NCG140208_MONITORING INFO_20190305

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
FDOCTYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
OaV��f u3�5
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT I(DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2018
*Report ALL WASTEWATER monitoring data on this form (include "No Elovi/T'No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14
Facility Name: Statesville
County: Iredell
Phone Number: { 33 983-2181
Certified Laboratory Prism Lab
Lab # 402
Lab #
Total no, of outfalls monitored 1
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No [,j✓
Does this outfall discharge WW to S13 or PNA waters? Yes ❑ No ✓l
Does this outfall discharge WW to HQW or ORW waters? Yes No 0
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑✓
Were there any limit violations in the calendar year? Yes ❑ No ✓❑
Outfall No.
Daily Flow Rate,
pH,
TSS,
SS,
Non -Polar O&G (EPA Method 1664
cfs
SU
mg/1
mlll
(SGT-HEM)), mgll
001
if applicable
Standard
Effluent
HOW or ORIN
550% Of 7Q10
ffm5hv ter
6.0-9.0
30
HOW, ORW, SA,
No Limit
Limitations
HOW
20
SB,PNA.orany
Trout
Indicate NO FLOW if
saltwater
5
Samples above Benchmark
applicable
6.8-q
HOW f pRW end 7r, or
subJect to Tlorea Responses
Oalfy Maximum
VV
PNA
15
10
Date
Sample_
�
N
Collected,
r
x-
-r'
molddiyr
3/29/2018
NO FLOW
IYINR v �
6/27/2018
NO FLOW
f r tT " 11 ES;
DWR SECTION
9/10/2018
NO FLOW
10/26/2018
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 [-4 E6
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 Wastewater 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 811t2017 — 6/30/2022
Last Revised 8-22-2017

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2018
*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. NCG14 ®20
Facility Name: Statesville Plant
County: Iredell
Phone Number: (336 ) 983-2181
Certified Laboratory Prism Lab
Lab # 402
Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑✓ RECEIVED
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency © MAR 0 4 2019
Yes, received approval from DEMLR to reduce monitoring frequency 0 CENTRAL FILES
Other - ❑ DWR S!`rTlnn.3
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids (TSS),
Mgt[
pH,
SU
Non -polar O&G
(EPA Method
1664 (SGT-HEM)),
mgll (VMA)
lfapplicable
New Motor Oil
Usage (gallmo.)
lfapplicable
Stormwater
1.
Benchmarks
Indicate NO FLOWN
applicable
Circle Benchmark
100150
/�
6.0-9.0
15
ASS g allmo. average requires TSS and
Non -polar 09Gmornitoring
Date Sample
Collected,��
s
�# �.
,�
3/29/2018
002 NO FLOW
6/27/2018
NO FLOW
9/10/2018
NO FLOW
1012612018
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 -dFC $E
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 relief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false informatior}, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CIwR §122.22]
Signature
Date
Ij
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

.• Y
r '
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2017
*Report ALL STORMWATER monitoring data on this form (include "No Flow"P'No Discharge" and Benchmark
Exceedance. ) from the previous calendar year to the DEQ by MARCH=1, ofea year'r)
Certificate of Coverage No: NCG14 ®2❑ 0
Statesville Plant CENTRAL FILES
Facility Name: M 10 or-..Y.
County:
Iredell vry 4 w'''
Phone Number: (704 } 878-6156 Total no. of SDOs monitored 2
Certified Laboratory Prism Lab Lab # 402
Lab #
Stormwater Discharge Outfall (SDO) No. 001 &002 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 0
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 0
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids , { )
mg/1
pH,
SU
Non -polar O&G
(EPA Method
1664TSS SGT-HEM )
( }
mgll (VMA)
If applicable
New Motor Oil
Usage (gallmo.)
Happficable
Stormwater
Benchmarks
Indicate NO FLOW H
applcable
Circle Benchmark
1 oa'F,O
ft
6. �'9.4
15
>55 gallmo. average requires TSS and
Non -polar O&G monitoring
Date Sample
Collected34
molddlyr
. >
4
�A4Y.�� A'ax.¢....�.:
Y"£ ;
a g� i
8 �� s':6 ii83tiSR'Y RT. j.
��
3 ry doF=
!r
.rT,+1.-3
Li F S E
.EY .-,.¢�. s4 ..o-!
3/28/2017
002 No Flow
6/23/2017
002 No Flow
9/29/2017
002 No Flow
9/29/2017
003 No Flow
12/20/2017
003 No Flow
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

_y
r-
Certificate of Coverage No. NCG14 d❑©®®
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 §122.221 ,
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 Contra! 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 81112017 - 6/30/2022
Last Revised 8-22-2015

? -_;�L
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rusty Jacobs
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
RECEIVED COUNTY:Iredell
PHONE NO. [phone]
JUL 27 2017 ADD TO. LISTSERVE? ❑YES ®NO EMAIL:
CENTRAL_ FILES DISCHARGING TO CLASS: []SA ❑HQW
DWR SECTION OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
1
Collected'Duration
(mm/dd/,yr)
Type of Wastewater
(VE, RM, MD)
pH
(standard)
TotatSuspended
(mg/L)
Settleable
(mL/L)
TPH using
method 1664A
SGT-HEM'
(mg/L)
Discharge
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
6-93'4_
303,5
53
(15)6.
-
-
SWO02
6/23/17
No Flow
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") 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
[phone]
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 thatAhere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date:7/1/2010-06/30/2015
//
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140241
FACILITY NAME: Monroe
PERSON COLLECTING SAMPLES: David Morris
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Reouirements
RECEIVED
JUL 2 7 2017
CENTRAL FILES
"WR SECTION
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec Dian -March ®April -June
COUNTY: Union
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
I
Collected
(mm/dd/yr)
Type of Wastewater
2
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method.1664A
SGT-HEM6
(mg/L)
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
6-93,4
303.5
53
(15)6
-
-
001
6/22/2017
NO FLOW
If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

5 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" 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
[phone]
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 thre arW nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee}
Permit Date:7/1/2010-06/30/2015
-7 6 zL--z-
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCC3140000
CERTIFICATE OF COVERAGE NO, NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rusty Jacobs
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES [:]NO
Part A: Wastewater Monitorine Reouirements
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
COUNTY: Iredell
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-HEltd6
(mg/L)
Discharge.
Duration
(minutes)
Total flow
7
(gallons/day)
-
-
RM, MD-
6-93,4
303s
53
SWO02
3/28/17
No Flow
MAY 0 5 i
01 /
If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/201S Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO F_L_O_W_") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 dire ly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awprefthat t4fire pfV significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date:7/1/2010-06/30/2015
'Lr'r
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rusty Jacobs
CERTIFIED LABORATORY: Prism Lab #f 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Manitorine Reouirements
REC
EIVED
COLLECTION YEAR: 2016
RECEIVED -SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec Dian -March ❑April -June
JAN 2 3 2017 COUNTY: Iredell
PHONE NO. [phone]
CENTRAL FILES ADD TO LISTSERVE? DYES ®NO EMAIL:
DWR SECTION DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
x
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/0
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-HEM'
(mg/L)
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
- 6-93'4
303s
53
(15)6
-
-
SW002
12/6/16
No Flow
SWO03
12/6/16
No Flow
tat
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY _iINCLUDING ALL "NO FLOW", "NO DISCHARGE") 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
[phone]
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 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 aWahe tha"here p�ignif!cant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

�.1
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: Iredell
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
Z
(VE, RM, MD}
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
s
SG g/L)
(m/L}
Duration
minutes)
Total Flow
7
(gallons/dayj
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
SW 002
10/8/2016
NO FLOW
SW 003
10/8/2016
NO FLOW
m
FILES,
` If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiies (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated, Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW "NO DISCHARGE") 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
[phone]
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 J�ereXe significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signaiure of Permittee)
Permit Date: 7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14O2O8
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Reouirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: Iredell
PHONE NO. [phone]
ADD TO USTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
2
(VE, RM, MD}
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
SG
/L)
(mg/L)
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
6-93.4
303.5
53
(15)6
-
-
SW001
6/30/2016
No flow
AUG
U
,
n � ru
/Lin 1
r-%IAIP
V",L FILES
N=rTInNI
If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VIVA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY
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
[phone]
UDING ALL "NO FLOW". "NO DISCHARGE"] WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
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 dir ctly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am a)nrarp thatXere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCC3140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: []Jul -Sept ❑Oct -Dec ®Jan -March []April -June
COUNTY: Iredell
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: [:]SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall Na.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEM'
(mg/L)
Duration
(minutes)
Total Flow
,
{gallons/dayj
-
-
RM, MD-
6-93.4
303.s
53-
SW001
3/31/2016
No flow
P R
, F I
SWO02
3/31/2016
No flow
ti
zo 0
1=11 r-c
,RPOTDAI
n >R
. 'ION
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") 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
[phone]
YOU MU5T 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 awarefthat thele are s}gnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
0-r/z.1 //f,
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES J�JNO 4W
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec Dian -March ❑April -June
COUNTY: Iredell
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
PH
(standard]
Total
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
1664A
S (mg/L)?6
mg/L)
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
RM, MD-
6-93,4
303,5
53
(15),
-
-
SW001
12/15/15
RM
8.6
460
.50
BRL
>1
>1
SWO02
12/15/15
RM
8.2
520
.10
BRL
>1
>1
C E I
v E_
CENTRAL
FILES
DWR SECTION
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here_ Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cieanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
CR==n

tastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
d is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shah be set to SO% of the Summer 7Q10 Flow as per 15A
.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" 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
[phone]
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 d' ectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awpreAtha4here are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
/ f 27 //;o
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville RECEIVED
��" /�®
PERSON COLLECTING SAMPLES: Rik Jones t1 �/
CERTIFIED LABORATORY: Prism Lab # 402 OCT 2 3 2015
LIMIT VIOLATIONS? YES ❑ NO ® CENTRAL FILES
DWR SECTIOr'
Part A- Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2015
eop?
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec Dian -March ❑April -June
COUNTY: I redel I
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
=
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD}z
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-HEM'
(mg/L}
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day]
-
-
RM, MD-
6-93,4
303,S
53
(15),
-
-
SW001
09/10/15
RM
8.4
1600
2.5
BRL
>1
>1
SWO02
09/10/15
RM
7.8
310
1.0
BRL
>1
>1
SWO03
09/10/15
No Flow
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-9.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
buinstead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 1SA
NCAC 02B .0224, Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") 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
[phone]
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 personsAth
irectl responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awore th are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
( 0(2f /f1�-
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik }ones
RECEIVED
CERTIFIED LABORATORY: Prism Lab #1402
,u II 2 4 2015
LIMIT VIOLATIONS? YES ❑ NO ®
C%KTRAL FILES
,VQ-,�rTION
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑!ul-Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: Iredeil
PHONE NO. [phone]
ADD TO LISTSERVE? OYES ®NO EMAIL:
DISCHARGING TO CLASS: [:]SA ❑HOW
OPTIONAL INFO:
❑PNA [—]Trout ®Other
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
,
RMMD)
(VE, ,
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
S (mg/L)g/L)
Duration
(minutes)
Total Flow
(gallons/day)
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
SW001
06/30/15
No Flow
SWO02
06/30/15
No Flow
SWO03
06/30/15
No Flow
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
` but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 70.10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") 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
[phone]
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 qu I flied personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those perso direct) esponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I amfpwarq at t e are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permitteej
Permit Date: 7/1/2010-06/30/2015
7/r 3i,--3-
(Date)
Last Revised 07/13/11
Page 2 of 2

Y
PROCESS V!/ASTEWATER — Quarterly Discharge Monitoring Report
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ® NO ❑
Part A: Wastewater Monitoring Requirements
GENERAL PERMIT No. NCG140000
SAMPLE COLLECTION YEAR: 2015
®AMPLE QUARTER: []Jul -Sept []Oct -Dec ®Jan -March ❑April -June
fREC E 101E [CbUNTY: Iredell
MAY 13 2015 PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL
CENTRAL EILESDISCHARGING TO CLASS: ❑SA ❑HQW []PNA ❑Trout ®Other
DWR SECTION OPTIONAL INFO:
Outfall Na.
Date.Sample
Collected'
(mm/dd/yr)
Type of Wastewater
x
WE, RM, MD)
pM
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT HEAT'
(rng/L)
Duration
(minutes)
Total Flow
(gallons/day),
-
-
RM, MD-
'6-93A
303'S
53
(15)5
-
-
SWo01
03/06/15
RM
8.1
270
.50
BRL
N/A
>1
SWO02
03/0611S
RM
7.3
BRL
.10
BRL
N/A
>1
SWO03
03/06/15
No Flow
` if wastewater systems have not discharged in this quarter —report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3.If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that.parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters., and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
errs
r�
r"
C7
�7

-6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "ISO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD51N CASE OF 'NO FLOW". TO:
-Division of Water -Quality
Attn: DWQ Central' =ales
1617'Mall Service Center
Raleigh., North Carolina 27699-1617
[phone]
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-persoo directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I ark Aware tqat tt, ere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ature of Permittee)
Permit Date; 7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

�• PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON -COLLECTING SAMPLES. Rik Jones �—
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Requirements
SAMPLE COLLECTION YEAR: 2014
_RE.EIV EDSAMPLE QUARTER: ❑Jut -Sept ®Oct -Dec — ❑Jan -March ❑April -June
COUNTY:-Iredell
,Hail 2 0 ZU15 PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
CENTRAL FILES DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
DWR SECTION
OPTIONAL INFO:
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)2
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT HEMS
(mg/L)
Discharge
Duration
(minutes)
Total Flaw
(gallons/day)'
-
-
RM, MD-
6-93,4
303,5
53
(15)6
-
-
01
11/23/2014
RM
7.14
BRL
BRL
N/A
N/A
>1
02
11/23/2014
RM
6.91
BRL
BRL
N/A
N/A
>1
03
11/23/2014
No Flow
` If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cieanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to Institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Proc 2, wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
_MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") 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 Fifes
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 quali1;9.4&afgnIf
personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dily res slble for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awarA that lcant penalties for submitting false Information, Including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 7/1/2010-06/30/2015
I !( I
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
rti GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec []Jan -March []April -June
COUNTY: Iredeil
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA []Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr]
Type of Wastewater
(VE, RM, MD)2
pH
(standard)
Total Suspended
Solids
(mg/L}
Settleable
Solids
(mL/L}
TPH usingDischarge
method 1664A
SGT-HEM6
(mg/L)
Duration
(minutes}
Total Flow
(gallons/day)'
-
-
RM, MD-
6-93.4
303,s
53
(ls)6
-
-
01
11/23/2014
RM
7.14
BRL
BRL
N/A
N/A
>1
02
11/23/2014
RM
6.91
BRL
BRL
N/A
N/A
>1
03
11/23/2014
No Flow
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate care measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE 11311
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
[phone]
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 clualifi personnel properly gather and evaluate the Information submitted. Based on my inquiry of the person or persons who manage the system, or
those pers.ns dir tly res sible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awar6.tha�j gnlficant penalties for submitting false information, including the possibility of flues and imprisonment for knowing violations."
(SignaturVof Permittee)
Permit Date: 7/1/2010-06/30/2015
I fr t
(Date)
Last Revised 07/13/11
Page 2 of 2

S
4
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
CERTIFICATE OF COVERAGE N0. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
GENERAL PERMIT NO. NCG140000
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: ®Jul -Sept []Oct -Dec ❑Jan -March ❑April -June
COUNTY: Iredell
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
(VERMMD)
, ,
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
S
g/L)
(mg/L)
Duration
[minutes]
Total Flow
7
[gallons/day)
-
-
RM, MD-
6-93.4
303.5
53
(15)6
-
-
01
7/21/2014
No Flow
02
7/21/2014
No Flow
03
7/21/2014
No Flow
_U1�
CO�ENTPA
WR S
If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing arum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
" pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2

E
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. How limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 026 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality T
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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
assure that qualified ersonnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dire I res sable for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awgrglhat tt a ignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 7/1/2010-06/30/2015
?l -9,// Y
( Date)
Last Revised 07/13/11
Page 2 of 2

i
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140208
FACILITY NAME: Statesville
PERSON COLLECTING SAMPLES: Rik Jones
CERTIFIED LABORATORY: Prism Lab # 402
LIMIT VIOLATIONS? YES [:]NO
Part A: Wastewater Monitorine Reouirements
SAMPLE COLLECTION YEAR: 2014
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: Iredell
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW
OPTIONAL INFO:
❑PNA []Trout ®Other
Outfall No.
Date Sample
i
Collected
(mm/dd/yr)
Type of Wastewater
Z
(VE, RM, MD)
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
S (mg/LGT-HEM'
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
RM, MD-
6-93,4
303'5
53
(15)6
-
-
01
5/15/2014
No Flow
02
5/15/2014
No Flow
03
5/15/2014
No Flow
boo I
1 l 18
2014
r-ai CC
If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE-) WITHIN 30 DAYS OF RECEIPT OF SAMPLE L0R
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
[phone]
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
assure that quali ed personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those per ns di ctly r ponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am awa that„ ere significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 7/1/2010-06/30/2015
?hI(I
(Date)
Last Revised 07/13/11
Page 2 of 2