NCG140147_MONITORING INFO_20190114

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv I y %
DOC TYPE
[I HISTORICAL FILE
�k MONITORING REPORTS
DOC DATE
❑ a 0 L?
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14Q Q�
FACILITY NAME, S 4
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLING PERIOD: ❑ July -December ❑ January -June
COUNTY C-
PHONE NO. (ZL7,_) 3- y3z f
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
Imo/dd/yr OR
NO FLOW)'
PH
(Standard
Units]
TSS
(mg/Lj
Event
Duration
(minutes]
Total
.
Rainfall
{in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 SamplingZ
-
-
5-9
100 '
-
-
..a
I
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. Tler 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
Date of last pH meter calibration: 0 ��7

Part 8: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year.
Qutfall
No.
Date Sample
collected i
(mo/dd/yr)
pH
(standard
Units)
TPH using method
2564ASGT-NEM
(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)
tt of Months
in Tier 2
Sampling2
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 Discharee" 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 responsibl for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware 4 therede sjg> tonalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 7/1/2011-60/30/2D1S
/Z-31-18'
(Date)
Last Revised 7/13/11
Page 2 of 2

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year <;b18
*Report ALL STORMWATER monitoring data on this form (include 'No Flow"I'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 ©0©❑n
Facility Name: AL)S /;,
County_ c?ed i5—±
Phone Number: (01S�Z) 5 f G - y -70 y _
-Certified Laboratory&J, _ �•G Lab # /(J
Lab #
Total ne�RB 1. ored _
D
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑ No 6Z
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No kj
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
Solids (TSS),
mg/1
pH,
SU:
N6n-pol6r:.0&G .,
(EPA Method :.
1664.(SGT-HEM)],"
mg11 (VMA).: `
ffapPlicable
.. ... .
New Motor Oil
Usage (gallmo.)
,f applicable
Stormwater
Benchmarks
Indicate NO FLOW H
applicable
Circle Benchmark
100150
IrS� [[11
6. V-.7. �
15
>55 g allmo. average requires TSs and
Non -polar OaG monitoring
Date Sample¢tic
Collected,
molddlyr
�
WF,
i _- }
M
Y
A
,F
�.. 5
/l
Permit Date $1112017 - 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 ©[(]jH]©
CERTIFICATION
" 1 certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false informs, iqn, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §1
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 8I112017 — 6130/2022
Last Revised 8-22-2015

EiNwohimmW % hgwpo mmUd
P.O. BOX 7085, 114 64- kM- ff- DRIVE _ �PR E [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
ARGOS READY MIXED(6213 WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST
WASHINGTON ,NC 27889
ID#: 1091
DATE COLLECTED: 06/11/18
DATE REPORTED : 06/13/18
REVIEWED BY:
Stormwater
Stormwater
Stormwater
Analysis
Method
PARAMETERS
(#l, Grab)
(#2, Grab)
(#3, Grab)
Date Analyst
Code
PH (not to be used for reporting)
7.0
6.7
6.9
06/11/18 JTH
4500E-1B-11
Total Suspended Residue, mgll
6.7
12
8.3
06/12/18 JMH
2540D-11

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O: '#k7x 7085, 114 Oakmont Dr.
Page I_ of _)`
Greenville. NC 27858
environment l inc.cam
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone] • Fax [phone]
CHLORINE
Ij
CLIENT: 1091 Week:13
pHCHECK (LAB)
Ij UV
E
P
CONTAINER TYPE,P/G
kRGOS READY MIXED(6213 WASHINGTON)
❑ NONE
OR. MIKE ODOM
1020 EAST 5TH ST
CHEMICAL PRESERVATION
NASHINGTON NC 27889
A
A
E
F- A -NONE D -NAOH
;252) 325-2004
�
w
K-i
Ld ZZ
U)
Cr
�
w
B HNO3 E HCL
0
UUj
C - HZSOQ F - ZINC ACETATE/NAOH
COLLECTION
LU
G
F m
o
�"
- NATHIOSULFATE
SAMPLE LOCATION
DATE
TIME
Stormwater #1 Grab
-/l l
��
0
G
1
CLASSIFICATION:
WASTEWATER(NPDES)
DRINKING WATER
Stormwater (#2 Grab)
Stormwater 03 Grab
-/�'/�
a l�m
0
1
DWQJGW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING PMENT/DELIVERY
Y N
SAMPLES COLLECTED BY:
(Please Print)
z IJ9,01 �5d
jj
SAMPLES RECEIVED IN LAB AT n 1 °C
RELI QUISHED BY (SIG) (SAMPLER)
DATE/TIME
RE D BY' .)
DATEMME
COMMENTS:
RELINQUISHED BY (SIG,)
DATE[ TIME
RECEIVED BY (SIG)
DATEMME
RELINQUISHED BY (SIG)
DATEMME
RECEIVED 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 d 355787

y
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 orally
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.
i
2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of6C otless. Freezing is
not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 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 Sodiuni, 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.ggr 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 }pis initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Col�rms (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 al I 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 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 MESAS 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
RECEIVED
SAMPLE COLLECTION YEAR: I �Y
CERTIFICATE OF C ERAGE NO. NCG14� flEC 7 M
FACILITY NAME: 7> SAMPLINGRIOD:`�July-December ❑January -tune
PERSON COLLECTING SA MrOLES r1 CENTRAL COUNTY
CERTIFIED LABORATORYI7PP1 31,: 1"n<c_ Lab# / 'VR SECPH��vNE NO. ( ) `� �Li7Ut-1
Lab# An TOIISTSERVE?❑YES KNO EMAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA [—]Trout ❑Other,
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
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
#! of Months in Tier
x .
2 Sampling
-
6-9
loo '
-
-
-
-
/- -/'7
yU
.2r
-
2 77yv
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.
x If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/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.
Qutfall
No.
Date Sample
Collected
(mo/dd/Yr)�
pH
(Standard
Units).
TRH using method
1664A SGT-HEM
(mg/L(
Total Suspended
Solids
(mg/0
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
z
Sampling
6-9
15
100 '
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE CES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO kr
HAVE YOU CONTACTED THE REGION? YES ❑ NO g
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" reoorts) 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 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 c�rgtly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware j ersignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

mmWohimEW Flo hmpumbd
:,
Wastewater ID: 10
P.O. BOX7085, 114 OAKMONT-DRIVE '-T - �- -� - -- - PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
READY MIX CONCRETE (WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST
WASHINGTON ,NC 27889
ID#: 1091
DATE COLLECTED: 11/09/17
DATE REPORTED : 11/13/17
REVIEWED BY:
/'�/—
Stormwater
Stormwater
Stormwater
Analysis
Method
PARAMETERS
(#1, Grab)
(#2, Grab)
(#3, Grab)
Date Analyst
Code
PH (not to be used for reporting)
7.8
7.9
7.7
11/09/17 KDS
4500HR-11
Total Suspended Residue, mg/l
42
40
40
11/10/17 KAC
254OD-11

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O. Box 7085, 114 Oakmont Dr. Page —1_ of __.I_
Greenville, NC 27858
environment I ine.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone] • Fax [phone]
CHLORINE
CLIENT: 1091 Week: 39
pH CHECK (LAB)
uv
P
1,
CONTAINER TYPE, PIG
READY MIX CONCRETE (N'ASHINGTOti)
NONE
MR. MIKE ODONI
CHEMICALPRESERVAT10N
1020 EAST 5TH ST1:3
WASHING`I.ON NC 27889
A
A
z�jE
�
A -NONE D-NAOH
[phone]
ui U
z JLd
ED �
-
:.
�
� B HNO3 E HCL
a p
_
cc O
U
z
cc
C - H,SO, F -ZINC ACETATEINAOH
COLLECTION
0 ¢
� 8
o
°�zj
C
�`'
o
Uj
< G - NATHIOSULFATE
SAMPLE LOCATION
DATE
TIME
Stormwater (#1 Grab)
%' g! �
r].IdAm
CLASSIFICATION:
WASTEWATER(NPDES)
❑ DRINKING WATER
Stormwater (#2, Grab)
11-911
2 Zo M
Stormwater #3 Grab
el
17.A
/04
1
.......
.......
DWCI'GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
Y N
SAMPLES CO CTED BY:
(Please Print)
L �,oyd
SAMPLES RECEIVED IN LAB ATO °C
RELINQUISHED BY (SIG.) (SAMPLER)
DATEMME
RECEI BY (SI
DATEIIIME
COMMENTS:
/-91-/ 1 O• ro
REL OUISHED BY (SIG.)
DATEMME
ECEIVE S .}
% ❑ TE111ME
RELINQUISHED BY (SIG.)
DATEMME
RECEIVED (SIG.
DA E
PLEASE REAL) Instructions for completing this form on the reverse side. Sampler must place a "C° for composite sample or a "G" for NO 337565
FORM #5 Grab sample in the blocks above for each parameter requested.
w.i

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 LABORATORYAS 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 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) arc available upon request which specify proper handling and personal protection.

� •T
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG1440 _L '1
FACILITY NAME: �,e A?IX — -- - _
PERSON COLLECTING SA APLEST;/SO!'�
CERTIFIED LABORATORYfA1�ar%-C,. L �vC. Lab# /D
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: b!
❑
SAMPLING PERIOD: Jum ly-Deceber anuary-June
COUNTY--�i _
PHONE NO. QLM) f-/C- 4'7oY-
ADD TO LISTSERVE? ❑YES NO EMAIL:
DISCHARGING TO CLASS: SA ❑HCJW ❑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
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
-
6-9
100 ,
-
-
-
4/-Zy -1
/Z G
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 shalt 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

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
a
Rainfall
(in)
New Motor Oil
Usage
{gal/month}
in Tier 2
Monthly
Monitoring?
(Y/n)
# of Months
in Tier 2
Sampling"
6-9
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 WL
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one coov of this DMR (includine all "No Flow" & "No Discharee" reports) within 30 days of receipt of samole 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 deer,2aXrsignificant
ly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware tha penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Sig ure of Permittee) (Date)
Permit Date:7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

EmwG'T@1flHW Flo kno
m%d
wastewater ID: to
}
YVV P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
READY MIX CONCRETE (WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST
WASHINGTON ,NC 27889
ID#: 1091
DATE COLLECTED: 04/24/17
DATE REPORTED : 04/27/17
REVIEWED BY: Al�l
Stormwater
Stormwater
Stormwater
Analvsis
Method
PARAMETERS (#1, Grab)
(#2, Grab)
(#3, Grab)
Date Analyst
Code
PH (not to be used for reporting) 7.5
Total Suspended Residue, mg/I 54
7.4 6.9 04/25/17 KDS 4500HB-00
61 52 04/26/17 MAR 254©D-97

Environment 1, Inc.
P.O. Box 7085, 114 Oakmont Dr.
Greenville. NC 27858
CHAIN OF CUSTODY RECORD
Page _l _ of —IL
environment 1 inc.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone (2523 *�z308 • Fax [phone]
CHLORINE
CLIENT: 1pgl Week: 13
� UV
pHCHECK (LAB)
READY MIX CONCRETE (WASH INGTON)
❑ NONE
E
P
CONTAINER TI'PE,PIG
AIR. MIKE OI)017
CHEMICAL PRESERVATION
1020 FAST sTH sT
WASHINGTON NC 27889
A
A
Cl)A-NONE D-NAOH
lao
EQ
[phone]
Ld U
z �
`
..LU
B HNO3 E HCL
Q 0
0
F
Er o
v
z
O
C- H,SO, F- ZINC ACETATE/NAOH
COLLECTION
¢
o OM
ta
8
LL
c
a
c
x
w
G - NATHIOSULFATE
SAMPLE LOCATION
DATE
T1ME
Stormwatcr (#1, Grab)
41 �p
1
CLASSIFICATION:
WASTEWATER(NPDES)
DRINKING WATER
Stormwatcr (#2, Crab)
-��/ /7
, 3S�rr1
f L.�e
1
Stormwatcr #3 Grab
`�'�y /
1. CIS
�� •�
1
.......
.......
DWO/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING MENT/DELIVERY
Y N
SAMPLES COLLECTED BY:
(Please Print)
1 /o 9, d - -/-5e V
SAMPLES RECEIVED IN LAB AT IC
RELINQU HED BY (SIG.) (SAMPLER)
DAT EMME
REC D BY G.)
DATFJi1ME
COMMENTS:
ELINQUISHED BY (SIG.)
DATEmME
ECE (SIG.)
n
AT ME
RELINQUISHED BY (SIG.)
DAT EMME
RECEIVED BY (SI
ATEMME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for FORM a5 Grab sample in the blocks above for each parameter requested. N 2 330330

SAMPLING INSTRUCTIONS AND FORM COMPLETION
FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE
TYPES MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE
SENSIVE 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 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.
5
3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or SodiumsHydroxide. The
laboratory will either provide the preservative in the sample bottle, or in the case of 40 mi. 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 (TotalK',,�'eldahl 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
ram.
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 pdt his initials in the
"Chlorine Neutralized at Collection" row on the front of this form above the proper parameter, Samples such as Colilorms (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.

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14� 1
FACILITY NAME: ci b y fir td 27
PERSON COLLECTING�SAI7 P�LES 2J6110 Zela.►
CERTIFIED LABORATORY���q/�a.& l BP1 Lab # tQ_
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: C70 IG
SAMPLIN RIOD: F
July-December ❑ January -June
COUNTY
PHONE NO. ( ) ¢ G -(4104
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
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
q of Months in Z Tier
2 Sampling
b-9
100 '
-
-
-
-
• 4
/�
DWR SECTION
' 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.
i 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:7/1/2011-60/30/201S
Last Revised 7/13/11
Page 1 of 2

•,�..:•~y i�
` •.f
. '+G�?ram i•'.
�_:, ti
j.
IL
♦
t'.J

i
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > SS 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
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 .
2
Sampling
6-9
15
100 '
_
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ N06C
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 MUSTSIGN 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''''''l.��.i���ffii111eed personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those personctly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware th ere aVsigpificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of
/D-/17
(Date)
Permit Date:7/1/2011-60/30/201S
Last Revised 7/13/11
Page 2 of 2

EAUTmUmIN Ala kwommud
Wastewater ID: 10
P.O. BOX 7085, 114 OAKMONT bRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
ID#: 1091
READY MIX CONCRETE (WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST DATE COLLECTED: 09/29/16
WASHINGTON ,NC 27889 DATE REPORTED : 10/03/16
REVIEWED BY:
Stormwater Stormwater Stormwater Analysis Method
PARAMETERS (#I, Grab) (#2, Grab) (#3, Grab) Date Analyst Code
PH (not to be used for reporting) 7.3 7.9 9.1 09/30/16 KKM 4500HB-00
Total Suspended Residue, mg/I 46 39 8.8 10/03/16 MAR 254OD-97

Environment 1, Inc.
P.O. Box 7085, 114 Oakmont Dr.
Greenville, NC 27858
CHAIN OF CUSTODY RECORD
Page 1 of I
environment] i nc.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone] - Fax [phone]
CHLORINE
CLIENT: 1091 Wtek: 39
uv
pH CHECK (LAB)
READY AIIX CONCRETE (WASHINGTON)
NONE
Lj
1'
P
CONTAINER TYPE, PIG
NIR. MIKE ODONI
CHEMICAL PRESERVATION
1020 EAST STH ST
❑
N'ASHINGTON,NC 27889
A
A
A -NONE D-NAOH
�o
E�
[phone]
zLU
w Z
B-HNO, E-HCL
00
mLD
Z
<
o�
ti"' C - H,SO, F - ZINC ACETATE/NAOH
COLLECTION
J
G NATHIOSULFATE
a,
a
o
F
-
a
SAMPLE LOCATION
DATE
TIME
Stormwaler (#1, Grub)
-29-14
�?, Jf
.�
1
CLASSIFICATION:
WASTEWATER(NPDES)
Stormwater (#2, Grab)
-29-4
13; y0
,�
I
Slormwater (//3, Grab)
'Z9—JG
I3 3�
�'�
I
...
...
Fi DRINKING WATER
DWQ/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
Y N
42
SAMPLES TED BY:
(Please Print)
Af
SAMPLES RECEIVED IN LAB AT 'T__°C
RELINQ ISHED BY (SIG.) (SAMPLER)
DATE/T1MEur�
REwCEIV {S�I
DATEMME
COMMENTS:
7
%BY
RELINQUISHED BY (SIG.)
DATEMME
CEIVE (SIG)
DATEMME
7yo) I (a I I I ?
REUNQUISHED BY (SIG)
DATE/TIME
RECEIVED BY (SIG.)
DATEMME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C for composite sample or a °G for N ° 3 1 2 5 4 2 ,
FORM #5 Grab sample is 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 nil. 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 or 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 or 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 Colilbrms (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
rc•�i.lyu»I;�:rrl•���
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.

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE'OF COVERAGE NO. NCG1'4-Dr q I
FACILITY NAME-T� *I-LXA C.a�.crr � Pis►n+-� 3
PERSON COLLECTING SAMPLES �_4so n
CERTIFIED LABORATORYAA'f r&,y ►tV 1 w.w r- Lab # to
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: o2oIC
SAMPLING PERIOD: ❑ July -December January -June
c ,Fjjj
IFD
APR 29
2016
COUNTY PHONE NO. (.c) ce'1aY WFORMA 0Q q E C1 N
SS1NG UNIT
ADD TO LISTSERVE7 . ❑YES�GO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall Na...
Date Sample
Collected
NO FLOW)' (mo/dd/yr OR
pH
{Standard
Units)
TSS
(mg/L)
Event
Duration
{minutes}
Total
a
Rainfall
(in]
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
z
2 Sampling
6-9
100 '
-
U�tz-tCe
'7.S
�o
I.zr
WIA
Z
�-1•z jt
! D
f2o
ZS
�l
A
qz- rC
P1. C>
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.
TSS benchmark values are 100 mg/l, 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

I

Part e: Vehicle Maintenance Activity Monitoring Requirements for facilities using> SS 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 a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2 Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-9
is
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 ❑ N0RS
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 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 MUSTSIGN THIS CERTIFICATION FOR ANYINFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those perso 90irectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am a:E-Ah'�
t ther re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
r
(Si#Kature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO.NCG14 d I Ll l
FACILITY NAME: 2,ee, �n JMt "-Cdnu^G�C
PERSON COLLECTING SAMPLES Z—/
CERTIFIED LABORATORY r�rt �Cnf` ab # /V-
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: Zoly
RECEIVED
Orr 27 if4
SAMPLING PERIOD: 'July -December ❑ January -June
COUNTY Rez,.,4rt - CENTRAL FILES
PHONE NO. (232-) T111--'116W 1)WR SECTION
ADD TO LISTSERVE? ❑YEO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
T55
(mg/L)
Event
Duration
(minutes)
Total
a
Rain#all
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
-
-
6-92
100Z
-
-
-
-
i
►v
,q
o
v
3
c7
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, 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.
Outfali
No.
Date Sample
Collected
{mo/dd/yr�l
PH
(standard
Units)
TPH using method
1664ASGT--HEM
{mg/L}
Total Suspended
Solids
{mg/L}
Event
Duration
(minutes)
Total
a
Rainfall
{in}
New Motor Oil
Usage
(gal/month)
to 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 EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO JZ
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (includine all "No Flow" & "No Discharee" 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 qualifi nnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those peysons dirnlysronsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aVge that jVjAre signifi
re �fPU�mitt ee)
ubmitting false information, including the possibility of fii�nes and imprisonment for knowing violations."
—Z
Date}
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

r
Emwohimmud Ala hmpumbd
Mastewnteraan
P.O. BOX 7085, 114 QAKMOlVT DRIVE PHONE (252) 756-
GREENVfLLE, N.C. 27835-7085 FAX {252) 756-
ID#: 1091
READY MIX CONCRETE(WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST DATE COLLECTED: 10/15/14
WASHINGTON ,NC 27889 DATE REPORTED 10/20/14
REVIEWED BY:
Stormwater Stormwater Storunwater Analysis Nlethod
PA,RAIIETERS (#1, Grab) (#2, Grab) (#3, Grab) Date Analyst Code
PH (not to be used for reporting) 7.5 7.4 7.3 10/16/14 TR13 4500HB-00
Total Suspended Residue, mg/1 15 11 7.9 10/17/14 L1V 254OD-97

ST0RMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual M0NITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 Q -1-Y-7
FACILITY NAME: QC'JI;eu wwz d GtrtGtt+ co
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY IF1tivilbrrM;r* I Lab # ID
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 10tq
SAMPLING PERIOD: ❑ July -December 2�January-June
COUNTY 3-e4It
PHONE NO. ( 252 ) 4746 rM
ADD TO LISTSERVE? ❑YES F!�tIVO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout �Qiher
Outfall No.
Date Sample
Collected
{mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
T55
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
-
6-9
100 ,
-
-
-
-
O I�
76 q
S
2
evive7lY
7.7
Z
.v
•
b 4v
S.
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.
s TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part BB 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
,
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
{Y/n)
# of Months
in Tier 2
z
Sampling
6-4
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 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 qual' ied personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those personWre
ly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
w
am ae th are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature o ermittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

Now,ommmid Flo NumpooQ Wo
wastewater In_ 10
P.O.-BOX 7085, 1t4 OAKMONT DRIVE___ - -- - --- -- ----� -- - - -PHONE [phone] -
GREENVILLE, N.C. 27835-7085 FAX [phone]
READY MIX CONCRETE(WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST
WASHINGTON ,NC 27889
ID#: 1091
DATE COLLECTED: 04/30/14
DATE REPORTED : 05/05/14
REVIEWED BY: "4e
Stormwater Stornmater Stornmater Analvsis Method
PARAMETERS (#1, Grab) (#2, Grab) (#3, Grab) Date Analyst Code
PH (not to be used for reporting) 7.9 7.7 8.1 05/01/14 TRB 4500HB-00
Total Suspended Residue, mgll 53 23 5.5 05/02/14 11DD 2540D-97

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 d 1 L1
FACILITY NAME: QeYa con&r ie CO. p% J* �3
PERSON COLLECTING SAMPLES L•, 1014 d
CERTIFIED LABORATORY r+oft4y%+ ) I ++GLab # / ci
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 201�
SAMPLING PERIOD- uly-December ❑ January -June
COUNTY,�'t
PHONE NO. (252 } br
ADD TO LISTSERVE? ❑YES 0 EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ❑Other,
Outfall No.
.Date Sample Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
T55
(mg/L)
Event
Duration
(minutes)
Totala
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in
Z Tier
2 Sampling
-
6-4
100 ,
-
-
-
-
I
'?. I
it
2j6
bo
2-
I&Lz /-
,N
2
.O
PVA
1a �2 5-
r 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 WO 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.
RECEIVED
NOV 0 6 2915
CENTRAL FILES
DWR SECTION
L�-
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

- PartS: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year.
s^
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
(gal/month)
In Tier 2
Monthly
(y/n) Monitoring?
#1 of Months
in Tier 2
z
Sampling
6-4
15
100 ,
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEE EN T ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ N0�
HAVE YOU CONTACTED THE REGION? YES ❑ N
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one coov of this DMR (includine all "No Flow" & "No Discharee" reports) within 30 days of receiot of sample (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 pers s dirggemqiN
y responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am awar7i, thsignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Sifnature of
Permit Date: 7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

ElMommumM % hon mUd
P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
ID#: 1091
READY MIX CONCRETE (WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST DATE COLLECTED: 10/12/15
WASHINGTON ,NC 27889 DATE REPORTED : 10/15/15
REVIEWED BY:
Stormwater Stormwater Stormwater Analvsis ;Method
PARAMETERS (#1, Grab) (#2, Grab) (#3, Grab) Date Analyst Code
PH (not to be used for reporting) 7.1 7.4 7.7 10/13/15 CMC 4500HB-00
Total Suspended Residue, mg/1 40 41 59 10/14/15 KDS 254OD-97

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_0 / 117
FACILITY NAME:. gf441 M.WA 4pAj Wi,- &)•
PERSON COLLECTING SAMPLES 1-O d cw)
CERTIFIED LABORATORY FrWiloH*re-i- hG• Lab # a
Lab #
OPTIONAL INFO:
Part A. Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: zoI S
SAMPLING PERIOD- ❑ July -December *�January-June
COUNTY 44'
PHONE NO. (25Z) Y6-470
ADD TO LISTSERVE? EYES PkO EMAIL:
DISCHARGING TO CLASS: ESA ❑HQW ❑PNA ❑Trout ❑Other,
Outfall No .'.
Date Sample
Collected
dd
(mo / /yr OR
NO FLOW):.'
PH.
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes]
Total
q
Rainfall
(m)
In.Tier 2
on
Monitoring?
.
Y/n
a of Months in Tier
2
2 Sampling
6-9
100-
Oco/oL I.5
•v
?-3
I D
Z
otoo2 /S
8
/O.1
1
V
% 02 S
,�7
r[/
i
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/l, 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/Lj
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
Sampling
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal 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 direc a onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am awar hat t e significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations,"
(Sigpilattre of rmittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

kmkomwid % hcwpo(mbd
w&Scavecer;ID: iu
P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
ID#: 1091
READY MIX CONCRETE (WASHINGTON)
MR. MIKE ODOM
1020 EAST 5TH ST DATE COLLECTED: 06/02/15
WASHINGTON ,NC 27889 DATE REPORTED : 06/05/15
REVIEWED BY:
100,
Stormwater Stormwater Stormwater Analysis Method
PARAAfETERS (#i, Grab) 02, Grab) (#3, Grab) Date Analvst Code
PH (not to be used for reporting) 8.0 7.8 7.7 06/03/15 TRB 4500HB-00
Total Suspended Residue, mg/I 7.3 10 4.0 06/04/15 SDB 2540D-97