NCG140328_MONITORING INFO_20190115

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑HISTORICAL FILE
ql MONITORING REPORTS
DOC DATE
❑ ��O I/ b I I S
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140328
Calendar Year 2018
*Report ALL STORMWATER monitoring data on this form (include "No Flow'1"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 9 4 0328
Facility Name: Carolina Sunrock LLC — North Raleigh
County: Wake
Phone Number: [phone]
Certified Laboratory Contest Lab # 652
Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Non -polar O&G
Total (EPA Method New Motor Oil
Total Rainfall, Suspended pH, 1664TSS, ( S_ GT-HEM)), Usage (gallmo.)
Outfall No. inches Solids ( ) SU mgll (VMA) IF applicable
m /I IF applicable
Circle Benchmark
Storm water
Indicate NO rt_OW if 100150 6.0-9.0 15 >55 gallmo. average requires TSS and
Benchmarks apprkable Non -polar OaG monitoring
Date Sample.
Collected,
molddlyr r
01-2018
02-2018
03-21-2018 0.51 7.1 8.44 2.3
04-24-2018 1.02 93 7.59 ND
05-2018 _
06-2018
07-2018 "
08-2018 `""'Y ! 6 201Q
09-17-2018 0.43 18 8.39 ND CEN7-pA I p—„
10-11-2018 2.68 12 8.54 N D VAR SE el—NCA 5
11-2018
12-2018
Permit Date 8/112017 — 6/30/2022
Last Revised 8-22-2015

m
Certificate of Coverage No. NCG14 0328
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.221
Sign
Date
Mail Annual Summary Storm water DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Storm water Permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140328
Calendar Year 2018
*Report ALL STORMWATER monitoring data on this form (include "No FlowTNo Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 14 0328
Facility Name: Carolina Sunrock LLC — North Raleigh
County: Wake
Phone Number: [phone] Total no. of SDOs monitored 1
Certified Laboratory Contest Lab # 652
Lab #
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 0328
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]
Signz
Date
Mail Annual Summary Storm water DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Storm water Permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 - 6/30/2022
Last Revised 8-22-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —WASTEWATER
SUBMIT TO CENTRAL OFFICE"
General Permit No. NCG140328
Calendar Year 2018
*Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 14 0328
Facility Name: Carolina Sunrock LLC — Norm Raleigh
County: Wake
Phone Number: [phone]
Certified Laboratory Contest Lab # 652
Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No. 1
Does this outfall discharge WW to SA waters?
Yes ❑
No
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No IR
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No
If so, what is the 7Q10 flow rate? or Tiadlly influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr)?
Yes ❑
No
Were there any limit violations in the calendar year?
Yes ❑
No
Non -polar O&G
Total
(EPA Method
SS,
Outfall No.
Dail Flow Rate
Y ,
Suspended
pH,
1664 SGT-HEM ,
�)
mlll
Cfs
Solids (TSS),
SU
m(ll VMA
9 ( )
ifapphrable
—mg/1
Ifapplicable
HOW or ORW
Circle Benchmark
HOW, ORW, SA,
Effluent
50% of
100150
6.0-9.0
15
SD, PNA, or any Trout
5
Limitations
7Q10
IndieaieNO FLO Wifappfirahle
Date Sample
Collected,MMM
molddlyr
01-2018
02-2018
03-21-2018
0.51
7.1
8.44
2.3
ND
04-24-2018
1.02
93
7.59
ND
ND
05-2018
06-2018
07-2018
08-2018
09-17-2018
0.43
18
8.39
ND
ND
10-11-2018
2.68
12
8.54
ND
ND
11-2018
12-2018
Permit Date 811/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 0445
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]
Signature/
Date
Mail Annual Summary Storm water DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Storm water Permitting Staff in the Central Office at:
[phone]
Permit Date 6I112017 — 6130/2022
Last Revised 8-22-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140328
Calendar Year 2018
'Report ALL STORMWATER monitoring data on this form (include "No Flow"1"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 0328
Facility Name: Carolina Sunrock LLC — North Raleigh
County: Wake
Phone Number: [phone]
Certified Laboratory Contest Lab # 652
Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No. 1
Does this outfall discharge WW to SA waters?
Yes ❑
No
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No
If so, what is the 7Q10 flow rate? or Tiadlly influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr)?
Yes ❑
No
Were there any limit violations in the calendar year?
Yes ❑
No
Non -polar O&G
Total
(EPA Method
SS,
Outfall No.
Daily Flow Rate,
Suspended
pH,
1664 SGT-HEM ,
))
mill
CA
Solids (TSS),
SU
m9(11 (VMA )
ifapplerable
mg/1
Napplicable
HOW or ORW
50% of
Circle Benchmark
1 00150
15
HQW, ORW, SA,
SB, PNA, or any Trout
Effluent
6.0-9.0
5
Limitations
7Q10
ladirateNO FLOII'i a livable
Date Sample
Collected,
molddlyr
01-2018
02-2018
03-21-2018
0.51
7.1
8.44
2.3
ND
04-24-2018
1.02
93
7.59
ND
ND
05-2018
06-2018
07-2018
08-2018
09-17-2018
0.43
18
8.39
ND
ND
10-11-2018
2.68
12
8.54
ND
ND
11-2018
12-2018
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 0445
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]
Signature
Date i -
Mail Annual Summary Storm water DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Storm water Permitting Staff in the Central Office at:
[phone]
Permit Date 811/2017 - 6/30/2022
Last Revised 8-22-2015

i
BSUNROCK 0
CAROLINA SUNROCK LLC
Scott Martino
Environmental Compliance Manager
200 Horizon Drive, Suite 100
Raleigh, NC 27615
January 8, 2019
N.C. Department of Environmental Quality
Division of Water Resources
1617 Mail Service Center
Raleigh, North Carolina 2799-1617
Re: NPDES Storm Water Semi -Annual DMR 2018
Carolina Sunrock LLC — North Raleigh Concrete
Permit No: NCG140328
5043 Unicon Drive
Wake Forest, Wake County, NC 27587
CERTIFIED MAIL No. 7015 640 0007 80851086
Retum receipt Requested
Dear Sir or Madam:
In accordance with the above referenced NPDES Permit, please find the attached Semi -Annual Data Monitoring Reports
(DMR) for the above referenced facility.
Please contact me if you need further information or if this does not meet your requirements.
Sincerely,
Carolin unrock, LLC
Scott Martino
Environmental Compliance Manager
[e-mail]
Phone: [phone]
Fax: [phone]

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM rd
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140328 SAMPLE COLLECTION YEAR: 2018
FACILITY NAME: North Raleigh Concrete SAMPLING PERIOD: ❑ July -December ® January -June
PERSON COLLECTING SAMPLES Scott Martino COUNTY Wake
CERTIFIED LABORATORY ConTest Lab # 652 PHONE NO. (919)0500
—]NO EMAIL: [e-mail]
Lab # ADD TO LISTSERVE? ®YES
OPTIONAL INFO:—Dicharging To Class C - DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
PH
(Standard
Units)
TS5
(mg/Lj
Event
Duration
(minutes)
Total
Rainfall"
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-92
1002,3
1
07-2018
-
-
-
-
N
-
1
08-2018
-
-
-
N
1
09-17-2018
8.39
18
1440
0.43
N
-
1
10-11-2018
7.59
12
1440
2.69
N
-
1
11-2018
-
-
-
-
N
-
1
12-2018
-
-
-
-
N
If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
"Date Sample
Collected
{mo/dd/yr)�
pH
.(Standard
Units)
TPH using method
•1664A SGT HEM
(mg/L) .
Total Suspended
Solids
(mg/t)
Event
Duration �
(minutes)
Total'
Rainfall a
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in,Tier 2
Sampling-2
6-g2
15x
1002,a.
9-17-2018
8.39
ND
18
1440
0.43
100
N
10-11-2018
7.59
ND
12
1440
2.69
100
N
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME; Raleigh
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: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am a�at tare significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:7/i/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

11SUNROCK a
CAROLINA SUNROCK LLC
June 28, 2018
Ms. Bethany Georgoulias
Environmental Engineer
1612 Mail Service Center
Raleigh, North Carolina 2799-1617
Re: NPDES Storm Water Semi -Annual DMR 2018
Carolina Sunrock LLC — North Raleigh Concrete
Permit No: NCG140328
5043 Unicon Drive
Wake Forest, Wake County, NC 27587
CERTIFIED MAIL No, 7015 640 0007 8090 2238
Retum receipt Requested
Dear Ms. Georgoulias:
Scott Martino
Environmental Compliance Manager
200 Horizon Drive, Suite 100
Raleigh, NC 27615, NC 27615
REeENED
JUL 0 9 2018
CENTRAL FILES
DWR SECTION
In accordance with the above referenced NPDES Permit, please find the attached Semi -Annual Data Monitoring Reports
(DMR) for our North Raleigh Concrete Facility,
Please contact me if you need further information or if this does not meet your requirements.
Sincerely,
Carolina Sunrock, LLC
Scott Martino
Environmental Compliance Manager
[e-mail]
Phone: [phone]
Fax: [phone]

STORMWA►ER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. NCG140328 SAMPLE COLLECTION YEAR: 2018
FACILITY NAME: North Raleigh Concrete SAMPLING PERIOD: ❑ July -December ® January -June
PERSON COLLECTING SAMPLES Scott Martino COUNTY Wake
CERTIFIED LABORATORY ConTest Lab # 652 PHONE NO. [phone]
Lab # ADD TO LISTSERVE? ®YES ONO EMAIL: [e-mail]
OPTIONAL INFO: _Dicharging To Class C - DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [—]Trout ®Other
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
PH
(Standard
Units}
TSS
Event
Duration
(minutes}
Total a
Rainfall'
{in}
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6.92
1002.3
-
-
-
1
01-2018
-
-
-
N
-
1
02-2018
-
-
-
N
1
03-21-2018
8.44
7.1
960
0.51
N
-
1
04-24-2019
7.59
93
1440
1.19
N
-
1
05-2018
-
-
-
-
N
-
1
06-2018
-
-
-
-
N
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)1
pH,
(Standard
Units)
TPH using method
1664A SGT HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
i ,
Ranfall
(in)
New Motor.0i1
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6,92
152
1002.1
-
-
-
-
-
3-12-2018
8.44
2.3
7.1
300
0.51
100
4-24-2018
7.59
ND
93
1440
1.19
100
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME: Raleigh
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring_ period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am awar there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit.Date: 7/1/2011-60/30/2015
6/28/2018
(Date)
Last Revised 7/13/11
Page 2 of 2

r
11SUNROCK�
CAROLINA SUNROCK LLC
January 2, 2018
Ms. Bethany Georgoulias
Environmental Engineer
1612 Mail Service Center
Raleigh, North Carolina 2799-1617
Re: NPDES Storm Water Semi -Annual DMR 2017
Carolina Sunrock LLC — North Raleigh Concrete
Permit No: NCG140328
5043 Unicon Drive
Wake Forest, Wake County, NC 27587
CERTIFIED MAIL No. 7015 640 0007 8085 0270
Retum receipt Requested
Dear Ms. Georgoulias:
Scott Martino
Environmental Compliance Manager
200 Horizon Drive, Suite 100
Raleigh, NC 27615, NC 27615
RPn1_=1VFI`
JAN 0 8 2018
!)VVR SECTION
RaOCESSING UNll
In accordance with the above referenced NPDES Permit, please find the attached Semi -Annual Data Monitoring Reports
(DMR) for our North Raleigh Concrete Facility.
Please contact me if you need further information or if this does not meet your requirements.
Sincerely,
Carolina Sunrock, LLC
Scott Martino
Environmental Compliance Manager
smartino@thesunrockgroup,com
Phone: [phone]
Fax: [phone]

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140328 SAMPLE COLLECTION YEAR: 2017
FACILITY NAME: North Raleigh Concrete SAMPLING PERIOD: ® July -December ❑ January -June
PERSON COLLECTING SAMPLES Scott Martino COUNTY Wake
CERTIFIED LABORATORY ConTest Lab # 652 PHONE NO. [phone]
Lab # ADD TO LISTSERVE? ®YES [—]NO EMAIL: [e-mail]
OPTIONAL INFO: _Dicharging To Class C - DISCHARGING TO CLASS: []SA❑HQW ❑PNA [—]Trout ®Other
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(standard
Units}
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall 4
{in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-92
1002.3
-
-
-
-
1
07-2017
-
-
-
-
N
-
1
08-2017
-
-
-
N
1
09-13-2017
7.39
7.0
960
0.5
N
-
1
10-2017
-
-
-
-
N
-
1
11-2017
-
-
-
-
N
-
1
12-6-2017
6.51
8.0
720
0.5
N
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)l
pH
(Standard
units)
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall c
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
#i of Months
in Tier 2
Sampling'
6-9'
1s'
looz,3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [—]NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one copy of this DMR (includine all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring; period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1/20/2017
(Signature of Permittee) (Date)
Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140328 SAMPLE COLLECTION YEAR: 2017
FACILITY NAME: North Raleigh Concrete SAMPLING PERIOD: ® July -December ❑ January -June
PERSON COLLECTING SAMPLES Scott Martino COUNTY Wake
CERTIFIED LABORATORY ConTest Lab # 652 PHONE NO. [phone]
Lab # ADD TO LISTSERVE? ®YES []NO EMAIL: [e-mail]
OPTIONAL INFO: _Dicharging To Class C - DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ®Other
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
mo dd r OR
( ' /y 1
NO FLOW)
PH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfafl s
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-92
1002.3
1
07-2017
-
-
-
-
N
-
1
08-2017
-
-
-
N
1
09-13-2017
7.39
7.0
960
0.5
N
-
1
10-2017
-
-
-
-
N
-
1
11-2017
-
-
-
-
N
-
1
12-6-2017
6.51
8.0
720
0.5
N
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/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.
Obtfall
No.
•
Date Sample
collected
.(mo/dd/Yr}1
pH
(Standard
Units)
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall a
(in] ..
New Motor Oil
Usage
(gal/month]
In Tier 2
Monthly
Monitoring?
(Yln) .
# of Months
in Tier 2
Z
Sampling
6-92
152
1002,3'
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [—]NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one copy of this DMR (includine all "No Flow" & "No Discharee" reports) within 30 days of receipt of sample for at end of monitorine period
in case of "No Flow" to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete,
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1/20/2017
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140328 SAMPLE COLLECTION YEAR: 2017
FACILITY NAME: North Raleigh Concrete SAMPLING PERIOD: ❑ July -December ® January -June
PERSON COLLECTING SAMPLES Scott Martino COUNTY Wake
CERTIFIED LABORATORY ConTest Lab # 652 PHONE NO. [phone]
Lab # ADD TO LISTSERVE? ®YES ONO EMAIL: [e-mail]
OPTIONAL INFO: _Dicharging To Class C - DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
Part A; Stormwater Monitorine Reauirements
Outfall No.
Date Sample Collected
(mo/dd/yr OR
NO FLOW)'
pH
(standard
Units)
TSS
(mg/L)
Event
Duration
{minutes}
Total
4
Rainfall
{in}
In Tier 2
Monthly
Monitoring?
(y/n)
#of Months in Tier
2 Sampling'
-
-
6-92
1002.3
-
-
-
-
1
01-2017 No Flow
-
-
-
-
N
-
1
02-15-2017
7.38
68
0.35
N
1
03-2017 No
Flow
-
-
-
-
N
-
1
04-2017 Now
FLow
-
-
-
-
N
-
1
05-24-2017
8.66
82
-
1.0
N
-
1
No Flow
-
-
-
-
N
r
`twj
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.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

-i
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2of2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfail
No.
Date Sample
Collected
(mo/dd/yr]1
pH
[Standard
Units]
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall a
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n]
# of Months
in Tier 2
Z
Sampling
6-92
152
1002,3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Orieinal and one coov of this DMR (includine 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 for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1/20/2017
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 3 of 2

11SUNROCK�
CAROLINA SUNROCK LLC
June 26, 2017
Ms. Bethany Georgoulias
Environmental Engineer
1612 Mail Service Center
Raleigh, North Carolina 2799-1617
Re: NPDES Storm Water Semi -Annual DMR 2017
Carolina Sunrock LLC — North Raleigh Concrete
Permit No: NCG140328
5043 Unicon Drive
Wake Forest, Wake County, NC 27587
CERTIFIED MAIL No. 7015 640 0007 8090 0195
Return receipt Requested
Dear Ms. Georgoulias:
Scott Martino
Environmental Compliance Manager
200 Horizon Drive, Suite 100
Raleigh, NC 27615, NC 27615
K1P=@[R0W110
JUN 2 7 2017',
In accordance with the above referenced NPDES Permit, please find the attached Semi -Annual Data Monitoring Reports
(DMR) for our North Raleigh Concrete Facility.
Please contact me if you need further information or if this does not meet your requirements.
Sincerely,
Carolina Sunrock, LLC
Scott Martino
Environmental Compliance Manager
[e-mail]
Prone: 919.747.6336
Fax: [phone]

x
Division of Energy, Mineral, and Land Resources
Land Quality Section / Stormwater Program
National Pollutant Discharge Elimination System (NPDES)
Energy, Mineral & PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
[WVIRONMENTAL. OUALMY (Individual Legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Date Reocind
Year
Moath
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or If the ownership of the fadlity has changed,
do NOT use this form. Instead, you must RIt out a Name -Ownership Change Form
and submit the completed form with all required documentation.
Ae
What does "legally responsible individual' mean? R E C E i V E
The person
• the responsible corporate officer (for a corporation); 1 5 2 Q 17.9,�a
• the principle executive officer or ranking elected official (for afzuncp$ii�tyj 661'e,
federal or other pi
agency); D W R SECTION�-
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the; above.
1) Enter the permitnumber for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit (or) Certificate of Coverage
N C S N I C I G 1 14103 2 8
2) Facility Information:
Facility name-
Company/Owner Organization:
Facility address:
Carolina Sunrock — North Ralei Concrete
Carolina Sunrock LLC
5043 Unicon Drive
Address
Wake Forest NC 27587
City Stec Zip
To find the current legally responsible person associated with your permit, go to this website:
httn://deo.ne.Lou/a oout/divisionS/MCTc,%r-mineral-land-resources/energy-mineral-land-permits/stormwater-prograze
and run the Permit Contact Summary Report.
3) OLD OWNER AFFMIATION that should be removed:
Previous legally responsible individual: Brain Pfohl
First MI Last
4) NEW OWNER AFFMIATION (legally responsible for the permit):
Person legally responsible for this permit:
Gregg _ _ Bowler
First MI Last
Pagel of 2
SM-OWNtRAFFI L-23Mard=17

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
CFO
Title
200 Horizon Drive
Suite 100
Mailing Address
_ Raleigh NC 27615
City State Zip
919 747-6400 gbowler a thesunrock ►rou .corn
Telephone )email Address
[phone]
Fax Number
5) Reason for this change:
A result of: ® Employee or management change
❑ Inappropriate or incorrect designation before
D Other
Ijother please explain:
The certification below must be completed and signed by the permit holder.
PERM1 TEE CERTIFYCATION:
I, Greer Bowler, attest that this application for this change in Owner Affiliation (person legally responsible
for the permit) ha been reviewed and is accurate and complete to the best of my knowledge. I understand
that if all d p s of this form are not completed, th' hange may not be processed.
L' 'a I
ignature Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral, and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website at:
http://dpq . nc. gov/about/divisions/enMv-mineral-land-resources/storrnwater
Page 2 of 2
swu-MNERAFF IL-23Marzot 7

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
li SUBMIT TO CENTRAL OFFICE* II
General Permit No. NCG140000
Calendar Year 2017
'Report ALL STORMWATER monitoring data on this form (include "No Flow'T'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 328
Facility Name: _ Carolina Sunrock LLC — North Raleigh Concrete
County: Wake
Phone Number: [phone] Total no. of outfalls monitored 1
Certified Laboratory: Contest Laboratory # 652
Lab #
Stormwater Discharge Outfall (SDO) No. 1 VIVIA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Permit Date 811/2017 — 6130/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 ❑❑❑❑
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by 40 CFR §122.221
Signature
Date /,,
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE'
General Permit No. NCG140000
Calendar Year 2017
*Report ALL WASTEWATER monitoring data on this form (include "No Flow" 1" No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 328
Facility Name: Carolina Sunrock LLC — North Raleigh Concrete
County: Wake
Phone Number: [phone] Total no. of outfalls monitored 1
Certified Laboratory: Contest Laboratory # 652
Lab #
Wastewater (WW) Discharge Outfall No. 01
Does this outfall discharge WW to SA waters? Yes ❑ No
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No JZ
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7010 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No
Were there any limit violations in the calendar year? Yes ❑ No
Outfall No. Daily Flow Rate, pH, TSS, SS, Non -Polar O&G (EPA Method 1664
cfs SU mgll mill (SGT-HEM)), mgll
if applicable
Standard
HOW or ORW freshwater 30 HQW, ORW, SA,
Effluent 50% of 7Q10 6.0-9.0 How SB,PNA,orany No Limit
Limitations Trout
Indicate NO FLOW if saltwater 20 Samples above Benchmark
applicable 6. a-p.5 HOW f ORW � Tr, or 5 subject to Tiered Responses
O Daily Maximum O PNA 15
10
Date
Sample
Collected,
molddl r OWN
02-15-2017 - 7.38 68 NA NA
05-24-2017 - 8.66 82 NA NA
09-13-2017 - 7.39 7.0 ND NA
12-06-2017 - 6.51 8.0 ND NA
Permit Date 811/2017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 ❑❑❑❑
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.2_2j.
Signatur
Date
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 811/2017 — 6/30/2022
Last Revised 8-22-2017

JISUNROCK 0
CAROLINA SUNROCK LLC
January 20 , 2017
Ms. Bethany Georgoulias
Environmental Engineer
1612 Mail Service Center
Raleigh, North Carolina 2799-1617
Re: NPDES Storm Water DMR 2016
Carolina Sunrock LLC — North Raleigh Concrete
Permit No: NCG140328
5043 Unicon Drive
Wake Forest, Wake County, NC 27587
CERTIFIED MAIL No. 7015 6400007 8090 0258
Return receipt Requested
Dear Ms. Georgoulias:
Scott Martino
Environmental Compliance Manager
200 Horizon Drive, Suite 100
Raleigh, NC 27615, NC 27615
RECEIVED
JAN252011
DENR-LAND QUALITY
STORMWATER PERMITTING
In accordance with the above referenced NPDES Permit, please find the attached Annual and Semi -Annual Data Monitoring
Reports (DMR) for our North Raleigh Concrete Facility.
Please contact us if you need further information or if this does not meet your requirements.
Sincerely,
Carolina Sunrock, LLC
Scott Martino
Environmental Compliance Manager
[e-mail]
Phone: [phone]
Fax: 919.747,6305

t
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 2016
Individual NPDES Permit No. NCSUj_JUUUU or
Certificate of Coverage (COC) No. NCG140328
This monitoring report summary of the calendar year should be kept on file on -site with the acility SPPP.
Facility Name: Carolina Sunrock LLC — North Raleigh Distribution Center 04
County: Wake ��t3
Phone Number: [phone] Total no. of SDOs monitored 1
Outfall No. 1
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Parameter, (units
Total
M inches
•:
�—
a .;iw.
y, ,11� �
�`:; i4. aL" ,
No Sampling • - occurred in 2016.
SW U-264-Generic-1 Mec2012

I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature ///
Date 01-13-2017
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
FAYETTEVILLE REGIONAL OFFICE
MOORESVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
WASIIINGTON REGIONAL OFFICE
,NVILMINGTON REGIONAL OFFICE
943 Washington Square Mail
127 Cardinal Drive Extension
3800 Barrett Drive
Raleigh, NC 27609
Washington, NC 27889
Wilmingon, NC 28405-2845
[phone]
[phone]
[phone]
LW INSTON-SALEM REGIONAL OFFICE
CENTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
'To preserve, protect
and enhance
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
[phone]
North Carolina's ivater..."
SW U-264-Generic-13Dec2012

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
CERTIFICATE OF COVERAGE NO. NCG140328
FACILITY NAME: North Raleigh Concrete
PERSON COLLECTING SAMPLES Scott Martino
CERTIFIED LABORATORY ConTest
GENERAL PERMIT NO. NCG140000
Lab # 652
Lab #
OPTIONAL INFO: _Dicharging To Class C - No FLOW 2016
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLING PERIOD: ® July -December ❑ January -June
COUNTY Wake
PHONE NO. [phone]
ADD TO LISTSERVE? ®YES ❑NO EMAIL: [e-mail]
DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA []Trout ®Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units)
TSS
(mg/L�
Event
Duration
(minutes)
Total
Rainfall ,
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling'
-
-
6-9'
1002,3
1
NO FLOW
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.
' If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr}1
pH
(Standard
Units)
TPH using method
1664A SGT-HEM
{mg/L}
Total Suspended
Solids
(mg/l)
Event
Duration
(minutes)
Total
a
Rainfall
{in}
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n}
N of Months
in Tier 2
Samplingz
6-92
152
1002,3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail OriOnal and one coov of this DMR (includine all "No Flow" & "No Discharge" 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 for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1/20/2017
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 2016
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG140328
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: Carolina Sunrock LLC — North Raleigh Distribution Center
County: Wake
Phone Number: {91 ) 554-0500 Total no. of SDOs monitored 1
Outfall No. 1
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
SW U-264-Generic-13Dec2012

I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature ��/
Date 01-13-2017
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
2090 US i
A_S_H_ EVI_LL_E.REGIONAL OFFICE F_AY_E_TTEVILLE R_EGIONA_L OFFICE MOO_RESVILLE REGIONAL OFFICE
Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swannanoa, NC 28778 Systel Building Suite 714 Mooresville, NC 28115
[phone] Fayetteville, NC 28301-5043 [phone]
[phone]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
WILMINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTON-SALEM REGIONAL OFFICE
CENTRAL OFFICE
585 Waughtown Street f
1617 Mail Service Center
"To preserve, protect
Winston-Salem, NC 27107
Raleigh, NC 27699-1617
and enhance
[phone]
[phone]
North Carolina's wafer._."
SW U-264-Generic-13Dec2012

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140328
FACILITY NAME: North Raleigh Concrete
PERSON COLLECTING SAMPLES Scott Martino
CERTIFIED LABORATORY ConTest Lab # 652
Lab #
OPTIONAL INFO: _Dicharging To Class C - No FLOW 2016
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLING PERIOD: ® July -December ❑ January -June
COUNTY Wake
PHONE NO. [phone]
ADD TO LISTSERVE? ®YES ❑NO EMAIL: smartino thesunrock rou .com
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall a
(in)
In Tier 2
Monthly
Monitoring?
n
(y/ )
# of Months in Tier
2 Samplingz
-
-
6-91
1002,1
-
-
-
-
1
NO FLOW
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)'
. pH
(Standard
Units)
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/1)
Event
Duration
(minutes)
Total
Rainfall"
(in)
'New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-92
152
10OZ13
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR f includine all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1/20/2017
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

06
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
M Calendar Year 2016
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or 105
Certificate of Coverage (COC) No. NCG140328 .
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: Carolina Sunrock LLC — North Raleigh Distribution Center
County: Wake
Phone Number: 919 554-0500 Total no_ of SDOs monitored 1
Outfall No. 1
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Parameter, units
Total
Rainfall,
pH
TSS
SS
turb
O&G
inches
Benchmark
N/A
Date Sample
Collected,
,, _
�
•r#""s �.y
� r
a � _six �
-+, w�x;�t5i'i� '�
�' "s
a"�
.N�
f
-:
mmldd/yy
s
�; s
h==
� 4
No Sampling Events/Discharge occurred in 2016.
SW U-264-Generic-13Dec2012

"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
systerr,designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature 4
Date 01-13-2017
For questions, contact your local Regional Office:
0WQ Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
(828) 2964500
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON-SALEM REGIONAL OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
_ _ [phone] _ _ _ —
FAYETCEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
225 Green Street
610 East Center Avenue/Suite 301
Systel Building Suite 714
Mooresville, NC 28115
Fayetteville, NC 28301-5043
[phone]
[phone]
WAS TON REGIONAL OFFICE
WILMINGTON REGIONAL OFFICE
943 Washington Square Mall
127 Cardinal Drive Extension
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
CENTRAL OFFICE
1617 Mail Service Center
'To preserve. protect
Raleigh, NC 27699-1617
andenhancee
[phone]
North Comma's water..."
SW U-264-Generic-13Dec2012

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140329
FACILITY NAME: North Raleigh Concrete
PERSON COLLECTING SAMPLES Scott Martino
CERTIFIED LABORATORY ConTest Late # 652
Lab #
OPTIONAL INFO: _Dicharging To Class C - No FLOW 2016
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLING PERIOD: ® July -December ❑ January -June
COUNTY Wake
PHONE NO. [phone]
ADD TO LISTSERVE? ®YES []NO EMAIL: smartino@thesu_nrockgroup.com
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units)
TS5
(mg/L)
Event
Duration
(minutes)
Total
Rainfall`
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling'
-
-
6-92
1002.3-
1
NO FLOW
x 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, HQW, Trout, and PNA waters where they are 50 mg/I.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part 6: 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
1664ASGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall'
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
0 of Months
in Tier 2
Sampline
6-9=
152
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this 17MR (including all "No Flaw" & "No Discharge" reports) within 30 days of receipt of sample (or at end of.monitorinperiod
In 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 CERTIFIC47YON FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
t - _ 1/20/2017
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

J
STORMWATER D RG TALL (SDO)
' F ANNUAL SUMMARY D Al REPORT (DMR
Calendar Year ed R�� MR
Revised 911712014
?019
JMI'q . r --
General Permit No. NCG1)60000 CENTRAL FILES
Certificate of Coverage No. NCG10��©®❑ OWR SECTION
This monitoring report summary is due to the DEMLR Regional Office later than November 1 of
each year. 4
t (� a
Facility Name: o+� �� � �ec Cjwe YIJC—
County: 1^14--
Phone Number: (G lei ) 6 6 S - ee l g %
Total no. of SDOs monitored 1
Part A. Outfall No. 1 (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No [�
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
butfall . t
:Total Rainfall;
inches . .
00530 .. .
TSS, rng/G
Benchmark
N/A
501100
Date Sample Collected,
molddlyr
A '
Page I l

Part B. On -Site Vehicle Maintenance Outfall'No'
Is this outfall currently in Tier 2 (monitored monthly)? f Yes ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
:
i
Outfail
Total Rainfall,-
Inches
00530
00556
TSS, mg/L
Non:=polar Oil &
Grease, mg/L
Benchmark
N/A
501100
15
Date Sample Collected,,
molddlyr
.�.s
Y
Page 12

N
`i certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Sign;
Date
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ...
[phone]
Mooresville Office. -
. [phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
ASHEVILLE REGIONAL OFFICE FAYETTEVILLE REGIONAIC_ FF 4I MOORESVILLE'�REGIONAL OFFICE j
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swannanoa, NC 28778 i Systel Building Suite 714 Mooresville, NC 28115
[phone] Fayetteville, NC 28301-5043 [phone]
[phone] i
R_ A_LEIGH _REGIONAL OFFICE I W_ _ASHINGTON REGIONAL OFFICE
3800 Barrett Drive ! 943 Washington Square Mall
Raleigh, NC 27609 Washington, NC 27889 j
t [phone] [phone]
w_ IN_sTON-SALEM REGIONAL j
OFFICE i
585 Waughtown Street
Winston-Salem, NC 27107
[phone] ;
Page 13
127 Cardinal Drive Extension
Wilmington, NC 28405-2845 i
[phone]
i
i

Semi-annual Stormwater Discharge Moni
for North Carolina DEMLR General Permit No. NCGI
Date submitted
CERTIFICATE OF COVERAGE No.NCG1 O _5 Z
FACILITY NAME AJ& _K
COUNTY W&r-_t
PERSON COLLECTING SAMPLES >o,Vy
LABORATORY f e o 'f�_ _�s� s_ __ Lab Cert. # ro S Z—
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
Irt DMR
- A&p4wft Caul�
SAMPLE COLLECTION YEAR Zy �
SAMPLE PERIOD ❑ Jan -June 09uy-Dec
or []Monthly' (month
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
[9ther C_
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
�% 5,�,�Jjj - &,,041+5
❑ No discharge this period?Z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inche53
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L or 50 mg/0
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. �/
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY O OUTFALL? YES ❑ NO LJ
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this OMR, including all "No Discharge" reports, within 30 days of receipt of the lab results {or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of
it Date:10/1/2014-9/31/2019
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2