NCG140437_MONITORING INFO_20190305

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. /v u& 7
DOC TYPE ❑HISTORICAL FILE
EA MONITORING REPORTS
DOC DATE 0 Jo)
YYYYMMDD

r
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2018
*Report ALL WASTEWATER monitoring data on this form (include "No FloWl"No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH i of each year.
Certificate of Coverage No, NCG14 ©® 3❑ 7
Facility Name: Mebane
County: Orange
Phone Number: (336 ) 996-2841 ?tea Total no. of outfalls monitored 1
Certified Laboratory qe_, to 1A^'4-ty` 04 Lab#
Lab #
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No 0
Does this outfall discharge WW to SIB or PNA waters? Yes ❑ No❑
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No 0
If so, what is the 7010 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No 0
Were there any limit violations in the calendar year? Yes ❑ No ❑✓
Outfall No.
Qa,
Daily Flow Rate,
cfs
pH,
SU
TSS,
mg/1
SS,
mlll
Non -Polar O&G (EPA Method 1664
(SGT-HEM)), mgll
it applicable
Standard
Effluent
Limitations
Daily Maximum
HOW or ORW
50% of 7Q10
Indicate NO FLOWif
appbcable
freshwater
6.0-9.0
saltwater
6. p-p. C
U V J
30
HOW
20
HOW ! O PNAand Tr, or
10
HOW, ORW, SA,
SB,PNA,orany
Trout
C
J
No Limit
Samples atwve Benchmark
subject to Tlered Responses
15
Date'
Sample
Collected,
r ��'
��
a �•
molddi r
311512018
NO FLOW
© ll; r it w r o
6/29/2018
NO FLOW
MAR U 5 ZM
rG
91131201B
NO FLOW
r�tnrta Ct:f"Tf('1P.1
12/20/2018
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

N
Certificate of Coverage No. NCG14 ❑D -T[73- 7",
CERTIFICATION
" 1 certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]
Signature
Date G
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 8/1/2017 -- 6/30/2022
Last Revised 8-22-2017

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
EMENEEN
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
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"14 ]F4 30 7❑
Facility Name: Mebane
County: Orange
Phone Number: (336 ) 996-0326 Total no. of SDOs monitored 1
Certified Laboratory Research and Analy. Lab Lab #
Lab #
Stormwater Discharge Outfall (SDO) No. 001 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 0
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids TSS
( )�
m ll
pH,
SU
Non -polar O&G
(EPA Method
1664 SGT-HEM
( ))�
� mgll (VMA)
lrapplicable
New Motor Oil
Usage (gallmo.)
If applicable
Stormwater
Benchmarks
Indicate NO FLOW if
applicable
Circle Benchmark
oois0
6.0-9.0
1
>55 gallmo. average requires T55 and
Non -polar OSG monitoring
Date Sample
Collected
molddlyr
9
3/1512018
NO FLOW
6/29/2018
NO FLOW
9/13/2018
NO FLOW
12/20/2018
NO FLOW
Permit Date 8/112017 — 6/30/2022
Last Revised B-22-2015

Certificate of Coverage No. NCG14 O� �f P
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 6y 40 CFR §122.22]
Signature
Date
11
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DFMLR)
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) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000,
Calendar Year 2017
"Report ALL STORMWATER monitoring data on this form (include "No Flow/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 9 of each year
e xL_%-*L_+ u �4a
0 Certificate of Coverage No. NCG 14 4 3 7
Facility Name:
Mebane Plant MAR 0 7 2018
County: Orange CCNTI;V,L FILE 5
DWR SECTION
Phone Number: (919 304-3377 Total no. of SDOs monitored 1
Certified Laboratory Prism Lab Lab # 402
Lab #
Stormwater Discharge Outfall (SDO) No. 001 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-month ly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids (
mg/1
pH,
SU
Non -polar O&G
(EPA Method
1664TSS), ( SGT-HEM)} ,
mgll (VMA)
if applicable
New Motor Oil
Usage (gallmo.)
l/applicable
Stormwater
Benchmarks
indicate NO FLOW!)
applicable.
Circle Benchmark
� On'�O
6.v_9.o
.� a
�a
�55 g allmo. average requires T55 and
Non -polar O&G monitoring
Date Sample
Collected 1
mo/dd/yr
t � i�° �
L
1- � � "fee,. yyr'�' ! �:;-,
s
d{ e';' "� Z fA+'s �� .�,
d
} R i k s ® ��.f �,j��E.i. $�
,
$'" i>4,{s tom', Y. � �� i� '� 7�P� �yf•.�n5 ,,�
3/3/2017
001 No Flow
6/29/2017
001 No Flow
9/27/2017
001 No Flow
12/18/2017
001 No Flow
Permit Date 811/2017 — 6/30/2022
Last Revised 8-22-2015

I
Certificate of Coverage No. NCG14 [dR©ll
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 J
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

i
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437 SAMPLE COLLECTION YEAR: 2017
FACILITY NAME: Mebane SAMPLE QUARTER: ❑Jul -Sept []Oct -Dec ❑Jan -March ®April -June
PERSON COLLECTING SAMPLES: Wayne Rutzen
CERTIFIED LABORATORY: Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other,
OPTIONAL INFO:
Outfall Plo.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
5GT-HEM6
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day),
-
-
-
6-9a.4
303.s
53-
001
6/29/2017
RM
No Flow
I7
2AI?
CENTRAL
FILES
DWI;
SEC; 1 IUN
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TS5 limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11
Pagelof2

06-
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware thaRthergore significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of Permittee)
Permit Date:7/1/2010-06/30/2015
T
(Date)
Last Revised 07/13/11
Page 2 of 2

1 . . ."
PROCESS WASTEWATER —Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Wayne Rutzen, Tony Hardison
CERTIFIED LABORATORY: Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Requirements
SAMPLE COLLECTION YEAR: 2017
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -March []April -June
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other,
Outfall No.
Date Sample
Collected)
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)Z
pH
(standard)
Total Suspended
Solids
(mg/L}
Settleable
Solids
(mL/L}
TPH usingDischarge
method 1664A
SGT-HEM s
(mg/L)
Duration
(minutes)
Total Flow
7
{gallons/day}
-
-
-
6-93''
303,5
53
(15)6
-
-
001
3/3/2017
RM
No Flow
.-.
�n
CENTRAL
ILES
If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
` pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

;.Or
c Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 1SA
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
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 directIM responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware tNt thernare siggificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re
Permit Date:7/1/2010-06/30/2015
57-6-/f7
(Date)
Last Revised 07/13/11
Page 2 of 2

-p PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437 SAMPLE' COLLECTION YEAR: 2016
FACILITY NAME: Mebane SAMPLE QUARTER: []Jul -Sept ®Ott -Dec []Jan -March ❑April -June
PERSON COLLECTING SAMPLES: Wayne Rutzen, Tony Hardison COUNTY: Orange
CERTIFIED LABORATORY: Lab # ED PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
LIMIT VIOLATIONS? YES [:]NON JAN 2 3 2017 DISCHARGING TO CLASS: ❑SA ❑HQW
CENTRAL FILES OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements nwp SFrTinm
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method.1664A
S mg/L�
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
-
6-93,4
303.5
53
(15)6
-
-
001
10/26/2016
RM
No Flow
,ter
(N U NA,;
, �, Y
u u�
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-S.S S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process,wastew ater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 1SA
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLUOR
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
[phone]
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 fat ther6re sjp�ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of'Permittee)
Permit Date: 7/1/2010-06/30/2015
lb /(7
(Date)
Last Revised 07/13/11
Page 2 of 2

l
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE No. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Wayne Rutzen
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
(VERMz
, , MD}
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
SG/L)
(mg/L)
Duration
(minutes)
Total Flow
7
(gallons/day}
-
-
-
6-93,4
303,5
53
(15)6
-
-
001
9/28/2016
RM
No Flow
Id D V U
1: 1,4 t 4
NOV O 1 2016
CTION'
' if wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" Here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cieanout (MD). Report more than one type if the waste -stream is commingled.
3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/201S Last Revised 07/13/11
Page 1 of 2

r
r
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
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.
1 am aware tt)Pt t" are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ature of Permittee)
Permit Date: 7/1/2010-06/30/2015
la Z-,(r//&
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Mebane Plant
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L) /I
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
S T-HEM'
Duration
(minutes)
Total Flow
(gallons/day)'
-
-
-
6-93'4 „
303
53
(15)6
-
-
001
6/29/2016
RM
No Flow
A
V
7r-r-r-ozen
�r
r
A
M A�;;1��i
��✓ 7
14W W
nMIP Cpr,
rin i
` If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VIVA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to SO% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: _ T T~
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware that tyre are s gnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
z-//�—
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER— Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Mebane Plant
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Reauirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -March ❑April -June
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: [:]SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other,
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
(VERMMO}Type of Wastewater
z
, ,
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
s
SG%HEM
(mg/L}
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day]
-
-
-
6-93,4
303.5
53
(15)6
-
-
001
3/25/2016
RM
No Flow
CENTRAL.
FILES
DVVR 5E
: TION
' If wastewater systems have not discharged in this quarter -- report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring,
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
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 dire IV 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 th _re are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
i2 e
(Date)
Last Revised 07/13/11
Page 2 of 2

i
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14P . 2- ,1 Q G SAMPLE COLLECTIYYEA a� lco
FACILITY NAME: `j % SAMPLE QUARTERSept ❑Oct -Dec []Jan -March []April -June
PERSON COLLECTING SAMPL S: al !a6 COUNTY: �rl.�
CERTIFIED LABORATORY: 14 Cre, C_. _ Lab # // PHONE NO. ('5a-) 5`3 7— 3z 3
Lab It ADD TO LISTSERVE? OYES ONO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout [tither
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD]
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
6
SGT HEM
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day]
-
-
-
6-93,a
303'5
53
(15)6
D
Q
tid
OCT 12
1 If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
TS5 limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

s Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Fiow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE 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
[phone]
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"i certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations." , r,
re of
to 17-1
(Date)
Permt* ^-ite: 7/1/2010-06/30/2015
Last Revise' "7/13/11
22of2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140347
FACILITY NAME: Thomas Concrete of Carolina- Fuquay Varina Plant
PERSON COLLECTING SAMPLES: Susan Bostian
CERTIFIED LABORATORY: E
Lab # ENV375
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec
COUNTY: Harnett
PHONE NO. (�919 _) 557-3144
ADD TO LISTSERVE? [-]YES ®NO EMAIL:_
®Jan -March ❑April -June
DISCHARGING TO CLASS: ❑SA ®HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEMS
(mg/L)
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
-
6-93,4
303.s
53
(15)6
-
-
01
NO DISCHARGE
A
FILES
If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TS5 limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
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."
�CL�'JZ
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
4/30/2016
(Date)
Last Revised 07/13/11
Page 2 of 2

__ i
PROCESS WASTEWATER — Quarterly Discharge Monitoring Reportr
k�
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Mebane Plant
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec ❑Jan -March ❑April -June
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW
OPTIONAL INFO:
❑PNA ❑Trout ®Other
Outfali No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard)
I
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
SGT-HEMS
(mg/L)
Duration
(minutes)
Total Flow
(gallons/day)'
-
-
-
6-93,4
303'5
53
(15)6
-
-
001
12/17/2015
RM
No Flaw
a !7P
CEN-
RAL FILES
DWF
-
- It wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit bate: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

ProceFs wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
"NCAC'd2B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
YOU MU5T 516N 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 d' ectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware thZherg are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
atuee of Permitteej
Permit Date: 7/1/2010-06/30/2015
27 //
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Mebane Plant
CERTIFIED LABORATORY:
LIMIT VIOLATIONS? YES "NO
Part A: Wastewater Monitorine Reouirements
RECEIVED
OCT 23 2015
CENTRAL FILES
a�VR SECTION
Lab #
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ®Jul -Sept ❑Oct -Dec []Jan -March ❑April -June
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? []YES ®NO EMAIL:
DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
i
RMMD)
IVE, ,
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
56
mg L)
(/
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
-
-
6-93''
303'5
53
(15)6
-
-
001
9/29/2015
RM
No Flow
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

a Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
r7 FloO rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW","NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
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 ayarr, thafitheWre significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
(- (z 11 r-)—
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Wayne Rutzen
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Renuirements
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ®Other
OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
MD] Type of Wastewater
2
(VE, RM,
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
S (mg/L)l6
mg/L)
Duration
(minutes)
Total Flow
7
gallons/dayj
-
-
-
6-93,4
303,5
53
(15)6
-
-
001
6/26/2015
RM
No Flow
4 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
s if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Pagel of 2

Q
AL.-

Pfocess wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. if the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWO, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (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
[phone]
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 qu re lified personnel properly gather and evaluate the Information submitted. Based on my inquiry of the person or persons who manage the system, or
those person directly onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I afn *are A t the a e significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
re of Permittee)
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140437
FACILITY NAME: Mebane
PERSON COLLECTING SAMPLES: Wayne Rutzen
IVCEED
CERTIFIED LABORATORY:
Lab
Lab #J1 III
LIMIT VIOLATIONS? YES ❑ NO
CENTRAL FILES
Part A: Wastewater Monitoring Requirements
DWR SECTION
SAMPLE COLLECTION YEAR: 2015
SAMPLE QUARTER: [_]Jul -Sept
COUNTY: Orange
PHONE NO. [phone]
ADD TO LISTSERVE? YES ®NC
DISCHARGING TO CLASS: ❑SA E
OPTIONAL INFO:
Oct -Dec ❑Jan -March ®April -June
EMAIL:
HQW ❑PNA oTrout ®Other
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
x
iVE, RM, MD]
pH
[standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664R
SGg/L) 6
[mg/L)
Discharge
Duration
(minutes)
Total Flow
7
[gallons/day)
-
-
-
6-93,4
303,S
53
(15)6
-
-
001
6/26/2015
RM
No Flow
1 If wastewater systems have not discharged in this quarter-- report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
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Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality T
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 qu lified personnel properly gather and evaluate the information submitted. Based on my Enquiry of the person or persons who manage the system, or
those person directly re ponsible for gathering the Information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I aln ware l t therare significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 7/1/2010-06/30/2015
1I 3 /( )--
(Date)
Last Revised 07/13/11
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