NCG090031_MONITORING INFO_20190201

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V (�i� (� � b d
DOC TYPE
❑HISTORICAL FILE
�?- MONITORING REPORTS
DOC DATE
❑ 010/7 D a 0
WYYMMDD

--STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)1 SPPP Annual Update DATA REVIEW FORM
Calendar Year 2018
Individual NPDES Permit No. NCS❑❑❑❑❑❑ orCertificate of Coverage (COC) No. NCG®9❑00❑❑ -RECEIVED
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP. FEB 0 12019
Facility Name: 2135 Manufacturing LLC
County: Richmond
Phone Number: ( 910 ) 895-5779
Total no. of SDOs monitored 1
Outfall No. SDQ 1
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No [R
CENTRAL FILES
DwR oeCT64
Parameter, (units)
Total
Rainfall,
inches
'Total
Cadmium
Total
Chromium
Total Lead
Benchmark
N/A
0.001 mg
1.0 m IL
0.03 m /L
Date Sample
Collected,
mmlddlyy
E========
3/28/18
1.5
<0.001 mglL
<0.001 m IL
<0.003 m IL
11/13/18
<0.005 m IL
<0.025 m L
<0.005 m *IL
SWU-264 - Generic Annual DMR
Last revised 511712013

"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
fof�fines and imprisonment for knowing violations."
Signature / ( ` Micheal Brown, CAI, Inc. Corp. EHS Director as an agent for 2135 Manufacturing LLC
Date _December 21, 2018
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
FAYETTEVILLE REGIONAL OFFICE
MOORE SVILLE REGIONAL OFFICE
225 Green Street
610 East Center Avenue/Suite 301
2090 US Highway 70
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
WILMINGTON RFGIONAL OFFICE.
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINS"TON-SALEM REGIONAL OFFICE
CENTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
"To preserve. protect
and enhance
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
919) 807-6300
North Carolina's seater._."
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

Facility Name:
Permit Number:
Location Address
County:
STORMWATER POLLUTION PREVENTION PLAN
DEVELOPMENT AND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Water Quality - Stormwoter Permitting Unit
2135 Manufacturing LLC
NCG 090031
106 Enterprise Drive
Rockingham, NC 28379
Richmond
I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all attachments
were developed and implemented under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information required by the SPPP. Based on my inquiry of
the person or persons who manage the system, or those persons directly responsible for gathering the information,
the information gathered is, to the best of my knowledge and belief, true, accurate and complete."
And
" 1 certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP has been
fully implemented at this facility location in accordance with the terms and conditions of the stormwater discharge
permit."
And
" I am aware that there are significant penalties for falsifying information, including the possibility of fines and
imprisonment for knowing violations."
Sign (according to permit signatory requirements) and return this Certification. DO NOT
SEND STORMWATER POLLUTION PREVENTION PLAN. WITH THIS CERTIFICATION.
Signature
1�-44�-- - �5--
Michael Brown - as an agent for 2135 Manufacturing LLC
Print or type name of person signing above
Date
Title
12/21/18
CAI, Inc. Corp. EHS Director
11
SPPP Certification 5/09

l
r
gNCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
$ For guidance on falling out this farm, please visit: bttll:Lortal,ngdenrQre/wcb/lrlapdes-storm —atuj
'. ,"'," m [. ca oao p3 1
Permit No.: N/C/_/_/_/_//_/_/ or Certificate of Coverage No.:
Facility Name: _I ISds _H_ RN�F/ry�'Rt��^�C� , LU., _
County: Rr_G_ 'f1"' NO _ Phone No. CtlJ •
Inspector: 1N CHJ9
Date of Inspection: W. l - I Q
Time of inspection:
Total Event Precipitation (inches): 1
r
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Z Yes ❑ No
r
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer` to these definitions, if applicable.
r ,
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. AIsinglestorm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and -the permittee
obtains approval from the local DWQ Regional Office.
By this signature,1sadifythat this report is accurate and complete to the best of my knowledge:
of Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description: p1
Outfall No. SD Oi Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the disc,ge using basic colors (red, brown, blue, etc.) and tint
(light, medium,.dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Nv
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 19 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:
1 `l� 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 0 3 4 5
7. Is there any foam in the stormwater discharge? Yes 4 0
B. Is there an oil sheen in the stormwater discharge? Yes N�
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
y
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further Investigation.
Page 2 of 2
SWU-242, Last modified 7/31/2013

for North Carolina Division of Water Quality General Permit No. NCG090000
Date submitted
0 0 3 1 ad.
CERTIFICATE OF COVERAGE No. NCG09 _
FACILITY NAME I , twc/ —
COUNTY ?XWONO
PERSON COLLECTING SAMPLES IN AW
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
mokI6-
4
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR WR g
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or [:]Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow []watersupply [—]SA
[]Other
—
PLEASE REMEMBER TO SIGN ON THE REVERSE
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Cadmium
Total Chromium
Total Lead
Benchmarks =__>
_
-
0.001 mg/L
1.0 mg/L
0.03 mg/L
SDD2.
1l -l5• IQ
2''
4,aox
4,0.02S
LDv�S
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
Note: Results must be reported in numerical format. Do not reportBelow Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format. "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or rer 3 responses. See General Permit text.
Permit Date: 11/l/2012-10/31/2017 5WU-255, last revised 10/25/2012
Page 1 of 2

Part 8: Ve„Icle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
® No discharge this period?Z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
ph
Benchmarks ===>
_
-
15 mg/L
100 mg/L or SO mg/L'
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
• See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART It SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copy of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitoring period
in the case of "No Discharge" reports) to;
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Permit Date: 11/1/2012-10/31/2017
SWU-255, last revised 10/25/2012
Page 2 of 2

�VMICROBAC`
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K8K0205
CAI Ink, Inc. Project Name: Stormwater Sample - Semi Annual
Mr, Kin Chaco Project 1 PO Number: NIA
7 Martel Way Received: 11/13/2018
Georgetown, MA 01833 Reported: 11/27/2018
Project Special Information
Analytical Testing Parameters
Client Sample ID: Outfall #1, Grab
Sample Matrix: Aqueous Collected By: Chaco
Lab Sample ID: K81<0205-01 Collection Date: 11/13/2018 14:46
Metals
Result
RL
Units
Note Prepared
Analyzed
Analyst
Method: Metals Aqueous/EPA 200.7 Rev 4.4 1994
Cadmium
<0.005
0.005
mglL
11/21/18 1336
11/21/18 1336
TAB
Chromium
<0.025
0.025
mg1L
11/21/18 1336
11i21118 1336
TAB
Lead
<0.005
0.005
mglL
11/21/18 1336
11121/18 1336
TAB
Field Sampling/Testing Result RL Units Note Prepared Analyzed Analyst
Method: SM 2550 B-2010
Temperature, Field 16 0.1 °C 11/13/18 1446 MJW
Method: SM 4500 H+B-2011
pH, Field Test 5.7 1.0 pH Units 11/13/18 1446 MJW
Definitions
MDL: Minimum Detection Limit
RL: Reporting Limit
Project Requested Certification(s)
Microbac Laboratories, Inc. - Fayetteville
11 North Carolina DENR NPDES
Report Comments
Reviewed and Approved By:
Samples were received in proper condition and the reported results conform to
applicable accreditation standard unless otherwise noted.
The data and information on this, and other accompanying documents, represents
only the sample(s) analyzed. This report is incomplete unless all pages indicated Jeanne Overstreet
in the footnote are present and an authorized signature is included. Client Relationship Specialist, Environmental
Reported: 1112 712018 12:15
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page l of 1

AV
=
' 1 0 A
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this farm, please visit: lip j/nortal.ncdenr.org/wgbjlr/nodes-storm aYi Ater/
kiGC, 0ao03l
Permit No.: rj/CJ_/_/__./^/—/—/_/• or Certificate Qf Coverage No.: W-Cl-GIOA1O/�0Q/
FacilityName: 21 AniUVAMILANrn LI,G
County: 91GHMOR10 — — Phone No. 0Il0 '
Inspector: 1nl 044
Date of Inspection:
Time of Inspection:
.W
N h
Total Event Precipitation (inches): J
RECEIVED
DEC 18 RR
Was this a "Representative Storm Event" or "Measureable Storm Even," as define�by fhe permit?
(See information below.) �-tE RAL FILE,9
dWR SECTION
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0A inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
Bythisjjgva, I certify that this report is accurate and complete to the best of my knowledge:
of Permittee or Designee)
Pagel of 2
5WU-242. Last modified 7/31/2013

1. Outfall Description:
Outfall No. 30 Ol Structure (pipe, ditch, etc.) ylzl�
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 00 h T
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): VAO
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 i� 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 0 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 Z) 3 4 5
7. Is there any foam in the stormwater discharge? Yes
a. Is there an oil sheen in the stormwater discharge? Yeso
9. Is there evidence of erosion or deposition at the outfall? Yes 0
10. Other Obvious Indicators of stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242. Last modified 7/31/21113

Semi-annual Storm_ water Discharge Monitoring Report
for North Carolina Division of Water Quality Genera! Permit No. NCG090000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG090000 //qccl OCA0031
FACILITY NAME CAI, Inc.
COUNTY Richmond
PERSON COLLECTING SAMPLES rli j GHpGO
LABORATORY Microbac Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 00LI
SAMPLE PERIOD © Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flaw [:]WaterSupply []SA
®Other Class C Waters
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period?'
Out#al! No.
Date Sample
Collected'
(mo/ Collected'
24-hour rainfall
amount,
Inches#
Total Cadmium
Total Chromium
Total Lead
Benchmarks ===>
-
-
0.001 mg/L
1.0 mg/L
0.03 mg/L
Soul.
3-12-:101
PIC
0.001
40:00P
4.0.U05
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: !f you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text.
+ Permit Date: 11/1/2012-10/31/2017 SWU-255, last revised 10/25/2012
j . Page 1 of 2

Part B: Venicle Maintenance Area Monitoring Results: onlyfor facilities averaging > 55 gal of new oil per month.
g g �
® No discharge this period?2
Outfall No.
Date Sample
Date
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =_= >
_
-
15 mg/L
100 mg/L or 50 mg/L"
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART It SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one can of this DMR includina all "No Discharae" resorts. within 30 days of receist of the lab results for at end of monitorina seriod
in the case of "No Discharae" reoortsl to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-255, last revised 10/25/2012
Page 2 of 2

CAI Ink, Inc.
Mr. Robert Fricke
7 Martel Way
Georgetown, MA 01833
Project Special Information
Analytical Testing Parameters
OMICROBACA'
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K8C0339
Project Name: Stormwater Sample - Semi Annual
Project 1 PO Number: NIA
Received: 03/12/2018
Reported: 04/03/2018
Client Sample ID: Outfall #1, Grab
Sample Matrix: Aqueous Collected By: Client
Lab Sample ID: K8C0339-01 Collection Date: 03/12/2018 8:00
Metals
Result
RL
Units
Note Prepared
Analyzed
Analyst
Method: Metals AqueouslEPA 200.7 Rev 4.4 1994
Cadmium
<0.001
0,001
mg1L
04/02/18 1125
04/02/18 1125
TAB
Chromium
<0.001
0.001
mg1L
03/26/18 1558
03126/16 1558
TAB
Lead
<0.003
0.003
mglL
04/02/16 1125
04/02/18 1125
TAB
Field Sampling/Testing Result RL Units Note Prepared Analyzed Analyst
Method: SM 2550 B-2010
Temperature, Field 8.1 0.1 °C 03/12118 0800 JPM
Method: SM 4500 H+B.2011
pH, Field Test 7.1 1.0 pH Units 03/12118 0800 JPM
Definitions
MDL: Minimum Detection Limit
RL: Reporting Limit
Project Requested Certification(s)
Microbac Laboratories, Inc. - Fayetteville
11
Report Comments
North Carolina DENR NPDES
Reviewed and Approved By:
Samples were received in proper condition and the reported results conform to
applicable accreditation standard unless otherwise noted. ,� Cl�
The data and information on this, and other accompanying documents, represents Bonnie K. Sanders
only the sample(s) analyzed. This report is incomplete unless all pages indicated
in the footnote are present and an authorized signature is included. Senior Project Manager
bon [e-mail]
04/03/2018 15:24
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1 910.864.1920 p I www.microbac.com Page 1 of 2

Semi-annual 5#ormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG090000
Date submitted -7f Zi6
CERTIFICATE OF COVERAGE NO. NCG09_0 a Q_ NC6Q 1003 ]
FACILITY NAME 2 f3.5` M/Jx�����r.�t, ire ,6 / i_ - 1
COUNTY D
PERSON COLLECTING SAMPLES p
LABORATORY_ Lab Cert. #
Comments on sample collection or analysis:
fCvnl G�,
4
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Z /,•
SAMPLE PERIOD ❑ Jan -June IM July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]Zero -flow ❑Water Supply ❑SA
RECEIVED []Other
JUL 2 5 2016 PLEASE REMEMBER TO SIGN ON THE REVERSE
CENTRAL FILES
DWR SECTION
❑ No discharge this period?'
Outfall No.
Date Sample
Collected 1
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Cadmium
Total Chromium
Total Lead
Benchmarks ===>
_
0.001 mg/L
1.0 mg/L
0.03 mg/L
o A
!
L oo?
00
40. 00
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
Note: Results must be reported in numerical format. Do not reportBelow Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-255, last revised 10/2S/2012
Page 1 of 2

Part 8: Vewde Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
® No discharge this period?2
OutfaEl No.
Date Sample
Collected"
(mo/dd/yr)
24-hour rainfall
i
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
TotalS spe6ded Solids
�pH---'
Benchmarks
15 mg/L
1__�100 mg/L or 50 mg/L*
,,-6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one cony of this DMR, including all "No Discharae" reports. within 30 days of receipt of the lab results for at end of monitorina period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
. / 17 ��-�-
of Permittee)
(Da e)
Permit Date:11/1/2012-10/31/2017
SWU-255, last revised 10/25/2012
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG090000
i 1Q C&'0q 003 Date submitted
CERTIFICATE OF COVERAGE NO. NCG094
h► '�,,, SAMPLE COLLECTION YEAR 10 t�' — /V.
Q
FACILITY NAME 3 S- M oQ,vvFRLCTUrzrLL G SAMPLE PERIOD 0 Jan -June ❑ July -Dec
COUNTY _� Grdnr Crx/r7 I 1
.or th
PERSON COLLECTING SAMPLES Kriv e-Wi i_o DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY ft(cgod G Lab Cert. # RECEIVED ❑Zero -flow ❑Water Supply ❑SA
Comments on sample collection or analysis: Other_ 0,1-ol- , S C_ �J
JUL 2 5 2046
PLEASE REMEMBER TO SIGN ON THE REVERSE
.� CENTRAL FILES
DWR SECTION
Part A: Stormwater Benchmarks and Monitoring Results
❑ No discharge this period?z
Out#all No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Cadmium
Total Chromium
TotalLead
Benchmarks ===>
_
-
0.001 mg/L
1.0 mg/L
0.03 mg/L
5 D
`3
< ,Ov
00 3
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfali.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format. "<XX mg/L where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-255, last revised 10/25/2012
Page 1 of 2

Part B: Vesicle Maintenance Area Monitoring Results: only for facilities dveraging > 55 gal of new oil per month.
❑ No discharge this period:2
Outfall No.
Date Sample
1
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended -Solids
pH
Benchmarks ===>
_
� -
15 mg/L
__1100 mg/L or 50 mg/L*
6.0 — 9.0 SU
//
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Il SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NOX
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one coov of this DMR. includina all "No Discharae" reports. within 30 days of receipt of the lab results tor at end of monitoring period
in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
6
(Da e)
Permit Date: 11/1/2012-10/31/2017 SWU-255, last revised 10/25/2012
Page 2 of 2

C�
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)1 SPPP Annual Update DATA REVIEW FORM
Calendar Year Zp / S
Individual NPDES Permit No. NCSUL_j UUL_1 U or
� O
Certificate of Coverage (COC) No. NCG©N 2z1a q6 V
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: ;1/'�iM1Ji�i=/iZsR��/N� LLL
County: _ 12J C �,;TnzQ -
Phone Number: (IZ/O ) �-y5- 5779 Total no. of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No K
Parameter, (units)
Total
Rainfall,
inches
I-V
4- 1
Y-U IX-6-
L&N.J
j;
Benchmark
N/A
6,
n , U
Date Sample
Collected,
mmlddlyy
7
!
L 0
L a
< 00a
1
of
o
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

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 systemor 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 possibijity of fines and imprisonment for knowing violations."
Signature
Date Qr..
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
ASHEVILL_E REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
3800 Barrett Drive
Raleigh, NC 27609
[phone]
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
_W_ASHI_NGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
(252) 946-648 1
WINSTON-SALEM REGIONAL OFFICE CENTRAL OFFICE
585 Waughtown Street 1617 Mail Service Center
Winston-Salem, NC 27107 Raleigh, NC 27699-1617
[phone] [phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
"To preserve, protect
and enhance
!North Carolina's ivater..."
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

w
]Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG090000
Date submitted `t Ll Z-// 7
CERTIFICATE OF COVERAGE NO. N00090000
FACILITY NAME CAI, Inc. j L/
COUNTY Richmond
PERSON COLLECTING SAMPLES ff'iW,0
LABORATORY Microbac Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2-01 7_
SAMPLE PERIOD Jan -June ❑ July -Dec
or Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVED ❑Zero -flow ❑Water Supply ❑SA
®Other Class C Waters
APR 18 Of?
CENTRAL FILE, PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION.
❑ No discharge this period?z
Outfali No.
Date Sample
Collected 1
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Cadmium
Total Chromium
Total Lead
Benchmarks =__>
_
-
0.001 mg/L
1.0 mg/L
0.03 mg/L
O
3
Z"
4 ,0
�01001--
.40 00'
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-255, last revised 10/25/2012
Page 1 of 2

- Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
® No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Il SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one coon of this DMR, includina all "No Discharge" reports. within 30 days of receipt of the lab results for at end of monitorina Period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the�best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
q-1 Z 7
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-255, last revised 10/25/2012
Page 2 of 2