NCG140246_MONITORING INFO_20150120

VIVO
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv
DOC TYPE
❑ HISTORICAL FILE
LO MONITORING REPORTS
DOC DATE
❑ c)
YYYYMMDD

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140246
FACILITY NAME: Arrowood
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab #lI 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorina Reouirements
SAMPLE COLLECTION YEAR: 2014
RECEIVED
` SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
lCCV PHONE NO. [phone]
JAN 2 0 20i1
5 ADD TO LISTSERVE? ❑YES ®NO EMAIL:
CENTRAL FILES DISCHARGING TO CLASS: [_]SA ❑HQW ❑PNA ❑Trout ®Other
DWR SECTION OPTIONAL INFO:
Outiall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day),
-
-
RM, MD-
6-93'4
303,5
53
(15)6
-
-
001
12/23/2014
RM
No Flow
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8,5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL. PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 - /
FACILITY NAME: &gig &W&Ic d%=;E+ I rtty/
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Reauirements
SAMPLE COLLECTION YEAR:
SAMPLE QUARTER: ❑Jul -Sept +Oct -Dec ❑Jan -March
COUNTY: 61YCOIA/
PHONE NO. (704 ) 3S3-
ADD TO LISTSERVE? DYES ONO EMAIL:
DISCHARGING TO CLASS: [_]SA ❑HQW ❑PNA ❑Trout KOther
OPTIONAL INFO:
RECEIVED
JAN 15 2015
CENTRAL FILES
DWR SECTION
❑April -June
Outfall No.
Date Sample
Collected'
(rnrn/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard]
Total Suspended
Solids
(mg/L)
TPH using
Settleable
method 1664A
Solids 6
SG
(mL/L) 1L)1
(mg/L)
Discharge
Total Flow
Duration 7
(minutes) (gallons/day]
-
-
6-93'4 1
303'5
S3 (15)6
c.0
er31A 1 C S te=
If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cieanout (IViD). tZeport more than one type if the waste-strearn is commingled.
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11

A
fi Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from vMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 1SA
NC -AC 02B :0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer-7Q10 flow and report this information to DWQ. If the permittee cannot:
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30'DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW"1 TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1637
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED•
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and.belief, true, accurate; and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
ufaiations."
(Signature of
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

t , --
PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140246
FACILITY NAME: Arrowood
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorin2 Reeuirpments
SAMPLE COLLECTION YEAR: 2014
RECEIVED
QUARTER: ❑Jul -Sept ®Oct -Dec []Jan -March ❑April -June
RECEIVED COUNTY: Mecklenburg
PHONE NO. [phone] =709
JAN 2 0 2015 ADD TO LISTSERVE? []YES ®NO EMAIL:
CENTRAL FILES DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
DWR SECTION OPTIONAL INFO: FV9
Outfall No.
Date Sample
Collected'
(mm/dd/yr]
Type of Wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L]
Settleable
Solids
(mL/L]
TPH usingDischarge
method 1664A
SGT-HEAP
(mg/L}
Duration
(minutes}
Total Flow
gallons/day)'
-
-
RM, MD-
6-93'4
303'5
53
(15)6
-
-
001
12/23/2014
RM
No Flow
002
12/23/2014
RM
7.81
7.6
BRL
N/A
>1
>1
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
e TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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_ � �:
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•, . _ �, . i
i
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s Pr acess wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q1O Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW"."NO DISCHARGE"LWITHIN 30 DAYS OF RECEIPT OF SAMPLEJOR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons direly re onslble for gathering the information, the information submitted Is, to the best of my knowledge and belief, true, accurate, and complete.
l am awa%thatX re r significant penalties for submitting false information, including the possibility of fines and Imprisonment for knowing violations."
(Signatu4of Permittee)
Permit Date: 7/1/2010-06/30/2015
r�
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG_140000 _
CERTIFICATE OF COVERAGE NO. NCG140246
FACILITY NAME: Arrowood
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Reauirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec []Jan -March ❑April -June
COUNTY: Mecklenburg
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)
PH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)7
-
-
RM, MD-
6-93,4
303,5
53
(15)'
-
-
001
8/12/2014
RM
8.3
130
BRL
BRL
75
>1
002
8/12/2014
RM
7.1
BRL
BRL
BRL
7S
>1
TCEIVEC-
•: n
L FILES
WR SECTION
` If wastewater systems have not discharged in this quarter — report "No Flow' or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
s if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

5 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report -this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW-, "NO DISCHARGE") WITHIN 30_DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
N 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 dire y responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware Mat th Jye aV7significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re f Permittee)
Permit Date: 7/1/2010-06/30/2015
TleC, le
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report RECEIVED
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140246
FACILITY NAME: Arrowood
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
JUL 18 2014
SAMPLE COLLECTION YEAR: 2014 CENJ 01BOGES
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March April -June
COUNTY: Mecklenburg
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)
PH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
sGT-HEM6
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)7
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
001
6/13/2014
RM
7.39
BRL
BRL
BRL
N/A
>1
002
6/13/2014
RM
8.13
BRL
BRL
BRL
N/A
>1
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 0213.0224.-Permittees.who.discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualif d personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons di ctly r onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am *aA thaA significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 7/1/2010-06/30/2015
7 �7 c
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000 -
CERTIFICATE OF COVERAGE NO. NCG140246 SAMPLE COLLECTION YEAR: 2014
FACILITY NAME: Arrowood SAMPLE QUARTER: []Jul -Sept ❑Ott -Dec ®Jan -March ❑April -June
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ® NO ❑
Part A: Wastewater Monitoring Requirements
COUNTY: Mecklenburg
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date SampleTPH
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
using
method 1664A
S �mLM'
Discharge
Duration
(minutes)
Total Flow
(gallons/day)7
-
-
RM, MD-
6-93`4
303,5
53
(15 )6
-
-
001
3/3/2014
RM
9.22
BRL
BRL
BRL
540
>1
002
3/3/14
RM
9.21
BRL
BRL
BRL
540
>1
IPD
lao
1 If wastewater systems have not discharged in this quarter-- report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Perrnittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. if the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified p rsonnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly esp sable for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware th# thgX are nificant penalties for submitting false Information, including the possibility of fines and imprisonment for knowing violations."
gnature f Permittee) (Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

RECEIVED
APR 15 2014
CENTRAL FILES
STATE OF NORTH CAROLINA
DWQlBQG
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG140246
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,
Concrete Supply Co., LLC
is hereby authorized to discharg4tormwater from a facility located at
Process l�s�z-wc�r a�l�
Concrete Supply Co. — Arrowood Plant
12148 Nations Ford Road
Charlotte
Mecklenburg County
to receiving waters designated as McCullough Branch, a class C water in the Catawba River
Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts 1, II, III, IV, V, and V I of General Permit No. NCG 140000 as attached.
This certificate of coverage shall become effective April 11, 2014.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 11, 2014
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. Johnie Alexander
Concrete Supply Co., LLC
P.O. Box 5247
Charlotte, NC 28299
Dear Mr. Alexander:
John E. Skvarla, ill
Secretary
April 11, 2014
Subject: NPDES General Permit NCG140000
Certificates of Coverage —See attached list
Concrete Supply Co., LLC
Formerly Concrete Supply Co.
Counties - Multiple
Division personnel received your request to revise your stormwater permit Certificates of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificates of Coverage for the 17 facilities that changed
ownership from Concrete Supply Co to Concrete Supply Co., LLC. The terms and conditions
contained in the General Permit remain unchanged and in full effect. These revised Certificates
of Coverage are 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 or need further information, please contact the Stormwater Permitting
Program at [phone].
Sincerely,
ORIGINAL SIGNED W
KEN PICKLE
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc: Mooresville RO, Z. Khan; Winston-Salem RO, M. Gantt (NCG140358)
Stormwater Permitting Program Files
Deborah Reese, DEMLR Budget Office — please update billing info
Central Files
Mecklenburg County DEP, Water Quality, 700 N. Tryon Street, Charlotte, NC 28202
Division of Energy, Mineral, and Land Resources
Energy Section - Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 - 919-707-92001 FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: http://oortal.ncdenr,org/web/i
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper