NCG060372_DMR_20210707

R (jejVED
JUL 12. 2021
CERTRALF
DWR SECTION
R `'/ED
2021
DWR SECTIONS
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCGO60000
Date submitted
o�37a
CERTIFICATE OF COVERAGE NO. NCG06 0 0 0 0
FACILITY NAME Harris Teeter Distribution Center - Indian Trail
COUNTY Union
PERSON COLLECTING SAMPLES Mackie McMahan
LABORATORY Waypoint Lab Carl.# 402
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2021
FACILITY ACTIVITIES INCLUDE (check all that
apply)❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ©NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rain all' 0.16 or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Feral Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
IGO or SO
Within 6.0-9.0
120
30
1000
500
001
BRL
7.22
BILL
BRL
002
0617717011
18
7.18
BRL
BRL
003
06/22/2021
BRL
3
BILL
BILL
004
06 2 2021
13
8.08
52
BILL
' Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no if es complete Part B)
Part B: Vehicle Maintenance Area Monitorine Results: only for facilities averaglne> 55 eal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual averse gal/mo
Benchmark
30
'100 or 50
6.0-9.0
' Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

"FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES INA 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, 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 Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, includingthe possibilitypPlr1tes and imprisonment for knowing violations."
(Signature
Additional copies of this form may�ree nloaded at: http://Dortal.ncdenr.org/web/wo/ws/su/npdesswtftab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2

T��
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance unJil/ing unt this form. please 1TVit ham,- da4.111-1'0, ahuutdlc i,wn, cnrm%-❑llnfrJl-land-
rcamrccvcnerav-minrrd-I:md-nernuu,wnnw.ncr-ncrntit>-nndr,-uulueyrd-„v=tah-!
Permit No.: N/C/ /_/_f_!_/_/_! or Certificate of Coverage No.:
FacilityName: Hams Teeter Distribution Center- Indian Trail
County: Union Phone No.
Inspector: ECS
Date of Inspection: 6-22-2021
Time of Inspection: 10:00am
Total Event Precipitation (inches): 0.16
704 844-3531
All permits require qualitative monitoring to be performed during a "measurable storm event"
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 stom7
interval does not apply if the permittee is able to document that u shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office. _
By this signature. I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. 001 Structure (pipe, ditch, etc.): pipe inlet structure
Receiving Stream:
stormwater retention pond
Describe the industrial activities that occur within the outfall drainage area:
oluwater separator, truck wash, fuel station
Page I of 2
SWU-242, LL t mWiticd 072W2017

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.): no noticeable odor
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
2 3 " 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge' O Yes O No
8. Is there an oil sheen in the stormwatcr discharge? 0Ycs E) No.
9, Is there evidence of erosion or deposition at the outfall? O Yes m 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.
Pagc 2 of 2
SwU-242, W1 maiiriad 07292017

I fF
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For gnidancennfillineoptrhisJbrnr,pleaxeriril mo, [,,i.n. _,�, twLit ,i, wn,: _,-uuur�.:i-I;❑:,i
rc uurccs-crterem•-minrntl•IanJ•txnnn++lornmaier-pernw, nndc,-mduatnal +w^tah-4
Permit No.: NICI_l_l_i_i_l_l_l or Certificate of Coverage No.: _NJL/Gi 0 a /0 /0 JO : o
Facility Name: Hams Teeter Distribution Center- Indian Trail
County: Union
Inspector: ECS
Date of Inspection: 6-22-2021
Time of Inspection: 10:00am
Total Event Precipitation (inches): 0.16
Phone No. 704-844-3531
j All permits require qualitative monitoring to be performed during a -'measurable storm event."
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 DEMLR
Regional Office.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. 002 Structure (pipe, ditch. etc.): Pipe
Receiving Stream:
stormwater pond - dry retention basin
Describe the industrial activities that occur within the outfall drainage area:
truck maintenance shop
Page I of 2
SWU 24:, mast modified Of-M2e17

2.
Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
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.): no noticeable odor
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with Floating solids:
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? O Yes E) No.
8. Is there an oil sheen in the stormwater discharge? OYes 0 No.
9. Is there evidence of erosion or deposition at the outfall? O Yes m 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
SWU-242. last modified 074N2017

Kro
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidagccoafillitrgaarrhislortn,pleascvisithpp, dr.i. III .u1N.1hh,ie�ii�i,��u,inire`-❑111ICIal-iand
resources,encrev-mineral-land-nenniustnnmrater-permits npcics-industrial-swgtab-S
Permit No.: NlC/_l_I_l /_/_/_! or Certificate of Coverage No.: N/C/G/o /6 /o /o
Facility Name: Harris Teeter Distribution Center- Indian Trail
County: union
Inspector: ECS
Date of Inspection: 6-22-2021
Time of Inspection: 10:00am
Total Event Precipitation (inches): 0.16
Phone No. 704-844-3531
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site i
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 DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Pemtittee or Designee)
1. Outfall Description:
Outfall No. 003 Structure (pipe. ditch. etc.): pipe inlet structure
Receiving Stream:
stonnwater retention pond
Describe the industrial activities that occur within the outfall drainage area:
drainage swale from warehouse, 18-wheeler truck parking area
Page 1 of 2
SWU•242. Litt mndifi�d e72W2017

2. Color: Describe the color of the discharge using basic colors (red, brown. blue, etc.) and tint
(light, medium, dark) as descriptors:
light green/clear
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.): no noticeable odor
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? O Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? OYes O No.
9. Is there evidence of erosion or deposition at the outfall? O 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 erosionideposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SwU--242. Lost modified 0712IV?O17

Kra
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For RniJance oafrlling Drat dri.+•Jorm. please visit htir,% deq.nc go% about do uum. cnci e.-iwucrtl-land-
resourc"enerey-mineral-land-ocrmi1% slorm%%aternermas. nude+-mdu.tn:d->w=tab-a
Permit No.: LI/C/_/_!_t_!_/_/_/ or Certificate of Coverage No.: Ny/C!G/o /a /o A /o /
Facility Name: Hams Teeter Distribution Center- Indian Trail
County: Union
Inspector: ECS
Date of Inspection: 8-22-2021
Time of Inspection: 10:00am
Total Event Precipitation (inches): 0.16
Phone No. 704.844-3531
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outtall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittce is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittec obtains approval from the local DEMLR
Regional Office.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
(Signature of Pernittee or Designee)
1. Outfall Description:
Outfall No. 004 Structure (pipe, ditch, etc.): ditch
Receiving Stream:
stommater retention pond - dry retention basin
Describe the industrial activities that occur within the outfall drainage area:
runoff from 18-wheeler truck parking area
Page I of 2
aWU 242, LOsi modified 07OW.1017

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
dark green
3. Odor- Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.): slight decaying organics odor
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge' Q Yes O No.
8. Is there an oil sheen in the stormwater discharge? OYes E) No.
9. Is there evidence of erosion or deposition at the outfall? O Yes m 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
SWU-242. Um modified a7P_8ne17