NCG100188_MONITORING INFO_20161229

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
B-MONITORING REPORTS
DOC DATE
❑ a 0( � /a a-
YYYYMMDD

CERTIFICATE OF COVERAGE'NO. NCG200 I y
Bra 4-1k ers M� �••�
FACILITY NAME
PERSON COLLECTING,SAMP.LE(S) _ I G.rn . n QRh
CERTIFIED LABORATORY(S) ,PAC A iJ, Pc: ScCylce 7
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
SAMPLES COLLECTED DURING CALENDAR YEAR: 2 16,
(This monitoring report shall be received by the Division no later than 30 Olys
from the date the facility receives the sampling results from the laboratory)
COUNTY .
PHONE NO. { -A'4 1, 3,9 3- 7 6.
Lab # PLEASE REMEMBER TO SIGN ON THE REVERSE 4
A
Part A: Stormwater Benchmarks and Monitoring Results4k&
For sampling periods with no discharge, you must submit :this discharge mo rt f noting "No Flow' or "No Discharge" within
30 days of the end of that period'to comply with permit re rting requirements.
-
� _ $
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,
.1.^a ,.t'..:, Via..
� 1-'1--{n..��`.
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-'Y �:..=A1.. .ir dad•-�"+��P_ $?
=MtV_"-
l�.a w�'� y,�y
w�a.-�� -`=i
r.tr�!`:0`='��r �^. .�
tl=.•- mom
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier.1 or Tier 2-responses in the General
Permit.
;See If pH values outside this range are recorded in'sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this
benchmark range is the pH of the preclpitationlwithin instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be
documented to demonstrate_ background. concentrations. were below the benchmark pH range of 6-9.
2See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, last revised October25, 2012
Page 1 of 2
%W

STORMWATER DISCHARGE OUTFALL {SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. The solvent
management plan shall include a list of the total toxic organic compounds used.and the other elements listed in the'General Permit. For those facilities allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan Certification Statement
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I
certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater•orareas which -are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
Title (Print title)
kAt4-1-��
Signa ure
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
;Date
"I, certify, under penalty,of law, that this document'and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel,properly gather and evaluate the information'submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly re"sponsiible 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 Designee)
DI - 1�-a— t-
(Date)
r
Form SWU-251, last revised October 25, 2012
Page 2of2

�ICDE�R
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. hU, //nortal.ncden i arg/web/wil/ws/sufnpde55W#tab-I
Permit No.: or Certificate of Coverage o,: hj1j;1.j/_L/_Q/ 21J /1/_Z/
Facility Name: J_.k.44C, 15(14-us Hi4,-- 1;-& • 11A Poxn Lzk LL(-n Osjs
County: L Phone No. (-7 0tj) 3 R - -7 06U
Inspector: FULDCOHEIVED
Date of Inspection: - _ 12 —fig - t b _ - .1
Time of Inspection: J su S PA-, _._ FEB 0 3 207/
Total Event Precipitation inches :� I • a''C:•; n CENTRAL FILES
p (� � bWR SECTION
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
9Yes No coPl
Please verify whether Qualitati I oring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring-tequirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However, {
i some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is'a storm event that measures greater than 0.1 inches of rainfall #
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event'may contain up to 10 consecutive hours of no
! precipitation.
A "measurable storm event" is a storm event that results in an actual discharge -from the -
permitted site outfall. The previous measrifabIre storm "event must'have'be6ri at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
SWU-242, Last MDdified 10/25/2012
r

E `
I. Outfall Description:
Outfall No. JL Structure (pipe, ditch, etc.) P fee -V J'
Receiving Stream: C �Pp r �'• w fi'+ + _ `_'
Describe the industrial activities that occurtwithin the butfall.drainage. area: tAS-d ti L4
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: . Se ram".
•:,
>,r
3. Odor: Describe any distinct odors that the discharge may have (i.e,, smells strongly of oil,
weak chlorine odor, etc.): ►'14 r-, e,_ _ _
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface..covered with floating solids:
1 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
7.
8.
9.
10.
1 3 4
Is there any foam in the stormwater discharge?
Is there an oil sheen in the stormwater discharge?
5
Yes No
Yes No
Is there evidence of erosion or deposition at the outfall?
Other Obvious Indicators of Stormwater. Pollution:
List and describe
Yes No
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

STORMWATER DISCHARGE OUTFALL (SOO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100 i
Lk c r y
FACILITY NAME d 6,, Dvkv, V-te), A ­�A-0 Qf-r 4 T
PERSON COLLECTING; SAMFLE(S)
CERTIFIED LABORATORY(S) Qr�-z a P,, t L=c.! sec;cr =.k- Lab # 2
SAMPLE& COLLECTED DURING CALENDAR YEAR: -z D 6
(This monitoring report shall be received by the Division no later than 30 days
from the date the facility receives the sampling results fro"KW; aboratary.)
mzs�
COUNTY &J-x
PHONE NO. •7 oaf „3 S 3` 7 0 6 cq
-rn
Lab # PLEASE REMEMBER TO SIGN ON THE REVER
Part A: Stormwater Benchmarks and Monitoring Results 0
For sanipling periods with no discharge, you must submit this -discharge monitoring form noting "No Flow" or "No Discharge" with
30 days of the end of that periddlb comply with'permit reporting requirements.
I I I .S--3-/6 10.�_-4V 11;.-7 1 0,-n./1 - l O L2 I oi"'i/L
Note: If you report a sampled value in excess of the�benchmark value, or outside the benchmark range for pH, you must implement Tiers' or Tier 2 responses in the General
Permit.
1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this
benchmark range is the pK of the precipitation (within instrument accuracy) instead'of 6 S.U. Readings from an on -site or local rain gauge (or Total precipitation data) must be
documented to demonstrate background concentrations. were below the benchmark pH range of 6-9.
ZSee General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, last revised October 25, 2012
Page 1 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may.request that DWQ waive monitoring of total toxic organics. The solvent
management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan Certification Statement
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTo), I
certify that to'the hest 11 of my knawledge:aPd'belief, no dumping of concentrated toxic organics into the stormwater...or areas,Whicli,are.exposed'to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
Li e" 3)nAN
Name (Print name)
e s ; 41
Title (Print title)
Signature ^
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date
"I certify, under penalty,of law, that this document'and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure.that qualified personnel.properly-gather and evaluate the Information submitted. Based on my inquiry _ofithe 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 informations, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee or Designee)
.�-- -z J - /6
(Date)
Form SWU-251, lost revised October 25, 2012
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100 _L j _ SAMPLES COLLECTED DURING CALENDAR YEAR: 0) '
(This monitoring reportshall be received by the Division no later than 30 days
Lwc�I
1zro �-1•,e-Ts M o Jr&a �,��. from the date the facility receives the sampling results from the laboratory.)
FACILITY
L; I9a.c V i
PERSON COLLECTING,SAMPLE(S) W Crl\ _. T70 )It A.) _
CERTIFIED LABORATORY(S)&(,t 4 rraT J �erxW Lab #_1.L
S� Lab #
Part A: Stormwater Benchmarks and Monitoring Results
DEC 2 9 2015 ._
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION
For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge" within
30 days of the end of that period fa Eomply with'permit reporting requirements.
Outfafl "
•.
No"
F_
:� Date
I
Sam'ple [ollected
LL rRo .dd ear "
I. !y
g.
.5 .. "'}�tr'�
s : e q
i �3-.,
E " Tota3
-Rainfall'
inches
q-.��'-'C' -u-�
0040©g'
`. •�%�F
•.-: - _ ^'t'
2 T+-+� ai✓..:M�.r_n
_ _ _ _!
F _ . . ..
pH; ,.
� Standard
Units
..
Totai�Susp Tded
- SolldsO&G
(TSS),
'm� `°
'Yez+'Mt�R�'Fll
Non -polar ' �0
,(Method 16fi4'x�
N
RAI
"'W T
'Eifiylene Glytol,+ ``
L
a
+..fr-.
k ea'd, Total
R overatile`�
mR/
r,
.4i :�'k.-..3�: -'..A"
T IrToxet
:,Orgamtst,
mg/L
✓-x3C�''-i,y
ONCE,ark .._:
q+..
��F•.e:�
,.., 50�
x:� : e a�'r''... �. .t'--
2 .:15
/{�t�
e�'= r-• :,, _-.4 .r..�
VVS7?=
;.
.<
dz3aaa3
e.,_ .°i;Ters2an )
.L ax
.
N r t
' 3
�, _ �A n."
t
�1 0-zoIf'
V, ,7
C,0
o m L_t2M
A
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier Por Tier 2-responses in the General
Permit.
ISee If pH values outside this range are recorded in sampled Stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this
benchmark range.is the pH of the precipitation, (with in instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be
documented to demonstrate,background concentrations were below the benchmark pH range of 6-9.
zsee General Permit text to identify whetherthe more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table it of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, Iasi revised October 25, 2012
Page 1 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention.Plan may request that DWQ waive monitoring of total toxic organics. The solvent
management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan Certification Statement
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I
certify that td the best of my knowledge and belief, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed`to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify tliat this facility is implementing allthe provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
L-I e w) 4 A�rJ
Name (Print name)
1pre,5 , P e e) -�
Title (Print title)
1Z-21-IS-
Signature Date
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document' and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief; true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee or Designee)
(Date)
Form SWU-251, last revised October 25, 2012
Page 2of2

FA
t air.ROF
Stormwater Discliarge Uutfall (SDO).
Qualitative Monitoring Report
For guidance on filling out this form, please visit. hUV:U-porW.ncdenr.org/web/wq/ws/sUinpde55w#tab-4
Permit No.: or Certificate of Coverage No.:
Facility Name: Ltitr, 2(`9 ~5 Eni-m.t" "2wc Pni.,., LA5L55 AL,," J? #EC
County: Phone No zL q 0 f; u
-Date of Inspection: ! 1- 30 —1 C _
Time of Inspection: 3 i l fg tz:7
Total Event Precipitation (inches): - /
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
R Yes ❑ No
r
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring req'uirem` ' is vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is'a storm event that measures greater than 0.1 inches of rainfall"
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10'c6n'secutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous me5s6fa61e storm event must -have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Pagel of 2
5WU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. Structure (pipe, i e 'ditch; etc.) n
Receiving Stream: Cry ''GC�CC l C
Describe the industrial activities that occurwithin th'e outfall drainage -area: fit, _S e� A _1.,�
2. Color: Describe the color of the discharge using basic colors (reel, brown, blue, etc.) ,arid tint
(light, medium, dark) as descriptors: a ,C
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of.oil, .
weak chlorine odor, etc.): _ n D 0 C
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 3' -4 s ,
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1= 3 4 5.
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
3 4 S
7: Is there any foam in the stormwater discharge? Yes. �c
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes oNo F
10. Other Obvious.I-ndicators of Stormwater Pollution:
,. . ' ' 'c •,�,i ,tint, � ,
List and describe, p) C?-�
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

�t
�iWIWI
NODE SIR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: ! cde r w w u ## -
Permit No.: or Certificate bf Coverage No.: 1/ U/j/ 1 / _&/_f/
Facility Name: L d.LKj -PokV, Use's &..chc
County:
Inspector:
�f• ���ri �r1�_ Phone No.
Date of Inspection: Iv 36 -1 r- _
Time of Inspection:
Total Event Precipitation (inches): 1 • M i h
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
R Yes. ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
j permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Pagel of 2
SWU•242, Last modified 10/25/2012

I. - Outfall Description: r
Outfall No. 1' Structure (pipe, ditch, etc.) _Dreg --,an
Receiving Stream: C
Describe the industrial activities that occur within the outfall drainage area: K S 4-1 L-0 u-
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): i T o o e
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 (9 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 a 3 4 5
7. Is there any foam in the stormwater discharge? Yes
B. Is there an all sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes ro)
10. Other Obvious Indicators of Stormwater Pollution:
List and describe Q in
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5WU-242, Last modiftted 10/25/2012