
Project: Davidson Quarry: 2081 Slate Mine Rd, Denton, NC
Page 1 of I
General Chemistry
Analyte
Result RL
Units
DF
Analyzed
By
Method.
Solids, Settleable a
< D 50 0.50
ml/I
1
09/29/16 13:30
]K
SM2540 F-11
Solids, Total Suspended
25 25
mg/I
1
09/29/16 18:2Q
II
Sh12540D-11
Turbidity
I1 9 1.0
NTU
1'
09/k/16 07A5
RC
EPA 180.1
pH b
so
1
09/30/16 15:00
ZC
SM4500H B-11/SW9040C
(a) No QC analyzed due to limited volume of sample.
(b) Field analysis required. Received out of hold time and analyzed by request
RL = Reporting Limit
0
6of16
c _ ACCUTEST
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Report of Analysis
Section 4
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FA37313

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ANALYSIS REQUESTED z IS UNCLEAR OR - OBSERVED TEMPS:
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Page 2 of 3
s-G ' 12 of 16
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Page 3 of 3
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QC Data'_ Summaries yr
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Includes the following wbere applicable:
• Method Blank and Blank Spike Summaries
• Duplicate Summaries
• Matrix Spike Summaries
1 14 of 16
_S_G$,_ ACCUTEST
FA%7'tl-*t

METHOD 5LANK AND SPIKE RESULTS SUM ARY
G£NEP.AL CHEMISTRY
Login Number: FA37313
Account; JCSCNCD Jacob's Creek Stone Company
Project. Davidson Quarry; 2081 S'_a:e Mine Rd, Denton, NC
MB Spike BSP BSP QC
Anaiyte Batch ID RL Result units Amount Result tRecov limits
Solids, Settleable GN72578
So' --ids, Total Suspended GN72517
Turbidity GN72518
Associated Sam_oles-
Batch G1472517: FA37313-1
Batch G1472510: FA373i.1-1
Batch GN72578: 7A37313-1
(-) Outside of QC limits
0.50 0 0, ml/1
1,0 0 Q ,:,• mg/1
1.0 0 0 NTU
Page 1
15 of 16
ACCUTEST
FA37313

DUPLICATE RESULTS SUNYARY
GENERAL CHEMISTRY
Login Numher: FA37313
Account: JCSCNCD - Jacob's Creek Stone Company
Projec_: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
QC Original DUP QC
Analyte Batch ID Sample Units Result Result RPD Limits
Solids, Total Suspended GN725]1 FP_37332-1 mg/1 3.2 4.0 '22:2_(a1.';y`'':?r 0-5k
Turbidity GN72518 FA37313-1 NTu 11.9 1l.E 01 B '.r 0-8%
PH GN72535 FA3£873-2 su 6.92 6.87 ,97 :=,�� 0-10§
Associated gamines: Qy
Batch GN72517: F707313-1 jay
Satch GN72518: FA37313-1
3atch GN72535: FA37312-1
(-) Outside of QC limits
(a) RPD acceptable due to low duplicate and sample concentrations.
Page 1
��°° �1, 16 of 16
_S-Gs ACCUTEST
FA3"1-1

NC Department of c4t,6
Environmental Quality
Received
JUN 2 4 2016
Winston-Salem
e Regional Office
Geological Resources, Inc.
June 17, 2016
Mr. Matt Gantt/Ms. Sue White
Surface Water Protection Unit
Division of Water Quality
North Carolina Department of Environmental Quality
Winston-Salem Regional Office
450 W. Hanes Mall Boulevard, Suite 200
Winston-Salem, North Carolina 27105
RE: Jacob's Creek Stone Co. Inc. —Davidson Mine
Discharge Monitoring Report — May 2016
Davidson County
Yadkin -Pee Dee River Basin
Certificate of Coverage No. NCG020206
GRI Project No. 1517
Dear Mr. Matt Gantt/Ms. Sue White:
On behalf of Jacob's Creek Stone Co. Inc., please find attached the results of the stormwater outfall sampling
that was conducted on May 19, 2016 for the Jacob's Creek Stone Co. Inc. facility in Denton, Davidson County,
North Carolina. Water samples were collected from the outfall of Pond #1 by Jacob's Creek Stone Co. Inc.
personnel on May 19, 2016 in accordance with the NORR dated January 28, 2013. Water samples were
analyzed for pH, settleable solids, total suspended solids, turbidity and fecal coliform. Results indicate that
concentrations of requested method constituents are below the permit levels. Per email correspondence from
Ms. Jenifer Carter of NCDEQ dated March 15, 2013, only Pond #1 will continue to be monitored. The
Stormwater Discharge Outfall Monitoring Report is included in Appendix A, the Stormwater Discharge
Outfall Qualitative Monitoring Report is included in Appendix B, and a,4complete laboratory analytical report
is included as Appendix C. �..
The next sampling event is scheduled io be. conducted between July and- September 2016 during a
representative rainfall event. Following this sampling event, it is requested that Jacob's Creek Stone Co. Inc.
be allowed to reduce the sampling frequency to semi-annual sampling instead of the current quarterly sampling
schedule. Please do not hesitate to contact me at [phone], if you have any questions or comments.
Sincerely,
4
Rohit Shetty, P.E.
Senior Engineer
cc: Jeff McKinney, Jacob's Creek Stone Co. Inc.
file
enclosures
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] [phone] • Fax [phone]

APPENDICES

APPENDIX A
STORMWATER DISCHARGE OUTFALL MONITORING REPORT

SIORMWATER DISCHARGE OUTFALL (SDO)
! MONITORING REPORT
Permit Number NCS NC G020206
FACII,ITY,NAME .lacohs Creek Stone Co. Inc
P r.RSON COLLECTING SAMPLE(S) _Jeff Meli inncy
CE1tTInEnLASORATORY(Sj Acrtlte51L�horafoReS Labe' 573�
• L.a b q
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DI,RING CAI.E\DAR 1"EAR: ?! 016
(Thu monitoring rrport shall be received by the Division no Infer than 311 daps from
the date the facility receives the sampling results from the hiboratory'.) :
COUNTY Davidson
PHOSENO. 336' R57-62112
SIGNATURE OF PER811 T'LE OR DESIGNEE
"R£OIifRED ON,PAGE 2'
Ourfatl .
1`o.<.° ,. �:
'
Date
Sample .:',
Collected
i• .., +.trw-.:l �
Total :'
Flow (tf app )s
'�,,a-Mf r -rf :
Total-'- _
Rainfall
r,,. !ti-�, M'
Settleable !,
5ofrds
; Sr,.f �.}''j'3'•.
6trj,2
Total -
Suspended
-$'i!
OIIdS 1-
Turbidir
pit.
-•
,
-
mU1dd1 T'+.
MG *!
IAehei` �.: '`.i'"
M r�0'
m 112 .ti �. ul
'N'rII'.i:.7 K� .
Stlt :1{° •-
.. "fi, -
.::,t :
Pond Nl
05l19116`:
NIA' _ ...y .
I ..:r :
�O SO"` m'
G:S q :; °,
6:1"' „ ..
6.76
.41
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no
(it'ves,complete Part B)
Part It: Vchiclr Maintenance Activitv Monitoring Rcquircmrnts
Outfall ...
No4' ,
Date .
Sample;-,,:
Collected
50U50 :' - -
- .
0[656 '-
Ofl_530
00400
Total ROW :..:
(ifapplicable)
Total p:- ,.... -.'
Rainfall
Oil;& Grease ';
(tfappl)`"
:Non polar. .,. ,
O&GITPIj
(M etbod 1664.,-.
SGT H£I4i), if
Total; ,:
Suspended
Solids
pH
New Soto .
Oil Usage
molddlvr:;
MGe"
umA
I m
itni[
I gaufno.;.
Form SWU-247, lase revised 2,2 2012
Page I oft

I
STORM EVE\ f CRARACTERISTiCS: Mail Original and one copy to:
Division of Water Qualiry '
Aatc 05119/16 Ann: Central Files
Total Event Precipitation (inchct): _l DC .] 6l7 Mai] Service Center—.
Event Duration (hours): (unl}• if applicable —see permit_) Raleigh; North Camhna 27699-1617
(il'more than one slarm event was sampled)
Date
Total Event Precinitatinn{inch6): -'f • ..;,
Event Duration (himrs): '(only ifupplicabl(�.—.see winit)
"1 certify, under.penalty,oflax, that ibis ducumcut and all attachments were prepared under my',direction or supers ision in accordance pith a
's�:5trtit distgned to assure tliai qualified -personnel -property gather;and etialuaie the infoiztiannii submitted Based on my-mquin`oftheperson;
or`per%6ns a ho inunagee t}ie system of thirs`e'peraans directly rc+dun Bible for gathering the,inforntation, the iutamiatiuit submi[ied is; to the,`'
best or 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 Pernnittee (Da )
Form SWU-.47, Iasi revi+cd Z 2-201?
Page 2 of

APPENDIX B
STORAIWATER DISCHARGE OUTFALL QUALITATIVE MONITORLNG REPORT

1
x . I
Stormwater Discharge OutfaIl (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htt ':I/tt2o.crtr. tate.' *c:uslsu/Forins � Documents.htmftistforms'
Permit No.: N/CITI_I_l�l 1 I_1 o: Ceitificate of Coverage No.: NICIG4I,ZI0/s;�1Dljl
Facility Name: EK S oAF Gv,
County: f e�Al Phone No. :r- ,fS 7- 3, Z - - -
Inspector:
Date of Inspection: '. :,.,.rU, �t,,, -1 ; r �.
Time of Inspection: fib
Total Event Precipitatign (inches):_ �,• }
Was this a Representative Stor�tn Ei,ent? (See.information below);;,-
Please check your permit to verify if Qualitative Monitoring must be performed during a "representative
storm event (requirements vary
A "Representativ'e Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in 'which no -storm event measuring greater, than -6.1 inches has
occurred.. A single storm event may contain up to 10 consecutive hours of no precipitation:
By this signature, I certify that this report is accurate and'coinplete to the best of my knowledge:
(Signature of Permiita-or Designde� _
1. Outfall -Description: Y
OutfaIl No.'' Structure (pipe,'ditch, etc.) . jil YVR_—
Receiving Stream.. D�Q/Yf cRE�k'
Descii6e the industrial activities that occur..;I thin the ouifaIl drainage area:
2. Color: Des6hbe'tlie�color of the,di-cliarge tisins
(light, medium, dark) as descriptors:
colors (red, brown, blue, etc.) and tint
: P, .. • r
3. Odor: Describe ayry distinct odors that the discharge may have (i.e., smells strongly of oil, weak
^/ v
chlorine odor, etc.):
Page 1 of 2
5WU-242-112608

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 _ 3 4 5 .
6. Suspended Solids:_ Choose the nurnber.which best describes the amount of suspended solids in.
the stormwater discharge..whcre I. is no solids and 5 is.extremely muddy:
a2 3 4 _5 -
7. Is there any foam in the'stormwatezrdischarge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes o
9. Is there cAdence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Storinwater Pollution:
List and describe
Note: Low clarity. high solids, and/or the presence of foam, oil sheen, or erosion/deposition maybe
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5wU•242-1126M

i ;iv'F;i=,}fir71. i. t.. _:x`'X;
^e e-HardCa�I� •2 0
Automated Report
Teclnical` Re 'or t for ''c'
�n F
Jacob's Creek Stone Company
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
SGS Accutest Job Number: FA34122
Sampling Date: 05/19/16
Report to:
Jacob's Creek Stone Company
@geologicalresourcesinc.com
ATTN: Jeff McKinney
Total number of pages. in 'report: 16
A'CCfi_ �U
R Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable.
Norm Farmer
Technical Director
Client Service contact: Muna Mohammed 407-425-6700
Certifications: FL (E83510), LA (03051), KS (E-10327), IA (366). IL (200063). NC (573), NIJ (FL002), SC (96038001)
DoD ELAP (L-A-B L2229), CA (2937), TX (T104704404), PA (68-03573), VA (460177),
AK, AR, GA, KY, MA, NV, OK, UT. WA
This report shall not be reproduced, except in its entirety, without the written approval of SGS Accutest.
Test results relate only to samples analyzed.
Southeast • 4405 Vineland Road • Suite C-15 • Orlando, FL 32911 • tel: [phone] • fax: [phone] • http:l/www.accutest.com
1 of 16
SGS Accutest is the sole authority for authorizing edits or modifications to this document. ACCUTE$i
Unauthorized modification of this report is strictly prohibited. FA34722

Sections:
Table of Contents
Section1: Sample Summary................................................................................................... 3
Section2: Summary of Hits.................................................................................................... 4
Section3: Sample Results......................................................................................................... 6
3.1: FA34122-1: POND 1............... ..................................................... ........... I.................... 6 _
Section 4: Subcontract Lab Data............................................................................................ 7
Section5: Misc. Forms ........................ ................. 10
6.1: Chain of Custody........................................................................................................... 11
y
Section6: General Chemistry - QC Data Summaries.......................................................... 14
6.1: Method Blank and Spike Results Summary
6.2: Duplicate Results Summary.......................................................................................... 16
ACCUTEsr

SGS Accutest
Sample Summary
Jacob's Creek Stone Company
Job No: FA34122
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Sample Collected_ Matrix Client
Number hDate Time By Received Code Type Sample ID
FA34122 1 05/19/16 09:00 JN4,, 05/20/16- AQ Water
POND 1
Sc-, ACCUTEST
FA34'122

Summary of Hits Page 1 of 1
Job Number: FA34122
Account: Jacob's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Collected: 05/19/16
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA34122-1 POND 1
Turbidity B.1 1.0 NTU EPA 180.1
PH a 76" su SM4500H B-11/S1%19090C
(a) Field analysis required. Received out of hold time and analyzed by request.
1 4of16
_S-ACCUTEST
FA34122

i
'
A MY
4,.5
- -CUTEST'
:p .Oel
Sd­m- p. lei Results
Report of Analysis
I.wmmMAN
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FA341zz

SGS Accutest
Report of Analysis
Client Sample ID: POND 1
Lab Sample ID: FA34122-1 Date Sampled: 05/19/16
Matrix: AQ - Water Date Received: 05/20/16
Percent Solids: n/a
Project: DaN,idson Quarry; 2081 Slate Aline Rd, Denton, NC
Page 1 of 1
General Chemistry
Analyte
Result RL
Units
DF
Analyzed
By
Method
Solids, Settieabie a
< 0 a0 - 0.50
ml/I
1
05/20/16 13:30
LE
SN12540 F-11
Solids, Total Suspended
< Z5 25
mg/t
1
05/23/16 07:Z0
LIESn12540
8-11
Turbidity
6:1 1.0
NTU
1
05/20/16 14:45
zC
EPA 180.1
pH
6.,76
su
1
05/20/1614:50
LE
5m4500xs-1vs��so4oc
(a) No QC analyzed due to
limited volume of sample.
(b) Field analysis required.
Received out of bold time and analyzed by request.
RL = Reporting Limit
6of'16
ACCUTEST
PA34z22

4
Report of Analysis
7 of 16
accuTEsr
PA34122

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Custody Documents arid Other Forms
Includes the following where applicable:
• Chain of Custody
Section 5
100(16
__..SCSI ACCUTESi
FA34322

Accutest Lawrat.ories,Nipumi6ast
:,-C-h` -1 V)qp
- Acow - esij6B'# 71"L PAGEOFTain,of Custo�T; , " I 1­- ' �'l 'j0N,C,=U—rEa—r. 4Q5 NrinclandRjoL. Suite C-15 C�iaWo.r 32811
LARGRATORIG111111 TF1.. 407.425 fi71]p ,,, FAX: 4�74254707 Accuiest Qoote #
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FA34122: Chain of Custody
Page 1 of 3
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1 110( 16
-GSA. ACCUTEST
I FA34122

t
A'
ACCddUTEST LABORATORIES SANIME RECEIPT CONFMAIATION
ACCUTFST'SJOB NUMBER: '13 7 CLIENT: tCGtJ"5'`�F—PROJECT: DATE/TIME RECEIVED: ZC) l G � {MM/DDlYY 24:001 NUMBER OF COOLERS RECEIVED: I
METHOD OF DELIVERY: FEDEX ��UPS ACCUTEST COURIER DELIVERY OTHER:
AMBD.L NUMBERS: pd F- 7 � 5 V 2 �1�
COOLER INFORMATION
CUSTODY SEAL NOT PRESENT OR NOT INTACT
CHAEN OF CUSTODY NOT RECEIVED (COC)
ANALYSIS REQUESTED IS UNCLEAR OR MISSING
SAMPLE DATES OR TIMES UNCLEAR OR MISSING
TEMPERATURE CRITERIA NOT MET
TRIP BLANK P40R.MATI0?r
TRIP BLANK PROVIDED
x TRIP BLANK NOT PROVIDED
_.
'''' TRIP BLANKL NO.T ON COC
'. TRIP BLANK 1TTAC1'
' TRIP BLANK NOT INTACT
CEIVED WATER TRIP BLANK
RECEIVED SOILTTRIP-BI:ANK
Is'
MISC- oRA'LAT70N—
NUMBER OF FNCORFS ? a-.35-GRAM S-GRAM
My NUMBER OF 5035 FIELD KITS
TEMPERATURE INFORMATION
IR THERM ID i CORR. FACTOR �• r'
OBSERVED TEMPS: 2-
CORRECTED TEMPS: z (USED FOR LIMS)
SAMPLE LNTORMATION
INCORRECT NUMBER OF CONTAINERS USED
SAMPLE RECEIVED IMPROPERLY PRESERVED
INSUFFICIENT VOLUME FOR ANALYSIS
DATESITIMES ON COC DO NOT MATCH SAMPLE LABEL
ID'S ON COC DO NOT MATCH LABEL
i VOC NTALS HAVE HEADSPACE (MACRO BUBBLES)
BOTTLES RECEIVED BUT ANALYSIS NOT REQUESTED
I NO BOTTLES RECEIVED FOR ANALYSIS REQUESTED
UNCLEAR FILTERL'NG OR COMPOSITING INSTRUCTIONS
SAMPLE'CON'I'Ai\ER(Sj RECE,�'EDBROI:i.N==... ..- .
i 5035 FIELD KITS NOT RECEIVED WITHIN 46 HOURS
} ` BULK VOA'SOIL JARS NOT RECEIVED UTTHL'N 48 HOURS
SOLIDS rJAR NOT, RECEIVED.
RESIDUAL CHLORINE PRESENT LOT#
� - NUMB_ ER OF LAB FILTERED, METALS ? 1A;F ICABLE TO EPA 600 SE US OR NORTH CAROIANA ORGAN1CSj
TEST STRIP LOT#s PH 0-3_230315 pH 10-12 219813A OTHER (specify)
SUMMARY OF C0.141MEhTS: � a Q r e (C Gi ✓) [a �—
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REVIEWER SIGNATUREIDATE
RECEIPTLOG040416. s'
FA34122: Chain of Custody
Page 2 of 3
12 of 16
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Page 3 of 3
1 13 of 16
_S-GS ACCUTEST
FAM122

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General Ctiemzstry
QC Data Summaries
Includes the following where applicable:
• Method Blank and Blank Spike Summaries
• Duplicate Summaries
• Matrix Spike Summaries
Section 6
�+
14 of 16
-GS ACCUTEST
FA34122

METHOD BLANK AND SPIKE RESULTS SUMMARY
GENEFAL CHEMISTRY
Looin Number: FA34122
Account: JCSCNCD - Jacob's Creek Stone Company
?roject: Davidson Quarry; 20al Slate Mine Rd, Denton, NC
ME Spike BSP ESP QC
IAnalyte Batch ID RL ^� Result Units Amount Result kReccv Limits
Solids, Settleable GN71016
Solids, Total Suspended GN71029
Turbidity GN71015
Associated Sa=:Ies:
!Batch GN71015: FP.34122-1
latch GN71016: FA34222-1
Bach GN71029: FA34122-1
(•) Outside of QC limits
o.se o 0
ml/1
5.0 0 0 7. m2/1
1.0 T
Page 1
1f�
15 of 16
rjACCUTEST
FA34122

DUPLICATE RESULTS SUMMARY
GENERAL CHEMISTRY
Locin Number: FA34122
Account: 3CSCNCD - .,acob's Creek Stone Company
Project: Davidson Quarry; 2061 Slate Mine R3, Denton, NC
Analyte
—
3atc`7 7D
— —_
QC
Samole
Units
original
Aesult
DUPRes
P.es u1:
??D
QC
Limits J
Solids, Total Suspended
GN71029
FA31047-2
mq/1
20.0
21.0
4 3
0-5%
Turbidity
GN71015
FA34122-1
IQTU
6.i
5.0
2 0
pH
GN71017
FA34106-1
su
6.22
6.22
Associa_ed Samn?es:
Batch GN71015: wR34122-1
Bach GN71017: F7-.34122-1
Batch GN71029: eA34122-_
(`) Outside of QC lim5ts
Page 1
E6of16
- ST.- ACCUTEST
FA34122

Geological Resources, lnc.
June 17, 2016
Mr. Matt Gantt/Ms. Sue White
Surface Water Protection Unit
Division of Water Quality
North Carolina Department of Environmental Quality
Winston-Salem Regional Office
450 W. Hanes Mall Boulevard, Suite 200
Winston-Salem, North Carolina 27105
RE: Jacob's Creek Stone Co. Inc. -- Davidson Mine
Discharge Monitoring Report — May 2016
Davidson County
Yadkin -Pee Dee River Basin
Certificate of Coverage No. NCG020206
GRl Project No, 1517
Dear Mr. Matt Gantl/Ms, Sue White:
On behalf of Jacob's Creek. Stone Co. Inc., please find attached the results of the stormwater outfall sampling
thatwas conducted on May 19, 2016 for the Jacob's Creek Stone Co. Inc. facility in Denton, Davidson County,
North Carolina. Water samples were collected from the outfall of Pond #1 by Jacob's Creek Stone Co. Inc.
personnel on May 19, 2016 in accordance with the NORR dated January 28, 2013. Water samples were
analyzed for pH, settleable solids, total suspended solids, turbidity and fecal coliform. Results indicate that
concentrations of requested method constituents are below the permit levels. Per email correspondence from
Ms. Jenifer Carter of NCDEQ dated March 15, 2013, only Pond # l will continue to be monitored. The
Stormwater Discharge Outfall Monitoring Report is included in Appendix A, the Stormwater Discharge
Outfall Qualitative Monitoring Report is included in Appendix B, and a complete laboratory analytical report
is included as Appendix C.
The next sampling event is scheduled to be conducted between July and September 2016 during a
representative rainfall event. Following this sampling event, it is requested that Jacob's Creek Stone Co. Inc.
be allowed to reduce the sampling frequency to semi-annual sampling instead of the current quarterly sampling
schedule, Please do not hesitate to contact me at [phone], if you have any questions or comments.
Sincerely,
4
Rohit Shetty, P.E.
Senior Engineer
cc: Jeff McKinney, Jacob's Creek Stone Co. Inc.
file N
enclosures
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G • Winterville, North Carolina 28590
Phone [phone] [phone] • Fax [phone]

APPENDIX A
STORMWATER DISCHARGE OUTFALL MONITORING REPORT

STORMWATER DISCHARGE OUTFA LL (SDO)
MONITORING REPORT
NW.t020206 SAMPLES COLLECTED DURING CALENDARVEAR' ' 12016
(This monitoring report shill be resolved by the Division'riii later thin,30 days from
the date thi facility receives the iarfipling ri�sulu frorn'thi lib-666ry.)
FACILITY NAME' _Jvtobs' ' Creek Stone Co,tnc COUNTY Davil6on
PERW6COLLECT[NdSA'MPUF{Sj JCffmimimey PHONE NO: 336 ' W57-6292
1ftktl01kb'lAHOkATORV(Sj Aicutest 6iborat'orja_ Lab lk.1_573�_
Lah N:
I
SIGNATURE OF PERMITTEE OR DESIGNEE
MITERED ON PAGF 7-
'Ps r1A: Specific Monit6ririg Riifuiremifiti
Otrtfall,'eay
Date
50050
i, k:� >
"A
!T'otal
Total
Total (!'�U '1111`g
-.4
suspendeill"A
io"E!ii, ;52-
TurbidityV.W2,
pH r�40'
P�--
molddtir
CMG:, V
iiijb6i r
TOM '1119'kVe
Pond N1
05119116
N/A,'
I
<0-94
'<25.
6.1
6.76-
L)oe5 thisca­cili-ty.1p.er1 fo-11
Vchide Wimicrj,incc Activilrm using rnotc dum,55, gAlons ofricivy motor oil per month?,_, yt;s ho
(if' yes; complete Port B)
Part R- Vehiele N112intertance Activity Mmitorinp Rrouirements
Outfall 6
Da � g,�
Dot[
:
500507 �7--
0 ,36
V
OMM
0"w- -
Total Fl.w,,jor,!,
Total
OR & Grimse'.
Noa-polar ;t
Total
H*
New Motor'
No i ,4?, -:1
SSample4l�
FITH; 'V
Sii*ided,
tm jsnct-.'n
f
'P
..
Iq-�; 4%:
;X;
,�V
IWSoD
a
i� ;NF
t
D2,
•
0'.
moIddbV�6
;MG!
I luchcm�L- A��-,
OKA
"a n2
Torm SVAj-Y47, 4is.1. rcv,' wd 2/ii2012.,

STORM
EVENT CHARACTERISTICS: mail anginal and one copy to:
Division of WateT Quality
Date 05119116' Attn: Ccnval Files
Tool Event Pitcipitation (inches): _ _'1,00 1617 Mad Service Center
Event Duration (hours): (only if applicable Sep permit,) Raleigh North Carolina 27699-1617
(if murc than one storm cvznt,%� sampled)
Uatr
Total Event Precipitifioii (inches):
Event buriition (houisj: (only if applicable — seepennit.) j
r
"1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualifled personnel properly gather and evaluate [he inforinati ' submitted. Haied on my inquiry'of the person
or persons who mirnagethe ipatcm,-or thoseptrsons directly'responaible for gathering the information, the.iaformation submitted is, to the
best of. my kriSwi tgeand belief, true, accurate, and complete. I am aware Ilm t there are significant penalties for submitting false information,
including the pomibility of fines in'd imprisonment for knowing violations."
<t
(Sigiaturc Permittee i
'Form SWU-247,lavrvvks d2'1I?0I2
Page'2 oft'

Stormwater bikharge QutfaH (SDO)
QualitatNe Monitoring. Report
For guidance bnfillin oLd.this 4jv �gp:azo:i�. uAForms ocuMcm.htM#rni5cf0m
..9 form �Irase mte.nc.
Permit -No.: or Certificatc.of Coverage No.:
Facility Name: GiQiEX STa
qounty-.
nspector. 7ZF/' M-X.,WP4V'
Da.te.of Inspection: A
Time of Inspection: It! 06
Total Evebt Precipitation (inches):
Was this aRe
Oresentative Storm Evient? e
Ptease check your permit,toverify if Qualitiu
storm evEnf(requirefiwnts vary).
'.1riforn.a on below Yes No ive Monitoring trust -be: Performed during atepresenrative
A '.'Representative Storm Event!' is a storm 'event that measures'gre4ter than 0.1 inches of rainfall and that
is Preceded b:ylat least 72 liours.'(3 days) in which no storm event measuring 0. 1. inches has
greater. dm
occurred. A single storm event may contain up to 10 conse.cutive,hodfs of no Precipitation.
By ihis-signature, I certify that this report is I a&&ite and edinpleieto the best of my Iffiow ledge'
-
(Signature of Permit rDesign
I. Outfid] Description:
Outfall NoA101L. Suiacture (Pipe . ,ditch, ,etc.) .
Receiving Stream: AX.
Describe the industrial activities that,occurwithin die,outfall drainage area:
Z. Color: Describe th6,color of the di harge usin baqw jeolop (red, brown, blue, etc.),and tint
(light, medium, dark) asdescriptors:
3. Odor: Describe distinct odors that the discharge may have (i'-e;, smells strongly of oil, weak,
chlorine odor, etc.)-
Pa8i I of 1
% I .
SWU-242-.112608

i
At Clarity: Choose the number which best describes'.the,clarity of the discharge, where I is clear
and 5'is very cloudy: j
2 13 4. 5 !
5. -Floating.Solids: Choose the number which best describes the amount of floating solids;in the
stormwater discharge, where I is no solids and 5. is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids Choose the number which best describes the amount'of suspended solids,in
.the stormwater:d scbarge; where I is no safids:and 5'is�cxtrernely muddy:
�l 2- 3 4 5
7. Is there.any foam°in the stormwater discharge? Yes o
1
8. Is there an oil -sheen in.the siormwater discharge? Yes
9. 'Is, of erosf . " . d i o at ou all? Yes o
. on or eposigon ache , tf
10. Ott er'Obvibus Indicators of Storniwater Pollution:
J. #
List; and, describe
E f
f
y, high presence of foam, oil sheep, oi,erosion/deposition.may`be
Nate: Low clarity, hi ,solids andlor the ,.
indicative;of,pollutarit exposure. These conditions warrant further. investigation.
F
r
- f
Page 2 of 2
SwU=242-112608

APPENDIX C
LABORATORY ANALYTICAL REPORT (MAY 19, 2016)

-&G-S�'
ACCUTEST_
Southeast
SGS ACCUTEST IS PART OF SGS, THi WORI.D's LEADING INSPECTION,
VERIFICATION, TESTING AND CERTIFICATION COMPANY,
Technical Report for
Jacob's Creek Stone Company
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
SGS Accutest Job Number: FA34122
Sampling Date: 05/19/16
Report to:
's Creek Stone Company
@geologicalresourcesinc. com
ATTN. Jeff McKinney
Total number of pages in report: 16
r
Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or slate specific certification programs as applicable.
e-Hardcol�ly 2.0
Automated Report
N
Norm Farmer
Technical Director
Client Service contact: Muna Mohammed 407-425-6700
Certifications: FL (E83510), LA (03051), KS (E-10327), IA (366), IL (200063). NC (573). NJ (FL002), SC (96038001)
DoD ELAP (L-A-B L2229), CA (2937), TX (T104704404), PA (68-03573), VA (460177),
AK, AR, GA, KY, MA, NV, OK, UT, WA
This report shall not be reproduced, except in its entirety, without the written approval of SGS Accutest.
Test results relate only to samples analyzed.
Southeast • 4405 Vineland Road •,Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone] • htip://www.acculesi.com
i of 16
tiG4 Accutest is the sole authority Rtr authorizing edits or modifications to this doctnucnt. GS ACCUTEST
l Inauthorizcd modification of this report is strictly prohibited. ,_ Fa34122

Sections:
Table of Contents
-l-
Section1: Sample Summar)....................................................................................................
3
Section2: Summary of Hits....................................................................................................
4
Section 3: Sample Results........................................................................................................
5
3.1: FA34122-1: POND 1....................................................................................................
6
Section4: Subcontract Lab Data............................................................................................
7
Section5: Misc. Forms............................................................................................................
5.1: Chain of Custody....................................................................................
10
11
Section 6: General Chemistry - QC Data Summaries..........................................................
6.1: Method Blank and Spike Results Summary ..................................................................
14
15
6.2: Duplicate Results Summary..........................................................................................
16
(±[�
� 2 of 16
SGSr ACCUTEST
FA 34122

SGS Accutest
Sample Summary
Jacob's Creek Stone Company
Job No: FA34122
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Sample
Collected��
Matrix
Client
Number
Date Time By
Received Code Type
Sample ID
FA34122-1 05/19/16 09:001M 05/20/16 AQ Water I POND 1
�+(�
' 3 of 16
-S_GS, ACCUTEST
FA 34122

J
Summary of Hits
Job Number:
FA34122
Account:
Jacob's Creek Stone Company
Project:
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Collected:
05/ 19/16
Lab Sample ID Client Sample ID Result/
Analyte Qua] RL MDL Units Method
]:A34122-1 POND 1
Turbidity 6.1 1.0 NTU
PH 6.76 su
(a) Field analysis required. Received out of hold time and analyzed by request.
Page ! of ]
EPA 180.1
SM45001-1 B-i 1/SW9040C
9%�' + 4 of 16
a7G�,— ACCUTEST
FA34122

ACCUTEST .a.
] Sample Results I
Report of Analysis
Section 3 w
((++��++ S of 16
R7_L7 ACCUTEST
FAU122

SGS Accutest
Report of Analysis
Client Sample ID: POND 1
Lab Sample ID: FA34122-1 Date Sampled: 05/19/16
Matrix- AQ - Water Date Received: 05/20/16
Percent Solids: nla
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Page IofI
Iwl
General Chemistry
Analyte
Result
RL
Units
DF Analyzed
By
Method
Solids, Settleabie a
< 0.50
0.50
mlll
1 05/20/ 16 13:30
LE
SM2540 F-1 I
Solids, Total Suspended
< 25
25
mg/l
l 05/23/ 16 07:20
LE -
SM2540 D-1 I
Turbidity
6.1
1.0
NTU
1 05/20/ 16 14:45
zC
EPA 180.1
pl-I b
6.76
su
l 05/20/ 16 14:50
LE
SM4500H B-I v5W9040C
(a) No QC analyzed due to limited volume of sample.
(b) Field analysis required. Received out of hold time and analyzed by request.
RL = Reporting Limit
SGSI ACCUTEST
FA34122

S(i9
ACCUTEST
Section 4
Subcontract Lab Data I a
Report of Analysis
_ZGSL ACCUTEST
FA34122

PA
PROM PT•ACCURATE• RELIABLE
LABORATORIES, INC
% %%V ' p"LRLABS.Com
REPORT OF ANALYSES
Attn. MONA MOHAMED.
ACCUTE~ T LABORATORIES SE
4465 VINELAI\t ROAD
SUITE C-1.5
'ORLANDO,• Ft 3281 1 -
PROJECT NAME. MAY 16
DATE: 05/31/16
SAMPLE NUMBER-
12-3407
SAMPLE:ID- POND 41
SAMPLE MATRIX- WW
DATE SAMPLED-
05/19/.16
TIME SAMPLED- 0900
DATE RECEIVED-
05/19/16
SAMPLER- JM
RECEIVED BY- DJ
TIME RECEIVED-
1140
DELIVERED'BY- CC
TYPE•SAMPLE- Grab
Page 1 of i
ANALYSIS
ANALYSIS
METHOD DATE TIME BY
RESULT UNITS
FECAL COLIFORM
SM 9222 b 05/19/1.6 1400 RE
17.21 col/I'UomLs
l•
LAPORATORY DIRECTOR
P.O,. Box 411483 - Charlotte,,NC 28241.1493
konc (704) 588-$333 r.Fax: [phone]
��++�±��++1 8 of 16
.7G S, ACCUTEST
PA34122

L4T
®� Accutest Laboratories Southeast
Chain of , Custody AcCuieSi JOB
® ACCUTEST. 4405Vineland Roud,Suite C-15 orlando.M328li
PAGE OF
y
•.
y EMERGENCY
■ .:
■ • .
■ I ,q EMERGENCY
■
..
.. -„ r •
• �'
,.
� t
- •3 : l4-ei
.:ll.ral �.v-'.. JIB: _.aW�..•.c !L.•'1.• �.•x`.•r:
1.:•.u.: ,1. • •.•,1
KIM"=
arm w
j
WI.A.
Lab Use Only: c4imody SeaT in Kam: Y N Temp Blank Ptovidod: Y N Preserved where�AqpUcable,, Y _N TotW t of Coolem: CODW Temperature (i) Celsitm:
_co i_

ACCUTEST
Snuthpast
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
Section 5
10 of 16
SGS ACCUTESr
FA34122

Accucest Laporatories 6oumeast
.. Chain of Custody Accutesi JOB # FA3` l.z'?- PAGE OF
EAC;C UTEST 4405 Vineland Road, Suite C-15 Orlando, 32811
L A A a R A r O R 1 i• 7EL. 407425-6700 • FAX [phone]
W W W.accutest.mm
ccutest Quote
Greet! a Inlonnmion •;
f. Proect inlormatwn-;io;E4!". �'t^"'
Arta
'ral
Inlornmtian �::t..:
Matn. as
Corm n Nam O.
Prot.a Nam.:
L.�
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yt
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DW Ors#y wabr
ow - oe-w41., er
ww afer
Sr.race wales
so-sw
SL. slutgt
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LIO - ptw liw:]
A1R -Ar
SOL-O-Ar SaW
rw w,a,
usL2W.L—
Adre .. D• o O
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ss:a
JA/ a
Pam •
Pri er _ e. Z
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SraaNrisl Nunpl dN
Ca.ft Psrm.sc omry
Am. m
c t
Field ID! Paint of CollectionWit
s.wtro
wernr.
row.
av
4
ANAROUND TIME Musi"11 s)
pe
eras
Informs:
�='
•.rx
'f.
t-arnronta
1
Remarrrs
❑ le) Days Standard Approved By: l Rush Code
❑7Day RDSH
❑ 5 Day RUSH
❑ a Day EMERGENCY __
❑ 2 Day EMERGENCY
❑ 1 Day EMERGENCY
❑ OTHER
F Wgancy or Rush VA Data AvaW* VIA Email a Labfnh
❑COMMERCIAL'A'(RESULTS ONLY)
*
�COMMERCIAL'B"�HESUL e ~hl
rj1]{��. C� ) f1p
RE071 2,82 J%' ,c Q U - CIV C`. r e DR
FUL7t (EPA LEVE
❑ CL 1 _7\lr 282JJ
El Eon
I am
r
e�yq h i m ! rha
anion 1nCltdt -ar
Relinq I Date Tie:
1
Rewiv
2 .
Relingm
3
6a{,�(.Time:
�/! /l. %fy
Received B :
4
Re ed by: Date Time:
s
R 'v gVLr
s a w 16
Relinquished try:
7
Date Time:
Received By:
a
Lab Use Dnl t Custody Seal in PlaCW. Y N Temp 81 ovidnq: Y N Preserved where Applicable: Y N Total p of Coolers: f Coohr Tcmporaturo {s Ceisius: z-
FA34122: Chain of Custody
Page 1 of 3
�+��++��++1 11 of 16
ACC
s7`ia� UTEST
FA34122

ACCUTEST LABORATORIES SAMPLE RECEIPT CONFIRMATION
ACCUTFST'SJOR UMBER: '13 �ZZ CLIENT: 5elCG5S' C�tt� PROJECT:
DATE/TIME RECEIVED: �` �l �r (MM(DDIYY 24:001 ^ NUMBER OF COOLERS RECEIVED;
METHOD OF DELIVERY: UPS ACCUTEST
ACCUTEST COURIER DELIVERY OTHER:
AIRSHJ, NUMFF.DEX � � / BERS: "T z % yZ -z�
COOLER INFORMATION
CUS TODY SEAL NOT PRESENT OR NOT INTACT
CHAIN OF CUSTODY NOT RECEIVED (COC)
ANALYSIS REQUESTED 1S UNCLEAR OR MISSING
SAMPLE DATES OR TIMES UNCLEAR OR MISSING
TEMPERATURE CRITERIA NOT MET
TRIP BLANK INFORMATION
TRIP BLANK PROVIDED
TRIP BLANK NOT PROVIDED
TRIP BLANK NOT ON COC
TRIP BLANK INTACT
TRIP BLANK NOT INTACT
RECEIVED WATER TRIP BLANK
RECEIVED SOIL i RI -BLANK
MISC. INFORMATION
NUMBER OF ENCORES? 25-CRAM 5-GRAM
NUMBER OF 5035 FIELD KITS?
NUMBER OF LAB FILTERED METALS?
TEMPERA'PURE INFORMATION
IR THERM m ] CORR. FACTOR �•"
OBSFRVEDTEMPS: 'Z-
CORRECTED TEMPS: (USED FOR LIMS)
SAMPLE INFORMATION
INCORRECTN'UMRFR OF CONTAINERS USED
SAMPLE RECEIVED IMPROPERLY PRESERVED
INSUFFICIENT VOLUME FOR ANALYSIS
DATESITIMES ON COC DO NOT MATCH SAMPLE LABEL
ID'S ON COC DO NOT MATCH LABEL
VOC VIALS HAVE HEADSPACE (MACRO BUBBLES)
BOTTLES RECEIVED BUT ANALYSIS NOT REQUESTED
NO BOTTLES RECEIVED FOR ANALYSIS REQUESTED
UNCLEAR FILTERING OR COMPOSITING INSTRUCTIONS
SAMPLE-CONT A.INER(S)- RECEIVED BROKEN''
5035 FIELD KITS NOT RECETVEII WITHIN 48 HOURS
BULK VOA SOIL JARS NOT RECEIVED WITHIN 48 HOURS
SOLIDS JAR NOT RECEIVED
RESIDUAL CHLORINE PRESENT LOT#
fAPPLICABLE TO EPA 500 SERIES OR NORTH CAROLINA ORGANICS)
TEST STRIP LOT#s pH 0-3_230315 PH 10-12 , ___219813A OTHER (specify)
SUMMARY OF COMMENTS: �`� f l ( e ✓1 ee
• CaL Sa r `C 5�� � �K1... �„ ,-Gce�'ve� CaG � rya s"`Y 5
TECHNICIAN SIC NA
NF 11115
S16NATURFJDA
REC EIPTLOG040416.XIS
FA34122: Chain of Custody
Page 2 of 3
12of16
CGS ACCUTEST
FA34122

Y
Me
FRi 20 MAY 3:OOP
- a66z B087 5429 4295 STAMDiRQ OVERNIGHT .
s2ail
XH TIXA' ;"i FL-11 MC0
gal.
i
FA34122: Chain of Custody
Page 3 of 3
GS. SACCUTEST
FA34122

ACCUTEST
Southeast
General Chemistry
QC Data Summaries
Includes the following where applicable:
• Method Blank and Blank Spike Summaries
• Duplicate Summaries
• Matrix Spike Summaries
Section 6
1 '
�±
14 of 16
SGS^ ACCUTEST
FA34122

METHOD BLANK AND SPIKE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA34122
Account: JCSCNCD - Jacob's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
MB Spike 6SP BSP OC
Analyte Batch ID RL Result Units Amount Result 9Recov Limits
Solids, Settleable GN71016
Solids, Total Suspended GN71029
Turbidity GN71015
Associated Samples:
Hatch GN71015: FA34122-1
Batch GN71016: FA34122-1
Batch GH710297 FA34122-1 ,
i*) Outside of QC limits
0.50 0.0 ml/l
5.0 0.0 mg/1
1.0 0.0 NTU
Page 1
15 of 16
_SGS ACCUTEST
' FA34122

DUPLICATE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA34122
Account: TCSCNCD - 3acob's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
QC Original DUP QC
Analyte Batch ID Sample Units Result Result RPD Limits
Solids, Total Susoended GN71029 FA34047-1 mg/1 20.0 21.0 r2.C)
0-5%
Turhidity GN71015 FA34i22-1 NTU 6.1 6.0 0-8%
pH GN7i0i7 FA34108-1 su 6.22 6.22 .0 ,0-10%
Associated Samples:
Batch GN71015: FA34122-1 N
Batch GN71011: FA34122-1
Batch GN71029: FA34122-1
('y Outside of QC limits
Page 1
�+�±
16 of 16
-SGs,_ ACCUTEST
FA34i22

•l�
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000 MAR 0 ?Ot6
Calendar Year 2015 r'r:ArTn R .
t ►vML t-IL
`Report ALL STORMWATER monitoring data on this form (include 'No Flow"/"No Discharge" and BencFrn '' 10t
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02 0❑2❑❑0MG
Facility Name: DAVIDSON MINE
County: DAVIDSON
Phone Number: ( 3 3 6 ) 8 5 7 - 6 2 02 Total no. of SDOs monitored 1
Certified Laboratory ACCUTES'T' LABORATORIES Lab # 573
Lab #
Stormwater Discharge Outfall (SDO) No. 1 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 0
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 ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Outfall No.
POND #1
Total
Rainfall,
inches
TSS,
mgll
SS,
MIA
Turbidity,
NTU
Upstream
U Turbidity,
() yr
NTU
Downstream
(D) Turbidity,
TNTUO&G,
Non -polar
mgll
(VMA)
New
Motor Oil
Usage
(gal/Mo.)
Stormwater
Benchmarks
indicate NO
FLOW tf
a rrca6,e
Bencrclehmark
Benchmark
100150
0.1
circle
Benchmark
50/25/10
NIA
Water Quality
Standard applies
NIA
Water Quality
Standard applies
15
y55 agall requires
average mquirea
TSS and Nan -polar
OaGmonitorin
Date Sample
Collected,
molddlyr
03/20/15
0.511+
<25
0.50
5.8 1
N/A
N/A
N/A
<55
07 14 15
1"
<25
<0.50
7.8
N/A
N/A
N A
<55
11 09 15
1"
<4.0
0.50
22.9
N/A
N/A
N/A
<55
Permit Date 10/112015 - 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 ❑ 2❑©E6:]
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 l[ -7 VC.
Date .Z _7 ``/,</
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 DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

. i It
N.C. Dept. of Eh� �F
JAN 15 L01S
4N
Winston-Salem
Regional Office y
Geological Resources, Inc.
January 12, 2016
Ms. Jenifer Carter
Surface Water Protection Unit
Division of Water Quality
North Carolina Department of Environmental Quality
Winston-Salem Regional Office
450 W. Hanes Mall Boulevard, Suite 200
Winston-Salem, North Carolina 27105
RE: Jacob's Creek Stone Co. Inc. — Davidson Mine
Discharge Monitoring Report — November 2015
Davidson County
Yadkin -Pee Dee River Basin
Certificate of Coverage No. NCG020206
GRI Project No. 1517
Dear Ms. Carter:
On behalf of Jacob's Creek Stone Co. Inc., please find attached the results of the storm xater outfall sampling
that was conducted on November 9, 2015 for the Jacob's Creek Stone Co. Inc. facility in Denton, Davidson
County, North Carolina. Water samples were collected from the outfall of Pond 91 by Jacob's Creek Stone
Co. Inc. personnel on November 9, 2015 in accordance with the NORR dated January 28, 2013. Water
samples were analyzed for pH, settleable solids, total suspended solids, turbidity, and fecal coliform. Results
indicate that concentrations of requested method constituents are below the permit levels. Per your email
correspondence dated March 15, 2013, only Pond "'I will continue to be monitored. The Stormv.,ater
Discharge Outfall Monitoring Report is included in Appendix A, the Stormwater Discharge Outfall
Qualitative Monitoring Report is included in Appendix B, and a complete laboratory analytical report is
included as Appendix C.
The next sampling event is scheduled to be conducted between February and April 2016 during a
representative rainfall event. Following this sampling event, it is requested that Jacob's Creek Stone Co. Inc.
be allowed to reduce the sampling frequency to semi-annual sampling instead of the current quarterly sampling
schedule. Please do not hesitate to contact me at [phone], if you have any questions or comments.
Sincerely,
4��
Rohit Shetty, P.E.
Senior Engineer
cc: Jeff McKinney, Jacob's Creek Stone Co. Inc.
File
enclosures
3502 Hayes Road • Monroe, North Carolina 28110
113 West Firetower Road, Suite G + Winterville, North Carolina 28590
Phone [phone] • [phone] • Fax [phone]

APPENDLY A
STORMWATER DISCHARGE OUTFALL MONITORING REPORT

STOR'►fV►ATER DISCHARGE 0UTFALL (SDO)
biONFTORL�G REPORT
Permit Number \CS NCG020206 SAMPLES COLLECTED DURNG CALENDAR YEAR: 201
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives.the sampling results from the iaboratory.)
FACILITY NAME Jacobs Creek Stone Co. Inc COUNTY Dvvidcnn
PERSON COLIXCf['1G SAMPLE(S)_jefiMcKinney PHONE NO. ( 336'1957 6202
CERTIFIED LABORATORY(S) Accutest Laboratories Lib it_573_
Lab#
SIGNATURE 'OF PERAfRTEE OR D ESIGI E E
REC1IiCRED ON PAGE 2.
Part A: Specific Monitoring Requirements �
Otitfall
ho ' ,
Date .. .'
Sample
CoAected'-
S0
r- F_�
::C.:
t., t arc
f e..tS
J• -
it = f h
Total
Flow(eCapp.)
Total C
Rntnia{! r
Settleable`
Soltda z `
Tata1
Suspended
TurbtdtTv r_
p13 A
r,r -
FA LL rLL �'
mofddivr.r.. -
:1IG_
tocbn'
f
Pond ell
I /0 115
NIA
1 "
'<a Si) _
�c4.0
224
634 -
Does this facility petfNtm Vehicle Maimenanee Activities using more than» gallons of new motor oil pet month? _yes _no
(if yes, complete Pan B) ;
PAm it- lrhirlr M.intrr .— Amiairy Mnnir—ina iR�irr�irwm:nra
Oatfell
Date
$tlilSa r
f rc,
DQSk " ter
i r r
QQ$3{!
(lti4ild
.t:
10
ample
Total Flow
Tota}
Or7 & ircasc
ion polar -,
Total, =
pH
\ew Motor
k
Callested
(dappittable)
Ramfall
(if ppl.)
O&-GMPH'
Stspended
r
Oil Usage:;
(Mcthio I664
Soh85'�
h.,
_
'
"_
- Y
-r-s
-
r
��• pig
JL�A [l.Lrl'1.tf
j
�541 ri^
�_ L NW }'r
-.21�. -3•X"
malddhr t,';'::...
lygG
inches .,. .,__..,:c'.
_,3ti=�' _
--y
it a
m :�,^:..�.
Form 5R'U.247, fare rew.ted 2'2:201?.
Page I'of2

STORM EVENT CHAR4CTERI.STICS; Hail Original and one copy to:
Division of Water Qualiry
Date 11/09/15 Ann: Central Files
Total Event Precipitation (inches): 1.001617 Mail Service Center
Event Duration (hours): (only if applicable — sce permit.) Raleigh, North Carolina 27699-1617
(if more than one storm event mas sampled)
Dale
Total Event Preciliitatinn (inches);
Event Duration (hours): !only if applicablt —see perrnit.)
i
"1 certify,.uncirr penalty of law, that thidocument and all ar6chments were prepared under my direction or supervision in accordance with a
sy stem designed to assure that qualifieds personae! property gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or,those, person¢ directly responsible for gathering the information, the information_ submitted is, to the
best of tr y knowleiEgs-and belief, true, ecciirate, and complet . 1 am ttWare that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for kno-Airig violations."
ZIV/''12-/l /Sr
(Signafur of Permirtee (Date)
Form SWU-247, lax? rerise112.22011
Page'_ of?

APPENDIX B
STORI IM'ATER DISCHARGE OUTFALL QUALITATIVE MONITORING REPORT

raSRSe
w�n .
7
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on -1-TIZIng out this fcm please visit f1�,2a.ets.5ats.zac.us%s�)Fb*ms D_C+cu�e�Ys.htrr� t csQ s
Perrrdt No.: VL 1 1�.1 1 ! 1 1 or C�ra5cate of Cov l ae No:: i !(JCr1�fJ©1 fl/fjl-,l
Facility Name: [.d C E T AI C � G'
County 192 Phone'No.
Inspector.
Date of Inspection:
Time of Inspection: _ e
Total Event Prre itation (i_uches):
Was this aRepresentative StormEvent7 (See.it3forna`ioa below).. Yes ❑ Na
Please check your permit +:o verify f Qu--Ji?=ve Monitoring must beperformed during Arepresemadve
storm event (requirements vary).
A "Representative Storm. Event" is a storm event that measures a:eater thin 0.1 inches of rainfall and that
is preceded by as least 72 hoots (3 days) i-a which no sto= event m=u-ina greater than 0.1 inches has
occurred. A single stoma event may contain up to 10 conse rt ve houns of no p:ecipitaiian: ,
By this signature, I certify that his report is acmate and'cdmple€r to the best of my knowledge:
(Signature of Pee or
1. Outf=Dekdan:-
OutfOf
all No:St-== (pi e, ditch, etc.)
Reeeivina Street:
Describe.the industrial activities that ocrxtr wi;ha3 the outfall drainage area:
2. Color. Descn-be the color of trip -
(light, zmedit= dark) as descriptors:
3. Odor- Desc-ibe any
chlorine odor. etc.):
using��;,4 .s (real, brown; blue, etc.) and tint .
odors tbat the discharge may have (Le- smells strongly of oil, weals
Page l of 2
SWU-242-112608

4. Clarity: Choose the number which best desczibes. the clarity of the discharge, whe; e 1 is clear
and 5 is very cloudy.
D 2 3 a: 5
5. Floating Solids: Choose the number which"best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
j� 2 _ 3 4 5
5. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, wb= 1 is no solids and 5 is extremely muddy.
2- 3 4 5
7.
Is there any fem in the stormvi-dw discharge?
Yes
S.
Is there an oil sheen in the stormwater discharge?
Yes
9.
Is there etiideace of erosion or deposition at the oat:M?
Yes
IU.
Other Olrvions Indicators of Stormwater FoBution:
List and describe
Hots: Low clarity, high solids, and/or the presence of foam, oil sheen, ore,osion/deposition maybe
indicative of pollutant exposure. These conditiotas 'w.ant,figther investigation.
0
J-242-112609
Pan 2 of 2

APPENDLX C
LABORATORY ANALYTICAL REPORT (NOVEMBER 9, 2015)

e-Hardeopy 2.0
Automated Report
Effective January 1, 2016, SGS has acquired all of the assets of Accutest Laboratories and will continue to
operate as SGS-Accutest. SGS-Accutest is part of SGS, the world's leading inspection, verification, testing and
certification company. . , -
kTechnical Report for
s
Jacob `s Creek Stone Company
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Accutest Job Number
Sampling Date: 11/09/15
Report to:
Jacob's Creek Stone Company
@geologicalresourcesinc.com
TTN: Jeff McKinney
Total number of pages in report: 23
&IW-1-6121
a
Test results contained within this data package meet the requirements
of the national Environmental Lahoratory Accreditation Program
and/or state specific certification programs as applicable.
Norm Farmer
Technical Director
Client Service contact: Muna Mohammed 407-425-6700
Certifications: FL (E83510), LA (03051), KS (E-10327), 1A (366), IL (200063), NC (573). NJ (FL002), SC (96038002)
DDD ELAP (L-A-B 1-2229), CA (2937), TX (T104734404), PA (68-03573). VA (460177).
AK, AR, GA, KY, MA, NV, OK, UT, WA
This report shall not be reproduced, except in its entirety, without the written approval of Accutest Laboratories.
Test results relate only to samples analyzed.
Southeast - 4405 Vineland Road - Suite C-15 - Orlando, FL 328I1 - tel: [phone] - fax: [phone] - httpa/u vw.acculest.com
Accutest Laboratories is the sole authority for authorizing edits or modifications to this ®�AT. o=u-rES
document. Unauthorized modification of this report is strictly prohibited. ®9t49

Sections:
fable of Contents
-1Fee-
Section1: Sample Summary................................................................................................... 3
Section2: Summary of Hits.................................................................................................... 4
Section3: Sample Results ........................................................................................................ 5
3.1: FA29149-1: POND 1................................................................................................... 6
Section4: Subcontract Lab Data............................................................................................ 7
Section5: Misc. Forms ......... ........... ................................................. :.............................. ......... 10
5.1: Chain of Custody.......................................................................................................... 11
Section 6: General Chemistry - QC Data Summaries .......................................................... 14
6.1: Method Blank and Spike Results Summary
6.2: Duplicate Results Summary 16
Section 7: Misc. Forms (Accutest Lafayette)......................................................................... 17
7.1: Chain of Custody........................................................................................................... 18
Section 8. General Chemistry - QC Data (Accutest Lafayette) ........................................... 21
8.1: Method Blank and Spike Results Summary.................................................................. 22 „
8.2: Duplicate Results Summary.......................................................................................... 23
®E3 2 of 23
®ACCUTEST.
FA29149 •""6x w1UF16•

IX
Accutest Laboratories
Sample Summary
Jacob's Creek Stone Company
Job No: F.g29149
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Sample 5661]ectedr , ; `E Matrix Client
Number Date Time By . Received Code Type Sample ID
PA29149 ] 11/09/15 09:00 RFJM 11/11/15 AQ Water POND 1 s
®D 3 of 23
® InIOOUTEST.
FA29149

Summary of Hits
Job Number: FA29149
Account: Iauoh's Creek Stone Company
Project: Davidson Quarry: 2081 Slate Mine Rd, Denton, NC
Collected: 11/09/15
.ab Sample 1D Client Sample 1D Result/
.na]N'te Qua] RL MDL Units !Method
Page 1 of 1 0
FA29149-1 POND 1
Turbidity a 22 9 Y 1.0 NTU EPA 180.1
pH b 6 34 y su SM4500H B-1 I1SW9040C
(a) Received out of hold.
(b) Field analysis required. Received out of hold time and analyzed by request.
®® 4 of 23
®accu-res-r.
FA29149 `..... 6w1••

--r-
Sample Results x
Report of Analysis
Section 3
®® 5 of 23
IN ACCLFTES"r.
PA29149 •••"••,"•:••

Accutest Laboratories
Report of Analysis Page 1 of I
,lient Sample ID: POND 1
,ab Sample ID: FA29149-1 Date Sampled: 11/09/15
latrix: AQ - Water Date Received: 11/11/15
Percent Solids: n/a
'roject: Davidson Quarry-, 2081 Slate Mine Rd, Denton, NC
General Chemistry
Analyte
Result RL Units DF
Analyzed By
Method
Solids, Settleable z
< 030 , .., .„ ='. 0.50 mlll 1
11/11/15 13:20 LE
SM2540 F-11
Solids, Total Suspended b
< 4 0 4.0 Mgt] 1
11/13/15 11:45
SM2540 D-II
Turbidity
9 1.0 NTU 1
11/11/15 13:30 LE
EPA ISO. 1
pH a
]22
su 1
11/11/15 13:45 LE
SM45DOH131vSW9MOC
(a) Received out of hold. Insufficient sample for duplicate.
(b) Analysis performed at Accutest Laboratories, Lafayette. LA.
(c) Received out of hold.
(d) Field analysis required.
Received out of hold time and analyzed by request.
RL = Reporting Limit
9
®® 6 of 23
®ACC UTEST.
FA29149 .....""°"'

Subcontract Lab Data' -
Report of Analysis
Section 4
®® 7 of 23
®ACCLITEST.
PA28948 `"'6w"""•

PVA".
_
tAso�TOR wI/C
N Raw mNI
REPUT OF ANALYSU
ww o: MUNA t ED
ACCUTEST LABORATORIES Q
4405 VINELAND ROAD
SUITE; ,s
ORLANDD. K » @,.
Q . NUMBER- 21272 S J 1. - !W! g
DATE SA3= E - 9Z09y5
TE RECEIVED- 9 Qed:SAMPLER- OM
TIME RECEIVEW „2DELIVERED By-
w , A ,
s.n &mE:NOV ;5
D z n 11/30115
sxE -- A
TIMF SOMPLED-q
RECEIVED - Di
TYPE S e:D Grab
q IJ-- - -- -� - � ANALYSIS TIME - -- s Iq-------�..����.------
.=__ wW., . S..22D 0Z0935 R G: 2 cW/110mLs
P.O.&x£&e.Omottc.N : S
pl ml 92= g. :(04)ngg5
■■ aoz3
■ �cce2Ee�
FAZ9149 ���I--

1
Accutest Laboratories Southeast
ME Chain of ACustody ACCuteslJOB#
IM C,CUTST E"MVinelandRoad,SuiteC-15 orland, • zzat)
PAGE_) --OF- ,
L A O P R iA T O P 1 0 e r r.L. au� a�-er[xT 17AX: 407-4254)707
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- Q':7DayRUSH
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r, r ik j { "
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Reri c'srted b Sa ter.
Da Time;
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Dat� lime:
Rere
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5
Date ilnTe;
Received 8y:
6
ReEirxluishad by.
7
Datv Tima:
Racelvatl By:
1 B
Lab Use Only: Custody Seal in Ptace; Y N Temp blank Provided: Y N Preservw where Applicable: Y N Tolal I of Coolers: Coohsr Temperalure W Celsius:

Section! 5
Custody Documents and Other Forms
-.---Includes-the following -where applicable: - - - - - - - - - - - - - - - - - - - - - - -
• Chain of Custody
013 10 of 23
® ACC UTEST.
FA29149 `••"•"�"`"•

FA29149: Chain of Custody
Page 1 of 3
®® 11 of 23
®aC c(D-U-rEESM
FAZ9149 I. .... -,..

ACCUTEST LABORATORIES SAMPLE RECEIPT CONFIRMATION
n
ACCUTESTSJOB NUM RER: T l� CLIENT:-(' PRD.TLCT: 0Vtr'LQC L..y
DAT,TIMERECEIVED: -TDI _{MM/DYY UA0] `�I �� D. NUMDF.ROFCOOLERS RECEIVED:
�i
METHOD OF DELIVERY! FFDEX UPS ACCUTEST COURIER DELIVERY OTHER:
AIRBILL NUMBERS: 9�23—g f 6 -3313 -.
COOI.F.R INFORMATION
CUSTODY SEAL NOT PRESENT OR NOT INTACT
CRAIN OFCUSTODY NOT RECEIVED (COC)
ANALYSIS REQUESTED 15 UNCLEAR OR MISSING
SAMPLE DATES OR TIMES UNCLEAR Olt MISSING
TEMPERATURE CRITERIA NOT NIET
TRIP HG`ANK INFORMATION
TRIP BLANK PROVIDED
TRIP RLANK NOT PROVIDED
TRIP BLANK NOT ON COC
TRIP BLANK INTACT
TRIP BLANK NOT INTACT
RF.CEIVE.D WATER TRIP BLANK
MISC. INFORMATION
NUMBER OF ENCORES ? I5-GRAM 5-GRAM
NUMBER OF 51135 FI rLD KITS ?
NUMBER OF LAB FILTERF,D METALS
TEMPFkAT 'RE INFORN'IATION
1R THrR.m 1D . r- - CORR FACTOR
OBSERVED TEMPS:
CORRECTED TF.MPS: Z,q (USED
SANIPLF INFORMATION
_ INCORRECT NUMBER OF CONTAINERS USED
SAMPLE RECEIVED IMPROPERLY PRESERVED
INSUFFICIENT VOLUME FOR ANAL)'S1S
DATI;SMMES ON COC DO NOT MATCH SAMPLE LABEL
ID'S ON COC DO NOT MATCH LABEL
VOC VIALS HAVE IMADSPACE (MACRO BUBBLES)
BOTTLES RP.CEIN'ED BUT ANALYSIS NOT REQUESTED
NO BOTTLES RECI:n-ED FOR ANALYSIS RP.QUFSTED
UNCLEAR FILTERING OR COMPOSITINC INSTRUCTIONS
SAMPLE CON'FALNBIt(S) P1:CEVEDBROKEN
15iu5 FIELD KITS NOT R C:::': i:i% iA'I ]iN t i 20URS'
BULK VOA SOIC-1ARS NOT RECFn'ED WITHIN 48 HOURLS
SOLIDS JAR NOT RECPII'FD
RESIDUAL CHLORINE. PRESENT LOT#
IAITLICARLE TO Ll'A 606 SF.RIM OR NORTH CIROLINA ORG&M—SI
TF.S'I"Sl'RIP LOTNS pH 0-3 204413A_ pH 1(I-12 219813A OTHER s Jr
SUMMARY OF COMMENTS:1h 1
FOR LIMS)
FA29149: Chain of Custody
Page 2 of 3
®p 12 of 23
®accu-rl=s-r
FA29149 •••""••"•'••

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ACCUTES.1 LABORATORIES
4405 VINELAND RD
STE C15
ORLANDO FL 328i1
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FA29149: Chain of Custody
Page 3 of 3
all 13 of 23
j3A,CCL-J-TE=-E-=.-7.
FA29148 ............

Section S
General Ci�emistry
a.
i r x Y•
QC Data Summaries
---Includes the folloxving-where-applicable: — - - - - - - - - - - - - - - - - - - - — -
• Method Blank and Blank Spike Summaries
• Duplicate Summaries
• Matrix Spike Summaries
®® 14 of 23
®ACCLITESM
FA29799 "•••"T9""•

METHO➢ BLANK AND SPIKE RESULTS SUMN.ARY
GENERAL CHEMISTRY
Login Number: FA29149
Account: JCSCNCD - Jacoh's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
MB Spike asp asp QC
Analyte Batch ID RL Result Units Amount Result £Recov Limits
Solids, Settleable
7ti:rbidity
Associaced Samples:
Batch GN666"s2: FA29149-1
Batch GN66638: FA29149-1
(') Outside of OC limits
GN68638 0.50 0 0 7 ml/1
GN6B632 1.0 9 0 N'.IJ
Page 1
®® 15 of 23
® ACCkJTES-r
FA"149

DUPLICATE RESULTS SUMMARY
GNER.AL CEE.MISTP.Y
Login NumberT FA29149
Account: JCSCNCD - Jacob's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
QC original DZiP QC
Analyze Batch ID Sample Units Result Result RPD Limits
Turbidity
PE
Associated Samples:
Batch GN68632: FA29149-1
Batch GN68638: FA29149-1
Batch GNES639: FA29149-1
(-) outside of QC 1lm4ts
GN68632
ONE 6639
:A29149-1 NTU 22.9 23.3 1 -7 0-617
FA29149-1 su 6.34 6.25 1 9 _: 0-101
Page 1
Isla 16 of z3
® /}.CCLJ-FrST.
FA29149 a ..`....t

�Misc Forms 4 ' ,�—
Custody Documents and Other Forms
(Accutest Lafayette)
Includes the following where applicable:
• Chain of Custody
Section 7
®M 17 of 23
® ACCIJTEST.
FA29149 " ......

CHAIN OF CUSTODY !
® 4CCl.!"TEST
Lweo 0.f n 0.ro nr�
7EL.40;>=5.aioa rw:: .mw�s-afir .�wa�a.
mn li
Page I of 1
FA29149
I chwtI R '.q,-B IRlortnauon' I - P 'e[1 }rdormation I
I R.
Lstmd Anal sic I arE TEST
=DE cheN
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A[[WutrL—dfs - i I I 7arrt.'a0n oniW iUB: S� Mu,e RC. penzrn, NC:
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FA29149: Chain of Custody
Page 1 of 3
Accutest Lafayette
75v7,
®[m 18 of 23
®accu-r
FA29149 `.... 17.—.

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S1,1ppl NG s T35ii800/LB MN
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®ACCLITEST. Accutest Laboratories Sample Receipt Summary
I -.O m A19 P.!.
Accutest Job Number: FA29149 Client: ACCUTEST FLORIDA
Data f Time Received: 1111312015 9:00:00 AM Delivery Method:
Cooler Temps (InitiallAdjusted): #1: f2.4r2.31:
Cooler Security Y
or N _
Y or N
1, Custody Seals Present: J
El
3, CDC Present:
'� ❑.
P. Custody Seals Intact: �t
E)
4, Smpl Date5rrimo, OK
�, ❑
Cooler Temoerature
Y or
N_._ '
1. Temp criteria achieved:
❑
2, Thermometer ID:
DV260;
3. Cooler media:
Ice direct contact
4. No. Coolers:
1
Quality Control Preservation
Y
or N NIA
1. Trip Blank present 1 Cooler:
❑
❑ -;011
2, Trip Blank listed on COC:
❑
❑ R
3. Samples preserved properi
�,
❑
4. VOCs headspece free,
❑
❑ k
Accutest Labt, a rigs
V:(80D) 5D4-5227
FedEx
Project: DAVIDSON QUARRY: 2061 SLATE MINE RD. DE
Airbill#'s: 612727564B79
Sample Integrity • Documentation
Y oZ N
1. Sample lahels present on "tiles:
❑
2. Container labeling complete:
'✓�
❑
3. Sample container libel I CDC agree:
a.
❑
Sample Integrity - Condition
1. Sample recvd within HT:
Y
or N
❑
2. AA containers accounted for:
❑
3. Condition of sample;
Intact
Sample Intearity • Instructions
1. Analysis requested is dear:
Y
R
or N NIA
2. Bottles received for unspecified tests
❑
3. Sufficient volume recvd for analysis:
��i,
❑
4. Compositing instructions dear.
❑
❑
5. Filtering instn+dions clear:
❑
❑ x
500 Ambantdtl Ceery Park�y
SmLt.aursutu 70553
—rrute t—
FA29149: Chain of Custody
Page 3 of 3
I
®p 20 of 23
U A,ccu'TEST.

.... R.+...r
General Chemistry
_ - -
QC Data Suimnaries
(.Accutest Lafayette)
Includes the following where applicable:
• Method Blank and Blank Spike Summaries
Duplicate Summaries
• Matrix Spike Summaries
Section 8
®® 21 of 23
® p.ccu-rEsT
FA29149 •••"•"•"""•

METHOD BLANK AND SPIKE RESUHLTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA29149
Account: ALSE - Accutest Laboratories Southeast, Inc.
Project: JCSCNCD: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
MR Spike ESP ESP QC
A.^.alyte Hatch ID RL Result Units Amount Result, kRccov Limits
Solids, Total Suspended GN5384 4.0 0_0 mg/1 1000 966-.96..'6_._ry"{", 90-1104
Associated Samples:
Batch GN5394: FA29149-1
(-) outside of OC limits
Page 1
ka?u.
®® 22 of 23
® ACC LiTE=ST.
FA29149 '"""" """•

DUPLICATE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA29149
Account: ALSE - Accutest Laboratories Southeast, Inc.
Project: SCSCNCD: Davidson Quarry; 2081 Slate Mine 'Rd, Denton, NC
QC Original DUP QC
Anal yte Batch ID Sample Urits Result Result RPD LirJ is
Solids, Total Suspended GN5384 .A13923-1 mg/l 0.0 0.0 ,0
,,,.0i__ _ 0-20t
Associated Samples:
Batch G1,15384: FA29149-1
f-) Outside of QC limits
Page I
®C➢ 23 of 23
® AGCLJT�ST,
FA29149 "......"'"

RECEIVED
N.C.Dept. of ENR
JAR, 2 4 2014
Winston-Salem
Regfionai0ffice
Geological Resources, Inc.
January 22, 2014
Ms. Jenifer Carter
Surface Water Protection Unit
Division of Water Quality
North Carolina Department of Environment and Natural Resources
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, North Carolina 27107
RE: Jacob's Creek Stone Co. Inc. — Davidson Mine
Discharge Monitoring Report — December 2013
Davidson County
Yadkin -Pee Dee River Basin
Certificate of Coverage No. NCG020206
Dear Ms. Carter:
On behalf of Jacob's Creek Stone Co. Inc., please find attached results of stormwater outfall sampling
that was conducted on December 10, 2013 for the Jacob's Creek Stone Co. Inc. facility in Denton,
Davidson County, North Carolina. Water samples were collected from the outfall of Pond #1 by Jacob's
Creek Stone Co. Inc. personnel on December 10, 2013 in accordance with the NORR dated January 28,
2013. Water samples were analyzed for pH, settleable solids, total suspended solids, turbidity, and fecal
coliform. Results indicate that concentrations of requested method constituents are below the permit
levels. Per your email correspondence dated March 15, 2013, only Pond #1 will continue to be monitored.
The Stormwater Discharge Outfall Monitoring Report is included in Appendix A, the Stormwater
Discharge Outfall Qualitative Monitoring Report is included in Appendix B, and a complete laboratory
analytical report is included as Appendix C.
The next sampling event is scheduled to be conducted between January and March 2014 during a
representative rainfall event. Please do not hesitate to contact me at [phone], if you have any
questions or continents.
Sincerely,
Rohit S�P:E.
Senior Engineer
cc: Jeff McKinney, Jacob's Creek Stone Co. Inc.
file
enclosures
2301 Crown Point Executive Drive Suite F Charlotte, NC 28227
Phone [phone] Fax: [phone]

APPENDICES

M»30aMI
STORE INNIATER DISCHARGE OUTFALL MONITORING REPORT

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPOW11'
Permit Number NCS NCG02020G
FACILITY NA 1E _Jacobs Creek Stone Co. Inc
PERSON COLLECTING SAMPLE(S) _Jeff McKinney
CERTIFIED LABORATORY(S) Accutest Laboratories Lab #_573
—Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTEODURING CALENDAR YEAR: 2013
(This monitoring report shall be received by the Division no later. timn 30 dnys from
the date the facility. receives the sninpi ug results from the )aiioratory.)
COUNTY Dpvidsou
PAONis; NO. '857-G202
SIGNATURI 'OTPERMFfTEC OR'DE;SIGNEE
REQUMEll'ON'.'PAGE: 2.
Uutiall ,
Na. z
Date
Sample
Collected
-50050
:ibtal
Tiow.(it app)
Total- -
Rainfall
Settleable'
Solids
Total
Sus endedr
Turbidity
phi
,
inches:: ��.:. "
.ni€/1
nj 1 ...
NTIJ
M
Pond #1
12110/13
,NIA:
.1
.<0.50
<25
3.4;
8.13
Li
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of now motor oil per month? _ yes no
(if yes, complete fart 13)
Part B: Vehicle Maintenance Activity Monitorin itci uircments
oiitfall ;
No.
Date
Sample:",
C oliccWd -
SOQSIF ;;.
Q055b
00530 . ' "
;0040U
'Total Flow : '
(if appficablc)r,
Cutai .-
Rauitall =' ..`.,
p &Crease ,,
(if ripply) Ir•
Nou polar
O&G/TP11
SGT
I`otal;
Suspended `-
:AEI
Nevi+ Motor
Oil Usage
?mo/dd/ �'
MG
inches
m'/i,;
,,
:: . ,
mYll,�
unit
allmo..
Form SW U-247, last revised.212120I2
Page i of 2.

STORM EVENT CHARACTERISTICS:
Dnte_t2/14213 K�, . wi:i
-Totn' venbPreci(iikntioni
EVent`Il:U, ik ton (lii)gvrs): .. (onlylf applicable -:see tleiintt) `
if.more [han.one storm event was,sam led
Date -
`total I:vent i?recipitafio�i5(i�ielics)
I.vent Dnrntion hours ;i J " ' ( } (Qtlly iF,OPPfCftl�IG �-SGG;j1GrlFlif:)
Mats Original and one copy to:
Division -of Water Quality.
•Atln: Central.Files
1617 Mail Service Center
Raleigh, Noilli Carolina 27699-1617
"I certify, Tinder penalty af.law,.(hat Ili is document acid all nttacliments were prepared under ifi direction or sispekAslon h accordance. with a.
system designed to assure that ilunlilted persniinel.piropet ly gaflier aid.evaluate`tlie anforinal�ou:submitfed Dnsed on,my 1nqiilry of the person
or pc� sang wlio, maiaage:the,systcm, or iliose persoa►s'directly respoiisi6le.for gailieran the Info matlon,,tlic lnf6imafioh sulairiHIM is, to: the
„knowledge and b;cllcf, iruc,;accurate, and cnmpletc Y am,aware:1liat.tt e�e,nre.sign . cant,pcnaltid f6r submittif gfolse informatl6n,
i cli dinj;itie ii' ibilitywof iiie§°nail linnrisoni ici�t_fnr lcnpwln ylnlatiuns.' 3
(Sigita 06ic -6f,F ee) (D"ate}
Form SWU-247, last revised 21212012
'Page 2 of 2

APPENDIX B
c'rnDA�Tul A'PCD Ylt Qi-rrADI-L' nrT�r'^AT 7 niTAT TTA"rrArU nRnT`7r-rnurX7n nTVnnn'r

1L/71I1VId IU:zI JdbtMIJIba JAUUtsb G� t'FlIL U,11tm
too
Stormmiater'Discbarge Outfall (SDO)
QuafiWtiive-MonitoringReport
Forguidmtce on fiillang out ibis form, please visit- :f c ;tar sta c slsulF omen ts.htnr#sro
permit NO.; �T CI�! !„_.! 1� l� ai• Ce�i��ca� v� Coverage No.: �11G�16 I �1 �/41 �I �l
facility Name:
County: O I oneNo.�,_i"•�' az
Datc Of InTime of inspectd / -Q
Total Event P ecipit4on (ittcbez):
Was this a Represcatative. Storm Eyc i V (Sec. information. below) 'III/Yes ❑ No
Pla"u check yourlpemdt lu verify if QgaMar&e Manitoring must be'performed during a re Jresmrarit�8
storm evelu (requirements MY).
A "Representative Stvrm I vet" is a suorrw event.that measures grsa'tzx than 0.1 iuches of rainfall and that
is preccdod by at least 72-}toots (3 days) b which to starmievent measuioil]g Zmater than 0.1 ind3rs b=
occuaed. A single storm event may oontain ER to 10 coiisecutive hours of no preci '6ow
By this signature, I omlify that this report is accurate anrt wipplete to the best of my knowledge:
1. OntM Description:
Uutfail No. _ Structure (pipe, ditch, etc
Receiving Stream:
DcscTibe,the industrial activities that occur within the oucfall dtainage area:
2. Color. Demibe the color of the dlschtat`ge
(light. medium, darn) as descriptors:
colors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct Odors that the discharge may hsave (i.e., s=Lls s=ngly of oil, weak
chlaa ine odor, etc.):... --
rage I of 2
5wi%7.44rl12fiEls

1'!:�/"lUI: s 1•L:44 . Jjt) z)1d1UV ia" Jiil�ur7 �rcccr� ;} ,'
4. C lKitY: Choose the number which best describes. theLLclarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 a 3 4 5
5. Floating Solids: Choose the Dutnbe; which best describes the arAount'of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
6. Suspended Solids: Choose the fibzl er whic$ best describes the amount of Suspended solids iEn
the stormwater'discliar e, where I is no soh anu 5 is exffeiiiely itiuddy: "'•«.x_`� j' =� 7?
7. Is there arty fown in the stormwat discharge? yes .
S. Is there an oil sheen in -the stormwater discharge? : `lies
ter..
9. Is there evidence of elrosion or deposition at the outfall? ' Yes
10. Other Obvious Indicatnr5 of Stormwater Fe'Rutaion: -
'Ai.
List and describe
Note: Low clarity. higb solids, and/or the presence of foam, oil sheen, or erosion/deposition maybe
indicative of polldtant exposure. 'These conditions war"raat 6u. 4er'i'nvesiigati6n.'
Page 2 of 2
SWU 242-112608

APPENDIX C

e-Hardcopy 2, 0
Automated Report
Technical:Report for qN
Jacob's Creek Stone Company
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Accutest Job Number: FA10729
Sampling Date: 12/10/13
Report to:
Jacob's Creek Stone Company
PO Box 608
Denton, NC 27239
[e-mail]; rshetty@geoI
ATTN: Jeff McKinney
Total number of pages in report: 12
.corn
Q A�fo,
I.a
Test results contained within this data package meet the requirements
Harry Behzadi, Ph.D.
Laboratory Director
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable.
Client Service contact: Muna Mohammed 407-425-6700
Certifications: FL (E83510), LA (03051). KS (E-10327), IA (366). IL (200063). NC (573), NJ (FL002), SC (96038001)
DoD ELAP (L-A-13 L2229), CA (04226CA), TX (T104704404), PA (68-03573), VA (460177).
AK, AR, CA, KY, MA, NV, OK, UT, WA
This report shall not be reproduced, except in its entirety, without the written approval of Accutest Laboratories.
Test results relate only to samples analyzed.
Southeast • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone] • http://,Aww.acculest.com
® 1 of 12
Accutest Laboratories is the sole authority for authorizing edits or modifications to this ®ACCLJTST.
document. Unauthorized modification of this report is strictly prohibited. Fatolza

Sections:
Table �of Contents
Section. l: Sample Summary ........................................................................... ........... 3
.... ..... ....
Sectifln 2 'Summary of Hits.................:.................................................................................. 4 �
Section 3: Sample Results........................................................................................................
3.1: FA10729-1: OUTFALL POND 1....................... ......................................... I................ 6
Section4: 117isc. Forms............................................................................................................ 7
4.1.: Chain of Custody
Section S: General Chemistry - QC Data Summaries........::................................................ 1.0
5.1: Method Blank and Spike Results Summary ....................................................I...........:. 11
5.2: Duplicate Results Summary ..................................................:....................................... 12
003 2of12
0.a00i..J-rES7-.
FAI0729

Accutest Laboratories
Sample Summary
Jacob's Creek Stone Company
Job No: FA10729
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Sample Collecfed::T'.'' Matrix Client
Number Date Time By Received Code Type Sample ID
FA07 129 1 12/10/13 11:00 JM 12/11/13 AQ Water ,OUTFALL PO ND 1 M1
�`F
Mn 3 of 12
®ACCL..tTEST.
FA10729 """""

Summary of Hits
Job Number: FA10729
Account: Jacob's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Collected: 12/10/13
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA10729-1 OUTFALL POND 1
Turbidity 3`4.";' 1.0 NTU EPA 180.1-,i
pH su SM 4500H BISW 9040C
(a) Field analysis required. Received out of hold time and analyzed by request.
M0 4of12
®accu-r�sT
FA10729

Section 3
Report of Analysis
®13 5 of 12
® A= LJ-FEBT
FAIC729

AccuEesi Laboratories -
RPnnrt of Annlvcic
Client Sample ID: OUTFALL POND I
Lab Sample ID: FA10729-1 Date Sampled: 12/10/13
Matrix: AQ - Water Date Received: 12/11/13
Percent Solids: n/a
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
General Chemistry
Analyte
Result RL
Units
DF
Analyzed
By
Method
Solids, Settleable
0 50 = ; 0.50
mlh
1
12/11/13 11:05
AC
sM19 2544E
Solids, Total Suspended
a ::
< 25 = 25
mg/1
1
12/12/13 12:50
KC
SN419 2540D
Turbidity
.3.4 `'' < ".: 1.0
NTU
1
12/I1/13 15:10
v-K
EPA 180.1
pH a
8 13
su
1
12/11/13 14:00
KC
SM 4500H B1SW 9040C
(a) Field analysis required. Received out of hold time and analyzed by request.
RL = Reporting Limit
an
® 6of12
®ACClJTEST.

Section 4
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
®p 7 of 12
FA10729

Accutest Laboratories Southeast
ChaintofL UStO4ly Acut a '. �.O'�' �+ 11
cPAGE---
44054+nslandRnatl;$U1I�C]5 Orkando`F)328I1 _ —
a TEI: 40"f-425-6700 t. F!.%i AOi-4ZS-070i CCIJtB$i CrB :>•• _ {
s x.., �Y �.� c�'t �i:35.'.C,e+tr� _,, -,. �:,.-,,;[�'i -`" [� J . .r r' _ Fww+v.accu[eslrOm � s . - � :.�. i' ,ri• ... i v it ! g,
I! a rttpr+rietgn P Gt inlomwtlm • - - Ane
ICe
In1G'ma![or�
Matra Coos
in Nam Aeo S., K . ad - ;. 'y.
vre.a wmsr Oi✓0- /.' '
(l.
iAj,
r
i'�k
v
bW. o e d a W>
Gw wet.
Sw s MW
Su d Say
LION LkpAd
BOL57-
,y "
P.rJ. •
�1Df/t
i• •
.Y --x " �["'_" Sake- .C:-' 723
Oq - Stw.
Phare
Fax/
s.r„w.n•I r+arn{n 0'w'+.e) K/+✓/►yE
Cbrt weuee oraa a
Reld ID l Point of Cellaction
'•�
o••,
6"iPLm
�°° r
K
i.
F ,c ' Rri✓d ;�
II'
A
�
URDUND TIME (Bu3im,a
Y'
- -
p 70 Days Suntlertl Aaprov a By:! Rusn Cod.
p 7Day {tL1SHCOMMERCIAL'B'tR�E,SVLT�+•{yp,{yW]
p 5 Day RUSH
p 3 Day EMERGENCY -
p 2Day EMERGENCY
© I Day EMERGENCY _
OTHER
Esrterpeney or Rush TM Data AwWabk VIA Emid or LablRk
COMMERCIAL •A' (RESULTS ONLY)
7 7/+f T t1D
El REDTS {F�S7E'C�T' c'QUEEN / yp t f r� Y V R
FULT1 (EPA LEVEL L' L T NC 282 V ,
EJ ED13'6 '
��-
-~s -
Rek e�e/y~�•
1 YL 11
Dale Tune:
Received
Relir(qulp7
Dale Tim_ e:
flats By'
ReG ulsh
5
a Time,
? G �=�
Recelved By:
6 SC
Relinqrtu ned by:
7 I. r (2
Date
Lab Use Only; custode Seal in Place: Y N Temp Blank Provided: Y N Preserved where ApphCable: Y N Tolal # of C.polers: Cooler Temperature {s) Celsius:
FA10729: Chain of Custody
Page l of 2
mm 8of12
®aI--I--
FAID729 `-�""• ",",""

ACCUTEST LABORATORIES SAMPLE RECEIPT CONFIRMATION
ACCUTESrS IOH l�JbIBEE:�► r Q I U 7 a c wn ��6s- (rrecC PROTECT: auQ �" 1
, DATFJI?tidH RE.CEfYED:. (z -� r-r 3 ' ;" ! c� 6 a � aa:o') . ' : rnsER OF lCOOLE is RF-cEnrFD
METHOD OF DELIVERY:,. UPS ACCVTEST COURIER GREYHOUND DELIVERY OTHER
ALEBII1,rI[J s R':C 7 .� �03
COOLER INFORMATION
CUSTODY SEAL. NOT PRESENT' OR NOT INTACT
CHAIN OF CUSTODY NOT BECMM (COC)
ANALYSIS REQUESTED IS UNK LEAK OR MISSING
SAMPLE DATES OR TIMES UNCLEAR OR MESSING
TENMELkTURE CAPFERLA NOT MET
Im PESSmv'T
TRIP BLANK IA1F'ORMATION. .
BLANK PROVIDED
TRIPM-eMNUTPROVIDEM?
BLANILTAT ONCOC
Tur ffi-emINTACT'
TBH HLANi NOT INTACT
IRECEIVED WATER TRIP BLANK
SOIL TRIP MANS
MISC.INRORMATION .
NWIDEROFENCORES7 =-mAM__ 5aF"
NUMBER OF 5035 FIELD STI'S 7 '
NU?,MM OF I.AB FMTE= METALS 7
TEMPERATURE DWORI4S&TION
THERM ID i CORE. FACTOR---Il�
esssvBD THt�sc 3.3.
CORRECTEAMa&
SAMPLE INFORMATION '
LABELS PXE9s TT ON ALL BOTTLES'
uRmcr. NubminE OF CONTAINERS USED
.,. SAl�I.Ii RECEIYEo DrSPROPF$LY PEESERVED
INMJM
CiEhTI' VOLUME FOR ANALYSIS
srMG�S ON COC Do NOT WATCH MKPLE LABHI
S ONCOC DO NOT MATCHLA$k'S
VLALs HAVE HSADSPACB,(MACRo BUBBLE*
MIM REcmvim BCTT ANALYSE NOT R8QUS5TED
BOTTIM RHCETVBD FOR ANALYSES REQUESTED'
UNCLEAKFMTERJNG OR COMPOWnNG DATRUCITONS
CONIAUaMS) RECE VMMLOS8N ,
SOLIDS IARNOT RECEIVED
5 FLU D =IT FROZEX WTTHIN db HOUR'S-
SOWAL CHLORINS PRESENT
{AMcA= TO s?A W0 6681£4 0K".M CAROLWAORGAM S)
SUI.OIARYOFCohf&uwS: cela tl R- 66-(G�$ coG•'1L1�(15_
01,12/
r =W-
TPCTINICIAN MONATUR.ErDATE RSVISWER SIGNATURFIMATE
NF 12J10 receipt conhTn;&on 1=910-As '
FAI0729: Chain of Custody
Page 2 of 2
all 9 of 12
®ACCUTEST.
FA10729 `"""""�""�"�

Sedtion 5-.A-
enera
'W', 1.4,41
J
QC `Mta "Summaries 4
IT
Includes the following where applicable:
- Method Blank and Blank Spike Summaries
- Duplicate Sfimmaries
- Matrix Spike Summaries
ffia 10 of 12
jffA,r-- (-- LJ-FE=- S-r.
FA107291.- 1.1- - I..

METHOD BLANK AND SPINE RESULTS SUNLMARY
GENEKr,L CHEMISTRY
Login Number: FMO1 29
Account: JCSCNCD - Jacob's Creek Stone Company
Project: Davidson O:%arry; 2081 Slate Mine Rd, Denton, NC
MB Spike BSP 135P QC
A.aIyte Batch ID RL Result Units Amou:t Result %Recov Limits
Solids, Settleable GN59260 0.50 0.0 _ ,' .' ml/1 Ln
Solids, Total Suspended GN59297 10 0.0 mg/1 .a
Turbidity GN59305 1.0 0 O,n NTU
?.ssociated Samples:
Batch GN592?0: FA10729-1
Batch GN 9297: FA10729-1
Batch GN593O5: FA10729-1
(1) Oa -side of 0C limi�5
Page 1
ED 11 of 12
® ACCU-rE-=S- -
FA10729

DUPLICATE RESULTS SUMMTRY
GENERAL CHEMISTRY
Login Number: F;_10729
Account: JCSCNCD - Jacob's Creek Stone Cemnany
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
QC Original DUP QC
Anelyte Batch 1D Sample Units Result Result RPD Limits
Solids, Settleable
GN59280
FA10729-1
Tr1/1
Solids, Total Suspended
GN59297
FA10740-3
me/l
Turbidity
GN59305
F410729-1
NTU
PH
GN59275
F-_20729-1
su
Associatea Samp_es:
Batch GN59275: PA10729-1
Batch GNS9280: FA10729-1
Batch GN59297: FA10729-1
Batch GN59305: FA10729-1
(•) Outside o: QC limits
Page 1
0.0 0.0 0.00-20€
31.0 31.D 0.0 D-5%
3.9 3.5 1 0 0-8�
1312 12 of 12
FA10729

Geological Resources, Inc.
November 12, 2013
Ms. Jenifer Carter
Surface Water Protection Unit
Division of Water Quality
North Carolina Department of Environment and Natural Resources
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, North Carolina 27107
RE: Jacob's Creek Stone Co. Inc. — Davidson Mine
Discharge Monitoring Report — September 2013
Davidson County
Yadkin -Pee Dee River Basin
Certificate of Coverage No. NCG020206
Dear Ms. Carter:
On behalf of Jacob's Creek Stone Co. Inc., please find attached results of storrnwater outfall sampling
that was conducted on September 26, 2013 for the Jacob's Creek Stone Co- Inc. facility in Denton,
Davidson County, North Carolina. Water samples were collected from the outi'all of Pond 91 by Jacob's
Creek Stone Co. Inc. personnel on September 26, 2013 in accordance to the NORR dated January 28,
2013. Water samples were analyzed for pI-i, settleable solids, total suspended solids, turbidity, and fecal
coliform. Results indicate that concentrations of requested method constituents are below the permit
levels. Per your email correspondence dated March 15, 2013, only Pond #1 will be monitored going
forward. The Stormwater Discharge Outfall Monitoring Report is included in Appendix A, the
Stormwater Discharge Outfall Qualitative Monitoring Report is included in Appendix B, and a complete
laboratory analytical report is included as Appendix C.
The next sampling event is scheduled to be conducted between October and December 2013 during a
representative rainfall event. Please do not hesitate to contact me at [phone], if you have any
questions or comments.
Sincerely,
241J—Ajt�,
Rohit Shetty, P.E.
Senior Engiueer
cc: Jeff McKinncy, Jacob's Creek Stone Co. Inc.
file
enclosures
2301 Crown Point Executive Drive Suite F Charlotte, NC 28227
Prone [phone] / [phone] Fax: [phone]

APPENDIX A
STORMWATLR DISCHARGE OUTFALL MONUORING REPORT

STORMWATER DISCHARGE OU'1TFALL (SDO)
MONITORING REPORT
Permit Number NCS NCGO20206
FACILITY NAtti1C_Jncobs Crccic Stoac Co. Inc
PERSON COLLE(f ING SAM PLE(S) Jeff McKinney
CEIIXIIPIED LABORATORY(S) Accutest Laborajories Lab # 573�
Lab #
Part A: Sliecific Monitoring; Regnircments
SAMPLES COLLLCI`ED DURING CALENDAR YEAR: 2013
(This monitoring report shall he received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY Davidson
PHONIC. NO. 336 857-6202
SIGNA'I'ORE OF PERMI'I'TEE OR DESIGN15
REQUIRED ON PAGE 2.
Outfall
No.
Date
Sample
Collected
50050
Total
Flow (if.npp.)
Total
Rainfall
Settleable
Solids
Total
Stspended
Solids
Turbidity
pH
_
mo/ddl r
MG
inches
mill
rii
N'rU
su
1'nud.#1
9/26/13
NIA
0.50
<0,50
45
12.1
6.44
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per munth? _ yes '_no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Rc(tuirements
Outhill
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if rtppl.)
Non -polar
O&GfI'PH
(Method 1664.
SGIAJEM), if
a yl, .. .
Total
Suspended
Solids
pill
New Motor
Oil Usage
molddl r
MG
inches
m g
m /I
unit
al/rno
ro.rm SWU-247, lull reviser121212012
rage: I oft

STORM EVENT CHARACTERISTICS:
Date 09/26/13
"Dotal Event f recipitation (inches): _0.56
Event Dnratiotr (hours): _ _(only ifapplicable — sec permit.)
(ifmiure titan one storm event was sampled)
Date
`total Event Precipitation (inches)-
[Event Duration (hours): (only if applicable-- see peanut.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central tiles
1617 Mail Service Center
Raleigh, North Carolina 2709-1617
"I certify, under penalty of law, flint this document and all at0chments were prepared under my direction or supervision in aceordance 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'lhe system, or those persons directly responsible for gathering the information, the Information submitted Is, to the
bast of my knowledte and lielief, true, accurate, and complete. I ntn aware that there are significant penalties for submitting false information,
including (lie possibility of fines and Imprisonment for knowing violations."
c 1D 30 o
(Signatur tf permittee) (DAtC)
Fomi S WIJ-247, last revised 2/2/2012
Page 2 of 2

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forgufdance an filling out thisform, please visit: httv:1lh2o.enr.state.nc.rrslsu/Forms Documents_htrn niscforms
Permit No.: NI/C/
Facility Name:
County:
Inspector:
Date of In or
Time of In oectio,
Total Event Precipitation (inches):
r
No-: N/C1Gl ZI O1 d I {I
Was this a Representative Storm Event? (See information below) ❑ Yes X No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Sib ature of PenZttee or
L Outfall D scription:
Outfall No_ Structure (pipe, ditch etc.)
Receiving Stream:
Describe the industrial activities that occur within the outzall drainage area-
2_ Color: Describe the color of the discharge
(light, medium, dark) as descriptors:
colors (red, brown, blue, etc.) and tint
3. Odor: Describeany distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.). ^&Z&L4=1
Pagc 1 of 2
SWU-242-1126U3

4. Clarity: Choose the number which best describes the clarity of the discharge, where l is clear
and 5 is very cloudy:
1 0 3 4 5
5. bloating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is nosolidsand 5 is the surface covered with floating solids:
/1J 2_ 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
6) 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes ea)
S. Is there an oil sheen in the stormwater discharge? Yes 100
9. Is there evidence, of erosion or deposition at the outfall? Yes tiro
14. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/depositionplay be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
S WIJ-242-I 3 2608

e4lardeopy 2. D
Autorstated Report
T �. .
10/03/13
Technical Report for
Jacob's Creek Stone Company
Davidson Quarry; 2081 Slate Kline Rd, Denton, NC
Accutest Job Number: FAS576
Sampling Date: 09/26/13
Report to:
Jacob's Creek Stone Company
PO Sox 608
Denton, NC 27239
jacobscreel c.net; rshetty@geol
ATTN: Jeff McKinney
Total number of pages in report: 12
com
e°its A C04
R
�
4rvo� �fi
a s
Test results contained within this data package meet the requirements
Harry Bebzadi, Pb-D.
of the National Enviranmcnml laboratory Accreditation Conference
Laboratory Director
arkdior state specific certification programs as aptlicarbie.
Client Service contact: Muna Mohammed 407-425-6700
Certifications: M (E83510), LA (03051), KS (F 10327), IA (366), IL (200063). NC (573), NJ (FLO02), SC (96038001)
poi] ELAP (LA-B L2229), CA (04226CA), TX (TW4704404), PA (68-03573), VA (46o177),
AK, AR, CA, KY, ALA, NV, QK, UT, WA
liars report shall not be reproduced, except in its entirety, without the written approval of Accutesi Laboratories.
Test results relate only to samples 2na4wd-
Southeast- 4405 Vineland Road • Suite C-15 - Orlando, FL 32811 - tel: 407-t25-6700 • lax: 407-425-0707 - hnqE/Iwww.nccutestcam
00 1 of 1 �
Accwest Laboratories is the sole aa:thOrity for authori2ing edits or modifications to this ® ACCU-FF_ST
document, Unauthorized modification at this report is strictly prohibited- FA8576 I ..... >e,,,,,

Sections:
Table of Contents
Section1: Sample Summary.................................................................................................. 3
Section2: Summary of Hits.................................................................................................... 4
Section 3: Sample Results
3.1: FA8576-1: OUTFALL POND 1.................... ............. .... .............. ............. ............... I .... 6
Section4: Misc. Forms............................................................................................................ 7
4.1: Chain. of Custody........................................................................................................... 8
Section 5: General Chemistry - QC Data Summaries ..............................0
5.1: Method Blank and Spike Results Summary ............................................................ 1
5.2: Duplicate Results Summary ............................................. ............. 12
ffla . 2 of I2
El AM(FJTE=-S"'r
FA8576

Accutest laboratories
Sample Summary
Jacob's Creek Stone Company
Job No: FA8576
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
FAS576-1 09/26/13 09:30 JVC 09/27/13 AQ Water OUTFALL YO\'D 1
I
Igo 3 of 1
® ACC�JT�^oT.

Summary of Hits
Job Number:
FA8576
Account:
,lacob's Creel: Stone Company
Project:
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Collected:
09/26/13
.ab Sample ID Client Sample ID RemAtl
malyte Qual RL MDL units Method
Page 1 of 1
FA8576-1 OUTFALL PONI) 1
Turbidity 12.1 1.0 NTU EPA 180.1
PH u 6.44 su SM 450011 B/SW 9040C
(a) Field analysis required. Received out of hold time and anal)7.ed by request
■D 4of1
E .a,0(--U`rEa7..
FA8576 •••a"e......

Ma
S
LABQ'I
Sample Results
Report of Analysis
Section 3
III
®EM 5 of 9 �
® ACCu-rEE3T.
FASS75 `..... - .1

Accutest Laboratories
Report of Analysis Page t of 1 P
,Rent Sample ID: OUTFA-LI., 1'OL" 1
,ab Sample ID: 1, A8576-1 Date Sampled: 09/26/13
datrix: AQ - Water Date Received: 09/27/13
Percent Solids: n/a
Project: Davidson Quarry; 2081 Slate Mine Rd, Deutou, NC
General Chemistry
Analyte
Result
RL
Units
DF
Analyzed
By
Method
Solids, Settleable
< 0.50
0.50
Jul/1
1
09/27/13 11.40
AA
Srti119 2540P
Solids, Total Suspended
< 25
25
rng/l
1
10/01/13 11:15
KC
SM)92540D
Turbidity
12.1
1.0
NTU
1
09/27/13 18:33
rN
EPA 180.1
pH a
6.44
so
1
09/27/ 13 11:52
irtG
SM 450011 BISW 9040C
(a) Field analysis required Received out of hold time and analyzed by request
RL = Reporting Limit
IN
®0 6 of 1;
®ACCU-rEE37,
FA8576 ...... . —

Misc. Forms
Custody Documents and Other Forms
Includes the following when. applicable:
Chain of Custody
Section 4
®IR 7of12
®aC--U-rE=-E3T
FAU576-

Accutest Laboratories Southeast No
Chain Of Custody n �QB (,q 9 576.ACUQF
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Page 1 of 2
®m 8 of 12
p .a.ccu-rEST
FAS576 ""'""

ACCUTEST LABORATOItiiIS SAMPLE RECEIPT COI*IRMATION
ACCVIESrs IOB N[A4>BF,R: - t35 6 CLipxl r�6f l Rdfd
DATFJnNS RE=IEo-DEWD
DAY :00}• ?MOM£ROFCOOLER5RECZVEp;
IriEIHOD OF D$I IVEfty;
UPS ACCltlftQl'rnr.orvo G8 XlluOND
CQQLERXgQEM&noW
L,O,:pRvpmSElNT
SP-AL NOT PRESENT' ORNOT INfACP
CQSTODY NQT REC&IVED (CoC)
REQU$STIa�1$ UNCLEAR OR ?+DSSLY6
ATES OR MI ES UNCLEAR OR
T(AtL CRTIBRL, NOT MET
TX.lP� TATPO
IiL&-NK P$OVDMD
TRIP ELANX NOTPRQVIDT n
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CORRECT NMMliM OF C011TATNFkS UKm
caum.r RECEIVWIMpV.orML,yFRHSmvw
CIEML VQLUM FOR ANALYSIS
Sh�S ON COC DO NOT MATCH SAT�LB LABIO,
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VIALSEIAYEEMADSPAC$_OL4CRO.U=.,S� .
TILES RBCEiY);p $UT ANALYSIS NQT RZQI7EST m
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receipt confirr lem i229l oA.
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FA8575: Chain of Custody
Page 2 of 2
®� 9of12
®acc�-r�s-r
FAME """>""••

Sc
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LAHOFi
General Chemistry
QC Data Summaries
Includes the following where applicable:
• Method Blank and Blank: Spike Summaries
• Dijplieade Summaries
• Matrix Spike Summaries
Section 5
la 10of1i
N ACCUTEST.
FA8576 .........

METRO❑ BLANK AND SPIKE RESULTS SU101ARY
GENERJkL CHEMISTRY
Login Number: FA8576
Account: JCSCNCO - Jacob's Creek stone Company
Project: Davidson Quarry; 2061 Slate Mine Rd, Danton, NC
M8 Spike BSP BSP QC
Analyte Batch ID RL Result Units Amount Result *Recov Limits
Solids, Settleable GN57955
C.50 0.0 ml/1 try
Solids, Total Suspenaed GN58009
10 0.0 mg/l
Turbidity GN57957
1.0 0.0 NTU
Associated Samples:
Batch GN57955: FAS576-1
Batch G457957: FA5576-1
Batch G1758009;-A9576-1
(`) Outside of QC iiml"
Page 1
®M 11 of 12
® A=—U-raST.
FA8576 "'""'""•••

DUPLIMTE RESULTS SDIIMFiR'_'
GENERAL CHEMISTRY
Login Number: FAe576
Account: JCSCNCD - Jacob's Creek Stone Company
Project: Davidson Quarry; 2061 Slate Mine Rd, Denton, NC
QC Original DUF QC
LInalyto Batch ID Semple Units Result Result RPD Limits
Solids, Total Suspended GN58009 FA9576-1 mg/i 10.0 10-0 0.0 0--5% (A
Tuzbidity CN57967 FA9576-1 NTU 12.1 12.6 9.0 0-88
PH GN57950 FAB562-1 su 2.50 2.51 0.4 0-10%
Associated Samples:
Batch GI457950: FA9576-1
Batch GN57967; FA8576-1
Batch GNS0005: FAB576-i
(*) Outside of QC limits
Page 1
■M 12 of 12
. ACCUTES-C:
FA9576

A FJ
GRA.
MCDE �p ��
North Carolina Department of Environment and Natural, Resources
Division of Water Quality
Pat McCrory Charles Wakild, P.E.
Governor Director
January-28, 2013 .
CERTIFIED MAIL #7010-2780-0001-4236-3857
RETURN RECEIPT REQUESTED
Jacob's Creek Stone Co., Inc.
Attn: Mr. Jeff McKinney
P.O. Box 608
Denton, NC 27239
Subject: NOTICE OF VIOLATION and
Certificate of Coverage #NCG020206
Jacob's Creek Stone Co., Inc.
Davidson County
Dear Mr. McKinney:
John E. Skvada, III
Secretary
On January 15, 2013, Jenifer Carter, from the Winston-Salem Regional Office of the Division of Water Quality,
performed a stormwater 'inspection at .Jacob's Creck . Stone. Company located on Slate Mine Road in Denton, North
Carolina. You were present during the inspection.
The following observations and/or permit conditions, violations were noted during the Division of Water Quality
inspection:
➢ A Stormwater Pollution Prevention Plan (SPPP) has been developed, but not properly implemented. It has not been
updated annually (including changes in the permit when it was renewed in 2010), and employee training has not been
documented.
➢ Analytical monitoring of pit #1 has not been monitored as required by the permit. This pit captures stormwater from
the majority of the land disturbing areas, as well mine dewatering wastewater. Since comingling of stormwater of
stormwater and wastewater is considered to be a wastewater for. analytical monitoring purposes, quarterly monitoring
requirements for wastewater (mine-dewatering) should be followed.
➢ Qualitative monitoring has not been conducted and recorded as required by the permit.
➢ Best Management Practices (BMPs) have not been inspected every 7 calendar days & within 24-hours of storm
events, as required by the Division of Land Resources. This requirement can be reduced to a monthly requirement
only if the mine possesses an `Inactive Renewal' from DLR. The site is stabilized due to inactivity since the last
inspection.
Corrective Actions Required:
Failure to monitor as required normally results in automatically increasing the required monitoring frequency to
monthly. Due to the fact that the mine has not been active since the last inspection, that there are no immediate
plans to activate the mine, and that the mine is currently stabilized, this increase in frequency has been waived.
To avoid monthly monitoring and/or further enforcement action, the following must be done:
continued on reverse...
North Carolina Division of Water Quality, Winston-Salem Regional Officene
CarOlina
Location: 585 Waughtown Street, Winston-Salem, NC 27107
Phone: (336) 771,50001 Fax: [phone] Customer Service: 1-877.623-6748 Qhlally
Internet: http:Ypertal.nodenr.orghvebfwq
An Equal Opportunity 1 Af imnative Action Employer 0 /31l

• Doc e t the annual review of the SPPP, noting any changes, such as those required in the most recently renewed
permi ' u d in 2010. Annual updates should also include any changes to the site plan, significant spills, etc.
• Document nnual employee training in the SPPP.
• Perforf alytical monitoring of the discharge from pit #1 quarterly, as required for mine-dewatering (Part III E
Tables 7-9} Submit Results on a Discharge Monitoring Report (DMR) form (see Part IV E-1)..Copies of the results
from t e f st two monitoring events of 2013 should also be submitted to me at the letterhead address no later'
than An s 21 2013. As a wastewater discharge, this monitoring does NOT have to be performed during a rain
event (note.; this is a correction to what you were told during the inspection and in subsequent emails)
• Perform Q alitative (visual) monitoring of the discharge from pit #1 semi-annually (Part Ill Section D). This IS
requiz`e�to e performed during a rain event. Copies of the monitoring forms normally do not need to be submitted,
and should e kept with the SPPP. However, in response to this NOV, please submit a copy of the next report to me,
along with e above lab results.
Thank you for your attention to this matter. These violations and any future violations are subject to a civil penalty
assessment of up to $25,000.00 per day for each violation. Should you have any questions regarding these matters,
please contact Jenifer Carter at [phone].
Sincerely,
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
attachment'
cc:, r—WSRQFiles]
NPS-ACO Unit
SWP — Central Files
■ Complete i#ems 1, 2, and 3. Also complete
A. Signature ❑ Agent
item 4 if Restricted Delivery Is desired.
X ❑ Addressee
■ print your name and address on the reverse
so that we can return the card to you.
ry y ( Print Name) C. of Delivery
■ Attach this card to the back of the mailplece,
�c e
or on the front if space permits.
D. Is delivery address different m item 17 ❑ Yes
1. Article Addressed to:
r de ivery address below: ❑ No
Mr. Jeff McKinney
0d 2913 k
Z
Jacob's Creek Stone Co., Inc.
iB
P.O. Box 608
3. �S�f�+ice Type Js
td`Certified Mall ❑Express Mail...=--
Denton, NC 27239
Registered 60 Ft'etum ReceiptfOr Merchandise
— 1,l' ❑ C.O.D.
❑ Insured Mail
-•— o Delivery) (Extra Fee) ❑ Yes
2. i 2?80 0001� ►1331�
38S?
aS tir1� 0\/ t 1g
?01t1 .
{ 102595-02-M-1540
PS Form 3811, February 2004 Domestic Return Receipt

Carter, Jenifer
From: Carter, Jenifer
Sent: Friday, March 15, 2013 11:27 AM
To: 'Rohit Shetty'
Subject: RE: Jacob's Creek Stone Stormwater Inspection
Rohit,
• Pond #3 does not need to be monitored. During the inspection, the outfall from pond 41 was determined to be the
only true outfall on the site.
• When you receive the results from the lab, fill out the Discharge Monitoring Form and send a copy to the address on
the form. In addition, just this one time, send a copy to me at my address below.
• Send me a copy of the of the last Qualitative Monitoring form. In the future, just keep it with the stormwater
records. Make sure this monitoring is done during a rain event. The quarterly lab samples do not have to be done
during a rain event. If the mine becomes active, it is preferred that lab samples be pulled during mine-dewatering
activities.
• Do not forget about the weekly inspection of BMPS, as per the Division of Land Resources mining permit.
Once I receive a copy of the lab results, and a copy of the qualitative monitoring form, I will consider the Corrective
Actions required in the NOV to have been completed.
Thank you for responding in a timely manner.
Jenifer Carter
Before printing -this email, please consider your budget and the environment.
If you must print, please print only what you need and save ink with the free Eco-Font.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Rohit Shetty [mailto:[e-mail]]
Sent: Tuesday, March 12, 2013 2:37 PM
To: Carter, Jenifer; [e-mail]
Cc: [e-mail]; Joanna Alley
Subject: RE: Jacob's Creek Stone Stormwater Inspection
Good Afternoon Jenifer,

I hope you are doing well. I just wanted to update you on the Davidson Mine site. In accordance with the permit, the
ponds (#1 and #3) outfalls were sampled today to satisfy the first quarterly sampling requirements of the NOV letter. As
soon as the lab results are received, I will submit a completed DMR form with the lab report. Qualitative Monitoring was
also conducted during the sampling event and will be maintained with the SWPPP.
As we had discussed previously, Pond #3 does not have a known outfall. A sample was collected from the downstream
end of the pond this time. Could you let me know if future sampling for Pond #3 could be waived.
GRI is assisting Jacob's Creek Stone to satisfy all the requirements of the NOV letter dated January 28, 2013. As
developed in the SWPPP on file, employee training was also recently completed and a record will be maintained on -site
with the SWPPP.
All BMPs (ponds, diversion ditches, etc.) with also be inspected as required and inspection records will be maintained
on -site.
Please let me know if this email will suffice as a response to the NOV or you would like me to send this on a cover letter.
We sincerely appreciate your help on this project.
Sincerely,
Rohit Shetty, P.E.
Vice -President
Geological Resources Inc.
2301-F Crown Point Executive Drive
Charlotte, NC 28227
Direct: [phone]
Main: [phone]
FAX: [phone]
Mail to: [e-mail]
Web: www.geologicalresourcesinc.com
From: Carter, Jenifer[mailto:[e-mail]]
Sent: Monday, January 28, 2013 2:26 PM
To: Rohit Shetty; [e-mail]
Subject: Jacob's Creek Stone Stormwater Inspection
Jeff & Rohit,
i have finally talked to my supervisor about monthly sampling (visual and analytical) due to missed sampling during the
last five years. Fortunately, he has agreed that monthly sampling be waived as long as there is no mine dewatering
taking place. Now that I know this, I can write the inspection report today, which will be in the form of a Notice of
Violation (NOV) for failure to monitor as per the stormwater permit. I will cc you, Rohit, on the report.
The NOV will demand that:
• The SPPP be updated annually (with the need or lack of the need being documented). This should cover any
changes to the site plan, significant spills, etc.
• Documentation of annual employee training be documented and kept with the SPPP.
• Analytical (laboratory) monitoring be done quarterly during a rain event from pit #1, as required by the permit.
Results are required to be submitted on a Discharge Monitoring Report (DMR) form, and submitted as per the
permit (Part IV E-1). In addition, copies of the results for the next two (2) monitoring events should be submitted to
me at the address below.

Qualitative (visual) monitoring be done semi-annually, during analytical monitoring events (above), as required by
the permit. Copies of the monitoring forms do not need to be submitted to the central office, and should be kept
with the SPPP. However, in as a response to the NOV, please submit a copy of the next report to me, along with the
lab results.
Failure to comply with the permit from this point forward will result in a monthly monitoring requirement, as well as
other possible enforcement actions that may include penalties.
Let me know if either of you have any questions after you have received the inspection report.
Jenifer Carter
Before printing this email, please consider your budget and the environment.
If you must print, please print only what you need and save ink with the free Eco-Font.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Carter, Jenifer
Sent: Tuesday, January 15, 2013 4:46 PM
To: 'Rohit Shetty'
Subject: RE: Davidson Mine - My Contact Information
Hi Rohit,
You can find a copy of the current permit using the following link:
http://Portal.ncdenr.org/web/wq/ws/­­su/npdessw
Click the blue 'General Permits' tab and scroll down to the NCG020000 section, where you will find a copy of the permit
and other related useful forms.
If you go back to the top and click on the blue 'Monitoring Forms' tab, you will find the forms for reporting Analytical
Monitoring results.
1.) When I talked to you and Jeff, I was saying that the discharge outfall at pit #1 fell under the stormwater
analytical and wastewater analytical monitoring requirements. PLEASE MAKE NOTE that I have decided, in order
to make things easier to follow and understand, that only the requirements for the quarterly analytical
wastewater (mine-dewatering) monitoring need to be followed. This means that the exceedences of the permit
limits will NOT initiate the permit's Tiered Response (that's for stormwater analytical monitoring only), though
exceedences will still need to be reported to my office within 30 days of receiving results from the lab, and will
be subject to normal enforcement protocol by DWQ
2.) The visual Qualitative monitoring will need to be semi-annually, at the same time samples are pulled for the lab.

3.) Qualitative and Analytical monitoring has to be done during a storm event, as defined in the permit.
4.) The Division of Land Resources (DLR) Mining Permit requires that the mine's Best Management Practices (BMPs)
with land disturbing activities, as approved by DLR, be inspected weekly AND. within 24 hours of a storm event.
Technically, since the monitoring as noted above has not been done as required, DWQ is supposed to require monthly
monitoring (Qualitative and Analytical) for the remainder of the permit. I will see if I can convince my supervisor that
this is pointless since there is no mine-dewatering taking place right now. However, the mine does not possess an
`inactive permit renewal' from DLR, so he may not be able to call the mine 'inactive' without DLR's approval.
I hope this helps to get you started anyway. I should get a inspection report out in the mail by the end of the week.
Let me know if you have any questions.
Jenifer Carter
P.S. Would you please provide Jeff McKinney's email address to me? I just realized it is not on his business card.
Before printing this email, please consider your budget and the environment.
If you must print, please print only what you need and save ink with the free Eco-Font.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Rohit Shetty[mailto:rsheM(y)geologicalresourcesinc.com]
Sent: Tuesday, January 15, 2013 12:01 PM
To: Carter, Jenifer
Subject: Davidson Mine - My Contact Information
Good Morning Jenifer,
Thank you for talking to me this morning. As we discussed, please email me a copy of the 2010 permit for the Davidson
Mine. Jeff McKinney and I will review the new permit together and get back in touch with you to make sure that we
satisfy the requirements. My contact information is below.
Also, as I was mentioning to Jeff, please copy me on any future correspondence on this site.
Sincerely,
Rohit Shetty, P.E.
Vice -President
Geological Resources Inc.
2301-F Crown Point Executive Drive

Charlotte, NC 28227
Direct: [phone]
Main: [phone]
FAX: [phone]
Mail to: rshett &,.eolo�icalresources nnc.com
Web: www. eolo icalresourcesinc.com
C` s. Only; . . , ,
Ln
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$zr
Certified Fee o[ S /
p(Endorsement Req ired) P H mark N Q y
C3 .r Restrleted Delivery Fee
0 (Endorsement Required) q 1
10
i Iti Tote! P.,e.e,.e - - - I
Sertf To
C3 Mr. Jeff McKinney
�
rq Jacob's Creek Stone Co., Inc. ......
--
I3 O.Poa P.O. Box 608
r` ........Gry s� Denton, NC 27239
an am

F Cc'�ii=D
MAY 16 2013
Winston-Salem
Regional Office
May 9,2013 Geo6ogOQal Resources, Unc.
Ms. Jenifer Carter
Surface Water Protection Unit
Division of Water Quality
North Carolina Department of Environment and Natural Resources
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, North Carolina 27107
RE: Jacob's Creek Stone Co. Inc. — Davidson Mine
Discharge Monitoring Report — March 2013
Davidson County
Yadkin -Pee Dee River Basin
Certificate of Coverage No. NCG020206
Dear Ms. Carter:
On behalf of Jacob's Creek Stone Co. Inc., please find attached results of stormwater outfall sampling
that was conducted on March 12, 2013 for the Jacob's Creek Stone Co. Inc. facility in Denton, Davidson
County, North Carolina. Water samples were collected from the outfall of Pond #1 and the downstream
end of Pond #3 by Jacob's Creek Stone Co. Inc. personnel on March 12, 2013 in accordance to the NORR
dated January 28, 2013. Water samples were analyzed for pH, settleable solids, total suspended solids,
turbidity, and fecal colifonn. Results indicate that concentrations of requested method constituents are
below the pen -nit levels. Per your email correspondence dated March 15, 2013, only Pond #1 will be
monitored going forward. The Stormwater Discharge Outfall Monitoring Report is included in Appendix
A, the Stormwater Discharge Outfall Qualitative Monitoring Report is included in Appendix B, and a
complete laboratory analytical report is included as Appendix C.
The next sampling event is scheduled to be conducted between April and June 2013 during a
representative rainfall event. Please do not hesitate to contact me at [phone], if you have any
questions or comments.
Sincerely,
Rohit Shetty,
Senior Engineer
cc: Jeff McKinney, Jacob's Creek Stone Co. Inc.
file
enclosures
2301 Crown Point Executive Drive Suite F Charlotte, NC 28227
Phone: [phone] Fax. [phone]

STORMWATER DISCIIARGE OUTFALL (SDO) RECEIVE® MAY' 0 8- 70?3
MONITORING REPORT
Permit Number NCS NCG020206
FACILITY NAME _Jacobs Creek Stone Co. Inc
PERSON COLLECTING SAMPLE(S) _Jeff McKinney
CERTIFIED LABORATORY(S) Accutest Laboratories Lab #_573_
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2013
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY Davidson
PHONE NO. ( 336 )857-6202
F
NATURE OF PERMITTEE OR DESIGNEE
QUIRED ON PAGE 2,
Outfall
No.
Date
Sample
Collected
50050
Total
Flow (if app.)
Total
Rainfall
Settleable
Solids:'
Total
Suspended
Solids
Turbidity
_
pH_
mo/ddl r
MG
inches
m1I1
iu ll
NTU
su
Pond #1
3/12/13
NIA
0.54
<0.50
<25
20.5
6.17
Pond #3
3/1.2/13
NIA
0.54
<0.50
<25
6.8
6.49
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
'Total Flow .'
(if applicable)
Total "
Rainfall .
Oil'&'Grease
(if appl.)
Non -polar
O&GITPH `
(Method 1664
SGT-HEM), if
appl.
Total
Suspended ,
Solids
pH "
New Motor;
Oil Usage i
molddl r
MG
inches
m Il
m 11, .
unit
gallmo
Form SWU-247, last revised 21212012
Page I of 2

STORM EVENT CHARACTERISTICS:
Date _03/12/13_
Total Event Precipitation (inches): 0.54
Event Duration (hours): (only if applicable— see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
(Signature f Permittee (Date)
Form SVl'U-247, last revised 21212012
Page 2 of 2

.p�OF wAr�Ap�
S
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/C/ L 1 1 I_ 1_1 1 or Certificate of Coverage No.: N1CIGIQIZ1011/016
Facility Name: j'TaAGa. ;2&_
County: Yltlla�✓- Phone No.1 / ,3 Zd01
inspector: gro f a
Date of Inspection:
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
1. Outfall Descriptio
Outfall No. MA (pipe, ditch, etc.)
Receiving Stream: / An*'e am C&JA
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge ussirng�b1asic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:, G�o�„ ,Gc�iGl _ _-
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.):
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 6) 3 4 5 6 7 8 9 10
Page 1
SW U-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
is no solids and 10 is the surface covered with floating solids:
3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
1�here is no solids and 10 is extremely muddy:
( 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
B. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Ye Na
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes 6No
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
SWU-242-020705
1
Page 2

o -C
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N1C1_1_I 1 1 1 1_! or Certificate of Coverage No.: NIC1G101Z101Z10141
Facility Name: ��'f C&Fent fgi' ce..C+'c.
County: Q/`il j�So n/ - .__ Phone No. - f-5-7- ZZ4 Z
Inspector: F
Date of Inspection: 3 11 -/
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
4
(Signature of Yerrrfittee or
1. Outfall Descriptio Outfall No i✓D J
Structure (pipe, ditch, etc.) A,6 /S 0e4rtdL4
Receiving Stream: 10464 ,0 4M e4 �
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: _ Ailk/
3. Odor
Describe any
etc.): -I
4. Clarity
nct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
Choose the number which best describes the clarity of the discharge where 1 is dear and 10 is very
cloudy:
1 b 3 4 5 6 7 8 9 10
Page 1
SW U-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
is no olids and 10 is the surface covered with floating solids:
3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
45here 61s ' no solids and 10 is extremely muddy:
3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes
B. Oil Sheen
Is there an oii sheen in the stormwater discharge? Yes 00
9. Deposition at Outfal[
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Ye?o
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes 00
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705
i

APPENDIX C
LABORATORY ANALYTICAL REPORT —March 12, 2013

e-Hardcopy 2.0
Arrto►nated Report
® Southeast
® ACC;UTF=E3T
x
L A[ 3 O_ R A T on I E_ .S _-
Technical Report for
Jacob's Creek Stone Company
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Accutest Job Number: FA2607
Sampling Date: 03/12/13
Report to:
Jacob's Creek Stone Company
PO Box 608
Denton, NC 27239
[e-mail]; rshetty@geologicalres
ATTN: Jeff McKinney
Total number of pages in report: 13
,N AC C 000
o �
. com
Test results contained within this data package meet the requirements �' 'J "ti"""`•+ ` •` ''
of the National Environmental Laboratory Accreditation Conference Laboratory Director
and/or state specific certification programs as applicable.
Client Service contact: Muna Mohammed 407-425-6700
Certifications: FL (E83510), LA (03051), KS (E-10327), IA (366), IL (200063), NC (573), N1 (FL002), SC (96038001)
Dad ELAP (L-A-B L2229), CA (04226CA), TX (T]04704404), AK, AR, GA, KY, MA. NV, OK, UT, VA, WA, WI
This report shall not be reproduced, except in its entirety, without the written approval of Accutest Laboratories.
Test results relate only to samples analyzed.
Southeast • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • let: 407-425-6700 • fax: [phone] • hup://www.accutesl.cont
: p 1 of 13
Accutest Laboratories is the sole authority for authorizing edits or modifications to this ACCIJi EST.
document. Unauthari2ed mortification of this report is strictly prohibitett. FA2607

Sections.
Table of Contents
-I-
Section1: Sample Summary................................................................................................... 3
Section2: Summary of Hits.................................................................................................... 4
Section3: Sample Results........................................................................................................ 5
3.1: FA2607-1: OUTFALL POND #1................................................................................. 6
3.2: FA2607-2: OUTFALL POND #3................................................................................. 7
Section4: Misc. Forms............................................................................................................ 8
4.1: Chain of Custody.............................................................................. ..... 9
........................
Section 5: General Chemistry - QC Data Summaries.......................................................... 11
5.1: Method Blank and Spike Results Summary .................................................................. 12
5.2: Duplicate Results Summary .......................................................................................... 13
N❑ 2of13
ACCUTEST.
FA2607

Accutest Laboratories
Sample Summary
Jacob's Creek Stone Company
Job No: FA2607
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
FA2607-1 03/12/13 12:00 JM 03/13/13 AQ Ground Water OUTFALL POND #1
FA2607-2 03/12/13 12:00 JM 03/13/13 AQ Ground Water OUTFALL POND #3
r�
■CI 3 of 13
®.n,=UYE=-srt
FA2607 `""""" ""'"`

Summary of Hits
Job Number:
FA2607
Account:
Jacob's Creek Stone Company
Project:
Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Collected:
03/12/ 13
Lab Sample ID CIient Sample ID Result/
Analyte Qual RL MDL Units Method
Page 1 of 1
FA2607-1 OUTFALL POND #1
Turbidity 20.5 1.0 NTU EPA 180.1
pH a 6.17 su SM 4500H B/SW 9040C
FA2607-2 OUTFALL POND #3
Turbidity 6.8 1.0 NTU EPA 180.1
pH a 6.49 su SM 4500H B/SW 9040C
(a) Field analysis required. Received out of hold time and analyzed by request.
■p 4 of 13
■ accu-r'E=-s-r
FA2607 `••°•••I.-.

Section 3
Southeast
ACCU���T
Sample Results
Report of Analysis
MD 5of13
E,O,CCLJTE=-ST.
FA2607 "'"".

Accutest Laboratories
Report of Analysis Page 1 of 1
;lient Sample ID: OUTFALL POND #1
,ab Sample ID: FA2607-1 Date Sampled: 03/12/13
Matrix: AQ - Ground Water Date Received: 03/13/13
Percent Solids: n/a
'roject: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
General Chemistry
Analyte
Result
RL
Units
DF
Analyzed
By
Method
Solids, Settleable
<0.50
0,50
ml/l
1
03/13/13 13:00
AA
SM192540F
Solids, Total Suspended
<25
25
mg/l
1
03/19/13 16:20
KC
SM19 2540D
Turbidity
20.5
1.0
NTU
1
03/13/13 15:20
LE
EPA 180.1
pH a
6.17
su
1
03/13/13 12:55
KC
SM 4500H RISW 9040C
(a) Field analysis required. Received out of hold time and analyzed by request
RL = Reporting Limit
to]
mn 6of13
■ .o.cc U-rES-r.
FA2607 "•.. .1-

Accutest Laboratories
Report of Analysis
Client Sample ID: OUTFALL POND #3
Lab Sample ID: FA2607-2 Date Sampled: 03/12/13
Matrix: AQ - Ground Water Date Received: 03/13/13
Percent Solids: n/a
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
Page 1 of 1
General Chemistry
Analyte
Result
RL
Units
DF
Analyzed
By
Method
Solids, Settleable
< 0.50
0.50
ml/1
1
03/13/13 13:00
AA
SM19 254OF
Solids, Total Suspended
< 25
25
mg/1
1
03/19/13 16:20
KC
SM19 2540D
Turbidity
6.8
1.0
NTU
1
03/13/13 15:20
LE
EPA 180.1
pH a
6.49
su
1
03/13/13 12:55
KC
SM 450011 B/SW 9040C
(a) Field analysis required. Received out of hold time and analyzed by request.
RL = Reporting Limit
■❑ 7 of 13
� �accuTEs�
FA2607 "°�•",•,"�••

Section 4
Southeast
LAEOF4ATO'+R I C:S
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
u
ME) 8 of 13
E .QGCLJTEBT.
FA2607

FA2607: Chain of Custody
Page 1 of 2
ED 9of13
FA2607 "

ACCUTEST LABORATORIES SAMPLE RECEIPT CONFIRMATION
ACCUTEST'SJOB NUlr m- O CLIENT:��ACDI31S PROIECT:_DAV)bY-aN
DATnaTmE RECEIVED: 3 - 13 -( 3- PDAIDD YY 2kOD) NUMBER OF COOLERS RECEIVED; t
METgOD OF DELIVERY: � UPS ACCUTEST COURIER GREYHOUND DELIVERY OTTMR
AIRBILL NUMBERS: - goo(-- 06o `T 3 6 9 9 - -- --
COOLER INFORMATION
CUSTODY SEAL NOT PRESENT OR NOT INTACT
CHAIN OF CUSTODY NOT RECEIVED (COC)
ANALYSIS REQUESTED IS UNCLEAR OR MISSING
SAMPLE DATES OR TDaS UNCLEAR OR MISSING
TMOTRATURE CRITERIA NOT MET
LIVETICE PRESENT,
73U BLANK INFORMATION
BI.AIiK PROVB7ED
TRIPA
Bi.ANK NOT PROVII>BD
$LANKNOT ON COC
TRIP$ ANiTNTACT
TRi? X-e&NOT INTACT.
WATER TRIP BLANK
SOIL TRIP BLANK
E�I�gjtMATION
NUMMM OF ENCORES 7 25-GR.AM 54MLAM
NUMMR OF 5035 FIELD SITS?
NUMBER OF LAD FILTERED METALS 7
SUMMARY OF
O
IR THERM ID 3 CORR. FACTOR 4-0
OBSERVBD TEAIPs: I
CORRECTED TEMPS: 3 • fi
SAMPLE IWORMATION
SAMPLE LABELS PRESENT ONALL BOTTLES
INCOR9BCT NUMBER OF CONTAZMS USED
SAMPLE RECEIVED DaROPERLYPRESFRVED
DUUMCIENT VOLUME FORANALYSIS
T'BS? MSS ON COC DO NOT MATCH SAMPLE LABEL
S ON COC DO NOT MATCH LABEL
OC VL1LS HAVE HEADS?ACE 0IACRO BUBBLES)
BOTTLES RSCHIVED BUT ANALYSIS NOT REQUESTED
BOTTLES RECEIVED FOR ANALYSIS REQUESTED
UNCLEAELFMTMLDMORCOWOgM4GD;SYRUMONS
SAMPLE CONTAINER(S) RECSIVSDBROLEN '
SOLOS JARNOT RECEIVED„ .
035 FIELD KIT FROZEN WTTHIN 46 HOUR'S
L_JRESIDUAL CHLORINE PRESENT
W-RCABLB TO EPA WO M— OR NORTH CAROLIIZA ORGAMCS)
TECHDIiCIANSIGNATUREIDAT'E - � REVIIiWERSIGNATUREMATE a
NF 12110 receipt confmnatian 12291 GAS
C
FA2607: Chain of Custody
Page 2 of 2
Np 10 of 13
■ accu-rl=s-r.
FA2607 .... I--"-----

Section 5
®D Southeast
® ACGiUTE=-E3T
LA M.0AATOR IF
General Chemistry
QC Data Summaries
Includes the following where applicable:
• Method Blank and Blank Spike Summaries
• Duplicate Summaries
• Matrix Spike Summaries
ME] 11 of 13
■accu- S-r,
FA2607`."'"�"..

METHOD HLANK AND SPIKE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA26C7
Account: JCSCNCD - Jacob's Creek. Stone Company
Project: Davidson Quarry; 2001 Slate Mine Rd, ❑enteD, NC
MB Spike BSP BSP QC
Analyte Batch ID RL Result Units Amount Result %Recov Limits
Solids, Settleable GN54589 0.50 0.0 ml/l (h
Solids, Total Suspended GN54707 10 0.0 mg/1
Turbidity GN54601 1.0 0.0 NTU
Associated Samples:
Batch GN54589: FA2607-1, FA2607-2
Batch GN54601: FA2607-1, FA2607-2
Batch GN54707: FA2607-1, FA2607-2
{') Outside of QC limits
Page 1
■® 12 of 13
S.o.ccu-res-r

DUPLICATE RESULTS SUMMARY
GENERAL CHEMISTRY
Login Number: FA2607
Account: JCSCNCD - Jacob's Creek Stone Company
Project: Davidson Quarry; 2081 Slate Mine Rd, Denton, NC
QC Original DUP QC
Analyte Batch ID Sample Units Result Result RPD Limits
Solids, Total Suspended GN54707 FA2598-1 mg/1 4.0
Turbidity GH54601 FA2607-1 NTU 20.5
pH GN54607 FA2607-2 Su 6.49
Associated Samples:
Batch GV54601: FA2607-1, FA2607-2
Batch 0N54607: FA2607-1, FA2607-2
Batch GN54707; FA2607-1, FA2607-2
(') Outside of QC limits
(a) RPD acceptable due to low duplicate and sample concentrations.
Pace 1
0.0 200.0(a) 0-5% (�
20.8 1.4 0-6% N
6.44 0.8 0-10%
MD 13 of 13
■.accu-rEsm
PA2607 """"""""`