NCG060028_MONITORING INFO_20190222

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v U& co pad
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑
YYYYM M DD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000 RECEA/17 j)
Date submitted
MAC
CERTIFICATE OF COVERAGE NO. NC606Q2
FACILITY NAME >r�nrn fYi1C a~
1 �': ill ►1 ra's1 �11Mez
• � mil
~t7
is
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR n2D !Q
FACILITY ACTIVITIES INCLUDE (check all that apply): ()W i '`-6 e-1-Es
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ❑NO
PLEASE REMEMBER TO SIGN ON THE REVERSE
Total event rainfall 1 or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd%yr
TSS, .
mg/L
pH,
Standard units
COD,,
mg/L
Oil and Grease,
m L
Fecal CoilfarM':,
Colonies per 100 ml .
Enterocdccl ,
Colonies per 100 ml .
Benchmark
100'br SO
Wltlilr B.0-=9:0 .
120
30 .
1000
.' Soo
r
L05•
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at AU outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Nno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No"0
Sattiple'Collected,
moJddJyr ',
`OIl:and Grease; •-'z
e �. .m L t.
TSS,'
: mgJh••.
pH,
'+ Staridacd units ''
NiW Motdr,Oil e,
:Usa
,�„ g
Annual'avera e:gal%rita
Benchmark..,,
.34.
100 or50
6.0 -•9.0
-
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General "•rmit text, Table 3, identifying the especially sensitive receiving water civ-'nations where the more protective benchmark applies.
t
if im complete Part 13)

*FOR PA,.. AAND PART B MONITORING RESULTS:
* A BENCHMARK a wXCEEDANCETRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
* Z EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME DUTFALL 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 ❑ NO19
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal_and one copy of this DMR.,includina all "No Discharge" reports, within 30 days of receipt of the lob results or at end a�
monitoring eriod in the case of "No Dischar e" re arts to:
Division of Water Quality
Attn-. DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document -and all attachrrients were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate th6 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,"
/- �
l
(Signature of Perrnittee) (Date)
r"
Additional copies of this form may be downloaded at: li-,Ip:/Iportal.ncLier)i,.org/webiyyq/ws/suynpd-essvy4Lau-4
SWU-249 Last Reviscd: Oc r IS, 2012
Page 1 of 2

SHEALY ENVIRONMENTAL SERVICES, INC.
Report of Analysis
ADM Milling Co.
620 W. 10th St
Charlotte, NC 28202
Attention: Vivian Nkem
Project Name: Stormwater
Lot Number:UB22054
Date Completed:03/08/2019
r
03/12/2019 2:15 PM
Approved and released by:
Project Manager: Grant Wilton
The electronic signature above is the equivalent of a handwritten signature.
This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page I of 15

SHEALY ENVIRONMENTAL SERVICES, INC.
5C DHEC No: 32010001 NELAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639
Case Narrative
ADM Milling Co.
Lot Number: UB22054
This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary
following this Case Narrative. The sample receiving date is documented in the header information
associated with each sample.
All results listed in this report relate only to the samples that are contained within this report.
Sample receipt, sample analysis, and data review have been performed in accordance with the most
current approved NELAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality
Assurance Management Plan (QAMP), standard operating procedures (SOPs), and Shealy policies. Any
exceptions to the NELAC standards. the QAMP, SOPS or policies are qualified on the results page or
discussed below.
If you have any questions regarding this report please contact the Shealy Project Manager listed on the
cover page.
The pH analysis associated with the sample(s) in this report wastwere performed after the method
recommended 15 minute holding time.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www,shealylab.com
Page 2o1'15

SHEALY ENVIRONMENTAL SERVICES, INC.
Sample Summary
ADM Milling Co.
Lot Number: UB22054
Project Name: Stormwater
Project Number:
Sample Number
Sample ID
Matrix
Date Sampled
Date Received
001
outtall #1 TSS
Aqueous
02/22/2019 0338
02/22/2019
002
outfall #1 O&G
Aqueous
02/22/2019 0340
02122/2019
003
ouflall #1 PH
Aqueous
02/22/2019 0342
02/22/2019
004
outfall #1 COD
Aqueous
02/22/2019 03"
02/22/2019
005
outfall #2 TSS
Aqueous
02/22/2019 0350
02/22/2019
006
outfall #2 O&G
Aqueous
02/22/2019 0355
02/2212019
007
outfall #2 PH
Aqueous
02/22/2019 0400
02/22/2019
008
outfall #1 COD
Aqueous
02/22/2019 0403
02/22/2019
(8 samples)
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 3 of I

SHEALY ENVIRONMENTAL SERVICES,
INC.
Detection Summary
ADM Milling Co.
Lot Number: UB22054
Project Name: Stormwater
Project Number:
Sample Sample ID
Matrix Parameter Method Result Q
Units
Page
001 outfall #1 TSS
Aqueous TSS SM 25400-
43
mg1L
5
005 outfall #2 TSS
Aqueous TSS SM 2540D-
15
m91L
9
008 outfall #1 COD
Aqueous COD SM 5220D-
48
mg/L
12
(3 detections)
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealyleb.com
Paged of t5

Inorganic non-metals
Client: ADM Milling Co. Laboratory ID: UB22054-004
Description: outfall #1 COD Matrix: Aqueous
Date Sampled:0212212019 0344 Project Name: Stormwater
)ate Received:0212212019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
3 (COD) SM 5220D-2011 1 03/07/2019 2213 NET 99509
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
COD SM 5220D- ND 20 mg1L 3
LOG = Limit of Quantitabon 6 =Detected In the method blank E = Guantitatmn of compound exceeded the calibration range
ND = Not detected at or above the LOO N - Recovery is out of cntena P = The RPD between two GC columns exceeds 40%
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Pape 8 of I 5

Inorganic non-metals
.Client:ADM Milling Co. Laboratory ID: UB22054-003
Description: outfall #1 PH Matrix: Aqueous
Date Sampled:0212212019 0342 Project Name: Stormwater
Date Received: 0212212019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
1 (pH) SM 4500-H B-2011 1 02/26/2019 1258 PJK 98758
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
pH@15°C
SM 4500-H B-2 6.6
LOO = Limit of Quantitation B = Detected m the method blank E = Quantitation of compound exceeded the cahbrat+on range
ND = Not detected at or above the LOQ N = Recovery is out of cntena P = The RPD between two GC columns exceeds 40%
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc,
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.s6ealylob.com
su 1
I'agc 7 of 15

Inorganic non-metals
Client:ADM Milling Co. Laboratory ID: UB22054-001
Description: outiall #1 TSS Matrix: Aqueous
Date Sampled:0212212019 0338 Project Name: Stormwater
Date Received:0212212019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
1 (TSS) SM 254OD-2011 1 02/26/2019 2143 AMR 98715
CAS Analytical
Parameter Number Method Result Q LOO Units Run
TSS SM 2540D- 43 6.3 mg1L 1
LOO = Limit of Quantitation 6 = Detected m the method blank E = Quantdation of compound exceeded the calibration range
No - Not detected at or above the LOO N = Recovery is out of criteria P - The RPf] between two GC columns exceeds 40%
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 5 of 15

Inorganic non-metals
Client:ADM Milling Co. Laboratory ID:UB22054-002
Description: outfall #1 O&G Matrix: Aqueous
Date Sampled:0212212019 0340 Project Name: Stormwater
)ate Received:0212212019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
1 (HEM (oil and) 1664B 1 03/01/2019 1055 ARP 99039
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
HEM (oil and grease) 1664E ND 5.0 mg1L 1
LDQ = Limit of Quantization 8 = Detected to the method blank E = Quantization of compound exceeded the calibration range
NO = Not detected at or above the LOO N = Recovery is out of cniena P = The RPD between two GC columns exceeds 4Wo
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia. SC 29172 [phone] Fax [phone] www.shealylab.com
Page 6 of 15

Inorganic non-metals
Client:ADM Milling Co. Laboratory ID:UB22054-005
Description: outfall #2 TSS Matrix: Aqueous
Date Sampled:0212212019 0350 Project Name: Stormwater
Date Received:0212212019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
1 (TSS) SM 2540D-2011 1 02/26/2019 2143 AMR 98715
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
TSS SM 2540D- 15 5.0 mg1L 1
LOQ = Limit of Quantitation B = Detected in the method flank E = Quantization of compound exceeded the calibration range
ND = Not detected at or above the LOD N = Recovery is out of criteria P - The RPD between two GC columns exceeds 40%
R = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 9 of 1

Inorganic non-metals
jCtient:ADM Milling Co. Laboratory 0: UB22054-006
Description: outfall #2 O&G Matrix: Aqueous
Date Sarnpled:0212212019 0355 Project !Name: Stormwater
Date Received; 02/22/2019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
1 (HEM (oil and) 1664E 1 03/01/2019 1055 ARP 99039
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
HEM (oil and grease) 1664E ND 5.0 mg/L 1
LOO = Limit of Ouantitabon 9 = Detected in the method blank E = Ouannabon of compound exceeded the calibration range
ND = Nat detected at or above the LOO N = Recovery is out at criteria P = The RPD between two GC columns exceeds 10%
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc
-
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
PaQc 10 of 15

Inorganic non-metals
Client:ADM Milling Co. Laboratory ID; U822054-007
Description: outfall #2 PH Matrix: Aqueous
Date Sampled:0212212019 0400 Project Name: Stormwater
Date Received:0212212019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
1 (pH) SM 4500-H B-2011 1 02/26/2019 1304 PJK 98758
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
pH @ 16.1 ° C SM 4500-H B-2 6.4 su 1
LOG = Lima of Quantitation B = Detected in the method blank E = Quahutafion of compound exceeded the calibration range
ND = Not detected at or above the LOQ N = Recovery is out of cntena P = The RPD between two GC columns exceeds 40%
H = Out of holding lime W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Pagc I I of 15

Inorganic non-metals
-Client: ADM Milling Co. Laboratory I D: U B22054-008
Description: outiall #1 COD Matrix: Aqueous
Date Sampled:0212212019 0403 Project Name: Stormwater
Date Received: 0212212019 Project Number:
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
3 (COD) SM 5220D-2011 1 03/07/2019 2213 HET 99509
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
COD SM 5220D- 48 20 mg/L 3
LOG = Limit of Ouantitation 8 = Detected in the method blank E = Ouantttation of compound exceeded the calibration range
ND = Not detected at or above the LOG N = Recovery is out of cntena P = The RPO between two GC columns exceeds 40%
H = Out of holding time W = Reported on wet weight oasis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 12 of 15

Chain of Custody
and
Miscellaneous Documents
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columtm, SC 29172 [phone] Fax [phone] www.shealylah.com
Page 13 of I i

'Jr
CWA l JVPDFS
Chain of Cusfarly Rernmf
nezq V-ovirnnmenual Serr./i':as, ,nr.•
101 V n•^ , Air r tinw
Tom uclulna a own carmha 2W
ra'ojpW,,re rv,.:DDT, 7ji-z7oo rar No. 00A.', -1 1
••.t x rlimll ih rr. n
Number
La,W,
�r?[>=rSMrI:rrlY',n
yg1I1CIE'i"7r:iA!'7-
��l•aEr•
',ti::r...,y
-I Ny:�..Vl w•r�.: _'r nA t- yy.
! -
`
..r
rp: cd-
PfY5E1;ct'._
L.,rrla:a l .::rn;:;u y
j
�
1..h71•r. I I r..^,..
� us._rl .�L4
�
'•Gnalrrr -s'L- •'oel,o'_ aas
W ••i,be W M cl r W.;
R"- IR Wrr
I
IJB2206-4
,.�: •'Si.a so , „ .;Cl; I - nr rlf: ml; h'
+Vl2lli•
_I'NC
�
.. � Ili•.
76
rnrr;rrr.Y nr `n='rll.
,i',K: f ,rr .ir:;
!•
.-..; Ir,
.1.
1l
UA
J..✓:
I
H
I
;r
r
13r
oat !1l 1 CCM
``13
SUM
P,
I
i
I
II'll'r
�Y r
I
r rr i.,i �Iw- - rr1'/•-9 tt �.9']•;I y7JrY.
r�rfl:xl;-. ...r
`'r r151i
:'+l}i }I
:5;'I>n�lr
5`.^l'r'~
a'!Y~L1Z]IM.c'!ulcu11':I^.-.:2'F:i/l:".\'11f1C.`Ch
a`�I:P_• ni!',IYr:••:`-r!: I•;i
:S,
4m•M"+:rnr
1-
l�IE!-In
rrrr,.1-
Jlllf'7,7r
-
�:,I<I'
•-r•:v n;A
?—:14'.t
r;ajlrl -
C'alr
: I In l }
Ii-IN 1"J Il+
L'ntn
II H
2.2 2..f `r
t,J
'! M:.:II'ry.�Fh Vl h.
l: arq
II'r7r;
'?':-,rr. r:: •Y iM•
liak:
Irv;
I
� uerl'il,�l,l;'411Fr _... .... .,
�]Le _. __.___
�.I IRS
�_n:urn x•t,•-?laexl J'� .'f/"j9�j�
l:'�Il:''J •y�y`
11�7' I /� 1
Note: All samples ara retala" f or four wooka from rt L 5C 01`412Y
h'ee 5 I�nIF
1:
er 1•, x
rocer t ullles3 Qthel orran emollts are made 'e:ioe::rl kr i=rltr_-.' ❑,4 ��Ita ra.I
l7
Y 'I
• Il',^.IMf'IS f•Filr S'I ".�=�:f.,f, '•; _.'.I

SHEALY ENVIRONMENTAL SERVICES9 INC.
til].ir1 S t�i:l V w1�7r1,11 �:: • FLi� t:Fl.
i In-.utire,s N,neUc[: !•1f �J� t &C-: �
Clirn:: ADM li'sliji�,
Sample Receipt Checklist (SRC)
CoolerImpcc�,Aht:'date• i' 1, '?:1V L,014: L.622954
Mewls ol'jeceipt. ® SL•ST ❑ c:lir 1. ❑ UPS ❑ 1-0 folic::
❑ i
® 1':,i
L Wrs vumudy wult; reticat_<m tht coe!&!
Lj Yrc
K0
NA
c- 1t V,',^Jr ifC5e111- >•'•O t:irY iutt-c: L ul un11r-A) .n`
14 SHP II}: 1$-2-225 (.Horinc Strip 113: NA _ i-stcc by: I341P
d (Con-ecLedl ir:ngcruw.-t upo-k Mr rint >5rla:l Si:aF, Cup ID: NA
Ciri�:nul ti.TtiPi:rituru ul,nn r.CCftt ' i�cri':c -
?:U NA ,•'NA ^C N;L : NA .0 NA ..'NA -C
Method: 07'etl:prraLi rr 11hill f,]AgBinst %r1c3 IK L 11111), rR Cr-ui Cor.wion F'riCtr r `l E
]tlelhod of c;rulant: ® Wei lvc ❑ L)e Pack,, ❑ Tjr,• 1c C) N:,ni. I
❑ Yes
❑ V[i
®1ti A
,. If xmipera urc of any coolar e.,:ce-xlr1 s ..". t . w:L, Yr;,j--=1A1an,,ec:r Ni:tif7tie'
PMwm; NT itifkA by: ph cone." t e.w tii : i:[ce-to-I'Lce tc:-ruIL onc)-
❑ Y:.s
© No,®
N_1
4. Ic fl- COmnen ill C*tu'irr`s pt:cl.iirs; slip ail ai;;l;::fl .c i us fornt..
ycs
❑ No
15. Vdcre prop:ar casioti_ pr;iUtdLlrs trCliri lin himl:'il'[:i:v,r.' fcdl v;cd"
Of YZ51
D.No
1 6. \'acre sample 105 Itstcd or. (lie COC?
�j Ycs
❑ `++1110
'<[:. Crc Sample IDS Esled on all s in'lalr c ,intainrrti,
21 Ycs
©+40
((J�
V. A.as Colicciian &rLc & linle listed Inn Ike CLOCC?
❑ Ycs
®N10
4. Was co?kc'ion date Sk Lime listed i ni >Jl Sample costa:mi i"
® Yes
©N1u
IT Did all c:nituiver label infnrrnadcn (ill, dax, tine) agree wish tac C Oc'
® Yes
❑ Nlu
11. W vie lests lu br 1lr*lnrnr l itvlctl rn the l UC'-
"
)
U. Did all Samples urine in tilt! : TCTler c;,r;vtinrta for calf tem .titd�u3 iai U.00l •;ori:li(ilrn
Oanbrokm lids c.a. cic.) _-.
Ye.;
❑ No
i.i- ) a; udequitr. sslnipkc vohuue wiuil:,ale?
Ye+
-CT)
❑ No
114.1A7cre n1i Kailip s rCCCived Wi1iii: V! t_lc 1101ditig ti-MZ I,ir -� h01i1:;, V.'111i11CVer iiMICN Jinl?
1J. wete =.v +an.l,le; Confainc-rs hitSS ri�'t xte3s i.Uiwlr [,ii nsumplicv Not J3—.c, j Qa C'UCM.
(CS
L,
;ZN
Yor V0A andt+'LT�bubbles"Its-�i""Fi,n11in liitinctC:)
in all*� of the VOA —AndA�'0
'rc�'-4o
NA
I;. Wetk :01 1)K0,,trctaLz,"mitric:i: sarnplr. rc�eiwdn(a 1.H of..Ycs
Nr
NA
7 S. wcrr Ail C.vawidr su_ii les reed+-_Yl s: a ph- 12 and sulfide ;ariiplcr: rc riv ,li rr a
El Ycs
i
❑ NC
®Nl:ti
ln. 1,, Al 1ppljcatlle 1;11tiT}kVrcyani[laPh:;znkYe?5 {' (t._,ei rL! ; [i,ip] FTC-' Or rtvitl;ial
ctloriuc:'
A00yy
❑ Nn
ZNA
?0'We:c clieul reuiail::'rr4urtil� (i.u, %Nu:s:cd JLh1ti0ai. Ii1S:.MSi� cic .i:!:i itrn.5;.ri •.. 4
corrcctl3'• unwcribed f?oui (lie COC into tie.C-mumoll Setilivu in Lil VY
Was the genie number li;trd nn rhr .-oRtailier 13icl? If yr., ()wlN : k
=N
12L
St711ip1r Prcxcnatiun (11135: be cl]nilal lod Ytlt any;amltir.;�f inr.Rrr-„[l� pn-s. vtd Jl with 11ru1 p1L:1%')
Samples) NA area rrcci:orl ir,::orrrx-fly presc.-.-cd and uri- U ju;lyd :nx;i;tdit)g.y
in Sample receiving ti•:(h NA ml- of Limic in:e: lP_SO4, ITNO 1, 140. Na0H using `it t KA
itrlt :,: )?ietir-4,i irnt NA If Ciofe UU111 urlr praserval:vc is ncszAcd, plc3.ii ji- to in laic C[imrt:f.Tits he:IrnL,
Y_
Sarripl4(s'l uric rc.uivL-d with bubbles:-6 nun in diLrneir , -
SF,rap1cs(.$) NA _ we'it rrceivei: u6 th TR(..:. (i, ` :ue,-L lL ,' l9 is MV ) L111L WC7C'
1i9.ltialtd aLuL1--dS7gl.. in sample rcec:v:rw- v,;t: i sodiur l thirnulfale, (Nla,�.: 1,) wilt SU::Iy TD: NA
SR Wco&- labels amlied by: F. B Dair: ?:?ii 1'-1
COMIC -MR:
LS:
Shealy Envimnmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylob.com
4r
Page 15 of 15

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000 REC I1/ED
Date submitted
CERTIFICATE OF FACILITY NAME COYNn1 �
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. g
Vt
_e_-- OCT 1.8 2a18
SA PLErCQ _ , J,_ EAR CENTRAL FILES
FA IL TY-ACTI ITIES INCLUDE (check all that apply): 0VVR SECTION
[R,4sg/gr?Egts meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? []YES XNO
CENTRAL Fii_ES
DWR ��=CCT nn,
11:LEa5 REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Results Total event rainfall 2, t
'�,p '.e a Sv:—a •�..•.; Monitoringv- war :n- 1. y,� ..J,,. •••
,,ttom� 4��p'.� r,�( •,-' �`'` 5 'his - p .. ' (- rsr.`x ,.Gv'��. j:;..f"sCSi•+,.; .: ., z �i.,a
�'"1S.
Wa- MN
: j t [ j
s,j k'�- .rt ,•.T .�"fn� «i7' �''; :f.•°if�,`� a"Wt „4T•"-.`W�}... ,�.7.'n' •"i�.^ `ax .nµd�P. _r'a`.'S':'" «.4.•..✓ y ,ii -}'S'� Y a��Mi'�ul r•'.'4u` \, ay �:..5
�ai'��ai�l'•`7a. i.Y�!a�C!)��:rr.;!c.�'1f'ra ..4��Lr.�Jd
_ 1
pF ¢:� r:�s:•�h44 q? .F ;• M1L'•R 4 �::�:.i;,• • � ..:: "�5. .�:d'A T4 •'^`^v4'i, �.ih ':r Q':s:*1 R•. 6 ." +r<% ::a S."� 'i :�Y r. �_ •�i�` �, � t w +•.1���1
E::�-£'.`2r1S1:_>'h • 4y� s`+��� i �jo-S'r,:"�avtx.'i�^
�,83�����.L�iF���i1{�1����i.�,..: �.'i!,.+.�.�iif.�J•.ri't�•i�.:.�.•...���+e4.�i.�'M�''6.�tYi.�;•<•���5.�'[�...-.�-e.t�t4l�'.?::.6�u�i..'��,1.9.:,:.1.�131%'.�l6�f1
EMU". MM t�� ©I'C��►I c
umy appoes to Tacinires tnat use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 9 no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
,$..r•'r 1.3� �. yy11•�.§
'iiRi i{' �-b •�':r'�;rr'E.'
�:ytqFnz,r�k
e _
,}..�.
^a
.-L.
�s•.v.
`*i. e ') f; � • r
ia;�i �_:7 �.1 %��I r�. •r
-Y-Iq!»i'e`+S`F.
f4 '.F `�•ti �wy+�]�,
r `r
1I'7 �'f. �'`
�h:.�n;G:;l��•.F?:�a..
r�I •f �{ tit�S=r�
r•3t,y,:. ,�, �p��}`�.y;'!
�' r�I�A:�'f-��' +-�•j,
IE i,
ii.h�'i$t.C':i• .r_:::,.
w
i.at.. � ..ti• �a..'tysE ,'�.:�L�x���,"il�
I�
7' �dL1.;i.:3�1
�1:�
I
unry appnes to Taciinies that use/process meats.
3 The total precipitation must be recorded using data from an on -site rain gauge'.
3 For sampling periods with no discharge at = outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See Gener •rmlt text, Table 3, Identifying the especially sensitive receiving water cla—'rications where the more protective benchmark applies.
L_
SWU-249
if es complete Part B)
Last Revised: October 18, 2012
Paaa 1 of 7

*FOR PA... A AND PARTB MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
2 EXCEEDANCES 1N 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 original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case of "No Discharge" reorts) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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,
tobest of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
ip or ation,_ineirniipg the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(67 (1 r( S
(Date)
Additional copies of this form may be downloaded at: httortal.ncdenr.or web w ws su n dessw#tab-4
SWU-249
Last Revised. Oc. ,r 18, 2012
Pave. 1 of')

SEMI -A
ATER DISCHARGE MONITORING REPOR
for North Carolina Division of Water Qualit General Pern#ttL&P OICGO60000
Date submitted _
CERTIFICATE OF COVERAGE NO. NCG06j�-a&Z
FACILITY NAME Ar`i7M
COUNTY . I rah l�'. -al; A UA
PERSON COLLECTING 4AMPLES �lv...l�...�.
LABORATORY Lab Cert. f#
enmyi?Y n
Part A: Stormwater Benchmarks and Monitoring Results
t4tfthal
Q18
SAMPLE COLLECTION YEAR;
FACILITY ACTIVITIES INCLUDI�t apply):
❑ use/process meats fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES D4NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall Zn'n!or ❑ No discharge this period;
,Sr `
Owls
riLif F•1'k
`idYU i,pC/
ao3 y�
_ i �: f'..-��5I
;A.
fir+ONAWMIN
teP
FA t .
®ry ONIMS
� VWOMWN 411
M :._�
t `�r
!D
o
.
1 Only applies to facilities that use/process meats.
3The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
�. $ iV,a�
i
rp.. �'yy.� �.�` r r.
WIN
i v I,..
01
•b'
� � i/ R3A � lM�
4n.���n 5 �v.. .'�, i
�H.j '�N
. ��.. .. ,„i. .i. • i'rrC4� .L .�•i'1!^MV^;XN
ti L{� �/�y� h
ld-. i
xx ��'ww'++
C'T�rfli.:. �i�ll.1•.�. ,�? r
k'
+ •� !'Fi
;S .i131 r-'F T. '..7�if',
1 Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge:
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
45ee General --rmit text, Table 3, identifying the especially sensitive receiving water clar-'`i1cations where the more protective benchmark applies.
(if ves. complete Part B)
S WU-249 Last Revised: October 18, 2012

*FOR PA... A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART ii SECTION B.
• 2 EXCEEDANCES 1N 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 ❑ NOV1
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case qt"No_Dischame" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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, inclu� the possibility of fines and imprisonment for knowing violations."
(Signature of 1Permittee)
3 - -Z) a --l5
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.orp/web/wcj/­ws%su/npdessw#tab-4
SWU-2'49
Last Revised: Oc ,r 18, 2012
Page ..?. of 2

SHEALY ENVIRONMENTAL SERVICES, INC.
Report of Analysis
ADM Milling Co.
620 W. 10th St
Charlotte, NC 28202
Attention: Vivian Nkem
Project Name: Stormwater
Lot Number:TCO2075
Date Completed:03/11/2018
03/13/2018 2:46 PM
Approved and released by:
Project Manager: Grant Wilton
'11
The electronic signature above is the equivalent of a handwritten signature.
This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page I of I I

SHEALY ENVIRONMENTAL SERVICES, INC.
SC DHEC No: 32010001 NElAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639
Case Narrative
ADM Milling Co.
Lot Number: TCO2075
This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary
following this Case Narrative. The sample receiving date is documented in the header information
associated with each sample.
All results listed in this report relate only to the samples that are contained within this report.
Sample receipt, sample analysis, and data review have been performed in accordance with the most
current approved NEtAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality
Assurance Management Plan (QAMP), standard operating procedures (SOPS), and Shealy policies. Any
exceptions to the NELAC standards, the QAMP, SOPS or policies are qualified on the results page or
discussed below.
If you have any questions regarding this report please contact the Shealy Project Manager listed on the
cover page.
The pH analysis associated with the sample(s) in this report was/were performed after the method
recommended 15 minute holding time.
Shealy Environmental Services, Inc.
106 Vantage point Drive west Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 2 of 11

SHEALY ENVIRONMENTAL SERVICES, INC.
Sample Summary
ADM Milling Co.
Lot Number: TCO2075
Project Name: Stormwater
Project Number:
Sample Number Sample ID Matrix Date Sampled Date Received
001 OUTFALL 001 Aqueous 03/01/2018 1000 03(0212018
002 OUTFALL 001 Aqueous 03/01/2018 1200 03/02/2018
003 OUTFALL 002
004 OUTFALL 002
(4 samples)
Aqueous 03101120181000 03/02/2018
Aqueous 03101120181200 03/02/2018
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 3 of I

SHEALY ENVIRONMENTAL SERVICES, INC.
Detection Summary
ADM Milling Co.
Lot Number: TCO2075
j
Project Name: Stormwater
Project Number:
Sample Sample ID
Matrix
Parameter Method
Result Q
Units
Page
001
OUTFALL 001
Aqueous
COD SM 5220D-
54
mg1L
5
002
OUTFALL 001
Aqueous
TSS SM 25400-
62
mg1L
6
003
OUTFALL 002
Aqueous
COD SM 5220D-
63
mg1L
7 I
004
OUTFALL 002
Aqueous
TSS SM 2540D-
63
mg/L
8
(4 detections)
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab ram
Page 4 of I I

Inorganic non-metals
Client: ADM Milling Co. Laboratory I D: TCO2075-002
Description: OUTFALL 001 Matrix: Aqueous
Date Sampled:0310112018 1200 Project Name: Stormwater
Date Received:0310212018 Project Number:
Run Prep Method
Anatytical Method
Dilutlon Analysis Date Analyst
Prep Date
Batch
1
(pH) SM 4500-H B-2011
1 03/03/2018 1321 KNI=
66012
1
(TSS) SM 254OD-2011
1 03/05/2018 1617 AJG
66067
GAS Analytical
Parameter
Number Method
Result Q
LOQ Units Run
pH
SM 4500-H B-2
5.66
su 1
TSS
SM 254OD-
62
10 m91L i
LOQ = Limit of Quantitation B = Detected in the method blank E = Quanfitation of compound exceeded the calibration range
ND = Not detected at or above the LOQ N = Recovery is out of criteria P = The RPD between two GG columns exceeds 40%
H = Out of ridding fime W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 6 of I I

Inorganic non-metals
Client:ADM Willing Co. Laboratory I0:TCO2075-001
Description: OUTFALL 001 Matrix: Aqueous
Date Sampled:0310112018 1000 Project Name: Stormwater
Date Receivfed:0310212018 Project Number:
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date Batch
1
(COD) SM 522OD-2011
1 03/05/2018 1405 AMM1
03/05/2018 1036
1
(HEM (oil and) 1664B
1 03/08/2018 0934 ARP
66378
CAS Analytical
Parameter
Number Method
Result Q LOQ Units Run
COD
SM 522013-
54 10 mg1L 1
HEM (oil and grease)
16648
ND 4.5 mg1L 1
LOO = Limit of 4uantitabon B = Detected in the method blank E = Ouantitation of compound exceeded the calibration range
ND = Not defected at or above the L00 N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40%
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc,
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www,shealylab.com
Page 5 of I I

Inorganic non-metals
Client: ADM Milling Co. Laboratory I D: TCO2075-003
Description: OUTFAL•L 002 Matrix: Aqueous
Date Sampled:0310112018 1000 Project Name: Stormwater .
Date Received:0310212018 Project Number:
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date Batch
1
(COD) SM 5220D-2011
1 03/05/2018 1405 AMM1
03/05/2018 1036
1
(HEM (oil and) 1664B
1 03/0812018 0934 ARP
66378
CAS Analytical
Parameter
Number Method
Resutt Q LOQ Units Run
COD
SM 5220D-
63 10 mg1L 1
HEM (oil and grease)
1664B
ND 4.7 mg1L 1
LOQ = Limit of Quantitation 3 = Detected in the method blank F = Ouantitation of compound exceeded the calibration range
ND = Not detected at or above the LOQ N = Recovery is out of criteria P = The RPO between two GC columns exceeds 40%
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 7 of 11

Inorganic non-metals
Client:ADM Miiling Co. Laboratory ID:TCO2075-004
Description: OUTFALL 002 Matrix: Aqueous
Date Sampled:0310112018 1200 Project Name: Stormwater
Date Received:03/0212018 Project Number:
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
1
(pH) SM 4500-H B-2011
1 03/03/2018 1326 KNF
66012
1
(TSS) SM 254OD-2011
1 03/05/2018 1617 AJG
66067
GAS Analytical
Parameter
Number Method
Result Q
LOQ Units Run
pH
SM 4500-H B-2
5.86
su 1
TSS
SM 2540D-
63
2.0 mg1L 1
LOQ = limit of Quantitauon B = Detected in the method blank E = Quant;Mbon of compound exceeded the calibration range
NO = Not detected at or above the LQQ N = Recovery is out of criteria P = The R PD between two GC columns exceeds 40%
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, inc.
106 Vantage Paint Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealytab.com
Page 8ofII

Chain of Custody
and
Miscellaneous Documents
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 9 of I I

n=
oID
p
3
m
n
w
m
b
O
.r^,N SHEALY E1hiViRONMENTAL SERVICES, INC.
SU-4 i ' �r -T l pant m - a Dive • 00 Pax
Nc. 9 -7 ?F171 Murnber f
�i�i '�„� � Cff�ifj Of VilSfOdy Re�i'Qr�d 7e19p�+a Na. �b9-761-��70o Fax Nc_ 843-?Bi-1�1t7
:vsnvr.shealyf$h.atwYr
Rp};K.nyl to C-0fy::F� r �JrP/p[b,}lrkklk Ata i.�ET&] i {al.(lfC' MI.
idurags SvmWr+s ggrmt lac;4 4' 1 IY Mwjktmt :x n 15�j F
�j'� _.. Fss•[a f v
I
P�fgcr new } TC 02075
ary::rfA17 !!V.�,b. ..I rbrr�.aYall 1 ;1 I, i GK'I'
•.$$}} I �. MCn'.ti� v� Are[:;.•v�etaF ' til c .
3ampk- fiJ Il?RwT rar F _.. R? ki 7,mP d ` 9 r ;. r N VI ' ' - -_
:kivu.Lr A' Wq M?O y, rW bOW1MAW fr a� hrr.l i marty
311111
oo
I
raraAMUIrd Tum FaV:hedRAW t2'Dto "ird Ie,ur*wFfl i s roktA .-K-A "4"arr1 ncmfcetrnrr �� cv'Hckwvtrra�fri,lxnwyi
u Slat d& p I t AraNr fL�fi+'cll}'1 _ -- — G 'h+flRR do Gdl;l,.' U �:/ m si..'j' J.ak ZlflWltnzpr.7 7 Fmmrmt a. y_ ^y h r �1n1 W r Pogo -1 llnkr[Fr,-, ���^--
r ,RauV o4'.x o1 - J c7 r, +. Ro
r m r_ cs r _ _ I Ck7 of ` } J _» .. ---- �—
5alueyeaf�! rtr / . r z. ," eew:7 er o-afG Ti'rx
3 sfla:f:y _ Ds:g 76ne 4LRe61E`•in!!:y !].Ww 1!YN _
NeRllrpk6ed 7y � --_ Data rn,_• v�t..IAarmr',)re:�.r-f r� --� k a A Data
Note. Alf 6nR44m Jim reWned for i;ur 4tioakq f(om rrrkgO? _ LAP Z7P,i_4'
fsit?'94 Oi�r amanoa7, on are rttF do. — — 4ece1� w Tz (Offs? r � !� P,yr.,4ilgtiyyLf
plS1R+BlflTt7NON:r:mZ,iY�,:17N-tiaA.rrrm�r5nrsaoryw•.Yr,3pmyrP`s,",e�Y��dk-F!d�d'C!�e,17tC.ty7yli0i5�'YIO!kik.rux-�^r'•.A^a-1�7 CI?eerirwl3elo-;G9�'?•.2�7.'a
n
Z
C
X
O
z
m
Z
r
0
C
n
ch
Z
n

SHEALY ENVIRONMENTAL SERVICES INC.
sf=ly rM%ir0wn= 1 &I"iwa, Ina
Daeutnad Nmn'bw- WPM IaC-12
pmr- I or
Srrectim l tuft; n?,vjr= )a
Sample Receipt Che klist (SRO
Client: _ )`I1 l'}} "I 4 vt r Cooler Inspected by/date: w, zI Lot 0: M 4
IWISL
Mews Ofrecei E$.1 Clicaf LIPS ❑1:edEx LjOrlier:
❑ Yes No
1. Wcrc cusludy scats present on Uic wolcr?
Ycsf ❑ Na I Q NA
2, If-CWtod scats were presew, wrm they fillUict and unbmken7
I, strip ID--- I!S - ir� C1310r•ine Strip IT3 W
Cooler ID .r original lrmpecattim upon receipt ! Derived (CrlrrectM) teniperaturr upon mr-cipt:
Mcahtnd: '_" "" Cure Blatdc 1_b4llrtinsl Bottles IR Cun Ift lR r;un i-arrection Factor:. L! °C
nd of coolant: lot Ice ❑ Icc Pads ❑ Dry le r ❑ None
❑ Yes
El No
1A
3. If"teroperuttue of any cooler exceeded 60C., was Project Manager Notified?
pM was Notified by- phone ! email! i face -to -Cat. (circle me).
❑ Yes
❑ No
EINM4-
15 rite eomtrencial cowiees packing slip wrenched to this f0mi?
Ycs
Cl No
S: Vera proper euswdti proccd=3 (relinquished! received) failoveod`l
es
❑ No
6. Were aarnple lAs listed on the CUC?
❑ No
±. Were sampic IDs listed an all sample conmincrs?
Ll
❑ No
8. Was collection date time listed on the COC?
k
Nn
9. Alas collection dutc & time limd on all sample owtainers"'
)J No
18. Did all confab= Ixbcl irtfurrrnpon (ID, date, tints) agme with the (UC:'1
0 Na
11. Were tests to be pciformed limed on the COC?
❑ ND
12. Did all samples arrive in the prrspcx conminers for rack test arlcl or in goad condition
(unbrokn4 lids on, etc.)7
Yes
Na
113. Was adequate sample: whane availuhic?
Yes
❑ Na
114, W. It samples rcocivW within 'fe the holding tinte or 48 hours, whichever Umies first?
Yes
BNo
115. Were any samples cwitaincrs missing'excess (Circle one) sarnpia% Not listed on COC?
;� Yee
01,40
_ NA
16- For V0 A also RSK-1 `a5 sarttplea, wrap babbles present ('.:"stir 6mm in dlWncter) in
any ofthe VOA vials?
es
No
U NA
17. Were all DROfmctaisinutrient samples received tat a pH of <217
❑ Yes
No
A
l $. Were all cyanide samples recci%, cd at n pi I > 12 and sulfide swupkn received at a pH ; 9?
❑ Yes
❑ No
Y NA
Y"
19. were Nil applicable NHy'I'iCK/cywidm'phcnolt625 ( , 0.5rng/L) samples i5mr, of residual
chlorinen
G
❑ .
�lA
�Ll. 1i+rem client rcmarkx/regttem CLe. requeswd dilutions. MS!MSi) designations, etc... j
corr;`.ctly transcribed from the CW. into the comment section in I.IK1S9
❑ Yea
No
121. Wes the suoft ournber used taken from the container label?
Sample Preserve lion (Must be completed for any sample(s) inmrrectly preserved or with headerilo )
Sample(s) - — _wt:re rrewived inearm.ctly preserved and were ad,}usted accordinpl ,
in sample receiving vthth _(H2SO4, HN01, I -ICI, NaOlf) using SR 4 _ --
Unc of pcMeit'attOn
__were received with bubbles >6 mm in diameter.
Samples(s) _ veers received with TRC > 9.5 rn91 OM9 is no) and ware
.jested accordingly in sl=pte receie7ng.vith sodimn r_hi,mulfttta (Na15,03) with Shealy ID:
SR burendc ksbels applio�d f�i'; Uate: _ � � /�
Comments;
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.sheaMab.com
Page I I of 1 1

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division
of Water QualitPermit No,
Date submitted 117 qRq—QZJVEJ)
CERTIFICATE OF COVERAGE NO. NCG06D _na$�
FACILITY NAME a
PERSON COLLECTING SAMPLES- \J%\J
LABORATORYF_kAjjj,A Lab Cert. #
Par A: StormwatenBenchmarks and Monitoring Results
FACILITY ACTIVITIES INCLUDE (check all that apgpif 7RALPILE,,
PLEASE REMEMBER TO SIGN ON THE REVERSE —)
Total eventroinƒoK2 or//��
Nodischoraethis period'
^ Only applies tufacilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
'ForsannpUn8periodsvvithnod|schargeata2youtfaUs.YoumuststiUsubmitthisdiachumgemunituringnopurtwithacheckmarkhere.
^DenGenera|Perm|ttext,Tab|e3'identifyinQtheuxpeciaUysensidveneceiv|nQwaterc|ass|8:adonswhenethemuvepnotectixabonchmarhapp|ies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? 1:1\esA no
Part B:Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor m| .
IqNew:Mof&�611! sage
^ Only applies to facilities thatue/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
^ForoampUn8periodswithnodisohu[geatanyoudaUs'youmuststU|subm|tthisdischargemuniturin0reportwithocheckmorkhere.
^ See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
complete Part B)
SWU-249 Last Revised: October l8.2O}%

*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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy-ofcopy-of this DAM including all "No Dischar e" reports, within 30 days of recei t of the lab results Lor at end o
monitoring period in the case o "No Discharge" re orts to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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
infKmatioD,jaducling the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr,orglwe,bZwgZws/suZnpde5sw#tab-4
SWU-249
Last Revised: Oc. z 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quail G?neral Permit No. NCGO60000
Date submitted :!r ? ,, ;
7
CERTIFICATE OF COVERAGE NO. NCG06 C7j22 2
FACILITY NAME .441C'6.'A4__ Co.
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY_262!e_,W Lab Cert. #.
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 00 1 *7
[ECEIVED
1!AY 15 2017
I
CENTRAL FILE FACILITY ACTIVITIES INCLUDE (check all that apply): S
L)VI'R SECTION-
E] use/process meats [] use animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES gNO
PLEASE REMEMBER TO SIGN ON THE REVERSE —)
Total event rainfall
21V 'Vor [] No discharge this period'
00tfal[No."
��Samp 6,Collettdd,:�
N4•
Ap. Hi
Neah aidu s;"
Co
7"
M
�hi ndGr�is' "A:3�
'Fecal Col or
if ifi
A
AWMC 1 R'.
=0
"ml 1
on e
A.0 4$ip
--
i7i '
peni66
K'Fz'�A6­
V
4—'--�
,6�
7j�6.6� .m'
T— -
'-
.
V �
w 4:��0ori96
<1 el 5—
Alo4L
<
I Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? [I yes A no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
rtfall,
*Nd.
V
Z
aai4o' �yrll
1111-a ind4rease'
' ' ;
P H
eWNoto& IV
N I[
X �
mo
a
;�560 i,3V
Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at AU out -falls, you must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
yes
, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*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 If 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 copy ot this DMR including all "No Discharge" re orts within 30 days of recei t of the lab results or at end o
monitoring period in the case of "No Discharge" reportsl to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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, incjpding the possibility of fines and imprisonment for knowing violations,"
(Signature of Permittee)
S -- 9,
(Date)
Additional copies of this form may be downloaded at: http://12ortal.ncdenr.org/web/wq/wslsu/npdessw#tab-4
SWU-249
Last Revised: Oc. z 18, 2012
Page 2 of 2

• i
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING -REPORT
for North Carolina Division of Water Quail G neral Permit ;No. NCG060060 f
Date submitted cc
CERTIFICATE OF COVERAGE NO. NCG06 D it.2_r
FACILITY NAME ,4,04 , "li-e-
COUNTY *"eCX&4r Al —
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. #
et v 4ptlffG
SAMPLE COLLECTION YEAR :2 CV G ^r
FACILITY ACTIVITIES INCLUDE (check all Ithat apply): pF�F1�1FC�
❑ use/process meats ❑ use animal fats/byprodJV 14 2016
DISCHARGING TO SALTWATERS? DYES 5<NO
p1r�4tSEGTi��
PLEASE REMEMBER TO SIGN ON THE REVglt.%t4110NPROOSINGUM'
Part A: Stormwater Benchmarks and Monitoring Results/Q,fev
Total event rainfall 2_A2f_ orA�rNo discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100or50
Within 6.0 — 9.0
120
30
1000
500
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at gny outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes A7 no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
(ifyes' complete Part B)
VIS (%,'r-
S�
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18, 2012
Page I of 2

*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 [I NO U
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end o
monitorina period in the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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."
(Signature of Permittee)
r%- 11 /9
(Date)
Additional copies of this form may be downloaded at: http://_portal.ncdenr.org/web/wgLs/su/npdessw#ftab-4
SWU-249 * 0
Last Revised: O*r 18, 2012
Page 2 of 2

L STORMWATER DISCHARGE MO
for North Carolina Division of Water Quail t el eral Permit No. NCG060a 0
Date submitted S` / son
,gym
CERTIFICATE OF COVERAGE NO. NCG06 0 d _2 p SAMPLE COLLECTION YEAR
FACILITY NAME CD. FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY _et1e'C&i eF~J5c/X 6- ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES_ ,8P*-/ DISCHARGING TO SALTWATERS? YES KNO
LABORATORY SjtEX �•�i�,++�'a'rLat�Cert. #1 •
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: 5tormwater Benchmarks and Monitoring Results
Total event rainfall z/ 46 !or
No discharge this peri�
Enterococci��'�� ,
,Outfall iNo"�
;,
Sam Ie:Callected
r .; mo/dd/ r :.:
-TSS� `
,.: m L'. `
H,* ,;
6:4:.ei Rlai^`Ex. T�
Standard:units,:
3 h. COD ,
<�,�1�r:LX'x r Y;
,c:, ,. m L
Oil and;Graase-'?Fecal
c.. �"�`,a� `:P +'+S ? �'�s
--m Ls k� :-:.,..':
Collform
4r �, �x,
Colonies;Y err10Q m1.�,
,
�2-i�e�
. 'Colonies: er 1QQmlp
Benc4imark'-; s
., :.r++. r:_
. ;iQO'or;50 '
.:Within 6 0-9 0 ,
:, 120
,,
_� 30 k -
"` -.1000
—_—_
!.;zY,
< T• J
1t
r !
/7
7 Z2
..
Al
'
1 Only applies to facilities that use/process meats. v�"'J i ►(AL FILES
2The total precipitation must be recorded using data from an on -site rain gauge. °WR SECTION
3 For sampling periods with no discharge at air outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No°
„3
Sam le CoNecte�
P
y me%dd/ r_ �:�,_"
l and Grease ,�
x _� .mg/L
4L� . F wmg/I•� 'F.
pH Yx
r
a. Standard units x�
New Motor011 !Usage,
, AnnWl�avera a al/mo
30 =r,
, r ,>:100 or.50 ,r
�:60 - 9 0,
` Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 IQ ln+'l

"FOR PART A AND PART 8 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 II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ N0�
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one cooir of this DMR! including all "No Discharge" reports, within 30 dabs -of receipt of the lob results (or 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, NC 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."
(Signature of Permittee)
k — .S - /b/
(Date)
Additional copies of this form may be downloaded at: http://Portal,ncdenr.org/web/wq/ws/su/­­npdessw#tab-4
SWU-249
Last Revised: Oc. ,r 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER&HARGE MONITORING REPORT
for North Carolina Division of Water Quali Ge eral Permit No. NCG060000E�EIVED
Date submitted 12
CERTIFICATE OF COVERAGE NO. NCG06 D 0, 9
FACILITY NAME,d.c.► tat rLGr.►.G- CF>-
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. # 32 9
F_ew"C0^.kA` --471'•
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR �2©/ S --tiGNTR;gL FILES
FACILITY ACTIVITIES INCLUDE (check all that apply)pWR SECTION
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ',&0
PLEASE REMEMBER 1.0 SIGN ON THE REVERSE
Total event rainfall 2/.?0 'ror r] No discharqe this period'
Outfall No,..
T
sample_Collected„
.`::mo/dd/ r'•`'-'
'_,' TSS,
�Vmg/L
pH,
Standard units
COD,
nmg/L
Oil and Grease, -
m E
Fecal Coliform' =;
Colonies er 100 ml
:Enterococci,
Colonies-ker 100 mi.
Ainch'niark
� 10b'or. 50
Within 6.0 = 9:0
120
= =30 -
1006
- Soo. F
/1447
O
C /0
C•
Av
.F
to
•
/�1
1 Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new motor oil/month.
.Outfall Nod' R
Sample'Collected,
".mo%dd/ r :
- 011 and Grease,
mg/L
a TSS,=
mg/L P
pH,.
Standard units
:New Motor,Oil Usage,
• .
Annual avers a al%mo';
Benchmark ' ,.
., _ .
30,
,100 or 50
1 Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
a For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
I
(if g& complete Part B)
SWU-249 Last Reviscd: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 2 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 ANYONE OUTFALL? YES ❑ NOeM7
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail on original and one copy of this DMR, including all "No Discharge" reports, within 30 days a recent of the lab results tor at end o
monitoring period In the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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
informatio_,. kcluding the possibility of fines and imprisonment for knowing violations."
(Signature of Perrriittee)
(Date)
Additional copies of this form may be dowriloaded`at: http:/Zportal.ncdenr.ore/web/wg/ws/su/npdessw#ta4)-4'
SWU-249 • • Last Revised: O• r 18, 2012
Page 1 of 2

SEMI-ANNUAL STORMWATER L CHARGE MONITORING REPORT
for North Carolina Division of Water Qua!Ay 9eneral Permit No. NCG060000
Date submitted 1.21 71A1 RECEIVED
CERTIFICATE OF COVERAGE NO. NCGO6QQ-9-f
FACILITY NAME Cn-
COUNTYr!![.�.y13u.C�i
PERSON COLLECTING SAMPLES�•4+..>
LABORATORY_ j2&-jW-/ Lab Cert. # �9
E�v� C o,.,r�,�,r•L
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR _.^201L _ DEC I 1 211114
FACILITY ACTIVITIES INCLUDE (cheek all that apply): CENTRAL FILES
use/process meats ❑ use animal fats/bypromkqtq SECTION
DISCHARGING TO SALTWATERS? DYES 00
PLEASE REMEMBER TO SIGN ON THE REVERSE
Total event rainfall 2 o %/nor ❑ No discharge this period3
Outfall No:
Safnple Collected,
:.. :.
mo/dtl/ r
T55, .:
L.<
rig '
,pH,.'
Standard' units
COD,%
.: s
—MIL.
011 and Grease; , "
m L~:
Fecal Colif6mi ,.,
on -per iD0 ml
Enteracacd;;
4F
,Coloniesi tei iQ0`ml, "
Bericihrriark`
106 , 5
WkfiIn;da=9'0
120.
30:r,:,r
":z, 1000
f41
36
-v
1 Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than SS gallons of new motor oil per month? ❑ yes jkno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
=04tfall No:Y
F .
Sample.Collectietl,
mb%dd/ =
< ,Oil slid Grease,
`m L = h
` _ TSS;,
,, Jm L ; ,„ rr, =
pH,
Standard units:--'
New: Motor 011 Usage,
AnnLW.avera
Benchmark'
30
-100 or'y
6.0 -.9:0
'Only applies to facilities that use/process meats.-
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water -classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
n i r�

*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 II SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO;Rr
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NOea
REGIONAL OFFICE CONTACT NAME:
Mail an orl anal and one cony of this DMR Includin all "No Discha e" reports, within 30 days of receipt of the lab results or at end o
monitor►na period In the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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, includingje possibility of fines and imprisonment for knowing violations."
ap _
( Date
Additional copies of this form may be downloaded at: htt ortal,ncdenr.or web w ws su n dessw#tab-4
S W U-249
List Rcvised: Oc. r 18, 2012