NCG140167_MONITORING INFO_20190415

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV C& / y bf 7
DOC TYPE
Cl HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ nhI � loy f
YYYYMMDD

PROC 'SS AS'TEWATER — Quarterly Discharge Monitoring Re r- .
Ujt tKAL FLKI II1 NO. N9_G14000U
CERTIFICATE OF COVERAGE NO. NCG144 d If� r7
FACILITY DAME: iP k $'QS 2e 0,_-
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY:?,,-,. tico(i�5t,10,mt-1 Lab#
- Lab # ^�
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
APR ag 2015
CENTRAL Fl E<_
SAMPLE COLLECTION YEAR: AO 19�F-UTj� `
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec YJan-March []April -.tune
COUNTY: 97-O iZs t -H J=
PHONE NO. Qaij ""Is' s
ADD TO LISTSERVP ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑trout ❑Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
VE, RM, MD)'
( 1
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 664A
i
SGt-Hse
Duration Discharge
(minutes]
Total Flow
y
(gallons/day}
-
-
6-93,4
�a35
53-
i
(, I
r"
�3
119311
: Q4 D
RE C
i 1,r
CENT i
el FIt re
DVVR S"CTION
f
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (Rltll), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.,
pH limits are 6-9 S,U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 rng/L for all other water classifications.
Permit Date:7/1/zo10-06/3o/2015
Date of last pH meter calibration: _ -3
Last Revised 07/13/11
Page 1 of z

Process wastewater discharges shall only be monitored forTPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. if the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE gQPX OF THI ANNUAL UM ARY INCLUDING AU "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS F RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFIOTION FOR AIyYWWRMATIOhI 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
V-0e
(pate)
Permit Date: 7/1/2010-06/30/2D15 Last Revised 07/13/11
Page 2 of 2

f.
KESEARCh & Ar4AiYIriCA .
o°o LAORATORiES' INCa
400
For: Ready Mixed Concrete Company (Williamson)
1590 Williamson Street
Winston-Salem, NC 27107
Attn: Danny Rathbone
Report of Analysis
4/2/2019
u7:p'r O
'rq NC #34 Z; .
s NC tt37701
Client Sample ID: 1-6239 Lab Sample ID: 64556-01
Site: Ready Mixed Concrete Collection Date: 3/26/2019 7:30
Parameter Method. Result- Units - Rea Limit Analyst Analysis Datefflme .
pH SM 4500 H+B-2000 7.33 Std. Units 3126/2019 0730
Settleable Matter SM 2540 F-1997 <0.1 mill 0.1 AW 3/26/2019 1200
Total Suspended Solids (fSS) SM 2540 D-1997 <5 mg/L 5 AW 3/28/2019
NA = not analyzed
P.O. Box 473 106 Short Street Kornersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randaiabs.com Page 1
ral coa basic, v1d

PROCESSWASTEWATER — Quarterly Discharge Monitoring Report
GENERA. PERMIT NO. NCG1410000
CERTIFICATE OF COVERAGE NO. NC 14 G a 1 _
FACILITY NAME: )Z
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY,Lab # -3-
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A. Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: I
SAMPLE QUAIjTER: DJul-S t ❑Oct -Dec ]Jan -March ❑April -June
COUNTY: U i l ,C (Z'
PHONE NO. (,b)L )�5-
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout []Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD) z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(rnL/L)
TPH using
method 1664A
5GT N
(ma/l.L )
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day}
-
6-93,4
3033
53
(15)6
n3_9G I
7
c5
A
1 If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles f RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
If an effluent limit is exceeded twice in a raw, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s T5S limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Per --nit Date: 7/1/2010-06/3D/2015
Last Revised 07/13/11
Page I of 2
Date of last pH meter calibration: — -3 A V^f

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VIVA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' F4ow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF TH15 ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE"] WITHIN 30 DAYS OF RECEIPT OF SAMPLE bR
AT.gND OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MU5T SIGN THIS CERT►F&ATION 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)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/1T
Page 2 of 2

PROCESS.WASTEWATER — Quarterly Discharge Monitoring Repon-'
GENERAL PERMIT NO. IMCG240000
CERTIFICATE OF COVERAGrt mo. N0514 0 ;A1 s SAMPLE COLLECTION YEAR: %� D 1 cj
FACILITY NAME: f=r2 � _ z ! M iX SAMPLE QUA!jTER: Jul-yt Oct -Dec ,]Jan -March []Arpr4I-;une
PERSON COUECTINGi SAMPLES:COUNTY* (�J t d cc
CERTIFIED LABORATORY: Z,:$. i:� 11 Lab # PHONE NO.
Lab 4 ADD TO LISTSERVE? AYES []NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO © .,_ DISCHARGINGTO CLASS: []SA ❑MQW ❑PNA ❑Trout DOcher
OPTIONAL iNFO:
Part A: Wastewater Monitoring Requirements
outfall No.
(Dace Sample
collected
(mm/dd/yr)
Type of Wastewater
z
E��, �� ��')
pH
(standard}
Total Suspended
solids
{rng/L1
Settleable
.Solids
i UL)
TPH using
method 1664A
s�i ��
(Mg/0
D&hargc
Duration
(minutes)
Total Flow '
y
(gallons/dray)
6-93'4
303'5
53
(15),
-
c�3.!�L I
977v"A
/
If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RIIA), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless Dk-VQ Ro staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saitwaters.
5 SSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications:
Pecmit Date: 7/1/2010-06/30/2015
Date of last pH'meter calibration: -3 "A (.,.)^
Last Revised 07/13/11
Page 1 of 2

i
e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Plow as per 1SA
NCAC 028 ,0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. if the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND -ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONIT06MG PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality .�
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone] "
VOU MV5T SIGIV THIS �FRTIFIOR ANY litffORIIRATlOW REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supeavision 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)
Permit Date: 7/1/2010-06/30/2015
z/ -._` 2
(Date)
Last Revised 07/13/11
Page 2 of 2

KE§EARCh & ANAiYIriCA .
For: Ready Mixed Concrete Company (Williamson)
1590 Williamson Street
Winston-Salem, NC 27107
Attn: Danny Rathbone
Report of Analysis
4/2/2019
IIIssIIIIII01111
�-�
M NC 1t34 � tR
r s NC t#37701
r~ter 0, ft cTo. �s %•�t
+,'4•+';i.'R D AWP W'4:,
Client Sample ID: 2-6238 L-ab Sample ID: 64555-01
Site: Ready Mixed Concrete Collection Date: 3/26/2019 7:00
Parameter Method Result Units a Limit . ALialys Analysis Date1?img.
pH SM 4500 H+13-2000 8.72 Std. Units 3/26/2019 0750
Settleable Matter
Total Suspended Solids (TSS)
SM 2540 F-1997
SM 2540 D-1997
<0.1 mlll
<5 mg1L
0.1 AW
5 AW
P.O. Box 473 106 Short Street Kernersville. North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com
rsr�_co4_has€�_v 1 ,i
3/26/2019 1200
3/28/2019
NA = not analyzed
Page 1

W
PROCESS ASTEWATER — Quarterly Discharge Monitoring Report`.
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO, NtCG14 b 1
FACILITY NAME: QM i,k`
PERSON COLLECTING SAMPLES: ,
CERTIFIED LABORATORY:l reg .PrhdX"Ietcti-i Lab # 3y
Lab t€
LIMIT VIOLATIONS? YES ❑ NO i/'
Part A: Wastewater Munitorine Requirements
SAMPLE COLLECTION YEAR: C7
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec []Jan -March []April -June
COUNTY:
PHONE NO_ (mac.) a7 '7s 3S
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQVIf ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Outfall No.
'Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, ftM, MD) x
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
5
img/Lg1LII �
-charge �
Dis
Duratlon
(minutes)
Total Flow
(gallons/day),
_
6-9;.�
30a.s
53
(15)"
NCO U
1 LII1
DWR S:I:("r�rlml
a If.wastewater systems have not discharged In this quarter —report "No'Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RIM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent lithit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring,
" pH limits are 6-9 S.U: for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters,
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications,
Permit Date:7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2
Date of last pH meter calibration: % `�

6 Process wastewater discharges shall only be monitored for TPH when commingled,with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewaterAischarges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ, If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shalt notify DWQ, and the DWQ Regional office may require an annual Flow
report on a case -by -case basis. ,
i
...•• Af•i•.u•w• w.1I� AwIr /"AnV Ae Tine A.IAIIIAI e11A&AAA DV IIwIPI NIf►IAIr All lIIIIA el AIAPI URI^ 1lirrll A n�r•II UrtTLII\I 9A MA WC Ar nrrClnT r.r IAAinl r fry
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service CerFter
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CFRTIFfCATION FOR ANY 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 possibllity,of fines and imprisonment for knowing
violations." ,
of Permitteel
Permit Date.7/1/2010-06/30/2015
b
1.
l -ate -/9,
(Date)
Last Revised 07/13/11
Page 2 of 2

} �ESEARCh & ANAty-EicAI
For: Ready Mixed Concrete Co (ARGOS)
1491 Brookford Road
Kernersville, NC
Attn: Dandy Rathbone
Report of Analysis
1 /3/2019
112r1rr�l
iq NC H34
NC :r37701
Client Sample 10: 623911 Lab Sample ID: 60737-01
Site: Ready Mixed Concrete -Argos Collection Date: 12/20/2018 14:36
Parameter Method Result Units Rep Limit Anal st Anal sis DatelTime
pH SM 4500 H+B-2000 8.28 Std. Units 12/20/2018 1436
Settleable Matter SM 2540 F-1997 <0.1 mlll
Total Suspended Solids (TSS) SM 2540 D-1997 13.7 mg1L
0.1 SK 12/2012018 1715
5 LP 12/24/2018
NA = not onofyzed
P.O. Box 473 106 Short Street Kernersville. North Carolina 27284 Tel: [phone] Fax: [phone] vn•Av.randalabs.com Page t

STORM -WATER -DISCHARGE O•UTFAL{L,'(SDO.)..Sem°i�;Arnnual�MONI:TO:RING,.F. RM_._.
GENERAL PERMIT NO-NCg140000
CERTIFICATE OF COVERAGE NO.-NCG14 b I 6a � SAMPLE COLLECTION YEAR: o�t�IS
FACILITY NAME: __(�;es SAMPLING`PERIO.D: 'Jul-Zy-December ❑ January -June
PERSON COLLECTING SAMPLES 1 ,� A ��F COUNTY F�1
CERTIFIED LABORATORY `I�-tA+�c'Ik.M �)'t't l� { Lab # PHONE NO. (fo }_'7gS'�S"'jS
Lab '# ADDTO.LISTS ERVE?-❑YES ❑NO EMAIL:. -
OPTIONAL INFO: --DISCHARGING TO..CLA55: ❑SA ❑HQW ❑PNA. ❑Trout; ❑Other
Part A: Stormwater monstoring.Requirements
.Outfall No.
Date Sample.
Collected
:.'
(mo/dd/yr QR.
NO FLOWji. .;
PH
(Standard ,
Units) ..
TSS
{mg/L}
Event'.
.Duration -
(minutes)
:Tots)
4
Rainfall -..
{in} ..
In Tier 2 -
Monthly
Monitoring?
(Y/n):.. ..
# of Months in Tier
Z...:.
2 Sampling
.
6-92
100 ,3. .
r
.Z
... L-r
t: U ,
UUT
` It "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or -"NO DISCHARGE" for each outfall here. Please.make,sure to mark the sample periocl above.
2 If a value is in excess of the benchmark, or outside the. benchmark.range (for pH), you must •implement the Tier.1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW,,HQW,.Trout, and RNA waters where they are'50.mg/I.
`For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 •:'Last Revised 7/13/11
Page Z of 2
,4

.`
i� `
+ �
Purto. Vehicle Maintenance Activity.M.bnitoring,R,equirements. for facilitiecuslng >GSgm|.o{new motor oil/mvnth-averaged over ucalendar vear.�^
'El
colle'c
HA3YOUR FACILITY H8D 4 ORMORE BENCH MAR KEK[EEDEN[ESATANY ONE OUTFAL (INCLUDING VGH|CLEMANTENAN[E}?YESNO
HAVE YOU 0NTACT�-EDREG|ON? YES [:]NOE] �
REGIONAL OFFICE CONTACT ' NAME:
Mail Original and one copy of this DMR fincluding all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
Division of Water Quaiity:.�
Attn: DWQ Central Files
1617 Mail Smice Center
Raleigh, North Carolina 27699-1617.
YOU MUST SIGN THIS CERTIFICATION FOR AWINFORMATION 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 ofthe person or persons who.manage '.the system, or
those persons directly res��nsible forgathering,theinfoririatioh, the information submitted is, to the best of my knowledge and b&Iiefj'true,' a6curate, and �omplete. I
am aware_tb.�there are s! 'ficantpenalties-for submitting false information, including the possibility -of fines and imprisonment for knowing -violations."
(sigommovf-,cnniittee)s`
`
Permit Date: 7/l/2011-60/30/2015
(Date)
\
� Last Revised7/I3/11
Page 2of2

-' PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
�} GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 1 G I
FACILITY NAME: X ' r
PERSON COLLECTING SAMPLES: n?�/iU 7C
CERTIFIED LABORATORY:II4�'C Lab # 3_
Lab ft
LIMIT VIOLATIONS? YES, ❑ NO F
Part A: Wastewater Monitorin7, Requirements
SAMPLE COLLECTION YEAR:
SAMPLE QUARTER: [KJul-Sept ❑Oct -Dec
COUNTY:
PHONY NO.
[]Jan -March []April -June
ADD TO LISTSERVE? []YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout Other
OPTIONALINFO:
Outfall Np,
Date Sample
Callected1
(rn-/ddlyr)
Type of Wastewater
z
{VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method1664A
5'� N6
Discharge
Duration
(minutes)
Total Flow
(gallonsJday)
-
6-93'9
303.5
53
(15)c
-
f
O.D35 OG
1 If wastewater systems have not discharged in'this quarter— report "No Flow" or "No Discharge' here. Please make sure to mark the sample quarter above. -
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for7rout and PNA waters, and 30 rng/L for all other water classifications..:,;
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a `limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the'permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
,i
I
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARG El WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality-
Attn: DWQ Central Files
1617 Mail Service Center`
Raleigh, North Carolina Z7699-1617
[phone] s
ii
YOU MUST SIGN THIS MRTIFICATION 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."
i
(Signature of Permittee)
?ermit Date: 7/1/2010-06/3'6/2015
y .
%0-/D -_/ 9
(Date) � " ••__._._
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly. Discharge Monitoring Reports EIVE®
GENERAL PERMIT No. NCG140000 JUL 13. 2018
C.E4 F RAL FILES
11 nlrwk SECTICN
CERTIFICATE OF COVERAGE NO. NCG14L Cv SAMPLE COLLECTION YEAR: - D 1
FACILITY NAME: ;��: if SAMPLE QUARTER: Jul -Sept []Oct -Dec []Jan March ©April -tune
PERSON COLLECTING SAMPLES: COUNTY' 1-45
CERTIFIED LAB l�. L�_cra_}G,-;c7 Lab# PHONENO.(a3 S-'715µ
Lab # ADD TO LISTSERVE? []YES [:]NO EMAIL: I
LIMIT VIOLATIONS? YES [] NO ❑ DISCHARGING TO CLASS: E]SA ❑HQW ❑PNA QTrout ❑Other.
OPTIONAL INFO:
Part A: Wastewater Monitoring Renuirpmpnte I
Outfall No.
Date Sample
Collected'
(mrn/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard}
Total Suspended
solids
(mg/L)
Settleable
Solids
(mL/L) .
TPH using
method 1664A
5� HEM'
(mg/L)
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
6-934
303.5
Ss I
(15)c
rj
4I
I
' if wastewater systems have not discharged In'thls quarter— report "No Flow" or "No Discharge" here. Please make surf to mark the sample quarter. above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
a If an effluent limit is exceeded twice in a row, the permittee is required to Institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all otherwater classifications.•7;
Permit Date: 7/1/2010-06/30/2015 ---: Last Revised 07/13/11
Page 1 of 2

J
e Process wastewater discharges shall only be monitored forTPH when commingled with stormwater discharges from VMA areas. TPH does not have a1imit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be"set to 5D90 of the Summer 7Q117 Flow as per 15A
NCAC 028.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10.flow and report this information to DWQ. If the''permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis,
I
i
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS ERTIFI ATI N FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
assure that qualified personnel properly gather and evaluate the Information submitted. Based on my inquiry of the; pets
those persons directly responsible for gathering the information, the Information submitted is, to the best of my knowlec
complete. I am aware that there are significant penalties for submitting false Information, Including the possibility of fin4
violations." n.
(5ignatu
Permit Date:7/1/2010-06/30/2015
accordance with a system designed to
i or persons who manage the system, or
and belief, true, accurate, and
and Imprisonment for knowing
Last Revised 07/13/11
Page 2 of 2

I
.t
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE No. NCG14� SAMPLE COLLECTION YEAR:
FACILITY NAME: _NegoS t�cnd� ih:X _ �� ,Zj\/ rAf0PLE QUARTER: []Jul -Sept ❑Oct -Dec NJan-March ❑April -June
PERSON COLLECTING SAMPLES: ].I,�r}�Z]cr�� COUNTY:
CERTIFIED LABORATORY:_L,�borz .'cs Lab # 0 2 NtPNc NO. (33(v
Lab ADD TO LISTSERVE? OYES ONO EMAIL: I `
LIMIT VIOLATIONS? YES NO s_{a 1 rviL FII CC
❑ ® DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trot ❑other
MIR SECTit INI
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
x
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mLIL)
TPH using
method1664A
S'T-HEAf
(mg/L)
Disi fnarge
_
Duration
(minufeS)
Total Flow I
,
(gallons/day)
-
6-93'
303,5
ss
(15),
1 if wastewater systems have not discharged !n•thfs quarter— report "No Flow" or "No Discharge" here. please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (111,41-Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS I'smits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for ail other water classifications.;;�x
Permit Date: 7/1/2010-06/30/2015 i Last Revised 07/13/11
;. Page I of 2

Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a''limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10'Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10.f1ow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permitter- shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis,
I
M i
MAIL:ORIGIIVAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW' "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
3.
A• �l
YOU MU5T SIGN THIS ERTIFI AT! N FOR ANY INFORMATION REPORTED..
I certify, under penalty of la;w, 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."
�(5ia of permittee) (Date) i
Permit Date: 7/1/2010-o6/30/2D15 Last Revised 07/13/11
Page 2 of 2

STORM.WATFR DISCHARGE'%OUTFALL (SD 0) :,.-Ser "i�AnnuaFMQN-FTO'.RiNG F.0RM,-:
`A
GENERAL PERMIT N0..NCG.j400.0,0:,:.:-.
CERTIFICATE OF COVERAGE NO. NCG14 } 1.� SAMPLE COLLECTION YEAR: vADI19
FACILITY NAME: 1)*,as SAMPLING PER.10. []'July -December January-June,,
PERSON COLLECTING SAMPLES COUNTY
CERTIFIED LABORATORY ZrJ>i� j_Q�o{+��orle5 Lab #�hJC; PHONE NO.
Lab # ADD TO LISTSERVE?_DYES QNO EMAIL:.
OPTIONAL INFO: DISCHARGING TO -CLASS: _]SA ❑HQW ❑PNA ❑Trout —]Other
Part A- Stnrmwntpr Mnnitnrinu.RPnEiirPmpntc
Outfail No.
Date Sample,
Collected
(mo/dd/yr•OR
NO'FLOW)t
PH
(Standard ..
Units)
755
(mg/L) }
Event
Duration -:••
(rnir�utes) -: :...:-..::..
"Total
4.-Monthly
'.'.Rainfall
(ink :, ..
In Tier.2
Monitoring?
(YIn):_-...,.
# of Months m.Tier
z
2 Samplrng
6,9z . ....,
..... 1001'3
(
03 0�
'`► (�3
at3.
D
r
.f
'If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "N0 DISCHARGE" for each outfall here. Please make,sure to mark the Sam pie period above.
z If a value is in excess of the benchmark, or outside the benchmark.range (for pH), you must implement the Tier-1 or Tier 2 responses in the General Permit. Tier 2 .
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
8 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW,.Trout, and PNA waters where.they are 50,mg/I. _
For each sampled measurable:starm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 -,,,Last Revised 7/13/11
Page 1 of 2

L;
Part B: Vehicle Maintenaiice Activity -Monitoring,Requirem .ents_for facif itiesusing > 55 gal,of, new motor oii/month — averaged.over a calendar year
i
I � _
-, r R-k#j_�.
H ,
T FH usrn
r�
ended4rEvent
r�Totaf�S
I N
do Tier-2
::-Ouffall
-Date Samp le
��
metliodal�Sas
. ;�. g=•�t;,_..,:�Y
r
r� ,.. a •
ti
w�1171atQr,Oil
Monthly
#IYaf Months
;:'•
,
-- `?' r p
Standardv .:.>~3664A
SGT,=HFM:
,.gyp,,-
?' y:Soiidscn a
Duration °
:Rainfall°
-"Usage:.
g
.a nTrer2,
Ti
..
No
Collected
z
a
g�
:2
i(mo
`£-,-;
Sampling
',y-'
I 1Y.
.wu:-•n
v s .:Y.'f, �.
,lam.:.'(,''
w�.,.
.-`��, IP.r•
F--
�..•^' r.L
4�
_
R=t'".�
-
i�S'�{K'L.`�
6 .7.-y'15
_ri s
all Vy%F Y,ti?iC, _
i'il-. li, t.l n+v-
�t .-
_
r.i- -•J♦
.eT,. '�Y ��k�
r
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)?' YES [:]NOD
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mai[ Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports)_ within 30 days of receipt of sample {or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality:'
Attn: DWQCentra[ Files
1617 Mail Service Center:f .r
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 orsupervision 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 forgathering the information, the information submitted is-, to the -best of my knowledge and belief; true, accurate, and complete. I
am aw�atares' ,In, ican �Ifli �bmitting false information, including the possibilitymof fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

RESEARCh & ANA1YT9CAL
LA ORAT®RIES, INC.
Report of Analysis
3/14/2018
Mixed.Concrete,Company.(Williamson).,
rT/C����'�,
;..,,,-.For:, ..For:, Ready,
. ___ 4`'`QG'�'�'•
1590 Williamson StreetI
Winston-Salem, NC 27107
OZ:
i�v, NC #34
Attn: Danny Rathbone
NCt137701
9r�'"1ED A�P�yS��.
s
"*irn„1111
Client Sample 1D: 6239-1
Lab Sample ID: 47463-01
Site: Ready Mixed Concrete -Argos
Collection Date: 3/6/2018 14:55
Parameter Method
Result Units Rea Limit Analyst Analysis DatelTime
pH SM 4500 H+13-2000
7.63 Std. Units 3/6/2018
Settleable Matter SM 2540 F-1997
a0.1 mill 0.1 AA 3/6/2018 1530
Total Suspended Solids (TSS) SM 2540 D-1997
23.4 mg/L 5 AA 3/8/2018
NA = not analyzed
9r,x 473 106 Short Street Kemersville. North Carolina 27284 _ TeY: 336-996-2841 Fax: [phone]� www.randalabs.com Page
v

CHAIN'OF CUSTODY:REC.ORU . '
s:"Ana lytical/,,Process-Cdflsdtations.
Phone [3361 U86-2BA1
COMPANY �_ �
JOB NO.
STRElEIhDORES�S%
PROJECT
CITY, STATE,.74P :'
SAMZLER W\ME (P SE NT)
y
CONTACT 6(D; •- PHONE
�_AM�PLER�SIGNATURE
d.
SAMPLE NUMER
{lAE3USEONLY)
GATE
ludE
,
COMP
GRAB+
E1.1P
•C
RES
Cf
fYcrtq
i .n-1
SAIdPLE LgCATION!!G
REl1NQUI5HE0 BY../` r'
DATEJTIME
3�;1
RECEIVED BY
REMARK
SAMPLE TEMP R TURE AT RECEIF
RELINQUISHED BY
DATEITI,ME
RECEIVED BY 1 -

PROCESS WASTEWATER —Quarterly Discharge Monitoring Report
GENERAL1,R R 1Ti \NOT_NCG140D00
JAN 19,20133
CERTIFICATE OF COVERAGE NO. NCG14 0 1 (a SAI�/IPLE COLLECTION YEAR: �o� ` I i
— —DWR SEC. «n,
FACILITY NAME: aS lr'F kdAT N PROvbAfi� EjgyARTER: ❑Jul -Sept [ZOct-Dec . ❑!an -March ❑April-lune
PERSON COLLECTING SAMPLES: COUNTY: i
CERTIFIED LA8QRATORY: ;0tj Lab # _ 3l} PHONE NO. (2�,gko) S- R75`7'
Lab # ADD TO LISTSERVE? []YES ONO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ® DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Outfall No.
Date Sample
Collected)
(mrn/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard)
Total Suspended
solids
(mgfL)
Settleable
Solids
(mL/Lj
TPH using
method1664A
5GT-HEM"
(mg/L)
Discharge
Duration
{minutes)
Total Flow
>
(&allongday)
-
-
-
6-93''
303 s
53
(15)s
-
-- f o
I.::.
1 If wastewater systems have not discharged In'this quarter— report "No Ffow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RIilIj, Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
If an effluent limit is exceeded twice in a row, the permittee is required to Institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
" pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications:;.;
Permit Date: 7/1/201MG/30/2015 ::"Last Revised 07/13/11
:; . Page 1 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a.Oimit for wastewater,
r but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits For wastewater discharges to HQW waters shall beset to 50% of the Summer 7Qz0 Flow as per 15A
NCAC 02B .0224. Permitteels who discharge wastewater to HQW waters shall obtain a Summer 7Q10.flow and report this information to DWQ, if the 'Permittee cannot
obtain a Sommer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual Flow
report on a case -by -case basis.
i
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCWDING ALL "NO FLOW", "NO DISCHARGE"] WITHIN 30 DAYS OF RECEIPT OF SAMPLE f0
Division of Water Quality
Attn: DWQ Central Files
1617 Ma Service Center
Raleigh, North Carolina 27699-1617
[phone]
a
.4"
YOU MUST SIGN mts CERTOCATION 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 beligf, 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 o ermittee) (Date)
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER —Quarterly Discharge Monitoring Report
rt
GENERAL PERMIT NO. NCG140000
r:
CERTIFICATE OF COVERAGE NO. NCG14 6 h (o
FACILITY NAME:
PERSON COLLECTING SAMPLES. _ r�-IrgM C'Y,;z� •+I-�� _
CERTIFIED LABORATORY:RS,�e�7_e4, aAmAO` Lab t$ 1 4
Lab #
LIMIT VIOLATIONS? YE5 ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLE QUARTER: []Jul -Sept ❑Oct -Dec ❑Jan -March April -June
COUNTY: _ I��Z6'�~t-t-�
PHQNE NO. --
ADD TO L15TSERVE? ❑YES ❑NCI EMAIL:
DISCHARGING TO CLA55: 05A ❑HQW ❑PNA ❑Trout ❑Other.
OPTIONAL I NFO: i
Outfall No,
Date Sample
Collectedl
(mrnfdd/yr]
Type of wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L]
Settleable
Solids
(mL/L] �
TPH using
method1664A
5G. H MC
(mg/W
Discharge
Duration
(miniltes]
Total Flow
{gallons/dayf
-
6-93'4
303.5
53
(15)6
-
-
(
D U
7.'9
�.'
�e.�
Aj
S
L?0 _15Ko
F— Ilk
VC
i I 2r
CENTRAL r(i
I=
UVVK SECT1:
A
If wastewater systems have,not discharged in'this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (Rlv1, Mixing Drum
Cleanout (WID), Report more than one type if the waste -stream is commingled.
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter For six months, unless DWOL RQ staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. k-
s TS5 limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.:;:,
Permit Date: 7/1/2010-06/30/2015 :`Last Revised 07/13/11
Page x of Z
T
R

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
7 but instead is subject to benchmarks and provisions of Part 1V, Section A, including the Tiered Response Action.
Flow rate can be measured cantlnuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q30 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10•flow and report this information to DWQ. If thepermittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permitter shall notify DWQ, and the DWQ Regional Office may require an annual Flow
report on a case -by -case basis.
i
MAIL�ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Majl Service Center
Raleigh, North Carolina 27699-1617
(919) 807-G379
s-:
s.;
YOU MUST SIGN THIS ERTIpI AT! N FOR ANY INFORMATION REPORTED:
"I certify, under penalty of Ia:�ri, 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 hest 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
r-
vio[atians." .
ture of Permittee)
Permit Date.-7/1/2010-05/30/2015
(Date)
:Last Revised 07/13/11
Page 2 of 2

R
STORMWA°TER° DIS:CHARGEVUTFALL(SDO)` .--;Semi=Annual, M,O:NITO:RIN'G FORM :. -
GENERAL PERMIT N0.,NCG140000
CERTIFICATE OF COVERAGE NO: NCG14_Q_ _L (o SAMPLE COLLECTION YEAR:
FACILITY NAME: C f s ��< ` . SAMP-L`ING`P.ERIO.D; "❑"July -December ©January -June
PERSON COLLECTING SA PLE5"&t-,,� Cr.�,yAli`k� COUNTY �o1�S
CERTIFIED LABORATORY '
(j}tIy CA�.ab# �;{ PHONE NO.
_Lab"# ADD TO LISTSERVE?.❑YES [:]NO EMAIL:•
OPTIONAL INFO:- _ DISCHARGING TO..CLASS: [:]SA ❑HQW ' ❑PNA ❑Trout [:]Other
Part A: Stormwater Monitorine Reouirements
Outfall No.
Date Sample
Collected
(mo/dd/yr�OR
NO FLOW)'
pH
(Standard
Units)
TSS
-
(mg/L) . •
Event
Duration
(minutes}
:Total,
4
r -Rainfall
.. _(in) .
In"T"er 2
Monthly"
Monitoring..
(y/n).....
# of Months in Tier
z
2 Sampling
6-9z
1002 3':"
_
T-0
4}
P -
/
JU
401 ;
CRKITF�,,i
aru rr
t
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW' or DISCHARGE" for each outfall here. Please.make,.sure to mark the sample period above.
z if a value is in excess of the benchmark, or outside the.benchmark,range (for pH), you must implement the Tiier.1 orTier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 10o mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where.they are 50.mg/I.
4 For each sampled measurable: -storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part S: Vehicle Mairiitenahce Act'pvity;Mbnitoring,Reouirements-for facilities. using > 55 gal,of new motor oil/month — averaged over a calendar year,
QutfallY_
Date Sam le'
C illected
.. .... ....
p H `
st
y Cv�
;TPH:usrn ;methods
s'r654A75G1z--HEM:3-
rng/
`iTotakSLs endedf
_(mg/L)
Ly j.
Event
Total
'NewTMotor O.ih-
'Aw i ler:
ont
V
#"of Months
2
NO
o-+
HAS YOUR FACIMY HAD 4.OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)?' YES ❑ NOX
HAVE YOU CONTACTED THE: REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT -NAME:
j,-
Mail Original and one cobs of this DIVIR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-11317
YOU MUST SIGN THIS CERhFfC4T1QN FOR ANY INFORMAT101V REPORTED:
"I certify, under penalty of law; that this document and all attachments were Prepared under my -direction or supervision in accordance with a system designed to
assure that qualified person ' nel properly gather and evaluate the information submitted. Based on my inquiry of.the person or persons who.manage'the system, or
those persons directly responsible for gathering the "inform''ation, the information submitted is; to the -best of my knowledge and belief;true, accurate, and complete. I
am aware that there are sigpifica na ies for submitting false information, including the possibility -of fines and -imprisonment for knowidg-violations."
(Signature of Permittee) (Date)
Permit Date, 7/1/2011-60/30/20.15 Last Re vi5ed 7/13/11
Page 2 of 2

7
STORMWATER:-DISCHA'R.GE,OU:TFALL.(SDO) .-:Semi Annual MONI:TORINGTORM=.I
GENERAL PERMIT NOACGI40000
CERTIFICATE OF COVERAGE NO. NCG14 o 1 (� �7 SAMPLE COLLECTION YEAR: vZ DI
FACILITY NAME: SAMPLING PERIOD: ❑ July=December January -June
PERSON COLLECTING SAMPLES �f�_('�:L�,�i� COUNTY
CERTIFIED LABORATORY srta6%)6'�iHM A-:r-nl Lab # 1S PHONE NO. (•.32t_) 943 -.1,44?
Lab # ADD TO LISTSERVETFJYES —]NO EMAIL:.
OPTIONAL INFO:
Part A: Stormwater Monitorine Reouirements
.. DISCHARGING TO..CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NOTLOW)1
PH
(Standard :..
Units) ..
TSS
,. ...
t
Event
-Duration ....
(minutes) .
::Total ,
4
-...,Rainfall ....
(in)
In Tier 2
Monthly.
Monitoring?
(y/n)'_.. ;
# of Months in Tier
z
2 Sampling
_
5_92
104Z'
-
c� Ya o
$. L
-)4 4 :.
f
4 201?
�C
z
If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfali here. Please.make,sure to mark the sample period above.
If a value is in excess of the benchmark, or outside the benchmark.rangg (for pH), you must implement the Tier-1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW„Trout, and PNA waters where they are 50.mg/I.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. F: .
Permit Date: 7/1/2011-60/302015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring:Requirements for faciIities'using> 55 gal of new motor oil/month —averaged over a calendar year
Outfafl
No
;Date Sample
Collected:
1
H
p =
{Standard
_-
Units)_
TP.H usrn' method'
9
I664ASGT HEM '
(mg/L)
:TotalfSus _ended'
p
„ ':5ohds
'
}-_(mg/L)
x E'vent
=Duration
`(minutes}
�� Total
,
Rainfall
(tn)
L
New: Motor pal °
Usage
r
(gal/month)
'Y t 51
In Tier 2
Monthly,:-
Monitormg7
x
# of.Months `
in Tier2; 't
,Z
Sampling-.
15
1 b
t :clt
ce
n
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)?' YES ❑ NOZ
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT -NAME:
Mail Original and one copy of this DMR(including all "No Flow" & "No Discharge" reports) within 30 days of recei t of sample or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQCentral Files
E•
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
arryaware that there are significan��alties for submitting false information, including the possibility -of fines and imprisonment for knowing violations.
(Signature of Perm
3--2S 1 -J P!
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

x
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG1.4 D J_
FACILITY NAME: _? M:X
PERSON COLLECTING SAMPLES: M&A, (a VA2!Lt'T+S
CERTIFIED LABORATORY:?.s-,L;,yx�l)t ,, t: 'r,cg4 Lab # Z!�_
Lab #
LIMIT VIOLATIONS? YES ® NO ❑
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: c, I
SAMPLE QUARTER: []Jul -Sept []Oct -Dec SJan-March ❑April -June
COUNTY:
PHONE NO.
ADD TO LISTSERVE? []YES ^❑NO EMAIL: I ''
DISCHARGING TO CLASS: ❑$A ❑HQW ❑PNA ❑Trout [—]Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected
(mm/dd/yr}
Type of Wastewater
VE, RM, MD)'
pH
{standard}
Total Suspended
solids
(mg/L)
Settleable
Solids
(mUL)
TPH using
method 1664A
5GT-NENJ�
{mg/L}
Discharge
Duration
{minutes}
Total Flow
y
(gallons/dayj
-
-
6-93.4
303.5
53-
i
a a 1
$-`R
s
4o•I
N
J
Ds01rT
1 If wastewater systems have not discharged In'this quarter— report No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM:), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
'if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter Far six months, Unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. ,
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 _ ` Last Revised 07/13/11
Page 1 of 2

a Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q1.0 Flow as per 15A
NCAC 0213.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10.flow and report this information to DWQ. If the'permittee cannot
obtain a Summer 7Q10 flow.for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mall Service Center
Raleigh, North Carolina 27699-1617
(919) 807-G379
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)
Permit Date:7/1/2010-06/30/2015
(Date)
.; last Revised 07/13/11
Page 2 of 2

RESEARCk & ANALyTiCAI
I.AbORATORiES, INC.
For: Ready Mixed Concrete Co (ARGOS)
1491 9rookford Roar!
Kernersville, NC
Attn: Danny Rathbone
Report of Analysis
1 /26/2017
=ov NC #34
NC 037701
r
.F1E�
Client Sample ID: Outfall #1 Lab Sample ID: 29934-01
Site: Ready Mixed Concrete Collection Date: 1/20/2017 7:50
aramete Method esu Units Rejo Limlt Analyst Analysis i]atelTim�
pH SM 4500 H+B-2000 8.62 Sid. Units 1/2012017 0750
Settleable Matter SM 2540 P-1997 <01 mpl 0.1 SK 1/2012017
Total Suspended Solids (iSS) SM 2540 D-1997 55.0 mg/L 5 JB 1/23/2017
NA = not analyzed
P.O. Box 473 106 Short Street Kemersrdlle, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com
ral coa basic Vld
Page 1

Y
...PROCESS. WASTEWATER — Quarterly Discharge:'Manitoring Report. �-
GENERAL PERMIT No. NCG140000 ' w
'}
CERTIFICATE OF COVE CE NO.wN G 4�1 `(, SAMPLE COC ECTION YtwAR- ��J
FACILITY NAME: SAMPi.I: CIUAITER;.,. �]]ul-Sept ®Oct -Dec ' QJan-lVlarch--[]APOI-lure
.PERS=COLLECTING SAMPLES: E I COUNTY
CERTIFIED'LAF30RATORY 4�!''d~t :. ., FH015El .NiO { �. '
^{` I.ab #
Lab # ADD(T.O$Ll5T5ERUE3 AYES []NO ,EMAIL .
LlNif7VIOLATIONS YE5 Q'Na`� r= DISCHARGING 76GASS 05A QHQW *[]PNA QTraut QOther
Part A: WastevraterMonitorine'Requirements
Outfall No.
Date Sampi • .
1
Coilected. '
(mni/dd/yr}
Type of Wastewater •
(VE, RM; MojZ
i3R
(standard)
Total Suspended -
5alids;
(mgjL)
: ' .' So '..
(mLjl.}
--TPH using
method1664.4'
...' SGr-N6 _
(mJLi : ,
Discharge:
Dura I"'
"
a, r t
(minutes)`
,.Total Flow
(gallaissjday�'
-
-
6-9",
3's
S�
(15js
y
4LJ
•
M
•
JAN
If wastewater systerns have not dlschareed
In this ouarter— reoort "No Flow" or "No
Discharge" here. Please. make sure to mark the saMof
auartdr above.
= Report the abbreviatlott for the type of Authorized Wastewater Discharges here: Vehlcla and Equipment Cleaning (VE), Raw Material Stock piles (HN
Cleanout (MD), Report more than one type if the waste -stream is commingled.
If an effluent limit is exceeded twice In a row, the'permlttee Is required to institute monthly monitoring for -that parameter for six months, L nless D4
notifies'You to.continue.monitoring.
a pRt ffrrilts are 6 9 5 O forwasYewater.discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saitwaters. .
s f SS iinicts are20 mg/trforvrastewa er`discharges to HQW waters; l0 mgLCforTroutand:PNA watemj'.arsd:3U:mg/L' for�all;other water,•dassl nations.
Permit b6fe::7/1/2D10-06/34/2D15
.I:.
ixing Drum
`a:Ro staff
"Iast Revised 07/13/11.
..:•:Page] of 2

6 Process wastewater discharges shall only be monitored for.TPH when commingled with stormwater dlsdiarges from-.VMA areas. TPH does not haveWImlt:for, wastewater,
but Instead is subject to benchmarks and.provlslons of Part IV, Section A, lnciutliq the `fie�ed aesponse Actlon. .
'.FIp"tq.c n.be.measured,continuously or calculated. Flow limits for wastewater discharges to HC1W waters shall be set to 50% of the Summer 7Q .'Flow as per-15A .:'.:
NCAC 028.0224 Perm"tteeswho discharge wastewater to.HQW_waters;shallobtain.a Surnmer•7Q10 flow,and.report this information :to DWQ;.If the jYermittee,cpnnoC ,.
%obtain a SumrnEir 7Q1b flow for"tFie rece�wng'waterspat Ehe d3srharge'locatlon, the-perWttee shall notlfy W4;="and,ihe BW, ' Reglanai;OfFce:may.regbIri a an annual flow
report on a'case=by-case basis -
MAIL ORIG1NAi:'AND° ; E�COR .F~TH S;ANNUAL SUMM RY- INC-LUDIN -L Als-" NO-FLOW','="NO.:DISCHAItGE" 3 AYS.OF R1=CEIMQF SAMPLE OR
s.
`A, N6_,oF: dNI t]RING-PERIOD,IN CASE OF "NO°FLOW =TO: _.._:a �.
!Divislon of Water'Quality..'.
.:Attn:'DWQCentral Files::..:-
1617•Mal1"Service!Center : : „
g 17.
Ra1el h �'Nortfi Carollna� 27699=16 .. _ , ..
-[phone]
.w
y 1
j
YOU l N,THI R7FICA 77 0 JYO A Y RMA TlON REP ORTED:
Icertlfy� under penalfy;of law„tharthis.dgcurrtenf and ail attachmentswere prepared under my di ection or.supervision in accordance.with a sYsterndesigned fio
assdi a that qualified persannelfproperly gather acid evaluate the information subrT' rted Basei3 on my inawry of thsrperson or -persons ivl�o'r�ianage the systerrz;'or .
those persons directly responsible for gathering the lnforniatinn, the Information subrnkted.Is'tarthe;best,of,m ,-riowledge arid;belief-truet.accu.�4te and
comp lete.'-1`arhaware tfiai>there.are significant penalties'f"r'sulimitting.-false Information,cl , lnuding the posslbillty:off nes and•Imprisonment for knowing
violat�ons�,-;.
57
(Slgna re of p • rmlttee {D"ate)_ F
Permft Date: 7/1/2010-06/30/2015 Last Revisers 07/13/11
Page 2 of 2
�5

+1
STORM.WA'TER.DISCHAR.GE �'UTFALL:�SDO) Semi Annual MO;N�ITORLN.GrFORM
GENERAL PERMIT NO. NCG400D0 ".
SAMPLE COLLECTION YEAR:
CERTIFICATE OF COVE GE NO: N G14
FACILITY NAME: -7,7: ;SAMPLING PERtO.Di � July -December ;❑January -June
COUNTY.
PERSON COLLECTING. SAMPLES
CERTIFIED LABORATORY dL � '��) Lafi # 3
Lah.#...: :.I.ADDNOLIISTSE VE. ❑ -.._. y ..
- - YES ❑NO EMAIL:..
OPTIONAL INFO: _.. _..:::' DISCHARGING; TO -CLASS: `❑SA-. ❑HQW ❑PNA ❑Trout: ❑Other- -
Part""A:Stormviik6fVionitoring:Re uirements "
Date Sample
. �. { .. In Tier 2 _
pM.,..... . . ....:.....-. :.... Event. , Total
Collected TS5 4 Monthly # of Months in Tier
Outfal{ No (Standard !Duration —-:.->Rainfall Z._
(mo/dd/yr-.0R (mg/L} IVlonitan�g�. 2 Sam—.
Units).:..,minutes m
-�.
I If "NO FLOW -or "NO DISCHARGE; Enter "NO FLOW" or."NO DISCHARGE" for each outfall hei&6 'Please make`,sure_ tb mark the swnple:period above:
a If a value is in excess of the benchmark; or outside the:Iienchmark..range (for'pWj,`you must implement the Tie`r.l &Tier2 responses` in'the_ Gene'ral'Permit. Tier 2
Monthly sampling shall be dome until 3 consecutive samples are below the benchmark or within the benchmark range.
s TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW,.Trout, and PNA waters where:they are 50.mg/l. '
"For each sampled measurablestorm event the total precipitation must he recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 :Last Revised 7/13/11'
Page 1 of 2
r

Part B: Vehicle Maintenance,Activity; Monitorine:Reduirements for facilities usine > 55 eal.of new. motor oil/month
l
�M
avBraePd ovel' a calendar vPar-
.i-.-,,� - i._
K
is-r.,f
,�r;.-:nY'%C��
{; i ,F. ;ib,,..
0.� .,5` „7,
1 •f -. :,
e'f :,s"e. rE
'".aa � �-
:P r.:.
e,—'G'. ,-,u.. �
-*"e -s-^
%',r ; s
i'. �::r <` t�'i�;�
e-. .i`e ., W'`,N'
t" 'L k�` r, .r,.�i"=,..�,
.! -.-�-:"�-
i.Y-:; 4-� 1• _
�
'��' -'�",. '��.yt �-..n
,•�" .w •sFj"4+t
vr�,,��,
,c = pis -F
:.F
�.�,� �.a
r.�i". Fy•'v'. _..re .,c.- v:_ t
P'!
:a' < '�'Ft.•
ry : +r-. ,, •.sue
-
4 4.�'l.,-.ta?1-s
,..��t,: '��
..� �� .:xr. ..-"" fir:
„rM - r
rrar
iG.fl""" p'::e.
�i�e� r r.S
�i4� ,� f'. ?'s4�k
f- `i't�-- _ s.-f
-- - -
" sa
�'"' ii�
�!"... fti �"fd'
%�!'r '� �--"_M=
..i:'.
� rh..'-�r-,'�
�' �i ..ri J.- ..ry .
t,7r'h •` 3'it`' ea:.",
_.-.;:
�.
�
H,',', M
P_
. --< _..�.. __.. _
FTPHusfn method=Total,�s
Kg
n ed
pe d
'
�- t
Total3rn
New Moto 0
fir,.;.
,#of,Months.,.
-._
+Fx.}i d`=}
Standar;d,,1664A"SGT
NEM':'}}Solyds',,._�:
-- •<'sDu`ration �%sr
Y..f?£'
fallS.fi--`:in`•7rer
'{�
2�. -
�il434
;i .; �,1
Fr!'. -' i.
FFrrII .-
f.v...:t4':�MM
3.x`{/m`o d
"^ ��a+ij", .�Y.i _•'w.:
_ ..�'"
dR'': ..3
fr+6`�-.^ C-
-.4,��
J f._:i+.F F.n 4 _h:
„R. 3 I :,fir..,:
4 ai. I.-�::.+',- .: 'S',
/.M 33✓w
�L,'1 'Sy
�n.-.
,"i -'.1 ": :r
.J�'
nutesjF
:°}L� - i'" - 'j ii r4
1 :'. J 'a
f :' i:�iF
11..�i1 .a+. *'
-:1 .b ,li.�`.�f
1 =K
1D 1. .-rt+e. f`b
5yf�5+.�
;Monitocg ?,<
g `.�
S - Y4C ;:••q �'Li
_~ n1u2 •'•r.. I
�'
�s , r _ �.zz_4u
i,
,a
`, p� g,:��r'a
- a-�C- {..(
�� e �'+� y
rr".,''A-F 4'. N
^�-"'Th(.S•'-!!'^�++.N� '� '„�-�`
.i.Si ��1
I �. 1,�+i
V �yy�� �
° ,'.�ic� 1 ' r_: -'l.
/•�•-S.Y, M;. t-y
Faf fd
I�,.MH7
�T
_ ) i' .: i-Y,.' � e_$tik
,y�
r� - ' �-,
.3�. � a"!�t - �54�,•
Y)
l ��
�: J ,l���•
y,�^•'�
i. °z yy�
_. �'.2:
_.�-J.,t'.�
F^: ..`A ;w"Zyi
.i.t ' ".-%�l1.?•�r }`
,4�',J
�k±r."i+WvS:"w
�1hc.}�
y_•�-1�.
u L, - :'T:
is i-:..._.r
7�5]':..,. j'G
:sa .. ^f..l�{:lW.
.K �'6 7 .. -,.,
k:L4; ':-•." 5,� -
L•ii-."F. �: �'ll+.'r' iJ, 's:!
- k++�,�!i�
�", I 3 /nV IP
Wes'
:.d. F`itiF
i�
•A'k{h]ti4.•
i
•Y
x
A
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING. VEHICLE MAINTENANCE)? YES []NO
[
HAVE YOU CONTACTED THE;.REGION? YES' ❑ NO [� _
-REGIONAL OFFICE CONTACT -NAME:
Mail Original_ and one copy of this__D_MR (including all "No Flow" & "No Discharge" reports) within 30 days of'receint of sample (or at end of moriitorirs period
in case of "No Flow") to:
Division of Water Quality -
Attn: DWQ Central Files
1617 Mail Service Center -
Raleigh, North Carolina 27699-1617
3
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'directinn-or supervision in accordance with a system designed to.
assure that qualified personnel properly gather and evaluate the information submitted. Based onmy inquiry of the person or persons who manage`the system, or .
those persons directly responsible for gather ng the information, the'information'submitted:is; to the; best of my knowledge and belief;true, accurate, and corriplete:''I
am aware that there are signif' nt'p t far submitting false information, including the possibility:of fines and imprisonment for -knowing violatrons.", '
(Signature of Perini ee) (Date)
_ y
Permit Date: 7/1/2011-60/30/2015 Last.Revised 7/13/11'-
Page 2 of 2

] •. ^ =;
PROCESS' WAS: -EWi -iER -- Quafterl " Discharge::Monitoring Report.
GENERAL PERMIT No. NCG14000O. M...;
CERTIFICATE OF'C VE GE'Na:-N G 4Q1' SAMPLE COU CT.ION-Y.t.AR: ✓)oi w'
FACILITY NAME:' SAMPLE [QUA y�TEW. DJul-Sept; .: ®Oct -Dec F]Jan-March . []Apfil-June
PERSON: COLLECTING 5AMPtiFS: I WCOUNTY: J`
CERi'IFIED`IABDRATDRY '> c �J d1- -t Lab # , t?HONE
NDDXO LISTSERUE?- QY>~5 .QNO
1� # -
LINiE7 UIDLATIC)NS? YE5 Q'idCf D15CHARGl111CY TD CiA55 'D5A DHQW DPNA`+DTrvut DCithei--
:OPTIONAV NFO+
Part A, Wastewater Monitonne iieouirpmQnfs
Clutfall No.
Date 5ampl6 ..
1
Collected.-
(rnnijdd/yrj
Type of Wastewater .
z
(VE, RM, MD)
pH
(standard)'
Total Suspended--
Solids"
[mg/L)(minuytes)'
; :Settleable:.:
Solids' :.
TPH-using
method 1664A
SGT HEA1' ;
(mg/L)
Discharge:
s, i : ;:
Duraflaii:;. -
�';' -
::Total. Plow
(9allohs/day)7
-
-
64'4
9D3's
59
[15)V
If wastewater. systems have not discharged
In this ouarter-• renort "No Flow" or "No
Discharge". here. Please.make sure to mark the SBMDIC
ouarteraliove.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stock piles (RM `
Cleanout (MD), Report more than one type if the waste -stream Is commingled.
'if an effluent Ilmit is exceeded twice In a row, the permittee Is required to institute monthly monitoring for -that parameter for six months, L nless DWC
notifies you to.continue.ri onitoring. cfi
"pH.iim
",::its are 6-9.5.
5 U forwastewater.dlscharges to freshwaters, and 6.M.5 S.U. for discharges to saltwaters.
5 T551imits are Z0 mgJE forwastewaler`dlsriiarges to HQW OA&s 160 ing/Lfor-7raut and -P.NA waters .and 30 mgJl for,allmtherwater,.-ciassi icationS. '?
Permit Dafe: 7J1J2D3D 06J3DJ7-015 y
Oruro
staff
st.Revised 07/13/11
,`. Page,1 of 2

Process wastewater discharges shall,only-be rnon1tored1or.7PH when commingled with stormwaterdlschargas from.VIV1A area5.7Pii does not have
but instead is subJect to benchmarks and,prvv[s[ons of Part IV, Section A, Including the `rEetged Respsp
onse Action.. ''
',J=low,ra,te.can be.measuredreontf nuousiy or calculated. Flow limits for wastewater discharges to.HQW waters shall be set to 50% of the Summer 7Q]
NCAC 02$ .0224 perm,tteeswho discharge wastewater to ligW waters sFiall vbtaln.a Summer-7Q10 flow and.reportthis information..to DWQ; if the
86taln a Surnrner'7Q10 flow for tF e.i eceiving watersX%t the discharge'iocatlonYthe permittee shalllnatify, WQsan;JJhe:D,W.Q:Reglanal;Office may:rer
report on`.a case by -case basis
I' r
Permit Date: 7/1/2010-06/30/2015
r"
Amt.tor wastewater,
Flow a5
,flow
cannot
Ire an annuaf flow
i.desEgned to
Lhe systein;:or
;ands. ,.•....:...:.:........
Revised 07/13/11
Page 2 of 2

STORM WATTER:DISCHARGEOUTFALL::(SDO) Semi=Annua1W0NI:T0RING1 F.ORM::
GENERAL PERMIT NO !N Q.I4.000U .
CERTIFICATE OF COVERAGE NO. NCG140 1 1 SAMPLE COLLECTION YEAR: �241
FACILITY NAME:LoS I�crtie�{ {l-t; Jc ^ SAMPLING PERIOD: 'M,July-December ❑January-lune
PERSON COLLECTING SAMPLES _ '�i44 I acsnc COUNTY. _J��izScj�1
CERTIFIED LABORATORYR_S�itpch_aL�iatt�l,s �-; � Lab # 31j PHONE NO. (.33L
Lab # ADD TO LISTSERVE7 ❑YES -]NO EMAIL:.
OPTIONAL INFO: DISCHARGING TO. CLASS: []SA ❑HQW ❑PNA []Trout [:]other
Part A. Stormwater Monitoring Requirements
Outfall No. '
Date Sample
_
Collected .`
(mo/dd/yr OR
NO FLOW)'
PH .:
(Standard :.
Units)
... ..
TSS
(rng/L)
...Event
Duration -.,-
[minutes).-
7atal
4
..._.- Rainfall .....
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
Z . .
2 Sampling
6.9z
' •. 1002.3
E _n
EDIED
nfIT
0
;
CENTRAL FILES
EC
!4N
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make.sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier-1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW,.Trout, and PNA waters where they are 50 mg/I.
° For each sampled measurable- .storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 ; Last Revised 7/13/11
Page 1 of 2

Part 8: Vehicle Maintenance Activity Monitoring; Require ments-for facilities using > 55 gal.of new motor oil/month — averaged over a calendar vear
Outfall
No
r
Date Sample
Collected`:'
i
.(mo/dd/yr)
pH
Standard
Units),;:
TPH using method
I664A SGT HEM
(mg/L) w
�Totaf:5uspended
•'
Solids
' ;;(mg/L) '= ,
c 7. 7
;, Event
-
Duration
^•(minutes
1
ws Total r
�' a
Rainfall
.(in);
New Motor Oil z
Usa' e
g
: {gad/month)
Monthl y
�Monrtorm ?
g
^
# of Months ,
mMer 2` '
=i<
Sampling 4 '
l
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to::i
Division of Water Quality
Attn: DWQCentral 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 signal ant "pe al ' s t'or submitting false information, including the possibility of fines'and imprisonment for knowing violations."
/ �. �O` I
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015
R
Last Revised 7/13/11
' Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO, NCG14 U I 4P 7
FACILITY NAME: a ;+ —
PERSON COLLECTING SAMPLES: U� i
CERTIFIED LABORATORY; t° " kA,4 -�-.'CAI Lab # _ 3!/
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A. Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: /A01 '7 ? 'r
SAMPLE QUARTER: ®Jul -;Sept ❑Oct -Dec ❑jars -March []April -June
COUNTY:
PHONE NO. ( 31c, ]'7$._S`
ADD TO LISTSERVE? ❑YES ONO EMAIL: i
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [:]Trout ❑Other
OPTIONAL INFO
Outfall No,
Date Sample
Collected)
(mm/dd/yr)
Type of Wastewater
VE, RMD z
M,)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
5GT-HEM"
(mg/L)
Discharge
Duration
{minutes}
Total Flow
7
(gallons/day)
"
-
6-93.4
3035
53
(15)s
_
r
CR
N
DIVR
SECT
CE
WR
1 If wastewater systems have not discharged In'this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here.: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (Rnnj, 'Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
31f an effluent limit is exceeded twice in a row, the permittee is required to Institute monthly monitoring for that parameter for six months, unless DWi t RO staff
notifies you to continue monitoring. ;
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS Limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L far all otherwater classifications,.;,_
Permit Date: 711/2010-06/30/2015 -,:Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored forTPH when commingled with stormwater discharges from VMA areas. TPH does not have a�limit for wastewater,
but instead is subject to benchmarks and provisions of Part Iv, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be 'set to 50% of the Summer 7Qi0 Plow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10.flow and report this information to DWQ, if the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
i
I
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO:
Division of Water Quality
Attn: DWQ Central Files y .
1617 Mail Service Center - -
Raleigh, North Carolina 27699-1617 "
[phone] a
YOU MUST SIGN THI5 CERTIFICATIQN 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. l 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)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVER GE NO, N G 4 b I (, 7
FACILITY NAME: fit: ,U a_,e 7�_ 60,
PERSON COLLECTING SA PLES: Rif f�rl-FA.
CERTIFIED LABORATORY: r [A Lab # &,
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: _ �� (e i
SAMPLE QUARTER: 2�ul-Se`pt ❑Oct -Dec ❑)an -March ❑April -June
COUNTY: Fb2STY�- -- _
PHONE NO. (3'�1 'SAS•��
ADD TO LISTSERVE? OYES ONO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Outfall Na.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
S
(mg1L) G
mg/L)
Disi:harge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
6-93'4
303.5
53
0
RI;;;('1-I
_i )
Ti
rti�nin
`f"hT /1N!
1 If wastewater systems have not discharged In'this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (Ri A), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for Chat parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6,8-8,5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 "Last Revised 07/13/11
Page 1 of 2

'i
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10.flow and report this information to DWQ. if the'permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL S11MMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone] -
YOU MUST S1GN THIS CERTIFICATION FORA Y 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 knowiedge and belief, true, accurate, and
complete. I am aware that'there are significInt Onalties for submitting false information, including the possibliity of fines and Imprisonment for knowing
�-
re of"Permittee]
Permit Date. 7/1/2010-06/36/2015 -
(Date)
;Last Revised 07/13/11
Page 2 of 2

PROCM WASTEWATER — Quarterl'Mcharge.;''MOnitoring Report. -'
GENERAL. PERMIT No. NCGI40000
µ. ,u
CERTIFICATE OF COVERAGENO. ' SAMPLE COLLECTION .��- 1 PLQUARTER -"I, ❑Qct-Dee Q_ 1an-j
M. �'pTi[-JuneFACILITY NAME C� SAMui-
PERSON' COLLECTING SAMPLES: cZS COUNTY P' LS4+�n
CERTIFIED LABORATORY .
PNO E,NO 3;v'�S�P
LIMIT VIOLATiON53 YE5 [� N0 piSCHARGING TD CLASS" QFiQW .OPNA' QTrdqt ]Other
'OPTIONALIWO.:r
Pari A: Wastewater Monitoring Re Wrements
Outfali No.
Date Sampl '•
-
Collected.
(mni/dd/yr
Type of Wastewater '
(VE, RM; MD) z
pH
(standard)
Total Suspended
Sands. ''
(mg/L�
Settleable'
SQiids'
(mLf L} ,
--TPH using
method 1664A
SG7 HEMS;:
0.11
Disci arEe.
c 1
Duration
a
(minutes).-,
"Total Flow
(gallons/day)
CENTRAI F,i
F
DWR SECT
ON
If wastewater systems have not discharged
In this quarter— report "No Flow" or "No
Discharge. here. Please make sure to mark the sample
qua rter`above.
Report the abbreviation for the type of Authorized Wastewater Discharges here. Vehicle and Equipment Cleaning (VE), Raw Material Stock iles (Rz Ali Mixing Drum'
Cleanout (MD). Report more than one type if the waste -stream Is commingled. ; ' '
s If an effluent limit is exceeded twice In a row, the permittee is required to Institute monthly monitoring for -that parameter forsix months, nIess DWQ RO staff
notifies you to -continue monitoring.
spH7lmtts are 6 9 S.U. for wastewater.dlscharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.. ,
TSS IlmEts are20 mg/i;for:wastewaXer' ischaiges ta:FiQW waters l0 mg/L`for'.. routand PNAwaters, and,3p;mg/L,fnrallv.ther,water.Bassi icat<ons
4' '
Permit Date: 7/1/2010;OS/3Q/2015 '":fast.Revised 07/1.3/11
a Pagel. of Z
- f
yam, i

Process wastewater dischar'ge's shall only be monitored for TPH when com mIi not have,"aI ' rnit for wastewater,
ngled with storm)A;6tdr discharges from VMA areas. TPH.does n I
.;.
7 but Instead is subject to benchmarks and Provisions of Part IV, Section A, lniduijhig the ter0d R""espan5a'Action. k,
.-.Flow. rate can be measured. contInuously or calculated. Flow limits for wastewater discharges to. H QW waters shall be set to 50% of the Summer 7Q) 1a Flow as per--15A,-
NCAC 028.02241 crmittees whoiodischarge wastewater t6.HQW wat
ers.shall- obtain a Summer7Q10 flqwandxeport this Informationto DW'Q,.If the Vermittee-cannot-i- -
recelvingwaters-ai. e�, Lscgaracil o6ti—n thefp6rmIttee shail[ `�6ndlthe-MaAe' ''alre
.0 tain.a Summer 7Q1O'fl6W'f&'tJ�
n WQ, eonaI:Office-rnay:req an annual now
re n 'by a CaSC7 -case� �b�sls.'
- MAILIO IGINAL'AND'-ONE;COPY1'-O.F-THIS-ANNUAL-SUMmARY-(INC-LUDIN(5--ALlL-,"NO.FLOW"m '"NOzblSCHAft(5E�-W-LT.81]213Q"nAYS.-O-F RECEIPT:OF SAMPLE
Qt
C tj NU'l-LUW;,110,'.
U cm
ofWt&QL
Divislon 21 Uality.
Attn:-DWQ:C
entral Files:-,
;1617-Mall-Se: ce;Center' 7.
27699.1k7--
[phone],
?
a
t
YOU !VN,Tms CER77FICA77ON FOR ANY lffQRMATION REPORTE6.
-under.p9nal of
"!.certify, ind all attachments Were prep d o�.supervjslon in accordancewitha 5'Y51assure that qualified '
law,
are under
person.ne prop.e.r.11V gather and evaluate the information Ba�sdd,6n my jjgp upersons�who ma 'i
those pe'rsons directly fiisponsibleforgathering th
therecomplete t am aware that are sOlflcant perIaltles' dr'su In F4
I ��41 mrprisonment for k
f - submitting Informal Inc u Ing, hef,
violations D yoss) I]tV:otfine
L lcu&
, I
(Signature of O'�rm ttee
Date
Permit Date. 7/1/2010-06/20/2015
I: dCSigF , led' t 0
theJ5ys t em,-or.
Last Revised 07113/11
Page 2 of 2

k
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14-(:2w.I _ —�
FACILITY NAME:
PERSON COLLECTING SAMPLES bnt
CERTIFIED LABORATORY J�sl j,�i �'1 Lab # _ 3
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: an Co _
SAMPLING PERIOD: ❑ July -December January -June
COUNTY 7�1+44-
PHONE NO. fib)
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HClW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
pH
(Standard
Units)
TS5
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
6-92
1002a
-
n
.
_o
�^VfllYlrill
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z if a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW; Trout, and PNA waters where they are 50 mg/l.
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
CIFIVED
R 2 2016
VR SECTION
}1� PROCESSING UNIT
Permit Date: 7/1/2011-60/30/201S Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year
Outfall
No.
Date Sample
Collected
(mo/dd/yr)1
pH
(Standard
Units)
TPH using method
1664ASGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfalla
(in)
New Motor Oil
Usage
(gal/month)
Month) In Tier 2
y
Monitoring?
(y/n)
# of Months
in Tier 2
2
Sampling
6-92
15$
1002,3
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons 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 %ignii icant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 7/1/2011-60/30/201S
(Date)
Last Revised 7/13/11
Page 2 of 2

STORM WATER-DISCHA'RGE,OUTFAW(SDO) = Semi.=Annual.MONITORING, FORM.-
GENERAL PERMIT NOACG14.00.00
CERTIFICATE OF COVERAGE NO, NCG/14Q L G -1 SAMPLE COLLECTION YEAR:
FACILITY NAME: ne�� �'1;1Cc LA 01le`►L t�D SAMPLING PERIOD: N- uly-December, . ❑ January -June
PERSON COLLECTING SAMPLES 1f1M Cr:-_vNLtx COUNTY J,c�S t1� _ it'6�
CERTIFIED LABORATORY do .&J,% -.cAJ Lab PHONE NO. [33G) '-i O
Lab # ADD TO LISTSERVE?.❑YES ❑NO EMAIL:.
OPTIONAL INFO: DISCHARGING TO.CLASS: ❑SA ❑HCtW ❑PNA []Trout ❑Othe_r
Part A- Stormwater Monitoring Reouirements
Outfall,No.
.,pate Sample,
Collected
•( mo/dd/yr OR
NO -FLOW)'
PH
(Standard
Units)._.
TSS
(mg/L):��
-Event ,. .
Duration-.•_.
�
(minutes).
Total ,.
4
_..._. Rainfall ._. -
(in)
In Tier 2 ,
Monthly
? .
- .
Monitoring.
(Y/n) ?
# of Months in T'
z -�
2Sampling
6 9z ...
. _... - 100z, r
Shy
<s ) L
Ltp
F
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier-1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW,.Trout, and PNA waters where they are 50 mg/I.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date:7/1/2011-60/30/2015
Last Revised 7/13/11
Page 1 of 2
/J

Part B: Vehicle Maintenance Activity Monitoring, Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
' ` �� K"=
f -
�'.>y''+-r r - �
� i Y -
-rF. �.
":method
y 2 , �--..s" '�
it -iL" i `.`Tiy.v!Yr.• .+.i
: aka
f, `�i%]`ice. MT'�`sn.ini
• �'- �+J •f r f
� _ A �
e] f 1-:--
s �i i..f�„
f x
Sh ASS '�
i '-k Y
izTP,.H usirr` .
Ti tal Sus ended
p
` 'Event
} :Totai
New Motor 0ll f
s0utfaEl
Date lSam le,
P
rp w•;.. ti
'
a. f =
Usage
Y
`
:No`C
r: i standard.
{
„µ1664A 5GT HEM
=SolidsA f
=Duration ,
t Rainfall
g
w. _ •`
�n Tier{2
.,. L
fl
,,Collected
w
, . .•. x _
__..
x
L y
,
minutes
r- in
month
g.;r
:
��'�5ain lin
b ,
mo dtlr
1
,Units
m ,L
m {
+, r;k xa.7�
t n
K-
al
r
n
$
--tip
f -r 4� --
+ r i T-e-.
_
-••..a,'C' ;±M w
�..
-�- --,LJn
� -
! c
� 4 x i..,- °i
}7�Py«++r
dw+.,. t -
iZ"A.'";,e+?``�''•^Y�'�y
3�1'f,6 -FµY- !'r•:
/r ��
� ;�.-: �. _. fi•.
,2. ,,;- t �
. i:1!.-'
¢�N7��.. ,,.. y+ S
i.
`MV4
.. 31
i..
.r••.=
_
-kr 2,3.A 5 a45
�n tk
i '�
h +` ?
W
-�":'�. --'r,.
-��st ��i
100
. r r
_ r
.,,
M- -1
HAS YOUR FACILITY HAD 4 0R MORE BENCHMARK EXCEEDENCES ATANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [:]NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT -NAME:
4.
Mail Orieinal and one conv of this DMR OncludinH all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample {or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for athering the information, the information submitted is, to the best of my knowledge and belief; true, accurate, and complete.
am aware that there are significagt-alties for submitting false information, including the possibility of fines and imprisonment forknowing violations."
(signature
Permit Date:7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report,
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO,, NCG14 o_I
FACILITY NAME: J 6k�a �q %yt..&(���'7rc Co • R
PERSON COLLECTING SAMPLES:1)6,6 Ns�.
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS?..YES ❑ NO
Part A. Wastewater Monitorinx Reauirements
SAMPLE COLLECTION YEAR:
SAMPLE QUARTER: [&Jul -Sept ❑Oct -bet Dan -March []April -June
COUNTY: FvXSq
PHONE NO.( :3i-
ADD TO LISTSERVE? [:]YES.❑NO EMAIL- i.
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA QTrout []Other_
OPTIONAL INFO:
Outfall Na.
Date Sample.
1
Collected'
(mrri/dd/yrj
Type of Wastewater
a
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
5ettieabie
Solids
(mL/L)
TPH using
method 1664A
(m SGT-HEM'
Dlscharge
Duration
(minutes)
Total Flow
�
(gallons/day)
-
-
-
6-9",
303.s
5s
(15)5
-
E)Q0
"1u i
r
iV
-1
Zrr '
1 If wastewater systems have not discharged in this quarter— report "No flow" or "No Discharge here, Please make sure to mark the sampi quarter; Bove.
Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stcckr Iles (RIN);' Mixing Drum
Cleanout (MD), Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permlttee Is required to Institute monthly monitoring for that parameter For six months, t nless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.. (;
s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L forTrout and PNA waters, and 30 mg/L for all otherwater classl ications.r
Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11
a .; Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have :'a`limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, inciuding the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Qi0 Flow as per 15A
NCAC 028.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If thei ­permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
i
AT fNb E-MONITORING PERIOD IN CASE OF NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files -
1617 Mall Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUSTSIGN.TH1 CFR.77FL0U0JY FORAlifY1NF0RPAA„T1gN 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 responslbie for gathering the Information, the information submitted Is, to the best 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 kn6wing
violations."
(Signature of Permittee). (Date).
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2of2

PROCESS WASTEWATER —Quarterly Discharge Monitoring Report. JUL 2015
GENERAL PERMIT NO. NCG140000
CENTRAL~ I`ILES
DWR SECTION
CERTIFICATE OF COVERA E NO. NCG14 D
FACILITY NAME: VWjiJ41 -cr
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: ( Lab # 4 314
Lab #
LIMIT VIOLATIONS? YES ❑ NO 54
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLE QUARTER: []Jul -Sept []Oct -Dec ❑Jan-Mbrch NApril-June
COUNTY:. F_9c 6q t
PHONE NO. (y' �a] 9�3' 14 DI
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA n]�Qnw ❑PNA ❑;rout ❑Other
OPTIONAL INFO: s�aLrf—``��JJp�I1S
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)Z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-HEM'
(mg/L)
Discharge
D+�rat lan
(minutes)
Total Flow
gallons/day)'
•
-
-
6-93.4
303.5
53
(15)6
-
/UD
I
.
' If wastewater systems have not discharged In this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sampl
Y Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Leaning (VE), Raw Material Stock
Cleanout (MD). Report more than one type if the waste -stream is commingled.
' If an effluent limit is exceeded twice In a row, the permittee is required to institute monthly monitoring for that parameter for six months,
notifies you to continue monitoring.
4 pH limits are 6-9 S.U, for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. .
' TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water class!
Permit Date:7/1/2010-06/30/2015
quarter above.
iles *Ai, 'Mixing Drum
nless DWQ RO staff
C,
iv
cations.r
'.Last Revised 07/13/11
Page 1 of 2

s Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have `a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ, If the. permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ,'and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL QRIGINAL AND -ONE OP OF TH15 ANNUAL SUMMARY IINCLUDING ALL "NO FLOW" "NO DISCHARGE-1 WITHIN 30 DAY5OF RECEIPT OF SAMPLE OR
AT END OF
MONITORING PERIOD IN CASE OF _NQFLOW"! TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center 7
Raleigh, North Carolina 27699-1617
[phone]
YOU MUs7 sio THIS CERTlFronou FOR ANY INFORM, Lm 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. 1 am aware that there are significant penalties for submitting false Information, Including the possibility of fines and Imprisonment for knowing
(Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NQ. NCG14 0 r :. -
FACILITY NAME: Scaj C"QP-;R C°0.
PERSON COLLECTING SAMPLES: Alrv,
CERTIFIED LABORATORY,i +► +-€"ck&, RI Lab# P4,C-f.,
Lab #
LIMIT VIOLATIONS? YES ❑ NO ff
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: a0L _ i
SAMPLE QUARTER: []Jul -Sept ❑Oct -Dec xJan-March ❑April -June
COUNTY: F0?:,,Vjr4/1
PHONE NO. (334
ADD TO LISTSERVE? []YES []NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA []Trout ❑Other
OPTIONAL INFO:
Outfall No.
Date Sample
i
Collected
(mm/dd/yr)
Type of Wastewater
x
RMMl7)
(VE, ,
pH
(standard]
Total Suspended
Solids
(mg/L) r
Settleable
Sollds
(mL/L)
TPH using
method 1664A
SGf-NEA?�
(mg/L)
Dlscharge
••
Duration
(minutes)
- Total Flow
y
(gallons/day}
-
-
6-93.4
303s
53
(15),
-
-
. oi0 b
-"7•S
1 l M %t-
o.l M1 L-
e
+r
`
l
-
I
.
1 If wastewater systems have not discharged In this quarter -- report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above,
: Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 Kan effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff .
notifies you to continue monitoring. ~
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. -
S TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications. .
Permit Date: 7/1/201M6/30/2015 Last Revised 07/13/11
Page 1 of 2

m

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 0260!0224, Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. if the`permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MU T SIGN THIS CER77FICATION i90RANY1NFQRMAWN 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)
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

.y
PROCFSS WASTE_'WA.T -R .' Quarterly .Discharge Monitor-ingReport
GENERAL PERMIT NO. NCG140000'
CERTIFICATE OF COVERAGE NO:
FACILITY NAME `A Mik '
, PERSON COLI.I:CTING SAMPLES:�F
CERTIFIED -LABORATORY. a
.�'.'-LIMiT�VIOLATIONS? YESr�❑NO'�
E
DECEIVED
DEC 2 9 2014
C
CENTRAL FILES
14 d { to � SAMPLE COLLECTION YEAR: a�.D i �{ '� � DW �EC�'I N
SAMPLE ❑ QUARTER: ':, Jul Sept f _:;K9d. Dec: , ❑ .Jan March --: April -tune
COUNTY y-
+,L�
A� �
Part A: Wastewater Monitorine Reauirements
'�►1xLab # x �.
ADD TO LlSTSERVE71. YES 7< NO _EMAIL �`..- Y
DISCHARGING TO CLASS:: []SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
_.. _
Via= . ,� .: ._`
_ .Date
Outfallk
2,
`��f�'�
'" a f ''1
_v+-a'._ra-
sample �;
=T
Coll 'ct 1
. ed
r
+�(. Y)
'�' �
'_`C' 3":.i.: {.- f`
�'T}
..
_ Yp e ofaWastewater :
2.
VE;.RM, MD
.� s
-
:-���"`
- c
f a-§,.
uT,otal
a-N 1 s F�ttr
S - .
a l
standard t's-
��
air.-),
�.�-�-,�����
? -� _
r== - iz_�-. - xy : 'l,s^.:i�r-",F,.-°
suspended: ^ n
WORO —611ds
_ w4
m L ��
.f .� 519?
_.
5ettlea6le
=Solids
mL L �'
{._ / )�
.;
TPHusrng
-�
ethod=1664�Aa�
=
3
�allans
� .,
-''
I!ng/�}7
Y}-.Y:--'
...:
rDrscharge:
Datn =e
(mr
E notes)��mm/dd/.
'
t,�-T �.{'4 W"
Total Flow;.
da�-
''�r�.�`:,����
Ei"��'� � 1d� �`
�_ . : ,�d+t:. .x
'... —�.� � �-�3H
--... _�.� �'._sc�.
r _: -. �X
• .LYE
_ �f'3 4 -
c,.�ts�_9 :�
� - -3;s .�r_
041,
..'h+�:,� � :� , . 4�
' �:T '-m
r;= r mw�;�? �rs� •2rr
��".r�' v.,',
�.��r ^ �r N �:
�_, r.�
� �-i
: a�.
1
'
1 If wastewater systems have not'discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation -for the type of Authorized -Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles'(F M), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
a if:an jeffluent'liriiit is.exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless'DWQ RO staff' .
notifies ,you to'canti-n°ue.itmonitoring.
a pH l... s:
6imitsare6-9.S.0awchargesto`atwaters:argsofreswaeis;'d ffrwsaten
watvWs10mgGor 7, ad fr aother:'wate`classificationss TSS,,jmits arre 20 hig/f.frounsa3o
Permit Date 7/1/2010-06/30/2015 _ .,_ ; - Last Revised 07/13/11
Page`:1. of 2

AA ,4 .�!y
(Signature of Permittee) (Date)
l l l f r ;' Last Revised 07/13/21
Permit Date: 7 1 2010-t)6 30 2015 ,5 �� �< x.{ ' ' r
Page 2of2

.. PROCESS. WASTEWATER 'Quarterly Discharge W nitolcing Report
GENERAL PERMIT N6.NCG140000 ,
CERTIFICATE OF:COVERAGE NO., NCG14 SAMPLE COLLECTION YEAR: 1 `�
FACILITY NAME: -� rJ c �-tc �D , '_ SAMPLE QUARTER: Jul -Sept ❑Ott -Dec ❑Jari=March' ❑April -June
PERSON COLLECTING SAMPLES: _Al aN „_- .�5.�, :COUNTY: btrS f
CERTIFIED LABORATORY: Lab # . PIiONE NO.
Lab # ADDTO LISTSERVE? []YI=S ONO'EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ❑ . : " DISCHARGING TO CLA55: ❑5A ❑HQW ❑PNA '[]Trout. ❑Other
OPTIONAL INFO:
Pait wastewater Monitoring Re uirements l
..Outfall Nor
Date Sample
:: Collected 1
(mm/dd/yr)
Type of Wastewater,
(VE, RM, MD)z
:PH
: (standard)
Total Suspended
solids
(m8/L)
settleable
`�5oilds
. (mL/L)
TP li. using
method I664A
SGT-.NElV♦�
(mg/L) .
Discharge
Duration
(minutes)
Total Flow
�
(gallons/day)
l"If wastewater systems have not discharged In this quarter report "No Flow" or "No Dlscharge" here. Please make sure to mark the sample.cl er above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE); Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report:more than one type if the waste -stream is commingled.
' if an effluent I1mit1s exceeded twice in a row, the permittee is required to lnstitute'monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.Urfor wastewater discharges to freshwaters, and 5:8�8.5 S.U. fordlscharges to saltwaters. .
s TSS.limits are 20 mg/L:for wastewater discharges to HQW waters, 10 mg/L-forTrout and PNA waters, and 30 mg/L for all other water classifications.
'-Permit Date: 7/1/201M6/30/2015 : " Last Revised 07/13/11
Page Z of 2

4 Pracess wastewater discharges shall only be monitored for!PH when'ea r niingied with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject.to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Avow rate can be measured continuously or calculated: flow limits For wastewater discharges'to HkUM waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
'.NCACO2B .0224. Permittees who discharge wastewater to•HQW waters shall obtain:a Summer 7Q10 flowand report this information to DWQ, if the permittee cannot
`.obtain a Summer 7QiO flow for the receiving waters at the discharge lacatlon, the permittee shall notify DWQ; ;and the DWQ Regional Office may require an annual flow
report.on a case-by-case•basis.
MAIL ORIGINAhAN�° N tpPY.QF TH15 ANNOAL SUMMARY'tINCLUDING ALL "NO Fi.QW" "NO DISCHARGE"i*THIN-30 DAYS OF RECEIPT OF SAMPLE (OR
:AT END:0FM0NIT0RING-0PERIOD IN CA,A,E:OF "NO:FLOWR) TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigli,-North Carolina 27699-1617 .
[phone]
LO UA4 U$T 51 N; THIS FICA TION FOR AN Y IM&ORMAT1 N REP Ri6.. .
' I eertify;.urider penalty of law; that this document and al�:attachments.were prep.ared'under my direction orsupervisioh in`accordance with a.system designed to
assure that:quallfied personnel.praperly gather and evaluate the i06ernatlon submitted. Based bn my Inquiry of the person or persons who manage the system, or
,. those persons�directly responslble for gathering the information, the.iaformation 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) (pate)..
Permit Date:7/1/2010=06/30/2015 ` Last Revised.07/13/11
Page 2 of 2

STORMWA-TER-DISCHARGE,OUTEALL'(SDO) =-�5emi-Annual. MONITORING FORM
GENERAL. PERMIT NO. NCG140000
: -CERTIFICATE OF COVERA ENO. NC �4 ,1 .G SAMPLE COLLECTION YEAR:
FACILITY NAME: �� �h,: d►1[h�f �;.. 'SAMPLING PERIOD: IN July-Decetazber [] January -June
:..,:PERSON.COLLECTING SAMPLES �In�r Cwe v4U(tf5
.:COUNTY Fags f�
CERTIFIED LABORATORY Lab ".3_ PHONE.NO, (mot j
Lab fl ADD 70 LISTSERVE7 ❑YES .❑NO EMAIL:
:' .OPTIONAL INFO: -DISCHARGING TO CLASS:: ❑SA : []HQW, .❑P.NA ❑Trout ❑Other
'Part A: Stonmwater Monitoring Requirements '
i
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
PH
(Standard
Units)
TSS
; (mg/L)
Event
Duration :- .
(minutes)
Total
4
Rainfall
(in),
In Tier x
'Monthly
Monitoring? ..
.
# of Months in Tier
:
7 Sampling+
i
'
I
If "NO FLOW" or "NO DISCHARGE, Enter "NO
FLOW" or"NO DISCHARGE" for each ou6all here. Please make sure to mark
the sample period above.
2 If a value is In excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier .l orTier 2 responses In the General Permit. Tier 2
Monthly sampling shall be done until consecutive samples are below the' benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
.4 For each sampled measurable storm event the total precipitation must be.recorded using data from an on -site raln gauge.
Perrnit-Date: 7/1/2011-60/30/2015 I Last Revised
.. .: .. .. . Page loft

Part B: Vehicle Maintenance Activity Monitoring itequirements.for facilities. 55 gal of,new motor oil/month —averaged over a calendaryear:
outfall
No.
Date Sample
Collected
(mo/dd/yr)'
pH
(Standard
Units)
TPH using method
.1664A SGT-HEM
(mg/L)
Total Suspended :,
Sollds .
: (mg/1)
Event
Duration
(minutes) " "
Total
a
Rainfall
(in)
New Motor Oil
"Usage-.
(gal/month) :
In Tier 2'
.. Monthly"
`Monitoring? ; <
(y/n) ::...
# of Months,..
in Tier 2,
:
.Sampling
:.
6-9
15
HAS YOUR FACILITY HAD 4:OR MORE BENCHMARK EXCEEDENCES AT -ANY ONE'OLJTFALL (INCLUDING VEHICLE:MAINTENANCE)7 YES ❑ NO ©"
HAVE YOU CONTACTED THE REGION? .YES ❑ NO 0' _
.. "... REGIONAL OFFICE CONTACT NAME: a
" Mail Original -and one'copy of this pMR (including, all "No -Flow" &'"No Discharge" reports) withiri-30-days of receipt of samplelor atend'of monitorini period
'in case'of "No Flow") to:
:Division of Water Quality
Attn: DWQ Central Files .
1617 Mail Service Center - ..
Raleigh, North Carolina - 27699-1617 s
YOU MUST SIGN .THIS CERTIFICATION fOR ANY INFORMA77ON REPORTEM .;
"I certify, under.penalty af'law, that this document and ail attachments Were -prepared under rn dirkdori'or supeNislon in aewrdance with a system designed to
—assure that qualified personnel properly gather and "e►+afuate 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 info rmatlon.submitted is; to the best of my knowledge and belief; true, accurate,.and complete.. I
- am aware that there are significant p altles.for submitting false Information, Including the possibility of fines and Imprisonment -for knowing violations."
(Signature of Permittee).. ! (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
.Page 2of2

Alp
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
24 July 2014
Danny Rathbone
Ready Mixed Concrete Co.
P.O. Box 12397
Winston-Salem, NC 27117
Subject: Compliance Evaluation Inspection
NPDES General Stormwater Permit NCG140000
Certificate of Coverage NCG140167
Ready Mixed Concrete Co. — Kernersville Plant
Forsyth County
Dear Mr. Rathbone:
John E. Skvarla, III
Secretary
F?ECE j VEp
JUL 3 I 2014
CENTRAL FILES
DWQ/kG
Aana Taylor -Smith of the Winston-Salem Regional Office of the NC Division of Energy, Mineral, and Land
Resources (DEMLR) conducted a compliance evaluation inspection atthe subjectfacility on 24 July 2014.
Your assistance and cooperation, as well as that of Mr. Alan Cervantes, were greatly appreciated. An
inspection checklist is attached for your records and the inspection findings are summarized below.
This facility is located at 1491 Brookford Road in Kernersville, Forsyth County, North Carolina.
Stormwater related to industrial activity is discharged from the site to an unnamed tributary to the West
Fork of the Deep River, which is currently classified as Class WS-IV waters, in the Cape Fear River Basin.
Documentation & Monitoring Review
The facility's Stormwater Pollution Prevention Plan (SPPP) is very thorough, up to date, and fully
implemented. Employee training is completed once each month and recorded in the SPPP. All
documents were well organized and available for inspection.
Qualitative and analytical monitoring have been completed as required. No discrepancies were noted
and sample results were well below benchmark values. No vehicle maintenance is performed on site.
The facility has one Stormwater Discharge Outfall (SDO) that discharges stormwater related to industrial
activity.
Site Review
The site is orderly and well maintained. Secondary containment is implemented as required. The outfall
was inspected and found to be in excellent condition. Best Management Practices (BMPs) at the outfall
include rip -rap, check dams, and vegetation to reduce potential contaminant loss from the site. No
evidence of erosion or instability at the SDO was observed. The receiving stream was free of pollution
indicators.
Division of Energy, Mineral, and Land Resources
Land Quality Section • Winston-Salem Regional Office
585 Waughtown Street, Winston-Salem, NC 27107 - Phone: [phone] FAX: [phone]

Ready Mixed Concrete Co. — Kernersville Plant
07/24/2014
Page 2 of 2
We appreciate your efforts to comply with the stormwater permit and the proactive steps taken to
identify and eliminate potential sources of pollution. No additional response to this letter is required.
Should you have any questions regarding the NCG140000 permit or this inspection, please do not
hesitate to contact Ms. Taylor -Smith or me at [phone].
Sincerely,
Matthew E. Gantt, PE
Regional Engineer
Land Quality Section
Enclosures: BIMS Inspection Checklist
cc: Central Files
WSRO/LQ

_',PROCESS,
CERTIFICATE OF COVE GE NO; NO
FACILITY NAME: ` i`
-PERSON COLLECTiNG,SAIVIPLES: At
CERTIFIED,LA80RATORY:
..:LIMITVIOLATION5? YES`'❑ NO�❑-
WASTEWATER ' - Quarterly Discharge Monitoring Report RECEI / [j
GENERALPERMIT NO. NCG140000 MAY 2 2 2014
CENTRAL FILES
3141? I G �I I SAMPLE COLLECTION YEAR: r � l _ DWQIBOG
n T :; � ,� -_; ' _•:: SAMPLE.QUART;ER- ❑Jul -Sept a , ❑Oct. Dec: Jan -Marco,';: &Pri.l-June
COUNTY
Jj­
PHON E N0 Le
,Lab,
ADD.TO;,IISTSERVE? -❑YES..❑NO ;EMAIL:
4.. DISCHARGING TO -CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements -
r' `E -
x-
OutfallsNo.
�
- TI,v`4;
:; DatewSample ,.
0� _ ' -_
�' Collect
i,"F it ' " `"F---:,
. �,u _ o ra_ _�:
.4 YP
T e of Wastewater
. z:
VERMMD a=w k.r
�2=�
,�"y' .:';ti..�a:,
s
" P H
v ; �� .
standards:
Total'Suspended:
_ _
z .:: Sollds�
"�-minutes
7
Settleable, �4
' -�method664l`
;a -Solids_. a
xSGT
c qa`r� 1 4
NE
rDischarge
m
N
-
Natal Flaw
allans .tla
,�- A :t' -.—v„
-: ii ,.__,,�'�,^. �r, , ..._,
,. _ r ate- _-:s_.
r..r34d',...yaJ�^,.6i1-�A-
- r
-rr.
• .w
alA:_�',ts.we
I!
Q
n, 9 7
4) ,O 1
c7 . l
I So
0 1�—(r 9
' if wastewater systems have not'discharged in thisquarter- report "No Flow' or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
31f.:an of 1uent'limit is,exceede'd twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless';DWQ RO staff
.notifies
,You to continue monitoring...
a AHaimits are 6-9 S.U. for wastewater discFiargesito freshwaters,°and 6 8 8:5;5 U.:for discharges to'saltWate�s;
. .. : a
T55 limits are 20 rimg/L foe:,W6stewater discharges to`HQW:wate�s 10 mg1Ufo:r' of and-PNA`waters, and.30 mp,/L fot all other vater'i !ossifications
Permit Date:--7/1/2010-D6/�0/2015:. �_, _ Last Revised 07/13/11
Page: L of 2

I
e Pro.cess;wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit,for wastewater,.
but instead is subjedt to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be' measured continuously o�rcalculated:.FloGu liinits'for wastewater.' ischarges tb'HQW,waters shall`be set to 50%.of the Summer:7410 Flow as per 15A .
NCAC 026.0224 Permittees'"who discharge wastewa4er fo HQIN watersshall .obtain a'SUmmer 7Q10'flow'and report this information to DWQ. If the permittee cannot
obtain:a.Summ& 7Q10 flow for'tlie receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may:require an annual flow.
' report on a case -by -case -basis. _
{ t
I MAIL-ORIGINALAND:ONE COPY-OFTHIS-ANNUAL-SUMMARY- INCLUDING ALL -"NO FLOW "NO' -DISCHARGE" :WITHIN 30DAYS OF,RECEIPT-OF SAMPLE• OR
Division of Water Qualit
i AT END'OF MONITORING-PERIOD=INZA' SE Of "NO'FLOW"1 T0; r -
Y
Attm DWQ Central,Files ;.i.. �I :.
1-617 Mail Service Center �:_ ._ ......
Raleigh; North:Carolina% 27699-1617 � . ......
[phone]',7 :....... , .._ ...... ? . _....
.F E
4�
I YOU,NIUSTSIGN_THIS CERTIFICATION FOR.ANY.-INFORMATION RJ PORTED'
I certify, under penalty of law, that this, document.and all attadhments were.prepared under my diredi6n:or-superwsionrin accordance with"a system:designed to
assure that qualified' p'erionnel properly_gather:and_eyaluate the�th�ejpfqrmatlon
information.submitted k' Sased=bh.my mgwry of the person`or persons who manage the system, or
i thosekpersons ihrectly respon_ sibEe forgathering the;information submitted is, to the best of my knowledge and belief, true, accurate, and
complete 1 anraware that there are significant penalties for submitting false Information;, Including theipossibility,offines andJrnprisonnient-for.knowing ,
violations.' , I tf.;s
(Signature of Permittee) f (Date)
Permit Date: 7/1/2010-06/3D%2015.: ', '1 ' ,.: ` ' last Revised 07/13/11
fPage iof 2
i
3 •

STORMIMATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GE,NERALPERMIT NO. NCG140000
CERTIFICATE OF COVEkAGE=; NCG 14, D. COLLECTION YEAR:
FACILITY 'NAME: .-SAMPLING PERIOD:,. n July, -December, January -June
-
PERSON COLLECTING, SAMPLES _COUNTY
PHONE NO. (:k%(o -A�� -i—ir
CERTIFIED LABORAT66��',� jWj,0,.c4-V' "Lab #
Lab # ADD TO LISTSERVE? []YES []NO EMAIL:
0 PTION . A . L . INFO: AI45- DISCHARGING TO CLASS: DSA []HQWE]PNAE]Trout [—]Other
.Part A: Stormwater Monitoring Requirements
2
np
A-�� Collected
dc4yr-VR�.
P_
.'-�
,[Standard.
qi;.
X
SS
4 i ,
!
40-
2T, hifutos
P�
_
_ _
,Mont
At
� r,�'
e.�Ve:�of4VO
z
Z,
UEIVED
i6n o I .,1. . .
tj JL 4U14
ATRAL FILES
If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to.mark the sample period above.
2
If a value is in exces'!Vof the benchmark;.qr outside the benchmark range (for pH)' -d
1.�pu must implement the Tier 1 or,Tier 2 responses, in,the•General Perihit. Tier 2
- M66thly sampli 'ng-sihaill be -done until-3,consecutive,sa.ipples are below the benchmark or within the ,benchmark
3 TSS-benchmark �aluei`a6e100 mg%l, except when discharg'-in"g to' _0R'W, HQW,,Trout,.and:PNA waters where they'are.50mg/I.
4 ion must recorded using data from an on -site rain gau'ge. A
For each sampled measurable�storm event the,total,peecipitat
Permit D6te:`1/1/W11-60;/"30/2b15 "Last Revised 7/13/11
Page 1 of 2

Part 8«'VehbleK8a MonitorinE Reauirements1forfocUitieyudmr>55ea|ofnewmutmroil/month—uvero2edovera:a|enda,vear.-' �
27
rnethoM
a it
tz
1 ®r; 4
49,
rT
, _ _
HAVE YOU CONTACTED THE REGION? __JES t[D!NO
REGIONAL OFFICE CONTACT NAME:
Division of Water (�uality_,.
Attn: DWQ Central Files
1617 'Mail Service Center',,,
Raleigh, North Carolina 27699-1617
e�i u �der`,_peAjl`2 if�i1it this document and all -attachments wer in'k�o�6n e with a syst'ern designed to
prepar6&under my direct.ion or supervision
assurEfthat`q'ualified personnel properly gather and evaluate the information submitte&--Based ommy-jnquiry of,the:person;or. persons who manage.,the system, or
those:peesdns d*irectly'respon'sib[6'for':gathering the information, the information submitted is, -to the best of my l<nowledge and -belief, true, accurate, and complete. I
am aware that there are significant penalties foFsubmitting false information, including thepossiJbility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Mat
Page 2 of 2

i
i
I
PROCESS. WASTEWATER' Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
. �....: �.. _' . ".:.. _.. .. ...E .. � "...... '
CERTIFICATE OF COVERAGE NO: N G14 b '! (o SAMPLE COLLECTION YEAR: odd i
=__ SAMPLE UARTER:: : JuLSe t, Oct IJec_ an -March:; ❑Apri.l-June
FACILITY NAME: '� k' o L • Q :,..P:, : 0
PERSQN COLLECTINGSANIPLES: i4' ' 1 '' COUNTY vQc.f "�'':'
- ,r>
CERTIFIED I.ABORATORY:1��e�;�. �y�icA� } L`ab #� �3 �� '�y�
PHONE NO,: (33Ci-i•'�7$S •..
A'DD T0,115TSERVE?-�❑Y S; ❑NQ.E A!
LIMIT VIOLATIONS? .YES ❑ NO DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
—��
~T- �
�P-
Outfalh ....�
No:
-, W
yate,Sam ie _
�Callected _ T
. I l
' a
�,: ..
kT_ e•of Wastewater
- , YP_ {: z`
=(VE3xRM IVID =
'Y . },: ''-
r .. ...�t?oSj
��r'-.-1c•N-".t' 1 i-'-
?- r-:—
r~
_ '�
M@y p
(standards
- - .)
'n- --
_
Total'5us ended.
- - - P-=Gmethodr3664A
Soli�d�
C_�J `�i-'.4}�
`'�:'r.-_ _
-,
-S ble."
r=Solitls
_SGT:NE�
-
�� g
,� .� y
�'
(,, 1,,,,�
l 61�._}-t ...
Dischar e
g ,�
.Durat�on����
mina esj
-' n
7otalFlow
f
[ga Ions/.day)
I _.
2.
S - �r=w�� �.�
r ,
aM 4r� {�„�
" s r�L-£'@
�z� . �:,��,. .+'��'.�..�
a•+. r, C_n-
+�Y.Fs7n
_ r 15 -_
�iL
r� �� ,�"man,
5��=�f���-s�•
' r
5
s-�6i� ���
F=,,,:alr _ s„
�i5 '".
.-H 3�
c-
< a-1 M;
'%O
OP p'
i!
MAR
A x 7nsA
G
fib
UAL FILES
1 If wastewater systems have not'discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above,
2 Report the abbreviation for the type of Authorized • Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles'(RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 If._an effluent limit is.exce'eded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless'DWQ RO staff
notifies yod to continue monitoring.
pH,limits'are 6-9 ,for' wastewater dikharg6s,to.freshwaters, and 6 S 8 5 5 U ".for discharges toaaltwatees. ..
s TSS.1imits are 20 riidL_'for:+uastewater discharges to FiQW:inraters;:10 mg%L'far.T�outahid PNA waters,'arid 30 rng/Z for all otherinrater"classificationsr
Permitpate:-7 }. .rp �_, _: _•. - Last Revised 07/13/11
.Page 1'of 2
I

i
c Pro.cess,wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a Iimit,for wastewater,
but instead is subject,to iienchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculateii Flow.lrmits for'wastewater:discharges to HQW waters shall beset to 50%:ofahe Summer,7Q10 Flow as per 15A ,
NCAC 0213 ­.0224 Permittee's +"ho'discliarge WSAewater to-HQW. waters'shall obtain a Summer 7Q10 flow'and reportthis information to DWQ. If the permittee cannot
obtain•a,Summer 7Q10 flow for he' -:receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may"require an annual flow
'"eporrton a case -by -case Basis.
• i
:
MAIL-ORIGINALANDONE -COPY-OF THIS -ANNUAL' -SUMMARY- INCLUDING-ALL"NO-FLOW' -'-`hO'-'DISCHARG El :-WITHIN.30 DAYStOFRECEIPT,'OF SAMPLE: OR
AT-END•OF-ONRI ITONG:PERIOD�IN.CASE OP NO FLOW"]PTO:
M
Division of Water Quality
Attn'DWQ Central -Files
1617 Mail Service Center.
Raleigh; North Carolina 27699-1617 _ ___ ........._. _ _. : - .: -
i' [phone] r• ... ,,._..
_..._..
I
•
T.
1 Y6UMUSTSIGN 7NlS CIERT'IFIG4TION FOR.'ANY-INFORMATiON.REPORTFAr -
!�L :,, .M, p P .' -. Y- _cR p ` l s t stem -designed to-..:...,•
I certify, under penalty of law, that this.document.and all attachments were re ared under m `direction or srJ envision in accordance with a sy
as
sure, tha# qualifietl personnellprope'rly_gather andevaluate•tFieJinformation_submitted `M8 96d`on my inquiry of the person or persons who manage the system, or
those persons'dlrectly responsible,for,gathering'the• information;�the information submitted is, to,the best of my knowledge and Belief, true, accurate, and
compli to 1 am aware that t_here'are significant penalties for submitting false informationriariiiUding therpossibility 9f,,fines an d?imprisonment:•for kriowing . .
violations"
(Signature of Permittee) (Date}
Permit Date: 7 1 2010-06 30 2015_: ,� E. ' •`
/ I l/ �: °1' 3 ':r ``°�';" Last Revised 07/13/11
!' _ Page 2 of 2

S .
' y J
..PROCESS WASTEWATER — Quarterly Discharge Monitoring Report. {
GENERAL PERMIT No. NC6140000
CERTIFICATE OF COVE GE Nbr"NCG14 O j- G ram` SAMPLE COLLECTION YEAR:
FACILITY NAME: M;YKrQ r�"t't� SAMPLE QUARTER:. []Jul -Sept Ott -Dec []Jan -March ❑April -June
PERSON COLLECTING SAMPLES: In ! w.�r _ COUNTY: 1` 0"Y±n �•
CERTIFIEIDIABORATORY: I► 6 h�t Lab #�--
Lab'#'1 ;AI7D:TOfUSTSERVE? YES.•.❑NO�,EMAlL:
LIMITVIOLATIONS7 YES:❑NO®,_ v '-DISCHARGINGTOCLASS.`QSA ❑HQW,4❑PNA°A[]Tr6ut-❑Other .
Part Ai Wastewater Monit6iiAi Requirements I A
Outfa9 No.
Date Sample •
1
Collected
.(mm/dd/yr)
Type of Wastewater
(VE, RM, MDjz
pH
(standard]
Total Suspended `
. Solids
(mg/W
Settleable
Solids �
(mL/L)
TPH using
method1664A
SGT-Jq&VIs .
(+a1L)
Dlscha�ge
s; s;1
Duratlan
..
(minutesj,
Total Flow
t
(gallons/dayj
303'5
53
(15y6
t
n ,
,.
N
= If wastewater systems have not discharged in this quarter— report "No Flow" or'No Discharge" here. Please make sure to mark thesamplei quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stock Iles (RMi,!: liAng Drum
Cleanout (MD). Report more than one type if the waste -stream Is commingled.
n if an effluent limit is exceeded twice in a row, the permittee Is required to institute monthly monitoring for that parameter for,six months, L nless DWq,RO staff
notifies you to continue monitoring.
`pH llrn is are 6 9 5`U. for wastewater discharges to freshwaters, and 6.&-8.5 S.U. for discharges to saltwaters.. 1
s TSS ilmits are 20 mg/L f o rkwi` itewak -e-ir"d Ischargii 1:6 HQW.-wate rs;'10'mg/L for Trout and PNA waters, and 30'mg/L-for all otherywater.classl
Permit Date: 7J1%2010-06130/2015
fast Revised 07/13/11
;1. = Pagelof2
' .- _. _i'.0 .i•. ., .• _.. .,.._yr, - .. as ..z} .. ..

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have'a.Ilmlt for wastewater,
but Instead Is subject to benchmarks and provisions of Part IV, Section A, lndui8ing the Tiered kesponse Action.
' Flow rate can be measured,continuousiy or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q1a Flow as per 15A .
N6C 02i3.0224:'Pe'r�mittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q1D`flowfor the receiv[ng vuaters`at th'e ifischarge location; the perFnittee shall,notify iJWQ, and.the DWQ Regional.affice may,reiquire an annual flow
'report on acase-by-case`basis: ;
:
t u
:MAIL'_QRIGINAL'AND:ONE COPY'OF TH ANNUAL S�lMMi4RY:f1NCLUDING'Ai;L "NO_FLOW"•"N�.DISCHARGE"f WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
T- ENUDFMON ITORIDIG -PERIOD -INCASF-OF" O•FL W'') TO: �>
: s
°.Division ofWater Quality
-Attn: DWQCentral Files
:-16171 Mall Service Center -
Raleigh, North -Carolina 27699-1617 _ __
[phone]
_
QU�[15 IGN.TNIS�ERiIFlCAT10 FOR;4NY�NFORMAVQNREPORTED =
"I.certify, under penalty of -law, that thls document and all attachments were prepared under my direction or supervision In accordance with a system designed to
assure that 6allffed peribrs eijirnperly gather and evaluate the infarmation submlitedd <F Baseii'ors my lnquiry at the person or.persons who manage tlie.systerr►,
those persons directly respanslble for gathering the information the Information submitted is to the best of m ;knowiedr a and.bellef; true •.accurtiete, and ...'
°y oyfnes and;lrnprisonment forwngcompleter<I am aware that tere are slgniHcantpenaltes for submittingfalse infomnldlgthepsbt
violations." M :
i
�3
(Signature of Permlttee). (hate)
Permit Date; 7/1/201D-06/30/2015 L. st Revised 07/13/11 w
ti 'Page 2 of 2
i