NCG140318_MONITORING INFO_20190305

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
EJ.MONITORING REPORTS
DOC DATE
p Qo) / D
YYYYMMOD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No NCG140000
Calendar Year 2018
Report ALL WASTEWATER monitoring data on this form (include No Flow 1 No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year R P r P I \,f i:= r-)
Certificate of Coverage No NCG14
MAR 0 5 2019
Facility Name CCC2-Liberty
uLJ TPUAL t•ILr=S
County Guilford DWR SECTION'
Phone Number 9( 19 ) 616-9260 Total no of outfalls monitored 1
Certified Laboratory Prism Lab Lab # 402
Lab #
Wastewater (WW) Discharge Outfall No 001 8,002
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 0
Were there any limit violations in the calendar year? Yes ✓❑ No ❑
Outfall No
001
Daily Flow Rate,
cfs
pH,
SU
TSS,
mg/1
SS,
mill
nrappricabfe
Non -Polar O&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
Daily Maximum
HDWoroRW
50% of 7Q10
fntlrcare NO FLOW rr
appfrcabre
rrestrvmtar
6 0-9 0
saltwrter
6 8-$
Standard
40
20
HQW ! ORW and Tr or
PNA
10
HOW SBP ARo<a y
Trout
No Limit
Samples above Benchmark
subject to Tiered Responses
1
1 5
Date
Sample
Collected,
molddlyr
a r
s
f
��,'
9
k�=
'4' 1 L
t �'
r'
r
3/16/2018
NO FLOW
�
R���t- �-
612912018
NO FLOW
5 2 019
9125/2018
NO FLOW
[; EN 1 KAL r-ILES
'
u1 n 5Ea i ea
12/21/2018
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

}
Certificate of Coverage No NCG14 [MZI M
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 22]
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 DEMLR Stormwater Permitting Staff in the Central 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 Flow 1 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 Greensboro/ =/Liberty
County Guildord
Phone Number (919 ) 616-9260
Certified Laboratory Prism Lab
00
Lab # 402
Lab #
Total no of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No 001 VMA Outfall? Yes ❑ No Q
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 ❑✓ RECEIVE
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 2W
Yes received approval from DEMLR to reduce monitoring frequency © CENTRAL FIL F
Other ❑ niirm Sr-r li )j
Outfall No
Total Rainfall,
inches
Total
Suspended
Solids TSS ,
( )
mg/1
pH,
SU
Non -polar O&G
(EPA Method
1664 SGT-HEM ,
( ))
mgll (VMA)
It applicable
New Motor Oil
Usage (gallmo )
if applicable
Stormwater
Benchmarks
lnrfrcare NO FLOW it
apprrcable
Circle Benchmark
1 UO1rJO
I�
6 a_9 0
� 5
>55 gallmo average requiros T55 and
Non polar 08G monitoring
Date Sample
Collected,
molddlyr
C
r i� i
,
�
�� -ter
3116/2018
001 NO FLOW
6/29/2018
NO FLOW
9/25/2018
NO FLOW
12/21/2018
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015
AI

Certificate of Coverage No NCG14 0
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 informatio , including the possibility of fines and imprisonment for knowing violations "
(Required by 40 CF)
Signature
Date
i�
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 81112017 — 6/30/2022
Last Revised 8-22-2015

+ 1%
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No NCG140000
Calendar Year 2017
*Report ALL STORMWATER monitoring data on this form (include "No FlowTNo Discharge" and Benchmark
Exceedences) from the previous calendar year to the DEQ by MARCH i of each_year
Certificate of Coverage No NCG 14 ®ff11❑® MAR 0 7 2018
Facility Name Greensboro/CCC2
4ti'✓
County Guilford DWRySECTION
Phone Number (336 ) 391-7798 Total no of SDOs monitored 1
Certified Laboratory Research & Analytical Lab Lab # 34
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
SuspendedTSS
Solids , { )
mg/1
p SU H,
Non -polar O&G
(EPA Method
( )) 1664 SGT-HEM ,
mgll (VMA)
1lappllcable
New Motor Oil
Usage (gallmo )
Happllcable
Stormwater
Benchmarks
Indicate NO FLOWd
appbcable
Circle Benchmark
L .7
1 L01�0
6 0-g O
J
1 r
>55 gallmo average requires T55 and
Non polar 08G monitoring
Date Sample
Collected
m olddl r
y I
bd�
,P�ji
11 .yf F!} P; f�r. Y i
R F w Yr 1
d} fM § !
C: E f. r 17
4°} ! did ¢7$ w�F 5SR Iat
S Y (�}'i'P 1F� 'j� +{iar
�i � ro t iX I k p
i f �p it> F... $yid
;g 9
a %,G *Y mitt .sa,
1
fP y���{}e �f 1pi✓ } ehC
P& y A 5jL 4d Ff ✓
r 1 1G V d
`� °` 'f j -�
yM f i^" t:`
t¢i i F
Y°2B�
1t d Y &�( 0,
yi= e.k lrPaiz 3tgE p� �lgq
a 3 E F� 3,
i r �;,.aa, xs� i �� r a
)V 4( �1S a , t
5 P 4 E°I.r ' L
y
A t# '}' `b Z
2�' f
3/14/2017
001 No Flow
6/30/2017
001 No Flow
9/26/2017
001 No Flow
12/18/2017
001 No Flow
-
Permit Date 311I2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No NCG14 ❑O ❑3 ❑t201
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 9
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 81112017 — 6130/2022
Last Revised 8-22-2015

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME GB#2-Liberty
PERSON COLLECTING SAMPLES Tony Pope
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR 2017
Rt IV ,AMPLE QUARTER ❑Jul -Sept []Oct -Dec ❑Jan -March ®April -June
OUNTY Guilford
JUL 2 7 2017 PHONE NO [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL
CENTRAL FILES DISCHARGING TO CLASS [:]SA ❑HQW
DWR SECTION OPTIONAL INFO
❑PNA ❑Trout ®Other
Outfall No
Date Sample
i
Collected
(mm/dd/yr)
Type of Wastewater
z
RMMD)
{VE, ,
pH
{standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT
/L)J�
(mg/L)
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
6-934
3035
53
(15)6
-
-
001
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
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
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

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 beset 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 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 awaW that IT
WVsignificant 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
t7(r7
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME GB#2-Liberty
PERSON COLLECTING SAMPLES Tony Pope
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A Wastewater Monitorrne Reauirements
SAMPLE COLLECTION YEAR 2017
SAMPLE QUARTER ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE7 ❑YES ®NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW
OPTIONAL INFO
❑PNA []Trout ®Other
OutfaH No
Date Sample
1
Collected
(mm/dd/yrj
Type of Wastewater
z
[VE, RM, MD}
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
(-
SGHEM
Duration
(minutes)
Total Flow
[gallons/day},
-
-
RM, MD-
6-934
3035
53
001
3/14/17
NO FLOW
r
� 4
MAI
L -
CENTRAL
FILES
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
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
4 pH limits are 6 9 5 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
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 directly4esponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
I am aware th#t therere sigr}rl'Itant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
of
Permit Date 7/1/2010 06/30/2015
V7,�(7
(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 NCG140318
FACILITY NAME GB#2 RECEIVED
PERSON COLLECTING SAMPLES Tony Pope
CERTIFIED LABORATORY Prism Lab # 402 ,BAN 2 3 2017
CENTRAL FILES
LIMIT VIOLATIONS? YES ❑ NO ® DWR SECTION
Part A Wastewater Monitorme Reouirements
SAMPLE COLLECTION YEAR 2016
SAMPLE QUARTER ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE7 ❑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)
TPH usingDischarge
method 1664A
method
SGT HEM'
(mg/L)
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD
6-93 °
303 5
53
(15)6
-
-
001
12/23/16
No Flow
1r' 11111
l� L[
ll �l�' 11
No�-/ 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
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 sox 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 7/1/21310 06/30/2015 Last Revised 07/13/11
Page 1 of 2

'r
6 Pro ess 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 beset 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 d rectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
I am aw a tha�there "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
r7 r
(Date)
Last Revised 07/13/11
Page 2 of 2

\1
NCDENR
Stormwater Discharge Outfail (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit http_//portal ncdenr orgf web/wg Jws/su /npdessw#tab-4
Permit No N/C/_/_/_/_/_/�/ _/ or Certificate of Coverage No N/C/G/1/4/0/3/8/1/
Facility Name Capital Ready Mix Concrete Plant (Formerly Jenco Concrete Plant)
County Ware Phone No 919 — G 15 O 5^7 z
Inspector V
Date of Inspection
Time of Inspection
I- - 21�,n
Total Event Precipitation (inches) CENTRAL FILES
DWR SECTION
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below) RECEIVED
❑ Yes ❑ No
NOV 2 1
Please verify whether Qualitative Monitoring must be performed during a "r' ���8N rm
event" or "measureahle 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 "measureahle storm event " However, ;
50 ent Please refer to these definitions, if applicable
F
A "representative storm event' is a storm ev that measures greater than 01 inches of rainfall
and that is preceded by at leas s 3 days] m which no storm event measuring greater than j
e A single storm event may contain up to 10 consecutive hours of no j
precipitation
A "measurable storm event" is a storm event that results in an actual discharge from the
permuted site outfall The previous measurable storm event must have been at least 72 hours
prior The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office
By this signature, I certify th4t this
(Signature of Permittee or Designee)
and complete to the best of my knowledge
SWU 242 Last modified 10/25/2012
Page 1 of 2

I Outfall Description
Outfall No 1 Structure (pipe, ditch, etc Pipe
Receiving Stream Marks Creek
Describe the industrial activities that occur within the outfall drainage area Parking Area and
Office/MaintenanceBuzldm
2 Color Describe the color of the discharge use g basic colors (re , brown, blue, etc) and tint
(light, medium, dark) as descriptors _ ) lski� 9 a5:17 I troV-11-1
3 Odor Describe any distinct odors that the discharge may have (i e , smells strongly of oil,
weak chlorine odor, etc) +tid Vk) �_
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 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 No
9 Is there evidence of erosion or deposition at the outfali? Yes No
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
maybe indicative of pollutant exposure These conditions warrant further investigation
Page 2 of 2
SWU 242 Last modified 10/25/2012

�r,w+n.we��so
NC®ENIR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit http //portal ncdenror2/web/wq/ws/su/npdessw#tab 4
Permit No N/C/�/4/_/_/_/_/_/ or Certificate of Coverage No N/C/G/1/4/0/3/8/j/
Facility Name Capital Ready Mix Concrete Plant (Formerly Jenco Concrete Plant)
County Wake � �Ph ne No 1) 75 5 O z—
Inspector _ Lr_S__ . l C1 %\, , . a' 1
Date of Inspection Z_+ - ) b
Time of Inspection f 0 00 � d r-oI
Total Event Precipitation (inches) 4 NOV 21 2016
CENTRAL
V
Was this a "Representative Storm Event" or "Measureable Storm Event" as defin4" �
(Seem rmation below)
Yes ❑ 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,
some perms t-have-thas-r-equirement Please refer to these definitions, if applicable
A " epresentative storm event' i orm event that measures greater than 01 inches of rainfall
anI t t is reced ast 72 hours (3 days) in which no storm event measuring greater than
01 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
3 permitted site outfall The previous measurable storm event must have been at least 72 hours
prior The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office
By this signature, I ceyfify that this report is accurate and complete to the best of my knowledge
(Signature of Permittee or Designee)
Page 1 of 2-
SWU 242 Last modified 10/25/2012

I Outfall Description
Outfall No 1 Structure (pipe, ditch, etc) ,ype
Receiving Stream Marks Creek
Describe the industrial activities that occur within the outfall drainage area Parking Area and
Office/Maintenance Building
2 Color Describe the color of the discharge using basic colors (red, brown, blue, etc) and tint
(light, medium, dark) as descriptors i qr r-r-, J
3 Odor Describe any distinct odors that the discharge may have (t e , smells strongly of oil,
weak chlorine odor, etc ) �jo �Ij t-
4 Clarity Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy
1 6) 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 2s the surface covered with floating solids
1 0 3 4 5
6 Suspended Solids Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy
1 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 6
9 Is there evidence of erosion or deposition at the outfall? Yes No
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
5wU 212 Last modified 10/25/2012

1 ! 1
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG14O318
FACILITY NAME GB#2
PERSON COLLECTING SAMPLES Tony Pope
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES [—]NON
Part A Wastewater Monitorme Renuirements
SAMPLE COLLECTION YEAR 2016
SAMPLE QUARTER ®Jul -Sept [j]Oct Dec ❑Jan -March ❑April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO
Outfall No
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
{VE, RM, MD)
pH
(standard}
Total Suspended
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT HEMSolids 6
(mg/L)/L)
Discharge
Duration
(minutes)
Total Flow
[gallons/day)
-
-
RM, MD-
6-93 °
303 s
53
(15)6
001
9/22/2016
No Flow
WR 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
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 1/1/2010 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 0224 Permittees who discharge wastewater to HOW 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 permMee 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 property gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
these persons +rectly re p}}onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am ayvajre thathere rebignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations
(S+gnatui4e of Permittee)
Permit Date 7/1/2010 06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

d
A PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
T GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME GB#2
PERSON COLLECTING SAMPLES Jimmy Chavis
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A Wastewater Monitonne Reauirements
SAMPLE COLLECTION YEAR 2016
RECEIVED SAMPLE QUARTER ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
f� COUNTY Guilford
AUG 0 9 1016 PHONE NO [phone]
CENTRAL FILES ADD TO LISTSERVE7 ❑YES ®NO EMAIL
DVIR SECTION DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO
Outfall No
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(1iEz
, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
SGT
(mg/L)/L)!
Duration
{minutes}
Total Flow
{gallons/day)
-
-
RM, MD-
6 934
3035
53
(15)6
-
-
001
6/22/2016
No Flow
A
1v�
711 A
v
fi
r
' 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
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 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 06/30/201S 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 ir, tead is-,ublect 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
NCAC 02B 0224 Permittees who discharge wastewater to HQW waters small 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 awRre th#t there are 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
�A //b
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME GB#2
PERSON COLLECTING SAMPLES Jimmy Chaves
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES [:]NO
Part A Wastewater Monitorme Requirements
SAMPLE COLLECTION YEAR 201
SAMPLE QUARTER ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE7 ❑YES ®NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW
OPTIONAL INFO
❑PNA ❑Trout ®Other
Outfall No
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(uE, RM, MD] Z
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
r�ethod.I664A
SG
(mgg/L)/L) 6
Discharge
Duration
(minutes)
Total Flow
(gallons/day)
-
-
RM, MD-
6-934
3035
53
(15)5
-
-
001
3/30/2016
No Flow
MAY 1 0
rMiq-rm
iL { IL.L
,
Y
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
3If an effluent limit is exceeded twice in a row the permfttee 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 7/1/2010 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 beset 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 lirectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
I am aware th# there are 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
2 ct�i
(pate)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME GB#2
PERSON COLLECTING SAMPLES Jimmy Chamois
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR 2015
SAMPLE QUARTER ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO
Outfall No
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)'
pH
{standard)
Iota! Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM'
(mg/L)
Duration
{minutes)
Total Flow
,
{gallons/day)
-
-
RM, MD-
6 934
3035
53
(15)6
-
001
11/07/15
No Flow
I
tL4JLZI
it I,
CENTRAL
ILES
SEC
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
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
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 7/1/2010 06/30/2015 Last Revised 07/13/11
Page 1 of 2
=-Mft

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
,Out inAread 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
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 aqi aware �iatAere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations
(Sig'Ature of Permittee)
Permit Date 7/1/2010 06/30/201S
lsrZr�I7�
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERA! PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME GB#2
PERSON! COLLECTING SAMPLES Jimmy Chavis
CERTINED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS) YES ❑ NO
Part A Wastetater Monitorine Reauirements
SAMPLE COLLECTION YEAR 2015
SAMPLE QUARTER ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE7 ❑YES ZNO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW
OPTIONAL INFO
❑PNA ❑Trout ®Other
Outf`all No
I Date Sample
x
Collected
(m
Type of Wastewater
RMiV4D} z
(VE, ,
pH
(standard)
Total Suspended
Solids
(mg/L}
Settleable
Solids
{mL/L}
TPA! using
method 1664A
SST- F
(mg%Lm/dd/yr}
)
Discharge
Duration
(minutes)
Total Flow
i
{gallons/dayj
-
RM, MD
6 934
303's
53
(15)6
-
-
001
04/01/15
No Flaw
�i�I°0
R�AA F
in
"--N FRA
I �r� ,-
""�
Crr)R
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 permatee 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 iiistead is subject to benchmarks and provisions of Part h! 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
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") WI THIN 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 tly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
I am awayp thaOxere,42 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
S r' I�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 NCG140318 SAMPLE COLLECTION YEAR 2014
FACILITY NAME GB#2 SAMPLE QUARTER ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
PERSON COLLECTING SAMPLES Jimmy Chavis RECE1 RUNTY Guilford
CERTIFIED LABORATORY Prism Lab # 402 V ONE NO [phone]
JAN 2 0 2015 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 Monitoring Requirements �
Outfall No
Date Sample
1
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
SGT HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)'
-
-
RM, M D
6-93 4
303 5
53
(15)6
-
001
12/31/14
No Flow
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
4 pH limits are 6-9 5 U for wastewater discharges to freshwaters, and 6 8-8 5 5 U for discharges to saltwaters
5 T5S 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

){
5 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 beset 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 permtttee 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 IOR
AT END OF MONITORING PERIOD_ IN CASE OF "NO FLOW" )_TO_
Division of Water Quality
AM 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 pers nel properly gather and evaluate the information submitted Based on my Inquiry of the person or persons who manage the system, or
those persons directly rIsIgOicot
onsib r gathering the information, the information submitted Is, to the best of my knowledge and belief, true, accurate, and complete
I am aware t�a}jhere,� penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(SgoR-ature of pe' rmittee)
Permit Date 7/1/2010-06/30/2015
z6zr
(Date)
Last Revised 07/13/11
Page 2 of 2

-*- .1' 402.
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME G8#2
PERSON COLLECTING SAMPLES David Morris
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A Wastewater Monitorine Reouirements
SAMPLE COLLECTION YEAR 2014
SAMPLE QUARTER ❑Jul -Sept []Oct -Dec []Jan -March ®April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE7 DYES ®NO EMAIL
DISCHARGING TO CLASS [—]SA DHOW
OPTIONAL INFO
❑PNA ❑Trout ®Other
Outfall No
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)x
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day),
-
-
RM, MD-
6-934
3035
53
(15f
-
-
001
4/22/14
No Flow
J L
) LU14
C
DWQ!
OG
' 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
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

1k -•.
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 beset 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 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#y relonsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
I am awarinthat 140reptesignificant 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
l
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG140318
FACILITY NAME GB#2
PERSON COLLECTING SAMPLES Dared Morris
CERTIFIED LABORATORY Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A Wastewater Monitoring Reoulrements
SAMPLE COLLECTION YEAR 2014
SAMPLE QUARTER ❑Jul -Sept ❑Oct -Dec ®Jan -March []April -June
COUNTY Guilford
PHONE NO [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL
DISCHARGING TO CLASS ESA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO
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)
TFH usingDischarge
method 1664A
SGT-HEM"
(mg/L)
DLration
(minutes)
Total Flow
(gallons/day)'
-
-
RM, MD-
649
303'
53
(15)6
-
-
001
1/10/14
No Flow
f
EB 9 d Sri
IA
v
ral� L_g
il4�L �"I
J
�r r..7tl17
' 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
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

r
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 beset 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 DISCHARgM WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO
Division of Water Quality �. _ _rT
4ttn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
919) 807-6379
OU 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
ssure that quail ed personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
hose persons di ct esponsible for gathering the information, the information submitted Is, to the best of my knowledge and belief, true, accurate, and complete
am aiv�e th.A a are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
of Permitteej
(Date)
ermit Date 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 2 of 2