NCG160161_COMPLETE FILE - HISTORICAL_20160902

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V L& /� 0 1
DOC TYPE,
O'HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
b OD
YYYYMMDD

$�TIE� V
0
PAT MCCRORY
R. VAN DER VAART
Energy, Mineral
and Land Resources
ENVIRONMENTAL OVALITY
September 2, 2016
Gregg W. Bowler
Carolina Sunrock LLC
200 Horizon Drive, Suite 100
Raleigh, NC 27616
TRACY DAVIS
Subject: General Permit No. NCG140000
Muirhead Distribution Center
COC NCG140445
Durham County
Dear Mr. Bowler:
IN,eclor
In accordance with your application for a discharge permit received on July 08, 2016, we are forwarding
herewith the subject certificate of coverage to discharge under the subject state — NPDES general permit.
This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between North Carolina,and the US Environmental Protection Agency dated
October 15, 2007 (or as subsequently amended).
With the acceptance of COC NCG140445, DEQ will also'officia�ind your NCG160000 permit
number NCG160161.
Please take notice that this certificate of coverage (COC) is not transferable except after notice to the
Division of Energy, Mineral, and Land Resources. The Division may require modification or revocation
and reissuance of the certificate of coverage.
Please note that NCG140000 contains effluent limitations for process wastewater discharges (see Part IV,
Section D). Wastewater discharges must meet the requirements of these effluent limitations. An
exceedance ofany of these limitations is a violation ofpermit conditions.
This permit does not affect the legal requirements to obtain other permits which may he required by the
Division of Energy, Mining, and Land Resources, or permits required by the Division of Water
Resources, Coastal Area Management Act, or any other federal or local governmental permit that may be
required.
Stale of North Cmolioa I F A mmenW Qualiry I Energy, Mineral and Land R...
1612 Mad Service Cmt 1 512 Nmih SnEabu y SR 1 Raleigh, NC 21699-1612
919 707 9200 T

If you have any questions concerning this permit, please contact Richard Riddle at telephone number
[phone].
Sincerely,
for Tracy E. Davis, P.E., CPM
cc: Raleigh Regional Office
Central Files
Stormwater Permitting Program Files
Sys c��•si: Ccaim �nm�r7,iQuky 'scexe: ]faen!m^t_rc1?,s»:atec
7fL'XLi:Sc:x Cct �l: �e-l5z:m_:t iLtC. _"v:eir .4"SaS:SL'
r79't? C_LG 7
Mt
Ya
"h b_

�QF WATF90 Michael F. Easley, Governor
\Q (� William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
1
p� Alan W. Klimek, P.E. Director
Division of Water Quality
December 5, 2004 4
Mr. Bryan Pfohl
Carolina Sunrock, LLC /+:i
DECPO Box 25 % f
Butner, NC 27509
Subject: NPDES Ge'titn ral•P.emvt•NCG16000
Certificate of CoverageNGl'60161
Carolina Sunrock, LLC-MDC
Distribution
Formerly Carolina Sunrock Corporation
Durham County
Dear Mr. Pfohl:
Division personnel have reviewed and approved your request to transfer coverage under the General Permit,
received on May 21, 2004.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General
Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of
North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S.
Environmental Protection Agency.
If you have any questions, please contact the Stormwater Permitting Unit at [phone], extension 502.
Sincerely,
Alan W. Klimek P. E.
cc: DWQ Central Files
Raleigh Regional Office, Water Quality Section
Stormwater Permitting Unit
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617
Internet: h2o.encstate.nc.us 512 N. Salisbury St. Raleigh, NC 27604
An Equal Opportunity/Af<nnafive Action Employer - 50% Recycled/10% Post Consumer Paper
NehCarolina
AlJfllPldy
Phone [phone] Customer Service
FAX [phone]

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCGI60000
CERTIFICATE OF COVERAGE No. NCG160161
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
CAROLINA SUNROCK, LLC
is hereby authorized to discharge stormwater from a facility located at
MDC DISTRIBUTION FACILITY
1503 CAMDEN AVENUE
DURHAM
DURHAM COUNTY
to receiving waters designated as Ellerbee Creek, a class WSIV NSW CA stream, in the Neuse River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, IV,
V, and VI of General Permit No. NCG 160000 as attached.
This certificate of coverage shall become effective December 5, 2004.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day December 5, 2004.
Alan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
� -i
May 3, 2004
Mr. Tony Sample
Carolina Sunrock Corporation
P.O. Box 25
Butner, NC 27509
Alan W. Klimek, P.E. Director
Colleen H. Sullins, Deputy Director
Division of Water Quality
Subject: Stormwater Compliance Evaluation Inspection
Carolina Sunrock Durham Asphalt Facility
Stormwater General Permit No. NCG160161
Durham County
Dear Mr. Sample:
On April 1, 2004 Jerry Rimmer of the Raleigh Regional Office —DWQ conducted a stormwater
compliance evaluation inspection of the Carolina Sunrock Durham asphalt & concrete facility
Permit # NCG 160161. A copy of the inspection checklist is attached. The assistance Mr. Dusty
Stone and Chuck Robertson provided during the inspection was greatly appreciated. Findings
listed on the checklist were as follows:
l . The permit, coverage certificate, SPPP documentation, site plan, site chemical
inventory, analytical records, training records, site inspection records and procedures
were compliant. Several additions are suggested below. It appears that you are
covering both the asphalt and concrete plants under the asphalt permit. This is
acceptable at this location.
2. The material storage piles were well managed. It was stated that recycle asphalt is
shipped to your RDU plant for processing. The storage inventory was high, but the
season is just beginning.
3. The oil tank is diked and maintained properly.
4. All stormwater is collected in a silt retention basin. This system is maintained and
accessible.
5. The process area has been paved.
6. There is no vehicle maintenance performed at this site.
7. Review of the analyses indicate that you are sampling per permit. The sample points
are acceptable. You are not yet eligible for cutoff exemption since you only began
coverage in 2003.
8. Annual updates need to be made to the SW plan. Add Dusty Stone to responsibility
list. A narrative section detailing tanker off loading procedures and pump valve
operations would be helpful to insure all site personnel avoid potential releases from
these operations. Also note that coverage renewal request is due since this permit
expires July 31, 2004. Please submit renewal request immediately if you have not
already submitted this request.
Raleigh Regional Office 1628 Mail Service Center
Water Quality Section Raleigh, INC 27699-1628
�
R�.1 aA
NL'DEi.'R
NorthCaroGna
phone [phone] Customer Service
facsimile [phone] 1-877-623-6748

Page 2
Mr. Tony Sample
May 3, 2004
Your continued attention to the stormwater protection program is appreciated. Although there
are some issues as mentioned above, the discussions engaged in during the inspection and via
telephone should lead to resolution of each of the issues. The stormwater program appears well
organized, well documented and is being managed in a timely manner. We appreciate the
commitment given to your stormwater program.
call me at [phone].
Sincerely,
Jerry✓ F. Rimmer
Environmental Specialist
cc: Mr. Dusty Stone, Carolina Sunrock Corp.
NPDES Compliance Unit
Central Files
If you have any questions or comments, please

na
Asphalt Facilities Stormwater Inspection Checklist
Type of Visit ®Compliance Inspection/Program Audit OTech Assistance or Recon
Location: Carolina Sunrock Corp. Asphalt /Concrete Plant, Muirhead Distr. Center,
1503 Camden Ave. Durham, NC
Facility Number NCG160161 Date 04/01/2004 Time In12:25pm Time Out 1:40pm
People Interviewed, and Titles: Dusty Stone, Plt.Mgr. & Chuck Robertson QA Mgr.
Inspector: Jerry F. Rimmer
SPPP Documentation (Site Plan Part II (A)(1)
1. Copy of Certificate of Coverage ®Yes pNo Copy of Permit ®Yes pNo Requested but not required
2. General Location (USGS) May shows plant 'Yes'- No, lines of discharge Part II(A)(1)(a)
to water of State_®Yes �No, Stream labeled'. No, Latitude and longitude ®Yes pNo
Comments:i- ".,}
3. Narrative Description of Practices ®Yes pNo_ Part II(A)(1)(b)
4. Site man ®Yes pNo Shows flows & areas served with arrows and Part II(A)(1)(c)
% impervious surface ®Yes pNo, buildings ®Yes pNo, process areas ®Yes pNo,
disposal areas ❑Yes ®No, drainage structures ®Yes pNo, existing BMPs such as secondary containment
®Yes ONo, list of potential pollutants ®Yes pNo
Comments: __,,
5. List of significant spills in last 3 years or certif. if none ®YesONo None Part II(A)(1)(d)
RRO called? OYes ONo x Na
6. SW outfalls have been evaluated for process water ®Yes _pNo Part II(A)(1)(e)
7. Feasibility of Changing Practices Oyes ONo NA Part II(A)(2)(a)
8. Secondary Containment ®Yes ONo J Schedule needed? pYes ONo Part Q(A)(2)(b)
Records of Draining Containment, Observations Made pYes p'No ;r_.- '>I
9. BMP Summary ®Yes pNo' ' 1 Part II(A)(2)(c)
10. SPRP Plan ®Yes ONo, Responsible personnel still employed here? ®Yes pNo Part II(A)(3)
Need to add Dusty to list.
11. PM and Housekeeping Plan ®Yes ONo E Record of Inspections? ®Yes pNo Part II(A)(4)
Not since Aug., 03.
12. Employee training®Yes pNo —for everybody ®Yes Yes Not documented Part II(A)(5)
13. Responsible parties, chain of command page ®Yes ONo Need to add Dusty Part II(A)(6)
14. Plan undated/reviewed annually pYes ®No New plan 03 Part II(A)(7)
15. Stormwater Facility Inspection Pro am ®Yes ONo� Part II(A)(8)
16. This Plan Has Been Implemented (documents in manual, Part II(A)(9)
employees show awareness ®Yes pNo Comments:'
Sampling and Analytical Data Part II(C)
All Stormwater and Process Water is Recycled (IIC(3)) OYes ®No
Rain Gauge on site (not required) ®Yes pNo
Collected Stormwater is mixed with Aggregate, but some overflows collection pond.
Record of an overflow pv--
Yes ®No Details
If not all recycled, what is allowed to discharge? Vehicle Cleaning (IIC2) Q Recycle overflow (IIC3
above) Ej Wetting of Aggregate (IIC4)M Mixing drum cleanout (IIC5) 0 Vehicle Maintenance
Concrete scrap is hauled off site for processing.
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.

For the topics checked in last Question, Analytical data present ®Yes ONo, Compliant. ®Yes []No
Details:Faxed while on site.
Total precip ®Yes pNo, Storm duration ®Yes ONo, Total flow Est. ®Yes ONo,Field pH ®Yes pNo,
Chain of custody ®Yes ONo
Qualitative Monitoring performed semiannually ®Yes ONo Part II(F)
Stormwater not combined with process wastewater — general runoff NO PartII(C)(1)
Analytical data ®Yes ONo, Chain of Custody ®Yes pNo, Qualitative Monitoring performed
semiannually (Section F) ®�
Yes p'�No,
If using cutoff policy, how many sample rounds Not eligible until more data is collected.
Cutoff Concentrations met OYes ONo t ° 'JEver have a Bypass? pYes ®No PartlE (C)(4)a(I&2)
Notification given? pYes ONo
Outdoor Inspection
I located all discharge points ®Yes ONo No. of areas served 2
Sample points appropriate ®Yes pNo jE:_
Location if different from discharge point Plus downstream.
Housekeeping: Trash pYes ®No Dust pYes ®No I;~`
Take pH QYes ®No V alue(s) " ` 7.7"' $ _
Take photos QYes ONo
Containment Area satisfactory ®Yes ONo, Loose drums QYes ®No, Locked drain ®_Yes pNo
How is asphalt tank heated?: #4 Waste Oil
Asphalt recovery pile comments Small pile, but not used on site. Sent to RDU plant for processing.
Inspection Summary Comments:
Need to update SPCC plan list of responsible persons at Durham site. Need to include sampling
and location list in SW manual.
Recommendations: Keep copy of analyses and training records on site or train mgr. to download
from intranet.
Requirements: M -,•
Letter is to go to:
Name Tony Samples
Title'
Address: Carolina Sunrock Corporation, PO Box 25, Butner, NC 27509
Helpful Information at http://l12o.enr state.nc us/su/Manuals Factsheets lmn
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.
Revised 03/19/04

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
2 ILI 1 31 NCG'_60161 111 121 04/04/01 117 18 u 19 U 20I uI
1 L'J
r.�
Remarks
211 111 111111111111111111111111111111111111111166
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 OA�,-----------------------Reserved-------------------
67 169 70 IJI71 U 72 U 73 W 74 75I I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Dale
Permit Effective Date
POTW name and NPDES permit Number)
Murihead Distribution Center (MDC)
12:25 PM 04/04/01
03/06/04
Exit Time/Dale
Permit Expiration Date
1503 Camden Avenue
Durham NC 27704
01:40 PM 04/04/01
04/07/31
Name(s) of Onsite Representative(s)(ritles(s)/Phone and Fax Numbers)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Tony Sample.P0 Box 25 Butner NC 27509//919-575-4502/9195754510 Contacted
.40
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Records/Reports Facility Site Review 19 Storm Water
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Dale
Jerry Rirmer Rho WQ//91.9-571-4700/919-571-471e
/a 2/f)y
Signature of Management O A Reviewer Agency/Office/Phone and Fax Numbers Date
5'14r04
L.
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.

NPDES yr/mo/day Inspection Type
31 NCG160161 I11 12 I 04/04/01 I17 181 I
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
See atta hment

Permit: NCG160161 Owner - Facility: Carolina Sunrock Corp - Murihead Distribution Center (MDC)
Inspection Date: 04/01/04 Inspection Type: Compliance Evaluation
Yes No NA NF
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
❑
❑
❑
Is the facility as described in the permit?
0
❑
❑
❑
Are there any special conditions for the permit?
❑
0
❑
❑
Is access to the plant site restricted to the general public?
0
130
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment:

ff SUNROCK
CAROLINA SUNROCK CORPORATION
-M. D. Capps
Plant Foreman
P.O. Box 25 • Butner, NC 27509
Phone: [phone]• Fax: [phone] ASPHALT
Nextel: 919/697-W6 • Nextel IDk: 150.105011.6 CONCRETE
Residence: 252/456-4975 AGGREGATES
Email: mdcapps®thesunrockgroup.com
USUNROCK
CAROLINA SUNROCK CORPORATION
: Michael Dustin Stone
Plant Foreman, Asphalt Division
1503 Camden Avenue
Durham, NC 27704
Phone: 919/68&6881 • Fax: 919/68&1936
Mobile: [phone] • Nextel ID 8: 150.105071.2ASPHALT
Email: [e-mail] CONCRETE
- AGGREGATES

,i
W ArFq
P
I 1
Mr. Tony Sample
Carolina Sunrock Corporation
1001 West B Street
P.O. Box 25
Butner, NC 27509
Dear Mr. Sample:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimeck, P.E.
Director
Division of Water Quality
Subject: General Permit No. NCG160000
Muirhead Distribution Center
COC NCG 160161
Durham County
In accordance with your application for a discharge permit received on September 24, 2002 we are
forwarding herewith the subject certificate of coverage to discharge under the subject state — NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated May
9, 1994 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Water Quality. The Division of Water Quality may require modification or revocation and reissuance of the
certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management
Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Aisha Lau at telephone number (919)
733-5083 ext. 578.
"tHf5iNk SIGNED BY
...: WILLIAM C. MILLS
Alan W. Klimek, P.E.
cc: Raleigh Regional Office
Central Files
Stormwater and General Permits Unit Files
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]
A%
NCDENR
Customer Service
1 800 623-7748

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG160000
CERTIFICATE OF COVERAGE No. NCG160161
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Carolina Sunrock Corporation
is hereby authorized to discharge stormwater from a facility located at
Muirhead Distribution Center
1503 Camden Avenue
Durham
Durham County
to receiving waters designated as Ellerbe Creek, a class WSIV NSW CA stream in the Neuse River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, II, III, and
IV of General Permit No. NCG160000 as attached.
This Certificate of Coverage shall become effective June 4, 2003.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 4, 2003. '1,; , .:1; • ' 'ORIGINAL SIGNED BY
! Prf . WILLIAM C. MILLS
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Asphalt Facilities Stormwater Inspection Checklist
Type of Visit 2ompliance Inspection/Program Audit ❑Tech Assistance or Recon
Location: C.cve%e 5 /e <k ( v-'^ //0- -"A- o..,1p rj /i 6 J N Cs. 7�1i/ /S a J Qa o%, 7 ` 0',
Facility NumberNCG16;.6(.6'J O Date, %lQY Time In I'jo,0,^. "/�'»
People Interviewed, and Titles: Oq s/ S'/a o
Inspector: T F X; m �.el
SPPP Documentation (Site Plan Part II (A)(1)
1. Copy of Certificate of Coverage p'6s pNo Copy of Permit [21 es pNo Requested but not required
2. General Location (USGS) Map shows plant ©Yes oNo, lines of discharge � Part II(A)(1)(a)
to water of State 93'�es UNo, Stream labeled ❑Yes bKo, Latitude and longitude O<es ONo
Comments:: �/
3. Narrative De , ri tion of Practices IlyYes ❑No , Part II(A)(1)(b)
4. Site map , es ONo ows flows & areas served with arrows and Part II(A)(1)(c)
% impervious surface Yes ❑No, buildings d es -5No, process areas' es pNo,
d�isposal areas gYes i `o, drainage struct s es pNo, existing BMPs such as secondary containment
- es pNo, list of potential pollutants r es ONo
Comments:, )
5. List of significant spills in last 3 years or certif. if none ii�es'pNo %tI6, 4 Part II(A)(1)(d)
RRO called? pYes pNo /t/ _
6. SW outfalls have been evaluated for Brocess water es ONo i' Part II(A)(1)(e)
7. Feasibility of Changing Practices es [7No , NA! Part II(A)(2)(a)
8. Secondary Containment p� es ONo Schedule needed? OYes Pico j Part H(A)(2)(b)
Records of DJraining Containment, Observations Made ❑Yes Io
9. BMP Summary QYes I]No _ f/y�° Part II(A)(2)(c)
10. SPRP Plan �es ONo, Responsible personnel still employed here? pYes ONo
11. PM and Housekeep in Plan . O �
� CTr es ONo _ �-, �Record of Inspections? Oyes No Part II(A)(4)
12. Employee training'1{YYes pNo — for everybody �rres pNo /(!d7r Part II(A)(5)
13. Responsible parties, chain of command page es ONo »' - ( Part II(A)(6)
14. Plan updated/reviewed annually Oyes ­0� y Part II(A)(7)
15. Stormwater Facility Inspection Program Yes pNo Part II(A)(8)
16. This Plan Has Been Implemented (documents in manual, Part II(A)(9)
employees show awareness &e`s pNo Comments:, ;
Sampling and Analytical Data Part II(C)
All Stormwater and Process Water is Recycled IIC 3 pYes tiallo
Rain Gauge on site (not required) ' .es ONo
Record of an overflow pYes — io Details t
If not all r ycled, what is allowed to dischc rge? Vehicle Cleaning (lIC2) 0 Recycle overflow (IIC3
above) Wetting of Aggregate (IIC4)[Xxing drum cleanout (IIC3) [I Vehicle Maintenance ❑
k�kl-e�, ufi .
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.
7-0y ,r 7 s - 4Ks o Z
o/isa

For the to ics checked in last question, Analytical data present ❑Yes'aj<o, Compliant? pYes pNo
Details ` e r�
Total precip VYes ❑ I Dio, Storm duration dyes pNo, Total flow Est. E Yes ONo,Field pH E5'es ❑No,
Chain of custody E4es O�No
Qualitative Monitoring performed semiannually 2Yes ONo Part II(F)
Stormwater not c bined with process was
er —general runoff �0 PartII(C)(1)
Analytical data ryes pNo, �am of Custody � es ONo, Qualitative Monitoring performed
semiannually (Section F) tZYes ONo, A r �
If using cutoff policy, how many sample rounds /
Cutoff Concentrations met OYes pNo Ever have a Bypass? CoYes L�iJNo PartM (C)(4)a(1 &2)
Notification given? ❑Yes ONo
Outdoor Inspection
I located all discharge oints I Yes pNo No. of areas served
Sample points appropriate 2 les qNo i
Location if different from discharge pointtiw,fR-
Housekeeping: Trashoyes ONo Dust OYes QNo y
Take pH C7Yes ZNo ',Value(s) j : 1
Take photos OYes'C3 0
Containment Area satisfactory -es pNo, Loose drums pYes E o, Locked drain Yes ONo
How is asphalt tank heated?: 7¢ y L .BTU,,/ ­
Asphalt recovery pile comments ? S /,Ok
Inspection Summary Comments / � J
L
Cc
Recommendations:"'-:,,.
Requirements::;'
Letter is to go to:
Name S� mP��
Title'
Address!-fO"&°X 2i r,
Helpful Information at http•//h2o enr state nc us/su/Manuals Factsheets.htm
Note: this checklist does not take the place of your permit. You are fully responsible for
following the permit.
Revised 03119/04

04/01/2004 TRU 17:33 FAX [phone] CAROLINA SUNROCB IA 0/01��J
CAROUNA SUNROCK CORPORATION
Corporate Raadgnarters
Po B" 25, Batw, Plorm Caromm 77509
Phone: [phone]M, —far. 9191575-4510
0
NUMBER °J 1 J ' 9 r1 i $ DATE ,1� 1-0
FROM o y S4* . �c —
TOTAL PAGES (iacludiug ewver)
COMMENTS
—��T •.-tee
Luismsaage B tatea8a 9* ar we orme- 6 W id oraft to iI ' It Isaddremd and may
contain
i+Grmatioa Gat fs prs'tad, aad eze mp45om dbd@mm,*dw e@p��
rmmet has re&&W ym is agar please rdam Cite ur%bwt =emr to su at the above addrem
'rhask yae.
AGGREGATES/CONCRETE/ASPHALT

A4ua Tech Environmental Labs, Inc.
936 N. Homer Blvd. • Sanford, NC 27330
Phone [phone] • 800-522-2832 • FAX [phone]
Analys*l
Is Request
& ChainOf Custody
i
Instructions On
Back
Page I Of
Name: /'
/oN S
Bill To:
.('r .
c Nr• Cm.
tioratory La'Use Only`
Company: �." r
l/fro .r .es r
ProjoCVPO M: �u111
—I 4
Processed ,:
BY; ` :.
DaWTI e
Address: nB �� zS
Ouote&:
''Method OV.
City, State, ZIP:
k.hvCL NG 7-7 So
Sampler Name:/'
f0N
S
•R 'diOn'lce -• r
Yea❑NO Tempel .:
Rush. •• t
d Yea 'O No Date Due- .A=
Phone: FAX:
9/-.5-75'- o S7S- ys�[�
Sampler Signature,
.`
Bush Costs
A'TEL Lati
`Numb'er'
Sample Information _
nilornfation
Analysis Information
Comments
Location
Matrix
Date
Time
C
G
Type
Size
Pres.
N
Analysis Requested
I GTO
R
.JP
iz
r!tJc)
Pc—
N?
�.
l..
n .
Ilah �:
ulshed By
Date
Time
Received By
Date
Time
,o
'ss
Copy Distribution: White/Marion Yellow/Melmore Pink/File Gold/Client
Please read and follow the instructions on the backof this chain of custody. Failure to fill out this form completely may delay the analysis of your sample and effect the legal defensibility of your darn.