NCG160133_MONITORING INFO_20190122

STORMWATER DIVISION CODING SHEET
NC6 PERMITS
PERMIT NO.
DOC TYPE
❑HISTORICAL FILE
� MONITORING REPORTS
DOC DATE
❑ � � I _I C � ,� �`
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 01/09/2019
CERTIFICATE OF COVERAGE NO NCG16 0 1 3 3
FACILITY NAME Piedmont Asphalt,-I_C - Pelham Plant
COUNTY Caswell
PERSON COLLECTING SAMPLES Julian Stinson
LABORATORY Pace Analytical Lab Cert. #
Comments on sample collection or analysis:
633
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2018
SAMPLE PERIOD ❑ Jan -June Q July -Dec
or ❑ Monthly' (monthl
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑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,
Inches3
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L
001
12/17/2018
0 04"
3 0 mg/L
RECOvED
AN 11 zols
UTVR SECTlO I
I 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 maybe 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, 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 8
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
Mari 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 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 "
1100
(Date)
Permit 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 06/07/2018
CERTIFICATE OF COVERAGE NO. NCG16 0 1 3 3
FACILITY NAME Piedmont Ash- LLC -_Pelham Plant
COUNTY Caswell
PERSON COLLECTING SAMPLES Steven Ashworth
LABORATORY Pace Analytical Lab Cert. # 633
Comments on sample collection or analysis.
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2018
SAMPLE PERIOD 0 Jan -June ❑ July -Dec
or ❑ Monthly) (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑zero -flow [—]Water Supply [:]SA
Other C
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period 22
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L
001
05/31/2018
0011,
3 7 mg/L
RECFI\/F-D
JUN I 1 2018
CENTkAL FILES
DWR SECTION
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 maybe 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 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 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 perlod?2
Qutfall 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/t or 50 mg/L
Footnotes from Part A also apply to this Part 0
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 PERMITS YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an onainal and one cony of this DMR, rncludrna all "No Drscharae" reports, within 30 days of receipt of the lab results for at end of monitorina period
in the case of "No Discharae" 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 are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signature o ermittee) (D e)
Permit 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
CERTIFICATE OF COVERAGE NO. NCG16 o 1 3 3
FACILITY NAME Piedmont Asphalt, LLC - Pelham Plant
COUNTY Caswell
PERSON COLLECTING SAMPLES Steven Ashworth
LABORATORY Pace Analytical _ Lab Cert. # 633
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2011
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 pernod;�'
Outfail No.
Date Sample
Collected)
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks ===>
-
-
100 mg/L or 50 mg/0
0(ollgi oil
051 '
1 � MAP,
' 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
-1Thetotal 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
° 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 ?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 ISGT-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 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 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" 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 are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
Permittee)
6 Uze 7
(Date)
Permit Date 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

f - 7
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 12/12/2016
CERTIFICATE OF COVERAGE NO. NCG16 0 1 3 3
FACILITY NAME Piedmont Asphalt. LLC - Pelham Plant
COUNTY Caswell
PERSON COLLECTING SAMPLES Steven Ashworth
LABORATORY Pace Analytical Lab Cert. # 633
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2016
SAMPLE PERIOD ❑ Jan -June Q July -Dec
or ❑ Monthly' (month}
MO
TO CLASS ❑ORW ❑HQW - []Trout ❑PNA
RECEM ❑Zero -flaw ❑Water Supply [:]SA
DEC 19 2A []Other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION
❑ No discharge this period ;2
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches}
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L or 50 mg/0
001
11/29/2016
0 32"
10 5 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 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. Far 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 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 I, 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,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 ►rig/L
200 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 KART 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 PERMITS YES ❑ NO Cj
REGIONAL OFFICE CONTACT NAME
Mail an on final and one capy of this DMR, includingall "No Di har e" reports, within 30 days of receipt of the lab results for of end of monitoring period
n the case o "No i har e" reports) o:
Division of Water Resources
Attn DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR 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 "
of
Permit Date 10/1/2014-9/31/2019
/Z/12-LOAC
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

(�5a'ceAnalytical'
wwwpecam .com
Pace Anatytical Services, LLC
205 East Meadow Road - Suite A
Eden NC 27288
{336}623-8921
ANALYTICAL RESULTS •
Project Pelham Asphalt Plant 001
Pace Project No 92321239
Sample Pelham Asphalt Plant 001 Lab ID 92321239001 Collected 11129/16 13 15 Received 11130116 1100 Matnx Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No Qual
25400 Total Suspended Solids Analytical Method SM 25400
Total Suspended Solids 105 mg1L 25 1 12101l16 15 20
HEM, Olt and Grease Analytical Method EPA 1664B
Oil and Grease <5 0 mg/L. 50 1 12/09/16 08 00
Date 12/09/2016 04 50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced except in full
Without the written consent of Pace Analytical Services, LLC
Page 5 of 12

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 7/12/2016
CERTIFICATE OF COVERAGE No. NCG16 0 1 3 3
FACILITY NAME PledmontAsohalt,LLC - Pelham Plant
COUNTY Caswell
PERSON COLLECTING SAMPLES Steven Ashworth
LABORATORY Pace Analytical Lab Cert. a 633
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
ao/.
SAMPLE COLLECTION YEAR 2016
SAMPLE PERIOD Q An=June ❑ July -Dec
orb® Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
.tom ❑Zero -flow ❑Water Supply ❑SA
,e ❑Other
F
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Outfali No.
pate Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/0
001
06/15/2016
1 82"
20 2 mg/L
No discharge this period �"
RFOR ED
JUL 15 2016
UWR :TI-CTION
J."I ORNIATION PROCESSING UNIT
' 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
' 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-
numericalformat 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 Genera! Permit text.
Permit Date 10/1/2014-9/31/2019 5WU-252, last revised 9/17/2014
Page 1 of 2

Part B:
t
Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new ail per month.
No dischorge 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 OUTFALO 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 copv of this DMR, includina all "'No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina period
in the case o "No Discharge' reports) to:
Division of Water Resources
Attn DWR Central Files
1617 Mail Servue 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 "
of Permittee)
02i r,2/,zoa
(Date)
Permit Date 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

aceAnalytical
wmvpacelabs corn
1
i
ANALYTICAL RESULTS
Project PELHAM ASPHALT PLANT
Pace Project No 92301673
Pace Analytical Serves, Inc
r.
205 East Meadow Road - Suite A
Eden NC 27288
(336 )6'2 3-8921
Sample PELXAM ASPHALT PLAINT Lab ID 92301673001 Collected 06/15/16 21 00 Received 06/16/16 13 52 Matrix `hater
001
Parameters Results Units Report Limit Dr Prepared Analvzed CAS No Qua!
2540D Total Suspended Solids Analytical Method SM 2540D
Total Suspended Solids 202 mg/L 2 8 1 06/16/16 15 27
Date 07/06/2016 09 21 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced except in full,
without the wntten consent of Pace Analytical Services Inc
Page 5 of 8

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 -Asphalt
Date submitted
CERTIFICATE OF COVERAGE NO. NCG16 0 1 3 3
FACILITY NAME Piedmont Asphalt. LLQ - Pelham Plant
COUNTY Caswell
PERSON COLLECTING SAMPLES Steven Ashworth
LABORATORY Pace Analytical Lab cent. q 633
Comments on sample collection or analysis.
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2015
SAMPLE PERIOD ❑ Jan -tune M 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 3
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L
001
11/19/15
1 32"
6 9 mg/L
No discharge this period ;12
R EEGEIVED
DEC 10 Z015
CENTRAL FILES
DWR SECTION
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 classificattons where the more protective benchmark applies
Note Results must be reported in numerical format. For examle, 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 1, 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 perrod?z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
inches'
Non -polar O&G by EPA
1.664 (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 9 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_oriarnal and one Cony 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 Discharae" rep_ortsl 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 vtolattons "
I Z 7 'Z "1S
(Date)
Permit Date 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

ac;Analytical'
w�rwpacefabsoom
ANALYTICAL RESULTS
Pace Analytical Services, Inc
/ 245 East Meadow Road - Suite A
Eden NC 27288
[phone]
Project PELHAM PLANT 001
Pace Project No 92277066
Sample PELHAM PLANT 001 Lab ID 92277066001 Collected 11/19/15 12 10 Received W20/15 11 09 Matrix Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No Qual
2540D Total Suspended Solids Analytical Method SM 2540D
Total Suspended Solids 69 mg1L 25 1 11/23/15 14 37
HEM, Oil and Grease Analytical Method EPA 1664B
Oil and Grease <5 0 mg/L so 1 12102115 06 10
Date 12/02/2015 03 22 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced except in full
without the written consent of Pace Analytical Seances Inc
Page 5 of 11

�-PaceAnalytical'
i
wuw oir elate cam
CHAIN -OF -CUSTODY 1 Anaiytical Request Document
The Chaln-of Custody Is a LEGAL DOCUMENT All relevant fields must be completed accurately
Sectton A Section 8 Section C
UP
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Required Client Information Required Protect Infor lm Invo,ee infonnatjon
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f Report To S Aitenhph
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Important Note ay srpnmg this form you are apeephng Paces NET 30 day payment te"S end agrverrig to Late crurges of 1 5% per month hx any m� not Pad wnnm 30 days F-ALL-0-020fev 07 15-May 2007

Semi-annual Stormwater Discharxe Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 06/23/2015
CERTIFICATE OF COVERAGE NO. NCG16 0 1 3 3
FACILITY NAME Piedmont Asphalt_ LLC - Pelham Planj
COUNTY Caswell
PERSON COLLECTING SAMPLES Steven Ashworth
LABORATORY Pace Analytical Lab Cert. # 633
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2015
SAMPLE PERIOD 0 Jan -June ❑ July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]WaterSupply []SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks
100 mg/L or 50 mg/L
001
06/14/15
0561.
113 mg/L
No discharge this period 72
kl�_CEIVED
JUN 2 5 ZU15
CENTRAL FILES
DWR SECTION
' Monthly sampling (instead of semi-annual) mast 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
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 Titer 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
;riLY,

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/ r
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
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 Tiler 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 1N 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 of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lob results for at end of monitoring period
In the case of "No Discharae" 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 desgned 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 mformatton, including the possibility of fines and imprisonment for knowing violations "
'm- zz
(Signature ermittee) (Date)
Permit Date 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

acmnalytical e
WWpacelah&WM
1
ANALYTICAL RESULTS
Paco Anslyttcat Services -Inc
205 East Meadow Road - Suite A
Eden NC 27288
{336)6234WI `
Project PELHAM PLANT
Pace Project No 92254720
Sample PEL"AM PLANT 001 Lab 10 92254720001 Collected 06/14/15 17 40 Received 06/1711510 00 Matrix Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No Qual
2540D Total Suspended Solids Analytical Method SM 2540D
Total Suspended Solids 113 mg1L 26 1 06/18/15 13 36
bate 06/21/2015 03 15 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced except in full
without the written consent of Pace Analytical Services Inc
Page 5 of 10

Semi-annual Stormwater DischaEgee Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 11-26-14
CERTIFICATE OF COVERAGE NO. NCG16 0 1 3 3
FACILITY NAME
COUNTY Caswell
PERSON COLLECTING SAMPLES Steven Ashworth
LABORATORY Pace Analytical Lab Cert. # 633
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2014
SAMPLE PERIOD ❑ Jan -June ® July -Dec
R�� � �� or ❑ monthly'-. __ Imonthl
ING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
DEC 0 1 2014 []Zero -flow []Water Supply []SA
®Other C
CENTRAL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
No discharge this period
Outfall No.
Date Sample
Collected
(me/dd/yr)
24-hour rainfall
amount,
Inches
Total suspended Solids
Benchmarks
100 mg/L or 50 mg/L
001
11 /17/14
038
2 8 m /L
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 mx/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 I, 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 8: 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/ r
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
Not Applicable
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 PERMITS YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an orraJnal and one -cony of this DJWR, J Edina a_I!! "No Dis�h�r a".repp , within dons of re-ceint of the lab results for at end of monitorina period
in the case of "No OJscharae" renortsl 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 INFQRMATION REPORTED: t
"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 "
Permittee) Dcs­-G4
AA C'hWS:A, G+-\
+ z5
(Date)
Permit Date 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG16Q[�Q 3[]
FACILITY NAME Piedmont Asphalt, LLC - Pelham Plant
PERSON COLLECTING SAMPLES _Steven Ashworth
CERTIFIED LABORATORY_ Pace Analyticai Lab # 633
Pace Analytical Lab # 12
Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2Q14
(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)
COUNTY Caswell
PHONE NO.( 336 ) 388-9581
RECEIVED
AUG 2 6 2014
e->= k'
Outran
No,
Date
Sample Collected,
mo/dd/ r
Total Ruitdat),
inches
00530
00556
Total Suspended Solids, mg/l
p 800
Standard units
Total Petroleum Hydrocarbons, mg/l
EPA Method 1664 SGT-HEM
l3enchmark
-
-
100
Within 6.0 - 9.0
1S
1
08118/14
022
167m /1
64
' 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 properly gather and evaluate the information submitted. Based un 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.
1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations "
9�-2� , 'M , '5��—'
�8 Aa -e /a.
(SignaturiAr Permittee) (Date)
SWU-252-051409
Page IofI

ceAnaVical
nwwwabbs.com
ANALYTICAL RESULTS
Pace Analytical Services, Inc
205 East Meadow Road - Suite A
Eden, NC 27288 r
[phone]
Protect Piedmont Asphalt, LLC
Pace Protect No 92213808
Sample PELHAM PLANT- Lab ID 92213808001 Collected 08/18/14 11 30 Received 08/19/14 09 45 Mabu Water
OUTFALL 001
Parameters Results Unrts Report Limit DF Prepared Analyzed CAS No Qual
2540D Total Suspended Solids Analytical Method SM 2540D
Total Suspended Solids 16 7 mg/L 25 1 08/20/14 15 23
HEM, Oil and Grease Analytical Method EPA 1664E
Oil and Grease ND mg/L 5 0 1 08/21/14 10 58
Date 08/21 /2014 03 15 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full
without the written consent of Pace Analytical Services tnc
Page 5 of 12

RECEIVED
N C Dept of ENR
!AN 31 2013
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) 9onwofice
Calendar Year 2012
General Permit No NCG160000
Certificate of Coverage No NCG16 0❑F1100❑
This monitoring report summary is due to the DWO Regional Office no later than 30 days from the date
the facility receives laboratory sampling results from the final sample of the calendar year.
Facility Name Piedmont Asphalt, LLC - Pelham Plant
County Caswell
Phone Number 3( 36 J 388-9581 Total no of SDOs rnonitoreo
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No Nf-
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No 9
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 DWQ to reduce monitoring frequency ❑
Other ❑
Outfalt 1
Total Rainfall
inches
00530-
00400
Vehicle
Maintenance
Activities
TSS, mglt,
pH, s it.
Method 1664A
(SGT-HEM)
Non-Polar O&GI
Total Petroleum
Hydrocarbons,
m IL
New Motor Oil
Usage,
gal/month
Benchmark
N/A
100
6 0—. 9 0
1s
N/A
Date Sample Collected
mofddlyr
y r
, ..y i'1l.A f�,l' i��iP•,�{�
=`h 1°5�, ".� f 1'i •5
!4 ��r vi�l.a%
S, ��i �L'r
rE. z �;.4'��+3' . �
��
tr'.v3.' iSS�
S i4 �l�i�
..-ar"� T s�;if: �.a
`.3 .k l
_ <_ a^-`aY�?-�..: ii'" w.--+" ��',
X' r' t»-•ice;. 1
.:t
_•
✓- • s-�•_-_
-<. �54��.u�."-. ��!
� t: i,•�5�. �-., � �i
t - % T'il, t1.:•e="F
�¢.r ..�.:,.Tt... �.,. •T_�
f AS��.iw ' �sf,.,.• %`."� '
rE•"=.-[7a.:- I ' � �v` V"` =_
i�'i' t-'-4=d.�-1`',�1
�`I � �tiT`�ry 4#
z
�': `-w"r, i,- , �.: � _ �S
£1 fr YY • - �'� �� , �+'�
q..c � � -
05114112012
068
6 1
6 4
ND
----
03
Last Devised 7-1-2010

I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel property gather and
evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons 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 I
Mall Annual DMR Summary Reports to:
DWQ Ropional Office Contact Information-
AsheWle Office
Fayetteville Office
Mooresviile Office
Raleigh Office
Washington Office
Wilmington Office
Winston-Salem
Central Office
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
[phone]
ASHEVILLE REGIONAL OFFICE
`FAXETTEVILI,E REGIONAL OFFICE'
MOORESVILLE REGIONAL OFFICE
i 2090 US Highway 70
` 225 Green Street
610 Bast Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville NC 28115
[phone]
i Fayetteville, NC 28301-5043
[phone]
[phone]
WII.,MI. NAL OFFICE
NGTON REGIO
1__R_-�.__ _._-.-_�_____ L_0___
RAI,E[GH EZw:GIUNAL OFFICE
—W_ �—.—__
� WASHINGTON 12EGIONAI.OFFICE
3800 Bariett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raletgh, NC 27609
I Washington, NC 27889
Wilmington NC 28405-2845
[phone]
[phone] 1
[phone]
WINSTON-SALEM REGIONAL I
- - - CENTRAL Ofr'FICR - - - _ '
OFFICE `
1617 Mail Service Center
585 Waughtown Street #
Raleigh, NC 27699-1617
Winston-Salem, NC 27107
[phone]
[phone]
l
"To Pteserve grotery
and enhance
Norlh ("a(oflniss S iVdiEr
Last Revised 7-1-2010

RKEIVED
N C De;� of ENR
NOV 1 � 2012
STORMWATER DISCHARGE OUTFALL (SDO)walem
Reyston-Sornai Ofrtoe
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year ).Qt I
General Permft No. NCG160000
Certificate of Coverage No. NGG 1 fi0ID0ID❑
This monitodng deport summary is dua to the DW O Regional Office no later than 30 days from the date
the facility receives laboratory sampling results from the Met sample of the calendar year.
Facility Name: Li e&nOnj
County ig f
Phone Number: i33 b 1;
Total no. of SDOs monitored
o u fall No. i
is this outfall currently In Tier 2 (monitored monthly)? Yes ❑ No [!f
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No [y
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 DWQ to reduce monitoring frequency ❑
Other ❑
5WU-25ONCG16-051709

"1 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 ingtdry of the person or persons who manage the system, or
those persons directly responsible for gathermg the information, the information submitted is, to the hest of my
knowledge and belief, true, accurate, and complete. l am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature
Date i 1
Mai! Annual DMR Summary Reports tot
DWQ Redbnal Office Contact triforrwAon:
Asheville Office... .. (828) 2964500
FayetteAle Office ...
[phone]
Mocresw"fle Office ...
[phone]
Raleigh Office .......
(919) 791-42M
Washington Office
...(252) 946-Ml
Wilmington Offer ..
[phone]
Winston-Salem . _
[phone]
f: entr-W Office .....
..(919) 807-63M
ASHEVIl3;E_;Itt3C�IONAi.�� ta'AYE'�1'EV1L � 10 AL�OF�IGE i13O�0iRk�V�I3U&REGIUNAI:�IF'�ICI?'J.
2090 US Highway 70 225 Green Street +Sl 0 East Center AveriuelSuite 301
E Swannanoa, NC 2877$ ► SystelBuilding Suite 714 Mooresville, NC 28115
j [phone] Fayetteville, NC 28301-5043 [phone]
[phone]
RALEtCHiR>IiHAI! GE J WA5E3NCT7N,iONhCF,1C: wt[,MINGTON7�[�[�ION�AL�(iFi±[CF.
3800 Barrett Drive ! 943 Washington Square Mall 127 Cardinal Drive Extension
Raleigh, NC 27609 Washington, NC 27889 Wilmington, NC 28405-2845
[phone] [phone] [phone]
1W- 1 '! ON=SA F fH'.REGl 3NALT - V AL C1
1617 Mali Service Center
*To
585 Waughtown Street Raleigh, NC 27699-1617 an enhanm
Winston-Salem, NC 27107 [phone]
[phone]
SWU-25ONCG16-051709

x qe k °B RR
VE1" A 5 2a
STORMWATER DISCHARGE OUTFALL (SOO) ash
ANNUAL SUMMARY DATA MONITORING REPORT (D)----
Catendar Year oZflf�
General Permit No. NCG160000
Certificate of Coverage No. NCG 1 fiOQL�]®❑
This monitoring report summary is due to the DWQ Reglonal Office no later than 30 days from the date
the facility receives laboratory sampling results from the final sample of the calendar year
Facility Nam a-Ebv"o'-i /� `-�tiA-�- T, LL C — Aec',/Ae�t R—"'wT
County: H/r z-
Phone Number: (33,6) �3 r1 1 Total no. of SDOs monitored
outfali No. I
Is this outtall currently in Tier 2 (monitored monthly)? Yes ❑ No [j�
Was this outkdl ever in Tier 2 (monitored monthly) during the past year's Yes ❑ - No [9
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 DWQ to reduce monitoring frequency ❑
Other ❑
SWU-25ONCG16-051709

"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 quarrWd 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 resporoble for gathering the mformabon, the information submitted is, to the best of my
knowiedge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of tines and imprisonment for knowing violations."
Signature -h) • "'�r'—"j
Date Z/ 9 f z o
Mail Annual DMR Summary Reports to:
DWO Rmlonal Office Contarf lnfor nation:
Asheville Office .....
[phone]
FayeitMle Office ...
[phone]
Moaresvflle Office..
(704) 663-IlW9
Rak4gh Office .....
[phone]
Washvngton Office ...[phone]
Wilmington Office ...
(910) 79&-7215
Winston-Salem _....
[phone]
Central Otfre .. .[phone]
i
2090 US Highway 70
Swannanoa, NC 28778
[phone]
3800 Barnett Drive
Raleigh, NC 27609
[phone]
-225-Green Street
Syitel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
943 Washington Square Mall
Washington, NC 27889
(252) 946-W I
610 East Center Avedue/Suite 301
Mooresville, NC 28115
[phone]
127 Cardinal Drive Extension
Wilmmgtfln, NC 28405-2845
[phone]
11'IIriS`7'QN�;�SAI{_L1G�±R_LG1�3NA1� fv�'1,1i.��1
t ?f R 1617 Mail Service Center --to Pme ve, PrWear
585 Waughtown Street Raleigh, INC 27699-1617 ;`� srid enhance
Winston-Salem, NC 27107 [phone] ith t.ern6rak ua►Qr
[phone]
SWU-25CNCG16-051709

' RECEIVED
N C Dent at EMR
STORMWATER DISCHARGE OUTFALL (SDO) MAR n 20)1
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) w Sail
Calendar Year 2010 t RF
General Permit No NCG160000
Certificate of Coverage No NCG160133
This monitoring report summary is due to the OWQ Regional Office no later than 30 days from the date
the facility receives laboratory sampling results from the final sample of the calendar year.
Facility Name W L Construction & Paving, Inc, Plant #26 (4318) Pelham, NC
County Caswell
Phone Number [phone]
Outfall No. 001
Total no of SDOs monitored 1
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 consecubve samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Yes ❑ No
Yes ❑ No
E
00530
+00400 i
JD0656
Vehicle
Maintenance
,Activities
Oil g,
1New!Motovoil
j (Dutfalll=
TotallRainfalkiinches
11
TSS,,mglt-
IpH,ssw
'Grease,
img/!
Osage,
gallmonth
lBenchmw*
11 IWA
,too
{6:0 - six f
30 4
/ V/A i
Date 1Collected,
S
09/27/2010 1 26.8 6.5 ND NA
SWLJ-25ONCG 16-051709

I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel property gather and
evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons 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 a^fig — L(
Mail Annual DMR Summary Reports to:
DWQ Renional Office Contact Information:
Asheville Office
[phone]
Fayetteville Office
[phone]
Mooresville Office
[phone]
Raleigh Office
[phone]
Washington Office
[phone]
Wilmington Office
[phone]
Winston-Salem
[phone]
Central Office
[phone]
�ASHM, LE +REGIONALOF'FICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
AYETTEWLEE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
ll AUEIGHREGIONAUOFFICE W.
3800 Barrett Drive
Raleigh, NC 27609
(919) 7914200
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
943 Washington Square Mall
Washington, NC 27889
[phone]
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
'MOORESVILL ;REGIONALFOFFICI
610 Fast Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
W[L'MINGTONIR_ EGIONAIE.,OF,F3CE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
"7o pte°serve pmfect '
and enhance i
ftith Cambna s vi"r
SVVU-250NCG 16-051709

11
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins Dee Freeman
Governor Director Secretary
October 25, 2010
Ms Lori, Carter, Division Environmental Representative
APAC-Atlantic, Inc — Thompson -Arthur Division
Post Office Box 21088
Greensboro, North Carolina 27420
Subject. General Stormwater Permit Inspection — NPDES Permit No. NCG160133
APAC-Atlantic, Inc M-L Construction, Pelham Plant — Caswell County
Dear Ms Carter
On October 19, 2010, Jenny Graznak of this office performed a Stormwater Permit
Inspection at the APAC-Atlantic, Inc /W-L Construction Asphalt Plant located at 1675 Rock
Quarry Road in Pelham, North Carolina This facility holds General Stormwater Permit No
NCG160133 under the National Pollutant Discharge Elimination System (NPDES) to discharge
stormwater from activities associated with Asphalt Paving Mixtures and Blocks You, Rick
Holland (Plant Manager) and Neal Echols (Plant Foreman) were present for the inspection
This type of inspection consists of two basic parts a review of facility files and self -monitoring
data and an inspection of the facility's storage areas and discharge points This particular
inspection evaluated five (5) areas, and observations from each area are addressed below
1 Permit
The permit became effective October 1, 2009 and expires September 30, 2014
2 Records/Reports
As required by the Permit, the facility has a Stormwater Pollution Prevention Plan (SPPP) that
was available for review during the inspection Engineering Consulting Services, Ltd
(Greensboro) created the SPPP Falcon Engineering is working to prepare a new updated
SPPP for the site, in order to comply with the new permit requirements and address recent
changes at the site
3Effluent/Receiving Waters
Stormwater from the property discharges to Dan River (Class C) in the Roanoke River Basin
4 _Facility Site Review
A large portion of the site is used for aggregate storage The site has several aboveground
storage tanks (with secondary containment) for diesel fuel, hot oil, industnal fuel, and hydraulic
oil The site has two outfalls Ouifall 001 discharges from a large sediment basin at the outer
edge of the property The basin was mostly dry on the day of the inspection and very little
discharge was noted Outfall 002 discharges from a smaller sediment basin and is located
below the Recycled Asphalt Product (RAP) pile on the property Paths were clear to both
outfalls
North Carolina Dnrtsion of Water Quality, Winston-Salem Regional Office
Location 585 Waughtown St Winston-Salem, North Carolina 27107
Phone [phone] ti FAX [phone] Customer Service 1-877-623-6748
Internet www ncwaterquality org
An Equal Opportunity l Affirmative Achon Employer
NonrthCarolina
;Vatumlly

5 Self -Monitoring Program
Pace Analytical performs the analytical monitoring for the facility Monitoring was performed on
March 12, 2010 and September 27, 2010 Results have not been received yet from the
latest sampling event. Please forward these to our office upon receipt Currently, Pace
Analytical is performing the pH analysis for the plant, but the site will be receiving a pH meter
and training on meter use by the end of the year A rain gauge is maintained at the facility, and
the rainfall data is stored in the control room Qualitative monitoring is also performed on a
semi-annual basis These inspection reports were available for review during the inspection
On -site vehicle maintenance monitoring requirements at the site are waived, since these
activities are performed off -site
If you have any questions concerning this letter or the attached inspection report, please
contact Ms Graznak or me at [phone]
Sincerely,
Steve W Tedder
Regional Supervisor
Surface Water Protection Section
cc WSRO;SWP
V
Central Files — SWP

I
Permit NCG160133
SOC
County Caswell
Region Winston-Salem
Compliance Inspection Report
Effective 10/01/09 Expiration 09/30/14 Owner W-L Construction & Paving Inc
Effective Expiration Facility L Construction & Paving, Inc -Asphalt
Plant # 4318
1675 Quarry Rd
Contact Person Neal Echc s Title
Directions to Facility 382 52
System Classifications
Pelham NC 27311
Phone [phone]
Primary ORC Certification Phone
Secondary ORC(s)
On -Site Representative(s)
On -site representative Lon Carter ) iv Phone [phone]
Related Permits
Inspection Date 1011912010 EntryTime 10 00 AM Exit Time 11 15 AM
Primary Inspector Jennifer F Graznak Phone [phone]
Secondary Inspector(s)
Reason for Inspection Routine Inspection Type Compliance Evaluation
Permit Inspection Type Asphalt Paving Mixture Stormwater Discharge COC
Facility Status ■ Compliant n Not Compliant
Question Areas
E Storm Water
(See attachment summary)
Page 1

�
Permit NCG160133 Owner - Facility W-♦. Construction & Paving Inc
Inspection Date 1011912010 Inspection Type Compliance Evaluation Reason for Visit Routine
Stormwater Pollution Prevention Plan Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
■ n n
# Does the Plan include a General Location (USGS) map?
■ n n
n
# Does the Plan include a "Narrative Description of Practices"?
■ n n
n
# Does the Plan include a detailed site map including outfall locations and drainage areas?
■ n n
n
# Does the Plan include a list of significant spills occurring during the past 3 years?
n ■ n
n
# Has the facility evaluated feasible alternatives to current practices?
■ n n
n
# Does the facility provide all necessary secondary containment?
■ n n
n
# Does the Plan Include a BMP summary?
■ n n
Q
# Does the Plan Include a Spill Prevention and Response Plan (SPRP)?
■ n n
n
# Does the Plan Include a Preventative Maintenance and Good Housekeeping Plan
■ 0 n
n
# Does the facility provide and document Employee Training?
■ n n
In
# Does the Plan include a list of Responsible Party(s)?
■ n n
n
# Is the Plan reviewed and updated annually?
n ■ n
n
# Does the Plan include a Stormwater Facility Inspection Program?
■ n n
n
Has the Stormwater Pollution Prevention Plan been implemented?
■ n n
n
Comment Falcon Engineering is working to prepare a new updated SPPP for the site,
in order to comply with the new permit requirements and address recent changes at the
site
Qualitative Monitoring
Yes No NA
NE
Has the facility conducted its Qualitative Monitoring semi-annually?
■ n n
n
Comment
Analytical Monitoring
Yes No NA
NE
Has the facility conducted its Analytical morntonng?
■ n n
n
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
n n ■
❑
Comment Results have not been received yet from the latest sampling event Please
forward these to our office upon receipt
Permit and Outfalls
Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site?
■ n n
n
# Were all outfalls observed during the inspection
■ n n
n
# If the facility has representative outfall status, is it properly documented by the Division?
n ❑ ■
# Has the facility evaluated all illicit (non stormwater) discharges?
■ n n
n
Page 3

N
0.
19
N
to
M
M
0.
Id7
v
0
0
ti
N
0
STORMWATFR nISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF (OVERAGE NO NCG 160 133
FACILITY NAME APAC Atlantic, Inc, Plant # 26 (0431$)
PERSON COLLECTING SAMPLE(S) Kenneth N Fcholq
ultl ll•IED LABORATORV(S) Pace Anal teal Lob 0 40
Lab #
Monitoring Requircmenti
SAMPLF—% COLLECTED DURING THY CAIRNDAR VFAIt 7010
(This monitoring report shall be received by the DIVISton no later than 30 days frorr
the date the fainiq recteves the Sdmphng resuhS from the laboratory)
COUNTY Caswell County_
PIIONE NO (336) 3RR-95R1
Outfall
No
Date
5awplc Collet led,
molddlyr
'total Rainfall,
Inches
aasaa
ounn
00556
Loral Suspended Solids, mull
pH,
Standard Unit*
Iolal Verroteutn hydrocarbons, mgli
I?PA Method 1664 SGT--HEM
B¢nehsnarkl
-
too
Within 6 0- 9 A
I5
1
41a712010
1
258
65
NO
1 If a value is in excess of the benchmark, or outside the benchmark range (for PH), you must implement the Ticr I or I itir 2 rmponses in the Gencral Permit
Mali Origival and une copy to
Division al Water Qualuy
Alto Ceow d File%
1617 Mad Servicc (_Llil[i
Raleigh North Carahnu 27699-1617
YOU MUST SIGIN TIIfS CFRI IFICATION FOR ANI INFROMATION RRPORTED
"I certify, under penalty of law, that this dncurnenl nnll 011 attnchmtnts were prepared under mi direction or iuperwslnn in areardance with a %ymem designrd to xsswre thitt qu.thfird personnel
properly gather and evaluate Itic information submitted Bated on my Inquiry of the Pei son or ptrsnnc who manage the systm, or those persons dirrctly responsibe for gathering the informsnan,
the ►nformstion submined is, to the best of m% knowledge and belief, Iruc, accurate, and complete I am aware that there are significant penalties for submitting false inrormatton, including the
possibilih of Pncs and imprisionmeul for knowing vinfatlon6 "
(Signature of Permfltec)
(slate)
Form SWU-253.051409
Page t of t

Uct 2 r 1 U U4 bbp Lori Carter
J,Ifj-412-blbI p 1
THDmARTDHUIt Safety Fimt,4&04V
An Equal Opportunity Employer
Thompson -Arthur Division
APAC-Atiantic, Inc.
P. 0 Box 21088
Greensboro, NC 27420
[phone] Main
FAX: [phone] - Main
[phone] - Estimating
[phone] - Shop
[phone] - T&A Trucking
[phone] - QMS Lab
[phone] - Executive
[phone] - Human Resource
[phone] - Accounts Payable
FAX TRANSMISSION COVER SHEET
Date: 10 ~r -)-10
From: Ln Cb_41-
Ta:
Fax:
Re:
336 q(. 30
Wkc_�`�
YOU SHOULD RECEIVE a PAGE(S), INCLUDING THIS COVER SHEET. IF YOU DO
NOT RECEIVE ALL OF THE PAGES, PLEASE CALL [phone].
NOTICE OF CONFIDENTIALITY
THIS FACSIMILE MAY CONTAIN INFORMATION THAT IS PRIVILEGED AND CONFIDENTIAL AND/OR EXEMPT
FROM DISCLOSURE UNDER APPLICABLE LAW_ THIS TRANSMISSION IS INTENDED SOLELY FOR THE INDIVIDUAL
OR ENTITY DESIGNATED ABOVE. IF YOU ARE NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT
RESPONSIBLE FOR DELIVERING IT TO THE INTENDED RECIPIENT, YOU SHOULD UNDERSTAND Ti1AT ANY
DISTRIBUTION. COPYING OR USE OF THE INFORMATION CONTAINED IN THIS FACSIMILE BY ANYONE OTHER
THAN THE DESIGNATED RECIPIENT IS UNAUTHORIZED AND STRICTLY MHIBITED IF YOU HAVE RECEIVED
THIS FACSIMILE IN ERROR, PLEASE IMMEDIATLEY NOTIFY THE SENDER BY TELEPHONE

C
Permit NCG160133
SOC
County Caswell
Region Winston-Salem
Compliance Inspection Report
Effective 10J02114 Expiration 09/30119 Owner Piedmont Asphalt LLC
Effective Expiration Facility P�edment Asphalt LLC - Pelham Plant
1675 Quarry Rd
Contact Person Steven Ashworth Title
Directions to Facility
System Classifications
Primary ORC
Secondary ORC(s)
On -Site Representative(s)
Related Permits
Inspection Date 05119/2017 Entry Time 11 OOAM
Primary Inspector Paul Williams
Secondary Inspector(s)
Pelham NC 27311
Phone [phone]
Certification Phone
Exit Time 11 45AM
Phone [phone]
Reason for Inspection Routine Inspection Type Compliance Evaluation
Permit Inspection Type Asphalt Paving Mixture Sterrnwater Discharge COC
Facility Status Compliant 61 Not Compliant
Question Areas
Storm Water
(See attachment summary)
Page 1

permit. NGG160133 Owner - Facility Piedmont Asphalt LLC
Inspection Date 05/19/2017 Inspection Type Compliance Evaluation Reason for Visit Routine
Inspection Summary
Intake area associated with outfall #2 (Recycled Asphalt Product - RAP area)was observed not to have any type of sediment
trap/filter associated with it Mr Williams informed Mr Douglas Dawson, General Manager, and Mr Carl Mitchell, Plant
Operator, that this should be corrected ASAP
Page 2

Permit NCG160133 Owner - Facility piedmont Asphalt LLC
Inspection Date 0511912017 Inspection Type Compliance Evaluation Reason for Visit Routine
Stormwater Pollution Prevention Plan
Does the site have a Stormwater Pollution Prevention Plan?
# Does the Plan include a General Location (USGS) map?
# Does the Plan include a "Narrative Description of Practices"?
# Does the Plan include a detailed site map including outfall locations and drainage areas?
# Does the Plan include a list of significant spills occurring during the past 3 years?
# Has the facility evaluated feasible alternatives to current practices?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan
# Does the facility provide and document Employee Training?
# Does the Plan include a list of Responsible Party(s)7
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment SPPP dated 1/23/2014 Most recent employee tratning-dated 3/14/2017
Yes No NA NE
■❑❑❑
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
❑ ❑ E ❑
■❑❑❑
■❑❑❑
■❑❑❑
❑ ❑ ❑
E ❑ ❑ ❑
■❑❑❑
■❑❑❑
❑ ❑ ❑
■❑❑❑
■❑❑❑
Qualitative Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? 0 ❑ ❑ ❑
Comment Most recent qualitative monitonng performed on January 9, 2017 and May 8, 2017, respectively
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? 0 ❑ ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ❑ 0 ❑
Comment Most recent analytical monitoring performed on June 15, 2016 and November 29, 2016,
respectively Vehicle maintenance is performed offsite
Permit and Outfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? ■ ❑ ❑ ❑
# Were all outfalls observed during the inspection? 0 ❑ ❑ ❑
# If the facility has representative outfall status, is it property documented by the Division? ❑ ❑ 0 ❑
# Has the facility evaluated all illicit (non stormwater) discharges? 011110
Comment Facility does maintain a rain gauge onsite
Page 3