NCG060244_MONITORING INFO_20191107

wsq
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCG b C9
DOC TYPE
❑ HISTORICAL FILE
C MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORTR[Frpll
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /0-31-19 NOV 0 7 2019
CERTIFICATE OF COVERAGE NO. NCG06 D,j_JA
FACILITY NAME 1%unil.�Pma
COUNTY (>g�; 1 Foep
PERSON COLLECTING SAMPLES.. J/T-F Coo�i»crtl
LABORATORY Lab Cert.11
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR D NTRAL FILES
FACILITY ACTIVITIES INCLUDE (check all that apply) SECTION
❑ use/process meats ❑ use animal f is/byproducts
DISCHARGING TO.SALTWATERS? ❑YES animal
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Tntnl nvgnf rnin fn ll2
Outfall.No.
Benchmark
Sample Collected,
mo/dd/yr
-
TSS,
mg/L
1o0 or s-0
pH,
Standard units
Within 6.0-9.0
COD,
mg/L
120
Oil and Grease,
mg/L
30
Fecal Collform ,
Colonies er lot) ml
1000
Enterococci ,
Colnnles per loll ml
Soo
D
uY uyNuca ry 1nl.�1ILJCs user use/Process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than SS gallons of new motor oil per month? ❑ yes [Gf no . (if es complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: nniv fnr farilitiac allgraaing % Cr. get s— ... ........ _u r
Outfall No.
Benchmark
Sample Collected,
mo/dd/yr
- -
- •
Oil and Grease,
mg/L
30
.-p...p
TSS,
Mg/ L
100or50
_ �- p,-. v. ..r uu ...V,VI
pH,
Standard units
6.0-9.0
VV/,IlVlllll.
New Motor Oil Usage,
Annual average gal mo
_
Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART It SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO 2'
1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one toff of this DMR including all "No Dischnrrye" reports, within 30 doVs of receipt of the lab results for at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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)
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.orgLweb w /ws/su/npdesswHtab-4

A
NCDEN
Stormwater Discharge ®utfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htro://nurtal.ncdenr.orJweb/wq/ws/au/nodcssw#lal)-1
Permit No.: N/C/_/_/_/_/_/ /1 or Certificate of Coverage No.: N/C/G
Facility Name: Muj 62 4,etnes
County: Phone No. 3$6-cW-.;430O
Inspector: FFF Coe.km*J
Date of Inspection: 8 ^ I • 19
Time of Inspection: M9CAJ
Total Event Precipitation (inches): Z� Nv 0/5B//&�w
Was this a Representative Storm Event? (See information below) ❑ Yes Z"No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
.norm event (requirements vary).
A "Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
or Designee)
1. Oulla3l Description: n
Outfall No. .( Structure (pipe, ditch, etc.) Yfi
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: a t /n
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of

4. Clarity. Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
l 2 3 4 5 N/A
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids; Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where t is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No A%/ 14
S. Is there an oil sheen in the stormwater discharge? Yes No 1/4
9. Is there evidence of erosion or deposliden at the cutfall? Yes No AlIq
10. 011her Obvious Indicators of'Stoi—mwatFr Fal7at2iori:
List and describe _ li%1Q
I
Note: , Low clarity, high solids, and/or the presence of foam, oil sheen, or eresion/deposition may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060001
Date submitted /0•,3/-19
CERTIFICATE OF COVERAGE NO. NCG06 B �j �� SAMPLE COLLECTION YEAR Am
t
FACILITY NAME �tk"m s FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY (7>i�io
f FLP aa // ❑ use/process meats ❑ use animal f is/byproducts
PERSON COLLECTING SAMPLES 366E C CJ6fCir)nn/ DISCHARGING TO.SALTWATERS? RYES QNO
LABORATORY :. ­�,i­-'Lab Cert. ff
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Part A: Storinwater Benchmarks and Monitoring Results Total event rainfall" or ,7l No d' h th' d3
Outfall No.
Benchmark
Sample Collected,
mo/dd/yr
TSS,
mg/L
100 or 60
pH,
Standard units
1Nthin 6.0 —9.0
COD,
mg/L
220
Oil and Grease,
mg/L
30
Fecal Conform ,
Colonies per 100 ml
1030
lsc urge Is per
Enterococcl ,
Coinnles per lo0 ml
Sao
D
--° -
— ,
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfails. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor all per month? ❑ yes Q no .
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal Of new moto o'1I/ th
Outfall No.
Benchmark
Sample Collected,
. mo/dd/yr
-
Oil and Grease,
mg/L
30
TSS,
mg/L
100or5a
pH,
Standard units
6.0-9.0
r man .
New Motor Oil Usage,
Annual average gal mo
_
i .Ily app,¢S w IGuuueS mdt u5e/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
RECEIVED
NOV 0 7 2019
(lf ves, c0J1?M'ui� ALES
DWR SECTION

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days fo
of receipt of the lab results r at end of
monitoring period in the case of "No Discharge" reports) for
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.ore web w /ws/su/npdesswHtab-4

N'C.D'EN
Starinwater Discharge Out -fall (SDO)
Qualitative Monitoring Report
For guidance onfi/ling out this fonn, please visit: htro://portal.ncdenr.orJweb/wq/ws/zu/nodessw#ial)-1
Permit No.: N/C/_/_/_/_/_/ /-/ or Certificate of Coverage No.: N/C/G/1//�/Q/,a/S[/k/
Facility Name: 4-1at.t2kr f.Ktns
County: I ryeoo Phone No. 3$6-S4 .V00
Inspector: -f6eA CoekmatJ
Date of Inspection: 1
Time of Inspection: _
Total Event Precipitation (inches): L Nv Di'sehAw
Was this a Representative Storm Event? (See information below) ❑ Yes E"No
Please.check your permit to verify if Qualitative Monitoring must be performed during a representative
.storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
A t
or Designee)
NOY 0 7 2019
1. Ov31211 DescripRlon: CENT f L fjJ ES
Outfall No. ( Structure (pipe, ditch, eZ�i�i u DU
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: n , /n
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): AIJA
Page I of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 5 N/A
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where t is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5 N/g
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foamin the stormwater discharge? Yes No /%/ 14
S. Is there an oil sheen: in the stormwater discharge? Yes No //%
9. Is there evidence of erosion or deposidom at the cutfall? Yes No a////t}
141. Other Obvious Lndlc2lors of'Slormnwafer Pa33u4iom:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposiiion may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCGO60000
Date submitted /0-.3/-19
CERTIFICATE OF COVERAGE NO. �NCG06 D jj _j_4 SAMPLE COLLECTION YEAR. A11
FACILITY NAME Huiy�. & H�+Gm4 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY &I&" f rrn.[O / ❑ use/process meats ❑ use animal f is/byproducts
PERSON COLLECTING SAMPLES - 36FF Lf�d�Cin9n/ DISCHARGING TO.SALTWATERS? [:]YES QNO
LABORATORY Lab Cert. ll - .
PLEASE REMEMBER TO SIGN ON THE REVERSE -3
Part A: Stormwater Benchmarks and Monitorine Results r..r.J.__,.: s ❑2 __ 1 Y.,- -__-
Outfall.No.
Benchmark
Sample Collected,
mo/dd/yr
-
TSS,
mg/L
100or50
pH,
Standard units
Within 6.0 - 9.0
COD,
mg/L
170
. _.... _._.. .....�....
Oil and Grease,
mg/L
30
.,, ,vi,�..
Fecal Calif orm ,
Colonies per 100 ml
1000
uu..nmyr uns putwu
Enterococcl ,
Colonies per 100 ml
500
I U
The total precipitation must be recorded using data from an on -site rain gauge. DWR SECTION
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes _q/no . (if ves, complete Part e)
Part B: Vehicle Maintenance Area Monitoring Re9dts• nnly fnr f.A1i low cc --I ..i _..... _-._ _:. r_
Outfall No.
Benchmark
Sample Collected,
. mo/dd/yr
-
Oil and Grease,
mg/L
30
T�;_
In- L
1Wor50
pH,
Standard units
6.0-9.0
New Motor Oil Usage,
Annual average gal mo
_
.. �„r w u.aL unejp.uLess meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO []�
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? VES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 dgvs of receipt of the lab results for at end of
monitoring period in the case of "No Discharge" reports for
Division of Water Quality
Attn: DWQ Central Files
1611 Mail Service Center
Raleigh, NC 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. 1 am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
(Date)
Additional copies of this form may be downloaded at: htto://nortal.ncdenr.org[web w /ws/su/npdesswlltab-4

� z
NCDENR
Srormwater (Discharge ®utfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit:. hlto://nurtal.nedenr.orJw eb/wq/ws/.u/nndcssw#ial)-1
Permit No.: N/C/_/_/_/_/_/ /� or Certificate of Coverage No.: N/C/G
Facility Name: 1 u_.t kz a kme
County: 116t. Phone No. 3.u-Sj,? ,ayoo
Inspector: FFt CoCkmJ
Date of Inspection: 0 -3 /- M
Time of Inspection:M901041
Total Event Precipitation (inches): 6n w Dl-seh w
Was this a Representative Storm Event? (See information below) ❑ Yes [+''No
Please, check your permit to verify if Qualitative Monitoring must be performed during a representative
.storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours Q days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
(Signa/rWermittee or Designee) RECEIVED
1. OU11213 DesoripliCn: P nn NOV 0 7 2019
Outfall No. I Structure (pipe, ditch, etc.) YE
Receiving Stream: NTRAL FILES
Describe the industrial activities that occur within the oulfall drainage ar(RVtlR SEC' l
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: e , A
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page I of

4. Clardy: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
l 2 3 4 5 /%/A
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes theamountof suspended solids in
the stormwater discharge, where l is no solids and 5 is extremely muddy:
i 2 3 4 5'
7. Is there any foam in the ^stormwater discharge? Yes No A)/ /q
S. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No NA
191. ©deer Obvious Ladicalors of 5do; r walEr Follutioa3:
List and describe II% 1.4
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /0.3/-11
CERTIFICATE OF COVERAGE NO. NCG06 B 2 _14 SAMPLE COLLECTION YEAR An/$
FACILITYNAME � NJ.6& jr ,'CM I FACILITY ACTIVITIES INCLUDE (check all that apply):
/" COUNTY f iti I F094. ,� / use/process meats use animal f s/byproducts
PERSON COLLECTING SAMPLES :T (��MlirACLI/ DISCHARGING TO SALTWATERS? AYES QNO
LABORATORY -_ Lab Cert. fl -
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitorine Results T. t IYI,G t : ; f u . 4AI..
Outfall.No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
—TOO
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Collform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
or SO
ithin 6.0-9.0
120
30
1000
Soo
_
�
1 LIJID
(DN
F AI
Only applies to facilities that use/process meats. -
rThe total precipitation must be recorded using data from an on -site rain gauge.
' For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Q yes Eno (if ves, complete Part B)
Part B: Vehicle Maintenance Area Monitorine Results- nnhr fnr farilitinc � cc � 1 ..r...,... ..._._ _:1 I.
Outfall No.
Benchmark
Sample Collected,
. mo/dd/yr
•
Oil and Grease,
mg/L
30
.-p...p
TSS,
mg/L
100orso,
- ....
pH,
Standard units
6.0-9.0
New Motor Oil Usage,
Annual average gal mo
-
ny OP„no. 411LICC uIaI V]e/PMLeN] meals.
' The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑'
1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "Alo Discharge" reports within 30 days of receipt of the lob results for at end of
monitoring period in the case of "No Discharge" reports:
Division of Water Quality
Attn: DWQ Central Files
1611 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY 1NFORMATION 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)
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/w /ws/su/npdesswfltab-4

HUW
NCD'EN
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onfilling out thisfonn, please visit: http://portal.ncdenr.orz/web/wq/ws/sulnpdcssw#ial)-1
Permit No.: N/C/_/_/_/_/_/ / / or Certificate of Coverage No.: N/C!G/f2
�— /�lQl�l Ql�l
Facility Name: 4yL& (.6ta i Kms
County: ( Phone No. 3.gsw
Inspector: FFF CoCkmao)
Date of Inspection: 0 -3 1- M
Time of Inspection: D
Total Event Precipitation (inches): 6Nd D/SG%
Was this a Representative Storm Event? (See information below) ❑ Yes dNo
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
.storm event (requirements vary).
A 'Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has '
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, t certify that this report is accurate and complete to the best of my knowledge:
or Designee)
1. Oulfall Description: tI
OutfalI No. I Structure (pipe, ditch, etc.) YE
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 4,14
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): A / /n _
Page I of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy: /V/
1 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
1 2 3 4
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No Al/14
S. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious hdicatars of Ster:mwaaer Follujion:
List and describe �
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /0,31-19
CERTIFICATE OF COVERAGE NO. NCG06 D ,2) _j 4 SAMPLE COLLECTION YEAR A/q
FACILITY NAME gt4lu 51e r,1,,M5 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY _&,, Fo[A
� ,� / ❑use/process meats ❑use animal f is/byproducts
PERSON COLLECTING SAMPLES 36GG ?yd"InJ DISCHARGING TO.SALTWATERS? ❑YES QNO
LABORATORY Lab Cert. It -
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event WWI' or (No d'sch th' d'
outfall.No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coltform ,
Colonies per 100 ml
i orge is per
Enterococci ,
Colonies per 100 mi
Benchmark
-
100 or SO
tMthln6.0-0.0
220
30
1000
500
D
_.
NOV (I 20
,., u,l�auc,a .v muuVC� V IOI Uic' p, VLCOO llledLb.
C
'The total precipitation must be recorded using data from an on -site rain gauge. DWR SECTION
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ER no _ (if ves, complete Part B)
Part B: Vehicle Maintenance Area Monitnrin¢ Results- nnly Fnr r„acue� . cc --.i—s....... __._ _:1 r
Outfall No.
Benchmark
Sample Collected,
mo/dd/yr
-
Oil and Grease,
mg/L
30
— .—.p -d-
TSS,
mg/L
100orso
--Iu —.V —,,,V
pH,
Standard units
lVI V111111V11n1.
New Motor Oil Usage,
Annual average gal mo
...,.y uppuo zu m11116eD illdL userprocess meals. The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [v]�
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? VES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Dischnrge" 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 Quality
Attn: DWQ Central files
1617 Mail Service Center
Raleigh, NC 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. 1 am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
(Date)
Additional copies of this form may be downloaded at: http://portaLncdenr.ore[web w /ws/su/npdesswHtab-4

o®
NCDENR
StDrmwater Discharge ®utfall (SDO)
Qualitative Monitoring Report
For guidance onfilling out thisfbnn, please visit., hitn://portal.ncdenr.orJwebhv(l/ws/au/nndcssw#ial)-3
Permit No.: N/C/_/_/_/_/_/ /J or Certificate of Coverage No.: NlC/G/f2/�lQl�lQl�l
Facility Name: }uu•(E2 4jetws
County: Tn Phone No. n4-r34 ei3oo
Inspector: FFG CoakMAA)
Date of Inspection: 0 -3 I - 1 °)
Time of Inspection: ZVOCA1
Total Event Precipitation (inches): 6L— Nv DIse-hpiv
Was this a Representative Storm Event? (See information below) ❑ Yes ❑✓�No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
n
or Designee)
9. Outfall Description:
Outfall No. ( Structure (pipe, ditch, etc.) YE
Receiving Stream:
Describe the industrial activities that occur within the outfall diainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 4114
3. Odor: Describe any distinct odors that the discharge may have (i.e., bmells strongly of oil, weak
chlorine odor, etc.):
Page I of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is dear
and 5 is very cloudy: �/
1 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
I 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
S. Is there an oil sheen in the stormwater discharge? Yes No N/ A
9. Is there evidence of eresion or deposition at the cutfall? Yes No//
10. other Gbvicus Indicators of Slorrnwaaer Pollution:
List and describe
I
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /0-.3/-/9
CERTIFICATE OF COVERAGE NO.. NCGO6 d �j _I rj SAMPLE COLLECTION YEAR A/9
FACILITY NAME IIt.AiJec��,GmS FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY _41,; ) r rp ❑ use/process meats ❑ use animal f is/byproducts
PERSON COLLECTING SAMPLES 36FF L9Da>(Ci»a,/ DISCHARGING TO.SALTWATERS? ❑YES QNO
LABORATORY '.', Lab Cert. If
Part A: Stormwater Benchmarks and Monitorine Results
PLEASE REMEMBER TO SIGN ON THE REVERSE --)
Tnfnl evanf rninfnll' r I ,.r At..L;
Outfall.No.
Sample Collected,
mo/dd/yr
T55,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per Ion ml
Enterococcl ,
Colonies per 100 ml
Benchmark
100 or SO
Within 6.0-0.0
120
30
1000
500
RECEIVE)
D
V n 7 m io
..IL.y nNNne� .o ieuuues .vdL use/process meats. t.tN I RAL FILES
2 The total precipitation must be recorded using data from an on -site rain gauge. DWR SECTION
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes dno (if ves, complete Part B)
Part B: Vehicle Maintenance Area Monitorine Results: nnhi for farilitioc a.raraolr.,. , cc o.l s. e.., . . Hi
__..
p
umy appues to tacnmes mat use/process meats.
' The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

"FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO [✓]'
1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? 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 for
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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) (Date)
Additional copies of this form may be downloaded at: http://partal.ncdenr.org/web/wn/ws/su/npdesswHtab-4

Y
NCD'EN
Stormwater Disrllarge ®utfall (SDO)
Qualitative Monitoring Report
For guidance onfilling out thisfonn, please visit: hltn://ourtal.ncdenr.orJweb/Nvcl/ws/su/nndcssiv#ial)-4
Permit No.: N/C/_/_/_/_/_/ /_/ or Certificate of Coverage No.: N/C/G/f2!%/Q/'A/l/k!
Facility Name: j4_LLA2 k r 4 Kms
County: Phone No. 5U-94 aVQQ
Inspector: eF1= Coe,kmao) p
Date of Inspection: 6' l • I °I
Time of Inspection: D
Total Event Precipitation (inches): lf� Nv &5G/,&�V
Was this a Representative Storm Event? (See information below) ❑ Yes Z✓ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
.storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred_A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
ttee or Designee)
1. Ou1ff2]1 Description: �
Outfall No. ( Structure (pipe, ditch, etc.) �Fi
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: e , / A
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page I of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy: �/
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5 Nlg
7. Is there any foam in the stormwater discharge? Yes No
B. is there an oil sheen in the stormwater discharge? Yes No N//4
9. Is there evidence of ea osicn or deposition at the outfall? Yes No N14
10. Other Obvious hdicators of'Storm water Pollution:
List and describe OU 14
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposilion may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /0'.11- I)
CERTIFICATE OF COVERAGE NO. NCG06 B SAMPLE COLLECTION YEAR Ad
FACILITY NAME 1ri-un kg �m5 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY 11m; roL0
,� / ❑use/process meats Ouse animal f s/byproducts
PERSON COLLECTING SAMPLES 3t56F t DC4Cirtklt/ DISCHARGING TO.SALTWATERS? [_]YES tZNNO
LABORATORY Lab Cert. It
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE j
Tntnl a,rant rnintnll I ✓1 r.i,..r;..,.a,,.-.... .�.:
Outfall.No.
Sample Collected,
mo/dd/yr
T55,
mg/L
pH,
Standard units
COD,
mg/L
'-'-"'"'..-••v�••
Oil and Grease,
mg/L
�. U,
Fecal Collform ,
Colonies per 100 ml
uuv,u, yc u,u pcnuu
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or50
within 6.0-0.0
120
30
1000
500
/
D
14Uv I Cul
'The total precipitation must be recorded using data from an on -site rain gauge. DWRSECTION
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 0no . (if es Complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 al of new t 'I/ I
Outfall No.
Benchmark
Sample Collected,
. mo/dd/yr
-
Oil and Grease,
mg/L
30
TSS,
mg/L
ion or5o
g mo
pH,
Standard units
or of mom. ,.
New Motor Oil Usage,
Annual average gal mo
v,ny dppnes,o ,da„ues mac use/process meats. _
' The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Z
1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? 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 Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY 1NFORMATION 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)
(Date)
Additional copies of this form may be downloaded at: htt port a l.ncdenr.orRLweb w (ws/su/npdesswfltab-4

:-
r
NCDENR
Storanwater Discharge ®utfall (SDO)
Qualitative Monitoring Report
For guidance onft/lingout thisfonn,please visit: hap://portal.ncdenr.orJwcb/Nva/ws/su/npdcssw#Iai)-4
Permit No.: N/C/_/_/_/_/_/ _/ or Certificate of Coverage No.: NICIGIb //P /Q/�l
Facility Name: 1- tx Ea 9/Kms
County: , AV&D Phone No. 3$6-,UJ -,7300
inspector: FGF COCkma+J
Date of Inspection: 10 -3 !- I
Time of Inspection: 9LCILU
Total Event Precipitation (inches): N'd Di5eha�v
Was this a Representative Storm Event? (See information below) ❑ Yes dNo
Please check your permit to verify if Qualitative Monitoring trust be performed during a representative
.storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0. t inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
n t
(Signapdio Pemittee or Designee)
]. Outfall Description: nn
OutfalI No. I Structure (pipe, ditch, etc.) ,PE
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
t 2 3 4 5 �%14
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No N/ A
S. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious LxHcators of 'Slorrmwatar Follution:
List and describe P 1.4
0
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
he indlcative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /0•,3/-/9
CERTIFICATE OF COVERAGE NO.. NCG06 D,h _14 SAMPLE COLLECTION YEAR A/9
FACILITY NAME µt&,u & &PAm's FACILITY ACTIVITIES INCLUDE )check all that apply):
COUNTY (1m; 1 inLp ❑ use/process meats ❑ use animal fis/byproducts
PERSON COLLECTING SAMPLES ?66G ?92_dkA74K1 DISCHARGING TO,SALTWATERS? ❑YES t NO
LABORATORY � � Lab Cert. 11 �
PLEASE REMEMBER TO SIGN ON THE REVERSE i
Part A: Stormwater Benchmarks and Monitorine Results Tntnl avent minfnll2 nr FL nr,. a;.,.t,,..,.,..r.:.......:...d
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
E lterococci ,
Colonies per 100 ml
Benchmark
-
100 or SO
Within 6.0-9.0
JIM
30
low
son
D
C !1
iry v t
army appueS Lu iectuues mat use/process meats. -
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor all per month? ❑ yes �o
Part B: Vehicle Maintenance Area Monitoring Results: c nhr fnr farilitins averaninn > cs nal of ..o,u ... ;f 1...__+1.
Outfall No.
Sample Collected,
. mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal mo
Benchmark
-
30
100 or SW
6.0-9.0
_
vury appnee m iaaiaies mat use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
/E©
019
CENTRAL FILES
DWR SECTION
(if es complete Part B)

'FOR PART A AND PART B MONITORING RESULTS:
C A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ERA
1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Disclrarr e" reports, within 30 daVs of receipt o(the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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) (Date)
Additional copies of this form may be downloaded at: httl?:ZZportal.ncdenr.org/web/w /ws/su/npdesswtitab-4

NCDENR
Storrnw2ter Discharge ®utfaU (Sift))
Qualitative Monitoring Report
For guidance on filling out this fonn, please visit:. huo://ngrtal.ncdcnr.or,/%cb/wq/ws/.u/nndesswktai)-4
Permit No.: N/C/_/—/_/_/_/ /—/ or Certificate of Coverage No.: N/C/G
Facility Name: JALM62ke - Kms
County. 1 �— Phone No. aVoo
Inspector: Fr%r Cockma+J
Date of Inspection: 0 -3 /- M
Time of Inspection: lvbcoj
Total Event Precipitation (inches): dl�— Nd D1,5ehAw
Was this a Representative Storm Event? (See information below) ❑ Yes ✓❑�No
Please check your permit to verify if Qualitative Monitoring trust be performed during a representative
,storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature. I certify that this report is accurate and complete to the best of my knowledge:
n t
or Designee)
1. ®utfail Description: D
Outfall No. Structure (pipe, ditch, etc.) i(i
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 4,14
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): n t /n
Page 1 of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy: 1 2 3 4 5 /V/
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5 N/g
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremelymuddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge?
Yes No
S. Is there an oil sheen in the stormwater discharge?
Yes No /l/%
9. Is there evidence of eroslon or deposition at the ouffall?
Yes No//
10. 01her Obvious Lmdicato s of Storrmwater Pollution.:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
he indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted N -3/-/9
CERTIFICATE OF COVERAGE NO. NCG06 D aA1 SAMPLE COLLECTION YEAR oJOIq
FACILITY NAME 4u 4,f*P— F,OP,e, FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ; (.,o n/❑ use/process meats ❑ use animal f is/byproducts
PERSON COLLECTING SAMPLES�(6Gt� lo(rK/AAw% DISCHARGINGTOSALTWATERS? ❑YES I IND
LABORATORY Lah Cert. if
PLEASE REMEMBER TO SIGN ON THE REVERSE i
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall or 1­7�No dischar0 a this eriodt
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Collfarm ,
Colonies per 100 ml
P
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
220
30
1000
Sao
n�9
Only annlia<in
6riGtin<rhv
- • --- ---------- ----- - r. -__-_ ..._..._. DWK Q". • -
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor all per month? ❑ yes ffj no . (if ves, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 pal of neu/ mntnr nil/month
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/I.
pH,
Standard units
New Motor Oil Usage,
Annual average gal mo
Benchmark
30
100or50
6.0-9.0
-
Only appues to Taauues tnat use/process meats.
r The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

*FOR PART A AND PART B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? 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 Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
A -
YOU MUST SIGN THIS CERTIFICATION FOR ANV 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."
f 14fto�
e of P.ermittee) (Date)
Additional copies of this form may he downloaded at: httn://portal.ncdenr.orgLweb/wq/ws/su/npdesswluab-4

NCDENR
Stormwaier Discharge ®utf2U (SDO)
Qualitative Monitoring Report
Forguidance onfilling out this form, please visit:. hu ram'.//portal.ncdenr.orJweb/wq/ws/.su/npdessw#lal)-t
Permit No.: N/C/ /—/_/_/ / /—/ or Certificate of Coverage No.: N/C!G1.L1-/,Al�[l�!
Facility Name: iuuI-Kz Kma
County: go T— Phone No. 3.u-.p ei300
Inspector: FFF CACkm&J
Date of Inspection: _ 10 -3 I • 11
Time of Inspection: � 949wi / Total Event Precipitation (inches): r2— Nv Qiseh
Was this a Representative Storm Event? (See information below) ❑ Yes ZNo
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
.storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
n d
or Designee)
1. OUIT233 Descripdion:
Outfall No. I
Receiving Stream:
Structure (pipe, ditch, etc.)
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: I , / I
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
49
ri
Page I of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
t 2 3 4 5 N/A
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
1
e'•
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where l is no solids and 5 is extremely'muddy: '. .
i 1
I 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
S. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the ouffall? Yes No
10. Other Obvious L-2d1c2tor5 of Slormwalzr Pollution:
List and describe N 14
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water duality General Permit No. NCG060000
Date submitted /0 •3/-/9
CERTIFICATE OF CfOfVERIGE NO. NCG06-6,,LII SAMPLE COLLECTION YEAR
FACILITY NAME 1�(pN4tE0— Q0&'h5 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY & Lt." f rt,2 Lc> ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES a DISCHARGING TO SALTWATERS7 ❑YES E10
LABORATORY Lab Cert. It
PLEASE REMEMBER TO SIGN ON THE REVERSE
Part A: Storinwater Benchmarks and Monitoring Results Tnfnl evanr rninfnii 2 n. I ,Ynt
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0-9.0
120
30
1000
Soo
AP
�
K
i yr
vnry nppges Lu Lnuuues idol use/process mears,
'The total precipitation must be recorded using data from an on -site rain gauge.
3For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑yes 13/
no _
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging 5 rA gal of ne,°, r„ntn,
Outfall No.
Sample Collected,
. mo/dd/yr
Oil and Grease,
MOIL
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal mo
Benchmark
-
30
100or50
t 'n.y nppuee Lu reauues mat use/process meats.
' The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge ate outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
) 7 Z019
CENTRAL FILE$
DWR SECTION
(if yes, complete Part B)

*FOR PART AAND PART B MONITORING RESULTS:
a A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES FIND
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? VES ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "Ato Discharge" reports, within 30 days of receipt of the lab results for at end o f
monitoring period in the case of "No Discharge" reports to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY 11VF0RMATI0N'17EP0RTE6:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature
(Date)
Additional copies of this form maybe downloaded at: htt portal.ncdenr.orgLweb/wn/ws/su/npdesswiltab-4

NCDEN
Stormw2ter Discharge ®utiall (SDO)
Qualitative Monitoring Report
For guidance onfillingout thisforn,please visit: hop://portal.nedenr.orz/"b/wgP.vshu/nr)dessw#Ial)—t
Permit No.: N/C/_/_/_/_/ / /� or Certi£cate of Coverage No.: N/C/G/Q/ b /Q/al/�/�
FacilityNattrj�e: AA-Awi q
County: _ 6-w ( Fotao Phone No. 536 -8.9d• a!Vo
Inspector: SEFF t9A&i hogAl
Date of Inspection: b �5 /-t 9
Time of Inspection: Nen,t)
Total Event Precipitation (inches): 0 t(/Q 0,5C: A�v
Was this a Representative Storm Event? (See information below) ❑ Yes [�No
Please check your permit to verify if Qualitative Monitoring trust be performed during a representative
.storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours Q days) in which no storm event measuring greater than 0.1 inches has
occurred_A sing!e stem event may contain up to 10 consecutive hours of no precipitation.
By this signature. I certify that this report is accurate and complete to the best of my knowledge:
(Sig7atyfWemittee or Designee)
9. Outffall Description: /J
OutfalI No. Structure (pipe, ditch, etc.) �Pti
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: A ///
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): I q//g
Page I of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 5 all
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where l is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5 /✓/A
6. Suspended Soiids: ,Choose.the number which best describes the amount of suspended solids in
the stormwater discharge, where t is no solids and 5 is extremely muddy. ,
1 2 3 4 5
7. Is there any foana iri the stormwater discharge? Yes No /V/4
S. Is there an oil sheen in the stormwater discharge? Yes No W/4
9. Is there evidence of erosion or deposition at the eutfall? Yes No A///g
10. Other Obvious Lrkkators of Sim=water Pollution:
List and describe N 1 a
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted /)
CERTIFICATE OF COVERAGE NO. NCG06-QA1f ! SAMPLE COLLECTION YEAR dQ/g
FACILITY NAME ►luu f s4 FaafnA FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ( Aao 11use/process meats El use animal f is/byproducts
PERSON COLLECTING SAMPLES _SIDE &�&k "A.) DISCHARGING TO,SALTWATERS? AYES 9i0
LABORATORY Lab Cert. if
PLEASE REMEMBER TO SIGN ON THE�E REVERSE
Part A: Stormwater Benchmarks and Monitoring Results Tntnl PVPnt rninfnll P . FiXntn .ri«ti..,,.e .r,;....,,.;, 9
Outfall No.
Sample Collected,
mo/dd/yr
TS5,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
I Fecal Collform ,
Colonies per 100 ml
Enterocoai ,
Colonies per 100 ml
Benchmark
-
100orSo
Within6.0-9.0
120
30
1000
Soo
4
i
�
-70
nnl/ U
vnry appues m iduunes that use/process meats.
rThe total precipitation must be recorded using data from an on -site rain gauge.
i For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Q yes Vo
Part B: Vehicle Maintenance Area Monitoring Results: oniv fnr facilities averapinp > SS Rol of nP.., ,.il /..., -+k
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
PH,
Standard units
New Motor Oil Usage,
Annual average gal mo
Benchmark
-
30
100 or 504
6.0-9.0
�nry dppues .0 iduuuen mar use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
IVED
9 2019
CENTRAL FILES
DWR SECTIOM
(if ves, complete Part B)

`FOR PART AAND PART B MONITORING RESULTS:
Y A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES LONO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? VES ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Dischorge" reports, within 30 dnVs of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANV 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)
/D-3/-lg
(Date)
Additional copies of this form may be downloaded at: htt portal.ncdenr.org/web/wn/ws/su/nodesswittab-4

HCDENR
Stonnw2ter Discharge ®utiFall (SDO)
Qualitative Monitoring Report
For guidance onfilling out thisfonn, please visit: hop://portal.ncdenr.orJweb/wq/ws/.u/npdcssw#ia[34
Permit No.: N/C/_
Facility Name:
County: I
County: gr
Inspector: TFFE
Date of Inspection:
Time of Inspection:
or Certificate of Coverage No.: N/C/G/-S-/fpf,Q/jA/V-1y1
Total Ev.,E ent Precipitation (inches): © NO Pt,; -ehm4 Was this a Representative Storm Event? (See information below) ❑ Yes ERNo
Please cheek your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
a
or Designee)
3. Outfall Description:
Outfall No.
Receiving Stream:
Structure (pipe, ditch, etc.) 01g
Describe the industrial activities that occur withi:i the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark)_as descriptors: q//14
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): I /V hp
Page I of 2

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
! 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5 A11
6. Suspended Solids:; Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extmmelymuddy:- J
1 2 3 4 5• ', N14
7. IS there any foam' in the stormwater discharge? Yes No
B. Is there an oil sheen in the stormwater discharge? Yes No Nl A
9. Is there evidence of erosion or deposition at the cutfall? Yes No
10. Other Ob-nous Indicators cf S1c=ater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or eresion/deposition may
be indicatiye of pollutant exposure. These conditions warrant further investigation.
Pale 2 of 2