NCG080778_MONITORING INFO_20190103

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ a o1 � Q I Ql
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 11112/18_
CERTIFICATE OF COVERAGE NO. NCG08 0778
FACILITY NAME: Republic Services L GDS Cleveland
COUNTY: Cleveland
PERSON COLLECTING SAMPLES: Jerry Powles
LABORATORY: NA Lab Cert. #
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR: 2018
REC1.1 i p� SAMPLE PERIOD ❑ Jan -June ® July -Dec
!I D or ❑ Monthly" _ (month)
JAN 2019 DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
CENT ❑Zero -flow alNater Supply [:]SA
DV+�R SECTIOA,S ❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? w yes x no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
Date
00530
No.
Sample Gallected,
Total Suspended
pH,
Non -Polar Oil and Grease/TPH EPA
New Motor age,
o/dd/,yr
Solids, mg/L
Standard units
Method 1664 (SGT,.HEM_, mgf L
§lIfflV
Annual avera/mo
Benchmark
',
50 or IOD see p 1-tl
01FRit-906.0—-
1
11/12/18
-23 gal/mo.
2
Ill/ 12/18
23 gal/mo.
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
_ 5WO-250 last revised April 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date:11/12/2018 (first event sampled)
Total Event Precipitation (inches): 2.96
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: !f you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II 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 rvpl► of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results (or at end of monitoring period in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date) .._
Additional copies of this form may be downloaded at: http:/Iportal.ncdenr.org/web/wct/-ws/5u/npdessw#tab-4
SWU-250
last revised April 11, 2013
Pnop 7 of

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 7 27 2017
CERTIFICATE OF COVERAGE NO. NCGO80778
FACILITY NAME: Republic Services of N.C. LLC
COUNTY: Cleveland
PERSON COLLECTING SAMPLES: Jeremy Kellam
LABORATORY: Pace Analytical Lab Cert. #
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR: 2017
RECEI1i VEDAMPLE PERIOD ® Jan -June ❑ July -Dec
JUL 3 1 2017 or ❑ Monthlyl (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
CENTRAL FILES ❑Zero -flow Owate► Supply [—]SA
DWR SECTION ❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes X no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
® No discharge this period'
Outfall `^ `
No
t 'Dater r
SampteCoHected;Totarl5iispended`
mo/dd/yr�F'
w 00530
9c -
:,. Solids, mg/L --
004fl0
`` pH �_�
G
yL-+H' ..
y Standardunits
_ -00556
iNon-Polar Oilland Grease/TPH,EPA
, ,.'c.. , .... - -..
-Methoil7ifi64°(SGT=HEM];mg/L
Nevuil111otor'Oi1(Ll ge ,E
Annual average gal/ir�o
BencfmaricF_"
_,_.:.' _.'. _
: 50'or 100Fseepermit
.:Within 60 ; 9..0-,_'_
15
iMel
24.56
Part 8: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
""� �
`rDate�
Sample�Collected,NonPolar
�'z`f It �,.
G:rno/dd/yFn.u(T3.HEM]�mg/L
00556 N's.� ., .
`00530
1
Oil and Grease/TPH�EPAMethod
�
Total Suspended Sof'rds,=
ml
pH; ,-
�F.V
"StandardFunrts.
Per rtmr#
15
50 or-100 see permit
6 0 ' 69:0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date: 6/30/2017 (first event sampled)
Total Event Precipitation (inches): NA
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 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 Discha e" reports, within 30 days of receipt of the lab results Lor at end of monitoring eriod in
the case of "No Discharge' reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible4Quatbrring 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 pena tie_for s Witting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at:
SWU-250 last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report ��
for North Carolina Division of Water Quality General Permit No. NCG0800
e,
Date submitted z ` Z - /
CERTIFICATE OF COVERAGE No. NCG08 0 r] 'I g
FACILITY NAME RWA V C see- iCAf Gas c IeAd 410
COUNTY( _Cl*-J[�
PERSON COLLECTING SAMPLES
LABORATORY K W C 0 Lab Cert. #
Comments on sample collection or analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR 2015
V .
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or Month mon" h
DISCHARGING TO CLASS ❑ORW ]HOW ❑Trout t NA
❑Zero -flow ❑Water Supply ❑sA
❑other
RECEIVED
Lc(, ? 8 �ui9
.ENTRAL FILES
OWR SECTdrw
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
❑ No discharge this period'
outfall
No.
Date
Sample Collected,
mo/dd/yr
00530•- -
.004W :
00556
Total Suspended
Solids; mg/L
_p%
• Standard:units
-Non-Polar Oil and Grease/TPH EPA
--Method 1664 (SGT-HEM); mg/L.
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
SO or.100 see permit
'Within 6.0 — 9.0
15
1113,0115
.S
2.?4
2
• `rz
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ,_,-• yes ,no
(if yes, report your analytical results in the table immediately below)
Part 8: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
outfall
No.
Date
Sample Collected,
mo/dd/yr
00556°: _
00530
00400
Non -Polar l-Fand:Grease/TPH EPA Method : •
1664'(SGT-HEM), mg/L.: j
Total Suspended Solids,
mg/L
pH,
Standard units.
Permit Limit
'50 or.100•see permit
6.0-9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised October 25, 2012
Page 1 of 2

a.
SibRiVl CHARACTERISTICS:
Date III? (fib event sampled)
Total vent Precipitation (inches): 3 • C
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample valve In excess of the benchmark, you must implement rier T, rer 2, or rer 3 responses. See General Permit text
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTIONS.
• 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:
Moil on orlafnal and one coov of this DMX Including all "No Dkschome"reuorts, within 30 days of recelpt of [he lab resultslor- at end of monktorkna oeriod in
the rase of "No Dlscharae" renortsl to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 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 signific4nt penalties for submitting false Information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
/ Z- Z. -
(Date)
Additional copies of this form may be downloaded at:.http://portal.ncdenr.orpJwebLwg/ws/su/npdessw#tab-4
SWU-250
last revised October 25, 2012
Page 2 of 2

4t
ENCO .laboratories
Accurate. Timely. Responsive. Innovative.
102-A Woodwinds industrial Court
Cary NC, 27511
Phone: 919A67.3090 FAX: [phone]
Friday, December 11, 2015
Republic Services of NC (RE014)
Attn: Jeff Wall
1160 Airport Rd
Shelby, NC 28150
RE. Laboratory Ittestelts for
Project Number: Shelby, NC, Project Name/Desc: Gb5-Cleveland
ENCO Workorder(s): C506715
Dear Jeff Wall,
Enclosed is a copy of your laboratory report for test samples received by our laboratory on
Tuesday, December 1, 2015.
Unless otherwise noted In an attached project narrative, all samples were received in
acceptable condition and processed in accordance with the referenced methods1procedures.
Results for these procedures apply only to the samples as submitted.
The analytical results contained in this report are In compliance with NELAC standards, except
as noted In the project narrative. This report shall not be reproduced except in full, without
the written approval of the Laboratory.
This report contains only those analyses performed by Environmental Conservation
Laboratories. Unless otherwise noted, all analyses were performed at ENCO Cary. Data from
outside organizations will be reported under separate cover.
If you have any questions or require further information, please do not hesitate to contact me.
Sincerely,
Stephanie Franz
Project Manager
Enclosure(s)
F1NAi TNI rOpMt relates only to the sample as rQMe oed by thetz w"V, arc may edy be MVWUmd in rtAl. Pg e 1 of S

www.enoolaba.00m
SAMPLE SUMMARY/LABORATORY CHRONICLE
COent 10: dutfall 1
Lab ID: C506715-01
Sampled: 11130/15 13:23 RecWved: 12/01/15 12.00
Eam!ffibs
EPA 1664A
12/28/15
ELLlm1
12/08/15
14:28 12/10/15 12:43
SM 25400.1997
12/07/15
12104115
10:23 12/04/15 1013
Imam Cw"mmene
Lab ID: 001171"2
Sampled: 11130/15 33:35 Received: 12/01119 1200
pall
EPA 16W
12/28/15
Emil
12MIS
14:28/2110/15 12:43
SM 7540a1997
12/07/15
12104/15
10:23 12j04tlS 10:23
FINAL TNI report remcas only to the Umpla a3 roxhea by ma latomamry, and may a* ea rapraduCW in run. I Page 2 of 0

www.encolabLcam
SAMPLE DETECTION SUMMARY
caets TD: Outfatl 1 tab SDI cs0570-01
&Mb6s SAC1 an M & ML uab Hato
Tom Suspended Solids 8.6 2.5 2.5 marl. Sep 25QD-1997
ADS
TOW &xpended SaNds
s m Sea K" Em
7.1 2.5 2.5
mWL
SM 254OD-1997
FINAL TM wort relates only to the sample as ram ed by the Woomd", end may way ba reproeu00 in run. Page 3 of 8

www.encolabs.com
ANALMCAL RESULTS
Description: Outfa 0 l Lab Sample ID: C506715-01 Received: 12/01/15 12:00
Matrix: Surface Water Sampled:11/30115 13:25 Work Order: C506715
Project: GOS-Cleveland Sampled By:Jeff Wall
CCI&wlcal Chemistry Parameters
^ •ACVciyreRrraiYweslta1AC Oil
Anatyta ICAS Numtrerl PAM an yft Qt Mu ML Allub el Analyzed ft tlIMS
Total Susperded sou"A @A Mg/L. 1 LS 2.5 5LA403 SM 2544D-1997 12/04/15 10:23 MMR
Classical Chemistry Parameters
ARM rus Num&l BAND an gnu 21 Ma ML AMI HeMod a 19M
Oil IN Grease (HEM•SM Non -filar Material 2.70 U m0/L 1 2.70 5.00 SL08017 EPA I664A 12/10/15 12:43 SMA
Description: Secondary Containment Lab Sample M. C506715-02 Reeehred: 12/01/15 12:00
Matrix: Surface Water Sampled:11/30/15 13:35 Work Order. CW6715
Project: GOS43eveland Sampled By:Jeff Wall
Classical Chemistry Parameters
^ • EWVGbVaWf0d^V4ftJAC 69tJ
RMM Ekg WIN 11F MRL 121. kuh Mn111Yd Anahasd !1 3=1
Total SuspendedSo0dsA 7.1 MWL I is 2.5 5LO4003 SM25WD.1997 12ID411510:23 MMR
Classical Chemistry Parameters
MAU fCAS Numberl
Oil h Grease (HEM-SGT) Non -Polar Mateial
FINAL
PAM Mg gab 2t MQL ML A= Mdoaiyzed M a=
2.70 U m0/L 1 2.70 5.00 51-08017 EPA 1664A 12/10j15 11:43 SMA
This resort reialr3 onM m we simple as n:wvpp try ure :soorstar, atne may omr be regrneumd h r:a. Page 4 of 8

t(�.�ai.
www.encolabs.com
QUALITY CONTROL DATA
Classical Chemistry Parameters - Quality Control
Batch 8 oom -No MW
Blank (51.04003-61.I(i)
Prepared & Analyzed: 12/04/2015 10:23
Spike Source %R8C
RPO
dnanda
RMR
Ekm
SQL
!hits
Level 121" %REC unju
RPD
Lim Wall.
Total Suspended Solids
2.5
U
2.5
mp/L
LCS (SL0W3-BS1)
Prepared & Aneyee l: 12)04/2015 10:23
Spike Source %REC
RPD
am
Ram
EM
EaL
Unit
Lave} AMad %REC UmUl
RPD
11.1mit i1obeff
Total Suspended Solids
98
2.5
mq/L
too 98 80.120
Duplicate (SL0400)-DUP1) ,
Prepared & Analyzed: 12/04/2015 10:23
Source: C534B81-01
Spike Source %REC
RPD
A1tal1m2
Read
Elsa
IML
Ud u
tAVd R" %REC UnI(A
RPD
Limit 1Notall
TOW Suspended SoIIdS
330M
2500
my/L
33000
0.6
20
Duplicate (5L04003-0UP3)
Prepared & Analyzed: 12/04/2015 10:23
Sourcet C513634-01
Spike Source %REC
RPD
Ailshlte
Read
fka
eau
VEM
Level BeVA %REC LIMN
RPD
LiB>!L 1l
Tool Suspended Solids
290
50
m2/L
300
5
20
Classical Chemistry Parameterm - Quality Control
Batch 5LOB017 - EPA Iof"A
Blank (SL.080174ma)
Prepared: 12JW2015 14:28 Anayred: 12/10/2015 12:43
Spike Source %REC
RPD
AnIm
IiEES1A
Elm
e0l
110Rs
Well g=ft %REC Lk tlti
' RPO
LlEott tl!>56f.
Oil g Grease (HEM-SGT) Non -Polar Material
2.70
U
S.00
m0/L
LCS (SL08017-BSI)
Prepared: 12/08/2015 1+28 Analvzed: 12/10/2015 12:43
Spike Source %REC
RPD
ADahiLe
R=d
SM
BOL
1ldw
Lewd Ray& %REC L(mltm
RIND
)Lmit BRtst
Oil ak Grease (HEM-SGO Non -Polar Material
69.0
5.00
m2/L
7M 89 6+132
LCS Dup (SL08O17-MI)
Prepared: 12/08/2015 14:28 Anetyted: 12/10/1015 M43
Spike Sotttoe %REC
RIND
ABRtttfa
821111E
an
M
1.11E t
Leval 81r a %REC UMb
RIND
911111 mgm
Oil IS Grease (HEM-SGTI Non -Polar Material
59.0
5.00
moll.
75.2 80 6+132
14
34
MOWN Spike (51.0017-MR)
Prepared: 12/08/2015 M28 Ana": 12/10/2015 12:43
Source: 030SLU-01
Spike Source %REC
RPD
AOande
RmuR
EWA
El L
1101h1
Level Soa1R %REC ;ipliEil
RPD
Lim1E Rate_ s
Od & Grease (HEM•SGn Non -Polar Material
16.9
5.00
mp/L
20.2 2.76 U 84 64.132
ANAL This report relates dory to the sample at remmo by the lateratory, and mar onk ba reproduced in roll. I Page 5 of 8

Ce W&
www.encolabs,corn
FLAGS/NOTES AND DEFIRMONS
a The analyte was detected in the associated method blank.
D The sample was analysed at dilution.
3 The reported value is between the laboratory method detection limit (MDL) and the laboratory method
reporting limit (MRL), adjusted for actual sample preparation data and moisture content, where applicable.
U The anatyte was analyzed for but not detected to the level shown, adjusted for actual sample preparation
data and moisture content, where applicable.
E The concentration indicated for this analyte is an estimated value above the calibration range of the
instrument. This value is considered an estimate.
MRL Method Reporting Limit. The MRL is roughly equivalent to the practical quantitation limit (PQQ and is
based on the low point of the calibration curve, when applicable, sample preparation factor, dilution
factor, and, In the case of soil samples, moisture content.
N The analysis indicates the presence of an anatvte for which there is presumptive evidence (85% or greater
confidence) to make a "tentative Identification'.
P Greater than 25% concentration difference was observed between the primary and secondary GC column.
The lower concentration is reported.
Ffwa TNs report r!! s mry to ow sample as re=YM by me WwrWy, and mry m Pr be rpo&KW in U. Page 6 of 8

ENVIRONMENTAL CONSERVATION LABORATORIES CHAIN -OF -CUSTODY RECORD www.enCalabs.[oM
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C3i E.MZ ft 3287� .)ac{�rcmttin, i 1. 3%'-itifiCti•i Carp, NC:7w71
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1160 Ali port Rd
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Totnf G of Containers
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Page 7 of 8

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Sample Preservation Verification Nis ��o
ENCO Cary
Work Order: C508715 Project! GDS-Cleveland
Client: Republic Services of NC (RE014) Project M Shelby, NC
Logged ln: 01-Dec-15 12:08 Logged By- Rachel Ann Yonish
C606715-01
AC
Type
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C
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Rasga 1Ja;
A
1 LA+H2SO4
e2
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7NI
Y/ N
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Rea ern Name 10 Rea ent Name ID Rea ent Name ID
I 31 5
21 41 s
page 8 0

�I f
f
CCDE VAR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
ForB Q uldonce onfilling out this form, pleose visit: htt or a . o eb w ede w#tab-4
Permit No.: JJJ- J of JJ _I or Certificate of Coverage No.: JJSI aQJ
J
Facility Name: SQK,vicGs d Nt . Ll.e
county: Cie
Inspector: � e-9 WC I I
Date of Inspection: It t 3or K
Time of inspection: LZir,Df-�
Total Event Precipitation (inches): 3. d
Phone No.
r.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[Yes 0 No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable'storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee
Page 1 of 2
SWU•242, Last modified 10/25/2012

2. Outfall Description:
Outfall No. if Z Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
_TA. * r Car-( , NcR-on-p-r4= ..
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 6-te
3. Odor: Describe any distinct odors that the discharge may have (I.e., smells strongly of oil,
weak chlorine odor, etc.): 146-4 "
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 0 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 Q 3 4 5
7. Is there any foam in the stormwater discharge? Yes
a. is there an oil sheen In the stormwater discharge? Yes 60P
9. Is there evidence of erosion or deposition at the outfall? No.
10. Other Obvious Indicators of Stormwater pollution -
List and describe i k1L. o Sk o r✓ "W t 44
r' Z Ca rt.",;'�: J e
prC_''�r,bj ' i }-o h,401 4 p ,:4 Je 1 -ta A" "ot Ck. 1::o: +cA,
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 2of2
5WU•242, Last modified 10/25/2012

NON&JORMWATE& 13152j&M KMkq&jL0bjER CA O
Republic Services of North Carolina, Inc. (dba RS-Cleveland)
115O Airport Road
Shelby, North Carolina 281SO
I certify that the stormwater outfall(s) listed below have been evaluated for the presence of non-
stormwater discharges. I understand that this certification must be performed on an annual basis.
Date of
Evaluation
Outfall(s)
Evaluated
Observations
Name
Title
Signature
o
�(�
p vt4ll reed c
�n�►,a<r.� t R�iP �`�
f,cc1(.)
ate , a�
S U�t o
11(3 o K
VIA -e it,
wait
S j pe-A%J S a

SEMI-ANNUAL STORMWATER MANAGEMENT SYSTEM INSPECTION FORM
SYSTEM
COMPONENTS
ACTION
REQUIRED?
Y/N)
COMMENTS
Operating
Equipment
Forklift
fJ
Other Site Equipment
Erosion and
Sedimentation
Control Facilities
Stormwater Conveyance
Channels
r
NS Vt !
Grates
Outfails
Safety/Security
Devices
Gate (Access)
Perimeter Fence
J
Fire Extinguisher
First Aid Kits
f
N
Spill Kits
Communications
Items Subject to
Spills
T1— (2) 55-Gallons Antifreeze
Drums
f
�J
T2 — Lubricating Fluids, Inc
Transmission Fluid, Gear Box
tube and Grease, Stored In
55-Gallon Drums
T4 — Solvent Station
u
T5—10,000-Gallon Diesel
Tank
T6 — 250-Gallon Motor Oil
Tank
T7 — 250-Gallon Hydraulic
Fluid Tank
T8 — 200-Galion Used Oil Tank
T9 — 200-Gallon Used Oil Tank
Inspection Completed by: Date of Inspection: _1r 2,7 0 I f
Time of Inspection: 1 'y 5P ►�

1gC1 lytrcal ®
mvw.peo kb&com
December 09, 2015
Travis Dotson
Republic Services
1220 Commerce St. SW Box 1
Conover, NC 28613
RE: Project: GDS-FOREST CITY
Pace Project No.: 92278137
Dear Travis Dotson:
Pace Analytical Services, Inc,
9800 KinceyAve. Sulte 100
Huntersvllte, NC 2Bc7e
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on December 02, 2015,
The results relate only to the samples included in this report. Results reported herein conform to the
most current TN standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sam pie analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please f eel free to contact me.
Sincerely,
V�t a-� Cr',)4o--
Liamm Harrison
[e-mail]
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
without the written consent of Pao* Analytical servkes, Inc..
Page 1 of 10

Pace Analytical Services, Inc.
na /I,�,�h,�'n�le 9S00 KinceyAve. Sufto 100
Vri/"Uidr�/j ca MuntersvIft. NC28078
www,pac*bs.com [phone]
CERTIFICATIONS
ProJect: GDS-FOREST CITY
Pace Project No.: 92278137
Charlotte Certification JDs
9800 KlnWyAve. Ste 100, Huntersvile, NC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification C 12
South Carolina Certification #: 99006001
Asheville Certification IDe
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87048
Massachusetts Certiticatfon #: M-NC030
North Carolina Drinking Water Certification #: 37712
Florida/NELAP Certification #• E87627
Kentucky UST Certification #: 84
West Virginia Certffication #: 357
MrginlaIVELAP Certification #: 460221
North Carolina Wastewater Cartlfication #, 40
South Carolina Certification #: 99030001
West Virginia Certification #: 356
VfrgfniaNELAP Certlflcation M 460222
REPORT OF LABORATORY ANALYSIS
This report shall not tm reproduced, except In Tull,
without the written consent of Pace Analytical Services, Inc.. Page 2 of 10

aceAnalytica!
www.paCOW&cdrfr
SAMPLE ANALYTE COUNT
Project: GDS-FOREST CITY
Pace Project No.: 92278137
Papa Analytical Services, Inc,
9800 Kinsey Ave. Sufte 100
Hunteravllle, NC 28078
[phone]
Lab ID Sample ID Method
Analysts
Analytes
Reported
Laboratory
92278137001 OUTFALL 1 EPA 1664B
JMS
1
PASI-C
SM 2540D
MJP
1
PASI-A
92278137002 OUTFALL 2 EPA 1664E
JMS
1
PASI-C
SM 2540D
MJP
1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 3 of 10

ceAnalOcal e
wwwpecsfabs,wn
ANALYTICAL RESULTS
Project: GDS-FOREST CITY
Pace Project No.: 92278137
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Hunterevllle, NC 28078
[phone]
Sample: OUTFALL 1 Lab ID: 92278137001 Collected: 12102?15 07:40 Received: 12/02/15 15:08 Matrix: water
Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qua[
HEM, Oil and Grease Analytical Method: EPA 11384E
Oil and Grease NO mg1L 5.0 1 12/09/15 07:13
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids NO mg/L 4.4 1 12/02/15 19:58
Sample: OUTFALL 2 Lab 10: 92278137002 Collected: 12102115 08A0 Received: 12/02/15 15:08 Matrix: Water
Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 16649
Oil and Grease NO mg1L 5.0 1 12/09/15 07:14
2640D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 6.1 mg1L 4.4 1 12102/1519:59
Data: 12/09/2015 02:34 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
without the written consent of Pace Analytical Services, Inc..
Page 4 of 10

CBARaly,frGa1
www.pscelabs.com
QUALITY CONTROL DATA
Project: GDS-FOREST CITY
Pace Project No.: 92278137
QC Batch: GCSV/23474 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664E Analysis Descriptlon: 1664 HEM, Oil and Grease
Associated Lab Samples: 92278137001, 92278137002
METHOD BLANK: 1623361 Matrix: Water
Associated Lab Samples: 92278137001, 92278137002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Oil and Grease mglL ND 5.0 12/09/15 06:59
LABORATORY CONTROL SAMPLE: 1623362
Parameter Units
Oil and Grease mg/L
MATRIX SPIKE SAMPLE: 1823363
Parameter Units
Oil and Grease m91L
Pate Analytical Services, Inc.
9800KInceyAve, Suiteloo
Hunlersvllle, NC 28078
[phone]
Spike LCS LCS % Rec
Cone. Result % Rec Limits Quailtiers
40 34.8 87 78-114
92278164004 Spike NIS MS % Rec
Result Cone, Result % Rec Limits Quaiitiers
NO 40 37.7 88 78-114
Rosufts presented on this page are in the units Indicated by the "Units" column except Mom an alternate unitle presented to the right of iho result.
REPORT OF LABORATORY ANALYSIS
This report shell not be reproduced, except in Puff,
Date: 12/09/2016 02:34 PM without the written consent of Paco Analytical Services, Inc..
Page 5 of 10

IoAnalytical
ttww.peeelabacom
QUALITY CONTROL DATA
Project: GDS-FOREST CITY
Pace Project No.: 92278137
Pace Analytical Services, Inc.
9800 Klncey Ave. Suite 100
Hunten9vide. NC 28078
(7D4)875-9092
QC Batch: WET141707
Analysis Method:
SM 2540D
QC Batch Method: SM 2540D
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92278137001, 92278137002
METHOD BLANK: 1618739
Matrix: Water
Associated Lab Samples: 92278137001, 92278137002
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
ND
2.5 12/02/15 19:58
LABORATORY CONTROL SAMPLE:
1618740
Spike LCS
LCS % Rae
Parameter
Units
Cone. Result
% Rae Limits Qualifiers
Total Suspended Solids
mg&
250 250
100 90-110
SAMPLE DUPLICATE: 1618741
92278100001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mglL
ND
ND
SAMPLE DUPLICATE: 1618742
92278136002 Dup
Parameter
Units
Result Result
RPD Quallfiers
Total Suspended Solids
mgfL
39.3 41.7 6 Da
Results preeerrted on this peat are In the units Indicated by the -Units" column except %here en alMmate unitis presented to the right or the resutL
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/09/2015 02:34 PM without the written oonseni of Paco Analytical Services, Inc -
Page 6 of 10

aceAnalytical�
www.paoslab&com
QUALIFIERS
Project: GDS-FOREST CITY
Pace Project No.: 92278137
DEFINITIONS
OF - Dilution Factor, If reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
J - Estl mated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL - Adjusted Method Detection Limit,
PQL- Practical Quantitation Limit.
Paco Analytical Services, Inc.
9800 KlnceyAvo. Suite 100
Huntersvillo, NC 28078
[phone]
RL - Reporting Limit.
S - Surrogate;
1,2-Diphenyihydrazlne decomposes to and cannot be separated from Azobenzone using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Slllca Gel - Clean -Up
U - Indicates the compound was ana lyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether, Styrene, and Vinyl chloride.
A separate vial preserved to a pH of 4-5 is recommended In SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitroeodlphenylamine decomposes and cannot be separated from Diphenylamine using Method 6270, The result reported for
each anayte Is a combined concentration,
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI -The NELAC Inatitute_
LABORATORIES
PAST -A Pace Analytical Services -Asheville
PASI-C Pace Analytical Services- Charlotte
ANALYTE QUALIFIERS
D6 The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory control limits.
REPORT OF LABORATORY ANALYSIS
This report shed not be reproduced, except In full,
Date: 12/09/2016 02:34 PM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10

Pace Analytical Sorvices, Inc.
8800 KIncey Ave. aCeAnaly�rcaJ` Hunte evllle, NCf28076
www.pacelaUcom (704)87S-B082
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: GDS-FOREST CITY
Pace Project No.: 92278137
Analytical
Lob ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92278137001 OUTFALL 1 EPA 1064B GCSV/23474
92278137002 OUTFALL 2 EPA 1864E GCSV/23474
92278137001 OUTFALL 1 SM 2540D WET141707
92278137002 OUTFALL 2 SM 2540D WET141707
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Date: 12/09/2015 02:34 PM without the written consent of Pace Analytical Services, Inc.. Page 8 of 10

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Page 10 of 10

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted t. I ?a I I it
CERTIFICATE OF COVERAGE NO. NCG08 0 9 9 g
FACILITY NAME "b(: C 2zn eel — ADS ELo_vg Ad
COUNTY Cle+k 14iiAld
PERSON COLLECTING SAMPLES _..
LABORATORY
Lab Cert. g
Comments on sample collection or analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR ZO 16
SAMPLE PERIOD [9 I n-June ❑ July -Dec
or ❑ Monthly( (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
RECEIVED ❑Other
JUL Q 7 tuib PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES o r
DWR SECTION discharge this period
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and G►ease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
S0 or 100 see permit
Within 6.0 — 9.0
15
-
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00M
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
K or sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised October 25, 2012
Page I oft

•' STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches): _
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note. If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or rer 3 responses. See General Permit text
FOR PART A AND PART 8 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION 6.
• 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 EXCEEDANCES 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 cony of this DMR including all "No Dischome" reports, within 30 days of recek t of the lab results for at end of monitoring period in
the case oho Dischame" Marts to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"i certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significynt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature
— 1115-
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org[web/�wgLw5Lsu/npdessw#ta_b_-4
last revised October 25, 2012
Page 2 of 2
S W U-250