NCG140038_MONITORING INFO_20190505

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V 14oU30
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ 2UA A 06
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2D18
*Report ALL WASTEWATER monitoring data on this form (include "No Flow"/No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year. r i ;: j�
Certificate of Coverage No. NCG14 ®0❑ 3�® iJAo n C )nin
Facility Name: Tri-City
+L FILES
County: Rutherford OlhlR SECTION
Phone Number: (704 ) 5296364 Total no. of outfalls monitored 2
Certified Laboratory Prism Lab
Lab # 402
Lab #
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No Q
Does this outfall discharge WW to SIB or PNA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑✓
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑✓
Were there any limit violations in the calendar year? Yes 0 No ❑
Outfall No.
0Q1
Daily Flow Rate,
cfs
pH,
SU
TSS,
mg/I
SS,
mlll
if applicable
Non -Polar 0&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
Gaily Maximum
HOW or ORW
50% of 7Q10
Indicate NO FLOW it
�pp;i=b!o
freshwater
6.0-9.0
saltwater
s.a-a.s
Standard
30
HOW
20
HOW ! ORW and Tr, or
PNA
10
HOW, ORIN, SA,
SB,PNA,orany
Trout
�
No Limit
Samples above Benchmark
subject to Tiered Responses
15
Date
Sample
Collected,
molddl r
-ai.
2/7/2018
NO FLOW
4/23/2018
NO FLOW
9/26/2018
NO FLOW
1011012018
PW 001
9.9
BRL
BRL
Oil and grease
Permit Date 8/112017 -- 6/30/2022
Last Revised 8-22-2017
W

Certificate of Coverage No. NCG14 ®® 3❑-1
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No. 002
Does this outfall discharge WW to SA waters? Yes ❑ No ❑
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑
Were there any limit violations in the calendar year? Yes ❑ No ❑
Outfall No.
002
Daily Flow Rate,
cfs
pH,
SU
TSS,
mgll
SS,
mlll
if applicable
Non -Polar O&G (EPA Method 1664
(SGT-HEM)), mg/1
Effluent
Limitations
Daily Maximum
HQW or ORW
50% of 7Q10
lndicafe NO FLOW if
applicable
freshwater
6.0-9.0
saltwater
p _5
6 O 8
Standard
30
HQW
20
HQW ! ORVY n Tr, or
10
HQW, ORW, SA,
SB,PNA,orany
Trout
5
No Limit
Samples shove Benchmark
subject to Tier Responses
1
Date
Sample
Collected,
moldd! r
;
3
d 1
m.
2/7/2018
NO FLOW
4/2312018
NO FLOW
10/10/2018
002 NO FLOW
Permit Date 8/1/2017 -- 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG 14 ®[-0C[S,
CERTIFICATION
"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."
[Required by 40 CFR §122.221
Signature
Date
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMt_R Stormwater Permitting Staff in the Centra; Office at:
[phone]
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2018
*Report ALL STORMWATER monitoring data on this form (include "No FloVi'"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14
Facility Name: Tri-city
County: Rutherford
Phone Number: 7( 04 ) 529-6364
.Certified Laboratory Prism tab
Lab f# 402
Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No. 001 ' VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0
Was this outfall ever in Tier 2 during the past year? Yes ❑ No RECEIVED
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency ❑ MAR 0 4 2019
Yes, received approval from DEMLR to reduce monitoring frequency 0 CENTRAL FILES
Other ❑ DWR SECTION
Outfall No.
001
Total Rainfall,
inches
Total
Suspended
Solids (TSS),
mg/1
pH,
SU
Non -polar O&G
(EPA Method
1664 (SGT-HEM)),
mgll (VMA)
if applicable
New Motor Oil
Usage (gallmo.)
if applicable
Stormwater
Benchmarks
Indicate NO FLOW if
applicable
Circle Benchmark
100/50
6.0-9.0
� �
i o
�55 gallmo. average requires i55 and
Non -polar OaG monitoring
Date Sam le
p
Collected,`
molddlyr
,•�
Ex
-�
�,
=ia z����
t t,,
k r�
#;.
s. a ....
2/7/2018
001 NO FLOW
4123/2018
NO FLOW
9/26/2018
NO FLOW
10/10/2018
001
BRL
9.9
oil and grease
Permit Date 811/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 Q1 1 3❑®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 002 VMA Outfall? Yes ❑ No ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ll
Yes, received approval from DEMLR to reduce monitoring frequency
Other
6
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids TSS
( )�
mg/1
pH,
SU
Non -polar O&G
(EPA Method
1664 (SGT-HEM)),
mgll (VMA)
1r applicable
New Motor Oil
Usage (gallmo.)
if applicable
Stormwater
Benchmarks
indicate NO FLOW 1f
applicable
Circle Benchmark
.t oOIC 0
l J
�` A-9 A
L V
1 G
J
a55 gallmo. average requires TSS and
Non -polar O&G monitoring
Date Sample
Collected,
molddl r
2/7/2018
NO FLOW
4/23/2018
NO FLOW
9/26/2018
NO FLOW
10/10/2018
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 dF071C7
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for
submitting false informatio , including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]7
Signature
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 811l2017 — 6/30/2022
Last Revised 8-22-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT(DMR)--STORMWATER
SUBMIT TO CENTRAL OFFICE„An „ w .
General Permit No. NCG14O000 owR�cTio s
Calendar Year 2017
'Report ALL STORMWATER monitoring data on this form (include "No Flow'T'No'Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 14 F93
Facility Name: Tri-City Plant
County: Rutherford
Phone Number: 8( 28 ) 429-2011
Certified Laboratory Prism Lab
70
Lab # 402
Lab #
Total no. of SDOs monitored 2
Stormwater Discharge Outfall (SDO) No. 001 & 002 VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No E]
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑✓
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids (TSS),
mg/1
pH,
SU
Non -polar O&G
(EPA Method
1664 SGT-HEM ,
( �)
nlgll (VMA}
flappifcable
New Motor Oil
Usage (gal/mo.)
rraPPlfcabfe
Stormwater
Benchmarks
indicate NO FLOW H
applicable
circia Barchrt ri
100150
6.0-9.0
1 �
>55 gaUmo. average require ass and
Nort-polar monitoring
Date Sample
Collected,
molddl r
17,_
r
E�]]� �U
,
p , ,
9
d
3/30/2017
001 No Flow
3/30/2017
002 No Flow
6/30/2017
001 No Flow
6/30/2017
002 No Flow
8/8/2017
001 No Flow
8/8/2017
002 No Flow
12/20/2017
001 No Flow
12/20/2017
002 No Flow
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

n
Certificate of Coverage No. NCG14 ©o❑®®
CERTIFICATION
"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."
(Required by 40 CFR § W2.221
Signature
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed In DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/112017 -- 6/30/2022
Last Revised 8-22-2015

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: Scott Miller
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Reauirements
RECEIVED
JUL 2 7 2017
CENTRAL FILES
DWR SECTION
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept []Oct -Dec ❑Jan -March ®April -June
COUNTY: Rutherford
PHONE NO. [phone]
ADD TO LISTSERVE? [-]YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW
OPTIONAL INFO:
❑PNA []Trout ®Other
Outfall No.
Date Sample
i
Collected
(mm/dd/yr]
Type of Wastewater
(VE, RM, MD)Z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
5GT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)7
-
-
RM, MD-
6-9M
303.S
53
(15)6
-
-
001
6/30/17
No Flow
002
6/30/17
No Flow
' If wastewater systems have not discharged in this quarter-- report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

t
e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL -NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW-1 TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST 51GN TH15 CER►IFICATION 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 perso 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 ;iati re are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
nature of Permittee)
Permit Date:7/1/2010-06/30/2015
7// r+2
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: David Morris
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
GENERAL PERMIT NO. NCG140000
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept
COUNTY: Rutherford
PHONE NO. [phone]
❑Oct -Dec ®Jan -March ❑April -June
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfali No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)z
pH
(standard)
Total
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using5uspended
method 1664A
5GT-NE&f
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day),
-
-
RM, MD-
6-93'6
3035
53
(1s),
-
-
001
3/30/17
No Flow
002
3/30/17
No Flow
ysr
MAY
0 5 U /
I If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 T55 limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

41
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action:
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 0213 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
You MUST SIGN THIS CERTIFIC4rION FORANY 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 direct) 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 thqr# are gnf icant penalties for submitting false information, including the possibility of lines and imprisonment for knowing violations."
re �f Permitteej
Permit Date: 7/1/2010-06/30/2015
L127—
(Date)
Last Revised 07/13/11
Page 2 of 2

T PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038 SAMPLE COLLECTION YEAR: 2016
FACILITY NAME: Tri-City SAMPLE QUARTER: []Jul -Sept ®Oct -Dec []Jan -March ❑April -June
PERSON COLLECTING SAMPLES: Rik Jones RECEIVED COUNTY: Rutherford
CERTIFIED LABORATORY: Prism Lab # 402 JAN 9 3 2,A17 PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ® CENTRAL FILES DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
DWR SECTION
OPTIONAL INFO:
Part A: Wastewater Monitorine Reauirements
Outfall No.
Date Sample
Collected"
(mm/dd/yr)
Type of Wastewater
2
{VE, RM, MD)
pH
{standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 16S4A
S
(mgL) /L)
Discharge
Duration
(minutes)
Total Flow
7
(gallons/dayj
-
-
RM, MD-
6-93'4
303's
53
(15)6
-
-
001
11/29/16
No Flow
002
11/29/16
No Flow
�
r1ia1111
1CI(ff
IMP
.1
_
ill V119\0b
11
�—
` if wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but insteAd is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWo, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dir ctly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aVafe that }"ier� significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permit -tee)
Permit Date:7/1/2010-06/30/2015
/If7 /f
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: David Morris
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES []NON
Part A: Wastewater Monitorine Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ?ZJul-Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: Rutherford
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CUSS: [:]SA ❑HQW
OPTIONAL INFO:
[]PNA ❑Trout ®Other
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
Z
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
SG
(mg/L]1L)
Duration
(minutes)
Total Flow
(gallons/day)'
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
001
9/22/16
No Flow
002
9/22/16
No Flow
RECEIVED
i
CENTRAL FIL
ES
DWR SECTION
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .022a. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 awpre that th#e aresignificantpenalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permitteej
Permit Date: 7/1/2010-06/30/2015
�1Z
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER —Quarterly Discharge Monitoring Report
s
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402 3
r'L C
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: Rutherford
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW
OPTIONAL INFO:
❑PNA []Trout ®Other
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
(VERMMD)
, ,
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
6
SGTdiE
(mg/L )
Discharge
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
RM, MD-
6-93,4
303'5
53-
001
06/27/16
No Flow
002
6/27/2016
No Flow
iV L_ L.-F
A,
l6
CEP
TRAL FILE,)
UV\
K Z)ECT ICM
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
' Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subiec{to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flaw rate can he'measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 0213.0224_ Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING_ ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 ware At there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Sifinature of Permittee)
Permit Date: 7/1/2010-06/30/2015
1�(
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES []NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept []Oct -Dec ®Jan -March ❑April -June
COUNTY: Rutherford
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
Z
(VERMMD}
, ,
pH
(standard}
Total Suspended
Solids
{mg/L}
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
c
SGTdiEM
[mg/L}
Duration
(minutes)
Total Flow
7
(gallons/day]
-
-
RM, MD-
6-93'4
303 s
53
(15)6
-
-
001
03/30/16
No Flow
,
002
03/30/16
No Flow
e R
. }ED
C; TRA
_..
- FILES
vm J_;;l_
ION
` if wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3It an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
a
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

s Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW water;; shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
_MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO. -
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 dire tly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
lama warerXhat tilriZe are�significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ® NO ❑
Part A: Wastewater Monitorine Reouirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY: Rutherford
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
:
(VE, RM, MD)
pH
(standard]
Total Suspended
Solids
(mg/L)
Sel:tleable
Solids
(mL/L)
TPH using
method 1b64A
SGT /L)
(mg/L)
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
RM, MD-
6-93.4
303,5
53-
001
11/30/15
No Flow
002
11/30/2015
No Flow
®�
j
V�
L N I I
CAL t-ILES
omwl
MMM
r�rMn
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cieanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 T55 limits are 20 mg/L for wastewater discharges to HOW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 How rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 70.10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
Yeport,cm a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dir ctly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware,;hat4ere afe significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ignatufe of Permittee)
Permit Date:7/1/2010-06/30/2015
27 (�
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly DischargE! Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ® NO
Part A- Wactawatar Mnnitnrinp RpnuirpmPnts
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY: Rutherford
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD}z
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(m
TPH using
method 1664A
(mg/L}L/L) S g/L)1�
Discharge
Duration
(minutes)
Total Flow
(gallons/day}
-
-
RM, MD-
6-93'4
30A's
53-
001
11/30/15
No Flow
` If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
S If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 3.0 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
CIO"
U

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flm n-Tate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 70.10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWCL and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING _ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN T1415 CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons irectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware tVAt there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

c-
PROCESS WASTEWATER — Quarterly Discharge! Monitoring Report
f GENERAL PERMIT NO. NCG140000 F I L E 6 P Y
CERTIFICATE OF COVERAGE NO. NCG140038 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Tri-City SAMPLE QUARTER: �jJul-Sept ❑Oct -Dec ❑Jan -March ❑April -June
RECEIVED PERSON COLLECTING SAMPLES: Rik Jones COUNTY: Rutherford
CERTIFIED LABORATORY: Prism Lab # 402 OCT 2 3 2015 PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
LIMIT VIOLATIONS? YES ® NO ❑ CENTRAL. FILES DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ®Other
DWR 5ECTIQ�.I OPTIONAL INFO:
Part A: Wastewater Mnnitorine Ranuirements
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-HEM'
(mg/L)
Discharge
Duration
{minutes)
Total Flow
7
(gallons/day}
-
RM, MD-
6-93,4
303,S
53-
001
9/28/15
No Flow
002
9/28/15
No Flow
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3It an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 1SA
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE")WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
A 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 at thAere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
I. i 2(If
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ® NO ❑
Part A: Wastewater Monitorine Reaulrements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
RECEIVED COUNTY: Rutherford
JUL 2 4 2015 PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
CENTRAL FILES DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ®Other
DWR SECTION OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)2
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEA ff
(mg/L)
Duration
(minutes)
Total Flow
gallons/day)'
-
-
RM, MD-
6-93,4
303,5
53
(15)r,
-
-
001
04/18/15
RM
7
230
BRL
N/A
>1
>1
002
04/18/15
No Flow
if wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges mere: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TS5 limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow an6 report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWCL and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DI'3CHARGE"1 WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END_ OF MONITORING PERIOD_ IN CASE_ OF"NO FLOW-) TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 ayva}q that4ery-Airsignificant penalties for submitting false informatlon, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

�• r
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140038
FACILITY NAME: Tri-City
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Reauirements
RECEIVED
MAY 13 2015
CENTRAL FILES
DWR SECTION
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: []Jul -Sept ❑Oct -Dee ®Jar; -March ❑April -June
COUNTY: Rutherford
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
x
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L}
Settleable
Solids
irnL/L}
TPM usingDischarge
method 1664A
SGT-NEM6
(mg/L)
Duration
(minutes}
Total Flow
(gallons/day)
-
-
RM, MD-
6-93'�
303'S
53
(15)6
-
-
001
03/30/15
No Flow
002
03/30/15
No Flow
Tom
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
N

•,r
e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END_ OF MONITORING PERIOD IN CASE OF "NO FLOW"] TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dir ctly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I arr aware that7ereAre significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Sign ure of Permittee) (Date)
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 2 of 2

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onftliing out this form, please visit: httn:/lh2o.enr.state.nc.us/su&orms Documents.htm#miscforms
Permit No.: NICI I I l�l I l l or Certificate of Coverage No.: N/C/G/ 1 I'[l 6/31a/ Z!
Facility Nsorae-or^6cl
e: �-At2 0 �7 A R 1' MIA F,yt , 5 Krj i,t-E
County: _ - Phone No. _15 3 2-3Z = `12 ° °
Inspector: tau r
Date of Inspection:
oIL
Time of Inspection: . 6 = o o prt
Total Event Precipitation (inches): 0-6
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A `Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this sigo6p6re„ I cer f' that tWs report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Ouffall Description:
OutfallNo. 4 Structure (pipe, ditch, etc.)
Receiving Stream: � SPIA) A a oAy S lL-
Describe the. industri'activities that occu within the outfall drainage area:
�or+cnfTf fkfl�w /Atye, �Aly- T - - -
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ G IN~t- ..4 -
3. Odor. Describe iy distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SWU-242-112608

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 0 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
-- — - - stormwater discbarge; where-1-is no-solids-and-5 is -the -surface covered with floating solids: -
1 0 3 4 5
G. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1. 2 0 4 5
7. Is there any foam in the stormwater discharge? Yes
8. 'Is there an oil sheen in the stormwater discharge? Yes 0
9. Is there evidence of erosion or deposition at the outfail? Yes L"O
10. Other Obvious Indicators of Stormwater Pollution: '
List and describe��
Dote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
S WU-242.112608

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14(5 3 � p
FACILITY NAME: " 4,011 [ `
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY I` CE Atzc T1GAL Lab #
Lab #
OPTIONAL INFO: _
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2-C) 1 Z-
SAMPLING PERIOD: D July -December g JanuaryJune's
COUNTY V_re
PHONE NO. ($Z`b) Z2p Z' -14-70 O
ADD TO LISTSERVE? DYES [—]NO EMAIL -
DISCHARGING TO CLASS: ❑SA ❑HQW DPNA DTrout ?Other,
Dutfall No.
Date Sample
Collected
{mo/dd/yrOR
NO FLOW )I
pH
(Standard
Units)
TSS
(m�L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)ZI
In Tier 2
Monthly
Mo`Y�njng7
fF of Months in Tier
2SamplingZ
-
-
6-9
100
-
-
-
-
1
170
f S T AU,- It -AB, , E
C.
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 orTier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activitv Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date.Sampie
Collected
(mo/dd/yr)1
PH
(Standard
Units)
TPH using methods
1664A'SGT HEM
(mg/L)
i!Total`Suspended i;'
Solids
(mg/L)
"''Event,. •
Duration
(minutes)
7otaU.
4
Rainfall
(inj
New Motor Oil
usage
(gal/month)
IrrTi 1r 2
Monthly
I
Monitoring?
wr)
# of Months
in Tier 2
z
Sampling
6-9
.15
:1D0•
-
-
-
-
0\1JA
1
I
I
t
1
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO Qr
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No_FIo-w7lto:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction orsupervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my Inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2011-60/30/201S
(Date)
Last Revised 7/13/11
Page 2 of 2

�Vrn�
Stvrmwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit: htt_p://h2o.enr.state.nc.us/su/Forms Documentskm#miseforms
Permit No.: N G
Facility Name: C
County: MACAe,
Inspector; u
Date of Inspection:
Time of Inspection
Total Event Precipitation (inches): - 0, -7 S_ -
Was this a Representative Storm Event? (See information below) ❑✓/Yes ❑ No
Please check yourpermit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm'event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 boars (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signaoe, I cerdfi that this rapport is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. IT Structure (pipe, ditch, etc.) t� t'-G � i
Receiving Stream: -rs t S,-C H 'E wA?> ,,.... Rtu s
Describe the industrial activities that occur thin the outfall drainage area:
2. CoIor: Describe the color of the discharge usin basic colors (red, brown, blue, etc.) and tint
(Light, medium, dark) as descriptors: �-- t C.tk7 c rzo W d
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): N) o,.] f
Page l of 2
5WU-242-112608

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
0 2 3 4 5
5._ _ Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1-is no solids and 5 is the surface covered -with floating solids:
2 3 4 5 --
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 I (D 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious ))Indicators of Stormwater Pollution:
List and describe (CIA,
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition maybe
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242-112609

STORMWATER DISCHARGE OIUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCGM 0 3 16 2
FACILITY NAME: Rf
Po,tpA -Aoi JA ( 00--rH� t1EU I, -LC ?441Y
PERSON COLLECTING SA PLES ^u �-�-
CERTIFIED LABORATORY &F_ r e_AL Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: _ b k -Z -A ISsTAVr�t agLE
SAMPLING PERIOD. ❑ July -December ®January -June
COUNTY MAD150r3
PHONE NO. _Z3 Z.— If7o O
ADD TO LISTSERVE? DYES [:]NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [::]Trout Other j
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
TSS
(nig/L)
Event
Duration
(minutes)
Total '
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling,
-
-
6-9
100
-
-
-
-
07 1 3 7-012
7. 5
jxI, 24
ga
0.15
IJ
If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW' or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above,
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 orTier ier 2 responses in the General Permit, Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
a TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/%
° For each sampled measurable storm event thetotal precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
outfall
No.
Date Sample
Collected
-(mo/dd/.yr)l
PH
(Standard
Units)
TPH using method!,
I664A'SGT-HEM
(mg/L)
'TotaGSuspended''
Solids
(mg/L)
:. Event'
Duration
(minutes)
:Total:;
n
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
i
Monitoring?
(y/n)
i
# of Months
in Tier 2
z
Sampling
6-9
.15
I
I � '
i
{{I
1
1 1
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (IN(tLUDING VEHICLE MAINTENANCE)? YES ❑ NO [�
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ i
REGIONAL OFFICE CONTACT NAME:
I Orieinal and one coov of this DMR [including all
in case of "No Flow") to:
Division of Water Quality
Attn: DWQCentral Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED. -
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage'the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

CHAIN -OF -CUSTODY /Analytical Request Document
3ceAnalgical •
The Chain-d-Custody!9 a LEGAL DOCUMENT. M relevant ft1d3 mustmustbe oomplow accurately.
Se on A Section 8 SactJon C
Requirod Clat fnfonr40on: Rocltflrsd P4cl lft6riistlan: IrNoloo Informarlion:
rA Kepml T . G" 8S
15202.'
Adilresa -,,j Cwv To; Company Name:
7
AddrqoD-. r— MQ r— r— DFUNKIft"- wA-MR-
Ernall To:
Purdwao Order NO.,
Pace Q�
UST r RCRA
j OTHER
Phone:
Fa�c.
Project Norco:
Pam prood
Mariopr.
rA M
Requested Due DtflerrAT:
ProJeclNumbor.
Ro
7.
Soc,tlom D
Ft"wft4cianl
Mn&b(Co&b
COLLECTED
,
Pro S49rV6f1wS
Z
DdnVJngWal6r` DW.
Wolof WT
Waslo Wutur WW
"P
MAX
ENMI141
Pfcducl
SAMPLE ID
Oil OL
wp
oc
" iU6F-
Sarrld. IDs MUST BE UN
.WI pa
AR
'nuo TS
U)
0
C>.
z
Z
Other OT
0
8
J
WIZ
0M
V)
2 12 '07
LU
R
A
a
'Pa -NoJ
0
DATE
TIME
OATE
TIME
:D
La
dd Project b I.D.
11LI
ZZZ7,Z)
/;Z 71 O�2
h.
I
I
V
I
U
0 V1.
D E0
ER. E� 4A
ORIGINAL
PRINT Name of &AYPI-Bt Signed
SIGNATURE of SAMPLER: —L4�—+(MWDATE DDtM:
$AMPLE CONDMONS
'Impmwl r4ow By algnkV "form you am awApOg Paso's NET 30 dAY poyrnoN Wm% wd ogroolN ID IaLe chargot of 1.5% per nV(4b for any Env*lc*Lnot PLO wkhln 30 dmy&
F-ALL,Q-020rev.07. 16-May-2007

'
- � aceAnalytrcal::
Document Name: Sample Condition Upon
� Recei t SCUR .
goculnent Revised: October 19, 2011
Page 1 of 2 "
Document No.:
issuing Authorities:
F-ASV-CS-003-rev.07
Pace Asheville Quality Office
Client Name::_ (z5� P.roject #_
Where Received: ClHuntersville' Asheville �. Eden
Courier (Circle): Fed Ex _.._ UPS_ - USPS go Commercial pace Other
Custody�Sealon CooferlBoz Pi+esent-0—yes no "Seals lntact:��-yes—�no � -
Packing Material: Bubble Wrap��_`1�3ubble Begs None Other-- r
Circle Thermometer Used: IR uS�R3�i�39'", Type of ice: Blue None -j;]_zamp[as on ice, cooling process has begun.
fR-Gun Back Up- 411565115
Temo Correction Factor:-Addlt•-nbmabt C
Corrected Cooler temp.:. J- 7 C
' Ddte and Initial of per examining
Biological Tissue Is Fruzeri:'. Yes No WA
Terrip should be above freezing to WC:
Comments: contents: 2
Chain of Custody Present:
es Olio
OwA
1.
Chain of Custody FWad Out.
PY,, ❑No
❑wA
2.
Chain of Custody Relinquished:
as ❑No
pwA
3.
Sampler:Name & Signature on COO:
ae ❑No
❑wA
4-
Samples Arrived wilhin Hold T!me:-J2MOs..ONo
pNrA
5.
Short Hold Time Anaiysls <72hr :
❑Yes o
pwA
6.
Rush Tur-6 Around Tlme Requested:
.❑Yes P4&� OWA
7;
SuMdlent Volume:
es ❑No
dWA
8.
Correct Containers Used.
tes ONO
❑wA
9, -
-Pace Containers Used: 7
,er�o ONo
oNfA
Containers Intact.
iJYcs 014o".174
10.
Filtered volume received for Dissolved tests
Dyes IJNO
WA
11.
Sample Labels match COC:
,KiY6 ON.
pwA
12.
-Includes date/time/lD1Analysis Matrix:
r
All containers needing preservation have been checked.
eYies ONO
17WA
13.
All containers needing preservation are found to be in
�
Yes
DwA
compliancevtth EPA: ro ommendation.
'6E ,CI
exceptions: VOp, colifonn, TOC, 08G, MORO (water)
-No
❑ENYes O
lntual when cem eted
Samples checked for dechiorlriatlon: '
❑Yes ❑No
WA
14.
Heads ace In VOA Vials (:�6mm :
❑Yee ONO
wA
16.
Trip Blank Present:
❑Yes ❑No
A
16.
Trip Blank Custody Seals Present
❑Yes ONO
❑
Pace Trip Blank Lot # (if purchased):
Client Notiticationt Resolution: Fteld•Data Requtred? Y I N.
Person Contacted: -Date/Tlme:
Comments/ Resolution:
SCURF Review: M Rate: (3 1oZ I SRF Review: pate:
Note:' Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of thI3 form will be sent to the North Carolina DEHNR
Certification Office ( Le out of hold, Incorrect preservative, out of temp, incorrect containers) -

aceAnaVical
WAwpaceiabsLeon
July 26, 2012
Mr. Mark Brooks
Brooks Engineering Assoc.
17 Arlington Street
Asheville, NC 28801
Pace Anslytical Services, Inc,
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
RE: Project: PLANT TSS 7111
Pace Project No.: 92124171
Pace Analytical Services, Inc.
2225 Riverside Dr.
Ashew5e, NO 28804
[phone]
Pace Analytical Services, Inc.
S800l0ncayAve, Suits 100
Huntersvlile, NO 28078
[phone]
Dear Mr. Brooks:
Enclosed are the analytical results for sample(s) received by the laboratory on July 13, 2012, The
results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless.
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Lorri Patton
[e-mail]
Project Manager
Endosures
= Mr. Mark Brooks, Brooks EnglneeringAssoclates
REPORT OF LABORATORY ANALYSIS
This teport shell not be reproduced, except In furl,
without the written consent of Pace Analytical Services, Inc..
Page 1 of 9

accAnalytical
W"Pacefab&;=
Project: PLANT TSS 7111
Pace Project No.: 92124171
Pace Analytical Sorvicaa, Inc.
205 East Meadow Road - Suite
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Pr.
AshevOle, NC 28604
[phone]
CERTIFICATIONS
Asheville Cerilflcatlon'1Ds -
2225 Riverside Dr., Asheville, NC 28604 North Carolina Wastewater Cerilticadon M 40
Flodda/NELAP Certification #: E87648 — — South Carolina Certiffcatlon #: 99030001
Massachusetts Certification #: M-NCO30 West Virginia Certification #: 356
North Carolina Drinking Water CeMficatlon #: 37712 VtrglnaNELAP CertiBeatton #: 460222
Pace Analytical Services, Inc.
9800 KlnceyAve. Suite SOU
Huntarsville, NC 28078
[phone]
REPORT OF LABORATORY ANALYSIS Page 2 of 9
This report shall not be reproduced, except in full,
vrilhout the written consent of Pace Analytical Services, Inc..

aceAnaVical
- v,�xivpacekbs.cgm
Project: PLANT TSS 7111
Pace Pr0]ect No.: 92124171
PaceAnalyUcal Services, Inc.
205 East Meadcru Road • Suite
Eden, NC 27288
[phone]
PaceAnalytical Services, Inc.
2225 Rlverslde Or.
Asha4a, NC 28604
[phone]
SAMPLE ANALYTE COUNT
Pace Ana:Aeal Services, Inc.
0800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Analytes
Lab 10 Sample ID Method Analysts Reported Laboratory
92124171001 SWANNANOA PLANT SM 2540D LMD 1 PASI-A
92124171002 MARSHALL PLANT SM 2540D LIVID 1 PASI-A
REPORT OF LABORATORY ANALYSIS Page 3 of 9
Th'ss report shall not be reproduced, except in full,
withovi the writte n consent of Pece Analytical Services, Inc.,

aceAnalytical
Wvwpa0Wbscom
Pace Analytical Services, In:.
205 East Meadow Road - Sulte A
Eden, NC 27268
[phone]
Paw Anatytical Services, Inc.
2225 RlversAo Dr.
Ashaville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 KinceyAve, Suite 100
Huntersville, NC 28078
[phone]
Project: PLANT TSS 7111
Pace Project No.: 92124171
Sample: SWANNANOA PLANT Lab ID: 92124171001 Collected: 07111112.18:00 Received: 07/13/12 13:44 Matrix: Water
Parameters Results Units Report Urnit OF Prepared Analyzed CAS No.
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids K2 mg/L 5.0 1 07/17112 17:52
Qual
Date: D712812012 11:16AM REPORT OF LABORATORY ANALYSIS Page 4 of 9
This report shall not be reproduced, axcept in full,
without the written consent of Pace Analytical Servlces, Inc..

aceAnalyrcal
rs�+sv.AaceFabsrnm
Project: PLANT TSS 7111
Pace Project No.: 92124171
Pace Analytical Services, Ina.
205 East Meadow Road - Suite A
Eden, NC 27283
(33E)923-8921
Pace Analytical Services, Inc.
2225 Riverside Dr.
Ashevale, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 KlcceyAve. Suite 100
Huntersnille, NC 28070
[phone]
Sample: MARSHALL PLANT Lab ID: 92124171002 Collected: 07113/12 13:00 Recelved: 07/13/12 13:44 Matrix: Water
Parameters Results Units Report Limlt OF Prepared Analyzed CAS No. Qua!
2540D Total Suspended Solids Anatytical Method: SM 2540D
Total Suspended Sallds 14.4 mg/L 3.1 1 07/18/12 22:38
Date: 07/2812012 11:18AM REPORT OF LABORATORY ANALYSIS Page 5 of 9
This report shell not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

(�Ianeftlj4ical
wuw.pacabbsmm
Project: PLANT TSS 7111
Pace Project No.: 92124171
PaceAnalytical Ssrvloea, Inc. Pa ce Analytical Services, Inc.
205 East Meadow Road - Sulle A 2226 Rlveralde or.
Eden, NC 27288 Asheville, NC 28804
[phone] [phone]
QUALITY CONTROL DATA
Pace AnalyticaI Services, Inc,
0800 Kinsey Ave. Suits 100
Huntersville, NO 26078
[phone]
•QC Batch:----WET121642 Analysls Method:. -....,SM 2540D - _ ___ - _ " I _ —
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92124171061
METHOD BLANK: 796185
Associated Lab Samples: 92124171001
Parameter Units
Total Suspended Solids mg1L
LABORATORY CONTROL. SAMPLE: 796186
Parameter Units
Total Suspended Solids mg1L
Matrix: Water
Blank Reporting
Result Llm(t Analyzed Qualifiers
ND 2.5 07/17112 17:48
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualiflers
250 250 100 80-120
SAMPLE DUPLICATE: 798187
92123690001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg1L 134 93.0 36 ,1(DB)
SAMPLE DUPLICATE: 796188
92124050001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg1L ND ND
Date: D712612012 11:16AM REPORT OF LABORATORY ANALYSIS Page 6 of 9
This report shall not be reproduced, except In full,
without the written consent of Pace Analytical Services, Inc„

aceAnalytical
wnrcpacaiabs.um
Project: PLANT TSS 7111
Pace Project No.: 92124171
Pace Analytical Services, Inc.
205 East Meadow Road - SuitsA
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Or.
Asheville, NO 28804
[phone]
QUALITY CONTROL DATA
Pace Analytical SsrOcas, Inc.
9800 Kincey Ave. Suite 100
Huntarsvi la, NO 28078
[phone]
QC Batch: WET121675
Analysis Method: SM 2640D
QC Batch Method: SM 2540D
Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92124171002
METHOD BLANK: 797496
Matrix: Water
Associated Lab Samples: 921241710o2
Blank Reporting
Parameter
Units
Result Limit Analyzed Quallfiers
Total Suspended Solids
mglL
NO 2.5 07118/12 22:36
LABORATORY CONTROL SAMPLE:
797497
Spike LCS LCS % Rec
Parameter
Units
Conc. Result % Rec Limits Qualifiers
Total Suspended Solids
mg/L
250 250 100 80.120
SAMPLE DUPLICATE: 797499
92124200001 Dup
Parameter
Units
Result Result RPO Qualifiers
Total Suspended Solids
mg/L
16,0 15.4 4
SAMPLE DUPLICATE: 797503
92124722001 Dup
Parameter
Units
Result Result RPD Qualftlers
Total Suspended Solids
mg1L
5800 6220 7
Dale: 07/26/2012 11:1a AM REPORT OF LABORATORY ANALYSIS Page 7 of 9
This report shag not be reproduced, except In fug,
without the written consent of Pace Analytical Services, Inc-

ce Analytical
al Services, Inc.
205aEast Meadow Road o SuiteA Pace Anelyt12225 Riverside Dr. Pare9800 KlncscyAve. Suite 100
/�aceAnafytical` ,
wimpacaw&wm Eden, NC 27288 Ashev>lle, NC 28804 Hunlersville, NC 28078
(356)6238921 [phone] [phone]
QUALIFIERS
Project: PLANT TSS 7111
Pace Prefect No.: 92124171
DEFINITIONS ----
OF - Dilution Facter, if reported, represents the factor applied to the reported data due to changes In sample preparation, dilution of
the sample aliquot, or moisture content.
ND - Not Detected at of above adjusted reporting limit.
MDL - Adjusted Method Detection Limit.
PRL - Pace Reporting Llmlt.
RL - Reporting Limit.
S - Surrogate
1,2-Dlphenylhydrazine (8270listed analyte) decomposes toAzobenzene.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Get - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte Is a combined concentration.
Acid preservation may not be appropriate for 2-Chloroethyivinyl ether, Styrene, and Vinyl chloride.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes,
TNI - The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services -Asheville
ANALYTE QUALIFIERS
J(DB) Estimated Value. The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory
control limits.
Date: 07126/2012 11:16 AM
REPORT OF LABORATORY ANALYSIS
This report shell not be reproduced, except In full,
wiLhoul the written consent of Pace Anasytcal Senr{ces, Inc..
Page 8 of 9
r

laneAnatvtical
wwwpaoYebscom
Pmjecl: PLAINT TSS 7111
Pace Project No.: 92124171
Paco Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27289
[phone]
Pace Anstytical Services, [no.
2226 Rlversfda Dr.
Asheville, NC 28804
(828)254-717B
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Pace Analytical Services, Inc.
000 MrioeyAve, Suite 100
Htintersville, NC 29078
[phone]
Analytical
Lab ID Sample 1D QC Batch Method QC Batch Analytical Method Batch
92124171001 SWANNANOA PLANT SM 2540D WET121642
92124171002 MARSHALL PLANT SM 2540D WET121675
Date: 07126/2012 11:16 AM REPORT OF LABORATORY ANALYSIS Page 9 of 9
This report shall not be reproduced, except In full,
Without the written consent of Pace Analytical SoMcas, Inc..