NCG030586_MONITORING INFO_20160928

PERMIT NO.
DOC-TYPE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
/v cc' 03 c
❑ HISTORICAL FILE
A MONITORING REPORTS
I
DOC, DATE ❑ a0# LP D q 2 �/ f
YYYYM M DD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
} Date submitted 0I a t.e. �.
CERTIFICATE OF COVERAGE NO. N0003 O S `d Uv
FACILITY NAME, i`R o, 0�, r�
COUNTY ©r-� S 0y
PERSON COLLECTING SAMPLES
LABORATORY 6,yNraR,v,4c& ChLrs , Lab Cert. # awu -I-AccSL�
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Q
SAMPLE PERIOD ❑ Jan -June Dfuly-Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW [?AQW ❑Trout - ❑PNA
❑Zero -flow ❑Water Supply ❑SA
RECEIVED []Other
SE P 2 g ?fib PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWR SECTION ❑ No discharge this period?z
Outf all 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 W mg/L
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
3
�a
�,0
33
,�
oo��
,4�
05
4
r_
/ #fl
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive bencty arWe' xceedance'*or�the..same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge mo 'toringireport with�axheckmark here.
'The 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.
a 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:
"cased upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(70), 1 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)
cy­�
(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 st 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?"
Outfall.No.
Date Sample
s
Collected �
(mo/dd/yr)
.24-ko' ui vrainfall' ..
u :
amount,.
3
.. � Inches .'
'.Non -polar O&G/TPH by
'.,-,EPA 1664 (SGT�HEM)
Total Suspended Solids .
pH
Benchmarks ==-�'
_ .
_
15 ing/L
100'mg/L or`56 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: 11/1/2012-10/31/2017 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.
r
FOR PART AND PART B MONITORING RESULTS:
o A'BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER ATTHE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION S.
e TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those'persons directly responsible for gathering the Information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

1�
rb'-q'CDENR
Storrnwater Discharge ®utfaii (SD®)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit. http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
Permit No.: N/C/_/_/_../_1 /�/ or Certificate of Coverage No.: N
Facility Name: (21, dv wY, c�h " o,,�
County: Q v-") Phone No. a to - 3 a `A
Inspector: S e. a C-T- En_
Date of Inspection: _ 9 Q, I.11, t o r Fr)
Time of Inspection: - co
�1-
Total Event Precipitation (inches): � �
CENTRAL FILES
DWR SECTION
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
911es 0 No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm.event that measures greater than 0.1 inches of rainfall
I and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
i 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
I .
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 of apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Pe'-mN&e or Designee)
Page 2 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.)cl
Receiving 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: �
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): N GN-,-�,-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 T 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 r2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes �o
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 of 2
5WU-242, Last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Qu lity General Permit No. NCG030000
Date submitted `1 1U- 1
CERTIFICATE OF COVERAGE NO. NQG03 O S a C,
FACILITY NAME•g—
COUNTY__r����� _
PERSON COLLECTING SAMPLES
LABORATORY �tp Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR l
SAMPLE PERIOD Dan -June ❑ July -Dec
or ❑ Monthly' _._(month)
DISCHARGING TO CLASS ❑ORW ZHQW []Trout ❑PNA
[]zero -flow [:]WaterSupply ❑SA
RECEIVED []Other
JUL 18 2u16 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
11WR SECTION
❑ No discharge this period72
Outfall No.
Date Sample.
1
24-hour rainfall.
Total Suspended Solids
pH,
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Total Toxic
Collected
amount,
Standard units
Hydrocarbons
Organic ss
(mo/dd/yr)
Inches3
Benchmarks, _=_>
_
-
100 mg/L or 50•mg/L
6.0'= 9.0
0.007 mg/L
0.033 mg%L
: 0.067 mall.
15 mg/L
1 mg/L
l� �S�L
\��
�• � �
���
. oa
. 1 4
�.
I Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmarkk ezceedance 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.
3 The 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). HLE
GUIr
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1of3

Facilities tha!�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. 1` or 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 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?z
Outfal! No.
Date Sample .
Collected
(mo/dd/yr)'
:24ho6rrainfall
amount, :
.:1nches3 :.. .
Non- polar O&G/TOH'by
-=
`'.EPA"16fi4(SGT-HEM)
Total Suspended Solids
pH '.
Benchmarks �_=>
_ _ .
15'mg/L
100 mg/L or 50:mg/L*•.
6A — 9:O:5u ..
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: 11/1/2012-10/31/2017 '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.
FOR PART A AND PART B MONITORING RESULTS:
0 A BENCHMARK EXC£EDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION B.
0 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 OMR, including all "No Discharge" reports, within 30 days of receipt of the lab results or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Perm
f �f
(Datej
Permit Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

Semi-annual 5tormwater Discharge ine Report
for North Carolina Division of Water Quality General Permit No. NCG03000 t
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 0 S `tip
FACILITY NAME
COUNTY -
PERSON COLLECTING SAMPLES¢_-
LABORATORY(%\ ,carnm-o.nk-, CI\efr Lab Cert. # aaN!?
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR I
SAMPLE PERIOD ❑ Jan -June [j�-July-Dec
or ❑ Monthly' fmont-j
DISCHARGING TO CLASS ❑ORWR ✓❑RQW ❑Trout -❑PNA
RECEIVED
❑Zero-flow ❑Water Supply ❑SA
V ❑Other
DEC rl 0 2015
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWR.SECTION
n No discharge this period?-7
Outfall No.
Date Sample
1
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches"
Total -Suspended Solids
PH,
Standard units
Copper
Lead
Zinc
Non -Polar O&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
01
rezir
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same p rarreter 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 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities bat 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. Forthose 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) r
Title (P int title) T
(Signature) (bate)
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 melL", 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 > SS gal of new oil per month.
No discharge this period?"
Outfall No.
Date Sample
Collected'
(ma/dd/yr)
24-hour rainfall
amount,
Inches .
Nan -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: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Not-2: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 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 QFFICE CONTACT NAME:
Mail an original and onecopy of this DMR including all "No Discha e" re orts within 30 days of receipt of the lab results jor at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified'personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
1 'a \-)—
�iV4
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

LT
WA
`4 f
r I�
WDENK
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
F'orguidance on filling out this form, please visit. httpj,(12ortal.ncdenr.org/web/wg/ws/­su/npdessw#tab-4
Permit No.: N/C/—/—/—/—/ _/ /—/ or Certificate of Coverage No.: IN/�/G/Q/�/�1/// raj/
Facility Name: P'sa\l �_!L1.
County: _Q c�_61�k-_� Phone No. c"l 51>
Inspector: • SR-W Mo'�n_-.� — — — —
Date of Inspection: l 1 f I, I
Time of Inspection: C1'.'�a
�l
Total Event Precipitation (inches):—
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
R(Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm ❑S
event'' or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature oNr t' tee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No.--m a Structure (pipe, ditch, etc.) . U�G!'� C`:.�'•°r' _
Receiving Stream:
Describefetthe mddu�,tri I activities that occur within he(�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:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): o n '�'—
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:
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:
1 [D 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes No
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 of 2
5WU-242, Last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted -I-,\ \3 �S
CERTIFICATE OF COVERAGE NO. N0003 O 5 -
FACILITY NAME dv O-- ,c..,�
COUNTY C�c1 �\ a 1rj
PERSON COLLECTING SAMPLES
LABORATORY E(V,',ronMAck Chc. Lab Cert. # 2015 . O'a0`l1.
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD gJan-June ❑ July -Dec
or ❑ Monthly) (month)
DISCHARGING TO CLASS ❑ORW [;�HCIW ❑Trout ❑PNA r
RECEIVED rED ❑Zero -flow ❑Water Supply []SA
G ❑Other
cENTr�r~ FltFILES��a 2 4 �a�s
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
�
DWR SECTION
❑ No discharge this period.
Outfall No.
Date Sample
1
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Nan -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
OrganicsS
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
3
a1r`ti tS
�Sa
io,5 �, 1L.
�►.CS
Z
.oIQ
oy. It
M ti_
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.
3 The 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
a

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."
S 1 • ,5 r
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 retorted 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 Z, 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
Outfali 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 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: 11/1/2012-10/31/2017 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 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 II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oria_rnal and one copy of this DMIi, including all "Na Discharge" resorts within 30 days of receipt o} the lob results for at end of monitoring veriod
in the case of "No Discharge" reeortsl 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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee
Permit Date:11/1/2012-10/31/2017
I I k-�
(Date)
SWU-245, last revised 10/25/2012
Page 3 of 3

NCDENR
R1FC` r v
Stormwater Discharge Outfall (SDO) M D
AR. Z 6 zi7f5
Qualitative Monitoring Report cENr
�CFILFg
For guidance on filling out this form, please visit: hitp:I/oortal.ncdenr.org/web fwgf ws/su/no # Lab. 4
Permit No.: /C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/-G/O /3
Facility Name: M AV 0""�
County:
Inspector: 5<5�� MCI'- S
,C'� It —
Phone No. "�"� - I-Y1- I
Date of Inspection: _ -�- \ \`- \ \
Time of Inspection: 1 3 4 AV--
Total Event Precipitation (inches): 1 1/,.A
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 an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature o$PeTmittee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No: 3 Structure (pipe, ditch, etc.)
Receiving 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: 0",r<51,P4
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): tU on4--
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 V 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 Z 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 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
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
5WU-242, Last modirted 10/25/2012