NCG140293_MONITORING INFO_20190528

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
❑HISTORICAL FILE
� MONITORING REPORTS
DOC DATE
❑ C)'OI
YYYYMMDD

EnAon►nenud
— Qua11ry
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling our this farm, please visit h ://de .nc. ov/about/divisions/ener -mineral-land-
resources/enerev-mineral-land-permits/stormwater-Aermits/nndes-industrial-sw#tab
Permit No.: NICI II 1 I I 1 I or Certificate of Coverage No.: NIC/G111 �l �l �l?/3/
/}
Facility Name: i L T C" exe-U_ - _ 011, 5O -n ^
r
County: , itJ C_� v �,^Phone No. , a�5'2 ; g 3- a�
Inspector: tAV!?--
Date of Inspection: —I
Time of Inspection: to 113
Total Event Precipitation (inches): - SAY 2 $ 2019
CENTRAL FILES
All permits require qualitative monitoring to be performed during a "measurable storm event"
A "measurable storm event' is a storm event that results in an actual discharge from, the permitted site
outfall. The previous measurable storm event must have been at Ieast 72 hours prior. The 72 hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Office.
By this signature, I c that this report is accurate and complete to the best of my knowledge:
cL /w A
ignature of Permittee or Designee)
1. Outfall Description: /� � �� �
Outfall No. Structure (pipe, ditch, etc.)f (?
Receiving Stream:
Describe the industrial
within the outfall drainage area:
page 1 of 2
SWU-242, Last modified 07/28/2017

m
CONCRETE
SERVICES
3214 Tvrnage Road
Wilson, NC 27893
RICK PROCTOR
VICE PRESIDENT/
GENERAL MANAGER
Mobile • 252.205.3337
Office • 252.293,0500
Fax • 252.293.0838
[e-mail]

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 1 Do`s
3. Odor: Describe any distinct odors that the
chlorine odor, etc.): _ k-h> 9
may have (i.e., smells strongly of oil, weak
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: � D
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5 pd p{�G6kL-),k,
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:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? 9 Yes �o. „ _ 1J6
S. Is there an oil sheen in the stormwater discharge? 0—Yes a (3 0 i SC
9. Is there evidence of erosion or deposition at the outfall? A Yes . A u O " t5 G
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
sWU 242, last modibed 0712812017

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NC(3140000
CERTIFICATE OF COVERAGE NO, NCG14 0 ad 3
FACILITY NAME: LT . , i` e
SAMPLE COLLECTOR:
CERTIFIED LABORATORY { F& CJ Lab #
lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: C;V 1`
SAMPLING PERIOD: El July -December January -June
COUNTY G
PHONE NO. ( ) Alij, • Q O
ADD TO LISTSERVE? ❑YES P&O EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout her`1� -
ivsw—
,;�•...y ",!•:y , S
r
�'�..r>
Oiitfall'No'�
a U
T:iti
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ecte�lk,r�%*
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; y: ar �x�.�= ' -N:;
. , . r
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w"a �; ,:
.*, , . r
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ar i:� k _Yt t .
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j•.rrn!tr'{ �J ::L "
<- 4..., -Y��, .fed +I
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?J 1, Y°' �.'- }+y g ��•iY''
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' 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/I.
°For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 8/1/2017-6/30/2022 Last Revised 07/27/17
- Page 1 of 2 C

Part 8: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
A 'n { jji
A �Ii O fry !}'
/ r `.:
Outfal! .� ;
{, ._, I
y y Now b�'°:Co}lecte'd'
n; 4
CT, •<. :.
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r�_ t � � �4 ��' '.�
r. '•; • , w .,r,
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I sr
(Standard;
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► Non Poiar�
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=�f K' 1664�;..:' ,�
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= �..
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_ r '_•. wa ``-
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Nevr,Motor 011ljUsage '
�: o _ r—
[gal/month),_' .a>'
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n '- �rT
? 1 In�11�r��
,hIgnthly_,
` G" ..:
.lvlonitonng?)` ,
r
r.• y.�
�i-..F11�t� S �.y 'i er
r k • ' ,!
# of Months in Tler�2::•
.a. "
►..' �' Samplings "
j
.t 2"pr
19
,� a ,c 3
.1si4�` { e
;<., v% , c-
1Q023
rtr'E«
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCSIrAT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO [�
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period in
case of "No Flow") to:
Division of Water Resources
Attn: DWR 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 res onsible for athering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there significa enalties r submitting false information, including the possibility of fin sZi
'm risonment for knowing violations."
V.s a
(Sign re of Permfttee) (Date)
Permit Date: 8/1/2017-6/30/2022 Last Revised 07/27/17
CPage 2 of 2 C

OMICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9E0233
PLT Concrete Services
Mr. Rick Proctor
3214 Tumage Road
Wilson, NC 27893
Case Narrative
Rocky Mount- Water Temperature, 730 F, Air 650 F pH 8.5
Zebulon - Water Temperature, 790 F, Air 640 F pH 8.4
Selma - Water Temperature, 710 F, Air 650 F pH 8.6
Wilson - Water Temperature, 74° F, Air 660 F pH 9.3
Analytical Testing Parameters
Project Name: Stormwater Samples
Project / PO Number: NIA
Received: 05/15/2019
Reported: 05/17/2019
Client Sample ID: Rocky Mount PLT, Grab
Sample Matrix: Stormwater Collected By: ParrishlEastwood
Lab Sample ID: KgE0233-01 Collection Date: 05/14/2019 11:19
Wet Chemistry Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2640 D-2011
Total Suspended Solids 17.0 8.20 mg/L 1 05/16/19 0816 TMC
SM 2540 F-2011
Settleable Solids t0.10 0.10 mUL 1 05/16119 0915 TMC
Client Sample ID: Zebulon PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K9E0233-02 Collection Date: 05/14/2019 %07
Wet Chemistry Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2540 0-2011
Total Suspended Solids 4.83 4.17 mg/L 1 05116/19 0816 TMC
SM 2640 F-2011
Settleable Solids
<0,10 0.10 mUL 1
05/16/19 0915 TMC
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com
Page 1 of 3 E

0MICROBACO
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
/ K9E0233
Client Sampl,-k ID: Wilson PLT, Grab
Sample Ma: Stormwater Collected By: Parrish/Eastwood
Lab Sample t K9E0233-03 Collection Date: 05/14/2019 10:40
Wet Chemistry Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2640 D-2011
Total Suspended Solids 4.83 4.17 mgiL 1 05/16/19 oars TMC
SM 2640 F-2011
Settleable Solids <0.10 0.10 mUL 1 05/16/19 0915 TMC
Client Sample ID: Selma PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K9E0233-04 Collection Date: 05/15/2019 10:24
Microbiological Parameters by Result RL Units Dilution Note Prepared Analyzed Analyst
Membrane Filtration
SM 9222 D-2006
Coliform, Fecal 12 1.0 per 100 mL 1 05/15/19 1535 TMC
Definitions
RL: Reporting Limit
Report Comments
The data and information on this, and other accompenying documents, represents
only the sample(s) analyzed. This report is incomplete unless all pages indicated
in the footnote are present and an auMor&ad signature is included.
Reviewed and Approved By:
Jeanne Overstreet
Client Relationship Specialist, Environmental
Reported: 05/1712019 09:07
I
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page 2 of 3

Fayetteville Dlvlslon 2592 Hope Mills Road Fayetteville, NC 28308 (910) 864-19201864-8774 fax
CHAIN OF CUSTODY RECORD
PAGE I OF i
C N"Ia&ADDRESS:
PLT Concrete Services
3274 Tumage Road
Wilson, NC 27893
Poo
PROJECT I LOCATION
Storm water sites
N
to
LL
TYPE OF ANALYSIS
PRESERVATION CODE
1
N
M
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¢a
U
Lu
Cool• p,, ,s�C oNiY,'
•, �,:: j3 p.�iM03 {ptti<,?� t 48 C� ;. ;'•• � :•I =�:'
:.... •. � .. �.•. ::.:�:;y';.
$-4ptet4 +8'C::�;
�`•.-= a:$Ddl[llft ID...,; �1 `�:s:t��4:,.F•�;� ;�!�
..... ....
CONTACT PEUDN
Mr. Rick Proctor
252.293.0500
aAuwJ R: r,rY �sl+i�-i SF.
DATE f METKOD 0P SWMENIt
LAB ID #
SAMPLE
Sample Start
Sample
Date
Sample
Start Time
Sample
Stop Deco
Sample Sic
Time
coup
cRA9
Lab pH
Field
pN
Water
Tamp
Air Tamp
,F
Rallr'
Mt. Plant
'1 -Iq
��:1 �f
y�jY�l`�
��%��
X
A
Z
Zebulon Plant
'fy-i
o %e (o
-
0 : 4'Z
X
A
aO
0 3
Wilson Plant
16,
1-1 f
; Yb
X
A
#
Selma Plant
'1S�t
D'
-15-
lo;
X
1
F
Raanpula :
t
Date
ma
A 5 9
aA t (81 a
z
ate
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e
atee
m
a
me
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e
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me
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B
PH Field :
Temp Field 1:
IS DATA FOR REG. COMPLIANCE PURPOSE?
YES NO WHICH: Doi Q

Envimrunentat
Qualtry
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out thisform, please visit h s://de -nc- ov/about/divisions/ener -mineral-land-
resources/enersv-mineral-land-permits/stormwater vermits/niDdes-industrial-sw#tab-4 -
Permit No.: NICI I I 1 I_I_I_I or Certificate of Coverage No.: NIGGI�I?I 6l 21 l �l
Facility Name: i L— 0"'.. e + 011���
County: W l S U Phone No.
Inspector: tAr, %-
Date of Inspection:
Time of Inspection: 3
Total Event Precipitation (inches): • ��
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm,
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I cergy that this report is accurate and complete to the best of my knowledge:
V A.
ignature of Permittee or Designee)
1. Outfall Description: Outfall No. Structure (pipe, ditch, etc.): f#nJ le_ — (SAWIA
Receiving Stream:
Describe the industrial activifiA that oqcur within the outfall drainage area:
Page 1 of 2
5wU-242,1.ast modified 07/28/2017

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: kb
3. Odor: Describe any distinct odors that the
chlorine odor, etc.): k3k> •1
may have (i.e., smells strongly of oil, weak
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy: f) t'.. �
1 2 3 4 5 i
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and. 5 is the surface covered with floating solids:
1 2 3 4 5 "0
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: �y
1 2 3 4 5 + `Jf��
7. Is there any foam in the stonnwater discharge? p Yes 0o. 6
S. Is there an oil sheen in the stormwater discharge? 9-Yes p. a 0 0
9. Is there evidence of erosion or deposition at the outfall? A Yes 6. kf(-) '/ r5 G
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
SWU-242, Last modified 07f28t2027

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 a 7
FACILITY NAME: �T r' C` ZQs hi r
SAMPLE COLLECTOR:
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: C;�o `
VJanua,-June SAMPLING PERIOD: ❑ July -December
COUNTY Wi�dGJV
PHONE NO. {C) c1 • O `00
ADD TO LISTSERVE7 ❑YES 0 0 EMAIL.
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout her . '��10
Nzvq EN
?i. y. ...'. �., ' -
.Outfall No -L
p.+ i.,_t.. r I
a :.- •.: -, " le7.ra.c.mt• ekpd, l"4s,
�h (mm /d_ LdO/.yt1Nr. 1OlrtiR:_;. ,.ts I , rry
•i- i; :Y,,�
N0.•
;(Stan.dard Und)
�5,..>..,-i � r,: 4^ f.+ ff. ..- {., •r-ii1
�F��:�a4+.� , A.t. ��y'�...I: �rt i,i t, .F.'..l.�W Y'Ic�,
Total
'[ �s,Yifd-` a.�4. R"aw�u�,i{n,fa�� ll4.k=`1.�
'.�d t f k n
-
In Tier2E
jC
1 T sr�. A�/l'ontY hel Yl,rr5yM/o1n.a it,.o4�� rtin., $;..7'�� ti: �>'A�
n
4
:�•�.>,: '
a`a�mn, prhs.'Yi.. - n,.:'5m,�Ng:.3.?rt,.:-
sift "y ,0MM�op #
✓.
tl.�t
-
:r.
;}wj6.92
.1�23� Z �4
•. tp �rl i. ,:. �` i a'
�, 'w . '� �a1
r.s..,�, �...
G
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: B/1/2017-6/30/2022 Last Revised 07/27/17
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.t,
No i
" r
�a
Date Saipie
Collected"
(rrio/dd/Yr11
r. r
pH;'
(Standard`
Units
-
Non -Polar
'Oil`& Grease using..
`riethod1664
5GT-NEM
( ,/ `
Total
Suspended
Solids
(mg/L),
Total
a
Rainfall.
�n y
�?
'
New Motor OiL Usage
(gal/month) "'
l
'�
In Tier 2
{,
: Monthly
Monitoring7
(Y/n)
« t r °
„# of Months in.Tier 2
r, Sampling2
`
2_.
15Z+x.. -
��77
ilAT'3 _.
_ "' _.,,
_ �q' s �'' y'x
R. v+• r�
ih ri �. - r 3
'
to
`/i
f
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC T ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitoring period in
case of "No Flow") to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFIC4TION 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 res onsible for athering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there significa enalties cr submitting false information, including the possibility of fin s and imprisonment for knowing violations."
sa
(Sign ure of Permittee) (Date)
Permit Date: 8/1/2017-6/30/2022 Last Revised 07/27/17
Page 2 of 2

• <§>MICROBAC°
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9E0233
PLT Concrete Services
Mr. Rick Proctor
3214 Tumage Road
Wilson, NC 27893
Case Narrative
Rocky Mount- Water Temperature, 730 F, Air 650 F pH 8.5
Zebulon - Water Temperature, 79° F, Air 640 F pH 8.4
Selma - Water Temperature, 71' F, Air 650 F pH 8.6
Wilson - Water Temperature, 740 F, Air 660 F pH 9.3
Analytical Testing Parameters
Project Name: Stormwater Samples
Project / PO Number: NIA
Received: 05/15/2019
Reported: 05/17/2019
Client Sample ID: Rocky Mount PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K9E0233-01 Collection Date: 05/14/2019 11:19
Wet Chemistry Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2540 D-2011
Total Suspended Solids 17.0 8.20 mg1L 1 05/16/19 0816 TMC
SM 2540 F-2011
Settleable Solids <0.10 0.10 mL1L 1 05/16/19 0915 TMC
Client Sample ID: Zebulon PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K9E0233-02 Collection Date: 05/14/2019 10:07
Wet Chemistry Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2540 D-2011
Total Suspended Solids 4.83 4,17 mg/L 1 05/16/19 0816 TMC
SM 2540 F-2011
Settleable Solids <0.10 0.10 mUL 1 a5116/19 0915 TMC
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 283061 910.864.1920 p I www.microbac.com Page 1 of 3

OMICROBAC"'
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K9E0233
Client SampI6 ID: Wiison PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample I K9E0233-03 Collection Date: 05/14/2019 10:40
Wet Chemistry Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2540 D-2011
Total Suspended Solids 4.83 4.17 mg/L 1 05/16/19 0816 TMC ;
SM 2540 F-2011
Settleable Solids <0.10 0.10 mL1L 1 05/16/19 0915 TMC
Client Sample ID: Selma PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K9E0233-04 Collection Date: 05/15/2019 10:24
Microbiological Parameters by Result RL Units Dilution Note Prepared Analyzed Analyst
Membrane Filtration
SM 9222 D-2006
Colifomt, Fecal 12 1.0 per 100 mL 1 05115/19 1535 TIVIC
Definitions
RL:
Report Comments
Reporting Limit
The data and information on this, and other accompanying documents, represents
only the sample(s) analyzed. This report is incomplete unless all pages indicated
in the footnote are present and an authorized signature is included.
Reviewed and Approved By:
Jeanne Overstreet
Client Relationship Specialist, Environmental
Reported: 05/17/2019 09:07
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1 910.864.1920 p I www.microbac.com Page 2 of 3

Fayetteville Division 2592 Hope Mills Road -- Fayetteville, NC 28306 [phone] / 864-8774 fax
CHAIN OF CUSTODY RECORD
PAGE 1 OF 1
C HrHAMEBAODP.MS
PLT Concrete Services
3214 Tumage Road
Wilson, NC 27893
PON
PROJECT I LOCATION
Storm water sites
W
p0
u-
TYPE OF ANALYSIS
PRESERVATION CODE
1
a
CODS• 14a.46'C
_•.,. .. _...::�.t:=,�; �:�•;:::;.:.::
�.�._::Z!`4Ptale+4�'C,•'" ;•;::..
r y ,f $OdfpQl IjD:.,Z. i;' ' ;' •I :•'_'� '' ti ='
...
CONTACT PERSON'
Mr. Rick Proctor
.293 son
2a2 ,0
9A11PLER:
�L( P�iil�-iSb.
c
DATE IMPTHOD OF SHIPMENT:
LAB ID #
8AMP�E
Sample Start
pate
Sample
Start Time
Sample
Slop Date
Sample Stop
Time
Cove
GRAB
Lab p
Field
PH
wet@►..,...
Tate
OF P
Air Tamp
.F
Rain"
'
_Rocky Mt. Plant
-f�l-f 9
1 <<'t
5'!Y-t
!�; r �'
X
A
�.
Zebulon Plant
D %,o b
- j -j
o; 0 rT
X
A
A/O
:#* 3
Wilson Plant
-1'4- 11
16:'V1>
X
A
q, .2q
#
•!S I`
D'
- if fr0:a
S
X
1
F
Selma Plant
R■➢nqulat" by:
Data
me
■d byt ISI atU
Q■te
Imo
R■ nqu ■
■te
T e
ace a posture
ate
fine
3
4
■ qu
■ e
so ■ . gtmnra
Date
ms
5
6
pH Field:
Tamp Field 1:
dnTs or_ a�ecia Haz s:
IS DATA FOR REG, COMPLIANCE PURPOSE?
YES NO NHICH: Doi

i
quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Rep6rt
For guidance on filling out this farm, please visit hfts://deq.nc.gov/about(divisions/energy-mineral4and
resources/energv-mineral4and-r)ermits/stormwatez:petslnndes-industrial-sw#tab-4
Permit No.: IVIC/_ l �l �- I / I I or Certificate of Coverage No. N/C/G/,/ q/ 6l l f ljl
Facility Name: Pt
County: u •l-k<.. ��� Phone No. _ aS� ~ IZ� " b d d —
Inspector: -e-y n•..� - i}�Z(�i 1
Date of Inspection: jp Apt, i �• r` t� ��
Time of inspection:
- NOV1G ZU16
Total Event Precipitation (inches): o I CENTFIALTLON
!, LES
DWR S C
All permits require qualitative monitoring to be performed during a "measurable storm event"
I
A "measurable storm event" is a storm event that results in an actual clischarge from the permitted site
outfall. The previous measurable storm event must have been at least 721hours 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 lapproval from the local DEMLR
Regional Office_ 1,
By this signature, I ertify tha this report is accurate and complete to the'best of my knowledge:
c�c V �.
(Signature of Permittee or Designee)
I. Outfall Description:
Outfall No.
Receiving Stream: _ c
Structure (pipe, ditch, etc.):
i
j
i
Describe the Indus ' ac teA that occur within the outfall drainage aria:
Pagel of2
5WU 242, Last modified 07/2sr2017

2. Color: Describe the color of the discharge bapp colors
Clight, medium, dark) as descriptors: %U Q
3. Odor. Describe any distinct odors the discharge may
chlorine odor, etc.): d � .S
brown, bhie, etc.) and tint
CLe., smells strongly of ail, weals
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy_ j Wo1 2 3 4
S. Floating Solids: Choose the nuoober which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface coverer l with floating solids:
II
2 3 4 SI "Jp
6. Suspended Solids: Choose the number which best describes -the amount of suspended solids in
the stormwwaater discharge, where 1 is no solids and 5 is extremely muddy
1 2 3 4
511
7.
Is there any foam in the stotmwater discharge? P Yes
p No.
S.
Is there an oil sheen in the stormwater discharge? gYes
if"S� No.
I
/Jp Di-5 C .
9.
Is there evidence of erosion or deposition at the outfall?
O'>ies -0
No. IV is -C.
It).
•
Other Obvious Indicators of Stormwater Pollution:
I
"
List
and desenbe
1 I
�I
1 I
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
sndicati -a ofpoliat i=at esposuzXUese condMons warrant further 1 4eS gailo]u1
I
Page 2 of2
SVAJ-242, Last mowed 07)=017

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. NCG14 G c3CR 3
FACILITY NAME: CG x U k
SAMPLE COLLECTOR: w
CERTIFIED LABORATORY 04tC'Rt : U&C _ Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
Wscp
SAMPLE COLLECTION YEAR: C� d O
SAMPLING PERIOD: Yjuly-December ❑ January -June
COU NTY W (J,�G J J
PHONE NO. (cRSat) a qT - 0— S\03
ADD TO LISTSERVE? DYES [TNO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout Other 1A SIN a
At,R w E4T
_
_Obtfall;,No
,. -
c
(mm/dd/yr�OR-
, �,, :u w, r>f r��f
�t�
.t
_., -�.�, ; ,
c:�(StandardJV6ts)
�f �,� .� ��.� �.
x }c �,
.{mg/L}
��4:;� � � *��� �`.�a.: �. � �^�
rTotal
a F . �.F `` P(in}`�'• �.
InTier,2
'
;Monthly Monitoring
�•
lYlri} ;.- �
7
4� Y .a
Months �n Tier 2
Samplingz
_ � � ` .ti �':
_ _ .,._ ..
� .. '. '• _, - - -
i;' 7y�w:� �*5"a. 'VFW
-`S"•--1M23�W �'�
-ti
1 - '^'!
Yr � '' r Y�i �'xt r.
If 11NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 8/1/2017-6/30/2022
East Revised 07/27/17
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.
' �k �CCll, ^•"":Fr'
a !;y,
,.
2 putFall } 'C
�,:�''r
qr oi! s
I.,.,$f,(}'�'y}�,it'
i. 1.'"'M
..k M1''�,1 - f '(
,,; •., ;
r Date`Sample
,;
T.;oCollecfedx�
"b' ,f v .,.a =
air �,
_ tmo%dd/yr)1
r��Wf . ,�- - :� y...y'
,r.
,A'E�
I 1 r�'p �'fi
:^'..'"c"�.i E
r pH :�
rt ' r ..t-.SuspendedM
5tandardk�t�ime[hod
! IT
? . Units3 =.
x }.
gam- :*�*
d% , , , .�..
iY¢N 1-,„
,'Rf'�„Y
:a 'a i
%V�.r. Non Polar wf. �:i
,r ..,
OII;&Grease using
1664
r,,SG"I=NEM
. =,U�. yr.x_
s• •.>`�) e : 1'�•
t_
p�, F-
74 �'�"'!i", irf -i
_ f,e ._ P
Tatdl _
_ .a r�.�? .I
, l(,
sr sc .;.�wr;Raliifal!w
Solids:,., y
61 � ,rs�'':.irk
k (rng/L):�
-
( f
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•: "i
F `�New.M6tor'aII Usages>M
�Td.,.
a ,, '[gal%monthJ;.s
,
4, a r .4 .p. •,�,Y ..s „ (
A'.iJ'! r'!. 51131.T1
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;r"aIhTIeK2 �
:r`-t; awl sir
,,,,. :,�ti�
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Monitoring7
`;�F t-i!, :&:.,- ,.t _
- _`l ,3�iri�Y� ..•}I
rr ir?
�,f �r:,.54 1=':�. r7=
. #.of;Monthsin,Tisr2 .,
;4. a
,+,,,�s '..
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Y'
Z-..I--Wa_'
I
...1C✓
.:l:"s'^..�'.4 �,r•�F Mi:.
v iAjA �,_emamu
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN S AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO IV
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" reports) within 30 days of receipt of sample (or at end of monitoring period in
case of "No Flow") to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUSTSIGN THIS CER77FIC477ON 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 gatherini information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are si ' ' n aaltia r submi in false info=t­ingthe possibility of fine an imprisonment for knowing violations.
s`
(Signature of Permitt e) (Date)
Permit Date: 8/1/20
i
Last Revised 07/27/17
Page 2 of 2

OMICROBAC°
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K8J0450
PLT Concrete Services Project Name: Stormwater Samples
Mr. Rick Proctor Project / PO Number: NIA
3214 Turnage Road Received: 10/24/2018
Wilson, NC 27893 Reported: 11/02/2018
Case Narrative
Rocky Mount- Water Temperature, 62' F, Air 650 F, Field pH 9.1
Zebulon - Water Temperature, 62' F, Air 55' F, Field pH 8.9
Selma - Water Temperature, 61' F, Air 55' F, Field pH 9.4
Wilson - Water Temperature, 61' F, Air fit° F, Field pH 9.1
Analytical Testing Parameters
Client Sample ID: Rocky Mount PLT, Grab
Sample Matrix: Stormwater Collected By: ParrishlEastwood
Lab Sample ID: K8J0450-01 Collection Date: 10/23/2018 11:59
Wet Chemistry Result RL Units Note Prepared Analyzed Analyst
Method: SM 2540 D-2011
Total Suspended Solids <4.17 4.17 mg1L Z10 10/25/18 1314 MT
Method: SM 2540 F-2011
Settleable Solids <0.10 0.10 mUL 10/25/18 0850 MT
Client Sample ID: Zebulon PLT, Grab
Sample Matrix: Stormwater Collected By: PardshlEastwood
Lab Sample ID: K8J0450-02 Collection Date: 10/23/2018 10:11
Wet Chemistry Result RL Units Mote Prepared Analyzed Analyst
Method: SM 2540 D-2011
Total Suspended Solids 7.16 6.17 mglL Z10 10/25/18 1314 MT
Method: SM 2540 F-2011
Settleable Solids <0.10 0.10 mUL 10/25/18 0850 MT
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1 910.864.1920 p I www.microbac.com Page 1 of 3

*MICROBAC@
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K8J0450
Client Sample ID: Wilson PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K8J0450-03 Collection Date: 10/23/2018 10:58
Wet Chemistry Result RL Units Note Prepared Analyzed Analyst
Method: SM 2540 D-2011
Total Suspended Solids <4.17 4.17 mg1L Zia 1012511E 1314 MT
Method: SM 2540 F-2011
Settleable Solids
:aix[l�il<ill 01 t11
10/25/18 0850 MT
Client Sample ID: Selma PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K8J0450-04 Collection Date: 10/24/2018 10:26
Microbiological Parameters by Membrane Result RL Units Note Prepared Analyzed Analyst
Filtration
Method: SM 9222 D-2006
Coliform, Fecal 3.0 1,0 per 100 mL 10124/16 1409 MT
Definitions
RL: Reporting Limit
Zia: Only one 1 L bottle was provided for both the Total Suspended Solid and the Settleable Solid tests. The Settleable Solid
was run first, followed by the Total Suspended Solid. During transfer of sample between tests, some sample was likely
lost.
Report Comments
The data and information on this, and other accompanying documents, represents
only the sample(s) analyzed. This report is incomplete unless all pages indicated
in the footnote are present and an authorized signature is included.
Reviewed and Approved By:
Jeanne Overstreet
Client Relationship Specialist, Environmental
Reported: 11 ! 0212 018 13 : 04
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1 910.864,1920 p I www.microbac.com Page 2 of 3

m
a
N
N
m
N
m
Fayetteville Division 2592 Hope Mills Road — Fayetteville, NC 28306 [phone] / 864-8774 f
CHAIN OF CUSTODY RECORD
*K8J0450*
CLENrMMESADDREM
PLT Concrete Services
3214 Tumage'Road
Wilson, NC 27893
Pos DIE ILOCA M
storm water sites
�
m
lL
TYPE OF ANALYSIS
PRESERVATION CODE
`
N
¢
U
�
CODE: A=.cs'COY;''�':`::`:
8.�.k3IPb4}+,56'C
r;C=,K2SO4 Ni) t?gs'G_ ;MOM
; '' 1== zry Acefete �4GC. i'•: ; �� ;:�,` =. ':
$p� {p ;; "'=tt1.•, -:t1t
coxrACTr�+sa�
Mr. Ride Proctor
252.293.0600
sArwonTe.n r�, j PCR SI +
Vw
DATErNEMODOFS!{i OCT:
LAS ID #
SAMPLE
sample Starr
Date
sample
Start Time
Sample
Stop Date
Sample stop
Time
GPAs
Lab pH
Field
pH
water
Tamp
�F
Air Temp
-F
Rain
J
RockyMt Plant
10-�3-j•
11 i5 ..1D
23-19
P• 1
X
A
q.i
!e
Zebulon Plant
10 •P '1 Y
10 Io P,4,
. 0-73'1 '
/40t //
X
A
�
Q
Wilson Plant
Z3 ?6
la�..
IO-? �$
/00'?
X
A
C1
61
to Z
N o
Selma Plant
10 )q-15
%a ,,?
/0,)4�S
iw
X
1
1=
' `�
j
S
t� 6
pH Reid:
Temp Field t:
Camments er Special Hazwds: *AAW E D
IS DATA FOR REG. COMPLIANCE PURPOSE?
YESZNO 1VHICH p w
Page 3 of 3

���
Kc- RECE ED
QuaUty MAY A 1 2018
Stormwater Discharge Outfall (SDO) CENTRAL FILES
Qualitative Monitoring Report DWR SECTION
For gradance on filling out this form, please visit hgRsJ/deq.no.gov/about/divisionsleneriy-m3Weral-laud-
reso&ces/enerav-mineral-land-permits/stormwater-permits/npdes_industnial-sw##tab-4
Permit No.: NICIJ / I I l l� or Certificate of Coverage No.: NIGGI j 1! I �l �l �l
Facility Name: P L T U)1' I T _
County: 31 S.O Phone No.
Inspector -
Date ofh spection:
Time of Inspection:
Total Event Precipitation (inches): G
All permits require qualitative monitoring to be performed during a "measurable storm event"
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall_ The previous measurable storm event must have been at least 72 hours prior. The 72 hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Reeional Office.
By this signature, I ce�tffy that tl is report is accurate and complete to the best of my knowledge:
of Permittee or
1. Outfall Description:
Outfall No.
Receiving Stream.:
Describe
Structure (pipe, ditch, etc.):
E�K �U-
;� that opcur within the outfall drainage area:
Page 1 of2
5wU--242* Iasi madfsd 07282017

2. Color: Describe the color of the discharge
(light, medium, dark) as descriptors:
basic colors (red, brown, blue, etc.) and tint
0 0 r5g e
3. Odor: Describe any distinct odors that the discharge may have (Le_, smells strop y of oil, weak
chlorine odor, etc.):
4. Clarity: Choose the number which best descries the clarity of the discharge, where 1 is clear
and 5 is very cloudy.
1 2 3 4 5 No p,5d
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5 a �1
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:
R ��, 0
1 2 3 4 5 '"�
7. Is there any foam in the stormwater discharge? Q Yes ro No. M A 5 L
.
8. Is there an oil sheen in the stormwater discharge? Yes Q No. Dtec
9. Is there evidence of erosion or deposition at the outfall? o Yes A No.
1.0. 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
E
3WU-7A2.LM=*di&sdo71 M017

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT N0, NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 c9k, 4. 3
FACILITY NAME: NIT Co],, 5e[Zv[ 7L
SAMPLE COLLECTOR: Ie1uAj,4 Pr*M f ` D goiji e, L. s-TW GGb
CERTIFIED LABORATORY M l ('(Z0 QA G Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: a CJ l d—
SAMPLING PERIOD: ❑ July -December January -June
COUNTY _ WMO J
PHONE NO. WSaa [ ,;�R ;) . 0S�00
ADD TO LISTSERVE? ❑YES ZNO EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW ❑PNA ❑Trout Other W ,5 --M
�5.
Out#aIINo:
E
7.
'`Sample.
'bate
1 Collected
(mm/dd/yrOR
;NOFLQ
�ti
�. s , pti P,vs '.f: }
�x 4
;(Standard LEnits)��
t. rl
,0
T55
, ' 7„Yr _
R� �mB/l) ,.y
y 4
eT. Rainfeli..�
L1 �r
,C.
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i , z ., .
, Monthly lVlon�tonng7,
h. � of M_ onths m Tier 2
;' Sam Ian
• -
'S, . �.
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�`f ,.��„ ' 1�23tt� �
1 r� �
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� t; r.5�s(.'
C
I
' If "NO FLOW" or "No DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
if a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 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: 8/1/2017-6/30/2022
Last Revised 07/27/17
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.
{�,�
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HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO Er
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Oriainal and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period in
case of "No Flow") to:
Division of Water Resources
Attn: DWR 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 prop rly gather and evaluate the information submitted, Based on my inquiry of the person or persons who manage the system, or those
per di r tly responsible gatherin the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that t are naltie for submitting false information, including the possibility of fine anwll�
-ent for knowing violations."
a
(Signature if Permittee) ( te)
Permit Date:
Last Revised 07/27/17
Page 2 of 2

PLT Concrete Services
Mr. Rick Proctor
3214 Tumage Road
Wilson, NC 27893
Case Narrative
6)MICROBACr
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K8D0380
Project Name: Stormwater Samples
Project / PO Number: NIA
Received: 04/17/2018
Reported: 04/19/2018
Rocky Mount- Water Temperature, 680 F, Air 61° F pH 9.3
Zebulon - Water Temperature, 64° F, Air 540 F pH 9.0
Selma - Water Temperature, 630 F, Air 49° F pH 9.1
Wilson - Water Temperature, 681 F, Air 580 F pH 8.9
Analytical Testing Parameters
Client Sample ID: Rocky Mount PLT, Grab
Sample Matrix: Stormwater Collected By: Parrish/Eastwood
Lab Sample ID: K8D0380-01 Collection Date: 04/17/2018 11:57
Wet Chemistry Result RL Units Note Prepared Analyzed Analyst
Method: SM 2640 D-2011
Total Suspended Solids 52.7 8.33 mg1L 04118/18 0931 MT
Method: SM 2640 F-2011
Settleable Solids <0.10 0.10 mUL 04/17/18 1541 MT
Client Sample ID:. Zebulon PLT, Grab
Sample Matrix: Stormwater Collected By: ParrishlEastwood
Lab Sample ID: KBD0380-02 Collection Date: 04/16/2018 10:44
Wet Chemistry Result RL Units Note Prepared Analyzed Analyst
Method: SM 2640 D-2011
Total Suspended Solids <4.17 4.17 mg/L 04/18/18 0931 MT
Method: SM 2640 F-2011
Settleable Solids <0.10 0.10 mUL 04117/18 1541 MT
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 283061 910.864.1920 p I www.microbac.com Page 1 of 2

6)MICROBACt
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K8D0380
Client Sample ID: Wilson PLT, Grab
Sample Matrix: Stormwater Collected By: ParrishlEastwood
Lab Sample ID: KSD0380-03 Collection Date: 04116/2018 1120
Wet Chemistry Result RL Units Note Prepared Analyzed Analyst
Method: SM 2640 D-2011
Total Suspended Solids 61.0 7,55 mg1L 04/18/18 0931 MT
Method: SM 2540 F-2011
Settleable Solids 0.10 0.10 mUL 04/17/18 1541 MT
Client Sample to: Selma PLT. Grab
Sample Matrix: Stormwater Collected By: PardshlEastwood
Lab Sample ID: K8D0380-04 Collection Date: 04/17/2018 10:24
Microbiological Parameters by Membrane Result RL Units Note Prepared Analyzed Analyst
Filtration
Method: SM 9222 D-2006
Coliform, Fecal <1 per 100 mL 04/17/19 1551 JR
Definitions
RL: Reporting Limit
Report Comments
Samples were received in proper condition and the reported results conform to
applicable accreditation standard unless otherwise noted.
The data and information on this, and other accompanying documents, represents
only the sample(s) analyzed. This report is incomplete unless all pages indicated
in the footnote an- present and an authorized signature is included.
Reviewed and Approved By:
Jeanne Overstreet
Project Manager
jeanne. [e-mail]
04/19/2018 17:38
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1 910.864.1920 p I www.microbac.corn Page 2 of 2

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Fayetteville Division 2592 Hope Mills Road — Fayetteville, NC 28306 (910) 864-19201854-8774 fax
CHAIN OF CUSTODY RECORD
PAGE 1 OF 4
CUENtNAME BADDPZn:
PLT Concrete Services
3214 Tumage Road
Wilson, NC 27893
PO
PROJECT I LOCATION
Storm water sltes
N
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�
TYPE OF ANALYSIS
PRESERVATION CODE
C0
¢
CODE: flaa,B'CO�iLY.;:;;.:;;•;
:, t....,:.•.... .. i•.: .. ,;44,
'•:=.+1n�03.(Qns}+<8*clu
: i .0 =, H?SO4. �ph�2) t •�� :G .:;�' i5',
s ;•....•:.•. .; .. :..: e: •:�i't. ��; ii
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i : •'�.' � SOd_ Illlrl.R10._ ti,i; ; ':'t '•� ": 1�::; :;'
CONTACT PERSON:
Mr. Rick Proctor
PHONE:
252.293,0500
�
DATE I METHOD OF SHLPMENT:
LAB ID ti
SAMPLE
Sample Start
Data
Sample
Start Time
Sample Sample Stop
Stop Date Time
COUP
GRAB
Lab pH
field
pH
Water
Te� p
Alr Temp
OF
Ra1a "
3
Rocky Mt. Plant
rt�
//=59-k
y 109 : _5'7 A„•,
X
j
A
15
IV O
Zebulon Plant
VW-X:
IA'1117
1 d `! V 1174
X
j
A
ct. a
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Wilson Plant
"�� i
11� fir'
yl� l Ic 20 Aw
X
A
7.91
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tD L2
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ate
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4
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pH Field:
Temp Field 1:
Comments or Sooclal Hazards:
IS DATA FOR REG. COMPLIANCE PURPOSE?
YES VINO WHICH: low

Environmental
- ��-
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit littps://deq.iie.gov/about/divisions/enercy-mineral-land-
resourceslener -mineral-land- ermits/stormwater- ermits/n des-industrial-sw�#iab-4
Permit No.: N/CI_I_I/ l I_l^l / or Certificate of Coverage No.: NICIGl�l'1l 6l2_l�l �l
Facility Name: L C 54<o Cesltie .
County: Phone No. 0 ,!S?
Inspector: K- Dn n r e-
Date of Inspection: 1 0-11 — 171
Time of Inspection: , U-V Total Event Precipitation (inches): } RECEIVED
OCT 2 7 201?
CENTRAL FILES
All permits require qualitative monitoring to be performed during a
event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I ce ify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Desig'hee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.): em, -
Receiving Stream: _ Ak '`L�
IK5 _
Describe the industrial activities that oc ur within the outfall drainage area: -u� -
CD-ZnC & -tea
Page 1 of 2
SWU-242, Last modified 07/2812017

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ _ _ _ N O 01 S C— L�tei,c,..
3. Odor: Describe any distinct odors that the discharge may have
chlorine odor, etc.); eja -\6 t
smells strongly of oil, weak
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: /JU
1 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:
�jo -0
1 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: No D ts',Jf_„ e
1 2 3 4 5►`�
7. Is there any foam in the stormwater discharge? Q Yes O No. & D 1 ! $ c .
S. Is there an oil sheen in the stormwater discharge? oYes O No. Q u 1) 14 e- ,
9. Is there evidence of erosion or deposition at the outfall? Q Yes O No. Ala b is- C
10. Other Obvious Indicators of Stormwater Pollution:
List and describe Nb m'el
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 07/28/2017

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 `
FACILITY NAME: A3C1Z�- C•
SAMPLE COLLECTOR:
CERTIFIED LABORATORY MIG C� Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: C� O r I
SAMPLING PERIOD: Q July -December ❑ January -June
COUNTY ._ W I JZG N
PHONE NO. rasa) all • Cl"0
ADD TO LISTSERVE? [—]YES [�Jll0 EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW ❑PNA ❑Trout Other I&/ — N
N s W FX
-..1� -
h :CEutfalliNo. ,
'., ... ..
..l.. -."Yi ".'I �•
Y-
,Date'Sam
s:hP^`�..+,�t,'�'�,-
,Collectedw
- hm
� (min/dd "rOR
FLOWj
"S �. 1. .i
,1 :�Y::%!i:�F �.T'a..Y."5'
•T,L'.' 'i ..4-'
� P s F
�: , �. 4,
(Standard`sUnits)
��.�b .t;. �,�-• '"
F: 1...r ..YiV•�c.EII•i'aG,Cu..L o7'.: C'1
'.L F.• ,C '.+?i*•,�i:�3..Y
•,P_+,�„, �4,r ��� 1-,.,�n�'•rt..:
�..:
.,�.; k75S�
,.,rh- :•r:;� _:� ;
, . �.;, u f ,h
.�
.; mg/L) Y,s
.,.: `:�,,.,.� .x. �
Yy1•'•
T.'G3��l;,V:hs'r: ..Oi� .�+. .11�.. in..v
�.'n.:h-...:., i�w:,',•y�- �Rs`
a,r 'gin-Y�;• _ .,.
r t •� . _
,r, a ,
7-•a,Ramfall r ,
;'�� �, F �;. ,.�
.:,•.; �. in � � k
Y�, J4:'C. ... r:±f-r1 - •,
i. _
-x; .,', ,t r =rfl
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�MoritMoiiltgrEn
. Y, . 8
r ;µ.,�,..
�- �s /n _-�
. t. �. f._ ��t.'-. ,•1.
w ;.1,... -4 nxr+..F.
a- .w. 1: �y"�.�•,,'
. : 'kh.
#af,Mo nths,In.Tier 2 �.
s
�, �S�x ��- - .,�Y
:i^i ..Z.:.T.ir..9'dx. F"1�:,.N. -i.
- a a?
.• - l,: 7 _
.�.: s+.3 r,�3in "te^.4
-y�:....23 !r
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{. "f -1..K-
J - � T
i f -.J_ P S -.�1 -'.(
Gil
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' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
Z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and RNA 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.
v.1v
M)X
Permit Date: 8/1/2017-6/30/2022
Last Revised 07/27/17
Page lof2

PartB: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year.
�'• E.:
?+ � Outf�all.;I kr�
f
rNo '
a� . .Y'{:x'.
�� Date Sam le
w
,�. P i�
Collected t{=.x
1
L(m%dd/vr) ,c+
o d� }.r
IPA '# J
hStandard .�„�.
,' ��
''..�
b.Non-Polar
—
4011 &Grease usfn
- �' ha' r =ga a
t��imethod16G4 s
r } ..
^aSGTN'EM , 'r�
j�o;,.
,` (mg/L}� '
�.s'S.s?, _•1.Y?`
r
;Total.�G
Sus entied-
;gyp ��.Ralnfall4;"<:,�
%' ,a.,,,SoHW ,,
°r, (]a
Y
(mg/U.
,' 1 '`'4
'' �,,, . pd/
r" r r
i Totalk
, r
{ln)�A:.�_�_�'st,
2^
�� i`> ,F,1;
�w� °.;i
.t� .'[_q•/�
E i 4;_ .V u_ frLv ca:u�+
�•:. �,> j 'i w Y J`
�New'IvlotorOii�Usager..
w -� z��:�y�_
at month „.>
.:(g / ) b r � 1
- .�,� ^��-.
�Mr �•4�tic ('. ��., YSi
"x
14
�Q� JY-'l'r'='%aC�
,,,
aintier2�;"v :r1,'
s k s.. SY • `I
Ntoilthi _
1-,Y..,.1
�y , g
Mondorin ?:
.r;,q� n�:taMni=,
f 1
p. .{Y%n)'d�;
wt. 'w
- 7 _ S �.
: - 1h cw
"ir ?e
��..:� •; 1
. ;# of M646s,in Tier 2
�.,. i').•r,; .a
'� p �
"'5am I[n
�d+;5r e.i'•. '. Za Y. r ." F_w�
UP j." �ti ��'G
,f, "�r T>..r . *,
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC�F,S AT ANY ONE OUTFACE (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO LvJ
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period in
case of "No Flow") to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUSTSIGN 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 a information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are Sig ' ' bmitti false information, including the possibility of finesand im isonm nt for knowing violations."
�0
(Signature of Pe ee) (Date)
Permit Date: 8/1/2Q17-6/30/2022
Last Revised 07/27/17
Page 2 of 2

(§>MICROBAC®
Fayetteville Division
Certificate of Analysis
PLT Concrete Services Date Reported: 10/18/17
Mr. Rick Proctor Project: Stormw•ater Samples Date Received: 10/12/17
3214 Turnage Road Date Sampled: 10/12/17
Wilson NC, 27893 Sampled By: Parrish
Rocky Mount PLT, Grab
K7J0454-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 9.0
pH Units
10/11/17 10:27
Parrish
pH
Temperature 76
°C
10/11/17 10:27
Parrish
Field
Analyzed by: Microbac laboratories, Inc. - Fayetteville
Settleable Solids <0.10
mL/L
10/13/17 09:19
A
SM 2540 F-1997
Total Suspended Solids 7.72
mg/L
10/16/17 11:15
TAB
SM 2540 13-1997
Zebulon PLT, Grab
K7J0454-02
I Analyte
Result
Units
Analyzed
Analyzed By
Method Qualifier
1Figld Data
PH
8.3
pH Units
10/11/17 11:30
Parrish
pH
Temperature
73
°C
10/11/17 11:30
Parrish
Field
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids
0.10
mL/L
10/13/17 09:19
JR
SM 2540 F-1997
Total Suspended Solids
3.64
mg/L
10/16/17 11:15
TAB
SM 2540 D-1997
Wilson PLT, Grab
K7J0454-03
I Analyte
Result
Units
Analyzed
Analyzed By
Method Qualifier
Field Data
PH
8.7
pH Units
10/11/17 11:01
Parrish
pH
Temperature
75
°C
10/11/17 11:01
Parrish
Field
Analyzed by: Microbac Laboratories, Inc.
- Fayetteville
Settleable Solids
0.10
mL/L
10/13/17 09:19
JR
SM 2540 F-1997
Total Suspended Solids
21.9
mg/L
10/16/17 11:15
TAB
SM 2540 D-1997
Selma PLT, Grab
K7J0454-04
Microbac Laboratories, Inc.
Page 1 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

PLT Concrete Services
Mr. Rick Proctor
3214 Turnage Road
Wilson NC, 27893
OMICROBAC°
Fayetteville Division
Certificate of Analysis
Project: Stormwater Samples
Date Reported: 10/18/17
Date Received: 10/12/17
Date Sampled: 10/12/17
Sampled By: Parrish
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH
9.2
pH Units
10/12/17 10:25 Parrish pH
Temperature
75
°C
30/12/17 10:25 Parrish Field
Analyzed by: Microbac laboratories, Inc.
- Fayetteville
Coliform, Fecal
8.0
per 100 mL
10/12/17 16:35 TAB SM 9222 D-1997
QC Batch Run - (Alicrobac Laboratories, Inc. - Fayeneville)
Analyte
Result
Units
Source RPD Limit
Total Suspended Solids
24.7
mg/L
K7J0457 24 5
Total Suspended Solids
State Certifications:
NCDNR #11
NCDOH 037714
5000 mg/L
K7J0316 0 5
Respectfully Submitted
Jeanne Overstreet, Project Manager
Thank you for your business. We invite vour feedback as our level afservice to Jnu. Please contact the Division Manager, Rob Dermer at 910-864-1920 with any
questions. You may also contact J. Trevor Boyce, President at presideniCamicrobac.com
Microbac Laboratories, Inc.
Page2of3
2592 Hope Mills Road I Fayetteville, NC 28306 1 910.864.1920 p 1910.864.8774 f I www.microbac.com

4
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Fay6ttevolle DMsl6n 2592 Hope:hft Rbad - Fao6leville, NC'28306(9,10)'864=19201864-877il -*K-7-J0454*�.
CHAIN OF CUSTODY FtECCkD q�������1�.
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PLT ConcreteServices7storrcn'rwzd&
3214�Tumage'Road
Whson'NC 271393
Poi,
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sites
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-TYPE OF ANALYSIS
PRESERVATION (CODE)'
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2522910500.
o
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X
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lo-k 141
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IS DATREG.,COMMLANCE PURPOSP
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REVIEWED
Page 3 of 3

0
Stormwater Discharge Outfall (SDO)
Qualitative Monitorung.Report
Permit No N!CJ /!_! ! / I ! or C=ffi=e of Coy elagc No� NIGC I I !qf 6I2, r f 31
Facility Name: l,,c�.i. c- S �- f S
County-- hA Phonc No-
' _Inspector—rl.�-+�'''n,`'i . , ��c-� - • ' •
Date of Lzspcctioa:
By this sign Inn Y is accurate and complete to the best of my bmowbodgm-
S%gnuat�e of Pe7mittcc or Design)
L OtintfaH Description
Outfalb No_ StrUc:=e (pipes ditch, ctc-)
Rccciviupg Stream= V"�a
Desca-be the industrial activities that occur wi, the [fall drainage arcs:
I�
2_ Color 10 AY
Descxk)r the color of the discharge using basic colors (red, bro blue, etc-) and"tiriL)V[ &lt, f nm4
da'as descriptors: " -- - JL► c7 � C'jC� - _ --
• 3_ Odor
Describe any -distinct odors that the discharge may y brave {Le,, smeiis strongly of oil, weak chlorine odor, .
etc-} - - -- - �5"O _ n r 5 c-k ►?l� ---e
4- Clarity.
Choose the number which best describes the clarity of the- dischaorgc where 1 is clear and 10 is very
cloud}r &J 6 .A C S 1:2-I
1 z 3 4 5 6 7 8 9 10
Phgn 1
SW1I-242-101599

I
o
5. Floating Solids '
Choosc the number which best describes the amoont of floating solids in the stonnwater discharge where
I is no solids and 10 is the surface covered with floating solids. ID PS c-,VvAY*-,-
I 2 3 4. 5 67 8 91 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in tlx stormwaw discharge
where I is no solids and 10 is exUrnkly muddy_
1 2 •3 4 5 6' •7 S 9 10 '
7. Foam. — -
L there any foam in the stonnwatm discibatge? Yes No
8. Oil Sheen
Is them an oil shoen in the stormwater discharge? Yes NO,
9. Other Obvious �I•ndicators of Stormtwater Pollution
List and describe Aj
Not= Loan clarity, high solids, andtor the presetim of foam or dU-shem may be —indicative of pollutant
exposure. These conditions may warrant fm-ther in'vestigatioiL
Page.2
CURS -4 Ai {N�iM

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 059N 3
FACILITY NAME: PKT co �A o- sk i cCIke-
PERSON COLLECTING SAMPLES I QMA.q pt� r?4,�
CERTIFIED LABORATORY Lab # It
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YF,AR: 0Q
SAMPLING P RIOD: 131-DecembZ January -June
COUNTY t cell1
PHONE NO.h�sa) �g3aSC�O "
ADD TO LISTSERVE7. []YES []NO EMAIL: WS �tV
DISCHARGING TO CLASS: []SA ❑HIJW ❑PNA []Trout MOther sw—
-Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
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 Sampling2
-
-
6-9
100 ,
-
-
-
-
aFm&L
-15
360C
•7.
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 small 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/I.
°For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
soJ„1D�
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.--
: DaterSample'
-'Collected
(mo/dd/yrjl:.._Unitsl
pH
(Standard
..,
m TPH using ethod
1664A-SGT-HEM
1 , (mg/L}
ToW lSuspended
_ "Solids
(mi3/L} s, ,
Event
Duration
(mmutesj
Total'4 ' ;.
Rainfall
,.:(in]
' New Motor Oil
Usage
,;(gal/month} _
In Tier 2
Monthly
Monitoring?
.. '(Y/n} -
" # of Months....
in Tier 2
z
Sampling..
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE CES 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 Discharee" reports) within 30 days of receipt of sample (or at end of monitorine period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh; North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify; under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified,personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons.who manage the system, or
those persons directly responsible r gathering the information, the information submitted is, to the. best of my knowledge and belief, true, accurate, and complete
am aware that t re significa t enalti for submitting false information, including the possibility fin and imprisonment for knowing violations,"
/
'46ft2�� 6\/01-/
(Signature ofPermittee) (D te)
Permit D-Jte: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of?

OMICROBAC®
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Date Reported: 04/28/17
Date Received: 04/25/17
Date Sampled: 04/25/17
Sampled By: Parrish
Rocky Mount PLT, Grab
K7D0803-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 9A pH Units 04/24/17 15:31 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 mL/L 04/26/17 09:45 TAB SM 2540 F-1997
Total Suspended Solids 61.3 mg/L 04/26/17 09:00 TAB SM 2540 D-1997
Zebulon PLT, Grab
K7D0803-02
Analyze Result Units Analyzed Analyzed By Method Qualifier
Field pgta
PH 9.4 pH Units 04/24/17 14:01 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids 0.10 mL/L 04/26/17 08:45 TAB SM 2540 F-1997
Total Suspended Solids 8.75 mg/L 04/26/17 09:00 TAB SM 2540 D-1997
Wilson PLT, Grab
K7D0803-03
I Analyte Result
Units
Analyzed
Analyzed By
Method Qualifier
Field Data
PH 9.4
pH Units
04/24/17 14:34
Parrish
pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10
mL/L
04/26/17 08:45
TAB
SM 2540 F-1997
Total Suspended Solids 18.0
mg/L
04/26/17 09:00
TAB
SM 2540 D-1997
Selma PLT, Grab
K7D0803-04
Analyte Result Units Analyzed Analyzed By Method Qualifier
Feld Data
PH 10.1 pH Units 04/25/17 10:44 Parrish pH
Microbac Laboratories, Inc.
Page 1 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

*MICROBAC"
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Date Reported: 04/28/17
Mr. Rick Proctor Project: Stormwater Samples
Date Received: 04/25/17
3214 Tumage Road
Date Sampled: 04/25/17
Wilson NC, 27893
Sampled By: Parrish
Selma PLT, Grab
K7D0803-04
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Coliform, Fecal 28 per 100 mL 04/25/17 14:47 TAB SM 9222 D-1997
QC Batch Run - (Microbac Laboratories, Inc - Fayetreville)
Analyte
Result
Units Source
RPD
Limit
Total Suspended Solids
113
mg/L K7130800
0
5
Total Suspended Solids
25.2
mg/L K7D0783
5
5
Total Suspended Solids
10.3
mg/L K7D0771
3
5
Rocky Mount- Water Temperature, 68° F, Air 59Q F
Zebulon - Water Temperature, 660 F, Air 600 F
Selma - Water Temperature, 64° F, Air 661 F
Wilson - Water Temperature, 65° F, Air 60' F
State Certifications:
NCDNR #II
NCDOH #37714
Respectfully Submitted
Jeanne Overstreet, Project Manager
Thank you for your business. We invite your feedback on our level ofservice to you. Please contact the Division Manager, Rob Dermer at 910-864-1920 with any
questions. You may also contact J. Trevor Boyce, President at [e-mail]
Microbac Laboratories, Inc.
Page 2 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

c: ac
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IMEMMEMOMMEREMEN
[MEMEMENEEMEMEME

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 a a 9 /3-�
FACILITY NAME:
PERSON COLLECTING SAMPLES jcpM ly
CERTIFIED LABORATORY M (C.R.QUAC. Lab # i
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: ' c;�U 6 V
SAMPLING PERIOD:.O.July-Decemberanuary-June
COUNTY _W I &SGN
PHONE NO. PJ 03S00_ tiV3 _N
ADD TO LISTS£RVE? ❑YES []NO EMAIL: NHS W- E4
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout MOther
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)
pFi
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total 4
Rainfa_EI
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
z
2 Sampling
-
6-9
100 '
-
-
-
-
46
.o
.
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
5Cwu__
SG ),f DS
-< Q./O
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
i
(mo/dd/yr)
pH:
(Standard
Units)
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L). ,
Event
Duration
(minutes)
Total-,', •:..
Rainfall 4
(in)
New Motor Oil
Usage
(gal/month) ;,
In Tier 2
Monthly
Monitoring?
(y/n)
*of Months
in Tier 2
z
Sampling
6-9
15
100 '
-
-
-
-
IMAKU
eg;�
Cj f N_
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDS CES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [:]NOV
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 ANYINFORMATION 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 ;t�a&res' enalti for submitting false information, including the possibility o fine annd imprisonment for knowing violations."
S (� l0
(Signature Permittee) (Date)
Permit Da e: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

OMICROBAC&
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Pro_jcct: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Date Reported: 05/01/16
Date Received: 04/28/16
Date Sampled: 04/28/16
Sampled By: Parrish
Rocky Mount PLT, Grab
K6D0989-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 9.1 pf-1 Units 04/27/16 10:41 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids 2.5 mL/1. 04/29/16 09:39 CCR SM 2540 1--1997
Total Suspended Solids 3T6 mg/L 04/29/16 11:21 CCR SM 2540 D-1997
Wilson PLT, Grab
K6D0989-02
Analyte Result Units Analyzed Analvzed By Method Qualifier
Field Data
PH 9.0 pl-1 Units 04/27/16 12:05 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 mL/L 04/29/16 09:39 CCR SM 2540 17-1997
Total Suspended Solids 11.8 mg/L 04/29/16 11:21 CCR SM 2540 D-1997
Zebulon PLT, Grab
K6D0989-03
Analyte Result Units Analvzed Analyzed By Method Qualifier
Field Data
PH 8.7 pl-1 Units 04/27/16 11:25 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids 0.20 mL/L 04/29/16 09:39 CCR SM 2540 F-1997
Total Suspended Solids 8.00 mg/f. 04/29/16 11:21 CCR SM 2540 D-1997
Selma PLT, Grab
K6D0989-04
Analyze Result Units Analvzed Analyzed By Method Qualifier
Field Data
Microbac Laboratories, Inc.
Page i of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1 910.864.1920 p 1910.864.8774 f { www.microbac.com

�DMICROBACd'
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwaler Samples
3214 Tumage Road
Wilson NC, 27893
Selma PLT, Grab
Date Reported: 05/01/16
Date Received: 04/28/16
Date Sampled: 04/28/16
Sampled By: Parrish
K6D0989-04
Analyte Result Units Analvzed Analyzed By Method Qualifier
pH 9.8 pH Units 04/28/16 09:28 Parrish PH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Coliform. Fecal <1.0 per 100 mil, 04/28/16 16:35 CCR SM 9222 D-1997
QC Batch Run - (ilicrobac Laboratories, Inc, - Fayedevilfe)
Analyte Result Units Source RPD Limit
Total Suspended Solids 15.0 mg/1- K6D0956 2 5
Total Suspended Solids 8.00 mg/L
Rocky Mount- Water Temperature, 74' F, Air 770 F
Zebulon - Water Temperature, 700 F, Air 81' F
Selma - Water Temperature, 71' F, Air 76' F
Wilson - Water Temperature, 73' F, Air 81' F
State Certifications:
NCDNR tI i l
NCDOH 937714
K6D0989
Respectful[), Submitted
Bonnie K. Sanders, Senior Project Manager
Thank you for your business. We imvre yvrrr feedhack on our level afser wce to you. !'lease contact the Divtsron Afanager, Roh Dernrer at 91O-f 64-1920 with anv
gueslions. lou may also contact J. D-emr Boyce, President at [e-mail]
Microbac Laboratories, Inc.
Page 2 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

® Microbac Laboratories Inc.
Southern Testing & Research Division
3809 Airport Drive, Wilson, NC 27896
Phane:,262-237-4176 • Fax:[phone]
Website: www.soulhernlestlnacam
9
CHAIN OF CUSTODY Mw_w_�r_w_w�w_Pew_w_w_w_
r� Lab Use Only
and Analyses Request lRush Approval By: IDatemme:
mare
0 inn epo o: C
Per on: ISample H Acci. 0 7renaparl: 1
' �'
dtfFej P
—.1e
T w �� Reed on Ice i Temp: Res. Cl. pH: i
I ❑ Yes ❑ No
Invoice drl� Fex # or Emel I SAMPLiNG CHARGES:1
jTime:
Mileage Other.
Sampled By: Project ID: Analyses Re uested
Requested Turnarounld Titob
❑ Narmal (2 i oAs) ❑ Rush (3-6 days) ' q �. y
0 Emergency ' PO # STRL QUOTE #
Rush (ASAP)
�� C�� C s
"ADDITIONAL CHARGES WILL, APPLY
CALL FOR APPROVAL
Client Requested Due Data: a
Item Stan End Comp Grab Semple
# Date/rime Datefrime •` Type.. DeacrlptlordSSomple Marks Vq Q
.........
...._..__
r
.............__-.
I
s
—
— —^--�
'r
✓
�r;ty
,�
-.---»--
-----------------
rt
_ .
A.
xf-
r
----------
1 f
RELIN
UISHED BY
DATEITIME
ECEIVED
BY
DATEITIME
MOTES:
�a
2
3
Fluid Res. Cl.: Field Conductivity: Field Temp: Field pH: Field D.O.;
IS- DATA TO BE USED FOR REGULATORY COMPLIANCE PURPOSES? UeYES 0 NO IFYES, WHICH REGULATORY AGENCY:
"7ae Reverse for Codes 11/oe

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 a f '
FACILITY NAME: PKT CO k1CR.C'l� 1V U IiC C .
PERSON COLLECTING SAMPLES fgM,tiP��__. T_
CERTIFIED LABORATORY M ldR_QR A C_ Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 0z4
SAMPLING PERIOD: 1f july-December ❑-January-June
COUNTY wlkXJ�J _
PHONE N0. P Q,93, Q3Q Ay
ADD TO LISTSERVE? []YES [:]NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout Mother NSW
. ,
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NCI,FLOW 1 ��
pH
{Standard
units]
,r°
TSS
{mg/L)
Event
ti on
Duration
[minutes)
Total
a
ll f i R
ana
� (in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling'
-M
M. ka C
6-9
100-
iN 0 V 0 4 2016
QWR
N
FTn�
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
6cm,ate.
so�„1D�
-<C.I0
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.
Otitfall
No.
_
Date Sample
Collected
(mo/dd/yr)1
PH
[Standard
Units)
TPH using method
1664A;SGT-HEM
(mg/L)
...
Total Suspended
Solids
(mg/L) ,, ,
i ..
. Event
Duration
(minutes)
Total -
_° - 4
Rainfall
Jin)
New Motor Oil
Usage
(gal/month), ;
In Tier 2
Monthly
Monitoring?
(Y/n)
# of Months
in Tier Z,
Z
Sa.mpling
6-92
15
100 '
0
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE CES AT ANYONE 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" reports) 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.
am aware t re ar 'cant p na ies for submitting false information, including the possibility of fines an imprisonment for knowing violations."
c 7 116
(Signature f Permittee) (Date)
Permit Date�,7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

I
R�1� n
V �/
NOV.
_ �EN7
VVRStormwater Discharge Outfall (SDO)
Qualitative Mouitoring. Report
Permit No-: NCI I I_I I I I I or Certificate of Coverage No_: N/CJGIe'll1 612, j 3
Facility Name: 'r1'Q lne?L e 1-5e4L_. 1-5D0.4 lei . C • -- -. _
County: LJ X ; S ►er Phone.No_ S 2- 293 = 0269
lnspe�dtor: Ke-va nsg t pU.,' SL /-DC)Ils►ti X 9ZA 5 T t _i a A,. - — --�_
Date of Inspection: �j T
By this signature, I certi t t this rt is accurate and complete to the best of my knowledge:
C
of Permittee or Designed)
1. Outfa.H Desexiption
Outfall No_ • Structure (pipe, ditch, ac.)
Receiving Stream: t
Describe the indusorial activitics tf;atoqpm wrihin the outfall drainage area:
o nc�f-`fie
z 61or
Describe the color of the discharge using
dark)'as descriptors:' Mn It>
3. Odor
colors (red, brown, blue, etc.) and tint (light, medium,
Describe any. distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, .
etc.) .. i�j ip - ma
4- - Clarity.
Choose the number which best describes the clarity of the discharge where I is clear and 10 is very
cloudy: j S Epp-) -.r—
1 2 3 4 5 6 7 8 9 10
Page l
SWU-242-101599

S. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
I is no solids and 10 is the surface covered with floating solids: NO = SGN�f4�
I 2 3 4 5 6 7 8 9. 10
6. Suspended Solids
Choose the number which best describes the atnouat of suspended solids Lit the stormwater discharge
where I is no solids and 10 is extremely muddy. l D i -s r—yeir -e
1 2 .3 4 5 6 .7 8 9 10
7. Foam .
Is there any foam in -the stortnwater discharge? Yes No r 10
8. - Oil Sheen
Is there an oil sheen in the siormwater discharge? Yes No,
0
9. Other Obvious Indicators of Stermwater Pollution
List and describe
Note- Low clarity, high solids. and/or the presence of foam or oil•sheen maybe indicative of pollutant
exposure. These conditions may warrant further investigation.
.Page.2

&>MICROBAC®
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Date Reported: 10/25/16
Date Received: 10/18/16
Date Sampled: 10/I8/16
Sampled By: Parrish
Rocky Mount PLT, Grab
K6J0564-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH 8.9
pH Units
10/17/16 12:46
Parrish
pH
Temperature 71
QC
10/17/16 12:46
Parrish
Field
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids 0.20
mL/L
10/19/16 09:27
JR
SM 2540 F-1997
Total Suspended Solids 9.00
mg/L
10/19/16 11:14
JR
SM 2540 D-1997
Wilson PLT, Grab
K6J0564-02
Analyte
Result
Units
Analyzed
Analyzed By
Method Qualifier
Field Data
pH
9.1
pH Units
10/17/16 13:21
Parrish
pH
Temperature
76
cc
10/17/16 13:21
Parrish
Field
Analyzed by: Microbac Laboratories, Inc.
- Fayetteville
Settleable Solids
<0.10
mL/L
10/19/16 08:56
JR
SM 2540 F-1997
Total Suspended Solids
8.00
mg/L
10/19/16 11:14
JR
SM 2540 D-1997
Zebulon PLT, Grab
K6J0564-03
I Analyte Result Units Analyzed Analyzed By Method_ Qualifier
Field Data
pH 8.5 pH Units 10/17/16 13:56 Parrish pH
Temperature 72 °C 10/17/16 13:56 Parrish Field
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 mL/L 10/19/16 08:56 JR SM 2540 F-1997
Total Suspended Solids 2.90 mg/L 10/19/16 11:14 JR SM 2540 D-1997
Selma PLT, Grab
K6Jo564-04
Microbac Laboratories, Inc.
Page 1 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

0MICROBACe
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Date Reported: 10/25/16
Date Received: 10/18/16
Date Sampled: 10/18/16
Sampled By: Parrish
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH 10.1 pH Units 10/18/16 10:42 Parrish pH
Temperature 74 °C 10/18/16 10:42 Parrish Field
Analyzed by: Microbac laboratories, Inc. - Fayetteville
Coliform, Fecal
<1.0
per 100 mL 10/18/16 16:16
JR
SM 9222 D-1997
QC Batch Run - (Aficrobac Laboratories, Inc. - Fayetteville)
Analyte
Result
Units
Source
RPD
Limit
Total Suspended Solids
21.0
mg/L
K6J0581
40
5
Total Suspended Solids
6.80
mg/L
K6J0572
11
5
Total Suspended Solids
10.0
mg/L
K6J0558
0
5
Rocky Mount- Water Temperature, 710 F, Air 820 F
Zebulon - Water Temperature, 721 F, Air 820 F
Selma - Water Temperature, 741 F, Air 701 F
Wilson - Water Temperature, 760 F, Air 82' F
State Certifications:
NCDNR # 11
NCDOH #37714
Respectfully Submitted
Jeanne Overstreet, Project Manager
Thank you for your business. We invite yourfeedback on our level ofservice to you. Please contact the Division Manager, Rob Dernier ai 910-864-1920 with any
questions. You may also contact J. Trevnr Boyce, President at presideni@microbac. con?
Microbac Laboratories, Inc.
Page 2 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1 910-864.1920 p 1910.864.8774 f I www.microbac.com

Mkrobac;Laboratofies Inc.,
Southern Testihg & Research Division
3809,-Airport Drive,,WiWn, NC 27896 L
PIJ6666 252-237-4175 Fax: [phone]i
We6te: www.southemtesfina.com,
'CHAIN IO.F.-CU.STODY
,and ,Analysieis Request
Page '!K6J.05,64�
r -----B
L�I�I�I,'Iu��ill�
0 abi Use!
fRush Approval :
0' I Re rt To; CoTaft
Per T —7-
-Ir 11?9,: ispMpleP 0
ice'! 7- - Temp: Res, Cl., pH:
49
Phone
446E
It
Fax # or Email JSAMPLING CHARGES:
Other
thine: Ile e: . . . . . .
S�Moled By, Project ID: 'Anal es Reauesttd
ecffsted Turnqro1r4,,qme_
Normal (2 weeks) ❑ Rush (3ZdaYS)Lt
PO #, STRL QUOTE#
13 Emer4en6y Ruih (ASAP)
ADDITIONAL CHARGES WILL APPLY
.CALL FORAPPROVAL C4ieritRequested D6eDidi-.-
Item, Start.' End: Comp Grab Sample
#.', Date/Time DaMrrfme DescriptbrJSample. Marks
'014
f�
VLA,s-A,
A A
---
----------
-----
— -----
---------
to k
a--
-.6
to-
4-A
TV-7-
— --
---- — ----
-----------
-
M 4
— -------
------
REILINQUISHED BY
DATEITIME
-IIRECEFVE_D
BY'
I f DATEMME;-
NOTES:.
Ont iox.
2!
^A
.-REVIEWED-
3;
Field Re$:CJ- Flaitl Canductivitr Field T&'p; Fleld 13
IS DATA TU BE USED FOR FIEGULATORYCOMPLIANCE'PURPOSES?i 'WYES -O'NO. AFYESWHICH REGULATORY AGENCY:
Reverse tar codes 11/08
Page 3 of 3
i

15'
RECEIVED
NU V 3 0 2015
CENTRAL F!
DWR SECTIONS
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring. Report
Permit No-: NIG / /_I I I / I or Certificate of Coverage No.:
Facility Name:
County: y � _ Phone No.
Inspector:
Date of Inspection: J
:(p �i dU, P, 31
By this signature, I c//ertify/ at this port is accurate and complete to the best of my knowledge:
/c
(Si tore of Permittee or Designee)
1. Outfall Description
Outf 1 No. Structure (pipe, ditch, tic.) All
Receiving Stream_ Al'%% T y
Describe the industrial activities that occur wid{n the outfall drainage area
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark)'as descriptors: _O - Il��
3. Odor
Describe any.distinct odors that th dischar e may have (i.e., smells strongly of oil, weak chlorine odor, .
A
etc.) _�.... !v 1 - ---
4. - Clarity .
Choose the number which best describes the cl -ty of the discharge where I is clear and 10 is very
cloudy: (vo. 0 i S C-
1 2 3 4 5 6 7 8 9 10
Page 1
1W
SWU-242- [ 0 f 599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids: U�`S
1 2 3 4 5 6 7 9 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I i5 no solids and 10 is extrerncly muddy. l�-► d 10 r &-C-' `' .' 0),(L-
1 2 .3 4 5 6' 7 8 9 10
7. Foam .
Is there any foam in,'thc stormwater discharge? Yes No
8. Oil Sbeen
Is there an oil sheen in the stormwater discharge? Yes No
9. Other Obvious Indicatorsof Stormwater Pdliution '
List and describe ' �
v 0AJ
Note. Low clarity, high solids, and/or the presence of foam or oil sheen maybe -indicative of pollutant
exposure. These conditions may warrant further investigation_
i!
Page.2

OMICROBACIA)
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Date Reported: 11/06/15
Date Received: 1 I/03/15
Date Sampled: 11/03/15
Sampled By: Parrish
Rocky Mount PLT, Grab
K5 K0096-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 9.6 pH Units 11/02/15 12:01 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 mL/L 11/04/15 I L04 SW SM 2540 F-1997
Total Suspended Solids 87.3 mg/L 11/05/15 21:33 SW SM 2540 D-1997
Wilson PLT, Grab
K5K0096-02
Analyze Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 9.2 pH Units 11/02/15 11:25 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 mL/L 11/04/15 11:04 SW SM 2540 F-1997
Total Suspended Solids 20.7 mg/L 11/05/15 21:33 SW SM 2540 D-1997
Zebulon PLT, Grab
K5 K0096-03
I Analyte Result
Units
Analyzed
Analyzed By
Method Qualifier
Field Data
PH 8.6
pH Units
11/03/15 07:10
Parrish
pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10
tnL/L
11/04/15 11:04
SW
SM 2540 F-1997
Total Suspended Solids 3.00
mg/L
11/05/15 21:33
SW
SM 2540 D-1997
Selma PLT, Grab
K5K0096-04
Analyte Result Units Analyzed Analyzed By Method Qualifies
Field Dalai
PH 10.2 pH Units 11/03/15 11:10 Parrish pH
Microbac Laboratories, Inc.
Page 1 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

OMICROBACr
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Selma PLT, Grab
K5K0096-04
Date Reported: 11/06/15
Date Received: 11/03/15
Date Sampled: 11/03/15
Sampled By: Parrish
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Coliform, Fecal <1.0 per 100 mL 11/03/15 15:45 AFO SM 9222 D-1997
QC Batch Run - (Microbac Laboratories, Ina - Fayexrville)
Analyte Result Units Source RPD Limit
Total Suspended Solids 296 mg/L K5K0222 7 5
Total Suspended Solids 1.25 mg/L K5K0144 0 5
Total Suspended Solids 6.00 mg/L KSK0103 8 5
Total Suspended Solids 206 mg/L K5K0091 8 5
Rocky Mount- Water Temperature, 650 F, Air 620 F
Zebulon - Water Temperature, 620 F, Air 600 F
Selma - Water Temperature, 66° F, Air 64, F
Wilson - Water Temperature, 661 F, Air 641 F
State Certifications:
NCDNR #11
NCDOH 437714
Respectfully Submitted
Jeanne Overstreet, Project Manager
Thank you for your business. We invite your feedback on our level of service to you, Please contact the Division Manager, Rob Dermer at 910-864-1910 with any
questions. You may also contact J. Trevor Boyce, President [e-mail]
Microbac Laboratories, Inc.
Page 2 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1 910.864.1920 p 1910.864.8774 f I www.microbac.com

® Microbac Laboratories Inc.
SotlthernTesting & Research Division
3809 Airport Drive, Wilson, NC 27896
Phone. [phone] - Fax:[phone]
Website: www.southemtesUng.com
CHAIN OF CUSTODY
and Analyses Request
Lab
(Rush Approval By:
Dept.
*K5KOO96*
11-10
PR
To:
G
C t Porao
— /sample # Acct. # Transport:
P Rec'd on Ice., Temp: Q Res. Cl, pH: r
❑ Yes ❑ No V '�
N
n A s: Fax # or Emal1 ISAMPLING CHARGES:
► !Time; Mlle$: Other.
---r—r—i—r
Sampled By: a Project ID: Anal ses Re uested
ie ua J Turn roan ime
Normal (2 weeks) Rush (3-5 days) ' Q� C, **
❑ Emergency Rush (ASAP)' PO # STRL QUOTE # �,O COS C
' 41
ADDITIONAL CHARGES WILL APPLY �`y `O
CALL FOR APPROVAL Client Requested Due Date:
Item Start End Comp Grab Sample
DateMme DatelTime •' '• Type.. DescriptlonlSample Marks
110
.._------
-.-----_-_
)1 =tm
sty. -
C"
1 i.�
-V-71,411-
-----__-
-------
"TI:R AI r G4
_- rzr-1506�1
{/
Plitt
RG
----------------------
fe-
--;7
----------------------
----------
RELINQUISHED BY
DATEMME
RECEIVED QY
DATEITIME
NOTES:
.��
z
I� ��
�•3-�s-•as�
3
Field Res. Cl.: Field Conductivity: Field Temp: Field pH: Field D.O.:
IS 10ATATO BE USED FOR REGULATORY COMPLIANCE PURPOSES? CrYES ❑ NO IFYES, WHICH REGULATORY AGENCY:
"Sae Reverse for Codes
Page 3 of 3

r
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring. Report
Permit No.: MCI—/ or Certificate of Coverage No_: NIC IG-I �l /1 41,?1P13/
Facility Name: PGT C42-Ar„�..0-A 5�L(L _-Lkyi FSCYr, -fV . C _
County: - v v-- 9 Phone No. 2= S 7 - ZQ '3 C� i� `] _
lnspedtor:
Date of Inspection:
By this signature. I c/ertify t this port is accurate and complete to the best of my knowledge:
(Sig;Ature. of Permince or Designee)
Outfait Description
Outfall No. Structure (pipe, ditch, rte.) _ _�� _- r—P _
Receiving Stream: t
Describe the industrial activities that occur Within the'outfall drainage area
2. Color
Describe the color of the discharge
dark)'as descriptors:
3. Odor
Describe any -distinct odors that
etc.) I&L62
basic colors (red, brown, blue, etc.) and tint (light, medium,
may have (i.e., stalls strongly of oil, weak chlorine odor, .
4. Clarity
Choose the nutnbcr which best describes the cl ity of the discharge where I is clear and 10 is very
cloudy: AJO C) i"S
l 2 3 4 5 6 7 8 9 10
Page t
SWU-242-101599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
I is no solids and 10 is the surface covered with floating solids: �jd J� js
1 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of susperided solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy. . t d i
1 2 .3 4 5 6 -7 8 9 10
7. Foam .
Is there any foam in the ston-nwater discharge? Yes No d �'� .HQ-
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No r� 5 C Q
9. Other Obvious Indic
ators Lof Storm water Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam or oil•sheen maybe indicative of pollutant
exposure. These conditions may warrant furthcr investigation.
i
Page.2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. NCG14 4 -k Q /3
FACILITY NAME: P).T CG 1s Qw�� S§ .`�1 t CLU , Iii C
PERSON COLLECTING SAMPLES ](�kAiN y p(.gN
CERTIFIED LABORATORY M (ClZORA C. Lab # 11
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: ' C� O 1
SAMPLING PERIOD: [1jJ�uly-December ❑,January -June
COUNTY VKKg ws =
PHONE N0. [_sa}_ ___*11Q3, 03_0
ADD TO LISTSERVE? []YES []NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout Other
Outfall No.
_ .
Date Sample
C
Collected
(mo/dd/yr OR
NO FLOW]'
pH
{Standard
�
Units]
TSS
(mg/L)
Event
Duration
(minutes)
Total a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
In
[vl
# of Months in Tier
2
2 Sampling,
-
-
6-9
100 ,
-
-
-
-
AZ U
0_.
- 7s
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
6-9,y6
swv&s
<o.io
K�P,�_,
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
I E
" Solids
(mg/L}.
Event
Duration
(minutes} .,
Total.
4
Rainfall
(ire}
New Motor Oil
Usage
(gal/month}
In Tier 2
Monthly
Monitoring?
.(y/n)
# of Months
in Tier 2
Sampling Z
6-9
15
100 '
-
-
-
-V
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE CES 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" 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: DWQCentral Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST S1GNtTHIS 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 niy inquiry of the person or persons who manage the system, or
those persons directly responsible f r gatheri g the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that th re significa enalti fo submitting false information, including the possibility of fines nd imprisonment for knowing violations."
(Signature of ermittee) (Date)
Permit Date: 2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

*M1ICROBACJ
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Date Reported: 11/06/15
Mr. Rick Proctor Project: Stormwater Samples
Date Received: 11/03/15
3214 Turnage Road
Date Sampled: 11/03/15
Wilson NC, 27893
Sampled By: Parrish
Rocky Mount PLT, Grab
K5K0096-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH
9.6 pH Units
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 mL/L
Total Suspended Solids 87.3 mg/L
11/02/15 12:01 Parrish pH
11/04/15 11:04 SW SM 2540 F-1997
11/05/15 21:33 SW SM 2540 D-1997
Wilson PLT, Grab
K5K0096-02
Analyte Result Units Analyzed Analyzed By Method Qualifier
■�J 071711111
PH 9.2 pH Units 11/02/15 11:25 Parrish pH
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 mL/L 11/04/15 11:04 SW SM 2540 F-1997
Total Suspended Solids 20.7 mg/L 11/05/15 21:33 SW SM 2540 D-1997
Zebulon PLT, Grab
K5K0096-03
I Analyte
Result
Units Analyzed
Analyzed By
Method _ _ Qualifier
Field Data
PH
8.6
pH Units 11/03/15 07:10
Parrish
pH
Analyzed by: Microbac Laboratories, Inc.
- Fayetteville
Settleable Solids
<0.10
mL/L 11/04/15 11:04
SW
SM 2540 F-1997
Total Suspended Solids
3.00
mg/L 11/05/15 21:33
SW
SM 2540 D-1997
Selma PLT, Grab
K5K0096-04
Analyte
Result
Units Analyzed
Analyzed By
Method Qualifier
Field Data
PH
10.2
pH Units 11/03/15 11:10
Parrish
pH
Microbac Laboratories, Inc.
Page 1 Ol3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774
f I www.microbac.com

6)MICROBACS
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Selma PLT, Grab
Date Reported: 11/06/15
Date Received: 11/03/15
Date Sampled: 11/03/15
Sampled By: Parrish
K5K0096-04
Analyte Result Units Analyzed Analyzed By Method Qualifier
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Coliform, Fecal <1.0 per 100 m.L 11/03/15 15:45 AFO SM 9222 13-1997
QC Batch Run - (Microbac Laboratories, Inc. - Fayetteville)
Analyte Result Units Source RPD Limit
Total Suspended Solids 296 mg/L K5K0222 7 5
Total Suspended Solids 1.25 mg/L K5K0144 0 5
Total Suspended Solids 6.00 mg/L K5K0103 8 5
Total Suspended Solids 206 mg/L K5K0091 8 5
Rocky Mount- Water Temperature, 650 F, Air 620 F
Zebulon - Water Temperature, 621 F, Air 601 F
Selma - Water Temperature, 66° F, Air 64° F
Wilson - Water Temperature, 661 F, Air 64° F
State Certifications:
NCDNR #]1
NCDOH ##37714
Respectfully Submitted
Jeanne Overstreet, Project Manager
Thank YOU for your business. We invite yourfeedback on our level afservice to you. Please contact the Division Manager, Rob Dermer at 910-864-1920 with any
questions. You may also contoer J. Trevor Boyce, President at prmident(jamicrobac. cam
Microbac Laboratories, Inc.
Page 2 of 3
2592 Hope Mills Road I Fayetteville, NIC 28306 1910.864,1920 p 1910.864.8774 f I www.microbac.com

*K5K0096`
® Microbac Laboratories -Inc.
Southern Testing & Research Division
3809 Airport Drive, Wilson. NC 27696
Phone:[phone] Fax:[phone]
Wabsite: www.southomtesting.com
CHAIN OF CUSTODY
and Analyses Request
Lab
,Rush Approval By.
(Dept
t Para 05ample # Acct # Transport:
401
P
Rec'd on lce i Temp; Q Res. Cl. pH:
rJ . a�� �4 _ram
G r " Cis ��GJ , ❑ Yes ❑ No V '�
n of A s: Fax # or Emall ISAMPLING CHARGES:
G►
Time; Mllee$: Other -
Sampled By: a Project ID. Ana es R wasted
qe ue Tu roun me
Normal (2vreeks ❑ Rush (35 days)' m ti1 }
# STRL QUOTE 0
❑ Emergency Rush (ASAP} •
' ADDITIONAL CHARGES WELL APPLY
CALL FOR APPROVAL Client Requested Due Date: �7 •
Item Start End Comp Grab Sample C r.��C�
# DateMme Datdnme Type.. Descpption/Sam le Marks
-- - -
-
----------------------
i
RELINQUISHED BY
DATEMME
RECENED
QY
DATEMME
NOTES:
-�- l•'�
�
11-3-�5 tt ��c.
[ISDATATO
ld Res. Cl.: Field ConductW. Field Tamp: Field PH: Fleld 0.0.:
BE U ED FOR REGULATORY COMPLIANCE PURPOSES? CrYES ❑ NO IFYES,WHICH REGULATORY AGENCY: MeV
"`See Reverse for Codes
Page 3 of 3

..
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14Q A 15
FACILITY NAME: PKT Co MQze-'rt Ik Q
PERSON COLLECTING SAMPLES IQMN q KRM(�tf
CERTIFIED LABORATORY ICiZDQ Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION Y R: C C 0 [�
SAMPLING PE1RIO�.D,: July -December ❑-January-June
COUNTY 6XQrJ
PHONE NO. EPc�} �r{J C}J3 C?
ADD TO LISTSERVE? []YES❑NO EMAIL: W`sy1,N
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout Other �QrV
�rl
Outfali No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW'I
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
2 Sampling
-
6-9
100 '
-
-
-
-
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/l, except when discharging to ORW, HOW, 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.
5 _e_*KZ_Q.
soir DS
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part 8: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gat of new motor oil/month — averaged over a calendar year.
Outfall -
No.
a;.
Date Sample'
Collected
(mo/dd/yr}1
pH-
(Standard
-
Units)
TPH usrn method
9
I664A!SGT-HEM
.; (mg/L)
Total Sus ended
- p
;. ..Solids
(mg/L)
_ Event
:, Duration
(minutes)
Total
d
Rainfall
, -
.(in}
New Motor Oil
Usage
(gal/month}
In Tier 2 ..
Monthly
-
Monitoring?
;:.. (Y/n) :
It of Months
in Tier 2
Sampling
6-9
15z
100 '
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE CES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Oriainal and one coi3v of this DMR (includina all "No Flow" & "No Discharge" reoorts) within 30 days of receipt of samole for at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS 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 r gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that the ign� Itie for ubmitting false information, including the possibility orinesd imprisonment for knowing violations."
Lam(/ (`' /
(SignatureAf Permittee) V (Date)
Permit Dat60/30/2015 Last Revised.7/13/11
Page 2 of 2

41
PLT Concrete Services
Mr. Rick Proctor
3214 Turnage. Road
Wilson NC, 27893
V MICROBAC`'
Fayetteville Division
Certificate of Analysis
Date Reported: 09/10/15
Project: Stormwater Samples Date Received: 09/04/15
Date Sampled: 09/03/15
Sampled By: Parrish
Wilson PLT, Grab
K5I0213-01
Analyte
Result
Units
nalyzed
Analyzed By
Method Qualifier
Field Data
PH
9.2
pH Units
09/02/15
16:00
Parrish
pH
Temperature
83.0
°C
09/02/15
1&00
Parrish
Field
Analyzed by: Microbac Laboratories, Inc.
- Fayetteville
Settleable Solids
<0.10
mUL
09/04/15
13:41
NCH
SM 2540 F-1997
Total Suspended Solids
21.7
mg/L
09/08/15
14:16
NCH
SM 2540 D-1997
Zebulon PLT, Grab
K5I0213-02
Analyte
Result
Units
Analyzed
Analyzed By
Method Qualifier
Field Data
pH
8.9
pH Units
09/03/15
15:10
Parrish
pH
Temperature
83
°C
09/03/15
15:10
Parrish
Field
Analyzed by: Microbac Laboratories, Inc.
- Fayetteville
Settleable Solids
<0.10
mL/L
09/04/15
1141
NCH
SM 2540 F-1997
Total Suspended Solids
2.25
mg/L
09/08/15
14:16
NCH
SM 2540 D-1997
Selma PLT, Grab
K510213-03
I Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 9.2 pH Units 09/03/15 08:35 Parrish pH
Temperature 80 °C 09/03/15 08:35 Parrish Field
Analyzed by: Micrebac Laboratories, Inc. - FayetteviVe
Coiiform, Fecal 3100 per 100 rnL 09/04/15 15:53 AFO SM 9222 D-1997 H
QC Batch Rut] - (Microbac Laboratories, Mc. - Fayenevaie)
Analyte Result Units Source RPD Limit
Total Suspended Solids 31.8 mg/L K510255 5 5
Total Suspended Solids 6.50 mg/L K5I0253 81 5
Microbac Laboratories, Inc.
Page 1 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910,864.8774 f I www.microbac.com

r
OMICROBAC`"'
Fayetteville Division
Certificate of Analysis
PLT Concrete Services
Mr. Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Date Reported: 09/10/15
Date Received: 09/04/15
Date Sampled: 09/03/15
Sampled By: Parrish,
QC Batch Run - (MicrobacLaboratories, Ina
-Fayetteville)
Analyte
Result
Units
Source
RPD
Limit
Total Suspended Solids
170
mg/L
K510185
10
5
Total Suspended Solids
8.75
mg/L
K510165
26
5
Total Suspended Solids
3.50
mg/L
K510153
67
5
Zebulon - Water Temperature, 831 F, Air 96' F
Selma - Water Temperature, 80° F, Air 711 F
Wilson - Water Temperature, 83, F, Air 961 F
Notes and Definitions
H Analyte was prepared and/or analyzed outside of the analytical method holding time
State Certifications:
NC1aNR #11
NCDOH #37714
Respectfully Submitted
Jeanne Overstreet, Project Manager
Thank you for your business. We invite yotirfeedback on our level ofservice to you. Please contact the Division Manager, Rob Dermer of 910-844-1920 with any
questions. You may also contact J Trevor Boyce, President atpresidenf@inicrobaccom
Microbac Laboratories. Inc.
• Page 2 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

Microbac Laboratories Inc.
Southern' Testing & Research Division
3809 Airport Drive, Wilson, NC 27896
Phone:[phone] • Fax: [phone]
Websile: www.southemtesting.com
Page of
CHAIN OF CUSTODY ...._______-
r__________________ .�
and Analyses Request 0 Lab Use Only i
Rush Approval lay �DatelTime; r
JDept:
Anginal
Contact
n: rSample # Acct. # TranSpOrl:
Rec'd on Ice' 'Temp: Res, Cl, pH:
# I ❑ Yes ❑ No
d
P
Inv9to� Fax# or Email SAMPLING CHARGES: I
f+1.L-� �. g`7 Mme: Mile e: Other.
_—_r._---1 r_­­r_—r—_—_
Sampled By: il Pro)ect ID: Analyses Requested
eque d Turnaround Time ' .
Normal (2 weeks)© Rush (3.5 days) ' Q) \°v
❑ Emergency Rush (ASAP) PO # STRL Q�JOTE #gyp �ti C��
'ADDITIONAL CHARGES WILL APPLY
CALL FOR APPROVAL Client Requested Due Date:
End Comp Grab Sample
# DatelTime DatelTime "' Type" Description/Sample Marks
.Sr.
L-,o
1 ~ ��
I
---------
----------
i.
fr
-SIB
1
----------------------
---------------------
=�f
-------
-------
s
.
-------
---------
}
---------
--------
4
RELINQUISHED BY
DAT£lTIME
RECEIVED.BY
DATEITIME
NOTES:
2
3
Field Res. Cl.: Field Condactivity: Field Temp: Fleld pH: Field D.Q.:
IS DATATO BE USED FOR REGULATORY -COMPLIANCE PURPOSES? VYES ❑ NO IF YES, WHICH REGULATORY AGENCY:
"See Reverse for Codes 11108

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 G -), q /3-�
FACILITY NAME: �.T Cr, I AQZ ,� S ` CUB 41 Ca.. .
PERSON COLLECTING SAMPLES jcpMAq R
CERTIFIED LABORATORY WO-ORA C. Lab # I
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION Y R: O i"
SAMPLING PERIOD: [lluiy-December ❑January -June
COUNTY itfl'10CjfJ _ U
PHONE NO. P�a43. 030G 1Vs
ADD TO LISTSERVE? DYES ❑NO EMAIL: NS w -
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout Other
Outfall No.
Date Sample
Collected
[mo/dd/yr OR
NO FLOW)
PHEvent
[Standard
Units}
TSS
(mg/L)
Duration
[minutes]
Total
Rainfall 4
[in}
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling:
-
6-9
100 '
-
-
-
-
Q.
7S
Nc
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.
s TSS 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: 7/1/2011-60/30/2015 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)
TotaLSuspended
Solids
. (mg/L); ,:
Event'
Duration
(minutes)
Total -
a
Rainfall
..,(in)
New Motor Oil
Usage
(gal/month) .;.
In Tier 2 .
Monthly
Monitoring?
• . ; (y/n)
#i of Months
in Tier 2-
z
Sampling
6-9 f'
15
100
HAS YDUR FACILITY HAD a OR MORE BENCHMARK EXCEEDE CES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO E<
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (includin2 all "No Flow" & "No Discharee" 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 f r gatheri g the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there.�re significa enafty o submitting false information, including the possibility o� finesnd imprisonment for knowing violations."
(Signature ofPermittee)
Permit Date: 2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

RECEIVED
OCT 2 9 2014
CENTRAL FILES
DVVR SECTION
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring. Report
Per"1it No-: NIG I 1l l l / I or Certificate of Coverage No.: 1`i16G1 I l'l UI215131
Facility Narhe:
County:'L,3.jo ✓1 Phonc No.
luspcetor: �� +^ `- _i� ���� - - - Onz't n 7 t ' 4�qS Iw = L' -
Date of Inspection:
By this si ature, I certify a[ this re. rt is accurate. and complete to the best of my knowledge:
(Signatude of Permitter or Designee)
1. ( Outfali Description
Outiall No. Structure (pipe, ditch, etc.) %~
Receiving Stream: _jm,3 L j j_ `S INS -
Describe the industzial tivitieS 9*t occur widlin the outfall drainage arcs:
2_ Color
Describe the color of the disc
dark)'as descriptors:.- = i
3, Odor
using basic colors (red, brown, blue, etc.) and tint (light, medium,
Describe any. djstmct 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 l is clear and 10 is very
cloudy:
1 2 �. 4 5 6 7 8 9 to
Page. i
SWU-242-101599

S. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 3 4, 5 .6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the. mo aunt of suspended solids in the stormwater discharge
where 1 is no solids and I0 is extremely muddy:
1 3 4 5 6 .7 8 9 10
7, Foam .
Is there any foam in'the stormwater discharge? yes Igo
B. Oil Sheen
Is there an oil sheen in the slormwater discharge? Yes
9. Other Obvious Indicators o[Stormwater Pdllutiop '
List and describe --
Note: Low clarity, high solids, and/or the pn=nce of foam or oil. show maybe indicative of pollutant
exposure. These conditions xnay warrant further investigation.
Page: .2
Swty-1Q2-101599

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO
r�
CERTIFICATE OF COVERAGE NO. NCG14 0
FACILITY NAME: CO 2 T S-P-kk iC
PERSON COLLECTING SAMPLES Q Q
CERTIFIED LABORATORY MI[CrQ0 C. Lab # t
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
NCG140000.
SAMPLE COLLECTION YEAR: C9,014-
SAMPLING PERIOD: RrJuly-December ❑ January -June
COUNTY CA (IJGM
PHONE NO. (ELSLAL) a i T • 03<210
ADD TO LISTSERVE? DYES ❑NO EMAIL: 1NS- N
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout Other NSW " 614--
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FL0W)1
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
## of Months in Tier
2 Sampling'
-
6-9
100 '
-
-
-
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfali 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/1, 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
SIZ70a
SG,tpS
,< G . [C3 rs��.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part 8: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
{mo/dd/yr)1
PH
{Standard
Units}
TPH using method
1664A 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
z
Sampling
6-9
15
100 '
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR', MORE BENCHMARK EXCEEDEI.S AT.ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES Q NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO Rf
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 2769.9-1617
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.directiomor supervision in accordance with a system designed to
assure that qualified pei sonnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly respons' ie for gatheringA.he information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware thqrtkere are signi i ant pe Itie for'submitting false information, including the possibility of fines d prisonment for knowing violations."
(Signature f Permittee) {Da(e)
Permit Dat�/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

PLT Concrete Services
Mr. Rick Proctor
3214 Turnage Road
Wilson NC, 27893
&)MICROBAC"
Fayetteville Division
Certificate of Analysis
Project: Stormwater Samples
Zebuion PLT, Grab
K410842-01
Date Reported: 09/30/14
Date Received: 09/25/14
Date Sampled: 09/25/14
Sampled By: Parrish
f Analyte - Result Units Analyzed Analyzed By Method Qualifier
Anatyzed by: Miaobac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10 m1/L 09/26/14 07:20 JAO SM 2540 F-1997
Total Suspended Solids 5.00 mg/L 09/29/14 08:50 SW SM 2540 D-1997
Wilson PLT, Grab
K4T0842-02
Analyte -
Result
Units
Analyzed
Analyzed By
Method Qualifier
Field Data
PH
8.1
pH Units
09/24/14 11:15
Parrish
pH
Analyzed by: Miaobac Laboratones, Inc.
- Fayetteville
Settleable Solids
<0.10
ml/L
09/26/14 07:20
JAO
SM 2540 F-1997
Total Suspended Solids
6.25
mg/L
09/29/14 08:50
SW
SM 2540 D-1997
Rocky Mount PLT, Grab
K410842-03
Analyte Result
Units
Analyzed
Analyzed By
Method Qualifier
Field Data
PH 9.3
pH Units
09/25/14 07:02
Parrish
pH
Analyzed by: Miaobac Laboratories, Inc. - Fayetteville
Settleable Solids <0.10
ml/L
09/26/14 07:20
JAO
SM 2540 F-1997
Total Suspended Solids 6.50
mglL
09/29/14 08:50
SW
SM 2540 D-1997
Selma PLT, Grab
K410842-04
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 9.1 pH Units 09/25/14 10:37 Parrish pH
Analyzed by: Miaobac Laboratories, Inc. - Fayetteville
Coliform, Fecal 280 per 100 ml 09/25/14' 15:40 JAO SM 9222 D-1997
Microbac Laboratories, Inc.
Page 1 of, 3'
2592 Hope Mills Road I Fayetteville, NC 28306 1 910.864.1920 p 1910.864.8774 f I www.microbac.com

PLT Concrete Services
Mr. Rick Proctor
3214 Turnage Road
Wilson NC, 27893
&)MICROBAC"
Fayetteville Division
Certificate of Analysis
Project: Stormwater Samples
Date Reported: 09/30/14
Date Received: 09/25/14
Date Sampled: 09/25/14
Sampled By: Parrish
QC Batch Run - (Microbac Laboratories, Inc - Fayetteville)
Analyte Result Units Source RPD Limit
Total Suspended Solids 6.50 mg/L K4I0886 7 5
Rocky Mount- Water Temperature, 701 F, Air 621 F
Zebulon - Water Temperature, 721 F, Air 580 F
Selma - Water Temperature, 701 F, Air 621 F
Wilson - Water Temperature, 72° F, Air 601 F
State Certifications:
NCDNR #ll
NCDOH 437714
Respectfully Submitted
Bonnie K. Sanders, Senior Project Manager
Thank you for your business. We invite your feedback on our level ofservice to you. Please contact the Division Manager, Rob Dermer at 910-864-1920 with any
gvestions. You may also contact J. Trevor Boyce. President [e-mail]
Microbac Laboratories, Inc.
_. Page 2 of3;
2592 Hope Mills Road i Fayetteville, NC 28306 1910.864.1920 p 1 910.864.8774 f J www.microbac.com

0 rMicrobac Laboratories Inc.
Wilson Division
3809 Airport Drive, Wilson, NC 27896
Phone:[phone] • 3=ax:252-237-9341
Webslte: www.microbac.com
CHAIN OF CUSTODY Page of
r—_—_—_—_— _—______-
and Analyses Request � Lab Use Only
!Rush Approval 8T.. Dater rime:
Dept:
Original Report To: �� �`
ddress: i (� I q P
. � i 1 `AX-�-AV `— '"
Contact Persornr �j /� f -�-� fSample # Acct # Transport
Phone # �. �} C% `r Rec d on ice % Temp: Res. Cl. pH:
�� ^ 2 r 3� �J Q� i❑ Yes ❑ No
nvoice Address: j Fax # or Ernall SAMPLING CHARGES:
i L 5ov,1 C • �ri �� J !Time; mow—� Milea$� _ Other. ,—
sampled By ! CA t Project ID: — Analyses Re Requested ----- --
lRequespri Turnaround Time
IV Normal (2 weeks) ❑ Rush (3-5 days) ' Qs +�
PO iF
0 Emergency Rush (ASAP)' STRL 4UOTE # o� �Z `ot`
• ADDITIONAL CHARGES WILL APPLY C�4"
CALL FOR APPROVAL Client Requested Due Date:
Item Start End Comp Grab Sample
# Datefime Date -Time Type" DescriptionJSample Marks
q_
iO`e
!Q
g
f J�
---__
--
Tit : J.t ATo-& 2A A
Se�rnff A:r
---------
ern AN?- 20 181-1z 6 z
RELINQUISHED BY
DATE7IME
RECEIVED BY
DATETIME
NOTES:
'
tww r e-
-1 ti %4-157 A,
2
3
Field Res, Cl.: Field Conductivity: Field Tamp: Field pH: Field D.O.:
IS DATA TO BE USED FOR REGULATORY COMPLIANCE PURPOSES? MIES Tj NO IFYES, WHICH REGULATORY AGENCY: D
"see Reverse for Codes `
:1/os

RECEIVED
MAI 0 2 Z014
- --
CEN s t�H1_ IFILES
..�� DWQIBOG
Stormwater Discharge 4utfall (SDO)
Qualitative Monitoring. Report
Permit No_: hIIG_I_I_I
Facility Name: PZ i
County:
Inspector:
Date of Inspection: �1
J n p
I_I 1 I or Certificate of Coverage No.: NIQU / 1 ` I dl $ 7 / 31
�nnGuf'C _I!A - w, k50in ,t i. C . .
Phone No.
By this si re, I certi that this re rt is accurate and complete to the best of my knowledge:
{Signs of Permittcc or Designee
1. Outfall Description
Outfall No_ Structure {pipe, ditch, .etc.) %1 ^ "�
Receiving Stream: M i LL _
Describe the industrial activiitics that occur within the outfail drainage area: - —
Z Color
Describe the color of the
dark)'as descriptors:
3. Odor
Describe anX.4
etc.) — -
O/A
ieclrgge using basic colors (red, brown, blue, etc.) and tint (light, medium,
odors that the diie i.e., smells strongly of oil, weak chlorine odor,
4. Clarity
Q/ 0
Choose the number which best describes the clarity of the diorii�ge where t is clear and 10 is very
cloudy: AID 015
1 2 C 4 5 6 7 8 9 to
Page i
Swtl-242-10 t 599

I
S. Floating Solids Pow
Choose the number which best describes the amount of floating solids in the stormwater di ge where
t is no solids and 10 is the surface covered with floating solids:
1 2 (3) 4 5 6. 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater disodge
where I is no solids and 10 is extremely muddy-
1 2 4 5 6 7 8 9 10
7. Foam
is theme any foam in'the stormwater di rge? Yes 60)
8. Oil Sheen
AND •
Is there an oiI sheen in the stomwater disc rge? Yes No
9. Other Obvious Indicators of Stormwater Pollution
List and describe
f
I
r
Note: Loci clarity, high solids, and/or the presence of foam or oil -sheen maybe indicative of pollutant
exposure. These conditions may warrant further invesdgatioh.
Page .2
SWU-242-101599

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 O �_ 3
FACILITY NAME: p�.T CG !�1 CZ��, S2 C�L1J�f C , 11 �.
PERSON COLLECTING SAMPLES IQM44 4 Phh�'Ri��f
CERTIFIED LABORATORY [Vj i C-('j0l3,q( Lab # 1
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: V t
SAMPLING PERIOD: July -December January -June
C0UNTY_WUG1i
PHONE N0. (; S, ) �. 4 7 ; G
ADD TO LISTSERVE? ❑YES []NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout EOther
0utfall No.
Date Sample
Collected
(m r OR
NO FLOW]
PH
(Standard
Units)
TSS
{mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
x
2 Sampling
6-9
100 '
-
-
-
-
i,5 r
o. s
sAJ
lAto
1 if "NO FLOW" or "NO DISCHARGE, Enter `NO FLOW o E" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, o the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
a TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
4 T..or each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
<d,ld
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.
4 T�
dutfall
[7No.
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
4
Rainfall
(in)
New Motor oil
Usage
(gal/month)
in Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
z
Sampling
6-92
15
23
100 '
-
-
-
I
. U.
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEYCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO Q
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (including all "No Flow" & "No Discharee" reports} within 30 days of receiot 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 respons,61ble for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that-*4re are signiftant pen
{Signature of
submitting false information, including the possibility o fines a/d irpprisonment for knowing violations."
r .
(Date)
PermitDate`7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2

w ' Micrabac Laboratories Inc.
Wilson Division
3809 Airport Drive, Wilson, NC 27896
Phone:[phone] Fax:[phone]
Website: www,microbac.com
1
CHAIN OF CUSTODY
and Analyses Request
Page of
r-----------------------------
f Lab Use Only
'Rush Approval By. �Datemme:
JDept
Original Report To: I
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Address: ^
3-;t Ly / 46" n Y4
Contact Person: ;Sample # _Cc # Transport:
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Phone # Rec'd an Ice' Temp: Res. Cl. pH:
; 5- 29 3 - I ❑Yes ❑ Na
Invoice Address: Fax # or Email SAMPLING CHARGES: L} �'% r J (Time: —,—_�� Mil e: Other.
Sampled By: Prot ID: Anatyses Requested
Requested Turnaround Time
Normal (2 weeks) 0 Rush (3 5 days) ' S STRL QUOTE # �Q� �co »� v
© Emergency Rush (ASAP)' C
• ADDITIONAL CHARGES WILL APPLY I
CALL FOR APPROVAL Mont Requested Due Date:
Item Start End Comp Grab Sample
# DatelTirnc Date/Time Type" Description/Sample Marks '� Q
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---__
RELINQU SHED Y
DATEMME
RECEIVED BY
DATEMME
NOTES:
1
�
'
2
3
Field Res, Cl.; Field Conductivity: Field Temp: Field pH: Field D.4.:
IS DATATO BE USED FOR REGULATORY COMPLIANCE PURPOSES? YES ❑ NO IF YES, WHICH REGULATORY AGENCY: i� 11J
"See Reverse for Codes t t/08

® Fayetteville Division
2592 Hope Mills Rd
Fayetteville, NC 28306
910.864.1920 Phone
910,864.8774 Fax
Certificate of Analysis
PLT Concrete Services Date Reported: April 23, 2014
Mr. Rick Proctor Project_ Stormwater Samples Date Received: April 21, 2014
3214 Turnage Road Date Sampled: April 17, 2014
Wilson NC, 27893 Sampled By: Parrish
Wilson PLT, Grab
1404431-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 8A pH Units 4/16/14 9:46 Parrish pH
Analyzed by: MiQobac - Fayetteville Division
Settleable Solids <0.10 ml/L 4/21/14 10:30 JAO SM 2540 F-1997 H
Total Suspended Solids 30.5 mg/L 4/23/14 8:30 JTL SM 2540 D-1997
Zebulon PLT, Grab
1404431-02
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH 8.4 pH Units 4/16/14 10:17 K. Parrish pH
Analyzed by: Miaobac - Fayetteville Division
Settleable Solids <0.10 ml/L 4/21/14 10:30 JAO SM 2540 F-1997 H
Total Suspended Solids 7.50 mg/L, 4/23/14 8:30 JTL SM 2540 D-1997 S1
Rocky Mount PLT, Grab
1404431-03
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 89 pH Units 4/16/14 10:50 Parrish pH
Analyzed by: Microbac - Fayetteville Division
Settleable Solids <0.10 mA 4/21/14 10:30 JAO SM 2540 F-1997 H
Total Suspended Solids 6.75 mg/L 4/23/14 8:30 JTL SM 2540 D-1997
State Certifications:
NCDNR # 11
NCDOH 937714
USDA #3787
Respectfully Submitted
Bonnie K_ Sanders, Senior Project Manager
QAPage'ilqofl2

® Fayetteville Division
2592 Hope Mills Rd
Fayetteville, NC 28306
910.864.1920 Phone
910.864,8774 Fax
Certificate of Analysis
PLT Concrete Services
Mr Rick Proctor Project: Stormwater Samples
3214 Turnage Road
Wilson NC, 27893
Wilson PLT, Grab
1404431-01
Date Reported: April 23, 2014
Date Received: April 21, 2014
Date Sampled: April 17, 2014
Sampled By: Parrish
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH 8.4 pH Units 4/16/14 9:46 Parrish pH
Analyzed by: Microbac - Fayetteville Division
Settleable Solids <0.10 mVL 4/21/14 10:30 JAO SM 2540 F-1997 H
Total Suspended Solids 30.5 mg/L 4/23/14 8:30 JTL SM 2540 D-1997
Zebulon PLT, Grab
1404431-02
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH 8.4 pH Units 4/16/14 10:17 K. Parrish pH
Analyzed bpMicrobac - Fayetteville Division
Settleable Solids <0.10 ml/L 4/21/14 10:30 JAO SM 2540 F-1997 H
Total Suspended Solids 7.50 mg/L 4/23/14 8:30 JTL SM 2540 D-1997 S1
Rocky Mount PLT, Grab
1404431-03
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH 8.9 pH Units 4/16/14 10:50 Parrish. pH
Analyzed by: Miaobac - Fayetteville Division
Settleable Solids <0.10 mVL 4/21/14 10:30 JAO SM 2540 F-1997 H
Total Suspended Solids 6.75 mg/L 4/23/14 8:30 JTL SM 2540 D-1997
State Certifications: Respectfully Submitted
NCDNR # 11
NCDOH 437714
USDA #3787
Bonnie K. Sanders, Sensor Project Manager