NCG160173_MONITORING INFO_20181211

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
DOC TYPE
❑HISTORICAL FILE
�] MONITORING REPORTS
DOC DATE
❑ ') D I is /07 11
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Per -t No. NCG160000 - Asphalt
Date submitted i � i
CERTIFICATE.OF COVERAGE NO. NCG16C] t —73
FACILITY NAME ,SELF TCLDMS
COUNTY M
PERSON COLLECTING SAMPLES _ A , C HITT'
LABORATbRY ��z— Lab Cert. 9 r�
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June t[luly-Dec
or ❑ Monthly' / (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
1 -sother--61465 G
NECEjV a D
DEC 11 2018
CENTRAL FILES
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
Qutfallluo.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks
- I
-
100 mg/L or 50 mg/E
v !
/10
0
o discharge this period?z
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfalt.
z For sampling periods with no discharge at any single outfall, you must still 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.
a See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?2
Outfail No.
Date Sample
Collected
r ,
(mo/dd/yr)
24-hour rainfall
amount,
a
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
A
�!o VF, ttic-
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME: { i Its,
Mail an original and one_copy_ of this DMR, including all "No Discharge_ "_reports, within 30 days of eceipt of the lab results1or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FUR ANY INFORMATION RLPORTED:
"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. t
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
it Iq le
(Da )
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General P r it No. NCG160000 - Asphalt
Date submitted 16
CERTIFICATE OF COVERAGE NO, NCG16o�,`L-11
FACILITY NAME 1NL-2�FMrj
COUNTY
PERSON COLLECTING SAMPLES C WAp t,. 71 A Ct`F/TTY
LABORATORY f-P—SM Lab Cert. 4 �qo;-9—
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YFAR c 0 6z-� V5 �I
SAMPLE PERIOD ❑ Jan -June 91 July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
Zero -flow ❑Water Supply ❑SA
Other (�—
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
No discharge this period?z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 g/L
l d l !d
aMet
IL
` 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
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. NA
❑ No discharge this period?'?
IUD
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches 3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
-
15 mg/L
100 mg/L or 50 mg/0
Footnotes from Part A also apply to this Part B
r� t
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.
FOP. PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO
REGIONAL OFFICE CONTACT NAME: A
Mail an original and one copy of this DMH including a!1 '7Vo Discharge" reports, within 3D days of receipt a/ the lab results (or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CER I IHCAtION FOR ANY INI-ORMATION' REPURTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
{Signature of Permittee
Permit Date: 10/1/201479/31/2019
it/-,//F
(D te)
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (I)MR)
for North Carolina DEMLR General P rmit o. NCG160000 - Asphalt
Date submitted 1
CERTIFICATE OF COVERAGE NO. NCG16"V f �_
FACILITY NAME Ti�_ — �r►� F}+�'1�
COUNTY Mg,! ."_ �
PERSON COLLECTING SAMPLES ('_HAQg,- A. 64 i % 7
LABORATORY P!:� 1 4N1 Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTIONYEAR
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW [—]Trout ❑PNA
Zero -flow ❑Water Supply [—]SA
Other I✓
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period ?z
Qutfall No.
Date
Date Sample
(mo/dd/yr)
24hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =-_>
_
-
100 mg/ 50 mg/0
i
►3 0
r� 6
L
RECEIVED
JUL 13 Z018
CENTRAL FILES
MR SECTION
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfail.
Z For sampling periods with no discharge at any single outfail, 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 mg(L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

• • ��
• .. � -f -
3 ..
1.
i- 1 � � - -
i� _ I
_ ... N
' - i . � .
� o ��' i r

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/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ==>
-
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
NIA
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NOX
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one cony of this DMR, includina all "No Discharge" reports, within 30 dovs of receipt of the lab results (or at end of monitorina period
in the case of "No Discharae" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
7/ 10 45
(Signature of Permittee) (Da e)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2

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1/15/2018
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 -Asphalt
Date submitted s ��
CERTIFICATE OF COVERAGE No. NCIS 16Ci
FACILITY NAME f7
COUNTY��C
PERSON COLLE TING SAMPLES C 14A14S5
LABORATORY_ ..N� _ _Lab Cert.
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
�] t'e
SAMPLE COLLECTION YEAR ` _ ` -_r
j�� I
EC ES-A4MPEPERiOD Jan -June �uly-Dec
�/ orMonthly" (rnontlr)
tAAt q �D115�Gt%ARGING TO CLASS �ORW �HQW Trout �PNA
J tit 2 c Elzero-flow ater Supply DA
ENTRAL FILES Other � P eP
D
WR SECTI��!
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
0 No discharge this period??
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
arnount,
Inches'
Total Suspended Solids
8encfrmarfrs=--�
10D mg/L
ra
�1
'0
o
' Monthly sarnpling (instead of semi-annual) rnust begin with the second consecutive benchmark exceedance for the same par arneter a[ the same outfall.
For saMj)ling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
;The total precipitation must be recorded using; data frorn an on -site rains gauge. Unattended sites may be eligible for a waiver of the rain pauge 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 resort Belov., Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in rng/L.
Note: If you report a'sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1,/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 1 of 2

1 / 1 5I2018
Part B: Vehicle Maintenance Area Monitoring Results: onlyforfacilities averaging>55 gal of new oil per month
No discharge th is p eriod r
Outfall No.Collected'
Date Sample
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar 0&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =_ _ >
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Vg� cc__L
fFE
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 /. AND PART b MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERSTIERI REQUIREMENTS.
• 2EXCEEDANCES INAROW FORT HE SAME PARAMETER AT THE SAME OUTFALLTRIGGER TIER 2REL)UIBEMENTS.
TIEit 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEE DANCES FOR THE SAIAE PARAMETER AT ANY ONE OUTFALL? YES 0140
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES L]t•I0 [[--
REGIONAL OFFICE CONTACT NAME: Nf
Moil an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results (or at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water -Resources
Attn: DWR CentralFiles
1617 retail Service Center
Raleigh, North Carolina27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR A 14Y I NFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments we re prepared under rny direction or supervision in acordancewith a systern designed to
assure that qualified personnel prop edy gather and evaluate the information submitted. Based on my inquiry ofthe person or personswhonanage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the bestof my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penaltiesfor submittingfalse information, including the possibility of fines and imp r•ipnmetit fork nowingviolations."
(Signature of Permittee)
Permit Date: 10/ 1/2014-9/31/2019
eQlte)
SW U-252, last revised 9/17/2014
Page 2 of 2

1 /15/2018
Semi-annual Stormwater Discharge Monitoring Report DMR
for North Carolina DEMLR General erm't No. NCGI60000 -Asphalt
Date submitted �
CERTIFICATE OF COVERAGE
�No. NCG16G t
FACILITY NAME�GC>3j _{CtriS
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY T _ Lab Cert. 01�{;_
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEARC7t�j�
SAMPLE PERIOD Jan -June my -Dec
or OMonthlyr (month)
DISCHARGING TO CLASS ❑ORW QHQW []Trout ❑PNA
[]Zero -flow ater Supply []SA
C
NPOther C____
PLEASE REMEMBFIt TO SIGN ON THE REVERSE --)
❑ No discharrge this period?
Outfail No.
Date Sample
Collected'
(rro/dd/yr)
23-hour rainfall
amount,
Inches'
fatal Suspended Solids
100 mg/L
r
;a gr qD17
iic
&0
/7
L-
' Monthly sampfinh (ir+stead of semi-annual) rnUst begin %: itlh the second consecutive benchmark exceedance for the same parameter at the same outf6ll.
For sampling periods with no discharge at any single outfall, you must still submit this discharge r7tunitoring report with a checkrnark here.
`The total ;rrecipitation must be recorded using data from art on -site rain gauge. Unattended sites may be eligible for a I.vaiver Of the rain gauge requirement.
a See General Permit text, Table 3, identifyinp 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 m L" where XX is the numerical value of the
detection limit, reporting limit, quarrtitation limit, etc. in rng/L.
Note: If you report o sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019
SWU-252, last revise d 9J17/2014
Page Iof2

1 / 1 51201 8
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging >55 gal of new oil per month
n No discharge this period r
Qutiall No.
Date Sample
Collected'
(mo/dd/yr)
2A-hour rainfall
amount,
In ches
Non -polar O &G by EPA
1664 (SG T-HEM)
Total Suspended Solids
Be neh marks == _ >
1.5 mg/L
100 mgA or 50 mg/L
footnotes from Part A also apply to this Part B
va" -
S
Note: if you report a sample value in excess of the benchmark, you must implement Pier 1, Tier 2, or Tier 3 responses. See GenerQl Permit text.
FOR PART.- AND PART B MONIT ORING RESULTS:
A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS.
• 2 EXCEEDANCES IN AROW FOR THE SAME P AR.Aiv1ETER AT THE SAME OUTFALL TRICGERTIER 2 REQUIREMIEUTS.
• TI EIR 3: HASYOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARANIETERAT :ANY OtJE OUTFALL? YES QPJO.:
IF YES, HAVE YOU CONTACTED THE DEfv1LR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES []n0
REGIONAL OFFICE CONTACT NAME:
Mail an on ginal and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Resources
4ttn: DWR Ce ntral Files
1617 rviail Service Center
Raleigh, North Carolina 27699-1617
You MUST SIGN THIS CERTIR CATION FOR ANY IHFORMATION REPORTED.
"I certify, under penalty of law, that tNs document and all attachmentswere prepared underrny direction orsupervision in acordancewith a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons whcrnanage the system, or
those persons directly responslble for gathering the information, the information submitted is, to the bestof 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 imprionrnent for knowing violations."
(Signature of Permittee)
a te)
Permit Date: 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year ;2t) I to
Revised 911712014
General Permit No, NCG160000
Certificate of Coverage No. NCG 10-T-03❑
* S
tt/9.1on I
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name:
County: MEc
Phone Number:
Total no. of SDOs monitored
Part A. Outfall No. _ (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No)4'
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall
Total Rainfall,
inches
00530
TSS, mglL
Benchmark
NIA
1 0
Date Sample Collected,
mohidly r
L
RECEIVED
DEC 2 8 2016
CENTRAL FILES
DWR SECTION
Page I I

Part B. On -Site Vehicle Maintenance Outfall No. Ve_�t
Is this autfall currently in Tier 2 (monitored monthly)? /110 �40 1 ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency
Other
Outfalk
Total Rainfall
inches
00530
00556
TSS, mglL
Non-polar Oil &
Grease, mglL
Benchmark
N/A
501100
95
Date! Sample Collected,
molddly r
a��
SY,t�;=1.F,a3•. ��^�"!':,�.
}� Mpy
:'2Y � �X �. 3e��,F '.:i�WY�f�
�,'
H�{a.
��!1°. ���3'�_:'�E:�"�
page 12

I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Sign
Date
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
ASHEViILLE REGIONAL OFFICE I FAYETTEVILLE.REGIONAL OFFICE
2090 US Highway 70 225 Green Street
Swannanoa, NC 28778 Svstel Building- Suite 714
[phone] Fayetteville. NC 28301-5043
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON.;SAL•EIM REGIONAL
OFFICE
595 Waughtown Street
Winston-Salem. NC 27107
[phone]
WASHIVGTON REGIONAL.OFFICE
943 Washington Square Mall
Washington. NC 27889
[phone]
,XIOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILM NGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
(9 10) 796-72 15
I Page 13

Semi-annual Stormwater Discha!ge Monitoring Report (DMR)
y for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted CP - 7 - ! G
CERTIFICATE OF COVERAGE NO. NCG16 d i 3 '
FACILITY NAME - J 5 l i/E
COUNTY 0UI
PERSON COLLE iNG SAMPLES y� A. CHITTY,
LABORATORY ISM Lab Cert. #
Comments on sample collection or 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
[]Zero -flow ❑Water Supply ❑SA
1japther QLAS5 0-
REC,EIVE®
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES ❑.1,Agischarge this period??
D r
Outfall No.
Date Sample
Collected'
jmo/dd/yr)
24-hour rainfall
amount,
lnches3
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L
OV 18 1 &
A,_
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.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non. -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L,,, where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

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Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
Nll�
❑ No discharge this period:2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount
Inche53
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or her 3 responses. See General Permit text.
FOR PARTA AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NOe
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR. includina 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 Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing vioiations."
(Signature of Permittee)
Permit Date;10/1/2014-9/31/2019
­7._��
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

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Semi-annual Stormwater Discharge Monitoring Report (DMR)..
for North Carolina DEMLR General Per it _14o.,KG160000 -Asphalt
Date submitted 1
CERTIFICATE OF COVERAGE NO. NCG16 O 7
FACILITY NAME .5 tZE_P�&'C
COUNTY
PERSON COLLECTING SAMPLES r VAS
LABORATORY_} IjM Lab Cert. # ya
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR (� a
SAMPLEPERIOD ❑'Jan -June gJuly-Dec
or [] Monthly' (month)
RECEI %dI EA,RGING TO CLASS []ORW CJHQW Trout [:]PNA'
DEC. 1 1 2015 Zero -flow []Water Supply [JSA
Qther S5 -C
CENTRAL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
V�No discharge this period?z
Outfall No.
Date Sample
- Collected 1
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks. _==>
_
-
100 mg/L or 50 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
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_mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
!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.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B. Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
0 JA
[] No discharge this period?z
Outfall No.
Date Sample
1
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FORTHE SAME PARAMETER ATTHE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainol and one copv of this DMR, including 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 Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there are significant penalties for submitting false information, including the possibility of fines aftd imprisonment for knowing violations,"
(D e)
Permit Date:10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

•)
Semi-annual Stormwater Discharge Monitoring Report (DMRI
for North Carolina DEMLR General Per it o. NCG160000 - Asphalt
Date submitted
s
CERTIFICATE OF COVERAGE NO. NCG16 S -7 3,
FACILITY NAME 5h� _�r A��'1i►S
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY?�!(-Srv\ _ Lab Cert. # yd—
Comments on sample collection or analysis:
Part A: Stormwater. Benchmarks and Monitoring Results
�� SAMPLE COLLECTION YEAR 04 i aZ
SAMPLE PERIOD ❑ Jan -June XC July-Dec��
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
�Qther CLASS C
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
No discharge this period ?2
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Tot ended Solids
Benchmarks.===>
_
-
00 to or 50 mg/L
t k�
e
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.
a 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 mgjL", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only -for facilities averaging > 55 gal of new oil per month..
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ==->
_
-
15 mg/L
100 mg/L or 50 mg%L
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
•F•
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• .2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETERATTHE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copv of this DMR, includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitorina oeriod
in the case of "No Discharae" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines ar1"tl imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:10/l/2014-9/31/2019
f ;;V 7 IX6_
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge_ Monitoring Report(DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted ::5� is
CERTIFICATE OF COVERAGE NO.-NCG16C> 17 3
FACILITY NAME
COUNTY
PERSON COLLECTING SAMPLES CK (7_TT
LABORATORY tS Lab Cert, 4
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR �;)d 1
SAMPLE PERIOD kJan-June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS [:]ORW [-]HQW' ❑Trout LjPNA
olero-flow Water Supply ❑SA
RECEIVED t h e r
1 $ Z1315 PLEASE REMEMBER TO SIGN ON THE REVERSE -4
CENTRAL FILES
DWR SECTION No discharge this period?2
Outfali No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
inches'
T Suspended Solids
Benchmarks.===>
_
S00 mg/L or 50 mg/L
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.
4 See General Permit text, Table 3, identifying the especially sensitive receivin' ater classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not re ort Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/l/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

.. I
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month..
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail on 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 monitorina period
in the case of "No Discharae" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date: 10/1/2014-9/31/2019
J
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring ReporQDMR],.
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted :�Q1S
CERTIFICATE OF COVERAGE NO. N4G164 I
FACILITY NAME EV-a-Belje� 3k; I"'r
COUNTY . M Vj_-T-T� UZ(-:�, _
PERSON COLLECTING SAMPLES GNc
LABORATORY ` ! =159'Vj„ Lab Cert. ii
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR �6)1­5
SAMPLE PERIOD Jan -June ` ❑ July -Dec
or ❑ Monthly'_ (month}
DISCHARGING TO CLASS ❑ORW ❑HQW'. ❑Trout ❑PNA:
❑Zero -flow ❑Water Supply ❑SA
Nther.C[_�.�5 C
i._.,-ice ..�t:r!�J. •��: 5.�.. 1 .. i�1i��� ��•I�'. .:.� .:��-�F �c �'
❑ No discharge this period?2
Outfall No.
Date Sample
Collected
(mo/dd/yr) '
24-hour rainfall
amount,
Inches3
TD Suspended Solids
Benchmarks,===>
_
-
100 mg/L or 50 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge, Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receivin&9ter classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX_mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for'facilities averaging > 55 gal of new oil per month.,
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
s
inches
Non -polar O&G.by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ==_>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: if you report a somple value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER ATANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, includina all "No Discharge" resorts, within 30 days of receipt of the lab results (or at end of monitorina ioeriod
in the case of "No Discharae" revorts) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
Permit Date:10/1/2014-9/31/2019
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

" 1
Semi-annual Stormwater Discharge Monitoring Report (DMR).
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted lv " a - 1:E
CERTIFICATE OF COVERAGE NO. NCG16b ( 1-3
FACILITY NAME ftg�se=_ A[ 6C 5
COUNTY MkC,?' /�(XP
PERSON COLLECTING SAMPLES
LABORATORY]2?.j5Ak Lab Cert. #
Comments on sampl collection or analysi
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
❑Zero -flow [:]Watersupply []SA
Other . Q-L/1j:t5C
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
KNo discharge this period?z
Out No.
I
Date Sample
Collected
[mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks,===>
_
100 mg/L or 50 mg/L
A
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 water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier .1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month..
No discharge this perioP2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches 3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy Of this DMR, including all "No Discharge" reports, within 30 dot's of receipt of the lab results (or at end of monitoring period
in the case o "No Dischar e" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: 117.
"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."
(Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2

.l
Semi-annual Storm_water Discharge_ Monitoring Report_(DMR)-
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 6 y ',3' - /is
CERTIFICATE OF COVERAGE NO. NCG16C7 ( 1-3
FACILITY NAME f
COUNTY 4j__�ZP P)c? Cti,
PERSON COLLECTING SAMPLES 1
LABORATORY_ 12T t`.5M, Lab Cert. #
Comments on sar P, collection or analysi s
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,
[]Zero -flaw ❑Water Supply ❑SA
F;;hflther_
KNo discharge this period?'
Ou!KNO.24-hour
Date Sample
Collected
(mo/dd/yr),.
rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks.===>
_
-
100 mg/L or 50 mg/L
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 receivingwaater 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 m L" where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 2, Tier Z, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part R: Vehicle Maintenance Area Monitoring Results: only for'facilities averaging > 55 gal of new oil per month..
No discharge this period72
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===a
_
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• Z EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FORT HE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitorina Deriod
In the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permitte
Permit Date:10/1/2014-9/31/2019
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

ECEI VEt�
e ... STATt: ,.�
APR 2 8 2014
. 4 CENTRAL
�� �• DWQ/$OGES
Stormwater Discharge Outfall (SDQ)
Qualitative Monitoring Report
•
For guidance on filling out this fornr, please visit: htip://h2o.enr.state.nc.us/su/Foram Doc inents.htnAniscforms
Permit No.: NICIbI I LO CI D/ 0 CY or Certificate of Coverage No.: NIC/GILILoIO/ / CI 3l
Facility Name: �
County: Phone No. 7 D H - Sari !7,2. �_
Inspector: �r-� �_�'r >\C-L
Date of Inspection: L4r 9 -- 19
Time of Inspection: q, "ar> ,ter.
Total Event Precipitation (inches):
,So
Was this a Representative Storm Event? (See information below) ❑ Yes No
Please check your permit to verify if'Qtutlitative Monitoring must he perfvrnred during a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0. l inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By t s sig ature, I cert' y that threport s accurate and complete to the best of my knowledge:
(Signature of Per tttee or Designee)
i. Outfall Description:
Outfall No. I
Receiving Stream: S,
Describe the industrial activiti
Structure (pipe, ditch, etc.)
r
that occur within the outfall drainage area: a MCL D- eS
2. Color: Describe the color of the discharge using basic colors
(light, medium, dark) as descriptors: e IQdz.!- Sk"�e.,
brown, blue, etc.) and tint
r- , (�)
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): Ij Ic> A.� C-
Page l of 2
SWU-242- t 12N)S

•
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
lO 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 I is no solids and 5 is extremely muddy:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 0Nq
S. Is there an oil sheen in the stormwater discharge'? Yes No
9. Is there evidence of erosion or deposition at the outfall'? Yes DNo
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
S WU-242-1 12W8