NCG120019_MONITORING INFO_20190318

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
fg, MONITORING REPORTS
DOC DATE
❑ � � �
YYYYMMDD

\�.
Semi-annual Stormwater Discharee Monitorine Report
for North Carolina Division of Water Quality General Permit No. NCG120000
' Date submitted 3' ► 9
:RTIFICATE OF COVERAGE NO. NCG12 0 � 1 q SAMPLE COLLECTION EAR 2 G 14
_
ICIUTY NAME c 1,44, C c+ �[ C i t- SAMPLE PERIOD Jan -June ❑ July -Dec
]LINTY rz ry f n or El Monthly' _ Imonth!
:RSON COLLE NG SAMPLES F v-J R E C E I V E tDISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
1BORATORY v: It i Hewl Lab Cert. # 3-7177 MAR � � 2019 ❑Zero -flow ❑Water Supply ❑SA
imments on sample collection or: analysis: ❑Other
CENTIUkL FILES
DWR SECTION 3 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
'art A: Stormvrater Benchmarks and Monitoring Results
n No discharae this period?z
Outfall
No.
j
f
Date Sample
Collected'
(rnq%dd/yr) .
24-hour rainfall
amount,
'Inches a
Chemical Oxygen Demand
Fetal Collform
Total Suspended Solids
8enclamorks
yea .
_
120 mg/L
10W count per 200 mL
100 mg/L or S0 mg/L
'
A/
2-4
25,
SSSS�
/ �. 16 7
I3
7 5-
i
lonthly sampling {instead of semi-annual} must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
)r sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here..
ie total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
ae General Per it text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
te: Results must be reported In numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non-
nerical format. When results are below the applicable limits, they must be reported In the format, "cXX ma/L", where XX is the numerical value of the
ection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX"
if you report a sample value in excess of the benchmark you must implement filer 1, Tier 2, or Tler 3 responses. See General Permit text.
Tilt Date.11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

'art 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period ?2
:ootnotes from Part A also apply to this Part B
Vote: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
'OR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE'TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il 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 ❑
tEGIONAL OFFICE CONTACT NAME:
Wall an odginal and one copy of this DMR_._Inclvdina_ all "No Dischrrraef regoM within 30 days of receipt of the lob results for at end of manitorina period
n the case o "'No Discharge" reports) to:
)ivision of Water Quality
>ttn: DWQ Central Files
L617 Mail Service Center
Weigh, North Carolina 27699-1617
FOU 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
:hose persons directly responsible forgathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
im. aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
3--II-19
(Date)
Date:11/1/2012=10/31/2017 -
SWU-248, last revised 10/25/2012
Page 2 of 2
I

Analytical Results
Rowan County Landfill
PO Box 532
Woodleaf, NC 27054
Receive Date: 02/20/2019
Reported: 02/26/2019
For: Stormwater
Comments:
STATESVILLE
ANALYTICAL
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
r
190220-14-01
Chemical Oxygen
#2
<25
mg/L HACH8000
02/21/2019
CL
Demand
190220-14-01
Fecal Coliforms
#2
555
CF1.1100 ML SM92220-2006
02/20/2019
WC
190220-14-01
TSS
#2
14.167
mg/L SM25400-2011
D2/22/2019
WC
190220-14-02
Chemical Oxygen
#3
<25
mg/L HACH8000
02/21/2019
CL
Demand
190220-14-02
Fecal Coliforms
#3
519
CFU100 ML SMIJ222o-2006
D212012019
WC
190220-14-02
TSS
#3
16.167
mg/L SM25400-2011
02/22/2019
WC
Respectfully submitted,
�Op'-� Jyht I
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
Sample Number 190220-14-01 Temp on Arrival: 3.2
Parameter Schedule: TSS
Received on Ice
PH on Arrival: <2 Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 190220-14-02 Temp on Arrival: 3.2
Parameter Schedule: TSS
Received on Ice
PH on Arrival: <2 Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

Client:
S7ATESVILLEANALYTICAL
Address: ' '
/^/
-
122 Court Street • P.O. Box 228
/✓
r "Jn b i� 3 7
Statesville, NC 28687
(7t)4) 87z 697
17?
�,.r. I i e r n JE-- p2 7 fa S"y
Contact Person:
�. �',C �o•
Phone #
7a '' Zo Z 5"5'R5
FAX#
% G`J rQ z g�
Chain of
Custody Record
Y
PO # % Requisitioned by: (
Z- ZD.aci
Customer
Sample ID#
-
Lab -ID #
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
n
Matrix
Parameters requested for analysis
shdya
w
ww
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X
7-1 13
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t' r� I)
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Relinquished by:
.!r C A, u A
Time 7,pm
Data �12OI i
Sampled by: i1.
Received by:
�C//�
Time s() (n
am, pm Date 2 ROIL
Transported by:
Relinquished by:
Time
am, pm Date _I�1�
Holding times met:
Received by:
Time
am, pm Date _I I
Compliance work:
Composite Sampling
#1:
Time begin
am, pm Date �1^I
Non-compliance work:
Time end
am, pm Date _I_I_
Lab Comments:
Samples Transported On Ice:
Composite Sampling
#2:
Time begin
am, pm Date _l�l
Time end
am, pm Date _I_I
Initials:

Arjar
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: httl;//portal.ncdenr.org/web/wg/LA , u� n ess L#tab-4
Permit No.: �C/ &/A/� f D/ /,/�/ or Certificate of Coverage No.: hL1C&1 L/_L/ R/ o/ 1 /3/
Facility Name:_ Robuq�,, c=au....k2o 16", j K u _
County: _
Inspector:
Phone No. 7 J -1 .27 8 .U) I
Date of Inspect4: /f -L -' .L D- I_'I
Time of Inspection: R" 3 O 6+,
Total Event Precipitation (inches): 7"
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
7 - ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
A "measurable storm event" is a storm event that results in an actual discharge from the
j permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify -that this report is accurate and complete to the best of my knowledge:
(Signat�AAOYrn(jttee/r Designee)
Pagel of 2
SWU-242, Last modified ] 0/25/2012 .

1. Out -fall Description:
Outfall No. �l Structure (pipe, ditch, etc.)
Receiving Stream: ,fit c Q d Cr e t- IL
Describe the industrial activities that occur within the outfall drainage area:
te
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: ,/ t
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): �✓- - -
,A Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
N ' clear and 5 is very cloudy:
1 2 3 4 5
Floating Solids: Choose the number which best describes the amount of floating solids in
r �T the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
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
,J/F- Is there any foam in the stormwater discharge? Yes No
tj'fy8. Is there an oil sheen in the stormwater discharge? Yes No
Is there evidence of erosion or deposition at the outfall? Yes No
o lri8. Other Obvious indicators of Stormwater Pollution:
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
SWU-242, Last modified 10/25/2012

Awl
illfn,
WDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit- http:.//portall.ncdenr.L)re/web/wq/wsisu/npdessw#tab-4
Permit No.: N/L/4
Facility Name: 0
County:
Inspector: '
Date of Inspe �o
Time of Inspection:
J
or Certificate of Coverage No.: N/- L/-L/ L / o /-g/
Total Event Precipitation (inches): • 7,1
Phone No. Z t l Y ./a ► r_
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
D/Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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 t
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation. I
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify'that this report is accurate and complete to the best of my knowledge:
(Signat , j6f �rfffittee/r Designee)
Pagel of 2
5WU-242, Last modified 10/25/2012 .

1. Outfall Description:
Outfall No. 2 Structure (pipe, ditch, etc.)
Receiving Stream: c c •.' e " /
Describe the industrial activities that occur within the outfall drainage area:
K
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:�yM LT_^
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): C.A- t
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
9) 2 3 4 5
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:
Q) 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 0
8. Is there an oil sheen in the stormwater discharge? Yes e
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
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
SWU•242, Last modified 10/25/2012

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http:.///portalscdear.or web/wQ/ws/su/nndessw#tab-4
Permit No.: N/-C/ 2
Facility Name:
County:
Inspector:
Date of Inspe opt
Time of Inspection:
or Certificate of Coverage No.:
Total Event Precipitation (inches); ._-? "
Phone No. —7,9 V ,2 2, . -21 +
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
QOYes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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. f
i
A "measurable storm event" is a storm event that results in an actual discharge from the
j permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signa9xKejbf)PYrAttee,6r Designee)
Page 1 of 2
5WU-242, Last modified 10/25/2012 .

1. Outfall Description:
Outfall No. --3- Structure (pipe, ditch, etc.)
Receiving Stream: St cc_ip n 1 Cr e *- &
Describe the industrial activities that occur within the outfall drainage area:
K C
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: b, &,.,.r J. 1_100-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of discharge, where 1 is
clear and 5 is very cloudy:
69 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:
0 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:
7.
8.
9.
10
Q 2 3 4 5
Is there any foam in the stormwater discharge? Yes
Is there an oil sheen in the stormwater discharge? Yes
Is there evidence of erosion or deposition at the outfall?
Other Obvious Indicators of Stormwater Pollution:
List and describe
C
Yes
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
SWU-2.42, Last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Resources General Permit No. NCG120000
Date submitted 1' $' I cl
CERTIFICATE OF COVERAGE NO. NCG12 D 9 1 q
FACILITY NAME -,t-
COUNTY _
PERSON COLLECTING SAMPLES At' I3 Du
LABORATORY SWes,I: Q.. Orwi,, t-awl Lab Cert. # 317 -5
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Z p 1 8
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' _ rmonth)
.DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECE4 to ❑Zero -flow ❑Water Supply [—]SA
,BAN 15 Z019 ❑Other
CENTW1- FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SEC7101"!
No discharge this period?Z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Chemical Oxygen Demand
Fecal Coliform
Total Suspended Solids
Benchmarks
-
120 mg/L
1000 count per 100 mL
100 mg/L or 50 mg/L
,,``
w 0 v �
-3
l - 20-1
'!
L ZS
4 1
Le . 5
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must stilt submit this discharge monitoring report with a checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX meLLJ' where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: If you report a sample value in excess of the ,benchmark, you must implement Tier 1, Tier 2, or rer 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?'
Outfall No.
Date Sample
Collected
Imo/dd/yr)
24-hour rainfall
amount,
Inches;
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A 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
in the case of "No Discharge" reports) to:
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Permit Date: 11/1/2012-10/31/2017
SWU-248, last revised 10/25/2012
Page 2 of 2

Analytical Results
Rowan County Landfill
PO Box 532 ;
Woodleaf, NC 27054
Receive Date: 12/20/2018
Reported: 12/27/2018
For:
Comments:
SYATESdILLE
ANALYTICAL
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
181220-19-01 Chemical Oxygen OF3 <25 mg/L HACHB000 12/26/2018 CL
Demand
181220-19-01 Fecal Coliforms OF3 41 CFU100 ML SM92220.2006 12/20/2018 WC
181220-19-01 TSS OF3 6.5 mg/L SM2540D-2011 12/21/2018 WC
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
43
la.
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
Sample Number 181220-19-01 Temp on Arrival: 3.2
Parameter Schedule: TSS
Received on Ice
pH on Arrival: <2 Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

Client:
Co L /
STATESVILLE ANALYTICAL
122 Cantact Sv=t • PO. Box 228
Ssvillc,NC 28M7
(7041871-4697
Address: ,� nv _ jL
jc 'J
W 12f%c(eFi/ /J.1 w5'`%
Contact Person.
Ph
J 2 Fr one a _-)Oy lv2 Sy �,r
J 2
FAxs
Chain of
PO 4
Requisitioned by:
(TI e
Custody Record
/ zoom; Y
Cuamrtler
Le l Y
Tlrre SemP�•d
(Gmb Only)
Dam Sampled
(Grab On )
9
Mam
PmwclesrryuerN rm mWyus
Sampm IDY
ISIZ I -0I
�.
X.
CC-2F uI
y t.
i J
Relinquished by: , i/T�/%�� '
Time /L: fr p}�, �m Date L/' 1117'I ,d
Sampled by: j,11,
Time 133J
am pm ete)�ro3C11:L
Transported by:
Received by:
Relinquished
by:
Time
am, pm Date �—J—
Holding times met: X—
.Received by:
Time
am, pm Date _l_I_
Compliance work: V/
PomoosRa 62m01113a
#'
Non-compliance work:
Time begin
am, pm Date _/_/_
Time end
Comooslte
am, pm Date _/_/_
emollna 12:
Lay Ca MMS;
samples Tra sported on ice:
Time begin
am, pm Date
Time end
am, pm Date _J—J—
Initials:
f\
N o
00 M
\ N
rn
0 a
n
00
00
t0
m
N
U
Z
N
N
t0
N
00
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N
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f
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A —1
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: hUI2:111?ortal,ncdenraWweblwq/ws/5u/npdessw#tab-
Permit No.: N/-C/,
Facility Name:
County:
Inspector:
Date of Insp
Time of Inspection
or Certificate of Coverage No.: NILIWJ I-41 o/i/ ► /3/
Total Event Precipitation (inches): 5"
Phone No. 7 01/ ? 9 g AZ I t
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
[%Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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. j
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
_obtains approval from the local DWQ Regional
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignatW,6f /rni'1ttee/r designee)
Pagel of 2
5WU-242, Last modified 10/25/2012

1. - Outfall Description:
Outfall No. 1 Structure (pipe, ditch, etc.)
Receiving Stream: 5cclpsll e 0-1
Describe the industrial activities that occur within the outfall drainage area:
K L 1rc, 6e_
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: ,VQ /D.'>-IZ Z, ,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.);
fljf�. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 4 5
Floating Solids: Choose the number which best describes the amount of floating solids in
X 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
B. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
I 10. Other Obvious Indicators of Stormwater Pollution:
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
SWU•242, Last modified 10/25/2012

NGDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http:f /por.tal cdenr.org/web/w ws/su/npdessw#tabs
Permit No.: N/-C/,
Facility Name: _�
County:
Inspector:
Date of Insp
i
Time of Inspection
or Certificate of Coverage No.: N—/-C/Sa/L/1/ L / o/ /3/
Total Event Precipitation (inches): ..r "
Phone No: 2-z l l
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
PYes ❑ No
Please verify whether qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement Please refer to these definitions, if applicable.
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.
i
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior- The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signatyl'{`/ffjrAtteedr 6esignee)
Pagel of 2
SWU-242, last modified 10/25/2012

1. - Outfall Description:
Outfall No. - Structure (pipe, ditch, etc.) c/.'
Receiving Stream: c-c 1p, c! e`1c
Describe the industrial activities that occur within the outfall drainage area:
14 1C y L047 rjr4a
2. Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ - n/o i cc I.,
If
3. Odor: Describe any distinct odors that the discharge may have (i.e.; smells strongly of oil,
weak chlorine odor, etc.): /J�
N�A 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 4 5
N/q 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
4/7 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
1,114 7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
r/N 9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
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
5WU•242, bast modified 10/25/2012

YA
NGDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit:http:.1/12ortal,ncdenr,org/web/wq/wsu n w t
Permit No.: LV/Q /A/_/ D/ /_/_/ or Certificate of Coverage No.: Ll/S�/Sz/L/�/L Q/ 1 /3/
Facility Name: Ropja3n69, J, t ct
County: .4 Phone. No. j9,1 -Z l i
Inspector:
Date of Insp Z 1
Time of Inspection:
Total Event Precipitation (inches): ,
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
®Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
{ Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement Please refer to these definitions, if applicable.
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.
i
A "measurable storm event" is a storm event that results in an actual discharge from the
j permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignatyiK6fjffrrKktee/r designee)
Pagel of 2
SWU-242, Last modified 30/25/2012 .

1. . Outfall Description:
Outfall-No. 3 Structure (pipe, ditch, etc.)
Receiving Stream: c l-, e �-1
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.� Frf _
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): -,o oA,,,Z
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
P 2 3 4 5
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:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge; where Z is no solids and 5 is extremely muddy:
i(V 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
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
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
5WU-242, Last modified 10/25/2012

r�•
Client: ""
E-IA,,
r
t E . ��- !i f
/�� < C/ �%
STATESVILLE ANALYTICAL
122 Court Street • P.O. Box 228
Statesville, NC 28687
(704) 8724697
Address.
{ tr E !
Contact Person: :
' ;` �`+ r �� Phone # ,f f , f �- .� PAX#
Chain of
Custody Record
PC # Requisitioned by: (Time T/�e),r�
Customer
Sample ID#
p
Lab -ID #
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
a
@
a
Matrix
parameters requested for anal sis
9 Y
she
w
ww
�
f„ �
4
/``} • ,! c
1, ,.. �,.
Relinquished by:
Received by:
Relinquished by:
Received by:
Composite Sampling
Time begin .4
Time end
Composite Sampling
Time begin
Time end
c �'�, .,
ICl/))
t
#1:
am, pm Date �l I
am, pm Date 1 I
#2: -
am, pm Date
am, pm Date _I_I
Time fZ , fi a' am', I� Date ! I "' I!��// Sampled by:
Time \J am, pm�Date _I1, Transported by:
Time am, pm Date _I_I_ Holding times met:
Time am, pm Date _/ 1
Compliance work:
, Non-compliance work:
Lab Comments: Samples Transported On Ice:
Initials:

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG120000
Date submitted 3 - ,� - (
CERTIFICATE OF COVERAGE NO. NCG12 P Q f
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES PC 8 �..�
LABORATORY$^c4e3,; Ilr_ gnA I. L,.v f Lab Cert. # 3 _11 5,5"
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTI(?N EAR Z &) if
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' (month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow []WaterSupply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE --i
❑ No dischorge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen Demand
Fecal Coliform
Total Suspended Solids
Benchmarks
120 mg/L
1000 count per 100 mL
100 mg/L or 50 mg/L°
I
35''
4' 2S
f I
Cl 1 By 4
MAN 10 ' la
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the, same parameter at the same outfall.
�--- - 1%nl rjl_ra
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge mdhitoring-report 1with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mig/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal Coliform results exceed the dilution upper limit, report the result as ">XX".
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L4
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A 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 oriainal and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitorina period
in the case of "No Discharae" reports) to;
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(SigngOe�djrPermitta6 )
3-5-18
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-248, last revised 10/25/2012
Page 2 of 2

Analytical Results
Rowan County Landfill
PO Box 532
Woodleaf, NC 27054
Receive Date: 02/19/2018
Reported: 02/27/2018
For: Stormwater
Comments:
Sample Humber Parameter Sample ID Result Unit Method Analyzed Analyst
180219-09-01 Chemical Oxygen <25
Demand
180219-09-01 Fecal Coliforms 11
180219-09-01 TSS 11.846
Respectfully submitted, nn
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
mg/L HACH8000 02/22/2018 CL
MPN/100 ml S11g2236 caiiert 18 02/19/2018 WC
mg/L SM264OD-1997 02/23/2018 WC
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
Sample Number 180219-09-01 Temp on Arrival. -
Parameter Schedule: TSS
Received on Ice
Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

Client;
Cif C I
!L
SWrESVILLE ANALYTICA 1.
122 Court Sucti , P.o. Box 228
Address: n
d' 1—
Sratcsvilk. NC 2 968 7
(704) 972-407
_
0 (' J'/C C 5
Contact Person: rC 6
t
Phone # p %, �� $ r FAX# y 7 6 j 7 7 r
Chain of
PO #
Requisitioned by; frime Date)
Custody Record
Customer
Sample 100
Latr1� N
Time sampled
IGrab Ordy)
Dale sampled
(Grab )
$
�y,�
Matrix
w
wx
Paramerera rerprest«t For.xu}ysis
2 110cl
zA11P
f
0
I
l
Relinquished by: 4
Time ' 0Om Date
Sampled by; q
Received by:
Time- 6�� rn Date 2 / 1 1 4
Transported by: ,y
Relinquished by:
Time am, pm Date /�!
Holding times met:
Date l
Received by:
Time am, pm �l
Compliance work:
C-QRmp_Rsite Sam ]p Ina
Time begin am, pm Hate _ _j
Non-compliance work:
Time end —am, pm Date _J_J_
( Lab Comments: Samples Transported On Ice:
GVM- osite Semolina #2;
Time begin am, pm Date
Time end am, pm Date J_ j�
l
Ir,itlals:
rn
m
LD
lzr co
N O
00 M
DD �
o a
r•
rr
00
ko
W
fV
U
Z
ai
N
V)
00
N
N
X
O
m
0
tz

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit: http:///12ortal,ncdenr.org/web/wgfwsisu/ni2dessw#tab-4
Permit No.: Zl/C/ 2
Facility Name: �f
County:
Inspector: !
Date of Ins
Time of Inspection:
-iq i3
3 Sr KX ,
or Certificate of Coverage No.: N/C/�11
Total Event Precipitation (inches): 5 t
Phone No. 7 0 c/ „298 .�) r
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
{ Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement Please refer to these definitions, if applicable.
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.
i
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signaty�j6f i rrritteetr designee)
Page 1 of 2
SWU-242. Last modified 10/25/2012 .

1. Outfall Description:
Outfall No. t Structure (pipe, ditch, etc.) 6/1
Receiving Stream: SScc es-1 J CR-e f- & _
Describe the industrial activities that occur within the outfall drainage area:
A4 x y L *n
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: s: ,,,_►� L: bar-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): ,^-f 9 e-c ^
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 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes Q
B. Is there an oil sheen in the stormwater discharge? Yes Vo)
9. Is there evidence of erosion or deposition at the outfall? Yes to
10. Other Obvious Indicators of Stormwater Pollution:
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
SWU-242, last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG120000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG12 0 © ► 9
FACILITY NAME XCWe-v. Co_u� - s�� Irz -4-X
COUNTY
PERSON COLLECTING SAMPLES �c s
LABORATORYSE+es,,Ti< Lab Cert. # 3.7 ASS`
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Z Of 7
SAMPLE PERIOD ❑ Jan -June ,�uly-Dec
or ❑ Monthly'(month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
❑Other
JAB! 0 3 ; u 1�3 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DVgP SEC i ION
I,N."OMATION PROCESSING UNI'f-1 No discharge this period?z
Outfall No.
Date Sample
Collected'
(mb/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen Demand
Fecal Colifarm
Total Suspended Solids
Benchmarks =_=>
_
-
120 mg/L
1000 count per 100 mL
100 mg/L or 50 mg/0
1
'--,
1. rs
2-
3
2-- . ;-7
Z,.
4- 25
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, etc, in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new ail per month.
❑ No discharge this period?z
Outfall No.
Date.Sample
Collected)
(mo/dd/yr)
24-hour rainfall .
amount,
3
Inches
Non -polar. O&G/TPH by
EPA 1664 (SGT-HEM) _
Total Suspended Solids
.. ..
pH
Benchmarks ==_>
_
-
15 mg/L
100 mg/L or 50 mg/L4
6.0 - 9.0 SU
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A 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 []NOR
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one conv of this DMR, includina all "No Discharae" 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, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am, aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
- LZ- j-7
(Date)
Date:11/1/2012-10/31/2017
SWU-248, last revised 10/25/2012
Page 2 of 2

Client:
G
4✓< CPS
aG
STATESVILLE ANALYTICAL
122 Coats Street P.O. Box 228
Statesville. NC 2W7
[phone]
Address:
Ap'e Z.
Contact Person:
Y �+ r /�
J Y /J
Phone # a v� s r8� FAX# 7C1/-1 -7 $ 37-7I
Chain of
Custiody Record
PO #
Requisitioned by: (TIrM Date)
customer
S"Io IDA
Lab -ID a
Time Sempted
{Grab Omer]
Date Sanoad
(Grab Drily)
Wtrlx
Parameters r ucste0 for ersatysia
sh .
w
ww
a . c!
1.
�S
v
Gold
Relinquished by:
Received by: �
Relinquished by:
Received by:
— - -
Composite Sampling #1:
l Time begin am, pm Date ��J—
Time end am, pm Date _I_I_
!Zony"Ite Samifto #�2;
Time begin - am, pm Date __J_!____
Time end am, pm Date
Time/ 1.' rs ar rr�Date �11 Sampied by: J. [�
Time/� � am,:ptrt Date• ��d `f� Transported by: $rrs-7C
Time am, pm Date _I—j_ Holding times met:_��
Time am, pm Date _I !_
Compliance work:
Non-compliance work:
Lab Comments:
n
rn
to
N o
n rn
00 N
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Analytical Results
Rowan County Landfill
PO Box 532
Woodleaf, NC 27054
Receive Date: 12/08/2017
Reported: 12/12/2017
For:
Comments:
Sample Number Parameter Sample ID Result Unit Method
171208-10-01 Chemical Oxygen 3
Demand
171208-10-01 Fecal Coliforms 3
171208-10-01 TSS 3
Respectfully submitted,
rC),A. "'V'0', J I' )Y'u ,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
<25 mg/L HACH8000
16.7 CFL1100 ML sM9220-1%7
<3.571 mg/L SM2540D-1997
Analyzed Analyst
12/08/2017 CL
12/08/2017 WC
12/08/2017 WC
f
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
Sample Number 171208-10-01 Temp on Arrival: 3
Parameter Schedule: TSS
Received on Ice
Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

RCD
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this farm, please visit c e w
Permit No.: �/�/.�/o/_/�� /�/_/ or Certificate of Coverage No.:
FacilityName: w G r u
County: a Phone No. 7 e9 -/ .27 8 .L ► I _
Inspector:
Date of Insp -o . _ 11
Time of Inspection: ____IYAl 74!!-A
Total Event Precipitation (inches): ., -1 "_
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event"or "measureable storm event"(requirements vary, depending on the permit).
{ Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
A "measurable storm event" is a storm event that results in an actual discharge from the
Ii permitted site outfall. The previous measurable storm event must have been at least 72 hours
r prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignatW,Zff/rrdiittee/r designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Dutfall No. 2- Structure (pipe, ditch, etc.) Gall A _
Receiving Stream: L c " J CrC1L-&
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: 6,fl.. -
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): _. t-c_
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
6 2 3 4 S
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:
P 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:
7.
8.
9.
2 3 4 5
Is there any foam in the stormwater discharge? Yes Op
Is there an oil sheen in the stormwater discharge? Yes
Is there evidence of erosion or deposition at the outfall?
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
6a
Yes 19)
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
sWU-242, Last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG120000
Date submitted _ j _J � , 1-1
CERTIFICATE OF COVERAGE NO. NCG12 D . I
FACILITY NAME
COUNTY V2 c
PERSON COLLECTING SAMPLES o .�- I"—.
LABORATORYtl-? Lab Cert.
Comments on sample collection or analysis:
SAMPLE COLLECTIO YEAR ��Ct�7
SAMPLE PERIOD EJan-June ❑ July -Dec
or ❑ Monthly' (monthl
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
�•lIa j- ���•���"�� ❑Zero -flaw ❑Water Supply ❑SA
RECEIVED Other
Part A: Stormwater Benchmarks and Monitoring Results
APR 19 2017 PLEASE REMEMBER TO SIGN ON THE REVERSE -i
CENTRAL FILES
DWR SECTION
❑ No discharge this period?2
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Chemical Oxygen Demand
Fecal Coliform
Total Suspended Solids
Benchmarks =_=>
_
-
120 mg/L
1000 count per 100 mL
100 mg/L or 50 mg/l
J/,
C
I✓ 7 sr`
,
-2
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L" where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See Genera! Permit text.
Permit Date: 11/1/2012-10/31/2017 5WU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfal! No.
Date_Sample
Collected}
(mo/dd/yr)
24-hour rainfall..
amount;
.3
inches
Non -polar. O&G/TPH by
..EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/l.'
6.0 — 6.0 SU
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A 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 -1 NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one coov of this DMR. includina 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, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible forgathering 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."
(Sigr�&yfe,6ype'irm
q-! p -1,
(Date)
11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 2 of 2

Rowan County Landfill
PO Box 532
Woodleaf, NC 27054
Receive Date
Reported:
For:
Comments:
Analytical Results
03/28/2017
04/04/2017
Stormwater
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
170328-11-01 Chemical Oxygen 3 28
Demand
170328-11-01 Fecal Coliforms 3 67
170328-11-01 TSS 3 6.703
Respectfully submitted,
rOP.wl�- J'Y'b
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
mg/L HACHaOW 03/30/2017 CL
MPNI100 ml SM92238 CoFiert 18 03/2812017 WC
mg/L SM254OD-1997 03/31/2017 CR
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
Sample Number 170328-11-01 Temp on Arrival: 2
Parameter Schedule: TSS
Received on Ice
pH on Arrival: <2 Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule:
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

Gient:
STA7ESVrl.LEANAI.1'I'rCAL
122 Court StrM • P.O. Box 228
Address-
[7
3 Z
Stmewille. MC 28687
[phone]
Contact Person:
Phone # FAX#
T6L' � ��8 aztl 0�8�71
Chain of
Custody Record
PO # Requisitioned by time Deus
Customer
Sample IDai
Lab -ID a
ane Sampled
Grab OnPy)
Date Sampled
(Grab Only)
Matrix
w ww
Parameters requested ror *rWy a
17
3
-z
I
fs
3
•,r rrs
3 •,,& •J1
I •c»/
2=
3- .29- r
,�
D
Relinquished by:
a f 'ex, z J
Time , 1-9m Date 112
Sampled by: ,]
Received by.
`
i
Time am m Dated
Transported by: S,a r-
Relinquished by:
_ Time am, pm Date —I—J—
Holding times met.
_
Received by:
Time am, pm Date _ll�
Compliance work:
Composite SaMl2
#1:
Time begin_
am, pm Date 1_/_
Non-compl lance work:_
Time end
am, pm Date 1�1_
Lab Comments:
Composite Sampling #2: .
Time begin
am, pm Date --J--J
'rime end
am, pm Date
I
rn
W
0O
rV
u
z
ai
7
61
«s
00
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0

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http:(lportal.ncdenr;org,�weblwglws/su f nndessw#tab-4
Permit No.: N/C//A /_/ F/ 3 /_/_/ or Certificate of Coverage No.: LV/�/�/L/�/ o / / ► /�/
Facility Name: e,�ybLa,r, C�PI±Ik4 Lam, d f u
County: gy iv A-n T Phone No. 7 t9,1 .2 '2
Inspector: d-z �
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): +, c.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
XYes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event' or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." however,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signat�rFe�f,rttee/r ijesignee)
Pagel of 2
SWU-242, Last modified 10/25/2012 .

1. Outfall Description:
Outfall No. I— Structure (pipe, ditch, etc.) el,' 6,4
Receiving Stream: e. c e - &
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.): _ _- _ A)v _t�; -i'.n b
]If �k4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
`` clear and 5 is very cloudy:
1 2 3 4 5
yr 5. Floating Solids: Choose the number which best describes the amount of floating solids in
1` the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
�r �i"'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
Pf l4 7. is there any foam in the stormwater discharge? Yes No
r f t;L 8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
1v 1010. Other Obvious Indicators of Stormwater Pollution:
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
SWU-242, Last modified 30/25/2012

A �ja
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http�li2ortal.ncdenr.org/weblwq/wslsuinpdessw-fitab:4
Permit No.: �V/C/ &/4/_ / D/3 /Y/_/ or Certificate of Coverage No.: LV/C/G/L/-./ cI / a/ l /�/
Facility Name:
County: I_q n w -►-" _ Phone No. _ 7 O `l .221 24- / t
—Inspector: _.%* �',p
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): , ie o,
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signaty ff,&fi/rm/ittee/r designee)
Pagel of 2
SWU-242, Last modified 10/25/2012 .

1. Outfall Description:
Outfall No. � 7 Structure (pipe, ditch, etc.) -
Receiving Stream: -C V"I .c�� arc $-1L
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: L).�ti�
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): 1v s tN
!�
R j �ta, 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 4 5
Jf 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
h}lf*. 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
Is there any foam in the stormwater discharge? Yes No
Is there an oil sheen in the stormwater discharge? Yes No
Is there evidence of erosion or deposition at the outfall? Yes No
0. Other Obvious Indicators of Stormwater Pollution:
j 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
SWU-242, Last modified 10/25/2012

KLT;-E;VA
JI�A
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this farm, please visit., htt rtal. ncd e rinor we w w n de w tab-4
Permit No.: N/ / /A/_/ E�/ /_/�/ or Certificate of Coverage No.: N-1-C&/,L/1/V/ !?/ 1 /S/
Facility Name: _ U�Ete, Cyu,. G,it, d K' a
County. 9-0 t--.) +4-01A Phone. No.
Inspector: i
Date of Inspection:
Time of Inspection: q, tl , r•..
Total Event Precipitation (inches):
7 12 -/ 291 a-ZII
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
'Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
1 prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignatyVfSrr>6ttee/r designee)
Pagel of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 3 Structure (pipe, ditch, etc.)
Receiving Stream: Scc v J Cf-c AL
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: 1�f P- �, 4tI ; 17,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): h{'( 01_-Sc_i.vh!aj, T
tr Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 4 5
,�jh4 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
j 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
A j)(4,7. is there any foam in the stormwater discharge? Yes No
1+8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
040. Other Obvious Indicators of Stormwater Pollution:
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
SWO-242, Last modified 10/2S/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG120000
Date submitted 1 r
CERTIFICATE OF COVERAGE NO. NCG12 0 O 1 r
FACILITY NAMEr��t, C��u.l ��rr�1;` •':.t
COUNTY
PERSON COLLECTING SAMPLES _ C 69 t,
LABORATORYs6",'}j,. A,41l , J;Coj Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Z D I (.0
SAMPLE PERIOD ❑ Jan -June my -Dec or ❑ Monthly'_ (month)
DISCHARGING ��TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RE
❑Zero-flow ❑Water Supply ❑SA
JAN 17 Z017 ❑other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE -i
D PJ'R SECTION
n No discharge this period ?2
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Chemical Oxygen Demand
Fecal Coliform
Total Suspended Solids
Benchmarks ==_>
_
-
120 mg/L
1000 count per 100 mL
100 mg/L or 50 mg/L
i
pAC
OKA
!z a �tt
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving waterclassifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they „must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(ma/dd/yr]
24-h6ur rainfall.
amount;
3
Inches
Non -polar O&G/TPH by
EPA 1664'(SGT-HEM)
Total Suspended Solids
....
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L°
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A 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 copy of this DMR. includina all "No Discharae" reports. within 30 days of receipt of the lab results !or at end of monitoring period
in the case of "No Discharae" reports] to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Sig
) J?
(DaA)
Date- 11/1/2012-10/31/2017
SWU-248, last revised 10/25/2012
Page 2 of 2

Semi-annual Stormwater Dischar a Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG120000
Date submitted _ „ , 1VA,
CERTIFICATE OF COVERAGE NO. N[Y�1 77 r? ., � SAMPLE COLLECTION YEAR
FACILITY NAME W -r, COw.� � - . -.� �t
` PLE PERIOD Jan -June ❑ July -Dec
COUNTY �„cr. or ❑ Monthly' month
PERSON COLLECTING SAMPLES �r O� 9 15CHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY Lab Ce . f# 7 2 T'S E`vED ❑Zero -flow ❑Water Supply ❑SA
Comments on sample collection or analysis: L1 ❑Other
F Eg .2 5 2016
L FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
DWRSECTION
❑ No discharge this period
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
lnches3
Chemical Oxygen Demand
Fecal Coliform
Total Suspended Solids
Benchmarks ===>
_
-
120 mg/L
1000 count per 100 mL
100 mg/L or 50 mg/L
p
�c
r
s c /, Ot
.45'
72.
�, 1
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any :tingle outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PC}L, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No
Date.Sample
Collected'
mo dd r
( / /y)
24-hour rainfall..
amount,
3
inches
Non -polar 0&G/TPH by
EPA 1664�(SGT-HEM} -
Total Suspended Solids
'....
pH
Benchmarks =__>
_
-
15 mg/L
=100 mg/L or 50 mg/L
6.0 -- 9.0 SU
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A 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 EXCEEDANCES 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 oriainal and one copv 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, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible forgathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
- L. ear (l _ -217
(Signal of rmitte (Da e)
Date:11/1/2012-10/31/2017
SWU-248, last revised 10/25/2012
Page 2 of 2 -0 �,

Semi-annual Stormwater Discharge Monitorinig Report
for North Carolina Division of Water Quality General Permit No. NCG120000
Date submitted - S- I /_
CERTIFICATE OF COVERAGE NO. NCG12 Z D
FACILITY NAME Rowl, cau tiFti, (,v�,n�
COUNTY RO,✓ur,
3
u
PERSON COLLECTING SAMPLES fe�19
LABORATORY ' ! - jW Lab Cert. # 3 7 7 T _
Comments on sample collection of analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' _ (month) ,
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVED ❑Zero -flow ❑Water Supply ❑SA
[—]Other
JAN132016 C.D
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 �1
DWR SECTION
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Chemical Oxygen Demand
Fecal Coliform
Total Suspended Sollds
Benchmarks =__>
_
-
120 mg/L
1000 count per 100 mL
100 mg/L or 50 mg/L
L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the saute parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicabl4 limits, they must be reported in the format, "<XX mgfL", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-haur rainfall
amount,
a
Inches
Non -polar O&G/TPH by
.. EPA 1664 (SGT-HEM) .
}
Total Suspended Solids
: . .. . . ..
pH
Benchmarks =_=�
_
1S mg/L
100 mg/L or SO mg/L
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART li SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li 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 tab 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, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment,for knowing violations."
619;7 iVe ofyerrl'iittee)
/= 5~_ / �
(Date)
11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 2 of 2

'AL
NODE R
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit
Permit No.: NICIff/V_/ Ems' or or Certificate of Coverage No.: X1C1! a./,L/-L/ LV -L11/
Facility Name: _ gu J.A. L t A Lc
County: — .40 tc� _ Phone No. 7 -9 j 211
Inspector: -lc �,
Date of Inspection:
Time of Inspection: �_.1�Sc2�
Total Event Precipitation (inches): : A"
Was this a ; Representative Storm Event" or''Measureable Storm Event" as denned'-6y the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
E and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 4
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
j permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-6ur storm interval does not apply if the permittee is able to document"that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Sjgnaq4Vff,Krnitteejdr Designee)
.*-
Page 1 of 2
SWIG-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) 64 - E�A
Receiving Stream: c c V 6 � 1 e 0 -
Describe the industrial activities that occur within the outfall drainage area:
5M"All it L *01 ire Cl
2. Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: t
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): "t'At`y 'L
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy: - i
jV 2 3. 4 _ 5
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:
1Q 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes C�
S. Is there an oil sheen 1n the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes Va
10. Other Obvious Indicators of Stormwater Pollution:
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
SM-242. Last modified 10/25/2012

IF
Analytical Results
Rowan County Landfill
PO Box 532
Woodleaf, NC 27054
Receive Date: 12/14/2015
Reported: 12/17/2015
For: Stormwater
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
151214-15-01 Chemical Oxygen #3 <25 mg1L HACH8000 12/15/2015 MD
Demand
151214-15-01 Fecal Coliforms #3 18 CFU100 ML SM922D-1997 12/14/2015 WL
151214-15-01 TSS #3 5.294 mg/L SM254OD-1997 12/15/2015 WL
Respectfully
submitted,
�DoZ-WaI-
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2

Condition of Receipt
Temp on
Sample Number 151214-15-01 Arrival: 3
Parameter Schedule: TSS
Received on Ice
Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2

r fIi
Client: �// '�+
Ro/E r, tr a-� C.G'� �% �' L �;
STATESVILLE ANALYTICAL
122 Court Street - P.O. Box 228 '
Address: - /� �� S '•'
-
j�
Statesville. NC 28687.
(704) 87213697
�+
Contact Person: (^
r
Phone 9a7e
FA7p`/e7
Chain of
Custody Record
PO # Requisitioned by: (Time Date)
Customer
Sample ID#
Lab -ID #
Time Sampled
(Grab On
Only)
Date Sampled
(Grab Only) .
a
b
n
E
0
Matrix
Parameters requested for analysis
s+ dg.
w
ww
AN
H
Co D
:.
rs�
S•
Jf _
-Relinquished by: J ��'o
-
Time �.��]
am, pm Date �� 1/yl �S✓
Sampled by:
'-Received by:
Time { 1
rr I
Date 1eZ/ t �I� S
/
.
am, pm
Transported by:
Aelinquished by:
Time
am, pm Date �—
Holding times met: -
Received by:
Time
am, pm Date _I /_
Compliance work:
Composite Sampling #1:
Time begin am, pm Date I
I
Non-compliance work:
Time end am, pm Date 1
1�
Lab Comments:
Composite Sampling #2:
Time begin am, pm Date 1
I_
Time end am, pm Date
U

Semi-annual Stormwater Dkchar a Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG120000
Date submitted /- 5 15'
CERTIFICATE OF COVERAGE NO.
FACILITY NAME Q rix- A'I Co C 14 n_TC : LA
COUNTY rq O wc�,
PERSON COLLECTING SAMPLES trt '3 ti
LABORATORY ., --W 1r Ane,AIOLI Lab Cert. # j
Comments on sample collection or analysis:
Part A. Stormwater Benchmarks and Monitoring Results
-- -
SAMPLE COLLECTION YEAR rZ � i �/rrq
SAMPLE PERIOD ❑ Jan -June kWuly-Dec
or ❑ Monthly' lmonth)
�g� ;DIS HMGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
C ��// �VJ ❑Zero -flow ❑Water Supply [—]SA
JAN 0 7 2015 ❑other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION
n No discharge this period?'
Outfall No.
Date Sample
Collected'..
(mb/dci/yr)
24-hour rainfall
amount,
Inches3
Chemical Oxygen Demand
Fecal Coliform
Total Suspended Solids
'Benchmarks
120 mg/L
1000 count per 200 mL
100 mg/L or 50 mg/L
L
f /
Zs
Iki
' Monthly sampling (instead of semi-annual) must.begin with the Second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging a 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No:
D7te,5ample
.Collectedl
-(mo/dd/yr)
: 24-hour rainfall
amount,
a
inches-' ...
Non polar O&G/TPH by'
...EPA 1664 (SGT-HEM)
Total Suspended Solids :.
pH. .
Benchmarks ===�
_
15'mg/L
300 ing/L or mg/L .
6.0 - 9.0 SU.
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART 8 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCUTRIGGERS 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 ❑ NOJLN�'
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an ari inal and one copy of this DMR includin all "No Discharge" reports, within 30 days oL receipt of the lab results or at end of monitoring eriod
in the case o "No Discharge" re orts to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
:11/1/2012--10/31/2017
SWU-248, last revised 10/25/2012
Page 2 of 2

Analytical Results
Rowan County Enviromental Management
Po Sox 532
Woodleaf, NC 27054
Receive Date: 12/16/2014
Reported: 12/23/2014
For: Stormwater
Comments:
Sample Number
Parameter
Sample ID
Result
Unit Method
Analyzed
Analyst
141216-12-01
Chemical Oxygen
#3
<25
mg/L HACH8000
12/18/2014
CL
Demand
141216-12-01
Fecal Coliforms
#3
<1
CFU100 ML SM922D-1997
12/16/2014
CL
141216-12-01
TSS
#3
4
mg/L SM254OD-1997
12/17/2014
WL
Respectfully
submitted,
kLp -V"(uJY))t
Dena Myers
NC Cert #440,
NCDW Cert #37755.
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2

M
Condition of Receipt
Temp on
,ample Number 141216-12-01 Arrival: 2
Parameter Schedule: TSS
Received on Ice
pH on Arrival: <2 Parameter Schedule: Chemical Oxygen Demand
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
PO Box.228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2

Client:
STATESVILLE AN
122 Court Street - Px
Address:
Statesville, NG 286,
[phone]
Chain of
Contact Person:fir:Phone #,., FM#
<
Custody Record
PO # Requisitioned by: (Time Date)
Customer
Lab -ID #
Time Sampled
Date Sampled
Matrix
Parameters requested for analysis
WW
Sample I D#
(Grab On
(Gfab Only)
All
<
-3
Relinquished by:
Time Vim, PM Date
Sampled by:
Received by:
Time,',,
M,: pm Date
Transported by:
Relinquished by.-
Time
am, pm Date
I
Holding times met:
Received by-.
Time
am, pm Date
Compliance work:
Composite Samplftfl:
Time begin-
am, pm Date
Non-compliance work:
Time end
am, pm Date
Lab Comments:
Composite sampling
#2:
Time begin-
am, pm Date
Time end
am, pm Date I

RaDEWAR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit hip;//portai.ncde r.orL/rue Jill m/suingdessw#tab 4
Permit No.: �/�J/�/_/��_/_/ or Certificate of Coverage No.:
Facility Name: lo�, j- f u __
County: Va ., Phone No. 7 0- ,/ .23 - -111 i
Inspector:
Date of Insp o �k
Time of Inspection: _ `Ps" •r, _
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
9(yes ❑' No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
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.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfail. The previous measurable storm event must have been at least 72 hours
i prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signat fjjrrditteetrdesignee)
Page 1 of 2
SWU-242, Last modified 10/25/2012 .

1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream: e. c " j e /
Describe the industrial activities that occur within the outfall drainage area:
��.� L,�►� a �btfl? c-11--t6e
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:. _ f , ,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A., c,
4. Clarity: Choose the number which best describes.the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
Q 2 3 4 5
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:
P 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:
7.
8.
9.
0 2 3 4 5
is there any foam in the stormwater discharge? Yes
is there an oil sheen in the stormwater discharge? Yes Q
Is there evidence of erosion or deposition at the outfall? Yes �D
10. Other Obvious Indicators of Stormwater Pollution:
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
SWU-242, Last modified 10/25/2012