NCG140216_MONITORING INFO_20190125

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv U& yDal
DOC TYPE
❑HISTORICAL FILE
tZ MONITORING REPORTS
DOC DATE
❑ r) Le) O f a 5
YYYYMMDD

Ze
Environmental
Quality
Stormwrater Discharge Outfall (SDO)
Qualitative ]Monitoring Report
Forguidance on filling out this form, please visit ht s://de .nc. ov/about/divisions/ener -mineral-land-
resources/ener -mineral-land- ermits/stormwater- ermits/n des-industrial-sw#tab4
Permit No.: NICI_I_I_I_I_rrI_I_I or Certificate of Coverage No.: N/C/G/ / 1 y/a
Facility Name: 31 d a 151,
County: W a r Phone No. ^ q I q 5,s' 4 as ?
Inspector: OJ
Date of Inspection:
-zs-—l8
Time of Inspection: Q,v( REGEIv 1-l-'
,BAN t 5 2019
Total Event Precipitation (inches):
.so
z
CENTRAL1=1
C,\NR SECT10i 1
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description: JJ
Outfall No. _ I Structure (pipe, ditch, etc.): c3+ ��-
Receiving Stream:
Describe the industrial activities that occur within the Loutfall drainage area:
C0 vt C" G!� IL- r r 9 A ,1 c.T 1'111\
Pagel of 2

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 4eo w ­4
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): ty e N c
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 C2) 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 Q 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
(J 2 3 4 5
7. Is there any foam in the stormwater discharge? O Yes ® No.
8. Is there an oil sheen in the stormwater discharge? OYes ® No.
9. Is there evidence of erosion or deposition at the outfall? o Yes 4D No.
to. Other Obvious Indicators of Stormwater Pollution:
List and describe N o N r-
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NOr. NCG14 d A f G
4 FACILITY NAME: C . �. a) v d
PERSON COLLECTING SAMPLES IP. a f +t
CERTIFIED LABORATORY A., lab # 5 i
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: zo I
SAMPLING PERIOD: ❑ July -December January -June
COUNTY Q., (( c�
PHONE NO. ( 4tI ) SS`f -
ADD TO LISTSERVE? [-]YES [eft EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
No FLOW)1
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall°
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months inTier
2 Sampling
-
6-92
100 '
-
-
-
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, 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 Z
Date of last pH meter calibration: / 11 Z- /-Z 19

({t
1
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outtall
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
Rainfall °
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(v/n)
# of Months
in Tier 2
Sampling2
6-9
15
1002,1
-
-
-
U
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE5 AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO [►��
REGIONAL OFFICE CONTACT NAME:
Mail Oriainal and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitorigperiod
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED,
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
e � % 2_ zolK
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

r
TABLE 9.2
ANALYTICAL MONITORING REQUIREMENTS -PROCESS WASTEWATER
READY MIXED CONCRETE COMPANY- PLANT #
DISCHARGE
UNITS-
EFFLUENT
SAMPLE
SAMPLING
CHARACTERISTIC
LIMITATIONS
LOCATION
SCHEDULE
pH
Standard
6.0 — 9.0'
Each Outfal12 .
Quarterly
Total Suspended Solids (TSS)
mg/L
30 mg/L3
Each Outfa112
Quarterly
Settleable Solids
mUL
5 mUL
Each Outfail2
Quarterly
Total Petroleum Hydrocarbons°,
mg/L
15 mg/L
Each OutfaJI2
Quarterly
Event Duration
Minutes
Not applicable
Each Outfa112
Quarterly
Flows
Gallons/Day
Not applicable
Each Outfal12
Quarterly
New Motor Oil Usage
Gallons/ Month
Not applicable
Not applicable
Quarterly
Total Volume of Wastewater
'Discharged (HQW)
Not applicable
50% of summer
7Q10 Flow
Not Applicable
Quarterly
Notes:
1. pH range for saltwaters is 6.8 — 8.5.
2. Samples shall be collected at each process wastewater outfall during a discharge event.
3. TSS effluent limitation HQW is 20 mg/L and 10 mg/L for Trout or PNA waters.
4. Only required for sites where vehicle maintenance activities occur and process wastewater
commingles with stormwater_
5. Flow may be measured continuously or calculated.
6. See 15A NCAC 02B .0224 and general permit for explanation.
7. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of
discharge from a process wastewater outfall.
8. If no discharge occurs during a sampling period, record "No Flow" or "No Discharge" within 30-days
of the end of the sampling period and file with SPPP.
9. Commingled discharges must be collected during a measurable storm event. A measurable storm
event is an event that results in an actual discharge from the permitted site outfails. The previous
measurable storm event must have been at least 72 hours prior.
10. For each sampled measurable storm event the total precipitation must be recorded using an on -site
rain gauge.
11. The permittee shall complete the analytical samplings in accordance with the schedule specified
above, unless adverse weather conditions prevent sample collection. Inability to sample due to
adverse weather conditions must.be documented in the SPPP and reported on the appropriate DMR
form (Appendix A).
12. For commingled discharges, a minimum of 60 days must separate each monitoring event unless
monthly monitoring has been instituted under a Tier Two response
13. The permittee shall compare monitoring results to the above -referenced effluent limitations for each
discharge characteristic. Exceedances of effluent limitations will result in a violation of permit
conditions and may be subject to enforcement.
14. Failure to monitor process wastewater quarterly per permit terms immediately institutes monthly
monitoring for all parameters. After six months of monthly monitoring, the permitee may make a
request in writing to the Division of Water Quality to return to a quarterly monitoring schedule.

(�IaneAnafytical"
WW..peoelab$.=n
April 30, 2018
Jay Watkins
Ready Mix Concrete
3610 Bush Street
Raleigh, NC 27609
RE: Project: Plant 31 Capital Blvd
Pace Project No.: 92382337
Dear Jay Watkins:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 400
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on April 25, 2018. The
results relate only to the samples included in this report. Results reported herein conform to the most
current, applicable TNUNELAC standards and the laboratory's Quality Assurance Manual, where
applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 10

aceAnalytical 410
W*wPacelabs.carn
Project: Plant 31 Capital Blvd
Pace Project No.: 92382337
Eden Certification IDs
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
CERTIFICATIONS
North Carolina Wastewater Certification #: 633
Virginia/VELAP Certification #: 460025
REPORT OF LABORATORY ANALYSIS
This report shah not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC,
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 2 of 10

aceAnalytical
wwwpecelabs.wm
SAMPLE ANALYTE COUNT
Project: Plant 31 Capital Blvd
Pace Project No.: 92382337
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
92382337001 Outfall #1 Plant 31 SM 2540D RAY 1 PASI-E
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 3 of 10

Pace Analytical Services, LLC
aceAnalytical 9800 Kincey Ave. Suite 100
Huntersville, NG 28078
wwwpacelabs.wm
[phone]
ANALYTICAL RESULTS
Project: Plant 31 Capital Blvd
Pace Project No.: 92382337
Sample: Outfall #1 Plant 31 Lab lD: 92382337001 Collected: 04/25/18 09:05 Received: 04/25/18 16:20 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 3.6 mglL 2,5 1 - 04/27/18 11:32
Date: 04/30/2018 02:13 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 4 of 10

aceAnalytical
www.p"iabs.com
QUALITY CONTROL DATA
Project: Plant 31 Capital Blvd
Pace Project No.: 92382337
QC Batch: 408249 Analysis Method: SM 2540D
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92382337001
METHOD BLANK: 2265174 Matrix: Water
Associated Lab Samples: 92382337001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mglL NO 2.5 04/27/16 11:28
LABORATORY CONTROL SAMPLE:
2265175
Spike
Parameter
Units
Conc.
Total Suspended Solids
mg1L
250
SAMPLE DUPLICATE: 2265176
92382423002
Parameter
Units
Result
Total Suspended Solids
mg/L
26.4
LCS LCS
Result % Rec
. 228 91
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Hunlersville, NC 28078
[phone]
% Rec
Limits Qualifiers
90-110
Dup
Result RPD Qualifiers
31.4 17 D6
SAMPLE DUPLICATE: 2265177
92382426001 Dup
Parameter Units Result Result
Total Suspended Solids mglL 155 160
RPD Qualifiers
3
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 04/30/2018 02:13 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 10

aeeAnalXical
wwwpm;Wabs.eorrr
QUALIFIERS
Project: Plant 31 Capital Blvd
Pace Project No.: 92382337
DEFINITIONS
Pace Analytical Services, LLG
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit,
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL-Adjusted Method Detection Limit.
POL - Practical Quantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenyl a mine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TN -The NELAC institute.
LABORATORIES
PASI-E Pace Analytical Services - Eden
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
Date: 04/30/2018 02:13 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 10

5ac e A na ly tica /
WWW..pamabs.mm
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Plant 31 Capital Blvd
Pace Project No.: 92382337
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 26078
[phone]
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92382337001 Outfall #1 Plant 31 SM 25401) 408249
0
Date: 04/30/2018 02:13 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 7 of 10

Document Name: Document Revised: February 7, 2018
Sample Condition Upon Recelpt(SCUR) Page 1 of 2
J +/ Document No.: Issuing Authority.
F-CAR-CS-033-Rev.06 Pace Carolinas Quallty Office
Laboratory receiving samples:
Asheville ❑ Edeno Greenwood ❑ Huntersville ❑ Raleig Mechanicsville❑
Client Name: t P q 9232337
Project
Courier: ❑Fed Ex Ouk ❑USPs Client
❑ Commercial ❑Pace []Other:
Y'9238233-7 _
Custody Seal Present? ❑Yesseals Intact? ❑Yes . P t/���,�
Date/Initials Person Examining Content-. <
Packing Material: ❑Bubble Wrap ❑Bubble Bags ef7fNone ❑ Other Biological Tissue F en?
Thermome er: �r r'�' ❑Yes ❑No N/A
iR Gun ID: r�- TYPe once: t"!et ❑Blue ❑None
Cooler Temp CC): 2— b Correction Factor: Add ubtrac ('C) .
Temp should be above freezing to 6'C
Cooler Temp Corrected {'C): _ ❑Samples out oftemp criteria. Samples on Ice, cooling process
has begun
USDA Regulated soil ?I/A, water sample)
Did samples orlgi a in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internati ,
I�YPt rUn inrludlne Hawaii ar.A Puertn Aicnh l—IYPs n
Comments/Discrepancy:
Chain of Custody Present?
es
on. ON/,
1.
Samples Arrived within I-Inld Time?
s
ONO
N/A
2.
Short Hold Time Analysis (<72 hr.)?
OYes
rX
/A
3.
Rush Turn Around Time Requested?
Dyes
o
N/A
q.
SufflCient Volume?
es
Na []N/A
S.
CorrectContalners Used?
-Pace Contain ers Used?
Y
es
No ©N/A
No ❑Y/A
6.
Contalners Intact?
Yer
No ❑N/A-
7.
Dissolved analysis: Samples Field Filtered?
❑Y
Na
24.,
8.
Sample Labels Match CDC?
-Includes Oate/Time/ID/Analysis Matrbc
X.
[]NO ❑N/A
9.
Heads pace in VOA Vials (>5-6mm)?
DYes
ONO
N/A
10.
Trip Blank Present?
Trip Blank Custod Seals Present?
❑Y.
Yes
ONO
No
N/A
N/A
COMMENT5/SAMPLE DISCREPANCY
Lot ID of split containers:
CLIENT NOTWICATION/RESOLUTION
Person contacted:
DateMme:
Field Data Required? ❑Yes ❑No
Project Manager SCURF Review: V 1 7 Date: t j U'5--o
Project Manager SRF Review: (1 �i.� i Date: t',' c•}?-, '�E Ni
Page 8 of 10

Document Name: Document Revised: February 7, 2018
$C8fiF12�,,tyCB�, Sample Condition Upon Recelpt(SCUR) Page f of 2
1" Document No.: Issuing Authority:
F-CAR-CS•033-Rev,06 Pace Carolinas Quality Office
*Check mark top half of box if pH and/or dechlorinatlon is
verified and within the acceptance range for preservation
samples.
Escceptions: VOA, Coliform, TOC, Oil and Grease, DRO/9015 (water) DOC, LLHg
"Bottom half of box is to list number of bottle
Project #;WO ";'."9238-23.3_._+-
ISue Dale: 05109/18"
PM: ,AMB_;
'CLIENia'-_ 92=Ready
Ed
b
Z
u
c
rs
a
E
ae
m
—'I
v
v
c
m
a
E
9
dm
m
ayy
2
N
c
T
a
E
>
n
m
a
n
1
7
ti
to
n
a
n
a
y
E
dr
ca
ry
n
Z
UU•
m
n
E
C)
Z
m
m
eZf
m
Zas
.!
a
E
n
ry
a
m
ti
A
a
U
a
E
u
CL
m
a
C�
N
o
E
v
7*+
Y
z
m
Z
n
E
iu
¢
;�
a
f:
v
i
^
4
d
2
°
j
Oi
of
an
7
m
4
N
v
c
O
=
E
a
V
E
¢
c
a7
a
-
V
x
z
J
p
n
J.
M
t9
m7
a
Z
-Ur•
4
O
>
E
0
a
d
_
d
Z
a
A
d
O
a7
]
2
C
¢
D
E
0
Lb
=
v
Q
O
>
E
a
C)
Y
o
r
N
Oa 4
7
Z
d
A
y
Y
i
d
2
y
N
f
h
w
i
F
m
A
E
of
�+
$
z
m
n
J
o
a4
m
x
O
Z
n
E
4
E
0
l7
4
?
M
c
u
N
E
f
a
E
a
0
1
2
3
-NN\N
I
N
1111
5
N-
6
7
I
I
B
9
10
11
I
i
12
f
pH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
FiH upon reccfpt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
F Lot 9
Nate: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy at this form will be sent to the North Carolina DEHNR Cer0fication Office {f.e.
out of hold, incorrect preservative, out of temp, incorrect containers.
Page 9 of 10

0
n
0
CHAIN -OF -CUSTODY I Analytical Request Document d,
—u The Chain-ot-CusIony is a LEGAL DOCUMENT, All relevant fields must be campleled accurately.
d
Suction A $"Lion B Section C

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit ht_ps://dea.nc.yoov/about/divisions/energy-mineral-land-
resources/energy-mi neral-land-permits/stormwater-permits/npdes-industrial-sw#tab-4
Permit No.: NICI_I_I_l 1_I—I_I or Certificate of Coverage No.: N/C/G/ I yl 0l?
Facility Name: Cad Q v v d 18 �- _
County: (, i o4 k e_- - r --Phone No. q l q -53q - A4 g j
Inspector:
Date of Inspection: 16 fill I -L o t Q _
Time of Inspection: 1; o b PA4 R EC E I V E L)
�r JAN 2 5 2019
Total Event Precipitation (inches): CENTRAL. FILLS
Ersl'J aECTIO" I
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. i
Receiving Stream:
Structure (pipe, ditch, etc.):
CY , `i-c l
Describe the industrial activities that occur within the outfall drainage area:
`26a -^ T Pro dAJf-tA -
Page] of 2

0
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: k 1-$L'if' ar.sw-/t
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): o tj-e-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 V 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 V 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 3 4 5
7. Is there any foam in the stormwater discharge? Q Yes 4 No.
8. Is there an oil sheen in the stormwater discharge? QYes 0 No.
9. Is there evidence of erosion or deposition at the outfall? O Yes ! No.
to. Other Obvious Indicators of Stormwater Pollution:
List and describe /V o
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 O A I f'o
FACILITY NAME: 1-i ei
PERSON COLLECTING SAMPLES V vti . I
CERTIFIED LABORATORY Lab # _ 7�(
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: Z0 1 9
SAMPLING PERIOD: Erjuiy-December ❑ January -June
COUNTY WlIt- e-
PHONE NO. { )
ADD TO LISTSERVE? ❑YES []NO EMAIL:
DISCHARGING TO CLASS. []SA ❑HQW ❑PNA []Trout [}Other
Outfall Na.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling'
5-92
100 '
-
-
-
-
zei8
, g
�f.
40
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.
1 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 T55 benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are SO mg/I.
4 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 Date of last pH meter calibration: I,� Z�ZC i Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gat of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)'
pH
(Standard
Units)
TPH using method
1664A 5GT--HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor ail
Usage
(gal/month)
In Tier 2
Monthly
Monitoring? Mo
(y/n)
k of Months
in Tier Z
Sampling z
6-9
1s
100 '
-
-
a
i
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC S AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO [�
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one copy of this OMR (includine all "No flow" & "No Discharge" reports) within 30 days of recut of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete,
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

TABLE 9.2
ANALYTICAL MONITORING REQUIREMENTS -PROCESS WASTEWATER
READY MIXED CONCRETE COMPANY - PLANT #
DISCHARGE
EFFLUENT
SAMPLE
SAMPLING
CHARACTERISTIC
UNITS
LIMITATIONS
LOCATION
SCHEDULE
pH
Standard
6.0 — 9.0'
Each Outfa112
Quarterly
Total Suspended Solids (TSS)
mg/L
30 mg/L3
Each Outfa112
Quarterly
Settleable Solids
mUL
5 mL/L
Each Outfai12
Quarterly
Total Petroleum Hydrocarbons4
mg/L
15 mg/L
Each Outfal12
Quarterly
Event Duration
Minutes
Not applicable
Each Outfa112
Quarterly
Flows
Gallons/Day
Not applicable
Each Outfa112
Quarterly
New Motor Oil Usage
Gallons/ Month
Not applicable
Not applicable
Quarterly
Total Volume of Wastewater
Not applicable
50% of summer
Not Applicable
Quarterly
Discharged (HOW)
7010 Flow
Notes:
1. pH range for saitwaters is 6.8 — 8.5.
2. Samples shall be collected at each process wastewater outfall during a discharge event.
3. TSS effluent limitation HQW is 20 mg/L and 10 mg/L for Trout or PNA waters.
4. Only required for sites where vehicle maintenance activities occur and process wastewater
commingles with stormwater.
5. Flow may be measured continuously or calculated.
6. See 15A NCAC 02B .0224 and general permit for explanation.
7. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of
discharge from a process wastewater outfall.
8. If no discharge occurs during a sampling period, record "No Flow" or "No Discharge" within 30-days
of the end of the sampling period and file with SPPP.
9. Commingled discharges must be collected during a measurable storm event. A measurable storm
event is an event that results in an actual discharge from the permitted site outfalls. The previous
measurable storm event must have been at least 72 hours prior.
10. For each sampled measurable storm event the total precipitation must be recorded using an on -site
rain gauge.
11. The permittee shall complete the analytical samplings in accordance with the schedule specified
above, unless adverse weather conditions prevent sample collection. Inability to sample due to
adverse weather conditions must be documented in the SPPP and reported on the appropriate DMR
form (Appendix A).
12. For commingled discharges, a minimum of 60 days must separate each monitoring event unless
monthly monitoring has been instituted under a Tier Two response
13. The permittee shall compare monitoring results to the above -referenced effluent limitations for each
discharge characteristic. Exceedances of effluent limitations will result in a violation of permit
conditions and may be subject to enforcement.
14. Failure to monitor process wastewater quarterly per permit terms immediately institutes monthly
monitoring for all parameters. After six months of monthly monitoring, the permitee may make a
request in writing to the Division of Water Quality to return to a quarterly monitoring schedule.

aceAnalytical
www.pacelabs.com
9800 Kinsey Ave. Suite 100
Nuntersville, NC 28078
[phone]
October 19, 2018
Jay Watkins
Ready Mix Concrete
3610 Bush Street
Raleigh, NC 27609
RE: Project: Capital Blvd Plant 31
Pace Project No.: 92403358
Dear Jay Watkins:
Enclosed are the analytical results for sample(s) received by the laboratory on October 12, 2018.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
0 Q0— q1') , +UlI
Angela Baioni
[e-mail]
[phone]
i
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 10

1,,'AlGeAnalytical 9800 Kincey Ave. Suite 100
Huntersville, r 28078
wmv.pacelabs.cam
[phone]
CERTIFICATIONS
Project: Capital Blvd Plant 31
Pace Project No.: 92403358
Eden Certification IDs
205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Wastewater Certification #: 633
North Carolina Drinking Water Certification #: 37738 Virginia/VELAP Certification #: 460025
REPORT OF LABORATORY ANALYSIS
This report shall not he reproduced, except in full,
without the written consent of Pace Analyticai Services, LLC, Page 2 of 10

/7P`a1ceAna1XicaJ
www.pamlabs.cnm
9800 Kinsey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project: Capital Blvd Plant 31
Pace Project No.: 92403358
Analyses
Lab ID Sample 10 Method Analysts Reported Laboratory
92403358001 Plant3l Capital Blvd Outfall 1 SM 254OD-2011 SOB 1 PASt-E
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 3 of 10

7.,Palcce Analytical
� ~rwrw.pacelabs.cam
9800 Kincey Ave. Suite'i00
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: Capital Blvd Plant 31
Pace Project No.: 92403358
Sample: Plant3l Capital Blvd Lab ID: 92403358001 Callected: 10/11/18 13:00 Received: 10/12/18 16:06 Matrix: Water
Outfall 1
Parameters Results Units Report Limit ' DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D-2011
Total Suspended Solids 4.6 mg/L 2.5 1 10/15/18 13:27
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 10/19/2018 08:43 AM without the written consent of Pace Analytical Services, LLC.
Page 4 of 10

�lRalceAnalytical
,yvw� pscelebs. can
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: Capital Blvd Plant 31
Pace Project No.: 92403358
QC Batch: 436237 Analysis Method: SM 254OD-2011
QC Batch Method: SM 254OD-2011 Analysis Description: 2540E) Total Suspended Solids
Associated Lab Samples: 92403358001
METHOD BLANK: 2400381 Matrix: Water
Associated Lab Samples: 92403358001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mglL NO 2.5 10/15/18 13:15
LABORATORY CONTROL SAMPLE: 2400382
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Total Suspended Solids mglL 250 242 97 90-110
SAMPLE DUPLICATE: 2400383
92403352001
Dup
Parameter
Units
Result
Result RPD Qualifiers
Total Suspended Solids
mglL
5.6
6.7 18 D6
SAMPLE DUPLICATE: 2400384
92403353001
Dup
Parameter
Units
Result
Result RPD Qualifiers
Total Suspended Solids
mg1L
ND
NO
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 10/19/2018 08.43 AM without the written consent of Pace Analytical Services, LLC. Page 5 of 10

117ceAnalytfcal 9800 Kincey Ave. Suite 100
kuntersville, NC 28078
wm+:Paceldbs.tcvrt
i [phone]
QUALIFIERS
Project: Capital Blvd Plant 31
Pace Project No.: 92403358
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI -The NELAC Institute.
LABORATORIES
PASI-E Pace Analytical Services - Eden
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 10/19/2018 08:43 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 10

/'PaceAnalytical
www,pacelabs.c=
i
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project; Capital Blvd Plant 31
Pace Project No.: 92403358
Lab ID Sample ID QC Batch Method QC Batch Analytical Method
92403358001 Plant3l Capital Blvd Clutfall 1 SM 254OD-2011 436237
REPORT OF LABORATORY ANALYSIS
Analytical
Batch
This report shall not be reproduced, except in full.
Date: 10/19/2018 08:43 AM without the written consent of Pace Analytical Services, LLC. Page 7 of 10

Uucurllt:nt Name:
WC11111rr.t Rovlw j; February 7, :v'1B
Sample Cwldidan Upon Aaceipt(SCuft) '
_ Page 1 of 2
keAnal�Cat^
Jucurneni No,: —7
�F
Issiling Authority:
CAR CS 033-Aev,O&
Pace CaroVilas Quality off;a:
Laboratory receiving samples:
Asheville Edeno Greenwood ❑ iluntersville lwloi!1l� j (v!eEhJrIiCSv(Ile(J
. = i iY;r~Yrllf�r ' Client N. iW 92403353
ks:• .: �;a:
Courler: �F'd Ex ❑UPS ❑USPS jClicnt �� III II I� �I
❑Commercial ❑Pace ❑other:_ L 92403358
Custody Seal Present? ❑ A.
silo Seats intact? ❑yr:5 Iy �/� 0 _
� � _f d]1CItI1111J1s PdrSJn Ex �Inll+iug Cu,itents: / Qf���/�
FiJ
Packing Material: ❑Bubble Wrap ❑Bubble flags Otllone ❑ Other Blulorical TissutFroten?
Thcrmom e : i7 un l D: / _ ❑Yes ❑Tin �f
j ltl d 0.� Type ur Ice: NleE ❑W- QNol+e
Cooler Teinp ('C): a-- Carrectiors Facto ,9
Adt ubtrac: j`CJ d _
1) Temp should be aLcvL: freez;n;; to G`C
Cooler Temp Corrected ('Cl: i. _ [ISa+aslls act c1i :a ou 1:1: szia. S;.rl:::!es ,+i_, i.::ilfg pre:cs
^as bLu.o
USDA Regulated Soil (Ft NIA, watar sample)
Did samples oriq` ate in a g arandrl, tone Within the Unhed St_tes: CA, NY, or SC icheck main)? old saalples t:04ir:aw iron) a fureign source {inwmm:nn lly�,
Myes r7CiYa usc!udiue Itawail and Paerta Wcol? nyes r1 a
-------
_—
_ Comments/Discrep-ancy:
Chain of Custody Present?
Samples Arrived within Hold Tlme?
�s— El NO CIN/A
2. — -
'-
Short Hold Time Analysis (472 hr.)?
Rush Turn Ae round Time Requested?
Yes ;o �N/n
❑yet fl jJiih�
4,
-- --- --- -
-
S+rfficicrt y'o}unt_? -
_ es nrlo ttJa
S.
-
corru-t Camaeflel S USE;i?
YYY , 1
u,
-Pace C01113ifle.rs Ui,eLl
F©flo
7. _ --
Container Intact? _ , ��]4cs :Jo - LIMA
Dissoivcd analysis: Samples Field filtered?
Sample Labels Match COC?
-tyres C14u ©N/a
9,
i
-Includes pate/Tltne/]D/Analysis htatriz;
�,_ _,
1
i
HeadspaceInVOAVraIsf>5.5MIn)?
©Yes ❑No N/A
_ _
10.
Trip Blank Plasent? -
QYes 1-34V INIA
11.
Trip 6};1;;%: Cu.cl„dV Sells Plescnt?
i
COMA MN rS/SA` I'LF DIS01F.PANCY
CLIENT NOTIF10,T10N/RESOLUTION
Person Contacted:
Project Nlarrager 5CURF Revlrrly:
Project NI:rnarer SRF Revievr:
Date/Time:
CIP
-- - - - -
t
ricldoataR:yv;rid7 IjYC: Elmo
tw ID of split rorltainer-a:
Data:
Dates --
Page 8 of 10

. �PaceAnal iCal'
Document Narne: - DccClnent Revised:�—
�nrpie Condition Upon Recelpt(SCUI{) I i of 2 —_
Document No.: lssuing Authority:
f•CAR-CS-033-Rev.06 Pace Carelirtas Quality Office
*Check marls tap half of box if pH and/or dechlorination Is
verified and within the acceptance range for preservation
Samples,
Exceptions: VOA, cD forrn,'rOC, Olt and Grease, UktO/8015 (walao DOC, LLIIU
*'Bottom half of box is to list nuinber of bottle
Project h I wog . 924033 o
PM: AMD Due Date: 10/26/18
CLIENT: 92—Ready Mix
F
_ pl-I Adjustinerlt Log for Preserved Samples
Sample lD Type of Preservative pH upon raceipt Uat� preservation adjusteJ Tine preservation } Amount utplCSelv�t':�0 ice II
��^ adjusted I adticd i
� f
Nate: V,'l:ecr:ver there is a discrepancy affecting f crm, Curo!tna rnplas, a copy of this fa: n; refill he sect t:::110 Af1,:t urc ,r : jli:zv i;'O-
Out al hclo, ia.:rrect p(nsenVat;vc. a.:t cf tep1l), incurcc�ct soraainers.
Page 9 of 10

F
CHAIN -OF -CUSTODY 1 Analytical Request Document
.... •,� The Chsiz-at-Custoay i D L-ii,L DOCUMENT. All rclevan; f9ePds musl 5^ cnmplesed asa,ila;'
ly.
Serlion A
j•lc:ion $ Sectian C
Rcgoi,�li
;;36:a: ...... _ c:vP'jvct infu:lnnian: Invnicr to m—miow
1 C.is 1
{Cc�s:::+r.4'• I itOaSy �1,. Crsrr,:.:: :rcrt i s JAY L Ya'crn:
f;�r::.:. I 'r.fif <Srr. St: c.•t �� t':'•r 7�;> a. �� �,3 ��. c-+j....—:CJ. �,:h-'��Cnrro�<<r.:
---•-t.-_.-.. __.--
� ^:n;:crt -
---'--'---
AC:k�•ar: �. _` _.». «..
R.•ryaf:nnn A—Cv'.•.
I[�a -ti �h hll: :ltiiC
1 I ! e.,:r.:'•a Cr:fr;r rt. ��,......_..�....._
�:rcd Q�o�;:
'' •n:. !.q C�_7?�} r p:a p. : ai-_. S.trr.=a:_r. Cc^r+ilk a�
',~�a,_ -l—'ax
P��?[ob;c:'lv�.rl:r. :as',�n:,LTs,rc �+:r
_. Sl..,f: fisiatinn.,r, _
i+rar�•�.y---•--- �
.Ir,
:y n�; n::iu - : C. �)�T vlr�--9 y �
Request
SAMPLE ID �
V
a
�TFeZI END
0a,
rt
Qng ChAra;te r. per boL Y'r
,a
,cl
u•
u
i
rl
.'rai:
�i
1 C
lAy 0.9 r I
u0
,,.•
j Srmpic Ws rws. be uniqua 71— -.s
w
c.r
`p
v
O
V
!E
�
r
�
�
�
O
�
c�
�
�
C •
i
f/��
'DAF;:
71N'Z
f1AT=
TI': �,
JoLU
.id
II}
1i
!�
47
L
d7
..12:?.
•i
- - ;OwlQNAL CO"PlYTSREUNgUISHtUBYIAJFRUATIaN
71
ATE .�
-. ZtM2
ACCEi'ZO gyr6P=lWF30u
. ... .
OATF,��'-
;t,
.SAMPLE CONDMONS
.
f�%t�`'� I?acre
so1i►�S
1inOco.
+....I..Y
{
I
SAMPLER 1:A.'.4E ANJ SICNATUR£ f ' • ...; • . - ..
PRI14 r -,m� of SAM PLEB:
r
?
_
• _
SIGNATURE of SAt:1 PLER: -- i 4AT' Si3neN:
h
a M
�•
ci e

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. NCG14 0 �Z— I (or
FACILITY NAME: twf ; l 7 1,/
PERSON COLLECTING SAMPLES vttial _ 5 t"
CERTIFIED LABORATORY P bc— Lab
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: Z0I � 1
SAMPLING PERIOD: pluly-December ❑ January -June
COUNTY
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)
TSS
(mg/L(
Event
Duration
(minutes)
Total `
Rainfall
(ml
In 71er 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling,
-
-
6-9
100 2,3
CFt
ITA F r
[MR
S n A
i
t If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each autfali here. Please make sure to mark the Sample period above.
r 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.
' T55 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 1 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 Tler 2 Monthly
Monitoring?
(yjn)
# of Months
in Tier 2
Sampling;
6-9
15
100 ,
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OLJTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Maii Orieinal and one conv of this DMR fincludine all "No Flow" & "No Discharae" reports) within 30 days of receipt of samole 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 CERTIFIG4 TION FQR ANY INF RMATI N 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 property gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date}
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

S77M
MCDEW R
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Porguidance onfilling out this form, please visit, http•llportal.ncde&r.Qre/we wy f w5isu/nFdeaw#tab-4
Permit No.: �/�/�/_/ _/,/�/_/_/ or Certificate of Coverage No.: W.C1;JQ—qjb-&Jj /
Facility Name: ' }7lWr ZZ
County: hi k
Inspector, boy
Date of Inspection:
Time of Inspection
1Z
1Q, 25 AY
Total Event Precipitation (inches): I V
Phone No. 514`554- Zagr7
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See i formation below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a 'representative storm
event" or "measureahle storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
or Designee)
Pagel of 2
SwU-242, Last modified lo/2S/2012

1. Outfall Description:
Outfall No. Structure Cpip itch, c.)
Receiving Stream:
Describe_Lhe industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc,): _ .--_W Wr_ —
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
6) 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
(j7 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
b 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes No
9. 1s there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be Indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

p
w
O
O
CHAIN -OF -CUSTODY! Analytical Request Document Co
The Chain -of -Custody Is a LEGAL DOCUMENT -AN relevant fields must to completed accumieiy. M
a
Sa';6m A Section B Section C r .... I
P-44W 4 Cuax tn$o Iion: i Rnqu"d Pfaloct Infon neo. tmra:co Wcrr udon: Paae : } of ,
Aeadv Mel C.an'vata Report Tw.. Ja vi jwu I nacre]670Bush8
Copy To: Compa y 11[a.aaC
Mi0
rocs.,.A✓*4
Fg.,
PwcAsse Order*:
race DucePawCown
Oue pau:
Prp Oti N:
J 1 t
race rrollro N.
NC
1
-
ftequeaetl
Anat
is
F"Ilewoa
JN
-
I
t.
•
i r.Tnu eves
?
Q
caurcl=
=
Preservatives
Y
omromm. ow
3
u
8
:?
wwlv.. w.a. ww
SAMRLE ID CL
Cbw"o
START
END
a+�
.Ono per cox. vwrr vrn
�
P
F.!,.
QMQ.
fr°
TIME
DATE
TIME
�,��
a:: ,:�'
-;, � •i ` Ply 3 �
�,
�
;�- �
Z�
f
�
�
7.-
T-
=12
'-4'^ �%;}. i=;�wK - tip,: -���,��_ LL_"� _
'.r;; S'.' J�I1OfI1C/iAL"1�111lF1r6' �; +7�' STf Ii`FQ.IA7ION-/.�-1
p;.I�-
:,a}..v� s;
,icy.
.R,4.
,:�
..1�•
�710FF•.
•t�J.. .. -.�..
v- TIlIE,
..t ^.mow
w.L'3J111a�y`�f.C;Of�ffMai:i..
-_C-_
..ram. .<
:1• .!�JiY.. "�.! .Y, -f :'"Sy�{l:L:
-
.�.•taa
Y! w}r-�
:>F
{
v�-•
::Y
wi :�-
.:OW7tR2:
- .?:
;'tv4J't. �
.� 1..} �:. .
-�1:-..+� !I
J
Z,
I
4
t
stwaLsx,(L ari�aluo'stcr+Aiuiie
PRWTN4vw of SAMPLER:
s
o
w
SIGNAURE of SAMPLER: QATE S19ma;

_lCeAnaliftal"
amw:pacafeba.corn
December 27, 2017
Jay Watkins
Ready Mix Concrete
3610 Bush Street
Raleigh, NC 27609
RE: Project: Plant 31 Capital Blvd
Pace Project No.: 92368001
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Dear Jay Watkins:
Enclosed are the analytical results for sample(s) received by the laboratory on December 21, 2017.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
cq
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
J.9
REPORT OF LABORATORY ANALYSIS
Thls repast sha8 not be reproduced, except in full,
without the wrkfen consent of Pace Analytical Services, LLC.
Page 1 of 10

_ aceAmliftal
wwrcpa�bacom
!
Project: Plant 31 Capital Blvd
Pace Project No.: 92368001
Pace Analytical Services, LLC
9800 KlnceyAve. Suits ioo
Huniersvllle. NC 28078
(704)M-W92
Eden Certification IDs
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
CERTIFICATIONS
North Carolina Wastewater Certification #: 633
VrginialVELAP Certification #: 46DD25
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 10

ceAnalytrcal.
- %wMcpicelebsoom
Project: Plant 31 Capital Blvd
Pace Project No.: 92369001
Lab ID Sample ID
92368001001 Outfall 91 Plant 31
SAMPLE ANALYTE COUNT
Method Analysts
SM 2540D NMH
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In hAl,
without the written Consent of Pace Analytical Services, LLC.
Po" Anaiydeal Services, LLC
9800 Kfncey Ave. Suits 100
Huntersville, NC 28078
Q04)875.9092
Analytes
Reported Laboratory
PASI-E
Page 3 of 10

ceAnalytical a
.cam
ANALYTICAL RESULTS
Pace Analytical t»rvicea, LLC
9800 KlnceyAve. Suite 100
Huntersville, NC 28078
[phone]
Project: Plant 31 Capital Blvd
Pace Project No.: 9236BOD1
Sample: Outfall #1 Plant 31 Lab ID: 92368001001 Collected: 12120/17 14:30 Received: 12/21/17 14:45 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed GAS No. 4uat
25400 Total Suspended Solids
Total Suspended Solids
Data: 12127/2017 09:32 AM
Analytical Method: SM 2540D
9.9 mglL 2.9 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
without the written consent of Pats Analytical Services, LLC.
12122/1714:24
Page 4 of 10

ceAnalyt�cal
www 6=kbe.Iwn
QUALITY CONTROL DATA
Project: Plant 31 Capital Blvd
Pace Project No.: 92368001
QC Batch: 392160 Analysis Method: SM 2540D
QC Batch Method, SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92368001001
METHOD BLANK: 2175740 Matrix: Water
Associated Lab Samples: 92368001001
Blank Reporting
Parameter Units Result Limit Analyzed Quallfiers
Total Suspended Solids mg1L ND 2.5 12122117 14:10
Pace Analytical Services, LLC
9800 KlnceyAve. Suite 100
Huntersvilte, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 2175741
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Total Suspended Solids mglL 250 256 102 9D-110
SAMPLE DUPLICATE: 2175742
923676650DI Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mglL 22.6 31.4 33 D6
SAMPLE DUPLICATE: 2175743
9236BOD4001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg1L 65.2 67.7 4
Results presented on this page are In the units Vrdicalad by the'Unt4" column ucept whate an altemete unit is presented to the rlgM of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/27/2017 09:32 AM without the written consent of Pace Analytical Services, LLC.
Page 5 of 10

Pace Analytical Services, LLC
acem1alytical s OM Kinney Ave. Sulfa
HuMersville, NC 28076
arVW.P aooun (704)675-M2
QUALIFIERS
Project Plant 31 Capital Blvd
Pace Project No.: 92368001
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL - Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each anaiyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis ofAcrolein and Acrylonitfile by EPA
Method 0260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PASI-E Pace Analytical Services - Eden
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in U.
Date: 12/27/2017 0g:32 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 10

ceAnalytical
wrrw.p=Pkbasom
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project Plant 31 Capital Blvd
Pace Project No.: 92368001
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
(7041875-9092
Lab ID Sample ID - QC Batch Method QC Batch Analytical Method
92368001001 Outfall 01 Plant 31 SM 2540D 392160
Date: 12/2712017 139:32 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproducecl, except In full,
without the written consent of Pace Analydtal Services, LLC.
Analytical
Batch
Page 7 of 10

Ate' s Fii:F2"r}i✓r;,+..''-.:., f..
D66merit'1436et - - = '0olurrrent Revised: July 25, 2027
Sample CondEt[ori'tj onlReeel SJSLURJI�.'J{! 3•'.--�r: Pa e ] of 1
! 8C�ARlCal' DacumenttJd:s1 "'` ISiuingAuthorlty:
J
F CAR-05 033aiev.03 ::e�Yy I Pace Quality Office
r —1 dbordtoyf lecefvin&-samples
--Greenwoad ---- — -. r,,•� , -
0-- — Hurite�s iE18i � 'Raleigh Mechanlcsville0•-•• -
- '
Client Name: `F W0 9236800 1
Upon Receipt..
Project q: -
l Commercial ❑Pace Uusps Went
UPS ❑Other:_
❑
�
Custody Sea! Present? ❑Yes &lo Seats Intact? ❑yes I 923661
Date/Inldals Person Examining Contents -
Packing Material: ❑Bubble Wrap ❑bubble Bags 21
ne ❑ Other Biological Tissue Frozen?
Thermometer: []Yes []No TA
❑ IR Gun ID: �� 2 ` wet ❑Blue ❑None
Typo of Ice:
.,_.-..�,..Ar- -��.— .,__._...-----. �__ ..----.—.----�'�•----.-•--.�Sasnples.aut�ltemp�[Leda.Samt�les.onhr.coo➢ni ProSee�{___..._....._ „_
Cf at•trw} has begun
USDA Regulated Sol] A, water sample}
Did samples or' nate I varantlne zone vAthln the United States: CA, NY, of SC (check maps)? old sasrples originate raun a foreign source lint r Zonally,
❑Yes InducitcHawallandPuertoRico)?❑Yes No
Ccunments/Discrepancr
Chain of Custody Present?
Ye
No
©N/A
1.
Samples Arrived withialloldTime?
Yes
No
/A
2.
Short hold Time Anal s e72 hr.)?
Elyes
❑N/A
3.
Rush Turn Around Time Requested?
OV.
Na
N/A
A.
Sufflcieet Volume?
es
[:IN.
❑N/A
S.
Correct Containers Used?
.-Pace Contalners Used?
n
Ow
No
❑N/A
NA
6.
Containers Intact?
Yes
❑No
❑N/
7.
Dissolved analysis: Samples Field Filtered?
Yes
ONO
N/A
a.
Sample labels Match CRC?
-Includes Date/Time/ID/Anal Is Matrix:
Yes ❑No
❑N/A
9.
Headspme In VOA Vialsfs-" r ro?
QYu
Of
N/A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
©Yes
Yes
❑No
❑No
JN/A
N/A
22.
C11ENTNDTIFICATION/RESOLLIFTI N
Person Contacted:
Comments/Sample Discrepancy:
Project Manager SCURF Review:
Date/Time:
Date:
Field Data Required? LEYes ❑No
Project Manager SRF Review, T n 3-j Date: q
No(e; whenever there Is a discrepancy affecting North Carolina compliance samples, a copy ofthls form w1R be sent to the North Caroline DEkNR Certification Office lie.
Out of hold, Incorrect preservative, out of temp, Incorrect containers)
•i
r
Page H,of 10

*Check mark top half of box if gltall � Mo
------ verified -and -within -the acceptame-renge-ior---
preservation samples.
` "Bottom half of box is to list number of bottles
ig
n6f e` y�.�n�ntReylsed:Jylyr25,2017
•,,� is.
n:liAan:ii;hipr SCUfi.{� �':•` - Pate 2bf 2'
iiltenk'�ipi �� .'"''�`��'� r•. ^ >' --�S171rig Authority:
5-439 Re"v.43:r; as ti�a Pace Quality office
W0# : 923fi30®1
PH: AND Due Date: 01/08/18
CLIENT: 92—Reedy Mix
Y
p
R
a
�
pp
f0
l
3
—S
�S
N
�s
4
\
5
6
7
9
4
10
\
\
11
\�]\
12
\
\
pH Adjustment
Log for ke' served Samples
Sample ID
Type of Preservative
pH upon receipt
Date preseivatioA adjusted
Time Pieserwtlarl
adjusted.
Amount of Preservative
added
Lot a
Page 9 of 10

ALT-19;AWF MAY p 4 2.11,
NCDEHR pvvR SECTION
Stormwater Discharge Outtall (SDO)
Qualitative Monitoring Report
For cquidnnce 6nfi lin� out this form, please visit: r1 dear. r wei lr tiv t r .
Permit N,o.:1_I—I_/ or Certificate of Coverage No.: N/C/G/ "11_1/ 4l?11/ �1
Facility Name: C I B I Ud f Iay1f 3 i
County: W Av< Phone No, 41 �i' 654—ZDWY
Inspector: Odmad d S+ad tl
Date of Inspection:
Tinie of l6spection: I :Do MrW+
Total Event Precipitation (inches); -4 WL
Was.this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below,)
[? r?s ❑ No
Please verify whether Qualitative Noiiitoilitg nrirst be peiforrned during a "representative storm
event" or "meosureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitadv.e monitoring to be
- performed during a "representative storm event" or- during a "measureable storm event:" However,
some permits do not have this regLIJrelnetit. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 'inches,a.f rainfall
anti that is &eceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred.. A single storm event may contain up to 10 consecutive hours of no
precipitation,
I
A "measurable storm event" is a storm event that results in an actual diseharge from the
,permitted site outfall. The previous tneasura.hle storm evert must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the perniittee is able to document that a shorter
interval -is representative for local storm events during the sampling period, and the pernrittee
obtains approval frorn the local DWQ Regional Office. l
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permitt. e or esignee)
11age 1 of 2
SW(J-242; Last niodit'ied 7/3 r/2013

1. Outfall Description:
Outfall No. I Structure (pipe, i t �c.)
Receiving Stream:
Describe the industrial activities that oc�i ur with' the outfall drainage area:
2. Color: describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: ctfAr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weal{ chlorine odor, etc.): u17"
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
© 2 3 4 S
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
t) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes V
AIITN
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe ML21J IR—
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5wii-242, fast modified 7/31/2013

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division -of Water Quality General.Permit No. NCG060000
Date submitted y I t 11— j
CERTIFICATE OF COVERAGE NO. NCG06 0 Z Lb SAMPLE COLLECTION YEAR 20n —
FACILITY NAME C& ; -Al e]yt pk&a. 31 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY 1 ky-f ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTiNG SAMPLES ha 1 U DISCHARGING TO SALTWATERS? [—]YES [�NO
LABORATORY_ pAL1& Lab Cert. #
PLEASE REMEMBER TO'SiGN ON THE REVERSE -'
Part A: Stormwater Benchmarks and Monitoring Results Total event -rainfall 2 Y or ❑ No discharge this period"
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD;
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100or. 0
Within 6.0 — 9.0
120
30
1000
Soo
' Only appliesto facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at a,M outfalls. You must still submit this discharge monitoring report with a checkmark here,
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of newmotor oil per month? Q yes no (if yes, complete Part.B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No,
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
' Only applies to facilities that use/Process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this -discharge monitoring report.with a checkmark here.
4See General permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 19. 2012
Page.] of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
* 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
a TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab „results Lor at end of
•monitoring period _in_the case of_"No Discharge" reports) ta:
Division of Water Quality,
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry'of the
person or persons who manage the system, or those persons directly responsible for gathering the- information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date).
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wglws/sulnpdessw#tab-4
SWU-249
Last Revised: October 18. 2012
Page 2 of 2

*FOR.PART A AND PART.B MONITORING RESULTS:
• ,A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
,, TIER 3; HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑NOgR
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑.
REGIONAL OFFICE CONTACT NAME:
Moil an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I.certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information -submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
Sh /1 7
(Date)
Additional copies-of.this form may be dbwnloaded at: http://,portal.ncdenr.org/web/wq/ws[s_uLnpdessw#tab-4
SWU-249
Last Revised: October 18. 2012
Page 2 of 2

T
co
m
0
O
iq
CHAIN -OF -CUSTODY 1 Analytical Request Document
Arralytc2i The Chain -of -Custody is a LEGAL DOCUMENT. Ali relevant fields must be completed accurately.
Seetlon A secCuo a Section C
Required Giant Information: R,Qairtd Project lnfarmeHon: invoice [nfarrrution: Pd ¢: 1 I Ot t ..
Company: Rsuoy Wx Com mtu
Report To. Jay Watkins
7domocs: 3610 Bush $treat
Copy To:
Ralo O, NC 27609
~
Email' - , .a � yt ('7•cGC, �K
Purchosa order♦:
Phcnt: (9i9j79o-t520 Fax
Prdjact Namc: , gt•rTFALL
Requesu'd Due De3t.
Projetz C:
IIASFIx
U"hN
was
udCE
r Cn
Wr
Nw
o
GU7
U
m
Warta
Pro[uct
SAMPLE ID �
=l
P
a
i
`s
�
sTanT
One Character Par box. w'+^
WP
(A-Z.0.91 , .l T. y,
Ni
of
a
r
Sample tds must tr■ unrqua z..,..
rsLLI
%
_
L
s
OAT.E T
prole 0
Q
U
END �+
v FT. A, � 7 2 � E 2 Z l7 •... � O
N
.Its^y .ti
i:y�
r i
U
i l•I� CZA4KW.Z NILr,�' 'NaU"iF....Mf#�L�G�,[�'
of SAMPL
U � h
F ha
v
izi 2 d ' 0
}

Ice Anallcal
www.pacelabs.com
1
ANALYTICAL RESULTS
Project: Outfall Plant 31 Capital Blvd
Pace Project No.: 92335465
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 2807E
[phone]
Sample: Outfall #1 Plant 31 Lab ID: 92335465001 Collected: 03/31/17 11:00 Received: 03/31/17 17:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 3.4 mg1L 2.5 1 04/05/17 10:00
Date: 04/06/2017 08:11 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 4 of 10

aceAnalytical,
Document Name: ESI Tech Spec
Sample Condition Upon Recelpt(SCUR)
cument Revised: Sept. 21, 2016
DoPage 1 of 2
Document No.:
F-CAR-QA-003-Rev.02
Issuing Authority:
I Pace Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville ❑ Raleigh® Mechanicsville❑
MEN; ..
Client Name:
0# 92335455
Project W
Courier:
❑Fed Ex ❑UPS ❑USPS
[WIlient 11111111
❑Commercial
❑Pace ❑Other:
9233°i I
Custody Seal Present?
❑Yes GND Seals Intact? ❑Yes
?NO
Date/initials Person Examining Contents:
Packing Material:
❑Bubble Wrap []Bubble Bags [None
❑Other, ✓�
Thermometer:
® IR Gun ID:
'�
15-3492_ Type of Ice: ewet
[]Blue ❑None (]Samples on ice, cooling process has begun
Correction Factor: Addo.6
Cooler Temp Corrected I°C): 3 ,
01ological Tissue Frozen'? []Yes ❑No O/A
Temp should be above ,,,ff���rr,e,,!!l///ezing to 6°C
USDA Regulated Soil (
N/A, water samp4e)
()id samples originate in
(—]Yes allo
quarantine zone within the United States: CA, NY, or SC (check
maps)? Did samples originate from a foreign source (internationally,
including Hawaii and Puerto Rico)? ❑Yes ,
Comments/Discrepancy:
Chain of Custody Present?
❑
❑
I.
Samples Arrived within Hold Time?
121
❑
❑
2.
short Hafd Time Analysis (472 hr.j?
❑
ff
❑
9.
Rush Turn Around Time Requested?
❑
M
❑
4.
Sufficient Volume?
❑
❑
5.
Correct Containers Used?
-Pace Containers Used?
❑
❑
❑
❑
6.
Containers Intact?
©
❑
7.
Samples Field Filtered?
©
8. Note if sediment is visible in the dissolved container
Sample Labels Match COC?
Includes Date% Time/1D/Analysis
©
❑
9.
Headspace in VC1A Vials (>5-6mm)? Yes No
Trip blank Present?
Trip Blank Custody 5eals Present?
Yes
Yes
No
No
N/
N/A
11.
CLIENT NOTIFICATION/RESOLUTION
Person Contacted:
Comments/Sample Discrepancy:
DateMme:
Field Data Required? ❑Yes ❑No
Project Manager SCURF f
Review: fl/ Date:
Project Manager SRF q
Note: Whenever Whenever there Is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR Certification Office (i.e.
Out of hold, incorrect preservative, out of temp, incorrect containers)
t s i S Page 8 of 10

0!
9
n
v
v
R
v
f
M
2
ti
m
i
i
i
a
z
r
_CL
C
m
'03
'T
f
N
R
M
A,
I
w
�
n
O
1
I
N
�
�
I
�
M
tG
mtD
1Z
`I
C
3
o
5
�
rn
n
I
o
d�
a
b �
R 'R
a
ro
m
I
i
K'
R
I(
t
A
0
r
Item#
BP4U-125 mL Plastic Unpreserved (N/A) (CI-)
BP3U-250 mL Plastic Unpreserved (NIA)
BP2U-500 mL Plastic Unpreserved (N/A(
BP1U-1 liter Plastic Unpreserved (NIA)
13133S-250 mL Plastic H2504 (pH < 2) (CI-)
BP3N-250 mL plastic HNO3 (pH < 2)
BP3Z-250 mL Plastic ZN Acetate & NaOH (>9)
BP3C-250 mL Plastic NaOH (pH > 12) (CI-)
wGFU-Wide•mouthed Glassjar Unpreserved
AG1U-1 IiterAmber Unpreserved (NIN (CI-)
AGSH-1 liter Amber HCI (pH < 2)
AG3U-250 mL Amber Unpreserved (N/A) (Ct-)
AG15-1 liter Amber H2SO4 (pH < 2)
AG3S-250 mL Amber H2504 (pH < 2)
pzzzzzz
A63A(DG3A)-250 mt Amber NH4CI (N/A)(CI-)
DG9H-40 mL VOA HCI (N/A)
I
VG9T-40 mL VOA Na25203 (N/A)
_
VG9U-40 mLVOA Unp (N/A)
DG9P-40 mL VOA H3PO4 (N/A)
VOA% (6 vials per kit)-503S kit (N/A)
V/GK (3 vials per kit)-VPH/Gas kit (N/A)
SP5T-125 mL Sterile Plastic (NIA — lab)
SP2T-2SO rn L Sterile Plastic (NIA — tab)
zzzzzzBRA-250
mL Plastic (NH2)2SO4 (9.3-9,7)
Cubitainer
VSGU-20ml-StintillationviaLs (NIA)
!
GN
i
J
0
frD�
rr
zt
v
� c
O�q
N�
n
W K 0
oQ
W
Ln —

9-
RCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
!'or�rtulutrce nrl fillrrl� Ullt tfr1C'01'nr, 11IcC75e (/iSIC: � i�'.rIi1U1*iiI.11CLIQnr".L�I'nJ 4YeI1�If'/i7jldi'S-�IUI'1t1LVdtCI"I
Permit No.: �i/c/_/_I_hI_L _I —I or Certificate of Coverage No.: N/C/ l-/ -i
Facility Name: CSVI- fat _Blmd Eiat 3 t
Comity: W �k[ Phone No. q 1 q_- 554- LOSS I
luspector:
Date of Inspection:. 3!,411.1_`7 Time ol* Iilspect(on: _L 1 00 out P-t .
Total Event Precipitation (inches): Iy2
Was this a "Representative Storm Event" or "Measureahle St01-111 Fveiit" as defined by the permit?
(See information below.)
{ ') Yes ❑ No
Please verrfy whetherQuolitative Morritorhrq roust he per formed din-ing a "representative Storm
event "or "measm-euble storm event" (requirements vaty, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be,
perforwed dUr'ing a "representative st(n'rn event" Or clrrr"ing a "nleasureable storm event." However,
some permits do not have this t•ecluiremetlt. Please refer to these derinitions, if applicable.
A "representative storm event" is a storm event that measiires greater than 0.1 incites of rainfall
and that is preceded by al least 72 hour's (3 days) in whirl no storm event nteasm-iog greaten Chair
O. I Inches has occurred. A Single storlii. event may Coist'.dn up to 10 c:onset:ufive IIOLII"S of uo
precipilabon.
A "measurable storm event" is a stortn event that I•esults in an actual discharge from the
permitted site oul-rall. The Itr•evious nteasclrahle siol•rrt (:vent must have been at least 72 how's
prior. The 72-hour scorn( interval does not apply if the pertnittee is able to clOCUntent that a shorter
interval is representative for local storm emits during the sampling period, and the permittee
obtains approval frow the local DWQ Regional Office.
By this signa€tn•c, l cc;rtiry That this reiJart is accurate altd conlltletc to the Itesl of my knowledge:
(Siglial:ul•e of Permilage of;Designee)
Ilaoe 1 or
SMI-2421 Last imidified 7/31 /2r113

1. Outfall Description;
Outfall No. I Structure (pipe, ET?c.)
Receiving Stream:
Describe the industrial activities that oc ur with] the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: CI1?JAr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): N0"_
4. Clarity; Choose the riurnber which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy: }
© 2 3 4 S
5. Floating Solids: Choose the number which best describes the arnount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
© 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount orsuspended
solids in the stormwater discharge, where J is no solids and 5 is extremely muddy:
V 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
S. Is theca an oil sheen in the stormmwater discharge? Yes
9. Is there evidence of erasion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 4 2PJ -e- _ w
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, bast modified 7/31/2013

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCGO60000
Date submitted q / f 1 f -1
CERTIFICATE OF COVERAGE NO. NCG05A Z _ _f- SAMPLE COLLECTION YEAR 'Zd n
FACILITY NAME 1 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY WKilt- I _ ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES na Y f h 014 DISCHARGING TO SALTWATERS? DYES [XNO
LABORATORY P Lab Cert. 4 y. 1
PLEASE REMEMBER TO SIGN ON THE REVERSE -i
Part A: Stormwater Benchmarks and Monitoring Results Total event roinfoll a or F1 No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
Col),
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 mi
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50'
Within 6.0-9.0
120
30
1000
Soo
t
3 1 I n
3
I
I
I
I
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For samolins periods with no discharge at any outfalls. You must ,till submit this discharge monitoring report with a checkmark here.
`See General Permit text, Table 3, identifying the especially sensitive receiving crater classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Q yes no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
me/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gallmo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
unry apones to raan[ies that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any. outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 19. 2012
Pagc I of

"FOR PART A AND PART S MONITORING RESULTS:
0 A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART 11 SECTION G.
0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALI_ T IGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
o TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUT FAT_!_? YES ❑ No ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the tab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wglwslsu/ngdesswntab-4
SWrU-219
L,i�t Revi,,ed: October 18. 2012
Pn�c 2 of--,

"FOR PART A AND PART.B MONITORING RESULTS:
Y A BENCHMARK EXCEEDANCE TR{GGERS TIER 1 REQUIREMENTS. SEE PERMIT PART it SECTION G.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge' reports within 30 da s o recei t of the fob results for at end o
mcnitoring period in the case o "No Discharge" reports)to:
Division of Water Quality
Attn: DWQ Central Giles
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED,
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who rnanage 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."
(Signature of Perm
sh //:z
(Date)
Additional copies of this form may be downloaded at: http://port3l.ncdenr.orgfwebZwg/ws/sv/npdesswl$tab-4
SWTJ-749 L,,,ct P%cvicerl: October IS. 2012
Pagc 2 of 2

CHAIN -OF -CUSTODY 1 Analytical Request Document
:: AJralyfe2!
The Criain-ef-Custody is a LEGAL DOCUMENT. Alt relevant fields must be compteted accurately.
Section 6 Section C
SeCUDn A
Required Prolect Information: inroile tnfwrnation: Pa 0 : 1
I Of 1
Required Client lntermation:
Report To: Jar YJ9lkins A@ention:
Company. Aeuoy Mix Conmew
Copy Ia: Company Nana'
I .
Adorosc., 36s0 BUSK SIroM
Re'4latory,A Agency
Ral�,gn,NCg7C-09
r Z r G./-'f
PuerlUax Order s;
paces Quoin:
PhonL: (9i9179o-1520 Fax
Prajau Name , OUTFAlL
Pace Project Monoger. ­gpin-caioni(!bpncelpl+y,wm.
Eii to l Locudoa
Requosied Due Dole:
Projcu8: t..� Jci'
Poca P10flc
o
—
Z
COLLECTED
Preservatives
rµtarx
crce
,
urri.y
x e err
0
g
16
tWrarer
ws
u
e
P,
SRMPL E 1d o'.
amr P
a
TrARI
Etr0
o
`a
I
• �
u
Y
w
0— Characrnr per box. wiNr
wp
q
:m
l
Sampla Ids must pe unique r4
7.
0
?
w
O
m
a
!—
c�
PA
i
S
x
Z
O
r Ov
I i I /1q_ /6r I3tV117�u (,,ttv f'cr-- C_ H131//?_ I f?�10 13, f I Y 11 A/ I _ I
MINT Mamc of
w
ro
0
0
0
DAIE
i i :i•s
� m N
IL

Pace Analytical Services, LLC
aceAnalical o 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
sw w.pacelabs.crom [phone]
ANALYTICAL RESULTS
Project: Outtall Plant 31 Capital Blvd
Pace Project No.: 92335465
Sample: Outfali #1 Plant 31 Lab ID: 92335465001 Collected: 03/31/17 11:00 Received: 03/31117 17:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 3.4 mglL 2.5 1 04/05/17 10:00
Date: 04/06/2017 08:11 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical services, LLC.
Page 4 of 10

Document Name: ESI Tech Spec
Document Revised: Sept. 21, 2016
Sample Condition Upon Receipt(SCUR)
Page 1 of 2
oocumentNo.:
_
Issuing Authority:
I
�� ;.d'ii(;eAnalytca!
F-CAR-QA-063-Rev.02
Pace Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville ❑ Raleigh® Mechanicsville❑
• Client Name: Project v W®# : 92335465
q�I
Courier: ❑Fed Ex []UPS ❑USP.S Client
❑ Commercial ❑Pace ❑Other: 92333465
Custody Seal present? ❑Yes gNo Seals Intact? ❑Yes Po � 1
Date/initials Person Examining Contents: 4
Packing Material; ❑Bubble Wrap ❑Bubble Sags None ❑Other:__
Thermometer;
IR Gun ID; I$-3g92 Typo of Ite: �4vet ❑Blue ❑None ❑Samples an ice, cooling process has begun
® __.. _
Correction Factor:Addo 6 Cooler Temp Corrected (°C): 3.1 Biological Tissue Frozen? ❑Yes ❑No (c 'i/A
Temp should be above ,,,ff���rre,,,//////ezing to 6'C
USDA Regulated Soil (I !N N/A, water sample)
Did samples originate inToul arantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internationally,
❑Yes bdNo including Hawaii and Puerto Rito)? ❑Yes . jib
Comments/Discrepancy;
Chain of Custody Present?
❑
❑
1.
Samples Arrived within Hold Time}
Or
❑
❑
2.
Short Hold Time Analysis (02 hr.)?
❑
❑
3.
Rush Turn Around Time Requested?
❑
M
❑
A.
Sufficient Volume?
a,❑
❑
S.
Correct Containers Used?
-Pace Containers Used?
❑
❑
❑
❑
5.
Containers Intact?
©
❑
7.
Samples field Filtered?
—
❑
8. Note if sediment is visible in the dissolved container
Sample Labels Match COC?
-Includes OatePime/ID/Analysis
_❑
f� f
❑
❑
9,
Headspace in VOA Vials (>5-Gmm)?
Yes
No
N
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑
Yes
El❑
Yes
❑
No
No
N/
❑
N/A
--
11.
CLIENT NOTIFICATION/RESOLUTION
Person Contacted: I
Comments/Sample Discrepancy:
Date/Time:
Field Data Required? UYes ❑No
Project Manager SCURF
Review: I j t 7 Date:
Project Manager SRF
Note; Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR Certification Office (i e.
Out of hold, incorrect preservative, out of temp, incorrect containers)
— - Page 8 of 10

n>
m
0
0
1
v
m
d
K
m
I
I
ro
T
�
1
CL
m
r+
a
r
0
3�
d
pQ
�
N
rD
3
m
a
Q
I
n
CA
b
a
K
d
n
Sl
a �
m �
n
m
i
N
u
p
Cl
V
T
c!
S
W
N
F+ Itemir
zzzSKU-125
mL Plastic Unpreserved (N/A) (Cl-)
OP3U-250 mL Plastic Unpreserved (N/A)
BP2U-50O mL Plastic Unpreserved (N/A)
—�
BP1U-1 liter Plastic Unpreserved (N/A)
*V
BP35.250 mL Plastic H25O4 (pH < 2) (Cl-)
V
XA
A
X
BP3N-250 mL plastic HNO3 (pH <2)
BP3Z«250 mL Plastic ZN Acetate & NaOH (>94
MC-250 mL Plastic NaOH (pH > 12) (CI-)
f
! WGFU•wide-mouthed Glass jar Unpreserved
l AG1U-1 liter Amber Unpreserved (N/A) (Cl-)
/
AGIH-1 liter Amber HCI (pH < 2)
AG3U-250 mLAmber Unpreserved (N/A) (Cl-)
AG IS-1 liter Amber H2$O4 (pH < 2) ^— i
AG3S-250 mL Amber H2SO4 (pH < 21
AG3A(OG3A)-250 mL Amber NH4CI (N/A)(0-)
OG9H-40 mL VOA HCI (N/A)
VG9T-40 mt VOA Nn2S2O3 (N/A)
VG9U-40 mL VOA Unp (N/A) I
OG9P4D mL VOA H3PO4 (N/A)
VOAK (6 vials per kit)-5035 kit (N/A)
V/GK (3 vials per kit)-VPH/Gas kit (N/A)
•
SPST-125 mL Sterile Plastic (N/A— Iab)
(
SPZT-250 mi-Sterile Plastic (N/A —lab)
IZzz/
I3P3A-250 mL Plastic (NH2)2SO4 (9.3.9.7)
Cubltainer
VSGU-20 mLScintillation vials (N/A]
i
GNGN
I
O
rr
zt
r
3
M
••
40
� � U
r'
ro c
A
c
d
K
Q
p o
zn
st
�
ro
r
da4b
L-
\
N
A

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling outthis farm, please visit: http_//12ortal.ncdenr.org/web/Ir/n12des-stormwater/
Permit No.: N/C/_/_/_/_/ _/�/�/ or Certificate of Coverage No.: N/C/G/./ A/d/Z:/ /'/G/
Facility Name: l A."- 31 cot ❑►;1 Is I V10
County: _
Inspector:
Date of Ins
Time of In,,
{NAKY I Phone No. gFjg .SSA{ -Zo$7
Total Event Precipitation (inches): , 15 ,
JUL 14 2016
DWR SECTION
Was this a "Representative Storm Event" or "Measureable St'o m hveii ' °a�s�defined��blyIthe permit?
(See information below.)
[� Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, i certify that this report is accurate and complete to the best of my knowledge:
(Sign/ure(Kf Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. Structure (pip ditch tc.)
Receivine Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C a_ur
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): �P00j2
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
6) 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes CID
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe N 6N
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
sWU-242, Last modified 7/31/2013

PaceAnalyfical'
CHAIN -OF -CUSTODY I Analytical Request Document
The ChMn-al-Custody is a LEGAL DOCUMENT. All relevant holds must be completed accurately. a,
Pepe. 01
Section A Soctlon 6 Sedlon C
2056316
Requlrnd Giant Infmmatlow Reguirad Propel Inle.maftm, Irwaica Information:
Y: - ReDw,10., AMlcnl�wr:
r
ee z7 L� Copy
To.,
ComperryNsme:
REGULATORY AGENCY
Address:
F NPOES I'"' GROUNDWATER i• ORINKINGWATER
f UST r' RCRA r OTHER
EmaL1l To: Purchau
Order No.:
Paco auNc
Rarmewe:
Ph _
Pf
led Name: E 61
SMa L,ocaHnn
Zr%b f
t `-
�teeo m
STATE: - - - --
Requested DueDattlTAAT:
"actNumtor. Zg �/
7H
PxcPF.C.t. t^�
1 .
Requested
Analysi3
Fittrtred
(Y!N}
9ectlan D Matrix Codae
—
2
PAgelnaCliorn lnrorr.aecr, MATRIX I coo€
9
COLLECTED
Pl9servativus
s`
CHnklrq e. DW
wal
,°
xa
water WT
waste water vow
rn. oour�
sTARr
ccv Pos re
Lmnrluw
L)
Z
Pnlduct P
e
w
!
SuIVSoFd St
_.
_
r.
SAMPLE Ip al of
WIDO WP
U
1'
w
w
-
m
.�
(A•Z,0.tiI.-) Air AR
-ample ID9 MUST BE UNIQUE TLtsuo rS
0
0
w
¢a
h
b
Olhc. OT
0
(]
ayp
-^
=Q
ri7
W
to
'=
Z)
X
i
Z
z
y
a
I-D.
DATE
TMMF
DATE
TIM6
_
]UC
Pace Project NoJ Lab
1
i �
/
l R
i
3
S
6
7
8
9
10
11
iz
ADDITIONAL WMMENTS
REL114=21HEDBYIAFFUJATION:
DATE
TIME
A
AFPI
PA1PTIME
SAMPLECONDVTiONS
L
i`r
ORIGINAL
PLER NAME AND SIGNATURE
v
m
PRINT Name or SAMPLER:
E
c m
C;
a
U .R
aTE SS17ned
SIGNATURE of SAMPLER:
sAlrAroD7YY}:
�
r++
"+,nW3,1 Nem- vy ,-9> .o hrs,am Y" — Acwgov P-WA NF r .AO d y pa%.",l lrr- a.+ in Wn. d--g R ar I,a% ue, , . P, lie eny rca pva v Tt U asrs. F-AI.t.-W2Drev.07, 15-6tay-2007

aceAnalytical.
r www.pacelabs.cnm
f
I
ANALYTICAL RESULTS
Project: PLANT 31 CAPITAL BLVD
Pace Project No.: 92303404
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: OUTFALL #11PLANT 31 Lab ID: 92303404001 Collected: 06128116 15:55 Received: 06/29/16 15:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 2.6 mg1L
Date: 07/01/2016 02:17 PM
2,5 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in fur,
without the written consent of Pace Analytical Services, Inc..
06/30/16 13:16
Page 4 of 9

eAna"cal
Document Name:
Condition Upon Recel
Document No.:
F-RAL•CS-001-Rev.04
Sim Client Name:
Project q:
Courier: ❑Fed E:x ❑UPS ❑USPS Client
❑ Commercial ❑Pace ❑other:
Custody Seal Present? ❑Yes ONO Seals Intact? []Yes K]No
Document Revised: May 24, 2Ulb
Page 1 of 2
Issuing Authority:
Pace Raleigh Quality Office
Page 2 of 2 for internal Use ONLY
r
LSO#:92303404
9I23���
03404
bate/Initials Person Examining Contents:
Packing Material: ❑Bubble Wrap ❑Bubble Bags eNa ❑0ther.
Thermometer: T1505 Type of toe: Wet ❑Slue ❑None E]Samplesonicecoolingprocesshasbegun
Correction Factor: O.O'C Cooler Temp Corrected ('C): 3 ,Z T Biological Time Frozen? Dyes ONO VN/A
Temp should be above fr ez4to 6'C
USDA Regulated Sell ( $N/A, water sample)
Did samples originate In a quarantine zone within the United States: CA, NY, or 5C {check maps)? Did Samples originate from a foreign source (int!n)btionally,
nYes V No Ineludine Hawarrand Puerto Riml? 11Yes o
—1
Comments/Discrepancy-
Chain Of Custody Present?
Ifies
[]No
❑NJA
1.
Samples Arf ived within Hold Time?
Yes
[]No
[]N/A
2.
Short Hold Time Analysis (�7Z hr.)?
Oyes
N!A
3.
Rush Turn Around Time Requested?
❑yes
N/A
4.
Sufficient volume?
es
No
E
JNL/A
5.
Correct Containers Used?
es
ges
ONO
❑N/A
6.
-Pace Containers Used?
❑NO
NJA
Containers Intact?
t"
[]No
N/A
7.
Samples Field Filtered?
[]Yes
❑No
WIA
8. Note if sediment is visible in the dissolved contalner
Sample Labels MatchCOC?
es
©No
❑NJA
9.
-includes Date/rime/ID/Analysis Matrix:
All containers needing acid/base preservation have been
10.
checked?
Yes
[]No
❑NJA
All containers needing preservation are found to be in
compliance with EPA recommendation?+.
(HNOI, H2SO_ HCI<2; NaOH >9 Sulfide, NaOH>12 Cyanlde)
yes
❑NO
❑N/A
mo+cxw0
Exceptions: VOA, C011form, TOC, Olt and Grease,
DRO/8015 (water) DOC,LLHI;
les
Q No
N A
Samples checked for dechlorination?
dYes
❑No
PNJA
11.
Heads ace in VGA Vials (>5-6mm)?
❑Yes
[]No
/A
12.
Trip Blank Present?
❑Yes
❑No
NIA
13,
Trip Blank Custody Seals Present?
[]Yes
[]No
XNJA
Pace Trl p Blank Lot p (if p urchased):
CLIENT NO RCAMNIRESOLUTION
Person Contacted: Date/Time:
Comments/Sample
Discrepancy:
Fkld Data Required? ❑Yes [:]No
Project Manager SCURF Review: � _ f ll 16 Date: L `?o -I �Q
Project ManagerSRFReview: _ _ Hr F 1 _ Date: [Q"'-.�ro—tL _
Note: Whenever there is a dlscrepancy affecting North Carolina comptiance samples, a COPY of this form will be sent to the North Carolina DEHNR Certification Office (Le.
Out of hold, Incorrect preservative, out of temp, Incorrect containers)
Page 8 of 9

r:����o}
GENERAL PERMIT NO. MC G140000
CERTIFICATE OF COVERAGE N0. INCG1l4 (9 Z I f
FACILITY NAME: I AV14- 31 a v
PERSON COLLECTING SAMPLES 4 -ij
CERTIFIED LABORATORY P k t--� Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEA
SAMPLING PERIOD: uly-December ❑ January -June
COUNTY U XYY-
PHONE NO. (q) K )_ SS11 0 $7
ADD TO LISTSERVE? RYES ❑NO EMA@L:
DISCHARGING TO CLASS: ❑SA ❑FICIVV ❑PNA [—]Trout
❑Other.
Outfall No.
Date Sample Collected
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
(mg/L)
Event
Duration
(minutes)
TotalTSS 4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
64
1&`
I
. o
!tzo
. �aAJ
NOV I
D fVIRALFILES
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TS5 benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/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 5Gi'-HEM
(mg/L)
Total Suspended Event
Solids duration
(mg/L) (minutes)
Total
n
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In tier 2
Monthly
Monthly
Monitoring?
(y/ri)
# of Months
tier 2
Sampling2
Ei-9,
15�
1002'3 -
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE 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 MUSTSIGN THIS CERTIFICATIOiV FOR ANY IIVF0RMATION 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 'gnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
w /D r
(Signature of Per ee (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7113111
Page 2 of 2

11C&DENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forgrridance on filling out this form, !lease visit:http;/.�p.or-�al.ncdoni-.org/webLw-ws s r s w# -
Permit No.: N/C/_/_/_/_/_/_/ / or Certificate of Coverage No.: N/C/G/L/- / 6/
Facility Name: Plgni 31 Cad"4w OND
County: W hy-e Phone No. 40- S 54 - Zb$7
Inspector:
Date of Inspection:
Time of Inspection: ll' w1
Total Event Precipitation (inches): P 5->
Was this a "Representative Storm Event" or °Measureable Storm Event" as defined by the permit?
(See information below.)
R Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "meosureahle storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 Hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signatur96f PeYmittee or Designee)
Page 1 of 2
SWIG-242, Lastmodilied 10/25/2012

1. ®u><tfail Description:
Cutfall No. I Structure (pip , disc tc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
P—,euL# p yed Coyle rty-4,c VlAKf
2. ;Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Gj-ea,✓ T
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weals chlorine odor, etc.): IVDu-a-
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is
clear and 5 is very cloudy: /)
ly 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
Z) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
& 2 3 4 5
i. Is there any foam in the stormwater discharge? Yes I�
v. is there an oili sheen in the stormwater discharge? Yes
Is there evidence of erosion or deposition at the outfall? Yes �f
i (D. Other Obvious indicators of Storrnwater Pollution:
List and describe U0Ua-
Dote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure, These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

/5a?ceAna1Xica1
I' wwwpacerabs.can
Laboratory Report
Jay WAtkins
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875r9092
Page 1 of 1
Report Date: 10/31/2014
Date Received: 10/16/2014
Project: PLANT #31 CAPITAL BLVD
Pace Project No.: 92221749
Sample: QUTFALL #1lPLANT 31 Lab ID: 92221749001 Collected: 10/15/14 12:15 Matrix: Water
Parameters Results Units Report Limit Analyzed Qualifiers
Total Suspended Solids 38.0 mg/L 2.8 10/22/14 09:49
Reviewed by:
Laura J Cooper
[e-mail]
Raleigh Certification IDs
6701 Conference Drive, Raleigh, NC 27607
North Carolina Wastewater Certification #: 67
North Carolina Bioassay Certification #: 16
North Carolina Drinking Water Certification #: 37731
Page 1 of 3

Document Name: Samplo Condition Upon
Dowment Revised: Apr1104,
rob.
R ecelpt (SICUR)
fpage 1 of 2
Doounnent No.:
IssulngAuthorldes:
F-RAL-CS-001-trov,02
Pace AshevilfeQualft Officit'-
ClientName:
Whore Received: Huntersville 0 Asheville 'Eden
Couilor (Circle): - Fed Ex UPS LISPS CiammoTdal pace. Other
Custody Sea] on Cooler/Box Present: yes no Sqgls intact.Eno
?'kcJ5fh9 MAtedal: 0 134bbla, wrap" —Bubble—eggs *0�q,
7
elicle, Thernionietor Used. IR Gun SN:12204��e of 1,,. Blue None, C]:Sampleta on fee. Doering P1C;�ese-.,has ,bQ.4un:.- -
' IR Oun Back Up SN.122096371 j
Temp., Correction Factor: Add if Su®r ct.—ZZ
d
Bate Inillals of personpersonax , a mt , ning-".
CorrqptoO Cooler T
Biological Tissue.la Fr6zen: Yes go
oontents/Pr 0
It
a p. C:
I m
check
Temp �s houtd be above freezing to VC
continents:
Custody Present:
Ay`- Mo EIWA
4. - -
Chaimof Custody -Filled Out:
ONo QWA
2.
Chain of Custodi Relingirlshad-.
zffl" ONo 04A
3.
Sampler -Name & Signature on COO,
0�e3 MNo [14A
4:1
-Samtes ArLIved Wth In Hold Time:
�rYss 0 No OWA
5-
Short Hold Time Anal yos'(<72hr),
.0yea MIA
6.
Rush Turn Around Tlhie Requ2sted:
0Ym Wo ON' A.
7.
sufficlent.volume:
Yes- ONo bIVA
8.
Corre6t Containers Uaod:
�Ckea; ONo DWA:
9,
4,
Pace Containers Used.,
G;T&, ONO, 11NiA
Containers intact-
2yea C3N* Ow
10,:
Filtered volume received for Dissolved tests
©Yee EINa JMA
li,
z.77,
Sample Labals match COC:
a, Qo OWA
12.
-includes date/tIme/iDlAnalysis . Maw:
All containsis neecling'preservatlon have been chocked.
a Elko OwA
13.
All 6Atalnem needlino praswaWn are found to be in
ONo 011VA
Compliance with EPA recommendation.
ox"Ptlorw VOA. QVlfvnn,T0C,0&G,WI-DR0(waW)
Samples checked for deQb lodnation:
0 Y03 ONo &wk
.14.
z
Beads ace in VOA Vials >6mm):,
OYip. ONo fiWA
16.
Trip Blank Present:
'Clyeii ONo XWA
16.
Trip Blank Custody Seals Present.
13yos Me, /MA
[Pace Trip Blank Lot# If
Client Notl0cationi Resolution:
Field Data Required?
Person Gontacled!,
Date/Time:
C' Ommen'W Resolution:
SCURF ISRF
Review:, It WEX
Now. Whene4ar there Is a diiorepanzy affecting North 0"Ing oompflancs
sempWs, a copy of this form YAII be sent to the North Carolina DEHNR
Cortfication -Ciffice, ( i.e out of had, Inorwract preservallyaj out of tamp,
(noarrect Dontslnars)
Page

:,CiiAlA4-OF-CUSTOQY 1 A�alyt��a., ., � e +�; �ii,,�': •;;,.! ; _ -��, �'=�� � � �-�-�-
aceco
Arralytical The Chain-&-Cucio* is a LEGAL DOWmENT.-AA rcJevam EetW moat �s pl&.cd o=rateh+. °cn
7
section Aa section c
Requhad Clio -a lrh�: RagvirRd PrciW Wcone:hrt:- • - �nvoix ::•: -
t
No.:
Section D taaM: Codes
R�pghvQLiYrtl lldcrr!latiCn esattmc•r 000e
Drlrk*g Wetcr DW
9
eg'-
CC}LLECTEO
z:
PreservatiF�s
Water WT
Wxta Walor WW
Product p
compown
START
m
enelcam
(F,7
soirsoac SL
SAMPLE IDVAN
w
,°�
U4Z 0 B 1 r1 Air AR
tu
K
Z
S mpfa of MUST aC UNi0UE- Tlwo TS
O,
z
Other OT
�t
to
J
b
it
w
D
d.,%
Z
V
m
- _
DATE
TIME
DATE
TIME
I
S
m
Z
2
Z
1821781
REGULATOR* AGEiidV-•;
NPDEs i GROUND WATER '�` cmmuNG wA. TER
r• UST F' RCRA r- QIliER
51irLot�tfon .+� =
STATE ; . x Fr• �;
his. FiitQTed (�YlNi. . ,•:;
po.,Lm�.
Pace Proled Pfol Lab LD-
t : At7Dit TONAL I:OMl6�►RS '
DATFX.
raw
B7.1.11>
YhLt
f' k
DA1E
r � ; •'•
SAMPLE CO iY01i10lt5
.
.t- ;•
t_
a
Sheri ER NAAff 'AND VGNATURE
¢
o
ORIGINAL'
o
Y 1
pRN1,4� ofSAhFP LER:
?
S(GNaT' ^Eb15s(FFLE ?
t
r' �' V• n ; i;� ✓��, L'.y 4` rtl x ., i �, FM J: ti
r'P, c..LYr�.. .1.�.... .y.�L.,' :i. •�.;, t! .x�:%-.
, (M0.:tifT-^=�_.'
.-`a _ ,. _•_ _.. �. . ,.''T'
-�-.—.........w..,.-.,....,�.....�........,...............�._,...��,_,.....+...,...k..,..........,�,c.�„_..........,.....lct."...,...s,^...w.�_.....•....1....-..:K..�..,.,..r-._.,__.,„....w.._._.......w�...r,...r:-....•:�..V.a=-.4!'rw-023:
,. _ _ - _ �tC •�.
evA7.. :'a•#'ay.•Y'�7 ._ .-_.., ...-,...

NCDENR
Stormwater Discharge Dutfall (SD®)
Qualitative Monitoring Report
For guidance on filling out thisform,please visit: lttr��:// �_�+raLn_cle�tr.r�r wyhjv Wtisj! tInIue";Sky#wtI-4
PermitNo.: N/C/W/`/�/_/_/_/_/ or Certificate of Coverage No.:
Facility Name: Pla-t 31 I no.tom. 91.,2
County: _ _ _ 6�01C—c Phone No. a _
Inspector: AA
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): . V
Was this a "Representative Storm Event" or "Measumable Storm Event" as defined by the permit?
(See information below.)
("Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to beY
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable. i
1
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
I
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
! A "measurable storm event" is a storm event that results in an actual discharge from the
1 permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
[ interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature ofPermittee or Designee)
RECEIVED RECEIVE®
MAR 13 Z014
CENTRAL FILES page 1 of 2 CENTRAL FILES
swu-242, Last modified 10/25/2012 DWQISOG D1NO/BOG

I. Outfall Description:
Outfall No. I Structure (pipe, itc , etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(fight, medium, dark) as descriptors: n"4 _
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A -lc,.&.
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is
clear and 5 is very cloudy:
2 3 4 5
5. Bloating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
V 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
�p 2 3 4, 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes l o )
10. Other Obvious Indicators of Stormwater Pollution:
List and describe IJCI .
Mote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5WU-242, Last modified IOJ25/2012

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING! FORM
GENERA! PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14Q
FACILITY NAME: Pt"; -31 Cap�4.A
PERSON COLLECTING SAMPLES Mo cW3_
CERTIFIED LABORATORY_ rays Lab #— Q 1
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: z-6 I Y - _
SAMPLING PERIOD: ❑ July -December O January -June
COUNTY L,/-IL.
PHONE NO. (!319 -) S.FY --?pF-7
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
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2
2 Sampling
-
-
6-92
100Z a
71
�l
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit, Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
`For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 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
Rainfalla
(in)
New Motor Oil
Usage
(gal/month)
2 Tier
In InTier#
Monthly
Monitoring?
Wri)
of Months
in Tier 2
z
Sampling
6-92
15z
1002,3
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO [�
HAVE YOU CONTACTED THE REGION? YES []NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coDv of this DMR (including all "No Flow" & "No Discharge" renorts) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
3r3�1
(Signatur of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

aceAnalytical
www.pacefaffscom
MD Capps
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: PLANT #31
Pace Project No.: 92192352
Sample: OUTFALL 1
Parameters
Total Suspended Solids
Reviewed by: `-
Nikitia Jones -Jackson
[e-mail]
Laboratory Report
Lab ID: 92192352001 Collected: 03/03/14 12:25
Results Units Report Limit Analyzed
9.8 mg/L 2.6 03/10/14 20:00
Asheville Certification IDs
2225 Riverside Dr., Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NCO30
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
Page 1 of 1
Report Date: 03/11/2014
Date Received: 03107/2014
Matrix: Water
Qualifiers
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
West Virginia Certification #: 356
Urginia/VELAP Certification #: 460222
Page 1 of 3

1Y.
ccAnalytical
Chain of Custody
lqz .5s�Z--
Report Results to: Bill Results to: E standard Report Delivery
Ready Mixed Concrete Ready Mixed Concrete Rush Report Delivery (w/ surcharge)
P.O.Box 27326 P.O.Box 27326 Requested Due Date:
Raleigh, NC 27611 Raleigh, NC 27611
Y)lb Gapes Project Reference: Plants #31
ATTN: IgbA WWWOR ATTN: Je44-W450" Purchase Order #:
Phone: [phone] cja5 w4" Sampled By: Mb(�Dna _
SampeaDese an :,Or1%ostt
M.'�..-.L"-�.�•' a� -
'.fe .?u:..lhr+c..
' j
Q1i3vr.OY
W"21 .`D �'
.'P t. ���i[�
.. '1
stop'' E3
,:'
i[]I
�......
Dy�
VLu_-
a=
70-4
}.^ a ,.rtw :_1 • ' nail .�sr a Lueted IT `s-,'i�
1f, pc�13. I '.'c�°=5—�+•i�. -
Outfall 1
G
-3` 311y
2-Zt- JL-
Sw
TSS
S�utfaliZ-
G
Sw
TSS
3elinquished by (signature)
Rec iced sig ture
D
e
Time
For Lab Use Only
Temperature at receipt:
Temp-. C`
telinquished signature)
Received by (signat e)
D e
Time
lellnquished by (signature)
Received by(signature)
Date
Time
a
N

Document Name: Sample Cond€lion Upon Document Revised: April 04, 2013
�E ArralyFlc�l. Receipt (SCUR) ___Page IV 2
Document No,: Issuing Authorities:
F-R L-CS-00i-rev:02 Pace Asheville Quality Otftce
Client lame:. 1
Where Received: ❑ Iluntersville ❑ Asheville ❑ Eden Raleigh
Courier (C€rcle): Fed Ex UPS USPS C[len Commercial pace. Other
Custody Seal on CoalerlBox Present: yes .' no Seals,intact „�1 yes ❑ no
Packing Material Bubble Wrap s None Other
Circle Thermometer Used: IR Gun N:122065387Type of Ice: Wet Blue .None Samples on ice, cooling process has begun
IR Gun B P 371.
Temp Correction Factor: Add/ ubtract,
Corrected Coo ierTamlr.: C .
Temp. should be above freezing to 6°C
La C Date and Initials of person examining
co to Pre ry
' •Blological Tissue is Froz@n:..Yes N NIA check:
Comments: .
Ch21nt)T'C"stOd .Present:..., . _.-_.'. ...
Yes:❑Ho'
'..f�YfA
1:...:.__.,_..-_._r...:-......._...-.- _..;..:.. _-._.. .. ... ,,.....,.._ ...._.
Chain of Custod�Fil€ed Out:
Yes -.❑No
.ONlA
2.,
Cha€6_bf Custod Relinquished:
Yes :❑No
❑N1A-
3.
Sampler Name & Sl nature on COCi
No
Yeg ON..'
❑NIA
4.'
Sam les Arrived Wthin Hold Time:..
- Yes ❑No'
❑NIA
5.:
Short Hold Time Ania1) sfs <72hr):
[]Yes o
❑NIA
6_
Rush T,urn,Around-Tline Requested:
171Ye5 116.
❑NIA
7..
Sufficlent_Volume:
, .IYes ❑No
❑NIA
Correct ConWners-Used:
-Pace Containers Used:
Yes . ❑l`io
Yes- ❑No
©WA
❑N11A
9..
Contalners rntact
Yes 0No
' ❑NIA
10.
Filtered volurrle:recefved.for Dissolved tests
❑Yes ON.
NIA
11,
Sample Labeis.match COC:• .
-Includes dateltimeliDlAnalys€s Matrix:
Yes ONo
©NIA
12..
All contalnem needing'preservatfon have been checked.
All contafn 'rs needing preservation are found to be In
compliance with EPA recommendation.
exceptions VOA, goliform, TOC, O&G, VJI-SRO (water) -
III
r is es ❑No
as ❑iJo
xy
Yes ONo
C]N!A
❑NIA
73.
Samples checked for dechlor€nation:
Yes ❑No
❑NIA
14,
Headspace in VOA Vials ( >.6mm :
❑Yes ❑No
NIA
15,
Trip Blank Present
Tr€p Blank Custody Seals Present _
Pace Trip Blank Lot # (if purchased):
'ElYes ❑No
❑Yes ❑No
__
X!NfA
- f NIA
r
16:
Client NotI%Dat1on7 Resoiutlon: Field Date Required? Y 1 N
Person Contacted: DatelTlme:
Commentsl Resolution:
SCURF JSRF pate~ Place label here
f J r �
'Review:: - // j`__�
Note: Whenever there is a discrepancy affecting North Carolina compliance W®# I ' 92192j 52
Samples, a copy of this form will be sent to the North Carolina DEHNR I
Certification Office (i.e out of hold, Incorrect preservative, out of temp,
incorrect contaihers) I I I
• � 821 33
Page 3 of 3