NCG140250_MONITORING INFO_20180219

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv b Q 5�
DOC TYPE
El HISTORICAL FILE
C3(MONITORING REPORTS
DOC DATE
❑ 101 b -0 a 1 �i
YYYYMMDD

STORMIMATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCGI40000
CERTIFICATE OF COVERAGE NO. NCG14_0 Z S •
FACILITY NAME: 5 3
PERSON COLLECTING SAMPLES nU�>NS
CERTIFIED LABORATORY pa&X Lab # C11
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLING PERIOD: 13 July -December
COUNTY 0 FAL'&-c
❑ January -June
PHONE NO. { 1
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)t
pH
(Standard
Units)
TSS
(mg/0MonitoringT
Event
Duration
(minutes)
Total ,
Rainfall
(inj
In Tier 2
Monthly
(y/n'
# of Months in Tier
pp ttZ'S�a"Ftt�l
RL E
-
-
6.9
100 '
-
-
-
FEB - 9 7012
•_
vtilY 1 I
MMIR Ct s,
`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.
375S benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/3012015 I Last Revised 7113/21
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 i
(mo/dd/yr)
pH
(Standard
units)
TIaH 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)
tt of Months
in Tier 2
Sampling,
6-9
15
100
-
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mai! 0riainal and one conv of this DMR {including all "No Flow" & "No Discharge" reports] within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFfC4TI01y FOR ANYI"RMATION 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."
w e zb4 J♦ s
(Signature of Perm e (Date)
Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

kNWWW
Stormwater Discharge 4utfall (SDO)
Qualitative Monitoring Report
For guidance on filling out thisform please visit: httn:/ portalm ar org/webllr./npdes•storiiiwater/
Permit No.: I�/S/_/_/�/^/ _/.�/_/ or Certificate of Coverage No..
Facility Name: l4ift364,togkis.63
County:
M»t Phone No.
Inspector: 'T" W" W 's
Date of Inspection: Ors 17
Time of Inspection: :I S Ak "*
Total Event Precipitation (inches): i fL-&
Was this a "Representative Storm Event" or'Measureable Storm Event" as defined by the permit?
(See information below.)
dyes n N o
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:
Perm ittee or Designee)
Page I oft
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. E Structure (pip ,ditch tc.)
Receiving Stream:
Describe �thf1e 'ilndustrial activities that occur within the outfall drainage area:
0.,..1 . ,,,..__ .t n . _ _ i. _
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): MOujz-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy: 0
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:
D 2 3 4 5
5. 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:
Q 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 Q
9. Is there evidence of erosion or deposition at the outfall? 490
10. Other Obvious Indicators of stormwater Pollution:
List and describe Ij'L
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 Z
5WU-242, Last modified 7/31/2013

ce Malyticai6
www.PMA3b&=n
i
September 18, 2017
Jay Watkins
Ready Mix Concrete
3610 Bush Street
Raleigh, NC 27609
RE: Project: Plant 53 Hillsborough
Pace Project No.: 92355106
Pau AnaWdcal 8ervless, LLC
9800 Itiacay Ave. Suns 100
Hurnersv8lo, NO 28078
(704)875-9D92
Dear Jay Watkins:
Enclosed are the analytical results for sample(s) received by the laboratory on September 13, 2017.
The results relate only to the samples included in this report. Results reported h erein conform to the
most current, applicable TNI/NELAC 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,
CL `M . 4ALor�
Angela Baioni
angela.baioni@ pacelabs.com
[phone]
Project Manager
Enclosures
4.
gBOit
.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
w1thoul the wrltLen consent of Pace Analytical Sarvlrea, LLC.
Page 1 of 10

e Paco Ans"cal Services, LLC
ea00 KlncayAve. Salle tpp
ceAnalytrcal
Hurrterevtile, NC 26078
wwwpva�la0 orm M4)8759092
CERTIFICATIONS
Project: Plant 53 Hillsborough
Pace Project No.: 92355106
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 be reproduced, except In full,
without the written consent of race Analytical SerVICS&, LLC.
Page 2 of 10

s
C,'�i11a,{lCc�e
www.paaelab&c=
SAMPLE ANALYTE COUNT
Pace Ana"cal Servkae, LLC
8800 KlnceyAve. Sufte too
Hurderavllle. NC 28078
(704)87&9062
Project: Plant 53 Hillsborough
Pace Project No.: 92355106
Analysts
Lab ID Sample lD Method Analysts Reported Laboratory
$2355106001 Outfall #1 Hillsborough 53 SM 2540D CTB 1 PASkE
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Service$, LLC. Page 3 of 10

ceAna]Xicel.
rw�vpeoelaesr;am
ANALYTICAL RESULTS
Project: Plant 53 Hillsborough
Pace Project No.: 92355106
Paw Analytical Servleaa, LLC
9800 Mricey Ave. Suite i o0
Hurders"le, NC 28078
[phone]
Sample: Outfal) 11 Hillsborough 53 Lab ID: 92366106001 Collected: 09/12/17 06:40 Received: 09113117 13:35 Matrtx: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2640D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 7.4 mg1L 3.4 1 09/15/17 10:38
REPORT OF LABORATORY ANALYSIS
Thts report shall not be reproduced, except in full,
Date: 09/1812017 03:24 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 10

IceAnalytical'
! aonilpw ttM"
. r
r
I
Project: Plan153 Hillsborough
Pace Project No.: 92355106
QC Batch: 3779W
OC Batch Method: SM 2540D
Associated Lab Samples: 92355106001
METHOD BLANK: 2093661
Associated Lab Samples: 92355106001
Parameter
Units
Total Suspended Solids
mg/L
LABORATORY CONTROL SAMPLE: 2093662
Parameter
Units
Total Suspended Solids
mgn-
k
SAMPLE DUPLICATE: 2093663
Parameter
Units
Total Suspended Solids
mglL
SAMPLE DUPLICATE: 2093664
Parameter
Total Suspended Solids
Pace Analytical Services, LLC
9800 KhceyAve. Sutie 100
Hurderavllk, NC 28078
[phone]
QUALITY CONTROL DATA
Analysis Method: SM 25400
Analysis Description: 2540D Total Suspended Solids
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 09115/17 10.33
Spike LCS LCS % Rec
Cone. Result % Rec Limits Qualifiers
250 240 96 W110
92355099001 Dup
Result Result RPD Qualifiers
159 273 53 D6
92365087001
Units Result
mg1L 3.7
Dup
Result
164
RPD Qualifiers
191 DO
Results prastrd" on this page are In the units indicated by the "UnW coh n n except where an aaemabe unit Is prsss7ded to the right of the ntturt
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 0911812017 03:24 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 10

ceAnalyilcal e
w»'wpaCaHbs.Porn
r
QUALIFIERS
Project: Plant 53 Hillsborough
Pace Project No.: 92355106
DEFINITIONS
Pace Analyticai Services, LLC
9800ItinceyAve. Suite goo
Huntersvilb, NC 28018
(704)8755-8092
DF - Dilution Rotor, 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 reporiing limit.
MDL -Adjusted Method Detection Limit.
PQL - Practical Cluantltation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphonythydmzine 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 (Dupl(cate)
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 Acrolain 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
PAST-E Pace Analytical Services - Eden
ANALY T E QUAUFIERS
136 The precislon between the sample and sample duplicate exceeded laboratory control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 0911 B12017 03:24 PM without the written consent of Pace Analytical Services, I.I.C. Page 6 of 10

1-�;a1ceAmIj6cal'
WWW. .=m
r
QUALITY CONTROL DATA CROSS REFERENCE TABLE
PrnjeCt: Plant 53 Hillsborough
Pace Project No.: 92355106
Pace Analytical Servlcea, LLC
9$00 Kncay Ave. Sulta 100
Huntersville, NC 28078
[phone]
Analytical
Lab ID £ample ID QC Batch Method QC Batch Analytical Method Batch
92355106001 Qutfall #1 Hillsborough 53 SM 2540D 377900
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 09/18/2017 03:24 PM wfthout the written consent of Pace Analytical Services, LLC.
Page 7 of 10

Document Name: Document Revised: July 15, 2017
�" �`!�• Samn to Condition Upon Reulposctin P40 S of I
Document No.: Issuing Authority.,
1 F-M-CS•033-Rev 03 Pace 4ue tY ofteT - —
Asheville ❑ Eden[:] Greenwood ❑ Huntersville _ Ralelohjg Ma hanlciAle[]
CllentNarn ►�ri I/ WO# • 9� 510
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IES'J.4 Reg.latad Saki water ter sample)
AgHmplero note a4Uirentinesort=within the United States: CA, NY, arSC(check maps)? 0ldaamriluodQlrsstefiomefargpitrrvn{Ints
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Samples Arrived within Hotd TIme7
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Correct Containers Used?
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Person Contacted:
Comments/Sartple Mvivpancy:
DW/nM;
FiNO DM HlpWMJ? 1JfU LJN*
Peuject Manager SCURF Review: Date: I
Project I4 Bnascr 50 R.Waw: I j�I) Date:
lro63: tuheneverft.relsaftarepancTaflectingNorthCarollnrearnPnanca7srplrs,0copy oftbtstorMV-IIlbeswrtto" North CamlinsWHRcaftAfmMeJh&
out of hall,%ccrrtq Preservative, out of temp, Weo Met mntair ers)
Page 8 of 10

Decument lame: NEYM"". ,
Condition Unan ReceIWSCURI Ppge 2 of
I„ __!. -- - � F.CAR•CS-033•Aev03. _ - � !Rr
ill® : 923551 0fi
'+Check marktv�ha �pFiana�i o3 Ehlbrinafiorti - _ V role_
is verified and within the acceptance range for PM: ' AMB Due Date: 09/27A7
preservation samples. CLIENT: 92- Ready Mix
'*Bottom half of box is to list numbor of bottles
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- „� �ettP�tloasTJu�—TlmapresaYatlon gmpvrdofPed
F�mp�tb `� Ty�enf.teseent�r �74ePonreaelpiiAitaud added
Page 9 of 10

CHAIN -OF -CUSTODY ! Analytical Request Document o
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f L*T rRCRA r OTHFR
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ORIGINAL SAMPLMNAME AND SIGNATURET —
P;;TRemeafSJWPLER: �` a
8WJLATURE4f $AMPLER
'M117iYWF a4r4" 6Y �37r'1 a 4 n.m lou aro trfaptnp PafXi HET ]a tlkY r�YaM.d e.a. atd aagrpq la tb W+y.. a71,aX put � lar arty Nimoi. rat pwd .WAn 706q�
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F-ILL-0-02f v.Ot, 15.May-2007

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted _ q Ixs 1 t-t
��- 0a
CERTIFICATE OF'COVERAGE
FACILITY NAME tk-' AS pstln�- F13
COUNTY D &0_
PERSON.COLLECTING SAMPLES its
LABORATORY Pyk(,-k Lab Cert. # qi
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2- C>1 "1
FACILITY ACTIVITIES INCLUDE Jcheck all that apply).
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? [—]YES ®ND
PLEASE REMEMBER TO�SIGWON'THE REVERSE +'
RECEIVED
MAY 0 4 1 0 !7
CENTRAL FILES
DWR SECTION
Totol event rainfall r 91& or ❑ No discharge this period3
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 mi
Benchmark
100or50
Within 6.0 — 9 .0
120
30
1000
500
T1 1 in
6•
I
1 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.
°See 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 new motor oil per month? ❑ yes �Ino if es, 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.
°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
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
.1 -A-BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER 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 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 co o this DMR includin all "No Dischar e" re orts within 30 days o receipt o the lab results or at end o
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 ofiPerfnittee)
(Date)
Additional copies-of.this form may be downloaded at: http://aortal.ncdenr.org//web/wgZws/su/npdessw4tab-4
SWU-249 Last Revised: October 18. 2012
Page 2 of 2

�aceAnafy�rcal'
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CHAIN -OF -CUSTODY I Analytical Request Document
The Chalr-of-Custody is a LEGAL DOCUMENT. An relevant. Wds must be completed accurafetp.
Pacc 01
SacUbrt A Seddon B socllon C
Required Owl! IrVamwlian: Rmqufrod Projed Worffi=m lrrwice tnformacon:
,r Repcn To: abrMow
2097575
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Company Norm:
REGULATORY AGENCY
A&nvs
r NPDES r GROUND WATER i DRINKING WATER
r UST RCRA OTHER
Emal To' ` y Purchase
Order No.:
Pace Dude
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Name:
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DO'S} 5-2 lF C
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(YIN)
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REL94QVMHED BY f AFFILLATIHIM
DATE
TIME
C Y f AFFWATION
DATE
TIME
SAMPLE COKD1T161i6
.
AtJ
SAMPLER NAME A ID MGKATURE
.
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(YYlAArYYj:
`Irrporbd Hot.'. 6y s{rKnQ ads Iwm you rra wa.qunp Paco'. MET ,10 erg pnyr.,ml uHrro and eytreNrp b life. ahxry.e W 5.5% nw mnnlh ki r'+y lnw�� s roe pnq wlWn 1tl Maas FALL-0-020nw.07, 15-Mar-2007

A r�-
NC®ENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
fot4guidance Oii filling out this form, please visit: litti),Ilpgrial.md-Qiir.org/well/ii-Inpdes-gorm�vate—rl
Permit No.: �V/�/_/ /_/_/_/_/�/ or Certificate of Coverage No.:
Facility Name: !it 1
County: C RMuw __ Phone No.
Inspector: a 14
1
Date of Inspection: I 1,2q 17
Time of Inspection: b : So AK MAY 04 _ 7
Total Event Precipitation (inches):_ WR �C 'IoIV
r�oN
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitutive MonitorhW must be performed during a "representative storm
event" or "measureable storrri 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 storhi 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, l certify that this report is accurate and complete to the best of my knowledge:
(Signature of PermiAe c°• Designee)
Page 1 of 2
5wrr-242, Last modified 7/3 r/2013

1. Outfall Description:
Outfall No. - - I - Structure (pipetc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
D1. ru... ,._1 P__..,...,1 _n
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C1edtr
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): ;✓
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1V 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:
Q 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:
11 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
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 0 L2 ! _
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

jeAnalytical'
wwwpacelsbs.cam
}
i
ANALYTICAL RESULTS
Project: PLANT 53 HILLSBOROUGH
Pace Project No.: 92338347
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)8759092
Sample: OUTFALL #1 PLANT 53 Lab ID: 92338347001 Collected: 04/24/17 06:50 Received: 04/25/17 14:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual
2540D Total Suspended Solids
Total Suspended Solids
Date: 04/27/2017 03:04 PM
Analytical Method: SM 2540D
16.4 mg1L 3.6 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
04126117 13:39
Page 4 of 10

I _
aceAnaocal `
Laboratory receiving samples:
Asheville ❑ Eden❑
DaCument Name: ESI Tech Spec
Sample Condition_ Upon Recelpt(SCUR)
Document NO.: ;
F-CAR-CIA-003-Rev.02
Greenwood ❑ HuntersvilleEl
Document Revised: Sept. 21, 2016
Page 1 of 2
Issuing Authority:
Pace Quality Office
Raleigh Mechanicsville[]
Sam- ' We COnd!Vcfi LJPOnW1Client Name. Project #: WO# : 92338347
Courier: ❑ d Ex ❑UPS LJUSPS lient �I II �I I �I I �II
❑ Commercial ❑pace ❑Other.
�9233$347
Custody Seal Present? ❑Yes O Seals Intact? ❑Yes No
!� Date/Initials Person Examining Cantents:
Packing Material: ❑bubble Wrap []Bubble Sags None ❑Other
Thermometer:
,
® IR Gun ID: IS-349Z _ Type of IcteIce.,Wet ©Blue ❑None ❑Samples pre Ice, c4pfing processha,,svbegun
Correction Fa ctor: A.&o.6 Cooler Temp Corrected (ICI: f r Blologlcaf Tissue Frozen? ❑Yes []NO /A
Temp should be above fr Zing to fi'C �C
USDA Regulated Sol] ( N/A, water sample)
Did samples orlginate in a uarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (in rnatlonally,
Dyes ffNo indudingHawaii -and Puerto Riro)?DYes No
Comments/Discrepancy;
i Chain of Custody Present?
❑
1.
Sam "fes'Ar"rived wiYliln Hold [me ~
0
2, - ..
Short Hold Time Analysis (<72 hr.)?
©
3.
Rush Tum Around Time Requested?
❑
111
0
4"
Sufficient Volume?
❑
❑
5,
Correct Containers Used?
-Pace Containers Used?
RE
❑
0
6.
Containers Intact?
110
❑
7.
Samples Field Phered?
8. Note ii sediment is visible In the dissolved container
Sample Labels Match COO
-Indudes Date/Time/ID/Analysis
9.
Head ace In VGA Vials (>5-6mm)?
El
Yes
13
No
N A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑
Yes
Yes
❑
No
No
N A
A
11.
WENT NOTIFICATION/RESOLUTION
Person Contacted: I
Comments/Sample Discrepancy:
Date/Time:
Project Manager SCURF
Review;I �y Date:
Feld Data Required? UYeS uNo
Project Manager SRF f
Review: __1 Date:
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form W11I be sent to the North Carolina DEHNR Certification Office {i.e.
Out of hold, incorrect preservative, out or temp, incorrect containers)
-`Page 8 of 10

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BP4U-125 mL Plastic Uripreserved (N/A) (CI-)
SP31J-750 mL Plastic Unpreserved (NIA)
BPZU-50D mL Plastic Unpreserved (NJA)
BP3U-1 liter Plastic Unpreservetl [NJAI
BP35-250 mL Plastic HZSO4 (pH <2) (CI-)
BP3N-250 mL plastic HNO3 (pH < 2)
BP32-250 mL Plastic ZN Acetate & NaOH (>9)
BP3C-250 mL Piastic NaOH {pH > 12[ (CI-)
WGFU Wine -mouthed Glass Jar Unpreservetl
AG1U•1 liter Amber Unpreserved (NIA) (0-)
AGIWI liter Amber MCI (pH < 2)
AGW-250mLArnber Unpreserved (N/A)(CI-)
AGIS-1 niter Amber H2504 (pH -e Z)
AG3S-250 mL Amber H2504 (pH [ 2}
AG3A(DG3A)-25 D mL Amber NH4Cl (NIA) (Ct-)
t149H-40 mL VOA kI. (NIA)
VG9T40 mL VOA Na2S203 MM
VG9U-40 mL VOA Unp 4N/A}
UG9P-40 mL VOA K3PO4 (N/A)
J
I
VOAK (6 vials per 10t)-5035 kit (N/A)
V/GK (3 vials per ktt)-VPH/Gas kit (N/A)
SPST•125 mL Sterne Plastic (N/A •- lab)
SP2T-250 MLSterilePlaidc (MIA lab)
BP3A-250 raL Plastic (NH2)2504 (9.3-9. )
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NC®ENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidonce on Jillittq out thisform, please visit: iitttr//partal.ncdenr.oi f weh /npdes stctrrnwater/
Permit No.: LVIC/—/_/—/—/—/—/—/ or Certificate of Coverage No.:
Facility Name: [ 1 0 1R plttb�51
County: (>Kuu&,e - Phone No.
Inspector: -r i LI kg
Date of inspection: 1 412911-7
Time of Inspection: - ib-• So Aril - __-•-
Total Event Precipitation (inches): • al
Was this a "ltepresentativr, Storrs Cvent" or "Measureable Stortu Event" its defined by the permit?
(See information below.)
I^ Yes ❑ No
Please verify whether Quolitative Monitoring Must be perfarmed during a "representative storm
event"or "measur•eahle storm event" (requirements vrny, depending on the permit).
Qualitative monitorhig requirements vary. Most hermits require qualitative monitoring to be
performed during a "representative storm event" or' dLII-illg a "nleaSUreable storm event." However,
some permits Ito 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 Ito storm event measuring greases' than
0,1 inches has occurred. A single storm event may contain ilp to 10 consecutive hours of 110
precipitation.
1 A "treasurable storm event" is a storm event that results in an actual discliarge from the
permitted site outfall. The. previous IlleaSnl'able S101111 eVelit Insist have been at least 72 IlUnl's
! 111 1111'. '[ lie 22-h0LII' StOI'111 interval does not apply if [lie permittee is able to document that a shorter
interval is representative for local storm events daring the sampling period, and the permittee
obtains approval From the local DWQ Regional Office.
By this signature, I certify that this report is accurate.IIId complete to the hest ol'my knowledge:
(Signature of Permile r'' Designee)
Page t ref 2
Sivtl-Z•12,i.3st modified 7/31/24113

1. Outfall Description:
Outfall No.. —A__-Structure (pipegE5tc.)
Receiving Stream:
Describe the industrial activities that occur within the outfail drainage area:
D _ I . ,A.. _. _ 1 r _ . _ ....
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, darn) as descriptors: C eGtr
3. Odor. Describe any distinct odors that the discharge may have (i.e., smeils strongly of oil,
weak chlorine odor, etc.): ,. A&o4e-
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is
clear and 5 is very cloudy:
J 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:
6) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 3 is no solids and 5 is extremely muddy:
V 2 3 4 5
7. is there any foam in the storrwater 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 N
M Other Obvious Indicators of Stormwater Pollution:
List and describe L2
Note: Low clarity, high solids, and/or the presence of foam, ail sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant furtlier investigation.
Page 2 of 2
SWU-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 9 I251 n
CERTIFICATE OF COVERAGE NO. NCGQ6 4 _ZS b
FACILITY NAME 121faV4- P13
COUNTY D
PERSON COLLECTING 5 MPLES T1NI WbT1C1%5S
LABORATORY PYAG`e Lab Cert. # AI
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR L OI'i
FACILITY ACTIVITIES INCLUDE (check all that apply):
use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? OYES [!?NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Tool event rainfall' 111. or C] No discharge this perio?
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 mi
Enterococcit,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
1 120
30
1000
Soo
n
1 16
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 sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring repart with a checkmark here.
°See 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 SS gallons of new rnotor oil per month? Q yes )1no (if yes, complete part By
Part 6: 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
100or50
6.0-9.0
-
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
S 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 1 h. 20?2
Page I of'_

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 2 EXCECDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Ii SECTION B.
n TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES []NO[]
REGIONAL OFFICE CONTACT NAME:
Mail an on inal and one copy ot this DMR including all "No Discharge" reports, within 30 days of receipt o the lab results or at end o
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 ofperTrnittee)
slj 117
(Date)
Additional copies of this form may be downloaded at: http://partal.ncdenr.org/web/wq/vas/su/npdesswHtab-4
SWU-2-19 Lact Revised: October IS.2012
Page 2 of 2

.,P;2��ceArr�lytica!'
CHAIN -OF -CUSTODY 1 Analytical Request Document
The Chaln-ol-Custody is a LEGAL DOCUMENT. All reiovanL fields must he completed accuralafy.
Paps: of
5nctlon eet
A Section B Slon C
Requirad lei Iforrabon: Required Pfolixt IrtaTnabon: Inwirc InrarmLan:
Cmpy. Report,fe: AfIaMon:
2097575
Addrmr
pyTa:
Compe y Nurrm:
REGULATORY AGE14CY
NPDES F GROUND WATER i DRINKING WATER
( UST RCRA OTHER
Emae ta:•
Puyase Order Ne.:
Paama
>
atLL6
Rdmncs:
Phone: Fer'
lPrejecL
Prolad Name:
Pam Pmf9H
$1th Lacavon
lilarager:
STATE'
Roquestad Ow DatofTAT:
Numaer: L �I
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Ana"ta
Ffttomd
{Y/Nf
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$
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PrNSdrVBfivBS
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SMPLER NAME AND ISIGNATUIZE
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llrg am Nc:.:: By 1yyn0i; n,b Ivan you are am,punq Pr '. NET W03Y Pepryrd teem and ayreNnp 10 tX0 dvvyn of 15%ter 1-111 tar Wy 1nw,.wr. � p W W11N. 3p C,rs F-ALL-Cl-020rev.07, 15-M By-2007

1--'..KaceAnalytical
wwwpocelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, HC 28078
(704)B75-9092
ANALYTICAL RESULTS
Project: PLANT 53 HILLSBOROUGH
Pace Project No.: 92338347
Sample: OUTFALL #1 PLANT 53 Lab ID: 92338347001 Collected: 04/24/17 06:50 Received: 04/25/17 14:55 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids
Total Suspended Solids
Date: 04/27/2017 03:04 PM
Analytical Method: SM 2540D
16.4 mg/L 3.6 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
04/26/17 13:39
Page 4 of 10

Document Name: ESi Tech Spec Document Revised: Sept. 21, 2o16
Sampfe Condition Upon Receipt(SCUR1 Page 1 of 2
%., if'dC8f�I181yfICt?I t
fssuing Authority:
Pace Quality Office
Laboratory receiving samples:
Asheville ❑ Eden[] Greenwood ❑ Huntersviile ❑ Raleigh® Mechanicsville[]
Client Name:
Project#f: 1.008 • 92338347
Courier: ❑ d Ex ❑UPS ❑LISPS fL11ilient 1119
BIIH(�Jppu ��I1�❑ Commercial ❑pace [:]other:other:
92338347
Custody Seat Present? ❑Yesfo Seals Intact? ❑Yes No
Po
Date/initials Person Examining Centepts:
Packing Material: ❑Bubble Wrap ❑Bubble Bags ,None ❑Other;�—
Thermometer:
® IR Gun ID: — IS-3492 — T Of Ice: Net ©Blue ❑None ❑Sa mples on ice, cgnling process has begun
Type i-,,n
Correction Factor:s�o6 Cooler TempCorrected ('Cl: RialogicafTissue Frozen? ❑Yes ❑No kdK/A
Temp should be above �Ml�/A
ing to WC �C
USDA Regulated Soli (, water sarnpte)
Old samples originate inarantine Tone within the United States: CA, NY, or SC (cherk maps I? Did samples originate from a foreign source (in (nationally,
Dyes KNo indudingHawail-avid Puerto Rico)?❑Yes NO
CommentsfDiscr a
I Chain of Custody Present?
❑
1,
Sam" !e5'Ar'rivi id within No Time?
❑
: 2.
Short Hold Time Analysis (<72 hr.)?
❑
3.
Rush Turn Around 11ma Requested?
4.
Sufficient Volume? f
❑
❑
5.
Correct Containers Used?
-Pace Containers Used?
©
❑
6.
Containers intact?
do
❑
❑
7.
Samples Field Filtered?.
❑
❑
8. Note it sediment is visible In the dissolved container
5ample labels Match COC?
-Indudes Dato/Time/ID/Anatys[s
❑_
©
9.
Headspace In VOA VWs (>5-6mm)?
Yes
No
N A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑
Yes
Yes
❑
NO
No
N A
A
11.
CLIENT NOTIFICATION/RESOLUTION
Person Contacted:
Comments/Sample Discrepancy:
Date/Time:
F•leld Data Required? Ues ©NO
Project Manager SCURF f
Review: � Date: L1
Project Manager SRF
Review: — Date:
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of lhts form vAl be sent to the North Carolina DEHNR Certification Offite (i.e.
Out of hold, incorrect preservative, out of temp, incorrect containers)
;'Page 8 of 10

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MU-250 ml, Plastic Unpreserved (N/A)
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BP1U-1 liter Plastic Unpreserved [N/Aj
SP3S-2W mL Plastic HZSO4 (pH <2) (Cl-)
8153N-250 mL plastic HNO3 (pH < 2)
I
BP32-2S0 mL Plastic ZN Acetate & NaOH (>9)
B C 250 mL Plastic NaOH (pH > 12) (Cl.)
WlGFU-Wide-mouthed Glass jar Unpreserred
RGIU-1liter Amber Unpreserved (N/Aj (Cl-)
RG11h1 IiterAmber HCI (pH < 2)
AG3U-250 mL Amber Unpreserved (N/Aj (CI-)
AG15.1 liter Amber H2504 (pH < 2)
AG3S-2SO mL Amber H2SO4 (pH < 2)
zzzAG3A(UG3A)-25
D mL Amber NH4CI (NIAI (Ct-I
DG9H-40 mL VOA HCI (NIA)
VG9T-40 mL VOA Na2S203 (NIA)
VG9U-40 mL VOA Unp (NIA)
D139P-40 mL VOA H31304 (N/A)
VOAK (6 vials "r kit)-5035 kit (NIA)
V/GK (3 vials por kit}-VPH/Gss kit (N/A)
SP5T-125 rnL Sterile Plastic (NIA -- lab)
SPXT-250 mLSterile Plastic (N/A -tab)
MA-250 nL Plastic (NH212SO4 (9.3-9.2)
Cubitainer
-
-
VSGU-20 mL Scintillation vials [N/A)
GN
L

pol
RECEIVED
NCDENR MAR 14 2016
Stormwater Discharge Outfall (SDO) CENTRAL FILES
Qualitative Monitoring Report DWR SECTION
Forguidance on filling orrt this form, please visit: http;-/poMl.ncdenr.org/weblwq/ws/su/nndessw#tab-4
Permit No.; N/C/ /�/_/_/_/_/_/ or Certificate of Coverage No.: NIC/G2f S/•0/
Facility Name: A II 5 10e t w4k # 53 _
County: v Phone No. T9 - -13 Z- i5 e
Inspector: -T S
Date of Inspection: 31y Ilk
Time of Inspection: q. ID ANA
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measu-eable 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 "measureoble 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
l obtains a
roval 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 M Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. _ I Structu pi ditch, 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
(light, medium, dark) as descriptors: C he ky -
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): U6L1-I-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
V 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:
Cl) 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 6lo
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 10/2S/2012

TABLE 9.1
ANALYTICAL MONITORING REQUIREMENTS-STORMWATER
READY MIXED CONCRETE COMPANY — PLANT #
DISCHARGE
UNITS
BENCHMARK
SAMPLE
SAMPLING
CHARACTERISTIC
VALUES
LOCATION
SCHEDULE
pH
Standard
Within range
6.0 to 9.0
Each Outfall'
Semi -Annually
Total Suspended Solids (TSS)
mg/L
100 mg/L2
Each Outfall'
Semi -Annually
Total Petroleum Hydrocarbons3
mg/L
15 mg/L
Each Outfall'
Semi -Annually
Event Duration
Minutes
Not applicable
Each Outfall'
Semi -Annually
Total Rainfall
Inches
Not applicable
Each Outfall'
Semi -Annually
New Motor Oil Usage3
Gallons/ Month
Not applicable
Not applicable
Semi -Annually
Notes:
1. Samples shall be collected at each stormwater discharge outfall unless representative outfall status
has been granted and documented by the Division of Water Quality. A copy of the letter granting
representative outfall status shall be kept on site.
2. TSS benchmark for ORW, HWQ, Trout or PNA waters is 50 mg/L.
3. Only required for sites where vehicle maintenance activities occur.
4. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of
discharge from a stormwater discharge outfall (SDO).
5. All samples 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. If no discharge occurs during a sampling period,
a monitoring report indicating "No Flow" must be submitted within 30-days of the sampling period.
6. For each sampled measurable storm event the total precipitation must be recorded using an on -site
rain gauge.
7. 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).
8. A minimum of 60 days must separate each monitoring event unless monthly monitoring has been
instituted under a Tier Two response
9. The permittee shall compare monitoring results to the above -referenced benchmark values for each
discharge characteristic. Exceedances of benchmark values require the permittee to increase
monitoring, increase management actions, increase record keeping, and/or install stormwater Best
Management Practices (BMPs) in a tiered program, as specified by the general permit.
10. Failure to monitor semi-annually per permit terms immediately institutes monthly monitoring for all
stormwater 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 semi-annual monitoring schedule.

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 Outfall2
Quarterly
Total Suspended Solids (TSS)
mg1L
30 mg/L3
Each Outfall2
Quarterly
Settleable Solids
mL/L
5 mUL
Each Outfall2
Quarterly
Total Petroleum Hydrocarbons4
mg/L
15 mg/L
Each OutfaII2
Quarterly
Event Duration
Minutes
Not applicable
Each Outfa112
Quarterly
FIow5
Gallons/Day
Not applicable
Each 0utfa112
Quarterly
New Motor Oil Usage4
Gallons/ Month
Not applicable
Not applicable
Quarterly
Total Volume of WaGstewater
Not applicable
50% of summer
Not Applicable
Quarterly
Discharged (HQW)
7Q10 Flow
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 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.

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NCI. NCG140000
CERTIFICATE OF COVERAGE NO- NCG14 SAMPLE COLLECTION YEAR: i
FACILITY NAME: SAMPLE QUARTER: ❑Iul-Sept ❑Oct -Dec ❑Jan -March ❑April -June
PERSON COLLECTING SAMPLES: COUNTY:
CERTIFIED LABORATORY: Lab # PHONE NO.
Lab It ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MDj3
pH
(standardl
Total Suspended
Solids
(mg/LI
SettleTPH
able
Solids
(ML/L)
usfrty
method 1664A
SGT HEM'
(mg/L)
Dlseharge
Duration
(minutes)
Total Flow
(gallons/day)'
5-93'4
3015
53
(15)`
3 if wastewater systems have not discharged in this quarter— report "ND Flow" or"No Discharge" here. Please make sure to mark the sample quarter above,
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (Rra% Mixing Drum
Clearout (MD). Report more than one type if the waste -stream is commingled.
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring Far that parameter For six months, unless DWQ RO staff
notifies you to continue monitorirg.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters,
' TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2o10-06J30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 5D% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (Q
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mall Service Center
Raleigh, North Carolina 77699-1617
[phone]
YOU MUST SIGN THIS C£R"WA TION EQfi ANY INFORMATfOlV 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." n
�v
(Sign re ermirtteeE - (Date)
Permit Date: 7/l/2010-06/30/2015 last Revised 07/13/11
Page 2 of 2

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PaceAnalytical'
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CHAIN -OF -CUSTODY i Analytical Request Document
The Chan-ol-Custody is a LEGAL DOCUMENT. All ralevant rreids must be compiel9d accurately.
Section A Soctlon 8 Section C
Pago: of
Raqulmd Glwml Inlormetion: Required Reject Informalion: Invoice Information:
Company: Rogan TD', Aitanlion:
2056302
CDpyTc
Address: $ -OLS
Company Name.
REGULATORY AGENCY
Address: -
NPDES r.. GROUND WATER I— DRINKING WATER
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Email To: te Pucrhase
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ace Analytical
www.pacelabs. com
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: HILLSBOROUGH #53
Pace Project No.: 92285571
Eden Certification IDs
205 East Meadow Road Suite A. Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
CERTIFICATIONS
North Carolina Wastewater Certification #: 633
VirginiafVELAP Certification #: 460025
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc.. Page 2 of 9

aceAnalytrcal
mm.pacefabs.mn
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Hurtersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project: HILLSBOROUGH #53
Pace Project No.: 92285571
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
92285571001 PLANT #53 OUTFALL #1 SM 2540D DWJ 1 PASI-E
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 3 of 9

aceAnalytical
www.pacelabs.com
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704 )875-9092
ANALYTICAL RESULTS
Project: HILLSBOROUGH #53
Pace Project No.: 92285571
Sample: PLANT #53 0UTFALL #1 Lab ID: 92285571001 Collected: 02/04/16 09:10 Received: 02/05/16 15:10 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D I
Total Suspended Solids 4.1 mg/L 2.5 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
Date: 02/12/2016 09:01 AM without the written consent of Pace Analytical Services, Inc..
02/10/16 10:54
Page 4 of 9

ace_ Analytical o
www.pacelabs.com
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: HILLSBOROUGH #53
Pace Project No.: 92285571
QC Batch: EDEN121705 Analysis Method: SM 2540D
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92285571001
METHOD BLANK: 1663133
Associated Lab Samples: 92285571001
Parameter
Units
Total Suspended Solids
mg/L
LABORATORY CONTROL SAMPLE: 1663134
Parameter
Units
Total Suspended Solids
mg/L
SAMPLE DUPLICATE: 1663135
Parameter
Units
Total Suspended Solids
mglL
SAMPLE DUPLICATE: 1663136
Parameter Units
Total Suspended Solids mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 02110/1610:51
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
250 250 100 90-110
I
92285759001 Dup
Result Result RPD Qualifiers
44.5 45.0 1
92285802001 Dup
Result Result RPO Qualifiers
98.0 95.0 3
Results presented on this gage 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: 02/12/2016 09:01 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 9

aceAnalyticaI
• wwwpacelabs.cam
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 2BO78
[phone]
QUALIFIERS
Project: HILLSBOROUGH 453
Pace Project No.: 92285571
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.
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 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, Styrene, and Vinyl chloride.
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.
TIN -The NELAC Institute.
LABORATORIES
PASI-E Pace Analytical Services - Eden
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02/12/2016 09:01 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 9

aceAnalytical
www.pacelabs, cam
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: HILLSBOROUGH #53
Pace Project No.: 92285571
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92285571001
PLANT #53 OUTFALL #1
SM 2540D
���1��1L��Ctrrb7
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02112/2016 09:01 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 9

%�WwAnalyiFical
Uvuitnent rvame;
Sample Condition Upon Rece
Document No.:
r-RAL-CS-Wi-rev.o3
vocurnent Kevlsea: lbut j Lute
Page I of 2
Issuing Authority:
Pace Huntersville Quality Office
Elm Client Name: Prefect #: WO : '028557
1
.Courier: — [--]Fed Ex ❑UPS ❑LISPS OCRent 'i III � Ili 11
❑Commercial ❑Pace 00ther: .22855'71
Custody Seal on Cooler/Box Present? Dyes 0No Seals Intact? Oyes - ONo _
Packing Material;KIR
❑Bubble Wrap ❑Bubble Bags None ❑Other.
Thermometer IR Gun SN: 122065a87
Used: Gun SN: 12Z065371 Type of Ice: [wet ❑Blue ❑None ❑Samples on Ice, cooling process has begun
Cooler Temp Corrected ('C): , Z Biological Tissue Frozen? ❑Yes ❑No N/A
Temp should be above fr ezing to fi'C Correction Factor: 0.01C Date and Initials of Person Examining Contents: Z 5 l
USDA Regulated Soil ( I/A, water sample) _
Did samples o iginate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from forelgn source (Intemational
❑Yes No Including Hawaii and Puerto Rico)? ❑YesNo
If Yes to either question, fill out a Regulated Soil Checklist and Include with SOUR/COC paperwork.
COMMENTS;
of Custody Presenl?
Yes
No
N/A
1,
of Custod Filled Out?
Yes
No
N A
Z.
O�Chal
of Custod Relinquished?
Yes
NoN/A
3.
ier Name and/or Signature on COC?
Yes
❑No
❑N/A
4.
5amplesArfived within Hold Time?
Yes
❑No
N/A
S.
Short Hold Time Anal sis (<72 hr)?
Yes
No
❑N/A
6.
Rush Turn Around Time Requested?
❑Yes
No
N/A
7.
Sufficient Volume?
Yes
Na[]N/A
-
8.
Correct Containers Used?
-Pate Containers Used?
j Yes
Yes
❑No
No
❑N/A
N/A.
9.
Contalners Intact?
Yes
oNo
N/A
V).
Filtered Volume Received for DlssoNed Tests?
Yes
❑No
N A
11. Note if sediment Is visible In the dissolved container
Sample labels Match COC?jyes
-Includes Date/Time/ID/Analysis Matrix:
[]No
❑N/A
12.
AJ1 containers needing acid/base preservation have been
checked?
All containers needing preservation are found to be in
compliance with EPA recommendadon?
(HNO3i H250,, HCIc2; NaOH>9 Sulfide, Na0H>12 Cyanide)
Exceptions: VOA, Coliform, TOC, oil and Grease,
DRO/8015 (water) DOC.LLHg
[Yes
Yes
Yes
❑No
❑No
No
❑N/A
❑NIA
N/A
13
Samples checked for dechlorization
Yes
No
N/A
14.
Headspace in VOA Vials >5-6mm)?
QYes ,
No
/A,
15.
Trip Blank Present?
Trip Blank Custody Seals Present?
Pace Trip Blank Lot 4 (if purchased):
[]Yes
[]yes.
[]NO
❑No
N/A
VN/A
16.
CLIENT NOTIFICATION/RESOLUTION
Person Contacted:
Comments/Resolution:
Project Manager SCURF Reviety: 1--rC— _
Note: Whenever there is a discrepancy affectlag North Caro
hold, Incorrect preservative, out of temp, Incorrect containe
Field Data Required? ❑Yes [INo
Date/Time:
l 14
`7 ��._
samples, a copy of this form wi!Ibe sert to the North Carolina : DffENNR Certification Office (I.e. out of
Page 8 of 9

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 Z 547
FACILITY NAME: I 3
PERSON COLLECTING SAMPLES 11164 !4`fiG:&.0
CERTIFIED LABORATORY Lab 4
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR; Z a 16 I
SAMPLING PERIOD: ❑ July -December January -June
COUNTY aC&,n
PHONE NO,(O 2
ADD TO LISTSERVE? ❑YES ONO EMAIL;
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ❑Other.
Dutfall No.
Date Sample
Collected
(mo/dd/yrOR
HD FLOWjt
pH
{Standard
units)
TS5
{mg/L)
Event
Duration
(minutesj
Total
Rainfall'
tin)
In Tler 2
Monthly
Monitoring?
(y/n)
It of Months in Tier
t
2Sampling
6-9
100
+? 1
LI I90.
z
` If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each oulfall here. Please make sure to mark the sample period above.
If a value is In excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be dune until 3 consecutive samples are below the benchmark or within the benchmark range.
a TS5 benchmark values are lob mg/I, except when discharging to ORW, HRW, Trout, and PNA waters where they are SO 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

s~_
Part B: Vehicle Maintenance Activitv Monitarin¢ Reauirements for facilities usine > 55 ¢al of new motor oil/month—avera¢ed over a calendar year.
Outfall
No.
Sample
Hate Sam p
Collected
(ma/dd/yr)
pH
(Standard
Units)
TPH usrrty method
1664ASGT-HEM
(mg/Q
Total Suspended
solids
(mg/L)
Event
Duration
{minutes)
Total
Rainfall'
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
n of Months
inTier 2
Sampling,
6-9
is
i
i
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEAT ANY ONE OUTFAIL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO E<
HAVE YOU CONTACTED THE REGION? YES ❑ NOV
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy ofthis DMR(including all "No Flow" & "No Discharge" reports) within 30da s of receipt of sample or at end of monitoring eriod
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:
't certify, under penalty of law, that this document and all attachments were prepared under my direction ar 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 ere are signiflcant penalties for submitting false information, including the possibility of fi es and Imprisonment for knowing violations.'
3 n 6
(Signor f p ittee} (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

RECEIVED
MC®EMR APR 0 1 2014
Stormwater Discharge Dutfall (SD®) CENTRAL FILES
Qualitative Monitoring Report DWQIBOG
Forguidance on filling out this form, please visit: httn:!![�urt:,].n�cl �r.�F:s;j4vvllj+ c +rti tst: r ►dcs,i� #Cain
Permit No.: N/C/�/_ /�/—/�/A/�/ or Certificate of Coverage No.: N/C/G/Z
Facility Name:--2ia,4g-`II
County: D,,�k.r,- Phone No. 73;�- 7
Inspector: 0?
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): . 25'
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Vyes ❑ 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
permitter[ site outrall. 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 aide 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 hest of my knowledge:
(Signature orPermittee or Designee)
Page 1 of 2
5WU-242, Lasr modified 10/25/2012

1. Outfall Description:
Outfall No. 1 Structure ( ape, itch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
.,.,....!SPA �� ��• ('....: _ta.�,_�u„� - ..
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: r—L"r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): IiG-
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
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and S is the surface covered with floating solids:
® 2 3 4 5
G. 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:
(D 2 3 4• 5
7. Is there any foam in the stormwater discharge? Yes
Ni�c
B. Is there an oil sheen in the stormwater discharge? Yes
6
9. Is 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

STORMWATER DISCHARGE OUTFALL (S®O) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 5 O
FACILITY NAME: _ PL,�-4 E;.3�#.1ISw-,-
PERSON COLLECTING SAMPLES _M 06W I
CERTIFIED LABORATORY Pam,« Lab # qr
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: ZOI y .
SAMPLING PERIOD: ❑ July -December January -June
COUNTY D a/4-, _
PHONE NO.( 9ig ) 13a - 1s09
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: USA ❑HQW ❑PNA []Trout ❑Other.
Outfall No.
Date Sample Collected
(mo/dd/yr OR
NO FLOW)'
pH
{standard
Units)
TS5
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(inj
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
z
2 Sampling
-
-
6-92
1002.3
-
-
-
-
IS(AL)
_ZS
1 if "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfafl 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.
9 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Dutfall
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
Rainfall4
{in}
New Motor Oil
Usage
(gal/month)
In InTier#
2 Tier
Monthly
Monitoring?
Wri)
of Months
in Tier 2
z
Sampling
6-9Z
is
1002.3
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO [vY
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature 6{Permittee}
31r7h-i
(Date)
Permit Date: 7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

(�55'neAnalyficale
www,pacetabs.com
Laboratory Report
MD Capps
Ready Mix Concrete
PO Box 27326
Raleigh, NC 27611
Project: PLANTS#53
Pace Project No.: 92193594
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 1 of 1
Report Date: 03/26/2014
Date Received: 03118/2014
Sample: OUTFALL 1 Lab ID: 92193594001 Collected: 03/17/14 12:11 Matrix: Water
Parameters Results Units Report Limit Analyzed Qualifiers
Total Suspended S`olliidss 5.3 mglL 2.5 03124/14 16:44
Reviewed by: _ "—
Nikitia Jones -Jackson
[e-mail]
Asheville Certification IDs
2225 Riverside Dr., Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #; 37712
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
West Virginia Certification #: 356
VirginiaA/ELAP Certification #: 460222
Page 1 of 3

2aceAnalyticalI
Report Results to:
Ready Mixed Concrete
P.O.Box 27326
Raleigh, NC 27611
mb(Aeps
ATTN: Jobn-WAsQR --
Phone: [phone]
Chain of. Custody
Bill Results to:
Ready Mixed Concrete
P.O.Box 27326
Raleigh, NC 27611
I. �=7wa�t<'t'
ATTN. 40 1 VAlse -
[;[Standard Report Delivery
Rush Report Delivery (w/ surcharge)
Requested Due Date:
Project Reference: Plants #53
Purchase Order #:
Sampled By: rnnup.,&:�
A.In 'ZC
Uorn
orm IF
NNW
4X V
NO
EVA
pgg e'
Outfall 1
G
3hlty
Sw
TSS
Relinquished b
lReceived
R ei cd_by t natu e
. I I P 0 -
Da
Time
For Lab Use Only
Temperature at receipt:
C
Relinquished , signature)
by (signature) I
Dat
Time
Relinquished by (signature)
Received by (sIgnature)
Date
Time
M

Document Name: Sample Condition Upon
Document Revised: April 04, 2013
;f Analytical
Recei t SCUR
Page 1 of 2
Document No,:
Issuing Authorities:
'
F- L-CS- 01-rev.02
Pace Asheville Quality Office
Client Name: 1 C�
Where Received: Huntersyille ❑ Ash e Eden Raleigh
Courier (Circle): Fed Ex UPS USPS Client Commercial Pace . Other
Custody Seaton Cooler/Box Present:. yes no Seals intact: ffj yes n no
Packing Material: ❑ Bubble Wrap die &�c7s No Other
Circle Thermometer Used: IR Gu SN:122065387 yype of lce: Wet Blue None n Samples on ice, cooling process has begun
IR'Gun t3 1
Temp Correction Factor: Add btract a l0 C
CorrectedCooler Temp.:-__ *� __ C Biological Tissue is Frozen: vas No NIA
Ternp should be abovefreezing to 6°C Comments:
Date and Initials of person exam€n€ng
cot to Pr o
check.
Chain of Custody Present:
es -CINo -ONIA
1. _.... ......
- _....... .. ....
Chain of Custody Filled Out:
Yes ❑No
❑NIA
2.
Chain of Custody Relinquished:
Yes ❑ e
©N/A
3.
Sampler Name & Signature on COC:'ZlYes
DNo
❑N1A
4.
Samples Arrived within'Hold Time:
Yes ❑No
❑NIA
5..
Short Hold Time.Anal s€s a72hr),
❑ves 4N.
❑NIA
6. .
Rush Turn Around Time Requested:
Dyes No
❑NIA
7.
Sufficient Volume:vyes
[]NO
©N/A
16.
Correct Containers Used:
-Pace Containers Used:
es ❑No
/. Yes ❑No
ONIA
❑NIA
9.
Containers intact:
es ❑No
ONIA
10,
Filtered volume -received for. Dissolved tests
❑Yes ONo
NIA
11.
Sample Labels match COC:
-Includes dateltimel[01Analysis Matrlx:
i1Yes �❑.too
❑NIA
12.
All containers needing preservation have been checked.
All containers needing preservation are found to be in
cornp€iance with EPA recommendation.
exceptions: VOA, Coliform, TOC, O&G. Wl-DRO {water}
es []No
r�Yea ❑No
r
Yes ❑ No
❑NIA
❑NIA
13,
Samples checked for dechlorinatlon:
oes ONo
❑NIA
14,
Headspace in VOA Vials ( >6mm :
Dyes El No
N/A
15.
Trip Blank Present:
Trip Blank Custody Seals Present
Pace Trip Blank Lot # (if purchased):
❑Yes ON.
Ores ❑No
NIA
P4A
16.
Client Notiflcatio67 Resolution: Field Data Required? Y I N
Person Contacted: Date/Time:
Comments! Resolution:
SCURF ISRF Hate: JQ Review:: I L
Note: Whenever there is a discrepancy affecting North Carolina compliance
samples, a copy of this form will be sent to the North Carolina DF-HNR
Certification Office ( i.e out of hold, Incorrect preservative, out of tamp,
.Incorrect containers)
Place label here
f3