NCG140449_MONITORING INFO_20190301

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE ❑ HISTORICAL FLEE
ia MONITORING REPORTS
DOC DATE ❑ jo l 1 030 j
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
_ REPORT (DMR) - WASTEWATER
SUBMIT TO. -CENTRAL .OFFICE` P<ECEI ED
mi
r_nnernl Dnrmi+ A!n Ktrrr_IAnnnn MAR ft I ma
Calendar Year 2018 CENTRAL F.C�
"Deport ALL .WASTEWATER monitoring data on this form (include "fro Flovd7"No Discharge' and bfr K iolati6-fftZfram
the previous calendar year to the DEQ by MARCH 9 of each year.
Certificate of Coverage No. NCG 14 ®®®9❑
Facility Name: Lane Construction Temp Concrete Batch Plant
County: Rowan
Phone Number: 7o( 4 712-1879 Total no. of outfalls monitored
Certified Laboratory NA Lab #
Lab #
Wastewater (WW) Discharge Outfall No. 1
Does this outfall discharge WW to SA waters? Yes ❑ No 0
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 Tidally influenced waters, 7Q10 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 0
.Outfall_No: " '
? ,... ,.
_
� Daily -Flow Rate,
cfs
-: pM,...
StY:
TSS,
mgll
SS,'.., -
mlll
if applicabla
_ '--,NomPolar O&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
Daily Maximum
oQWorORW
50 /o of 7Q10
Indicate NO FLOW H
applicable
Freshwater
6.0-9.0
saltwater
p.
Ov
Standard
30
HQW
20
HQW I ORW and Tr, or
PNA
10
HQW, ORW, SA,
SB, PNA, or any
Tru
a
5
No Limit
Samples above Benchmark
subject to Tiered Responses
15
Sam le =T
p
Collected,
,.molddlyr
e '
�2
:.�
�.
!�
��,� �' �� •�
41171201 B
No Flow
7/9/2018
No Flow
101112018
No Flow
Permit Date 8/112017 — 6130/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 EY®®
Additional Outfail Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No.
Does this outfali discharge WW to SA waters? Yes ❑ No ❑
Does this outfali discharge WW to SIB 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 Tidally influenced waters, 7Q10 not available ❑
Does this outfali discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑
Were there any limit violations in the calendar year? Yes ❑ No ❑
`OutFaIl No. Daily Flow Rate, pH TSS, SS... Non=Polar O&G (EPA Method 1664
cfs SU mg/1 m11I (SGT-HEM)), mgll
Frapplicable
Effluent
17QWorORW
50 /t, of 7Q10
freshwater
6.0-9.0
30
HQW, ORW, SA,
No Limit
Limitations
HOW
SE3, PNA, or any
Trout
Indicate NO FLOW if
saltwater
20
�
Samples above Benchmark
applicable
6$�
HQW I ORW and Tr, or
subject to Tiered Responses
Daily Maximum
•
PNA
15
10
-lected, -,
'.'w.r1�# ' 11. `b
yr4.y,a�,� �
y°L
�a"�°NFvk.'
a�,,.� P,1.
5.�' �i x -!j
ie s+t� R'{' �
,r ^n�ef n
• -. id r a �.
iv,.r.•t�e .
Z•� t f MI' ,My
.
$•r�r t;1
zz
• •
Permit Date 8/1/2017 -- 6/30/2022
Last Revised 8-22.2017

Certificate of Coverage No. NCG14 R2-][Y]©©
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No.
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 Tidally influenced waters, 7Q10 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,
cfs
;, pH;`:':
SU
' ', . TSS,
mgll
SS,
mlll
It applicable
`Idon-Polar O&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
bally Maximum
HQW orORW
50% of 7Q10
Indicate NO FLOW if
applicable
Freshwater
6.0-9.0
saltwater
6.8^8.
Standard
30
HQW
20
HOW l ORW and Tr, or
PNA
10
HQW, ORW, SA,
58,PNA,orany
Trout
5
No Limit
Samples above Benchmark
subject to Tiered Responses
15
Date.
Sample=k
Collede'*d
_r t
£i-• r v
-, Y
6ha..iL:el�
} 1
r = + _ �1 j
" '
'•\Li:. - S ': �. ;r r x_RS.`0•' .itia.t: ,LK
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 0�®®®
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. 1 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],0e----?n
Signature /
Date 2/28/2019 -100'�
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
SUBMITTO. CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 20111
*.Report ALL STORMWATER monitoring data on this.form .(include "No Flow"PNo Discharge" and..Benchmark
Exceedances) from the previods' cale�i,ndar year to-the'DEQ.RGA'��;of�year.
Certificate of Coverage No. NCG14 ®®®® MAR 01 2019
Facility Name: Lane Construction Temp Concrete Batch Plant CENTRAL FIL ES
County: Rowan DVVR SECTION
Phone Number: 70( a ) 72-1879 Total no, of SDOs monitored 3
Certified Laboratory prism Laboratories, Inc Lab # 4e2
Lab #
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other
Outfall No.
Total Rainfall,
inches
-.
Total
Suspended
Solids ( )
m II
pH,
SU
Non'-. polar. O&G
(EPA Method
1664TSS, (SGT-HEM)),
mg/1 �VMA)
If applicable
New Motor Oil
Usage (gallmo.)
!lapp!lcabla
Stormwater
Benchmarks
lndlcafe NO FLOW it
applicable
circle Benchmark
� Qd1J�
6.0-9.0
"I �
>55 gagmo. average requires TSS and
Non•polarO&Gmonitoring
Dafe'Sample:°.=.ti,=
Collecteai
. Y'
�
.,,
r
- a
,,
-�
,;_
r �; -
12/12/2018
0
81
8.4
Permit Date 81112017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No
NCG14 ®®®9❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 2 VMA Outfall? Yes ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑
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 ❑
No 0
No 0
No
'Outfall No.
z
Total Rainfall,
inches
Total
Suspended
Solids TSS ,
( )
mg/1
pH,
SU
rNon=polar O&G:
(EPA Method
1664 (SGT-HEM)),
mgll (VMA)
lfapplicable
:: New Motdr11=
Usage (gallmo.)
If applicable
Stormwater
Benchmarks
InNO FLOWif
applicable
Circle Benchmark
1 D015Q
6.Q^9.fl
'� rj
>55 gaSlma, average squires 755 and
Nan-polarOaG monitoring
]DateSarriple`fL=
molddl. r
a
a
� r
121121201 B
0
60
7.1
Permit Date 8/112017 — 6/3012022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 ®®®®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfali (SDO) No. 3 VMA 0utfalI? Yes ❑ No [Z]
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0
Was this outfall ever in Tier 2 during the past year? Yes ❑ No 0
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
■❑
O.utfall No.
3 ;_....
Total Rainfall,
inches
Tatal
Suspended
Solids (TSS),
m II
pH
SU
Non! olar O&G
EPA Method
1664SGT-HEM )),
mgll (VMA)
New Motor Oil
Usage (gallmo.)
Stormwater
Benchmarks
Indicate NO FLOW If
applicable
Circle Benchmark
1 QIJ1 JU
. .
6�-�O
.� �
>55 g alfmo. average requires TSS and
Non-polarD&G monitoring
Date'Sainpie:
Collected;
molddlyr
;_ . Lr.,�
Y� ,w�,
1211212018
0
72
7.4
Permit Date 8/1/2017 — 6/30/2022
Last Revised 5-22-2015

Certificate of Coverage No. NCG14 ®®®9❑
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 §1
Signature
Date 02/28/2019
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 811/2017 — 6/30/2022
Last Revised 8-22-2015

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140 L( Q
FACILITY NAME: T&4P.C, c. T" P - La Cwyrgycrxg
PERSON COLLECTING SAMPLES: cf4o'zs~1460. M. AN(,
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO[]
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 20 1 y
SAMPLE QUARTER: NJul-Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: RawAt4
PHONE NO. (_3&( _) 406-4o60
ADD TO LISTSERVE? ❑R YES ❑NO EMAIL: _ dMAjg(,E V_L41JE6nA)STP_ coM
DISCHARGING TO CLASS: ❑5A ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
s
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH usingDischarge
method 1664A
c
SGT--HEM
(mg/L)
Duration
(minutes)
Total Flow
,
(gallons/day)
-
-
6-93.4
303.5
53
(15),
-
FL -ow
,
L1 t t vnn 3
u i
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.
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.
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 ali 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 Parr 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 .D224. 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 an my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering tNe info'rrriation; 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 s'ubmittink false infai'mation, including the possibility of fines and imprisonment for knowing
violations � � � / —/ • .
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
!o / i g
(Date)
Last Revised 07/13/11
- Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 O Ci ' g SAMPLE COLLECTION YEAR:
FACILITY NAME: _riF-Mr. Ncr r[ Ht P -L.QNE ,vC73Z,,,SAMPLE QUARTER: ❑]ul-Sept
PER50N COLLECTING SAMPLES: HszL ue /'^• Av !;- COUNTY: RowAN
CERTIFIED LABORATORY: r Leh #
PHONE NO. (336) Koh -Q06 0
Lab # ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout ❑Other,
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
aot W
❑Oct -Dec ❑Jan -March April -June
Outfall No.
Date Sample
Collected)
(mm/dd/yr)
Type of Wastewater
MD)'
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
a
5GT-HEM
(mg/L)
Discharge
Duration
(minutes)
Total Flow
�
(gallons/day)
-
6-93'4
303'5
53
(15),
-
-
No F cCOw
PP(()riINIcI1
Ul
1 7f)1
u��v +
nn_L, rrly_rw5
.. vi.�V,LIJVI�i
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.
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

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.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset 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 th a 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." _ i I / A/
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
? q /,2aI 19
(Date)
Last Revised 07/13/11
Page 2 of 2

RECEIVED
APR 2 3 2018
CENT- <AL FILES
DWR SECTION
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140 Q cl Q
FACILITYNAM CrE.AP•C.N[.&7rN PGhe-LAB Cn•rsntuar%on�
PERSON COLLECTING SAMPLES: C kxss-mPNciz— M. Ate„
CERTIFIED LABORATORY: "` Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 1-01$
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec
COUNTY: Raw ra
PHONE NO. (3 ) L(06 -406 c,
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
j
Xan-March ❑April -June
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ❑Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
x
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
ImL/L)
TPH using
method 1664A
a
SGT-HEM
(mg/L)
Discharge
Duration
(minutes)
Total Flow
�
(gallons/day)
-
6-93'4
303,5
53
(15)r,
-
No ]='4 ova
ArR 2 3 201
4
i
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.
a 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.
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 T5S 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

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 1N 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:
"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 fin es and imprisonment for knowing
violations
'1 1
(Signature of Permittee)
Permit Date:7/1/2010-06/30/2015
-V r r4
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 _q_ q,
SAMPLE COLLECTION YEAR: ;ZO 1-4—
FACILITY NAME: _rEMP. !g C.. V*C,44 PL*JT— LIMP Ceus-�vt,T?oiJ SAMPLE QUARTER: ❑1ul-Sept Oct -Dec []Jan -March ❑ApriE-June
PERSON COLLECTING SAMPLES: GNrtsSrbP)46-z %�i. AN{r COUNTY: l owAN
CERTIFIED LABORATORY: Lab # PHONE NO. (336 ) 406-gu60
Lab # ADD TO LISTSERVE? MYES ❑NO EMAIL: CJ�+4Fllr�� L+4NE�R-�M
LIMIT VIOLATIONS? YES ❑ NON DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout [—]Other
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Outfall No.
Date Sample
Collected)
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-HEM'
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day)
-
-
-
6-93,4
303,5
53
(15)fi
-
DEff
2%
DV1�R
rrILCO
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 (VET, 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.
s T55 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.
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 MUST5IGN 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."
�./- �-- - -.. 0- a. - VV C
�a ly a�ol�
ignature of Permittee) (Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

FI
J
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_0 q Ci 9
FACILITYNAME: �r✓MP• C614CAE7E 9A-Tr- 1 PLANT-LANE6or157-_
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: — Lab #
Lab #
LIMIT VIOLATIONS? YES n NO ❑
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: Zo 1-4-
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March �&pril-June
COUNTY: koyy 4t4
PHONE NO. [ 3''S6 j cl o6 - 19O(po
ADD TO LISTSERVE? DKYES ❑NO EMAIL: CrMANGe @L4W6Gor3STR0c7-,coM
DISCHARGING TO CLASS: [-]SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
z
EVE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
5GT-HEM'
(mg/L)
Discharge
Duration
(minutes)
Total Flow •
(gallons/day)7
-
6-93'4
303,s
53
(15)6
-
FL
RE . 11 r
&_ f
AUG 0
~�ibAL t-ILES
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 TSS limits are 20 mg/L for wastewater discharges to FIQW 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

e Pr3cess 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. 1 am aware that there are signif' Fant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
7� violations." ",
re of Permitteej
Permit Date: 7/1/2010-06/30/2015
-I- Ar.I (-I-
(Date)
Last Revised 07/13/11
Page 2 of 2

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t
It
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t.
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a ' 4"
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51
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31 x I 1 Bottom Dimensions 1 r *.NIX ' ` n
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fie
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340'x 50'TopDimensions •'-�_:. -.
--334'xv
.;ons Dimensi
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- If site conditions permit,coul X00 - �..�►•> �:: 066906161000 ::. t Stormwater Basin # 1 Info:be converted to tiered basin .`
0
• :.:.
150'x50'Top Dimensions
;M �. Y 4 Baffles S aced Evenl It M� :.:.:.::-: 0
...
-® 138'x 38'Bottom Dimensions
i@ - 1 1 -F
-yµ .�..�,.n :. •: : ;•.•:.•:::. , 3 deepat weir, 2:1 slo es
.....p
,,. ..ems.. - ...�. 4� ..... � ♦ •
:1t
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.... .� .� � � �r 5 �"a+ . ti 1� r� .: s.. t� • a * • • •� is
w ,..,�.. '� � .'•�--'•� •tip. � TI.�,,..,i> - -.^. .a T 1 d- � � r "'Fz•+.. • � � R +�F+♦ • � .� !r
. � a ' . �,„r � ! �, !B t � ,.1., rP#t .�. �y � .. � � . � � � S era••• :.+ R i
.i... - �.' :.;.,.:. ; g _ �..wt ..,:.�.• . 0.208'DrivingHead
• . 7L;- .� • c,'•",.'.y. e..• t •..S .,`;,, "`' ' 4 �LIL
IL
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-n 1 -„t z,` ,e"-'• 7.e . m.i t a lJ�k �-+ g� �® •ri Y • •• 2.0" Orifice Diameter
n 4r P �•"...�. � a ♦ •
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'•"`T•' 42'Spillway Width
pH Reduction Basin Info: �+ ::....= ° •,:.. I ,-
.,P
x • 50'x 25'TopDimensions •3 Baffles Spaced Evenly � -
1 3 8' x 13'Bottom Dimensions
Legend
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Calculated By: CMA
Date: 12i5n01e BAN
PROPOSED TEMPORARY CONCRETE PLANT SITE PLAN prawn By:
Date:
FOR STORM AND WASTE WATER TREATMENT � I� checked By:
Date:
Revision No.: submitted To:
I
t
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