NCG140076_MONITORING INFO_20170601

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV C& /q00%(p
DOC TYPE
❑HISTORICAL FILE
� MONITORING REPORTS
DOC DATE
❑ c� db � I
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality §eneral Permit No, NCG060000
IVC (-- i y o b 7,6 Date submitted $ / 3 i rr +�
CERTIFICATE OF COVERAGE NO. OG'06 0 0 Lb SAMPLE COLLECTION YEAR ZO 1 r RECF.IVED
FACILITY NAME W go 3 FACILITY ACTIVITIES INCLUDE (check all that apply): �Is Q 1 Z017
COUNTY Wad ❑ use/process meats ❑ use animal fats/byproduct
PERSON COLLECTING SAMPLES r DISCHARGING TO SALTWATERS? []YES LZNO CENTRAL FILES
LABORATORY �aC� Lab Cert. 9( pWR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 /, ?— or ❑ No discharge this• period
Outf all 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
I 120
30
1000
Soo
z4
114-
I
I
I Only applies to facilities that use/process meats.
The 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.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Laid this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? [N yes ❑ no cif Ves, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55gal 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
-
i
i
' Only applies to facilities that use/process meats.
2The 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.
°See 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
Pace I of 2

*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 copv of this DMR, inciudina all "No Discharge" reports, within 30 dovs of receipt of the lab results for at end of
monitoring period in the case of "No Discharge" reportsl_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."
W mLk---
(Signature
(pate).
5131I1`7
Additional copies of this form may be downloaded at: htt ortal.ncdenr.or wveb w ws su n dessw4tab-4
SWU-2 t9 Last Revised: October IS.. 2012
Pacre 2 of 2

aceAnalytrcal b
www.pacelsds.corn
i
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: PLANT 3 WESTGATE
Pace Project No.: 92338342
Sample: OUTFALL #1 PLANT 3
Lab ID: 92338342001 Collected: 04/24/17 11:30
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
28.6 mg1L
4.9 1
04/26/17 13:38
Sample: OUTFALL #2 PLANT 3
Lab ID: 92338342002 Collected: 04/24/17 11:41
Received:
04/25/17 14:55 Matrix: Water
GRAB
Parameters
Results Units
Report Limit DF
Prepared
Analyzed CAS No. Qual
2640D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
11.4 mg1L
2.5 1
04/26/17 13:38
Sample: OUTFALL #2 PLANT 3 Lab ID: 92338342003 Collected: 04/24/17 11:41 Received: 04/25/17 14:55 Matrix: Water
COMP
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664B
Oil and Grease N❑ mg1L 5.0 1 05102/17 07:30
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05102/2017 03:00 PM without the written consent of Pace Analytical Services, LLC, Page 4 of 11

Document Name: ESI Tech Spec
Document Revised: Sept. 21, 2016
r
Sample Condition Upon Recetpt(SC_U_R)_
Page 1 of 2
Document NO.:
Issuing Authority:
1' -" tii;eAiia�ytical
FCAR-QA•003-Rev.02
Pate Quality Office
Laboratory receiving samples.
Asheville ❑ Eden[:] Greenwood ❑ Huntersville ❑ Raleigh® Mechanicsville[]
Courier:
❑ commercial
Custody seal Present?
Client Name:
Project q:
❑ d Ex ❑UPS ❑L1spS lient
❑Pace ❑Other.
❑Yes N40 Seals Intact? ❑Yes rNo
WOp:92338342
1111111111111111111111!
pate/Initials Person Examining Convents:
Packing Material: ❑Bubble Wrap ❑Bubble Bags None ❑Other._ —
Thermometer:(,,
® IR Gun ID: _ IS-3492 — 'type of Ice: Xc et []Blue [-)None ❑Samples on Ice, coaling process has begun
Correction Factor: Addtf.6 Cooler Temp Corrected ("C): 1 r Biological Tissue Frozen? Des ❑Na #I/A
Temp should be above qNJA,.,,ater
tiring to 61C
USDA Regulated Soll { sample)
Did samples originate inuarantine zone within the united States: CA, NY, or SC (check maps)? Did samples ari&atefrom a foreign source lin mationaiiy,
❑Yes KNo including Hawaii and Puerto Rico)? []Yes TNo
Comments scr a
Chain of Custody Present?
ef
El1.
--i
ampreslVn"ve&V7[tii1nlidldTTri+2? ...:__..,,.,.
,.._-..-.,...
Q:....
,
2...
Short Hold Time Analysis (472 hr.)?
3.
Rush Turn Around Time Requested?
Ll
Ej
0
4•
Sufficient Volume?
I]
0
5,
Correct Containers Used?
-Pace Containers Used?
©
6•
Contain em Intact?
©
7•
Samples Field Filtered?
8. Note if sediment is visible in the dissolved container
Sample Labels Match COO
-Includes Oate/Time/rD/AnaWs.
9.
Headspace In VOA Vlals >S-tmm ?
a
YPA
a
No
N A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
Yes
0
Yes
NO
11
No
JA
11.
CLIENT NMI FiCATION/RESCUMON
Person Contacted: i
Comments/Sample Discrepancy:
DateMme:
Field Data Required? []Yes ©NO
Project Manager SCURC Review: ry
- Y 1 Date:
Project Manager 5RF
Review: Ayy1i [late:
Note: whenever there is a discrepancy affecting North Carolina compllance samples, a Copy of this form will be sent to the North Carolina DEHNR Certification Dtfica li.e.
Out of hold, incorrect preservative, out of temp, Incorrect containers)
xJ:. :IPage 9 of 11

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Item#
SP4U-125 mL Plastic Unpieserved (N/A) (CI-)
MU-2510mL Plastic Unpreserved (N/A)
BP2U-SOOmL Plastic Unpreserved IN/A)
BPIU-Miter Plastic Unpreserved (NJA)
-
8P35-2SO mL Plastic H2SO4 (pH < 2) (Cl.)
BM-250 mL plastic HNO3 (pH < 2)
— ------------
#
:
8P3Z-250ml.Plastic ZNAcetate &NaOH(>9)
BP3C-Z50 mL Plastic NaOH (pH > 12) (CI-)
!
t
WGFU•Wide-mouthed Glass jar Unprtserved
AGMLI liter Amber Unpreserve4 (N/A) (Cl-)
A1511+1 liter Amber HCI (pH < 2)
AG31.1-250 mL Amber unpreserved (NJA) (CH
AG1S-1 liter Amber H2504 (PH - 2)
AG735-250 mL Amber H2SO4 (pH < 2j
AG3A(DG3A)-250 mL Amber NH4C1 (N/A)(CI-)
OG9H-40 mL VOA HCI (N/A)
VG9T-40rnL VOA Na25203 (NIA)
�1
!
VG9U-40 mL VOA Unp (N/A)
D69P-40 mL VOA M3PO4 (N/A)
VOAK (6 vials per kit)-5035 kit (N/A)
11f
V/GK (3 vials per k€t)-VPH/Gas kit (N/A)
SP5T-12S mL Sterlle Pla stir (N/A -lab)
—
SPHT250 MLSterile Plastic (N/A -tab)
zzzzzzIA/
MA-250 mL Plastic (NH2)ZSO4 (9.3-9.7)
Cubitalner
VSGU-20 ml Scintillation via(s (N/A)
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CHAIN -OF -CUSTODY 1 Analytical Request Document 1
The Ctrain.ol•Guslody is a LEGAL DOCUMENT. All eelevant rwlds must ec completed aocumlely. o
XAra�,�r�car-
v...pee`tl�t.rxtn .....,,
Paps: of
Section A Section B Section C
Required uanl fmanratton: RegUmd Pra)ect InhNmaXn: Invoice IrtfomwUpw
Con�xry: Repon To: Aliert9dr: 2097579
dross copy
TV.
Company Nww;
REGULRTQRY AGENCY
Add w
- NPDES r GROUNDWATER i- DRINKLNG WATER
r- UST RC€3A f OTHER
EreailTce Purchase
e
Order No,
pa' Q-1.
a 'towRctaenc.:
Phme:
Far Props
Name:
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morat€Gn
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Site L
STATE;
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Analysis
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COLLECTED
Aresarvafives
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Water VVT
Wastewaxer viw
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SojVScid SL
SAMPLE ID Wipe, P
{A 2, 0.91;) Air AP
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Sample IOs MUST 0E U71rQUE 1&see TS
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SAMPLER h1AAle to SIGMATURE
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SIUNATURE.1 BAKKER: GATE SIRned
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•rrnpw—a Noce. By s g*9 via hum tou are accearna Pace's rdO 7a oar a t.Slh pw;,r h v ".rro.rae rsA peq .Nlw w wys. FALL-042DrevA7. 15-M43y-2007

NCDENR
Stormwater Discharge 4utfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit, http://portal.ncdenr.or_g/web/wq /ws/su/npdessw#tab-4
Permit No.: i/C/�/_/_//_/_/`/ or Certificate of Coverage No.:
Facility Name: 1 Je..sjpj•g ..Rp FP1a� ±# 3
County: w M _� Phone No. 91 q- 7 91— I ZQS
Inspector: AT T w
Date of Inspection: q)2q 11,7
Time of Inspection: 1 I:%o hVA _
Total Event Precipitation (inches): 1.4
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, I certify that this report is accurate and complete to the best of my knowledge:
(Signagre'of Permittee or Designee)
Page 1 of 2
r
SWU-242, Last modified 10/25/2012 j

1. Outfall Description:
Outfall No. 2 Structure (pi , ditc , e )
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: C I "'Ar
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): �3Q O�e
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 its
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
01 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:
23 4 5
7. Is there any foam in the stormwater discharge? Yes I o
8. Is there an oil sheen in the stormwater discharge? Yes info
9. Is there evidence of erosion or deposition at the outfall? Yes rjNN;p%
10. Other Obvious Indicators of Stormviater Pollution:
List and describe ^ 00 o
Note: Low clarity, high solids, and/or the presence of foam, oii sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SwU-242, Last modified 10/2S/2012 J

1. Outfall Description:
outfall No. t Structure (pipe, ditch etc.)
Deceiving 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:. CjweAr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): No&-ge
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
V 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:
6) 2 3 4 5
& 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:
6) 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes60)
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes 60)
10. Other Obvious Indicators of stormwater Pollution:
List and describe W-6_ _
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
maybe indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SIVU•242, last modified W/2.1/2012
ti

4'
RECEIVED
Ar
JtlN 0 1 20f7
i,;All CENTRAL, FILES
NCDENR OWR SECTION
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: httl2,//­12ortal.ncdenr.org/weblwg/wslsu/ni2dessw#tab-4
Permit No.: j�/�/_/_/_/_/_/_/_/ or Certificate of Coverage No.: bL/jQ/Wr/-Y/-,_/r/7/!�j
Facility Name: e # 3
County: WAlce Phone No. _ gla-181— I Z95
Inspector: J-A4 Wwrw NS
Date of Inspection: ti12411-7
Time of Inspection: [I:%a NFA
Total Event Precipitation (inches): 1.4
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, I certify that this report is accurate and complete to the best of my knowledge:
of Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 2, Structure (pip(, ditc , e ,)
Receiving Stream:
LY
Describe the industrial activities that occur within the outfall drainage area:
K-f&A4 )Yl44 A Cni^CVjk& `True ftnW
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: (I sear
3. Odor. Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): U 0 A2'e
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 fioating solids:
G) 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:
V 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes (if)
B. Is there an oil sheen in the stormwater discharge? Yes (9
9. is there evidence of erosion or deposition at the outfall? Yes E ivy
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
,"VU-242, Last modified 10/25/2012

{
1. Outfall Description:
Outfall No. 1 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: C 1-ear-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): NOti'e
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 1 is no solids and 5 is the surface covered with floating solids:
i) 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:
(9 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 9)
B. Is there an oil sheen in the stormwater discharge? Yes 0)
9. Is there evidence of erosion or deposition at the outfall? Yes ED
10. Other Obvious Indicators ofStormwater 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

STORMWATER DISC*GE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG20 0 4 9 8
FACILITY NAME Wise Recycling 1, LLC _
PERSON COLLECTING SAMPLE(S) Jim Frei fSwSG)
CERTIFIED LABORATORY(S) _Pace Analytical Lab # 12140
SwSG Lab # 5054
COUNTY JOHNSTON
PHONE NO. 9( 19) 5508008
Part A: Specific Monitoring Requirements
•
SAMPLES COLLECTED DURING
CALENDAR YEAR: 2017
(This monitoring report is due at the Division no
later than 30 days from the date the facility receives
the sampling results from the laboratory.)
Outfall
No.
Date
Sample .
Collected
mo/dd/ r
Total
Rainfall
inches
00530
00340
00556
00400
01119
01114
01094
Total Suspended
Solids
m l
Chemical Oxygen
Demand
mg/1
Oil & Grease
m /l
pH
S.U.
Copper
m /l
Lead
mg/1
Zinc
mg/1
Benchmark
-
-
100
120
15
6.0 — 9.0
0.010
0.075
0.126
001
05/05/17
0.89"
7.8
40.0
< 5.0
6.89
0.64
< 0.0050
0.15
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement -the Tier I or Tier 2 responses in the General Permit. �' �� �
Z Tntal recnverahle_
Only complete Part B if this facility uses more than 55 gallons of new motor ail per month.
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total
Flow
Oil and Grease
Total Suspended
Solids
pH
New Motor Oil
Usage
mm/ddl r
MG
mg/1
mg/1
units
al/month
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
JUN o I ul
p 1NR SECTION
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 those persons who manage the system, or those persons directly responsible for gathering
the informah n, the information ^mAjkFd is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
infoprratiQ,nki luding the possibi ' s and imprisonment for knowing violations.
of Permittee)
(Dat )
Form SWU-256
Page I of 1

• � � - � ...
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C�
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG14 0 v 1 (o
FACILITY NAME: .>,,t' �• F-C9
PERSON COLLECTING SAMPLES Q-"-" -
CERTIFIED LABORATORY At eLab # q
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: Z-b f . I'
SAMPLING PERIOD: ❑ July -December anuary-June
COUNTY
PHONE NO. { 0C1 c7 ) 7 53 L-
ADD TO LISTSERVE? []YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout []Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
PH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall 4
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-9
100 '
• r7y
RFCix
t
4, t 0
?. z-
? 3
s'�
?S
/J
CENTRAI
R 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 TS5 benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
' For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
vEj)c
2615
v
FILES c=::::i9
TION
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 year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)`
PH
(Standard
Units)
TPH using method
1564A 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?
(y/n)
# of Months
in Tier 2
a
Sampling
6-9
1S
100 '
-
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN ES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO M
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" & "No Dischame" reports) within 30 days of receipt of sample for at end of monitorine 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."
(Signature of Permittee)
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

aceAnalytical
www.pacalabs.ccm
Jay Watkins
Ready Mix Concrete
3610 Bush Street
Raleigh, NC 27609
Project: WESTGATE RD PLANT #3
Pace Project No.: 92254107
Sample: OUTFALL #1 PLANT #3
Parameters
Total Suspended Solids
Sample: OUTFALL #2 PLANT #3
Parameters
Total Suspended Solids
Sample: OUTFALL #2 PLANT #3
Parameters
Oil and Grease
Reviewed by:
Liamm Carrubba
Laboratory Report
Pace AnalyticaL Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 280%8
[phone]
Page 1 of 1
Report Date: 06/24/2015
Date Received: 06/11/2015
Lab ID:
92264107001 Collected:
06/10/15 16:10
Matrix: Water
Results
Units Report Limit
Analyzed
Qualifiers
73.0
mg/L 25.0
06115/1510:15
Lab ID:
92254107002 Collected:
06/10/15 16:00
Matrix; Water
Results
Units Report Limit
Analyzed
Qualifiers
58.5
mg/L 6.2
0611511510:16
Lab ID: 92264107003 Collected:
06/10/15 16:00
Matrix: Water
Results
Units Report Limit
Analyzed
Qualifiers
ND
mg1L 5.0
06/2411510:37
[e-mail]
Raleigh Certification IDS
6701 Conference Drive, Raleigh, NC 27607
North Carolina Wastewater Certification #: 67
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #; 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #; 12
South Carolina Certification #: 99006001
North Carolina Bioassay Certification #: 16
North Carolina Drinking Water Certification #: 37731
FloridalNELAP Certification #: E87627
Kentucky UST Certification #: 84
West Virginia Certification #: 357
VirginiaNELAP Certification #: 460221
Page 1 of 3

. acoAnarlcal�
rvwtiyRne•ra ..pan
Document Name: Sample Condition Upon
-Receipt SCUR
Document Revised: May 15, 2015
Page 1 of 2'
Document No.:
F-RAL-CS-001-rev.03
Issuing Autiloritios:,
Pace Raleigh Quality Office
` 'Page 2 of 2 Is for Intomal Use Only
Client Name:
�('
Coudor (Circle): Fed Ex UPS LISPS Ifent Commerclal Pace Other
Custody Seat on Cooierlbax present: (] yes no Seals intact: yes no
Packlnp Material: ❑ Bubble Wrap 6 o Bags UT None Other
Circle Thermometer Used: IR G N:122065387 pe of Ice. Wet Blue None 5amplos on ico, cooling procoss has bdgun
IR Gun 5 zo6*3r1
Temp Correction Factor: Add t C-)
La C
Dato and Initiate of par on a
amining
Corrected Cooler Tem p" C
Blologlcal Tissue Is Frozen: Yea No A
t r e ail
kc= r�
chock:
ti
Temp should be above freezing to WC
Comments:
Chain of Custody Present:
as ONO
❑NIA
1.
Chain OfCLlstody Filled Out;
os ONO
❑NIA
2.
Chain of Custody Relinquished:
ONo.
❑WA
3.
Sam ler Name & S€ nature on COC:
1EYes
Yes ONO
❑NIA
4.
Samples Arrived within Hold Time:
Yea ONo
11N1A
5.
Short Hold Tlmo Anal le c72hr :
Oyes 0.
❑N1A
&
Rush Turn Around Time Requested:
❑Yes XN.
❑NIA
7.
Sufficient Volume:
OYe3 ONO
❑NIA
S.
Correct Containers Used:
�es ONo
❑WA
U.
-Pace Cenialners Used:
Yos ONO
❑NIA
Containers Intact.
Vou ©No
❑NIA
10.
Fllterad volume received for Dissolved lasts
❑Ysa ONO
NIA
11.
Sample Labels match COC:
v ONO
❑wA
12.
-includes datell€mellDlAnal sls Matrix:
All containers needing praservatlon have been checkod.
Yoe ❑No
❑NIA
13.
All contetnem needing proservatlon are found to be In
s ©No
©NIA
compliance with E PA racommondatlon,
exceptlors: VOA, cowarrn, TOC. O&G, wl•DRO (water)
a ONO
Samples chocked for dechlorination:
Yes ❑No
❑NIA
14.
Head space in VOA Vials >6mm :
❑Yes ONO
2frVA
15.
Trip 81ank Present:
❑Yss ONO
2TIA 1
�IA
16,
Trip Blank Custody Seals Present
❑Yea ❑No
Pace Trip Blank Lot # If purchased):
I
.
Client Nogflcotlonl Resolution: Field Data Requfrod? Y 1 N
Person Contacted: DatelTime:
Comments( Resolution:
I
I
SCURF /SRF Date• L tl�t� Place labet here
Review::) �, 1`L 1�
OR
Note: Whenever there is a disuopancy affecting North Carolina compliance['q ®�
samptos, a copy of this farm will ba sent to the North Carolina DEHNR ® • 9Ze�S�g
Certiiicallon Office ( I.e out or held, Incorrect preservative, out of temp,
Incorrect conlalnera) - II B III 11111111
III III
92254107
'Page 2 of 3

Vical
...;aneAna
o
CHAIN -OF -CUSTODY I Anatytica'FRe "est,
Chain-Tfre l Custody is a LEGAL DOCUMENT. All ralcvard fieldS ffKzSZ be oompletad u=watety.
Co
0-
Section A SoctionB.
Required r-.A;em lmfop.ruucm RtWmd Project Information: I-fo."U56'r
-02782
�07�4 11tpm T- Aaen5om
Add robs: n
Copy
Company N&ne:
REGULATORY AGENCY
.,j C-
NPDES f GROUND WATER t DRINKING WATER
UST f— RCRA OTHER
I T%
Pwctm� Order No.:
P� ov-te
Re�
,7K
Ex---
F=
roject Namo,
I k-
Sh. Ltk.
eQLwm1&d Due DatefrAT,
*vt Number.
pmp- C
I
Requested
Analysis
Filtered
(YIN)
Section D NL-Mx Cods:
MA-MTX I cz:)O-
0OLLECTED
Presefvagves
Drlrldng W&w DW
Water ,-r
Wa I.WZEU yww
-a
Prod= p
SOWWA SL
al 01-
SAMPLE ID
0
%mce
(xz A.r AR
LLJ
0
uJ
<
Samwo 10s MUST BE UNIOVE TS
0
w
Or,or OT
0
0
a2
0
C)
z
Cy
DATE
TIME
DATE
TtME
z
z
M
Pace PriDject NoJ Lab I.D.
bro
12,
7
.10
12
AaDrrbONAL COMMENTS
RELINWSHED BY/ AFFiLLATM
DATE
-TIME
T.- -
SAPAPLE CONDMEms
ORIGINAL
SAMPLER NAME AND SIGNATURE
2
$ —
z
PMAT Marw of SAMPLER:0
o
Z
3
—
SIGNATURE of SAKWLER; -Z

1,!;ZcEAnal .1Cul
Document Name: Sample Condition Upon
Receipt (SCUR
Document Revised: March 13, 2013
-Page 1 of 2
Document No.:
F-RAL-CS 01-rev.01
Issuing Authorities:
Pace Asheville Quality Office
Client Name: t.�,�,��°�,
Where.`Received: [] Huntersville Asheville F], Eden [3-Ra€eigh
Courier(Circle): Fed Ex UPS LISPS Client Commercial Pace Other
Custody Seal on Cooler/Box Present: ❑. yes �o Seals intact: © yes _.E�'no
Picking Material: ❑ Bubble Wrap'ags � N Other
Circle Thermometer Used: IR Gun S�PType of Ice: Blue None Samp:as on Ice, cooling process has begun
IR Gun Back Up 71
Temp Correction Factor: Add I Subtract X7, -
Corrected Cooler Temp.- C
Temp should be above freezing to'6°C
Biological Tissue is Frozen: Yes No NIA Date and Init s 0fp0qojexamln1ng7
• contents:
Comments:
Chain of. Custody Present:
OYes ONO
QNIA
1.
Chain of Custody Filled Out:
J�lYes ❑No
ONIA
2.
Chain of Custody Relinquished:
27ea LJNo
❑NIA
3.
Sampler Name & Signature on COC:
BYes ONO
❑NIA
4.
Samples.Arrived within Hold Time:
6aY . ONO
❑NIA
5.
Short Hold Time Analysis (<72hr):
❑Yes ENO
ONIA
6.
Rush Turn.Around Time Requested:
❑Yas OHO
ONIA
7.
Sufficient Volume:
l?os ONO
❑NIA
8.
Corracf Containers Used: •
-Pace Containers Used:
0TOs ONO
2fes ONO
ONIA
ONIA
9,
.
Contalriers intact:
aWs ONO
ONIA
10.
Entered volume received for Dissolved tests
❑Yes ONO
L NIA
11,
Sample Labels match COC:
-includes dateltimellD/Analysis Matrix:
,12'6s ONO
❑NIA
12.
Alf cantainers needing preservation have been checked.
Ail containers needing preservation are found to be in
compliance with EPA recommendation.
exceptions: VOA, collform, TOG, C&G, MORO (water)
/C74es OHo
' des ONO
2vle—s ©No
ONIA
ONIA
13.
Initial when completed
Samples checked for dechlorination:
1�es ONO
ONIA
14.
Headspace in VOA Vials ( >6mm):
❑Yes ❑Na-9#IA
15.
Trip Blank -Present:
Trig Blank Custody Seals Present . -� _._._._
Pace Trip Blank Lot # if purchased :
❑Yes ONa
dre5 ©No
ONIA
❑ _.,...._
NIA
16,
...............__........__........_ . _._.._..___..._.__ .._._ ..;.__ .._-_---.-.-__._._
Client Notification/ Resolution: Field Data Required? Y 1 N
Person Contacted: Date/Time:
Comments/ Resolution:
SCURF Review: t1a=o: Wo# : 92173243
SRF Review:
Note: Whenever there Is a discrepancy Gng North Carolina compliance
samples,' a copy of this form will be s to the North Carolina DEHNR
Certification Office ( i.o out of hold, incorrect preservative, out of tamp, 92173243
incorrect containers) — —
Page 3 of 3

NCDENR
St®rmwater Discharge ®utfaii (SDO)
Qualitative Monitoring Report
For guidonce on filling out this form, pleose visit: itttal.ncdenr.orgf weh/wgJws/sundessGv#Cah 4
Permit No.: N/C/—/—/—/—/—/—/—/ or Certificate of Coverage No.: N/C/G/ 1/Y/a/o/ t/(>/
Facility Name: _j;. e�t�_f ��
County: 1,1,\tS - Phone No. _ j i `t - 7 X .2 - 1795-
Inspector: 9Pu r r_ L�--r-,tL-h
Date of Inspection:
Time of Inspection:
Total )event Precipitation (inches): : 25'
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." Ho)
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
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
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1of2
5WU-242, Last modified 10/25/2012

1. Outfail Description:
Outfall No. i Structure (pipe, 0
etc.)
Receiving Stream:
Describe the industrial activities th((�a�t occur within the outfall drainage area:
Z. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ T4 .1,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): N.,10
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2a 3 4. 5
S. li:ioating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 0 3 5
15. 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 (T 3 41 5
7. Is there any foam in the stormwater discharge? Yes Na
8. Is there an oil sheen in the stormwater discharge? Yes No
C. Is there evidence of erosion'or depositioe� at the outfall? Yes No
ifa. Other Obvious indicators of Stormviater 1Poilution:
List and describe 0 a >s e—
Note: Low clarity, high solids, and/or the presence of foam, oili 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

�,h
R® NR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance ors filling out this form, please visit. 11ttp=/ jpor_tal,ncdennorg/web/wrljws jsu/npdessw#tab-4
Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.:
Facility Name:------toc_ (Ly . 101,11- „ --;
County: "�L e- Phone No. co i
Inspector:�- L
Date of Inspection: o
Time of Inspection: Y11160
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 trust be per formed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain Up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
5WU-2 2, Last modified 10/25/2012

I. O utfall Description:
Outfall No. v2 Structure {pipe ditcl etc.}
Receiving Stream:
Describe the industrial ��al1ctivities that occur vithin the outfall drainage area:
(&Ii cL � ncLJ I /u<-1, S(�� -j'V
2, Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C f r .k r _
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): ,J� N c--
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:
(J 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
a. Is there an Sri! sheen in the stormwater discharge? Yes 6D
�. Is there evidence of erosirun or deposition at the outfall? Yes No
16. Other Obvious indicators of Stormwater ]Pollution:
List and describe N 0 0 -,?--
Note: Low clarity, !€nigh 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

NC®ENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For 9uidance on filling out this form, please visit: httna/nortal.ncdeor. we ws/su/npdessw#tab-4
Permit No.: )�/C/_/�/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/ % / y/ 0/ 9/ 7/%/
Facility Name: Na + 3 w5kaA#e M I
County: WAU Phone No. __ AI1-782-1-1g5,
Inspector: _ _ �y IrkATK1 W
Date of Inspection:
Time of Inspection:
q
:23
Total Event Precipitation (inches): 175 4 2014
Was this a "Representative Storm Event" or "Measureable Storm EV-�FfftM,80H' the permit?
(See information below.) pWR SECTIffl
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, I certify that this report is accurate and complete to the best of my knowledge:
(Sign/ur,,4/of Permittee or Designee)
Page 1 of 2
5wU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. �_ Structure (pip ditch)etc.)
Receiving Stream:
Describe the industrial activities that occur wit in the outfall drainage area: _
Qeaau IM,JCe4 , LI S ow
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: f (e-CA r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): ocAW
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:
1 (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 3 4 5
7. Is there any foam in the stormwater discharge? Yes
H. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes 60D
10. Other Obvious Indicators of Stormwater Pollution:
List and describe N100 f—
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

NC®ENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: httl2://portal.ncdenr.ol,g./web/wq../ws/su/­iii2dessw#tab-4
Permit No.:
Facility Name: h-at- 3 14y-e5 4t
or Certificate of Coverage No.: N/C/G/L/ Y/Q/Q/Z/ 6/
County: W 14Phone No. 91q -7Q ILI. 17g5�
Inspector: rikv WAnc-IL35
Date of Inspection:
Time of Inspection: I q " 2 0
Total Event Precipitation (inches): 415
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
'es ❑ 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 annroval from the local DWO Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignalAr"e 64)ermittee or Designee)
Pagel of2
SWU-242, Last modified 10/25/2012

I. Outfall Description:
Outfall No. Z-- Structure (pipe itch c.)
Receiving Stream:
Describe the i dustrial activities that occur within the outfall drainage area:
zfA % Wvod lAnt •p4--e n lah4- ! Sko-JO
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C [it4 i
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): 140A%&
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
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 (j> 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? YesV
9. Is there evidence of erosion or deposition at the outfall? Yes COD
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 1,.3 on ff
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

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG1.40000
CERTIFICATE OF COVERAGE NO. NCG14_.(� p Z�
FACILITY NAME: El Allf-
PERSON COLLECTING SAMPLES l NS
CERTIFIED LABORATORY PAC Lab # _ 11
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: Z. Iq
SAMPLING PERIOD: �uiy-December ❑ January -June
COUNTY _ IQAR
PHONE NO. ( q14 1 62
ADD TO 1_15T5ERVE? ❑YES []NO EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW ❑PNA []Trout ❑Other
Outfall No.
Date Sam pie
Collected
(mo/dd/yr OR
NO FLOW)1
PH
{Standard
Units)
TSS
(mg/0Monitoring?
Event
Duration
(minutes)
Total
Rainfall ,
(in)
In Tier 2
Monthly
n
(y/ )
# of Months in Tier
2 Samplingz
-
-
6-92
1oo",
-
-
Il Itb lsi
r5
q.6
D
Z
JQ61 IN
be
ti I Ii
5
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. Tler 2
Monthly sampling shalt be done until 3 consecutive samples are below the benchmark or within the benchmark range.
a TS5 benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
`For each sampled 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 year.
Outfall
No.
Date Sample
Collected
jmo/dd/yr)i
pH
(Standard
units)
TPH using method
1664ASGT--HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
New Motor Oil
usage
(gal/month)
In Tier 2
Monthly
Monitoring
(y/n)
�
# of Months
in Ter 2
z
Sampling
6-9
Is
100
-
-
-
-
II
z
J. 2b3Lz
o
TSAak
i
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO Cg
HAVE YOU CONTACTED THE REGION? YES []NO
REGIONAL OFFICE CONTACT NAME:
Mail driRinaf and one cony of this DMR fincludina all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitorine 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 thatthere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signatur f mittee) ': (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

•
aceAnalytical
www.pacelabaoom
Laboratory Report
Jay Watkins
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: Plant #3 Westgate Rd.
Pace Project No.: 92224895
Pace Analytical Services, Inc.
9800 KinceyAve, Suite 100
Huntersville, NC 28078
[phone]
Page 1 of 1
Report Date: 11/24/2014
Date Received: 11/10/2014
Sample: Outfall #1 1 Plant 3 Lab ID: 92224895001 Collected: 11/06/14 14:23 Matrix: Water
Parameters Results Units Report Limit Analyzed Qualifiers
Total Suspended Solids 4.6 mg/L 2.9 11/13/14 09:32
Sample: Outfall #21 Plant 3 Lab ID: 92224895002 Collected: 11/06/14 14:28 Matrix: Water
Parameters Results Units Report Limit Analyzed Qualifiers
Oil and Grease ND mg1L 5.0 11/13/14 07:32
Total Suspended Solids 4.7 mg1L 4.2 11/13/14 09:33
Reviewed by:
Laura J Cooper
[e-mail]
Raleigh Certification IDs
6701 Conference Drive, Raleigh, NC 27607
North Carolina Wastewater Certification #: 67
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
South Carolina Certification #: 99006001
North Carolina Bioassay Certification #: 16
North Carolina Drinking Water Certification #: 37731
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
West Virginia Certification #: 357
VirginiafVELAP Certification #: 460221
Page 1 of 3

Document Name: Sample Conditlon Upon Daument Revised: April D4, 2013
j ceAnaical, Recei t SCUR Page 1 oft
/ N,.w.nronp aeon, Document No.: Issuing Authoritles:
' F-RAC-CS-0014ev,02 Pace Asheville QuAl#y twice
Client Name;
Where Received; C1 Huntersviile 0 Asheville C7 den Raleigh-
Courier (Circle): • Fed Ex UPS LISPS Clkonl Commerclal Pace .Other
Custody Seai on CoaterlBox Present: D yes no Seaia Intact: yas El no
Packing Mntorlal: ❑ Bubble Wrap B Bags V None Other
Clrolo Thermometer Used; IR Quit S •122pe5367 a of toe: Wet Blue None J �] Samples on Ica, cooling process has begun
IR Gun Ba 22t185371
Temp Correctlon Factor: Add / ubtr
C
Date and lnitlata o porn examin ng
Corrected Cooler Temp.: e C
Blological Tiaeue Is Frozon: Yea No p
co tot 1 Preser alto
ohock:
Temp, should be above freezing to 0*0
Comments:,
ChdlnofCustody Present:
XYas ❑No ❑WA
1: -
Chain of Custody -Filled Out:
Yea ❑No
❑WA
2.
Chaln of Custody Relln ulahed:
Yw Elmo
MWA
3.
Sampler Name & Signature on COC:
Yee ON,
OwA
4.
Samples Arrived within Hold Time:
vryos ONO
❑NIA
5.
Short Hold Time Mal sis' <72hr :
OYea ;MNoi
❑WA
S.
Rush Turn Around Tlme t3o ueated:
❑Yer< .
©WA
7..
Sur4ctentvolumo:
MYos EINo
❑WA
8.
Correct Containers Used:
Xyeo ❑No
❑WA
8.
-Pace Containers Used:
eY.. ONO
❑NiA
Containers Intact:
Yes ❑No
©M
10.
Filtered vol ume•received for Dlasolved tests
Oyes ONO
P5VA
11.
Sample Labols match COC:
a Cho
❑WA
12.
Includes dateltimellUlAnal sts Matrix
All containers needing preservation have been chuckod.
Yoe ©Nn
❑WA
13.
All containers needing preservation are found to be In
yea ONo
©WA
compliance with EPA recommendation.
excW..lonr yOA, conform, TOC, 010. WI.ORO (water)
Yoe, ONO
Samples chocked for dochiodnatlon;
vas ❑No
❑WA
14.
Heads ace In VOA Via Is >6mm :
OYes ONo
PIMA
16•
Ttlp Blank Present:
Civai ONO
NJA
16,
Trip Blank Custody Seals Present
DYes ONO
A
Pace 7d 'Blank Lot # If purchased): .
Client Notification/ Resolution: Field Date Requlrod? Y I N
Person Contacted; DatefTime`
Comments/ Resolution:
SCURF ISRF ._ j Uato: °I rc •. EN®irY° : 92224895
Review::
Note: Whenever there Is a discrepancy affecting North Carolina oornptianco I IIII II III III III i samples, a copy of this form Wit Ira sent to the North Carollna p.HNR
CeMicalion•Offiice (Le out of bald, Incorrect preservative, out of temp, 92224895
Incorrect containers)
Page 2 of 3

CHAIN -OF -CUSTODY / Analytical Request Document M
The ciw ■mdy Is e LECAL D=WENT. An MIWM fines =Mt ee nompWW D=f;31W v
ZAnapiml'
NiWm4 iia. 3+ Jia! .
• •
s �
ht
_
- GRouNDwATER 1 GwATER
.rF OTMER
.at l _'.Jj
Vftiw ow
wr
SAMPLE ' •. .
Y
�
Air AR
J
SwnpIo93s&AUSTMLWME T=w Ts
•
cow OT
e
�����■■■■■■■■■■■.
Imo/■■■■■■■■■■■■
OEM,
91
©or
r
r
■■■■■■■■■■■■■
■�■■■■■■■■■■■
.
e
■■■■■■■■�■■■■■■■■■■■
■■■■■■■■■■■■■
. � �i.irair��■I
«--...... u.... n­— �­...--- — — 1.1—..—-.�-•. � -- r , c --- — ...,........:_ �— r-&l 1 1'L (r.'C .+ M 7 P-kC -71)n7

A �
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://portal.ncdenr. we wn/ws/suJnndessw#tab-4
Permit No.: N/C/ _/^/_/_/_/—/—/ or Certificate of Coverage No.: N/C/G/ I / y/ O/ 4/ 7/%/
Facility Name: Plant e1444%e fd I
County: WKYK Phone No. lg-71g2-rig5,
Inspector: ry W ATK1 W 4
Date of Inspection: l bb 1 1'
Time of Inspection: �14; Z 3
Total Event Precipitation (inches): 015
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 DWO Reeional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SigiyfuWof Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. �_ Structure (pipe ditch etc.)
Receiving Stream:
Describe the industrial activities that occur wit in the outfall drainage area:
Qf-oAu w,;,nod (rncv-ems aP1a.4- I5�o,A
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: [ ko r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc,): T y)c-)y1,-e
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
D 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 0 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1kA3 4 5
7. Is there any foam in the stormwater discharge? Yes 'V
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the Outfall? Yes Lo
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
r
sWU-242, last modified 10/25/2012

NCDENR
Stormwater Discharge OutfaIl (SDO)
Qualitative Monitoring Report
Forguidance on filling outthisform, please visit: littp;.//portal.ncdcnr,org.lVeb./Wq./ws/su/npdessw#tab-4
Permit No.:
Facility Name: elAni- 3 14--es
County: �
Inspector: Tkq WATjqL35
Date of Inspection:
Time of Inspection: 04, 20
or Certificate of Coverage No.:
Total Event Precipitation (inches): i T5
Phone No.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
les ❑ No
Please verify whether qualitative Monitoring must be performed during a "representative storm
event" or "rneasureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to he
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
j 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 permi ttee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains aDDroval from the local DWO Rer?ional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
ermittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 2- Structure [pipe, itch)Lc.)
Receiving Stream:
Describe the i dustrial 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.): .Q
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:
1 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 0) 3 4 5
7. Is there any foam in the stormwater discharge? Yes 6)
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes CO)
10. Other Obvious Indicators of Stormwater Pollution;
List and describe Iv on ce
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

STORMWATER DISCHARGE OUTFALL (SDO) - Semi-AoouM MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_0 p Z(Q
FACILITY NAME: Ql a++ 3 If #-4cot6"o
PERSON COLLECTING SAMPLES �i tv5
CERTIFIED LABORATORY QGl _ Lab # 1 I
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: Zo I q
SAMPLING PERIOD: July -December ❑ January -June
COUNTY KIA 4
PHONE NO. ( 4 ) '7 6 2 — I "7
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ❑Other,
OutfaEl No.
Outfall No.]
Date Sample
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units}
TSS
(mg/L)
Event
Duration
(minutes}
iota!
4
Rainfall
{in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling�
-
-
6-92
10Di',
-
-
(1 Db
Iq
6,s
4-6
Z&O
M 5
7-
IN
b-Z
4,1
2- 6 a
►� 5
N
' 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
Micnthly 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, HC[W, 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.
Permit Date: 7/1/2011-60/3D/2015 I Last Revised 7/13/11
Page 1 of 2

Part B; Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No,
Date Sample
Collected
(mo/dd/yr)'
PH
{Standard
Units)
TPH using method
1664A 5GT-HEM
(mgJE)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
2
Sampling
6-9
15 2
100 ,
-
-
II
,Z
z Irp c
7Sob
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 coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for 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 tha there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
/2/1//yi
(Signatur,f P mittee) ! (Date)
Permit Date: 7/1/2011-60/30J2015 Last Revised 7/13/11
Page 2 of 2

Analytical
www.pacelabs.com
Jay Watkins
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: Plant #3 Westgate Rd,
Pace Project No.: 92224895
Sample: Outfall #1 / Plant 3
Parameters
Total Suspended Solids
Sample: Outfall #2 1 Plant 3
Parameters
Oil and Grease
Total Suspended Solids
Laboratory Report
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 2807B
[phone]
Page 1 of 1
Report Date: 11/24/2014
Date Received: 11/10/2014
Lab ID: 92224895001 Collected: 11/06/14 14:23 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
4.6 mg1L 2.9 11/13/14 09:32
Lab ID: 92224895002 Collected: 11/06/14 14:28 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
ND mg1L 5.0 11/1311407:32
4.7 mglL 4.2 11/13/1409:33
Reviewed by: '_1,2`" �= z;1,.�..
Laura J Cooper
[e-mail]
Raleigh Certificatfon IDS
6701 Conference Drive, Raleigh, NC 27607
North Carolina Wastewater Certification #: 67
Charlotte Certification IDS
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
South Carolina Certification #: 99006001
North Carolina Bioassay Certification #: 16
North Carolina Drinking Water Certification #: 37731
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
West Virginia Certification #: 357
VirginiaNELAP Certification #: 460221
Page 1 of 3

Document Name; Sample Condition Upon Document Revlsed: April 04, 2013
P1 °Analytical + Rece1 t (SCUR) Page 1 of 2
1 Document No.: Issuing Authoritles;
' 1=-RAL-CS-001,rev.02 Pace Asheville Quality Office
Client Name:
Where Received: 0 Huntersvllle [] Asheville dery Raleigh
Courier (Circle): Fed Ex UPS LISPS GlienE Commerolal Pace . Other
Custody Seal on Cooler/Box Present: 0 yes no Seals Intact: 7f yos 0 no
Packing Material- 0 Bubble Wrap B Bags [� None Other
Circle Tharrnometer Used; IR Gun S 122iJt353t17 a of Ice: Wet Blue None Samples on Ice, cooling process has begun
Il't Gun Ba : 22065371
Temp Correction Factor: Add 1 ubtr C Data and initial, of pens examining
Corrected Cooler Temp.: r C .Blotagical 118sue le Frozen: Yee NoCA, co !a t 1 Prase ett
,hack:
Temp should be above freezing to 6tC Comments:.
Chdln of Custody Present:
0YG8 ONO ❑WA
1..
Chain of Custody -Filled Out:
Yes ONO ONIA
2. '
Chain of Custody Relln ulshed:
vOe ONo Qr4IA
3.
Samoler Name & Sianature on COC:
ZY. ONO DwA
4.
Sam as Arrlvod withln Hold Time:
a: ONO
❑NIA
5.
Short Hold Time Anal als(C72hr :
©Yes ONO
❑NIA
8.
Rush Turn Around Time Requested-,
❑Yes
OwA
7.
Sufficient Volumo;
Yes ONO
DWA
8.
Correbt Containers Used:
-Pace Contalners Used:
Yes ONO
e6 ONO
❑NIA
©NIA
9. '
Contalners Intact:
Yes ONO
OwA
10.
Filtered volume•recoivod for Dissolved tests
QYes Onto
MA
11.
Sample t-abols match dOC:
-Includes dateltlme/lO/AnalvsIS Matrl)c
es ©No
OWA
12.
All containers nseaing preservation have been checked.
_
Yes ONO
❑N1A
13.
All contalnere needing preservation are found to be In
Yea ONO
❑NIA
compile nco wish EPA recommandabon.
KY1,;
exeepitons: VOA, conform, TOC, c&G, Wt-gRO (water
ONO
Samples chocked for dechlorinatlon,
16Y. ❑No
❑MA
14,
Heads oco in VOA Vials >6mm :
❑Yes ❑NO
NIA
16.
Trlp B1ank'Present:
QYe9 ONO
NIA
VNIA
16.
Trip Blank Custody Seats Present
C1Yee ONO
Client Notification/ Resolution: Field Data Required? Y / N
Person Contactedr DateTitme:
Commenisl Resolutlon,
SCURF 1SRF hate:
tfl
Review:.
Note: whenever there Is a discrepancy affecting North Carolina compliance
samples, a oopy of this form wtll be sent to the North Carolina OEHNR
Certification -Office( I,e out of hold, Incorrect preservative, out of temp,
Incorrect containers)
WO#:92224895
92224895
Page 2of3

.aceArraiytica�'
CHAIN -OF -CUSTODY I Analytical Request Document
The cnah-d-Cumcdy is e LEGA I oocue oNr. m ri..t —a b- —pjaw —,Ay.
1
-.'
..
GROUNDWATERmmaNrwATER
UST r -m
_.�
' -
•Mr
-
I®■■�■■�■■■■■■
•
SAMPLE ID Ce OL
Ar AR
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NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: bttn://purtal.nc enr.org/web/wq/ws/su/nndessw#tab-4#tab-4
Permit No.: N/C/_/�/�/,/,/_/_/ or Certificate of Coverage No.: N/C/G/1/4/ O/
Facility Name: p l nn4- 5 3 µi 1191hor"y'
County: 0 Vna,e Phone No. — I 32 —
Inspector: .Tdwl
Date of Inspection: 116hl14
Time of Inspection: '
Total Event Precipitation (inches): l SD
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[?Kes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signa*e ofpermittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. I Structure pi ditch, etc.)
Receiving Stream:
Describe the i ustrial activitithat occur within the outfall drainage area:
��w �Vi;x�e LanGrele P1401-
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Che G1-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): w6u -a
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 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:
U 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes V�
B. Is there an oil sheen in the stormwater discharge? Yeso
4. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators ofStormwater 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

STORMWATER DISCHARGE OUTFAti (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_Q Z_5 _0
FACILITY NAME: _ _ Q! pYllk- 53 q : l3 baeo t,E_ q %
PERSON COLLECTING SAMPLES ZiiY WIA-rKM
CERTIFIED LABORATORY_ %90LCV Lab t#
Lab #
OPTIONAL INFO:
Part A. Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: _ Z.GI!
SAMPLING PERIOD: Eel�uly-December ❑January -June
COUNTY 0 Ab4pot
PHONE NO. (!g ft) 3Z ' i 5 10 1
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Dutfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
PH
{Standard
Units)
TSS
(Mg/0Monitoring?
Event
Duration
(minutes)
Total
Rainfall 4
(in)
In Tier 2
Monthly
(YIn)
# of Months in Tien
2 Samplingz
-
6-9z
100"
-
-
I
tlobl
ISO
b
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.
z If a value is In excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
`For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
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 gat of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)i
PH
{Standard
Units)
TPH using method
1664A SGT--HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
'(gal/month)
In Fier 2
Monthly
Monitoring?
(y/n)
s# of Months
in Tier 2
2
Sampling
6-9
15
290
-
-
-
-
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:
Mai! Orieinal and one cores of this DMR fincluding all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitorine 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."
(Signature of r eel (Date)
Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

aceAnalytical
www.pacelabs.cam
Jay Watkins
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: Plant #53 Hillsborough
Pace Project No.: 92224894
Sample: Outfall #1 1 Plant #53
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: 11/14/2014
Date Received: 11/10/2014
Lab ID: 92224894001 Collected: 11/06/14 16:02 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
5.1 mg/L 4.5 11/13/14 09:32
Reviewed by: " " C' WF1 —
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 1 of 3

w
AV
Document Name; Sample Condition Upon
Document Revised: April 04, 2013
��Pc7CBf{nafytiCal
Recel t (SCUR)
Page 1'of 2.
Document No.:
Issuing Authorities:
w.wv.pnawpa: ea,n
'
F- L-CS-001,rev.02'
race Asheville Quality Office
Client Name: Y t
ACc
Where Rocelved: ❑ HuntersyMe [] Asheville
Q den
]
Raleigh
Courlor (Circle): , Fed Ex 'UPS USPS Cile
Commercial
Pace .
Other
Custody 5oal on CoolarlSox Present: 0 yes no
Seals Intact:
0 yes
❑ no
Packing Material: 0 Bubble Wrap B Bags Id No Outer
ClrcIoThormomotorUsod;IR'3unE
[] Samples on Ica, cooling process has begun
None
IR OumBa M095371
Temp Correction Factor: Add f S61ac
C
`
pars
Date and Initials of on examining.
Corrocted Cooler Temp.: 1 - C
Biological Tissue Is Frozen: Yes No IA
pro cruet
—Chou t
temp should be atwvo finezing to V40
Comments:
Chain of Custody Present:
Yea ON.
OWA
1;'
Chain of Custod Filled Out:
Yes Elko'
❑WA
2. '
Chain of Custody Relin ulshod:
j&es ONO
ONIA
3.
Sampler Name & Si nature on COC:
Yes ❑No
❑WA
4.
Sam les Anlved within Hold Time:
Yos ONO
OWA
5..
Short Hold Time Anal sls' <72hr :
ClYes 6❑NJA
B.
Rush Turn Around Time Requested:
❑Yes IANG
❑NIA
7.
Sufficient Volume:
Yes ❑No•
❑NIA
8.
Correct Containers Used:
as ONO
❑NIA
9.
-Pace Containers Used:
Wyss ONO
OWA
Contairiars Intact:
6Yes ONO
OWA
16.
Filtered volume•recelved for Dlssoived tests
ayes ONo
AWA
11.
Sample Labels match COG:
Yea QRo
ON1A
12.
-Includes dalelftellD/Anal sts Matrix:
All containers needing'preeemation have been checked.
res ONO
OWA
13.
All containers needing piesarvat€on are found to be In
�jYes [a110
i_iN1A
compliance with EPA recommondatlon.
exceptions: V0A. Conform, TOC, Bali. M-DR0 Yratsr
41S ONO
Samples checked for dechlodnatlon:
6Yas IJNo
OWA
14.
Headspaco In VOA Vials nmm :
❑vas ONO
XNIA
16.
Trip Blank Present:
©Yee ©No
'NIA
16,
Trip Blank Custody Seals Present
❑Yes ONO
WA
Pace Trip Blank Lot I! urchssed :.
Client Notification/ Resolution: Field Wte'RegWred7 Y I N
Person Contacted; _ I?atelTlme:
Commanlsl Resolution:
SCURF•/$RF Date: 1� I W0# : 92224894
Review:: Y
Note: Whenever there s a discrepancy affecting North Carolina compliance
samplos,,a Copy of this form will bo sent to the North Carolina DEHNR 92224894
Certification Office (I,o out of hold, incorrect preservative, out of temp.
Inaormot oontalnem)
Page 2 of 3

M
CHAIN -OF -CUSTODY 1 Analytical Request. Document
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Ayp'A�
NCDENiR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onfilling out thisform,please visit. bttRf/12ortal.ncdenr.orglweb/wq/ws/su/npdessw-#talz4
Permit No.: N/C/_/_/T/_/_/_/_/ or Certificate of Coverage No.: N/C/G/l/�L/ pl 7-
Facility Name: p la,n+ 53 t�; It9i�erouain
County: OIZAAAIP Phone No. AICj - '132 --2 5 m !
Inspector: _ Tbu LtiuLt►.a`�
Date of Inspection: 1166,114
Time of Inspection: q; �12
Total Event Precipitation (inches): l 50
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
�es ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
even t"or "measureable storm event" (requiremen ts vary, depending on the permit),
j Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
i some permits do not have this 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
jpermitted 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
I obtains approval from the local DWQ Regional Office. i
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignaWe ogermittee or Designee)
Page 1 of 2
SWU-242, Last modiSed 10/25/2012

1. Outfall Description:
Outfall No. �� Structure pip ditch, etc.)
Receiving Stream:
Describe the i ustrial activitie 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: "ham Gr _.._
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Ig 6U a _
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:
1� 2 3 4 S
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
U 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes (1
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe —Whvl�e_
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

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_0 jj
FACILITY NAME: Q AV -A- 53 1. iJ g 6araue, L+
PERSON COLLECTING SAMPLES A iA114-M&O
CERTIFIED LABORATORY fP&L Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLING PERIOD: 1 July -December ❑ January -June
COUNTY O RAN
PHONE r 43Z 75,01
ADD TO LISTSERVE? []YES []NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
{Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes]
Total
Rainfall"
(in)
Wrier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling?
-
-
6-92
1002'3
-
-
,1
SO
d
i
' 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, HOW, Trout, and PNA waters where they are So mg/I.
"Far 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 1 Last Revised 7/13/11
Page 1 of 2

Part 8: Vehicle Maintenance Activitv iMonitorine Reauirements for facilities using a 55 gat of new motor oil/month — averaged over a calendar year.
0utfa11
No.
Date Sample
Collected
(mo/dd/yr);
pH
(Standard
units)
TPH using method
1664A 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?
(y/n)
# of Months
in Tier 2
x
Sampling
6-9
15
100 '
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 copy of this DMR (including all "No Flow" & "No Discharge" resorts) within 30 days of receipt of sample for 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 CERTIFJCATION 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_ eased 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."
�xIly
(Signature of r ee (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

" PaceAnalytical
wrwvpacelabs.com
r
r
Laboratory Report
Jay Watkins
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: Plant #53 Hillsborough
Pace Project No.: 92224894
Pace Analytical Services, Inc.
98CD Kincey Ave. Suite 10D
Huntersville, NC 28078
[phone]
Page 1 of 1
Report Date: 11/14/2014
Date Received: 11/10/2014
Sample: Outfall #1 1 Plant #53 LAID: 92224894001 Collected: 11/06/14 16:02 Matrix: Water
Parameters Results Units Report Limit Analyzed Qualifiers
Total Suspended Solids 5.1 mg/L 4.5 11113/14 09:32
n
Reviewed by;
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 1 of 3

r
Document Name: Sample Condition Upon
Doautnent Revised: April 04, 2013
I AcEAnaoical,
Receipt (SCUR)
Page 1 oft
Document No.:
Issuing Authorities:
F- f-CS-001,rev.02
race Asheville Quali 09108
Client Name; . EgELAI_ILLi
Where Received: Huntersville
C] Asheville
[] den
Raleigh
Courior(Circle): - Fed Ex 'UPS LISPS
Commercial Pace
,Other
Cuslody5oal on Cooler/Box Present:
yes Pno
Seals intact; 4 yes
El no
Packing Material; ❑ Bubble Wrap B Begs 4 None Olher
Circle Thermometer Used: IR Gun : 22065387T a of Ice: et Blue Nona
❑ Samples on Ice, cooling process has begun
IR Gun B
2085311
Temp Correction Factor: Add I S ac
Corrected CoolorTemp.: t -
OAR C
C Biological Tissue is Frozen: Yes No
pate and Inli leis o1 person examining
IA choo f Pre rust i
'ramp should be above freezing to VC
Comments:
Chain of Custody Present:
Yea ❑No
❑NIA
1.
Chain ofCustodyfifledOut:
Yes ONO
❑WA
2.
Chain of Custody Relinquished:
36yes LINO
❑NIA
3.
Sampler Name & Signature on COC:
Yes ONo
❑NIA
4.
Sampiles AMved within Hold Tlme:
6Ye3 ONO
❑WA
S. -
ShortHoldTimeAnal sis' <72hr :
LOYsa t/
❑WA
6.
Rush Turn Around Time Requested:
❑Yea I&D
©WA
7.
Sufficient Volume;
Yes ONO
❑NIA
8,
Correct Containers Used,
Yes ONO
❑NIA
9.
-Pace Containers Used:
Yet DNO
❑WA
Contalrtars Intact:
Yes ❑No
©WA
10,
Filtered voluma•recelved for Dissolved tests
❑Yea ON,,
41WA
11.
Sample Labels match COG:
Vy,. ON,
❑NIA
112.
-Includes date/tlmellD/Analysis Matrix:
All conlelners neoding'preservatlon have been checked, �Be ❑No OWA 13,
All containers needing preservation are found to be In (�jYes ❑No ❑NIA
compliance with EPA recommendation.
exocptione: YCA Conform, TOC, O&G, VA -SRO vralar} VY0.5 L}No
Samples checked for dechlortnation: 6Yes ❑No ❑NIA 14.
Headspaco In VOA Vials >8mm : ❑Yea ❑No XNIA 1S.
Trlp Blank Present: ❑Yes ❑No 'WA 16,
Trip Blank Custody Seals Present ❑vas ❑No �SWA
Pace Trip Blank Lot If purchased), •
Client Notification/ Resolution: held Date Required? Y 1 N
Person Contacted:. DatofTlmo:
Comments! Resolution:
SCURF•ISRF ._ Date: ='
Review:: r r r2 IY
Noto: Whenever there s a discrepancy affecting North Carolina complianco
samplos, a copy of this form will be sent to iho North Carolina DEHNR
Certification Offlea ( I.e out of hold, incorrect preservative, oul of temp,
incorrect containers)
wott:szzzassa
11111111111101111
Page 2 of 3

r7
: �aceAnalytrcal'
....hs..
CHAIN -OF -CUSTODY 1 Analytical Request Document
Tne Chain -&-Custody is a LEGA1 DOCUMENT. All relavartt fields M= be Mmpletnd nwxzlely.
a
r7
In
Page: of
Se,caon A Section B SeetE G
RequkW Client h4miordorr Rrquirad Projed Inrormatom t ,
Comae Ra pat To: ,°n
17 4 5 3 5 E
Addressf
Copy To:
omp" Name.
R>=GUiATQRY ASaF CY -
NPOES GROUNDWATER DRINKING WATER
;" UST i RCRA j`- OTHER
Ema7To, /)I A
Q IC
Pun:hm Order No:
1 r� Fax
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?w�cl
sheL�c tion
STATE
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red
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yeis
FiKared
07
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SaWun D Matrix C7o
a
R&WIM0 CHora +s+accew. c
COLLECTED
Preseroat�ves
T
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Drinkingwater Dw
v
o
Water WT
Waste Water Y w
p
coupowk
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Product P
SAW
rJup e�
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SAMPLECONDmONS
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:r►�r .®.. RECEIVED
E®
MCDEHR
Sto rmwater Discharge Outf'a➢➢ (00) APR 01 2014
Qualitative Monitoring Report CENTRAL FIDES
Dwa18oc
Forguidancc 0n filling Outthisforrn, Please visit, Illr�_./�ri r' tJ.f 'rl4rill,Ti_il'�!�, _iqj).,
Permit No.: IV/C/_/_/_/_/�/�/�/ or Certificate of Coverage No.:
Facility Name: P1a„ k Ga�s R2 _
County: Wok, - Phone No. 9 19 - 7?,-1195
Inspector: ,Mp-CAPps
Date of Inspection: -J i-r (iL4
Time of Inspection: 9:2o A•k
Total Event Precipitation (inches): 2S
Was ibis a "Representative Storrrr Event" or "Measr11-ea131e Storm Event" as defined by the permit?
(See information below.)
21"Y es ❑ No
Please verify r•vhether Qualitative Monitoring must be perfbrnled during a "representative storm
event" or "meosurcuvle storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most. permits require qualitative monitoring to be
performed during a "representndvo storm event" or duringa. "measureabie storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicablc.
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 fours (3 clays) in which no storm event measuring greater than
0.1 inches bas 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 discliarge from the
permitted site outfall. The preirious measurable storm event must have been at least 72 bours
prior. The 72-horn- storm interval does not apply if the perrnittee is able to document that a shorter
interval is representative for local storm events during Lhe sampling period, and the perrnittee
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 Perlrlittee nr Designee)
Page 1 of 2
SWU-242, Last alodified10/25/2012

A. Outffall Description:
Outfall No. _ 1 Structure Cpipe ditch tc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color; Describe the color of the discharge using basic colors Cred, 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.): nLA-
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:
1 <D 3 4 5
65 ,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 C. 3 4 5
7. is there any foam in the stormwater discharge? Yes
S. Is there an oil sheen in the stormwater discharge? Yes V
9. Is there evidence of erosion or deposition at the outfall? Yes do
10. Other Obvious indicators of Stormwater Pollution:
List and describe N—
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 farther investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

Afflj!'
.�..
NCDENR
Stormwater Discharge ®utfall (SD®)
Qualitative Monitoring Report
Torguidanceonfillingout thisform,please visit: httL/iport.1_t�rcl �ii.��r� till,/�vc +�fsai E�i�clti�s�ti#t:.�l,-j
Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.:
Facility Name: PI. -A A 1.1"i rn,t R2
County: In)ak-. phone No.
Inspector: f"Q upp_5 _
Date of Inspection: -11I i-7 (1'4
Time of Inspection: 4: 2CAY►-
Total Event Precipitation (inches): , 2;�
Was this a "Representative Storm Event" or "Meastiteable Storm Event" as defined by the permit?
(See information below.)
21�Y es ❑ N o
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event." or "measureable storm evert" (requirements vad/, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable, i
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the 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
5WU-242. Last modified 10/25/2012

1. Outfall Description:
Outfall No. �L Structure (pipe ditch tc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
f2� rw xe _ Coo,"- EL-4 161&�p
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc,) and tint
[light, medium, dark) as descriptors: C{�
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): O°jx-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
Q 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 N 3 4 5
G. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 0 3 4 5
7. Is there any foam in the stormwater discharge? Yes
B. is there an oil sheen in the stormwater discharge? Yes ly-o'
9. is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe �JG4'--
dote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5WU-242, Last modified 10/25/2012

STORMWATER DISCHARGE OUTEALL (S®®) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 D 0 2 (g
FACILITY NAME: Plano '� We,7F An>k e-)
PERSON COLLECTING SAMPLES . >fi'liltwQCJ�
CERTIFIED LABORATORY Lab
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 014.
SAMPLING PERIOD: ❑ July -December January -June
COUNTY Wal4
PHONE NO. (919 ) 7,VA— 174<
ADD TO LISTSERVE? RYES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
❑PNA ❑Trout [—]Other
Outfall No.
Date Sample
Collected
(mo/dd/yrOR
NO FLOW)'
(Standard
(Standard
Units}
TSS
(mg/L)
Event
Duration
{minutes}
Total
Rainfall
(in}
In Tier 2
Monthly
Monitoring?
n
(Y/ }
# of Months in Tier
2Sampling7
-
-
6-92
1002,3
-
-
-
-
r
F If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/L
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 13: 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
1654A SGT HEM
(mg/L)
Total Suspended
Solids
{mg/L}
Event
Duration
(minutes)
Total
Rainfallv
(in)
New Motor Oil
Usage
(gal/month)
Month) in Tier Z
y
Monitoring?
(y/n)
# of Months
in Tier 2
z
Sampling
6-92
152
1002,3
-
-
a
I7
7 `I
a�M
SyU
2'
Poo 41J
1J
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO 0
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow' & "No Discharge" reports) within 30 days of 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."
of Permittee}
9/1-7LLq
(Date)
Permit Date:7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

aceAnalytr'cal
www.pacetabs.com
MD Capps
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: PLANTS #3
Pace Project No.: 92193588
Sample: OUTFALL 1
Parameters
Tctal Suspended Solids
Laboratory Report
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, INC 28078
[phone]
Page 1 of 1
Report Date: 03/25/2014
Date Received: 03/18/2014
Lab ID: 92193588001 Collected: 03/17/14 09:21 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
22.6 ri 2.7 03/22/14 11:37
Sample: OUTFALL 2 Lab ID: 92193588002 Collected: 03/17/14 09:26 Matrix: Water
Parameters Results Units Report Limit Analyzed Qualifiers
Gil and Grease ND mg/L 5.0 03/20/14 08:38
Total Suspended Solids 28.0 mg/L 3.1 03/22/14 11:37
Reviewed by:
Nikitia Jones -Jackson
[e-mail]
Charlotte Certification IDs
9800 Kincey Ave. Sie 100, Huntersville, INC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certifcation #: 12
South Carolina Certification #: 99006001
Asheville Certification IDs
2225 Riverside Dr., Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
West Virginia Certification #: 357
VirginiaNELAP Certification #: 460221
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 990300D1
West Virginia Certification #: 356
VirginiaNELAP Certification #: 460222
Page 1 of 3

Report Results to:
Ready Mixed Concrete
P.O.Box 27326
Raleigh, NC 27611
Nib rcipp---�
ATTN: I A h n Wi4sen
Phone: [phone]S20
Kcal Chain of Custody
Bill Results to:
Ready Mixed Concrete
P.O.Box 27326
Raleigh, NC 27611
ATTN:
1T.
�Ldw
J .
9z
[2 Standard Report Delivery
E] Rush Report Delivery (wl surcharge)
Requested Due Date:
Project Reference: Plants #3
Purchase order #:
Sampled By: "I)
R
WINE
wg
$NAM
-il --M. i,-- �
-J
T
M=x
DW�S
-WIR
.ft!
W. e�gj
:H VE
. =
Outfall 1
G
3/17/ty
Sw
TSS
9, -2
4- s:5 J3 o)'I 3 csrA�, .
Relinquished by (signature)
R e-
ed by
! n at re
Da a
Time
For Lab Use Only
Temperature at receipt:
Temp: C. —J
Relinquished 6Asignature)
ED
Received by (signature)
Dale
Time
RelidPished by (signature)
Received by (signature)
Date
Time
r

Document Name: Sample Condition Upon Document Revised_ : April 04, 20'13
. ;���aceArialytrca!"
Recei t SCUR Page 1 of 2
l Document No,: Issuing Authorities:
F L•-CS- 01-rev,02 Pace Asheville Quality Office
Client Name: VYW�(
Where Received: Huntersville (] As Eden Raleigh
Courier (Circlo): Fed'Px UPS LISPS Client Commercial. Pace Other
Custody Seal on Cooler laox Present: yes no Seals intact: A yes Q no
Packing Material: 0 Bubble Wra�N:�1;2�720
CCi4gsNo OtherCircle Thermometer Used: IR Gu7Type of Ice: Wet Blue None Samples on ice, coaling process tras begunIR Gun B;skttp
Temp Correction Factor: Addd]l � btra - t
Corrected Cooler Temp.: G< < C
Temp should be above freezing to 61C
r C
Biological Tissue is Frozen: Yes !la NrA
Comments:
15ate and Initials of person examining
co Pr o
check.
Chain'of Custody Present:
es -ONO
❑NIA
1:- ..__.. _.. ..........:. _
.. ; ... : .
Chain of Custody -Filled Out:
Yes ONO
❑wA
2,.
Chain. of Custody Relinquished:
Yes ON-
❑NIA
3.
Sam ler Name.& Signature on COC:
RfY03 ON.
©NIA
4.
Saul !es Arrived within Hold Time:
Yea ❑No
❑NJA
5.
Short Hold Time'Anai sis (<72hr):
❑yes No
❑N!A
6•
Rush Turn Around Time Requested:
❑yes No
❑N1A
7,
SufflCientVolUmQ:
VYar ONO
❑N!A
8.
Correci Containers Used:
-face Containers used:
i I- ONO
Yes ` ONO
©NIA
❑NiA
9. "
Containers lntact7
es C No
❑NIA
10,
Filtered volume -received for Dissolved tests
(~lees ONO
ZfNIA
11,
Sample Labels match GOO:
-Includes datel me/lDlAnalysis Matrix:_
UlYB�NO
❑xlA
12.
Al; containers needing preservation have been checked.
All containers needing preservation are found to be In
compliance with EPA recommendation.
woaptlons. VOA coliform, TOC, o&G, Wi-DRO (water)
lAas. ©No
Yes ONO
Yes ❑No
❑NIA
❑N/A
13.
Samples checked for dechlorination:
2LGs ❑No
C JNrA
14.
Heads alce in VOA Vials >6mm :
Oyes. 6No
NIA
16,
Trip Blank Present:
Trip Blank Custody Seals Present .
Pace Trip Blank Lot# if purchased):
©yea ❑No
Oyes LINO
NIA
NIA
16,
Client Notification] Resolution: Field Data Required? Y 1 N
Person Contacted..DatelTime:
Commenist Resolution:
SCURFt {
Review:: "�
Note: Whenever there is a discrepancy affecting North Gerolma compliance
samples, a copy of this form will be sent to the North Carolina DEHNR
Certification -Office { !,e out of hold, incorrect preservative, out of temp,
incorrect containers)
3of3