NCG060339_MONITORING INFO_20190430

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/`/
DOC TYPE
❑HISTORICAL FILE
V MONITORING REPORTS
DOC DATE
❑ �n � � � 4 3�
YYYYMMDD

Form S
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT ��������
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted -\ Zs APR 3 Q
CERTIFICATE OF COVERAGE NO. NC 0 O Q Q 3
FACILITY NAME _ J t r,1 ors Y" t i-""'
COUNTY w+'cr,�
PERSON COLLECTING SAMPLES iZ2asc. qY
LABORATORY.i Lab Cert. # i o
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2C,� c[
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES NNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Totol event rainfall 1 or N No discharge this period3
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
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0 — 9.0
120
30
1000
500
t�
33
L4`f
S
3
g
za
►
i
c
APR 3 0 ZU
Only applies to facilities that use/process meats.
ZThe 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
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results; only for facilities averaging > 55 gal of new motor oil/month.
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 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
ZThe 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.
(ifyes, complete Part B)
S WU-249 Last Revised. October 18, 2012
Page 1 of 2

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted LAI25 1 kc.
CERTIFICATE OF COVERAGE NO. NCG06 O _L2 Q _2 SAMPLE COLLECTION YEAR Z.o�E� —
FACILITY NAME ��.,, g� s a�Mcs�s FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY \,k❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES _ c�-r Elks DISCHARGING TO SALTWATERS? ❑YES ®NO
LABORATORY T_-Q 1 eopmem,x 1 Lab Cert. # to
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfafi z or RNo discharge this period'
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
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 -- 9.0
120
30
1000
S00
431i4
1
1.
3L)
4.
Aj 131 1 rt
2
1 Only applies to facilities that use/process meats.
2 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
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 SO
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
Z 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.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page I of 2

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 DM& 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 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."
{ot
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http:/Iportal.ncdenr.org/web/wq/ws/su/npdessvv#tab-4
SWU-249 East Revised: October 18, 2012
Page 2 of 2

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for -North Carolina Division of Water Quality General Permit No. NCG060000
REDa ct submitted
CERTIFICATE OF COVERAGE NO. NCG06D Q (_ fD OCT 2 9 201$
FACILITY NAME jir4S_ Jc"ba§
COUNTY ,ing,vah .GbtiJt� UECT1C�,ti
PERSON COLLECTING SAMPLES r- tri K A,ld,d-,
LABORATORY izo a,,t 1. TALC, " Lab Cert. fl r D
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR pG-obQr Z01 $
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal f is/byproducts
DISCHARGING TO SALTWATERS? ❑YES ❑✓ NO
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Total event rainfall z. z or ❑ No discharge this period'
Outfall No.
Sample Collected_ ;',
trio/dd/ r
`,TSs;'
-.m L
pH,
Standard�units
COD,
m /L
Oil end Grease,
m S/L
',Fecal Conform ;
Colonies,' a 100'mI
Enterococdl, .
Colonlest er 100 ml
Benclimai-k
-
:100.6r 50.
Within 6:0'= 9:0
120.
_`.••'1000.1 _
'=:500-
10 16 !9
1
72.
L1
<S
1 Only applies to facilities that 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.
°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 ❑ no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfell No.
Sample Coliei ed; "`
_
riio%dd/yr
0[I and Grease,
,,.
mg/L
'TSS,
mg/L
' "pH,
-
Standafd,u'
IVew MotorOil Usage,
.Arinuai'averagega.1/mo
B6KCKhi6rk
30
166,- �t0.
1 Only applies to facilities that use/process meats.
2 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.
S WU-249. Last Revised: October 18, 2012
Page 1 of

4Sc1- Ge offal I'+:r rlliI 1+:H1, 3, 0+:11111y6p, tlu: +:sp(clally Sons Itivc r+fctJVIIIV w�U+:c ck Issi I ic;l I Io Iv. wht:r+: tlu: Iiorr. I)ro14!dWe tx:nciunar k appIies.
'FOR PART A AND EAfll Q 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 arl ina! and one copy of his MR Including all "No D! r e" LiWprts, within 0 da rec 1 t of the lab results Lot at end o
monitdting Period Mn the case of "No Discharge" reports) -t :
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 al! 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 of Permittee
10 20
(Date)
Additional copies of this form may be downloaded at: http:lbortal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S WU-249
Last Revised: October 18, 2012
Paget oft

E@w'nRE(PM % hmpumUd
114 OAKMONT DRIVE
GiREENVILLE, N.C. 27858
JUMBOS JUMBOS, INC.
P.O. BOX 465
EDENTON ,NC 27932
Sp
Analysis
Method
PARAMETERS
Date Analyst
Code
PH {not to be used for reporting)
7.7
10/16/18
JTH
4500HB-11
COD, mg/I
24
10/19/18
SEJ
H8000-79
Total Suspended Residue, mg/l
18
10/18/18
JMH
2540D-11
Oil & Grease (,HEM), 1119/1
<5
10/16/18
SU
1664B
PHONE (2,52) 755-32',p
FAX (252) 756 OE -3
ID#: 1011
DATE COLLECTED: 10/16/18
DATE REPORTED : 10/19/18
REVIEWED BY: Z�0�

-lln ronment 1. Inc. CHAIN OF CUSTODY RECORD
P-O. Box 7085, 114 Oakmont Dr. Pace 1 of 1
Greenville, NC 27858
environment I inc.rorn
Phone [phone] • Fax [phone]
DISINFECTION
CHLORENE NEUTRALIZED AT COLLECTION
CHLORINE
Ij
�,�
z'
pH CHECK (LAB)
CLIENT: 1011 Week: 1
Ij 1; v
P
P
P
G
CONTAINER TYPE. PIG
SOS RJNfBOS, INC.
❑ NONE
.O. SOX 465
CHEMICAL PRESERVATION
:DENCON NC 27932
A
C
A
C
- NONE D - NAOH
z
oLnA
C5 Z) 482-2193
=
B - HNO, E - HCL
Q
z
RC
O
cc
C - H,SO, F - ZINC ACETATFJNAOH
w
COLLECTION
� -a
�o o
' 6
a
w
c
c
QV
a
h
O
¢ G - NATHIOSULFATE
Cr
a
SAMPLE LOCATION
DATE
TIME
m
CLASSIFICATION:
I� WASTEWATER(NPOES)
sx ?
w
DRINKING WATER
❑ DYY{aW
ID /6 I q
3.
Sample #5
SOLID WASTE SECTION
sEs4
wean
nroo-!q
a
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING S IPMENTlDELIVERY
Y N
SAMPLES CTED BY:
(Please Print)
pa, ffir-K /V,ue`r5
SAMPLES RECEIVED IN LAB AT = �_ qC
RE U&EID R)
TEITIME
R
EO BY (5
OATE110
COMMENTS:
�4�:ATE
RELINQUISHED BY (SIG.)
DA'MMME
RE6KED $Y SIb.
DATEMME
RELII`WSHE0 BY (SIG.)
DATEMME
RECEIVED BY (SIG.)
DATEMME
PLEASE READ instructions for cumplefinq this town on the reverse side.
roHM for,
Sampler must place a -C" Ior cornposile sample or a "G" for
Grab sample in,hfb biocks srbovu for each parameter requested. NO 359844

r4
Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
UC (ji O6 0337
Date submitted
CERTUICATE OF COVERAGE NO. NCG060 C a
FACILITY NAME i t ti /r--
....�r._r
r'
COUNiY _�L1owr, n. v L—LJ
, ..
PERSON COLLECTING SAMPLES _ ci�`/i , ide r; g nCT_ 9 9 ma
LABOFaATORY Lab Cert. 0 10
DWR SECTION
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 9016
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? []YES ZNO
PLEASE REMEMBER TO SIGN ON THE REVERSE --�
Totol event roinfa117 5" or ❑ No discharge this period'
Outfxll No.
;Sample Collected,
mo/dd% r
TSS'
rri L
pH,
Standard units
COD,
m L
Oil grid Grease;
in L
Fecal Culiform ,:
colonies' er'100 ml
Enterococcl.,
• Colonles. eelo0.mi
Berich6ark
100'oi,50, Y,
_-Withln,b:0-.9.Q `
120 .
80''
.`
' S00
>
1g 16'30
7.
3
2
q h $ 1
Z4
3
9 15 16
1
70
ZZO
47
14
18 tg
LZO
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.
°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 [:]no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
SampleCollected,
h dd/yr
0ifand Grease,
mg/L
TSS;
mg/L
H' `
Standard units
New.Motor OII'Lisage,
Annual average gal/mo
Berichmark
-
30
JAO'ar 50
.6OY-.9:0
Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at anv outfalls, you must still submit this discharge monitoring report with a checkmark here.
SWU-249 Last Revised: October 18, 2012
Paoe 1 nf7

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06
FACILITY NAME _,1rsJej ,&75
COUNTY Chowon,
PERSCaN COLLECTING SAMPLES P+.4rlGk Mu1r�c,;U
LABOMATORYGvjropion•1 _/„G Lab Cert.l# 10
Part A; Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Seft44 1 b4f, .- ZU 15
FACILITY ACTIVITIES INCLUDE (c ieck all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? []YES [3h0
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rain al! 1 5a or 0 No dlschor a thisperiod'
Outfall'N6:
= ' 1
:Samlile Collected,
rrto/dd/ r
TSS;
m L
tpH,
Stande�d units
COD,
m L
Oil and.Grea-se,
m ' L
Fecal Collform ,
Colonles er 100ml
; U teiocacci. ,
Colanleiper 100 ml
Bencti6 'rk
100 or,S0
,Wlthih 6A - 9.0
120 '
''30
;'S00
6-
9I 1s
38
>
42o
6
7
s 1
1 °S
s
p
4 5
' Only applies to facilities that use process meats.
2 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oll/month.
Ouifa"ll'IVo.
Sample Collecteii,
ino/dd%yr.
Off and Grease; '
mg/L
TSS;
rrig/L
Standard units
N6VK46t6i Oil Usage,
_
Annual average gal/ino
8erichmark
30
100 or 50:
6.0 =,9.0_
, • _
' Only applies to facilities that use/process meats.
Z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at �jny outfalls, you must still submit this discharge monitoring report with a checkmark here
(if yes, complete Part B)
S WU-249 Last Revised: October 18, 2012
Pape 1 of 7

4icr7 Genrr;I1 1'r,111111 WKI, ]MA.- 3, Irir:nfifying tItr. rafu:rialIy wlrsIIivr: rr:c:eivlIIV. water riassificatirrn•. what: the r oie pioti:c:tivo berichrnark aI]pllca,
'FOR PMT AND PART 0 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT DART II SECTION B.
• 7 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART it SECTION B.
• 7IER 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 DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
M 11 an orl lnal and gae copy of this DM& In ludin all "No Discharge" a orts w1th1n 30 dareceipt of the lob Lesults or at end Qf
1non1tofing period In the case o "No Discharge" s o:
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
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 of Permittee)
Cf l�
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tabb_4
S WU-249
Last Revised: October 18, 2012
Page 2 of 2

prinking water Ip; 31715
wastewater ID: `16W
Or.Kh:1,0,N' i DRIVE PHONE [phone]
GREENIVILL-, N.C. 27858—_ _ _ y -. _� . 1 w _. FAX (252),756-0633
ID#: 1011
JIMBOS JUMBOS, INC.
P.O. BOX 465
EDENTON ,NC 27932 DATE COLLECTED: 09/18/18
DATE REPORTED : 09/21/18
REVIEWED BY•
Sample
Sample
Sample
Sample
Sample
Analysis
i lethod
PARA:N[ETERS
#1
#2
#3
#4
#5
Date Analyst
Code
PH (not to be used for reporting)
7.0
7.4
7.0
7.0
7.2
09/18/18
KDS
4500HB-11
COD, mg/1
36
20
<20
<20
<20
09/21/18
SE.1
H8000-79
Total Suspended Residue, mg/l
30
<4.2
21
25
143
09/19/18
JMH
25401)-11
00 & Grease (HEN1), mgfl
<5
<7
. <7
<6
<6
09/19/18
S U,
1664B
r Z
aj iJ« 1 ed
Alz� Saop !� 5
K, `P�1
C-00 T5R o�1, 6�e-)
G��l�,�� /Z7/f S@ 2 03 PM
5�.MID � K14 bifva cn,-- lot il3,
nif !o 161tK
�.nvc5 CL,
1Q� ��23'►g Na �G,ti�
c�
J
A,� JJ 136 Mary aT
lY0 ��[rSio�, f � u�.;�c� rc. ,r- �✓a5 ro�cc�� �.�, Sw;r�r'���
b-na �`"�5,iSadt r�iq�.rl
f n Le 5
` 1G !•*15
� C{rti j� J[� rl f I 'r
r&,. !S ro 51Go— Q�eoloSf-o1'', �t5PCC It"1 t�e.WIA]" $�1� ��ICS LAle (�

Gpmx, % hg@Tvw@ftd
Drinking Water ID: 37715
W0. �8tew0.t er ID:�10
114 OAKMOiNT DRIVE PHONE [phone]
GREENVILLE, N.-C. 27858 _ FAX (252) 756_0633
ID#: 1011
JIMBOS JUMBOS, INC.
P.O. BOX 465
EDENTON ,NC 27932 DATE COLLECTED: 09/18/18
DATE REPORTED : 09/21/18
REVIEWED BY:
Sample
Sample
Analysis
Method
PkRA,N=FRS
#6
#7
Date
Analvst
Code
PH (not to be used for reporting)
7.5
7.5
09/18/18
KDS
4500HB-11
COD, mgA
<20
<20
09/21/18
SEJ
H8000-79
Total Suspended Residue, mg/i
38
15
09/19/18
.TMH
254OD-11
OR & Grease (FIF- ), mgA
<6
<5
09/19/18
SEI
1664B

I?nvri'raIinunllC-VAIN 014'(:IJtiTODY Rf"CC)RD
1'.O. J.it,.\ 7095, E I-1 {?akrn„nt llr,
envirorrmcrttIin,:.Ellin
I)rNINE-'fa."I'] IN
CHLORINE NEUTRALIZED AT COI,LECTIC�N
11ionc ('wi2) 750-0208 • F'ax (2521) 75r,-mO.i
{�lil..f>LINIi
CLIENT: loll Week:I
la
h�
pHCHECK (LAB)
Q tiv
CONTAINER TYPE, PIG
IMBOSJIJNILDDS, INC.
� N{)N17
`.O. BOX 465
CHEMICAL PRESERVATION
,DEN7'ON NC 17932
A
C
A
C
Cn A -NONE D-NAOH
i
c5
252) 482-2193
z�
u
-
w
t B - HNO, E - HCL
C'p
x
¢
c
cc
w C HzSO, F -ZINC ACETATE/NAOH
COLLECTION
o Qa
a
t
gym:
a
q
O
�7
O
< G - NA THIOSULFATE
cc
SAMPLE LOCATION
DATE
TIME
Sample A`1 i;
j
5
CLASSIFICATION:
WASTEWATER (NPDES)
DRINKING WATER
Sample N2
(�
`I !�
r q
D' GG
3
1 `V
?=
Sample 113
3''S•.
{f%°'
�>M
'�
g
n
Sample #4
3OMNI
,':
�'•;
3
Sample N5
SOLID WASTE SECTION
�. `T 5/
Sample #6
3
A
V
3
:.;:..:.x
is>xi%
CHAIN OF CUSTODY (SEAL) MAINTAINED
Sam ple N7
! j
CI
`"''
DURING SHIPMENT/DELIVERY
N
SAMPLES COLLECTED BY:
(Please Print) rr II
SAMPLES RECEIVED IN LAB AT L _ °C
RELI OUISHED Y (SIG.) ( MP ER)
DATEJTIME
RECEIVED BY (SIG.) _
DATUnME
COMMENTS:
RELINQUISHED BY {SIG.}
DATErnME
RECEIVED BY (SIG.)
DATErHME
RELINQUISHED BY (SIG.}
DATEIf1ME
RECEIVED BY (SIG.)
DATE/T1ME
PLEASE READ instructions for completing this form on the reverse side. Sampler must place a "C for composite sample or a "G' for
FORM #5 Grab sample in the blocks above for each parameter requested, N G 361081

From: Jimbo's Jumbos
185 Peanut Drive
Edenton, NC 27932
[phone]
Re: Testing Error —Storm Water
To Whom It May Concern,
October161", 2017
NC6--d6-0'3'37
It is believed that Sample 7 (a!so denoted as 4C in our storm water maps) has been subject to a testing
error. Visual records written at the time of sample collection show that fish and frogs were viewed in the
immediate area to where the sample was taken and in many instances were actually attracted to the bottle
involved in sampling as it was being filled. A PH of 1.9 is between (for simplicities sake) battery acid and vinegar —
neither of which would be conducive for life.
In addition, sample 7 (4C) is opposite the pipe from which sample 4 is collected. Sample 4 and sample 7
testing sites are roughly 10 feet apart, and the water is contained within a drainage pipe, meaning that there is
minimal opportunity for the downstream sample to be contaminated.
Due to the physical location of the sample site in its relation to other samples, and that fish and
amphibians were witnessed at the time of sampling, it can only be concluded that sample 7 was an erroneous
result.
Sincerely,
Jimbo's Jumbos
O C T $ 2017
pW R�L FILES
CT -ION

U -19 01If @ 1-idRIOT- L
Waotawatar ID: 10
P.J. BOX 7085. 114 OAKMON� DRIVE
PHONE [phone]
GREENVILLE, N.C_27835-7085 - . ,_FAX [phone]
.. r._. _ _. 1- -._�_ _ .. ..�..tlx.. _- .. ..__.� .�
JIMBOS JUMBOS, INC.
P.O. BOX 465
EDENTON ,NC 27932
ID#: 1011
DATE COLLECTED: 09/26/17
DATE REPORTED : 10/05/17
REVIEWED BY:
Sample Sample Sample Sample Sample Analysis Method
PARAN ETERS #1 #2 #3 #4 #5 Date Analyst Cade
PH (not to be used for reporting) 6.9 7.5 7.3 7.5 8.0 09/26117 BNC 4500HB-II
COD. mg/1 108 27 34 61 28 09/27117 SEJ H8000-79
Total Suspended Residue, mg/ 28 9.3 56 15 12 09/27117 KAC 2540D-II
Oil & Grease (HE11), mg/1 <5 <6 <5 09/28/17 SEJ 1664B
Oil & Grease (HEM), mg/1 <5 <5 10/04/17 SEJ 1664B

�ii3�Ylllf �� ffll Cfi11 � � i�G®QpOQa�C�d
P.O. BOX 7085. 114 OAKMONT DRIVE
GrREENVILLE,_N.C. 27835 7085z—"Z.,_ . _ � .�--_
JIMBOS JUMBOS, INC.
P.O. BOX 465
EDENTON ,NC 27932
PA RA \ LETERS
PH (not to be used for reporting)
COD, mg/1
'Fatal Suspended Residue, mgll
Oil 8: Grease (HEM1i), mgll
Drinking Water_ID:_37715
Waa tewater ID: �10
PHONE [phone]
FAX [phone]
ID#: 101.1
DATE COLLECTED: 09/26/17
DATE REPORTED : 10/05/17
REVIEWED BY:
Sample
Sample
Analysis
Method
#16
#7
Date
Analyst
Code
8.3
1.9
09/26/17
BNC
4500HB-11
27
38
09/27/17
SFJ
H8000-79
24
700
09/27/17
1tAC
2540D-11
< 5
< 5
10/04/17
SEJ
1664B

I.IIIC. CIIAIN {)I+'(.r1.1ti'I'0I)Y RF('f)IL!)
P0. BOX 701,5, 11.1 I ):,kmiml I ):• I',k„r I "! L--
GTC�ew,,:IIC. 10 • 27X�K
envirun�nrit it i n.,,,, i
Phimr (25217:;r,-r,,'lli • I rig I`'5) 715r,4403
I �I tir,ti l l is "r'I(�ti
Cl LOPINL NE:UTHALIZE€_) Al COLO'C, I ION
C'lIL(.1ltfNI;
L
.
I,1ICHFCK(LAB)
CLIENT: I o i I %Veek:I
I IV
CONIAINER TYPE. PIG
JIRI130SJUi�1KOti, INC.
( Nlf,'�fi
P.O. ROX 46
l
I,
1,
h
(�
CHEMICAL PRESERVATION
EDG;r'"1'U\ KC 27932
A - NONE D -NAOH
o
[phone]
t=
w
--j
`
+•
_
�
�L H - HNO, E - HCL
W
0 p
o
cr
U
z
5
C
�^,,,
F"- C- H,SO, F- ZINC ACI:TATI:/NAQH
LLJ
COLLECTION
7
o0- p
¢
G
0
G - NA THIOSULFATE
SAMPLE LOChT€ON
DATE
TIME
Sam Ile 1
Cf% I
1�! j7
}`r
z
CLASSIFICATION:
WASTE�lVATER(NPDES)
Sample #2
yl16117
l 7
3
J�
Sample, #3
l2410
DRINKING WATER
/
qht! q
! q
! y
f
3
�DWQ/GW
C�IL,/� j
1 : �G
::
Ea
9
!
3
SOLID WASTE SECTION
'4117
Z;'�
3
.<:
>=
Sample #7
�1za11
?
Z' ZD
CHAIN OF CUSTODY (SEAL) MAINTAINED
3
DURInyPMENTIDELIVERY
N
SAMPLES COLLECTED BY:
(Please Print)
SAMPLES RECEIVED IN LAB AT "- —OC
RELINQUISHED BY (SIG.) (SAMPLER)
P,41,,C, /if�I�Or,e
DATEMME
' �Z n I q-n 3
RECEI BY (SI
(-2��/'
ATE/TIME
V/�
COMMENTS:
RELINQUISHED BY (SIG
DATFJTIME
RECEIVED BY ( .
DATEfrIME
RELINQUISHED BY (SIG.)
DATEf11ME
RECEIVED BY (SIG.)
DATEMME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G for N0 337005
FORM ns Grab sample in the blocks above for each parameter requested.

I. Outfall Description:
Outfall No. _—_q Structure Cpipe, ditch, etc.) t
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
Clight, medium, dark) as descriptors: C�
3. Odor: Describe any distinct odors that the discharge may have (Le., smells strongly of oil,
weak chlorine odor, etc.): C le'. r
4. Clarity: Choose the number which best describes the clarity of the discharge, where k is
clear and 5 is very cloudy:
U 2 3 4 5
5. FIoating 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:
0 2 3 4 5
G. 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 8No
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes DNO
10. Other Obvious Indicators of Stormwater Pollution:
List and describe L o' s o f r�nno�✓ S. oci 5
Note: Low clarity, high solids, and/or the presence of foam, Oil sheen, or eroslaIl/depo51d011
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2of2
SWU-242, Last modified 7/31/2013

1. Outfall D cription:
Outfall No. � Structure (pipe, ditch, etc.)
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: Iejc.—
3. Odor: Describe any distinct odors that the discharge may have (i.e_, smells strongly of oil,
weak chlorine odor, etc.): GIcG
4. CIarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy: /"�
( 1\ 2 3 4 S
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:
0 2 3 4 S
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:
0 2 3 4 5
7. is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes No,
9. is there evidence of erosion or deposition at the out#all? Yes oNo
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 0s ct' ,,,,,c>'
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 f irther investigation.
Page 2 of 2
SWU-742, Last modified 7/31/2013

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06_ _
FACILITY NAME JA,,6as
COUNTY Ck-.+o^- r ,
PERSON COLLECTING SAMPLES I irrc r� /�NInJ`��j
LABORATORY t-,i1 "^ f !�­ Lab Cert. # 011
�Pcenv<11C /VG
Part A: 5tormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2017
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ❑NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z or ❑ No discharge this period?
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 504.Within
600 — 9.0
120
:30
1000
500
I
Z17
6, q
/off,
Z_ 5
Z
9.3
7 S
27
[ 6
3
56
. 3
3`4
L7
t '5
-7 t5
61
;
5
1 Z
90
Z 9,
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at qny out€alls. 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 ❑ no
Part B: Vehicle Maintenance Area Monitoring -Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfal! No.
Sample Collected,
mo/dd/yr
Oil _and. Grease,:
ring/L
.TSS,
mg/L
pH,
Standard units.
New Motor. Oil Usage,
Annual average gal/mo
Benchmark
-
30.
100'or 50
6.0 - 9.0
-
Only applies to facilities that 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.
(if es, complete Part B)
S WU-249 Last Revised: October 18, 2012

Form 8 Z
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06_
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Part A, Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? [—]YES ❑NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Totol event rainfall z or ❑ No discharge this period3
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
. Enterococci , .
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6.0-9.0
120
30
1000
500
6
9. 3
21
z 5-
7
70o
1.
3 g
.57'
I Only applies to facilities that use/process meats.
ZThe 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B:-Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
- Outfall No. -
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
-TSS, -
mg/L
-pH, ':
Standard units "
New Motor 011"W6ge,
'Annual'average'gal/mo
Benchmark
-
30
100 or 50
6.0 - 9.0
-
Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at qny outfalls, you must still submit this discharge monitoring report with a checkmark here.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
pane 1 of

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06SAMPLE COLLECTION YEAR 20/7
FACILITY NAME Jimbo'S t"b03 RE FGA611fIT�Y CTIVITIES INCLUDE (check all that apply):
COUNTY t1�n�✓an, se/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES JA 6151CPArAllING TO SALTWATERS? ❑YES ONO
LABORATORY Lab Cert. # CENTRAL TES
DWR SECTICPLIEASE REMEMBER TO SIGN ON THE REVERSE -�
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 or ❑ No discharge this period'
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
Enterococci .,
Colonies per 100 ml
Benchmark
-
100 or 50
within 6.0 -- 9.0
120
30
1600
500
1
113 1
0"6
6.
Z 6
5
3 17
12
7
Gh
3
1 3117
G
6.6
ZZ
1/5'
y
113117
3
.2
z2
LS
1/3I17
73
7- Z
ZO
L
1 Only applies to facilities that 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 outfalh. 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 ❑ no (ifyes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 teal of new motor all/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and,C-4ease,
mgjL
755,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30.
100 or 50
6.0 - 9.0.
-
Only applies to facilities that 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.
RECEIVED
JAN 18 2017
CENTRAL, FILES
OUJR SECTION
S W U-249
Last Revised: October 18, 2012

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06�
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ❑NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 or [] No discharge this perio?
Outfall No.
Sample Collected,
mo/dd/yr
- TSS,
mg/L
pH,
Standard units
COD,
mg/L.
Oil and. Grease,
mg/L
Fecal Col€form ,
Colonies per 100. ml
Enterococci , .
Colonies per 100.ml
Benchmark
-
100 or 50
Within 6.0 - 9.0
120
.30
1000
500
1/3/17
60
-2.'
21
L5
7
)/ 3/i7
y6
• 3
3 Z
G s
Only applies to facilities that use/process meats.
2 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B, Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 eal of new motor oil/month
Outfall No.
Sample Collected;
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil'Llsage,
Annual average'gal/mo
Benchmark
-
30
100 or 50
6.0"= 9.0
-
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 a,Ry outfalls, you must still submit this discharge monitoring report with a checkmark here.
(if ves, complete Part B)
SWU-249 Last Revised: October 18, 2012
D ­ 1 ., f"I

°See 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 11 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 orlginal 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 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,wrtYuding the possibility of fines and imprisonment for knowing violations."
(Sigriature of Permittee)
I 13 125
(D te)
Additional copies of this form may be downloaded at: http.,//­portaLncdenr.ory wel)%wq/ws su nl (Iessw#tah- l
S WU-249
Last Revised: October 18, 2012
Page 2 of'2

F'U:�:C30X74S5 ;i�T 4�K��1JIVT:C��IVE
.`G REENV11'CE, :Wc.7278,- 5.708
JIMBOS JUMBOS, INC.
P.O. BOX 465
EDENTON ,NC 27932
PARAMETERS
PH (not to be used for reporW:g)
CUD, :nglt
'total Suspended Residue, mgll
Oil & Grease (HEM), n:gll
E
ID#: 1011
DATE COLLECTED: 01/03/17
DATE REPORTED : 01/06/17
REVIEWED BY:
Sample
sample
Sample
Sample
Sample
Analysis
MOW
#1
#2
#3
#4
#5
I}nte
Analyst
Code
6.5
6.7
6.6
6.2
7.2
01/03/17
KKR4
45001 B-00
28
27
22
22
20
01/05/I7
SlU
H8000-79
8.6
12
6.5
38
73
01/04/17
MAR
254OD-97
<5
<5
<5
<5
<5
01/061.17
SEJ
1664B
0jIvI.
�v o�'
pl,
C110{
CD
�1'

°
GRE1 fl ILLE I!`:C' 27835 7085
JIMBOS JUMBOS, INC.
P.O. BOX 465
EDENTON ,NC 27932
sample
PARAMETERS #6
PH (not to be used for reporting) 7,3
COD, mg[l 21
'rain] Suspended Residue, mg/1 60
Oil & Grease (HER-1), mg/l <5
A X-" (252) .756
ID#: 1011
DATE COLLECTED: 01/03/17
DATE REPORTED s 01/06/17
RHVI$WED BY
Sample Analysis Method
#7 Date Analyst Code
6.3 01/03117 KKAI 4500HR-00
32 01/05/17 Sl,d B8000-79
46 01/04/17 AFAR 254OD-97
<5 01/06117 SEJ 1664B

-TT
I NO F (--U! S.1.() D D
0 'J-0FW-iE NEU1 Ti.-ALIZED Al WiLLECTiot"i
ion Week: I
pH
JEMBOS SUMBOS, INC.
P.O. BOX 465
EDENTON NC 2793:2
P
A
P
C
P
A
G
C
C i, i F-10 i Q A L P R L.'� F 9 \4AT i Crf, i
[phone]
B, iiN,0. L
GOL LE(: 'T%,
SAMPLE LCCATUi DATE ItLAE-
Sample #1 q,67-)
I c,
's i
L—T
T --L--
�i
CLASST IC;' 10N, II
Sample #2 3 'r7CI.'O -�f
Sample #3
jm Sample #4 q,
3
3
3
.
. . . . . .
.
. . . .
IJ
R I i i N G'NATL P.
Sample #5
7q:35
Sample #6
Sample #7
3
.-L&JED UIV,
Ft
-)AMPLEti R.ECER. ET) 1N [AR,;T
UY 18W" (SAWR' ER) DAI E,-'
: 7,1
T
nmc
Iizzl
q-6-!5
q
U'LiNQUI-SHEU RY ISIGA �Ai E; �!.ME
foic.1
!]AHEIAME
E-C,
e a fL L0 11)0-si to 52.rnpl 0 0: G" Ic r Savlpl,�( 1,wj�l C
PLIA"H RFAD i0f 011-19�0111) 1111� io!!It Lill th" :cvu�tl S!
F-00M V:, I — ...— Grab sawple in �il , ali"NO No— 329301

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted u -ZI-16 lh/ 2 12016
CERTIFICATE OF COVERAGE NO. NCG0603 �l
FACILITY NAME Jimb0'S Jumbo T
COUNTY _C:howaPV
PERSON COLLECTING SAMPLES _ li7G,� Cf Q k _ A41C & P
LABORATORY EAvi#V-6 +f_!L _ Lab Cert. # 1011
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2016 CENTRAL FILES
DAIR SECTION
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? []YES [:]NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 or ❑ No discharge this period3
Outfall No,
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,-
mg/L
011 and Grease,
mg/L
Fecal Coliform ,
Colonies per 100.m1 1
Enterococci ,
Colonies per 100 ml
Benchmark
-
100 or 50
Within 6:0-9.0
120
30
1000
500
1
14-y- IG
141
A.7
142
41!7
Z
-w-
4.6
36
C.rs
3
Il-L4-16
3.-7
-7.0
Cd
e-
�{
i t - N - ► 6
I $ FS
b . t
!z
<
I'f-y- !d
lib
61V
Z7
<
1 Only applies to facilities that 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.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark S.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
I TSS,
mg/L
pH,
Standard units
New. Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0'-0.0'
-
Oniy appnes to taaEities that use/process meats.
2 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
CaPiN TINe o.,t a,
S W U-249
Last Revised: October 18, 2012
n-_- i _rl

4

Form S
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06_
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS?. []YES []NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 or ❑ No discharge this period'
Outfall No:
Sample Collected,
mo/dd/yr
TSS,
mg/l.
pf-t, ,.
Standard units
COD,
mFZLe
. Oil;and'Greaset
mg/L
Fecal_Coliform!;
Colonies per i00 mi.
Enterococci-, ;
Colonles.per160 ml
Benchmark
-
100 or 50
Within 6.0 - 9.0
120
30
1000
50o
11-4-16
1-7
7.6
ZZo
4s
1- L4-/6
2 9
G 7
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
a 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 ❑ no f to Part B)
rd,
IAL
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease;
mg/L
TSS,
mg/L
pH,
Standard units_
New,Motor Oil Usage,..
An.nual'aVerage;gal/mo
Benchmark
-
30
100 or 504
6.0 =- 9.0
-
Only applies to tadimes that use/process meats.
2 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.
SWU-249 Last Revised: October 18, 2012
Dona t -P'f

°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
*FOR PART A AND PART 8 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 on inal and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results Lor at end o
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 Cow
18ENT141
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, includi irthe possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
l/-i</"�-'��
(Date)
Additional copies of this form may be downloaded at: htlp-//portal.ncdenr.orplweb/wq/ws/suLnpdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2

Form 8
:MI -ANNUAL. STORMWATER DISCHARGE MONITORING REPORT
North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
RECEIVED
DEC 2 9 . ,
CERTIFICATE OF COVERAGE NO. NCG06 _ SAMPLE COLLECTION YEAR CENTRAL FILE;"
FAClLITY NAME J+,nbo'S__ Ju•4 bo5 T `F� CILIFI( ACTIVITIES INCLUDE (check all that apply):
�V► r SEC 71r,-
COUNTY owo~ II�I� EK /W1 use/process meats [:]use animal fats/byproducts
PERSON COLLECTING SAMPLES Pcjv,1rK M!jLlir � �r DISCHARGING TO SALTWATERS? ❑YES ❑NO
LABORATORY ^Lab Cert. 9
Ci~Iv i 'rzG, . ;• ?LEF. PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Totol event rainfall z or Q No discharge this period"
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
m L
pH,
Standard units
COD,
mg1L
Oil and Grease,
mg/L
Fecal Collform,,
Colonies per 100.mI
Enterococci 1,
Colonies per 100 ml
Benchmark
-
100 or SO4
Within 6.0 -- 9.0
120
30
1000
500
I Z -6 -1
3Q
7 I
L.s
17-- 6-16
IO
H3
L r
12 . -16
.S
.q
314
1
IZ-6-16
1q
7.5
Z-7 1G
IZ-b.I6
y.
<5
Only applies to facilities that use/process meats.
z 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
'Outfall No.
Sample;Collected,
mo/dd/.yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units.
New Motbr Oil Usage,
Annua! average gal/mo
Benchmark
30
100.`or 50
6.0..- 9:0',
` Only applies to facilities that use/process meats.
zThe 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.
(if yes, complete Part B)
SWU-249 Last Revised: October IS, 2012
pnrta 1 of

a
P
�
3
i
L
L

Form 8
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCGO6��, _
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? OYES []NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall a or ❑ No discharge this perrod3
outfall No.
Sample Collected,
mo/dd/ r
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
-MELL
Fecal Coliform;,
Colonies per 100 ml
Enterococcl ,
Colonies per 100 ml
Benchmark
-
106 or 50
Within 6.0 — 9.0
120
30
1000
Soo
A0 6.6
36
LS
1 Only applies to facilities that use/process meats.
2 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B;.Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.'
Sam_ ple.Collected,
mo/dd/yr - .
Oil:and Grease, ..
mg/L
TSS,
mg/L
PI; ;
Standard units.
New IVEotvf •Oila3sage�. .
'.Annual`average'gal %mo
Benchmark.
-
. 30_
300or.50.
Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at �!ny outfalls, you must still submit this discharge monitoring report with a checkmark here.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
pnvP 1 of 7

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 ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE,DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one coj2y of this DMR, including all "No Discharge" reports, within 30 dais of receipt of the lab results or at end o
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 knooWdge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, inclujdKg the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
121Z 7 1 116
(Date)
Additional copies of this form may be downloaded at: http:LLortal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
5 WU-249
Last Revised: October 18, 2012
Page 2 of 2

7 1
Form 7
STORNINVATI:R DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERA9IT NO. NCGO60000 SAMPLES COLLECTED DURING CALENDAR YEAR: 5
.CERTIFICATE OF COVFRAGE NO. NCG06(This monitoring report is due at the Division no later than 30 days from
f the date the facility receives the t milling results from the laboratory.)
FACILITY NAi1IF s �I� `��C.OUNTYN
G SA
PERSON COLLECTINAII ES V PHONE O. ( )
CERTIFIED LABORATORY Lab 4i
Lab # JAN 2 1 2016 PLEASE SIGN ON "THE REVERSE 4
Part A: Specific Monitoring Requirements
CENTRAL FILES
DWR SECTION
Outfall
No.
Date
Sample
Collected,
mo/dd/ yr
00530
00400
00340
00556
31616
Total Suspended
Solids,
m IL
pll,
Standard units
Chemical Oxygen
Demand,
m TIL
Oil and Grease,
nig/L
Fecal Coliform,
Colonies per 100 nil
Benchmark
-
100
Within 6.0 — 9.0
120
30
1000
17. 1
t
L
c�-
O
Note: 1f you report a sampled value in excess of the benchmark value, or ou side the benchmark range for pH, you must implement 'Pier l orVier') 2 responses.
See General Permit text. �Wk4- � l f' m f m yj e� dt 1 63�lw� em �/
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes 2i iio
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Oil and Grease,
m L
Total Suspended Solids,
m L
pH,
Standard units
New Motor Oil Usage,
Annual aversegal/nit)
Benchmark
-
30
100
6.0 — 9.0
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pl-1, you :oust implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM I:VI:NT' CIIARACTERIS'1'ICS:
Date 1,aj;�kfirst event sampled)
Total Even( Precipitation (inches):_.
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
\tail Originaland one copy to:
Division of Water Qualitv
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S1VU-249-102107
Page 1 of 2

0
"I certify, under penalty of law, that i:his 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 systein, 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 es and imprisonment for knowing violations."
(Signature of Permittee) (Date)
S W U-249- ] 02107
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG06 O -;3q (This monitoring report is due at the Division no later than 30 days from
the date the facility receives the s mpling results from the laboratory.)
FACILITY NAME e s COUNTY _C ri vo 1A
PERSON COLLECTING SAMPLES PHONE NO. (_ ) ti 94 - o X�3,
CERTIFIED LABORATORY v�I-L ALab#
Lab # PLEASE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Requirements
Outfall
No.
Date
Sample
Collected,
mo/dd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
pH,
Standard units
Chemical Oxygen
Demand,
m
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmark
100
Within 6.0 - 9.0
120
30
1000
ISAI L
I
5�c
Note: If you report a san1pled vaAle in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 respon ` EC E I f E D
See General Permit text. y
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?— yes _✓no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
MAY 2 2 2014
CENTRAL FILES
DWO/BOG
Outfall
No.
Date
Sample Collected,
mo/dd/y r
00556
00530
00400
Oil and Grease,
Total Suspended Solids;
pH,
Standard units
New Motor Oil Usage,
Annual average al/mo
Benchmark
-
30
100
6.0 - 9.0
-
Nate: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date04 (first event sampled)
Total Event Precipitation (inches): r, J `
+ rk,5
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
At= DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S W U-249-102107
Page I of 2

"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 1�6s and imprisonment for knowing violations."
(Signature 9f Permittee) (Date)
S W U-249- ! 02107
Page 2 of 2

IM
C7
411
[7
' � h; � � STkORMW4�TER�P'" LLUTION;PREVENTION;�P�LAN�Yf' 'F�t �rrfx�;w�
��`'=DEI/EL�PMENTANDIMPL'EMENTATIONr�:� { "'
l+n
t ,F r w tau p 4 7�n y?FF'S uY" 1� - 7 y & 7 i i S✓ 'fi
LRT,Ir 1F ey r p f:
t_�CEFICATiON�1=js�'ri,, �
North Carolina Division of Water Quality - Stormwater Permitting Unit
r
Facility Name: )L J,nt7e-)G
Permit Number: AIC Q7)93q _
Location Address:
MCI a 7GL 3 J---
County: rind 1�y►
"I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all attachments
were developed and implemented under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information required by the SPPP. Based on my inquiry of
the person or persons who manage the system, or those persons directly responsible for gathering the information,
the information gathered is, to the hest of my knowledge and belief, true, accurate and complete."
And
"I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP has been
fully implemented at this facility location in accordance with the terms and conditions of the stormwater discharge
Permit."
And
"I am aware that there are significant penalties for falsifying information, including the possibility of lines and
imprisonment for knowing violations."
Sign (according to perinit signatory requirements),and return this Certification. D0.NOT
SEND STORMWATER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION.
Signature —Ci f�
G- .-/u.a)--) �.r� I�.c��711,✓
Print or type name of person signing above
Date
'title
SPPP Certification S/09