NCG060348_MONITORING INFO_20190603

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0. I Iv C& (Q C2 0
DOCTYPE I ❑ HISTORICAL FILE
2$ MONITORING REPORTS
i
DOC DATE ❑ Sol U3
J
YYYYMM DD

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted �0!
CERTIFICATE OF COVERAGE NO. NCG06
FACILITY NAME AM M ��t 5 b 6H bU I LlV,
COUNTY )
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
RECEIVED
JUN 10 2M
CENT I�AL FILES
DWR SECTION
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR a I -
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or 2rMonthlysM,(k � 9 011 (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
Piero -flow ❑Water Supply ❑SA
❑Other
FACIL,IT,YArT.IVITIES INCLUDE (chec all that apply):
use/meats Muse animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall' or VNo discharge this period3
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 per 100 ml
Enterococci,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
10001
5001
Parameter Code
-
COS30
00400
00340
00556
31616
61211
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 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.
Outfall No.
Date Sample Collected
(mo/dd/yr)
24-hour rainfall amount,
IncheS2
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/Total
Petroleum Hydrocarbons
Total Suspended Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/L4
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 SEC ION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES OR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ff NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES O ❑
REGIONAL OFFICE CONTACT NAME: jrtfiR �
Mail an original copy of this OMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case
of "No Discharge" reportsi :
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
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 Permitte
ace M
Date
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qualit Ge rai Permit No. NCG060000
Date submitted 7 1c) 0 P�
CERTIFICATE OF COVERAGE NO. NC606Da a SAMPLE COLLECTION YEAR
FACILITY NAME � r LC FACILITYACTIVITIES INCLUDE (chp3k all that apply):
COUNTY Va 1Z use/process meats Eyuse animal! byproducts
PERSON COLLECTING SAMPLES wn DISCHARGING TO SALTWATERS? DYES E3hO
LABORATORY V} Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
lr
Total event rainfall 2 D s 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
Enterococcf ,
Colonies per 100 m1
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
3o
1000
500
.
U
5
S
III
5
,51
15
15
0560
<5
3 2
-
Only applies to facilities that use/process meats. APR ZQ ��
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
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark aprhyt SECTION
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/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
300 or 50
6.0 — 5.o
-
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.
(ifyes. complete Part B)
S'i U-249 Last Revised: October 18, 2012
Page 1 of 2

"FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCE£DANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il 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 EXCEEDENCE FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES �O ❑
IF YES, HAVE YOU CONTACTED THE D_W GI AL OFFI E? YES NO ❑
REGIONAL OFFICE CONTACT NAME: _'IGUM"
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 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
1�
(D te)
Additional copies of this form may be downloaded at: http:URortal.ncdenr.oriz/web/wgws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

Environmental Chemists, Inc.
envirochem
ANALYTICAL & CONSULTING CHEMISTS
6602 Windmill Way, Wilmington, NC 28405 • 910,392.0223 Cab • 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
[e-mail]
American Skin, LLC. Date of Report: Apr 16, 2019
Post Office Box 1445 Customer PO #:
Burgaw NC 28425 Customer ID: 08100003
Attention: Ray Talbot Report #: 2019-05244
Project ID: Stormwater
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
19-13155 Site: Outfall Area 1 4/2/2019 8:30 AM Water Client
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1564 5 mg/L 04/11/2019
Residue Suspended (TSS) SM 2540 D 126 mg/L 04/03/2019
COD SM 5220D 76 mg/L 04/0812019
Fecal Coliform SM 9222D MF 1150 Colonies/100mL 04/02/2019
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
19-13156 Site: Outfall Area 2 4/2/2019 8:25 AM Water Client
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 04/11/2019
Residue Suspended (TSS) SM 2540 D 54.0 mg/L 04/03/2019
COD SM 5220D 75 mg/L 04/08/2019
Fecal Coliform SM 92220 MF 12500 Colon ies/100mL 04/02/2019
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
19-13157 Site: Outfall Area 3 4/2/2019 8:20 AM Water Client
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 04/11/2019
Residue Suspended (TSS) SM 2540 D 81.0 mg/L 04/03/2019
COD SM 52200 72 mg/L 04/08/2019
Fecal Coliform 5M 9222D MF 364 Colonies/100mL 04/02/2019
Comment:
Reviewed by:
Rpoon ft- 201a-n59dd " .

?eems
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWO CERTIFICATION # 94 NCDHHS: OLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, N0'28405
OFFICE: 910-392-=3 FAX [phone]
Info 0environmentalchemists.com
Client: American Skin, LLC-Bur aw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO: `Z
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO: Ray Talbot
PHONEIFAX:
COPY TO:
email:
Sampled By: SAMPLE TYPE: I = influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
a
a A
E o
o
�,
cC9
c o
G E
"
�,
c�
o
v
Q
ow
a
'' z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
_
i
=
$
2
o
=
0
z
0
F-
Outfall:
1
.3b
C
P
` r
`��7
X
X
A
X
Oil & Grease, TSS, ,COD,Fecal
—,7—T
G
n
C
P
G
G
C
P
G
G
Outfall:
` J f
X
X
X
Oil & Grease, TSS, , . ,COD,Fecal
G-)
G
C
P
G
G
C
P
G
G
Outfall: 3
X
X
X
Oil &Grease, TSS. �COD,Fecal
G )
G
C
P
G
G
C
P
G
G
Transfer
Aeftquf&he4 By:
Date/Time,
Received By:
Daterrime
2.
Temperature when Received: 2. Ld— Accepted: Re! cted: Resample Requested:
Delivered By: Received By: Date: C1 Time: 4 as
Comments: _ _ _ TURNAROUND:

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Wate u�jj neral Permit No. NCG060000
Date submittedU
CERTIFICATE OF COVERAGE NO. NCG06 0 SAMPLE COLLECTION YEAR
FACILITY NAME .4mW[W] FACILITY IVITIES INCLUDE (check atthat apply):
COUNTY � Use/process meats ED4se animal fats byproducts
PERSON COLLECTING SAMPLES IVIA DISCHARGING TO SALTWATERS? ❑YES
LABORATORY Lab Cert. #
PLEASE REMEMBER TO SIGN ON;NeoV
E RESE
Part A. Stormwater Benchmarks and Monitoring Results Total event rainfall or discharge this periods
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
m /L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 200 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
Soo
'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.
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 (if yeS complete part Bj
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
-
o 41144I�
CU��uuc��e
havvT
in Marc,N ao1 q
1 Only applies to facilities that use/process meats.
7.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, 'Fable 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
S WU-249
Last Revised; October 18, 2012
Page I of 2

U
r
*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 VIER 2 REQUIREMENTS. SEE PERMIT PART II SE ON B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES �O
IF YES, HAVE YOU CONTACTED THE pW yQ ALNI ? ES [ NO
REGIONAL OFFICE CONTACT NAME:JU E
Mail an original and one copy -of this DMR, including all "No Discharge" reports, within 30 dabs 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 27699-1617
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
inform ion, includin q,possibility of fines and imprisonment for knowing violations."
~ e-1r I I q -
re of Permittee) (Date)
Additional copies of this form may be downloaded at: httn://portal.ncdenr.ore/weblw /ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

- SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
�t
for North Carolina Division of Water Qual't DGeneral Permit No. NCG060000
Date submitted 3 C�
CERTIFICATE OF OVERAGE NO. NCG06 D 6 SAMPLE COLLECTION YEAR Q bl
FACILITY ME r�-� FACILITY IVITIES INCLUDE (chec all that apply):
COUNTY EIVE[. use/process meats Muse animal is/byproducts
PERSON COLLECTING SAMPLES A guSCHARGING TO SALTWATERS? []YES'O
LABORATORY Lab Cert. #
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
nwR S EcTi3Oc\!
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall z or [�P)No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
m /L
Oil and Grease,
mg/L
)fecal Collform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
Soo
r
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.
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.
Outfali 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
-
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 B)
SWU-249 Last Revised: October 18, 2012
Pagel 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 11 SE lON B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [�O
IF YES, HAVE YOU CONTACTED THE }�j��'IPNAL OFFFFIC�E?? YES � NO ❑
REGIONAL OFFICE CONTACT NAME; T l� IT :16 11W1
Mail an original and one copy of this DMR, including all "No Discharge" reports,, within 30 days off_o ,receipt of the lab results r at end of
monitoring period In the case d_"No Discharge" reportsf to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFIG4 TION 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."
Dj
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wo/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVU.;
for North Carolina Division of Water ality, General Permit No. NCG060000 FEB 0 6 2019
Date submitted pvl d
y hh CENTRAL_ FILEu
CERTI ICATE OF COVERAGE NO. NCG060 3 SAMPLE COLLECTION YEAR �� 1 'i DW. R SECTION
FAG'LITY , AME 1rQ0 [�� FACILITY CTIVITIES INCLUDE (che all that apply):
COUNTY Fuse/process meats R1 use animal f /byproducts
PERS(;N COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES NO
LABORATORY rt Lab Cert. #
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfa112 or VNo discharge this Perim?
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 mi
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0--9.0
120
30
1000
Soo
r
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? ❑ yes dno
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 SO
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.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
400
4600 GV1,,.I
jan�u,� -to
(if yes, complete Part Bj
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 11 SECTION B.
0 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 EXCEEDEN S FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES []ENO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGI NAL OFF[ ? YES WNO
REGIONAL OFFICE CONTACT NAME;
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days pf receipt of the fah results for at end of
monitorina period in the case o "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."
of
{ atej
Additional copies of this form may be downloaded at: htti)://portal.ncdenr.oriz/web/`wg/ws/su/`nUdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
r
for North Carolina Division of Water Quali General Permit No. NCGO60000
3 S PO
Date submitted i 1 oil_
�J U
CERTIFICATE OF COVERAGE NO. NCG060 SAMPLE COLLECTION YEAR
FACILITY NAME } n F ) r I r P IV AS TY,ACTIVITIE5 INCLUDE (Fhk all that apply):
COUNTY f [�� use/process meats se animal f tsJbyproducts
PERSON COLLECTING SAMPLES i Uv JAN 18 2V9CHARGING TO SALTWATER5? ❑YE5 QNO
LABORATORY
bCert. # n r R rr.-i
I_ FILE
LU/13 SECTION
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
i
Total event rainfall I or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
can,
m /L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 mt
Benchmark
-
100 or 50
Within 6.0-9.0
120
30
1000
s00
�a 1
H, 9
ETA
JH
5
&QQ0
aCp,
000
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 ank 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.
Outfali No. 1
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
rn 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 M 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 Z 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 it SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCfS FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [D'NO ❑
IF YES, HAVE YOU CONTACTED THE DW REG,1n0 AL OFFICE? YES QNO ❑
REGIONAL OFFICE CONTACT NAME: I — - -)&WLA2,Q _
Mail an original and one cony of this DMR, including all "No Discharge„ reports, within 30 days of receipt of the lab results f or at end of
monitoring period in the case of "No Discharge" reports) ta:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFIC4TION 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."
of Permitteej
11 it-11(q
to ej .�
Additional copies of this form may be downloaded at: http:l/Portal.ncdenr.org/web/w-q/ws/su/njRdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

Environmental Chemists, Inc.
ANALYTICAL 8 CONSULTING CHEMISTS
6602 Windmill Wa}; Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 8owsertown Road, Manteo, NC 27954 . 252,473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
American Skin, LLC. Date of Report: Jan 11, 2019
Post Office Box 1445 Customer PO #:
Burgaw NC 28425 Customer ID: 08100003
Attention: Ray Talbot Report #: 2018-21488
Project ID: Stormwater
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
18-54118 Site: Outfall Area 1 12/28/2018 12:15 PM Water Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 01/07/2019
Residue Suspended (TSS) SM 2540 D 24.9 mg/L 12/30/2018
COD SM 5220D 24 mg/L 01/03/2019
Fecal Coliform SM 9222D MF 6200 Colonies/100mL 12128/2018
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
18-54119 Site: Outfall Area 2 12/28/2018 12:20 PM Water Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (0&G) EPA 1664 <5 mg/L 01/07/2019
Residue Suspended (TSS) SM 2540 D 26.7 mg/L 12130/2018
COD SM 5220D 48 mg/L 01/03/2019
Fecal Coliform SM 9222D MF 23000 Colonies/100mL 12/28/2018
Lab ID Sample ID: Collect DaterTime Matrix Sampled by
18-54120 Site: Outfall Area 3 12/28/2018 12:10 PM Water Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (0&G) EPA 1664 <5 mg/L 01/07/2019
Residue Suspended (TSS) SM 2540 D 114 mg/L 12/31/2018
COD SM 5220D 41 mg/L 01 /03/2019
Fecal Coliform SM 9222D MF 145 Colonies/100ml- 12/28/2018
Comment: KQ
c
Reviewed by:

Analytical & Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
Client: American Skin, LLC-Bur aw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO: '' Z
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO: Ray Talbot
PHONEIFAX:
COPY TO:
email:
Sampled By: L, 4 AA 9 A. A 11 Y VAN I SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
m
q F
y
r
A
2 0
t
c o CL
U
m
c J
s�
U
�
a
J 2
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
_
Z
s
y
S
o
=
0
Z
0
O
Outfail:
C
P
4
X
X
X
Oil & Grease, TSS, ,COD,Fecal
1
G
C
P
G
G
C
P
G
G
Outfall: O�
U
C
P
X
X
X
I Oil &Grease, TSS, ;COD,Fecal
G
c
C
P
G
G
C
P
G
G
Outfall:
C
P
X
X
`
X
Oil & Grease, TSS, pdJr-OD,Fecal
G
G
- - VV
��Z[�
(j}
GEEF
P
I
T_
G I
G
Transfer
r II I R li wished By:
Date[Timq
Received By:
Date/Time
2.
Temperature when Received: ____1) . i Accepted: /
Delivered By: Received By:
Comments:
Resample Requested:
r) Date: # L �`� ! Time:
TURNAROUND:

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
,L for North Carolina Division of Water Quality General Permit No. NCG060000
Datesubmitted
�l a I n/ iX
CERTIFICATE OF COVERAGE NO. NCGQ6� Q U PCCrte7 (S MA PLE COLLECTION YEAR _,2 ��, K
FACILITY NAME A FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY UIL
RECE I I rD"use/process treats �e animal fats/byproducts
byproducts
PERSON COLLECTING SAMPLES N DISCHARGING TO SALTWATERS? []YESL�
LABORATORY Lab Cert. # ��� I2 2018
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTIRAL FILES
Part A: Stormwater Benchmarks and Monitoring Results DWR SECTION Total event rainfall) or No discharge this period3
outfail No.
Sample Collected,
mo/dd/yr
TSS,
mg/1
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
Soo
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? ❑ yes EYno
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
-
(if yes. complete Part B)
dJJ S('h ([ n1-e_ W/
cvvl tLjote �U w p)"-r
NOV a.di8
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.
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
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 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN19ES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES D40 ❑
IF YES, HAVE YOU CONTACTED THE DW REGI AL OFFI r? ES NO ❑
REGIONAL OFFICE CONTACT NAME:. �y� j �� 1"
Mail an on lnal and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt Of the lab results or at end o
monitarinq 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 INFORMA TION 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, includir�tf'e possibility of fines and imprisonment for knowing violations."
re of Permittee)
l.- 10 �
(Dat )
Additional copies of this form may be downloaded at: httr)://Uortal.ncdenr.—oWweb/w-q/ws/su/gpdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2

`L
CERTIFICATE OF
FACILITY NAME
COUNTY
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qualit General Permit No. NCG060000
#' Date submitted d�-Q
E� O�NCG i5 U v 0�d3 y SAMPLE COLLECTION YEAR 0-0 10
PERSON COLLECTING SAMPLES "`IH
LABORATORY r AA Lab Cert. #
RECEIVED
NOV 0 9 2€118
c 1A C FACILiIY,ACfIVITIES INCLUDE (che k all that applyl: CFNTIRAL FILES
use/process meats 5use animal fa /byproductsS�C�iC��
DISCHARGING TO SALTWATERS? []YES
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE —>
Total event rainfall 2 or �o discharge this period
outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COO,
mg/L
Oil and Grease,
mg/L
Fecal Coiiform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
Soo
`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
-
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
(ice complete Part B)
� ND aQ�1iCu.bl-, dEkka��
his NRi h - (1oh't
dwi V)� s(IM P 114
mQ6
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 it 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 EXCEEDEN ES FOR THE SAME PARAMETER AT ANY ONE OUTFALL?, YES VNO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONA OFFICE? YES Fq 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 lob results (or at end of
monitoring period in the case o "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
informaAion, including the p9ssibility of fines and imprisonment for Knowing violations."
r1-,�e
(D to
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wglws/su/npdessw#tab-4
SWU-249 Last Revised: October I8, 2012
Page 2 of 2

"- SEMI-ANNUAL. STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qu H neral Permit No. NCGO60000
Date submitted v C) a
o
CERTIFICATE OF COVERAGE NO. NCG06 () O SAMPLE COLLECTION YEAR � LO
FACILITY AME r``�� FACILITY ACTIVITIES INCLUDE (cheq all that apply):
COUNTY r Q use/process meats Vuse animal f /byproducts
PERSON COLLECTING SAMPLES r. ISCC�GING TO SALTWATERS? []YES
LABORATORY _ Lab Cert. # i//
OCT11 10 2018 PLEASE REMEMBER TO SIGN ON THE REVERSE -�
Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES Total event rain all z or FT lNo discharge this period3
Outfall No.
Sample Collected,
mo/dd/
TSS,
mg/L
pH,
Standard units
CNKA>5 ECT
mill.
lOtbii and Grease,
mg/L
Fecal Coliform I, IEnterococci
Colonies per 100 ml
,
Colonies per 100 ml
Benchmark
100or50
Within 6.0 — 9.0
120
30
1000
SOD
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? Elves Q no (if ves, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 5S gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
oil and Grease,
mg/L
TSS,
moll.
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
AND T O Ulk lt Scharge
sq w W
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
Page 1 of 2

*FGR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 £XCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Il SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES E 'NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NNO ❑
REGIONAL OFFICE CONTACT NAME: - ff n± ,1Ia`w
Moil an ariclinal and one copy of this OMR, including all "No Discharcle" reports, within 30 days of receipt of the lab results or at end of
monitorin eriod in the case o "No Dlschar e" re orts 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 knowle ge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, inZXZ)
possibility of fines and imprisonment for knowing violations."
jojqjje�
I[SkQure of Permittee) (Dat )
Additional copies of this form may be downloaded at: httpJ/portal.ncdertr.ore/web/wq/ws/su/ngdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

t SEMI-ANNUAL STORMWAT_ER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quail' y General Permit No. NCG060000
IY 1 , K% Date submitted `o
IV _
CERTIFICATE OF COVERAGE NO. NC 06fj
FACILITY NAME S in j
COUNTY W Yl
PERSON COLLECTING SAMPLES _NIA
LABORATORYLab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 01 (A
t C r� C FACILITY. -ACTIVITIES
- ` INCLUDE (check all that apply):
a �� •use/process meats use animal fa/byproducts
-AJIG 1 D1!RlifRGING TO SALTWATERS? []YES
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
GMIR SECI'i0f ]
Total event rainfall 2 or [9 No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH, i
standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 104 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
S00
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? ❑ yes D/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 54
6.0 — 9.0
-
(if ves, complete Part B)
uo aficubi-e
aol�-not ena�qh
dry dayg i✓� a row
to
2 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge. i l [/,o,, � Iupraj
3 For sampling periods with no discharge at ga 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

..J
*FOR PAST 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 SE ION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES QNO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ZNO ❑
REGIONAL OFFICE CONTACT NAME:
0
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) ta:
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 violations."
S1,7112
(Da )
Additional copies of this form may be downloaded at: http://oortal.ncdenr.or web/wg/wslsulnpdessw#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 Q ality GenK
al Permit No. NCG060000
if/ G- 6 � a3 Date submitted o�U
CERTIFICATE OF OVERAt2E NO. NC 060 0 0 0 SAMPLE COLLECTION YEAR :20)
FACILITY N E r 1, FACILITY A IVITIE5 INCLUDE (check all that apply):
COUNTY �
se/process meats lSe animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? DYES R>d
LABORATORYa1V1MYl1Bfj1[Cjl LabCert.#
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
(Jr l
Total event rainfall 3 ! or ❑ No discharge this periods
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 SO
Within 6.0 — 9.0
120
30
1000
Soo
1
. i,
45
3,14000
,..
a.
%•f
50
45
15000
•3
. a
<
000
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 anj 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 l"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 SO
6.0 — 9.0
-
l 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 gjn 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)
RECEIVED
,SUN 28 2018
CENTRAL FILES
DWR SECTION
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 11 SECTION B.
0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES 2110 ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFIC ? YES ►INO
REGIONAL OFFICE CONTACT NAME: _ Dantu-
Mail an original and one copy of this D_MR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case d"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."
re of Pe
l /"1115
(D te)
Additional copies of this form may be downloaded at: httq://yortal.ncdenr.org/web/wg/ws/su/npde5sw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

1-
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Wi),, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 252.473.5702 Lai/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 a 910.347.5843 Lab/Fax
info[lietivii-ofinlciltalclienlists.coln
American Skin, LLC. Date of Report: Jun 22, 2018
Post Office Box 1445 Customer PO #:
Burgaw NC 28425 Customer ID: 08100003
Attention: Ray Talbot Report #: 2018-09537
Project ID: Stormwater
Lab ID Sample ID: Collect Daterflme Matrix Sampled by
6/14/2018 2:25 PM Water Kelley Brown
18-24033 Site: Outfall Area (9 0
Test Method
Oil & Grease (O&G) EPA 1664
Residue Suspended (TSS) SM 2540 D
COD SM 5220D
Results Date Analyzed
Fecal Coliform SM 9222D MF
Lab ID Sample ID: Collect DatefTime Matrix
18-24034 Site: Outfall Area `% 6/14/2018 2:20 PM Water
<5 mg/L 06/20/2018
42.0 mg/L 06/15/2018
50 mg/L 06/18/2018
13000 Colon ies/100mL 06/14/2018
Sampled by
Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
<5 mg/L
06/18/2018
Residue Suspended (TSS)
SM 2540 D
18.2 mg/L
06/15/2018
COD
SM 5220D
34 mg/L
06/18/2018
Fecal Coliform
SM 9222D MF
34000 Colonies/100ml-
06/14/2018
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
18-24035 Site: Outfall Area 3
6/14/2018 2:15 PM
Water Kelley Brown
Test
Method
Results Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 06/20/2018
Residue Suspended (TSS) SM 2540 D 78.3 mg/L 06/15/2018
COD SM 5220D 98 mg/L 06/18/2018
Fecal Coliform SM 9222D MF 12000 Colonies/100mL 06/14/2018
Comment:
Reviewed by:

A
I -RillENVIRONMENTAL CHEMISTS, I N C 6602 IWindmill: 910-3 2-02231mingtonFAX 910-392-44245
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info 0environmentalchemists.com
Analytical & Consulting Chemists
COLLECTION AND CHAIN OF CUSTODY
Client: American Skin, LLC-Burgaw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO: N'_ 053
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO: Ray Talbot
PHONEIFAX:
COPY TO:
email:
Sampled By: SAMPLE TYPE: I Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
&
H
2
0.E
�,
B
m
E `o
o
cc7
6
o a
" _
m
r
r
¢
CµW
a
Z
PRESERVATION
ANALYSIS REQUESTED
D to
Time
Temp
z
g
x
$
o
i
0
z
o
W
M
Outtall: ��
MkA
C
P
���
X
I
X
X
Oil & Grease, TSS, ,COD,Fecai
G
G
G
G
C
P
G
G
Outfall:
C
P
!!!!
I�-
X
X
X
Oil & Grease, TSS, pfcOD,Fecal
G
I G
`•�
C
P
G
G
C
P
G
G
,R' fit"
Outfall:
C
P
I�10
X
X
X
Oil & Grease TSS, COD,Fecal
p
G
G
P
G
G
C
P
G
G
Transfer
Relinquished By:
I DqterTjrne _
Received By:
Dateffime
2.
Temperature when
[a
Delivered By: Received By:
.Comments:
mple Requested:
ate: J - (Lf- (V Time:
TURNAROUND:
04

ANAL"CAL & CONSULTING CHEMISTS
Environmental Chemists, Inc,
6602 Windmill Way, G1 ilminglon, NIC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highk•ay, Jacksonville, 1\'C 28540 • 910.347.5843 Lab/Fax
info V l I'U II 171C17131C1]Ctl] I S l S. CU!]7
American Skin, LLC. Date of Report: Jun 22, 2018
Post Office Box 1445 Customer PO #:
Burgaw NC 28425 Customer ID: 08100003
Attention: Ray Talbot Report #: 2018-09537
Project ID: Stormwater
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
18-24033 Site: Outfall Area/a 6/14/2018 2:25 PM Water Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (0&G)
EPA 1664
Residue Suspended (TSS)
SM 2540 D
coo
SM 5220D
Fecal Coliform
SM 9222D MF
Lab I❑ Sample ID:
18-24034 Site: Outfall Area
Collect DatelTime Matrix
6/14/2018 2:20 PM Water
<5 mg/L
06/20/2018
42.0 mg/L
06/15/2018
50 mg/L
06/18/2018
13000 Colon ies/100mL
06/14/2018
Sampled by
Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
<5 mg/L
06/18/2018
Residue Suspended (TSS)
SM 2540 D
18.2 mg1L
06/15/2018
COD
SM 522DD
34 mg/L
06/18/2018
Fecal Coliform
SM 9222D MF
34000 Colon ies/100mL
06/1412018
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
18-24035 Site: Outfall Area 3
6/14/2018 2:15 PM
Water Kelley Brown
Test
Method
Results Date Analyzed
Oil & Grease (0&G) EPA 16FA <5 mg/L 06/20/2018
Residue Suspended (TSS) SM 2540 D 78.3 mg/L 06/15/2018
COD SM 5220D 98 mg/L 06/18/2018
Fecal Coliform SM 9222D MF 12000 Colon ies/1 00m L 06/14/2018
Comment.
Reviewed by:

Way
dmill
mington
ENVIRONMENTAL CHEMISTS, INC OF ICE�n910-392-0223iFAX910-392-4424$
Analytical•& Consulting Chemists
NCDENR: DWa CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info®environmentalchemists.com
COLLECTION AND CHAIN OF CUSTODY
Client: American Skin, LLC-Burgaw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO: 0��3
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO: Ray Talbot
PHONEIFAX:
COPY TO:
email:
Sampled By: SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
E CL
a
E o
3
e°
`
z
"
m
PRESERVATION
ANALYSIS REQUESTED
D to
Time
Temp
i
3
0
0
°
Ouffail:
C
P
!
�U3
X
X
X
Oil & Grease, TSS, ,COD,Fecal
G
G
G
C
P
G
G
Outfail:
C
P
GD
X
1
4
d
I X
Oil & Grease, TSS, p ,COD,Fecal
G
�-
G
G
C
P
G
G
Outfafi:
�bZ
X
X
X
Oil & Grease, TSS, p ,COD,Fecal
G
�+
P
G
G
C
P
G4
G
Transfer
Relinquished By:
i D elijme a
Received By:
Date/7-ime
2.
Temperature when Received-. `rV Accepted: ✓
Delivered By: Received By:
Comments:
ile Requested:
Le _ (L_-'t�K —Time: ;
TURNAROUND: ,

�J
_4
CERTIFICATE OF
FACILITY rAAME
COUNTY WIl it
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Wat�f� ual tv General Permit No. NCG060000
Date submitted l9
PERSON COLLECTING S MPLESWY .1 JA
LABORATORY AJ
W
Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
RECENED
JUN 2 2 2018
CENTRAL FILES
SAMPLE COLLECTION YEAR _ DWR SECTION
FACILITYCTIVITIES INCLUDE lchec all that apply):
se/process meats use animal fats/byproducts
DISCHARGING TO SALTWATERS? [DYES
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfoll z or aodischarge 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
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
Soo
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 [2/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/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
-
No Qo���
W 1 agci l W-C
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.
S W U-249
Last Revised: October 18, 2012
Page 1 of 2

*FnE'�PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il SECTION B.
• Q 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 EXCEEDENC S FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES �O ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES VNO
REGIONAL OFFICE CONTACT NAME:�J`1]�1
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 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."
a[0 g d-oa
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wc[Zws/`su/npdessw#tab-4
SWU-249 Last Revised: October 19, 2012
Page 2of2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
r Date submitted S d
CERTIFICATE OF COVERAGE NO. NCG06 �- D` �_� � SAMPLE COLLECTION YEAR
FACILITY NAME gnf) CCa�) M f (�S,_ FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY eP C�)C [use/process meats use animal f s/byproducts
PERSON COLLECTING SAMPLES ) A ISCHARGING TO SALTWATERS? DYES O
LABORATORY N JA Lab Cert. # N 4 R sLjN/V
AY ZQ�$ PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results ,. ,� a1FILES Total event rainfall 2 or &�INo discharge this period3
Outfall No.
Sample Collected,
p
mo/dd/yr
T55,
mg/L
p H,
Standard units
�6 CQDC
GW�� , Tl0
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococd ,
Colonies per 100 mi
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
Soo
Z Only applies to facilities that use/process meats. IECQ��� �SLI'2f�tYc� t G1�gvC�(�(�,ZJ�-�, �� A f
The total precipitation must be recorded using data from an on -site rain gauge. Sam m { i- I,
3 For sampling periods with no discharge at any, outfalls. You must still submit this discharge monitoring report with a checkmark here. �` (A
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. vyi.CAnL'7� [ 11 D)�
Did this facility {perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes E. 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 S0
6.0 -- 9.0
-
' 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
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

M
*FOR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCE£DANCE 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 EXCEEDENC£5 FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [2'NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES + NO ❑
REGIONAL OFFICE CONTACT NAME: a ffil Ia ft
Mail an original and one co a this DMR including all "No Discharge" reports within 3C days a revel t a 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 27699-1617
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."
(Da e)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.ors/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

J
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water lurlit� neral Permit No. NCG060000
1 1 C �O 60 �Date�bmitted
CERTIFICATE OF COVERAGE NO. NCG0 � SAMPLE COLLECTION YEAR d G 1 U
FACILITY NAME W� FACILITYACTIVITIES INCLUDE (ch k all that apply):
COUNTY [use/process meats Fuse animal f is/byproducts
PERSON COLLECTING SAMPLES N DISCHARGING TO SALTWATERS? ❑YES NO
LABORATORY LABORATORY 0 IA Lab Cert. #
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall or Ea 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
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
I 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 E�/no (if ves, 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
200 or SO
6.0 — 9.0
-
5 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.
in Ma(Ch
'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 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 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES aNO ❑
IF YES, HAVE YOU CONTACTED THE DWW'
1
QDRE IONAL OFFICE? YES NO
REGIONAL OFFICE CONTACT NAME: I i`[ 4 ]y
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days o receipt of the lab results far 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 27699-1517
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_he possibility of fines and imprisonment for knowing violations."
re of
L11-51113
(Dat )
Additional copies of this form may be downloaded at: httQ://aortal.ncdenr.or weblwct/ws/su(nodessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2of2

_J
SEMI-ANNUAL. STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water u .lity General Permit No. NCGO60000
Datesubmitted 3 o24i�
``�I,� .�
CERTIFICATE OF COVERAGE NO. NCG06Q���J
FACILITY NAME AMUI Ccul Sr-10 Foed &rb , L-bC
COUNTY 1'U) i
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR c­9 0 I 0
�3 T
FACILITY ACTIVITIES INCLUDE (check all that apply): P� S
D"use/process meats (fuse animal fats/byproducts
DISCHARGING TO SALTWATERS? []YES [XO l�
i RS
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event roinfall1 or E�No discharge this perioa3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform I,
Colonies per 100 ml
Enterococci ,
Colonies per 100 mi
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
500
7
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? ❑ yes [ nno
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
-
of ves• complete Part B)
J�p d rPh C001-e
jai vY i
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.
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 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 li SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCESFOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES E�'NO
IF YES, HAVE YOU CONTACTED THE DWQ R IONAL OFFICE? YES CTNO Fj
REGIONAL OFFICE CONTACT NAME: _ ,}"T
Mail an original and one copy of this DMR including all "No Discharge" re arts within 30 days of receipt a 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 CERTIFIC4 TION 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 , possibility of fines and imprisonment for knowing violations."
re of Perm
3 10 l�
(Da e)
Additional copies of this form may be downloaded at: hqg:agortai.ncdenr.oEg/web/wct/ws/sutnpdessw#tab-4
npdessw#tab-4
SWU-249 Last Revised; October 19, 2012
Page 2of2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water QualityGeneral Permit No. NCG060000
L(-->3%'? Date submitted 0 1 0
CERTIFICATE OF COVERAGE NO. NCG06 U0 y SAMPLE COLLECTION YEAR 0
FACILITY NAME IM LL (}) 'AL111 75od L-a FACILITY ACTIVITIES INCLUDE (iche
5k all that apply): FEB 10 Z018
COUNTY - [t use/process meats Lljuse animal f /byproc�ycts
PERSON COLLECTING SAMPLES J DISCHARGING TO SALTWATERS? ❑DW IR
YES NO fSECTION
TES
LABORATORY IV 1A Lab Cert. # Vtf
PLEASE REMEMBER TO SIGN ON THE REVERSE
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall'2 or F�rNo 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 Collform ,
Colonies per 200 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or SO
Within 6.0 — 9.0
120
30
1000
Soo
I 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? ❑ yes gno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > S5 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
-
(ifyes. complete Part Bj
* D&4a rq-e oa ay�ed ,
bit nod -�o Imes
samrlfl
w Rof c411 3 d cc 6
,p�Eoy -tn i�vl.e�s�rQ.I�I� �
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.
(CU l 1 CVf'".
S WU-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 Il SECTION B.
• 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 EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [EI'NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES M NO [�
REGIONAL OFFICE CONTACT NAME: Trerw JMW10
Mail an on anal and one copy pf this DMR including all "No Discharge" reiports within 30 days of receipt of the lab results Lgr 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 27699-1617
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
informogn, including the_pgss' ' y of fines nd imprisonment for knowing violations."
(Q e)
Additional copies of this form may be downloaded at: htt2://oortal.ncdenr.org/web/w.ctlws/sulngdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2of2

M
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water ual'ty General Permit No. NCG060000
Date submitted to i
Op CO q g nn
CERTIFICATE OF COVERAGE NO. NCGO� 0 � � �� SAMPLE COLLECTION YEAR a N
FACILITY AM ICE n ��� LC - ��1{�jr—FACILITY CTIVITIES INCLUDE (ch all that apply):
COUNTY JAN 3 Q [use/process meats use animal f /byproducts
PERSON COLLECTING SAMPIES wI'? 2018DISCHARGING TO SALTWATERS? []YES NO
LABORATORY - G I Lab Cert. # ►ni,. 031P s_c..,,
WL20 CIV PLEASE REMEMBER TO SIGN ON THE REVERSE 4
u
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 0 5or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
CUD,
m 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
S00
1
tia 8 r)
33,3
Sao
5
'7 100 D100
P lift
`3
5
">i30Doo
45
a$ 0 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.
°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 ves, complete Part 8)
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
-
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
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.
0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES � NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFIC ? YES Q NO
REGIONAL OFFICE CONTACT NAME: 701)
Moil an original and one copes 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 CERTIFIC4TION FOR ANYINFORMATION REPORTED:
I certify, under penalty of Jaw, 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 tb-e-possibility of fines and imprisonment for knowing violations."
1,4 kI1l -jr--
(Date)
Additional copies of this form may be downloaded at: http://Qortal.ncdenr.org/web/w4/ws/5u/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

ANALYTICAL 8. CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Wiridtnill Way, Wilmington, NC 28405 • 910.392.0223 Lab 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@environmen talchemists. com
American Skin, LLC. Date of Report: Dec 21, 2017
Post Office Box 1445 Customer PO #:
Burgaw NC 28425 Customer ID: 08100003
Attention: Ray Talbot Report #: 2017-19171
Project 1D: Stormwater
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
17-46487 Site: Outfall Area 1 12/8/2017 7:50 AM Water Client
Test
Oil & Grease (O&G)
Residue Suspended (TSS)
pH
COD
Fecal Coliform
Lab ID Sample ID:
17-46488 Site: Outfall Area 2
Method
EPA 1664
SM 2540 D
SM 4500 H B
SM 5220D
SM 9222D MF
Test Method
Results Date Analyzed
<5 mg/L
12/14/2017
33.3 mg/L
12/110017
8.06 units
12/08/2017
<20 mg/L
12/11/2017
>120000Colonies1100mL
12/08/2017
Collect DatelTime Matrix
12/8/2017 7:55 AM Water
Oil & Grease (O&G) EPA 1664
Residue Suspended (TSS) SM 2540 0
pH SM 4500 H B
COD SM 5220D
Fecal Coliform SM 9222D MF
Lab ID Sample ID: Collect DatelTime
17-46489 Site: Outfall Area 3 12/8/2017 7:45 AM
Test Method
Oil & Grease (O&G)
EPA 1664
Residue Suspended (TSS)
SM 2540 D
pH
SM 4500 H B
COD
SM 5220D
Fecal Coliform
SM 9222D MF
Comment: pH results provided by client.
Reviewed by: _ avda
Results
Sampled by
Client
Date Analyzed
<5 mg/L 12/14/2017
57.3 mg/L 12/11/2017
8.20 units 12/08/2017
31 mg/L 12/11/2017
>120000 Colonies/100mL 12/08/2017
Matrix Sampled by
Water Client
Results Date Analyzed
<5 mg1L
12/14/2017
110 mg/L
12/11/2017
8.51 units
12/08/2017
43 mg/L
12/11/2017
28000 Colonies/100mL
12/08/2017

6602 Windmill Way Wilmington, NC 28405
ENVIRONMENTAL CHEMISTS, IN C OFFICE: 910-392-0223 FAX 9I a-392- 424
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DI_S CERTIFICATION # 37729 Info® environmentalchomists.com
Analytical & Consulting Chemists
COLLECTION AND CHAIN OF CUSTODY
Client: American Skin, LLC-Burgaw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO:
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO: Ray Talbot
PHONE/FAX:
COPY TO:
email:
Sampled By: _ SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
K
F
a
m
s
A
o m
v
_
i� C7
o
CL
o
V E
ui
m
z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
i
i
=
g
g
i
o
z
o
w
o
Outfall:
a
o
C
P
N441'
X
X
X
Oil & Grease. TSS, COD,Fecal
G
G
01
P
G
G
C
P
G
G
7iOutfall:
�
X
X
X
Oil & Grease, TS COD,Fecal
G
G
C
P
G
G
C
P
G
G
Outfall:
�t
X
X
c
X
Oil $ Grease, TSS, COD,Fecal
G
G
P
G
C
P
:G
G
Transfer
Relinquished By:
Datelrime
Received By:
paterrime
1_
2.
Temperature when
V""
Delivered By: Received By:
Comments:
ile Requested:
Time:
TURNAROUND:

t
L SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
/t� r(YoDate submitted is I i [ a oI'LCERTIFICATE OF COVERAGE NO. NCGOV 0 U_ � � SAMPLE COLLECTION YEAR aCi
FACILITY NAME A111Ui(ff �gjA 1:603 &-i I FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY k n4ef _ _ 2se/process meats C use animal fa Jbyproducts
PERSON COLLECTING SAMPLES _IJ I; �- DISCHARGING TO SALTWATERS? ❑YES []4
LABORATORY oJA Lab Cert. # � C EIVED PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DEC Q 5 2017
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall or [ No discharge this periods
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
6
Dmhj#�SE
and Grease,
ION 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
1 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.
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,
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_f yes, complete Part B)
NO 04ordbiee discklw
4,ro��.11r�1o>°.r a-Ol7 durih9
8vtwi vio-k KOJI,
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
Page 1 of 2

;/
*FUR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER ATANY ONE OUTFALL? YES 01<0
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ErNO
REGIONAL OFFICE CONTACT NAME: :n,atl,U1'1.tJ1
Mail an_original and one My of this DMR, including all "No Discharge" reports, within 30 days of receiPt_of the lab results Lor at end of
monitoring period in the case of "No -Discharge" reporter 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."
•`,r,'of Permittee)
Additional copies of this form may be downloaded at: http!lZgortal.ncdenr.org/web/wq/ws/suLngdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Waterll
D �v�y� Qual'ty.General Permit No. NCG060000
Date submitted 02
CERTIFICATE OF COVERAGE NO. NCG060
FACILITY NAME. WIAO IL M SVIA Fl
COUNTY
li�r�r,=17�is, LLC
PERSON COLLECTING SAMPLES Ai Ili -_
LABORATORY NIA Lab Cert. it
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR a U 1 f
FACILITY ACTIVITIES INCLUDE (chec II that apply):
[" use/process meats use animal # /byproducts
DISCHARGING TO SALTWATERS? []YES ZNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z or E2 o 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 200 mi
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100or•50
Within 6.0 — 9.0
120
30
1000
Soo
-ROV
0 9 2011
1 only applies to facilities that use/process meats. CENTRAL FIDES
2The total precipitation must be recorded using data from an on -site rain gauge. , FILES
s For sampling periods with no discharge at and outfalls. You must still submit this dischargem on�toririg 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 Yno
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
ma/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
-
(ifyes, complete Part B)
4 0. SC1n a fc{-C
ycurfea'
i'�Gll�i � Ufa vJ-eJi�P
o _sitt to CbML+
' 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.
S01%W
SWU-249
Last Revised: October 18, 2012
Page 1 of 2

*FOR PART AA 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 EXCEEDEN S FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES v❑�NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES M NO ❑
REGIONAL OFFICE CONTACT NAME: ITYN
Mail an original and one copy of this DMRLincluding all "No Oischarrge" 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 27699-1617
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."
101311)1
(Date)
Additional copies of this form may be downloaded at: http:Uportal.ncdenr.o[g/web/wg/ws/su/nRdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2of2

r
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water qyallity General Permit No. NCG060000
A,C�C:-C] .03 Date submitted Al (G
CERTIFICATE OF COVERAGE NO. NCG060 L( O l
FACILITY NAME �n Y� ( (I [) S U 1) __ �70�CQJD Lp f b
CO U NTV -
PERSON COLLECTING SAMPLES +.A
LABORATORY_ 1 % `A Lab Cert. # N�/A —
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 00
FACILIIY,AUIVITIES INCLUDE (check all that apply):
use/process meats [D]use animal f is/byproducts
DISCHARGING TO SALTWATERS? []YES fNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
RECEIVED
OCT ] 2 2017
CENTRAL FILES
DWR :SECTION
Totol event rainfoll 1 or ['No discharge this perlod3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Colifarm ,
Colonies per 100 mI
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or $0
Within 6.0 — 9.0
120
30
1000
500
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 performvehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 0 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 SQ
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.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
17q
�,iSchurq� /none
inq opUMunc�
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

'-"FOR PART A AND PART B MONITORING RESULTS:
1 • A BENCHMARK EXCEEDANCE TRIGGERS TIER I 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 SECTION B.
+ TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES �10 ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFIgj ? YES "NO ❑
REGIONAL OFFICE CONTACT NAME: XaLf—1 1
Mail an original and one copy of this MR, including all "No Discharr�e" reports, within 30 days of receipt of th_e 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 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 he4u4,, ibility of fines and imprisonment for knowing violations."
of
to d 1
(D te)
Additional copies of this form may be downloaded at: htt ortai.ncdenr.or web w ws su n dessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

CERTIFICATE OF
FACILITY NAME
COUNTY Vft
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qqalft General Permit No. NCGO60000
Date submitted
). NCG06� Q 0 O SAMPLE COLLECTION YEAR 00
PERSON COLLECTING SAMPLES
LABORATORY
UM)
Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
FACILITY ACTIVITIES INCLUDE (che k all that apply):
[� use/process meats use animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES 1260
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
it
Total event rainfall 2 3h or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/ r
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
Soo
1
.55C
?(00D00
• —
11 . l 0
I
?0000n
--
5. u
[o
I 'i
S
7 D
--
Only applies to facilities that use/process meats.
2The 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.
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 averagirig > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
T55,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or So
6.0 — 9.0
-
lC
(ifyes, complete Part H)
SEP 21 2017
' Only applies to facilities that use/process meats.
G: � 1 iiON
2The total precipitation must be recorded using data from an on -site rain gauge. R�i4TION PROCESSING UNIF
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 bast 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 EXCEEDENC S FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES g'NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ R��REGIONAL OFFIC ? YES MNO ❑
REGIONAL OFFICE CONTACT NAME: �1—& z(
_Mail an original and one cry of this DMR, including all "No Discharge" regortsLwfthfn 30 days of receipt of the lab results tpr at end of
monitoring period in the case o} "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFIC4TION 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 thg possibility of fines and imprisonment for knowing violations."
Additional copies of this form may be downloaded at: http://Portal.ncdenr.oEglweb/wc[/ws/su/­npdessw4tab-4
SWU-249 Last Revised: October 18, 2412
Page,2 of 2

-- - -En.Rvi-ronmentai-Chem-ists; Ine.- _
6602 Windmill L1ray, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertovm Road Manteo, NC 27954 • 252.473.5702 Lab/Fax
? . 255-A Wilmington Highway, jacksc)nville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS
info@em!iroiimentalelicrnists.com
American Skin, LLC. Date of Report: Sep 15, 2017
Post Office Box 1445 Customer PO #:
Burgaw NC 28425 Customer ID: 08100003
Attention: Ray Talbot Report #: 2017-12955
Project ID: Stormwater
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
17-31062 Site: Outfall Area 1 8/29/2017 5:30 AM Water Richard Hodges
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA IVA <5 mg/L 08/31/2017
Residue Suspended (TSS) SM 2540 D 6.6 mg/L 08/30/2017
COD SM 5220D 59 mg/L 08/31/2017
Fecal Coliform SM 9222D MF >60000 Colon ies/100mL 08/29/2017
Lab ID Sample ID: Collect DateMme Matrix Sampled by
17-31073 Site: Outfall Area 2 8/29/2017 5:40 AM Water Richard Hodges
Test
Method
Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
7 mg/L 08131/2017
Residue Suspended (TSS)
SM 2W D
18.3 mg/L 08/30/2017
COD
SM 5220D
98 mg/L 08/31/2017
Fecal Coliform
SM 9222D MF
>60000 Colonies1100ml- 08/29/2017
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
17-31074 Site: Outfall Area 3
8/29/2017 5:45 AM
Water Richard Hodges
Test
Method
Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
<5 mg/L 09/08/2017
Residue Suspended (TSS)
SM 2540 D
25.6 mg/L 08/30/2017
COD
SM 5220D
174 mg/L 08/31/2017
Fecal Coliform
SM 9222D MF
>60000 Colon ies/100mL 08/29/2017
Comment:
Reviewed by:
Report #:: 2017-12955

ex�v�rochexnI Analytical & Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION ff 94 NCDHHS: DLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
info®envlronmentalchemista.com
Client: American Skin, LLC-Burgaw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO:
f
ADDRESS:
CONTACT NAME:
PO NO:
j
REPORT TO: Ray Talbot
PHONE/FAX:
COPY TO; j
email:
-
Sampled By: ffghi d SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL - Sludge, Other:
'
Sample Identification
Collection
°1
2m
o f
_
o
m
o 01
M M
z0
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
w
�
8
M
s
o
m
Outfall:
3-21
C
P
ff ,
_ 1
X
X
X
Oil & Grease, TSS, ,COD,Fecal
G
G
i
in 7v S $
C
P
G
G
C
P
G
G
7
Outfaii:
C
P
X
X
�-
I X
jOil & Grease, TSS, COD,Fecal
G
G
5:q0A
C
P
a�
G
G
C
P
G
G
06ffaik:
SqSA
C
P
`� 1
X
X
X
Oil & Grease, TSS, COD,Fecal
G
G
•�
C
P
G
G
C
P
G
G
I
Transfer
Relin uished By:
Dateliirne
Received By:
Date/Time
!7
2. ;
Temperature whe Receiv ; Accepted: Rejecte Resample Request
Delivered By: Received By: T l.t�C3ll�� _Date: i Time:
Comments: _ TURNAROUND:
T

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quail ty General Permit No. NCGO60000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06'QQ ,Q
FACILITY NAME c LL(
COUNTY ��—
PERSON COLLECTING SAMPLES �
LABORATORY 9. ii-ro)iVi r.i,lRO Lab Cert. #
00U a i f n (.
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o0-1
FACILITY CTIVITIES INCLUDE (che k all that apply):
1 use/process meats [use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES E10
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
u
Total event rainfall 1 3N or ❑ No discharge this period?
Outfall No.
Sample Collected,
mo/dd/
TSS,
mg/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
120
30
1000
500
>(0000Q
~
`1 10
7
5. {o
U. P
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? ❑ yes Ev 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/yr
Oil and Grease,
mg/L
TSS,
m L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
T 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 ves, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
0 A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SE ION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ENO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFIC ? YES NIS❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one ropy of this DMRLincluding all "No_ Discharge" retorts, within 30 da rs of rece pt 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 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 thg possibility of fines and imprisonment for knowing violations."
qldlF
(Da )
Additional copies of this form may be downloaded at:.http://oortal.ncdenr,oEglweb/wg/ws/­sulnpdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page.2 of 2

if
en.vir..66 em
$fit- .��+.✓3;� .z.
ANALYTICAL & CONSULTING CHEMISTS
- --:Environmentai-.Chemists,- Inc.-- --. -- --.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 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(41 environ3nentalchciniStS.con1
American Skin, LLC. Date of Report: Sep 15, 2017
Post Office Box 1445 Customer PO #:
Burgaw NC 28425 Customer ID: 08100003
Attention: Ray Talbot Report #: 2017-12955
Project ID: Stormwater
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
17-31062 Site: Outfall Area 1 8/29/2017 5:30 AM Water Richard Hodges
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 16U <5 mg/L 08/31/2017
Residue Suspended (TSS) SM 2540 D 6.6 mg/L 08/30/2017
COD SM 5220D 59 mg/L 08131 /2017
Fecal Coliform SM 9222D MF >60000 Colonies/100ml- 08/29/2017
Lab ID Sample 11): Collect Date/Time Matrix Sampled by
17-31073 Site: Outfall Area 2 8/29/2017 5:40 AM Water Richard Hodges
Test Method Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
7 mg/L 08/31/2017
Residue Suspended (TSS)
SM 2540 D
18.3 mg/L 08/30/2017
COD
SM 5220D
98 mg/L 08/31/2017
Fecal Coliform
SM 9222D MF
>60000 Colon ies/100mL 08/2912017
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
17-31074 Site: Outfall Area 3
8/29/2017 5:45 AM
Water Richard Hodges
Test
Method
Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
<5 mg/L 09/08/2017
Residue Suspended (TSS)
SM 2540 D
25.6 mg/L 08/30/2017
COD
SM 5220D
174 mg/L 08/31/2017
Fecal Coliform
SM 9222D MF
>60000 Colonies/100mL 08/29/2017
Comment:
Reviewed by: Ck _K',A
i -,,� k A LA, A A CU--�
Report#:: 2017-12955 Dom^=' -11

F
Analytical 8 Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENA: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 3T729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 9I-392-0223 FAX 91"92-4424
info®environmentalchemiste.com
Client: American Skin, LLC-Burgaw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO:
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO: Ray Talbot
PHONE/FAX:
COPY TO:
email:
Sampled By: . ! SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
:Sample Identification
Collection
fI
a
o`
S o
CL
`�
s
Q
m
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
U,
$
0
0
Z
0
O
Outfall:
�-
C
P
X
X
X
Oil & Grease, TSS, /,COD,Fecal
G
G
= ! + 58'
G
G
C
P
G
G
OO fall:
C
P
X
X
a.
I X
Oil & Grease, TSS, ,COD,Fecal
G
G
_
O-A
C
P
G
G
C
P
G
G
Otitfall:
5, q5A
C
P
r'
X
X
X
Oil & Grease, TSS, PAOD,Fecai
G
G
•D
C
P
G
G
C
P
G
G
I
Transfer
Relin uished By:
Date/Time
Recjft#d By:
Date/Time
2.
Temperature
Delivered By:
Comments:
Time:

SEMIANNUAL STORMWATER DISCHARGE MONITORING REPORT UEWED
for North Carolina Division of Water Q alit General Permit No. NCGO60000 AUG 07 2011
it U �o Q 3 Date submitted � � � � CENTRAL PfLES
� y
CERTIFICATE OF COVERAGE NO. NCG060 0 D O SAMPLE COLLECTION YEAR �O�i7WlR SECTION
FACILITY NAME Slf� FACILITY CTIVITIES INCLUDE (che all that apply):
COUNTY Muse/process meats 0 use animal f /byproducts
PERSON COLLECTING SAMPLES MA DISCHARGING TO SALTWATERS? DYES PhO
LABORATORY_ _ N)A Lab Cert. # —u t
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfaii 2 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
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 An� 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 > S5 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
-
(if ves. complete Part B)
Only applies to facilities that use/process meats. �5W-% h 0 t �
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.
5R'U-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 I! 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 EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES E21NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 1,4 NO ❑
REGIONAL OFFICE CONTACT NAM E:"��
Mail an original and one copy of this DMR, i_ncludina all "No Dischaige" reports,_ within 30 days of receiptof-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 MUST SIGN THIS CERTIFIC4 TION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. i am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Additional copies of this form may be downloaded at: http.:I/portal.ncdenr.org/web/wq/­ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

I SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water uality General Permit No. NCG060000
NC-6- b(p Date submitteo a o {
CERTIFICATE OF COVERAGE NO. NCGO6 V SAMPLE COLLECTION YEAR
FACILITY NAME FACILITY ACTIVITIES INCLUDE (che k all that apply):
COUNTY _ 4{�.(i f�hX _ _ [use/process meats Muse animal fats/byproducts
PERSON COLLECTING SAMPLES _ ���' B COLS A ! IR�CPJSi�H R[]YES TO SALTWATERS� YES �10
LABORATORY y __C. yf ( :?S Lab Cert. # Lj
JUN 2 2 2017 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
f ll
Part A: Starmwatier Benchmarks and Monitoring Results CENTRAL FILES Total event rainfall I 1$ or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/L
pH,
Standard units
mg/L
l and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
I -
100 0r 50
Within 6.0 — 9.0
1 120
30
1000
Soo
I
1
Ci
000
a
0o0
-
3
`I
► 5
z 5
7 0
-
aOnly applies to fa6illties that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling perl�ds 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 [ f no
Part B. Vehicle i 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
}CFI,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
1 -
30
100 or 50
6.0 — 9,0
-
I
k
!
t
i
i
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 l of 2

i
*FOR PART A AND PART B MONITORING RESULTS:
i
• 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 If SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK IEXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? , YES [TNO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES Q'NO ❑
REGIONA OFFICE CONTACT NAME: :ffij 76
Mail an original and
monitorina verlod in
Division of�Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
N certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the Information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
i
ture of Permitte (Date)
i
Additional copies of this form may be downloaded at: htt ortal.6cdenr, r web w ws su n dessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

envrochem>
..fir .
American Skin, LI_C.
Post Office Box 1445
Burgaw NC
Attention: Ray Talbot
Environmental Chemists, Inc.
6602 Windmill Way, 4Vihnington, NC 28405 ' 910.392.0223 Late • 910.392, 424 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(ir,em ironrnciiialcheanists.com
Date of Report: Jun 19. 2017
Customer PO #:
28425 Customer ID: 08100003
Report #: 2017-07725
Project ID: Stormwater
Lab ID Sample ID:
17-18266 Site: Outfall Area 1
Test Method
Oil & Grease (O&G) EPA 1664
Residue Suspended (TSS) SM 2540 D
COD SM 52201)
Fecal Coliform SM 9222D MF
Lab ID Sample ID:
17-18267 Site: Outfall Area 2
Test
Oil & Grease (O&G)
Residue Suspended (TSS)
COD
Fecal Coliform
Lab ID Sample 0:
17-18268 Site: Outfall Area 3
Test
Oil & Grease (O&G)
Residue Suspended (TSS)
COD
Fecal Coliform
Comment:
Reviewed by:
Collect DatelTime Matrix Sampled by
6/5/2017 11:57 AM Water Kelley Brown
Results Date Analyzed
<5 mg/L
06/09/2017
17.9 mg/L
06/05/2017
39 mg/L
06/13/2017
>60000 Colonies/100mL
06/05/2017
Collect DatelTime Matrix Sampled by
6/5/2017 11:55 AM Water Kelley Brown
Method Results Date Analyzed
EPA 1664 5 mg/L 06/12/2017
SM 2540 D 62.0 mg/L 06/05/2017
SM 5220D 158 mg/L 06/13/2017
SM 9222D MF >60000 Colonies/100ml- 06/05/2017
Collect DatelTime Matrix Sampled by
6/5/2017 11:50 AM Water Kelley Brown
Method Results Date Analyzed
EPA 1654 <5 mg1L 06/09/2017
SM 2W D 177 mg/L 06/05/2017
SM 5220D 105 mg/L 06/13/2017
SM 9222D MF >60000 Colonies/100mL 06/05/2017
Report #: 2017-07725 Page 1 of 1

4WDENVIRONMENTAL CHEMISTS, INC O6F#CEInci illWay
Wilmi-392-0223 FAXngton,
N248405
Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 3TM into0environmentalchemists.com
COLLECTION AND CHAIN OF CUSTODY
Client: American Skin, LLC-Burgaw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO:
ADDRESS:
CONTACT NAME.
PO NO:
REPORT TO: Ray Talbot
PHONE/FAX:
COPY TO:ffff
emall:
Sampled By: I SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
a
0
m
$ g e
m _
c r,
s g
v
m
e
"
M
m
i
PRESERVATION
ANALYSIS REQUESTED
Date
Tlme
Temp
g
i;
Y
o
W
0
Outfall:
C
P
X
X
X
1011 & Grease, TSS, ICOD,Fecal
I
tijG
LY
P
G
G
C
P
G
G
Outfall:
P
X1
Ix
Ix
1 Oil & Grease, TSS, COD, Fecal
G
G
G
C
P
G
G
Outfall:
C
P
X
X
t
X
10il
& Grease, TSS, COD,Fecai
G
G
C
P
G
G
C
P
G
G
Transfer
Relinquished By:
Daterrime
Received By:
Dateffime
1.
2.
Temperature eiv : Accepted: R led: Resampie Requested:
Delivered By: 17Received By. L Date: i _'4' Time:
Comments: TURNAR UND:

EMI -ANNUAL
6� 6 3yy
CERTIFICATE OF COVERAGE NO. NG06
FACiLITY NAME PyvmVAb '' U.0
COUNTY'ja CA
PERSON COLLECTING SAMPLES _WA
LABORATORY Kd A Lab Cert. #
Part A: Stormwater Benchmarks and Monitorine Results
)RMWATER DISCHARGE MONITORING REPORT
ixion of Water Qu lity General Permit No. NCG060000 RECEIVED
Date submitted OUi 9
SAMPLE COLLECTION YEAR ol-Q 1 ! JUN 0 G 2017
FACILITY ACTIVITIES INCLUDE (cheqk all that apply): CENTRAL FILES
use/process meats use animal f:%tC/bypra&A SECTION
DISCHARGING TO SALTWATERS? DYES NO
PLEASE REMEMBER TO SIGN ON THE REVERSE -)�
Total event rainfall or IVT No dischoroe this neriod3
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 ,
Colonies per 100 ml
Benchmark
-
100 or SD
Within 6.0— 9.0
120
30
1000
S00
- 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 an_j 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 F.
no (ifyes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: oniv for facilities averaging > SS aal 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 S0
6.0 -- 9.0
-
4 Ob a;u0yq &�Y_w (Urge
w�ju Soopilm F(,90606
W�X� auCUla����C�faoYL�►�
W ", ne-
Only applies to facilities that use/process meats. A (Lq a of I
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.
S WU-249
Last Revised: October 18, 2012
Page 1 of 2

r
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il 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 EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFACE? YES [�NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES HNO
REGIONAL OFFICE CONTACT NAME: a0u,6
Mail an original and one copy_ of this DMR, including all "No Discharge" reports, within 30 days a 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 violations."
S 31 !
(Da e)
Additional copies of this form may be downloaded at: http:f/portal.ncdenr.or /e 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 Quaility General Permit No. NCG050000
Date submitted 5 0
CERTIFICATE OF COVERAGE NO. NCG V6 ()1i;r/_/eSAMPLE COLLECTION YEAR aOI i
FACILITY NAME ' FACILITY 4CTIVITIE5 INCLUDE (5che5K all that apply):
COUNTY use/process meats use animal fa s/byproducts
PERSON COLLECTIING SAMPLES _ NIA ,• DISCHARGING TO SALTWATERS? ❑YES �f0
LABORATORY_ 1 TI i fl; __ Lab Cert. #
Bart A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall a or PjNo discharge this period
Outfall No.
Sample Collected,
I mo/dd/ r
TSS,
mg/L
pH,
Standard units
I COD,
1; mg/L
oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
I -
10o or 50
Within 6.0 -- 9.0
120
30
1000
Soo
s
I N
13
'
a
I&jA
NI
MA
4L4
I
I
I
'
Only applies to fa6llties 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.
°See General PermlI text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
I
Did this facility pl rform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes [g a (if yes, complete Part B)
i
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
# Sample Collected,
I mo/dd/yr
Oil and Grease,
mg/L
iTSS,
1 mg/L
pH,
Standard units
New Motor Oil usage,
Annual average gal/mo
Benchmark
I
30
100 or 50
6.0 — 9.0
-
I
�.
1
i
1
I
!`3
ND apifabl-e dischorq'e
qri t doll 7
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 outfalis, 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.
I
r
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FORVART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 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 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES M NNO ❑
REGIONA OFFICE CONTACT NAME:%�T �Q
E
Mail an oriainal and one cony of this DMR, including all "No Discharae" renorts. within 30 dovs of receipt of the lab results for at end of
Division of#ater Quality
Attn: DWQ Central Files
1617 Mail �ervice Center
IL Raleigh, NC 27699-1617
i
"l 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 cornplete. I am aware that there are significant penalties for submitting false
information, incl,udi g^tkte-pc7bility of fines and imprisonment for knowing violations."
J
s �l�
(Efate)'
i
Additional copies of this form may be downloaded at: http://portal.6cdenr.orelweb/wp/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

Z.
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water �i General Permit No. NCG060000
N� � p � � Date submitted s
CERTIFICATE OF COVERAGE NO. NCG06� � 3 �� SAMPLE COLLECTION YEAR
FACILITY NAME 1-L ( FACILITY IVITIES INCLUDE (chec ail that apply): R✓}
COUNTY use/process meats use animal f /byprod IIL_�v
PERSON COLLECTING SAMPLES —A 1A DISCHARGING TO SALTWATERS? DYES [ NO H� 0 5 2017
LABORATORY lab Cert. It
PLEASE REMEMBER TO SIGN ON THE REVER
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfoll2 or lvl No dischorae this oerioc?
Outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/1
pH,
Standard units
COI?,
mg/L
Oil and Grease,
mg/L
Fecal Coiiform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 —9.0
120
30
1000
S00
- 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 SS gallons of new motor oil per month? [Dyes &Kho
Part B: Vehicle Maintenance Area Monitorine Results: oniv for facilities averaging > 55 eal of new motor oil/month.
Outfall No.
Sample Collected,
ma/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 SO
6.0 — 9.0
-
(if yes, complete Part B)
N o t�preS-en tt, -t ve
queen-+ dUV'1# 1
quorng h ws I'Vi
nnvol aUi `?
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
Pagc I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION 8.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC S FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ONO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ENO ❑
REGIONAL OFFICE CONTACT NAME: efita Myw ej
Mail an oriQinal and one cry of, this DMR including crll "No Discharge" reports, within 30 days of receipt of the lab results_ or at end
monitoring period in the case of "No^Discharge" marts) 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 violations."
(Si e o Permi (Da e)
Additional copies of this form may be downloaded at: http://portal.ncdenr.ore/webzwq/wslsuZnpdessw##tab-4
SWU-249
Last Revised: October IS, 2012
Page 2 of 2

SEMI-ANNUAL. STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qua 't General Permit No. NCGO60000
3 J f Date submitte
d d o?
CERTIFICATE OF COVERAGE NO. NCG06Q rO 0 O
FACILITY NAME L V
COUNTY
PERSON COLLECTING SAMPLES V,40XIN 13MWV1
LABORATORY fWl, (,k && Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
RECEIVED
MAR 0 9 2011
SAMPLE COLLECTION YEAR �fJl CENTRAL FILES
FACILITY,ACTIVITIES INCLUDE (check all that apply);
DWR SECTION
use/process meats use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES gN'O-
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall - n Vor ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/1
pH,
Standard units
COD,
mg/L
Oil and Grease,
m /L
Fecal Collform ,
Colonies per 100 mi
Enterococci ,
Colonies per 200 ml
Benchmark
-
100or50
Within 6.0 — 9.0
120
30
1000
S00
15.
4
a
(0
314000
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 SS gallons of new motor oil per month? ❑ yes Zno (if ves, 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,
m /L
TSS,
mg/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.
°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 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 EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES VNO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES �NO
REGIONAL OFFICE CONTACT NAME: IY- :am"
Mail an original and one copy of this DMR, includina 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 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."
n ure of Permi ee (Da e)
Additional copies of this form may be downloaded at: htto://gortal.ncdenr.org/web/w ws/su/Mdesswt#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

• Environmental Chemists, Inc.
rt
p 6602 Windmill Way, Wilmington, NC 29405 • 910.392,0223 Lab • 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
ANALYTICAL B CONSULTING CHEMISTS infoCrcenvironmentalcheniisls.com
------American Skin,.
Date-of-Report:—Feb23,-201.7
—____
Post Office Box 1445
Customer PO #:
Burgaw NC 28425
Customer ID:
08100003
Attention: Ray Talbot
Report #:
2017-02259
Project ID: Stormwater
Lab ID Sample ID:
Collect Date/Time Matrix
Sampled by
17-05327 Site: Outfall Area 1
2/15/2017 11:45 AM Water
Kelley Brown
Test
Method
Results Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 02/16/2017
Residue Suspended (TSS) SM 2540 ❑ 13.5 mg/L 02/17/2017
COD SM 5220D 34 mg/L 02117/2017
Fecal Coliform SM 9222D MF 46000 Colonies/100mL 02/16/2017
Lab ID Sample ID: Collect DatelTlme Matrix Sampled by
17-05329 Site: Outfall Area 2 2/15/2017 11:55 AM Water Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664 6 mg/L 02/16/2017
Residue Suspended (TSS) SM 2540 D 116 mg/L 02/17/2017
COD SM 5220D fit mg/L 02/17/2017
Fecal Coliform SM 9222D MF 2910 Colonies/100mL 02/15/2017
Lab ID Sample ID: Collect Daterrime Matrix Sampled by
17-05330 Site: Outfall Area 3 2/15/2017 12:05 PM Water Kelley Brown
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664 <5 mg/L 02/16/2017
Residue Suspended (TSS) SM 254o D 158 mg/L 02/17/2017
COD SM 5220D 78 mg/L 02/17/2017
Fecal Coliform SM 9222D MF 14000 Colonies1100mL 02/15/2017
Comment: j
Reviewed by:&1L'L'2L
ReportgY 2017-09299 Pane 1 M

f e><ivirocl�ein;
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION 4 94 NCDHHS: DLS CERTIFICATION 0 37729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
Client: American Skin, LLC-Burgaw
PROJECT NAME: Storm Water -Due Monthly
REPORT NO:
ADDRESS:
CONTACT NAME:
PO NO: U Z2Sj
REPORT TO: Ray Tal6at
PHONEIFAX:
COPY TO:
email:
Sampled By: 1-vvl SAMPLE TYPE: I = Influent, E = Effluent, W Y Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
j Collection
K
n
1 A
°
6..
C a
c 8
'� `
m
C
° t
"
¢
O m
m¢ s
-' z
PRESERVATION
ANALYSIS REQUESTED
!
I
Date
Time
Temp
z
-+
y
$
=
o
z
o
u�
c
Outfall:
f�S 1
C
P
3Z
X
X
X
Oil & Grease, TSS, lXCOD, Fecal
IJ
G
G
T1 V
C
P
I
G
G
C
P
G
G
Outfall:
C
P
� �
X
X
X
oil & Grease, TSS, P ,COD,Fecal
`1
G
I
P
G
G
'
I
c
P
k5L30
G
G
Outfall:
I
C
P
X
X
X
Oil & Grease, TSS, COD,Fecal
1
[F.-G
G
C
P
G
G
C
P
G
G
Transfer
# Relinquished By:
DateTime
Received By:
Datefrime
1
i
2.

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
D b 0 345? Date submitted aQj j Pqgy pp
CERTIFICATE OF COVERAGE NO. NCG06LD—o0 SAMPLE COLLECTION YEAR 00I 1 FEB 0 7
FACILITY N ME i iFACILII!p=IVITIES INCLUDE riche all that apply): 2017
COUNTY ti use/process meats use animal fa /byprodudENT
PERSON COLLECTING SAMPLES N DISCHARGING TO SALTWATERS? [—]YES 260 DWR -`� rlo
LABORATORY N A Lab Cert.1# MIA
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Total event rainfall 2 or F\7KNo discharge this neriod3
Outfall No.
Sample Collected,
mo/dd/ r
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
SOU
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 ate 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 YE o
Part B: Vehicle Maintenance Area Monitorine Results: only for facilities averaging > SS eal 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
200 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 In 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.
S WU-249
(ifyes• complete Part B)
4 DiSc
tuh��1 �Iu�t 17�IlSO� ��
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 Il SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SE ION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFALL7 YES [� NO ❑
IF YES, HAVE YOU CONTACTED THE DW REGIONAL OFF CE7 YES Ej 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 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
informat qn, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
(Date)
Additional copies of this form may be downloaded at: http:l/portal.ncdenr.or weblwg/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2of2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qualitv General Permit No. NCG060000
N C G U G 6 3 y Date submitted P Ji?q 1 Q 01(0
0 CERTIFICATE OF COVERAGE NO. NCG06D 0_Q SAMPLE COLLECTION YEAR o o Fu RECEIVED
FACILITY NAME F00d 6rMQ, LLFACILITY ACTIVITIES INCLUDE (check all that apply)':
COUNTY Izuse/process meats [ use animg1fis/byproducts JAIL0 4 20i7
PERSON COLLECTING SAMPLES j� il�,L{ I�fown DISCHARGING TO SALTWATERS? [:]YES O CENTRAL FILES
LABORATORY N- Chf,MiftS Lab Cert. # DWR SECTION
PLEASE REMEMBERTO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event roinfoll z.Q_7 or ❑ No discharge this period'
outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform I,
Colonies per 100 mi
Enterococci ,
Colonies per 100 mi
Benchmark
-
100 or 50
Within 6.0 -- 9.0
120
30
1000
Soo
i
0
7 00
--
I
V
B-�
—
Lf
$•
7 ao o
-
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 outfails. 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 gno (i_fyes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 5S 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
-
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 pM 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 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 it SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC S FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ONO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL FFICE? YES Ej NO ❑
REGIONAL OFFICE CONTACT NAME: ! �T JQffiL
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the Jab 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 MUST SIGN THIS CERTIFIG4TION 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
informatiov3rcluding t oss' ' ' of fines nd imprisonment for knowing violations."
re of Permittee)
�Z
(Date)
Additional copies of this form may be downloaded at: http://Uortal,ncdenr.orglweblw�wslsu/nj3dessw#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 a L
CERTIFICATE OF qOVERAGE NO. NCG061_ff
FACILITY NAME ,) r r
COUNTY 1.�LW
PERSON COLLECTING SAMPLES
LABORATORY �j
Lab Cert. #
Part A: Stormwater Benchmarks and Monitorinr: Results
SAMPLE COLLECTION YEAR 0 U 1
LLB FACILITY ACTIVITIES INCLUDE (check all that apply):
[ use/process meats Buse anim5zor-,
/byproducts
DISCHARGING TO SALTWATERS? ❑YES
PLEASE REMEMBER TO SIGN ON THE REVERSE --)
Total event rainfall z or I 6� No dischorae this neriod3
Outfall No.
Sample Collected,
mo/dd/ r
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 SO4
Within 6.0 — 9.0
120
30
1000
Soo
!Uf
R
k11A
VIA
' 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 Ono (if ves, complete Part B)
Part B: Vehicle Maintenance Area Monitorine Results: onlv for facilities averaeina > 55 real 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
200 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.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
& a �1C_ 1rcl t
-- No me asi-XC -b l-{
AJOV
)n
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 11 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 EXCEEDEN ES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ff NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NO ❑
REGIONAL OFFICE CONTACT NAME:. . !a, f a-W�A
Marl an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of recelot 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 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 t sibility of fines and imprisonment for knowing violations."
(5
1;� a 1 ao��
(Date)
Additional copies of this form may be downloaded at: htto al.ncdenr.o web w ws su n desswt#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
03 Date submitted 10/6! 001i-o
CERTIFICATE OF COVERAGE NO. NCG06O0 00 i SAMPLE COLLECTION YEAR
FACILITY NAME 1 d Ste` LL( ! FACILITY CTIVITIES INCLUDE (check all that apply):
COUNTY i [use/process meats [use animal fats/byproducts
PERSON COLLECTING SAMPLES Y- ,) ItQ _gf-DW O _ DISCHARGING TO SALTWATERS? []YES E940
LABORATORY. V_IC'(}il1JM to -h d Lab Cert. #
a M is)-s i PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: 5tormwater Benchmarks and Monitoring Results ! Total event rainfall z 5 or ❑ No discharge this period'
Outfall No.
5ample 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
I -
100 or 50
Within 6.0-9.0
i 120
30
1000
Sao
1
I o r(.-
aodo
1.1�5
I
0o0
10 (,0
a`
0.qI
101
45
'2 01 000
--
10 11 ci I(P
T19
133
9
>co0 000
I
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.
°See General Permlt 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 [R/no
r
i
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
outfall No.
Sample Collected,
i mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
I -
30
100 or SO
6.0-9.0
-
I
1.
{
I
I
I
I
I
`
'Only applies to facilities that use/process meats. I
ZThe 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.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(i.i; yes, complete Part B)
S WU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART 8 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
i
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENT& SEE PERMIT PART II SECTION B.
• TIER 3: MAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES R NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONA OFFICE;? YES Q w ❑
REGIONAL OFFICE CONTACT NAME: Tr� Ju YYLQ11
Mail an oriainal and one copv of this DMR. includina all "No Discharae" reports. within 30 days of receipt of the lab results (or at end of
i
Division of Water Quality
Attn: DWQ Central Files
1617-Mail Service Center
Raleigh, NC 27699-1617
i
I
"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 possibilit of fines and imprisonment for knowing violations."
I
I �l9
(Sign jCure f Permittee (Date)
I '
Additional copies of this form may be downloaded at: http:(/portal.ncdenr.orglweb/wglws/su/nndessw##tab-4
I
r`
SWU-249 i Last Revised: October 18, 2012.
Page 2of2

CERTIFICATE OF
FACILITY NAME
COUNTY __jL
PERSON COLLEC
LABORATORY
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
1 b(oo 3 49 Date submitted T� /Po1i� C W
RAGE NO. NCG06_a SAMPLE COLLECTION YEAR U I Cp _ NOV%(}
n 1i" r !I ;l n .e !� L .-..� .-t f .�-w �A I O(� V $ 2016
SAMPLES
Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
Ljj(� FACILITY,ACTIVITIES INCLUDE (chepk all that apply):
use/process meats Efuse animal fa s/byproduMNTRAL FILES
DISCHARGING TO SALTWATERS? ❑YES P10 DWR SECTION!
PLEASE REMEMBER TO SIGN ON THE REVERSE -�
' Total event rainfall 2 or &�No discharge this period?
Outfall No.
Sample Collected,
mo/dd/ r
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 rm-9.6
120
30
1000
Soo
N
A11A
QJA
a
1 NIA
1111
)1
N
fA
1 NJA
-A)4
OA-
Alk±
P r
1 Only applies to facilltles that use/process meats.
2The 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.
°See General Permlt 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
(It jes complete Part B)
i
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new motor oil/month. ajl- votY VUU daLl
Outfall No. Sample Collected, Oil and Grease, ' TSS, pH, New Motor Oil Usage, h P 10l -9 V) 0 11I
mo/dd/yr
mg/L
mg/L
Standard units
Annual average gal/mo
Benchmark
I -
30
100 or 50
6.0-9.0
-
i
Ci115 c u' -1
604b v, �'e pa)dQciion
o is n0i 0((Ur ail o !or
era, fl-eri 3am �i�nr�
P�Oy)n-I VM na
1 Only applies to fal:illties 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 anyr 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 bast Revised: October 18, 2012
Page 1 of 2

*FOR.PART A ANI
'~ • A BENCH
• 2 EXCEED.
• TIER 3: it
IF YES, W
REGIONA
PART B MONITORING RESULTS:
1ARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
kNCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION 8
AS YOUR FACILITY HAD 4 OR MORE BENCHMARK iEXCEEDENC€S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [2(NO
VE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES Q NO []
.OFFICE CONTACT NAME: Ti�4'l� 1C1>rrY1JQJ�
I
Division of�IWater Quality
Attn: DWQ Central Files
1617-Mail I ervice Center
Raleigh, NC 27699-1617
i
Wi
"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 i y o fines d imprisonment for knowing violations."
I
I
of
I
I
Additional copies of this form may be downloaded at: http://oortal.ncd! enr,orglwe,blwglws/suZngdessw#tab-_4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT Xf
" for North Carolina Division of Water Quality General Permit No. NCG060000 'v CG U� � -
Date submitted �c�i of i n
i
CERTIFICATE OF COVERAGE NO. NCG06DQ 0 Q SAMPLE COLLECTION YEAR
FACILITY NAME g nV(Q s&,, �!=-66d_ Crr , LUC FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Eno DE I [� use/process meats M use animal fats/byproducts
PERSON COLLECTING SAMPLES UA I l� )+U 1J� Y� D15CHARGING TO 5ALTWATERS? RYES
al
LABORATORY. 4�� �111i 1�i1`��Jy AQV Lab Cert. # i
0m j 4_�6 I PLEASE REMEMBER TO SIGN ON THE REVERSE 4
s and Monitoring Results Total event rainfall z 0 I or ❑ No discharge this period'
Part A: Stormwater Benchmark
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
I, COD,
i 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
Sao
y
i
!
7Q0, 0100--
ri g a LP
i -0--
I
Only applies to facilities that use/process meats. 5EFj 0 2 Z516
The total precipitation must be recorded using data from an on -site rain giauge. CENT a For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. Din RAC FILES
°See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark app[te#,SECTION
i
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)
i
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
I mo/dd/yr
Oil and Grease,
mg/L
TSS,
I mg
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
i,
�
I
I
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.
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
i
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES X NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [.@j NO ❑
--� -- - -
REGIONAL OFFICE CONTACT NAME:.
Mail an original and one copy_ of this DMR, including all "No Discharge" reports, within_ 30 days of recelpt of the lab results (or at end of
manitorina period in the case of "No Discharge" reports) to: II _
Division ofiWater Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
I
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 manag the system, or those persons directly responsible for gathering the information, the information submitted is,
to the bes of my knowle e a elief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, incl.ucl th oss' ' ��im risonmernt for knowing violations."
(Sign2V
4p,-6
j Pei
,64DICa
(D e)
I
I
Additional copies of this form may be downloaded at: httpa/13ortal.ncdenr,or-g(weblwa/ws/sulnodessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2of2

SEMI-ANNUAL. STORMWATER DISCHARGE MONITORING REPORT
for Nofth-Ea o iha Division of Water Quality General Permit No. NCG060000
Date su rnitted 0
()� ``11,n,
CERTIFICATE OF COVERAGrNO.NCG1063_aLt � AMPLE COLLECTION YEAR � �1FACILITY NAME F LI✓t FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY �J i ] use/process meats 9 use animal fats/byproducts
PERSON COLLECTING SAMPLES___—_—__ DISCHARGING TO SALTWATERS? []YES, ®NO
LABORATORY --_—_ _ Lab Cert. # I 7N
PLEASE REMEMBER TO SIGN ON THE REVERSE
I
Part A: rJtOrmwater Benchmarks and Monitoring Results ' Total event rainfall Z or �Na 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
Soo
Only applies to fadlltles that use/process meats,
2The total precipitation must be recorded using data from an on -site rain gauge. BUG a 2916
a 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 theifl@re-ptectlue Benchmark applies.
DWR SCCTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ►• no
i
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,
I mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100or50
6.0-9.0
-
E
(lf yes, complete Part B)
+No-C,tiy1, bj C di3chu,rge
ocCu Yf,nq i n 30ty' a of cp
C�* U• n � p P .3 OU t"fCA
oisc� ar 'a_ 6 4-t-cr
2 Only applies to facilities that use/process meats. CCcuo ed duy� rlq
The total precipitation must be recorded using data from an on -site rain gauge, 1 j� a s For sampling periods with no discharge at any outfalls, you must still subritiit this discharge monitoring report with a checkmark here. Cj f OCC UYf.ffA,
"See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
. II i n�r5 d � Q ��ee� ec� i �y •��-�
SWU-249 Last Revised: October 18, 2012
Page l of 2

*FOR PART A AND PART B MONITORING RESULTS:
i
+ 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 �EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ✓rNO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [ZNO ❑
REGIONAL OFFICE CONTACT NAME:
I
I
i
Division ofiWater Quality
Attn: DWQ Central Files
1617 -MalI Service Center
Raleigh, NC 27699-1617
I
"I certify, under Ipenalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
i
Permitte (Da ej
I`
i
Additional copies of this form may be downloaded at: httn://portal,ncdenr,or-g/weblwq/wslsuLnpdes_s_w#tab-4
i
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for No ina Division of Water Quality General Permit No. NCG060000
� O3 Date submitted 0.1. 1 _J m w RECE'VED
CERTIFICATE OF COVERAG NO. NCG06 O Q L SAMPLE COLLECTION YEAR Jo 1 Lo JUC 18 zu)6
FACILITY NAME S�� LC FACILIT ACTIVITIES INCLUDE (check all that apply): CENT
COUNTY �( [ use/ meats Buse animal fats/bypi'oaigr't� CF'L�S
PERSON COLLECTING SAMPLES }3�1v I� DISCHARGING TO SALTWATERS? []YES�WO r��N
LABORATORY v Lab Cert. # i
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 0. (004r ❑ No discharge this period'
Outfall No.
Sample Collected,
I mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterocacci ,
Colonies per 100 ml
Benchmark
I -
100 or SO
Within 6.0-9.0
1 120
30
1000
Soo
I
V0 .
a
15
-7
ixa U
10
10
too,coo
--
05
I
U0 00
—
Only applies to facilities that use/process meats.
zThe total precipitation must be recorded using data from an on -site rain gauge.
s 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 receivIing 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
i
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
1
Only applies to facilities that use/process meats, f
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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(Ifyes, complete Part B)
S WU-249 I i 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 OUTFAi_L TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK IEXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES &ZNO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [ZNO
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 cased "No Discharge" reports to: 1
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 ttha+Qs�ibility of fines and imprisonment for knowing violations."
7 s L.
(la to
Additional copies of this form may be downloaded at: litto:l/portal.ncdenr,org/"web/`wcl/ws/"su/npdessw#tab-4
SWU-249 I Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER Di CHARGE MONITORING REPORT
Division of Water Qlity Genera! Permit No. NCG060000
C�o�N�thXarofi-�-'
Date submitted 0lilt'5/1
CERTIFICATE OF COVERAGE NO. NCG06_ _ SAMPLE COLLECTION YEAR QW(p
FACILITY NAME h))JU'M� S Lys _FQ[j�l�� Li.� FACILITY'ACTIVITIES INCLUDE (check all that apply):
COUNTY k use/process meats R use animal fats/byproducts
PERSON COLLECTING SAMPLES OWD DI36ARGING TO SALTWATERS? []YES WNO
LABO RATO RY13Y1 D.La Cert. it Jf
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall I W-4 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 mi
Enterococcl ,
0
Benchmark
-
100 or 50
Within 6A-9.0
120
30
3000
500
ON o'
�3•+%
U5
`5
000
9
Em
3
07
1
U
DWk 5
lU p�
vFn
R
' Only applies to facilities that use/process meats. A 2 +�
2The total precipitatibn must be recorded using data from an on -site rain gauge. 8 CQ16
3 For sampling period., with no discharge at any outfalls. You must still submit this discharge itorm report with a checkmark here.
aSee General Permit text, Table 3, Identifying the especially sensitive receiving water r1 ��the more protective benchmark appiie
�OCESSING UNIT
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 91 no ifi es 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 (crease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or SO
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.
S WIJ-249
Last Revised: October 18, 2012
Page 1 of 2

*FCR PART A AND PART 8 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 W NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 9 NO ❑
REGIONAL OFFICE CONTACT NAME: ly-60 3 DIGS
Mall an or! !na! and one ca o this DMR includin a!l "1V Dischar e'� re orts within �0 da s o recei t o the la results or at end o
mon toting 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 INFORMARON 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 person:, 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 theppsA+lity of fines and imprisonment for knowing violations."
kt)
�II-
D
Additional copies of this form may be downloaded at: httartI.ncd nr.or web w ws su dessw#tab-4
SWU--249 Last Revised: October 18, 2012
Page 2of2

0
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
4 3 ( q Date submitted i —1 Z—JS
CERTIFICATE OF COVERAGE NO. NCG06 0 a o o SAMPLE COLLECTION YEAR �RECEIVED
FACILITY NAME en',wf Sitza LLG FACILITY CTIVITIES INCLUDE (chru
all that apply1:
�JaN zap
COUNTY �nr_ _ ,use/process meats seanimal fats/byproducts
PERSON COLLECTING SAMPLES w eo- DISCHARGING TO SALTWATERS? ❑YES [✓ENO CENTRAL FILES
LABORATORY lab Cert. # 411 DWR SECTION
7NC . IPLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results V Total event rainfall z .1 or ❑ No discharge this period3
Outfall No. Sample Collected, TSS, pH, COD, Oil and Grease, Fecal Coliform , Enterococcl ,
mo/dd/Y r mg /L Standard units mIf /L mg/ L Colonies per 100 ml Colonies per 100 ml
Benchmark
I?- -ZZ-191
100 or SO
Within 6.0-9.0
120
30
1000
Soo
- z-
Z 8.4
723
yG
71 z ooa
n
- 7-/
78.0
7. Y6
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.
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 Zno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
rrio/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
-
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,
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ides, complete Part Bj
W
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.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME;
Mail an original and one 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 27699-1617
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 ibility of fines and imprisonment for knowing violations,"
N ( gna ' e (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/weblw2/wslsulnpdessw#tab=4
SWU-249 Last Revised: October 19, 2012
Page 2 of 2

�. •
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
�j/-% /�_ b r„ E,2 � Date submitted ?~ 7-1q
TI j T OC/ 11 CERTIFICATE OF COVERAGE NO. NCGOfi_ O00 _
FACILITY NAME �r4t�itq.r S�i.y /�J Gr�..r, LLC
COUNTY ---------—
PERSON COLLECTING SAMPLES �a.•a cl 5•�++-
LABORATORY �v�✓�!i�+�a.►1`ir Lab Cert. # qq
ke wv! LS , e.
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2:�I/q
•
RE�CEIV D
JUL 0 9 2014
CENTRA, rILES
FACILITY ACTIVITIES INCLUDE (check all that apply): DWQ/80G
Ouse/process meats 2Fuse animal fa s/byproducts
DISCHARGING TO SALTWATERS? ❑YES + NO
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
Total event rainfall z •496 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 Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
Soo
1
- ,5—
2z. S
6.71
17q
33
r A
Z
-
33
ZO/
Z 7d
I 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? ❑ yes Xno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > S5 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
-
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.
(ifye complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

C�
*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 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEED ENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO Q/
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 lab results (or at end of
monitoring period in the case o "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 ANYINFORMATION 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-pvssrbi�ity of fines and imprisonment for knowing violations."
( t of Perm' (Date)
Additional copies of this form may be downloaded at: http://r)ortal.ncdenr.ora/web/wq/ws/su/nodessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2