NCG060292_MONITORING INFO_20181109

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�v
DOC TYPE
❑HISTORICAL FILE
•H'MONITORING REPORTS
DOC DATE
❑ � � I � � � O � .
YYYYM M D D

Envinmmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: NIC/O /b / 0 /01.0/ d 10/ or Certificate of Coverage No.: NIC/G/014o 1O l.a I cj /a l
Facility Name:
County: �. �U6! _ Phone No.
Inspector: (1 Jim ,E��� —
Date of Inspection: -- —
Time of Inspection: Ck`. U
NLULIVEL
Total Event Precipitation (inches): 1110V 0 9 2018
CENTRAL FILES
DWR SECTION
All permits require qualitative monitoring to be performed during a "measurable storm event."
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 DEMLR
onal Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of P6mittee or Designee)
1. Outfall Description:
Outfall No. 1 Structure (pipe, ditch, etc.): Yti�
Receiving Stream:
Describe the industrial activities that occur within the outfalI drainage area:�rwLa��
��-K-L�v\ CSC Z�16 �n��► +�� z� ICE _
Page 1 of 2
5WU-242, Last modified 06/01/2018

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:
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:
�D 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? ,o Yes 0 No. &JQ
S. Is there an oil sheen in the stormwater discharge? oYes ® No. Q0
9. Is there evidence of erosion or deposition at the outfall? O Yes ® No. �,!d
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 furthei investigation.
i
Page,2 of 2
SWU-242, bast modified 06/01/2018

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Resources General Permit No. NCG060000
bate submitted
CERTIFICATE OF COVERAGE NO. NCG06D SAMPLE COLLECTION YEAR
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY LZ,6o,R ®use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? DYES [ENO
LABORATORY FA,4L-- Lab Cert. # In
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall Z I., or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at gny outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at Any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if gS complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

"FOR-PARTkAND.PART &MONITORING RESULTS:
• A'BENCHMARK EXCEEDANCE TRIGGERS TIER I 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:YOURTACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO 10
IF -YES, HAVE YOU CONTACTED THE.DWQ REGIONAL OFFICE? YES ❑.NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail_ an-a[Lg1na1'and
one-cayy-ofthis'DMRtincludinu
all
"No-Discherae"'reports within:30 dano trecei t.of the•lab results for at end o
monitoring
period:in the'casepf
"No Discharae" -reports)
to:
Division, of Water- Resources
Attn: DWR Central Files
1617 Mail Service -Center
Raleigh, NC 27699-1617
YOU MUST SIGN'THIS CERTIFICATION FOR°ANY INFORMATION -REPORTED:
"I certify, under penalty of law, thatthis 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 forgathering the information, the information submitted is,
to the best of. my knowledge and belief, true; accurate; andicomplete. I am aware -that the re`are-significant penalties -for submitting false
information, including -the possibility of fines -and .imprisonment_for knowing violation's."
Additional copies of this form may be downloaded at: http://portal.ncdenr.ore/web/wq/ws/su/npdesswiitab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

A
114 OAKMONT DRIVE
SMITHFIELD PACKING -K2 PLANT
ATTN: CHARLIE PRENTICE
1780 SMITHFIELD WAY
KINSTON ,NC 28504
PARAkETERS
COD, mg/l
Fecal Collrorm (MF), /100 Mls
Total Suspended'Residue, mg/1
O[I & Grease (HEM), mgh
Stormwater
Analysis
Method
(Nl, Grab)
Date Analyst
Code
22
IW29/18
SEI
H8000-79
15
I0/26118
JMT
9222D=06
<2.6
10/29/18,
JMH
254OD-11
<5
W30/18
SEJ
1664B
"A'
Wa10
PHONE [phone]
FAX [phone]
ID#: 465 C
DATE COLLECTEDE•10/26/18
DATE REPORTED :'10/31/18
REVIEWED BY:

Enviionment.l., Inc. CHAIN OF CUSTODY RECORD
P.O. Box 7085, 114 Oaks ont Dr: Page L of 1
Greenville. NC 27958
environmentl inc.com
Phone (252) 756-E2109—P x (252)' 756-0633.
DISII IMCI'ION
;
I
CHLORINE NEUTRALIZED AT.00LLECiI0N
.CHLORLINE
J
` _
-
-
pH (1A8)
-
CLIENT: 465 c Week: 31
❑ uv
LLD PACKINGK2 PLANT
❑ NONE
P
•P,
P
G
4
COI+frAINERTYPE, PIG
►TrN. CHARLIE PREN ICE
L
i
CHEMICAL- PRESERVATION
780 S�ELD WAY
�j
CINS'I'ON NC 28504
r.i
C
G
A
C"
r
A -NONE D'NAOH
5so
E�
252) 208-4706
�
�zO
1
oCr
C
,. B : HNO, E - HCL-
.98
�=
Vj- C'- Hz50;. F = ZINC ACETATE/NAOH
COLLECTION
v¢
c5,
; o o.
a
8
¢
Gi
U
m
x
G9.
a G-NATHIOSULFATE
SAMPLE LOCATION'
DATE
TIME
Stormwater (# I Grab)
p-
j r
5;
4
'4
u
t
'
' CIJISSlFICAT101V
Lima 14ASTEWATER(NPDES)
_
' ❑ DRWIONG WATER
-.....
-
-
- -
-
s
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
CHAIN,
-
-
—
_
MENT/DELIVERY
N
i
SAMPLES CALLECTED BY: I
j
SAMPLES'RECEIVEDINLAB AT_5�-C
G,) (PSAI
- DATEMME "
RECEIVED {SI)
TEMME
COMMENTS:
_ -- — -
RUMUISHED BY (SIG.)
DIATE1TiME I
RECEIVED BY .)
DATEMME
-
RELINQUISHED BY (SIG.) u
DATEITIME
RECEIVED BY (SIG.)
DATEMME•
-
PLEASE READ Instructions for completing this form on.the reverse side.
FORM 05 —
Sampler must place a V for.composite sample or a V for
Grab sample in the'bloft above for each parameter requested: N 0' 3 3.800 2
AAs it 1 '

ALIT A
HCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this farm, please visit: hun://portal.ncdeiii•.org/web/wq/ws/su/npdessw#ial) 4
Permit No.: NIGb l_6l of C D/QI or Certificate of Coverage No.: NIC/GI 0l-LIQ1a19 I,II
Facility Name:-�.�.z��
County: ��Ji7�`1 _ _ _ PhoneNo.
Inspector.
Date of Inspection:Time of Inspection: w.
Total Event Precipitation (inches): d .
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
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 Q 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.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
RECEIVED
1. Outfall Description: MAY 2 4 2018
Outfall No.. t Structure (pipe, ditch, etc.)
Receiving Stream:�ti,,
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: C LQR
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SwU-242-20 3 20613

4. Clarity: Choose the number which best describes the clarity of the discharge, where I iS clear
and 5 is very cloudy:
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> 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:
2 3 4 5
7. is there any foam in the stormwater discharge? Yes C'
8. Is there an oil sheen in the stormwater discharge? Yes �J
9. Is there evidence of erosion or deposition at the outfall? Yes �1
14. 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
SwIJ-242-20f 20613

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted -- V
CERTIFICATE OF COVERAGE NO. NCG06 p SAMPLE COLLECTION YEAR _ .:aolg
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES t G� DISCHARGING TO SALTWATERS? —]YES ®NO
LABORATORYLab Cert. # _ in
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z-a_ or ❑ No discharge this period'
Outfal! No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
oil'and Grease, .
,1mg/L r
:-'Fecal•Coliform ,- -.
-•'Cal6nies,per100 ml
;Enterococci,,
Colonies per 100 ml
Benchmark
-
100 or 50
-Within 6'.0-9.0
'120
'30.
.,, '. 1000
, :50D
5r Itdl,In
Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfail No.
Sample Collected;
mo/dd/yr
-I" 01176ndiGrease, . _ �
-'rng/L"
TSS,
":ing%L`� �s
pH,
Standard units `
..,New Motor.011 Usage,
A nnual+ai+erag'e gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at AU outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
5WU-249 Last Revised: October 19, 2012

*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 N
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR,, including all "No Discharge" reports, within 30 days of receipt, of the lab results (or at end of
monitorina-period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR.ANY INFORMATION. REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the -information submitted. Based on my inquiry of the
person or persons who manage the system, or those, persons. directly responsible for gathering -the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant,penalties for submitting false
information, including the possibility -of fines.and imprisonment for knowing violations."
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
D...... 11 _. r 11

l
Egow'OhmmU4 % howummUd
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE. N.C. 27835-7065
SMITHFIELD PACKING -K2 PLANT
ATTN: CHARLIE PRENTICE
1780 SMITHFIELD WAY
KINSTON ,NC 28504
PARAMETERS
COD, mgll
Fecal Coliform (MIT), /100 Mls
Total Suspended Residue, mgfl
Oil & Grease (HEM), mg/l
Stornrnater
Analysis
Method
(#I, Grah)
Date
Analyst
Code
26
05/18/18
SEJ
H8000-79
12
05/16/18
JMS
9222D-06
2.8
05/17/18
JMS
2540D-11
<6
05/17/18
SEJ
1664B
ID#: 465 C
DATE COLLECTED: 05/16/18
DATE REPORTED : 05/21/18
REVIEWED BY:

,__En_+�nnment 1, tnc. CHAIN OF CUSTODY RECORD
P.O. Box 7085, 114 Oakmont Dr.
Greenville. NC 27858 Page of . 1 1
environment I inc .com
Phone [phone] • Fax [phone]
DISINFECTION
4
1
CF LORINE NEUTRALIZED AT COLLECTION
� CHLORINE
- --
CLIENT:465 C Week: 5
UV
or
pH CI­I(LAB)
AffTIIiELD PACIUNC-V,2 PLANT
NONE
P
P
P
G
CONTAINER TYPE, PIG
►TIN: CHARLIE PRENTICE
JA
CHEMICALPRESElTVAiION
780 SNUTHFIELD WAY
❑
QNSTON NC 28504
C
G
C
A•NONE D•NAOH
az
252) 208-4706
z
w �G
S . HNO, E - HCL
U¢
Cr "'
z
a
p
o
U
W C- H,SO, F- ZINC ACETATEJNAOH
COLLECTION
a S
o
s G- NATHIOSWATE
SAMPLE LOCATION
DATE
TIME
0 o
a
a
U
E-
O
1
a
.01.
NA
IS
�
I
Stontnwater (Ili. Grab)
S�lb _Ig
4
CLASSIRCAnON:
WASTEWATER WES)
DRfN" WATM
L) DWQGW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENTA)ELIVERY
© N
SAMPLES COLLECTED BY:
(Please Prim
e ,F
SAMPLES RECENED IN LAB AT _4-?.— °C
BY ( PLER}
DATETIME
RECEIVED BY (SIG.)
DATEf M
COMMENTS,
1
-11
i2:yg
01.
5*18 1-m
RELINQUISHED 13Y (SIG.)
DATEl11ME
RECEM BY (SIG)
DATErnME
RELINQUISHED BY (SIG)
DATEfrIME
RECEIVED BY (SIG.)
DATEITNE
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a T" for composite sample or a'G' for NG 340657
.
FORM #S Grab sample in the blocks above for each parameter requested.

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted - 2 - "I ,
CERTIFICATE OF COVERAGE NO. NCG060 -L '
FACILITY NAME �fi�tiiX
COUNTY
PERSON COLLECTING SAMPLES r',rt?QLt Z:
LABORATORY � 1- Lab Cert. # 10
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR .Qen 70
FACILITY ACTIVITIES INCLUDE (check all that apply): SEP 22 201�
© use/process meats ❑ use animal fats/byproducts,.,,;
DISCHARGING'TO SALTWATERS? DYES ®NO J.IR„g�'4r��r,J1Q 7(C£,3
�VIT
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
Total event roinfal1z or ❑ No discharge this period
Outfall No.
Sample Collected,
mo/dd/yr
.. TSS,
: mg/L
pH,
Standard units
COD,
mg/L
-Oil'and Grease,
,mg/L
,jeci[Coliforrn' +
Colonles,per.100 ml' ,
,Enterococcl" '
,. Colonies per 100 ml
Benchmark
-
100 or 50
Within-6.0 - 9.0
120
- 30
- -1000` "
, .500
1 19,
10Aq
L5
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes © no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected;
m- dd/yr
`!".Oil''and,Grease, _
mg%L''
TSS,
.mg/L' i" . 4
pH,-.- - ,- -
Standard units"}
• ,New Motor; Oil,Usage,
�Anssual'average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
ASee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012

*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 AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR,=including all "No Discharge" reports; within 30 days of ieceipt 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, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR. ANY 1NFORMATION.REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the -information submitted. Based on my inquiry of the
person or persons who manage the system, or those, persons directly responsible for gathering -the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant'penalties for submitting false
information, including the possibility of fines.and imprisonment for knowing violations."
re of �ermittee)
17,2 � /
�z
(bate)'
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18. 2012
n.,.... '} -.r 7

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: huP:o)Ortal.ncdenr.orJweb/wq/wsl,u/nPdessw#tab-4
Permit No.: N/C/QI-LI ol-olD olpl or Certificate of Coverage No.: NIC/GIo 11Q/0l q /j/a /
Facility Name:
County: Phone No. _ 5� qcv5? - W`1VZ
Inspector: 0,�-E�x _Y332�—. en —
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): .7
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check your pennit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
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.
'• By this signature, I certify that this report is accurate and complete to the best of my knowledge:
ure of Pefinittee or Designee)
I. Outfall Description:
Outfall No. l _ _ Structure (pipe, ditch, etc.)' _
Receiving Stream: 1r i-., g-\C f���V, T
Describe the industrial activities that occur within the outfall drainage area.a
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C'c.�
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): jQoO5
Page 1 of 2
4 SNU-242-20120613
Jk

4. Clarity: Choose the number which best describes the clarity of the discharge, where I 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:
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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 1\To
S. Is there an oil sheen in the stormwater discharge? YesU
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
S WU-242-201206 i 3

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT KECEIVE'L)
for North Carolina Division of Water Quality General Permit No. NCG060000 JUN 15 201?
Date submitted (r-)V -) 7. CENT
�wR �CTlpNS
S,
CERTIFICATE OF COVERAGE NO. NCG06c� SAMPLE COLLECTION YEAR -Rc k'l
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ® use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? ❑YES [ENO
LABORATORY ,,, i Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE -4
Total event rainfall Zc�, y or ❑ No discharge this period
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD, •
mg/L
Oil°and Grease;
�mg/L , :, ..
Feca6Coliform,,; _ ::
-•'Colonles,perA00 ml `
I:nterococci., '
:Colonies per 100 ml .
Benchmark
-
100or50
-Within,6A-9.0
'120
'30
,., 1000
:500
5/a.
7
T09
_.�k2
L5
1�l
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes © no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected;
mo/dd/Yr
Oil'and'Grease,
tng%L' ^
TSS,
mg/L "' " `
pH,•••- -
"" 'standard units``
;-.New Motor;011.Usage,
"Annual`average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if es complete Part B)
SWU-249 Last Revised: October 18, 2012

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 £XCEEDANCES 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, NC 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 sign ificant,penalties for submitting false
information, including the possibility of fines.and imprisonment for knowing violations."
(Pate)
Additional copies of this form may be downloaded at: http://portal.ncdenr,orglweblwq/ws/su/nl)dessw#tab-4
SWU-249 Last Revised: October 18, 2012
n--_ I c

t.:
NCDENR s;
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://portal.ncdenr.orQ/web/wu/�vs/su/apdessw#tab4
Permit No.: or Certificate of Coverage No.: NIC/G/ol(o la Ial�Lll/
Facility Name:
County: i _t�� _ Phone No. 5 :. qn!�i -\ cog
Inspector. L' yk, AR
Date of Inspection:. � - t i
Time of Inspection: `7 _;�o �'�• _
Total Event Precipitation (inches): Q .
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check your pennit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
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 Q 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.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
ture of P6miittee or Designee)
1. Outfall Description:
Outfall No. I Structure (pipe, ditch, etc.)
Receiving Stream: G `-
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: Ct,L0?,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): A kgr-
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
• and 5 is very cloudy:
? s 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� 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:
V 2 3 4 5
7. Is there any foam in the stormwater discharge?
S. Is there an oil sheen in the stormwater discharge?
9. Is there evidence of erosion or deposition at the outfall?
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Yes lvo
Yes
Yes iU
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
Sv4'U-242-20120613

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water Quality General Permit No. NCG0fi0000
Date submitted 1!/(�e ULU 3 0 2016
CERTIFICATE OF COVERAGE NO. NCG06g SAMPLE COLLECT#ON YEAR ��tiv CENTRAL FILES
g-Q-- ❑WR SECTION
FACILITY NAME Sn,,;t+,zr �,,��a„hi� l�oS�P FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY o,� 0 use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES L•��f �t _�; DISCHARGING TO SALTWATERS? DYES ❑X NO
LABORATORY Lab Cert. # to
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall Z. r,_ or ❑ No discharge this period3
Outfall No.
Sample.Collected,
mo/dd/yr
TSS,
mg/L
PH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,, .
Colonies per 100 ml
Enterococci,,
Colonies per 100 rril
Benchmark
-
100 or 50
Within 6.0-9.0
120
`30
- 1000 _
500
-05- /
7,o t
o
4.5
I Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes © no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
• mo/dd/yr
'= Oil and Grease,
mg/L
` ' TSS,
mg/L -
pH,
Standard •units
New Motor Oil Usage,
Arinual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at a§,y outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012

*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 kj
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, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Additional copies of this form may be downloaded at: http:/Zportal.ncdenr,org/web/wglws/5u/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Pacer+ ?. of 7

A7L*�-A
NC®ENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: hitp:/lportal,nc(letir.or-web/wq/ws/su/npdessw#tab-4
Permit No.: N/C/o 1(�l a /ems I v /j> 1 b I or Certificate of Coverage No.: N/C/G/o l /n /fit A 1
Facility Name:
County: �'.2 _ Phone No. _.5- �S - L-1 14
Inspector:
Date of Inspection: �.l --5 --t(c
Time of Inspection: `I � IG 1ti`
Total Event Precipitation (inches):
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check your pennit to verify if Qualitative Monitoring must be performed during a representative
stoma event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at Ieast 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.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of Permittee or Designee)
1. Outfall Description:
Outfall No. I Structure (pipe, ditch, etc.)
Receiving Stream: 'jai ►��,: C C z=� �L
Describe the industrial activities that occur within the outfall drainage area:��C��ayr��
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 01 t
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): 1,-, L\LT
Page I of 2
S U-242-20I206t3

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:
d 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:
OE 2 3 4 5
7. is there any foam in the stormwater discharge? Yes Ta
S. 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-242-20120613

f
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 5 —13 —/ 6, _
CERTIFICATE OF COVERAGE NO. NCG06o a c SAMPLE COLLECTION YEAR '�?yti Ic
FACILITY NAME C� A",-- 2� 'R,ac],tr,- (, aw� FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY © use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES V`rc DISCHARGING TO SALTWATERS? []YES ®NO
LABORATORY r—_OjOt t,- A- Lab Cert. # 1 4n,
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 1 .7 or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform.,.
Colonies per,100 ml
Enterococci IL
Colonies per 100 ml
Benchmark
-
100or50
Within 6.0 — 9.0
126
30
1000
500
35
45
t to
NEU
Only applies to facilities that use/process meats.
Z CENTRAL III cc
The total precipitation must be recorded using data from an on -site rain gauge. CENTRAL
3 DWR EC -
For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report wA a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑X no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
m9/1' '
TSS,
- = mg/U :
pH,
Standard units
New Motor Oil Usage,
Annua[average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Last Revised: October 18, 201
i
S W U-249
(if yes, complete Part B)

*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 If 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 al! "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the cased"No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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 Lander my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons -who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility. of fines and imprisonment for knowing violations."
re of Fjermittee]
6-11 S /x,
(Date) .
Additional copies of this form may be downloaded at: http://portal.ncdenr.Drg/web/wg/wsZsu/npdessw#tab-4
s
1
S W U-249
Last Revised: October 18, 2012
poor I of 7

!r
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this forWn, please visit: hitp://portal.nc(lenr.or,/web/wq/ws/su/nVdessw#tab-4
Permit No.: N/CIO ILIO 10 /010 IO l or Certificate of Coverage No.: N/CIG/d 1101U ld A 1
Facility Name:
County: Phone No. -52 --- AOR - i-t'k 1$
Inspector: 014,Q,,F,
Date of Inspection: 110
Time of Inspection: 7:cn �
Total Event Precipitation (inches):
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check vour permit to verify if Qualitative Monitoring must he petformed dining a representative
storm event (requirements vary.
- - ...........,...........,.............-........_ _ __._ T _. --- -
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.
By this signaturej-certify that this report is accurate and complete to the best of my knowledge:
of Per6ttee or Designee)
1. Outfall Description:
Outfall No. I Structure (pipe, ditch, etc.) '�'tQS
Receiving Stream: Ct
Describe the industrial activities that occur within the outfall drainage area:�1?�L-�����
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.):
Page t of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
C 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
�jl - 2 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:
I C2) 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
S. 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-242-20120613

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted i I - ►8 -%5
CERTIFICATE OF COVERAGE NO. NCG06jD2c SAMPLE COLLECTION YEAR
FACILITY NAME ���;t \1 ,.��,��c.C-=�o� FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES -. ��= 1ING TO 5ALTWATERS? [-]YESZ]NO
LABORATORY i�;vti44,,,s a ,.r`,` 1 Lab Cert. #—.10
�Q' 4 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
,t,,,tti.II ES
Part A: Stormwater Benchmarks and Monitoring Results C ,� Gc [ION Total event rainfall z� or ❑ No discharge this period
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
mg/L
Oil and Grease,.
mg/L
Fecal Coliform ,,
Colonies per 100 ml
Enterococci,,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6:0 — 9.0
120
' 30
1000 -
500
t a is
-14
s
a va
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge. �F���D
a For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark he�hm� 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective bencapplies. Z�1
tom 2 0
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes & w L(�complete Part B)
p�VR 9�CT10�1
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
• Oil and•Grease;
mg/L
` TSS,
mg/L •
pH,
Standard units
New Motor Oil Usage;
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18, 2012
n. _ , _r"

*FOR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART If 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 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, NC 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 w.µ;
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility -of fines and imprisonment for knowing violations."
( ate
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 bast Revised: October 18, 2012
A:,aa 7, of 7

NCDEPR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: hiij2://poi-tal.ncdeiii-.or�/web/4kg/ws/su/npdessw#iab-4
Permit No.: N1C101 & 1 c31t� lol0101 or Certificate of Coverage No.: N/CIGIo l&,lo �1 I
Facility Name:
County:,-2 -- PhoneNo.
Inspector: L� F►a�e _G; n-� __ _ �—
Date of Inspection: w i - �L - 6`
Time of Inspection: h.�,
fr
Total Event Precipitation (inches): P
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
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.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of F(ermittee or Designee)
1. Outfall Description:
Outfall No. I Structure (pipe, ditch, etc.)
Receiving: Stream: -, C. lss�
Describe the industrial activities that occur within the outfall drainage area- �L
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.):?ate
9
Page I of 2
swU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
V 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:
CU 2 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:
6 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
S. Is there an oil sheen in the stormwater discharge? Yes 10
9. Is there evidence of erosion or deposition at the outfall? Yes 00
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-242-20120613

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT LOP
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted `7
CERTIFICATE OF COVERAGE NO. NCG06_a g SAMPLE COLLECTION YEAR 3
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY © use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES PJZr''Ft:-j- DISCHARGING TO SALTWATERS? ❑YES X]NO
LABORATORY Lab Cert. # �I
AUG 0 5 2015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results DkA/P RAL FILES Toiai event rainfall z ar ❑ No discharge this period3
Outfall No.,
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
[OD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
500
iC)
W
1 Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes" complete Part B)
SWU-249 Last Revised: October 18, 2012
Page I of 2

*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 ATTHE 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:
Marl an original and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature cif Permittee)
7/, 7 /e, s, -
Dat) -
Additional copies of this form may be downloaded at: http://portal.ncdenr.oEgLweb/wq/wsLsu/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page I of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
• for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted Iq
CERTIFICATE OF COVERAGE NO. NCG06 O 9 ;L SAMPLE COLLECTION YEAR IO _1_14
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ® use/process meats use animal fats/byproducts
PERSON COLLECTING SAMPLES Gaa�w� a roc=_ _ DISCHARGING TO SALTWATERS? []YES ©NO
LA90RATORY_I�i�n,J,�y.'-1_ Lab Cert. # 1 b
• PLEASE REMEMBER TO SIGN ON THE REVERSE -a
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfa112 or ❑ No discharge this period
Outfall No..,
Sam Ie Collected,
P
mo/dd/yr
;, . TSS,
mg/L
pH,....
Standard units _
OD,
mg/L
Oil and Grease,
. .
mg/L
Fecal Coliform�,.
Colonies per 100 ml
Enterococci
Colonies per 100 ml
Benchmark' ``'
-
100 or 50 '
Within 6.0 — 9.0
120
-30
1000
Soo, _
% 5
'15
45,0
Cb
C
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Q no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
=`Outfall'Nb. ` '°
`Sample Collected;
ma/dd/Yr
+"Oil arid-Greme;- `
e� , ;`, xmg/L. -i .•
TSS,
m L,
F g/
pH,
'-.-Standard units
New Motor Oil Usage,
Arinual;a►iera a gal mo' '
g
Benchmark
-
30 ..
100 or S0
6:0 — 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
ED
n q
DWR SECTIONS
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page I of 2

*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 results1or 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, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
informationNncluding the po A ility of fines and imprisonment for Knowing violations."
z 9 y )// 1/)/0 j �
(Signature of WIittee) ( ate
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 3 of 2

ALIV-VYWA
itl
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htlp://120FLai.ncdeiii-,orLlwet)/�kg/ws/,su/npclessw#tab-4
Permit No.: NICIO 6 1DI-I-1Li 1 c31 or Certificate of Coverage No.: NIC/Glo 1(010 /,2 / l
Facility Name: \A�'D oa__
County: a�,l�_ _ Phone No. �:15a - ),.nct - LA3
Inspector: f' O%A -,S
Date of Inspection: i v - 5 v i L4
Time of Inspection:
Total Event Precipitation (inches): 0-9
Was this a Representative Storm Event? (See information below) © Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
stortn event (requirements vary).
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.
By this sj,g_ Lu I certify the his report is accurate and complete to the best of my knowledge:
(Signature ck Pertriittee or
1. Outfall Description:
Outfall No. I Structure (pipe, ditch, etc.) N>I
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: 1,6tti rd, ct .1 i
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak -
chlorine odor, etc.): t�Ot.1G
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2� 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
l (D 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 4 5
7. Is there any foam in the stormwater discharge? Yes No
S. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfali? Yes 6)
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-242-20120613

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060nno
Date submitted 5— S-" i
CERTIFICATE OF COVERAGE NO. NCGOG O
FACILITY NAME C'�t,,;�,���G-�� V,.."�;�
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #i 16
Part A: Stormwater Benchmarks and Monitoring Results
RECEIVED
MAY 0 6 2014
SAMPLE COLLECTION YEAR AO �y CENTRAL FILES
FACILITY ACTIVITIES INCLUDE (check all that apply): DWQ/BOG
® use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES [&NO
PLEASE REMEMBER TO SIGN ON THE REVERSE
Total event rainfall Z� L,_ or [] No discharge this period'
Ctutfall No ;
L"
, Sample Collected,
..
mo/dd/yr.
„ TSS,
i .
'.mg/L
pH,_ ..
Standard units-
COD,.
mg/L
,OiLand:Grease;
.
mg/L
Fecal Coliformf,;
Colonies per 100 ml
•,Enterococci
Colonies per.100'ml
Benchmark'"'
=
100or50
Within6.0-9.0'
120
'30
1000
500' `
3
5.o
abo
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than S5 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outf'No."•
-,'Sample tollected; ..
;,: mo/dd/yr
' '.' Oil arid�Grease; '
,mg/La ".h' 7= ::
TSS;
mg/L-
pH, ,
Standaid'uiiits
New Motor,Oil Usage,
Annual average gal/mo
Bencht-hark
-
30
100 or 50
&0 - 9.0
-
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑X
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 Lor_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, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee
- "5 /<
(Da i
Additional copies of this form may be downloaded at: http://portal.ncdenr.orgZwebZwq/ws/su/npdessw#tab-4
S W U-249
List Revised: October 18-',7012
Puge�uf 2

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on f lling out this fonn, please visit: hitp://portal.ncclens-.orL,/web/wq/ws/su/np(lessw#tab-4
Permit No.: NIC/_Qjj& Q5 vl o /6161 or Certificate of Coverage No.: NICIG/o I6 /0l /9 1A I
Facility Name: ;-cup ,� .a 4 ��-
County: 1zEyetA Phone No. --IXaPL- 1-;Z053 -- L41% 9
Inspector: 0 ylkk, .E
Date of Inspection: L\ 15 -H
Time of Inspection: q'• t G
Total Event Precipitation (inches): .6
Was this a Representative Storm Event? (See information below) [) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring mist be performed during a representative
storm event (requirements vary).
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.
By Oyis� sigqature, I certify that this report is accurate and compete W the best of my knowledge:
9
(Signature of Permittee or
1. Outfall Description:
OutfaIl No. 1 Structure (pipe, ditch, etc.)
Receiving Stream:0>EEEk
Describe the industrial activities that occur within the outfall drainage area: PLC, r
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: (2t r.k
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): — �- c "
Page 1 of 2
5 WU-242-201206 l3

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:
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:
2 3 4 5
7. Is there any foam in the stormwater g mdischarge? Yes No
S. Is there an oil sheen in the stormwater discharge? Yes No
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-242-20120613