NCG160024_MONITORING INFO_20190517

STORMWATER DIVISION CODING SHEET
NC6 PERMITS
PERMIT NO
/VC-,&'�uoaCf
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
l7I q D 5 /'
YVYYMMDD

May 10, 2019
N C Department of Environmental Quality (DEQ)
Division of Water Resources
Attn DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE Annual Summary Discharge Monitoring Report DMR
NCG160024
Harrison Waynesville Asphalt
Waynesville, NC
Haywood County
To Whom It May Concern
HARRISON
ACANCOMPANY
MAY 17 2olS
C'%"VRA!_ FILE-
"',A'R rECiIC»!
Please find accompanying this letter, one original and one copy of the Discharge
Monitoring Report DMR for the above referenced location
If you have any questions or need more information, please contact me at Harrison
Construction Company Division of APAC Atlantic Inc P O Box 449 Franklin, NC 28744 or
call me at (865)-279-6374
Sincerely,
Jeffrey Arnette
Environmental Compliance
P O Box 449 (28744) a 136 Rock Quarry Road . Franklin NC 28734 • Tel [phone] • Fax [phone]
A Division of APAC-Atlantic Inc
An Lquai Opportunity Employer

it
Semi-annual Stormwater Discharge Monitoring Report DMR
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 5 f f o I I i
CERTIFICATE OF COVERAGE NO NCG16 0 0 ;� 4
FACILITYNAME UVA,fNrSV:IyLE ASPIJAL.T
COUNTY HAS Woo:7
PERSON COLLECTING SAMPLES IIQ N� i-f r
LABORATORY ?Ai-_ Ir Lab Cert # 4 O
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR O l g
SAMPLE PERIOD ❑Jan -June ❑ July -Dec
or ❑ monthly" month
DISCHARGING TO CLASS ❑ORW ❑HQW Trout ❑PNA
[]zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period ?2
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks
-
-
100 mg/L o mg/L
dal
14 96 t Iq
S
X CoN i K0L,(.r0 RELFASE-
JIB+ Sr yMr1G-Z
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance forthe same parameter at the same outfall
For sampling periods with no discharge at any single outfali, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the rain gauge requirement
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU-252 last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this penod?'
Outfall No
Date Sample
Collected"
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks —>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an onainal and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monrtoring period
in the case of "No Discharge" reports) to
Division of Water Resources
Attn DWR Central Files
1617 Mad Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
I certify, under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information the information submitted is to the best of my knowledge and belief, true accurate, and complete I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signature of
Permit Date 10/lfl Y4-9/31/2019
5bo�i9
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

Is
Semi-annual Stormwater Discharge Monitonng-Report (DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
Date submitted _ 5' I U 1 1 q
CERTIFICATE OF COVERAGE NO NCG16D 0 . 4
FACILITY NAME LAJA�/�1GCV itrLE St71aAL7 _ _
COUNTY H A,t lnxn�o s7
PERSON COLLECTING SAMPLES A?_ N,,—_ s T f
LABORATORY PAGIi _ Lab Cert # 14 a
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR O 1 g
SAMPLE PERIOD [Jan -June ❑ July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
❑ No discharge this period
Outfafl No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks===>
-
-
1.00 mg/L oRIP mg/L
do 1
14 19b Iq
d
5
X GvN 1 Izow relo ?ELF_Ase
v j-A 5r, �-MMr-�
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the ram gauge requirement
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reporters in the format,_"<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU-2S2, last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period �"
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ==_>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this_DMR, includirrg_all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitonna nenod
in the case of "No Discharge" reports) to
Division of Water Resources
Attri DWR Central Files
1617 Marl Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information the information submitted is to the best of my knowledge and belief, true accurate, and complete I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signature of
Permit Date 10/] 2QV4-9/31/2019
5 A!)
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

October 25, 2018
Division of Water Resources
Attn DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE Discharge Monitoring Report DMR
NCG160024
Harrison Waynesville Asphalt Plant
Waynesville, NC
Haywood County
To Whom It May Concern
HARRISON
REcFI V ED
OCT 2 9 2o18
cc— fE /q Fit'3
L1�Ji, '�ECTIC',�
Please find accompanying this letter, one original and one copy of the Discharge
Monitoring Report DMR for the above referenced location
If you have any questions or need more information, please contact me at Harrison
Construction Company Division of APAC Atlantic Inc P O Box 449 Franklin, NC 28744 or
call me at (865)-279-6374
Sincerely,
Je rey Arnette
Environmental Compliance
P O Box 449 (28744) . 136 Rock Quarry Road • Franklin NC 28734 • Tel [phone] • Fax [phone]
A Division of APAC-Atlantic Inc
An E qu it Opportunity Employer

Semi-annual Stormwater Discharge Monitoring Report -(DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
Date submitted /O /Q 5 / / S
CERTIFICATE OF COVERAGE NO NCG16 O O as 4
FACILITY NAME WA�4N997&GTr K< PAAl, t
COUNTY �J M WQQ O
PERSON COLLECTING SAMPLES Ayt4 GT i E
LABORATORY_ PAr-e� —Lab Cert # �y o
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 201 f
SAMPLE PERIOD 0 Jan -June July -Dec
or ❑ monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW ZTrout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
[]Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period72
Outfall No
pate Sample
Collected}
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =__?
-
-
100 mg/L o m
_X Coij Twirl, 1, ED RE & EAS E
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the rain gauge requirement
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this perl'od�2
Outfali Na
Date Sample
Collected3'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =-=a
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses see General Permit text
FOR PART A AND PART 8 MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMITS YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Marl an original and one cooly of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period
1n the case o "No Discharge- reports) to
Division of water Resources
Attn DWR 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 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 "
fo /
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period ?2
Outfall No
Date Sample
Collected'
(mo/dd/yr)
2�4-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART 8 MONITORING RESULTS
a A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
+ TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ON E OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this DMR, including all "No Discharge" reports, withal 30 days of receipt of the lab results (or at end of monitoring period
in the case of "No Discharge" reports] to
Division of Water Resources
Attn DWR 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 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
/O /
(Date)
SWU 252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
Date submitted Ib S ► $
CERTIFICATE OF COVERAGE NO NCG16 a O d 4
FACILITY NAME „ WA&a(�,%1?LG� eSPHAL
COUNTY U Aq vuOO t:>
PERSON COLLECTING SAMPLES AVm r- i E
LABORATORY PAr.G_ Lab Cert # 140
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2 o i
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ monthly' Jmonthl
DISCHARGING TO CLASS ❑ORW ❑HQW ZTrout ❑PNA
❑Zero -flow []Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
❑ No discharge this period?'
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks = =>
-
-
100 mg/L o m
1
-7/,i�
was
.X CoA -rRo & ED RR—EAS E
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
z For sampling periods with no discharge at any single outfaII, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites maybe eligible for a waiver of the ram gauge requirement
See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Ter Z or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period ;>2
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL7 YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT'> YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy_af_this DMR,_i_ncludinq all "No Discharge" reports, within 30 day+s of receipt of the lob results (or at end of monitarina oenod
in the case of "No Discharge" reaorts) to
Division of Water Resources
Attn DWR 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 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 "
(Date)
SWU-252 last revised 9/17/2014
Page 2 of 2

F9ARFtISON
January 9, 2018
NCDEQ
Division of Water Quality
2090 US Highway 70
Swannanoa, NC 28778
RE Annual Summary Data Monitoring Report (DMR)
NCG160024
Harrison Waynesville Asphalt Plant
Waynesville, NC
Haywood County
To Whom It May Concern
Please find accompanying this letter, one original and one copy of the Annual
Summary Data Monitoring Report DMR for the above referenced location
If you have any questions or need more information, please contact me at Harrison
Construction Company Division of APAC Atlantic Inc P O Box 449 Franklin, NC 28744 or
call me at (865)-279-6374
Sincerely,
Received
Jeffrey Arnette
JAN 12 201$ Environmental Compliance
Land QtIality Section
Al,heville
P O Box 449 (28744) • 136 Rock Quarry Road . Franklin NC 28734 • Tel [phone] • Fax [phone]
A Division of APAC-Atlantic Inc
An Equal Opportunih Employer

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year a0 1 "7
Revised 911V2014
General Permit No NGG160000
Certificate of Coverage No NCG1B[d©®❑4
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year
Facility Name N `-(, PN yr
County 11A`? Wain
Phone Number 02-L&a4 SE+SS
Total no of SDOs monitored
Part A Outfall No (use multiple sheets for multiple outfalls)
Is this outfall currently In Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall �_
Total Rainfall,
Inches
00530
TSS, mglL
Benchmark
N/A
i00,
Date Sample Collected,
molddtyr
05 as I 1-
0
3
X CoN;rbl.c,eD R6LfA5E VIA Sr.-SMM6i-e,
Yes ❑ No [v�
Yes ❑ No [�
Page 1 1

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 Ones and imprisonment for knowing violations "
Signature
Date I /
Mall Annual DMR Summary Reports to
DEMLR Regional Office Contact Information
Asheville Office
[phone]
Fayetteville Office
[phone]
Mooresville Office
[phone]
Raleigh Office
[phone]
Washington Office
[phone]
Wilmington Office
[phone]
Winston-Salem
[phone]
ASHEVILLE REGIONAL OFFICE FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
WILMINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Page 13

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year oi0
Revosed 9/t7/2014
General Permit No NCG160000
Certificate of Coverage No NCG16❑p 0®4 ❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 9 of
each year
Facility Name ASPmu-r-
County H -? woc)r)-
Phone Number ( $Safi )ISDA 54SS
Total no of SDOs monitored I
Part A Outfall No I (use multiple sheets for multiple outfalls)
Is this outfall currently In Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall,
Total Rainfall,
Inches
00530
TSS, mglL
Benchmark
N/A >
Y 900
Date Sample Collected,
molddlyr
[IM.''
M� t
os as II
q
3 T7
0 0-I t57
o
�a 5
X COry jj?6(, C-D RcLrA5E V-TA SK7MMF,2
Page I 1
Yes ❑ No
Yes ❑ No

"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, Inc
Signature
Date 1 1
the possibility of fines and imprisonment for knowing violations "
Mail Annual DMR Summary Reports to
DEMLR Regional Office Contact Information
Asheville Office
Fayetteville Office
Mooresville Office
Raleigh Office
Washington Office
Wilmington Office
Winston-Salem
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Page 13
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]

OIL.
August 15, 2017
Division of Water Resources
Attn DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE Discharge Monitoring Report DMR
NCG160024
Harrison Waynesville Asphalt Plant
Waynesville, NC
Haywood County
To Whom It May Concern
FIARRISON
RECEIVED
AUG 18 2017
CEN [RAL FILES
D1VR SECTION
Please find accompanying this letter, one original and one copy of the Discharge
Monitoring Report DMR for the above referenced location
If you have any questions or need more information, please contact me at Harrison
Construction Company Division of APAC Atlantic Inc P O Box 449 Franklin, NC 28744 or
call me at (865)-279-6374
Sincerely0eyrnette
Environmental Compliance
P O Box 449 (28744) • 136 Rock Quarry Road • Franklin NC 28734 a Tel [phone] . Fax [phone]
A Division of APAC Atlantic Inc
An Equal Opportunio Employer

Semi-annual Stormwater Discharge_ Monitoring Report (DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
Date submitted 8 l 15 /1-7
CERTIFICATE OF COVERAGE NO NCG16 O Q e� 4
FACILITY NAME WA`INESV- f
COUNTY W O
PERSON COLLECTING SAMPLES E'r m_
LABORATORY ;A Le lab Cert # 46
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR aO l 7
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW ZTrout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
❑ No discharge this period;"
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L o 0 m
1
S
425
>K 6,5koJ ti 1C0W-E D )?E(.EASE
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the rain gauge requirement
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX m /L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU 252, last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period'."'
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg)IL
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Der 2, or Tier responses See General Permit team
FOR PART A AND PART B MONITORING RESULTS
A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFACE? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Marl an original and one copy of this DMR, including all "No Discharge" reports, within 30 days 9 r copt of the lab results (or at end of monrtormp period
in the case of "No Discharge" reports) to
Division of Water Resources
Attn DWR 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 ,n accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system or
those persons directly responsible for gathering the information the information submitted is to the best of my knowledge and belief, true, accurate and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations
15 1.7
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

June 8, 2017
Division of Water Resources
Attn DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE Discharge Monitoring Report DMR
NCG160024
Harrison Waynesville Asphalt Plant
Waynesville, NC
Haywood County
To Whom It May Concern
HARRISON
BRA.
Please find accompanying this letter, one original and one copy of the Discharge
Monitoring Report DMR for the above referenced location
If you have any questions or need more information, please contact me at Harrison
Construction Company Division of APAC Atlantic Inc P O Box 449 Franklin, NC 28744 or
call me at (865)-279-6374
Sincerely,
J rey Arnette
Environmental Compliance
P O Box 449 (28744) . 136 Rock Quarry Road • Franklin NC 28734 . Tel [phone] • Fax [phone]
A Division of APAC-Atlantic Inc
An Equal Opportunity Employer

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Per It No NCG160000 - Asphalt
Date submitted 17
CERTIFICATE OF COVERAGE NO NCG 16 6 O 4-
FACILITY NAME W AqN9 S11'7Lt, �PtaAL't
COUNTY kA300
PERSON COLLECTING SAMPLES R
LABORATORY PAr_ C Lab Cert ># 40
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR � 01 7
SAMPLE PERIOD 0Jan-June ❑ July -Dec
or ❑ monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW ZTrout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks ==>
_
-
100 mg/L or 50 mg/L
as
No discharge this period;"
.)C CoN-rfiat,&ED R F t,6. A5E
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from anon -site rain gauge Unattended sites maybe eligible for a waiver of the rain gauge requirement
See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "¢XX me/L where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period ;12
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALLI) YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this DMR,_rncludina all "No Discharge" reports, within 30 days oLreceipt of the lab results for at end of monitonng period
in the case of "No Discharge" reports) to
Division of water Resources
Attn DWR 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 responsible for gathering the information the information submitted is to the best of my knowledge and belief, true accurate, and complete
am aware that there arp significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations '
(,
A,fi�_
(Date)
SWU-252 last revised 9/17/2014
Page 2 of 2

ti
HARRISON
January 27, 2017
NCDEQ
Division of Water Quality
2090 US Hwy 70
Swannanoa, NC 28778
RE Annual Summary Data Monitoring Report (DMR)
NCG160024
Waynesville Asphalt Plant
Haywood County
To Whom It May Concern
Please find accompanying this letter, one original and one copy of the
Annual Summary Data Monitoring Report (DMR) for the above referenced location
If you have any questions or need more information, please contact me c/o Harrison
Construction Company Division of APAC Atlantic Inc P Q Box 449 Franklin NC 28744 or
call me at 828-421-0448
Reee'�d
t<artd �rraiit� 5ectlan
Asheville
SI Lrell
Dort Mas(
Environm
nce
P O Box 449 (28744) • 136 Rock Quarry Road + Franklin NC 28734 . Tel [phone] • Fax [phone]
A Division of APAC-Atiantic Inc
An Equal Opportunity Lmplover

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year a01
Revised 911712014
General Permit No NCG160000
Certificate of Coverage No NCG 16❑Q ❑O [94 ❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year
Facility Name W A\4tjSSV r{rE ASP MAL.
County
Phone Number (1A) SU-5455 Total no of SDOs monitored
Part A Outfali No I (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No [�
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfail t
Total Rainfall,
Inches
00530
TSS, mg1L
Benchmark
N/A
0 00
Date Sample Collected,
molddlyr
.v�{ .�:� {t�
ko" x� N'l
Y�j ��
3 Ib
075
40
8 r�
04
42
X CONTITOLL,90 R6&OA!5.6 Vjy SKyr"!!` 0,Z—
Page I 1

I certify under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations "
Signature
Date 4
Mail Annual DMR Summary Reports to
DEML-R Regnonal Office Contact Information
Asheville Office
Fayetteville Office
Mooresville Office
Raleigh Office
Washington Office
Wilmington Office
Winston-Salem
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
Page 13

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
Date submitted I l l ri t l 7
CERTIFICATE OF COVERAGE NO NCG16D Q _a4
FACILITY NAME W R-
jESQ5GGF. ASQyAUT
COUNTY CL,
PERSON COLLECTING SAMPLES 113 FTTE
LABORATORY A Lab Cert # 40
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o o
SAMPLE PERIOD ❑ Jan -June July -Dec
or C Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
Zero -flow ❑Water Supply []SAOther NQr -S - -
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period ?2
Outfall No
date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks
100 mg/L or 50 mg/L
la I r&
0 6a
7
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waver of the rain gauge requirement
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitatton limit, etc in mg/L
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/112014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > SS gal of new oil per month
❑ No discharge this period72
Outfa[I No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
+ 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
+ TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ON E OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMITS YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end,0 manrtorrnu period
in the case of "No Discharge" reports
Division of Water Resources
Ann DWR 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 responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
1 /7
(Date)
10/1/2014-9/31/2019 SWU-252 last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
Date submitted g/ I I l (0 T
CERTIFICATE OF COVERAGE NO NCG160 O 24
FACILITY NAME IA) A, i"_C IJTU F AG P m, it,-T
COUNTY �AAy WOOt>
PERSON COLLECTING SAMPLES A pyF— TE
LABORATORY PAr_G Lab Cert # a()
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR ao 4 b
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW RTTrout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period>z
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks
-
1W mg/L or D m
r64
za 5
FILEPODD
'y
©m � M
X�cn� -0 0
M m
-� C
omM c M
z {„
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites maybe eligible for a waiver of the rain gauge requirement
See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format "<XX m L" where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > SS gal of new oil per month
❑ No discharge this penod?2
Outfalf No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 2, Tier ,2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an oriainal and one copy of this DMR, including_ all "No Discharge" reports, within 30 days of receipt of the lab results !or at end of monitoring period
in the case of "No Discharge" reportsi to
Division of Water Resources
Attn DWR 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 responsible for gathering the information the information submitted is to the best of my knowledge and belief, true accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations '
q r 1&
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

A
May 112016
Central Files
North Carolina Department of Environment and
Natural Resources Division of Water Quality
1617 Mail Service Center
Raleigh N C 27699-1617
ro Whom It May Concern
H RA RISON
RECEIVED
MAY 16 2016
CENTRAL FILES
DWR SECTION
Please find enclosed duplicate copies of NCG16000 SDO/DMR reports for the Waynesville Asphalt
Plant NCG 160024
If you have any questions or need more inform ale sercall me at 828-421-0448
Thank you
Sin rely Y rs > copy
Don anon
P O Box 449 (28744) • 136 Rock Quarry Road • Franklin NC 28734 . Tel [phone] a Fax [phone]
A Division of APAC-Atlantic Inc
An Equal Opportunity Employer

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
Date submitted 5 / 1 1 // &
CERTIFICATE OF COVERAGE NO NCG 16 O 2
FACILITY NAME WA111V6S - E S?NA .7
COUNTY W
PERSON COLLECTING SAMPLES
LABORATORY ]AA GIG Lab Cert #
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
a
SAMPLE COLLECTION YEAR 3 0 1&
SAMPLE PERIOD Q 1an-June ❑ July -Dec
or []Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW RITrout ❑PNA
ero-flow ❑Watersupply ❑SA
Other GLASS C.
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period ;2
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks
-
100 mg/L or SO mg/L
5 3 /
-3
vM C
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3 The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the rain gauge requirement
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX me/L where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 5wU 252 last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period;"
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24 hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
_
15 mg/L
100 mg/L or 50 mg/L
1A
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
+ 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days ot recer t of the lob results for at end pf monitoring eriad
in the case of "No Discharge" reports) to
Division of water Resources
Attn DWR Central Files
1617 Mad Service Center
Raleigh North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information the information submitted is to the best of my knowledge and belief true accurate, and complete I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations
15 II �1
(Date)
Permit Date 10/1/2014 9/31/2019 SWU-252 last revised 9/17/2014
Page 2 of 2

ow
Semi-annual Stormwater Discharge Monitoring Report DMR
for North Carolina DEMLR General Per It No NCG160000 - Asphalt
Date submitted
CERTIFICATE OF COVERAGE NO NCG 16Q
FACILITY NAME 14
Y LG
COUNTY C&AY
PERSON COLLECTING SAMPLES 'T
LABORATORY PA C—E Lab Cert #
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR d C) I S
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
ero-flow ❑Water Supply ❑SA
RECEIVED Other dAl6
DEC I 1 �015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
QWR SECTION ❑ No discharge this penod?'2
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L or 50 mg/L
DI
la 5
6
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the rain gauge requirement
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 1 of 2

Papt B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period ;'2
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/0
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this DMR, including oil "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoringperiod
enod
in the case o "No Discharge" reports) to
Division of Water Resources
Attn DWR 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 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
(Signatu
Permit Date 10/1/2014-9/31/2019
lA 7 15
(Date)
SWU 252 last revised 9/17/2014
Page 2 of 2

rai
HA R1 ON
Harrison Construction Division APAC-Atlantic, Inc
Hwy 64 West • P O Box 449Franklin, North Carolina 28734
[phone] . FAX [phone]
December 17, 2014
Central Files, NCDENR
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE Discharge Monitoring Report DMR
NCG160024
Hayesville Asphalt Plant
Clay County
To Whom It May Concern
?'EcEN S V
0Ec 2 2 J0%
pW�L � oN
R SEC
Please find accompanying this letter, one original and one copy of the
Discharge Monitoring Report DMR for the above referenced location
If you have any questions or need more information, please contact me c/o
Harrison Construction Company Division of APAC Atlantic Inc P O Box 449 Franklin
NC 28744 or call me at 828-421-0448
Si cerely Yours
Don Mason
Environmental Compliance

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No CG160000 - Asphalt
Date submitted /G 1 l7° i/z
CERTIFICATE OF COV AGE NO CG1 o 0 Z
FACILITY NAME I � HlGT"
COUNTY L_4
PERSON COLLECTING SAMPLES rN SO/�
LA130RATORY Lab Cert #
Comments on sample collection or analysis
Part A Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
[]Zero -flow ❑Water supply [_]SA.
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
No discharge this period ?2
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks -_->
_
-
100 mg/L or 50 mg/1.
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site ram gauge Unattended sites may be eligible for a waiver of the rain gauge requirement
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
Permit Date 10/1/2014 9/31/2019 5WU 252 last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period 22
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
inchee
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses see General Permit text
FOR PART A AND PART 8 MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this DMR, including all "No Discharge"reports, within 30 days of receipt of the lab results -for at end of monitoring period
in the case of "No Discharge" reports) to
Division of Water Resources
Attn DWR 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 ualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those pers s directly sponsible for gathering the information the information submitted is, to the best of my knowledge and belief, true accurate, and complete
am aware t t there(artsignificant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations
(Signature
Permit Date 10/1/2014 9/31/2019
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

HARRISON
no�
APAC-Atlantic, Inc • Harrison Construction Division • Hwy 64 West • P O Box 449
Franklin North Carolina 28734 • [phone] + FAX [phone]
December 16, 2014
Central Files RECEIVED
North Carolina Department of Environment and
Natural Resources, Division of Water Quality DEC 2 2 20i4
1617 Mail Service Center CENTRAL FILES
Raleigh, N C 27699-1617 DWIR SECTION
To Whom It May Concern
Please find enclosed duplicate copies of NCG16000 SDOIDMR reports for the
Waynesville Asphalt Plant NCG160024
If you have any questions or need more information, please call me at
828-421-0448 Thank you
Singorely
Don' Masont
dlmason@harrisoncc com

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No NCG160000 - Asphalt
CERTIFICATE OF COVERAG NO NCG16 D O
FACILITY NAME 6 63r /—
COUNTY
PERSON COLLECTING SAWKES 45�J�
LABORATORY GCE Lab Cert #
Comments on sample collection or analysis
Date submitted
SAMPLE COLLECTION YEAR
LT SAMPLE PERIOD 0 Jan -June ® July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW 5?HQW [Trout ❑PNA
? ❑Zero -flow ❑Water Supply ❑SA
❑Other W6 -/„ _
Part A Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE -)�
❑ No discharge this period ?2
Outfall No
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L or 50 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site rain gauge Unattended sites may be eligible for a waiver of the ram gauge requirement
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, theymust be report_e_d in the format, "<XX me/L where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc in mg/L
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tiei 3 responses See General Permit text
Permit Date 10/1/2014-9/31/2019 SWU-252 last revised 9/17/2014
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only for facilities averaging > 55 gal of new oil per month
❑ No discharge this period?'
Outfall No
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS
e TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results tar at end of monitoring period
in the case o "No Dischar e" reports) to
Division of Water Resources
Attn DWR 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 qu lified pens o"nel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system or
those person irecdy r�sfionsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware th there abehignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations
(Signaturd of Permittee)
Permit Date 10/1/2014-9/31/2019
1 l
(Date)
SWU 252 last revised 9/17/2014
Page 2 of 2

HARRISON
Harrison Construction Division APAC-Atlantic, Inc
Hwy 64 West • P O Box 449Franklin, North Carolina 28734
[phone] - FAX [phone]
August 14, 2014
Central Files, NCDENR
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE Discharge Monitoring Report DMR
NCG160024
Hayesville Asphalt Plant
Clay County
To Whom It May Concern
Please find accompanying this letter, one original and one copy of the
Discharge Monitoring Report DMR for the above referenced location
If you have any questions or need more information, please contact me c/o
Harrison Construction Company Division of APAC Atlantic Inc P O Box 449 Franklin
NC 28744 or call me at 828-421-0448
Si erely Y urs
Do Mason
Environmental Compliance

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO NCG160000
DISCHARGE. MONITORING. REPORT (DMR)
CER I IP ICA rE OF COVERAGE NO NCG 16 OC� zg
FACILI l Y NAME l'T ES!//E A-5alr1141-7—
PERSON COLLECTING S MPLE .�D
CERTIFIED LABORATORY Lab #
Lah #
Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR l
(This monitoring report is due at the Division no later than 30 days from the date
the lacihty receives the Sampling results from the laboratory)
COUNTY Zvi _
PHONE NO (
Outfall
No
Date
Sample Collected,
moldd/ r
Total Rainfall,
inches
00530
00400
00556
Total Suspended Solids, mg11
pH,
Standard umts
Total Petroleum Hydrocarbons, mg/I
EPA Method 1664 (SGT•HEM
Benchmark
-
-
100
Within 6 0 — 9 0
15
O
, /V
Aco
•Co
C S•a
If a value is in excess of the benchmark or outside the benchmark range (for pH) you must implement the Tier I or Tier 2 responses in the General Permit
Mail original and one copy to
Division of Water Quality
Attu Central Files
1617 Mail Service Center
Ralei h North Carolina 27699-1617
YOU MUS I SIGN 1 HIS CERTIFICA1 ION FOR ANY INFORMA PION REPORTED
"I certify, under penally 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 prop rly gather and evaluate. the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly re onsible f( te gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and comple
1 am aware that there aq*signifi ja t penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signature
( ate)
S W U-252-051409
Page IofI

ti
STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO NCG160000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICA'1 E OF COVERAGE NO NCG16 R ©g
FACILI i Y NAME "A
PERSON COLLECTING S A
CERTIFIED LABORATORY
Monitoring Requirements
Lab #
SAMPLES COLLECTED DURING CALENDAR YEAR l
(This monitoring report is due at the Division no later than 30 days from the date
the facility receives the sampling results from the laboratory)
COUNT Y Zl"-el .
PHONE NO (
Outfall
No
Date
Sample Collected,
mo/dd/ r
Total Rainfall,
inches
00530
00400
00556
Total Suspended Solids, mg/1
pH,
Standard units
Total Petroleum Hydrocarbons, mg/l
EPA Method 1664 (SGT-HEM
Benchmark
-
- i1
100
Within 6 0 — 9 0
15
0061
Im 'Al
A e i
1 Z-40
S•
i
I
I
I
i If a value is in excess of the benchmark or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the General Permit
Mail original and one copy to
Division of Water Quality
Attn 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 propfrly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly re onsible f gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
I am aware that there aiNsigmfija t penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signature of Perna
r! -, ' W
(Era t e)
S W U-252-051409
Page 1 of 1