NCG030440_MONITORING INFO_20190107

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV C('j ()3o`Iyti
DOC TYPE
El HISTORICAL FILE
N MONITORING REPORTS
DOC DATE
❑ (:� t)I7 nI () "7
YYYYMMDD

Semi-annual Stormwater Discharge MonitoringReport
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted % - 7 - a 019
CERTIFICATE OF COVERAGE NO. NCG03 0 _
FACILITY NAME -_Tra�-e_A1L A
COUNTY '?CA
PERSON COLLECTING SAMPLES 3UIJ IAI�n�
LABORATORY Pme A-N� -r- (, L.ab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR ' W q
SAMPLE PERIOD ❑ Jan -June EFTuly-Dec
FX1ECP FQ or El Monthly'. (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
SAS 9 NIS ❑Zero -flow ❑Water Supply [:]SA
[Other C.
owns c�loN
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 4 -�
❑ No dischorge this period?2
Outfall No.
Date
Sample
Collected'
mm/dd/yr
24-hour rainfall
amount,
lnches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics;
Benchmarks
-
-
100 mg/L or 50 mg/L°
6.0 — 9.0
0.040mg/L
0.0.25rng/L
O4)jAApmg/L
15 mg/L
1 mg/L
p;,t�at1001
I -1 -Ig$3,(0
�,45
,0l�3
d.n
,orgy
d.C)
rr1
(� J -FA 1I op),
—l�f-/$
.
133
05-
10131
1 0.0
16 79A
010
N
1 Monthly sampli ng (i nstead of semi-annual) must begi n with the second consecutive benchmark exceed ance forthe same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring reportwith a
checkmark here.
3 The total precipitationmust berecordedusingdata fromanon-site rain gauge. Unatte nde d si tes may be e I i gi ble f o r a waive r of the rai n
gauge requirement.

4 See General Permit, Table 3identifyingthee speciallysensitivereceivingwaterclassificationswherethe more protective benchmark
applies.
s Total Toxic Organics sampling is applicable only for those faci Iities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines forthe facility subjectto the requirementto sample (for metal finishing use the definition
as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture
use the definition as found in 40 CFR469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement
for total toxic organics (TTO) monitoring maybe waived. The solvent management plan shall include a list of the total toxic organic
compounds used and the otherelements listed in the General Permit. Forthosefacilities electingtoemploy the TTO monitoring waiver,the
discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible forma nagingcompli a nce with the permit monitoring requirement for TTO,
certify that to 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 sincefilingthe lastdischarge monitoring report. I further certify that this facilityis implementingthe
all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Printname)
i ACI F
Title (Printtitle)
1/2
(Sign 4Xfr (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar
non-numericalformat. When results are below the applicable limits, they must be reported in the format, "<XX mg/L" where XX is the
numerical value of the detection limit, reporting limit, etc. in mg/L.

Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Trer 3 responses. See General Permit
text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
mm/dd/yrj
24-hour rainfall
amount.
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)Total
Suspended Solids
pH
Benchmarks =>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotesfrom Part A also apply to this Part B
* See General Permit text, Table5, identifyingthe especiallysensitivereceivingwater classificationswhere the more protectivebench markapplies.
Note: If you report a sample valuein excess of the benchmark, you must implement Ter 1, Trer2, or Tier 3 responses. See General Permit
text
FOR PART AAND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART I SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME 0UTFALL 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 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, North Carolina 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 accordancewith a
system designed to assurethat qualified personnel properlygather and evaluatethe information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible forgatheringthe 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 submittingfalse information, includingthe
possibilityof fines and imprisonmentfor knowing violations."
(Signature of Permittee)
/ — .;?.3- /9_
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 5_A0 / S
CERTIFICATE OF COVERAGE NO. NCG03 U
FACILITY NAME (+► a.., ae) — ^� : �•'t
COUNTY puk V—
PERSON COLLECTING SAMPLES 30 )A w^J
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR ) D' 8
SAMPLE PERIOD ❑ Jan -June July-tDec
����� or ❑'Monthly' Pr; 1 (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
MAY 2 2 2018 ❑zero -flow ❑Water Supply ❑SA
[]Other G
CENTf�AL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
No discharge this period?Z
Date
24-hour rainfall
Total Suspended
pH,
Non -Polar O&G/
Total
Outfall No.
Sample
amount,
Solids
Standard
Copper
lead
Zinc
Total Petroleum
Toxic
Collected'
Inches;
units
Hydrocarbons
Organics'
(mo/dd/yr)
Benchmarks
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
pu+F 1) oo r
- 3-18
. `7
0, v
. 85
D, 0
0. 0
, 05&
0, a
,,.31,E
Pe.t-l0J*FAl) 00I
- -1$
.)
0,0
("40
0,0
010
.0K3
010
0IA-
bo+FA 0 00
-/g
3J
310
is
0.0
0.0
► o3,i1
0.0
tjIA .
tJ" 0JWAI1 001
- -I9
yls
. 65
0,0
0,0
' 055
O.o
IA
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
' See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
R-ep.
Title (Print title)
9
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?Z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inche53
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART It 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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REG ONAL OFFICE? YES NO
REGIONAL OFFICE CONTACT NAME: �1k�7�
Mail an oriainal and one coov of this DMR, includina all "No Discharae" revorts, within 30 days of receipt of the lab results for at end of
monitoring period in the case o "No Dischar e" Marts) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

�t f
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
impris ent for knowing violations."
(Signature of Permittee)
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted L%—; 6 _) of g
CERTIFICATE OF COVERAGE NO. NCG03 U D
FACILITY NAME I thN _, StCa- f _ -f ry o .r e/ Q �itG•!!F
COUNTY _ POt LL
PERSON COLLECTING SAMPLES 36b���`
LABORATORY PA cc
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR .2 (2) q
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
RECEIVED or ['Monthly'_ Mile-H _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
APR 3 0 2018 ❑Zero -flow ❑Water Supply ❑SA
[Other C
uVI R ,`3ECTION1 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?Z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/V
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
Ov4 FA i 1 0o l
3 -1-Pig
?5�
s.
Cam. 97
v. o
0.0
, 09s1
0,0
l
00Ii l oo)�
3-/40) g
,'75
9.0
D.)
0.0
, 0(193
0.0
/1i,4
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
--s-0 S )Awe
Name (Print e) n
Fltc, ) 1 4 y
Title (Print title)
Ll�D4
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX me/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
!Vote: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inchesj
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L':
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULT5:
• 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 ANY ONE OUTFALL? YES Q NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [TNO ❑
REGIONAL OFFICE CONTACT NAME: �A �De,.s ,44A_')S6,-I , _S14h w,jA
Mail an odainal and one copv 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, North Carolina 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)
�zo /e-)
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted //-.20_ .� o ) 9
CERTIFICATE OF COVERAGE NO. NCG03 0 1 1-/ 0
FACILITY NAME - 7c,., o�-s Pea IC FAc%) I -\
COUNTY V011L
PERSON COLL CTING SAMPLES
LABORATORY!\ r-c- Rr°1 ! _A+z_A j _ Lab Cert. # _
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR '2 0 ) 8
SAMPLE PERIOD ❑ Jan -June ❑ Jul -Dec
or amonthly' r< f v Ar month
DISCHARGING TO CLASS ❑ORW ❑HQW Trout ❑PNA
Zero -flow ❑Water Supply [:]SARECEIVED
Other C
APR 3 0 2018 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENI'tiAL, FliES
D+Nib S"..�IOt,f
No discharge this period?z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organicss
Benchmarks
_
-
100 mg/L or s0 mg10
6.0 - 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
is mg/L
i mg/L
u4FAI 60
-�-18
�, y0
D.o
+'�. $
,o��
0,0
.13q
D,D
tj
vTFA1) 00)
- -A
J,qo
15,1
/
010
010
D3W
0,D
NIA
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the stormwater Pollution Prevention Plan."
nD,\ SQ IA i,.r �► __ _
Name (Print n )
Fri L_1; A
Title (Print title)
(Signatu a (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX me/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

t
n
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharge this Deriod?2
Outfall No.
Date Sample
Collected'
Imo/dd/yrj
24-hour rainfall
amount,
Inches'
Nan -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 P-9
REGIONAL OFFICE CONTACT NAME: LAW Da.j N vA)Sb�4 , S1 IA4.%OW AIf
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, North Carolina 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
impa�onment for knowing violations."
re of Permittee)
(Date)

l
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Ruality General Permit No. NCG030000
Date submitted - - 9019
CERTIFICATE OF COVERAGE NO. NCG03 O q 0
FACILITY NAMETS�C/ —
COUNTY ' PrnlTr!ja,j 10,AC F4 G 1r f 4
PERSON COLLECTING SAMPLES _'�oD AW I J
LABORATORY c. a A,,,-k, oc.E I Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR � 0
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
RECEIVED or PMonthly' UAr month
DISCHARGING TO CLASS ❑ORW ❑HQW Trout ❑PNA
FEB 15 2018 ❑Zero -flow ❑Water Supply ❑SA
CENTRAL FILES []"Other L
DWR SECTION PLEASE.REMEMBER TO SIGN ON PAGES Z AND/OR 3 4
❑ No discharge this period:2
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount
Inches3
total Suspended
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/L"
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
0,-0T-rA 001
1-0-/9
5-
Sj?
0.0
d,o
.LXg0
0.0
0ll 00-1
1-1
S
().o
.0GV/
0.0
,�Ik
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
° See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
L�

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
3t, b �
Name (Print'name)
FAc;I-Ik� .S.JI xr-I Rip.
Title (Print title)
(Signature) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format "<XX m L" where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharae this period?Z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
IncheS3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks -__>
_
-
iS mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 EXCEEDENCE FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [�' WO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [�3 NO y 1 }
REGIONAL OFFICE CONTACT NAME: LAB'-� *���5•✓� .S%ar4iA sUG1C
Mail an oriainal and one copv of this DMR. includina all "No Discharae" reports. within 30 days of receipt of the lab results for at end of
monitorina period in the case of "No Discharae" reports! to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
D

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)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 2 - %-; 0) q
CERTIFICATE OF COVERAGE NO!. ,NCIGI03 D d
FACILITY NAMEM1.cwl�t�i1
COUNTY pvl�
PERSON COLLECTING SAMPLES -3p S 1Avj"i
{
LABORATORY &-G &,.kk t ,r- I Lab Cert #
SAMPLE COLLECTION YEAR � o/%
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or [?Monthlyl Deccw.b-f (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
Comments on sample collection a ��
or analysis: RLGEI [other L
Part A., Stormwater Benchmarks and Monitoring Results
FEB 13 2018
CENTRAL FILES
DWR SECTION
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?'
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
ut-All 001
--!
ar,•�
D•D
00tPA11 00,1
0.0
0.0
, as9
0.0
AJIA
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
a See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469,22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print e)
Title (Print title)
(Signatu ) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier2, or Tier responses. See General permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 ISGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L"
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SE ION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEIN S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ONO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REhGIONAL OFFICE? , }YES [ANO,,I� �]
REGIONAL OFFICE CONTACT NAME: .4�Do,,j u6vl s,J S Aw 0, i UA le
Mail an oriainal and one coov of this DMR. including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitorina period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

r
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)

v U v
Semi-annual Stormwater Discharge Monitoring Report
JAN 10 2018
for North Carolina Division of Water Quality General Permit No. NCG030000 DWR SECTION
Date submitted INFORMATION PROCESSING UNIT
CERTIFICATE OF COVERAGE NO. N0003 0 q Q
FACILITYNAME _rZmh ev.5eed-t"fmoo-+ Pz,+1C PiAwt-
COUNTY Yo l V_ _
PERSON COLLECTING SAMPLES �o
LABORATORY V�,Acc. A, -A Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR .2 O f
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or [ 'Monthlyl N010"--ger (Month)
R�/�
t J=_1\/ SCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
JAN 10 2018 ❑Zero -flow [:]Water Supply ❑SA
Other
D . SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
INTORNIATiON PROCESSING UNIT
❑ No discharge this period?'
Outfall No.
Date
Sample
Sam p
Collected'
(mo/dd/yr)
24-hour rainfall
amount
Inches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics5
Benchmarks
-
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
IS mg/L
1 mg/L
0��4'�l1 001
0-7-0
75
D-D
7. I •
0.0
0.0
, 0409
0.0
rJ/4
pu-tll oo
J - -1
,7S
3,1
107
0.0
0.0
.070
0.0
IJ!A
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

u
s Total Toxic organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
-Top S lAw'i
Name (Print ame)
Title (Print title)
(Signature) (Date)
Note: Results must be reported in numerical format. Do -not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format "<XX m L" where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

.l
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit
text.
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 ZNO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES aNO
REGIONAL OFFICE CONTACT NAME: 1..A,-�uN �Av.DSu�•+ s%�AuJ�IA
Mail an original and one copy of this DMR, includina all "No Discharae" reports, within 30 days of receipt of the lob 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, North Carolina 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
imprtsgnment for knowing violations."
of Permittee)
r f f —/
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted //—!U --,Poi,
CERTIFICATE OF COVERAGE NO. NCG03D— _q_ L
FACILITY NAME ii.44- ►�ie_d tr,to,J t--"eA 11L
COUNTY Wo l IL
PERSON COLLECTING SAMPLES AI [AvJIJ
LABORATORY P Q '; Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR � D1 "
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
j1 ` or Q Ionthlyl bG4Dber (month)
V QSCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑RNA
NOV 15 2017 ❑Zero -flow ❑Water Supply ❑SA
�ther L
CENTRAL. FILES
IDWR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
❑ No discharge this period:'
outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inche0
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
i mg/L
oo,r�ll opt
!od-347
1,3
S.
i.vs
0.0
8,0
132
0•0
JjA
a(>)-
o 2.3-r-2
1. 3
S,9.
J1
0.0
0. o
.09
0.0
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Prin ame)
Title (Print tit qe
IN6-1?
(Signature (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note. If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharae this period ?l
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches s
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES P NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES PINO
REGIONAL OFFICE CONTACT NAME: kA�-+bo-j Q Wb_`- J_ tS Ng LjN.4 _RLA I'e_
Mail an odainal and one copv of this DMR includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end of
monitoring period in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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/ -117
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted /0 - a0 ' 2 01%
CERTIFICATE OF COVERAGE NO. NCG03 0
FACILITY NAME "C`i�.kc .� s�Gt� �`lU Pe -At PIA. -
COUNTY Pol V— j
PERSON COLLECTING SAMPLES SODA �� iAJ'J
LABORATORYPAGe. XHk(�${:4A Zab cert. #
Comments on sample collection or analysis:
Part A, Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o ol
SAMPLE PERIOD ❑ J n-June ❑ July -Dec
or Q Monthly' s / ,ti, e r month
DISCHARGING TO CLASS ❑ORW nHQW [_]Trout ❑PNA
REC VD
❑Zero-flow ❑Water Supply ❑SA
NOV 02 2f�1l [�f?ther_ � ,
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWR SECTION
No discharge this period?'
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
IncheS3
Total Suspended
Solids
PH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/L'
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
55-
0,O
7. 2-
0.o
d, v
.0991
0,0
N 11q
otrA(l
��a-i�
, S
v -0
. /
o. o
D - 0
010
/
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name
(Print nlame)
Title (Print title) 111 111
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text
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 SE ON B.
+ TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES O ❑
IF YES, HAVE YOU CONTACTED THE DWQ EGIONAL OFFICE? YES UJ
REGIONAL OFFICE CONTACT NAME: I-Aribo,�• )AEv:Dso ti► S 4-j'-JA I�
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
monitorina oeriod in the case of "No Discharae" renortsl to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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. eased 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 -zs
jDate)

i
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Cua{ity General Permit No, NCG030000
Date submitted ?0)-
CERTIFICATE OF COVERAGE NO. NCG03Q � U j
FACILITY NAME —Ty rej TC4u IAvJf_
COUNTY —70 IL
PERSON COLLECTING SAMPLES 'Sod l Sa �k,,r rl
LABORATORY %6e A,,al6l Lab Cert. #
Comments on sample collection or analysis:
Part A: 5tormwater Benchmarks and Monitoring Results
SAMPLE COLI
SAMPLE PERI
or
DISCHARGING 1
)
O
PLEA
CP
o n•
ra
ION YEAR Q 017
❑ Jan -June ❑ July -Dec
Eamonthiy' v J,s month
) CLASS ❑W ORHQW ❑Trout ❑PNA
[]zero -flow ❑Water Supply ❑SA
[her L
REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?z
Date
24-hour rainfall
Total Suspended
pH,
Non -Polar O&G/
Total
Outfall No.
Sample
amount,
Solids
Standard
CoUer
Lead
Zinc
Total Petroleum
Toxic
Collected'
Inches;
units
Hydrocarbons
Organics'
(mo/dd/yr)
Benchmarks
_
-
100 mg/L or 50 mg/0
6.0 — 9.0
0.007 mg/L 1
0. 63
mg/L
0.067 mg/L
15 mg/L
i mg/L
oL..)4A �.
g - -I
.7s
0.0
7. iS
, 009
.0
. ►a.s
0.0
'jA
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
a See General Permit, Table 3 identifying the especially sensitive receiving water classifications where th;e more protective benchmark applies.

5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the 5tormwater Pollution Prevention Plan."
-
Name (Print name) (�
rACI _t
Title (Print title — 0"')
�^
4-13-1
(SignatxV (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Rate Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Non -polar O&G/TPH by
EPA 1664 {SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/t
100 mg/L or 50 mg/L*
6.0 - 9.0 sU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULTS:
* A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES D NO
4 REGIONAL OFFICE CONTACT NAME: &jb a r t NVZk,►s , S N&�F-JA Palle -
Mug an original and one coon of this DMR, includina all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitorina Period in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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."
9' /3-/7
ature of Permittee) (Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted _ 9-3k,20/2
CERTIFICATE OF COVERAGE NO. NCG03 O V
FACILITY NAME
COUNTY o Ilt~
PERSON COLLECTING SAMPLES
LABORATORY DXce A-AI-,fle-A I Lab Cert. # ^
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
RECEIVE MPLE COLLECTION YEAR 1200
C
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
SEP 11 2017 or EaMonthly'. 5l)� (month)
DISCHARGING TO CLASS ❑ORW ❑HCIW ❑Trout' ❑PNA
CENTRAL FILES ❑Zero -flow ❑Water Supply []SA
DWR SECTION [gether_ C
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
[;1fo discharge this period?
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/V
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
" See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the 5tormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
3 o-', : QQ A,,J J
Name (Pri name)
ACs).'f o R
Title (Print tit e
(Signat ) (Date)
Note: Results must he reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharge this period?'
Outfall Na.
bate Sample
Collected;
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text
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 ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NOR
REGIONAL OFFICE CONTACT NAME:
Mail an original and one coon 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, North Carolina 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."
I 93I 17
(Signature of Permittee)
(Date)

n n !
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 o
PAUCITY NAM T Mu t_+Stte i' cs-JeA� PIi°+.►
COUNTY O
PERSON COLLECTING SAMPLES
LABORATORY h Le'''°I,if; Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR _ 2 d f
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or Q'Monthlyl iQ {.ari I (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
REC i ® ❑Zero -flow ❑Water Supply ❑SA
[Other C
MAY 0 9 2017 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWR SECTION
❑ No discharge this period?2
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
inches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
-
-
100 mg/L or 50 mg/L"
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
0.0
,os
0,0
0.6
1019!o3
0.0
nr1A
o
Y-3
Q ga3
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic. crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
Fri✓, I � +�, ���or-� R.�p.
Title (Print title)
__ Qz7
q/
(Signat a (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX miziL", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period:
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3 '
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z or Tier 3 responses. See General Permit
text.
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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ EGION AL"OFFICE? YES 0$40
REGIONAL OFFICE CONTACT NAME: l...A.�to- BNV-'AS#1` S Aiq-,V I' Q,21t
Mail an original and one copy of this DM,includina all "No Discharge" reports within 30 days of receiFt of the lab results tor _at end of
monitoring period in the case of "No Discharge" reoortsLto:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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)
V*/
7-
(6ate)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 7
CERTIFICATE OF COVERAGE NO. NCG03 D
FACILITY NAME I Mki-f.�{ccj Tr�o�r ck�lA•rf' _
COUNTY p„ l V T
PERSON COLLECTING SAMPLES--� 1Av---j
LABORATORY t-'F►�: �r����ErA! La-cert. q
Comments on sample collection or analysis.
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR P` el
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or DIMonthlyl rMAI-e-A _(month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
RECEIVED
ED ❑[]Zero flow [:]WaterSupply [:]SA
her
MAY
29' PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 -�
CENTRAL FILES
DWR SECTION
[�'I�Io discharge this period?z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics5
Benchmarks
-
-
100 mg/L or 50 mg/L"
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
IS mg/L
i mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
500,, Snk,.J,
Name (Print name)
►��:1.�� _�ppo/-t Rip,
Title (Print title)
(Signatur) (Date)
Note: Results must 6e reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note. if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharge this period?
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L'
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
" See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES aNO
REGIONAL OFFICE CONTACT NAME: L..A, t..-1 �s(tytil,So.-r 0S,4A.I jA Qv /e
Mail an orioinal and one caav of this DMR. includina all "No Discharge" reuorts. within 30 do vs of receipt of the lab results for at end of
monitorinaperiod in the case o "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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."
alil- i-/1�14�— C1105�11-2
(Signature of Permittee)
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted .1 Z 9- /-7
CERTIFICATE OF COVERAGE NO. NCG03 Z D
FACILITY NAME A,r+f-
COUNTY na t ((
PERSON COLLECTING SAMPLES 3oD� �F� ��►J
LABORATORY P&C - P--Ark j f--44 Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o? 6 %-?
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
® �+ or Monthly' `eRry Arr month
f l �r�tHAQG TO CLASS ❑ORW ❑HQW Trout ❑PNA
MAR Q 8 2017 ❑Zero -flow ❑Water Supply []SA
QOther
CENTRAL FILES
DWR SECTIONPLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?2
Outfall No.
Date
Sample
Sam P
Collected'
(mo/dd/yr)
24-hour rainfall
amount
'
Inches3
Total Suspended
Solids
pH,
Standard
units
Co pper.
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
toxic
Organics'
Benchmarks
-
-
100 mg/L or 50 mg1V
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
601
-�s-i7
,� I�
�.8
7./6-
.oa5
0.D
.i23
D.D
144
p0a
F)avr ,"
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
�a0 A,.I,-J
Name (Print name)
Title (Print title)
(Signs (Date)
Note: Results must be reported in numerical format. Do _not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, <XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
(] No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or SO mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 ANY ONE OUTFALL? YES END ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES aNO E
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one coov of this DMR, includina 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, North Carolina 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 f nes and
imprisp(pment for knowing violations."
(Signature of Permittee)
Ol�117
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quaiil General Permit No. NCG030000
Date submitted a —)- `/7
CERTIFICATE OF COVERAGE No. NCG03 0
FACILITY NAME Ttnkw!St�tcj-"rr-a,-► PeAk 01A�Jr _
COUNTY _ Po i K
PERSON COLLECTING SAMPLES 3C�D-� �Uliwr-f
LABORATORY PAce— A�-,Nln .'c-k1 Cert.t#
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR V ��
_ SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
C mor g Monthly' ^,ova month
CHARGING TO CLASS ❑ORW ❑HQW Trout ❑PNA
hiQR U 6 201T ❑Zero -flow []Water Supply ❑SA
CENTRAL FILES 20ther !L _
DWR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
F�Mo discharge this period?'
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organicss
Benchmarks
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
�f4c�l�t� .�3ppa(rt Qd _
Title (Print title)
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inche53
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 - 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 ANY ONE OUTFALL? YES Z N0 ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NO ❑
REGIONAL OFFICE CONTACT NAME: L A.-)ZN---r Dk-V-,Zi6 f S -W-C.
Mail an original and one coov of this DMR. includina 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, North Carolina 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
imprisorMnent for knowing violations."
(Signature of Permittee)
z z ZIZ
( Date)

r
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted _ —a / 7
CERTIFICATE OF COVERAGE NO. NCG03
FACILITY NAME 'rtftVe.fstet1 —
COUNTY Pa i V_
PERSON COLLECTING SAMPLES
LABORATORY PA-Ge_ A jkl f&A I db Cert. It
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2 4)11,
® [� SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
RE E I "�/E ^DISCHARGING TOCLCLA S t❑ORW ❑HQW hlyl_r ❑Tr ut month❑PNA
JAN 18 2 r t 7 ❑Zero -flow ❑Water Supply ❑SA
[other C.
CENTRAL FILES
OWR SECT IOI` PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?Z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended
Solids
pH,
Standard
units
Copper.
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics5
Benchmarks
-
-
100 mg/L or 50 mg/L°
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
ovt
1;L1
r- "
_01
010
0,0
112.
0.0
1A
b
6,0
0.0
"D
0,0
A�A
' Monthly sampling (instead of semi-annual) must begin with.the second consecutive benchmark exceedance for the same parameter at the
same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture Semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
FAt J &jDporf
Title (Print title
(Signature)
(Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mp,/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

4
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3 '
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER i 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 RkGIONAL OFFICE? `,YES aNO
REGIONAL OFFICE CONTACT NAME: ).AIDO,l AJ: DSd� S1 AA P't-o'-
Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of recei t o 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, North Carolina 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."
of Permittee)
alz-
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 1-/.2-/7
CERTIFICATE OF COVERAGE NO. NCG03 0 _�/ _�/ b
FACILITY NAME TT,11V, f Sfl t,A —77_r 1,0,J PP k-
COUNTY Pot
PERSON COLLECTING SAMPLES
LABORATORY2hj1, ��t�{ Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2 61(�p
SAMPLE PERIOD ❑ Jan -June [] July -Dec
` or E�J i Ionthly' IJOI e-"el(month)
AR NG TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
JAM l a �p17 9Mher C_
FILF-S
6wR� ` 1 0VRLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
inches'
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
-
100 mg/L or 50 mg/L°
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
001
11 3� , Z
(.39
6,0
O.d
.ors'
0,0
tjlA
00
1113011
.1 "
0,0
7.0
.0044
0.0
.ZI$
.C3
lA
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
Title (Print title
J4
l
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX m /L", where XX is the numerical
value of the detection limit, reporting limit, etc, in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

C\
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
F-1 Na discharae this Aeriod?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 Q NO ❑
REGIONAL OFFICE CONTACT NAME: I,1 AN6 r s R,AAi °_
Mail an original and one coon of this DMR, includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end of
monitorina period in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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)
1117-117
(Date)

Semi-annual Stormwater Discharge. Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted //-.2— gl, of
CERTIFICATE OF COVERAGE NO. NCG0f3 0 SI I O
FACILITY NAME `Ti/:%y i-_/ P -A
le -
COUNTY 9
PERSON COLLE ING SAMPLES -SOD S !A4 4r 1
LABORATORY FAc e- X,JA K I j-,'Y.4 Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR U/
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or DMonthly' Oc.f06e,*- /month)
DISCHARGING TO CLASS ❑ORW ❑HQW [I]Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
RECEIVED 26ther C
DEC 0 6 2016 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWR SECTION
No discharge this period?Z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
-
-
100 mg/L or 50 mg/L°
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

I Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
Tf0 monitoring may be waived. 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 electing to employ the TFO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the 5tormwater Pollution Prevention Plan."
=0 b )Ajd
Name (Print name)
At,1f
Title (Print title
ly
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format,"<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharae this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches s
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 EXCEEDEWOQ
OR THE SAME PARAMETER AT ANYONE OUTFALL? YES El NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YESrl
REGIONAL OFFICE CONTACT NAME: kAk , o+l bA jrr� , � HAcr-l�J s le—
Mail an original and one coov of this DMR includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end of
monitorina period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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
imprisgrament for knowing violations."
(Signature of Permittee)
fl/-Z3
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted % 0 -/� -; D/�,
CERTIFICATE OF COVERAGE NO. NCG03
FACILITY NAME la t
COUNTY POI
PERSON COLLECTING 4AMPLES
LABORATORY PkCG 041-A14 ffc.,1 La Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR U /�,
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or [-Monthly' S e^b e1— month
DISCHARGING TO CLASS ❑ORW HCtW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [_]SARECEIVED
ther_
O C T 17 2016 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWR SECTION
F_-'No discharge this period?'
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended
Solids
PH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organicss
Benchmarks
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
' See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print -blame)
FpichiA SJRporr (1�p,
Title (Print title)
c/,
(Signatur (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
. 6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE?} YES P*o ❑
REGIONAL OFFICE CONTACT NAME: ^L A�,A,r +ti,'Ay As2,i , S �IAc f+JA R : -W-c
Mail an original and one coon of this OMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitorina Deriod in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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
imprisjoWnent for knowing violations."
(Signature of Permittee)
(Date)

Semi-annual Stormwater Discharge Monitoring Report AOL
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 Q SAMPLE COLLECTION YEAR 00
FACILITY NAME Mked_S7ca_ ) — A ]A-rt SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY or [ lonthly' OST month
PERSON COLLECT NG SAMPLES 3 lE1r �� ����GING TO CLASS ❑ORW HQW ❑Trout ❑PNA
LABORATORY ALL uA c At Cent. # ❑Zero -flow ❑Water Supply ❑SA
AUG 3 0 201f# her
Comments on sample collection Zr analysis:
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWR SECTION
Part A: Stormwater Benchmarks and Monitoring Results
No discharge this period?z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
001
$ vk
. 3' "
01
G, gs
, vo
0.0
J 5 3
D, b
14A
002
S
.3"
�.S
'),v9
0.0
0.0
0ss1
0.0
¢
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
mop �:, =$0 iA-.I
Name (Print name)
rA c.I ; _ ,J r+ _
Title (Print title
(Signafu
(Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
(Vote: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

f ; 1
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected!
(mo/dd/yr)
24-hour rainfall
amount,
Inches a
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 ONO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YE/WY"jh(S �NOREGIONAL OFFICE CONTACT NAME: )—AJbO.Q tW)bD Dn 2 1AI-1ruC
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
monitorina veriod in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Olk
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)
D
(Date)

-
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted . - - 7`2/=%�a
CERTIFICATE OF COVERAGE NO. NCG03 D 4- V 0
FACILITY NAME TMKe,,5,tee I = ] r v,..►��,g J, PIA— -
COUNTY vk �
PERSON COLLECTING SAMPLES
LABORATORY Pj}Ge_ A,-Alttrc.4 Lab Ceh. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR v� 0/�,
SAMPLE PERIOD ❑ fan -June ❑ July -Dec
or 0 Monthly' __-TuN f.- (month'
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout❑PNA
IREcE� / j1 ❑Zer flow ❑Water Supply ❑SA
� a � 21� �� �....rr [�pther L
AUG
. .
CENT PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
°wR �crioN
\ jg�; F;f*g-o discharge this period:
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended
Solids
pH,
Standard
units
W
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organicss
Benchmarks
_
-
200 mg/L or 50 mg/L4
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines foe the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469,12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print na
�-AC-J it,. _
Title (Print title)
(Signature (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX_m L" where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

r
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks
15 mg/L
100 mg/L or 50 mg/L*
6.0 - 9.0 SU
Footnotes from Part A also apply to this Part B
" See General Permit text, Table S, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 [�i'NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [�NO FI REGIONAL OFFICE CONTACT NAME: LN6o. , s P4,-,A uu �,Il
e
le
Mail an original and one copy of this DMR. including all "No Discharae" reports, within 30 days of receiat of the lab results for at end of
monitoring period in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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."
of Permitteel
I I � ('
7Z
(Date)

"June 3, 2016
Landon Davidson
Water Quality Supervisor
North Carolina Department of Environmental and Natural Resources
Asheville Regional Office
2090 US 70 Highway
(;F-1vF-D
Swannanoa, NC 28778
sup 9 2416
Attn: Division
DWQ Central Files
LES
owR S CTION
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Certified Mail
RE: General Permit No. NCG030440 Benchmark Sampling Results
Dear Mr. Davidson:
On May 31, 2016 we received the test results for our May 20, 2016 stormwater sampling event.
The values reported have exceeded our Benchmark Values for Cooper and Zinc. In
accordance with the Tier Three response requirements, we have continued to perform the
required monthly analysis and have instituted the suggested housekeeping BMP's suggested by
Ms. Shawna Riddle of your department.
In addition, we are monitoring internal stations in an attempt to isolate the source and instructed
our lab to run total dissolved solids on each sample in order to gain a better understanding of
the source and the potential to ultimately reduce these metals in the stormwater runoff. In the
near future, we will be providing a summary of our efforts to date for your review with the goal of
pursuing a request to be released from Tier Three monitoring. Any thoughts that you or Ms.
Riddle may have on this matter would be greatly appreciated. If you should have any
questions, feel free to contact me at [phone].
Sincerely,
Jody Splawn
cc: Shawna D. Riddle,
North Carolina Department of Environmental and Natural Resources
Asheville Regional Office
2090 US 70 Highway
Swannanoa, NC 28778
k%7

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 d y D
FACILITY NAME Ttft fja 4ce.l Tr'�e..3 141t__P1Aw•+t
COUNTY P0:l1.
PERSON COLLEkTING SAMPLES 1A ✓fj
LABORATORY I a Cent. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or D'Monthlyl M A!% (month)
DISCHARGING TO CLASS ❑ORw ❑HQW ❑Trout ❑PNA
R,-» � D ❑Zero -flow ❑Water Supply [:]SAC E2CIther !L
3VN 0 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
DWR SECTION
No discharge this period?z
Outfall.No.
Date
Sample
1
Collected
[mo/dd/yr).
24-hour rainfall
amount,
a
Inches
Total Suspended:;
Solids-
pH,
Standard
units
Copper
Lead
-Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
g Total
Toxic
Organics s
Benchmarks
100 . ;'
-9.0
0.007 m/L
O.D3m/L
.0.6J7am/ /L
mg/L.
m8/L
3.S
,ongs
o.o
r�Oo
00),
9
0.00
o
T
.J
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here. .
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
3olby �)&,J-Ij
Name (Print name) nn
Title (Print title
(Signat ) (Date)
Note: Results must be reported in numerical format. Do not reportBelow Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/V, where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample valve in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑
No discharge this per
outfall No.
Date Sample:.,.:.
Collected'
(mo/dd/yr)
24-hour;ralnfall
amount,
inches;
Non -polar 0&G/TPH by
EPA 1664.(SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
=
-
15 mill
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
tes from Part A also a I to this Part B
Footno pp y
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
iod ?z
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 EXCEEDENCE FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ RE IONAL OFFICE? YES L NO I
REGIONAL OFFICE CONTACT NAME: j A--1bD►-s AvIL ,o►-� , SI�iI ^rA Q c dl�t
Mail an oriainal and one copy of this DMR includina all "No Discharge" reports, within 30 days of receipt of the lab results for at end of
monitorina period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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)
6;/61C='
(Date)

W
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE No..NCG03 0 Z
FACILITY NAME -Fr �--,5tcLt — i'rya.a �cqf,( P1A&t
COUNTY pot {L
PERSON COlLE,,TING SAMPLES SpjN!:N SipjA j J R _
LABORATORY ACd Au %+ICert. # T
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Ode
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ['Monthly' Aeri-1 _ (month)
D RGING TO CLASS ❑ORW ❑HQW [:)Trout❑PNA
Rt❑Zero -flow ❑Water Supply ❑SA
�C�I
i�{AY 13 2016 Qother C
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
0WR SECTION
❑ No discharge this period?'
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total SuspendedSolids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons i
Total
Toxic
Organicss
Benchmarks
-
-
100 mg/L or 50 mg/L°
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
t
0.0
.221
0.0
NIA
0 O
00
/ o tr,..f
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
-:Soo_y .S,oi��.,. -J
Name (Print nAe)
r*C;It.
Title (Print title — 627-
(Signatu (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?Z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 ANY ONE OUTFALL? YES [] NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES
REGIONAL OFFICE CONTACT NAME: ),A. -be,' QA��Sor-� S �Rw•�4 ty`a`it
Mail an original and one coon of this DMR, includincr all "No Discharge" reports, within 30 days of receipt of the lob results for at end of
monitoring period in the case of "No Discharge" reports) ta:
Division of Water Quality
Attn. DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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
impriWpment for knowing violations."
(Signature of Permittee)
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted -3 1A /4.,
CERTIFICATE OF COVERAGE NO. NCG03Q
FACILITY NAME _rf1-%ke�JSi-caI ::- ,.a Yta{L PlAn•
COUNTY V10I
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o/L
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or Q*onthly' r
e, LroAir month
DISCHARGING TO CLASS ❑ORW ❑HQ ❑Trout ❑PNA
❑Zero -flow ❑Water supply ❑SA
[lther C.
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics'
Benchmarks
_
-
100 mg/L or SO mg/O
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
IL mg/L
Ool
0.0
b.
,o
0.0
3
.3o.o
R .3 7
o .o
0.0
059
o.o
VIA
x Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4 See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
Title (Print title)
(Signatur
(Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format "<XX m L" where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfa€I No.
pate Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
IncheS3
Non -polar O&G/TPH by
EPA 1664 {SGT-HEM}
Total Suspended Solids
pH
Benchmarks ===>
-
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit
text.
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 it 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 aA "No Discharae" reports within 30 days of receipt of the lab results for at end of
monitorina period in the case of "No Discharae" renortsl to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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)

1
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted ,.2 -AV ,Zol (o
CERTIFICATE OF COVERAGE NO. NCG03 Q
FACILITY NAME k&1S - -&
COUNTY k
PERSON COLLECTING SAMPLES 3aJ�� �n fA�+-1 1�►�
LABORATORY Pl ,i c jdkl. La Ceri.1€--- G��
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ )an -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]zero -flow ❑Water Supply [-]SA
Dother (�L
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
❑ No discharge this period?'
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics
Benchmarks
_
100 mg/L or 50 mg/O
6.0 - 9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
vo r
L-17-I
o.o
,05
0.0
0.0
, 37s
0.0
^J
®o
- -1
.o
4
0.0
0.0
010.s
0.0
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3 The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan_"
Name (Print name)
A C, I i♦ ti S o faoo r'j` iRrp.
Title (Print title)
o2
(Sign r (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit
text.

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G/TPH by
EPA 16641SGT-HEM)
Total Suspended Solids
pH
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark, you must implement Tier T, Tier 2, or Tier 3 responses. See General Permit
text.
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 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
monitorina period in the case of "No Discharae" resorts) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 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."
of Permitteej
(Date)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03`��`+i� 2-10'�
FACILITY NAME ) 1 _r o,a Pga 11 121AI-If
COUNTY o
PERSON COLLECTING SAMPLES 7: t. AL4jJ
LABORATORY Qf t c, Aa&l !j+i c.A Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
fL_J
SAMPLE COLLECTION YEAR "q0 %5-
SAMPLE PERIOD ❑ Jan -June ❑-luly-Dec
IREIor ❑Monthly' (month)
D SC GiNG TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
FEB 0 5 2016 ❑Zero -flow ❑Water Supply [:]SA
CENTRAL FILES [Other C
DWR SECTION PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
No discharge this period?z
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
pH,
Standard
units
Copper
Lead
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organicss
Benchmarks
_
-
100 mg/L or 50 mg/L
6.0 — 9.0
0.007 mg/L
0.03 mg/L
0.057 mg/L
is mg/L
i mg/L
00
0- -1S
D
„ -
0/0
0.0
-OKI
6,0
N
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the
same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a
checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
requirement.
4
See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

• • •
--s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,
manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that
definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as
found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the
definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. 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 electing to employ the TTO monitoring waiver, the discharger shall sign the following
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 or areas 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 the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
-
Name (Print name)
rA :,14% S�ppor zp.
Title (Print title)
— 0,
—�
(signs (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical
value of the detection limit, reporting limit, etc. in mg/L.
Note. if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or tier 3 responses. See General Permit
text.

10 0
L_J
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
OutfaEl No.
Date Sample
Collected'
(mo/dd/yr)
24hour rainfall
amount,
Inches;
Non -polar O&G/TPH by
EPA 1664 (SGT-HEM)
Total Suspended Solids
pH
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L*
6.0 — 9.0 SU
Footnotes from Part A also apply to this Part B
* See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note. If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z or Tier 3 responses. See General Permit
text
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 ANY ONE OUTFALL? YES ❑ NO �r
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one cove of this DMIt 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" reportsto
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

0 0 0
V 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."
/- 07._64/�
(Signature of Permittee) (Date)

t- STORMWATER DISCIIA,RGE OUTF ALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCC030000
CERTITICATE Or COI'I RAGE NO. NCG03 O 7 0
rACILITYNAMET—i MI!c.r5/-r—d __7"Tsw^' pe'l.le P1',
PERSON COLLECTING SAMPLES
CmuriICD LA ORATORY a , Lab #
Lab #
Part A: Specific Monitoring Requirenicn(s.
SAMPLES COLLECTED DURING CALENDAR YEAR; U2U/
(This woulturing report is due at the Division tw later than 30 days from
the date the facility receives the st rpli g results from the laboratory.)
COUNTY F10 /7/
-PHONE NO. L 9
PLEASE SIGN ON THE RE, VERSL+' 4
:O trill.
. ; p
fNo:
-
Ilate7 't
p
Snnt leCull cicii;
nlo/dd� �r '
:x< ^_:,, Oo53o:
a. ,
0 55
ISX 11.
r'
otal. u's c'd+�d`Su'ds
r ' t- •In �•'=
'- I'..� "k..`.;"'. l['�: '.s•
i ; to [lard ul 19
'e'd",id i"
1�15:M"'...';, i4 ..Y=•Lr.�
y
OiI'and 'Grcriso
�..••:�� ../�';.•I.._
::3ut�il7ld lc Or �anlcs
.i�•'. �L. S"-
�13eneliriiark�
•�: .•5+'••:a
-
-_ *:ii. _
�;� `•>00,
-A-' I. fT-: 'vJwl,
.r•_Vltitliiz<.i-i U
,V''.-�,,.l�C�yRi;
!.1vl-i'
S4✓r
f7
- 2c3�L.3
t1
Note: If you report a sampled value. in excess of the benchmark value, or outside the benchmark range for pH, you niust implement
Tier I or Tier 2 responses -
See General Pentut text.
RECEIVED
Did this facility perform Vehicle Maintenance Activities using more dtan 55 gallons of new motor oil per montl17 _yes Nlb,
FEB 2 9 2016
(if yes, complete fart 13)
CENTRAL FILES
Part B: Vehicle Maintenance Activity onituring Re[ uiretnculs
DWR�TIR02
1482
1313
7OI
"oc
SartipEo;ollecteii, J
:Qilttnd,C3�easG;''� ",
�fotl. qpETE`"
fr
y Y{ 1
h
sell ❑ (aa3 ejk3) I/ftantleh7 peto.
° o o m @ m
,tran11a0 uo P01100 © IIeNt peans
�.
T -� N �� sm
Note: If you report a sampled value in excess of die bencli nark value, or outside the bel eslput?gwgW .col adleoaa Wtnem ©
i�
See General Permit text. �s
U '�
I
STORM EVENT CHARACTERISTICS: "� �,' r's� '^ '"' " w
ice• a.
CD
Date first event sampled)
Total ,Event Precipitation (inches): �
o' " :moleq smppE IUenllap je ti 1 t`:
Date (list each additional event sampled thus reporting period, an sex t waltw?� h i C o
? e
Total Event Precipitation (inches): IGan;leC] to step 'p {e—N Ae�ulad) Aq p N
eessaapw
tueov p t_n
' ejr�e i b
l�

_J
Total Toxic Organics sampling is applicable only for those facilities Ml uli perfonn metal finishing operations, uivtufaclure semiconductors, manufacture electronic crystals, or
manufacture cathode ray tubes.: for purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA l;fflucut Guidelines for the facility subject
to the requiremeit to sample (for-tnetal finishing' use tiie �iefiiiition as fatutd.itz 40 CCIt 433.1 l; .for semieoriductof imaitufacture-iise tlic'dc# niti6tt as found in 40 C171t 469.12; for
electronic crystal manufacture use the defuution as fnurtd zu 40 CFR 469.22; and for cathode ray tube manufacture use the definition -found in 40 CFR 469.31).
Facilities that incorporate a solvent management plan into the Storntwvater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. The solvent
nua,aagement plan shalt include a list of the total toxic organic compounds used and the other elements Iisted in the General Pe ntit. For those facilities allowed stwh a waiver, lire
discharger shall sigh the following certification statement:
"Based upon ray inquity of the person or persons directly responsible for managing compliance with the peanit 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 stonnwater or areas which are exposed to rainfall or storrnwater
runoff has occurred since filing die last discharge monitoring report. I further certify that this facility is iuuplementiztg [lie all the provisions of the solvent ntanagentent
plan included in the Stormwater Pollution Prevention Plan."
7o�I JA-,,JI
Name (Print uame)--^
Title (Print (itle)
(Date)
"I certify, under penalty of law, that this document and all attachments were prepared tender 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 systene,-or those pet -suits
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 signilieaut penalties for submitting false information, including
the possibility f-fines and imprisonment for lunowing violations."
(Si re f Permittee) lDa e)
5WU-245-102107

5
1 �
RECEIVED
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT MAY 0 7 2015
GENERAL PERMIT NO. NCGO30000 SAMPLES COLLECTED DURING CALEN • F� /RJ
CERTIFICATE OF COVERAGE NO. NCG03 b1-iyo (This monitoring report is due at the Division no ater han o days from
the date the facility receives the s pling results from the laboratory.)
FACILITY NAME rAkestrel —T - � PtAk PiA4t COUNTYy
PERSON COLLECTING SAMPLES -PHONE NO. —
CERTIFIED LABORATORY J4 r Lab #
Lab # PLEASE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Requirements
OutfaU .
No.
Date:
Sample Collected,,
I �l1
mo/dd/ r:
'"' s 00530;.'
-=:00556
)Gatal'S'spendSotids;
.J .-F l
µ it +m d 3
t s pH;,FLead;ing/Land
'.0 nn 1 _ jj��
i ;Staada'Fr�l�$y
.�./T _.
I :':r
Grease,
S. /rt� J Y
Total Toiic Organics„
t •I' _
Benclimarlt
4 ` :
- I� I :. g0
;� t u „X
00 1di3
p
no OL's28/
V
/\I
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses.
See General ,Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes 140-1
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall.
o:..
Da#e
Sample GQllect d'�
rrio�ddl .r..;,,� a,,%
0055fi `: ''
0.053A+ "': _
i 00400°
`, t'J -Qil,Bnd Greaser ' ' Y
�. .:: m
3ota�[9yPeudeci 5alrfls,
a, .. 7.; F• ,...
pH,' ,
^_ ;Standard units, ,.
c New Motox 0i1: Usage,.
;'.Annaaffiv a c allmo
-Benchmark"
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.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date — — (first event sampled)
Total Event Precipitation (inches): o�
Date (list each additional 'event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S WU 245- IO2I07
Page I of 2

l Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic cryGLAis, or
manufacture cathode ray tubes.. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facts subject
to the requirement to sample (for metal finishing use the.46fiai6on as found in 40 CFR 433.11; for semicoriduotnf`ii�cture-iise (lie definition as found in 40 CFR 469. I2; for
electronic crystal manufacture use the definition -as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31 }.
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 shalt 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:
"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 or areas which are exposed to rainfall or stormwater
runoff has occurred since filing the last discharge monitoring report l further certify that this facility is implementing the all the provisions of the solvent management
plan included in the Stormwater Pollution Prevention Plan."
o � �lJ ^
Name (Print name) %-S T�
FACT &gPor-f k4P,_
Title (Print title)`"
S
(Sig (Date)
"I certify, tinder 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 besi of my knowledge and belief,
true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including
the possibility mes and imprisonment for knowing violations" -
�ll�.
(Si re f Permittee) (Da e)
S WU-245-102107

STORMWATER DIS,,,,-_i"GE OUTFALL (SDO)
y. MONITORING REPORT
fW '
GENERAL PERMIT NO. NCG030000
CERTIFICATE OF COVERAGE NO. NCG03
FACILITY NAME Ker-S{eA - 7-r p, �bt ,41--
PERSON COLLECTING SAMPIXS b wN
CERTIFIED LABORATORY aJA Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 0
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the s. np 'Aff results from the laboratory.)
COUNTY
-PHONE NO.
PLEASE SIGN ON THE REVERSE 3
=: Outfall.
;No
'�` r..
Sa Ple Col ected,�
r •-.':- c,•;1"$
ate-:;. - :°:'." rP•
t -
.� -
- ,:,ter;,;_,.,` .
78Y44�
. aUali .us ended<SoLds,
'ash ° RH;
- X-�ry.�
unt
I_'i' i4A 4
_-',�
' QtI andtiGregaq-7'
iF
3 l�Tv c Jig;anics;;,
B nc'h inarli
e
,.,0
W�thin;h:tl 9.l)
O l)33( .x
i• , - 3Q
1
o
-/ -/
fl
Note: If you report a sampled value in excess of tie benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 respu �, l CG D
�/
See General Permit text
R [�
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes
-Ko
FEB 2 9 2015
(if yes, complete Part B)
CENTRAL FILES
Part B: Vehicle Maintenance ActivityMonitarin Re uirements
IpWR SECTION
Oirtfali ,
:Diite _.
a�
Samgle G lIei - �r
f .= An Ge�eas ' "'
Y ,ail d e,
Tot E de "S61,dc
�fS Rau. :
. _.....
�" �
- t': `
-" '
7012
2210 0000 7562 1295
Benchmar`
k
='" r
s�,I"
m
rom
t:
o �y u
•
562T
° a
�mm
x
saA ❑ t8e UQX3) jAAOAllaa P8}0u} -
bt " QiG'
AJ0AllQU uo lo'J
IOW ins
a
•'�
c''
T-
T
t0a[ ❑
Note: If you report t a sampled value in excess of the benchmark value, or outside the ben
y P P ' �o;tdleoaa wn}ea p
esl>x�{a�eW
: �
• W
See General Permit text. ssaldx� IIeW f4lioNd ❑
018114 POW_
�
,
adlfl 901
STORM EVENT CHARACTERISTICS:
Date -1 % (first event sampled) It
Total Event Precipitation (inches):
F'
ON ❑ :moiaq ssaippa Aj8fd ap aa}ua `S
�—
Date (list each additional event sampled this reporting period, and, sak p LI wet! wog! WO-1a.4P ssajpps rGaA}I C
Total Event Precipitation (inches):
• ; RtanlleQ io a}sa 'O (a+.uElV pa)uNdl Aq p9^4�
w.
;; •v
r

l T-6W Toxic Organics sampling is applicable only for those facilities which perform metal f .ishing operations, manufacture semiconductors, manufacture electronic crystals, or
manufacture cathode ray tubes.. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject
to the requirement to sample (for metal finishing use the definition as found .in 46 CFR 433.11; .for semiconductor manufacture -Use ifie defmiti& as found in 40 CFR 469.12; for
electronic crystal manufacture use the'def'mition.as found in 40 CFR 469.22; and'for cathode ray tube manufacture use the definition,found in 40'CFR 469.31).
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 shalt 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:
"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 or areas 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 the all the provisions of the solvent management
plan included in the Stormwater Pollution Prevention Plan."
Name (Print naiiiel
Title (Print title)
(Signa (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 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 possibili f-fines and imprisonment for knowing violations." -
of Permittee)
ate)
S WU-245-102107

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG030000 SAMPLES COLLECTED DURING CALENDAR YEAR: '2O/
CERTIFICATE OF COVERAGE NO. NCG03 d�i?�� _ _ _ (This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sa UnTresults from the laboratory.)
FACILITY NAME -F1 rk ejStd--C (�OrPo r0ro —%r N ,pAk Pla,.,f- COUNTY
PERSON COLLECTING SAMPLES oD 5 u•i PHONE NO.
CERTIFIED LABORATORY Lab #
Lab # PLEASE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Requirements
U:itfall.
tNo;
`Date�F
Sample Coil cted
no/ddlyi.
�.;.ODS30,.":':.
p04 p;, x
;01051' `.
'-0-00556
t. .7$141
, 1Cot 11uspended,5ol,ds,
-.� W 1 - !
t{ )H, �.
s
, ,. Standard. uut,
Lea<d, it�g�I
,a * . -..
`Qil andsGrease,{.
,-;h'F'..-
"S. -far
Tofa) Tauc Urga]Ilksi
`i i v ,, m
BenchmarkxWIthin
$:Q 9 Q w _
9.03_: M t
, . ,' : 30.
/o'
oFlo
W
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.
See General Permit text. RECEIVED
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes --rz—
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Reuuirements
JUL 21 Z914
CENTRAL FILES
DWQIBOG
Outfall
Date 8 i l
Santpe-C
,�
Otisr
F= _ .:0
rnd" Solids'
w.
013,
Stmuuits.
NewMotorOi.Usage,-No.
Auaaverage llmo-.'
Benchmark.:,
Y : fi,�.,
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.
See General Permit text.
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date (first event sampled) Attn: DWQ Central Files
Total Event Precipitation (inches): 1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
S WU-245-102107
Page 1 of 2

T-
1 Total Toxic Organics sampling is applicable only for those facilities which perform metal fuaishing operations, manufacture semiconductors, manufacture electronic crystals, or
manufacture cathode ray tubes., For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject
to the requirement to sample (for metal finishing use the Ofinitiozn as found in 40 CFR 433.1 l far semiconductor manufacture use the definition as found in 40 CFR 469.12; for
electronic crystal manufacture use the'defan tion .as found in 40 CFR 469.22; and' for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
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
"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 or areas 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 the all the provisions of the solvent management
plan included in the Stormwater Pollution Prevention Plan."
Name (Print name) -
Title (Print title)
(Signature (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 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 possib' ' o fines nd imprisonment for knowing violations."
( a re of Permlittee) (Date)
SWU-245-102107

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCGO30000
CERTIFICATE OF COVERAGE NO. NCG03-
FACILrrYNAME Y,&A5ieet -Tr o,-+ �11AiC
PERSON COLLECTING SAMP S /*'//j
CERTIFIED LABORATORY Lab #
Lab #
Part A: Specific Monitoring Requirements
•
SAMPLES COLLECTED DURING CALENDAR YEAR: UI
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the s p' from the laboratory.)
results
RECEIVEDIDFNCOUNTY o..Ly -
JAN 2 2 2015PLEASE SIGN ON THE REVERSE 4
Water Quality Regional
- :Outfail
No
'Dates °
Sample Collctesf,�
llfll/.. r - • #
.0053Qr
'>�atal'$sertded Solids,
y, _'
k` I y
0 0.4Y
7�� EH. s
S l��
�'�lta Y7u�d'ui�i
,•
,LesdmgEli, 3
Gam-^ �?r'wR _S
_ 00556
Qit and;Greae;'
7./.i•_ T� �
.Y
�To+TozEc Orgatiics,,
1 � Rz
"Cl'I.
e3enttmarl
o
Wtu$Q= Q
30
T
i
1
062
1-1 '/
,
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.
See General Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? — yes
(if yes, complete Part B) —
Part H: Vehicle Maintenance Activity Monitoring Requirements
Outfall
iq.
.'�. _-.. ...
D�1te�:� ,,�`
r.
Sample Cap 'I. l
I. Fi [.
... mo��Yl r+. �::!IlF,
�' u �::0D556.: �� �
I' n �K:.00S�;01 rt. _ �
�,' :4,00g00'�.-:•
t{' -
ti il' and;Grease
t ; > #
.r. ~-.?I•in _1-•-+ _
iotai5yrp de Sands,
I '!
�r
- vfFj_.,1-'F.
pH, ` _
a Stan��.Qnit�}
Nety MotorOil iTsage,
,�+' sror �/mom
.A�Wti.ai4g e'.-- "IF�MV
Benchmark"
. -"-A
a` -� 3 ' ;, `
if ; • _' }'?�Q0 ;€nN
«y� "�F._:�y60 :9,0r :r� �` .:
; F::... cM
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.
See General Permit text
STORM EVENT CHARACTERISTICS:
Date 1 17 Ifirst event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
wdlC
S WU-245-102107
Page 1 of 2

a
x Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or
manufacture cathode ray tubes.: For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject
to the requirement to sample (for metal finishing use the de%ition as found in 4l3 CFR 433.1 l; for semiconducto-rma- tufacture rise tfie'de mition as found in 40 CFR 469.12; for
electronic crystal manufacture use the'definition as found in 40 CFR 469.22; aacC for cathode ray tube manufacture use the definition found in 40 CFR 469.31).
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 certifcation statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics ("fTO), I
certify that to 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 that this facility is implementing the all the provisions of the solvent management
plan included in the Stormwater Pollution Prevention'Plan."
Name (Print name}�
Title (Print title)
(Signs (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 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 possibili"f-fines and imprisonment for knowing violations."
of Permittee)
/&,k�-
ate)
S WU-245-102107