NCG030011_MONITORING INFO_20190620

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V �� (� �j1701
DOC TYPE
❑HISTORICAL FILE
Cy MONITORING REPORTS
DOC DATE
❑ lod D (v a �
YYYYMMDD

RECEIVED
Environmental
JUN 7 0 2019
Quality CENT kAL HLE;
Stormwater Discharge Outfall (SDO) S�&,R SECTION
Qualitative Monitor"ing Report
For guidance on filling out this form, please visit https:Hdeq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: NIC16 I U 1.311010 /0 / 0/ or Certificate of Coverage No.: N/C/G/ O I T /01 e
Facility Name: �prgwgrntrrn�q
County: �Zv,d,rsby) Phone No. Z — 3EO 1
Inspector: 5p.tv1«' �1a-1t /. C Ovf.r Qt�6r4-
r i
Date of Inspection: _ _� f 71
Time of inspection: Q t 30 Am
Total Event Precipitation (inches): 0,11
All permits require qualitative monitoring to be performed during a "measurable storm event."
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 DEMLR
Rel3ional Office.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
114 T,,r•c 2di
(Signature of PermitteC or Designee)
1. Outfall Description: Outfall No. f Structure (pipe, ditch, etc.): A &.
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area;
Page 1 of 2
SWU-242, Last modified 06/01/2018

r
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Ita✓
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): o or
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
V 2 3 4 5'
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
V' 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? O Yes ® No.
8. Is there an oil sheen in the stormwater discharge? 0Yes ® No.
9. Is there evidence of erosion or deposition at the outfall? O Yes v No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 9 ook
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further, investigation.
Page 2 of 2
SWU-242, Last modified 06/01/2018

Semi-annual Stormwater D.. _,iar a Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 0 ?�
FACILITY NAME , OMNLYM
COUNTY H* n&rsdV)
PERSON COLLECTING SAMPLES '5o#ACAC e--a►-�C �roylr
LABORATORY Pao- Lab Cert.
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 1-011
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW 2QTrout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?'
Outfall No.
Date Sample
p
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
p H,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks =__>
_
-
100 mg/L or 50 mg/L
6.0 - 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1y q
D. iI
2U.!
G.6
•oc�s-r
�. Go5
. o-rg
C +�.
C,alo
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the -same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Da' 1/1/2012-10/31/2017 SWU-245, last revised ' ^'25/2012
Page 1 of 3

Facilities incorporate a solvent management plan into the Stormwater Pc on Prevention Plan may so certify, and the requirement for TTO , iitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
• , r'. a .-, Le - s . r---C
Name (Print name)
P�_—�_ Hr-- .d-tCe-
Title (Print title)
(Signature) �r�^
1�4I-Q< I
(Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they -must be reported in the format, "<XX me/L where X_X is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
pate Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar 0&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks == >
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date ' 11/2012-10/31/2017 SWU-245, last revised ]' •12012
Page 2 of 3

Note: 'if ydu report a sample value in excess of the benchmark, you must imple... nt 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 ATTHE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART I! SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCP FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES XN0 ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES)KNO ❑
REGIONAL OFFICE CONTACT NAME: L Gct V R ey be-y f
'J :,'r E ev, e- K"C- kevk
Mail an original and one copy of this DMR, including all "No Discharge"reports, within 30 days of receipt of the lab results tor at end of monitoring period
in the case of "No Discharae" reuortsl 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."
.___j
(Signature of Pe
t`I Sum z.Ulg
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Fn vironinen f ui
Quulif v
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance onfflling oul lhisform, please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_IC_I G 101.31.01.01.0 / 0/ or Certificate of Coverage No.: N/C/G/ a / T l0 / C / 1 11
Facility Name:
l -Rorawar' rGrrv�a
County: i ey)d rmn Phone No. r6 z- i ^ 6 614 - 35-0 1
Inspector: e!�-ove.Y De- r4-
Date of Inspection: 6h -7 I I
Time of Inspection: 5. 3a AM
Total Event Precipitation (inches): 0.11
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfali. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
114 T0,,c 2 01
(Signature of Permitted or Designee)
1. Outfall Description:
Outfall No. i Structure (pipe, ditch, etc.): 1
Receiving Stream:
1100ptr5 G rc,e-k
Describe the industrial activities that occur within the outfall drainage area:
Page 1 of 2
S WU-242, Last modified 06/01/20 t 8

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Cleo✓
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): _ y1()_Coto r-
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
V 2 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:
tJ 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
61) 2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes ® No.
8. Is there an oil sheen in the stormwater discharge? oYes ® No.
9. Is there evidence of erosion or deposition at the outfall? O Yes ® No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe I boas
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 06/01/2018

Semi-annual Stormwater Di....haree Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 D Q I
FACILITY NAME 20Woknvjr
COUNTY
PERSON COLLECTING SAMPLES _ ur (�airk/6roVL - r).2,4G1"
LABORATORY Pace Lab Cert. # U
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR _
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW 4Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
[]Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?z
Outfall No.
Gate Sample
Collected'
(mo/dd/yr)
24hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organics
Benchmarks ===>
_
-
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
i7
O ll
w. l
G 6
.009-7
. 0-r9
C �J
� ; 005
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. Far purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Da' 1/1/2012-10/31/2017 SWU-245, last revised 1" 25/2012
Page 1 of 3

Facilities incorporate a solvent management plan into the Stormwater Pc on Prevention Plan may so certify, and the requirement for TTO . iitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
Title (Print title)
(Signature) (Date)
Note: Results must be reported in numerical format. Do not re ort Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
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.
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?Z
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 _ 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date•-'l./1/2012-10/31/2017 SWU-245, last revised 1r'-S/2012
Page 2 of 3

Note: 7f ydu report a sample value in excess of the benchmark, you must imp 1& :.ent 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 [I SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES XNO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YESXNO ❑
REGIONAL OFFICE CONTACT NAME: „ L 6 a
( ey e— vi C i��V1
Mail an oriainal and one copv of this DMR, includina all "No Discharge"reports, within 30 days of receipt of the lab results for at end of monitorina 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
t`4 Znig
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

I
Semi-annual Stormwater Ucharge Monitoring Report
for North Carolina Division of Water Quality General" Permit No. NCG030000
Date submitted
CERTIFICATE OF COVARAGE NO. NCG03 ) 0 1 /
FACILITY NAME 0 tr4 Oa o e,1 0 &v-1 4 t{
COUNTY tj C A e-- o v, _ PERSON COLLECTING SAMPLES n, V-q La Lk Iki r GJ\o,) cf M
a Vt
LABORATORY - F61 C- e Lab Ce . # ; ~
SAMPLE COLLECTION YEAR -2O (,6
SAMPLE PERIOD ❑ Jan -June my -Dec
or [] Monthly' month
DISCHARGING TO CLASS ❑ORW []HOW rout ❑PNA
❑Zero-fiow []WaterSupply [—]SA
Comments on sample collection or analysis: RECEIVED ❑Other
JAN 2 8 2019 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Part A: Stormwater Benchmarks and Monitoring Results
CENTRAL FILE=
G1rdR SECTION
No discharge this period?2
Outfall No. "
Date Sample
Collected-'
. (mo/dd/yr)-
24-hour rainfall
amount,
lnches3'
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks =_->
_
-
100 mg/L or 50 mg/L
6.0 -- 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
0, 00 5
0,0b5
o, 033 i
Z 4, 8
0, a5
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CPR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
j4CVI
Title (Print title)
(Signature) (Date)
Note. Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be re orted in the format "<XX m L" where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z, or Tier responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?'
Outfall "No.
- Date,-Safriple:-
Collected �
{ma/dd/yr);
:'24 li6dr rainfall
amount,
a
w:fnches.
' Non -polar o&G/TPH by ,
EPA 1664 (5GT-HEM)
Total. Suspende.d;5olids.. ,
-,. • .. ..:
. ,. pH
Benchmarks ===>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 sU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
A
Permit D: '/1/2012-10/31/2017 SWU-245, last revised "15/2012
Page 2 of 3

Note: •'lf yoi. sort a sample value in excess of the benchmark, you must imple. t 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 cove of this DMRR including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitorinaperiod
in the case of 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 Permi ee)
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://pQrtal.ncdenr.ore1weblwq/ws/su./n12dessw#tab-4
Permit No.: N/C/ k/o/ 2:�;'/O/O/ glo
Facility Name: 0 J C4 e J
County:
Inspector: l,e u. in t
Date of Inspection: 2 ��+' 8
Time of Inspection: _ _ - =
or Certificate of Coverage No.:
eNo.Z�
-e_V / irrczV,
Total Event Precipitation (inches): 0' l 5
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ 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.
f
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 DWO Reizional Office.
13y thi signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Perini esignee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description: '
Outfall No. I Structure (pipe, ditch, etc.) i
Receiving Stream:
Describe the industrial activities that occur w0in the outfall drainage area:
iM Cc ✓1 U Qi C ` ` CA- Y- ,k a
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: G ( '�-- r, V-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak'chlorine odor, etc.): _4-1 4 _CD S © '-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
6) 2 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: .
2 3 4 5
b. 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes ONo
10. Other Obvious Indicators of Stormwater Pollution:
List and describe C r e, vk to o-4 e 4-
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

­N
CERTIFICATE OF
FACILITY NAM4
COUNTY
ERAGE No. NCG03 O O ! 1
,0�rg1k)Qv,vte- Tr
—��
PERSON COLLECTING SAMPLES _ DEC
LABORATORY /"V Lab Cert. # ,�...
Comments on sample collection or nalysis: Dtr �iTR�� �iLE5
In o f a �J e lJ � _c el, (A V -�
tGi f Vt e U I l / f ! 5 ( (i 0CV,
Part A: Stormwater Benchmarks and Monitoring Results
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
SAMPLE COLLECTION YEAR z di e>
SAMPLE PERIOD ❑ Jan -June my -Dec
❑ Month' ' th
DISCHARGING TO CLASS ❑ORW ❑HQW rout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 -->
No discharge this period?z
Outfall No.
Date Sample
p
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
p H,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks ===>
_
-
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Da' '1/2012-10/31/2017
RECEIVED
DEC 19 2w
CE NTRA; FILES
C7V4rFi L � TJO '
5WU-245, last revised "5/2012
Page 1 of 3

Facilities icorporate a solvent management plan into the Stormwater Pc n Prevention Plan may so certify, and the requirement for TTO , coring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or
Stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
�►�rGvt Lac s"
Name (Print name)
G.v.+Gvi� <Cti
Title ' t title)
(Signature)
12(s-I f8
(Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharge this period?Z
Outfall No.
Date Sample
Collected"
(mo/dd/yr)
24=hour rainfall
amount,
3
Inches
Non -polar o&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or SO mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table S, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

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.
-y
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 ATTHE 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 on inal and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results or at end gf 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 MIDST 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."
—_j — r
(Signature of Permittee)
!Z/S/!?
(Date)
Permit D2 './1/2012-10/31/2017
SWU-245, last revised -15/2012
Page 3 of 3

r�
NCDE R
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: ht;p: (/nortal.ncdenr.org/web/wq./ws f su Inpdessw#tab-4
Permit No.:
Facility Name: or < Wa,r,, e„
County: j e
Inspector: i ke a c= k -� ec
Date of Inspection: 11 t7 i -7
Time of Inspection: 30 A-62
Total Event Precipitation (inches):y' / r"
or Certificate of Coverage No.:
-r k e- d' 1 S 4,f w� 5
Phone No. 63 '2- - 68
^OJe,!' 5--Relr {
-35o1
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ 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 ail 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 DWO Rei;ional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or
)
- LL -f7
SWU-242, Last modii'ied 10/25/2012
Paget of 2

M
,-1k
1. Outfall Description:
Outfall No. i tructure [pipe, ditch, etc. I
Receiving Stream: do 0 �y'S G+ree
Describe the industrial activities that occur within the outfall drainage area: Y► -� C m
2. Color: Describe the color of the dischar a using basic colors (red, brown, blue, etc.) and tint
(light, medium,,dark) as descriptors: C f e a( ►T
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak'chlorine odor, etc.): h 0 0 tlo, 0 ►- _
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
S. 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:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
01 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
B. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence_of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe Y 1 0 6 V O cat S L't .a
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of°2
SWU-242, Last modified 10/25/2012

Semi-annual Stormwater bibchar a Monitoring Report
for North Carolina Division of Water Qu lity General Permit No. NCG030000
Date submitted 1 112 Zdl -7
CERTIFICATE OF COVERAG NO. NCG030 O
FACILITY NAME of CA�V�ed
COUNTY a evkgke Sate
PERSON COLLECTING SAMPLES M,Ke t4k �4,ei %G,r`'ucf +ar+
LABORATORY �Gi-C e- - �^ Lab Cert. # D
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 0 1 7
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthlyl_ I _ _(month}
DISCHARGING TO CLASS ❑ORW ❑HQW rout ❑PNA
❑Zero -flow E]WaterSupply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?2
Outfal! No.
Date Sample
Collected"
.'(mo/dd/yr)
24-hour rainfall
amount,
lnches
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks ===>
-
-
100 mg/L or 50 mg/L4
6.0 - 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
I
/r 1 17
D. !(p
a .
-7, 1
a. 0o6 I
L0, 005
0,007
4 5
4 0,05
I Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2012-10/31/2017 5WU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the 5tormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
AllcL �t
Name'(Print name)
Title (Print title).._�
(Sig attire) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable Jimits, theymust be reported in the format "<XX m L" where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
(Vote. 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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
_
bate sample`' •
Collected 1
.(mo%dd/yr}.
24hour rainfall
amount,
a
Inches �-
Non -polar O&G/TPH by
EPA .1554 (SGT->-]EM}
talpe
'Ta..susnded;5olids.. ,
..
pH ;
� .
Benchmarks =-_>
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 -- 9.0 su
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Dr' 11/2012-10/31/2017 y
SWU-245, last revised ' ^ �').5/2012
Page 2 of 3 ��

Note: -if you report a sample value in excess of the benchmark, you must imple—ent 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 TRIGGERMER 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 copy of this DMR including all "No Discharge" reports within 3t1 da s o recei t o the lab results or at end o monitoringeriod
in the cased "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:
"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 significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
�i zz-�7
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

,I
���
�, .. AL
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
J
For guidance on filling out this form, please visit: httP:4/12orial.ncdenr.org./web/wqlws/su/nl2dessw#tab-4
/mortal.ncdenr.org/web/wq/ws/su/ngdessw#tab-4
Permit No.: N/C/CT/ D/-�/U/D/ e/ p/ or Certificate of Coverage No.: N/C/G/ d/3 q/ R r/ I /
Facility Name: o%r V)a r vt e s a S S+C wt5
County: R e Vx c#�" S� VA Phone No. �28 —6 S 1'/-35C I
Inspector: M', Kf— (—akgln -ems (5f ), 14ctaV-+
Date of Inspection: _T�Z 20/ 7
Time of Inspection: (2 20
Total Event Precipitation [inches): C?, D 0 I
M
JUL 17 2017
CENTRAL FILES
DUIJR SE�TJQN
Was this a "Representative Storm Event" or "Measureable Storm Event" as define by the permit?
(See information below.)
XYes ❑ 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:
of Permittee or Designee)
5WU-242, Last modified 10/25/2012
Page 1 of 2

1. Outfall Description:
Outfall No. 1 Structure (pipe, ditch, etc.)
Receiving Stream: o o e-,f' S C Y, e
Describe the industrial activities 6at oc within the outfall drainage area:
1M R tI u �4 C-+ (4 V I ► L 4
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: G l e a v"
3. Odor: Describe any distinct odors that the d' charge may have (i.e., smells strongly of oil,
weak'chlorine odor, etc.): no 6 D V_ _
4. Ciarity.' Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
/ 3. J 2 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-
2 3 4 5
G. 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:
2 3 4 5
7. is there any foam in the stormwater discharge? Yes Na
B. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence. of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe t< e ct
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of
5WU-242, Last modified 10/25/2012

Semi-annual Stormwater b scharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG030 O r / l
FACILITY NAME 8 Pccj Wav-Vt ef rt L,r V&a- 1
COUNTY e C 0 /`
PERSON COLL£ NG SAMPLES /CFV-0V(-,r
LABORATORY r6i Le- Lab Cert. r�0
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 7—D/ 7
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly" _(month)
DISCHARGING TO CLASS ❑ORW ❑HQW rout ❑PNA
❑Zero -flow ❑Water Supply ESA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?Z
Outfall No.
Date Sample
Collected"
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics5
Benchmarks =_=>
-
-
100 mg/L or 50 mg/L
6.o - 9.o
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
d 2z1�r7
0,081
L..5
6,el
0,0/3
40,005
o.z8(a
G r�-,0
Lfl,O
" Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible forma nag ing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
IIA a ­�4- R; C e,
Name (Print name)
Title (Pri t.title)
--12- 204 7
(Signature) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they_must be reported in the format, "<XX mgjLf where XX is the numerical value of the detection
limit, reporting limit, etc, in mg/L.
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.
Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
-bate'Sample'
1
Collected
(mo/dd/yr),
24'H6 i^rainfall
amount;
3
w_ Inches...
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
..Total.Suspended,Solids...,
pH . .
Benchmarks=_>
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 4.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Dr' 11/2012-10/31/2017 5WU-245, last revised 1^'75/2=2P,
Page 2 of 3

t'
Note: -If you report a sample value in excess of the benchmark, you must implr...ent Tier 1, Tier 1, 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 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART R 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:
Mall an orictinal and one _copy ofthis DMR,_includimi 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."
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htW:Ilportal.acdear.org./weblwq.lws/su/l)pdessw#tab-4
Permit No.: N/C/V/ U/- /.
Facility Name: 0V'4' V-
County: a e- Vx d ` .'-
'�2/ e/ P/ or Certificate of Coverage No.: N/C/ j/ -� ?/ZI e/ r f r/
4,v«.r l Sxs+e��•s
Inc ector• &(r Ke L-o A.1 [ tf-e- V-
p
Hate of Inspection:
Time of Inspection:
7- Z DI 7
i 2 ,2�
Phone No. ZP­6 e `-- 5 !�7
('vl oVk a v-+
Total Event Precipitation (inches): 0, 001
M
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
XYes ❑ 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 DWO Rei;ional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Sigiature of Permittee or Designee)
Page 1 of 2

1. Outfall Description:
Outfall No. �.__ Structure (pipe, ditch, etc.)
Receiving Stream: o o ew- <f-r
Describe the industrial activities hat oc�ur within the outfall drainage area:
IM Gt bI tc - (" C-+ i.c v r V1, C"4'
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C t e C v"
3. Odor: Describe any distinct odors that the d" charge may have (i.e., smells strongly of oil,
weak'chlorine odor, etc.): � U 0yo +f
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
/ 1 j 2 3 4 5
S. 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� 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes oNo
B. is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence. of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe _ I VG t< e, C. 1 4 Vk
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of2
SWU-242, last modified 10/25/2012

Semi-annual Stormwater charge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No. NCG03 0 0 f E
FACILITY NAME Char 1r�ar h e,r -Tke%r,,—al S s e.--S
COUNTY -a a J e,rSo 0"
PERSON COLLECTING SAMPLES Kiel Lath+<,r \ GroJc,( De-Nac-f-
LABORATORY PC C i✓ Lab Cert. #� �d
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR oc
SAMPLE PERIOD ❑ Jan -June my -Dec
or ❑ Monthly' _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQWrout ❑PNA
❑Zero=flow ❑Water Supply ❑SA
❑Other
RECUpLURE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
JAI, 18 "17
CENTRAL ril FS ❑ No discharge this period?'
Outfall No.
Date Sample
1
Collected
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Total Suspended Solids
pH,
Standard units
DWR SECTION
Copper
-
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
s
Organics
Benchmarks
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
{` z� r(o
�•
y.5
—7, f
0.0079
L0,005
0.07y7
4 5.D
40,0p2
1 Monthly sampling (instead of semi-annual) must begisi with the -second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
k See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
RECEIVED
Permit Date: 11/1/2012-10/31/2017 Cit. SWU-245, last revised 10/25/2012
Dv; ; jECTION Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Na a (Print name)
Title (Print title)
(Sig ture) (Date)
Note. Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format: When results are -below the applicable limits, they must be reported in the format "<XX m L" where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
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
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall'No.
Date 5arnple
s
Collected
(mo/dd/yr).
24=hour rainfall
amount,
a
-..Inches.
Non -polar O&G/TPH by.
EPA 1664 (SGT-HEM).
,.Total.Suspended;Solids.. ,
.pH
Benchmarks -__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 - 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit D I/1/2012-10/31/2017 SWU-245, last revised "/25/2012 '
Page 2 of 3

Note: 'if yc,_ . eport a sample value in excess of the benchmark, you must imp. -nt Tier 1, Tier 2, or Tier 3 responses. See Genera! 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 ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an oricinal and one copy of this DMR _includint! all "No Discharge" reports, within 30 days of the lab results Lr 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."
1-10
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Semi-annual Stormwater bibchar a Monitoring Report
'r for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No. NCG03 4 D SAMPLE COLLECTION YEAR -62 0( 0
FACILITY NAME a01-120a r K e d- T eJ'v+ Lk _5 Z S +�e m S SAMPLE PERIOD ;ET4an-June ❑ July -Dec
COUNTY 4C.nQ eJ S 00 � or ❑ Monthly' _ (monthl
PERSON COLLECTING SAMPLES J : 'Le- _ La!:4 i&+tf l (reoucs be 9-tv- ` DISCHARGING TO CLASS ❑ORW ❑HQW tout ❑PNA
LABORATORY Pa C e Lab eC rt. # ❑Zero -flow ❑Water Supply ❑SA
Comments on sample collection or analysis: ❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
ZG16
Part A: Stormwater Benchmarks and Monitoring Results jUJ, I I
,..-,.►-tRAL AILS n No discharge this period:
-12
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
�W R S
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics$
Benchmarks =__>
-
-
100 mg/L or 50 mg/L4
6.0 - 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
(
;5All/(
11500
1510
`7.1
6.C�072
ZO,00.G
0.0`f50
2,71
Z0,0so
'-Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in' 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/2S/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible forma naging compliance with the permit monitoring requirement far total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
A ,�
Name (Print name)
P I cunLi
Title (Print title)
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See Genera! Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
-bate Sample'
Collected
(mo/.dd/yr),
' 24=hour rainfall
amount;
_..Inches...
Non -polar O&G/TPH by.
EPA 1664 (5GT-HEM)
Total. Suspended -Solids . ,
:...:. ;; :...
pH
Benchmarks ==_>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* see feneral Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit D,' 11/1/2012-10/31/2017 SWU-245, last revised 1'1/25/2012
Page 2 of 3

Note: if you report a sample value in excess of the benchmark, you must impit.— nt Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AAND 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 ATTHE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER ATANY ONE OUTFALL? YES ❑ NO ❑
1F 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 Tor at end of monitoring period
in the case o f "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. 1
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
rmittee)
. c -23 !eo
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

►J
Ain
NCD NR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this farm, please visit. htti2://portal.ncdeDr.org/web/wq./m/sulni2dessw#tab-4
Permit No.: N/C/iT/ 0/ 3/0 / p/ 0/2/ or Certificate of Coverage No.: N/C/G/ D/ 3/
Facility Name: gDfq U�a�.naf' _Thsr+M� t �aYS-��.•�5
County: Phone No. 00-6— 61 eel- 3501
Inspector: eVk ,r+
Date of Inspection: 5 — 17 - /.(e
Time of Inspection: 02 : 00 Pk^
Total Event Precipitation (inches): ' / 5; d ►'S " • 'w
Was this a "Representative Storm Event" or "Measureable Storm Event"/sU'defited by the permit?
(See information below.) CEN7,1
DwR sEer��s
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureablestorm 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:
(Sigha#ure of Permittee or Designee)
SM-242. Last modified 10/25/2012
Page t of 2

I. Outfall Description:
Outfall No. , _.�_ Structure (pipe, ditch, etc.) i
Receiving Stream: i-� ooet rS Cr��
Describe the industrial acti ties that occur within the outfall drainage area:
M Ia Vl t- T G r f LA V"t V l 4
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: G ( e e-, ✓-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak'chlorine odor, etc.): k/t O 09VC
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
S. 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:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
B. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence.of erosion or deposition at the outfall?
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
No
Yes No
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 oU2
SWU-242, Last modified 10/25/2012

Semi-annual Stormwater Urbcnarge Monitoring. Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No. NCG03_0y 1 !
`}
FACILITYNAME 04 ri UDC,,,`we?4 l/teiV►,-r,
COUNTY__IA) d rSOL,,,
PERSON COLLECTI SAMPLES_M . kt._
LABORATORY a C e, Lab Certj#
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR C�Z V 1 5 % f
SAMPLE PERIOD ❑ Jan -June duly -Dec V
or ❑ Monthly' (month)
vein Do He r� DISCHARGING TO CLASS ❑ORW ❑HQW, I out ❑PNA
❑Zero flow ❑W t rSu I ❑SA
a e F?1FCErV ❑Other pp y
FF8 ! 16 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CEN-NAL FI
LES
DWI' SECTiO/V ❑ No discharge this period?z
0u#fall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks == >
-
-
100 mg/L or 50 mg/[4
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
i
rr 3v IL'+5
r , 3
D , ca045
61, 8
4 0,005
ta,C�C,, S
p1C,'_32_ -
4 0, 005
<0P002
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the 170 monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TCO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
Stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
-7-o" -Re ji'l`rvt f )0-
Name (Print name) 1.0
Ti (Print title)
(Signature) (Date)
Note: Results must be reported in numerical format. Do not re ort Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period:2
Outfall No.
bate Sample'
1
Collected
.(ma/dd/yr),:
' 24=hour rainfall
amount;
a
Inches. .
Non -polar 0&G/.TPH by
EPXtI664 (SGT-HEM)
TTotal.Suspended;Solids
..
Benchmarks =T->
-
-
15 mg/L
100 mg/£ or 50 mg/L*
6.0 — 9.0 SU
FootAntes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Dr' 11/1/201.2-10/31/2017 SWU-245, last revised " 125/2012
Page 2 of 3

it
Note: if you report a sample value in excess of the benchmark, you must imp)e,..ent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PAP.-AAND PART MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES 1N 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 copv of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina Period
in the case of "No Discharge" reportsl 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 g her and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dir ctly-responsible for Bring the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1
am aware th here a' a significant pdnalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Si
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

_ Semi-annual Stormwater L .narge Monitoring Report
�. for North Carolina Division of Water Quality ualit General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No. NCG03 - D 0 t f
FACILITYNAME o ^c, (�Gi✓' ✓' TIC war` I sy� 5 �'(f S
COUNTY 5 O
PERSON COLLECTING SAMPLES/Vi,Ke
LABORATORY e- Lab ert. ## �{D
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
1`.
SAMPLE COLLECTION YEAR �2 0 15
SAMPLE PERIOD JgJan-June ❑ July -Dec
or ❑ Monthly'^ _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW rout ❑PNA
[]zero -flow []Water Supply ESA
REC81v5% []Other
JUL 09 2C05EAASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILeS
DWR SECTION �
[] No discharge this period
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-ho6r rainfall '
amount,
Inches3'
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks = =>
_
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 m7 g/L
0.033 mg/L
0,067mg/L
15 mg/L
1 mg/L
J
(y Qom' i 5
/
©r i �/ Q�
0 1 "0 0 8 ,�
413
0, 007 1
� 0 O P 5"
i 0711
6
L i Q� S
0,217
' Monthly sampling (instead of semi-annual) must begin with the'second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from.an on-site.rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially,sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes:' For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), l certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
��� rKitJN•r Cron/
Name (Print name)
6 Z2- 0
(Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/t", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sainpie''>'
Collected'
(mo/
-`=241K6ii rainfall
amount,' :
3
lnthes.
'Non -polar O&G/TPH by.
Total.SusndedSolids
pa.d
,pH.d/yr)
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
. * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
�Perrriit D- 1/1/2012-10/31/2017 SWU-245, last revise'-125/2012
Page 2 of 3

Qter ' y report a sample value in excess of the benchmark, you must implk. it 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 ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one coon of this DMR, includina all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitorina period
in the case of "No Discharge" resorts) 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 dir sponsible for gat eying the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware th ere ay significantIties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature
(Date
Permit Date. 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

NCDENR zW4
Stormwater Discharge Outall (SDO) DWRs� c oN
Qualitative Monitoring Report
Forgufdance on filling out this form, please visit: h rtal.ncdenr.or we w ws n dessw#tab-4
G
Permit No.: N/C/-%
Facility Name: F
County: e
inspector:
Date of Inspection:
Time of Inspection:
��gln�GtJ'cti�J `(
e,r spw
'/ y iy
47,'00 �M
or Certificate of Coverage No.: N/C/G/U/3/ a/
tee wLQL sy5'fGw. S
_ Phone No. ZS - 6S - 3 0
l G r,o � e r 0 e H �•r'-�
Total Event Precipitation (inches): �' "' e he 5
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Pl"Yes ❑ 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 DWO Regional Office.
By th ignature,' I certify tjiflt fhis report is accurate and complete to the best of my knowledge:
(Sig lure of Peiee or Designee)
Page 1. of 2
SWU-242, East modified 10/25/2012

1. Outfall Description:
Outfall No. ! Structure (pipe, ditch, etc.)
Receivine Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: s t Itit h roW v�
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak'chlorine odor, etc.): n O d do {
4. Clarity: Choose the number which best describes the.clarity of the discharge, where 1 is
clear and 5 is very cloudy:
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:
(:2 ) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
( 1 J 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes GD
8. is there an oil sheen in the stormwater discharge? Yes 1i0
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of2
5WU-242, East modified 10/25/2012

Semi-annual_Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted / Z
CERTIFICATE OF COVERAGE No. NCG03 d O 1 /
FACILITY NAME (3o,r tDrafine,r e1`o%E1 5 5-few-S
COUNTY 14 e vi eIr so,n
PERSON COLLECTING SAMPLES M,it 1�ak4h4-ar /Groper_be}i<rt
LABORATORY G Lab Cert. # ={p
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR fi0 / y
SAMPLE PERIOD ❑ Jan -June ,July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW 3ZTrout ❑PNA
❑Zero -flow []WaterSupply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?2
Outfall No.
Date Sample
i
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
s
Organics
Benchmarks =__>
_
-
100 mg/L or 50 mg/0
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
I
1r �� ZdrY
a, o5
91 a
6, 2
C .005
.c .005
0-02q,91
4,005
4.0a
1 Monthly sampling (instead of semi-annual) must begin with`the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on-site'rain gauge.. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. Forpurposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
N e {print na e)
Tit itl )
i2 tb /
i (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, N D, or other similar non -numerical
format... When results are below the applicable limits, they must be reported in -the format, _"<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
(Vote: 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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
-Date sample'--
Collected'
(mo/dd/yr),
'244io61r rainfall
amount;
3
Inches
Non -polar O&G/TPH by.
EPA, 1664 (SGT-HEM)
Tota1,Sus pended,Solids
=.
,pH',
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit D, ' 1/1/2012-10/31/2017 SWU-245, last revised '^/29;%_012 .
Page 2 of 3

Note: if you report a sample value in excess of the benchmark, you must impit...,ent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AAND 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 Il 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 on inal and one covy yL this DMR including all "No Discharge" Worts within 30 days of receipt of the lab results or at end of monitoring eriod
in the case of "No Discharge" re12orts) 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 dir sponsible for gat ering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware tharithere arfi significant pe ties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of P
Z /G
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Semi-annual Stormwater rL...charge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No. NCG030 0 _L. 1
FACILITY NAME 19 w V, vt e- r e �r i,, e;L- Sy S frv►� S
COUNTY
PERSON COLLECTING SAMPLES M -3,t
LABORATORY G G Lab Cert. #Q_
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD Sin -June ❑ July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW Trout ❑PNA
❑Zero -flow []WaterSupply []SA
[]Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
-
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organics5
Benchmarks =__>
_
-
100 mg/L or 50 mg/0
6.0 - 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
I
e37
s.3
6
0,0067
Z , C95
,0703
-57,0
.y�g
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2012-10/31/2017
RECEIVED
JUL 15 2014
CENTRAL FILES
a►�Q/§OG
SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the require mentforTTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(Tf0), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
v O Y t CJl li c'c , e
Title ,(P ' t titl
ure)
ld l
(Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)_ _
14=Kour rainfall
amount,
Inches
Non -polar O&G/TPH by.
EPA 1664 (SGT-HEM)
Total Suspended Solids
• . . -
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9-0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
,.Permit P 1/1/2012-10/31/2017 SWU-245, last revises' "'25/2012
Page 2 of 3

'Vote: If ye... report a sample value in excess of the benchmark, you must imp,,_..ent Tier 1, Tier Z 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 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 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 o "No Discharge" re orts 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 qualif�are
el properly gather a d evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dirsible forgather' the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that t ficant pen s far submitting false information, including the possibility of fines and imprisonment for knowing violations."
itteej
710
(date)
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3