NCG060310_MONITORING INFO_20190523

PERMIT NO.
DOC. TYPE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
/v C.� c a I
0 HISTORICAL FILE
X MONITORING REPORTS
DOC DATE ❑ 00)
YYYYMMDD
7

i
STORMWATER DISCHARGE OUTFALL (SDO)
IYMONTTORING REPORT
G100TRAL PERMIT NO, NCG060000
SAMPLES COLLECTED DURING CALENDAR YEAR; �?Pj 7
CERTIFICATE OF COVERAGE NO, NCG06. n 1)
Q
(This monitoring report is due at the Division no later than 30 d&ys from
FACILITY NAME �f� J'IPAI
-
r�
2 I%712-x--
the date the facility receives the sa plin resu from the laboratory,)
L
i �i
PERSON COLLECTING SAMPLES
!l
�P>3oUNTY NE NO, r� a
CERTOUD LABORATORY d
Lab # 40
MAY 2 3 �� 19
Lab #
PLEASE SIGN ON THE REVERSE 3
Part A. Specific Monitoring Requirements
CENTRAL FILES
DWR SECTION
' Outfall
Date
00530
00400
00340
00556
31616
No,
Sample
Total Suspended
pH,
Chemical Oxygen
Oil and Grease,'
Fecal Collform,
Collected,
Solids,
Standard units
Demand,
mg/L
Colonies per 100 ml
mo/dd! r
to gLL
w
Benchmark
-
100
Within 6,0 -- 9.0
120
30
1000
—/ 7 C�
Note; Ifyou report a sampled value in oxoess of the benchmark value, or outside the bonohrnark range for pH, you must implement Tier I or Tier.2 responses,
Soo General Pormli text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of now motor oil per month? _ yes -no
(If yes, complete Part B)
Part B; Vehicle Maintenance Activity onitoring Reg uirements
Outfall Date 00556 00530 00400
No. Sample Collected, Oil and Grease, Total Suspended Solids, pH, Now Motor Oil Usage,
mo/dd/ r m m Standard uoW Annual avers a gaYmo
,BenaHmark 30 100 6,0 --9,0 -
Note: lryou report a sampled value in excess of the benchmark value, or outside the benchmark range For pH, you must lmplement Tier 1 or Tier 2 responses,
See General Perml(taxi•
STORM EVENT CHARACTERISTICS: Mail Original and one copy to;
Division or Water Quallty
Data first event sampled) ��� Attn: DWQ Central Flies
Total v t Precipitation (inches).,� 1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
S WU-249-102107
Page I of 2

Aria
® NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
•
,Forguidance on filling out thisform, please visit-. h=:Ztportal.ncdenr.orgfwebJwgfws/su/npdessw#tab-4
Permit No.:
Facility Name:
County:
Inspector:
Date of Inspection: _
Time of Inspection:
_l � a
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
es ❑ No
Please verify.whether. Quali_tative'Monrtoring.must be:performed during.a "representative'storm _
-event"or"measureablestorm'event"Crequiremena-vary, depending on'the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event' is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours }
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter ,
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signaturescertify that this report is accurate 4a n Vlete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
5WU-242, Last modified 10/25/2012

I. Outfall Descri tion:
Outfall No. S ructure(pipe, ditch, etc.)
Receiving Stream: '—
Describe the industrial activities that occccuj within a outfall drainage area:
/i7 j F�Iz J
2. Color: Describe the color of the discharges asic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odth tt e discharge may have (Le., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
10). 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 0
3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
7
8.
1 02 3
Is there any foam in the stormwater discharge?
4 5
Yes
Is there an oil sheen in the stormwater discharge? Yes
ONo
No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of SJtoormwater Pollution:
//''
List and describe !� %% i0 /�
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of
SWU-242, Last modified 10/25/2012

•
1. Outfall Descrtion:
Outfall No. 17 Stru
Receiving Stream:
Describe the industrial activities
2. Color: Describe the color of the discharge using basic colo s ed, brown, blue, etc.) and
[light, medium, dark) as descriptors: jQ%t7X) Bra E
3. Odor: Describe any distinct o s th the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): _
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 (L24� 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 (0 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2� ,. 3) 4 5
rg
7. Is there any foam in the stormwater discharge? Yes . No
S. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes DNo
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

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STORMWATER DISCHARGE OUTFALL (SDO)
MONP1'ORING REPORT
GEMBRAL PERMIT NO, NCC060000 SAMPLES COLLECTED DURING CALENDAR YEAR: •24%le
CERTIFICATE OF COVERAGE NO, NCG06_ �/� _ _ _ (This monitoring report Is due at the Division no later than 30 days from
FACILITY NAME ,ti! vc7 j�E e dafe,the.f6eflity receives the s rupli,g�,�g resul from the laboratory,)
COUNTY YG!
PERSON COLLECTING SAMPLES /z� _ A�1� Z�i�i PHONEN-0
CERTIF�D LABORATORY Lab P
AW ill" RZ50r/yI Lab #
Part A: Specific Mor:ltoring Requirements
CENTR All FlL�'w PLEASE SIGN ON THE REVERSE ->
MR SECTlor.i
Outfall
No.
Date
Sample
00530
00400
00340
00556
31616
Total Suspended
pH,
Chemical Oxygen
Oil and Grease,
Fecal Collform,
Collected,
Solids,
Standard units
Demand,
mg/L
Colonies per 100 ml
moldd/ r
m
m
Benchmark
-
100
Within 6.0 - 9.0
120
30
1000
Note; I f you report a sampled value In excess of the benchmarks value, or outside the
Soo General Permit text,
range for pH, you most implement
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of now motor oil per month?_ yes no
(ifyes, complete Part B)
Part B: Vehicle Maintenance Activity Monitorino Requirements
t or Tier, 2 responses,
Outfall
No,
Date
Sample Collected,
mo/dd/ r
00556 -
00530
00400
Oil and Grease,
m
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual average goYmo
Benchmark
30
100
6.0-9.0
Now: :i you report a sampled value in excess of the benchmark value, or outside the benchmark range For pH, you must Implement Tier 1 ar Tler 2 responses,
See General Permit text.
STORM EVENT CHARACTERISTICS;
Dat first event sampled) �l
Total vent Prccipitatiou (Inches): 0, $�
Date (Nst each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to;
Division of Water Quality
Attn: DWQ Central Files
1617 Mall Service Center
Raleigh, North Carolina 27699-1617
S W U-249-102 l07
Page I of 2

" 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. T 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
S WU-249-102107
Page 2 of

Environmental Chemists, Inc.
1 6602 Windmill Way, Wilmington, NC 78405 • ' 910.392.0223 Lab • 910.392.4424
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
sM 255-A Wilmington Highway, Jacksonville, NC 28540 ' 910.347.5843 Lab/Fax
1
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
House of Raeford Date of Report: Jul 06, 2018
Post Office Box 40 Customer PO #:
Rose Hill NC 28458 Customer ID: 08100079
Attention: Chris Murray Report #: 2018-10346
Project ID:
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
18-26027 Site: Outfall #1 6/26/2018 4:10 PM Water Client
Test
Method
Results
Date Analyzed
Oil & Grease (O&G)
EPA 1664
<5 mg/L
06/28/2018
Residue Suspended (TSS)
SM 2540 D
66.5 mg/L
06/28/2018
pH
SM 4500 H B
7.36 units
06/28/2018
COD
SM 5220D
74 mg/L
0710212018
Lab ID Sample ID:
Collect Daterrime
Matrix Sampled by
18-26029 Site: Ouffall #2
6/26/2018 4:20 PM
Water Client
Test
Method
Results
Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 06/28/2018
Residue Suspended (TSS) SM 2540 D 14.3 mg/L 06/28/2018
pH SM 4500 H B 7.87 units 06/28/2018
COD . SM 5220D 95 mg/L 07/02/2018
Comment: r
Reviewed by:
E-MAILED JUL 0 9 2918
Report #:: 2018-10346 Page 1 of 1

=�O
RMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO, NCG0b0 SAMPLES COLLECTED DURING CALENDAR YEAR: Ra! 7
CERTIFICATE OF COVERAGE NO, NCG06_C _ (This monitoring report is due at the Division no later than 30 dAys from
FACILITY DAME && the date'twe 4llii`y t the s li g restSlts from the laboratory,)
COUNTY
PERSON COLLECTING SAMPLE f MAR 01 PI(mNE NO, &Z agn
CERTIKED LABORATORY Lab #
Lab # ,rm-TRALgLIEWSE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Acquirements
utrall Date 00530 00400
No, Sample Total Suspended PH,
Collected, Solids, I Standard units
Benchmark 100 Within 6.0 —
Note; If you report a sampled value in excess of the benchmark value, or outside the
Sec General Permit text.
pWR SECTION
00340 00556 31616
Chemical Oxygen Oil and Grease, Fecal Coliform,
Demand, mg/L Colonies per 100 ml
120
range for pH, you must implement Tier I or Tier 2 responses.
Did this racility perform Vehicle Maintenance Activities using more than 55 gallons of now motor oil per month? _ yes -no
(If yes, complete Part B)
Part B; Vehicle Maintenance Activit
Outfall Date
No, Samplo Collected,
mo/dd! r
Benchmark
cuts
00556
Oil and Grease,
mg/L
_... 30 -
Note; If you report a sampled value In excess of the benchmark
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date " %6first event sampled)
Total .8 nt Precipitation (incbes);
Total Suspended Solids, pH,
m Standard uj
100 6.0 -- 9.0
iue, or outside the benchmark range for pH, you must
Date (list each additional event sampled this reporting period, and rainfall amount)
Now Motor Oil Usage,
Annual average ag l/mo
ement Tier l or Tier 2 responses.
Mail Original and one copy to;
i]ivislon of Water Quality
Attn: DWQ Central Files
1617 Mall Service Center
Raleigh, North Carolina 27699-1617
Total Event Precipitation (inches);
S WU-249-102107
Pagel of 2

"I certify, under penalty of law, that this document and all attachmeuts 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."
4(8ignatur'eof Permittee) (Date)
�a f�1UGL
SWU-249.102101
Page 2 of 2

Environmental Chemists, Inc.
1
6602 Windmill Way, Wilmington, NC 28405 - 910,392.0223 Lab - 910.392.4424 Fax
SM)
710 Bowsertown Road, Manteo, NC 27954 - 252,473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 - 910.347.5843 Lab/Fax
ANALYTICAL_& CONSULTING CHEMISTS
info eenvironmentalchemists.coni
House of Raeford
Date_of_Report: —Eeb.27-,-201.7
Post Office Box 40
Customer PO #:
Rose Hill NC 28458
Customer ID: 08100079
Attention: Chris Murray
Report #: 2017-02322
Project ID: Feed Mill Storrs Water
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
17-05464 Site: outfall 1
2/15/2017 2:00 PM Water Client
Test
Method Results Date Analyzed
Oil & Grease (O&G)
EPA 1664 <5 mg/L 02/17/2017
Residue Suspended (TSS)
SM 2540 D 138 mg/L 02/17/2017
pH
SM 4500 H B 7.26 units 02/21/2017
COD
SM 5220D 94 mg/L 02/17/2017
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
17-05465 Site: outfall 2
2/15/2017 2:27 PM Water Client
Test
Method Results Date Analyzed
Oii & Grease (O&G) EPA 16" 6 mg/L 02/17/2017
Residue Suspended (TSS) SM 2540 D 89.3 mg/L 02/17/2017
pH SM 4500 H B 6.57 units 02/21/2017
COD SM 5220D 179 mg/L 02/17/2017
Comment:
Reviewed by: /e-
eport :: 017-02322
fl...._ a —L a

4=0
ENVIRONMENTAL CHEMISTS, INC OFFi Ei 9 0i23
392 11FAX[phone]
��
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
Analytical & Consulting Chemists
I COLLECTION AND CHAIN OF CUSTODY
Client: House of Raeford -Rose Hill
PROJECT NA
REPORT NO: G
NO: V
ADDRESS:CONTACT
NAME: Chris MurrayPO
EPORT TO:
PHONE/FAX:
E
COPY TO:
email:
Sampled By: E SAMPLE TYPE: I = Influent, E = Effluent, W = Well. ST = Stream, SO = Soil, SL = Sludqe, Other:
Sample Identification
f Collection
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PRESERVATION
ANALYSIS REQUESTED
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Temp
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=
=
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Effluent Comp 21month
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E Relin ui d By:
Date/Time
Received By:
Date/Time
'ature when Re
By:
M
ed
�Resample Regpes ed:
t^ Date:_i t0 j Time- l
TUi�N�AR UND.

I
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMrr NO, NCCT060000
CERTIFICATE OF COVERAGE NO, NCG06 gn
P'ACiLTrY NAME ,.:Ta�/.clS�-�S 1J? L L-L—
PERSON COLLECTING SAMPLEfc�
CERTWWD LABORATORY
Lab #
Part A; Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR,
(This monitoring report Is due at the Division no later than 30 dAys from
the date the facility receives the
RECEIVED
sa pl p r ul�s from the laboratory.)
PHONE NO. �� �
JAN 19 Z017 PLEASE SIGN ON THE REVERSE -i
CENTRAL FILES
DWR SECTION
Outfall
No.
Date
Sample
Collected,
moldd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
m
. pH,
Standard units
Chemical Oxygen
Demand,
rn
Oil and Grease,
mg/L
Fecal Collform,
Colonies per 100 ml
Benchmark
-
100
Within 6,0 -- 9,0
120
30
1000
< . o
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses,
See General Permit text,
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no
(if yes, complete Part S)
Part B; Vehicle Maintenance Activity Monitoring Requirements
Outfall
No,
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
m
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual average gaVmo
Benchmark
-
30
100
6,0 — 9.0
Note: I f you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses,
See General Permit text,
STORM EVENT CHARACTERISTICS:
Date/� first event sampled)
Total ve t Precipitation (inches);
Date (list each additional event sampled this reporting pe0od, and rainfall amount)
Mail Original and one copy to,
Division of Water Quality
Ann: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Total Event Precipitation (inches),
S WU-249-102107
Page I of 2

"Y 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. X am aware that there are significant penalties for submitting false information, including
the possibility of fines and imprisonment for knowing violations."
fA
(Signature of Permittee)
(Date)
-ire 2
z/v�S�
5 W U-249-102107
Page 2 of 2

Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
�
p} 410}710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 * 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
House of Raeford Date of Report: Dec 29, 2016
Post Office Box 40 Customer PO #:
Rose Hill NC 28458 Customer ID: 08100079
Attention: Michael Newton Report #: 2016-17991
Project ID: Stormwater
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
16-43258 Site: Outfall #1 12/13/2016 2:30 PM Water Client
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 12/23/2016
Residue Suspended (TSS) SM 2540 D 131 mg/L 12/15/2016
pH SM 4500 H B 6.99 units 12/28/2016
COD SM 52201) 25 mg/L 12/16/2016
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
16-43261 Site: Outfall #2 12/13/2016 2:45 PM Water Client
Test
Method
Results
Date Analyzed
Oil & Grease (O&G)
EPA 1664
10 mg/L
12/23/2016
Residue Suspended (TSS)
SM 2540 D
140 mg/L
12/15/2016
pH
SM 4500 H B
6.70 units
12/28/2016
COD
SM 5220D
253 mg/L
12/16/2016
Comment:
Reviewed by:
Report #:: 2016-17991 Pape 1 of 1

4M min
ENVIRONMENTAL C H E M J S i S, I N C OFFICE: 910i 3 2 02 311FAX [phone]
Analytical & Consulting Chemists NCDENR: DWO CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
Client: House of Raeford
PROJECT NAME: Storrhwater
REPORT NO:
ADDRESS: P,(), P)ON
CONTACT NAME:
PO NO:
R g ; .
REPORT TO: -44tL mevi-rc-i
PHONEIFAX: 0 •- 'ZTq-- l06
I
COPY TO:Chris Murra
email: inicliae,l. n ©A-vX:',r4 ru��rc! r�rn
Sampled By: SAMPLE TYPE, I = Influent, E = Effluent, W = Well, ST.= Stream, SO = Soil, Si_ = Sludge, Other:
Sample Identification
Collection
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PRESERVATION
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Outfall: 2
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Relinquished By:
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Received By:
DatelTlme
1.
2.
Temperature when Received: Accepted: ✓
Delivered By: Received
Comments:
LLTime: 40�22
4

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envirochem`
�;ul
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392,0223 Lab • 910.392.4424 Fax
710 Bowscrtown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910-347.5843 Lab/Fax
info ct znvironmentalcllcinists.coni
House of Raeford Date of Report: Dec 29, 2016
Post Office Box 40 Customer PO #:
Rose Hill NC 28458 Customer ID: 08100079
Attention: Michael Newton Report #: 2016-17991
Project ID: Stormwater
Lab ID Sample ID: Collect Daterrime Matrix Sampled by
16-43258 Site: Outfall #1 12/13/2016 2:30 PM Water Client
Test Method Results ,-Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 12/23/2016
Residue Suspended (TSS) SM 2W D 131 mg/L 12/15/2016
pH SM 4500 H 8 6.99 units 12/28/2016
COD SM 5220D 25 mg/L 12/16/2016
Lab ID Sample ID: Collect Daterrime Matrix Sampled by
16-43261 Site: Outfall #2 12/13/2016 2:45 PM Water Client
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664
10 mg/L
12/23/2016
Residue Suspended (TSS) SM 2540 D
140 mg/L
12/15/2016
pH SM 4500 H B
6.70 units
12/28/2016
COD SM 5220D
253 mg/L
12/16/2016
Comment:
Reviewed by:
Report #:: 2016-17991 Paqe 1 of 1

r
dml Way Wilmington, NC
ENVIRONMENTAL CHEMIST'S) INC OFFI E:6602 10'3 2-02 3 AX610392-44245
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: OLS CERTIFICATION # 37729 [e-mail]
Analytical & Consulting Chemists
COLLECTION AND CHAIN OF CUSTODY
Client: House of Raeford
PROJECT NAME: Stormwater
REPORT NO:
ADDRESS: P. 2 , 62tj
CONTACT NAME: - ►}�Ei� N E; j-rc-p 7
PO NO:
40. tjC Z-Sy
REPORT TO: 1Lw4ft- MevJ`Tc J
PHONEIFAX: IU - 2�3y-l�lya
Hill
COPY TO:Chris Murray
email: ricl1eje'!.nrwJc^Qtlaxra&E2.c4t►a
Sampled By. SAMPLE TYPE, i = Influent, E = Effluent, w = well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
m
E
E.o D
°
�,
=c�
o
`' 4
m
" e
ff
ow
m
z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Tem
_
Z
x
oin
=
z
o
�
o
Outfall:
30 PP
C
P
7
u1LT.
X
X
COD,TSS,O&G, H
G
Outfall:
C
P
COD,TSS,O&G, H
G
G
Outfall:
C
P
I
jC0D,TSS,0&G,pH
G
AG
Outfall:
C
P
X..
X
COD,TSS,O&G, H
! z 13 I
G
G
Outfall:
C
P
COD,TSS,O&G, H
G
G
C
P
G
G
C
P'
G
G
C
P
G
G
C
P
--L—iL
A
I
G
G
Transfer
Relinquished By:
Daterrime
Received By:
DatelTime
1.
2.
Temperature when
J
Delivered By: Received
Comments:
le Requested
-
TURNAROU D:

STORMWATER DISCHARGE OUTFALL (SDO)
MONTrORING REPORT
GEI+TRAL PERMIT NO, NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR;
CERTIMCATE OF COVERAGE NO. NCG06AO—,'3,10 _ (This monitoring report is due at the Division no later than 30 dAys from
FACILITY NAM �J� the date the facility receives the sam ling results from the laboratory.)
COUNTY Lr
PERSON COLLECTING SAMPLES L _ _ � � I� NO. !a 8 -- 7 2
CERTIFIED LABORATORY / F Lab #
Lab # FEB 2 5 ffl�kSE SIGN ON THE REVERSE -!
Part A: Specific Monitoring Requirements
EN RAL FILES
Outfoll
No,
Date
Sample
Collected,
moldd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
m
pH,
Standard units
Chemical Oxygen
Demand,
m
Oil and Grease,
mg/1,
Fecal Coliform,
Colonies per 100 ml
Benchmark
100
Within 6.0 — 9.0
120
30
1000
O
0
Note: if you. report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I orTier-2 responses.
See General Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of now motor oil per month? —yes ^no
(If yes, complete Part B)
Part B. Vehicle Maintenance Activity Monitoring Requirements
Outfau
No.
Date
Sample Collected,
moldd/ r
00556
00530
00400
Oil and Grease,
,m
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual averse gaVmo
Benchmark
30
100
6.0 — 9.0
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Pvent Precipitation (inches)-
Date (list each additional event sampled this reporting petlod, and rainfall amount)
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Total Event Precipitation (inches)-
S WU-249-102107
Page 1 of 2

"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. T am aware that there are significant penalties for submitting false information, including
the possibility of fines and imprisonment for knowing violations."
xgnature of Permittee) (hate)
z
i
1
S WU-249-102 ! a7
Page 2 of 2

Environmental Chemists, Inc.
f 6W2 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
© 710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Pax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Pax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Johnson Breeders CIO House of Raeford
Date of Report:
Feb 17, 2016
PO Box 40
Customer PO #:
Rose Hill
NC 28458
Customer 1D:
15080011
Attention:
Chris Murray
Report #:
2016-01531
Project ID: Stormwater
Lab ID
Sample ID: Big Ed Feed Mill
`Collect DatelTime' Matrix
Sampled by
16-0358B
Site: outfall 1
2/4/2016 9:00 AM' Water
Client
Test Method Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
<5 mg/L
02109/2D16
Residue Suspended (TSS)
SM25400
10.8 mg/L
02/05/2016
PH
SM 4500 H B
7.09 units
02/1612016
COD
SM 5220D
60 mg/L
02/08/2016
Lab ID Sample 1D: Big Ed Feed Mill Collect DateITime`
Matrix Sampled by
16-03589 Site: outfail 2
2/4/2016 9:15 AK
Water Client
Test
Method
Results Date Analyzed
Oil & Grease (O&G)
EPA 1BS4
<5 mglL
0210912016
Residue Suspended (TSS)
SM 2540 n
35.6 mg/L
02/0512016
py
SM 4500 H a
2.50 units
02/16/2016
Estimate: result is outside calibration range. Sample showed no reaction to BaCI-botle was not acidified with H2SO4
COD
SM5220D
124 mg/L
02/08/2016
Comment:
Reviewed
by�.4
Report �'r.: 201E-01531 Page 1 of 1

6602 Windmill Way
mington
ENVIRONMENTAL CHEMISTS, INC OFFICE:9 0-3 2-02231FAX[phone]
Analytical &Consulting Chemists
NCDENR: DWQ CERTIFICATION # 94 NCOHM DL5 CERTIFICATION # 37729 infoQenvlronmentalchemisls.com '
COLLECTION AND CHAIN OF CUSTODY
Client: House of Raeford Johnson Breeders
PROJECT NAME: Big Ed Feed Mill -Rose Hill
REPORT NO:
ADDRESS,
CONTACT NAME: Michael Newton
PO NO:
REPORT TO:
PHONEIFAX:
COPY TO:Chris Murray
small:
Sampled By: SAMPLE TYPE: I = Influent, E =; Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
N F
E$ ID
ti
0 0
U a
`a E
V
�
z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
z
z
x
x
x
o
o
Outfall: -lip
C
P
3�
X
X,
COD,TSS,O&G .
G
A&MC
G
Outfall: t
C
P
X
X
L
COD,TSS,O&G
G
G
#2
c
G
#- Z
:5A
C
G
2
C
G
`
C
P
C
P
G
G
Meter reading start): Meter reading (end):
Transfer
Relinquished By:
Date/Time
Rec ived By:
Daterrime
I.
° rrJ
Y � zo .Lx—.�
2.
Temperature when Received: I ' Accepted: R jecte : Resample Re ue ted:
Delivered By; Received By. Date: 0- �`�` I Time: S
Comments: TURNAROUND:

i'
envirochem---�
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc. ?•
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab 0 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
info®eaviroamentalchemists.com
Johnson Breeders C/O House of Raeford
Date of Report:
Feb 17, 2016
PO Box 40
Customer PO #:
Rose Hill
NC 28458
Customer ID:
15080011
Attention:
Chris Murray
Report #:
2016-01531
Project ID: Stormwater
Lab ID
Sample ID: Big Ed Feed Mill
Collect Date/Time' Matrix
Sampled by
1"3588
Site: butfall 1 '
2/4/2016 9:00 AW Water
Client
Test
Method
Oil & Grease (O&G) EPA 1664
Residue Suspended (TSS) SM 2540 D
PH SM 4500 H B
COD SM 5220D
Lab ID Sample ID: Big Ed Feed Mill Collect Date/Time
16-03589 Site: outfall 2 2/4/2016 9,15 AM'
3
Results Date Analyzed
<5 mg/L 02/09/2016
10.8 mg/L 02/05/2016
7.09 units 02/1612016
60 mg1L 02/08/2016
Matrix Sampled by
Water Client
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1604 <5 mg1L 02/09/2016
Residue Suspended (TSS) SM 2540 D 35.6 mg/L 02/05/2016
PH SM 4500 H 8 2.50 units 02/16/2016
Estimate: result is outslde calibration range. Sample showed no reaction to BaCI-botle was not acldltied with H2SO4
COD SM 5220D
Comment: n
Reviewed. by: - -p�(Q - O�LX IiUU 1,
124 mg1L 0210812016
Report#:: 201"1531 Page 1 of 1

• 1E
ENVIRONMENTAL CHEMISTS, INC OFFICE: 9103 2-0223Imingto FAX[phone]
Analytical Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail] '
COLLECTION AND CHAIN OF CUSTODY
Client: House of Raeford Johnson Breeders
PROJECT NAME: Big Ed Feed Mill -Rose Hill
REPORT NO:
ADDRESS:
CONTACT NAME: Michael Newton
PO NO:
RIEPORT TO:
PHONEIFAX:
COPY TO:Chris Murray
email: Mjr ,C
Sampled By: SAMPLE TYPE: I = Influent, E ; Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
2,
E CL
y
in �
o a r
U
cC7
s o
" ..
2
=
"
dw
n
_
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
z
=
x
x
x
o
Outfall: 1
prj A
C
P
3s� S
X
X.4
1
COD,TSS,O&G ,
G
G
I
f
C
G
Outfall:
C
P
X
X
L
�, f
jC0D,TSS,0&G I
G
G
- 2
C
G
- Za
5
C
I G
i ZQ
F19
Am
C
6
G
Z.
C
P
G
C
P
G
G
Meter reading start): Meter reading (end):
Transfer
Relinquished By:
DatelTime
Rec ived By:
DatefPime
.{
1.
[�
2.
Temperature when Received: I '6 16— Accepted:
Delivered By: R
Comments:

STORMWATER DISCHARGE OUTFALL (SDO)
MONTTOR.ING REPORT
GENERAL PERMIT NO, NCGO60000
CERTIFICATE OF COVERAGE NO, NCGO60 &42 y
FACILITY NAME ar4q--axe �" �G�
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Lab #
Lab N
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2c'�
(This monitoring report is due at the Division no later than 30 d4ys from
the date the facility receive the sa jpIng� esu rare the laboratory,)
PHONE NO. /D ��/ Z
PLEASE SIGN ON THE REVERSE 4 RECEIVED
Outfall
No,
Date
Sample
Collected,
mo/dd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
m
pH,
Standard units
Chemical Oxygen
Demand,
m
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmark
-
100
Within 6.0 — 9.0
120
30
1000
RA3/
.5
. 17
./
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier-2 responses.
See General Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes _no
(if yes, complele Part B)
Part B; Vehicle Maintenance ActivityMonitoriu Requirements
Outfan
No,
Date
Sample Collected,
mo/ddl r
00556
00530
00400
Oil and Grease,
AWL
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual averse allmo
Benchmark
30
100
6,0 — 9.0
-
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses,
See General Permit text.
STORM EVENT CHARACTERISTICS;
Date aff (first event sampled)
Total Event Precipitation (inches): el
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (incises):
Mail Original and one copy to;
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
MAR 14 2016
ENTRAL FILES
►WR SECTION,
SWU-249.102107
Page 1 ON

" 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. X am aware that there are significant penalties for submitting false information, including
the possibility of fines and imprisonment for knowing violations."
of Permittee)
t �
(Date)
S WU-249-102107
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG06 4 3/a (This monitoring report is due at the Division no later than 30 days from
FACILITY NAME �X&AS/�j�j�%� /YJ/LL the date the facility receives the am ins res Its from the laboratory.)
COUNTY
PERSON COLLECTING SAMPLES _ R E C E I V E D HONE NO. a --
CERTIFIED LABORATORY Lab #
Lab # ' DEC 2 9 2015 PLEASE SIGN ON THE REVERSE -�
Part A: Specific Monitoring Requirements
Outfall Date 00530
No. Sample Total Suspended
Collected, Solids,
mo�an� r
Benchmark q/
Note: If you report a sampled value
Soe General Permit text,
100
pH,
Standard units
6.0 — 9.0
CENTRAL FILES
DWR SECTION
00340
Chemical Oxygen
Demand,
120
00556
Oil and Grease,
mg/L
30
31616
Fecal Collform,
Colonies per 100 ml
excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier-2 responses.
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 Activi onitoring Requirements
Outfall
No,
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
m
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual average al/mo
Benchmark
30
100
6,0 — 9.0
w.
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range For pH, you must implement Tier I or Tier 2 responses.
See General Permit lext.
STORM EVENT CHARACTERISTICS:
Date o&�— (first event sampled)
Total Event Precipitation (inches);
Date Olst each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches);
Mail Original and one copy to:
Division or Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S WU-249-102107
Page I of 2

"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
Mid Atiou 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."
re of Permittee)
(Da e)
S WU-249-1021 a7
Page 2 of

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO, NCG060000
CERTIFICATE OF COVERAGE NO. NCG.0r6 DR/CO
FACILITY NAME .%1�5? � N /L
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY _/,P,A/�'� Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR;
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the am ng re Its from the laboratory.)
COUNTY ,M .1RJ
PHONE NO. /c
PLEASE SIGN ON THE REVERSE 4 RECEIVED
OCT 2 6 2015
Outfall
No.
Date
Sample
Collected,
moldd/ r
00530
00400
00340
00556
31616 CE,
Total Suspended
Solids,
gT&
pH,
Standard units
Chemical Oxygen
Demand,
mWL
Oil and Grease,
mg/L
Fecal Coliform, DIA
Colonies per 100 ml
Benchmark
-
100
Within 6,0 -- 9,0
120
30
1000
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier l or Tien 2 responses.
See General Permit text. /�
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yesYF-
(if yes, complete Part B)
Part B. Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample Collected,
moldd/ r
00556
00530
00400
Oil and Grease,
to
Total Suspended Solids,
m g&
pH,
Standard units
New Motor Oil Usage,
Annual averse al/mo
Benchmark
-
30
100
6.0 — 9.0
-
Note; If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses,
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date g (first event sampled)
Total f9vent Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Am DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
4TRAL FILES
RCTlON
S WU-249-102107
Page I of 2

"I certify, under penalty of law, that this document and all attachmeuts 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)
0
/S WU.249-102107
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO, NCG060000
CERTIFICATE OF COVERAGE NO. NCG06_
FACILITY NAME A4Vi4 inS
PERSON COLLECTING SAMPLE
CERTIFIED LABORATORY V Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: AP1.
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the so I results from the laboratory,)
COUNTY _ 1� 4!1It)
"e PHONE NO.
PLEASE SIGN ON THE REVERSE 4
Outfall
No.
Date
Sample
Collected,
moldd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
mg/L
pH,
Standard units
Chemical Oxygen
Demand,
in
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmark
-
100-
Within 6.0 — 9.0
1 120
30
1 1000
.Z
7"
. //
dote: 1 f you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses.
See General Permit text. RECEIVED
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 Activi Monitorin Requirements
MAR 052015
CENTRAL FILES
DWF SECTION
Outfall
No,
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
m
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual averse al/mo
Benchmark
-
30
100
6.0 — 9.0
-
Note: I f you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date ! z (first event sampled) Q �� Attn: DWQ Central Files
Total Event Precipitation (inches): 7 1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
S WU-249-102 t 07
Page I of 2

1 "Leertify, 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)
S WU-249-102107
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06 67310
FACILITY NAME
PERSON COLLECTING SAMPLES L�
CERTIFIED LABORATORY Lab # CJ22—
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: •�
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the samg re„s� s fr„pm the laboratory.)
pli
COUNTY f A.J
PHONE NO, a) '
PLEASE SIGN ON THE REVERSE 3
Outfall
No.
Date
Sample
Collected,
mo/dd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
m
pH,
Standard units
Chemical Oxygen
Demand,
MEL
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmark
-
t00
Within 6.0 — 9.0
120
30
1000
r z:>
f
�A/.!
23
ri
. ,
Note: If you report a sampled (alue in excess of the benchmark value, or outside the benchmark range for pl-1, you muse implement Tier l or Tier 2 responses.
See General Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons ornew motor oil per month? —yes �_`rno
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
m
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual averse al/mo
Benchmark
-
30
100
6.0 — 9.0
-
Note: If you report a sampled value in excess of the henchrnark value, or outside the benchmark range for pli, you must implement Tier l or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date(first event sampled) ! /�
Total Event Precipitation (inches): L%
Date (list each additional event sampled this reporting period, and rainfall amount)
Mail Original and one copy to:
Division of Water Quality
Attn; DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
C
EEI V ED
AU 01 Z014
CENTRAL FILES
DWaieoG
Total Event Precipitation (inches):
S WU-249-102107
❑- 1 .,F'1

"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)
SWU-2a9-102107
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCGO60000 SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG06 Q (This monitoring report is due at the Division no later than-30 days from
1 4 y� ' the date the facility receives the sampling results from the laboratory.)
FACILITY NAME tg s Soil � A� S^ 2ti /'�(G� COUNTY PVAI_jN
PERSON COLLECTING SAM LES C tf e)5 ffi UA%'t PHONE NO. (aro qYO —~_ q'
CERTIFIED LABORATORY �f�1� t 'i3� — a6 # 0
Lab # PLEASE SIGN ON THE REVERSE
Part A: Specific Monitoring Requirements
Outfall
No.
Date
Sample
Collected,
mo/dd/ r'
00530
00400
00340
00556
31616
Total Suspended
Solids,
m
pH,
Standard units
Chemical Oxygen
Demand,
m
Oil and Grease,
mg/L
Fecal Coliform;
Colonies per 100 ml
Benchmark
a. -
100
Within 6.0 — 9.0
120
30
.-rE 1000'F 0
Sba D I
t z Z
O
c
d
ll
I
Note: If you report J sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 br Tier 2 responses.
See General Permit text. �1
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? T yes _,,.no
(if yes, complete Part B) VIP
Part B. Vehicle Maintenance Activity onitoring Requirements
Outfall
No.
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
mgfL
Total Suspended Solids,
m
pH,
Standard units
New Motor Oil Usage,
Annual average al/mo
Benchmark
-
30
100
6.0 — 9.0
-
Dote: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date?31 first event sampled) r3 .
Total Event Precipitation (inches): �!
Date — (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
SWU-249-102107
Page 1 of 2

"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 e} (D e)'
Swu-249-102107
Page 2 of 2