NCG160221_MONITORING INFO_20181203

....................
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE ❑ HISTORICAL FILE
3 MONITORING REPORTS
DOC DATE ❑� i�
YYYYM M DD

Semi-annual Stormwater Discharge Monitoring; Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted / �,- 3 - /R
CERTIFICATE OF COVrERAGE N . NCG160 SAMPLE SAMPLE COLLECPERIODI❑ Jan -June June O ly Dec
FACILITY NAM I rl IaS {o RECEIVED i
COUNTY .� N/ // or ❑Monthly (month)
PERSON COLLECTI G SA PL S 0,
a rTo 4 DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY �4 Lab Cert. #
DEC 13 ma ❑Zero -flow ❑WaerSupply ❑SA
�.�
Comments on sample collection or analysis: CENTRAL FILES Q6ther
DWR SECT10,N! PLEASE REMEMBER TO SIGN ON THE REVERSE a
Part A: Stormwater Benchmarks and Monitoring Results
❑ No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
Benchmarks ===>
-
-
100 mg/L or 50 mg/L
500- G/
I1-1 -l8
'�5
: S L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
° 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, NO, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX m¢/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/l/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.
F-] No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===>
-
-
15 mg/L
100 mg/L or 5o 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 1, 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 ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an orfainal and one copv of this DMR, including all No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina period
in the case of 'No Discharae" 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."
of Permittee)
Permit Date: 10/l/2014-9/31/2019
113 I S
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

CERTIFICATE OF
FACILITY NAME
COUNTY14&S
PERSON COLLEC
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 12 - 3 - / g
0
t ,%TaK
Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR /mil./ /-6
SAMPLE PERIOD ❑ Jan -June 1416ly-Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
[fFier G
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
Benchmarks ===>
_
-
100 mg/L or So mg/L
5DO-0')-
- -Ig
.1i
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' 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.
" 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/l/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

i
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
OuHall 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 Z 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 ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO Ej
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for 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
"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 signifjr.�nt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of
o_3 !F
(Date)
Permit Date: 10/l/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2

.® •
c
•
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 1 2 - 3 - / $
CERTIFICATE OF COVERAGE NO. NCG160 ;
FACILITY NAME ro r
COUNTY ,- J
PERSON COLLECTINGnSAM LES 6� o/ /'
LABORATORY Y /140 Lab Cert. # 'mod
Comments on sample collection or analysis
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 0/'9
SAMPLE PERIOD ❑ Jan -June my -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
[gather
PLEASE REMEMBER TO SIGN ON THE REVERSE a
No discharge this period?z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
Benchmarks ===>
-
-
100 mg/L or 50 mg/L
-003
l/- JT
3 2 m L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
" 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 1, 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

l�
LJ
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new ail per month.
❑ No discharge this period?'
OuNall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
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 Z, 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. L�
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY O OUTFALL? YES ❑ NO
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 DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for 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.
am aware that re are si rf ctc t penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
zI 3 "/r
of Permittee)
Permit Date: 10/1/2014-9/31/2019
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit N_9j NCG160000 - Asphalt
Date submitted 7-16 -/ O
CERTIFICATE OF COVERAGE N . NCG16_0�Z-�
FACILITY NAME f
COUNTY
PERSON COLLECTI G 5MIy)AJPLES
LABORATORY i�W Lab Cert. # �-
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 20 ! 5
SAMPLE PERIOD an -June ❑ July -Dec
or
,U DISCHARGING TO❑CLASS monthly' (month)
❑ORW ❑HQW ❑Tro t❑PNA
24 Zp18 ❑Zero -flow ❑Watersupply ❑SA
JU� 20�ther
'EN Fit_ floN
,Wp, SECT)Ot`. PLEASE REMEMBER TO SIGN ON THE REVERSE =t
discharge this period?z
Date Sample 24 hour rainfall
Outfall No. i I :
Collected amount,:`
(mo/dd/yr), Inches'.. Total's spe Solids
Benchmarks ===r.
1I Y) e),n ^ I Lj 5 ( F('
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
' 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 5WU-252, last revised 9/17/2014
f Pagel i of 2
n ..

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
t
n No discharge this period?'
Outfall No.
Date Sample
Collectedr.
(mo/dd/yr) "'
24-hour rainfall
:amount,
'- Inches.
.Non -polar O&G by IPA
-` --�� 1664'(SGT-HEM)
Total Suspended Solids
Benchmarks
-1Smg/L
100.mg/L oo50 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 ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriqinal and one copy of this DMR including all "No Discharge" reports within 3a 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 significan alties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ignature of Permittee) (Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit. NCG160000 - Asphalt
Date submitted 7-/6 -1
CERTIFICATE OF CO RAGE NO NCr�r'16D —�--1
FACILITY NAME rotAef � _
COUNTY rk ir,,,%, e—Co1
PERSON COLLE INNGI PMPLES O rn CO- /O Ilk
LABORATORY �� Lab Cert. If 'Z
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION AR
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Ze o-flow,❑SA
[�ther
PLEASE REMEMBER TO SIGN ON THE REVERSE -4
❑ No discharge this period?2
Outfall No.
Date Sample
Collectedr
(mo/dd/,yr)
- 24 hour rainfall.
-
amount;°
Inches'.
_ -
Total SusPended'Solids
-
Benchmarks===�-
- ,.
"100 mg/lZon-50 mg/0
5100 002
�-i
V-
6 �, L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
" 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.
n No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)` ""'
24-hour rainfall
.amount,
'ilnches3
:Non -polar GT by IPA
',:1664'(SGT-HEM)
Total Suspended Solids
Benchmarks===> -
---
- -
-15mg/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 ONE OUTFALL? YES ❑ NO ❑
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 cppv of this DMR including all "No Discharge" reports within 30 days ofreceipt of the lab results for 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 signifieffa penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 10/1/2014-9/31/2019
•
7 /6 /8
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2
o •

_0 -0 0
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit -No. NCG160000 - Asphalt
Date submitted 7-I/-15
CERTIFICATE OF CO AGE NO. C 160000
FACILITY NAI XfAe
COUNTY ,'Y/!° n u,'9 /
PERSON COLLECTI S PLIES )OA f-0P /- -'
LABORATORY Lab Cert. q 2
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2 0 / 9
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Watersupply ❑SA
QOther
PLEASE REMEMBER TO SIGN ON THE REVERSE
No discharge this period?2
Outfall No.
Date Sample
Collected'
r
(mo/dd/y)
. 24 hour rainfall:-
amount;.
3 '
.Inches,=.-
Total Suspended Solids
Benchmarks ===>
_ .
` '100 mg(L or"50 mg/1
-003
6-.17-1$
. V 5
.,�
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
n No discharge this period?Z
Outfall No.
Date Sample
Collected' -
:(mo/dd/yr) ".'
-24-hour rainfall
-amount,
' ---:Inches3
Non -polar O&G byEPA
- ,:166flSGT-HEM)
Total Suspended Solids .
Benchmarks.===�
- -.
- -
45: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 ONE OUTFALL? YES ❑ NO ❑
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 DMR 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 fo ring the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are signifi t pepLaffies for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 10/1/2014-9/31/2019
-/7 6 ft?
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2
•

PAR
PROM PT•ACCUR ATE -RE LIAR I-E
LABORATORIES, INC
VwV%V.rARl.nnx.00M
REPORT OF ANALYSES
Attn: MATTHEW SPENCER
BLYTHE BROTHERS ASPHALT CO LLC PROJECT NAME: JUN 18
1415 E. WESTINGHOUSE BLVD DATE: 07/06/18
CHARLOTTE, NC 28273-
SAMPLE NUMBER-
132192
SAMPLE ID- BBA
SDO-002
SAMPLE MATRIX- WW
DATE SAMPLED-
06/27/18
TIME SAMPLED- 0930
DATE RECEIVED-
06/29/18
SAMPLER- JP
RECEIVED BY- DJ
TIME RECEIVED-
1050
DELIVERED BY-
JP
TYPE SAMPLE- Grab
Page 1 of 2
ANALYSIS
ANALYSIS
METHOD
DATE TIME BY
RESULT UNITS
TOTAL SUSPENDED SOLIDS
SM 2540
D 07/02/18 0825 DJ
61 mg/L
LABORATORY DIRECTOR 6� ZLt
P.l1. Hm 411483 • Ch;ulnur. NC 28241-1483
Phony: (m4) 5,"-8333 • Pus 17041 5,"-833i

PAR
PROM PT- ACCURATE -RE L I A OLE
LABORATORIES, INC
%%' W %%'.PARl.A9S.CI ql
REPORT OF ANALYSES
Attn: MATTHEW SPENCER
BLYTHE BROTHERS ASPHALT CO LLC PROJECT NAME: JUN 18
1415 E. WESTINGHOUSE BLVD DATE: 07/06/18
CHARLOTTE, NC 28273-
SAMPLE NUMBER-
132193
SAMPLE 1D- BBA
SDO-003
SAMPLE MATRIX- WW
DATE SAMPLED-
06/27/18
TIME SAMPLED- 0950
DATE RECEIVED-
06/29/18
SAMPLER- JP
RECEIVED BY- DJ
TIME RECEIVED-
1050
DELIVERED BY-
JP
TYPE SAMPLE- Grab
Page 2 of 2
ANALYSIS
ANALYSIS
METHOD
DATE TIME BY
RESULT UNITS
TOTAL SUSPENDED SOLIDS
SM 2540
D 07/02/18 0825 DJ
76 mg/L
LABORATORY DIRECTOR tit
RU. Box J I I483 • Charlouc. NC 2S'-a l-14N3
Phone: 1711 i) StiF-ti3 :? • I'as: 1704) SSX-S 335

M.R
LABO itATO�ESy L14C
Shipping:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
Mailing:
PO Box 411483
Charlotte, NC 28241-1483
n is essential bat all information be recorded on this Chain of Custody dodument for acceptance by PAR Laboratories, Inc and the Nord
C mllns rlw,uNn„nl M Fnvlrn wmnl anti Nminal Rm..,mna
Company Name (bill ng)
1 the laj�P�S s % l�
Comments/ Special Instructions
Address --
,// S 82— V O
City State 8 zip tole —_---
R. v,dto IIVC 28�27.3
Point of Con� t, li Telephone Number
o1 70�- 06- 5 575--
Sample
Taken By:
PRINTED NAME �'t ✓�%�"�
ARE SAMPLES FOR STATE or EPA REPORTING? 'YES' � NO
'Sample Type: DIN W W GWMw Kw Sou Other
Sample Temp at time of sampling: _ e C Sample Temp upon receipt: e C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
Comp
Grab
�i x
?rtsery
'.ut'y
Set Up
d
DateJTkne,,�£;;
`CalleClonT�7.GG
, sagM-z;Jk.kz?"�w,''
-00
TS 5
5 oa 3
6- y > ^
T5 5
neon ned uaternmff''e Receive by:: Date/Time
Relinquished by: Datelrime Received by: Date rime
' C-Composite G=Grab DW=Drinking Water WW=wastewater GWMV =Groundwater Monitoring Well MN=Hazardous Waste

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit o. NCG160000 - Asphalt
Date submitted d— 5 — T
CERTIFICATE OF COVERAGE No. NCG16 0 ?- 22 1
FACILITY NAME ��7`fP IS1-o rill ,fiiD�o/r LLC
COUNTY / •Itocklen lJ — ..11
PERSON COLLEC`/I,�IINnNG`,,SAMPLES n G/!an
LABORATORY Y/7rl %Jr4fwie5 Lab Cert. q .Z
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Cf/ 7
SAMPLE PERIOD ❑ Jan -June July -Dec
RFr\ ��(., or El monthly' (month)
+^F1DISCHARGINGTOCLASS❑ORW ❑HQW ❑Trout ❑PNA
JAN 0 9 2018 ❑Zero -flow ❑Water Supply ❑SA
[hither
I)PP iEG fION
IINIORMAT!ON PROCESSING UNIT PLEASE REMEMBER TO SIGN ON THE REVERSE =�
No discharge this period?'
Outfall No.
Date Sample
Collected -
(mo/dd/yr) -
• 24 hour. rainfall:--
amo1. u. nt;
3:
,Inches.=.-,
-- - -
Total Suspended Solids
-
Benchmarks ===>
100 mg/L"or'50 mg/L -
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
" 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?2
Outfall No.
Date Sample
r
Collected
(mo/dd/yr) - "'
24-hour rainfall
.amount,
.'.Inches'
olar O&G b EPA
� Non-p y
' = 1664(56T-HEM)
.Total Suspended Solids
-
Benchmarks .===>
-.
-. -
--15mg/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 ONE OUTFALL? YES ❑ NO W
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? . YES ❑ NO ❑ /'—'
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results for 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 27699-1G17
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 sWificimt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
rmit Date: 10/1/2014-9/31/2019
•
I�S-lg
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

PAR
PROM PT, AOCU RATE -RE LIASLF-
.LABOR.ATORIES, INC
\VW W.PARLARS.COM
REPORT OF ANALYSES
Attn: MATTHEW SPENCER
BLYTHE BROTHERS ASPHALT CO LLC PROJECT NAME: DEC 17
1415 E. WEST'INGHOUSE BLVD DATE: 12/29/1'I
CHARLOTTE, NC 2P,273-
SAMPLE NUMBER- 130122
SAMPLE ID- BHA
OUTFALL
;Srti';Pl.�li MATRIX- W61
DATE SAMPLED- 12/20/11
'Il:,ll'. SAll E'l.CD- 17.30
DATE RECEIVED- 12/20/17
SAMPLER- JP
RECEIVED TIY- DJ
TIME RECEIVED- 1255
DELTVP.RED 13Y-
JP
'T YPI:: S:1tdPL P} Grab
Page 1 cf 1
ANALYSES
ANALYSIS
METHOD
DATE 'PIMP; BY
RESULT
TOTAL SUSPENDED SOLIDS
SM 2.540
D 12./22/17 0805 DJ
27 v-1/1',
LABORATORY DIRECTOR r'' I,: . r ' .•... ..
P.O. Hox 4I1483 • Charloue,NC 28241-1483T
Phone: [phone] • Fax: [phone]

• 0
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 6-2y— 1 %
CERTIFICATE OF COyERAGE N0 NCGI6_601��2 / /
FACILITY NAME —/7J—w� fop W,bApls /YsO " "—`a LLC..-
COUNTY / On Nr J
PERSON COLLECTING SAMP ES
LABORATORY fl�tQ L Ar..%rJPS Lab Cert. # 2 C7
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2-0/7
SAMPLE PERIOD ` Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero-flowWater Supply ❑SA
[96ther
PLEASE REMEMBER TO SIGN ON THE REVERSE =>
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall`
amount,
In0es3' -
-
- -
_Total SuspendedSolids
Benchmarks ===>
_
100 mg/L or So mg/L4
O-/
6 -.24 17
0
16 IL
No discharge this period?Z
RECEIVED
JUL 0 5 2011
CENTRAL FILES
DWR SECTION
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
" 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,
`Inches'
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 ANYONE OUTFALL?
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
YES ❑ NO VW
Mail an oriainal and one coov of this DMR. including all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina 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
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Z,i;� -F,*— ol-�L9-17
ignature of Permittee) (Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
L Page 2 of 2

PAR
PRO. PT- A CCU RATE• R ELF A 8 LE
LABORATORIES, .INC
W WW:PARl,AItS.00M
REPORT OF ANALYSES
Attn: MATTHEW SPENCER
BLYT_HE BROTHERS ASPHALT CO LLC PROJECT NAME: JUN 17
1415 E. WESTINGHOUSE BLVD DATE: 06/29/17
CHARLOTTE, NC 28273-
SAMPLE NUMBER- 128041 SAMPLE ID- BBA STORM. -WATER SAMPLE MATRIX- WW
DATE SAMPLED- 06/21/17 TIME SAMPLED- 0830
DATE RECEIVED- 06/22/17 SAMPLER- JP RECEIVED BY- DJ
TIME RECEIVED- 0857 DELIVERED BY- JP TYPE SAMPLE- Grab
Page 1 of 1
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
TOTAL SUSPENDED SOLIDS SM 2540 D 06/26/17 08200 DJ 16 mg/L
LABORATORY DIRECTOR
I10. Box 411483 • Charlotte, NC 28241-1483
I'hone: (704) 58$-8333 • Pax: [phone]

C,
_Semi-annual Stormwater Discharge Monitoring Report (DMR)
CERTIFICATE OF COVERAGE N8fj�. NCG160 .Z _L
FACILITY NAME B�yri/P D/OP/S ,Jya/K,//- CO, ��G
COUNTY _LV%PC.� M h/q��—
PERSON COLLECTING SAMP EL S ,TOn /gi AO 11
LABORATORY PAq 1(.b1f1hOr1e3 Lab Cert. tt (�?
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
.f
'SAMPLE COLLECTION YEAR 20 16
SAMPLE PERIOD ❑ Jan -June [July -Dec
or F1 Monthly' (month)
DISCHARGING TO CLASS ❑ORW [-]HQW EjTrout E]PNA
❑Zero -flow ElWatersupply -QSA-
QOther C
PLEASE REMEMBER TO SIGN ON THE. REVERSE ,
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
Benchmarks ===>
_
-
100 mg/L or 50 mg/L
-1
r2 0� lb
.5S
2/ L
' Monthly sampling (instead of semiannual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
i For sampling periods with no discharge at any single outfall, you must still Submit this discharge monitoring report with a checkmark here.
`The 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.
' 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. Whenresults are below the applicable limits, they must be reported in*the format, "<XX mph where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample volue in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/.L/2014-9/3l/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging> SS gal of new oil per month.
[] No discharge this periods
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
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, Ticr 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 EXCFFDANCES 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 EXCEFDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO [4
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results for 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 sigmficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
rgnature of irmuttee) .(Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014_
Page 2 of 7

Permit Number NCG160221
Central Files: APS _ SWP
5/9/2016
Permit Tracking Slip
Program Category
Status Project Type
NPDES SW
In review New Project
Permit Type
Version Permit Classification
Asphalt Paving Mixture Stormwater Discharge COC
COG
Primary Reviewer
Permit Contact Affiliation
rick.riddle
Coastal SWRule RECCI V LEE L)
MAY 11 2016
Permitted Flow
CENTRAL FILES
DWR SECTION
Facility
Facility Name
Major/Minor Region
Blythe Brothers Asphalt Company, LLC
Minor Mooresville
Location Address
County
10447 Old Nations Ford Rd
Mecklenburg
Charlotte NC 28273
Owner
Facility Contact Affiliation
Matthew Spencer
1415 E Westinghouse Blvd
Charlotte NC 28273
Owner Name
Owner Type
Blythe Brothers Asphalt Company L L C
Non -Government
Owner Affiliation
Franklin W. Blythe
Owner
1415 E Westinghouse Blvd
Dates/Events
Charlotte NC 28273
Scheduled
Orig Issue App Received Draft Initiated Issuance
3/1612016
Public Notice Iss/{re/
;7;11
Eff9cti/pe E I atlo
'S/Q�!(. 1�a��
/
Regulated Activities
Requested /Receiv///ed Events
RO staff report requested
4/1/16
RO staff report received
4/27/16
Outfall
Waterbody Name Streamindex Number Current Class Subbasin

Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
May 9, 2016
Matthew Spencer
Blythe Brothers Asphalt Co., LLC
1415 E. Westinghouse Blvd.
Charlotte, NC 28273
PAT MCCRORY
C." ,„
DONALD R. VAN DER VAART
3ecrGary
TRACY DAVIS
Dmr wr
Subject: General Permit No. NCG 160000
Blythe Brothers Asphalt Co., LLC
COC NCG160221
Mecklenburg County
Dear Mr. Spencer:
In accordance with your application for a discharge permit received on March 16, 2016, we are
forwarding herewith the subject certificate of coverage to discharge under the subject state —NPDES
general permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-
215.1 and the Memorandum of Agreement between North Carolina and the US Environmental Protection
Agency dated October 15, 2007 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except after notice to the Division of
Energy, Mineral, and Land Resources. The Division may require modification or revocation and
reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Energy, Mining, and Land Resources, or permits required by the Division of Water
Resources, Coastal Area Management Act, or any other federal or local governmental permit that may be
required.
If you have any questions concerning this permit, please contact Richard Riddle at telephone number
[phone].
Sincerely,
for Tracy E. Davis, P.E., CPM
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Program Files
Mecklenburg County DEP, Water Quality, 700 N. Tryon Street, Charlotte, NC 28202
State or Nunn Carolina J Enrironmental Quality I Energy, Mineral and Land Resources
1612 Mail Smice Center 1 512 Numb Salisbury Street I Raleigh, NC 27699-1612
919 707 9200 T

STATE OF NORTH CAROLINA
DEPARTMENT OF BNVIRON MGNTAL QUALITY
DIVISION OF ENIERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG160000
CERTIFICATE OF COVERAGE No. NCG160221
STORM WATER DISCHARGES
NATIONAL POLLUTAN'r DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Blythe Brothers Asphalt Co., LLC
is hereby authorized to discharge stormwater from a facility located at
Blythe Brothers Asphalt Co., LLC
10447 Old Nations Ford Rd.
Charlotte
Mecklenburg County
to receiving waters designated as Kings Branch, a class C water in the Catawba River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts 1, 11, 111, and IV of General Permit No. NCG 160000 as attached.
This certificate of coverage shall become effective May 9, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 9, 2016.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

©� L
Division of Energy, Mineral, and Land Resources
ff��
Land Quality Section
NCDENR
National Pollutant Discharge Elimination System
damw[vr wNw,w Rcws[a
NCG160000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Dale Received
Yem Da
C.ti6cxleurr'uvti e­ 1
NI
Clnek 0 t
A
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG160000 for STORMWATER DISCHARGES associated with activities classified as:
SIC 2951 The manufacture of Asphalt Paving Mixtures and Blocks,
And, Like activities deemed by DEMLR to be similar in the process, or the exposure of raw
materials, intermediate products, final products, by-products, or waste materials.
(Please print or type)
1) Mailing address of the ownerloperator (address to which official permit correspondence will be mailed):
Name BLYTHE BROTHERTA PHALT
Owner Contact MATTHEW SPENCER
Street Address 1415 E. WESTINGHOUSE BLVD.
City CHARLOTTE State NC ZIP Code 28273
Telephone No. 7 - 88- Fax: [phone]
E-mail Address [e-mail]
2) Location of the facility producing the discharge:
BLYTHE BROTHERS ASPHALT CO., LLC
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
Email
JON PARTON
10447 OLD NATIONS FORD
CHARLOTTE Stale NC ZIP Code 28273
MECKLENBURG
704-556-5575 OR 704-527-5975 Fax: [phone]
3) Physical Location Information:
2016
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). SEE ATTACHED MAP W/DIRECTIONS
(A copy of. a county map or USGS quad sheet with facilky clearly located on the map is a required part of this application.)
4) Latitude 35.116228 Longitude-80'895498 (degrees, minutes, seconds)
3s.14M - 6o. jqIl
5) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility' Date operation is to begin
6(I Existing
`If this new or proposed facility is located in one of the 20 coastal counties, please contact the appropriate DEMLR Regional
Office (see page 4) to determine if a State Stormwater Permit is required pdor to construction.
Page 1 of 4
SWU-231-030909
Last revised 9110/14

w
NCG160000 N.O.I.
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary Industrial
activity at this facility
SIC Code: 2 9 5 1
7) Services and Activities
a) Provide a brief narrative description of the types of industrial activities and products
manufactured at this facility: (Include a site diagram showing the process areas and location of
activities present at this facility.) WE PRODUCE ASPHALT MATERIALS FOR ROADWAYS AND
PARKING LOTS
b) Check all activities conducted at this facility.
RI Outdoor stockpiling of materials
M Storage of raw materials
fN Storage of materials in above-
ground tanks
IJ Material Loading and Unloading
B) Discharge points / Receiving waters:
El Transport of materials by a conveyor
or front-end loader
❑ Vehicle and equipment maintenance
❑ Vehicle or Equipment Washing
P9 Vehicle and equipment fueling
How many discharge points (ditches, pipes, channels, curb and gutter, swales, etc.) convey stormwater from
the property. WO
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? KINGS BRANCH
If the site stormwater discharges to a separate storm sewer syst Nr�Aname the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
Receiving water classification (if known): RAIN
9) Does this facility
a) Have an untreated wastewater discharge? IN No Cl Yes
b) Have a treated wastewater discharge? IN No ❑ Yes
If yes, list the permit
c) Have a wastewater discharge from a recycle system? [XNo Cl Yes
If yes, list the permit number.
d) Have a non -discharge permit? IN No ❑ Yes
If yes, list the permit number.
e) Discharge wastewater to a municipal wastewater collection system? 6 No ❑ Yes
If yes, list the municipality and permit number
Note: Stormwater discharge permit NCG160000 does not authorize the discharge of any wastewater.
If this site discharges wastewater, you must obtain the appropriate wastewater discharge
permit in addition to coverage for stormwater discharges under NCG160000.
10) Does this facility employ any best management practices for stormwater control?
U No ® Yes (Show any structural BMP's on the site diagram.)
If yes, please briefly describe: WE HAVE SILT FENCE AND SOME ROCK CHECK DAMS
SWU-234-030909
Page 2 of 4
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NCGI60000 N.O.I.
11) Does this facility have a Stormwater Pollution Prevention Plan?
In No ❑ Yes
If yes, when was it implemented?
12) Are vehicle/equipment maintenance activities occurring at this facility?
IN No ❑ Yes
13) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
in No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
® No CI Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
IN No ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
6 No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored: _
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor: _
Vendor address:
14) Certification:
North Carolina General Statute 143.215.6B (I) provides that:
Any person Who knowingly makes any false statement, representation, or certlficallon In any application, record, report, plan, or other
document tied a required to be maintained under this Article or a rule Implementing INS Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article or who falsifies, tampers with, or knowingly
mnders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
(Fnvironmerdal Management) Commission Implementing this Article shall be guilty of a Class 2 misdemeanor which may Include a fine
not to exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit. I certify that I am familiar with the Information contained in this application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing:
Title: OPERATIONS MANAGER
ROBERT E. MCKINNEY
(Signature of Applicant) (at Signed)
This Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
NCDENI2
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SWU-234-030909
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ti
NCG160000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been Included.
Please do not ask us to "hold" an incomplete application in anticipation of a check under separate cover.
Z Check for $100 made payable to NCDENR
0" This completed application signed by the applicant, and all supporting documents
A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater oulfalls
(corresponding to which drainage areas), (d) runoff conveyance structures, (e) areas where materials are
stored, (I) impervious areas, (g) site property lines, (h) vehicle and equipment maintenance, blasting,
painting, and washing areas, and (i) location of activities listed in 7b.
© Copy of county map or USGS quad sheet (preferred) with location of facility clearly marked on map
Please mall the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Please note:
The submission of this document does not guarantee the Issuance of NPDES permit coverage.
For questions, please contact the DEMLR Regional Office for your area.
To visit our webslte please go to http://portal.ncdenr.ora/webAr/stormwater
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
707-9220
SWU-234-030909
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Last revised 09/10/14