NCG140398_2021 DMR_20220110

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG140000
Ready -Mixed Concrete
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG14 0 3 9 8 Person Collecting Samples: N/A
Facility Name: Carolina Ready Mix and Builders Supply. LLC Laboratory Name:
Facility County: Madison Laboratory Cert. No.:
Discharge during this period: ❑ Yes ❑® No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? ❑ Yes *No
If so, which Tier (I, 11, or III)?
Part A: Analytical Monitoring Requirements for Qutfalls with Industrial Activities —Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
No Discharge
this qtr
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0-9.0)
Non -Polar oil & Grease in
00552
mg/L (15) for drainage areas that use > 55
gal/mo of new hydraulic oil on average
rNCOILEstimated
New Motor/Hydraulic Oil
Usage in gal/month
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L.
Notes (optional):
"I certify by my signature below, 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."
Signature o mittee or Delegated Authorized Individual
01/07/2022
Date

NCDEQ Division of Energy, Mineral and Land Resources
Wastewater Discharge Monitoring Report (DMR) Form for NCG140000
Ready -Mixed Concrete
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG14 0 3 9 $ Person Collecting Samples: N/A
Facility Name: Carolina Ready Mix and Builders Supply, LLC Laboratory Name:
Facility County: Madison Laboratory Cert. No.:
Discharge during this period: ❑ Yes X No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? ❑ Yes ffi� No
If so, which Tier (I, II, or III)?
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Effluent Limits in (Red)
Parameter
Parameter
Outfall
Outfall
outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
NO DISCHARGE
THIS QUARTER
N/A
Date Sample Collected MM/DD/YYYY
Daily Flow Rate in cfs (50% of 7Q10
82220
for HQW/ORW)
C0530
TSS in mg/L (30, 20, or 10*)
Settlleable Solids in HOW, ORW, SA,
00545
SB, Tr & PNA (5 mL/L)
pH in standard units (6.0-9.0
00400
freshwater, 6.8-8.5 saltwater)
Non -Polar Oil & Grease in mg/L (N/A,
00552
but samples above 15 require tiered
responses)
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW) have a TSS limit of 20 mg/L, outfalls to Trout Waters (Tr) and
Primary Nursery Areas (PNA) have a TSS limit of 10 mg/L. All other water classifications have a benchmark of 30 mg/L.
No#es (optional}:
"I certify by my signature below, 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."
&�t % q q-
or Delegated Authorized Individual D to

EPWIVnmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling oul this forin, please visit littps://deq.nc,gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/ l 1. l / I / I or Certificate of Coverage No.: N/C/G/ 1/410/ SW $1
Facility Name: _ Carolina Ready nA'
County: Maths Phone No,
Inspector: Gary Kilker
Date of Inspection: 12(31J2021
Time of Inspection:
Total Event Event Precipitation (inches): Q
All permits require qualitative monitoring to be perforined during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfaIl. 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 DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
or Designee)
1. Outfall Description:
Outfall No. 001 Structure (pipe, ditch, etc.): _NO -disc arge_.this period
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Concrete, Manufacturing
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SWU-242, Last modified 06/01/201 S

2. Color: Describe the color of the discharge 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.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where l is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where l is no solids and 5 is the surface covered with floating solids:
1 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:
7.
S.
9.
10.
1 2 3 4 5
Is there any foam in the stormwater discharge? O Yes o No. —
Is there an oil sheen in the stormwater discharge? 0Yes 0 No. _
Is there evidence of erosion or deposition at the outfall? o Yes O No,
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 06/01/2018

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No, NCG140000
Calendar Year 2021
*Report ALL STORMWATER monitoring data on this form (include "No FloWl"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the: DEQ by !MARCH 1 of each year.
Certificate of Coverage No. NCG14 ®3� 90®
Facility Name: Carolina Ready Mix and Builders Supply, LLC
County: Madison
Phone Number: (82$ a 686-3040
Certified LaboratoryPace Lab # 40
Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No, 001 VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency 0
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Permit Date 811/2017 — 6130/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 E]0Q®
CERTIFICATION
I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR, §122,22]
Signature
Date /.
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/112017 — 6/30/2022
Last Revised 8-22-2015