NCG080674_MONITORING INFO_20180425

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE 1 ❑ HISTORICAL FILE
Ft MONITORING REPORTS
DOC DATE ❑ `�I g 04 ag:i�)
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report MAY 2 4 2011)
for North Carolina Division of Water Quality General Permit No. NCG080000jN1-1V\
Date submitted T' rZ11„ • n 1 �CWR SE CTl0"=
CERTIFICATE OF COVERAGE NO. NCG08_ _L
FACILITYNAME Cam. Ce s lllic.5 i,c��
COUNTY W"1---
PERSON COLLECTING SAMPLES
LABORATORY T,^Lab Cert. # 0 `f Ot 5,(`1 -0
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR a d / 9
SAMPLE PERIOD 0 Jan -June ❑ July -Dec
or ❑ Monthly's -month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]Zero -flow ❑Water Supply ❑SA
],Other G ' NS't,1
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ✓es —no
(f.yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (if applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (5GT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit .
Within 6.0 - 9.0
15
-
001
o9 I Iq 119
<5#0
6,6�
0
003
0 1
6..3.5
4 SS, D
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Jlf applicable}
Outfall
No.
Date
Sample Collected,
ma/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 -- 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here,
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date 4 (first erient sampled)
Total Event Precipitation (inches): .2, 3 4
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches): _
Note: If you report a sample value in excess of the benchmark, you must Implement Tier 1, Tier 2, or T1er3 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 If 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:
Mall an on anal and one cgRv of this DMR including all "No Discharge" rep arts within 30 days o recei t a the lab results or at end of monitoring period In
the case o "No Dischar e" reports)to:
Division of Water Quality
Attn: DWQ Central Flies
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."
C
(Signature of Permittee)
2,, `C,
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wqL, s -su/npdesswtttab_4
SWU-2S0
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 4 ( 91 a o i' F
CERTIFICATE OF COVERAGE NO. NCG08 _ C? _ 4
FACILITY NAME M- t=uc,lw+„
COUNTY W & I
PERSON COLLECTING SAMPLES G u+�L, C-vy'A v�
LABORATORY._ P0ca�_. G_,4._f�r.1_ Vic-__ Lab Cert. # Slci
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR a 01 l'
SAMPLE PERIOD CgJan-June ❑ July -Dec
or ❑ Monthly' _ _ . jmonth)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑5A
t ❑Other f;; JVStJ
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
APR 25 20
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons N7 motor � I per month? �es _no
(if yes, report your analytical results in the table immediately below) RHL F!1-ES
DWR SECTION
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 - 9.0
15
001
03 1l id'
13. h
5. 0
q � -7
OQ-
03
S.
6.63
<5.0
0t?�0
3 ,
(0 &
<S.�
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (if applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit limit
-
15
50 or 100 see permit
6.0 - 9.0
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Pagel of 2

STORM EVENT CHARACTERISTICS:
Date -3 lr� (first event sampled)
Total Event precipitation (inches): 1,0
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 ❑ NOIK
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
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
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of I w, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnaing
y gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible fo 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 per tong false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Perm
? I
1
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/wsZsu/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

,0-
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted �d.5 v
CERTIFICATE OF COVERAGE NO. NCG08Q 2 L
FACILITYNAME Fac,114
COUNTY inJ a 1x-
PERSON COLLECTING SAMPLES Go.+di,o S Cc,vvar�
LABORATORY PaLe G. C. 1,j c_ Lab Cert. #3 0 S D
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 20177
p SAMPLE PERIOD E Jan -June ❑ July -Dec
J CE/ ' � or ❑ Monthly' (month)
APRD15CF1AfRGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
�017 ❑Zero -flow ❑Water Supply ❑SA
DENrRAL FIL ®Other_ �yS,•J
WR 5ECr1pN
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ✓yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L i
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.6 - 9.0
15
001
D3 a it 1-1
-7. '
Uo a
I 03 1,3 1 117
4-6, 2
C
003
1 01 3 1
, z
-
0
Ae,-t lcnt PH (CsLlS be.in4 mur+i'�-o�'ccl A�cr+f9+ly u�'ytc-� �►G��t ShoF-'� av�t.vt,�,c- A �' icvU�J hcfo- 4-44- bencl,W�-IL C- (0,04n,'�S,
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 - 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

n
STORM EVENT CHARACTERISTICS:
Date 03 (first event sampled)
Total Event Precipitation (inches): i.00
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 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 ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR includin all "No Discharge" reports, within 30 days of receipt of the lab results (arat 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
"I certify, under penalty of aw, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified person I operly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible r hering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significan pe al ties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
4,1
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/webZwgZws/su/npdessw#tab-4
S WU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 41 a8 I ;L-01 io
CERTIFICATE OF COVERAGE NO. NCG08Q _ `7 L SAMPLE COLLECTION YEAR . a 01 la
FACILITY NAME Ge,nef �„r�ltcc� Ce�a.r.,� Mss-,t Eac', I \'� SAMPLE PERIOD ❑Jan -June ®July -Dec
COUNTY W C', IGc C !`' or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES G-.x i . S t` r, v�� r� REC G ` VESPARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
LABORATORY PocL a.C. L, .F Lab Cert. # —040S i _ OCT 0 5 2016 ❑Zero -flow ❑Water Supply ❑SA
Comments on sample collection or analysis: ®Other C ; AIS W
CENTRAL FILES
[)w t SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE -
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Zyes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (if applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
1s
-
0 0 1
0 9 1 0
s•O
4a,a.
00 a
o aj Ito
5.3
<S. J
0o3
01 L,
5.
<S.
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
* 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 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 0
REGIONAL OFFICE CONTACT NAME:
Ar bNC 4A i«�� av� �tir.55 r,,�.:.�iire� Nn�iahlh wln�cl. lnavt l�►c�d�d �i� tievell �tia�c� i�er+ch�.l� � (0.0uv�t�t,
Mail an original and one cony of this DMIi, 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 la , that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified person i erly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible fo ering 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 ties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
Ala r�
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wa/ws/su npdgssw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report �C1
for North Carolina Division of Water Quality General Permit No. NCGO80000
.. Date submitted _ 5 1 1 X.1.2 01 w
CERTIFICATE OF COVERAGE NO. N0008 O (o7 Lf SAMPLE COLLECTION YEAR _ � 01 {o I —
FACILITY NAME G-e,,.-v ����- CcS� M����r. Fa<<I;�, SAMPLE PERIOD Jan -June ❑July -Dec
COUNTY %1 or ❑ monthly' (month)
PERSON COLLECTING SAMPLES _ C•r,a ,`,1,. T iu wz: r, _ f 0� ARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
LABORATORY P cp. . C , h'.��, c_ Lab Cert. # 0 0 1 ����� V � ❑Zero -flow ❑Water Supply ❑5A
Comments on sam le collection or analysis: �^ MAY 6 alb ®Other_ _ L ; NS 4.!
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DNJR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _✓yes —no
(if _yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00S56
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark .
-
50 or 100 see permit
Within 6.0 -- 9.0
i5
-
o1
0Lj 1 la 1b
9.3
6,3,
<S10
Li6a
ooa
o Li, 12-
a,o
6.33
<5,0
003
OLI 2- 1 b
aa
<S•O
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 -- 9.0
E For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
S WU-250 last revised April 11, 2013
Pagel of 2

STORM EVENT CHARACTERISTICS:
Date 1.1 b (first event sampled)
Total Event Precipitation (inches): 0,5-0
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION 8.
• 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 ❑ NON
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMA, 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
"I certify, under penalt law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified perso I roperly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsib f thering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are signific nt Ities for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
-1-bl/N
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wp/ws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

4
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit. hUt //portaLncdennorg/web /wgJws/su/nndessw#tab-4
Permit No.: N/�_/T/�/�/`/_/�/ or Certificate of Coverage No.: N/UG/Q/y/Q/�/7/ /
Facility Name: (r C4%..,e C .,i,cc Cr4',t A/1u1w4W-,7 c f aci It,�y
County: W w Imo- _ Phone No.
Inspector: Gu , Cc. vlruvti
Date of Inspection:
Time of Inspection:
Total Event Precipitation (incises): ^ O 1 SD
4 y ,-
Was this a "Representative Storm Event" o "Measureable Storm Even ' as defined by the permit?
(See information below.)
10 Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
i' precipitation.
i
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
1 interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of *rmittee or Designee)
Page 1 of 2
1WU-242, Last modified 10/25/2012

I. Outfall Description:
Outfali No. (0 0 ! Structure (pipe, ditch, etc.)
Receiving Stream: �' i 5t cr- f-},j wwc- h raArk C rr .4y r'U Crcr.d4- Jo Nc
Describe the industrial activities that occur within the outfall drainage area: _
u 10tii C 4or,rou- u n4eA ffVA-(- k0"'ff, 4el W ar<a14..4
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C I -ea �'-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weals chlorine odor, etc.): A/orc_
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
C 2 3 4 S
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 .3 4 5
b. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
Q2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes Na
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe No+t-
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 00 a Structure (pipe, ditch, etc.) a IKL-4-? m4nwa ,
Receiving Stream: i Cc.dre e c iz r .
Describe the industrial activities that occur within the outfall drainage area:
AnP-1t Rnd{LI✓I4 ���'. 4u rha4L '� C4vlA�udrr� GluwJ1 �� d(1 .
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Am. k - _ color -,A .
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): Nu r'-e- T
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 U2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
11 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy.-
1 G7 3 4 5
7. Is there any foam in the stormwater discharge? Yes �I
$. Is there an oil sheen in the stormwater discharge? Yes N
9. Is there evidence of erosion or deposition at the outfall? Ye No kx. vt + f r V 54-r* W
10. Other Obvious Indicators of Stormwater Pollution:
List and describe c4 S efo r rJ d- P
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 0-3 -- - Structure (pipe, ditch, etc.) -P; A,- /,SOU r,� L, � �. _ c � l knh �-_ _ `nanwk y ,
Receiving Stream: j�b ru.+ c�, .b Crc 0r re- C, I-6 tV c ll r v`z.
Describe the industrial activities that occur within the outfall drainage area: C' •, tick n �.1��_�� d—j- j
-_Cw� . Gt. �.¢ _ 1 oad to h4 V d u cfc .
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C Ira "-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A/or,,,-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
�P 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 Q 3 4 5
7. is there any foam in the stormwater discharge? es No
8- Is there an oil sheen in the stormwater discharge? Yes `V J
9. Is there evidence of erosion or deposition at the outfall? YesI
10. Other Obvious indicators of Stormwater Pollution:
List and describe EQ aT Kf1 Lt ft k.,. r M V441
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report 4 .
for North Carolina Division of Water Quality General Permit No. NCGO80000A
Date submitted Ill I F t a 01 S �< Aj;-�%
CERTIFICATE OF COVERAGE NO. N0008 O 6 `I
FACILITY NAME ivtxv �: st:,•y c cc.. r n� _ _.:.. t . �µ c 1 t^
COUNTY Vj,,
PERSON COLLECTING SAMPLES _ C9 �, �L• _5 Cw ,.ru tires
LABORATORY l�ac�_ f>. c. 1�y.� �,,� _ Lab Cert. # 040 SI 4 O _
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR -� U 1 S
SAMPLE PERIOD ❑ Jan -June S July -Dec
or ❑ Monthly' month�,,,,
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout.4�[DPNA
❑Zero -flow ❑Water Supply ❑SA
®Other DVS W
RECEIVED
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
DEC 4 2
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new mo oAit per month? -�,/-yes _no
(if yes, report your analytical results in the table immediately below) CENTRAL FILES
DWR SECTION
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
0C) i
S
14, (01
<5. �
2
Ova
Za.
b.5
e ,�
003
-7 11 -
7,`
Y,9a
1S.J
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013 { .
Pagel of 2

r+�
STOR _j}:.:HARACTERISTICS:
Date IOi� (first event sampled)
Total Event Precipitation (inches): ©. L4,5
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 [:]NOR
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall 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 monitorincl 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 persopfiel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly resp 0
ib 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 signi i nt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ittee)
r(�23 5-
(Date)
Additional copies of this form may be downloaded at; http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
6yi,T1111041f
last revised April 11, 2013
Page 2 of-2

1<
STORMWATER DISCHARGE OUTFALL (SDO)
'~ ANNUAL SUMMARY DATA MONITORING REPORT (DMR)1 SPPP Annual Update DATA REVIEW FORM
Calendar Year l o i S-
Individual NPDES Permit No. NCSU{JUUULj or
Certificate of Coverage (COC) No. NCGQ®Q©00
DEC 01 2015
CENTRAL FILES
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPA SECriON
Facility Name: _ -- �7�v�c✓` -� � [ rd tCe l Lin a % +C4—knee - �a c t l ►
County: W
Phone Number: (21L) WS6 - 5 7 7 7 _ Total no. of SDOs monitored 3
Outfall No. O o 1 ®�
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No Eg NO
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes No ❑
Total
Rainfall,
inches
Parameter,
units,
r t
l t
S10111�
c "10
Benchmark
N/A
(9 — 9
100
Date Sample
Collected,
mmlddlyy
.
19
1 iS
1,30
G,-+S
< s O
3610
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

Additional Outfall Attachment
Outfall No. 0a-A
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Total
Rainfall,
inches
Parameter, (units)
/
�l`"r"}��
/IfUr - A')14
ofI *(sc�
Get e�
j 0#-,..L S'je'4A
Benchmark
N/A
Date Sample
Collected,
mmlddlyy
w
3'
=
lq I Is-
1,30
(0.3 Cl
.'7
-r
0.Hs-
G..
<s,J
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

Additional Outfall Attachment
Outfall No. 003
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No �}
Total
Rainfall,
inches
Parameter, (units)
�+s
� �n� �
Polk,
o ,` f t &--
Benchmark
N/A
- g
J S
t o o
Date Sample
Collected,
mmrdd/yy
0311 5 S
3 0
6,36
0
17,0
10 17 11
D, 4 1
g,9 a
<S.0
7,S
SWU-264 - Generic Annual DMR
Last revised 5/172013

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
including the possibilitypf
Signature
Date ilk
f, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
and imprisonment for knowing violations."
DWQ Regional Office Contact_ Information:
For questions, contact your local Regional Office:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
WINSTON-5ALEM REGIONAL OFFICE CENTRAL OFFICE
585 Waughtown Street 1617 Mail Service Center
Winston-Salem, NC 27107 Raleigh, NC 27699-1617
-- - [phone] _ _...__.... __. .. [phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
i "To preserve, protect
and enhance
'5� s North Carolina's water_."
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit., htt oi-tal.iicdenr.or �veb w �v su n dess�v#tab-4
Permit No.: N/�/ _/_/�/�/ / _ / or Certificate of Coverage No.: NICK Q'� � / / 7/y/
EacilltyName: GGv�cfG� JICCI Ce-^,kpi-L jL%sni-tnHr+K
County: W4'.kv— Phone No.
Inspector: , d-, S
Date of Inspection: o 1 .
Time of Inspection: l a 3 +\ rA, I a. r
_t
Total Event Precipitation (inches): tf S
Was this a "Representative Storm Event" or (M:ea:-sur:ea:ble=Storm!Even�t- s defined by the permit?
(See information below.)
® Yes ❑ No
Please vetmewa:eab:
hether ualitative Monitoring must be performed during a "representative storm
event" ore stormevent' requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storin event' is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of P#mittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 0 0 (,^ Structure (pipe, ditch, etc.)
Receiving Stream: P 1 c. c,a. k J w-ic- 6 rz. n,;,k 4, C rc, �64y'c c . C rc mil, do Ai r wk (Z i �
Describe the industrial activities that occur within the outfall drainage area: 1)ti,'P f fit•
r & %A"%� .4r2,w p u u 4.,,� m u.t v% " t+ J R t U w, ;-1 Ft, a r ("+•J
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C 1 � G -
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): _ N o r% C-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
(D 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1D 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
(1 � 2 3 4 5
7. Is there any foam in the st�ormwater discharge? Yes No
S. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe ..... N u "-f—
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, East modified 10/25/2012

1. Outfall Description:
Dutfall No. O 0 a Structure (pipe, ditch, etc_) _ N nk. 11a rw+wc. c.� L Icy +•-, In4nwG
Receiving Stream: o 4. �' I4 do /Vcwk- Arum
Describe the industrial a A 'vities that occur within the outfall drainage area: L phj + a. r kln s
�U S &,CLAC4A_ [[urBS�. Sets
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: r.j. am-ci' Ta n n AZ' a 4-",
1c1� -� &-br l .
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): >f u v..c_
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 O 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
7.
B.
9.
10 3
Is there any foam in the stormwater discharge?
4 5
Yes
Is there an oil sheen in the stormwater discharge? Yes
Is there evidence of erosion or deposition at the outfall? Yes 2
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SW'U-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 4 D 3 Structure (pipe, ditch, etc.) {� ; C4- c o 1 k 47'n-- r„cAnwu�
Receiving Stream: P ► �Zt- h owx. h 4, C . 10
Describe the industrial activities that occur within the outfall drainage area, Cw.('rCtk nd �lzi� r C-lc�
�t9cAn r i� w.v 4-u -
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: __ C 1_tA-r_
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): No n4.
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy-
1 @ 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes Io
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe AacV- rcrcA+1v clr,," Q�k reS.-r4cel
c<rrv4r � io e1cv 4c Ak, Icvu .
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, last modified 10/25/2012

Semiannual Stormwater Discharge Monitoring Report ��
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 4 1 19.1 a a 151
CERTIFICATE OF COVERAGE NO. NCGO8 0 C ­7 y
FACILITYNAME
COUNTY _ W a --
PERSON COLLECTING SAMPLES
LABORATORY Pau ,c.tznjLab Cert. # 04Qd5i50
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR--- _ ; o 1 S__
"ESAMPLE PERIOD Jan -June ❑ July -Dec
CCr En or � Monthly' (month)
APR pl,$ HAR15ING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
G �j2015 ❑Zero -flow ❑Water Supply ❑SA
CENTRAL FILES IgOther 0: V s w
=GTION
PLEASE REMEMBER TO SIGN ON THE REVERSE
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Zyes _no
(if .yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No,
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6,0 — 9.0
15
-
CD o 1
O.35
.Q
L4 Y,ti
0 o z
o a is-
0 2
03 5 �s
T0
L
Part B: Oil/water Separators and seonclary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit: Limit
-
15
50 or 100 see permit
6.0 — 9.0
t For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
swu-250 last revised April 11, 2013
Pagel of 2

STORM EVENT CHARACTERISTICS:
bate l IT (first event sampled)
Total Event Precipitation (inches): 1,3
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 JE
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR� includina a!! "No Discharge" reports, within 30 days of receipt of the lab results for at end o fmonitoring period in
the case o ""No Discharge" reports) to:
Division of Water Quality T
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 pfoperly 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 tiering 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 tips for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Pe
23
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Ai A
CONC®ENR
VS
rmwater Discharge Outfall (SDO)
Qualit
ative Mon<tor<n Report
Forguidance on filling out thisform, please visit: htCU://porta€.ncdcnr.oi;g/web/wq/ws/SLI n,IAessw#tab-4
Permit No.: N/C/_/_/� /�/�/ _/ _/ or Certificate of Coverage No.:
Facility Name: O any ram_ [c1 C e-14Y-U )A "%^++rnaM K_ F-,, Ik+I T_ _
County: WN1+-C Phone No. °4i RYL -5777
Inspector:
Date of Inspection: 31 ig 1 a o tS
Time of Inspection: _i ! L4 5 P, r" i `l i s p,
Total Event Precipitation (inches): 1.3
Was this a "Representative Storm Event" or "Measureable Storm Eventl' as defined by the permit?
(See information below.)
®, Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or `measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of PerACittee or Designee)
Paget of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. 0 0 r Structure (pipe, ditch, etc.) _ fill d-e_
n
Receiving Stream: f f q Ga,1 i'1 u x.Si In V-",% ck 40 ( re- G _ rtc.(' -l.o Nc "t
Describe the industrial activities that occur within the outfall drainage area:
C+mdCAJazt- C)r-uiri'61 c- -�rjj' H✓frc a r�;�lS. ruv-f d►d Act sadz�ti..
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Li -t a
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): IV0j,.t— T
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
V 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
VA
B.
9.
1 2 0
Is there any foam in the stormwater discharge?
4 5
Yes
Is there an oil sheen in the stormwater discharge? Yes
S
0
Is there evidence of erosion or deposition at the outfall? S No Lcx,Jcd 4, p' r"'- T4V'0'--' .
10. Other Obvious Indicators of Stormwater Pollution:
List and describe N o k,.,—
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2of2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No_ 0 0 a Structure (pipe, ditch, etc.) i�r w� t� ✓ c�t�/lle<.iil,_ nan wa�
Receiving Stream: PiGc o,. huw,�_ [�,c n�L� �r'c-�CL rcGfL- ,% Alcs, !<(-
Describe the industrial activities that occur within the outfall flrainage area:
04 R.1
A-splG-1 F P� mint—�or QtirC. hu c -1' G.'d�] -& t r 1 � Si�ltJ
2. Color. Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: d r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weals chlorine odor, etc.): A"'on.,— _
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 (D 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 (D 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? es No L��"'�-
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 4. ,Ak� e,+ cl-c 6 ,A p r„d
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, last modified 10/25/201Z

.J
1. Outfall Description:
Outfall No. 00.3 ^ Structure (pipe, ditch, etc.) PC 'SJo rr�w� f Ic,.-h (r,
Receiving Stream: i s o h� 4, Crn ec try<(, e er
Describe the industrial activities that occur within the out�}fall drainage area: Con c r a,-r riG cCf c
e"rHcyrL -, G/rR,�ec4-yL Sr PC /0r~C i?IC 6a5 UoC/L
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C f c " ✓
3. Odor: Describe any distinct odors that the discharge may have (i.e., smeIls strongly of oil,
weak chlorine odor, etc.): Npi--z-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
'U 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
7.
8.
9.
1 3
Is there any foam in the stormwater discharge?
4 5
es No
Is there an oil sheen in the stormwater discharge? Yes f�o
Is there evidence of erosion or deposition at the outfall? Yes (9
10. Other Obvious Indicators of stormwater Pollution:
List and describe Na
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
SWU-242, Last modified 10/25/2012
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted la 1 Z S 1 a o 1 Y
CERTIFICATE OF COVERAGE NO. NCGO8 O, 6 7 `f
FACILITY NAME iYcricr.-L ccA 4-1
COUNTY IN «I�
PERSON COLLECTING SAMPLES G u y � S C a vv-(,-
LABORATORY Pa cc , G-. c. li. 'j Lab Cert. # O `} 0 , .5f 9 0
Comments on sample collection or analysis:
RECEIVED
JAN 0 8 2015
CENTRAL FILES
SAMPLE COLLECTION YEAR _. 19 01 4 DWR SECTION
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow []WaterSupply ❑SA
®Other N
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Y/yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (if applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gat/mo
Benchmark
-
50 or 100 see permit
Within 6.0 -- 9.0
is
-
o0 1
to oc -t
R. fl
< 6-,0
0 %i 1 1 `L
2-4
5.417
C , , 0
0t9
kal ),Cl-1
10,10
6.4+0
<5-.0
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 - 9.0
t For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Pagel of 2

J;,
STORM EVENT CHARACTERISTICS:
--Date 4 I i ' (first event sampled)
Total Event Precipitation (inches): 1,
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 8 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 N
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
leVA1 4r<- betn� v op'14—+ , rAr-ti0l whicf.
;Marl an..orkinal and one copy of thisDMR, including pll "No Discharge" reports, within 30 days_o}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 f law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified person I operly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible or hering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significan ties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
(— .5— l.5—
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/w_eb/wq/ws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)1 SPPP Annual Update DATA RE%
Calendar Year R01L4 _
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG❑p ®❑0 ©7❑Q
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: e-0e rl-I evfc^C1ti FetC !1
County: W" I'je
Phone Number: cit c ) _ Ns6 -- 57-77 __ Total no. of SDOs monitored 3
FORM
NC DENR Raleigh Regional
.Oiitfall No. 0 O I
Is this outfall currently in Tier 2 (monitored monthly)?
Yes ❑ No
ra1"" cL"c-
Was this outfall ever in Tier 2 (monitored monthly) during the past year? .
Yes [] No ®
hG'
"5 rv,vn'��onA a.. C'
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
,r �} "' ►�' `� �" ` s �'""` °'`
Enough consecutive samples below benchmarks to decrease frequency
❑
a,XrG111- 4-"
Received approval from DWQ to reduce monitoring frequency
0 S. �.
Other
❑
Was this SDO monitored because of vehicle maintenance activities?
Yes Z No ❑
Total
Rainfall,
inches
Parameter,
(units)
��un�►S�
�;I d- Ctire
I
S id`.(
S�I�a. t►'fle)
bad
/�
-
q'Y%b i`"T
pug-
Prt�f, 4fj
Benchmark
N/A
6 -
S
100
Date Sample
Collected,
m mlddlyy
04 I
0,J/0
,oar
0
I q,-7
6,b2,
dz lio iy
s,zL
,D
6.3
< j, 0
5 by
OX ve 1Y
5. 13
0-?) ro r`f
q, $S
O'r uP 1y
5, $7
09 aJ1`{
5'.5-3
10) 03 ,y
Y. S7
05 oxry
5,77
s(10s iq
6,511
0('100/11
4.U7
tz 00 1y
S*. 14�6
SWU-264 - Generic Annual DMR
Last revised 5/172013

•. —
r
Additional Outfall Attachment
Outfall No. QQ a
Is this outfali currently in Tier 2 (monitored monthly)? Yes Q No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Total
Rainfall,
inches
Parameter, (units)
( `""'
AfO"-
+
L►� 1 �)
-TOtIl -(`"fAx"
ry �)
Benchmark
N/A
Date Sample
'Collected,
mmlddlyy
01+ 4
Q,RO
S,g
<S,D
I ,�
IM U qj Iq
a7.0
SWU-264 - Generic Annual DMR
Last revised 511712013

Additional Outfall Attachment
Outfall No. 00
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No Z
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes [] No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No K
Total
Rainfall,
inches
Parameter, (units)
0;)1,Y
Tb*,L
Benchmark
N/A
-
j .s
100
Date Sample
Collected,
mmlddlyy
407Iq
00
5,9
<S.0
<S,
la.1 oy jjq
!,
6.40
D
SWU-264 - Generic Annual DMR
Last revised 511712013

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 an¢ belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the posslbigtyof fines and imprisonment for knowing violations."
Signature
Date /—
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information: Y•
ASHEVILLE REGIONAL OFFICE �FAYETTEVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
Swannanoa, NC 28778
Systel Building Suite 714
[phone] i
Fayetteville, NC 28301-5043
[phone]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
3800 Barrett Drive j
943 Washington Square Mall
Raleigh, NC 27609
Washington, NC 27889
[phone]
[phone]
WINSTON-SALEM REGIONAL OFFICE
_ CENTRAL OFFICE --- -
585 Waughtown Street
1617 Mail Service Center
Winston-Salem, NC 27107 i
Raleigh, NC 27699-1617
--- _--[phone] _. _._L
__-- --- [phone]
...... ........ --._.._-...------- ------...- _ -- - —I
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone] E
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
c,?Serve. protect
�ifJUd�7� n"f!G' 2r11121iC$
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

r STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) 1 SPPP Annual Update DATA REVIEW FORM
Calendar Year 1014
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG❑p ®❑0 ©7❑ 4❑
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
r N' DINR Raleiah Region..!.
Facility Name: a-04,V- JLCc. LC a,rwQ nf-e F. II
County:
Phone Number:( Q I -t ,; 7-77 Total no. of SDOs monitored 3
Outfall No. © o i
Is this outfall currently in Tier 2 (monitored monthly)?
Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
h "I "
Enough consecutive samples below benchmarks to decrease frequency
❑
aVyrG � 1"'j) 4, 1-
Received approval from DWQ to reduce monitoring frequency
❑
(0.0 s• v.
Other
❑
Was this SDO monitored because of vehicle maintenance activities?
Yes No ❑
Total
Rainfall,
inches
Parameter, (units)
�K(u�,�s'
mow.- Pao-_
p;4 d-C3rc
m{�
Tom' ,4..t
r'ir��
Soi11k { 1
�a�e.
P�i�n'`��
Gty l
p��
p�u-'+rj
at-y1C' e
Benchmark
NIA
Date Sample
Collected,
mmiddlyy
04 I
0.V0
(9, oS
{5,0
1 %-7
or 131Y
G.i,�
a7 ,� ry
s, zZ
,D
6.3
o3) I a l if
t{, t3
D cl nP 1'{
5, ?7
oy a1 ty
5,53
to 1 03 1y
14 S7
03 cz ty
5,77
1c10S tq
1b,s Y
0G110I11
f.b7
I L.1 4Q 1�
J. ti3{c
SWU-264 _ Generic Annual DMR
Last revised 5H7/2013

Additional Outfall Attachment
Outfall No. OU a.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Total
Rainfall,
Parameter, (units)
�� (,,, �s
J
No.•- p �l�y
d
0� ! k
C" ! j
'root s
Sa ICriYI�J
Benchmark
N/A
10 t7
Date Sample
Collected,
mmlddlyy
0 4 10-7.1ILI
0, Ro
5,9:z
Si0
i i7
U I
o
a7.0
7-7
SWU-264 - Generic Annual DMR
Last revised 511712013

Additional Outfall Attachment
Outfall No. Can
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes L3 No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Total
Rainfall,
inches
Parameter, (units)
a
Soil ("it)
Benchmark
N/A
IS—
I C 0
Date Sample
Collected,
mmlddlyy
4 o'7
D=&o
5. D
<S.
la. uy I
d, D
YO
�.0
D
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

"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 possitft �f fines and imprisonment for knowing violations."
Signature _ tr
Date ! 5- 15-
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
Wa �inglon
VAl ~ • :1` J�slyer►liu Maargsv'sc.•'
ASHEVILLE REGIONAL OFFICE
FAYETTEVILLE REGIONAL OFFICE
I MOORESVILLE REGIONAL OFFICE
2090 US Highway 70
€ 225 Green Street E
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714 i
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RAL6G-H REGIONAL OFFICE
-
; WASHINGTON REGIONAL OFFICE „
WILMINGTON REGIONAL OFFICE
3800 Barrett Drive
j 943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
j Washington, NC 27889 E
Wilmington, NC 28405-2845
[phone]
i [phone]
[phone]
STON-SALEM REGIONAL OFFICE
i CENTRAL OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
i 1617 Mail Service Center
� Raleigh, NC 27699-1617
T"—
., czgserve. ur-o!e&' I
enhance
771-5000 - -
_i ... _ [phone]
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

-'7
Semi-annual Stormwater Discharge Monitoring_ Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 4.1a 01 a o 1 SF
CERTIFICATE OF COVERAGE NO. NCGO8 O ( -1
FACILITY NAME c✓"&L kv vt cj Ce 4w-&St AA-w%ic*+r�nu F4,, i i+
,r
-- CENTRALnFIILE� PLEASE RZyes
MEMBER TO SIGN ON THE REVERSE
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of nnew0rrioC0 ail per month? !no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
4
No discharge this period'
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
001
04 1071 y
t v7
6,
< E.0
310
00 a
o4 C, 7j 1,4
i 11.0
5.17
< S,0
003
1 0 1-1 o y
45-.1
5,91
<�',0
Part B: Oil/water Separators and Secondary Containment Areas at Petroieum Bulk Stations and Terminals (If applicable)
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date 41,71gLo1q.(first event sampled)
Total Event Precipitation (inches): 0. 00
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an original and one copy of this DMA, including all "No Dis_ charge"_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
�r�nl4icni- 1 it legCAS CL, 6GrnS5 ynan�d-0+� Witi�clti 1�lcliCaJs trw avera� f CvclS �lo.� dis_ beni� l� c� 6•0 u"'",
YOU MUST SIGN THIS CERTIFICATION Fa"'
ANY INFORMATION REPORTED:
"I certify, under penalty of w, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel perly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsibl for g hering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are signific nt en ies for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
s G 1�
(Date)
Additional copies of this form may be downloaded at: http://portal,ncdeTir.org/web/wq/ws/su/npdessw#tab-4
S W U-250
last revised April 11, 2013
Page 2 of 2