NC0022497_Regional Office Historical File Pre 2018

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T NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
R NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
DE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 07-2019 (July 2019) VERSION: 2.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
X
o'
e
F
e
E
U°
gg
F
.8
u°
A
k%
1-
€
7.
O
w
o
F
5
o
Ea
a
O
e
8
s5
9.
a
Z
50056
00010
00400
50060
C0310
C0610
C0530
31616
00300
Centinvops
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TEMP-C
p11
CHLORINE
DOD -Cone
N113-N-Cone
T55•Coae
ECOL1 OR
DO
2300 cIok
Hr.
2400 clock
Hn
Y7847
m8d
degc
su
ue,J1
moil
malt
mgll
0/100m1
moll
t
0720
.42
Y
0.013
23
2
1030
1400
.58
Y
0.014
24
3
0950
23.3
0920
1.0
Y
0.014
23
6.4
33
<2
<0.2
<2.5
<I
5.7
.
HOLIDAY
3
0735
.62
Y
0.019
24
< 17
6
0.017
7
0.019
9
1215
.83
Y
0.012
25
9
1340
.66
Y
0.011
25
10
1030
1400
.50
Y
0.012
25
11
0958
23.4
0900
1.33
Y
0.011
24
6.6
< 17
<2
< 0.2
< 2.5
< 1
5.4
12
1135
1.17
Y
0,012
24
<17
13
0.013
14
0.013
19
1235
.33
Y
D.012
24
16
1225
.42
Y
0.015
24
17
1030
1355
.58
Y
0.011
25
18
0912
22.7
0845
1.0
Y
0.012
24
7.2
<17
<2
<0.2
<2.5
<I
5.8
19
1225
.75
Y
0.013
25
<17
20
0.013
21
0013
22
1225
.58
Y
0.011
25
u
1235
.66
Y
0,014
24
21
1030
1355
.58
Y
0.012
24
26
0925
22,9
0845
1.25
Y
0,012
22
7.6
< 17
<2
<0.2
<2.5
<1
5.8
26
1215
.66
Y
0,012
23
< 17
27
0012
25
0,016
29
1205
.83
Y
0.013
23
30
1210
.58
Y
0.011
23
31
1030
1405
.50
Y
0.01
24
Monthly Avenge Llmic
0065
30
3
30
2011
D:onrhly Avenge:
0.013067
23.954545
4.125
0
0
0
1
5,675
Daily Mstn un.
0.019
25
7.6
33
0
0
0
0
5.8
D.ily Mlaknum:
0.01
22
6.4
0
0
0
0
0
5,4
No Reporting Reasoaa: ENFRUSE No Flow-Reuse/Recycle; ENVWTHR=NoVisitation- AdverseWeather; NOFLOW=No Flow; HOLIDAY=No Visitation - Holiday

IT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
FR NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
DE: WW-2 ORC HAS CHANCED: No
eDMR PERIOD: 07-2019 (July 2019) VERSION: 2.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
4
~
,
e
E
U
Tole Compo.ile Time
F
11
<
2
S
C
F
!
§
•
01
€
p
3
a
X
S.
x
Cam
Co665
Quarterly
Quarterly
Composite
Composite
TOTAL N-Cunt
TOTAL P - Coot
2400 clock
Hn
2400 clock
Hn
YFBIN
mg/I
mg)
1
0720
.42
Y
1
1030
1400
.58
Y
3
0950
23.3
0920
1.0
Y
25.28
3.62
4
HOLIDAY
5
0735
.62
Y
6
7
8
1215
.83
Y
9
1340
.66
Y
10
1030
1400
.50
Y
11
0958
23.4
0900
1.33
Y
12
1135
1.17
Y
13
14
1S
1235
.33
Y
16
1225
.42
Y
17
10313
1355
.58
Y
111
0912
22.7
0845
1.0
Y
19
1225
.75
Y
20
21
22
1225
.58
Y
23
1235
.66
Y
24
1030
1355
.58
Y
25
0925
22.9
0845
1.25
Y
26
1215
.66
Y
27
2s
29
1205
.83
Y
30
1210
.58
Y
31
1030
1405
,50
Y
Monthly/0 erne Lima:
Monthly Menge:
25.28
3.62
Dail, 0 isnon:
25.28
3.62
Daily Mlninn.=
25.28
3.62
"aalloReporting Reason: ENFRUSE=NoF1ow-Reuse/Recycle; ENVWTHR=NoVisitation -- Adverse Weather, NOFLOW=No Flow; HOLIDAY= No Visitation - Holiday

IT NO.: NC0022497
NAME: Cross Country Campground
R NAME: Cross Country Campground
DE: WW-2
eDMR PERIOD: 07-2019 (July 2019)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 2.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SUBMISSION DATE: 09/04/2019
09/04/2019
ORC/Certifier Signature:
G eg Trombello E-Mail:gmetwater(r✓yahoo.com
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The perm ttee shall report to the Director or the appropriate Regional Office any noncomplian
Any information shall be provided orally within 24 hours from the time the permittee became
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -
the NPDES permit.
Phone #:[phone] Date
ce that potentially threatens public health or the environment.
aware of the circumstances. A written submission shall also be
table for improvements to be made as required by part II.E.6 of
09/04/2019
Permittee/Submitter Signature:*** Gig Trombello E-Mail:[e-mail] yahoo.com Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

lopir th: NC0022497
IC: Cross Country Campground
ME: Cross Country Campground
p
WW-2
., 'IR PERIOD: 06-2019 (June 2019)
PERMIT VITRSION:
CLASS; WW-2
ORC: Gregory Alettondttr Trombei
614' 2
ORL HAS CHANCED: No
VERSION:
PERMIT STATUS: Actit\iEve
::OUNTY: Catawba
ORC CERT 'NUMBER: 1005: 05
kJ\ RLF:'3
avvR sEcTio;i STAT uS: Processed
SAMPLING LOCATION: D 'NS 'REAM DISCHARGE NOQI
2 2t
14
1,5
112,1P,C
. deg c
Mombly, Atm&
Monthly AMtrAget
Nett Mmimtmt: ,„
i'Mttt, Minimum
t
fFVEDfCDEN
ROS
"QLE REGIONAL OFFICE
**** No Reporting Reason: ENFRUSE ,,- Fhyx-ReuseiRecycle:, LNYWTHR - No t nation Adt,orse Wean ken NOtil 1ton, - No V u,,a1Mion 1Aiday

NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
ss Country Campground CLASS: W W-2 COUNTY: Catawba
: Cross Country Campground ORC: Gregory Alexander Trombclio ORC CERT NUMBER: 1005905
W-2 ORC HAS CHANGED: No
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
r
r
v.
0
u
r
-
e`
tj
w
F
Operator Arrival Time i
O
s
:
g
•
G
0
p
0
IContinuous
a
5
j
50050
00010
06400
50060
C0310
C0610
C0530
31016
00300
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Grub
Grab
Grab
Composite
Composite
Composite
Grub
Grab
FLOW
TEMP-C
p11
CHLORINE
DOD-Cooe
NH3-N-Cone
T55-Cone
MOLL BR
DO
2400 dock
lira
2400 clock
Hn
YI8TN
mgd
dcgc
su
ug/I
mg/
mg/1
mg/1
5/100m1
mg/1
l
2
3
1110
.66
Y
0.02
21
4
1230
.92
Y
0.015
21
5
1030
1400
.50
Y
0.015
21
6
0942
23.2
0915
.66
Y
0.013
21
6.5
25
<2
<02
<2.5
<1
5.8
7
1215
.83
Y
0.019
21
<17
13
0.024
9
0.034
10
1150
1.33
Y
0.016
22
11
1210
.92
Y
0.013
21
12
1030
1350
.33
Y
0.014
21
13
0943
23.2
0910
.92
Y
0.014
20
6.7
<17
<2
<0.2
<2.5
<1
5.7
14
1240
.58
Y
0.013
21
< 17
15
0.014
16
0.014
17
1150
1.0
Y
0.013
21
18
1315
1.25
Y
0.02
21
19
1030
1400
.50
Y
0.012
22
20
1015
23.7
0950
.75
Y
0.012
22
6.3
22
<2
1.57
<2.5
<1
5.5
21
1200
.92
Y
0.013
22
< 17
22
0.014
23
0.015
24
1135
1.25
Y
0.015
23
25
1205
.75
Y
0.013
23
26
1030
1350
.42
Y
0.013
23
27
0941
23.1
0915
1.0
Y
0.013
22
6.9
<17
<2
1.12
<2.5
<1
5.3
26
1210
.75
Y
0.013
23
< 17
29
0.015
30
0.016
Mon to Average limit
0A65
30
3
30
200
Monthly Average:
0.015536
21.6
5.875
0
0.6725
0
1
5.575
Da0y t•[aatmam:
0.034
23
6.9
25
0
1.57
0
0
5.8
Daily Minimum:
0.012
20
6.3
0
0
0
0
0
5.3
"" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR - No Visitation -Adverse Weather; NOFLOW = No Flow; HOLIDAY =No Visitation - Holiday

1piNC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
ss Country Campground CLASS: WW-2 COUNTY: Catawba
E: Cross Country Campground ORC: Gregory Alexander Trombcllo ORC CERT NUMBER: 1005905
r
W-2 ORC HAS CHANGED: No
IOD: 06-2019 (June 2019) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
pa
I.
fin.FL'
5
rj
Total Composite Time
111
Y
aLi
E
Operator Time On Site
o
5
p
0
cl
a
a
j
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTAL N - Cane
TOTAL. P-Con e
2400 clock
Ms
2400 stock
H.
Y18/N
mg/1
mg/1
1
2
3
1110
.66
Y
4
1230
.92
Y
5
1030
1400
.50
Y
6
0942
232
0915
.66
Y
7
1215
.83
Y
8
9
10
1150
1.33
Y
11
1210
.92
Y
12
1030
1350
.33
Y
13
0943
23.2
0910
.92
Y
14
1240
.58
Y
15
16
17
1150
1.0
Y
18
1315
1.25
Y
19
1030
1400
.50
Y
20
1015
23.7
0950
.75
Y
21
1200
.92
Y
22
23
24
1135
1.25
Y
25
1205
.75
Y
26
1030
1350
.42
Y
27
0941
23.1
0915
1.0
Y
is
1210
.75
Y
29
30
%Ion hly Average limit:
Monthly Ai craze:
Daily Maximum:
Daily 31inimam:
No Reporting Reaon: ENFRI.JSE = No Flow-Reuse/Recycle; ENVWTHR—No Visitation -- Adverse Weather; NOFLOW = No Flow; HOLIDAY=NoVisitation— Holiday

WW-2
R PERIOD: 06-2019 (June 2019)
: NC0022497 PERMIT VERSION: n.0 PERMIT STATUS: Active
1E: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
.ME: Cross Country Campground ORC: Gregory Alexander Fromhello ORC CERT NUMBER: 1005905
ORC HAS CHANCED: No
VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
=
g
F fu
H
6.4
s
Ip^
!
08010
00300
Weekly
Weekly
Grab
Grab
TE11P-C
DO
2400 deck
deg c
mrdl
2
3
4
5
6
0924
20
7.8
T
8
9
10
11
12
13
0924
18
8.6
rl
15
16
IT
18
19
20
0953
23
7.5
21
22
23
24
25
26
27
0922
21
8.3
28
29
30
Monthly Average Limit:
Monthly Menlo:
20.5
8.05
Doily Maximum:
2.i
8.6
Daily .Minimum:
l8
7.5
•**• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation— Advert Weather, NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

O.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
ir
1E: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
ME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
: WW-2 ORC HAS CHANGED: No
PERIOD: 06-2019 (June 2019) VERSION: 1.0 STATUS: Processed
COMPLIANCE STATUS: Compliant CONTACT PHONE #: [phone] SUBMISSION DATE: 07/30/2019
07/30/2019
ORC/Certifier Signature: Gr Trombello E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to he made as required by part II.E.6 of
the NPDES permit.
07/30/2019
Permittee/Submitter Signature:*** Gre Trombello E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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 lines and imprisonment for
knowing violations.
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be an file with the state per 15A NCAC 2B
.0506(b)(2)(D).

O.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
E: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
ME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
: WW-2 ORC HAS CHANGED: No
R PERIOD: 06-2019 (June 2019) VERSION: 1.0 STATUS: Processed
Report Comments:
FLow is missing for days 6-1-19 and 6-2-19. Flow chart cord fell unplugged over weekend for unknown reason.

ipprr
' NO.: NC0022497 PERMIT VERSION:4 ) 'PERMIT" STATUS: ,,\ etive
AME: Cross Counu'Campground CLASS: W W-2 COUNTY: Catawba
'ANIE: Cross Coon try Campground CIRC Gregory Alexander 'frombello —"'—' '",-'1, I ;01*:::cERT NUMBER: 1005905
V. OR( HAS ( HANGED: No
NIR PERIOD: 05-2019 (Ma.y 2019).VERSION! I 0
STA ICS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
W OROS
M 00 R ESV1 E E GIO . 0 Er
EifNi.,st RiDwR
lh
Ai,erage LimiL
Monthly Averagr
**** No Reporting Reason: EN) RUSE No Flow-Ren5o/Royele:, F:N vati R. — No Visnanon .AdveJse We:ober: NOHFLOW No Flow:.. HOLIDAY — Viskanon HcAiday

NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
AME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
AME: Cross Country Campground ORC: Gregory Alexander Trombcllo ORC CERT NUMBER: 1005905
E: WW-2 ORC HAS CHANGED: No
PERIOD: 05-2019 (May 2019) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
O
P
e
e
U
e
U'
7
2
la
1
0
6
Operator Time On Site
o`
a
n
e
g
d
50050
00010
01400
50060
C0310
C0610
C0530
31616
00300
Continuous
5 X week
Weekly'
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Grrb
Grab
Grab
Composite
Composite
Composite
Grab
Gtub
FLOW
TEMP-C
PH
CHLORINE
POD -Cone
NH3.N.Corr
T5S-Caere
000L111R
DO
2400 clock
Hn
2400 clack
Hre
YIBIN
tngd
dcg c
su
ug/1
mgll
mg/I
mgll
4ll00ml
mgll
1
1030
1350
.42
Y
0.012
19
2
1000
23.5
0915
.83
Y
0.014
19
7.4
<17
<2
<0.2
<2.5
<I
6.9
a
1210
.92
Y
0.013
19
<17
4
0.015
5
0.019
6
1130
.75
Y
0.015
20
7
1215
.75
Y
0.015
20
8
1030
1405
.33
Y
0.014
20
9
1020
23.8
0940
.75
Y
0.013
19
7
<17
< 2
<0.2
4.7
< 1
5-3
10
1250
.58
Y
0,013
20
<17
11
0.037
12
0.02
13
1210
.83
Y
0.016
19
14
122D
.83
Y
0.014
19
15
1030
1405
.50
Y
0.014
19
16
0945
23.2
0905
1.08
Y
0.015
16
6.9
<17
< 2
< 0.2
9.7
< I
6.8
17
1230
.66
Y
0.016
19
< 17
18
0.015
19
0,018
20
1200
.66
Y
0.015
20
21
1130
1.5
Y
0.016
20
22
1030
1400
.50
Y
0.014
20
73
1012
23.7
0945
.75
Y
0.015
20
7.2
< 17
<2
< 02
5.2
< 1
6.1
39
1245
.42
Y
0.015
21
< 17
25
0.018
•
26
0.02
27
HOLIDAY
28
1205
.83
Y
0.014
21
29
1030
1405
.50
Y
0.016
22
30
1017
23.7
0945
.83
Y
0.014
22
6.5
<17
<2
<0.2
4,7
<1
5.2
31
1245
.50
Y
0.013
22
< 17
Mon 01y Average Limit:
0 065
30
3
30
200
]Iootkly Average:
0.015933
19.909091
0
0
0
4.86
1
6.06
Daily Marimom:
0.037
22
7.4
0
0
0
9.7
0
6.9
Dolly Minimum:
0.012
18
6.5
0
0
0
0
0
5.2
*•"e No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation - Holiday

NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
AME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
AME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
E: WW-2 ORC HAS CHANGED: No
MR PERIOD: 05-2019 (May 2019) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
o
A
F
sc.
4;
S.e°
u
Total Composite Time
Operator Arrival Time
—
F
O
w
u
O
I
o.
zA
C0600
C0665
Quarterly
Quancrly
Composite
Composite
TOTAL N-Cone
TOTAL P - Cone
2400 clock
Hn
2400 clock
firs
Y(B N
mg/1
mgll
1
1030
1350
.42
Y
2
1000
23.5
0915
.83
Y
3
1210
.92
Y
4
5
6
1130
.75
Y
7
1215
.75
Y
8
1030
1405
.33
Y
9
1020
23.8
0940
.75
Y
to
1250
.58
Y
11
12
13
1210
.83
Y
14
1220
.83
Y
15
1030
1405
.50
Y
16
0945
23.2
0905
1.09
Y
17
1230
.66
Y
18
19
20
1200
.66
Y
21
1130
1.5
Y
22
1030
1400
.50
Y
23
1012
23.7
0945
.75
Y
24
1245
.42
Y
25
26
27
HOLIDAY
28
1205
.83
Y
29
1030
1405
.50
Y
30
1017
23.7
0945
.83
Y
31
1245
.50
Y
Mon My Avenge Limit:
JIont11y Average:
(lolly Maximum:
Daily Minimum:
.•is No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
AME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
ME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
lop
: WW-2 ORC HAS CHANGED: No
ERIOD: 05-2019 (May 2019) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
s
17'TE41P-C
—
h
9
a
2
0.
00010
00300
Weekly
Weekly
Grab
Grab
DO
2400 clerk
deg c
vigil
1
2
0922
18
10.2
3
4
5
6
7
8
9
0945
18
8.8
10
11
12
13
14
I5
16
0916
15
9.3
17
t8
19
20
21
22
23
0950
19
8.5
24
25
26
17
28
29
30
0950
21
R.3
31
Monthly Average Limit:
]Monthly Average:
18.2
9.02
Doily Alnimum:
21
10.2
Daily ]Minimum:
15
8.3
9•*' No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY _ No Visitation — Holiday

NO.: NC0022497 PERMIT VERSION; 4.0
E: Cross Country Campground CLASS:: W\\2
:E: Cross Country Campground ORC: Gregory Alex.ander Troinhollo
ORC HAS CHANGED: No
VERSION: 10
COMPLIANCE STATUS: Compliant CONTACT PHONE #: 704900
L. W W-2
MR PERIOD: 05 2019 (May 2019)
ORCICertifier Signature:
PERMIT STATUS; Active
COUNTY; Catawba
ORC CF,RT NUMBER: 1005905
STATUS: Processed
SUBMISSION DA'FE: 06/:30/2019
Tronibcllo E-Mail:gmetwateriii,yahoo.com Phone :4,704-9 S9-016,5
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge.,
06130/2019
Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance Oral potentially threatens public health or the environment,
Any infomiation shall be provided orally within 24 hours from the time the permittee became aware of the circumstances, A written submission shall also he
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part 11„E„6 of
the NPDES permit,
06130/2019
Pertnittee/Submitter Signature:*** Eirg Trombello [e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Pertnit Expiration Date: 04/30/2020
I certify, under penalty of law:, that this document and all attachments were prepared under illy direction or super noon 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 managed the
system„„ or those persons directly responsible for gathering the infonnation, 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 to:
knowing violation.s.
1,AB NAME: Water Tech 'Labs Inc.
CERTIFIED LAB 0 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAIYIr 1ER CODES
Parameter Code assistance may be obtainedby calling the NP.DES Unit [phone] or by visiting 'http://portal,nedenr.orglwehlwq1swplpsInpdesifonns„
FOOTNOTES
Useonly units of measurement designated in the reporting facility's NPDES permit for reporting data:
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there .are no data to be entered for all of the parameter's on the DMR.
for entire monitoring period,
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the pernhiltec, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

prli
O.: NC00224M 97 PERIT VERSION: 4,0
,ME: Cross Country Campground CLASS: WAV-2
i AME: Cross Country Campground ORC: Gregory Add:milder Id-or:MGM
El YW2 ORC HAS CHANGED: N
io,
MR PERIOD: 04-20d 9 (April 2019) VERSION: 2,0
3 6 PIF-RMI1 STATUS Active
COUNTY: Cittawba
dif id/RC CERT N 1.37(1 DER: 1005905
PIECE RISONCOENRIDWR
S I V11 S: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO/6
MOORE'S kt G ION =
82
; 1
-it 8 .
0 i
i
:11
Lt t t
i
1 s i-
.c., H,
2409 02042 Hes 2499 2742220 5712275"
1240 513
1250 58
1010 1400 .50
I I 2105 2 3„5 0940
12(0 80
13 1030
89318 23„4
I 1413 : 1,35 721
1,240 2332 I
1400 „50 11Y
3342 321
81
V 241 ! .1313
11
IS
1213
17
73"
1215 ,5211'8
I 340 42 I Y
JS: 2 ! 23,5 0323
• 1202
Y
1 21
22
3
1125 1:33
1250
24 10.10
14
09236 22,6
58
50
1.25
L 1200 1 08
27
29
1050
58959
Ll:IontinteLrtrs
Recorder
22'2,oss'
02115
332210
02017
5017
23029
0.021
0(4
0,037
0.022
0,016
0.017
2303 !
0,020
0,02
0,017
130 I 5
0 017
08818
11446 46966 coma C0810
C0530,
31818
18)819*1
5 ,X wen trolly 2 X teek 90223.10 +.550010 WM.:1y 3822902:1y
Grah 1 (.0 012213 0210 posit0 dempoolle ConnlesIte 072,2220 ` Grab
Tr sm.c p88 C111,0,8U80E OD L Cc8,8 MO-N.' , Coot "ISS L. C848 /LLCM]: DR DO
2292
03315
0,012
5
518
Lodi
rned
mad
0,100n11 II
3 222 17
5,9
522202910 ikvaerage 1,11041
05165
Monthly AveritgeLL
1(87
16,2331030
118
2375 0.7175
8)ddds 5222:220-9229,
1.037
037
7,1
13 2 22
290
3:3751 6.7
9,9 7.7
"" No Reporting Reason: ENFRUSE No How-Reuse/Recycle: ti:NN/WIttk - No V Lsitatior Ndser:LLe 'Wetaller: NOFLOW d No How.: HOLID,V6 L No V3181118111- idity
3.6

O.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
ME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
AME: Cross Country Campground ORC: Gregory Alexander Trombcllo ORC CERT NUMBER: 1005905
E: WW-2 ORC HAS CHANGED: No
MR PERIOD: 04-2019 (April 2019) VERSION: 2.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
o
E
F
g
y
.V.
o
0-a
V
E
_
'
U'
F=
Operator Arrival Time
E.-,
E
IZ
2
E.
O
0
O
O
e
Y
'E
=
Y
'[,
C0600
C0645
Quarterly
Quarterly
Composite
Composite
TOTAL ti-enac
TOTAL P - Cone
2400clerk
lira
2400clock
11n
WEN
mull
mg1
1
1240
.58
Y
2
1250
.58
Y
3
1030
1400
.50
Y
4
1005
23.5
0940
.58
Y
12.78
2.12
5
1230
1.0
Y
6
7
e
1140
1.33
Y
9
1240
.92
Y
la
1030
1400
.50
Y
11
0958
23.4
0940
.58
Y
12
1240
.83
Y
13
14
15
1215
.75
Y
16
1215
.50
Y
17
1030
1340
.42
Y
III
1002
23.5
0920
.83
Y
19
1200
.66
Y
29
21
22
1125
133
Y
23
1250
.58
Y
j4
1030
1400
.50
Y
25
0906
22.6
0825
1.25
Y
26
1200
1.08
Y
27
28
1050
.25
Y
29
1200
1.0
Y
30
1.
Monthly Average Limit:
!dandily Axerage:
12,78
2.12
Daily Maximum:
12.78
2.12
Daily alinimum:
12.78
2.12
*86* No Reporting Reason: ENFRUSE No Flow-Reuse/Recycle; ENVWTHR=No Visitation -Adverse Weather, NOFLOW No Flow; HOLIDAY=NoVisitation- Holiday

IrNC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
oss Country Campground CLASS: WW-2 COUNTY: Catawba
s Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
ORC HAS CHANGED: No
19 (April 20I9) VERSION: 2.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
o
F
6
h
a
a
.�
z
x.
00010
00300
Weckty
Weekly
Grab
Grab
TEMI-C
D0
2400 dock
drg c
mgil
1
2
3
4
0944
12
10.2
s
6
l
8
9
10
11
0916
14
10
12
13
14
15
16
17
18
0930
15
9.6
19
20
21
22
23
24
35
0839
16
9.1
26
27
28
29
30
—
3198114 Avenge Limit;
Monthly A, erne:
14.25
9.725
Da0yMittman
16
10.2
Daily 311a1rnam.
12
91
**** No Reporting Reason: ENFRUSE= No Flow-Reuse/Recycle; ENVWTHR —No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY=NoVisitation— Holiday

O.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
. ME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
. AME: Crass Country Campground ORC: Gregory Alexander Treasono ORC CERT NUMBER: 1005905
E: WW-2 ORC HAS CHANGED: No
MR PERIOD: 04-2019 (April 2019) VERSION: 2.0
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
p
B
F
It
el
1.0
E
c
a
00010
00320
Weekly
Weekly
Grab
Grab
TEMP-C
Pa
2400 clock
dcg c
mg/1
1
2
3
I I
11.4
1
0953
5
6
7
a
9
la
11
0924
14
9.8
13
13
14
15
16
17
16
0940
15
9.2
19
20
21
22
23
74
25
0849
16
8.8
26
27
28
29
30
alonlhly Average Limit:
VoathIy Average:
14
9.8
Daily Maximal:
16
11.4
Daily .tllaimam:
ll
8.8
*** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recyele; ENVWTHR = No Visitation— Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

O.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
E: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
AME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
E: W W-2 ORC HAS CHANGED: No
MR PERIOD: 04-2019 (April 2019) VERSION: 2.0 STATUS: Processed
COMPLIANCE STATUS: Compliant CONTACT PHONE #: [phone] SUBMISSION DATE: 06/04/2019
06/04/2019
ORC/Certifier Signature: G eg Trombello E-Mail:gmetwater[ayahoo.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
06/04/2019
PermitteelSubmitter Signature:*** Greg Trombello E Mai.1:[e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC Hwy I50 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for ail of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per I5A NCAC 2B
.0506(b)(2)(D).

NO.: NC0022497
ME: Cross Counny Cammound
ME: Cross Country Campground
!W-2
,RIOD: 03i-2019 (March 2019)
PERMIT VERSION: TO
TERMEr STATUS:
CLASS: .WW--2 COUNTY: Catawba
ORC: Gregory Alexander TrombellolUL 1 1 ;:!1,. Ur.) ORC CERT NUMBER; 1005905
ORC RAS CRANCED: No i9449.4 ECENEDINCDENRIDWR
VERSION: 2.0 ' ' ; STATES: Processed
SAMPLING °CATION': DOWNSTREAM DISCHARGE NO.: 001 wcpos
MOORESVILLE PEGIONAI OFFEEE
\ "Ming
.15942,1424
2145421-0
10112
941191141
4
6
7
13
14
15
9111
14
17
19
211
21
22
0943
23
15
27
2/2
9'3
131
Iti
1132
I 10,
419411715 5599944 9191111
Monthly AVer445,
0i90 °,00999,00, w
Dah Ntoiromm
t1.475
130
"" Na Reporting Reason: ENFRUISE -No Flow-Reuse/Recycle; ENVW1FIR No Nihsitaiion - Adverse Weather NOELOW - No Flow; HOLIDAY - No Visitation - Hord

NO.:NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
ME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
E: Cross Country Campground ORC: Gregory Alexander Trombcllo ORC CERT NUMBER: 1005905
W-2 ORC HAS CHANGED: No
RIOD: 03-2019 (March 2019) VERSION: 2.0
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
STATUS: Processed
Ih.
ti
E
U
F
1
5
V'
F
Operator Arrival Time
V
til
ce
e
l
-
e
,8'o
_
8
U
.
a111
j
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Continuous
5 X week
Weekly
2 X week
Weekly
Weekly
Wally
Weekly
Weekly
Recorder
Grab
Grab
Grab
Composite
Composite
Composite
Grub
Grah
FL(Y.S
TF81P-C
pll
CHLORINE
BO➢-Cony
3113-N-Cone
T55-Cant
FCOLI BR
DO
2400 clock
Hrs
2400 c104k
Hrs
Y/B/N
mgd
deg c
su
ugl1
mg11
mg/1
mgll
11/ l O0m1
mg/1
I
0.038
2
0730
.58
Y
0.034
13
18
3
0.022
4
1340
.33
Y
0.022
12
0
1240
.58
Y
0.018
12
6
1030
1400
.50
Y
0.019
11
7
1002
23.5
0930
.58
Y
0.019
10
7.4
24
<2
<112
5.3
< I
9,8
s
1255
.50
Y
0.019
10
19
9
0.021
10
0.02
11
1255
.50
Y
0.017
13
12
1230
.66 .
Y
0.017
14
13
1030
1325
.33
Y
0.016
13
14
0920
22.8
0840
.83
Y
0.017
13
7.5
<17
<2
< 0.2
3.6
< 1
7.9
15
1230
.58
Y
0.018
14
<17
16
0.017
17
1855
.33
Y
0.02
15
18
1230
.66
Y
0.017
14
19
0.017
20
1030
1415
.25
Y
0.017
13
21
1003
23.5
0925
,75
Y
0.016
13
7.2
<17
<2
<0.2
<2.5
<I
8
22
1240
.59
Y
0.017
14
< 17
23
0.018
24
0.019
25
1235
.58
Y
0.018
15
26
1100
.42
Y
0.017
15
17
1030
1400
.50
Y
0.017
14
22
0953
23.3
0910
.83
Y
0.017
13
7.7
< 17
<2
<0.2
5.3
< I
8.2
29
0.017
30
1630
.50
Y
0.017
15
< 17
31
0.018
.44-
-4.
-
'I
]ton Sly Avenge Limit
0-063
.
30
9
30
s
290
Mor1h1y Average:
0.019226
13.142857
6.777778
0
0
3.55
1
8.475
➢*Ily 3fu.lmom:
0.038
15
7.7
24
0
0
5.3
0
9.8
➢aiIy StiOimum:
0.016
10
7.2
0
0
0
0
0
7.9
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation -Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation - Holiday

W-2
NO.:
E:
E: Cross
NC0022497
PERMIT VERSION: 4.0 PERMIT
CLASS: WW-2 COUNTY:
STATUS: Active
Cross Country Campground
Catawba
Country Campground
ORC:
ORC
VERSION:
EFFLUENT
Gregory Alexander Trombello ORC CERT NUMBER: 1005905
(March 2019)
HAS CHANGED: No
2.0 STATUS:
DISCHARGE NO.: 001 NO
Processed
RIOD:
AMPLING
03-2019
LOCATION:
DISCHARGE*: NO (Continue)
Dale
Composite Sample Time
I
6`
t°
—
w
Operator Arrival Time
Operator Time On Sile
10
O
u
FC
O
•
a
1
E.
x
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTAL N - Conc
TOTAL P • Conc
140D clock
Hra
2400 clock
Hn
YIWN
mb,/I
MO
1
2
0730
.58
Y
3
4
1340
.33
Y
5
1240
.58
Y
6
1030
1400
.50
Y
7
1002
23.5
0930
,58
Y
8
1255
.50
Y
9
10
11
1255
.50
Y
12
1230
.66
Y
13
1030
1325
.33
Y
11
0920
22.8
0840
.83
Y
15
1230
.58
Y
16
17
1855
.33
Y
18
1230
.66
Y
19
28
1030
1415
.25
Y
21
1003
23.5
0925
.75
Y
22
1240
.58
Y
23
24
25
1235
.58
Y
26
1100
.42
Y
27
1030
1400
.50
Y
28
0953
23.3
0910
.83
Y
29
30
1630
.50
Y
31
5Ionthly Average Li aic
Monthly Average:
Doily 31aaimam:
Dal1y 3Itolmum:
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

-2
OD:
O.: NC0022497 PERMIT
VERSION: 4.0 PERMIT
W W 2 COUNTY:
STATUS: Active
: Cross Country Campground CLASS:
Catawba
E: Cross Country Campground ORC: Gregory Alexander Trombollo ORC.
CERT NUMBER: f 005905
Processed
ORC
03-2019 (March 2019) VERSION:
HAS CHANGED: No
2.0 STATUS:
UPSTREAM DISCHARGE
SAMPLING LOCATION:
NO.: 001
P.
e
;�
I
a
a,.
x"
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 dock
dcg a
mn i
1
3
4
5
6
7
0933
7
12.3
a
9
10
12
13
14
0848
10
1 D.4
15
16
17
IS
19
20
21
0931
10
11.2
22
23
24
25
26
27
211
0920
8
9.9
29
30
31
Monthly, Avenge Lbni1:
Mombly Averse;
8.75
10.95
Daily Maximum:
10
12.3
Daily Minimum:
7
9.9
*"** No Reporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY =No Visitation— Holiday

NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
E: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
E: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
-2 ORC HAS CHANGED: No
OD: 03-2019 (March 2019) VERSION: 2.0 STATUS: Processed
IANCE STATUS: Compliant CONTACT PHONE #: [phone] SUBMISSION DATE: 05/01/2019
05/01/2019
RC/Certifier Signature: Gr g Trombello E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
41
Permittee/Submitter Signature:*** G eg Trombello E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
05/01/2019
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.orglweb/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

pir, ,,,,,,D.., NC:0022=197
. NAME: CrOSS C011.111ry Campground
NAME: Gross Couniry Campground
. : E: WW-2
. MR PERIOD: 02-2019 (Febnlary 2019.1
PERMIT VERSION:
RFr t\PERMIT SIAVI1S: Active
CLASS: WAV-2 ' IF DcouN"IN: Camwlm
ORC: Grcoory Alexander Trombelkr 2 0 19 oRc c14 KT NUMBER: I 005905
ORC RAS CH(EL) CEN NAL FiL,ES
% EK'IO. 1 0 OMR SECTION sTA-ccs: Processed
CPR"' roNcoENRIDWR
SAMPL. NG LOCATION: DOWNSTREAM DISC ARGE NO.: 09_, woRos
p5,,,,w1NAL,
70bniatutm
1)4k1,,, Nliairmon:
IF SIPA'',
01cp
"" No Reporting Reason: ENTRUST - No Flow-Rttui,i/Porcyd ENV',,ATHR tt No. — Adverse Wexher, NOIMOVV -- low; HOLIDAY No V.1511a0on F14.11iitay

IT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
E: WW-2 ORC HAS CHANGED: No
MR PERIOD: 02-2019 (February 2019) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
A
Composite Sample Time
E
F
v.
E
z
(2O
Operator Arrival Time
Operator Time On Site
a'
0
4.:x
ir
e
T
2.
7
50050
00010
0010
511060
C0310
C0610
C0530
31616
00300
Continuous
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grdb
FLOW
TEMP-C
pH
CIILOHINE
HOD -Cove
NE1341-Coon
155-Cove
FCOLI DR
DO
2406 clock
Hn
2400 crock
Hrs
Y!H!N
mad
deg a
su
WI
mg/1
mg/1
mg11
10ll00ml
mgll
1
1315
.25
Y
0.019
10
<17
2
0855
.33
Y
0.018
10
3
0.018
4
1250
,66
Y
0.017
11
5
1210
.75
Y
0.017
13
6
1030
1415
.25
Y
0.016
12
7
1002
23.5
0930
.83
Y
0.016
13
7.4
<17
<2
<0.2
3.5
<1
8
a
1255
.50
Y
0.015
15
<17
9
0.016
10
0.017
11
1220
.33
Y
0.016
13
11
1155
.92
Y
0.022
13
13
1030
1205
.66
Y
0.02
14
14
0957
23.4
0935
.75
Y
0.019
11
7,8
<17
<2
<02
3.6
<1
8.9
15
1315
.42
Y
0.018
14
<17
16
10.031
17
0.027
10
1220
.58
Y
0.06
13
19
1125
.50
Y
0.026
11
20
1030
1400
.50
Y
0.044
11
21
0850
22,3
0815
.75
Y
0.065
9
7.3
< 17
< 2
< 0.2
4.8
<1
9,9
22
1250
.58
Y
0.06
11
< 17
23
0.036
24
0.024
23
1440
.42
Y
0.018
12
26
1150
1.0
Y
0.016
12
27
1030
1400
,50
Y
0.016
13
28
1005
23.5
0925
.83
Y
0.041
12
7.8
23
<2
<0.2
:3.5
<1
9.2
Man hly Avenge Limit:
0.065
!
30
9
30
200
Monthly Menge:
0.026
12.047619
2.875
0
0
3.85
1
9
Daily Maximum:
0.065
15
7.8
23 I
D
0
14.8
0
9.9
Rally Minimum:
0.015
9
7.3
0 .0
0
3.5
0
8
No Reporting Reason: ENFRUSE = No Flow-ReuselRecycle; ENVWTHR=No Visitation- Adverse Weather, NOFLOW=No Flow; HOLIDAY = No Visitation - Holiday

IT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
DE: WW-2 ORC HAS CHANGED: No
MR PERIOD: 02-2019 (February 2019) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
A
1I
1
e
v
Total Composite Time
9
E.2
—
i
y
r.
p.
G
22
q
O
.12
e
&
ORC On Site?1e
!tie Reporting Reason'*'•
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTAL st-CantTOTAL
P-Cone
2J00 clock
Hn
2107 clock
Hie
YIBFI4
mg/I
m87l
1
1315
.25
Y
2
0855
.33
Y
3
J
1250
.66
Y
5
1210
.75
Y
6
1030
1415
.25
Y
7
1002
23.5
0930
.83
Y
8
1255
.50
Y
9
10
11
1220
.33
Y
12
1155
.92
Y
13
1030
1205
.66
Y
14
0957
23.4
0935
.75
Y
is
1315
.42
Y
i6
17
18
1220
.58
Y
19
1125
.50
Y
20
1030
1400
.50
Y
21
0850
22.3
0815
.75
Y
22
1250
.58
Y
23
23
2S
1440
.42
Y
26
1150
1.0
Y
17
1030
1400
.50
Y
28
1005
23.5
0925
.83
Y
Sion bly Average Limit:
Monthly Avenge:
Daily Slaiimenr.
Daily Minimum:
No Reporting Reason: ENFRUSE = No Flow-ReuselRecycle; ENVWTHR=NoVisitation— AdverseWeather; NOFLOW = No Flow; HOLIDAY=NoVisitation— Holiday

IT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
DE: WW-2 ORC HAS CHANGED: No
MR PERIOD: 02-2019 (February 2019) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
A
t
e
y
LI
I• a
tY
z°
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 clock
deg c
mg/1
t
2
3
4
5
6
7
0935
13
F0.2
s
9
10
11
12
13
14
0940
6
12.4
15
16
17
18
19
20
21
0637
7
12.1
22
23
24
25
26
27
28
0932
9
11.3
Monthly Average Limit:
Monthly Average:
8.75
11.5
Daily Maximum:
13
12.4
Daily Minimum:
6
10.2
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

IT NO.: NC0022497
NAME: Cross Country Campground
NAME: Cross Country Campground
DE: WW-2
MR PERIOD: 02-2019 (February 2019)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SUBMISSION DATE: 03/30/2019
03/30/2019
ORC/Certifier Signature: Gr g Trombello E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ILE.6 of
the NPDES permit.
!;
03/30/2019
Permittee/Submitter Signature:*** Greg Trombello E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2) (D).

NPDES PERMIT NO.: NC0022497 PERMIT VERSIONPERMIT STATUS: Active
FACCLITY NAME: Cross Country Carupg,round CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Caropvound ORC: Gregory AlexanderTNrbert ORC CERT NUMBER: 1005905
GRA4E: WW-2 ORC HAS CHANGED: No kiAR 2 8 2019
eDMR PERIOD: 01-20 9 (January2 VERSION: L
STATUS: Proceed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
2400 clack
1220
1 300
11 1020
/6 10-10
1,7 pg5
MILIDAY
0414400
Cmatimioux
ReCatiez
Or/19
0,00
0, Ili
01018
0101N
0,01 7
0.0 7
0,I) 24
On25
0 07
0041
0 019
0 02
0,0 if{
0.9 I 9
0,021
0.1122.367
0,058.
t711131.0
161
Wrck1
011134)
Compov90
iliOnr01
11009
Cffah
IJU
GOON
.5 X vocelL
Groh
TEMP-(`
10
10
1.)
**** No Reporting Reaso- „n!ENTRUSE No Flow-Reuseltecycir, ENVVYTHR =No Visitation - Advers
`C41h121 ON._
' - No Flow HOLIDAY Vi6zation - Holiday

NitbES ktitiva i O.: N 1X 2Z49T
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRAM: WW-2
eDMR PERIOD: 01-2019 (January 2019)
PERM1TYERS[ONr 4.0
CLASS: WW 2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
PE G HTS1ATi1S: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001. NO DISCHARGE*: NO (Continue)
Ide
'4
gg
Fes-
0
U
sE.
(5
A
1
v:
e
J
el
14
Q
2
n.
4
a
x
C0600
C0665
Quarterly
Quarterly
e, capoa;u
Coral o to
TUTAI,N-Con
TOTAL 1'-Coos
2400 dock
lira
2400 dodo
Hn
YIBg
mRq
ru i
1
1200
HOLIDAY
2
1
1236
24.1
1230
.50
Y
8.411
1.11
3
1005
.33
Y
4
1229
.33
Y
5
-
6
r
7
3245.
:26
Y.
a
1300
_50
Y
9
1030
1410
S0
Y
10
10211 •
23.5
0945
.53
Y
11
1240
.42
Y
12
13
14
1310
33
Y
15
1305
SO
Y
16
1030
1405
.42
Y
L7
0951
233
0920
.75
Y
15
toair
A3
it
'
19
20
21
1135
.33
Y
22
1245
.75
Y
23
1030
1410
.33
Y
24
1003
235
0925
.75
Y
25
1250
.50
Y
26
27
2E
1255
.50
Y
29
30
1030
1400
.42
Y
,31
1013
23.7
0945
.75
Y
Momhly Average Limn:
Memhly.6tersge
5.48
1.11
DaayMaalmom
8.48
1.11
bay WaFmum:
x.4R
1.11
"No Reporting Reason: ENFRUSENoPIow-Reuse/Recyc1c; ENVWTHR=No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

NPDES PERMfrNO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 01 2019 (January 2019)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
g
a`
g
t-
g
r$
e
7
a
va
3
fa
z
00010
00300
Weekly
Weekly
Grab
Gta6"
TEMP-C
01
1403 dode
deg c
mgJ1
L
3
1233
12
10.6
3
4
5
6
7
a
9
1e
D951
6
11.1
11
12
13
14
1s
16
17
U9211
5
11.7
09
l9
20
11
11
23
11
0936
9
10.11
25
26
27
20
2!
30
31
0950
3
12.4
Numbly Avenge Limit:
Monthly Average:
7
1132
Day Maehnum:
12
12.4
Doily M1u]mam:
3
10.6
••NoReportingReason:ENFRUSE=NoFlow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY =No Visitation —Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 01-2019 (January 2019)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombell o
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
A
F.
O.
E
n
2
V°
a
Z.
00010
003011
Wct1dy
Weekly
arab
Grab
ifR11,C
DO
2400 dock
ckg c
mg/1
l
2
17A5
11
9.9
3
4
5
6
7
11
9
19
10117
6
113
11
11
13
14
15
16
17
0941
5
11.9
10
19
20
2I
22
23
24
0944
9
10.6
2s
26
17
20
29
39
j1
r
1001
3
12.1
Monthly Arer1e Unlit
Monthly Aicrase:
6.1;
11.16
Daily Maximum:
11
12.1
Daly Minimum:
3
9.9
•"'NoReporting Reason: ENFRUSE=No Flow-Reuse/Recycle: ENVWTHR=No Visitation —Adverse Weather, NOFLOW=NoFlow; HOLIDAY=NoVisitation —Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRAti'1E: WW-2
eDMR PERIOD: 01-2019 (January 2019)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE th 7049890165
hZILP
ORC/Certifier Signature; Gr g Trombello E-Mail:[e-mail] Phone 4:704-989-0165 Date
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SUBMISSION DATE: 02/27/2019
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
02/27/2019
The permittec shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part Ii.E.6 of
the NPDES permit.
02/27/2019
Permittee/Submitter Signature:*** Greig Trombello E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB 1: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site: Check this lox if no discharge occurs and. as a result. there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 80 .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 28
.0506(b)(2)(D).

?RMIT NO.; 497 PERMIT VERSION. 4
CLASS: 11° Vi'_2
ER NAME: (;rose l'ounlry° ('ampgrnund
(BRA N"\1'-2
c I)V'1R PERIOU: 1 2-21. 14 Ity� .�ar�k t° 2QI "I
ERNIIT STATUS: r1
bai
'FiR'I" NUMBER 5
S'1", 1"I" US: L'ic 5ticrf
SAMPLING LOCATION: ION: D NSTREAM DISCHARGE NOR : MO
is
No iLe, Ertdn r sdTva 1.'NFR rSE = tibi FBs+
ORC. f Erc jory Alex :tJcr Troto..t
OR('
VERSION: 40
E8

RMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
ITY NAME: Cross Country Campground CLASS: WW-2 I COUNTY: Catawba
WNER NAME: Cross Country Campground ORC: Gregory Alexander Trombcllo ORC CERT NUMBER: 1005905
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 12-2018 (December 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
p'
Composite Sample Time
1
Is
ua
nt.
2
Operator Arrival Time
It
ti
E
i
o
il
C.
u
j
No Reporting Reasons•••
511050
00010
00400
59060
C0310
C0610
C0530%
31616
00300
Continuous
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Reconler
Grab
Grab
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TE51P-C
pH
CIILOIHNE
non -Cone
SH3-N-Cane.
TSS-Cane
FCRLIIIR
00
240n clock
Hrs
L100 clack
Hn
MTi
mgd
degc
su
ug/1
moil
mp/1
mg11
8/100m1
mail
1
0.025
2
1130
.25
Y
0.025
14
3
0940
.33
Y
0.017
14
4
0,016
5
1030
1240
.33
Y
0.017
13
6
1022
21.8
0945
.75
Y
0.018
13
7.1
9
<2
3.38
8.3
< 1
7.3
7
0.017
>t
1530
.33
Y
0.017
13
7
9
0.017
10
ENVWTHR
11
1350
.50
Y
0.032
12
12
11130
0830
.25
Y
0.021
10
13
0955
23.4
0915
.92
Y
0.02
l0
7,6
3
< 2
< 0.2
5.8
< I
9.6
14
1255
.42
Y
0.049
12
4
15
0.038
16
0,019
17
1255
.50
Y
0.017
12
19
1205
.42
Y
0.016
13
19
1030
1335
.58
Y
0.016
13
20
1025
23.9
1020
.83
Y
0.074
11
7.6
-2
<2
<0.2
4.7
< 1
9.5
!1
1305
.50
Y
0.048
13
2
22
0.019
23
1140
.25
Y
0.017
12
24
0.017
15
HOLIDAY
26
1030
1200
.42
Y
0.016
11
17
1020
23.8
0950
.66
Y
0.016
11
7.4
5
< 2
< 0.2
7.2
< 1
9.3
28
1400
.50
Y
0.065
11
4
20
0.02
36
0.017
31
1320
.50
Y
0.022
12
]Ion Hy Average Limit:
0A65
30
9
30
200
Monthly Mune:
0.025103
12,105263
4
0
0.845
6.5
I
8.925
PatIy Maximum:
0.074
14
7.6
9
0
3.38
8.3
0
9.6
Daily Mntmum:
0.016
10
7.1
-2
0
0
4.7
0
7.3
"" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation - Holiday

RMIT NO.: NC0022497 PERMIT VERSION; 4.0 PERMIT STATUS: Active
1TY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
WNER NAME: Cross Country Campground ORC: Gregory Alexander Trombcllo ORC CERT NUMBER: 1005905
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 12-2018 (December 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
Cemposire Sample Time
E.
~
1
E
u
—
i2
i
E
—
O
v
O
e
~r.
O
ORC On Site?••
c
C
a
2
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTALN - Conn •
TOTAL P.Conc
2400 clack
Itrs
2100 clock
tin
'OWN
mg/1
mg 1
1
2
1130
.25
Y
y
0940
.33
Y
4
5
1030
1240
.33
Y
6
1022
23.8
0945
.75
Y
7
A
1530
.33
Y
9
10
ENVWTHR
11
1350
.50
Y
12
1030
0830
.25
Y
13
0955
23.4
0915
.92
Y
14
1255
.42
Y
15
16
17
1255
.50
Y
1A
1205
.42
Y
19
1030
1335
.58
Y
20
1025
23.9
1020
.83
Y
21
1305
.50
Y
22
23
1140
.25
Y
21
25
HOLIDAY
26
1030
1200
.42
Y
27
1020
23.8
0950
.66
Y
2s
1400
.50
Y
29
30
J1
1320
.50
Y
Mon hly Acarege Limit:
3lonthty A•rroce:
Daily Maximum:
Daily Minima=
""`"• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR — No Visitation— Adverse Weather; NOFLOW = No Flaw; HOLIDAY —No Visitation — Holiday

RMIT NO.: NC0022497
ITY NAME: Cross Country Campground
WNER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 12-2018 (December 2018)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
=
a
E.
v
E
y
C
z
0
:-,
00010
00300
Wcckly
Weekly
Grab
Grab
TES1P-C
DO
2400 clack
deg c
mg/1
1
2
3
4
5
6
0952
6
12.4
7
B
9
10
11
12
13
0930
5
11.2
14
15
16
17
I0
19
20
[036
8
11.3
21
22
23
24
25
26
27
1004
6
11.9
28
29
30
31
Monthly Average Limit:
Monthly Average:
6.25
11.7
Daily hiaimum:
8
12.4
Daily Minimum:
5
11-2
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

RMIT NO.: NC0022497
ITY NAME: Cross Country Campground
NER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 12-2018 (December 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SUBMISSION DATE: 01/30/2019
01/30/2019
ORC/Certifier Signature: Greg Trombello E-Mail:[e-mail] Phone ff:704-989-0165 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittce became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part 1LE.6 of
the NPDES permit.
Aft'titifi7
Permittee/Submitter Signature:*** Greg rombello E-Mail:[e-mail] Phone #:[phone] Date
01 /30/20 19
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204.
*** Signature of Pennittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDESPERM» NO.: NC0022,I97
FACILITYNAMe Cross CountryC wgrou
�VIVRNAMR Cross CountryC9
GRADE: »!
q#R PERIOD.} 20 I a mamb a,\
PERMIT 1H
Cs SS:V \
UR( Gm z
DRC HAS CHANGED; :
VERSION: /! CENTS
L DVv SECT FILES
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
PERMIT sT ¥rUS: &A w
(OU Y: Catawba
ORE CER NUMBER: I 905
w.No Reporting ammo mUSE=w Flcm,eusel kecy &.avAVT q.wVI:am.9,vo,e weati z vEmw=wHow; HOLIDAY =wvisita zion
!

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 11-2018 (November 2018)
PERMIT VERSION: 4.0
CLASS: W W-2
ORC: Gregory ALcxandcrTrolnbella
ORC HAS CHANGED: No
VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
•
0
iti
.6
6
i
e
6
4
Operator Arrival Time
•
Operator Time On Site J
:S
la.
Or
C
o
eg
w
:'c
50050
00010
011400
59960
C0310
C0610
C0530
31616
90300
Continuous
5 X week
Wcckly
2 X week
Wcckly
Weekly
Wcckly
Wcckly
Weekly
Recorder
lamb
Grab
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TEMP-C
pl[
CHLORINE
U[7U-Coat
:itll•SE - Coot
735-Coin
FCOLI BR
00
2400 c1or4
Hri
2100 clock
all
MIN
mgd
dcgc
Su
ugil
mgll
mg/1
mg/I
#1100m1
mgll
i
1010
.92
Y
0.015
17
7.2
11
2.3
< 0.2
4.8
86
7.3
2
1005
.66
Y
0.041
18
8
3
1230
.75
Y
0.017
19
1
1235
.42
Y
0.017
17
5
1145
.75
Y
0.019
18
6
1200
.42
Y
0.019
18
7
1330
.50
Y
0.015
18
5
8
1025
1.0
Y
0.015
17
7.5
11
4.5
<0.2
4.1
8
7.9
9
0.025
to
0.015
11
0.018
12
1150
.33
Y
0.082
15
13
1250
.66
Y
0,039
15
14
1320
.66
Y
0.019
15
15
0735
1.08
Y
0.083
15
7.4
9
<2
1.58
6.8
260
5.2
16
0735
.75
Y
U.019
16
15
17
0.018
18
0.018
19
1300
.58
Y
0.016
14
20
1030
1340
.42
Y
0.015
15
21
1025
23.9
1020
1.0
Y
0.015
13
7.5
8
6.2
3.1
7.5_
123
8.1
22
HOLIDAY
23
1405
.35
Y
0.018
13
9
24
0.025
25
0,017
26 '
1150
.66
Y
0.016
14
27
1400
.50
Y
0,017
13
28
1030
0315
.50
Y
11.013
13
29
1005
23.5
0920
.92
Y
0.018
12
7.1
3
7.1
<0.2
3.8
210
8.5
30
1325
.33
Y
0.015
14
6
Mon hip Avenge limit:
0,,,
30
9
30
200
I
3foarkfy AyrraCr:
0,023586
15.409091
8.5
4.02
0.936
5.4
85.6914
7,4
Doily Minimum:
0.983 --
19 -
7.5
15
7.1
3.1 _
7,5 _
260
8.5
0o77y Minimum:
0.0155
12
7.1
3
0
0
3.6
R
5.2
' No Reporting Reason: ENFRUSE No Flow-ReuselReeycle; ENVWTHR=No Visitation - AdverseWeather; NOFLOW=Nu Flow; HOLIDAY=NoVisitation- Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
°WIER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 11-2018 (November 2018)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombcllo
ORC HAS CHANCED: No
VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
O
rEie
e`
y
V
.
8
cj
v
.2
z=
v
0
O
Operator Time On Slte
to
o'
u
O
z
w
n
m
z
CO600
C0665
Quarterly
Quarterly
Composite
Composite
TOTALS -Cone
TOTAL P-Coos
MOO clack
Hn
2400clock
11rs
Y0131N
m}Jl
MO
1
1010
.92
Y
13.4
2.25
2
1005
.66
Y
3
1230
.75
Y
4
1235
.42
Y
3
1145
.75
Y
6
1200
.42
Y
7
1330
.50
Y
8
1025
1.0
v
9
19
11
12
1150
.33
Y
13
1250
.66
Y
14
1320
.66
Y
15
0735
1.08
Y
16
0735
.75
Y
•
17
18
-
19
1300
.58
Y
20
1030
1340
.42
Y
S1
1025
23.9
1020
1.0
Y
22
HOLIDAY
23
1405
.35
Y
24
25
26
1150
.66
Y
27
1400
.50
Y
18
1030
0815
.50
Y
29
1005
23.5
0920
.92
Y
30
1325
.33
Y
Mon ltry Avenge 1Jm11:
-- ---
:Math]y Avenge:
13.4
2.25
[nib, hlnlmum:
13.4
2.25
Daily Minimum:
13.a
2.25
"" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWI-HR =No Visitation - Adverse Weather, NOFLOW = No Flow; HOLIDAY =No Visitation -Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OW1 .ER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 11-20I8 (November 2018)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombclio
ORC HAS CHANGED: No
VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
if'
a
F-
N
e
m
�.
a
00010
00300
Weekly
R'cckly
Grub
Grub
"rE111'-C
DU
2400 clack
del a
nisn
1
1030
14
10
2
3
4
5
6
7
.
8
1114
14
10
9
10
11
12
13
14
15
0754
13
10.8
16
17
18
19
20
21
1035
9
11.4
22
23
24
25
26
27
28
29
0934
5
11.4
30
s
_ Monthly Avenge Limit:
Monthly Menge:
11
10.72
Daily 9Inximum:
14
11.4
Daily 611nimuns:
5
10
**** No Reporting Reason: ENFRUSE W No Flow-Reuse/Recycle; ENV WTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY =No Visitation —Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OR 3ER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 11-2018 (November 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 2.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SUBMISSION DATE: 01/01/2019
01/01/2019
ORC/Certifier Signature: G g Trombello E-Mail:[e-mail]
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
Phone #:[phone] l 65 Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the pennittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ILE.6 of
the NPDES permit.
0I/01/2019
Permittee/Submitter Signature:*** G
Trombello E- it me wahoo.com Phone #:[phone] Date
Mat .g tater@y
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME: Water Tech Labs Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Greg Trombello
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the pennittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

ER NO.: wi g
,sa4w 1L
CIV
*ERE MR fCoo y musounci
G De * Z
m\ PERIOD: m
2 18)
PERMIT VERSION:
(L V
ORC; Ciogory A as T
OR(B*S(11 \
VERSION; VR SE
SAMPLING LOCAT N: EFFLUENT DISC HARGENO.MD NO DISC HARG

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Gregory Alexander Trombella ORC CERT NUMBER: 1005905
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 10-2018 (October 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
E;
1
5
6
9
IE
'�
s
y
E
t
2
g
4
n
o`
p
.
ti
�-
I
z°
C0600
C0645
Quarterly
Quarterly
Composite
Composite
TOTALN-Cent
TOTAL P•Cene
2400 clock
Hrs
2400 clack
Hr.
WHIN
mull
m4Jl
1
1545
.25
Y
-
1730
.75
Y
3
1030
1430
.42
Y
4
1030
24,0
1025
.92
Y
5
1630
.50
Y
6
7
8
1500
.50
Y
9
1505
.42
Y
10
1030
1435
.33
Y
11
1025
23.9
1020
.75
Y
11
1525
1.17
Y
13
14
19
1605
.50
Y
26
1430
.92
Y
17
1030
1455
.42
Y
19
1030
24.0
1025
.92
Y
19
1455
.42
Y
2n
21
22
1635
.92
Y
23
0940
2.0
Y
74
1030
1620
.25
Y
39
1935
24.0
1030
.83
Y
36
1420
.58
Y
n
2s
29
1610
.03
Y
30
31
1030
1400
,66
Y
Men hly Horace Lhalh
!deathly Menge.
Dolly Maximum;
Dolly 30o'smae..
a••' No Reporting Reason: ENFRUSE —No Flow-Reuse/Recycle; ENVWTHR = No Visitation —Adverse Weather; NOFLOW -= No Flow: HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
1
FACILITY NAME: Crass Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Gregory Alexander Trombcllo ORC CERT NUMBER: 1005905
GRADE: WW-2 ORC HAS CHANGED: No
e13»IR PERIOD: 10-2018 (October 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
elI
F11
.0
ti
.r
&
a
z.
00010
P0300
Weekly
Weekly
Grab
Grab
TEMP-C
n0
2100 cluck
dog c
rn_ddl
3
.2
1039
21
a
a
6
7
8
9
10
11
1053
22
7.6
S:
13
13
13
16
17
18
1044
16
9.3 -
19
20
21
22
23
u
23
1048
11
10.8
26
27
28
29
30
31
_
Monthly A; enirUm[)
Monthly Menge:
17.5
8.925
Oa113 31.1113121111
22
10.8
Daily Mloi,rmn:
11
7.6
No Reporting Reason: ENFRUSE = No Flow-ReuselRecycle: ENVWTHR=NoVisitation— AdverseWeather; NOFLOW No F ow; HOLIDAY= NoVisitation—Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 10-2018 (October 2018)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
4
F
1.
•
6
a
B.
a
Ze
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2460 clock
des c
mgfl
2
3
4
1052
21
6.3
5
6
7
6
9
l0
11
1053
22
7.6
12
13
11
1%
15
17
18
1057
16
B.9
19
20
21
21
23
24
25
1101
I
102
26
27
26
19
30
31
Mona¢ A.era6e t.imir:
Monaly Average:
17.5
6.25
Daily Mrtmom:
22
]0,2
Daily Minimum:
'1i
6.7
•-•• \ Reporting Reason: ENFRUSE= No Flow-Reuse/Recycle; ENV WTIIR = No Visitation- Adverse Wcather, NOFLOW =No Flow; HOLIDAY = No Visitation - Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
•
GRADE: WW-2
eDMR PERIOD: I0-2018 (October 2018)
COMPLIANCE STATUS: Compliant
ORC/Certifier
PERMIT VERSION: 4.0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
ORC HAS CHANCED: No
VERSION: 1.0 STATUS: Processed
CONTACT PHONE #: [phone] SUBMISSION DATE: 11/30/2018
ItSignature: Gr Trombello E-Mail:gmetwaterrryahoo.com
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge.
11/30/2018.
Phone 4:704-989-0165 Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
prm.ided within 5 days of the time the permittee becomes aware of the circumstances.
the tacility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part 1I.E.6 of
the NPDES permit.
Permittee/Submitter Signature:*** Gr g Trombello E-Mail:gmetwaterrryahoo.com Phone #:[phone] Date
/Zieli/
11/30/2018
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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 far
knowing violations.
LAB NAME: Water Tech Laboratories
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation oldie signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

&mESPERMIT N:Nq@2#7
PERMIT 1ERS O
£ IL1T NAME: Cross _ry Campground CLASS: WW2
0»«ER NAME: Cross Country Campground
Gk DE! >»e
m MR PERIOD: 092 18(Sepr 2018) VERSION: w
40
(RC:gam \ \9
ORCHAS CHANGED: No
I
Active
CERT NUMBS
TITS: Processed
R GE4 ±tE1
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGEM NO
w 7 5 m
""wRepo R
NR li G meR 6R a
ow=wFlow; HOLIDAY N0 m

r
NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FAfILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Gregory AlexanderTrombello ORC CERT NUMBER: 1005905
GRADE:-2 ORC HAS CHANGED: No
eDMR PERIOD: 09-2018 (September 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
G
II
1-
a
A
E
V
i
E
u
.
i=
-
.t
e
€
C
—
's
8
u
R
b
o
a
z
8•
r
z
C0600
C0665.
Quancrlt
Quarterly
Com site
Composite
TOTAL N. - Cons
TOTAL. P-Cant
2400 clock
Hrs
2400 clack
Ho
Y/OM
mg/1
mgfl
1
2
3
HOLIDAY
4
1435
1.17
Y
5
1030
1410
.33
Y
6
1028
23.9
1020
1.0
Y
7
1605
.33
Y
8
9
10
1505
.75
Y
11
1410
.50
Y
12
1030
1535
.42
Y
13
1027
23.9
1020
1.17
Y
14
1350
,33
Y
li
I:
1510
.75
Y
18
1410
,58
Y
19
1030
1510
.33
Y
20
0842
22.2
0835
1.0
Y
21
1450
.33
Y
22
23
1145
.33
Y
24
1400
.75
Y
25
26
1030
1440
.33_
Y
27
0940
23.1
0930
1.17
Y
28
1115
.58
Y
29
30
Ytoalhy Mango LIm21:
Monthly Mow:
Daily nolmum:
Duly Mlalmanx
'•" No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; EN VWTHR = No Visitation — Adverse Weather, NOFLOW = No Flow: HOLIDAY = No Visitation— Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
P\4'ILITY-NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
GRADE:VW-2 ORC HAS CHANGED: No
eDMR PERIOD: 09-2018 (September 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
o
.Y
S
4
1
e
a 2Weekly
C
II
;
04010
00300
Weekly
Grab
Grab
TEMP.0
DO
2490 c6h
deg c
mg/1.
1
2
3
4
5
6
1040
24
7.2
7
8
9
10
11
12
13
1045
24
7.4
14
15
16
17
IS
19
2°
0259
22
7.9
21
22
33
24
25
26
27
0948
22
7,4
28
29
30
111mm1y As trap Limit:
M.nildy Memo:23
7.45
Day M+irenm:
24
7.8
Duly Minimum:
22
7.2
•"' No Reporting Reason: ENFRUSE= No Flow-Reuse&Reaycle; ENVWTHR — No Visitation --Adverse Weather NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

NPDE$ PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FAFILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
GRADE:tWW-2 ORC HAS CHANGED: No
rD %IR PERIOD: 09-2018 (September 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
p
E
F
a
,
G
a
5
=
ee
L
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
240 clock
deg c
mgii
t
2
3
a
5
6
1058
24
5.3
7
9
9
10
II
13
1106
24
SA
14
15
16
17
19
19
20
0914
22
7.2
21
22
23
21
25
26
27
0959
22
6.2
26
29
39
Monthly A+erage 13m11:
Monrlrly Average:
23
6,025 ,
Daay Slasinum:
24
7.2
Daily Minimum:
22
5.3
' •• No Reporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation - Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNEI NAME:.Cross Country Campground
?'! GRADEWW-2
eDMR PERIOD: 09-2018 (September 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SUBMISSION DATE: 10/3012018
1 0/30/2 01 8
ORC/Certifier Signature: GregTTrombello E-Mail:gmetwaternyahoo.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge,
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
lithe facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ILE.6 of
the NPDES permit.
10/30/20 '
Permittee/Submitter Signature:*** Gre, Trombello E-Mail:[e-mail] Phone #:[phone] • Date
Permittee Address: 6254 NC Hwy I50 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.l am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech Laboratories
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No F low/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 213
.0506(b)(2)(D).

,P1)a 'PER Th ~3tc9.eI'(11224 7
F,.A(11.
`.rooss Cnu
OWNER !NAME: Cross CounEry Cam uund
GRADE: WW-2
d) tR.PERIOD:082f)Iti(Augu)'2l.8
PERMIT VERSION: 4.rl
(I LASS: '41,-,`!, .TM
OR( : (:arq:oi): Alosamdo
I'I:Fiti1()\: I j)
PERMIT STATUS: .,ac�
EWE NUMRERt I I)(
SAMPLING LOCA'I'ION: EFFLUENT I IS 'HARGI; NO.: 001 NO DISCHARGE,
No Ri ponmg Reason- EN RUST No 1 Iow.Reo.' 'Wet P.A i 1A`'[`)(R - A I IMutton
WeaThCr
T 2shk, Crxa,w s0e
BOO, row Nitl-N . Cox.
s�i

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACIL1ffY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
GRADE: WW-2 ORC HAS CHANGED: No
eDMR PERIOD: 08-2018 (August 2018) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
d
e
U
a
A
C
<
.g
1
O
=
8
v
o
.
2..
C(WAS
Quartert3
Quarterly
Composite
Composite
TOTALN-C
TOTAL P•Cone
2400 dock
Hn
2400 dock
Hn
VIM
1ngorl
mg.i
1
1030
1420
.42
Y
2
1026
23.9
1020
.80
Y
3
1510
.50
Y
4
1030
.33
Y
6
1910
.25
Y
3
1500
.42
Y
8
1030
1400
.42
Y
9
0950
23,3
0940
.83
Y
10
1325
1.0
Y
It
11
13
1350
1.42
Y
14
1345
1.0
Y
15
1030
1415
.50
Y
16
1030
2400
1055
.66
Y
17
1540
.33
Y
t8
19
1300
.33
Y
20
1623
25
Y
21
I42S
,S8
Y
22
1030
23
1020
23.8
1010
1.08
Y
21
1415
.42
Y
73
26
27
1330
.66
Y
28
1445
.58
Y
29
1030
1435
.23
Y
30
0950
23.3 10950
.66
Y
31
1600
.33
Y
Monthly Anna U=60.
Maamy Menges
•
Daly 3la:lemm:
Da113 I<Iiatma=
**'*NoReporting Reason: ENFRUSE=NoFlow-Reuse/Recycle; ENVWTIiR=NoVisitation — Adverse Weather,. NOFLOW=No Flow; HOLIDAY=NoVisitation — Holiday

NPDES PERMIT NO.: NC0022497
FACILr?Y NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 08-2018 (August 2018)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Gregory Alexander Trombello
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
a
Jlgg
il
it
z .7E11tP-C
00010
00300
Weekly
Weekly
Grab
Grab
Do
2400 e1ak
deg a
mg/]
1
2
1037
24
7.8
2
4
5
6
7
e
9
1000
24
6.7
l9
11
12
13
1♦
15
16
1111
24
7.4
17
I0
19
20
11
22
23
1034
24
7.9
2a
25
16
27
18
19
1J
1003
24
7.4
31
Maly awn, Una
Mo ttr A.rvpr.
24
744
Day aAamuac
24
7.9
D.gyMimic.=
24
5.7
r*sr No Reporting Reason: ENFRUSE No Flow-Reuse/Recycle; ENVWTHR = No Visitation —Adverse Weather; NOFLOW -- No Flow; HOLIDAY = No Visitation— Holiday

NPDES PERMIT NO.: NC0022497
FACIL1iY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-2
eD MR PERIOD: 08-2018 (August 2018)
PERMIT VERSION: 4,0
CLASS: WW-2
ORC: Gregory Alexander Trombella
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 1005905
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
s
p"
1
ig
sWeekly
6.
x
I
00010
00300
Week
Grab
Grab
TEMP•C
DO
2400 deck
deg c
mg/1
1
2
1046
24
7
3
4
5
6
7
8
9
1006
24
6.9
10
11
12
13
14
15
16
1124
23
6.8
17
18
19
20
21
22
23
1048
7.1
22
24
23
26
27
28
29
30
1013
24
6,2
31
Munmry Menge Unlit
Monthly Memo
2042
9.76
Ddl y hl.diamm:
24
22
De03 hllnimvm:
71
6.2
•••• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = ND Visitation =Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497
FACILIFY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-2
eDMR PERIOD: 08-2018 (August 2018)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Gregory Alexander Trombello ORC CERT NUMBER: 1005905
ORC HAS CHANGED: No
VERSION: 1.0 STATUS: Processed
CONTACT PHONE #: [phone] SUBMISSION DATE: 09/30/2018
09/30/2018
ORC/Certifier Signature: Greg'/Trombello E-Mail:gmetwaterrryahoo.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
I'he permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ILE.6 of
the NPDES permit.
09/30I20I 8
Permittee/Submitter Signature:*** Greombello E-Mail:[e-mail] Phone #:[phone] Dale
Permittee Address: 6254 NC Hwy 150 E Denver NC 2 037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME: Water Tech Laboratories
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Gregory Trombello
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DIv[le.
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per I5A NCAC 28
.0506(b)(2)(D).

NPDES PERMIT NO: NC0022497
FACILITY NAME: Cross Country Cart 3:0 nd
OWNER NAME: 'Cross Country, Campground
GRA D I::: NW T
eDMR PERIOD: r 7 10Iliu 10I
PERMIT VERSION: .L 'FRijHr sTATus: Active
CLASS: 'VIAV-2 COUNTY: Calawha
0 4 '- - - - k3
ORC: f/um stKvIc?Ott, OR( (
Mettcycoo - - .LR NUMBER.. 6 ; 7
ODC DAN 'CI -LANCED: NoREceweotNeDENR/DWFi
<3323,3"-24,3't
VEKSiON: —3 3' 3 sT.A.Tvs-
_ .
SAMPLING LOCATION: EFFLUENT DISCHARGE NO..: OM NO DISCHARGE*: tN, ytiQ rt.i.06
1j7I Itiq,,tFt RE"-iNi:\ 0
00010 1, 01111 f '0-010 310% 10401011
1
1777ldkH 5433 lop"
04,40,30383
FLO+,
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t
NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2018 (July 2018) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
o"
A
11 1
ci
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€
17:'� is
O
'_
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.
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C0605
Quarterly
Quarterly
Composite
Composite
TOTAL N-Con e
TQTALP-Cone
2400dack
lies
1400 ebek
Hn
Y/DJN
Tagil
mgjl
1
2
1325
.50
Y
3
1510
.50
Y
3
1030
HOLIDAY
s
1021
23.8
1015
1.0
Y
19,96
3.07
6
1500
.33
Y
8
9
1615
,25
Y
to
1410
.42
Y
II
1030
1445
.33
Y
12
0925
22.9
0920
.75
Y
13
1430
.75
Y
14
1s
16
1445
1.5
Y
17
1340
.42
Y
1f1
1030
1400
.42
Y
19
1003
23.5
0955
.83
Y
2n
1500
.42
Y
21
22
1050
.50
Y
13
1100
1455
.42
Y
24
1100
24.0
1055
1.0
Y
25
:
1415
.42
Y
26
1430
.33
Y
it
29
30
3t
1730
.50
Y
Monthly Ai nage Limit:
Momhty Average:
19.96
3 07
D68y Mazrmum:
19.96
3.07
Dolly htlnlmum:
19.96
3.07
a " No Reporting Reason; ENFRUSE = No How-Reuse/Recycle; ENVWTHR = No Visitation - Advcrsc Weather, NOFLOW = No Flow: HOLIDAY = No Visitation -Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreycon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2018 (July 2018) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
It
I
11
L
z
6001U
00300
Weekly
Weekly
Grab
Grab
TEMRC
Do
.
2100 clack
deg c
mg/1
2
1
3
1
5
1035
24
7.8
6
7
8
9
10
11
12
0935
23
7
13
14
15
16
17
13
'
1913
23
7.6
•
21
22
23
•
11
1110
22
8.2
15
26
27
25
29
30
31
Monthly Average Llm11:
•_,
Monthly A.er:<eel
23
7.65
Daly Magma=
24
8.2
Daffy 9tinlmom:
22
7
"" No Repotting Reason: ENFRUSE = No Flow-ReusefRecycic; ENVWTHR— NoVisitation— AdverseWeather; NOELOW No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2018 (July 2018) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
el
3t
e`
.
N
c
L
z
0...
,)„.
Weekly
Weekly
Grab
Grab
TEMP-C
DO
1400 clock
deg c
mgil
3
4
3
1050
24
6.2
6
7
8
9
ID
11
12
0948
23
6.3
13
1
14
15
16
17
18
19
1024
23
5.7
20
,1
2-i
1121
22
8
25
26
17
2R
29
3a
31
Manihly Aieruga Limit:
Monthly Arentie:
23
6.55
rally M.•imum:
24
S
Daily Minimum:
22
5.7
•••• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR=NoVisitation— AdverseWeatller; NOFLOW-NoFlow; HOLIDAY No Visitation — Holiday

ti
NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: No
ta) 11R PERIOD: 07-2018 (July 2018) VERSION: 2.0 STATUS: Processed
CO:viPLIANCE STATUS: Compliant CONTACT PHONE #: [phone] SUBMISSION DATE: 11/23/2018
„ (� , T4 1 1 /23/2018
ORC/Certifier Signature: Dusty Kyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
By this signature,1 certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
zdAA7
I1/23/2018
Permittee/Submitter Signature:*** Dus1yyVKyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
' :city. 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 managed 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.
LAB NAME: Water Tech Laboratories
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Greg Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result. there are no data to be entered for all of the parameters on the DMR
t'or entire monitoring period.
": ° ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature ofPermittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDFes ;:E.RM'IT NO.» NC0022497 PERMIT VERSION: TO
FACII.ETV NAME: Cross Country CaWW-2
1 NL.R NAME„ Cross Country (.`arnpground ORC; ET
�Jii,A15Ea W4W�4 ORC IIAS CI1,A\(.I U No
eD IR PERIOD: O7-2018t (July 2018) VERSION: 1
PER LIT & I \TES; Ad T.
COl'ti"L`1: t:'akea;t
ORC CE:RT Nl°:MB R:� J
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 N() DISOJ =A G ,v7N'03ic
"" No Reporting Reason: ENE,R P:r. 4"osU i ion - AE4i)T4

,1
NPDES "ERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2018 (July 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
a
i.
J
IWeekly
S.
z
00010
110300
Weekly
Grab
Grab
TEMP-C
DO
2-100 clock
deg a
met{
l
3
1
3
1035
24
7.8
6
7
8
9
10
11
12
0935
23
7
13
14
13
16
17
18
19 .
1013
23
7.6
!a
'
11
22
23
u
1110
22
8.2
25
26
27
20
29
30
31
Monthly M. p Unit
Monthly Menge:
23
7.65
Daily 111491murrr
24
8.2
D5117 Mlnim ..
22
7
•"' No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENV WTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY =No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2018 (July 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
a
J.
.1q
ii
m
1
8
a"
C
00010
00300
Weakly
Weekly
Grab
Grab
TEMP-C
o0
2400 Bork
deg c
mc,Jl
I
2
3
4
5
1050
24
6.2
6
7
0
9
10
1l
12
0946
23
6.3
13
II
15
16
t7
18
1.9
1024
23
5.7
20
21
22
23
24
1121
22
a
25
26
27
2s
29
30
31
r Manrhh Alone Limit:
Monthly *tempt
23
6.55
p.a.!' Matimnm•
24
8
Daly Minimum:
22
5.7
•""NoReporting Reason: ENFRUSE=NoFlow-Reuse/Recycle; ENVWTHR=No Visitation —Adverse Weather, NOFLOW=No Flow; HOLIDAY=NoVisitation— Holiday

NPDE5 #ERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4, ORC IIAS CHANGED: No
eDMR PERIOD: 07-2018 (July 2018) VERSION: 1.0
COMPLIA E STATUS: Co ,.<'ant CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SUBMISSION DATE: 08/29/2018
08/29/2018
y Kyle Metreyeon E-Mail:dmetwaterrJaol.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES perm
08/29/2018
Permitte'/Submitter S g ature:*** DusKyle Metreyeon E-Mail:dmetwateraaol.com Phone 4:704-506-4255 Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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 foi
knowing violations.
CERTIFIED LABORATORIES
LAB NAME: Water Tech Laboratories
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Greg Trombello
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

901110
1109411109119
00490
Composite
111110111
IMIIIE1111111
EMI
121.11111111111113=
11111111111111=11111111
11111111111111=
111111111111=11111111111
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MEM 111111 moo=
IIIIIMIIIIIIIIIIM111111 111•11111111=1111
1111 11111•1•11111 111111111111•1=
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IIMIIIIIIIIIIIMM111111111111111 IIIIIIIIIIIIIIM=Ill
• 111111•11111•1 IIIMIIIIMINIIIIIMIMMIIIIIII
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INIIIMIIIIIIIIIIII•11111111111111111 IIIIMM=M1111111111111111111111
EINIMM=111111•11•111111
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IIIIMM 1.1•1111=I
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09309
rekly
ab
0g1
NPD ES PERMIT NO.: NC0022497
FACT:1,M NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
(tRADE:
&MR PERIOD: 06-2018 (June 2018)
PERMIT VERSION: 4 0
CLASS: WW-2
(:7"4
ED
ORC: Dustin Kyle Moreycon
ORC HAS CHANGED: Yos NOV20 ?i)
VERSION: 2.0 C E I ,c,..%L. IP IL 'E. S STATES: Processed
DVVR SECTION
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NU MUM 11697
EIVERIN CD ENIFUDWR
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DIS
1
4
MIME
1111111.1111111111111111111=111111111
illiNE1111111111111111M
1111111111111111111MMININ
111111111111•1111.1111111=
1E1=11111 MEI
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Ne Reporting Reasim...'.
9
19
14
15
20
22
'01
29
1003
24.0
400
1430
1015
400
1040
1000
1430
13 10
1020
1400
1 0
4490 clock
450
420
Monthly ,59o3110
Month. Ave 6!
btatis Minimum
Daily Miy1199ms:
CI 010
OSto
HOD ^ CONIC
'OS
z A310NAL °MCP
(990005516
209
."*. No Repwing Reason: ENFRUSE No Flow-ReuseIRceycle: ENV0-11-112 io isitation Athorse 10C/11110'1 NOTTOW :No F1ow: IK11.,11:1"1Y -- No Vigil:a:ion -1,1o1iday
6
4
9, 2

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4,0
FACT JTY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: Yes
eDMR PERIOD: 06-2018 (June 2018) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
c'
Campo lie sample Time
Tout Composite Time
A
a
m
4
ia
o
Oprnrar Time On Site
ORC On Site?••
C
10
5
t
a
2
CO600
C0665
Quarterly
Quarterly
Composite
Composite
TOTALN - Cone
TOTAL. P-Conn
2400 clock
Hn
2400 dock
Hn
WHIN
mgil
mgll
1
1220
.66
Y
2
3
4
1625
.25
Y
1450
.42
Y
6
1030
1420
.75
Y
7
1025
23.9
1017
.66
Y
8
1245
1.0
Y
9
10
11
1400
.83
Y
12
1430
.50
Y
la
1030
1425
.50
Y
14
1023
23.8
1015
.83
Y
15
1400
.50
Y
is
17
18
1040
.33
B
19
0715
.50
B
20
1030
1400
.25
B
21
1030
24.0
1000
1.17
B
22
1330
.33
B
23
24
25
1430
.42
Y
$6
1310
.42
Y
27
1030
1430
.58
Y
28
1024
23.9
1020
1.0
Y
29
1400
.42
Y
30
Monthly Avenge Limit:
Monthly Avenge:
0.0. Matlmam:
o.av Minimum:
•"' No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENV WTHR= No Visitation — Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: Yes
eDMR PERIOD: 06-2018 (June 2018) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
2
q'
f
E
A
•
a
a`
A
00010
06366
Weekly
Weekly
Grab
Grab
TEMP-C
1.0
2400 clock
deg c
mgll
3
4
5
I
7
1032
20
8.8
8
9
10
11
12
13
14
1029
23
8.6
15
16
17
18
19
20
21
1005
24
6.9
22
23
24
2S
26
27
28
1035
23
8.1
29
30
Monthly Average Limit:
Monthly Aremge:
225
8,1
Oaty Maximum:
24
8.8
Dail; Minimum:
20
6,9
**** No Reporting Reason: ENFRUSE — No Flow-Reuse/Recycle; ENV WTHR— No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FAC LITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANCED: Yes
eDMR PERIOD: 06-2018 (June 2018) VERSION: 2.0
PERMIT STATUS: Active.
COUNTY: Catawba
ORC CERT NUMBER: 1 [ 697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
a
E
Jr
J.1
21
.5
S.
Z
00010
60306
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2460 clock
deg c
me,Jl
3
4
5
6
7
1046
20
R.1
8
9
10
11
12
13
14
1046
22
7.9
15
16
17
18
19
20
21
1010
24
6.2
22
23
2-1
2S
20
27
26
1048
23
6.8
29
36
Monthly Avenge Limit:
Manthlr Arcngc:
22.25
7.25
Daily Maximum.
24
R 1
Dail. Minimum:
20
6.2
No Reporting Reason: ENFRUSE = No Flow-Reuse/Reeyelc; ENVWTHR=NoVisitation-AdverseWeather; NOFLOW = No Flaw: HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
ORADE: WW-4.
eDMR PERIOD: 06-2018 (June 2018)
COMPLIANCE STATUS: Compliant
ORC/C
igna nr Dusty K
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Dustin Kyle Metreyeon
ORC IIAS CHANGED: Yes
VERSION: 2.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SUBMISSION DATE: 08/29/2018
le Metreyeon E-Mail:[e-mail] Phone #:[phone]
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
08/29/2018
Date
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ll.E.6 of
the NPDES permit.
08/29/2018
ature:*** Dust Kyle Metreyeon E-Mail:dmetwaleraaol.com Phone 4:704-506-4255 Date
Perm' ee ddress .254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
1 certify, . r . 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 managed 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.
LAB NAME: Water Tech Laboratories Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Greg Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.nedenr.orglweb/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
* ** Signature of Permittee: If signed by other than the permittee, then delegation oldie signatory authority must be on tile with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACIfITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
G?2ADE: WW-4, ORC HAS CHANCED: Yes
eDMR PERIOD: 06-2018 (June 2018) VERSION: 2.0
Report Comments:
Greg Trombello is ORC
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed

NIMES PERMIT' NO:: NC00.2249.7
EA.CILITY NAME: Cross Country Campground
AVNER NAME: Cross Country Compound
GRADE: WW-4.
elAIR PERIOD: 05-20 8 (May 2ORj
103D
21
12s
134
SAMPLING LOCATION:
(130,
YARN
,522504.C11
PERMIT VERSI4V2dE'
76601 2"" 6S3
CLASS; WW-2
DRC: Dustin Kis le Motes eon
SS 151
OR( DAS CD ANGETh No
tsttissiit, iit±to
*VERSION: 120
DWR SECTION
PERNIFF S Ft S: Acme
COI NT$ : Catowba
OIRC CERT NIAIRIER1
STA I S: oecssec),
6„,26262
vIEDINCE)ENRIDWR
vic.)Res
EFFLUENT DISCHARGE NO.: ON NO DISCILARGEtt„NWSIONALOFFiCE
MoORIR 00•05301,141316
%ody locroto
ORD 10351nom,
DO13 M.1aiRnoo,
DOM
,11.2159999996
R6695rder
19.0w
3 667
0 625
9 015
9 5115
o 179 5
0 1216
51 2617
16916
oia19
Si 07
916
617
212
11:111,011
0128
917
11.1140
969
5,1115
110141 444441444
90,1121
A 1.19,22k17 ! 2 151,6967k 1111'2,251,19
C15612 .t 6617 12026 'mil 4444,11144
1 r, 011 4 1.00 14" /11,C11011+ 2. ROD -Ow
5196
21 1252225
21
16
7561
C050
2 2 <
.511
11 555556 42
7,5 7
1''
9 7,
2'01520
5 7
10
56.32,
31•1116
V.15,ekly
Gra
FC01,1 RR
42111s11ni
59
6 7728512 5156
259 .7
S 5
ss" .N(5 Reporting Rea/ow ENFR USE , No F0ow-Reuse5Recys‘.1e, E1510.1121/41151-1R 112,, V 11131311OR 155i5052O. '2200110ri .15152161 OW 1129 14.4444, 414 Na5 Visitabon - Holiday
3 1
ss" No Reporting Reason: ENFRUSE 55, No Floss5ReaseiRecselc,; 1.211NVWT11E 115125 Visnatiol+ Adven,e 51C00 1„110.0. 2, No rk,,,t, 1100 s' 5 No Visit-mon 2 Hondas

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreycon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 05-2018 (May 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
c
N
.9
I
2.
m
c
2
DIM
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2700 clock
deg c
mg/1
l
2
3
1103
17
9,1
4
5
6
7
9
9
ID
1041
Is
8.5
11
12
13
14
1S
16
17
1001
21
7.6
ix
19
20
21.
22
23
21
1054
21
8.1
25
26
-
27
23
29
30
31
1104
20
Ni
8.3 ,
Monthly Are eaee Unlit
Meuthy Mengel
19.4
8.32
Daily Maainnm:
21
9.1
Daiy Mirilnneu
17
7.6
"" No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse Weather; NOFLOW = No Flaw; HOLIDAY = No Visitation - Holiday

•
NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 05-2018 (May 2018) VERSION: 1.0 STATUS: Processed
COMPLIANCE STATUS: ;mpliant CONTACT PHONE #: [phone] SUBMISSION DATE: 06/27/2018
ORC/Certier
06/27/2018
Dusty Kyle etr eyeon E-Mail:[e-mail] Phone #:[phone] Dnt
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A %%Titter' submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, pl a a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
06/27/20I8
Permittee/Submitte Si ature:**usty Kyle MEttreyeon E-Mail:dmetwatereaol.com Phone li:704-506-4255 Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME: Water Tech Laboratories Inc.
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Greg Trombello
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result. there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.: NC0022497 PERMEr VERSION: 4.0
7VACILITY NAME: Cross Country Campground CLASS: W1/4y-2
OWNER NAME: Cross Countr: Campground ORC: Dutiu k eMetrey(ion
GRADE: WW-4, ORC HAS ( HANGED; Ye•,.
er)MR PERIOD: 04-2018 (April 201.8) VERSION: 20
1
1
SAMPLING LOCATION: EFFLUENT
MORE
,33011 OMR
PERMIT STATUS: Active
C011:NTY: Catalevba
ORC CF.7.RT NUMBER: li097,
RECEIMINCOENRID
STATUS: Processed
.RCE NO.: 001 NO DISCHARGE*: NOd
COMO
X week Weald), 7 X 676{4. Woekly
ecordei Grab (asti 3 3'earoostie
#1.007 1"88060
010701
0 02
73{55 6 017
..{{._ 08.50 {. 016 7
4 : 1:030 12.55 0,016
--- -- --- -38----- - - - -
5 '. 0030 [ 24..0 : 1000 03 0.006
1330 0.010
0'16
0 016
;1410 • 0.015
38 445
1 0 1 1030
E
010
1500
24 0
17gri
{2
16 1430 11116 00 7 1 8
,
0 1550 I {0 1{46
4
, 1
# 1 7 ' 143 071 046 ' ((1
030
0 1025
6,617 17
6{ 013
0000
400-780
10,60 7
048
648 , 17
{ 089. 18.
023 : 6
018
1240 0 016, 17
38tEE38(iy Avo.go Um&
initt. ill 0833
Daily 3443knowit.
1313 33 33343033 1431413 Erattc
3330
f
MOQRESWILE O;GlIONAL OFF1‘,.13E
leofm 31116.10 3143333*
'oak, Weekly
Co troe Cerritaisie
16033-0 - 4.664# Coat
3
'3 3303 E a.74
7 0 28
0
W007kly
ab
sCoki Ism
'eekly
i337102r. 6 877
78
4,3 0 -6 2
No Reporting Reason; ENFRUSE NoF low.; R cuselReCyCle; 1iN o; No VisOatioo 31.033030r, 33.PW; ;;;; No How: 1101..11.F51Visittetion Floilday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
[FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANCED: Yes
eDMR PERIOD: 04-2018 (April 2018) VERSION: 2.0
PERMIT STATUS: Active.
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
2.
III
a`
u'
ee
u
xx
F
S
h
E
C
'y
&
CJ
o
S
a
a
X.
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTAL N-Coos
TOTAL P-Cony
2400.166k
Hn
2400eho6k
MI
Y/WN
mgll
MO
1
2
1355
.40
Y
3
0650
.33
H
4
1030
1255
.25
Y
1030
24,0
1000
.83
Y
16,66
2.09
6
1330
.46
Y
7
s
9
1410
.33
Y
to
1445
.50
Y
11
1030
1500
.50
Y
�2
1030
24.0
1010
,83
Y
13
1250
.55
Y
14
19
16
1430
.55
Y
17
1550
.50
Y
15
1030
1430
.60
Y
19
1030
24.0
1025
.80
Y
20
1340
.50
Y
21
23
23
1400
.55
Y
24
1425
.38
Y
25
1030
1440
.25
Y
'-6
1025
21.9
0945
.92
Y
27
1340
.38
Y
29
29
30
1240
.25
Y
Alanlhl. Avenge Limo:
hrnnlhl7 Arend:
16.68
2.09
Da h Maolmuml
16.68
2.09
Dag/ Minivwm,
16.68
2.09
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR= No Visitation - Adverse Weather; NOFLOW - No Flow; HOLIDAY - No Visitation - Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION:4.0
.FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4, ORC HAS CHANGED: Yes
eDMR PERIOD: 04-2018 (April 2018) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
na
.3
ki•
1.1.1
Z
00010
00309
Weekly
Weekly
Grab
Grab
TE71tP-C
DO
2400 clack
deg
m Jl
1
2
3
a
0
1036
14
I LI
6
7
B
9
10
11
12
1018
13
11.3
13
14
15
16
17
16
19
1040
17
10.2
26
21
22
23
21
•
23
26
0954
14
9.9
27
29
29
33
Monthly Average Limit:
Wald,/ Avenge:
14.5
10.625
Daily Mutmua:°
17
11.3
Daily Mkflnnrm:
13
9.9
"is No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle: ENVWTHR = No Visitation — Adverse Weather; NOFLOW=NoFlow; HOLIDAY= NoVisitation— Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
;FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: Yes
eDMR PERIOD: 04-2018 (April 2018) VERSION: 2,0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
o
y
E
,.1
C
9
.h
s:
s"
2
O0010
00300
Weekly
Weakly
Grab
Grab
TEMP-C
DO
2400 dock
deg c
ma/1
1
2
3
3
5
1017
13
10.7
6
7
9
9
10
11
12
1030
13
II
13
14
I5
16
17
19
19
1055
16
9.8
20
21
72
22
24
21
2a
1013
14
10
27
21
29
35
Mmlha A.eram Limit:
, 1
an,,
Monthly Ae rage:
14
10.375
Daily Mailmum:
16
11
Daly Minimum:
13
9,8
•.a• No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENVWTHR = No Visitation - adverse Weather, NOFLOW = No Flow; HOLIDAY No Visitation— Holiday

NPDES PERMIT NO.: NC0022497
+FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 04-2018 (April 2018)
COMPLIANCE STATU ompliant
ORC/Certifi
PERMIT VERSION: 4.0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
ORC HAS CHANGED: Yes
VERSION: 2.0 STATUS: Processed
CONTACT PHONE It: 7049890165 SUBMISSION DATE: 07/25/2018
07/25/2018
: Dusty Ky e Metreyeon E-Mail:dmetwaterrJaol.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became asvare of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
Ifthe facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
Permittee/Sub
07/25/20I8
ure:* * Dusty KylyMetreyeon E-Mail:dmetwaterrraol.com Phone 4:704-506-4255 Date
Permittee Address: 62' N . wy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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 tines and imprisonment for
knowing violations.
LAB NAME: Water Tech Laboratories Inc
CERTIFIED LAB #: 50
PERSON(s) COLLECTING SAMPLES: Greg Trombello
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting htlp://portal.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation Jibe signatory authority must be on file with the state per 1SA NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: Yes
eDMR PERIOD: 04-2018 (April 2018) VERSION: 2.0 STATUS: Processed
Report Comments:
ORC on April 1st from Dusty Metreyeon to Greg Trombello. Dusty is now backup

SPDES tERmrr NO.: NC0022497
FACILITYNAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDAIR PERIOD: 03-2018 (March 2018)
PERAIEE VERSION: 4 0
CLASS: WW-2 F catawba
oRc, Dustin Kyle Metreyenn NO V 2 0 :2018 CERT NUMBER: 11697
OR( DAS CDANGED° No c„::EN L, r
VERSION: r(.1 Er3VV" SECTIOS1A I LS. I rt. o,..,s_sr
a.
R N
9ww
PERMIT STATUS: Aitot
rtr.-CEIVDINCDFARtEMR
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NQRos
„,OREStIlL.L REGIONAL C.).FF10E
241X1clack
1330
5005e
0 000OCK)139
FLOW
rrisd
021
0,01
0.016
0 017
0.017
6 0900 o 02o
7 MIEN 1426
1111 094 1111111M1
1130 MEMO
11111111111110111M
IMIMMIN1111111111111111
1111M11111 400
030 0' 0
1140
37
II1130
1111111/ 1410
20
1111111111••11=9
011=1111111111111111111.111111111
1111111MM 00
11111111MM 00. MN=
;) Ole
13
0017
Of6010
5 X we e
Grab
3 33111.1.111111111111
0015.
0.9 t 6
:016
0016 I 5
25 1111 1)029
Monthly Urine 114011,
Nfortfily A, crag.
[Doily M,wiretier,
Dully Minim 6
e
0017
0 0 I b
0.0 65
0 0 49
Ol 7
0.019
0.00
0 0 1N4 52
0.03
0.015
13 454 5431
10
IN141141
Weekly
1
(5
NM&
2 X week
Grab
113)40331N
Weekly
Crenpostte
N333,N -Com
02
0 24
CON 331 D06
Weekly Weekly
Corre5os4e Grab
INS ennc ITC0L4 tlft
I 00011
4.5 < 1
e 52
-**** No Reportiog Reason: ENFRUSE NO Flow-Reuse/Recycle; EN VWTHR N.0 0 00tation r Adverse Wefolun NOFLOW -5 No Flow: HOIADAY w No Visitatio» - Holiday

NPDES'ERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC IIAS CIIANGED: No
eDMR PERIOD: 03-2018 (March 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
8
„�
1
Er3
u°
E
e
c$
[+°
`
C
O
N
[Composite
6
'y
v
O
•
a
C0600
C0663 '
Quarterly
Quarterly
TOTAL N.Canc
TOTAL P-Cant
2460 duck
Hn
2400 that
Hn
Y/1304
t /1
mrll
t
1030
24
1020
.33
y
2
1130
.33
y
3
4
3
1330
.33
y
6
0900
.5
y
7
1420
.33
y
s
1030
24
0940
,75
y
9
1130
.33
y
ID
r1
12
1350
.25
y
i
13
0900
.33
y
14
1400
.25
15
1030
24
0920
1.15
16
1140
33
b
17
18
19
1330
.25
y
20
0900
.33
Y
E1
1410
.25
y
2=
1030
24
0920
1.15
y
23
1030
.25
y
24
23
26
1000
.33
y
27
1000
.33
y
2a
1400
.33
y
29
1030
24
1020
1.0
y
30
1142
.33
y
31
Monthly Mange Limit
��
M1famh0 Avenge:
Oily Maximum:
• Daily Minimum:
+1
k
•••• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle: ENVWTHR = No Visitation - Adverse Weather; NOFLOW = No Flow: HOLIDAY = No Visitation- Holiday

NPDES ! ERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 03-2018 (March 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
1A
P
sGrab
E
•01010
•
ti
110300
Weekly
Weekly
Grab
TEMP-C
DO
2400 crock
deg c
mg/1
1
1020
11
10.2
2
3
J
5
6
7
8
0940
8
11.2
9
10
11
12
13
14
15
0920
6
11.6
16
17
18
19
20
21
22
0923
9
11,3
23
21
25
26
27
25
29
1020
14
9.7
30
31
'
Monthly Average Limit
Monthly A•ecap;
9.6
10.6
Daily Maximum:
14
11.b
Dail) Minimum:
6
9.7
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENV WTI-IR = No Visitation -. Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation - Holiday

NPDESj1ERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4, ORC HAS CHANGED: No
eDMR PERIOD: 03-2018 (March 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
2
it
E`
a
s
r
z
00016
00300
Weekly
Weekly
Grab
Grab
TEMP-C
Do
2i00 cluck
deg c
mg0
1
1050
11
9.3
2
3
4
6
7
R
0950
8
12.2
9
16
11
12
13
14
15
0910
6
12.1
16
17
1R
19
20
21
22
0930
9
10.2
23
24
25
26
27
20
29
1040
14
10.2
30
31
Monthly Average Limit.
Monthly Avenge:
9.6
10.8
Daily Maximum:
14
12
Daily Minimum:
6
9.3 ,
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTEIR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

i
NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
cDMR PERIOD: 03-2018 (March 2018)
COMPLIANCE ST US: Complian
ORC/Certi ' Sig at re: Dusty
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Dustin Kyle Metreyeon
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERNIITSTATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SUBMISSION DATE: 04/29/2018
04/29/2018
Kyle Metreyeon E-Mail:dmetwatcra.aol.com Phone 4:704-506-4255 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is nonco
the NPDES perm:
Permitte
please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
04/29/2018
Kyle Metreyeon E-Mail:dmetwaterrraol.com Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES: Metwater
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wgfswp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs find, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 1SA NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 213
.0506(b)(2)(D).

NPDF:S MOW NO.: NC0022497
FACII. TV tiA tE: Cross Country Campgrc
t)V1" NER NAME: Cross Country Campground
(RARE: WW-4_
cDIVIR PERIOD::02-2018 (Februtlr 2018)
.PER 11I'T VERSION 4
CLASS: SS: WW-2
°RC; Dustin Kyle Metreyr
ORC IIAS MANGER: No
VERSION: 1 0
ORC CP
?LIMIT STATUS: ,+\crave
`;atawba
8
S I' 1'I IS: I'i°mess erl
T C1 11
: 11.697
,ECE.iV1:.
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*4 Q S
**** No Reporting Reason: ENFRL SI^ No l lov.-Reis Holiday

J
NPDES PFj4MIT NO.: NC0022497 PERMIT VERSION:4.0
FACILITY MIME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC IlAS CIIANGED: No
eDMR PERIOD: 02-2018 (February 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
2
C
,9M
k
3t
ry�
vi
11
1.
u'
E
i-.
a
ea'
1
.E
4
0
w 8
g
q
vk
U
O
-
i
a
$
r;
A
CO600
C060.1
Quarterly
Quarterly
Composite _
Composito
TOTAL N-Coss
TOTAL P - Coot
2400 clock
Hn
2400 clock
Hn
WHIN
mgl1
mall
1
1030
24
0900
1.5
y
2
1230
.33
y
3
4
4 •
1240
.33
y
6
0900
.25
y
7
1600
.5
y
A
1030
24
1000
1,0
y
9
1202
.33
y
I0
11
It
0915
.25
y
13
1240
.25
b
14
1305
.25
y
15
1030
24
0905
1,0
y
16
1130
.25
y
17
IA
19
1200
.25
y
IA
1200 _
24
1125
1.0
y
21
1330
.25
y
22
1230
.25
b
23
1000
.33
y
2:
23
06
1200
.25
b
37
0905
.75
y
20
1420
.33
y
Monthly Avenge Llmlt:
Ma lan, A1n.Kes
Day nlulamms
Daily hlialmutx
•"* No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENVWTHR = No Visitation —Adverse Weather: NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon
GRADE: WW-4. ORC IIAS CHANGED: No
eDMR PERIOD: 02-201'8 (February 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
o
x
>
LI
Li
!i
a"
Z
00010
06300
Weekly
Weekly
Grab
Grab
TEMP-C
Do
MO dada
deg c
mell
1
0905
17
11 4
2
3
4
0
6
7
6
1004
a
11.09
9
10
it
12
13
14
13
0905
11
10.9
14
17
1.
19
10
1115
13
10,13
21
12
23
2t
13
26
27
2s
Monthly A.er+ae Limo:
Mordik A.8.990
12.25
10 la
D.t[.Mariamm:
17
11,4
Es0' Minimum
8
10.17
++++ No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather: NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

{
NPDES PEMEIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 02-2018 (February 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
a
n'
I
Fi.
J
.1
d
z
no010
003nn
Weakly
Weekly "
Grab
Grab
TGTIP.G
130
2400 dock
des c
men
1
0915
17
11 7
2
3
4
5
6
7
8
1615
8
II 26
9
ID
11
12
13
14
15
0920
11
11,6
16
17
15
19
20
1130
13
11,09
.i
El
23
24
25
26
27
7.5
Monihy Avenge Lime:
Monthly A e go•.
I2 25
11.4125
Daly Madman,:
17
11.7
Daily minimum:
s
11.09
aa4a No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR t No Visitation — Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

NPDES PE.V.MIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 02-2018 (February 2018) VERSION: 1.0 STATUS: Prdcessed
COMPLIANCE STA US: Compli
ORC/
CONTACT PHONE #: [phone] SUBMISSION DATE: 03/30/2018
03/30/2018
Sig ture: Dust, Kyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part I1.E.6 of
the NPDES permit.
Permittee/Submi
03/30/2018
ignature:*** Dusty Kyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 6 '' C Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting.http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country. Campground
OWNEit.'. NAME: Cross Country Campground
GRA DE:
eDMR PERIOD: 01-2018 (January 20181
WQ R S
M04::)RESVLLE::: R 10 NA L OF ME:
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
PERMIT VERSION, 4 0 PERM Fr sTATA IS: Actiye
(T.:ASS: ‘71.7'7 V' RELFI
-_,,,vEDCOUNTY:
OR Dustni 1:::::1::: f\ 1:1,11":::voll nil 1 4 . lit: OR( CERT NUMBER: 11697
At ,t, .:<:) t.. s..: , ..,
OR( DAS (RANGED: N',2
VERSION: 1:C: CENTRAL FILES sTATus., pw,„„ed
OWR SECTION
M,77777 070 Pr: 17:577a: staaao 0:7:501 C06777 COMO 1,646
Coniznuo:57 5 N. week .33,! 555:ek V7:07771 Weekly 17/7777k ly kIvWeekly
kteL777'aier :Grab Grab Go all Cc7:55555:te Composae (151777.posite Grata 7 Grab
HAM 417MP43 70,0171744. 7RID CfMr C.411C FX3041 NA DO
clea
ialka7thla 44430.777 lnak
744777777777 7C7735.75,77 .1848 .7,
110 774'791-7
Mith Matitd.M.
Da777,
, I n577.71 afl 557l
7 7
-77
77 5'
7-777
C2 3 77 2 c
9 A
77!
123773
;2237
3 3
87
2
4 :7R
( 7 5
(555
' 7
7,6
••• • No Reporting Reason: ENFRt...:SE !IOW. Ret:.;e:::Roo:::71:7, 75i V 45' 117:1:7 - 57i5t7a:Kai. 77G17 7777thoi LOW ' No7 117-:::77. :1117:71711.),AV :7 No Vi5itatikal Hokiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW'-2
OWNET.TNAME: Cross Country Campground ORC: Dustin Kyle Mctteycoi
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 01-2018 (January 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*; NO (Continue)
.s
O
1
r.
E
6
6
3
7
1=
Operator Arrival Time
6'
U
O
=
0.
a
C0600
C0665 •
Quarterly
Quarterly
Composite
Composite
TOTAL N-Caar
TOTAL P-Cora
2400 eleelt
Hn
2400 ekdt
Hn
WEN
msn -
me/1
1
HOLIDAY
2
1105
b
.25
3
1005
.25
b
4
1030
24
0945
10
y
10.1
1.38
3
1430
.25
y
6
7
B
1300
.25
y.
9
1150
.25 .
b
10
1410
.25
y
II
1030
24
0930
1.0
y
tx
13
0900
.25
b
14
15
HOLIDAY
16
1100
.25
b
17
1330
.25
y
13
1015
24
0920
1.25
y
19
1100
.25
y
20
21
22
r
1240
.25
b
23
1205
.25
b
24
1230
.25
b
25
1030
24
0910
125
y
26
1050
.25
y
27
25
29
1315
.25
b
w
1110
.25
b
3t
1400
.25 dy
Man hl. A..I 13 Llmlc
Monthly Av,+2r.
10.1
1.38
Daly blaalmun,:
10.1
1.38
Daily tit adman:
10.1
1.39
•••• No Reporting Reason: ENFRUSE No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse SVealher, NOFLOW = No Flow: HOLIDAY = No Visitation - Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER.NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon
GRADE: WW-4. ORC HAS C1IANGED: No
eDMR PERIOD: 01-2018 (January 2018) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
o
li
J
1
a
1
t
a
t
z
anew
mu3ne
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 dark
dc_g c
mgn
1
2
3
4
0945
13
10.2
5
6
7
s
9
10
11
0940
5
12
12
13
14
15
16
17
10
0920
2
13
19
20
21
22
23
24
25
0915
9
12.1
26
27
26
29
30
32
Mnnt6ly A.crage Lin42
Mnmhly A. erage:
7.25
I I.825
Nit, Melimunr
13
13
Daily Minimum:
2
10,2
"so No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitalion - Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation- Hotiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNE1!NAME: Cross Country Campground ORC: Dustin Kyle Mctrcyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 01-2018 (January 2018) VERSION: I :0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
2
r
,a`
�
a
1
t
a
2
D0010
093110
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 clock
deg c
mgil
2
3
4
1000
12
9.8
5
6
7
B
9
10
11
0950
5
11.3
12
23
14
15
16
t7
18
0928
1
12.8
19
20
21
22
23
24
25
0922
R
11.1
26
27
21
29
30
31
M1lonthly A.enRe Limit:
M.nlhh loci -Age:
6.5
11,25
Daily Mesimum:
12
12 8
D:ah Minimum:
1
9.8
"" No Reporting Reason: ENFRUSE — No Flow-Reuse/Recycle; ENVWTHR = 14o Visitation — Adverse Weather. NOFLOW = No Flow; HOLIDAY — No Visitation— Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNERINAME: Cross Country Campground ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 01-2018 (January 2018) VERSION: 1.0 STATUS: Processed
COMPLIANCE STATUS: Co iant CONTACT PHONE 4: 7045064255 SUBMISSION DATE: 02/26/2018
02/26/2018
ty Kyle Metreyeon F.-Mail:dmetwateruJ.aol.com Phone 4:704-506-4255 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of carrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NP S permit.
02/26/2018
tee/Submitter Sign/cure:*** Dusty Kyle Metreyeon E-Maii:dmetwaterrraol.com Phone 4:704-506-4255 Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
*No Flow/Discharge From Site: Check this box if no discharge occurs and. as a result, there are no data to be entered for all attic parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee. then delegation of the signatory authority must be on tile with the state per 15A NCAC 2B
.0506(b)(2)(D).

NP©ES PERMIT NO.: NCOi122497
FACILITY NAME:C
()%% ER NIYIE: Cros
GRADE: WW-4.
eD'MLR PERIOD. 12-2017 (December 2017)
PERMIT I1` VERSION 4.0
I 1 ASS. 1,1
OR(-
ORC I1,AS('IIANGED: N
VERSION: )11
PERMIT STATUS: Active
aE 4El\(,:1��D6)1'tiI"1:C,tawba
OH( (: 1 R`{ '4MRFR: 11 697
CENTRAL FILES,
OWRS CTON I'1
Processed
SAMPLING LOCATION: EFFLUENT LHscIIAR E NO.: 001 NO DISCHARGE*: NO(

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon
GRADE: WW-4. ORC HAS CIIANCED: No
eDMR PERIOD: 12-20[7 (December2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
il
G
11
3r
e
4
e
i4
1-
-
e
u
-I
1--
1g
2.
O
..
S
5-
Z
a
O
a
1
2
C0600
Co66}
Quarterly
Quoncrly
Composite
Composite
TOTAL N-Cone
TOTAL P-Cone
2400 clock
tin
2400 dock
Hn
YID/N
tpFA
my]
1
1140
.25
y
2
3
4
1250
.25
v
5
1500
.25
b
6
1400
,25
y
7
1030
24
1015
1.0
y
6
1350
.5
y
9
10
11
1240
.25
y
12
1550
.25
b
13
1350
,33
y
11
1030
24
0950
1.0
y
is
1150
.33
y
16
17
-
18
1230
25
y
19
1100
.25
b
20
1400
.25
y
21
1030
24
0950
1.0
y
22
1100
.25
y
23
24
25
HOLIDAY
26
HOLIDAY
27
1245
.25
b
25
1030
24
0930
1.5
y
29
1120
.33
y
30
31
Stun hly Ai mQr Lindl:
Mor104, Meng.
0.0, Maximum
Daily Minimum:
"" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle: ENV W'I'IlR = No Visitation - Adverse Weather, NC/FLOW = No Flow: HOLIDAY = No Visitation-- Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: W\V-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Nletreyeon ORC CERT NUMBER: 1 I697
GRADE: WW-4, ORC HAS CHANGED: No
eDMR PERIOD: 12-2017 (December 2017) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
a
F
A
1
iII
8
2
96010
06300
Weekly
Weekly
Grab
Grab
TEMP-C
nq
taw clock
deg c
mg/I
2
3
.1
5
6
7
1015
10
10
0
9
10
11
12
t3
I1
0950
4
10.6
15
16
17
15
19
-
20
21
0950
9
10
22
,
23
21
25
26
27
Di
0930
3
12
29
30
31
Mnathly At encr LIm41:
Msmdly 6%066 :
6.5
10.65
Daily M11eilmum:
10
12
D,ny M1r imam:
3
10
•rs• No Reporting Reason: ENFRUSE= No Flow-Reuse/Recycle; ENVWTHR— No Visitation — Adverse 1Vealher, NOFLOW = No Flow; HOLIDAY = No Visitation --Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 12-2017 (December 2017)
PERMIT VERSION: 4-0
CLASS: WW-2
ORC: Dustin Kyle Mctrcycon
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 0D1
2
4
s
A
5
I
g
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 rbrk
dew a
mull
1
2
3
6
6
7
1020
10
8.9
a
9
10
11
11
13
14
1010
4
11.2
15
16
l8
19
20
21
1015
10
10
22
23
24
25
26
27
28
0950
3
12.4
29
30
31
111o0191l Po. rage Llmil:
M.nrhk As trace:
6.75
10.625
D.Iy h1,-Et:num:
to
12.4
. D.u3 h11.1mnnn
3
6.9
s*** No Reporting Reason: ENFRUSE= No Flow 1Reuse/Recycle: ENVWTHR= No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER N,►ME: Cross Country Campground ORC: Dustin Kyle MNelrcyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 12-2017 (December 2017) VERSION: 1.0 STATUS: Processed
COMPLIANCE STATCompliant CONTACT ('HONE #: 7045064255 SUBMISSION DATE: 01/29/2018
0 1/29/201 8
ORC/Cer,rfier S gnature: Dusty Kyle M treyeon'E-Mail:[e-mail] Phone #:[phone] Date
By this signature,'I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee becatne aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part ILE.6 of
the NPDES permit.
Permittee/Submi
Permittee Address: 6254
01/29/2018
Dusty Kyle Meyfeyeon E-Mail:[e-mail] Phone #:[phone] Date
150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
I certify, under penalty of law, that this document and all attachments%vere 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 managed 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.
CERTIFIED LAI3ORATORIES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.orglweb/wq/swp/pslnpdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit Ibr reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there arc no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.:. NC0022497 PERNIFI 1'1414SION 4. 41 PERM FE STATUS: Acme
FACILITY NAME: Cross Country Can!Around t I „‘SS: 4iiiv'i.V-4!.
RECEI'VED cot',vrv, c,t,1,477, .„.<
OWNER NAME: Cross Country Campground ORC: Diailso Ka i C N1(121,220.77:10 ORC CERT NUMBER: 14.1,0,7.-
9 -ft„,,,=,,,:i771 VELMCDENROWR
GRADE: WW-4. ORC DAS CIII.A.Nt:ED: N,, A2016
1R. I
eDMR PERIOD: 11-2017 (November 2017)
26
76
17 t 130
ERSION; 1 0 CENTRAL FILES sTA-11,S: Process4:d
DWR SECTION
waRos
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
M 11o6 4+2
1 41 a
17345
1.220
1200 33
1 30
1400 725
'1020 • 24 1020 ! 0
1250
54
/0.07 22
t 030 24 1015 . 75
210070 +00 0
06106 4E.E.116
10w0010114 4+ 3434 4.2072217+ 7 X 46.4641:
I
ipli I., illiElEtNE ' WED - li .664. 41i.4M6 irt4,044
1. .
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' nw r 61
X22.171,
34741,rE344,,41.1.
6.16660.4
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0_006
1,10067
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,Vi6r440). 4. qi
4
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1 48
117225224
erkly
31616
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#iloCrrol
%"" No Reporting Remorc ENFRUSE - No Flow-Rause,RaQ.iotle: tacA: \l 11 14,iuf4ov Nr..4c1704 4434 ',.:00aw 1434X% 1loxx. 1101. ID AY No Visitation Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kvle Mctreyeon
GRADE: WW-4. ORC HAS CIIANGI D: No
eDMR PERIOD: 11-2017 (November 2017) VERSION: 1.0
PERNIIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
a
p
'9
II.E
1*
15
fl
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A
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Compos4e _
Composite
TOTAL01- Cn9
TOTAL P-Cum:
2.100 clock
11n
2400 dock
nn
179M
mini
MO
1
1410
.33
y
1
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1000
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6
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.33
y
7
1220
•.25
b
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1400
.25
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9
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24
1000
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y
10
1040
.33
y
11
12
13
1309
.33
y
16
1130
.25
b
15
1400
.25
y
16
1030
24
1020
1.0
y
17
1255
.5
y
10
19
20
0915
.5
y
21
1030
24
0915
L.25
y
22
1350
.33
y
n
HOLIDAY
2.1
1250
.33
y
25
26
27
1330
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b
26
1035
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29
1415
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y
99
1030
24
1015
,75
y
.
01nnth15 A+cnge L1mk:
M ol142 Meraoer
09.0, Masimum:
6.0v hlmimam:
"" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse Weather: NOFLOW = No Flow; HOLIDAY = No Visitation -Holiday

NPDES P RMIT NO.: NC0022497
FACILIT NAME: Cross Country Campground
OWNER riME: Cross Country Campground
GRADE: V'W-4.
eDMR PERIOD: l 1-2017 (November 2017)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Dustin Kyle Mctrcycon
ORC HAS CHANCED:No
VERSION: I.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
�y'
a'
•
i
gt
2
01110
011300
Weekly
Weekly
Grab
Gras
TEMP-C
DO
2400 clock
deg c
mp11
1
2
1000
14
7-9
3
a
5
6
7
8
9
1025
13
7.6
10
lI
.
12
13
H
15
16
1020
10
9.9
17
18
19
20
21
0917
9
9.2
22
13
24
25
26
27
28
29
30
1015
7
Monthly A. emlm Limit:
-a10
,
Monthly Moog.
10.6
892 '
' Daly9l.dmum:
14
10 -
Dail. Minimum:
7
7.6
• "' No Reporti
g Reason: ENFRUSE = No Flow-Reuse/Recycle: ENVWTItR = No Visitation -- Adverse Weather; NOELOW W No now; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER N%ME: Cross Country Campground ORC: Dustin Kyle,Metrcyeon
GRADE: WW-4. ORC IIAS CIIANGED: No
eDMR PE2IOD: 11-2017 (November 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
OC
•
sl
d
9
1
i14Weekly'
2
060 0
00300
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Grab
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00
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dee, c
rt1f, 1
1
2
1015
14 .
6.6
3
4
S
6
7
8
9
1017
13
7 9
10
11
.
12
13
14
IS
16
1040
10
9.8
I7
IS
If
20
21
0922
9
8.6
22
23
24
2S
76
27
26
•
29
30
1026
7
9.6
!Monthly Arer.ge Llm10
Numbly A+era6e:
10.6
8.5
Pally Maximum:
14
9.8
Pally Mlntmum:
7
6,6
••'• No Reporting Reason: ENFRUSE = No Floiv-Rouse/Recyele; ENVWTIIR = No Visitation — Adverse Weather, NOFLOW = No Flow; HOLIDAY No Visitation — Holiday

NPDES PERMIT NO.: NC0022497
FACILIT NAME: Cross Country Campground
OWNER N.#ME: Cross Country Campground
GRADE: WW-4.
1
eDMR PERIOD: 11-2017 (November 2017)
COMPLIANCE STATUS: Compliant
ORCIC
PERMIT VERSION: 4_0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
ORC HAS CHANGED: No
VERSION: 1.0 STATUS: Processed
CONTACT PHONE #: [phone] SUBMISSION DATE: 12/22/2017
12/22/2017
ignat re: Dusty 1CyJ Metreyeon E-Mail:[e-mail] aol.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the hest of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the pennittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
12/22/2017
Permittee/5. itte Signat re:*** Dusty ki!yle Metreyeon E-ivlail:dmetwateraaol.com Phone #:[phone] Date
Permittee Address 6 4 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/3(1/2020
I certify, u Ider 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 managed the
system, or those persons directly responsible for gathering the information. the infomiation submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware that there are significant penalties liar submitting false information, including the possibility of fines and imprisonment for
knowing violations.
LAB NAME
CERTIFIED LAB fJ:
PERSON(s) COLLECTING SAMPLES:
CERT1I'lED LABORATORIES
PARAM ETER CODES
Parameter Code assistance may be obtained by calling the NPDES (}nit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only uni's of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and. as a result. there are uo data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on lite?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee. then delegation oldie signatory authority must be on rile with the state per 15A NCAC 2B
.0506(b)(2)(
).

NPDES7PERMIT NO.: NC0022497
PERMO VLKSIONst tt,0 FERMI 1 S1A1 LS; tt' Wu vo
1 4i( IITIN NAMEt. Cross Country uunityround LAN(Litt t N IA': CaLttiwInt
CS: '
°wit FR NAME: Cross Country Conprottord ()RC: Dt„Istm Ist,tte
v..ECtEIVED ORCCER INUMBER1693,
tit:ttCEIVELYNCti):NRIDWR
GRA.D WW-4.
oR( uf .1/4 s (22I :NtGItt Uttekt A p p tit (ttti '2 1
eDMR PERIOD: 10-'201 etober 2017) VERSION; ,:'t,,t S ItATLS: Processed,
CENTRAL FILES
DWR SECTION woRos
SAMPLING LOCATION: EFFLUEN'll DISCHARGE NO.: 001 NO DISC1JARGENINORE:7.c..00toa„ oFtIcE:
s4.4f.S.fi noty, t out*,
It. ottstnottos : 2: tti tkkktt, :Week tk 2 \ tkokt,t2_22!‘kkelktk_t_tat t2tttt:ttett.ty _
Rtkotttdet ! tt it 91, !ktktk ; tt1ratt: ! tt knpoktk k ktk-ttittokttik
F1.04 : tit aka' i' 0.1 : i* alatailat. Ma*** +ma ,4-13.N , (-tm.v.
...,-,_ . ..... • in„,,CI 4,,,y. ,
iota,
tt.kfttk
110
't I Ft: ttrtt
Male
"" No Repotting Reason. ENFRUS) No HOW-RettseAtttto:kitt-t. t'ttAt'Vt. tt 'ttttt t -tittt ttt•t \tt3..A. ,C 1tt !ttatilkak 2:tt,fit t tttt: kto: lotk DA No Vtsuattort 1ohday

Nil) ES?I RAITT NO... N00022497
E^AC 111T"Y NA!►1E:. Cross Country Camp
C)VVNET2 NAME: Cross Country Campground
GRADE: W. -4.
eT)%1R PERIOD: 14-2Q 7( )tithe
PERMIT U 1s"R- r
CI ASS: ty' v
OR(': i")rz;lirr Y ; 6e (9 t
SAMPLING LOCATION: EFFLI ENT
NO W)WS 7. HARG *: NO
*** No Reporting Reason: E.NI^R,C St - N . ow-Rr°use, lRr, r°rL l.h v<r h,:r: w,,r PFI.OW No l lkw.

NPDES PERMIT NO.: NC0022497 PERNIIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Nleireyeon
GRADE: WW-4. ORC IIAS CIIANGL O: No
eDMR PERIOD: 10-2017 (October 2017) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
A
II
Y
1et
`s
a
+e
2
Z
00815
003Q0
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 clock
deg a
my1
t
2
3
4
5
1000
16
8.1
6
7
8
9
10
11
11
1022
22
5.2
13
14
[5
16
17
18
19
1000
14
8.3
20
21
22
23
24
25
26
1020
13
8.8
17
28
19
30
-
31
Moethh A[9rage I.lessf-
Monthly A.erege:
16.25
7.6
D 1I 31.onev :
22
8.8
Daily 9.1lninruen:
13
5,2
sus' No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTNR = No Visitation — Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcyeon
GRADE: WW-4. ORC HAS CI LANCED: No
eDMR PERIOD: 10-2017 (October 2017) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
2
Y
45
a
r
G
0
a
a
z
94/010
I10300
Weekly
Weekly
Grab
Grab
TEMP-C
aD
low clock
del; c
mg/1
1
2
3
4
3
1015
16
61
6
7
S
9
10
11
12
1109
22
4,6
13
14
15
16
17
12
19
1010
14
8.3
70
31
21
23
24
15
26
1030
13
7.9
27
211
19
30
31
r
Mnnrhly plunge Limits
31nnrhl. A.er,sr:
14.2s
6.875
Daily M51.19aum4
22
8.3
D,0 M11/:murn:
13
4.6
"s• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycte; ENVWTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDESERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 10-2017 (October 2017)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Dustin Kyle Nletreyeon
ORC HAS CHANGED: No
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
VERSION:2.0 STATUS: Processed
CONTACT PIIONE #: 7045064255 SUIIMISSION DATE: 04/16/2018
•
42445'e' 04/16/2018
Signatur Dusty Kyle Metreyeon E-Mail:[e-mail] aol.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best any knowledge.
The permittee shall report to the Director or the appropriate. Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circtimstances. A written submission shall also be
provided within 5 days of the time the pemiittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a lime -table for improvements to be made as required by part II.E.6 of
the NPDES 'ermit.
16/2018
Pe a/Subm er Signatu e:*** Dusty Kyle t 1ctrcyeon E-Mail:[e-mail] aol.com Phone #:[phone] Date
Pe rttee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed the
system, or those persons directly responsible for gathering the information, the information submitted is. to the best or -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.
C1RTIFIED LABORATORI ES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
- PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.nedcnr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee. then delegation of the signatory authority must be on file with the state per l5A NCAC 2B
.0506(b) (2)(D).

NPDES PERMIT NO.: NC0022497 I'ERNIIT VERSION. RSION. 4,0 I'ERNIIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle. Mctrevcon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS C11.1NGE :f: No
eDMR PERIOD: 10-2017 (October 2017) VERSION: 2.0 STATUS: Processed
Report Comments:
4-16-18 Revised to include omitted TN/TP 4th quarter results 2017 per Wes Bell,

r
'mES PERMIT NO:N
FACILITY' NAME: Cross Cou ,R»
OWNER NAME: CTOSS Country Cinr 3
GRADE WW4
mwR PERIOD:1
SAMPLING LOCATION:
-NT
pu.:worr srATus,
,@CEO G l
/AO\
»Q3001 NO 9|SC# RCE NO
••• &m¥9R _IERUSE- G e !« m<«mr r«> » s,x-slG +#ma wvt .+

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WI' -2
OWNER NAME: Cross Country Campground O12C: Dustin Kyle Mctreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 10-2017 (October 2017) VERSION: 1,0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
a
x
1
1
Lr
1
F
t
ti
i
I"
I
8`
S'
V
a
.N
4
O
•
€
al
2.
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTAL N-rt. e
TOTAL A - Cane
2409 clock
Ihn
7400dac4
lin
VAIN
mv]
mcll
1
2
1405
.25
b
3
1510
25
b
4
1205
.25
6
5
1030
24
1000
1.0
b
6
1305
.25
b
t_
7
8
9
1232
.25
y
10
0840
.33
y
11
1350
.33
y
12
1030
24
1022
.66
y
13
1210
.25
y_
14
15
16
1305
.33
y
17
0900
.25
y
is
,
1400
.33
y
19
1030
24
1000
1.0
y
20
1245
.25
y
21
22
23
1045
.25
b
24
1100
.25
b
25
1700
.25
b
26
1030
24
1020
1.0
y
27
1000
.25
y
2a
s9
30
1340
.25
y
31
1100
.25
b
51512161y M ance Limo:
alonll. Menge:
Pall?. 6l6513mm:
Dail, MMh1 r r
••i* No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather. NOFLOW — No glow; HOLIDAY =No Visitation — Holiday

f
NPDES PERMIT NO.: NC0022497 PERMIT'VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC IIAS CHANGED: No
eDMR PERIOD: 10-2017 (October 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
Y
�
J
i
&
aY
Z
I mlo
06300
Weekly
Weekly
Glatt
Grab
TEMP-C
Do
3100 ikek ,
deg e
mg/1
1
2
3
4
5
1000
16
6.1
6
7
8
f
10
11
IS
1022
22
5.2
13
11
15
16
17
l8
19
1000
14
8.3
10
21
21
23
21
25
26
1020
13
6.8
27
28
19
38
31.
hlaa+hl• Menge L14/11:
6144thly At clog.
16.2s
7.6
Daily htadmam:
22
8.8
De11. h15 Loam:
13
5.2
"*a No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR =• No Vi.;ila3i0n — Adverse Weather. NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Crass Country Campground
GRADE: WW-4.
eDMR PERIOD: 10-2017 (October 2017)
PERMIT VERSION: 4.0
CLASS: WW-2
ORC: Dustin Kyle Metreycon
ORC HAS CIIANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
9
aA
k§
1t
0
1
&
a
g
00010
90300
weekly
R'celdy •
Grab
Gmb
TEMP-C
Du
2100 clock
deg a
mg4
1
3
4
3
1015
16
6.7
6
7
0
9
10
01
12
1109
22
4.6
13
11
is
16
17
10
19
1910
14
8.3
20
21
22
23
71
25
26
1030
13
7,9
37
28
29
30
31
Monthly A,erage Limit:
Monrbl+ A.erare:
1535
6 973
Dallr D1..inruIle:
22
A 3
Dana nllnlmam:
13
4 G
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTI fR = No Visitation— Adverse Weather: NOFLOW = No Flow: HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS:WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground O11C: Dustin Ky'1. Me�rcveon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC IIAS CIIANGED: No
eDMR PERIOD: 10-20I7 (October 2017) VERSION: 1.0 STATUS: Processed
COMPLIANCE STA : Compliant CONTACT PHONE 1/: 7045064255 SUBMISSION DATE: 11/28/2017
ORC/Ce
11/28/2017
ignature: Dusty- Ky e htetreycon E-Mail:[e-mail] Phone #:[phone] Date
By this signature,) certify that this report is accurate and complete to the best ol'rny knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a lime -table for improvements to be made as required by part 11.E.6 of
the NPDES permit.
1I/28/2017
Permittee/ mit r Sigture:*** Duty Kyle Melreyeon E-Mfail:dmetwatcraaoLcom Phone 4:704-506-4255 Date
Permittee Addre 254 NC Hwy 150 E Denver NC 28037 Pennit Expiration Date: 04l/30/2020
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 managed the
system, or those persons directly responsible for gathering the information. the information submitted is, to the best ofmy 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.
CERTIFIED LABORATORIES
LAB NAME:
CERTIFIED LAB s2:
PERSON(s) COLLECTING SAMPLES:
I'AI(AMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting hltp://portal.nedenr.org/wcbhvq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and. as a result. there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the pennittee. then delegation of the signatory authority must be on file with the state per I5A NCAC 2B
.0506(b)(2)(D).

NP©t P RM T' NC) NCOO224.97
FACILITY NAME. Cross Country Cam t
OWNER NAME,: Cross Country C`ampgrou
CRAI)E: WW-3.
el)MR PERIOD: 06.2
SAMPLING LON: t,
.0., No Rgporting K a ,nF'FRC,SE
IR.
r PI kv)I I N 1A11,)S:
1WED ((PI vIV:CaLoYtui
FILES.
T ON
C.)ICC C:'L!fl` NUM DER:„ 11697 ..
S I 1 F.S Pro.
1,R(.►Ia. NO.: 001 NO DISCHARRGL f�
Nn•• G brit_ Idtil.!h�NY. • NO A •• flo day

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Ivletreyeon
GRADE: WW-4. ORC HAS CHANGED: No
cDMR PERIOD: 06-2017 (June 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
Pi
P,
1.aa
V
i
ti•
!„
f
K
v.
�
k
S
a
O
.
A
C0600
C0665
Qvnricrly
Quartt;rly
Composite
Composite
TOTAL Ic-Cent
TDTAl. P-Coat
2400 clock
lln
2100 dock
lin
Y!!eN
mgri
mg,/
1
1010
24
1000
1.0
y
2
1200
.25
y
3
4
5
1350
.25
b
6
0715
.25
y
7
1010
.25
b
8
1000
24
0850
1.25
y
9
1205
.25
y
ID
I1
12
0900
25
y
13
1115
.33
b
14
1230
.33
y
15
1000
24.
0920
1.25
y
!6
1030
.33
y
1T
18
19
1330
.33
y
20
1050
.25
b
21
1050
.25
b
.
11
1015
24
0930
1.25
y
:2
1150
.33
24
_y
25
26
1330
.25
y
17
18
0935
.25
b
19
1030
24
0930
125
y
30
1200
33
y
270. hb Aan:,Usk:
Momhy A. men
M03 M.clrtrnm:
thtly!Weinman
"" No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle: ENVWTHR = No Visitation - Adverse Weather: NOFLOW = No Flew: HOLIDAY = No Visitation —Holiday

NPAES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyenn
GRADE: WW-4. ORC IIAS CHANGED; No
eDMR PERIOD: 06-2017 (June 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
pI
0
:
i
a
i4
00010
coos
Weekly
Weekly
Orate
Groh
TE611,41
1111
2400 do k
•
deg c
illy1
1
1050
22
6.5
2
3
4
5
6
7
8
0050
21
6.1
9
10
11
12
.
13
14
15
0920
24
5.5
16
17
18
19
30
21
21
0930
24
6.2
23
24
13
26
27
26
29
0930
22
6,9
30
6147 0ll..l.enee Mali:
Nmf 11y A•.n>;ei
22-6
6.64
11.lb \la.intomr
74
8.5
Maly 6t1.lmvm:
21
5.5
'•*• No Reporting Reason: ENFRUSE = No Flow-Reuse/Rccycle, ENVWT1111.= No Visitation - Adverse Weather: NOFLOW = No How: HOLIDAY = No Visitation- Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 06-2017 (June 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
t2
F
e
a
a
g
m
00010
00100
Weekly
Weekly
Grob
Gr ib
TEMP-C
DU
1100 clads
LINO
MO
1
I030
23
7.6
1
1
.
5
6
7
e
0910
21
6.6
9
10
11
12
l3
t4
15
0937
24
5.9
16
17
II
19
20
21
22
1000
25
5.1
23
2.
23
26
27
19
29
0940
22
6.7
30
Mool61y Al env LImIl:
Monthly Avrr.Cr:
23
6.38
Way %I..Imw.:
25
7.6
D.ily Mthim.m:
21 -
5.1
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle: ENVIVTIIR = No Visitation — Adverse Weather NOFLOW = No Frew; HOLIDAY = No Visitation —Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 06-2017 (June 2017)
COMPLIANCE STATUS: Compliant
ORC/
PERMIT VERSION: 4.0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Dustin Kyle Metrcycon ORC CERT NUMBER: 11697
ORC IIAS CHANGED: No
VERSION: 1.0 STATUS: Processed
CONTACT PHONE #: [phone] SUBMISSION DATE: 07/21/2017
07/21/2017
ature: Dusty/Kyle Metrcycon E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the penniltce became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the penniltce becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES pe , it.
Pe ubm
Perm Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
07/21/2017
ter Signature ** Dusty Kyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
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 infonnation submitted. Based on my inquiry of the person or persons who managed 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.
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http:l/portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 80 .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on tile with the state per 15A NCAC 2B
.0506(b) (2)(D),

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4 0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctreycon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC IIAS CHANGED: No
eDMR PERIOD: 06-2017 (June 2017) VERSION: I 0 STATUS: Processed
Report Comments:
No visitation on 6-27-17 due to family emergency. however the visitation mad: up «Rhin the saute week on Saturday July 1. Iiiis report will not allow me to show that. time
0900... hrs .25.., temp 25

,PEWS PERMIT Na: NC0022497
FACILITY IL.I T NAME Cross Country Carnpkround
OWNER NAME: Cross Cournery Camp ,round
GRADE: WV-4
c[)MR PERIOD; 06-2017 IJrrne 2017)
PERMIT VERSION 3EI. Yl
ED
(,LASS: W V 2
OR( Oust in Kyle hlcrrt.ycor .p ,?, 0 9 U { t`
ORC HAS CHANGED:. t�"`�-F.NTRAL FILES
VERSION: .0 DWR SECTION
PERMIT STATUS: A trve
( OUN°I"Y: Cutasvbu
ORC CoERT NUMBER:. I1
ors ��r��ta
SAMPLING LQCA`E" ON: EFFLUENT DISCHARGE NO.: 001 NO E T + � ; I€u A , = v..
"*" No Reporting Reason: ENFRLS( No F'l w-tteuSv Rti prcP ; t t'W i iR N�° L'isitattia i� — A w w&a' iti t c.E< C'0 (V N ( sv; UOI II).AY No Visitation 14oliday

,r
NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4_0
FACILITY NAME: Cross Country Campground CLASS: W W-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 06-2017 (June 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
a
1E
II
V
_
~et
V.,�F.
u'
a
2
i'l—
—
e
O
8
O
[7.[B
8
u
re
=r.
a`
2.
C0600
C0665
Quarter1y
Quirt221y.
Composite
Composite
TOTALN-Cnae
TOTALP-Co,K
2400 doe&
Hn
2490 clock
Uri
YIWN
mg/
melt
I
1010
24
1000
1.0
y
2
1200
.25
y
3
4
5
1350
.25
b
6
0715
.25
y
7
1010
25
b
8
1000
24
0850
1.25
y
9
1205
.25
y
10
11
12
0900
25
y
13
1115
.33
b
14
1230
.33
y
Is
1000
24
0920
1.25
y
16
1030
33
y
17
18
19
1330
33
y
20
1050
.25
b
21
1050
.25
b
22
1015
24
0930
1.25
y
r
23
1150
.33
y
24
25
26
1330
.25
y
27
28
0935
.25
b
29
1030
24
0930
1.25
y
30
1200
.33
y
Mon 61y Arerau Llmft:
Monthly A%eestc:
Deity 6fseimcm:
Daily Minimum
'*** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY No Visitation— Holiday

4 i ',:'DES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreycon
GRADE: WW-4. ORC HAS CHANGED: No
cDMR PERIOD: 06-2017 (June 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
`
a
P0
d
E
•
m
1.
00010
00360
Weekly
Weekly
Grab
Grab
TF.)1Pr
DO
2400 clock
drg a
mglt
I
1050
22
8.5
2
3
4
5
8
0850
21
6.1
9
.
10
11
11
13
14
15
0920
24
5.5
16
17
18
19
20
11
22
0930
24
6.2
23
24
15
26
27
sy
29
0930
22
6.9
36
0194tN1y Menage Um11:
31onlhly Avenge:
22.6
6,64
Deny MAW..
9:
24
8.5
Daily Minimum:
21
5.5
****No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR— No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY =No Visitation —Holiday

t ` a NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
F;\IR PERIOD: 06-2017 (June 2017)
PERMIT VERSION:4.0
CLASS: WW-2
ORC: Dustin Kyle Metreyean
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
a
e
F
y
Ir
i
A
y
-
S.
00010
20320
Weekly
Weekly
Gmb
Grab
Tr+IP.0
Da
2400 clock
deg c
mg!I
1
1030
23
7.6
1
3
4
5
6
7
8
0910
21
6.6
9
Io
11
14
15
0937
24
5.9
16
17
13
19
22
21
22
1000
25
5.1
23
24
25
26
27
28
29
0940
22
6.7
30
ManDity Avenge Limit:
Monlhy.Aven¢r:
23
636
Daily 31.4m343:
25
7.6
D.113 Minimum:
21
5.1
i*' No Reporting Reason: ENFRUSE = No Flow-Rcuse/Rccycic; ENVWTHR = No Visitation —Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcyeon ORC CERT NUMBER: 11697
tRADE: WW-4. ORC HAS CHANCED: No
eDMR PERIOD: 06-2017 (June 2017) VERSION: 1.0 STATUS: Processed
Report Comments:
No visitation on 6-27-17 due to family emergency, however the visitation made up within the saute week on Saturday July 1. This report will not allow me to show that. time
0900... hrs .25... temp 25

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctreyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 06-2017 (June 2017) VERSION: 1.0 STATUS: Processed
COMPLIA - STATUS: Compliant CONTACT PHONE #: [phone] SUBMISSION DATE: 07/21/2017
07/21/2017
Signature/ Dusty Kyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the perrnittce became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
tithe facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
07/21/2017
Perm(#ckfressm:r6i21
Signatur *** Dusty Kyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
Permit C Hwy 150E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 properlygather and evaluate the information submitted. Based on my inquiry of the person or persons who managed 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.
CERTIFIED LABORATORIES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING,SAMPLES:
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per l SA NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NP©ES PERMIT NO.: NCtib022497 PERMIT VERSION; 4.0 FF;RMITSt"A'I'11S A Ive
FACILITY NAME; Cross Country' Campgiuurrd CLASS: �it41 •_' COUNT!': Cntaw.ba
OWNER NAME: Cross Country CCarnp rouncd ORC : I.lusiin Ky1 tilc1ar}= cyrd ORC C'ER f ' NUMBER: 1697
GRADE: WW n4a ORC IIAS CHANGED:
7 5✓ r
el)MR. PERIOCi: £1 •?11I7 ay "ddl7} VERSION: 1 U CENTRAL FILES STATUS: US: Processed
OWR SECT4ON
SAMPLING LOCATION: EFFLUENT' DISCHARGE NO.: 001 NO DISCHARGE*: NO wapc.
�a wc8e Fpv - L7
0,01
WOW
z uk
I
.0'
"C5S - kenae
Redo n Reason°ENERIMiSE NoY•loc--Rcuscrk. cyckTM; 9*.! c'1w!"i1iR- eii:W \ NoF o.; HOLIDAY N'oVisitafion--IluGcyay
Weekly
AL lrF7q,

NPDES PERMIT NO.: NC0022497 PERMIT VERSION; 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctreycon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 05-2017 (May 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
o
m
.
s
u
Taul Camposlie Time
7
'E
<
15.
o
—
D
F
2
O
c
if,
C
No Reporting Reason...*
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTAL N-Cope
TOTALP - Cone
2400 clock
lire
2400 clock
lira
V/BIN
mg/I
Me
1
1300
.2
y
2
1130
.2
b
3
1230
.25
y
4
1000
24
0945
.5
y
5
1200
.25
y
6
6
1300
.25
y
9
1140
25
b
l0
1300
.25
y
11
1000
24
1000
.66
y
12
1140
.25
y
13
14
15
1a05
.33
y
16
1000
24
0900
1.25
y
17
1600
.25
b
18
1330
.25
b
19
1100
.25
b
20
21
22
1250
.33
y
23
1250
.25
y
24
1000
.25
b
25
1000
24
0850
1.5
y
26
1145
.25
r
27
28
29
HOLIDAY
30
1100
.25
y
31
1230
25
y
31os hly Avenge Limit:
M11onthlyAvrr.ge:
Doily 51..imum:
Daily Minimum:
I*** No Reporting Reason: ENFRUSE= No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY=NoVisitation— Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 05-2017 (May 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
o
K
•
8,
z
00010
00300
Weekly
Weekly
Grab
Grab
TE319-C
DO
2400 cloak
deg a
mgll
2
3
1
1015
•
18
7
5
6
.
7
8
9
10
11
1044
19
7.6
12
13
14
15
16
1020
20
6.3
17
IS
19
a6
21
22
23
24
25
0910
20
7.3
26
27
2a
29
30
31
1
klonthly Avenge Limtr.
Monthly Menge:
19.25
7.05
Daily 3lnlimera;
20
7.6
Dtay 91 iImvm:
to
6.3
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; EN VWTHR = No Visitation — Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyean
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 05-2017 (May 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
=
yq'
cl
a
2
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
130
2400 dell
deg c
mg, I
3
4
1020
18
6.2
5
6
7
8
9
10
I3
1024
19
7
12
13
14
15
16
0930
20
7.1
17
is
19
20
21
22
17
24
25
0850
21
6.9
26
27
28
29
36
31
3lanlbly Menial? Limit:
514662ly Avenge:
19.5
6.8
2140y 3 .xlmenc
21
7.1
Deily Mlnlm.m:
18
6.2
ar•• No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS; Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CHANGED: No
DMR PERIOD: 05-2017 (May 2017) VERSION: 1.0 STATUS: Processed
COMPLIANCE STATUS: Cot CONTACT PHONE #: [phone] SUBMISSION DATE: 06/23/2017
06/23/2017
ORC/CertifierSi e: 1y Kyle etreyeon E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
06/23/2017
Permittee/Submitter re:** lusty Kyle yfetreyeon E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 6254 NC ' wy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LABORATORIES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.orglweb/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
'p No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
ORC on Site?: ORC must visit facility and document visitation of facility as required per 1 SA NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

DES PERMIT NO.: NC0022491
FACILITY N.,AMEtatKS,COuntry Curium::Onnd
OWNER NAME: Cross Country Campground
GRADE: WW-C,
eDMR PERIOD: 01q013 (March2013)
vERrorr VERSION:
CLASS': \
OR( : DUSIIT1 Ky1,1 Nietreyeon
ORC DAS CHANGED: No CENTRAL FILES
vEksloN, 1b
:7% E \„e EL TL1HrSIATM Activc
COUNTY; Catawba
M AY I) 8 OR( cERT NuM
MYR SECTION STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE, NO.: 001 NO
044017
kktk'r-
C.kktWk
ekk401ft
.1,!2i11€6
(
11
o(.) f J28 02 24 <
04W,
5.094,41 4.03919 1 ( tkOF14
NAL: 0 F FK;E
6,kat,
9E1
Ck4 43:4
4414,14,44444Mk. VIM .04,14 k 3rah
Ow Mk4k - Com
44t4k1kk
•
°,215.11,jk, CartiptAite Collt,V2sil
,k„.4:1,1k1 Wc,elk 'eekh.
'eck
mpg mg4
14116 kk_
rP (if kk i'
9,•ai 4k rkk 1
Low
Nixaatitly A kkrrutokk 1.5444;
11
Moorllb A,,twgs,
11m4.4 NTANhMl.14, 0
dkke,R4 Xin0h111.119, '0 000
< 20
7 7
0.25
*4"' No Reporting Reason-: ENFRUSE No fluw,ReuseRecycic,1 1 lIR N 1 i,iU,?1:i041 NOFLOW Flow: HOLM No Viis.iiafion. tit:111(14y

DES PERMIT Na: NC0022497
.FACILITY NAMEFi,pvsi,Colitrory'Cainpgrourid
OWNER NAMEt Cross Country' Canwround
GRADE: W
el/MR PERIM-R.03-2W (Math '201
PERMTI VERSION:4.0 PERMIT STATUS; Active
CLASS:, V 1 COUNTY: Cal" ba
ORC: Dri,1 K MORC)0
ORC DAS CHANG
VERSION: .0 STATUS: Processed
ORC CERT NUMBER t 1697
SAMPLING LOCATION: EFFLUENT DISCHARGE NO,: 001 NO DISCHARGE*: NO (Continue)
,crug,
Max.imktou
laally Mailroom:
"OW (IWO
Qa,tri0.1), Quar,o1),
Cortry,Re
N. • ram
fibgit
Reporting RCAS.011: ENFRUSE No Flow-ReuserRociiidy; FN \ lI 5o Ad% We.:Ahvr. NOFLOW HOIADAY No Visitation - Holiday

DES PERMIT NO.: NCo022497
FACILI"FY NAME: (,psis Country Campground
OWNER NAME:Cross Country, Campground
GRADE: WW-4.
eDMR PERIODO3-' 117 (Itilarch 2017)"
PERNi1';I" 1'I^.R,SIO.A. •A..B
CLASS: A\'1Y"-2
ORCt D
ORC HAS CH ANG
VERSION: I it
SAMPI ING LOCATION: L]PS'I'RE
arum: .iffs0 .
OW, Micattraau:
No Reporting Reason; FINER No N Flow, RCW.e R }:E 1.A4'N°"9.V,ER . Aru, l
al
PERMIT STATUS: Ac
COUNTY: Catawba
ORC CERT NUMBER:. 11697
STATUS: Pr, 7 cased
"HARGE NO.: 001

DFS £'ER'C1 TT NO.: NOV22497
FACILITY' NAME:,Cro s Country Camp&r fund
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOBt,04OI7 (M+urh 2017,
PERMIT VERSION.4_tl
CLASS: W�ti-2'
ORC: t)usit* Kyle \ltlreve
ORC: OAS CHAN(.,Ii1
VERSION:
PERMIT STATUS: Active
COUNTY: GOWN ha
ORC (w'ERT NUMBER.: I,Ift97
STATUS: Prose ed
SAMPLING L. AT`ION: I)+ °NSTRI;AM DISCHARGE NO.: 001
Reuv;in: ENIRLSE =Nu Now-R*usclHc
"T'HNo VI - VWo,,i her, NON (i14 N.r (ticovr,, H0LIf)A%" - Nu Visi latttuHoliday

fDES PERMIT NO,: NC0022497
FACILITY NAME 44gass Coaaritry Campground CLASS: 11`\1' /
OWNER NAME: Cross t un¢ry Campgromad
GRADE: WW-4.
eI»IR, PERIOD: 03-2t 17 EMarch'20414"
COMPLIANCE STATUS:
By this s
attire
h
ure: usty
The perrmttt't°. tihall report to the Directasr car
Any inform atattn shall he provided orally wi
provided within 5 days of the time the per
If thefacil.ity is non .caual)liant, please attach
the NPDES perrtia
Perini ttee/Sub
PERMIT VERSION:.
ORCt Da,ria Kyle Morele�u'i
ORC HAS CRAN(101): No
' 1 RSION:
PERMIT STA"Ih;S: A,
COUNTY: Catawba
ORC CERT 1NIt1ATBFR: 1 1697
STATUS: Processed
CONTACT PI'1ONI. #. '104506, Y SUBMISSION DATE: 04/28/2(1'7
e appropri:
ira 24 hours
;.e beconte_N raw:art t+f Ch
Ii t ofcorreettve act.it
Dua
Permittee Address. 6254 NC 1-Iwy 1.50 E Denver NC 2504"
certify, under penalty of law, that this document :and all autsa
04/28/2017
1.corrtt Phone #:[phone] Date
ntrarnlaloance that potcratially ihreatcns public health or the enw`itonment..
be a4v'• re of the: cirr.:uartstanees. A written submission shall attlso h
aken atattl
Permit Erpirartiora f)a
d under
ten&
to assure that qualified personnel properly gather and evaluate the inli,rrnaifiictta submitted, Based on any
system, or those persons directly responsible for gathering the inforMlation, the information submitted i
accurate, and complete, I am aware that there are sin' ant 1: naltiaxs fray cabtatitting faafse infcartro- ttitart,
knowing violations,
LAB NAME;:
CERTIFIED LAB #:
PERSON(sj COLLEC'TINC SAMPLES:
Parameter Codc assistance may he ob
Use only units
* No Flow/Discharge I rer,na Stte: Ctmct.k this box if no discharge occurs :old. rsu
far entire monitoring period.
*'* ORC on Site?: ORC must visit facility and document t=isfirniitn ot atculiljtia5 ecltti
**a` Signature of Permute:: If signed by other than the permince, then delcration of Mc .
,0506(h)f2)(D).
Cf;I2111°1C:I3I.,Al-h RATORISiS
PARAMETER (:"(;)DL'
it taa1'9) 8t17-6rttl() ti'rr fr
nt
designated in the reporting face ty`a NPDES ps:rntn
u
d by part II of
04/`28/2017
#:704-506-4255 Date
e with a system deliogned
d the
dgc and belief, true,
I' 17nes and imprisonment for
nl.
/ps/n
d for all of the parameters on the DCa!1R
1 N(°AC it .0204.
authority trust he on Ole with the state per 15A NCAC 2B

im• '
NPDIS PERMIT Na: NC00229197
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4,
eDMR PERIOD: 02-2017 I cbruu 20 7 ),
PERMIT STATUS: Aciive
'V: (iwIn
ORC CERT NUMBER: 11697
'
klkr )4
CENTRAL rssTATUS: Procu.ssed.
DWR SEcTaK
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCIFARGV::N070'W"'''AL
PERM TI CRS ION 4 0
ORC: Dustin Kylo Ninvycon
OR( HAS CHANGED: No
VERSION: I
q*0,0
90919
00404 Matrfot, COMM ,
com99909, X 0094, V02.9k!1: Wcekly Wo2.4,21, , Woeki
R02.202k9 Grikb e•CIPT.KtW • COly21,.!y,.. :00410, Grab
01(0A 'l jfl 110009E fq if, Cow NW-N. 0.011.2 TM. 90K
. ng21 .1920 9009 tugti
90.
,90tV
99109 1. at
'7117
16.9
22Ci: )998
0 MS t
029,0$ 1
il 005 t'' 2 0 09
f.
).002',
001:90
'9000
91200 1.14
9.000 t
9—'12 it 9+
• ..„, .....
T„
r t-
1 ,
-i-
, 00001 i
---r—
ri-
9fixtthiy ,i2,091•4010,90 . —
Ni00091 ,ttatt,
OW00
Mik‘i M." 410
12101.0 Mkeimattl: ,os
0 0
9
1 0 7
j
No Reporting Reas4rn: ENFRUSE No H090Rel,9292R029910, No 1 ismik ion Ad ver.i.9 Weathes, Ni .No How, I 01,,,IDAY No Vi.siEation Holidoy

NPDES PERMIT NO.: NC:002"2497
FACILITY NAME: Cross Country Caamdaerlourid
OWNER NAME: Cross Country CampEi°uuaod
GRADE: WW-4,.
eDMR PERIOD: 02-20I7 (Febru rry "2097)
SAMPLING L©CA' IOI
2710 eam ti afire i
24
ORC" VAS C:"IIaANGED
VERSION: 1 0
PERMIT STATUS: Ardve
COUNTY: Cril;av hat
ORC (.:FRT NUMBER: 11697
S'I"A
ENT I 'HARC; NO,: 0(9 NO I > 'MARC : N Continue)
2
24
4
142
2T
?.3u
222*,* No Report
el 7

NTIDES PERMIT NO: NCD022497 PERMIT VERSION:
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: DastM KyD Meoeyeon
GRADE: WW-4. OR( HAS CHANGED: No
eDMR PERIOD:02-2017 (February 2017 ERSION
PERMEr STATUS: Aenve
COUNTY:. Catawba
ORC .CERT NUMBER: it97
STATUS: Pmeessed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
3
4
12
13
14
15
4440
(11440
16 101,54.2
2!
0,2
29
24
(15
22
23
25
27
90910
90.91)
. Grab
T411*111" 110
1.11.9,1
9
1 7
144,490h2y ;kveragt
Mqrdhly Avoapc
12 25
ax9o99.0,
11412411417,144o4v 2,24
T77T1
9.9
"" NO 'FZ.CpOrting Rt4,5021: ENFRUSE =No 1-low-f0,!!!!,e!Recyd,:; .171.,NVWITIR. 9 No Vi.!tAttl! Advcr,c- N4!!1 .00. =No Him; HOLIDAY No Vktuttion 0.041d414

NPDES PERM,J NO. 7
FACILITYNAME: Cross G
OWNER NAME: CvossCountry Carnurowld
GRADR WV 1
cD !� R PERIOD: m r; r , d o!
PER i 'VERSION;
H S:WW
(R( v «Meltezeon
(RC DASCHANGED; Na,
VERSION; 1.0
SAMPLING LOCATION:IOWNSTJ
• NoJ r . Reporting R � e m
PERMIT STATUS. <<
( q:c m&
ORC CERT NUMBER: i 1697
b1SCHARG £NOwl!

NO„ N(`.".0022497
EA LIIY NAME: Cross Cnxlntry Cannp
OWNER NAME: Cross Country Calm re and
GRADE: WW•d,.
eDMR PERIOD:1)2-2017 ('February 201.7)
COMPLIANCE STATUS:,
PERMIT VERSION: 4,0
WW
ORC:I) tinttkt &itar°,.e5ss
ORC 11 S (.11,ANGV1).'c,
VERSION: !,0
CONTACT PIIONIc/1: T(t<) C)R 4.255 SUBMISSION DATE: (1.3/2.7/21)17
PE3R;t✓II 1 S A:I"'l S: Active
COUNTY: Catawba
ORC CERT NI1\lBER: 116 7
STATUS: Processed
03/27/2017
t,ur;ate; and c-orn1Aete to that he of any knowledge,
The pe;rtrtmtt c shalla port. to the Director or the tl,ppropriatma Rclg instal C)1'tiv aoaw nranr°
Any information shall be provided orally within 24 hours I trt tP)c tint . tP)a. pertrait4c.e.
provided within 5 days of the rime the perrnittee becomes ziwa l . of the. 'ir Ctn n.4.m es.
11
Phone # TC14-506-4255 Date
ihreatuns public health or the environment.
atstzu'teas..A written submission shall also be
If the facility is noncompliant, please attach a list or coffees ve ieltons luting taken and a tie:ae-table for improvements to he: made as required by part 11P 6 of
the NPDES permit..
Perm
Permitter. Address: 62
1 certify, under penalty of law,
Denver NC 2)4)).77 Pell
r1t and all :altac
_o assure that qualified personnel properly gather and evaluate :Ire
y stem, or those persons directly responsible for gathering tfte iltla
accurate, and complete, I an aware that theme are sinlfit :anf Ixc na
knowing violations.
LAB NAME:
CERTIFIED LAB 4 ;
PERSON(s) COLLECTING P1..ES:
Parameter Code assistance may be obtained by cttllirt tl
Use only unifa;. of measuretnent
rr
((4/ 30/ 202(1
under II1\ d re
lrt, Mc 111
'uIamitting
C"FR"I`1E=1I C) i.,\I3(>R."IfiC)R1I:
PAR\Ml.s"I"IMR COI:)E3ti
03/2.7/2t}17
r. Phone #.[phone]:55 Date
r)n n)y 1nsltriryF of the person or persons who managed the
,titna4d is., to the hest vl'nny kato sled e and belief, true,
r)&uier1 including 'the possibility of tunes and imprisonment fin
(017-6300 or by visitital: httl+.r/pl Ital.nedenr"org/web/wry/swwpfps/npdes/tiarrms.
I.0) 1 NO"TES
* No Flow/Discharge From Site: Cheek this box if no dischargr occurs at)(l, tab .a result, theme rr
for entire !monitoring period.
* ORC on Site?: ORC must visit facility and dtrc/un)em visi�
*** Signature of P'crnrittec: If signed by other than the point
.0506(h)(2 )(D),
e.
errd for all ofthe parameters on the l?IIR
ir't I pea NC",AC (0 ,0204.
da
me on file with the state per ISA NCAC 213

PERMIT \(F.: NC0()12'Z4'97
IA("lLI i \ :NAME: Cross Country (Hmpt.roalmm
OWNER NME: Cross C:ia�rrri ' t ` mpgrcarar wl
GRADE WW-4.
eDMR PERIOD; )1-2017 (January 3O17)
PERMIT STATUS;
I RTNUMBER: 11697
MAR 2
WV-64, H L :lk ti`l'l S: Processed
C1O1
SAMPLING LOCATION; E F FLUEN"1' l)ISCIIARC1 NO.: 001 NO D1SC Li E*:
Repo ni Reason' 1=NITRIISI, No 1 Iow-Reuse R.oy=clo; r ht`WTI lI - Na 41;rt„ue ni ;stiir 4r by`authce "tiC}1 P OW ;tie,d Flow: f-1(11 IDA)" - No 1`rsilnlmrrn - Holiday

NPD▪ 1 ▪ S PERMIT NO.: NC0022497 PERMIT VERSION: 4,0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD: 01-2017 (January 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
.,
o
E
8
H
u
4
e`
t°,
a
F=
1
a
8
r
6-O
3: DI
6
E.
1=
et
is
O
:
a
Z
COMM
C0665
Quarterly
Quarterly
Composite
Composite
TOTALPI - Cana
TOTALP - Cone
2400 clerk
Hn
2400 clack
Hn
Y1I1114
MOmNl
1
2
HOLIDAY
3
1000
.33
b
4
1240
.75
y
5
1000
24
0900
l.0
y
10
1.34
6
1100
.25
y
9
9
1210
.33
y
ID
1315
.25
b
t1
1230
.33
y
12
1000
24
0830
1.5
y
13
1230
.33
y
1.1
15
16
HOLIDAY
17
1120
.25
b
16
1230
.5
y
19
1000
24
0900
1.25
y
F
ii'
20
1215
.33
y
21
22
23
1140
.33
y
24
1230
.33
y
25
1035
.25
b
26
1000
24
0600
2.0
y
27
1230
.33
y
29
29
30
1300
.25
b
31
1155
.25
b
Men hi) Mange Limit:
Monthly Marna:
10
1.34
Daily Maximum:
10
1.34
DaII9 5lininmm=
10
1.34
•s•• No Reporting Reason: ENFRUSE -No Flow-Reuse/Recycle; EN VWTHR = No Visitation - Adverse Weather, NOFLOW = No Flow; HOLIDAY =No Visitation - Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground 'ORC: Dustin Kyle Mclrcycon
GRADE: WW-4. ORC IIAS CHANGED: No
eDMR PERIOD: 01-2017 (January 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
{
p'
1
p
de
E
•
e
u
c
E.
a
110010
110303
Weekly
Weekly
Grab
Grab
TEMP-C
DO
tam clock
dce c
mt1
2
3
4
0900
7
11
3 .
6
7
9
9
10
11
12
0837
7
12
13
11
I5
16
17
19
19
D904
9
9
20
21
22
73
24
1s
26
0807
13
9
27
29
29
-
30
31
Menittly A•cr.ec 1.Imi1:
,
Monthly Aterne:
9
10.25
Dail) M.dnxtm:
13
12
Dilly Minimum:
7
9
•"'•NoReporting Reason: ENFRUSE=NoFlow-Reuse/Recycle; ENVWTHR=NoVisitation — Adverse \Vcalher; NOFLOW=No Flow; HOLIDAY = No Visitation — Holiday

NPD;zS PERMIT NO.: NC0022497 PERMIT VERSION: 4,0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Melreycon
GRADE: WW-4. ORC HAS CI IANGED: No
eDMR PERIOD: 01-2017 (January 2017) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: ON
F
F
s
E
L3
S
a
A
:
et.
i
00010
00300
Weekly
Weekly
Grab
Grab
0 h1P-c
Do
2400 clock
deg c
in fl
1
2
3
4
0930
7
11.4
5
6
7
A
9
10
11
12
0910
7
12.5
13
14
15
16
17
18
19
0915
9
8.5
20
21
12
2!
2.1
2s
26
0850
13
8.8
27
20
29
30
31
Momhly A+rnfis Unlit:
Monthly Arrrage:
9
10.3
Daily Maximum:
13
12.5
Daily Minlnwnc
8.5
"" No Reporting Reason: ENFRUSE= No Flow-Reose/Recycle; ENVWTE IR s Nu Visitation— Adverse Weather, NOFLOW = No Flow; HOLIDAY = No Visitation —Holiday

NPAES PERMIT NO.: NC0022497 PERMIT VERSION: 4,0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreveon ORC CERT NUMBER: 11697
GRADE: WW-4, ORC HAS CHANCED: No
eDMR PERIOD: 01-2017 (January 2017) VERSION: 1.0 STATUS: Processed
COMPLIANCE STATUS: : 'pliant CONTACT PI IONE #: 7045064255 SUBMISSION DATE: 02/27/2017
ORC/Certi 'rer
ture: u
02/27/2017
sty Kyle etreyeon E-Mail:dmetwaternaol.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance (hat potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a timetable for improvements to be made as required by part I1.E.6 of
the NPDES permit.
02/27/2017
Permittee/Submitter .ignat c:*** lust Kyle Metr yeon li-Mail:dmetwatcrrraol.com Phone 4:704-506-4255 Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 ofthe person or persons who managed 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.
LAB NAME:
CERTIFIED LAB##:
PERSON(s) COLLECTING SAMPLES:
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, (here are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee. then delegation ofthe signatory authority must be on file with the state per I SA NCAC 2B
.0506(b)(2)(D).

¥Ab PERM# NO.: NC0027
IF(I1�*NAME: Cross CmyCamp <!
OWNER NAME: Crow ,
GRADE: >w +
mMR'ERmm myaJ
r
PERM' VERSION: 1
ra,
O RC:
DRY FLYS (11 11No
VERSION
SAMPLING LOCATION: EFFLUENT
7R\RS 4ma
RG£ NO.:901 NO NSCHARGE N9 y
,w.G Repe nit* Reasonom:«»= "So f v m.m»ms& « same a :« r nz« yr1 «oAm=a s_+.Ho »

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctrcyeon
GRADE: WW-4. ORC 11AS CIIANCED: No
eDMR PERIOD: 12-2016 (December2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
e'
Jr
L.
8
u'
a
t8
L&
1-
•D
e
g�
6
3
g
r
g
S
y
s
O
a
a
5i.
c
2
Comm
COte.
Quarterly
QuePerlY
Composite
Composite
TOTAL N• Cont
TOTAL P. Cnnc
1406 clock
Ha
2100 clock
Ws
V!D!N
mg!!
m..11
1
1000
10
0900
1.0
y
2
1700
.25
y
3
4
5
1300
,5
y
6
1130
.25
b
7
1400
.25
b
a
1000
0
0820
1,75
y
9
1250
.33
y
t6
11
12
1230
.75
y
13
1200
.25
b
14
1300
.5
y
15
1000
24
0917
1.0
y
16
1255
.5
y
17
10
19
1425
.25
b
20
1300
,25
y
21
1250
1 •
y
21
1000
24
0900
1.0
y
23
1220
.33
y
21
25
26
HOLIDAY
27
1100
.23
y
vs
122D
,25
h
29
1000
24
0900
1,0
y
36
1220
.25
y
31
Mon hI9 Aserape Limb:
f.lnnlhl. Al erne:
Dal. 3lalimom:
Daly hltntmum:
'"• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather. NOFLOW = No Flow: HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
i FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle.Mctreycon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC IIAS CHANGED: No
eDMR PERIOD: 12-2016 (December2016) VERSION: 1.0
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
$
1
s
i
tth
r
cf
2
00010
00300
Weekly
Weekly
Grab
Grab
TEMMr.0
Do
MOD clock
deg c
mail
1
0948
13
9}
2
3
4
s
6
7
s
0820
10
9.6
9
10
11
13
13
1-I
15
0917.
16
9.6
16
17
I0
19
20
21
22
0915
6
13
23
24
25
26
27
29
29
0900
9
10.5
30
31
Monthly A.enge Limit:
,
Rlonthly Atsrage:
10.8
10.3 i
Daily nl..lmunt:
16
13
Daily Mb6.nurm
6
93
**** No Reporting Reason: ENFRUSE a No Flow-Reuse/Recycle: ENVWTHR = No Visitation —Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation— Holiday

NPDES PERMIT NO.: NC0022497 PERIIIIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. O12C IIAS CHANGED: No
eDMR PERIOD: 12-2016 (December2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
.
o`
11
_
A
0
5
ti
a
z
0nn10
00300
Week!
Weekly
Grab
Gr..b
TL31r-c
o0
2300 clock
deg c
1611
1
0958
13
0.5
2
3
3
5
6
7
s
0840
15
6.7
9
10
11
12
13
14
15
1022
11
El
16
17
I9
19
10
21
22
0920
6
13.7
23
21
25
26
27
29
29
09]0
9
11.6
30
31
h1.n1ht1 Mem, Llnlit:
Monthly Awnme:
10.8
9.72
1.42 Maximum:
15
13.7
Daily Minimum:
6
6.7
""' No Reporting Reason: ENFRUSE=No Flow-Reuse/Recycle: ENVWTIIR=No Visitation —Adverse Weather; NOFLOW = No Flow: IIOLIDAY=No Visitation —Holiday

NPDES PERMIT NO.: NC0022497
r ; FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 12-2016 (December 2016)
COMPLIANC . TATUS: Non- impliant
PERMIT VERSION: 4.0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Dustin Kyle Metreyeon ORC:CERT NUMBER: 11697
ORC HAS CHANCED: No
VERSION: 1.0 STATUS: Processed
CONTACT PHONE #: [phone] SUBMISSION DATE: 01/27/2017
01/27/2017
OR /Ce��er Si ature: Dus y Kyle Metreyeon E-Mail:dmetwaleraaol.com Phone 4:704-506-4255 Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a tithe -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
Permittee/Submitter Si
01/27/2017
y Kyle Meyfcycon E-Mail:dmctwater«aol.com Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting littp:/Iportal.ncdenr.org/web/wq/swp/pslnpdes/forms.
- FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there arc no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctrcycon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD: 12-2016 (December2016) VERSION: 1.0 STATUS: Processed
Report Comments:
per WesBel, NCDQQ...facility is non -compliant because sampler did not provide for 24 composite first tv,o weeks. Flow meter has been replaced and sampler recalibratcd.

*CIES PER MLTNO.: NC0022497
FACILITY NAME: Cross C"ountry Campground
OWNER N AY4E: Cross Country Canaprouid
GRADE: WW.4
ef%IR PERIOD: 10w208ti (f7uko a 2CICl
PERMEE % 11040N-, 4 ?P
('LASS: AV \-a-2
(}I(MC7. Di s,00 t,a9 1 Bu ,ee�
OIRC WAS (U1 Vs(;I.1): N,
'.1 R,SR)y. I m
R,!'1IT STATUS; Ae-rive
91t1LlVT C`ataswa
61R(°C"ERI MEMBER: I097
S'EA'1'1,IS: Pi esseci
SAMPLING LOCATION: EFFLUENT DIM ."II K(1 N().: tltli NO DISCHARGE* NO
"" No Reporting Reason' ENFRt tit = Vo 1 lOW-Reuse'RNycle, F "^R �i 11R -loci "
RECEIVED
DEC 0 5 /016
CENTRAL FILES
NR SECTION

4PDES PERMIT NO.: NC0022497 PERIIIIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon
GRADE: WW-4. ORC IIAS CIIANGED: Nn
eDMR PERIOD: 10-2016 (October 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
q
J.,
8•
G.V
Q P
t
F
1
12
Operator Arrival Time
Operator Time On Site
Si
L
O
, :
Y
Z oe
C0600
C0665
Quarterly
Quarterly
Composite
Composite
TOTALN - Cony
TOTALis - Cone
2400 deck
Firs
2400 clock
Firs
Y/RN
mg/1
mg4
1
2
3
1025
.33
y
4
1200
.21
y
5
1717
.25
y
6
1000
24
0900
1.0
y
14.84
4.66
7
1510
.33
y
8
9
10
1100
.5
y
11
1030
.33
y
12
1 100
1.0
b
13
1000
24
0900
1.0
y
14
1230
.33
y
15
16
17
1000
.33
y
DI
1020
.25
y
19
1015
.25 .
6
20
1000
24
0920
1.25
y
21
1300
.25
Y
.
22
23
24
1200
.5
y
25
1240
33
y
26
0930
.25
b
27
1000
24
0900
1.0
y
28
1215
.33
y
29
30
31
1150 _
.33
y
Monthly Average Limit:
Monthly Average:
14.84
4.66
Daily Maximum:
t484
4.65
Daily Minimum:
[4.24
4.66
*1" No Reporting Reason: ENFRUSE= No Flow-Reuse/Recycle; ENV'WTHR = No Visitation — Adkerse Weather. NOFLOIV = No Flow; HOLIDAY = No Visitation — Holiday

leDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kvlc Metreyeon
GRADE: WW-4, ORC IIAS CHANGED: No
eDMR PERIOD: 10-2016 (October2016) VERSION: I
PERMIT STATUS: Active
COUNTY; Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
12
Composite Sample
Time
Total Composite Time
E
1~
.y
s
r-
0
Operator lime On Site
ORC On Site?•,
1 ;
a` •
e' ° a`E
x'
00010
00300
Wtek1y
Weekly
Grab
Grab
TEMP-C
DO
2400 clock
firs
2400 dock
Hrs
YIB/N
deg c
mail
1
2
3
4
5
6
0940
18
7.2
7
8
9
10
11
12
13
0930
14
9.2
14
15
16
17
18
'
19
20
0930
18
76
21
22
23
24
25
26
27
0930
13
104
28
29
30
31
Monthly Average Limit:
Monthly Average:
15 75
8 6
Daily Maximum:
iS
10.4
Daily Minimurn:
13
7-2
•"' No Reporting Reason: ENFRUSE = No Floty-RcusofRecycte: ENVWTHR = No Visitation -- Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

1
' ,IPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: W W-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD: 10-2016 (October 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
y
6
a
a
8
U 1:
Total Composite Time
Operator Arrival Time
v
f;
a
g
F.•a
0
ORC On Site!••
m
:
a
z° m
uuo-lo-
o-uso-o-
Weekly
Weekly
Grob
Grab
TEMP-C. .
DO
2400 dock
Hrs
2400 dock
Firs
YBFN
deg c
mg/1
1
2
3
4
5
6
0950
18
6.9
7
8
9
10
II
12
13
0920
14
8.8
14
15
16
17
18
19
20
0920
18
7.1
21
22
23
24
25
26
27
0440
13
9.7
28
29
30
31
Monthly Average Limit:
•
Monthly Average:
15.75
8.125
Daily Maximum:
18
9.7
Daily Minimum:
13
6.9
•*"• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHIt = No Visitation - Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation - Holiday

)iIPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4,0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 10-2016 (October 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
COMPLIANCE: Compliant CON'rACT PHONE #: [phone] SUBMISSION DATE: 11/29/2016
ORC/
rtig 'Signat
11/29/2016
re: Dusty •yle Metreyeon E-Mail:dmetwaternaol.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the pcnnittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncomplia i - ase attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
11/29/2016
Permittee/Submit - ature: * Dust- Kyle Metreyeon E-Mail:[e-mail] Phone #:[phone] Date
Permittee Address: 62 wy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
I certify, under penalty o 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 managed the
system, or those persons directly responsible for gathering the infonmation, 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 infomiation, including the possibility alines and imprisonment for
knowing violations.
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http:/lportal.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES perinit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittec: If signed by other than the pertnittee. then delegation of the signatory authority must be on file with thestate per 15A NCAC 2B
,0506(b)(2)(D).

NPDES PERMIT Na: NC0022497
FAC;411TV NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4,
eDMR PERIOD: 09-2016 (September 2016)
KSION: o
CLASS: WV
016C: Dte,tin Kyle Meueycon
OR( IIAS ClIANIAD: No
VERSION: 1 0
PERMIT STATUS: Aalve
COI Catawba
086: (1.1:161. NUMBER:
STA"I'ITS: lLeJ
SAMPLING •)CATION: D 'NS-REAM DISCHARGE NO.: 001
2400 dock firs VIE"
Grab
4UIdV Awns
MOnihity AV,0,1
Mits. Sialsienuirtu
psikst ii0.1114,71;
114L1416
finit r"-trsty4.- ' fitt tr=
**.• Rcpcminp. Req.$011". ENFR.USE No Floia-ReiRocycle\\JUVKAtillon t\dso-22 H111„ IDA V No Viskation Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACI;TY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreycon
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD: 09-2016 (September 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
q
O
E
GI
c E"
[J P
it
o
E
=
12
P
I
e
O
y
0
g
E
E
O
ORC On Site'. ""
ea
I
a ,i
z, oC
50050
00010
00400
50060
C0310
C0610
C0530
31616
00300
Continuous
5 X week
Weekly
2 X week
Weekly
Weekly
Weekly
Weekly
Weekly
Recorder
Grab
Groh
Grab
Composite
Composite
Composite
Grab
Grab
FLOW
TEMP•C
pH
CIILORINE
DOD - Cane
NII3-N-Cone
TSB - Con e
FCOLIBR
DO
2400 clock
Ho
2400 clack
firs
YIB1N
mgd
deg
su
ural
mgjl
mII
mg4
tr1100m1
mg/1
1
1000
24
0900
1.0
L
0 007
25
6.9
30
< 2
0.29
19.5
< 1
5.1
2
1020
.5
y
0,007
25
30
3
0.01
4
0.01
5
0800
.5
y
0.01
26
6
1800
.33
y
0.009
26
7
1100
.33
y
0.009
25
8
1030
24
1020
.66
y
0.007
24
6.8
41
<2
<0.2
9
< 1
5.6
9
1130
33
y
0,006
25
<20
10
0.007
_
11
0.007
12
1030
.33
b
0007
26
13
0830
.33
b
0.006
26
:4
1000
24
0900
1.0
b
0.006
25
69
< 20
<2
0,29
10.8
< 1
5.5
15
1130
.33
b
0.006
25.
16
0900
.33
b
0.007
25
< 20
17
0.008
18
0.008
I9
1600
.5
y
0008
25.
20
1400
.5
y
0.006
25
21
1700
,33
y
0.006
25
22
1000
24
0840
1.25
y
0.007
24
7
<20
<2
<0,2
4.3
<1
5.7
23
1230
.33
y
0.01
24
<20
24
0.014
25
0.014
26
1230
.33
y
0.014
25
27
1050
.33
y
0.01
25
28
1130
.25
y
0,006
26
29
1000
24
0915
1.0
y
0.006
25
7.1
<20
52
<0,2
6.2
<1
5.3
30
1230
.33
y
0.008
26
<20
•
Monthly Average Limit:
aA65
1.
,
30
3
30
1
200
Monthly Avenge'
0.0082
25.136164
10.1
0
0116
9.96
1
5.44
Daily Macimum:
0,014
26
71
41 _
0
0.29
19.5
0
5.7
Daily Minimum:
0.006
24
6.8
0
0
0
4.3
0
5,1
***' No Reporting Reason: ENFRUSE=No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse Weather, NOFI.OW = No Flow: HOLIDAY = No Visitation - Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
r
FACI.4TY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANCED: No
eDMR PERIOD: 09-2016 (September 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
q
W
Composite Sample
Time
Total Composite Time
E
1~
73
a
O
YY
A
O
Operator Time On Site
;'
L
O
aG
O
w
. •
L
u
Z ce
C0600
C0665
Quarterly
Quarterly
Composite
Cornposile
TOTAL N-Cony
TOTALP -Cone
2400 clock
Hrs
2400 clock
Hrs
WAN
mgll
mgll
1
1000
24
0900
1.0
y
2
1020
.5
y
3
4
5
0800
,5
y
6
1800
,33
y
7
1100
.33
y
8
1030
24
1020
.66
y
9
1130
.33
y
10
11
12
1030
.33
b
13
0830
.33
b
14
1000
24
0900
1,0
h
15
1130
.33
b
16
0900
.33
b
17
18
19
1600
.5
y
20
1400
.5
y
21
1700
.33
y
22
1000
24
0840
1.25
y
23
1230
.33
y
24
25
26
1230
.33
y
27
1050
.33
y
28
1130
.25 '
y
29
1000
24
0915
1.0
y
30
1230
.33
y
• Monthly Aserage Limit:
Monthly Ayernge:
Daily 5larinmm:
Daily Minimum:
•*+' No Reporting Reason; ENFRUSE= No Flow-Reuse/Recycle; ENV WTHR = No Visitation — Adverse Weather; NOELOW = No Flow: HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACIIe;TY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mclreyeon
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD: 09-2016 (September 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
Z.
Composite Sample
Time
Total Composite Time
a
l:
r
.E
6
E
a
Operator Time Oo Site
ORC On Site'. ••
a
° '•
a °
a`
z ce
00010
00300
Weekly
Weekly
Grob
Gran
TEMP-C
Do
2400 dock
Hrs
2400 clock
Hri
YIBIN
den c
mgn
1
0905
24
5.6
2
3
4
5
6
7
8
1020
23
6.7
9
10
SI
12
13
14
0930
22
7.2
15
16
17
18
19
20
21
22
0900
24
6
23
24
25
26
27
28
29
0950
22
6.7
30
Monthly Average limit:
Alonlhly Average:
23 _
6.44
Daily Masimo m:
24
7 2
Daily Minimum:
22
5.6
"•" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWT}IR = No Visitation — Adverse Weather. NOFLOW — No Flow; HOLIDAY = No Visitation—1loliday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4 0 PERMIT STATUS: Active
FAC. ITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD: 09-2016 (September 2016) VERSION: 1.0 STATUS: Processed
COMPLIANCE: Compliant j9ONTACT PIIONE #: 7045064255 SUBMISSION DATE: I0r28/2016
ORCICertifier• Si
10/28/2016
Metreyebn E-Mail:dmetwaleraaol.cont Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list ective actions Bing taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
Permittee/Submitter Signature:*** Dusty Kyle letreycon E-1Glail:dmetwaterrraol.com Phone #:[phone] Date
Permittee Address: 6254 NC Hwy 150 E Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
10/28/2016
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
CERTIFIED LABORATORIES
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to he entered for all of the parameters on the DMR
for entire monitoring period.
ORC on Site?: ORC must visit facility and document visitation of Facility as required per ISA NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee. then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

NPDES PERMIT NO: .NC0022497 PERMIT VERSION: 4
FACILITY NAME: Cruss Country earnpgroi.!nd C1,, \ WW-2
OWNER NAME: Cross CountrE Campground ORE': Dustin KyIc Metruyoon
GRADE:: WW-4. OR(U.S CEIANGLIE No
eIDAIR PERIOD: 08-2016 (August 20164 VVIZSION: I 0
E
I
io
244 dark
PIRVII 1 IVI CS: Aou+c
COEN I V; Cot:imUn
oft( ("FRI' 1697
STAT1
SAMPLING LOCATION: EFFLUENT DISCI [ARC L NO.: 001 NO DISCHAl
141.111 clock
9930
0830
0950
0930
100
1730
0915 75
1.200 4)
4)4
1,25
• 75
/ 705 33
Averagt I 4444))
Monthly AV•tr ;Age:
Daily MR111011M:
Daily
0.4)4)/6 iiO4/10 `101 ( 4111
f."0000 o000,_
ItOvistL,I,E1
(if:0/101S
0 0
5 X 43
41
TIVD/4
1/6
7.U.X.rit'
X 44ex:461,
0 al)44 lt1)4 IV
/1.117/1:, DOI) -film
DI, 10
(05.1i/ .1/1616 )}0X10
3 Vtel I y
50,0t.0 340 Gtah
43341••4) 143.5;
0t.01 mai
44) 5 4
, /5,4
21i0
40 9 /5 4
1 ) 'T ,,. • 0
No Reponing Reason: ENPR.USE No 334)414) 44)8 04)4.4 4) 4333 WHIR No 5,0,s1:q0:01. Ad5 00.,0 ‘5:0:4010r, No Vlow 44 VIA titth,n. 33ltiday
OCT 06 Z016
5 a)

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
1 FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mclreycon
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD; 08-2016 (August 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
I.'E
a
Composite Sample
Time
Total Composite Time
5
F
Y
e
O
0
H
e
O
E
I=
O
2
0
•
�,
eta
ct
0
w
yt
C
9 c
C0600
C0665
Quarterly
Quanz:1y
Composite
Composite
TOTAL N-Cone
TOTAL P-Coot
2400 dock
Hro
2400 dock
Hrx
WWII
mgl
mgll
1
0930
.5
y
2
0830
.5
y
3
0950
.5
y
4
1000
24
0930
.66
0930
.5
it
8
0930
.5
y
9
0900
.25
I0
1000
.5
y
tt
1130
24
1055
.66
y
12
0630
,75
y
13
14
15
1230
.5
y
16
1620
.33
y
17
1730
.25
y
18
1000
24
0915
.75
y
19
1200
.33
y
20 .
21
22
1600
.5
y
23
0920
.33
y
24
1300
.33
y
25
1000
24
0900
1.25
y
26
0800
.75
y
77
28
29
1115
.25
y
30
1100
.25
y
31
1705
.33
y L
Monthly Average limit:
Monthly Average:
Duly Maximum:
Daily Minlmnm:
**** No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle: ENVWTIIR = No Visitation - Adverse Weather. NOFLOW = No Flow: 1-IOL1OAV = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcyeon
GRADE: WWI. ORC IIAS CHANGED: No
cDMR PERIOD: 08-2016 (August2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
Composite Sample
Time
a
E
U
0-
Operator Arrival Time
Operator Time On Site
•
in
O
0
1 i
a°e
2 re
(loo10
cam
Weekly
Weekly
Grab
Grab
TESIP-C
DO
2400 clock
11rs
2400 dock
firs
Y11EIN
deg a
mgll
1
2
3
4
0950
24
6
5
6
7
8
9
10
j
it
1050
24
7.1
12
13
14
15
16
17
18
0940
24
7.6
19
20
21
22
23
24
25
0930
23
5.9
26
27
28
29
30
31
Monthly Average Ltmil:
Monthly Average:
23.75
6.65
Daily Maximum:
24
7 G
Daily Minimum:
23
5.9
" ' No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle: ENV WTHR = No Visitation — Adverse Weather, NOFLOW — No F ow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 08-2016 (August 2016)
PERMIT VERSION; 4.0
CLASS: WW-2
ORC: Dustin Kyle Mctreyeon
ORC HAS CHANGED: No
VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS:. Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: ON
p
4
LIli
i
BC.
V P
Total CompositeTime
Operator Arrival Time
Operator Time Oa Site
•
•y
U
cg
O
No Reporting
Reason•••'
00010
00300
Weekly
Weekly
Grab
Grab
TEMP.0
DO
2400 dock
Hes
2400 dock
Firs
YID/Ni
deg a
mgil
2
3
4
1008
24
6.3
5
6
7
8
9
10
11
1055
24
7.6
12
13
14
15
16
17
18
0950
24
7.2
19
20
21
22
23
24
25
0950
23
6.2
26
27
28
29
30
31
num
Monthly Average limit:
Monthly Average:
23.75
6.825
Daily Maximum:
24
7,6
Daily Minimum:
23
6.2
•**• No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle: FNVWTHR No Visitation.. Adverse Weather; NOFLOW = No Flow; HOLIDAY = No Visitation — Holiday

NPDES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC IIAS CIIANGED: No
eDMR PERIOD: 08-2016 (August 2016) VERSION: 1.0 STATUS: Processed
COMPLIANCE: Complia. CONTACT PHONE #: [phone] SUBMISSION DATE: 09l30/2016
ORC/Certifier
09/30/2016
ature: 1 ty Kyl Metreycon E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
1ny information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware or the circumstances.
If the facility is noncompliant, pl ase attach a list of corrective actions being taken and a time -table for improvements to be made as required by part 11.E.6 of
the NPDES permit.
Permittee/Submi
09/30/2016
nature:* `* lusty Kyle etreyeon E-Mail:dmetwaterrraol.com Phone 4:704-506-4255 Date
Permittee Address: 6254 NC Hwy 150 1; Denver NC 28037 Permit Expiration Date: 04/30/2020
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 managed 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.
CERTIFIED LAI3ORATORIES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit.[phone] or by visiting htlp:/lportal.ncdenr.org/weblwglswplpslnpdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box lino discharge occurs and. as a result. there are no data to he entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: if signed by other than the permittee, then delegation ()Nile signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).

Fr
(..:RADE: WW4. CLASS: WW-2
ORE': Dustin Kyte Mcarcycon
PERMET VERSION: 4.0
WOES PERMIT NIL: NC002:!;97
ORC !LAS (TIAN:GEM No RECEIVED'
cotINTY: Catawba
CERT NUMBER: 11697
FACILITY' NAME: Cross Country Campground
OWNER NAME: Cross Country Camp round
eDMR PERIOD: 07-20 its Duly 2.016) VERSION: 2 0 DEC Z 8 ZGIfirATus! 1:10CeSSCili
COMMANCE STATUS: Cornplu t MISSION DA rE: 12/o2/20; 6
"" r ‘,(r r 14(”*" .1.11.CENTRAL FiLte
Dom SECTION
--------,_
PERMIT ST NIES: Active
RC/ rtific Si nature: o ty Kyle ttileircycon 1.-Mailrdiuitit‘ater Phone -0E:70 -506-4255 Date
By this si ature 1 certify that this report is accurateand complete to the hest orink ledge,
The permittee shall report to the Director or the appropriate Regional Office any I1011C01111119:1Ilee that potentially threatens puht ic health or the environment,
Any information shall be provided orally within 24 hours From the time the .permiticc hecrune tiware of the circumstances. A written submission shall also he
provided within 5 days elate time the permince becomes ftW'dre of the circumstances.
IF the facility is noncompliant, please attach j Io,i()I' corrective actimis being taken arid a lune-table for improvements to be made as required by ail ,
the NPDES pc
12/02/2016
sty, k'‘v, le AlcirQ con I: -Mall:dinetwatertiaol.corn ['hone 0704-506-4 255 Date
Permt1c4 kddres 6254 NC liwy 150 E Denver NC 28037. Permit Itspiratitin Date: 04/30/2020
1 cenify, u drpena1iy oflaw, that this document and all ;iltachnienis were prepared under niy direction or supervision in accordance with a..system designed
to assure that qualified personnel properly „rather and evaluate the information submitted, Based on UTIY inquiry of the person or persons \mho managed the
system, or those persons directly responsible for gathering the intairmation.i h bantation submitted to the best of my knowledge and belief, true,
.accurate, and complete,. 1 am aware that there are signifie,mt peruiltie,: Mr submitting Use11101 naGon, including the possibility ,of fines and imprimmment for
knowing violations.
LAB:NAME:
CERTIFIED LAB ft:
PERSON(0 COI „ETICTI NC S'IPl ES:
CII( 11E11 1) A IS
P.,•1,RANIE1I.R ((id:
Parameter Code, assistance may he obtained by calling the 'Nl'D1',S I !nit 019) hy visiting hilmilportal.nedenr. orgItychisvq/swpipsinpdesillorms.
FOOTNOTES
Use only units olmeasurement designated in the reporting facility's 'Npor s permit tOr reporting dath.
*No How/Disch.arge From Site, Check this ho &no discharge (wows an1. as a result, thgtc tire no data to he entered for all of the parameters on c DM
for entire monitoring period.
ORC on Site?: ORC must visit 'facility and document visitation as required per I 5A NC:A.0 & 0204.
***. Signature of Permittee: 'If signed by other than he permince, Men delegation oldie signatory authority must he on file \sail) the state per 15A NCAC 213
,0506(b)(2)(D),

rNP DES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 07-2016 (July 2016)
Report Comments:
First EDMR submittal...revised to add TN / TP 12-1-16
PERMIT VEILSION: 4 0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Dustin Kyle Metrcyeon ORC CERT NUMBER: 11697
ORC HAS CIIANCED: Na
VERSION: 2.0 STATUS: Processed
12����

DES PERMIT NO.: NC0022497 NFrPERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon
GRADE: WW-4. ORC HAS CIIANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CER'I' NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO
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22
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,
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28
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23
0.01
24
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26
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0.44
9,3
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5.9
39
0900
.66
y
0.01
26
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30
0,015
31
0,015
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0.06s
30
3
30
200
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0.010867
272
3.133333
3.025
1,32
12.025
1
5,375
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0,02
]0
7
30
9.7
4.13
20
0
5.9
D.i>rnlloim+rm:
0006
24
6,8
0
0
0
5.6
0
5.1
•'•" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR = No Visitation - Adverse Weather; NOFLOW = No Flow: HOLIDAY = No Visitation - Holiday

DES PERMIT NO.: NC0022497 NPrPERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctreycon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
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Qom -telly
Ovenerly
Composite
Composite
TOTAL N-Con y
TOTAL P-Cone
2400 clock
Him
2400 clock
Iln
MIN
mg!!
mt„-dl
1
0920
.33
y
1
3
4
HOLIDAY
3
0900
.66
y
.
6
1430
.5
y
7
1000
24
0930
.75
y
23.4
4.47
8
0900
.33
y
9
10
11
1000
.66
y
12
0800
.5
y
13
0900
.5
y
14
1000
24
0900
1.0
y
15
0850
.66
y
16
17
18
0935
.5
y
19
0830
.5
y
20
0930
.5
y
21
1000
24
0930
,66
y
22
1000
.5
y
23
24
25
0925
.5
y
26
0900
.5
y
37
0900
.75
y
28
1130
24
1130
.5
y
19
0900
66
y
30
31
Mon hay A. erne Limit:
Monthly M.rapr:
23.4
4,47
D.n. M.rinmo:
23.4
4.47
- Dolly Minimum:
23.4
4,47
"" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle; ENVWTHR — No Visitatiotl — Adverse Weather, NOFLOW = No Flow: HOLIDAY = No Visitation — Holiday

rNP DES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 2,0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
.0
8d
I
i
t
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u
2
2
-a
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e
g
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8
4
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8
a
0
a
.
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Weekly
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TEMP•C
DO
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Hn
2400 clock
11n
YlalN
deg c
mgll
I
2
3
4
5
6
7
1000
24
5.1
I
9
10
11
12
13
1*
0955
24
8.9
IS
I6
17
I3
l9
2a
21
0950
24
6.9
22
23
24
25
26
27
25
1145
26
5.2
29
30
31
Mon kly Menge. Llmil:
- Monthly Avenge:
24.6
6'_525
Doll 3lnslmum:
26
8.9
-Daily Minimum
24
5.1
**** No Reporting Reason: ENFRUSE No Flow-Reuse/Recycle; ENVIVTIIR = No Visitation — Adverse Weather. NOPLOW No Flow: HOLIDAY — No Visitation— Holiday

DES PERMIT NO.: NCOD22497 NPrPERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreycon
GRADE: WW-4. ORC HAS CHANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 2.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
o
A
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u
8
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Trg/1
t
3
4
5
6
7
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24
6.8
8
9
10
1l
12
13
14
0910
24
8.2
15
16
17
16
19
20
21
0940
24
6.5
22
23
24
25
26
27
Ss
1140
26
4.9
29
30
31
Monthly Me npe Limit:
M.n,hl A,eraoet
24.5
6.6
mik Maximum
26
8.2
Daily hllnlmuni
24
4.9
•"'NoReporting Reason: ENFRUSE=NoFlow-Reuse/Recycle; ENVWTHR=NoVisitation —Ad%erseWeather; NOFLOW = No Flow; HOLIDAY — No Visitation — Holiday

DES PERMIT NO,: NC0022497
t, A Ct LITV NAME: Cross Country Campground
OWNER ItiAM.E: Cross Country Campground
GRADE: W'W.4_
eDNIR PERIOD: 07-2016 (July 2016)
PERMIT A`V I2.ION:
I'IR\II 1 ti I 1 11iti::ActIvc^
012C( 1:R1 \I \1111:R: F1
till 111'ti; 1
LEN CD E RREVV xl.
SAMPLING LOCATION: EFFLUENTIII'CHAIR; E NO,: 001 y DI +C 'BARGE*: N� w

ES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4. ORC HAS CIIANCED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 1,0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NO (Continue)
Composite Sample
Time
y
F.
Y
i
�
e
U
M
F
Operator Arrival Time
Operator Time On Site
ORC On Site?••
No Reporting
Reason••••
C0600
C0665
Quarterly
Qvanerly
Composite
Composite
TOTAL N-Cant
TOTALP-Cone
2400 clock
Hrs
2400 clock
Iles
Y/BIN
mill
mgI
1
0920
.33
y
2
3
4
HOLIDAY
5
0900
.66
6
1430
.5
7
1000
24
0930
.75
y
8
0900
33
y
9
10
1t
1000
.66
12
0800
.5
_y
y
13
0900
.5
y
14
1000
24
0900
1.0
y
15
0850
.66
y
16
17
18
0935
.5
y
19
0830
.5
y
20
0930
.5
y
2!
1000
24
0930
.66
y
22
1000
.5
y
23
24
25
0925
.5
y
26
0900
,5
y
27
0900
.75
y
28
1130
24
1130
,5
y
29
0900
.66
y
30
31
Ment1Jy Average Limi I:
la
Monthly Average:
Daily 1111aimum:
Daily Minimum:
•••• No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENVWTHR = No Visitation — Adverse Weather, NOFLOW = No Flow: I[OLIDAY = No Visitation— Holiday

DES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metrcycon
GRADE: WW-4. ORC IIAS CHANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: DOWNSTREAM DISCHARGE NO.: 001
d
G
Composite Sampte
Time
Total Composite Time
Operator Arrival Time
Operator Time On Site
ORC Oo Site?"'
ve
E. O
a" E
Z a`
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
DO
2400 clock
lire
2400 clock
Hrs
YWI:/N
deg c
mgol
I
2
3
4
5
6
7
1000
24
5.1
8
9
10
t1
12
13
14
0955
24
8.9
15
16
17
18
19
20
21
0950
24
6,9
22
23
24
25
26
27
28
1145
26
5.2
29
30
31
Monthly Average limit:
Monthly Average:
24 5
6,525
Daily 51aoimum:
26
R.9
Daily Minimum:
24
5. 1
**** No Reporting Reason: ENFRUSE =No Flow-Reuse/Recycle; ENVWTHR=NoVisitation— AdverseWeather NQFLOW=NoFlow; HOLIDAY=NoVisitation— Holiday

ES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0
FACILITY NAME: Cross Country Campground CLASS: WW-2
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Metreyeon
GRADE: WW-4, ORC HAS CHANGED: No
eDMR PERIOD: 07-2016 (Duty 2016) VERSION: 1.0
PERMIT STATUS: Active
COUNTY: Catawba
ORC CERT NUMBER: 11697
STATUS: Processed
SAMPLING LOCATION: UPSTREAM DISCHARGE NO.: 001
a
a
Composite Sample
Time
g
i=
5.1
'd
E
V
V
12
Operator Arrival Time
OperatorTime On Site
ORC On Site?••
m
a' a
F
z a
00010
00300
Weekly
Weekly
Grab
Grab
TEMP-C
Do
2400 clock
Iles
2400 clock
lira
YIBIN
deg c
m;fl
1
2
3
4
s
6
7
0940
24
6.8
8
9
10
11
12
13
14
0910
—
24
8.2
I5
16
17
18
19
20
21
0940
24
6.5
22
23
24
25
26
27
28
1 140
26
4,9
29
30
31
Monthly AN Limit:
Monthly Average:
2.1 5
6.6
Daily Maximum:
26
8.2
Daily Minimum:
24
4.0
"" No Reporting Reason: ENFRUSE = No Flow-Reuse/Recycle. ENVWTHR = No Visitation — Ad%erse Weather; NOFLOW = No Flow: HOLIDAY = No Visitation —Holiday

DES PERMIT NO.: NC0022497
FACILITY NAME: Cross Country Campground
OWNER NAME: Cross Country Campground
GRADE: WW-4.
eDMR PERIOD: 07-2016 (July 2016)
COMPLIANCE: Co • iant
ORC/ ertifieignature:
PERMIT VERSION: 4.0 PERMIT STATUS: Active
CLASS: WW-2 COUNTY: Catawba
ORC: Dustin Kyle Metreyeon ORC CERT NUMBER: 11697
ORC IIAS CIIANGED: No
VERSION: 1.0 STATUS: Processed
CONTACT PIIONE #: 7045064255 SUBMISSION DATE: 08/29/2016
08/29/2016
etreyeon E-Mail:dmetwatcraaol.com Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
Perm ittee/Su
Permittee Addre
08/29/2016
ignatur :*** Dusty Kyle etreyeon E-Mail:dmetwatera,aol.com Phone #:[phone] Date
C Hwy 150 :-nverNC 28037 Permit Expiration Date: 04/30/2020
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 managed 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 alines and imprisonment for
knowing violations.
CERTIFIED LAI3ORATORIES
LAB NAME:
CERTIFIED LAB #:
PERSON(s) COLLECTING SAMPLES:
PARAMETER CODE'S
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.nedenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
" No Flow/Discharge From Site: Check this box i f no discharge occurs and. as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee. then delegation of the signatory authority must be on file with the state per l5A NCAC 2B
.0506(b)(2)(D).

DES PERMIT NO.: NC0022497 PERMIT VERSION: 4.0 PERMIT STATUS: Active
FACILITY NAME: Cross Country Campground CLASS: WW-2 COUNTY: Catawba
OWNER NAME: Cross Country Campground ORC: Dustin Kyle Mctreycon ORC CERT NUMBER: 11697
GRADE: WW-4. ORC IIAS CIIANGED: No
eDMR PERIOD: 07-2016 (July 2016) VERSION: 1.0 STATUS: Processed
Report Comments:
First EDMR submittal

Effluent
PDES PERMIT NO. NC 224 Discharge No: 001 MonthYear.
Facility Name: Cross Cou Cam round Class: II _.. County: I Hr+ccln
Operator in Responsible Grade, 1V P
Certified Laboratory (1): Water Tech L am Ind (2) Metwater Inc,
CHECK BOX IF ORC HAS CHANGED
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALl1Y
1617 MAIL SERVICE CENTER
RALEIOH, NC 27699-1617
HRS HR
3
4
17 %
21
24 &la)
2
AVERAGE
MAXIMUM
I regtaertcY
Monthly limit (Avo)
0
NL
SU
k
45,0
RE : `t7NSBSLE CHARGE
TIFY THAT THIS R PORT IS
TO THE BEST OF MY KNOWLEDGE,
4j
G
11wk 11'wk qtr
NL NL

Facility Status: (Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements
(including weekly averages, if applicable)
All monitoring data and sampling frequencies do NOT meet permit requirements
Compliant
Noncompliant
lithe facility is noncompliant, please attach alist of corrective actions being taken and a time -table for
improvements to be made as required by Part II.E.6 of the NPDES permit.
"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 managed 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."
emu A
e (Please pnn
"RTred un
e-mail add
ADD1TOMAL CERTIFIED LI7RORATORIES
Date
d electronically)
it Expiration Dare
Certified Laboratory (2) Certification No.
Certified Laboratory (3) Certification No,
Certified Laboratory (4) Certification No.
Certified Laboratory (5) Certification No.
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit at [phone] or by visiting the Surface
Water Protection Section's web site at 112o.enr.statenc,ustwqs and linking to the unit's information pages.
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be
entered for all of the parameters on the DMR for the entire monitoring period.
** ORC On Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Pertnittee: Ifsigned by other than the permirtee, then the delegation of the signatory authority must be on
file with the state per 15A NCAC 2B ,0506(b)(2)(D).
Page 2

MINIMUM
MAXIMUM
AVERAGE
ONo
N
V
W
NN
CJi
e
NN
W
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O
i
CO
J
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i
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Op
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3
Dissolved
Oxygen
0
o
c
pH
0
$
0
8
s
r
Fecal Coliform
°'
0
co
r
Ammonia
Nitrogen
0
m
o
02
1
4
.
......,
....
uk
T3
Time
�Ut
j
ri
Temperature
0
-0
s
Igtilj
N
.j
"
Na
S
11
3
'�
Dissolved
Oxygen
§
G
1
c
pH
0
o
z
8
r
Fecal Coliform
o
3
`e
Ammonia
Nitrogen
g
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0
0
0
0
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0
0
3 n
2
a
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:"ON a Jeyos!Q
0
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Weel4SUMOP 1100E
clo
3

Effluent
NPDES PERMIT NO. NC0022497 Discharge No.,
Facility Name: Crews Country Campgra�urad
Operator in Responsible Ch
Certified Laboratory (1):
CHECK BOX IF ORC HAS CHANGED
Month: f Year:
Class: County.
(ORC) Dusty b< Metreyeon ,., Grade IV P
ter Tech Labs Inc
Mail ORIGINAL and ONE COPY to
ATTN: CENTRAL FILES
DIVISION OF WATER. QUALITY
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617
ht.! nc,
NG SAMPLES 0
RATOR Ii RESPONSIBLE CHARGE
BY TM W NATURE, I CERTIFY THAT HI REPORT IS
ACCURATE AND COMPLETE ro THE BEST OF MY KN©WLEDOE.
NAME ANO UNITS BELOW

Facility Status: (Please check one ttf the folio
ing data and sampling frequencies meet permit requirements
(including weekly averts e if applicable)
All monitoring data and sampling frequencies do NOT meet pe
en
Noncompliant
if the facility is noncompliant, please attach a iist of corrective actions being taken and a tame -table for
improvements to be trade as required by Part 11.E.6 of the NPDES permit.
"l certiof law, t% th s 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 managed 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 pcissibilit of
fines and imprisonment for knowing violations."
sign
(R uired unie stt
Phone Number
Certified
Certified
Certified
Certified
Pi
ADDITIONAL. CERTIFWELABORATORIES
PARAMETER CODES
tertificatiort No.
fication No.
fication No.
fication No.
Param r Code y be obtained by calling the NPDES Unit at (919) '733.5083 or by visiting the Su
Water Protection Section's web site at h2o.enr.state.nc.us/w and linking to the unit's information pages.'
Use onent des g tac
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to ire
entered for all of the parameters on the DMR for the entire monitoring period.
** ORC Ou Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC SG .0204.
***Signature of Permi'ttee: if signed by other than the permittee, then the delegation of the signatory authority must be on
file with the state per 'i 5A NCAC '2f .0506(b)(2)(13).
Page 2

Pr
Upstream
NPDES Permit No.: NC0022497
Discharge No.: 001 Month: /y)
Downstream
Year. (720/ 6
Facility Name: Cross Country Campground County: 'Lincoln
Stream: Tributary Stream: Tributary
Location: 100 ft. upstream Location: 300 ft. downstream
rn
m
E
1-
00010
00300
00400
31616
00610
Temperature
Dissolved
Oxygen
n.
Fecal Coliform
Ammonia
Nitrogen
.
HRS
°C
mglL
SU
#1100mL
mg/L
1
2
3
4
5
/L
/$
/a. a
6
7 .
8
9
10
11
12cm11-7.
13
14
15
16
17
18
19Q?,
/3..8a
20
21
22
23
24
25
26eN�1'T
y
9D
27
28
29
30
31
AVERAGE
d
8. es.
MAXIMUM
/
/().Q
MINIMUM
t
V: 7r
m
E
i=
00010
00300
00400
31616
00610
00600
00665
Temperature
Dissolved
Oxygen
a.
E
0
m
c
m
LL
Ammonia
Nitrogen .
HRS
°C
rng/L
SU
#1100mL
mg/L
lino
/
/L .c
I05IgS.1
r

Effluent
NPDES PERMIT N0, t C0Q 2 R Discharge No.: 001 Month: / f (,. Year:
Facility Name: Cass Own 0 round Class_ _�____ II __ __,,, County: l irrr yry
Operator in. Responsible G ('ORC): C a b Kn M yelin Gee: IV Phone: [phone]
Certified Laboratory (1): Tech L xI Ir? (2}
cHECic BOX IF ORC was CHANGE? P +N{ a) ±r: LLE TING SAMPLE
Mal ORIGINAL and ONE COPY to:
ATTN: CENTRAL FtLES
DIVISION OF WATER QUALITY
1617 MAIL. SERVICE CENTER
RALEIGH, NC 276116-1617
aI OP' RA OIa RESPON SISLE CHARGE
TORE, I CERTIFY THA TH REPOHT
'0 THE NESTOF uY KNOWLEDGE.

Facility Status:. (Please check one of the folktwing)
All monitoring data and sampling frequencies meet permit requirements
(including weekly averages, if applicable)
Comp tant
Noncompliant
If the facility is noncompliant, please attach a is of corrective actions being taken and a time -table for
improvements to be made as required by Part II.E.6 of the NPDES permit.
All monitoring data and sampling frequencies do NOT meet permit requirements
"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 man: ,ed 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'
Phone Number
e-mail address
ennit Expiration Date
Certified Laboratory (2)
Certified Laboratoiy (3)
Certified Laboratory (4)
Certified Laboratory (5)
ADLMTONAL CERTIFIED LARORATORIES
PARAMETER CODES
Certification No.
Certification No.
Certification No.
Certification No.
Parameter Code assistance may be obtained by calling the NPDES Unit at [phone] or by visiting the Surface
Water Protection Section's web site at h ,./q,gmState•nc.,nVsyg5 and linking to the unit's information pages.
ly
designated's NPDES permit ng data.
* No Flow/Discharge From Site: Check ibis box if no ,Jiseharge occurs and, tis a result, there are no data to be
entered for all of the parameters on the DMR for the enure monitoring perioti
** ORC On Site?: ORC must visit facility and document visitation of facility as required per I5A NCAC 8G .0204,
*** Signature of Permittec: if signed by other than the permittee, then the delegation of the signatory authority must be on
file with the state per 15A NCAC 2B „0506(b)(2)(D)„
Page 2

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Effluren
NP©ES PERMIT NO, NC0022497 Discharge No.: !L 1 Month:
Facility Name: Cross Country Carngrrurnd
Operator in Responsible 'Charge (ORC): gusty K Metreyeon
Certified laboratory (1): jevater Tech Labs Inc
CHECK BOX IF On HAS CHANGED
Mail ORIGINAL and ONE COPY to:
ATrN: CENTRAL FILES
DIVISION OF WATER QUALITY
itI17 MAIL BERME CENTER.
RALEIGH, NC 27699-1617
MAXIMUM
MINIMUM
Comp. (CyGrab (G
Fes(
Monthly a it (Avg)
Maximum
Class:
Grade:
(2)
Oi l ECTIN
IV
Year:
County.
Phone: [phone]
E CHARGE) DATE

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5
DATE
Time
'Temperature g
Ts
-: Dissolved
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pH
Fecal Coliform
Ammonia
Nitrogen
9 1.900 91.91£
tits
vimpj
4
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[i
va
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a
3
Time
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pH.
Fecal Coliform
Ammonia
Nitrogen
8
0
1
0,
0,
1
0
c7
z
p
o
).N3

CHECK BOX IF CRC HAS CHANGED
Mail ORIGINAL and ONE COPY to,
ATTN: CENTRAL FILES
DIVISION OF WATER QUAUTY
1617 MAIL SERVICE CENTER
RAALEIGH, NC 27629-1617
Effluent
NPDES PERMIT Na NC00224.97 Discharge No.: 00 M Year:
Facility Name: Cross Country Campground Class: It . Y County:
Operator in Respcxisible Charge (ORC): Duster K Mjtreyeon Grade; Pw". P)
Certified Laboratory (1): Water Tech Later Irk (2)
PERSON(S) COLLE TING
x
(SIG
E CHARGE) DATE
Er THiN r GER THAT T IE T iS
ACCURATE AND COMPLETE TO THE RENT OF MY KNOWLEDGE.

Facility Status: (Please check one of the follnvvin)
All monitoring data and sampling frequencies meet permit requirements
(including weekly averages, if applicable)
All monitoring data and sampling frequencies do NOT meet
he facility is noncompliant, please attach a li
Compliant
utretnents
Noncompliant
f corrective actions being taken and
improvements to be made as required by Part ILE.6 of the NPDES permit.
for
"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 managed the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. 1 am aware that there are significant penalties for submitting false information, including the possibility of ,
fines and imprisonment for knowing violations. -
of Peittee**
bate
quired unless submitted electronically)
Ad
e Number Permit Expiration Date
Certified laboratory (2)
Certified Laboratory (3)
Certified Laboratory (4)
Certified Laboratory (5)
AI3I ITI©NAL CERTIFIED I:.FA iRAT i RIES
PARAMETER CODES
Certification No.
Certification No.
Certification No.
Certification No.
Parameter Code assistance may be obtained by calling the NPDES Unit at [phone] or by visiting the Surface
Water Protection Section's web site at ,.h2o.enr.state.nc.us/wqs and ➢inking to the unit's information pages.
Ilse only units
t designated in the reporting facility's NPDES etxitit fqr reporting data,
* No FlowfDiscbarge From Site: Check this box if no discharge occurs and, as a result, there are no data to be
entered for all of the parameters on the DMR for the entire monitoring period.
** ORC On Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC SG .0244..
*** Signature of Permittee: If signed by other than the permittee, then the delegation of the signatory authority must be on
file with the state per 15A NCAC 2B ,0506(b)(22)(D).
Page 2

Stream:
Location:
Upstream Downstream
NPDES Permit No.: NC0022497 Discharge No.: 001 Month: rebataf fear'. Zd /ta
Facility Name: Cross Country Campground County: Lincoln
Stream: Tributary
Location: 300 ft. downstream
Tributary
100 ft. upstream
o
E
00010
00300
00400
31616
00610
2
2
E
m
1—
Dissolved
Oxygen
E
o
m
Ammonia
Nitrogen
•
HRS
°C
mg!L
SU
anoornL
mg/L
1
2
3
5
6
7•
6
9
10
11
/036
a.°
12
13
14
15
16
`
17
18
Mk
6
4.4
19
20
21
22
23
24
25
(OHS
/a
MO,
26
27
28
29
30
31
AVERAGE
g
//. 6
MAXIMUM
/ x
/2 . a
MINIMUM
4.
/0.O
m
E
00010
00300
00400
31616
00610
00600
00665
Temperature
Dissolved
Oxygen
x
a
t
:°
U
_
�i
Ammonia
Nitrogen
HRS
°C
mg/L
SU
unoon,L
mg/L
/o/S
4
,c3 o
,
ex)
//
/O.
IS
/1. 9
/9-/,3.0
4 9.62

r
Effluent
ERMT NO. NC©022497 Discharge No ame:
Operator in Responsible Charge (ORC): Dusty K. Metre
Certified Laboratory (1): Water Tech Labs Inc
Cross Country Campground
c$FECK BOX IF ORC HAS CHANGED
Mail ORIGINAL and ONE COPY to:
ATTN: CENTRAL FILES
DIVISION OF WATER QUALITY
1617 MAIL 'SERVICE CENTER.
RALEIGH, NC 276$B-1617
n
Phono: 704-50§-4 5
` ATU`' rP E TOR 1N SPONSIRL CHARGE) CAT
BY S&c. ATURE I C itTff Y THAT REPORT IS
ACCt?r Alit c'TC t Fiia eT S[Y Nt'
NTE3 PARAMETER Off' A
NAME AND UWTS BELOW
HRS HR a Y/SIN LCai} °C SU III L , • i In«: L. t1t L 111©

Facility Status: (Please check one oi`the following)
All monitoring data and sampling frequencies meet pewit requirements
(including weekly averages, if applicable)
All monitoring data and
uencl
do NOT meet pet
uiremen
Noncompliant
lithe facility is noncompliant, please attach a list of corrective actions being taken and a lima tabie for --
improvements to be made as required by Part II.E.6 of the NPDES permit.
"I certify, under penalty of law, that this document and all attachments were prepared under ttty direction or suptervision
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 managed 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."
ptture t*iznittee** late
equired unless submitted electronically)
Certified Laboratory (2)
Certified Laboratory (3)
Certified Laboratory (4)
Certified Laboratory (5)
Phone Number
ail Ltd
AD I ITIO AL CERTI "IE) LAR0RAT©RIES
PARAMETER CODES
Certification No.
Certification No.
Certification No.
Certification No,
e assistance may be obtained by calling the NPUES Unit at [phone] or by visiting the Surface
lon Section's web site at h2o.enr.state.nc.usiwgs and linking to the unit's information pages.
only units ofrneasurer►terttdesig:
porting facility's NPDES permit for re
* No Flow/Discharge From Site: Check this box if no disc h:t c +occurs and, as a result, the
entered fora]) of the parameters on the DMR for the entire monitoring period,.
** ORC On Site; ORC must visit facility and docuinent visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then the delegation of the signatory authority must be on
file with the state per 15A NCAC 213 .050,60)(2)(D).
0
Page 2

MINIMUM I
c0
0
C
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8
8
N
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8
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8
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,
DATE
t
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i
.
Time
1
s
-�
6
Temperature
1
JyK-ryo
�`
p
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\
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7
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Vn
3
Dissolved
Oxygen
0
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0
0
8
a
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a
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3
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Nitrogen
0
o
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■
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Time
--�
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0
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. '
N
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:}Jco
8
Dissolved
Oxygen
o
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1_
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pH
0
o
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8
A
Fecal Coliform
j
a
0r
9
Ammonia
Nitrogen
0
a
0
rn
0
0
-.
0
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punoi6duie3 A unoo ssoio
op-0)
YS C
Pl a
0
:'oN a6Jeyasta

Effluen
DES PERMIT N d. NC00224 7 Discharge No 11 Month : � j Year.
Facility Name Clre Coon Cam rand Class II County:
Operator In Responsible Charge (ORC): dusty . Metfeyecan Grade
Certified Laboratory (1): a r'Fah tnc (2)
CHECK BOIL IF ORC HAS CHANGED
Mall ORIGINAL and ONE COPY to
ATTN: CENTRAL FILES
DIVISION OF WATER QUAUTY
1617 MAJ4 SERVICE CENTER
RALEIGH, NC 27699-1617
Y
ACC
Ti
T NS
E CHARGE) DATE
TO THE BEST CIF' MY KNOWLEDGE.
ENTER PARAMETER CODE ABOVE
NAMEWOUNITS setow
AVERAGE
MAXIMUM
MINIMUM
Cornp. (C)/Grtlb G
Frequency
Month) limit A
Dail Maximum

facility Status: (i'iease check one of the following)
All monitoring data and sampling frequencies meet permit requirements
(including weekly averages, if applicable)
All monitoring data and sampling frequencies do NOT meet permit requirements
Compliant
Noncompliant
If the faci.iity noncompliant, please attach a listof corrective actions being taken and a timetable for
improvements to be made as required by Part II.E.6 of the NPDES permit.
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 pet sons who managed 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
fired unless submitted electronically)
ermittee Address
Certified 1w
Certified Laboratory (3)
Certified Laboratory (4)
Certified Laboratory (5)
2
Phone Nu
e- rnazl ldress
ADDITIONAL f"ERTII "II D I ABO'RATOR!
PARAMETER CODES
Certification No.
Certification No.
Certification No.
Certification No.
Parameter Code assistance may be obtained by calling the NPDES Unit at [phone] or by visiting the Surface
Water Protection Section's web site at h2o.enr.state.nc.us/wgs and linking to the unit's information pages.
fality's NPDES permit for reporting data
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be
entered for all of the parameters on the DMR for the entire monitoring period,
** ORC On Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Perrnittee: If signed by other than the permittee, then the delegation oldie signatory authority must be on
file with the state per I SA NCAC 2B .4506tb)(2)(D).
Page 2

Downstream
Upstream
NPDES Permit No.: NC0022497 Discharge No.: 001 Month: jaN gt\p• Year: �Ql(3
Facility Name: Cross Country Campground County: Lincoln
Scream: Tributary Stream: Tributary
Location: 100 ft. upstream Location: 300 ft. downstream
IIJ
<
O
m
E
F
00010
00300
00400
31616
00610
Temperature
Dissolved
Oxygen
o
Fecal Coliform
Ammonia
Nitrogen
HRS
°C
mg!L
SU
#r100mL
mg/L
1
2
3
4
5
6
7
OM
64
/01
8
9
10
11
12
13
-14
y495
AD
15
16
.
17_
18
19
20
21-i9.3D
.it-
4,5"
22
23
24
25
26
27
28-
T40,
6,
l0
29
30
31
AVERAGE
5
//, Q
MAXIMUM .n,
/ f ,
MINIMUM 4-
/013
'
w
00010
00300
00400
31616
00610
00600
00665
Temperature
Dissolved
Oxygen
a
E
73
U
is
O
0
Ammonia
Nitrogen
HRS
°C
mglL
SU
/merit
mglL
0446
6of0
Il./
(3?
//,,)
r
1-
A
/6-33
(P
//' Q
/o5
%/,
4
//,0