NCG140273_MONITORING INFO_20170522

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
f V �� �'7 u a`73
DOC TYPE
❑ HISTORICAL FILE
f5( MONITORING REPORTS
DOC DATE
°?
YYYYM M D D

I . ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year. 2017
*Report ALL STORMWATER monitoring data on this form (include "No Flow" 'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 140273
Facility Name: Southern Concrete Materials — Salisbury Plant
County: Rowan
Phone Number: ( 828 ) 253-6421 Total no. of SDOs monitored 2
Certified Laboratory ETA Lab # 600
Lab #
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthty monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Permit Date 811l2017 — 6/30/2022
Last Revised 8-22-2015

- It Certificate of Coverage No. NCG 140273
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 2 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall,
inches
-
Total
Suspended
Sus
Solids (TSS),
m 11
pH,
SU
Non -polar O&G
(EPA Method
1664 (SGT-HEM)),
mgll (VMA)
New Motor Oil
a allmo.
Usage
g (g }
Stormwater
Benchmarks
Indicate NO FLOW 1f
applicable
Circle Benchmark
1 041CJO
.
6.0-90
15
�55 g allmo. average requires TSS and
Non -polar O&G monitoring
Date Sample
Collected,MMM
molddl r
05/22/2017
0.4
12
7.7
No Flow
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 RNETU
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR § 122.22]
Signature
Date a/,�6/
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in D WR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
_ 1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 811/2017 - 6/30/2022
Last Revised 8-22-2015

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140273
FACILITY NAME: _Southern Concrete Materials -Salisbury
PERSON COLLECTING SAMPLES Jeff Lamm
CERTIFIED LABORATORY ETS Lab # 600
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLING PERIOD: 9 July -December
COUNTY Rowan
PHONE NO. ( )
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
® January -June
❑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'
(in)
In Tier 2
Monthly
Monitoring7.
(y/n)
# of Months in Tier
2 Samplingz
-
-
6-42
1002.3
_
-
-
-
1
No Flow
N/A
N/A
N/A
N/A
(N y
2
2
No Flow
N/A
N/A
N/A
N/A
41 Y
2
Huu
CENTRAL
FILES
' 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/l, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/l.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)l
pH
(Standard
Units)(m
TPH using method
1664A SGT-HEM
/L)(m
Total Suspended
Solids
/L)
Event
Duration
(minutes)(in)(gal/month)
Total
a
Rainfall
New Motor Oil
Usage
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier Z
Sam lin 2
6-92
152
1002.3
-
-
-
-
-
N/A
N/A
N/A
N/A
N/A
N/A
N/A
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail OriPinal and one copy of this DMR (includins all "No Flow" & "No Discharee" reports) within 30 days of receipt of sample for at end of monitorine period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are ignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
8/1/2016
(Date)
Permit Date: 7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140273
FACILITY NAME: _Southern Concrete Materials -Salisbury_
PERSON COLLECTING SAMPLES _Bill Jory
CERTIFIED LABORATORY Prism Lab # _402
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: _2016
SAMPLING PERIOD: ❑ July -December ® January -June c
COUNTY Rowan
PHONE NO. ( )
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW ❑PNA ❑Trout ®Other
0
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units]
TSS
(mg/L)
Event
Duration
(minutes]
Total
Rainfall'
(in}
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-92
1002,3
_
-
_
-
1
6-16-16
7.8
62
165
0.32
yes-
1
N/A
iJ 1b
CENTRA,
5
CT10N
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/l.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
N
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)'
pH
(standard
Units)
TPH using method
1664A SGT--HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall a
(in)
New Motor Oil
Usage
(gal/month]
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-91
1s,
1002,3
N/A
N/A
N/A
N/A
N/A
N/A
N/A
n
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [:]NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail OriEinal and one coov of this DMR (includinE all "No Flow" & "No Dischame" 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 TH15 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 signifjcgnt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Per
6/28/2016
(Date)
Permit Date.7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. NCG140273
FACILITY NAME: _Southern Concrete Materials -Salisbury
PERSON COLLECTING SAMPLES _Jeff Lamm
CERTIFIED LABORATORY ETS Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: _2016
SAMPLING PERIOD: El July -December ® January -June
COUNTY Rowan
PHONE NO. ( )
ADD TO LISTSERVE? ❑YES ❑NO EMAIL: �)
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Othe�r�_
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW) 1
PH
{Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling'
-
6_92
1
No Flow
N/A
N/A
N/A
N/A
N/A
N/A
N/A
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/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part 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
Rainfall ,
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-92
152
1002,3
N/A
N/A
N/A
N/A
N/A
N/A
N/A
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" retorts) within 30 days of receipt of sample for at end of monitoring period
in case of "No Flow" to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
7/6/2016
(Date)
Permit Date:7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

11
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 7
FACILITY NAME: 131,� Ir^_TSr+a/i
PERSON COLLECTING SAMPLE I
CERTIFIED LABORATORY f S)►-, Lab #
Lab #
OPTIONAL INFO:
SAMPLE COLLECTION YEAR: 0�—d ) --
SAMPLING P RIOD: ❑ July -December January -June
COUNTY fZdZ11; 41
PHONE NO. ( )
ADD TO LISTSERVE? []YES ❑NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA [-]Trout
EO
the�
m+
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
PH
(Standard
Units}
TSS
Event
Duration
(minutes)
}
Total
Rainfall'
in
['}
In Tier 2
Monthly
Monitoring?
(y/n)
r
# of Months in Tier
i
2 Sampling'
�r
-
-
6-92
1002,3
-
-
-
-
/
11,7 Z
c
C
11,r0 ._, �� fi1!L' lFs
' `-4iitJ�V
If "NO FLOW" or "NO
DISCHARGE Enter "NO
FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the samnle nerind ahnve_
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
Morithly 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.
'M
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Partb: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
-'
Outfal!
No.
Date Sample
Collected
(mo/dd/yr)'
PH
(standard
Units)
TPH using method
1664A SGT HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall a
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-92
152
1002,3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [—]NO
❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one coov of this DMR (includine all "No Flow" & "No Discharee" reports) within 30 days of receipt of sarnole for at end of monitorine eeriod
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 the are signifi nt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
C gzLA
(Signature of P rmdit e) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG 4� 7 ,3
FACILITY NAME: .d4 r r�n 1 d e�� G S
PERSON COLLECTING SAMPLES / iYa'r
CERTIFIED LABORATORY , s Z Lab # U
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: �� ,
SAMPLING P IOD: ❑ July -December January -June
COUNTY 1< 6),14-rl
PHONE NO. ( CS'
ADD TO LISTSERVE? ❑YES PNO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout Other
Outfall No.
Date Sample
Collected
C
(mo/dd/yr OR
NO FLOW)'
pH
[standard
units)
TSS
(mg/L)
Event
Duration
[minutes]
Totalc
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-92
1002.3
_
-
,33
Al
1::i 9t
JUN 0 9 2.O1
rF:N R I
DWQIBOG
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.
s 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.
a
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

if
<-+ Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 5S gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)'
PH
(Standard
Units)
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
2
Sampling
6-92
152
1002.3
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 coov of this DMR (including all "No Flow" & "No Discharge" reoorts) within 30 days of receipt of sample for at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware thatAere are sigIOificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
{Signature
(
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2