NCG060279_MONITORING INFO_20190603

PERMIT NO.
DOC-TYPE
DOC DATE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
❑ HISTORICAL FILE
[XMONITORING REPORTS
a01.t23 k
YYYYM M DD

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
CERTIFICATE OF COVERAGE NO. NCG04 rk )
FACILITY NAME
COUNTY Gt
PERSON COLLECTING' SAMPLES
LABORATORY
Lab Cert. #
Part A, Stormwater Benchmarks and Monitoring Results
Date submitted C — 3 I l
SAMPLE COLLECTION YEAR O
SAMPLE PERIOD ❑ Jan -June ❑ Ju -Dec
or 0JIVronthly' _ (month}
Ili
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow Water Supppl ❑SA
�C!'ther a.T
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats se animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
MM -- NO F LO [J
Total event rainfall' or a discharge this Period3
Out
Date Sample , C
Coili cikd rii dd&o
TSS;., ,
.: ' ' m L` '` .
H, ,.
.;Stenderd'units a
COD,.
,'. 4m .L:. r .
.OII and Grease;
.. :''m L
Fe6l Colifcwm,
Colonies er 300 m1 �
Enteracocci;
"Coionles` er.100.mi
'Benchmark:
"
"lOD`'or'SQ4U'Within.6.D`-`9io'.
120 '
" 30
'10001 ".
5001
Parameter Code
C0530' '
Q040Q`' ,
:0034Q'
00556
31816'
61211' '
' Only applies to facilities that use/process meats,
'The total precipitation must be recorded using data from an on -site rain gauge.
'For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfah.
Did this facility perform Vehicle Maintenance Activities using more than S5 gallons of new oil per month? ❑ yes ❑ no
Permit Date; 11/1/2018-05/31/2021
{ifyes. complete Part B)
SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
- `' ''` i
AS .�
Outfell>No,
,, ={ • "
a Att
Co cted•
to Sanlpl Ile �,
-) R
(md%dd/yr="i«`'��.rs
"I4 rrur?rell�fall,em4urit-
hN
r Y 7
ir�ahea-�n.
era ew,; : to 011;orx
Mo r
iltr " l.f 1 ': 3tM1-n:-fY Wi
=�1lydraullc GIIU�ags G F
_ :G_.
.:t-�
Nan�I'olar 08�t3T;Totalr
Y /
�.. } S. s ! 5.iY 4: ;
}}� P.trolrum Hydra_carbgne;
6 •
TMtaIFSY■ Bnd9:SOlIdY
s P r`
3 .�
^ s.
.:8enchmarkx�,,
a.. -,. Z¢ 'Y
- h?Yy r "N."
r v �� i=
�. k ��t� �- ...,,
+c¢ i :f r >..'t E; .,.Y'SoiS
. r_ ... � • �.. _ �.
�� _ �..
�7fw
�,.., ,� �, r ; A } r � >.«
�- � �„r. -<-
18 rfift�/L�°���.� t t
.1Q4 mg/L.ar 50 ing/L .
V
QlalnRt�l COrIe . tc f
c r t; Z o
r r' i
as : `f. 2 t
— kt
;c0$3a
Footnotes from Part A also apply to Part B
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART ll 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [UNO
IF YES, HAVE YOU CONTACTED THE DEM�RREGI NAL OFFI E? yESffIVO ] 11 11
REGIONAL OFFICE CONTACT NAME: iu�T�C105�b o�c� �I\ 52.ti`OTpAmer"'
V
Mail an original copy of this DMR including all "No Discharge" reports, within 30 days of recel t o 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, NC 27699-1612,
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 Pe
Permit Date: 11/1/2018-05/31/2021
-3��
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO6000a
CEIVED
:
Date submitted - ( _ 3- P
CERTIFICATE OF COVERAGE NO. NCGOA !
FACILITY NAME
COUNTY '�) k
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
JUN 0 7 2019
STa DENR-LAND QUALITY
SAMPLE COLLECTION YEAR ORMWATER PERMITTING
SAMPLE PERIOD ❑ Jan -June ❑ Ju -Dec
or fl�4-Wonthlys month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow Water 5uppl ❑5A
K]O"ther a.S 1J1./
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats se animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
MAY -No FL0DJ
Total event rainfall Z or o discharge this period'
No s
Date Sampl
!�:..
Collected,,ma/dd/
TSS
, , m /La
,
r H.< ,
pOutfall
dad
;COD', „oil
and 'Grease;
Fecal ,C_oliform;
00ml
Coloniese'
Enera`cocci,-
-.Colanies'er 1DD ml
100'or S0"
�Wlthin 6.0`�9 0
"120•
:' ;'' 30 ::
10DO1:
SOD'
Parameter.°Code
`C053D'4`
=00400'~
00340'
• ° 00556-^ " s
' r 31616'
'`61211' `
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at anv outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall,
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes [] no
(if Yes, complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
..,✓,..t sT"xv a- ,ra;1 ta
°�"�- � �, y.
e0utfalllNo:s
�=a . ��_
--r".w'-7. r;. ,»:,r'
`pate Sam Ie�Callected`�`
, ; K (mn/dtl/yr}
"`C , .•c; 5 '?S•" =:' �-y;9 :',.s
�24-haurlralnfalliamount,a
Iriches2 f
ae-,':. -..�. _ -ram. ,v-
"��New�IlAotor 01l�a��
..� �
zjaHydraullc O11,l1sage;��
;��-"1-:#_ "�.' ?r. `I%�; lU: 'WI-1
��'Non-Polar 0&(3�Total -'�-,
_�,:Total'Sua
f P,etroleum;Hyiirocarbons,�,"
�'' . g �
ended 5olldst
- r!"
,Benchma'rks X c i` ,.r.
.,.. / +`+i ri.3` 7.V',i�
� � d ., , r ti
T-'��f�lij .s�'.i:'Lv'.h
er 1 . , r , %�
,�,,.- 2.tY,�
t��
(`.�1'�•f.� '±Slfi-+ - �7 �.4,%'Lf t
w �.,,,15 mg/L°ems .
'.b
�K E. i ` 4�ir[i
lOQ;mg%L or 50:mg/L
P',
_arameter Cnde
r 44.- t , !"
r, •48529 ' r �;
�4":
1' 'i W'f - �' ::zs
ram, 'NCOIL, ` ..♦y�
+ t' `ilia _stom
Ise00552.,y,
Footnotes from Part A also apply to Part B
*FOR PART A AND PART B MONITORiNG RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART It SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART ll SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES MO i]
IF YES, HAVE YOU CONTACTED THE D M R REGIONAL OFFI E? ES E NO � l
REGIONAL OFFICE CONTACT NAME:O`CS-bt�ot�
Mail an original copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results or at end of monitoring period in the case
of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617,Mail Service Center
Raleigh, NC 27699-1617—,
YOU MUSTSIGN 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 violatijLps.� _
Signature of
Permit Date:11/1/2018-05/31/2021
-3��
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted �, _ 1_1- I
CERTIFICATE OF C RAGE NO. NCG �, !
FACILITY NAME(l��C�l�
COUNTY f1
PERSON COLLEC�TTI~~N SAMP ES c\
LABORATORY_t`J,t�%%C Rom_�CA Cert.# o1�
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 0,01'�'l
MAY 0 0 201.)
DENR-LAND QUAL11
STORMwATER PERMITTING
SAMPLE PERIOD ❑ Jan -June ❑ J ly-Dec
or ©-f9lonthlys f� month
DISCHARGING TO CLASS ❑ORW ❑HQW -]Trout ❑PNA
❑Zero -flow ❑Wat r Siup ❑SA
�8tfi e rs� �, �L�%
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
j)
Total event rainfall 2 l� or ❑ No discharge this period'
Outfall No "
, . pate Sample
Collected,'nio/dd/ r
TSS,
-� 'rrtg/L
hpH,
, Standard:units
m /L . _..
r�
mg/L,
F ecalaoliform,
=
Colanles et 300 ml.
Enterococd;
Colonies er 100.mi
:benchmark
`100'ar 504
w Withlri�&D L 9 0
120
l _'30 ,
1000E
.500'
Parameter'Code
°' • "
' ' C0534 " '
00400 _'"'
`00340`'
3161G
61211
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? yes ❑ no
(ifyes, complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results. only for facilities averaging > 55 gal of new motor oil/month.
^' '
., .<Ou-tfall No,.,r•.
Dati3;Sample Collected
z
(mojdd/yrj
24 hour°ralnfall,amount,
;„,r.,�,,f t7'
Inches
New�Motor Oli or E
, t� i
Hydraulic 011,Usngq
,.Non-PoIar,0&G/Total`„
k< a t A
!,petroleum,Hydibcarbons:
..`
TotalLSuspended Solids :.
..
-�
Serarhmarks �.
f�. �- x x;.'�
15 mg/L a
, ._ 4r-
o rn ar 50:mg/L, '
P,crameterCode :`''L ,*
" 46529`a
00552
C0530 t
_
a s
s.
Footnotes from Part A also apply to Part B
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER i 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES gNO ❑
IF YES, HAVE YOU CONTACTED THE DE L REG{G+IONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME: � (\q tSCty a
-j
Mail an original copy of this DMR,_ including all "No Disch_arae" reports, within 30 days of receipt of the lob 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, NC 27699-161Z-
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 violatigps.." _
Signature of Pe
If—M —
Date
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000�j
Date submitted � — ICA— I l ' 1 ��►
CERTIFICATE OF C RAGE NO. NCG !
FACILITY NAME
COUNTY
PERSON COLLECTIN .SAMPLES t�
LABORATORY �e is C Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR . QQ l� AY 05 2013
SAMPLE PERIOD Sri DRNR-tjND
❑ Jan -June ❑ 1 ly-Dec ORnq QU
or [ onthly' �'` m.",h) ERP6R 7'tAt/Nc
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Wat r Ship ❑SA
�r�as,5 `' } tt__/
-T-
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall )�o� or ❑ No discharge this period'
OutfalL No.
Date Sample - ; .
Collecte'tl'' mo dd/"r
TSS,
" :' m L. > ..
r,; �pH,
x:Steriderd:'units ,
COD,
Ft . mr L'
t Oil and Grease,
W ' +` m L
Fecal.Cnliform,
Cofanles° er 100 m1
Enterococd,'
, :Calonles er 10D ml
400 or, 50'.'=
_Mithln�6.0`"-- 9 0}
100D'. '' . .,
5001
Parameter'Code:
7�X00340uri
' ' �'`00556, -3
"� �-31616' ,
61211:
1
0
lv.
30
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at"outfalls, You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? Pry -es ❑ no
Permit Date: 11/1/2018-05/31/2021
(if yes, complete Part B)
SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new motor oil/month.
°1-;.
~ c' Dut all. �1C
7 • f•^fr
-Datie Sam "IeiCollectad,
pr -
C'Y'f�S
,, �ma%dd/vr1. h�
-24�haur �alnfall amount
.-' 'h. r . i- fil a�.�
- ram,''- i i iYr3f Ff`{
�, > x Inchesliydraullc
NewtMator�0lk,nr;
l" 5:ln3t
- 3r r i
OII UMap-
IVon=Poli�r,0&a Total
°/' r. e-._�;•'�
*Patrolaum Hydrocarbons
r=
t.SaTOtBI'~Ji�� 8nde' &SaliiLlS
re,_: r•"1 _N ;�,
-r s{q;ys. i�}y-r H� a3t , 1
9-1 aXY`;. ?y i'�L 2'�`NF• -3^€
[ Z'.:1 a'�.fi" 1�1� - �t
8�s �, .i"-- 1 r:.-
�.:Y' �' 4t�r_
.380mg/l c`t} rrig/l
- P,
€
'-6529"r
r ._NC-.
r.:.
0530 ,s
_a =79a
s
Footnotes from Part A also apply to Part B
cr�"C"Ua� cwl�
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE. PERMIT PART ll SECTION B.
*tea-)8
• 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 gNO
IF YES, HAVE YOU CONTACTED THE DE L RE{G�ION,�L OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME: 6 �'C� ►Uri �� is+[`! �N
Mail an original copy of this DMR including all "No Dischar e" reports, within 30 days of recei t o the lab results or at end o monitoringPeriod in the case
of "No-Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617,,Mail Service Center
Raleigh, NC 27699-1612L—
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 violatiQps."
Signature of
— t
Date
Permit Date: 11/1/2018-05/31/2021 5WU-249, last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
CERTIFICATE OF C RAGE NO. NCG04 G_9 i `
FACILITY NAME It's �0.0
COUNTY
PERSON COLLECT G SAMPLESCk
LABORATORY 4=j\Vti M tV\ Cert.
Date submitted 3 ~ S-" 19
a
�,PR i � 2019
SAMPLE COLLECTION YEAR ao19,
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or [PiVfonthlyl- WPC( s (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow []Watersupply ❑SA
PMher S C �SVl1
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
�1
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 . or [:]No discharge this period
Outfall No.
Date Sample
Collected, mo/dd/yr
TSS,
mg/L.
pH,
Standard units.
COD;
mg/L.
_ Oil.and:Grease,
mg/L
Fecal Coliform,
Colonies. perV100 ml
Enterococci,
Colonies.per 100 ml
Benchmark':.
-
100 or 504 ; .
• Within 6.0 - 4.0;
120
30
10001
5001
Parameter Code
-
C0530' -
00400
00340'
00556
31616
61211
S
' Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
'For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here,
'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? yes ❑ no
(ifyes, complete Part B)
Permit Date: 11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No:
Date Sample Collected:.
(mo/dd/yrj
24�hdur rainfall amount,
2 .:..
Inches ..
New Motor Oil or °.
F
Hydi aupc:O11 ))sage : ;
Non-Poiar'O&G/T6tal5 =
Petroleum _Hyd�oca_r6ons
`
Total Suspended Solids
Benchmarks'
Y`
�;,.r t �,. = 'z
" w
15tiiiig/L
100riig/L�or50rt►g/L°
Pbrameter Cade`.
_ 4fi529
NCOIL'
-00552,,
C0530 .
' ►
s
�.
Footnotes from Part A also apply to Part B
*FOR PART A AND PART B MONITORING RESULTS:�S1mo��
• 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 S TION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR T E SAME PARAMETER AT ANY ONE OUTFALL? YES MNO Q
IF YES, HAVE YOU CONTACTED THE DE 4 REGIO AL OF CE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results or at end of monitoring period in the case
of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
161-,Z,Mail Service Center
Raleigh), NC 27699-1617,
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the.best of my knowledge and
belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations.; _
Signature of Per
Permit Date: 11/1/2018-05/31/2021
--
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT �
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG0600 0 EV E D
CERTIFICATE OF PVERAGE NO. NCG06�
FACILITY NAME' O {'AA
COUNTY Z)LkQ: [\
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. k
Part A: Stormwater Benchmarks and Monitoring Results
Date submitted 3 4 S— C L
SAMPLE COLLECTION YEAR a 19.
MAR 1 12019
CEN'7-fRAL FILES
01P!R SECTItJst
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ❑1 - onth(month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero-flo ❑Water Supply ❑SA
Other 7QS S C i Svtf
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
�PEKUA (�Y- NO �-- L6 W
Total event rainfall 2 or PRNo discharge this period'
Out#all Na.
Date Sample
Collected, mo/dd/ r
TSS,
mg/L
- pH'
Standard units.
COD,
mg/L
Oil and Grease,
mg/L
Fetal Collform,
Colonies e..r 100 mi
Enterococcl,
Colonies per 100 ml
Benchmark , °
-
100 or 504
Within 5.0 - 9.0'
120
30
10001
5001
Parameter Code
-
COS30
00400
00340
00SS6
31616
61211
'Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
'For sampling periods with no discharge at anv outfalls. You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes ❑ no
(if yes, complete Part B)
Permit Date: 11/1/2018-05/31/2021 5WU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Date Sample Coliected
(mo/dd/yr)
24-hour.ralnfW amount,
Inches,
New Motor 011 or
Hydraulic OII-Usage
Non -Polar O&G/TotaL
Petroleum Hydrocarbons
Total Suspended Sollds
Benchmarks
- '
= '
15`mg/L'
100 mg/L'or 50 mg/L°
Parameter Code
-
46529
NCOIL .,
00552,
C0530
Footnotes from Part A also apply to Part B
*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 S CTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR E SAME PARAMETER AT ANY ONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTACTED THE D R EGIONAL FF CE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME-. 1 S
Mail an original 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" reports) -to:
Division of Water Quality
Attn: DWQ Cenral Files
1617,Mail Service Center
Raleigh, NC 27699-1617,
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and
belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violatikns."
Signature of Pe
Permit Date: 11/1/2018-05/31/2021
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG06000[�,. ECEIVED
Date submitted a- � I MAR 11 2019
CERTIFICATE OF C VERAGE NO. NCG06O r� SAMPLE COLLECTION YEAR O 9 CENTRAL FILES
EArYR
FACILITY NAME 0 SAMPLE PERIOD ❑ Jan -June ❑July -Dec
COUNTY
PERSON COLLECTING SAMPLES or RMonthlys Cbll�ux' month
LABORATORY
Lab Cert. #
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]Zero -flaw ❑Water Sup ly []SA
�ther 9S � _M
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall' or 12<0 discharge this period'
Outfall No.
Date Sample
Collected, mo/dd/ r
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform,
Colonles er 100 ml
Enterococcl,
Colonies per 100 ml
.Benchmark
100 or 501
Within 6.0 — 9.0
120.
­ 30
10001
5001
Parameter Code
-
C0530
00400
00340
00556
31616
61211
1 only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
"see General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes ❑ no
(ifyes, complete Part B)
Permit Date:11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfail No,
Date Sample Collected
(ino/dd%yr�
-24-hour_ralnfall amount,
Inches 2 '
NewiMotor-Oil or
Hydraullc 0l[Usage
Non -Polar O&G/Total
Petroleum Hydrocarbons ;
Total, Suspended Solids
Benchmarks
-
- '
-
15 mg/L
100 mg/L or 50 mg/V
Parameter Code
46529
NCOIL
00552—
C0530
Footnotes from Part A also apply to Part B
*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 D L R GiO AL OF FICA. Y 5 4 NO
REGIONAL OFFICE CONTACT NAME: \ \
Mail an original copy of this DMR including all "No Discharge' reports, within 30 da s of receipt ot 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
161.7,Mail Service Center
Raleigh, NC 27699-161.7\
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 Pe
Permit Date:11/1/2018-05/31/2021
a-
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted ) - '5 � 19
RECE ED
!� Q FEB 01 2019
CERTIFICATE OF ERAGE NO. NCGOA 1 SAMPLE COLLECTION YEAR Oy _ CENTRAL FILES
FACILITY NAME C e FACILITY ACTIVITIES INCLUDE )check all that apply): GIrVR SECTION
COUNTY c� ❑ use/process meats use anlmal fa,/byproducts
PERSON COLLECTING SAMPL S o DISCHARGING TO SALTWATER5? [:]YES
LABORATORY Cert. #
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
1
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall or ❑ No discharge this perlod3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m /L
Fecal Collform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
1o0 or 50
Wlthin:6.0 — 9.0
120
30
1000
Soo
Q
S
--, -
111
C 1
tiS
��
AZ
l Oniy applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at aann y outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies,
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mold r
Oil and Grease,
m L
TSS,
m L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
S
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at � outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART It SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO THE SAME PARAMETER AT ANY ONE OUTFALL? YES WNO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFIC % ES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to. -
Division of Water Quality
Attn: DWQ Central Files
1617-Mall Service Center
Raleigh, NC 27699-1612-
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
(Date)
Additional copies of this form may be downloaded at: http;//portal.ncdenr.o[g/weblwq/ws/­su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted l�— C ! 1 8
CERTIFICATE OF FJDVERAGE NO. NCG06 aa
9
FACILITY NAME
COUNTY
PERSON COL�G SAMPLES
LABORATORY
Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR dQ I u
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats [Ef use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES [q'60
PLEASE REMEMBER TO SIGN ON THE REVERSE '�'i
Total event rainfall or 9No discharge this periori3
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
m /L
pH,
Standard units
COD,
mg/L
oil and Grease,
mg/L
Fecal Collform ,
Colonies per 10D ml
Enterococcl ,
Colonies per 10D ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
' Only applies to facilities that use/process meats. n O� /��B Eke it O F�_OVU , J
ZThe total precipitation must be recorded using data from an on -site rain gauge. j V v 1 V lJ
s For sampling periods with no discharge at aM outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mold d r
Oil and Grease,..
m L
TSS,
m /L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0'— 9.0
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART It SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SE TION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR HE SAME PARAMETER AT ANYONE OUTFALL? YES [VNO ❑
IF YES, HAVE YOU CONTACTED THE D RE ION OFFICE? YES y❑ NO t
REGIONAL OFFICE CONTACT.NAME:l L
Mail an original and one cony of this nMR, including all "No Discharge" reports within 30 daVs.of receipt of the lab results for at end of
monitoring period In the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
161;LMaii Service Center
Raleigh, NC 27699-161'4?.
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
1a-,-+ - M
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.or Zweb/wg/ws/su/npdessw#tab-R
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qualit General Permit No. NCG060000
Date submitted i --- -- a
CERTIFICATE OF CPqRAGE NO. NCG066 SAMPLE COLLECTION YEAR Cx O l 3
FACILITY NAME 05 m L FACILITY ACTIVITIES INCLUDE (che k all that apply):
COUNTY , _ ❑ use/process meatsse animal ats/byproducts
PERSON COLLECTING-
SAMP ES �` l I—�',I5CtiARGING TO SALTWATER5? ❑YESNO
LABORATORY____ �� � (b QAj,�, Lab Cert. #
NUV 15 2018 PLEASE REMEMBER TO SIGN ON THE REVERSE -i
.;ENTRAL FILES t l
Part A: Stormwater Benchmarks and Monitoring Results rstnr;? fiPr .TIQNI Total event rainfall 3 or ❑ No discharge this period]
Outfall No.
Sample Collected,
mo/dd r
TSS,
m L
pH,
Standard units
COD,
mg1L
Oil and Grease,
m /L
Fecal Coliform ,
Colonies per 100 ml
Enterococd ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9,0
120
30.
1000
S00
1
i
Only applies to facilities that use/process meats.
x The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? [yes ❑ no
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo dd r
Oil and Grease,
m L
TSS,
m L
pH,
Standardunits
New Motor Oil Usage,
Annual averse al mo
Benchmark
-
30
100 or 504
6.0 - 9.0 1
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge,
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 W U-249
{if es, complete Part B)
Nov 13 2018
DENR•LANO QUALITY
SrORMWArR PERMITTING
Last Revised: October 19, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART It S CTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO THE SAME PARAMETER AT ANY ONE OUTFALL? YES V NO ❑
IF YES, HAVE YOU CONTACTED THE DW REGiON L OFFI E Y ❑ NO
REGIONAL OFFICE CONTACT NAME: i �
Mail an original and one copy of this_DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
161:LMail Service Center
Raleigh, NC 27699-1617—
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Pe
U-
(Date)
Additional copies of this form may be downloaded at:.http://portal.ncdenr.orglweb/wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October IS, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality Gerieral Permit No. NCG060000
Date submitted 416 It -- 1 zs
CERTIFICATE OF C ERAGE NO. NCG06Ck' SAMPLE COLLECTION YEAR -
FACILITY NAME U6QVV �1 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ❑ use/process meats O�use animal fats/byproducts
PERSON COLLECTIN SAMPLES(IS I E DDISCHARGING TO SALTWATERS? ❑YES Nf6b
LABORATORY Lab Cert. #
2018 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES 2
Part A. Stormwater Benchmarks and Monitoring Results nIA/s? ��r.T,r,, , Total event rainfall or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m /L
Fecal Coliform ,
Colonies per 100 ml
Enterococci I,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6:0 — 9.0
120
30
1000
S00
Only applies to facilities that use/process meats. ��J� , err Go i �4n1n
zThe total precipitation must be recorded using data from an on -site rain gauge. {tic k (� C'MW (}[ 1
3 For sampling periods with no discharge at an outfalls. You must still submit this ar a monitoring report with a checkmark here. C L R�
P g P g g g P
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfail No.
Sample Collected,
mo dd/ r
Oil and Grease,
m L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or S0
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at AU outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
C A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART 11 SECTION B.
C 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART it 5 CTION B.
C TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO THE SAME PARAMETER AT ANYONE OUTFALL? YES] NO ❑
IF YES, HAVE YOU CONTACTED THE D�1! R IO L OFF C Y S ❑ NO �]
REGIONAL OFFICE CONTACT NAME. \
Mail an original and one covy of this DMR includin all "No Discharge" reports, within 30 days of recei t of the lab results for at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1612—Mail Service Center
Raleigh, NC 27699-1612.
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
(Date)
Additional copies of this form may be downloaded at:.http://portal.ncdenr.org/web/`wq/ws/su/­npdesswtttab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted C.--_(z I U
CERTIFICATE OF CO ERAGE NO. NCG06O
FACILITY NAME S C
COUNTY Q WV
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. #
Part A. Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats N'Ce animal fats/byproducts �UA4
DISCHARGING TO SALTWATERS? DYES R WO '°FR4In.NG
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfo/1 a or VNo discharge this period'
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
m /L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m /L
Fecal Collform ,
Colonies per.100 ml
Enterococck ,
Colonies per 100 ml
Benchmark
-
200 or 50
Within 6.0 — 9.0
120
30
1000
50o
' Only applies to facilities that use/process meats.�n 1 I l �: �f,V (~) O
2The total precipitation must be recorded using data from an on -site rain gauge. [� C�
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Simple,Colkected,;
mo dd/ r•
OII and Grease; ..- :.
m L..
TSS,
mpIL
pH,
Standard units
New Motor Oil usage,
Annual average al mo
Benchmark
30
100 or 504
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at anv outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
RECEIVED
SEP 12 2018
SWU-249 Last Revised: October 18, 2012
Page l of 2

*FOR PART A AND PART B MONITORING RESULTS:
C A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II S TION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR HE SAME PARAMETER AT ANY ONE OUTFALL? YES [NO
IF YES, HAVE YOU CONTACTED THE D R GI NA OFFIC ? YE5��NO, M
REGIONAL OFFICE CONTACT NAME: \C��
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results tor at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
161;.Mail Service Center
Raleigh, INC 27699-1612
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 Perris
( `-' C — t
(Date)
Additional copies of this form may be downloaded at: http-.flportal.ncdenr.ori?Zweb/wq/ws/suingdesswttab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted '� _ ,~ 1�^
CERTIFICATE OF CO RAGE NO. NCGO
FACILITY NAME Q f'�1clC
COUNTY
PERSON COLLECTING SAMP ES Q 5o ct T
LABORATORY_ U, f 0*EM Lab
Part A: Stormwater Benchmarks and Monitoring Results
APPROVED FOR
PAYMENT
SAMPLE COLLECTION YEAR alb AUG 0 71013
.�'+ FACILITY.ACTIVITIES INCLUDE (c ck all that apply): 13y
FV r E (V kEfl use/process meats Muse anima fats/byproducts
A 1 0 WS� IARGING TO SALTWATERS? [:]YES NO
CENTRAL R ES PLEASE REMEMBER TO SIGN ON THE REVERSE �
GV/R bECTION
Total event rainfall zA or ❑ No discharge this period?
Outfall No.' '
: Sample' Collected;
mo/dd/yr
f' : •,TSS
--mg/L
:pH;
Standard'units
coo.,!Oil
mg/L
and Grease,
mg/L
Fecal Coliform ,_
Colonies per`100 ml
Enterococci ,
Colonies per 100 mE
Benchmark,100
or 50:. }
';Within:6.0 - 9.0
r4120:.1, .
.,30 , .:: _
< , •. 1000i1.
500 '
r1kAIA
1 Only applies to facilities that use/process meats.
zThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes ❑ no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
a0atfall No
Sample Collected„
.;.
m'o/dd/. r .
,- Oil:and Grease, , `"
f�
•: - mg/L,
TSS,
h mg%L •
pH„
Standardunits
New Motor O1I Usage,
Annual average.gal/mo
Benchmark;
-
30
100 6r'50
6.0 — 9:0"
-
G
1 Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at anv outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 1$, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER i REQUIREMENTS. SEE PERMIT PART li SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II jCTION 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 D RE �ON �OFFI�E_?l� �YES ❑ NO
REGIONAL OFFICE CONTACT NAME: ml-ACs�l� �T`&_S -cy
Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results or at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1612-Mail Service Center
Raleigh, NC 27699-1612
YOU MUSTSIGN 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
1�-31- �%
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4 `
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality G neral Permit No. NCG060000
Date submitted _�
CERTIFICATE OF C ERAGE NO. NCG066 U 9
FACILITY N ME OS2MA1' e t
COUNTY
PERSON COLLEC NG SAMPLES 5 S ot` , 0 0C
LABORATORY_ I:Z;� _4 tt r, Lab Ce . # °��
IQ
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR M)
FACILITY ACTIVITIES INCLUDE (�ck all that apply):
❑ use/process meats use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES jZNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
II
Total event rainfall z In or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m /L
Fecal Conform',
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 -- 9.0
120
30
1000
500
S
C V
'
AIA
1 Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at aM outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes ❑ no (ifyes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfail No.
Sample Collected,
mo/dd/ r
Oil and Grease,
m /L
TSS,
m /L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
S W U-249
Ric
SroR NR 0j"2'7 0
FRM�� G
Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II S CTION B.
Y TIER 3; HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO THE SAME PARAMETER AT ANYONE OUTFALL? YES �NO 0=
IF YES, HAVE YOU CONTACTED THE D Q REGIONALOFFI 7 Y �NO
REGIONAL OFFICE CONTACT NAME:.
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality of
Attn: DWQ Central Files
161;LMail Service Center
Raleigh, NC 27699-1612.
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 P4rmittee)
SS 8
(Date)
Additional copies of this form may be downloaded at: http;//portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 19, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT REFiCE�/VjEF
for North Carolina Division of Water Quality General Permit No. NCG060000 AP D
Date submitted '" / �__ C g D Z L�ll�
EAlR
CERTIFICATE OF CO RAGE NO. NCG06 �1 SAMPLE COLLECTION YEAR � - Q U Sri �D QUALITY
FACILITY NAME os �+ Q e FACILITY ACTIVITIES INCLUDE (check all that apply): RP^�Mfrrlrv�
COUNTY ❑ use/process meats [] u e animal fats/byproducts
PERSON COLLEC ING SAMPL S 0. d 1tli� Fr-, � ir(1DISCHARGING TO SALTWATERS? []YES I O
LABORATORY _PAW � Cb Lab Ce . # f C� *
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall �!� or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/y►
TSS,
mg/L
pH,
Standard units
COD,
mg/L
OII and Crease,
mSIL
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
500
N .
-
IOnly applies to facilities that use/process meats. i�,uts.-iE_:,.
The total precipitation must be recorded using data from an on -site rain gauge. CC ry N1 :� ,: i l�'�•
s For sampling periods with no discharge at aDy outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes ❑ no {ifyes, complete Part B}
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/ r
Oil and Grease,
m /L
TSS,
m L
pH,
Standard units
New Motor Oil Usage,
Annual averse al/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
-- 4 --
G
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at a•_y outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 last Revised: October 18, 2012
Page 1 of 2

*FOR PART AND PART B MONITORING RESULTS:
Y 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 SE TION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR E SAME PARAMETER AT ANYONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTACTED THE DW EGIONA OFFICE? YES NO W
REGIONAL OFFICE CONTACT NAME: D i —
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 endue
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
161:LMail Service Center
Raleigh, NC 27699-1612-.
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."
(Signaturqfof Permittee)
l^ V
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.orp/web/wa/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted `� — S-- l $
APR 0 9
1018
SrpR��A ENO QUAD'
CERTIFICATE OF RAGE NO. NCG06 °t `` ++ SAMPLE COLLECTION YEAR 2 0 1 8 R11ERM/7'PN,;
FACILITY N E OS `L FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY RaE ias:use/process meats use animal fats/byproducts
� � L PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? ❑YE5 L N6
LABORATORY Lab Cert. # APR 11 2018
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
Part A: Stormwater Benchmarks and Monitoring Results CVIR SECTION Total event rainfall z or ro discharge this period3
Outfail No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
S00
zOnly applies to facilities that use/process meats. � T ������
The total precipitation must be recorded using data from an on -site rain gauge. L} lJv C
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B. Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/ r
oil and Grease,
m /L
TSS,
m L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part Bj
SWU-249 Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II 5 TION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR HE SAME PARAMETER AT ANY ONE OUTFALL? YES ENO ❑
IF YES, HAVE YOU CONTACTED THE D Q RE ONX OFFI E7 YES ❑ NO 1
REGIONAL OFFICE CONTACT NAME: N6 C9�6 C
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 eriod in the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
161Z.Mail Service Center
Raleigh, NC 27699-16114.
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 Pero, ittee) .
(Date)
Additional copies of this form may be downloaded at: http-.//portal.ncdenr.org/web/­wq/ws/su/­npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT DECEIVED
for North Carolina Division of Water Quality General Permit No. NCG060000 �a� 28
Date submitted 3 " 2018
CERTIFICATE OF C RAGE NO. NCG06 SAMPLE COLLECTION YEAR ����-LAND
l �4 - STORMWATERP Mirrn,c
FACILITY NAME G(f1 1 FACILITY ACTIVITIES INCLUDE (chec II that apply):
COUNTY r ❑ use/process meats se animal fats/byproducts
PERSON COLLECTING SAMP EN�t`(\ C� 1 DISCHARGING TO SALTWATERS? [:]YES�IO
LABORATORY �'1S CCX' Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
11
Total event rainfall 2�� or [:]No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m /L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
100 or 504
Within 6.0 — 9.0
120
30
1000
500
C,
0AIA
L
a�
1 Only applies to facilities that use/process meats. AFH U 4 LUld
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. CENTRAL FILES
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark apppyVR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/ r
Oil and Grease,
m /L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average Sallmo
Benchmark
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
* A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
* 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SE ON B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR T E SAME PARAMETER AT ANY ONE OUTFALL? YES [Z NO ❑
IF YES, HAVE YOU CONTACTED THE DWS R GIONAL FFICE? YES NO
REGIONAL OFFICE CONTACT NAME: �cs.
Mail an original and one copy of this DMR including all "'No Discharge" reports, within 30 days of receiipt of the lab results jor at end o
monitoringperiod in the case of "No Discharge" reports to:
Division of Water Quality
Attn: DWQ Central Files
161a`tMail Service Center
Raleigh, NC 27699-1612
r
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 Perfi�it`teej
3-a3-1l�
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/wslsulnpdessw#tab-4
SWU-249 Last Revised: October 18, 2012
., 1b •, Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 3 -Q3- f �
CERTIFICATE OF CqVRAGE NO. NCG06 a SAMPLE COLLECTION YEAR Q U
FACILITY NAME C'.{ fib I FACILITY ACTIVITIES INCLUDE (chec it that apply):
COUNTY ❑ use/process meats se animal fats/byproducts
PERSON COLLECTI G SAMP ES C� DISCHARGING TO SALTWATERS? []YES R10
LABORATORY Lab Cert. >#
— PLEASE REMEMBER TO SIGN ON THE REVERSE
it
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 4\_ or n No discharge this period
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
m /L
pH,
Standard units
COD,
mg/L
Oil and Grease,
m /L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
moo,
0
C
a-
s
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfaks. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes ❑ no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
ma dd r
Oil and Grease,
mg1l.
TSS,
m L
pH,
Standard units
New Motor Oil Usage,
Annual average al/mo
Benchmark
30
100 or 50
6.0— 9.0
-
3
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
a A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B,
e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SE ON B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR E SAME PARAMETER AT ANYONE OUTFALL? YES U NO ❑
IF YES, HAVE YOU CONTACTED THE DWS R GIONAL FFICE? YES ;NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617—Mail Service Center
Raleigh, NC 27699-161'
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 Perfi3fttee)
3-r,�3-`a(S
(Date)
Additional copies of this form may be downloaded at: http:l/portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water QuaN G ral Permit No. NCG060000
Date submitted
CERTIFICATE OF C94RAGE NO. NCGU&�
FACILITY NAME o5 aC ee \)l
COUNTY 2)U
PERSON COLLECTING SAMPLES \ 1714\
LABORATORY C1R Lab Cert. q
t
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 9 O ! S
D 11@ROWR
-H `t22018`
D A R I~ O
401 8 BUFFER PERMITTINQ
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats Vuse animal f is/byproducts
DISCHARGING TO SALTWATERS? DYES O
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
11
Total event rainfall ��or ❑ No discharge this period'
Outfall No.
Sample Collected-,
mo/dd/yr
TSS,
rng/L
pH,
Standard units
COD,
m /L
Oil and Grease,
- mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
220
30
1000
500
<
-
q'
G S
2 Only applies to facilities that use/process meats. 6 Nib
The total precipitation must be recorded using data from an on -site rain gauge.
For sampling periods with no discharge at g.0 outfails. You must still submit this discharge monitoring report with a checkmark here. r1L FILES
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.CWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes ❑ no (if y_ S, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/ r.
Oil and Grease,
m /L
TSS,
m /L
pH,
Standard units
New Motor Oil Usage,
Annual avers a gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
-
G �—
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES PNO ❑
IF YES, HAVE YOU CONTACTED THE D�W E ONA OFFICE. ES NO
REGIONAL OFFICE CONTACT NAME: i I ` l . �,R -
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: T
Division of Water Quality
Attn: DWQ Central Files
161;LMail Service Center
Raleigh, NC 27699-1612—
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 ofPermittee)
a-UIN
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr,org/web/wq/ws/su/npdessw4tab-4
'n.
S W U-249
Last Revised: October_ 18,, 20 2T i i
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qu�aN G �eral Permit No. NCGO60000
Date submitted00,
CERTIFICATE OF CqKERAGE NO. NCGO&u
FACILITY NAME OS ^nCNCLAE' ul
COUNTY U+ i
PERSON COLLECTING SAMPLES rat> �
LABORATORY_ ON\i 06T rc\ Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR W 8
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats &ruse anima! f is/byproducts
DISCHARGING TO SALTWATERS? [:]YES ®NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
r/
Total event rainfall z _X r ❑ No discharge this period'
Outfall No.
Sample Collected,
mo dd/ r
TSS,
m /L
pH,
Standard units
COD,
m /L
011°and Grease,
m /L
Fecal Coliform ,
Colonies er 100 ml
Enteracoccl ,
Colonies per 100 ml
Benchmark
-
100 or S0
Within.6.0 — 9.0
120
30
1000
S00
+
.[ r-~
+
ro
J
AM
' Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at Any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes ❑ no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No..
Sample Collected,
mold r
Oil and Grease,.
m L
TSS,
m L _
pH,
Standard units
New Motor Oil Usage,
Annual averse al mo
Benchmark
-
30
100 or 504
6.0-9.0
-
' Oniy applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5WU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
C 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li SECTION B.
• TIER 3, HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES kNO ❑
IF YES, HAVE YOU CONTACTED THE D�Q ��ONA Oi FICE ES NO
REGIONAL OFFICE CONTACT NAME: ► ► fL
Mail an oriainal and one copy of this DMR, including all "No Discharge" reports, within 30 dales of receipt of the lab results (or at endue
monitoring period in the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQCentral Files
1617-Mail Service Center
Raleigh, NC 27699-161'2—
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) .
(Date)
Additional copies of this form may be downloaded at: htt ortal.ncdenr.or web w ws su n dessw#tab-4
5 W U-249
Last Revised: October 18, 2012
Page 2 of 2

CERTIFICATE OF
I�t[�II�II>1�►I,1►�il�
COUNTY
PERSON COLLEC
LABORATORY_
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water QualitGal Permit No. NCG060000 RECEIVED
Date submitted . I� -e rDrr 9 A 9
L.:1i7
SAMPLE COLLECTION YEAR DENR-LAND QUALITY
IT
ACTIVITIES INCLUDE (che all that apply),STORMWATER PERMITTING
J ❑ use/process meats use animal f is/byproducts
DISCHARGING TO SALTWATERS? ❑YES ®NO
UL1' i SECTION
1,W" rRMATION PROCESSING UNIT
Part A: Stormwater Benchmarks and.Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
t/
Total event rainfall-" qor ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
160 or 50
Within 6.0 — 9.0
120
30
1000
500
0\1
[�_
-r
4 V
Al A
' Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes [:]no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
,�
'r
Lf' 13,
1 Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
S W U-249
DEC 22 2017
Last Revised: October 19. 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II S CTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO THE SAME PARAMETER AT ANY ONE OUTFALL? YES [NO ❑
IF YES, HAVE YOU CONTACTED THE D Q EGiON L OFFIC ? YE �NO
REGIONAL OFFICE CONTACT NAME; d� 1
Mail an original and one copy of this DMA, 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 Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617-Mail Service Center
Raleigh, NC 27699-1612.
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 nest 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
U- -1 l—--I_
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249
1-ast Revised: October 18. 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Q;-Ltlalitc General Permit No. NCG060000
Date submitted — + I
CERTIFICATE OF CO RAGE NO. NCGJ a_ q I
FACILITY NA E OSC e2 1
COUNTY u r\
PERSON COLLECTING SAMPL
__C ian t at\k l��
LABORATORY�V\C Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 4 0
FACILITY ACTIVITIES INCLUDE
❑ �ch ck all that aPPIy1:
use/process meats Vuse
V
animal ats/bypr�� ?Q,,
DISCHARGING TO SALTWATERS. ❑YES MNO �9J4
OQG
'a�$P� ' /�Y
PLEASE REMEMBER TO SIGN ON THE REVERSE �/N
�� G
Total event rainfall z 0 or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0-9.0
120
30
1000
500
k —
d
--to
rn r—e-%
r--,.
Only applies to facilities that use/process meats.
E� 1 2d�1
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here `TFRAL pf
LE
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark-applies�11.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vyes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
I
G
1 Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfaks, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: Octoher 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 FXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II S CTION 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 D Q E kONAL OFFICE? YE \ NO V
REGIONAL OFFICE CONTACT NAME: , C4• �bt� * r�.
Mail an original and one cony 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' reports) to:
Division of Water Quality
Attn: DWQ Central Files
151ZMail Service Center
Raleigh, NC 27699-161$.
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
/,a- y-
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October Ili. 20l2
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qualit General Permit No. NCG060000
Date submitted a,*--
�
CERTIFICATE OF C VERAGE NO.,NCGO6 � SAMPLE COLLECTION YEAR Rol
1
FACILITY NE jZe-MOTA l}� FACILITY ACTIVITIES INCLUDE (cck all that apply):
COUNTY i ❑ use/process meats qj use animal ats/byproducts
PERSON COLLECTI G CAMP S 0. DISCHARGING TO SALTWATERS? ❑YES [NO
LABORATORY ` E�\\J 5 f_0C - n,, Lab Cert. ##
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN
N ON THE REVERSE 4
REC E N' `'
OCT 2720r�
STC?I'
Total event rainfall z * or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Collform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
Clk—
a
C,
nf~T ii!
Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? 01yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0— 9.0
-
a
�\ f
`
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
D
CENTRAL_ FILES
Dlr'4`R SECTION
(if yes, complete Part B)
SWU-249 List Revised: October 19, 2012
Page l of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCFEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II 5 TION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES JNO ❑
IF YES, HAVE YOU CONTACTED THE D Q REGIONAL OFFICE? YE ❑ NO
REGIONAL OFFICE CONTACT NAME:.h
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, NC 27699-161L
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 Pkrmittee)
(Date)
Additional copies of this form may be downloaded at: http:l/portal.ncdenr.orj%/web/wg/ws/suZnpdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

lzsc
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT �ez)
for North Carolina Division of Water Quality General Permit No. NCG060000 stp ? 5 2017
Date submitted
CERTIFICATE OF C ERAGE NO. NCG06L�_q _a SAMPLE COLLECTION YEAR Q FR.p uA ry
FACILITY NAME � slz4n b FACILITY ACTIVITIES INCLUDE (check all that apply): r7
COUNTY ❑ use/process meats 9—use animal is/byproducts
PERSON COLLECTI G SAMPL S L'Sia-Gqt0h DISCHARGING TO SALTWATERS? [:]YES[IVO
LABORATORY E�N�J 1 CO Q)r ­Ot Lab Cert. # q
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
r/
Total event rainfall 2 e 4 or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
500
- L31
4t 0. 6
q%q 11
G
S-
53,3
(z2z
S
�d
f
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Ves ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
30
100 or 50
6.0-9.0
-
3 —
6
�f
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at a_y outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
t�VED
SEA 2 g z017
CEN-rRAL FILE
DIVR SEC7-1 -;
(if yes, complete Part B)
SWU-249 Last Revised: October lx, 2012
Page l of 2

*FOR PART A AND PART B MONITORING RESULTS:
* A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
* 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION
* 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
161'LMail Service Center
Raleigh, NC 27699-1617—
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge,and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of PermAtee)
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wa/ws/sulnpdessw#tab-4
SNVU-2 49
Last Revised: October 19, 2012
Page 2 of 2

REcFIvIEfl
SEMIANNUAL STORMWATER DISCHARGE MONITORING REPORT AUG 10 2011
for North Carolina Division of Water Qu Ilty General Permit No. NCGo� 60000
Date submitted g " �. DENR LANb QUALITY
�O� STORMWATER FERMI?TING
CERTIFICATE OF CO RAGE NO. NCG06 I SAMPLE COLLECTION YEAR
FACILITY N E FACILITY ACTIVITIES INCLUDE (E!gKk all that apply):
COUNTY - - ❑ use/process meats [M use animal ats/byproducts
PERSON COLLECTING SAMPLES _ _ , `' DISCHARGING TO SALTWATERS? DYES 0NO
LABORATORY Lab Cart. #
PLEASE )REMEMBER TO SIGN ON THE REVERSE 4
`The total precipitation must be recorded using data from an on -site rain gauge. N U r CU W `" 1�13 u LI
H For sampling parlods with no discharge at yamX outfalls. You must still submitthis discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor all per month? ❑ yes ❑ no (if vas, complete Part 13)
B: Vehicle Maintenance- Area Monitoring Resulte: only for facliltles averazinsc > 55 gal of new motor
Only applies to facilities that use/process meats.
TThe
total precipitation mint tie recorded U61�9 data from an on -site rain gauge.
I{or sampling periods with no discharge at am outfalls, you must still submit this discharge monitoring report with a checkmark here -
See General permit text, Table 3, ldentlfWng the especially sensitive receiving water classifications where the more protective benchmark applies.
SUM-249 * - ,•__.�_ �. �...w 10 "nil)

I
I
*FOR PART A AND PART is MONITORING RESULTS:
o 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 a REQUIREMENTS. SEE PERMIT PART 11 SECTIONfi-
TIER S: 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:
Tart �S 5 NAB,, i5 o r\ MG-CA�ncyr-,��C�
Division of Water Quality
Attn: DWQ Central Files
16191VIall Service Center
Raleigh, NC 27699-161aZ
"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 qualifled 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 forgathering the Information, the Information submitted Is,
to the best of my knowledge and �ellef, 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
Additional copies of this form may be downloaded at:http.Lioonal.nGdi3nr.griiiweblwatwl/lgbgd@AsWiftah-4
SWU-249
ram.
Last Revised: October 18, 2012
Page 2 of 2 .,

CERTIFICATE OF
FACILITY NAME
COUNTY
PERSON COLLEC
Part A:
for North Carolina Division of Water Quality General Permit No. C 060000RECEIVED
Date submitted J U L 26
NO. NICGQS Q a rI SAMPLE COLLECTION YEAR O f !^
L of 11� ; l FACILITY ACTIVITIES INCLUDE (check all that apply): CENTRAL r;;_M
DWi
l ❑ use/process meats M16se animal f is/byproducts
LE& - Z1 0- , CDISCHARGING To SALTWATERS? [:]YES [ O
Lab Cart. #
and Monitorins Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
ttr
Total event rainfall z L U1or 0No discharge this
1 C�6_ 1 C,— off.n-1 rl I tl R • 1 r_ . G n . I 11Cl 11�_ I . L" ,— I A//-f 1 /I//i ___J
" Only -applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at spy outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of now motor all per month? [1yes ❑ no (U vea• complete Part B)
B: Vehicle Maintenance Area Monitoring Results: only for facliitles averaging s 55 gal of new motor
RECEIVED
v: ii_ 2.5 2017
DENR-LAND QUALITY
STORMWATER PERMITTING
'Only applies to facilities that use/process meats.
ZThe total pro dpltatlan must he retarded u511%data from an on-ifte rain gauges
1 kor sampling periods with no discharge atay outfalls, you must atifi submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SVM-249 � ,__.�__a. n ....ti _ + o 'Snt 1)

'"FOR pA 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 a REQUIREMENTS. SEE PERMIT PART It SECTION .
• TIER 3: HAS YOUR FACILITY. HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 0 NO
IF YES, HAVE YOU CONTACIrED;THE DWQ REGIONAL OFFICE? YES ❑ No ❑
REGIONAL OFFICE CONTACT NAME;
Division of Water Quality
Attn: DWQ Central Files
161XMail Service Center
Raleigh, NC 27699-1613,
"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 quallfled 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 forgathering the information, the Information submitted Is,
to the best of my knowledge and iiellef, 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
Additional copies of this form may bet downloaded at;
,I— to - l�
(Date)
SVM-249
eh.
Last Revised: October 18, 2012
Page 2 of 2 ,.

CERTIFICATE OF
FACILITY NAME
COUNTY
PERSON COLLEt
LABORATORY
i
SEM11 ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for-Nor,th Carolina Division of -Water Quality General -Permit No. NC_ Go60090
Date submitted
NO. NCGQ SAMPLE COLLECTION YEAR „ Qdl
FACILITY ACTIVITIES INCLUDE (check all that apply):
y ❑ use/process meats use animal fats/byproducts
Las 7 ��v, Q.it new In DISCHARGING TO SALTWATERS? [ IYES MM
Part Ai Stormwater Benchmarks and Me'
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
tI
Results Total event ralr¢aN 2 o or (� No discharge this
C
IL Only'applles to facilities that use/process meats.
2The total precipitation must be recorded using data from an on site rain gauge.
3 For sampling periods with no discharge at mix outfails. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Malnteriance Activities using more than 55 gallons of new motor all per month? OVER- ❑ no (Ifys& complete Part B)
Part B: Vehicle Maintenance Area MonitarinB Results: oNv for facilities averaging > 55 gal of new motor oil/month.
RE
C = j',v1 rD
DEC 12 2016
Only applies to facilities that use/process meats.
The total preciphiltlon must he recorded using data from an on -site rain gauge, .
1 �or sampling periods with no discharge at iw] outfalls, you must still submit this discharge monitoring report with a checkmark here.
`see General Permit text, Table 3, Identifying the especially sensitive receiving water classificatlons where the more protective benchmark applies.
SWU-249

}I
I
}
*FOR PART A AND E&RI B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE. PERMIT PART II SECTION B,
2 EXCEEDANCE5 IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION a:
o TIER 3: HAS YOUR FACILITY. HAD 4 OR -MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL7 YES ❑ No f�
IF YES, HAVE YOU CONTACTED}THE DWQ REGIONAL OFFiCE7 YES ❑ NO 1-1
REGIONAL OFFICE CONTACT NAME:
Division of Water Quality
Attn:.DWQ Central Files
161XMall Service Center
Raleigh, NC 27699-1619�.
O MUSTSIG T IS CERTf 1CATION FOR ANY MMMA O REFOREM
"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 posslblllty of fines aryd Imprisonment for knowing violations."
(Signature of
(Date)
Additional copies of this form may be downloaded at: o c o s s es w -4
SWU 249
r"
Last Revised: October 18, 2012
Page 2 of 2

CERTIFICATE OF
FACILITY NAME
COUNTY 'b
PERSON COLLEC
LABORATORY_A
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted off, a 9,— /C
E NO. NC606 6
Part A! Stermwater Ranelhmarke and Mnnitnrina Raeulta
SAMPLE COLLECTION YEAR Oq d `
FACILITY ACTIVITIES INCLUDE (check all that apply):
use/process meats @;�dse animal fats/byproducts
DISCH_AR��GffING TO SALTWATERS? [DYES WO
If
P 1: REMEMBER TO SIGN ON THE REVERSE 4
JUL 0 S 2016 % r 1
rC?:,-_ . Total event rainfall z �a or M No discharge this period'
•[
- «
_i ei.:.9' _ ��. ,f%
aCB�f_�
'...*
y
4 b y t r?�:
_ �,i "t5�7 r��
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OEI"
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f vr"^- r,
7i r"•
f.`-�-•t'v�
r
E
urny appnes to Tach ues mat use/process means.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at env outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor all per month? Oeyes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: aniv for facillties averaging > SS gal of new motor oil/month.
!D'�r�'���j_�c''�£���.
s 65 ldf�'��
j��i4li`�
fflm-
•, I-
x:•`j'rsd;.,i.y
f�. 0-1 ` �'3�rC Cl�
I� 'I tr�
:t s?6
■
3 Only applies to facilities that use/process meats. -
IThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
n
ff Yes complete Part B)
5WU-249 i.Firt ReviRed: October 18. 2012

-FOR PART A AND PAT 0-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 11 SECTION
• 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 or! inal and one cogy.o this DMR including all "No Pis-ah-aray"marts,Mthln 30 days of mce-int -of the lab-resul s for at end of
monitorina period In the case. of "No Discharge" eortsl to: =
Division of Water Quality
Attn: DWQ Central Files
161&Maii Service Center
Raleigh, NC 27699-1617,
YOU MUST SIGN THU CERTIFICATION FOR ANY INFORMATION REPOR TED.
"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 Permitt4)
{Date)
Additional copies of this form may be downloaded at: tto a , cden o we w ws s n dessW#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2. of 2 „

` SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water Quality General Permit No. NCGO60000 APR 2 0 2015
f� q Date submitted — B' r S CEWRAL FILES
CERTIFICATE OF CO ERAGE NO. NC 06 t l ^^
SAMPLE COLLECTION YEAR DWR SECTION �S� � S
FACILITY NAME OS FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Zl-") u. \, r-, - _ ❑ use/process meats l use animal fats/byproducts
PERSON COLLECTI G SAMPLES DISCHARGING TO SALTWATERS? ❑YES 2NO
LABORATORY&SiC� La ert. #.
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall 2 1 • e or ❑ No discharge this periods
7.4 �f 1v,.. r?w"'�!'r
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1 Only -applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor all per month? IVyes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
�`l�t allfki�
(gWTy
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, f�F ,A� i .,5. fixk..3 r[.
.-�!!rlf,. �"�Jr.t'.• ,Y� .'�o"tr r:
R.
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at anyoutfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
ti4
��s
( es complete Part 8)
SWU-249
Last Revised: October 18, 2012

*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 .
a TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO [0
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YEs ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one cony of this DMR, Including all "No Discharge" resorts. wi#hhr 30 days of receipt of the lab results for at end of
monitorina period in the case. o "No Dischar e" reports) to:
5
Division of Water Quality
Attn: DWQ Central Files
1617,Mail Service Center
Raleigh, NC 27699-161dZ
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
q-1 —(S
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/ws/"su/npdessw#tab-4
SWU-249 Last Revised: October 18. 2012
Page 2 of 2 ,

1
CERTIFICATE OF CG
FACILITY NAME_
COUNTY
PERSON COLLECTI
LABORATORY -E
REV O V E-
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT APR 2 0 2015
for North Carolina Division of Water Quality General Permit No. NCGO60000 CENTRAL FILES
Date submitted �i r 1k— � 5 _ D\l+.fR SECTION
r
NO: NCGo O 2�, SAMPLE COLLECTION YEAR A O c S
�VlFACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats [� se animal fats/byproducts
LES ' k 17 S C A _ DISCHARGING TO SALTWATERS? DYES ENO
�e r4\ Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Total event rainfall 1112_
It or ❑ No discharge this period'
ggw .�:+�
,R�.�utif��l1i�F��
-d n �-'t sW� � �' ��
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L
1 Only -applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor all per month? ❑ yes 9R'n-a-" (if yes• complete Part B)
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
x..-.� 'a1r i
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•� - xi �• .�.�R:�@ {{ .,�
'.r�: r ,z ��a � .. � . °.
J. +cam i t _ .: '� �:
'Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249
Last Revised: October 18, 2012

*FOR PART A AND PART B MONITORING RESULTS:
* A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
+ 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART it SE ION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN S FOR THE SAME PARAMETER AT ANY ONE OUTFALL7 YES [ZNO ❑
IF YES, HAVE YOU CONTACTED THE D Q REGION 4 FFICE7 Y ShT ❑
REGIONAL OFFICE CONTACT NAME:
Mallon original and one co g?f this DMR including all "No Discharge" rearts within 30 days of recei t of the lob -results for at end o
monitoring erlad In the case. o "No Dischar a" Warts) to:
Division of Water Quality
Attn: DWQ Central Files
167*1,Mail Service Center
Raleigh, NC 27699-161dZ
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 relief, 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
-q` (,S
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/­wglwslsu/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2 ,

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Datesubmitted RECEIVED
CERTIFICATE OF COVERAGE NO. NCG06 o 3 3 (o SAMPLE COLLECTION YEAR .2a►4-
DEC 2 9 �OA
FACILITY NAME PRr',-tA -_ *21 GEED lK r t. t_ FACILITY ACTIVITIES INCLUDE (check all that apply): CENTRAL F= LE`
COUNTY SAnnP" + ❑ use/process meats X❑ use animal fats/byprodtRWR SECT10 ,
PERSON COLLECTING SAMPLES 0. 6[.E414 CLIF: 04 DISCHARGING TO SALTWATERS? []YES 13NO
LABORATORY 5_jjtj Rt*mAbhA, Q gut r Lab Cert. # c-
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 O or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
3
11 11- r 4-
7
-7. 3
7o
No
5
AID cE
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? © yes [:]no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected, .
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 - 9.0
-
14-
7.54aD
I Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
a For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ifye$, complete Part B)
SWU-249 Last Revised: October 18, 2012
Pagel of 2

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*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 Q
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES Q NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, Including all "No Discharge" reports, within 30 days of recelet 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, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document. and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
flo
(Signature of Pe
1 z(zzJ )4--
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.orp/web/wq/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2

a►
4
_ a.
�r '� =f
' � . .. -
1 _ _ - 7

!::: I Environmental Chemists, Inc.
O:h7em 6602 Windmill Way • Wilmington, NC 28405
[phone] (Lab) • [phone] (Fax)
© 710 $owsertown Road • Manteo, NC 27954
[phone]
ANALYTICAL & CONSULTING
CHEMISTS NCDENR: DWQ CERTIFICATE #94. DLS CERTIFICATE #37729
Prestage Farms Date of Report: Dec 08, 2014
P. O. Box 438 Customer PO #:
Clinton NC 28328 Customer ID: 09010051
Attention: Glenn Clifton Report #: 2014-14551
Project ID: Storm Water (Clinton Feed Mill)
Lab ID Sample ID: Collect Datefrime Matrix Sampled by
14-35712 Site: Outfall #3 11/24/2014 9:35 AM Water Glenn Clifton
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 16M <5 mg/L 12/05/2014
Residue Suspended (TSS) SM2540 D 47.0 mg1L 11/25/2014
pH SM4500HB 7.33units 11/28/2014
COD SM 5220D 70 mg/L 12/0712014
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
14-35713 Site: outfall #6 11/24/2014 10:15 AM Water Glenn Clifton
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1W 5 mg/L 12/05/2014
Residue Suspended (TSS) SM 2540 D 7.8 mg/L 11125/2014
pH SM 4500 H B 7.54 units 11/28/2014
COD SM 5220D B8 mg/L 12/07/2014
Comment: {
Reviewed by:
Report#:: 2014-14551 Page 1 of 1

4=
ENVIRONMENTAL CHEMISTS, INC 910.392.0223 252.473.5702
[[e-mail]
Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
CLIENT. Presto a Farms -Clinton NC
PROJECT NAME: Storm water 421 Feed 111II11
REPORT NO: . rsfs�i
ADDRESS: QO. far +313
CONTACT NAME:
PO NO:
0'Lt.i7eeJ 14C. ,2t 29'-
REPORT TO: Glenn Clifton
PHONEIFAX:
COPY TO:
email:
Sampled By: G Llg- a a Ct eV—rb .] SAMPLE TYPE: 1 = Influent, E = Effluent, W = Well, ST a Stream, SO = Soil, SI_ = Sludge, Other:
Sample Identification
Collection
F
2
o`co
U
C�
V
r E
V
o
cox
Z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
Z
z
o
oY
o
Outfall # 1
C
P
X
X
TSS, O&G, COD, H
G
G
Outfall # 2
C
P
X
X
TSS, O&G, COD,pH
G
G
Outfall # 3
C
P
X
X
TSS, O&G, COD,pH
G
G
Ou#all tie3 u/
9,'3 APA
Z I .`7 G
C
P
f�
X
X
TSS, O&G, COD,pH
G
G
'
Outfall # 5 '�
C
P
X
X
TSS, O&G silica gel), COD,pH
G
G
Outfall 6
11 4- 4-
6:15Ara
19 4a
C
I P
f 3
;
X
I
X
I
I
1TSS,
O&G silica gel), COD,pH
G
G
Outfall # 7
C
P
X
X
I
TSS, O&G, COD,pH
G
G
Outfall # 8
C
P
X
X
TSS, O&G, COD,pH
G
G
C
P
X
X
I
ITSS, O&G, COD,pH
G
G
Note: Outfall 516 require silica gel. Limits: pH 6-9, TSS 100, O&G 30, COD 120 mg/L.
Transfer
Relinquished By:
DatelTime
rRecelved By:
DatefTime
1.
J 17A 14- (°,P
11 K �
2.
Temperature when Received: IV Accepted: Rejected: Resample R qu sted:
Delivered By: _ Received By: -Date: o1vtJ c4 Tim
Comments: TURNAROUND:

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
n Date submitted _., �� , ,23 :�a n
CERTIFICATE OF C ERAGE NO. NCG06O l SAMPLE COLLECTION YEAR dO �a
FACILITY TE FACILITY AC 1VJTIES INCLUDE (check all that apply):
COUNTY � ` use .processais. , eCQ use animal fats/byproducts
PERSON COLLECT NG SAMPLES n� DISCHARGING, SALTU�I�ATERS? ❑YES [ 1G0
LABORATORY �1�j�Coc err�� La rt. # L- U LL
Part A: Stormwater Benchmarks and Monitoring Results
PL•gt4 ft%i1�E
R R TO SIGN ON THE REVERSE 4
DWSECTION
Total event rainfall �a or ❑ No discharge this period
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1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? M/yes ❑ no (if yes. complete Part 8)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 5S gal of new motor oil/month.
�" __ - y5. �:
�;�,D�tfall� off, �
((F.f'a/.- 'S �?`2l i".'
_.aa - -•r8• ';Cr• v�ir�,a3
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s
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18. 2012

*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
• 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 anal and one copy of this DMR including all "No Dischar e" re arts within 30 days of recei t of the lab -results for at end o
monitoring period In the case. of "No Discharge" reports to:
Division of Water Quality
Attn: DWQ Central Files
�. 161dZMail Service Center
Raleigh, NC 27699-161ok-
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
IL/9 -I
(Date)
Additional copies of this form may be downloaded at: httR://Portal.ncdenr.org/web/wq/­ws/­su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2 „

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED -
for North Carolina Division of Water Quality Ge eral Permit No. NCG060000 JUN 17 2014
Date submitted 6 "
q 'a � L� CENTRAL FILES
CERTIFICATE OF CO RAGE NO. NCG06� a [ SAMPLE COLLECTION YEAR DWQIBOG
FACILITY NAMEDS 4C FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY - ❑ use/process meats [}use animal fats/byproducts
PERSON COLLECTING SAMPLES R DISCHARGING TO SALTWATERS? ❑YES ENO
LABORATORY a-3kcdC Lab ert.-4- OM
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall z o rI _, G or ❑ No discharge this period'
:'.:..
:_Dutfall o n
:: `Y•:r -✓ C �i�.F
.- _ . �L:s
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S-IS-I
G
<5dA
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? dyes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
iDutfa)I;{1fa a ,,
.? .
a .r4�..?"n+a.^
w ;„SaplexColle¢ted,
;i e--� srm �.1:•-a'.:r2F.xs
�'gg �ltiS'��_a1..I ,::�1.7;,�?.
T, .•�,,Qi) and:Grease,� •�.;��rT55,�'�=
uatr�-}':Fx�. a�?ram 3.,.'- s.r
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'i`:...j-1 •l..t
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r '.,s�{=r"rr+i''^'`•.:.F =.�:
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,Benchmark
}� + � ; � , �;.
y 30 ,� �
�: 41Q0 ar, 0• r
s � -
, _,,,;1; ,� r �. � _ ,,�-. b
3
s- -
<s
s,3
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if Les, complete Part Bj
SWU-249 Last Revised: October 18. 2012

*FOR PART A AND PART S 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 IV,
• 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 final and one copy of this DMR including all "No Discharge" reports within 3� da s a recei t o the lab, results or at end o
monitoring period in the case. of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Fifes
161.6-,�Mail Service Center
Raleigh, NC 27699-161c7,
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
_C-�-1�
(Date)
Additional copies of this form may be downloaded at: http1Lportal.ncdenr.org/web/wgzws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2 „