NCG140071_MONITORING INFO_20180219

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
1v 1
DOC TYPE
❑HISTORICAL FILE
�j MONITORING REPORTS
DOC DATE
❑ p2b
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 b 0 1 I
FACILITY NAME: pit wt et JSIA c w
PERSON COLLECTING SAMPLES •Zt I c-.c
CERTIFIED LABORATORY -t.Lab # L-L�
Lab 9
OPTIONAL INFO:
Part A. Stormwater Monitoring Requirements -
SAMPLE COLLECTION YEAR: Za 1 7
SAMPLING PERIOD: [v��Uly-December ❑ January -June
COUNTY Fro-,�,k I,�t
PHONE NO.
ADD TO LISTSERVE? DYES []NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Oultfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
TSS
(mg/Li
Event
Duration
(minutes)
Total
Rainfall°
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
if of Months in Tier
2 5amplirle
-
-
F,9
100 2,3-
-
-
vs..ty EFJ
F-B
19 7w
+ (
f 19 7
G
.2,
60
20
r~ 1
_
�% L J
CPr• lr kt
i
2 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is In excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TS5 benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
4 For each sampled measurable storm event the total precipitation must be recorded using datifrorn an on -site rain gauge.
Permit Date: 7/1/2011-50/30/2015 I Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gat of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(moldd/yr)1
pH
(standard
Units
TPH using method
1664A SG7-HEM
(m L
g/)
Total Suspended
Solids
m L
) g/)
Event
Duration
minutes )
Total
,
Rainfall
In )
New Motor Oil
Usage
al month
(g / )
In Tler 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sam lin
p 8i
6-9
1S
l00
-
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one cove of this DMR fincluding all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quailty
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
_1
Z �� ig
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

��n��
MCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. httpf /portal.ncdenr uEej3mrbLUjoWes-storM4YaLer/
Permit No.: 1y/�/_/_ /_/�/,/`/_/ or Certificate of Coverage No.: h[1jC/jj/L /*—V1-01-'f-L1
Facility Name: Plomik _(,.o_Wkc o
County: 7_gn Phone No.
Inspector: 13M
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): r Zd
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 evene 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 report is accurate and complete to the best of my knowledge:
Permittee or Designee)
Page ] of 2
5WU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. i Structure (pip ditch tc.)
Receivine 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: c 6r
3. Odor: Describe any distinct odors that the discharge may have (Le., smells strongly of oil,
weak chlorine odor, etc.): 'fa?U'P
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 0 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
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:
lJ 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. 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 000Q-
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

I. Outfall Description:
i]utfall No. __ Z Structure (pipe, itch, tc.)
Receiving Stream:
Describe the industrial activities th t occur within the outfall drainage area:
QIonl�t, Ylll�Y 6,dt=
2. Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: �110! LOr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): ljpktK_
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:
l) 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:
G 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes C�q
10. Other Obvious Indicators of Stormwater Pollution:
List and describe Npl.srt
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

IaceAnalj6dal
xwr•.pecekDsaora
November 20, 2017
Jay Watkins
Ready Mix Concrete
3610 Bush Street
Raleigh, NC 27609
RE: Project: Plant 9
Pace Project No.: 92362961
Paco Analytical Services, LLC
9800 KinceyAva. Suite 100
Huntersville, NC 28078
(704)B75.9092
Dear Jay Watkins:
Enclosed are the analytical results for sample(s) received by the laboratory on November 10, 2017.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
C " , 1-$"
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
INCCq
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written Consent of Pace AnatAral Services, LLC.
Page 1 of 11

ac"AnalXical
wwotipamk bs wm
Pace Analytical Services, LLC
W00 Kincey Ave. Suite 100
Huntersvllle, NC 28078
[phone]
CERTIFICATIONS
Project: Plant 9
Pace Project No.: 92362961
Eden Certiflcatlen iDa
205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Wastewater Certification #: 633
North Carolina Drinking Water Certification #: 37738 VirgWaNELAP Certification #: 460025
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
without the written consent of Pace AnalytiCal Services. LLC. Page 2 of 11

acMnalytical
wwwpaoelebs.com
SAMPLE ANALYTE COUNT
Project: Plant 9
Pace Project No.: 92362961
Pace Analytical ServiCea, LLC
0800 Kincey Ave. Suite 100
Huntersvllle, NC 28078
[phone]
Ana lytes
Lab ID Sample ID Method Analysts Reported Laboratory
92362961001 Plant 9 #1 SM 2540D CTS 1 PASI-E
92362961002 Plant 9 02
SM 2540D
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
without the written Consent of Pare Analytical Services, LLC.
CTB
PASI-E
Page 3 of 11

aceAnaIXilcal
Kwwpicak tf.com
ANALYTICAL RESULTS
Pace Analytfcel Services, LLC
9800 Kincey Ave. Suite 100
Huntarsvilte, NC 28078
(704)87tr9092
Project: Plant 9
Pace Project No.: 92362961
Sample: Plant 9 #1 Lab ID: 92362961001 Collected: 11109/17 06:31 Received: 11/10/17 12:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
25400 Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 4.9 mg1L 4.0 1 11/16117 13:16
Sample: Plant 9 #2 Lab ID: 92362961002 Collected: 11/09/17 06:31 Received: 11110117 1255 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
25400 Total Suspended Solids Analyticat Method: SM 2540D
Total Suspended Solids 29.2 mg1L 2.7 1 11116117 10:35
Date: 11/20/2017 04:42 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
without the wrtttan consent of Pace AnslytIcal Services, LLC.
Page 4 of 11 1

a
ceAnalylfical
wwW.PW&kf apart
Pace Analytical Services, LLC
9800 KlneeyAve. 5ulte 100
Huntersvllle, NC 2807B
(704)B76.9092
QUALITY CONTROL DATA
Project: Plant 9
Pace Project No.: 92362961
QC Batch: 387083 Analysis Method: SM 2540D
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92362961002
METHOD BLANK: 2147064
Associated Lab Samples: 923629B1002
Parameter Units
Total Suspended Solids MA
LABORATORY CONTROL SAMPLE: 2147065
Parameter Units
Total Suspended Solids mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
NO 2.5 11/16/17 10:32
Spike LCS LCS 7. Rec
Conc. Result % Rec Limits Qualifiers
250 234 94 90-110
SAMPLE DUPLICATE: 2147066
92362803001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg11- 13.7 534 190 D6
SAMPLE DUPLICATE: 2147W
92363262001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg1L 174 186 7 D6
ftesutts presented on this page ere in the units Indlcsttd by the "Units" calumn except where an alternate unit Is presented to the fight of the rMlt.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Date: 11/2012017 04:42 PM without the written consent of Pace Analytical Services, I.I.C.
Page 5 of 11

aceAnapical
—pacakb3zom
QUALITY CONTROL DATA
Project: Plant 9
Pace Project No.: 1 92362961
Pace Analytical ServIc", LLC
9800 Kincey Ave. Sulte 100
Huntersvllle, NC28078
[phone]
QC Batch: 387129
Analysis Method:
5M 2540D
QC Batch Method: SM 2540D
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92362961001
METHOD BLANK: 2147379
Matrix: Water
Associated Lab Samples: 92382901001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg1L
ND
2.5 11116/17 13:13
LABORATORY CONTROL SAMPLE: 2147380
k
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Total Suspended Solids
mg1L
250 242
97 90-110
SAMPLE DUPLICATE: 2147381
92362960001 Dup
Parameter
Units
Result Result
RPO Qualifiers
Total Suspended Solids
mglL
ND
398
SAMPLE DUPLICATE: 2147382
92363284003 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg/L
224
214 5
Results presented on this page are b the units indicated by the'Units' column except where on attemete unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 1112012017 04:42 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 11

ceAnaljftal
WWW.P6090 a.Com
QUALIFIERS
Project Plant 9
Pace Project No,: 92362961
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit,
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MID -Adjusted Method Detection Llmit.
PQL - Practical Quantilatlon Limit.
RL - Reporting Limit.
Pace Analytical Services, LLC
9800 Klncey Ave. Suite 100
Huntersvllie, NC 28078
[phone]
S • Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobertzene using Method 8270. The result for each anaiyte is
a combined concentration.
Consistent wlth EPAguldelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether,
A separate vial preserved to a pH of 4-5 is recommended in SW845 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PASI-E ' Pace Analytical Services - Eden
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Date: 11/20/2017 04:42 PM without the written Consent of Pace Analytical Services, I.I.C. Page 7 of 11

aceAnalj cal e
www.PgDwh1.ccm
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Plant 9
Pace Project No.: 92362961
Pace Analytical Services, LLC
9800 Kincey Ave. Sufte 100
Huntersvllle. NC 28078
;704)875-9092
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method
923ON61001
92362961002
Plant 9 #1
Plant 9 #2
SM 2540D
SM 2540D
367129
387083
Date: 11/20/2017 04:42 PM
REPORT OF LABORATORY ANALYSIS
This report shad not be reproduced. except In full,
without the written consent of Pace Analytical Services, LLC.
Analytical
Batch
Page 8 of 11

Document Name;
Document Reldsed: July 25, 2017
h M ja
Sample Cond)tlen Upon t SCUR)
e J. of 2
Document No.:
Issuing Authority,
F-CAR43V33-Rev.03
PacequarF Office
. iilboratory
Courier:
❑ Commercial
Custody Seal Pre
Packing Material;
Thennem t r:
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USDARegtdated S
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Wing samples:----------
vllte❑ Eden Greenwood Hunter6vllle W®# : 92�fi29fi1^
Client Now: II II +
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in a vamourla rune within the United States? CA, NY, or SC (check maps!? tnd tsunplesodglmte from a foreign source (lntemstionslly,
IndrdhgHaw+Hand Puerto Rico)?oYes f7ND -
Chain Of Custodiv
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PMect Manag r SRF Review: DDILL,} 11- I R - I 1 T
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DOCUMent Name:
Condtidark Upon Rea
Docurncnt No..
Mecic.mark. phali—Project
Is verified and withIn the acceptance range for
preservations Imples.
"Bottom half of box is to fist number of bottles
Dacum#nt Revised; JWY 25, 2D17 !
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FKAJ
A
WDEt4R
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidonce on filling out this foi-rn, please visit: Irtt;/loartal,ncdenr.orgf web/]r/uncles stacmwater�
Permit No.: l�I I I _I_I—I_ I _ I —I or Certificate of Coverage No.: N&/G/ -LI yl�d1�11/ 1
Facility Name: Plant el 4bA16NII
Count c k W 4l 9gLm u 4 9S
Y� _..._.�a4y►_._..� Phone No. g
inspector: �_ A b_` 105
Date of Inspection: .41'i411"j
Time of Inspection: 4 11 31 AV
Total Event. Precipitation (inches): ? n
Was this a "Representative Stornl Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes El No
Please verify whether Qualitative Mcmitor•in,ci niust be performed chwityj a "representative Storm
event" or "measureable storm event" (requirements vary, depending un the per mitj.
Qualitative monitoring requirements vary, Most permits require qualitative monitoring to be
perfarmed during a "representative storm event" or during a" meas u reib I e storfil event." Vloweve.r-,
some herniits 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 evetit" is a storm event that results in an actual discWirge from the:
Permitted site outfall. The previous measurable starrn evetrt 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 tale local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Sif,natur*f Pti•nrittee or Designee)
Page .l of 2
SWn-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. I'. Structure (pipe ditch etc.)
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: Ctator
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Nai.V
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1. is
clear and 5 is very cloudy:
1 G 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:
m 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:
iL.J 2 3 4 5
7. is there any foam in the stormwater discharge? Yes
TN
S. is there an oil sheen in the stormwater discharge? Yes i�N
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious indicators of Stormwater Pollution:
List and describe N 0 Ly-e-
mote: 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, laid modified 7/31/2013

1. outfall Description:
Outfall No. 7— Structure [pipe itc r tc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
(Lea a LAAN c1 Onat.,te 4-�P—
2. Color Describe the color of the discharge using basic colors (red, Drown, 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.): 0 z
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.
© 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:
0 2 3 4 5
7. is there any foam in the stormwater discharge? Yes VI
$, is there an oil sheen in the stormwater discharge? Yes I
9. Is there evidence of erosion or deposition at the outfall? Yes O')
10. Other Obvious Indicators of Stormwater Pollution -
List and describe P
Note: Low clarity, high solids, and/or the presence of Foam, oil sheen, or erosiori/deposition
may be indicative of pollutant exposure. These conditions warrant further, investigation.
Page 2of2
SWU-242, bast modified 7/31/2613

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division -of Water Quality eneral-Permit No. iYCG060000
Date submitted `i AL5 1 " 1
CERTIFICATE OF COVERAGE NO. NCG06 G l2 11 SAMPLE COLLECTION YEAR Z C lrl
FACILITY NAME P 1 kr+k q r DA+<<9 DurA FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY_ Fre;lwlhli*3 _ ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES ao-5 DISCHARGING TO SALTWATERS? DYES [!?NO
LABORATORY . pm-e Lab Cert. # q t
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER,TO�SIGN ON`THE REVERSE -i
Total event rainfall 2 &1 -70 or ❑ No discharge this periad3
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 ml
Benchmark
100or.504
Within 6.0 — 9.0
120
30
1000
S00
I
1uh
z.
c
4
if.-
L.St
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.
°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 [Yno
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
200 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.
if es, complete Part B)
SWU-249 Last Revised: October 18. 2012
Page I of 2

`FOR PART A AND'PART.13 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART li SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION 13.
s TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO (y
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Marl an on final and one copy of this DIM including all "No Discharge' reports, within 30 days of receipt of the lab results or at end o
monitoring period in the case of "No Discharge" reports) ta:
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:
"].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 Relief, 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 Perm
-11,11-)
(Date)
Additional copies of this form may be downloaded at:.http://Uortal.ncdenr.orp,/web/wq/ws/su/­npdessw#tab-4
S W-U-249
Last Revised: October I & 2012
Page 2 of 2

I
eAnalytrcal "
www.pamlabs.com
ANALYTICAL RESULTS
Project: PLANT 9 LOUISBURG
Pace Project No.: 92338350
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875r9092
Sample: OUTFALL #1 PLANT 9 Lab ID: 92338350001 Collected: 04/24/17 08:32 Received: 04/25/17 14:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 32.5 mg1L 3.0 1 04/26/17 13:40
Sample: OUTFALL #2 PLANT 9 Lab ID: 92338350002 Collected: 04/24/17 08:33 Received: 04/25117 14:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 11.2 mglL 2.5 1 04/26/17 13:41
Date: 04/27/2017 03:05 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consem of Pace Analytical Services, LLC.
Page 4 of 10

PaceAnalytiral'
�L��
CHAIN -OF -CUSTODY l Analytical Request Document
The Chein-nf-Custody Is a LEGAL DOCUMENT. AR relevant fiaids must be corn eted accutaoity.
err
Section A Section 9 Section C
2097570
Wqu and Cientkiformation: Ruquind Prq'od InformWoom kwofm trdonrmtan:
Cam: Report To: AtterNon:
Addrtw:
Copy Ta
Comparry Nama
--
REGULATORY AGENCY
Addreer.
i"' NPOES f " GROUND WATER (" DRINKING WATER
� UST F' RCRA � OTHER
Emsll TO: ` _f y
Paehaae Order No.:
vam Qwee
a s �#IOp�%il�#Q i tC.[ti
Rarsrerov
fine:
fax:
PeWer� Name:
Pew Pro�su
tpEB LOfBlitX!
Wnerjr.
S7Ai!<:
Requested Due D bnA7:
� _,may
Pm�ed Number. ;i
Pn°" Prone 6:
iiequesEed
Aaaiytsis
FfItered
(YIN)
,
section MatrizCodee
ii
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nM1arW Grant lniomrlln, �jT,jjfX F-fAIIE
9
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COLLECTED
Pimservatrves
Dt*lrq Weser DW
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wage WaterYvLr
fN
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sraar
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SAMPLE ID OL
MPG
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(A-7, 0-91 r) Air AR
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DATE
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DATE
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7
8
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ADDI v#"L.ARTS
RELINOUMNED ST I APPILIAIMON
DATE
796E
BY 1 APMLiAT1OM'
DATE
TIME.
SAMPLE LONIMMS
ORIGINALSAMf'LERRAMEAND SIONATURE
PVMT Narne of SAMPLER:
9
a
$ a g
y
g
..
DATE Sig nal
MMATURS of SAMPLER:
t-
$
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iMMR7WYY):
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>u Iw+n er yD"+'v Uric dam Yvu arc Nr`Y 4nowree Pot Paid w.iain 50 tlorn. F-ALL"0-020ra V LO7. t 5-L%V-2G07
" araeptng Palls NE7 30 Wj PaYrsaN leans and a4rceY�a W lan rYvrgec ar t SYi pw rrxrror 1nr

Document Name: ESI Tech Spec Docurnent Revised, Sept, 21, 2D16
Sample Condition U on Racelpt(5CUR) Page 1 of 2
aceAnafytica! Document No.: Issuing Authority;
F-CAR-QA-QQ3-RevA2 Pace QUality Off Ce !
Laboratory receiving samples:
Asheville ❑ E:den❑ Greenwood ❑ Huntersville ❑ Raleigh® Mechanicsville[]
Sample. Condit.i'oon ALIP6 Client Name: WO# : 92338350
'ReceiptProject #I:
Courier: 40d x ❑UP5 ❑LISPS lent
❑ Commercial ❑Pace ❑other. $2338350
Custody Sea$ Present? Dyes Po
Seals Intact? ❑Yes JNo ��}
ram' Date/Initials Person txaininingfoTnenU:_$/� .
Packing Material: ❑Bubble Wrap []Bubble Bags XNone ❑other. / -
7hermameter. ,wet aluu None
® tR Gun Io- _ IS•3A92 _ tiype of Ice: © ❑Samples on Ice, cooling process has begun
Correction factor: Add 0.6 Cooler Temp Corrected ('Cj: 1 f Biological Tissue frozen? ❑Yes []NO *1/A
Temp should be above fr ezingta 6'C
USDA Regulated Sol, ( kNJA, water sample)
Did samples originate Ina uarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source Ptilrnationalfy,
❑Yes AfN0 including Hawail and Puerto Rlco)? []Yes AffNo
Comments Dlscre an :
Chain of Custody Present?
21
❑
Sam�les Arrived 'inNoldTiniei
Eff
LJ
El
2.
Short Hold lima Ana sis (<72 hr.)?
0ff—
3.
Rush Turn Around Time Requested?
4.
Sufficient Volume?
Ur
❑
❑
5.
Correct ConWnersUsed?
-Pace Containers Used?
ET❑
❑
6.
Containers Intact?
7,
Sam les Field rifteted7
8. Note if sediment is visible inthe dissolved container
Sample Labels Match COC?
-Includes Date/Time/ID/Anatysis
❑
9,
Heads arse in VOA Vials (>5-6mm)?
Yes
No
N A
10,
Trip Blank Present?
Trip Blank Custody Seals Present?
El
Yes
❑
Yes
13
No
❑
No
i[—
CLIENT NOTI FICATIONIRESOLUT ION
Person Contacted:
Comments/Sample Discrepancy:
Project Manager SCURF 4,
Review: i 7
Project Manager SRF
Review:
YD
Field Data Required? (JYes UNo
Date Jtime:
Rate: Li "-'sin - i r)
Date: `,-! _Z,(_0-1
Note: Whenever there is a discrepancy affecting North Cam Una campliance samples, a copy of this form wit be sent to the North Carolina DEHNR Certification Office (Le,
Out of hold, incorrect preservative, out of temp, incorrect containers)
.'.Page 8 of f 0

ro
0
S
v
a
M
3
s
a
Mx
D
a
G
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rt
0
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CA
Oi
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jp
a
K
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0
a
ttemn �-'----
BP4U-125 mL Plastic Uapreserved (NJA) (Cl,)
BP3U-250 ml Plastic Unpreserved (N/A)
BP21J-500 mC Plastic Unprmserved (N)A)
i
BP1U-1 liter Plastic Unpreserved (N/Al
BP3S-250 mt Plastic H2504 (pH 4 2) (0-)
MM-250 mi plastic HNO3 (pH c Z)
BP3Z-250 mL Plastic ZN Acetalc & NaDH (>9)
BP3C-250 mL Plastic NaCH (pH > 12) (C1-)
WGFU-Wide-mouthed Glass jar Unpr4served
AGiU-1 liter Amber Unpreserved (N/A) (CI-)
AG1 H-1 liter Amber HC1(pH < 2)
AG3U-250 mL Amber Unpreserved (N/A) (Cl.)
A635-1 liter Amber H2SO4 (pH < 2)
AGEIS-M mL Amber M2SO4 (pH c 2)
Y
AG3A(0453OZ50 m L Amber NH40 IN/A)(CI-)
QG9H-40 mL VOA HCI (N/A)
VG9T-4D mL VOA Na2S203 (N!A)
VG9U-40 mL VDA Unp (N/A)
....
DG9P-40 mL VOA H3PO4 (N/A)
VOAX (6 %491s per kit)-S035 kit (N/A)
V/Gic (3 vials per Idt)-VPH/Gas kit (N/A)
SPST-12S mL Sterile Plastic (N/A-- lab)
SP2T-250 ml Sterile Plastic (N/A - lab)
BP3A-250 rnt Plastic(NH2)2SO4 (9.3-9.7)
Cubitalner
MU-20mLScinttltationvials (N/A)
GN
0

A��
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidonce on filling out thisform, please visit: h p-.:J po.rtal.ncdeni-.org/web/Ir/npdes-stormwater/­
Permit No.: iv/C/_/_/,L� I�I�L I or Certificate of Coverage No.:
Facility Name: PlayA- 9 Lou ksktAfA u L
County: Phone No. q Iq — 4q b — W11 S
Inspector: Ift C14-*-aVt
Date of Inspection: 6 lzg 116
Time of Inspection: 2:2 S Pt-- '!!!�
Total Event Precipitation (inches): J(1L
Was this a eve Storm Event" or "Measureable Storm Eventl�las��13 � �
(See information below.)
the permit?
21"Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
even t"or "measureable storm event" (requirements vary, depending on the perinit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to he
performed during a "representative storm event" or during a "measureable storm event." However,
same 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 report is accurate and complete to the best of my knowledge:
(Signatu/e JNrmittee or Designee)
Page 1 of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Dutfall No. I Structure (pip ditch, c.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
- - - 4-dam- M:>�A - t.aAf 1ECI c 'QfAV) t
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C � r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Me"t
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
6 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
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:
(;> 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 N�
10. Other Obvious Indicators of Stormwater Pollution:
List and describe P00,0-
mote: 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

AQ=
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, Tease visit: httl2:1/12ortal.ncdeni*.org/webllr/npdes-stormwater/­
Permit No.: N/C/_/_/�/�/_/`/_/ or Certificate of Coverage No.:
Facility Name: PI AI& a Loulghuca i NL
County: 'Phone No.
Inspector: QrtACAC [-fert-6
Date of Inspection: 6 X41 1
Time of Inspection: ri
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 monito
ring 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 report is accurate and complete to the best of my knowledge:
(Signat//e oOermittee or Designee)
Page 1 of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. ,_,- _.- Z, Structure (pipe it tc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
R.aL ft.V,wl tnr►c,rtAW Pl arMAL-
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: CI V- wr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): 0 063
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:
0 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:
G> 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 65
8. Is there an oil sheen in the stormwater discharge? Yes 0
9. Is there evidence of erosion or deposition at the outfall? Yes Ao
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.
Page 2 of 2
SWU-242, Last modifed 7/31/2013

2ceAnalytical
1 www.pavelab&com
1
ANALYTICAL RESULTS
Project: PLANT 9 LOUISBURG
Pace Project No.: 92303405
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: OUTFALL #11PLANT 9 Lab ID: 92303405001 Collected: 06/28116 14:25 Received: 06/29/16 15:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2640D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 12.6 mg1L 2.9 1 06/30/16 13:16
Sample: OUTFALL #21PLANT 9 Lab ID: 92303405002 Collected: 00/28/10 14:30 Received: 06/29/16 15:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 9.2 mg1L 2.6 1 06/30/16 13:17
Date: 07/01/2016 02:17 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 4 of 9

,! ; �aceAr�lyfical `
Document Name: Document Revised: May 24, 2016
Sample Condition Upon Receipt(SCUR) Page 1 of 2
Document No.: Issuing Authority:
F-RAL•CS-001-Rev.04 Pace Ralelah ouality Office
Client Name: � WV# : 92303405
"Al Project q:
Courier: ❑Fed Fat ❑UPS ❑USPS 7Cflent 1 ITCH1111111111111
❑ Commercial ❑Pate ❑Other.
1 92303405
Custody Seal Present? Des VfJo Seals Intact? ❑Yes ONO
Datellnldals Person Examining Gontenai*
Packing Material: ❑Bubble Wrap ❑Bubble Bags 4Non ❑Other:
Thermometer: T1505 Type of Ica: Vwet ❑Blue ❑None []Samples on ice, coaling process has begun
Correction Factor: 0.O'C Cooler Temp Corrected ('C): , 71 Biological Tissue Frozen? ❑Yes ONO N/A
Temp should be above tr enng to VC
USDA Regulated Soil (7) N/A, water sample)
Did samp9l originate In a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (intertlationaly,
❑Yes LANo iocludine Hawail and Puerto Ricol? F lYes rA0
Comments/Dlscre anc
Chain of Custody Present?
Yes
ONO
N/A
1.
Samples Arrived within Hold Time?
Yes
No
❑NJA
2.
Short Hold Time Analysis (q2 hr.)?
❑Yes
CtNo
❑NJA
3.
Rush Tum Around Time Requested?
❑Yes
No
❑N A
a.
Sufficient Volume?
Yes
No
NJA
S.
Correct Containers Used?
tv[]No
[]No
❑N/A
6.
-Pace Containers Used?
❑N/A
Containers Intact?
Ypz
No
❑NJA
7-
Samples Field Filtered?
©Yes
No
/A
8. Note 9 sedimentis visible In the dissolved container
Sample labels Match COC?
Yes
❑No
❑N/A
9,
-Includes DateMme/ID/Analysis Matrix:
All containers needing acid/base preservation have been
lo. rwn:µa
checked? .
[]Yes
❑No
[]N/A
All containers needing preservation are found to be in
f!
"a04
compliance with EPA recommendation?
wsa4W-2
(HNOa, H250•, HCk2; NaOH >9 Sulfide, NaOH>12 Cyanide)
yes
❑No
[]N/A
rtbmpwsz
Exceptions: VOA, Coliform, TOC, Oil and Grease,
DRO/8015 (water) DOC,ULHg
yes
Nu
ONJA
XioKft.Q Fm
Samples checked for dechlorinatlon?
yes
❑No
❑NJA
11.
Headspace In VOA Vials (>5-6mm)?
[]Yes
❑No
N/A
12.
Trip Blank Present?
❑Yes
[]No
NIA
13.
Trip Blank Custody Seals Present?
[]Yes❑No
N/A
P
Pace Trip Blank Lot p (If urchased):
CLIENT NOTIFICATir7NJRE50LU110N Feld Data Requlred7 ❑Yes ❑No
Person Contacted: Datefl-ime:
Comments/Sample
Discrepancy:
Project Manager SCURF Review: 1� Date: /"�[J't W _-
Project Manager 5RF Review: _ 61Y I6 _ _ _ Date: 1 tr0
Note: Whenever there is a discrepancy affecting North Carolina campllance samples, a copy of this form will be sent to the north Carolina DEHNR LertiflcaUon Office (Le.
out of hold, incorrect preservative, out of temp, Incorrect containers)
1v
Page 8 of 9

r�dCBf�FJci�}/C1Cc��r
CHAIN -OF -CUSTODY i Analytical Request Document
ThC Ch2in-dZuslody Is a LEGAL DOCUMENT. All relevant. Roldc must Ire domplelud uc=atoly.
• ----
�
Papa. of
Secdon A Suction 8 seebon C
20:
Required Client In mmvli : Ruquired Ptnjarl Irdormal,nn: Invoke Inlormiftn:
Ca Report Ta: AIIenllan
5
,5
AMres i
Capy To:
Company Name.
Rltcvu►Yorty nGeNcv
L E
Address:
r NPOES f GROUND WATER ; ORINXING WATER
f- UST (" RCRA - OTHERW>r
sm�a rd: n
Liypa
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STATE:
Raquasd OwOaWrAT:
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Requested
Analysis
Fittsred
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Paco Projeet Nod Lab 1.0.
4
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7
8
9
t0
+2
ADDITIONAL COMMENTS
RELINQUISHED BY I AFFILIATION
DATE
TIME
a
AFFI
-n
D
TIME
SAMPLE CONDrITDNS
!a
j
l
ORIGINAL
SAMPLERNAhtEANDSI6NATURE
o^
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c
PRINT Names o1 SAMPLER:
V
SIGNATURE or SAMPLER: RATE Slgnod
a -`-'
u
E
I MmmorYYt-
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•anaon-ml Nod: er ugnwl mr, ervm Y„ ate. conw,n n..-NET ,a nnv rwy n�ra e.rn., nnrs x�. : ,,e M En cl rg- �t 1eve Iva . t_ d5 or. F-ALL-0-02Irev.07. 15-May.20p7

��P GFMI-ANNI IA1 CT(1RM111/GTGR IIICfHARf.F Mf1NITARINr RFD(1RT
CERTIFICATE OF COVERAGE
FACILITY NAME P1 ah
COUNTY re&% V-1 I
for No a a Division of Water Quality General Permit No. NCG060000
Date submitted t z
N 0���yoo 7/SAMPLE COLLECTION YEAR 2,01C.
>✓ L FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? ❑YES [XNO
__ Paw Lab Cert. # _ Qi
PLEASE REMEMBER TO SIGN ON THE REVERSE
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall Z 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
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0-9.0
120
30
1000
Soo
6 Ile,
Z
b
Q,Z
eb
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.
45ee 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 - Y 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
-
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.
45ee 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: Ociober 18, 2012
Page 1 of 2

*FOR r,R-LA AND PART B MONITORING RESULTS:
.0 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 S
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 recelpt 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 V41S 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 Pdrmittee)
7/1_ //1
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/we_blwg/ws/`su/npdessw#tab-4
5 WU-249
Last Revised: October 18, 2012
Paae 2 of 2

v<
SEMIARNW
for Caro
v�
CERTIFICATE OF COVERAGE/NO. N
FACILITY NAME
COUNTY W*11C I
PERSON COLLECTING SA PLES Y e
LABORATORY_ 1011 Cert. #
)RMWATER DISCHARGE MONITORING REPORT
Di�sion of Water Quality General Permit No. NCG060000
Date submitted . 7 1 f't If(.
Part A: Stormwater Benchmarks and Monitoring Results
I�-D-o 7,�
SAMPLE COLLECTION YEAR _ Z016
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES XNO
PLEASE REMEMBER TO SIGN ON THE REVERSE �
Totol event roinfall2 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 ml
Benchmark
-
100 or So°
Within 6.0 — 9.0
120
30
1000
Soo
ts
la r
7. z
S1 ,
xs.d
- .
1 Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
a 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,
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 yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FU i PART A AND PART B MONITORING RESULTS:
C 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 on final and ane 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."
of Permittee)
-7/17//6
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Paae 2 of 2

r'
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
ECEIVED
fo.r North -Ca olina•Oivision of Water Quality General Permit No. NCG060000
N'Date submitted �] 1 IZ� ib MAY 0 8 Ui l
CENT
CERTIFICATE OF COVERAGE NO.laUGG _ !y d SAMPLE COLLECTION YEAR 241C� RAL FILES
FACILITY NAME 8a'=LjC'_7_ FACILITY ACTIVITIES INCLUDE (check all that apply): QwR SECTION
COUNTY WA ts� ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMhES; _ F 4 DISCHARGING TO SALTWATERS? [—]YES �flNO
LABORATORY YCAUe Lab Cert.�## i
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z 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 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
500
II rb
��.
•3
Ile
L •�
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 Nno
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
-
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.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if Ves, complete Part B)
SWU-244 Last Revised: October 18, 2012
Pacre 1 of 2

4
*FOR PART A AND PART B MONITORING RESULTS:
C 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 jj
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports,- within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, 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."
(SignatupVof Permittee)
7/1 Z
(Date)
Additional copies of this form may be downloaded at:.http://portal.ncdenr.org/web/­wq/ws/su/npdessWtttab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

�r�;,�li���r�r�� �►�isc�-r��rc� ouT���tt �soo� - s��►���-,I�.�l��,i Ic.�,��i�-����i�� �c.�r;
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG14 D .+01 1
FACILITY NAME: 1 /'li
PERSON COLLECTING SAMPL 5
CERTIFIED LABORATORY_ T1tC J Lab # qj
Lab ##
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION7JUIV-December
R: Z01 q
SAMPLING PERIOD: ❑ January -June
COUNTY 6"_KJ ; Iq
PHONE NO. (00_%_) qqb - 9-0115�
ADD TO LISTSERVE? ❑YES ❑NO EMAIL: _
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trou$
❑Other.
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
PH
(Standard
Units)
T5S
(mg/L)
Gvent
Duration
(minutes)
Total
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2
2 Sampling
_
-
6-9z
100 3
-
-
-
-
D
I
"7�8
Zfl
n1
-7
Z
a
-7►
z a
IV
NOV 12
o
G
DWR SE
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/i, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
VED
Z014
FILES
MON
Permit Date: 7/1/2011-60/30/2015 Last Revised 7113111
Page 1 of 2

Part B. Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year
Outfall
No.
Date Sample
Collected
{mo/dd/yr)1
PH
(Standard
Units)
TPH using method
1664R SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
Wri)
# of Months
in Tier 2
z
Sampling
6-9z
15
100Z'
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO Q/
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail OrieinaI and one coat/ of this DMR (includinp, all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Per ee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

aceAnalytical
www.pacelabs.com
i
Jay Watkins
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: PLANT #9 LOUISBURG, NC
Pace Project No.: 432221763
Sample: OUTFALL #11PLANT 9
Parameters
Total Suspended Solids
Sample: OUTFALL #21PLANT 9
Parameters
Total Suspended Solids
Laboratory Report
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 1 of 1
Report Date: 10/31/2014
Date Received: 10/16/2014
Lab ID: 92221763001 Collected: 10/15/14 13:45 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
7.8 mg/L 3A 10/22/14 09:59
Lab ID: 92221763002 Collected: 10/15/14 13:50 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
7.6 mg1L 3.1 10/22/14 09:59
1
Reviewed by. =7y..<_�_,
Laura J Cooper
[e-mail]
Raleigh Certification IDs
6701 Conference Drive, Raleigh, NC 27607
North Carolina Wastewater Certification #: 67
North Carolina Bioassay Certification #: 16
North Carolina Drinking Water Certification #: 37731
Page t of 3

Document Narr* Sample Condition Upon
Document Ctevlsed; April 04, 2013
Recol t SWU .
Page 1 of 2
,� ,F'aCQAn�lyfiC?I~
Document No.:
Issuing Authorities:
F-Rf1t.-05-001 rov.t72
Pace Asheville QuFiRY Office "
Client Name: mom'
Wtiere`tteceivad: ❑ Huntersville ❑ Asheville .0 Eden,/� Raleigh
Cour16r(CJrclo): Fed Ex UPS' USPS II Commercial face Other
Custody Seat on CoolerlBox Present: [] yes �( no Sasis Intact: ye5 o no
:.::�:; .PackEnl4laterlal: SuhhEa Wrap 6uhbl a s. None Other'
Circle'Thermomotor Used: IR Gun SN:14 OI Type of tce: W Blue None (] Samples on lea; eooliripprocoss'Wbegun
IR Oun Back Up SNA22065371
A"
Temp Correction Factor: Add d Su tr Pt C
Date and initials of person examlaing
�
Corroctdcl CooterTemp.. C
RlologlcalTissue Is Frozen: Yes'ko. fA
cont6 1 rest etlo�
chec>G
Tomp.siiould be above framing to VC
'Commonte:
Chatri:of CUstoti Present:
Yes •t7No
❑NIA
1: '
Chain of Custod Flited Out:
Yas• ONo
OWA
2. '
Chain of Custod RalingVlshed:
eYea ONo
❑tVA
3.
Sams JUNamaA SI nature on COG:
Oes ❑No
❑wA
4,
Sam' W Arrived within Hold Time:
Yoe 0N.
13WA
5ttb'rtrUo"IdIbe Asial sls' <7,2hr :
C7Y4a eND,
OWA
6.
Rush Tiirn: Around Tuna Requested:
❑Yes o
OwA
7:
Suffi' a " t volume:...
os ClNo' OWA
B.
Corre,;tICofttainors Used:
.
,fives ONO
❑NiA
9. '
p(,.'', ,;a...
-f ac Caritalnere Used:
�Ve§ ❑No
OWA
Containers Intact:
,laves C]Wo
❑WA
10.
Ftlterod:volume received for Dissolved tests
PYO. ON.
AA
I l.,
Sam ploLabels.matohCOG:
-O?oa ni4.
I.7NlA
12.
-
�lrlaluife's.'dateltEmellEalAnal sis Maldx:
W
AO Qa�+tBoera geeding'pretervatson have been checked.
Plea pNo
❑NJA
13.
r
All coiitalners needing preservollon are found to be in
ONO
C1NlA
sons fiari'co`�vtih EPA reoornmendatton.
©xtt; 's;l C/A;-collform,Too, QSO,WI.ORdvmter
" ONO
Sa"rri Idk-6 66dfordechlorinallon;
❑Yes Na:/
A
keaii's6816 VOA Vials >6mm :
11Yea ❑NO.
AIA
15,
Trip t31ari1c=Freseiit:
DY9a ONo
wA
16-
Tf[p;8fentctCu`stody Seals Present
UYet. 009 AN1A
PaC6',`f r1 •Blank Lot# (If purchased}:
CliantNotitleatlonlResolution: Field WeRegulrad? Y '! -N
'3� etEson Contacted: Matins.;
CornMentsl Resolution: !
' S60'ft "ISRF l — — lam. �rr��,qqw, rr��
Reirlew:. l� ' .._ Date: 0 EW0,¢; 922�L`17�J& $ I
y q..' 1-
; NatosrlNWnever there Is a discrepenoy alfeoting North Caroline.compllanco I`II IIJ as
samples; a copy ofthls form will bosentto the North Carollne DE»I1NFt ll�[lill l�lII1I II III, : r.•3 s,., gE,;, �3, i.... , I
(s~atti L6&Vd i office ( I,e out of held, Incorrect preservathie, out of temp, 92221763 1
Incorrect oontainers} =`
' _
j.
y -, ; Page 2 of 3

W69AWcal*
-..- wL0=
Seaon A
Reaubvd C6erd tnfolmation:
M
CHAIN -OF -CUSTODY I Analytical, Request Dbbitheerifi' D`•'
r The Kreln-01-Custody is a LEGAL DOCUMENT. All retavant Skids must tfe completed zi carat*. � ' r:, • i_. rr; ; ::'• ;:; :-.. - _ .. w • dj
ScctJon 6 Section C _ p+ ..,..
Raaoirod Pmled l:ftorrmn on_ • 1n,;o�r �rilnriroilk.ri• �.
k
-•
UST • «- A OTHER
..
Marbe Code*
SAMPLE ID Ott 01.
r s
01rw OTf
i
_ - ...
sicNxiurE of SAMPLER.,
ou.'ri;_�.,a�ec. �/s
_
-;j
" _
c: o _
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'lnR*xvn NrRc 8! op xc can ;,,•m yrsu xn xeopure Mery NE T t7 yar �Yrne:r.:Cm: xi7 s�rxn� L-r Gln._Rss[(aG or 1 S?r yrr mnvR:a,..yC 'not"e r m+.z� T.I ct�y:' .. - a �„ - _ ......:.. - .- . .�i�
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AFTil-,KLATA
WDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http21/portal.ncrlenr.org/web/wq/wslsti/ni2dessw#tab-4
Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/ //-Y/ D/ b/-71 j1
Facility Name: ran+ J L&4jsbwA 1 Wt
County: Ff:CL-% Wi0 "I Phone No. liq- qq6 - `jg75
Inspector: \1 �q
Date of Inspection::
Time of Inspection:
M
Total Event Precipitation (inches): I - 75
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 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, 1 certify that this report is accurate and complete to the best of my knowledge:
(Signatur)Vof Vrmittee or Designee)
Pagel of 2
SWU-212, Last modified 10/25/2012

1. Outfall Description:
Outfall No. -- Structure (pip ditch tc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
�a�.0 :xel� Cnhce�� �arti
2, Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: QeAr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Wbu -e-
4. Clarity: Choose the number which hest describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 95
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 amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
Iv' 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 6)
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

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http//portal.ncdenr.org/web/wq/ws/sLi/npd"sw#tab-4
Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.:
Facility Name: u ' 4 6 'A If Q I &J (,
County: C`f'Ali U Phone No. Q19-Y9b ' 97
Inspector: _ J o q ,u s
Date of Inspection: lot 1 S )+4
Time of Inspection: i : 5o iPV- _
Total Event Precipitation (inches): t 7�
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Q 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 t11e permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignaAre mi Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 7— Structure (pip ditch, c.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
RfAdU un: t0d !A„ I VA4--P nla N I
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: (J
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): _ N0PJ4
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 45
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) 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 VD.A6
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-292, Last modified 10/25/2012

NCDENR
Stormwater Discharge ®utfall (SD®)
Qualitative Monitoring Report
l:orguidaace on filling out this form, please visit:
Permit No.: N/C/_/_/_/_/_/—/—/ or Certificate of Coverage No.: iV/C/L/1
Facility Name: P64 9 t�H�'sbu� , tJL
County: Phone No. 919- 49io-y975-
inspector: m,DcA,op5
Date of Inspection: 3 L5 f r y
Time of Inspection: l
Total Event Precipitation (inches): - Y
Was this a "Representative Storm Event" or "MeaSUreable Storm Event" as defined by the permit?
(See information below.)
LV Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "n7easureable .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 stormy 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 0A 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 report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee) RECEIVED
MAR 13 2014
CENTRAL FILES
Page 1 of 2 aWQ/,30G
$WO-242, Last modified 10/25/2012
RECEIVED
CENTRAL FILES
DWQf30G

1, Outfall Description:
Outfall No. I--_ Structure (pipe, do, etc.)
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:
3, Odor. Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): NC
4. Clarity: Choosc the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
0 2 3 4 5
5. )Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 3 is no solids and 5 is the surface covered with floating solids:
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 i9
a. Is there an oil sheen in the stormwater discharge? Yes Vp
9. Is there evidence of erosion or deposition at the outfall? Yes NC)
10, Other Obvious indicators of stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, mil 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

44 - V. A
NCDENR
Stormwater Discharge Dutfall (SD®)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: Irtr ((rr7l.ti_rtl.41i.r_.n4y}�4 �ti ti/fit: r�l�d�;;swt:�h t
Permit No.: N/CI_I _ I_I�I _/�I_ / or Certificate of Coverage No.: NIC/�i11IJL LO °l-1/1I
Facility Name: r1a 9 4o�,'sixr�, 0 G
County: _ �canrc_I:.. Phone No. 9/9-Y9&-VI75
Inspector: �Q c4,fln3
Date of Inspection: _ 3 1;3q
Time of inspection: __ __� Say.•.
Total Event Precipitation (inches): Y
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[YYes ❑ 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
1 performed during a "representative storm event" or during a "measureable storm event." However,
i some permits do not have this requirement. Please refer to these definitions, if applicable. I
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 ,
j 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
I 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 report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
SWU-242, bast modified 10/25/2012

I. Outfall Description:
Outfall No. 01- Structure (pipe, do, etc.)
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: Ct,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Ilk
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
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
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 (21r
8. Is there an oil sheen in the stormwater discharge? Yes iC�
9. is there evidence of erosion or deposition at the outfall? Yes
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 be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Lastmodified 10/25/2012

STORiNIWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 O o 1
FACILITY NAME: —Pl.nj Q Lak;s,, ,, 1\lL
PERSON COLLECTING SAMPLES rrmQlR/
CERTIFIED LABORATORY Lab #— C?d _
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: czo, q _
SAMPLING PERIOD: ❑ July -December ^January -June
COUNTY
PHONE NO. (9 M q46 - 415-
ADD TO LISTSERVE? ❑Yi;S ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other,
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
-
-
6-9z
100Z 3
3 t U
9.9
I If "NO FLOW" or "NO DJSCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit, Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar vear
Outfall
No.
Date Sample
Collected
(mo/dd/yr)1
pH
(Standard
units)
TPH using method
.1664A SGT-HEM
{mg/L}
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfalla
(in)
New Motor Oil
Usage
(gal/month)
Month) In Tier 2
y
Monitoring?
Wri)
# of Months
in Tier 2
z
Sampling
6-92
is
1002,3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one caoV of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
WI
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

(.�Iacmnalyfical"
www.pacalabs.com
MD Capps
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: PLANTS #9
Pace Project No.: 92192348
Sample: OUTFALL 1
Parameters
Total Suspended Solids
Sample: OUTFALL 2
Parameters
Total Suspended Solids .
Reviewed by: _
Nikitia Jones -Jackson
Laboratory Report
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 1 of 1
Report Date: 03/11/2014
Date Received: 03/07/2014
Lab ID: 92192348001 Collected: 03/03/14 13:46 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
9.3 mg1L 2.5 03/10/14 20M
Lab ID: 92192348002 Collected: 03/03114 13:51 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
9.9 mg/L 2.5 03/10/14 20:00
[e-mail]
Asheville Certification Ids
2225 Riverside Dr., Asheville, NC 28804
FRorida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #; 40
South Carolina Certification #: 99030001
West Virginia Certification #: 356
VirginiaNELAP Certification #: 460222
Page 1 of 3

M
;Cal Chain of Custody
9z1%,
Report Results to: Bill Results to: [Standard Report Delivery
Ready Mixed Concrete Ready Mixed Concrete 0 Rush Report Delivery (w/ surcharge)
P.O.Box 27326 P.O.Box 27326 Requested Due Date:
Raleigh, NC 27611 Raleigh, NC 27611
01 D LW'5 Project Reference: Plants #9
ATTN: johR k"I'l— ATTN: Purchase Order Phone: [phone] '-'o-w* Sampled By. M06pp,�:,
37� w'
MAW,
R.011110
'Emp
_05
—90 A
H NY-".
E ME
Wmagg. ON
IS L-69m,
M
P
Outfall I
G
3/31/y
YG P—
sw
TSS
Outfall 2
G
3/3/ty
1:57/.
SW
TSS
Relinquished by (signature)
Rec - t
20 .11
D
W,
T me
For Lab Use Only
Temperature at receipt.
Co
Relinquished bsignature)
Receivedby(signature)
Date I
Time
Relinquished by (signature)
Received by (signature)
Date
Time

Document Name: Sample Cond
,eAnal iC41' Recef f ja2yR
Document No,:
F-RAL-CS-001-rev.02
on Upon Document Revised: April 04, 2013
page 1 of 2
Issuing Authorlties:
Client Name:. if
Where Received: [] Hunter, syille E Mhaville�OEden Raleigh
Courier (Circle): - Fed Ex UPS USPS Fno
Commercial Pace Other
Custody Seal on CoolerBox Present: El. yes Seals intact:] yes no
Packing Material. ❑ Bubble Wrap s None Other
Circle 'thermometer Used: IR Gun N:12S D653 7Type of Ice: Wet Blue None Samptes on Ice, cooling process has begun
tR Gun B p
Temp Correction Factor: Add 1 ubtract"
Corrected Cooler Temp,: C ....
Terripshould be above freszing'to 6°C
C
Biological , '
g I Tissue is Frgzen:. Yes M MIA
'Comments::
Data and initials of person examining
eo to Pre ry o "
cheek:.
Chaln'ofCustody Present: ..... .... .... . :.......-
Yos ❑No% '❑NIA
1:'--. ....--:.;._....-.-...-...
-' •.-... ---.-..,.....-..•. ,..._.
Chaimof Custody:Filled out:
Yes :❑Ne
©NIA
2.
Chalh-ofCustod Relinquished: -
Yes .ONO
©NIA
�.
Sampler. Name.& Signature an C=
1688,ONO
❑NIA.
4.
Sainples Arrived within Hold Time:..
Yes.. ❑tfo
❑tJ1A
5..
Short Hold Tlme,Anal is <72hr :
❑Yes o
QNIA
6.
Rush.'Turn:;4i'riund.Tl>ne Requested:
Dyes No "
❑wA
7," "
5ufiteient.VolumB: .:
Yas ON
0N' IA
Correct Containers USed:
-Pace Containers Used:
Yes "❑No
Yev- ©No'
❑N1A
❑ilia.
9.
Containers Intact
Yes 'LINO''CINIA
10'.
Filtered volume•`recelyed.for.Dissolved tests:.'
❑Yes ❑No'
VNIA
11.
Sample Labels match COC:' .
-includes dateltlme11DIAnalysis Matrix:
Yes ..ONO '
1JN1A
12.
All containers heading; preservatlon have been shacked.
All contelne'rs'needing,preservatlon are found to be In-
compliance with EPA recommendation.
exceptions: VoA, colifomt, TOC, 0&G, W1-GRO (rater)
es l�No
�j
�dYes ONO
/Yes ON.
CJNIA
NIA
13.
Samples.checked for dechlorination:
71 Yes ❑No
©NIA
.14. -
Heads ace Irt VOA Vials >6mm :
- Dyes ❑No
NIA
15.
Trip Blank Present:
Trip Blank Custody Seals Present;
Pace Trip B16nk'Lot 11 p purchased :
❑Yes "❑No NIA
❑Yes "❑Na . I�WA
16.'
Client Notiflcation't Resolution: Field Data Required? Y ! N
Person Contacted: DateMmo:
Comments! Resolution:
SCURFlSRF Place label here
Dater j
ReView::
Note: Whenever there Is a discrepancy affecting North Carolina compli nce
samples, a copy of this form will be sent to the North Carolina DEHNR -
Cer5fication.Office (1.e out of hold, incorrect preservative, out of temp,
Incorrect containers)
-nrZ
WO # : 92192348 l
i
IIl11�11�lIl�II IlII '}�-�--
Page 3 of 3