NCG060352_MONITORING INFO_20190102

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V ��jO �3 S�
DOCTYPE
El HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ a b ��1 6) b�
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000 RECEIVED
Date submitted /
JAN 0 2 2019
CERTIFICATE OF COVERAGE NO. NCG06 G -aa2- SAMPLE COLLECTION YEAR Z,018 CENT
FACILITY NAME 5 +- 0-- k 3o1� FACILITY ACTIVITIES INCLUDE (check all that apply): CENTRAL TILES
COUNTY CL i,a- r S ❑ use/process meats ® use animal fats/byproducts SECTION
PERSON COLLECTING SAMPLES Mn,-j_ . , re I DISCHARGING TO SALTWATERS? OYES ®NO
LABORATORY &cg (N T,em I^ Lab Cert. # 52`
g.�.0
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z or ❑ No discharge this period
Outfall No -
5ample.Collected,';
/dd/yr
TSS;
mg/L''.;: f
pM, ,
s6ridardwnits
COD,
mg/,L
Oil and:Grease -:
mg/L
Fecal Coliform , '`
Colonies`per;l00:m1:. ''
Enterococci.,
Colonies per 100 ml
Benchmark
":100 or 50 `
Wltiriln 6 0.,= 9 0: `'
, 120 .
30
1000
500
z
5-
C.,
N
I Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
''0ut6WNo.1.`,
r
mo/dd/yr
4, Oil and Grease;
� ' m C ,
�. �;f g/
4 TSS;
? m L xx.
g/
_PK
Standard units `
Neuir�Motor�011 Usage,
Annual°Aiidra ei° al mo
g g /
Benchmatk
r�n3Us =
,4'•10o or 50 r
610:4.q
Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(Ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
TIER 1 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http:Uportal.ncdenr,orq/web/wq/ws A"/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

axAnalytical
wwwpacnlabseonr
December 13, 2018
Sal DiGiovanni
S&D Coffee
300 Concord Pkwy S
Concord, NC 28027
RE: Project: Stormwater Sampling
Pace Project No.: 92409771
Dear Sal DiGiovanni:
Pace Analytical Services, LLC
9B00 KinceyAve. Suite 100
Huntersville, NC 28078
(704)B75-9092
Enclosed are the analytical results for sample(s) received by the laboratory on December 06, 2018.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNUNELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Wo— �m k-�1.Ctt'Li
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
cc: Mark Weisel, S&D Coffee
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 15

aceAnalytical
wwW.pecelebsmm
Project: Stormwater Sampling
Pace Project No,: 92409771
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
Louisiana/NELAP Certification # LA170028
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
Asheville Certification IDS
2225 Riverside Drive, Asheville, NC 28804
Flodda/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
South Carolina Certification #: 99006001
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
VirginialVEIAP Certification #: 460221
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
VirginialVEL4P Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not he reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 2 of 15

aceA lximl
w ww.peoelaescom
Project: Stormwater Sampling
Pace Project No.: 92409771
Lab ID Sample ID
92409771001 Stormwater
SAMPLE SUMMARY
Matrix Date Collected Date Received
Water 12/05/18 09:30 12/06/18 11:32
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Ana"cal Services, LLC.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 3 of 15

aceAnalyircal
wwwcpacel b&mn
Project: Stormwater Sampling
Pace Project No.: 92409771
Lab ID Sample ID
92409771001 Stormwater
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Method
Analysts
Analytes
Reported
EPA 1664B
JMS
1
SM 254OD-2011
MJP
1
EPA 9040C
SMK
1
SM 5220D-2011
GC
1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 4 of 15

acmnalytircal
wwwpw@kbs G=
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite100
Huntersvitle, NC 28078
[phone]
Project: Stormwater Sampling
Pace Project No.: 92409771
Sample: Stormwater Lab ID: 92409771001 Collected: 12/05/18 09:30 Received: 12/06/18 11:32 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease
Oil and Grease
2540D total Suspended Solids
Total Suspended Solids
9040 pH
pH at 25 Degrees C
5220D COD
Chemical Oxygen Demand
Date: 12/13/2018 05:01 PM
Analytical Method: EPA 16M
ND mglL
4.8 1 12/0811819:58
Analytical Method: SM 2540D-2011
2.5 mg1L
2.5 1 12/07/18 12:31
Analytical Method: EPA 9040C
6.4 Std. Units
0.10 1 12/13/18 15:39 H3
Analytical Method: SM 5220D-2011
Preparation Method: SM 522OD-2011
ND mglL
25.0 1 1211111815:30 12/1111819:05
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, L-C.
Page 5 of 15

aceAtWical'
wwwpeoelatecom
Project: Stormwater Sampling
Pace Project No.: 92409771
QC Batch: 446598
QC Batch Method: EPA 1664E
Associated Lab Samples: 92409771001
METHOD BLANK: 2447587
Associated Lab Samples: 92409771001
Parameter
Oil and Grease
QUALITY CONTROL DATA
Analysis Method: EPA 1664E
Analysis Description: 1664 HEM, Oil and Grease
Matrix: Water
Blank Reporting
Units Result Limit Analyzed Qualifiers
mg1L ND 4.8 1210811819:45
LABORATORY CONTROL SAMPLE:
2447688
Parameter
Units
Oil and Grease
mg1L
MATRIX SPIKE SAMPLE:
2447689
Parameter
Units
Oil and Grease
mg/L
Pace Analytical Services, LLC
9600KinceyAve. Suite100
Huntersville, NC 28078
[phone]
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
38.5 37.1 96 78-114
92409733001 Spike MS MS % Rec
Result Conc. Result % Rec Limits Qualifiers
ND 38.5 37.5 96 78-114
Results presented on this page are In the units Indicated by the "Units" column except where an attemate unit Is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report small not be reproduced, except to full,
Date: 12111312018 05:01 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 15

aCo. eAnalytica!
wwwtpawwmcom
Project: Stormwater Sampling
Pace Project No.: 92409771
QC Batch: 446307
QC Batch Method: SM 254OD-2011
Associated Lab Samples: 92409771001
METHOD BLANK: 2446270
Associated Lab Samples: 92409771001
Parameter
Units
Total Suspended Solids
mg1L
LABORATORY CONTROL SAMPLE: 2446271
Parameter
Units
Total Suspended Solids
mg1L
SAMPLE DUPLICATE: 2446272
Parameter
Units
Total Suspended Solids
mg1L
SAMPLE DUPLICATE: 2446273
Parameter
Units
Total Suspended Solids
mg1L
QUALITY CONTROL DATA
Analysis Method: SM 254OD-2011
Analysis Descripbon: 2540D Total Suspended Solids
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 12/07/18 12:24
Spike LCS LCS
Conc. Result % Rec
250 232 93
92409843001 Dup
Result Result - RPD
5.6 7.3 26
92409672001 Dup
Result Result RPD
ND NO
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28o78
[phone]
% Rec
Limits Qualifiers
90-110
Max
RPD Qualifiers
5 D6
Max
RPD Qualifiers
5
Results presented on this page are In the units Indicated by the'Units' coturrat except where an alternate unit Is presented to the right of the resutt.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/1312018 05:01 PM without the written consent of Pace Analytical Services, LLC, Page 7 of 15

to
aceAnalytical
wwwpaaefaLa com
Project: Stolmwater Sampling
Pace Project No.: 92409771
QC Batch: 446928
QC Batch Method: EPA 9040C
Associated Lab Samples: 92409771001
SAMPLE DUPLICATE: 2449270
Parameter
pH at 25 Degrees C
SAMPLE DUPLICATE: 2449271
Parameter
pH at 25 Degrees C
Pace Analytical Services, LLC
9800 Kincey Ave. Suite t00
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Analysis Method: EPA 9040C
Analysis Description: 9040 pH
92409771001 Dup Max
Units Result Result RPD RPD Qualifiers
Std. Units 6.4 6.5 1 9 H3
92409855001 Dup Max
Units Result Result RPD RPD Qualifiers
Slid. Units 7.5 7.5 0 9 H3
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report Shall not be reproduced, except in full,
Date: 12/13/2018 05:01 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 15

ceAnalytical *
wrwpaoefatAcom
Project: Stormwater Sampling
Pace Project No.: 92409771
QC Batch: 446433
QC Batch Method: SM 5220D-2011
Associated Lab Samples: 92409771001
METHOD BLANK: 2447007
Associated Lab Samples: 92409771001
Parameter
Chemical Oxygen Demand
QUALITY CONTROL DATA
Analysis Method: SM 5220D-2011
Analysis Description: 5220D COD
Matrix: Water
Blank Reporting
Units Result Limit Analyzed Qualifiers
mg[L ND 25.0 1211111818:53
Pace Analytical Services, LLC
9800 Kincey Ave. Suite100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 2447008
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mg1L 750 761 102 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2447009 2447010
MS MSD
92409441001 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg1L 364 100 100 458 418 94 54 90-110 9 3 M1,R1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2447011 2447012
MS MSD
92409549004 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qua[
Chemical Oxygen Demand mg1L <25.0 100 100 108 110 101 103 90-110 2 3
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
Date: 12113/2018 05:01 PM without the written consent of Pace Analytical Services, LLC.
Page 9 of 15

aceAnalytical
wivwpeoelahs.00m
QUALIFIERS
Project: Stormwater Sampling
Pace Project No.: 92409771
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
M DL - Adjusted Method Detection Limit.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
PQL - Practical Quantitation Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethyivinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
ANALYTE QUALIFIERS
06 The precision between the sample and sample duplicate exceeded laboratory control limits.
H3 Sample was received or analysis requested beyond the recognized method holding time.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
R1 RPD value was outside control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12113/2018 05:01 PM without the written consent of Pace Analytical Services, LLC. Page 10 of 15

eeAnalytical'
wrw.pecefaba.com
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Stormwater Sampling
Pace Project No.: 92409771
Pace Analytical Services, LLC
9800 Kincey Ave. Suite100
Huntersvlle, NC 28078
[phone]
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method
92409771001
Stormwater
EPA1664B
446598
92409771001
Stormwater
SM 254OD-2011
446307
92409771001
Stormwater
EPA 9040C
446928
92409771001
Stormwater
SM 5220D-2011
446433 SM 5220D-2011
Date: 12/1312018 05:01 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Analytical
Batch
446813
Page 1 i of 15

Document Name:
Document Revised: February 7, 2018
e
Sample Condition Upon Receip SOUR)
Page 1 of Z
BCeARaly 01
Document No.:
Issuing Authority:
f-CAR-Ci-033-Rev.06
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersviile [� Raleigh[] Mechanicsville❑
Client Name: W07T : 92409771
. � � i Project #f;
Courier: �QFed Ex ❑UPS ❑USPS []Client
❑ Commercial UPace ❑Other: 92409771
Custody Seal Present? ❑Yes ONOw Seals Intact? []Yes No
Date/initlak Person Eno mining Contents: i 24. - L
Packing Material: ❑Bubble Wrap 26ubbie Bags []None ❑ Other Biological Tissue Frozen?.
Thermometer: ,�� ❑Yes ONO �/A
N Gun tn: 92TO46 Type of ice: eE JWet (3Blue []None
Cooler Temp CQ: � Correction Factor: Add/Subtract('C) 0.0
Temp should be above freezing to VC
Cooler Temp Corrected CC): r ❑Samples out of temp criteria. Samples on Ice, tooting process
has begun
USDA Regulated Soil (EN/A, water sample)
Did samples originate in a quarantine tone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source ontemationally,
I ]Yes i,No inrlecdimr NatvaS and Pisorm RimI7 FVac I-W.-
Comments Discre an
Chain of Custody Present?
Yes
No
❑N/A
I.
Samples Arrived within Hold Time?
Yes
No
❑NIA
2.
Short Hold Time Analysis (<72 hr.)?
es
Q C.
ONJA
3.
Rush Turn Around Time Requested?
❑Yes
N/A
4.
Sufficient volume?
Ye
ON.
❑NIA
5.
Correct Containers Used?
-Pace Containers Used?
a
Yes
ON.
❑No
❑N/A
❑NIA
6.
Containers Intact?
❑Yes
No
N/A.
7
CY
j
b z'Q` ce 1-1
Dissolved analysis: Samples Field Filtered?
Yes
Na
NIA
B.
Sample Labels MatchCOC?
-includes Date(Time/ID/Ana is Mahn
❑yes
[:]No
❑N/A
9.l�
/� �; �` ��� C i✓
Heads ace in VOA Vials >5-6mm 7
es
No
i'JN/A
10.
Trip Blank Present?
Trip91anitCustody Seats Present?
❑Yes
es
o
No
(_-]N/A
❑N/X
11.
COMMENTS/SAMPLE DISCREPANCY
Field Data Required? []Yes ❑Ne
Lot ID of s it containers:
LIENT N0TIFICATLONIRMWTION
r rp rKA� j\t-P(I <)nvpriri+PA o-o\\P.o-x - *vu- R nq
Person contacted: Date/Time:
Project Manager SCURF Review: y� Date:
Project Manager SRF Review: V Date:
Page 12 of 15

a
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N Items
BP4U-125 mL Plastic Unpreserved (N/A) (CI-)
8P3U-250 mt Plastic Unpreserved (N/A)
SP2U-500 mL Plastic Unpreserved (NIA)
BP1U-1 liter Plastic Unpreserved (N/A)
8P45-125 mL Plastic H2SO4 (pH < 2) (Cl-)
BP3N-250 mL plastk HNO3 (PH < 2)
BP42-125 mL Plastic ZN Acetate & NaOH (>9)
SP4C-125 mL Plastic NaOH (pH > 12) (CH
WGFU-Wide-mouthed Glass Jar Unpreserved
AG1U-1 liter Amber Unpreserved (N/A) (Cl-)
AG1H-1liter Amber HCl (pH <2)
AG3U-250 mLAmber Unpreserved (NIA) (Cl-)
AG1S-1 liter Amber HZSO4 (pH < 2)
AM-250 mLAmber H2504 (pH <2)
AG3A(OG3A)-250 mt Amber NH4C1(N/A)(CI-)
QG9H-4O mt VOA HO (N/A)
VG9T-40 mL VOA Na2S103 (N/A)
VGSU-40 mL VOA Unp (N/Al
(>G9P-40 mL VOA H3PO4 (N/A)
VOAK (6 vials per kit)-5035 kit (N/A)
V/GK (3 vials per klt)-VPH/Gas klt (NIA)
SPST-M mL Sterile Plastic (N/A - lab)
SPIT•250 ml.Sterile Plastic (N/A- lab)
SP3A-250 mL Plastic (NH2)2SO4 (9.3-9.7)
AGOU-100 mL Amber Unpreserved vials (N/A)
VSGU-20 ml. SClntillation vials (N/A)
069U-40 mL Amber Unpreserved vials (NIA)
O
10

Section A
Required Client Information:
Section B
Required P-I..t lnfennatinn:
CHAIN -OF -CUSTODY 1 Analytical Request Document
The Chain -at -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately.
Section C
Inuelce Inlomullon�
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Patio: I Of 1 a
COVIV-Yr S&V COFFEE
Rapdrt To Mark Weisel
Attention:
Addross: 300 Cgrlcord P S
Copy To.
Company Name:
Concord, NC 25027
Addreat:
R Meta A n
Email:
Purchase Order 0:
Pam Quote:
Phona: Irax
Proud Name: Slormwaler So
Pace Picied Manager. aNela.baionifbalabs.cm,'
State! Location
Requested Due Date:
Proied a:
Paw Profile /: 691 o.1
NC
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DATE
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DATE
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3
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7
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RELINQUISHED BY I AFFILIATION
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TIME
ACCEPTED BY I AFFILIATION
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SAMPLE CONGmONS
►L1
j %DATE
SAMPLER NAME AND SIGNATURE
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PRINT Name of SAMPLER:
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SIGNATUREofSAMPLER:
DATE Signed:
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Section 0
Rwulrvd Proiact Information:
CHAIN -OF -CUSTODY I Analytical Request Document
The Chaln-of-Custody Is a LEGAL 00CUIVIENT, All relevant fields must be completed accurately.
Servon C
Invoice Infonwtion:
IPenn- I of 4 1
C-Twy- S&D COFFEE
Report To,. _jg2"mpwwfr—
Altgnd=
30D Concord PM 8 Addrair
copy To:
cwrpony Raw:
Concord, NC 20027
Addrow: 40-rUtA
Ridul it iW. A 4-W
EmWP.
Purchase Order 0,,
Paco Quo*
Phoner, Fe c
Ptn)W Nam: mormwelor Gamh-Q
Poe* PmJW Man@Wr [e-mail],
kecpxsked Due Ouldr
Pro)- 0:
Paw pfofllof: BBSO.1
NC
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SAMPLE ID 00 OL
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SICINATURgafRAMPL 7
DATE 61
L L

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qualit General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06&, 1 .2._ SAMPLE COLLECTION YEAR deO/8
FACILITY N/A�ME S-D r. 9Q. r .3 Act &Ax.r4 kV.. FACILITY ACTIVITIES INCLUDE (check all that apply): JUN 2 8 2018
COUNTY ❑ use/process meats ® use animal fats/byproduc t�, ;L FlLeS
PERSON COLLECTING SAMPLES IM.AA_ n,&c DISCHARGING TO SALTWATERS? YES �NO rV1J'SECTION
LABORATORY Pot.,Aw\!%4fi o& Lab Cert. #
Ss•y� S PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall' or ❑ No discharge this periad3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliforml,
Colonies:per 100,m1, ,
Enterococcil,
., Colonies. per 100 ml
Benchmark
-
100 or 504
Within 6.0 —.9;0
120
30
' 1000 w: ;
: ;' 500
6
N �
' Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at �Ia outfalls. You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New.Mot`orbil'Usage;
Annual'average.gal/mo
Benchmark.
T
30
100 or 504
6.0 - 9.0
i
(if Yes
' complete Part B)
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
a For sampling periods with no discharge at pn
j outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18, 2012
Pate 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR,_including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring -period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
?�
Raleigh, INC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
/2-5 g
(Dat)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S WU-249
Last Revised: October 18, 2012
Page 2 of 2

aceAnalytical
nrrpacrJabscam
June 21, 2018
Sal DiGiovanni
S&D Coffee
300 Concord Pkwy S
Concord, NC 28027
RE: Project: Stormwater Sampling
Pace Project No.: 92387547
Dear Sal DiGiovanni:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
Enclosed are the analytical results for sample(s) received by the laboratory on June 07, 2018. The
results relate only to the samples included in this report. Results reported herein conform to the most
current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where
applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
oj*a, "
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
la
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
[phone]
Page 1 of 14

(�Ia'ceAWkale
WW4Mce(a6a.c0m
Project: Stormwater Sampling
Pace Project No.: 92387547
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Charlotte Certification Ids
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
Louisiana/NELAP Certification # LA170028
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
Asheville Certification Ms
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
South Carolina Certification #: 99006001
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
VrginiaNELAP Certification #: 460221
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
Vrginia/VELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 14

(�2eAn*ical"
www-.08006152 0ertr
Project: Stormwater Sampling
Pace Project No.: 92387547
Lab ID Sample ID
SAMPLE SUMMARY
Matrix Date Collected Date Received
92387547001 #1-5 WT Storrawater Water 06/06/18 09:00 06/07/18 09:28
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 2807B
[phone]
Page 3 of 14

OeAn*ical•
WWW4*oetat+scom
Project: Stormwater Sampling
Pace Project No.: 92387547
Lab ID Sample ID
92387547001 #1-5 VYT Stormwater
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Method
Analysts
Analysts
Reported
EPA 1664B
JMS
1
SM 2540D
CJR
1
EPA 9040
RLO
1
SM 5220D
GC
1
REPORT OF LABORATORY ANALYSIS
This report shall not he reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 4 of 14

Pace Analytical Services, LLC
fop
a
9800 Kincey Ave. Suite 100
'+'+�
Huntersville, NC 2BO78
00M
[phone]
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92387547
Sample: #1-5 WT Stormwater
Lab ID: 92387547001 Collected: 06/06/18 09:00
Received: 06/07/18 09:28 Matrix: Water
Parameters
Results Units
Report Limit DF
Prepared Analyzed CAS No. Quall
HEM, Oil and Grease
Analytical Method: EPA 1664B
Oil and Grease
ND mg/L
5.0 1
06/21/18 04:30
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
22.3 mg1L
6.2 1
06/11/18 17:10
9040 pH
Analytical Method: EPA 9040
pH
6.4 Std. Units
0.10 1
06/08/18 04:02 H3,H6
5220D COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
ND mg/L
25.0 1
06/11/18 18:26
REPORT OF LABORATORY ANALYSIS
This report shall not he reproduced, except in full,
Date: 06/21/2018 02:10 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 14

(�15'ceAWa*
waloFacom
Project: Stormwater Sampling
Pace Project No.: 92387547
QC Batch: 416041
QC Batch Method: EPA 1664E
Associated Lab Samples: 92387547001
METHOD BLANK: 2307198
Associated Lab Samples: 92387547001
Parameter Units
Oil and Grease mg/L
LABORATORY CONTROL SAMPLE: 2307199
Parameter Units
Oil and Grease mg/L
Pace Anatytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Analysis Method: EPA 1664B
Analysis Description: 1664 HEM, Oil and Grease
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 5.0 06/21/18 04:29
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
38.5 37.9 99 78-114
MATRIX SPIKE SAMPLE: 2307200
92388527004 Spike MS MS % Rec
Parameter Units Result Conc. Result % Rec Limits Qualifiers
Oil and Grease mg/L ND 38.5 38.5 99 78-114
Results presented on this page are in the units indicated by the -Units" cohnnn except where an alternate unit is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/21/2018 02:10 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 14

(�Iacl
Analyiiica!'
tnrwPacewmeom
Project: Stormwater Sampling
Pace Project No.: 92387547
QC Batch: 414783
QC Batch Method: SM 2540D
Associated Lab Samples: 92387547001
METHOD BLANK: 2300168
Associated Lab Samples: 92387547001
Parameter
Units
Total Suspended Solids
mg/L
LABORATORY CONTROL SAMPLE: 2300169
Parameter
Units
Total Suspended Solids
mg/L
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Analysis Method: SM 2540D
Analysis Description: 2540D Total Suspended Solids
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 06/11/1817:05
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
250 252 101 90-110
SAMPLE DUPLICATE: 2300170
92387830001 Dup
Parameter Units Result Result
Total Suspended Solids mglL 51.7 3&3
SAMPLE DUPLICATE: 2300171
92387492001 Dup
Parameter Units Result Result
Total Suspended Solids mg/L 2600 2850
Max
RPD RPD Qualifiers
30 5 D6
Max
RPD RPD Qualifiers
9 5 D6
Results presented on this page are in the units indicated by the "Units' column except where an alternate untt Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/21/2018 02:10 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 14

aceAnalytical'
rrw.p�Gscvrst
Project: Stormwater Sampling
Pace Project No.: 92387547
QC Batch: 414404
QC Batch Method: EPA 9040
Associated Lab Samples: 92387547001
SAMPLE DUPLICATE: 2298185
Parameter Units
pH Std. Units
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Analysis Method: EPA 9040
Analysis Description: 9040 pH
92387631001 Dup Max
Result Result RPD RPD Qualifiers
5.9 5.9 0 9 H6
Results presented on tivs page are In the units Indicated by the "Units" column except when: an alternate unit is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/21/2018 02:10 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 14

aceAnalytical
wwwpweleb�s wm
QUALITY CONTROL DATA
Project: Stormwater Sampling
Pace Project No.: 92387547
QC Batch: 414456 Analysis Method: SM 5220D
QC Batch Method: SM 5220D Analysis Description: 5220D COD
Associated Lab Samples: 92387547001
METHOD BLANK: 2298392 Matrix: Water
Associates! Lab Samples: 92387547001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 06/11/18 18:26
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 2298393
Spike LCS LCS % Rec
Parameter Units Cone. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 773 103 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2298394 2298395
MS MSD
92386855003 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conn. Conc. Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg1L 145 100 100 252 247 107 102 90-110 2 3
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2298396 2298397
MS MSD
92387512006 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg/L <25.0 100 100 25.0 23J 7 5 90-110 3 M1
Ftesutts presented on this page are in the units Indicated by the 'Units' column except whore an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/21/2018 02:10 PM without the written consent of Pace Analytical Services, LLC.
Page 9 of 14

aceAWa'
wiwpacabbsc m
QUALIFIERS
Project: Stormwater Sampling
Pace Project No.: 92387547
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL-Adjusted Method Detection Limit.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
PQL - Practical Quantitation Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration_
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis ofAcrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
H3 Sample was received or analysis requested beyond the recognized method holding time.
H6 Analysis initiated outside of the 15 minute EPA required holding time.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
Date: 06121 /2018 02:10 PM without the written consent of Pace Analytical Services, LLC. Page 10 of 14

aceArralyticat
gpwahlDacam
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Stormwater Sampling
Pace Project No.: 92387547
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method
92387547001
#1-S WT Stormwater
EPA 16648
416041
92387647001
#1-5 WT Stormwater
SM 2540D
414783
92387547001
#1-5 WT Storrnwater
EPA 9040
414404
92387547001
#1-5 WT Stormwater
SM 5220D
414456
Date: 06/21/2018 02:10 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Analytical
Batch
Page 11 of 14

7 ,,,/cep.
Documertt No..
Issuing Authority:
"arolinas fluality Office
Laboratory receiving samples:
Asheville ❑ Eder:❑ Greenwood ❑
Hunters%nlleEf
Dent Name:
. • P j� f�� � Project
Courier: OFe Ex {]UPS ❑USPS ❑Client
C.ornmerda! ❑ ❑Outer:
�^ Custody Seal Proem? ❑Yes E o 5eais [ tarn ct3- ❑Yes
r+8 Materials - ❑Bubble Wrap dutrble Bags ❑None ❑ other
Therrtiomet5r.
JJ1R Gun lD: 92TO40 ripe of Ice: Vwes pate
CocierTemp rCj: - Correction Factor: Add/Subtract ('C) +0.4
Cooler Temp Corrected ('C).
MechanicsVileD
WOii -2387547
NI�Illulllfll IIIW
Raleigh[]
4iteJlniSals person Examinin6 Canters: �`i�— -I lea
_ Biological Tissue ?
-❑N- - /A- . . - --
[�flrne
Ttmp should be above freeting to VC
DWOes out of tamp aiteria. Samples -on ice, cwLing process
has begin
USFA Reglrlated Sell P NIA, water sample)
Did sarrsples originate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Cad saasples o*-tefrarss a farei�r source Onterrrationany,
(fYes FIN,, bdodnsr Hawd and Puerto Rim)? ❑Yes —DN.
CemmcrstslDiscre ancy: .
L
Chain of C=ody Present? E2o NIA
Samples Arrived within Hold Time?
es
No
NIA
2.
Short Hold Time Analysis (472 hr.)?
Yes
No
N/A
3.
RwhTurn Around TimeRequested?
es
No
NIA
4.
SufiBdent Volume?
es
oft
N/A
5-
COnictContalners Used?
-Pats! Containers Used?
VYes
❑Na
ClHo
ON/A
N/A -
6_
Containers Intact?
0(.
No
CLtQA
7.
Dissolved ana .: Sarnples Reld Filtered?
es
No
[ NA
8-
Sample Labels Match CDCI
-tncfudesDateiawl,,- D/Anafysis Matrbe
es
13No
(]MIA
-9.
Headsmce in VaA vials (>5 rni?
es •
No
N
10.
Trip 111ankPresent?
T Blank Custody Seals Present?
(]Yes
DYes
QNo
No
A
V N/A
11
COMIr eM/SAAMPLE DfSL'3t MCY meld Dais Requited? ❑Yes QNo
VID GU'i S Gtx� Go �� f14
Lot iD of sprit containers
tL1ENT NOTlF1CAS10H/gE5C1LUTlON
Person mntacted: C1atFkMrne:
Project Manager SCURF Review —
Project Manager SRF Review: f 11 f � Date: (0— � r
Page 12 of 14

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BPBU-250 mL Plastic Unpreserved �(N/A)
BP2U500 mL Plastic Unpreserved (N/A)
BP1U-1 liter Plastic Unpreserved (1V/A)
BP45-125 mL Plastic H2SO4 (pH <2) (CI-)
BPBN-2SO mL plastic HNO3 (p'< 2)
H
BP4Z-12S mL Plastic ZN Acetate & NaOH (>9)�
BP4C-M mL Plastic NaOH (pH > 2.2) (Cl.) i
WGFU-Wide-mouthed Glass )ar Unpreserved
AGSU-lliterAmber Unpraserved,(N/A)(d-)
AG1H-1 liter Amber HCI (pH <2)
AG3U-250 mLAmber Unpreserved (N/A) (Cl-")
AG1.S-1 liter Amber HZSO4 (pH <2)
AGBS-250 mL Amber H2SO4 (pH < 2)
AG3A(DG§AI-250 mL Amber HMO (N/A)(CI')
DG9H-4O mL VOA HD (N/A)
VOWr-40 mL VOA 141,23203 (N/A)j
VQ9U-40 mL VOA llnp (N/A) E
DG9P-40 mL VDA H3p04 (N/A)
I
VOAK (6 vials per klt)-503S kit (N/A)
V/GK (3 vials per kit)-VPH/Gas:kit (N/AI
SPST-125 MI. Startle Plastic (NIA —lab)
SP2T-250.mL Startle Plastic (N/A— lab)
I
6P3A-250 mL Plastic (N)-12)2SO4 (9.3.9.7)�
AGOU-100 mLAmber Unpreserved vials (NIA)
VSGU-20 mLSClntiltation viats+(WA)-
DGSU-40 mL Amber Unpreserved vials (N/A)
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CHAIN -OF -CUSTODY ! Analytical Request Document
The Chain -of -Custody is a LEGAL DOCUMENT. AR relevant fields must be completed accurately.
Section A Section 0 Section C
Required Client information: Required Project Information: hwoico Information: Pa t3 : 1 Of 1
Company, S&D COFFEE 1 1 1 Report To: Sal DIGlovanni AlMrkion:
Address: 300 Concord PkwY S I I Copy To: Company Name:
Coneard, NC 28027 ! I
Address:
at
Email: - I
PLechase Order 0:
Pace Quote:
Phone: Fay I I
Prood Noma: Stornwaler SampiJing
Pace Project ManaGer: woftbawtieMlabs.com.
Efate I Location '.
Reclwated Due Date: - I i
Project C
Pace Profile 0: 8910.1
NC
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6/22/20% 8
Concord Month Weather - AccuWeather Forecast for NC 28027
World > North America > United States > North Carolina � Concord ENGLISH (US), °F
® Follow us on
Concord, NC
in partnership with
United States Weather k Concord, NC 80°F— - I Allergies: Low ICI
Now I Weekend (Extended Month I� Radar MinuteCastC��l� I Watch News
Dx
May 2018 View: June 2018 - July 2018
Date Hdl-o ?recap Snow 1 Forecast _ Avg. HI I L6 It's time
T
for a
Fri 6/1
91'165'
0.07 IN
0 IN
84'161'
Sat612
69'166'
0IN
OIN
85'161'
change.
Sun 6/3
92°166'
0.02 IN
0 IN
85'162"
Get up to
$5oo when
Mon 614
88°159'
0 IN
0 IN
65'162'
you make the
Tue 615
851160,
0 IN
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85°162°
switch today!
Wed 616
91 °/62'
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0 IN
86°163° s Pectrum.com
Thu 617
88°/66'
0 IN
0 IN
8063'
Fri 618
92°/66°
0 IN
0 IN
86°163°
Sat 6/9
93'/68°
0 IN
0 IN
86'164'
Sun 6110
95'170'
0 IN
0 m
87'164'
Mon 6111
91 *163'
0.12 IN
0 IN
87°164'
Tue 6/12
731/63'
0 IN
0 IN
87°/64°
Wed 6113
89*167'
0.05 IN
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88'165°
Thu 6114
95'169°
0 IN
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88*165'
Fri 6/15 93'167' 0 IN 0 IN
88'/65'
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https:ltwww.accuweather.comlen/us/concord-nc/28027/month/11634_pc?view=table 1/3

6/22/2018 Concord Month Weather - AccuWeather Forecast for NC 28027
Date HFLO Preap Snow Forecast Avg :d3 - LO
Mon 6118 100°174° 0 IN 0 IN 89°166°
Tue 6119
100°774°
0 IN
0 IN
89°166°
Wed 6120
99°172°
0 IN
0 IN
89°!66°
Thu 6121
91 °171 °
0.10 IN
0 IN
89°167°
Fri 6122
92°170°
0.04 IN
0 IN
Mostly cloudy; humid
89°167°
Sat 6123
92°171 °
0 IN
0 IN
Partly sunny
90°167°
Sun 6124
94°170°
0 IN
0 IN
Mostly sunny; hot, humid
90°167°
Mon 6125
91'/68°
0.1 IN
0 IN
An afternoon thunderstorm
90°167°
Tue 6126
87°165°
0 IN
0 IN
Partly sunny; pleasant
90°168°
Wed 6127
88°170°
0 IN
0 IN
Partly sunny
90°168°
Thu 6128 94°172° 0 IN 0 IN
A thunderstorm possible
90°168°
Fri 6/29 94°173° 0 IN 0 IN
A strong t-storm possible
90°168'
Sat 6130 93°172° 0.04 IN 0 IN
A p.m, t-storm possible
90°168°
May 2018
July 2018 i
Temperature Graph June 2018
Today
t10
100
90
80
70
60
50
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Avg. Hi Avg. Lo Actual Hi Actual Lo - - - -- Forecast Hi - - - -- Forecast Lo
Actual
Normal Departure Record
High
92°
88° 105°(2012)
Low
67°
65° 40°(1971)
Average
79°
76° +3°
Precip
0.36 in
4.35 in -3.99 in
Snow
0 in
1>
httpsalwww,accuweather.comlen/us/concord-ncJ28027/monthll l634_pc?view=table 213

.6122f4M
Concord Month Weather - AccuWeather Forecast for NC 28027
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hftps-1/www.accuweather.com/en/us/concord-nc/280271month/l1634_pc?view=table 313

__1Y J •.
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No, NCG060000
Date submitted 1241 7
CERTIFICATE OF COVERAGE NO. NCG06 0 3 S Z SAMPLE COLLECTION YEAR _ 2017 .
FACILITY NAME S+bCo14-e e, 300 Q4NcQ _park Wolf y-+h FACILITY ACTIVITIES INCLUDE (check all that apply) -
COUNTY ❑ use/process meats fZ use animal fats/byproducts
PERSON COLLECTING SAMPLES OacJ4 IrI.. rt RE�:'JC:M�A�l TO SALTwATERS? ❑YES �NO
LABORATORY i'.�e �►�1..�-1�� � s-r,►.c. Lab Cert. # 5.3Y Z _
OEC 12 Zd 10LEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL. FILE
Part A: Stormwater Benchmarks and Monitoring Results DVAI P ��rpp,,Totol event rainfall �,_ or ❑ No discharge this perioc?
r `.OutfalhNo '"
�„
s Sample Collected,
.. mo/dtl/yr . ,;...::
,: TSS .
mg/L
pH,
Standard units
COD,
mg/L
Hand Grease,
� mg. .,"., . _
Fecal Collformoq .
Colonies`per lOQmljr.).
� .a nterococci -
LCd onles;per.•100.ml ,
Benchmark
100 or 50
Within 6,0 - 9.0
120;
30' +,
4, ,. 1000r"�;
, . ?•„`�: :; .: 50q ..
.Sh00
11 t(,17
g, S
6.5
4 7so
N 5.0
'Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No
Sample Collected,
,sma/dd/yr;.
Oil and Grease,
mg/L -
TSS, ,,
mg/Lv
' pH,,;
Standardiunits ,`
New.MatorgOl Usage,
Annual,average;gal%mo
iBenchmark,
00 or"so
! 6
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
{ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

,-V ,--"
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
_Mall an original and one copy of this DM_R, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge." reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
0'1� �- U/,---,� _ r z 1117
(Signature of Permittee) (Date
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/­wq/­ws/­su/­nodessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

CeAllal cal
December 01, 2017
Sal DiGiovanni
S&D Coffee
300 Concord Pkwy S
Concord, NC 28027
RE: Project: Stormwater Sampling
Pace Project No.. 92364040
Dear Sal ❑iGiovanni:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on November 17, 2017.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
a. "-
Angela Baioni
[e-mail]
[phone]
Project Manager
Endosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 23

CEAlTi?1 cal•
1NWM=PsceJ9b&—
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
Louisiana/NELAP Certification # L4170028
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
Asheville Certification IDS
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
South Carolina Certification #: 99006001
Florida/NELAP Certification #: F87627
Kentucky UST Certification #: 84
VrginiafVELAP Certification #: 460221
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
VirginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 23

CBAlk3I'CaI
*wwPtS.Cam
Project: Stormwater Sampling
Pace Project No.: 92364040
SAMPLE SUMMARY
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)8759092
LAID
Sample ID
Matrix Date Collected
Date Received
92364040001
SD001
Water 1111611714:00
1111711710:11
92364040002
SD002
Water 11/1611714:00
1111711710:11
92364040003
SD003
Water 11/1611714:00
11117/1710:11
92364040004
SD004
Water 11116/1714:00
11/1711710:11
92364040005
SD005
Water 11116/1714:00
11/1711710:11
92364040006
SD006
Water 11116/1714:00
11/17/1710:11
92364040007
SD007
Water 11/1611714:00
11/1711710:11
92364040008
SD008
Water 1111611714:00
11/17/1710:11
92364040009
SD009
Water 11/1611714:00
11 /17117 10:11
92364040010
SD010
Water 11116/1714:00
11117/1710:11
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 3 0123

aceAnalytical
M+rnpaaelaW.carrr
SAMPLE ANALYTE COUNT
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Service's, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
92364040001
SD001
SM 2540D
SLB
1
92364040002
SDO02
SM 2540D
SLB
1
92364040003
SDO03
EPA 9040
KMM
1
92364040004
SDO04
EPA 9040
KMM
1
92364040005
SD005
SM 5220D
SLB
1
92364040006
SDO06
SM 5220D
SLB
1
92364040007
SDO07
EPA 1664B
JMS
1
92364040008
SDO08
EPA1664B
JMS
1
92364040009
SDO09
EPA 1664B
JMS
1
92364040010
SD010
EPA 1664E
.iMS
1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 4 of 23

Pace Analytical Services, LI_C
e_
9800 Kinsey Ave. Suite 100
Huntersville, NC 28078
w4w.pa mm (704)B75-9092
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92364M
Sample: SD001 Lab ID: 92364040001 Collected: 11/16/17 14:00 Received: 11/17/17 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 8.8 mglL 5.0 1 11/22/17 12:42 D6
Date: i 2I0112017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 5 of 23

aceArr* ical'
�pepel�.mm
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: SDO02 Lab ID: 92364040002 Collected: 11/16/17 14:00 Received: 11117117 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 8.9 mglL 3.8 1 11/22/17 12:42
Date: 12/01/2017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 6 of 23

Pace Analytical Services, LLC
• 9800 Kincey Ave. Suite 100
aceAnalyiica! Huntersville, NC 28078
w"Pacalabs [phone]
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92364040
Sample: SD003 Lab ID: 92364040003 Collected: 11/16/17 14:00 Received: 11/17/17 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
9040 pH Analytical Method: EPA9040
pH 6.5 Std. Units 0.10 1 11/20117 23:55 H6
Date: 12/01/2017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 7 of 23

IeAnalytrcal*
www.pacefts com
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Services, LLC
9800 Kinsey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: SD004 Lab ID: 92364040004 Collected; 11/16/17 14:00 Received: 11/17117 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
9040 pH Analytical Method: EPA 9040
PH 6.5 Std. Units 0.10 1 11/20/17 23:55 H6
Date: 12t0112017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 8 of 23

ceAnalyfical
www!I B&CO 1
ANALYTICAL RESULTS
Pate Analytical Services, LLC
9800 Kinsey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Stormwater Sampling
Pace Project No.! 92364040
Sample: SDO05 Lab lD: 92364040005 Collected: 11/16/17 14:00 Received: 11/17/17 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
5220D COD
Chemical Oxygen Demand
Date: 12/01/2017 02:50 PM
Analytical Method: SM 5220D
ND mg1L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
11127/17 11:15
Page 9 of 23

aceAna0ca1
www.p8elab&="
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Service's, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: SDO06 Lab ID: 92364040006 Collected: 11/16117 14:00 Received: 11/17/17 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
5220D COD Analytical Method: SM 5220D
Chemical Oxygen Demand ND mg1L 25.0 1 11/27/17 11:15
Date: 12/01/2017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 10 of 23

ceAnalyticaf
mvw.paelatrtmm
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Stormwater Sampling
Pace Project No.: 92364040
Sample: SDO07 Lab ID: 92364040007 Collected: 11/16/17 14:00 Received: 11/17117 10:11 Matrix: water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664E
Oil and Grease ND mglL 5.0 1 12/01/17 04:35
Date: 12/01/2017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in Cull,
without the written consent of Pace Analytical Services, LLC,
Page 11 of 23

IoAnalyiical
w»reparadabsmm
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Serviced, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: SDO08 Lab ID: 92364040008 Collected: 11/16/17 14:00 Received: 11/17/17 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua]
HEM, Oil and Grease Analytical Method: EPA 1664B
Oil and Grease ND mg1L 5.0 1 12/01/17 04:35
Date: 12/01/2017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 12 of 23

Ail`1lIrV[JI +
trww.pec�abarom
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9B00 Kincey Ave. Suite 100
Huntersville, NC 28o78
[phone]
Project: Stormwater Sampling
Pace Project No.: 92364040
Sample: S0009 Lab ID: 92364040009 Collected: 11/16/17 14:00 Received: 11/17/17 10:11 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664E
Oil and Grease ND mg1L 5.0 1 12/01/17 04:35
Date: 12101/2017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 13 of 23

aceAnaOcal
tirrwpacalmh ="
ANALYTICAL RESULTS
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
Sample: SD010 Lab ID: 92364040010 Collected: 11/16/17 14:00 Received: 11117/17 10:11 Matrix; Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664E
Oil and Grease ND mg1L 5.0 1 12I01117 04:36
Date: 12/01/2017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 14 of 23

(�ICV*Wcale
t ut►--- F F&CM
QUALITY CONTROL DATA
Project: Stormwater Sampling
Pace Project No.: 92364040
OC Batch: 388984 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease
Associated Lab Samples: 92364040007, 92364040008, 92364040009, 92364040010
METHOD BLANK: 2157900 Matrix: Water
Associated Lab Samples: 92364040007, 92364040008, 92364040009, 92364040010
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Oil and Grease mg/L ND 5.0 12/01/17 04:29
Pate Analytical Services, LLC
9800 Kinsey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE:
2157901
Spike LCS
LCS
% Rec
Parameter
Units
Conc. Result
% Rec
Limits
Qualifiers
Oil and Grease
mg/L
40 37.3
93
78-114
MATRIX SPIKE SAMPLE:
2157902
92363758001 Spike
MS
M5
% Rec
Parameter
Units
Result Conc.
Result
% Rec
Limits Qualifiers
Oil and Grease
mg/L
N❑ 40
37.6
93
78-114
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/01/2017 02:50 PM without the written consent of Pace Analytical Services, LLC.
Page 15 of 23

ceAnalyiical'
tuww.pa�ma
QUALITY CONTROL DATA
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 387949 Analysis Method: SM 2540D
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92364040001, 92364040002
METHOD BLANK: 2152330
Matrix: Water
Associated Lab Samples: 92364040001, 92364040002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed
Total Suspended Solids
mg1L
ND
2.5
11/22/17 12:4
LABORATORY CONTROL SAMPLE:
2152331
Spike
LCS
LCS
Parameter
Units
Conc.
Result
% Rec
Total Suspended Solids
mglL
250
244
98
SAMPLE DUPLICATE: 2152332
92364040001
Dup
Parameter
Units
Result
Result
RPD
Total Suspended Solids
mglL
8.8
10.2
15
SAMPLE DUPLICATE: 2152333
92364037001 Dup
Parameter Units Result Result
Total Suspended Solids mg1L ND ND
Qualifiers
% Rec
Limits Qualifiers
90-110
Max
RPD Qualifiers
5 D6
Max
RPD RPD Qualifiers
5
Results presented on this page are In the units indicated by the "units" column except where an alternate unit is presented to the right of the resuiL
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/01/2017 02:50 PM without the written consent of Pace Analytical Services, LLC. Page 16 of 23

7
eAnalytical cl
wrtrpaodabs.tam
QUALITY CONTROL DATA
Project: Stormwater Sampling
Pace Project No.: 92364040
QC Batch: 387716 Analysis Method: EPA 9040
QC Batch Method: EPA9040 Analysis Description: 9040 pH
Associated Lab Samples: 92364040003, 92364040004
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE DUPLICATE: 2151045
92364040003 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
pH Std. Units 6.5 6.5 0 9 H6
Results presented on this page are In the units indicated by the "Emits" column except where an alternate unit Is presented to the right of the resu1L
REPORT OF LABORATORY ANALYSIS
This report shall not tx reproduced, except in full,
Dale: 12/01/2017 02:50 PM without the written consent of Pace Analytical Services, LLC. Page 17 of 23

aceftlytical'
wrn►:pa[aGaba.nam
Project: Stormwater Sampling
Pace Project No.: 92364040
QC Batch: 388201
QC Batch Method: SM 5220D
Associated Lab Samples: 92364040005, 92364040006
METHOD BLANK: 2153870
Associated Lab Samples: 92364040005, 92364040006
Parameter Units
Chemical Oxygen Demand mglL
QUALITY CONTROL DATA
Analysis Method; SM 5220D
Analysis Description: 5220D COD
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
NO 25.0 11127/1711:15
Pace Analytical Services`, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 2153871
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mglL 750 761 101 90-110
MATRIX SPIKE S MATRIX SPIKE DUPLICATE: 2153872 2153873
MS MSD
92364276001 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conc, Conc. Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg1L 2330 100 100 1700 1790 -628 -538 90-110 5 3 M1,R1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2153874 2153875
MS MSD
92363780001 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conc, Conc. Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg1L 151 100 100 151 149 0 -2 90-110 1 3 M1
Results presented on this page are in the units indicated by the "ilnits" column except where an altemate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
Date: 12/01/2017 02:50 PM without the written consent of Pace Analytical Services, LLC.
Page 18 of 23

CA MIS
ww4►.Pcarrr
QUALIFIERS
Project: Stormwater Sampling
Pace Project No.: 92364040
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL-Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit.
Pace Analytical Services, LLC
9B00 Kinsey Ave. Suite 100
Huntersville, NC 28078
[phone]
S - Surrogate
i,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each anatyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Get - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAG Institute.
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
H6 Analysis initiated outside of the 15 minute EPA required holding time.
M 1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery,
R1 RPD value was outside control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/01/2017 02:50 PM without the written consent of Pace Analytical Services, LLC. Page 19 of 23

ceAnalytical
Mwwpeped�At,cam
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Stormwater Sampling
Pace Project No.: 92364040
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Nuntersville, NC 28078
[phone]
Lab ID Sample ID QC Batch Method QC Batch Analytical Method
92364040007
SDO07
EPA1664B
388984
92364040008
SDO08
EPA 1664B
388984
92364040009
SDO09
EPA 1664E
388984
92364040010
SD010
EPA1664B
388984
92364040001
SD001
SM 2540D
387949
92364040002
SDO02
SM 2540D
387949
92364040003
SDO03
EPA9040
387716
92364040004
SD004
EPA 9040
387716
92364040005
SD005
SM 5220D
388201
92364040006
SDO06
SM 52200
388201
Date: 1210112017 02:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Analytical
Batch
Page 20 of 23

Document Name:
Document Revised: August 4, 2017
2CCAnafyfical"
Sample Condition Upon Recel t(SCUR
Page 1 of 2
r
Document No.:
Issuing Authority:
j
F-CAR-CS-033-Reu.04
Pace Quality Office
Laboratory receiving samples:
/
Asheville ❑ Eden❑ Greenwood ❑
Huntersville Q Raleigh❑ Mechanicsville[]
Sample • ClientNa
�
Project M•IWO#:92364040
Courier. QFed Ex -❑UPS ❑USPS
❑Client
❑ Commercial ❑Pace ❑Other:
82364040
l
Custody Seal Present? ❑Yes 0-no Seals Intact? ❑Yes
❑No
rs
Date/Inhleh Peron Faam[nbrg Cantu: fy� I VA,
Packing Material: []Bubble Wrap "]Bubble Bags ❑None
❑ Other Blaloglcal Tissue F en?
Therrnornet ,- uwet
[a Gun [O: �,
❑Blue ❑None ❑Yes ❑No N/A
Type of Ice:
Correction Factor: Cooler Temp Corrected {•cj: i'
Temp should be above freezing to 6•C
❑Samples out of temp criteria. samples on ice, cooling process
USDA Regulated ((2 NJA, water sample)
has begun
Solt
Did samples odg Kate in a quarantine zone within the United States: CA, NY, or SC Icheck maps)? Old samples orlenate from a foreign source (internationally,
rises Milo
includirur Hawaii and Puerto Rim)? rites FIrlo
Comments/D ancy:
Chain of Custody Present?
E Yes
No
N A
1
Samples Arrived within Hold lime?
, Yes
Na
FI A
2.
Short Hold Time A is 1<72 hr.)?
Yes
[]No
sr/A
3.
Rush Turn Around lime Requested?
Qyes
�Na
N/A
4.
5uffidentVolume7
EfY
[]NO
N/A
S.
Correct Containers Used?
-Pace Containers Used?
Yes
Yes
❑No
No
❑N/A
N A
6.
Containers intact?
by'.
0m.
N /1
7.
Dissolved anal cis: Samples Field Filtered?
es
No
Q n A
g.
Sample Labels Match COC?
-includes Date/Time/ID/Ana h Matrix:
Yes
Y�
❑No
❑N/A
9.
Heads ace In VOA Vials (>5 6mm 7
Yes
N
N/A
10,
Trip Blank Present?
TripBlank Custody Seals Present?
Dyes
Yes
ErNo
Na
/
;N/A
11.
CLIENT 1111071FICATION/RESOLUT[ON
Person Contacted: Datefrime:
Comments/Sample Discrepancy:
Field Data Required? ❑Yes [:]No
Lot ID of split Containers:
Project Manager SCURF Review: fate: {—,,//��',r}
Project Manager SRF Review Date: 1 I ' � lil 1' E
Note: whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DPHNII Certification Office (i.e.
Out of hold, Incorrect preservative, outof temp, incorrect containers)
Page 21 of 23

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9P1U-1 liter Plastic Unpreserved (N/A)
6P4S-125 mL Plastic H2504 (pH < 2) (Cl-)
BPSN-2S0 ml plastic HNO3 IPH < 2)
GRZ-125 mL Plastic ZN Acetate & NaOH (2-9)
8P4C-12S mL. Plastic NaOH (PH:- 12) (CI-)
WGFU-WIde-marthed Glass Jar Unpreserved
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AG3S-2S0 mL Amber H2504 (pH <2)
AG3A(DG3ARS0 mL Amber NH4C1 IN/A)(CI-)
DGSH-40 mL VOA HC1 (NIA)
VG9T40 mL VOA Na2S203 (N/A)
VG9U-40 mL VOA Unp IN/A)
D69P-40 mL VOA H3PO4 (N/A)
VOAK (6 vials per kit)-5035 kit IN/A)
V/GK (3 vials per kit)-VPH/Gas kit (N/A)
SP5T-i25 mLSterile Plastic IN/A—tab)
SPZT-2SO ML Sterile Plastic (N/A —tab)
BP3A-2S0 mL Ptastic(NH2)2SO4 (9.3-9.7)
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CHAIN -OF -CUSTODY 1 Analytical Request Document
The Chaln-of-Custody is a LEGAL DOCUMENT. All relevant fields must be completed accun
Section A Section B Section C
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SEMIANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted O io 12-1 /2-01-4-
CERTIFICATE OF COVERAGE NO. NCG06 a 3 5 2
FACILITY NAME S8D Coffee. 300 Concord Parkway South.
COUNTY Cabarrus
PERSON COLLECTING SAMPLES MoAK r-%SGL
LABORATORY PACE &1'J"TtCAL Lab Cert. # 534L-
5ef�'+«s
Part A: Stormwater Benchmarks and Monitoring Results
R CEIVSD
JON 23 (li%
GEN7RgL FILE
SAMPLE COLLECTION YEAR Zola DWR'SECS
7lO►V
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats 0 use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ❑x NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 0.0 or ❑ No discharge this period"
Outfall'No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
011 and Grease,
mg/L
Fecal Coliform ,
Colonies per 10D ml
Enterococci ,
Colonies per 100 ml
,Benchmark
-
100 ar 50
Within 6.0-9.0
120
30
1000
Soo
SDo 001
Q(p I IS I 1
13e to
7.0
61
ND
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge,
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes 0 no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No,
Sample Collected;
mo/dd/yr.
OiFand Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New. Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any, outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
5WU-249 Last Revised: October 18, 2012
Page l of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Ii SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitaring period in the case o "No Dischar e" reports to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
co /Z I 121D 1-4-
(Date)
Additional copies of this form may be downloaded at: http:/Zportal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 6 - 30- ► 5
CERTIFICATE OF COVERAGE NO. N0006D I
FACILITY NAME S 90 I K C. �y fs4,cor_d 1k
COUNTY _ 41—✓✓-5
PERSON COLLECTING SAMPLES to A-e- I
LABORATORY&,4 Lab Cert. # �4;/-*
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR D 15
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? []YES. [ NCI
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 or [� No discharge this period3
Outfall No.
500-01
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L .
Oil and Grease,
mg/L
Fecal Coliformi,
Colonies per 100.ml
Enterococci
Colonies per 100 MI.
Benchmark
-
100 or 50°
Within 6.0 — 9.0
120
30
1000
500
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/,mo
Benchmark
-
30
100 or 50
6.0 - 9.0
-
Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ifyes, complete Part B)
;D
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S W U-249
Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
1
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case of "No Discharge" reports) to:
t.
N Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"i certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
C/,O --?d-15
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.oriz/weblwq/ws/su/npdessw#tab-4
4
S WU-249
Last Revised: October 18, 2012
Page 2 of 2

The Perfect Blend of Quality and Service
June 30, 2015
Division of Water Quality
ATTN: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Reference: AD Coffee, Inc.
300 Concord Parkway S.
Concord, North Carolina 28027
2014 Semi -Annual Stormwater Discharge Monitoring Report
Certificate of Coverage No. NCG060352
Please find enclosed the two copies of the 2014 Semi -Annual Stormwater Discharge Monitoring
Report for the S&D Coffee, Inc. (S&D) facility at 300 Concord Parkway S., Concord, North
Carolina 28027. There were no rainfall events this period that met the
requirements/procedures for sampling due to normal operating hours, previous events being
too recent to current event (72 hours), no discharge, or safety of personnel sampling during
event. We hope to have an event meeting requirements during second half of this year for
submittal.
If you have any questions concerning this submittal please feel free to contact me at (704) 782-
3121 ([e-mail]).
John F. Weibel
Environmental Systems Program Manager
Enclosure
300* oncord Parkway S. • Concord, NC 28027-9030.800.933.2210.800.950.4378 (far) • www.sndcoffee.com
a

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted J �,Ay ! ij
CERTIFICATE OF COVERAGE NO. NCG06Q 3 5
FACILITY NAME Sir o it c. v% Wd 6mowJ to -
COUNTY 6thwvy-v5
PERSON COLLECTING SAMPLES JeJ� WLibt- I
LABORATORY ec- I-, 6 s Lab Cert. # 7;L ;L 2 177 Y
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2 D � �—]
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES [4NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
RECEIVED
JAN U 5 2015
CENTRAL FILES
DWR SECTION
Total event rainfall 2 • $ -- or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
'Fecal Coliform ,
Colonies per 100 m!
Enterococci ", .. •
Colonies per 100-m1
Benchmark
- -
100 or 50
Within 6.0 = 9.0
120
30
1000
500
I /V.
7
6.71
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? [] yes Ej no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfal! No:
-
Sample Collected, :
mo/cid/yr ..'.
Oil and Grease,
mg/L
TSS,
mg/L
;pH _
y Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark-
-
30'
100 or 50
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 for sampling periods with no discharge at 2ny outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies,
own=
r"
(ice complete Part B)
1'0
M4
SWU-249 Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy_ of this DMR, including all "No Discharge" reports, within 30 days of
receipt of the lob results for at end of
monitoring eriod in the case of "No Discharge" reports to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather'and"evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
r
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at: http:/Zportal.ncdenr.org/web/wcl/­wslsuZnpdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

t
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECLZ/
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted Tune 23, 2014 VED
JUG 0 2 1014
CERTIFICATE OF COVERAGE NO. NCG06 0 3 5 2 SAMPLE COLLECTION YEAR 2014 CEN
FACILITY NAME S&D Coffee, Inc.-300 Concord Parkway S. FACILITY ACTIVITIES INCLUDE (check all that apply): bwaigALES
COUNTY Cabarrus ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES John F. Weibel DISCHARGING TO SALTWATERS? []YES ONO
LABORATORY Pace Analytical Services, Inc. Lab Cert. # 5342 Y .
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall 1 2.5" or ❑ No discharge this period'
....�•
n ti < 8
Outfall''Na:
;atir ,>
,e E¢v,.[h�Eh he :. ... :..:.f.,...o Eit� E
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Fecal Coliform ,
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30
^: -@ r, "v !.. i, t --
1000: ';.';,i.'
E r E '=E '� ;N •. i" �"3:'s
' E u� °.' 1' ` 50D�g i€. 'jti;:�li!
05 14/ 14
461 m L
7.03
76.0 m /L
ND m /L
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any, outfalls. You must still submit this discharge monitoring report with a checkmark here.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
"piKOWNII.NoEill'if,l
'1? Sample Collected;
dd...
Oil'and Grease,
,m..:
TSS
'H '
Standard
New Motor OilLb usage;
a Anridahaveiage-gal/mo,;
100or50
6.0-9U
s };s_ u.
'Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an on inal and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results Lor at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at: http://r)ortal.ncdenr.org/web/wq/ws/suZnpdesswtitab-4
JIVU-249 Last Revised: October 18, 2012
Page 2 of 2

'SUr'
The Perfect Blend of Quality and Service
June 27, 2014
Division of Water Quality
Attention: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Reference: S&D Coffee, Inc.
300 Concord Parkway S.
Concord, North Carolina 28027
2014 Semi -Annual Stormwater Discharge Monitoring Report
Certificate of Coverage No. NCG060352
Dear Sir or Madam,
Please find enclosed one original and one copy of the 2014 Semi -Annual Stormwater Discharge
Monitoring Report for the S&D Coffee, Inc. facility at 300 Concord Parkway S., Concord, North
Carolina 28027.
If you have any questions concerning this submittal please feel free to contact me at (704) 782-
3121 ([e-mail]).
Sin
<24
John F. Weibel
Environmental Systems Program Manager
Enclosure
It
300 Concord Parkway S. • Concord, NC 28027-9030.800.933.2210.800.950.4378 (fax) • www.sndcoffee.com

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted a 61 (.0
j"
CERTIFICATE OF COVERAGE NO. NCG06 c s i; 2
FACILITY NAME S&D Coffee, 300 Concord Parkway South.
COUNTY Cabarrus
PERSON COLLECTING SAMPLES
LABORATORY wtc- }4&1P-VW"8Lab Cert. # 639;L
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR aQ 16
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats [E use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ❑x NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall Z • a or ❑ No discharge this period'
Outfall;No
.
Sample Collected,
mo/,dd/yr.
TSS,
�mg/L
pH;
Standard units-
COD,
m L :-
Oil and Grease,
7' ...mg%l
Fecal Coliform ;
,Colonies per,100tm1
Enterococcr:,
.Colonies:per`.`100,m1�:+
Benchmark
-
100 or 50 ''.
.Within 6:0 - 9.0;
120
SDO 001
-
W w.45
a
1 Only applies to facilities that use/process meats. L�
ZThe total precipitation must be recorded using data from an on -site rain gauge. 0WRSECTION
3 For.sampling periods with no discharge at anyoutfalls. You must still submit this discharge monitoring report with a ��iKa�klld�'fOCESSING UNIT
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes X1 no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No
-Sample Collected, "
mo/dd/yr
Oil and Grease,
mg/L'
TSS,
mg/ .
pH,
Standard'units..: ,
NewaMotor`Oil Usage; Wa
, Annual.a�erage'gaE/mo as
Benchmark
_
30
100 0r,50
6:0',-
„....
Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge. ;
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(jigs complete Part B)
SWU-249 Last Revised: October 18, 2012
Dana 1 nr'7

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
# 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO Z
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate thq 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)
5/ 3//6
(Date)
Additional copies of this form may be downloaded at: htt : ./portal.ncdenr.ora/web/`wq/ws/su/­nodessw#tab-4
S W U-249
Last Revised: October 18, 2412
nano'7 nr 1)