NCG140390_2023 DMR_20230321

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR)Form for NCG140000
Ready-Mix Concrete
Click here for instructions
V Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR) Upioad form within
I 30 days of receiving sampling results_ Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NC614 Person Collecting Samples: G
Laboratory Name:
' Facility Name: r Ir
Facility County: Laboratory Cert. No.:
Discharge during this period:❑Yes No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑ No
if so,which Tier(1, II,or Ili)
A copy of this DMR has been uploaded electronically via https//edocs deg nc gov/Forms/SW-DMR ❑Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DDJYYYY !
4G529 ( 24-Hour Rainfall in inches i
COS30 TSS in mg/L(100 or 501
00400 pH in standard units(6.0—9.0)
Additional parameters for outfalls in drainage areas that use> gallons per month of new hydraulic bm,,on average
00552 Non-Polar Oil&Grease in mg/L(IS)
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gafjmonth '
* outfelis to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of 50 mg/L.All other water classifications have a benchmark of 100 mg/L
Notes(optional):
°I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,intruding the possibifity of fines and imprisonment for knowing violations."
Signa se of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
CCU W-'r�4yleonl. r-J_

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
Click here for instructions
FComplete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
30 days of receiving sampling results_ Mail the original,signed hard copy of the DMR to the appropriate DFMLR Reatonal Office.
Certificate of Coverage No. NCG14 Person Collecting Samples:
Facility Name: Laboratory Name:
c Laboratory Cert. No.,
Facility County: :
Discharge during this period:❑Yes ❑ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑ No
If so,which Tier(I, II,or II1)?
A copy of this DMR has been uploaded electronically via https•//edocs deg nc,gov/FormsLSW-DMR ❑Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY i
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(100 or 50*)
00400 pH in standard units(6.0—9.0)
Additional parameters for outfalls in drainage areas that use>SS gallons per month of new hydr ' oil on average
00552 Non-Polar Oil&Grease in mg/L(15)
NCOIL Estimated New Motor/Hydraulic Oil
usage in gal/month
Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark T55 limit of 50 mg/L.All other water classifications have a benchmark of 100 mg/L
Notes(optional):
'4 certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,fncfuding the possibility of fines and imprisonment for knowing violations.V—W 0 41 LL_Ci__)
"
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Wastewater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG14 j
Person Collecting Samples:
facility Name: 0274i Laboratory Name: )
Facility County: • f
Laboratory Cert. No.: Ej
Discharge during this period:❑Yes [q°No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑ No
If so,which Tier(I, 11,or III)?
A copy of this DMR has been uploaded electronically via https:lledocs.deg.nc.gov/Fo.rms/SW-DMR ❑Yes ❑No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Effluent Limits in(Red)
Parameter Parameter Outfall Outfall__—TOutfatl Outfall Outfall
Code 7: _
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
Daily Flow Rate in cfs(5096'of 7Q10
82220 for HQW/ORW) i
C0530 TSS in mg/L(30,20,or 10*)
00400 pH in standard units(6.0-9.0
freshwater,6.8-8.5 saltwater)
00545 Settleable Solids in HQW,ORW,SA,
SB,Tr&PNA(5 mL/L)
Non-Polar Oil&Grease in mg/L(N/A,
00552 but samples above 15 require tiered
responses)
*Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW)have a TSS limit of 20 mg/L,outfalls to Trout Waters(Tr)and
Primary Nursery Areas(PNA)have a TSS limit of 10 mg/L.All other water classifications have a benchmark of 30 mg/L.
Notes(optional):
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
v 6v-6-kreoac�r�:, �,��,r,d►5-�reQ l�r�•�- - 7��1�t�i c�-o�c�3

NCDEQ Division of Energy,Mineral and Land Resources
ort DMR}Farm for NCG140000
Wastewater Discharge Monitoring Concrete
Ready-
I
Click here for instructions
scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
Complete,sign, of the DMR to the appropriate DEMLR Re ig onal Office.
30 days of receiving sampling results. Mail the original,signed hard copy
Person Collecting Samples:
Certificate of Coverage No. NCG14 �t Laboratory Name:
Facility Name: ' +-
Laboratory Cert. No.:
Facility County: f l
Discharge d:❑Yes No (if no,skip a signature and dote)
during this perio
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances7❑Yes ❑ No
If so,which Tier(I, il,or lll)? []Yes ❑No
A copy of this DMR has been uploaded electronically via https//edocs dea nc gov/Fo rms/SW-D
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Effluent Limits in(Red)
Outfatl Outfall
Parameter Parameter Outfall Outfall Outfalt
Code
N/A Receiving Stream Class
N/A Date Sample Collected MMJDDIYYYY
Daily Flow Rate in cfs(50%of 7Q10
82220 for HQW/ORW)
C0530 TSS in mg/L(30,20,or 10*)
00400 pH in standard units(6.0-9.0
freshwater,ti.8-8.5 saltwater)
Settleable Solids in HQW,ORW,SA,
00545 Sg Tr&Pr
(5 mL/L)
Non-Polar Oil&Grease in mg/L(N/A,
00552 but samples above 15 require tiered
responses)
*outfalls to Outstanding Resource Waters(ORW),High Quay Waters(HQW)have a TSS limit of 20 mg/L,outfalls to Trout Waters(Tr)and
Primary Nursery Areas(PNA)have a TSS limit of 10 mg/L.All other water classifications have a benchmark of 30 mg/L.
Notes(optional): i
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false informatiron,including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
1••a o�� ►��-�-�-1 t c?�c3�� �r�ri��c C� L�,r�c�.s�,-ec�m . Rat- `�Gy— ��Gl�-1 --2�,.��

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
Click here for instructions
Complete,sign,scan and submit the DMR via the 5tormwater NPDES Permit Data Monitoring Report(DMR) Upload form within
30 days of receiving sampling results_ Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG14C)39 Person Collecting Samples:
Facility Name: i_ Laboratory Name: N
Facility County: bon Laboratory Cert. No.:
Discharge during this period:❑Yes gNo (if no,skip to signature and dote)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑ No
If so,which Tier(1,11,or 111)?
A copy of this DMR has been uploaded electronically via https•//edocs.deq.nc.gov/Forms/SW-DMR Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(100 or 50*)
00400 pH in standard units(6.0—9.0)
Additional parameters for outfalis in drainage areas that use>55 gallons per month of ne hydraulic oil on averag
00552 Non-Polar Oil&Grease in mg/L(1S)
NCOIL Estimated New Motor/Hydraulic Oil {
usage in gaf/month !
*Outfalis to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of 50 mg/L.All other water classifications have a benchmark of 100 mg/L
Notes(optional):
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,including the possibility of fines and imprisonment for knowing violations.ZOL4 __y_1 ) 03-e7:R
Signal re of Permittee or Delegated Authorized Individual Date
Email Address Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG14 Person Collecting Samples:
Laborator Name:
Facility Name: L Y
Facility County: ; Laboratory Cert. No.:
Discharge during this period:❑Yes Z No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?®Yes ❑ No
If so,which Tier(1, 11,or 111)?
A copy of this DMR has been uploaded electronically via https:/Zedocs.deg.nc.gov Forms/SW-DMR Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall outfali
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches i
C0530 TSS in mg/L(100 or SO*)
00400 pH in standard units(6.0—9.0)
Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average
00552 Non-Polar Oil&Grease in mg/L(15)
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gat/month
*Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of SO mg/L.All other water classifications have a benchmark of 100 mg/L
Notes(optional):
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,including the possibility of fines and imprisonment for knowing wafations."o �V_)aet� q' Qdm �,-L
Signat of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
Iri,�dre r reac�►�r�•x@ vJ`►+ S�rea.rY-•,r�e,�- c�i��4�c.eq�-a1-i3�j

NCDEQ Division of Energy, Mineral and Land Resources
Wastewater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office. i
Certificate of Coverage No. NCG14 Person Collecting Samples:
Facility Name: % t% Laboratory Name:
Facility County: p Laboratory Cert. No.:
PA
Discharge during this period:❑Yes No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances7❑Yes ❑ No
If so,which Tier(1, 11,or HI)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ff�Yes ❑No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Effluent Limits in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/yyyy
Daily Flow Rate in cfs(50%of 7Q10 ,
82220 for HQW/ORW)
C0530 TSS in mg/L(30,20,or 10*)
00400 pH in standard units(5.0-9.0
freshwater,ox-5.5 saltwater)
00545 Settleable Solids in HOW,ORW,SA,
SB,Tr&PNA(5 mL/L)
Non-Polar Oil&Grease in mg/L(N/A,
00552 but samples above 15 require tiered
responses)
*Outfails to Outstanding Resource Waters(ORW),High Quality Waters(HQW)have a TSS limit of 20 mg/L,outfalls to Trout Waters(Tr)and
Primary Nursery Areas(PNA)have a TSS limit of 10 mg/L.All other water classifications have a benchmark of 30 mg/L.
Notes(optional):
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,including the possibility of fines and imprisonment for knowing violations." /�
0. ak Co�
Signat a of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
\fir -hr�cl�rr,xi OVA +�dS�-ream.r, rl 0(4 (�q�-aC�`3

NCDEQ Division of Energy, Mineral and Land Resources
Wastewater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG14 Person Collecting Samples:
Facility Name: r Laboratory Name:
Facility Coun Laboratory Cert. No.:
Discharge during this period:❑Yes No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑ No
If so,which Tier(I, 11,or I11)?
A copy of this DMR has been uploaded electronically via httt)s:/Iedocs.deg.nc.gov/Forms/SW-DMR OYes []No
i
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Effluent Limits in(Red)
Parameter Parameter Outfall outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
82220 Daily Flow Rate in cfs(50%of 7Q10
for HQW/ORW)
C0530 TSS in mg/L(30,20,or 10*)
00400 pH in standard units(6.0-9.0
freshwater,6.3-8.5 saltwater)
00545 Settleable Solids in HQW,ORW,SA,
SB,Tr&PNA(5 mL/L)
Non-Polar Oil&Grease in mg/L(N/A,
00552 but samples above 15 require tiered I
responses)
*Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW)have a TSS limit of 20 mg/L,outfalls to Trout Waters(Tr)and
Primary Nursery Areas(PNA)have a TSS limit of 10 mg/L.All other water classifications have a benchmark of 30 mg/L.
Notes(optional):
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,including the possibility of fines and imprisonment for knowing violations."
Signat a of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
h Idre,�lr�res dc�rv� x@V►'dsj rea,7.. "e:v ncq)upt -R03�