NCG140185_MONITORING INFO_20180622

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑ HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ ']p( g OU 9 A
YYYYM M DD

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING RECEIVED
FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 d _�
FACILITY NAME:
PERSON COLLECTING SAMPLES Irlilke' . ,e-!zr/-
CERTIFIEDLA80RATORY I�!?yl�oclker+t l.abli Q
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Re uirements
610
! ,IUN 22 Zp fg
SAMPLE COLLECTION YEAR: C��•R�
SAMPLING PE D: luly-December �t{a�i�
COUNTY -eI1 a (-
PHONE NO. {_0LV)^ - & BG' - .7O
ADD TO LISTSERVE? []YES ONO EMAIL:
DISCHARGING TO CLASS: []SA' ❑HQW ❑PNA []Trout ]Other
Outfall No.
Date Sample
Collected
Smo/dd/yr OR
NO FLOW)'
pH TSS
{Standard (mg1t)
Units)
Event
Duration
�minutesj
Total 4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
Monitoring;
d of Months In Tier
2 Sampling=
i
1 if "NO FLOW" or "NO DISCHARGE, Enter "NOFLOW" or "NO DISCHARGE" for each outfali 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 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/l.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 711/2011-60/30/2015
I Last Revised 7/13/11
Page 1 of 2
Date of last pH meter calibration: Lf 2 y-/of

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 5S gal of new motor oil/month —averaged over a calendar year.
Outfal#
No.
Date Sample
Collected
jmo/dd/yr)'
pH
(Standard
Units)
TPH using method
16644 SOT -HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
jminutes)
Total
Rainfall'
(In)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
(y/n) Monitoring?
tr of Months
in Tier 2
Sampling
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (including all "No Flow" & "No Discharee" reports) within 30 days of receipt of sample (or at end of monitoring -period
io ,Ease of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOUALuU SIGN = CERTIFICATION FOR ANY &FO�t,MATION R Pf_RTED:
"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.
am aware that ther e si ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
7
(Signature of Permittee) - ! (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

4
VAA6MDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on f lling out this fonn, please visit: htLV74112ortalais e .o b i s u I npdessw4 tab-4
Permit No.: JC/_/,/_/_/_/`/,/ or Certificate of Coverage No.:
Facility Name: A-�t;
n5 5cah4_s 1AX
County: ?ev'AL-tr, _ Phone No.
Inspector: Ic r r-4'2 p
Date of Inspection:
Time of Inspection. �] : K S iA V%"
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
,Yes '❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
even t"or "measureablestorm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the perm ittee is able to document that a shorter ,l
interval is representative for local storm events during the sampling period, and the permittee i
i. obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Pagel of 2
SWll-242, Last modified 10/25/2012

1. Outfall Description: ` —
Outfall No. 6V�1� Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: G i eSr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): N 0 K 't
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
6) 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1� 2 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:
0 2 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
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may he indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

4
Environmental Chemists, Inc.
6602 Windmill Way Wilmington, NC 28405 • 910.192.U223 Lab • 910-192.4424 Fax
710 6owsertown Road, Manteo, NC. 27954 . 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC,285140 . 910.347.5843 Lab/Fax
infu(ti en,. irotrruentafcheniists.c'nm
Argos Ready Mix Concrete Date of Report: Apr 26, 2018
PO Box 11120 Customer PO #:
Wilmington NC 28404 Customer ID: 09080016
Attention: E. B. Godwin Report #: 2018-06321
Project iD: Scottshill 67
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
18-15733 Site: Outfali # 1 4/24/2018 T45 AM Water Client
Test Method Results Date Analyzed
Residue Suspended (TSS) SM 2540 D 154 mg/L 04/24/2018
pH SM 4500 H B 8.90 units 04/24/2018
Client provided.
Comment:
z
Reviewed by:
Reoort #:: 2016-06321

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG1415 1 8 J
FACILITY NAME: c_o 443 :) l ^ 05
PERSON COLLECTING SAMPLES M t kt e z e r
CERTIFIED LABORATORY &ViTWkewl Lab # 9
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: ? d /
SAMPLING PERIOD: ® July -December ❑ January -June
COUNTY Meier
PHONE NO. (5IO 1 GiNo -
ADD TO LISTSERVE? [DYES [—]NO EMAIL: /0,;EP..Sr
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
{Standard
Units?
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months inTierier
2 Sampling
d !o 0d
7 7
7
vizu
��-
2017
L'wR s6,
r,a
i
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.
If a value is In excess of the benchmark, or outside the benchmark range ifor pH), you must implement the Tier 1 or Tier 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 TS5 benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
`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
Date of last pH meter calibration: Je /n 42JI7 -

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using a 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
Imo/dd/yr}'
pH
(standard
Units)
TPH using method
1664A 5GT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
2
Sampling
6-9
15
1
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL f INCLUDING VEHICLE MAINTENANCE)? YES [:]NO[]
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 for at end of monitoring period
in of "No Flow"i to:
Division of Water Quality
Attn: DWO Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION MANY INFORMATION RE RTED:
"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.
am aware hat there are si niflcant penalties For submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of PermitteeP (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

A
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. http: Uportal,ncdenr.orglweb /"/Ws/&L14j3pdpmw4 tab-4
Permit No.: �C/�/�//_/,/�/�/ or Certificate of Coverage No.:
Facility Name: Sca44s P. A[:�j o
County: f elTe Phone No. i )6 - t_86- y 8 qO
Inspector. Al kp 6-e er
Date of I nspection: /°//o /-2e 11
"fiine of Inspection: � /; S° PIPI
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
ayes ❑ No
Please verify whether Qualitative Monitoring must he performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature ofPerAttee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012

rM
1. Outfall Description: 1
Outfall No. — I Structure (pipe, ditch, etc.) D I
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C leer—
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): N a''�'�
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
Q 2 3 4 5
S. 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:
D2 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:
0 2 3 4 5
7. is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
SWU-242, Last modified 10/25/2012
Page 2 of 2

[envirroehe)m
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab + 910.392.4424 Fax
710 Bow�sertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
info@ environmentalchemists.com
Argos Ready Mix Concrete Date of Report: Nov 09, 2017
PO Box 11120 Customer PO #:
Wilmington NC 28404 Customer ID: 09080016
Attention: E. B. Godwin Report #: 2017-15688
Project ID: Scottshill 67
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
17-37838 Site: outfall 1 10/10/2017 12:50 AM Water Mike Setzer
Test Method Results Date Analyzed
Residue Suspended (TSS) SM 2540 D
pH SM 4500 H B
Comment:
Reviewed by:
117 mg/L
7.74 units
10/11/2017
10/10/2017
Report #::. 2017-15688 Page 1 of 1

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 8 5—
FACILITY NAME: S co4s N-A � L IQ c'Gp� 1
PERSON COLLECTING SAMPLES M ,kr
CERTIFIED LABORATORY ,-n 0ro6%eNt___ Lab # �
Lab #i
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: a6 t -7
SAMPLING PE
,jIOD- [�C July -December ❑ January -June
COUNTY en _,ei '
PHONE NO. ( 10
ADD TO LISTSERVE? []YES ❑NO EMAIL: Ie• 5"izer ®R� - +ns • ca'^n
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA [_]Trout Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total `
Rainfall
(Inl
In Tier 2
Monthly
Monitoring?
Wn)
p of Months in Tier
2 Samplingt
i
UI V
C NTRAJ
uv 5�
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO D15CHARGE" 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 or Tier 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/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I,
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
I V ED
20P
FILES
,TIaN
Permit Date: 7/l/2011-50/30/2015 1 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/acted'
pH
(Standard
Units)
TPH using method
15644 SGT HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
In Tier 2
Monitoring?
(Y/n1
N of Months
in Tier 22
Sampiing
S
1
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR tincludine all "No Flow" & "No Discharee" reports) within 30 days of receipt of sample for at end of monitoriniz period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU, MUST SIGN THIS CERTIFICATION FOR ANY Lffif Tl2N REPQRTE0
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted_ Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Pe
Permit Date: 7/1/2011-60/30/2015
S-/7-2U!_-7_
(Date)
Last Revised 7/13/11
Page 2 of 2

r
��Nri..rwr.
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit., htt rtal.ncdenr.or web w ws su iid ssw#tab-4
Permit No.:
Facility Name: Sco-NS tl% II
County: /'e)ider
or Certificate of Coverage No.: N/-C/G/_/_/_/_/_/_/
Phone No.
- /,, q( ' 4,1J q
Inspector: IW,'ke _ _ Sehv—
Date of Inspection: Z/-o21-/- .20 f 7
Time of Inspection: 8.'36 q rn
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
j r]� Wes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However, E
some permits do not have this requirement Please refer to these definitions, if applicable.
I �
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. 1
A "measurable storm event" is a storm event that results in an actual discharge from the
jpermitted site outfall. The previous measurable storm event must have been at least 72 hours f
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee i
obtains approval from the local DWQ Regional Office.
Sy this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
k
SWU-242, Last modified 10/25/2012
Page 1 of 2

r1 1. Outfall Description:
Outfall No. - L` Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C\'24c
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): i"Id�Q
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
r
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:
0 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:
n 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes Io
S. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242. Last modified 10/25/2012.

Environmental Chemists, Inc.
t
envirochem
6602 Windmill Way, Wilmington, NC 28405 a 910.392.0223 Lab . 910.392.4424 Fax
O 710 Bowsertown Road, Manteo, NC 27954 . 252.473.5702 Lab/Fax
sM 255-A Wilmington Highway, Jacksonville, NC 28540 . 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Argos Ready Mix Concrete Date of Report: Apr 25, 2017
PO sox 11120 RECEIVED Customer PO #:
Wilmington NC 28404 Customer ID: 09080016
Attention: MAY 1 1 2017 Report #: 2017-05628
Project ID: 67 Scottshill
Lab ID Sample ID: I Collect Date/Time Matrix Sampled by
177'13338 ' Site: SD01, 44/24/2017 8:30 AM Water Mike Setzer
Test Method' Results- Date Analyzed
Residue Suspended (TSS) SM 2540 D ' { { s 69.0 mg/L 04/24/2017
Comment: ph.7.89 -
Reviewed by: )
Report C 2017-05628 Page 1 of 1

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 D 1 _-5"
FACILITY NAME: I-10
PERSON COLLECTING SAMPLES n4f S
CERTIFIED LABORATORY b7V ? re3c eel Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: �d
SAMPLING PERIOD ,July -December ❑ January -June
COUNTY C-
PHONE NO. (qjQ
ADD TO LISTSERVE7 ZYES ❑NO EMAIL: Xe Se s-p!�— 10
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(rna/dd/yr OR
NO FLOW)t
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
otal
Rainfa
Tlnfall `
(in)
In Tier 2
Monthly
Monitoring?
ly/n)
A of Months in Tier
2 Sampling:
U� rim h
-t
gy
a
2 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.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 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.
1 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 rng/I.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
� ���D
07 2016
SAL FILES
3EC7-1%j
Permit Date: 7/l/2011.60/30/2015 I Last Revised 7/13/11
Page 1 of 2

Pan 8: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Qutfall
No.
Date Sample
Collected 4
(mo/dd/yr)
PH
(Standard
Units)
TPH using method
1664ASGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event'
Duration
(minutes)
Total
.
Rainfall
(in)
New Motor oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
Wrt)
X of Months
in Tier 2
Sampfing2
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE5 AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [:)NOD
HAVE YOU CONTACTED THE REGION? YES [:]NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sarnnle for at end of monitoring period
in case of "No Flow) to:
Division of Water Quallty
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFIC ALION 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
am aware that th are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) ! (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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