NCG080142_MONITORING INFO_20170119

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/VC�v�jOJ(,�a
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
CERTIFICATE OF COVERAGE NO. NCGO80142
FACILITY NAME Sueedwav Truck Maintenance Facilit
COUNTY Forsyth County
PERSON COLLECTING SAMPLES
LABORATORY ESC Lab Cert. # 375
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2016
SAMPLE PERIOD ❑ Jan -June ® July -Dec
SR or ❑ Monthly' _ (month)
d EC 1 6� tONG TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
BAN 2Q1� []zero -flow [:]water Supply ❑SA
®Other Class C; NSW
CENTRAL FILES
D" SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pk,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 60 - 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
.mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L :.
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 0.0
Outfall No. 1
12/31/2016
No Sample
No Sample
No Sample
Outfall No. 2
12/31/2016
No Sample
No Sample
No Sample
Outfall No. 3
12/31/2016
No Sample
No Sample
No Sample
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April I I, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date NA (first event sampled)
Total Event Precipitation (inches): NA
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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.
FOR PART AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 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 DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days_ of recent of lab results (or at end of monitoring period in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly 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 Permittee) (Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
SWU-250 last revised April 11, 2013
Page 2 of 2

r Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080A)*
Z,4,
Date submitted 3/17/16
CERTIFICATE OF COVERAGE NO. NCGO80142
FACILITY NAME A.T. Williams Oil Company University Parkway
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R & A Lab Cert. t# 34 Comments on sample collection or
analysis:
( r%
* 0jo 1,0
SAMPLE PERIOD X Jan -June July -Dec
or Monthly'
RECE RGING TO CLASS ❑ORW ❑HQW [:]Trout
❑PNA
MAR 21 2016 ❑zero -flow ❑Water Supply ❑SA
Other C
CENTRAL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
SAMPLE COLLECTION YEAR 2016
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _x_ yes
(if yes, report your analytical results in the table immediately below) -
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
no
❑ No discharge this period'
Outfall
No - �:
y
Date'`
4Sample Collected,
Imo/cid/yr n
0053U
x` 00400
00556
'TotallSuspended , _
Solyds,:mg/L '
P
'�tandaa�unrts "„
5 (_
on N=;066 bii and Grease/TPH EPA'
k 'Method=1664 S_GT-WEMm L�
( ),1 _!a/
Ne+nr�,Moto.r,oil Usa e :
Annual a�era a al mo ;
g ;g. _/ .
B n limah��
�..
Y' .�`i. 100'
"Wit hin�6
SDO ##1
1/15/16
36.8
8.1
<5.0
>55
SDO ##2
1/15/16
34.2
8.4
<5.0
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
OutfallDate
-s�r°_�
� Sample Collected,
tmod/Yr;:
- OQ556 }�
00530,E _
G_OU400-
•vx�u
Non Polar—bil4Aa Grease%TPH:EPA Method
�51 --- - -.i_
"` rt .1664:.(SG,THEM),,mg/�
-rev - r v a o-s�a..,.
Total 5uspende ISolyds,
gyp^ pH,
Standard units by
€Permit Lrmrt;
` ti
fir.e15_�
50or 100'see permrt�
x 6g0�9 0"
r For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
s
Date: 01/15/16 (first event sampled)
Total Event Precipitation (inches):.79
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES NO X
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 o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly 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."
-A
Lynne Hays for A.T. Williams Oil Cosh an S eedwa
(Signature of Permittee)
03 17 16
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 9/1/15
CERTIFICATE OF COVERAGE NO. NCGO80142
FACILITY NAME A.T. Williams Oil Company University Parkway
COUNTY Forsyth
SAMPLE COLLECTION YEAR 2013
SAMPLE PERIOD Jan -June x July -Dec
RECEIVED or Monthly" (month)
PERSON COLLECTING SAMPLES Lynne Hays DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout
SEP Q 3 201
LABORATORY R & A Lab Cert. # 34 Comments on sample collection or
analysis: CENTRAL FILES
DWR SEF3N
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑Zero -flow ❑Water Supply
Other C
❑PNA
❑SA
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
motor(tl ger,month?" x yes _no
No dischorge this period'
Outfall
No.
= . .
Date
Sample Collected,
mo/dd/yr
00530
00460
00556
Total Suspended: -
' Solids, mg/L ` : -.
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT=HEM), mg/L
-New Motor'Oil Usage;, ,
Annual average_gal/mo'
.Benchmark.
10.0
Within 6.d--9.0
15
-
SDO #1
8/10/15
6.8
6.9
<5.0
>55
SRO #2
8/10/15
<7.14
6.4
<5.0
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
T Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
. 1664-(SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit1imlt
-
-15
50 or 100 see,,.permit
6.0 — 9.0
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-2-50 last revised April 11. 2013
Pare I of 2

STORM EVE;IT CHARACTERISTICS:
Date: 08/10/15 (first event sampled)
Total Event Precipitation (inches): 1.02
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NO n
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 manitarinq period in
the case of "No Discharge" reports to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly 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."
Lynne Hays for A.T. Williams Oil Company
(Signature of Permittee)
09 1 15
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web//wq/ws/su/npdesswtttab-4
SWU-250
lasl revised April l l . 2013
Page 2 of 2

EnviroLinc
Environmental Compliance Solutions
September 1, 2015
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Stormwater Discharge Outfall Monitoring Report
A.T. Williams Oil Company General Permit Number NCCY080000 Y)C&-c D G
C)
Please find enclosed the Stormwater Discharge Outfall Monitoring Report for A.T.
Williams/WilcoHess site located at 5446 University Park%vay in Wl'nston- Sale III, North
Carolina (Home Office). If you have any questions please feel free to contact us at (336)
687-2256.
Yours truly,
�Iml of
Lynne Hays
Y y
109 Gentle Pond Court • Winston Salem, NC 27107 • Phone: [phone] Fax: [phone]

Semi-annual Stormwater Discharge Monitoring Re ort
for North Carolina Division of Water Quality General Perm1&7 8000.00
Date submitted 2/13/15
CERTIFICATE OF COVERAGE NO. NCG080142 SAMPLE COLLECTION YEAR 2013
FACILITY NAME A.T. Williams Oil Company University Parkway SAMPLE PERIOD x Jan -June July -Dec
COUNTY Forsyth or Monthly' month
PERSON COLLECTING SAMPLES Lynne Hays ®ECEIQ DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY R & A Lab Cert. # 34 Comments on sample collection or ❑Zero -flow ❑Water Supply ❑SA
analysis: FEB 16 �,; Other C
—ENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _x_ yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
rk ' > ,Date;O[�530
g. ;ti00400�
W4,
�.
'
Sam Ie Goilected y
' Total�Sus ended .�+'?
,;,, ;CFI . `°
I?„_ �T ::
,t/
R� Norr=Polar0il'and Gcea a TPFIEPA
Y /
New Motor.OiE«UsA6,
o/dd/Yra', N
Solids m' L� ..
;StandardunitsIVlethod1664
(SG].eHEM};mg/�i-°
average gal/
` .-•
,Annual
Ji�'ys- �.t'.r.`:
4Benclimarkf�
oK'
gta t!'
i`.' tl
..V11 i n6
n nYa .
t
€k 15�
-
` ' : -
SDO #1
` 1/23/15
38.4
7.8
6.10
>55
SDO #2
`1/23/15
40.0
7.6
<5.0
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
3 ,
Outfall
No -:
_
Date
Sample?�Collected,
ter_ .r00530x
00556�; >
r=____�g
-., 00_400 _ r:
"Non Pillar Oil,and;Grease%TPH EPA Methotlr
1664(SG�_IVI};:mg/�L` �Rxmg/L
=;Total SuspendedFSvlid"s ,
T ' pH,
Y:. Standard units
FRer,mit
90
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
t
fa'late: 01/23/15 (first event sampled)
Total Event Precipitation (inches):.46
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier z, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? 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 Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly 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."
k
Lynne Hays for A.T. Williams Oil Comps 02 13 15
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250 last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 8/12/14
CERTIFICATE OF COVERAGE NO:-NCG080142
FACILITY NAME A.T. Williams Oil Company University Parkway
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R & A Lab Cert. # 34 Comments on sample collection or
analysis:
SAMPLE COLLECTION YEAR 2013
SAMPLE PERIOD Jan -June x July -Dec
R����� jKPARGING
or x Monthlyl (month)
�j TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
AUG 15 NIA ❑Zero -flow ❑Water Supply [:]SA
Other C
CEDWQIBOGFILES
PLEASE REMEMBER TO SIGN ON THE REVERSE
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _x_ yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period
0utfall
6=;` "4Dafe°
'00530
00400
00556
`Sample Collected,
Total•Suspended� :
pH, �;. "
:, No,n-PolarOd and GreaseftPH'EPA
New Motor%Oif.Usage, ..
r=
�s�mo/d'd/yr
` Solids,,mg/L�
"Standard units `
IVlethod=1664 ($GT-HEM);;mg/,L
averag gal/mo.
;;
,'Annual
Benchmark:
., ` -
, WithinY6 0 69:_0
_ H
--100�� ,'_
SDO #1
7/24/14
4.33
7.2
<5.0
>55
SDO #2
7/24/14
9.0
5.5
<5.0
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfa l l4 �. ,
. No a
Date t� 7 �,�
ti-.
Sampl Collected,
Y rt.
s. -�4 Y._
,..,.� . a' : a., 005567 �:�,�-.F� `�'
.... __. l_,t
4•. _ fir^ '2..
r.0il d Grea PHEPA t�TotalSus
Non=Pula ;an se/T Methodi
16fi4SGT-H_ EM /Lr;m
(_ } g
�� p 'ended�5olids;. Slow
F L+mo/hdd%
g /L
S_tandard�units'
�.v _ �Y
aP,ermitLimit
�; n
".
"3 fil. M :�„'� �5�' uy �
._� :v#Ar...< 35 '?`�
�r'�_ �sxs�x>�^<
50.,or 100 see=
ice.+t -� t _- perrr�it�,
� �
6.a,9 0>.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April t 1, 2013
face 1 of 2

STORM EVENT CHARACTERISTICS:
Date: 07/24/14 (first event sampled)
Total Event Precipitation (inches):.16
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? 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 Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly 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."
4� 14-
Lynne Hays for A.T. Williams Oil Company 0$ 12 14
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr,org/web/wq/ws/su/npdessw#tab-4
SWU-250 last revised April 11, 2013
Page 2of2

!
�•1 r I1 \�.�Z��• :S �.�"•� 7j1 `� _c��. „ �* Q �' ems\. � .° I 1 � i /T•` 1,,�•��•
N� ot� 1,. \1/I ,/) �� : � �rl; �� f t � � o I t ' �h` ' �' y r \ � \.• 1 �� I'=_ I
If
1/ / � ;'•�,� (si(f �r - ^,'��I C.OUf� �.J° �J.(!ir [[[� =- ��/,L-�.� 0 �., ° ` I oC ur a
/,`.1 ' !tl� I' , HOf1! r \•t` 1` i\\\+� / gy �:
_:�• �'� r l— — _ � �.\�� �,�� � � fir% ilk_ �� / 8 � � � 1 ��, � _ _ ri' � �°,r. ' � '� •Z�
L' •� � __- y- +.I/ � � S ilk'' �` \ �/"�� � � � i�•� \�f b �iY - � "`\ \
W'
80
a k1 ���� 9��%`�`- `l� ��_ fi �\r�,��.\o• \ 1 % i � 'tom � � � � °, ��r�� / (`, ���,'�``
pip;:;f`, ;ti,,� s27�ec iJ
�1 "�`I� � r � ...,,1�..���,G .�rl-'--\ 'r' _ ' �ii � ,' L �,N tY � 1 • , � I. t , r• ' --'%ti : d -i.-,: _f,� II (/ "' • r �' • /� k
�,. %(r •�r,`'/• ; , ' MO r Tl"1 7 I / ', . �� � 1�1 ''pe�i,,. �ry+-• � .1 �`'��•'f �•�� t� _
I�:��✓, '�r,�: j�! :1�" �''�•, athfania
Stat#on 1 A�� 1 i ' �� '1 �� Jai/ -{, ✓ i, �� `�/
..f � F�4- � y C1 CS st r�,. � � L- r �/ (• ;j" `��, :�• r� r 7 1� .l.
•\ •�. �/ !�. �'4:� r;• \��° J � �i � /. �j\ � ��� o� t:; / FCt7�0
}� I � ll J.\ J � ���'�-�_•� o I � m 0� Sri �': � i k 1'" .e i _� `i 3f� ''��/
{� I,. - :! �� ��r.J�\�J' `• I�.'� +' ti � ,� i ��' L t�` ���:���..� I � I v� /r% 9 d"���`_�'�• 7
't( } 14 � : � -;-'47 ti�.. •^�.� R +/(. ..�--:. _ .. r j\/ •' .� � r i � � I r � �, 1 -e�>~�� � � _i1 /� //!' `;o \'•\ �\�i'�
J 1 � �� �1 L.•Av•V�� � I%r�� �-� ��_"p � i�/� \ .� /`�• '�I• � i j:1�; �' �:L�,�il�: - A� �A� �� �,�
��\\1���'^-. ��� �._'Y�'. /i `• i,� � ��fl ��( i14 ,n1' ��S}r� `�•lr1 '�'��1�1�1 •,1 .�
111 Imo. h �' �r /-� ---, � � �� �� fl r� � 1 \ �.� � •• � V �� ,, �� ,� t
r' •� , " �r-�i� ��//r• ��\5 ����� I�' 4 jI'\' \�ji1 ��1 Z��\�a �� rr�rf�'f� ,/•� ! �\
:y�: r• `},;1� �''.�(- :-� ; �`1 ` �. r•`� J . T, ' 'mil '' ' I /•:��\ l 1,7
r I �� ,,,, •, .. • Imo/
I U;` � i � ' ! ��J. •'• ,t J���' � �I' �i ��� '� C �I\
.,`--�� � / 5 \\1 11 i 4`. ty�f •r .��r��,I i � aA,. �}r �•.AI� , /,�_1�,.• �. l•=t
> _ ,`��� bars ! f `� o ( .• ryrr •. ti T"�� `ry' '< z s r{{/ v .� ��
.!� fh' • �I i� !� �oJ1,,� J�) •.r �w4f ,I� '��.1 ,� r�\� oy /iJ) e/
,nj,(�I
Da
IL
�^ �, o�� Q,��r •�o� �U' �;�1 1%� - '// �1�\ID'1 98811®i �L'3,. }
IL

FACILITY 0-ti co
COUNTY FO
NPDES NGGOt,-.,
DS FLOW NIA
�Ah-SUB
ox
Co' 21 �
REi; STREAM . 1 C (LY- oY
CLASS C
DiSCHi"'l `bGE TYPE 5VJ
EXPIRATION DATE 5131+q"1