NCG030270_COMPLETE FILE - HISTORICAL_20171105

STORMWATER DIVISION CODING SHEET
RESCISSIONS .
PERMIT NO.
NBC
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
YYYYMMDD

wr�w� ;A�
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http;/Ip—tal.ncdenr.org/web/wq/ws�u/npdessw#tab-4
Permit No.: N/C/Q/P/J14 /_6/
]{acility Name: e
County:
Inspector: ,t
Date of Inspection. 16
Time of Inspection: D PM
�i
Total Event Precipitation (inches):
1 6-
Q/ or Certificate of Coverage No.:
Phone No. 8,) g- -287 ,2aDQ
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[ryes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
i prior. The 72-how- storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Oflice.
By this s!gnature,
7tify at t report is accurate and complete to the best of my knowledge:
l 1 r l -�
(Signature of Permittee or Designee)
Pagel of 2
SWu-242, Last modified 10/2S/2012

Z. Outfall Description:
Outfall No. _NZ -- Structure (pipe, ditch, etc.)��
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area: -
7i'essure z(JCLSIi 'a r&27 -f-ucks en1-6-1;;�q dAy /4'4uIt�F ma'. '
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Z,�ahkyX a'Im sz �'fa'ez .,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): /L2AZej
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
O 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
(1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 Q2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
NQ
a. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall?
Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, last modified 10/25/2012

T�
1 I
Semi-annual Stormwater D{►��haree Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 D Z SAMPLE COLLECTION YEAR
FACILITY N E SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY or Eg*onthlyl month
ING SAMPLES
DISCHARGING TO CLASS ❑ORW HQW ❑Trout ❑PNA
PERSON COLLE
LABORATORY Lab Cent, #��/` ❑Zero -flow ❑Water Supply ❑SA
Comments on sample collectia or analysis: 2�17 [:]Other
CENTRAL FIeLfiASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Part A: Stormwater Benchmarks and Monitoring Results pWR SECTION
No discharge this period:2
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organlcss
Benchmarks = =>
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
5—,�--
.70
Z /4
< <,OS
t ,CAD
. 422,6,S
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall,�you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2012-10/31/2017 5WU-245, last revised 10/25/2012
Page 1of3

t
Facilities( incorporate a solvent management plan into the Stormwater PI _ron Prevention Plan may so certify, and the requirement for T70 ( itoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the Tf0 monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the stormwater Pollution Prevention Plan."
�r ldp� ✓
Name,(PY]nt name)
Title
z/_-.,/
(Date)
Note: Results must be reportedan numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When. results are below the applicable limits, they must be reported in the format. "<XX mg/L where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L. ,
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Ter 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?2
Outfatl Ala.
Date Sample
Collected"
(mo/dd/yr)
24-hour rainfall
amount,
Inche?
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks ===>
_
-
15 mg/L
200 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Perit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 5WU-245, last revised 10/25/2012
Page 2 of 3

Note: if i report a sample value in excess of the benchmark, you must imd, ;ent Tier 1, Tier 2, or Tier 3 responses. See General Permit text
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART it SE ION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ff NO
IF YES, HAVE YOU CONTACTED T . E DWQTTONAL OFFICE? YES NNrNO ❑REGIONAL OFFICE CONTACT NAME: %3v& J ke
Mar_"1 an original and one copy, of this DMR,.includlna a1! "No Discharge" reoarts, within 30 days of receipt of the lab results for at end of monitoring period
in the case of 'No Discharge".reports) to:
Division of Water 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 perso.9ydirectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am awar at;here are signi nt p naities for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of
Ir
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

ARM
MCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: bttp;JLnortalmedennorg/web/wq 1ws fsit/npdessvti#tab_4
Permit No.: ICI1-C1j: /Q/yJ/2/2 G%a or Certificate of Coverage No.: ht/U. i/Q/3/Q/2/z/0
Facility Name: %%e ,; % �? Z' 6?4Z",,9V —.- --� --------------,
County: Phone No.
Inspector: Lohblj
Date of Inspection: „ , , , .S ,5 / % _
Time of Inspection: ZA�%� ----_
Total Event Precipitation (inches): %
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
�-- ; Qualitative monitoring requirements vary, Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
i and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
;Byhis ature, I cert' that 's report is accurate and complete to the best of my knowledge:
gnature of Permittee or Designee)
Page 1 of 2
sWU-242, Last modified 10/25/2012

i
1. Outfall Description:
Outfall No.'A ---j— -- Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area: 1
S , G
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: fZ2 + �4�, E�_�
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
Q 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 0 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 © 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. is there evidence of erosion or deposition at the outfall? Yes `
10. - Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
`�. may he indicative of pollutant exposure.- These conditions warrant further investigation.
i;
Page 2 of 2
'SWIG-242, Last modified 10/25/2012

Semiannual Stormwater,`jscharee Monitoring Report'
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 3- - /
CERTIFICATE OF COVERAGE NO. NCG03 O k 7 D
FACILITY NAME � %i�?/� 1,o,��L
COUNTY ,er— e-
PERSON COLLEC-PNG
LABORATORY 14C,
b Cert. #
Comments on sample collectidn or analysis:
SAMPLE COLLECTION YEAR oO / 7
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or [I2'Monthly' (month)
CC DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
ECEIVED ❑Zero -flow ❑Water Supply ❑SA
❑Other
MAY 2 '2 2017
CENTRAL FILESPLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Part A: Stormwater Benchmarks and Monitoring Results DwR SECTION
No discharge this period?z
Outfall No.date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics5
Benchmarks
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0,067 mg/L
15 mg/L
1 mg/L
2 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date; 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilitie � t incorporate a solvent management plan into the Stormwater "tion Prevention Plan may so certify, and the requirement for TTC)itoring
may be vded. The solvent management plan shall include a list of the total`, _ is organic compounds used and the other elements listed in the G«�ral
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevent, Ian."
Z/GAS /�
Name J nt name)
Title (BzMt tiVel
ature) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Note: lf�.,report a sample value in excess of the benchmark, you must im, rent Tier 1, Tier Z, or Tier 3 responses. See General Permit text.
FOR PART AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES �10 ❑
IF YES, HAVE YOU CONTACTED THE DWQ R/�EEGI NAL OFFICE? YES [NO ❑
REGIONAL OFFICE CONTACT NAME: L9�2A( /yf PAi
Mail an original and one copy of this DMR, including all "No Discharge" resorts, within 30 days of receipt of the lab results or at end of monitoring period
in the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. i
am aware t where are significan�pae&t &&Jor submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of Permittee)
`� �• / '7
{Dat )
Permit Date: 11/1/2072-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

.1%
wrir.w�a.o..�
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http:I/portal.ncdenr.org./web/wq/ws/su/npdessw#tab-4
Permit No.: N/C/e!-j/a/I-i/j6)161f/
Facility Name:
County:
Inspector: Zlj `
Date of Inspection. /
Time of Inspection:
Total Event Precipitation (inches):
or Certificate of Coverage No.: N/C/G/,0/0/I/S/-7/.L/
one No.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
MYes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
! obtains approval from the local DWQ Regional Office.
By thijxllgriature, i certify hat thi re p 011,01rccurate and complete to the best of my knowledge:
ignature of Permittee or Designee)
b
SWU-242, Last modified 10/25/2012
Page 1 of 2

1. Outfall Description:
Outfall No.� Structure (pipe, ditch, etc.) `
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area: ?
. f �J
P
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: A1 z
3. Odor: Describe any
weals chlorine odor, etc.): A
tinct odors that the discharge may have (i.e., smells strongly of oil,
4. Clarity. Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
0 2 3 4 5
S. Floating Solids: Choose the number- which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2' 3 4 5
C. Suspended Solids: Choose the number- which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. is there an oil sheen in the stormwater discharge? Yeso
9. is there evidence of erosion or deposition at the outfall? Yes Vol
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
b
(Vote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure.. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE
FACILITY NAME
COUNTY
PERSON COLLE ING SA
LABORATORY Q.GP
comments on sample colll iorror analysis:
zQ
Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR ail
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or Monthly'_- -;&Y `C� (month)
DISCHARGING TO CLASS ❑ORW E]HQW ❑Trout ❑PNA
t I^D ❑Zero -flow [:]Water Supply ❑SA
RECEIV
ED t ❑Other
MAY 0 1 Z017 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWR SECTION
�No discharge this period:
Outfall No.
DateSample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
topper
Lead
Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organlcs5
Benchmarks =__>
_
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling'is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

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`.
1.
F�
• i,+ r5.,
1
i
1
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M
f
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.,
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I

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(70), 1 certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Pla I`
// ///I- -, r, ✓s� %` ,/
me
Title le}
Y �
ignature) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format. "<XX_mg%L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?2
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1654 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =-->
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 - 9.0 Su
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Note: if you report a sample value in excess of the benchmark, you must Implement Tier 1, Tier 2, or Tiler 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER ATTHE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SE TION B.
• TIER 3: C HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN FOR THE SAME PARAMETER AT ANY ONE OUTFALL7 YES [NO El
IF YES, HAVE YOU CONTACTED THE DWQ EGIONA OFFICE? YES NO
REGIONAL OFFICE CONTACT NAME: $� �f
Mail an original and one copy of this DMR, including all "No Discharcie" reports, within 30 days of receipt of the lab results for at end of monitoringweriod
in the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly respons' gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am awarjed7ft there are sigKificant pghaltiej for submitting false information, including the possibility of fines and imprisonment for knowing violations."
e5Lj
[Signature of Permittee}
Permit Date: 11/1/2012-10/31/2017
.4/ -� 7-1-1 v
EDate)
SWU-245, last revised 10/25/2012
Page 3 of 3

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Semi-annual Stormwater Achame Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 34-J7
CERTIFICATE OF COVERAGE NO. NCG03
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES ih LI [Tif?rSD�
LABORATORY Lbb Cert. ##
Comments on sample collecti n or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR ; /J / 7
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or VMonthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]zero -flow ❑Water Supply []SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organicss
Benchmarks =_->
_
-
100 mg/L or 50 mg/L
6.0 _ 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: I1/1/2012-10/31/2017 5WU-245, last revised 10/25/2012
Page 1 of 3

_ .c- - �
- � .. V
5 � . - J -
' J � -

Facilities0l incorporate a solvent management plan into the Stormwater PSI on Prevention Plan may so certify, and the requirement for TTO Otoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the T O monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TrO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention PIS"
/l/t /�r L r/J
Name (Prjnt name)
( te)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?Z
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

r
F
1
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Note: If Oreport a sample value in excess of the benchmark, you must imment Tier 1, Tier 2, or Tier responses. See General Permit text. 0
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 531NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES M NO
03 c❑
REGIONAL OFFICE CONTACT NAME: � 141 ,P j I
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period
in the case of "No Discharge" reports] ta:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant xmatttes,for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
/ 7
(D e)
11
Permit Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/2S/2012
Page 3 of 3

P CDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http:%/uortal.ncdennorg/web/wolf ws/su/nodessw#tab-4
Permit No.: t_v/C/9-/Q/3/0/O//
Facility Name
Coutity: Ru
Inspector: ;A '
Date of Inspection:/— _
Time of Inspection: ` 5
Total Event Precipitation (inches):
or Certificate of Coverage No.: N/C/G/Q/j/-Q/Z/Z/42/
, 4D y
one No.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
dyes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
i
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" ,is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the pertnittee
obtains approval from the local DWQ Regional Office.
_.. ................._.._....._........_._........__.. _.._._._._.. __. _..__...._ ...._.,..------ ..._._ ._...... . _.................... _.................... ........ ._..................._i
By &thillrertify tha his r port is acc ate and complete to the best of my knowledge:
>/
(Signature of Permittee or Designee)
Pagel of 2
sWO-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 02 Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities
^that occur within the/ outfallldrainage area: Xzz go
2. Color: Describe the color of the discha
(light, medium, dark) as descriptors: -&a
using basic colors (red, brown, blue, etc.) and tint
e2%A
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Vgz.)4e., _
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and S is very cloudy:
O 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
0 2 3 4 5
b. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
Q 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the Storlwater discharge? Yes G
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution. -
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, last modified 10/25/2012

A�A
1
NCDENR
Stormwater Discharge Outfail (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: w
Permit No.: N /y/�/
FacilityN e:
County:
Inspector:
Date of Inspection:
Time of Inspection: 3:6?D
or Certificate of Coverage No.: N1-C1-G/QAj/Q1.21Z1Q/
I/
Total Event Precipitation (inches):
No.
ED
FED 17 ZOV
CENTRAL FILES
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by tFie pR $pit.
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
i
1
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this i "ature, I certify th
repo s accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 7/3112013

Y y
. �
1 � / ..
a
.� ,,
!. � r � r � ,
�. � � .� .�
., . r
. �
F s �

I. Outfall Description:
Outfall No. j Structure (pipe, ditch, etc.) h'00 e.�
Receiving Stream:
Describe the industrial activities hat occur within the outfall drainage area: QonAl
jua iprLle�'1' 1'Is,2. Color: Describe the color of the di arsln basg colors (red, rown, blue, etc.) and tint
(light, medium, dark) as descriptors: i/ P!'l.J �i Tnu) �1 n�E
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 O2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 O2 3 4 5
7. Is there any foam in the stormwater discharge? Yes ®o
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, last modified 7/31/2013

AN
ANFA,
NC®ENR
Stormwater Discharge 4utfall (SDQ)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit. hJ,p://portal.ncdenE.ora/web/ir/nodes-stormwater/
Permit No.: or Certificate of Coverage No.: NILIQ/Q/3/a4/1/Q/
Facility Name:
County: LZ Pplk—PhoneNo.
Inspector: L�ALI
Date of inspection: Z-- ;Q %-- L7
Time of Inspection: =_�-4 YOM
Total Event Precipitation (inches):
9S rr
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Ej'/Yes ❑ N o
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
1
{
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
E
z
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter �.
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office. E
By this sjgpdjure, I c9rtify the this report is accurate and complete to the best of my knowledge:
ignature of Permittee or Designee)
Page 1 of 2
5wU-242, Last modified 7/31/2013

1. Outfall D scription:
Outfall Ni. Structure (pipe, ditch, etc.) �r n-e ,
Receiving Stream:
D scribe the in ustria] act' ities that occur within the outfall drainage area:F
L2 el`1 `
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: V%rra
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): �%� A A-1 1 _
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 ZO 3 4 5
S. Floating Solids: Choose the number which best describes the amount of Floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 O2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 0 3 4 5
7. Is there any foam in the stormwater discharge? YesIo
B. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5WU-242, Last modified 7/31/2013

ALIT,
M 3
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: 1 w r w
Permit No.: / / or Certificate of Coverage No.:
Facility Nye: ,' 7 e, 7 /114E ,'( /fh 0/212U
County: Phone No.
r
Inspector: 1
Date of inspection: _
Time of Inspection: 15
Total Event Precipitation (inches): 95'I/
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
M1/1yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this r ort is
((ignature of Permittee or Designee)
rate and complete to the best of my knowledge:
Page 1 of 2
5Wu-242, last modified 7/31/2013

I. Outfall Description: 1
Outfall No. a - Structure (pipe, ditch, etc.) ZIIA A
Receiving Stream:
D scribe the in ustrial activitie that occ r within th outfall drama a area: h1�?SfeL �
% -
�i 0! Ctll l�rn'l�'�as�1 !,'2lCJ rii �c21/if2�}i
2. Color: Describe/ the color of t'he/discharge usi ba is colors (red, brown, ue, etc.) and tin
(light, medium, dark) as descriptors:)/fry .� iC�h2t �--QuL2 J
3. Odor: Describe any dis i
weals chlorine odor, etc.): L2
odors that the discharge may have (i.e., smells strongly of oil,
i)ij,
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 '2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 `2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes is
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
Tame
SWU-242, last modified 7/31/2013

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No. NCG03
FACILITY NAME / L
COUNTY am echL—d
PERSON COLLE ING SAMPLES
LABORATORY i
Comments on sample collection or analysis:
1_ 2 Q SAMPLE COLLECTION YEAR -2017
SAMPLE PERIOD ErJan-June ❑ July -Dec
Rzecei VED or F Monthly' - _month)
f DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
Cert. # �E� 17 2017 ❑Zero -flow ❑Water Supply ❑SA
[]Other
pWRL FILES
g CT(4N
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Part A: Stormwater Benchmarks and Monitoring Results
❑ No discharge this period:2
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organicss
Benchmarks W==>
_
-
100 mg/L or 50 mg/L
6.0 - 9.0
0.007 mg/L
0.03/ymg/L
0.0�6]7 mg/L
15 mg/L
1 mg/L
7
.5- //
. 3
a
-- .
C
C`
_
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR-469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
GA
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution PreventZ,,
9er/�
Name IMnt name)
Title (Plin itle)
�� CSC/� ! -�_�� ;/ ✓
re) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier .1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks ===>
_
-
15 mg/L
200 mg/L or SO mg/L*
6.0 -- 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

.,.. - � f ,
I" �-�
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r i
� 1 • . _ _ .. � L. 1

` Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
r
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Ii SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [INO ❑
IF YES, HAVE YOU CONTACTED HE DWQ REGIONAL OFFICE? YES [ZNO ❑
REGIONAL OFFICE CONTACT NAME: ;4a-n xj'j(S /
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results (or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my 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 fW submittig2 false information, including the possibility of fines and imprisonment for knowing violations."
C�
(Signature of Permittee)
111,,7
(_
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Semi-annual Stormwater( 'charge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted-42 - �,�-112
CERTIFICATE -OF COVERAGE NO. NCG03_e Q
FACILITY NAME '
COUNTY
PERSON COLLECTING SAMPLES ikil -T
LABORATORYPnt e ,OA/ni.i.1 / o n ab Cert. #4-
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR I ")016
SAMPLE PERIOD ❑ Jan -June PlJuly-Dec
or ❑ Monthly' (month}
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
RECEIVED ❑Zero -flow ❑Water Supply ❑SA
f� ❑Other
DEC 292016
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWR SECTION
n No discharge this period?'
Outfall No.
Gate Sample
Collected"
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics'
Benchmarks ==_>
_
-
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
, le�.
QD5AIA
<
.O
4.
..40�
C. 005-
4 .496_ r<
.410 1
L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433,11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Pagel of 3

Facilities(' t incorporate a solvent management plan into the Stormwater V tion Prevention Plan may so certify, and the requirement for TTO,,'- iitoring
maybe wowed. The solvent management plan shall include a list of the total L-xic organic compounds used and the other elements listed in the G—eral
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
v
Title (P ' itle)
I( /L Z� 6
(Signature) (Dat )
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L" where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected"
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 - 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Note: If( report a sample value in excess of the benchmark, you must im(lent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES �NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 5ZNO ❑
REGIONAL OFFICE CONTACT NAME:..S�N AAPAZ
Mail an on inal and one My of this DMA including all "No Discharge" re arts within 30 da s o recei t o the !ab results or at end a monitorin eriod
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware thatpere are significa na tE for sybmitting false information, including the possibility of fines and imprisonment for knowing violations."
l/L- v >✓ Zv b ✓
(Signature of Permittee) (Date)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

Semi-annual Stormwater scharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. N
FACILITY N Ej��
COUNTY
PERSON COLLI
LABORATORY
Comments on
NG SAM
Lah Cert. # � %
pie collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 01016
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' 1month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]Zero -flow []WaterSupply [:]SA
RECEIVE ❑over
JUN 2 O- 201KEASE REMEMBER TO SIGN ON PAGES z AND/OR 3
-
CENTRAL FILES (j C. PDWR
SECTION] }�
NO�AChar e thrs eti d?2ff
L 9 P
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
_
Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organicss
Benchmarks =__>
_
-
100 mg/L or 50 mg/Lk
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
5= -
1
Q
, 0/
-S
5, P"
7-, Q
OZ2G-
d
pD
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall:
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3 The total precipitatibn must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR,433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469,31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
D n n 1 _; 0

Facilitie t incorporate a solvent management plan into the Stormwater f tion Prevention Plan may so certify, and the,requirement for TTC nitor , I _K•
may be w-,ved. The solvent management plan shaft include a list of the total -xic organic compounds used and the other elements listed in the 6,' Ie.ral
_Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon My inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the fast discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Preve4ionan."
/G l
Name (Print name)
Title (Pri rtle)
(Signature)
G /S-,/
Ir (Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below -the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. 5ee General Permit text.
Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Date
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 2 of 3

Note: if report a sample value in excess of the benchmark, you must im, rent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
'FOR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFAI_L TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SE TION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN_CE5 FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 0 NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES LWft
REGIONAL OFFICE CONTACT NAME: .SzMeAl
Mail an oriainal and one copv of this bMR, includina all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period
in the case of "No Discharge" resorts) 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 awar that there are significan enafties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
ell,
(Signature of.Permittee) (Date)
i
i
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Paoo '2 of q

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://porLal.ncdenr.or web wq"wj5u npdes2wIItab-4
Permit No.: N/C/d/- /,%/
Facility Name: '
County:
Inspector:
Date of Inspection. 5 -
Time of Inspection: J'-I'
L)1-01 1 or Certificate of Coverage No.:
Total Event Precipitation (inches): /, 5f
Phone No.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
ff Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
l
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge,.from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply.if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
I
By thi �gnature, l certify tihafthi�/report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
N
SWU-242, Last modified 10/25/2012
Page 1 of 2

_ .1. Outfall Description:
' Outfall No. Structure (pipe, ditch, etc.) T� �
Receiving Stream:
Describe the industrial activities that occur within the outfail drainage area: /`
i P
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):�����
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
Q 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
o Z 3 4 5
b. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
O 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
B. is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall.? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant -exposure. These conditions warrant further investigation.
J
Page 2 of 2
SWU-242, Last modified 10/25/2012

NCDEHR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http:f/poi-tal.ncdent-.orglweb/wq/ws/siiliip(lessw4tab-4
Permit No.: N/C/6/L)/-Z/
FacilityName:
county:
Inspecfor:
Date of Inspection : 1
Time of Inspection:
C110/a/ or Certificate of Coverage No.: N/C/c/r'/3/C/�2/7-/0/
Phone No.
i
Total Event Precipitation (inches): i�-___�
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
M Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "Measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be.
performed during a "representative storm event" or during a "measureable storm event." However, I
some permits do not have this requireme-nt. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge,,f-.om the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains auproval from the local DWQ Rep-ional Office.
By this , nature, I certify t this report is accurate and complete to the best of my knowledge:
ature of Permitt:ee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

A. Outfall Description: p
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream:
.� Describe the industrial activities that occur within the outfali drainage area:Ai/� /' Cl/1z���a.G ✓u�/�!<r
2. Color: Describe the color of the discha
(light, medium, dark) as descriptors: .ffZ,
using basic colors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): i1 / rr
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the arnount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes y
a. Is there an oil sheen in the stormwater discharge? Yesl
9. Is there evidence of erosion or deposition at the outfali? Yes !g
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant -exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

YIF
NCDENR
.. Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
horguidance on filling out this form, please visit: httIL.(/portal.ncclenr,org/web/`w ws stk npdessw#tab-4
Permit No.: N/C/6/ 2101- '/n/Q/Q/ or Certificate of Coverage No.: N/C/G//. z1 /
Facility Name: je i a -
County: P one No.
Inspector: i
Date of Inspection.
Time of Inspection:
Total Event Precipitation (inches): ,
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined.by the permit?
(See information below.)
[dyes . ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "Measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
Performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement- Please refer to these definitions, if applicable.
- I
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge, from the
permitted site ouffall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Re0onal Office. !
By this si nature, I certify that thi por is accurate and complete to the best of my knowledge:
( gnature of Permittee or Designee)
Page 1 of 2
SWO-242, Last modiried 10/25/2012

1. Outfall Description: �
Outfall No. Structure (pipe, ditch, etc.) 7, illk_/ _
Receiving Stream.
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:At
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 O 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
01 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
4. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Law clarity, high solids, and/or the presence of foam, oil sheen, or erosion deposition
may be indicative of pollutant -exposure. These conditions warrant further investigation.
Page 2 of 2
7"
SWU-M, Last modified 10/25/2012

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Fbrguidance on filling out this form, please visit: h tip:/ /12ortal, ncdennorg /web 11C/np
Permit No.: or Certificate of Coverage No.:
Facility Name: -Z
County:
Inspector:
Date of Inspection:
Time of Inspection: _/d 1 f 0 amT,
Total Event Precipitation (inches):— 41 //
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
2 Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or 'measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this sigyatuqq� I certify that this t is accurate and complete to the best of my knowledge:
re of Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 7/31/2013

0
1. Outfall Description:
Outfall No. 1 Structure (pipe, ditch, etc.) �'�-r—
Receiving Stream: _
Describe the industrial activities that occur within the outfall draina a area: -De l, '✓e r,, if - o ails Aol
AAnIMAII
CL[ts7
an a;A handbmay
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: lVv 411d& — CXeLIje-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): ,Al'o-A/e, T
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
01 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
O1 2 3 4 S
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
Q 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
B. Is there an oil sheen in the stormwater discharge? Yes N
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
VA
SWU-242, Last modified 7/31/2013

1,A11,
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htm: //nortal.ncdelinare/web/]r/nodes-stormwater/
Permit No
Facility Nz
County: _
Inspector:
Date of In.,
Time of In
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
9 Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation. i
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this sigatyy-e, I certify
(Signature of Permittee or Designee)
is accurate and complete to the best of my knowledge:
Page 1 of 2
SWU-242, Last modified 7/31/2013

' 1 ��. r r
_ _ .. _ _ _ .. l : . .
f r
._ it .. � � 1
. •o e � �
1
.y ,
>,
i . � •. f I - . �' 1

1. Outfall Description:
Outfall No, _ Structure (pipe, ditch, etc.) 'eiA7_�
Receiving Stream:
Describe the industrial activities �that occur within the outfall drainage area: "p"nen�
62.nn1if a , ��Gk �qC�/1 t %�i.'✓eL Qr -
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: "aj-/ 61ear, Ve-, Fa,�71 ZF,,,,uW- ,�
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): f 4Ale
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 O 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1Q 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and S is extremely muddy:
(J 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes Qo
9. is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
swU-242, Last modified 7/31/2013

�WA
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this farm, please visit. h
Permit No.: N/C/9/-0/,5/,0/,Q/QJQI or Certificate of Coverage No.: N/�C�/Q/%3/Q/j91z/Q/
Facility Name:
County: Phone No.
Inspector: IWU
Date of Inspection: q Q 5 l.S`
Time of Inspection: �9:_a"177 __
N
Total Event Precipitation (inches): %. 4
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[✓T Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signat , I certify that =thit is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Pagel U 2
SWU-242, Last modified 7/31 /2013

1. Outfall Description:
Outfall No. ____5 Structure (pipe, ditch, etc)
Receiving Stream:
Describe the industrial activities th t occur within the outfall draina a area:
1�ilasl� �1kerL, Truc,�s discharge
2. Color: Describe the color of the ischarge usin basic colors (red, brawn, blue, etc:) and tint
(light, medium, dark) as descriptors: // dUl ed.e. , /i'!g BWQ ILI;9A_-7-,'&_�______
3. Odor; Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 Z� 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 '() 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 0 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes NO
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 7/31/2013

Semi-annual Stormwater ;charge Monitoring Report
�z for North Carolina Division of Water Quality General Permit No. NCG030000
CERTIFICATE OF COVERAGE NO. NCG03�QZ Q
FACILITY NAME ne- _ tN UIZ
COUNTY Wzy A-ti v r k, '
PERSON COLLE(
LABORATORY
Comments on s
NG SAMPLES
b Cert. W
ple collection or analysis:
Date submitted /6-/9_ 45
Part A: Stormwater Benchmarks and Monitoring Results
i
SAMPLE COLLECTION YEAR _ -M-57'
SAMPLE PERIOD ❑ Jan -June • 2July-Dec
yyi� or ❑ Monthly'_ (month)
kP6f1 V EQISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
OCT 2 3 2015 []Zero -flow ❑Water Supply ❑SA
❑Other
CENTP,AL FILES
DWR S CT ON
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
No discharge this period?Z
Outfal! No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/total
Total Petroleum
Hydrocarbons
Toxic
Organicss
Benchmarks ==_>
_
-
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
. D
7. 18
. D
t
6'
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample {for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found yin 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilitie t incorporate a solvent management plan into the Stormwater ! tion Prevention Plan may so certify, and the.requirement for TTC iitoring
may be w.,ved. The solvent management plan shall include a list of the total _.dc organic compounds used and the other elements listed in the 6—eral
Permit. Fof`those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: . , _
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the ail the provisions of the
solvent management plan included in the Stormwate o tion Prevention PIa
Name (Print name)
Title (Print title) I
xj�d-c tj _s
(Signature) (Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period:'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from PartA also apply to this Part B
* See General Permit text, Table S, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Note: If report a sample value in excess of the benchmark, you must im, lent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART k SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER ATANY ONE OUTFALL? YES ❑ NO
If YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an ordinal and pne copy of this DMR,.including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attm DWQ Central Files
t 1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: '
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant 44for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Pennittee)
/c7 / .Yv-,
(Date)
Permit Date:11/l/2012-14/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

s
1
Semi-annual Stormwater_Discharige Monitoring Report
for North Carolina Division of Water Quali General Permit No. NCG030000
Date submitted S- r 5'
CERTIFICATE OF COVERAGE NO
FACILITY NAME >
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY A116
NCGo 2 4n
Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR v20
SAMPLE PERIOD [�fian-June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[_]zero -flow ❑Water Supply ❑SA
R E!CL I VE D ❑Other
MAY 18 . Z015 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL_ FILES
D1NR SECTION
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organics5
Benchmarks =__>
_
- 1
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
i mg/L
l
'-
911
<.
L
L
AIA-
�_N_1_5'„-,
J L
C L
©D 1
19L<
A
—/
H
L
.L�
di
LL4�
< LIVA
�1
r Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31),
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
' may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwwa/
ater Pollution Prevention P /
K4,,,
Name (Print name)
Title (P ' le)
(Signature) (Da )
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L. -
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected[
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Nate: !f you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports. within 30 days of receipt of the lab results for at end of monitoring Period
in the case of "No Discharge" reports to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant peQalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) ( ate)
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 3 of 3

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://portal.ncdennorg/web11r/npdes- stormwater/
Permit No.: N/C/ G / 0 / 3/ 0 / 0/ 0/ 0/ or Certificate of Coverage No.:
Facility Name: The Timken CompaU
County:
Inspector:
e No. 828-287-2200
Date of Inspection:f—/_5
Time of Inspection:
Total Event Precipitation (inches): - lfJ /%
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
eYes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
------ -- --- - ----- -- - - - -_. _. _ - - __----- ___._-.-.-.--.._--._-.-.-._-._------------- ------- ------- .-.-.---------- ---- ----- -..................................
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be E
jperformed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall
j and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
j precipitation.
i A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this s}ture, I certify that
(Signature of Permittee or Designee)
accurate and complete to the best of my knowledge:
5WU-242, Last modified 7/31/2013
Pagel of 2

Y
�
� �
� J
_ '
�
.. �
.t
- !

1. Outfall Description:
Outfall No. 3 Structure (pipe, ditch, etc.) Ditch
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area: Grind Swarf &
Absorbent Hoppers. Metal Hopper. Trash Compactor, Waste Coolant and Used Oil Tanks, Pressure
Wash Area, Trucks Entering and Leaving the area.
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: -X&y-&&2t e' /e�� 1 iQ6:� �r� L� n
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A-/,_QAI o>
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 O 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 O2 3 4 5
b. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
O 2 3 4 5
7. is there any foam in the stormwater discharge? Yes L °J
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
n
Page 2 of 2
SWU-242, Last modified 7/31/2013

`�;k
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http:l/portal.ncdenr.orglweb/Ir/npdes-stormwater/
Permit No.: N/C/ G / 0 / 3/ 0 / 0/ 0/ 0/ or Certificate of Coverage No.:
Facility Name: The Timken Company
County: Rutherford Phone No. 828-287-2200
Inspector: Ti O
Date of Inspection: -
Time of Inspection: g:.? lJ R/)U
i
Total Event Precipitation (inches): 4 9
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
iYes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this s ature, I/certify th report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
SWU-242, Last modified 7/31/2013
Pagel of 2

4
'4
1. Outfall Description:
Outfall No. 2 Structure (pipe, ditch, etc.) Pipe
Receiving Stream:
Describe the industrial activities that occue within the outfall drainage area:
Air Handling Equipment, Shipping Dock, Facility Driveway.
2. Color: Describe the color of thArr
scharge sin�rb'asic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:� Ue-al, lzla ih Zna,).+/' fir/
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): lyeAz& T ^�
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 9 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 20 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
Q1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes ®°
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, last modified 7/31/2013

xj1;Ae
NC®ENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://portal.ncdenr.org/web/lr/npdes-stormwater/
Permit No.: or Certificate of Coverage No.:
Facility Name: The Timken_Company
County: Rutherford Phone No. 828-287-2200
Inspector: 46bi, r
Date of Inspection: -, 14-jls,
Time of Inspection: �'� 40 AlyC
Total Event Precipitation (inches):
9 '/
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
❑V Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this ' ature, I certify
J �1
(Signature of Permittee or Designee)
is accurate and complete to the best of my knowledge:
SWU-242, Last modified 7/31/2013
Page 1 of 2

1. Outfall Description:
Outfall No. 1 Structure (pipe, ditch, etc.) Pipe
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area: Deliveries to and from
the facility on driveways, empty drum pad, material handling equipment, exhaust fans and air
handling equipment.
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Alm1),4 Clio-6- ZZ9` .&-o1jjAZ s 7:/22�
3. Odor: Describe any
weak chlorine odor, etc.): —
odors that the discharge may have (i.e., smells strongly of oil,
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 Q? 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 0 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
O 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
B. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erasion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 7/31/2013

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: Litt : _portalmcclenr.ai l web/wq/ws/su/npdessw#tab-4
Permit No.: N1Q&Q1O1 D/Q/Q/D/ or Certificate of Coverage No.: N/C/G1a1O16/,,4L/-7/a/
Facility N ie: 7 �e 7r
County: hone No.
Inspector: idtay
Date of Inspection: ` /h - R—/.If
Time of Inspection:
Total Event Precipitation (inches): r
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures, greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than r
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
i precipitation.
i
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
i prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval,is-representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this , i ture certif h- this report is accurate and complete to the best of my knowledge:
ignature of Permittee or Designee)
Page I of 2
SWU-2h2, Last modified 70/25/2012

1. Outfall Description: n
Outfall No. Structure (pipe, ditch, etc.) �1
Receiving Stream:
Describe the industrial activities that occur withi the /outfall drainage area: /'
�ckf=,/rJ_[:' 4,Vtir
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _y?�� l jn ! 4W;5' Oka/ T
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weals chlorine odor, etc.): ,A% Lye
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
O 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
0 2 3 4 5
b. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 Q 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes G
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Dote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicat ive of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

IN
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidonce on filling out this forrn, please visit: littp://uortai.ticdenr.oig/web/wq ws sun dessw#tab-4
Permit No.: N/C/0/Q /D/,Q/Q/f�/ or Certificate of Coverage No.: N/C/G/Q/-/-0/1/Z/Q/
Facility Name:
County: T&Ae Phone No.
Inspector: �0,4A(, l,i jAAJ C FIV'IV1)
Date of Inspectidl:
-Time of Inspection:
q
Total Event Precipitation (inches): - J�
CENTRAL FILES
DWR SECTION
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
--- - - --
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hour j
prior. The 72-hour storm interval does not apply if the perinittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this sigp�ture, I certifytllat,t is report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
SWU-242, Last modified 10/25/2012
Pagel of 2

I. Outfall Description:
Outfall No. -. -/ Structure (pipe, ditch, etc.) `
T
Receiving Stream:
D scribe the industrial activities that occur within the outfall drainage area:
e
'lk�-t s z2��� hair /,.`ci
2. Color: Describe the color of the d- charge Z1169
basic colors (red brown, blue, etc.) and tint
(light, medium, dark) as descriptors: ( _Q:_f R
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): '1Z4AJe_'
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
@ 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
O 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 O2 3 9. 5
7. Is there any foam in the stormwater discharge? Yes
B. Is there an oil sheen in the stormwater discharge? Yes
O
9. Is there evidence of erosion or deposition at the outfall?
Yes I
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Dote: Low clarity, high solids, and/or the presence of foam, oil sheen, or• erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, List modified 10/25/2012

Semi-annual Stormwater ichar a Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 D '� 7 _
FACILITY NNE e
COUNTY
PERSON COL TING SAMPLES
LABORATORY Ae Lab Cert. # l �2 w
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR .?6 /Al
SAMPLE PERIOD ❑ Jan -June E! July -Dec
or ❑ Monthly' _ _'month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVED zero- low [:]Water Supply ❑SA
❑
NOV 10 2014
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWR $ECTION
No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organicss
Benchmarks =_>
_
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
7. z z.
o
<
16 - -1
S
7.
_71-
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Tabie 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.12; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017
5WU-245, last revised 10/25/2012
Page 1 of 3

l

�, jjitie t incorporate a solvent management plan into the Stormwater r tion Prevention Plan may so certify, and the requirement for TTC iitoring
may be waived. The solvent management plan shall include a list of the total I..,& organic compounds used and the other elements listed in the G—eral
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and relief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. i further certify that this facility is implementing the all the provisions of the
solvent management plan included in the stormwater Pollution Prevention Plan."
Name (Print name)
2Title(P'
le)
I/ ✓
- (Signature} ( (ate)
Note: Results must be reported in numerical format. Do not reportBelow Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in -the format, "<XX ms/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?Z
Outfa[I No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

IFA
Note: If report a sample value in excess of the benchmark, you must im, rent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART I I SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [jY
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this AMR including all "No Discharge" reports, within 30 days of receipt of the lab results or at end of monitoring period
in the case of "No Discharge" retorts) 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 Omt thfwe are signiTNant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
nature of Permittee)
(Dat )
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

%j
Semi-annual Stormwater. . scharge Monitoring Report
for North Carolina Division of Water Quality Gen ral Permit No. NCG030000
CERTIFICATE OF COVERAGE 0. NCG03V 2 _Z D
FACILITY E
COU NTY
PERSON COLLECTING SAMPLES
LABORATORY tQAo- ffa
Comments on sample col
on or analysis:
Cert. #
Date submitted / _ 9-
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Q % 4
SAMPLE PERIOD ❑ Jan -June ] July -Dec
or E�4onthly? (month)
DISCHARGING TO CLASS ❑ORW [JHQW [Trout ❑PNA
► C E I VE D ❑Zero -flow ❑Water Supply ❑SA
JUN 1 1 2014 ❑other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
DWQIBOG
❑ No discharge this period?Z
OutfaH No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
PH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics'
Benchmarks
100 mg/L or 50 mg/L°
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
7, e8
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/2S/2012
Page 1 of 3

Facilities t incorporate a solvent management plan into the Stormwater P tion Prevention Plan may so certify, and the requirement for TTO -iitoring
may be waived. The solvent management plan shall include a list of the total 'W AC organic compounds used and the other elements listed in the G,..zral
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Preve ' n Plan.'
fume rint name)
/ 1rY-y
Title (Pre). Z�?
6 S % v
ature (D te)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX m /L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Note: If. report a sample value in excess of the benchmark, you must im, rent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 2'
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an -original and one copV gL this DMR including all "No Discharge"' reports, within 30 days of receipt of the lab results or at end of monitoring period
in the case of "No Discharge" reeortsl 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 t there are si ican penalti for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

i
;A
iffl Arm
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: littp:l/poi-tal.ticdp-nt-.org/weblwgLws/sti/iipdcssw#tab-4
Permit No.: N/C/Q/0a/4/D/L9/a/ or Certificate of Coverage No.:
FacilityNanlL e TineGP�1 ��.,�Dl1�Il -
County:
Inspector: ,'AL
Date of Inspection:
Time of Inspection
Total Event Precipitation (inches): I,%
Phone No.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
E� Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or duing a "measureable storm event." However,
r
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
I I
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter I
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office
By this si&yrdtge, 1 cyA-rlfy that tWreVqrt is accurate and complete to the best of my knowledge:
(Signature of Perm1� tee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfali No. -- a. StructuroG� ditch, etc.)
Receiving Stream:
Describe the in/dust/]-ial activities that occurr within the ou/tfall drainage area:
/1
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc,) and tint
(light, medium, dark) as descriptors: 1 � �er� Y.i/ � �4'�2� 12raLt)-tj 4' }I-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): _/V a y e✓
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
lO 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 Q 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1O 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes ®o
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5WU-242, Last modified 10/25/2012

Semi-annual Stormwater. . scharge MonitoringRrt
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE o. NCG03 Q 2 Z n
FACILITY NAME n e
COUNTY Uiaa!' n
PERSON COLLECTING SAMPLES
LABORATORY 3 ' Lab Cert. #
Comments on sample collet ion or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR a240 14
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or Q'll/ionthly'T (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
ECol V � ❑Zero -flow ❑Water Supply ❑SA
❑Other
MAY 13 2014
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWQ/BOG
No discharge this period:
Outfall No.
Sample
Collected'
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
inches'
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organicss
Benchmarks =_->
_
-
100 mg/L or 50 mg/L4
6.0 - 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
C See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for -semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Fac ilitie t incorporate a solvent management plan into the Stormwater f tion Prevention Plan may so certify, and the requirement for TTC-sitoring
may be waived. The solvent management plan shall include a list of the total exit organic compounds used and the other elements listed in the G4..zral
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTo), l certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. i further certify that this facility is implementing the all the provisions of the
solvent management plan included in the stormw
ater Pollution Prevention Plan." O
NameV_;r nt name)
1�y// �-
(
(Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches s
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Nate: If report a sample value in excess of the benchmark, you must im, rent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an originsl and one copy of this DMR, including all "No Discharge" reports within 30 days of receipt of the lab results (or at end of monitorin4_period
in the case of "No Discharge"' reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for Bring the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware t�Rt ter re are signifi t penalties fNr submitting false information, including the possibility of fines and imprisonment for knowing violations."
(SOKature of Permittee)
Y z V q-
(date)
Permit Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit., http://12oi-tal.ncdeiir.oi-g/webZwgf ws/stt pdessw#tab-4
Permit No.: N/f-r/do/�
Facility Name:
County:
Inspector: _
Date of Inspection-.
Time of Inspection: 8
or Certificate of Coverage No.:
Total Event Precipitation (inches): /.
//
hone No.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[if Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation. I
I
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this sit;;prtuj-e, I certify t is rr)port)s accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Pagel of 2
5WO-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. - 1P,_ Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainaee'area:
2. Color: Describe the color of the discharge usin basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: `'_Very"I �°eh b A0144z�<f &Azlo— _
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A.47m% _
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
0 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stortmwater discharge, where 1 is no solids and 5 is extremely muddy:
0 2 3 4. 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. is there evidence of erosion or deposition at the outfall? Yes o0
10. Other Obvious indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

Semi-annual Stormwater _ scharee Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG030 L�s
FACILITY NAMED—_
COUNTY
PERSON NG
LABORATORY�22TIC 9 ,4� d% ab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR -'� 0I
4-
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or 7monthlyl (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
. ����� ❑❑Zero -flow ❑Water Supply []SA
REC Other
APR 14 Z014 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWQIBOG .
No discharge this period?2
.V .
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
inches3
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar O&G/Total
Total Petroleum
Hydrocarbons
Toxic
Organicss
Benchmarks =__>
_
-
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfail, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible fora waiver of the rain gauge requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 5WU-245, last revised 10/25/2012
Page 1 of 3

Facilitie t incorporate a solvent management plan into the Stormwater f tion Prevention Plan may so certify, and the requirement for TTC iitoring
may be waived. The solvent management plan shall include a list of the total wxic organic compounds used and the other elements listed in the G,..,eral
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or pergons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief,no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention an.
� .s s � • r'o s� s/ .
Name (P int name)
I/// /I Y ,--
'
(Dale)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDI_, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format "<XX m L" where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See Generol Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
{ See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Mote: if report a sample value in excess of the benchmark, you must im, rent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER-Y REQUIREMENTS. SEE PERMIT PART JI SECTION B.
• 2 EXCEEDANCES W A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end ofmonitoring period
in the case o "No Discharge" re orts) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mai€ Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS.CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Z2
(Signature of Permittee)
(Da e)
Permit Date:11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3

,.• a-AdjFA
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on f lling out this form, please visit. littp:/Zl)oi-tal.ncdeiit,.w:6,Zweb/wq/ws/�ti/tipdessw#tati-4
Permit No.: N/C/d/jQ/O/ O/Q/Q/Q/ or Certificate of Coverage No.: N/C/G/,(�/,�/Q/ 21-7 - �/
Facility Name: %
County: 81- Phone No.
Inspector:
Date of Inspection.
Time of Inspection: _/: 3OPat
Total Event Precipitation (inches): 1, 25
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[O/Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "rneasureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "treasurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
' obtains approval from the local DWQ Regional Office.
By this s�TWure, 1 certifytKa-t this r*oq is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) :Ell
Receiving Stream:
Describe the industrial activities that occur wifIin the outfall drainage area: '
2. Color: Describe the color of the discharge using basic colors (red, bro n, blue, etc.) and tint
(light, medium, dark) as descriptors: r
3. Odor: Describe any distinctodors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where I. is
clear and 5 is very cloudy:
l) 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 Q2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
0 2 3 4 5
7, Is there any foam in the stormwater discharge? Yes G
8. is there an oil sheen in the stormwater discharge? Yes Q
9. is there evidence of erosion or deposition at the outfall? Yes S1
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
!Vote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may he indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

Semi-annual Stormwater _ scharge Monitoring Report
for North Carolina Division of Water Quality neral Permit No. NCG030000
Date submitted 3-/ G
CERTIFICATE OF COVERAGE NO.�N0003
FACILITY NAME
COUNTY zz P r
PERSON COLLECTING SAMP
LABORATORY_7Vo t
Comments on sample collecti
-2 -2 SAMPLE COLLECTION YEAR 2.014
OQ� v SAMPLE PERIOD RJan-June ❑ July -Dec
i or ❑ Monthly' (mon
b Cert. #
or analysis:
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
g i ECEIV�� ❑Zero -flow []watersupply [:]SA ❑
f�[C Other
Part A: Stormwater Benchmarks and Monitoring Results
MAR 18 2014 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
CENTRAL FILES
DWQ/BOG
No discharge this period?"
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3I
Total Suspended Solids
pH,
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organicss
Benchmarks =__>
_
-
100 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.033 mg/L
0.067 mg/L
15 mg/L
1 mg/L
os
sAIA
2.
. 3
-
12
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

Facilitie., t incorporate a solvent management plan into the Stormwater P tion Prevention Plan may so certify, and the requirement for TTO nitoring
ma�.be waived. The solvent management plan shall include a list of the total L�Xic organic compounds used and the other elements listed in the G,_eral
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Name rint name)
Title (Pri
ture) {Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mA/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period:
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar 0&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks ===>
_
15 mg/L
100 mg/L or So mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 2 of 3

Note: If. report a sample value in excess of the benchmark, you must im, rent Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
y
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO 0
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significa enaltie for submitting false information, including the possibility of fines and imprisonment for knowing violations."
C
(Signature of Permittee)
Permit Date: 11/1/2012-10/31/2017
SWU-245, last revised 10/25/2012
Page 3 of 3