NCG140066_MONITORING INFO_20190305

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v U& j LI 00 L (o
DOC TYPE
❑1 HISTORICAL FILE
P MONITORING REPORTS
DOC DATE
❑ 001 q o 30
YYYYM M DD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
I SUBMIT TO CENTRAL OFFICE* 11
General Permit No. NCG140000
Calendar Year 2018
Report ALL WASTEWATER monitoring data on this form (include "No FloWl"No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 0❑®®®
Facility Name: Thomasville Plant
County: Davidson
Phone Number: (336 ) 983-2181
Certified Laboratory Prism Lab
Lab # 402
Lab #
Total no. of outfalls monitored 1
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No ❑✓
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 ❑ No 2)
Outfall No.
001
Daily Flow Rate,
cfs
pH,
Su
TSS,
mgll
SS,
mill
if applicable
Non -Polar O&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
Daily Maximum
HQW or ORW
50% of 7Q10
Indicate NO FLOW A
applicable
freshwater
6.0-9.0
saltwater
r
6.8-$.�
Standard
30
HQW
20
HQW 1 ORW and Tr, or
ANA
10
HQW, ORW, SA,
SB,PNA,orany
Trout
C
J
No Limit
Samples above Benchmark
subject to Tiered Responses
15
Date
Sample
Collected,
molddl r�.,
°
x,
�r.
r
a
t
e:
3/13/2018
001 NO FLOW
M—c;RVED
6/3012018
NO FLOW
MAK e7
rrzm-ri;-A.l Pit PS
912512018
NO FLOW
DWR SECTION
12/27/2018
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG 14 ®F —0C[U.
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 15
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 Piles
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 8/1/2017 — 6130/2022
Last Revised 8-22-2017

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000 MAR 0 7 2018
Calendar Year 2017 CENTRAL FILES
'Report ALL STORMWATER monitoring data on this form {include "No Flow"P'No.Discharge" and Benchmark-""
Exceedances} from the previous calendar year to the DEQ by MARCH I of each year.
Certificate of Coverage No. NCG14 OQ®©®
Facility Name: Thomasville Plant
County: Davidson
Phone Number: (336 ) 451-4087 Total no. of SDOs monitored 1
Certified Laboratory Prism Lab Lab # 402
Lab #
Stormwater Discharge Outfall (SDO) No. 001 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall
inches
Total
Suspended
Solids (TSS
`)r
moll
pH,
SU
Non -polar O&G
(EPA Method
1664 SGT-HEM ,
{ ))
mgll (VMA)
!f appllcable
New Motor Oil
. Usage (gal/mo.)
Nappllcable
Stormwater
Benchmarks
fndfcate NO FLOW if
applfcabfe
Circle Benchmark
.� LU1.]A
V /JV0
6.U-9.�
....
.� C
J
>55 gallnro. average requires TSS and
Non -polar OaG monitoring
Date Sample
Collected,FAY,;
L ;. -S" "i �'}
o ,
�t b' Si$'3:
�; d
r 5 j
a i2*
f
4.
M1
'if'- !
s E,3
,
a gyp, 4
3/6/2017
001 No Flow
6/30/2017
001 No Flow
9/28/2017
001 No Flow
12/11/2017
001 No Flow
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 00®®
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.
Signature ! /
Date b Y/! -"'
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. NCG140066 SAMPLE COLLECTION YEAR: 2017
FACILITY NAME: Thomasville SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
PERSON COLLECTING SAMPLES: Tony Hardison RECEIV COUNTY: Davidson
CERTIFIED LABORATORY: Research and Analytical Lab # 34JUL 2 7 Z017 PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ® CENTRAL FILESDISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
DWR SECTION OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Outfall Na.
Date Sample
1
Collected
Type of Wastewater
(VE, RM, MD)z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
5GT HEfte
(mg/L)
Duration(mm/dd/yr)
(minutes)
Total Flow
(gallons/day),
-
-
RM, MD-
6-93'4
303'5
53
(15),
-
-
001
6/30/2017
NO FLOW
1 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 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: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

A
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.
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 026 .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 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 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 an) awar4 tha Ahere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ture of Permittee)
Permit Date:7/1/2010-06/30/2015
7le'5 67
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140066
FACILITY NAME: Thomasville
PERSON COLLECTING SAMPLES: Tripp Welch
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorina Requirements
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept []Oct -Dec ®Jan -March ❑April -June
COUNTY: Davidson
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®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
RMMD)
[VE, ,
pH
{standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SG
/L)16
(mg/L)
Dis charge
Duration
(minutes)
Total Flow
7
{gallons/day]
-
-
RM, MD-
6-93'4
303,5
53
(15)6
-
-
001
3/6/2017
NO FLOW
MAY'��
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.
4 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 VNIA 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") 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 esponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware thgt there re s�ioficant 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
Slg (7
(Date)
Last Revised 07/13/11
Page 2 of 2

r
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
RECEIVED
CERTIFICATE OF COVERAGE NO. NCG140066 JAN 2 3 2017
FACILITY NAME: Thomasville CENTRAL FILES
PERSON COLLECTING SAMPLES: Tripp Welch DWR SECTION
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Manitarine Reauirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec Dian -March ❑April -June
COUNTY: Davidson
PHONE NO. [phone]
ADD TO LISTS ERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [—]Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected"
(mm/dd/yr)
Type of Wastewater
z
{VE, RM, MD)
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1b64A
SGT HEM6
(mg/L}
Discharge
Duration
(minutes)
Total Flow
7
{gallons/day)
-
-
RM, MD-
6-93,4
303,s
53
(15)6
-
-
001
12/14/16
No Flow
n � lam,
l A 11 Lt
�A
1111 _I
v •'
u�
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.
i 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 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

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.
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 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 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 din tly res risible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am ay+arg that; t eye 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
If►-7
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER— Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140066
FACILITY NAME: Thomasville
PERSON COLLECTING SAMPLES: Tony Pope
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Reauirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March []April -June
COUNTY: Davidson
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
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L}
Settleable
Solids
(mL/L}
7PH usingDischarge
method 1664A
SGT-HEMS
(mg/L)
Duration
(minutes)
Total Flow
,
(gallons/dayj
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
001
9/24/16
No Flow
2%
FILES
' 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.
4 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.
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") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN TN15 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 aereye�significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re 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
.l GENERAL PERMIT No. NCG140000�
CERTIFICATE OF COVERAGE NO. NCG140066 SAMPLE COLLECTION YEAR: 2016
FACILITY NAME: Thomasville
PERSON COLLECTING SAMPLES: Tony Pope
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES [-]NO
Part A: Wastewater Monitoring Requirements
SAMPLE QUARTER: ❑Jul-5ept ❑Oct -Dec
COUNTY: Davidson
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
❑Jan-MarchGAF,�April-June
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
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
S
mg/
(mg/L)
Duration
(minutes)
Total Flow
7
(gallons/day}
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
001
6/24/16
No Flow
kctjLI, v L.,rta
I IG 0 9 2016
CENTRAL FILE,
i
DVVR SEU I Ivll
' 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.
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 in°dead 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 beset to 50% of the Summer 7Q10 Flow as per 15A
NU,-C 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
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 nest of my knowledge and belief, true, accurate, and complete.
I am awarelhat th4e are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature,df Permittee)
Permit Date:7/1/2010-06/30/2015
V2
(Date)
Last Revised 07/13/11
Page 2of2

ti
y�-- PROCESS WASTEWATER— Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140066
FACILITY NAME: Thomasville
PERSON COLLECTING SAMPLES: Tony Pope
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES []NO
Part A: Wastewater Mnnitnrine Renuirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: []Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY: Davidson
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW
OPTIONAL INFO:
❑PNA [—]Trout ®Other
Outfall Na.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
i
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM6
(mg/L)
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
RM, MD-
6-93A
303,5
53
(15)6
-
-
001
12/14/15
No Flow
1 ` \JL1
D
CENTRAL. FI
DWR 5_
ED
116
_ES
DN
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.
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

e ProW- vaasl_ewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
PSG
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 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 SfGN 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 property gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons df(ectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
►�u I am aaW tha fherp are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signatdre of Permit -tee)
Permit Date-7/1/2010-06/30/2015
L7 /
(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. NCG140066
FACILITY NAME: Thomasville
PERSON COLLECTING SAMPLES: Tony Pope
CERTIFIED LABORATORY: Research and Analytical
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
RECEIVED
OCT 2 3 2015 SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
CENTRAL FILES COUNTY: Davidson
DWR SECTION PHONE NO. [phone]
Lab ti 34
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
0utfall Na.
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 using
method 1664A
SGT-NEV
(mg/L)
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
6-93''
303'5
53
(15)6
-
-
001
09/25/15
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.
31f 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
liaw

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 5ummer 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 perso s directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am Avare $atOere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ature of Permittee)
Permit Date: 7/l/2010-06/30/2015
lot r h
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NC6140000
CERTIFICATE OF COVERAGE NO. NCG140066 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Thomasville �SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec Dian -March
PERSON COLLECTING SAMPLES: Tony Pope �cPl��„�JUNTY: Davidson
CERTIFIED LABORATORY: Research and Analytical Lab # 34 PHONE NO. [phone]
3UL 2 4 N15ADD TO LISTSERVE? DYES ®NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
®April -June
pWR SECT FILEMSCHARGING TON INFO:
CLASS: ❑SA ❑HQW ❑PNA [:]Trout ®Other
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 usingDischarge
method 1664A
SGT-HEM"
(mg/L)
Duration
(minutes)
Total Flow 7
(gallons/day)
-
-
RM, MD-
6-93,4
303,5
53
(15)5
-
-
001
06/29/14
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.
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 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: 7/112010-06/30/2015 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.
' Mow 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") TO: T
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 dire
ly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am avga/ that tore ajsignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of Permitteej
Permit Date:7/1/2010-06/30/2015
AO�, r
}
( Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140066 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Thomasville SAMPLE QUARTER: []Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
PERSON COLLECTING SAMPLES: Tony Pope, Greg Smith COUNTY: Davidson
CERTIFIED LABORATORY: Research and Analytical Lab ft 34 RECEIVPSE NO. [phone]
MAY 13 9fflD TO LiSTSERVE? _❑YES MNO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO M
Part A: Wastewater Monitoring Requirements
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout Mother
CENTRAL FILGI'IONAL INFO:
DVUR SECTION
autfaEl No.
Date Sample
i
Collected
(mm/dd/yrj
Type of Wastewater
2
(VE, RM, MD)
PH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mLIQ
TPH usingDischarge
method' 1664A
5
Duration
(minutes)
Total Flow
r
(gallons/day)
-
RM, MD-
6-93'6
303's
53-
001
03/23/14
No Flow
3 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.
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 Rp 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.
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 Hate: 7/1/2010-05/30/2015 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.
r F!ow 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 02I3 .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 Sendce 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 forgathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
l am alyyre that Were,-�pe significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signal re of Permittee) (Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140066
FACILITY NAME: Thomasville
PERSON COLLECTING SAMPLES: Tony Pope, Greg Smith
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorina Reouirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: []Jul -Sept ®Oct -Dec []Jan -March ❑April -June
E PROW NO. Davidson(704) 372-2930
JAN 2 0 Apy TO LISTSERVE?, ❑YES ®NO EMAIL:
CENTRAL F�IEHARGING TO CLASS: ❑SA ❑HQW
DWR SECTRAIONAL INFO:
❑PNA ❑Trout ®Other
Dutfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD
pH
(standard) (standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(ml./L)
TPH using
method 1664A
SGT-HEM'
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day)'
-
-
RM, MD-
6-93.a
303s
53
(15)6
-
001
12/23/14
RM
No Flow
002
12/23/14
RM
No Flow
If wastewater systems have not discharged in this quarter — report "No Flaw" or "No Discharge" here. Please make sure to mark the sample quarter above.
a 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 saitwaters.
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

'1441
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") 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 di ctly responsible for gathering the information, the Information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aw*e that#her�re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signatu,le of Permittee)
Permit Date: 7/1/2010-06/30/2015
r2r�
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140066 SAMPLE COLLECTION YEAR: 2014
FACILITY NAME: Thomasville SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
PERSON COLLECTING SAMPLES: Tony Hardison
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
COUNTY: Davidson
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfali 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 using
method 1664A
SGT Hae
(mg/L)
Discharge
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
RM, MD-
6-93,4
303'5
53
(15)6
-
-
001
9/30/14
RM
No Flow
002
9/30/14
RM
No Flow
T16214
CENTRAL
F!
ES
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.
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 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 026 .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 r ponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware th4 therg� sjg¢;ficant penalties for submitting false Information, including the possibility of fines and imprisonment for knowing violations."
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. NCG140066
FACILITY NAME: Thomasville
PERSON COLLECTING SAMPLES: Tony Hardison
CERTIFIED LABORATORY: Research and Analytical Lab # 34
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: [_]Jul -Sept []Oct -Dec ❑Jan -March ®April -June
COUNTY: Davidson
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: [_]SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected'
Imm/dd/yr}
Type of Wastewater
{VE, RM, MD}
pH
(standard)
Total Suspended
Solids
{mg/L)
Settleable
Solids
{mL/L}
TPH usingDischarge
method 1664A
S mg/L)16
(ml>;/Ll
Duration
{minutes}
Total Flow
{gallons/day}7
-
-
RM, MD-
6-9M
303'5
53
(15)6
-
-
001
6/26/14
RM
9.55
3.5
N/A
N/A
>1
>1
002
6/26/14
RM
9.55
4.5
N/A
N/A
>1
>1
Sample for Both Ontfalls were sampled in the wrong
location, they were sampled from onsite holding areas,
not at the point of discharge.
RECEIVED
,
U1._ 18 20
4
WROG
' 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.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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.
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.
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") TO:
Division of Water Quality T
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 y re nsible for gathering the Information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am away#}at t)h a significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Ignatur4 of Permittee) (Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
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