NCG140149_MONITORING INFO_20180305

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�V �� 40I
DOC TYPE
❑ HISTORICAL FILE
CSC MONITORING REPORTS
DOC DATE
p �OJ� U
YYYYM M D D

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year )-0
`Report ALL STORMWATER monitoring data on this form (include "No Flow" 1"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 140149
RECEIVED
Facility Name: Southern Concrete Materials — Burnsville Plant kAAP 0 r ?m
County: Yancey CENTRAL F-p ES
Phone Number: ( $28 ) 253-6421 Totallno; of-SDOs. monitored 1
Certified Laboratory ETA Lab # 600
Lab #
Stormwater Discharge Outfall (SDO) No. 1 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 ❑ No
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 ❑
Permit Date 8/112017 — 6130/2022
Last Revised 8-22-2015

r --% _ Certificate of Coverage No. NCG 14 M©RZ9
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 §122.22]
Signature
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in D WR (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 811/2017 — 6/30/2022
Last Revised 8-22-2015

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140149
FACILITY NAME: _Southern Concrete Materials -Burnsville
PERSON COLLECTING SAMPLES _Jeff Lamm
CERTIFIED LABORATORY ETS Lab # 600
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLING PERIOD: ® July -December
COUNTY Yancey
❑ January -June
PHONE NO. ()
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}
T55
(mg/L)
Event
Duration
(minutes]
Total
Rainfall'
(in)
. In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-9Z
1002,3
_
-
1
7-12-16
8.8
9.4
40
0.5
N
N/A
N
N/A
[,%Atg
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.
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/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
(mo/dd/yr)1
pH
(standard
Units)
TPH using method
1664A SG%HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall a
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-92
152
1002.3
N/A
N/A
N/A
N/A
N/A
N/A
N/A
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 Orieinal and one copv of this DMR fincludinR 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 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 arp signific4nt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
8/1/2016
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

f
TORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCQ_140149] RFC VF3Arm"PLE COLLECTION YEAR: _2016
FACILITY NAME: _Southern Concrete Materials -Burnsville— APR 2 8 '20 IAMPLING PERIOD: ❑ July -December ® January -June
PERSON COLLECTING SAMPLES _Jeff Lamm COUNTY Yancey
CERTIFIED LABORATORY ETS Lab � _I MSl`CTIQRPHONE NO. ( )
Lab ���ati'xCs LISTSERVE? ❑YES ❑NO 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
Rainfall'
(in]
In Tier 2
Monthly
Monitoring?
(Y/n)
# of Months in Tier
2 SamplingZ
-
-
6-92
1001,3
_
-
-
-
1
4-1-16
8.S
5.0
180
1.05
no-
v�
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/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)l
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
Sampling'
6-9'
15'
1002•3
-
-
-
-
-
1
Click here
to enter
text.
Click here to
enter text.
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 Orieinal and one copy of this DMR i'includine all "No Flow" & "No Discharee" resorts) 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 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 re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Permit at 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. NCG14O149
FACILITY NAME: Southern Concrete Materials -Burnsville
PERSON COLLECTING SAMPLES _,_,Eddie Teague r
CERTIFIED LABORATORY ETS Lab # _600�
Lab ##
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR; 2015
SAMPLING PERIOD: ® July -December ❑ January -June
COUNTY Yancev
PHONE NO. ( )
ADD TO LISTSERVE? []YES. ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout 20ther.
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FL0W)1
pH
{Standard
Units]
TSS
(mg/L)
Event
Duration
{minutes]
Total a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
n
(y/ )
i# of Months in Tier
2 Sampling2
-
-
6_92
1002,3
-
1
9-29-15
7.0
6.S
1140
1.29
N
RECEIVED
kink,
� n
is
i VQ r
CENTRAL
WILES
bvIR
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/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.
,2
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
Rainfall'
(in)
-
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
Wn)
# of Months
in Tier 2
Sampling'
6-92
152
1001.3
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE QUTFALL (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:
A certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware tnatAnere are
(Signature
ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
4 � 1
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

r,.
Ak
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14­0 / y 7 I
FACILITY NAME: S d tr .� �, r .
PERSON COLLECTING SAMPLES `� 1
CERTIFIED LABORATORY J Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YE rf-' R: i /
SAMPLING PERIOD:
RIOD: [July -December ❑ January -June
COUNTY 5 ?) G r,I
PHONE NO."(_)
ADD TO LISTSERVE? ❑YES MNO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units}
TS5
(mg/L)
Event
Duration
(minutes]
Total
Rainfall'
(in}
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-92
1002,3
9 /
6
j
Y r r.ln �—
AUG 2;
T
PNTRA
DW01
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.
IVED
2014
FILES
30G
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

1'4 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/yrjl
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
2
Sampling
6-92
152
1002,;
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NCI[
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 (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are si nificant pe Ities for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permitte ( te}
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_�) I
FACILITY NAME: e t 6�#
PERSON COLLECTING SAMPLES T _ ,.t 1 ASS ui
CERTIFIED LABORATORY FT v Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: a o
SAMPLING PE IOD: ❑ July -December January -June
COUNTY �1CP
PHONE NO. )
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA rout ❑Other,
Outfall Na.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
[Standard
Units]
TSS
(mg/L)
Event
Duration
[minutes]
Total
Rainfall'
(in]
In Tier 2
Monthly
Monitoring?
(y/n'
# of Months in Tier
2 Sampling'
-
-
6-92
1002,3
f �a
CENTRAL 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.
' 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 SO 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.
Outfali
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
Rainfall a
(in)
New Motor Oil
Usage
(gal/month)
In Tier Z
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling'
6-9'
15'
1001"
HAS YOUR FACILITY HAD a 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 qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there ar ignificant p nalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
G %
(Signature of Permi ee ( ate
Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2