NCG140442_MONITORING INFO_20180803

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/vCc, lyDyy�
DOC TYPE
❑HISTORICAL FILE
V, MONITORING REPORTS
DOC DATE
❑ Jo)�6 D� v 3
YYYYMMDD

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO NCG140000
2 QTR
� 0 Ong -- State
0
Copy — State
0
Copy Winston
0
Copy — Plant
0
Copy Fite
CERTIFICATE OF COVERAGE NO NCG 14 0 4 4 2 SAMPLE COLLECTION YEAR 2018
FACILITY NAME Chandler Concrete Com an MEBANE Pit#_610 SAMPLE QUARTER ❑Jan -March ®April -June ❑Jul -Sept ❑Oct -Dec
PERSON COLLECTING SAMPLES NO FLOW COUNTY ALAMANCE
CERTIFIED LABORATORY Pace Analytical Lab #633 IWAE NO [phone]AUG D 3 28kDD TO LISTSERVE7 ❑YES ®NO EMAIL
LIMIT VIOLATIONS? YES ❑ NO ® CENTRAL �I�DISCHARGING TO CLASS ❑SA ❑HOW ❑PNA ❑Trout ®Other WSV NSW
D1NR SECTIG��IONAL INFO
Part A Wastewater Monitoring Requirements
Non -Polar
Date Sample
Type of Wastewater
pH
Total Suspended
Settleable
Oil & Grease
Discharge
Total Flow
Outfall No
Collected 1
(VE RM MD) z
(standard]
Solids
Solids
using method
Duration
(gallons/day] '
(mm/dd/yr)
(mg/L)
(nri
1664SGT HEMS
(minutes)
(mg/L)
-
6 934
3035
S3
(15)6
-
1
VE RM MD
NA
NA
NA
THIS FACILITY IS NO LONGER PRESENT THE PORTABLE PLANT HAS BEEN TAKEN DOWN AND REMOVED FROM THE PROPERTY THIS PROPERTY IS NOW
UNDER A CONSTRUCTION PERMIT FOR SAMET OR CONTRACTOR / CUSTOMER OF SAMET CONSTRUCTION
A LETTER OF PERMIT RESCISSION IS BEING SUBMITTED SEPARATELY
Ken Waegerle
' If wastewater systems have not discharged in this quarter — report No Flow or No Discharge here Please make sure to mark the sample quarter above
Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE) Raw Material Stockpiles (RM) Mixing Drum Cleanout [MD) Report more
than one type if the waste stream is commingled
'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 DEMLR 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
` 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 1SA NCAC 02B 0224 Permittees
who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DEMLR If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the
discharge location the permittee shall notify DEMLR and the DEMLR Regional Office may require an annual flow report on a case by case basis
Permit Date 8/1/2017 06/30/2022 Last Revised 07/27/17
Page 1 of 2

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 Resources
Attn DWR 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 a I I 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 t 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 fo_rrs iittingfalseinformation including the possibility of fines and imprisonment for knowing violations
(Signature of Perm
Permit Date 8/1/2017 06/30/2022
?a
// x
(te)
Last Revised 07/27/17
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
1 QTR
/ Ong - State
0 Copy - State
-6---6ePy�tffi-
0 Copy - Plant
0 Copy File
CERTIFICATE OF COVERAGE NO NCG 14 0 4 4 2 SAMPLE COLLECTION YEAR 2018
FACILITY NAME Chandler Concrete Company-- MEBANErPIt# 610SAMPLE QUARTER ®Jan -March ❑April -June ❑Jul -Sept ❑Oct -Dec
PERSON COLLECTING SAMPLES NO FLOW `- --U COUNTY ALAMANCE
CERTIFIED LABORATORY Pace Analytical Lab #633 APR 3 0 201a PHONE NO [phone]
LIMIT VIOLATIONS? YES ®NO ❑
Part A Wastewater Monitoring Requirements
CENT ;hL l'-ilLi
DIAIR SECTION
ADD TO LISTSERVE? ❑YES ®NO
EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Tfoul ®Other WSV NSW
OPTIONAL INFO
Outfall No
Date Sample
Collected 1
(mm/dd/yr)
Type of Wastewater
{VE, RM, MD} z
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
Non -Polar
Oil & Grease
using method
16645GT-HEM6
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day}
-
6 934
3035
53
(15)6
1
03/01/18
VE RM MD
70
366
N/A
N/A
50
N A
Discharge was result of rain event - SW comingles with Process Water
' If wastewater systems have not discharged in this quarter — report No Flow or No Discharge here Please make sure to mark the sample quarter above
` Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (VE) Raw Material Stockpiles (RM) Mixing Drum Cleanout (MD) Report more
than one type if the waste stream is commingled
'if an effluent limit is exceeded twice in a row the permrttee is required to institute monthly monitoring for that parameter for six months unless DEMLR RO staff notifies you to
continue monitoring
4 pH limits are 6 9 S U for wastewater discharges to freshwaters and 6 8 3 5 S U for discharges to saitwaters
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 al I other water classifications
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 DEMLR If the permrttee cannot obtain a Summer 7Q10 flow for the receiving waters at the
discharge location the permrttee shall notify DEMLR and the DEMLR Regional Office may require an annual flow report on a case -by -case basis
Permit Date 8/1/2017-06/30/2022 Last Revised 07/27/17
Page 1 of 2

MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLER AT END
OF MONITORING PERIOD IN CASE OF "NO FLOW") TO
Division of Water Resources
Attn DWR 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 person net 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
sign ificantpenaltiesforsu,4mittingfaIseinformation including the possibiIityoffines and imprison mentforknow ingviolations°
(Signature of Permittee)
Permit Date 8/1/2017 06/30/2022
�t//-� //'�
(D0te )
Last Revised 07/27/17
Page 2 of 2

PROCESS WASTEWATER -Quarterly Discharge'Monitoring Report
GENERAL PERMIT NO NCG140000
3QTR
Ong — State
0
Copy — State
0
Copy Winston —
0
Copy — Plant
0
Copy - File
CERTIFICATE OF COVERAGE NO NCG14 0 4 4 2 SAMPLE COLLECTION YEAR 2017
FACILITY NAME Chandler Concrete Com an MEBA Plt IQ SAMPLE QUARTER []Jan -March ❑April -June ®Jul -Sept ❑Oct -Dec
PERSON COLLECTING SAMPLES BINKLEY �, COUNTY ALAMANCE
CERTIFIED LABORATORY Pace Analytical Lab #633 NOV 0 01 PHONE NO [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL
LIMIT VIOLATIONS? YES [:]NO ® t;CNTRAL FILES DISCHARGING TO CLASS ❑SA ❑HOW ❑PNA ❑Trout ®Other WSV NSW
OWR SECTION OPTIONAL INFO
Part A Wastewater Monitoring Requirements
Qutfall No
Date5ample
Collected 1
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD) z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
Non -Polar
Oil &Grease
using method
1664 SGT HEM'
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day}
-
-
6-934
3035
53
(15)6
-
i
9/12/17
VE RM MD
83
ND
N LA
N/A
190
N A
f
+
k
Discharge was result of rain event - SW comingles with Process Water
' If wastewater systems have not discharged in this quarter —report No Flow or' No Discharge' here Please make sure to mark the sample quarter above ' ,
'Report the abbreviation for the type of Authorized Wastewater Discharges here Vehicle and Equipment Cleaning (V€) Raw Material Stockpiles {RM} Mixing Drum Cleanaut (MD) Report more
than one type if the waste stream is commingled
'1f an effluent lima is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months unless DEMLR 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 5 U for discharges to saltwaters
STSS 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 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 DEMLR if the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the
discharge location the permittee shall notify DEMLR and the DEMLR Regional Office may require an annual flow report on a case by case basis
Permit Date 8/1/2017-06/30/2022 Last Revised 07/27/17
Page 1 of 2

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 Resources
Attn DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
,
r
j
,
' I
YOU MUST SIGN THIS CERTIFIC4TION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision In accordance with a system designed to assure that
qualified personnel properly gather and evaluate the Information submitted Based on my Inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the Information, the information submitted Is, to the best of my knowledge and belief, true, accurate and complete I am aware that there are
significant penalties for su Itting false Information, Including the posslbllltyof fines and Imprisonment for knowing violations
--jo- -- - - - -- �v y - - - - -- -- - -- I
( gnatureofPermlttee) (D e) _
0
Permit Date 8/1/2017-06/30/2022
,
,
Last Revised 07/27/17
Page 2 of 2

i,
` PROCESS WASTEWATER — Quarterly Discharge Monitoring;Report
trlvlronrnelital �,
GENERAL PERMIT No NCG140000 Rece, red
CERTIFICATE OF COVERAGE NO NCG14 0 4 4 2
FACILITY NAME Chandler Concrete Company - Mebane Plant #610
PERSON COLLECTING SAMPLES Todd Binkley
CERTIFIED LABORATORY Pace Analytical Lab #633
LIMIT VIOLATIONS? YES ® NO ❑ Turbulent flow / some erosion
may have contributed to high TSS Not able to obtain another
qualifying sample during testing period
Part A Wastewater Monitoring Requirements
0 Ong - State
0_,—Copy - State
Copy Winston
0 Copy - Plant
0 Copy - File
SAMPLE COLLECTION YEAR 2017n$t0n-5a1,T
SAMPLE QUARTER []Jul-Septeg [ loct`--Dec []Jan -March ®April -June
COUNTY Alamance
PHONE NO (336) 578 - 2912
ADD TO LISTSERVE7 ❑YES ®NO EMAIL
DISCHARGING TO CLASS [:]SA []HQW ❑PNA ❑Trout ®Other WS-V
NSW
OPTIONAL INFO
Outfall No
Date Sample
Collected 1
(mm/dd/yr)
Type of Wastewater
(VE RMMD )z
,
pH
(standard)
)
Total Suspended
Solids
s
(mg/L)
Settleable
Solids
(mL/Lj
TPH using
method 1664A
SGT --HEM 6
(mg/L)
Discharge
Duration
(minutes)
Total Flow
/da
(gallons y)7
-
-
-
6-934
3035
53
(15)6
-
-
1
4/25/17
VE RM MD
72
419
ND
N/A
360
2052
No Qualifying Discharge observed this Period
-
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
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 permrttee 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 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 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 permrttee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permrttee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case by -case basis
Permit Date 7/1/2010 06/30/2015 Last Revised 07/13/11
Page 1 of 2

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]
Torrential rain event, had difficulty collecting sample due to localized flooding
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations "
ature of
Permit Date 7/1/2010-06/30/2015
�1
- -/ zz
(D te)
Last Revised 07/13/11
Page 2 of 2

?� STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
NC Department( f0 Ong - State
GENERAL PERMIT NO NCG140000 Envlron�d
meCentaelQua itov Gopy - State
RT C T OF CO RAG NCG14 0 4 4 2 SAMPLE COLLECTION YEAR 2017
JUL 2 4 2017 0 copy -Plant
FACILITY NAME Chandler Concrete Company - MEBANE #610
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Pace Analytical Lab #633
OPTIONAL INFO
Part A Stormwater Monitorine Requirements
SAMPLING PERIOD ® July -December
COUNTY Alamance
PHONE NO (336) 578 - 2912
ADD TO LISTSERVE7 [:]YES. ®NO EMAIL
DISCHARGING TO CLASS []SA ❑HQW
NSW
❑VI] IJanuary-June
Regional Office
❑PNA ❑Trout ®OtherWS-V
Outfa[I No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW] 1
pH
(Standard Units)
TSS
(mg/L)
Event
Duration
I
(minutes)
Total
Rainfall'
(in)
In Tier 2 -
Monthly
Monitoring?
(Y/n)
# of Months in
Tier 2 Samphng2
-
-
6-92
- 10023
-
-
-
-
1
4/25/17
72
419
360
30
N
N/A
SW and PW samples share same outfall
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
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
s TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are SO mg/I
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year
+
Outfalk,
No _
fwl w�Sb
Date Sample
Collected �r
(mo/dd/yr}l
' !
`
pH A
{Standard-
Units)
h
TPH using method,;
r
1664A SGT-HEM
{mg/L)
aa
�y�Hi�}�JO�i
,, Total'Suspendedr °
t-
,� . Solids
{mg/L}
k Y'.�"
' � Event ��
1
Duration
(minu`tesj
-
}Q <Total �%
4«
! Rainfall
(inj
New Motor Oil
f r
3 Usage
(gal/month)
y[
- In Tier 2
Monthly
Monitoring
{y/ ]
# of Months
s
- in Tier 2
Sampling 2
,6_92 « t
715z F
10023 :6-
i
N/A
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [INC)
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail OnRinal and one copy of this DMR (includinR all "No Flow" & "No Discharge" reports) 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
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 directl responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware Vttar ignificant penalties For submitting false information, including the possibility7z-
ines nd imprisonment for knowing violations "
T/�� _��i �7
(Sign"afure of PeYmittee) /J (Dbte)
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
Ong - State
0 Copy - State
0 Copy Winston
0 Copy - Plant
0 Copy File
CERTIFICATE OF COVERAGE NO NCG14 0 4 4 2 SAMPLE COLLECTION YEAR 2017
FACILITY NAME Chandler Concrete Company - Mebane Plant #610 SAMPLE QUARTER ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
PERSON COLLECTING SAMPLES Todd Binkle COUNTY Alamance
CERTIFIED LABORATORY Pace Analytical Lab #633 RECEIV HO TON10578 - 2912
DYES ®NO EMAIL
LIMIT VIOLATIONS? YES ❑ NO ® Turbulent flow / some ercf3Lq�t 0 7 HDISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout ®Other WS-V
may have contributed to high TSS Not able to obtain another I�S
DWR SECTIGCt�
qualifying sample during testing period CENTRAL FA ANAL INFO
Part A Wastewater Monitoring Requirements
Outfall No
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD}
pH
{standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
SGT-HEM
(mg/L )
Duration
(minutes)
Total Flow
7
{gallons/day}
-
-
-
6-93 4
303 5
53
(15)6
-
-
1
12/6/16
VE RM MD
80
43
ND
N/A
90
450
Discharge was result of rain event - SW comingles with Process Water
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
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
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
Permit Date 7/1/2010 06/30/2015
Last Revised 07/13/11
Page 1 of 2

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 aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations " /l
f
ignature of Permittee)
Permit Date 7/1/2010 06/30/2015
5" 112
(Da e)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO NCG 14 0 4 4 2
FACILITY NAME Chandler Concrete Company - Mebane Plant #610
PERSON COLLECTING SAMPLES Todd Blnkley
CERTIFIED LABORATORY Pace Analytical Lab #633
C�
SAMPLE COLLECTION YEAR
SAMPLE QUARTER ®Jul-5201 ❑Oct -Dec
COUNTY Alamance
PHONE NO (336) 578 - 2912
ADD TO LISTSERVE7 ❑YES ®NO EMAIL
LIMIT VIOLATIONS? YES ❑ NO ® Turbulent flow / some erosion DISCHARGING TO CLASS [:]SA ❑HQW
may have contributed to high TSS Not able to obtain another NSW
qualifying sample during testing period #REV E IVEOPTIONAL INFO
Part A Wastewater Monitoring Requirements
Ong - State
0
Copy - State
0
Copy -- Plant
0
Copy File
Dian -march ❑April -June
❑PNA ❑Trout ®Other WS-V
Outfall No
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)2
0
N H L RL
C
j�Tj"rtd iO
Total Suspended
S Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SG7-HENI�
(mg/L)
Discharge
Duration
(minutes)
Total Flow 7
(gallons/day)
-
-
6-93 4
303 S
53
(15 )s
-
1
/22/16
VE RM MD
87
ND
ND
N/A
40
80
Discharge was result of rain event - SW comingles with Process Water
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 �= n n rp= /S� � n\\ fl
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter foo x months; u Iri,ess DWQ RO staff
notifies you to continue monitoring ttf� l
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
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
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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]
One or more discharaes occurred during this period but a aualifving sample could not be obtained — plant was not in operation / attended within the first 60 minutes of
discharge or other non-aualifying event
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 awareere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations "
of
Permit Date 7/1/2010-06/30/2015
/5- lz
(Da )
Last Revised 07/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 0 4 4 2
FACILITY NAME Chandler Concrete Company - MEBANE #610
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Pace Analytical Lab #633
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
� lh
SAMPLE COLLECTION YEAR 7
SAMPLING PERIOD ®uly-December
COUNTY Alamance
PHONE NO (336) 578 - 2912
ADD TO LISTSERVE? ❑YES ®NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW
NSW
FORM
X Ong - State
0 Copy - State
0 Copy - Plant
0 Copy - File
❑ January -June
-❑PNA ❑Trout ®OtherWS-V
Outfall No
Date Sample
Collected
(mo/dd/
N w)i
pH _
(Standard Units)
TSS
(mg/L)
Duration
{minutes]
TotalEvent
Rainfall°
(in]
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in
Tier 2 Sampling
-
-
6-9 z100
23
-
-
-
-
1
8/22/16
87
ND
ND
10
N
N/A
NOV 0 4 7i,}
r pi
DWR
._
SW and P W samples share same outfall
"- -, r
1 n V
JF
n
MHO k�M (On/7
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here Please make sure to mark the sample p4h6d abbve�
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
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, 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
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year
Outfall
No
Date Sample
Collected
{rno/dd/yrj'
pH
(Standard
units)
TPH using method
16fi4A SGT-HEM
(mg/L)
Total Suspended
Salads
(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
100 23
-
-
-
-
-
1
N/A
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 coDv of this DMR (includins all "No Flow" & "No Discharge" reports) 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
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 spansible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that t e nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
S
(Signal r of Permittee) (Da e)
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING
GENERAL PERMIT NO NCG140000
CERTIFICATE OF COVERAGE NO NCG14 0 4 4 2
FACILITY NAME Chandler Concrete Company - MEBANE #610
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Pace Analytical Lab #633
OPTIONAL INFO
Part A Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR 2017
SAMPLING PERIOD ® July -December
COUNTY Alamance
PHONE NO (336) 578 - 2912
ADD TO LISTSERVE7 []YES ®NO EMAIL
DISCHARGING TO CLASS [:]SA ❑HQW
NSW
FORM
���Ong - State
0 Copy - State
0 Copy - Plant
0 Copy File
❑ January -June
❑PNA ❑Trout ®OtherWS-V
Outfall No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard Units)
TSS
(mg/L)
Event
Duration
(minutes)
mutes)
Total a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in
Tier 2 Sampling2
-
-
6-92
10023
-
-
1
4/25/17
72
419
360
30
N
N/A
n I1 9 17
C&N i RAL r-i t E
3
SW and P W samples share same outfal l
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
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
3 TSS benchmark values are 100 mg/i, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on site rain gauge
Permit Date 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year
Outfall
No
Date Sample
Collected
(mo/dd/yr)1
pH
(standard
Units)
TPH using method
I664A5GT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall"Usage
(in)
New Motor Oil
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
5ampling2
6-92
152
1001
1
N/A
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGIONS YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mall Original and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No 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 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 directl responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware th t t ar ignificant penalties for submitting false information, including the possibility off Ines nd imprisonment for knowing violations "
i �l r -2 %7
(Signs{ure of Permittee)
Permit Date 7/1/2011 60/30/2015 Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No NCG140000
CERTIFICATE OF COVERAGE NO NCG14 0 4 4 2
FACILITY NAME Chandler Concrete Company - Mebane Plant #610
PERSON COLLECTING SAMPLES Todd Binkle
CERTIFIED LABORATORY Pace Analytical Lab #633
LIMIT VIOLATIONS? YES ® NO ❑ Turbulent flow / some erosion
may have contributed to high TSS Not able to obtain another
qualifying sample during testing period
Part A Wastewater Monitoring Requirements
0%rig — State
0
Copy — State
0
Copy Winston
0
Copy — Plant
0
Copy File
SAMPLE COLLECTION YEAR 2017
SAMPLE QUARTER ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY Alamance
PHONE NO (336) 578 - 2912
ADD TO LISTSERVE? ❑YES ®NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HQW ❑PNA ❑Trout ®Other WS-V
NSW
OPTIONAL INFO
Outfall No
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)2
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-NEM6
(ing/L)
Discharge
Duration
(minutes)
Total Flow
gallons/day)'
-
-
-
6-93 °
303 5
53
(15)6
-
I-
1
4/25/17
VE RM MD
72
419
ND
N/A
360
2052
n
Na Qualifying Discharge observed this Period
-
CENT a r
r_
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here Please make sure to mark the ls'amp_Its g9te,r,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
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 1SA
NCAC 02B 0224 Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis
Permit Date 7/1/2010 06/30/2015
Last Revised 07/13/11
Page 1 of 2

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]
Torrential rain event, had difficulty collecting sample due to localized flooding
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations "
ature of
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
Ong - State
0 Copy - State
0 Copy Winston
0 Copy - Plant
0 Copy File
CERTIFICATE OF COVERAGE NO NCG14 0 4 4 2 SAMPLE COLLECTION YEAR 2017
FACILITY NAME Chandler Concrete Company - Mebane Plant #610 SAMPLE QUARTER ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
PERSON COLLECTING SAMPLES Todd Binkley miaeYmTL amance
CERTIFIED LABORATORY Pace Analytical Lab #633 PHONE NO (336) Sib - 2912
A 7llt/
LISTSERVE? -]YES ®NO EMAIL
APRA�D TO
LIMIT VIOLATIONS? YES ❑ NO ® Turbulent flow / some erosion CENTR.�ki�lFLING TO CLASS [:]SA ❑HQW ❑PNA ❑Trout ®Other WS-V
may have contributed to high TSS Not able to obtain another DWRTION
qualifying sample during testing period OPTIONAL. INFO
Part A Wastewater Monitoring Requirements
Outfall No
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
(VERMMD)
, ,
pH
{standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
gallons/day}
-
-
-
6-91 °
303 5
53
(15)6
-
-
1
NO FLOW
VE RM MD
-
-
-
N/A
-
-
No Qualifying Discharge observed this Period
-
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 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
Permit Date 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

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 respo sable for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete I am aware that ere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations "
LG
(Signature of Perm
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 NCG14 0 4 4 2
FACILITY NAME Chandler Concrete Company MEBANE Plt# 610
PERSON COLLECTING SAMPLES NO FLOW K L(_. t 1 V t U
CERTIFIED LABORATORY Pace Analytical Lab #633 FEB 0 5 Z013
LIMIT VIOLATIONS? YES ❑ NO ® CENTRAL FILEQ
GINR SECTION
Part A Wastewater Monitoring Requirements
4 QTR
�,OS�pOrig - State
0 Copy - State
0 Copy Winston
0 Copy -- Plant
0 Copy - File
SAMPLE COLLECTION YEAR Z017
SAMPLE QUARTER ❑Jan -March ❑April -June ❑Jul -Sept ®Ott -Dec
COUNTY ALAMANCE
PHONE NO [ 3361 226-1181
ADD TO LISTSERVE? ❑YES ®NO EMAIL
DISCHARGING TO CLASS ❑SA ❑HOW ❑PNA ❑Trout ®Other WSV NSW
OPTIONAL INFO
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)
Non -Polar
Oil & Grease
using method
1664SGT HEM6
(mg/L)
Discharge
Duration
(minutes)
Total Flow 7
(gallons/day)
-
-
-
6 934
3035
53
(15)fi
-
1
j NO FLOW
j VE RM MD
-
-
NIA
N/A
-
N/A
No Discharge this Period -
' 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
'if an effluent limit is exceeded twice in a row, the permAtee is required to institute monthly monitoring for that parameter for six months unless DEMLR 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 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
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas TPH does not have a Emit 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 DEMLR If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the
discharge location the permittee shall notify DEMLR and the DEMLR Regional Office may require an annual flow report on a case by case basis
Permit Date 8/1/2017-06/30/2022 Last Revised 07/27/17
Page 1 of 2

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 Resources e
Attn DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone] 1 '
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 Enquiry 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 fors bmitting false information, including the possibility of fines and imprisonment for knowing violations
Si nature of Permrt
( t g ( )
Permit Date 8/1/2017 06/30/2022 Last Revised 07/27/17
Page 2 of 2