NCG140111_MONITORING INFO_20181211

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO,
l v U& f y u� I. 1
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ a 1
YYYYM M DD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year. 1 9
`Report ALL STORMWATER monitoring data on this form (include "No Flopri-' harge" and Benchmark
Exceedances) from the previous calendar year to the f Q.b�,�rARCN,Jkgf each year.
Certificate of Coverage No. NCG 14 L.J ULCU
Facility Nane:G6S
<rrCounty:
Phone Number: („tS �2IIIIJ.ZZ Total no. of SDOs monitored
Certified LaboratoryCaY, Wit.-�ihr.v TiL Lab # 11�
Lab #
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑ No ®`-
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No&
Was this outfall ever in Tier 2 during the past year? Yes ❑ No4�Q'
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total F2ainfall,
inches.
Total :
Suspended
_Solids
pH
- ..
ESA Method
1664, SGT-HETiIi
t )):
mg/1 (VMA)
.. .. Happlrcabfe..
New Motor Oil
Usage (gal!lMo.)
lfaPPrcab,e
..
Stormwafer
Benchmarks
Indicate NO FLOW A
applicable
CirclertBenchmark
'rto 150
V !
6 • a_9• �
') $
>55 gallmo, average requires 7s5 and
Non -polar G&G monitoring
Date Sample
Collected,
molddlyr
k
Permit: Date 8/1/2017 — 6/30/2022
Last Revised B-22-2015

Certificate of Coverage No. NCG14 F-]F-]nF-1
CERTIFICATION
"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."
(Required by 40 CFR §122.
Signature G{�/
Date
Mail Annual Summary Stormwater DrVIR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DOAR)
N.C. Department of Environmental Quality (DEQ)
Division of Dater Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, CSC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEM!_R Stormwater permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

&w'0T(m1mH(@M Flo hmpumbd
Wcataweter...ID; 10
- 114 OAKMONT DR1VE
GREENVILLE, N.C. 27858 FAX [phone]
ARGOS READY MIXED(6215 PLYMOUTH)
QUINN VAUGHAN
1020 E. 5TH STREET
WASHINGTON ,NC 27889
PARAMETERS
PH (not to be used for reporting)
Total Suspended Residue, mgll
Stormwater Analysis Method
Discharge Date Analyst Code
7.8 11/13/18 JiV1S 4500HB-11
18 11/14/18 JTH 2540D-11
ID#: 1096
DATE COLLECTED: 11/13/18
DATE REPORTED : 11/15/18
REVIEWED BY:

Environment I, Inc. CHAIN OF CUSTODY RECORD
P.-G,-Box 7085, 114 Oakmont Dr. Page I of
Greenville- NC 27Rik
environment I inc.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone] • Fax [phone]
CFfLpRINE
Ij
CLIENT: 1096 Week: 39
pH CHECK (LAB)
Ij UV
p
p
CONTAINER TYPE, PIG
�RGOS READY MIXED(6215 PLYMOUTH)
❑ NONE
ZUINN VAUGHAN
020 E. STH STREET
CHEMICAL PRESERVATION
VASHINGTON NC 27889
A
A
Cn A - NONE D - NAOH
oIM
E �
252) 325-2004
z J
Z
=
Cn
C 8 HNO E -HCL
s
0 ocz
it
z
o
w C - HZSO, F - ZINC ACETATE/NAOH
COLLECTION
o
div
ti?
< G - NATHIOSULFATE
C
SAMPLE LOCATION
DATE
TIME
Stormwater Discharp e
lb
CLASSIFICATION:
Lj WASTEWATER(NPDES)
DRINKING WATER
DWWW
LlSOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURIN�f MENT/DELIVERY
N
SAMPLES COLLECTED BY:
(Please Prim)
SAMPLES RECEIVED IN LAB AT °C
RELINQUISHED SIG.) (SAMPLER)
DATErnME`RECEIVEDBY
DATEMME AOL
COMMENTS
n1r3
jl j13f 1V
RELINQUISHED BY (SIG.)
DATEITIME
RECEI BY (SIG.)
ATE,/TIME
!
++
RELINQUISHED BY (SIG.)
DATEMME
RECEIVED BY (SI .
DATEMME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a T" for composite sample or a "G" for N 0 338700
CORM #5 Grab sample in the blocks above for each parameter requested.

SAMPLING INSTRUCTIONS AND FORM COMPLETION
+FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE
TYPES, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE
SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING
REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE.
1) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any
deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current
samples. Any samples analyzed outside of the required guidelines will be "qualified". This means that a note will be included on the
sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the
deviations.
2) Sample "Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is
not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the
temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there
is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed in wet ice using as
much ice as will fit in the cooler.
3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium Hydroxide_ The
laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Volatiles Vials, provide a battle of Acid with
detailed descriptions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the
bottle is required for proper chemical preservation. The lab must verify proper chemical preservation upon arrival in the lab and will note
this information in the spaces provided on the front of this form.
4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will
provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen
and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the
dechlorinating agent. Therefore, these samples must be de -chlorinated at the time of collection before being placed in our sample bottles.
Sodium Thiosulfate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for
Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total
Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must put his initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Coliforms (which have
Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you
note the "Total Chlorine at Collection" on the front of this form for any sample locations applicable. This value would be before any
neutralization is performed.
5) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box for all requested parameters. Grab temperatures
as well as Composite start dates and times can be recorded in the "comments" section.
6) Other information required to be completed by the client are:
Collection Date and Collection Time for each sample location Temperature at Time of Collection
Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished
Other added sample locations and analyses required Type Of Disinfection
Deletion on the form for any samples which are not needed (example: dry upstream location)
Any other information felt to be pertinent should be included in the "Comments" section
CONSIDERATIONS:
Colilorm and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should
be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis.
BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and M BAS samples have a 48 hour holding time. The lab reserves the
right to establish required sample collection and delivery dates in order to meet the required holding times.
CAUTION
Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals
for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping
container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical
attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection.

S
r
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year QD1
'Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Covergge No. NCG14
Facility Name:
County:
Phone Number: (Q Ste) '7�t `7'>�:�1 Total no. of SDOs monitored
Certified Laboratory t Lab # 1U
Lab #
Stormwater Discharge Outfall (SDO) No. I VMA Outfall? Yes ❑ No,
Is this outfall currently in Tier 2 for any {parameter? Yes ❑ Noe
Was this outfall ever in Tier 2 during the past year? Yes ❑ No4?r
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outf II No.
Total Rainfall, '
inches.:..
Total
Suspended.
Solids TSS ,
(. )
- 'm Il -
pH, ..
SU
=' Non-0o1ar:0&G
(EPA MetFod
1664, SG' HEM
( )),
mgll (VMA)
ffappficable
New Motor Oil
Usage (gallmo.)
trappricable
Storm Water
Benchmarks
indicate NO FLOW i/
appticabfe
Circle Benchmark
f
A 1oo i$0
6` 0_9 0
.� �
55 gat/ average wires TSS and
} 8 9 9
Non polar OSG monitoring
Date Sample
Collected,,
mo ddly
gztr: �k�z
t
x�� fog
Fg�
a
Zola
`ENT r—r.
Wa S
Permit Date 8/1/2017 -- 6130/2022
Last Revised 8-22-2015

•I
Certificate of Coverage No. NCG 140000
CERTIFICATION
"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, in,Gding the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122,22]
If
Signature
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
.[phone]
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

EmwokmEM T, hCOT
Mod
Wastewater ID: 10
P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
ARGOS READY MIXED(6215 PLYMOUTH)
QUINN VAUGHAN
1020 E. 5TH STREET
WASHINGTON ,NC 27889
PARAMETERS
Stormwater Analysis Method
Discharge Date Analyst Code
PH (not to be used for reporting) 7.7 04/25/18 HAINT 4500HB-11
Total Suspended Residue, mg11 9.5 04/26/18 KDS 254OD-11
ID#: 1096
DATE COLLECTED: 04/24/18
DATE REPORTED : 04/27/18
REVIEWED BY:

Environment 1,1nc. CHAIN OF CUSTODY RECORD
10, Box 7085, 114 Oakmont Dr. 1 i
Page of
LYb&n—ville, NC 27958 _
envy.-. 1 i;c.com
DISINFECTION
Phone [phone] • Fax [phone]
CHLORINE NEUTRALIZED AT COLLECTION
CHLORINE
pH CHECK (LAB)
CLIENT:1096 Week.13
Ij UV
P
P
CONTAINER TYPE, PIG
;EADY MIX CONCRETE (PLYMOUTH)
� NONE
IR, MIKE ODOM
CHEMICALPRESERVATION
020 E. 5TH STREET
VASHINGTON NC 27889
A
A
A -NONE D-NAOH
E
l52) 325-2004
1=
¢ �
L z
�'
U)
B - HNO3 E - HCL
00
= F
U
ar O
5 t3
z
O
�°
oc
w C- H2SO4 F- ZINC ACETATEINAOH
COLLECTION
J :
F
w
� 8
g
0
�-
x
QC G - NATHIOSULFATE
SAMPLE LOCATION
DAT�E1
TIME
Stormwater Discharge
7f l�
I
` `'
5,
l
-
CLASSIFICATION:
WASTEWATER(NPDES)
DRINKING WATER
DWQ1GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING HIPMENTIDELIVERY
Y N
SAMPLES COLLECTED BY:
(Please Print)
SAMPLES RECEIVED IN LAB AT °C
RELINQUISHED B G.) (SAMPLER)
DATEMME
IG.)
Rr!S
DATErnME
COMMENTS:
RELINQUISH D BY (SIG.)
DATE/I1ME
ECEIVS )
DATEMME
nj[' I CAI
RELINQUISHED BY (SIG.)
DATEMME
RECEIVED BY ( .)
DATUME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a T" for composite sample or a "G" for W Q 341854
FORM a5 Grab sample in the blocks above for each parameter requested.

SAMPLING INSTRUCTIONS AND FORM COMPLETION
FAI JRE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE
TYPES, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE
SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING
REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY- CODE.
]) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any
deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current
samples. Any samples analyzed outside of the required guidelines will be "qualified". This means that a note will be included on the
sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the
deviations.
2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is
not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the
temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there
is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed im wet ice using as
much ice as will fit in the cooler.
3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium Hydroxide. The
laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Voiatiles Vials, provide a bottle of Acid with
detailed descriptions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the
bottle is required for proper chemical preservation. The lab must verify proper chemical preservation upon arrival in the lab and will note
this information in the spaces provided on the front of this form.
4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will
provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjel(lahl Nitrogen
and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the
dechlorinating agent. Therefore, these samples must be de -chlorinated at the time of collection before being placed in dur sample bottles.
Sodium Thiosulfate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for
Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total
Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must put,his initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Coliforms (which have
Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you
note the "Total Chlorine at Collection" on the front of this form for any sample locations applicable. This value would be before any
neutralization is performed.
5) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box for all requested parameters. Grab temperatures
as well as Composite start dates and times can be recorded in the "comments" section.
6) Other information required to be completed by the client are:
Collection Date and Collection Time for each sample location Temperature at Time of Collection
Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished
Other added sample locations and analyses required Type Of Disinfection
Deletion on the form for any samples which are not needed (example: dry upstream location)
Any other information felt to be pertinent should be included in the "Comments" section
CONSIDERATIONS:
Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should
be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis.
BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and M BAS samples have a 48 hour holding time. The lab reserves the
right to establish required sample collection and delivery dates in order to meet the required holding times.
CAUTION
Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals
for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping
container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical
attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection.

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year Z 017
*Report ALL STORMWATER monitoring data on this form (include "No FlowT'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
.�. a— i% r- 19, r 17 "
Certificate of Coverage No. NCG14 ®D�I1_I �c%.jIL7_1 v L_L-1
Facility Name: c� �t7n[,r Uhl 1 2017
County: ccSW In CENTRAL FlU S
U\A R SEC`i'1t7N
Phone Number: (-25)_749-y23) Total no. of SDOs monitored
Certified Laboratory EHvr/bYw�rB►�}'_ iI yC Lab # 10
Lab #
Stormwater Discharge Outfall (SDO) No. I— VMA Outfall? Yes ❑
No
Is this outfall currently in Tier 2 for any parameter? Yes ❑
No
Was this outfall ever in Tier 2 during the past year? Yes ❑
No7
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
p
Solids (TSS),
mg/1
H
p �
SU
Non -polar O&G
(EPA Method
1664 (SGT-HEM}},
mgll (VMA)
Happlicable
New Motor Oil
Usage allmo.
9 {g }
Napplicable
Sformwater
Benchmarks
Indicate NO FLOW if/n/��
applicable
Circle nchmark
0
(�
�.�_9.0
1 5
>55 gallmo. average requires T55 and
Non -polar OSG monitoring
Date Sample
Collected,
molddl r
M
=
=
7
Al
Permit Date 8/1/2017 -- 6/30/2022
Last Revised 8-22-2015

L
Certificate of Coverage No. NCG14 DOQQD
CERTIFICATION
"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."
[Required by 40 CFR §122,420
Signature
Date IL
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date $1112017 - 6/30/2022
Last Revised 8-22-2015

F
Elmwok
MR(M % kwff pumbd
° - - - - Wastewater ID: 10
PO. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASHINGTON ,NC 27889
PARAiN9ETERS
PH (not to be used for reporting)
Total Suspended Residue, mg/1
Stormwater Analysis ,Method
Discharge Date Analyst Code
7.4 11/10/17 KDS 450OH13-11
<3.8 11/13/17 AKS 254OD-11
ID#: 1096
DATE COLLECTED: 11/09/17
DATE REPORTED : 11/14/17
REVIEWED BY:

A
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
P/�- G``
CERTIFICATE OF COYERAGEwNo. NCG14 DIF L
FACILITY NAME: 17 c_
PERSON COLLECTING SAMPLES r c•. CG/G
CERTIFIED LABORATORY ero C- Lab# IC7
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 026/1
SAMPLING PE IOD: ❑ July -December January -June
COLINTY
PHONE NO. ( ll) 3 yr2&I
ADD TO LISTSERVE? []YES RNO EMAIL:
DISCHARGING TO CLASS: MSA ❑HC+W ❑PNA []Trout ❑Other.
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FL0W)1
PH. .
[Standard
Units)
TS5
(mg/L)
Event
Duration
(minutes)
Total
Rainfall 4
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
-
6-9
100 ,
1p1-.2&j-.r -7
'7, b
�v
i
.�r
.,✓
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.
a TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
"For each sampled measurable 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
(mo/dd/yr)'
pH
(Standard
Units)
TPH using method
1664A SGT-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 Tier 2
Z
Sampling
6-9
15
100 '
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDS CES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NOZ
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 monitorinP 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 qualifi personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons d' tly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware thaAAere are -significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of Permittee)
Permit Date: 7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

Emw'0m1mH(@M Ala d1mcupp( bd
P.O. SOX 7085, 114 OAKMONT
GREENVILLE. N.C. 27835-7085
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASHINGTON ,NC 27889
Stormwater Analvsis Method
PARAMETERS Discharge Date Analyst Code
PH (not to be used for reporting) 7.0 04/25/17 KDS 4500HB-00
Total Suspended Residue, mg/1 5.0 041261t7 MAR 254OD-97
FAX [phone]
ID#: 1096
DATE COLLECTED: 04/24/17
DATE REPORTED : 04/27/17
REVIEWED BY:

Environment 1, Inc.
P.O. Box 7085, 114 Oakmont Dr.
Greenville, NC 27858
CHAIN OF CUSTODY RECORD
Page i of I
environment 1 inc.corr,
DISINFECTION
Phone [phone]a=• Fax [phone]
CHLORINE NEUTRALIZEDATCOLLECTION
❑ CHLORINE
pHCHECK (LAB)
CLIENT: 1096 Week: 13
❑ UV
P
P
CONTAINER TYPE, PIG
READY MIX CONCRETE (PLYMOUTH)
❑ NONE
MR. \11KE ODONI
CHEMICAL PRESERVATION
1020 E. 5TH STRP',F'I'
❑
WASIIINCT-ON NC 27889
A
A
U3 A -NONE D-NAOH
o
[phone]
L U
z LU
Ca]
r
-
U]
1 B.HNO, E.HCL
0o
ro
z
Cr
¢
a
G
w C- H2SO, F -ZINC ACETATE/NAOH
COLLECTION
ir o
w
a
o
a
F
a G-NATHIOSULFATE
a
SAMPLE LOCATION
DATE
TIME
Stormwater Discharge
oiT
�•���
,�
I
CLASSIFICATION:
WASTEWATER (NPDES)
❑ DRINKING WATER
❑ DWQIGW
❑ SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
CG N
SAMPLES COLLECTED BY. -
(Please Print)
SAMPLES RECEIVED IN LAB AT Z -C
RELINQUISHED BY (SAMPLER)
DATEMME
REC D B 51G.)
DATEI IME
COMMENTS:
o
'-,*/7 j f'11/
RELINQUISHED BY (SIG.)
DATEMME
4ECEIVE (SIG.)
DATEMME
RELINQUISHED BY (SIG.)
DATEMME
RECEIVE BY (SIG.
DATEMME
Sampler must place a "C" for composite sample or a "G" for
PLEASE READ Instructions for completing this form on the reverse side.
FORM #5 Grab sample in the blocks above for each parameter requested. N _ 330328

SAMPLING INSTRUCTIONS AND FORM COMPLETION
FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE
TYPES., MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE
SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING
REJEd'TED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE.
5
1) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any
deviation and asked to collect another set of samples!-,Mie•cIient may request the laboratory to proceed with the analyses of the current
samples. Any samples analyzed outside of the requite `guidelines will be "qualified". This means that a note will be included on the
sample result and "Chain of Custody" specifying the d_.%iation. The laboratory is also required to send a letter to the State noting the
deviations.
2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or. less. Freezing is
not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the
temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there
is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed in wet ice using as
much ice as will fit in the cooler. - ,?
3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium'Hydroxide. The
laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Volatiles Vials, provide a bottle of Acid with
detailed descriptions on how to collect the sample. Never rinse sample bottles belbre collecting samples. Any residue or liquid in the
bottle is required for proper chemical preservation. The lab must verify proper chemical preservation upon arrival in the lab and will note
this information in the spaces provided on the front of this form.
4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will
provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen
and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the
dechlorinating agent. Therefore, these samples must be de -chlorinated at the time of collection before being placed in dur sample bottles.
Sodium Thiosulfate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for
Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total
Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must pui,his initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Colitorms'(which have
Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you
note the "Total Chlorine at Collection" on the front of this form for any sample locations applicable. This value would be before any
neutralization is performed.
5) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box for all requested parameters. Grab temperatures
as well as Composite start dates and times can be recorded in the "comments" section.
6) Other information required to be completed by the client are:
Collection Date and Collection Time for each sample location Temperature at Time of Collection
Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished
Other added sample locations and analyses required Type Of Disinfection
Deletion on the form for any samples which are not needed (example: dry upstream location)
Any other information felt to be pertinent should be included in the "Comments" section
CONSIDERATIONS:
Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should
be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis.
BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and MBAS samples have a 48 hour holding time. The lab reserves the
right to establish required sample collection and delivery dates in order to meet the required holding times.
CAUTION
Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals
for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping
container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical
attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection.

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF CQYERAGE NO. NCG14-0 11
FACILITY NAME: td .v
PERSON COLLECTING SAMPLES el<•
CERTIFIED LABORATORY J- t I IW— Lab # LO
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: ,?y I
SAMPLING PEF3 IOD: [Jul -December ❑January -June
COUNTY jdjJS� % �+;,.
PHONE NO. ( )
ADD TO LISTSERVE? ❑YE5 NO EMAIL:
DISCHARGING TO CLASS: OSA ❑HQW ❑PNA ❑Trout []Other,
Outfall No.
Date Sample
[ollected
(mo/dd/OR
NO FLOW)1
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
,
Rainfallyr
(in)
In Tier 2
Monthly
Monitoring?
(vin)
# of Months in Tier
2 Samplingz
6 9
100
-
�-�
CENTRAL
FILE$
R SE
CTION
' 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: 7/1/2011-60/30/201S Last Revised 7/13/11
Page 1 of 2

<i
"1
+
IA
ew
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i 1
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Aw
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 1
(mo/dd/yr)
pH
(Standard
Units)
TPH using method
1664A SGT-HEM
'(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes) .
Total
Rainfalla
(in)
New Motor Oil
Usage
igal/month}
r 2
In TiMonehly
Monitoring?
Wn)
# of Months
in Tier 2 .
SamplingZ
6-9
15
100 '
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO JZ
HAVE YOU CONTACTED THE REGION? YES ❑ NO;Z
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample 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 qua li i personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons it ctly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware t t ere,aX,4i&nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signatthe of Permittee
(Date)
Permit Date: 7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

Elow'DMIMMM alp DMWTPO@TMq@d
Wastewater ID: 10
TP.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASHINGTON ,NC 27889
PARAMETERS
PH (not to be used for reporting)
Total Suspended Residue, mgll
Stormwater Analysis Method
Discharge Date Analyst Code
6.9 09/30/16 KKM 4500HB-00
5.6 10/03/16 MAR 254OD-97
ID#: 1096
DATE COLLECTED: 09/29/16
DATE REPORTED : 10/03/16
REVIEWED BY:

0.
• Environment l,Inc.
P.O. Box 7085, 114 Oakmont Dr.
Greenville, NC 27858
CHAIN OF CUSTODY RECORD
Page I of
environment 1 i nc .com
DISINFECTION
CHLORINE !NEUTRALIZED AT COLLECTION
Phone [phone] • Fax [phone]
CHLORINE
Ij
pH CHECK (LAB)
CLIENT: 1096 Week: 39
Ij UV
P
P
CONTAINER TYPE, PIG
READY MIX CONCRETE (PLYMOUTH)
Ij NONE
MR. MIKE ODOM
CHEMICAL PRESERVATION
1020 E. 5'rH STREFT
Ij
WASHI,NG'rON NC 27889
A
A
A - NONE D - NAOH
o
E�
[phone]
z
L; z
'
U)
C B HNO E HCL
3
20
Cr0
z
cc
F
a
¢
c
C - H2SO, F -ZINC ACETATE/NAOH
COLLECTION
_
F =
o
Uj
M cg
�"
LL
-
G NATHIOSULFATE
SAMPLE LOCATION
DATE}
T1ME
5tormwater Discharge
�""�I
��i�Lb
t
CLASSIFICATION:
WASTEWATER(NPDES)
DRINKING WATER
DWO/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
N
SAMPLES COLLECTED BY:
(Please Print)
SAMPLES RECEIVED IN LAS AT-3 - °C
RELINQUISHED BY
DATEMME
COMMENTS:
-.36'%(.
RELINQUISHED BY (SIG.)
DATEMME
ECEIV (SIG.)
DATEMME
r
2U
RELINQUISHED BY (SIG.)
DATEMME
RECEIVED BY (SIG.
DATEM E
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for (v o 3 2 5 4 -
FORM #5 Grab sample in the blocks above for each parameter requested. __

SAMPLING INSTRUCTIONS AND FORM COMPLETION
FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE
r TYPES, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE
SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING
REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE.
l) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any
deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current
samples. Any samples analyzed outside of the required guidelines will be "qualified". This means that a note will be included on the
sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the
deviations.
2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is
not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the
temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there
is a temperature drop from the tirne of collection until received in the lab. Regardless, all samples should be packed in wet ice using as
much ice as will fit in the cooler.
3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium,Hydroxide. The
laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Volatiles Vials, provide a bottle of Acid with
detailed descriptions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the
bottle is required for proper chemical preservation. The lab must verify proper chemical preservation upon arrival in the lab and will note
this information in the spaces provided on the front of this form.
4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will
provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen
and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the
dechlorinating agent. Therelore, these samples must be de -chlorinated at the time of collection before being placed in our sample bottles.
Sodium Thiosulfate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for
Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total
Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must put his initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Coliforms (which have
Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you
note the "Total Chlorine at Collection" on the front of this form for any sample locations applicable. This value would be before any
neutralization is performed.
5) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box for all requested parameters. Grab temperatures
as well as Composite start dates and times can be recorded in the "comments" section.
6) Other information required to be completed by the client are:
Collection Date and Collection Time for each sample location Temperature at Time of Collection
Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished
Other added sample locations and analyses required Type Of Disinfection
Deletion on the form for any samples which are not needed (example: dry upstream location)
Any other information felt to be pertinent should be included in the "Comments" section
CONSIDERATIONS:
Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time ofanalysis. Therefore, samples should
be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis.
BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and MBAS samples have a 48 hour holding time. The lab reserves the
right to establish required sample collection and delivery dates in order to meet the required holding times.
CAUTION
Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals
for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping
container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical
attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection.

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14DL I 1
FACILITY NAMEITC144 ice Cy^.ya4* Cw_ - Gr46fq
PERSON COLLECTING SAMPLES ge/JCr► iz -
CERTIFIED LABORATORY&%Xd,% 1 rIVW— Lab # tLO.�
Lab #
OPTIONAL INFO:
Part A. Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 0201 (r
SAMPLING PERIOD: ❑ July -December January -June
COUNTY ftk,
PHONE NO. (S) ^14 7 - Y?Sd
ADD TO LISTSERVE? ❑YES ANO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout
[]Other
Outfall No.
Date Sample Collected
(mo/dd/yr OR
NO FLOW)1
PH. . _
{Standard .
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
-
-
6-9
100 '
-
-
-
-
-�
.240
t/11WR
C
-NTRAL FILES
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit, Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

m
r 1-1

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)l
pH
(Standard
Units) •
TPH using method
1664A SGT-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 Tier 2
a
Sampling
6-9
15
100 '
-
-
-
------------------
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 X
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 samole (or 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 person rectly res nsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware there a ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
3- N
(SivIrature of Permitteell(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

hC&jq0jjt
NRw'Hm1mUm01W % hmpoOPaUCI
P.O. BOX 7085, 114 OAKMONT
GREENVILLE, N.C. 27835-7085
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASHINGTON ,NC 27889
PARAMETERS
PH (not to be used for reporting)
Total Suspended Residue, mg/l
Stormwater Analysis Method
Discharge Date Analyst Code
7.5 02/25/16 CMC 4500HB-00
11 02/26/16 SDB 2540D-97
DNE [phone]
FAX [phone]
ID#: 1096
DATE COLLECTED: 02/24/16
DATE REPORTED : 02/29/16
REVIEWED BY:

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O. N,.,. 7f)85, 114 O;rkmow Dr. Page 1 4)t'
Greenville, NC 27859
environment I inC.00m
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Plioni (252) 756-020R • I'm [phone]
CHLORINE
C L I EN'I': 1096 Week: 13
pH CHECK (LAB)
UV
P
I'
READY MIX CONCRETE (PLYMOUTH)
NONECONTAINERTYPE,PIG
MR. MIKE ODOM
1020 E. 5TH STREET
CHEMICAL PRESERVATION
WASHINGTON NC 27889
AlA
A - NONE D -NAOH
U)
zo
[phone]
� J
w z
w
t B- HNO3 E HCL
o 0CC
_ 0
LD
Z
w
C - H,SO, F - ZINC ACETATE/NAOH
COLLECTION
`a a
F m
Fo o
w
rL o
, ¢
o
o
F.
w
< G- NATHIOSULFATE
d
SAMPLE LOCATION
DATE
TIME
Stormwater Discharge
�`�� ��
�� '
� '
1
CLASSIFICATION:
WASTEWATER(NPDES)
DRINKING WATER
JDWO/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
�:Y) N
SAMPLES COLLECTED BY.
(Please Pnnt)
SAMPLES RECEVED IN LAB AT _jam °C
RELINQUISHED BY (SIG.) (SAMPLER)
DATEITIME
REC ED DY(,SIG.)
DATEIfIME
COMMENTS:
RELINQUISHED BY (SIG.)
DATEMME
ECEIVF (SIG.)
Z DATEITIME
x,_ )os)
RELINQUISHED BY (SIG)
DATEMME
RECEIVED BY (51
DATEITIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for No— 303479
FORM #5 - Grab sample in the blocks above for each parameter requested. — -

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
.. - . =.... GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14Ql- I !
FACILITY NAME: g84+� i+Le COnC1iE`�F G l.1rr�
PERSON COLLECTING -SAMPLES r� G+
CERTIFIED LA 80RATORY&V*Xd,%P%t&* t iwc Lab it
Lab f#
C6li1[GP►► IPk11110TI
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: oco!(r
SAMPLING PERIOD: ❑ July -December January -June
COUNTY 0A5V= f+�
PHONE NO. (2S
ADD TO LISTSERVE? DYES 6NO 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
4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
z
2 Sampling
-
6-9
100 '
-
-
-
-
��-
N
Q
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.
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.
a TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, 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
1-
(mo/dd/yr)
pH . _ ;..
(Standard:
Units)
TPH'using method
1664A SGT-HEM
.(rng/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)
q of Months
in Tier 2
a
Sampling
6-9
15
100 '
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO Z
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 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 person rectly res nsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware there a ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Si ature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

1, kwpomUd
P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASHINGTON ,NC 27889
PARAMETERS
PH (not to be used for reporting)
Total Suspended Residue, mg/I
Stormwater Analysis Method
Discharge Date Analyst Code
7.5 02/25/16 CMC 4500HB-00
11 02/26/16 SDB 2540D-97
ID#: 1096
DATE COLLECTED: 02/24/16
DATE REPORTED : 02/29/16
REVIEWED BY:/,-,/-----

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O_ Boy 7085, 114 Oakmont Dr. Page I of
Greenville. NC 27858
environment I inc.com
DISINFECTION
CHLORINE NEUTRAUZED AT COLLECTION
Phone [phone] • Fax [phone]
CHLORINE
CLIENT: 1096 Week. 13
pH CHECK (LAB)
UV
P
P
CONTAINER TYPE, PIG
READY MIX CONCRETE (PLYM0U'l'H)
NONE
MR. MIKE ODONI
CHEMICALPRESERVATION
1020 E. 5TH STREET
WASHINGTON NC 27889
A
A
A -NONE D-NAOH
E o
[phone]
�
z J
w z
Cr
LU
LU
B- HNO, E- HCL
0 0
z F
Cc 0
vulC-
z
cc
HzSO, F- ZINC ACETATE/NAOH
COLLECTION
9-
P o
S
��¢
2SAMPLE
o
a
F
<C G - NATHIOSULFATE
a
LOCATION
DATE
TIME
Stormwater Discharge
1
CLASSIFICATION:
WASTEWATER (NPDES)
DRINKING WATER
DWQIGW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURINnPMENT/DELIVERY
N
SAMPLES COLLECTED BY:
(Please Pnnt)
SAMPLES RECEIVED IN LAB AT I ' O °C
RELINQUISHED BY (SIG.) (SAMPLER)
DATEITIME
REC IEDY(51G-)
DATEITIME
COMMENTS:
5-le I've
RELINQUISHED BY (SIG.)
DATETIME
ECEIV (SIG.)
DATEIIIME
RELINQUISHED BY (SIG.)
DATIDTIME
RECEIVED BY (SI .
DATEMME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C"for composite sample or a "G"far N o 303479
FORM #5 Grab sample in the blocks above for each parameter requested. — -

SAMPLING INSTRUCTIONS AND FORM COMPLETION
N`AILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE .
TYPES, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE
SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING
REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE.
1) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any
deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current
samples. Any samples analyzed outside of the required guidelines will be "qualified". This means that a note will be included on the
sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the
deviations.
2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is
not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the
temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there
is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed in wet ice using as
much ice as will fit in the cooler.
3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium Hydroxide. The
laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Volatiles Vials, provide a bottle of Acid with
detailed descriptions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the
bottle is required for proper chemical preservation. The lab must verify proper chemical preservation upon arrival in the lab and will note
this information in the spaces provided on the front of this form.
4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will
provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen
and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the
dechlorinating agent. Therefore, these samples must be de -chlorinated at the time of collection before being placed in our sample bottles.
Sodium Thiosulfate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for
Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total
Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must put his initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Coliforms (which have
Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you
note the "Total Chlorine at Collection" on the front of this lbrm for any sample locations applicable. This value would be before any
neutralization is performed.
5) A "C"for Composite Sample or a "G" for Grab Sample should be placed i n the box for all requested parameters. Grab temperatures
as well as Composite start dates and times can be recorded in the "comments" section.
6) Other information required to be completed by the client are:
Collection Date and Collection Time for each sample location Temperature at Time of Collection
Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished
Other added sample locations and analyses required Type Of Disinfection
Deletion on the form for any samples which are not needed (example: dry upstream location)
Any other information felt to be pertinent should be included in the "Comments" section
CONSIDERATIONS:
Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should
be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis.
BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and M BAS samples have a 48 hour holding time. The lab reserves the
right to establish required sample collection and delivery dates in order to meet the required holding times.
CAUTION
Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals
for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping
container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical
attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection.

V, .� ---STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF CO ERAGE NO. NCG14 Oj_ L_ L
FACILITY NAME:
PERSON COLLECTING SAMPLES C
CERTIFIED LABORATORYA444 M>rwi- i arc,. Lab # 10
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: Xjr
SAMPLING PERIOD: July -December ❑ January -June
COUNTY
PHONE NO. i. SJ 1 7 • Z
ADD TO LISTSERVE? []YES ?KNO EMAIL:
DISCHARGING TO CLASS: SA ❑HQW ❑PNA ❑Trout
❑Other,
"
Outfall No
y
w
Date Sample
Collected r ,:
[mo/dd/yr OR
t v'
NO FLOW]
AH
(Standard`'
Units)
?�s
'A
,
[mg/L
$� '
w �.:r
r ,.
Event
Duration
&r' [minutes]
„
TbtaE & `
a
Riinfall rr
.[in] y
- In Tier,2
Monthl
x y P
Mon,toring�
{yln]°.,
k. x
li of Montfts in Tier
_��;� 7,
2 Sampling
�#
6 9
100
L
7,
t•Z.-r S'
7.
Zo
. S'
ter.
DEC
2,
DWE o
L. FILES
r J UIV
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.
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/i, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/i.
° 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

4
m
Ow

Part B Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
;; � .E'
Date Sample
pH' <_:.
TPH using method;
Total Suspended
Event
Total
. New Motor Oil ;
in Tier 2
Monthly,
# of Months,
_
( Standard"'
1664A SGT-HEM
Solids'
8 Duration ,3.
II
Rainfall °
Usage
in Tier 2 '
No.,.,
Collected
1
Units)
{rr,g/Ll
(mg/L) ':
(minutest
[in) .
{gal/month]
Monitoring
Samphngx
(mn/dd/y'rj
,
`
/na
6w9
_� � 1
�. ��100
'_ n
r..'
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;K
REGIONAL OFFICE CONTACT NAME:
Mail Ori inal and one copy of this DMR(including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample or at Lsnd 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:
N 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
ass/awart�ther
ied personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
thoectly r sponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am Wre nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
( nature of Permi e) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

■ Dec. 7,2015 1:43PM Environment 1
■
nvironment 1, incorporated
No. 1813 P. 1
P.O. BOX 7085, 114 OAKMONT DRIVE
OREENVILLE, N.C_ 27835-7085
READY MI% CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASRXXOTON NC 27089
Stormwater
Analysis
Method
PARAMETERS
Discharge
Date Analyst
Code
PH (not to be used for reporting)
7.5
11/03I15 XXF
4600IM-00
Total Suspended Residue, mg/1
22
11/03/15 MLH
294OD-97
Priaking pater IDI a7711
Maptgva ter XPI 10
a1
PHONE [phone]
FAX [phone]
ID#r 1096
DATE COLLECTEDt 11/02/15
DATE REPORTED 1 11/04/15
REVI D B

' Environment 1, Inc-
P-a. Box 7085,114 Oa]cmont Dr.
. Grecnvz'ut, NC 27858
1
1
CHAIN OF CUSTODY RECORD
Page 1 of 1
environnieni5inc.carn DISINPECiLou
'hone (252) 756-b20S -Pax [phone] CHLOAW�NEIJ7RED1[TCOLLJ=Ci]ON
CKWFJNE
MEENT: 10m We&: 3P � pH C�EECi((L o8)
UV
RRAD•Y AIIK CONCRETE (1PLYMOUM NONE p p 00WAINER TYPE - Pit;
hdJL MUM ODOM
1020 E, M S" 1('R&ET CHEMICALPFESEWATION
WASHWGTON NC 27589 A A
s A -NONE D•NAOH
( sx) 3-2s-2004 a B - I NO, E-MCL
Uj
Q z cc
c� C-H=SOi F-ZINCAGEfATEmAcH
COLLECTION'i R
G-NATHIC]SULFATE
SAWLE LOCATION DATE TIME
Stormwater Diiehiree `r`?�f T • 1 CLAMFIC'TM
. WASTRVATER(NPDES)
DRINKINGW ER
DWWW
SOW WAM S8=N
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENTIDELIVERY
N
ShMKa OQI.LKTM BY.
( IB= PrhQ
S4kiPLES RECENED IN LAB AT d ` G °C
AE)NOUISFEDBY )(`..FhIPLER} UATFrMt RECEIVE G.) I fAIhADAL CbNU,1EAIT5:
4 EUrJOUISfD B7(S1G,) DATFli1ME pt gY (") %% ' DATF1iWE
°:� 11, 11
PELINGUtSHED BY(SIG.) DATF. TWE FECBVEDBY V DAmqjgE
PLEASE READ knstructians knr completing this farm an the reverse siQe, Sampler crust place a V for composite sample or a `W fop b -- -
FORM 45 Grab sample in the blacks above for each parameter requested. N _ 3 0 5 Z 4 0
AE)NOUISFEDBY )(`..FhIPLER} UATFrMt RECEIVE G.) I fAIhADAL CbNU,1EAIT5:
4 EUrJOUISfD B7(S1G,) DATFli1ME pt gY (") %% ' DATF1iWE
°:� 11, 11
PELINGUtSHED BY(SIG.) DATF. TWE FECBVEDBY V DAmqjgE
PLEASE READ knstructians knr completing this farm an the reverse siQe, Sampler crust place a V for composite sample or a `W fop b -- -
FORM 45 Grab sample in the blacks above for each parameter requested. N _ 3 0 5 Z 4 0
PLEASE READ knstructians knr completing this farm an the reverse siQe, Sampler crust place a V for composite sample or a `W fop b -- -
FORM 45 Grab sample in the blacks above for each parameter requested. N _ 3 0 5 Z 4 0

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_0 1 l 1 SAMPLE COLLECTION YEAR: ZD1.S
FACILITY NAME: ?e4 � M + ]FCA- eob1C!3* CD, � y'} #3`jr SAMPLING PERIOD: ❑ July -December nuary-June
PERSON COLLECTING SAMPLES B Irirrs C C COUNTY 4.5 L,
CERTIFIED LABORATORY E" v; rd,#%rh j,/,,c. Lab # / O PHONE NO. (7SZ1 7y3-yZ3
T Lab # ADD TO LISTSERVE? []YES $;�40' EMAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: [_]SA ❑HQW ❑PNA []Trout ❑Other,
Part A: Stormwater Monitoring Requirements
Outfall Na:
Date Sample;
Collected
mo dd r11 OR
( NO FLOW) , .
pH
PH
(Standard',,.2g
Units]
' .
� TSS ~-
(rr►glL�
'Event
_- Duration- "
(minutes).
Total
q
Rainfall
(in)
In Tier 2
Monthly,
Monitoring?
yln}
# of Months m•Tier
Samplin
-
6=4 ..
100 '--
2.
r0
;Z0
�1
JUN1826
DW
ES
' 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.
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/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 8: 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
1
(mo/dd/yr) ,:
pH
(Standard
Units)
TPH using method
1664ASGT-HEM,"
(mg/L)
a
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.
inTier2
Z
Sampling
69
s15
100
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE, NSAT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ N!Crr
HAVE YOU CONTACTED THE REGION? YES ❑ NO r�l�
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 of "No Flow") t
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 qualifi personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons P ly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am a e th!j� �Vrent penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of termittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

EmAnfluml % how
TOW
Wa9tewa ie r.
P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE. N.C. 27835-7085 FAX {252) 756-0633
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASHINGTON ,NC 27889
Stormwater
Analysis
Method
PARAMETERS
Discharge
Date Anaivst
Code
PH (not to he used for reporting)
7.0
06/03/15 TRB
4500HR-00
Total Suspended Residue, mg/l
20
06/04/15 SDB
254OD-97
ID#: 1096
DATE COLLECTED: 06/03/15
DATE REPORTED : 06/05/15
REVIEWED BY:

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NaCG14 a I L I G
FACILITY NAME: i
PERSON COLLECTING SAMPLES fle—_
CERTIFIED LABORATORY F"16M rh en+ 1 )tiL Lab # / U
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
RI!CEIVED
SAMPLE COLLECTION YEAR: Zany ACT 2Q14
SAMPLING PERIODly-December ❑ January -June CENTRAL FILES
COUNTY w4s411+4_+r\ DWR SECTION
PHONE NO. (�� !S 3-u23
ADD TO LISTSERVE? ❑YES !r5_'jff0 EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ❑Other
Outfal] No.
Date Sample
Collected
mo/dd/yr OR
NO FLOW)'
PH
(Standard
Units}
TSS
(mg/L)
Event
Duration
(minutes}
Total
a
Rainfall
(in}
In Tier 2
Monthly
Monitoring?
(y/n'
# of Months in Tier
2 Sampling'
-
6-92
1002,3
o s l
(iz
z
AlN
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/l/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 p
Collected
{mo/dd/yr}1
PH
(Standard
Units)
TPH using method
1664A 5GT-HEM
(mg/L)
Total Suspended
Solids
{mg/L}
Event
Duration
(minutes)
Total
Rainfalls
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
{y/n}
# of Months
in Tier 2
2
Sampling
6-92
15
1002,3
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (includinF, all "No Flow" & "No Discharee" 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 ail attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qua
IIfi d personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those ersons di y responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am gre th t are significa alties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
o-z3 I
(SiAaVjrekittee) (Date)
Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

RMOTmum(M % No@
©r MA
P.O BOX 7085, f14 OAKMONTbffiv PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. STH STREET
WASHINGTON ,NC 27889
PARAMETERS
Stormwater Analysis Method
Discharge mate Analyst Code
PH (not to be used for reporting) 6.2 10/16/14 TRB 45UGHB-00
Total Suspended Residue, mg/l 13 10/t7/14 L%V 2540D-97
ID#: 1096
DATE COLLECTED: 10/15/14
DATE REPORTED : 10/20/14
REVIEWED BY:

0,��f1 1) ALL �SDO)� . Sr,�-iti�­AnniuiajL [iAl'0!,�lV i
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF CO ERAGE NO. NCG14 Qj / L SAMPLE COLLECTION YEAR:
FACILITY NAME: m"' SAMPLING PERIOD: July -December anuary-June
PERSON COLLECTING SAMPLES itn COUNTY
CERTIFIED LABORATORY LWitV11#%j"— I Lab If PHONE NO. ( ) 3
_ Lab # ADD TO LISTSERVE? [--]YES MAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: [_]SA ❑HQW ❑PNA ❑Tro
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)
pH
(standard
Units}
TSS
(mg/L)
Event
Duration
{minutes)
Total
4
Rainfall
(in}
to Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-9
10041
-
-
-
-
a
7•8
3.-Z.
140
+
1if "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfatl 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 I 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.
3T5S 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 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 SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
)
Total
Rainfalla
(in}
New Motor Oil
Usage
(gal/month}
In Tier 2
Monthly
Monitoring?
(y/n)
tI of Months
in Tier 2'
z
Sampling
6-9
15
100 ,
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (including all "No Flow" & "No Discharge" reports} within 30 days of receipt of sample 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 ers nel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those ptrsons dir#jy re onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete,
am awbreithat
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
slg?-I
(Date)
Permit Date: 711/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

EmwohmEmmq % Imm
GREENVILLE, N.C. 27835-7085
TOW
READY MIX CONCRETE (PLYMOUTH)
MR. MIKE ODOM
1020 E. 5TH STREET
WASHINGTON ,NC 27889
Storm -water
Analysis
Method
PARAi\4ETERS
Discharge
Date Analyst
Code
PH (not to be used for reporting)
7.8
05/01/14 TRB
4500HB-00
Total Suspended Residue, mgll
3.2
05/02/14 i11DD
254OD-97
0001 ff
;r
riking,_Wat;erN IA.7;T.15.
:gWastewater.�si➢:•10.--
DN E [phone]
FAX [phone]
ID#: 1096
DATE COLLECTED: 04/30/14
DATE REPORTED : 05/05/14
REVIEWED BY: